Objective:This study introduces a novel approach utilizing a self-made drug delivery cannula implanted into the cerebellomedullary cistern(CMC)of rats to allow repeated administrations in conscious subjects.Methods:A self-made medication cannula is inserted through a drilled hole at the midpoint of the occipital crest of the rat's skull,de-scending along the inner wall of the occipital bone until reaching the CMC,and securing it in place with skull screws and self-curing resin.Lipopolysaccharide(LPS)is injected into the CMC to induce neuroinflammation,and the feasibility of this method is assessed using X-ray imaging,behavioral testing,and immunofluorescence staining.Results:The place-ment of the brain cannula was confirmed using X-ray film and pontamine sky blue staining.Rats in the LPS group exhib-ited a lower facial mechanical pain threshold compared to the Control group(P＜0.001),along with reduced residence time in the open field center(P＜0.01).Immunofluorescence staining revealed LPS-induced activation of caudal spinal trigeminal nucleus(SpVc)microglia.Conclusion:This method proves to be suitable for multiple administrations to the cerebellomedullary cistern of conscious rats,enabling the study of the SpVc's role in pain modulation.

Systematic light chain (AL) amyloidosis is the most common forms of amyloidosis, which manifests as multiple organ system involvement, rapid progress, dire prognosis, difficult therapy and high mortality. Many patients may miss the optimal treatment as a result of not being diagnosed timely. Therefore, early diagnosis and assessment of involved extent of AL are clinical focuses. Related clinical studies have demonstrated that nuclear medicine imaging can be non-invasive in detecting amyloid deposits. It can not only early assess the extent and distribution of amyloid deposits in systemic AL amyloidosis, but also offer the indications for risk stratification, treatment response monitoring and prognosis assessment of the patients, especially for positron amyloidosis-specific tracers, which may have great prospects in the future. This review summarizes the application of nuclear medicine imaging in the systematic AL amyloidosis.

Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with lightchain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49–63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At followup after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%–1.1%] vs. 1.7% [-5.5%–7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%–1.3%] vs. 2.0% [-3.0%–5.0%]; P = 0.01) compared with those with inferior response. Conclusion Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

Objective To investigate the clinical features of patients with drug-induced liver injury (DILI). Methods A retrospective analysis was performed for the clinical data of 1 376 patients with DILI who were admitted to 20 hospitals in Shaanxi Province, China, from 2009 to 2019 and were diagnosed with RUCAM scale as the diagnostic criteria, and these patients were analyzed in terms of sex, age, underlying diseases, suspected drugs causing DILI, clinical manifestations, laboratory examination, treatment process, and prognosis. The t -test and Wilcoxon test were used for comparison of continuous data between two groups, the chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H rank sum test was used for comparison of ordered polytomous data between groups. Results Among the 1 376 patients, there were 577(41.93%) male patients and 799 (58.07%) female patients, with a male/female ratio of 0.72:1. As for different age groups, the 40-60 years group had a higher incidence rate and accounted for 44.77%, and there was a significant difference in sex distribution between different age groups ( χ 2 =20.784, P =0.008). As for the three clinical types, there was no significant difference in incidence rate between men and women ( χ 2 =1.409, P =0.494), and there was a significant difference in the distribution of clinical types between different age groups ( χ 2 =47.025, P < 0.001). The top three drugs causing DILI were traditional Chinese medicine (41.13%), antitubercular agents (11.70%), and antipyretic and analgesic drugs (7.27%). Hepatocellular injury type was the main clinical type and accounted for 65.77% (905 cases). The mean length of hospital stay was 15.31 days, mostly 1-4 weeks which accounted for 91.86%. Among these 1376 patients, 45 (3.27%) were cured and 1 322 (96.08%) were improved, suggesting a good overall prognosis. The patients with different clinical types had significantly different prognoses ( H =59.300, P =0.011), and further comparison showed that the patients with hepatocellular injury type and mixed type had a significantly better prognosis than those with cholestasis type ( P < 0.05), while there was no significant difference in prognosis between the patients with hepatocellular injury type and those with mixed type ( P > 0.05). Conclusion There is a high incidence rate of DILI in women and middle-aged and elderly people, and traditional Chinese medicine is the leading cause of DILI. Patients with different clinical types tend to have different prognoses, with a good overall prognosis.

Humans ; Consensus ; Immunoglobulin Light-chain Amyloidosis/therapy* ; Heart ; Immunoglobulin Light Chains ; China