Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

Objective To explore the implementation effects and application value of the Clinical Rehabilitation Integration Plan based on the graded management of rehabilitation treatment programs in a 3A general hospital.Methods The details of the programme were firstly formulated according to the needs of clinical rehabilitation and the implementation plan was formed,and then the integrated clinical rehabilitation work was carried out for 1 year accordingly,and finally the effects before and after the implementation of the programme were compared and analysed by selecting the indicators of departmental operation and patient satisfaction.Results The rehabilitation programme was classified into 4 levels according to the degree of technical difficulty and medical risk,and its connotation and management requirements were defined in detail.The implementation of the programme included organisational structure,training and assessment,authorisation management and quality control.The programme was carried out in 8 clinical departments in the hospital,and the overall willingness of the clinical departments to develop early rehabilitation was improved since 2022.Conclusion This program can improve the operational efficiency of clinical departments and patient prognosis.

ObjectiveTo explore the biological mechanism of drought improving the quality of Rhizoma Atractylodis Chinensis and establish a new method for the production of high-quality medicinal materials. MethodThe fresh roots of Atractylodes chinensis were soaked in 0 （control）， 5%， 10%， and 20% PEG-6000 solutions. The changes in reactive oxygen species （ROS） level， antioxidant enzyme activity， activities of key enzymes in primary metabolism and secondary metabolism， and content of secondary metabolites were compared. ResultCompared with the control group， the treatment with 20% PEG for 2 days elevated the levels of superoxide anion radicals （O2-·）， hydrogen peroxide （H₂O₂）， and malondialdehyde （MDA） by 172.5%， 56.9%， and 14.7%， respectively. The treatment did not change the activity of superoxide dismutase （SOD）， reduced the peroxidase （POD） activity， and increased the catalase （CAT） activity by 10.8%. It increased the activities of 3-hydroxy-3-methylglutaryl-CoA reductase （HMGR）， phosphoenolpyruvate carboxylase （PEPC）， and acetyl-CoA carboxylase （ACC） by 49.9%， 12.1%， and 19.0%， respectively. Furthermore， the content of atractylodin， β-eudesmol， atractylone， and atractylenolide Ⅱ was increased by 51.0%， 36.9%， 47.1%， and 91.5%， respectively. The simulated drought stress can cause the burst of ROS in the fresh roots of A. chinensis， induce the physiological state of plants under drought， change the antioxidant system， and promote the massive synthesis of secondary metabolites in a short time. ConclusionPEG-6000-simulated drought stress can greatly improve the quality of A. chinensis in cultivation.

ObjectiveTo investigate the effect of exogenous H₂O₂ on secondary metabolism in Atractylodes chinensis and its mechanism. MethodFresh rhizomes of A. chinensis were treated with 5.0， 1.0， 0.2， 0.04 mmol·L^-1 H₂O₂ solution and clean water， and the relationships between the contents of reactive oxygen species， activities of antioxidant enzymes， activities of key enzymes of secondary metabolites， and contents of secondary metabolites in A. chinensis were compared. ResultUnder treatment with exogenous H₂O₂， the content of reactive oxygen species and malondialdehyde （MDA） in the fresh rhizomes of A. chinensis were significantly elevated on the 4th day， and returned to normal level on the 6th-8th day. The activities of superoxide dismutase （SOD）， catalase （CAT） and peroxidase （POD） were all increased first and then decreased， and reached the peak on the 4th， 4^th-6^th and 2^th-4^th day， respectively. The activities of 3-hydroxy-3-methyl glutaryl coenzyme A reductase （HMGR） and acetyl CoA carboxylase （ACC）， key enzymes of the secondary metabolites， were remarkably enhanced， and under treatments with different concentrations of H₂O₂， the activities of key synthetic enzymes of the secondary metabolites in 0.2 mmol·L^-1 H₂O₂ group were increased most， with the highest biosynthesis of secondary metabolites. The contents of atractylodin， β-eudesmol， atractylone， atractylenolide Ⅱ， and atractylenolide Ⅲ on the 6th day of 0.2 mmol·L^-1 H₂O₂ treatment were 89.5%， 108.7%， 308.8%， 64.7% and 9.3%， respectively higher than those in the control. ConclusionThe antioxidant enzymes and secondary metabolites in A. chinensis synergistically maintain the balance of reactive oxygen species， and exogenous H₂O₂ can improve the medicinal quality of A. chinensis remarkably.

OBJECTIVE To provide emp irical evidence for relevant decision makers in China to formulate and improve policies related to children ’s medicine use . METHODS Based on the purchase data （Jul. 2016-Jun. 2019）of 18 tertiary children ’s hospitals，the availability of medicines included in the 7th edition of WHO Model List of Essential Medicines for Children （WHO EMLc）and their influential factors were investigated according to standard medicine investigation method recommended by the WHO and Health Action International . RESULTS A totally 189 active ingredients listed in the 7th edition of WHO EMLc were available at 18 tertiary children ’s hospitals in China ，which referred to 229 medicines. The availability of Budesonide inhalation suspension，oral rehydration salt ，Immunoglobulin for injection and Water for injection was 100%. In each quarter from Jul . 2016 to Jun . 2019，the availability of more than half of the medicines exceeded 50%，and the availability of the medicines remained basically stable in each quarter . The overall availability of cardiovascular system medicines and blood system medicines was the highest，while that of antiparasitic medicines and dermatology medicines was lower . There were 28 medicines（12.2%）that were not approved for use in children in China ，the use of which were off -label. The medicines which had been approved for children and which were included in national essential medicine list had a significantly higher availability （P＜0.05）. CONCLUSIONS The availability of essential medicines for children is generally better at tertiary children ’s hospitals in China . But the use of some essential medicines in children are off -label. In order to ensure the safety and the availability of essential medicines for children ，it is suggested to introduce China ’s essential medicines list for children ，to promote clinical trials in children for commonly used medicines，and to updete the drug manual in time .

Accumulating evidence has confirmed the links between transfer RNA (tRNA) modifications and tumor progression. The present study is the first to explore the role of tRNA methyltransferase 5 (TRMT5), which catalyzes the m1G37 modification of mitochondrial tRNAs in hepatocellular carcinoma (HCC) progression. Here, based on bioinformatics and clinical analyses, we identified that TRMT5 expression was upregulated in HCC, which correlated with poor prognosis. Silencing TRMT5 attenuated HCC proliferation and metastasis both in vivo and in vitro, which may be partially explained by declined extracellular acidification rate (ECAR) and oxygen consumption rate (OCR). Mechanistically, we discovered that knockdown of TRMT5 inactivated the hypoxia-inducible factor-1 (HIF-1) signaling pathway by preventing HIF-1α stability through the enhancement of cellular oxygen content. Moreover, our data indicated that inhibition of TRMT5 sensitized HCC to doxorubicin by adjusting HIF-‍1α. In conclusion, our study revealed that targeting TRMT5 could inhibit HCC progression and increase the susceptibility of tumor cells to chemotherapy drugs. Thus, TRMT5 might be a carcinogenesis candidate gene that could serve as a potential target for HCC therapy.
Humans ; Carcinoma, Hepatocellular/pathology* ; Cell Hypoxia ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Liver Neoplasms/pathology* ; Signal Transduction/genetics* ; tRNA Methyltransferases/metabolism*