Objective To compare the renal toxicity of vancomycin with continuous infusion vs intermittent infusion. Methods The databases of EMBASE,PUBMED,the Cochrane Register of Controlled Trials,CBM,CNKI and WanFang were searched.The Cochrane Revman5.2 software was used for Meta-analysis.Results Two RCTs and eight observational studies were included in the systematic literature search with total of 1 764 patients.1 037 patients received vancomycin with continuous infusion while 727 patients with intermittent infusion.The Meta-analysis indicated that there was no significant difference in renal toxicity between continuous infusion group and intermittent infusion group(P>0.05).Conclusion Vanco-mycin continuous infusion cannot effectively reduce the incidence of renal toxicity.

Cerebral Cortex ; China ; History, 20th Century ; Humans ; Neuropsychological Tests ; history ; Neuropsychology ; history

Objective:To investigate the influence of perioperative oral nutritional supple-mentation on short-term efficacy of laparoscopic sleeve gastrectomy (LSG) for obesity patients.Methods:The prospective study was conducted. The clinical data of 218 obesity patients who underwent LSG in the General Hospital of Ningxia Medical University from January 2018 to December 2021 were selected. Patients receiving perioperative oral nutritional supplementation were allocated into the experiment group, and patients receiving perioperative conventional treatment were allo-cated into the control group, respectively. Observation indicators: (1) grouping situations of the enrolled patients; (2) postoperative situations and follow-up; (3) nutrition related indicators; (4) dietary compliance; (5) weight loss related indicators. Follow-up was conducted using telephone interview, WeChat communication and outpatient examination to detect albumin (ALB), hemoglobin (HB), dietary compliance and weight loss related indicators of patients up to February 2022. Patients were followed up once every 30 days after discharge. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the indepen-dent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test. Repeated measurement data were analyzed using the repeated ANOVA. Comparison of ordinal data was analyzed using the rank sum test. Results:(1) Grouping situations of the enrolled patients. A total of 218 patients were selected for eligibility. There were 42 males and 176 females, aged (32±9)years with body mass index (BMI) as (39±7)kg/m 2. Of the 218 patients, there were 109 patients in the experiment group and 109 patients in the control group. Gender(male, female), age, BMI, preoperative albumin (Alb), preoperative hemoglobin (Hb) were 17, 92, (33±9)years, (39±7)kg/m 2, (40.6±4.8)g/L, (141.7±13.9)g/L in the experiment group, versus 25, 84, (31±8)years, (39±8)kg/m 2, (40.9±4.2)g/L, (142.9±9.7)g/L in the control group, showing no signifi-cant difference in the above indicators between the two groups ( χ2=1.89, t=?1.52, 0.51, 0.40, 0.71, P>0.05). (2) Postoperative situations and follow-up. The duration of initial hospital stay, the cost of initial hospital stay were (9.1±2.9)days, (3.6±0.5)ten thousand yuan in the experiment group, versus(11.6±3.7)days, (4.9±1.0)ten thousand yuan in the control group,showing significant differences in the above indicators between the two groups ( t=5.58, 12.38, P<0.05). Of the 218 patients,119 patients were followed up,including 62 patients in the experiment group and 57 patients in the control group,with the follow up time as 31.0(range, 25.0?38.0)days. Of the 218 patients, 14 cases were read-mitted for postoperative complications. There were 2 cases in the experiment group including 1 case with nausea and vomiting and 1 case with ileus, and there were 12 cases in the control group including 10 cases with nausea and vomiting and 2 cases with gastric fistula. There was a significant difference in the readmission between the two groups ( χ2=7.63, P<0.05). The interval between readmission and initial discharge of the 14 patients was(22.0±6.7)days. (3) Nutrition related indica-tors. The Alb and Hb of the 62 patients being followed up in the experiment group were (40.4±5.5)g/L, (35.9±3.8)g/L, (45.4±2.9)g/L and (140.8±13.9)g/L, (130.5±16.9)g/L, (147.8±17.2)g/L before opera-tion, before the first discharge and one month after operation, respectively. The above indicators of the 57 patients being followed up in the control group were (41.2±3.9)g/L, (34.2±3.9)g/L, (42.7±5.3)g/L and (143.0±9.7)g/L, (122.9±12.8)g/L, (139.0±11.4)g/L before operation, before the first discharge and one month after operation, respectively. There were significant differences in change trends of Alb and Hb before operation to one month after operation between the two groups ( Fgroup=4.27, 5.72, P<0.05). There were significant differences in Alb and Hb before operation to one month after operation between the two groups ( Ftime=187.46, 85.13, P<0.05). There were interaction effects in change trends of Alb and Hb before operation to one month after operation between the two groups ( Finteraction=7.25, 9.13, P<0.05). Results of individual effect shown that there was no significant difference in the intervention effect of Alb and Hb before operation between the two groups ( t=?0.90, ?0.99, P>0.05), and there were significant differences in the intervention effect of Alb and Hb before the first discharge and one month after operation ( t=2.45, 3.34, 2.75, 3.34, P<0.05). (4) Dietary compliance. Cases with dietary complete compliance, partial compliance, non-compliance of the 62 patients being followed up in the experiment group were 28, 19, 15, respectively. The above indicators of the 57 patients being followed up in the control group were 17, 16, 24, respectively. There was a signifi-cant difference in the dietary compliance between the two groups ( Z=?2.14, P<0.05). (5) Weight loss related indicators. The body mass, body fat mass, skeletal muscle mass, body fat ratio, waist hip fat ratio, visceral fat area of the 62 patients being followed up in the experiment group were (111.0±23.0)kg, (50.0±15.0)kg, (34.0±7.0)kg, 45%±6%, 0.99±0.08, (178±53)cm 2, respectively, before opera-tion. The above indicators of the 57 patients being followed up in the control group were (108.0±22.0)kg, (49.0±13.0)kg, (33.0±7.0)kg, 45%±5%, 0.98±0.09, (174±51)cm 2, respectively, before opera-tion. There was no significant difference in the above indicators between the two groups ( t=?0.71, ?0.48, ?1.04, 0.70, ?0.80, ?0.46, P>0.05). The body mass loss, body fat mass loss, skeletal muscle mass loss, body fat ratio loss, waist hip fat ratio loss, visceral fat area loss of the 62 patients being followed up in the experiment group were 13.8(range, 11.8?16.5)kg, 7.5(range, 6.3?10.1)kg, 3.4(range, 2.5?4.6)kg, 2.05%(range, 1.19%?3.21%), 0.04(range, 0.03?0.06), 31.5(range, 24.4?41.0)cm 2, respectively, one month after operation. The above indicators of the 57 patients being followed up in the control group were 10.8(range, 8.5?13.1)kg, 5.9(range, 4.8?8.0)kg, 4.0(range, 3.0?5.2)kg, 2.0%(range, 0.75%?3.20%), 0.04(range, 0.03?0.05), 29.1(range, 21.8?37.9)cm 2, respectively, one month after operation. There were significant differences in the body mass loss and body fat mass loss between the two groups ( Z=?4.99, ?3.54, P<0.05), and there was no significant difference in skeletal muscle mass loss, body fat ratio loss, waist hip fat ratio loss, visceral fat area loss between the two groups ( P>0.05). Conclusion:Perioperative supplement of oral nutritional can reduce the incidence of post-operative complications and readmission and enhance the postoperative nutritional status and short-term efficacy of obesity patients undergoing LSG.

Anterior cervical discectomy and fusion is one of the classic procedures for the treatment of cervical spondylosis, and dysphagia is a common perioperative complication of this procedure, which affects patients′ recovery to different degrees. This paper summarizes and analyzes the perioperative assessment and interventions in the care of patients with dysphagia after anterior cervical discectomy and fusion, aiming to improve clinical nursing staff′s attention to dysphagia in patients after anterior cervical discectomy and fusion, and provide scientific basis for the prevention and treatment of high-risk groups.

Objective:To investigate the clinical efficacy of laparoscopic sleeve gastrectomy (LSG) in obesity patients of different grades.Methods:The retrospective and descriptive study was conducted. The clinical data of 139 obesity patients of different grades who were admitted to the General Hospital of Ningxia Medical University from January 2018 to December 2021 were collected. There were 37 males and 102 females, aged (32±9)years. Of the 139 patients, there were 45 cases of grade Ⅰ obesity, 44 cases of grade Ⅱ obesity and 50 cases of grade Ⅲ obesity, respectively. Obser-vation indicators: (1) intraoperative and postoperative situations in obesity patients of different grades; (2)hematological related indicators in obesity patients of different grades; (3)body quality related indicators in obesity patients of different grades. Measurement data with normal distribution were represented as Mean± SD, and comparison within three groups was conducted using the One-way Anova test and comparison between groups was conducted using the LSD test. Measurement data with skewed distribution were represented as M(range), and comparison within three groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed by the repeated ANOVA. Results:(1) Intraoperative and postoperative situations in obesity patients of different grades. The operation time,volume of intraoperative blood loss,duration of postoperative hospital stay and cases readmitted within 30 days after surgery were 2.0(range, 1.5-2.0)hours,50(range, 50-100)mL, 5(range, 4-6)days and 2 in the 45 cases of grade Ⅰ obesity. The above indicators were 2.0(range, 1.5-2.0)hours, 60(range, 50-187)mL, 5(range, 4-6)days and 4 in the 44 cases of grade Ⅱ obesity and 2.0(range, 1.5-2.1)hours, 60(range, 50-135)mL, 5(range, 4-7)days and 4 in the 50 cases of grade Ⅲ obesity. There was no significant difference in the operation time, volume of intraoperative blood loss,duration of postoperative hospital stay among the three groups of patients ( H=4.11, 0.77, 3.59, P>0.05) and there was no significant difference in cases readmitted within 30 days after surgery among the three groups of patients ( P>0.05). (2) Hematological related indicators in obesity patients of different grades. All 139 patients were followed up at postoperative 3, 6 and 12 month. The total cholesterol (TC) were (4.5±0.9)mmol/L, (4.6±0.9)mmol/L, (4.3±0.8)mmol/L, (4.6±1.1)mmol/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (4.5±0.8)mmol/L, (4.4±0.8)mmol/L, (4.4±1.0)mmol/L, (4.3±0.9)mmol/L in cases of grade Ⅱ obesity and (4.4±1.0)mmol/L, (4.7±1.1)mmol/L, (4.5±0.8)mmol/L, (4.4±0.5)mmol/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=20.81, P<0.05) and results of multi-variate test showed that there was no significant difference in the time effect, intergroup effect and interaction effect of TC among the three groups( Ftime=0.45, Fgroup=0.40, Finteraction=0.66, P>0.05). The triglyceride (TG) were (2.0±1.1)mmol/L, (1.3±0.4)mmol/L, (1.0±0.4)mmol/L, (1.0±0.4)mmol/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (2.2±1.1)mmol/L, (1.5±0.5)mmol/L, (1.1±0.3)mmol/L, (1.0±0.3)mmol/L in cases of grade Ⅱ obesity and (2.3±1.1)mmol/L, (1.7±0.7)mmol/L, (1.4±0.6)mmol/L, (1.2±0.4)mmol/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=290.49, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of TG among the three groups ( Ftime=80.44, Fgroup=4.13, Finteraction=2.67, P<0.05). The vitamin D were (12.9±5.9)μg/L, (16.5±5.9)μg/L, (18.0±6.3)μg/L, (20.1±5.7)μg/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (11.5±4.4)μg/L, (17.1±5.0)μg/L, (18.2±5.6)μg/L, (20.2±6.6)μg/L in cases of grade Ⅱ obesity and (9.8±3.5)μg/L, (17.2±4.6)μg/L, (18.1±4.7)μg/L, (19.5±5.2)μg/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=53.07, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect and interaction effect of vitamin D among the three groups ( Ftime=150.88, Finteraction=3.86, P<0.05)and there was no significant difference in the intergroup effect of vitamin D among the three groups ( Fgroup=0.35, P>0.05). (3) Body quality related indicators in obesity patients of different grades. The body mass and body mass index (BMI) were (88±8)kg, (71±8)kg, (65±8)kg, (61±7)kg, (32±2)kg/m 2, (26±2)kg/m 2, (24±2)kg/m 2, (22±2)kg/m 2 at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (106±11)kg, (82±8)kg, (75±9)kg, (70±9)kg, (37±1)kg/m 2, (29±2)kg/m 2, (26±2)kg/m 2, (25±3)kg/m 2 in cases of grade Ⅱ obesity and (131±20)kg, (101±15)kg, (89±13)kg, (79±12)kg, (45±6)kg/m 2, (35±5)kg/m 2, (31±4)kg/m 2, (27±4)kg/m 2 in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=194.60, 179.52, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of body mass and BMI among the three groups( Ftime=492.59, 543.86, Fgroup=89.13, 95.91, Finteraction=13.97, 13.32, P<0.05). The percen-tage of excess weight loss (EWL%) were 61%±16%,84%±21%,96%±23% at postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were 55%±7%,72%±16%,85%±19% in cases of grade Ⅱ obesity and 45%±12%,64%±15%,78%±7% in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=51.61, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect and intergroup effect of EWL% among the three groups ( Ftime=374.52, Fgroup=15.69, P<0.05) and there was no significant difference in the interaction effect of EWL% among the three groups ( Finteraction=1.08, P>0.05). The percentage of total body weight loss (TWL%) were 19%±5%, 26%±6%, 30%±6% at postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were 21%±6%, 29%±6%, 34%±7% in cases of grade Ⅱ obesity and 22%±7%, 32%±7%, 39%±8% in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=58.54, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of TWL% among the three groups ( Ftime=290.61, Fgroup=12.32, Finteraction=5.49, P<0.05). The waist to hip ratio (WHR) and visceral fat area (VFA) were 0.92±0.04, 0.86±0.03, 0.84±0.03, 0.83±0.03, (129±19)cm 2, (79±17)cm 2, (63±15)cm 2, (57±14)cm 2 at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indi-cators were 0.98±0.05, 0.90±0.05, 0.87±0.05, 0.86±0.05, (169±20)cm 2, (105±23)cm 2, (85±20)cm 2, (73±20)cm 2 in cases of grade Ⅱ obesity and 1.05±0.09, 0.94±0.06, 0.91±0.06, 0.89±0.05, (218±42)cm 2, (144±35)cm 2, (114±26)cm 2, (96±19)cm 2 in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2 =289.99, 191.92, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of WHR and VFA among the three groups ( Ftime=361.39, 707.60, Fgroup=34.28, 12.69, Finteraction=8.31, 94.89, P<0.05). Conclusion:Treatment of obesity patients of different grades with LSG can improve patients′ TG and vitamin D levels, and reduce patients′ body mass, BMI, EWL%, TWL%, WHR and VFA.

Objective:To observe early postoperative changes in body composition in patients receiving laparoscopic sleeve gastrectomy (LSG) and to explore the relationship between body composition and glycolipid metabolism, so as to provide stage-specific information for doctors in the weight loss team on metabolic surgery effect assessment and postoperative follow-up and guidance.Methods:The study was a retrospective cohort study. According to inclusion and exclusion criteria, a total of 44 patients who underwent LSG in the Department of Gastrointestinal Surgery, General Hospital of Ningxia Medical University from December 1, 2017 to May 30, 2021 were included. Body composition was measured using bio-electrical impedance analysis at baseline and after surgery.Results:The patients' body composition changed significantly at 1 month and 3 months after surgery, and glucose and lipid metabolism indicators improved significantly. Body composition indicators, including body mass index (BMI), the amount of moisture in the body, inorganic salts, body fat, skeletal muscle mass, fat free mass, body fat percentage, waist-to-hip fat ratio, visceral fat, basal metabolic rate and bone mineral content, decreased significantly within 3 months after surgery ( P<0.05). The ratio of upper and lower limb muscle to body weight (U/W, L/W) increased significantly after surgery ( P<0.05). The ratio of trunk muscle to body weight (T/W) decreased within 3 months after surgery ( P<0.05). Pearson and Spearman correlation analyses showed that skeletal muscle mass and U/W were positively correlated with triglyceride ( r=0.637 and 0.304, respectively, both P<0.05) in 3 months after operation. L/W was positively correlated with fasting blood glucose ( r=0.454, P<0.05). T/W was negatively correlated with triglyceride ( r=-0.643, P<0.05). Conclusions:Patients undergoing LSG displayed significant changes in body composition in the early postoperative period. Changes in muscle mass of different body parts varies and showed different effects on glucose and lipid metabolism parameters. The trunk muscle mass is negatively correlated with glucose and lipid metabolism indicators, while limb muscle mass and skeletal muscle mass are positively. It is suggested that the changes of body composition in different parts should be observed when evaluating patient outcomes after LSG and the trunk body mass should be preserved as far as possible.

OBJECTIVE: To investigate the effects of ALKBH5 on migration, invasion and epithelial-mesenchymal transition (EMT) of human trophoblast cells. METHODS: The expression plasmid of ALKBH5 or a negative control plasmid (ALKBH5-NC) was transfected in human trophoblast HTR-8 /SVneo cells, and the expressions of ALKBH5 mRNA and protein were detected by qRT-PCR and Western blotting. Transwell assay was used to assess the changes in migration and invasion abilities of the trophoblast cells after the transfection. Western blotting was performed to detect the expressions of EMT-related proteins in the cells including vimentin, fibronectin, E-cadherin, N-cadherin, MMP9 and MMP2. RESULTS: ALKBH5 mRNA and protein expressions were significantly higher in ALKBH5 group than in the control group ( CONCLUSIONS ALKBH5 is involved in the pathogenesis of preeclampsia by inhibiting EMT of trophoblast cells and hence reducing their migration and invasion abilities.
AlkB Homolog 5, RNA Demethylase ; Cell Line, Tumor ; Cell Movement ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Vimentin/genetics*

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.

OBJECTIVE To establish the ultra-high liquid chromatography （UPLC） characteristic spectrum of Uncariae Ramulus Cum Uncis from different producing areas， to conduct chemical pattern recognition analysis， and to identify the medicinal materials of their different origins and counterfeit products. METHODS UPLC method was adopted to establish the characteristic spectra of 43 batches of Uncariae Ramulus Cum Uncis from different origins； cluster analysis combined with principal component analysis were used to analyze their quality； Uncariae Ramulus Cum Uncis from different origins and counterfeit products were identified. RESULTS UPLC specific spectrum of Uncariae Ramulus Cum Uncis was established， and 13 common peaks were calibrated； peak 2 was identified as catechin， peak 3 as chlorogenic acid， peak 4 as cryptochlorogenic acid， peak 7 as isochlorogenic acid B， peak 8 as isodehydroguotenine， peak 9 as isooguotenine， peak 10 as dehydroguotenine， peak 11 as isochlorogenic acid C， peak 12 as goutenine， and peak 13 as camptothecin. Through cluster analysis， the medicinal materials of 43 batches of Uncariae Ramulus Cum Uncis could be divided into 5 categories according to their different origins. Further principal component analysis revealed that the principal component comprehensive scores of Uncariae Ramulus Cum Uncis produced in Jiangxi and Hunan were relatively high， ranging from 0.264 to 2.904. The specific chromatogram could effectively distinguish among the different origins and their counterfeit products of Uncariae Ramulus Cum Uncis. CONCLUSIONS The established UPLC specific chromatogram can be used for quality control of Uncariae Ramulus Cum Uncis， and the study found that the quality of Uncariae Ramulus Cum Uncis from Jiangxi and Hunan provinces is relatively good.

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
Anilides/pharmacology* ; Cerebral Hemorrhage/drug therapy* ; Hematoma/drug therapy* ; Humans ; Macrophages ; Microglia ; Neuroprotection ; PPAR gamma ; Retinoid X Receptor alpha