Objective To investigate aspirin resistance (AR) and its related factors in patients with stage 3-4 chronic kidney disease(CKD).Methods The clinical data of 108 patients with stage 3-4CKD from nephrology department in Beijing Chaoyang Hospital were collected (CKD group) ; and 110 age and sex-matched subjects with normal renal function served as control group.Anthropometric parameters,blood biochemistry index,ultrasonography and thromboelastograph (TEG) were examined in both groups; and inhibition ratio of arachidonic acid ＞ 50％ on TEG was defined as AR.Results The incidence of cardio-cerebral vascular disease,the incidence of peripheral vascular disease,ratio of female,the intimamedia thickness (IMT) of carotid artery,the levels of high-sensitive C-reactive protein (hsCRP),homocysteine(Hcy),evaluated glomerular filtration rate(eGFR) and maximal thrombelastodegree (MA) on TEG in CKD group were significantly higher than those in control group (all P ＜ 0.05),while R value was significantly lower in CKD group.Pearson's correlation analysis revealed that the levels of MA,hsCRP,Hcy,IMT were positively correlated and R value was negatively correlated with eGFR in CKD group.The incidence of AR in CKD group (32.4％) was significantly higher than in control group (20.0％).According to TEG,the patients were divided into AR group (n =35) and aspirin sensitive (AS) group (n =73).The incidence of cardio-cerebral vascular disease,the incidence of peripheral vascular disease,ratio of female,IMT,ratio of diabetes,the levels of hsCRP,Hcy,fasting plasma glucose (FBG),eGFR and MA in AR group were significantly higher than those in AS group (all P ＜ 0.05),while R value was significantly lower in AR group.Binary logistic regressive analysis revealed that the ratio of diabete,FBG,eGFR,hsCRP were independent risk factors for AR in patients with stage 3-4 CKD.Conclusions CKD stage 3-4 is associated with increased ratio of platelet activation and atherosclerosis,and this condition is aggravated while eGFR declining.Incidence of AR is 32.4％ in this group of CKD patients,the independent risk factors of AR in CKD patients are the ratio of diabetes,FBG,eGFR and hsCRP.

Objective To explore aspirin resistance (AR) and its relevant influencing factors in patients on maintenance hemodialysis (MHD).Methods Patients on MHD who visited Beijing Chaoyang Hospital from June 1 to 30,2011 were enrolled in this study.A total of 150 age and gender matched individuals with normal renal function were taken as control group.Anthropometric data,biochemistry parameters,ultrasonography and thromboelastograph (TEG) were inspected in the both groups.AR was defined as inhibiting rate of acetylsalicylic acid drugs [MA (AA)] ＞ 50％ by TEG.Results Among the total 391 patients on MHD,hypercoagulation was found in 18 patients (4.6％),nomal coagulation in 288 patients (73.7％) and hypocoagulation in 85 patients (21.7％).Pearson's correlation analysis revealed that the reaction time (R) and the thrombus maxithrombelastic degree (MA) values were not correlated with the levels of hemoglobin and platelet in MHD patients.A total of 306 patients with hypercoagulation and normal coagulation were chosen as the MHD group.Compared with the control group,higher high sensitivity C reactive protein (hsCRP),homocysteine (Hcy) and R value were observed in the MHD group (P ＜ 0.05),while MA was significantly lower in the MHD group.Statistically higher incidence of AR was shown in the MHD group (48.0％ vs 20.0％,P =0.00).Patients in the MHD group were divided into the AR group and the aspirin sensitive (AS) group by the result of TEG.Compared with the AS group,patients in the AR group were found to be older with a higher female/male ratio,longer dialysis sustained time,higher ratio of diabetes history,higher hsCRP,Hcy and fasting blood glucose (FBG) and MA.They also manifested a higher incidence of cardiovascular and cerebrovascular diseases,peripheral vascular disease and arteriovenous fistulas with thrombosis with more spots of carotid artery and higher intima thickness of carotid artery (IMT) (all P values ＜0.05).Lower R value was shown in the AR group.Binary logistic regressive analysis revealed that the ratio of diabetes history,age and dialysis sustained time.Hcy and hsCRP were the independent risk factors for AR in patients on MHD.A total of 289 patients on MHD with atherosclerosis were followed up for the mean time of 18.0 months with no hemorrhage found in the process.Cox proportional hazards regression modeling demonstrated that AR was associated with the major adverse longterm outcome of the vascular events [HR =0.40,95 ％ CI 0.29-0.72,P =0.00].Conclusions The ratio of platetet activation in patients on MHD is significantly lower than in those with normal renal function.Small dose of aspirin could be prescribed for the patients on MHD with atherosclerosis to prevent vascular events.The incidence of AR is 48.0％ in the MHD group and the independent risk factors for AR in MHD patients are the ratio of diabetes history,age,dialysis sustained time,Hcy and hsCRP.AR is associated with the major adverse long-term outcome of acute vascular events.

β-blockers are widely administered to patients with various cardiovascular diseases including hypertension. However, in recent years, studies have questioned or even denied the antihypertensive effect of β-blockers, which has caused confusion to cardiovascular clinicians. Based on the systematic analysis of a number of studies, the author believes that β-blockers still remain the status as the first-line antihypertensives.

Objective To evaluate the effectiveness of a rat model for comorbidity of Tourette syndrome and anxiety with empty water bottle stimulation plus iminoodipropionitrile(IDPN) injection.Methods The 48 male SD rats were randomly divided into four groups:the blank control group,the TS group,the anxiety group and the comorbidity group.The blank control group was injected with saline for 7 days.The TS groop was injected with 3,3-iminodipropionitrile (IDPN) with 250 mg/kg once a day for 7 consecutive days.The anxiety group was given empty water bottle stimulation for 21 consecutive days.The comorbidity group was given empty water bottle stimulation plus IDPN injection.At the end of the 3rd week,the behavioral changes of the stereotyped movement,elevated plus-maze and open field of the rats in each group were measured,and the contents of monoamine neurotransmitters in striatum and hippocampus were determined by HPLC.Results The results of stereotyped movement showed that there was no significant difference between the groups except for the blank control group.The elevated plus-maze test showed that the 0E/TE values of the comorbidity group (21.33±11.35) ％ and the anxiety group (17.68±16.89) ％ were significantly decreased,lower than that of the blank control group (73.24± 19.33) ％ and TS group(61.43±21.84) ％.The results of open field test showed that the total scores of open field in the comorbidity group(15.22±9.87)and anxiety group (11.17±10.76) were lower than that of the blank control group (41.86±33.30) and TS group(48.83± 17.65) (P＜0.01).However,there was no significant difference between the comorbidity group and the anxiety group.The test of monoamine neurotransmitters in striatum showed that the content of HIAA in the comorbidity group(0.03±0.00) ng/mg was the highest,and that of the TS group and anxiety group (0.02±0.00) ng/mg was higher than that of the blank control group (0.01±0.00) ng/mg (P＜0.01).The DA test showed that the content of DA in the comorbidity group (0.03±0.00) ng/mg was the highest,and that of the comorbidity group,TS group(0.02±0.00) ng/mg and anxiety group was higher than that of the blank control group(0.01±0.00) ng/mg (P＜0.01).The expression of 5-HT was most significant among the groups (P＜0.01),and there was significant difference between the anxiety group ((0.011 ± 0.001) ng/mg)and the comorbidity group ((0.014±0.002) ng/mg) (P＜0.01).The expression of HVA in the three model groups ((0.05±0.00) ng/mg) was higher than that in the blank group ((0.02±0.00) ng/mg) (P＜ 0.01).The expression of DOPAC in the TS group ((0.23±0.02) ng/mg) was higher than that in the blank control group((0.16±0.01) ng/mg) and comorbidity group ((0.16±0.02) ng/mg) (P＜0.01).The test of monoamine neurotransmitters in hippocampus showed that the content of 5-HT in the comorbidity group ((0.14±0.02) ng/mg) was the highest,followed by the anxiety group ((0.1 ± 0.03) ng/mg) and the TS group ((0.07±0.04) ng/mg),which were all higher than the blank control group((0.04±0.03) ng/mg) (P＜0.05,P＜0.01),and there were significant differences between the comorbidity group and the TS group or anxiety group (P＜0.01).The expressions of HIAA and HVA were higher in the comorbidity group((0.44±0.04)ng/mg,(0.01±0.00) ng/mg),TS group ((0.46±0.15) ng/mg,(0.01 ±0.01) ng/mg) and anxiety group ((0.46±0.08)ng/mg,(0.01±0.00) ng/mg) than that in the blank control group((0.21±0.10)ng/mg,(0±0) ng/mg) (P＜0.05,P＜0.01).Conclusion This study confirms the reliability of the model and it is an ideal animal model for the study of TS with comorbidity of anxiety,which can be used for follow-up research.

Objective:To evaluate the impacts of radioactivity in foods since begining of the operation of the Hongyanhe Nuclear Power Plant (HNPP).Methods:The levels of radioactivity in foods collected within 30 km of HNPP from 2013 to 2020 were analyzed by comparison of the control samples and those collected before the operation. The impacts on the operation of the HNPP on foods were evaluated.Results:The man-made radionuclides such as 131I, 134Cs, 60Co, 58Co, 110Ag m were not found in food samples. The nautral radionuclides such as 238U, 226Ra, 232Th, 40K were at the normal levels, with the average levels of (0.088±0.053), (0.155±0.178), (0.314±0.388)and(81.3±18.1)Bq/kg(fresh weight)in foods, respectively. The average levels of man-made nuclide 137Cs in foods were (0.013±0.010) Bq/kg (fresh weight). There was no increase in radionuclide levels compared with the control samples and the samples before the operation. Conclusions:The impacts on foods due to the operation of HNPP was not found.

Objective:To investigate the effects of adherent-invasive Escherichia coli ( E. coli) LF82 on the structure and function of intestinal barrier in mice with ulcerative colitis (UC). Methods:Twenty-four specific pathogen free (SPF) C57BL/6 mice were divided into UC with E. coli LF82 group, UC group and healthy control group with eight mice in each group. The UC mice model was induced by dextran sulfate sodium (DSS). One week before modeling, the mice of UC with E. coli LF82 group were intragastric administrated with 1×10 9 colony-forming unit (CFU) E. coli LF82 to colonize the bacteria strain. The effects of E. coli LF82 on colitis of mice with UC were evaluated by disease activity index (DAI), gross morphological injury score, colonic mucosal injury index (CMDI), myeoloperoxidase (MPO) activity and pathological features. The ultrastructure and the changes of cytoskeleton F-actin of mice colonic tissues were detected by transmission electron microscope (TEM) and direct immunofluorescence. The ability of colonic mucin production and degree of fibrosis were estimated by periodic acid Schiff reaction (PAS) stain and sirius red stain. T test, least significant difference, repeated measurement analysis of variance and one-way analysis of variance were used for statistical analysis. Results:On the fourth, fifth, sixth and seventh day after the modeling, the DAI scores of UC with E. coli LF82 group were all higher than those of UC group ((2.53±0.38) points vs. (2.01±0.53) points, (3.02±0.62) points vs. (2.67±0.24) points, (3.13±0.61) points vs. (2.20±0.24) points, (3.27±0.28) points vs. (2.20±0.69) points, respectively), and the differences were statistically significant ( t=3.37, 2.25, 9.56 and 10.24, all P<0.05). The gross morphological injury score of mice colon of UC with E. coli LF82 group was higher than that of UC group ((6.17±1.94) points vs. (2.83±0.98) points), and the difference was statistically significant ( t=-3.75, P<0.05). The CMDI and MPO activity of UC with E. coli LF82 group were both higher than those of UC group ((16.80±2.79) points vs. (11.80±3.11) points, (729.3±77.5) U/mg vs. (594.4±31.9) U/mg), and the differences were statistically significant ( t=-2.83; mean difference=134.82, 95% confidence interval ( CI) 72.12 to 197.51; both P<0.05). The results of TEM showed that the E. coli LF82 could invade the submucosa of colon and caused further injury of colonic tissues in mice. The distribution of cytoskeleton F-actin of mice colonic tissues changed. The results of PAS staining showed that the percentages of PAS positive cells of UC with E. coli LF82 group and UC group were both lower than that of healthy control group ((32.40±8.02)% and (41.90±8.99)% vs. (57.70±11.52)%), and the difference was statistically significant ( F=17.63, P<0.01). The percentage of PAS positive cells of UC with E. coli LF82 group was lower than that of UC group, and the difference was statistically significant (mean difference=-9.50, 95% CI -18.33 to -0.67, P<0.05). The results of sirius red staining showed that the villous epithelium of colon mucosa of UC with E. coli LF82 group was partially injured and collagen fibers hyperplasia was serious. The area ratios of collagen fiber of UC with E. coli LF82 group and UC group were both higher than that of healthy control group ((51.83±5.78)% and (37.11±5.59)% vs. (15.41±2.25) %), and the difference was statistically significant ( F=86.72, P<0.01). The area ratio of collagen fiber of UC with E. coli LF82 group was higher than that of UC group, the difference was statistically significant (mean difference=14.83, 95% CI 8.91 to 20.76, P<0.05). Conclusions:E. coli LF82 can aggravate DSS-induced colitis in UC mice, leading to changes in colon ultrastructure and cytoskeleton, it can also reduce the ability of mucus secretion of colon of mice and increase the degree of colonic tissues fibrosis.

BACKGROUND: Syringomyelia is a progressive chronic disease that leads to nerve pain, sensory dissociation, and dyskinesia. Symptoms often do not improve after surgery. Stem cells have been widely explored for the treatment of nervous system diseases due to their immunoregulatory and neural replacement abilities. METHODS: In this study, we used a rat model of syringomyelia characterized by focal dilatation of the central canal to explore an effective transplantation scheme and evaluate the effect of mesenchymal stem cells and induced neural stem cells for the treatment of syringomyelia. RESULTS: The results showed that cell transplantation could not only promote syrinx shrinkage but also stimulate the proliferation of ependymal cells, and the effect of this result was related to the transplantation location. These reactions appeared only when the cells were transplanted into the cavity. Additionally, we discovered that cell transplantation transformed activated microglia into the M2 phenotype. IGF1-expressing M2 microglia may play a significant role in the repair of nerve pain. CONCLUSION Cell transplantation can promote cavity shrinkage and regulate the local inflammatory environment.Moreover, the proliferation of ependymal cells may indicate the activation of endogenous stem cells, which is important for the regeneration and repair of spinal cord injury.

Objective To investigate the ADC value and intravoxel incoherent motion (IVIM) parameters to predict the early response to chemotherapy in patients with locally advanced non-small cell lung cancer (NSCLC). Methods Twenty-six patients with pathologically confirmed NSCLC in our hospital from June 2015 to January 2017 were prospectively studied. MR routine scan, DWI and IVIM scans were performed before and at the end of the first cycle of chemotherapy. The ADC value, pure diffusion parameter (D), perfusion parameter (D*) and perfusion fraction (f) before and after chemotherapy were recorded respectively, and the maximum diameter of tumor (MDMRI) was measured on T2WI. The effective group and the ineffective group were divided according to RECIST 1.1. Intra- and interobserver reproducibility were assessed with intraclass correlation coefficient (ICC). The differences of the parameters and their change rate were compared pre-and posttreatment, in the effective and the ineffective groups by using t test. Receiver operating characteristic (ROC) curves were generated to explore the optimal parameters and thresholds for early prediction of the efficacy of chemotherapy. Z test was used to compare the differences in the areas under the ROC curves. Results The repeatability of D*was relatively poor (ICC 0.507-0.716). The ADC and D values of the effective group before chemotherapy were (1.28±0.21)×10-3 and (1.05±0.14)×10-3mm2/s, respectively, and those of the ineffective group were (1.55 ± 0.25) × 10-3 and (1.29 ± 0.18) × 10-3mm2/s, respectively. The differences between two groups were statistically significant (t=-2.989, -3.755, respectively, P all<0.05). While there was no significant difference in f between the effective and ineffective groups before chemotherapy (t=-1.034, P=0.312). The ADC, D and f values of the effective group before chemotherapy were lower than those after chemotherapy, and the differences were statistically significant (t=-3.969,-5.617 and-2.876, respectively, P all<0.05). While there was no significant difference in ADC and D values in ineffective group (t=-0.737, -0.866, P>0.05, respectively). The difference of f was statistically significant (t=-2.731, P<0.05).ΔADC％,ΔD％andΔMDMRI％in effective group were (23.90 ± 22.28)％, (32.58 ± 20.63)％ and (18.77 ± 10.36)％, respectively, and those in ineffective group were (1.19 ± 11.35)％, (6.22 ± 21.63)％ and (9.35 ± 8.26)％, respectively. The differences between two groups were statistically significant (t=3.393, 3.154 and 2.487, respectively, P all<0.05). There was no significant difference inΔf％between two groups (t=1.346, P=0.191). ROC curve analysis showed that the area under curve (AUC) of preADC, preD, ΔADC％, ΔD％ and ΔMDMRI％ was 0.788, 0.848, 0.800, 0.830 and 0.727, respectively. When setting the preD=1.20×10-3 mm2/s as the boundary under the largest AUC, however, there was no significant differences in AUC compared with preADC, ΔADC％, ΔD％ and ΔMDMRI％ (Z=1.336, 0.363, 0.136, 1.395, P>0.05). Conclusion The ADC value, D value before chemotherapy and the early change rate after chemotherapy can better predict the early response of chemotherapy in NSCLC patients.

Objective To investigate the food radioactivity levels in areas around the Xudabao nuclear plant before operation. Methods The food radioactivity levels were achieved by detecting samples collected within 30 km around the Xudabao nuclear power plant with a HPGe detector. Results The major radionuclides in food were ²³⁸U, ²²⁶Ra, ²³²Th, ⁴⁰K and the man-made radionuclide of ¹³⁷Cs. The average activity levels of natural ²³⁸U、²²⁶Ra、²³²Th、⁴⁰K were(1.2 × 10⁻¹¹ ± 2.6 × 10⁻¹¹)、(9.2 × 10⁻¹² ± 1.6 × 10⁻¹¹)、(3.6 × 10⁻¹¹ ± 6.5 × 10⁻¹²)、(9.0 × 10¹ ± 5.8 × 10¹)Bq/kg respectively. The average level of ¹³⁷Cs in food was (1.2 × 10⁻¹² ± 9.0 × 10⁻¹³)Bq/kg. Conclusion The man-made radionuclides were not detected except ¹³⁷Cs in the collected food. The radioactivity concentrations were lower than the national standards. The effective dose for local residents by ingestion of ¹³⁷Cs was around 6.0 × 10⁻¹² µSv/a.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.