INTRODUCTION: Lecanemab has shown promise in treating early Alzheimer's disease (AD), but its safety and efficacy in Chinese populations remain unexplored. This study aimed to evaluate the safety and 6-month clinical outcomes of lecanemab in Chinese patients with mild cognitive impairment (MCI) or mild AD. METHODS: In this single-arm, real-world study, participants with MCI due to AD or mild AD received biweekly intravenous lecanemab (10 mg/kg). The study was conducted at Hainan Branch, Ruijin Hospital Shanghai Jiao Tong University School of Medicine. Patient enrollment and baseline assessments commenced in November 2023. Safety assessments included monitoring for amyloid-related imaging abnormalities (ARIA) and other adverse events. Clinical and biomarker changes from baseline to 6 months were evaluated using cognitive scales (mini-mental state examination [MMSE], montreal cognitive assessment [MoCA], clinical dementia rating-sum of boxes [CDR-SB]), plasma biomarker analysis, and advanced neuroimaging. RESULTS: A total of 64 patients were enrolled in this ongoing real-world study. Safety analysis revealed predominantly mild adverse events, with infusion-related reactions (20.3%, 13/64) being the most common. Of these, 69.2% (9/13) occurred during the initial infusion and 84.6% (11/13) did not recur. ARIA-H (microhemorrhages/superficial siderosis) and ARIA-E (edema/effusion) were observed in 9.4% (6/64) and 3.1% (2/64) of participants, respectively, with only two symptomatic cases (one ARIA-E presenting with headache and one ARIA-H with visual disturbances). After 6 months of treatment, cognitive scores remained stable compared to baseline (MMSE: 22.33 ± 5.58 vs . 21.27 ± 4.30, P = 0.733; MoCA: 16.38 ± 6.67 vs . 15.90 ± 4.78, P = 0.785; CDR-SB: 2.30 ± 1.65 vs . 3.16 ± 1.72, P = 0.357), while significantly increasing plasma amyloid-β 42 (Aβ42) (+21.42%) and Aβ40 (+23.53%) levels compared to baseline. CONCLUSIONS: Lecanemab demonstrated a favorable safety profile in Chinese patients with early AD. Cognitive stability and biomarker changes over 6 months suggest potential efficacy, though high dropout rates and absence of a control group warrant cautious interpretation. These findings provide preliminary real-world evidence for lecanemab's use in China, supporting further investigation in larger controlled studies. REGISTRATION ClinicalTrials.gov , NCT07034222.
Humans ; Alzheimer Disease/drug therapy* ; Male ; Female ; Aged ; Middle Aged ; Cognitive Dysfunction/drug therapy* ; Aged, 80 and over ; Amyloid beta-Peptides/metabolism* ; Biomarkers ; East Asian People

Objective:To observe the clinical features and prognosis of eyes with corneal suture-related infective endophthalmitis.Methods:A retrospective interventional case series. From January 2020 to December 2021, 5 patients (5 eyes) with corneal suture-related infectious endophthalmitis diagnosed by ophthalmic examination at Department of Ophthalmology of the Eye-ENT Hospital of Fudan University were included in the study. Among them, there were 3 males and 2 females; all had unilateral disease; the mean age was 30.80±21.98 years. Sutures of 4 cases were secondary to lens related surgery and of 1 case was secondary to penetrating keratoplasty. Average retention time of corneal suture was 20.00±7.41 months. Of the 5 eyes, corneal sutures were removed in 1 eye due to redness and eye pain in another hospital; 3 eyes were loosened of the sutures in the remaining 4 eyes. The patients were given standard treatment for infectious endophthalmitis, including systemic and local anti-infective therapy; corneal suture removal, intraocular injection, and vitrectomy (PPV). In PPV, it was decided whether to give silicone oil filling according to the situation. The follow-up time after treatment was 11.00±7.38 months. The best corrected visual acuity (BCVA), B-mode ultrasound and microbial culture results of the affected eye before and after surgery were observed and analyzed.Results:Infiltrates, ulcers, or abscesses surrounding the suture may be seen on the cornea of the affected eye. B-mode ultrasonography showed vitreous opacity, preretinal cords, and spherical wall edema in the entire segment of the affected eye. The results of vitreous humor culture were positive in 3 eyes, which were Streptococcus viridis, Staphylococcus hominis subspecies, Staphylococcus epidermidis. After treatment, all the intraocular infections in the affected eyes were successfully controlled, and there were no cases of enucleation of ocular contents or enucleation. Before treatment, the BCVA of the affected eye was from no light perception to counting fingers; after treatment, 2 eyes had BCVA> 0.3.Conclusions:Infiltration, ulcers or abscesses around the sutures can be seen in the cornea of corneal suture-related infective endophthalmitis patients, which are related to the long-term retention of the sutures in the eye. Most of the affected eyes have loose sutures when they go to the doctor; timely treatment can effectively control the infection, and some eyes have good visual prognosis.

Objective:To investigate the effects and underlying mechanisms of phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/NF-κB signaling pathway in human kidney-2(HK-2) cells of hyperuricemic nephropathy.Methods:HK-2 cells were cultured in vitro and randomly divided into control group and experimental group. The experimental group was induced by high uric acid (720 μmol/L) immersion for 48 h to establish a cell model of hyperuricemic nephropathy in vitro and subsequently divided into hyperuricemic group, overexpressed protease activated receptor 2 (PAR2) and knockdown PAR2 group. The expressions of PAR2, PI3K, AKT, NF-κB mRNA were measured by real-time PCR. The expressions of PAR2, PI3K, AKT and NF-κB protein were measured by Western blotting. The expressions of tumor necrosis factor-α (TNF-α), monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), pro-interleukin-1β (pro-IL-1β), interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) were detected by enzyme linked immunosorbent assay (ELISA). Results:(1) Compared with the control group, the expressions of PAR2, PI3K, AKT and NF-κB mRNA and protein in hyperuricemic group were significantly increased (all P<0.05), the expressions of TNF-α, MCP-1, IL-6, pro-IL-1β, IL-1β and TGF-β1 in the supernatant in hyperuricemic group were significantly increased (all P<0.01). (2) Compared with the hyperuricemic group, the expressions of PAR2, PI3K, AKT and NF-κB mRNA and protein in overexpressed PAR2 group were significantly increased (all P<0.05), the expressions of TNF-α, MCP-1, IL-6, IL-1β and TGF-β1 in the supernatant were significantly increased (all P<0.05). (3) Compared with the hyperuricemic group, the expression of PAR2, PI3K, AKT and NF-κB mRNA and protein in knockdown PAR2 group were significantly decreased (all P<0.05), the expressions of IL-6, pro-IL-1β, IL-1β and TGF-β1 in the supernatant were significantly decreased (all P<0.05). Conclusions:In the process of uric acid-induced HK-2 cell damage, uric acid significantly up-regulates the expression of PI3K/AKT/NF-κB signaling pathway by activating PAR2, leading to a marked increase in inflammatory damage. Knocking down PAR2 inhibits the expression of PI3K/AKT/NF-κB signaling pathway, which can effectively reduce the inflammatory damage of HK-2 cells.

Objective:To design a new medication guidance tool for clinical intravenous therapy and nursing safety which covers all-dimensional information of intravenous therapy and nursing needs, and observe its application effects.Methods:(1) The treatment plans of common and frequently-occurring diseases in the priority departments of Class Ⅲ general hospitals in Jilin Province from January 2016 to December 2017 were retrospectively investigated and summarized to determine the index framework of intravenous therapy guidance tools. (2) The status quo survey, expert meeting and literature search were used to determine the content of the guidance tool and the drug information. (3) The expert consensus was used to determine the presentation of the guidance tool. (4) Totally 127 nurses in the departments were selected by convenient sampling for a non-contemporaneous controlled trial to compare the effects of the guidance tool after one month of application and nursing staff's level of knowledge about the risk of intravenous therapy.Results:(1) A guidance tool with 8 specialties, 73 treatment plans, and 326 commonly used drug information presented with specialties as an index and visualized signs was designed and developed, which covers relevant information such as requirements for infusion device materials, selection of infusion device, and requirements for inter-group tube flushing and sealing. (2) From May to June 2019, the nurses were tested before and after use, who were required to complete the specialist drug knowledge questionnaire within the specified time. The accuracy of the three dimensions of the physical and chemical properties of drugs, pharmacological effects, and safe use was 89.76%, 90.55%, and 95.27%, respectively, which were higher than that before use, and the difference was statistically significant ( P<0.05) . Conclusions:Based on the needs of clinical intravenous therapy and nursing safety medication, the novel guidance tool for intravenous therapy and safe medication nursing is designed and completed, which can effectively improve the nurses' ability to safely use intravenous medications and work efficiency and is worth promoting in clinical practice.

Objective: To explore the effect of distance education in the teaching mode of medical clinical skills, and to provide theoretical and practical basis for finding a better teaching mode to promote the combination of theory and practice. Methods: A total of 172 trainees of clinical skill training in the training center were divided into the control group and the observation group (the observation group was divided into pre-class long-distance group, in-class long-distance group, after-class long-distance group). There were 43 trainees in each group. The control group adopted traditional teaching methods in clinical basic skills courses, and the observation group adopted mixed teaching mode under long-distance education. The satisfaction of teachers and students under the two teaching modes were investigated, and the performance of each group of students in skills, human-computer dialogue, and team first aid comprehensive test were compared. Results: There were significant differences in teacher satisfaction between the control group and the pre-class and in-class distance groups (χ² = 15.315, P = 0.000). There were significant differences in student satisfaction between the control group and the pre-class and in-class distance groups in terms of interactive participation, liveliness, interesting training skills and teaching level (χ²=4.497-17.153, P = 0.000-0.034). The results of each group reached the expected teaching goals. There were significant differences between the skill test score control group and the pre-class and in-class remote groups (t=25.357, 14.712, all P =0.000). There were significant differences between the human-machine dialogue test control group and the three observation groups (t=14.561, 19.420, 3.821, all P =0.000). There were significant differences between the team emergency comprehensive test control group and the three observation groups (t=14.561, 19.420, 3.821, all P=0.000). Conclusions Distance education has flexible in the mixed teaching mode of clinical skills, especially in pre-class and in-class. It can rapidly improve the basic clinical skills, theoretical knowledge and team mobilization ability of students. It is one of the best bridges to communicate their clinical theory and practice.

Objective To observe the level of CD4+CD25+ regulatory T cells (CD4+CD25+ Treg cells) with positive fork head transcription factor 3 (Foxp3) and changes of T-box transcription factor TBX1 (TBX1) and myocyte specific enhancer 2D (MEF2D) expression in peripheral blood of rats with acute rejection after renal transplantation,and to investigate its regulatory mechanisms by combined with renal function,plasma interleukin-10 (IL-10),interferon-γ (IFN-γ) and renal histopathological changes.Methods Rat renal transplantation model was established and divided into two groups:acute rejection group (AR group) and non-acute rejection group (non-AR group).Their renal function including serum creatinine (Scr) and blood urea nitrogen (BUN) in plasma was measured.The renal histopathology was observed by HE staining.Levels of IL-10 and IFN-γ in plasma were detected by ELISA.The proportion of CD4+CD25+ Treg cells was measured by flow cytometry.The mRNA expressions of Foxp3,TBX1 and MEF2D in CD4+CD4+Treg cells were detected by real-time PCR,and their protein expressions were tested by Western blotting.Results Compared with these in the non-AR group,the levels of BUN,Scr and IFN-γ significantly increased in AR group (all P ＜ 0.05),while IL-10 decreased (P ＜ 0.05).Renal histopathology in the acute rejection group showed glomerular hypertrophy and mesangial cell proliferation,capillary proliferation and neutrophil infiltration;renal interstitial edema and tubular necrosis,accompanied by lymphocytes,plasma cells and neutrophils infiltration.Compared with that in the non-AR group,the percentage of CD4+CD25+ Treg cells in peripheral blood was notably lowered in AR group (4.50％±0.50％ vs 5.74％±1.96％,P ＜ 0.05).The mRNA and protein expressions of Foxp3 and MEF2D were lower in AR group than those in non-AR group,while the expressions of TBX1 was elevated (all P ＜ 0.05).Conclusions In rats with acute renal allograft rejection,the percentage of CD4+CD25+ Treg cells and expressions of Foxp3,MEF2D and IL-10 decrease,while the expressions of TBX1 and IFN-γ enhance.These participate in the development of acute rejection after renal transplantation,and aggravate the renal damage.

Objective To explore the effect of micro-lectures withadvanced simulation man in improving the practical skills teaching of nursing students, so as to promote the students' post competency. Methods Totally the 186 nursing internswere divided into control group and observation group by random number method with 93 people in each group. The control group used the traditional teaching modein the teaching of practical skills.The observation group used the micro-lectures with high simulation teaching.Comparing the two groups of nursing students comprehensive assessment test simulation results in the theory, skills, scenarios, and nursing students the evaluation of the curriculum. Results The scores of the two groups were all above the qualification line, but the scores of the observation group were significantly higher than those of the control group (P<0.05). The theoretical examinations and the situation simulation comprehensive testswas(77.89 ± 7.79), (75.60 ± 7.92)points in control group, and (93.87 ± 3.90),(92.87 ± 4.08)points in observation group, there was significant difference between two groups (t=17.67, 18.70,all P=0.000). The curriculum evaluation results of improving learning initiative, active curriculum atmosphere, clear operation demonstration, exercise clinical thinking, improve the clinical interest were 81.72％(76/93), 72.04％(67/93), 93.55％(87/93), 60.22％(56/93), 67.74％(63/93)in control group, and 96.77％(90/93), 95.70％(89/93), 100.00％(93/93), 92.47％(86/93), 98.92％(92/93)in observation group, there was significant difference between two groups(χ2=20.39, P=0.016).Conclusions The effect is significant of micro-lectures combined with high simulation of human using in clinical skills teaching. Thismold can conducive to the cultivation of clinical thinking of nursing students, and improve clinical comprehensive ability, and promote the promotion of nursing students post competency.

Objective To investigate the antimicrobial resistance profile of the Streptococcus pneumoniae strains isolated from respiratory tract of children in Zhongshan Boai Hospital, Guangdong Province for better management of such infections. Methods The sputum samples were collected from respiratory tract of children in pediatric outpatient and inpatient from May 2013 to August 2017. S. pneumoniae strains were isolated and identified and their susceptibility to antimicrobial agentswas determined. Results The prevalence of S. pneumoniae was 10.6％ (2 963/28 006) in the sputum samples. S. pneumoniae was mainly isolated from children under 6 years old, and relatively higher in winter and spring. About 43.0％ of the S. pneumoniae isolates was associated with mixed infection, especially Moraxella catarrhalis and Haemophilus influenzae. About 6.0％ of the S. pneumoniae isolates were non-susceptible to penicillin, 59.3％ non-susceptible to ceftriaxone, and more than 95％ non-susceptible to erythromycin, clindamycin or tetracycline. However, more than 95％ of the isolates were susceptible to chloramphenicol or ofloxacin. No S. pneumoniae isolate was found resistant to rifampin, linezolid or vancomycin. Conclusions The respiratory tract infection caused by S. pneumoniae of children is increasing year by year, which is associated with age, season, and higher rate of mixed infection. These data showed that penicillin non-susceptible S. pneumoniae is highly prevalent in Zhongshan. More than 95％ of the S. pneumoniae isolates from children are resistant to erythromycin, clindamycin or tetracycline. S. pneumoniae isolates should be closely monitored for the emergence of multidrug resistant strains. Appropriate control measures must be taken according to the results of susceptibility testing.

OBJECTIVE:To conduct component analysis for the 40％ ethanol eluate of Hyssopus officinalis,and investigate its improvement effect on inflammation in asthmatic mice. METHODS:The 40％ ethanol eluate of polyamide resin column was col-lected,and HPLC-high resolution mass spectrometry was used for the component analysis of 40％ ethanol eluate of H. officinalis. Totally 72 mice were randomly divided into blank group (normal saline),model group (normal saline),dexamethasone group (positive control,1.6 mg/kg) and 40％ ethanol eluate of H. officinalis high-dose,medium-dose,low-dose groups (200,100,50 mg/kg),12 in each group. Except for normal group,mice in other groups were intraperitoneally injected 0.2 mL ovalbumin (OVA)for sensitization in 0,14 d and intragastrically administrated in 25-31 d,once a day. After administration,2 mg/mL OVA was dropped in nose for 7 d. After 24 h of last dropping in nose,tumor necrosis factor α(TNF-α),interleukin-4(IL-4),interfer-on-γ(IFN-γ)levels in bronchoalveolar lavage fluid(BALF)were detected;pathological changes in lung tissue were observed. RE-SULTS:Totally 11 compounds were identified,the relative percentage content of 40.89％. The main components were rosmarinic acid,luteolin 7-O-β-D-rhamnoserhamnose (1→6)-α-D-pyran glucoside,hyperoside,etc. Compared with blank group,TNF-α, IL-4 levels in BALF in model group were increased,IFN-γ level was declined,and IL-4/IFN-γ ratio was enlarged(P<0.01);lung tissue was seriously damaged,there was infiltration of inflammatory cells around the blood vessels. Compared with model group, TNF-α,IL-4 levels in BALF in dexamethasone group,40％ ethanol eluate of H. officinalis high-dose,medium-dose groups were declined,IFN-γ level was increased,and IL-4/IFN-γ ratio was reduced (P<0.01);pathological changes in lung tissue were improved. CONCLUSIONS:The established analysis method can effectively analysis the chemical components of 40％ etha-nol eluate of H. officinalis,which has certain regulatory effect on releasing inflammatory factors and reducing inflammatory lesions in lung tissue of mice with bronchial asthma.

Objective To investigate the current situation of prediabetic self-efficacy of middle aged and elderly prediabetes and its influencing factors. Method Unified questionnaires were used to investigate the self-efficacy of 234 prediabetes and its influencing factors. Results The total scores of self-efficacy in the middle-aged and elder prediabetes were at moderate level. The score of the older patients was significantly higher than that of the middle aged (P<0.01). Multiple regression analysis showed that marital status and disease knowledge were main factors impacted their self-efficacy of the middle aged and family history of diabetes and the disease knowledge were the main factor affecting the self-efficacy of the elderly prediabetes. Conclusions The self-efficacy of middle-aged and elderly prediabetes is at middle level. Nurses need to enhance the knowledge of the prediabetic patients, attaching more attention to those not in marriage and those without history of diabetes so as to strengthen their self-efficacy.