Objective To explore the characteristics of the cross-sectional area(CSA)of the vagus nerve in a healthy population in Qujing,Yunnan,and its correlation with demographic characteristics.Methods High-resolution nerve ultrasound examinations were conducted on the vagus nerve of 201 healthy volunteers from a hospital in Qujing,Yunnan from September 2022 to March 2023.The CSA was measured through transverse scans of the vagus nerve.The correlation of vagus nerve CSA with age,body mass index(BMI),and gender was assessed.Results The mean CSA of the bilateral VN were 1.9 mm2(right)and 1.3 mm2(left),respectively.The average CSA of the right vagus nerve was significantly greater than that of the left(P<0.001).In the high-age group(>50 years),the average CSA of the right vagus nerve was significantly higher than that of the low-age group(≤50 years)(P=0.0142).However,there was no statistically significant difference in the average CSA of the right vagus nerve between the BMI>24 kg/m2 group and the≤24 kg/m2 group(P=0.0852).The average CSA of the left vagus nerve showed no statistically significant differences across different age groups and BMI groups(P>0.05),but the average CSA of the bilateral vagus nerve in the male group was greater than that in the female group,with a statistically significant difference(P<0.05).Correlation analysis further confirmed a negative correlation between the average CSA of the right vagus nerve and age(r=-0.17,P=0.0139).Multiple linear regression models indicated that age(P=0.007)and gender(P=0.001)were independent influencing factors for the average CSA of the right vagus nerve.Conclusion In the healthy population of Qujing,Yunnan,the CSA of the right vagus nerve is significantly greater than that of the left,and males also exhibit a significantly greater CSA than females.With increasing age,the vagus nerve gradually becomes thinner.

Background::Although the treatment of peripheral T-cell lymphoma (PTCL) has undergone advancements during the past several years, the response rate and long-term effects with respect to patients with PTCL remain unsatisfactory—particularly for relapsed or refractory (R/R) patients. This phase II trial was designed to explore the efficacy and safety of an all-oral regimen of chidamide plus prednisone, cyclophosphamide, and thalidomide (CPCT) for R/R PTCL patients who could not tolerate the standard chemotherapy for a variety of reasons.Methods::We conducted a multicenter phase II clinical trial in which we combined chidamide (30 mg twice weekly) with prednisone (20 mg daily after breakfast), cyclophosphamide (50 mg daily after lunch), and thalidomide (100 mg daily at bedtime) (the CPCT regimen) for a total of fewer than 12 cycles as an induction-combined treatment period, and then applied chidamide as single-drug maintenance. Forty-five patients were ultimately enrolled from August 2016 to April 2021 with respect to Chinese patients at nine centers. Our primary objective was to assess the overall response rate (ORR) after the treatment with CPCT.Results::Of the 45 enrolled patients, the optimal ORR and complete response (CR)/CR unconfirmed (CRu) were 71.1% (32/45) and 28.9% (13/45), respectively, and after a median follow-up period of 56 months, the median progression-free survival (PFS) and overall survival (OS) were 8.5 months and 17.2 months, respectively. The five-year PFS and OS rates were 21.2% (95% confidence interval [CI], 7.9-34.5%) and 43.8% (95% CI, 28.3-59.3%), respectively. The most common adverse event was neutropenia (20/45, 44.4%), but we observed no treatment-related death.Conclusion::The all-oral CPCT regimen was an effective and safe regimen for R/R PTCL patients who could not tolerate standard chemotherapy for various reasons.Trial Registration::ClinicalTrials.gov, NCT02879526.

Objective To observe the clinical effect of traditional Chinese medicine bone-setting technique using spinal,pelvi-lower extremity line to treat patients with knee osteoarthritis(KOA).Methods 426 patients with KOA were all from the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine.They were randomly divided into experimental group(384 cases,57 cases of elimination,shedding and termination)by computer generated sequence.Traditional Chinese bone setting techniques were applied with spinal-pelvic-lower limb force line(divided into three parts:lumbar fixed point reduction method,hip joint push-pull and extension method and knee peripheral tendon recovery method every 3 days.2 weeks)treatment;The control group was the waiting treatment group(48 cases,6 cases were eliminated,abscission,termination),which was only used for clinical observation for 2 weeks.The main outcome index was WOMAC pain score.Secondary outcome measures were WOMAC stiffness score,functional score,standardized score and quality of life score(SF-12).The test time points were baseline,2 weeks after enrollment,and follow-up(14 weeks after enrollment).The control group was at baseline and 2 weeks after enrollment.Results Compared with baseline,WOMAC pain score,stiffness score,functional score and standardized score were all decreased in 2 groups 2 weeks after enrollment(P<0.05),but the experimental group was significantly decreased compared with the control group(P<0.001).SF-12 quality of life scores were all higher than before(P<0.001),but the experimental group was significantly higher than the control group(P<0.001).At follow-up,compared with 2 weeks after enrollment,WOMAC pain scores were increased(P<0.001),WOMAC stiffness,joint function and standardized scores were decreased(P<0.001),and SF-12 scores were increased(P<0.001).Conclusion The use of spinal-pelvi-lower extremity line of traditional Chinese medicine bone-setting technique in the treatment of KOA is effective in improving the knee joint function and improving the quality of life of patients,but the short-term effect of pain relief is good,and the long-term effect is not good.Its safety is good,and it can be considered in clinical application for KOA patients with joint dysfunction as the main manifestation.

Objective:To investigate the effect of salvia miltiorrhiza-derived Sal-miR-58 on the radiosensitivity of glioma U251 cells and its possible mechanism. Methods:Glioma U251 cells were treated with different concentrations of miR-Ctl or Sal-miR-58 mimic, and subsequently treated with radiation to establish the radiotherapy model in vitro. The effect of Sal-miR-58 upon U251 cell viability was assessed by MTT assay. The effect of Sal-miR-58 on apoptosis of glioma U251 cells was evaluated by Hoechst33342/ propidium iodide (PI) staining. The changes of reactive oxygen species (ROS) content in U251 cells were detected by 2',7'-dichlorodihydrofluorescein diacetate (DCFH-DA) fluorescent probe. The effect of Sal-miR-58 combined irradiation on the radiosensitivity of U251 cells was detected by clone formation assay. The expression levels of HCLS1-related protein X-1 (HAX1), apoptosis marker proteins B cell lymphoma 2 (Bcl-2), cleaved-cysteine-containing aspartate-specific protease (Cleaved-Caspase) 9 and Cleaved-Caspase 3 were detected by Western blot. Multi-group comparison was conducted by one-way ANOVA. Two-group comparison was performed by independent sample t-test. Results:Sal-miR-58 could exacerbate the inhibition of U251 cell proliferation after irradiation ( P<0.05). Sal-miR-58 could promote the apoptosis of U251 cells and increase the production of ROS in U251 cells after radiation ( P<0.05). Clone formation assay showed that Sal-miR-58 increased the radiosensitivity of U251 cells, with a radiosensitization ratio of 1.43. Western blot showed that Sal-miR-58 inhibited the expression of HAX1 in U251 cells. Sal-miR-58 could inhibit the expression of Bcl-2 and increase the activation of Caspase 3 and Caspase 9 by reducing the expression of HAX1. Conclusions:Sal-miR-58 enhances the radiosensitivity of U251 cells. The possible mechanism is that Sal-miR-58 inhibits the expression of HAX1 induced by radiation and accelerates the apoptosis process of tumor cells.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Humans ; Electronic Health Records ; Phenotype ; Renal Insufficiency, Chronic/epidemiology* ; Databases, Factual ; Algorithms

Adventitia ; Atherosclerosis/genetics* ; Cell Communication ; Humans ; Hyperhomocysteinemia/genetics* ; Sequence Analysis, RNA

Objective:To retrospectively analyze the clinical and genetic features of PCDH19 gene mutation related epilepsy in 11 families. Methods:The clinical manifestations and genetic mutation characteristics of 13 children (from 11 families) diagnosed with PCDH19 gene mutation related epilepsy at the Department of Pediatric Neurology, the Third Affiliated Hospital of Zhengzhou University from March 2013 to July 2019 were analyzed. Results:(1) The results of PCDH19 gene mutations: among 11 probands, 10 children had point mutations of PCDH19 gene and one child was with Exon 5 deletion.One male patient was detected with mosaic PCDH19 mutation, which was c. 840C > A, and the proportion of variation was 34.27%.Five hereditary and 6 de novo mutations were identified in 11 probands.Three patients inherited mutations from their clinically asymptomatic fathers with hemizygous mutation.Two patients inherited from their mothers, 1 case was diagnosed with epilepsy and the other was asymptomatic carrier.(2) Clinical features: there were 12 females and 1 male in the enrolled 13 children, with the age of onset of less than 2 years old.The clinical phenotypes: epilepsy with mental retardation in 9 patients, which including 3 patients with Dravet syndrome, and the remaining 4 patients were epilepsy without mental retardation.The phenotypic heterogeneity was observed in females with identical mutations from the same family, and a few girls can be asymptomatic.In all patients, seizures in clusters were observed in all 13 cases, fever sensitivity in 12 cases, and status epilepticus was only found in 3 cases.Of all the patients, only 2 cases had no seizures for more than 2 years, 3 cases with Dravet syndrome were given 6 to 8 kinds of antiepileptic drugs successively, but there were still frequent seizures. Conclusions:Most patients with PCDH19 mutations-related epilepsy are females, while rare mosaic males can be affected, phenotypic heterogeneity is obvious.Seizures in clusters and fever sensitivity are the major clinical features, and most patients are companied with different levels of intellectual impairment.Mutations in PCDH19 can be inherited or de novo, most of which are point mutations.

OBJECTIVE:To observe the efficacy and safety of Compound yimucao oral liquid combined with oxytocin in the prevention of postpartum hemorrhage and promotion of uterine involution for puerpera of vaginal delivery. METHODS:240 preg-nants with natural childbirth of vaginal delivery were randomly divided into control group and observation group. Control group was injected oxytocin 20 U in buttock after delivery. Observation group was additionally treated with Compound yimucao oral liquid 20 ml,tid for consecutive 2 weeks. Postpartum vaginal bleeding,uterine involution and incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with control group,postpartum hemorrhage volume after delivery 2-24 h,incidence of post-partum hemorrhage,uterus size,uterine hemorrhage and lochia duration in postpartum 42 d in observation group were significantly better than control group,the differences were statistically significant(P<0.05);there were no significant differences in the hemor-rhage postpartum volume after delivery 1 h and 1-2 h and fundal height in postpartum 42 d in 2 groups(P>0.05). There were no fever,rash,nausea and other obvious adverse reactions in 2 groups. CONCLUSIONS:Compound yimucao oral liquid combined with oxytocin can obviously decrease the postpartum bleeding and promote uterine involution,with good safety.

To observe the clinical effect of compound Yimucao oral liquid on postpartum lochiorrhea. Methods:A to-tal of 200 patients with postpartum lochiorrhea were randomly divided into the observation group ( 100 cases ) and the control group (100 cases). The patients in the observation group received 20ml compound Yimucao oral liquid three times a day for seven days, while those in the control group were given 15g Yimucao granules three times a day for seven days. After the treatment, the duration, amount, color and quality of lochia, lower abdominal pain, uterine involution and the status of postpartum infection in the two groups were compared. Results: The total effective rate in the observation (94. 0%) was higher than that in the control group(84. 0%). Compared with that in the control group, less average hemostasis time, better situation of abdominal pain, uterine involution and lower postpartum infection rate in the observation group were observed after the treatment(P<0. 05). Conclusion:Compound Yimucao oral liquid can promote the uterine involution. It’ s effective and safe in the treatment of postpartum lochirrhea.