OBJECTIVE To establish a method for simultaneous determination of plasma concentration of lamotrigine（LTG）， levetiracetam（LEV） and perampanel（PER） in children with epilepsy and apply this method in clinical practice. METHODS Plasma proteins were precipitated with acetonitrile. Using PER-D 5 as internal standard， ultra-high performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） method was adopted. The determination was performed on ACQUITY UPLC HSS T3 C 18 column with mobile phase consisted of 0.1% formic acid with 5 mmol/L ammonium acetate-acetonitrile （gradient elution） at the flow rate of 0.3 mL/min. The column temperature was 40 ℃， and sample size was 5 μL. The analysis time was 5 min. The electrospray ionization source and multiple reaction monitoring mode were used for positive ion scanning. The ion pairs used for quantitative analysis of LTG， LEV， PER and internal standard were m / z 255.9→144.9， m / z 171.1→126.1， m / z 350.1→219.0 and m / z 354.9→220.2， respectively. The steady-state trough concentrations of the aforementioned drugs in the plasma of 14 pediatric epilepsy patients receiving combination therapy were determined using the same UPLC-MS/MS method as above. RESULTS The linear ranges of LTG， LEV and PER were 0.15-24 μg/mL （ R 2 ＞0.993）， 0.312 5-50 μg/mL （ R 2 ＞0.997） and 6.25-1 000 ng/mL （ R 2 ＞0.997）， respectively. The lower limits of quantification were 0.15 μg/mL， 0.312 5 μg/mL and 6.25 ng/mL， respectively. RSDs of intraday and interday precision tests of the three drugs were no more than 9.83%， and the accuracies （relative errors） were between －9.33% and 13.72%（ n ＝6 or n ＝18）； the average extraction recovery rates were 86.4%-97.9%， and the average matrix effects were 86.9%-110.0% （ n ＝6）. The absolute values of the relative errors in the stability tests were all below 15%. The steady-state trough concentrations of LTG， LEV and PER were （5.64±4.03）μg/mL， （10.67±8.78）μg/mL and（450.20±251.27）ng/mL， respectively； the rates of achieving target trough concentrations were 71.4%， 37.5% and 84.6%， respectively. CONCLUSIONS The established UPLC-MS/MS method is specific， rapid and suitable for the plasma concentration monitoring in epileptic children receiving combination therapy.

BACKGROUND:In recent years,numerous studies have shown that autophagy and mitophagy play an important role in the regulation of bone metabolism.Under non-physiological conditions,mitophagy breaks the balance of bone metabolism and triggers metabolism disorders,which affect osteoblasts,osteoclasts,osteocytes,chondrocytes,bone marrow mesenchymal stem cells,etc. OBJECTIVE:To summarize the mechanism of mitophagy in regulating bone metabolic diseases and its application in clinical treatment. METHODS:PubMed,Web of Science,CNKI,WanFang and VIP databases were searched by computer using the keywords of"mitophagy,bone metabolism,osteoblasts,osteoclasts,osteocytes,chondrocytes,bone marrow mesenchymal stem cells"in English and Chinese.The search time was from 2008 to 2023.According to the inclusion criteria,90 articles were finally included for review and analysis. RESULTS AND CONCLUSION:Mitophagy promotes the generation of osteoblasts through SIRT1,PINK1/Parkin,FOXO3 and PI3K signaling pathways,while inhibiting osteoclast function through PINK1/Parkin and SIRT1 signaling pathways.Mitophagy leads to bone loss by increasing calcium phosphate particles and tissue protein kinase K in bone tissue.Mitophagy improves the function of chondrocytes through PINK1/Parkin,PI3K/AKT/mTOR and AMPK signaling pathways.Modulation of mitophagy shows great potential in the treatment of bone diseases,but there are still some issues to be further explored,such as different stages of drug-activated mitophagy,and the regulatory mechanisms of different signaling pathways.

Objective To discuss the CT features of the recurrent intussusception in pediatric patients after air-enema intestinal reduction,and to analyze its influencing factors.Methods The clinical data of child patients with intussusception,whose diagnosis was initially confirmed and treated with air-enema intestinal reduction at the Children's Hospital of Soochow University from January 2020 to May 2022,were retrospectively analyzed.The general data,clinical characteristics and CT imaging findings were collected.Logistic regression analysis was used to determine the factors related to the recurrence of the intussusception.Results A total of 162 child patients were enrolled in this study,among them 103 child patients were males,the mean age was 2.3 years(3 months to 5 years).Thirty-two children(19.75％,recurrent group)developed in-hospital recurrence of intussusception after successful air-enema intestinal reduction.Univariate analysis showed that the incidences of intussusception length,intussusception thickness,target-shaped mass sign,comet's tail sign and enlarged mesenteric lymph nodes in the recurrent group were remarkably higher than those in the non-recurrent group,the differences were statistically significant(all P＜0.05).No statistically significant difference in the incidence of ascites existed between the two groups(P＞0.05).Multivariate logistic regression analysis revealed that age＞3 years(OR=2.10,95％CI=1.25-2.94,P＜0.01),enlarged mesenteric lymph nodes(OR=2.05,95％CI=1.07-2.68,P＜0.01),and the target-shaped mass sign(OR=3.32,95％CI=1.53-6.62,P＜0.01)were the independent influencing factors for the recurrence of intussusception in child patients with intussusception after receiving air-enema intestinal reduction.Conclusion Age＞3 years,enlarged mesenteric lymph nodes and target-shaped mass sign are the risk factors for the recurrence of intussusception in child patients with intussusception after receiving air-enema intestinal reduction.

肿瘤免疫治疗主要通过调节机体免疫和肿瘤之间的平衡来实现肿瘤治疗的目的，已证实对多种肿瘤具有显著的临床 疗效，被认为是继手术、化疗、放疗后又一重要的治疗方法。但目前肿瘤免疫治疗尚无统一的临床应用方案，对不同的肿瘤或同 一肿瘤的不同个体疗效差异巨大，严重制约其发展。既往研究发现,影响免疫检查点抑制剂反应和耐药性的关键因素包括肿瘤本 身的特征（如癌症基因组、表观基因组和微环境）、肿瘤免疫表型、宿主免疫组分（全身免疫和抗肿瘤免疫）及其他的外部影响。然 而，最新研究表明，肿瘤突变负荷、DNA修复基因、HLA基因型、PD-L1表达以及肿瘤免疫抑制微环境与免疫检查点抑制剂的反 应密切相关。因此，本文将从肿瘤突变负荷、DNA修复基因、HLA基因型、PD-L1表达以及肿瘤免疫抑制微环境等5个方面阐述 其影响免疫检查点抑制剂的新机制，旨在为肿瘤的靶向治疗提供借鉴。

Objective To explore the effects of α-keto acid combined with low protein diet on oxidative stress and electrolyte levels in patients with diabetic nephropathy. Methods Ninety-eight cases with type 2 diabetic nephropathy were randomLy divided into the treatment group(low-protein diet with α-keto acid 1 tablet,n=58) and the control group(normal protein intake,n=40). The 24 h urinary albumin excretion rate,glomerular filtra-tion rate ,serum oxidative stress (SOD ,MDA ,AOPPs) and electrolyte levels were measured before and after treatment. Results After 24 weeks of treatment,the 24 h urinary albumin excretion rate of DN patients in the treatment group was significantly lower than that before treatment and the control group (P < 0.05). However, there was no significant change in the glomerular filtration rate of the patients. Compared with the control group , the serum SOD activity of DN patients was significantly increased and the levels of MDA and AOPPs were decreased(P < 0.05)after 24 weeks of treatment. Simultaneously,the levels of serum potassium and phosphorus in the treatment group was decreased ,while the levels of calcium and magnesium were improved (P < 0.05). Conclusion α-keto acid combined with low protein diet can significantly reduce the urinary albumin excretion rate,improve the body′s antioxidant activity,and maintain serum electrolytes balance.

Objective To investigate the correlation between ADAM33 T1, S2 gene polymorphism and Bronchial asthma risk in china. Methods We retrived the relevant published studies about ADAM33 T1, S2 gene polymorphism and bronchial asthma risk. Then we divided the population into Chinese and other Asian population. Odds ratio (OR) of Case group and control group was selected as the effect index. Stata 11.0 software was used to calculate heterogeneity test, ORs and 95%CI of two areas, and gave the forest plot and funnel plot of meta results. Results A total of 27 studies were included in this analysis,18 studies in ADAM33 T1 site were 3881 cases in case group, and 3780 cases in control group;and 14 studies in ADAM33 S2 site were 3222 cases in case group, and 3513 cases in control group. Additive model, dominant model, recessive model of ADAM33 T1 in Chinese had association with the susceptibility of bronchial asthma. The results were OR=1.488, 95% CI:1.002-2.167 in Additive model, OR=1.619, 95%CI:1.059-2.475 in dominant model;OR=2.523, 95%CI:1.910-3.333 in recessive model. Three models of ADAM33 T1 in other Asian country had no association with the susceptibility of Bronchial Asthma. Three gene model of ADAM33 S2 in Asian had no association with bronchial asthma susceptibility. Except ADAM33 T1 polymorphism in recessive model, other mode of T1, S2 had no publication bias in Chinese population. Conclusion There are association between ADAM33 T1 gene polymorphism and bronchial asthma, but ADAM33 S2 gene polymorphism and bronchial asthma have no association in Chinese population.

A study program was worked out by analyzing the papers on Chinese drug prescriptions. A database of Chinese drug prescriptions was developed by automatic abstraction of data from the papers on Chinese drug pre-scriptions using the regular expression form in order to provide a new visual angle for studying the information in Chinese drug prescriptions.

New strategies to improve vaccine efficacy against human immunodeficiency virus type 1 (HIV-1) are still required. DNA vaccines, exhibiting potential advantages over conventional vaccines for their simplicity and versatility, can induce specific humoral and cellular immune responses. We developed a recombinant pVAX1 DNA vector carrying p24 gene of HIV-1. The results showed that pVAX1 mediated gene possessed the ability of effective expression in both transfected 293T cells and BALB/c mice. And pVAX1-p24 DNA prime and boost immunization can induce significant P24-specific humoral immune responses and cellular immune responses in BALB/c mice. Furthermore, immunization with pVAX1-p24 DNA prime and protein boost induced 7.3 to 8.0-fold greater p24-specific humoral responses than pVAX1-p24 DNA prime and boost, while the cellular immune responses induced by combined immunization was lower. The results suggested that pVAX1-p24 DNA and P24 protein vaccine is a promising HIV-1 vaccine, and the selections of the immunization strategies are important for the immunization results.
AIDS Vaccines ; genetics ; immunology ; Animals ; DNA ; genetics ; immunology ; HEK293 Cells ; HIV Core Protein p24 ; genetics ; immunology ; Humans ; Immunization ; Mice ; Mice, Inbred BALB C ; Vaccines, DNA ; genetics ; immunology

RNA silencing is a conserved eukaryotic pathway involved in the suppression of gene expression via sequence-specific interactions that are mediated by 21-23 nt RNA molecules. During infection, RNAi can act as an innate immune system to defend against viruses. As a counter-defensive strategy, silencing suppressors are encoded by viruses to inhibit various stages of the silencing process. These suppressors are diverse in sequence and structure and act via different mechanisms. In this review, we discuss whether RNAi is a defensive strategy in mammalian host cells and whether silencing suppressors can be encoded by mammalian viruses. We also review the modes of action proposed for some silencing suppressors.
Animals ; Gene Expression Regulation, Viral ; Gene Silencing ; Host-Pathogen Interactions ; Humans ; Mammals ; virology ; MicroRNAs ; genetics ; metabolism ; Plant Viruses ; physiology ; Plants ; virology ; RNA, Small Interfering ; genetics ; metabolism ; Repressor Proteins ; genetics ; metabolism ; Viral Proteins ; genetics ; metabolism ; Viruses ; growth & development

Objective To observe and assess the effect of different dosages of aspirin on inflammatory biomarkers, hemorheology (platelet aggregation rate) and clinical prognosis in patients with acute coronary syndrome ( ACS). Methods ACS patients were randomly assigned to receive different dosages of aspirin treatment orally. Patients in group A,B and C took 100 mg, 500 mg and 1000 mg of aspirin per day respectively. They were treated and followed-up for 1 year. High-sensitivity C-reactive protein ( hsCRP) , IL-6, tumor necrosis TNFot and platelet aggregation rate were examined and major adverse cardiac events( MACE) were recorded. Results A total of 312 patients with ACS were enrolled in the study. The baseline characteristics of the three groups were not different with respect to age, gender, cardiovascular risk profile, level of inflammatory biomarkers and concomitant treatment before and after randomization. The levels of baseline serum hsCRP, IL-6 and TNFa were higher in subjects of the study as compared with normal reference value (P<0. 05, <0. 05, <0. 01) and they decreased significantly after therapy with 3 different doses of aspirin (detected at 30 days, 6 months and 12 months, P <0. 001 ) , but there were no significant differences among the three groups( P >0. 05) . Rehospitalization , MACE and the change of platelet aggregation ratio were not significantly different among the three groups. The incidence of gastrointestinal complaints was significantly higher in groups B and C than in group A ( P < 0. 05 ). Conclusions The levels of serum inflammatory biomarker increase in patients with ACS. Aspirin therapy may decrease the level of inflammatory markers significantly, but increasing the dosage of aspirin from 100 mg to 1000 mg daily does not decrease the level of inflammatory markers and the clinical MACEs further. However, the incidence of gastrointestinal complaints increase significantly with the increase of aspirin dosage.