Background::There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods::In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.Results::At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab. Conclusion::Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration::ClinicalTrials.gov, NCT05108766.

To summarize the nursing care of a patient with acute myocardial infarction after double knee joint replacement due to alkaptonuria.The main nursing points were as follows:strict condition monitoring,being alert to the occurrence of cardiac complications;strengthening thrombus and bleeding management to prevent related complications;early progressive rehabilitation exercise to promote functional rehabilitation of the affected limb;implementing analgesic management to improve pain symptoms;carrying out nutrition assessment and personalized nutrition support;paying attention to humanistic care,targeted psychological nursing.After careful treatment and nursing care,the patient was discharged from the hospital.After 3 months of telephone follow-up,the patient recovered well.

Objective To analyze the correlation of the main chemical components,physical parameters and the color of Fructus Sophorae in nine-steam-nine-bask processing.Methods The contents of sophoracin,genistein,rutin and 5-hydroxymethylfurfural were simultaneously determined by high performance liquid chromatography(HPLC).The content of polysaccharide was determined by ultraviolet spectrophotometry.The correlation of main components,physical parameters and the color was studied by the measurement of the physical parameters and the color(L*、a*、b*)combined with hierarchical cluster analysis(HCA),principal component analysis(PCA)and partial least squares(PLS).The criteria importance through intercriteria correlation(CRITIC)method was used to make a comprehensive evaluation of the nine-steam-nine-bask processing of Fructus Sophorae.Results The methods for the content determination and chromaticity measurement were accurate and reliable.The precision,stability and repeatability tests were good.The results of HCA and PCA showed that Fructus Sophorae,which was steamed-basked for one to four times,could be grouped into one category.Fructus Sophorae steamed-basked for five to nine times were classified into another category.PLS correlation analysis showed that the contents of polysaccharide and rutin were significantly correlated with physical parameters and color.The water absorption expansion and relative density were significantly correlated with the color.The comprehensive evaluation showed that nine-steam-nine-bask Fructus Sophorae was the best.Conclusion There is certain regularity in the overall changes of the content of main components,physical parameters and the color of Fructus Sophorae during nine-steam-nine-bask processing.The combination of the internal components,the color and physical parameters provides the basis for revealing the mechanism on nine-steam-nine-bask processing of Fructus Sophorae.

Objective Studies on the expression and location of zinc finger protein A20 (A20) and connective tissue growth factor (CTGF) in liver tissues of patients with chronic hepatitis B were conducted, and the relationship between them and liver fibrosis was determined by FibroScan. Methods Studies on A20 and CTGF in liver tissues of 160 patients with chronic hepatitis B were conducted in accordance with the stage of pathological fibrosis and inflammation of the liver, and quantitative immunohistochemistry test was conducted, and statistical analysis was conducted by FibroScan. Results The expressions of A20 and CTGF in liver tissues increased with the aggravation of liver pathological fibrosis and inflammation, and there were significant differences between each stage and the control group (P<0.05), and there were significant differences between adjacent groups (P<0.05). Studies have shown that FibroScan increases along with pathological fibrosis and inflammation in the liver. There are significant differences between the stage and the control group (P<0.05), and no significant differences between the adjacent groups (P>0.05). There was positive correlation between liver A20 and CTGF, r=0.796 (P<0.05). Conclusions In patients with chronic hepatitis B, A20, CTGF and FibroScan are positively correlated with the degree of liver fibrosis, and A20 and CTGF are also positively correlated with the degree of liver inflammation, which can be used as indicators to evaluate the degree of liver inflammation and fibrosis, and further guide the anti-inflammatory and anti-fibrosis treatment of patients.

Objective:To explore whether sleep quality suffers in patients with mild Alzheimer's disease(AD)and mild cognitive impairment(MCI), and to further investigate the correlation between sleep disorders and cognitive function in these patients.Methods:In this study, 30 mild AD patients, 39 MCI patients and 43 demographically matched healthy controls were enrolled.Sleep quality was assessed by the Pittsburgh sleep quality index(PSQI), and cognitive function was assessed by the mini-mental state examination(MMSE), the Montreal cognitive assessment(MoCA)and a set of neuropsychological scales.The correlation of sleep quality with cognitive function was analyzed for the three groups.Results:Differences were significant in sleep time score[0.0(1.0), 1.0(2.0) vs.1.0(1.0), F=8.18, P=0.02]and daytime function score[1.0(1.0), 1.0(1.0) vs.0.0(1.0), F=8.73, P=0.01]between mild AD, MCI and health control groups.Spearman correlation analysis suggested that scores of sleep disorders were negatively correlated with DSB( r=-0.43, P=0.02)and scores of daytime function were positively correlated with ADL( r=0.39, P=0.03)in patients with mild AD.In addition, scores of sleep quality were negatively correlated with the DSB score( r=-0.40, P=0.01), scores of sleep disorders were positively correlated with ADL( r=0.45, P<0.01), scores of daytime function were negatively correlated with DSF( r=-0.42, P=0.01), DSB( r=-0.62, P<0.01)and VFT-S( r=-0.33, P=0.04), and the total PSQI score was negatively correlated with DSF( r=-0.45, P=0.01)and DSB( r=-0.44, P=0.01)in the MCI group. Conclusions:Patients with mild AD and MCI have longer sleep time and impaired daytime function than healthy people, and sleep quality is correlated with memory, attention and daily living ability in patients with mild AD and MCI.

Adult ; Aged ; Altitude Sickness ; metabolism ; Bone Marrow ; metabolism ; Chronic Disease ; Humans ; Male ; Middle Aged ; Peptide Fragments ; metabolism

Bacterial Proteins ; chemistry ; Bacterial Secretion Systems ; Crystallography, X-Ray ; Legionella pneumophila ; metabolism ; Models, Molecular ; Protein Structure, Tertiary

AIM: To investigate the effects of EPA and DHA on oxidative stress of lipopolysaccharide-stimulated rat mesangial cells. METHODS: The glomerular mesangial cells (GMCs) were stimulated by lipopolysaccharide (LPS) and incubated with EPA (10 μmol/L or 100 μmol/L) and DHA (10 μmol/L or 100 μmol/L) for 24 h, 48 h and 72 h. The activity of SOD, GSH-Px and the level of MDA was measured. The protein and mRNA expressions of MCP-1 and TGF-β_1 were detected by immunocytochemistry and real-time PCR method, respectively. RESULTS: The activities of SOD and GSH-Px were decreased and the concentration of MDA was increased when stimulated with LPS. EPA and DHA increased the activities of SOD and GSH-Px and decreased the concentration of MDA significantly. Meanwhile, the protein and mRNA expressions of MCP-1 and TGF-β_1 stimulated by LPS were decreased. DHA was more effective than EPA at the same concentration. CONCLUSION: EPA and DHA enhance the activities of antioxidant enzymes, decrease the concentration of MDA and inhibit the expression of TGF-β_1 and MCP-1, suggesting that the protective effect of EPA and DHA on kidney is related to the antioxidation and the inhibition of TGF-β_1 and MCP-1 expression.

Objective To study the influence of arachidonic acid (AA) on L-type calcium channel in rabbits sin-gle cardiomyocyte and its mechanism of antiarrhythmia. Method The single ventricular cardiomyocyte was isolat-ed by using enzyme dispersion method and whole-cell clamp-patch technique was used to record L-type calcium current.All data were analyzed using ANOVA. Results AA inhibited Ica-L in a concentration-dependent manner. The application of 3 μmol/L, 10 μmol/L and 20 μmol/L arachidonic acid reduced the density of peak Ica-L from (10.79±0.93)pA/pF to (8.99±0.43)pA/pF to (7.60±0.35)pA/pF and to (5.60±0.30)pA/pF, respctive-ly (n=7, P<0. O1 ). The Ica-Lpartially resumed after washout. The AA up-shifted the I-V curves of Ica-L without changes of their shape,peak and reverse potentials. The AA also markedly shifted the inactivation curve to left, and prolonged the recorvery time from inactivation,but did not change the curve of calcium channel activation. Con-clustions By acceleration of L-type calcium channel inactivation and prolongation of recorvery time from inactiva-fion,arachidonic acid can reduce the calcium ion influe and prolong effective refractory period, playing the role of antiarrhythmia.

ObjectiveTo investigate clinical characteristics and perioperative management of abdominal aortic aneurysm in elderly patients. MethodsThe clinical data of 24 patients aged 60 years and over with abdominal aortic aneurysm in our hospital were analyzed retrospectively. ResultsThe average age was 75.5 years and the proportion of male and female was 5 : 1. The course of disease was 2 days to 15 years and the median course was 2.8 months. 17 patients were complicated with hypertension, 5 patients with coronary heart disease, 4 patients with type 2 diabetes mellitus, 3 patients with chronic bronchitis, 2 patients with lacunar cerebral infarction, 3 patients with abdominal aortic aneurysm rupture, 13 patients with endovascular stent grafts, 10 patients with abdominal aortic aneurysm resection and artificial vascular replacement, 1 patient with endovascular stent grafts, endarterectomy of right femoral artery and right deep femoral artery,right deep femoral artery plasty and the application of artificial blood vessel in right femoro-popliteal arterial bypass. Postoperative complications happened in 15 cases (62.5%, 15/24) and the postoperative mortality rate was 20.8%.ConclusionsThe elderly patients with abdominal aortic aneurysm are always complicated with manyother chronic diseases such as hypertension, coronary heart disease , diabetes mellitus, chronicbronchitis. The operation for abdominal aortic aneurysm in elderly patients has high risk. Reasonablesurgical procedure and active perioperative management are the key for successful treatment.