OBJECTIVE: To study bioactive compounds from the endophytic fungus Penicillium sp. HJT-A-6 isolated from stem of Rhodiola tibetica, and evaluate its allelopathic activity. METHODS: The chemical constituents were isolated and purified by silica gel, Sephadex LH-20 column chromatography and semi-preparative HPLC. Their structures were elucidated by extensive spectroscopic analysis and electronic circular dichroism (ECD) calculations. In addition, the allelopathic activity of compound 1 was evaluated by measuring the seed germination rate of R. tibetica. RESULTS: Two new polyketides 4-hydroxy-3,6-dimethyl-2H-pyran-2-one (1) and penilactone E (2), together with six known compounds walterolactone A (3), 5-hydroxyhexan-4-olide (4), 3-methyl-2-penten-5-olide (5), chaetoquadrin F (6), (Z)-6-acetyl-3-(1,2-dihydroxypropylidene)-5-hydroxy-8-methylchroman-2-one (7) and 4-hydroxy-3-(4-hydroxyhexanoyl)-5-methylfuran-2(5H)-one (8) were isolated from Penicillium sp. HJT-A-6. Compound 1 showed moderate seed-germination-promoting activity at a concentration of 0.001 mg/mL while inhibiting the seed germination at concentrations of 0.1 and 0.01 mg/mL. Compared with the positive drug 6-benzyladenine (6-BA), compound 1 could extend the seed-germination period of R. tibetica (up to 11 d). CONCLUSION Two new compounds were isolated from R. tibetica endophytic fungus Penicillium sp. HJT-A-6. Compound 1 displayed plant hormone-like activity, which inhibited the seed germination of the host plant at high concentrations and promoted the seed germination of the host plant at low concentrations. The results not only enrich the chemical constituents of the endophytic fungi isolated from Rhodiola tibetica, but also provide a theoretical basis for understanding the interaction mechanism between Rhodiola tibetica endophytic fungi and the host plant.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Atypical absences are generalized non-motor epileptic seizures which are one of the characteristics of developmental epileptic encephalopathy, and are typically affecting patients with cognitive and intellectual disabilities. Compared with typical absence seizures, the pathogenesis, etiology, electro-clinical characteristics, treatment, and prognosis of atypical absence seizures are more complex. This article aims to summarize the clinical characteristics and etiological research progress of atypical absence seizures, to increase clinicians′ awareness of them and provide new ideas for etiology-based diagnosis and treatment.

Objective:To investigate risk factors for failure of non-invasive ventilation(NIV)in elderly patients with acute hypercapnic respiratory failure(AHRF).Methods:Retrospective analysis was performed on the data of 100 elderly patients hospitalized for NIV treatment for AHRF at Beijing Hospital between August 2015 and August 2017.The patients were divided into an NIV failure group and an NIV success group according to patient treatment results.Logistic regression was used to analyze the related factors of NIV treatment failure in elderly patients with AHRF.Results:Of the 100 patients, there were 53 men(53.0%), with an age of(79.4±6.4)years, and 43(43.0%)failed with NIV treatment.Before NIV treatment, concurrent severe pneumonia( OR=5.109, 95% CI: 1.203-21.702, P=0.027), chest X-ray showing lesion infiltration≥3 quadrants( OR=5.903, 95% CI: 1.514-23.013, P=0.011)and a simplified acute physiology score Ⅱ(SAPS Ⅱ)≥34 points( OR=7.046, 95% CI: 2.164-22.944, P=0.001)were independent risk factors for failure of NIV treatment in elderly patients with AHRF. Conclusions:Elderly patients with AHRF face the risk of failure with NIV therapy.Before NIV treatment, concurrent severe pneumonia, chest X-ray showing lesion infiltration ≥3 quadrants and SAPS Ⅱ≥34 points are independent risk factors for failure of NIV treatment in elderly patients with AHRF.Evaluation before NIV therapy is important to prevent NIV treatment failure.

Objective:To explore the effect of rehabilitation nursing guided by precision nursing theory on the health belief and self-management behavior of patients with myocardial infarction after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 184 patients with myocardial infarction who received PCI treatment at Queshan County People's Hospital from January 2020 to January 2021 were selected as the research objects. According to the random number table method, they were divided into the observation group and the control group, with 92 cases in each group. The control group was given routine postoperative nursing, while the observation group was given rehabilitation nursing guided by precise nursing. Health Belief Scale and Self-management Scale were used to evaluate the effect of intervention.Results:Repeated measures analysis of variance showed that total scores of health beliefs and self-management behavior of patients in two groups existed time, the interaction effect between groups, time and between groups ( P<0.05) . Conclusions:Rehabilitation nursing guided by precision nursing theory can improve the health belief level and self-management behavior of patients with myocardial infarction after PCI.

Objective:To evaluate the efficacy of endovascular stenting of various types of venous sinus stenosis in idiopathic intracranial hypertension (IIH).Method:Clinical, radiological, and manometric data before and after stenting in venous sinus stenosis were retrospectively analyzed in 99 IIH patients who were refractory to medical therapy or rapidly progressed between July 2004 to July 2019. The follow-up period was between 2.3 months to 11 years.Results:Our study enrolled 21 men (21.2%)and 78 women (78.8%) with average body mass index (BMI) 19.2-40.6(27.0±4.4) kg/m2 and median age 37 years. Before stent placement, the mean transverse sinus stenosis gradient was 1-59(26±8) mmHg. Patients with extrinsic stenosis were younger than those with intrinsic and mixed stenosis. In all cases, stenting was effective for papilledema. Fifty patients complained of headaches. Pulsatile tinnitus in twenty-eight patients completely alleviated after stenting. In one patient, replacement of stent did not improve symptoms, and a subsequent CSF diversion procedure was performed and effective.Conclusion:Irrespective of the type of stenosis, stenting of venous sinus stenosis is an effective treatment for IIH. Patients with persistent papilledema post-stenting and elevated transverse pressure pre-stenting should be followed closely as high risk of stenting failure may occur and further diversion procedure is needed.

Objective To review the failure patterns and clinical outcomes for patients with cervical esophageal carcinoma (CEC) undergoing definitive radiotherapy (RT).Methods Medical records,clinical characteristics and outcomes of patients with CEC treated by definitive RT from August 2008 to May 2017 were retrospectively reviewed and analyzed.Results A total of 97 patients with squamous cell CEC were enrolled in this study with a median age of 59 years old (range 18-78 years old).There were 34 patients with limited cervical esophagus,and 63 patients with diseases beyond cervical region,respectively.There were 69,7,and 6 patients with Bronchi invasion,thyroid lobes involvement and aortic involvement,respectively.There were 11,80 and 6 patients with stage Ⅱ,Ⅲ and Ⅳ (non-regional lymph node metastases),respectively.The median dose to the gross tumor volume (GTV) was 66 Gy,in which 46 patients received above 66 Gy and 51 patients received less than 66 Gy,respectively.The median progression free survival (PFS) and overall survival (OS) were 16.03 and 23.30 months,respectively,with a median follow-up of 14.90 months.The 1,2,3-year PFS and OS were 56.86％,30.35％,26.34％,and 72.54％,47.94％,40.81％,respectively.Sixty-one patients had treatment failure at their last follow-up,in which 40,27,and 18 patients developed local failure,regional failure,and distant metastasis,respectively.Univariate analysis revealed that thyroid lobes involvement resulted in lower PFS (x2 =5.773,P＜0.05) and OS (x2 =13.461,P＜0.05),and bronchi involvement (x2 =4.283,P＜0.05) was associated with lower OS.Multivariate analysis indicated that aortic involvement and thyroid lobes involvement were associated with lower PFS (x2 =6.796,4.548,P＜0.05) and OS (x2 =13.421,10.581,P＜0.05),and GTV dose above 66 Gy was associated with higher OS (x2=5.296,P＜0.05).Conclusions Local-regional recurrence was the main failure pattern for patients with CEC after definitive RT.Aortic,thyroid lobes,and/or bronchi involvement were associated with poor prognosis,and GTV dose ≥66 Gy tended to improve OS.Prospective studies with larger population were needed to further confirm this study.

Objective To describe the characteristics of radiation induced mucositis in patients withhead and neck cancer ( HNC) during radiotherapy, and analyze the effect of radiation induced mucositis on diet patterns and weight change and the influencing factors for radiation induced mucositis. Methods Patients with HNC treated with radiotherapy in one cancer hospital were recruited. Data were collected before, during and at the end of the radiotherapy, which included radiation induced oral and pharyngeal mucositis, pain during eat-ing, diet patterns and weight. Results Two hundred and two patients were completely investigated and 43.5％and 34. 2％ of the patients suffered from moderate to severe (≥grade 2) oral mucositis and pharyngeal mucosi-tis, respectively during the radiotherapy. At the end of radiotherapy, 53. 5％ and 51. 5％ of the patients suffered from moderate to severe oral mucositis and pharyngeal mucositis (≥grade 2 ) , respectively. Oral and pharyngeal mucositis were significantly correlated with pain during eating, diet patterns and weight ( P<0. 05) . Tumor site was the main reason that affected the severity of mucositis ( Wald χ2 =26. 033, 14. 216;P<0.001). Conclusion Radiation induced mucositis was gradually aggravated with radiotherapy progress, which is closely related to pain during eating, change of diet patterns and weight loss. The severity of mucositis is re-lated to the tumor site. Measures should be taken to strengthen the management of adverse reactions and nutri-tional status of patients.

The progressive encephalopathy with edema,hypsarrhythmia,and optic atrophy (PEHO) syndrome is a unique pediatric neurodevelopmental disorder,characterized by a combination of severe mental retardation,early onset epileptic seizures,pedal edema,optic/cerebellar atrophy,and early death.The affected individuals have neither optic atrophy nor the typical neuroradiological findings has been described as PEHO-like syndrome.At present,there are few reports about PEHO syndrome in China.In this study,we summarizes the incidence,etiology,clinical manifestations,and related genes of PEHO syndrome,and aims to provide assistance for future clinical work.

Objective To analyze the function connection of the brain in smokers with resting-state fMRI.Methods Resting-state fMRI data of 53 smokers (smoking group) and 53 non-smokers (control group) were observed.The subjects in smoking group were divided into small or large amount smoking subgroup,as well as mild or severe addiction subgroup.The fractional amplitude of low-frequency fluctuation (fALFF) values of all subjects were calculated,and the differences of fALFF values and whole brain functional connectivity were observed.Results Compared with control group,fALFF significantly increased in the left limbic lobe,and decreased in the right superior temporal gyrus in smoking group.Compared to small amount smoking subgroup,fALFF significantly increased in the right superior temporal gyrus,and decreased in the bilateral limbic lobe in large amount smoking subgroup.Compared with mild addiction subgroup,fALFF significantly increased in the bilateral middle frontal gyrus,and decreased in the left limbic lobe in severe addiction subgroup.There are many increased and decreased functional connectivity brain areas in smoking group compared with control group.Conclusion There are many activity changes in addiction related brain areas and less in emotion control areas in smokers,and some brain areas activation changes are related to smoking amount and addiction level.