Objective:To explore the efficacy and prognosis of preoperative treatment based on arterial infusion chemotherapy (PTAC) in patients with advanced gastric cancer.Methods:Clinical and follow-up data of 821 patients with advanced gastric cancer who received PTAC treatment at the General Hospital of the Eastern Theater Command of the People's Liberation Army from January 2001 to January 2021 were collected. According to the treatment regimen, patients were divided into the FLEEOX group (89 cases), the XEEOX group (196 cases), the SEEOX group (406 cases), and the SEEOX+PD-1 group (130 cases). The primary endpoint was the 3-year progression-free survival rate. Secondary endpoints included the 3-year overall survival rate, objective response rate, radical resection rate, major pathological response rate, and incidence of treatment associated adverse events.Results:After PTAC treatment, the objective response rate was 74.9% (615/821). A total of 671 patients underwent radical surgery, with a radical resection rate of 81.7% and an R0 resection rate of 70.2% (576/821). The pathological complete response rate was 16.7% (112/671), and the major pathological response rate was 32.2% (216/671). With an average follow-up of 27.7 months, the 3-year progression-free survival rate was 52.2%, and the 3-year overall survival rate was 55.8%. The 3-year progression-free survival rate of patients in the SEEOX+PD-1 group was 66.9%, the objective response rate was 83.8% (109/130), the major pathological response rate was 45.3% (53/117), and the radical resection rate was 90.0% (117/130), all of which were better than those in the XEEOX and SEEOX groups (all P＜0.05). However, during the treatment period, three patients in the SEEOX+PD-1 group died from immune-related adverse events. Conclusion:PTAC treatment is an effective preoperative treatment method for advanced gastric cancer, and is expected to further improve the treatment effect when combined with immunotherapy such as PD-1 monoclonal antibodies.

Objective:To explore the efficacy and prognosis of preoperative treatment based on arterial infusion chemotherapy (PTAC) in patients with advanced gastric cancer.Methods:Clinical and follow-up data of 821 patients with advanced gastric cancer who received PTAC treatment at the General Hospital of the Eastern Theater Command of the People's Liberation Army from January 2001 to January 2021 were collected. According to the treatment regimen, patients were divided into the FLEEOX group (89 cases), the XEEOX group (196 cases), the SEEOX group (406 cases), and the SEEOX+PD-1 group (130 cases). The primary endpoint was the 3-year progression-free survival rate. Secondary endpoints included the 3-year overall survival rate, objective response rate, radical resection rate, major pathological response rate, and incidence of treatment associated adverse events.Results:After PTAC treatment, the objective response rate was 74.9% (615/821). A total of 671 patients underwent radical surgery, with a radical resection rate of 81.7% and an R0 resection rate of 70.2% (576/821). The pathological complete response rate was 16.7% (112/671), and the major pathological response rate was 32.2% (216/671). With an average follow-up of 27.7 months, the 3-year progression-free survival rate was 52.2%, and the 3-year overall survival rate was 55.8%. The 3-year progression-free survival rate of patients in the SEEOX+PD-1 group was 66.9%, the objective response rate was 83.8% (109/130), the major pathological response rate was 45.3% (53/117), and the radical resection rate was 90.0% (117/130), all of which were better than those in the XEEOX and SEEOX groups (all P＜0.05). However, during the treatment period, three patients in the SEEOX+PD-1 group died from immune-related adverse events. Conclusion:PTAC treatment is an effective preoperative treatment method for advanced gastric cancer, and is expected to further improve the treatment effect when combined with immunotherapy such as PD-1 monoclonal antibodies.

Objective: Cognition impairments are considered as a fundamental characteristic of severe mental disorders (SMD). Recent studies suggest that hyperprolactinemia may exert a detrimental influence on cognitive performance in patients with SMD. The objective of this study was to investigate the correlation between serum prolactin levels and cognitive function in female individuals diagnosed with SMD. Methods: We conducted a study on 294 patients with SMD and 195 healthy controls, aged between 14 to 55 years old. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), while prolactin levels were measured in serum. Descriptive analysis and comparative analysis were performed to compare cognitive function and prolactin levels between groups, and linear regression models were used to explore the relationship between prolactin and cognitive function. Results: Compared to the healthy control, individuals with SMD exhibited significantly higher levels of prolactin, while scoring lower on RBANS total and every index scores. Furthermore, a negative association between prolactin levels and cognitive function (RBANS total index score, attention, and delayed memory) was observed in SMD patients. Importantly, this inverse correlation between prolactin and cognition function (RBANS total index score, total scale score, and attention) persisted in patients who were not taking medications that could potentially influence serum prolactin levels. Conclusion Our study reveals a significant correlation between elevated prolactin levels and cognitive impairment in female patients with SMD, underscoring the importance of monitoring prolactin levels in order to prevent cognitive deterioration among female SMD patients.

Objective: Sex differences have been observed in many aspects of schizophrenia, including cognitive deficits. Despite extensive research into the relationship between metabolic factors and cognitive deficits in schizophrenia, few studies have explored the potential sex difference in their association. Methods: We recruited 358 schizophrenia patients and 231 healthy controls. The participants underwent measurements of body mass index (BMI), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. Metabolic risk factors included abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. A collection of these metabolic risk factors has been defined as metabolic syndrome. These diagnoses were based on the criteria of the National Cholesterol Education Program’s Adult Treatment Panel III. Cognitive performance was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A descriptive analysis, difference analysis, and linear regression model were used to identify the metabolic risk factors for cognitive function in schizophrenia. Results: Our findings revealed sex differences in the rate of abdominal obesity and hypertension in schizophrenic patients. Additionally, we observed sex differences in the association between metabolic risk factors and cognitive impairment in schizophrenia. Specifically, hyperglycemia was associated with the immediate memory index score of RBANS in male patients, while dyslipidemia was associated with language, attention, delayed memory index scores, and RBANS total score in female patients. Conclusion Our results suggest that sex should be considered when evaluating the impact of metabolic disorders on the cognitive function of schizophrenic patients. Moreover, our study identifies hyperglycemia and dyslipidemia as potential targets for precise treatment by sex stratification, which could benefit the improvement of cognitive impairment in schizophrenic patients.

Objective:To investigate the effect of triptolide on the apoptosis of human melanoma A375 cells through the inositol-requiring enzyme 1 (IRE1) /c-Jun N-terminal kinase (JNK) signaling pathway, and to explore its possible mechanisms.Methods:Cultured A375 cells were treated with triptolide at different concentrations of 0, 50, 100, 200 nmol/L (experimental control group, 50, 100, 200 nmol/L triptolide groups, respectively), and a blank control group (DMEM high-glucose medium without cells) was set up. Methyl thiazol tetrazolium (MTT) assay was performed to evaluate the cell viability at 24, 48, and 72 hours after the start of treatment, flow cytometry to detect cell apoptosis at 24 hours after the start of treatment, and real-time fluorescence-based quantitative PCR (RT-qPCR) and Western blot analysis were conducted to determine mRNA and protein expression of IRE1, JNK, and c-Jun, respectively. After pretreatment with the JNK inhibitor SP600125 for 72 hours, some A375 cells were then treated with 100 nmol/L triptolide for 24 hours (SP600125 + 100 nmol/L triptolide group), and the A375 cells only treated with 100 nmol/L triptolide served as control group (100 nmol/L triptolide group). Effects of triptolide on the mRNA expression of IRE1, JNK, and c-Jun in A375 cells, as well as on cell apoptosis, were investigated. Statistical analysis was performed using two-way analysis of variance, one-way analysis of variance, and Dunnett′s test.Results:After the treatment with different concentrations of triptolide for different durations, the cell viability was significantly lower in all triptolide groups than in the experimental control group ( Ftriptolide concentration = 18.36, P = 0.002), and gradually decreased over time ( F time = 8.54, P = 0.018). After 24-hour treatment, the apoptosis rate of A375 cells significantly differed among the 4 groups treated with different concentrations of triptolide ( F = 5 234.97, P < 0.001) ; additionally, the apoptosis rate was significantly higher in the 50, 100, and 200 nmol/L triptolide groups (16.99% ± 0.33%, 30.78% ± 0.40%, 38.91% ± 0.51%, respectively) than in the experimental control group (4.33% ± 0.02%, all P < 0.05), and gradually increased with the rising concentrations of triptolide. The mRNA expression levels of IRE1, JNK, and c-Jun were all significantly higher in the 50, 100, and 200 nmol/L triptolide groups than in the experimental control group (all P < 0.05), and gradually increased with the increase of triptolide concentration. Moreover, the protein expression levels of IRE1, JNK, c-Jun, p-JNK, and p-c-Jun in A375 cells in the triptolide groups also showed the same trend. After pretreatment with the JNK inhibitor SP600125 for 72 hours, the apoptosis rate was significantly lower in the SP600125 + 100 nmol/L triptolide group (21.88% ± 0.55%) than in the 100 nmol/L triptolide group without SP600125 pretreatment (30.78% ± 0.40%, t = -22.51, P < 0.001), and the mRNA expression levels of IRE1, JNK, and c-Jun were also significantly decreased in the SP600125 + 100 nmol/L triptolide group compared with the 100 nmol/L triptolide group (all P < 0.05) . Conclusion:Triptolide may induce apoptosis of human melanoma A375 cells by activating the IRE1/JNK signaling pathway.

Background::High-dose dual therapy (HDDT) with proton pump inhibitors (PPIs) and amoxicillin has attracted widespread attention due to its favorable efficacy in eradicating Helicobacter pylori ( H. pylori). This study aimed to compare the efficacy and safety of high-dose PPI–amoxicillin dual therapy and bismuth-containing quadruple therapy for H. pylori rescue treatment. Methods::This was a prospective, randomized, multicenter, non-inferiority trial. Patients recruited from eight centers who had failed previous treatment were randomly (1:1) allocated to two eradication groups: HDDT (esomeprazole 40 mg and amoxicillin 1000 mg three times daily; the HDDT group) and bismuth-containing quadruple therapy (esomeprazole 40 mg, bismuth potassium citrate 220 mg, and furazolidone 100 mg twice daily, combined with tetracycline 500 mg three times daily; the tetracycline, furazolidone, esomeprazole, and bismuth [TFEB] group) for 14 days. The primary endpoint was the H. pylori eradication rate. The secondary endpoints were adverse effects, symptom improvement rates, and patient compliance. Results::A total of 658 patients who met the criteria were enrolled in this study. The HDDT group achieved eradication rates of 75.4% (248/329), 81.0% (248/306), and 81.3% (248/305) asdetermined by the intention-to-treat (ITT), modified intention-to-treat (MITT), and per-protocol (PP) analyses, respectively. The eradication rates were similar to those in the TFEB group: 78.1% (257/329), 84.2% (257/305), and 85.1% (257/302). The lower 95% confidence interval boundary (–9.19% in the ITT analysis, –9.21% in the MITT analysis, and –9.73% in the PP analysis) was greater than the predefined non-inferiority margin of –10%, establishing a non-inferiority of the HDDT group vs. the TFEB group. The incidence of adverse events in the HDDT group was significantly lower than that in the TFEB group (11.1% vs. 26.8%, P < 0.001). Symptom improvement rates and patients’ compliance were similar between the two groups. Conclusions::Fourteen-day HDDT is non-inferior to bismuth-containing quadruple therapy, with fewer adverse effects and good treatment compliance, suggesting HDDT as an alternative for H. pylori rescue treatment in the local region. Trial registration::Clinicaltrials.gov, NCT04678492.

OBJECTIVETo assess the value of combined fetal karyotyping and chromosomal microarray analysis (CMA) for the verification of high-risk pregnancy signaled by noninvasive prenatal screening (NIPS) based on high-throughput sequencing.

METHODSOne hundred and fifty-one pregnant women with high risks for aneuploidies of chromosomes 13, 18, 21, X and Y or pathological copy number variations (CNVs) by NIPS were subjected to amniocytic karyotyping and CMA analysis.

RESULTSOne hundred and forty-two women were found to have a high risk for fetal chromosomal aneuploidies, which included 83 cases of trisomy 21, 17 cases of trisomy 18, 2 cases of trisomy 13, and 40 cases of sex chromosome aneuploidies. Amniocytic karyotyping and CMA analysis has confirmed 81 cases of trisomy 21, 15 cases of trisomy 18, 10 cases of 47,XXY, 4 cases of 47,XXX, 2 cases of 47,XYY and 1 case of 46,X,del(X)(q26.1). Two trisomy 21, two trisomy 18, 2 trisomy 13, and 23 cases of sex chromosomal aneuploidies were verified as false positives. For 9 women with pathological fetal CNVs detected by NIPS, combined fetal karyotyping and CMA has confirmed 1 case of chromosome 13 microdeletion, 1 case of chromosome 18 microduplication, and 1 case of chromosome 18 deletion. For a case with 30 Mb duplication of chromosome 2 and 25 Mb duplication of chromosome 8, CMA analysis had no positive finding, while fetal umbilical cord blood karyotyping has yielded a 46,XX,dup(2)(p23.1p25.3)[13]/46,XX[87] karyotype. The remaining 5 cases were confirmed as false positive results.

CONCLUSIONCombined fetal karyotyping and CMA has provided a powerful tool for verifying high-risk fetuses signaled by NIPS.

Aneuploidy ; DNA Copy Number Variations ; Down Syndrome ; Female ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Karyotyping ; Microarray Analysis ; Pregnancy ; Prenatal Diagnosis ; Trisomy 13 Syndrome ; Trisomy 18 Syndrome

We detected Zika virus (ZIKV) in a febrile case returning from Suriname and entry China from Guangzhou Baiyun International Airport Port.Serum and saliva samples were collected from a suspected case returning from Suriname.We detected ZIKV RNA using real-time fluorescence RT-PCR methods by both in-house reagent and commercial detection kits.RT-PCR detection was carried out with saliva sample and sequence analysis was performed.Phylogenetic tree was constructed to analyze the source of imported cases.Real-time fluorescent RT-PCR result showed that saliva was detected ZIKV RNA positive while for serum was weakly positive.A specific 1 500 bp fragment in size was amplified with saliva sample by RT-PCR.Sequence analysis showed 99％ homologous to the corresponding sequence of Brazil ZIKV (GenBank No.KX197250).Phylogenetic tree indicated it was located on African lineage.According to the epidemiological investigation results,clinical manifestations and nucleic acid detection of case,the suspected case was confirmed to infect Zika virus,being the first case from Suriname into Guangdong Province.

OBJECTIVE: To evaluate the prescription behavior for outpatients in primary health care institutions of Yiyang and to provide scientific basis for promoting the rational use of drugs.
 METHODS: A multi-stage random sampling method was conducted in 21 primary health care institutions from Yiyang. Fifteen prescriptions were randomly selected in every month from each institution and a total of 3780 prescriptions were eventually collected in a year.
 RESULTS: Both the number of drugs and percentage of injection in a prescription were greater than the international standards. Children were more likely to be prescribed by multiple prescriptions, antibiotics prescriptions, hormones and injections prescriptions. The utilization of essential drug was more frequent in female. Antibiotics and hormones were more frequently used in summer and autumn season. Polypharmacy, antibiotics, injections and essential drugs were more frequently used in hospitals of small town. The skin and subcutaneous tissue diseases were often treated with multiple prescriptions, while the respiratory diseases were often treated with antibiotics, hormones and injections. Most primary health care institutions were at the upper limit of rational drug use.
 CONCLUSION The usage of prescription drug in most primary health care is rational, but some still surpass international standards. Thus, primary health care physicians should strictly control their prescriptions behavior.
Anti-Bacterial Agents ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization Review ; Drugs, Essential ; Hormones ; Humans ; Injections ; Outpatients ; Practice Patterns, Physicians' ; Primary Health Care

Objective To explore the effect of fentanyl and midazolam intravenous anesthesia in bronchoalveolar lavage in pneumoconiosis patients .Methods A total of 47 pneumoconiosis patients were divided into intravenous anesthesia group ( n=19 ) and surface anesthesia group ( n=28 ) .The intravenous anesthesia group used fentanyl and midazolam intravenous anesthesia based on local use of lidocaine , the surface anesthesia group only used lidocaine aerosol anesthesia .The success rate of operation , comfort and patients′reaction in two groups were compared .The blood pressure ( BP ) , heart rate ( HR ) and oxygen saturation ( SpO2 ) of patients in two groups were monitored before and during the operation .Results The success rate of operation in intravenous anesthesia group was higher than that in surface anesthesia group ( 100% vs 93%) . The comfort in intravenous anesthesia group was better than that in surface anesthesia group , and the difference was statistically significant ( Z =-3.415, P <0.05 ).The patients′adverse reaction was less and the compliance was higher when lavage again in intravenous anesthesia group .There was no significant difference in monitoring indexes between two groups before lavage (P>0.05).The BP and HR were lower in intravenous anesthesia group than those in surface anesthesia group at the same time point during lavage , and the differences were statistically significant (P<0.05).There was no significant difference in SpO 2 between two groups (P>0.05).There was no significant difference in monitoring indexes before and during lavage in intravenous anesthesia group (P>0.05).During the operation, the systolic pressure and HR were higher than before in surface anesthesia group, and the differences were statistically significant (P<0.05).There was no significant difference in SpO2 before and during lavage (P >0.05).Conclusions The application of fentanyl and midazolam intravenous anesthesia in bronchoalveolar lavage in pneumoconiosis patients can increase the success rate of operation and comfort , decrease the patients′adverse reaction , and make the respiratory and circulatory system stable.