Objective To investigate the correlation between skeletal muscle mass index(ASMI)and islet β cell reserve function in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with newly diagnosed T2DM were included in this study.All the patients were admitted to the Department of Endocrinology in the First People's Hospital of Yinchuan between June 2022 and November 2023.They were divided into two groups according to their skeletal muscle mass index(ASMI):patients with T2DM accompanied by sarcopenia(Sar,n=50)group,and patients with simple T2DM(T2DM,n=50)group.Additionally,a control(NC)group consisting of 50 healthy participants was selected.Fasting C-peptide levels,liver and kidney function,blood lipid profiles,and other indicators were assessed in all the individuals.The correlation between ASMI and other indicators was analyzed,and the influencing factors for ASMI and T2DM combined with sarcopenia were analyzed respectively.Results The levels of HbA1c,FPG,and TG were higher,while FC-P and Scr levels were lower in the T2DM group and Sar group compared with the NC group(P<0.05).FPG was higher,while ASMI,FC-P,BMI were lower in the Sar group than in the T2DM group(P<0.05).Spearman correlation analysis revealed a negative correlation between ASMI and FPG and HbA1c(P<0.05),whereas a positive correlation was observed with BMI,ALT,Scr,SUA and FC-P(P<0.05).Multiple linear regression analysis indicated that BMI,HbA1c and FC-P were influencing factors for ASMI(P<0.05).Furthermore,logistic regression analysis demonstrated that BMI,HbA1c,FC-P were influencing factors for T2DM with sarcopenia(P<0.05).Conclusions The level of ASMI may be related to the reserve function of islet β cells.

Objective To investigate the dynamic characteristics of intestinal pathological development at different time points in a mouse model of colitis-associated colon cancer.Methods A colitis-cancer model was established in C57BL/6 mice using azoxymethane(AOM)combined with dextran sulfate sodium(DSS).Samples were collected at 7,10,and 14 weeks post-modeling and the spleen index,colon length,mass,and colon mass per unit length were measured.Histopathological changes in the colon were observed by hematoxylin and eosin and Masson staining.Expression levels of the cancer stem cell marker CD44 and Wnt signaling pathway genes Wnt2b,Lrp5,Axin2,and Znrf3 at different pathological stages were detected by reverse transcription quantitative real time PCR.Cancer-associated fibroblasts(FAP),CD44,the proliferation marker Ki67,and goblet cell MUC2 protein were detected by multiple immunofluorescence histochemistry(mIHC)and immunofluorescence.In addition,colon organoids were isolated from model mice at ten and fourteen weeks and cultured in vitro to observe changes in organoid morphology and marker expression.Results AOM/DSS-induced mice showed reduced,distorted,and branched colon crypt structures with a few collagen fibers at 7 weeks,and varying degrees of colon intraepithelial neoplasia,with an increased proportion of high-grade intraepithelial neoplasia over time and increased collagen fiber staining at ten and fourteen weeks.mRNA levels of CD44 and Wnt2b in the colon were significantly increased(P＜0.05)and Axin2 was decreased(P＜0.01)in model mice compared with control mice at fourteen week,and levels of Wnt2b,Lrp5,and Znrf3 were increased compared with seven-week mice(P＜0.01,P＜0.05,P＜0.01),and Axin2 was decreased(P＜0.01).mIHC staining showed increased expression of FAP and CD44 in the colon in model mice at ten and fourteen weeks,with decreased MUC2 expression.Colon organoids showed cystic dilation,especially at fourteen weeks,with more prominent expression of Ki67 and CD44.Conclusions The AOM/DSS-induced mouse model exhibited chronic colonic inflammation,low-grade intraepithelial neoplasia,and high-grade intraepithelial neoplasia at seven,ten,and fourteen weeks,respectively.The pathological microenvironment was characterized by fibroblast activation and abnormal proliferation of epithelial cells.

Objective To investigate the correlation between skeletal muscle mass index(ASMI)and islet β cell reserve function in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with newly diagnosed T2DM were included in this study.All the patients were admitted to the Department of Endocrinology in the First People's Hospital of Yinchuan between June 2022 and November 2023.They were divided into two groups according to their skeletal muscle mass index(ASMI):patients with T2DM accompanied by sarcopenia(Sar,n=50)group,and patients with simple T2DM(T2DM,n=50)group.Additionally,a control(NC)group consisting of 50 healthy participants was selected.Fasting C-peptide levels,liver and kidney function,blood lipid profiles,and other indicators were assessed in all the individuals.The correlation between ASMI and other indicators was analyzed,and the influencing factors for ASMI and T2DM combined with sarcopenia were analyzed respectively.Results The levels of HbA1c,FPG,and TG were higher,while FC-P and Scr levels were lower in the T2DM group and Sar group compared with the NC group(P<0.05).FPG was higher,while ASMI,FC-P,BMI were lower in the Sar group than in the T2DM group(P<0.05).Spearman correlation analysis revealed a negative correlation between ASMI and FPG and HbA1c(P<0.05),whereas a positive correlation was observed with BMI,ALT,Scr,SUA and FC-P(P<0.05).Multiple linear regression analysis indicated that BMI,HbA1c and FC-P were influencing factors for ASMI(P<0.05).Furthermore,logistic regression analysis demonstrated that BMI,HbA1c,FC-P were influencing factors for T2DM with sarcopenia(P<0.05).Conclusions The level of ASMI may be related to the reserve function of islet β cells.

Objective To investigate the dynamic characteristics of intestinal pathological development at different time points in a mouse model of colitis-associated colon cancer.Methods A colitis-cancer model was established in C57BL/6 mice using azoxymethane(AOM)combined with dextran sulfate sodium(DSS).Samples were collected at 7,10,and 14 weeks post-modeling and the spleen index,colon length,mass,and colon mass per unit length were measured.Histopathological changes in the colon were observed by hematoxylin and eosin and Masson staining.Expression levels of the cancer stem cell marker CD44 and Wnt signaling pathway genes Wnt2b,Lrp5,Axin2,and Znrf3 at different pathological stages were detected by reverse transcription quantitative real time PCR.Cancer-associated fibroblasts(FAP),CD44,the proliferation marker Ki67,and goblet cell MUC2 protein were detected by multiple immunofluorescence histochemistry(mIHC)and immunofluorescence.In addition,colon organoids were isolated from model mice at ten and fourteen weeks and cultured in vitro to observe changes in organoid morphology and marker expression.Results AOM/DSS-induced mice showed reduced,distorted,and branched colon crypt structures with a few collagen fibers at 7 weeks,and varying degrees of colon intraepithelial neoplasia,with an increased proportion of high-grade intraepithelial neoplasia over time and increased collagen fiber staining at ten and fourteen weeks.mRNA levels of CD44 and Wnt2b in the colon were significantly increased(P＜0.05)and Axin2 was decreased(P＜0.01)in model mice compared with control mice at fourteen week,and levels of Wnt2b,Lrp5,and Znrf3 were increased compared with seven-week mice(P＜0.01,P＜0.05,P＜0.01),and Axin2 was decreased(P＜0.01).mIHC staining showed increased expression of FAP and CD44 in the colon in model mice at ten and fourteen weeks,with decreased MUC2 expression.Colon organoids showed cystic dilation,especially at fourteen weeks,with more prominent expression of Ki67 and CD44.Conclusions The AOM/DSS-induced mouse model exhibited chronic colonic inflammation,low-grade intraepithelial neoplasia,and high-grade intraepithelial neoplasia at seven,ten,and fourteen weeks,respectively.The pathological microenvironment was characterized by fibroblast activation and abnormal proliferation of epithelial cells.

Objective:To explore the effect of clinical pharmacists′ intervention in therapeutic drug monitoring (TDM) of voriconazole on medication safety.Methods:The study subjects were inpatients with fungal infection, admitted from January 2019 to June 2020 in the Department of Infectious Diseases, West China Hospital, Sichuan University, who were scheduled to be treated with voriconazole. Using random-cluster method, patients were divided into intervention group and control group based on their doctor medical groups. In the intervention group, clinical pharmacists participated in the whole process of voriconazole TDM and provided pharmaceutical care, while in the control group, no clinical pharmacists participated in TDM. The percentage of voriconazole-treated patients achieved target trough concentration(1.5-5.5 mg/L), the incidence of adverse reactions, and clinical cure rate between the 2 groups were compared. The timely (within 24 hours) management rate of medication orders containing drugs with interaction by doctors and the detection frequency of blood drug concentration were compared between the 2 groups.Results:A total of 303 patients were enrolled in the analysis, including 166 in the intervention group and 137 in the control group. There was no significant difference between the 2 groups in demographic characteristics, liver function indexes, types of fungal diseases, main combined diseases, and the use of drugs with interactions with voriconazole before voriconazole treatment (all P>0.05). After receiving voriconazole, percentage of patients achieved target trough concentration in the intervention group was similar to that in the control group in the first detection [55% (91/166) vs. 50% (69/137), P=0.440] while significantly higher in the last detection[81% (134/166) vs. 47% (65/137), P<0.001]. The total frequency of trough concentration detection in the intervention group and the control group were 403 and 244 respectively. Percentage of detection values consisted with target trough concentration was significantly higher, while percentage of detection values exceeding target trough concentration (>5.5 mg/L) was significantly lower in the intervention group than those in the control group, respectively [63% (254/403) vs. 44% (107/244), P<0.001; 19% (63/403) vs. 22% (54/244), P=0.037)]. The total incidence of voriconazole-related adverse reactions [14% (23/166) vs. 23% (31/137)], the incidence of severe adverse reactions [2% (4/166) vs. 8% (11/137)], and incidence of liver injury [Council for International Organizations of Medical Sciences standard: 8% (13/166) vs. 15% (21/137); International Drug-induced Liver Injury Expert Working Group standard: 2% (4/166) vs. 7% (10/137)] in the intervention group were significantly lower than those in the control group (all P<0.05), and the clinical cure rate was similar in the 2 groups [86% (142/166) vs. 81% (111/137), P=0.291]. In the intervention and control groups, some patients were using drugs which had interactions with voriconazole when starting voriconazole treatment, and the timely management rates of these medication orders were 71% (24/17) and 18% (3/17) respectively, with a statistically significant difference between the 2 groups ( P=0.001). The detection frequency of voriconazole trough concentration in the intervention group (2.4 times per patient) was higher than that in the control group (1.8 times per patient), and the proportion of patients with ≥3 detection was significantly higher [38% (63/166) vs. 23% (32/137), P=0.006]. Conclusion:The involvement of clinical pharmacists in voriconazole TDM can enlarge the percentage of patients who achieve target trough concentration, improve the timely management rate of medication orders containing drugs with interactions with voriconazole, reduce the incidence of voriconazole-related adverse reactions, and improve medication safety.

Objective:To explore the effect of clinical pharmacists′ intervention in therapeutic drug monitoring (TDM) of voriconazole on medication safety.Methods:The study subjects were inpatients with fungal infection, admitted from January 2019 to June 2020 in the Department of Infectious Diseases, West China Hospital, Sichuan University, who were scheduled to be treated with voriconazole. Using random-cluster method, patients were divided into intervention group and control group based on their doctor medical groups. In the intervention group, clinical pharmacists participated in the whole process of voriconazole TDM and provided pharmaceutical care, while in the control group, no clinical pharmacists participated in TDM. The percentage of voriconazole-treated patients achieved target trough concentration(1.5-5.5 mg/L), the incidence of adverse reactions, and clinical cure rate between the 2 groups were compared. The timely (within 24 hours) management rate of medication orders containing drugs with interaction by doctors and the detection frequency of blood drug concentration were compared between the 2 groups.Results:A total of 303 patients were enrolled in the analysis, including 166 in the intervention group and 137 in the control group. There was no significant difference between the 2 groups in demographic characteristics, liver function indexes, types of fungal diseases, main combined diseases, and the use of drugs with interactions with voriconazole before voriconazole treatment (all P>0.05). After receiving voriconazole, percentage of patients achieved target trough concentration in the intervention group was similar to that in the control group in the first detection [55% (91/166) vs. 50% (69/137), P=0.440] while significantly higher in the last detection[81% (134/166) vs. 47% (65/137), P<0.001]. The total frequency of trough concentration detection in the intervention group and the control group were 403 and 244 respectively. Percentage of detection values consisted with target trough concentration was significantly higher, while percentage of detection values exceeding target trough concentration (>5.5 mg/L) was significantly lower in the intervention group than those in the control group, respectively [63% (254/403) vs. 44% (107/244), P<0.001; 19% (63/403) vs. 22% (54/244), P=0.037)]. The total incidence of voriconazole-related adverse reactions [14% (23/166) vs. 23% (31/137)], the incidence of severe adverse reactions [2% (4/166) vs. 8% (11/137)], and incidence of liver injury [Council for International Organizations of Medical Sciences standard: 8% (13/166) vs. 15% (21/137); International Drug-induced Liver Injury Expert Working Group standard: 2% (4/166) vs. 7% (10/137)] in the intervention group were significantly lower than those in the control group (all P<0.05), and the clinical cure rate was similar in the 2 groups [86% (142/166) vs. 81% (111/137), P=0.291]. In the intervention and control groups, some patients were using drugs which had interactions with voriconazole when starting voriconazole treatment, and the timely management rates of these medication orders were 71% (24/17) and 18% (3/17) respectively, with a statistically significant difference between the 2 groups ( P=0.001). The detection frequency of voriconazole trough concentration in the intervention group (2.4 times per patient) was higher than that in the control group (1.8 times per patient), and the proportion of patients with ≥3 detection was significantly higher [38% (63/166) vs. 23% (32/137), P=0.006]. Conclusion:The involvement of clinical pharmacists in voriconazole TDM can enlarge the percentage of patients who achieve target trough concentration, improve the timely management rate of medication orders containing drugs with interactions with voriconazole, reduce the incidence of voriconazole-related adverse reactions, and improve medication safety.

Objective To observe the effect of different stimulative ways of scalp penetration acupuncture on acute stroke. Methods 90 inpatients with acute stroke from July, 2011 to July, 2014 were randomly divided into manual acupuncture group (n=30), electroacupuncture group (n=30) and simple acupuncture group (n=30). All the groups accepted scalp penetration acupuncture from Baihui (GV20) to Taiyang (EX-HN5) and stimulated manually, electrically and simply maintained, respectively. They were assessed with Neurological Deficit Score (NDS), measured with neuron-specific enolase (NSE) before and 14 days after treatment. The incidence of improvement was observed. Re-sults The NDS was the least in the manual acupuncture group (P<0.05), as well as the serumal level of NSE (P<0.05). The incidence of im-provement was the most in the manual acupuncture group (P<0.05). Conclusion The manual stimulation of scalp penetration acupuncture is more effective on the acute stroke.

OBJECTIVETo explore the induction of L-forms of Mycobacterium abscess using isoniazid.

METHODSMycobacterium abscess were cultured in aqueous culture media in the presence or absence of 128 µg/ml isoniazid. The culture media containing isoniazid were filtered with 0.45 µm membrane, and the filtrate was subcultured in nutrient agar media for reversion. The isoniazid-free and isoniazid-containing media and the reversion bacteria were observed for cell wall integrity by cell wall staining and transmission electron microscopy, and the microstructures of the cell surfaces were observed by scanning electron microscopy. The isoniazid-containing culture was subcultured in L-form agar media, and the isoniazid-free culture and the reversed bacteria in nutrient agar media to observe the colony morphology. The reversed and non-induced bacteria were identified for 16S rDNA.

RESULTSThe bacteria induced with 128 µg/ml isoniazid showed cell wall defect, presenting with a spherical cell morphology and typical fried egg-like colonies in L-form agar media, while in isoniazid-free cultures, the cells showed intact cell walls with rod-like shapes and round colony morphologies on nutrient agar. The reversed bacteria, showing also intact cell walls with rod-like shapes and round colonies on nutrient agar, had identical 16S rDNA with the non-induced bacteria.

CONCLUSIONIsoniazid can induce the L-forms of mycobacterium abscess for use in studies of multidrug resistance and treatment of the bacteria.

Cell Wall ; drug effects ; Culture Media ; Isoniazid ; pharmacology ; L Forms ; drug effects ; Mycobacterium tuberculosis ; cytology ; drug effects