In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To analyze the circuit-qi patterns during early embryonic period and at conception in congenital heart disease(CHD)patients based on the five-circuit and six-qi theory,and to explore the pathogenesis and etiology of CHD from a circuit-qi perspective.Methods With 16 400 non-CHD individuals as the healthy control group,a statistical analysis was performed for the circuit-qi patterns during early embryogenesis and at conception in 4 100 CHD patients(CHD group).Results The following factors were identified as significant predisposing factors for CHD:yearly circuit being excessive fire circuit during early embryogenesis,yearly qi being taiyang cold water of celestial qi combined with taiyin damp earth of terrestrial qi during early embryogenesis,yearly circuit being concurrent excessive fire circuit and earth circuit deficiency at conception,and yearly qi being taiyin damp earth of terrestrial qi paired with jueyin wind wood of celestial qi at conception(all P＜0.05 or P＜0.01).Conclusion There is a certain correlation between circuit-qi endowment during embryonic development and the prevalence of CHD.The core pathogenesis of CHD is rooted in heart-spleen insufficiency,with hyperactive heart-fire and cold kidney-water as its manifestations,and spleen deficiency failing in transportation serves as an important contributing factor in the development and progression of CHD.

Objective To evaluate the effect of doxepin on the expression of p38 mitogen-activated protein kinase (p38 MAPK) in the spinal cord of rats with neuropathic pain (NP).Methods Sixty clean-grade male Wistar rats in which intrathecal catheters were successfully implanted,weighing 200-250 g,were divided into 3 groups (n =20 each) by a random number table method:sham operation group (S group),NP group and doxepin group (D group).NP was induced by chronic constriction injury (CCI) to sciatic nerve.Doxepin 20 mmol/L (10 μl) was intrathecally injected at 3,7,14 and 21 days after CCI (T1-4) in group D.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI (T0) and at T1-4.The rats were sacrificed after measurement of pain threshold at T4,and L4-6 segments of the spinal cord were removed for determination of the expression of p38MAPK protein by Western blot.Results Compared with S group,MWT was significantly decreased and TWL was shortened at T2-4,and the expression of p38MAPK protein was up-regulated in NP and D groups (P＜0.05).Compared with NP group,MWT was significantly increased and TWL was prolonged at T2-4,and the expression of p38MAPK protein was down-regulated in D group (P＜0.05).Conclusion The mechanism by which doxepin mitigates NP is related to down-regulating p38MAPK expression in the spinal cord of rats.

Objective To study the effect of ratanasampil (RNSP) which is Traditional Tibetan Medicine on the levels of serum β-amyloid protein, interleukin and tumor necrosis factor alpha (TNF-α) in patients with mild to moderate Alzheimer's disease (AD). Methods One hundred AD patients were divided into two groups in randomized controlled study, including treatment group (RNSP 1 g/d) and control group (piracetam 2.4 g/d). The treatment lasted 12 weeks. The Mini Mental State Examination (MMSE), Alzheimer' s disease Assessment Scale-cognitive subscale (ADAS-cog) and Activity of Daily Living Scale (ADLs) were taken to evaluate the efficacy. Serum levels of amyloid peptides (Aβ40 and Aβ42 ) were measured by ELISA assay. The radioimmunologic assay was used to determine the serum levels of IL-1β, IL-2, IL-6, IL-8 and TNF-α. Results The scores of MMSE, ADAS-cog and ADL significantly improved at 12 weeks after RNSP treatment (P＜0.01, 0.01, 0.05, respectively), while had no significant changes in piracetam group (P＜0.05).The levels of TNF-α, IL-1β, IL-6 and Aβ42 were significantly lower in RNSP group than in Piracetam group (P＜0.01). There was a decrease trend of the Aβ42/Aβ40 ratio at 12 weeks after RNSP treatment (P＜0. 05, P＜0.01 ). The serum Aβ42 level had strong correlations with TNF-α, IL-1 β and IL-6. There were no significant differences in Aβ40 and IL-8 between RNSP group and piracetam group. No obvious drug side effect happened on the groups. Conclusions The reductions of serum TNF-α, IL-1β and IL-6 levels after RNSP treatment may lead to decrease of Aβ42 production in AD patients. RNSP may decrease the Aβ42/Aβ40 ratio and slow down the progress of AD. It may improve the learning and memory ability in treating patients with mild to moderate AD and is well tolerated and safe.

Objective To determine the possible genetic background and the source of our hospital's 43 clinical isolates of multidrug-resistant Acinetobacter baumannii, and the category of gene cassettes in type 1 integrons of all strains.Methods Restriction enzyme Apa I was chosed for all strains in pulsed-field gel electrophoresis (PFGE) methods.Multilocus sequence typing ( MLST) was used to compare the allelic profiles of all the strains. PCR method was used for amplify the integrons of all strains. Results PFGE results showed that 43 strains were divided into four types. A-type and B-type were divided into 4 and 2 subtypes, respectively. The MLST results showed the existing of three allelic profiles; 1-3-3-2-2-7-3, 1-3-3-2-2-11-3, and 1-3-3-2-2-14-3.B-type and D-type of PFGE have the same allelic profile(1-3-3-2-2-11-3).A-type strains were detected mainly in ICU, and in burn unit only found B- and D-type.The same integron was detected in 62.8% of the strains.The constituent ratio of A1,A2,A3,A4,B1,B2,C and D-type was 40.7% , 18.5% , 7.4% , 3.7% , 14.8% , 3.7% , 3.7% and 7.4% , respectively.Conclusions The coexistence of multiple cloning system in this region was proved by the PFGE and MLST, and the same clone can evolve to different subtypes when stimulated by different environmental conditions; and the different carrying-situationt of the same integron in strains prove the possibility of the change during the evolution of resistance mechanisms.

Objective To detect the encoding gene of efflux pump and two-component system, and investigate the effect of efflux inhibition on the multiresistance of Acinetobacter baumarmii. Methods PCR was used to detect the adeB, adeR and aries gene. Agar dilution was used to determine the minimum inhibitory concentrations(MIC) of ciprofloxacin, cefotaxime, amikacin and imipenem of 50 multiresistance Acinetobacter baumannii, with or without 25 μg/ml reserpine. Results 94%, 96% and 92% of 50 muhiresistance of Acinetobacter baumannii were detected for adeB, adeR and aries gene,respectively. At least four fold decrease of MIC was observed in 49, 50, 50 and 46 isolates for ciprofioxacin, cefotaxime, amikacin and imipenem, respectively. Conclusion The multiresistance of Acinetobacter baumannii is related to the effect of the efflux system.

OBJECTIVE To study the changing trends of drug-resistance of Acinetobacter baumannii isolates.METHODS All 668 isolates of A.baumannii were obtained from clinical patients in the First Affiliated Hospital of China University of Sciences Medical between 2001-2006.K-B test was used to determine the susceptibility and the results were read based on National Committee for Clinical Laboratory Standards(NCCLS)of the USA.RESULTS The number of A.baumannii isolates was increasing from 61 in the year of 2001 to 247 in the year of 2006.And during the six years,the resistant rate to ciprofloxacin,gentamicin and imipenem was increasing from 28.8%,25.4%,5.4% to 64.9%,72.7% and 48.5%,respectively.The resistant rate of the 50 multidrug-resistant A.baumannii isolates to polymyxin B was 18.6%.CONCLUSIONS During the six years,the isolating rate is increasing,the result showed that there is not a large scale outbreak.The resistant rate is so high that we must strengthen the monitoring and indentify the drug-resistance mechanisms.

Background and purpose:Survivin,a member of the inhibiter of apoptosis gene family,has been detected in fetal tissue and in variety of human malignancies.In the current study,we not only investigated the expression of a novel inhibitor gene of apoptosis,survivin in Cervixneoplasms but also studied its relationship between the expression of P53 and HPV-16. Methods:Using streptavidin-bintin peroxidase(SP)method,We examinined the expression of the proteins survivin , p53 and HPV-16 in 21 normal cervical tissues ,33 CIN and 72 cervical cacinoma tissues.Results:Survivin was expressed in 52 of 72(72.2%) cases of cervical carcimomas ,however,it was not expressed in normal cervical tissues and it was expressed in6 of 33(18.18%)cases of CIN. Overexpression of survivn was related to the tumor grade and clinical stage.Survivin positive cases were strongly associated with p53 expression (P

OBJECTIVE To study the information of drug resistance of 1292 coagulase-negative staphylococci(CNS) isolates. METHODS There were 1292 isolates of CNS obtained from clinical patients in between 2001-2006.K-B test was used to determine the susceptibility and the results were read based on Clinical and Laboratory Standards Institute(CLSI) of the USA. RESULTS The isolating rate of CNS isolates was decreasing from 11.0% in the year of 2001 to 6.4% in the year of 2006.During the six years,the resistant rate to erythromycin,oxacillin and benzylpenicillin was high(90.0%,78.9% and 95.0%,respectively) and the resistant rate to cefepime,ciprofloxacin and levofloxacin increased from 17.3%,42.4%,and 28.7% in the year of 2001 to 39.1%,56.0% and 42.6% in the year of 2006.But the resistant rate to tetracycline,trimethoprim/sulfamethoxazole decreased from 71.2% and 72.0% in the year of 2001 to 52.7% and 33.3% in the year of 2006.The resistant rate to quinupristin /dalfopristin was 5.6%. CONCLUSIONS The steady resiatence rate of CNS over the past six years provides powerful evidence for the choice of clinical medication and practice of infection control.

OBJECTIVE To compare the changing trends of antibiograms of Salmonella typhi and S.paratyphi A isolates.METHODS A total of 42 isolates of Salmonella obtained from blood cultures patients in the First Affiliated Hospital of Chinese Medical University between 2001-2004 were included in the study.K-B test was used for the antimicrobial susceptivity test and the results were read based on National Committee for Clinical Laboratory Standards(NCCLS) of USA.RESULTS Twenty two isolates were identified as S.typhi and 20 were identified as S.paratyphi A.Sensitivity of S.typhi isolates to cephalosporins and chloramphenicol was found to have increased from 2001 to 2004 while that of S.paratyphi A showed a decline,meanwhile there was obviously increasing in resistance to ciprofloxacin.CONCLUSIONS Perhaps the schedule of empirical treatment of typhoid fever needs to be adjusted.