Objective:To investigate the incidence of osteoporosis in elderly women after radical mastectomy and analyze its influencing factors, so as to provide guidance for the prevention of this disease.Methods:Clinical data of 103 elderly women treated in our hospital after radical mastectomy from Jan. 2020 to Jan. 2021 were collected and separated into osteoporosis group ( n=58) and non-osteoporosis group ( n=45) according to whether osteoporosis occurred. The factors affecting the occurrence of osteoporosis and the relationship between endocrine hormones and bone metabolism were analyzed, and prevention strategies were formulated. Results:(1) The proportion of patients with osteoporosis >70 years old, menopausal years ≥5 years, body mass index <25kg/m 2, endocrine therapy in osteoporosis group was higher than that in non-osteoporosis group ( χ2 =8.68, 18.54, 9.72, 16.98, 36.51, P=0.003, <0.001, 0.002, <0.001, <0.001) ; (2) The level of estradiol in the osteoporosis group was lower than the other group ( t value =20.53, P<0.05), and the level of follicle-stimulating hormone was higher ( t value=19.14, P<0.05) ; (3) Old age, endocrine therapy, low bone mineral density and low estradiol level were the risk factors for osteoporosis after radical mastectomy ( P<0.05) ; (4) Pearson correlation analysis showed that bone mineral density in patients with osteoporosis after radical mastectomy was positively correlated with estradiol and testosterone levels ( r=0.352, 0.316, P<0.05), and negatively correlated with follicle-stimulating hormone levels ( r=-0.334, P<0.05) . Conclusions:Osteoporosis in elderly women with radical mastectomy is affected by age, endocrine therapy, bone mineral density and estradiol, and there is a correlation between hormone levels and bone mineral density. Clinical prevention and treatment measures should be implemented in the direction of monitoring bone mineral density, physical exercise, safe drug use, and prevention of falling.

On the basis of the clinical characteristics of atherosclerosis(AS)in traditional Chinese medicine(TCM)and Western medicine,this paper analyzes common animal models of AS.The coincidence of clinical characteristics of the models was scored in the hope of providing new ideas and a reference for those studying AS.This paper reviews the varieties,modeling method,modeling principles,and characteristics of common animal models of AS.Moreover,similarities among common animal models,in terms of their clinical diagnostic criteria and symptom characteristics,were assessed.High-fat feeding type,mechanical injury combined with high-fat feeding type,genetic engineering combined with high-fat feeding type,chemical induction combined with high-fat feeding type,and combined Chinese clinical syndrome and Western disease AS models are widely established.Comparative analysis showed that balloon injury combined with high fat feeding type,ApoE receptor-knockout mouse combined with high-fat diet type,and phlegm and blood stasis type models of disease and symptom combinations showed a comparatively high level of clinical agreement between Chinese and Western medicine.Presently,most animal models of AS have a high degree of relevance to Western medicine,and the evaluation criteria used for the models are predominately from a Western medicine perspective.Models that combine disease and syndrome are lacking,hindering the development of wholism concepts and treatment through the differentiation of syndromes used in TCM.Therefore,establishing an animal model with a high degree of accuracy and coincidence between TCM and Western perspectives that combines the disease and its TCM symptoms is a top priority for studying the prevention and treatment of AS.

Objective To analyze the development trajectory and predictors of endocrine therapy associated arthralgia in breast cancer patients.Methods From January 2022 to July 2022,breast cancer patients in the breast medicine department or outpatients of a tertiary cancer hospital in Hunan Province were selected as respondents using a convenience sampling method.A baseline survey was conducted using the General Information Questionnaire,the Symptom Assessment Scale for Patients Treated with Endocrine Therapy for Breast Cancer,and the Self-Rating Anxiety Scale within 1 week prior to patient treatment.The Symptom Assessment Scale for Patients Treated with Endocrine Therapy for Breast Cancer was used to assess patients'arthralgia levels at 3,6,and 9 months after treatment,and data were analyzed using growth mixed model,univariate analysis of variance,and multiple logistic regression.Results A total of 418 breast cancer patients completed the follow-up,with 235 cases(56.22%)developing arthralgia.3 potential categories of arthralgia develop-ment trajectories were identified:high level-slowly increasing group(11.48%),low level-slowly increasing group(44.74%),and asymptomatic group(43.78%).The results of multifactorial analysis showed that anxiety,history of bone and joint disease,sleep duration,place of residence,monthly household income,and frequency of exercise were predictors of potential categories for the development of trajectory of arthralgia levels associated with endocrine therapy in breast cancer patients(P<0.05).Conclusion Arthralgia levels associated with endocrine therapy in breast cancer patients exhibit different trajec-tories,and clinical staff should emphasize the assessment and intervention of pain levels in patients with the anxiety,a history of bone and joint disease,poor sleep,poor finances,living in urban areas,and low frequency of exercise.

Objective:To explore the effect of combining hand-brain perception training with hand-brain motor training based on mirror neuron theory on the recovery of upper limb function after a stroke.Methods:A group of 105 stroke survivors with upper limb dysfunction were randomly divided into a hand-brain perception (HP) group, a hand-brain motor (HM) group, and a combination (C) group, each of 35. In addition to conventional rehabilitation treatment (including exercise therapy, occupational therapy and physical factor therapy), the HP and HM groups were given hand-brain perception training and hand-brain motor training respectively, while group C was provided with both. Before the intervention and after 4 weeks, the upper limb motor functioning of all of the participants was assessed using the simplified version of the Fugl-Meyer upper limb motor function scale (FMA-UE). Sensory functioning was quantified using the tactile Semmes Weinstein monofilament examination (SWME), and the modified Barthel index (MBI) was used to quantify the participants′ ability in the activities of daily living.Results:After the intervention the average FMA-UE, MBI and SWME scores of all three groups had improved significantly, with group C′s average FMA-UE and MBI scores significantly better than the other two groups′ averages. The average SWME score of group C was then significantly better than that of group HM.Conclusions:Hand-brain perception combined with hand-brain motor training based on mirror neuron theory can further promote the recovery of upper limb sensory and motor functioning of stroke survivors., Such therapy is worthy of clinical promotion and application.

Objective To explore the risk factors for prolonged stay of menopausal female patients in intensive care unit(ICU)and construct a predictive model.Methods A total of 260 menopausal women hospitalized in ICU of Taizhou Central Hospital from June 2019 to December 2022 were selected as study subjects.According to the length of ICU stay,the patients were divided into extended group(≥5d,156 cases)and non-extended group(<5d,104 cases).The clinical data of patients were collected,and the factors affecting the length of stay in ICU patients were analyzed by multivariate Logistic regression.A nomogram prediction model was constructed,receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated.Results The proportion of coma,invasive operation and using of broad spectrum antibiotic in extended group were significantly higher than those in non-extended group(P<0.05).The incidence of abnormal blood pressure,muscle/bone joint pain,abnormal heart rate,abnormal respiratory function and infection in extended group were significantly higher than those in non-extended group(P<0.05).Multivariate Logistic regression analysis showed that coma,invasive operation,using of broad spectrum antibiotic,abnormal blood pressure,abnormal heart rate,abnormal respiratory function and infection were the risk factors leading to prolonged ICU stay in menopausal women(P<0.05).The constructed nomogram model had a good fit(χ2=5.072,P=0.285).The AUC of patients with prolonged ICU stay predicted by nomogram model was 0.857(95%CI:0.778-0.937),the sensitivity was 78.16%,and the specificity was 83.67%.Conclusion Unstable conscious state,invasive operation,using of broad spectrum antibiotic,abnormal blood pressure,abnormal heart rate,abnormal respiratory function,and infection are all risk factors leading to prolonged ICU stay in menopausal women,which should be paid close attention to and timely targeted treatment.

Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy(HCM) by myocardial contrast echocardiography (MCE) combined with adenosine stress test.Methods:Fifteen adult patients with HCM who were treated in Fuwai Central China Cardiovascular Hospital from May 2021 to March 2022 were prospectively selected as the HCM group, and eighteen healthy volunteers matched by gender, age and body surface area during the same period were chosen as the control group. All subjects underwent routine echocardiography, rest and adenosine stress MCE. The MCE images were analyzed by QLab software to obtain the myocardial perfusion parameters: peak signal intensity (A value), rising slope of the curve (β value) and A×β value, and the differences of above parameters between the two groups were compared.According to whether the end-diastolic wall thickness ≥12 mm, the myocardial segments in the HCM group were divided into hypertrophic segments and non-hypertrophic segments. The differences in myocardial perfusion parameters were compared among control group segments, hypertrophic segments and non-hypertrophic segments of the HCM group. The correlations of stress myocardial blood flow with maximal left ventricular wall thickness (MLVWT), left ventricular mass index (LVMI) and left atrial volume index (LAVI) in the HCM group were analyzed.Results:Compared with the control group, the A value, β value and A×β value of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased in the rest and adenosine stress state, and the differences were statistically significant (all P<0.05). In the stress state, the A value, β value and A×β value of the hypertrophic segments were significantly lower than those in the non-hypertrophic segments in the HCM group, and the detection rate of abnormal perfusion segments in the HCM group was significantly higher than that in the rest state(all P<0.05). Compared with the control group, the myocardial blood flow reserve of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased, and the differences were statistically significant(all P<0.05). The stress myocardial blood flow in the HCM group was negatively correlated with MLVWT, LVMI and LAVI ( r=-0.815, -0.805, -0.742; all P<0.05). Conclusions:Myocardial blood perfusion abnormalities can occur in both hypertrophic and non-hypertrophic myocardial segments in patients with HCM, and adenosine stress MCE can significantly improve the sensitivity of detecting myocardial perfusion abnormalities. The stress myocardial blood flow in patients with HCM is negatively correlated with MLVWT, LVMI and LAVI.

Objective:To investigate the current status of diagnosis and treatment of Helicobacter pylori ( H. pylori) infection in primary hospitals in Jiangsu Province, and to evaluate the capability of comprehensive prevention and management of H. pylori infection in the primary hospitals. Methods:From 2020 to 2022, a questionnaire survey was conducted among 430 primary hospitals, which participated in the Incubation Center Project of Primary Gastroenterology Specialty Department in Jiangsu Province. The questionnaire survey includedthe establishmment of endoscopy and department of gastroenterology, items of H. pylori detection, H. pylori treatment, eradication plans and treatment course. The questionnaire was filled by the director of the primary hospital. Descriptive analysis was used for statistical analysis. Results:A total of 413 valid questionnaires were received. Among the 413 primary hospitals, 286 (69.2%) were equipped with endoscopy centers, and 202 (48.9%) had departments of gastroenterology. In terms of diagnostic methods for H. pylori, 35.8% (148/413) of the primary hospitals did not have urea breath test equipment, of which 84 hospitals did not carry out any H. pylori testing items, 8 hospitals only had rapid urease test, 45 hospitals only had serum H. pylori antibody test, 7 hospitals had both rapid urease test and serum H. pylori antibody test, and 4 hospitals had fecal H. pylori antigen test. In terms of therapeutic drugs, all the hospitals could provide proton pump inhibitors, and 82.8% (342/413) of the hospitals had bismuth agents. According to diagnosis and treatment guideline for H. pylori infection at the primary care, 7 combinations of two antibiotics were recommended. A total of 14 (3.4%) hospitals could provide all the combinations, 369 (89.3%)hospitals could provide 2 to 6 combinations, 20(4.8%)hospitals could provide only one combination, and 10 (2.4%) hospitals could not provide any combination. For the selection of the eradication scheme and treatment course, the bismuth-based quadruple scheme was chosen in 248 (60.0%) hospitals, 14-day course was selected in 363(87.9%) hospitals, and 14-day course of bismuth-based quadruple scheme was selected in 232 (56.2%) hospitals. Conclusion:Improving the H. pylori testing equipment in primary hospitals, preparing all types of therapeutic drugs, and improving doctors′ knowledge of diagnosis and treatment of H. pylori in are of great significance for improving the prevention and treatment efficacy of H. pylori infection at the primary hospitals.

Objective To study the chemical constituents from the herbs of Dendrobium crepidatum and identify its antitumor bioactive compounds.Methods The constituents were extracted by methyl alcohol and isolated by CC and Sephadex LH-20.Their structures were identified by spectroscopic analysis(1H NMR,13CNMR and EIMS).The antitumor activity of the constituents was determined by MTT assay in vitro.Results 9 compouds were obtained and identified as p-hydroxybenzaldehyde(1),p-methoxyphenol(2),p-Hydroxybenzyl alcohol(3),hydroquinone(4),(24R)-ethylcholest-5-en-3-ol-7-one(5),sinalexin(6),bis(2-ethylhexyl)benzene-1,2-dicarboxylate(7),pinoresinol(8),Chaenomin B(9).The antitumor activity of compounds 5～9 was tested,and it was found that compound 9 had good inhibitory activity against A549 cell line.Conclusion Compounds 2～5,7～8 were isolated from the herbs for the first time and compounds 6,9 were isolated from this genus for the first time.IC50 of 9 on A549 cell line is 29.35 μM.

Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy (HCM) by myocardial contrast echocardiography(MCE) combined with exercise stress test.Methods:Twenty-seven patients with clinically diagnozed of asymmetric HCM in Fuwai Central China Cardiovascular Hospital from May 2020 to April 2021 were selected as the HCM group, and 29 healthy subjects during the same period were selected as the control group. All patients underwent routine echocardiography, resting and exercise stress MCE. The myocardial perfusion parameters of each segment of interventricular septum in the 2 groups were quantitatively analyzed: the peak plateau intensity (A value), ascending slope of the curve(β value) and value of A×β. According to the end-diastolic myocardial thickness, the interventricular septum of the HCM group was divided into hypertrophic and non-hypertrophic segments, and the myocardial contrast parameters of the interventricular septum of the study group were compared with those of the control group. The myocardial blood flow reserve value of the two groups were calculated, and the correlation of myocardial blood flow reserve value with left ventricular mass index (LVMI) and left ventricular remodeling index (LVRI) were analyzed.Results:No matter at rest or under stress, the A value, β value and A×β value of ventricular septal hypertrophic and non-hypertrophic segments in the hypertrophic cardiomyopathy group were lower than those in the control group, and the differences were statistically significant (all P<0.05). Under stress, the A value, β value and A×β value of interventricular septal hypertrophic segments were lower than those in non-hypertrophic segments in the HCM group, and the differences were statistically significant (all P<0.05). The myocardial blood flow reserve in the HCM group was negatively correlated with LVMI and LVRI( r=-0.899, -0.676; all P<0.001). Conclusions:In patients with HCM under resting and exercise stress, microcirculation disorders were found in both hypertrophic and non-hypertrophic segments of the ventricular wall, and the myocardial blood flow reserve was negatively correlated with LVMI and LVRI.

Genome sequences of 4 644 representative strains from human gut microbiota were analyzed to mine gene clusters for biosynthesis of novel secondary metabolites, as well as genes encoding antibiotic resistance and virulence factors. AntiSMASH analysis showed that more than 60% of the representative strains encoded at least one secondary metabolite gene cluster, and 8 potential novel secondary metabolite gene clusters were identified from 8 unculturable bacteria. The secondary metabolite gene clusters in human intestine are mainly composed of nonribosomal peptide synthetase (NRPS), bacteriocin, arylpolyene, terpene, betalactone and NRPS like gene clusters distributed in Clostridia, Bacilli, Gammaproteobacteria, Bacteroidia, Actinobacteria and Negativicutes. PathoFact analysis showed that genes encoding antibiotic resistance and virulence factors are widely distributed in representative strains, but the frequency encoded by potential pathogens is significantly higher than that of non-potential pathogens. The frequency of genes encoding secretory toxins such as outer membrane protein, PapC N-terminal domain, PapC C-terminal domain, peptidase M16 inactive domain, and non-secretory toxins such as nitroreductase family, AcrB/AcrD/AcrF family, PLD-like domain, Cupin domain, putative hemolysin, S24-like peptidase, phosphotransferase enzyme family, endonuclease/ exonuclease/ phosphatase family, glyoxalase/ bleomycin resistance was high in potential pathogens. This study may facilitate mining new microbial natural products from the intestinal microbiome, understanding the colonization and infection mechanism of intestinal microorganisms, and providing targeted prevention and treatment of intestinal microbial related diseases.
Humans ; Virulence ; Multigene Family ; Bacteria ; Drug Resistance, Microbial ; Virulence Factors ; Peptide Hydrolases