Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

Objective To investigate the diagnostic value of neutrophils CD64(nCD64)index,C reactive protein(CRP),interleukin-6(IL-6)and procalcitonin(PCT)in viral and bacterial upper respiratory tract infections.Methods Patients with upper respiratory tract infection treated in Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University from January 2023 to January 2024 were selected as study objects.According to the results of etiological examination,they were divided into bacterial infection group(46 cases)and viral infection group(58 cases).The levels of nCD64 index,CRP,IL-6 and PCT before medication were compared between two groups.Receiver operating characteristic(ROC)curve was used to evaluate the value of infection markers in the differential diagnosis of bacterial and viral upper respiratory tract infections.Results The levels of CRP,nCD64 index,IL-6 and PCT in bacterial infection group were significantly higher than those in viral infection group(P＜0.01).ROC curve results showed that the area under the curve(AUC)of nCD64 index,CRP,PCT and IL-6 to distinguish the two types of infection were 0.818,0.776,0.692 and 0.654,respectively,and the combined AUC of four indexes was 0.870.Conclusion nCD64 index,CRP,IL-6 and PCT are closely related to the pathogen types of patients with upper respiratory tract infection,and the combined detection of all indicators can improve the diagnostic efficiency of upper respiratory tract infection types.

Background Bipolar disorder is a severe mental disorder characterized by cycling between mania/hypomania and depression,yet its underlying pathophysiological mechanism remains unclear.Several prior studies have suggested a potential role for voltage-gated calcium channel subunit genes in the etiology of bipolar disorder,particularly in their influence on brain structure.Objective To investigate the differences in grey matter volume(GMV)for individuals with bipolar disorder compared to healthy controls,and to explore the potential influence of calcium channel voltage-dependent T-type α1 G subunit(CACNA1G)rs757415 polymorphism on GMV in bipolar disorder and clarify the specific brain regions associated with this genetic variation,thus offering a new opportunity to gain insight into the pathophysiological mechanism of bipolar disorder.Methods A cohort of 289 patients who met the Diagnostic and Statistical Manual of Mental Disorders,fourth edition(DSM-IV)criteria for bipolar disorder were selected for participation.These patients were either admitted to hospital or examined in outpatient clinic for bipolar disorder at the Mental Health Center of West China Hospital,Sichuan University between September 2013 and December 2022.Another 322 healthy individuals were concurrently recruited as a control group from Sichuan University and surrounding communities.All participants underwent brain imaging using a 3.0 T magnetic resonance scanner to acquire data on GMV.Additionally,the presence of the CACNA1G rs757415 polymorphism was validated using the imLDRTM technique.Spearman correlation analysis was utilized to investigate potential relationship between abnormal brain regions identified through GMV data and clinical characteristics of the patients.Then the genotype-by-diagnosis interaction effect for CACNA1G rs757415 on GMV was observed using the full factor method.Results The study successfully enrolled 173 patients with bipolar disorder and 207 healthy controls who completed all the necessary procedures.Analyses revealed decreased GMV for patients with bipolar disorder compared to healthy controls in the left cerebellar declive extending to cerebellar anterior/posterior lobe,fusiform gyrus,parahippocampal gyrus and inferior occipital gyrus(t=5.664,P<0.05);in the right cerebellar anterior/posterior lobe,fusiform gyrus,parahippocampal gyrus extending to lingual gyrus(t=4.583,P<0.05);in the bilateral anterior cingulate/paracingulate gyri,superior frontal gyrus and precuneus(t=7.543,P<0.05);in the left lingual gyrus and superior temporal gyrus(t=6.593,P<0.05);and in the right insula entending to central operculum(t=7.153,P<0.05).Correlation analysis indicated that the duration of bipolar disorder was positively correlated with cerebrospinal fluid volume(r=0.258,P=0.003),whereas negatively correlated with the GMV in the left cerebellar declive extending to cerebellar anterior/posterior lobe,inferior occipital gyrus and parahippocampal gyrus(r=-0.204,P=0.019),in the right cerebellar anterior lobe extending to right cerebellar posterior lobe,fusiform gyrus,parahippocampal gyrus and lingual gyrus(r=-0.238,P=0.006),in the bilateral superior frontal gyrus extending to anterior cingulate/paracingulate gyri and precuneus(r=-0.219,P=0.012),in the left lingual gyrus extending to superior temporal gyrus(r=-0.296,P=0.001),and in the right insula extending to central operculum(r=-0.257,P=0.003).A significant genotype-by-diagnosis interaction effect for CACNA1G rs757415 on GMV was observed in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5(F=19.967,P<0.05).In the control group,individuals carrying the non-risk allele showed increased GMV in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5 compared to those carrying the risk allele.In contrast,within the patient group,risk allele carriers exhibited increased GMV in the same brain regions when compared to non-risk allele carriers.Moreover,the GMV in the right parahippocampal gyrus-fusiform gyrus-cerebellum 4-5 of patients with bipolar disorder carrying risk alleles was increased compared to healthy controls.Conclusion CACNA1G rs757415 polymorphism may affect the GMV in the right parahippocampal gyrus,fusiform gyrus and cerebellum 4/5 of patients with bipolar disorder.

Objective To analyze the risk factors for postoperative gastroparesis syndrome (PGS) in gastric cancer patients undergoing laparoscopic radical gastrectomy (LRG) and to construct and validate a nomogram prediction model for PGS. Methods The clinical data of 439 gastric cancer patients were retrospectively analyzed. Patients were divided into PGS group and control group based on whether PGS occurred within 2 months after surgery. Logistic regression analysis was used to screen for risk factors of PGS in LRG patients, and a nomogram prediction model was constructed based on the screening results. The discriminative ability of the nomogram was assessed by the receiver operating characteristic (ROC) curve, and its consistency was evaluated by the calibration curve. Results Among 439 patients, 52 developed PGS, with an incidence rate of 11.85%. The proportions of patients aged ≥60 years, complicating with diabetes, having a history of abdominal surgery, complicating with pyloric obstruction, having surgery duration ≥4 hours, and intraoperative anastomosis type of B-Ⅱ were higher in the PGS group than those in the control group (P < 0.05). The results of multivariate Logistic regression analysis showed that diabetes, a history of abdominal surgery, pyloric obstruction, surgery duration ≥4 hours, and intraoperative anastomosis type of B-Ⅱ were risk factors for PGS in LRG patients (P < 0.05). Internal validation results showed that the area under the ROC curve was 0.839 (95%CI, 0.773 to 0.905), the calibration curve fitted well, and the Hosmer-Lemeshow goodness-of-fit test result was good(χ²=9.078, P=0.247). Conclusion Diabetes, a history of abdominal surgery, pyloric obstruction, surgery duration ≥4 hours, and intraoperative anastomosis type of B-Ⅱ are risk factors for PGS in LRG patients. The nomogram constructed based on these factors can effectively predict the risk of PGS in LRG patients.

To evaluate bioequivalence and safety of two kinds of metformin hydrochloride sustained-release tablets (test preparation vs reference preparation) under the condition of fed and single administration.A single center, randomized, open, single-dose, two-period, two-sequence, and double-crossover design was used.32 healthy subjects took 0.5 g of test preparation or reference preparation under fed and single-dose administration.4 mL of venous blood was collected from before administration (0 h) to 1, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12, 15, 24, 36 and 48 h after administration.The concentration of metformin in plasma samples was detected, and then the pharmacokinetic parameters were calculated by WinNonlin 7.0 software.When the 90% confidence intervals of cmax, AUC0-t and AUC0-∞ geometric mean ratio of test preparation and reference preparation were within 80.00%-125.00% equivalent intervals respectively, the bioequivalence of the two preparations was proved.One subject fell off due to adverse events.The main pharmacokinetic parameters of test preparation and reference preparation as follows: cmax were (0.68 ± 0.14) and (0.65 ± 0.11) mg/L, AUC0-t were (7.33 ± 1.65) and (7.00 ± 1.89) h·mg/L, AUC0-∞ were (7.39 ± 1.67) and (7.06 ± 1.91) h·mg/L, respectively.The 90% confidence intervals of the geometric mean ratio of the two main pharmacokinetic parameters were 101.45%-109.14%, 100.08%-112.32% and 100.24%-112.28%, respectively, which fell within the bioequivalence interval of 80.00%-125.00%.There were no serious adverse events and unexpected adverse events during the trial.The results show that test preparation and reference preparation are bioequivalent under fed and single-dose administration, safe and well tolerated in healthy subjects.

Objective:To explore the selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle.Methods:The retrospective observational research method was used. From January 2017 to December 2022, 16 patients with skin and soft tissue defects in foot and ankle after high-voltage electric burns were treated in General Hospital of Eastern Theater Command, including 11 cases of unilateral defect and 5 cases of bilateral defect. All patients were male, aged from 25 to 75 years. After thorough debridement, the area of the defect to be repaired with the flap was 5.0 cm×4.0 cm to 12.0 cm×8.0 cm. Before operation, the color Doppler ultrasound, computed tomography angiography, or digital subtraction angiography was used to fully evaluate the degree of vascular injury in the affected limb and to identify the distribution and traffic anastomosis of vascular network. Pedicled axial flaps with reliable blood supply were used to repair the wounds as soon as possible, and the area of flaps ranged from 3.0 cm×2.0 cm to 13.0 cm×8.0 cm. The wound in the donor area of flaps was repaired with split-thickness skin graft from head or medium-thickness skin graft from thigh. The flap repair of wounds in various areas of the ankle and foot was recorded. The postoperative survivals of the flaps and skin grafts were observed after surgery. The postoperative appearance of flaps and walking function of patients were followed up. At the last follow-up, the foot and ankle function was evaluated and rated using the American Association of Foot and Ankle Surgeons Ankle Posterior Foot Scoring System.Results:Two wounds in toe area were repaired with reverse dorsal pedis flaps, 3 wounds in medial ankle area and 2 wounds in heel area were repaired with medial plantar flaps, 2 wounds in anterior plantar area combined with toe area were repaired with reverse medial plantar flaps, 2 wounds in anterior plantar area combined with toe area and 5 wounds in anterior plantar area were repaired with reverse medial pedis flaps, 1 wound in toe area was combined with proper plantar digital artery flap, 1 dorsal pedis wound and 1 lateral malleolus wound were repaired with lateral supramalleolar perforator flaps, and 1 lateral malleolus wound and 1 dorsal pedis wound were repaired with sural neurovascular flap. One flap had venous reflux disorder after surgery and survived after treatment, while the other flaps and skin grafts survived completely after surgery. During the follow-up of 6 to 24 months after operation, the appearance of the flaps was good, and the walking function of patients was normal. At the last follow-up, the functional score of foot and ankle was 76 to 95, which was evaluated as excellent in 11 cases and good in 5 cases.Conclusions:According to the condition of high-voltage electric burn in foot and ankle, early and thorough debridement, preoperative imaging examination to evaluate blood vessels of the affected limb, and selection of pedicled axial flap with reliable blood supply are good methods for wound repair and related functional reconstruction of high-voltage electric burn in foot and ankle.

OBJECTIVE To compare anti-ischemic stroke （IS） effect of different extraction parts from Gastrodia elata， and to provide reference for screening the anti-IS effective parts of G. elata. METHODS G. elata was extracted and separated by ethanol reflux extraction and ethyl acetate extraction. The rat model of diffuse cerebral thrombosis was induced by internal carotid artery injection of arachidonic acid （AA）； the anti-IS effect of G. elata powder， ethanol extract of G. elata， residue of ethanol extract of G. elata， ethyl acetate extract of G. elata， residue of ethyl acetate extract of G. elata， gastrodin and aspirin （positive control drug） were investigated with the content of Evans blue （EB） in the ischemic brain tissue as index. RESULTS Compared with model group， aspirin， ethanol extract of G. elata and ethyl acetate extract of G. elata could significantly decrease the content of EB in the ischemic brain tissue of model rats （P＜0.05）. G. elata powder had the tendency to reduce the content of EB in the ischemic brain tissue of model rats， without statistical significance （P＞0.05）. The residue of ethanol extract of G. elata， residue of ethyl acetate extract of G. elata and gastrodin had little effect on the content of EB in the ischemic brain tissue of model rats. CONCLUSIONS Both ethanol extract of G. elata and ethyl acetate extract of G. elata have anti-IS effects， which are stronger than that of G. elata powder.

BACKGROUND: MicroR-10 b can regulate the characteristics of breast cancer stem cells, and acetaldehyde dehydrogenase 1 (ALDH1) is one of the most important markers of breast cancer stem cells. The interaction between them in breast cancer cells needs further explorations. OBJECTIVE: To investigate whether over-expression of microRNA-10 b affects ALDH1 mRNA and protein levels in human breast cancer MCF-7 cells. METHODS: hsa-miR-10 b mimics or its negative control was transfected into breast cancer MCF-7 cell line. At 48 hours after transfection, the mRNA and protein expression of ALDH1 in the cells was detected using real-time RT-PCR and western blot assays, respectively. RESULTS AND CONCLUSION: Over-expression of microR-10 b was found in the MCF-7 cell line transfected with hsa-miR-10 b mimics, which was significantly higher than that in the control group (P=0.003 47). Both of ALDH1 mRNA and protein levels were up-regulated in the MCF-7 cell line overexpressing microR-10 b, as compared with the control group (P=0.009 54 and P=0.003 11, respectively). To conclude, over-expression of microR-10 b induces the ALDH1 mRNA and protein expression in the breast cancer MCF-7 cell line, providing new evidence that microR-10 b regulates the invasion and metastasis of breast cancer cells.

Objective To investigate the factors affecting the efficacy of leflunomide combined with medium/low dose corticosteroids in the treatment of progressive IgA nephropathy (IgAN).Methods Clinical and pathological parameters were collected retrospectively in patients of primary IgAN with proteinuria＞ 1.0 g/24 h and chronic kidney disease (CKD) stage 1-3 treated with leflunomide combined with medium/low dose corticosteroids in Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University from Jan 2005 to Dec 2010.According to the treatment effects,patients were divided into complete remission group and non-complete remission group.The biochemical and pathological indexes of the two groups were compared.Results A total of 42 patients were included.The remission rates at 3,6,9 and 12 months were 62％,64％,67％ and 74％,respectively.Seventeen (40.5％) and fourteen (33.3％) patients achieved complete and partial remission after one-year treatment,and the remission rate remained stable within one year after withdrawal of drugs.The 24hour proteinuria was 1.50 (0.67,2.66) g,which was significantly reduced compared with the baseline 2.44 (1.36,3.74) g (P ＜ 0.01).The decrease rate was 31.3％.There was a slight decrease in proteinuriawithin one year after withdrawal of drugs.Estimated glomerular filtration rate (eGFR) remained stable during the treatment and a year of follow-up.No serious adverse event was observed during the followup period.Among 31 responder patients,6(19.4％) patients relapsed.Logistic multivariate regression analysis suggested that the degree of renal interstitial inflammatory infiltration was an independent predictor of complete remission with one-year treatment of leflunomide combined with medium / low dose corticosteroids (HR=0.067,95％ CI 0.008-0.535,P=0.011).Conclusions IgAN treated with leflunomide and medium/low dose corticosteroids can achieve remission in early stage,and the remission rate remains stable after withdrawal of drugs.It is a safe option for the treatment of IgAN.Renal interstitial inflammatory infiltration is an independent predictor of complete remission.

Objective To validate the effect of Renji acute kidney injury score (RAKIS) on predicting patients with acute kidney injury (AKI) after cardiac surgeries,and make comparison with Cleveland score,simplified renal index (SRI) and acute kidney injury following cardiac surgery (AKICS).Methods Patients undergoing open heart surgery from 2008/01/01 to 2010/10/31 in Renji hospital were enrolled,and their scores of those four scoring models were calculated.AKI patients were diagnosed by KDIGO,and those scores of AKI patients and non-AKI patients were compared.Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to decide the predictive values of those models.Results A total of 1126 patients were chosen in this cohort,with the average age of (58.43±14.88) years (rang from 18 to 88).The male to female ratio was 1.47:1.And 355(31.5％) patients were developed AKI.AKI stage Ⅰ,Ⅱ and Ⅲ were 65.4％,23.7％ and 11.0％ respectively.RAKIS was significantly higher in AKI patients than in non-AKI patients (17.5 vs 9.0,P ＜ 0.001).The AUCs of RAKIS to predict AKI,AKI Ⅱ-Ⅲ stages,renal replacement therapy (RRT)and in-hospital death were 0.818,0.819,0.800 and 0.784 respectively.The AUCs of Cleveland score and SRI were 0.659 to 0.710,lower than those of RAKIS and AKICS.AKICS had lower value for predicting AKI and AKI Ⅱ-Ⅲ stages (AUC 0.766 and 0.793),but good value in predicting RRT and inhospital death after surgery (AUC 0.804 and 0.835) as compared with RAKIS.Conclusions RAKIS is valid and accurate in the discrimination of KDIGO defined AKI patients,while for predicting the composite end point,AKICS may be more useful.