Objective To explore the value of diffusion kurtosis imaging(DKI)in the diagnosis of Parkinson's disease with mild cognitive impairment(PD-MCI)patients.Methods A total of 18 patients with Parkinson's disease cognitive normal(PDN),22 patients with PD-MCI,and 24 healthy controls(HC)were prospectively included.All participants underwent DKI,and regions of interest(ROI)were selected in the substantia nigra,red nucleus,striatum,and posterior cingulate gyrus for post-processing.The diagnostic efficacy of DKI parameters on PD patients' cognitive status was analyzed by the receiver operating characteristic(ROC)curve.Results Compared with the PDN group,the PD-MCI group had a longer disease duration and a higher H-Y stage.Compared with the HC group,the PD-MCI group showed significantly lower mean kurtosis(MK),radial kurtosis(RK),axial kurtosis(AK),and fractional anisotropy(FA)values in the substantia nigra and posterior cingulate gyrus.In the PDN group,FA and MK values in the substantia nigra were significantly decreased,while FA values in the striatum and posterior cingulate gyrus were significantly increased(P＜0.05).Compared with the PDN group,the PD-MCI group showed significantly decreased DKI parameter values in the substantia nigra and posterior cingulate gyrus,and significantly decreased RK,AK,and FA values in the striatum(P＜0.05).The FA values of striatum,posterior cingulate gyrus and joint predictors were the most effective in the diagnosis of PD-MCI and the area under the curve(AUC)were 0.826,0.853 and 0.960,respectively.Conclusion DKI can detect microstructural changes in PD patients.Microstructural alterations in the striatum and posterior cingulate gyrus have an impact on early cognitive function changes in PD patients.FA demonstrate high sensitivity and specificity in the diagnosis of PD-MCI,and the combined diagnostic efficacy across multiple regions is even higher.

Animal models of cardiac arrhythmia are important tools for analyses of antiarrhythmic drug mechanisms and medical laboratory teaching.In this study,two major models,namely,barium chloride-induced arrhythmia in rabbits and ouabain-induced arrhythmia in guinea pigs,were systematically compared in terms of technical principles,modeling method,and indexes.By optimizing electrocardiographic parameters,standardizing arrhythmia grading criteria,and introducing quantitative analysis method,we revealed differences between the two models in terms of ion channel mechanisms,drug targets,and applicability to teaching.The barium chloride model was characterized by rapidly induced ventricular arrhythmia,which is suitable for the observation of acute drug efficacy.The ouabain model simulated the development of progressive arrhythmia,which is suitable for the study of the preventive effects of anti-arrhythmic drugs.This study provides a technical reference for the selection of arrhythmia models,optimization process,and mechanistic analyses in medical experimental teaching and is of great significance for improving the electrophysiology experimental skills of medical students.

Animal models of cardiac arrhythmia are important tools for analyses of antiarrhythmic drug mechanisms and medical laboratory teaching.In this study,two major models,namely,barium chloride-induced arrhythmia in rabbits and ouabain-induced arrhythmia in guinea pigs,were systematically compared in terms of technical principles,modeling method,and indexes.By optimizing electrocardiographic parameters,standardizing arrhythmia grading criteria,and introducing quantitative analysis method,we revealed differences between the two models in terms of ion channel mechanisms,drug targets,and applicability to teaching.The barium chloride model was characterized by rapidly induced ventricular arrhythmia,which is suitable for the observation of acute drug efficacy.The ouabain model simulated the development of progressive arrhythmia,which is suitable for the study of the preventive effects of anti-arrhythmic drugs.This study provides a technical reference for the selection of arrhythmia models,optimization process,and mechanistic analyses in medical experimental teaching and is of great significance for improving the electrophysiology experimental skills of medical students.

Objective To explore the value of diffusion kurtosis imaging(DKI)in the diagnosis of Parkinson's disease with mild cognitive impairment(PD-MCI)patients.Methods A total of 18 patients with Parkinson's disease cognitive normal(PDN),22 patients with PD-MCI,and 24 healthy controls(HC)were prospectively included.All participants underwent DKI,and regions of interest(ROI)were selected in the substantia nigra,red nucleus,striatum,and posterior cingulate gyrus for post-processing.The diagnostic efficacy of DKI parameters on PD patients' cognitive status was analyzed by the receiver operating characteristic(ROC)curve.Results Compared with the PDN group,the PD-MCI group had a longer disease duration and a higher H-Y stage.Compared with the HC group,the PD-MCI group showed significantly lower mean kurtosis(MK),radial kurtosis(RK),axial kurtosis(AK),and fractional anisotropy(FA)values in the substantia nigra and posterior cingulate gyrus.In the PDN group,FA and MK values in the substantia nigra were significantly decreased,while FA values in the striatum and posterior cingulate gyrus were significantly increased(P＜0.05).Compared with the PDN group,the PD-MCI group showed significantly decreased DKI parameter values in the substantia nigra and posterior cingulate gyrus,and significantly decreased RK,AK,and FA values in the striatum(P＜0.05).The FA values of striatum,posterior cingulate gyrus and joint predictors were the most effective in the diagnosis of PD-MCI and the area under the curve(AUC)were 0.826,0.853 and 0.960,respectively.Conclusion DKI can detect microstructural changes in PD patients.Microstructural alterations in the striatum and posterior cingulate gyrus have an impact on early cognitive function changes in PD patients.FA demonstrate high sensitivity and specificity in the diagnosis of PD-MCI,and the combined diagnostic efficacy across multiple regions is even higher.

The immune checkpoint blockade therapy has profoundly revolutionized the field of cancer immunotherapy. However, despite great promise for a variety of cancers, the efficacy of immune checkpoint inhibitors is still low in colorectal cancer (CRC). This is mainly due to the immunosuppressive feature of the tumor microenvironment (TME). Emerging evidence reveals that certain chemotherapeutic drugs induce immunogenic cell death (ICD), demonstrating great potential for remodeling the immunosuppressive TME. In this study, the potential of ginsenoside Rg3 (Rg3) as an ICD inducer against CRC cells was confirmed using in vitro and in vivo experimental approaches. The ICD efficacy of Rg3 could be significantly enhanced by quercetin (QTN) that elicited reactive oxygen species (ROS). To ameliorate in vivo delivery barriers associated with chemotherapeutic drugs, a folate (FA)-targeted polyethylene glycol (PEG)-modified amphiphilic cyclodextrin nanoparticle (NP) was developed for co-encapsulation of Rg3 and QTN. The resultant nanoformulation (CD-PEG-FA.Rg3.QTN) significantly prolonged blood circulation and enhanced tumor targeting in an orthotopic CRC mouse model, resulting in the conversion of immunosuppressive TME. Furthermore, the CD-PEG-FA.Rg3.QTN achieved significantly longer survival of animals in combination with Anti-PD-L1. The study provides a promising strategy for the treatment of CRC.

Objective: Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province. Methods: A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data. Results: The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05). Conclusions The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Objective: To improve clinical management of maternal and neonatal listeriosis through analyzing the clinical characteristics and antibiotic treatment. Methods: A retrospective analysis of 26 cases of listeriosis, including their demographic and clinical features, was conducted, involving 16 pregnant women from Civil Aviation General Hospital, Xiamen Humanity Hospital, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing Tiantan Hospital, Tangshan Maternal and Child Health Hospital, the Fourth Hospital of Tianshui City from October, 2011 to May, 2018, and 10 newborns from the Fourth Hospital of Tianshui City, Tangshan Maternal and Child Health Hospital, Zhengzhou Children's Hospital from February, 2016 to April 2018. Descriptive methods were used for data analysis. Results: (1) Among the 16 gravidas, one, five and 10 developed the infection in the 1st, 2nd and 3rd trimester of pregnancy, respectively, and eight had pregnancy complications. Furthermore, all of them developed fever [(38.9±0.5) ℃]. Symptoms such as cough, nasal congestion, runny nose, sore throat, dizziness, headache and other flu-like symptoms were observed in six cases. Gastrointestinal symptoms and flu-like symptoms were presented in four. Fetal distress, tachycardia and decreased fetal movement occurred in 11 cases. Elevated C-reactive protein and white blood cell count were detected in 16 and 14, respectively. Eight underwent placental pathological examination which shown various degrees of pathological changes, including neutrophil infiltration, acute chorioamnionitis and inflammatory necrosis. The main empirical antibiotic treatment for the 16 patients was cephalosporins and only four covered Listeria monocytogenes. Only two delivered at term, while the others (14/16) ended in miscarriage, premature delivery or stillbirth. (2) Among the 10 newborns with listeriosis, there were eight early-onset infections and two late-onset infections. All of them were febrile [(38.6±0.6)℃]. Six had cyanosis, groaning, foaming and three concave sign; five showed shortness of breath; meningitis and skin rash were found in one, respectively. All had elevated white blood cell and C-reactive protein. Six received antibiotics covering Listeria monocytogenes during the initial empirical treatment. Four were treated with cephalosporins alone, one of which died after the treatment was withdrawn. One was cured by initial treatment with meropenem alone, while eight recovered after adjustment of treatment with ampicillin, penicillin, meropenem, vancomycin alone, or meropenem combined with ampicillin or vancomycin. (3) The isolates that were susceptible to penicillin, ampicillin and meropenem accounted for 96.1% (25/26) all together and 88.5% (23/26) were susceptible to compound sulfamethoxazole. Conclusions There is no specific clinical manifestations of maternal or neonatal listeriosis. Maternal listeriosis is often characterized by acute onset and high incidence of adverse pregnancy outcomes.

Objective To analyze the influence of evidence-based nursing on psychological status and vascular complications in patients with radial artery puncture line PCI surgery.Methods A total of 96 radial artery puncture patients with PCI surgery were randomly divided into control group and observation group,the control group received conventional nursing care and observation group received evidence-based nursing care.The PHQ-9 and GAD-7 score before and after the operation were compared,and the incidences of vascular complications including local hematoma,subcutaneous ecchymosis,upper limb venous thrombosis,vascular occlusion and puncture sites with oozing blood were analyzed.Results After nursing,the PHQ-9 and GAD-7 scores at 24 h before operation in observation group were significantly lower than that in the control group (P ＜ 0.05).At 24 h after operation,the incidence of vascular complications in the observation group was 6.3 ％,which was lower than 29.2％ in control group (P ＜ 0.05).Conclusion Evidence-based nursing care can ease depression and anxiety in some extent,and reduce the incidence of postoperative vascular complications.Hence,it is worthy of further popularization and application in clinic.

Objective To analyze the influence of evidence-based nursing on psychological status and vascular complications in patients with radial artery puncture line PCI surgery.Methods A total of 96 radial artery puncture patients with PCI surgery were randomly divided into control group and observation group,the control group received conventional nursing care and observation group received evidence-based nursing care.The PHQ-9 and GAD-7 score before and after the operation were compared,and the incidences of vascular complications including local hematoma,subcutaneous ecchymosis,upper limb venous thrombosis,vascular occlusion and puncture sites with oozing blood were analyzed.Results After nursing,the PHQ-9 and GAD-7 scores at 24 h before operation in observation group were significantly lower than that in the control group (P ＜ 0.05).At 24 h after operation,the incidence of vascular complications in the observation group was 6.3 ％,which was lower than 29.2％ in control group (P ＜ 0.05).Conclusion Evidence-based nursing care can ease depression and anxiety in some extent,and reduce the incidence of postoperative vascular complications.Hence,it is worthy of further popularization and application in clinic.

Objective Through summaring all the randomized controlled trials published in Chinese Acupuncture & Moxibustion during the last 30 years,to investigate clinical researching situation of acupuncture in home and to provide objective and reliable data for other researchers.Methods All clinical research papers published in Chinese Acupuncture & Moxibustion from 1981-2010 was categorized and scored accordingto the size of sample,methods of grouping,and having or not having international or national diagnostic criteria,and then made a comprehensive analysis and comparison.Results ① RCT articles published in Chinese Acupuncture & Moxibustion has increased annually.②The methods of grouping has become more and more normative,which indicates that the level of RCT has been elevated.Of them,randmon digital table has been put into use the most frequently.Conclusion The quality of acupuncture clinical research papers are improving continuously,but the descriptions of the process need to be standardized.