Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The △APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among △APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among △APTw,NIHSS and mRS scores(R2=0.659,0.522,P<0.001),and the differences of △APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.

Immunoglobulin (IgG) glycosylation affects the effector functions of IgG in a myriad of biological processes and has been closely associated with numerous autoimmune diseases, including systemic lupus erythematosus (SLE), thus underlining the pathogenic role of glycosylation aberration in autoimmunity. This study aims to explore the relationship between IgG sialylation patterns and lupus pregnancy. Relative to that in serum samples from the control cohort, IgG sialylation level was aberrantly downregulated in serum samples from the SLE cohort at four stages (from preconception to the third trimester of pregnancy) and was significantly associated with lupus activity and fetal loss during lupus pregnancy. The type I interferon signature of pregnant patients with SLE was negatively correlated with the level of IgG sialylation. The lack of sialylation dampened the ability of IgG to suppress the functions of plasmacytoid dendritic cells (pDCs). RNA-seq analysis further revealed that the expression of genes associated with the spleen tyrosine kinase (SYK) signaling pathway significantly differed between IgG- and deSia-IgG-treated pDCs. This finding was confirmed by the attenuation of the ability to phosphorylate SYK and BLNK in deSia-IgG. Finally, the coculture of pDCs isolated from pregnant patients with SLE with IgG/deSia-IgG demonstrated the sialylation-dependent anti-inflammatory function of IgG. Our findings suggested that IgG influences lupus activity through regulating pDCs function via the modulation of the SYK pathway in a sialic acid-dependent manner.
Humans ; Pregnancy ; Female ; Lupus Erythematosus, Systemic/pathology* ; Signal Transduction ; N-Acetylneuraminic Acid/metabolism* ; Immunoglobulin G ; Dendritic Cells/pathology*

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

OBJECTIVE：To establish HPLC fingerprints of different polar parts of Zhuang medicine Calonyction muricatum ， and to study its spectrum-effect relationship with analgesic and anti-inflammatory effects. METHODS ：The total part ，ethyl acetate part，n-butanol part and water part of C. muricatum were prepared. HPLC fingerprints of different polar parts were established by HPLC method combined with the Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2012A），and the common peaks were identified. Using writhing times and ear swelling degree in mice as analgesic and anti-inflammatory indexes ，analgesic and anti-inflammatory activity of different polar parts of C. muricatum were investigated. The correlation of the common peaks of HPLC fingerprint with analgesic and anti-inflammatory indexes was analyzed by grey correlation analysis ，bivariate correlation analysis and partial least square （PLS） method. RESULTS ： There were 11 common peaks for the different polar parts of C. muricatum ，and 5 components were identified by reference comparison，i.e. neochlorogenic acid （peak 3），chlorogenic acid （peak 5）， cryptochlorogenic acid （peak 6）， isochlorogenic acid A （peak 10），isochlorogenic acid C （peak 11）. The grey correlation analysis showed that the correlation between all common peaks and analgesic and anti- inflammatory effects were greater than 0.6 （except the correlation between peak 6 and analgesic effects ），showing correlation relationship ；the correlation of peaks 3，7 and 10 with analgesic and anti-inflammatory effects were all greater than 0.8，which was highly related. Bivariate correlation analysis showed that the correlation of peak 1，3，4，7，9，10，11 with analgesic and anti-inflammatory effects were all greater than 0.6，showing correlation relationship. PLS method showed that peaks 1，3，4，7，9，10，11 contributed greatly to playing an analgesic and anti-inflammatory role. CONCLUSIONS ：HPLC fingerprints of different polar parts of C. muricatum is established and five common peak components were identified. Neochlorogenic acid ，isochlorogenic acid A ，isochlorogenic acid C and chemical components represented by peaks 1，4，7，9 may be the pharmacodynamic substances of C. muricatum to exert analgesic and anti-inflammatory effects.

OBJECTIVE：To eval uate the effect of pharmacists intervention on opioid treatment and management in outpatients with cancer pain under multidisciplinary team （MDT）mode. METHODS ：Totally 120 outpatients with cancer pain were selected from outpatient department of our hospital from Jan. 2016 to Dec. 2018，and divided into observation group and control group according to random number table method ，with 60 cases in each group. After 1 month follow-up ，patients in the control group were given opioid analgesics and routine intervention according to pain degree ，while patients in the observation group were given same treatment as control group and pharmacist intervention based on MDT. The pain condition ，medication compliance condition ， quality of life （QOL）score，the incidence of ADR and satisfaction degree were observed in 2 groups before and after intervention . RESULTS：Follow-up were completed in 2 groups. After intervention ，NRS scores of 2 groups were significantly lower than before intervention；the observation group was significantly lower than the control group ；medication compliance scores and QOL scores of 2 groups were significantly higher than before intervention ，the observation group was significantly higher than the control group at the same time . With the prolongation of treatment time ，the number of patients with mild pain and general medication compliance in 2 groups increased gradually ，and the observation group were significantly higher than the control group at the same time；the number of patients with moderate , severe pain and low medication compliance were significantly decreased gradually ， and the observation group was significantly lower than the control group at the same time. The number of patients with good medication compliance in the observation group was significantly higher than that in the same group before intervention and the control group at the same time （P＜0.05 or P＜0.01）. There was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. The satisfaction of pain control results ，doctors’treatment and pharmacists follow-up in the observation group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Under MDT mode ，pharmacists participating in the management of opioid treatment for cancer pain outpatients can effectively relieve the pain ，and improve the medication compliance and quality of life .

Objective To investigate the effect of transcranial direct current stimulation (tDCS) on the amplitude of low-frequency fluctuation (ALFF) of the resting brain function network in patients in a minimal conscious state (MCS) so as to explore the mechanism.Methods Eleven MCS patients were selected.Among them,there were 9 males and 2 females,10 with cerebral trauma and 1 with cerebral hemorrhage,with an average age of (37.3±8.4) and an average course of disease of (3.4±0.1) months.All subjects were given a resting-state functional magnetic resonance imaging (rs-fMRI) assessment prior to the single tDCS treatment,followed by a 20-minute single sham tDCS treatment at a time.After single-sham stimulation,a second time rs-fMRI assessment test will be conducted,followed by a real tDCS treatment for 20 minutes.Eventually,a third time rs-fMRI assessment test will be implemented.Results No significant statistical difference was shown in terms of all the parameters after single shamtDCS as compared to those before the treatment (P＞0.05).After single real-tDCS,no significant change was observed with CRS-R score,ALFF of default network (left anterior wedge),the frontal-parietal network (left fróntal lobe,right superior gyms),sensory motor network (left auxiliary motor area),subcortical network (right thalamus,bilateral caudate nuclei) was significantly higher than that before treatment,while the ALFF of the frontal network (frontal lobe) and auditory network (bilateral temporal lobes) was significantly decreased (P＜0.05).After single real-tDCS,the ALFF of default network (right frontal lobe) was significantly enhanced compared to that after single sham-tDCS (P＜0.05),while that of the salient network (left insula) and sensorimotor network (right central frontal) was significantly decreased (P＜0.05).Conclusion The enhancement of ALFF activity in the resting state brain function network is a possible neural mechanism for tDCS to promote the recovery of consciousness level in pa tients with minimal conscious state.

OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.

Objective To explore the effect of electroacupuncture and transcutaneous electrical acupoint stimulation (TEAS) on somatosensory evoked potential (SEP) of the upper extremity in healthy subjects. Methods From October, 2015 to April, 2016, ten healthy young volunteers were selected. Each of the subjects was randomly treated with electroacupuncture and TEAS. Before and after treatment, the latency and amplitude of N20 and N9 of SEP were detected. Results After electroacupuncture, the latency of N20 prolonged in the stimulated side (Z=-2.620, P<0.01); the latency of N9 prolonged (Z=-2.454, P<0.05), and the amplitude of N9 decreased (Z=-2.330, P<0.05) in the non-stimulated side. After TEAS, the latencies of N9 both in the stimulated side and the non-stimulated side prolonged (Z>2.695, P<0.01). There was no significant difference in the D-value of latency and amplitude of N20 and N9 in both two sides between two treatments (Z<1.817, P>0.05). Conclusion Both electroacupuncture and TEAS could affect the latency and amplitude of N20 and N9, and no difference was found between two treatments.

Objective To research and design-an personal dosimeter system to provide data for nuclear radiation injury protection.Methods The overall architecture,hardware module and software of the system were designed with ZigBee wireless network technology and the principle.The system was composed of a terminal node,a router and a coordinator.Results The system could collect the information on nuclear radiation dosage of the serviceman within 1 km,and then the data were uploaded with the wireless network.Conclusion The system gains advantages in low power consumption,low cost,low interference and etc,and plays a very important role for commander to hold the combatants' nuclear radiation dose in the battlefield.In addition the system can also be applied in civilian field to enhance the personal dose management.

Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.