Objective To investigate the effect of malignant cerebellar hemorrhage on 3-month prognosis of small spontaneous cerebellar hemorrhage.Methods Clinical data of 380 consecutive patients with spontaneous cerebellar hemorrhage admitted in Emergency Department of the Affil-iated Hospital of Guizhou Medical University,Neurosurgery Department of Jinyang Hospital Af-filiated to Guizhou Medical University,and Neurosurgery Department of the Second Affiliated Hospital of Guizhou Medical University from April 2014 to March 2023 were collected and retro-spectively analyzed,and finally,70 patients who met the requirements of small amount of sponta-neous cerebellar hemorrhage were enrolled in this study.They were assigned into benign cerebel-lar hemorrhage group(43 cases)and malignant cerebellar hemorrhage group(27 cases).Accord-ing to their clinical outcomes in 3 months after onset,they were divided into a good prognosis group(51 cases)and a poor prognosis group(19 cases).General clinical data,imaging data,com-plications,inflammatory indicators and prognosis were collected.After collinear diagnosis was used to exclude factors with collinear influence,the independent correlation between good progno-sis and poor prognosis was analyzed by binary logistic regression model.Finally,ROC curve was plotted to analyze the significant data.Results The maximum diameter of hematoma was signifi-cantly larger in the malignant cerebellar hemorrhage group than the benign group(P=0.021).The patients of the poor prognosis group had larger proportion of malignant cerebellar hemor-rhage,and higher neutrophil percentage,WBC count and NLR than those of the good prognosis group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that malignant cere-bellar hemorrhage was an independent predictor of poor prognosis in 3 months(OR=6.218,95％CI:1.140-17.623,P=0.013).The sensitivity,specificity,positive predictive value,negative pre-dictive value and Youden index of malignant cerebellar hemorrhage in predicting the 3-month prognosis of patients were 63.2％,70.6％,44.4％,83.7％and 0.338,respectively,and the AUC value was 0.669.Conclusion Malignant cerebellar hemorrhage is an independent predictor of 3-month prognosis in patients with small spontaneous cerebellar hemorrhage.The patients with malignant cerebellar hemorrhage have poor prognosis than those with benign cerebellar hemorrhage.

In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.
Humans ; Mice ; Animals ; Non-alcoholic Fatty Liver Disease/metabolism* ; NF-kappa B/metabolism* ; Organelle Biogenesis ; Retrospective Studies ; Mice, Inbred C57BL ; Obesity/metabolism* ; Liver ; Inflammation/metabolism* ; Body Weight ; Lipid Metabolism ; Lipids ; Diet, High-Fat/adverse effects*

Objective:To evaluate various blood lactate parameters in elderly patients with sepsis for prognostic prediction and exploration of optimal threshold values.The parameters include initial lactate concentration(LACinitial), lactate peak concentration(LACpeak), lactate peak time(LACtimetopeak), lactate accumulation area(LACarea), and 6-hour and 12-hour lactate clearance rates(LC_6 h and LC_12 h).Methods:This study conducted a retrospective screening of elderly patients with sepsis who were admitted to the intensive care unit(ICU)of the Beth Israel Deaconess Medical Center between 2008 and 2019.The study collected general information of the patients, as well as vital signs and laboratory indicators within 24 hours after admission.Additionally, the APSⅢ score, SOFA score, and OASIS score were continuously collected or calculated.The outcome variables examined were 28-day mortality from ICU admission, ICU length of stay, hospital length of stay, and mechanical ventilation time.The study compared the blood lactate parameters between the survival group and the nonsurvival group, and calculated the odds ratio( OR). A receiver operating characteristic curve(ROC curve)was plotted to analyze and compare the predictive performance of each lactate parameter based on 28-day mortality.The area under the curve(AUC)was calculated.Additionally, Kaplan-Meier survival curves were analyzed using the cutoff value of each lactate parameter. Results:A total of 4 773 elderly sepsis patients were included in the study.Among them, 1 166(24.4%)died within 28 days.The nonsurvival group had significantly higher levels of LACinitial[3.30(2.40, 5.30) vs.2.70(2.20, 3.50)mmol/L, Z=-13.047, P<0.001], LACarea[36.40(18.28, 63.00) vs.14.80(7.40, 27.30)mmol·L -1·h, Z=-10.298, P<0.001], LACpeak[4.00(2.80, 6.70) vs.3.10(2.50, 4.10)mmol/L, Z=-15.573, P<0.001], and LACtimetopeak[7.00(3.00, 15.00) vs.4.00(2.00, 8.00)h, Z=-13.084, P<0.001]. Additionally, the nonsurvival group had significantly lower levels of LC_6 h[0.06(-0.21, 0.29) vs.0.14(-0.22, 0.39), Z=2.966, P=0.003]and LC_12 h[0.12(-0.21, 0.42) vs.0.29(-0.09, 0.50), Z=5.638, P<0.001]. In this study involving 4 773 elderly sepsis cases, the lactate parameters were evaluated for their ability to predict death within 24 hours of ICU admission.The area under the curve(AUC)values, presented in descending order, were as follows: LACpeak[0.651(0.632, 0.670)], LACinitial[0.627(0.607, 0.646)], LACtimetopeak[0.626(0.607, 0.646)], and LACarea[0.590(0.569, 0.610)]. After excluding the cases where the LACarea was 0, the AUC increased to LACarea2[0.739(0.714, 0.764)]. A total of 1 217 patients had their lactate clearance rates at 6 hours and 12 hours calculated, with AUCs of LC_6 h[0.515(0.481, 0.548)]and LC_12 h[0.568(0.534, 0.603)], respectively.Furthermore, among 1 042 elderly sepsis patients with LACinitial>2 mmol/L, the AUCs of LC were LC_6 h[0.560(0.524, 0.596)]and LC_12 h[0.614(0.577, 0.651)]. The optimal cutoff values for LACinitial, LACpeak, LACtimetopeak, LACarea, LC_6 h, and LC_12 h, calculated from ROC curve analysis, were 3.55 mmol/L, 4.45 mmol/L, 7.50 h, 28.65 mmol·L -1·h, 0.304 and 0.272, respectively.The study population was divided into two groups based on whether they achieved the optimal cutoff value or not.The Kaplan-Meier survival curve showed a significant and distinguishable difference between these two groups(all P<0.05). Conclusions:In the prediction of 28-day mortality in elderly sepsis patients, LACarea was found to be the most effective indicator.LACpeak, LACinitial, and LACtimetopeak also showed acceptable predictive capabilities.On the other hand, LC performed the worst among the indicators, but its performance could potentially be enhanced by adjusting the applicable population.

OBJECTIVE To identify an d analyze chemical cons tituents of Pleione yunnanensis with origin of Pleione yunnanensis. METHODS UPLC-Q-Exactive-Plus-Orbitrap-MS was adopted. The determination was performed on Hyperdil GOLD column with mobile phase consisted of 0.1％ formic acid solution-0.1％ formic acid acetonitrile solution （gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was set at 40 ℃，and sample size was 2 µL. The electrospray ion source was adopted，and the scanning range was m/z 100-1 500，and the scanning mode was positive and negative ion exchange mode of full scan+ddMS2. The structure of chemical constituents were determined by using Compound Discoverer 3.1 software，comparing with mzCloud，PubChem network database and OTCML ，on the basis of reference substance and published literatures. RESULTS & CONCLUSIONS A total of 42 chemical constituents were identified （positive ion mode has 24，negative ion mode has 27）， including 13 benzyl succinate glycosides （such as dactylorhin C ，coelovirin A ，militarine），4 phenol glycosides （such as adenosine ， guanosine，gastrodin），3 alkaloids（choline，betaine，berberine），and one flavonoid （nobiletin），7 aromatics（such as DL-lysine ， DL-arginine，DL-glutamine），one sugar （sucrose），3 benzenes（shancigusin H ，shancigusin H isomer ，batatasin Ⅲ）and 10 others （such as p-methoxybenzoic acid ，monomethyl dodecanedioate ，diphenylamine）. Glucose oxybenzyl and some small mole cules are easy to be lost in the cleavage of benzyl succinate glycosides；glycosyl is easy to be lost in the cleavage of phenol glycosides；the cleavage of alkaloids mainly manifest as the cleavage and loss of small molecular substituents ；demethyla- tion reaction is occurred in most flavonoids.

Intracerebral hemorrhage (ICH) is an acute cerebrovascular disease with the highest mortality in subtype of stroke, accounting for 15%-20% of all strokes. There was no specific treatment for ICH currently. The mechanism of secondary neurological impairment after ICH remains unclear. Whether it is related to the process of ferroptosis caused by iron deposition is worth to further discuss. This paper reviews the related published articles about ferroptosis, which include mechanisms, inhibition methods and biomarker of ferroptosis.

Objective:To summarize the clinical characteristics of patients with chronic eosinophilic pneumonia (CEP), so as to provide reference for clinicians and improve the level of diagnosis and treatment.Methods:14 patients who met the diagnostic criteria of CEP in Xiangya Second Hospital of Central South University from January 2012 to July 2021 were analyzed retrospectively. Their clinical manifestations, laboratory examination, imaging characteristics, diagnosis and treatment were analyzed.Results:The male to female ratio of 14 patients with CEP was 6∶1, with a median age of 51 years. 3 patients had allergic rhinitis, sinusitis, rash and other allergic history. The course of the disease was about 4 months. The common symptoms included cough (14 cases), expectoration (13 cases), shortness of breath (10 cases), and occasional extrathoracic symptoms such as rash and lymphadenopathy (2 cases). Eight patients had abnormal pulmonary auscultation, mainly coarse respiratory sounds of both lungs and scattered dry and wet rales. The eosinophil count (EOS) in peripheral blood was increased in all patients, and the median EOS count was about 1.42×10 9/L. Total serum IgE increased in 11 patients, of which 10 cases were more than 1 000 ng/ml. Pulmonary function tests were performed in 11 patients, including 5 cases of normal pulmonary function, 3 cases of obstructive ventilation dysfunction and 3 cases of restrictive ventilation dysfunction. All 14 patients underwent lung computer tomography (CT) examination. Most of them (13 cases) were double lung infiltration. The pathological signs were mainly patch shadow (6 cases), ground glass shadow (4 cases), grid shadow (3 cases) and consolidation shadow (3 cases), and scattered nodule shadow (3 cases) was seen in some cases; Mediastinal or hilar lymphadenopathy occurred in 6 patients. 9 patients underwent bronchoscopic alveolar lavage (BAL) and cell classification and counting. Only 3 cases had EOS counts higher than the normal value (normal value<3%). 10 patients underwent bronchoscopic lung biopsy, and 6 patients had EOS infiltration in lung tissue. 9 patients were treated with glucocorticoids, 8 patients were treated with oral corticosteroids (OCS) (prednisone or methylprednisolone), and the initial dose was 30-50 mg; One case was treated with budesonide atomization alone; Five patients were not diagnosed with CEP, only used antibiotics or other symptomatic treatment, and did not use hormones. Conclusions:As a rare pulmonary disease, CEP has no specific clinical manifestations. The common symptoms are cough, expectoration, shortness of breath, etc, which is easily misdiagnosed. Laboratory tests often indicate increased peripheral blood EOS count and total IgE, and imaging usually shows diffuse infiltration in both lungs, with lymph node enlargement. OCS therapy is the first-line treatment for CEP. The short-term prognosis after OCS treatment is good, but it is prone to relapse. Some novel monoclonal antibody biologics can be used as alternative therapy.

A patient with thymoma associated immunodeficiency syndrome (Good's syndrome) and bronchiectasis was retrospectively analyzed. Good's syndrome is a rare condition of immunodeficiency that is characterized by thymoma and hypogammaglobulinemia. It is important to bear in mind that Good's syndrome should be included in the differential diagnosis When patients repeatedly visited for bronchiectasis or infection, we should alert to their immune state and history of thymoma. Early screening of immunological status and aggressive correction of immune deficiency are beneficial to improving the prognosis to patients with Good's syndrome.
Agammaglobulinemia/complications* ; Bronchiectasis/complications* ; Humans ; Retrospective Studies ; Thymoma/complications* ; Thymus Neoplasms/complications*

OBJECTIVE：To struc turally modify shikimic acid ，and to investigate the reversal effects of its derivatives on paclitaxel-resistant human breast cancer cells MCF- 7/PTX. METHODS ：Using shikimic acid as the lead structure ，1-position carboxyl group was structurally modified to synthesize a series of shikimic acid derivatives through esterification ，amidation， hydrogenation and reduction ，etc. Using non-drug resistant cells MCF- 7 as reference ，MTT assay was used to screen derivatives with inhibitory activity as well as half-inhibitory concentration （IC50）and reversal index （RI）of derivatives to MCF- 7/PTX. With the drug resistance-related transgelin 2 as the target ，the molecular docking of the active derivatives with the drug resistance-related protein was carried out by using Glide 1.0 computer-aided design software. RESULTS ：Totally 15 derivatives were obtained （T1-T15）， of which T 4-T15 were obtained for the first time. MTT assay showed that （3R， 4S， 5R） -N-benzyl-3， 4， 5-trihydroxy-1-cyclohexene-1-formamide（T7），（3R，4S，5R）-N-（3，4，5-trihydroxy-1-cyclohexenylmethyl）-benzylamine（T14）， （3R，4S，5R）-3，4-O-isopropyl-5-O-acetyl-1-cyclohexene-1-methyl formate （T15）inhibited MCF- 7 and MCF- 7/PTX cells to a certain extent ；IC50 values of T 7，T14 and T 15 combined with pacliaxel to MCF- 7/PTX cells were significantly lower than that in negative control （Paclitaxel alone ）group（P＜0.05）. RIs of T 14 and T 15 were higher ，and RIs of the highest dose were 8.8 and 9.3， which were equivalent to positive control verapamil （10.8）. Th e results of molecular docking showed that the hydroxyl groups at positions 3，4 of T 7 could form multiple hydrogen bonds with ； Arg625 and Asp 627 in the catalytic region of transgelin 2. In addition to the hydrogen bond mentioned above at T 7，the mail：batistuta28@126.com secondary amine side chain at position 1 of T 14 could also form hydrogen bond with Glu 657 of transgelin 2. When the hydroxyl group on the T 15 mother nucleus was derived from the donor group ，the binding of the hydroxyl group to transgelin 2 was closer and the inhibition was enhanced. CONCLUSIONS ： The derivatives T 7，T14 and T 15 have certain reverse activity to paclitaxel-resistant human breast cancer cells. The polyhydroxy structure of the mother nucleus is the main structural region of the hydrogen bond between shikimic acid and its derivatives and transgelin 2. The derivation of its power supply group or the introduction of secondary amines and hydrophobic groups into the 1-carboxyl group of shikimic acid is benifit for enhancing the drug resistance reversal effect of derivative .

Objective: To understand the health literacy and relevant factors of cancer prevention consciousness in Chinese urban residents from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of demographic characteristics and cancer prevention consciousness focusing on nine common risk factors, including smoking, alcohol, fiber food, food in hot temperature or pickled food, chewing betel nut, helicobacter pylori, moldy food, hepatitis B infection, estrogen, and exercise. The logistic regression model was adopted to identify the influencing factors. Results: The overall health literacy of the cancer prevention consciousness was 77.4% (24 980 participants), with 77.4% (12 018 participants), 79.9% (6 406 participants), 77.2% (1 766 participants) and 74.5% (4 709 participants) in each group (P<0.001). The correct response rates for nine risk factors ranged from 55.2% to 93.0%. The multivariate logistic regression analysis showed that compared with community residents, people with primary school level education or below, and the number of people living together in the family <3, the cancer risk assessment/screening intervention population, cancer patients, those with junior high school level educationor above and the number of people living in the family ≥3 had better health literacy of the cancer prevention consciousness (all P values <0.05). Compared with females, 39 years old and below, government-affiliated institutions or civil servants, from the eastern region, males, older than 40 years, company or enterprise employees, and from the middle or western region had worse health literacy of the cancer prevention consciousness (all P values <0.05). Conclusion The health literacy of the cancer prevention consciousness in Chinese urban residents should be improved. The cancer screening intervention, gender, age, education, occupation, the number of people co-living in the family, and residential region were associated with the health literacy of the cancer prevention consciousness.

Objective: To understand the consciousness of the cancer early detection among urban residents and identify the influencing factors from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. Self-designed questionnaires were used to collect population, socioeconomic indicators, self-cancer risk assessment, regular participation in physical examination and other information. The multivariate logistic regression model was used to identify the factors of people who had not regularly participated in the regular physical examination in the past five years. Results: The self-assessment results of 32 357 residents showed that there were 27.54% (8 882) of total study population with self-reported cancer risk, 45.48% (14 671) without cancer risk and 26.98% (8 704) with unclear judgement on their own cancer risk. Among population with cancer risk, 79.84% (7 091) considered physical examination accounted. In the past five years, there were 21 105 (65.43%) residents participated in regular physical examination and 11 148 (34.56%) participated in non-scheduled one, respectively. The multivariate logistic regression analysis showed that compared with unmarried and western region residents, divorced, middle and eastern region residents had a stronger consciousness to participate in the regular physical examination (P<0.05). Compare with residents with annual household income less than 20 000 CNY in 2014, cancer risk assessment/screening intervention population, and self-assessment with cancer risk, residents with annual household income between 20 000 CNY and 59 000 CNY in 2014, occupational population, community residents, cancer patients, self-reported cancer-free risk, and self-assessment with unclear judgement of cancer risk were less likely to participate in the regular physical examination (all P values <0.05). Conclusion From 2015 to 2017, the Chinese urban residents had a acceptable consciousness of the cancer early detection. The marital status, annual household income, population group and self-assessment of cancer risk were related to the consciousness of the cancer early detection of people who had not participated in the regular physical examination in the past five years.