Objective To observe the efficacy,cognitive function and safety of lurasidone hydrochloride in the treatment of acute schizophrenics.Methods Patients with acute schizophrenia were randomly divided into treatment group and control group.The treatment group was given lurasidone hydrochloride at the dosage of 40 mg on day 1,and 40-80 mg according to the need within 1 week,once a day.The control group received 4-6 mg·d-1 risperidone twice a day.The total observation lasted for 6 weeks.The positive and negative symptoms scales(PANSS)were performed at baseline,the 1st,the 2nd,the 4th and the 6th weekend of the treatment.Both groups were evaluated by Montreal cognitive assessment(MoCA)at baseline,and the 6th weekend.Compare the clinical efficacy and incidence of adverse drug reactions between the 2 groups of patients.Results 42 patients in the treatment group and 41 patients in the control group.The total effective rates for the treatment and control groups were 80.95％and 80.49％,respectively,with no statistically significant difference(P＞0.05).In treatment group and control group,at baseline,the total PANSS scores were 88.12±8.99 and 88.68±9.29,the MoCA scores were 20.48±2.65 and 20.24±2.85,respectively.At the 6th weekend of the treatment,the total PANSS scores were 55.90±11.14 and 54.68±13.34,the MoCA scores were 26.74±1.99 and 25.22±2.46,respectively,both were statistically different with those before treatment(all P＜0.01).MoCA scores were higher in the treatment group than those in the control group at the 6th weekend(P＜0.01).The incidences of adverse reaction in the treatment group and the control group were 30.95％and 56.10％,respectively,with significant difference(P＜0.05).Conclusion The efficacy of lurasidone hydrochloride and risperidone in the treatment of acute schizophrenia is equivalent.It is a kind of cognitive function well improved drug,as well as fewer adverse drug reactions,and well tolerated.

Fungal mycetoma is a chronic granulomatous lesion that persists in the skin and subcutaneous tissue for a long time.It is commonly caused by fungal infection in field workers who are pricked to the subcutaneous tissue by thorns from soil,plants,or bramble.Fungal mycetoma cases is rare in China.This article reports two cases of fun-gal mycetoma caused by Madurella grisea and Aspergillus flavus infection,which improve after surgical debride-ment and antifungal drug treatment.This study aims to improve clinicians'understanding on fungal mycetoma and achieve early diagnosis and treatment.

AIM To study the chemical constituents from the stems of Gnetum parvifolium(Warb.)C.Y.Cheng ex Chun and their xanthine oxidase inhibitory activities.METHODS The 95%ethanol extract from the stems of G.parvifolium was isolated and purified by silica gel,MCI and preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The inhibitory activities on xanthine oxidase was determined by ultraviolet spectrophotometry.RESULTS Seventeen compounds were isolated and identified as isorhapontigenin(1),resveratrol(2),4-hydroxybenzaldehyde(3),cycloeucalenol(4),(E)-1-(3',5'-dimethoxyphenyl)-2-(3,4-dimethoxyphenyl)ethene(5),stigmast-4-en-3-one(6),medioresinol(7),chrysin(8),aurantiamide acetate(9),(-)-pinoresinol(10),methyl 4-hydroxybenzoate(11),2-methoxybenzene-1,4-diol(12),gnetumontain C(13),syringaresinol(14),homoeriodictyol(15),vanillin(16),β-sitosterol(17).The IC50 values of compounds 1-3,15-16 were(11.4±0.54),(14.1±1.06),(320.4±0.75),(360.6±0.78),(386.3±0.71)μmol/L,respectively.CONCLUSION Compounds 3-4 are isolated from this plant for the first time.Compounds 5-13 are first isolated from genus Gnetum.Compounds 1-3,15-16 have xanthine oxidase inhibitory activities.

Objective: To evaluate the inter-observer agreement of the severity of oral epithelial dysplasia in oral leukoplakia, providing a theoretical basis for the development of a more objective grading system. Methods: This study included 60 digital pathological slides of oral leukoplakia from Oral Medicine Department of West China Hospital of Stomatology, Sichuan University, and 239 tissue microarray images of oral leukoplakia from State Key Laboratory of Oral Diseases, Sichuan University, to evaluate the agreement of grading. Besides, 1 000 patches were generated from the 60 digital pathological slides and were divided into 500 small-sized patches (224 pixel×224 pixel) and 500 large-sized patches (1 024 pixel×1 024 pixel), to evaluate the agreement of feature detection. Gradings and feature detections were completed by three pathological experts from the oral pathology departments of two Grade 3, Class A stomatological hospitals in China. Kappa coefficient was used to quantify the inter-observer agreement among pathologists. Results: Minimal agreement was found in the grading of oral epithelial dysplasia among pathologists (Kappa=0.30 in the pathological slide group, Kappa=0.30 in the tissue microarray group). None agreement was found in feature detection within the small-sized patches group (median Kappa=0.14 for architectural features, median Kappa=0.18 for cytological features), and minimal agreement was found in feature detection within the large-sized patches group (median Kappa=0.25 for architectural features, median Kappa=0.25 for cytological features). Conclusions: Generally, the agreement of grading and feature detection of oral epithelial dysplasia in oral leukoplakia is poor. Development of a more objective grading system of oral epithelial dysplasia based on artificial intelligence may be helpful to improve the agreement.
Artificial Intelligence ; China ; Humans ; Leukoplakia, Oral ; Observer Variation ; Precancerous Conditions

OBJECTIVE: To compare the clinical efficacy of lengthened proximal femoral nail anti-rotation(PFNA) combined with minimally invasive percutaneous plate osteosynthesis(MIPPO) and common PFNA in the treatment of AO-A3.3 intertrochanteric fracture. METHODS: The clinical data of 58 patients with AO-A3.3 intertrochanteric fracture treated from January 2015 to April 2020 were retrospectively analyzed. Among them, 27 patients were treated with extended PFNA + MIPPO plate to reconstruct the lateral wall (group A), and 31 patients were treated with closed reduction and PFNA fixation (group B). The bleeding volume, operation time, femoral neck length and tip apex distance(TAD), fracture healing time and postoperative complications were observed and compared between two groups. Harris score was used to evaluate hip joint function 10 months after operation. RESULTS: All patients were followed up for 12 to 28 months. The incision healed well after operation. The bleeding volume and operation time of group A were significantly more than that of group B (P<0.05), and the fracture healing time of group A was significantly less than that of group B(P<0.05). There was no significant difference in the length of femoral neck between two groups at 2 days after operation(P>0.05). The length of femoral neck at 6 months after operation in each group was shorter than that at 2 days after operation(P<0.05), and the shortening of femoral neck at 6 months after operation in group B was significantly shorter than that in group A(P<0.05). There was no significant difference in TAD values between two groups at the same time point(P>0.05) at 2 days and 6 months after operation. There was no significant difference in TAD values between 2 days and 6 months after operation(P>0.05). The incidence of complications in group B was significantly higher than that in group A(P<0.05). The Harris scores of hip joint function in group A were higher than those in group B 10 months after operation (P<0.05). CONCLUSION Compared with the treatment of AO-A3 femoral intertrochanteric fracture with closed reduction and PFNA fixation, the lengthened PFNA combined with MIPPO small plate for reconstruction and fixation of the lateral wall can promote the fracture healing, improve the patient's functional recovery, and significantly reduce the complications.
Humans ; Bone Nails ; Fracture Fixation, Intramedullary ; Retrospective Studies ; Hip Fractures/surgery* ; Bone Plates ; Femoral Fractures/surgery*

Objective To compare and analyze the lower limb muscle activity and knee joint force during the stance periods of gait cycle in patients with osteoarthritis before and after total knee arthroplasty (TKA). Methods Based on the OpenSim platform, lower extremity musculoskeletal models of one healthy subject and three patients with osteoarthritis before and after TKA were established. A three-dimensional （3D） motion capture system and a force platform were used to collect the lower limb kinematic data and the ground reaction force during walking, which were used as input parameters to simulate the lower limb muscle activation and knee joint forces. Results The results from the musculoskeletal model were consistent with the results by inverse dynamics based on the 3D motion capture system. The patient's rectus femoris was activated in the loading response and mid stance phases, which was different from that of healthy subject. The activation timing and amplitude of the quadriceps muscle in 3 patients were significantly different before and after TKA. The peak joint forces of 3 patients before TKA were 2.95, 3.15 and 3.43 times of body weight (BW) with the constant load of more than 2 times of BW during stand phase. The peak joint force after TKA were 2.09, 2.48 and 3.96 times of BW respectively. The joint force was not improved and the knee function did not reach the normal level six months after TKA. Conclusions The results of the established musculoskeletal model have certain reliability, and this model can provide a biomechanical auxiliary method for TKA surgery in the future.

OBJECTIVE: To study the value of anti-neutrophil cytoplasmic antibody (ANCA) in assessing the severity of bronchiolitis obliterans (BO) in children. METHODS: A prospective analysis was performed on 59 children who were diagnosed with BO from June 2009 to October 2014. ELISA was used to measure the concentrations of myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA in serum. According to the results of ELISA, the children were divided into three groups: double-negative ANCA (n=22), single-positive ANCA (n=17), and double-positive ANCA (n=20). The three groups were compared in terms of the scores of BO risk factors, clinical symptoms, chest high-resolution computed tomography (HRCT), and lung pathology on admission, as well as the changes in the expression level of ANCA and the scores of clinical symptoms and chest HRCT over time. RESULTS: Compared with the double-negative ANCA group, the double-positive ANCA group had a significantly higher score of BO risk factors (P<0.05), and the single-positive ANCA group and the double-positive ANCA group had significantly higher scores of clinical symptoms, chest HRCT, and lung pathology (P<0.05). The children were followed up for 6 months after discharge, and there were significant reductions in MPO-ANCA and PR3-ANCA titers from admission and discharge to the end of follow-up (P<0.05), as well as a significant reduction in the score of clinical symptoms from admission to the end of follow-up (P<0.05), while there was no significant change in the score of chest HRCT from admission to the end of follow-up (P>0.05). The single-positive ANCA and double-positive ANCA groups still had a significantly higher score of clinical symptoms than the double-negative ANCA group (P<0.05). CONCLUSIONS The expression level of ANCA is correlated with the severity of BO in children and thus has certain clinical significance in disease evaluation.
Antibodies, Antineutrophil Cytoplasmic ; Bronchiolitis Obliterans ; Child ; Humans ; Myeloblastin ; Peroxidase ; Prospective Studies

BACKGROUND: Currently, there are few studies about prostaglandin E1 in the paracrine and migration of bone marrow mesenchymal stem cells. OBJECTIVE: To explore the effects of prostaglandin E1 in the paracrine and migration of bone marrow mesenchymal stem cells. METHODS: Bone marrow mesenchymal stem cells isolated from Sprague Dawley rats were cultured in vitro. Passage 3 cells were co-cultured with prostaglandin E1 at concentrations of 10 μg/L, and then culture supernatant was collected at 3, 6, 9, 12, 24, 48, and 72 hours after co-culture. The level of vascular endothelial growth factor was detected by enzyme-linked immunosorbent assay. Effects of prostaglandin E1 on the migration of bone marrow mesenchymal stem cells were detected by Transwell assay and cell scratch assay. RESULTS AND CONCLUSION: After treatment with prostaglandin E1 for 3 hours, bone marrow mesenchymal stem cells began to secrete vascular endothelial growth factors, and the secretion level was peaked at 24 hours and then gradually decreased. Results from the Transwell assay and cell scratch assay showed that the migration ability of bone marrow mesenchymal stem cells was significantly promoted by prostaglandin E1 (P < 0.05). Overall findings reveal that prostaglandin E1 promotes the secretion of vascular endothelial growth factor from bone marrow mesenchymal stem cells and enhances cell migration.

Objective To investigate the antagonistic effect of ω-3PUFAs on cognitive impairment in MK-801-induced schizophrenia (SZ) rats and its mechanism.Methods Rat model of schizophrenia was induced by MK-801.Morris water maze was used to detect the change of cognitive function in rats.The number of neonatal neurons in hippocampus was detected by Brdu staining.CREB,p-CREB,BDNF,TrkB and p-TrkB levels were detected by Weston Blot.Results MK-801 induced schizophrenia-like cognitive impairment (the escape latency in the water maze test was (6.51±3.10)s for Ctr group,(15.27±6.20)s for Mod group;acrossing times was (4.63±1.06) times for Ctr group,(2.00±1.15) times for Mod group),reduced the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Mod/Ctr was 0.656±0.066) and impaired the CREB/BDNF/TrkB pathway (the relative level of gray value,Mod/Ctr:CREB was 0.393±0.065,p-CREB was 0.591±0.015,BDNF was 0.716±0.115,TrkB was 0.787±0.029,p-TrkB was 0.586±0.013).ω-3PUFAs improved the CREB/BDNF/TrkB pathway activity by increasing CREB and TrKB level and their phosphorylation (the relative level of gray value,Pre/Ctr:CREB was 1.139±0.111,p-CREB was 0.845±0.243,BDNF was 0.864±0.133,TrkB was 0.916±0.022,p-TrkB was 0.952±0.047),and then recovered the number of neonatal neurons in hippocampus (the relative level of neonatal neuron number per unit area,Pre/ Ctr was 1.183±0.101),thereby reduced the cognitive dysfunction in schizophrenia rats(the escape latency in the water maze was (7.44±4.55)s for Pre;acrossing times was (3.86±1.68) times for Pre).Conclusion ω-3PUFAs can relieve the MK-801-induced schizophrenia-like cognitive impairment.

This study was to determine the protective effect of ω-3 polyunsaturated fatty acids (ω-3PUFAs) on MK-801-induced cognitive impairment in schizophrenia (SZ) rats and the underlying mechanism.A rat model of schizophrenia was induced by MK-801.The cognitive function of rats was assessed using a Morris water maze.The number of hippocampal neurons was measured by Nissl staining.The expression of CREB,p-CREB,BDNF,TrkB,p-TrkB,AKT,p-AKT,ERK,and p-ERK in the hippocampus of rats was detected by Western blotting.The results showed that ω-3PUFAs attenuated MK-801-induced cognitive,impairment and hippocampal neurons loss,reversed the injury of the CREB/BDNF/TrtB pathway induced by MK-801,and antagonized MK-801-induced down-regulation of p-AKT and p-ERK in the hippocampus of rats.In conclusion,ω-3PUFAs enhances the CREB/BDNF/TrkB pathway by activating ERK and AKT,thereby increasing the synaptic plasticity and decreashng neuron loss,and antagonizing MK-801-induced cognitive impairment in schizophrenic rats.