Effect of dietary with Zhibai dihuang pills and gonadotropinreleasing-hormone-analogue on girls with precocious and rapidly progressive puberty

BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.

Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection

Objective Contact precautions,especially the initiation of isolation,are important measures to prevent and control multidrug-resistant organisms(MDROs).However,the implementation in clinical practice remains weak.This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection,and determine the factors that affect the implementation of isolation measures.Methods A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1,2018.The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected.Then,the issuance of isolation orders was retrospectively analyzed.Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation.Results The overall issuance rate of isolation orders was 61.21%,which increased from 33.12%to 75.88%(P<0.001)after the implementation of the multidisciplinary collaborative intervention.The intervention(P<0.001,OR=0.166)was a promoting factor for the issuance of isolation orders,in addition to the length of stay(P=0.004,OR=0.991),department(P=0.004),and microorganism(P=0.038).Conclusion The isolation implementation remains far lower than policy standards.Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors,thereby promoting the standardized management of MDROs,and providing reference for further improving the quality of hospital infection management.

Characterization of oral and gut microbiome and plasma metabolomics in COVID-19 patients after 1-year follow-up

Background:Due to the outbreak and rapid spread of coronavirus disease 2019(COVID-19),more than 160 million patients have become convalescents worldwide to date.Significant alterations have occurred in the gut and oral microbiome and metabonomics of patients with COVID-19.However,it is unknown whether their characteristics return to normal after the 1-year recovery.Methods:We recruited 35 confirmed patients to provide specimens at discharge and 1 year later,as well as 160healthy controls.A total of 497 samples were prospectively collected,including 219 tongue-coating,129 stool and 149 plasma samples.Tongue-coating and stool samples were subjected to 16S rRNA sequencing,and plasma samples were subjected to untargeted metabolomics testing.Results:The oral and gut microbiome and metabolomics characteristics of the 1-year convalescents were restored to a large extent but did not completely return to normal.In the recovery process,the microbial diversity gradually increased.Butyric acid-producing microbes and Bifidobacterium gradually increased,whereas lipopolysaccharideproducing microbes gradually decreased.In addition,sphingosine-1-phosphate,which is closely related to the inflammatory factor storm of COVID-19,increased significantly during the recovery process.Moreover,the predictive models established based on the microbiome and metabolites of patients at the time of discharge reached high efficacy in predicting their neutralizing antibody levels one year later.Conclusions:This study is the first to characterize the oral and gut microbiome and metabonomics in 1-year convalescents of COVID-19.The key microbiome and metabolites in the process of recovery were identified,and provided new treatment ideas for accelerating recovery.And the predictive models based on the microbiome and metabolomics afford new insights for predicting the recovery situation which benefited affected individuals and healthcare.

Artifacts in two-dimensional shear wave elastography of liver

BACKGROUND Artifacts are common when using two-dimensional shear wave elastography(2-D SWE)to measure liver stiffness(LS),but they are poorly recognized.AIM To investigate the presence and influence of artifacts in 2-D SWE of liver.METHODS We included 158 patients with chronic liver disease,who underwent 2-D SWE examination by a novice and an expert.A cross line at the center of the elastogram was drawn and was divided it into four locations:top-left,top-right,bottom-left,and bottom-right.The occurrence frequency of artifacts in different locations was compared.The influence of artifacts on the LS measurements was evaluated by comparing the elastogram with the most artifacts(EMA)and the elastogram with the least artifacts(ELA).RESULTS The percentage of elastograms with artifacts in the novice(51.7%)was significantly higher than that of the expert(19.6%)(P<0.001).It was found that both operators had the highest frequency of artifacts at bottom-left,followed by top-left and bottom-right,and top-right had the lowest frequency.The LS values(LSVs)and standard deviation values of EMAs were significantly higher than those of ELAs for both operators.An intraclass correlation coefficient value of 0.96 was found in the LSVs of EMAs of the two operators,and it increased to 0.98 when the LSVs of the ELAs were used.Both operators had lower stability index values for EMAs than ELAs,but the difference was only statistically significant for the novice.CONCLUSION Artifacts are common when using 2-D SWE to measure LS,especially for the novice.Artifacts may lead to the overestimation of LS and reduce the repeatability and reliability of LS measurements.

Anemia status of infants and young children aged six to thirty-six months in Ma'anshan City:A retrospective study

BACKGROUND Anemia in infants and young children can have long-term effects on cognitive and physical development.In Ma'anshan City,China,there has been growing concern about the prevalence of anemia among children aged 6 to 36 mo.Understanding the factors influencing this condition is crucial for targeted interventions and improving overall child health in the region.AIM To analyze the anemia status and influencing factors of infants and young children aged 6 to 36 mo in Ma'anshan City,China.Providing scientific evidence for reducing the incidence of anemia and improving the health level of children in this age group.METHODS The study encompassed 37698 infants and young children,aged from 6 to 36 mo,who underwent health examinations at the Ma'anshan Maternal and Child Health Hospital from January 2018 to October 2022 were included in the study.Basic information,physical examination,and hemoglobin detection data were collected.Descriptive analysis was used to analyze the prevalence of anemia in children in the region,and univariate analysis was used to analyze the influencing factors of anemia.RESULTS The mean hemoglobin level of infants and young children aged 9 to 36 mo increased with age,and the anemia detection rate decreased with age.The anemia detection rate in rural infants aged 6,9,and 12 mo was higher than that in urban infants.Although the anemia detection rate was higher in 6-mo-old boys than girls,it was higher in 24-mo-old girls than boys.There were statistically significant differences in the anemia detection rates among 9-mo-old and 12-mo-old infants with different nutritional statuses(emaciation,overweight,obese,and normal).Moreover,there were no statistically significant differences in anemia detection rates among infants and young children with different nutritional statuses at other ages.Besides,the anemia detection rates in obese infants aged 9 and 12 mo were higher than those in normal and overweight infants,with statistically significant differences.Finally,there were no statistically significant differences in the anemia detection rates between emaciation infants and those with other nutritional statuses.CONCLUSION The anemia situation among infants and young children aged 6 to 36 mo in Ma'anshan City,China,is relatively prominent and influenced by various factors.Our result shown that attention should be paid to the anemic infant and young child population,with strengthened education and targeted prevention and dietary guidance to help them establish good living habits,improve nutritional status,and reduce the occurrence of anemia to improve children's health levels.

Family-based Helicobacter pylori infection status and transmission pattern in central China,and its clinical implications for related disease prevention

BACKGROUND Helicobacter pylori(H.pylori)has characteristics of family cluster infection;however,its family-based infection status,related factors,and transmission pattern in central China,a high-risk area for H.pylori infection and gastric cancer,have not been evaluated.We investigated family-based H.pylori infection in healthy households to understand its infection status,related factors,and patterns of transmission for related disease prevention.AIM To investigate family-based H.pylori infection status,related factors,and patterns of transmission in healthy households for related disease prevention.METHODS Blood samples and survey questionnaires were collected from 282 families including 772 individuals.The recruited families were from 10 selected communities in the greater Zhengzhou area with different living standards,and the family members’general data,H.pylori infection status,related factors,and transmission pattern were analyzed.H.pylori infection was confirmed primarily by serum H.pylori antibody arrays;if patients previously underwent H.pylori eradication therapy,an additional 13C-urea breath test was performed to obtain their current infection status.Serum gastrin and pepsinogens(PGs)were also analyzed.RESULTS Among the 772 individuals examined,H.pylori infection rate was 54.27%.These infected individuals were from 246 families,accounting for 87.23%of all 282 families examined,and 34.55%of these families were infected by the same strains.In 27.24%of infected families,all members were infected,and 68.66%of them were infected with type I strains.Among the 244 families that included both husband and wife,spouse co-infection rate was 34.84%,and in only 17.21%of these spouses,none were infected.The infection rate increased with duration of marriage,but annual household income,history of smoking,history of alcohol consumption,dining location,presence of gastrointestinal symptoms,and family history of gastric disease or GC did not affect infection rates;however,individuals who had a higher education level showed lower infection rates.The levels of gastrin-17,PGI,and PGII were significantly higher,and PGI/II ratio was significantly lower in H.pylori-infected groups than in H.pylori-negative groups.CONCLUSION In our study sample from the general public of central China,H.pylori infection rate was 54.27%,but in 87.23%of healthy households,there was at least 1 H.pylori-infected person;in 27.24%of these infected families,all members were infected.Type I H.pylori was the dominant strain in this area.Individuals with a higher education level showed significantly lower infection rates;no other variables affected infection rates.

Bioinformatics analysis of aberrantly methylated-differentially expressed genes and pathways in hepatocellular carcinoma

AIM To discover methylated-differentially expressed genes(MDEGs) in hepatocellular carcinoma(HCC) and to explore relevant hub genes and potential pathways. METHODS The data of expression profiling GSE25097 and methylation profiling GSE57956 were gained from GEO Datasets. We analyzed the differentially methylated genes and differentially expressed genes online using GEO2 R. Functional and enrichment analyses of MDEGs were conducted using the DAVID database. A protein-protein interaction(PPI) network was performed by STRING and then visualized in Cytoscape. Hub genes were ranked by cytoH ubba, and a module analysis of the PPI network was conducted by MCODE in Cytoscape software. RESULTS In total, we categorized 266 genes as hypermethylated, lowly expressed genes(Hyper-LGs) referring to endogenous and hormone stimulus, cell surface receptor linked signal transduction and behavior. In addition, 161 genes were labelled as hypomethylated, highly expressed genes(Hypo-HGs) referring to DNA replication and metabolic process, cell cycle and division. Pathway analysis illustrated that Hyper-LGs were enriched in cancer, Wnt, and chemokine signalling pathways, while Hypo-HGs were related to cell cycle and steroid hormone biosynthesis pathways. Based on PPI networks, PTGS2, PIK3 CD, CXCL1, ESR1, and MMP2 were identified as hub genes for Hyper-LGs, and CDC45, DTL, AURKB, CDKN3, MCM2, and MCM10 were hub genes for Hypo-HGs by combining six ranked methods of cytoH ubba. CONCLUSION In the study, we disclose numerous novel genetic and epigenetic regulations and offer a vital molecular groundwork to understand the pathogenesis of HCC. Hub genes, including PTGS2, PIK3 CD, CXCL1, ESR1, MMP2, CDC45, DTL, AURKB, CDKN3, MCM2, and MCM10, can be used as biomarkers based on aberrant methylation for the accurate diagnosis and treatment of HCC.

Morin enhances hepatic Nrf2 expression in a liver fibrosis rat model

AIM To investigate whether morin can reduce hepatic fibrosis by activating the NF-E2-related factor 2(Nrf2) signaling pathway.METHODS Twenty male Sprague-Dawley rats were randomly divided into four groups: control group, morin group, carbon tetrachloride(CCl4) group, and morin + CCl4 group. Rats in both the CCl4 and morin + CCl4 groups were injected intraperitoneally with CCl4 at a dose of 2 mL/kg twice a week. Rats in both the morin and morin + CCl4 groups were treated orally with morin at a dose of 50 mg/kg twice a week. Control rats were treated with vehicle only twice a week. At the end-point of the 8 wk of the experimental period, serum AST, ALT, and ALP were measured, and the liver specimenswere obtained for pathological assessment. Real-time PCR and Western blot methods were used to analyze the expression of α-smooth muscle actin(α-SMA), collagen Ⅰ, collagen Ⅲ, Nrf2, heme oxygenase(HO-1), and quinone oxidoreductase 1(NQO1) using frozen liver specimens.RESULTS Morin-treated rats in the morin + CCl4 group had less hyperplasia of fiber tissue, minimal inflammatory cells, and less body weight loss with favorable liver enzyme measurements compared to rats treated with CCl4 only. Additionally, morin-treated rats had significantly lower m RNA and protein expression of α-SMA, collagen Ⅰ, and collagen Ⅲ, but significantly higher m RNA and protein expression of Nrf2, HO-1, and NQO1 compared to rats treated with CCl4 only(P < 0.05).CONCLUSION Morin could play a protective role by inducing the expression of Nrf2 and its downstream antioxidant factors(HO-1 and NQO1) and reducing the expression of α-SMA, collagen Ⅰ, and collagen Ⅲ in CCl4-induced liver fibrosis rats.

高度近视合并青光眼患者视神经纤维层厚度的变化

目的:通过光学相干断层成像(OCT)检测高度近视合并青光眼患者视神经纤维层厚度的变化规律。方法:选取2017-01/12于我院进行治疗的高度近视合并青光眼患者80例160眼作为观察组,并选择同期于我院进行体检的健康志愿者60例120眼作为对照组。采用OCT分析所有受检者视神经纤维层厚度。结果:与对照组受检者相比,观察组患者鼻侧、颞上、鼻下、鼻上、颞下及全周平均视神经纤维层厚度均降低,而颞侧视神经纤维层厚度升高(P<0.05),且观察组中屈光度-10.00^-11.00D的患者鼻侧、颞上、鼻下、鼻上、颞下及全周平均视神经纤维层厚度均显著高于屈光度≥-12.00D的患者(P<0.05)。Spearman相关分析结果显示,观察组患者屈光度的绝对值与鼻侧、颞上、鼻下、颞下及全周平均厚度视神经纤维层厚度呈负相关,与颞侧视神经纤维层厚度呈正相关。结论:高度近视合并青光眼患者除颞侧外各象限视神经纤维层变薄。

In vitro degradation resistance of glucose and L-cysteine-bioinspired Schiff-base anodic Ca−P coating on AZ31 magnesium alloy

A Schiff base(a compound containing a C=N bond)induced anodic Ca−P coating was prepared on AZ31 Mg alloy in a mixed solution of CaCl_(2) and KH_(2)PO_(4) at 60℃ in the presence of glucose and L-cysteine.The microstructure and chemical composition of the coatings were characterized using FE-SEM,FT-IR,XRD,and XPS.The in vitro degradation resistance of the coated samples was evaluated via potentiodynamic polarization(PDP),electrochemical impedance spectroscopy(EIS),and hydrogen evolution test.The experimental results show that the Ca−PSchiff base coating is composed of CaHPO_(4)(DCPA)and hydroxyapatite(HA),whereas HA is not present in the Ca−P coating.The Ca−P_(Schiff base) coating thickness is about 2 times that of Ca−P coating(Ca−P coating:(9.13±4.20)μm and Ca−P_(Schiff base):(18.13±5.78)μm).The corrosion current density of the Ca−P_(Schiff base) coating is two orders of magnitude lower than that of the Ca−P coating.The formation mechanism of the Ca−P_(Schiff base) is proposed.

Neuroprotective Effect of Bu-Shen-Huo-Xue Extract against High Glucose-induced Apoptosis in PC12 Cells

Objective： To investigate the neuroprotective effect of Bu-Shen-Huo-Xue （BSHX） extract, a polyherbal formula, against High Glucose （HG）-induced neurotoxicity in PC12 cells. Methods： Cell viability assay, Lactate Dehydrogenase （LDH） assay, Reactive Oxygen Species （ROS） detection, Hoechst 33258, Acridine Orange （AO）/Ethidium Bromide （EB） double stain and Mitochondrial Membrane Potential （MMP） assay were performed. In addition, Bax, Bcl-2, caspase-3, cleaved caspase-3, PARP, cleaved PARP, cytochrome c and Mitogen-Activated Protein Kinases （MAPKs） were detected by western blot. Results： BSHX extract increased cell viability and decreased LDH leakage in a concentration-dependent manner in HG-induced PC12 cells. Moreover, BSHX extract decreased the level of intracellular ROS, increased mitochondrial membrane potential, regulated the expressions of Bax and Bcl-2, and inhibited the release of cytochrome c from mitochondria. Furthermore, BSHX extract attenuated the activation of caspase-3 and PARP, and inhibited the phosphorylations of c-Jun N-terminal kinase （JNK） and p38 MAPKs. Conclusion： BSHX extract exhibited significant neuroprotective effect on HG-induced apoptosis in PC12 cells. This effect may be associated with the suppression of ROS generation as well as mitochondria-mediated caspase and JNK/p38 MAPK signaling pathways.

Graphene-gold Nanoparticle Composite Film Modified Electrode for Determination of Trace Mercury in Environmental Water

The graphene-gold nanoparticles composite film modified glassy carbon electrode （EG- AuNPs/GCE） was prepared by one-step coelectrodeposition and employed for determination of trace mercury in environmental water with differential pulse stripping voltammetry. Such a nanostructured composite film combined with the advantages of gold nanoparticles and graphene, can greatly promote the electron-transfer process and increase accumulation abil-ity for Hg（Ⅱ）, leading to a remarkably improved sensitivity. The linear calibration curve ranged from 0.2 μg/L to 30 μg/L for Hg（Ⅱ） and the detection limit （S/N=3） was found to be 0.03 μg/L at a deposition time of 300 s. Moreover, the stablity of the as-prepared electrode and interferences from other substances were evaluated. The modified electrode was successfully applied to the direct detection of Hg（Ⅱ） in real water samples.

Highlighting the importance of early diagnosis in progressive multi-organ involvement of IgG4-related disease: A case report and review of literature

IgG4-related disease(IgG4-RD)is an increasingly recognized pathological entity that tends to involve multiple organs with an elevated level of serum IgG4,which is easily misdiagnosed owing to sharing common clinical features with a variety of other diseases.Here,we report an interesting IgG4-RD case of a woman with progressive multi-organ involvement for over 19 years,started with swollen eyelids,dry eye and mouth,and polydipsia and hydruria.Imaging diagnosis revealed diffuse enlargement of the parotid glands,enlargement of the head of the pancreas,pulmonary infection and interstitial lung.Serological tests showed a remarkable elevation of the serum IgG4,and cytological analysis further revealed a large amount of lymphoplasmacytic infiltration into the focal lobule,and IgG 4-positive cell infiltration in bladder mucosa.Therapeutically,the patient responded well to steroid therapy,and thus,she was diagnosed as IgG 4-RD suspicious.This report highlights the importance of an early diagnosis in this autoimmune disease and suggests that patients with a clinically unclear cause of inflammation,swelling and refractory glands,rhinitis,pancreatitis,hypophysitis,and/or interstitial pneumonia should be considered for IgG 4-RD.The plasma IgG4 level and lymphoplasmacytic infiltration may be useful indexes for screening,and a low dose of steroid maintaining therapy may offer benefits for patients with IgG4-RD.

Fast generation of W state via superadiabatic-based shortcut in circuit quantum electrodynamics

We propose a scheme to fast prepare the three-qubit W state via superadiabatic-based shortcuts in a circuit quantumelectrodynamics (circuit QED) system. We derive the effective Hamiltonian to suppress the unwanted transitions betweendifferent eigenstates by counterdiabatic driving, and obtain the W state with high-fidelity based on the superadiabaticpassage. The numerical simulation results demonstrate that the proposed scheme can accelerate the evolution, and is moreefficient than that with the adiabatic passage. In addition, the proposed scheme is robust to the decoherence caused by theresonator decay and qubit relaxation, and does not need additional parameters, which could be feasible in experiment.

Impact of Luveris and Gonal-F on bovine immature oocytes developmental competence in vitro

Objective: To investigate the gonadotrophin drug Luveris? (L) and Gonal-F? (G) effects on bovine immature oocyte in vitro maturation culture. Methods: In total, 2000 bovine cumulus-oocyte complexes (COCs) were purchased commercially and cultured in media with ovulation stimulation drugs Gonal-F and Luveris (0, 5, 10, 20, 40 IU/mL), individually, for maturation in vitro. 2000 Oocytes were divided evenly into two groups, Luveris and Gonal-F groups, individually, 1000 Oocytes. After 24 and 48h culture, cumulus expansion was assessed under dissecting microscopes. Oocyte maturation (GV, MI, MII) was determined by examining nuclear maturation and polar body formation under inverted microscopes. Results: Luveris and Gonal-F enhanced oocyte maturation in vitro in a dose-dependently manner. Culture media supplemented with L or G significantly improved MⅡ Oocyte maturation rates after culture for 24 h and 48 h in comparison with the control group. Oocyte maturation rates were 33.3% and 37.5%(20 IU/mL), individually, 33.3% and 53.6% (40 IU/mL);20 IU/mL G was 15.1% and 16.2%;40 IU/mL G was 38.9% and 39.5%, respectively. Conclusion: LH (Luveris) can promote prophase bovine immature oocytes developmental competence in vitro, which is mostly likely stimulated by FSH(Gonal-F ). Furthermore, LH can delay oocytes GVBD that is very useful for IVF clinical medication guidance.

Best time for progesterone supplementation in aid ovulation induction cycles by letrozole

Objective:To explore the best time for progesterone supplementation in AID ovulation induction cycles by Letrozole.Methods: The data analysed in this study were collected from 509 patients who were performed AID (Artificial Insemination by Donor) administrated letrozole (LE) between 2014.8-2015.7. All patients were randomly divided into 4 groups by the time of progesterone administrated, including experimental group and the control group. The experimental group was divided into group 1-72 h after ovulation, group 2-48 h after ovulation, group 3-24 h after ovulation and control group—without administrated LE. The gestation and live birth rate were evaluated by monitoring vaginal ultrasound and HCG blood value 14 d after AID.Results: The pregnancy rate with administrated progesterone added 72 h after ovulation was 31.9%, which was significantly higher than those of other groups, the same situation as groups added progesterone was significantly higher than the control group. However, there was no significant difference in the numbers of abortions among the four groups. The LBR of group 4 was significantly lower than that of group 1.Conclutions: Progesterone administrated 72 h after ovulation can promoted the gestation rate, but did not affect the rate of miscarrage .

基于标签和分块特征的新闻网页关键信息自动抽取

针对抽取新闻关键信息需要人工构造或训练生成模板的问题,提出了基于标签和分块特征的新闻关键信息自动抽取方法。该方法首先通过计算新闻网页相关特征来定位新闻正文标签块,然后通过编辑距离定位新闻标题标签块,最后根据正文块和标题块定位新闻发布时间和来源标签块,并通过抽取各块的文本获得目标新闻关键信息。在该方法的基础上提出了针对新闻站点的目标新闻自动抽取框架,并用该框架对10个新闻站点的30个新闻栏目进行了新闻抽取。对抽取到的1 597条新闻随机选择了1 000条进行了实验。实验结果表明,该方法对新闻标题、发布时间、来源、正文均表现出良好的抽取效果,且优于实验对比对象。

Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai

Objective:To summarize the use rate,safety,efficacy of antithrombotics in stroke/transient ischemic attack (TIA) prevention,and reasons for not using dabigatran etexilate (DE) in Shanghai,China.Methods:Non-valvular atrial fibrillation (NVAF)-associated stroke patients were prospectively registered as an electronic database.Use rate of antithrombofics and reasons for not using DE were extracted during follow-up.Patients' baseline characteristics,recurrent ischemic stroke/TIA events and bleeding complications were analyzed.Patients:From April 2012 to August 2014,110 inpatients with NVAF-associated stroke were studied in our hospital.NVAF was diagnosed by 12-lead electrocardiogram,24 h Holter and echocardiography.Results:Before introduction of DE (April 2013),use rates of warfarin and antiplatelets were 28.9％ (11/38) and 60.5％ (23/38)respectively; after that,use rates of warfarin,DE,and antiplatelets were 20.8％ (15/72),12.5％ (9/72),and 43.1％ (31/72).The DE did not improve use of anticoagulants (P =0.639).There were 19 (17.3％) recurrent ischemic stroke events up to October 2015; two (9.5％) in the non-user group,10 (18.5％) in the antiplatelet group,and seven (20.0％) in the anticoagulants group (P =0.570).Furthermore,recurrence rates were similar between the DE group (20.0％) and the Warfarin group (20.0％,P =1.000).The most common reason for not using DE was financial concerns (61.0％),followed by inconvenience to purchase (14.0％) and hemorrhage concerns (11.0％).Two patients using warfarin found fecal occult blood so they stopped warfarin and began to use antiplatelet drugs.No bleeding event occurred in the other groups.Only one patient had side effects (dyspepsia and gastroesophageal reflux)from DE.Conclusion:The use rate of either DE or warfarin in Shanghai was low; DE had not improved anticoagulation therapy for NVAF patients in Shanghai mainly because DE had not been covered by health insurance.

Heterogeneity of Monosymptomatic Resting Tremor in a Prospective Study： Clinical Features, Electrophysiological Test, and Dopamine Transporter Positron Emission Tomography

Background： The relationship between monosymptomatic resting tremor （mRT） and Parkinson＇s disease （PD） Iemains controversial. In this study, we aimed to assess tile function ofpresynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography （DAT-PET） and to evaluate the utility of clinical features or electrophysioIogical studies in differential diagnosis. Methods： Thirty-three consecutive patients with toRT were enrolled prospectively. The Unified Parkinson＇s Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index （SAI） was calculated, and a normal DATPET was defined as a SAI of 〈15%. Scans without evidence of dopaminergic deficits （SWEDDs） were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging. Results： Twenty-eight toRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking m motor experiences of daily living （Part I1） and motor examination （Part Ill ） were significant different between two groups （P 〈 0.05 and P 〈 0.01, respectively）. Bilateral tremor was more frequent in the SWEDDs group （P 〈 0.05）. The frequency of resting tremor and the amplitude ofpostural tremor tend to be higher in the SWEDDs group （P = 0.08 and P= 0.05, respectively）. Conclusions： mRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

Mediating the Migration of Mesenchymal Stem Cells by Dynamically Changing the Density of Cell-selective Peptides Immobilized on β-Cyclodextrin-modified Cell-resisting Polymer Brushes

Dynamic control of mesenchymal stem cell(MSC)behaviors on biomaterial surface is critically involved in regulating the cell fate and tissue regeneration.Herein,a stimuli-responsive surface based on host-guest interaction with cell selectivity was developed to regulate migration of MSCs in situ by dynamic display of cell-specific peptides.Azobenzene-grafted MSC-affinitive peptides(EPLQLKM,Azo-E7)were grafted toβ-cyclodextran(β-CD)-modified poly(2-hydroxyethyl methacrylate)-b-poly(2-hydroxyethyl methacrylate-co-glycidyl methacrylate)(PHG)brushes,which were prepared by using surface-initiated atom transfer radical polymerization(SI-ATRP).X-ray photoelectron spectroscopy(XPS),quartz crystal microbalance(QCM),and water contact angle were used to characterize their structure and property.Cell adhesion assay showed that the combination effect of resisting property of PHG and MSC-affinity of E7 could promote the selective adhesion of MSCs over other types of cells such as RAW264.7 macrophages and NIH3 T3 fibroblasts to some extent.UV-Vis spectroscopy proved that the competing guest molecules,amantadine hydrochloride(Ama),could release Azo-E7 peptides from the CD surface to different extents,and the effect was enhanced when UV irradiation was employed simultaneously.As a result,the decrease of cell adhesion density and migration rate could be achieved in situ.The cell density and migration rate could be reduced by over 40%by adding 20μmol/L Ama,suggesting that this type of surface is a new platform for dynamic regulation of stem cell behaviors in situ.