Effects of intensive psychological intervention on treatment compliance,psychological status,and quality of life of patients with epilepsy

BACKGROUND Epilepsy is a nervous system disease characterized by recurrent attacks,a long disease course,and an unfavorable prognosis.It is associated with an enduring therapeutic process,and finding a cure has been difficult.Patients with epilepsy are predisposed to adverse moods,such as resistance,anxiety,nervousness,and anxiety,which compromise treatment compliance and overall efficacy.AIM To explored the influence of intensive psychological intervention on treatment compliance,psychological status,and quality of life(QOL)of patients with epilepsy.METHODS The clinical data of 105 patients with epilepsy admitted between December 2019 and July 2023 were retrospectively analyzed,including those of 50 patients who underwent routine intervention(control group)and 55 who underwent intensive psychological intervention(research group).Treatment compliance,psychological status based on the Self-Rating Anxiety Scale(SAS)and Depression Scale Self-Rating Depression Scale(SDS)scores,hope level assessed using the Herth Hope Scale(HHS),psychological resilience evaluated using the Psychological Resilience Scale,and QOL determined using the QOL in Epilepsy-31 Inventory(QOLIE-31)were comparatively analyzed.RESULTS Treatment compliance in the research group was 85.5%,which is significantly better than the 68.0%of the control group.No notable intergroup differences in preinterventional SAS and SDS scores were identified(P>0.05);however,after the intervention,the SAS and SDS scores decreased significantly in the two groups,especially in the research group(P<0.05).The two groups also exhibited no significant differences in preinterventional HHS,Connor-Davidson Resilience Scale(CD-RISC),and QOLIE-31 scores(P>0.05).After 6 months of intervention,the research group showed evidently higher HHS,CD-RISC,tenacity,optimism,strength,and QOLIE-31 scores(P<0.05).CONCLUSION Intensive psychological intervention enhances treatment compliance,psychological status,and QOL of patients with epilepsy.

Machine learning identifies the risk of complications after laparoscopic radical gastrectomy for gastric cancer

BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.

Circulating tumor cells: Biological features and survival mechanisms

Circulating tumor cells(CTCs)are neoplastic cells that are detached from primary tumors and enter circulation.Enumeration and characterization of CTCs are of significance in cancer diagnosis,prognosis,and treatment monitoring.CTC survival in the bloodstream is a limiting step for the development of metastases in distant organs.Recent technological advances,especially in single-cell molecular analyses have uncovered heterogeneous CTC survival mechanisms.Undergoing epithelial-to-mesenchymal transition(EMT),increasing stem cell-like properties,and forming cell clusters enable CTCs to adapt to the harsh microenvironment of the circulation.Expressing and releasing several immunosuppressive molecules help CTCs escape from anti-cancer immune mechanisms.This review article summarizes the biological characteristics of CTCs and focuses on the recent understanding of the mechanisms by which CTCs survive in circulation.Additionally,the clinical and therapeutic implications of CTCs are discussed.

Analysis of mental health status and related factors in patients with acute cerebral infarction

BACKGROUND Acute cerebral infarction(ACI)is characterized by a high incidence of morbidity,disability,recurrence,death and heavy economic burden,and has become a disease of concern in global researchers.As ACI has serious effects on patients’physical status,life and economy,often causing anxiety,depression and other psychological problems,these problems can lead to the aggravation of physical symptoms;thus,it is very important to understand the factors affecting the mental health of these patients.AIM To understand the elements that affect the mental health of patients who have suffered an ACI.METHODS A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals(Quanzhou First Hospital,Fuqing City Hospital Affiliated to Fujian Medical University,and the 900 Hospital of the Joint Service Support Force of the People’s Liberation Army of China)in Fujian Province from January 2022 to December 2022 using the convenience sampling method.ACI inpatients who met the inclusion criteria were selected.Informed consent was obtained from the patients before the investigation,and a face-to-face questionnaire survey was conducted using a unified scale.The questionnaire included a general situation questionnaire,Zung’s self-rating depression scale and Zung’s self-rating anxiety scale.All questionnaires were checked by two researchers and then the data were input and sorted using Excel software.The general situation of patients with ACI was analyzed by descriptive statistics,the influence of variables on mental health by the independent sample t test and variance analysis,and the influencing factors on psychological distress were analyzed by multiple stepwise regression.RESULTS The average age of the 220 patients with ACI was 68.64±10.74 years,including 142 males and 78 females.Most of the patients were between 60 and 74 years old,the majority had high school or technical secondary school education,most lived with their spouse,and most lived in cities.The majority of patients had a personal income of 3001 to 5000 RMB yuan per month.The new rural cooperative medical insurance system had the largest number of participants.Most stroke patients were cared for by their spouses and of these patients,52.3%had previously smoked.Univariate analysis showed that gender,age,residence,course of disease,number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI.Age,living conditions,monthly income,course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI.The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients’anxiety scores,and the course of disease was also the most important factor influencing patients’depression scores.CONCLUSION Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders.These groups require more attention and counseling.

翼管神经切断术治疗难治性变应性鼻炎的分子机制

目的探讨低温等离子鼻内镜下翼管神经切断术治疗难治性变应性鼻炎的分子机制。方法选取我科自2012年5月—2018年6月住院的63例难治性变应性鼻炎患者作为实验组进行低温等离子鼻内镜下翼管神经切断术。选取同时期58例难治性变应性鼻炎患者作为对照组进行药物保守治疗。分析两组患者治疗前后的鼻腔呼出气一氧化氮、血清嗜酸性粒细胞变化水平及组间差异。结果术后随访3个月,实验组44例显著改善,8例明显改善,11例无效,总有效率达82.5%。对照组随访3个月,13例显著改善,21例明显改善,24例无效,总有效率达58.6%。两组治疗前后鼻腔呼出气一氧化氮、血清嗜酸性粒细胞均下降,且差异具有统计学意义(P<0.05)。结论低温等离子鼻内镜下翼管神经切断术可以降低难治性变应性鼻炎患者的鼻腔呼出气一氧化氮、血清嗜酸性粒细胞水平,可考虑作为疗效判断的指标。

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

BACKGROUND Myocardial infarction is one of the most common types of coronary heart disease.It is mainly caused by the rupture of coronary atherosclerotic plaque,which leads to platelet agglutination and thrombosis.The occlusion of coronary arteries and vessels leads to insufficient myocardial blood supply,subsequently causing cardiac interstitial fibrosis,gradual enlargement of ventricles,and heart failure,which affects the quality of life and safety of patients.AIM To investigate the effects of emergency percutaneous interventional therapy(PCI)and delayed stenting in acute myocardial infarction with high thrombotic load and identify factors related to major adverse cardiovascular events(MACE).METHODS A total of 164 patients with acute myocardial infarction and high thrombotic load who received PCI were included.Of them,92 patients were treated with delayed stent implantation(delayed group)and 72 patients received emergency PCI(immediate group).Myocardial perfusion after stent implantation was compared between the two groups.Patients were followed up for 12 mo,and the occurrence of MACE was used as the endpoint.Univariate and multivariate models were used to analyze the factors affecting MACE occurrence.RESULTS After stent implantation,66(71.74%)patients in the delayed group and 40(55.56%)patients in the immediate group had thrombolysis in myocardial infarction(TIMI)flow grade 3(P<0.05),while 61(66.30%)patients in the delayed group and 39(54.17%)patients in the immediate group reached TIMI myocardial perfusion grade 3(P>0.05).MACE occurred in 29 patients.There were statistically significant differences between the MACE and non-MACE groups in diabetes rate,TIMI grading,stent implantation timing,intraoperative use of tirofiban,and the levels of white blood cells(WBC),neutrophils,red blood cell distribution width(RDW),and uric acid,and high-sensitivity C-reactive protein(hs-CRP)at admission(P<0.05).Logistic regression analysis showed that TIMI grade 3 and intraoperative use of tirofiban effectively reduced the risk of MACE(P<0.05),while immediate stent implantation,increased WBC,hs-CRP and RDW on admission increased the risk of MACE(P<0.05).CONCLUSION Delayed stent implantation outweighs emergency PCI in improving postoperative myocardial perfusion in acute myocardial infarction with high thrombotic load,and effectively reduces MACE in these patients.

Intravenous injection of Xuebijing attenuates acute kidney injury in rats with paraquat intoxication

BACKGROUND: The study aimed to investigate the therapeutic benefits of intravenous Xuebijing on acute kidney injury(AKI) in rats with paraquat intoxication.METHODS: Male Sprague-Dawley rats were randomly divided equally into three groups: sham group(n=8), paraquat group(n=8) and Xuebijing-treated group(n=8) using a random number table. The rats were intraperitoneally injected with 50 mg/kg of paraquat. One hour after paraquat administration, the rats were treated intravenously with Xuebijing(8 mL /kg). At 12 hours after paraquat administration, serum was collected to evaluate kidney function, then the rats were sacrificed and kidney samples were immediately harvested. AKI scores were evaluated by renal histopathology and pro-in? ammatory cytokines mR NA levels in kidney were assayed using real-time RT-PCR.RESULTS: Serum urea nitrogen, creatinine and AKI scores were significantly higher in the paraquat group, compared with the sham group(P<0.05, respectively). Moreover, interleukin(IL)-1β, IL-6 and TNF-α m RNA levels were signi? cantly higher in the paraquat group(P<0.01, respectively). However, intravenous Xuebijing signi? cantly decreased serum urea nitrogen, creatinine, AKI scores and IL-1β, IL-6 and TNF-α m RNA levels, compared with the paraquat group(P<0.05, respectively).CONCLUSION: Intravenous Xuebijing attenuates AKI following paraquat poisoning by suppressing in? ammatory response.

Serum neuron-specific enolase:A promising biomarker of silicosis

BACKGROUND Silicosis is a type of chronic pulmonary fibrosis caused by long-term inhalation of silica dust particles.There has been no ideal biomarker for the diagnosis and differential diagnosis of silicosis until now.Studies have found that elevated neuron-specific enolase(NSE)concentration in the serum of silicosis patients is helpful for diagnosis and severity assessment of the disease.However,the number of cases in these studies was not enough to arouse attention.AIM To investigate the clinical significance of serum NSE in the diagnosis and staging of silicosis.METHODS From January 2017 to June 2019,326 cases of silicosis confirmed in Quanzhou First Hospital Affiliated to Fujian Medical University were included in the silicosis group.A total of 328 healthy individuals or medical patients without silicosis were included in the control group.Serum NSE concentrations of all subjects were determined by electrochemical luminescence.RESULTS There were no significant differences in sex,age,smoking index and complications between the silicosis and control groups.The mean serum NSE concentration was 26.57±20.95 ng/mL in the silicosis group and 12.42±2.68 ng/mL in the control group.The difference between the two groups was significant(U=15187,P=0.000).Among the 326 patients with silicosis,103 had stage I silicosis,and the mean serum NSE concentration was 15.55±6.23 ng/mL.The mean serum NSE concentration was 21.85±12.05 ng/mL in 70 patients with stage II silicosis.The mean serum NSE concentration was 36.14±25.72 ng/mL in 153 patients with stage III silicosis.Kruskal-Wallis H test suggested that the difference in serum NSE concentration in silicosis patients in the three groups was significant(H=130.196,P=0.000).Receiver operating characteristic curve analysis indicated that the area under the curve was 0.858(95%confidence interval:0.828-0.888;P=0.000).When the NSE concentration was 15.82 ng/mL,the Jorden index was the largest,the sensitivity was 72%,and the specificity was 90%.CONCLUSION Serum NSE concentration may be a promising biomarker for the diagnosis and assessment of severity of silicosis.

Study on pathogenic genes of dwarfism disease by next-generation sequencing

BACKGROUND There are many factors that lead to dwarfism,and the mechanism has not yet been elucidated.Next-generation sequencing may identify candidate-related gene mutations,which may clarify the molecular cause.AIM To analyze genetic variation by using a constructed panel related to dwarfism by utilizing next-generation sequencing platform sequencing analysis to screen candidate-related gene mutations.METHODS Physical and laboratory characteristics,including clinical examination,growth hormone drug challenge test,serum insulin-like growth factor-1(IGF-1),IGF binding protein 3,other related tests,imaging examination,and chromosome karyotyping,were analyzed.Next-generation sequencing was performed to analyze pathogenicity variability.RESULTS In the 39 dwarfism patients,10 had pathogenicity variability.Gene variation was found in the OBSL1,SLC26A2,PTPN11,COL27AI,HDAC6,CUL7,FGFR3,DYNC2H1,GH1,and ATP7B genes.Of the 10 patients with pathogenicity variability,the related physical characteristics included double breast development and growth hormone deficiency,enuresis and indirect inguinal hernia on the left,two finger distance of 70.2 cm,head circumference of 49.2 cm,ischium/lower body length of 1.8 cm,weak limb muscles,and partial growth hormone deficiency.After 6 mo of growth hormone therapy,the concentrations of IGF-1 and IGF binding protein 3 increased from 215.2±170.3 to 285.0±166.0 and 3.9±1.4 to 4.2±1.1,respectively.CONCLUSION OBSL1,SLC26A2,PTPN11,COL27AI,HDAC6,CUL7,FGFR3,DYNC2H1,GH1,and ATP7B genes may be related to the incidence of dwarfism,and more research needs to be performed to elucidate the mechanism.

Integrated Analysis of the Gene Expression Profiling and Copy Number Aberration of the Ovarian Cancer

Objective: DNA copy number alterations and difference expression are frequently observed in ovarian cancer. The purpose of this way was to pinpoint gene expression change that was associated with alterations in DNA copy number and could therefore enlighten some potential oncogenes and stability genes with functional roles in cancers, and investigated the bioinformatics significance for those correlated genes. Method: We obtained the DNA copy number and mRNA expression data from the Cancer Genomic Atlas and identified the most statistically significant copy number alteration regions using the GISTIC. Then identified the significance genes between the tumor samples within the copy number alteration regions and analyzed the correlation using a binary matrix. The selected genes were subjected to bioinformatics analysis using GSEA tool. Results: GISTIC analysis results showed there were 45 significance copy number amplification regions in the ovarian cancer, SAM and Fisher’s exact test found there have 40 genes can affect the expression level, which located in the amplification regions. That means we obtained 40 genes which have a correlation between copy number amplification and drastic up- and down-expression, which p-value < 0.05 (Fisher’s exact test) and an FDR < 0.05. GSEA enrichment analysis found these genes were overlapped with the several published studies which were focused on the gene study of tumorigenesis. Conclusion: The use of statistics and bioinformatics to analyze the microarray data can found an interaction network involved. The combination of the copy number data and expression has provided a short list of candidate genes that are consistent with tumor driving roles. These would offer new ideas for early diagnosis and treat target of ovarian cancer.

Diagnostic Efficacy and Possible Underlying Mechanisms of Noninvasive Clinical Markers in Hepatocellular Carcinoma

Background and Aims:In this study,we aimed to evaluate the diagnostic values of alpha-fetoprotein(AFP),soluble AXL(sAXL),des-γ-carboxy prothrombin(DCP),the aspartate aminotransferase-to-platelet ratio index(APRI),and the gamma-glutamyl transpeptidase-to-platelet ratio(GPR)in hepatocellular carcinoma(HCC)and the possible underlying mechanisms of the correlations between them.Methods:We collected serum samples from 190,128,and 75 patients with HCC,cirrhosis,and chronic viral hepatitis,and from 82 healthy subjects.Serum levels of AFP,sAXL,and DCP were determined,and APRI and GPR values were calculated.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of single and combined biomarkers.Results:We detected significant differences between the HCC group and other groups regarding serum AFP,sAXL,DCP,and APRI levels.GPR significantly differed between the HCC group and other groups,except for the liver cirrhosis group.AFP,sAXL,DCP,APRI,and GPR had positive correlations with each other,and AFP showed a higher area under the curve(AUC)and Youden index values,while APRI and DCP showed the highest sensitivity and specificity.Also,when AFP was combined with sAXL,DCP,APRI,and GRP,the highest AUC(0.911)and a higher net reclassification improvement value were obtained compared with those obtained for the individual biomarkers.Conclusions:AFP,sAXL,DCP,APRI,and GPR are independent risk factors for HCC,and the diagnostic performance of AFP combined with sAXL,DCP,APRI,and GPR for HCC diagnosis was superior to that of the individual biomarkers.

IL2-inducible T-cell Kinase is Required for HBV-induced Type T Interferon Expression and Antiviral Response

Background and Aims:Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus(HBV),and is seen as a serious global health problem.HBV infection induces the expression of type I interferon(IFN),including IFN-αand IFN-β,which have anti-HBV activities,and have been used for HBV treatment.IL2-inducible T-cell kinase(ITK)is a tyrosine kinase,which regulates T-cell differentiation and activation,while its precise effects on type I IFN production during HBV infection remain unknown.Methods:We monitored the ITK expression in peripheral blood mononuclear cells(PBMCs)from healthy donors and patients with acute and chronic HBV infection.We used ITK inhibitor ibrutinib to treat hepatocytes and evaluated the type I IFN expression after HBV infection.We also administrated ibrutinib to mice and evaluated its effect on HBV infection in vivo.We generated ITK,suppressor of cytokine signaling 1(SOCS1)knockout and ITK/SOCS1 double knockout cells using CRISPR,and monitored the HBV-induced type I IFN production.Results:ITK and type I IFN were upregulated in patients with acute HBV infection.Inhibition of ITK by ibrutinib suppressed HBVinduced expression of type I IFN mRNA in mice.ITK knockout cells had decreased IRF3 activation but promoted the expression of SOCS1.ITK negatively regulated SOSC1 expression.The down regulation of type I IFN in ITK knockout cells after HBV stimulation was abolished in the absence of SOCS1.Conclusions:ITK regulated HBV-induced expression of type I IFN mRNA by modulating SOCS1.

The Effect of Internal Heat Acupuncture on the Tolerance Time of Plantar Hot Plate and Pain Threshold of Gastrocnemius Muscle in Rats with Chronic Myofascial Pain Syndrome

Objective:To investigate the effect of internal heat acupuncture on the tolerance time of plantar hot plate and the pain threshold of gastrocnemius in rats with chronic myofascial pain syndrome(MPS).Methods:A total of 80 adult Wistar rats were randomly selected to establish chronic MPS rat models,and randomly divided into four groups:control group,acupuncture group,internal heat acupuncture group A,and internal heat acupuncture group B,with 20 rats in each group.The rats in the control group were not given any treatment,and the rats in the acupuncture group were only given acupuncture treatment.The rats in group A were treated with internal heat acupuncture(needle heating up to 42℃),and the rats in group B were treated with internal heat acupuncture(needle heating up to 44℃).The tolerance time of plantar hot plate,the pain threshold of gastrocnemius muscle and the level of tumor necrosis factor-α(TNF-α)were observed and compared before modeling,1 d before treatment,and 1,7 and 14 d after treatment.Results:There were significant differences in hot plate tolerance time,time and interaction among the four groups(P<0.05),as well as in gastrocnemius tenderness threshold,time and interaction among the four groups(P<0.05),and there were also significant differences in TNF-αlevel among the three groups(P>0.05).There were significant differences in the number of electric shocks,time and interaction among the four groups(P<0.05).Conclusion:In contrast to conventional acupuncture treatment,internal heat acupuncture demonstrates greater efficacy in extending the tolerance duration of hot plate exposure and enhancing the pain threshold of the gastrocnemius muscle in rats afflicted with myofascial pain syndrome.Additionally,it accelerates the amelioration of inflammatory markers and motor function.However,it is important to note that the therapeutic impact of internal heat acupuncture may be influenced by its temperature,with 44℃being the most effective in this research.

Digoxin Ameliorates Glymphatic Transport and Cognitive Impairment in a Mouse Model of Chronic Cerebral Hypoperfusion

The glymphatic system plays a pivotal role in maintaining cerebral homeostasis.Chronic cerebral hypoperfusion,arising from small vessel disease or carotid stenosis,results in cerebrometabolic disturbances ultimately manifesting in white matter injury and cognitive dysfunction.However,whether the glymphatic system serves as a potential therapeutic target for white matter injury and cognitive decline during hypoperfusion remains unknown.Here,we established a mouse model of chronic cerebral hypoperfusion via bilateral common carotid artery stenosis.We found that the hypoperfusion model was associated with significant white matter injury and initial cognitive impairment in conjunction with impaired glym・phatic system function.The glymphatic dysfunction was associated with altered cerebral perfusion and loss of aquaporin 4 polarization.Treatment of digoxin rescued changes in glymphatic transport,white matter structure,and cognitive function.Suppression of glymphatic functions by treatment with the AQP4 inhibitor TGN-020 abolished this protective effect of digoxin from hypoperfusion injury.Our research yields new insight into the relationship between hemodynamics,glymphatic transport,white matter injury,and cognitive changes after chronic cerebral hypoperfusion.

Characterization and biological evaluation of a novel silver nanoparticle-loaded collagen-chitosan dressing

Effective coverage and protection is a priority in wound treatment.Collagen and chitosan have been widely used for wound dressings due to their excellent biological activity and biocompatibility.Silver nanoparticles(AgNPs)have a powerful antibacterial effect.In this study,a macromolecular and small-molecular collagen mixed solution,a macromolecular and small-molecular chitosan mixed solution were prepared,and a silver nanoparticle-loaded collagen-chitosan dressing(AgNPCCD)has been proposed.First,the effects of a collagen-chitosan mixed solution on the proliferation of human umbilical vein endothelial cells and the secretion of cytokines were evaluated.Then,the characteristics and antibacterial effects of the AgNP-CCD were tested,and the effects on wound healing and the influence of wound cytokine expression were investigated via a deep second-degree burn wound model.The results showed that at the proper proportion and concentration,the collagen-chitosan mixed solution effectively promoted cell proliferation and regulated the levels of growth factors(vascular endothelial growth factor[VEGF],epidermal growth factor[EGF],plateletderived growth factor[PDGF],transforming growth factor[TGF-b1],basic fibroblastic growth factor[bFGF])and inflammatory factors(TNF-α,IL-1β,IL-6,IL-8).Moreover,AgNP solutions at lower concentrations exerted limited inhibitory effects on cell proliferation and had no effect on cytokine secretion.The AgNP-CCD demonstrated satisfactory morphological and physical properties as well as efficient antibacterial activities.An in vivo evaluation indicated that AgNP-CCD could accelerate the healing process of deep second-degree burn wounds and played an important role in the regulation of growth and inflammatory factors,including VEGF,EGFL-7,TGF-β1,bFGF,TNF-α and IL-1β.This AgNP-CCD exerted excellent biological effects on wound healing promotion and cytokine expression regulation.

Adsorptive hemofiltration for sepsis management: expert recommendations based on the Asia Pacific experience

To the Editor:In sepsis,bacterial endotoxins play a central role by inducing a dysregulated and exaggerated release of inflammatory mediators and cytokines,often described as the“cytokine storm”or“cytokinemia.”[1]Both endotoxins and cytokines have been implicated in the development of organ dysfunction,including acute kidney injury(AKI).[2]Removing circulating endotoxins and excess cytokines from the circulation restores chemotactic gradients,localizing the immune response to the principal site of infection and re-establishing a regulated immune response.[1,3]Therefore,using hemofilters with enhanced endotoxin and cytokine adsorptive properties may bring about additional therapeutic benefits compared with conventional continuous renal replacement therapy(CRRT)filters.

具有反常热增强发光且可超低功率激发的稀土掺杂无机纳米颗粒

稀土掺杂的纳米发光颗粒因其具有优异的上转换和近红外发光性能,被当作生物深层组织影像剂广泛研究.但是,目前用于生物体内成像材料的辐照功率密度远高于近红外光辐照生物组织安全阈值,阻碍了其临床应用.在此,我们利用注射泵辅助壳层外延生长的方法,首次构建了一类可低功率激发的稀土掺杂核壳结构纳米颗粒(KMgF_(3):Yb/Er@KMgF_(3)).该纳米颗粒可通过氙灯或者功率密度低至0.08 mW cm^(−2)的980 nm激光器激发,这比美国国家标准协会设定的生物体内成像安全阈值低约4个数量级.基于光谱对比和原子级高分辨球差透射电镜的研究,我们发现KMgF_(3):Yb/Er@KMgF_(3)纳米颗粒可超低功率激发的主要原因是晶体缺陷的减少.另外,所得的核壳结构纳米颗粒还表现出异常的热增强光致发光行为以及优异的光热稳定性.本论文的这些发现为制备可超低功率激发而且具有良好光热稳定性的稀土掺杂无机纳米荧光探针奠定了良好的基础.

Association of thiopurine S-methyltransferase and NUDT15 polymorphisms with azathioprine-induced myelotoxicity in Chinese patients with rheumatological disease

To the Editor:Rheumatic diseases are disorders characterized by joint inflammation,but other organs are also affected.[1]Rheumatic diseases are common in China,and the clinical application of azathioprine(AZA),a purine analog immunosuppressant,for these diseases is attracting increasing attention.Although AZA is widely used in the treatment of rheumatic diseases,its clinical application is limited by adverse effects,especially leukopenia.