PurposeAcute pulmonary contusion (APC), a life-threatening trauma-associated condition, currently lacks targeted pharmacological therapies. Fraxinellone (FRA) inhibits Hypoxia-inducible factor-1α (HIF-1α) synthesis, but its binding mechanism and anti-APC action remain unclear. This study was designed to assess the therapeutic potential of FRA, a natural substance with known anti-inflammatory properties, as a means of attenuating APC progression through the inhibition of HIF-1α.MethodsAn in vivo APC model was generated via weight-drop lung injury in C57BL/6 mice, and an in vitro model was established using thrombin (THR)-injured MLE-12 cells. The efficacy of FRA (10 μM in vitro; 5 mg/kg in vivo) was evaluated through cell viability assays, measurement of inflammatory cytokines via enzyme-linked immunosorbent assay (ELISA), histopathological examination, and molecular analyses including Western blot (WB) and real-time quantitative polymerase chain reaction (RT-qPCR). Mechanistic validation was performed through HIF-1α siRNA knockdown and mutation, ML228-mediated activation, and molecular docking simulations.ResultsFRA notably diminished APC severity by reducing pulmonary edema (wet/dry ratio), lowering pro-inflammatory cytokine levels ((interleukin-1β [IL-1β], interleukin-6 [IL-6], interleukin-18 [IL-18]), and decreasing pyroptosis markers (NOD-like receptor family pyrin domain containing 3 [NLRP3], gasdermin D [GSDMD]) in both in vitro and in vivo models. Molecular docking revealed FRA binding to HIF-1α at Arg258, and HIF-1α activation abrogated the protective effects of FRA. HIF-1α knockdown and mutation reproduced the anti-pyroptotic effects of FRA, confirming pathway specificity.ConclusionFRA mitigates APC progression by targeting HIF-1α to suppress NLRP3/GSDMD-mediated pyroptosis and inflammation, providing a novel therapeutic approach for trauma-induced lung injury.

Shrimp preservation currently relies mainly on petroleum-based plastic films and refrigeration, which, although effective, may release microplastics into the environment. Developing biodegradable alternatives is therefore of great significance. In this study, potato starch (PS)/apple pectin (AP)/cedarwood essential oil (CEO) composite films were prepared via the casting method and evaluated for their potential in giant tiger prawn preservation. CEO incorporation markedly improved the film's properties, including mechanical strength (from 9.6 % to 32.4 %), UV shielding efficiency (EAB from 7.47 % to 33.2 % at 600 nm), and antibacterial activity. Films containing 2 % CEO exhibited superior antibacterial performance. Preservation tests further demonstrated that 2 % CEO films effectively inhibited increases in total volatile basic nitrogen (TVB-N) and pH: after 48 h, TVB-N rise decreased from 42.55 % to 23.04 %, while pH increase was reduced from 0.83 to 0.16. These findings highlight the potential of PS/AP/CEO films as sustainable packaging materials for extending the shelf life of seafood.

A positively charged ammonium side chain, a pyridylboronic acid side chain, and mixed two moieties were grafted on intrinsic g-C3N4 to yield functionalized materials, g-C3N4-C4, g-C3N4-B, and g-C3N4-C4-B. All the decorated g-C3N4 materials displayed enhanced photocatalytic ROS (1O2 and •O2-) generation capabilities compared to intrinsic g-C3N4. Among them, g-C3N4-B displayed the most potent ROS generation capability. In addition, ξ potential results revealed the strongest affinity of g-C3N4-C4-B toward representative Gram-negative and positive bacteria (MDR Acinetobacter baumannii and Staphylococcus aureus). The photocatalytic antibacterial results demonstrated that g-C3N4-B could achieve faster and efficient bacterial killing compared with g-C3N4-C4 and g-C3N4-C4-B (>99% killing rates toward MDR A. baumannii and S. aureus and >95% toward Escherichia coli). Thus, it could be concluded that ROS generation capability plays a more important role in photocatalytic antibacterial activity over bacterial binding capability in the current case. g-C3N4-B was further fabricated into a PAN fiber membrane for photocatalytic antibacterial application. The 0.8 wt % g-C3N4-B-loaded PAN membrane showed potent antibacterial activities toward MDR A. baumannii, S. aureus, and E. coli, with efficiencies of 99.79%, 99.37%, and 99.96%, respectively. Thus, g-C3N4-B could serve as a potent broad-spectrum photocatalytic antibacterial material. And we proposed a novel strategy for improving photocatalytic antibacterial activity for g-C3N4.

BackgroundSepsis is highly heterogeneous. Therefore, identifying biomarkers that can stratify patients with sepsis into more homogeneous cohorts to develop individualized treatment and care measures for patients and carry out early intervention to reduce the risk of death and improve the prognosis of patients has become a current research hotspot.MethodsUsing the MIMIC-IV database, we analyzed data from 1,575 adult patients with sepsis. Serum lactate levels were measured once daily for 5 consecutive days after admission. The GBTM model was used to stratify the risk of sepsis and explore the relationships between different lactate trajectories and 28-day mortality in septic patients.ResultsWe report a new method for identifying subphenotypes of sepsis patients based on lactate trajectories. Through group-based trajectory modeling, we identified and validated five groups of sepsis patients with different lactate trajectories, namely, “Low-stable group,” “low-slowly declining group,” “high-rapidly decline group,” “Moderate-slow declining group,” and “high-slow decline group.” The relationships between sepsis patients with different lactate trajectories and 28-day mortality were explored. Among them, patients with a “Low-stable group” had the lowest in-hospital 28-day mortality. Patients with a “high-slow decline group” had the highest 28-day mortality.ConclusionIn this study, different subtypes of sepsis were successfully identified by analyzing lactate trajectories. Combined with the dynamic changes in lactate levels, the GBTM model was used to stratify patients according to their risk of sepsis. This model provides a theoretical basis for clinicians to evaluate the prognosis of patients using the lactate change trajectory.

Several cation graphite carbon nitrides (g-C3N4-(CH2)(n)-ImI(+)) were synthesized by chemically attaching imidazolium appended alkane chains with different lengths (n = 2, 4, 8, 12 and 16) to g-C3N4. The introduction of a cation segment potentially improved the interaction between the carbon material and Gram negative (MDR-A. baumannii) and Gram positive (S. aureus) bacteria as characterized by zeta potential measurement. Short alkane chain (carbon numbers of 2, 4 and 8) carbon materials displayed relatively stronger bacterial interactions compared to long alkane chain bearing ones (n = 12 and 16). In addition, short chain carbon materials (g-C3N4-(CH2)(4)-ImI(+)) displayed relatively higher photocatalytic reactive oxygen species (O-1(2), O-center dot(2)- and (OH)-O-center dot) production efficiency. Bacterial interaction and ROS production efficiency synergistically contribute to photocatalytic antibacterial performance. The current data revealed that g-C3N4 with short flexible cations attached exhibited bacterial interaction and ROS production. Among these synthesized materials, g-C3N4-(CH2)(4)-ImI(+) exhibited the most pronounced photocatalytic antibacterial efficiency (>99%).

目的:探讨急性胰腺炎（acute pancreatitis, AP）合并休克患者的Δ平均动脉压（ΔMAP：院前与早期液体复苏后MAP之间的差值）与急性肾损伤（acute kidney injury, AKI）发生率之间的关系。方法:本研究是一项单中心回顾性观察性研究。收集2015年8月至2021年10月在扬州大学附属医院就诊的AP合并休克的216例患者，依据ΔMAP四分位数分为ΔMAP四分位数第1组（54例）和ΔMAP四分位数第2~4组（162例）；依据是否发生AKI，分为AKI组（148例）和非AKI组（68例）。分析比较两组人口学资料、基础疾病、体重指数(入院24 h内)、临床评分（入院24 h内）、病因、生化指标（入院24 h内）、院前和复苏后MAP、住院前6个月至7天的基线血肌酐水平、住院期间的血肌酐水平、血管活性药物使用、血管加压素使用和液体平衡等临床资料。采用逐步Logistic回归分析AKI的独立危险因素，并计算优势比( OR)。 结果:本研究中，患者男性112例（51.9%）；年龄52（40，62）岁；AKI组与非AKI组患者ΔMAP差异无统计学意义（ P>0.05）；ΔMAP四分位数第1组与第2~4组患者的AKI发生率（53.7% vs. 73.5%）差异有统计学意义（ P<0.05）；逐步Logistic回归分析结果示，ΔMAP四分位数第1组（ OR=0.23，95% CI:0.11~0.51）对AKI发生率有影响（ P<0.05）；高血压亚组分析示基本一致的结果。 结论:ΔMAP四分位数第1组（-25.3~4.0 mmHg）AP患者AKI发生率显著降低；APACHEⅢ评分、SOFA评分、乳酸初始值、院前的MAP、ΔMAP四分位数第1组是AKI发生率的独立危险因素；建议临床医生根据AP患者院前的MAP水平，制定早期液体复苏阶段的个体化目标MAP。

BACKGROUND:Sepsis is a life-threatening organ dysfunction caused by abnormal immune responses to various, predominantly bacterial, infections. Different bacterial infections lead to substantial variation in disease manifestation and therapeutic strategies. However, the underlying cellular heterogeneity and mechanisms involved remain poorly understood.METHODS:Multiple bulk transcriptome datasets from septic patients with 12 types of bacterial infections were integrated to identify signature genes for each infection. Signature genes were mapped onto an integrated large single-cell RNA (scRNA) dataset from septic patients, to identify subsets of cells associated with different sepsis types, and multiple omics datasets were combined to reveal the underlying molecular mechanisms. In addition, an scRNA dataset and spatial transcriptome data were used to identify signaling pathways in sepsis-related cells. Finally, molecular screening, optimization, and de novo design were conducted to identify potential targeted drugs and compounds.RESULTS:We elucidated the cellular heterogeneity among septic patients with different bacterial infections. In Escherichia coli (E. coli) sepsis, 19 signature genes involved in epigenetic regulation and metabolism were identified, of which DRAM1 was demonstrated to promote autophagy and glycolysis in response to E. coli infection. DRAM1 upregulation was confirmed in an independent sepsis cohort. Further, we showed that DRAM1 could maintain survival of a pro-inflammatory monocyte subset, C10_ULK1, which induces systemic inflammation by interacting with other cell subsets via resistin and integrin signaling pathways in blood and kidney tissue, respectively. Finally, retapamulin was identified and optimized as a potential drug for treatment of E. coli sepsis targeting the signature gene, DRAM1, and inhibiting E. coli protein synthesis. Several other targeted drugs were also identified in other types of sepsis, including nystatin targeting C1QA in Neisseria sepsis and dalfopristin targeting CTSD in Streptococcus viridans sepsis.CONCLUSION:Our study provides a comprehensive overview of the cellular heterogeneity and underlying mechanisms in septic patients with various bacterial infections, providing insights to inform development of stratified targeted therapies for sepsis.

In this study, gold nanoparticles (AuNPs) were grown on the surface of a metal-organic framework (UiO-66-NH2). The resulting AuNPs/UiO-66-NH2 composite nanomaterials were further used for antibody immobilization on a microcantilever surface. By harnessing the robust signal processing capabilities of integrated circuits, a highly sensitive piezoelectric microcantilever sensor was constructed. The incorporation of nanomaterials resulted in enhanced antibodies immobilization amount, thereby improving the immunosensor's sensitivity. Under optimized experimental conditions, a promising linear correlation (R=0.993) was observed between the voltage output intensity of the microcantilever sensor and the logarithmic PCT concentration within a range of 0.1-50 ng/mL. The constructed microcantilever immunosensor based displayed several advantages such as simplicity, rapidity, high sensitivity, and low cost. Moreover, it potentially provided a novel approach to detect other biomolecules.

OBJECTIVE:Cardiac dysfunction and remodeling are serious complications of sepsis and are the main causes of death in sepsis. RCAN1 is a feedback regulator of cardiac hypertrophy. Here, we aim to investigate the role of RCAN1 in septic cardiomyopathy.METHODS:Mice were randomly divided into control-WT, control-RCAN1-/-, LPS-induced WT and LPS-induced RCAN1-/- groups, some with Midiv-1 or KN93 treatment. The protein levels of RCAN1, p-ERK1/2, NFAT3, Drp1, p-Drp1, p-CaMKII in mouse hearts or cultured cardiomyocytes were determined by Western blotting. Myocardial function was assessed by echocardiography. Cardiac hypertrophy and fibrosis were detected by H&E and Masson's trichrome staining. Mitochondrial morphology was examined by transmission electron microscope. Serum level of LDH was detected by ELISA.RESULTS:Our data show that RCAN1 was downregulated in septic mouse heart and LPS-induced cardiomyocytes. RCAN1-/- mice showed a severe impairment of cardiac function, and increased myocardial hypertrophy and fibrosis. The protein levels of NFAT3 and p-ERK1/2 were significantly increased in the heart tissues of RCAN1-/- mice. Further, RCAN1 deficiency aggravated sepsis-induced cardiac mitochondrial injury as indicated by increased ROS production, pathological fission and the loss of mitochondrial membrane potential. Inhibition of fission with Mdivi-1 reversed LPS-induced cardiac hypertrophy, fibrosis and dysfunction in RCAN1-/- mice. Moreover, RCAN1 depletion promoted mitochondrial translocation of CaMKII, which enhanced fission and septic hypertrophy, while inhibition of CaMKII with KN93 reduced excessive fission, improved LPS-mediated cardiac remodeling and dysfunction in RCAN1-/- mice.CONCLUSIONS:Our finding demonstrated that RCAN1 deficiency aggravated mitochondrial injury and septic cardiomyopathy through activating CaMKII. RCAN1 serves as a novel therapeutic target for treatment of sepsis-related cardiac remodeling and dysfunction.

探讨情景模拟教学在急诊住院医师规范化培训中的应用价值,以期活跃学习氛围,提高住院医师考核成绩,提高其参与积极性,实现能力、素养、职业认同等全方位提升.

我国存在江流湖泊多、海岸线长、海岛数量多等特点,洪涝灾害及意外落水事故频发,给人民生命和财产安全带来巨大风险.现阶段,我国水上救援装备发展相对落后,尚不能满足救援需求.为增加救援成功率,最大程度降低救援人员自身风险,迫切需要开发全天候、多情境水上智能救援装备来提高救援效率,保障溺水及救援人员的人身安全.

In vivo toxicity of aromatic ring (BODIPY, 1,3,5,7,8-pentamethyl dipyrrin borondifluoride) attached monofunctional Pt(II) complexes mCBP {[cis-Pt(NH3)2Cl] 8-(para-pyridine-methylene),1,3,5,7-tetramethyl dipyrrin borondifluoride}+ Nitrate− and dCBP {[cis-Pt(NH3)2Cl]28-(1,3-pyrimidine-5-methylene),1,3,5,7-tetramethyl dipyrrin borondifluoride}2+ diNitrate2− were tested in Caenorhabditis elegans (C. elegans). dCBP showed promising reactive oxygen ROS (reactive oxygen species) generating capability. This complex resulted reduction of lifespan, body length and egg laying rate under dark and light irradiation in both N2 (wild-type, cisplatin resistant) and ok938 (asna-1, cisplatin sensitive) C. elegans. Expressional change of several key cancer related pathway (JNK (c-Jun N-terminal kinase) and Wnt/β-catenin (Wingless/Integrated/β-catenin)) related genes (for instance, jnk-1, wrm-1 and gst-4) were confirmed by RNA sequencing experiments. These transcriptional alternations could explain physiological parameters change in nematode and partially revealed how both Pt(II) based complexes influence cancer related pathways. Furthermore, these associated genes exhibited the function of apoptosis, reduced chemoresistance of cancer cells and most of those expressional changes were linked to extended survival of cancer patients.

目的 探讨血小板分布宽度(PDW)在青年冠心病人群中的分布特征及其与冠脉病变严重程度的关系,评价PDW对青年冠心病的预测价值.方法 收集扬州大学附属医院2018年10月至2019年10月连续住院的青年患者(年龄14～44岁)为研究对象,经冠脉造影(CAG)确诊冠心病组240例,除外冠心病88例为对照组.比较2组及青年冠心病各亚组间的PDW水平,分析PDW与冠脉病变严重程度(Gensini评分)的相关性及青年冠心病的独立危险因素.结果 青年冠心病组PDW水平明显高于对照组(P＜0.05),PDW在急性心肌梗死(AMI)、不稳定性心绞痛(UAP)和稳定性心绞痛(SAP)组均高于对照组(P＜0.05);青年冠心病组PDW与Gensini评分之间存在正相关(r= 0.371,P＜0.01);多因素 logistic 回归分析显示 PDW(OR= 2.757,95％CI:2.117～3.590,P＜0.01)是青年冠心病的独立危险因子,绘制ROC曲线分析,PDW预测青年冠心病的截断点为15.65％,ROC曲线下的面积为0.87(95％CI:0.826～0.914,P＜0.01),敏感度84％,特异度82％.结论 PDW与青年冠心病的冠脉病变严重程度密切相关,是青年冠心病的独立危险因素,为青年冠心病的诊断提供一定预测价值.

Objective:To investigate the related factors that affect the timing and prognosis of early tracheostomy in patients with multiple rib fractures.Methods:A retrospective case series study was conducted on medical data of 222 patients with multiple rib fractures who underwent tracheostomy in Affiliated Hospital of Yangzhou University from February 2013 to October 2019，including 160 males and 66 females，with the age of 18 to 85 years ［（49.5 ± 16.3）years］. According to the practice management guidelines for tracheostomy timing and the use of propensity score matching technology，there were 118 patients with tracheostomy within 7 days of tracheal intubation （early group） and 104 patients with tracheostomy after 7 days of tracheal intubation （late group） before matching，and there were 87 patients in early group and 87 patients in late group after matching. Data were compared between groups including the gender，age，underlying disease，injury severity score （ISS），Glasgow coma score （GCS），number of fractured ribs，total number of rib fractures （NTRF），first rib fracture，flail chest，traumatic brain injury，combined injuries （spine，maxillofacial，sternum），acute respiratory distress syndrome （ARDS），volume fraction of pulmonary contusion（VPC），blood lactic acid （within 24 hours of admission），hemothorax，pneumothorax，mechanical ventilation time，duration of tracheostomy，time from tracheal intubation to incision，length of hospital stay，length of stay in ICU，closed thoracic drainage，number of fiberoptic bronchoscopy，multi-drug resistant bacteria infection，ventilator-associated pneumonia，antibiotic use time，duration of sedative and analgesic drugs used and 28-day mortality. The multivariate Logistic regression analysis was used to predict independent risk factors for early tracheostomy. The Pearson method was used to compare the relationship between multiple factors. The receiver operating characteristic （ROC） curve was used to predict indicators that affect the prognosis of patients with early tracheostomy，and calculate the best cut-off value. The Kaplan-Meier single factor and COX multivariate survival were used to analyze the relevant factors affecting the 28-day mortality of patients.Results:（1） In early group，the NTRF，ARDS and VPC were higher than those in late group，and the time from tracheal intubation to incision and 28-day mortality rate were lower than those in late group （ P < 0.05），while the two groups showed no significant differences in the gender，age，underlying diseases and ISS （ P > 0.05）. （2） The multivariate Logistic regression analysis showed that there was statistical significance in NTRF （ OR = 1.775，95% CI 1.439-2.188），ARDS（ OR = 3.740，95% CI 1.441-9.711），VPC （ OR = 1.087，95% CI 1.052-1.124） （ P < 0.05）； the Pearson method analysis showed a significant correlation between VPC and NTRF （ r = 0.369， P < 0.05） and a low degree of correlation between ARDS and VPC （ r = 0.179， P < 0.05），but there was no significant correlation between ARDS and NTRF （ r = 0.132， P > 0.05）. （3） The ROC curve analysis showed that the area under the curve （AUC） of the VPC and NTRF ［AUC = 0.832 （95% CI 0.770-0.893），AUC = 0.804 （95% CI 0.740-0.868）］ were significantly higher than those of the number of rib fractures ［AUC = 0.437（95% CI 0.352-0.523），GCS ［AUC = 0.519 （95% CI 0.432-0.605）］ and ISS ［AUC = 0.484 （95% CI 0.398-0.571）］ （ P < 0.05）. After calculating the Yorden index，the best cut-off value for VPC was 23.9，and the best cut-off value for NTRF was 8.5. （4） The Kaplan-Meier single factor and multivariate COX model survival analysis showed that the 28-day survival ratio of patients with early tracheostomy was significantly better than that of late tracheostomy （ P < 0.05）. Conclusions:The NTRF，ADRS and VPC are independent risk factors for the timing and prognosis of early tracheostomy. There is a significant correlation between VPC and NTRF. The VPC ≥ 23.9% and or NTRF ≥ 8.5 can be used to predict early tracheostomy in patients with multiple rib fractures. Early tracheostomy may benefit the 28-day survival of patients with multiple rib fractures.

Background Nonmotor symptoms (NMS) are prodromal characteristics of Parkinson's disease (PD). The first-degree relatives (FDR) of PD patients had a higher risk of PD and also had more NMS. Objective To delineate NMS in FDR of patients with different clinical types of PD. Methods A total of 98 PD probands were recruited; 256 siblings of them were enrolled in the FDR group. Various scales were used to assess NMS, including depression, anxiety, cognitive impairment, insomnia, constipation, excessive daytime sleepiness, rapid eye movement sleep behavior disorder (RBD), and restless legs syndrome (RLS). The incidences of NMS were further compared between the FDR groups of PD with different types. Results The FDR of early-onset PD (EOP) showed a higher incidence of moderate to severe depression (OR = 4.08; 95% CI: 1.12–14.92; P=0.033), anxiety (OR = 4.22; 95% CI: 1.87–9.52; P=0.001), and excessive daytime sleepiness (OR = 3.40; 95% CI: 1.00–11.48; P=0.049) than the FDR of late-onset PD (LOP). It was also found that RBD (OR = 11.65; 95% CI: 3.82–35.54; P < 0.001), constipation (OR = 4.94; 95% CI: 1.85–13.21; P=0.001), sleep disorders (OR = 4.51; 95% CI: 1.73–11.78; P=0.002), cognitive impairment (OR = 3.55; 95% CI: 1.62–7.77; P=0.002), and anxiety (OR = 2.49; 95% CI: 1.32–4.71; P=0.005) were more frequent in FDR of tremor-dominant PD (TDP) than in FDR of non-tremor-dominant PD (NTDP). Conclusions The siblings of patients with EOP and TDP have more NMS, presuming that they have a higher risk in the PD prodromal stage. Whether they have a greater possibility to progress into PD requires further investigation.

Bone marrow-derived mesenchymal stem cells (MSCs) from systemic lupus erythematosus patients (SLE-BMSCs) exhibited abnormalities in cytokine production and immune modulation. Deregulation of Nod-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome plays an important role in SLE. Herein, we explored whether miRNAs are involved in the regulation of NLRP3 in SLE-BMSCs. ELISA assay was used to detect the levels of inflammatory cytokines. The expression levels of let-7f-5p and gene mRNAs were determined by qRT-PCR assay. The protein levels of NLRP3, Cleaved caspase-1 and ASC were measured by western blot. The interaction between let-7f-5p and NLRP3 was verified using dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. In vivo assay was performed to explore whether let-7f-5p upregulation could ameliorate inflammation in MRL/lpr mice. Our data indicated that SLE patients had significantly serum higher levels of IFN-γ, IL-6, IL-18, IL-12, IL-13 and IL-1β. We demonstrated that NLRP3 expression was upregulated in SLE-BMSCs. Let-7f-5p directly targeted NLRP3 and repressed NLRP3 expression. NLRP3 depletion or let-7f-5p upregulation repressed IL-1β production and the expression of NLRP3 inflammasome components. Moreover, upregulated let-7f-5p-mediated anti-inflammation effect was significantly abrogated by NLRP3 expression restoration. Besides, let-7f-5p upregulation ameliorated inflammation through modulating NLRP3 in vivo. In conclusion, our study suggested that high level of let-7f-5p alleviated inflammation in SLE-BMSCs at least partly through targeting NLRP3, highlighting let-7f-5p as a novel promising therapeutic strategy for SLE treatment.

Objective To compare the effect between the standardized warfarin anticoagulation and antiplatelet therapy on the psychology and quality of life in patients with cardiogenic cerebral embolism.Methods Two hundred and one patients with cardiogenic cerebral embolism were enrolled in this study,including 107 subjects in warfarin anticoagulant group and 94 subjects in antiplatelet therapy group. All subjects were assessed for anxiety,depression, and quality of life at 3rd day,1st,3rd,6rd,9rd,and 12th months using the self-rating anxiety scale (SAS),self-rating depression scale (SDS)and the 36-item short form health survey (SF-36).Results SAS and SDS scores in anticoagulation group at 12th months were significantly lower than those at 3rd days(t＝10.142,t＝9.704;all P＜0.001). Compared with antiplatelet therapy group,SAS and SDS scores in anticoagulation group at 3rd,6th,9th, 12th month were significantly lower (all P＜0.001). Compared with 3rd day,PCS and MCS scores of SF-36 at 12th month were significantly higher in anticoagulation group(t＝ －32.426,t＝ －33.549;all P＜0.001). Compared with 3rd day, there was no statistical significance MCS score at 12th month in antiplatelet therapy group (t＝ －0.613,P＝0.541),and PSC at 12th month were significantly higher (t＝ －25.994,P＜0.001). Compared with antiplatelet therapy group,MCS score in anticoagulation group at 3rd,6th,9th,12th month were significantly higher (all P＜0.01).Conclusion Standardized warfarin anticoagulant in the anticoagulant clinic can significantly reduce anxiety and depression,and improve the quality of life in patients with cardiogenic cerebral embolism.

Objective: Non-motor symptoms (NMS) are important prodromal characteristics of Parkinson's disease (PD). However, the incidence of NMS in first-degree relatives, such as siblings of PD patients, is still unknown. Methods: A total of 98 PD patients of the Affiliated Hospital of Yangzhou University were recruited; 210 siblings of these patients were included in a first-degree relatives (FDR) group and 250 healthy individuals were included in a control group. Various scales were used to assess NMS, including depression, anxiety, cognitive function, sleep status, constipation, daytime sleepiness, Rapid-Eye-Movement Sleep Behavior Disorder (RBD), and Restless Legs Syndrome (RLS). Results: NMS were more common in the PD group than the control group. The incidence of anxiety (OR = 3.434, 95%CI: 2.058-5.731, P < 0.001), depression (OR = 2.438, 95%Cl: 1.289-4.609, P = 0.005), and RBD (OR = 4.120, 95%CI: 1.897-8.945, P < 0.001) was higher in the FDR group than the control group. There were non-significant differences in constipation, cognitive impairment, sleep disorder, daytime sleepiness, and RLS between the two groups. The incidence of RLS in FDR of PD with an age of onset <60 years was higher than in the controls (OR = 2.273, 95%CI: 1.107-4.667, P=0.023). Conclusions: Siblings of PD are more likely to suffer from anxiety, depression and RBD than the general population. RLS is more common in siblings of PD with onset age<60 than in the general population. It is speculated that PD patients and their siblings have common pathogenic genetic factors and early living environment for neurodegeneration. (C) 2018 Elsevier Ltd. All rights reserved.

敌草快是全球第三大灭生性除草剂,仅次于草甘膦和百草枯,他的毒性比百草枯低.百草枯退市后,敌草快目前被广泛应用于农业生产.2016年11月我科收治第一例敌草快中毒患者,因患者71岁,有脊柱肿瘤癌痛病史,家属放弃进一步救治,选择自动出院.2017年2月我科收治第二例敌草快中毒患者,经28 d住院抢救治疗,救治成功,患者治愈出院,目前门诊随访均正常.现报告如下.

规律适当性运动是改善心血管危险因素、延缓心血管疾病进展、降低心血管疾病病死率的一种重要预防策略.心血管疾病与低级别的系统性炎症反应相关,适当性运动可能通过抗炎效应发挥心脏保护作用[1] .