Resumo: Antecedentes: Com o contínuo aumento da prevalência da doença de Alzheimer (DA), a reconciliação medicamentosa no tratamento de pacientes portadores da doença é também iminente. Objetivo: Explorar o papel e a importância da reconciliação medicamentosa no tratamento de DA. Métodos: 100 pacientes com mais de 65 anos de idade com diagnóstico de DA foram divididos aleatoriamente em dois grupos: tratamento convencional (CON) e mudança medicamentosa (MED). A relação das prescrições médicas de todos os indivíduos foi obtida dentro das 24 horas após a admissão, usando-se os critérios Beers, os critérios STOPP / START, e a Farmacopéia Chinesa foi usada como intervenção no grupo MED. A reconciliação medicamentosa foi realizada em 2 semanas, 1 mês e 2 meses após a admissão hospitalar. O número de medicamentos prescritos, a quantidade de medicamentos, a taxa de erro de medicação, o efeito terapêutico, as reações adversas a medicamentos e os níveis de satisfação dos familiares e cuidadores principais foram comparados entre os dois grupos. Resultados: Após a intervenção, os tipos e a quantidade de medicação no grupo MED foram menores em comparação com o grupo CON, juntamente com uma taxa de erro de medicação reduzida. A pontuação do mini-exame do estado mental (MEEM) e a proporção de pacientes bem nutridos no grupo MED foram maiores do que no grupo CON. Observou-se também que o escore da habilidade física de autocuidado e a proporção de pacientes com deglutição alterada foram menores quando comparados ao grupo CON. A incidência de reações adversas a medicamentos no grupo MED foi menor do que no grupo CON. Por outro lado, o índice de satisfação foi superior ao do grupo CON. Conclusão: A reconciliação medicamentosa pode reduzir os erros de medicação em pacientes com DA.

ABSTRACT Background: With the continuous increase of Alzheimer's disease (AD), it is also imminent to treat patients with AD for medication reconciliation. Objective: To explore the role and value of medication reconciliation in AD treatment. Methods: 100 patients over 65 years of age diagnosed with AD were randomly separated into two groups: conventional treatment and medication reforming. The list of medical orders of all subjects was obtained within 24 hours after admission with Beers criteria, STOPP/START criteria, and Chinese Pharmacopoeia used as the MED intervention criteria. Medication reconciliation was performed at 2 weeks, 1 month, and 2 months after hospital admission. The number of medications prescribed, the quantity of the medication, medication error rate, therapeutic effect, adverse drug reactions, and satisfaction levels of family members and main caregivers were compared between the two groups. Results: After the intervention, the types and amount of medication in the MED group were less compared to the CON group along with a reduced medication deviation rate. The Mini-mental state examination (MMSE) score and the proportion of well-nourished patients in the MED group were higher than those in the CON group. It was also observed that the physical self-care ability score and the proportion of patients with abnormal swallowing were lower when in comparison with the CON group. The incidence of adverse drug reactions in the MED group was lower than that in the CON group. However, the satisfaction rate was higher than that in the CON group. Conclusion: Medication reconciliation can reduce the medication deviation in AD patients.

Resumo: Antecedentes: Com o contínuo aumento da prevalência da doença de Alzheimer (DA), a reconciliação medicamentosa no tratamento de pacientes portadores da doença é também iminente. Objetivo: Explorar o papel e a importância da reconciliação medicamentosa no tratamento de DA. Métodos: 100 pacientes com mais de 65 anos de idade com diagnóstico de DA foram divididos aleatoriamente em dois grupos: tratamento convencional (CON) e mudança medicamentosa (MED). A relação das prescrições médicas de todos os indivíduos foi obtida dentro das 24 horas após a admissão, usando-se os critérios Beers, os critérios STOPP / START, e a Farmacopéia Chinesa foi usada como intervenção no grupo MED. A reconciliação medicamentosa foi realizada em 2 semanas, 1 mês e 2 meses após a admissão hospitalar. O número de medicamentos prescritos, a quantidade de medicamentos, a taxa de erro de medicação, o efeito terapêutico, as reações adversas a medicamentos e os níveis de satisfação dos familiares e cuidadores principais foram comparados entre os dois grupos. Resultados: Após a intervenção, os tipos e a quantidade de medicação no grupo MED foram menores em comparação com o grupo CON, juntamente com uma taxa de erro de medicação reduzida. A pontuação do mini-exame do estado mental (MEEM) e a proporção de pacientes bem nutridos no grupo MED foram maiores do que no grupo CON. Observou-se também que o escore da habilidade física de autocuidado e a proporção de pacientes com deglutição alterada foram menores quando comparados ao grupo CON. A incidência de reações adversas a medicamentos no grupo MED foi menor do que no grupo CON. Por outro lado, o índice de satisfação foi superior ao do grupo CON. Conclusão: A reconciliação medicamentosa pode reduzir os erros de medicação em pacientes com DA.

ABSTRACT Background: With the continuous increase of Alzheimer's disease (AD), it is also imminent to treat patients with AD for medication reconciliation. Objective: To explore the role and value of medication reconciliation in AD treatment. Methods: 100 patients over 65 years of age diagnosed with AD were randomly separated into two groups: conventional treatment and medication reforming. The list of medical orders of all subjects was obtained within 24 hours after admission with Beers criteria, STOPP/START criteria, and Chinese Pharmacopoeia used as the MED intervention criteria. Medication reconciliation was performed at 2 weeks, 1 month, and 2 months after hospital admission. The number of medications prescribed, the quantity of the medication, medication error rate, therapeutic effect, adverse drug reactions, and satisfaction levels of family members and main caregivers were compared between the two groups. Results: After the intervention, the types and amount of medication in the MED group were less compared to the CON group along with a reduced medication deviation rate. The Mini-mental state examination (MMSE) score and the proportion of well-nourished patients in the MED group were higher than those in the CON group. It was also observed that the physical self-care ability score and the proportion of patients with abnormal swallowing were lower when in comparison with the CON group. The incidence of adverse drug reactions in the MED group was lower than that in the CON group. However, the satisfaction rate was higher than that in the CON group. Conclusion: Medication reconciliation can reduce the medication deviation in AD patients.

ABSTRACT Explaining where plants originated and how plants migrated between eastern Asia and other Northern Hemisphere regions is still challenging. The genus Arisaema is considered a good example to illuminate this process, due to its wide distribution in both the tropical and temperate zones. Based on comprehensive taxon sampling, the historical biogeography of Arisaema was conducted using the molecular data from four chloroplast DNA regions. The phylogeny of Arisaema was studied by using ML and BI methods. Divergence times of Arisaema species were estimated by the uncorrelated lognormal Bayesian method. The ancestral area reconstruction of Arisaema was performed with BioGeoBEARS and Bayes-DIVA. Our results indicated that the crown group of Arisaema originated in Southeast Asia ca. 31.28 Ma. After the initial origin, Arisaema was inferred to have become widespread in Southeast Asia. Members in Himalayas, Africa and North China, Japan, the Korean Peninsula region (NJK region) were derived from migrants originating in Southeast Asia. American members were derived from migrants originating in the NJK region. Arisaema originated in Southeast Asia during the Oligocene with the development of tropical rainforest and a warm, moist climate. During the Oligocene to Miocene, Southeast Asia was the original center for the diversification of Arisaema in the NJK region.

SUMMARY: Lumbar disc herniation is considered to be the main pathological factor for the common clinical disease of low back pain. Biomechanical factor is an important cause of lumbar disc herniation, so it is urgent to analyze the stress/strain behavior of intervertebral disc under different loading condition. Slow repetitive loading is considered to be an important factor of spine and disc injuries, and the effect of fatigue load on internal displacement in the intervertebral disc was investigated by applying the optimized digital image correlation technique in this study. The first finding was that fatigue load had a significant effect on the displacement distribution in the intervertebral disc under compression. Superficial AF exhibited the largest axial displacements before fatigue load, while it exhibited the smallest axial displacements after fatigue load. Inner AF exhibited slightly smaller radial displacements than outer AF before fatigue load, while it exhibited significantly greater radial displacements than outer AF displacements after fatigue load. The second finding was that fatigue load had a certain effect on the internal displacement distribution in the flexed intervertebral disc under compression. Middle AF exhibited the smallest axial displacements before fatigue load, while deep AF exhibited the smallest axial displacements after fatigue load. The radial displacement distribution did not change before and after fatigue load, as the radial displacement in outer AF was the smallest, while the radial displacement in inner AF was the largest. The third finding was that with the increase in fatigue time and amplitude, the Young's modulus of the intervertebral disc increased significantly. This study can provide the basis for clinical intervertebral disc disease prevention and treatment? and is important for mechanical function evaluation of artificial intervertebral disc as well.

RESUMEN: La hernia de disco lumbar se considera el principal factor patológico para la enfermedad clínica común del dolor lumbar. El factor biomecánico es una causa importante de hernia de disco lumbar, por lo que es urgente analizar el comportamiento de esfuerzo / tensión del disco intervertebral bajo diferentes condiciones de carga. La carga repetitiva lenta se considera un factor importante de lesiones de columna y disco, y en este estudio el efecto de la carga de fatiga sobre el desplazamiento interno en el disco intervertebral se investigó mediante la aplicación de la técnica de correlación de imagen digital optimizada. El primer hallazgo fue que la carga de fatiga tuvo un efecto significativo en la distribución del desplazamiento en el disco intervertebral bajo compresión. El AF superficial exhibió los desplazamientos axiales más grandes antes de la carga de fatiga, mientras que exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. El AF interno exhibió desplazamientos radiales ligeramente más pequeños que el AF externo antes de la carga de fatiga, mientras que exhibió desplazamientos radiales significativamente mayores que los desplazamientos AF externos después de la carga de fatiga. El segundo hallazgo fue que la carga de fatiga tenía un cierto efecto sobre la distribución del desplazamiento interno en el disco intervertebral flexionado bajo compresión. El AF medio exhibió los desplazamientos axiales más pequeños antes de la carga de fatiga, mientras que el AF profundo exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. La distribución del desplazamiento radial no cambió antes ni después de la carga de fatiga, ya que el desplazamiento radial en la FA externa fue el más pequeño, mientras que el desplazamiento radial en la FA interna fue el más grande. El tercer hallazgo fue que con el aumento del tiempo de fatiga y la amplitud, el módulo de Young del disco intervertebral aumentó significativamente. Este estudio puede proporcionar la base para la prevención y el tratamiento clínico de la enfermedad del disco intervertebral, y también es importante para la evaluación de la función mecánica del disco intervertebral artificial.

ABSTRACT Objective Intrathyroid injection of dexamethasone (IID) was used for decrease the relapse rate of hyperthyroidism in the treatment of Graves’ disease (GD), but the mechanism is still unclear. We aimed to explore the effect of IID on T help (Th)1/Th2 cells and their chemokine in patients with GD. Subjects and methods A total of 42 patients with GD who were euthyroidism by methimazole were randomly divided into IID group (n = 20) and control group (n = 22). Thyroid function and associated antibody, Th1/Th2 cells proportion, serum CXCL10 and CCL2 levels, and CXCR3/CCR2 mRNA expression in peripheral blood mononuclear cells before and after 3-month IID treatment were tested by chemiluminescence assay, Flow cytometry, ELISA, and real-time PCR, respectively. Thyroid follicular cells were stimulated by IFN-γ and TNF-α and treated with dexamethasone in vitro. CXCL10 and CCL2 levels in supernatant were determined. Results After 3-month therapy, the proportion of Th2 cells and serum CCL2 levels, as well as TPOAb, TRAb levels and thyroid volume decreased in IID group (p < 0.05). However, the proportion of Th1 and CXCL10 levels had no change in IID group and control (p > 0.05). The CXCR3/CCR2 ratio had no change in both groups (p > 0.05). Conclusion IID therapy could inhibit peripheral Th2 cells via decreasing CCL2 level in peripheral blood, and this result partly explain the effects of IID therapy on prevention of relapse of GD. Arch Endocrinol Metab. 2020;64(3):243-50

A series of 2,3-dioxoindolin-N-phenylacetamide derivatives was evaluated for inhibitory activity against CDC25B and PTP1B enzymes. Most of the derivatives showed inhibitory activity against CDC25B (IC50 = 3.2-23.2 µg/mL) and PTP1B (IC50 = 2.9-21.4 µg/mL). Compound 2h showed the most inhibitory activity in vitro with IC50 values of 3.2 and 2.9 µg/mL against CDC25B and PTP1B, respectively, compared with the reference drugs Na3VO4 (IC50 = 2.7 µg/mL) and oleanolic acid (IC50 = 2.3 µg/mL). The results of selectivity experiments showed that the 2,3-dioxoindolin-N-phenylacetamide derivatives were selective inhibitors against CDC25B and PTP1B. Enzyme kinetic experiments demonstrated that compound 2h was a specific inhibitor with the typical characteristics of a mixed inhibitor. In cytotoxic activity assays compound 2h had potent activity against A549, HeLa, and HCT116 cell lines. In addition, compound 2h showed potent tumor inhibitory activity in a colo205 xenograft model in vivo.

In the present study, a series of novel 5,7-diisoprenyloxyflavone derivatives were designed, synthesized, and evaluated for their antibacterial activity. Most of these compounds displayed significant antibacterial effects against Gram-positive bacteria, especially against strains of multidrug-resistant clinical isolates. Compounds 4c, 4g, 4i, 4j, 4k, 4l, 4n, 4q and 4t showed high levels of antimicrobial activity against Staphylococcus aureus RN4220 with minimum inhibitory concentrations of 4.0-20 µM. Compound 4k showed the most potent activity among these compounds against all multidrug-resistant clinical isolates tested. Unfortunately, none of the compounds were active against Gram-negative bacteria at the doses of 24-164 µM.

Abstract Purpose Bile duct injury (BDI) is a catastrophic complication of cholecystectomy, and misidentification of the cystic anatomy is considered to be the main cause. Although several techniques have been developed to prevent BDI, such as the “critical view of safety”, the infundibular technique, the rates remain higher during laparoscopic cholecystectomy (LC) than during open surgery. We, here, propose a practical new strategy for ductal identification, that can help to prevent laparoscopic bile duct injury. Methods A retrospective study of 5539 patients who underwent LC from March 2007 to February 2019 at a single institution was conducted. The gallbladder infundibulum was classified by its position located on an imaginary clock with the gallbladder neck as the center point of the dial, 3-o’clock position as cranial, 6-o’clock as dorsal, 9-o’clock as caudal, and 12-o’clock as ventral, as well as the axial position. Patient demographics, pathologic variables and infundibulum classification were evaluated. Detailed analysis of ductal identification based on gallbladder infundibulum position was performed in this study. All infundibulum positions were recorded by intraoperative laparoscopic video or photographic images. Results All the patients successfully underwent LC during the study period. No conversion or serious complications such as biliary injury occurred. Gallbladders with infundibulum of 3-o’clock position, 6-o’clock position, 9-o’clock position, 12-o’clock position, axial position were 12.3%, 23.4%, 28.0%, 4.2%, and 32.1%, respectively. The 3-o’clock and 12-o’clock position were pitfalls that might cause biliary injury. Conclusion The gallbladder infundibulum as a navigator is useful for ductal identification to reduce BDI and improve the safety of LC.

ABSTRACT Objective: The aim was to characterize blood glucose fluctuations in patients with fulminant type 1 diabetes (FT1DM) at the stable stage using continuous blood glucose monitoring systems (CGMSs). Subjects and methods: Ten patients with FT1DM and 20 patients with classic type 1 diabetes mellitus (T1DM) (the control group) were monitored using CGMSs for 72 hours. Results: The CGMS data showed that the mean blood glucose (MBG), the standard deviation of the blood glucose (SDBG), the mean amplitude glycemic excursions (MAGE), the blood glucose areas and the percentages of blood glucose levels below 13.9 mmol/L were similar between the two groups. However, the percentage of blood glucose levels below 3.9 mmol/L was significantly higher in the FT1DM group compared to the T1DM group (p < 0.05). The minimum (Min) blood glucose level in the FT1DM group was significantly lower than that of the T1DM group (p < 0.05). Patients with FT1DM had severe dysfunction of the islet beta cells and alpha cells compared to patients with T1DM, as indicated by lower C-peptide values and higher glucagon/C-peptide values. Conclusion: In conclusion, patients with FT1DM at the stable stage were more prone to hypoglycemic episodes as recorded by CGMSs, and they had a greater association with severe dysfunction of both the beta and alpha islet cells compared to patients with T1DM.

Fake review detection has been studied by researchers for several years. However, so far all reported studies are based on English reviews. This paper reports a study of detecting fake reviews in Chinese. Our review dataset is from the Chinese review hosting site Dianping, which has built a fake review detection system. They are confident that their algorithm has a very high precision, but they don't know the recall. This means that all fake reviews detected by the system are almost certainly fake but the remaining reviews may not be all genuine. This paper first reports a supervised learning study of two classes, fake and unknown. However, since the unknown set may contain many fake reviews, it is more appropriate to treat it as an unlabeled set. This calls for the model of learning from positive and unlabeled examples (or PU-learning). Experimental results show that PU learning not only outperforms supervised learning significantly, but also detects a large number of potentially fake reviews hidden in the unlabeled set that Dianping fails to detect.

Purpose The determination of the size of a renal tumor is important for staging, prognosis and selection of the appropriate surgical treatment. We investigated the difference of radiographic and pathologic size of renal tumors in a contemporary cohort of patients who underwent nephron sparing surgery and evaluated its clinical implications. Materials and Methods The records of 169 patients who received nephron sparing surgery for renal lesions suspicious for malignancy between January 2006 and December 2010 were reviewed retrospectively. Radiographic tumor size, defined as the largest diameter of tumor measured by CT images, and pathologic size, the largest diameter of tumor measured in the surgical specimen, were compared and analyzed. Results Among all subjects, mean radiographic and pathologic tumor size were 3.25 ± 1.78 cm and 3.03 ± 1.91 cm, respectively (P < 0.001), with a discrepancy of just 0.22 cm. When the patients were categorized according to radiographic tumor size in the 1 cm range, the mean radiographic tumor size was significantly greater than pathologic tumor size in the following groups: 2 to 3 cm (P < 0.001), 3 to 4 cm (P < 0.001), and 4 to 5 cm (P = 0.028). When radiographic and pathologic tumor sizes were compared according to the pathologic tumor subtype, a significant difference was observed only among those with clear cell renal carcinoma (P < 0.001). Conclusions Renal tumor size was overestimated by radiography as compared with pathology. The difference was just 0.22 cm with little clinical significance, suggesting that CT provides an accurate method to estimate renal tumor size preoperatively.

The number of Web services are growing at an explosive speed, which brings great challenges to the accurate, efficient and automatic retrieval of target services for users. This paper presents a service discovery method with semantic matchmaking which could be used in remote medical systems. Adding ontology related semantic annotations to service interfaces is considered, and a method of service discovery based on bipartite matching of semantic message similarity is proposed. The method is easy to implement because it is not limited to specific service model. It also contributes to the improvement of service discovery efficiency when service is retrieved in an automatic way.