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During neuronal pruning, phagocytes engulf shed cellular debris to avoid inflammation and maintain tissue homeostasis. How phagocytic receptors recognize degenerating neurites had been unclear. Here, we identify two glucosyltransferases Alg8 and Alg10 of the N-glycosylation pathway required for dendrite fragmentation and clearance through genetic screen. The scavenger receptor Draper (Drpr) is N-glycosylated with complex- or hybrid-type N-glycans that interact specifically with galectins. We also identify the galectins Crouching tiger (Ctg) and Hidden dragon (Hdg) that interact with N-glycosylated Drpr and function in dendrite pruning via the Drpr pathway. Ctg and Hdg are required in hemocytes for expression and function, and are induced during dendrite injury to localize to injured dendrites through specific interaction with exposed phosphatidylserine (PS) on the surface membrane of injured dendrites. Thus, the galectins Ctg and Hdg bridge the interaction between PS and N-glycosylated Drpr, leading to the activation of phagocytosis., (© 2024. The Author(s).)

Purpose: Patient-controlled subcutaneous analgesia (PCSA) with sufentanil is an alternative analgesia strategy in patients with stage III-IV cancer; however, its efficacy and safety have not been fully investigated., Methods: From May 10, 2017 to November 10, 2017, 120 patients with stage III-IV cancer suffering from moderate to severe pain were prospectively enrolled from six hospitals and randomized to receive PCSA with morphine (control group) or sufentanil (intervention group). Before the PCSA and on days 1, 3, 7, 14, 28, and 56 after treatment, the numeric rating scale (NRS) and 36-item Short Form health survey (SF-36) were completed for each patient and the side effects were also recorded., Results: No significant differences (P > .05) were observed in the preoperative NRS score and the SF-36 parameters between the two groups. Patients in the intervention group achieved better pain relief, as indicated by lower NRS scores at days 14 (P = .040), 28 (P < .001), and 56 (P < .001) after PCSA device implantation (vs control group). Furthermore, the patients in the intervention group also achieved a better life quality, as indicated by the physical role, general health, social function body pain, and mental health scores. Finally, the patients receiving sufentanil showed lower levels of nausea and somnolence than those in the control group., Conclusion: PCSA with sufentanil achieves better pain control and life quality as well as fewer adverse reactions in stage III-IV cancer patients with pain and may be a promising pain management in these patients., Trial Registration: This study was registered at chictr.org.cn with the trial number: ChiCTR-IPR-17011280., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

To systematically review the incidence rate of adverse drug reaction/event by Qingkailing injection. Such databases as the PubMed, EMbase, the Cochrane library, CNKI, VIP WanFang data and CBM were searched by computer from foundation to July 30, 2015. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and cross check data. Then, Meta-analysis was performed by using the R 3.2.0 software, subgroup sensitivity analysis was performed based on age, mode of medicine, observation time and research quality. Sixty-three studies involving 9,793 patients with Qingkailing injection were included, 367 cases of adverse reactions/events were reported in total. The incidence rate of adverse reaction in skin and mucosa group was 2% [95% CI (0.02; 0.03)]; the digestive system adverse reaction was 6% [95% CI(0.05; 0.07); the injection site adverse reaction was 4% [95% CI (0.02; 0.07)]. In the digestive system as the main types of adverse reactions/events, incidence of children and adults were 4.6% [0.021 1; 0.097 7] and 6.9% [0.053 5; 0.089 8], respectively. Adverse reactions to skin and mucous membrane damage as the main performance/event type, the observation time > 7 days and ≤ 7 days incidence of 3% [0.012 9; 0.068 3] and 1.9% [0.007 8; 0.046 1], respectively. Subgroup analysis showed that different types of adverse reactions, combination in the incidence of adverse reactions/events were higher than that of single drug, the difference was statistically significant (P < 0.05). This study suggested the influence factors of adverse reactions occur, and clinical rational drug use, such as combination, age and other fators, and the influence factors vary in different populations. Therefore, clinical doctors for children and the elderly use special care was required for a clear and open spirit injection, the implementation of individualized medication.

The preparation of beta-In2S3 nanomaterial was carried out by reacting In (NO3)3 with thioacetamide through hydrothermal process at 120 degrees C for 12 h. The size and morphology of In2S3 were characterized by the scanning electron microscope (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD) while the degradation efficiency was evaluated by the photocatalytic degradation of oxytetracycline under natural sunlight. The results revealed that beta-In2S3 nanoparticles are made up of nanosheets with a length of 15-30 nm and with high efficient catalytic performance, in which more than 98% of the initial oxytetracycline (30 mg x L(-1)) was degraded in 4 h. Furthermore, the prepared pG-In2 S3 can be recycled and kept efficient catalytic performance above 85% even after reusing for four times, which reflected the good stability and relative photocatalytic activity of In2S3.

Magnetic porous Fe-Mn binary oxide nanowires were successfully fabricated to efficient removal of As(III) from water. The adsorption capacity of the porous nanowires for As(III) obviously increased with increasing of manganese oxide in the composite, accompanying decrease of the saturation magnetization of the adsorbents. Magnetic porous Fe-Mn binary oxide nanowires with an initial Fe:Mn molar ratio of 1:3 exhibited the highest absorption capacity for As(III) and enable magnetic separation from water. The maximal adsorption capacity value is 171mgg(-1) at pH 7.0. In the initial pH range from 3 to 9, 200μgL(-1) of As(III) could be easily decreased to below 10μgL(-1) by the magnetic porous Fe-Mn binary oxide nanowires (0.05gL(-1)) within 75min, and the corresponding residual As was completely oxidized to less toxic As(V). The coexisting chloride, nitrate and sulfate had no significant effect on arsenic removal, whereas, phosphate and humic acid reduced the removal of As(III) by competing with arsenic species for adsorption sites. The resulting magnetic porous Fe-Mn binary oxide nanowires could be a promising adsorbent for As(III) removal from water., (Copyright © 2014 Elsevier B.V. All rights reserved.)

The notions of Evidence-based medicine developed through two phases, which successively looked into the doctor-patient relationship and decision-making background. One of the new trends in evidence-based medicine deals with how to make theory into practice. Applying the practical model from post-SSK to interpret how the notions of evidence-based medicine changed, it is found that evidence-based medicine is an indivisible practical network integrating many natural and social factors as well as material and cultural factors which interconnect through "translation". Therefore, the involvement of various factors such as natural matter, social relations, regional factors, resources of traditional culture and scientific instruments leads up to the ultimate theory becoming the result of multiple factors in a continuous process of seeking the best way in scientific practice. In this motile process, the borderline between nature and society, material and human, natural science and social science vanishes and a new stage called humanistic medicine appears.

Science is coming from the background of social culture. Evidence-based medicine (EBM) was generated at the early 90's of 20th Century, and there were some landmark things before its appearance. The background of EBM included: (1) risk control of medical techniques at the 70s of 20th Century; (2) ethical ideas of Protestant, including secularism, rationalism and utilitarianism; (3) British positivism and its tradition.

Patient safety has become a hot topic and a big challenge for healthcare services globally during the past ten years. Patient safety is not a new concept but has its explicit cultural root. There were some related elaborations early in the collected works of Hippocrates. Reviewing the origin and developmental process of the concept of patient safety can benefit acquiring a deeper recognition of the basic concept of patient safety. "Medical risk is everywhere" has become the consensus of healthcare professions globally. Patient safety is a perpetual task of the medical area as well as the most basic starting point and final destination in healthcare service.

Objective: To assess the effect and safety of therapies in common use for acute myocardial infarction (AMI) patients with failed thrombolytic therapy., Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 2, 2006), MEDLINE (1966 to July 2006), EMBASE (1984 to July 2006), China National Knowledge Infrastructure (CNKI, 1994 to July 2006), China Biomedicine Database disc (CBMdisc, 1980 to July 2006). We also searched several key Chinese journals in the field of cardiovascular diseases. The language was limited to Chinese and English. We included all the randomized controlled trials (RCTs) for acute myocardial infarction patients with failed thrombolytic therapy. Two authors independently assessed the methodological quality of the included studies, the data were analyzed by RevMan 4.2.8 from the Cochrane Collaboration., Results: Nine RCTs met the inclusion criteria. A significant difference was found between the rescue percutaneous coronary intervention (PCI) group and conventional treatment group in the mortality rate at the end of the follow-up [RR=0.64, 95%CI (0.41, 0.98)]. Thromboembolic stroke and bleeding in rescue PCI group were significantly higher than that in conventional treatment group [RR=4.39, 95%CI (1.14, 16.87), and RR=2.79, 95%CI (1.55, 5.02), respectively]. Compared with conventional therapy, rescue thrombolytic treatment was associated with a significantly higher reperfusion rate [RR=2.92, 95%CI (1.75, 4.85)]. Comparison between rescue PCI with rescue thrombolytic treatment revealed that the revascularization rate in rescue PCI group was significantly lower than that in rescue thrombolytic group [RR=0.57, 95%CI (0.34, 0.95)], and the incidence of bleeding was significantly higher in rescue PCI group [RR=2.15, 95%CI (1.27, 3.63)]. Comparison of glycoprotein (GP)IIb/IIIa receptor antagonists with standard treatment showed no significant difference between them in the mortality rate and bleeding rate at the end of the follow-up., Conclusion: Current evidence does not confirm the effect or safety of the therapies for AMI patients with failed thrombolytic therapy, nor support the routine use of these therapies in clinical practice except for rescue PCI that reduces mortality compared with traditional treatment. Further high-quality randomized controlled trials are needed to provide reliable evidence for the treatments of AMI patients with failed thrombolytic therapy.

Objective: To investigate the efficacy of continuous propofol infusion via the common carotid artery for general anesthesia., Methods: Forty adult patients scheduled for abdominal surgery were randomly assigned into 2 groups to receive propopol via the common carotid artery (IC group, n=20) or via the median cubital vein (IV group, n=20). Anesthesia was induced with intravenous administration of drugs and maintained with continuous propofol infusion via the common carotid artery or the median cubital vein, with the CSI stabilized at 40-/+5 till the end of the operation. During the anesthesia, intravenous injection of fentanyl (3 microg.kg(-1).h(-1)) and vecuronium (50 microg.kg(-1).h(-1)) were given intermittently to maintain the analgesia and muscular relaxation. The dose of propofol used, hemodynamics and recovery of the patients were observed., Results: The dose of propofol used during the surgery to maintain a CSI of 40-/+5 was significantly lower in group IC and than in group IV (2.57-/+0.67 vs 5.72-/+1.37 mg.kg(-1).h(-1), P<0.01). In group IC, the blood pressure was elevated in more than half of the patients and in some cases, the elevation exceeded one third of baseline value and needed intervention with hypotensive drugs. In the IV group, the patients' blood pressure remained stable and varied within the amplitude of 15% of the baseline level. Recovery of spontaneous breathing and consciousness was more quickly in group IC than in group IV (P<0.05)., Conclusion: Loss of consciousness and nervous reflex can be achieved with propofol infusion via the common carotid artery, which reduces propofol dose by about 50% in comparison with intravenous infusion and allows more rapid recovery of spontaneous breath and consciousness.

Aim: Empirical therapy for children with febrile neutropenia has traditionally consisted of combination antibiotics, usually a beta-lactam and an aminoglycoside. However, recent trends and international guidelines have now made monotherapy a feasible option in the management of this group of patients. We prospectively evaluated the efficacy and safety of cefepime monotherapy in our population of paediatric cancer patients with febrile neutropenia., Methods: An audit was performed on children aged 16 years and younger presenting with fever and neutropenia who were managed with empirical single-agent cefepime. The patients were analysed for clinical outcome, documented infections and side-effects of the study drug. Success was defined as clinical improvement without treatment modification. Death or any change to the empirical antibiotic was considered as failure., Results: In this study 79 children (median age 5.2 years) with 133 episodes of febrile neutropenia were prospectively studied between August 2004 and August 2005. A microbiologically documented infection was seen in 26 episodes. The success rate of cefepime monotherapy was 60%. The rate of survival through neutropenia (with or without modification) was 98%. No significant adverse effects were seen., Conclusion: Cefepime monotherapy is a safe and feasible option for treatment of childhood cancer patients with febrile neutropenia.

Objective: To compare the effects of common carotid artery and femoral vein administration of propofol for electrocerebral silence (ES) on circulatory and respiratory function and the dosage of propofol required during ES in dogs., Methods: Eight dogs were anesthetized by common carotid arterial and femoral vein administration of propofol for ES for 1 h. The time of consciousness loss and recovery, dose of propofol during ES, mean arterial pressure, heart rate, respiration rate, end-tidal carbon dioxide, SpO2, cerebral state index (CSI) and anal temperature were continuously monitored. Changes in the outcome variables were analyzed at 7 time points, namely the baseline, upon loss of consciousness, at 10 s, 30 min and 1 h of CSI=0, and recovery of CSI and consciousness., Results: Carotid artery propofol administration produced ES with only half of the dose for intravenous administration. Compared with the baseline values, the mean artery pressure and respiration rate remained unchanged or decreased transiently during ES with carotid artery propofol administration. In contrast, intravenous propofol administration resulted in systemic hypotension and severe respiratory depression., Conclusion: Carotid artery propofol administration produces ES with a much smaller dose than intravenous propofol administration without causing systemic hypotension or respiratory depression.