Population pharmacokinetics of long-term hydroxychloroquine therapy in patients with rheumatic diseases.

Aims: Hydroxychloroquine (HCQ) is recommended for the long-term treatment of rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. Given the complex process of HCQ metabolism and individual physiological differences, the metabolic profile of HCQ after long-term administration is unknown. This study aimed to establish a population pharmacokinetic model for long-term HCQ treatment in patients with rheumatic diseases and to identify the factors influencing HCQ metabolism.

Successful diagnosis and treatment of scrub typhus associated with haemophagocytic lymphohistiocytosis and multiple organ dysfunction syndrome: A case report and literature review.

Scrub typhus is a natural foci disease caused by the bacteria . Symptoms of the disease range from fever to severe multiple organ dysfunction. The diagnosis is based on clinical signs and antibody serological tests, which has poor sensitivity and specificity.

Mycophenolic Acid Induces the Intestinal Epithelial Barrier Damage through Mitochondrial ROS.

Mycophenolic acid (MPA) may cause gastrointestinal adverse effects by damaging the intestinal epithelial barrier, the underlying mechanisms remain elusive. Studies have demonstrated that oxidative stress caused by reactive oxygen species (ROS) is linked to tight junction (TJ) proteins and apoptosis, both of which cause abnormalities in intestinal barrier function. Mitochondria, one of the main sources of ROS and abnormally high levels of ROS are linked to mitochondrial dysfunction.

Sequential use of midazolam and dexmedetomidine for long-term sedation may reduce weaning time in selected critically ill, mechanically ventilated patients: a randomized controlled study.

Background: Current sedatives have different side effects in long-term sedation. The sequential use of midazolam and dexmedetomidine for prolonged sedation may have distinct advantages. We aimed to evaluate the efficacy and safety of the sequential use of midazolam and either dexmedetomidine or propofol, and the use of midazolam alone in selected critically ill, mechanically ventilated patients.

Schisandrin A alleviates mycophenolic acid-induced intestinal toxicity by regulating cell apoptosis and oxidative damage.

The gastrointestinal side effects of mycophenolic acid affect its efficacy in kidney transplant patients, which may be due to its toxicity to the intestinal epithelial mechanical barrier, including intestinal epithelial cell apoptosis and destruction of tight junctions. The toxicity mechanism of mycophenolic acid is related to oxidative stress-mediated, the activation of mitogen-activated protein kinases (MAPK). Schisandrin A (Sch A), one of the main active components of the Schisandra chinensis, can protect intestinal epithelial cells from deoxynivalenol-induced cytotoxicity and oxidative damage by antioxidant effects.

Study on alleviate effect of Wuzhi capsule (Schisandra sphenanthera Rehder & E.H. Wilson extract) against mycophenolate mofetil-induced intestinal injury.

Ethnopharmacological Relevance: Schisandra sphenanthera Rehder & E.H. Wilson (S.

[Annual progress in critical care medicine in 2020].

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on.

PD-1/PD-L1 enhanced cisplatin resistance in gastric cancer through PI3K/AKT mediated P-gp expression.

Background: Programmed cell death receptor 1 (PD-1) is an immunosuppressive molecule expressed on T cells, and its ligand (PD-L1) which expressed on tumor cells play pivotal roles in regulating host immune responses. However, little is known whether PD-1/PD-L1 axis could directly activates intracellular oncogenic signaling pathways in tumor cells, leading to tumor resistance.

Methods: In the present study, the expression of PD-1 and PD-L1 in the tissues of gastric cancer was detected by western blot and immunofluorescence.

Identifying Circular RNA and Predicting Its Regulatory Interactions by Machine Learning.

Circular RNA (circRNA) is a closed long non-coding RNA (lncRNA) formed by covalently closed loops through back-splicing. Emerging evidence indicates that circRNA can influence cellular physiology through various molecular mechanisms. Thus, accurate circRNA identification and prediction of its regulatory information are critical for understanding its biogenesis.

CCRDB: a cancer circRNAs-related database and its application in hepatocellular carcinoma-related circRNAs.

Circular RNAs (circRNAs) are widely expressed in human cells and tissues and can form a covalently closed exon circularization, which have stable patterns and play important regulatory roles in physiological or pathological process. There is still lack of a comprehensively disease-related knowledge base for in-depth analysis of circRNAs. In this paper, a cancer circRNAs-related database (CCRDB) was established.

End-of-Life Care in ICUs in East Asia: A Comparison Among China, Korea, and Japan.

Objectives: To compare physicians' perceptions and practice of end-of-life care in the ICU in three East Asian countries cultures similarly rooted in Confucianism.

Design: A structured and scenario-based survey of physicians who managed ICU patients from May 2012 to December 2012.

Setting: ICUs in China, Korea, and Japan.

AN IMPORTED CASE OF ACUTE MELIOIDOSIS CAUSED BY ST881 BURKHOLDERIA PSEUDOMALLEI.

A previously healthy Chinese male working in Malaysia returned to China with high fever. A blood culture showed Burkholderia pseudomallei strain WCBP1. This isolate was sequenced, showing type, ST881, which appears to be present in Malaysia.

Withholding and withdrawal of life-sustaining treatments in low-middle-income versus high-income Asian countries and regions.

Purpose: To compare the attitudes of physicians towards withholding and withdrawing life-sustaining treatments in intensive care units (ICUs) in low-middle-income Asian countries and regions with those in high-income ones, and to explore differences in the role of families and surrogates, legal risks, and financial considerations between these countries and regions.

Methods: Questionnaire study conducted in May-December 2012 on 847 physicians from 255 ICUs in 10 low-middle-income countries and regions according to the World Bank's classification, and 618 physicians from 211 ICUs in six high-income countries and regions.

Results: After we accounted for personal, ICU, and hospital characteristics on multivariable analyses using generalised linear mixed models, physicians from low-middle-income countries and regions were less likely to limit cardiopulmonary resuscitation, mechanical ventilation, vasopressors and inotropes, tracheostomy and haemodialysis than those from high-income countries and regions.

[Changes of Intestinal Mucosal Barrier and Intestinal Flora in Rats with Severe Acute Pancreatitis].

This paper is to explore changes of intestinal mucosal barrier, intestinal flora, and bacterial translocation in rats with severe acute pancreatitis (SAP). Twenty four male SD rats were randomly divided into the control group (n = 10) and the experimental group (n = 14). The model of severe acute pancreatitis of rats was induced by the method of injecting adversely 5% sodium taurocholate into the common biliary-pancreatic duct.

Effects of rhubarb on intestinal flora and toll-like receptors of intestinal mucosa in rats with severe acute pancreatitis.

Objective: The aim of this study was to examine the effects of rhubarb on intestinal flora and toll-like receptors (TLRs) of intestinal mucosa in rats with severe acute pancreatitis (SAP).

Methods: Healthy male Sprague-Dawley rats were randomly allocated into sham-operated surgical model of SAP without or with postoperative rhubarb treatment groups (7 in each group). Rats in with rhubarb group received 10% rhubarb decoction (1 mL/200 g) through tube feeding at every 8 hours during postoperative 24 hours.

Withholding and withdrawal of life-sustaining treatments in intensive care units in Asia.

Importance: Little data exist on end-of-life care practices in intensive care units (ICUs) in Asia.

Objective: To describe physicians' attitudes toward withholding and withdrawal of life-sustaining treatments in end-of-life care and to evaluate factors associated with observed attitudes.

Design, Setting, And Participants: Self-administered structured and scenario-based survey conducted among 1465 physicians (response rate, 59.

Intestinal ischemia-reperfusion of macaques triggers a strong innate immune response.

Aim: To investigate inflammatory injury in the intestinal mucosa after intestinal ischemia-reperfusion (IIR) with Toll-like receptor (TLR)-mediated innate immunity.

Methods: Ten macaques were randomized into control and IIR groups. The distribution and expression level of TLR2, TLR4, MD2, nuclear factor (NF)-κB p65 and interferon (IFN)-γ were measured by immunohistochemical stain and western blotting.

[Risk factors and therapy strategies of acute pulmonary edema in critically ill patients with multiple trauma].

Objective: To analyze the risk factors and therapy strategies of acute pulmonary edema (APE) in critically ill patients with multiple trauma.

Methods: We conducted a retrospective analysis with the clinical date of all the critically ill patients with multiple trauma treated in General ICU from Jan. 2009 to Jan.

Misidentification of Burkholderia pseudomallei as Burkholderia cepacia by the VITEK 2 system.

A previously healthy Chinese male returned from working in the Malaysian jungle with a fever. A blood culture grew Gram-negative bacilli that were initially identified as Burkholderia cepacia by the VITEK 2 system but were subsequently found to be Burkholderia pseudomallei by partial sequencing of the 16S rRNA gene. The identification of B.

Association of IL-10-1082 G/G genotype with lower mortality of acute respiratory distress syndrome in a Chinese population.

We aimed to investigate whether interleukin-10 (IL-10) -1082 G/G genotype is associated with lower mortality of acute respiratory distress syndrome (ARDS) in a Chinese population. A hospital-based case-control study was conducted in 314 cases of ARDS and 210 controls who were admitted to an intensive care unit with sepsis, trauma, aspiration or massive transfusions. Cases were followed for 30-day mortality.

Association of interleukin-10-1082 G/G genotype with lower mortality of acute respiratory distress syndrome in a Chinese population.

We investigate whether interleukin-10 (IL-10)-1082 G/G genotype is associated with the mortality rate of acute respiratory distress syndrome (ARDS) in a hospital-based case-control study in China conducted on 314 patients with ARDS and 210 controls admitted to an intensive care unit for sepsis, trauma, aspiration, or massive transfusions. IL-10-1082 promoter polymorphisms were analyzed with polymerase chain reaction amplification followed by restriction fragment length polymorphism. Mortality was recorded if it occurred within 30 days from admission.

[Role of procalcitonin in the diagnosis of ventilator-associated pneumonia].

Objective: To evaluate the diagnostic value of procalcitonin (PCT) in ventilator-associated pneumonia (VAP).

Methods: Prospective study was performed. All adult patients who were admitted into the intensive care unit (ICU) of West China Hospital of Sichuan University between June 1st and October 1st and were clinically suspected of having developed VAP after 48 hours of mechanical ventilation were enrolled.

[Clinical implication of blood somatostatin determination in critically ill patients].

Objective: To investigate the relationship between contents of blood somatostatin (SST) and inflammatory reaction or severity of illness in critically ill patients, and its value in the evaluation of prognosis.

Methods: Sixty critically ill patients were divided into three groups according to the acute physiology and chronic health evaluation II (APACHE II) score as mild (<16, 23 cases), mediate (16 - 20, 20 cases) and severe (>20, 17 cases) group; and also divided as dead (D, 13 cases) or survival group (S, 47 cases) according to the final outcome; 20 healthy volunteers served as control. The blood SST concentration was detected by radioimmunoassay, while the levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay (ELISA).