目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimu...目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rhG-CSF)在预防恶性肿瘤化疗相关中性粒细胞减少症中的疗效与安全性差异,为临床合理用药提供循证医学依据。方法本研究采用系统性文献检索策略,全面检索Embase、Web of Science、PubMed、the Cochrane Library、中国知网、万方和维普数据库,收集从建库至2024年8月17日发表的关于PEG-rhG-CSF与rhG-CSF预防恶性肿瘤化疗相关中性粒细胞减少症的随机对照试验。由2名研究者独立进行文献筛选、数据提取及方法学质量评价,采用Cochrane偏倚风险评估工具对纳入研究进行质量评估。使用RevMan 5.4软件进行Meta分析,二分类变量采用风险比及其95%CI表示效应量,连续性变量采用均数差(MD)及其95%CI表示。研究间异质性采用I²统计量进行评估,I²>50%时采用随机效应模型,否则采用固定效应模型。结果共纳入28项随机对照临床试验,涉及2879例恶性肿瘤患者。根据Meta分析结果表明,PEG-rhG-CSF组在减少Ⅲ/Ⅳ度中性粒细胞减少持续时间方面优于rhG-CSF组(P<0.05)。不良反应事件发生率与rhG-CSF组差异没有统计学意义(P>0.05)。结论与rhG-CSF相比,PEG-rhG-CSF可显著缩短恶性肿瘤患者化疗后重度(Ⅲ/Ⅳ度)中性粒细胞减少的持续时间。基于现有循证医学证据,建议在恶性肿瘤化疗患者中优先选用PEG-rhG-CSF进行中性粒细胞减少症的预防,以降低感染风险,保障化疗周期顺利进行并改善患者预后。展开更多
The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber ris...The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber risks. Although comprehensive, the complexity of the NIST CSF can be overwhelming, especially for those lacking extensive cybersecurity resources. Current implementation tools often cater to larger companies, neglecting the specific needs of SMEs, which can be vulnerable to cyber threats. To address this gap, our research proposes a user-friendly, open-source web platform designed to simplify the implementation of the NIST CSF. This platform enables organizations to assess their risk exposure and continuously monitor their cybersecurity maturity through tailored recommendations based on their unique profiles. Our methodology includes a literature review of existing tools and standards, followed by a description of the platform’s design and architecture. Initial tests with SMEs in Burkina Faso reveal a concerning cybersecurity maturity level, indicating the urgent need for improved strategies based on our findings. By offering an intuitive interface and cross-platform accessibility, this solution aims to empower organizations to enhance their cybersecurity resilience in an evolving threat landscape. The article concludes with discussions on the practical implications and future enhancements of the tool.展开更多
BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorde...BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorder or endogenous opioid peptide functional disorder. OBJECTIVE： This study was designed to observe the effects of electro-acupuncture, at the ＂Sanyinjiao＂ point （SP 6）, on brain tissue norepinephrine and blood lactic acid content in anxiety-model mice after morphine withdrawal. DESIGN： A randomized controlled animal experiment. SETTING： This study was performed in the Laboratory of Acupuncture, Electro-acupuncture ＆ Tuina College, Chengdu University of Traditional Chinese Medicine, from June to September 2001. MATERIALS： A total of 50 healthy Kunming male mice were provided by the Laboratory Animal Center of Chengdu University of Traditional Chinese Medicine. The protocol was performed in accordance with ethical guidelines stated in the Guide for the use and care of laboratory animals, approved by the Committee on the Care and Use of Laboratory Animals of the Institute of Laboratory Animal Resources Commission on Life Sciences, National Research Council, China （1985）. Experimental reagents and equipment used were as follows： morphine hydrochloride （Lot No. 930503, Shenyang No.1 Pharmaceutical Factory, China）, norepinephrine （Sigma Chemical Company, USA）, fluorospectrophotometer （RF-510, Shimadzu Corporation, Japan）, Han electro-acupuncture apparatus （WQ 1002, No. zun （91）-227270-588, Beijing Anlong Photoelectricity-Technique Company, China）, and T-maze （self-made）. METHODS： A total of 50 mice were randomly divided into 5 groups, with 10 mice in each group： blank control, T-maze, model, model ＋ electro-acupuncture, and electro-acupuncture groups. Establishment of anxiety model after morphine withdrawal： the mouse hot plate assay was used to detect the activity of morphine. The median effective dose of morphine, 2.95 mg/kg, was defined as the base. Mice were subcutaneously administered morphine, 3 times a day, for 4 days successively （initially 2.95 mg/kg, then increased day by day, as described below）. Interventions： In the model ＋ electro-acupuncture group, after model induction, mice were subjected electro-acupuncture at bilateral ＂Sanyinjiao＂ （SP6） points using a Han electro-acupuncture apparatus with sparse-dense waves and frequency of 2-100 Hz, once a day, for 6 days. In the model group, after anxiety-model induction, mice were subjected to fixation as same as model ＋ electro-acupuncture group within 6 days of model induction. In the electro-acupuncture group, the anxiety model was not induced and mice were subjected to fixation, electro-acupuncture and the T-maze test. In the T-maze group, the anxiety model was not induced and mice were subjected to fixation. The T-maze test was performed in the 4 groups after experiment. In the blank control group, the anxiety model was not induced and mice were subjected to fixation only. MAIN OUTCOME MEASURES： Brain tissue norepinephrine content of morphine-withdrawal anxiety mice was detected by fluorospectrophotometry after 6 days of electro-acupuncture. Blood lactic acid content was detected by visible spectrophotometry. RESULTS： A total of 50 mice were included in the final analysis. Brain norepinephrine content was significantly greater in the model group compared to the T-maze, blank control, electro-acupuncture and model ＋ electro-acupuncture groups, （P 〈 0.05-0.01）. Brain norepinephrine content was similar between the model ＋ electro-acupuncture and the blank control groups （P 〉 0.05）. There was no significant difference in blood lactic acid content among the groups （P 〉 0.05）. CONCLUSION： Electro-acupuncture lowers brain norepinephrine content but does not influence peripheral blood lactic acid content in morphine-withdrawn, anxiety-modeled mice. These results demonstrate that anxiety-inhibiting effects of electro-acupuncture, after morphine withdrawal, might be related to regulation of norepinephrine release.展开更多
Background: To compare the mortality rates and benefits of norepinephrine and vasopressin in patients with septic shock. Methods: PubMed, EMBASE, and the Cochrane Library database were searched from database inception...Background: To compare the mortality rates and benefits of norepinephrine and vasopressin in patients with septic shock. Methods: PubMed, EMBASE, and the Cochrane Library database were searched from database inception to December 2013. We selected randomized controlled trials in adults with septic shock and compared norepinephrine with vasopressin. After assessing the heterogeneity of treatment effects across trials using the I2 statistic, we used a fixed effects model(P≥0.1) and expressed the results as risk ratios(RRs) for dichotomous outcomes or as standardized mean differences(SMDs) for continuous data with 95% confidence intervals(CIs). Meta-analysis was conducted using Review Manager 5.1 software.Results: Seven trials(n=2323) met the inclusion criteria. Overall, the mortality rate in these seven trials was 36.2%(840/2323). There was no difference in mortality following the use of norepinephrine or vasopressin(RR 1.07; 95%CI 0.97-1.20; P=0.19). Compared to norepinephrine, vasopressin had no significant effect on heart rate(HR)(SMD 0.21; 95%CI-0.08-0.50; P=0.15), mean arterial pressure(MAP)(SMD 0.15; 95%CI-0.15-0.44; P=0.33), cardiac index(CI)(SMD-0.10; 95%CI-0.64-0.44; P=0.73), systemic vascular resistance index(SVRI)(SMD 0.15; 95%CI-0.39-0.70; P=0.58), oxygen delivery(DO2)(SMD-0.06; 95%CI-0.62-0.49; P=0.82), oxygen consumption(VO2)(SMD 0.03; 95%CI-0.52-0.59; P=0.91) or lactic acid(SMD 0.07; 95%CI-0.23-0.36; P=0.66). No significant heterogeneity was found in these comparisons(P≥0.1).Conclusions: There is not sufficient evidence to prove conclusively that norepinephrine is superior to vasopressin in terms of mortality and hemodynamics. The effects of norepinephrine and vasopressin on patients with septic shock require further study in large randomized controlled trials.展开更多
The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in...The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in major depressive disorder research. In the present study, we evaluated the depression symptoms of subjects with major depressive disorder, who were all from the North of China and of Hart Chinese origin, using the Hamilton Depression Scale. We examined the relationship between two single nucleotide polymorphisms in the norepinephrine transporter, rs2242446 and rs5569, and the retardation symptoms of major depressive disorder using quantitative trait testing with the UNPHASED program, rs5569 was associated with depressed mood, and the GG genotype may be a risk factor for this; rs2242446 was associated with work and interest, and the TT genotype may be a risk factor for loss of interest. Our findings suggest that rs2242446 and rs5569 in the norepinephrine transporter gene are associated with the retardation symptoms of depression in the Hart Chinese population.展开更多
文摘目的通过系统评价和Meta分析方法,比较聚乙二醇化重组人粒细胞集落刺激因子(pegylated recombinant human granulocyte colony-stimulating factor,PEG-rhG-CSF)与重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor,rhG-CSF)在预防恶性肿瘤化疗相关中性粒细胞减少症中的疗效与安全性差异,为临床合理用药提供循证医学依据。方法本研究采用系统性文献检索策略,全面检索Embase、Web of Science、PubMed、the Cochrane Library、中国知网、万方和维普数据库,收集从建库至2024年8月17日发表的关于PEG-rhG-CSF与rhG-CSF预防恶性肿瘤化疗相关中性粒细胞减少症的随机对照试验。由2名研究者独立进行文献筛选、数据提取及方法学质量评价,采用Cochrane偏倚风险评估工具对纳入研究进行质量评估。使用RevMan 5.4软件进行Meta分析,二分类变量采用风险比及其95%CI表示效应量,连续性变量采用均数差(MD)及其95%CI表示。研究间异质性采用I²统计量进行评估,I²>50%时采用随机效应模型,否则采用固定效应模型。结果共纳入28项随机对照临床试验,涉及2879例恶性肿瘤患者。根据Meta分析结果表明,PEG-rhG-CSF组在减少Ⅲ/Ⅳ度中性粒细胞减少持续时间方面优于rhG-CSF组(P<0.05)。不良反应事件发生率与rhG-CSF组差异没有统计学意义(P>0.05)。结论与rhG-CSF相比,PEG-rhG-CSF可显著缩短恶性肿瘤患者化疗后重度(Ⅲ/Ⅳ度)中性粒细胞减少的持续时间。基于现有循证医学证据,建议在恶性肿瘤化疗患者中优先选用PEG-rhG-CSF进行中性粒细胞减少症的预防,以降低感染风险,保障化疗周期顺利进行并改善患者预后。
文摘The NIST Cybersecurity Framework (NIST CSF) serves as a voluntary guideline aimed at helping organizations, tiny and medium-sized enterprises (SMEs), and critical infrastructure operators, effectively manage cyber risks. Although comprehensive, the complexity of the NIST CSF can be overwhelming, especially for those lacking extensive cybersecurity resources. Current implementation tools often cater to larger companies, neglecting the specific needs of SMEs, which can be vulnerable to cyber threats. To address this gap, our research proposes a user-friendly, open-source web platform designed to simplify the implementation of the NIST CSF. This platform enables organizations to assess their risk exposure and continuously monitor their cybersecurity maturity through tailored recommendations based on their unique profiles. Our methodology includes a literature review of existing tools and standards, followed by a description of the platform’s design and architecture. Initial tests with SMEs in Burkina Faso reveal a concerning cybersecurity maturity level, indicating the urgent need for improved strategies based on our findings. By offering an intuitive interface and cross-platform accessibility, this solution aims to empower organizations to enhance their cybersecurity resilience in an evolving threat landscape. The article concludes with discussions on the practical implications and future enhancements of the tool.
基金the Grant from Administration of Traditional Chinese Medicine of Sichuan Province, No. 2000-48
文摘BACKGROUND： Following morphine withdrawal, anxiety is associated with abnormal norepinephrine content change. However, increasing blood lactic acid content can induce anxiety or panic in patients with anxiety disorder or endogenous opioid peptide functional disorder. OBJECTIVE： This study was designed to observe the effects of electro-acupuncture, at the ＂Sanyinjiao＂ point （SP 6）, on brain tissue norepinephrine and blood lactic acid content in anxiety-model mice after morphine withdrawal. DESIGN： A randomized controlled animal experiment. SETTING： This study was performed in the Laboratory of Acupuncture, Electro-acupuncture ＆ Tuina College, Chengdu University of Traditional Chinese Medicine, from June to September 2001. MATERIALS： A total of 50 healthy Kunming male mice were provided by the Laboratory Animal Center of Chengdu University of Traditional Chinese Medicine. The protocol was performed in accordance with ethical guidelines stated in the Guide for the use and care of laboratory animals, approved by the Committee on the Care and Use of Laboratory Animals of the Institute of Laboratory Animal Resources Commission on Life Sciences, National Research Council, China （1985）. Experimental reagents and equipment used were as follows： morphine hydrochloride （Lot No. 930503, Shenyang No.1 Pharmaceutical Factory, China）, norepinephrine （Sigma Chemical Company, USA）, fluorospectrophotometer （RF-510, Shimadzu Corporation, Japan）, Han electro-acupuncture apparatus （WQ 1002, No. zun （91）-227270-588, Beijing Anlong Photoelectricity-Technique Company, China）, and T-maze （self-made）. METHODS： A total of 50 mice were randomly divided into 5 groups, with 10 mice in each group： blank control, T-maze, model, model ＋ electro-acupuncture, and electro-acupuncture groups. Establishment of anxiety model after morphine withdrawal： the mouse hot plate assay was used to detect the activity of morphine. The median effective dose of morphine, 2.95 mg/kg, was defined as the base. Mice were subcutaneously administered morphine, 3 times a day, for 4 days successively （initially 2.95 mg/kg, then increased day by day, as described below）. Interventions： In the model ＋ electro-acupuncture group, after model induction, mice were subjected electro-acupuncture at bilateral ＂Sanyinjiao＂ （SP6） points using a Han electro-acupuncture apparatus with sparse-dense waves and frequency of 2-100 Hz, once a day, for 6 days. In the model group, after anxiety-model induction, mice were subjected to fixation as same as model ＋ electro-acupuncture group within 6 days of model induction. In the electro-acupuncture group, the anxiety model was not induced and mice were subjected to fixation, electro-acupuncture and the T-maze test. In the T-maze group, the anxiety model was not induced and mice were subjected to fixation. The T-maze test was performed in the 4 groups after experiment. In the blank control group, the anxiety model was not induced and mice were subjected to fixation only. MAIN OUTCOME MEASURES： Brain tissue norepinephrine content of morphine-withdrawal anxiety mice was detected by fluorospectrophotometry after 6 days of electro-acupuncture. Blood lactic acid content was detected by visible spectrophotometry. RESULTS： A total of 50 mice were included in the final analysis. Brain norepinephrine content was significantly greater in the model group compared to the T-maze, blank control, electro-acupuncture and model ＋ electro-acupuncture groups, （P 〈 0.05-0.01）. Brain norepinephrine content was similar between the model ＋ electro-acupuncture and the blank control groups （P 〉 0.05）. There was no significant difference in blood lactic acid content among the groups （P 〉 0.05）. CONCLUSION： Electro-acupuncture lowers brain norepinephrine content but does not influence peripheral blood lactic acid content in morphine-withdrawn, anxiety-modeled mice. These results demonstrate that anxiety-inhibiting effects of electro-acupuncture, after morphine withdrawal, might be related to regulation of norepinephrine release.
文摘Background: To compare the mortality rates and benefits of norepinephrine and vasopressin in patients with septic shock. Methods: PubMed, EMBASE, and the Cochrane Library database were searched from database inception to December 2013. We selected randomized controlled trials in adults with septic shock and compared norepinephrine with vasopressin. After assessing the heterogeneity of treatment effects across trials using the I2 statistic, we used a fixed effects model(P≥0.1) and expressed the results as risk ratios(RRs) for dichotomous outcomes or as standardized mean differences(SMDs) for continuous data with 95% confidence intervals(CIs). Meta-analysis was conducted using Review Manager 5.1 software.Results: Seven trials(n=2323) met the inclusion criteria. Overall, the mortality rate in these seven trials was 36.2%(840/2323). There was no difference in mortality following the use of norepinephrine or vasopressin(RR 1.07; 95%CI 0.97-1.20; P=0.19). Compared to norepinephrine, vasopressin had no significant effect on heart rate(HR)(SMD 0.21; 95%CI-0.08-0.50; P=0.15), mean arterial pressure(MAP)(SMD 0.15; 95%CI-0.15-0.44; P=0.33), cardiac index(CI)(SMD-0.10; 95%CI-0.64-0.44; P=0.73), systemic vascular resistance index(SVRI)(SMD 0.15; 95%CI-0.39-0.70; P=0.58), oxygen delivery(DO2)(SMD-0.06; 95%CI-0.62-0.49; P=0.82), oxygen consumption(VO2)(SMD 0.03; 95%CI-0.52-0.59; P=0.91) or lactic acid(SMD 0.07; 95%CI-0.23-0.36; P=0.66). No significant heterogeneity was found in these comparisons(P≥0.1).Conclusions: There is not sufficient evidence to prove conclusively that norepinephrine is superior to vasopressin in terms of mortality and hemodynamics. The effects of norepinephrine and vasopressin on patients with septic shock require further study in large randomized controlled trials.
基金supported by the National Natural Science Foundation of China,No. 30770770,30971054,and81171290Science Foundation for the Youth of Shanxi,No.2011021036-1
文摘The norepinephrine transporter plays an important role in the pathophysiology and pharmacological treatment of major depressive disorder. Consequently, the norepinephrine transporter gene is an attractive candidate in major depressive disorder research. In the present study, we evaluated the depression symptoms of subjects with major depressive disorder, who were all from the North of China and of Hart Chinese origin, using the Hamilton Depression Scale. We examined the relationship between two single nucleotide polymorphisms in the norepinephrine transporter, rs2242446 and rs5569, and the retardation symptoms of major depressive disorder using quantitative trait testing with the UNPHASED program, rs5569 was associated with depressed mood, and the GG genotype may be a risk factor for this; rs2242446 was associated with work and interest, and the TT genotype may be a risk factor for loss of interest. Our findings suggest that rs2242446 and rs5569 in the norepinephrine transporter gene are associated with the retardation symptoms of depression in the Hart Chinese population.
