Excess Oxygen Supply for Different Time Periods Affect Energy Metabolism in Rat Alveolar Epithelial Type Ⅱ Cells / 中国医学科学院学报

Objective To observe the effect of excess oxygen supply for different time periods on the mitochondrial energy metabolism in alveolar epithelial type Ⅱ cells. Methods Rat RLE-6TN cells were assigned into a control group (21% O2 for 4 h) and excess oxygen supply groups (95% O2 for 1,2,3,and 4 h,res-pectively).The content of adenosine triphosphate (ATP),the activity of mitochondrial respiratory chain complex V,and the mitochondrial membrane potential were determined by luciferase assay,micro-assay,and fluorescent probe JC-1,respectively.Real-time fluorescence quantitative PCR was employed to determine the mRNA levels of NADH dehydrogenase subunit 1 (ND1),cytochrome b (Cytb),cytochrome C oxidase subunit I (COXI),and adenosine triphosphatase 6 (ATPase6) in the core subunits of mitochondrial respiratory chain complexes Ⅰ,Ⅲ,Ⅳ,and Ⅴ,respectively. Results Compared with the control group,excess oxygen supply for 1,2,3,and 4 h down-regulated the mRNA levels of ND1 (q=24.800,P<0.001;q=13.650,P<0.001;q=9.869,P<0.001;q=20.700,P<0.001),COXI (q=16.750,P<0.001;q=10.120,P<0.001;q=8.476,P<0.001;q=14.060,P<0.001),and ATPase6 (q=22.770,P<0.001;q=15.540,P<0.001;q=12.870,P<0.001;q=18.160,P<0.001).Moreover,excess oxygen supply for 1 h and 4 h decreased the ATPase activity (q=9.435,P<0.001;q=11.230,P<0.001) and ATP content (q=5.615,P=0.007;q=5.029,P=0.005).The excess oxygen supply for 2 h and 3 h did not cause significant changes in ATPase activity (q=0.156,P=0.914;q=3.197,P=0.116) and ATP content (q=0.859,P=0.557;q=1.273,P=0.652).There was no significant difference in mitochondrial membrane potential among the groups (F=0.303,P=0.869). Conclusion Short-term excess oxygen supply down-regulates the expression of the core subunits of mitochondrial respiratory chain complexes and reduces the activity of ATPase,leading to the energy metabolism disorder of alveolar epithelial type Ⅱ cells.

RIP1-dependent linear and nonlinear recruitments of caspase-8 and RIP3 respectively to necrosome specify distinct cell death outcomes

There remains a significant gap in our quantitative understanding of crosstalk between apoptosis and necroptosis pathways. By employing the SWATH-MS technique, we quantified absolute amounts of up to thousands of proteins in dynamic assembling/de-assembling of TNF signaling complexes. Combining SWATH-MS-based network modeling and experimental validation, we found that when RIP1 level is below ~1000 molecules/cell (mpc), the cell solely undergoes TRADD-dependent apoptosis. When RIP1 is above ~1000 mpc, pro-caspase-8 and RIP3 are recruited to necrosome respectively with linear and nonlinear dependence on RIP1 amount, which well explains the co-occurrence of apoptosis and necroptosis and the paradoxical observations that RIP1 is required for necroptosis but its increase down-regulates necroptosis. Higher amount of RIP1 (>~46,000 mpc) suppresses apoptosis, leading to necroptosis alone. The relation between RIP1 level and occurrence of necroptosis or total cell death is biphasic. Our study provides a resource for encoding the complexity of TNF signaling and a quantitative picture how distinct dynamic interplay among proteins function as basis sets in signaling complexes, enabling RIP1 to play diverse roles in governing cell fate decisions.

Suitability survey on N95 filter masks for public health emergency personnel / 上海预防医学

Objective To assess the suitability of N95 masks for public health emergency personnel. To compare the consistency between mask fit test result and subjective evaluation of mask-wearing air tightness so as to guide scientific selection and use of protection masks for emergency personnel. Methods By ambient aerosol condensation nuclear counter method, the quantitative fit test was done among 235 public health emergency personnel from both Municipal and District disease control centers. Questionnaires were conducted among them for investigation and comparison of their subjective evaluation of mask-wearing air tightness and mask fit test results. Results Of the 235 subjects , 160 passed the fittest with the pass rate being 68.1%. With various wearing actions for the test, the subjective evaluation for mask-wearing air tightness was compared with the fit test pass rate in terms of consistence, the kappa value range being from −0.09 to 0.43. K value of the action 5 (loudly speaking) was above 0.4, while the k values of other 6 actions were all below 0.4. Both Kappa value (0.09) and consistency rate (49.7%) were the lowest for action 8 (normal breathing) among all test actions. Conclusion The accuracy of the subjective evaluation for mask-wearing air tightness proves to be poor, unable to reflect the true protective effect and substitute for the fit test. It is advised that the public health personnel should rely on the fit test results to correctly choose and use suitable respiratory protective products.

Death and do-not-resuscitate order in the emergency department: A single-center three-year retrospective study in the Chinese mainland / 世界急诊医学杂志（英文）

@# Current Issue Archive 15 December 2020, Volume 11 Issue 4 Previous Issue Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia Rebekah Shaw, Erica Popovsky, Alyssa Abo, Marni Jacobs, Nicole Herrera, James Chamberlain, Andrea Hahn World Journal of Emergency Medicine. 2020, 11(4): 199-205. doi:10.5847/wjem.j.1920-8642.2020.04.001 Asbtract HTML PDF (151KB) Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study Hai-jiang Zhou, Tian-fei Lan, Shu-bin Guo World Journal of Emergency Medicine. 2020, 11(4): 206-215. doi:10.5847/wjem.j.1920-8642.2020.04.002 Asbtract HTML PDF (255KB) Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen World Journal of Emergency Medicine. 2020, 11(4): 216-222. doi:10.5847/wjem.j.1920-8642.2020.04.003 Asbtract HTML PDF (107KB) Effects of sepsis on hippocampal volume and memory function Miao Yuan, Ding-yi Yan, Fang-shi Xu, Yi-di Zhao, Yang Zhou, Long-fei Pan World Journal of Emergency Medicine. 2020, 11(4): 223-230. doi:10.5847/wjem.j.1920-8642.2020.04.004 Asbtract HTML PDF (138KB) Death and do-not-resuscitate order in the emergency department: A single-center three-year retrospective study in the Chinese mainland Chuan-qi Ding, Yu-ping Zhang, Yu-wei Wang, Min-fei Yang, Sa Wang, Nian-qi Cui, Jing-fen Jin World Journal of Emergency Medicine. 2020, 11(4): 231-237. doi:10.5847/wjem.j.1920-8642.2020.04.005 Asbtract HTML PDF (144KB) BACKGROUND: Consenting to do-not-resuscitate (DNR) orders is an important and complex medical decision-making process in the treatment of patients at the end-of-life in emergency departments (EDs). The DNR decision in EDs has not been extensively studied, especially in the Chinese mainland. METHODS: This retrospective chart study of all deceased patients in the ED of a university hospital was conducted from January 2017 to December 2019. The patients with out-of-hospital cardiac arrest were excluded. RESULTS: There were 214 patients’ deaths in the ED in the three years. Among them, 132 patients were included in this study, whereas 82 with out-of-hospital cardiac arrest were excluded. There were 99 (75.0%) patients’ deaths after a DNR order medical decision, 64 (64.6%) patients signed the orders within 24 hours of the ED admission, 68 (68.7%) patients died within 24 hours after signing it, and 97 (98.0%) patients had DNR signed by the family surrogates. Multivariate analysis showed that four independent factors influenced the family surrogates’ decisions to sign the DNR orders: lack of referral (odds ratio [OR] 0.157, 95% confidence interval [CI] 0.047-0.529, P=0.003), ED length of stay (ED LOS) ≥72 hours (OR 5.889, 95% CI 1.290-26.885, P=0.022), acute myocardial infarction (AMI) (OR 0.017, 95% CI 0.001-0.279, P=0.004), and tracheal intubation (OR 0.028, 95% CI 0.007-0.120, P<0.001). CONCLUSIONS: In the Chinese mainland, the proportion of patients consenting for DNR order is lower than that of developed countries. The decision to sign DNR orders is mainly affected by referral, ED LOS, AMI, and trachea intubation.

Suitability survey on N95 filter masks for public health emergency personnel / 上海预防医学

Objective To assess the suitability of N95 masks for public health emergency personnel, and to compare the consistency between mask suitability test result and subjective evaluation of mask air tightness so as to guide scientific selection and use of protection masks for emergency personnel. Methods By ambient aerosol condensation nuclear counter method, qualitative suitability test was done among 235 public health emergency personnel from both municipal and district disease control centers.Questionnaires were conducted among them for investigation and comparison of their subjective evaluation of mask air tightness and mask suitability test results. Results Of the 235 subjects, 160 passed the suitability test with the pass rate being 68.1%. With various wearing actions for the test, the subjective evaluation for mask air tightness was compared with suitability test pass rate in terms of consistence, the kappa value range being from -0.09 to 0.43.The kappa value of the action 5 (loudly speaking) was above 0.4, while the kappa values of other 6 actions were all below 0.4.Both kappa value (0.09) and consistency rate (49.7%) were the lowest for action 8 (normal breathing) among all test actions. Conclusion The accuracy of the subjective evaluation for air tightness of the mask proves to be poor, unable to reflect the true protective effect and unable to substitute the suitability test.It is advised that the public health personnel should rely on the suitability test results to correctly choose and use suitable respiratory protective products.

Bibliometric analysis and quality assessment of clinical evidence on Xiaotong Tiegao / 中国中药杂志

Many clinical studies on Cheezheng Xiaotong Tiegao have been accumulated since it was launched in 1993,but they have not been comprehensively analyzed and evaluated. This study systematically retrieved relevant studies in six databases at home and abroad as of December 2017. This study analyzed the statistics of the included studies in several aspects,including publication time,region,fund,disease category and type of study. In this study,various tools were used to evaluate the methodological quality of included studies,such as the Cochrane collaboration's tool for assessing the risk of bias in randomized trials,MINORS,IHE,AMSTAR2.The results showed that the literatures were mainly published from 2010 to 2011,and a total of 28 projects were financially supported.The most involved disease was arthropathy. The randomized controlled trials were the majority in the included studies,but the quality was low,and most of the literatures didn't report the allocation concealment and blinding. This study comprehensively reflected the current situations and shortcomings of the clinical studies of Cheezheng Xiaotong Tiegao,and put forward several suggestions,in the expectation of providing a reference for the future clinical research direction of Cheezheng Xiaotong Tiegao.

Effects of puerarin on H2O2-induced SH-SY5Y cell apoptosis / 中国药理学通报

Aim To investigate the neuroprotective effects of puerarin on H2O2-induced SH-SY5Y cell ap-optosis and the molecular mechanisms underlying the neuroprotective effects. Methods Neuron injury mod-el was established in vitro through H2O2-induced SH-SY5Y injury. MTT assay was performed to detect the effect of puerarin on H2O2-induced SH-SY5Y survival rates. Hoechst 33342 staining was used to observe the cell apoptosis. JC-1 staining was employed to detect the level of mitochondria membrane poential. Caspase-3 was determined by caspase-3 catalyze the substrate specificity Ac-DEVD-pNA. Caspase-9 was determined by caspase-9 catalyze the substrate specificity Ac-LE-HD-pNA. The effects of puerarin on the protein level of Bcl-2,Bax,p-Akt and Akt were determined by West-ern blot. Results The cell survival rate significantly increased after puerarin pretreatment compared with H2O2model group. Furthermore, puerarin pretreat-ment not only inhibited the decreasing of mitochondrial membrane potential,increasing of caspase-3, caspase-9 enzymatic activity and the expression of Bax,but also promoted the expression of p-Akt and Bcl-2, which was prevented by LY294002, an inhibitor of PI3K/Akt. Conclusion Puerarin can play a neuroprotective role for SH-SY5Y cell apoptosis induced by H2O2, maybe via activating PI3K/Akt signaling pathway.

Chemical variation in Aurantii Fructus before and after processing based on UHPLC-Q-TOF-MS / 中国中药杂志

To explore the processing mechanism of Aurantii Fructus decoction pieces used in Guangdong province and Hong Kong by analysing the chemical variation between raw and processed Aurantii Fructus with different methods based on UHPLC-Q-TOF-MS. The total ion chromatograms detected in positive and negative ion modes, and ion peak area ratio before and after processing were taken as variation indexes in the comparison. The results indicated that fermented Aurantii Fructus could produce three new ingredients, namely eriodictyol-7-glucoside, hesperetin-7-O-glucoside and 5-demethylnobiletin. At the same time, it could significantly increase the content of naringenin and hesperetin components, and could increase the content of such limonin derivatives as sudachinoid A, obacunoic acid and limoninand nomilinic acid. This suggests that the fermentation processing method of Aurantii Fructus decoction pieces used in Guangdong province and Hong Kong is of important significance for enhancing biological activity and bioavailability, and improving the clinical efficacy of Aurantii Fructus decoction pieces, and so is worth further protection and promotion.

Efficacy and safety of bevacizumab plus chemotherapy in Chinese patients with metastatic colorectal cancer: a randomized phase III ARTIST trial / 癌症

The efficacy and safety of bevacizumab with modified irinotecan, leucovorin bolus, and 5-fluorouracil intravenous infusion (mIFL) in the first-line treatment of metastatic colorectal cancer (mCRC) has not been well evaluated in randomized clinical trials in Chinese patients. We conducted a phrase III trial in which patients with previously untreated mCRC were randomized 2:1 to the mIFL [irinotecan (125 mg/m(2)), leucovorin (20 mg/m(2)) bolus, and 5-fluorouracil intravenous infusion (500 mg/m(2)) weekly for four weeks every six weeks] plus bevacizumab (5 mg/kg every two weeks) group and the mIFL group, respectively. Co-primary objectives were progression-free survival (PFS) and 6-month PFS rate. In total, 214 patients were enrolled. Our results showed that addition of bevacizumab to mIFL significantly improved median PFS (4.2 months in the mIFL group vs. 8.3 months in the bevacizumab plus mIFL group, P < 0.001), 6-month PFS rate (25.0% vs. 62.6%, P < 0.001), median overall survival (13.4 months vs. 18.7 months, P = 0.014), and response rate (17% vs. 35%, P = 0.013). Grades 3 and 4 adverse events included diarrhea (21% in the mIFL group and 26% in the bevacizumab plus mIFL group) and neutropenia (19% in the mIFL group and 33% in the bevacizumab plus mIFL group). No wound-healing complications or congestive heart failure occurred. Our results suggested that bevacizumab plus mIFL is effective and well tolerated as first-line treatment for Chinese patients with mCRC. Clinical benefit and safety profiles were consistent with those observed in pivotal phase III trials with mainly Caucasian patients.

Chromosome 22q11.2 microdeletion and phenotype analysis of patients with non-syndromic tetralogy of Fallot / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the frequency and clinical phenotypes of 22q11.2 microdeletion in patients with non-syndromic tetralogy of Fallot (TOF).</p><p><b>METHODS</b>Six-eight non-syndromic TOF patients (38 males and 30 females, aged 0-11 years) were selected and evaluated by history, physical examination and review of medical records. After informed consent was obtained, peripheral blood was drawn for genomic DNA extraction. Chromosome 22q11.2 microdeletion was screened by multiplex ligation-dependent probe amplification (MLPA). Suspected cases were confirmed with fluorescence in situ hybridization (FISH). Data was analyzed with SPSS 11.5 software. Phenotype-genotype correlations were assessed using Fisher's exact test. P values less than 0.05 on a 2-sided test were considered to be significant.</p><p><b>RESULTS</b>Six-eight non-syndromic TOF children were screened for a 22q11.2 deletion, among which 59 (86.8%) presented pulmonary stenosis (PS) and 9 (13.2%) presented pulmonary atresia (PA). Seven patients (10.3%) were found to have carried a deletion. Among these, four had TOF-PS, three had TOF-PA. The frequency of 22q11.2 deletion in patients with TOF-PA (3/9, 33.3%) is much higher than that of TOF-PS (4/59, 6.80%) (P< 0.05).</p><p><b>CONCLUSION</b>22q11.2 microdeletion is present in approximately 10.3% of patients with non-syndromic TOF. The deletion tends to have a higher prevalence in patients with TOF-PA. 22q11.2 deletion should be screened in non-syndromic TOF children and genetic counselling may be provided.</p>

Professor Li Shi-zhen's clinical experiences on compatibility application of hegu (LI 4) / 中国针灸

The present paper introduces professor LI Shi-zhen's clinical experiences on compatibility application of Hegu (LI 4). Hegu (LI 4) is mostly used to treat acute pyreticosis, exterior syndrome of exogenous diseases, mind diseases and deficiency of vital energy. Acupuncture at this acupoint by using reducing method can dispel wind to relieve exterior syndrome, clear away heat to disperse lung. Powerful stimulation by needle can dredge stagnant meridian, open orifice to activate spirit. Acupuncture at this acupoint by using reinforcing method can invigorate qi to strengthen superficies and replenish qi to prevent collapse. Based on this method, reinforcing Zusanli (ST 36) and Baihui (GV 20) can strengthen middle energizer to nourish qi, which show the same benefits as Buzhong Yiqi Decoction; reinforcing Sanyinjiao (SP 6) can nourish both qi and blood, which show the same benefits as Decoction of Eight Ingredients; reducing Neiting (ST 44) can clear away evil heat of qifen in yangming meridians, which show the same benefits as Baihu Decoction.

Application of hereditary "Promoting qi activating blood prescription" in clinical acupuncture and moxibustion / 中国针灸

The present paper introduces the composition and clinical application of "Promoting qi Activating Blood Prescription" handed down from the great-great-grandfather of the author, which can promote flow of qi and blood circulation. The prescription is composed of Jianshi (PC 5) and Sanyinjiao (SP 6) point. Its scope of treatment is very extensive and can be widely applied to many clinical diseases in departments of internal medicine, surgery, gynecology and orthopedics and traumatology, etc. For all the diseases and syndromes of retention of blood stasis and qi-stagnancy and blood stasis, if promoting flow of qi and blood circulation, this prescription will be available.

Application of "Bazhen prescription" in clinical acupuncture and moxibustion / 中国针灸

"Bazhen Prescription" is composed of acupuncture at bilateral Hegu (LI 4) and Sanyinjiao (SP 6) with reinforcing method, functioning supplementing qi and blood, which is a commonly-used prescription for treating the diseases with deficiency of qi and blood. This is a proved recipe summarized by tens years' clinical practice of the author's grandfather and farther, and is a basic recipe for general treatment, treatment based on TCM differentiation and supplementing both qi and blood, with functions similar to Chinese medicine "Bazhen Decoction". Practice proves that for all the diseases and syndromes of deficiency of qi and blood, if only differentiation of syndromes is correct, satisfactory results will be obtained. In the present paper, the source, composition of acupoints, manipulation, function and indications, clinical application of the recipe are introduced.

Try to discuss on double regulative and therapeutic actions of acupoints / 中国针灸

<p><b>OBJECTIVE</b>To explore double regulative and therapeutic actions of acupoints, and clinically exert and use these actions.</p><p><b>METHODS</b>Discuss functions of points, reinforcing and reducing amount of reinforcing and reducing manipulation, combination of acupoints, and application of prescription of acupoints.</p><p><b>CONCLUSION</b>The double regulative and therapeutic actions of acupoints are carried out by means of different acupuncture reinforcing and reducing manipulation under different pathological states of the organism.</p>