The effectiveness of closed-loop oxygen therapy for adult non-mechanical ventilation patients: a Meta-analysis / 中国实用护理杂志

Objective:To evaluate the effect of closed-loop therapy system in adult non-mechanical ventilation patients in order to provide evidence-based basis for promoting the safety of oxygen therapy.Methods:Randomized controlled trials of closed-oxygen therapy system on the percentage within SpO 2 target, the incidence of hypoxaemia or hyperoxia, oxygen consumption, the mean oxygen therapy days, as well as the length of hospital stay in adult non-mechanical ventilation patients were searched in PubMed, Web of Science, Embase, Cochrane, CNKI, Wanfang, VIP from inception to June 30, 2022. Data extraction, and literature quality evaluation were performed by two researchers independently, RevMan 5.3 was used for meta-analysis. Results:A total of 5 articles including 502 patients were included. The results showed that the closed oxygen therapy system could significantly improve the percentage of time within SpO 2 target of patients ( SMD=1.56, 95% CI 1.22-1.90, Z=9.04, P<0.001) and reduce the percentage of time with hypoxaemia ( SMD=-0.35, 95% CI-0.50--0.19, Z=4.37, P<0.001) or hyperoxia ( SMD=-0.91, 95% CI-1.07--0.75, Z=11.04, P<0.001) of patients. Moreover, the mean oxygen flow rate of closed oxygen therapy ( SMD=-0.64, 95% CI-1.25--0.03, Z=2.07, P<0.05), the mean oxygen therapy days ( SMD=-0.55, 95%, CI-1.06--0.03, Z=2.08, P<0.05), as well as the length of hospital stay ( SMD=-1.68, 95% CI-2.22--1.14, Z=6.11, P<0.001) were lower than those of patients with manual adjustment systems. Conclusion:The closed oxygen therapy system can promote the safety of oxygen use, but it needs clinical application to further explore.

Association between abdominal obesity and incident chronic kidney disease: a systematic review / 中华临床营养杂志

The aim of the present study is to explore the association between abdominal obesity and chronic kidney disease (CKD) through a systematic review of published studies. Databases including Wanfang data, CNKI, VIP, CBM, Cochrane Library, PubMed, Web of science and Embase were searched up to July 2021 to collect longitudinal studies published in Chinese and English on the association between abdominal obesity and CKD. In order to avoid omission, reference lists of related articles were also checked manually. After literature selection, data were extracted and study quality was evaluated by the Newcastle-Ottawa scale. Statistical analysis of this study was conducted using Stata 11.0 software. Finally, five studies were included in this study. The results showed that abdominal obesity defined by waist circumference was not associated with CKD (OR=1.17,95% CI:0.93-1.48). According to the results of subgroup analyses, whether adjusted body mass index might be part of the reason of heterogeneity. Based on results of this study, the association between abdominal obesity defined by waist hip ratio and CKD, as well as the association between abdominal obesity and CKD in different genders, remains unknown. In conclusion, abdominal obesity might not be associated with incident CKD. However, more studies are needed in the future to explore this association.

P4HA2 promotes occurrence and progression of liver cancer by regulating the PI3K/Akt/mTOR signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the role of proline 4-hydroxylase Ⅱ (P4HA2) in the occurrence and progression of liver cancer.@*METHODS@#GEPIA and Human Protein Atlas database were used to predict the expression of P4HA2 in hepatocellular carcinoma (HCC), and K-M plotter online database was used to analyze the relationship between P4HA2 expression and the prognosis of HCC. We also examined the expressions of P4HA2 in HCC cells and normal hepatocytes using qRT-PCR and Western blotting. With lentivirus-mediated RNA interference, P4HA2 expression was knocked down in hepatoma SNU-449 and Hep-3B cells, and the changes in cell proliferation, migration and invasion were assessed using cell counting kit-8 (CCK-8) assay, colony formation test, scratch test and Transwell assay. The changes in the expressions of epithelial-mesenchymal transition (EMT) and PI3K/Akt/mTOR signal pathway-related proteins were detected using Western blotting.@*RESULTS@#Online database analysis showed that the expression of P4HA2 was significantly higher in HCC tissues than in normal liver tissues (P < 0.05). The expression levels of P4HA2 mRNA and protein were also significantly higher in HCC cell lines than in normal hepatocytes (P < 0.01). Lentivirus-mediated RNA interference of P4HA2 significantly lowered the expression levels of P4HA2 mRNA and protein in the hepatoma cells (P < 0.05) and caused obvious inhibition of cell proliferation, migration and invasion. P4HA2 knockdown significantly increased the expression of E-cadherin protein, lowered the expressions of N-cadherin and Snail, and obviously decreased the expressions of phosphorylated PI3K, AKT and mTOR (P < 0.05).@*CONCLUSION@#P4HA2 enhances the proliferation, migration, invasion, and EMT of hepatoma cells by activating the PI3K/Akt/mTOR signaling pathway to promote the occurrence and progression of liver cancer.

Effects of probiotics supplementation on the prevention and treatment of gestational diabetes mellitus: a systematic review / 中华临床营养杂志

Objective:To systematically review the effects of probiotics supplementation on the prevention and treatment of gestational diabetes mellitus (GDM).Methods:Computerized literature search (CNKI, Wanfang, CBM, VIP, PubMed, Web of science, Embase, and Cochrane Library) as well as manual search was conducted to collect relevant studies. Data were extracted from qualified literature per pre-defined selection criteria and the risk of bias was evaluated. Systematic review was conducted using Stata 11.0 and Revman 5.3 software.Results:Six studies were included in the systematic review of the prevention effects of probiotics on GDM. The results showed that probiotics supplementation was not associated with the incidence of GDM ( RR=0.84, 95% CI: 0.53~1.34). Moreover, probiotics supplementation may be not associated with the level of glucose, either. Twelve studies were included in the systematic review of the treatment effects of probiotics on GDM. The results showed that in GDM patients, probiotics supplementation could decrease the levels of fasting blood glucose ( WMD=-2.06, 95% CI: -3.95~-0.17), fasting serum insulin ( SMD=-0.61, 95% CI: -0.79~-0.42), insulin resistance index as assessed by homeostatic model assessment ( WMD=-0.64, 95% CI: -0.86~-0.43), triglycerides ( WMD=-21.96, 95% CI: -36.15~-7.78), total cholesterol ( WMD=-10.63, 95% CI: -19.43~-1.83), high-sensitivity C-reactive protein ( SMD=-0.77, 95% CI: -1.00, -0.53), and cesarean section rate ( RR=0.57, 95% CI: 0.38~0.83). Conclusions:Probiotics supplementation could not prevent the onset of GDM but seems beneficial in the treatment of GDM. More studies are needed in the future to explore the effects of probiotics supplementation on GDM.

In vitro and in vivo evaluation of folate-mediated triptolide exosome targeted delivery system against malignant melanoma / 药学学报

In this study, exosomes were extracted from human malignant melanoma cell A375. Folic acid (FA) receptor was used as target and triptolide (TPL) was used as model drug to prepare exosome targeted drug delivery system, FA-Exo/TPL. The physicochemical properties and antitumor effect were evaluated in vivo and in vitro. Gradient centrifugation method was applied to collect exosomes. Then, exosome was modified with FA for loading TPL. The particle sizes of the FA-Exo/TPL were about 100 nm with a double-layer membrane structure like a tray. It is characteristic of high encapsulation efficiency and drug loading. In vitro experiments showed that FA-Exo/TPL could be effectively uptaken by A375 cells, thus significantly inhibiting proliferation and promoting apoptosis the cells. In vivo experiment results showed that FA-Exo/TPL could effectively inhibit the growth of tumor tissue, prolong the model mice life cycle, and significantly reduce the systemic toxicity of the free drug, playing a synergistic and toxic role. Animal welfare and experimental procedures follow the regulations of the Animal Ethics Committee of Fudan University Shanghai Cancer Center. This study provides a new strategies and methods for the preparation of TPL against malignant melanoma.

Current Status of Etiology, Epidemiology, Clinical Manifestations and Imagings for COVID-19

Coronavirus disease 2019 (COVID-19) is a transmissible respiratory disease that was initially reported in Wuhan, China in December 2019. With the alarming levels of COVID-19 spread worldwide, the World Health Organization characterized COVID-19 as a pandemic. Over the past several months, chest CT has played a vital role in early identification, disease severity assessment, and dynamic disease course monitoring of COVID-19. The published data has enriched our knowledge on the etiology, epidemiology, clinical manifestations, and pathologic findings of COVID-19. Additionally, as the imaging spectrum of the disease continues to be defined, extrapulmonary infections or other complications will require further attention. This review aims to provide an updated framework and essential knowledge with which radiologists can better understand COVID-19.

Infection Control and Management Strategy for COVID-19 in the Radiology Department: Focusing on Experiences from China

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

Research advances in exosomes as biomarkers for tumor diagnosis / 医学研究生学报

Malignancy is one of the leading causes of death worldwide. Effective screening and early diagnosis of tumors are clinically difficult. The existing tumor markers have low sensitivity and poor specificity. Exosomes, the nanoscale vesicles with a phospholipid bilayer structure, are widely distributed in various body fluids. Studies have shown that tumor-derived exosomes (TEXs) are closely related to the occurrence and progression of cancers. The contents of TEXs including proteins, RNA and DNA, glycoproteins, glycolipids and lipids can serve as highly sensitive tumor-specific markers, playing a crucial role in the basic research and clinical examination of cancers. Therefore, TEXs are expected to become new non-invasive tumor diagnostic biomarkers. This review describes the biological characteristics of exosomes, their advantages as diagnostic biomarkers and their applications in diagnosis of tumors, treatment monitoring and prognosis evaluation.

Advancements in medical and surgical treatments of Takayasu arteritis-induced renal arteritis: a systematic review / 中华医学杂志(英文版)

BACKGROUND@#Takayasu arteritis-induced renal arteritis (TARA), commonly seen in Takayasu arteritis (TA), has become one of the main causes of poor prognosis and early mortality in patients with TA. TARA progressing into Takayasu arteritis-induced renal artery stenosis (TARAS), could lead to severe complications including malignant hypertension, cardiac-cerebral vascular disease, and ischemic nephropathy. Since there existed no guidelines on treatments, this study aimed to review the comprehensive treatments for TARA.@*METHODS@#We searched systematically in databases including PubMed, Ovid-Medline, EMBASE, Web of Science, China National Knowledge Infrastructure, Wanfang, and SinoMed, from inception to May 2018. Literature selection, data extraction, and statistical analysis were performed.@*RESULTS@#Eighty-two literatures were recruited focusing on medical treatments (n = 34) and surgical treatments (n = 48). We found that combined medical treatments of glucocorticoids and conventional synthetic disease-modifying anti-rheumatic drugs could reach high rates of remission in patients with TARA, and biological disease-modifying anti-rheumatic drugs were preferred for refractory patients. After remission induction, surgical treatment could help reconstruct renal artery and recover renal function partly. Percutaneous transluminal angioplasty was the first choice for patients with TARAS, while open surgery showed a good long-term survival.@*CONCLUSIONS@#Patients with TARA should benefit both from medical treatments and from surgical treatments comprehensively and sequentially. Multidisciplinary team coordination is recommended especially in patients with severe complications.

Roles of Probiotic Supplementation in the Prevention and Treatment of Asthma:A Systematic Review / 中国医学科学院学报

To systematically review the effects of probiotic supplementation on the prevention and treatment of asthma. A computerized literature search was conducted in CNKI,CBM,VIP,Wanfang,PubMed,Embase,Cochrane Library,and Web of Science from their inception to February,2019 to collect all relevant studies. Cochrane Collaboration's risk of bias tool was used to assess the methodological quality of the included studies. Twelve studies were included in the systematic review of the value of probiotics in asthma prevention. The results showed that probiotic supplementation was not significantly associated with a lower risk of asthma (=0.95,95%=0.82-1.11) or wheeze (=0.99,95%=0.88-1.11). Subgroup analyses based on interventions did not show significant differences. Six studies were included in the systematic review of the role of probiotics in asthma treatment. The results showed that probiotic supplementation improved pulmonary function and asthma control in asthmatic patients. However,more studies are needed to validate this effect. Moreover,further studies are needed to clarify the effect of probiotics on the immune markers and the use of asthmatic drugs in asthmatic patients. Based on the currently available literature,probiotic supplementation can not prevent asthma or wheeze. However,it may improve pulmonary function and asthma control in asthmatic patients,although further studies are needed.

Construction of monoclonal cells derived from the human glioblastoma U87 cell line and study of their heterogeneity / 医学研究生学报

Objective The human glioblastoma (GBM) U87 cell line is employed as a model for studying the heterogeneity of GBM. This study was to examine the phenotypic profiles and genetic backgrounds of different monoclonal cells derived from the human GBM U87 cell line and explore the molecular mechanisms underlying the phenotypic difference. Methods Using the finite dilution method labeled with 5(6)-carboxyfluorescein diacetate N-hydroxy succinimidyl ester (CFSE), we constructed the monoclonal cell lines CF5 and G11 with typical morphological characteristics derived from the human GBM U87 cell line and identified them by short tandem repeat (STR). We detected the proliferation of the cells by CCK8 assay, EdU incorporation and colony-formation assay, their self-renewal capability by tumor sphere formation assay, their adhesion ability by immunofluorescence and CCK8 adhesion assay, their invasion ability with a 3D culture model, and their sensitivity to chemotherapeutic agents by Annexin V/PI double-staining flow cytometry. We performed transcriptome sequencing and bioinformatics analysis on the genetic profiles and determined the mRNA expressions of the representative differential genes in the enriched pathway by real-time quantitative PCR (qRT-PCR). Results The CF5 and G11 monoclonal cell lines morphologically typical of U87 were successfully constructed, the former small, short and thick, while the latter big, long and thin. Compared with the U87 and G11 cell lines, the CF5 cells showed a significantly higher proliferation ability (P < 0.01), though higher in the U87 than in the G11 cell line, a higher proportion of EdU-positive cells (0.35 ± 0.03 and 0.44 ± 0.03 vs 0.54 ± 0.05, P < 0.01), though higher in the U87 than in the G11 cell line, and a higher tumor-sphere formation ability (P < 0.01), though higher in the U87 than in the G11 cell line. In comparison with the U87 and CF5 cell lines, the G11 cells exhibited remarkably higher abilities of adhesion (P < 0.01) and invasion (P < 0.05), though both higher in the U87 than in the CF5 group. Totally, 159 genes were down-regulated and 303 up-regulated in the CF5 cells compared with those in the U87 and G11 cells, while 281 were down-regulated and 116 up-regulated in the G11 cells compared with those in the CF5 and U87 cells. The CF5 and G11 cells manifested the highest enrichment in the extracellular matrix-associated pathways, which were shown to be closely associated with the invasiveness and drug-resistance of the tumor. Conclusion We successfully constructed human GBM U87-derived monoclonal cell lines CF5 and G11 with different morphological features, phenotypic profiles and genetic backgrounds, which has paved the ground for further studies of the heterogeneity of GBM.

Accumulation of nitidine chloride in rat heart and the underlying mechanism / 药学学报

Nitidine chloride (NC) is a compound with prominent anti-tumor activity. To determine potential cardiotoxicity of NC, this study was designed to investigate the distribution of NC in rat heart and the underlying mechanism. The animal studies were approved by Institutional Animal Care and Use Committee of Zhejiang University Medical Center (2015-380-01) and complied with the standards of animal welfare in China. At 0.25, 0.5 and 2 h after a single intravenous injection (iv) of 5 mg·kg-1 NC, the concentrations of NC in rat heart were 47.7, 71.1 and 63.2 μg·g-1 respectively, which were 576, 1 352 and 1 212 folds of that in plasma. This study also revealed that the NC concentration in heart was 458.5 μg·g-1 (7 336 folds of that in plasma) at 2 h after the last dose in rats, after daily iv administration of NC at 5 mg·kg-1·day-1 for successive 20 days. Further studies showed that the accumulations of NC in MDCK-hOCT1 and MDCK-hOCT3 cells were 16.1 and 4.99 folds higher than that of the mock cells, respectively. There is no significant difference between the accumulations of NC in MDCK cells transfected with hOCTN1, hOCTN2 or hPMAT and the mock cells. Additionally, quinidine, L-tetrahydropalmatine and Decynium 22, the inhibitors of OCTs, clearly reduced the accumulations of NC in primary cardiomyocytes and cardiac fibroblasts from neonatal rats. MTT assay showed that the LC50 of NC on cardiomyocytes and cardiac fibroblasts were 10.9 and 10.4 μmol·L-1, respectively. Moreover, treatment of the primary cardiomyocytes and cardiac fibroblasts with NC (1～15 μmol·L-1) for 48 h resulted in significantly increased LDH enzyme leakage. These results indicated that NC can be highly accumulated in the heart, and accumulation is mediated by OCT1 and OCT3, but not by OCTN1, OCTN2 and PMAT. The accumulated NC has potential cytotoxicity as shown in the results from primary cardiomyocytes and cardiac fibroblasts.

An Investigation and Suggestions for the Improvement of Brain Death Determination in China / 中华医学杂志(英文版)

Background@#Brain death is the irreversible cessation of the function of the brain including the brainstem. In 2013, the Brain Injury Evaluation Quality Control Centre (BQCC) of the National Health and Family Planning Commission issued criteria and practical guidelines for the determination of brain death. This study aimed to evaluate whether the institutions have adopted these guidelines and to make suggestions for the improvement of the current criteria and practical guidelines for brain death determination in China.@*Methods@#Consecutive brain death cases from 44 hospitals were evaluated for summary statistics for the following data: the performance of BQCC criteria and practical guidelines, clinical examination, apnea testing, ancillary testing, and the number of examinations as well as the waiting periods between examinations and details of who determined brain death. Data analysis was conducted from January 2013 to December 2017.@*Results@#A total of 550 cases were obtained. All patients were determined to have deep coma and met the prerequisites for clinical testing. The performance rates of four brainstem reflex examinations (except cough reflex) ranged from 97.5% to 98.0%, and the completion rate as well as the coincidence rate were both 100.0%. The 238 cases (50.7%) completed apnea testing, and 231 cases (42.0%) had to stop apnea testing during the examination because of instability. The performance rates of the three ancillary tests, including electroencephalogram, short-latency somatosensory evoked potential, and transcranial Doppler, were 89.5%, 67.5%, and 79.5%, respectively; furthermore, the coincidence rates were 98.6%, 96.5%, and 99.5%, respectively. The combination of two ancillary tests was more accurate than one single ancillary test. A total of 401 (72.9%) cases successfully underwent two separate examinations to determine brain death with at least a 12-h waiting period. All brain death cases were determined by at least two qualified physicians.@*Conclusion@#This study might provide suggestions for brain death determination in China.

Risk Factors of Asthma Attack in An Open Cohort / 中国医学科学院学报

Objective To investigate the risk factors of asthma attack.Methods In this open cohort study,74 492 initially healthy subjects aged 20 years or more in a longitudinal multi-center health management cohort in Shandong province from January 2007 to December 2015 were enrolled in this study. These subjects had no baseline bronchial asthma or other chronic airway disease and did not migrate to other provinces in the past 10 years. All subjects were followed up till 2016,and the asthma attack and its influencing factors were analyzed. The baseline data including sociodemographic data,smoking history,disease histories,and family disease histories were collected and analyzed by Poisson regression analysis.Results The regression analysis showed that age between 40 and 50 years(RR=3.3,95%CI=1.8-6.0),female(RR=1.6,95%CI=1.1-2.3),nasal polyps(RR=9.5,95%CI=2.3-39.6),pneumonia(RR=6.5,95%CI=3.7-11.2),bronchitis(RR=8.7,95%CI=5.1-14.7),and chronic obstructive pulmonary disease(RR=6.6,95%CI=3.1-13.8) significantly increased the risk of asthma attack.Conclusion Age,gender,and previous histories of certain respiratory tract diseases increase the risk of asthma attack.

Analysis on breast repair and reconstruction after conserving surgery for upper inner quadrant breast cancer / 局解手术学杂志

Objective To study the clinical effect of adjacent flap on immediate breast repair in conserving surgery for upper inner quadrant breast cancer.Methods A total of 100 women with breast cancer treated in our hospital from August 2012 to August 2016 were selected as the study subjects.According to the different surgical methods,46 cases were divided into control group and 54 cases in observation group.The patients in the control group were treated with modified radical mastectomy for breast cancer.The patients in the observation group were treated with adjacent flap for immediate repair of breast defect in breast conserving surgery.The quality of life,the follow-up results and between the two groups were compared.The cosmetic effect of the observation group was evaluated.Results At 6 months after operation,the physiological function,affective function,physical pain,social function,physiological limitations,vitality,mental health and overall health score of the observation group were higher than those of the control group,the difference was statistically significant(P ＜ 0.05).There was no significant difference in local recurrence rate,distant metastasis rate,non-survival rate,loss of follow-up or mortality between the two groups (P ＞0.05).The excellent and good rate of breast cosmetic effect was 96.3％ after surgery in observation group.The satisfaction rate of observation group was 92.59％ (50/54),the control group was 45.46％ (21/46),the difference was statistically significant (x =26.582,P =0.000).Conclusion The clinical effect of repairing breast defect by using adjacent flap transfer is very effective in improving the quality of life and reducing the risk of local recurrence and distant metastasis.

Measurement and correlation analysis of vermilion and facial skin color / 中国组织工程研究

BACKGROUND: Prosthesis simulation is critical for maxillofacial defects caused by maxillofacial tumor and trauma. Few studies have been reported on the vermilion color, much less the correlation between facial skin color and vermilion color. OBJECTIVE: To collect thecolorimetric values of human vermilion and facial skin, so as to determine the colorimetric value range and its relevance.. METHODS: The colorimetric values of vermilion and facial skin in 202 volunteers were measured by Japanese Konica Minolta CM-700d spectrophotometer, L* (brightness), a* (from –a* (green) to +a* (red)), b* (from –b*(yellow) to +a* (blue)) values were surveyed and calculated, and then analyzed with CIELAB color system. The correlation betweencolorimetric values of the vermilion and cheek skin color was analyzed.RESULTS AND CONCLUSION: For the vermilion color in 202 volunteers, L* value was 53.25±3.42, a* value was 11.19±1.70, and b* valuewas 8.77±2.12; for the cheek skin color, L* value was 61.87±3.59, a* value was 7.21±1.29, and b* value was 12.98±1.64. L* value of thevermilion was negatively correlated with its a* value, positively correlated with its b* value, positively correlated with L* value of cheek skin andnegatively correlated with a* value of the cheek skin. a* value of the vermilion was positively correlated with a* value of the cheek skin. b*value of the vermilion was positively correlated with b* value of the cheek skin. L* value of the cheek skin was positively correlated with b*value of the vermilion, and negatively correlated with its a* value. a* value of the cheek skin was negatively correlated with b* value of thevermilion, and negatively correlated with its b* value. In summary, we preliminarily determine the colorimetric value range of the facial skin andvermilion, as well as their relevance, which provide a basis for prosthesis production and choice of colors in clinic.

Clinical application of purse?string suture on the treatment of patients with peptic ulcer bleeding / 中华消化内镜杂志

Objective To study the clinical efficacy and safety of purse-string suture on the treatment of peptic ulcer bleeding. Methods Data of 42 patients with peptic ulcer bleeding treated by purse-string suture with hexiejia combined with endoloop in Dongguan Tung Wah Hospital from January 2016 to January 2017 were retrospectively analyzed. The immediate hemostasis rate, effective hemostasis rate, additional surgery rate, recurrence rate in two weeks and mortality were analyzed. Results Among 20 cases with active bleeding during operation, 19 were immediately arrested, and 1 case of failure was diagnosed as marginal ulcer after gastric resection. The overall effective hemostasis rate was 97. 6%(41/42), additional surgery rate was only 2. 4%( 1/42). The vital signs of 41 patients with successful endoscopic hemostasis were stable after operation, and no fever, hematemesis, black stool or other symptoms occurred. No recurrence of bleeding or death occurred within two weeks. The ulcers were healed well in follow-up of one month. Conclusion Endoscopic purse-string suture is a safe and feasible method for treatment of patients with peptic ulcer bleeding.

Chinese Systemic Lupus Erythematosus Treatment and Research Group Registry IX: Clinical Features and Survival of Childhood-Onset Systemic Lupus Erythematosus in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Approximately 15-20% cases of systemic lupus erythematosus (SLE) are diagnosed in children. There have been a few studies reporting the epidemiological data of pediatric-onset SLE (cSLE) in China, neither comparing the differences between cSLE and adult-onset SLE (aSLE). The aim of this study was to describe the impact of age of onset on clinical features and survival in cSLE patients in China based on the Chinese SLE Treatment and Research group (CSTAR) database.</p><p><b>METHODS</b>We made a prospective study of 225 cSLE patients (aged Results: The mean age of cSLE patients was 12.16 ± 2.92 years, with 187 (83.1%) females. Fever (P < 0.001) as well as mucocutaneous (P < 0.001) and renal (P = 0.006) disorders were found to be significantly more frequent in cSLE patients as initial symptoms, while muscle and joint lesions were significantly less common compared to aSLE subjects (P < 0.001). The cSLE patients were found to present more frequently with malar rash (P = 0.001; odds ratio [OR], 0.624; 95% confidence interval [CI], 0.470-0.829) but less frequently with arthritis (P < 0.001; OR, 2.013; 95% CI, 1.512-2.679) and serositis (P = 0.030; OR, 1.629; 95% CI, 1.053-2.520). There was no significant difference in SLE disease activity index scores between cSLE and aSLE groups (P = 0.478). Cox regression indicated that childhood onset was the risk factor for organ damage in lupus patients (hazard ratio 0.335 [0.170-0.658], P = 0.001). The survival curves between the cSLE and aSLE groups had no significant difference as determined by the log-rank test (0.557, P = 0.455).</p><p><b>CONCLUSIONS</b>cSLE in China has different clinical features and more inflammation than aSLE patients. Damage may be less in children and there is no difference in 5- year survival between cSLE and aSLE groups.</p>

Mechanism for ginkgolic acid (15 : 1)-induced MDCK cell necrosis: Mitochondria and lysosomes damages and cell cycle arrest / 中国天然药物

Ginkgolic acids (GAs), primarily found in the leaves, nuts, and testa of ginkgo biloba, have been identified with suspected allergenic, genotoxic and cytotoxic properties. However, little information is available about GAs toxicity in kidneys and the underlying mechanism has not been thoroughly elucidated so far. Instead of GAs extract, the renal cytotoxicity of GA (15 : 1), which was isolated from the testa of Ginkgo biloba, was assessed in vitro by using MDCK cells. The action of GA (15 : 1) on cell viability was evaluated by the MTT and neutral red uptake assays. Compared with the control, the cytotoxicity of GA (15 : 1) on MDCK cells displayed a time- and dose-dependent manner, suggesting the cells mitochondria and lysosomes were damaged. It was confirmed that GA (15 : 1) resulted in the loss of cells mitochondrial trans-membrane potential (ΔΨm). In propidium iodide (PI) staining analysis, GA (15 : 1) induced cell cycle arrest at the G0/G1 and G2/M phases, influencing on the DNA synthesis and cell mitosis. Characteristics of necrotic cell death were observed in MDCK cells at the experimental conditions, as a result of DNA agarose gel electrophoresis and morphological observation of MDCK cells. In conclusion, these findings might provide useful information for a better understanding of the GA (15 : 1) induced renal toxicity.

Determination of baicalin and naringin inQinbei mixture by HPLC / 国际中医中药杂志

Objective To establish a high performance liquid chromatography (HPLC) method for the determination of baicalin and naringin inQinbei mixture.Methods The HPLC system consisted of the Fortis-C18(4.6 mm × 250 mm, 5μm) column, and the mobile phase consisted of MeOH:0.4% H3PO4 (42:58), and the flow rate was 1.0 ml/min, and the UV detector was set at 280 nm, and the column temperature was 30℃.Results The linear response range of baicalin was 0.062-0.930μg. The linear response range of naringin was 0.033-0.492μg. The average recovery of baicalin was 98.11% (RSD=1.62%). The average recovery of naringin was 96.78% (RSD=1.74%).Conclusions The method is simple, rapid, accurate and repeatable. It can be applied in determination of baicalin and naringin inQinbei mixture.