Analysis of High-Risk Clinical Factors of Early Death in Secondary Hemophagocytic Lymphohistiocytosis / 中国实验血液学杂志

OBJECTIVE@#To explore the high-risk clinical factors of early death in patients with secondary hemophagocytic lymphohistiocytosis (sHLH), and further identify the clinical factors related to the rapid progression of sHLH in the short term.@*METHODS@#The clinical manifestations, laboratory examination and prognosis of sHLH patients were retrospectively analyzed. Continuous variables were grouped by median, univariate and multivariate Cox regression analysis and Kaplan-Meier survival curve were used to explore the risk factors affecting early death of sHLH. Then, a nomogram model was established with independent risk factors, Bootstrap resampling method was used for verification, and consistency index (C-index) and calibration curve were used to detect the prediction accuracy.@*RESULTS@#A total of 126 sHLH patients were enrolled, with a median age of 48.5(16-88) years, including 74 males and 52 females. Fifty-five patients (43.6%) died within 30 days, including 39 males and 16 females. Univariate regression analysis showed that lymphocyte count <0.45×109/L, platelet count (PLT) <39.5×109/L, prothrombin time (PT)≥13.3 s, activated partial thromboplastin time (APTT)≥39.7 s, albumin (ALB) <25.9 g/L, lactate dehydrogenase (LDH)≥811 U/L, creatinine (Cr) ≥67 μmol/L and procalcitonin (PCT)≥0.61 ng/ml were risk factors for death within 30 days in sHLH patients. Multivariate regression analysis showed that lymphocyte count <0.45×109/L, APTT≥39.7 s and ALB <25.9 g/L were independent risk factors for death within 30 days in sHLH patients. A nomogram model was established based on the above three risk factors, its C-index was 0.683, and the calibration chart showed good agreement between the observed and predicted values of sHLH.@*CONCLUSIONS@#Lymphopenia, prolonged APTT, and hypoalbuminemia are risk factors for early death of sHLH patients. Early identification and positive intervention are expected to reduce early mortality in sHLH patients. The nomogram model based on the above risk factors provides a method for clinicians to evaluate sHLH.

Effects of Nardostachys jatamansi on gut microbiota of rats with Parkinson's disease / 中国中药杂志

Under the guidance of the traditional Chinese medicine(TCM) theory of "Zangfu-organs of spleen and stomach" and the modern theory of "microbiota-gut-brain axis", this study explored the effects of Nardostachys jatamansi on the gut microbiota of rats with Parkinson's disease(PD). The 40 SD rats were randomly divided into the control group, PD model group, levodopa group, and Nardostachys jatamansi ethanol extract group. The PD model was established by subcutaneous injection of rotenone in the neck and back area. After 14 days of intragastric administration, the PD rats' behaviors were analyzed through open field test, inclined plane test, and pole test. After the behavioral tests, the striatum, colon, and colon contents of rats in each group were collected. Western blot was employed to detect the protein expression of tyrosine hydroxylase(TH) and α-synuclein(α-syn) in striatum and that of α-syn in colon. Enzyme linked immunosorbent assay(ELISA) was used to detect the levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), and nuclear factor-kappa B(NF-κB) in striatum and colon. High-throughput sequencing of 16 S rRNA gene was conducted to detect the differences in microbial diversity, abundance, differential phyla, and dominant bacteria of rats between groups. The results indicated that Nar. ethanol extract could relieve dyskinesia, reverse the increased levels of α-syn, TNF-α, IL-1β, and NF-κB in striatum, and improve the protein expression of TH in striatum of PD rats. The α diversity analysis indicated a significant decrease in diversity and abundance of gut microbiota in the PD model. The results of linear discriminant analysis effect size(LEfSe) of dominant bacteria indicated that Nardostachys jatamansi ethanol extract increased the relative abundance of Clotridiaceae, Lachnospiraceae, and Anaerostipes, and reversed the increased relative abundance of Proteobacteria, Gammaproteobacteria, Enterobacteriaceae, and Escherichia-Shigella in PD model group to exhibit the neuroprotective effect. In summary, the results indicated that Nar. ethanol extract exert the therapeutic effect on PD rats. Specifically, the extract may regulate gut microbiota, decrease the levels of proinflammatory cytokines, and reduce the protein aggregation of α-syn in the colon and striatum to alleviate intestinal inflammation and neuroinflammation. This study provides a basis for combining the theory of "Zangfu-organs of spleen and stomach" with the theory of "microbiota-gut-brain axis" to treat PD.

β -Glucan Improves Protective Qi Status in Adults with Protective Qi Deficiency-A Randomized, Placebo-Controlled, and Double-Blinded Trial / 中国结合医学杂志

OBJECTIVE@#To test the hypothesis that β -glucan enhances protective qi (PQi), an important Chinese medicine (CM) concept which stipulates that a protective force circulates throughout the body surface and works as the first line of defense against "external pernicious influences".@*METHODS@#A total of 138 participants with PQi deficiency (PQD) were randomized to receive β -glucan (200 mg daily) or placebo for 12 weeks. Participants' PQi status was assessed every 2 weeks via conventional diagnosis and a standardized protocol from which a PQD severity and risk score was derived. Indices of participants' immune and general health status were also monitored, including upper respiratory tract infection (URTI), saliva secretory IgA (sIgA), and self-reported measures of physical and mental health (PROMIS).@*RESULTS@#PQi status was not significantly different between the β -glucan and placebo treatment groups at baseline but improved significantly in the β -glucan (vs. placebo) group in a time-dependent manner. The intergroup differences [95% confidence interval (CI)] in severity score (scale: 1-5), risk score (scale: 0-1), and proportion of PQD participants (%) at finish line was 0.49 (0.35-0.62), 0.48 (0.35-0.61), and 0.36 (0.25-0.47), respectively. Additionally, β -glucan improved URTI symptom (scale: 1-9) and PROMIS physical (scale: 16.2-67.7) and mental (scale: 21.2-67.6) scores by a magnitude (95% CI) of 1.0 (0.21-1.86), 5.7 (2.33-9.07), and 3.0 (20.37-6.37), respectively, over placebo.@*CONCLUSIONS@#β -glucan ameliorates PQi in PQD individuals. By using stringent evidence-based methodologies, our study demonstrated that Western medicine-derived remedies, such as β -glucan, can be employed to advance CM therapeutics. (ClinicalTrial.Gov registry: NCT03782974).

Historical Evolution and Modern Research Progress of Quality Evaluation Based on Character Identification of Traditional Chinese Medicinal Materials / 中国实验方剂学杂志

Quality evaluation based on character identification of traditional Chinese medicinal materials is the wisdom crystallization of the long-term medication experience of the pharmacists in the past dynasties， and is a quality evaluation system with the characteristics of traditional Chinese medicine （TCM）. Because of its simple language， easy to understand and easy to operate， it plays an important guiding role in the quality evaluation of TCM. Modern electronic sensory apparatus technology can realize the objective expression of TCM characters. Some scholars correlated their expression results with the contents of the main chemical components in TCM， proving that quality evaluation based on character identification of traditional Chinese medicinal materials has a certain scientific basis. However， the scientific connotation of quality evaluation based on character identification of traditional Chinese medicinal materials has not yet been clearly clarified. There is a lack of systematic research on which characters of TCM can truly reflect its quality. Therefore， the author summarizes quality evaluation based on character identification of traditional Chinese medicinal materials from three aspects. It makes clear that the idea of quality evaluation based on character identification of traditional Chinese medicinal materials is derived from analogical thinking， and combs the four stages of germination， development， prosperity and maturity experienced in its formation process， summarizes the modern research progress of this theory， clarifies that the role of the theory in evaluating the quality of medicinal materials， guiding the classification of commodity specifications， and harvesting and processing of medicinal materials. It is recommended that the follow-up should be strengthened on the research of quality evaluation based on character identification of traditional Chinese medicinal materials， make full use of electronic sensory instruments， liquid-mass spectrometry， biological efficacy evaluation and other technologies， strengthen the objective description of the characteristics of TCM， and attach importance to the analysis of the correlation between the overall characteristics of TCM and its efficacy， and establish a new research model related to the characteristics-active ingredients-pharmaceutical effects of TCM， in order to elucidate the scientific connotation of quality evaluation based on character identification of traditional Chinese medicinal materials， so as to better serve the quality evaluation of TCM.

Application evaluation of whole-genome sequencing technology in predicting drug resistance of second-line injectable of anti-tuberculosis drugs / 中华检验医学杂志

Objective:To evaluate the clinical-application values of whole genome sequencing (WGS) technology to detect the drug resistance feature of second-line injectable drugs (SLIDs) for multidrug-resistant tuberculosis treatment.Methods:The proportional-method drug sensitivity test and the whole gene sequencing technology were used to simultaneously examine the resistance of three SLIDs: kanamycin (Km) and Amikacin(Am) and capreomycin (Cm) in 172 multidrug-resistant tuberculosis (MDR) strains preserved in the strain bank of the Tuberculosis Laboratory of Shenzhen Chronic Disease Prevention and Control Center from 2013 to 2017. The proportional-susceptibility tests were considered as the gold standard to evaluate the sensitivity, specificity and consistency of WGS results. The samples with differences between the two methods were compared with the minimum inhibitory concentration detection method. The McNemar test was used to statistically analyze the detection rates of the two methods, and a P value<0.05 indicated the significant difference between two groups. Results:A total of 172 MDR strains were included in this study. Two mutated genes were identified by the WGS examination: rrs and eis. Among these genes, rrs-A1401G mutation occurred in 58.3% in Am resistant strains, 14/18 in Km resistant strains or 14/14 in Cm resistant strains, respectively. The sensitivity, specificity and consistency of WGS predicted Am were 14/15, 93.6%, and 68.0%, 15/15, 98.1%, and 90.0% in Km, or 14/15, 100%, and 96.0% in Cm. There were 13 strains with inconsistent results by the two methods. One strain was retested by MIC as a drug-resistant strain and other 12 strains were sensitive. There were 11 strains with inconsistent Am test results, and WGS test results showed that 8 strains had rrs-514-A/C mutations, while DST and MIC tests were sensitive. Conclusion:WGS is enough is sensitive and specific for diagnosing SLIDs resistance.

Spectrum-effect relationship of the blood-activating efficacy of Notoginseng Radix et Rhizoma / 中国中药杂志

This study aims to establish the high-performance liquid chromatography(HPLC) fingerprints of different batches of Notoginseng Radix et Rhizoma, determine their pharmacodynamic indexes of promoting blood circulation, and explore the spectrum-effect relationship between the chemical components of Notoginseng Radix et Rhizoma and the efficacy of promoting blood circulation. Firstly, the HPLC fingerprints of different batches of Notoginseng Radix et Rhizoma were established. Then, the pharmacodynamic indexes were determined after the capillary coagulation experiment and the cerebral ischemia-reperfusion in rats, including capillary coagulation time, percentage of cerebral ischemic area, cerebral water loss rate, and brain-body index. Afterward, the partial least-squares method was used to explore the spectrum-effect relationship between the chemical components of Notoginseng Radix et Rhizoma and the pharmacodynamic indexes. The results showed that this study successfully established the HPLC fingerprints of different batches of Notoginseng Radix et Rhizoma, found 23 common peaks, and identified 12 of them, all of which were saponins. The method was proved stable and reliable. Both the capillary coagulation experiment and the middle cerebral artery occlusion(MCAO)-induced cerebral ischemia-reperfusion experiment on rats revealed that there were obvious differences in the pharmacodynamic indexes of different batches of Notoginseng Radix et Rhizoma. The relationships between 23 common components of Notoginseng Radix et Rhizoma in different batches and the pharmacodynamic indexes were discussed by means of spectrum-effect correlation analysis, of which 17 components had positive effects while 6 components had negative effects on the pharmacodynamic indexes. This study provides a certain reference basis for the clinical rational use and quality control of Notoginseng Radix et Rhizoma.

Spectrum-effect relationship of hemostatic effects of Notoginseng Radix et Rhizoma with different commodity specifications / 中国中药杂志

This article aims to establish the fingerprints, determine the hemostatic pharmacodynamic indicators, and explore the spectrum-effect relationship of Notoginseng Radix et Rhizoma in 12 different specifications. Firstly, HPLC and liquid chromatography-mass spectrometry(LC-MS) were employed to establish the fingerprints of Notoginseng Radix et Rhizoma. The rat plasma recalcification experiment and the rat gastric bleeding experiment were conducted to determine the pharmacodynamic indicators, including plasma recalcification time(PRT), thrombin time(TT), prothrombin time(PT), and activated partial thromboplastin time(APTT). Afterwards, the partial least squares method was employed to explore the spectrum-effect relationship of Notoginseng Radix et Rhizoma in different specifications. Twenty-six common peaks were detected in the HPLC fingerprints of different specifications of Notoginseng Radix et Rhizoma, and 11 out of the 26 common peaks represented saponins. The content of dencichine was determined by LC-MS. The rat experiments showed that the pharmacodynamic indicators were significantly different among different specifications of Notoginseng Radix et Rhizoma. The spectrum-effect relationship was explored between 27 common components and pharmacodynamic indicators. Among them, 16 components had positive effects on the pharmacodynamic indicators of Notoginseng Radix et Rhizoma, and 11 exerted negative effects. This study provides a basis for the precision medication and quality control of Notoginseng Radix et Rhizoma.

Cryptotanshinone May Induce Ferroptosis of Human Liver Cancer HepG2 Cells / 中国医学科学院学报

Objective To observe the effect of cryptotanshinone on the ferroptosis of human liver cancer HepG2 cells. Methods The viability of the HepG2 cells cultured

Study on mechanism of Valerianae Jatamansi Rhizoma et Radix against post-traumatic stress disorder based on molecular docking and network pharmacology / 中国中药杂志

This paper aims to investigate the active components and mechanism of Valerianae Jatamansi Rhizoma et Radix against post-traumatic stress disorder(PTSD) based on network pharmacology and molecular docking. The main components and targets of Valerianae Jatamansi Rhizoma et Radix were obtained by literature mining methods, SwissTargetPrediction, BATMAN and ETCM database. PTSD-related genes were collected from DrugBank, TTD and CTD databases. The protein-protein interaction(PPI) network was constructed based on STRING, and the core targets of Valerianae Jatamansi Rhizoma et Radix in the treatment of PTSD were selected according to the topological parameters. Cytoscape 3.7.2 was used to construct the compound-target network. DAVID database was used for GO enrichment analysis and KEGG enrichment analysis. The relationship network of "compound-target-pathway" was constructed through Cytoscape 3.7.2 to analyze and obtain the key targets and their corresponding components in the network, and their results were verified by molecular docking. The results showed that a total of 47 components(such as valeraldehyde, dihydrovalerin, valerate, chlorovaltrate K, 8-hydroxypinoresinol, 6-hydroxyluteolin, apigenin, farnesin, vanillin, luteolin, kaempferol, glycosmisic acid and pogostemon) of Valerianae Jatamansi Rhizoma et Radix may act on 94 key targets such as CNR1, MAOA, NR3 C1, MAPK14, MAPK8, HTR2 C and DRD2. Totally 29 GO terms were obtained by GO functional enrichment analysis(P<0.05), and 20 signaling pathways were obtained from KEGG pathway enrichment, mainly involving neuroactive ligand-receptor interaction, serotonergic synapse, calcium signaling pathway, cAMP signaling pathway, dopaminergic synapse, retrograde endocannabinoid signaling, neurotrophin signaling pathway, gap junction, cholinergic synapse, estrogen signaling pathway, glutamatergic synapse and long-term potentiation. Molecular docking analysis showed that hydrogen bonding, π-π interaction and hydrophobic effecting may be the main forms of interaction. This study used the network of compound-target-pathway and molecular docking technology to screen the effective components of Valerianae Jatamansi Rhizoma et Radix against PTSD, and explore its anti-PTSD mechanism, so as to provide scientific basis for exploring the anti-PTSD drugs from traditional Chinese medicine and clarifying its mechanism of action.

Discussion on Prescription Discovery and Molecular Mechanism of Portulacae Herba in Treating Diabetes Mellitus Based on Data Mining and Integrative Pharmacology / 中国实验方剂学杂志

Objective:A new prescription containing Portulacae Herba was created and the molecular mechanism of the new prescription for treating diabetes was clarified based on big data of traditional Chinese medicine （TCM）. Method:Taking Portulacae Herba as the key word， the TCM Inheritance Support System and Encyclopedia of TCM （ETCM） were used to excavate the most frequently used medicines combined with Portulacae Herba， and form a new prescription. Based on the basic theory of TCM， this paper analyzed the rationality of the new prescription in treating diabetes， and used the Integrative Pharmacology-based Research Platform of TCM （TCMIP） to predict the target of the new prescription， and constructed the interaction network between drugs and targets of diabetes-related diseases， the key targets of drug intervention were enriched and analyzed， and the network graph of TCM-chemical composition-key target-pathway was drawn. Result:There were 89 prescriptions containing Portulacae Herba in ETCM. The most frequently used medicines in combination with Portulacae Herba were Phellodendri Chinensis Cortex， Rehmanniae Radix and Saposhnikoviae Radix， the four medicines were combined into a new prescription. According to the new prescription to treat diabetes， 89 key core target information was obtained， among which there were 10 targets of drug and disease， including phosphoinositide-3 kinase regulatory subunit 1 （PIK3R1）， insulin （INS）， glucokinase （GCK）， etc. The new prescription treated diabetes by regulating growth hormone receptor signaling， protein kinase A （PKA） activation， adrenoceptors and other pathways. Conclusion:The therapeutic effect of new prescription containing Portulacae Herba created by big data analysis of TCM on diabetes reflects multi-component， multi-target， multi-pathway characteristics of TCM， which can provide scientific basis for explaining the mechanism and material basis of this new prescription in the treatment of diabetes.

Effect of Traditional Chinese Medicines in Treatment of Post-traumatic Stress Disorder / 中国实验方剂学杂志

Post-traumatic stress disorder (PTSD) is a mental disorder characterized by restitution of trauma and emotional irritability and avoidance caused by sudden, threatening or catastrophic life events. PTSD occurs not only abnormal behavioral indicators but also abnormal neurobiological indicators. Studies on the pathogenesis of PTSD have focused on neuroendocrine system, central nervous system and immune system, mainly finding abnormal levels of stress hormones, pro-inflammatory cytokines, neurotransmitters and neuroprotective factors. Traditional Chinese medicines(TCM) have many advantages in the treatment of PTSD due to their multi-target, multi-component and multi-pathway characteristics. Current studies have showed that a variety of TCM can improve the abnormal behaviors of animals in the models of post-traumatic stress disorder and reverse the neurobiological indicators. As many of these TCM compounds have been used in clinic and have good efficacy, TCM treatment of PTSD has a broad application prospect. However, there is no specific medicine for PTSD, and its mechanisms have not been fully understood. Therefore, this paper reviews the current studies on the treatment of PTSD with TCM, and focuses on the occurrence and treatment progress of PTSD in terms of TCM, mechanisms of action and animal models, so as to provide references for the treatment of PTSD.

Early Warning of Acute Altitude Sickness by Physiological Variables and Noninvasive Cardiovascular Indicators / 中国医学科学杂志(英文版)

Objective To examine if the variations at sea level would be able to predict subsequent susceptibility to acute altitude sickness in subjects upon a rapid ascent to high altitude. Methods One hundred and six Han nationality male individuals were recruited to this research. Dynamic electrocardiogram, treadmill exercise test, echocardiography, routine blood examination and biochemical analysis were performed when subjects at sea level and entering the plateau respectively. Then multiple regression analysis was performed to construct a multiple linear regression equation using the Lake Louise Score as dependent variable to predict the risk factors at sea level related to acute mountain sickness (AMS). Results Approximately 49.05% of the individuals developed AMS. The tricuspid annular plane systolic excursion (22.0±2.66 vs. 23.2±3.19 mm, t=1.998, P=0.048) was significantly lower in the AMS group at sea level, while count of eosinophil [(0.264±0.393)×109/L vs. (0.126±0.084)×109/L, t=-2.040, P=0.045], percentage of differences exceeding 50 ms between adjacent normal number of intervals (PNN50, 9.66%±5.40% vs. 6.98%±5.66%, t=-2.229, P=0.028) and heart rate variability triangle index (57.1±16.1 vs. 50.6±12.7, t=-2.271, P=0.025) were significantly higher. After acute exposure to high altitude, C-reactive protein (0.098±0.103 vs. 0.062±0.045 g/L, t=-2.132, P=0.037), aspartate aminotransferase (19.7±6.72 vs. 17.3±3.95 U/L, t=-2.231, P=0.028) and creatinine (85.1±12.9 vs. 77.7±11.2 mmol/L, t=-3.162, P=0.002) were significantly higher in the AMS group, while alkaline phosphatase (71.7±18.2 vs. 80.6±20.2 U/L, t=2.389, P=0.019), standard deviation of normal-to-normal RR intervals (126.5±35.9 vs. 143.3±36.4 ms, t=2.320, P=0.022), ejection time (276.9±50.8 vs. 313.8±48.9 ms, t=3.641, P=0.001) and heart rate variability triangle index (37.1±12.9 vs. 41.9±11.1, t=2.020, P=0.047) were significantly lower. Using the Lake Louise Score as the dependent variable, prediction equation were established to estimate AMS: Lake Louise Score=3.783+0.281×eosinophil-0.219×alkaline phosphatase+0.032×PNN50. Conclusions We elucidated the differences of physiological variables as well as noninvasive cardiovascular indicators for subjects after high altitude exposure compared with those at sea level. We also created an acute high altitude reaction early warning equation based on the physiological variables and noninvasive cardiovascular indicators at sea level.

Correlation between the Position of the Pituitary Stalk as Determined by Diffusion Tensor Imaging and Its Location as Determined at the Time of Surgical Resection of Pituitary Adenomas

Objective@#: An important factor during pituitary adenoma surgery is to preserve pituitary stalk (PS) as this plays a role in reduction of the risk of postoperative diabetes insipidus. The hypothalamic-hypophyseal tract (HHT) projects through the PS to the posterior pituitary gland. To reconstruct white matter fiber pathways, methods like diffusion tensor imaging (DTI) tractography have been widely used. In this report we attempted to predict the position of PS using DTI tractography and to assess its intraoperative correlation during surgery of pituitary adenomas. @*Methods@#: DTI tractography was used to tract the HHT in nine patients before craniotomy for pituitary adenomas. The DTI location of the HHT was compared with the PS position identified at the time of surgery. DTI fiber tracking was carried out in nine patients prior to the planned craniotomy for pituitary adenomas. In one patient, the PS could not be identified during the surgery. In the other eight patients, a comparison was made between the location of the HHT identified by DTI and the position of the PS visualized at the time of surgery. @*Results@#: The position of the HHT identified by DTI showed consistency with the intraoperative position of the PS in seven patients (88.9% concordance). @*Conclusion@#: This study shows that DTI can identify the position of the HHT and thus the position of the PS with a high degree of reliability.

Effect of Modified Yangxintang on Chronic Pulmonary Heart Disease with Syndrome of Deficiency of Heart and Lung Qi / 中国实验方剂学杂志

Objective:To discuss the effect of modified Yangxintang on chronic pulmonary heart disease (CPHD) with syndrome of deficiency of heart and lung Qi and progress of disease. Method:One hundred and twenty-eight patients were randomly divided into control group 64 cases and observation group 64 cases by random number table. Patients in control group got comprehensive rehabilitation measures of western medicine. Those who had respiratory distress got Salmeterol ticasone powder inhaler, 1-2 times/day, 1 inhale/time.And those who had cough and phlegm got Ambroxol hydrochloride tablets for 1-2 week, 1-2 tablet/time, 3 times/day. In addition to the therapy of control group, patients in observation group was also added with modified Yangxintang, 1 dose/day, 5 days/week. Record the and times of acute aggravate and cold, pulmonary artery systolic pressure (PASP), mean pulmonary artery pressure (MPAP), left ventricular ejection fraction (LVEF), stroke volume (SV) and cardiac output (CO) were recorded during 48 weeks. Before and after treatment, scores of modified British medical research council respiratory questionnaire (mMRC questionnaire), Minnesota Heart Failure Quality of life scale (MLHFQ), syndrome of deficiency of heart and lung Qi and 6-minute walking test (6 MWT) were scored. And levels of N-terminal B-type natriuretic peptide (NT-proBNP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), nitric oxide (NO), endothelin (ET-1), CD3+, CD4+, CD8+ and CD4+/CD8+ were detected. Result:The clinical efficacy in observation group was better than that in control group (Z=2.108, P<0.05). During 48 weeks of observation period, times of acute aggravate and cold in observation group were less than those in control group (P<0.01). Levels of PASP, MPAP and NT-proBNP were lower than those in control group (P<0.01). And levels of LVEF, SV, CO, 6 MWT and NO were higher than those in control group (P<0.01), levels of CD3+, CD4+ and CD4+/CD8+ were higher than those in control group (P<0.05). And levels of mMRC, MLHFQ, score of syndrome of deficiency of heart and lung Qi, TNF-α , IL-6, ET-1, CD8+ and were all lower than those in control group (P<0.01, P<0.05). Conclusion:In addition to anti-inflammatory, anti-asthmatic and anti-tussive therapies, modified Yangxintang can improve the immune function, relieve the symptoms of heart and lung, improve the function of heart and lung and the quality of life, inhibit the inflammatory reaction, improve the function of vascular endothelium, reduce the pulmonary hypertension, control the progress of disease.

Cloning and expression of LAR gene and its correlation with phloridzin content in Lithocarpus polystachyus / 中草药

Objective: To clone the leucoanthocyanidin reductase (LAR) gene of Lithocarpus polystachyus, and analyze the relationship between LAR gene expression level and phloridzin content. Methods: According to the results of L. polystachyus transcriptome sequencing (unigene: DN30711_c0_g1_i1), the full-length cDNA sequence of LAR gene was amplified by PCR and the bioinformatics analysis was carried out. Its expression was detected by quantitative Real-time PCR (qRT-PCR). The phloridzin content of L. polystachyus was measured by UPLC method and the correlation between LAR gene expression and phloridzin content was analyzed by SPSS 18.0 software. Results: The full-length cDNA of the LAR gene was 1 053 bp and contained a complete open reading frame that encoded 350 amino acids. This protein did not exist a transmembrane domain and was localized in the cytoplasm. The LAR protein of L. polystachyus was the number of PCBER_SDR_a family and had a high similarity (95%) to the LAR protein of Quercus suber and their genetic relationship was close. The phloridzin content of L. polystachyus was positively correlated with the expression of LAR gene (P < 0.05). Conclusion: The LAR gene of L. polystachyus was cloned for the first time. It was confirmed that the content of phloridzin was positively correlated with the expression of LAR gene of L. polystachyus, which laid a theoretical and technical basis for revealing the biosynthesis mechanism of phloridzin of L. polystachyus.

Protective Effect of Ganshuang Granules () on Liver Cirrhosis by Suppressing Regulatory T Cells in Mouse Model / 中国结合医学杂志

OBJECTIVE@#To investigate the potential antifibrotic mechanisms of Chinese medicine Ganshuang Granules (, GSG) and to provide clinical therapeutic evidence of its effects.@*METHODS@#A cirrhotic mouse model was established by intraperitoneally injecting a mixture of CCl (40%) and oil (60%) at 0.2 mL per 100 g of body weight twice a week for 12 weeks. After 12-week modeling, GSG was intragastric administrated to the mice for 2 weeks, and the mice were divided into low-, medium- and high-dose groups at doses of 1, 2 and 4 g/(kg·day), respectively. Liver morphology changes were observed using Masson's trichrome staining and B-ultrasound. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and hyaluronic acid (HA) in serum were detected using an automatic biochemistry analyzer. The expressions of desmin, smooth muscle actin (SMA) and Foxp3 in liver were detected by immunoflfluorescence. The regulatory T cell (Treg) frequency was determined through flflow cytometry analysis. Collagen-I, SMA, IL-6, tumor necrosis factor α (TNF-α), interleukin (IL)-1β and transforming growth factor β1 (TGF-β1) expression levels were measured using quantitative polymerase chain reaction (qPCR).@*RESULTS@#Masson's staining result showed fewer pseudolobule structures and fibrous connective tissue in the GSG-treatment groups than in the spontaneous recovery group. Ultrasonography showed that GSG treatment reduced the number of punctate hyperechoic lesions in mice cirrhotic livers. The serum ALT, AST, HA levels were significantly ameliorated by GSG treatment (ALT: F=8.104, P=0.000; AST: F=7.078, P=0.002; and HA: F=7.621, P=0.001). The expression levels of collagen-I and SMA in the cirrhotic livers were also attenuated by GSG treatment (collagen-I: F=3.938, P=0.011; SMA: F=4.115, P=0.009). Tregs, which were elevated in the fibrotic livers, were suppressed by GSG treatment (F=8.268, P=0.001). The expressions of IL-6, TNF-α and IL-1β increased, and TGF-β levels decreased in the cirrhotic livers after GSG treatment (IL-6: F=5.457, P=0.004; TNF-α: F=6.023, P=0.002; IL-1β: F=6.658, P=0.001; and TGF-β1: F=11.239, P=0.000).@*CONCLUSIONS@#GSG promoted the resolution/regression of cirrhosis and restored liver functions in part by suppressing Treg cell differentiation, which may be mediated by hepatic stellate cells.

Physiological Variables Associated with the Development of Acute Mountain Sickness / 中国医学科学杂志(英文版)

Objective To identify the physiological variables associated with the development of acute mountain sickness (AMS). Methods Eighty four young Chinese men residing at low altitude were taken to an altitude of 4000 m within 40 hours. At sea level and at high altitude, we measured the heart rate, blood pressure, and peripheral oxygen saturation (SpO2) respectively. We also collect blood samples from each participants before and after the altitude elevation. The blood routine and biochemical examinations were performed for all blood samples. The revised Lake Louise Criteria was adopted to diagnose AMS after the subjects arrived at the target high altitude. The association between the presence of AMS and subjects' physiological variables were analysed statistically. Results Of 84 participants, 34 (40.5%) developed AMS. Compared with non AMS group, in the AMS group, the percentage of neutrophils was significantly higher (64.5%±11.2% vs. 58.1%±8.8%, P =0.014), while the level of SpO2 was significantly lower (79.4%±5.4% vs. 82.7%±5.6, P=0.008). Binary logistic regression analyses emphasized the association of neutrophils (OR: 1.06, 95% CI: 1.01-1.12, P=0.034) and SpO2 level (OR: 0.87, 95% CI : 0.79-0.95, P=0.004) with the development of AMS. Conclusion The ability to sustain SpO2 after altitude elevation and the increase of neutrophils were associated with the development of AMS in young males.

Effect of enteral nutritional emulsion on nutritional status and immune function in patients with gastrointestinal tumor / 中国基层医药

Objective To observe the effect of enteral nutritional emulsion on nutritional status and immune function in patients with gastrointestinal cancer. Methods From January 2014 to January 2017,100 patients with gastrointestinal cancer in Yuncheng Central Hospital were selected in the research and randomly divided into two groups according to the digital table, with 50 cases in each group. All the patients underwent chemotherapy, the observation group was given enteral nutritional emulsion during chemotherapy. The indicators of nutritional status, immune function, the effect of chemotherapy, the incidence of adverse reactions were compared between the two groups. Results After treatment,the prealbumin,albumin,transferrin and hemoglobin levels in the observation group were (0. 30 ± 0. 07)g/ L,(32. 93 ± 1. 67)g/ L,(2. 61 ± 0. 15)g/ L,(109. 94 ± 2. 31)g/ L,respectively,which in the control group were (0. 19 ± 0. 09)g/ L,(30. 89 ± 1. 49)g/ L,(2. 49 ± 0. 14)g/ L,(108. 07 ± 2. 04)g/ L,respectively, there were statistically significant differences between the two groups(t = 6. 822,6. 445,4. 135,4. 291,all P < 0. 05). After treatment,the CD +3 ,CD4 / CD8,NK cells in the observation group were (43. 84 ± 7. 65)％ ,(1. 70 ± 0. 18) and (37. 78 ± 7. 51)％ ,respectively,which in the control group were (36. 12 ± 6. 57)％ ,(1. 52 ± 0. 19) and (31. 07 ± 4. 20)％ ,respectively,there were statistically significant differences between the two groups ( t = 5. 413,4. 863, 6. 124,all P < 0. 05). The objective response rate of the observation group (64％ ) was significantly higher than that of the control group(44％ )(χ2 = 4. 026,P < 0. 05). The incidence rate of adverse reaction of the observation group (18％ ) was significantly lower than that of the control group(36％ )(χ2 = 4. 110,P < 0. 05). Conclusion Enteral nutritional emulsion can effectively improve the nutritional status and immune function of patients with gastrointestinal cancer during chemotherapy,but also can effectively enhance sensitivity to chemotherapy,improve the effect of chemo-therapy,and the safety is reliable.

Diagnosis of Spinal Muscular Atrophy: A Simple Method for Quantifying the Relative Amount of Survival Motor Neuron Gene 1/2 Using Sanger DNA Sequencing / 中华医学杂志(英文版)

Background@#Spinal muscular atrophy (SMA) is caused by homozygous deletion or compound heterozygous mutation of survival motor neuron gene 1 (SMN1), which is the key to diagnose SMA. The study was to establish and evaluate a new diagnostic method for SMA.@*Methods@#A total of 1494 children suspected with SMA were enrolled in this study. Traditional strategy, including multiplexed ligation-dependent probe amplification (MLPA) and TA cloning, was used in 1364 suspected SMA children from 2003 to 2014, and the 130 suspected SMA children were tested by a new strategy from 2015 to 2016, who were also verified by MLPA combined with TA cloning. The SMN1 and SMN2 were simultaneously amplified by polymerase chain reaction using the same primers. Mutation Surveyor software was used to detect and quantify the SMN1 variants by calculating allelic proportions in Sanger sequencing. Finally, turnaround time and cost of these two strategies were compared.@*Results@#Among 1364 suspected SMA children, 576 children had SMN1 homozygous deletion and 27 children had SMN1 compound heterozygous mutation. Among the 130 cases, 59 had SMN1 homozygous deletion and 8 had heterozygous deletion: the SMN1-specific peak proportion on exon 7 was 34.6 ± 1.0% and 25.5 ± 0.5%, representing SMN1:SMN2 to be 1:2 and 1:3, respectively. Moreover, five variations, including p.Ser8Lysfs *23 (in two cases), p.Leu228*, p.Pro218Hisfs *26, p.Ser143Phefs*5, and p.Tyr276His, were detected in 6/8 cases with heterozygous deletion, the mutant allele proportion was 31.9%, 23.9%, 37.6%, 32.8%, 24.5%, and 23.6%, which was similar to that of the SMN1-specific site on exon 7, suggesting that those subtle mutations were located in SMN1. All these results were consistent with MLPA and TA cloning. The turnaround times of two strategies were 7.5 h and 266.5 h, respectively. Cost of a new strategy was only 28.5% of the traditional strategy.@*Conclusion@#Sanger sequencing combined with Mutation Surveyor analysis has potential application in SMA diagnosis.

Status and correlation between professional autonomy and turnover intention of clinical specialist nurses / 现代临床护理

Objective To investigate the status of professional autonomy and turnover intention of clinical specialist nurses and analyze the correlation between them. Method A total of 200 clinical specialist nurses in Shandong Province were selected for questionnaire survey. Nursing job behavior scale and turnover intention were investigated. Results The total score on clinical autonomy was(172.26±18.31)points,with an average of(4.92±0.56).The total score on turnover intention was(15.84 ± 3.47)points, averaged (2.64 ±0.65). There was a negative correlation between the professional autonomy and turnover intention (P<0.01). Conclusion Nursing administrators should take measures to improve the professional autonomy of specialist nurses in order to reduce their turnover rate and stabilize the nursing team.