Research Advance of Chinese Medicine in Treating Atherosclerosis: Focus on Lipoprotein-Associated Phospholipase A2 / 中国结合医学杂志

As a serious cardiovascular disease, atherosclerosis (AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 (PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatidylcholine (oxPC) to produce lysophosphatidylcholine (lysoPC). Moreover, macrophage apoptosis within plaque is promoted by localized Lp-PLA2 which also promotes plaque instability. This paper reviews those researches of Chinese medicine in treating AS via reducing Lp-PLA2 levels to guide future experimental studies and clinical applications related to AS.

Analysis of Medication Rules of Traditional Chinese Medicine for Malaria Treatment Based on Data Mining / 中国医学科学杂志(英文版)

Objective To analyze the medication rules of traditional Chinese medicine (TCM) for malaria treatment.Methods Statistical analysis was conducted on the basic attributes of TCM drugs with regard to property, therapeutic methods, flavor, and meridian tropism. A complex network of TCM drug associations was constructed. Cluster analysis was applied to obtain the core drugs for malaria treatment. The Apriori algorithm was applied to analyze the association rules of these core drugs.Results A total of 357 herbs were used 3,194 times in 461 prescriptions for malaria treatment. Radix Glycyrrhizae (), Rhizoma Pinelliae (), Radix Bupleuri (), and Radix Dichroae () were the frequently used herbs through supplementing, exterior-releasing, heat-clearing, qi-rectifying, and damp-resolving therapeutic methods. Such herbs had warm, natural, and cold herbal properties; pungent, bitter, and sweet flavors; and spleen, lung, and stomach meridian tropisms. Cluster analysis showed 61 core drugs, including Radix Glycyrrhizae, Rhizoma Pinelliae, Radix Bupleuri, and Radix Scutellariae (). Apriori association rule analysis yielded 12 binomial rules (herb pairs) and 6 trinomial rules (herb combinations). Radix Bupleuri plus Radix Scutellariae was the core herbal pair for treating malaria. This pair could be combined with Rhizoma Atractylodis Macrocephalae () for treating warm or cold malaria, combined with Pericarpium Citri Reticulatae () or Radix Dichroae () for treating miasmic malaria, or combined with turtle shells () for treating malaria with splenomegaly.Conclusions TCM can be used to classify and treat malaria in accordance with the different stages of development. As the core herbal pair, Radix Bupleuri and Radix Scutellariae can be combined with other drugs to treat malaria with different syndrome types.

Prescription and medication rules of traditional Chinese medicine for prevention and treatment of diabetic microangiopathy based on literature mining / 中国中药杂志

This study explored the prescription and medication rules of traditional Chinese medicine(TCM) in the prevention and treatment of diabetic microangiopathy based on literature mining. Relevant literature on TCM against diabetic microangiopathy was searched and prescriptions were collected. Microsoft Excel 2021 software was used to establish a prescription database, and an analysis was conducted on the frequency, properties, flavors, meridian tropism, and efficacy classifications of drugs. Association rule analysis, cluster analysis, and factor analysis were performed using SPSS Modeler 18.0 and SPSS Statistics 26.0 software. The characteristic active components and mechanisms of action of medium-high frequency drugs in the analysis of medication rules were explored through li-terature mining. A total of 1 327 prescriptions were included in this study, involving 411 drugs, with a total frequency reaching 19 154 times. The top five high-frequency drugs were Astragali Radix, Angelicae Sinensis Radix, Poria, Salviae Miltiorrhizae Radix et Rhizoma, and Rehmanniae Radix. The cold and warm drugs were used in combination. Drugs were mainly sweet, followed by bitter and pungent, and acted on the liver meridian. The majority of drugs were effective in tonifying deficiency, clearing heat, activating blood, and resolving stasis. Association rule analysis identified the highly supported drug pair of Astragali Radix-Angelicae Sinensis Radix and the highly confident drug combination of Poria-Alismatis Rhizoma-Corni Fructus. The strongest correlation was found among Astragali Radix, Angelicae Sinensis Radix, Poria, and Salviae Miltiorrhizae Radix et Rhizoma through the complex network analysis. Cluster analysis identified nine categories of drug combinations, while factor analysis identified 16 common factors. The analysis of active components in high-frequency drugs for the treatment of diabetic microangiopathy revealed that these effective components mainly exerted their effects by inhibiting oxidative stress and suppressing inflammatory reactions. The study found that the pathogenesis of diabetic microangiopathy was primarily characterized by deficiency in origin, with a combination of deficiency and excess. Deficiency was manifested as Qi deficiency and blood deficiency, while excess as phlegm-heat and blood stasis. The key organ involved in the pathological changes was the liver. The treatment mainly focused on supplementing Qi and nourishing blood, supplemented by clearing heat, coo-ling blood, activating blood, and dredging collaterals. Commonly used formulas included Danggui Buxue Decoction, Liuwei Dihuang Pills, Erzhi Pills, and Buyang Huanwu Decoction. The mechanisms of action of high-frequency drugs in the treatment of diabetic microangiopathy were often related to the inhibition of oxidative stress and suppression of inflammatory reactions. These findings can provide references for the clinical treatment of diabetic microangiopathy and the development of targeted drugs.

Impact of high-sensitivity troponin as a selection criterion for healthy people on the reference range of N-terminal pro-B-type natriuretic peptide / 中华检验医学杂志

Objective:The 97.5th percentile upper reference limit (97.5th URL) of N-terminal prob-type natriuretic peptide (NT-proBNP) is influenced by multiple factors and depends on the inclusion criteria of apparently healthy people. In this study, the reference upper limit of NT-proBNP was established on apparently healthy people in Beijing area with abnormal hs-cTn as the exclusion criterion.Methods:According to the latest expert consensus recommendation standards of natriuretic peptide in the detection and clinical application of heart failure published by the Clinical Application Group of Cardiac Bio-Markers of the International Union of Clinical Chemistry, 1 635 healthy people without abnormal appearance of routine indicators such as sex, age, glycated hemoglobin, estimated glomerular filtration rate and medical history were collected. After excluding participants with potential myocardial injury according to hs-cTnI and/or hs-cTnT concentration>99th URL, NT-proBNP 97.5th URL was established in healthy subjects aged 21-40 years ( n=205), 41-50 years ( n=535), 51-60 years ( n=556) and >60 years ( n=339) based on non-parametric statistics. Results:The level of NT-proBNP was positively correlated with age ( r=0.254, P<0.001). The levels of NT-proBNP were positively correlated with hs-cTnI, hs-cTnT in males ( r=0.377 and r=0.429, both P<0.001). The levels of NT-proBNP were also positively correlated with hs-cTnI, hs-cTnT in females ( r=0.132 and r=0.296, both P<0.001). When hs-cTn>99th URL was used as the criterion to exclude patients with potential myocardial injury, among apparently healthy people aged 21-40 years old, 41-50 years old, 51-60 years old and >60 years old, male NT-proBNP 97.5th URL was 81.9 (90% CI 60.0-588.8), 141.2 (90% CI 100.0-263.6), 272.0 (90% CI 193.0-494.0) and 547.9 (90% CI 311.2-738.6), respectively; For females, the rates were 227.5 (90% CI 81.9-360.8), 153.2 (90% CI 128.2-239.5), 300.6 (90% CI 211.0-376.4) and 395.8 (90% CI 242.3-543.5) ng/L, respectively. Conclusions:This study confirmed that hs-cTn>99th URL can be used as an apparent population screening criterion for natriuretic peptide reference interval studies, which is helpful to remove conventional means to include individuals with occult myocardial injury in apparently healthy patients, so as to establish a more rigorous healthy cohort and establishing solid normal NT-proBNP reference interval.

Effects of Qingre Huoxue Jiedu Formula on Nerve Growth Factor-Induced Psoriasis / 中国结合医学杂志

OBJECTIVE@#To elucidate the mechanisms of 4 effective components from a Chinese medicine formula, namely Qingre Huoxue Jiedu Formula (QHJ heat- and toxin-clearing and blood-activating formula), in the treatment of nerve growth factor (NGF)-induced psoriasis.@*METHODS@#Keratinocyte proliferation and T cell proliferation models were developed using NGF. An NGF solution (NGF+DMEM, 100 ng/mL) was added to all induced groups and treated groups and were cultured for 24 h, while a solution with NTRK1 antagonist (K252a+DEME, 300 nmol/L) was added and cultured for 1 h. The models were used to evaluate the effects of the treatment with each of the 4 components of QHJ, namely shikonin, paeonol, astilbin and ursolic acid. Cell apoptosis and proliferation were measured by flow cytometry analysis and CCK8 assay, respectively. The mRNA expression levels of Bax, Bcl-xl, and NGF receptor (NGFR) were assessed by quantitative real-time PCR (qRT-PCR) and Western blot analysis, respectively.@*RESULTS@#(1) All QHJ-treated groups showed significantly increased cell apoptosis and inhibition of cell proliferation compared with the NGF-induced groups (P<0.05). In addition, treatment with QHJ plus NTRK1 significantly enhanced cell apoptosis and inhibition of cell proliferation compared with cells treated with QHJ only (P<0.05), particularly in cells treated with ursolic acid. (2) QHJ-treated groups showed higher protein expression levels of Bax, Bcl-xl compared with other groups (P<0.05). Additionally, treatment with QHJ plus NTRK1 significantly increased the protein expression levels of Bax, Bcl-xl and NGFR compared with those treated with QHJ only (all P<0.05), especially in those treated with shikonin.@*CONCLUSION@#The action mechanism of QHJ on psoriasis might be through enhancing cell apoptosis and inhibition of cell proliferation, and upregulating the expression level of Bax, Bcl-xl and NGFR.

Tetrahydropalmatine alleviated diabetic neuropathic pain by inhibiting activation of microglia via p38 MAPK signaling pathway / 中国中药杂志

Neuropathic pain is one of the common complications of diabetes. Tetrahydropalmatine(THP) is a main active component of Corydalis Rhizoma with excellent anti-inflammatory and pain-alleviating properties. This study aims to investigate the therapeutic effect of THP on diabetic neuropathic pain(DNP) and the underlying mechanism. High-fat and high-sugar diet(4 weeks) and streptozotocin(STZ, 35 mg·kg~(-1), single intraperitoneal injection) were employed to induce type-2 DNP in rats. Moreover, lipopolysaccharide(LPS) was used to induce the activation of BV2 microglia in vitro to establish an inflammatory cellular model. Fasting blood glucose(FBG) was measured by a blood glucose meter. Mechanical withdrawal threshold(MWT) was assessed with von Frey filaments, and thermal withdrawal latency(TWL) with hot plate apparatus. The protein expression levels of OX42, inducible nitric oxide synthase(iNOS), CD206, p38, and p-p38 were determined by Western blot, the fluorescence expression levels of OX42 and p-p38 in the dorsal horn of the rat spinal cord by immunofluorescence, the mRNA content of p38 and OX42 in rat spinal cord tissue by qRT-PCR, and levels of nitric oxide(NO), interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), interleukin-10(IL-10), and serum fasting insulin(FINS) by enzyme-linked immunosorbent assay(ELISA). RESULTS:: showed that the mo-del group demonstrated significant decrease in MWT and TWL, with pain symptoms. THP significantly improved the MWT and TWL of DNP rats, inhibited the activation of microglia and p38 MAPK signaling pathway in rat spinal cord, and ameliorated its inflammatory response. Meanwhile, THP promoted the change of LPS-induced BV2 microglia from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, suppressed the activation of the p38 MAPK signaling pathway, decreased the expression levels of inflammatory factors NO, IL-1β, IL-6, and TNF-α, and increased the expression level of anti-inflammatory factor IL-10. The findings suggested that THP can significantly ameliorate the pain symptoms of DNP rats possibly by inhibiting the inflammatory response caused by M1 polarization of microglia via the p38 MAPK pathway.

Revision of the Physical Courage at Work Scale / 环境与职业医学

Background According to China's Labor Statistics Yearbook 2020, there were 113293 work-related injuries and 25092 work-related deaths in 2019. It is of great significance to enhance the courage quality of high-risk workers for the maintenance of personal health and the effectiveness of organizational work. Objective To revise the Physical Courage at Work Scale (PCWS) for its application in Chinese employees exposed to high-risk workplace. Methods A total of 1280 high-risk workers completed the revised PCWS for Chinese employees. Item analysis and exploratory factor analysis were used to analyze the scale's construction validity. Confirmatory factor analysis was used to verify the results of exploratory factor analysis, Cronbach's α coefficient was used to verify the reliability of the scale, Pearson correlation analysis of the scale with Mental Quality Questionnaire for Armymen (MQQA) and Norton Courage Measure (CM) was used to verify the validity of the revised PCWS, and Pearson correlation analysis was used to determine the discrimination for each factor of the revised PCWS. Results The results of item analysis showed that the correlation coefficients between the scores of all items and the total score of the revised PCWS were greater than 0.4. The exploratory analysis indicated that there were five factors including immediate danger,providing for family, confronting other's aggression, reporting violations, and contributing to society in the revised version. The confirmatory analysis indicated the five-factor model fitted well (minimum fit function Chi-square/degree of freedom, CMIN/DF=4.60; normed fit index, NFI=0.93; comparative fit index, CFI=0.95; incremental fit index, IFI=0.93; standardized root mean square residual, SRMR=0.05; root mean square error of approximation, RMSEA=0.07). The internal consistency coefficient of the revised PCWS was α=0.95. The correlation coefficients of the revised PCWS with MQQA and CM ranged from 0.11 to 0.28 (P<0.01), and the correlation coefficients between factors of the revised scale ranged from 0.35 to 0.72 (P<0.01). Conclusion The revised PCWS has good reliability and validity in Chinese employees.

Doxycycline-moxifloxacin sequential therapy for Mycoplasma genitalium urethritis/cervicitis: a clinical observation / 中华皮肤科杂志

Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.

UPLC fingerprint and determination of five components of substance benchmark of classical prescription Shentong Zhuyu Decoction / 中国中药杂志

Fingerprints of 18 batches of substance benchmark of Shentong Zhuyu Decoction(SZD) were established by UPLC under the following conditions: Waters Sun Fire C_(18) column(3.0 mm×150 mm, 3.5 μm), column temperature of 35 ℃, gradient elution with mobile phase of acetonitrile(A)-0.1% phosphoric acid aqueous solution(B) at the flow rate of 0.4 mL·min~(-1), and detection by wavelength switching. A total of 16 common peaks were identified. The similarities among the fingerprints were calculated by Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine(2012 Edition) and the result showed they were in the range of 0.911-0.988. Based on the 16 common peaks, cluster analysis(CA), principal component analysis(PCA), and partial least square discriminant analysis(PLS-DA) all categorized the 18 batches of samples into two groups(S1, S2, S5-S8, S14, and S17 in one group, and S1, S2, S5-S8, S14, and S17 in another), and 11 most influential components were screened. Five known components with great difference among samples(hydroxysafflor yellow A, ferulic acid, benzoic acid, ecdysone, and ammonium glycyrrhizinate) were determined. The combination of multi-component content determination and fingerprints can reflect the overall cha-racteristics of the primary standards of SZD, which is simple, feasible, reproducible, and stable. This study can serve as a reference for the quality control of the primary standards of SZD.

Obstetric Diseases Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

In recent years， with the change in life style， social environment， and national childbearing policy， the proportion of high-risk pregnant women has increased significantly， triggering the spectrum of obstetric diseases to constantly change， which has brought new challenges to the diagnosis and treatment of obstetrics. Traditional Chinese medicine （TCM） has been proved effective in dealing with a variety of obstetric diseases， and various treatment methods are available， which can serve as alternative means for solving refractory obstetric diseases. However， most obstetric clinicians are currently less aware of the therapeutic effects of TCM， which has significantly hindered its participation in clinical treatment. Therefore， the China Association of Chinese Medicine （CACM） organized the outstanding young obstetricians of TCM and western medicine to discuss 15 obstetric diseases responding specifically to TCM or integrated TCM and western medicine， including hyperemesis gravidarum， threatened abortion， ectopic gestation， cough during pregnancy， pregnancy-induced hypertension syndrome， maternal-fetal ABO incompatibility， postpartum hypogalactia， residual pregnancy tissue in uterine cavity， puerperal infection， pantalgia after childbirth， hematoma/undesirable healing after caesarean section， postpartum urinary retention， ileus after cesarean section， pelvic floor dysfunction， and postnatal depression. The suggestions for their treatment with TCM or integrated TCM and western medicine were also proposed， aiming to provide patients with effective and personalized treatments in clinical practice and improve the diagnosis and treatment effects of obstetric diseases， thus benefiting the public. At the same time， more obstetrical clinicians are expected to understand the therapeutic effects and advantages of TCM and draw on the strengths of both TCM and western， thereby promoting the establishment of an obstetric diagnosis and treatment system with Chinese characteristics.

Study on scrophulariaceae radix reference extract and its application in quality control of Scrophulariae Radix / 中国中药杂志

By establishing the preparation process of Scrophulariaceae Radix reference extract(SRRE) and calibrating it, we discussed its feasibility as a substitute for single reference substance in the quality control of Scrophulariae Radix. The SRREs were prepared by solvent extraction method and chromatographic separation technology, and then calibrated with the reference substances of harpagide, angoroside C and harpagoside. The HPLC content determination method of Scrophulariae Radixl was established with SRREs of the known content and the reference substances of harpagide, angoroside C and harpagoside respectively as the control ones. Then the content of three components in Scrophulariae Radix was determined, and the t-test method was used to compare the results of the two methods. With SRRE as references, harpagide, angoroside C and harpagoside were in a good linear relationship(r≥0.999 8) within each range, and the average recovery rate was 98.55% to 100.6%. The t-test results showed that the P values of two determination methods were 0.493, 0.155 and 0.171 for harpagide, angoroside C and harpagoside respectively, indicating no significant diffe-rence between the two methods of content determination. The SRRE can be used as a substitute for the reference in the quality control of Scrophulariaceae Radix. The SRRE can replace the corresponding reference substance for the quality control of Scrophulariae Radix. The results of this study provide new methods and new ideas for the quality evaluation of Scrophulariae Radix, and provide a scientific basis for the application of reference extracts in the quality research of traditional Chinese medicine.

Prescription compatibility connotation and action mechanism of Siwu Decoction in treating primary dysmenorrhea / 中国中药杂志

The aim of this paper was to study the prescription compatibility connotation in the treatment of primary dysmenorrhea(PD) and verify the mechanism as predicted by network pharmacology of Siwu Decoction(SWD). Mice PD model was constructed by using estradiol benzoate-oxytocin. PD mice were randomly divided into 8 groups, namely normal group, model group, positive group, complete formula group, Rehmanniae Radix Praeparata-free group, Paeoniae Radix Alba-free group, volatile oil-free group, Chuan-xiong Rhizoma and Angelicae Sinensis Radix-free group. Latent time, writhing times, inhibition rate, prostaglandin F_2_α(PGF_2_α) and prostaglandin E_2(PGE_2) levels in serum, endothelin-1, Ca~(2+), expression levels of prostaglandin synthase 2 G/H(PTGS2), estrogen receptor(ESR1), glucocorticoid receptor gene(NR3 C1) mRNA and protein expression levels in the uterus homogenate and pathological changes of uterine tissue were index to explore the prescription compatibility connotation and verify the mechanism of SWD in the treatment of PD. Compared with the extraction liquid of the whole recipe, the effect of Rehmanniae Radix Praeparata-free group and Paeoniae Radix Alba-free group with volatile oil were slightly lower, the effect of essential oil-free group was significantly lower, and the effect of Chuanxiong Rhizoma and Angelicae Sinensis Radix-free group was worse than that of the whole recipe. The relative expression levels of PTGS2 protein and mRNA were significantly reduced by the SWD. The relative expressions of protein and mRNA of ESR1, NR3 C1 were significantly increased. SWD treats PD by regulating the expression of key proteins PTGS2, ESR1 and NR3 C1.Its main medicinal herbs were Angelicae Sinensis Radix and Chuanxiong Rhizoma. Active components were mainly in volatile oil, but Paeo-niae Radix Alba and Rehmanniae Radix Praeparata also had some contributions.

Effects of electroacupuncture on skeletal muscle and blood glucose in rats with diabetic amyotrophy / 中国针灸

OBJECTIVE@#To explore the effects of electroacupuncture (EA) on skeletal muscle and blood glucose in rats with diabetic amyotrophy.@*METHODS@#Among 40 SD rats, 10 rats were randomly selected into the control group and received no treatment. The remaining 30 rats were treated with intraperitoneal injection of streptozotocin (STZ, 60 mg/kg) to establish diabetes mellitus (DM) model, and then the rats were treated with vascular ligation at right posterior limb to establish amyotrophy model. The rats with diabetic amyotrophy were randomly divided into a model group and an EA group, 10 rats in each group (10 rats were excluded due to unsuccessful model establishment and death). The rats in the EA group was treated with EA at right-side "Yishu (EX-B 3)" "Shenshu (BL 23)" "Zusanli (ST 36)" and "Sanyinjiao (SP 6)", disperse-dense wave, 2 Hz/ 15 Hz, 20 minutes each time, once a day for 3 weeks. Before and after EA treatment, the blood sample was collected from inner canthus and the "glucose oxidase-peroxidase" method was used to detect fasting blood glucose level; ELISA method was used to detect insulin content. At the end of the treatment, HE staining method was used to observe the morphology of ischemic skeletal muscle in the right hindlimb; the real-time PCR method was used to detect the mRNA expression of muscle atrophy F-box (MAFbx), muscle ring finger-1 (MuRF1) and forkhead box O3a (FOXO3a) in the ischemic skeletal muscle tissue of right hindlimb.@*RESULTS@#Before the treatment, the body mass in the model group and EA group was lower than that in the control group (<0.01); after the treatment, the body mass in the control group was increased, while the body mass in the model group and EA group was decreased (<0.01). Compared with the control group, the fasting blood glucose was significantly increased and insulin content was significantly decreased in the model group (<0.01); compared with the model group, the fasting blood glucose was significantly decreased and the insulin content was significantly increased in the EA group after treatment (<0.01). The muscle fibers of the model group were obviously broken, the number of the nuclei decreased, and the nuclei shrinked or even dissolved; the morphology of the muscle tissue of the EA group after intervention was improved compared with the model group. Compared with the control group, the cross-sectional area of ischemic skeletal muscle cells in the right hindlimb in the model group was decreased (<0.01); compared with the model group, the cross-sectional area of ischemic skeletal muscle cells in the right hindlimb was increased in EA group (<0.05). Compared with the control group, the levels of MAFbx, MuRF1 and FOXO3a mRNA in the right hindlimb ischemic skeletal muscle in the model group were increased significantly (<0.01, <0.05); compared with the model group, the levels of MAFbx, MuRF1 and FOXO3a mRNA in the EA group were decreased significantly (<0.05, <0.01).@*CONCLUSION@#EA may play a role in the treatment of diabetic amyotrophy by inducing FOXO3a to reduce the transcription of MAFbx and MuRF1.

Analysis of the effect of cervical conization through cervical endoscopy in the treatment of High-grade cervical intraepithelial neoplasia / 中国综合临床

Objective@#To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN).@*Methods@#From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods.@*Results@#The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ2=4.98, P<0.05). The postoperative follow up was proceed one year.The incidence of cure were significantly higher than that in the control group(96%(48/50)vs.84%(40/50)), and the residual rate and recurrence rate were lower than that of the control group(6%(3/50) and 14%(7/50), 2%(1/50)and 8%(4/50)), the difference was statistically significant (χ2=10.56, 3.98, 13.96, all P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [6% (3/50) and 18% (9/50)], the difference was statistically significant (χ2=11.25, P<0.05). There was no significant difference in bleeding volume, operation time and wound healing time between the two groups (t value was 1.46, 1.26 and 0.98 respectively, all P>0.05).@*Conclusion@#The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications.

Etiological analysis of surveillance cases of diarrhea syndrome in Gansu Province from 2009 to 2018 / 中华疾病控制杂志

@#Objective To understand pathogenic distribution and epidemiological characteristics of diarrhea syndrome in Gansu Province． Methods Fecal specimens from diarrhea syndrome surveillance cases at sentinel hospitals in Gansu Province from 2009 to 2018 were collected，and virus nucleic acids were detected by real－time fluorescent chain reaction，and bacteria were detected by isolation culture． Ｒesults 1 547 positive cases were detected from 4 406 stool specimens with the positive rate of 35. 11%． Among the positive samples，1 281 cases were positive for virus with the positive rate of 47. 20%; 287 ca- ses were positive for bacteria with the positive rate of 8. 57%． Top five of pathogenic spectrum were rota- virus ( 46. 04%) ，astrovirus ( 13. 37%) ，norovirus ( 13. 15%) ，Shigella ( 9. 90%) and adenovirus ( 7. 81%) ． In different age groups，statistically significant differences were found in the positive rates of rotavirus，norovirus，astrovirus，Shigella and non typhoid Salmonella ( all P＜0. 05) ． The positive rate of virus was higher from November to March of next year，and the positive rate of bacteria was higher from June to August． The epidemic seasons of pathogens were different，of which rotavirus was dominating in four seasons． Conclusions The pathogenic spectrum of diarrhea is wide relatively in Gansu Province， and viral diarrhea is more common，with obvious seasonal peak． Continuous monitoring should be strengthened to grasp characteristics and epidemic trends of pathogens，and it is helpful to take targeted and seasonal preventive measures in population at high risk．

Analysis of the effect of cervical conization through cervical endoscopy in the treatment of High-grade cervical intraepithelial neoplasia / 中国综合临床

Objective:To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN).Methods:From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods.Results:The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ 2=4.98, P<0.05). The postoperative follow up was proceed one year.The incidence of cure were significantly higher than that in the control group(96%(48/50)vs.84%(40/50)), and the residual rate and recurrence rate were lower than that of the control group(6%(3/50) and 14%(7/50), 2%(1/50)and 8%(4/50)), the difference was statistically significant (χ 2=10.56, 3.98, 13.96, all P<0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group [6% (3/50) and 18% (9/50)], the difference was statistically significant (χ 2=11.25, P<0.05). There was no significant difference in bleeding volume, operation time and wound healing time between the two groups ( t value was 1.46, 1.26 and 0.98 respectively, all P>0.05). Conclusion:The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications.

Mediating effects of rejection sensitivity between adult attachment and depressive symptoms in college students / 中华行为医学与脑科学杂志

Objective:To explore the relationship between adult attachment, rejection sensitivity and depressive symptoms in college students.Method:A total of 705 college students were recruited with cluster sampling and measured with rejection sensitivity questionnaire(RSQ), experiences in close relationships inventory(ECR), and Beck depression inventory(BDI). Based on the criteria of depressive symptoms of Beck depression scale, those with scores <5 were divided into the group with no depressive symptoms(non-depression group, n=373) and those with scores ≥5 were divided into the group with depressive symptoms(depression group, n=332). SPSS 17.0 and AMOS 19.0 were used to conduct data analysis of the results, and the mediating effect was tested by Bootstrap method. Results:(1) The scores of anxious attachment (71.00(57.00, 80.00)) and avoidant attachment(66.00(55.00, 72.00)) in the depressive group were both significantly higher than those in the non-depressive group(65.00(52.50, 74.00))、(66.00(51.50, 72.00))( Z=-7.29, -2.85, P<0.01), the score of rejection sensitivity (9.78(8.27, 11.06)) in the depressive group was significantly higher than that in the non-depressive group(9.39(7.63, 10.67))( Z=-6.15, P<0.01). (2)Anxious attachment had significantly positively correlation with rejection sensitivity ( r=0.33, P<0.01) and depressive symptoms( r=0.33, P<0.01). Avoidant attachment had significantly positively correlation with rejection sensitivity ( r=0.15, P<0.01) and depressive symptoms( r=0.10, P<0.01). Rejection sensitivity had significantly positively correlation with depressive symptoms ( r=0.28, P<0.01). (3)Rejection sensitivity partially mediated the relationships between adult attachment and depressive symptoms.The mediating effect of rejection sensitivity on the influence of anxious attachment on depressive symptoms was 8.7%, accounting for 39.73% of the total effect.And the mediating effect for avoidant attachment was 3.0%, accounting for 29.90% of the total effect. Conclusion:Adult attachment has indirect effects on depressive symptoms through rejection sensitivity.

Iodine nutritional status of key population and its correlation with water iodine and salt iodine in Hainan Province / 中华地方病学杂志

Objective:To understand the iodine nutritional status of key population and its correlation with water iodine and salt iodine in Hainan Province, and to provide scientific basis for iodine supplement.Methods:According to the "National Water Iodine Content Survey Program for Drinking Water" and the "National Iodine Deficiency Disorders Surveillance Program (2016)", surveys on water iodine and iodine nutritional status of key populations in 21 cities (counties, districts) in Hainan Province in 2017 and 2018 were conducted. Water samples, urine samples at random and home salt samples of children aged 8 - 10 years old and pregnant women were collected to detect water iodine, urinary iodine and salt iodine. At the same time, the thyroid volume of children was measured by B-mode ultrasound, and the goiter rate was calculated. According to the geographical location, Hainan Province was divided into 3 areas: central mountainous, western coastal and eastern coastal, the results of water iodine, salt iodine and urinary iodine in different areas were compared and analyzed. Water iodine was detected by "Water Iodine Detection Method Suitable for Iodine Deficiency and High Iodine Areas" recommended by National Reference Laboratory for Iodine Deficiency Disorders; urinary iodine was detected by arsenic cerium catalytic spectrophotometry; salt iodine was detected by direct titration.Results:A total of 2 566 water samples were detected, and the median water iodine was 6.0 μg/L. A total of 4 220 urine samples of children were detected, the median urinary iodine was 170.0 μg/L (appropriate range was 100 - 199 μg/L), the goiter rate was 0.09% (4/4 220). A total of 2 124 urine samples of pregnant women were detected, the median urinary iodine was 120.7 μg/L (appropriate range was 150 - 249 μg/L). A total of 6 344 salt samples were detected, coverage rate of iodized salt, qualified rate of iodized salt and consumption rate of qualified iodized salt were 97.76% (6 202/6 344), 97.47% (6 045/6 202), and 95.29% (6 045/6 344), respectively. In central mountainous, western coastal and eastern coastal areas, medians water iodine were 3.3, 6.5, and 6.5 μg/L, respectively, the difference was statistically significant ( H = 13.721, P < 0.01); the consumption rates of qualified iodized salt were 97.86% (1 833/1 873), 90.52% (1 613/1 782), and 96.65% (2 599/2 689), respectively, the difference was statistically significant (χ 2 = 71.217, P < 0.01); the medians urinary iodine of children were 182.4, 160.1, and 167.4 μg/L, respectively; the medians urinary iodine of pregnant women were 120.1, 117.7, and 103.9 μg/L, respectively. There was a positive correlation between urinary iodine in children and pregnant women and salt iodine ( r = 0.394, 0.657, P < 0.05). Conclusions:The iodine nutrition of children in Hainan Province is generally at an appropriate level, and pregnant women are at risk of iodine deficiency. There is a positive correlation between urinary iodine in children and pregnant women and salt iodine. The prevention and treatment of iodine deficiency disorders should focus on strengthening iodine nutrition monitoring of pregnant women.

Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation

Objective: To examine the effects of coronavirus disease-2019 (COVID-19) exposure, expressive suppression/cognitive reappraisal, and demographic variables on post-traumatic stress symptoms (PTS) among Chinese. Methods: Participants were recruited by social media through WeChat and 6 049 Chinese (aged from 17 to 63 years; median=24) from 31 provinces were included in the study. PTS symptoms, expressive suppression, and cognitive reappraisal were assessed after the outbreak of COVID-19. A regression mixture analysis was conducted in Mplus 7. Results: A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID- 19 exposures on PTS symptoms: (1) Class 1 (mildly PTS symptoms, 80.9%), (2) Class 2 (moderate PTS symptoms, 13.0%), and (3) Class 3 (high PTS symptoms, 6.1%). The results demonstrated that the young, women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms; and they had more expression inhibition and less cognitive reappraisal in three latent classes. Conclusions: The findings suggest that more attention needs to be paid to vulnerable groups such as the young, women and people with responsibilities and concerns for others. Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.

Psychological impacts of the COVID-19 epidemic on Chinese people: Exposure, post-traumatic stress symptom, and emotion regulation

Objective: To examine the effects of coronavirus disease-2019 (COVID-19) exposure, expressive suppression/cognitive reappraisal, and demographic variables on post-traumatic stress symptoms (PTS) among Chinese. Methods: Participants were recruited by social media through WeChat and 6 049 Chinese (aged from 17 to 63 years; median=24) from 31 provinces were included in the study. PTS symptoms, expressive suppression, and cognitive reappraisal were assessed after the outbreak of COVID-19. A regression mixture analysis was conducted in Mplus 7. Results: A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID- 19 exposures on PTS symptoms: (1) Class 1 (mildly PTS symptoms, 80.9%), (2) Class 2 (moderate PTS symptoms, 13.0%), and (3) Class 3 (high PTS symptoms, 6.1%). The results demonstrated that the young, women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms; and they had more expression inhibition and less cognitive reappraisal in three latent classes. Conclusions: The findings suggest that more attention needs to be paid to vulnerable groups such as the young, women and people with responsibilities and concerns for others. Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.