The value of cardiac MRI in the risk stratification in patients with hypertrophic cardiomyopathy / 中华心血管病杂志

Objective: To explore the value of cardiac magnetic resonance imaging (CMR) in the risk stratification of hypertrophic cardiomyopathy (HCM). Methods: HCM patients who underwent CMR examination in Fuwai Hospital between March 2012 and May 2013 were retrospectively enrolled. Baseline clinical and CMR data were collected and patient follow-up was performed using telephone contact and medical record. The primary composite endpoint was sudden cardiac death (SCD) or and equivalent event. The secondary composite endpoint was all-cause death and heart transplant. Patients were divided into SCD and non-SCD groups. Cox regression was used to explore risk factors of adverse events. Receiver operating characteristic (ROC) curve analysis was used to assess the performance and the optimal cut-off of late gadolinium enhancement percentage (LGE%) for the prediction of endpoints. Kaplan-Meier and log-rank tests were used to compare survival differences between groups. Results: A total of 442 patients were enrolled. Mean age was (48.5±12.4) years and 143(32.4%) were female. At (7.6±2.5) years of follow-up, 30 (6.8%) patients met the primary endpoint including 23 SCD and 7 SCD equivalent events, and 36 (8.1%) patients met the secondary endpoint including 33 all-cause death and 3 heart transplant. In multivariate Cox regression, syncope(HR=4.531, 95%CI 2.033-10.099, P<0.001), LGE% (HR=1.075, 95%CI 1.032-1.120, P=0.001) and left ventricular ejection fraction (LVEF) (HR=0.956, 95%CI 0.923-0.991, P=0.013) were independent risk factors for primary endpoint; Age (HR=1.032, 95%CI 1.001-1.064, P=0.046), atrial fibrillation (HR=2.977, 95%CI 1.446-6.131, P=0.003),LGE% (HR=1.075, 95%CI 1.035-1.116, P<0.001) and LVEF (HR=0.968, 95%CI 0.937-1.000, P=0.047) were independent risk factors for secondary endpoint. ROC curve showed the optimal LGE% cut-offs were 5.1% and 5.8% for the prediction of primary and secondary endpoint, respectively. Patients were further divided into LGE%=0, 0<LGE%<5%, 5%≤LGE%<15% and LGE%≥15% groups. There were significant survival differences between these 4 groups whether for primary endpoint or secondary endpoint (all P<0.001) and the accumulated incidence of primary endpoint was 1.2% (2/161), 2.2% (2/89), 10.5% (16/152) and 25.0% (10/40), respectively. Conclusion: LGE is an independent risk factor for SCD events as well as all-cause death and heart transplant. LGE is of important value in the risk stratification in patients with HCM.

Exercise regulates bone metabolism via microRNAs / 生理学报

It has been well documented that exercise can improve bone metabolism, promote bone growth and development, and alleviate bone loss. MicroRNAs (miRNAs) are widely involved in the proliferation and differentiation of bone marrow mesenchymal stem cells, osteoblasts, osteoclasts and other bone tissue cells, and regulation of balance between bone formation and bone resorption by targeting osteogenic factors or bone resorption factors. Thus miRNAs play an important role in the regulation of bone metabolism. Recently, regulation of miRNAs are shown to be one of the ways by which exercise or mechanical stress promotes the positive balance of bone metabolism. Exercise induces changes of miRNAs expression in bone tissue and regulates the expression of related osteogenic factors or bone resorption factors, to further strengthen the osteogenic effect of exercise. This review summarizes relevant studies on the mechanism whereby exercise regulates bone metabolism via miRNAs, providing a theoretical basis for osteoporosis prevention and treatment with exercise.

A nested case-control study on the association of neonatal cord blood selenium, iron and copper with congenital heart disease / 中华预防医学杂志

Objective: To investigate the relationship between the levels of selenium, iron and copper in cord blood of neonates and the risk of congenital heart disease (CHD), and analyze their interaction effects. Methods: The subjects were obtained from the birth cohort in Lanzhou area established from 2010 to 2012. A baseline survey was conducted in the first trimester, and the follow-up was conducted in the second trimester, third trimester and 42 days after delivery. The umbilical vein blood was collected from newborns at delivery, and information on their birth outcomes was extracted from medical records. A nested case-control study was used to select 97 neonates with CHD newly diagnosed by echocardiography as the case group, and 194 neonates were selected as the control group by 1∶2 matching according to their mother's age, block and CHD onset time. Inductively coupled ion mass spectrometry was used to detect the concentrations of selenium, iron and copper in neonatal cord blood. The element exposure was categorized into three groups, the low, medium and high concentrations, according to the quartiles Q1 and Q3 of selenium, iron and copper concentrations in the control group. The association between cord blood selenium, iron and copper concentrations and CHD was analyzed by conditional logistic regression model using medium concentration as the reference standard. The association of their interactions with CHD was analyzed by a phase multiplication model. Results: The M (Q1, Q3) concentration of neonatal cord blood copper was 746.12 (467.48, 759.74) μg/L in the case group and 535.69 (425.21, 587.79) μg/L in the control group, with a statistically significant difference between the two groups (P<0.05). After adjustment for confounders, logistic regression models showed that the risk of CHD development was increased in neonates with either high copper in cord blood (OR=4.062, 95%CI: 2.013-8.199) or high copper combined with high iron (OR=3.226, 95%CI: 1.343-7.750). No correlation was observed between selenium and iron concentrations and the development of CHD in neonates. There was a multiplicative interaction between copper and iron in cord blood on the risk of developing CHD (OR=1.303, 95%CI: 1.056-1.608). Conclusion: There is a multiplicative interaction between iron and copper elements. The high copper and the high copper combined with high iron in umbilical cord blood are risk factors for neonatal CHD.

Forensic Research Progress on Postural Asphyxia / 法医学杂志

In recent years, the increase in the number of cases of postural asphyxia has gradually attracted the attention and discussion of forensic scientists domestically and internationally, but a systematic, comprehensive and recognized expert consensus and identification standard has not been established at home and abroad. This paper reviews the case characteristics, occurrence, mechanism of death, and identification criteria of postural asphyxia, to provide reference for future research.

Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy: A case report and hypothesized mechanism of the therapy / 中西医结合学报

Acupoint autohemotherapy at bilateral Zusanli (ST36) and Xuehai (SP10) was used to treat a 26-year-old female patient who had suffered from recalcitrant atopic eczema (AE) for five years. The treatment was applied at a frequency of once per week for the first month, followed by a three-month period of once every other week. At the end of treatment, the patient's AE symptoms were entirely resolved, and by the end of a six-month follow-up her immunoglobulin E level had returned to the normal range. Further, there was no relapse of AE symptoms during the six-month follow-up. Therefore, we hypothesized that after the repeated treatments the local inflammatory reaction induced by autologous blood injection triggered a local immune response, followed by a systemic immune response after the repeated treatment, finally leading to the anti-inflammation and immunomodulation effects. This case suggests that acupoint autohemotherapy could be used as an effective complementary treatment for recalcitrant AE, especially in cases where other treatments have failed. Further comparative studies are needed to corroborate the value and mechanisms of this therapy.

Isolation of Fusarium and identification of its toxins from tuberous root of Pseudostellaria heterophylla / 中国中药杂志

Fusarium is the major pathogen of root rot of Pseudostellaria heterophylla. This study aims to explain the possible distribution of Fusarium species and the contamination of its toxin-chemotypes in tuberous root of P. heterophylla. A total of 89 strains of fungi were isolated from the tuberous root of P. heterophylla. Among them, 29 strains were identified as Fusarium by ITS2 sequence, accounting for 32.5%. They were identified as five species of F. avenaceum, F. tricinctum, F. fujikuroi, F. oxysporum, and F. graminearum based on β-Tubulin and EF-1α genes. LC-MS/MS detected 18, 1, and 5 strains able to produce ZEN, DON, and T2, which accounted for 62.1%, 3.4%, and 17.2%, respectively. Strain JK3-3 can produce ZEN, DON, and T2, while strains BH1-4-1, BH6-5, and BH16-2 can produce ZEN and T2. PCR detected six key synthase genes of Tri1, Tri7, Tri8, Tri13, PKS14, and PKS13 in strain JK3-3, which synthesized three toxins of ZEN, DON, and T2. Four key synthase genes of Tri8, Tri13, PKS14, and PKS13 were detected in strains BH1-4-1, BH6-5, and BH16-2, which were responsible for the synthesis of ZEN and T2. The results showed that the key genes of toxin biosynthesis were highly correlated with the toxins produced by Fusarium, and the biosynthesis of toxin was strictly controlled by the genetic information of the strain. This study provides a data basis for the targeted prevention and control of exo-genous mycotoxins in P. heterophylla and a possibility for the development of PCR for rapid detection of toxin contamination.

Screening of zearalenone-degrading bacteria and analysis of degradation conditions / 中国中药杂志

Zearalenone(ZEN) is a mycotoxin produced by Fusarium, possessing estrogen-like effects, carcinogenicity, and multiple toxicities. To seek more efficient and practical agents for biological detoxification and broaden their application, this study isolated 194 bacterial strains from the moldy tuberous root of Pseudostellaria heterophylla, which were co-cultured with ZEN. An efficient ZEN-degrading strain H4-3-C1 was screened out by HPLC and identified as Acinetobacter calcoaceticus by morphological observation and molecular identification. The effects of culture medium, inoculation dose, culture time, pH, and temperature on the degradation of ZEN by H4-3-C1 strain were investigated. The mechanism of ZEN degradation and the degrading effect in Coicis Semen were discussed. The degradation rate of 5 μg·mL~(-1) ZEN by H4-3-C1 strain was 85.77% in the LB medium(pH 6) at 28 ℃/180 r·min~(-1) for 24 h with the inoculation dose of 1%. The degradation rate of ZEN in the supernatant of strain culture was higher than that in the intracellular fluid and thalli. The strain was inferred to secret extracellular enzymes to degrade ZEN. In addition, the H4-3-C1 strain could also degrade ZEN in Coicis Semen. If the initial content of ZEN in Coicis Semen was reduced from 90 μg·g~(-1) to 40.68 μg·g~(-1), the degradation rate could reach 54.80%. This study is expected to provide a new strain and application technology for the biological detoxification of ZEN in food processing products and Chinese medicinal materials.

Efficacy and safety of a parylene-coated occluder for atrial septal defect: a prospective, multi-center, randomized controlled clinical trial / 中华医学杂志(英文版)

BACKGROUND@#Nitinol-containing devices are widely used in clinical practice. However, there are concerns about nickel release after nitinol-containing device implantation. This study aimed to compare the efficacy and safety of a parylene-coated occluder vs. a traditional nitinol-containing device for atrial septal defect (ASD).@*METHODS@#One-hundred-and-eight patients with ASD were prospectively enrolled and randomly assigned to either the trial group to receive a parylene-coated occluder (n = 54) or the control group to receive a traditional occluder (n = 54). The plugging success rate at 6 months after device implantation and the pre- and post-implantation serum nickel levels were compared between the two groups. A non-inferiority design was used to prove that the therapeutic effect of the parylene-coated device was non-inferior to that of the traditional device. The Cochran-Mantel-Haenszel chi-squared test with adjustment for central effects was used for the comparison between groups.@*RESULTS@#At 6 months after implantation, successful ASD closure was achieved in 52 of 53 patients (98.11%) in both the trial and control groups (95% confidence interval (CI): [-4.90, 5.16]) based on per-protocol set analysis. The absolute value of the lower limit of the 95% CI was 4.90%, which was less than the specified non-inferiority margin of 8%. No deaths or severe complications occurred during 6 months of follow-up. The serum nickel levels were significantly increased at 2 weeks and reached the maximum value at 1 month after implantation in the control group (P  0.05).@*CONCLUSIONS@#The efficacy of a parylene-coated ASD occluder is non-inferior to that of a traditional uncoated ASD occluder. The parylene-coated occluder prevents nickel release after device implantation and may be an alternative for ASD, especially in patients with a nickel allergy.

Anti-tumor Effect of Piceatannol on Triple Negative Breast Cancer Cell Line MDA-MB-468 and Its Mechanism / 中国实验方剂学杂志

Objective:To investigate the effect of piceatannol （PIC） on the proliferation， apoptosis and cell cycle of MDA-MB-468 triple negative breast cancer cells and its mechanism. Method:The methylthiazolyldiphenyl-tetrazoliu bromide （MTT） colcorimetry method was used to investigate the effect of different concentrations of PIC （0， 2.5， 5.0， 10.0， 20.0， 40.0， 80.0， 160.0 μmol·L^-1） on the cell viabilities of triple negative breast cancer MDA-MB-468 cells and calculate the half maximal inhibitory concentration （IC₅₀） value， the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the cell cycle of MDA-MB-468 were investigated by flow cytometry with propidium iodide （PI） staining. The apoptotic effect of PIC （5.0， 10.0， 20.0 μmol·L^-1） on MDA-MB-468 cells in triple negative breast cancer was investigated by flow cytometry with cell apoptosis detection Annexin V-FITC and PI double staining. Western blot was used to investigate the effect of different concentrations of PIC （5.0， 10.0， 20.0 μmol·L^-1） on the proliferation and apoptosis of MDA-MB-468 cells and detect the expressions ofsecreted glycoprotein Wnt/<italic>β</italic>-catenin pathway related proteins. Result:MTT results showed that compared with the blank group， PIC could inhibit the proliferation of MDA-MB-468 cells in a concentration-dependent manner （<italic>P</italic><0.05， <italic>P</italic><0.01）， with IC₅₀ at（39.4±4.6）μmol·L^-1. Compared with the blank group， PIC could increase the percentage of MDA-MB-468 cells in G₀/G₁ phase about cell cycle in a concentration-dependent manner （<italic>P</italic><0.01）. Compared with the blank group， 5.0， 10.0， 20.0 μmol·L^-1 PIC could induce apoptosis of MDA-MB-468 cells for 48 h（<italic>P</italic><0.01）， and the apoptosis rate of MDA-MB-468 cells reached 49.87% when treated with 20.0 μmol·L^-1 for 48 h. Compared with the blank group， PIC could significantly reduce the expressions of <italic>β</italic>-catenin， proto-oncogene （C-myc） and adhesion factor （CD44） proteins in MDA-MB-468 cells， significantly inhibit the phosphorylation of<italic> </italic>protein kinase B （Akt） and p38 mitogen activated protein kinase （p38 MAPK） proteins and the protein expression of B lymphocyte tumor-2 （Bcl-2）， and enhance cysteine aspartic acid protease-3 （Caspase-3）， Bcl-2 related X protein （Bax） and phosphorylated <italic>β</italic>-catenin protein expression（<italic>P</italic><0.01）. Conclusion:PIC may inhibit the proliferation of MDA-MB-468 cells by inhibiting the Wnt/<italic>β</italic>-catenin signaling pathway， block the cell cycle in G0/G1 phase， and induce its apoptosis.

Determination of formic acid in urine by automatic headspace-gas chromatography-mass spectrometry / 中国职业医学

OBJECTIVE: To establish a method for the determination of formic acid in urine by automatic headspace-gas chromatography-mass spectrometry. METHODS: The urine sample was added with 3 mL 15.00%(V/V) sulfuric acid ethanol and heated in an automatic headspace sampler. The formic acid and ethanol underwent an esterification reaction to produce ethyl formate which was separated by gas chromatographic column and detected by mass spectrometer. The quantification was based on external standard method. RESULTS: The linear range of the method was 2.93-97.60 mg/L, with the regression equation correlation coefficient of 0.999 5. The detection limit was 0.65 mg/L and the minimum quantitative limit was 2.17 mg/L, with the recoveries of 95.61%-106.47%. The within-run relative standard deviation(RSD) ranged from 2.52% to 8.05% and the between-run RSD ranged from 6.58% to 8.42%. CONCLUSION: The method has simple pretreatment, good specificity, high precision and has little interference. It is suitable for large scale rapid determination of formic acid in urine in occupational contact population, patients with acute methanol poisoning and general population.

Role of cardiac magnetic resonance imaging in myocarditis patients with biopsy negative: a retrospective case series study / 中华心血管病杂志

Objective: To analyze the cardiac magnetic resonance (CMR) imaging feature of clinically diagnosed myocarditis patients with negative endocardial biopsy (EMB) results, and to further demonstrate the diagnostic value of CMR in these patients. Methods: This was a retrospective case series study. Fourteen patients, who were clinically diagnosed as myocarditis according to 2013 European Society of Cardiology (ESC) clinical diagnostic criteria for myocarditis, but with negative EMB results, were enrolled. All patients underwent CMR examinations. The morphological, functional and histological changes of the heart were assessed based on black blood sequence, cine sequence, T2W-STIR sequence and contrast agent late gadolinium enhancement,(LGE). Results: There were 10 males and 4 females in this cohort, the age was (25.6±13.2) years. The interval between symptom onset and CMR was 21 (13, 60) days, and the interval between symptom onset and EMB was 19 (9, 40) days. There were 13 patients with abnormal CMR results including myocardial oedema, fibrosis, decreased ejection fraction, pericardial effusion or increased cardiac chamber dimension. Nine out of 14 patients had CMR morphological and/or functional abnormalities, including 1 case of left atrium enlargement, 1 case of left ventricle enlargement, 3 cases of right ventricle enlargement, 4 cases of increased left ventricular end diastolic volume index. Left ventricular ejection fraction was<50% in three cases, right ventricular ejection fraction was<40% in 5 cases, and pericardial effusion depth>3 mm was detected in 3 cases. Of the 14 patients, 11 had histological changes, of which 6 had T2 ratio≥2. Among the 10 patients (10/14) with positive LGE, the most common patterns were subepicardial LGE of the lateral wall and/or midwall LGE of the septum (n=9); 2 cases showed extensively subendocardial LGE of the left ventricular wall. No LGE involved in the right ventricular wall in the whole cohort. Conclusion: CMR plays a complementary role in the diagnosis of myocarditis in clinically diagnosed myocarditis patients with negative EMB findings.

Clinical performance of rensin-bonded composite strip crowns in primary incisors / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical success of the treatment of maxillary anterior primary incisors caries with composite resin strip crowns.@*METHODS@#Children who presented with severe early childhood caries and were treated comprehensive caries under general anesthesia from January to December 2016 were enrolled in this study. Composite crowns using preformed celluloid crown (3M ESPE, USA) called as "strip crown technique" were applied to treat vital primary incisors with two or multiple surface cavities. Selective etchings of enamel, Universal Bond adhesive and 3M Z350 resin were used to make strip crowns. The patients returned at the end of 6, 12 and 18 months and received clinical and radiologic examinations. Dentists who did not attend the treatment evaluated the strip crowns clinically by modified United States Public Health Service (USPHS) criteria.@*RESULTS@#Four hundred eighteen restorations, placed in 127 children aged 1.17-5.75 years (average of 3.22), were evaluated. The overall retention rate was 97.8% at the end of 6 months, 93.6% at 12 months and 89.2% at 18 months. After 18 months, 28 restorations (6.7%) were totally lost and 4.1% were rated as having lost some resin material. Only four teeth (1.0%) had secondary caries at the end of 18 months and 1.4% teeth had pulpal pathology requiring root canal treatment. Composite crowns had good performance in contour and adjacent contact and improved aesthetics significantly. Twenty-nine teeth (6.9%) showed mild gingivitis and 93.1% showed healthy gingival. 11.2% of the teeth demonstrated color change because plaque accumulation and the polish could remove the stains. The complete loss of strip crowns was mainly related to eating bites.@*CONCLUSION@#Strip crowns performed well for restoring primary incisors with large or multisurface caries for periods of over 18 months. The strip crowns can be a durable and aesthetic restoration for vital carious primary incisors with adequate tooth structure after caries removal. Functional movement is an important cause of complete loss. Because of the high technical sensitivity and its requirement of the cooperation of children, strip crowns are more suitable for older and cooperative children as well as children receiving dental treatment under sedation or general anesthesia.

Late gadolinium enhancement distribution pattern of left ventricular wall in patients with dilated cardiomyopathy: a preliminary study / 中华心血管病杂志

Objective: To investigate the distribution pattern of late gadolinium enhancement (LGE) in left ventricular free wall of patients with dilated cardiomyopathy (DCM). Methods: A total of 130 consecutive DCM patients who were hospitalized in our hospital, underwent both CMR and CTA examinations and met the inclusion and exclusion criteria including negative results of coronary angiography or coronary CTA, were retrospective included in this study. The LGE pattern, extent and distribution in left ventricular free wall were analyzed. Results: Left ventricular free wall LGE was detected in 56 out of 130 DCM patients. LGE was observed in both septal and free wall in 53 out of 56 patients with LGE (94.6%). Prevalence of NYHA classification Ⅲ/Ⅳ, intraventricular block, paroxysmal ventricular tachycardia, and secondary mitral insufficiency was significantly higher, while left ventricular ejection fraction was significantly lower, left ventricular end-diastolic/systolic volume, left ventricular end-diastolic/systolic volume index and left ventricular end-diastolic diameters values were larger in patients with LGE than without LGE (all P<0.05). In terms LGE pattern among these 56 patients, percent of involved myocardial segments in patients with subepicardial LGE (n=19) was significantly higher than patients with intermural LGE (n=30), patients with transmural LGE (n=21), and patients with subendocardial LGE (n=9)(60.8%(127/209) vs. 32.4%(107/330), 32.5%(75/231), 26.3%(26/99), respectively, all P < 0.01). Transmural LGE was most likely to involve the left ventricular inferior lateral basal (18/21) and mid (13/21) segment, followed by anterior lateral basal (15/21) and mid (11/21) segments and inferior mid segment (9/21). Subepicardial LGE was more likely to occur in the inferior lateral basal (13/19) and mid (16/19) segment, anterior lateral basal (13/19) and mid (15/19) segment, anterior lateral basal (13/19) and mid (15/19) segment, lateral apical (13/19), anterior and inferior mid segment (12/19 and 10/19), and apical segment (15/19 and 10/19). Intermural LGE mostly involved the anterior and inferior basal (19/30, 16/30) and mid (18/30 and 14/30) segment. There were 33 cases of single LGE pattern and 23 cases of multiple LGE pattern. Percent of involved myocardial segments was significantly higher in multiple LGE group than single LGE group (60.9% (154/253) vs. 49.9%(181/363), P = 0.007). Of 130 patients, 23 received heart transplantation, of which 6 patients had septal LGE alone and 17 patients had septal and free wall LGE. The rate of heart transplantation in the latter group was higher (32.1% (17/53)vs. 13.6%(6/44), P=0.034). Conclusions: There are several LGE distribution patterns in left ventricular wall among DCM patients.

Distribution of Traditional Chinese Medicine Syndromes and Relevant Factors in 6 Months After Percutaneous Coronary Intervention / 中国实验方剂学杂志

Objective:To investigate the distribution of traditional Chinese medicine (TCM) syndromes in patients with coronary heart disease (CHD) in 6 months after interventional therapy, and to analyze relevant influencing factors. Method:The clinical data of 1 000 patients with coronary heart disease in 6 months after interventional therapy, including the four diagnosis information of TCM, were collected, and the distribution of TCM syndromes and the influencing factors were analyzed. Result:Among 48 kinds of information about the four diagnostic methods of TCM, chest pain was the most frequent (98.10%)， among 9 kinds of common TCM syndrome types, blood stasis was the most frequent (89.90%), and the others were heart-Qi deficiency syndrome, phlegm turbidity syndrome, cold-dampness syndrome, kidney-Qi deficiency syndrome, heart-Yin deficiency syndrome, kidney-Yin deficiency syndrome, Heart-Yang deficiency syndrome and kidney-Yang deficiency syndrome in turn. Among 6 common TCM syndrome types, Qi deficiency and blood stasis syndrome were the most frequent (35.40%), and the others were phlegm turbidity and blood stasis syndrome, cold congealing heart pulse syndrome, Qi-Yin deficiency syndrome, heart-kidney Yin deficiency syndrome and heart-kidney-Yang deficiency syndrome in turn. There was no significant difference in sex ratio among different syndrome types . Patients with heart-kidney Yang deficiency syndrome had no significant difference. Compared with the average age of other syndromes, there were significant differences. Common complications included hypertension, diabetes, cerebrovascular diseases and dyslipidemia, among which hypertension had the highest frequency, with significant differences from other diseases (P<0.05). Phlegm, turbidity and blood stasis were found in patients with hypertension. The risk of syndromes was higher (OR=3.29, 95% CI [2.11, 5.05]), while the risk of cold congealing heart pulse syndrome was lower (OR=0.56, 95% CI [0.32, 0.98]), the risk of Qi and Yin deficiency was higher (OR=2.88, 95% CI [2.01, 4.99]), whereas the risk of heart and kidney Yang deficiency was lower (OR=0.54, 95% CI [0.29, 0.95]) when complicated with cerebrovascular diseases. The risk of Qi deficiency and blood stasis was higher (OR=2.97, 95% CI [2.05, 5.28]), while the risk of heart and kidney Yang deficiency was lower (OR=0.54, 95% CI [0.29, 0.95])， the risk of phlegm turbidity and blood stasis was higher when complicated with dyslipidemia (OR=3.55, 95% CI [2.32, 5.29]), and the risk of heart and kidney Yang deficiency was lower (OR=0.54, 95% CI [0.29, 0.95]). The time distribution of the disease had obvious seasonal characteristics. Conclusion:The main distribution characteristics of TCM syndromes in 6 months after coronary heart disease intervention are basically the same as those in patients without intervention. The main TCM syndromes are Qi deficiency and blood stasis syndrome, phlegm turbidity and blood stasis syndrome, cold congealing heart pulse syndrome, Qi-Yin deficiency syndrome, heart-kidney Yin deficiency syndrome and heart-kidney-Yang deficiency syndrome. The distribution pattern may be related to age, complications and seasons.

Distribution Characteristics of Traditional Chinese Medicine Syndromes in Patients with Critical Lesions of Coronary Heart Disease / 中国实验方剂学杂志

Objective::To explore the distribution characteristics of traditional Chinese medicine (TCM) syndromes of critical lesions of coronary heart disease, and determine the classification and diagnostic criteria of syndromes, so as to provide reference for the differentiation and treatment of this disease. Method::Totally 1 000 patients with critical lesions of coronary heart disease treated in the Department of Cardiology, Yunnan Provinceal Hospital of TCM from January 2016 to December 2018 were selected as the subjects by clinical epidemiological research methods. Basic information, diagnosis and treatment of the patients, as well as the information obtained through observation, hearing, inquiry and pulse-taking of TCM were collected. Symptoms, signs, tongue signs, pulse signs and other four diagnostic information, as well as relevant clinical data were collected for mathematical statistics analysis by cluster analysis and factor analysis research methods, and expert group opinions were also included in discussion. Result::First, the results of cluster analysis showed six types of basic TCM syndromes in accordance with the clinically actual critical lesions of coronary heart disease: blood stasis syndrome, phlegm turbidity syndrome, cold congealing heart pulse syndrome, Qi deficiency syndrome, heart-kidney Yin deficiency syndrome, Heart-Yang deficiency syndrome. Second, a factor analysis was carried out on the basis of cluster analysis, and the main syndromes of each basic syndromes were preliminarily determined. Third, because of the duplicate content or the unified combination of different syndromes, the TCM syndromes of the critical lesions of coronary heart disease can be summarized in five categories, namely phlegm turbidity and blood stasis syndrome (368 cases, 36.80%), cold congestion heart pulse syndrome (156 cases, 15.60%), Qi deficiency and blood stasis syndrome (315 cases, 31.50%), Yin deficiency of heart and kidney (91 cases, 9.10%) and Heart-Yang depression (70 cases, 7.00%). The main and secondary syndromes refer to factor analysis results of six basic syndromes. Conclusion::Cluster analysis and factor analysis can be made on TCM syndromes of critical lesions of coronary heart disease to pave the way for the classification of TCM syndromes and the establishment of diagnostic criteria of TCM syndromes of coronary heart disease, with an important clinical significance.

Effects of artesunate combined with bortezomib on apoptosis and autophagy of acute myeloid leukemia cells in vitro and its mechanism / 中华血液学杂志

Objective: To investigate the effects of artesunate combined with bortezomib on the proliferation, apoptosis and autophagy of human acute myeloid leukemia cell lines MV4-11, and its mechanisms. Methods: MTT method was used to determine the anti-proliferation effect of different concentrations of artesunate, bortezomib and their combination on MV4-11 cells. The cell apoptosis were analyzed by flow cytometry. The expression of cleaved-Caspase-3, Bcl-2 family protein (Bcl-2, Mcl-1, Bim, Bax) and autophagy-related protein LC3B were assayed by Western blot. Results: Artesunate displayed a proliferation inhibition effect on MV4-11 with dose- and time-dependent manner, the IC(50) of artesunate on MV4-11 after 48 hours was 1.44 μg/ml. Bortezomib displayed a proliferation inhibition effect on MV4-11 with dose-dependent manner, the IC(50) of bortezomib on MV4-11 after 48 hours was 8.97 nmol/L. The combination of artesunate (0.75, 1.0 μg/ml) and Bortezomib (6, 8 nmol/L) showed higher inhibition on MV4-11 than artesunate or bortezomib alone in the same concentration gradient after 48 hours (P<0.05) . The cooperation index of the two drugs were all less than 1. The 48 h apoptotic rate of artesunate (1.5 μg/ml) on MV4-11 was (15.27±2.18) %, (19.85±3.23) % of bortezomib (8 nmol/L) , (81.67±5.96) % of combination of the two drugs, significantly higher than the single group (P<0.05) . When combination of the two drugs on MV4-11 after 24 hours, the levels of pro-apoptotic protein Bim and the cleaved activation of Caspase-3 and autophagy-related protein LC3B were up-regulated and the anti-apoptotic protein Bcl-2 expressions was down-regulated. Conclusion: Combination of artesunate with bortezomib shows a significant synergistic effects on proliferation, apoptosis and autophagy of MV4-11 cell lines, which may be associated with Bcl-2 family proteins expression.

Embolic effects of Bletilla striata microspheres in renal artery and transplanted VX2 liver tumor model in rabbits / 中国结合医学杂志

OBJECTIVES@#To evaluate the characteristics of Bletilla striata microspheres (BSMs) and its effects as an embolic agent in a rabbit model.@*METHODS@#BSMs were prepared with an emulsification-cool condensation-chemical cross-linking method. The characteristics of BSMs in vitro were observed. Embolization experiments were performed in renal artery of rabbit and in a rabbit liver VX2 carcinoma model. Seventy-two New Zealand rabbits were divided into 2 groups, and the right renal artery was embolized with BSMs (200 μm in diameter) in the experimental group and with polyvinyl alcohol (PVA) of the same size in the control group. The pathological findings were examined with hematoxylin-eosin and Masson stainings. Liver and renal functions were tested before and after embolization. VX2 tumor was transplanted in 15 New Zealand rabbits, which were randomly divided into 3 groups (n=5). Group A were treated with saline, group B with a mixture of doxorubicin and lipiodol, and group C with hepatic arterial infusion of BSMs (200 μm in diameter). Tumor growth rate was evaluated by magnetic resonance imaging scan. Apoptosis-related factors (bax, bcl-2) and tumor vascular endothelial cell growth factor (VEGF) were evaluated through immunohistochemical staining.@*RESULTS@#The characteristics of BSMs in vitro were in full compliance with the requirements for use in interventional procedures. In the renal artery embolization experiment, after BSMs intervention, it was more difficult to form collateral circulation than that with PVAs, and the kidney manifested atrophy and calcification. There were no significant difference of liver and renal functions in rabbits between groups. In the liver VX2 carcinoma embolization experiment, compared with group A, the growth rate of VX2 liver tumor and Bcl-2 levels was reduced, while apoptosis index, Bax, and VEGF were increased in group B (P0.05).@*CONCLUSIONS@#The characteristics of BSMs in vitro and in vivo meet the requirements for its use as an embolic agent in interventional approaches.

Study on quantification method of non-starch polysaccharides in Dendrobium catenatum / 中国中药杂志

The non-starch polysaccharides,mainly composed of glucomannans,are the major bioactive compounds in Dendrobium catenatum. In order to evaluate the quality of the medicinal materials and guide the production and processing,a quantification method of non-starch polysaccharides was established by stems of D. catenatum C15 strain collected from the pear epiphytic cultivation. The non-starch polysaccharides were obtained by " water extraction,α-amylase pretreatment,and alcohol precipitation once" method. The contents of starches,non-starch polysaccharides and monosaccharides were analyzed. In addition,the system suitability was tested. Compared with method of the Chinese Pharmacopoeia( 2015 edition),the contents of total polysaccharides,glucose,and mannose were decreased by 20. 9%,58. 8% and 1. 6% respectively. The method effectively digested starch and retained non-starch polysaccharides,and the analysis result was accurate and repeatable. Therefore,it is suitable for the content measurement of non-starch polysaccharides of D. catenatum. Furthermore,it could be an alternative method for quality control of D. catenatum and a reference in the determination of non-starch polysaccharides in other starch-containing medicinal materials.

Identification of Illicium difengpi and Its Fake I. jiadifengpi Using DNA Barcoding / 中国实验方剂学杂志

Objective:To evaluate and compare the identification of several DNA barcoding candidate sequences on Illicium difengpi and its fake I. jiadifengpi. Method:Samples from different origins of I. difengpi and I. jiadifengpi, were collect extraction of total DNA,nuclear gene ITS2 sequence,chloroplast rbcL,matK gene sequence were selected for PCR amplification,product purification and sequencing,and CondonCode Aligner V3.7.1 was used to proofread stitching. Result:PCR amplification and sequencing of rbcL sequences of I. difengpi and I. jiadifengpi were not satisfactory. It is assumed that their rbcL sequences were too long with slow evolution,which was unsuitable for interbreeding. The success rate of matK sequencing of I. difengpi and I. jiadifengpi was 0 and 76.8%,which may be because primer standards were different for matK sequences of different groups. The results of PCR amplification and sequencing of ITS2 on I. difengpi and I. jiadifengpi were successful,with the success rate of sequencing was 89.3% and 91.2%. Analysis sequencing results, the total length of ITS2 sequences was 268 bases,and there were 2 variation sites of I. difengpi. The total length of ITS2 sequences was 430 bases,and there were 4 or 3 variation sites of I. jiadifengpi. It shows that ITS2 sequences of I. difengpi and I. jiadifengpi were short and has obvious variability and can be amplify,that ITS2 sequence was better than rbcL and matK sequence in molecular identification of I. difengpi and I. jiadifengpi. Conclusion:DNA barcoding based on ITS2 sequence was a powerful and efficient tool for identification of I. difengpi and its fake I. jiadifengpi.

Observation Effect of Erbao Granule on Children with Diarrhea Due to Spleen Deficiency / 中国实验方剂学杂志

Objective:To observe the effect of Erbao grains on levels of immunoglobulin, T cells, secretory immunoglobulin A from feces, and intestinal microecology index of children with diarrhea due to spleen deficiency. Method:One hundred and eighty patients with diarrhea due to spleen deficiency were randomly divided into control group (90 cases) and observation group (90 cases) by random number table. Patients in control group got Montmorillonite powder. In addition to the therapy in control group, patients in observation were additionally given Erbao grains. And the course of treatment was 10 days. Before and after treatment, levels of serum immunoglobulin G (IgG), IgM, IgA, CD3+, CD4+, CD8+, ratio CD4+and CD8+, secretory immunoglobulin A from feces (SIgA), activity of salivary amylase and urine D-xylose were detected, the main symptoms and signs were scored, and the safety was discussed. Result:After treatment, the clinical total effective rate in observation group was 95.56%, which was higher than 80%in control group (χ2=10.149, PPP+, CD4+, CD4+/CD8+, activity of salivary amylase and urine D-xylose were higher than those in control group (PPConclusion:In addition to the therapy of Montmorillonite powder, Erbao grains can relieve the symptoms of children with diarrhea due to spleen deficiency, improve the efficacy, and ameliorate immunity of children.