Gastrodin inhibits microglia-mediated inflammatory response in isch-emic hypoxic neonatal mice via CCR5/JAK1/STAT1 signaling pathway / 中国病理生理杂志

AIM:To investigate the effect of gastrodin(GAS)on microglia-mediated inflammatory response after hypoxic-ischemic brain damage(HIBD)neonatal mice by regulating the expression of JAK1/STAT1 pathway through C-C chemokine recepeor 5(CCR5).METHODS:Forty-eight C57BL/6J mice at about 10 days after birth were randomly divided into sham group,HIBD model group and HIBD+GAS group.BV-2 microglia were divided into control(Con)group,oxygen glucose deprivation(OGD)group,oxygen glucose deprivation with gastrodin intervention(OGD+GAS)group,GAS group,Maraviroc(MVC)group,OGD+MVC group,and OGD+MVC+GAS group.The mRNA expression of CCL4 and CCR5 were detected by RT-qPCR.The protein expression of CCR5,p-JAK1,p-STAT1,tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)were detected by Western blot.The expression of CCR5,p-JAK1 and p-STAT1 in cells were observed by immunofluorescence staining.RESULTS:(1)Compared with sham group,the expression levels of CCL4 and CCR5 mRNA,and CCR5,p-JAK1 and p-STAT1 proteins were significantly higher in the ischemic side of the corpus callosum in HIBD group(P＜0.05).(2)Compared with Con group,the protein levels of CCR5,p-JAK1 and p-STAT1 significantly increased in BV-2 cells of OGD group(P＜0.05).The protein levels of CCR5,p-JAK1 and p-STAT1 in BV-2 cells of OGD+GAS group were significantly lower than those of OGD group(P＜0.05).(3)Maraviroc did not cause significant BV-2 cell death in the 0～80 μmol/L range.The p-JAK1 and p-STAT1 protein levels in MVC+OGD group were significantly lowered compared with OGD group(P＜0.05),but no significant difference was found between MVC+ OGD and OGD+MVC+GAS groups.CONCLUSION:Gastrodin can exert neuroprotective effects via CCR5/JAK1/STAT1 signaling pathway.

Comparison on effects among different modes of cardiac resynchronization therapy / 重庆医学

Objective To investigate the application effects of cardiac resynchronization therapy(CRT)of[left bundle optimization(LOT)]and biventricular pacing(BiV)in the patients with chronic heart failure complicating left bundle branch block.Methods The single center,prospective and non-randomized controlled study method was used.Forty-two patients with heart failure meeting CRT in this center from April 2020 to April 2022 were consecutively included.Among them,32 cases adopted the BiV-CRT(BiV-CRT group)and 10 cases adopted LOT-CRT(LOT-CRT group).The pacing-making parameters,quality of life scale(SF-36)score,6-min walk test(6-MWT),ECG QRS width(QRSd),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and New York cardiac function grade(NYHA)situation were collected before surgery,after surgery immediately and in postoperative 3,6,12 months.Their complica-tions and clinical outcomes were evaluated.Results The pacing threshold value in the LOT-CRT group was stable and lower than that in the BiV-CRT group(P＜0.05);QRSd in postoperative 12 months in the LOT-CRT group was shorter than that in the BiV-CRT group[(115.0±14.3)ms vs.(133.0±14.0)ms,P＜0.05]and 6-MWT was longer than that in the BiV-CRT group[(327.0±52.8)m vs.(274.0±52.8)m,P＜0.05],and the differences were statistically significant(P＜0.05);LVEF,LVEDD,NYHA cardiac grade and SF-36 score in postoperative 12 months were improved compared with those before implantation.The rehospitaliza-tion rate of heart failure in the LOT-CRT group was lower.Conclusion LOT-CRT could obtain a narrower QRS wave and longer 6-MWT than BiV-CRT.

Natural Products Treat Atopic Dermatitis via NF-κB Signaling Pathway： A Review / 中国实验方剂学杂志

Atopic dermatitis （AD） is a chronic， recurrent， inflammatory， and pruritus skin disease caused by multiple internal and external factors， ranking first in the global burden of skin diseases. Due to the adverse reactions and high costs of conventional treatments and biologics， the development of natural products has attracted much attention. The nuclear factor-κB （NF-κB） signaling pathway is a key pathway for inhibiting inflammation and modulating immunity. This paper summarizes the pharmacological effects and molecular mechanisms of natural products such as flavonoids， alkaloids， phenols， terpenoids， coumarins， glycosides， and anthraquinones via NF-κB signaling pathway， aiming to provide guidance for the development of natural products. Basic studies have shown that natural products have high safety and efficacy. Oral or topical administration of natural products can regulate the phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）， mitogen-activated protein kinase （MAPK）， nuclear factor erythroid 2-related factor 2 （Nrf2）， high mobility group box 1 protein （HMGB1）/receptor for advanced glycation endproducts （RAGE）， and nucleotide-binding oligomerization domain-like receptor protein 3 （NLRP3） signaling pathways to exert anti-inflammatory， anti-allergy， antioxidant activities， thus reversing the pathological changes of AD. However， it is worth noting that the clinical application of natural products is still insufficient， and more rigorous clinical trials are still needed to verify their effects. The basic experiments and clinical evidence prove that natural products may play a role in alleviating AD， which provide a basis for evaluating the functioning mechanism of natural active substances and enrich the candidates for the development of potential drugs.

Stability study of umbilical cord mesenchymal stem cells formulation in large-scale production / 药学学报

Umbilical cord mesenchymal stem cells (UC-MSCs) have been widely used in regenerative medicine, but there is limited research on the stability of UC-MSCs formulation during production. This study aims to assess the stability of the cell stock solution and intermediate product throughout the production process, as well as the final product following reconstitution, in order to offer guidance for the manufacturing process and serve as a reference for formulation reconstitution methods. Three batches of cell formulation were produced and stored under low temperature (2-8 ℃) and room temperature (20-26 ℃) during cell stock solution and intermediate product stages. The storage time intervals for cell stock solution were 0, 2, 4, and 6 h, while for intermediate products, the intervals were 0, 1, 2, and 3 h. The evaluation items included visual inspection, viable cell concentration, cell viability, cell surface markers, lymphocyte proliferation inhibition rate, and sterility. Additionally, dilution and culture stability studies were performed after reconstitution of the cell product. The reconstitution diluents included 0.9% sodium chloride injection, 0.9% sodium chloride injection + 1% human serum albumin, and 0.9% sodium chloride injection + 2% human serum albumin, with dilution ratios of 10-fold and 40-fold. The storage time intervals after dilution were 0, 1, 2, 3, and 4 h. The reconstitution culture media included DMEM medium, DMEM + 2% platelet lysate, 0.9% sodium chloride injection, and 0.9% sodium chloride injection + 1% human serum albumin, and the culture duration was 24 h. The evaluation items were viable cell concentration and cell viability. The results showed that the cell stock solution remained stable for up to 6 h under both low temperature (2-8 ℃) and room temperature (20-26 ℃) conditions, while the intermediate product remained stable for up to 3 h under the same conditions. After formulation reconstitution, using sodium chloride injection diluted with 1% or 2% human serum albumin maintained a viability of over 80% within 4 h. It was observed that different dilution factors had an impact on cell viability. After formulation reconstitution, cultivation in medium with 2% platelet lysate resulted in a cell viability of over 80% after 24 h. In conclusion, the stability of cell stock solution within 6 h and intermediate product within 3 h meets the requirements. The addition of 1% or 2% human serum albumin in the reconstitution diluent can better protect the post-reconstitution cell viability.

Diagnostic value of endoscopic ultrasound-guided tissue acquisition with rapid on-site evaluation performed by endoscopists in immunohistochemistry-required solid pancreatic lesions / 中华胰腺病杂志

Objective:To evaluate the diagnostic value of rapid on-site evaluation (ROSE) performed by endoscopists for solid pancreatic lesions requiring tissue for immunohistochemistry (IHC) staining with different approach of endoscopic ultrasound-guided tissue acquisition (EUS-TA).Methods:After screening 1 573 cases who underwent EUS-TA operation at the Endoscopy Center of Peking Union Medical College Hospital between August 2018 and October 2022, a total of 65 cases of solid pancreatic lesions whose diagnosis rely on IHC staining was collected and summarized with clinical data of each case. Among 65 cases, there were 46 cases of pancreatic neuroendocrine tumors (PNETs), 13 cases of pancreatic solid pseudo-papillary tumors (SPTs), and 6 cases of lymphomas and mesenchymal. Patients were categorized into ROSE group (36 cases) and non-ROSE group (29 cases) according to the presence or absence of endoscopists performed ROSE during EUS-TA operation. They were further divided into subgroups of FNA-ROSE (26 cases), FNB-ROSE (10 cases), FNA-non-ROSE (24 cases) and FNB-non-ROSE (5 cases) according to the type of EUS-TA. Diagnostic accuracy and IHC success rate were compared between different groups and subgroups. Binomial logistic multifactorial regression analysis was used to evaluate the influence of ROSE and EUS-TA type on diagnostic accuracy and IHC success rate.Results:There were no statistically significant differences between ROSE group and non-ROSE group in terms of age, gender, bilirubin level, CA19-9 level, lesion site, lesion size, composition ratio of diagnosis, and surgical rate. The differences in mean size of lesions, needle gauge, location of puncturation, and number of needle pass between subgroups were not statistically significant. The diagnostic accuracy was 88.9% in ROSE group and 79.3% in non-ROSE group, and the difference between the two groups was statistically significant ( P=0.023). The diagnostic accuracy of FNA-ROSE group was higher than that of FNA-non-ROSE group (88.5% vs 75.0%), but the difference was not statistically significant ( P>0.100). The differences in diagnostic accuracy and success rate of IHC between FNB-ROSE group and FNB-non-ROSE group were not statistically significant. Binomial logistic multifactorial regression analysis did not reveal any independent influences on diagnostic accuracy. Conclusions:ROSE performed by endoscopists improved diagnostic accuracy of EUS-TA in solid pancreatic lesions requiring IHC staining, and therefore is potentially valuable for improving the diagnostic efficiency of EUS-TA for such diseases.

Clinical analysis of 25 patients with type 2 autoimmune pancreatitis / 中华胰腺病杂志

Objective:To explore the clinical characteristics and outcomes of type 2 autoimmune pancreatitis (AIP) and compare with type 1 AIP.Methods:Clinical data of the patients diagnosed with type 2 AIP by the International Consensus on diagnostic criteria of AIP at Peking Union Medical College Hospital from January 2001 to December 2022 were retrospectively analyzed, and type 1 AIP patients diagnosed in Peking Union Medical College Hospital from January 1985 to December 2016 were collected as controls. The clinical symptoms, treatments and follow-ups were analyzed.Results:A total of 25 patients with type 2 AIP were included, of which 16 cases (64.0%) were pathologically confirmed cases (13 cases by endoscopic ultrasound puncture, 2 cases by surgery, and 1 case by interventional puncture), and 9 cases (36.0%) were suspected. The average age of onset was 40 years old. Most patients ( n=23, 92.0%) had abdominal pain along with emaciation to a various degree. Among them, 3 cases primarily presented as acute pancreatitis. Two cases were diagnosed after surgery for pancreatic masses. Eighteen cases were complicated with inflammatory bowel disease, including 16 cases with ulcerative colitis, one case with Crohn's disease, and one case with indeterminate colitis. All patients had typical imaging manifestations, including 13 cases (52.0%) with diffuse pancreatic enlargement, 12 cases (48.0%) with focal or multifocal pancreatic lesions, and 5 cases (20.0%) with simultaneous focal pancreatic masses and diffuse enlargement. All patients had normal serum IgG4 levels, anti-neutropil cytoplasmic antibodies (ANCA) positivity rate was 35.3% (6/17), and anti-nuclear antibody (ANA) positivity rate was 29.2% (7/24). Two surgical patients recovered well after surgery, and the other patients all achieved clinical and imaging relief after hormone therapy, and no recurrence was seen during follow-up. Compared with type 1 AIP, type 2 AIP had younger onset age, main manifestation as abdominal pain without jaundice, rare involvement with extra-pancreatic organs, the lesions mainly located in the intestine and normal IgG4 level with statistically significant differences. The recurrence rate of type 2 AIP was lower than that of type 1 AIP (0 vs 16%). Conclusions:Type 2 AIP has different clinical characteristics from type 1 AIP. Due to the lack of specific serum markers, the diagnosis is more difficult. It responds well to glucocorticoids and has a low recurrence rate.

Potential categories of health risk behaviors of college students in Wuling Mountain Area and its association with campus bullying / 中国学校卫生

Objective@#To understand the potential categories of harmful behaviors of college students in Wuling Mountain Area and its relationship with campus bullying, so as to provide a theoretical basis for promoting the development of college students physical and mental health.@*Methods@#The stratified random cluster sampling method was used to select 3 042 college students from six universities in Wuling Mountain Area from October to December, 2022. The "Chinese Youth Health Related/Risk Behaviors Questionnaire" (University Edition) compiled by the National Youth Health Related/Risk Behaviors Survey Group was used to investigate the health risk behaviors. The potential category analysis method was used to analyze the food preference, insecurity, fighting, loneliness, depression, insomnia, heartbreak, suicidal ideation, smoking, drinking, game addiction, Internet addiction of health risk behaviors were used to further analyze the relationship between different categories and campus bullying by using multi category Logistic regression method.@*Results@#College students in Wuling Mountain Area were classified into low risk group of category 1 (44.2%), category 2 (5.4%) substance dependent group, category 3(50.4%) emotional disorder group. The distribution of potential categories of health risk behaviors among college students was statistically significant by gender( χ 2=31.44, 11.69， P < 0.05 ). Logistic regression analysis showed that after controlling demographic variables, campus bullying was the risk factor of category 3 emotional disorder group( OR =1.88, P <0.01).@*Conclusion@#bullying. Colleges and universities should attach great importance to the occurrence of campus bullying, formulate intervention programs for different categories of health hazard behaviors, and promote the healthy development of college students physical and mental health.

Aucubin combined with ADSCs-exos protects TBHP-induced nucleus pulposus cells via TLR4/NF-κB pathway / 中国中药杂志

This paper aims to investigate the effects and mechanisms of adipose-derived stem cells-exosomes(ADSCs-exos) toge-ther with aucubin in protecting human-derived nucleus pulposus cells(NPCs) from inflammatory injury, senescence, and apoptosis. The tert-butyl hydroperoxide(TBHP)-induced NPCs were assigned into normal, model, aucubin, ADSCs-exos, and aucubin+ADSCs-exos groups. The cell viability was examined by cell counting kit-8(CCK-8), cell proliferation by EdU staining, cell senescence by senescence-associated-β-galactosidase(SA-β-Gal), and cell cycle and apoptosis by flow cytometry. Enzyme-linked immunosorbent assay was employed to examine the expression of interleukin-1β(IL-1β), IL-10, and tumor necrosis factor-α(TNF-α). Real-time fluorescence quantitative PCR and Western blot were employed to determine the mRNA and protein levels of aggregated proteoglycan(aggrecan), type Ⅱ collagen alpha 1(COL2A1), Toll-like receptor 4(TLR4), and nuclear factor-kappa B(NF-κB). The results showed that compared with the model group, the aucubin or ADSCs-exos group showed enhanced viability and proliferation of NPCs, decreased proportion of G_0/G_1 phase cells, increased proportion of S phase cells, reduced apoptosis and proportion of cells in senescence, lowered IL-1β and TNF-α levels, elevated IL-10 level, down-regulated mRNA and protein levels of TLR4 and NF-κB, and up-regulated mRNA and protein levels of aggrecan and COL2A1. Compared with the aucubin or ADSCs-exos group, the aucubin+ADSCs-exos combination further increased the viability and proliferation of NPCs, decreased the proportion of G_0/G_1 phase cells, increased the proportion of S phase cells, reduced the apoptosis and proportion of cells in senescence, lowered the IL-1β and TNF-α levels, elevated the IL-10 level, down-regulated the mRNA and protein levels of TLR4 and NF-κB, and up-regulated the mRNA and protein levels of aggrecan and COL2A1. In summary, both aucubin and ADSCs-exos could exert protective effects by inhibiting inflammatory responses, reducing apoptosis and senescence of NPCs, improving cell viability and proliferation as well as extracellular matrix synthesis, which may be associated with the inhibition of TLR4/NF-κB signaling pathway activation. The combination of both plays a synergistic role in the protective effects.

A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies / 中华血液学杂志

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.

Evaluation of the efficacy of endoscopic posterior nasal neurectomy with pharyngeal neurectomy of allergic rhinitis combined with chronic rhinosinusitis with nasal polyps / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the effect of posterior nasal neurectomy（PNN） with pharyngeal neurectomy （PN） on chronic sinusitis with nasal polyps （CRSwNP）complicated with perennial allergic rhinitis （PAR）. Methods:83 patients with perennial allergic rhinitis combined with chronic group-wide sinusitis with nasal polyps who attended our hospital from July 2020 to July 2021 were selected. All patients underwent conventional functional endoscopic sinusitis surgery（FESS）+ nasal polypectomy. Patients were divided according to whether they underwent PNN+PN. 38 cases in the experimental group underwent FESS combined with PNN+PN; 44 cases in the control group underwent conventional FESS alone. All patients underwent the VAS, RQLQ, and MLK before treatment, and at 6 months and 1 year after surgery. Meanwhile, other relevant data were collected and the preoperative and postoperative follow-up data were collected and analyzed to assess the differences between the two groups. Results:The total postoperative follow-up period was 1 year. The recurrence rate of nasal polyps at 1 year postoperatively and the nasal congestion VAS score at 6 months postoperatively were not statistically significant in the two groups（P>0.05）. However, the patients in the experimental group had statistically significantly lower effusion and sneezing VAS scores, MLK endoscopy scores and RQLQ scores at 6 months and 1 year postoperatively, and nasal congestion VAS scores at 1 year postoperatively compared to the control group（P<0.05）. Conclusion:For patients with perennial AR complicated with CRSwNP, the combination of the PNN+PN in FESS can significantly improve the short-term curative effect, and PNN+PN is a safe and effective surgical treatment.

Clinical application of special fluoroscopy method in the treatment of distal radius fractures with volar locking plate / 中国骨伤

OBJECTIVE@#The relationship between the distal screws and the wrist articular surface was assessed by the additional lateral oblique fluoroscopic view during the operation, and the dorsal tangential view of the wrist was used to observe whether the distal screw penetrated the dorsal cortex, so as to evaluate the clinical efficacy of the volar locking plate in the treatment of distal radius fractures.@*METHODS@#From January 2020 to June 2021, 45 cases of fresh distal radius fractures were treated using the volar Henry's approach, including 20 males and 25 females, aged from 32 to 75 years old with an average of (52.4±8.1) years old. During the operation, they were divided into 2 groups according to the different intraoperative fluoroscopic views:the control group of 20 cases, treated with standard anteroposterior and lateral fluoroscopic view;25 cases in the observation group, additional lateral oblique fluoroscopic view and dorsal tangential view of the wrist were taken. The wrist joint function score and postoperative complications were evaluated at 6 weeks, 3 and 6 months after operation between two groups.@*RESULTS@#All 45 patients were followed up and the duration ranged from 6 to 14 months, with an average of (10.8±1.7) months, all patients achieved bone union and the incision healed well. The incidence of postoperative complications in the observation group was lower than that in the control group, and the difference was statistically significant (P<0.05). In terms of Gartland-Werley score of wrist joint function, the score of wrist function in the observation group was (4.58±1.31) at 6 weeks, (2.98±0.63) at 3 months and (1.95±0.65) at 6 months post-operatively, which were better than those in the control group (6.32±1.96) at 6 weeks, (3.63±0.76) at 3 months and (2.43±0.73) at 6 months. The difference was statistically significant (P<0.05). In the observation group, 7/25 cases(28%) were found to have screw penetration during the operation by additional lateral oblique and dorsal tangential radiograph fluoroscopic views of wrist.@*CONCLUSION@#The addition of lateral oblique and dorsal tangential during the operation could improve the accuracy of distal screw placement, reduce postoperative complications, and achieve early functional exercise.

To explore the effects of blood-letting at jing points and auricular tips on body temperature and inflammatory factors in emergency patients with coronavirus disease 2019 based on real world / 中国中西医结合急救杂志

Objective To observe the effect of exsanguination at jing points and auricular tips on antipyretic effect and inflammation factors level in patients with fever caused by coronavirus disease 2019(COVID-19).Methods A retrospective study was conducted.A total of 521 febrile patients with COVID-19 admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from January 1 to 10,2023 were selected as the study subjects.The patients were divided into the control group(treated with conventional treatment)and the experimental group(treated with exsanguination of jing points and auricular tips based on the control group)according to whether they received traditional Chinese medicine(TCM)exsanguination treatment.The body temperature before treatment and 30 minutes and 4 hours,24 hours after treatment,the immediate(within 30 minutes)antipyrexia efficiency,the time of body temperature returning to normal,and the levels of inflammatory factors before treatment and 48 hours after treatment were collected,and the differences between the two groups were compared.According to the standard of fever relief≥1℃within 4 hours,the differences of the average onset time of fever and the rate of fever relief at 2.5,3 and 4 hours after treatment were compared between the two groups.Kaplan-Meier curve was drawn to analyze the change of 4-hour antipyrexia rate in the two groups before and after matching.Results A total of 169 cases in the experimental group and 352 cases in the control group were finally included.Because this study was retrospective,there were significant differences in the course of disease and underlying diseases(chronic bronchitis,diabetes,renal insufficiency,hepatobiliary diseases)between the two groups at baseline(all P＜0.05).In order to reduce the differences,the above 4 factors were included in the predictor variables,and a 1∶1 propensity matching was performed to match 166 pairs of case samples,which were comparable.The result showed body temperature of the two groups gradually decreased with the extension of time,and the body temperature of the experimental group was significantly lower than that of the control group at each time point(℃:30 minutes was 38.32±0.22 vs.38.43±0.24,4 hours was 37.67±0.32 vs.38.13±0.51,24 hours was 37.03±0.38 vs.37.14±0.51,all P＜0.05),the immediate antipyrexia efficiency was significantly higher than that of the control time group[63.86%(106/166)vs.44.58%(74/166),P＜0.05],and the time of body temperature recovery to normal was significantly shorter than that of the control group(hours:19.25±7.79 vs.38.90±17.17,P＜0.05).In terms of the 4 hours antipyretic onset dynamic time,the average antipyretic onset time of the experimental group was significantly shorter than that of the control group[hours:4.39(4.11,4.68)vs.7.16(6.71,7.61),P＜0.05],the fever relief rates at 2.5,3 and 4 hours were significantly higher than those in the control group[6.63%(11/166)vs.0.60%(1/166),24.10%(40/166)vs.4.82%(8/166),74.10%(123/166)vs.38.55%(64/166),respectively,all P＜0.05].Kaplan-Meier curve analysis showed that there were statistically significant differences in 4 hours fever reduction rates between the two groups before and after matching(all P＜0.05).In terms of inflammatory factors,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in the two groups after treatment were significantly lower than those before treatment[hs-CRP(mg/L):control group was 32.03±15.38 vs.79.78±13.34,experimental group was 33.21±16.07 vs.80.03±14.66;TNF-α(μg/L):control group 2.91±0.88 vs.5.09±0.95,experimental group 2.83±0.98 vs.5.10±0.87;IL-6(ng/L):control group was 96.30±48.12 vs.206.48±56.70,experimental group was 94.01±45.13 vs.202.38±55.38,all P＜0.05],but there was no significant difference in the levels of the above indicators between the two groups after treatment.Conclusion Exsanguination at the jing points and auricular tips has a good antipyretic effect in the treatment of fever caused by COVID-19,which can accelerate the antipyretic time,improve the antipyretic efficiency,and reduce the level of inflammatory factors.

Research Advance in Primary Liver Cancer of qi Stagnation and Blood Stasis Pattern / 世界科学技术-中医药现代化

Primary liver cancer(PLC)is one of the most common malignant tumors of digestive system in clinic.TCM plays an important role in the treatment of PLC.After sorting out the medical records and literatures related to the syndrome types of primary liver cancer in recent years,it was found that the syndrome type of qi stagnation and blood stasis was one of the important syndrome types of primary liver cancer.This article discusses and supplements the syndrome type of qi stagnation and blood stasis from the aspects of etiology and pathogenesis,proportion of syndrome types,staging of liver cancer,objective indicators of liver cancer,etc.It provides a new understanding for the treatment of primary liver cancer based on syndrome differentiation,so as to improve the clinical cure rate of liver cancer,alleviate the clinical symptoms of patients,improve the quality of life,and prolong the survival period.

Effect of dual wavelength laser in the treatment of chronic periodontitis and the influence of cytokines in gingival crevicular fluid / 中国医师进修杂志

Objective:To investigate the clinical efficacy and prognostic factors of Neodymium doped: Yttrium Aluminum Garnet (Nd:YAG ) laser combined with Erbium:Yttrium Aluminum Garnet (Er:YAG) laser assisted subgingival scaling root planing (SRP) in the treatment of periodontitis.Methods:A prospective research method was adopted. A total of 66 patients with periodontitis treated in Hebei Chest Hospital from August 2018 to August 2020 were selected and divided into experimental group and control group according to the random number table method, with 33 cases in each group. The control group was treated with SRP, and the experimental group received Er:YAG laser curettage combined with root surface leveling on the basis of SRP, and irradiated the periodontal pocket with Nd:YAG laser. The changes of periodontal clinical indicators and cytokine levels in gingival crevicular fluid were examined before treatment, 4 weeks and 12 weeks after treatment. The patients were divided into PD<3 mm group and PD ≥ 3 mm group according to the probing depth (PD) of periodontal pocket after 12 weeks of treatment, the clinical data of the two groups were compared and analyzed, and the Logistic regression analysis was performed to analyze the risk factors affecting the prognosis of patients with periodontitis after laser treatment.Results:After 4 and 12 weeks of treatment, the PD, clinical attachment loss (CAL), sulcus bleeding index (SBI) and plaque index (PLI) of the two groups were significantly lower than those before treatment ( P<0.05), and the PD, CAL, SBI and PLI in experimental group were significantly lower than those in control group, after 4 weeks of treatment: (3.36 ± 0.21) mm vs. (3.91 ± 0.39) mm, (4.14 ± 0.67) mm vs. (4.75 ± 0.73) mm, (1.83 ± 0.20) scores vs. (2.58 ± 0.17) scores, (1.29 ± 0.24) scores vs. (1.61 ± 0.52) scores; after 12 weeks of treatment: (3.04 ± 0.28) mm vs. (3.66 ± 0.54) mm, (3.91 ± 0.47) mm vs. (4.68 ± 0.66) mm, (0.88 ± 0.06) scores vs. (1.35 ± 0.14) scores, (1.05 ± 0.31) scores vs. (1.57 ± 0.56) scores, the differences were statistically significant ( P<0.05). After 12 weeks of treatment, the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-8 (MMP-8) and interleukin-1β (IL-1β) in gingival crevicular fluid in experimental group were significantly decreased compared with those in control group: (2.95 ± 0.19) μg/L vs. (4.32 ± 0.84) μg/L, (2.63 ± 0.82) μg/L vs. (3.58 ± 0.51) μg/L, (12.42 ± 1.19) μg/L vs. (13.26 ± 0.68) μg/L, (4.15 ± 1.12) ng/L vs. (5.36 ± 0.42) ng/L, (2.65 ± 0.08) ng/L vs. (4.12 ± 0.19) ng/L, the differences were statistically significant ( P<0.05), while the level of transforming growth factor-β (TGF-β) was significantly increased compared with that in control group: (51.35 ± 8.95) ng/L vs. (44.90 ± 5.84) ng/L, and the differences between the groups were statistically significant ( P<0.05). Logistic regression analysis showed that the clinical indexes PD, SBI, PLI, IL-6, IL-8, TNF- α, MMP-8, IL-1β and crown root ratio of gingival crevicular fluid were all the risk factors for prognosis of periodontitis treated with dual wavelength laser ( P<0.05). Conclusions:Nd:YAG laser combined with Er:YAG laser assisted SRP can obtain good curative effect in the treatment of periodontitis. Periodontal clinical indexes PD, SBI, PLI, gingival crevicular fluid IL-6, IL-8 and TNF-α, MMP-8, IL-1β level and crown root ratio were independent risk factors for the prognosis of periodontitis treated with dual wavelength laser.

Comparison of modified "double flaps" pyeloplasty and traditional pyeloplasty in the treatment of special types of hydronephrosis in children / 中华泌尿外科杂志

Objective:To compare the efficacy of modified "double flaps" pyeloplasty and traditional dismembered pyeloplasty in the treatment of special types of hydronephrosis with small pelvis and long proximal ureteral stricture in children.Methods:The data of 39 children with special types of hydronephrosis treated in Seventh Medical Center, General Hospital of PLA from June 2018 to June 2019 were retrospectively analyzed. Among them, 33 were boys and 6 were girls. The median age of the patients was 12.0(4.5, 63.5) months. Nine of them had left hydronephrosis and four children had right hydronephrosis. These patients with small pelvis existed the characteristics that the anteroposterior diameter of pelvis was smaller than 2.5 cm and these patients existed the symptom of hematuria, flank pain or recurrent urinary tract infection with the imaging revealing ureteral obstruction. The length of proximal ureteral stenosis ranged from 2.0 to 4.0 cm. Among 39 cases, 19 cases were operated with modified "double flaps" pyeloplasty, which was the modified "double flaps" pyeloplasty group. 20 cases were operated with traditional Anderson-Hynes pyeloplasty, which was traditional pyeloplasty group. The technique of modified "double flaps" pyeloplasty mainly included that the renal pelvis was cut into double flaps, the inferior flap was anastomosed with the spatulated ureter and the superior was covered, so that the length and caliber of the ureter were partial extended. The median age of two groups were 12.0 (6.0, 44.0) months and 12.0 (4.8, 62.8) months respectively, the anterior and posterior diameter of renal pelvis were (2.8±0.8)cm and (2.6±0.6)cm respectively, and split renal function were (36.7±5.1)% and (36.0±6.8)% respectively. There were no statistically significant differences in above parameters between the two groups( P>0.05). The clinical efficacy of the two groups were compared by collecting and comparing the operation related data and postoperative follow-up data. Results:The operation of 39 children in this study was successfully completed without conversion to open surgery.The operation time of "double flap" pyeloplasty group and traditional pyeloplasty group were (142.6±9.6) min and (124.5±8.6) min respectively, and the intraoperative anastomosis time were (56.1±7.2) min and (47.6±4.8) min respectively. There were significant difference in operation time and intraoperative anastomosis time between the two groups( P<0.05). Thirty-nine children were followed up normally without loss. The mean follow-up time was (27.7±2.5) months after surgery. In the "double flaps" pyeloplasty group, 2 cases suffered with fever who were diagnosed as urinary tract infection and improved after antibiotic treatment. In the traditional pyeloplasty group, 2 cases suffered with fever who were diagnosed as urinary tract infection and improved after antibiotic treatment. Two children had flank pain during follow-up to more than one year and the examination revealed that the anteroposterior diameter of the renal pelvis gradually increased. So surgery were performed again and the two children recovered. There were no significant differences in complication rate (2/19 and 4/20) and short-term surgical success rate(19/19 and 18/20) between the two groups ( P>0.05). Conclusions:The operation time and anastomosis time of the modified "double flap" technique for treating hydronephrosis are longer than those of the traditional method. But in the treatment of special types of hydronephrosis with small renal pelvis or long proximal ureteral stricture, it may have application prospects in reducing complications.

Natural orifice transluminal endoscopic lithotripsy with intelligent control of renal pelvic pressure for staghorn calculi with infection: a case report with surgical video / 中华泌尿外科杂志

Percutaneous nephrolithotripsy is the first line treatment for complete staghorn calculi, but there are risks such as renal function damage, bleeding, and infection. A case of complete staghorn calculi 8.3 cm×4.5 cm and mean CT value of 1 321 HU was reported. Urine culture suggested proteus mirabilis infection. The patient was given sensitive antibiotics for 3 days, and was treated with one session of natural orifice transluminal endoscopic lithotripsy with intelligent control of renal pelvic pressure. KUB on the first postoperative day showed residual stones of 1.0 cm×0.5 cm. There were no complications.

Role of PI3K/Akt/mTOR signaling pathway in edaravone-induced reduction of postoperative cognitive dysfunction in aged rats / 中华麻醉学杂志

Objective:To evaluate the role of phosphatidylinositol 3-kinase (PI3K)/serine threonine protein kinase (Akt)/mammalian rapamycin target protein (mTOR) signaling pathway in edaravone-induced reduction of postoperative cognitive dysfunction in aged rats.Methods:Sixty healthy male Sprague-Dawley rats, aged 20 months, weighing 600-700 g, were divided into 4 groups ( n=15 each) using a random number table method: control group (group C), operation group (group O), edaravone group (group E) and PI3K inhibitor LY294002 group (group LY). The rats received laparotomy under 3% sevoflurane anesthesia in O, E and LY groups. Edaravone 3 mg/kg was intraperitoneally injected at 30 min before operation in E and LY groups, and LY294002 0.3 mg/kg was simultaneously injected via the tail vein in group LY. Open field test was performed at 3 days after surgery to evaluate the spontaneous activity of rats, then Morris water maze test was performed to evaluate the cognitive function of rats. The rats were sacrificed after the end of behavioral experiment to isolate hippocampal tissues for determination of the expression of phosphorylated PI3K (p-PI3K), phosphorylated Akt (p-Akt), phosphorylated mTOR (p-mTOR), synaptophysin (SYP) and postsynaptic density protein 95 (PSD 95) (by Western blot ) and dendrite length in hippocampal CA1 area (using Golgi staining). The density of dendrites was calculated. Results:There were no statistically significant differences in exercise speed, distance, and time of staying at the center between the four groups ( P>0.05). Compared with group C, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of p-PI3K, p-Akt, p-mTOR, SYP and PSD-95 was down-regulated, the dendritic length of neurons in hippocampal CA1 region was shortened, and the density of neurons in hippocampal CA1 region was decreased in group O ( P<0.05). Compared with group O, the escape latency was significantly shortened, the number of crossing the original platform was increased, the expression of p-PI3K, p-Akt, p-mTOR, SYP and PSD-95 was up-regulated, the dendritic length of neurons in hippocampal CA1 region was prolonged, and the density of neurons in hippocampal CA1 region was increased in group E ( P<0.05). Compared with group E, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of p-PI3K, p-Akt, p-mTOR, SYP and PSD-95 was down-regulated, and the dendritic length of neurons in hippocampal CA1 region was shortened, and the density of neurons in hippocampal CA1 region was decreased in group LY ( P<0.05). Conclusions:The mechanism by which edaravone reduces postoperative cognitive dysfunction is related to activating PI3K/Akt/mTOR signaling pathway and improving synaptic plasticity in aged rats.

Effect of edaravone on ERK-CREB signaling pathway in hippocampus of aged rats with postoperative cognitive dysfunction / 中华麻醉学杂志

Objective:To evaluate the effect of edaravone on the extracellular signal-regulated kinase (ERK)-cAMP responsive element binding protein (CREB) signaling pathway in the hippocampus of aged rats with postoperative cognitive dysfunction (POCD).Methods:Sixty SPF healthy male Sprague-Dawley rats, aged 20 months, weighing 650-700 g, were divided into 4 groups ( n=15 each) using a random number table method: control group (group C), POCD group (group P), edaravone group (group E) and ERK inhibitor group (group I). The rats received laparotomy under 3% sevoflurane anesthesia to prepare POCD model in P, E and I groups. Edaravone 3 mg/kg was intraperitoneally injected at 30 min before operation in E and I groups, ERK inhibitor PD98059 0.3 mg/kg was injected via the tail vein in group I. The open field test was performed at 3 days after operation to evaluate the spontaneous activity of rats, then Morris water maze test was performed to evaluate the cognitive function of rats on 3-7 days after operation. The rats were sacrificed after the end of Morris water maze test, and hippocampal tissues were obtained for determination of the expression of phosphorylated ERK (p-ERK), phosphorylated CREB (p-CREB), synaptophysin and postsynaptic density protein 95 (PSD-95) (by Western blot) and dendrite length and density of dendrites in hippocampal CA1 area (using Golgi staining). Results:Compared with group C, the escape latency was significantly prolonged after operation, the number of crossing the original platform was reduced, the expression of p-ERK, p-CREB, synaptophysin and PSD-95 was down-regulated, and the dendritic length and density of hippocampal neurons were reduced in group P ( P<0.05). Compared with group P, the escape latency was significantly shortened, the number of crossing the original platform was increased, the expression of p-ERK, p-CREB, synaptophysin and PSD-95 was up-regulated, and the dendritic length and density of hippocampal neurons were increased in group E ( P<0.05). Compared with group E, the escape latency was significantly prolonged, the number of crossing the original platform was reduced, the expression of p-ERK, p-CREB, synaptophysin and PSD-95 was down-regulated, the dendritic length of hippocampal neurons was shortened, and the density of hippocampal neurons was decreased in group I( P<0.05). Conclusions:The mechanism by which edaravone improves POCD may be related to activating ERK/CREB signaling pathway and changing synaptic plasticity in hippocampal CA1 region in aged rats.

Progress of neoadjuvant therapy for high-risk prostate cancer in the era of novel hormonal therapy / 现代泌尿外科杂志

In the past, the use of neoadjuvant androgen deprivation therapy (ADT) for prostate cancer did not exhibit survival benefits and was not recommended by the practicing guidelines. In recent years, with the emergence of novel hormonal therapeutics such as Abiraterone, Enzalutamide, Apalutamide and Darolutamide, the interest for neoadjuvant therapy has been reignited. Here, we summarize the four categories of neoadjuvant therapy with new hormonal agents, and discuss how to evaluate the efficacy and explore the molecular mechanism after neoadjuvant therapy.

Practice and thinking of medical equipment management in medical aid mission in Ethiopia / 医疗卫生装备

The problems existing in the management of medical equipment in the General hospital of the Ethiopian Defense Forces were introduced,and some suggestions were put forward from domestic aid units,equipment suppliers,aid medical teams and assisted hospitals.The management efficiency of aid-Ethiopia medical equipment and the medical service capacity of the assisted hospitals were enhanced greatly.References were provided for the medical equipment management during foreign aid missions.[Chinese Medical Equipment Journal,2023,44(11):95-99]