Changes in body-related indices in people exposed to long-term low-dose nuclear radiation / 中国辐射卫生

@#<b>Objective</b> To investigate the effects of low-dose nuclear radiation exposure on the body by analyzing the antioxidant indices, immune indices, lymphocyte proliferation activity, and blood biochemical indices of persons exposed to long-term low-dose nuclear radiation, and to provide a basis for radiation protection and occupational health monitoring. <b>Methods</b> Eighty nuclear radiation workers were selected as the exposure group, and another 30 non-exposure personnel were selected as the control group. In both groups, blood biochemistry, serum total antioxidant capacity (T-AOC), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), lymphocyte proliferation activity, proliferating cell nuclear antigen (PCNA), apoptosis factors Bcl-2 and Bax, lymphocyte transformation rate, and lymphocyte micronucleus rate were measured. <b>Results</b> Compared with the control group, T-AOC, GSH-Px, SOD, cell proliferation activity, PCNA, Bcl-2, lymphocyte transformation rate, white blood cell count, and platelet count in the exposure group were significantly decreased, while MDA and Bax were significantly increased (<i>P</i> < 0.05). The lymphocyte micronucleus rate showed no significant difference between the two groups (<i>P</i> > 0.05). <b>Conclusion</b> Long-term low-dose exposure to nuclear radiation has certain effects on related indices of workers, but does not cause significant damage. The personnel exposed to nuclear radiation should enhance the awareness of protection and strengthen scientific protection to reduce radiation damage.

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio (UHR) and the risk of nonalcoholic fatty liver disease (NAFLD) in Chinese adults.@*METHODS@#A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination and a blood test. NAFLD was diagnosed using ultrasonography after other etiologies were excluded. Logistic regression and restricted cubic spline model were conducted to evaluate the relationship of UHR with NAFLD risk.@*RESULTS@#The multivariable adjusted odds ratio (95% confidence interval, CI) for NAFLD in the highest versus lowest quartile of UHR was 3.888 (2.324-6.504). In analyses stratified by sex and age, we observed significant and positive associations between UHR and the risk of NAFLD in each subgroup. In analyses stratified by body mass index (BMI), a significant and positive association was found only in individuals with a BMI of ≥ 24 kg/m2. Our dose-response analysis indicated a linear positive correlation between UHR and the risk of NAFLD.@*CONCLUSION@#UHR is positively associated with the risk of NAFLD and may serve as an innovative and noninvasive marker for identifying individuals at risk of NAFLD.

Expression and Clinical Significance of Serum sFas/sFasL in Patients with Secondary Hemophagocytic Lymphohistiocytosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significance of soluble Fas (sFas) and sFasL in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).@*METHODS@#From September 2015 to December 2020, 86 sHLH patients who met the HLH2004 diagnostic criteria were collected. They were divided into 55 cases in the MAHLH group and 31 cases in the NonMAHLH group according to the etiology. Thirty healthy persons were chosen as the normal control group, and 20 patients with systemic lupus erythematosus (SLE) were chosen as the disease control group. The expression levels of sFas and sFasL in the serum of patients with each group were detected by ELISA, and the clinical data were collected for statistical analysis. The significance of sFas and sFasL in sHLH was analyzed by ROC curve.@*RESULTS@#Serum levels of sFas and sFasL in patients with newly diagnosed sHLH were significantly higher than those in disease control group and normal control group (P<0.01). The levels of sFas and sFasL in MAHLH group were significantly higher than those in nonMAHLH (infection related HLH and autoimmune disease related HLH) group (P<0.01). The serum levels of sFas and sFasL in 17 newly treated patients with sHLH (17/86) after treatment were significantly lower than those before treatment (P<0.01). The serum sFas level in newly diagnosed sHLH patients was positively correlated with SF(r=0.35), sCD25(r=0.79) and sFasL(r=0.73). The serum sFasL level was positively correlated with SF(r=0.39), sCD25(r=0.64) and sFas(r=0.73). Compared with the NonMAHLH group, the area under the ROC curve was 0.707 (95% CI: 0.593-0.821) (P=0.0015). The optimal critical value for diagnosing MAHLH by sFas level was 12 743 pg/ml, and the sensitivity and specificity were 70.9% and 71% respectively. Compared with the NonMAHLH group, the area under the ROC curve was 0.765(95% CI: 0.659-0.87)(P<0.01). The median OS time of sFas high expression group (≥16798.5 pg/ml) and sFasL high expression group (≥4 785 pg/ml) was significantly shorter than that of the low expression group (P<0.001).@*CONCLUSION@#Serum levels of sFas and sFasL can be used for the early diagnosis and differential diagnosis of sHLH disease, and are the factor related to the poor prognosis of sHLH.

A real-world study of the efficacy and safety of sofosbuvir and velpatasvir in the treatment of HCV-infected patients in a county in northern China / 中华肝脏病杂志

Objective: To evaluate the real-world efficacy and safety of sofosbuvir and velpatasvir (SOF/VEL) tablets in the treatment of Chinese patients with chronic HCV infection. Methods: An open-label, single-center, prospective clinical study was conducted in a county in northern China. A total of 299 cases were enrolled. Of these, 161 cases with chronic hepatitis C and 73 cases with compensated cirrhosis received SOF/VEL for 12 weeks. 65 cases with decompensated cirrhosis received SOF/VEL combined with ribavirin for 12 weeks (22 cases) or SOF/VEL for 24 weeks (43 cases). Virological indicators, liver and renal function indexes, and liver stiffness measurement were detected at baseline, the fourth week of treatment, the end of treatment, and the 12-weeks of follow-up. Adverse reactions and laboratory abnormalities were observed during the course of treatment . The primary endpoint was undetectable rate of HCV RNA (SVR12) at 12 weeks of follow-up with the use of modified intention-to-treat (mITT) approach. Measurement data between two groups were compared using t-test. One Way ANOVA was used for comparison between multiple groups. Enumeration data were analyzed by chi-square test or Fisher's exact test. Results: 291 cases had completed treatment. HCV RNA was undetectable after 12 weeks of follow-up, and the SVR12 rate was 97.3% (95% confidence interval: 95.4%-99.3%). Among them, 97.4% of genotype 1b, 96.4% of genotype 2a, and 100% of those with undetected genotype achieved SVR12. The SVR12 rates in patients with chronic hepatitis C, compensated and decompensated liver cirrhosis were 98.1%, 98.6% and 93.8%, respectively. An improvement in alanine aminotransferase, aspartate aminotransferase and other liver biochemical indicators accompanied with virological clearance and reduced liver stiffness measurement was observed in patients with compensated cirrhosis, with statistically significant difference. There was no significant abnormality in renal function before and after treatment. The most common adverse reactions were fatigue, headache, epigastric discomfort and mild diarrhea. The overall adverse reactions were mild. One patient died of decompensated liver cirrhosis combined with massive upper gastrointestinal bleeding, which was unrelated to antiviral treatment. Four patients discontinued treatment prematurely due to adverse events. Relapse was occurred in four cases, and drug-resistance related mutations were detected in three cases. Conclusion: Sofosbuvir and velpatasvir tablets in Chinese HCV-infected patients with different genotypes, different clinical stages or previously treated with pegylated interferon combined with ribavirin resulted in higher SVR12, indicating that the treatment safety profile is good.

Traditional Chinese medicine treatment for COVID-19: An overview of systematic reviews and meta-analyses / 中西医结合学报

BACKGROUND@#Coronavirus disease 2019 (COVID-19) is a rapidly spreading disease that has caused an extensive burden to the world. Consequently, a large number of clinical trials have examined the efficacy of traditional Chinese medicine (TCM) for treating and preventing COVID-19, with coinciding proliferation of reviews summarizing these studies.@*OBJECTIVE@#This study aimed to evaluate the methodological quality and evidence quality of systematic reviews and meta-analyses on the efficacy of TCM.@*SEARCH STRATEGY@#Seven electronic databases, including PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chongqing VIP, Wanfang Data and SinoMed, were searched for systematic reviews and meta-analyses in October 2021. Search terms such as "Chinese medicine," "Lianhua Qingwen" and "COVID-19" were used.@*INCLUSION CRITERIA@#Systematic reviews and meta-analyses of randomized controlled trials that evaluated the efficacy of TCM treatment of COVID-19 were included.@*DATA EXTRACTION AND ANALYSIS@#A Measurement Tool to Assess Systematic Reviews Version 2.0 (AMSTAR 2) was used to evaluate the methodological quality. The quality of evidence was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Data extraction and analysis were performed by two reviewers independently.@*RESULTS@#There were 17 meta-analyses included in our overview. The intervention group was defined as TCM combined with Western medicine, while the control group was Western medicine alone. The methodological quality of all the included studies was moderate to poor. A total of 89 outcome indicators were evaluated, of which, 8 were rated as moderate quality, 39 as low quality, and 41 as very low quality. Only one outcome measure was graded as being of high quality. The moderate quality of evidence indicated that, for the treatment of COVID-19, the clinical efficacy of TCM in combination with Western medicine was better, in terms of lung recovery, rate of conversion to severe/critical cases, symptom scores, duration of symptoms, mortality, and length of hospital stay.@*CONCLUSION@#Evidence from the included studies shows that, compared with conventional Western medical therapy alone, the addition of TCM to COVID-19 treatment may improve clinical outcomes. Overall, the quality of evidence of TCM for COVID-19 was moderate to poor. Meta-analyses of the use of TCM in the treatment of COVID-19 can be used for clinical decision making by accounting for the experiences of clinical experts, medical policies, and other factors.

The predictive value of the distance between the placenta and the internal os of the cervix in second trimester to placenta previa / 中国医师杂志

Objective:To explore the predictive value of the distance between the placenta and the internal os of the cervix (IOD) in second trimester to placenta previa.Methods:476 pregnant women with placenta previa diagnosed by systematic ultrasound in the Affiliated Hospital of North Sichuan Medical College from May 2016 to June 2020 were analyzed retrospectively. The ultrasonic parameters such as IOD, cervical length and placental main attachment position were measured, and the clinical characteristics and pregnancy outcome were recorded. Logistic regression analysis was used to analyze the influencing factors of placenta previa from mild pregnancy to late pregnancy. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of IOD value for placenta previa.Results:197 cases of placenta previa were diagnosed in this study. Multivariate regression analysis showed that the number of previous pregnancies, IOD and history of cesarean section were the related factors of placenta previa from mid pregnancy to late pregnancy ( P<0.05). The risk of placenta previa in pregnant women ≥3 pregnancies was 1.826 times that in pregnant women with less than 3 pregnancies. The risk of placenta previa when the lower edge of placenta covers and crosses the internal orifice of cervix (IOD<0 mm) was 11.494 times that of IOD=0 mm and 22.222 times that of IOD>0 mm<20 mm (low placenta). The risk of placenta previa in pregnant women with a history of cesarean section was 1.908 times that of pregnant women without a history of cesarean section. When the cutoff value of IDO was 20 mm, all pregnant women with placenta previa could be screened out in the group with cesarean section history and the area under the curve (AUC) was 0.840 (95% CI: 0.783-0.896, P<0.05); When the cutoff value of IOD was 13.5 mm, all pregnant women with placenta previa could be screened in the group without cesarean section history, and the AUC was 0.814 (95% CI: 0.759-0.869, P<0.05). Conclusions:The second trimester IOD has a good predictive value for placenta previa.

Mechanism of Traditional Chinese Medicine in Treatment of Autism Spectrum Disorder Based on Heart and Spleen / 中国实验方剂学杂志

Autism spectrum disorder （ASD） is a common neurodevelopmental disorder in childhood， whereas there is no specific medicine at present. There are more and more researches on the treatment of ASD with traditional Chinese medicine（TCM） which the curative effect is reliable. The heart and spleen are the main viscera for the treatment of ASD， but there is still a lack of in-depth analysis of the mechanism of TCM. In order to explore the relationship between the core symptoms of ASD and the heart and spleen， this article specifically explores the theoretical origins of the heart and the spleen in the formation of the core symptoms of ASD， and to clarify the role of the heart and spleen in the occurrence and development of the two core symptoms of ASD from the perspective of TCM. In view of social communication and communication obstacles， the author puts forward and explains the language problems of children with ASD based on the functions of the heart and spleen， the theory of the viscera， the ascription of the meridians， and the classics. The mechanism of the heart and spleen in TCM about the failure of the spleen， the loss of the heart， and the endogenous phlegm. Aiming at the mechanism of the stereotyped symptoms of abnormal behaviors in children with ASD， this paper proposes and explains the TCM mechanism of constant deficiency of the spleen and dereliction of duty， leading to loss of mind， heart and spleen injury， and finally a series of stereotypes and strange syndromes due to lack of spirit. Through the analysis and excavation of TCM theory， it explores theoretical basis for ASD from the theory of heart and spleen， with a view to preliminarily constructing the theoretical framework of TCM syndrome differentiation and treatment of the deficiency of both the heart and spleen， and provide theoretical reference for TCM syndrome differentiation and treatment of ASD. The treatment of ASD from the differentiation of symptoms and signs of the heart and spleen is supported by a strong theoretical basis of TCM， and the rationale， law and prescriptions are complete， which may be the direction of screening effective TCM prescriptions for the treatment of ASD in the future.

Women's preconception health patterns in traditional Chinese medicine as a predictor of fertility outcomes / 中西医结合学报

OBJECTIVE@#To examine the association between traditional Chinese medicine (TCM), preconception health patterns and fertility outcomes.@*METHODS@#A community-based prospective cohort study was conducted in China. A total of 3012 newly married women who were willing to conceive within 2 years were enrolled in the study and took National Free Prepregnancy Checkups (NFPC). A reliably structured self-rating scale was used to measure the TCM preconception health patterns of the enrolled women. A 3-year follow-up was conducted to obtain the fertility outcomes, including pregnancy rate, time to pregnancy, spontaneous miscarriage and newborn status. Statistical analyses were conducted using Chi-square or Fisher's exact tests, logistic regression models, general linear models and the Cox proportional hazard model.@*RESULTS@#The fertility outcomes showed no statistic correlations to the terms of NFPC in this population. Approximately a half of the women (46.66%) had unhealthy patterns. Women with qi & blood-deficiency (odds ratio [OR] = 35.19, 95% confidence interval [CI] = 1.55-801.15) or qi-stagnation (OR = 4.55, 95% CI = 0.90-23.06) pattern took a longer time to get pregnant, and those with qi-stagnation (OR = 2.05, 95% CI = 1.1-3.82) or yang-deficiency (OR = 1.91, 95% CI = 1.12-3.25) pattern had a higher risk of spontaneous miscarriage.@*CONCLUSION@#Three unhealthy TCM patterns during the preconception period might be risk factors for low fecundity or poor pregnancy outcomes. The TCM preconception pattern identification may provide a convenient and effective way to screen for potential pregnancy risks beyond the NFPC. Further, appropriate interventions based on the TCM preconception health patterns are needed to improve quality in women's fecundability and birth outcomes.

Expression and Clinical Significance of Soluble B7-H3 in Patient with Secondary Hemophagocytic Lymphohistiocytosis / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression and clinical significance of soluble B7-H3 (sB7-H3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).@*METHODS@#The plasma samples of 85 newly diagnosed sHLH patients from December 2012 to April 2018 were collected. The patients were divided into lymphoma-related HLH（LHLH）group and infection-related HLH（IHLH）group. The expression of sB7-H3 in plasma was detected by ELISA, and the clinical data were collected for analysis. Fifteen healthy people were chosen as control group.@*RESULTS@#The expression level of sB7-H3 in lymphoma-related HLH and infection-related HLH group significant increased as compared with the control group, (P＜0.05), and the expression level of sB7-H3 in lymphoma-related HLH group was significant higher than that in infection-related HLH group [(35.75± 9.90) vs (28.70±8.95) ng/ml)] (P＜0.001). There were no significant statistical difference in the expression of some clinical factors (including age, fever, splenomegaly, ANC, Plt, FIB, calcium ion, serum albumin, LDH, serum ferritin, sCD25) in lymphoma-related HLH and infection-related HLH group (P＞0.05). The evaluation of expression and significance of sB7-H3 in sHLH by using ROC curve, showed that the area under ROC curve comparison of patients in lymphoma-related HLH group and infection-related HLH group was 0.718 (95% CI 0.610-0.810) (P=0.0002), and predicting the sensitivity and specificity of the lymphoma-related HLH patients were 77.36% and 59.38%, respectively. The best cut-off value of patients in sB7-H3 was 29.81 ng/ml, the overall survival time of sB7-H3 high-expression group (≥29.81 ng/ml) was significant shorter than that in low-expression group (＜29.81 ng/ml) (24 vs 440 d) (P＜0.001). The clinical factors affecting the survival status of sHLH patients were neutrophils, albumin, serum ferritin, serum calcium ions and sB7-H3 levels.@*CONCLUSION@#sB7-H3 associates with poor prognosis of sHLH patients, and may be involved in disease progression.

Comparison of intermittent fasting diet and continuous energy-restricted diet on weight loss and metabolic profile in overweight people / 中华临床营养杂志

Objective@#To compare the weight loss and metabolic profile between a continuous energy-restricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China.@*Methods@#Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index(BMI), body fat, change of visceral fatarea, fasting glucose(FPG), triglyceride(TG), total cholesterol(TC), high density cholesterol(HDL), low density cholesterol(LDL), glutamic pyruvicaminotransferase(AST), signglutamic pyruvic transaminase(ALT), gamma-glutamyltranspeptidase(GGT), alkalinephosphatase (ALP), fasting insulin level(FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried.@*Results@#Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle(P<0.01)at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR(P<0.01 or P<0.05)were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group(P<0.01 or P<0.05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group(P<0.01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks(P>0.05).@*Conclusion@#Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.

Finite-element analysis of mandibular first molar with two marginal designs of endocrown for the repair of different defects / 华西口腔医学杂志

OBJECTIVE@#This study aimed to evaluate the stress distribution of the mandibular first molar with different thicknesses and heights of the axial wall restored by the endocrown with two marginal designs and thus provide a theoretical basis for selecting clinical preparation through the finite-element method.@*METHODS@#Two marginal endocrowns of the mandibular first molar with different axial-wall thicknesses (t=1, 2, 3 mm) and heights (h=2, 3, 4 mm) were established. Group A was the butt-joint design, whereas group B was the shoulder-surrounded design. After applying vertical and oblique loads , the size and distribution of the maximum principal stress and equivalent stress of residual tooth tissue were recorded.@*RESULTS@#The maximum principal stress and equivalent stress distribution of residual tooth tissue were similar among different models. Group A showed a lower maximum principal stress and equivalent stress than group B at the same thickness and height under vertical load. Meanwhile, under oblique load, the maximum principal stress values of groups A and B decreased with increased thickness at constant height. Group A showed lower equivalent stress than group B at the same thickness and height of 2 and 
3 mm. However, when the height was 4 mm, the trend was reversed.@*CONCLUSIONS@#In mastication, when bearing the vertical force, the retention of the butt-joint marginal endocrown preferred to the shoulder-surrounded one. Given the higher axial wall of the shoulder-surrounded marginal endocrown, it showed better ability to bear the oblique force than the butt-joint one.

Predictive value of plasma level of dimethylglycine for risk of death in patients with acute myocardial infarction／ / 心血管康复医学杂志

To explore relationship between plasma level of dimethylglycine (DMG) and risk of death and its predictive value for risk of death in patients with acute myocardial infarction (AMI ).Methods : A total of 2406 AMI patients from 2010 to 2014 in our hospital were selected .According to survival condition of three‐year follow‐up , patients were divided into death group (n＝319) and survival group (n＝ 2087) , another 2000 healthy volun‐teers undergoing physical examination in our hospital simultaneously were enrolled as healthy control group .Predic‐tive value of plasma DMG level for risk of death in AMI patients were analyzed .Results : Plasma DMG level of AMI group was significantly higher than that of healthy control group [ (4.16 ± 1. 06) μmol／L vs.(2.93 ± 0. 47) μmol／L] , and that of death group was significantly higher than that of survival group [ (4.81 ± 1.05) μmol／L vs.(4.06 ± 1.08) μmol／L] , P＝ 0. 001 both .ROC curve analysis indicted that AUC of plasma DMG level predicting pa‐tients′death was 0. 756 , optimal cutoff point was 4.76μmol／L , and sensitivity and specificity was 76.7% and 69. 2% respectively .According to the cutoff point , AMI group was divided into low level group (DMG≤4.76μmol／L , n＝1103) and high level group (DMG＞4.76μmol／L , n＝1303).Compared with low level group , there were significant rise in BMI , percentages of smoking , hypertension , diabetes mellitus and triple‐vessel coronary disease , levels of TC , LDL‐C , Apo B and Apo A1 , and significant reductions in percentage of single vessel coronary disease and HDL‐C level in high level group , P＜0. 05 or ＜0.01. Kaplan‐Meier survival analysis indicated that three‐year total survival rate of DMG high level group was significantly lower than that of low level group (84. 19% vs. 89. 76%, P＝0.001).Multi‐factor analysis of COX proportional hazard regression indicated that coronary disease severity and plasma DMG level were independent risk factors of prognosis in AMI patients (HR＝1. 746 ,1.823 , P＝0.001 both).Conclusion : Plasma DMG level is one of independent risk factors predicting death of AMI patients .

Incidence and risk factors of infection related to totally implantable access port in upper arm in cancer patients / 上海交通大学学报（医学版）

Objective: To explore the incidence and risk factors of infection related to totally implantable access port (TIAP) in upper arm in cancer patients. Methods: A total of 1 961 patients who received TIAP for deliverance of chemotherapy at Renji Hospital, Shanghai Jiao Tong University School of Medicine during the period from February 2014 to December 2018. The general clinical data, catheterization status, bacteriological data and incidence of TIAP-related infections were retrospectively analyzed. The univariate analysis and multivariate Logistic regression analysis were used to determine the risk factors TIAP-related infections. Results: A total of 43 patients developed TIAP-related infections, with an incidence of 2.2% (43/1 961). The mean time interval from the implantation of upper arm TIAP to the diagnosis of infection was (116.88±95.39) d (7-377 d). In univariate analysis, gender (P=0.001), catheter diameter (P=0.000), upper extremity venous thrombosis (UEVT) (P=0.000) and outpatient (P=0.005) were significantly associated with the risk of infection related to upper arm TIAP. Multivariate binary Logistic regression analysis showed that gender (OR=0.35, P=0.012), UEVT (OR=31.59, P=0.000) and catheter diameter (OR=2.81, P=0.005) were three significant independent predictors of infection related to upper arm TIAP. Conclusion: Gender, UEVT and catheter diameter are independent risk factors for upper arm TIAP-related infection.

Clinical analysis of secondary hemophagocytic lymphohistiocytosis complicated with capillary leak syndrome / 中华血液学杂志

Objective: To investigate the clinical characteristics of secondary hemophagocytic lymphohistiocytosis (sHLH) complicated with capillary leak syndrome (CLS) . Methods: The clinical and laboratory data of 87 sHLH patients, who were treated in our hospital between January 2015 and December 2017, were retrospectively analyzed. Depending on whether they were complicated with CLS, 21 sHLH patients were classified as the CLS-sHLH group, while 66 were classified as the non-CLS-sHLH group. The differences of clinical manifestations, laboratory tests, treatment and prognosis between the two groups were compared. Results: There was no significant difference in the etiology of sHLH between the CLS-sHLH group and the non-CLS-sHLH group (P>0.05) . The neutrophil, fibrinogen and albumin levels in the CLS-sHLH group were lower than those in the non-CLS-sHLH group, while the triacylglycerol levels were higher than those in the non-CLS-sHLH group (P<0.05) . Varying degrees of edema, weight gain, hypotension, hypoproteinemia, oliguria and multiple serous effusions were observed in the CLS-sHLH group. Among them, there were 15 patients that CLS get improved, and the medial time of improvement was 7 (5-14) days. The other 6 patients did not get remission, while they died within 6-30 days. The median overall survival of the CLS-sHLH group was lower than that of the non-CLS-sHLH group (75 days vs not reached, P=0.031) . Conclusions: There may be no correlation between the cause of sHLH and the occurrence of CLS. Severity of neutropenia, fibrinogen and albumin levels, and triglyceride levels may be accompanied for sHLH patients complicated with CLS. Patients with sHLH who complicated with CLS have a poor prognosis. Active treatment of HLH and its primary disease, reasonable fluid replacement and oxygen supply are crucial, which can effectively control disease progression.

Catalpol ameliorates LPS-induced endometritis by inhibiting inflammation and TLR4/NF-κB signaling / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Catalpol is the main active ingredient of an extract from Radix rehmanniae, which in a previous study showed a protective effect against various types of tissue injury. However, a protective effect of catalpol on uterine inflammation has not been reported. In this study, to investigate the protective mechanism of catalpol on lipopolysaccharide (LPS)-induced bovine endometrial epithelial cells (bEECs) and mouse endometritis, in vitro and in vivo inflammation models were established. The Toll-like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) signaling pathway and its downstream inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (qRT-PCR), western blot (WB), and immunofluorescence techniques. The results from ELISA and qRT-PCR showed that catalpol dose-dependently reduced the expression of pro-inflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin (IL)-1β, and IL-6, and chemokines such as C-X-C motif chemokine ligand 8 (CXCL8) and CXCL5, both in bEECs and in uterine tissue. From the experimental results of WB, qRT-PCR, and immunofluorescence, the expression of TLR4 and the phosphorylation of NF-κB p65 were markedly inhibited by catalpol compared with the LPS group. The inflammatory damage to the mouse uterus caused by LPS was greatly reduced and was accompanied by a decline in myeloperoxidase (MPO) activity. The results of this study suggest that catalpol can exert an anti-inflammatory impact on LPS-induced bEECs and mouse endometritis by inhibiting inflammation and activation of the TLR4/NF-κB signaling pathway.

Effect of activated canonical wnt/p-catenin/tcf7l2 signaling pathway in type 1 diabetic cardiomyopathy / 中国药理学通报

Aim To determine the role of Wnt/β-catenin/TCF7L2 pathway in diabetic cardiomyopathy.Methods A model of type 1 diabetes mellitus was established by intraperitoneal injection of streptozotocin(STZ)into 7 or 8-week old C57BL/6 mice.After four weeks, the diabetic animals were divided into three groups with seven to eight in each:diabetes mellitus(DM), diabetes injected with β-catenin inhibitor iCRT14(2.5, 5 mg·kg-1).After continuous intrap-eritoneal administration for 8 weeks, heart samples were stained with HE and examined under light microscopy.Expressions and distributions of β-catenin and TCF7L2 in myocardium were detected by immunohistochemistry.Protein levels of β-catenin, Tcf7l2 were detected by Western blot.mRNA levels of β-catenin, Tcf7l2, Nppa and c-Myc were detected by qPCR.Results The myocardial cells in DM were relatively disordered and the size of the nucleus was irregular.Western blot and immunohistochemistry data showed that the expressions of β-catenin and TCF7L2 in heart with DM increased, while those in nucleus of the cardiomyocytes significantly increased.qPCR showed that the mRNA expression of β-catenin downstream target c-Myc and cardiac hypertrophy marker Nppa were up-regulated.After injection of eight weeks with different iCRT14 doses, the cardiomyocytes were relatively regular; the protein levels of β-catenin and TCF7L2 decreased, and their expressions in nucleus decreased as well; the mRNA levels of Nppa and c-Myc markedly decreased.Conclusions Activation of canonical Wnt/β-catenin/TCF7L2 signaling pathway plays a pivotal role in diabetic cardiomyopathy; iCRT14 significantly improves the phenotype of cardiomyopathy in type 1 diabetic mice.

Comparison of intermittent fasting diet and continuous energy-restricted diet on weight loss and metabolic profile in overweight people / 中华临床营养杂志

Objective To compare the weight loss and metabolic profile between a continuous energyrestricted diet and intermittent fasting diet in order to present an optimal nutritional weight reduction method for obese people in China. Methods Sixty overweight or obese adults were selected and divided into two groups as the continuous energy-restricted diet group and the intermittent fasting diet group. Height, weight, waist circumference, body mass index (BMI), body fat, change of visceral fatarea, fasting glucose (FPG), triglyceride (TG), total cholesterol ( TC), high density cholesterol ( HDL), low density cholesterol (LDL), glutamic pyruvicaminotransferase ( AST), signglutamic pyruvic transaminase ( ALT), gammaglutamyltranspeptidase (GGT), alkalinephosphatase (ALP), fasting insulin level (FINS) and HOMA-IR were assessed at baseline and 8 weeks after weight loss methods carried. Results Both continuous energy-restricted diet and intermittent fasting diet resulted improvement on body shape indexes and a significant decrease in weight, waist circumference, BMI, body fat, visceral fat area and skeletal muscle (P<0. 01) at 8 weeks. Both groups experienced improvements in biochemical outcomes and metabolic indicators at 8 weeks. A significant reduction in TC, AST, ALT, GGT, ALP, FINS and HOMA-IR (P<0. 01 or P<0. 05) were observed in continuous energy-restricted diet group. And a significant decline in TC, LDL, HDL, AST, ALT, GGT, ALP, FINS and HOMA-IR were observed in intermittent fasting diet group (P <0. 01 or P < 0. 05). HDL was found significantly reduced in intermittent fasting diet group as compared with continuous energy-restricted diet group (P<0. 01) at 8 weeks, however, there were no difference in weight loss, waist circumference, BMI, body fat, visceral fat area and other metabolic indicators at 8 weeks (P>0. 05). Conclusion Both intermittent fasting diet and continuous energy-restricted diet have a similar effect on weight loss and metabolic indexes like blood glucose, HOMA-IR and blood lipid, but intermittent fasting diet can more significantly decrease HDL level.

Investigation of the occurrence of arthralgia and the quality of life of patients with breast cancer treated with aromatase inhibitors / 国际肿瘤学杂志

Objective To analyze the occurrence of arthralgia in patients with breast cancer treated with aromatase inhibitors,and to evaluate the impact of arthralgia on patients' quality of life.Methods One hundred and eighty seven patients with breast cancer treated with aromatase inhibitors in our hospital from December 2013 to December 2015 were selected.The occurrence and severity of arthralgia in patients were evaluated by using visual analogue scale method.The 36-item short-form health survey (SF-36) was used to evaluate patients' quality of life.The occurrence of arthralgia in patients was analyzed.In addition,the quality of life of breast cancer patients with and without arthralgia and those with different degree of arthralgia was compared.Results The incidence of arthralgia was 77.5％ (145/187) among 187 patients,of which 30.3％ was mild (44/145),40.0％ was moderate (58/145) and 29.7％ was severe (43/145).The scores of the rolephysical (16.73 ±7.34 vs.39.73 ± 12.54;t =9.18,P =0.02),physiological function (53.63 ± 12.91 vs.77.18 ± 9.82;t =7.49,P =0.04),mental health (53.18 ± 14.76 vs.75.14 ± 17.21;t =14.96,P =0.01),role-emotional (46.23 ± 14.30 vs.68.75 ± 15.93;t =12.17,P =0.02),bodily pain (40.35 ± 18.49 vs.91.48 ± 19.67;t =16.28,P =0.01),social function (60.14 ± 12.57 vs.89.22 ± 10.16;t =13.07,P =0.02),general health (45.52 ± 14.61 vs.60.78 ± 18.45;t =15.77,P =0.01) and vitality (55.31 ± 13.69 vs.68.22 ± 18.43;t =15.84,P =0.01) of patients with arthralgia were all lower than those of patients without arthralgia,with statistically significant differences.The scores of the role-physical (F =6.67,P =0.03),physiological function (F =10.94,P =0.02),mental health (F =11.32,P =0.02),role-emotional (F =11.49,P =0.02),bodily pain (F =15.71,P =0.01),social function (F =14.92,P =0.01),general health (F =9.98,P =0.02) and vitality (F =7.36,P =0.03) of different degree of arthralgia in patients with breast cancer had also statistical significance differences.Conclusion Arthralgia is more likely to occur in the treatment of breat cancer with aromatase inhibitors.Arthralgia and its severity can affect the patients' quality of life.

A visualization analysis of current research on stem cell transplantation in the treatment of neonatal hypoxic-ischemic encephalopathy / 中国当代儿科杂志

OBJECTIVE@#To reveal the current research status on stem cell transplantation in the treatment of neonates with hypoxic-ischemic encephalopathy (HIE), and to summarize the recent hotspots of the research in this field.@*METHODS@#Using the key words of "stem cells" and "HIE", a computerized search was performed for the articles in English published before June 1, 2018 in PubMed, EMBASE, and Web of Science. Microsoft Office Excel 2013 was used for the statistical analysis of key words. Bicomb 2.0 and VOSviewer 1.6.6 were used for the cluster analysis of hot words and plotting of knowledge maps, respectively.@*RESULTS@#A total of 106 articles were included and 43 high-frequency key words were extracted. The words of "cell transplantation" and "hypoxia-ischemia" were in the core position of the co-word map. The cluster analysis showed that the studies of stem cell transplantation in the treatment of neonatal HIE mainly focused on umbilical cord blood cell transplantation (32.6%), mesenchymal stem cells and neural stem cells (29.5%), perinatal brain injury (28.1%), and other topics (9.8%).@*CONCLUSIONS@#In the current studies of stem cell transplantation in the treatment of neonatal HIE, umbilical cord blood cell transplantation, mesenchymal stem cells, neural stem cells, and perinatal brain injury are popular research topics at different levels.

Berberine-Promoted CXCR4 Expression Accelerates Endothelial Repair Capacity of Early Endothelial Progenitor Cells in Persons with Prehypertension / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate whether the berberine treatment can improve endothelial repair capacity of early endothelial progenitor cells (EPCs) from prehypertensive subjects through increasing CXC chemokine receptor 4 (CXCR4) signaling.</p><p><b>METHODS</b>EPCs were isolated from prehypertensive and healthy subjects and cultured. In vivo reendothelialization capacity of EPCs from prehypertensive patients with or without in vitro berberine treatment was examined in a nude mouse model of carotid artery injury. The protein expressions of CXCR4/Janus kinase-2 (JAK-2) signaling of in vitro EPCs were detected by Western blot analysis.</p><p><b>RESULTS</b>CXCR4 signaling and alteration in migration and adhesion functions of EPCs were evaluated. Basal CXCR4 expression was significantly reduced in EPCs from prehypertensive patients compared with normal subjects (P<0.01). Also, the phosphorylation of JAK-2 of EPCs, a CXCR4 downstream signaling, was significantly decreased (P<0.01). Berberine promoted CXCR4/JAK-2 signaling expression of in vitro EPCs (P<0.01). Transplantation of EPCs pretreated with berberine markedly accelerated in vivo reendothelialization (P<0.01). The increased in vitro function and in vivo reendothelialization capacity of EPCs were inhibited by CXCR4 neutralizing antibody or pretreatment with JAK-2 inhibitor AG490, respectively (P<0.01).</p><p><b>CONCLUSION</b>Berberinemodified EPCs via up-regulation of CXCR4 signaling contributes to enhanced endothelial repair capacity in prehypertension, indicating that berberine may be used as a novel potential primary prevention means against prehypertension-related atherosclerotic cardiovascular disease.</p>