Mechanism of Dahuang Zhechongwan in Treating Myocardial Fibrosis of Rats via TGF-β1/Smads/miR29 Pathway / 中国实验方剂学杂志

ObjectiveTraditional Chinese medicine， namely Dahuang Zhechongwan （DHZCW） was used to treat myocardial fibrosis in model rats， observe its effect on myocardial fibrosis in rats， and explore its action mechanism. MethodThirty-six SPF male Kunming rats were divided into blank group， model group， low-， medium-， high-dose groups of DHZCW （0.056， 0.084， 0.168 g·kg-1）， captopril group （10 mg·kg-1）， with six rats in each group. Except for the blank group， the other groups were intraperitoneally injected isoproterenol solution of 5 mg·kg-1 for 15 consecutive days to replicate the myocardial fibrosis model. At the beginning of modeling， the rats in each group took drugs， and they were sacrificed 28 days after administration. Serum and heart tissue were collected for the corresponding detection. Hematoxylin-eosin （HE） staining and Masson staining were used to observe tissue inflammation， cellular degeneration， necrosis， and fibrosis. The contents of hydroxyproline （HYP）， tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， hyaluronic acid （HA）， laminin （LN）， type-Ⅲ procollagen （PC Ⅲ） in serum of rats and rats were determined by enzyme-related immunosorbent assay （ELISA）. The expression levels of key pathway proteins transforming growth factor-β1 （TGF-β1）， α-smooth muscle actin （α-SMA）， Smad2， Smad3， and Smad7 were detected by Western blot. The expression levels of key pathway genes TGF-β1， α-SMA， Smad2， Smad3， Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were detected by Real-time quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， the pathological changes of fibrosis in the model group were obvious， the contents of serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ were increased （P<0.01）， the protein expression levels of TGF-β1， α-SMA， Smad2， and Smad3 were increased； the protein expression level of Smad7 was decreased （P<0.01）. The mRNA expression levels of TGF-β1， α-SMA， Smad2， and Smad3 were increased （P<0.05， P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were decreased （P<0.01）. Compared with the model group， after 28 days of administration， serum HYP， TNF-α， IL-1β， IL-6， HA， LN， and PCⅢ in high-， medium-， and low-dose groups of DHZCW and captopril groups were decreased （P<0.01）. Except for the low-dose group， the protein contents of TGF-β1， α-SMA， Smad2， and Smad3 were decreased， while the protein content of Smad7 was increased （P<0.01）. The mRNA expression levels of TGF-β1， Smad2， α-SMA， and Smad3 in high-dose group of DHZCW were decreased （P<0.05，P<0.01）， while those of Smad7， miR-29a-5p， miR-29b-2-5p， and miR-29c-5p were increased （P<0.05）. The mRNA expressions of TGF-β1， Smad2， and Smad3 in the medium-dose group of DHZCW were decreased （P<0.05， P<0.01）， while mRNA expression of Smad7 was increased （P<0.01）. The mRNA levels of TGF-β1 and Smad2 in the low-dose group of DHZCW were decreased （P<0.01）. ConclusionDHZCW can improve myocardial fibrosis in rats， and its action mechanism may be related to the regulation of the TGF-β1/Smads/miR-29 pathway. In addition， there is dose dependence in the range of 0.056-0.168 g·kg-1， and the effect of the high-dose group is more stable.

Establishment and evaluation of predictive models of platelet transfusion effect in multi-center tumor patients / 中国输血杂志

【Objective】 To study the platelet transfusion predictive models in tumor patients and evaluate its application effect. 【Methods】 A retrospective study was conducted on 944 tumor patients, including 533 males and 411 females who received platelet transfusion in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University, the Affiliated Cancer Hospital of Xinjiang Medical University and Kailuan General Hospital from August 2022 to January 2023. Multivariate Logistic regression analysis was used to establish the platelet transfusion predictive models, and Medcalc15.8 software was used to draw the receiver operating curve (ROC) to evaluate the application effect of the prediction model. The actual application effect of models was verified through 162 female clinical cases and 172 male clinical cases. 【Results】 The incidence of platelet transfusion refractoriness in tumor patients was 28.9% (273/944), with 33.2% (177/533) in males, significantly higher than that in females [23.4% (96/411)] (P<0.05). Platelet transfusion predictive models: Y1 (female) =-8.546+ (0.581×number of pregnancies) + (0.964×number of inpatient transfusion bags) + number of previous platelet transfusion bags (5-9 bags: 1.259, ≥20 bags: 1.959) + clinical diagnosis (lymphoma: 2.562, leukemia: 3.214); Y2 (male) =-7.600+ (1.150×inpatient transfusion bags) + previous platelet transfusion bags (10-19 bags: 1.015, ≥20 bags: 0.979) + clinical diagnosis (lymphoma: 1.81, leukemia: 3.208, liver cancer: 1.714). Application effect evaluation: The AUC (area under the curve), cut-off point, corresponding sensitivity and specificity of female and male platelet transfusion effect prediction models were 0.868, -0.354, 68.75%, 89.84% and 0.854, -0.942, 81.36%, 77.53%, respectively. Actual application results showed that the sensitivity, specificity, and accuracy of female and male model were 89.47%, 92.74%, 91.98% and 83.72%, 91.47%, 89.53%, respectively. 【Conclusion】 There is high incidence of platelet transfusion refractoriness in tumor patients, and the predictive model has good prediction effect on platelet transfusion refractoriness in tumor patients, which can provide reliable basis for accurate platelet transfusion in tumor patients.

Development of Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students / 中国学校卫生

Objective@#To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students.@*Methods@#The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed.@*Results@#Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. @*Conclusion@#This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Study on map analysis and trend prospect of campus thermal environment based on CiteSpace / 中国学校卫生

Objective@#To grasp the research dynamics and development trend of the thermal environment of campus buildings in China, so as to lay the foundation for in depth research and provide a reference basis.@*Methods@#Based on 479 documents in CNKI from 2000 to 2020, the documents were visualized and analyzed by keywords, including co occurrence, clustering, outbreak and author cooperation network in CiteSpace.@*Results@#In the past 20 years, the research on thermal environment of campus buildings in China had gone through a period of formation development growth, and was at a high growth stage now. The word frequency of "thermal comfort, thermal environment, indoor thermal environment, natural ventilation" was greater than 50, which was a high frequency keyword. The highest outbreak rate of "green campus" was 3.75, and "university library, university building, microclimate and green building" was in the outbreak period. And LIU Jiaping, LIU Zehua, WANG Hongguang and others were highly productive authors and have formed cooperative network groups with their own cores, but the cooperation among the network groups was less to be strengthened.@*Conclusion@#The research dynamics of the thermal environment of campus buildings is closely related to the policy development in China, and the research on "green campus, campus energy saving optimization, and university buildings" based on human thermal comfort theory is a hot topic of continuous attention.

Application of closed-loop blood transfusion information system in the whole process management of blood transfusion / 中国输血杂志

【Objective】 To explore the effect of mobile transfusion closed-loop information system in the whole process management of clinical blood transfusion. 【Methods】 The hospital information system (HIS) of Soochow Hospital affiliated to Nanjing Medical University was integrated with the blood information system (BIS) and personal digital assistant (PDA) to build a closed-loop transfusion management process to ensure the safety of clinical blood use. From May 2021 to April 2022, 1 395 patients who were admitted to our hospital for blood transfusion therapy were studied. Among them, 632 patients from May to October 2021 (before the implementation of closed-loop management) were the control group, and 763 patients from November 2021 to April 2022 (after the implementation of closed-loop management) were the observation group. Before and after the implementation of closed-loop management, we compared the implementation rate of double-checking before blood sample collection, rate of transfusion within 30 min after blood issuing, implementation rate of double-checking of bedside transfusion, situation of patrol every 15 minutes, rate of transfusion completed within 4 h, rate of nursing documentation standardization, so as to evaluate the improvement effect of the whole process of transfusion management. 【Results】 The implementation rate of double-checking before blood sample collection was 99.48%(759/763) in the observation group and 93.99%(594/632) in the control group; the transfusion rate within 30 min after blood issuing was 95.02%(725/763) in the observation group and 91.46%(578/632) in the control group; the implementation rate of double-checking of bedside transfusion was 100%(763/763) in the observation group and 95.73%(605/632) in the control group; the complete rate of patrol every 15-min was 94.36%(720/763) in the observation group and 90.35%(571/632) in the control group; the completion rate of transfusion within 4 h was 95.81%(731/763) in the observation group and 92.25%(583/632) in the control group; the rate of nursing paperwork standardization was 98.03%(748/763) in the observation group and 81.80%(517/632) in the control group, and the difference between the two groups was statistically significant (P<0.05). 【Conclusion】 The mobile transfusion closed-loop information system can realize the whole process management of clinical blood transfusion, effectively improve the standardization of blood transfusion and transfusion documents, and guarantee the safety of clinical blood transfusion.

The role and mechanism of amino acids in regulating hepatic glucose and lipid metabolism / 生理学报

Amino acids are essential nutrients for humans and have a wide range of biological functions. They are the constituent units of protein and energy metabolites. In addition, they are also widely involved in the maintenance and regulation of various physiological functions, and play a role in transcription, translation, post-translational modification and other levels. The liver is a key metabolic organ, and it acts as a hub that connects the metabolism of various tissues. Amino acid sensing plays a very important role in the regulation of hepatic glucose and lipid metabolism. Therefore, accurately sensing the levels of intracellular and extracellular amino acids is the key to maintaining cell homeostasis. There are several well-known amino acid sensors in eukaryotic cells, such as general control non-derepressible-2 (GCN2), mammalian target of rapamycin (mTOR) and taste receptors, which play an important role in maintaining metabolic homeostasis. This article gives a detailed introduction to the role and mechanism of amino acids in regulating hepatic glucose and lipid metabolism, laying a foundation for further exploration of amino acid sensing mechanism and treatment of hepatic glucose and lipid metabolism disorders.

Effect of Suanzaoren Tang on Learning-memory Function and NLRP3 Pathway in Sleep-deprived Rats / 中国实验方剂学杂志

Objective:To explore the mechanism of Suanzaoren Tang in improving learning-memory of sleep-deprived rats based on Nod-like receptor 3 （NLRP3） inflammatome pathway. Method:The rats were randomly divided into normal control group， model group， Eszolam group（5.4×10^-4 g·kg^-1·d^-1）， low-dose Suanzaoren Tang group（4.59 g·kg^-1·d^-1）and high-dose Suanzaoren Tang group （18.36 g·kg^-1·d^-1）. In addition to normal control group， other groups were used to constructed sleep-deprived model， which was concurrent with 30-day continuous drug administration. Water maze was used to evaluate the learning-memory function of rats； The mRNA and protein expressions of NLRP3， apoptosis-related speckle proteins （ASC）， aspartic acid-specific cysteine protease-1 （Caspase-1）， interleukin-1（IL-1） and IL-18 in the hippocampus of rats were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. Result:Compared with control group， the incubation period of the platform， the total distance of swimming and the duration of first reaching the platform in model group were significantly increased （<italic>P</italic><0.01）， while the number of platform crossings and the target quadrant time were decreased （<italic>P</italic><0.01）. Compared with the model group， the incubation period， total swimming distance and the duration of first reaching the platform in low-dose Suanzaoren Tang group and high-dose Suanzaoren Tang group were decreased to different degrees （<italic>P</italic><0.05，<italic>P</italic><0.01）， while the number of platform crossings and the target quadrant time were increased significantly （<italic>P</italic><0.05，<italic>P</italic><0.01），but with no significant change in estazolam group. Compared with normal control group， mRNA and protein expressions of NLRP3， ASC， Caspase-1， IL-1<italic>β</italic>， IL-18 in the hippocampus of the model group were significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with model group， mRNA and protein expressions of NLRP3， ASC， Caspase-1， IL-1<italic>β</italic> and IL-18 in the hippocampus of the rats in low-dose Suanzaoren Tang group and high-dose Suanzaoren Tang group were all decreased to different degrees （<italic>P</italic><0.05）. The mRNA and protein expressions of NLRP3， ASC， Caspase-1， IL-1<italic>β</italic> and IL-18 in the hippocampus of Suanzaoren group also decreased， but with no significant change. Conclusion:Suanzaoren Tang can improve the learning-memory function of sleep-deprived rats， and its mechanism is related to the inhibition of NLRP3 inflammatome pathway in hippocampus and the alleviation of neuroinflammation.

Preparation of silybin self-nanomicroemulsion containing functional oil and its in vitro evaluation / 中草药

Objective: In order to improve the bioavailability of the insoluble drug silybin, silybin supersaturated self- nanoemulsifying drug delivery systems (SLB-S-SNEDDS) containing functional oil were prepared, its characterization and in vitro evaluation were also performed. Methods: Functional oils were screened by performing potassium ferrohydride reduction and 1,1- diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging experiments. The pseudo-ternary phase diagram was drawn to investigate the emulsifying ability of emulsifier. The proportion of mixed oil phase and drug loading capacity were explored by analyzing particle size, polydispersity index (PDI), zeta potential, etc. The type and concentration of supersaturated substance in SLB-S-SNEDDS were obtained by conducting the compatibility and dissolution experiments. SLB-S-SNEDDS was characterized with appearance, particle size distribution, self-emulsification efficiency, and morphology, and its in vitro dissolution, antioxidant capacity, and cytotoxicity were also evaluated. Results: The prescriptions of SLB-S-SNEDDS were as follows: (1) wheatgerm oil/Capryol 90- Cremophor ELP-Transcutol HP; (2) seabuckthorn seed oil/Capryol 90-Cremophor ELP-Transcutol HP. One g S-SNEDDS matrix contained 0.043 g of wheatgerm oil or sea-buckthorn seed oil, 0.387 g of Capryol 90, 0.380 g of Cremophor ELP, and 0.190 g of Transcutol HP. The adding amount of silybin in S-SNEDDS prescription was 20% of the sum of the equilibrium solubility of silybin in each component, and the adding amount of Soluplus was 0.1% of the total mass described above. The two obtained SLB-S-SNEDDS were transparent homogeneous liquid with light yellow (wheat germ oil) and bright yellow (seabuckthorn seed oil) color, respectively. After being dispersed, SLB-S-SNEDDS turned into subspherical white flat emulsion droplets with the particle size of about 50 nm, and the emulsification time was 65 s. Compared with raw materials and SLB-SNEDDS, the cumulative dissolution of silybin in SLB-S-SNEDDS was maintained between 85% and 110% within 8 h, indicating that the two systems can significantly improve the dissolution of silybin. The absorbance of SLB-S-SNEDDS after reaction with potassium ferricyanide (0.452-0.782, 0.488-0.765) and the DPPH free radical clearance of SLB-S-SNEDDS (39.09%-96.02%, 30.54%-89.20%) were all higher than those of raw silybin (0.411-0.760, 22.89%-63.21%), which suggested that the two systems can enhance the antioxidant capacity of silybin. Cytotoxicity test results showed that the cell survival rate in silybin raw material group, combination of silybin and S-SNEDDS group, and blank S-SNEDDS group were greater than 90% at 5 µmol/L and 10 µmol/L drug concentration, indicating that SLB-S-SNEDDS and its auxiliary materials were safe and less toxic to human cloned colorectal adenocarcinoma cell line (Caco-2). Conclusion: The SLB-S-SNEDDS containing functional oil prepared in this paper can not only increase the cumulative dissolution of silybin, but also enhance its antioxidant capacity, which provides a useful reference for supersaturated self-nanoemulsifying drug delivery systems (S-SNEDDS) to improve the water-solubility and bioactivity of insoluble drugs.

The clinical experience of transurethral columnar balloon dilation of prostate for benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To summarize the clinical experience of transurethral columnar balloon dilation of prostate (TUCBDP) in the treatment of patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis of 379 BPH clinical data from the Hubei Provincial Hospital of Traditional Chinese Medicine using TUCBDP was performed between June 2015 and June 2018.Their age was (71.3±14.5)years old. The history of disease ranged from 1 month to 36 years. The prostate volume was(47.4±2.1) ml. Preoperative maximum urinary flow rate was (Q max)(9±4) ml/s, postvoid residual urine(PVR) was (123.1±72.4) ml. Their international prostate symptom score (IPSS) was (21±6) points. The quality of life score (QOL)was (5±1) points. The international index erectile function questionnaire (IIEF-5)in 32 patients, who had sex before surgery, was 15±4. We set the time of catheter structure improvement in June 2016 as the boundary, including the early stage (June 2015 to May 2016, 121 cases) and the recent stage (June 2016 to June 2018, 258 patients). In the early stage, the principle of operation is the inner balloon of the catheter to dilate the membrane urethra, and the outer balloon to dilate the urethra of the prostate and the bladder neck. The main surgical steps include the insertion of a dilatation catheter, localization by touching the skin of the scrotum bottom, the inner and outer balloon are filled with water, the first time of drainage and decompression in the inner and outer balloon, the catheter continuous irrigation, drainage and decompression of the inner and outer balloon again, removing the dilatation catheter, and the ordinary urinary catheter was replaced and continuous irrigation. In the recent stage, the principle of surgery is that the inner balloon only served for positioning and fixation. The outer balloon is used to dilate the membrane urethra, prostate urethra, and bladder neck. The inner and outer balloon are drained and decompressed at one time after surgery. The main surgical steps are that the resectoscope was used to examine the bladder and urethra and to guide the dilatation catheter into the bladder. The apex of the prostate touching was used to conform the location. The inner balloon water filling was used for fix the positioning. The inner and outer balloon are filled with water, decompressed and pulled out for urination test, the gland expansion is observed under the resectoscope, and ordinary urinary catheter is replaced for continuous flushing. We observed the changes in Q max, PVR, IPSS, and QOL at 1, 3, 6, 12, and 24 months after the operation. the complications differences in two-stage patien, including the International Incontinence Advisory Committee Urinary Incontinence Questionnaire (ICI-Q-SF) score; those who had sex before surgery were recorded changes in the IIEF-5 score, was compared. Results:There were no deaths during and after operation in this study. The operation time was (18.5±6.7) min. The number of follow-up cases at 1, 3, 6, 12, and 24 months after operation were 326, 253, 201, 194, and 181, respectively. The Q max at 1, 3, 6, 12, and 24 months after operation were (17±9)ml/s, (15±2)ml/s, (12±4)ml/s, (13±6)ml/s and (13±4)ml/s, respectively. The PVR were (17.4± 11.6) ml, (20.6±9.8)ml, (25.4±13.1)ml, (31.5±11.5)ml, and (29.1±12.4)ml, respectively. The IPSS were(7±5) points, (4±4) points, (4±4) points, (6±5) points, (4±4) points, respectively. The QOL were (2±1) points, (2±1) points, (2±1) points, (2±1) points, and (2±1), respectively. All those results that were significantly different from those before surgery ( P<0.05). There were 32 patients who had sex before the operation. The postoperative IIEF-5 score was (17± 6), which was not significantly different from that before the operation ( P>0.05). Two patients had transient retrograde ejaculation, which relieved spontaneously within the 6 month. 4 cases with pseudourinary incontinence in the recent stage (1.5%) were not statistically different from 6 cases (4.9%) in the early stage ( P>0.05). one case(0.4%) of major bleeding in the recent stage was statistically different from 6 cases (4.9%) in the early stage ( P<0.05). 2 cases (0.7%) of patients with acute urinary retention in the recent stage were significantly different from 15 cases (12.4%) in the early stage ( P<0.05). Conclusions:TUCBDP has a positive overall effect and high safety. The major complications of surgery in the recent stage, except for pseudo-urinary incontinence, are significantly lower than that in the early stage, which may be related to the improvement of the catheter structure and the accumulation of clinical experience.

Effect of peer intervention by popular opinion leaders among young students who have sex with men / 中国学校卫生

Objective@#The proposal of this study is to determine the feasibility of using online social software to guide popular opinion leaders(POLs) among young students MSM (men who have sex with men, MSM) carrying out comprehensive AIDS prevention in young students MSM.@*Methods@#From November to December 2019 in Tianjin, 22 POLs who had previously experienced AIDS prevention education and training foucus on life skills were recruited. Though snowball sampling method, 100 POLs partners (friends, sexual partners, classmates, etc) were invited into the study. From January to March 2020, regular posters will be sent through the WeChat platform to guide POL to intervene their partners/sexual partners. The questionnaire surveys were conducted before and after the intervention.@*Results@#After the intervention, both the proportion of young students MSM had sex and with multiple sex partners decreased(χ2=12.12, 5.94, P<0.05). The comprehensive ability of AIDS prevention has improved significantly, the "National Eight Items" correct rate has risen from 90.0% to 99.0%(χ2=5.82, 7.56, P<0.05), and the "Youth Eight Items" correct rate has increased from 86.0% to 98.0%(P<0.01). Knowledge score increased from(11.08±1.89) to (11.84±1.27); Attitude score increased from (54.29±4.01) to (56.06±3.75), the behavior score increased from (52.12±4.78) to (55.08±4.25), skill score increased from (51.96±4.75) to (54.67±5.04), The comprehensive prevention ability score (percent) increased from (87.30±6.95) to (91.86±5.42)(t=-4.21, -3.51, -5.32, -5.16, -6.45, P<0.01).@*Conclusion@#Using Wechat platform to guide POL carrying out comprehensive AIDS prevention is effective for improving the comprehensive AIDS prevention ability of young students MSM.

Analysis of Pharmacovigilance Thoughts in Herbal Masterpieces of Ming Dynasty / 中国实验方剂学杂志

Based on the pharmacovigilance thoughts of Chinese medicine of cognition, application, prevention and rescue of drug toxicity, to sort out the pharmacovigilance information in representative herbal works of the Ming dynasty, and to analyze the characteristics of the pharmacovigilance thoughts of the Ming dynasty, so as to provide reference for rational drug use in modern clinical practice. Taking Bencao Pinhui Jingyao, Bencao Gangmu, Paozhi Dafa, Bencao Shengya Banjie, Bencao Mengquan as the blueprints, and taking the traditional Chinese medicines in these books as the research objects, the text information was extracted from the four aspects of drug identification, drug use, drug prevention and detoxification, and the idea of pharmacovigilance was summarized. In Ming dynasty, pharmacovigilance had a systematic understanding, and cognition of drug toxicity was clear in identifying poison and correcting the mistakes of predecessors, in the aspects of using and preventing poisons, the use of poisons was prominent, the compatibility and process of poisons were emphasized, and the methods and mechanism of poison relief were clear in detoxification. Ming dynasty has initially formed the whole pharmacovigilance theoretical frame of cognition, application, prevention and rescue of drug toxicity, which has certain guiding and reference significance for modern clinical rational drug use.

Research Status of Gouty Arthritis at Home and Abroad-Visual Analysis Based on CiteSpace Software / 中国实验方剂学杂志

Objective:To analyze the research status of gouty arthritis at home and abroad in the past 15 years，and to provide reference for for further in-depth research in this field. Method:With “Gouty arthritis” as the research topic, the related papers during 2004—2019 were searched in Web of science core collection database and CNKI databases respectively. The results were statistically sorted out according to publication year，author，institution，literature source and key words，etc，and were visualized by CiteSpace software. Result:A total of 5 071 Chinese papers and 1 136 English papers were included. The amount of domestic and foreign publications continued to rise，forming a core team represented by LI Zhao-fu，XIONG Hui，SCHLESINGER NAOMI and other authors. The research hotpots focused on the pathogenesis，diagnosis methods， Chinese and Western medicine treatment，clinical observation，risk assessment and other aspects of gouty arthritis. Both of them had their own emphases. Domestic researches tended to focus on the treatment of gouty arthritis with traditional Chinese medicine，while foreign ones focused on the pathological research and clinical investigation of gouty arthritis. Conclusion:The number of researches in the field of gouty arthritis is on the rise as a whole，and there are both consistency and differences in the research content and hot topics between domestic and foreign literature. Therefore， we should strengthen cooperation and exchange between different teams and countries，so as to promote the overall development of this field.

Individualized prediction of recurrence-free survival after operation in patients with papillary renal cell carcinoma / 中华泌尿外科杂志

Objective@#To explore the independent predictors for recurrence-free survival (RFS) in patients with papillary renal cell carcinoma (PRCC), and establish a nomogram to predict individual 2-year RFS.@*Methods@#The data of patients diagnosed in Xijing Hospital of the Air Force Medical University from June 2009 to May 2018 were retrospectively analyzed. A total of 71 patients with primary T1-4N0M0 unilateral tumor were included in this study. The median age was 54 (range from 25 to 83) years. There were 51 males and 20 females. There were 27 cases of typeⅠ, 44 cases of type Ⅱ, 36 cases of left tumor and 35 cases of right tumor. Patients with clinical Ⅰ, Ⅱ, Ⅲ, Ⅳ stage were 47 cases, 12 cases, 9 cases and 3 cases, respectively. Tumor necrosis occurred in 15 cases (21.1%). The average preoperative alkaline phosphatase (ALP) was 89.0(43.0-217.0) U/L, the average preoperative hemoglobin (Hb) was (132.5±19.9) g/L, with 20 cases (28.2%) of Hb<120 g/L before surgery; the average of preoperative Hb was (132.5±19.9) g/L, among which 20 cases (28.2%) had Hb<120 g/L before surgery; the average of preoperative neutrophils/lymphocytes (NLR) was 2.40 (1.03-6.77); radical nephrectomy was performed in 43 patients and nephrectomy was performed in 28 patients. The 1-, 2-, and 3-year RFS were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using Log-rank test. Univariate and multivariate Cox regression analysis were used to identify the independent predictors for RFS, and the nomogram was developed using R software according to the results of multivariate Cox regression analysis. Furthermore, the predictive ability of the nomogram was internally validated using the Bootstrap method by calculating the C-index and drawing the calibration plot.@*Results@#After a median follow-up of 41 ( range from 25 to 83) months, 16 (22.5%) recurrence occurred, including 4 local recurrence and 12 distant recurrence, and 11 (68.8%) patients relapsed within 2 years after surgery. The 1, 2, and 3-year RFS were 88.6%, 80.4%, and 78.7%, respectively. Clinical stage Ⅱ (HR=3.655, 95%CI 1.036-12.890, P=0.044) and stage ≥Ⅲ(HR=3.654, 95%CI 1.008-13.248, P=0.049), preoperative ALP≥90U/L(HR=3.274, 95%CI 1.044-10.267, P=0.042), preoperative Hb<120 g/L (HR=4.771, 95%CI 1.553-14.660, P=0.006), and preoperative NLR≥2.40(HR=4.701, 95%CI 1.238-17.849, P=0.023) were identified as independent risk factors for RFS. On internal validation, the nomogram which integrates the four predictors of clinical stage, preoperative ALP, preoperative HB and preoperative NLR, has a good predictive performance (C-index =0.829, 95%CI 0.819-0.839).@*Conclusions@#In the present study based on single center data, clinical stage Ⅱ and ≥Ⅲ, preoperative ALP≥90 U/L, preoperative Hb<120 g/L and preoperative NLR ≥2.40 were independent predictors for postoperative RFS in patients with PRCC, and a new preoperative nomogram for predicting individual postoperative 2-year RFS was established, which would be helpful for urologists to develop more systematic treatment plans.

Individualized prediction of recurrence-free survival after operation in patients with papillary renal cell carcinoma / 中华泌尿外科杂志

Objective To explore the independent predictors for recurrence-free survival (RFS) in patients with papillary renal cell carcinoma (PRCC),and establish a nomogram to predict individual 2-year RFS.Methods The data of patients diagnosed in Xijing Hospital of the Air Force Medical University from June 2009 to May 2018 were retrospectively analyzed.A total of 71 patients with primary T1-4 N0M0 unilateral tumor were included in this study.The median age was 54 (range from 25 to 83) years.There were 51 males and 20 females.There were 27 cases of type Ⅰ,44 cases of type Ⅱ,36 cases of left tumor and 35 cases of right tumor.Patients with clinical Ⅰ,Ⅱ,Ⅲ,Ⅳ stage were 47 cases,12 cases,9 cases and 3 cases,respectively.Tumor necrosis occurred in 15 cases (21.1％).The average preoperative alkaline phosphatase (ALP) was 89.0(43.0-217.0) U/L,the average preoperative hemoglobin (Hb)was (132.5 ± 19.9) g/L,with 20 cases (28.2％) of Hb ＜ 120 g/L before surgery;the average of preoperative Hb was (132.5 ± 19.9) g/L,among which 20 cases (28.2％) had Hb ＜ 120 g/L before surgery;the average of preoperative neutrophils/lymphocytes (NLR) was 2.40 (1.03-6.77);radical nephrectomy was performed in 43 patients and nephrectomy was performed in 28 patients.The 1-,2-,and 3-year RFS were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using Log-rank test.Univariate and multivariate Cox regression analysis were used to identify the independent predictors for RFS,and the nomogram was developed using R software according to the results of multivariate Cox regression analysis.Furthermore,the predictive ability of the nomogram was internally validated using the Bootstrap method by calculating the C-index and drawing the calibration plot.Results After a median follow-up of 41 (range from 25 to 83) months,16 (22.5 ％) recurrence occurred,including 4 local recurrence and 12 distant recurrence,and 11 (68.8％) patients relapsed within 2 years after surgery.The 1,2,and 3-year RFS were 88.6％,80.4％,and 78.7％,respectively.Clinical stage Ⅱ (HR=3.655,95％CI 1.036-12.890,P =0.044) and stage ≥Ⅲ(HR =3.654,95％CI 1.008-13.248,P =0.049),preoperative ALP ≥ 90U/L (HR =3.274,95％ CI 1.044-10.267,P =0.042),preoperative Hb ＜ 120 g/L (HR =4.771,95％ CI 1.553-14.660,P =0.006),and preoperative NLR ≥2.40(HR =4.701,95％ CI 1.238-17.849,P =0.023) were identified as independent risk factors for RFS.On internal validation,the nomogram which integrates the four predictors of clinical stage,preoperative ALP,preoperative HB and preoperative NLR,has a good predictive performance (C-index =0.829,95％CI0.819-0.839).Conclusions In the present study based on single center data,clinical stage Ⅱ and ≥ Ⅲ,preoperative ALP≥90 U/L,preoperative Hb ＜ 120 g/L and preoperative NLR ≥2.40 were independent predictors for postoperative RFS in patients with PRCC,and a new preoperative nomogram for predicting individual postoperative 2-year RFS was established,which would be helpful for urologists to develop more systematic treatment plans.

Application and safety of hydroxychloroquine sulfate in rheumatic diseases:a multicenter retrospective study in Suzhou / 中国实用内科杂志

OBJECTIVE: A multicenter survey is conducted to study the application,the long-term effect and safety of hydroxychloroquine(HCQ)in the treatment of rheumatic diseases in Suzhou. METHODS: Retrospectively collect the data of outpatients and inpatients from Rheumatology Department of four general hospitals in Suzhou(the First Affiliated Hospital of Suzhou University, and Suzhou Hospital of Traditional Chinese Medicine, the First People's Hospital of Kunshan, the First People's Hospital of Changshu)from June 2017 to July 2018. A special questionnaire was used to collect data on general information, diagnosis, methods and courses in the use of hydroxychloro-quine, duration, efficacy and compliance, combined medication, adverse reactions of ophthalmology and other systems, and the use of hydroxychloroquine(HCQ)during pregnancy.Result Totally there were 856 cases, including 68 males(7.9%)and 788 females(92.1%).Classification of diseases: 147 cases of RA(including secondary SS of RA), 425 cases of SLE,12 cases of APS, 167 cases of PSS,104 cases of others, and 1 case of overlap syndrome(RA with SLE)The treatment course of HCQ: minimum 0.5 years, maximum 22.75 years, with an average of 3.59(SD=3.08)years.Dosage: 0.2 g/day in 604 cases, 0.4 g/day in 424 cases, 193 cases of using 0.4 and 0.2 successively, and 21 in other cases;721 cases used continuously. There were adverse reactions in 183 cases(7 males and 176 females), which were distributed in 30 cases of RA, 105 cases of SLE, 2 cases of APS, 31 cases of SS and 15 other cases. Ophthalmological adverse reactions occurred in 70 cases, with positive correlation in 4 cases. Ophthalmological examination: 121 cases(14.1%)every year;68 cases(7.9%)every two years. There were 92 cases of adverse skin reactions, with 8 cases of positive correlation. Other systems had few adverse reactions and there was no positive correlation. Continuous medication, combination of anti-rheumatic drugs and adverse reactions were associated, and continuous medication or combination of anti-rheumatic drugs were significantly associated with adverse reactions in ophthalmology and skin, respectively. The adverse reactions of ophthalmology were related to the course of treatment, and the adverse reactions of fundus increased after taking medicine for more than 7 years.There were 37 pregnancies and HCQ was used in 17 cases throughout pregnancy, and only 1 case had non-drug-related neonatal defects. CONCLUSION: HCQ is mainly used in the treatment of SLE, SS, RA and APS in Rheumatology Department in Suzhou. HCQ medication is standardized, but ophthalmic follow-up monitoring is not. Adverse reactions are mainly in skin and ophthalmology. Continuous medication and combination of antirheumatic drugs are associated factors of adverse reactions.Long-term treatment with HCQ is safe and well-toleratrd.

Differentiation Diagnosis and Treatment of Functional Constipation of Children Based on Theory of Qi Ascending and Descending / 中国中医药信息杂志

The main pathogenesis of functional constipation in children is the disturbance of large intestine conduction function, so the treatment of lubricating bowel and purging stool, dispersing food and abducting stagnation, nourishing blood and enriching yin is used in clinic. According to the characteristics of the physiopathologic of children, based on the clinical practice, this article believed that the occurrence of this disease was closely related to the ascending the clear of the spleen, the descending turbidity of the stomach, the dispersion of the lung and the catharsis of the liver. The root of pathogenesis is disturbance in ascending and descending of the functional activities of qi, so it is effective to treat the disease with the theory of qi ascending and descending.

The 465th case: intestinal obstruction, gastrointestinal hemorrhage and duodenal fistula / 中华内科杂志

This is a complicated and difficult case. The onset symptom of a 62-year-old male was recurrent intestinal obstruction. Ileocecal and ileocolic operation was done twice. Massive gastrointestinal bleeding occurred due to giant fistula of descending duodenum, which connected to ileocolic anastomosis. After consultation by multidisciplinary team, jejunal-feeding tube was placed to provide enteral nutrition. With general condition improving, duodenal fistula repair and involved bowel resection were performed. Postoperative pathology confirmed Crohn's disease. The patient was treated with thalidomide and recovered well during follow-up.

Diagnosis comparison of intraoperative imprint cytology and frozen section for sentinel lymph node metastasis in breast cancer / 肿瘤研究与临床

Objective To evaluate whether intraoperative imprint cytology can be used as a diagnostic method of sentinel lymph node metastasis for breast cancer patients in China. Methods A total of 154 breast cancer patients diagnosed histologically as ductal carcinoma in situ or T1-3N0M0 invasive breast cancer who underwent intraoperative sentinel lymph node biopsy from July 2012 to August 2015 in Shanxi Dayi Hospital were enrolled. The sentinel lymph node was detected by using standard dual tracer method. Intraoperative diagnosis was performed with imprint cytology as well as frozen section, and the final diagnosis was assessed by using paraffin pathology after surgery. Results The area under the receiver operator characteristic curve (AUC) for the diagnosis of sentinel lymph node metastasis by intraoperative frozen section and imprint cytology was 0.854 and 0.755, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of imprint cytology were 52.1 ％ (25/48), 99.1 ％ (105/106), 96.2 ％ (25/26), 82.0 ％ (105/128), 84.4 ％ (130/154) respectively, and the corresponding diameters of frozen section were 70.8 ％ (34/48), 100.0 ％ (106/106), 100.0 ％ (34/34), 88.3 ％ (106/120), 90.9 ％ (140/154) respectively. There was no statistically significant difference between the two groups (P>0.05). The frozen section result was highly consistent with paraffin pathology, with a Kappa value of 0.7698; while the Kappa value of imprint cytology was 0.5874, which was moderately consistent with paraffin pathology. ConclusionsThere is no significant difference between imprint cytology and frozen section in the intraoperative diagnosis of sentinel lymph node metastasis. The consistency between frozen section and paraffin pathology is high. After standardized operations and professional training, imprint cytology can be considered as a substitute of intraoperative sentinel lymph node diagnosis in breast cancer patients.

Investigation on procalcitonin in diagnosis of fever in cancer patients / 国际检验医学杂志

Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.

Pharmacological Inhibition of Macrophage Toll-like Receptor 4/Nuclear Factor-kappa B Alleviates Rhabdomyolysis-induced Acute Kidney Injury / 中华医学杂志(英文版)

<p><b>Background:</b>Acute kidney injury (AKI) is the most common and life-threatening systemic complication of rhabdomyolysis. Inflammation plays an important role in the development of rhabdomyolysis-induced AKI. This study aimed to investigate the kidney model of AKI caused by rhabdomyolysis to verify the role of macrophage Toll-like receptor 4/nuclear factor-kappa B (TLR4/NF-κB) signaling pathway.</p><p><b>Methods:</b>C57BL/6 mice were injected with a 50% glycerin solution at bilateral back limbs to induce rhabdomyolysis, and CLI-095 or pyrrolidine dithiocarbamate (PDTC) was intraperitoneally injected at 0.5 h before molding. Serum creatinine levels, creatine kinase, the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6, and hematoxylin and eosin stainings of kidney tissues were tested. The infiltration of macrophage, mRNA levels, and protein expression of TLR4 and NF-κB were investigated by immunofluorescence double-staining techniques, reverse transcriptase-quantitative polymerase chain reaction, and Western blotting, respectively. In vitro, macrophage RAW264.7 was stimulated by ferrous myoglobin; the cytokines, TLR4 and NF-κB expressions were also detected.</p><p><b>Results:</b>In an in vivo study, using CLI-095 or PDTC to block TLR4/NF-κB, functional and histologic results showed that the inhibition of TLR4 or NF-κB alleviated glycerol-induced renal damages (P < 0.01). CLI-095 or PDTC administration suppressed proinflammatory cytokine (TNF-α, IL-6, and IL-1β) production and macrophage infiltration into the kidney (P < 0.01). Moreover, in an in vitro study, CLI-095 or PDTC suppressed myoglobin-induced expression of TLR4, NF-κB, and proinflammatory cytokine levels in macrophage RAW264.7 cells (P < 0.01).</p><p><b>Conclusion:</b>The pharmacological inhibition of TLR4/NF-κB exhibited protective effects on rhabdomyolysis-induced AKI by the regulation of proinflammatory cytokine production and macrophage infiltration.</p>