Huangqi Sijunzi decoction for treating cancer-related fatigue in breast cancer patients: a randomized trial and network pharmacology study / 南方医科大学学报

OBJECTIVE@#To evaluate the clinical efficacy of Huangqi Sijunzi decoction (HQSJZD) for treating cancer-related fatigue (CRF) of spleen and stomach Qi deficiency type after chemotherapy in patients with breast cancer.@*METHODS@#A total of 94 breast cancer patients who developed CRF of spleen and stomach Qi deficiency type after chemotherapy were randomized into chemotherapy group (n=47) and traditional Chinese medicine (TCM) + chemotherapy group (n=47). The patients in chemotherapy group received the AC or EC regimen and non-drug interventions including psychological counseling, and those in TCM + chemotherapy group received oral administration of HQSJZD in addition to chemotherapy for 21 days as a treatment cycle, after which improvement of fatigue was assessed using Modified Piper Fatigue Scale. The active ingredients and targets of HQSJZD were screened using the TCM System Pharmacology Analysis Platform (TCMSP); the CRF- and breast cancer-related disease targets were retrieved based on data from the GeneCards, NCBI gene and OMIM databases to construct the component-target network and the protein-protein interaction (PPI) network. GO functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes KEGG pathway enrichment analysis of the target genes were performed to construct the component-disease-pathway-target biological network. The binding strength of the major drug ingredients and CRF key targets were predicted using AutoDock software.@*RESULTS@#The scores for somatic fatigue, emotional fatigue and cognitive fatigue, along with the overall fatigue score, showed more significant improvements in TCM+chemotherapy group than in chemotherapy group (P < 0.001), and the response rate reached 89.4% in the combined treatment group. We identified 250 targets for HQSJZD, 2653 CRF-related genes, 15 329 breast cancer-related genes and 161 prescription-disease intersected targets, from which topological analysis identified 66 potential key targets. GO and KEGG enrichment analyses predicted multiple pathways related with the disease. Molecular docking results suggested that the core ingredients of HQSJZD showed high affinities to the key targets AKT1, CASP3, IL6, JUN and VEGFA, among which AKT1 might be the most important target for HQSJZD to treat CRF.@*CONCLUSION@#HQSJZD can obviously improve CRF symptoms in breast cancer patients possibly by regulating multiple signaling pathways including PI3K-Akt through AKT1.

Relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among postpartum mothers / 上海预防医学

Objective:To explore the relationship between breastfeeding knowledge， self-efficacy and exclusive breastfeeding behavior among mothers of one-month old babies. Methods:Random sampling method was conducted for choosing 5 out of 13 community service health centers in Jiading district of Shanghai. A cross-sectional online survey was conducted among the mothers. Results:A total of 456 valid questionnaires were received， the full score of breastfeeding knowledge was set at 60， with an average of 47.17±5.65， ranging from 12 to 60. The full score of self-efficacy was set at 70， with an average of 47.70±14.48， ranging from 14 to 70. The exclusive breastfeeding rate of one-month old infants was 55.3%（252/456）. Multivariate logistic analysis showed that mothers with higher scores of breastfeeding knowledge had significantly higher rate of exclusive breastfeeding （OR=1.717， 95%CI 1.034-2.851， P=0.037）. Those with higher scores of breastfeeding self-efficacy also had significantly higher rate of exclusive breastfeeding （OR=5.736， 95%CI 3.455-9.522， P=0.001）. Conclusions:The breastfeeding knowledge and self-efficacy of mothers of one-month old babies were significantly associated with the rate of exclusive breastfeeding. Medical staff should strengthen the delivery and cultivation of breastfeeding knowledge and skills for mothers to improve breastfeeding self-efficacy， and ultimately promote the rate of exclusive breastfeeding.

Mitochondrial Oxidative Stress Enhances Vasoconstriction by Altering Calcium Homeostasis in Cerebrovascular Smooth Muscle Cells under Simulated Microgravity / 生物医学与环境科学（英文）

Objective@#Exposure to microgravity results in postflight cardiovascular deconditioning in astronauts. Vascular oxidative stress injury and mitochondrial dysfunction have been reported during this process. To elucidate the mechanism for this condition, we investigated whether mitochondrial oxidative stress regulates calcium homeostasis and vasoconstriction in hindlimb unweighted (HU) rat cerebral arteries.@*Methods@#Three-week HU was used to simulate microgravity in rats. The contractile responses to vasoconstrictors, mitochondrial fission/fusion, Ca @*Results@#An increase of cytoplasmic Ca @*Conclusion@#The present results suggest that mitochondrial oxidative stress enhances cerebral vasoconstriction by regulating calcium homeostasis during simulated microgravity.

Premature mortality caused by four main non-communicable diseases in Fenghua District / 预防医学

Objective To analyze the probability of premature mortality and temporal trend caused by four main non-communicable diseases (NCDs) in Fenghua District of Ningbo City from 2010 to 2015, and to provide data support for achieving Health China 2030 reduction target. Methods The data of deaths were from chronic disease surveillance information management system in Zhejiang Province from 2010 to 2015. According to the life-table method of calculating premature mortality probability, the premature mortality of four main NCDs by different gender, years and regions was analyzed and compared. Taking "Health China 2030" goal of reduction 30％ as the standard for the probability of premature mortality caused by major NCDs to evaluate the descent space of premature mortality. Results The probability of premature mortality of cardiovascular and cerebrovascular diseases and cancer was higher than that of chronic respiratory disease and diabetes, and the probability of premature mortality in men was higher than that in women. The top three villages and towns in terms of probability of prematuremortality caused by four main NCDs were Dayan town, Songao town and Xiwu Street in turn. From 2010 to 2015, the probabilities of premature mortality in four main NCDs were all declined consistently in Fenghua District of Ningbo City (P<0.05), and the total of four main NCDs decreased from 12.05％ to 10.21％. The probability of premature mortality of four main NCDs declined by 3.26％ a year on average with higher decreasing in women (6.56％) than that in men (1.32％) . Compared with 2015 baseline, the premature mortality of four NCDs in men would decrease by 4.11％ to reach 2030 goal (9.60％), and the probability of premature mortality four main NCDs in women would decrease by 1.96％ to reach the 2030 goal (4.58％) . Conclusions The probabilities of premature mortality in four main NCDs were all declined consistently in Fenghua District of Ningbo City. Compared with women, the men had higher probabilities and declined slower, and there were significant different in probabilities of premature mortality and their change speed among villages and towns.

A study on the mRNA expression of cell cycle related genes in population occupationally exposed to hexavalent chromium / 预防医学

Objective The aim of our study was to investigate the influence of hexavalent chromium exposure on mRNA expression of cell cycle related genes in electroplating workers, and to provide population data for investigating the toxic mechanisms of hexavalent chromium. Methods A total of 155 cases of workers occupationally exposed to hexavalent chromium were selected, including 89 males and 66 females, and the average age of workers was 39.65±8.856 years old. Questionnaire was used to collect essential information of workers. Peripheral blood was collected from electroplating workers. The inductively couple plasma mass spectrometry (ICP-MAS) was used to measure total blood chromium content. The workers were divided into four groups according to the blood chromium content. After extracting total RNA from whole blood and reverse transcription, the mRNA expression levels of p16 and CDK6 genes were detected by real-time quantitative PCR. Meanwhile, the levels of blood chromium (BCr) and the mRNA expression of p16 and CDK6 genes were compared among four groups. The impact of BCr, smoking habits, drinking habits, gender on the mRNA expression of CDK6 gene was analyzed. Results The levels of BCr in group 1 to 4 were 0.04ppb, 0.47±0.29 ppb, 2.76±1.16 ppb, 9.36 ±4.38 ppb, respectively, and the difference between every two groups was significant (P<0.05) . The median of p16 gene expression in four groups was 4.22, 7.19, 7.47, and 14.60, respectively, and the difference between every two groups was not significant (P>0.05) . The mRNA expression levels of CDK6 gene in groups 2 to 4 were 15.05, 8.03 and 24.81, respectively, which were significantly higher than that in group 1 (P<0.05) . The results of logistic regression showed that the level of Bcr was the main influence factor, while smoking habits, drinking habits and gender had no obvious impact on the mRNA expression of CDK6 gene. Conclusions Long-term exposure of hexavalent chromium led to higher mRNA expression of CDK6 gene, and it may serve as a biomarker for workers occupationally exposed to hexavalent chromium.

Rescue of the recombinant infectious bronchitis virus with the ectodomain region of H120 spike glycoprotein / 病毒学报

To explore the expression potential of heterogeneous genes using the backbone of infectious bronchitis virus (IBV) Beaudette strain, the ectodomain region of the Spike gene (1,302 bp) of IBV H120 strain was amplified by RT-PCR and replaced into the corresponding location of the IBV Beaudette strain full-length cDNA. This recombinant was designated as BeauR-H120(S1). BeauR-H120(S1) was directly used as the DNA template for the transcription of viral genomic RNA in vitro. Then, the transcription product was transfected into Vero cells by electroporation. At 48 h post-transfection, the transfected Vero cells were harvested, and passaging continued. A syncytium was not observed until the recombinant virus had passed through four passages. The presence of rBeau-H120(S1) was verified by the detection of the replaced ectodomain region of the H120 Spike gene using RT-PCR. Western blot analysis of rBeau-H120 (S1)-infected Vero cell lysates demonstrated that the nucleocapsid (N) protein was expressed, which implied that rBeau-H120(S1) could propagate in Vero cells. The TCIDs0 and EIDs0 data demonstrated that the titer levels of rBeau-H120(S1) reached 10(590+/-0.22)TCID50/mL and 10(6.13+/-0.23)EID50/mL in Vero cells and 9-day-old SPF chicken embryos, respectively. Protection studies showed that the percentage of antibody-positive chickens, which were vaccinated with rBeau-H120(S1) at 7 days after hatching, rose to 90% at 21 days post-inoculation. Inoculation provided an 85% rate of immune protection against a challenge of the virulent IBV M41 strain (103EID50/chicken). This recombinant virus constructed using reverse genetic techniques could be further developed as a novel genetic engineering vaccine against infectious bronchitis.

Effectiveness of Bushen Huoxue Granule (补肾活血颗粒) on 5-serotonin and norepinephrine in the brain of Parkinson's disease patients with depressive state / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical curative effect of Chinese medicine Bushen Huoxue Granule(补肾活血颗粒, BHG) on Parkinson's disease (PD) patients with depressive state.</p><p><b>METHODS</b>Sixty-two PD patients with depressive state were randomly assigned to two groups by using a random number table, 31 in each group. Madopar was given to all as the conventional treatment. The fluoxetine hydrochloride dispersible tablet was given to the patients in the control group and BHG was given to those in the treatment group. The therapeutic course for all was 12 weeks. Before and after treatment, Hamilton depression rating scale (HAMD) was applied to judge the curative effect, and the changes of cerebral neurotransmitters levels in the brain of patients were detected by encephalofluctuograph technique.</p><p><b>RESULTS</b>The scores of HAMD in the two groups were decreased markedly after 12-week treatment. It was lower in the treatment group than that in the control group with significant difference (P<0.01). The contents of norepinephrine (NE) and 5-serotonin (5-HT) in the PD patients were obviously lower than normal value. There was no significant difference between the two groups before treatment (P>0.05). The contents of NE and 5-HT were all increased in the two groups after treatment (P<0.05), with significant differences between the two groups (P<0.01).</p><p><b>CONCLUSION</b>BHG could increase the contents of NE and 5-HT in PD patients' brain to improve the depressive state of PD patients.</p>

Biomechanical comparison between triple Endobutton technique and modified Weaver Dunn procedure for anatomical reconstruction of coracoclavicular ligament / 医用生物力学

Objective To compare the biomechanical behavior of a triple Endobutton technique for anatomic reconstruction of coracoclavicular ligament and with a modified Weaver-Dunn procedure. Methods Twelve fresh frozen cadaveric shoulders were applied with 70 N in superior, anterior and posterior direction, respectively, to measure displacement of the acromioclavicular joint. The failure test with the load at the rate of 25 mm/min was conducted to record the failure load and failure mode. The specimens were then randomly assigned to 2 groups: the triple Endobutton technique group and the modified Weaver-Dunn procedure group for reconstruction and to conduct displacement test and failure test again. The stability and mechanical strength of acromioclavicular joints after reconstruction under different states were then compared. Results The triple Endobutton technique group had significantly less anterior ((8.72±1.41) mm vs (37.03±5.05) mm) and posterior ((8.03±3.68) mm vs (14.85±1.89) mm) displacement than that in the modified Weaver-Dunn procedure group after reconstruction (P<0.05), and the former had similar displacement ((7.81±2.22) mm anterior and (7.16±1.95) mm posterior) as compared to the intact state. There were no significant differences in superior displacement among the groups. The modified Weaver-Dunn procedure group had significantly smaller failure loads ((172±9) N) than that in the triple Endobutton technique group ((687±115) N) and the intact ligament group ((685±234) N) (P<0.05). Conclusions The triple Endobutton technique has less anterior and posterior displacement and its stability is more closely approximate to the intact ligament; meanwhile, it has similar strength as coracoclavicular ligaments, which can better restore the function of coracoclavicular ligaments.

The treatment of non-small cell lung cancer by interstitial I-125 seeds implantation combined with chemotherapy and Chinese medicine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive I-125 seeds interstitial implantation (ISI) synchronized chemotherapy and Chinese medicine (CM) for the treatment of advanced stage of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Ninety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups: the synchronized therapy group (A), the chemotherapy plus CM-treated group (B), and the chemotherapy-treated group (C); a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers (carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment), clinical symptoms, and quality of life (QOL) in patients.</p><p><b>RESULTS</b>The total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing signifificant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more signifificant in Group A than those in Group C (all P<0.05).</p><p><b>CONCLUSION</b>The synchronized therapy of I-125 implantation with chemotherapy and CM was a safe therapeutic method and can be regarded as a new mode for treatment of advanced-stage NSCLC.</p>

Effect of Bushen Huoxue Decoction on the orphan receptor and tyrosine hydroxylase in the brain of rats with Parkinson's disease / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effect of Bushen Huoxue Decoction (BHD) on the orphan receptor (Nurr1) and tyrosine hydroxylase (TH) in the brain of rats with Parkinson's disease (PD).</p><p><b>METHODS</b>One hundred and twenty SD rats were divided into 100 in the model group and 20 in the normal control group, fifty-eight SD rats from the model group, established into PD model successfully by injuring their substantia nigra (SSN) with 6-hydroxydopamine, were divided equally into the model group and the test group, and they were treated with saline and BHD, respectively, for eight successive weeks. The change in the rats' behavior before and after treatment was observed by counting the cycles of rotation induced by apomorphine injection; the pathology of neurons, level of Nurr1 mRNA expression, and amount of TH positive cells in SSN were observed after treatment.</p><p><b>RESULTS</b>The rats' behavior was improved in the tested group significantly, the rotation cycle after treatment being 84.0 ± 20.0 cycles/40 min, which was significantly lower than that in the model group (377.0 ± 62.3 cycles/40 min, P<0.01). Besides, the Nurr1 mRNA expression and TH positive cell in the test group were 0.97 ± 0.15 and 49.40 ± 14.72, respectively, which were significantly higher than those in the model group, 0.22 ± 0.03 and 5.45 ± 2.58, respectively (all P<0.01).</p><p><b>CONCLUSION</b>BHD could treat PD by enhancing the Nurr1 mRNA expression, increasing the TH content in brain, and promoting the repairing of injured neuron in cerebral SSN.</p>

Effect of Bushen Huoxue Decoction on dopamine D2 receptor in the brain of rats with Parkinson's disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the mechanism underlying the therapeutic effect of Bushen Huoxue Decoction (BHD), a traditional Chinese medicinal preparation, on dopamine D2 receptor (DRD2) in the brain of rat models of Parkinson's disease (PD).</p><p><b>METHODS</b>A total of 120 SD rats were randomized into normal control group, saline model group and BHD-treated group. In the latter two groups, PD rat models were established by direct injection of 6-OHDA to destruct the substantia nigra compact part (SNC) with corresponding treatments. The behavioral changes of the rats were observed. Radioimmunoassay was employed to determine the changes in the equilibrium dissociation constant (Kd) and maximal binding capacity (B(max)) of DRD2, and immunohistochemistry was used to observe the number of the DRD2-positive cells in the brain of the rats.</p><p><b>RESULTS</b>BHD can markedly improve the behavioral abnormalities of PD model rats. Compared with those in the saline model group, the B(max) of DRD2 in the damaged hemisphere increased while the Kd of BHD decreased significantly after BHD treatment (P<0.01). The number of DRD2-positive cells in BHD-treated group was significantly higher than that in the model group (80.9∓13.59 vs 11.15∓6.78, P<0.01), but showed no significant difference from that in the normal control group (P>0.05).</p><p><b>CONCLUSION</b>BHD can improve the behavioral abnormalities and increase the cerebral expression and affinity of DRD2 in PD rat models.</p>

Effect of chronic exposure to ultraviolet on skin barrier function / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effect of chronic ultraviolet (UV) exposure on skin barrier function and photoaging process.</p><p><b>METHODS</b>One hundred and fifty-six volunteers from Hanghzou areas were enrolled in the study. UV-exposed skin areas (neck, dorsum of hand or frontier chest) and UV-unexposed areas (waist, buttock or abdomen) were tested. Probe CM 825 of skin multi-functional detector MPA9 was applied to test the skin water content; probe TM 300 was applied to test transepidermal water loss (TEWL) and probe RVM 600 was applied to detect skin elasticity (Ur/Uf). Relative perfusion unit (PU) of the skin was detected by laser doppler flowmetry (LDF).</p><p><b>RESULT</b>Skin water content value at UV-exposed skin areas was 12.78 ± 2.36 in elderly group (>50y), which was significantly lower than that of UV-unexposed skin areas(23.68 ± 3.24, P= 0.036). Highest level of TEWL (12.98 ± 2.86) g . m(-2) . h(-1) was detected at UV-exposed areas in elderly group; there were trends of increasing TEWL levels at UV-exposed areas than at UV-unexposed areas in all age groups, however, there were no statistical differences (P>0.05). The elasticity of Ur/Uf value at UV-exposed skin areas in elderly group was 0.11 ± 0.07, which was remarkably lower than that of UV-unexposed skin areas (0.32 ± 0.1, P=0.028). No significant difference of skin perfusion was observed between UV-exposed and UV-unexposed areas.</p><p><b>CONCLUSION</b>Chronic exposure to UV may damage skin barrier function and therefore play a role in skin photoaging process.</p>

Free peroneal perforator-based sural neurofasciocutaneous flaps for reconstruction of hand and forearm / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sural neurofasciocutaneous flap has been popularly used as an excellent option for the coverage of soft tissue defects in the lower third of leg, ankle and foot, but its free transplantation has been rarely reported. The objective of our work was to investigate the operative technique and clinical results of repairing the soft tissue defects of hand and forearm with free peroneal perforator-based sural neurofasciocutaneous flap.</p><p><b>METHODS</b>Between May 2006 and March 2007, 10 patients including 7 men and 3 women were treated. Their ages ranged from 22 to 51 years. They presented to emergency with large soft tissue defects of 16 cm x 7 cm to 24 cm x 10 cm in size in hand and forearm after injured by motor vehicle accidents (2 cases) or crushed by machine (8 cases). Thorough debridements and primary treatments to associated tendon ruptures or bone fractures were performed on emergency. And free peroneal perforator-based sural neurofasciocutaneous flaps were transplanted when the wound areas were stable at 5 to 7 days after emergency treatment. The flaps were designed along the axis of the sural nerve according to the shape and size of the soft tissue defects, with the peroneal perforator above the lateral malleolus as the pedicle and along with a part of the peroneal artery for vascular anastomosis. Then the flaps were harvested to repair the recipient sites with the peroneal artery anastomosed to the radial (or ulnar) artery and the peroneal veins to one of the radial (or ulnar) veins and the cephalic vein respectively. The flap sizes ranged from 18 cm x 8 cm to 25 cm x 12 cm. The donor areas were closed by skin grafts.</p><p><b>RESULTS</b>All of the 10 flaps survived after surgeries. Marginal necrosis occurred in only 2 cases. The skin grafts survived entirely in the donor sites, and no obvious influence on the donor legs was observed. All of the transplanted flaps presented favourable contours and good functions at 9 to 12 months' follow-up.</p><p><b>CONCLUSIONS</b>Peroneal perforator-based sural neurofasciocutaneous flap has favourable appearance, constant vascular pedicle, reliable blood supply, large size of elevation, and minimal influence on the donor site. The free transplantation of this flap offers a satisfactory alternative for repairing the large soft tissue defects of forearm and hand.</p>

The role of protein kinase C alpha in recurrence of superficial bladder carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship of protein kinase C-alpha (PKCalpha) expression/activation with tumor differentiation and resistance to chemotherapy drugs in superficial bladder carcinoma.</p><p><b>METHODS</b>Expression of PKCalpha was measured by Western-blot analysis in 76 samples including tumor and normal tissues, respectively. A human RT4 bladder cancer cell line stably expressing green fluorescent protein (GFP)-PKCalpha (RT4/PKCalpha) was established. The sensitivity of the RT4/PKCalpha and parental cells to adriamycin (ADM) was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The change of sensitivity of the RT4/PKCalpha to ADM were observed under the conditions of PKC activation and inhibition, respectively.</p><p><b>RESULTS</b>Total level of PKCalpha expression and the ratio of the amount of PKCalpha expression or PKC activity in membrane to that in cytosol (M/C) were all more higher in cancerous tissues than in normal tissues (P < 0.01); With the increase of tumor grade, the relative level of PKCalpha expression significantly increased in membrane (P < 0.01) and decreased in cytosol (P < 0.01), M/C of PKCalpha was significantly elevated (P < 0.01), and total relative level of PKCalpha expression significantly increased (P < 0.01). Thirty-eight cases recurred during the follow-up period in total seventy cases. Multivariate analysis showed that high M/C of PKCalpha was independent prognostic factor for tumor recurrence after standard ADM treatment in the 2-year follow-up (RR = 3.98, 95% CI 1.22-5.68, P = 0.03). Transfection of PKCalpha increased resistance of RT4 cells to ADM [resistance index (RI): 6.97, t = 3.24, P < 0.01]. PKCalpha activation further greatly promoted the resistance (RI: 148.11, t = 5.18, P < 0.001) while inhibition of PKCalpha did conversely (RI: 1.6, t = 1.29, P > 0.05).</p><p><b>CONCLUSION</b>The abnormal activation and expression level of PKCalpha closely correlate with both tumor grade and intrinsic resistance to ADM in patients with superficial bladder carcinoma.</p>