Quantitative evaluation of global left ventricular myocardial work in patients with hepatitis B cirrhosis by pressure-strain loop / 中华肝脏病杂志

Objective: To quantitatively evaluate myocardial work in patients with hepatitis B cirrhosis by using left ventricular pressure-strain loop. Methods: 70 cases with hepatitis B cirrhosis who were hospitalized in Henan Provincial People's Hospital from March to December 2020 were selected as the study group. Patients were divided into three subgroups according to the Child-Pugh score of liver cirrhosis (Child-Pugh class A, B, and C groups: 25, 25, and 20 patients, respectively). At the same time, 25 healthy volunteers were included as the control group. Global longitudinal strain (GLS), global myocardial work index (GWI), global work efficiency (GWE), global constructive work (GCW), and global wasted work (GWW) were obtained by applying pressure-strain loops. The differences were analyzed and compared among the four groups parameters. Results: Compared with the control group, the Child-Pugh class A group had decreased GLS, while Child-Pugh class B and C had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class A group, Child-Pugh class B group had decreased GLS, GWE, and increased GWW, while Child-Pugh class C group had decreased GLS,GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class B group, Child-Pugh class C group had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Conclusion: The pressure-strain loop can detect early myocardial dysfunction, and has a certain value in the diagnosis, treatment and prognosis evaluation of myocardial function changes in patients with hepatitis B cirrhosis.

Clinical features of children with colorectal polyps and the efficacy of endoscopic treatment: an analysis of 1 351 cases / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features of children with colorectal polyps and the efficacy of endoscopic treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 1 351 children with colorectal polyps who were admitted and received colonoscopy and treatment in the past 8 years, including clinical features and the pattern and outcomes of endoscopic treatment.@*RESULTS@#Among the 1 351 children, 893 (66.10%) were boys and 981 (72.61%) had an age of 2-<7 years, and hematochezia (1 307, 96.74%) was the most common clinical manifestation. Of all the children, 89.27% (1 206/1 351) had solitary polyps, and 95.77% (1 290/1 347) had juvenile polyps. The polyps were removed by electric cauterization with hot biopsy forceps (6 cases) or high-frequency electrotomy and electrocoagulation after snare ligation (1 345 cases). A total of 1 758 polyps were resected, among which 1 593 (90.61%) were pedunculated and 1 349 (76.73%) had a diameter of <2 cm. Postoperative complications included bleeding in 51 children (3.77%), vomiting in 87 children (6.44%), abdominal pain in 14 children (1.04%), and fever in 39 children (2.89%), while no perforation was observed. The children aged <3 years had the highest incidence rates of postoperative bleeding and fever (P<0.0125), and the children with a polyp diameter of ≥2 cm had significantly higher incidence rates of postoperative bleeding, vomiting, and fever (P<0.05).@*CONCLUSIONS@#Solitary polyps, pedunculated polyps, and juvenile polyps are common types of pediatric colorectal polyps. Electric cauterization with hot biopsy forceps or high-frequency electrotomy and electrocoagulation after snare ligation can effectively remove colorectal polyps in children, with good efficacy and few complications. Younger age and larger polyp diameter are associated with a higher risk of postoperative bleeding.

Clinical value of TDI combined with 2D-STI on evaluating the microcirculation dysfunction and left ventricular dysfunction in patients with non-obstructive coronary angina / 中华心血管病杂志

Objective: To explore the value of tissue Doppler imaging (TDI) combined with two-dimensional speckle tracking imaging (2D-STI) at rest on evaluating microcirculation dysfunction and left ventricular dysfunction in patients with angina and no obstructive coronary artery disease(ANOCA). Methods: This retrospective study recruited 78 ANOCA patients, who hospitalized in the People's Hospital of Liaoning Province from August 2019 to July 2021. These patients underwent conventional echocardiography examination, including TDI and 2D-STI, to evaluate the left ventricular dysfunction, and adenosine stress echocardiography (SE) to evaluate the coronary flow velocity reserve (CFVR). ANOCA patients were divided into coronary microcirculation dysfunction CMD group (CFVR<2) and control group (CFVR≥2) according to CFVR. Clinical data, routine echocardiographic parameters, TDI parameters including isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), ejection time (ET), and STI parameters including global longitudinal peak strain (GLS), time to peak (TTP); peak strain dispersion (PSD) were compared between the two groups. Binary logistic regression was used to analyze the risk factors of CMD and the predictive value of each parameter to construct a joint prediction model for the diagnosis of CMD in this patient cohort. Results: The mean age was (55.5±11.2) years, 43 (55%) patients were females in this patient cohort, 38 (49%) patienst were didvided into the CMD group and 40 (51%) into the control group. Age, prevalence of hypertension, diabetes, dyslipidemia, and smokers were significantly higher in the CMD group than in the control group (all P<0.05). Tei index was higher, IVCT and TTP were longer, PSD was higher, ET was shorter, and absolute GLS was lower in the CMD group than in the control group (all P<0.05). The results of logistic regression analysis showed that longer IVCT, higher Tei index, higher time to PSD and lower absolute GLS were the independent risk factors of CMD. The ROC curve revealed that the predicting efficacy on CMD was satisfactiory with the combined predictors: AUC=0.884, sensitivity of 82% and specificity of 80%. Conclusions: TDI combined with 2D-STI is associated with a good diagnostic value on the diagnosis of CMD and left ventricular dysfunction in patients with ANOCA, which provides a feasible non-invasive tool for the diagnosis of CMD and risk stratification of patients with ANOCA.

Bioinformatics analysis and expression pattern of NAC transcription factor family of Angelica dahurica var. formosana from Sichuan province / 中国中药杂志

NAC(NAM/ATAF/CUC) protein plays an important role in plant growth and development, secondary cell wall formation and stress response. In this study, based on the sequencing data of Angelica dahurica, the NAC family was systematically analyzed using bioinformatics methods and its expression pattern was analyzed. Studies showed that 75 candidate genes had been selected from the NAC transcription factor family of A. dahurica, with the protein size of 148-641, all of which were unstable hydrophilic proteins. Most NAC proteins were localized in the nucleus, and had complete NAC domain. Phylogenetic analysis of NAC family proteins of A.dahurica and Arabidopsis thaliana showed that among the 17 subfamilies, NAC members were unevenly distributed in each subfamily, indicating that the evolution of species is developing in multiple directions. Among them, ANAC063 subfamily contained no NAC sequence of A. dahurica, which might be due to the functional evolution of the species. Analysis of protein transmembrane structure and signal peptide showed that NAC transcription factor could carry out transmembrane transportation, but its signal peptide function had not been found. Expression analysis showed that most transcription factors responded to abiotic stress and hormones to varying degrees, and the effects of hormones were obvious, especially ABA and IAA. In different organs of A. dahurica, most members of the NAC family had higher expression in root phloem, followed by root xylem. This study lays a foundation for further research on the function of A. dahurica NAC transcription factor and for solving the biological problems of A. dahurica.

Inhibitory effect of paeonol on aortic endothelial inflammation in atherosclerotic rats by up-regulation of caveolin-1 expression and suppression of NF-κB pathway / 中国中药杂志

To explore whether paeonol can play an anti-atherosclerotic role by regulating the expression of aortic caveolin-1 and affecting NF-κB pathway, so as to inhibit the inflammatory response of vascular endothelium in atherosclerotic rats. The atherosclerotic model of rats was induced by high-fat diet and vitamin D_2. The primary culture of vascular endothelial cells(VECs) was carried out by tissue block pre-digestion and adherent method. The injury model of VECs was induced by lipopolysaccharide(LPS), and filipin, a small concave protein inhibitor, was added for control. HE staining was used to observe pathological changes of aorta. TNF-α, IL-6 and VCAM-1 were detected by ELISA. Western blot assay was used to detect the protein expression levels of caveolin-1 and p65 in aorta and VECs. The results showed that as compared with model group, paeonol significantly reduced aortic plaque area and lesion degree in rats, decreased the level of serum TNF-α, IL-6 and VCAM-1 in the rats and enhanced the relative expression level of caveolin-1, decreased p65 expression conversely(P<0.05 or P<0.01). In vitro, as compared to model group, paeonol obviously improved cell morphology, decreased the secretion of TNF-α, IL-6 and VCAM-1 in VECs, increased caveolin-1 expression, and decreased p65 protein expression(P<0.05 or P<0.01). Furthermore, filipin could reverse the effect of paeonol on expression of inflammatory factors and proteins(P<0.05 or P<0.01). According to the results, it was found that paeonol could play the role of anti-atherosclerosis by up-regulating the expression of caveolin-1 and inhibiting the activation of NF-κB pathway to reduce vascular inflammation in atherosclerotic rats.

Clinical efficacy and prognostic factors of locally recurrent nasopharyngeal carcinoma with intensitymodulated radiotherapy / 上海交通大学学报（医学版）

Objective • To retrospectively analyze the treatment outcome, radiation toxicity and the prognostic factors in patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Methods • From January 2012 to August 2016, a total of 44 patients who were diagnosed with locally recurrent NPC and received reirradiation with IMRT were included in the study. Among all the patients, there were 33 male patients and 11 female patients, the median age of whom was 51.5 years (range 25-76 years). According to the 2012 American Joint Committee on Cancer Stage Classification Cancer Staging Manual, the distribution of disease restaging was 25.0% for stage rT1, 22.7% for stage rT2, 22.7% for stage rT3 and 29.6% for stage rT4. The median recurrence interval was 28 months (range 5-168 months). The median prescribed dose to the target volume was 66 Gy (range 54-70 Gy). The toxicities were evaluated by Radiation Therapy Oncology Group (RTOG). The survival rate was determined using the Kaplan-Meier method. Prognostic factors were analyzed by Log-rank tests and Cox proportional hazard model. Results • Three months after reirradiation therapy, the complete remission rate, the partial remission rate, the stabilization rate and the progressive rate were 18.2% (8/44), 47.7% (21/44), 27.3% (12/44) and 6.8% (3/44), respectively. The 3-year overall survival (OS), 3-year progression free survival (PFS), 3-year local recurrence-free survival and distant metastasis rates were 56.8%, 43.2%, 58.9% and 11.4%, respectively. In a univariate analysis, age, recurrent T stage, recurrence interval, adverse reactions and response to re-IMRT were significant prognostic factors for OS and recurrent T stage was also an independent prognostic factor for PFS. In a multivariate analysis, recurrent T stage remained significant for OS and PFS. During follow-up, 21 patients died. Five patients died of nasopharynx hemorrhea. Grade 3-4 toxicities were reported in 12 patients. Conclusion • Re-irradiation with IMRT is available to improve OS and thus is a reasonable choice for patients with locally recurrent NPC. However, the incidence of severe adverse events is still high. Younger ages lower recurrent T stage and longer recurrent interval are independent prognostic factors for OS of recurrent NPC.

Clinical efficacy and prognostic factors of locally recurrent nasopharyngeal carcinoma with intensity-modulated radiotherapy / 上海交通大学学报（医学版）

Objective·To retrospectively analyze the treatment outcome, radiation toxicity and the prognostic factors in patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). Methods?·?From January 2012 to August 2016, a total of 44 patients who were diagnosed with locally recurrent NPC and received reirradiation with IMRT were included in the study. Among all the patients, there were 33 male patients and 11 female patients, the median age of whom was 51.5 years (range 25–76 years). According to the 2012 American Joint Committee on Cancer Stage Classification Cancer Staging Manual, the distribution of disease restaging was 25.0% for stage rT1, 22.7% for stage rT2, 22.7% for stage rT3 and 29.6% for stage rT4. The median recurrence interval was 28 months (range 5–168 months). The median prescribed dose to the target volume was 66 Gy (range 54–70 Gy). The toxicities were evaluated by Radiation Therapy Oncology Group (RTOG). The survival rate was determined using the Kaplan-Meier method. Prognostic factors were analyzed by Log-rank tests and Cox proportional hazard model. Results?·?Three months after reirradiation therapy, the complete remission rate, the partial remission rate, the stabilization rate and the progressive rate were 18.2% (8/44), 47.7% (21/44), 27.3% (12/44) and 6.8% (3/44), respectively. The 3-year overall survival (OS), 3-year progression free survival (PFS), 3-year local recurrence-free survival and distant metastasis rates were 56.8%, 43.2%, 58.9% and 11.4%, respectively. In a univariate analysis, age, recurrent T stage, recurrence interval, adverse reactions and response to re-IMRT were significant prognostic factors for OS and recurrent T stage was also an independent prognostic factor for PFS. In a multivariate analysis, recurrent T stage remained significant for OS and PFS. During follow-up, 21 patients died. Five patients died of nasopharynx hemorrhea. Grade 3–4 toxicities were reported in 12 patients. Conclusion?·?Re-irradiation with IMRT is available to improve OS and thus is a reasonable choice for patients with locally recurrent NPC. However, the incidence of severe adverse events is still high. Younger ages lower recurrent T stage and longer recurrent interval are independent prognostic factors for OS of recurrent NPC.

Effect of anti-adhesion products on the healing of abdominal muscle / 医用生物力学

Objective To evaluate the effect of commonly used anti-adhesion products on the healing of abdominal muscles, and to provide guidance for surgeons to use anti-adhesion products in their clinical practice. Methods Adult SD rats were used. Except the sham group, surgical traumas were created on the serosal layer of the cecum and the underlying muscles of the abdominal wall. The wounds were covered without (Adhesion group) or with anti-adhesion products. Fourteen days after the surgery, the mechanical properties and histology of abdominal muscles were investigated to evaluate the healing of injured muscles. Results The ultimate tensile force and stiffness of the healing abdominal muscles in the groups of Polylactic acid membrane and Medical polyethylene glycol berberis lye were the same as those of normal muscles (P>0.05). The ultimate tensile force of the healing muscle in the groups of Chitosan gel and Seprafilm was significantly smaller than that of normal muscles (P0.05). The significant losses of mechanical properties of the healing muscles occurred in the Adhesion and Medical sodium hyaluronate gel group (P<0.05). HE staining indicated that more capillaries were found in Medical sodium hyaluronate gel, Polylactic acid membrane and Medical polyethylene glycol berberis lye group. The wound in Medical sodium hyaluronate gel group had less fibroblasts and fewer inflammatory cells, while the inflammatory cells were fully infiltrated with dense fibers in the other product groups. Conclusions Polylactic acid membrane and Medical polyethylene glycol berberis lye can promote abdominal muscle healing and are superior to Medical sodium hyaluronate gel, Chitosan gel and Seprefilm.

Effect of huangqin tang on the regulatory NF-κB p65 signal pathway in rats with ulcerative colitis / 药学学报

To investigate the effect of huangqin tang on expression of cytokines and NF-κB p65 in rats with ulcerative colitis (UC), and to probe into its underlying mechanisms of action. The mode of UC rats with cell immunoreactivity was made using compound method (trinitrobenzene sulfonic acid and ethanol). Rats were randomly divided into control group, model group, SASP group and high dose, middle dose and low dose of huangqin tang group. The food intake, body weight and microscopic damage of rats in each group were evaluated after being treated for five days. The blood and colon tissue were also collected. Production of NO was detected by Griess assay, the expression levels of IL-6, TNF-α, PGE2 were detected by ELISA. ICH method was undertaken to determine the expression of NF-κB p65 protein in colon tissue. The food intake and body weight of model group rats were lower than that of control group. The expression levels of NO, IL-6, TNF-α, PGE2 in serum and NF-κB p65 protein of colon tissue in model group were higher than that of control group. The above indexes were ameliorated in high and middle dose of huangqin tang groups. But there was no significant difference with SASP group. NF-κB p65 may be involved in the pathogenesis of UC, and huangqin tang can inhibit the relative activity of NF-κB p65, and decrease the expression levels of NO, IL-6, TNF-α and PGE2.

Pharmacokinetics and pharmacodynamics of huangqin tang in febrile rats / 药学学报

The pharmacodynamic (PD) and pharmacokinetic (PK) properties of Huangqin Tang (HQT) were investigated in yeast-induced febrile rats. Blood sample and rectal temperature data of the rats were collected at different times after single oral administration of HQT at 20 g x kg(-1). The plasma concentrations of paeoniflorin, baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid were quantified by a sensitive liquid chromatography-tandem mass spectrometric (LC-MS) method. The blood concentrations of PGE2, 1L-1β and TNF-α were detected by radioimmunoassay (RIA). All pharmacokinetic parameters were processed by non-compartmental analysis using WinNonlin software. The potential relationship between the mean concentration of eight constituents and the antifebrile efficacy was investigated by calculating Pearson correlation coefficients. It was found that HQT had significant antifebrile efficacy in yeast-induced febrile rats, but had no effect to normal rats. The antifebrile effect of HQT can be attributed to the inhibition of PGE2, 1L-1β and TNF-α. The constituents (baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid) in febrile rats had delayed absorption and elimination, a longer residence time in the body, and higher C(max) and AUC than those in normal rats. Febrile condition could affect the pharmacokinetic behaviour of HQT in vivo; the flavonoids with the same backbone showed the similar fate in the body; baicalein and wogonin had a strong positive correlation (R > 0.66, P ≤ 0.02) with the antifebrile efficacy determined. Together, these constituents demonstrated different pharmacokinetic properties in the febrile body.

LC-MS quantification and pharmacokinetics of the multi-constituents of Huangqin Tang in rat plasma after different single oral doses / 药学学报

The current study aims to investigate the pharmacokinetic properties of Huangqin Tang on different oral doses. An LC-MS method for simultaneous determination of flavonoids and terpenoids in rat plasma was developed and validated. Plasma samples were treated with hydrochloric acid (containing 1% ascorbic acid), precipitated with acetonitrile, separated on a Zorbax SB-C18 column, detected by single quadruple mass spectrometry with an electrospray ionization interface, and quantified using selected ion monitoring mode. All pharmacokinetic parameters were processed by non-compartmental analysis using WinNonlin software. The results of specificity, linearity, intra-day and inter-day precisions, accuracy, and stability for LC-MS assay were suitable for the quantification of paeoniflorin, baicalin, wogonoside, baicalein, wogonin, oroxylin A, glycyrrhizic acid and glycyrrhetinic acid in rat plasma. The concentration-time profiles of baicalin, wogonoside, baicalein, wogonin, oroxylin A and glycyrrhizic acid showed double-peak phenomenon after Huangqin Tang was orally administered at 40 g x kg(-1) dose; all eight constituents in rat plasma showed good dose-exposure relationship within the dosage of 10-40 g x kg(-1); although plasma concentrations were different, the flavonoids with the same backbone showed the similar fate in the body with the corresponding dosage. In conclusion, the LC-MS assay was successfully applied for the pharmacokinetic study of multi-constituents of Huangqin Tang with different doses. Additionally, these constituents demonstrated good pharmacokinetic properties in the body.

Compatibility principle research of Yupingfeng powder based on cocktail probe substrates approaches / 中国中药杂志

To elucidate the compatibility principle of Yupingfeng powder, a cocktail probe substrates approaches were developed. The enzymatic activity of cytochrome P450 from rat liver microsome was evaluated after being interfered with 7 prescriptions of Yupingfeng powder, which was designed according to the decomposed recipes design of traditional Chinese medicine. In vitro test, rat liver microsome incubation system was utilized to detect the 50% inhibitory concentrations of Yupingfeng powder with the decomposed recipes to cytochrome P450 (CYP1A2, CYP2A6 ,CYP2C9, CYP2C19, CYP3A4) enzyme. The CYPs IC50 value of Yupingfeng powder with different compatibility were greater than crude drug 1.0 g x L(-1), which indicated that all Yupingfeng powder prescriptions had no significant inhibitory activity to cytochrome P450. For CYP1A2, CYP2C19, CYP3A4, the IC50 value of Yupingfeng powder with the decomposed recipes had a tendency to increase, compared with the major impact factor from Yupingfeng powder. For CYPs, the detected IC50 of Yupingfeng powder with the decomposed recipes tended to decrease, compared with the linearly predicted value. From the point of view of the impact of drugs on the metabolic activity, the compatibility of Yupingfeng powder has certain advantages and reasonable.

Inflammatory myofibroblastic tumor of the prostate: a case report and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of inflammatory myofibroblastic tumor (IMT) of the prostate.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of a case of IMT of the prostate and reviewed relevant literature. The patient was a 62-year-old man, who was twice referred to the local hospital for recurrence of dysuria. He was diagnosed as with benign prostatic hyperplasia (BPH) and twice underwent transurethral resection of the prostate (TURP). But frequent recurrence of dysuria followed postoperatively, for which he came to our hospital and received another TURP and transurethral resection of the bladder tumor (TURBT). Pathological findings showed chronic inflammation of the bladder, papillary hyperplasia with mild dysplasia in regional urothelial and IMT of the prostate. Six months later, the patient came again to our hospital for recurrence of dysuria. Computed tomography revealed a large mass in the bladder.</p><p><b>RESULTS</b>The patient underwent laparoscopic bladder radical resection and ileal conduit diversion, simultaneously with pelvic lymph node dissection. The pathological examination confirmed it to be an IMT of the prostate with the bladder but not regional lymph nodes involved. An 11-month follow-up showed neither local recurrence nor distant metastasis.</p><p><b>CONCLUSION</b>IMT of the prostate is a rare borderline lesion, whose diagnosis is very difficult and mainly depends on pathological findings. IMT of the prostate is liable to recur and even invade the bladder. Radical resection is recommended for patients with large and recurrent tumors, and close follow-up is strongly warranted.</p>