Efficacy Evaluation of Biejiajianwan in the Treatment of Primary Liver Cancer Based on Real-world Data of Traditional Chinese Medicine / 中国实验方剂学杂志

ObjectiveTo evaluate the efficacy and influencing factors of Biejiajianwan in the treatment of primary liver cancer based on real-world data of traditional Chinese medicine （TCM）. MethodClinical diagnosis and treatment data of patients with primary liver cancer admitted to five Grade-A tertiary hospitals in Henan Province from January 2015 to December 2020 were collected from the medical electronic database. The patients treated with Biejiajianwan for ≥30 days were assigned to the exposure group and those without treatment with Biejiajianwan or treated with Biejiajianwan for <30 days to the non-exposure group. The propensity score matching model was used to balance confounding factors between the two groups according to the 1∶1 genetic matching method. Kaplan-Meier method was used for survival analysis and survival curve plotting. Log-rank was used to test the difference in survival rate between the two groups. Univariate analysis of Biejiajianwan in the treatment of primary liver cancer was performed by Log-rank test combined with the Kaplan-Meier method. The factors with statistical significance （P<0.05） were combined with unbalanced factors by the propensity score matching model， and at the same time， clinical common sense and relevant prognostic factors by literature search were considered， which were subjected to multivariate analysis by Cox proportional hazards regression model. ResultA total of 2 207 electronic cases were collected，including 174 cases in the exposure group （Biejiajianwan group） and 2 033 cases in the non-exposure group. After propensity score matching， there were 174 cases in the exposure group and 174 cases in the non-exposure group. The Kaplan-Meier method was used for survival analysis on the matched data， and the Log-rank test results showed that the survival rate of patients with primary liver cancer in the Biejiajianwan group was higher than that in the control group （χ2=12.193， P<0.01）. Cox proportional hazards regression model analysis showed that the regression coefficient of Biejiajianwan was -0.916 4 with the hazard ratio （HR） ［95% confidence interval （CI）］=0.4 （0.239 5-0.668 0）， P<0.01， and the regression coefficient of radiofrequency ablation treatment was -0.976 5 with HR （95% CI）=0.376 6 （0.172 8-0.821 1， P<0.05）. Fibrinogen （FIB） abnormal regression coefficient was 0.481 4 with HR （95% CI）=1.618 4（1.022 0-2.562 9），P<0.05. ConclusionBiejiajianwan can prolong the survival period of patients with primary liver cancer. Radiofrequency ablation is an independent protective factor for Biejiajianwan in the treatment of primary liver cancer，while abnormal FIB are independent risk factors for Biejiajianwan in the treatment of primary liver cancer.

Medical nutrition management and follow-up of patients with late-onset ornithine transcarbamylase deficiency / 中华实用儿科临床杂志

Objective:To explore the clinical characteristics and medical nutritional therapy of 6 patients with late-onset ornithine transcarbamylase (OTC) deficiency.Methods:The clinical features, biochemical data, gene variations and treatment outcomes of 6 children with late-onset OTC deficiency admitted to the Department of Clinical Nutrition, Children′s Hospital of Nanjing Medical University from January 2020 to April 2022 were retrospectively analyzed.The 6 patients were all intervened by a long-term medical nutrition management.Results:Liver dysfunction and hyperammonemia (172.1-348.0 μmol/L) were found in all the 6 children with late-onset OTC deficiency.Serum citrulline decreased in 3 patients (3.95-5.43 μmol/L). Three patients showed increased urine orotic acid (123.48-342.60 mmol/mol Cr). Urine uracil increased in 4 patients (106.77-1 207.26 mmol/mol Cr). Variations of the OTC gene [c.364G>C p. (E122Q), c.1028C>G p. (T343R), c.664-2(IVS6)A>C, c.635G>T p. (G212V), c.929_c.931delAAG p. (E310del), c.829C>T p. (R277W)] were identified in all patients.The 6 children were all managed by individualized medical nutrition program and followed up for a long time.During the follow-up period, 3 cases developed hypoproteinemia, acute metabolic crisis and growth retardation, 3 cases had normal growth and laboratory indicators, and 1 case received liver transplantation after 3 months of nutritional management. Conclusions:The clinical manifestations of OTC deficiency are non-specific.Blood amino acids, urine organic acids and genetic tests are important for the diagnosis.Long-term regular medical nutrition management is helpful to improve the prognosis and quality of life of children.

The role of heparin-binding protein in predicting bacterial infection in traumatic intracerebral hemorrhage / 中华急诊医学杂志

Objective:To investigate the role of heparin-binding protein (HBP) as a predictor of early bacterial infections in patients with traumatic intracerebral hemorrhage.Methods:Patients with traumatic intracerebral hemorrhage admitted to the Emergency Department of the First Hospital of Shanxi Medical University from September 2021 to June 2022 were collected prospectively. Patients with bacterial infection diagnosed by pathogenic examination were classified as the infected group, and those with negative pathogenic examination were classified as the non-infected group. Peripheral blood HBP counts were measured within 48 h of admission, and general information and relevant laboratory tests were collected. The differences of the indicators between the two groups were compared, the receiver operating characteristic (ROC) curve was drawn, the predictive value of the indicators for patients with co-infection was assessed, and the valuable predictors were screened out using multivariate logistic regression analysis.Results:Eighty-five patients [44 males and 41 females, aged (55.09±1.18) years] , were included in the study. Among the patients included in the study, 39 patients had bacterial infection and 46 were non-infected. Patients in the infected group were older , and had more surgeries, higher respiratory rate and injury severity score, and higher levels of HBP [(33.00±3.49) ng/mL vs. (16.27±1.61) ng/mL, P<0.001], leukocytes, and neutrophils [(15.32±3.19) ×10 9/L vs. (6.69±0.57) ×10 9/L, P=0.005] than in the non-infected group, while the Glasgow Coma Scale [(8.72±0.63) vs. (11.37±0.48), P=0.001] was lower than that in the non-infected group, with statistically significant differences (all P<0.05). There was no significant differences in lymphocytes, red blood cells, platelets, calcium, procalcitonin and coagulation indexes between the two groups (all P>0.05). Logistic regression analysis showed that neutrophils ( OR=1.252, 95% CI: 1.075-1.457, P=0.004) and HBP ( OR=1.081, 95% CI: 1.025-1.141, P=0.004) were independent risk factors for infection in patients with traumatic cerebral hemorrhage. The area under ROC curve for HBP of diagnosing early co-infection in patients with traumatic intracerebral hemorrhage was 0.82 (95% CI: 0.71-0.88), the sensitivity was 92.31%, and the specificity was 52.17%. Conclusions:HBP is a valuable predictor of early traumatic intracerebral hemorrhage complicated with bacterial infection in the emergency department, and has a good supplementary value to the existing test indicators.

Effects of ferrocene position isomerization on the self-assembly behavior and antibacterial effect of coupled cationic peptides / 中国药房

OBJECTIVE To design the two isomers of ferrocene （Fc）-coupled cationic peptides （hereinafter referred to as “peptides”） [Fc-K（C8）FFHK and C8-K（Fc） FFHK] and the control peptide [C8-K（C8）FFHK]， and to explore the effects of Fc position isomerization on the self-assembly behavior and antibacterial effect of peptides. METHODS All isomerized peptides were prepared by standard solid-phase synthesis and purified by reversed-phase high-performance liquid chromatography. The stability of the peptide was analyzed by using UV spectrophotometry to detect UV absorption spectra， and Zeta potential analyzer to determine Zeta potential. The secondary structure was characterized by circular dichroism spectrum （CD）， Fourier transform infrared spectrometer （FTIR）， thioflavin T （ThT） fluorescence spectrum and transmission electron microscopy （TEM）. The differences in antibacterial activity and biocompatibility of the 2 kinds of isomerized peptides were evaluated by in vitro reactive oxygen species （ROS） generation test， growth curve determination test， plate method， cytotoxicity assay and hemolysis test. RESULTS Three peptides with purity higher than 95% were synthesized. The stability test results showed that the UV absorption spectra of Fc-K（C8）FFHK and C8-K（Fc）FFHK remained almost unchanged when placed at room temperature for 24 and 96 hours， and their Zeta potential were decreased by 0.3 mV and 0.5 mV， respectively. Secondary structure characterization results showed that Fc-K（C8）FFHK and C8-K（Fc）FFHK were self-assembled to form twisted nanoribbons and short nanofibers， respectively； C8-K（C8）FFHK was assembled into cylindrical nanofibers. The optical spectrum results showed that there were certain differences in the content of structures such as β-sheet and α-helix. The in vitro ROS generation test results showed that ROS generation efficiency of Fc-K（C8）FFHK at pH 6.0 was higher than C8-K（Fc）FFHK. The results of in vitro antibacterial activity showed that for methicillin-resistant Staphylococcus aureus， both the isomeric peptides had similar minimum inhibitory concentration （MIC） values of 50 μg/mL which were far lower than the control peptide （400 μg/mL）. To Escherichia coli， Fc-K（C8）FFHK had better antibacterial activity than C8-K（Fc）FFHK. Finally， cytotoxicity assay and hemolysis test results showed that both isomeric peptides had good biocompatibility. CONCLUSIONS By wangjingwen8021@163.com coupling Fc， the antibacterial activity of cationic self-assembled peptides can be improved. Regulating the position of Fc in the peptide sequence could regulate the self-assembly behavior and antibacterial effect of the self-assembled peptides.

Discussion on quality control in clinical trials of interventional valvular medical devices / 中国胸心血管外科临床杂志

@#With the rapid development of the field of interventional therapy of cardiac valve, the innovative researches of interventional therapy of cardiac valve products have become the focus of global research. At present, there is a serious shortage of interventional valvular medical devices on the market in China, and large-scale interventional valve products are undergoing early human trials or confirmatory clinical trials. The effective quality control of clinical trials is of great significance to ensure that clinical trial data can be used to support the marketing of device products. By analyzing the problems in clinical trials quality control of interventional valvular medical devices in our hospital, and combining the characteristics of device products and diseases, we explore the key points of quality control and provide reference for the implementation and completion of high-quality clinical trials.

Study on protective mechanism of kaempferol against cerebral ischemia/reperfusion injury in vitro and in vivo / 中国药房

OBJECTIVE To explore the protective mechanism of kaempferol （KAE）on cerebral ischemia/reperfusion （CI/R） injury in vitro and in vivo . METHODS Firstly，the potential targets of KAE in the treatment of CI/R injury were preliminarily screened by network pharmacology. AutoDock Vina software was used to conduct molecular docking between KAE and the top 10 core targets ，and the binding affinity was used as the evaluation standard to further clarify the possible mechanism of KAE in treating CI/R injury. Finally ，the above results were verified by in vivo and in vitro experiments. The oxygen glucose deprivation/ reperfusion（OGD/R）HT22 cell injury model and the middle cerebral artery occlusion （MCAO）rat model were constructed. The cell activity was detected by CCK- 8 method. The neural function score and TTC staining were performed on the rats and their brain tissues. The phosphorylation levels of protein kinase B （Akt）and Src in HT 22 cells and brain tissue of rats were detected by Western blot. RESULTS The results of network pharmacology screening showed that KAE in the treatment of CI/R injury was closely related to 10 core targets including prostaglandin-endoperoxide synthase 2，matrix metalloproteinase 9，JUN，Akt1，tumor necrosis factor ，caspase-3，mitogen activated protein kinase 8，intercellular cell adhesion molecule 1，vascular cell adhesion molecule 1 and Src. The results of molecular docking showed that KAE was stably bound with Akt 1 and Src . The results of in vitro and in vivo experiments showed that KAE could significantly improve the survival rate of OGD/R-injuried HT 22 cells （P＜0.05）， significantly reduced the neurological function score of MCAO model rats （P＜0.05），significantly reduces the volume of cerebral infarction in rats （P＜0.05），and significantly increased the phosphorylation levels of Akt and Src in HT 22 cells and brain tissue of rats（P＜0.05），which showed a dose dependent trend. CONCLUSIONS KAE may play a neuroprotective role by regulating the phosphorylation expression of Akt and Src ，thus treating CI/R injury.

Analysis of 4 Cases of Fungal Infections in Children and Literature Review / 中国药房

OBJECTIVE：To prov ide a reference for the diagnosis and treatment of invasive fungal infection in children. METHODS：Four male children with invasive fungal infection in critical condition ，aged from 3 months to 17 years，were treated in our hospital. The types of diseases included pneumonia ，endocarditis，meningitis and pulmonary infection. The pathogens involved Trichosporon asahii ，Candida portugal ，Malassezia globosa ，Pichia guilliermondii ，Alternaria alternate and Candida krusei. Clinical pharmacists comprehensively followed up the treatment and reviewed the literature to assist doctors in formulating treatment plans. They provided Fluconazole sodium chloride injection （6 mg/kg，ivgtt，qd），Caspofungin acetate for injection （loading dose 32 mg，maintenance dose 25 mg，ivgtt，qd），Fluconazole capsules （400 mg，p.o.，qd）and Voriconazole for injection（200 mg，i.v.，q12 h）+Capofungin acetate for injection （loading dose 70 mg，maintenance dose 50 mg，i.v.，qd）and other symptomatic treatment ，and closely monitored the changes of relevant indicators and the occurrence of ADR during the treatment of children. RESULTS ：The doctor adopted the clinical pharmacist ’s suggestion ，three cases were relieved and one was not cured. No serious ADR was found. CONCLUSIONS ：Once similar infections are found in clinic ，timely targeted treatment should be given in combination with the types of pathogens and drug resistance characteristics ，so as to effectively control the disease. The real cases provided in this article can provide evidence for the treatment of children with fungal infection.

Analysis of nurses′ innovative behavior from the perspective of empowerment theory / 中国实用护理杂志

Based on the concept of empowerment theory and innovation behavior, this paper summarizes the status quo of the impact of empowerment theory on nurses′ innovative behavior, analyzes the essence and influencing factors of innovation behavior of nurses according to the elements of empowerment theory, analyze the empowerment theory and nurses′ individual innovation behavior scale, and puts forward the feedback mechanism of empowerment theory. In order to further improve the innovative behavior of nurses by applying the empowerment theory management mode, it is helpful for nursing managers to train nursing talents by using empowerment theory.

Improvement Effects of β-boswellic Acid on Hippocampal Neurons Cells Injury Induced by Oxygen-glucose Deprivation / 中国药房

OBJECTIVE：To study the imp rovement effects of β-boswellic acid on hippocampal neurons cells injury of rats induced by oxygen-glucose deprivation. METHODS ：The hippocampal neurons cell of rats were divided into normal control group ， model group and β-boswellic acid low-concentration ，medium-concentration and high-concentration groups （1，10，100 μmol/L）. Except for normal control group ，other groups were cultured with relevant medium and given oxygen glucose deprivation to induce oxygen-glucose deprivation induced injury model. MTT assay was adopted to detect cell viability. Chemical colorimetry was used to detect LDH activity in cell culture supernatant. Hoechst-PI staining was used to detect the morphology change of cells. Flow cytometry was used to detect early apoptosis rate of cells. The expression of apoptosis-related protein （Bcl-2，Bax and cleaved caspase-3） were detected by Western blot. RESULTS ：Compared with model group ，the survival rate of cells and protein expression of Bcl- 2 were increased significantly in β-boswellic acid medium-concentration and high-concentration groups （P＜ 0.01），while LDH activity ，early apoptosis rate ，protein expression of cleaved caspase- 3 and Bax were all decreased significantly （P＜0.05 or P＜0.01）. The densely stained nuclei and fragmentation decreased significantly. CONCLUSIONS ：β-boswellic acid can relieve oxygen-glucose deprivation induced injury of hippocampal neurons cells ，the mechanism of which may be associated with down-regulating the protein expression of cleaved caspase- 3 and Bax and up-regulating the protein expression of Bcl- 2.

Relationship between exercise related syncope and iron deficiency anemia in Children and analysis of nutrition supply / 中国医师进修杂志

Objective:To investigate the relationship between exercise related syncope and iron deficiency anemia in children, and analyze the effect of nutrition supply on exercise related syncope.Methods:Three hundred and six children with iron deficiency anemia in Quanzhou Medical College People′s Hospital Affiliated from June 2018 to June 2020 were enrolled, and they were divided into two groups: observation group (105 Children with exercise related syncope) and control group (201 Children without exercise related syncope). General data, red blood cell parameters, iron metabolism index and blood trace element level were compared between two groups. The daily food composition, the intake of three major nutrients, trace elements and Vitamins were analyzed.Results:The body mass index and waist-to-hip ratio in the observation group were lower than those in the control group, the blood oxygen saturation was lower than that in the control group, the proportion of males, severe anemia, picky eaters and more intake of snack were higher than those in the control group, the differences were statistically significant ( P<0.05). The levels of hemoglobin, mean corpuscular hemoglobin concentration and mean corpuscular volume in the observation group were lower than those in control group: (70.12 ± 9.68) g/L vs. (83.64 ± 10.12) g/L, (20.12 ± 3.64) pg vs. (26.97 ± 3.52) pg, (63.46 ± 8.46) fl vs. (71.34 ± 8.12) fl; and the red blood cell distribution width was higher than that in control group: 0.258 ± 0.058 vs. 0.201 ± 0.064, the differences were statistically significant ( P<0.05). The levels of serum ferritin content and total iron binding capacity in observation group were higher than those in the control group: (136.58 ± 28.71) ng/L vs. (113.21 ± 24.45) ng/L, (69.64 ± 7.23) μmol/L vs. (56.48 ± 8.65) μmol/L, the levels of serum ferritin and transferin saturation were lower than those in the control group: (15.32 ± 4.15) μmol/L vs. (17.69 ± 4.21) μmol/L, 0.198 ± 0.056 vs. 0.265 ± 0.062, the differences were statistically significant ( P<0.05). The levels of blood calcium and zinc in the observation group were lower than those in the control group: (5.44 ± 0.28) mmol/L vs. (5.63 ± 0.34) mmol/L, (63.23 ± 2.73) μmol/L vs. (68.42 ± 2.65) μmol/L, the differences were statistically significant ( P<0.05). The daily intake of cereals, meats, vegetables and fruits, beans, eggs and milk in the observation group were lower than those in the control group, the daily intake of sugar and protein in the observation group were lower than those in the control group, the daily intake of iron, Vitamin C and Vitamin A in the observation group were lower than those in the control group, the differences were statistically significant ( P<0.05). Conclusions:Iron deficiency anemia in Children may be one of the risk factors of exercise related syncope. Health education should be strengthened for children and their parents. Moreover, change of unhealthy diet behavior and adjustment of dietary structure can reduce the incidence of exercise related syncope.

Study on Methodology Re-evaluation for Systematic Review/Meta-analysis of Antidepressants in the Treatment of Post-stroke Depression / 中国药房

OBJECTIVE： To re-evaluate t he methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression. METHODS ：Retrieved from Cochrane Library ，PubMed，Embase， SinoMed，CNKI，Wanfang database ，VIP，CBM and other databases ，systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec. 2019. After literature screening and data extraction ， methodology quality of included literatures were evaluated by using the AMSTAR scale. RESULTS ：A total of 33 systematic reviews/Meta-analysis were included ，involving 523 RCTs and 41 020 patients. Average score of AMSTAR methodological quality evaluation was 6.76. Citalopram ，duloxetine and paroxetine were effective for the therapy of post-stroke depression ，but the conclusions about the effectiveness among antide-pressants were not consistents. The ADR incidence of Paroxetine was low. It was not clear that sertraline and citalopram may improve the neurological function of patients. CONCLUSIONS ：The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium ，and the conclusions about the effectiveness of antidepressants ，improvement of daily life ability and the recovery of neurological function are still controversial.

Clinical characteristics and prognosis of children with sepsis complicated with myocardial injury / 中国医师进修杂志

Objective:To investigate the clinical features and prognostic factors in children with sepsis complicated with myocardial injury.Methods:The clinical data of children with sepsis complicated with myocardial injury from January 2017 to January 2019 in Department of Intensive Care Unit, Children′s Hospital of Kunming City, were retrospectively analyzed. The pediatric critical illness score (PCIS) at admission, gender, age, infection site, clinical outcome, mechanical ventilation and blood purification were recorded. The etiological results, creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB), myoglobin, hypersensitive cardiac troponin T (hs-cTnT), procalcitonin (PCT), lactate, left ventricular ejection fraction (LVEF), cardiac output, left ventricular truncation rate (LVFS) were recorded. According to the clinical results, the children were divided into improvement group and deterioration group, and the clinical data of each group were compared. The receiver operating characteristic (ROC) curve and multivariate Logistic regression were used to screen the relevant clinical indicators that could predict the prognosis of children.Results:A total of 138 children with sepsis complicated with myocardial injury were enrolled. Thirty cases died in 28 d, and the mortality of 28 d was 21.7%. The respiratory tract was the main infection site, and the main pathogens were gram-negative bacteria and virus. The 35.4% (28/79) of children were complicated with multiple infections. There were 102 cases in improvement group; and there were 36 cases in deterioration group, among whom 5 cases died in hospital and 31 cases was discharged without treatment. The proportion of the girls in deterioration group was significantly higher than that in improvement group: 63.9% (23/36) vs. 34.3% (35/102), and there was statistical difference ( P<0.01); there were no statistical differences in age, infection site, mechanical ventilation, blood purification and PCIS between 2 groups ( P>0.05). The hs-cTnT and lactate in deterioration group were significantly higher than those in improvement group: (1.87 ± 0.67) ng/L vs. (1.62 ± 0.51) ng/L and (0.46 ± 0.31) ng/L vs. (0.34 ± 0.27) ng/L, and there were statistical differences ( P<0.05); there were no statistical differences in CK, CK-MB, myoglobin, PCT, LVEF, cardiac output and LVFS between 2 groups ( P>0.05). ROC curve analysis result showed that the hs-cTnT and lactate were risk factors for predicting clinical prognosis in children with sepsis complicated with myocardial injury, the area under the curve were 0.623 and 0.613, the optimal value were 159.59 and 2.65 ng/L, with a sensitivity of 36.1% and 55.6%, and a specificity of 98.2% and 70.6%. Multivariate Logistic regression analysis result showed that the hs-cTnT and gender were independent risk factors for prognosis ( OR = 2.237 and 0.286, 95% CI 1.093 to 4.578 and 0.127 to 0.644, P = 0.028 and 0.003). Conclusions:The 28 d mortality in children with sepsis complicated with myocardial injury is higher, and the respiratory tract is the most common infection site. The increased hs-cTnT and lactate levels indicate that the prognosis is poor in children with sepsis complicated with myocardial injury. The hs-cTnT and and gender are independent risk factors of prognosis.

Clinical research of Lishi-Jianpi-Quyu decoction combined with conventional western medicine for the patients with oral lichen planus / 国际中医中药杂志

Objective@#To evaluate the therapeutic effect of Lishi-Jianpi-Quyu decoction combined with conventional western medicine for the oral lichen planus (OLP).@*Methods@#A total of 80 OLP patients who met the inclusion criteria were divided into two groups by random number table method, 40 in each group. The control group was treated with conventional medicine, while the research group were treated with Lishi-Jianpi-Quyu decoction on the basis of control group. Two groups were treated for 4 weeks. The severity of oral mucosal lesions was assessed by REU scale, and oral discomfort was assessed by VAS scale. The serum tumor necrosis factor-α (TNF-α), IL-6 and IL-8 levels were detected by ELISA, peripheral blood CD3+, CD4+ levels were detected by flow cytometry, and the ratio of CD4+/CD8+ was calculatedand the clinical efficacy was evaluated.@*Results@#The effective rate of research group was 82.5% (33/40), while the control group was 62.50% (25/40), and the difference between two groups was statistically significant (χ2=9.031, P=0.003). After treatment, TNF-α (1.19 ± 0.28 μg/L vs. 3.59 ± 0.72 μg/L, t=19.807), IL-6 (11.14 ± 2.04 ng/L vs. 16.34 ± 3.20 ng/L, t=8.666), IL-8 (1.15 ± 0.61 ng/L vs. 2.04 ± 0.76 ng/L, t=5.776) of research group were significantly lower than the control group (P<0.01). The serum CD3+ (64.02% ± 5.16% vs. 58.07% ± 4.85%, t=5.314), CD4+ (41.26% ± 3.61% vs. 37.15% ± 3.04%, t=5.508), CD4+/CD8+ (1.60 ± 0.43 vs. 1.31 ± 0.40, t=3.668) of research group were significantly higher than those of the control group (P<0.01). After treatment, the REU score and VAS score in the research group were significantly lower than that in the control group (t=10.980, 11.146, P<0.01).@*Conclusions@#The Lishi-Jianpi-Quyu decoction combined with conventional western medicine can improve the clinical symptoms of OLP, reduce the level of serum inflammatory cytokines, and enhance the body's immunity and improve the curative effect.

Analysis of Drug Utilization in Obstetric Patients of Our Hospital during Pregnancy / 中国药房

OBJECTIVE： To analyze the characteristics of pregnancy medication in obstetric patients of our hospital， and to provide reference for promoting rational drug use in obstetric department. METHODS： Using hospital information system， 30 prescriptions of women who produced in our hospital were randomly selected monthly from Jan. 2015 to 30th， 2017. The modes of production and pregnancy outcomes were recorded. The drugs used during pregnancy in our hospital were summarized. Statistical analysis was made on the number of cases， varieties and frequency of drug use in neonatal outcomes and different stages of pregnancy. The rationality of drug use in different stages of pregnancy was evaluated. RESULTS： Totally 1 076 valid prescriptions were collected， including 528， 343 and 205 cases aged 21-30， 31-34， 35 and above， 462 cases with cesarean and 614 patients with spontaneous labor， 1 041 cases with single fetus and 35 cases with twins， 1 089 neonates with APGAR score of 8-10，20 neonates with 4-7，and 2 neonates with 0-3， 96 neonates with low birth weight and 4 neonates with abnormal. The rate of drug use during pregnancy was as high as 96.65％ （1 040/1 076）. The utilization rate of drugs were 55.19％ （574/1 040）， 99.42％ （1 034/  1 040） and 57.98％ （603/1 040） in the first， second and third trimesters of pregnancy， involving 137 drugs. Classification of top 3 drugs in the list of frequency were drugs for digestive tract and metabolic diseases for Fuzheng agent （Chinese patent medicine） and for sex hormones and regulators of reproductive system in the first trimesters of pregnancy， and for digestive tract and metabolism， urinary and reproductive system and cardiovascular system in the second trimesters， for digestive tract and metabolism， blood and hematopoietic organs and systemic hormones except sex hormones and insulin in the third trimesters. There were unreasonable use of drugs in the first trimester and there were also abnormalities outcomes of birth， but the correlation between abnormalities and drugs used during pregnancy could not be determined in the study. CONCLUSIONS： The rate of drugs used during pregnancy was high， and the value of DDDs was highest in the second trimester； the types of drugs used in different periods basically accord with the epidemiological characteristics of pregnancy. However， there are some unreasonable medication problems and potential safety hazards in medication during pregnancy， which need to be further rectified. The correlation between adverse pregnancy outcomes and drugs used during pregnancy has not been determined， and needs to be studied with large sample data.

Practice of Standardizing Rational Use of Proton Pump Inhibitors in Neurosurgery Department of Our Hospital by PDCA Cycle Management / 中国药房

OBJECTIVE： To promote rational use of proton pump inhibitors （PPIs） during perioperative period. METHODS： PDCA （Plan， Do， Check， Action） cycle management was used， the irrational use of PPIs of 300 medical records in neurosurgery department of our hospital were collected. The reasons were analyzed， management target was formulated and measures were implemented. The effects of management were evaluated through comparing the rate of irrational drug use and ratio of irrational type of PPIs in 300 medical records of neurosurgery department during perioperative period after management. RESULTS： Through collecting related data to confirm risk factors of stress ulcer， establishing rationality evaluation criteria for perioperative prophylactic use of PPIs， conducting rational drug use training among medical staff， drawing up various management systems and strengthening supervision and management， the rate of irrational use of PPIs was decreased significantly in our hospital； the number of irrational drug use cases decreased from 240 before management to 156 after management， among which the rate of prophylactic drug use without indication decreased from 37.33％ to 29.00％ （P＜0.05）； the irrational dosage rate decreased from 11.33％ to 6.33％ （P＜0.05）； the rate of irrational dosing frequency dropped from 12.67％ to 5.00％ （P＜0.01）. CONCLUSIONS： PDCA cycle management of our hospital can standardize the prophylactic use of PPIs in neurosurgery department during perioperative period and promote rational use of PPIs.

Nutritional risk screening and its clinical significance of infants with severe pneumonia / 中国实用护理杂志

Objective To investigate the nutritional risk of hospitalized infants with severe pneumonia and its relationship with clinical outcome. Methods Totally 113 infants with severe pneumonia admitted to pediatric intensive care unit (PICU)were enrolled in the study. Nutritional risks were screened by STRONGkids, and the nutritional were assessment with WHO Anthro. Clinical outcomes were recorded and analyzed, including mechanical ventilation, length of PICU stay, total hospital expenses, prognosis, and biochemical test index. Results A total of 44 infants (38.9％) had high nutritional risk, 49 (43.4％) had medium nutritional risk, 20 (17.7％) had low nutritional risk when they admitted to PICU. A total of 59 (52.2％) infants were malnourished when they admitted to PICU. There was a significant correlation between the degree of malnutrition and nutritional risk (r =0.574, P<0.01).The incidence of high nutritional risk was significantly higher in 28d～1year-old group than in 1～3 year-old group (χ2=20.46, P<0.01). Nearly 42.5％(48/113) of the children had congenital disease and had higher incidence of high nutritional risk (χ2=11.375, P=0.003) and higher incidence of malnutrition (χ2=10.083, P=0.001) than those without congenital disease. The rate of mechanical ventilation (P=0.028), the duration of mechanical ventilation (P<0.01), total hospital expenses (P=0.002) and the incidence of poor prognosis(P=0.014) were significantly higher in high nutritional risk group than the low nutritional risk group. The retinol binding protein in the high nutrition risk group was significantly lower than the low nutrition risk group (χ2=6.333, P=0.021). Conclusions High nutritional risk and malnutrition are common in infants with severe pneumonia. Malnutrition and nutritional risk are increased in patients less than 1 year old or suffering from congenital disease. Patients with high nutritional risk are more likely to have worse clinical outcomes. STRONGkids is a valid tool for nutritional risk screening in hospitalized children, and early nutrition support is recommended.

Diagnosis and treatment progress of ocular adnexa mucosa-associated marginal zone lymphoma / 白血病·淋巴瘤

Primary ocular adnexal mucosa-associated marginal zone lymphoma is the most common ocular adnexal lymphoma. In recent years, its incidence has been increasing, and some techniques of immunology and molecular biology can make us better identify lymphoma with other lymphadenopathies, and some imaging tools can better judge the stage. In addition to radiotherapy and chemotherapy, antibiotic therapy and immune therapy have made progresses in treatment. This paper reviews the research progress of the diagnosis, staging and treatment of the disease.

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment / 基因组蛋白质组与生物信息学报·英文版

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders (ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother-child pairs of ASD children and 30 matched mother-child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother-child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.

Complete Mitochondrial Genome of the Chagas Disease Vector, Triatoma rubrofasciata

Triatoma rubrofasciata is a wide-spread vector of Chagas disease in Americas. In this study, we completed the mitochondrial genome sequencing of T. rubrofasciata. The total length of T. rubrofasciata mitochondrial genome was 17,150 bp with the base composition of 40.4% A, 11.6% G, 29.4% T and 18.6% C. It included 13 protein-coding genes, 22 tRNA genes, 2 rRNA genes and one control region. We constructed a phylogenetic tree on the 13 protein-coding genes of T. rubrofasciata and other 13 closely related species to show their phylogenic relationship. The determination of T. rubrofasciata mitogenome would play an important role in understanding the genetic diversity and evolution of triatomine bugs.

Effects of Emodin against Renal Tubular Epithelial Cell Fibrosis via the Inhibition of Akt/mTOR Signal Pathway / 中国药师

Objective: To investigate the mechanism of emodin ( EM) in the expression of related protein for the fibrosis of the transforming growth factor-β1(TGF-β1)-stimulated human renal tubular epithelial (HK-2) cells. Methods: HK-2 cells were randomly divided into the normal control group, TGF-β1-stimulated model control group and emodin ( TGF-β1 +EM) group. The contents of Collage Ⅰ and fibronectin in the culture supernatant were determined by ELISA. After HK-2 cells were stimulated with TGF-β1 for 24 h, the cells were collected for immunofluorescence, Western blot and RT-PCR analysis. RT-PCR was used to detect PI3K, p-Akt and mTOR. The protein expressions of PI3K, p-Akt and mTOR were detected by Western blot. Immunofluorescence was used to detect PI3K. Results: Compared with those in the model control group, the contents of CollageⅠand fibronectin in the supernatant of emod-in group significantly decreased (P<0. 05), the expression of PI3K protein was inhibited, the expression of downstream p-Akt protein decreased, and the downstream mTOR decreased (P<0. 05), the expression levels of PI3K, p-Akt and mTOR mRNA decreased, the differences were statistically significant (P<0. 05), and the expression of PI3K decreased. Conclusion: Emodin can alleviate fibrosis of HK-2 cells stimulated by TGF-β1 through the classical Akt/mTOR pathway of autophagy.