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Yigongsan， derived from QIAN Yi’s Key to Therapeutics of Children’s Diseases in the Song Dynasty， is a classic pediatric prescription that is included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） released by the National Administration of Traditional Chinese Medicine in 2022. This paper verifies and analyzes the historical origin， composition， dosage， processing， decoction method and efficacy of Yigongsan by systematically combing ancient books and modern documents. As a result， Yigongsan is composed of five herbs： Panax ginseng， Poria cocos， Atractylodes macrocephala， Citrus reticulata and Glycyrrhiza uralensis， of which P. cocos should be peeled， A. macrocephala is fried with soil， G. uralensis is roasted with honey while P. ginseng and C. reticulata are raw products. According to the dosage of ancient and modern times， each medicinal herb must be ground into fine powder， 1.6 g for each， added with 300 mL of water， 5 pieces of Zingiber officinale， and 2 Ziziphus jujuba， decocted together to 210 mL， and taken before meals. In ancient books， Yigongsan is used to treat vomiting， diarrhea， spleen and stomach deficiency， chest and abdominal distension， and lack of appetite， etc. Modern research showed that Yigongsan could also be used in the diseases of immune system， respiratory system， blood system， etc.， involving infantile anorexia， asthma， anemia， tumors and so on.
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Tripterygium glycosides liposome(TPGL) were prepared by thin film-dispersion method, which were optimized accor-ding to their morphological structures, average particle size and encapsulation rate. The measured particle size was(137.39±2.28) nm, and the encapsulation rate was 88.33%±1.82%. The mouse model of central nervous system inflammation was established by stereotaxic injection of lipopolysaccharide(LPS). TPGL and tripterygium glycosides(TPG) were administered intranasally for 21 days. The effects of intranasal administration of TPG and TPGL on behavioral cognitive impairment of mice due to LPS-induced central ner-vous system inflammation were estimated by animal behavioral tests, hematoxylin-eosin(HE) staining of hippocampus, real-time quantitative polymerase chain reaction(RT-qPCR) and immunofluorescence. Compared with TPG, TPGL caused less damage to the nasal mucosa, olfactory bulb, liver and kidney of mice administered intranasally. The behavioral performance of treated mice was significantly improved in water maze, Y maze and nesting experiment. Neuronal cell damage was reduced, and the expression levels of inflammation and apoptosis related genes [tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), BCL2-associated X(Bax), etc.] and glial activation markers [ionized calcium binding adaptor molecule 1(IBA1) and glial fibrillary acidic protein(GFAP)] were decreased. These results indicated that liposome technique combined with nasal delivery alleviated the toxic side effects of TPG, and also significantly ameliorated the cognitive impairment of mice induced by central nervous system inflammation.
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Mice , Animals , Tripterygium , Liposomes , Glycosides/therapeutic use , Administration, Intranasal , Lipopolysaccharides , Central Nervous System , Cognitive Dysfunction/drug therapy , Inflammation/metabolism , Tumor Necrosis Factor-alpha/metabolism , Cardiac GlycosidesABSTRACT
OBJECTIVE Alzheimer's disease(AD)is the most common neurodegenerative disease worldwide.Neuroinflammation is a potential target for the patients with AD.It is attributed to activated microglia and the release of various inflammatory mediators from infec-tion,ischemia and toxin accumulation.Accumulating evi-dence has indicated that the cGAS-STING pathway driven neuroinflammation in neurological disease.TSG is a main natural active ingredient that derived from polyg-onum multiflorum.Previous research from our group found that TSG has beneficial effects of anti-aging,anti-inflammatory action and improving memory function in APP/PS1 transgenic AD mice.Here,we investigated the effects of TSG on cognitive impairment and neuroinflam-mation in APP/PS1-AD mice and explore the underly-ing mechanism by which TSG ameliorates memory func-tion in the cGAS-STING-mediated inflammatory response.METHODS The Morris water mace test and the novel object recognition test were performed to test the effects of TSG on spatial learning and cognitive and memory abil-ity in APP/PS1 double transgenic AD mice model.In addi-tion,real-time quantitative PCR,Western blotting,ELISA analysis,and flow cytometry to examine gene and pro-tein expression of cGAS-STING related pro-inflammatory cytokines and chemokines.Statistical analyses were ana-lyzed using the SPSS 25.0 package by analysis of vari-ance(ANOVA).Neuman-Keuls or Tukey's multiple-com-parisons test were conducted as ANOVA justified post hoc comparisons between group means.RESULTS We demonstrated that AD transgenic mice exhibited cognitive deficits accompanied by the elevated serum and brain inflammation.The expressions of serum inflammatory cytokines and the activation of microglia in cerebral cor-tex and hippocampus were suppressed after TSG treat-ment,which was probably attributable to the decrease of cyclic GMP-AMP synthase(cGAS)and stimulator of interferon genes(STING)triggered immune response.Additionally,the data showed that TSG treatment reduced the expression level of inflammatory cytokines(IL-1β,TNF-α,IFN-β,IFN-α)in microglial cells BV2 primed with LPS and IFN-γ.CONCLUSION TSG implicated the health benefits in preventing cognitive disorders by inhib-iting neuroinflammation via cGAS-STING signalling path-way in AD.
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OBJECTIVE Vascular dementia(VaD)is associated with cerebral hypoperfusion,which results in long-term cognitive impairment and memory loss.Neuroin-flammation is an important mechanism of vascular demen-tia.Cornel iridoid glycoside(CIG)is the major active con-stituent isolated from the ripe fruit of Cornus officinalis.Previous studies have shown that CIG enhances neuro-logical function in VaD rats.In the present research,we attempted to clarify the molecular processes underlying the role of CIG on neuroinflammation in VaD.METHODS In vivo,we created a chronic cerebral ischemia rat model by ligation of the bilateral common carotid arteries(2VO).The rats were divided into sham operation,2VO,2VO + CIG(60 and120 mg·kg-1·d-1),and 2VO+ butylphthalide(100 mg·kg-1·d-1)groups and then treated rats with differ-ent concentrations of CIG.In vitro,BV2 microglia cells were induced with bacterial lipopolysaccharide(LPS)and interferon-γ(IFN-γ)to construct the model of microglias with analog neuroinflammation.Histopathology and biel-schowsky silver staining were used to detect myelin integrity and neuronal loss.Immunofluorescence was used to observe changes in microglia.Magnetic Luminex Assay was used to detect changes in inflammatory fac-tors.Western blotting,ELISA or calpain activity assay was used to measure the expression and activity of cal-pain,as well as the expression of NLRP3 inflammasome protein.Furthermore,NLRP3 overexpressing cells were used to further elucidate the potential anti-inflammatory molecular mechanism of CIG.RESULTS ① CIG improved neuronal impairment in the brain of 2VO rats.②CIG increased white matter(WM)integrity in 2VO rats.③ CIG reduced microglia inflammatory response in the cortex and hippocampus of 2VO rats.④ CIG inhibited calpain activity in the cortex and hippocampus of 2VO rats.⑤ CIG exerted anti-inflammatory effects on BV2 cells stimulated by LPS and IFN-γ.⑥ CIG Inhibited the expression and activity of calpain in LPS/IFN-γ-activated BV2 cells.⑦ The main component of CIG had a weak binding force to calpain1.⑧ CIG inhibited the activation of the NLRP3 inflammasome.⑨CIG reduced the activity of calpain induced by NLRP3 overexpression.CONCLU-SION CIG inhibits microglial polarization into a proinflam-matory state by attenuating the assembly of the NLRP3 inflammasome and calpain activation,thus reducing brain inflammation,WM injury,and the loss of neurons.To sum up,the present study suggests that CIG inhibits neuroinflammation.The NLRP3/calpain pathway may be the main pathway by which CIG protects against neuroin-flammation.
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Alzheimer's disease(AD)is a neurode-generative disease with complex pathological mecha-nism characterized by accumulation of amyloid plaques and neurofibrillary tangles in the brain.Increasing evi-dence suggests that vascular dysfunction due to endothe-lial cell injury may have a pathogenic role in the occur-rence and development of AD.Malfunction of the blood-brain barrier caused by endothelial cell dysfunction is associated with the accumulation of several neurotoxic molecules within brain parenchyma,a reduction in cerebral blood flow,amyloid-β transfer and hypoxia,especially at the early stages of the disease.At the same time,it can-not be ignored that the peripheral arterial vascular endo-thelial cell dysfunction also seems to be closely related to the risk and the severity of symptoms of AD.Some mole-cules are thought to be messengers connecting the central and peripheral endothelial cells.Peripheral and central vascular endothelial cells communicate with each other and influence the progression of AD through some common mechanisms.In this review,we provide an ap-praisal of the endothelial cell dysfunction in cerebral and systemic vasculature,and give the evidence that vascular pathology is inextricably linked to disease onset and pro-gression of AD.
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Background and Objectives@#Regenerative endodontic procedures (REPs) are a research hotspot in the endodontic field. One of the biggest problems of REPs is that it is difficult to realize regeneration of pulp-dentin complex and functional reconstruction. The reason is still not clear. We hypothesize that the migration may be different in different dental stem cells. Periodontal ligament stem cells (PDLSCs) may migrate faster than stem cells of apical papilla (SCAPs), differentiating into cementum-like tissue, bone-like tissue and periodontal ligament-like tissue and, finally affecting the outcomes of REPs. Hence, this study aimed to explore the mechanism that regulates the migration of PDLSCs. @*Methods@#and Results: After isolating and culturing PDLSCs and SCAPs from human third molars, we compared the migration of PDLSCs and SCAPs. Then we investigated the role of SDF-1α-CXCR4/CXCR7 axis in PDLSC migration. We further investigated the impact of Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS) on PDLSC migration and the potential mechanism. PDLSCs showed better migration under both noninflammatory and inflammatory conditions than SCAPs. SDF-1α can promote the migration of PDLSCs by elevating the expression of CXCR4 and CXCR7, increasing the interaction between them, promoting expression of β-arrestin1 and activating the ERK signaling pathway. P. gingivalis LPS can promote the migration of PDLSCs toward SDF-1α through increasing the expression of CXCR4 via the NF-κB signaling pathway, promoting the expression of β-arrestin1, and activating the ERK signaling pathway. @*Conclusions@#This study helped elucidate the potential reason for the difficulty in forming pulp-dentin complex.
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Dengzhan Shengmai capsule, as a compound Chinese patent medicine, consists of four herbs: Herba Erigerontis, Ginseng, Ophiopogon, and Schisandrae Chinensis Fructus, and contains significant components of flavonoids, lignans, saponins, and organic acids. It is widely used clinically to treat cerebrovascular diseases such as chronic cerebral hypoperfusion and dementia with remarkable efficacy. This study proposes a research strategy for multi-component traditional Chinese medicine metabolites based on prediction databases and unfolds the analysis using Dengzhan Shengmai capsule as an example. Using the UPLC-Q-TOF/MS method, the analytical method was established and detected biological samples such as urine, feces, and bile of rats before and after administration based on the prediction of theoretical metabolites of Dengzhan Shengmai capsule. The possible secondary fragment ion information of metabolites was identified by comparing the detected results with prediction databases. The metabolites were identified based on the archetypal component mass spectrometric cleavage law and multistage mass spectrometric data. 51 metabolites, mainly flavonoid, organic acid, and lignan constituents, were finally identified from rat biosamples based on 306 theoretical metabolites of Dengzhan Shengmai capsule. This study provides a new strategy for the identification of metabolites in vivo and the analysis of metabolic pathways of TCM. The study complied with the procedures established by the Animal Experiment Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and passed the animal experiment ethics examine (No. 00003645).
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AIM: To investigate the efficacy of micropulse laser combined with intravitreal injection of ranibizumab in the treatment of macular edema(ME)secondary to non-ischemic branch retinal vein occlusion(BRVO).METHODS: A total of 200 cases(200 eyes)of non-ischemic BRVO secondary to ME who were treated in our hospital from January 2020 to March 2022 were selected and divided into the control group(100 cases, 100 eyes)and the observation group(100 cases, 100 eyes)by random number table. The control group was given intravitreal injection of ranibizumab, and the observation group was given micropulse laser combined with intravitreal injection of ranibizumab. The best corrected visual acuity(BCVA), central macular thickness(CMT), subfoveal choroidal thickness(SFCT), total number of injections, macular leakage and complications were compared between two groups.RESULTS: After treatment, the BCVA of the two groups were improved, and the BCVA of the observation group was better than those in the control group at 1, 3, 6 and 12mo after treatment(all P<0.05). After treatment, the CMT and SFCT of the two groups decreased, and the CMT and SFCT of the observation group was lower than those in the control group at 1, 3, 6 and 12mo after treatment(all P<0.05). The total number of injections in the observation group during the treatment period was less than that in the control group [(4.06±1.12)times vs.(5.32±1.15)times](t=5.852, P<0.001). The leakage rates of the control group and the observation group after 12mo of treatment were 69.0% and 27.0% respectively, with statistical significance between the two groups(χ2=35.337, P<0.001). The incidence of complications in the control group and observation group were 11.0% and 5.0% respectively, with no statistical significance between the two groups(χ2=2.446, P=0.118).CONCLUSION: Micropulse laser combined with intravitreal injection of ranibizumab has a significant clinical efficacy in the treatment of ME secondary to non-ischemic BRVO, which is safe and can improve patients' vision and ME, reduce the total doses of ranibizumab without increasing the incidence of complications.
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Objective:To explore the clinical significance of hepatitis B virus (HBV) DNA detection in screening patients with hepatitis B.Methods:Clinical data of 682 331 hepatitis B patients were retrospectively analyzed. The HBV DNA of these patients was detected in the Fifth Medical Center of the PLA General Hospital from January 2017 to December 2021, there were 481 159 males and 201 172 females in this cohort, the average age was (41.34±16.13) years. Patients were divided into HBV DNA positive group (219 879 cases) and HBV DNA negative group (462 452 cases). Clinical characteristics, data of five serologic markers of hepatitis B and hepatitis B surface antigen quantification (HBsAg-QN), liver function, alpha fetoprotein (AFP) and prothrombin time (PT) results were collected and analyzed and compared between the two groups.Results:The positive rate of HBV DNA was 32.22% (219 879/682 331) in this cohort. Among the different age groups, the positive rate of HBV DNA was the highest (40.34%, 128 038/317 380) in young people aged 18-44 years. The proportion of patients was lower among aged <1, 45-59 and ≥60 years patients in HBV DNA positive group than that in HBV DNA negative group, while the proportion of patients was higher among aged 1-17 and 18-44 years patients in HBV DNA positive group than that in HBV DNA negative group (all P<0.001). Among 2 291 <1-year-old infants tested for HBV DNA, 71 infants were HBV DNA positive. The positive rates of HBV DNA from 2017 to 2021 were 4.86% (27/556), 3.68% (14/380), 3.47% (17/490), 1.55% (6/386) and 1.46% (7/479) respectively, showing a downward trend year by year. The positive rate of HBV DNA in acute hepatitis B (AHB) patients was the highest (49.88%, 208/417) among 680 040 patients with hepatitis B. The proportion of AHB patients (0.09%, 208/219 808) and chronic hepatitis B (80.44%, 176 806/219 808) in HBV DNA positive group was higher than that in HBV DNA negative group [0.05% (209/460 232) and 65.45% (301, 216/460 232)], while the proportion of patients with HBV-related liver cirrhosis (11.28%, 24 793/219 808), HBV-related liver cancer (6.72%, 14 775/219 808), liver cancer surgery (1.39%, 3 055/219 808) and liver transplantation (0.08%, 171/219 808) were lower than that in HBV DNA negative group [22.99% (105 813/460 232), 7.25% (33 385/460 232), 3.50% (16 129/460 232) and 0.76% (3 480/460 232)] (all P<0.001). At the same time, positive rate of hepatitis B surface antigen (HbsAg), HBsAg-QN, hepatitis B e antigen (HbeAg), level of total bilirubin, total bilirubin, AFP and PT were higher in HBV DNA positive group than those in HBV DNA negative group, while the age, male ratio and albumin results in HBV DNA positive group were lower than those in HBV DNA negative group (all P<0.01). The HBV DNA loads were higher in HBsAg positive group, hepatitis B surface antibody positive group and HBeAg positive group than those in respective negative groups, while the HBV DNA loads were lower in hepatitis B e antibody positive group and hepatitis B core antibody positive group than those in respective negative groups (all P<0.001). Conclusions:The mother to child transmission rate of<1-year-old infants decreases year by year. HBV DNA is an important factor for the progression of hepatitis B disease. HBV DNA positive hepatitis B patients with higher HBsAg-QN values are more likely to have abnormal serum markers such as liver dysfunction. HBV DNA detection is therefore of clinical importance in screening patients with hepatitis B.
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Aortic dissection (AD) is a life-threatening vascular disease due to the tearing of aortic intimal layer, leading to the formation of pseudocavity. Once the acute progression of dissection happens, serious complications such as rupture and stroke may occur. The current imaging examinations for AD are invasive and may cause adverse effects related to contrast medium, which cannot be used for large-scale screening of AD. The latest studies have found that metabolic processes and metabolites of lipids,saccarides and proteins are involved in the pathogenesis and development of AD. In this article, we review the research progress in the caracteristics of AD related metabolism,summarize changes of specific metabolites in AD,and explore the clinical implication of studies on AD related metaboliome..
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Objective:To evaluate the long-term outcome of Viabahn stent graft in the treatment of complex femoropopliteal occlusive lesions.Methods:From Sep 2013 to Mar 2020, clinical data of TASC C and D femoropopliteal lesions treated with Viabahn were retrospectively analyzed. Patency rates, the freedom rate from clinically-driven target lesion revascularization (F-TLR), limb salvage and survival after five years were calculated.Results:A total of 65 patients (67 lower limbs) were included. 20 limbs were TASC C lesions, 47 limbs were TASC D lesions. The mean lesion length was (29.1±9.4) cm, including 48 chronic total occlusion (CTO) lesions (71.6%) with mean lesion length of (26.1±10.4) cm. Technique success rate was 98.6%. Mean length of stent graft was (31.3±10.1) cm.Major amputation was performed in 4.2% cases within 5 years. All-cause mortality in 5 years was 23.1%. Primary patency rates at 1,3,and 5 years were 76.8%,59.4%,50.9%, Assisted primary patency rates were 88.4%, 83.4%, 83.4% and secondary patency rates were 88.4%, 85.8%, and 85.8% . F-TLR at 1, 3 and 5 year was 88.2%,76.9%,73.1% .Conclusion:Viabahn for complex and long femoropopliteal artery occlusions is an acceptable treatment with fair long-term outcome.
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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly ravaged the world and infected hundreds of millions of people since its outbreak. Early diagnosis of COVID-19 is conducive to the control of virus transmission and the timely treatment of patients. Among the imaging techniques, chest CT is an important basis for the diagnosis and evaluation of COVID-19. 18F-FDG PET is not generally recommended as a routine diagnostic tool for COVID-19, but it plays an important role in the assessment of SARS-CoV-2-related events based on the characteristic of whole-body multi-systemic scan and functional imaging diagnosis. In this paper, the application of 18F-FDG PET in COVID-19 diagnosis, prognostic evaluation and long-term sequelae evaluation, and clinical performance of 18F-FDG PET after COVID-19 vaccine are summarized on the basis of literature research and clinical reports analysis. Furthermore, the application and development direction of other new molecular probes for nuclear medicine in COVID-19 are prospected.
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The classic formula Zhulingtang, derived from the medical work Treatise on Cold Damage (《伤寒论》) compiled by ZHANG Zhongjing, a medical sage in the Eastern Han Dynasty, has been included in the Catalogue of Ancient Classic Formulas (First Batch) published by the National Administration of Traditional Chinese Medicine in 2018. Using the method of textual research, this study systematically reviewed ancient and modern literature to conduct a historical and textual analysis of Zhulingtang, including its origin, composition, dosage, processing, decoction methods, efficacy, and applications. A total of 733 pieces of relevant information related to Zhulingtang were collected, involving 206 ancient Chinese medical texts, with 52 of them providing detailed records of the composition, dosage, processing, and efficacy of Zhulingtang. The results of the analysis showed that Zhulingtang was composed of Polyporus, Poria, Alismatis Rhizoma, Asini Corii Colla, and Talcum. Polyporus and Poria should be used without their peels, Asini Corii Colla should be stir-fried with clam powder, and Talcum should be ground into powder or soaked in water. Based on the conversion of ancient and modern dosages, Polyporus, Poria, Alismatis Rhizoma, and Talcum, 15.63 g for each one, were decocted with 800 mL of water to 400 mL. Then the drug residue was removed, and 15.63 g of Asini Corii Colla was added to the drug juice for melting by heating. The decoction should be taken warm, 140 mL each time, three times a day. Zhulingtang has the effects of promoting diuresis, nourishing yin, and clearing heat, and it is mainly used to treat water-heat combination syndrome, characterized by symptoms such as difficult urination, fever, and thirst. Modern research indicates that Zhulingtang is commonly used to treat diseases such as cirrhotic ascites, chronic glomerulonephritis, nephrotic syndrome, diarrhea, and urinary tract infections. This study provides key information about the famous formula Zhulingtang, which can serve as a reference for further development and research on its application.
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AIM: To investigate the efficacy and safety of orthokeratology combined with 0.01% atropine solution in adolescents with myopia.METHODS: A total of 100 adolescent myopic patients(100 right eyes)who received treatment at the Department of Ophthalmology, People's Hospital of Hengshui from January 2019 to January 2022 were enrolled. All patients were divided into two groups based on the patient's preferences and randomized controlled principles: control group(n=50)and experimental group(n=50). Patients in the control group received orthokeratology alone, while those in the experimental group received orthokeratology in combination with 0.01% atropine solution. Treatment data for both groups were collected at 1, 3, 6, 9 and 12mo after treatment. The observed indicators included refraction, corneal curvature, axial length(AL), central corneal thickness(CCT), pupil diameter(PD), lipid layer thickness(LLT), break-up Time(BUT), root-mean-square of higher-order aberration(RMSh), subfoveal choroidal thickness(SFCT), corneal endothelial cell density(CD), and hexagonal cell ratio(HEX). The adverse reactions experienced during follow-up period were also observed and recorded.RESULTS: After 12mo of treatment, the refraction, corneal curvature, and AL in the experimental group were -2.42±0.17D, 38.89±1.18D and 25.44±0.23mm, respectively, which were significantly better than the control group(-2.56±0.19D, 40.12±1.65D and 25.54±0.19 mm, all P<0.05). The CCT of the experimental group(538±33 μm)was lower than that of the control group(545±41 μm), while the PD of the experimental group was higher than that of the control group(6.38±0.38 mm vs. 6.12±0.37 mm, P<0.05). LLT and BUT in the experimental group was 61.14±8.41 nm and 9.24±2.05s, respectively, which were significantly higher than those in the control group(56.14±7.22 nm and 7.27±1.99s, all P<0.05). RMSh in the experimental group was lower than that of the control group(0.73±0.21 μm vs. 0.85±0.12 μm, P<0.05), and SFCT in the experimental group was significantly higher than that of the control group(289±55 μm vs. 282±59 μm, P<0.05). Additionally, after 12mo of treatment, there was no significant difference in CD and HEX between the experimental group and the control group(all P>0.05). The main adverse reactions of both groups during treatment period were photophobia, anaphylaxis, conjunctivitis and keratitis, but there was no significant difference between the two groups(all P>0.05).CONCLUSION: Compared to orthokeratology alone, the combination of orthokeratology and 0.01% atropine solution effectively prevents and improves the development of adolescent myopia without increasing the incidence of adverse reactions.
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Diabetic kidney disease （DKD） is characterized by the hyperfiltration and albuminuria in the early phase which are followed by progressive renal function decline， renal tubular epithelial cell hypertrophy， and tubulointerstitial fibrosis. Thus， it is one of the leading causes of chronic kidney diseases. The currently available therapies mainly aim to control the primary diseases and reduce the risk of kidney injury. Based on syndrome differentiation， traditional Chinese medicine （TCM） relieves the symptoms by excreting water and alleviating edema and eliminates the root cause by tonifying deficiency and supplementing the original Qi， thereby showing therapeutic effect and delaying the progression of DKD. It excels in comprehensively regulating the constitution of patients with little side effects. Among the Zang-fu organs， kidney takes the second place in the content of mitochondria which participate in the metabolism of water and fluid and are the foundation of kidney Yin and kidney Yang. Mitochondria are energy producers within a cell， which carry out cellular respiration， produce reactive oxygen species， and generate adenosine triphosphate by oxidative phosphorylation. Mitochondrial quality control （MQC） is an effective way to maintain mitochondrial dynamic balance， whose imbalances， such as mitochondrial oxidative stress， mitophagy， mitochondrial dynamic changes， and abnormal calcium regulation， are related to the occurrence and development of DKD. It is generally believed that the destruction of mitochondrial structure in the case of metabolic disorder is the main cause of the disease. In recent years， TCM has attracted the attention of both Chinese and foreign researchers for the unique advantages of treating both symptoms and root cause at the same time and multi-target synergy in the treatment of DKD. However， the specific mechanism is still unclear. It has been frequently verified that mitochondria may be one of the targets of TCM in the treatment of DKD. At the moment， no review on the treatment of DKD by TCM through the intervention of MQC is available. Therefore， this paper aims to summarize the research on TCM treatment of DKD by regulating MQC in the past 10 years， which is expected to provide a new direction for the treatment of DKD by TCM.
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Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of breast myofibroblastoma. Methods: The clinicopathological data and prognostic information of 15 patients with breast myofibroblastoma diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from 2014 to 2022 were collected. Their clinical characteristics, histological subtypes, immunophenotypes and molecular characteristics were analyzed. Results: There were 12 female and 3 male patients, ranging in age from 18 to 78 years, with a median and average age of 52 years. There were 6 cases in the left breast and 9 cases in the right breast, including 12 cases in outer upper quadrant, 2 cases in inner upper quadrant and 1 case in outer lower quadrant. Most of the cases showed a well-defined nodule grossly, including pushing growth under the microscope in 13 cases, being completely separated from the surrounding breast tissue in 1 case, and infiltrating growth in 1 case. Among them, 12 cases were classic subtype and composed of occasional spindle cells with varying intervals of collagen fiber bundles; eight cases had a small amount of fat; one case had focal cartilage differentiation; one case was epithelioid subtype, in which epithelioid tumor cells were scattered in single filing or small clusters; one case was schwannoma-like subtype, and the tumor cells were arranged in a significant palisade shape, resembling schwannoma, and one case was invasive leiomyoma-like subtype, in which the tumor cells had eosinophilic cytoplasm and were arranged in bundles, and infiltrating into the surrounding mammary lobules like leiomyoma. Immunohistochemical studies showed that the tumor cells expressed desmin (14/15) and CD34 (14/15), as well as ER (15/15) and PR (15/15). Three cases with histologic subtypes of epithelioid subtype, schwannoma-like subtype and infiltrating leiomyoma-like subtype showed RB1 negative immunohistochemistry. Then FISH was performed to detect RB1/13q14 gene deletion, and identified RB1 gene deletion in all three cases. Fifteen cases were followed up for 2-100 months, and no recurrence was noted. Conclusions: Myofibroblastoma is a rare benign mesenchymal tumor of the breast. In addition to the classic type, there are many histological variants, among which the epithelioid subtype is easily confused with invasive lobular carcinoma. The schwannoma-like subtype is similar to schwannoma, while the invasive subtype is easily misdiagnosed as fibromatosis-like or spindle cell metaplastic carcinoma. Therefore, it is important to recognize the various histological subtypes and clinicopathological features of the tumor for making correct pathological diagnosis and rational clinical treatment.
Subject(s)
Female , Humans , Male , Adolescent , Young Adult , Adult , Middle Aged , Aged , Antigens, CD34 , Biomarkers, Tumor/analysis , Leiomyoma/pathology , Neoplasms, Muscle Tissue/pathology , NeurilemmomaABSTRACT
Objective: This article investigated the clinical characteristics and distribution of drug resistance mutation sites in HBV RT region of hepatitis B infected patients. Methods: Retrospective analysis was made on 1 948 patients with HBV infection, who had been tested for NAs resistance mutation and had a medical history of NAs in the Laboratory Department of the Fifth Medical Center of the PLA General Hospital from January 2020 to December 2021. Basic clinical information and drug resistance related mutation information were recorded. Meanwhile, the serological index data of hepatitis B were collected. Drug resistance gene mutant group and non-mutated group were grouped according to whether the drug resistance genes had a mutation in HBV RT region, and the clinical characteristics and genotype distribution of the two groups were statistically analyzed. The pattern of drug resistance gene mutation, number of mutation sites, drug resistance type and mutation of NAs resistance-related sites were analyzed in 917 patients with drug resistance gene mutation in HBV RT region. χ2 Inspection was used for counting data. Meanwhile, two independent samples t-test and Wilcoxon rank sum test were used for measurement data. Results: Among the 1 948 patients with chronic HBV infection, 917 patients had drug resistance gene mutation in RT region (47.07%). The proportion of patients with acute hepatitis B and CHB in HBV RT resistance gene mutant group was lower than that in the non-mutated group, while the proportion of patients with HBV-related cirrhosis was higher than that in the non-mutated group, these differences were statistically significant. Compared with the non-mutated group in HBV RT region, the age, the positive rates of HBeAg and HBV DNA, and HBV DNA load of these patients were increased in drug resistance gene mutant group, these differences were statistically significant. Genotypes of patients in both groups were dominated by C, followed by B and D. The proportion of patients with genotype C in HBV RT drug resistance gene mutant group was higher than that of non-mutated group, the difference was statistically significant. There were 53 gene mutation patterns in 917 patients with drug resistance gene mutation in HBV RT region, and the main pattern was rtL180M+rtM204V+rtS202G (9.70%). The mutation sites were dominated by 3 (20.74%). There were 5 types of drug resistance, LAM+Ldt (21.25%) was the most. Among the 18 sites that were clearly associated with LAM, ADV, ETV and Ldt resistance in the HBV RT region, 14 sites were mutated, and the most common mutation sites were rtL180M, rtM204V, rtM204 and rtS202G. what's more, the proportion of patients with NAs drug resistance was LAM>Ldt>ETV>ADV. Conclusion: In order to prevent adverse consequences of this study such as disease recurrence or disease progression caused by HBV drug resistance, HBV infected patients, who have long-term use of NAs antiviral therapy, should monitor the level of HBV DNA and drug resistance genes in HBV RT region in order to optimize the treatment plan in time or guide individualized treatment.
Subject(s)
Humans , Hepatitis B virus/genetics , Hepatitis B, Chronic , Antiviral Agents/therapeutic use , DNA, Viral/therapeutic use , Retrospective Studies , Mutation , Drug Resistance, Viral/genetics , Lamivudine/therapeutic useABSTRACT
The establishment of limit values for standards of drinking water quality is an important and complex process. This study systematically introduced the methodology of the establishment of standard limit values for drinking water quality and elaborated on the workflow of setting limit values of water quality indicators, principles and methods of selecting water quality indicators, derivation of safety reference values, and establishment of limit values. It also aimed to provide reference and support for the future revision of relevant standards.
Subject(s)
Humans , Water Supply , Drinking Water , Reference Standards , Water Quality , Water Pollutants, Chemical/analysisABSTRACT
The usage of vinyl chloride and trichloroethylene in China has been increasing year by year, and they have been detected in both drinking water and environmental water, making them important environmental pollutants. Based on the latest research results on the health effects of vinyl chloride and trichloroethylene, the newly issued, "Standards for Drinking Water Quality (GB5749-2022)" in China has adjusted the standard limit of vinyl chloride from 0.005 mg/L to 0.001 mg/L and the standard limit of trichloroethylene from 0.07 mg/L to 0.02 mg/L. This article analyzed and discussed the relevant technical contents for determining the above standard limits, including the levels and exposure conditions of vinyl chloride and trichloroethylene in the water environment, health effects, derivation of safety reference values, and determination of hygiene standard limits. Suggestions were also made for the implementation of this standard.
Subject(s)
Humans , Vinyl Chloride/analysis , Trichloroethylene/analysis , Drinking Water , Environmental Pollutants , China , Water Pollutants, Chemical/analysisABSTRACT
China is rich in antimony, boron, and vanadium mineral resources, which have been detected in environmental water bodies and drinking water. During the revision process of the "Standards for Drinking Water Quality (GB5749-2006)", research and evaluation are focused on three indicators: antimony, boron and vanadium. Vanadium is added and the limit value of boron is adjusted. This study reviews and discusses the technical contents related to the revision of the antimony, boron and vanadium, including the environmental presence levels, exposure status, health effects, and the revision of the standard limits of these three indicators. Suggestions are also made for the implementation of this standard.