Structure identification and content analysis of active components in Xiaoyao pills / 药学学报

Xiaoyao pills are a famous traditional Chinese medicine collected in Welfare Pharmacy, which is a classic prescription for treating liver depression and spleen deficiency. However, its composition is complex. In order to better control the quality of Xiaoyao pills, in this study, HPLC-ion-trap time-of-flight mass spectrometry (LC-IT-TOF/MS) was used to identify the main ingredients of Xiaoyao pills, paeoniflorin, albiflorin, glycyrrhizic acid, saikosaponin A and saikosaponin B2. Then a liquid chromatography tandem mass spectrometry (LC-MS/MS) was developed for simultaneous determination and quantification of the main compounds. Fragmentation pathways of five active components were obtained. The method was validated. Five active ingredients in Xiaoyao pills had a good linear relationship, and the values of RSD (%) of repeatability were all less than 5%, the recovery ranges were between 90% and 115%, and the values of RSD (%) of each substance were less than 10% after the sample solution is placed for 24 hours. Three batches of Xiaoyao pills (concentrated pellets) and two batches of Xiaoyao pills (water pellets) were determined, the contents of paeoniflorin in concentrated pills were more than 4.0 mg·g-1, and those in water pills were more than 2.5 mg·g-1, which was accordance with Chinese Pharmacopoeia. However, other compounds behave differently. This method has high sensitivity and reliable measurement results, which provides basis for quality control of Xiaoyao pills and material basis for pharmacology research.

Advances in three-dimensional tumor models for colorectal cancer / 中华肿瘤杂志

Conventional tumor culture models include two-dimensional tumor cell cultures and xenograft models. The former has disadvantages including lack of tumor heterogeneity and poor clinical relevance, while the latter are limited by the slow growth, low engraftment successful rate, and high cost. In recent years, in vitro three-dimensional (3D) tumor models have emerged as the tool to better recapitulate the spatial structure and the in vivo environment of tumors. In addition, they preserve the pathological and genetic features of tumor cells and reflect the complex intracellular and extracellular interactions of tumors, which have become a powerful tool for investigating the tumor mechanism, drug screening, and personalized cancer treatment. 3D tumor model technologies such as spheroids, organoids, and microfluidic devices are maturing. Application of new technologies such as co-culture, 3D bioprinting, and air-liquid interface has further improved the clinical relevance of the models. Some models recapitulate the tumor microenvironment, and some can even reconstitute endogenous immune components and microvasculature. In recent years, some scholars have combined xenograft models with organoid technology to develop matched in vivo/in vitro model biobanks, giving full play to the advantages of the two technologies, and providing an ideal research platform for individualized precision therapy for specific molecular targets in certain subtypes of tumors. So far, the above technologies have been widely applied in the field of colorectal cancer research. Our research team is currently studying upon the application of patient-derived tumor cell-like clusters, a self-assembly 3D tumor model, in guiding the selection of postoperative chemotherapy regimens for colorectal cancer. A high modeling success rate and satisfactory results in the drug screening experiments have been achieved. There is no doubt that with the advancement of related technologies, 3D tumor models will play an increasingly important role in the research and clinical practice of colorectal cancer.

Gallic Acid Ameliorates Cognitive Impairment Caused by Sleep Deprivation through Antioxidant Effect

Sleep deprivation (SD) has a profound impact on the central nervous system, resulting in an array of mood disorders, including depression and anxiety. Despite this, the dynamic alterations in neuronal activity during sleep deprivation have not been extensively investigated. While some researchers propose that sleep deprivation diminishes neuronal activity, thereby leading to depression. Others argue that short-term sleep deprivation enhances neuronal activity and dendritic spine density, potentially yielding antidepressant effects. In this study, a two-photon microscope was utilized to examine the calcium transients of anterior cingulate cortex (ACC) neurons in awake SD mice in vivo at 24-hour intervals. It was observed that SD reduced the frequency and amplitude of Ca2+ transients while increasing the proportions of inactive neurons. Following the cessation of sleep deprivation, neuronal calcium transients demonstrated a gradual recovery. Moreover, whole-cell patch-clamp recordings revealed a significant decrease in the frequency of spontaneous excitatory post-synaptic current (sEPSC) after SD. The investigation also assessed several oxidative stress parameters, finding that sleep deprivation substantially elevated the level of malondialdehyde (MDA), while simultaneously decreasing the expression of Nuclear Factor erythroid 2-Related Factor 2 (Nrf2) and activities of Superoxide dismutase (SOD) in the ACC. Importantly, the administration of gallic acid (GA) notably mitigated the decline of calcium transients in ACC neurons. GA was also shown to alleviate oxidative stress in the brain and improve cognitive impairment caused by sleep deprivation. These findings indicate that the calcium transients of ACC neurons experience a continuous decline during sleep deprivation, a process that is reversible. GA may serve as a potential candidate agent for the prevention and treatment of cognitive impairment induced by sleep deprivation.

Protective mechanism of Yinchenzhufu decoction against cholestatic liver injury induced by lithic acid based on network pharmacology / 药学学报

Yinchenzhufu decoction (YCZFD) is a classic formula for treating Yin Huang syndrome, which can improve liver injury caused by cholestasis. However, the mechanism of action of YCZFD still remains unclear. This article used network pharmacology, molecular docking, animal experiments, and molecular biology methods to explore the mechanism of YCZFD in treating liver injury caused by cholestasis. A mouse model of acute cholestasis induced by lithocholic acid was used to investigate the effects of YCZFD on liver injury. The experimental procedures described in this paper were reviewed and approved by the Ethical Committee at the Shanghai University of Traditional Chinese Medicine (approval NO. PZSHUTCM190823002). The results showed that YCZFD could reduce the levels of blood biochemical indicators and improve hepatocyte damage of cholestatic mice. Then, multiple databases were used to predict the corresponding targets of YCZFD active components on cholestatic liver injury. An intersection target protein-protein interaction (PPI) networks based on String database and Cytoscape software was used to demonstrate the possible core targets of YCZFD against cholestatic liver injury. The results indicated that core targets of YCZFD include tumor necrosis factor, interleukin-1β, non-receptor tyrosine kinase Src, interleukin-6, etc. GO (gene ontology) and KEGG (kyoto encyclopedia of genes and genomes) enrichment analysis indicated that YCZFD may regulate the tumor necrosis factor signaling pathway, nuclear factor-κB signaling pathway, bile secretion, and other related factors to ameliorate the cholestatic liver injury. AutoDockTools software was used to perform molecular docking verification on the core targets and components of YCZFD. To verify the results of network pharmacology, UPLC-MS/MS method was used to determine the effect of YCZFD on levels of bile acid profiles in mouse liver tissues. It was found that treatment with YCZFD significantly reduced the content of free bile acids, taurine bound bile acids, and total bile acids in the liver tissues of cholestatic mice. Then, results from real time PCR and Western blot also found that YCZFD can upregulate the expression of hepatic nuclear receptor farnesoid X receptor, metabolizing enzyme (UDP glucuronidase transferase 1a1), and efflux transporters (bile salt export pump, multidrug resistance-associated protein 2, multidrug resistance-associated protein 3, etc) in cholestasis mice, promote bile acid metabolism and excretion, and improve bile acid homeostasis. Moreover, YCZFD can also inhibit pyroptosis and inflammation by regulating NOD-like receptors 3 pathway, thereby inhibiting cholestatic liver injury.

The association between Alzheimer's disease and constitution classification of traditional medicine / 中华行为医学与脑科学杂志

Objective:To explore the relationship between constitutional types of Chinese medicine and Alzheimer's disease (AD) and to construct an early warning model for AD risk.Methods:In the established multimodal interventions to delay dementia and disability in rural China (MIND-China) study, 4 033 elderly subjects aged ≥60 years old were included. The data including demographic, underlying disease and neuropsychological data were collected.The Chinese medicine service record form for the elderly was used to assess constitutional types of Chinese medicine and to apply the NIA-AA diagnostic criteria published by the National Institute on Aging and the Alzheimer's Association in 2011 for the diagnosis of clinically likely AD. Logistic regression analysis and AD risk prediction models were constructed using R statistical software, and the final prediction results were presented using columnar plots.Results:The MIND-China cohort was dominated by the abnormal constitution (69.28%), of which Phlegm-wetness type was the most common (58.05%), followed by Yang-deficiency type (23.85%). The most constitutional type of Chinese medicine among AD patients was Phlegm-wetness type (54.35%), followed by Qi-depression type (38.04%). Multi-factorial logistic regression analysis suggested that increasing age ( β=0.101, P<0.001, OR=1.107, 95% CI=1.069-1.146) and Qi-depression type ( β=0.622, P=0.016, OR=1.862, 95% CI=1.116-3.076) were able to increase the risk of developing AD, while education ( β=-1.047, P<0.001, OR=0.351, 95% CI=0.205-0.584) was able to reduce the risk of developing AD. By using the risk score model to calculate the total risk score for each subject and plotting the receiver operating characteristic curve (ROC), the area under the ROC was 0.769 and the calibration curve showed excellent consistency between prediction and reality. Conclusion:Older adults with Qi-depression type are significantly associated with an increased likelihood of AD.

Safety and prognosis analysis of transanal total mesorectal excision versus laparoscopic mesorectal excision for mid-low rectal cancer / 中华胃肠外科杂志

Objective: To compare the short-term and long-term outcomes between transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (laTME) for mid-to-low rectal cancer and to evaluate the learning curve of taTME. Methods: This study was a retrospective cohort study. Firstly, consecutive patients undergoing total mesorectal excision who were registered in the prospective established database of Division of Colorectal Diseases, Department of General Surgery, Peking Union Medical College Hospital during July 2014 to June 2020 were recruited. The enrolled patients were divided into taTME and laTME group. The demographic data, clinical characteristics, neoadjuvant treatment, intraoperative and postoperative complications, pathological results and follow-up data were extracted from the database. The primary endpoint was the incidence of anastomotic leakage and the secondary endpoints included the 3-year disease-free survival (DFS) and the 3-year local recurrence rate. Independent t-test for comparison between groups of normally distributed measures; skewed measures were expressed as M (range). Categorical variables were expressed as examples (%) and the χ(2) or Fisher exact probability was used for comparison between groups. When comparing the incidence of anastomotic leakage, 5 variables including sex, BMI, clinical stage evaluated by MRI, distance from tumor to anal margin evaluated by MRI, and whether receiving neoadjuvant treatment were balanced by propensity score matching (PSM) to adjust confounders. Kaplan-Meier curve and Log-rank test were used to compare the DFS of two groups. Cox proportional hazard model was used to analyze and determine the independent risk factors affecting the DFS of patients with mid-low rectal cancer. Secondly, the data of consecutive patients undergoing taTME performed by the same surgical team (the trananal procedures were performed by the same main surgeon) from February 2017 to March 2021 were separately extracted and analyzed. The multidimensional cumulative sum (CUSUM) control chart was used to draw the learning curve of taTME. The outcomes of 'mature' taTME cases through learning curve were compared with laTME cases and the independent risk factors of DFS of 'mature' cases were also analyzed. Results: Two hundred and forty-three patients were eventually enrolled, including 182 undergoing laTME and 61 undergoing taTME. After PSM, both fifty-two patients were in laTME group and taTME group respectively, and patients of these two groups had comparable characteristics in sex, age, BMI, clinical tumor stage, distance from tumor to anal margin by MRI, mesorectal fasciae (MRF) and extramural vascular invasion (EMVI) by MRI and proportion of receiving neoadjuvant treatment. After PSM, as compared to laTME group, taTME group showed significantly longer operation time [(198.4±58.3) min vs. (147.9±47.3) min, t=-4.321, P<0.001], higher ratio of blood loss >100 ml during surgery [17.3% (9/52) vs. 0, P=0.003], higher incidence of anastomotic leakage [26.9% (14/52) vs. 3.8% (2/52), χ(2)=10.636, P=0.001] and higher morbidity of overall postoperative complications [55.8%(29/52) vs. 19.2% (10/52), χ(2)=14.810, P<0.001]. Total harvested lymph nodes and circumferential resection margin involvement were comparable between two groups (both P>0.05). The median follow-up for the whole group was 24 (1 to 72) months, with 4 cases lost, giving a follow-up rate of 98.4% (239/243). The laTME group had significantly better 3-year DFS than taTME group (83.9% vs. 73.0%, P=0.019), while the 3-year local recurrence rate was similar in two groups (1.7% vs. 3.6%, P=0.420). Multivariate analysis showed that and taTME surgery (HR=3.202, 95%CI: 1.592-6.441, P=0.001) the postoperative pathological staging of UICC stage II (HR=13.862, 95%CI:1.810-106.150, P=0.011), stage III (HR=8.705, 95%CI: 1.104-68.670, P=0.040) were independent risk factors for 3-year DFS. Analysis of taTME learning curve revealed that surgeons would cross over the learning stage after performing 28 cases. To compare the two groups excluding the cases within the learning stage, there was no significant difference between two groups after PSM no matter in the incidence of anastomotic leakage [taTME: 6.7%(1/15); laTME: 5.3% (2/38), P=1.000] or overall complications [taTME: 33.3%(5/15), laTME: 26.3%(10/38), P=0.737]. The taTME was still an independent risk factor of 3-year DFS only analyzing patients crossing over the learning stage (HR=5.351, 95%CI:1.666-17.192, P=0.005), and whether crossing over the learning stage was not the independent risk factor of 3-year DFS for mid-low rectal cancer patients undergoing taTME (HR=0.954, 95%CI:0.227-4.017, P=0.949). Conclusions: Compared with conventional laTME, taTME may increase the risk of anastomotic leakage and compromise the oncological outcomes. Performing taTME within the learning stage may significantly increase the risk of postoperative anastomotic leakage.

The self-care ability of dementia patients and family caregivers′ care burden: the mediating role of caring ability of caregivers / 中国实用护理杂志

Objective:To explore the mediating effect of caring ability of family caregivers on dementia patients′ self-care ability and family caregiver burden.Methods:A total of 113 dementia caregivers of dementia patients recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Mental Health Center from September 2020 to January 2021 were selected, and the Barthel Index, Family Caregiver Task Inventory and Zarit Burden Interview were used to capture their responses on dementia patients′ self-care ability, caring ability, and caregiver burden.Results:The score of self-care ability of dementia patients was (75.19 ± 28.56), and scores of caring ability and care burden of caregivers were 9.00(4.00, 15.00) and (33.78 ± 16.53), respectively. The self-care ability of dementia patients was negatively associated with caring ability and care burden of caregivers ( r=-0.424, -0.420, both P<0.01), and the caring ability and care burden were positively correlated ( r=0.605, P<0.01). The intermediary effect of dementia caregivers' caring ability between patients' self-care ability and caregivers' care burden is significant. The indirect effect was -0.107 and the total effect was -0.187. The indirect effect accounted for 57.22% of the total effect. Conclusions:Caring ability of family caregivers mediates the relationship between self-care ability of dementia patients and caregivers' care burden.The caring ability may be used as an intervening target for future studies.

Risk factors of primary acute mesenteric venous thrombosis in plateau area / 中华普通外科杂志

Objective:To explore the risk factors of primary acute mesenteric venous thrombosis (AMVT) in plateau area.Methods:Data of 54 primary AMVT cases admitted to the People's Hospital of Tibet Autonomous Region between Jan 2015 and Jul 2021 were retrospectively analyzed. There were 42 males and 12 females, aged from 29-79 years. One hundred and ninty matched volunteers severed as control. Logistic multivariate regression analysis was used to screen out independent risk factors. The receiver operating characteristic (ROC) curve and the area under the curve are used to evaluate the value of each indicator and model prediction.Results:Univariate analysis showed that the two groups were significantly different in gender, smoking history, drinking history, and hemoglobin concentration ( P<0.05); there was no significant difference in age, altitude of residence, uric acid and BMI ( P>0.05). Logistic multivariate regression analysis showed that male ( OR=2.466, 95% CI: 1.166-5.212, P=0.018), elevated hemoglobin levels ( OR=2.761, 95% CI: 1.411-5.403, P=0.003) were independent risk factors for primary AMVT. The area under the ROC curve of the two predictors and prediction model are 0.639 (95% CI: 0.559-0.719), 0.650 (95% CI: 0.563-0.737), 0.697 (95% CI: 0.618-0.776). Conclusion:Male and elevated hemoglobin levels are independent risk factors for primary AMVT in plateau areas.

Prevention and reperfusion therapy of ischemic stroke in patients with heart failure / 国际脑血管病杂志

Heart failure and stroke are the important causes of death worldwide, and both are closely related. This article reviews the prevention and reperfusion therapy of ischemic stroke in patients with heart failure.

Risk factors of postoperative surgical site infection in colon cancer based on a single center database / 中华胃肠外科杂志

Objective: To explore the incidence and risk factors of postoperative surgical site infection (SSI) after colon cancer surgery. Methods: A retrospective case-control study was performed. Patients diagnosed with colon cancer who underwent radical surgery between January 2016 and May 2021 were included, and demographic characteristics, comorbidities, laboratory tests, surgical data and postoperative complications were extracted from the specialized prospective database at Department of General Surgery, Peking Union Medical College Hospital. Case exclusion criteria: (1) simultaneously multiple primary colon cancer; (2) segmental resection, subtotal colectomy, or total colectomy; (3) patients undergoing colostomy/ileostomy during the operation or in the state of colostomy/ileostomy before the operation; (4) patients receiving natural orifice specimen extraction surgery or transvaginal colon surgery; (5) patients with the history of colectomy; (6) emergency operation due to intestinal obstruction, perforation and acute bleeding; (7) intestinal diversion operation; (8) benign lesions confirmed by postoperative pathology; (9) patients not following the colorectal clinical pathway of our department for intestinal preparation and antibiotic application. Univariate analysis and multivariate analysis were used to determine the risk factors of SSI after colon cancer surgery. Results: A total of 1291 patients were enrolled in the study. 94.3% (1217/1291) of cases received laparoscopic surgery. The incidence of overall SSI was 5.3% (69/1291). According to tumor location, the incidence of SSI in the right colon, transverse colon, left colon and sigmoid colon was 8.6% (40/465), 5.2% (11/213), 7.1% (7/98) and 2.1% (11/515) respectively. According to resection range, the incidence of SSI after right hemicolectomy, transverse colectomy, left hemicolectomy and sigmoid colectomy was 8.2% (48/588), 4.5% (2/44), 4.8% (8 /167) and 2.2% (11/492) respectively. Univariate analysis showed that preoperative BUN≥7.14 mmol/L, tumor site, resection range, intestinal anastomotic approach, postoperative diarrhea, anastomotic leakage, postoperative pneumonia, and anastomotic technique were related to SSI (all P<0.05). Multivariate analysis revealed that anastomotic leakage (OR=22.074, 95%CI: 6.172-78.953, P<0.001), pneumonia (OR=4.100, 95%CI: 1.546-10.869, P=0.005), intracorporeal anastomosis (OR=5.288, 95%CI: 2.919-9.577,P<0.001) were independent risk factors of SSI. Subgroup analysis showed that in right hemicolectomy, the incidence of SSI in intracorporeal anastomosis was 19.8% (32/162), which was significantly higher than that in extracorporeal anastomosis (3.8%, 16/426, χ(2)=40.064, P<0.001). In transverse colectomy [5.0% (2/40) vs. 0, χ(2)=0.210, P=1.000], left hemicolectomy [5.4% (8/148) vs. 0, χ(2)=1.079, P=0.599] and sigmoid colectomy [2.1% (10/482) vs. 10.0% (1/10), χ(2)=2.815, P=0.204], no significant differences of SSI incidence were found between intracorporeal anastomosis and extracorporeal anastomosis (all P>0.05). Conclusions: The incidence of SSI increases with the resection range from sigmoid colectomy to right hemicolectomy. Intracorporeal anastomosis and postoperative anastomotic leakage are independent risk factors of SSI. Attentions should be paid to the possibility of postoperative pneumonia and actively effective treatment measures should be carried out.

AC092127.1-miR-451a-AE binding protein 2 Signaling Facilitates Malignant Properties of Breast Cancer / 한국유방암학회지

Purpose@#The purpose of the current study was to explore the functions and potential mechanism of miR-451a in breast cancer (BC). @*Methods@#Quantitative reverse transcription real-time polymerase chain reaction was used to analyze the expression of miR-451a in human normal mammary cells (MCF-10A) and BC cells. Colony formation assay, terminal-deoxynucleoitidyl transferase mediated nick end labeling assay and transwell assays were conducted to validate the effect of miR-451a on proliferation, apoptosis, migration and invasion of BC cells, respectively. RNA pull-down, RNA immunoprecipitation and luciferase reporter assays were applied to investigate the upstream and downstream mechanisms of miR-451a in BC cells. @*Results@#MiR-451a was expressed at a low level in BC cells. Overexpression of miR-451a repressed BC cells proliferation, migration and invasion. Moreover, long non-coding RNA AC092127.1 acted as a sponge of miR-451a to enhance the expression level of AE binding protein 2 (AEBP2) that was demonstrated to be the target gene of miR-451a in BC cells. Finally, rescue experiments validated that miR-451a and AEBP2 involved in AC092127.1-mediated BC cell growth, migration and invasion. @*Conclusion@#In a word, AC092127.1/miR-451a/AEBP2 axis contributes to BC cell growth, migration and invasion. Our results may help to find novel potential targets for BC treatment.

AC092127.1-miR-451a-AE binding protein 2 Signaling Facilitates Malignant Properties of Breast Cancer / 한국유방암학회지

Purpose@#The purpose of the current study was to explore the functions and potential mechanism of miR-451a in breast cancer (BC). @*Methods@#Quantitative reverse transcription real-time polymerase chain reaction was used to analyze the expression of miR-451a in human normal mammary cells (MCF-10A) and BC cells. Colony formation assay, terminal-deoxynucleoitidyl transferase mediated nick end labeling assay and transwell assays were conducted to validate the effect of miR-451a on proliferation, apoptosis, migration and invasion of BC cells, respectively. RNA pull-down, RNA immunoprecipitation and luciferase reporter assays were applied to investigate the upstream and downstream mechanisms of miR-451a in BC cells. @*Results@#MiR-451a was expressed at a low level in BC cells. Overexpression of miR-451a repressed BC cells proliferation, migration and invasion. Moreover, long non-coding RNA AC092127.1 acted as a sponge of miR-451a to enhance the expression level of AE binding protein 2 (AEBP2) that was demonstrated to be the target gene of miR-451a in BC cells. Finally, rescue experiments validated that miR-451a and AEBP2 involved in AC092127.1-mediated BC cell growth, migration and invasion. @*Conclusion@#In a word, AC092127.1/miR-451a/AEBP2 axis contributes to BC cell growth, migration and invasion. Our results may help to find novel potential targets for BC treatment.

Clinical application of the concept of enhanced recovery after surgery in perioperative nursing of patients with total hip replacement / 中国实用护理杂志

Objective:To explore the clinical effect of the concept of enhanced recovery after surgery (ERAS) in the perioperative nursing of patients with total hip replacement.Methods:A total of 93 patients with hip osteoarthritis admitted from June 2017 to June 2018 were divided into routine nursing group and ERAS nursing group according to the random number table method. Patients in both groups were treated with unilateral total hip arthroplasty. Routine nursing group was treated with routine perioperative nursing, and ERAS nursing group was treated with ERAS concept. The ERAS nursing team was established, including a head nurse and an orthopedic physician, in addition to the regular nursing staff. The treatment, perioperative pain and nursing satisfaction of the two groups were compared.Results:The first time of getting out of bed activity [(1.95 ± 0.45) days vs. (5.52 ± 2.52) days], the first time of defecation after operation [(1.34 ± 0.56) days vs. (2.15 ± 0.84) days], the time of hospitalization [(5.73 ± 1.65) days vs. (10.04 ± 2.14) days] in ERAS nursing group were shorter than those in routine nursing group, and the cost of hospitalization [(49 450.50 ± 880.52) yuan vs. (53 053.50 ± 780.50) yuan] was lower than that in routine nursing group, the differences were statistically significant ( t=6.639-31.622, P < 0.05). The NRS scores of 24 hours [(3.35 ± 0.85) vs. (4.32 ± 1.05)], 48 hours [(2.65 ± 0.52) vs. (3.48 ± 0.54)] after operation and discharge [(1.74 ± 0.65) vs. (2.36 ± 0.53)] in the ERAS nursing group were lower than those of the routine nursing group, the differences were statistically significant ( t=4.526, 4.856 and 4.456, P < 0.05). The nursing satisfaction rate of ERAS nursing group (95.7%, 45/47) was higher than that of routine nursing group (76.60%, 36/47), the difference was statistically significant ( P<0.05). Conclusion:The idea of ERAS has a good clinical effect in perioperative nursing of patients with total hip replacement.

Abnormal metabolism of gut microbiota reveals the possible molecular mechanism of nephropathy induced by hyperuricemia

The progression of hyperuricemia disease is often accompanied by damage to renal function. However, there are few studies on hyperuricemia nephropathy, especially its association with intestinal flora. This study combines metabolomics and gut microbiota diversity analysis to explore metabolic changes using a rat model as well as the changes in intestinal flora composition. The results showed that amino acid metabolism was disturbed with serine, glutamate and glutamine being downregulated whilst glycine, hydroxyproline and alanine being upregulated. The combined glycine, serine and glutamate could predict hyperuricemia nephropathy with an area under the curve of 1.00. Imbalanced intestinal flora was also observed. , , , , and other conditional pathogens increased significantly in the model group, while and , the short-chain fatty acid producing bacteria, declined greatly. At phylum, family and genus levels, disordered nitrogen circulation in gut microbiota was detected. In the model group, the uric acid decomposition pathway was enhanced with reinforced urea liver-intestine circulation. The results implied that the intestinal flora play a vital role in the pathogenesis of hyperuricemia nephropathy. Hence, modulation of gut microbiota or targeting at metabolic enzymes, , urease, could assist the treatment and prevention of this disease.

Analysis of Characteristics and Relevant Factors of 1 340 Cases of Intentional Injury Cases in Southwest China / 法医学杂志

Objective To investigate the characteristics and patterns of factors such as victims' information, injury tools and time of occurrence of intentional injury cases in southwest China. Methods One thousand three hundred and forty intentional injury cases from several places in southwest China from 2014 to 2016 assessed as minor injury level Ⅱ and above had been randomly selected. Data on victims' information, motives, injury tools, sites of occurrence, time of occurrence, injured parts and degrees of injury were classified and gathered, and then association analyses of motives and types of injury tools as well as degrees of injury and injury tools were made. Results Most of the victims were young adults between 20-50 years （65.2%）, male （82.3%）, rural household registration （62.8%）; the motives were mainly dispute （45.8%）. Injury tools were mostly blunt （54.6%） or sharp （36.0%）. Specifically, injuries were mostly made bare-handed （36.9%） and by cutting tools （33.2%）; the cases mainly occurred in public areas （59.0%）. Cases occurred more frequently in January （11.3%）, February （13.1%）, March （11.6%） and from 22：00 to 01：00 every night. Injuries mainly involved the craniofacial region. The wounds were mainly assessed as minor injury level Ⅱ （61.6%）. There was statistical significance in the difference of types of injury tools among cases with different motives （P<0.05）. There was statistical significance in the difference of the distribution of injury tools among cases with different degrees of injury （P<0.05）. Conclusion The occurrence of intentional injury cases in southwest China has potential patterns and relevant influencing factors. Prevention and analysis of such cases need to be comprehensively considered from the aspects such as victims' information, injury tools and time of occurrence.

Imaging anatomy and clinical significance of the inferior pancreaticoduodenal veins / 中华消化外科杂志

Objective To investigate the imaging anatomy and clinical significance of the inferior pancreaticoduodenal veins (IPDVs).Methods The retrospective and descriptive study was conducted.The clinicopathological data of 42 patients with pancreatic head ductal adenocarcinoma who were admitted to Peking Union Medical College Hospital from January to June 2018 were collected.There were 24 males and 18 females,aged from 41 to 78 years,with an average age of 61 years.Patients received preoperative contrast-enhanced computed tomography (CT) examination with 1 mm slice thickness,and underwent corresponding surgery according to the preoperative evaluation.Observation indicators:(1) results of preoperative CT examination;(2) surgical situations.Normality of measurement data was analyzed using Shapiro-Wilk test.Measurement data with skewed distribution were described as M (QR) or M (range),and comparison between groups was analyzed by the Mann-Whitney U test.Count data were described as absolute number or percentage,and comparison between groups was analyzed by the chi-square test.Results (1) Results of preoperative CT examination:42 patients received preoperative contrast-enhanced CT examination with 1 mm slice thickness.① The first jejunal venous trunk was identified in all the 42 patients.The first jejunal venous trunk crossed dorsal to the superior mesenteric artery (SMA) in 34 patients and ventral to the SMA in 8 patients.② Of 42 patients,2 showed no IPDV,and 40 showed IPDV including 23 with 1 IPDV,13 with 2 IPDVs,3 with 3 IPDVs,and 1 with 4 IPDVs.A total of 62 IPDVs were identified in the 42 patients,with an average IPDV number of 1 (range,0-4).There were 43 IPDVs drained into first or second jejunal venous trunks and 19 IPDVs drained into superior mesenteric vein (SMV).③ Of 42 patients,type Ⅰ IPDV was identified in 32 patients including 20 with 1 IPDV drained into jejunal venous trunk at dorsal side of SMA,7 with 2 IPDVs drained into jejunal venous trunk at dorsal side of SMA,2 with 3 IPDVs drained into jejunal venous trunk at dorsal side of SMA,and 3 with 1 IPDV drained into jejunal venous trunk at ventral side of SMA,and non-type Ⅰ IPDV was identified in 10 patients;type Ⅱ IPDV was identified in 18 patients including 17 with 1 IPDV drained into SMV and 1 with 2 IPDVs drained into SMV,and non-type Ⅱ IPDV was identified in 24 patients.Some patients can simultaneously had type Ⅰ and type Ⅱ IPDV.(2) Surgical situations:42 patients underwent pancreatoduodenectomy,14 of which underwent laparoscopic surgery and 28 underwent open surgery.There were 5 cases with SMV or portal vein reconstruction,and 18 with intraoperative blood transfusion.All the 42 patients were diagnosed as pancreatic ductal adenocarcinoma by postoperative pathological examination,including 30 of R0 resection and 12 of R1 resection.The volume of intraoperative blood loss,cases with intraoperative blood transfusion,cases with R0 and R1 resection (situation of surgical margin),cases with SMV or portal vein reconstruction were 650 mL(853 mL),15,20,12,4 in the 32 patients with type Ⅰ IPDV,aod 475 mL (480 mL),3,10,0,1 in the 10 patients with non-type Ⅰ IPDV;there were significant differences in the volume of intraoperative blood loss and situation of surgical margin (Z=94.000,x2=5.250,P＜ 0.05).There was no significant difference in the cases with intraoperative blood transfusion,cases with SMV or portal vein reconstruction between patients with type Ⅰ and non-type Ⅰ IPDV (x2 =0.045,0.886,P＞0.05).Conclusions IPDVs can be distinguished on the contrast-enhanced CT with slice thickness,and classified as IPDVs drained into SMV or jejunal venous trunk.It is necessary to carefully deal with IPDVs drained into jejunal venous trunk in the pancreaticoduodenectomy due to its more volume of intraoperative blood loss and lower R0 resection rate.

Neuroprotective effects of alpha-lipoic acid on human lens epithelial cells cultured in the condition of high glucose in vitro / 眼科新进展

Objective To investigate whether alpha-lipoic acid (ALA) possesses neuroprotective effects against high glucose-induced damage in vitro.Methods The cultured human lens epithelial cells (HLEC-B3 cells) were divided into normal control group,high glucose group and ALA group.Normal control group left untreated,ALA group was pretreated with different concentrations of ALA (25 μmol · L-1,50 μmol · L-1,100 μmol · L-1) for 1h,and then ALA group and high glucose group were cultured under high glucose conditions for 48h.After above treatment,the activity of lens epithelial cells in each group was detected immediately by MTT,and the changes in intracellular reactive oxygen species (ROS) were detected by flow cytometry.In addition,the expression of manganese superoxide dismutase (MnSOD) was detected by Western blot and RT-PCR in all groups.Results The activity of HLEC-B3 cells in high glucose group was 53.60％ ±4.10％,which was significantly lower than that in normal control group (P ＜ 0.01).The cell viability in 25 μmol · L-1,50 μmol · L-1,100 μmol · L-1 ALA group was 65.30％ ± 3.70％,72.70％ ± 4.90％ and 83.40％ ± 3.60％,respectively,all which were higher than those in the high glucose group (all P ＜ 0.05).Flow cytometry showed that intracellular ROS level in the high glucose group was significantly higher than that in the normal control group (P ＜ 0.01),but ROS levels were decreased to 14.70％ ±0.70％,8.70％ ±0.87％,5.20％ ±0.53％ after25 μmol· L-1,50 μmol· L-1,100 μmol · L-1 ALA treatment,respectively,with significant difference (all P ＜ 0.01).RT-PCR and Western blot results indicated that the relative expression of MnSOD mRNA and protein in the high glucose group was significantly lower than that in the normal control group (all P ＜ 0.01).Compared with the high glucose group,MnSOD mRNA and protein relative expression levels were significantly increased to 0.63 ± 0.06,0.71 ± 0.06,0.84 ± 0.04,and 0.25 ± 0.03,0.31 ± 0.02,0.45 ± 0.04,respectively (all P ＜ 0.05).In addition,the protective effects of ALA (25-100 μmol · L-1) on HLEC-B3 cells induced by high glucose was in a dose-dependent manner.Conclusion ALA has a protective effect on human lens epithelial cell line HLEC-B3 cultured in high glucose condition,and this protective effect may be achieved by increasing the expression level of intracellular MnSOD.

Prehospital delay and its influencing factors in acute ischemic stroke in Fuxin area / 国际脑血管病杂志

Objective To investigate Prehospital delay and its influencing factors in acute ischemic stroke in Fuxin area.Methods Consecutive patients with acute ischemic stroke admitted from March 1,2015 to July 1,2017 were enrolled prospectively.The patients were grouped by the cutoff value from onset to admission time ≤3 h.The demographic data,vascular risk factors,onset to admission time,and clinical data were recorded.Multivariate logistic regression analysis was used to identify the independent influencing factors of prehospital delay.Results A total of 758 patients were enrolled,including 123 (16.2％) from the onset to the admission time ≤3 h.Multivariatelogistic regression analysis showed that women (odds ratio,[OR] 14.782,95％ confidence interval [CI] 2.378-91.809;P=0.004),Mongolian (OR 6.218,95％ CI 1.642-23.520;P=0.008),low level of education (0-6 years:OR 5.047,95％ CI 1.306-19.519;P=0.023),place of residence (suburb or rural area:OR 4.024,95％ CI 1.080-14.987;P =0.038),low economic income (0-1500 yuan/month:OR 5.985,95％ CI 1.500-23.873;P =0.011),previous history of stroke/transient ischernic attack (OR 6.293,95％ CI 1.558-25.384;P=0.013),National Institutes of Health Stroke Scale score ≤8 (OR 12.352,95％ CI3.239-47.119;P＜0.001),limb weakness (OR 3.335,95％ CI 1.043-10.658;P=0.042) and dizziness (OR 7.031,95％ CI 1.814-14.027;P=0.005) as the initial symptom,transportation means (non-120 ambulances,private cars or taxis:OR 1.929,95％ CI 1.106-3.366;P =0.021),transferred from other hospital (OR 1.761,95％ CI 1.011-3.067;P=0.045),and first visit hospitals as health centers or primary hospitals (OR 1.811,95％ CI 1.034-3.173;P=0.037) were the independent factors of prehospital delay in patients with acute ischemic stroke.Conclusion Women,Mongolian,educational level,residence,economic income,history of stroke/transient ischemic attack,severity of illness,transportation initial,level of first visit hospital,and transfered from other hospital are the influencing factors for prehospital delay in patients with acute ischemic stroke in Fuxin area.

Data analysis on 232 cases of critically ill pregnant women cured by combination of the department of obstetrics and ICU / 安徽医科大学学报

Objective To explore the clinical characteristics and outcomes of obstetric patients in intensive care unit(ICU).Retrospective study over a period of four years and 232 cases were included.Methods Records were reviewed for clinical characteristics,maternal and neonatal outcomes.All patients were divided into obstetric related disease group and non-obstetric related disease group.Results The patients who had regular antienated examination only accounted for 34.5％.Seven patients died.Hypertensive disorders,heart disease and hemorrhage are the main cases of admission.Among the 232 obstetric patients,there are 131 cases(56.5％) in the obstetric group,101 cases(43.5％) in the non-obstetrical group.The average age of the patients in obstetric related disease group were lower than those in non-obstetric related disease group (P ＜ 0.001).The postpartum hemorrahge within 24 hours,the rates of hystereyomy and the rates of hemorrhagic shock in obstetric related disease group were all higher than those in non-obstetric related disease group (P ＜ 0.001).Conclusion The establishment of specialized obstetric ICU and physicians with obstetric and ICU knowledge to manage such patients will be a future development trend.

Impact of the 2016 new definition and classification system of pancreatic fistula on the evaluation of pancreatic fistula after pancreatic surgery / 中华外科杂志

Objective@#To discuss the impact of updated definition and classification system of pancreatic fistula published in 2016 on the postoperative classification of pancreatic fistula.@*Methods@#Retrospective analysis was made on patients who underwent pancreatic surgery at ward 1 in Department of General Surgery, Peking Union Medical College Hospital from January 2015 to December 2016.A total of 408 patients were included in this retrospective study, male/female was 184/224, aged from 9 to 81 years with mean age of 51.6 years.One hundred and fifty-two cases were performed pancreaticoduodenectomy, 125 cases for distal pancreatectomy, 43 cases for spleen preservation distal pancreatectomy, 61 cases for partital pancreatectomy or enucleation, 8 cases for middle pancreatectomy, 6 cases for pancreaticojejunostomy and 13 cases for other procedures.Clinical data including postoperative drainage fluid volume, amylase concentration, duration of hospitalization and drainage were obtained, revaluated and re-analyzed, classified grounded on 2005 edition and 2016 edition, respectively.t-test was adopted for data analysis.@*Results@#According to the previous standards, the incident rate of pancreatic fistula was 57.4%, and the incident rate of B-level plus C-level pancreatic fistula was 35.8%, which decreased to 13.7% based on 2016 edition.Nine patients who received percutaneous puncture or endoscopic drainage was regraded from C-level to B-level. The average duration of postoperative hospitalization of patients without pancreatic fistula was (12.5±6.0)days, demonstrating no significant difference compared to (14.1±7.7)days, duration of postoperative hospitalization of A-level(under 2005 edition of criteria) pancreatic fistula group(t=1.66, P=0.09) and (12.4±6.1)days, duration of postoperative hospitalization of biochemical leakage group(t=0.14, P=0.89). Nevertheless, there was statistical significant difference between the average postoperative duration of hospitalization(30.7±16.9) days of B-level(under 2016 criteria) pancreatic fistula patients and pancreatic fistula-free patients as well as the biochemical leakage group patients (t=7.10, 7.13; both P<0.01).@*Conclusions@#Based on the new diagnostic criteria, the incidence of postoperative pancreatic fistula decreased dramatically.New classification system downgraded part of cases graded C-level pancreatic fistula to B-level and some B-level to biochemical fistula.The new diagnostic classification and criteria facilitated clinical practice, accomplished better conformity to clinical reality and potentially enacted clinical outcome.