Research on community learning model in network teaching of Biochemistry course / 中华医学教育探索杂志

In the online teaching of Biochemistry course, a variety of network resource platforms (such as Zhihuishu learning network, teleconference, WeChat, QQ, etc) were used to establish a learning community. The teaching content and teaching plan were carefully designed and implemented, enriching the knowledge system of the learning community. And then blending teaching was performed through the combination of live broadcasting and online interaction. In addition to teaching students the basic knowledge of biochemistry, it is also combined with clinical cases and life examples to interact and discuss with students in various forms, giving full play to the advantages of learning community and improving the quality and effect of online learning.

Ten-year changes in clinical characteristics and antiviral treatment patterns of chronic hepatitis B in China: a CR-HepB-based real-world study / 中华肝脏病杂志

Objective: To understand ten-year changes in clinical characteristics and antiviral treatment patterns of chronic hepatitis B in China. Methods: Patients with chronic HBV infection:demographic, virologic, hematologic, blood biochemistry, and antiviral treatment data were extracted from the China Registry of Hepatitis B (CR-HepB) database between 2012 and 2022 for descriptive statistics and change trend analysis. Multiple group comparisons were conducted using the Kruskal Wallis H test, while counting data was compared between groups using χ (2) test. Results: A total of 180 012 patients with chronic HBV infection were included, with a median age of 40 years old, and a male proportion accounting for 60.2%. The HBeAg positive rate was 43.3%. Over time, the median age of new patients each year increased from 39 to 47 years, while the HBeAg positive rate decreased from 51.3% to 32.8%. The initial diagnosis of patients was mainly CHB (71.4%), followed by hepatitis B cirrhosis (11.8%), inactive HBsAg carrier status (10.6%), and chronic HBV carrier status (6.2%). Among the newly registered patients every year from 2012 to 2022, the proportion of hepatitis B cirrhosis remained stable, but after 2019, the proportion of CHB increased and the proportion of other diagnoses decreased. The proportion of patients with cirrhosis increased with age in different age groups, with 3.5%, 19.3%, and 30.4% in the < 40, 40-69, and≥70 age groups, respectively. The proportion of women in patients with cirrhosis also increased with age, from 16.1% in those < 30 years old to 44.3% in those≥80 years old. From 2012 to 2022, the proportion of patients receiving first-line nucleos(t)ide analog antiviral treatment increased year by year, from 51.0% in 2012-2013 to 99.8% in 2022. Conclusion: The CR-HepB registration data reflect the changes in clinical characteristics and antiviral treatment patterns in patients with chronic HBV infection in China over the past ten years and can thus provide a reference to promote hepatitis B diagnosis and treatment practice, as well as scientific research.

Interpretation of the essential updates in guidelines for the prevention and treatment of chronic hepatitis B (Version 2022) / 中华肝脏病杂志

Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association update the guidelines for the prevention and treatment of chronic hepatitis B (version 2022) in 2022. The latest guidelines recommend more extensive screening and more active antiviral treating for hepatitis B virus infection. This article interprets the essential updates in the guidelines to help deepen understanding and better guide the clinical practice.

Effects of umbilical moxibustion on phobic behavior and monoamine neurotransmitters in stress-model rats / 中国针灸

OBJECTIVE@#To investigate the effects of umbilical moxibustion therapy on phobic behavior and the contents of norepinephrine (NE), dopamine (DA) and 5-hydroxytryptamine (5-HT) in different brain regions of the stress-model rats and explore the potential mechanism of umbilical moxibustion on phobic behavior.@*METHODS@#Among 50 Wistar male rats, 45 rates were selected and randomly divided into a control group, a model group and an umbilical moxibustion group, 15 rats in each one; and the rest 5 rats were used for preparing the model of electric shock. The bystander electroshock method was adopted to prepare phobic stress model in the model group and the umbilical moxibustion group. After modeling, the intervention with umbilical moxibustion started in the umbilical moxibustion group, in which, the ginger-isolated moxibustion was applied at "Shenque" (CV 8), once daily, 2 cones for 20 min each time, for consecutively 21 days. After modeling and intervention completed, the rats in each group were subjected to the open field test to evaluate the state of fear. After intervention, the Morris water maze test and fear conditioning test were performed to evaluate the changes in learning and memory ability and the state of fear. Using high performance liquid chromatography (HPLC), the contents of NE, DA and 5-HT in the hippocampus, prefrontal cortex and hypothalamus were determined.@*RESULTS@#Compared with the control group, the horizontal and vertical activity scores were lower (P<0.01), the number of stool particles was increased (P<0.01), the escape latency was prolonged (P<0.01), the times of target quadrant were reduced (P<0.01), and the freezing time was prolonged (P<0.05) in the rats of the model group. The horizontal and vertical activity scores were increased (P<0.05), the number of stool particles was reduced (P<0.05), the escape latency was shortened (P<0.05, P<0.01), the times of target quadrant were increased (P<0.05), and the freezing time was shortened (P<0.05) in the rats of the umbilical moxibustion group when compared with the model group. The trend search strategy was adopted in the control group and the umbilical moxibustion group, while the random search strategy was used in rats of the model group. Compared with the control group, the contents of NE, DA and 5-HT in the hippocampus, prefrontal cortex and hypothalamus were reduced (P<0.01) in the model group. In the umbilical moxibustion group, the contents of NE, DA and 5-HT in the hippocampus, prefrontal cortex and hypothalamus were increased (P<0.05, P<0.01) when compared with the model group.@*CONCLUSION@#Umbilical moxibustion can effectively relieve the state of fear and learning and memory impairment of phobic stress model rats, which may be related to the up-regulation of contents of brain neurotransmitters, i.e. NE, DA, and 5-HT.

Oral nano-formulation improves pancreatic islets dysfunction via lymphatic transport for antidiabetic treatment

Type 2 diabetes mellitus (T2DM) therapy is facing the challenges of long-term medication and gradual destruction of pancreatic islet β-cells. Therefore, it is timely to develop oral prolonged action formulations to improve compliance, while restoring β-cells survival and function. Herein, we designed a simple nanoparticle with enhanced oral absorption and pancreas accumulation property, which combined apical sodium-dependent bile acid transporter-mediated intestinal uptake and lymphatic transportation. In this system, taurocholic acid (TCA) modified poly(lactic-co-glycolic acid) (PLGA) was employed to achieve pancreas location, hydroxychloroquine (HCQ) was loaded to execute therapeutic efficacy, and 1,2-dilauroyl-sn-glycero-3-phosphocholine (DLPC) was introduced as stabilizer together with synergist (PLGA-TCA/DLPC/HCQ). In vitro and in vivo results have proven that PLGA-TCA/DLPC/HCQ reversed the pancreatic islets damage and dysfunction, thus impeding hyperglycemia progression and restoring systemic glucose homeostasis via only once administration every day. In terms of mechanism PLGA-TCA/DLPC/HCQ ameliorated oxidative stress, remodeled the inflammatory pancreas microenvironment, and activated PI3K/AKT signaling pathway without obvious toxicity. This strategy not only provides an oral delivery platform for increasing absorption and pancreas targetability but also opens a new avenue for thorough T2DM treatment.

Establishment of UPLC fingerprint and study on anti-respiratory syncytial virus spectrum-effective relationship of ethanol extract from Callicarpa nudiflora / 中国药房

OBJECTIVE To establish the fingerprint of the ethanol extract from Callicarpa nudiflora， analyze its anti- respiratory syncytial virus （RSV） activity in vitro， and study the relationship between spectrum and effect. METHODS Using 10%， 30%， 50%， 70% and 90% ethanol as solvent， 20 batches of ethanol extracts from 4 batches of C. nudiflora were prepared. The fingerprints for 20 batches of ethanol extracts from C. nudiflora were mapped by ultra-high-performance liquid chromatography （UPLC）， and the similarity evaluation was conducted by using the Similarity Evaluation System for Traditional Chinese Medicine Chromatographic Fingerprints （2012 edition）. The cytopathic effect method and MTT method were used to investigate the in vitro inhibitory activity of the ethanol extracts from C. nudiflora on RSV. Pearson correlation analysis， grey correlation degree and orthogonal partial least squares （OPLS） analysis were used to study the spectrum-effect relationship. RESULTS There were 25 common peaks in 20 batches of ethanol extracts from C. nudiflora， and the similarities ranged from 0.912 to 0.998， and the RSDs of common peak areas were 33.54%-162.28%. The average values of IC50 for RSV of 20 batches of ethanol extracts from C. nudiflora were 9.55-272.23 μg/mL. The results of Pearson correlation analysis， grey correlation analysis and OPLS analysis showed that the Pearson correlation coefficients （P＜0.05） of the common peaks 8， 10， 12， 16， 18-19， 22-24 with pharmacodynamic indicators and regression coefficients were all negative， the correlation coefficients were all greater than 0.6， and the values of variable importance in projection were all greater than 1. CONCLUSIONS Twenty batches of ethanol extracts from C. nudiflora have similar components but significant differences in content， and exhibit different degrees of anti-RSV activity in vitro. The corresponding components of common peaks 8， 10， 12， 16， 18-19， 22-24 may be the characteristic components of anti-RSV of C. nudiflora.

Prognostic factors affecting the success of conversion chemotherapy in patients with unresectable liver metastases from initially colorectal cancer / 中华胃肠外科杂志

Objective: To investigate the factors affecting the success of conversion therapy in patients with initially unresectable colorectal cancer liver metastases (CRLM) in order to provide evidence-based medical evidence for formulating individualized treatment strategies for patients. Methods: A retrospective case-control study was used in this study. Clinical data of 232 patients with initially unresectable CRLM receiving first-line systemic treatment in Sun Yat-sen University Cancer Center from January 2013 to January 2020 were collected, including 98 patients of successful conversion and 134 patients of failed conversion as control. Conversion therapy scheme: 38 patients received FOLFOXIRI regimen chemotherapy (irinotecan, oxaliplatin, calcium folinate and fluorouracil), 152 patients received FOLFOX regimen (oxaliplatin, calcium folinate and fluorouracil), 19 patients received FOLRIRI regimen (irinotecan, calcium folinate and fluorouracil), 23 patients received systemic chemotherapy combined with fluorouridine hepatic artery infusion chemotherapy; 168 patients received targeted therapy, including 68 of bevacizumab and 100 of cetuximab. Logistics analysis was used to compare the factors affecting the success of conversion therapy. The Kaplan-Meier method was used to calculate progression-free survival (PFS), and the Log-rank test was used for survival comparison. Results: Among 232 patients, 98 patients had successful conversions and 134 patients had failed conversions with a successful conversion rate of 42.2%, meanwhile 30 patients underwent simple hepatectomy and 68 underwent hepatectomy combined with intraoperative radiofrequency ablation. After first-line chemotherapy, 111 patients (47.8%) were partial remission, 57 patients (24.6%) were stable disease, and 64 patients (27.6%) were progression disease. During the median follow-up of 18.8 (1.0-87.9) months, 148 patients were dead or with tumor progression. The median PFS time of patients with successful conversion was longer than that of patients with failed conversion (31.0 months vs. 9.9 months, P<0.001). Univariate analysis found that the bilobar distribution of liver tumors (P=0.003), elevated baseline carcinoembryonic antigen (CEA) levels (P=0.024), tumor invasion of the portal vein (P=0.001), number of metastatic tumor>8 (P<0.001), non-FOLFOXIRI (P=0.005), and no targeted therapy (P=0.038) were high risk factors for the failed conversion therapy. The results of multivariate logistics analysis indicated that the number of metastatic tumor >8 (OR=2.422, 95%CI: 1.291-4.544, P=0.006), portal vein invasion (OR=2.727, 95%CI: 1.237-4.170, P=0.008) were the independent risk factors for failed conversion therapy, while FOLFOXIRI regimen (OR=0.300, 95%CI: 0.135-0.666, P=0.003) and targeted drugs (OR=0.411, 95%CI: 0.209-0.809, P=0.010) were independent protective factors for successful conversion therapy. Conclusions: The number of metastatic tumor and portal vein invasion are key factors that affect the outcomes of conversion therapy for initially unresectable CRLM. If a patient can tolerate chemotherapy, a combination program of three-drug and targeted therapy is preferred for the active conversion therapy.

Clinical application of serum Golgi protein 73 in patients with chronic liver diseases / 中华肝脏病杂志

Golgi protein 73 (GP73) is a transmembrane protein on the Golgi apparatus and can be cut and released into the blood. In recent years, an increasing number of clinical studies have shown that the elevated serum GP73 level is closely related to liver diseases. And thus GP73 is expected to be used as a new serum marker for assessing progress of chronic liver diseases. Herein, the clinical application of serum GP73 in chronic hepatitis, liver fibrosis, liver cirrhosis and hepatocellular carcinoma with different etiologies was reviewed based on available literatures; and a research outlook in this field is made.

Effects of brain-specific knockout of Sirt6 gene on cerebral cortex in aged mice / 中华行为医学与脑科学杂志

Objective:To study the effect of senescence gene silent information regulator 6 (Sirt6) knockout on the brain of aged mice.Methods:Sirt6-flox transgenic mice were constructed, and the mouse brain tissue was specifically knocked out by Emx1-Cre tool mice.According to genotyping, 11 wild-type mice were selected as control group(WT group) and 10 Sirt6 gene konckout mice were selected as conditional knockout group(cKO group). Body size and body weight of the aged mice were measured and cerebral cortex thickness was measured by HE staining.Brain neurogenesis was analyzed with EdU markers.The expression of RNA-binding protein HuR and apoptosis-related protein Caspase-3 were detected by Western blot.Meanwhile, histone acetylation levels in the cortex were detected.Results:Sirt6 brain tissue-specific knocked out mice were successfully constructed.Compared with the brain tissue area((2.07±0.22) cm 2)and cortical thickness ((970.56±80.91) μm) of WT mice in the 12-month-old group, the brain tissue area ((1.61±0.14)cm 2) and cortical thickness ((822.88±53.94) μm) in Sirt6 cKO group were smaller, and the differences were statistically significant (both P<0.05). EdU incorporation into nerve cells showed that the number of EdU incorporation into periventricular nerve cells in cKO group was lower ((4.75±1.48)) than that in WT group ((10.29±1.93)). The difference was statistically significant ( P<0.001). In the experiment of 17 months age group, mice in cKO group were smaller in body size, lower in body weight ((29.00±1.08) g) and smaller in brain area ((1.54±0.55)cm 2)compared with WT group in body size, body weight ((35.25±4.17) g) and brain tissue area ((1.98±0.18) cm 2)(both P<0.05). The expression of Caspase-3 and HuR in cortical proteins of these two age groups decreased( t=2.95, 5.38, both P<0.05), and the expression of H3K9ac and H3K56ac increased( t=3.53, 2.78, both P<0.05), but the expression of Sirt1 homologous gene remained unchanged( t=1.26, P>0.05). Conclusion:The specific deletion of Sirt6 in brain tissue can lead to the decrease of brain neurogenesis in aged mice, and the aggravation of aging and the increase of apoptosis, which may be the reason for the thinning of cerebral cortex and brain tissue atrophy.The molecular mechanism is speculated to be related to the increase of acetylation level after Sirt6 knockout

Daphnane-type diterpenes from genus Daphne and their anti-tumor activity / 中草药·英文版

Daphnane-type diterpenenoids are the major biologically active constituents in the genus Daphne. We find that there are about 101 Daphnane-type diterpenes in this genus, most of those compounds show different degrees of inhibitory effect on various cancer cell. Some of them have been studied in depth and the potent molecular mechanisms might be associated with modulation of different cell-signaling pathways. In addition, some compounds of this type also can inhibit the synthesis of protein and DNA. Absolutely, the anti-tumor activity of Daphnane-type diterpenes is worthy of attention. Unfortunately, most of the current research on the activity of these compounds is focused on simple drug efficacy, and its in-depth mechanism research is far from enough. On the other point of view, there still exists wide growing space on the depth of these compounds.

Optimized anaesthetic strategy for laparoscopic pancreaticoduodenectomy: erector spinae plane block combined with general anesthesia / 中华麻醉学杂志

Objective:To evaluate the optimized effect of erector spinae plane block (ESPB) combined with general anesthesia when used for the patients undergoing laparoscopic pancreaticoduodenectomy.Methods:Sixty-eight American Society of Anesthesiologists physical status Ⅱ orⅢ patients of both sexes, aged 18-64 yr, with body mass index of 18-24 kg/m 2, scheduled for elective laparoscopic pancreaticoduodenectomy, were divided into general anesthesia group (group G, n=34) and ESPB combined with general anesthesia group (group EG, n=34) using a random number table method.In group E, ultrasound-guided ESPB was performed before induction with general anesthesia, and 0.375% ropivacaine 20 ml was injected into both sides.Total intravenous anesthesia was applied in both groups.Patient-controlled intravenous analgesia (PCIA) with sufentanil 1.5 g/kg in 100 ml of normal saline was performed after surgery.The PCIA pump was set up to deliver a 2 ml bolus dose with a 5-min lockout interval and background infusion at 3 ml/h.Analgesia was performed until 24 h after operation, and the visual analogue scale score at rest was maintained at ≤4.Sufentanil 0.1 g/kg was intravenously injected as rescue analgesic when visual analogue scale score >4.The extubation time and occurrence of intraoperative cardiovascular events were recorded.The amount of sufentanil used during operation and within 24 h after operation was recorded.The time to first pressing the analgesia pump after operation and effective pressing times of PCA within 24 h after operation were recorded.Time to first flatus, first ambulation time and length of postoperative hospital stay were recorded.The development of postoperative adverse reactions such as nausea and vomiting, irritability and respiratory depression within 24 h after operation was recorded. Results:Compared with group G, the incidence of intraoperative hypertension and tachycardia was significantly decreased, the extubation time was shortened, the consumption of sufentanil during operation and within 24 h after operation was reduced, the time to first pressing the analgesia pump was prolonged, the effective pressing times of PCA within 24 h after operation were reduced, time to first flatus, first ambulation time and length of postoperative hospital stay were shortened, and the incidence of nausea and vomiting, irritability and respiratory depression within 24 h after operation was decreased in group EG ( P<0.05). Conclusion:The combination of ESPB and general anesthesia is helpful in achieving an anesthesia mode of lower opioid consumption and more helpful for inhibition of postoperative pain responses and for early postoperative recovery than general anesthesia alone when used for the patients undergoing laparoscopic pancreaticoduodenectomy.

Correlation Between Effective Components Content and Color Values of Gentianae Radix et Rhizoma Based on Color Difference Principle / 中国实验方剂学杂志

Objective:To measure the color values of Gentianae Radix et Rhizoma and the contents of gentiopicroside,the appearance index value of the representative color was correlated with the intrinsic index value representing the quality,in order to explore the correlation between the contents of active ingredients and the color values,and provide basis for the quality evaluation of Gentianae Radix et Rhizoma. Method:The color difference values of Gentianae Radix et Rhizoma powder was measured by colorimeter.The content determination method of gentiopicroside in the 2015 edition of China Pharmacopoeia was adopted. The content of gentiopicroside was determined by HPLC,and the correlation and regression analysis was carried out by SPSS 21.0 software. Result:There was a significantly positive correlation between the contents of gentiopicroside and L* (representing colorshade)and E* ab(representing total color difference)(Pa* (representing color red-green direction) and b* (representing color yellow-blue direction) had a significantly negative correlation (PConclusion:The color value of Gentianae Radix et Rhizoma has a certain correlation with the content of gentiopicroside,and yellowish Gentianae Radix et Rhizoma contain more active ingredients, with a better quality.The contents of gentiopicroside active ingredients in Gentianae Radix et Rhizoma can be quickly predicted by determining the color difference values,which can provide a new idea for quality evaluation of this herb.

First line nucleos(t)ide analog monotherapy is more cost-effective than combination strategies in hepatitis B e antigen-positive chronic hepatitis B patients in China / 中华医学杂志(英文版)

BACKGROUND@#Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed "functional cure," based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective.@*METHODS@#A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively.@*RESULTS@#In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA - PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results.@*CONCLUSION@#Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

First line nucleos(t)ide analog monotherapy is more cost-effective than combination strategies in hepatitis B e antigen-positive chronic hepatitis B patients in China / 中华医学杂志(英文版)

Background@#Nucleos(t)ide analog (NA) in combination with peginterferon (PegIFN) therapy in patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) shows better effectiveness than NA monotherapy in hepatitis B surface antigen loss, termed "functional cure," based on previous published studies. However, it is not known which strategy is more cost-effective on functional cure. The aim of this study was to analyze the cost-effectiveness of first-line monotherapies and combination strategies in HBeAg-positive CHB patients in China from a social perspective.@*Methods@#A Markov model was developed with functional cure and other five states including CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and death to assess the cost-effectiveness of seven representative treatment strategies. Entecavir (ETV) monotherapy and tenofovir disoproxil fumarate (TDF) monotherapy served as comparators, respectively.@*Results@#In the two base-case analysis, compared with ETV, ETV generated the highest costs with $44,210 and the highest quality-adjusted life-years (QALYs) with 16.78 years. Compared with TDF, treating CHB patients with ETV and NA - PegIFN strategies increased costs by $7639 and $6129, respectively, gaining incremental QALYs by 2.20 years and 1.66 years, respectively. The incremental cost-effectiveness ratios were $3472/QALY and $3692/QALY, respectively, which were less than one-time gross domestic product per capita. One-way sensitivity analysis and probabilistic sensitivity analyses showed the robustness of the results.@*Conclusion@#Among seven treatment strategies, first-line NA monotherapy may be more cost-effective than combination strategies in HBeAg-positive CHB patients in China.

Stress sources and anxiety symptoms of medical graduate students: the mediating role of negative emotion and the moderating role of social support / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between stress sources and anxiety symptoms of medical graduate students, as well as the mediating role of negative emotion and the moderating role of social support.@*Methods@#A questionnaire survey was conducted among 1 216 medical students of 16 medical colleges in 13 provinces (municipalities directly under the Central Government) by using graduate stressors scale, Hopkins symptom checklist, the positive and negative affect scale and perceived social support scale.Correlation analysis, regression analysis, SPSS-process mediation and adjustment methods were used for data processing.@*Results@#(1) The whole average score of stress source was (2.45±0.54), and the scores of anxiety symptoms, negative emotions and social support were (1.68±0.59), (2.26±0.70) and (5.28 ±1.01). (2) There was a positive correlation between stress and anxiety symptoms (r=0.37, P<0.01), and negative emotion (r=0.38, P<0.01) and a negative correlation between stress source and social support (r=-0.20, P<0.01). (3) Negative emotion plays a significant partial mediating role between stressors and anxiety symptoms (indirect effect value=0.24, SE=0.02, 95%CI: 0.20-0.28), accounted for 58.54% of the total effect.(4) Social support moderated the effects of stressors on negative emotion (R2=0.24) and the effects of stressors on anxiety symptoms (R2=0.44).@*Conclusion@#Negative emotion plays a partial intermediary role in stress sources and anxiety symptoms, and social support plays a multiple moderating role.

Outcomes of twin neonates and association with chorionicity and modes of conception / 中华围产医学杂志

Objective@#To investigate the pregnancy and neonatal outcomes in twin pregnancies and the association with chorionicity and modes of conception in order to provide evidence for early prevention and reduction of complications and life quality improvement of twin neonates.@*Methods@#This study retrospectively enrolled 756 women with twin pregnancies who gave birth at Peking University Third Hospital from January 1, 2014 to December 31, 2015. Clinical features of the mothers and newborns were collected, the pregnancy and neonatal outcomes were analyzed. Impacts of chorionicity and different modes of conception on the outcomes were also evaluated. Two independent-sample t test and Chi-square test were used as statistical methods.@*Results@#Twin pregnancies accounted for 6.7% (756/11 169) of all deliveries in the hospital during the study period and the preterm birth rate was 59.4% (449/756). Twenty five women underwent fetal reduction (3.3%, 25/756) and intrauterine death occurred in 85 pregnancies (11.2%, 85/756). Eventually 1 400 babies were born alive (92.6%, 1 400/1 512). Subgroup analysis suggested that compared with dichorionic diamniotic (DCDA) pregnancies, monochorionic diamniotic (MCDA) cases showed younger maternal age at conception [(30.5±4.2) vs (32.9±4.0) years, t=-7.412], smaller gestational age at delivery [(34.1±3.1) vs (35.7±2.2) weeks, t=-7.325] and higher preterm birth rate [78.4% (174/222) vs 51.5% (263/511), χ2=46.554], all P<0.05. Moreover, the incidence of neonatal complications, including respiratory distress syndrome [18.3% (40/219) vs 8.0% (21/261), χ2=11.210], neonatal pneumonia [18.3% (40/219) vs 8.8% (23/261), χ2=9.331] and sepsis [6.8% (15/219) vs 1.5% (4/261), χ2=8.854], etc. was higher in the MCDA group than those in the DCDA group, resulting in a higher mortality rate [7.8% (17/219) vs 1.1% (3/261), χ2=13.042] in the MCDA pregnancies, all P<0.05. Compared with spontaneously conceived twin pregnancies, women underwent in vitro fertilization-embryo transfer were older at conception [(33.4±3.8) vs (30.6±4.4) years, t=-6.095], delivered at a greater gestational age [(35.8±2.1) vs (35.2±2.6) weeks, t=-2.452] and had a lower preterm birth rate [49.2% (206/419) vs 63.5% (54/85), χ2=5.838] in the DCDA group, all P<0.05. No significant differences in the incidence of neonatal diseases were observed between the two subgroups.@*Conclusions@#The incidence of preterm birth is high in twin pregnancies. Compared with DCDA twin pregnancies, MCDA twin pregnancies are associated with more adverse outcomes due to higher incidence of neonatal diseases. In vitro fertilization-embryo transfer does not increase the incidence of preterm birth and the neonatal outcomes were comparable to those of spontaneously conceived ones.

Clinical study on tuina for acute cervical radiculopathy / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of Ba-pulling and Qian-traction manipulation with neck suspension and movement for acute cervical radiculopathy. Methods: A total of 85 patients who met the inclusion criteria were randomized into an observation group and a control group by random numbers, with 43 cases in the observation group and 42 cases in the control group. The observation group was treated with Ba-pulling and Qian-traction manipulation with neck suspension and movement;while the control group was treated with Bashen-pulling and stretching manipulation in a supine position. The treatment was performed once a day, 10 times as a treatment course. The therapeutic efficacy was evaluated after 1 treatment course, and the changes in the scores of visual analog scale (VAS) and neck disability index (NDI) were observed. Results: The total effective rate was 97.7% in the observation group, and 83.3% in the control group, and the difference between the two groups was statistically significant (P＜0.05). After treatment, the VAS and NDI scores of both groups were significantly decreased (both P＜0.01), and the differences in the VAS and NDI scores between the two groups were statistically significant (both P＜0.01). Conclusion: Both Ba-pulling and Qian-traction manipulation with neck suspension and movement and Bashen-pulling and stretching manipulation in a supine position can relieve pain and improve cervical function in patients with acute cervical radiculopathy, and Ba-pulling and Qian-traction manipulation with neck suspension and movement can produce more significant efficacy than Bashen-pulling and stretching manipulation in a supine position.

Outcomes of twin neonates and association with chorionicity and modes of conception / 中华围产医学杂志

Objective To investigate the pregnancy and neonatal outcomes in twin pregnancies and the association with chorionicity and modes of conception in order to provide evidence for early prevention and reduction of complications and life quality improvement of twin neonates.Methods This study retrospectively enrolled 756 women with twin pregnancies who gave birth at Peking University Third Hospital from January 1,2014 to December 31,2015.Clinical features of the mothers and newborns were collected,the pregnancy and neonatal outcomes were analyzed.Impacts of chorionicity and different modes of conception on the outcomes were also evaluated.Two independent-sample t test and Chi-square test were used as statistical methods.Results Twin pregnancies accounted for 6.7％ (756/11 169) of all deliveries in the hospital during the study period and the preterm birth rate was 59.4％ (449/756).Twenty five women underwent fetal reduction (3.3％,25/756) and intrauterine death occurred in 85 pregnancies (11.2％,85/756).Eventually 1 400 babies were born alive (92.6％,1 400/1 512).Subgroup analysis suggested that compared with dichorionic diamniotic (DCDA) pregnancies,monochorionic diamniotic (MCDA) cases showed younger maternal age at conception [(30.5 ±4.2) vs (32.9±4.0) years,t=-7.412],smaller gestational age at delivery [(34.1±3.1) vs (35.7±2.2) weeks,t=-7.325] and higher preterm birth rate [78.4％ (174/222) vs 51.5％ (263/511),x2=46.554],all P＜0.05.Moreover,the incidence of neonatal complications,including respiratory distress syndrome [1 8.3％ (40/219) vs 8.0％ (21/261),x2=11.210],neonatal pneumonia [18.3％ (40/219) vs 8.8％ (23/261),x2=9.331] and sepsis [6.8％ (15/219) vs 1.5％ (4/261),~=8.854],etc.was higher in the MCDA group than those in the DCDA group,resulting in a higher mortality rate [7.8％ (17/219) vs 1.1％ (3/261),x2=13.042] in the MCDA pregnancies,all P＜0.05.Compared with spontaneously conceived twin pregnancies,women underwent in vitro fertilization-embryo transfer were older at conception [(33.4±3.8) vs (30.6±4.4) years,t=-6.095],delivered at a greater gestational age [(35.8±2.1) vs (35.2±2.6) weeks,t=-2.452] and had a lower preterm birth rate [49.2％(206/419) vs 63.5％ (54/85),x2=5.838] in the DCDA group,all P＜0.05.No significant differences in the incidence of neonatal diseases were observed between the two subgroups.Conclusions The incidence of preterm birth is high in twin pregnancies.Compared with DCDA twin pregnancies,MCDA twin pregnancies are associated with more adverse outcomes due to higher incidence of neonatal diseases.In vitro fertilization-embryo transfer does not increase the incidence of preterm birth and the neonatal outcomes were comparable to those of spontaneously conceived ones.

Study on in vitro Antibacterial，Anti-inflammatory and Immunopotentiating Activity of An ’erning Granules / 中国药房

OBJECTIVE： To evaluate the in vitro antibacterial， anti-inflammatory and immunopotentiating activity of An’erning granules. METHODS： Micro-dilution method was used to determine the minimum inhibitory concentration（MIC）of An’erning granules （1.562 5-100 mg/mL） on 10 kinds of common pathogenic bacteria. Using RAW 264.7 cells （mono-nuclear macrophage） as objects， LPS was used to replicate inflammation model. MTT assay was used to investigate the effects of An’erning granules （0.312 5-20 mg/mL） on proliferation and the release of NO of macrophage. Using spleen lymphocyte of BALB/c mice as objects， MTT assay was used to investigate the effects of An’erning granules （0.312 5-20 mg/mL） on lymphocyte proliferation. RESULTS： MIC of An’erning granules to Epidermis staphylococcus and Streptococcus pneumoniae was 6.25 mg/mL； MIC of An’erning granules to Proteus vulgaris， Klebsiella pneumoniae， Bacillus subtilis and Escherichia coli （standard strain） were 12.5 mg/mL； MIC of An’erning granules to Pseudomonas aeruginosa， Enterococcus faecalis and Bacillus cereus were 25 mg/mL； MIC of An’erning granules to E. coli （clinical isolates） and Salmonella typhia were 50 mg/mL. Compared with LPS model group， An’erning granules could significantly reduce the LPS-induced release of NO in RAW 264.7 cells at the dose of 0.312 5-1.25 mg/mL （P＜0.05）. Compared with blank control group， An’erning granule had no interference on the proliferation of RAW 264.7 cells and spleen lymphocytes of mice or had a tendency to promote proliferation. It could significantly promote lymphocyte proliferation at doses of 0.625 and 0.312 5 mg/mL （P＜0.05）. CONCLUSIONS： An’erning granules not only have certain in vitro inhibitory effects on clinical common Gram-positive and Gram-negative pathogenic bacteria， but also have anti-inflammatory and immunization enhancement effects.

Application of Multiple Genetic Markers in Determination of Full and Half Sibling Relationship： A Case Report / 法医学杂志

Objective To investigate the application of the comprehensive use of multiple genetic markers in full and half sibling relationship testing through the identification of a case of suspected sibling relationship. Methods Genomic DNA were extracted from bloodstain samples from 4 subjects （ZHANG-1, ZHANG-2, male; ZHANG-3, ZHANG-4, female）. Autosomal STR loci, X-STR, Y-STR loci and polymorphisms of mtDNA HV-Ⅰ and Ⅱwere genotyped by EX20 STR kit, X19 kit, Data Y24 STR kit, and Sanger sequencing, respectively. Results According to autosomal STR based IBS scoring results, full sibling relationships were indicated among ZHANG-2, ZHANG-3 and ZHANG-4, but those were not indicated between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4. According to autosomal STR based FSI and HSI, with ITO method and discriminant function method, full sibling relationships among ZHANG-2, ZHANG-3 and ZHANG-4 were indicated, and half sibling relationships between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4 were also indicated. X-STR and mtDNA sequencing results showed that all the 4 samples came from a same maternal line, and Y-STR results showed that ZHANG-1 and ZHANG-2 did not come from a same paternal line, which supported the half sibling relationship between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4, verified by parental genotype reconstruction based on autosomal STR genotyping. Conclusion For the identification of sibling relationships, it is effective to have reliable results with the mutual verification and support of multiple genetic markers （autosomal STR, sex chromosomal STR and mtDNA sequence） and calculations （IBS, ITO, discriminant function method and family reconstruction）.