Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020 / 中华流行病学杂志

Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.

Interpretation of the World Society of Emergency Surgery Guidelines for Diagnosis and Treatment of Acute Left Colonic Diverticulitis in the Elderly (2022 edition) / 中华外科杂志

Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. Acute left colonic diverticulitis in the elderly presents with unique epidemiological features when compared with younger patients. Elderly patients have a lower risk of recurrent episodes, higher in-hospital and postoperative mortality. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) formulated the guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly (2022 edition). This article aims to interpret the guidelines statements on the following topics: diagnosis, management, non-surgical therapy and surgical technique.

Design of surgical procedures for patients with special protrusion with digital technology / 中华医学美学美容杂志

Objective:To analyze the symmetry of different reference planes in the surgical simulation design of patients with protrusive jaw deformity with high and low eyes.Methods:Fifteen patients with partial jaw deformity were selected from January 2019 to June 2020, including 3 males and 12 females, aged 18-26 years, with average 23.78 years. Inclusion criteria were that the patients, aged more than 18 years, were diagnosed as protrusive jaw deformity with maxillary occlusal plane tilt and high and low eyes by clinical and imaging analysis. Three different 3D reference plane systems were established by different modeling methods. The distance between the landmarks of soft and hard tissues and the median sagittal plane was measured. The symmetry of skull was qualitatively analyzed by mirror image technique. The difference of three reference planes in surgical simulation symmetry of patients with protrusion jaw and high and low eyes was evaluated by one-way ANOVA.Results:Qualitative analysis showed that in the three measurement planes, the symmetry of the third reference plane was the best, and the symmetry of the second and the first was poor. Quantitative analysis showed that in measurement index of hard tissue, there was statistical difference between the distance of each landmark in the reference plane established by Method 3 and Method 1, Method 2 [(1.65±1.19) mm; (3.37±1.58) mm; (3.26±2.36) mm, P<0.05], but there was no statistical difference between Method 1 and Method 2 (P > 0.05). The measurement result of soft tissue was consistent with that of hard tissue, and the distance of each landmark in Method 3 from the median sagittal plane was very small, and the mean error was less than 0.5 mm, which was consistent with the clinical results. Conclusions:Digital model surgery technology can assist orthognathic surgeons in the design and prediction of surgical scheme, especially for patients with special partial jaw deformity.

Digital measurement of anatomical morphology of a zygomatic arch / 中华医学美学美容杂志

Objective:To analyze the anatomical morphology of the zygomatic arch for reduction malarplasty.Methods:Computed tomography (CT) data were obtained from the electronic records of 45 patients in the Tianjin Stomatological Hospital from January 2018 to February 2020. Among them, there were 30 patients with normal protrusion of zygoma (group A) and 15 patients with prominent protrusion of zygoma (group B). The data were imported into modeling and analysis software (Mimics). Left and right three-dimensional (3D) zygoma models were created through standard procedures. In the 3D models, a vertical cut of the zygomatic arch was done, and anatomical morphological characteristics of the zygomatic arch were obtained through bone data measurement and morphological observation. Mean values with 95% confidence intervals ( CI) were calculated for the positional data. Independent sample T-test was conducted on the positional data and anatomical morphology data of the zygomatic arch in the two groups. P< 0.05 was considered as statistically significant. Results:In group B, the anterior edge of the stabilization area was located in front of the articular tubercle point (15.12 mm, 17.16 mm). The posterior edge of the stabilization area was located in front of the articular tubercle point (7.11 mm, 8.24 mm). The posterior edge of the enlarged area was located in front of the articular tubercle point (3.17 mm, 3.94 mm). There were significant differences between group A and group B in the posterior edge of the stabilization area ( t= 2.41, P= 0.018), the posterior edge of the enlarged area ( t=2.58, P= 0.012), and the width of the unilateral face ( P<0.01). Conclusions:There exists a stabilization area of bone morphology and enlargement area in zygomatic arch. The anatomical morphology of the zygomatic arch is different in width of the unilateral face and location of the enlarged area between populations with normal protrusion and prominent protrusion of the zygoma.

Effect of Jiangtang Xiaozhi Tablet on Liver Circadian Clock-related Genes CLOCK， BMAL1， REV-ERBα， and REV-ERBβ in Mice with Metabolic Dysfunction-associated Fatty Liver Disease / 中国实验方剂学杂志

ObjectiveTo explore the effect of Jiangtang Xiaozhi tablet （JTXZT） on metabolic dysfunction-associated fatty liver disease and to study the mechanism from the perspective of circadian clock-related genes such as circadian locomotor output cycles kaput （CLOCK）， brain and muscle aryl hydrocarbon receptor nuclear translocator-like protein 1 （BMAL1）， reverse-eritroblastosis receptor （REV-ERB）α and β. MethodA total of 50 male SPF C57BL/6J mice were randomized into normal group （n=10） and modeling group （n=40）. The normal group was fed with normal diet， and the modeling group with high-fat diet for 4 weeks. Then the model mice were randomly classified into model group， high-dose （12.5 g·kg-1） and low-dose （6.25 g·kg-1） Jiangtang Xiaozhi tablet groups， and orlistat group （70 mg·kg-1）， with 10 mice in each group. The normal group and model group received equivalent volume of distilled water （8 weeks）. Then， the body weight of mice was measured， and the content of serum triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） was determined with biochemical method. Serum content of free fatty acid （FFA） and leptin was detected by enzyme-linked immunosorbent assay （ELISA）. Pathological changes of liver tissue and epididymal adipose tissue were observed based on hematoxylin-eosin （HE） staining. Liver fibrosis was examined based on Masson's trichrome staining， and changes of lipids based on oil red O staining. The expression of CLOCK， BMAL1， REV-ERBα， and REV-ERBβ was detected by Western blot and immunohistochemistry assay. ResultCompared with the normal group， the model group had high content of TG， TC， LDL-C， HDL-C， AST， ALT， FFA， and leptin （P<0.05， P<0.01）， showed ballooning degeneration and focal microvesicular steatosis of liver cells， enlarged adipocytes， and inflammatory cell clusters and fibrous tissue hyperplasia， and displayed increased protein expression of sterol regulatory element binding protein （SREBP） 1 and peroxisome proliferators-activated receptor （PPAR）γ （P<0.01） and decreased protein expression of PPARα （P<0.05）， CLOCK， BMAL1， REV-ERBα and β （P<0.05， P<0.01）. Compared with the model group， JTXZT-H group down-regulated the content of TG， TC， LDL-C， HDL-C， AST， ALT， FFA， and leptin in mice （P<0.05， P<0.01）， and the JTXZT groups demonstrated reduction in the degree and range of ballooning degeneration of liver tissue， alleviation of the compression of hepatic sinusoidal tissue， unobvious inflammatory cell infiltration and fibrous tissue proliferation， reduction in the expression of SREBP1 and PPARγ （P<0.05， P<0.01）， and rise of the protein expression of PPARα （P<0.01）， CLOCK， BMAL1， REV-ERBα， and REV-ERBβ （P<0.05， P<0.01）. ConclusionJTXZT can significantly alleviate the metabolic dysfunction-associated fatty liver disease in mice caused by high-fat diet. The mechanism is the likelihood that it regulates downstream related lipid metabolism proteins （such as SREBP1， PPARγ， and PPARα）.

Effect of Jiangtang Xiaozhi Tablet on Liver Circadian Clock-related Genes CLOCK， BMAL1， REV-ERBα， and REV-ERBβ in Mice with Metabolic Dysfunction-associated Fatty Liver Disease / 中国实验方剂学杂志

ObjectiveTo explore the effect of Jiangtang Xiaozhi tablet （JTXZT） on metabolic dysfunction-associated fatty liver disease and to study the mechanism from the perspective of circadian clock-related genes such as circadian locomotor output cycles kaput （CLOCK）， brain and muscle aryl hydrocarbon receptor nuclear translocator-like protein 1 （BMAL1）， reverse-eritroblastosis receptor （REV-ERB）α and β. MethodA total of 50 male SPF C57BL/6J mice were randomized into normal group （n=10） and modeling group （n=40）. The normal group was fed with normal diet， and the modeling group with high-fat diet for 4 weeks. Then the model mice were randomly classified into model group， high-dose （12.5 g·kg-1） and low-dose （6.25 g·kg-1） Jiangtang Xiaozhi tablet groups， and orlistat group （70 mg·kg-1）， with 10 mice in each group. The normal group and model group received equivalent volume of distilled water （8 weeks）. Then， the body weight of mice was measured， and the content of serum triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， and alanine aminotransferase （ALT） was determined with biochemical method. Serum content of free fatty acid （FFA） and leptin was detected by enzyme-linked immunosorbent assay （ELISA）. Pathological changes of liver tissue and epididymal adipose tissue were observed based on hematoxylin-eosin （HE） staining. Liver fibrosis was examined based on Masson's trichrome staining， and changes of lipids based on oil red O staining. The expression of CLOCK， BMAL1， REV-ERBα， and REV-ERBβ was detected by Western blot and immunohistochemistry assay. ResultCompared with the normal group， the model group had high content of TG， TC， LDL-C， HDL-C， AST， ALT， FFA， and leptin （P<0.05， P<0.01）， showed ballooning degeneration and focal microvesicular steatosis of liver cells， enlarged adipocytes， and inflammatory cell clusters and fibrous tissue hyperplasia， and displayed increased protein expression of sterol regulatory element binding protein （SREBP） 1 and peroxisome proliferators-activated receptor （PPAR）γ （P<0.01） and decreased protein expression of PPARα （P<0.05）， CLOCK， BMAL1， REV-ERBα and β （P<0.05， P<0.01）. Compared with the model group， JTXZT-H group down-regulated the content of TG， TC， LDL-C， HDL-C， AST， ALT， FFA， and leptin in mice （P<0.05， P<0.01）， and the JTXZT groups demonstrated reduction in the degree and range of ballooning degeneration of liver tissue， alleviation of the compression of hepatic sinusoidal tissue， unobvious inflammatory cell infiltration and fibrous tissue proliferation， reduction in the expression of SREBP1 and PPARγ （P<0.05， P<0.01）， and rise of the protein expression of PPARα （P<0.01）， CLOCK， BMAL1， REV-ERBα， and REV-ERBβ （P<0.05， P<0.01）. ConclusionJTXZT can significantly alleviate the metabolic dysfunction-associated fatty liver disease in mice caused by high-fat diet. The mechanism is the likelihood that it regulates downstream related lipid metabolism proteins （such as SREBP1， PPARγ， and PPARα）.

Establishment and evaluation of anesthesia nurses training system for postoperative delirium assessment / 中华麻醉学杂志

Objective:To establish training system for postoperative delirium (POD) assessment and evaluate the efficacy of training for anesthesia nurses.Methods:Sixteen nurse anesthetists of both sexes in our hospital were selected and received the systemic training for POD assessment.The training system included questionnaire survey, theoretical teaching, simulated visit, clinical observation, independent evaluation, centralized question-answering, evaluation of efficacy and random inspection.The level of POD knowledge tests were performed before the training and at the end of the fourth week of independent evaluation, respectively.At week 1 and 4 of independent evaluation, the diagnostic rate of POD and sensitivity and specificity of the assessment were calculated, and Kappa consistency analysis was used to assess the consistency between anesthesia nurses and training group in diagnosis of POD.In the first week of the third month after the end of training, the evaluation results were randomly inspected, the POD diagnosis rate was calculated between the anesthesia nurses and the training group, and the consistency analysis was conducted.Results:Compared with the scores of POD knowledge questionnaire and sensitivity of the assessment of the anesthesia nurses in the first week of training, the scores were significantly increased ( P<0.05), and no significant change was found in the POD diagnosis rate in the fourth week of training ( P>0.05). Compared with the training group, the diagnosis rate of POD of anesthesia nurses was significantly decreased in the first week of training ( P<0.05), and no significant change was found at the fourth week of training ( P>0.05). In the first and fourth weeks of training, the Kappa value of anesthesia nurses and the training group was 0.676 and 0.954 ( P<0.001), respectively.In the first week of the third month after the end of training, the Kappa value between anesthesia nurses and the training group in diagnosis of POD was 0.862 ( P<0.05). Conclusion:The training system of POD assessment has been successfully established, and the standardized anesthesia nurses training of POD has been achieved with good results.

Research progress in miRNAs mediated radiation-induced by stander effect / 中华放射医学与防护杂志

Radiation-induced bystander effect (RIBE) refers to that irradiated cells release signaling factors and induce responses in nonirradiated cells.In other words, it is the communication between irradiated and nonirradiated cells by intracellular signals. RIBE could influence the efficacy of tumor radiotherapy, but also has potential risk to the normal tissues outside of radiation field. Studies have found that ionizing radiation can induce the alteration of miRNA expression not only in the irradiated cells but also in adjacent nonirradiated tissues, and miRNAs may play an important role in the regulation of signaling pathways between irradiated and nonirradiated bystander cells. This article reviewed the roles of miRNAs in RIBE.

Unity and separation of lifting-thrusting and twirling reinforcing-reducing manipulation / 中国针灸

To analyze the collaborative use and separation reasons of lifting-thrusting and twirling reinforcing and reducing manipulation. Lifting-thrusting manipulation and twirling manipulation are two important contents of acupuncture methods. In traditional acupuncture and moxibustion, the two methods were used in reinforcing and reducing concert, which was mainly related to the therapeutic thought guided by the

Effects of Shenfu Injection () on Inflammatory Response during Post-Resuscitation Myocardial Dysfunction after Cardiac Arrest in Swine / 中国结合医学杂志

OBJECTIVE@#To investigate whether Shenfu Injection (SFI, ) can alleviate post-resuscitation myocardial dysfunction by inhibiting the inflammatory response.@*METHODS@#After 8 min of ventricular fibrillation and 2 min of basic life support, 24 pigs were randomly divided into 3 groups (n=8), which were given intravenous bolus injections of SFI (1.0 mL/kg), epinephrine (EP, 0.02 mg/kg) and normal saline (SA), respectively. The animals were sacrificed at 24 h after restoration of spontaneous circulation (ROSC), and serum interleuking-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were measured by enzyme-linked immunosorbent assay (ELISA); expressions of Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) mRNAs and proteins were determined by RT-PCR and Western blot, respectively.@*RESULTS@#Compared with the EP and the SA groups, the ultrastructure of myocardial cells were slightly damaged and the systolic function of the left ventricle was markedly improved in the SFI group at 24 h after ROSC (P<0.05). In addition, compared with the EP and SA groups, the SFI group also showed significantly reduced levels of serum IL-6 and TNF-α, protein and mRNA levels of myocardial NF- κB and TLR4 (P<0.05).@*CONCLUSIONS@#Activation of TLR4/NF-κB signaling pathway may be involved in the pathological mechanisms of post-resuscitation myocardial dysfunction. SFI may block NF-κB-mediated inflammatory response by reducing the activity of NF- κB and the level of TNF-α, thus playing a protective role in post-resuscitation myocardial dysfunction.

Mechanism of Astragali Radix Vesicle-like Nanoparticles for Reducing Blood Glucose in db/db Diabetic Mice by Regulating Gut Microbiota / 中国实验方剂学杂志

Objective:To study the extraction method and characteristics of vesicle-like nanoparticles （VLNs） in Astragali Radix decoction， and to explore the mechanism of the VLNs in reducing blood glucose by regulating the gut microbiota of db/db diabetic mice. Method:Ultracentrifugation and size exclusion chromatography were used to enrich VLNs from Astragali Radix decoction， and the morphology， particle size and concentration of the VLNs were analyzed by transmission electron microscope and nanoparticle tracking analyzer. The db/db diabetic mice were randomly divided into model group， Astragali Radix VLNs high-， medium- and low-dose （21.1， 10.6， 5.3 g·kg^-1） groups and metformin group （0.25 g·kg^-1） according to their blood glucose levels. There were 7 mice in each group， and another 7 C57BL/6 mice were set as the normal group. The mice were given intragastrically for 3 weeks （once a day）， and the changes of fasting blood glucose were observed every week. Hematoxylin-eosin （HE） staining was used to observe the pathological morphology of liver and pancreas of diabetic mice. The feces of mice were collected for 16S rRNA diversity detection of intestinal microbes. Result:The size of the nanoparticles obtained by the two methods was about 200 nm. Astragali Radix VLNs extracted by ultracentrifugation had a typical saucer-like shape with the concentration of 3.0×10¹¹ particles·mL^-1. The morphology of Astragali Radix VLNs obtained by size exclusion chromatography was relatively poor with the concentration of 2.2×10¹¹ particles·mL^-1. After 3 weeks of administration， compared with the model group， Astragali Radix VLNs high-， medium- and low-dose groups could significantly reduce the fasting blood glucose of diabetic mice （<italic>P</italic><0.05， <italic>P</italic><0.01）. The VLNs could improve the gut microbiota dysbiosis， significantly decrease the ratio of Firmicutes/Bacteroidota， and increase the relative abundance of beneficial bacteria and reduce the relative abundance of harmful bacteria. Conclusion:Astragali Radix VLNs may reduce the blood glucose of db/db diabetic mice by adjusting the ratio of Firmicutes/Bacteroidota in the intestinal flora.

Molecular Mechanism Analysis of Jiangtang Xiaozhi Tablets in Treatment of NAFLD / 中国实验方剂学杂志

Objective:To explore the molecular mechanism of Jiangtang Xiaozhi tablets （JTXZT） in the treatment of non-alcoholic fatty liver disease （NAFLD） by means of network pharmacology and molecular docking. Method:With the help of traditional Chinese medicine （TCM） Systems Pharmacology Database and Analysis Platform （TCMSP）， TCMs Integrated Database （TCMID）， Encyclopedia of TCM （ETCM） and Bioinformatics Analysis Tool for Molecular Mechanism of TCM （BATMAN-TCM）， the chemical compositions of medicinal materials in JTXZT were obtained， the compound targets were predicted in SwissTargetPrediction database and STITCH database. The targets of NAFLD were searched by The Human Gene Database （GeneCards）， Online Mendelian Inheritance in Man （OMIM）， Therapeutic Target Database （TTD） and DisGeNET， and intersection analysis was performed with the targets of the active ingredients to obtain the targets of JTXZT for treatment of NAFLD. Based on STRING 11.0 database， the protein-protein interaction （PPI） network of therapeutic targets was constructed， and the enrichment analysis of therapeutic targets was carried out by DAVID 6.8. Finally， the interaction characteristics of key components and core therapeutic targets of JTXZT for treatment of NAFLD were verified based on molecular docking. Result:The key components of JTXZT for treatment of NAFLD were quercetin， luteolin， kaempferol， berberine， isorhamnetin， betulinic acid， oleanolic acid， ursolic acid. formononetin and hexitol， and the core targets of JTXZT for treatment of NAFLD were mitogen-activated protein kinase 1 （MAPK1）， Jun proto-oncogene， activator protein-1 （AP-1） transcription factor subunit （JUN）， MAPK3， protein kinase B1 （AKT1 or Akt1）， tumor protein p53 （TP53）， E1A binding protein p300 （EP300）， Fos proto-oncogene， AP-1 transcription factor subunit （FOS）， tumor necrosis factor （TNF），amyloid beta precursor protein （APP） and cytochrome P450 family 2 subfamily E member 1 （CYP2E1）. Biological function and pathway enrichment analysis showed that JTXZT mainly through xenobiotic metabolic process， oxidation-reduction process， cholesterol metabolic process and other biological processes， regulating phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， MAPK signaling pathway， NAFLD and insulin signaling pathway to play a role in the treatment of NAFLD. The results of molecular docking showed that the active components of JTXZT had a good affinity with the core targets of JTXZT for the treatment of NAFLD. Conclusion:JTXZT treats NAFLD through multiple active components， multiple key targets and multiple action pathways.

Analysis on Medication Rules of Traditional Chinese Medicine for Treatment of Diabetic Peripheral Neuropathy Based on Clinical Literature / 中国实验方剂学杂志

Objective:To investigate the medication rules of traditional Chinese medicine (TCM) for the treatment of diabetic peripheral neuropathy (DPN).Method:The literature published in China Knowledge Resource Integrated Database (CNKI), Wanfang Database, China Biomedical Literature Service System (SinoMed), VIP Database and PubMeb from 2008 to 2019 were retrieved by setting the topics of diabetic peripheral neuropathy and TCM. After screening, a database was established to analyze the medication rules (efficacy, frequency, flavor and meridian tropism, common couplet medicinals and core medicines) of TCM by frequency statistics, association rules and data statistical methods of constructing complex networks.Result:A total of 461 papers for treatment of DPN were included in this study, including 275 kinds of TCM and a total frequency of 6 361 times. Astragali Radix had the highest frequency. Among all kinds of medicinal materials, activating blood circulation and removing stasis was the most commonly used medicine, followed by Qi-invigorating medicine. Flavor of medicines was mainly sugariness and warm, and most of their meridian tropism was liver meridian. After the analysis by association rules, the couplet medicinals with the highest support was Astragali Radix-Angelicae Sinensis Radix. The core medicines obtained by complex network analysis were Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Spatholobi Caulis, Cinnamomi Ramulus, Carthami Flos, Pheretima, Paeoniae Radix Rubra, Salviae Miltiorrhizae Radix et Rhizoma and Persicae Semen.Conclusion:This study comprehensively analyzes the medication rules of TCM clinical treatment of DPN. The main treatment methods of TCM for DPN are invigorating Qi and blood, activating blood circulation and removing stasis, activating meridians to stop pain, which can provide guidance for the TCM clinical use and new Chinese medicines research and development of DPN.

Network Pharmacology Approach to Explore Mechanisms of Qizhu Granules for Treatment of Diabetic Nephropathy / 中国实验方剂学杂志

Objective:To explore the mechanism of Qizhu granules in the treatment of diabetic nephropathy by using network pharmacology. Method:The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform database （TCMSP） and The Encyclopedia of Traditional Chinese Medicine（ETCM） database were used to screen out the chemical constituents and protein targets of each drug in the Qizhu granules based on oral bioavailability and drug-like properties. The protein target was standardized into the corresponding gene name through the UniProt database. Online Mendelian Inheritance in Man（OMIM）， DisGeNET， Therapeutic Target Database （TTD）， ETCM database were used to search for related targets of diabetic nephropathy， after the intersection of the two， construct a protein interaction network through protein interaction database （STRING）， use Cytoscape to analyze the core target of the network， and the relevant targets were analyzed by KOBAS 3.0 database for Gene Ontology （GO） pathway enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. Result:A total of 93 chemical components were obtained from Qizhu granules， involving 254 targets， and 607 targets related to diabetic nephropathy. After the intersection， 76 sputum granules were determined to treat diabetic nephropathy， including protein kinase B1 （Akt1）， vascular endothelial growth factor （VEGFA）， interleukin （IL）-6， tumor necrosis factor （TNF）， mitogen-activated protein kinase 1 （MAPK1）， matrix metalloproteinase （MMP）-9 and other core targets， after GO analysis and KEGG analysis， Qizhu granules can affect cellular response to nitrogen compound， regulation of reactive oxygen species metabolic process and other biological processes， regulate advanced glycation end product （AGE）/advanced glycation end product receptor （RAGE） signaling pathway in diabetic complications， fluid shear stress and atherosclerosis， IL-17 signaling pathways， HIF-1 signaling pathways TNF signaling pathways and other pathways. Conclusion:The therapeutic effect of Qizhu granules on diabetic nephropathy may affect Akt1，VEGFA， IL-6， TNF， MAPK1， MMP-9 and other targets， and regulate AGE/RAGE signaling pathway in diabetic complications， fluid shear stress and atherosclerosis， IL-17 signaling pathways， hypoxia-inducing factor-1（HIF-1）signaling pathways TNF signaling pathways and other pathways， which can provide a theoretical reference for further basic experimental research.

Finite element study of the mandibular angle width changes in retrogression surgery by bilateral sagittal split ramus osteotomy / 中华整形外科杂志

0bjective@#To establish a three-dimensional finite element model of mandible and study the transverse displacement of proximal segment after Bilateral Sagittal Split Ramus Osteotomy (BSSRO) with different retrogression amounts during mastication.@*Methods@#DICOM data of a skull model were processed with MIMICS and ANSYS software, reconstructing the 3D model including the teeth and temporomandibular joint in order to simulate BSSRO and evaluate the transverse displacement of proximal segment with different retrogression amounts during mastication.@*Results@#The mean of proximal segment width change were 2.955 mm and 3.490 mm, when retrogression amounts of distal segmentwere 3 mm and 8 mm, respectively.No significant difference between the two groups were found (P=0.131). Meanwhile the displacement color scale of the 3D finite element models showed that the apparent transverse displacement distribution of the proximal segment was measured around the gonial area, decreased from the exterior to the interior.@*Conclusions@#The mandibular angle width was significantly expanded right after BSSRO. The masticatory muscle system and single cortical fixation system played an important role in expanding the width of proximal segment. However there was no correlation between the widening effect and retrogression amounts of distal segment of mandible.

Morphological changes of soft tissue on lip after orthognathic surgery with Class Ⅲ skeletal malocclusion / 中华医学美学美容杂志

Objective To evaluate changes from the front in morphology and improvement degree of smiling lip after orthognathic surgery with class Ⅲ skeletal malocclusion.Methods Adult males in experiment were divided into two groups,orthognathic surgery group and the normal group,25 in each group.Experimental subjects in orthognathic surgery group and the normal group were taken positive images before and after the surgery,respectively,and the 35 marks were labelled in every photoes.The mark points were put in the coordinate system of XY,where apophysiary point was original.Test was used to compare changes of lip shape in static and smiling situation before and after treatment and differences between groups.Results Position of upper and lower lip were lower than the normal group when smiling before treatment in orthognathic surgery group,and the upward amplitude of upper lip and angulus oris less than normal group.Between bilateral corner of mouth it was obviously wider than before horizontally when smiling after the treatment.After the surgery,the patient's smile characteristics were significantly improved,but there was still difference comparing with the normal group.Conclusions The lip shape of patients with Class Ⅲ skeletal malocclusion are significantly improved after orthognathic surgery.

Farrerol inhibits AngII-induced VSMCs proliferation by reducing Cx43 expression / 中国药理学通报

Aim To study the role of Cx43 in inhibi-tion of AngII-induced vascular smooth muscle cells(VSMCs) proliferation by farrerol. Methods The primary VSMCs were isolated and cultured by direct adherent culture methods. VSMCs were identified by immunohistochemstry. The cells were divided into the following groups:control group,AngII group,AngII+Farrerol group. The cell viability was measured by CCK-8 cell vitality test. The proliferation of VSMCs was measured by the methods of Edu. The cell cycle of VSMCs was detected by flow cytometry. The mRNA levels of Cx43 were measured by Real-time PCR. The protein levels of Cx43 were measured by Western blot. Results 60 μmol·L-1farrerol could significantly de-crease the cell viability and EdU rate of VSMCs in-duced by AngII(P<0.05),which could also prevent the transformation of VSMCs from G0/G1phase to S phase. The results of real-time PCR and Western blot showed that,compared with the model group,Farrerol could significantly reduce the mRNA and protein ex-pression level of Cx43(P <0.01). After the interfer-ence of Cx43 by siRNA, the inhibition of proliferation by farrerol decreased significantly. Conclusion Far-rerol inhibits AngII-induced VSMCs proliferation signif-icantly, which might be associated with reducing the expression of Cx43.

Free SiO2 promotes the foaming of alveolar macrophages / 医学研究生学报

Objective Lipid metabolism disorders caused by cell foam plays an important role in atherosclerosis,but wheth-er it is involved in the development and progression of silicosis has not yet been elucidated. This study aimed to investigate the effect of free silica(SiO2) in inducing foam cell formation of NR8383 alveolar macrophages in rats. Methods NR8383 cells were cultured in vitro by the routine method (the control group) or in 50 μg/mL SiO2 (the SiO2group), 50 μg/mL ox-LDL (the ox-LDL group), or 50 μg/ml SiO2and ox-LDL (the model group), all for 36 hours. The survival rate of the cells was calculated with the cell proliferation and cytotoxicity assay (MTS),the lipid deposition observed by oil red O staining,the levels of total cholesterol (TC), free cholesterol (FC) and cholesterol esters(CE) measured by ELISA,and the mRNA and protein expressions of PPARγ and CD36 in the cells determined by RT-PCR and Western blot, respectively. Results Compared with the control group,the cells treated with ox-LDL showed a significantly increased survival rate, which reached the peak at 50 μg/mL ([1.501±0.201]%) (P<0.05). Foam cells were observed in the SiO2,ox-LDL and model groups,but most significantly in the model group. In comparison with the ox-LDL group,the model group exhibited remarkable increases in TC([14.195±2.260] vs[35.764±4. 226] μg/mg,P<0.05),FC([7.722±0.690] vs[10.049±0.698] μg/mg,P<0.05),CE([6.473±1.707] vs[25.715±4.243] μg/mg,P<0.05),and CE/TC (45.057% vs 71.642%, P<0.05). Conclusion Free SiO2promotes the lipid metabolism disorder in macrophages and enhances the foaming of the cells,in which PPARγ and CD36 may play an important role of regulation.

Clinical effect and nursing of small needle therapy in the treatment of retrograde lumbar spine stenosis / 现代临床护理

Objective To observe the clinical efficacy of small needle therapy in the treatment of retrograde lumbar spine stenosis. Methods About 30 patients with retrograde lumbar spinal stenosis from June 2015 to March 2016 were set as control group;30 patients with the same disease from ApriI 2016 to December 2016 were set as observation group. The control method of traction and massage therapy, the observation group on the basis of increased by small needle knife therapy. Result The effect of the observation group was better than the control group, the difference was statistically significant (P<0.01). Conclusions Treatment of retrograde lumbar spinal stenosis with small needle knife therapy is effective in treating patients' pain and improving clinical effect. Well condition observation and nursing during the treatment can ensure the smooth progress of treatment, the correct guidance and urged patients to exercise to reduce the recurrence of the disease, has the vital significance.

Update and progress of the response-to-therapy assessment system in differentiated thyroid cancer / 中华核医学与分子影像杂志

Recent research has gained much depth and details on the response-to-therapy assessment system (RTAS) of DTC. The concept of RTAS was first proposed in the 2015 ATA guidelines, mainly advocating dynamic and ongoing assessment of a disease process after primary therapy is completed. This recommendation is to compensate for the deficiency of a static, single-parametric evaluation system that is conventionally pathology-dominated. The concept of risk-adaptive management has been adopted in individual decision-making processes, so as to tailor treatment plans accordingly with an understanding that therapies (e.g. surgery, etc.) should also be involved as a continuum of risk assessment. The RTAS according to the new guidelines has been clearly highlighted worldwide. This review aims to outline the progress and latest update of RTAS on DTC.