Clinical Effect of Runzaoling Combined with Iguratimod on Primary Sjögren's Syndrome / 中国实验方剂学杂志

ObjectiveTo investigate the clinical efficacy and safety of iguratimod combined with the Chinese medicine Runzaoling in the treatment of primary Sjögren's syndrome （pSS）. MethodSeventy-two patients treated in the Department of Rheumatology and Immunology of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine（TCM） from January 2021 to June 2022 who met the Western medical diagnosis of pSS and had the TCM syndrome of Yin deficiency and heat toxin syndrome were randomly assigned into an observation group and a control group， with 36 patients in each group. The observation group was treated with iguratimod combined with Runzaoling， and the control group was treated with iguratimod. The treatment in both groups lasted for 12 weeks. The clinical symptoms， EULAR Sjogren's syndrome patient reported index （ESSPRI）， EULAR Sjögren's syndrome disease activity index （ESSDAI）， erythrocyte sedimentation Rate （ESR）， C-reactive protein （CRP）， immunoglobulin （IgG）， Schirmer score， and saliva flow of the two groups were determined before and after treatment. Furthermore， the incidence of adverse reactions was compared between the two groups. ResultThe total response rate in the observation group was 75.0% （27 patients with response and 9 patients with no response）， which was higher than that （61.11%， 22 patients with response and 14 patients without response） in the control group （P<0.05）. After treatment， the ESSPRI， ESSDAI， and TCM syndrome scores in both groups decreased and the decreases were more obvious in the observation group than in the control group （P<0.05）. The treatment in both groups recovered the ESR， CRP， IgG， Schirmer score， and saliva flow （P<0.05）. Moreover， the observation outperformed the control group in terms of the ESR， CRP， IgG， and saliva flow （P<0.05） and had no significant difference in the Schirmer score compared with the control group. During the treatment period， 2 patients in the observation group had nausea， and 1 patient had an abnormal liver function， which were relieved after symptomatic treatment and did not affect the treatment. In the control group， 1 patient withdrew from the study due to rashes and showed no special discomfort in the follow-up 4 weeks， and 1 patient had nausea， which was relieved after symptomatic treatment. ConclusionIguratimod combined with Runzaoling has good clinical efficacy and safety in the treatment of pSS.

Associations between the sense of school belonging and mental health status among medical students during the post-epidemic period / 中华医学教育探索杂志

Objective:To explore the status of medical students' sense of school belonging and its relationship with depression and anxiety symptoms in the context of COVID-19 prevention and control.Methods:An online questionnaire survey was conducted among 1 629 full-time students from 8 medical universities. The 18-item psychological sense of school membership scale (PSSM-18), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder scale (GAD-7) were used as measurements. Spearman correlation coefficients were used to analyze the correlations between PSSM-18, PHQ-9, and GAD-7 scores. Logistic regressions were used to analyze the impact of lack of school belonging on depression and anxiety symptoms.Results:The mean score of school belonging was (77.31±14.12), and the detection rates of depression and anxiety symptoms were 25.97% (423/1 629) and 21.92% (357/1 629), respectively. PSSM-18 score was negatively correlated with PHQ-9 scores ( r=-0.52, P<0.001) and GAD-7 scores ( r= -0.49, P < 0.001). After adjusting for covariates, students with low school belongingness had 4.33 times the risk of depression symptoms ( OR=4.33, 95%CI=2.48-7.43) and 5.85 times the risk of anxiety symptoms ( OR= 5.85, 95%CI=3.76-8.15) compared to students with high school belongingness. Conclusion:Lack of school belonging increases the risk of depression and anxiety symptoms. Under the normalization of COVID-19 prevention and control, the school should strengthen health education and support services to improve the students' sense of belonging and alleviate their mental health problems.

Feasibility of a single-port thoracoscopy-assisted five-step laparoscopic procedure via transabdominal diaphragmatic approach for No.111 lymphadenectomy in patients with Siewert type II esophageal gastric junction adenocarcinoma / 中华胃肠外科杂志

Objective: We aimed to explore the feasibility of a single-port thoracoscopy- assisted five-step laparoscopic procedure via transabdominal diaphragmatic(TD) approach(abbreviated as five-step maneuver) for No.111 lymphadenectomy in patients with Siewert type II esophageal gastric junction adenocarcinoma (AEG). Methods: This was a descriptive case series study. The inclusion criteria were as follows: (1) age 18-80 years; (2) diagnosis of Siewert type II AEG; (3) clinical tumor stage cT2-4aNanyM0; (4) meeting indications of the transthoracic single-port assisted laparoscopic five-step procedure incorporating lower mediastinal lymph node dissection via a TD approach; (5) Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1; and (6) American Society of Anesthesiologists classification I, II, or III. The exclusion criteria included previous esophageal or gastric surgery, other cancers within the previous 5 years, pregnancy or lactation, and serious medical conditions. We retrospectively collected and analyzed the clinical data of 17 patients (age [mean ± SD], [63.6±11.9] years; and 12 men) who met the inclusion criteria in the Guangdong Provincial Hospital of Chinese Medicine from January 2022 to September 2022. No.111 lymphadenectomy was performed using five-step maneuver as follows: superior to the diaphragm, starting caudad to the pericardium, along the direction of the cardio-phrenic angle and ending at the upper part of the cardio-phrenic angle, right to the right pleura and left to the fibrous pericardium , completely exposing the cardio-phrenic angle. The primary outcome includes the numbers of harvested and of positive No.111 lymph nodes. Results: Seventeen patients (3 proximal gastrectomy and 14 total gastrectomy) had undergone the five-step maneuver including lower mediastinal lymphadenectomy without conversion to laparotomy or thoracotomy and all had achieved R0 resection with no perioperative deaths. The total operative time was (268.2±32.9) minutes, and the lower mediastinal lymph node dissection time was (34.0±6.0) minutes. The median estimated blood loss was 50 (20-350) ml. A median of 7 (2-17) mediastinal lymph nodes and 2(0-6) No. 111 lymph nodes were harvested. No. 111 lymph node metastasis was identified in 1 patient. The time to first flatus occurred 3 (2-4) days postoperatively and thoracic drainage was used for 7 (4-15) days. The median postoperative hospital stay was 9 (6-16) days. One patient had a chylous fistula that resolved with conservative treatment. No serious complications occurred in any patient. Conclusion: The single-port thoracoscopy-assisted five-step laparoscopic procedure via a TD approach can facilitate No. 111 lymphadenectomy with few complications.

Combined effects of low calf circumference and vitamin D deficiency on all-cause mortality among community-dwelling older adults / 中华老年医学杂志

Objective:To investigate the individual and combined effects of calf circumference and vitamin D levels on all-cause mortality risk in community-dwelling older adults based on the Chinese Longitudinal Healthy Longevity Survey.Methods:The calf circumference was measured in the baseline survey in 2012 and 2014.Low calf circumference was defined as <34 cm for men or 33 cm for women at screening.Vitamin D deficiency was defined as plasma 25-hydroxyvitamin D[25(OH)D]levels <50 nmol/L.All participants were followed up until 2018, when death outcomes and survival time were collected.Cox proportional hazard regression models were used to analyze the effects of calf circumference and 25(OH)D levels on the risk of all-cause mortality.Results:A total of 3 052 older adults were included in the analysis, of which 1 960(64.22%)had low calf circumference and 2 245(73.56%)had vitamin D deficiency.After 10 559.9 person-years of follow-up period, 1 312 death events were recorded.After adjusting for sociodemographic characteristics, physical activities, cognitive function, and multiple chronic diseases, calf circumference and 25(OH)D levels were negatively associated with the risk of all-cause mortality(both P<0.05). In the combined analysis, compared with the normal group, the risk of death was highest in the participants with both low calf circumference and vitamin D deficiency, which was higher than those with low calf circumference or vitamin D deficiency alone, with a hazard ratios( HR)(95% CI)of 2.51(1.81-3.45), 1.71(1.22-2.42)and 1.53(1.09-2.15), respectively.There was a significant additive interaction between low calf circumference and vitamin D deficiency on mortality(RERI>0). Conclusions:Low calf circumference and vitamin D deficiency are associated with higher mortality.Older adults with combined conditions had a even higher risk of death.Attention should be paid to joint screening and comprehensive intervention for older adults with both low calf circumference and vitamin D deficiency.

Research advances on antitumor mechanism of NK cells and its application in cancer targeted therapy / 药学学报

Natural killer (NK) cells, as an essential part of innate immunity, can directly identify and kill tumor cells after being activated by the synergistic action of surface inhibitory receptors and activated receptors. It can secrete cytokines to recruit dendritic cells (DCs), induce DCs maturation and enhance adaptive immune response. It can target cancer stem cells (CSCs) and circulating tumor cells (CTCs) to inhibit cancer metastasis. NK cells have a unique inflammatory tendency, which can respond to cytokines and chemokines released from tumor sites and migrate to tumor sites, making them occupy an important advantage in cancer targeted therapy. The research on cancer targeted therapy of NK cells as drug delivery carriers, NK cell membrane-coated biomimetic nanoparticles, and NK cell extracellular vesicles (NKEVs) has attracted more and more attention. The article will focus on the mechanism of NK cells inhibiting cancer, and summarize the research progress of cancer targeted therapy of NK cells.

Applicability assessment and application of the general self-efficacy scale among medical postgraduates / 中华医学教育探索杂志

Objective:To assess the reliability, constructive validity and item characteristics of the general self-efficacy scale (GSES) among Chinese medical postgraduates using classical test theory and item response theory.Methods:A questionnaire survey was conducted among 1 021 medical postgraduates from 6 comprehensive level Ⅲ A hospitals in Beijing. Demographic characteristics and general self-efficacy were investigated. SPSS 24.0 software was used for statistical analysis. Internal consistency of the GSES was evaluated using Cronbach’s α coefficient and intraclass correlation coefficient. Factor analyses were implemented to test the structure of the scale. An item response theory (IRT) framework with a graded response model was performed to estimate the parameters of each item. Results:The overall Cronbach’s α coefficient of the GSES was 0.92. Parallel analysis and confirmatory factor analysis supported the unidimensional structure of the GSES. The discrimination parameter of the 10 items ranged from 1.82 to 3.65, and the difficulty parameter ranged from -3.51 to 1.66, with a monotonically increasing trend. The maximum test information of the scale among medical postgraduates was 19.16. Conclusion:The GSES has good reliability, validity and measurement precision, showing a good applicability in the survey of medical postgraduates. However, the difficulty of specific items is relatively low, and the scale may be further optimized and improved.

The exploration of the significance of proactive healthy living index for the elderly based on the functional capacity of Chinese older people / 中华老年医学杂志

Objective:To explore the significance of proactive healthy living index(PHLI)to provide a reference for the elderly to maintain function through healthy daily life.Methods:The functional status of the elderly was defined based on gait speed and cognitive function.Logistic regression model was used to select the daily life indicators which could be the risk factors for the functional status, and a nomogram was graphed for its visualization.PHLI was formed according to the result of the nomogram.Receiver operating characteristic curve(ROC)was plotted according to the functional status of the elderly, and the cut-off value of PHLI was determined based on the principle of the maximum sum of sensitivity and specificity.Results:A total of 4 971 participants with an average age of (70.9±7.5)years were included in the cross-sectional study, of whom 2 649 cases(53.3%)maintained normal function.The Logistic regression analysis showed that the housework had the most significant effect on the functional status of the elderly, followed by positive psychology( OR=2.04, 1.92; both P<0.001), increasing the likelihood of maintaining normal function by 104% and 92%, respectively.Regular life patterns, adequate protein intake, sleep quality and so on also influenced functional status of the elderly(all P<0.05). The PHLI median score of the elderly was 7.3(5.9, 8.3)points.The area under the curve(AUC)was 0.70(95% CI: 0.68-0.71), and the cut off value of PHLI was 6.8 points. Conclusions:The PHLI is associated with the maintenance of functional capacity in the elderly, which can be applied as a simple tool to provide reference for old people to keep functional health through living a proactive healthy daily life.

Clinical characteristics of elderly patients with coronavirus disease 2019 / 中华老年医学杂志

Objective:To investigate the clinical characteristics of elderly patients with coronavirus disease 2019(COVID-19), in order to provide scientific evidence for the diagnosis and treatment of COVID-19 in elderly patients.Methods:Clinical data of 102 patients with COVID-19 admitted to the B11 East Ward of the Zhongfaxincheng campus and the E1-3 ward of the Guanggu Campus of Tongji Hospital affiliated to Huazhong University of Science and Technology in Wuhan from 1 February 2020 to 28 February 2020 were retrospectively collected and analyzed.Patients were categorized into 2 groups: the elderly group(≥60 years old)and the young and middle-aged group(<60 years old). Differences in epidemiological features, demographics, clinical symptoms, laboratory results and imaging findings between the two groups were retrospectively analyzed.Results:Among 102 patients with COVID-19, 58 were in the elderly group(≥60 years old), with a median age of 67.0(63.8, 71.0)years old, and 44 in the young and middle-aged group(<60 years old), with a median age of 47.5(38.0, 51.8)years old.There was no significant difference in gender ratio between the two groups( χ2=0.033, P=0.855). Of 102 patients, 42.0%(21/50)had close contact with an infected person, 14.0%(7/50)were from infection clusters, and 18.0%(9/50)had suspected hospital-acquired infections.Fever and cough remained the most common symptoms, but gastrointestinal symptoms such as nausea, poor appetite, diarrhea and muscle cramps were also warning signs.Fatigue and cough were the most common presenting symptoms in elderly male patients.Bilateral patchy infiltrates(57.9%, 22/38)and ground-glass opacities(42.1%, 16/38)were the main imaging features and 42.1%(16/38)patients had multiple areas of the lungs involved.Over 50% patients had increased levels of blood glucose, D-dimer, fibrinogen, C-reactive protein, procalcitonin, multiple cytokines and neutrophil-to-lymphocyte ratio, as well as decreased levels of albumin, hemoglobin, hematocrit, lymphocytes and serum calcium.Compared with the young and middle-aged group, the elderly group had higher rates of abnormality in levels of D-dimer and serum calcium( χ2=7.067 and 4.166, P=0.008 and 0.041). Conclusions:Fever and cough are the most common symptoms in elderly patients with COVID-19.Elderly patients with COVID-19 have multiple abnormalities in clinical laboratory test results, which show a certain level of specificity compared with young and middle-aged patients.

Latest research progress: The health-related home safety assessment methods for the elderly / 中华老年医学杂志

This article reviews the health-related home safety assessment methods for the elderly, and briefly introduces the development process of the "Person-environment fit" model from the concept, to the risk assessment method of environmental factors and then to the interactive risk assessment method of human-environment factors.Especially, this article introduces several risk assessment methods of residential environment, such as "The Enabler" human function and environmental obstacle assessment tool, the Safety Assessment of Function and the Environment for Rehabilitation(SAFER), the Safety Assessment of Function and the Environment for Rehabilitation-Health Outcome Measurement and Evaluation(SAFER-HOME), the Westmead Home Safety Assessment(WeHSA), the Home Falls and Accident Screening Tool(HOME FAST), the Cougar Home Safety Assessment(CHSA), the in-Home Occupational Performance Evaluation(I-HOPE), the In-Home Occupational Performance Evaluation for Providing Assistance(I-HOPE Assist), the In-Home Medication Management Performance Evaluation(HOME-Rx).

Analysis on the concentration of chloroform and risk factors of swimming pools in Bao’an District of Shenzhen City / 上海预防医学

Objective:To investigate the concentration level of chloroform in the water of swimming pool in Baoan District of Shenzhen City，and determine the risk factors. Methods:During May and July，2019，a total of 110 water samples from 40 swimming pools were collected in Xin’an subdistrict of Bao’an District for the examination of chloroform routine indicators. In addition， 38 pipe water samples were collected for the examination of chloroform and free residual chlorine． Results:The concentration of chloroform in the swimming pools was determined to be （43.400±27.802） μg/L with the median of 37.343 μg/L. Chloroform was correlated positively with total bacterial count（P<0.05），turbidity， free chlorine residual， and PH value（P<0.01）. Conclusion:The disinfection quality of swimming pool water in Bao’an District remains low. It is necessary to determine the risk factors associated with chloroform in the swimming pool and further reduce the concentration level of disinfection by-products.

A new phloroglucinol compound from Dryopteris fragrans / 中国中药杂志

Two phloroglucinol compounds(1-2) were isolated and purified from 95% ethanol extract of Dryopteris fragrans through various column chromatographies on silica gel, Sephadex LH-20, medium pressure column chromatography, and preparative HPLC. Their structures were elucidated as 2',4',6'-trihydroxy-5'-methyl acetate-3'-methyl-1'-butyrophenone(1) and aspidinol B(2) based on their chemical and physicochemical methods and spectroscopic data. Compound 1 is a new phloroglucinol compound named "dryofraginol".

Five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph node dissection for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction / 中华胃肠外科杂志

Objective: Surgical operation is the main treatment for advanced adenocarcinoma of esophagogastric junction (AEG). Due to its special anatomic location and unique lymph node reflux mode, the surgical treatment of Siewert II AEG is controversial. Lower mediastinal lymph node dissection is one of the most controversial points and a standard technique has not yet been established. This study is aim to explore the safety and feasibility of five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph node dissection for Siewert type II AEG. Methods: A descriptive case series study was conducted. The intraoperative and postoperative data of 25 patients with Siewert type II AEG who underwent five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph node dissection in Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2019 to April 2021 were retrospectively analyzed. Five-step maneuver was as follows: In the first step, the subcardiac sac was exposed; the right pulmonary ligament lymph nodes and the anterior thoracic paraaortic lymph nodes were dissected cranial to inferior pericardium, left to left edge of thoracic aorta. In the second step, the left diaphragm was opened, and a 12 mm trocar was placed through the 6-7 rib in the left anterior axillary line. The supra-diaphragmatic nodes were dissected through the thoracic operation hole. In the third step, the left inferior pulmonary ligament was severed. The anterior fascia of thoracic aorta was incised to join the anterior space of thoracic aorta formed in the first step and then the lymphatic tissue was dissected upward until the exposure of left inferior pulmonary vein. In the fourth step, the posterior pericardium was denuded retrogradely from ventral side to oral side to the level of left inferior pulmonary vein, right to right pleura, and then the right pulmonary ligament lymph nodes were completely removed. In the fifth step, the esophagus was denuded, and the esophagus was transected 5 cm above the tumor using a linear stapler to complete the dissection of lower thoracic paraesophageal lymph nodes. Results: Operations were successfully completed in 25 patients without conversion, intra-operative complication and perioperative death. Total gastrectomy was performed in 19 cases and proximal gastrectomy in 6 cases. The mean operative time was (268.7±85.6) minutes, the mean estimated blood loss was (90.4±44.2) ml, the mean time of lower mediastinal lymph node dissection was (38.6±10.3) minutes, and the mean harvested number of lower mediastinal lymph node was 5.9±2.9. The length of esophageal invasion was >2 cm in 7 cases and ≤ 2 cm in 18 cases. Eight patients (33.0%) had lower mediastinal lymph node metastasis, including 3 cases with esophageal invasion >2 cm and 5 cases with esophageal invasion ≤ 2 cm. The mean time to postoperative first flatus was (5.5±3.1) days. The average time of postoperative thoracic drainage was (5.9±2.9) days. The mean hospital stay was (9.7±3.1) days. Two patients (8.0%) developed postoperative grade IIIa complications according to the Clavien-Dindo classification, including 1 case of pancreatic fistula and 1 case of pleural effusion, both of whom were cured by puncture drainage. Conclusions: Five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymph nodes dissection for Siewert type II AEG is safe and feasible. Which can ensure sufficient lower mediastinal lymph node dissection to the level of left inferior pulmonary vein.

Large- scale prospective clinical study on prophylactic intervention of COVID-19 in community population using Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules / 中国中药杂志

To scientifically evaluate the intervention effect of Chinese medicine preventive administration(combined use of Huo-xiang Zhengqi Oral Liquid and Jinhao Jiere Granules) on community population in the case of coronavirus disease 2019(COVID-19), a large cohort, prospective, randomized, and parallel-controlled clinical study was conducted. Total 22 065 subjects were included and randomly divided into 2 groups. The non-intervention group was given health guidance only, while the traditional Chinese medicine(TCM) intervention group was given two coordinated TCM in addition to health guidance. The medical instructions were as follows. Huoxiang Zhengqi Oral Liquid: oral before meals, 10 mL/time, 2 times/day, a course of 5 days. Jinhao Jiere Granules: dissolve in boiling water and take after meals, 8 g/time, 2 times/day, a course of 5 days, followed up for 14 days, respectively. The study found that with the intake of medication, the incidence rate of TCM intervention group was basically maintained at a low and continuous stable level(0.01%-0.02%), while the non-intervention group showed an overall trend of continuous growth(0.02%-0.18%) from 3 to 14 days. No suspected or confirmed COVID-19 case occurred in either group. There were 2 cases of colds in the TCM intervention group and 26 cases in the non-intervention group. The incidence of colds in the TCM intervention group was significantly lower(P<0.05) than that in the non-intervention group. In the population of 16-60 years old, the incidence rate of non-intervention and intervention groups were 0.01% and 0.25%, respectively. The difference of colds incidence between the two groups was statistically significant(P<0.05). In the population older than 60 years old, they were 0.04% and 0.21%, respectively. The incidence of colds in the non-intervention group was higher than that in the intervention group, but not reaching statistical difference. The protection rate of TCM for the whole population was 91.8%, especially for the population of age 16-60(95.0%). It was suggested that TCM intervention(combined use of Huoxiang Zhengqi Oral Liquid and Jinhao Jiere Granules) could effectively protect community residents against respiratory diseases, such as colds, which was worthy of promotion in the community. In addition, in terms of safety, the incidence of adverse events and adverse reactions in the TCM intervention group was relatively low, which was basically consistent with the drug instructions.

The relationship between doing housework and gait speed among the elderly / 中华老年医学杂志

Objective:To explore the relationship between doing housework and gait speed(GS)in order to identify ways to maintain physical capability in elderly people.Methods:A nationwide cross-sectional survey was conducted from Jan.2011 to Dec.2011.Subjects in this survey, with a sample of 2 519 males and 2 541 females aged ≥60 years, came from six regions across the country and satisfactorily completed a GS test.A GS in the lower 20% of the reference population(<0.7 m/s)was used as the cut-off point to define slow GS(SGS). Housework was defined as activities such as house cleaning, shopping, cooking and taking care of grandchildren and a response of"often"(≥5 d/week)was considered as doing housework.Propensity Score Matching(PSM)was performed to select comparable sub-groups of the study population to evaluate the association between housework and GS.Results:There were 3 290 subjects(1 645 pairs)selected by PSM.Logistic regression analysis showed that doing housework was inversely associated with SGS, and housework activities reduced the risk of SGS by 60%( OR=0.40, 95% CI: 0.35-0.46, P<0.01). Conclusions:Elderly people who conduct housework often are more likely to maintain GS and therefore should be encouraged to engage in daily activities to help maintain adequate physical performance.

A case-control study on clinical characteristics, awareness of foods & drinks and compliance of 111 early-onset gout cases / 中华风湿病学杂志

Objective:To study the clinical characteristics and compliance of early-onset gout patients by case-control analysis.Methods:A total of 111 early-onset patients (onset age ≤35 years old) were included as Group A, and 111 non-early-onset patients (onset age >35 years old) with matched disease durationwere included as Group B. The differences ofclinical characteristics, causes of acute gout attack, dairy diet habits, compliance, and misunderstanding of the disease were compared.Results:Compared with the non-early-onsetgoutpatients, the early-onset patients had a higher proportion of obesity (63 cases vs 28 cases), family history (36 cases vs 20 cases) and tophus (39 cases vs 23 cases) and higher level of VAS scores (8.5±1.3 vs 7.6±1.7; χ2=22.988, P<0.01; χ2=5.749, P=0.016; χ2=5.729, P=0.017; t=4.639, P<0.01), lowerproportionof the first metatarsophalangeal joint involvement as the initial joint involvement (45.9%, 51 cases vs 59.4%, 66 cases; χ2=4.066, P=0.044), higher proportion of the ankle involvement as the initial joint involvement (34.2%, 38 cases vs 21.6%, 24 cases; χ2=4.386, P=0.036), higher proportion of alcohol drinkers and high fructose drinkers, which was more likely to relate to alcohol intake, strenuous exercise and high fructose intakeas trigger of the flare ( χ2=6.513, P=0.011; χ2=7.126, P=0.008; χ2=1.978, P=0.160), while the proportion of regular exercisers and on diet in the family was lower ( χ2=22.887, P<0.01; t=-4.917, P<0.01). The proportion of poor diet and medication compliance in Group A was higher than that in Group B(57.7%, 64 cases vs 38.7%, 43 cases; χ2=5.207, P=0.022; χ2=5.867, P=0.015). As for the reason for poor treatment compliance, early-onset gout patients were more worry about the side-effects of drugs than non-early onset patients ( χ2=4.190, P=0.041). There was no significant difference between the two groups in the main misunderstanding of gout. Conclusion:Although early onset gout patients are young, their condition is more serious, and compliance is poorer, this group of patients should be highly valued in clinical diagnosis and treatment.

Hsa-let-7b-5p Inhibits Proliferation of Human Leukemia THP-1 Cells via FTO/m / 中国实验血液学杂志

OBJECTIVE@#To investigate the down-regulation effect of let-7b-5p on the expression of FTO in acute myeloid leukemia cell line THP-1 and inhibitory effect on THP-1 proliferation via m@*METHODS@#The acute myeloid leukemia cell line THP-1 and the normal human peripheral blood mononuclear cells (PBMNC) were selected as subjects. The expression of let-7b-5p and FTO mRNA in those cells was detected by qPCR, further the expression of FTO protein in those cells was detected by Western blot. And, the luciferase reporter gene assay was used to verify the targeting effect of let-7b-5p on FTO. Finally, THP-1 cells were transfected respectively with let-7b-5p mimic, and PBMNC with let-7b-5p inhibitor, there after the C-MYC mRNA m@*RESULTS@#Compared with PBMNC, the expression of let-7b-5p in THP-1 significantly decreased, while the expression of FTO was significantly increased (P<0.05). After transfection with let-7b-5p mimic combined with FTO 3'-UTR, the luciferase activity of transfected THP-1 cells significantly decreased, but the luciferase activity significantly increased after transfection with mutant 3'-UTR, which was significantly different from the negative control group(blank vector) (P<0.05). Let-7b-5p inhibitor down-regulated c-MYC mRNA m@*CONCLUSION@#Human acute myeloid leukemia cell line THP-1 low expresses the let-7b-5p, which regulates c-MYC expression through let-7b-5p-/FTO-/m

Study on the effect of histone deacetylase gene polymorphism and environmental factors on type 2 diabetes mellitus / 中华疾病控制杂志

@#Objective To examine whether polymorphisms of histone deacetylase( HDACs) and environment factors can be implicated in type 2 diabetes mellitus ( T2DM) ，and to provide evidence for the prevention and treatment of T2DM． Methods In 2017，T2DM patients and controls were selected from 17 villages in Huadu District，Guangzhou． According the Diagnostic criteria for T2DM，the case group of T2DM was matched with control group from the population diagnosed as normal by gender，age no more than 5 years old，and from the same natural village． Conditional logistic regression model was used to analyze the effect of gene and environment and their interaction on T2DM． Results The average age of 499 cases group were ( 61．53±13．08) years old，and the average age of 499 controls group were ( 61．48±13．09) years old． There were no statistic difference between two groups． Furthermore，the two groups were gender－balanced too． In conditional logistic regression model，we found that glycerin trilau- rate ( TG) abnormalities ( OR= 2．410，95% CI: 1．755－3．310，P＜0．001) and cholesterol total ( TC) ab- normalities ( OR= 1．436，95% CI: 1．046－1．972，P = 0．025) were risk factors for T2DM． The subjects carries rs72792338 TC+TT genotype ( OR= 0．526，95% CI: 0．349－0．793，P= 0．002) had lower the risk to develop T2DM． Conclusions Abnormal TG and TC are risk factors for T2DM． Rs72792338 TT and TC genotype carryings decrease the risk of T2DM．

Quality Control of Dynamic Volatile Components in Lonicerae Japonicae Flos and Lonicerae Flos / 中国实验方剂学杂志

Objective:The molecular connectivity index method and total statistical moment method were used to control the quality of traditional Chinese medicine （TCM）， and the stability and consistency of volatile components of Lonicerae Japonicae Flos and Lonicerae Flos were clarified. Method:Volatile oils in Lonicerae Japonicae Flos and Lonicerae Flos from different producing areas was extracted for GC-MS determination with electron bombardment ion source， ion source temperature of 230 ℃， and detection range of m/z 35-650. Then National Institute of Standards and Technology （NIST） 05 and ChemicalBook database were used for qualitative analysis of these volatile components， the peak area normalization method was used for quantitative analysis， and the total statistical moment parameters and the zero-order， first-order， second-order， third-order molecular connectivity indexes of the components were calculated. Result:Number of peaks （RSD were 28.5%， 33.4%， respectively）， total zero-order moments （RSD were 55.5%， 128.9%， respectively） and total second-order moments （RSD were 15.3%， 21.5%， respectively） of 10 batches of Lonicerae Japonicae Flos and Lonicerae Flos were unstable， indicating that the types and contents of volatile components fluctuated sharply， but the total first-order moments （RSD were 7.5%， 8.8%， respectively） and the zero-order， first-order， second-order and third-order molecular connectivity indexes （RSD ranged from 8.1% to 10.3% and 4.2% to 5.5%， respectively） were relatively stable， indicating that the overall "imprinting template" of the components was similar. Statistical analysis of each parameter found that there were no significant differences in the number of peaks， total first-order moments and zero-order， first-order， second-order， third-order molecular connectivity indexes between volatile oils from Lonicerae Japonicae Flos and Lonicerae Flos. Conclusion:Under the guidance of supramolecular gas evolution "imprinting template" theory， the molecular connectivity index method and total statistical moment parameters are used to jointly characterize the "imprinting template" of TCM components in vitro， which can control the stability and consistency of TCM quality.

Metabolic characteristics of active parts of lipid-lowering flavonoid extract of Daidai in liver and intestinal microsomes of rats / 中国中药杂志

The paper studies and compares the metabolic difference of active ingredients of lipid-lowering flavonoid extract of Daidai in rat livers and intestinal microsomes,in order to explore the phase Ⅰ metabolism characteristics of active ingredients in livers and intestines. UPLC-MS/MS was used to establish a quantitative analysis method for active ingredients,neohesperidin and narngin,in a phase Ⅰ metabolism incubation system of liver and intestinal microsomes. Differential centrifugation was used to make liver and intestinal microsomes of rats. A phase Ⅰ metabolism incubation system was established,and the concentrations of the residual at different incubation time points were analyzed. Graphs were plotted to calculate the metabolic elimination half-life of the main active parts,with the natural logarithm residual percentage values ln( X) at different time points as the y axis,and time t as the x axis. The metabolism characteristics of the active ingredients were compared. The established UPLC-MS/MS quantitative analysis method has a good specialization,standard curve and linear range,accuracy and precision,with a satisfactory lower quantitative limit. The method allows quantitative detection of the active ingredients in a phase Ⅰ metabolism incubation system of liver and intestinal microsomes of rats. In the rats liver microsomes incubation system,the metabolic elimination half-life of neohesperidin and narngin were( 2. 20 ± 0. 28) h and( 1. 97±0. 28) h respectively. The elimination half-life of neohesperidin was larger than that of narngin,but with no statistically significant difference. In the rats intestinal microsomes incubation system,the metabolic elimination half-lives of neohesperidin and narngin were( 3. 68±0. 54) h and( 2. 26±0. 13) h respectively. The elimination half-life of neohesperidin was larger than that of narngin,with statistically significant differences( P<0. 05). The elimination half-lives of the active ingredients in liver microsomes were smaller than those in intestinal microsomes. The experiment results showed that the active ingredients of lipid-lowering flavonoid extract of Daidai had different elimination half-lives in phase Ⅰ rats liver and intestinal microsomes incubation system. This implied that they had different metabolic characteristics in rats liver and intestine,and liver may be the main metabolism site of the active ingredients. The phaseⅠ metabolism of narngin was stronger than that of neohesperidin. The differences between their metabolic characteristics may be related to the binding sites of B-ring hydroxyl in flavonoid glycosides and the number of methoxyl group. The results provided an important experimental basis for further development and clinical application of lipid-lowering flavonoid extract preparation of Daidai.

Analysis of Effective Substance of Qingre Chushi Decoction by UPLC-Q-TOF-MS / 中国实验方剂学杂志

Objective:To characterize and compare the chemical information of four extracts of Qingre Chushi (QRCS) decoction by liquid chromatography-mass spectrometry (LC-MS), and combine the chemical information of the four extracts with their results of anti-inflammatory effect for a multivariate statistical analysis, in order to identify the compounds directly relating to the anti-inflammatory effects of QRCS decoction. Method:Four extracts of QRCS decoction were characterized by UPLC-Q-TOF-MS:①ethanol extract+water extract,② ethanol extract+supernatant after water extraction and alcohol precipitation, ③ ethanol extract+precipitation after water extraction and alcohol precipitation,and ④ standard decoction. On the basis of the results of inhibition of the four above extracts on xylene-induced ear swelling in mice,multivariate statistical analysis[principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA)] were carried out to lock the chromatographic peaks with significant differences between group ① (the best pharmacological action group) and group ④ (standard decoction group). According to the accuracy of quasi-molecular ion and fragment ion data,and the reference materials and literature data,those chromatographic peaks were identified. Result:PCA could cluster the four extracts of QRCS decoction,and the differences between groups was reflected in the distance between groups. Group ④ (standard decoction) had the most significant differences with the other three groups, especially in the first principal component; group ① (ethanol extract+water extract),group ② (ethanol extract+supernatant after water extraction and ethanol precipitation) and group ③ (ethanol extract+precipitation after water extraction and ethanol precipitation) had certain differences in the second principal component. OPLS-DA was used to compare group ① (the best pharmacological action group) and group ④ (standard decoction group). Eleven chromatographic peaks with great contribution and high reliability to group differences,were identified as gentiopicrin,skimmin,baicalin,baicalin isomer,wogonoside,5,6,7-trihydroxy-8-methoxyflavone-7-O-glucurodonaldehyde,5,6-dihydroxy-6,8,2',3'-tetramethoxyflavone,salicin-6-C-arabinose-8-C-glucoside,plantamajoside and glycyrrhizic acid. Conclusion:In the mode of pectrum-effect combination, this study explores and identifies compounds relating to the anti-inflammatory effect of QRCS decoction,so as to provide the basis for screening the extraction and purification process and optimizing the formulation of preparation of Qingre Chushi decoction.