Polyarthritis, hyperuricemia and right shoulder pain: a report of one case with literature review / 中华风湿病学杂志

Objective:To improve the clinical differential diagnosis ability of rheumatoid arthritis (RA) complicated with gout and septic arthritis (SA).Methods:The clinical characteristics, diagnosis, and treatment of one RA patient with hyperuricemia and recurrent swelling and pain in right shoulder were reported and discussed.Results:A patient, with a history of RA for 10 years, hyperuricemia for 8 years, recurrent swelling and pain in right shoulder for 1 year. RA, gout, and SA were diagnosed before, and the response was poor after symptomatic treatment. In recent 1 month, the symptom was aggravated with the formation of fistula on the right shoulder. The laboratory tests for tuberculosis T cell interferon release test (IGRA) and tuberculin (PPD) test were negative, and the CD4 + cell count decreased. The comprehensive analysis of the imaging with right shoulder showed MSU deposition on right shoulder, with bone erosion, bone destruction, bone marrow edema, joint effusion, and multiple sites of connective tissue involvement (synovial bursa, tendon sheath, tendon, and muscle) GeneXpert MTB/RIF (GeneXpert), metagenomic next-generation sequencing (mNGS) of puncture fluid and joint fluid culture prompted Mycobacterium tuberculosis complex group. He was finally diagnosed with RA, gout, and osteoarticular tuberculosis (OAT). Symptoms were relieved after symptomatic treatment. Conclusion:RA patients with hyperuricemia have recurrent single arthritis. In addition to considering for gout, the presence of OAT should also be considered. The immune functional status of the patient and drug used may interfere with the interpretation of immune function tests. It is necessary to integrate the clinical characteristics of patients, a variety of imaging examinations, and etiological detection to confirm the diagnosis and avoid misdiagnosis.

Mechanism of Buyang Huanwu Decoction glycosides against atherosclerotic inflammation through NF-κB signaling pathway / 中国中药杂志

This study aims to explore the effect of Buyang Huanwu Decoction glycosides on the inflammatory response of apolipoprotein E~(-/-)(ApoE~(-/-)) mice and RAW264.7 cells through nuclear factor kappa-B(NF-κB) signaling pathway. In the in vivo experiment, ApoE~(-/-) mice were fed with high-fat diets for 12 weeks to induce the animal model of atherosclerosis, and 75 μg·mL~(-1) oxidized low-density lipoprotein(Ox-LDL) incubated RAW264.7 cells for 24 h to establish the atherosclerosis cell model. Automatic biochemical analyzer, hematoxylin-eosin(HE) staining, enzyme-linked immunosorbent assay(ELISA), Western blot, and droplet digital polymerase chain reaction(PCR) were used to determine the blood lipid levels, aortic intimal thickness, inflammatory factor content, NF-κB pathway-related proteins, and mRNA expression levels, and evaluate arterial atherosclerotic lesions and anti-atherosclerotic mechanisms of the drug. The model of atherosclerosis was successfully established in ApoE~(-/-) mice after 12 weeks of feeding with high-fat diets. In the model group, the plasma levels of total cholesterol(TC), triglyceride(TG), and low-density lipoprotein cholesterol(LDL-C) were increased(P<0.01), the intima of the blood vessels was thickened, the levels of inflammatory factors tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) were increased, and the protein and mRNA expressions of NF-κB and inhibitor of NF-κB(IκBα) were significantly increased as compared with the control group. Compared with the model group, the high-dose Buyang Huanwu Decoction glycoside group decreased the plasma levels of TC, TG, and LDL-C, reduced the plaque area and thickness and the content of inflammatory factor TNF-α, and inhibited the protein and mRNA expressions of NF-κB and IκBα, with the effect same as Buyang Huanwu Decoction. In the in vivo experiment, 75 μg·mL~(-1) Ox-LDL stimulated RAW264.7 cells for 24 h to successfully establish a foam cell model. As compared with the control group, the nuclear amount of NF-κB and the protein and mRNA expressions of IκBα in the model group increased. Compared with the model group, the middle-dose and high-dose Buyang Huanwu Decoction glycoside groups decreased the nuclear amount of NF-κB and the protein and mRNA expressions of IκBα. The above results show that the glycosides are the main effective substances of Buyang Huanwu Decoction against atherosclerosis, which inhibit the NF-κB pathway and reduce the inflammatory response, thus playing the role against atherosclerotic inflammation same as Buyang Huanwu Decoction.

Research on Sealing Performance of One Way Valve of Thoracic Drainage Device / 中国医疗器械杂志

For one-off water seal of components "one-way" chest drainage device in the actual process of using the sealing function of accidental failure problem, with the component design and processing quality, the rationality of the related production technology as a research object, through to the device internal sealing surface and processing quality, one-way valve floating switch, seal diaphragm installation effect, the weight of the components of clean degree and so on has carried on the experiment and analysis, find out the chest drainage of water sealing device of the main causes of the one-way valve seal failure in, and sum up the corresponding improving methods according to the results of the experiments, and improve the one-way valve sealing performance.

Tripterygium wilfordii in Treatment of Kidney Diseases and Its Toxic and Side Effect： A Review / 中国实验方剂学杂志

In recent years， with the rapid development of traditional Chinese medicine industry in China， the efficacy of Chinese medicinals in treating disease and maintaining health has been increasingly recognized. Tripterygium wilfordii， a Chinese medicinal for expelling wind， dredging collaterals， removing dampness， and relieving pain， is commonly used for treating acute and chronic glomerulonephritis， rheumatoid arthritis， and other diseases. However， the frequent occurrence of adverse reactions has limited its wide application in clinical practice. The existing studies have gradually confirmed that T. wilfordii and its active ingredients exert the bidirectional effects on kidney function. This paper reviewed the related clinical applications and articles published in the past decades and summarized the material basis for its bidirectional effects and the specific action mechanisms in renal protection and renal damage. It was found that the main active ingredients in T. wilfordii were tripterygium glycosides and triptolide， which exerted the protective or toxic and side effects on kidney by regulating immunity， influencing mitogen-activated protein kinases （MAPK） pathway， and changing the expression and function of renal transporters. Besides， the roles of administration time， dosage， and body status in the exertion of protective or toxic and side effects by T. wilfordii were also discussed. The review aimed to provide new ideas for the research on the treatment of kidney diseases with T. wilfordii and its safety application.

Correlation Between Peripheral Blood Biomarkers and Efficacy of PD-1/PD-L1 Inhibitors Treatment on Lung Cancer / 肿瘤防治研究

Objective To investigate the predictive and guiding significance of peripheral blood biomarkers on the therapeutic effects of PD-1/PD-L1 inhibitor treatment on lung cancer patients. Methods We collected the data of 200 lung cancer patients treated with PD-1/PD-L1 inhibitors treatment, including clinical indicators, peripheral blood indicators, efficacy indicators and survival indicators. Results The DCR of patients with non-hepatic metastasis, immune combined chemotherapy, NLR≤2.81 and LDH≤202.5 u/L was higher (P < 0.05). The AUC value of NLR combined with LDH predicting DCR was 0.698 (P < 0.05). Univariate analysis showed that non-hepatic metastasis, first-line immunotherapy, immunotherapy combined with chemotherapy and LDH≤202.5 u/L were related to PFS (P < 0.05). Multivariate analysis showed that the patients with non-hepatic metastasis and LDH≤202.5 u/L had longer PFS (P < 0.05). The significant decrease of NLR and LDH after two cycles of immunotherapy indicated the effectiveness of immunotherapy (P < 0.05). Conclusion NLR≤2.81, LDH≤202.5 u/L, non-hepatic metastasis and immunotherapy combined chemotherapy are positively correlated with immunotherapy efficacy. Non-hepatic metastasis and LDH≤202.5 u/L are independent prognostic factors of the patients treated with immunotherapy. The changes of peripheral blood NLR and LDH are related to the efficacy of PD-1/PD-L1 inhibitors treatment.

Application of online teaching in stomatology education under the background of COVID-19 epidemic prevention and control / 中华医学教育探索杂志

Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 267 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.

Efficacy and safety of levetiracetam versus phenytoin as second-line drugs for the treatment of children with convulsive status epilepticus: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To systematically evaluate the efficacy and safety of levetiracetam (LEV) versus phenytoin (PHT) as second-line drugs for the treatment of convulsive status epilepticus (CSE) in children.@*METHODS@#English and Chinese electronic databases were searched for the randomized controlled trials comparing the efficacy and safety of LEV and PHT as second-line drugs for the treatment of childhood CSE. RevMan 5.3 software was used for data analysis.@*RESULTS@#Seven studies with 1 434 children were included. The Meta analysis showed that compared with the PHT group, the LEV group achieved a significantly higher control rate of CSE (@*CONCLUSIONS@#LEV has a better clinical effect than PHT in the treatment of children with CSE and does not increase the incidence rate of adverse events.

Application and effects of objective structured clinical examination in the clinical ability assessment of stomatology undergraduates / 中华医学教育探索杂志

Objective:To explore the objective structured clinical examination (OSCE) on the improvement of clinical competence of stomatology undergraduates, and to promote their ability and skills of taking the National Medical Licensing Examination (NMLE).Methods:The OSCE was implemented to evaluate the clinical skills of stomatology undergraduates from Batch 2009 to Batch 2012. The OSCE results were analyzed and compared with the NMLE (Stomatology) results on the correlation coefficient analysis of annual passing rate.Results:The passing rate of practical skills in the NMLE (Stomatology) of Batch 2009 to Batch 2012 stomatology undergraduates was basically consistent with the excellent rate of OSCE, and the correlation coefficient was 0.94.Conclusion:It has not been proved that the OSCE assessment organized by our school can increase the passing rate of practical skills in the NMLE, but it has certainly helped students better understand and apply theoretical knowledge, and it plays a positive role in promoting students' future development.

Effect of Acupuncture and Biofeedback on Fecal Incontinence after Anus Preservation Operation for Rectal Cancer / 中国康复理论与实践

Objective:To investigate the effect of acupuncture and biofeedback on the recovery of fecal incontinence after anus preservation operation for rectal cancer. Methods:From January 1st, 2016 to June 30th, a total of 226 patients with rectal cancer after anus preservation operation were selected. Finally, 120 patients with fecal incontinence were randomly divided into control group (n = 40), acupuncture group (n = 40) and observation group (n = 40). All the groups accepted levator ani movement. In addition, the acupuncture group received acupuncture, and the observation group received acupuncture and biofeedback, for three months. Cleveland Clinic Florida Faecal Incontinence Scores (CCF-FIS), anorectal pressure, pelvic floor surface electromyography and quality of life were measured before treatment, and one month, two months and three months after treatment. Results:There was no significant difference in CCF-FIS, anorectal pressure, pelvic floor surface electromyography and quality of life among three groups before treatment (F < 2.943, P > 0.05). After treatment, all the above indexes improved (F > 5.235, P < 0.01), and were better in the acupuncture group and observation group than in the control group (P < 0.05), especially in the observation group (P < 0.05) at each time point. The curative effect of the observation group was related to the location of the tumor (χ2 > 4.405, P < 0.05) one month after treatment, and it was related to whether pelvic autonomic nerve preservation was performed during the operation (χ2 > 4.706, P < 0.05) and whether radiotherapy was added after the operation (χ2 > 5.013, P < 0.05) at each time point after treatment. At three months follow-up, the recurrence rate was lower in the observation group (8.6%) than in the acupuncture group (35.7%) and in the control group (35.0%) (χ2 > 5.976, P < 0.05). No complication occurred in all groups. Conclusion:Acupuncture and biofeedback can improve the symptoms of defecation incontinence and promote the recovery of anal function after anus preservation operation for rectal cancer.

Molecular characteristics of Acinetobacter baumannii and the changes of efflux pump expression under tigecycline pressure / 医学研究生学报

Objective　Acinetobacter baumannii (A. baumannii) is a commonly infective bacterium in the hospital. This study aims to analyze its molecular epidemiological characteristics, detect the carrying rate of efflux pump and regulatory protein genes, and investigate the effects of tigecycline on the efflux pump and expression of regulatory protein genes.　Methods　A total of 183 A. baumannii strains were collected from inpatients of the affiliated hospital of Jiangsu University from May 2017 to March 2019. They were divided into an antimicrobial-resistant group (one or more antimicrobial-resistant strains, 139 strains) and a sensitive group (the drugs in the drug sensitivity test were all non-resistant strains, 44 strains). Repeated sequence PCR was used for homology analysis of the strains, and pulse-field gel electrophoresis (PFGE) was used as the gold standard for homology analysis to verify and compare some strains. PCR was used to detect the occurrence of drug resistance-related genes. Based on homology analysis, efflux pump carrying rate detection and antibiotics sensitivity test results, 6 clinical strains carrying all efflux pump genes but different resistance phenotypes were selected as experimental strains, including sensitive strains (SAB), the multidrug resistance strain (MDRAB) and the extensively drug-resistant strain (XDRAB). All strains were induced in vitro with the minimum inhibitory concentration (MIC) of tigecycline. The induced strains were categorized as induction group, and the same strains cultured in LB agar without tigecycline was used as a control group. MIC was used to analyze the tigecycline susceptibility, and RT-qPCR was used to detect the gene expression of efflux pumps, such as TetB, AbaQ and regulatory proteins (AdeS and BaeS), in drug-resistant strains.　Results　Homology analysis showed that there were 45 clonal groups in the detected clinical isolates, with no obvious outbreak of epidemic clonal groups. Efflux pumps and regulatory proteins were widely distributed in the clinical isolates, and the expression of AdeB, TetB, AbeS, AdeS in MDRAB and XDRAB is significantly higher than that insensitive group SAB. Continuous in vitro induction with tigecycline could increase the antimicrobial resistance of some clinical strains and even significantly increase the expression levels of efflux pumps and regulatory proteins.　Conclusion　A. baumannii is widely distributed in the clinic, and efflux pumps and regulatory proteins might play an important role in drug resistance process. The unreasonable use of tigecycline could enhance the tolerance of A. baumannii by up-regulating the expression of some bacterial efflux pumps.

Application of online teaching in stomatology education under the background of COVID-19 epidemic prevention and control / 中华医学教育探索杂志

Objective:To understand and compare the online learning effect of students majoring in stomatology and dental technology under the background of COVID-19 epidemic prevention and control, and to analyze the advantages and challenges of online teaching, so as to provide reference for the reform of teaching mode of stomatology education.Methods:A questionnaire survey on online learning was carried out among 269 students majoring in stomatology and 92 students majoring in dental technology in Chongqing Medical University. The results were statistically analyzed by SPSS 21.0, and chi-square test or rank sum test was used to count the data.Results:Computers and mobile phones are the main tools for students to study online. 52.92% of students used computers and 38.72% used smart phones. About 80% of the students said that they could adapt to online learning, and there was no statistical difference between the students of two majors. The online learning time of students majoring in stomatology was mainly 4-6 hours, while that of students majoring in dental technology was 2-4 hours, with statistical significance. However, the latter were more likely to ask questions to teachers than the former, and the proportion of students who often asked questions to teachers was 29.35% and 20.60%, respectively, with statistical significance. A small number of students of both majors failed log on the platform to learn and complete all the teaching materials on time. More than 50% of the students thought that online teaching was not as effective as offline teaching, and offline teaching was more conducive to mastering curriculum knowledge, without statistical differences between the students of two majors. They thought that the unsmooth learning platform, poor network conditions at home, and insufficient teaching materials prepared by teachers were the main reasons that affected the online learning effect.Conclusion:The online teaching is an important and also an advisable way to maintain teaching activities during the epidemic prevention and control of COVID-19. It will be the direction of further research on the education and teaching reform to make full use of information technology, combine the advantages of online teaching and traditional classroom teaching, and actively explore the blended teaching mode from the perspective of specialty and course characteristics.

Active loading of verteporfin into cationic liposome for neovasculature- and tumor-targeted photodynamic therapy / 药学学报

To target neovasculature and tumor cells, a novel cationic liposome with verteporfin (BPD) active-loaded in lumen (CLL) was designed and its basic in vitro and in vivo behaviors were evaluated in this study. Calcium acetate gradient loading method was applied to encapsulate BPD actively and cationic lipid (2,3-dioleoy-loxy-propyl)-trimethylammonium (DOTAP) was added by post-insertion for the positive charge of CLL. Results of characterization showed that the diameter and zeta-potential of CLL were around 100 nm and 28 mV, respectively. Compared with passive loading liposomes, CLL significantly enhanced the stability of BPD loading. What's more, the loaded BPD in lumen could switch off the fluorescence and photosensitization during blood circulation by homo-fluorescence resonance energy transfer (homo-FRET) effect, leading to the diminished phototoxicity to normal tissues. In vitro cellular uptake and cytotoxicity assay exhibited that positive charge dramatically enhanced the uptake of CLL both in vascular endothelial cells and tumor cells leading to superior therapeutic efficacy. In vivo study further showed that CLL reduced the clearance rate and increased tumor accumulation compared with passive loading group. Quantitative results of exvivo organ indicated that negligible CLL distributed in normal organs contributing to low phototoxicity. Animal experiments were conducted according to the Guidelines of the Experimental Animal Ethics Committee of Peking University Health Science Center and International Animal Experiments. In conclusion, we successfully designed a novel cationic targeting liposome that overcame the limitations of passive loading and significantly enhanced the efficacy of photodynamic therapy.

Evaluation of self-management model among HIV-infected men who have sex with men / 中华疾病控制杂志

Objective To evaluate practical effects of self-management model among HIV-infected men who have sex with men (MSM), and to provide evidence for the development of HIV/AIDS comprehensive management strategies for this population. Methods Respondent-driven sampling (RDS) sampling was used to recruit subjects with the help of the non-governmental organization. Selected MSM were randomly divided into intervention group and control group. The intervention group implemented a self-management model and established a self-management group to conduct health education courses and peer-education based on chronic disease self-management (CDSM) theory. The control group was organized by the center for diseases control and prevention (CDC ) to carry out medical follow-up and other related activities. After one year, the evaluation survey was carried out, and the data was statistically analyzed using SPSS software. Results The CDSM team had different degrees of improvement in the scores of general health, role function,quality life,health transition and mental health sumonary scores. The proportion of self-management groups with anxiety symptoms decreased from 38.6% to 22.6%, the proportion of condom use increased from 43.3% to 47.3%, and the proportion of adherence to medication increased from 68.2% to 78.8%. Conclusion The self-management model can effectively break through the bottleneck of HIV/AIDS management for MSM and can improve quality of life of them.

Biotransformation of Natural Saponins / 中国实验方剂学杂志

Saponin is a kind of complex compounds with triterpenoid or spiral aglycones.Natural saponins are used as substrates,and many novel compounds are obtained by biotransformation technology. Especially, converted products of saponins with strong activities provide valuable lead compounds for the research and development of new drugs. Saponins can be divided into triterpenoid saponin and steroidal saponin according to the structure of the mother nucleus. There are about 89 reported saponin components,including 56 triterpenoid saponins and 33 steroidal saponins. Biological enzyme catalysis,microbial transformation and intestinal microflora transformation are the main bioconversion technologies and key development directions of saponins. The research and optimization technology of biological enzyme and microbial transformation of saponins are the effective methods to prepare active secondary saponins. The biotransformation reaction of saponins mainly includes hydrolysis,redox and rearrangement,resulting in the formation of aglycones,secondary glycosides and their derivatives. The hydrolysis of saponin sugar chains was the main biological transformation pathway, and could generate a number of secondary saponins with less glycosyl groups. The secondary saponins could be absorbed into blood and become real active ingredients in body. Preparation of rare secondary saponins,discovery of lead compounds and development of new drugs are the main directions of biotransformation of saponins. The studies on the metabolism and mechanism of natural saponins by microbial and intestinal microbial biotransformation will also become hotspots. According to relevant papers at home and abroad,the researches on transformation technique,transformation approach and transformation reaction of saponins from natural products in the past thirty years were summarized, and the prospects of research and development were also analyzed to provide scientific basis for further study and comprehensive utilization of these conversion products.

Effects of propofol, dexmedetomidine, and midazolam on postoperative cognitive dysfunction in elderly patients: a randomized controlled preliminary trial / 中华医学杂志(英文版)

BACKGROUND@#Postoperative cognitive dysfunction (POCD) is a serious complication after surgery, especially in elderly patients. The anesthesia technique is a potentially modifiable risk factor for POCD. This study assessed the effects of dexmedetomidine, propofol or midazolam sedation on POCD in elderly patients who underwent hip or knee replacement under spinal anesthesia.@*METHODS@#The present study was a prospective randomized controlled preliminary trial. From July 2013 and December 2014, a total of 164 patients aged 65 years or older who underwent hip or knee arthroplasty at China-Japan Friendship Hospital and 41 non-surgical controls were included in this study. Patients were randomized in a 1:1:1 ratio to 3 sedative groups. All the patients received combined spinal-epidural anesthesia (CSEA) with midazolam, dexmedetomidine or propofol sedation. The sedative dose was adjusted to achieve light sedation (bispectral index[BIS] score between 70 and 85). All study participants and controls completed a battery of 5 neuropsychological tests before and 7 days after surgery. One year postoperatively, the patients and controls were interviewed over the telephone using the Montreal cognitive assessment 5-minute protocol.@*RESULTS@#In all, 60 of 164 patients (36.6%) were diagnosed with POCD 7 days postoperatively, POCD incidence in propofol group was significantly lower than that in dexmedetomidine and midazolam groups (18.2% vs. 40.0%, 51.9%, χ = 6.342 and 13.603, P = 0.012 and < 0.001). When the patients were re-tested 1 year postoperatively, the incidence of POCD was not significantly different among the 3 groups (14.0%, 10.6% vs. 14.9%, χ = 0.016 and 0.382, P = 0.899 and 0.536).@*CONCLUSION@#Among dexmedetomidine, propofol and midazolam sedation in elderly patients, propofol sedation shows a significant advantage in term of short-term POCD incidence.

Long-term effect of Tripterygium Glycosides Tablets combined with traditional Chinese medicine on adulthood fertility / 中国中药杂志

To preliminarily investigate the effect of Tripterygium Glycosides Tablets( TGT) combined with traditional Chinese medicine( TCM) on the fertility and female menstruation on persons who have took during childhood. The children with henoch-schonlein purpura( HSP) or henoch-schonlein purpura nephritis( HSPN) who treated with TGT under 18 years old and now older than 18 years old( including 18 years old) during January 1998 to December 2010 were selected in our research. The content of follow-up visit included marriage,marriage age,fertility and child health; and unmarried female patients were asked whether they had menstrual abnormalities. The data of the unmarried female patients,including age,clinical classification,TCM syndrome type,initial dose and other related factors that may affect menstrual cycle,was analyzed by using binary logistic regression analysis. A total of 195 patients who met the criteria were followed up in this study,and 26 patients married for more than 1 year. Among the 26 married patients,1 HSP patient had no birth planning due to rheumatoid arthritis,and the remaining 25 patients all had given birth or were pregnant. The 169 unmarried patients included 89 female patients. Among the 89 female patients,4 cases refused to tell the menstrual situations,72 cases had normal menstruation( 84. 7%),13 cases had abnormal menstruation( 15. 3%),and there was no case of amenorrhea. Logistic regression analysis results showed that the age,clinical classification,TCM syndrome type and initial dose had no correlation with abnormal menstruation. Our results demonstrated that TGT has no effect on adulthood fertility among patients who took TGT combined with traditional Chinese medicine during childhood.

Study on the use of CT three-dimensional reconstruction technique for guiding tracheal intubation with rigid fiber bronchoscope in difficult airway / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the significance of CT three-dimensional reconstruction technique for guiding tracheal intubation with rigid fiber bronchoscope in difficult airway.@*METHODS@#In this study, 44 patients undergoing selective operation of ASA (American Society of Anesthesiologists physical status) I to II, neck stiffness, neck trauma needed braked, or severe cervical spondylosis were selected. The patients were randomly divided into two groups: 24 cases in the experimental group (group E) and 20 cases in the control group (group C). The stylets of the rigid fiber bronchoscopes were shaped according to the CT three-dimensional reconstruction images and parameters obtained before surgery. The rigid fiber bronchoscopes shaped according to the CT three-dimensional reconstruction images were used in group E, while the rigid fiber bronchoscopes with the original angles were used in group C. Tracheal intubation operations were all performed by an anesthesiologist who had more than 10 years' clinical experience and mastered in rigid endoscopic intubation techniques. The first attempt success rate and the total success rate of tracheal intubation, intubation time, blood pressure, heart rate and pulse oxygen saturation at different time points including pre-induction, immediately after intubation, 1-5 minutes after intubation, and intubation related complications within 24 hours were recorded.@*RESULTS@#The total success rate of intubation in the two groups were both 100%. The first attempt success rate of intubation was 96% in group E, and 70% in group C. The first attempt success rate of group E was higher than that of group C. The intubation time of group E was (20.7± 10.6) s, and (21.5 ± 17.6) s of group C. Group E was shorter than that of group C, but there was no significant difference (P > 0.05). RPP equaled the product of heart rate and systolic pressure, which represented the stress reaction of intubation on hemodynamics, was lower in group C at T0, T1, T2, T4 and T5 separately than that in group E, but there was no significant difference (P>0.05). There was no significant difference in tracheal intubation related complications between the two groups (P>0.05).@*CONCLUSION@#CT three-dimensional reconstruction technique has certain guiding significance in difficult tracheal intubation with rigid fiber bronchoscope in patients with fixed cervical spine.

Impacts of particle shape on cellular uptake and tumor imaging application of ultra-pH sensitive micelles / 药学学报

This study was designed to investigate the impacts of particle shape of micelles on cell uptake and tumor imaging applications. We designed and synthesized an ultra-pH sensitive PEG-iPDPA diblock polymer, and prepared it into wormlike micelles and spherical micelles by thin-film dispersion method and modified solvent evaporation method, respectively. Firstly, the pH responsiveness of two kinds of micelles was investigated in vitro. Both forms of micelles responded to pH sensitively, and each of them could reach 100 times of ON/OFF fold after conjugated with BDP fluorescent probe. Moreover, the cellular uptake of two forms of micelles depended on the concentration and incubation time. However, the amount of cellular uptake of spherical micelles was much higher than that of the wormlike micelles, which proved that the shape of nanoparticles had a great influence on the cellular uptake. The results of in vivo imaging revealed that the spherical micelles had a better tumor accumulation as well as tumor imaging outcomes. Finally, the biosafety of micelles was tested by MTT assay and H&E staining, which indicated that none of the two kinds of micelles had obvious toxicity. Collectively, these results suggest that the spherical micelles could be a better carrier compared with wormlike micelles in terms of cellular uptake, tumor accumulation and tumor detection.

Effects of toxic fractions of Euphorbiae Ebracteolatae Radix on toxicity of mice intestinal tract and colon aquaporins expression level before and after vinegar processing / 中国中药杂志

To investigate the toxicity changes of Euphorbiae Ebracteolatae Radix (EER) before and after vinegar processing, toxic diterpenoids were concentrated with chloroform as extraction solvent from EER. Then the residue was extracted for non-chloroform extract with 95% ethanol and water after extraction with chloroform. The chloroform extraction of vinegar processed EER was prepared with the same method. The mice received the drug by oral administration. Moisture content in mice feces, duodenum and colon tissue, aquaporin AQP1, AQP3, AQP4 protein expression levels were assayed as the indexes to investigate the toxicity variation of chloroform fraction, non-chloroform fraction, as well as intestinal tract toxicity before and after vinegar processing of EER. The results showed that the chloroform fraction extracted from EER could significantly increase the moisture content in mice feces, duodenum and colon, and decrease AQP1 protein expression level, increase AQP3 and AQP4 protein expression levels in the colon. The intestinal toxicity of the chloroform extract was significantly higher than that of non-chloroform extract. The moisture content in mice feces, duodenum and colon was significantly decreased, and the AQPs protein expression tended to be normal in the colon after vinegar processing. The results showed that the chloroform fraction extracted from EER could lead to diarrhea, intestinal edema, and the intestinal toxicity action was associated with interfering AQPs protein expression and promoting intestinal fluid transport disorder in mice. Vinegar-processing could reduce intestinal toxicity of EER, so vinegar processing was considered to be the scientific processing method of EER.

Muscarinic acetylcholine receptor M1 mediates prostate cancer cell migration and invasion through hedgehog signaling / 亚洲男科学杂志(英文版)

The autonomic nervous system contributes to prostate cancer proliferation and metastasis. However, the exact molecular mechanism remains unclear. In this study, muscarinic acetylcholine receptor M1 (CHRM1) expression was measured via immunohistochemical analysis in human prostate cancer tissue array slides. PC-3, LNCaP, and A549 cells were treated with pirenzepine or carbachol, and the cell migration and invasion abilities were evaluated. Western blotting and quantitative real-time PCR were performed to measure GLI family zinc finger 1 (GLI1), patched 1 (PTCH1), and sonic hedgehog (SHH) expression levels. High expression of CHRM1 was found in early-stage human prostate cancer tissues. In addition, the selective CHRM1 antagonist pirenzepine inhibited PC-3, LNCaP, and A549 cell migration and invasion, but the agonist carbachol promoted the migration and invasion of these three cell lines. Muscarinic signaling can be relayed by hedgehog signaling. These data show that CHRM1 is involved in the regulation of prostate cancer migration and invasion through the hedgehog signaling pathway.