Establishment and validation of a nomogram model for detect the risk of anemia after chemotherapy for the triple-negative breast cancer patients with Fukangning / 国际中医中药杂志

Objective:To explore the risk factors analysis and validation of anemia after triple-negative breast cancer (TNBC) and risk prediction model, to provide reference for reducing the incidence of anemia after TNBC-NAC.Methods:Retrospectively, 316 female TNBC-NAC patients in the breast department of our hospital from January 2016 to July 2021 were selected as the study subjects (modeling set), and the condition of anemia after the last chemotherapy was set as the observation group. In addition, 98 breast cancer patients in 2022 were selected for validation. Multivariate Logistic regression was used to analyze the effect of Fukangning capsule on TNBC-NAC anemia. We established the risk nomogram prediction model and calibration curve of anemia after chemotherapy by using R software and conducted internal and external verification. Hosmer-Lemeshow test was used to evaluate the prediction deviation between the risk prediction value of the nomogram model and the actual observed value, and the ROC curve was used to evaluate the prediction effect of the model.Results:A total of 75 (23.73%) among 316 patients developed anemia. The results of multivariate Logistic regression analysis showed that menopause [ OR (95% CI)=26.739 (5.063-141.227)], RBC [ OR (95% CI)=0.168 (0.098-0.286)], Hb level [ OR (95% CI)=0.952 (0.929-0.976)], and pathological stage Ⅲ[ OR (95% CI)=4.182 (1.759-9.946)] were independent risk factors for anemia after TNBC-NAC ( P<0.05). The nomogram prediction model established based on the above factors. Hosmer-Lemeshow test results showed that the difference between the risk prediction value and the actual observed value is ( χ2=3.68, P=0.885). The correction curve approaches to the ideal curve and the average absolute error was 0.012. The area under the ROC curve was 0.945, 95% CI was 0.918-0.972, sensitivity was 0.921 and specificity was 0.853, suggesting that the model has good differentiation and calibration degree. The external validation results showed that the nomogram predicted anemia with sensitivity of 88.7%, spectificity of 85.45% and accuracy of 86.73%. Conclusion:Menopausal status, RBC, Hb level before chemotherapy and pathological stage are independent risk factors for anemia after taking TNBC-NAC. The nomogram prediction model based on the above indicators had good discrimination and calibration, and accurately predicted the possibility of anemia after TNBC-NAC.

Clinical analysis of 11 patients with neuroendocrine carcinoma in maxillofacial region / 中华口腔医学杂志

Objective: To investigate the clinicopathological features, treatment and prognosis of maxillofacial neuroendocrine carcinoma. Methods: A total of 11 patients with maxillofacial neuroendocrine carcinoma diagnosed in the Department of Pathology of The First Affiliated Hospital of Zhengzhou University from December 2010 to July 2022 were retrospectively enrolled, including 8 males and 3 females, aged (65.2±9.5) years (ranged from 49 to 87 years), with a disease course of 0.5 to 6.0 months. The clinicopathological data including head and neck CT, MRI and treatment methods were analyzed. Results: Submandibular gland and maxilla were involved in 3 cases, parapharynx in 2 cases, and face, tongue root and soft palate in 1 case respectively. Clinically, the initial symptom is a rapidly growing painless or tender mass, which may be accompanied by restricted mouth opening, dysphagia, and local numbness after invasion of masticatory muscles and nerves. The tumors were all invasive and low-density, with unclear boundaries from the surrounding tissues. Among the patients, 9 received surgical treatment, and 5 received adjuvant treatment after surgery (2 received chemotherapy, 3 received radiotherapy+chemotherapy). According to the 5th edition of the World Health Organization classification of head and neck tumors in 2022, there were 1 case (1/11) with poorly differentiated large cells and 10 cases (10/11) with poorly differentiated small cells. Histologically, the macrocell type is composed of large cells with rough chromatin, obvious vacuolar nucleolus, protruding nucleolus, and necrosis. The small cell type is dominated by small blue round cells with neuroendocrine characteristics, with active growth and multifocal necrosis. Immunohistochemical staining showed that cytokeratin (CK), epithelial membrane antigen (EMA) and synaptophysin (Syn) were diffusively expressed, 10 cases expressed CD56, 8 cases expressed p63, 6 cases expressed weakly punctated chromograin-A (CgA), and S-100 was not expressed. The Ki-67 index ranges from 20 to 90 percent. By the end of follow-up (0.5 to 127.0 months), 3 patients were alive, and the mean progression-free survival (21.0 months) of postoperative chemoradiotherapy patients was significantly longer than that of surgery and/or chemotherapy alone (3.3 months). Conclusions: Maxillofacial neuroendocrine carcinoma is characterized by low differentiation of small cells, high degree of malignancy and poor prognosis. Radical surgery combined with chemoradiotherapy has better local control effect.

Exploration and practice of artificial intelligence assisted primary vision health management / 中华预防医学杂志

It has attracted much attention worldwide that the application of artificial intelligence (AI) in primary screening and clinical diagnosis and treatment of eye diseases. In recent years, this technology has also been widely used in various grass-roots eye disease management, effectively improving the current situation of weak eye disease diagnosis ability and shortage of human resources in primary medical institutions. At present, there is no reference standard or guideline for the management mode, implementation content and management method of vision health management based on this technology, which are in urgent need of standardization. The article described the work mode exploration of AI-assisted grass-roots visual health management in Shanghai and shared practical experience. The aim is to provide reference for other provinces in China to carry out relevant work.

Genetic analysis of a Chinese pedigree affected with Congenital coagulation factor XII deficiency due to a c.1A>G start codon variant of F12 gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic etiology of a consanguineous Chinese pedigree affected with Congenital coagulation factor XII (XII) deficiency.@*METHODS@#Members of the pedigree who had visited Ruian People's Hospital on July 12, 2021 were selected as the study subjects. Clinical data of the pedigree were reviewed. Peripheral venous blood samples were taken from the subjects. Blood coagulation index and genetic testing were carried out. Candidate variant was verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#This pedigree has comprised 6 individuals from 3 generations, including the proband, his father, mother, wife, sister and son. The proband was a 51-year-old male with kidney stones. Blood coagulation test showed that his activated partial thromboplastin time (APTT) was significantly prolonged, whilst the FXII activity (FXII:C) and FXII antigen (FXII:Ag) were extremely reduced. The FXII:C and FXII:Ag of proband's father, mother, sister and son have all reduced to about half of the lower limit of reference range. Genetic testing revealed that the proband has harbored homozygous missense variant of c.1A>G (p.Arg2Tyr) of the start codon in exon 1 of the F12 gene. Sanger sequencing confirmed that his father, mother, sister and son were all heterozygous for the variant, whilst his wife was of the wild type. By bioinformatic analysis, the variant has not been included in the HGMD database. Prediction with SIFT online software suggested the variant is harmful. Simulation with Swiss-Pbd Viewer v4.0.1 software suggested that the variant has a great impact on the structure of FXII protein. Based on the Standards and Guidelines for the Interpretation of Sequence Variants: A Joint Consensus Recommendation of the American College of Medical Genetics and Genomics (ACMG), the variant was rated as likely pathogenic.@*CONCLUSION@#The c.1A>G (p.Arg2Tyr) variant of the F12 gene probably underlay the Congenital FXII deficiency in this pedigree. Above finding has further expanded the spectrum of F12 gene variants and provided a reference for clinical diagnosis and genetic counseling for this pedigree.

The observation on the effect of Buyang Huanwu Decoction combined with suspension exercise training for the patients with cerebral infarction and lower limb hemiplegia / 国际中医中药杂志

Objective:To explore the curative effect of Buyang Huanwu Decoction combined with suspension exercise training for the patients with cerebral infarction combined and lower limb hemiplegia.Methods:According to random number table method, 94 patients with cerebral infarction and lower limb hemiplegia meeting the inclusion criteria were divided into the control group and the observation group between January 2017 and February 2021, 47 in each group. The control group was treated with suspension exercise training, while observation group was additionally treated with Buyang Huanwu Decoction on the basis of the control group treatment. All were treated for 6 weeks and then followed up for 3 months. Before and after treatment, the Traditional Chinese Medicine (TCM) syndromes scores were recorded. The severity of nerve function injury was evaluated by National Institutes of Health Stroke Scale (NIHSS). The lower limb function was evaluated by Fugl-Meyer Assessment (FMA). The balance function was evaluated by Berg Balance Scale (BBS). The activities of daily life were assessed by Barthel Index (BI). The whole blood high shear viscosity, plasma viscosity and hematocrit were detected by full-automatic hemorheology analyzer. The levels of plasma total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were detected by full-automatic analyzer. All were followed up for 3 months. The prognosis of patients was assessed by modified Rankin scale (mRS). The adverse reactions during treatment were recorded.Results:After treatment, scores of TCM syndromes and NIHSS in observation group were significantly lower than those in control group ( t=5.35, 4.54, P<0.01), while scores of FMA, BBS and BI were significantly higher than those in control group ( t=3.40, 3.10, 7.57, P<0.01). The whole blood high-shear viscosity, plasma viscosity and hematocrit in observation group were significantly lower than those in control group ( t=2.94, 3.81, 4.23, P<0.05 or P<0.01), and levels of TC, TG and LDL-C were significantly lower than those in control group ( t=4.10, 4.27, 3.61, P<0.01). The differences in good prognosis rate between observation group and control group were statistically significant [74.47% (35/47) vs. 51.06% (24/47); χ2=5.51, P=0.019]. Conclusion:The Buyang Huanwu Decoction combined with suspension exercise training can relieve clinical symptoms, recover lower limb function, improve activities of daily life and prognosis in cerebral infarction combined with lower limb hemiplegia.

Analysis of community intervention effects for diabetic eye diseases in Shanghai Xinjing community from 2016 to 2018 / 中华预防医学杂志

Objective: To analyze the effects of community-based interventions for diabetic eye diseases in Xinjing community, Shanghai from 2016 to 2018. Methods: Based on the project of "Establishment of Service Model for Comprehensive Prevention and Treatment of Diabetic Eye Diseases in Shanghai", the participants were not suffering diabetic retinopathy (DR) in Xinjing community in 2016 before interventions and received community-based interventions for diabetic eye diseases. The incidence of DR, visual acuity and awareness of DR were used as evaluation indicators to analyze the effects of interventions for diabetic eye diseases in the community. Results: A total of 537 patients were included in this study, the incidence of DR among diabetic patients in Xinjing community was 7.6% after interventions. The duration of diabetes (OR= 1.065) and HbA1c (OR= 1.090) were the risk factors of DR. Before and after the interventions, the patients with monocular low vision and binocular low vision were 27 cases (5.0%), 8 cases (1.5%), 19 cases (3.5%) and 7 cases (1.3%) respectively. After interventions, the awareness on the prevention and treatment of DR increased significantly, and the proportion of regular visits to ophthalmology examination, diet control and physical exercise also increased significantly. Conclusion: Community-based interventions for diabetic eye diseases are helpful to improve the awareness of DR prevention and control, reduce the incidence of DR.

Effect of Yiqi Jiedu Prescription-containing Serum on Proliferation of mTEC and Regulatory T Cells in Myasthenia Gravis Patients with Thymus Hyperplasia / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Yiqi Jiedu prescription-containing serum on the proliferation of medullary thymic epithelial cells （mTEC） and regulatory T （Treg） cells in myasthenia gravis （MG） patients with thymus hyperplasia. MethodAccording to serological methods，35 SD rats were adaptively fed for one week and randomized into the low-，medium-， and high-dose Yiqi Jiedu prescription groups，control group， and prednisone group，with seven rats in each group， which were then gavaged with the corresponding drugs for one week for preparing the drug-containing serum. The effect of Yiqi Jiedu prescription-containing serum at different concentrations on the proliferation of mTEC and Treg cells were determined by cell counting kit-8 （CCK-8） assay. Besides， the effect of mTEC and Yiqi Jiedu prescription-containing serum on Treg cell proliferation were observed through co-culture. ResultThymocytes were cultured for a period of time. Their mean positive rate revealed by flow cytometry using mTEC characteristic marker Ulex europaeus agglutinin Ⅰ （UEAI） was 92.54%. Treg cells were sorted by magnetic beads. The purity of Treg cells after repeated magnetic bead sorting was as high as 92%. mTEC and Treg cells showed high positive expression rates，and their cell purity met the requirements of subsequent experiments. When the concentration of Yiqi Jiedu prescription-containing serum was 2.5%-15%，it exhibited an inhibitory effect against mTEC and Treg cells. When the concentration was equal to or greater than 20%，it promoted cell proliferation，which was further enhanced with the extension of action time. The results after 48 h of culture showed that compared with the control group，prednisone and low-dose Yiqi Jiedu prescription had no significant effect on the proliferation of these two kinds of cells，but the medium- and high-dose Yiqi Jiedu prescription remarkably reduced their proliferation inhibition rate （P<0.01）. After co-culture with mTEC， the control group was not significantly different from the prednisone group and the low-dose Yiqi Jiedu prescription-containing serum group in the proliferation of Treg cells，while the medium- and high-dose Yiqi Jiedu prescription-containing serum groups significantly lowered the proliferation inhibition rate （P<0.01）. ConclusionYiqi Jiedu prescription-containing serum affects the proliferation of mTEC and Treg cells in MG patients with thymus hyperplasia. Compared with the solely cultured Treg cells isolated from MG patients，the Treg cells co-cultured with mTEC exhibit enhanced proliferation in MG patients，suggesting that mTEC can regulate the proliferation of Treg cells. This effect becomes more obvious after the intervention with Yiqi Jiedu prescription-containing serum，indicating that intervention effect of Yiqi Jiedu prescription on Treg cells can be produced during its treatment of mTEC， which may be one of the mechanisms of Yiqi Jiedu prescription-containing serum in alleviating MG.

Modified Tuoli Xiaodusan-assisted Treatment of Hp-positive Peptic Ulcer / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of modified Tuoli Xiaodusan （TLXDS） in adjuvant treatment of Helicobacter pylori （Hp）-positive peptic ulcer （PU） with cold-heat complex syndrome and explore its regulating effect on invasive/protective factors. MethodA total of 136 patients were randomly assigned into the control group （68 cases， including 4 cases missing， 3 cases eliminated， and 61 cases completed） and the TLXDS group （68 cases， including 4 cases missing， 1 case eliminated， and 63 cases completed）. Both groups adopted the quadruple therapy of acid suppression and Hp eradication. The patients in the control group received Weinai'an capsules orally at 4 capsules/time and 3 times/day， and those in the TLXDS group took modified TLXDS orally at 1 dose/day. The administration of both groups lasted for 8 consecutive weeks and the follow-up lasted for 12 months. Electronic gastroscopy was carried out before and after treatment for evaluating the healing of ulcer， the score of mucosal morphology， and the maturity of regenerated mucosa. The Hp infection and the score of cold-heat complex syndrome were evaluated before and after treatment. The serum levels of gastrin （GAS）， prostaglandin E2 （PGE2）， pepsinogen （PG）-Ⅰ， PG-Ⅱ， epidermal growth factor （EGF）， and trefoil factor 2 （TFF-2） were determined before and after therapy. The recurrence of Hp and PU was recorded， and the drug safety was evaluated. ResultAfter treatment， the mucosal morphology score and the traditional Chinese medicine （TCM） syndrome score in the TLXDS group were lower than those in the control group （P<0.01）. The levels of GAS， PG-Ⅰ， and PG-Ⅱ in the TLXDS group were lower than those in the control group （P<0.01）， whereas those of PGE2， EGF， and TFF-2 showed an opposite trend （P<0.01）. After treatment， the Hp eradication rate in the TLXDS group was 95.24% （60/63）， higher than that （83.61%， 51/61） in the control group （χ2=4.467， P<0.05）. The total effective rate of TCM syndromes in the TLXDS group was 98.41% （62/63）， higher than that （81.97%， 50/61） in the control group （χ2=9.589， P<0.01）. The total effective rate of the TLXDS group under gastroscopy was 98.41% （62/63）， higher than that （86.89%， 53/61） in the control group （χ2=4.525， P<0.05）. The excellent and good rate of regenerated mucosal maturity in the TLXDS group was 92.06% （58/63）， also higher than that （73.77%， 45/61） in the control group （χ2=7.372， P<0.01）. After 12 months of follow-up， the TLXDS group had lower PU recurrence rate ［19.05% （12/63） vs 37.70% （23/61）， χ2=5.325， P<0.05］ and lower Hp recurrence rate ［15.00% （9/60） vs 33.33% （17/51）， χ2=5.165， P<0.05） than the control group. No adverse reactions related to TLXDS were detected. ConclusionModified TLXDS-assisted quadruple therapy demonstrates significant short-term clinical efficacy and high Hp eradication rate for Hp-positive PU （cold-heat complex syndrome） patients. Moreover， it can adjust the levels of invasive/protective factors to facilitate ulcer healing and reduce the recurrence rates of Hp and PU in a long term， with good clinical safety.

Acromion morphology affects acromion osteolysis and fracture after clavicular hook plate fixation / 中华创伤骨科杂志

Objective To investigate the impacts of acromion morphology on acromion osteolysis and fracture after clavicular hook plate fixation.Methods The clinical data were analyzed retrospectively of 255 patients who had been treated by clavicle hook plate from January 1st,2011 through December 31th,2012 at Department of Orthopedics,Shanghai Sixth People's Hospital.They were 182 males and 73 females with an average age of 46.6 years (from 14 to 76 years).Of them,130 were diagnosed with distal clavicular fracture,of which 126 were acute cases (within 14 days) and 4 chronic ones.The other 125 patients were diagnosed with acromioclavicular dislocation,of which 121 were acute cases and 4 chronic ones.Radiological data were reviewed to analyze the morphology and clinical outcome of acromion osteolysis.The hook-acromion (HA) angle was measured and the relationships between HA angles and different types of acromion osteolysis were statistically analyzed.Results The follow-up for the 255 patients averaged 6 months (from 1 to 24months).Acromion osteolysis with different migrations of clavicular hook plate was observed in 175 cases (68.6％),of which 77 were type Ⅰ (osteolysis with clavicular hook migration) and 98 type Ⅱ (osteolysis without clavicular hook migration).Acromion fractures were observed in the other 6 cases (2.35％).The HA angles in type Ⅰ osteolysis (11.05° ± 11.69°) were significantly larger than that in type Ⅱ (6.36° ± 11.47°)(P ＜ 0.05) Conclusions An increased HA angle may be a risk factor for acromion osteolysis with clavicular hook migration and acromion fracture.Variation in acromion morphology may increase the HA angle.Stress localization may be one of the mechanisms of acromion osteolysis and fractures.

PID1 based connection of insulin resistance to hepatocellular carcinogenesis / 中国药理学与毒理学杂志

OBJECTIVE To investigate the effect of phosphotyrosine interaction domain containing 1 (PID1, NYGGF4) onpromotion of IR and HCC, and explore its underlying mechanisms. METHODS Lentivirus were used to mediate the knockdown of PID1 in HFD induced IR mouse model as well as ob/ob mice. Intraperitoneal glucose and insulin tolerance were performed 4 weeks after lentivirus injection. Hydrodynamics-based transfection was applied to induce the liver specific overexpression of PID1. Flow cytometry was exerted to detect the proportion and function of immune cells.qRT-PCR and Western blot were used to detect the expression of downstream pathways of PID1. Liquid chromatography-mass spectrometry (LC-MS) and co-immunoprecipitation (Co-IP) were conducted to identify proteins interacting with PID1.Chromatin immunoprecipitation(ChIP)was operated to measure the modification of H3K4me3 of PID1 promoter.RESULTS PID1 restriction improved insulin resistance,hyperglycemia and fatty liver. Conversely, hepatic knockdown of PID1 attenuated liver xenografted tumor growth. Moreover,PID1 liver-specific protooncogenes via hydrodynamics-based transfection established a primary hepatocellular carcinoma mouse model,induced an immunosuppressive environment,with the reduction of CD3+,CD4+,CD8+T cells,retarded maturation of dendritic cells(DCs),pronounced differentiation of regulatory T cells(Tregs),and recruitment of MDSC.In addition,PID1 overexpression activated prolifer-ation related genes, promoted anti-inflammatory genes, suppressed pro-inflammatory genes, induced glycolysis and lipid metabolism genes to facilitate tumorigenesis in liver. Importantly, PID1 exerted its tumor-promoting function through binding to epidermal growth factor receptor(EGFR)and activation of downstream KRAS/ERK pathway.As such,PID1 exist trimethylation of histone H3 at lysine 4(H3K4me3) modification and IR up-regulated the expression of PID1 by activation the H3K4me3 modification. CONCLUSION PID1 is a new gene that exerts both liver cancer-promoting and insulin resistance inducing function.IR accelerates liver cancer development and progression partially dependent on the activation of PID1.

Effect of low intensity pulsed ultrasound on the morphology of microglia in hippocampus of mice / 局解手术学杂志

Objective To study the effect of low intensity pulsed ultrasound on the hippocampus and to study its possible mechanism in mice.Methods Totally 32 adult C57/BL6 mice were randomly divided into the sham group(n=16)and the LIPUS group(n=16).Mice in the sham group were treated with sham operative,while mice in the LIPUS group were treated by low intensity pulsed ultrasound(average power density of 150 mW/cm2).After 7 days of treatment,immunohistochemical(IHC)and western bolt(WB)were used to determine the expression of DCX,GFAP,and Iba1 in the hippocampus,and the behavioral changes of mice in open field test were observed.Results After 7 days of treatment,the results of IHC showed that the number of microglial cells in the LIPUS group were significantly increased,and the difference was statistically significant compared with that in the sham group(P<0.05).The WB results indicated that the expression of Iba 1 protein in hippocampus was significantly increased in LIPUS group compared with that in the sham group(P<0.05).In the meantime,the behavior score of LIPUS group in the open field test was increased significantly(P<0.05).Conclusion Low intensity pulsed ultrasound can increase the number of microglia in the hippocampus and reduce the anxiety of the mice.

Intrathecal infection of TRESK overexpression adenovirus to relieve neuropathic pain via inhibiting JNK activation and neuronal apoptosis / 实用医学杂志

Objective To observe the effect of intrathecal injection of TRESK overexpression adenoviruson phosphorylation of JNK and apoptosis of neurons in neuropathic pain rats.Methods Seventy-two male SD rats were randomly divided into six groups:groups C,S,NP,T,V,and NS,12 for each group.SNI was administrated to rats in groups NP,T,V and NS.TRESK adenovirus and negative virus were intrathecally injected after use of SNI in groups T and V,while equal volume of NS was injected to rats in group NS.MWT and TWL were measured at 1 day before operation(baseline,BL)and at 1,3,7 and 14 days after operation (days 1,3,7,and 14).Six rats in each group were sacrificed at D7 to determinate the expression of TRESK protein of DRG.The other rats were sacrificed at D14 to determinate neural apoptosis and the expressions of caspase3 and p-JNK of DRG.Results As compared with groups C,S and T,the expression of TRESK protein was significantly decreased at D7 in groups NP,NS and V (P＜0.05).Compared with groups C and S,MWT was significantly decreased at days 1,3,7 and 14 (P＜0.05),phosphorylation of JNK in DRG was significantly increased at D14 (P＜0.05),neuronal apoptosis rate and expressions of Caspase3 of DRG were significantly increased at D14 (P＜0.05) in groups NP,T,NS and V.Compared with groups NP,V and NS,MWT was significantly increased at time points of days 1,3,7 and 14 in group T (P＜0.05),phosphorylation of JNK of in DRG was significantly decreased at D14 in group T (P＜0.05),neuronal apoptosis rate and expression of Caspase3 of DRG were significantly decreased at D14 in group T (P＜0.05).Intrathecal injection ofpAd/CMV/VS-DEST-TRESK obviously reduced mechanical hyperalgesia,upregulated TRESK expression,and lowered JNK phosphorylation and NP in SNI rat.Conclusions Intrathecal injection of TRESK over expression adenovirus relieves NP via inhibiting JNK activation and neuronal apoptosis.

Protective effect and mechanism of total anthraquinone extract of Rhei Radix et Rhizoma on cerebral ischemia-reperfusion injury / 中成药

AIM To investigate the effect and mechanism of total anthraquinone extract of Rhei Radix et Rhizoma on cerebral ischemia-reperfusion injury and to provide relevant data references for its promising use in the management of cerebral ischemia-reperfusion injury.METHODS SD rats randomly assigned to model group,sham operation group,nimodipine group,total anthraquinone extract groups (high,medium and low dose),8 in each group,were orally administered with corresponding drugs daily for a week,with rats of the model group and sham operation group given the same volume of normal saline before the models established by middle cerebral artery occlusion (MCAO).MCAO started thirty minutes after final oral administration,and the induced ischemia went on for 1.5 h for a further reperfusion,24 h after which the neurological function score,brain index,brain water content and cerebral infarct volume were measured.Elisa kits were used to detect superoxide dismutase (SOD),Malondialdehyde (MDA),Nitric oxide (NO),interleukin-1 β (IL-1β),tumor necrosis factor (TNF),interleukin-6 (IL-6).RESULTS The total anthraquinone extract of Rhei Radix et Rhizoma significantly improved the neurological function score,decreased the brain index,brain water content,reduced the cerebral infarct volume (P ＜ 0.05),increased the activity of SOD in brain tissue (P ＜ 0.01),and reduced the levels of MDA and NO in brain tissue (P ＜0.01),and the levels of IL-6,TNF and IL-1β in serum (P ＜0.01) as well.CONCLUSION The obviously protective effect on rats' cerebral ischemia-reperfusion injury by total anthraquinone extract of Rhei Radix et Rhizoma may contribute to its inhibition of inflammatory response,and its existence as an antioxidant as well.

Preparation of Guizhi Fuling transdermal patch / 中成药

AIM To prepare Guizhi Fuling transdermal patch.METHODS With kinds of pressure-sensitive adhesive and penetration enhancer,kind and consumption of solvent,drug loading as influencing factors,appearance,formability and viscidity of patch,extract dispersion as evaluation indices,single factor test was applied to optimizing the preparation.And subsequent in vitro transdermal absorption test was performed to investigate the steady-state permeation rates of paeoniflorin,cinnamic acid and paeonol onto rat skins.RESULTS The optimal conditions were determined to be Duro-Tak 87-2677 polyacrylate pressure-sensitive adhesive (matrix),1 ∶ 0.5 for ratio of extract to propanediol (solvent),3％ azone as a penetration enhancer,and 20％ for drug loading,the obtained transdermal patch demonstrated both ideal initial adhesion force and holding adhesion force.These three constituents' average transdermal rates were 34.32,1.684,72.90 μg/(cm2 · h) with the average release rates of 26.81,1.523,111.8 μg/(cm2 · h),respectively,whose in vitro transdermal permeation curves conformed to Higuchi equation.CONCLUSION Guizhi Fuling transdermal patch processed with simple and stable preparation technique exhibits good in vitro transdermal permeation performance.

Lexiscan can open the blood-brain barrier temporarily and reversibly / 中华核医学与分子影像杂志

Objective To evaluate the opening level and optimal time window of the blood-brain barrier induced by adenosine A2 receptor agonist ( Lexiscan) via dynamic enhanced MRI. Methods Twen-ty New Zealand white rabbits were divided into experiment group ( group A, n=10) and control group ( group B, n=10) . Rabbits in group A were injected with Lexiscan and rabbits in group B were injected with physiological salt via ear vein, then the coronary scanning was performed. Contrast enhanced MRI was performed at different time points ( 5, 10, 15, 20 min, and then every 10 min, until 2 h) following the in-fusion of Gd-diethylene triamine pentaacetic acid (DTPA). The signal intensity (SI) of region of interest ( ROI) was measured and the percent enhancement of SI was calculated. Evens blue staining results in brain tissues were observed. Pair t test was used to analyze the data. Results The percent enhancement of SI in group A significantly increased to (40. 93±3.70)％ at 5 min, reached the maximum of (43.03±3.62)％ at 30 min, slowly decreased until 50 min, and got to a stable level at almost 80 min. At each time point, the per-cent enhancement of SI in group A was significantly higher than that in group B ( t values:6.88-20.28, all P<0. 05) . The staining was evident in group A. Conclusions Lexiscan can open blood-brain barrier tem-porarily and reversibly, and the optimal opening time window is 10-50 min post-injection.

FU Ru-mei's Experience in Using Classical Prescriptions to Treat Lung Diseases / 中国中医药信息杂志

Professor FU Ru-mei uses classical prescriptions to treat lung diseases, such as cough, asthma, the lung distension. Her treatment attaches importance to yin and yang, and emphasizes the six meridians. She pays attention to pulse and syndrome, and distinguishes evil qi and healthy qi and the primary and secondary symptoms. Her medication does not stick to classical cases. She considers pathogenesis carefully, gives and combines the prescriptions according to the symptoms. She usually combines classical prescriptions, seasonal prescriptions and local prescriptions, to make better clinical efficacy.

Urinary albumin-to-creatinine ratio as a useful risk marker in patients with cerebral infarction

Objective: To evaluate the urinary albumin-to-creatinine ratio [UACR] as a risk factor for the incidence, severity of neurological deficits, and cerebral arterial stenosis in cerebral infarction

Design: Case control study, cross-sectional study

Setting: The Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China

Subjects: This study included 111 patients with acute ischemic stroke, consisting of 81 patients with atherothrombotic cerebral infarction [ATCI] and 30 patients with lacunar infarction [LI] between September 2015 and August 2016. A total of 57 subjects with risk factors for cerebral infarction who did not have acute stroke were included as controls

Intervention: None

Main outcome measures: UACR, stroke scale score, the rate of cerebral arterial stenosis

Results: There were no significant differences between the two groups on their baseline clinical characteristics.The positive rate of microalbuminuria was significantly higher in patients with acute ischemic stroke compared to controls. ATCI patients had a higher rate of microalbuminuria than LI patients. In ATCI patients, those with microalbuminuria exhibited a higher severity of neurologic deficits and a higher rate of cerebral arterial stenosis compared to those without microalbuminuria

Conclusions: UACR was a risk factor for cerebral infarction. It was closely correlated with the incidence, severity of neurological deficits, and cerebral arterial stenosis in ATCI patients

Effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter on metastasis or recurrence of hepatocellular carcinoma after hepalobectomy / 中国现代普通外科进展

Objective:To study the effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter (BCP) on metastasis or recurrence of hepatocellular carcinoma (HCC) after hepalobectomy.Methods:Two-hundred and eleven patients with HCC were included in this study after hepalobectomy.Initial demographic data,clinical history,physical examination,biochemical tests,imaging examination and serum HBV DNA level was recorded.The DNA sequences of the S region and BCP region of HBV was determined by direct sequencing following nested-PCR amplification.Prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.Results:Of the 187 HCC cases,119 experienced tumor metastasis or recurrence.The univariate analysis showed that a higher metastasis or recurrence rate was associated with larger tumor size,no intact capsule,positive portal vein tumor thrombosis,higher level of gamma-glutamyl transpeptidase,higher level of HBV DNA and positive BCP mutation.The median metastasis or recurrence time for patients with positive BCP mutation was 9 months (95％ CI:7.922-10.078).Cox analysis indicated that larger tumor size,no intact capsule and positive BCP 1762/1764 double mutations were indepent risk factors for HCC recurrence or metastasis [OR (95％ CI),P:25.946 (2.819-57.149),0.007;8.741 (1.896-21.218),0.033 and 27.966 (8.167-58.132),0.003,repsectively].Conculsion:Infection with HBV carrying the positive BCP 1762/1764 double mutation,initial larger tumor volume as well as no intact capsule around the tumor independently predict the development of HCC metastasis or recurrence and ealier time for metastasis or recurrence after hepalobectomy.

Effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter on metastasis or recurrence of hepatocellular carcinoma after hepalobectomy / 中国现代普通外科进展

Objective:To study the effects of hepatitis B virus DNA mutation at 1762/1764 in the basic core promoter (BCP) on metastasis or recurrence of hepatocellular carcinoma (HCC) after hepalobectomy.Methods:Two-hundred and eleven patients with HCC were included in this study after hepalobectomy.Initial demographic data,clinical history,physical examination,biochemical tests,imaging examination and serum HBV DNA level was recorded.The DNA sequences of the S region and BCP region of HBV was determined by direct sequencing following nested-PCR amplification.Prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model.Results:Of the 187 HCC cases,119 experienced tumor metastasis or recurrence.The univariate analysis showed that a higher metastasis or recurrence rate was associated with larger tumor size,no intact capsule,positive portal vein tumor thrombosis,higher level of gamma-glutamyl transpeptidase,higher level of HBV DNA and positive BCP mutation.The median metastasis or recurrence time for patients with positive BCP mutation was 9 months (95％ CI:7.922-10.078).Cox analysis indicated that larger tumor size,no intact capsule and positive BCP 1762/1764 double mutations were indepent risk factors for HCC recurrence or metastasis [OR (95％ CI),P:25.946 (2.819-57.149),0.007;8.741 (1.896-21.218),0.033 and 27.966 (8.167-58.132),0.003,repsectively].Conculsion:Infection with HBV carrying the positive BCP 1762/1764 double mutation,initial larger tumor volume as well as no intact capsule around the tumor independently predict the development of HCC metastasis or recurrence and ealier time for metastasis or recurrence after hepalobectomy.

Changes in APPL1 expression during renal fibrosis in a mouse model of renal ischemia-reperfusion injury / 中华麻醉学杂志

Objective To evaluate the changes in the expression of adaptor protein containing pleck-strin homobgy domain, phosphotyrosine-binding domain and a leucine zipper motif 1(APPL1)during renal fibrosis in a mouse model of renal ischemia-reperfusion(I∕R)injury. Methods Twenty-four male C57BL∕6 mice, aged 8 weeks, weighing 20-25 g, were divided into 2 groups(n=12 each)using a random number table: sham operation group(S group)and renal I∕R group.The model of renal I∕R injury was established by clipping the bilateral renal pedicles for 30 min followed by reperfusion in group I∕R.Six mice were selected at 2 days of reperfusion, and venous blood samples were collected for determination of serum concentrations of blood urea nitrogen and creatinine.The animals were then sacrificed, the renal specimens were obtained for microscopic examination of tubular necrosis with a light microscope, and the damage to the renal tubules was scored using a semi-quantitative method.Six mice were sacrificed at 14 days of reperfusion, and the renal specimens were obtained for assessment of the degree of renal fibrosis(using picric acid-sirius red staining) and for determination of the expression of collagen type 1, fibronectin and α-smooth muscle actin in renal tis-sues(by Western blot or immunofluorescence method). At 2 and 14 days of reperfusion, the expression of APPL1 in renal tissues was detected by Western blot and the expression of APPL1 mRNA in renal tissues by real-time polymerase chain reaction. Results Compared with group S, the serum concentrations of blood u-rea nitrogen and creatinine, scores of renal tubular damage and degree of renal fibrosis were significantly in-creased at 2 days of reperfusion, the expression of collagen type 1, fibronectin and α-smooth muscle actin in renal tissues was up-regulated at 14 days of reperfusion, and the expression of APPL1 protein and mRNA was up-regulated at 2 and 14 days of reperfusion in group I∕R(P<0.05). Conclusion Up-regulated expression of APPL1 may be involved in the process of renal fibrosis in a mouse model of renal I∕R injury.