Advances in the Treatment of Glucocorticoid Resistance and Relapsed Immune Thrombocytopenia --Review / 中国实验血液学杂志

Immune thrombocytopenia (ITP) is an immune-mediated acquired hemorrhagic autoimmune disease. At present, the first-line therapeutic drugs for ITP include glucocorticoids and intravenous immunoglobulins. However, about 1/3 of the patients had no response to the first-line treatment, or relapsed after dose reduction or withdrawal of glucocorticoids. In recent years, with the gradual deepening of the understanding on the pathogenesis of ITP, the drugs targeting different pathogenesis continually emerge, including immunomodulators, demethylating agents, spleen tyrosine kinase (SYK) inhibitors and neonatal Fc receptor (FcRn) antagonist. However, most of these drugs are in clinical trials. This review summarized briefly the recent advances in the treatment of glucocorticoids resistance and relapsed ITP, so as to provide reference for the clinical treatments.

Contamination status and exposure risk of mycotoxins in Coicis Semen / 中国中药杂志

By investigating the contamination status and predicting the exposure risk of mycotoxin in Coicis Semen, we aim to provide guidance for the safety supervision of Chinese medicinal materials and the formulation(revision) of mycotoxin limit standards. The content of 14 mycotoxins in the 100 Coicis Semen samples collected from five major markets of Chinese medicinal materials in China was determined by UPLC-MS/MS. The probability evaluation model based on Monte Carlo simulation method was established after Chi-square test and One-way ANOVA of the sample contamination data. Health risk assessment was performed on the basis of margin of exposure(MOE) and margin of safety(MOS). The results showed that zearalenone(ZEN), aflatoxin B_1(AFB_1), deoxynivalenol(DON), sterigmatocystin(ST), and aflatoxin B_2(AFB_2) in the Coicis Semen samples had the detection rates of 84%, 75%, 36%, 19%, and 18%, and the mean contamination levels of 117.42, 4.78, 61.16, 6.61, and 2.13 μg·kg~(-1), respectively. According to the limit standards in the Chinese Pharmacopoeia(2020 edition), AFB_1, AFs and ZEN exceeded the standards to certain extents, with the over-standard rates of 12.0%, 9.0%, and 6.0%, respectively. The exposure risks of Coicis Semen to AFB_1, AFB2, ST, DON, and ZEN were low, while 86% of the samples were contaminated with two or more toxins, which needs more attention. It is suggested that the research on the combined toxicity of different mycotoxins should be strengthened to accelerate the cumulative exposure assessment of mixed contaminations and the formulation(revision) of toxin limit standards.

Methods for synchronous detection of 14 mycotoxins in Pseudostellariae Radix and investigation on its contamination / 中国中药杂志

This study aimed to establish a method for synchronous detection of 14 mycotoxins in Pseudostellariae Radix and investigate its contamination with mycotoxins, so as to provide technical guidance for monitoring the quality of Chinese medicinal materials and medication safety. The sample was extracted with 80% acetonitrile in an oscillator for 1 h, purified using the modified QuEChERS purifying agent(0.1 g PSA + 0.3 g C_(18) + 0.3 g MgSO_4), and separated on a Waters HSS T3 chromatographic column(2.1 mm×100 mm, 1.8 μm). The gradient elution was carried out with 0.1% formic acid in water and acetonitrile, followed by the scanning in the multi-reaction monitoring(MRM) mode and the analysis of mycotoxin contamination in 26 Pseudostellariae Radix samples. The recovery rates of the established method were within the range of 82.17%-113.6%, with the RSD values less than 7% and the limits of quantification(LOQ) being 0.019-0.976 μg·kg~(-1). The detection rate of 14 mycotoxins in 26 batches of medicinal materials was 53.85%. The detection rate of sterigmatocystin(ST) was the highest, followed by those of zearalenone(ZEN), aflatoxin G_2(AFG_2), fumonisin B_1(FB_1), HT-2 toxin, and nivalenol(NIV). Their respective detection rates were 38.46%, 26.92%, 23.08%, 11.54%, 11.54%, and 7.69%, with the pollution ranges being 1.48-69.65, 0.11-31.05, 0.11-0.66, 0.28-0.83, 20.86-42.56, and 0.46-1.84 μg·kg~(-1), respectively. The established method for the detection of 14 mycotoxins is accurate, fast and reliable. The research results have very important practical significance for guiding the monitoring and prevention and control of exogenous fungal contamination of Chinese medicinal materials.

Triptolide inhibits inflammatory response and migration of fibroblast like synovial cells in rheumatoid arthritis through the circRNA 0003353/JAK2/STAT3 signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of triptolide (TPL) on inflammatory response and migration of fibroblast like synovial cells (FLS) in rheumatoid arthritis (RA-FLS) and the mechanism of circular noncoding RNA (circRNA) 0003353 for mediating this effect.@*METHODS@#We collected peripheral blood mononuclear cells (PBMCs) and serum samples from 50 hospitalized RA patients and 30 healthy individuals for detecting the expression of circRNA 0003353, immune and inflammatory indexes (ESR, CRP, RF, anti-CCP, IgA, IgG, IgM, C3, and C4) and DAS28 score. Cultured RA-FLS was treated with 10 ng/mL TPL and transfected with a circRNA 0003353 overexpression plasmid, and cell counting kit-8 (CCK-8) assay and Transwell assay were used to detect the changes in the viability and migration of the cells. Enzyme-linked immunosorbent assay (ELISA) was used to examine the cytokines IL-4, IL-6, and IL-17, and real-time fluorescence quantitative PCR (RT-qPCR) was performed to detect the expression of circRNA 003353; Western blotting was used to detect the expressions of p-JAK2, pSTAT3, JAK2 and STAT3 proteins in the treated cells.@*RESULTS@#The expression of circRNA 0003353 was significantly increased in PBMCs from RA patients and showed a good performance in assisting the diagnosis of RA (AUC=90.5%, P < 0.001, 95% CI: 0.83-0.98). CircRNA 0003353 expression was positively correlated with ESR, RF and DAS28 (P < 0.05). Treatment with TPL significantly decreased the expression of circRNA 0003353, suppressed the viability and migration ability, decreased the expressions of IL-6 and IL-17, and increased the expression IL-4 in cultured RA-FLS in a time-dependent manner (P < 0.01). TNF-α stimulation of RA-FLS significantly increased the ratios of p-JAK2/JAK2 and p-STAT3/STAT3, which were obviously lowered by TPL treatment (P < 0.01). TPL-treated RA-FLS overexpressing circRNA 0003353 showed significantly increased cell viability and migration ability with decreased IL-4 expression and increased IL-6 and IL-17 expressions and ratios of p-JAK2/ JAK2 and p-STAT3/STAT3 (P < 0.01).@*CONCLUSION@#The expression of circRNA 0003353 is increased in PBMCs in RA patients and in RA-FLS. TPL treatment can regulate JAK2/STAT3 signal pathway and inhibit the inflammatory response and migration of RA-FLS through circRNA 0003353.

Effects of 3D-printed porous metal cup with hip dual-mobility revision system for reconstruction of severe acetabular ring defects in revision total hip arthroplasty / 中华骨科杂志

Objective:To prospectively analyze the early clinical effects of 3D-printed porous metal cup with hip dual-mobility revision (HDR) system in treating severe acetabular bone defects.Methods:A total of 17 patients with severe acetabular defects (15 patients in Allan-Gross type 4 and 2 patients in type 5; 2 patients in Paprosky type 2B, 4 patients in type 3A and 11 patients in type 3B) who underwent revision hip arthroplasty between July 2019 and May 2020 were analyzed. There were 7 males and 10 females (mean age 67.3±9.3 years; range 42-80 years). The average body mass index was 22.2±3.8 kg/m 2 (range 17.7-33.3 kg/m 2). The preoperative mean leg length discrepancy (LLD) was 42.9±31.1 mm (range 10-160 mm) . One patient presented positive Trendelenburg sign. The follow-up duration was 12.1±3.0 months (range 6-16 months). The clinical and radiographic hip scores in all patients were evaluated. Results:The mean Harris Hip Score (HHS) was 31.2±11.3 points at preoperatively, 63.5±10.0, 68.7±10.4 and 70.2±10.1 points at 3 days, 7 days and 1 month postoperatively. At the latest follow-up, HHS was increased to 81.6±7.0 points. The outer cup mean abduction angle was 48.1°±10.6° and the mean inclination angle was 10.8°±6.0° postoperatively. The inner cup mean abduction angle was 45.0°±6.2° and the mean inclination angle was 10.8°±3.7°. The mean LLD decreased to 11.1±3.8 mm (range: 0-15 mm) after surgery. At the latest follow-up, all acetabular components were radiologically stable without displacement. No osteolysis or absorption was observed. There was no infection, loosening or nerve injury in all cases.Conclusion:During short-term follow-up, the 3D-printed porous metal HDR system can effectively enhance the stability of implants with satisfied quality of life. It can provide a good result for the revision of total hip arthroplasty with severe acetabular defects.

Xinfeng Capsules promotes apoptosis of synovial fibroblasts and attenuates inflammation in rheumatoid arthritis by regulating lncRNA MAPKAPK5-AS1 / 中国中药杂志

To explore the regulatory effects of Xinfeng Capsules(XFC) on the apoptosis of synovial fibroblasts(FLS) and inflammation in rheumatoid arthritis(RA) via lncRNA MAPKAPK5-AS1(MK5-AS1). Thirty healthy people and 30 patients with RA due to spleen deficiency and dampness exuberance were collected for extracting the peripheral blood mononuclear cells(PBMCs) before and after XFC treatment, which were used to observe the correlation between MK5-AS1 and clinical indicators as well as MK5-AS1 expression before and after XFC treatment. Following the establishment of RA-FLS cell line and the preparation of XFC-containing serum, MK5-AS1-overexpression plasmid was constructed and transfected into RA-FLS for investigating the efficacy of XFC-containing serum in regulating inflammation and apoptosis of RA-FLS via MK5-AS1. The expression of MK5-AS1 in PBMCs of patients with RA due to spleen deficiency and dampness exuberance was decreased(P<0.001). The ROC curve analysis revealed the AUC of 83.9%. Correlation analysis showed that MK5-AS1 was negatively correlated with ESR, CRP, RF, CCP, and spleen deficiency and dampness exuberance syndrome score. The expression of MK5-AS1 increased significantly after XFC treatment(P<0.001). As demonstrated by association analysis, XFC decreased MK5-AS1, ESR, CRP, RF, and spleen deficiency and dampness exuberance syndrome score, with the degree of support all greater than 83%, confidence greater than 80%, and lift greater than 1. The results of RT-qPCR showed that the MK5-AS1 RNA expression significantly decreased after TNF-α stimulation(P<0.01), which, however, increased significantly after the intervention with XFC-containing serum(P<0.05). Such expression rose again after the transfection of pcDNA3.1-MK5-AS1(P<0.01). ELISA results showed that TNF-α stimulation elevated the expression of pro-inflammatory factor IL-17 but lowered the expression of anti-inflammatory factor IL-4(P<0.01). After intervention with XFC-containing serum, the expression of IL-17 decreased while that of IL-4 increased(P<0.01). The transfection of pcDNA3.1-MK5-AS1 contributed to the reduction in IL-17 expression but the elevation in IL-4 expression(P<0.01). The immunofluorescence(IF) findings demonstrated that the expression of pro-apoptotic protein Bax was down-regulated, whereas that of the anti-apoptotic protein Bcl-2 was up-regulated after TNF-α stimulation(P<0.01). After the intervention with XFC-containing serum, the Bax expression was increased, while Bcl-2 expression was decreased(P<0.01), which were remarkably collaborated by the transfection of pcDNA3.1-MK5-AS1(P<0.05). The expression of MK5-AS1 is significantly decreased in both RA-PBMCs and RA-FLS, implying that XFC inhibits inflammatory reaction and promotes the apoptosis in RA by regulating the expression of MK5-AS1.

Effect of Xinfeng Capsules-containing serum on TNF-α-induced apoptosis and inflammation of fibroblast-like synoviocytes in rheumatoid arthritis / 中国中药杂志

The aim of this paper was to observe the effect of Xinfeng Capsules(XFC)-containing serum on the apoptosis and inflammation of fibroblast-like synoviocytes(FLS) in rheumatoid arthritis(RA) induced by tumor necrosis factor-α(TNF-α), so as to investigate the mechanism of XFC in the treatment of RA. RA-FLS immortalized cell line was established, and XFC drug-containing serum was prepared. CCK-8, ELISA, RT-qPCR, immunofluorescence and TUNEL were used to observe the effect of XFC-containing serum on RA-FLS apoptosis and inflammatory indexes. CCK-8 results showed that the optimal concentration and time of TNF-α on RA-FLS were 10 ng·mL~(-1) and 48 h, respectively; and the optimal concentration and time of XFC on RA-FLS were 6.48 mg·g~(-1) and 72 h, respectively. The results of ELISA showed that compared with RA-FLS group, the expressions of TNF-α, IL-1β, IL-6, IL-8 in TNF-α+RA-FLS group were significantly increased, while the expressions of IL-4 and IL-10 were significantly decreased(P<0.01); after intervention with XFC-containing serum, the expressions of TNF-α, IL-1β, IL-6, IL-8 were significantly decreased, whereas the expressions of IL-4 and IL-10 were significantly increased(P<0.01). The results of RT-qPCR showed that compared with RA-FLS group, the mRNA expressions of Fas, FasL, caspase-3, caspase-8, Bax, Bcl-X1 in TNF-α+RA-FLS group were significantly decreased, while the mRNA expression of Bcl-2 was significantly increased(P<0.001); after intervention with XFC-containing serum, the mRNA expressions of Fas, FasL, caspase-3, caspase-8, Bax, Bcl-X1 were significantly increased, whereas the mRNA expression of Bcl-2 was significantly decreased(P<0.01). The results of immunofluorescence showed that compared with RA-FLS group, the protein expressions of caspase-3 and Bax in TNF-α+RA-FLS group was significantly lower than those in RA-FLS group(P<0.05); after intervention with XFC-containing serum, the protein expressions of caspase-3 and Bax were significantly increased, whereas the protein expression of Bcl-2 was significantly decreased(P<0.05). TUNEL results showed that compared with RA-FLS group, the apoptosis of TNF-α+RA-FLS group was decreased(P<0.05); after intervention with XFC-containing serum, the apoptosis was significantly increased(P<0.05). One of the mechanisms of XFC in the treatment of RA is to promote the apoptosis of RA-FLS and inhibit its inflammatory reaction.

Research Advances on Ex Vivo Expansion Strategy of Hematopoietic Stem Cells--Review / 中国实验血液学杂志

Abstract　　Hematopoietic stem cells (HSCs), as a kind of adult stem cell, is first used in clinical practice. It has been widely used in hematopoietic stem cell transplantation and has broad application prospects in the field of gene therapy. However, the shortage of HSC is still the main bottleneck restricting the clinical application of HSC transplantation, especially cord blood HSC transplantation. With the continuous improvement of the concept of HSC and the in-depth study of the molecular mechanism regulating HSC self-renewal and differentiation, it have been explored that a variety of strategies for ex vivo expansion of HSC, such as adding small molecule compounds in vitro culture system, simulating bone marrow microenvironment, regulating HSC metabolism and biomaterial-based amplification methods. In this review, recent advances in research of ex vivo expansion strategy of HSC are summarized and discussed.

Effect of magnetic beads auricular point sticking therapy on intrapartum fever in primipara with epidural labor analgesia / 中国针灸

OBJECTIVE@#To observe effect of magnetic beads auricular point sticking therapy on intrapartum fever in primipara with epidural labor analgesia and explore its possible mechanism.@*METHODS@#A total of 160 primipara were randomly divided into an observation group (80 cases, 12 cases dropped off ) and a control group (80 cases, 15 cases dropped off ). The primipara in the control group received epidural labor analgesia. In the observation group, 15 min after epidural labor analgesia was performed, magnetic beads auricular point sticking therapy was given at shenmen (TF@*RESULTS@#There was no significant difference in tympanic temperature in the observation group at each time point (@*CONCLUSION@#Magnetic beads auricular point sticking therapy can reduce the amount of anesthetics, decrease the effect of epidural analgesia on primipara's body temperature regulation and labor progress, and lower the incidence of fever during labor analgesia by regulating the level of inflammatory response in the primipara.

Validation of Dose Conversion of Banxia Houpotang Based on Systematic Evaluation / 中国实验方剂学杂志

There are many different opinions on dose conversion of famous classical formulas from Treatise on Febrile Diseases or Synopsis of the Golden Chamber, which has become a difficult point in research and development of famous classical formulas. At present, the clinical application dose of Banxia Houpotang is similar to the viewpoint that 1 Liang is equivalent to 3 g, in order to provide scientific basis for this conversion method, this paper systematically evaluated the effectiveness of Banxia Houpotang in intervening globus hystericus. Randomized controlled trials (RCTs) of Banxia Houpotang in intervening globus hystericus from CNKI, VIP, Wanfang Data, China Biology Medicine (CBM), Web of Science and PubMed databases were collected online, the retrieval time was from inception to April 1, 2019. Two reviewers independently screened the literature, extracted the data and assessed the risk of bias of the included studies. Then, Meta analysis was performed by RevMan 5.3 software. A total of 17 RCTs involving 1 575 patients were included. The effective rate [relative risk (RR)=1.24, 95%confidence interval (CI) (1.18, 1.30), P<0.000 01] and the curative rate [RR=1.76, 95%CI (1.45, 2.15), P<0.000 01] of Banxia Houpotang in intervening globus hystericus were all better than the control group. Current evidence shows that Banxia Houpotang under the conversion of 3 g in 1 Liang has a significant effect on intervention of globus hystericus. Due to the limitations of quantity and quality of the included studies, the above conclusions need to be verified by more high-quality studies, but the author suggests that such dose conversion should be considered in the research and development of famous classical formulas.

Influencing factors for the clinical effect of bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia and atelectasis / 中国当代儿科杂志

OBJECTIVE@#To study the influencing factors for the clinical effect of bronchoalveolar lavage (BAL) in children with Mycoplasma pneumoniae pneumonia (MPP) and atelectasis.@*METHODS@#A total of 75 children with MPP and atelectasis were divided into a good response group with 51 children and a poor response group with 24 children according to the clinical effect of BAL treatment. LASSO logistic regression analysis was used to investigate the factors influencing the clinical effect of BAL treatment. The receiver operating characteristic (ROC) curve and restricted cubic spline model analysis were used to evaluate the value of the course of the disease at the time of BAL treatment in predicting the clinical effect of BAL treatment.@*RESULTS@#Compared with the good response group, the poor response group had a significantly lower percentage of lymphocytes in bronchoalveolar lavage fluid, a significantly higher proportion of children with atelectasis of two or more lung lobes or stenosis of the bronchial cavity or opening caused by inflammation, and a significantly longer course of the disease at the time of BAL treatment and azithromycin treatment (P<0.05). The LASSO logistic regression analysis showed that a prolonged course of the disease at the time of BAL treatment (OR=1.23), atelectasis of two or more lung lobes (OR=11.99), and stenosis of the bronchial cavity or opening caused by inflammation (OR=5.31) were independent risk factors for poor clinical effect of BAL treatment (P<0.05). The ROC curve analysis showed that the course of disease of ≥11.5 days at the time of BAL treatment suggested a poor clinical effect of BAL treatment, with a sensitivity of 91.7% and a specificity of 54.9%. The restricted cubic spline model analysis showed that there was a non-linear dose-response relationship between the course of disease at the time of BAL treatment and the clinical effect of BAL treatment (P<0.05).@*CONCLUSIONS@#Early BAL treatment may have a good clinical effect in children with MPP and atelectasis. Atelectasis of two or more lung lobes and inflammation-induced stenosis of the bronchial cavity or opening shown under bronchoscope may indicate a poor clinical effect of BAL treatment.

Effect of traditional Chinese medicine invigorating spleen unit therapy on inflammatory markers in patients with osteoarthritis based on random walk model / 中国中药杂志

To evaluate the effect of traditional Chinese medicine(TCM) invigorating spleen unit therapy on inflammatory markers of osteoarthritis(OA) patients by random walk model. The patient information was collected by the data processing system of medical records of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine. In-patient information of the department of rheumatology of the hospital between June 2012 and December 2016 was collected and summarized. Based on the use of traditional Chinese medicine decoction and hospital-prepared compound Qiyi Capsules(Xinfeng Capsules),the patients were divided into the unit therapy group and the simple endotherapy group. The random walk model was used to evaluate the effect of traditional Chinese medicine invigorating spleen unit therapy on TCM spleen therapy unit(ESR) and high sensitive C reactive protein(hs-CRP). A total of 3 517 cases of OA patients met the study requirements. The simple endotherapy group had 1 771 cases(50. 36%),while the unit therapy group had 1 746 cases(49. 64%). The baseline data analysis showed that the general information of the cases,the TCM oral intake frequency and the core prescription information had no statistically significant difference,with comparability. The unit therapy group showed the maximum ESR stochastic volatility at 924,walking step number of 1 771,forward walking growth rate at 0. 264 5,ratio at3. 78,random fluctuation power law at 0. 306 5± 0. 076 8,positive increase rate of comprehensive evaluation index at 0. 264 5,and comprehensive evaluation index record number of 1 771; whereas the simple endotherapy group showed the maximum ESR random fluctuation value at 478,walking step number of 1 399,forward walking growth rate at 0. 152 4,ratio at 6. 56,random fluctuation power law at 0. 347 4±0. 101 7,positive increase rate of comprehensive evaluation index at 0. 152 4,and comprehensive evaluation index record number of 1 399. The unit therapy group showed the maximum hs-CRP random fluctuation value at 391,walking step number of1 081,forward walking growth rate at 0. 178 1,ratio at 5. 62,random fluctuation power law at 0. 343 6±0. 094 7,positive increase rate of comprehensive evaluation index at 0. 178 1,and comprehensive evaluation index record number of 1 081; while the simple endotherapy groups showed the maximum hs-CRP random fluctuation value at 210,walking step number of 797,forward walking growth rate at0. 113 2,ratio at 8. 83,random fluctuation power law at 0. 382 6±0. 109,positive increase rate of comprehensive evaluation index at0. 113 2,and comprehensive evaluation index record number of 797. According to our department of rheumatism,there was a longrange correlation between the two groups in the comprehensive evaluation index and the intervention measures. TCM spleen strengthening unit therapy has a better effect in alleviating the inflammatory index of OA than traditional Chinese medicine.

Effect of triptolide in improving platelet activation in patients with ankylosing spondylitis by regulating VEGFA,SDF-1,CXCR4 pathway / 中国中药杂志

The effect of triptolide( TP) on VEGFA,SDF-1,CXCR4 pathway were investigated in vitro to explore the mechanism in improving platelet activation in patients with ankylosing spondylitis( AS). Peripheral blood mononuclear cells( PBMC) were used for the experiment and divided into 4 groups: normal group( NC),model group( MC),triptolide group( TP),and AMD3100 group. The optimal concentration of TP was measured by the MTT method. The expressions of TNF-α,IL-1β,IL-4,IL-10,VEGFA and VEGFR were detected by ELISA. The expressions of SDF-1,CXCR4 and VEGFA were detected by real-time quantitative PCR( RT-qPCR).The expressions of SDF-1,CXCR4,VEGFA and VEGFR were detected by Western blot. The expression levels of CD62 p,CD40 L and PDGFA were detected by immunofluorescence. MTT results showed that medium-dose TP had the strongest inhibitory effect on cells at24 h. The results of ELISA and PCR showed that TP inhibited mRNA expressions of IL-1β,TNF-α,VEGFA,VEGFR and SDF-1,CXCR4 and VEGFA. The results of Western blot indicated that TP inhibited SDF-1,CXCR4 and VEGFA,VEGFR protein expressions; immunofluorescence results indicate that TP can inhibit the expressions of CD62 p,CD40 L,PDGFA. TP may regulate platelet activation by down-regulating SDF-1,CXCR4,VEGFA and VEGFR mRNA expressions,thereby down-regulating IL-1β and TNF-αexpressions,and up-regulating the expressions of IL-4 and IL-10 cytokines.

Effect of Tripterygium Glycosides Tablets on immune-induced liver and kidney function in patients with rheumatoid arthritis based on data mining / 中国中药杂志

This paper aims to investigate the effect of oral administration of Tripterygium Glycosides Tablets combined with traditional Chinese medicine on immune inflammatory index in patients with rheumatoid arthritis,in order to explore the compatibility mode of traditional Chinese medicine in the treatment of rheumatoid arthritis. Medical records of hospitalized patients with rheumatology at the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2012 to December 2017 were collected. The combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine was adopted for the experimental group,while the simply administration of Tripterygium Glycosides Tablets were adopted for the control group. SPSS 21. 0 was used to analyze the changes of general conditions and immune inflammatory metabolic indexes in the two groups of RA patients. The association rules were analyzed by SPSS Clementine 14. 2 software Apriori module,and the random walk model was evaluated by ORACLE 10 g tool. The results showed that a total of 1 220 patients with rheumatoid arthritis met the requirements of this study,including 322 in the experimental group and 898 in the control group. Before treatment,there was no significant difference in age and duration between the two groups. The difference value of Ig A,Ig G,RF,CCP-AB,hs-CRP and ESR in the two groups of RA patients decreased before and after treatment,and the experimental group was superior to the control group in reduction of Ig A,Ig G,RF,CCP-AB,hs-CRP and ESR.The control group was superior to the experimental group in reduction of Ig M( P<0. 01 or P<0. 05). Compared with before treatment,ALT,AST,ALP,GGT,CREA,BUN,b-MG,MA,TRU and Ig U all increased,with statistically significant differences( P<0. 01).The UA of the two groups of RA patients decreased after treatment,with statistically significant differences( P<0. 01). The experimental group was superior to the control group in reduction of UA,with statistically significant differences( P < 0. 05 or P < 0. 01). The herbs adopted in the prescriptions of 1 220 patients were mainly classified into four categories,namely spleen-sweating herbs,blood-activating and stasis-relieving herbs,phlegm and phlegm-relieving herbs,and heat-clearing and antidote herbs. The results of association rule analysis indicated a significant correlation between the single-flavored Tripterygium Glycosides Tablets,oral Chinese medicine and immune inflammation,and improvement of liver and kidney function indexes. The results of the random walk model analysis indicated that the experimental group's Ig M and hs-CRP were superior to those of the control group in terms of random fluctuation maximum,walking positive growth rate,comprehensive evaluation index increasing rate,comprehensive improvement rate,comprehensive evaluation index recording times,and expected improvement value. The results of this study showed that the single administration of Tripterygium Glycosides Tablets can effectively improve the immune inflammatory metabolic index of patients with rheumatoid arthritis,and the combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine could alleviate the immune inflammatory index of RA patients and reduce liver and kidney dysfunction compared with simple oral administration. The comprehensive evaluation Ig M and hs-CRP in the group of combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine were better than those in the group of the Tripterygium Glycosides Tablets. There was a long-term correlation between the comprehensive evaluation index and the intervention measures of the two groups of patients.

Effect of ginsenoside metabolite compound K on migration and invasion of human hepatocellular carcinoma line HepG2 / 中国药理学通报

Aim To investigate the effect of ginsen-oside metabolite compound K ( CK) on migration and invasion of human hepatocellular carcinoma line HepG2, and the possible signaling pathway underlying these processes .Methods HepG2 cells were exposed to ginsenoside CK (0, 10, 20, 40, 80 μmol· L-1 ) for 24 h.The cell viability was examined by MTT as-say, and the ability of migration and invasion was ob-served with the wound healing and transwell assay .The expression of E-cadherin , N-cadherin and other related signal molecules such as p-ERK, ERK, p-Akt, Akt were detected by Western blot .Results The cell via-bility was significantly reduced by ginsenoside CK (20, 40, 80 μmol· L-1) (P<0.01).The ability of cell migration and invasion was significantly inhibited after exposure to ginsenoside CK .After treatment with ginsenoside CK (20, 40, 80 μmol · L-1 ) in HepG2 cells, the expression of E-cadherin markedly in-creased, while N-cadherin expression significantly de-creased.Meanwhile, the expression of p-ERK and p-Akt decreased after treated with ginsenoside CK .Con-clusion Ginsenoside CK inhibits the migration and invasion of human hepatocellular carcinoma line HepG2, which may be through suppression of ERK and Akt signaling .

Study on neuroprotection of α-phenyl-N-tert-butyl nitrone for anti-Parkinson's disease in vitro and in vivo / 中国药理学通报

Aim To discuss the neuroprotection of an-tioxidant α-phenyl-N-tert-butyl nitrone ( PBN) in Par-kinson's disease ( PD) model. Methods The neuro-protective effects of PBN was explored on 1-methyl-4-phenylpyridinium/1-methyl-4-phenyl-1,2,3,6-tetrahy-dropyridine ( MPP+/MPTP ) induced PD models through a chemical releasing of free radicals in neurons and in vivo. Results PBN significantly scavenged chemical derived free radicals, reduced MPP+induced SH-SY5Y injury and enhanced neurons' viability. In MPTP induced PD model, PBN significantly enhanced the number of tyrosine hydroxylase ( TH)-positive do-pamine ( DA) neurons in the substantia nigra, restored the expression of Nrf2 and HO-1, and raised striatal contents of DA and its metabolites. Conclusion PBN has a potent neuroprotective effect against MPP+/MPTP induced PD models.

The effect of nicorandil on slow-flow phenomenon in PCI in patients with non-ST segment elevated myocardial infarction / 天津医药

Objective To observe the effect of nicorandil on slow-flow phenomenon in percutaneous coronary intervention (PCI) in patients with acute non-ST segment elevated myocardial infarction (NSTEMI). Methods A total of 159 NSTEMI patients were enrolled. Based on the TIMI flow of target lesion blood vessels after PCI, patients were divided into two groups. There were 31 cases in no flow/slow flow group (TIMI≤2), and 128 cases in normal group (TIMI=3). The general clinical data, immediate TIMI flow grade of infarct-related artery (IRA) after PCI treatment, post-operative corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), thrombolysis in myocardial infarction signs of a blood clot, number of diseased vessels and major adverse cardiac events were compared between the two groups. The patients in no flow/slow flow group were given nicorandil, and changes of blood flow before and after treatment were observed. The influence factors of no flow/slow flow were analyzed by multifactor Logistic regression. Results The proportions of patients with history of smoking, the proportion of patients with diabetes history, the proportion of patients with hyperlipidemia, the proportion of patients with low blood pressure in operation, and the number of implanted stents, the proportions of patients took tirofiban in operation, post-operative CTFC, the proportions of patients with thrombosis signs were significantly higher in no flow/slow flow group than those in the normal group (P<0.05). There were no significant differences in heart rates in operation, IRA distribution and the number of lesion vessels between the two groups. There were also no significant differences in the incidence of MACE and left ventricular ejection fraction between the two groups. After the application of nicorandil, the proportion of patients with TIMI blood flow 3 and proportions of cTFC and TMPG were significantly higher than before treatment (P<0.05). Results showed that smoking history, history of diabetes, multiple stents (more than 3), hypotension in PCI, and signs of blood clot were factors influencing the slow flow of coronary arteries. Conclusion Nicorandil can significantly improve the no flow/slow flow in PCI in patients with NSTEMI.

Clinical Significance of Serum Level of Cyclopropaneoctanoic Acid 2-Hexyl in Patients with Hypertriglyceridemia-Related Disorders / 现代检验医学杂志

Objective To observe the serum level of cyclopropaneoctanoic acid 2-hexyl (CPOA2H) in patients with hypertrilyceridemia-related disorders,and investigate its clinical significance.Methods 53 obese patients (Obese group),62 obese patients after a 3 month low calorie diet (Obese patients after low calorie diet group),46 patients with chronic kidney disease (CKD group),and 60 healthy controls (Control group) were collected from Mar 2013 to Dec 2015 in Shaanxi Provincial People's Hospital.Gas chromatography-mass spectrometry (GC-MS) were used to detect the serum fatty acid and CPOA2H level in four groups.Results Ages,body mass index (BMI),C-reaction protein (CRP),total cholesterol (TC),triacylglycerols (TAG) among four groups had significant difference (F=6.85 ～ 25.36,P＜0.05).Most saturated fatty acid (14 ∶ 0,16 ∶ 0) and monounsaturated fatty acid (14 ∶ 1,16 ∶ 1,18 ∶ 1,20 ∶ 1) in obese group were higher than controls (F=3.251～7.351,P＜0.05).The polyunsaturated fatty acid (18 ∶ 2n-6,20 ∶ 4n-6) in CKD group were lower than controls (F=4.351 ～6.251,P＜0.05).There existed significant difference of serum levels of CPOA2H among four group (F=19.95,P=0.005).Serum level of CPOA2H in control (r=0.63,P=0.033) and CKD group (r=0.61,P=0.044) were positively related with TAG.Serum level of CPOA2H in obese group and obese patients after low calorie diet group were positively related with TC (r=0.70,P=0.011;r=0.48,P=0.021) and TAG (r=0.75,P=0.024;r=0.72,P=0.018).Conclusion Hypertrilyceridemia-related disorders,such as obesity and CKD,presented with elevated serum levels of CPOA2H,it suggested that serum level of CPOA2H is positively related to serum TAG concentration rather than BMI.

Rebamipide repairs injury of small intestinal epithelial barrier induced by aspirin in mice / 中国病理生理杂志

AIM:To investigate whether rebamipide repairs the small intestinal epithelial barrier in aspirin-induced small intestinal injury (SII) in mice and its mechanism.METHODS:Small intestinal injury was induced by aspirin (200 mg · kg-1 · d-1 for 5 d) in BALB/c mice.Based on the treatment with aspirin and/or rebamipide (320 mg ·kg-1 · d-1),the mice were divided into 4 groups (n =18 in each group).The living mice in each group (n =6) were sacrificed via cervical dislocation method at day 0,day 5,and day 10.The structure and function of intestinal barrier and the levels of the signaling pathway factors were measured by transmission electron microscopy,immunohistochemistry,qPCR,and Western blot.RESULTS:Tight junctions between intestinal epithelial cells improved significantly after rebamipide treatment.The expression of ZO-1 and occludin in the injured small intestine showed a gradually increasing trend after rebamipide administration (P ＜ 0.05).There was a decreased trend of D-lactate level in rebamipide-treated SII mice (P ＜ 0.05).The expression of cyolooxygenase-2 (COX-2),β-catenin,and c-Myc,and prostaglandin E2 concentration in small intestinal tissues were significantly increased in rebamipide treatment group (P ＜ 0.05).However,down-regulated COX-1 expression in the SII mice was sustained at a low level after rebamipide administration.CONCLUSION:Rebamipide repairs the injury of small intestinal mucosa and improves the structure and function of small intestinal barrier in aspirininduced SII mice by up-regulating the expression of COX-2.