The chemical constituents and hypoglycemic activity of alcoholic extract of sea buckthorn leaves / 药学学报

The purpose of this research is to identify the chemical constituents of sea buckthorn leaves extract (SBLE) and explore its hypoglycemic biological activity. SBLE was prepared by hot reflux extraction with 65% ethanol, and its chemical composition was analyzed by ultra-high-performance liquid chromatography-photodiode array-mass spectrometry/mass spectrometry (UHPLC-PDA-MS/MS) system. The animal experiments were compliant with ethical principles for animal use and had been approved by the Animal Experiment Ethics Committee of Jinan University. Mice were injected with streptozocin (STZ) to establish a hyperglycemic animal model, and SBLE (1.5 g·kg-1) was administered by gavage for 5 weeks. The fasting blood glucose (FBG) and oral glucose tolerance were detected. Normal mice were given SBLE (1.5 g·kg-1) by intragastric administration for 10 days, and blood was collected from the tail vein to detect the changes in blood glucose within 120 min after sucrose or starch loading. The mucous membrane of the small intestine of mice was taken to detect the activity of α-glucosidase (AG), and the activity of yeast-derived AG incubated with SBLE was evaluated. The glucose uptake by Caco-2 cells treated with SBLE was detected by fluorescence microscopy and cytometry, and the gene expression of sodium-dependent glucose transporter 1 (SGLT1) and glucose transporter 2 (GLUT2) in Caco-2 cells were detected by real-time quantitative PCR (qPCR). A total of 18 compounds were identified, mainly including tannins and flavonoids. SBLE reduced FBG and increased oral glucose tolerance in STZ hyperglycemic mice. SBLE effectively inhibited the increase of blood glucose caused by starch intake in normal mice. SBLE exerted good inhibitory activity on yeast-derived AG (IC50 = 16.94 μg·mL-1) and small intestinal mucosa AG with an inhibition rate of 15.48%. SBLE (25-100 μg·mL-1) dose-dependently inhibited glucose uptake by Caco-2 cells, and SBLE significantly reduced the mRNA level of SGLT1 without changing the expression of GLUT2. In conclusion, the UHPLC characteristic fingerprint of SBLE is established with 18 chemical components identified by mass spectrometry, and SBLE exerts hypoglycemic effect by inhibiting the activity of AG and the absorption of glucose by intestinal epithelial cells.

Diagnostic performance of VEGF-D for lymphangioleiomyomatosis: a meta-analysis / Desempenho diagnóstico do VEGF-D para linfangioleiomiomatose: meta-análise

ABSTRACT Objective: VEGF-D is a potential biomarker for lymphangioleiomyomatosis (LAM); however, its diagnostic performance has yet to be systematically studied. Methods: We searched PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library to identify primary studies on VEGF-D in relation to the diagnosis of LAM. The quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Summary estimates of diagnostic accuracy were pooled using a bivariate random effects model. Subgroup and sensitivity analyses were performed to explore possible heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was applied to rate the quality of evidence and indicate the strength of recommendations. Results: Ten studies involving 945 patients were of high risk in quality, as assessed using the QUADAS-2. The pooled diagnostic parameters were indicated as follows: sensitivity = 0.82 (95% CI, 0.71-0.90); specificity = 0.98 (95% CI, 0.94-0.99); and diagnostic OR = 197 (95% CI, 66-587). The AUC of summary ROC analysis was 0.98. The subgroup and sensitivity analyses revealed that the overall performance was not substantially affected by the composition of the control group, prespecified cutoff value, the country of origin, or different cutoff values (p > 0.05 for all). A strong recommendation for serum VEGF-D determination to aid in the diagnosis of LAM was made according to the GRADE. Conclusions: VEGF-D seems to have great potential implications for the diagnosis of LAM in clinical practice due to its excellent specificity and suboptimal sensitivity.

RESUMO Objetivo: O VEGF-D é um potencial biomarcador para linfangioleiomiomatose (LAM); entretanto, seu desempenho diagnóstico ainda não foi sistematicamente estudado. Métodos: Foram realizadas buscas nos bancos de dados PubMed, EMBASE, Scopus, Web of Science e Cochrane Library para identificar estudos primários sobre o VEGF-D com relação ao diagnóstico de LAM. A qualidade dos estudos foi avaliada por meio da ferramenta Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). As estimativas sumárias de acurácia diagnóstica foram combinadas utilizando um modelo bivariado de efeitos aleatórios. Análises de subgrupo e de sensibilidade foram realizadas para explorar possíveis heterogeneidades. O sistema Grading of Recommendations Assessment, Development, and Evaluation (GRADE) foi aplicado para avaliar a qualidade das evidências e indicar a força das recomendações. Resultados: Dez estudos envolvendo 945 pacientes eram de alto risco em qualidade, segundo a ferramenta QUADAS-2. Os parâmetros diagnósticos combinados foram indicados da seguinte forma: sensibilidade = 0,82 (IC95%: 0,71-0,90); especificidade = 0,98 (IC95%: 0,94-0,99); e OR diagnóstica = 197 (IC95%: 66-587). A ASC da análise summary ROC foi de 0,98. As análises de subgrupo e de sensibilidade revelaram que o desempenho global não foi substancialmente afetado pela composição do grupo controle, valor de corte pré-especificado, país de origem ou diferentes valores de corte (p > 0,05 para todos). Uma forte recomendação para a dosagem de VEGF-D sérico para auxiliar no diagnóstico de LAM foi feita de acordo com o sistema GRADE. Conclusões: O VEGF-D parece ter grandes implicações potenciais para o diagnóstico de LAM na prática clínica em virtude da excelente especificidade e sensibilidade subótima.

Prognostic nomogram incorporating radiological features for predicting overall survival in patients with AIDS-related non-Hodgkin lymphoma / 中华医学杂志(英文版)

BACKGROUND@#Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).@*METHODS@#A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.@*RESULTS@#In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.@*CONCLUSION@#A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.

Research progress of febuxostat derivatives as xanthine oxidase inhibitors / 药学学报

Febuxostat, as a xanthine oxidase inhibitor, is a classic anti-gout drug with significant therapeutic effects and good tolerability. The structures of febuxostat and its derivatives can be divided into two parts: a substituted phenyl ring and a five-membered or six-membered heterocyclic ring with a carboxyl substitution. This paper reviewed the research progress of febuxostat derivatives in recent ten years and classified the structure-activity relationships of various febuxostat derivatives. Exploring the action mechanisms and structure-activity relationships of xanthine oxidase inhibitors might be significant for the rational design and development of new anti-gout chemical entities.

Analysis of Chemical Constitutions of Polygonatum cyrtonema Dried Rhizomes Before and After Processing with Wine Based on UPLC-Q-TOF-MS / 中国实验方剂学杂志

Objective:To quickly analyze and identify the components in raw and wine-processed products of <italic>Polygonatum cyrtonema</italic> （PC） dried rhizomes by ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS）， and then find out the differential components before and after processing. Method:The ACQUITY UPLC BEH C₁₈ column （2.1 mm×100 mm， 1.8 μm） was used with 0.1% formic acid aqueous solution-acetonitrile as the mobile phase for gradient elution at a flow rate of 0.25 mL·min^-1. Electrospray ionization was selected for collection and detection in positive and negative ion modes， and the data were analyzed by PeakView 1.2.0.3. According to the retention time， accurate relative molecular weight and fragmentation ion information provided by MS， and combined with the reference substance and literature， the components were identified. After normalized treatment， the MS data of each sample were analyzed with principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA）， and then the differential components before and after processing were screened according to the principle that variable importance in the projection （VIP） value was >1. Result:A total of 38 components were identified from raw and wine-processed products of PC dried rhizomes， including 15 steroidal saponins， 6 alkaloids， 3 flavonoids， 2 amino acids， 2 organic acids and 10 others. The results of PCA and OPLS-DA showed that there were significant differences in the contents of components in PC dried rhizomes before and after processing， and 16 differential components such as kingianoside Z， disporopsin and linoleic acid were screened. Conclusion:UPLC-Q-TOF-MS technique can accurately and comprehensively identify the components in PC dried rhizomes， these components are mainly steroidal saponins， flavonoids and alkaloids. It takes a great difference in the contents of components before and after processing， and transformation of the same category components is the main reason for the differences of raw and wine-processed products， which will provide reference for the researches on material basis and processing chemistry of PC dried rhizomes.

Parent child communication about sex related topics and associated factors in rural area of Sichuan / 中国学校卫生

Objective@#To understand parent child communication about sex related topics in rural areas of Sichuan Province, and to provide the basis for family sex education.@*Methods@#A multi stage stratified cluster sampling was adopted to select 2 801 parents of children from 53 township kindergartens in Sichuan Province. Questionnaires were conducted to parents about sex education in family by face to face interview or self filling.@*Results@#About 41.63% of parents reported that children had questions about sex, and the rate of proper parent child communication was 57.46%. The results of binary unconditional Logistic regression analysis showed that township residence( OR=1.46, 95%CI =1.12-1.90), high school or higher educational background of mothers( OR= 1.77 , 95%CI =1.38-2.28), non-left-behind children( OR=1.32, 95%CI =1.03-1.69), supportive for parent child communication about sex related topics( OR=1.66, 95%CI =1.05-2.63), sex education at home( OR=1.60, 95%CI =1.25-2.05) were associated with a higher rate of proper parent child communication on sex( P <0.05).@*Conclusion@#In rural areas of Sichuan, proper parent child communication about sex related topics was not common. It is suggested that in rural areas, parents should enhance their awareness of the knowledge and importance of children s sex education, and improve the coping methods of children s sex-related problems so as to promote the healthy growth of children s body and mind.

Carrier screening model for Duchenne muscular dystrophy for women of reproductive age based on a pre-pregnancy birth defect control platform / 中华医学遗传学杂志

OBJECTIVE@#To establish a screening model for females of reproductive age carrying Duchenne muscular dystrophy (DMD) variants based on a current community health examination platform.@*METHODS@#A total of 61 870 participants were recruited between October 2017 and October 2019. Serum creatine kinase (CK) was measured with a Roche Cobasc 701/702 using an enzymatic rate method. Genetic testing was offered to those with a CK level of ≥ 200 U/L. For carriers of DMD variants, genetic counseling and follow up were provided.@*RESULTS@#For the 61 870 females participating in the program, 1078 were found with raised serum CK (≥ 200 U/L), of which 618 (57.33%) accepted CK re-measurement after at least a two-week interval. One hundred and twenty cases were found with sustained serum CK elevation, of which 6 were confirmed to be definite DMD carriers regardless of family history. Genetic testing was provided to 33 females with a family history for DMD, and 13 were determined as definite carriers. An affected fetus was detected by prenatal diagnosis. After genetic counseling, the parents had opted induced abortion.@*CONCLUSION@#Large-scale DMD carrier screening through a three-step approach based on the current community health examination platform is both feasible and cost effective.

Clinical significance of sirtuin 1 level in sepsis: correlation with disease risk, severity, and mortality risk

This study aimed to investigate the value of sirtuin 1 (SIRT1) in differentiating sepsis patients from healthy controls (HCs), and its correlation with inflammation, disease severity, as well as prognosis in sepsis patients. Serum samples were collected from 180 sepsis patients and 180 age- and gender-matched HCs. The SIRT1 level in the serum samples was detected by enzyme-linked immunoassay. The clinical data of the sepsis patients were documented, and their disease severity scores and 28-day mortality rate were assessed. SIRT1 was decreased in sepsis patients compared with HCs, and the receiver operating characteristic curve (ROC) showed that SIRT1 distinguished sepsis patients from HCs (area under the curve (AUC): 0.901; 95% confidence interval (CI): 0.868-0.934). In sepsis patients, SIRT1 negatively correlated with serum creatinine (Scr), white blood cells (WBC), C-reactive protein (CRP), acute physiology, and chronic health evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score, while it positively correlated with albumin. No correlation of SIRT1 with primary infection site or primary organism was observed. Furthermore, SIRT1 was reduced in 28-day non-survivors compared with 28-day survivors, and subsequent ROC showed that SIRT1 predicted 28-day mortality of sepsis patients (AUC: 0.725; 95% CI: 0.651-0.800), and its prognostic value was not inferior to Scr, albumin, WBC, and CRP, but was less than SOFA score and APACHE II score. In conclusion, measurement of serum SIRT1 might assist with the optimization of disease assessment, management strategies, and survival surveillance in sepsis patients.

Study on mechanism of combination of Platycodonis Radix and Lilii Bulbus with homology of medicine and food in treating pneumonia / 中国中药杂志

To investigate the potential molecular mechanism of the combination of Platycodonis Radix and Lilii Bulbus with the homology of medicine and food in the treatment of pneumonia by means of network pharmacology and in vitro verification experiment. Under the condition of bioavailability(OB)≥30% and drug-like(DL)≥0.18, the active components of Platycodonis Radix and Lilii Bulbus were screened in TCMSP database; the prediction targets of active components were searched from TCMSP, DrugBank and other databases, and the potential targets of pneumonia were obtained through GeneCards and OMIM database. The common targets were obtained by the intersection of drug and disease targets. The PPI network of common targets was constructed by STRING 11.0, and the core targets were obtained by topological analysis. Then the core targets received GO and KEGG analysis with use of WebGestalt and Metascape. The "component-target-pathway" network was constructed with the help of Cytoscape 3.7.1 software, and the component-target molecular docking verification was carried out with Discovery Studio 2016 software. Finally, the core targets and pathways were preliminarily verified in vitro. In this study, 12 active components were screened, 225 drug prediction targets and 420 potential diseases targets were obtained based on data mining method, and 14 core targets were obtained by topological analysis, including TNF, MMP9, AKT1, IL4 and IL2. The enrichment results of GO and KEGG showed that "Platycodonis Radix and Lilii Bulbus" drug pair may regulate inflammation, cell growth and metabolism by acting on 20 key signaling pathways such as TNF and IL-17, thereby exerting anti-pneumonia effects. The results of molecular docking showed that 12 active components had good binding ability with 14 core targets. In vitro experiment results showed that the core components of "Platycodonis Radix and Lilii Bulbus" drug pair could inhibit the expression of MMP9 and TNF-α by regulating TNF signal pathway. This study confirmed the scientificity and reliability of the prediction results of network pharmacology, and preliminarily revealed the potential molecular mechanism of the compatibility of Platycodonis Radix and Lilii Bulbus in the treatment of pneumonia. It provides a novel insight on systematically exploring the mechanism of the compatible use of Platycodonis Radix and Lilii Bulbus, and has a certain reference value for the research, development and application of new drugs.

Early childhood sexuality education among parents of 3-6 years old left behind children in rural areas and associated factors / 中国学校卫生

Objective@#To understand the current situation of early childhood sexuality education among parents of leftbehind children in rural areas and associated factors, to provide the evidence to launch the sexuality education for left behind children in rural areas in the future.@*Methods@#An anonymous questionnaire survey was conducted among 1 348 parents of left behind children in rural areas who were selected by multistage stratified sampling during Mar. to May. 2018.@*Results@#The rate of early childhood sexuality education of rural areas in Sichuan was 48.4%(652). Multivariate analysis showed that parents whose child was in higher grade ( OR=1.32, 95% CI =1.12-1.55); total annual income <10 000 yuan( OR=1.48, 95%CI =1.02-2.14), children had asked sexrelated questions ( OR=1.44, 95%CI =1.11-1.87), reckoning it necessary( OR=3.78, 95%CI =2.57-5.58), considering children’s sexuality education should be held by parents ( OR=2.69, 95%CI =1.78-4.07), other family members had launched the early childhood sexuality education( OR=7.86, 95%CI =5.16-11.95), school had launched it ( OR=3.13, 95%CI =2.25-4.34) had a highter rate of early childhood sexuality education.@*Conclusion@#Early childhood sexuality education of parents of left behind children of rural areas in Sichuan is in low level. Sexual health education should be based in school, together with parental training towards positive attitude and increases in early childhood sexuality education.

Research progress on processing history evolution, chemical constituents and pharmacological action of Paeoniae Radix Alba / 中草药

Paeoniae Radix Alba (PRA) is a clinically commonly used drug for tonifying blood and regulating meridians, which was listed as one of the highest grade herb in Shengnong's Classic of Materia Medica. The main chemical constituents of PRA are monoterpenes, triterpenes and flavonoids, and its processing methods are cleansing, cutting, adding auxiliary materials, etc. At present, the mainstream processing methods are stir-frying or stir-frying with wine. Modern studies have shown that PRA has the effects of protecting cardiovascular, anti-inflammatory and anti-oxidant. In this paper, we consulted with the ancient Chinese materia medica and ancient Chinese medical book, analyzed the local traditional Chinese medicine slices processing norms and modern pharmacopoeia. Meanwhile, we reviewed the history of PRA in function and processing, and discussed the modern processing technology, chemical composition and pharmacological research in some extent. We hope it can be helpful for some related research of PRA.

Progress of Historical Evolution of Processing, Chemical Composition and Pharmacological Effect of Platycodonis Radix / 中国实验方剂学杂志

Platycodonis Radix, which was first recorded in the Agriculture God's Canon of Materia Medica. It is a multi-functional drug with a wide range of applications. The processing of Platycodonis Radix has been recorded as early as in the Jin dynasty, and has a long history of processing. Today, in addition to the washing, cutting and stir-frying with honey, there have also been more than 20 kinds of processing methods, such as stir-frying with wine, stir-frying with bran, stir-frying with Lilii Bulbus juice and so on. The ancients believed that Platycodonis Radix could enhance the effect of diffusing the lung, promoting pharynx and relieving cough by processing. In terms of the chemical compositions in Platycodonis Radix, more than 100 compositions, like triterpenoid saponins, flavonoids, phenols, sterols, polysaccharides and polyacetylenes, have been isolated and identified from it. Among them, triterpenoid saponins are the essential compositions. In addition, Platycodonis Radix has the pharmacological effects of expectorant, antitussive, anti-inflammatory, anti-tumor, etc. The medicinal ingredients of Platycodonis Radix are mainly triterpenoid saponins and polysaccharides. Among them, triterpenoid saponins have diverse biological activities, which lead it to be one of the hotspots of current researches. Platycodonis Radix has a good role in promoting lung and removing phlegm. After being processed, its medicinal effects are enhanced. It is complex and diverse in compositions of Platycodonis Radix so that has rich pharmacological activities. On the basis of sorting out the literature, this paper discusses the processing history, chemical composition and pharmacological effect of Platycodonis Radix, in order to provide reference for the special processing and modern research of Platycodonis Radix. Furtherly, it provides a theoretical basis for the research of its processing mechanism and quality control.

A retrospective study of ocular manifestations and aquaporin 4 antibody concentrations in 132 patients with neuromyelitis optica / 中华眼底病杂志

Objective To observe the ocular manifestations and the titer of aquaporin 4 antibody (AQP-4) in NMO patients,and to evaluate the BCVA prognosis in patients with different titers of AQP-4Ab.Methods A retrospective case study.From September 2009 to March 2014,132 NMO patients diagnosed in Department of Neurology and Ophthalmology in Huashan Hospital of Fudan University were included in the study.Among the patients,74 patients (56.06％) were involved in optic nerve for the first time,among which 63 patients (47.72％) were involved in optic nerve alone,and 11 patients (8.33％) were involved in optic nerve and spinal cord at the same time.The recurrence rate was 62.88％ (twice or more).All patients underwent BCVA,slit lamp microscope,fundus examination,thyroid function,sex hormones,and serum AQP-4Ab detection.BCVA was recorded at admission and before discharge from hospital,and worse BCVA was recorded in binocular patients.The BCVA of patients with different titers of AQP-4Ab were analyzed comparatively.Results Among the 74 patients with optic nerve involved in the first onset,50 patients with BCVA＜0.1 at the initial diagnosis (67.57％);AQP-4Ab positive was found in 56 patients,which including 13,9 and 34 patients of AQP-4Ab titer 5-60,61-100 and ＞ 100 RSRU/ml.After 2 weeks of treatment,BCVA improved in 40 patients (71.42％),including 11 (84.62％),6 (66.67％) and 23 (67.64％) ofAQP-4Ab titer 5-60,61-100 and ＞ 100 RSRU/ml.Among 132 patients,98 patients (74.24％) were AQP-4Ab positive.There were 73 patients (55.30％) with abnormal immune rheumatoid index.Conclusions The optic nerve is involved in 56.06％ patients with NMO for the first time,and 67.57％ of the patients had poor vision with BCVA＜0.1.BCVA prognosis is better in patients with serum AQP-4Ab titer of 5-60 RSRU/ml.

The value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced T1 mapping MRI in the quantitative evaluation of hepatic fibrosis in patients with hepatitis B / 中华放射学杂志

Objective@#To investigate the quantitative evaluation efficiency of gadolinium- ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced T1 mapping in staging hepatic fibrosis caused by viral hepatitis B.@*Methods@#One hundred and fifty patients with chronic hepatitis B were prospectively enrolled in Shanghai Public Health Clinical Center, Fudan University from August 2016 to August 2018.These patients underwent liver aspiration biopsy were divided into four subgroups: S1 (n=38), S2 (n=30), S3 (n=33), S4 (n=49) according to Scheuer-Ludwig scoring system. Non-enhanced and Gd-EOB-DTPA-enhanced MRI were performed in all subjects. Look-Locker sequences were performed to acquire T1 mapping of pre and post-contrast at 20 minutes after Gd-EOB-DTPA administration. The T1 value after 20 minutes of Gd-EOB-DTPA administration (T1 20 min), the reduction rate of T1 value (ΔT1 20 min%), the increase of 1/T1 value (ΔR1 20 min%) were measured and calculated. The one-way ANOVA was applied to compare the difference in T1 20 min, ΔT1 20 min%, ΔR1 20 min% of various fibrosis stages. ROC curves were used to assess the efficacy of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing ≥ S2, ≥ S3, ≥ S4. P<0.05 was considered to be statistically significant.@*Results@#The T1 20 min raised with fibrosis stage increased, ΔT1 20 min% and ΔR1 20 min% reduced with fibrosis stage increased. Areas under the curves of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing ≥ S2 were 0.844, 0.905, 0.869; and diagnosing ≥ S3 were 0.832, 0.907, 0.862; and diagnosing ≥ S4 were 0.853, 0.897, 0.873, respectively. The diagnostic efficiency of ΔT1 20 min% was the best.@*Conclusion@#Gd-EOB-DTPA-enhanced T1 mapping could be regarded as a reliable diagnostic tool for the evaluation of hepatic fibrosis caused by viral hepatitis B.

The value of gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid enhanced T1 mapping MRI in the quantitative evaluation of hepatic fibrosis in patients with hepatitis B / 中华放射学杂志

Objective To investigate the quantitative evaluation efficiency of gadolinium?ethoxybenzyl?diethylenetriamine pentaacetic acid (Gd?EOB?DTPA) enhanced T1 mapping in staging hepatic fibrosis caused by viral hepatitis B. Methods One hundred and fifty patients with chronic hepatitis B were prospectively enrolled in Shanghai Public Health Clinical Center, Fudan University from August 2016 to August 2018.These patients underwent liver aspiration biopsy were divided into four subgroups: S1 (n=38), S2 (n=30), S3 (n=33), S4 (n=49) according to Scheuer?Ludwig scoring system. Non?enhanced and Gd?EOB?DTPA?enhanced MRI were performed in all subjects. Look?Locker sequences were performed to acquire T1 mapping of pre and post?contrast at 20 minutes after Gd?EOB?DTPA administration. The T1 value after 20 minutes of Gd?EOB?DTPA administration (T1 20 min), the reduction rate of T1 value (ΔT1 20 min% ), the increase of 1/T1 value (ΔR1 20 min% ) were measured and calculated. The one?way ANOVA was applied to compare the difference in T1 20 min, ΔT1 20 min%, ΔR1 20 min% of various fibrosis stages. ROC curves were used to assess the efficacy of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing≥S2,≥S3,≥S4. P<0.05 was considered to be statistically significant. Results The T1 20 min raised with fibrosis stage increased, ΔT1 20 min% and ΔR1 20 min% reduced with fibrosis stage increased. Areas under the curves of T1 20 min, ΔT1 20 min%, ΔR1 20 min% for diagnosing≥S2 were 0.844, 0.905, 0.869; and diagnosing≥S3 were 0.832, 0.907, 0.862; and diagnosing≥S4 were 0.853, 0.897, 0.873, respectively. The diagnostic efficiency of ΔT1 20 min% was the best. Conclusion Gd?EOB?DTPA?enhanced T1 mapping could be regarded as a reliable diagnostic tool for the evaluation of hepatic fibrosis caused by viral hepatitis B.

Progress of Electrospinning Drug-loaded Fibers and Application in Transdermal Drug Delivery System / 中国药学杂志

Electrospinning technology opens up a new method for the construction of drug delivery system. The unique fiber structures of drug-loaded electrospinning nanofibers with the characteristics of similar to the extracellular matrix,good air permeability and hygroscopicity are very suitable for transdermal drug delivery systems.In this paper, the definition, characteristics, matrix selection, preparation methods, drug-loaded forms and drug-released profiles of drug-loaded electrospinning nanofibers are summarized and analyzed. Meanwhile, the application of drug-loaded electrospinning nanofbiers in the transdermal drug delivery systems is analyzed. This review is to provide support for the further studies on electrospun nanofiber transdermal drug delivery system.

Electro-acupuncture regulates the cholinergic anti-inflammatory pathway in a rat model of chronic obstructive pulmonary disease / 中西医结合学报

<p><b>OBJECTIVE</b>Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease (COPD), and the cholinergic anti-inflammatory pathway (CAP) has been shown to be involved in regulation of inflammation. In this study, we investigated whether electro-acupuncture (EA) affects the CAP in COPD.</p><p><b>METHODS</b>Sprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli (ST36) and Feishu (BL13) points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal + EA, normal + α-bungarotoxin (α-BGT) (the antagonist of the nicotinic acetylcholine receptor α7 subunit (α7nAChR)) + EA, COPD, COPD + EA, and COPD + α-BGT + EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine (ACh), acetylcholinesterase (AChE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid (BALF) and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreactivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 (JAK2), signal transducers and activators of transcription 3 (STAT3), nuclear factor-κB (NF-κB), were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry.</p><p><b>RESULTS</b>Compared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve (P < 0.01), a marked sign of lung inflammation and an increase of ACh, AChE, IL-6 and TNF-α level in BALF or lung tissue (P < 0.05, P < 0.01) and higher expression of α7nAChR, JAK2, STAT3 and NF-κB (P < 0.05, P < 0.01) in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced (P < 0.01), lung inflammation was improved and the levels of ACh, AChE, IL-6 and TNF-α were decreased (P < 0.01). Further, the expression of α7nAChR, JAK2, STAT3 and NF-κB was downregulated (P < 0.05, P < 0.01). However, the above effects of EA were blocked in rats injected with α-BGT (P < 0.01).</p><p><b>CONCLUSION</b>EA treatment can reduce the lung inflammatory response and improve lung function in COPD, which may be related to its involvement in the regulation of CAP.</p>

Short-term effectiveness of single-level lsobar TTL dynamic internal fixation in the treatment of lumbar degenerative diseases / 中国组织工程研究

BACKGROUND: The short-term effects of dynamic internal fixation and whether dynamic internal fixation system can prevent or delay the process of adjacent level degeneration after lumbar surgery remain in controversy.OBJECTIVE: To investigate the short-term clinical effectiveness of single-level Isobar TTL dynamic internal fixation in the treatment of degenerative lumbar diseases. METHODS: Data of 20 patients who suffered from lumbar degenerative diseases and underwent posterior decompression combined with single-level Isobar TTL dynamic internal fixation, including 11 male patients and 9 female patients, were retrospectively analyzed; the average age of these patients was 47.4 (35-62) years old. Visual analog scale, Japanese Orthopaedic Association scores and Oswestry disability index were used to assess clinical outcomes. Disc height, range of motion, and University of California at Los Angeles Grading Scale were measured on X-ray films to evaluate the status of disc degeneration on both dynamic fixed segment (index segment) and superior adjacent segment. RESULTS AND CONCLUSION: All follow-up patients successfully completed the operation. The average follow-up time was 14.4 (12-27) months. No blood vessels, nerve injury, loose internal fixation or rupture occurred. At the last follow-up, Visual Analog Scale, Japanese Orthopaedic Association scores and Oswestry Disability Index were significantly improved (P < 0.05); range of motion of dynamic fixation segment reduced (P < 0.05) as compared with that before surgery. Intervertebral height of dynamic fixation segments and University of California at Los Angeles Grading Scale classification were not significantly different between follow-up and before surgery (P > 0.05). Intervertebral height of superior adjacent segment, intervertebral range of motion and University of California at Los Angeles Grading Scale classification were not significantly different (P > 0.05). These results indicate that single-level Isobar TTL dynamic internal fixation proved to have satisfactory clinical outcomes in the treatment of lumbar degenerative diseases. During follow-up, disc degeneration on either index segment or superior adjacent segment is not accelerated.

Clinical Application of Immediate Implant Placement of Zimmer Dental Implant System in the Mandibular Posterior Region / 中山大学学报(医学科学版)

[Objectives]To observe the clinical effects of the immediate implant placement of Zimmer dental implant sys-tem in the mandibular posterior region.[Methods]67 cases with a total of 89 mandible posterior teeth to deal with immediate implantion which selected to be treated with Zimmer dental implant system.76 teeth between implant and tooth socket bone wall were simultaneously filled with Bio-oss Collagen.The upper structure was repaired with PFM porcelain crown after the postoperative phase I of 3~6 months.All the patients were followed up for 6~24 months.[Results]During the clinical follow up,the implant survival rate was 100%. In 67 patients,89 implants was successfully loaded,with stable implants,good condition in synosteosis and without adverse subjective symptoms. All of the 67 patients had achieved good synosteosis and success loads clinically and radiologically.[Conclusion]A good osseointegration is obtained in the mandibular posterior re-gion with Zimmer dental implant system,Correctly dealing with Bio-oss Collagen between implant and tooth socket bone wall.At the same time,it can shorten the time of therapy,simplify the procedure,so that the clinical results are more satis-factory.

The clinical features of 19 endogenous endophthalmitis cases / 中华传染病杂志

Objective To investigate the etiological features and visual outcomes of endogenous endophthalmitis (EE).Methods A retrospective consecutive case series of 19 patients (23 eyes) presenting with presumed EE from 2009 to 2016 in the Ophthalmology Department of Zhongshan Hospital and Huashan Hospital,Fudan University were included.Patients' medical history (main risk factors),microbial culture results,treatment regimen and visual outcomes were evaluated.Results In total,19 patients (23 eyes) were identified,including 7 female (8 eyes) and 12 male (15 eyes).Mean age was 54.0 ±17.9,ranging from 24 to 85.Most patients had severe underlying diseases,mainly diabetic mellitus (9/19) and liver abscess (8/19).Twenty vitreous samples from 17 cases were cultured,and 12 eyes from 10 cases were positive with a positive rate of 12/20.Fifteen cases had blood or body fluids cultures and 10 were positive,with the positivity rate of 10/15.Candida albicans (5/6) was the most common pathogen isolated in fungal endophthalmitis,and Klebsiella pneumonia (7/13) was the most common pathogen in bacterial endophthalmitis.Patients mainly received vitrectomy,intravitreal injection,and systemic/local antibiotic therapy.Only five eyes had improved visual acuities,and 6 eyes were enucleated or eviscerated.Among the 10 eyes from 8 cases who were treated within one week after onset,5 eyes from 3 cases (5/10) had improved visual acuities;one eye from one case had no visual improvement;four eyes from four cases had no light perception or enucleated.No improved visual acuity occurred in patients who were treated after one week.Conclusions Although the incidence is low,EE has poor visual outcomes.Timely diagnosis and treatment may be helpful to maximize the recovery of vision.