Research progress and maturity assessment of continuous manufacturing of traditional Chinese medicine / 中国中药杂志

The pharmaceutical manufacturing model is gradually changing from intermittent manufacturing to continuous manufacturing and intelligent manufacturing. This paper briefly reviewed the supervision and research progress in continuous pharmaceutical manufacturing in China and abroad and described the definition and advantages of continuous pharmaceutical manufacturing. The continuous manufacturing of traditional Chinese medicine(TCM) at the current stage was summarized in the following three terms: the enhancement of the continuity of intermittent manufacturing operations, the integration of continuous equipment to improve physical continuity between units, and the application of advanced process control strategies to improve process continuity. To achieve continuous manufacturing of TCM, the corresponding key technologies, such as material property characterization, process modeling and simulation, process analysis technology, and system integration, were analyzed from the process and equipment, respectively. It was proposed that the continuous manufacturing equipment system should have the characteristics of high speed, high response, and high reliability, "three high(H~3)" for short. Considering the characteristics and current situation of TCM manufacturing, based on the two dimensions of product quality control and production efficiency, a maturity assessment model for continuous manufacturing of TCM, consisting of operation continuity, equipment continuity, process continuity, and quality control continuity, was proposed to provide references for the application of continuous manufacturing technology for TCM. The implementation of continuous manufacturing or the application of key continuous manufacturing technologies in TCM can help to systematically integrate advanced pharmaceutical technology elements and promote the uniformity of TCM quality and the improvement of production efficiency.

Study on preparation technology of long-acting sustained-release oral ulcer membrane based on analytic hierarchy process and orthogonal design / 药学实践杂志

Objective To prepare a sustained-release membrane with longer adhesion time and dissolution time, and compare it with the commercially available oral ulcer membrane. Method Adhesion strength, adhesion time, swelling coefficient, dissolution time, etc. were used as the inspection indicators, and a combination of single factor inspection and analytic hierarchy process were used to screen the membrane -forming materials. The dispersion method of clotrimazole, ornidazole and borneol were investigated to prevent the drug from seed out. The method of combining orthogonal experiment and analytic hierarchy process were used to optimize the dosage of CMC-Na, PVA-1788 and glycerin; and the commercial products were compared. Results Through single-factor investigation and orthogonal experiment, the optimal ratio of excipients was selected as CMC-Na∶PVA-1788∶glycerol (3∶1∶0.08). The water-insoluble component clotrimazole, ornidazole and borneol were treated by precipitation in liquid with good effect. The best method was used to prepare the membrane. The adhesion strength was 102 g. The adhesion time was 55 min. The swelling coefficient was 1 939.52. The average dissolution time was 110 min. The appearance was white and the surface was free of bubbles, soft and elastic. The membrane forming time at 60 ℃ was 300 min and the demolding effect was better which could be completely peeled off with moderate thickness. Conclusion The oral ulcer membrane developed in this method has good appearance, comfortable use, strong adhesion, long adhesion time and dissolution time, and could stay on the ulcer surface for a long time to form physical isolation, and slowly release the drug during the dissolution process, which could play the role of long-term pain relief, antibacterial, anti-inflammatory and promote healing effects on oral ulcers.

Latent tuberculosis infection and screening method among close contacts in schools in Xuhui District，Shanghai from 2020 to 2022 / 上海预防医学

ObjectiveTo investigate the latent tuberculosis infection （LTBI） of close contacts in schools of Xuhui District， and to explore the tuberculin skin test （TST）- interferon-γ release assay （IGRA） two-step method in order to discover the screening strategy of tuberculosis in Xuhui District. MethodsClose contacts of tuberculosis in schools of Xuhui District from 2020 to 2022 were selected as research subjects. Screening was conducted using symptom questionnaire， TST， chest X-rays， IGRA， and the information including the etiological results and grade of the index cases， as well as gender， age， and relationship with the index cases of the research subjects were collected. ResultsTotally 615 close contacts of 32 tuberculosis cases occurred in the schools were finally included. Of the 609 close contacts who completed tuberculosis infection screening and underwent TST testing， 153 TST（+） individuals underwent IGRA testing. The final LTBI rate was 4.6%， and the pulmonary tuberculosis detection rate was 163 per 100 000. The relationship with the index cases was an influencing factor for LTBI. The IGRA positivity rate was higher among close contacts with TST ≥15 mm than among those with 10 mm≤ TST <15 mm （χ2=14.41， P<0.05）. ConclusionThe latent tuberculosis infection among close contacts of school tuberculosis cases in Xuhui District remains serious. TST-IGRA two-step method can assist in the accurate diagnosis of LTBI and pulmonary tuberculosis cases.

Determination of a reasonable threshold of total bilirubin for the diagnosis of hepatitis B virus-associated acute-on-chronic liver failure / 临床肝胆病杂志

Objective To investigate a reasonable threshold of total bilirubin for the diagnosis of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF), and to realize accurate early diagnosis. Methods A retrospective analysis was performed for the clinical data of 1232 patients with HBV-ACLF who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from September 2008 to September 2018, and according to the baseline serum level of total bilirubin (TBil), the patients were divided into group A (TBil 15%) in patients with acute-on-chronic liver failure (ACLF). Although there was a difference in long-term mortality rate between the two groups, there was no significant increase in transplant-free mortality rate after 90 days in either group. Conclusion Under the premise of international normalized ratio ≥1.5, it is not recommended to increase the threshold of TBil to 205.2 μmol/L in the diagnostic criteria for HBV-ACLF, so as to ensure the early diagnosis of more ACLF patients and bring more opportunities for treatment and cure.

Effects of the resin base and retention depth on fracture resistance of molars restored with nano-ceramic endocrowns / 北京大学学报(医学版)

OBJECTIVE@#To compare the effects of resin base and different retention depth on the fracture resistance of mandibular molars restored with nano-ceramic endocrowns.@*METHODS@#Forty mandibular molars selected and randomly divided into 5 groups: ① The control group which was consisted of intact teeth, ② the non-resin base group, ③ the 2 mm retention depth group, ④ the 3 mm retention depth group, ⑤ the 4 mm retention depth group, respectively. After tooth preparation, in vitro root canal therapy was conducted, which was followed by endocrown design, production and adhesive of groups ②-⑤. All the samples were under load (N) of the universal mechanical testing machine after embedding. The fracture pattern of each sample was observed under stereomicroscope. Then the microstructure of the fracture surface was observed by scanning electron microscopy.@*RESULTS@#The fracture loads of each group were respectively: the control group fracture load was (3 069.34±939.50) N; experimental groups: fracture load of (2 438.04±774.40) N for the group without resin base; fracture load of (3 537.18±763.65) N for the group with 2 mm retention depth. The fracture load of the retention depth 3 mm group was (2 331.55±766.39) N; the fracture load of the retention depth 4 mm group was (2 786.98±709.24) N. There was statistical significance in the effect of resin base and different retention depth on the fracture loads of molars restored with nano-ceramic endocrown (P < 0.05). Repairable fractures in each group were as follows: control group 2/8, non-resin base group 1/8, retention depth of 2 mm group 1/8, retention depth of 3 mm group 2/8, and retention depth of 4 mm group 0/8. The effects of the retention depth and the presence of resin base on the fracture resistance of the resin nano-ceramic endocrowns were statistically significant (P < 0.05). Scanning electron microscopy showed more arrest lines and small twist hackles on the fracture surface of the restorations with resin base (retention depths of 2 mm, 3 mm, and 4 mm), with cracks extending towards the root. In addition to the characteristics above, more transverse cracks parallel to the occlusal surface, pointing outwards from the center of the pulp cavity retention, were also observed on the fracture surface of the non-resin base restorations.@*CONCLUSION@#When molar teeth with nano-ceramic endocrowns are restored, resin base and the retention depth of 2 mm help the teeth to obtain optimal fracture strength.

High-flow nasal cannula oxygen therapy and noninvasive ventilation for preventing extubation failure during weaning from mechanical ventilation assessed by lung ultrasound score: A single-center randomized study / 世界急诊医学杂志（英文）

@#BACKGROUND: We sought to demonstrate the superiority of a targeted therapy strategy involving high-flow nasal cannula oxygen (HFNCO2) therapy and noninvasive ventilation (NIV) using lung ultrasound score (LUS) in comparison with standard care among patients in the intensive care unit (ICU) who undergo successful weaning to decrease the incidence of extubation failure at both 48 hours and seven days. METHODS: During the study period, 98 patients were enrolled in the study, including 49 in the control group and 49 in the treatment group. Patients in the control group and patients with an LUS score <14 points (at low risk of extubation failure) in the treatment group were extubated and received standard preventive care without NIV or HFNCO2. Patients with an LUS score ≥14 points (at high risk of extubation failure) in the treatment group were extubated with a second review of the therapeutic optimization to identify and address any persisting risk factors for postextubation respiratory distress; patients received HFNCO2 therapy combined with sessions of preventive NIV (4-8 hours per day for 4-8 sessions total) for the first 48 hours after extubation. RESULTS: In the control group, 13 patients had the LUS scores ≥14 points, while 36 patients had scores <14 points. In the treatment group, 16 patients had the LUS scores ≥14 points, while 33 patients had scores <14 points. Among patients with the LUS score ≥14 points, the extubation failure rate within 48 hours was 30.8% in the control group and 12.5% in the treatment group, constituting a statistically significant difference (P<0.05). Conversely, among patients with an LUS score <14 points, 13.9% in the control group and 9.1% in the treatment group experienced extubation failure (P=0.61). The length of ICU stay (9.4±3.1 days vs. 7.2±2.4 days) was significantly different and the re-intubation rate (at 48 hours: 18.4% vs. 10.2%; seven days: 22.4% vs. 12.2%) significantly varied between the two groups (P<0.05). There was no significant difference in the 28-day mortality rate (6.1% vs. 8.2%) between the control and treatment groups. CONCLUSIONS: Among high-risk adults being weaned from mechanical ventilation and assessed by LUS, the NIV+HFNCO2 protocol does not lessen the mortality rate but reduce the length of ICU stay, the rate of extubation failure at both 48 hours and seven days.

Synchronous conjugation of i-motif DNA and therapeutic siRNA on the vertexes of tetrahedral DNA nanocages for efficient gene silence

The functionality of DNA biomacromolecules has been widely excavated, as therapeutic drugs, carriers, and functionalized modification derivatives. In this study, we developed a series of DNA tetrahedron nanocages (Td),

Safety of Thread Embedding Acupuncture Therapy: A Systematic Review / 中国结合医学杂志

OBJECTIVE@#To evaluate the safety of thread embedding acupuncture therapy (TEAT) and discuss the prevention and treatment of some adverse events (AEs).@*METHODS@#Review of databases, including China National Knowledge Infrastructure (CNKI), CBMdisc, Wanfang, VIP databases and English literature published in PubMed, MEDLINE, EMBASE and Web of Science, were searched from their inception to January 2020, randomized controlled trials (RCTs) and case reports in which AEs with TEAT were included. Cochrane Collaboration's tool and RevMan V.5.3.3 software were used to evaluate the quality of the studies.@*RESULTS@#A total of 61 studies (45 RCTs and 16 case reports) with 620 cases of AEs were included in this review. These studies were published in two countries: China and South Korea. Twenty eight kinds of AEs were summarized. The most common AEs were induration, bleeding and ecchymosis, redness and swelling, fever, and pain. They were accounted for 75.35% (425/564) in the review, and most of them were mild. The rarest AEs were epilepsy, irregular menstruation, skin ulcer, thread malabsorption, and fat liquefaction, with 1 case each. But not all of them had clear causal relationship with TEAT. Most of the AEs were local reactions [with incidence of 9.83% (480/4,882)] and systemic reactions accounted for only 1.27% (62/4,882). Although the included studies showed that AEs were very commonly encountered (11.09%), only 5 cases of severe AEs reported from 2013 to 2017 (0.1%) by using catgut thread, which are rarely seen nowdays with the wide use of new absorbable surgical suture. All of the severe AEs were recovered after symptomatic treatment with no sequelae.@*CONCLUSIONS@#The evidence showed that TEAT is a relatively safe and convenient therapy especially since application of new absorbable surgical suture. Improving practitioner skills, regulating operations, and paying attention to the patients' conditions may reduce the incidence of AEs and improve safety of TEAT.

Clinical study on obstructive sleep apnea following pharyngeal flap surgery / 华西口腔医学杂志

OBJECTIVES@#This study aims to investigate the incidence and severity of obstructive sleep apnea (OSA) in cleft patients with velopharyngeal insufficiency (VPI) after pharyngeal flap surgery (PFS) and explore the influence of operation age.@*METHODS@#A retrospective study was conducted in 82 cleft patients after PFS. The patients were divided into two groups according to their age at the time of surgery. The incidence and severity of OSA were assessed at least 1.2 years (mean 6.0 years) postoperatively by polysomnography (PSG).@*RESULTS@#The incidence rates of OSA were 20% in the adult group and 31% in the child group. No significant difference was found between the two groups (@*CONCLUSIONS@#Some patients still have OSA average of 6.0 years after PFS, and operation ageis unrelated to the incidence and severity of OSA.

Clinical significance of EPHX2 deregulation in prostate cancer / 亚洲男科学杂志(英文版)

The arachidonic acid (AA) metabolic pathway participates in various physiological processes as well as in the development of malignancies. We analyzed genomic alterations in AA metabolic enzymes in the Cancer Genome Atlas (TCGA) prostate cancer (PCa) dataset and found that the gene encoding soluble epoxide hydrolase (EPHX2) is frequently deleted in PCa. EPHX2 mRNA and protein expression in PCa was examined in multiple datasets by differential gene expression analysis and in a tissue microarray by immunohistochemistry. The expression data were analyzed in conjunction with clinicopathological variables. Both the mRNA and protein expression levels of EPHX2 were significantly decreased in tumors compared with normal prostate tissues and were inversely correlated with the Gleason grade and disease-free survival time. Furthermore, EPHX2 mRNA expression was significantly decreased in metastatic and recurrent PCa compared with localized and primary PCa, respectively. In addition, EPHX2 protein expression correlated negatively with Ki67 expression. In conclusion, EPHX2 deregulation is significantly correlated with the clinical characteristics of PCa progression and may serve as a prognostic marker for PCa.

Comparative study between 3D guide plate assisted and free-hand insertion of anterior cervical transpedicular screw / 中国骨伤

OBJECTIVE@#To compare accuracy of anterior cervical pedicle screws between assist of rapid prototyping 3D guide plate and free-hand insertion, and evaluate the safety of two methods.@*METHODS@#Eight adult cervical cadaver specimens after formaldehyde immersion, including 4 males and 4 females, aged 32 to 65(40.3±5.6) years old. After X-ray examination to exclude bone damage and deformity, 4 of them (3D guide plate group) randomly selected were for CT scan to obtain DICOM format data, and the data was imported into Mimics software for model, designed the ideal entry point and nail path for anterior cervicaltranspedicular screw (ATPS). After obtaining the personalized guide plate of the nail channel, it was exported as STL data, and the individual guide plate was printed by rapid prototyping and 3D printing technology. In turn, with the assistance of 3D guide plates, one-to-one personalized ATPS screws were placed on the four lower cervical cadaver specimens. Another 4 (free-hand group) lower cervical cadaver specimens were implanted with ATPS screws using free-hand technique. All specimens were performed CT thin-layer scanning and three-dimensional reconstruction after operation. The Tomasino method was used to evaluate the safety of the screws on the CT cross-sectional and sagittal images, to determine whether there was a cortical puncture of the lower and inner edges of the pedicle. According to the CT rating results, gradeⅠandⅡwere safe, and grade Ⅲ- Ⅴ were dangerous.And the accuracy of screws was recorded and analyzed between two groups.@*RESULTS@#Two screws were inserted in each segment from C@*CONCLUSION@#The 3D printing rapid prototyping guide plate assisted insertion of the anterior cervical pedicle screw can significantly improve the accuracy and safety, and provide a theoretical basis for further clinical application.

The bioinformatics and metabolomics research on anti-hypoxic molecular mechanisms of Salidroside via regulating the PTEN mediated PI3K/Akt/NF-κB signaling pathway / 中国天然药物

Salidroside (SAL), a major bioactive compound of Rhodiola crenulata, has significant anti-hypoxia effect, however, its underlying molecular mechanism has not been elucidated. In order to explore the protective mechanism of SAL, the lactate dehydrogenase (LDH), reactive oxygen species (ROS), superoxide dismutase (SOD) and hypoxia-induced factor 1α (HIF-1α) were measured to establish the PC12 cell hypoxic model. Cell staining and cell viability analyses were performed to evaluate the protective effects of SAL. The metabolomics and bioinformatics methods were used to explore the protective effects of salidroside under hypoxia condition. The metabolite-protein interaction networks were further established and the protein expression level was examined by Western blotting. The results showed that 59 endogenous metabolites changed and the expression of the hub proteins of CK2, p-PTEN/PTEN, PI3K, p-Akt/Akt, NF-κB p65 and Bcl-2 were increased, suggesting that SAL could increase the expression of CK2, which induced the phosphorylation and inactivation of PTEN, reduced the inhibitory effect on PI3K signaling pathways and activated the PI3K/Akt/NF-κB survival signaling pathway. Our study provided an important insight to reveal the protective molecular mechanism of SAL as a novel drug candidate.

In vitro evaluation of the application of digital individual tooth tray in the impression making of mandibular full-arch crown abutments / 北京大学学报(医学版)

OBJECTIVE@#To establish a method for the production of digital individual tooth tray based on three-dimensional (3D) scan, computer-aided design (CAD) and 3D printing, and to evaluate the effect of impression taking of full-arch crown abutments by digital individual tooth tray technique and conventional method through in vitro study.@*METHODS@#The full crown preparation was performed on all the fourteen resin teeth in a standard model of mandibular dentition. The surface data of prepared abutments was collected by 3D scanning. A new project was created in a dental CAD software including all the fourteen teeth in the mandibular dentition. The design modules of anatomy crown and coping were selected for each tooth. The dentition was divided for three sections: right posterior teeth, anterior teeth, and left posterior teeth areas. The connector design was added between the abutments within the same section. The scanned data of the abutments were imported. The occlusal plane and insertion path were determined. The position of margin line, as well as the shape of anatomy crown and connector as the main body of the individual tooth tray were designed for each abutment. The shape of coping was generated as the space for holding the impression material. The finalized data of the main body was imported into Geomagic software. The retentive attachment was added at the external surface and the tissue stop was formed at the internal surface. The completed individual tooth tray was manufactured by 3D printing with resin material. The data of full-arch crown abutments were modified and printed. The conventional dentition trays A and B, as well as digital individual tooth tray were designed and printed for four copies each. The polyether impressions of the full-arch abutments were made by conventional one-step method using dentition tray A, and by sectional-impression technique using digital individual tooth tray and dentition tray B for four times each. The time spent for each impression taking and the numbers of defects at the shoulder and axial/occlusal surface in each impression were recorded. The impression quality of each abutment was evaluated. The overall quality distribution and the pass rate of abutments between the two methods were analyzed.@*RESULTS@#The impressions made by conventional method had more defects at shoulder than those made by digital individual tooth tray technique. No difference of the number of defects at axial/occlusal surface between the two methods was observed. The digital individual tooth tray technique for the full-arch abutment impression exhibited higher pass rate of abutments and better quality of impression, compared with conventional methods.@*CONCLUSION@#A new method for the production of digital individual tooth tray based on digital scanning, CAD and 3D printing was established. Compared with conventional method, using digital individual tooth tray technique for impression taking of full-arch abutments can achieve better effect.

Differential Expression of Integrin β1 in Two Brain Injury Models of Rats / 法医学杂志

Objective To study the characteristics of positive expression of integrin β1 in the rat brain tissue of two kinds of traumatic brain injury models and to explore the feasibility of inferring the mode of traumatic brain injury using the positive expression of integrin β1. Methods The occipital region of rats was hit by hydraulic impact method and pendulum striking method to produce two closed brain injury models of linear and rotation acceleration respectively, then 120 SD rats were randomly divided into linear acceleration injury group, rotation acceleration injury group, sham operation group and normal control group. Immunohistochemistry staining and Western blotting method were used to detect the positive expression of integrin β1 in different parts of the brain tissue at 30 min, 3 h, 6 h, 12 h, 3 d and 7 d after rat injury. The data was processed statistically by SPSS 18.0 software. Results The positive expression of integrin β1 was detected 30 min after brain injury and reached the peak 6 h after brain injury. With the extension of injury time, the expression tended to enhance. At the same time points after injury, the differences in the positive expression of integrin β1 between the linear acceleration injury group and the rotation acceleration injury group in the occipital strike point and thalamus had no statistical significance （ P>0.05）, but the differences in the expression of integrin β1 in the frontal lobe and brain stem had statistical significance （P<0.05）. Conclusion The characteristics of positive expression of integrin β1 in brain tissue can be used to infer the strike point and the manner of injury and has application value for the reconstruction of craniocerebral injury process.

Possibility of mesenchymal stem cell transplantation in the treatment of coronavirus disease 2019 / 中华危重病急救医学

2019 Novel coronavirus (2019-nCoV) infection has caused a global pandemic. Although researchers have carried out a lot of research on 2019-nCoV, analyzed the molecular structure and conducted evolutionary tree analysis, there is still insufficient understanding of its specific pathogenic mechanism, resulting in the lack of specific and effective therapeutic drugs and method. 2019-nCoV infection can cause inflammation and may deteriorate to acute respiratory distress syndrome (ARDS) and sepsis, which have become the main complication of its death. Therefore, using antiviral and symptomatic treatment with inflammation reduction can have a better therapeutic effect. Mesenchymal stem cells (MSCs) not only have a significant immune-regulation function, but also play a role in regeneration and repair, repairing damaged lungs, so they can be considered as a new effective method for the treatment of coronavirus disease 2019 (COVID-19). This article analyzes the main pathogenic mechanism of 2019-nCoV, and the process of developing into ARDS, combined with the research status of MSCs, to explore its significance and feasibility for the treatment of COVID-19. Finally, it will provide a substantial theoretical basis for clinical treatment now and in the future.

Analysis of Cao Yongqing's experience on treating constipation based on Traditional Chinese Medicine Inheritance Support System / 国际中医中药杂志

Objective:To explore and annalize the characteristics of Cao Yongqing's prescription characteristics and medication rules for treating constipation. Methods:To collect the TCM prescription by Professor Cao Yongqing for treating constipation from Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine from January 1, 2007 to December 31, 2017. The Traditional Chinese Medicine Inheritance Support System (V2.5) was used to analyze the treatment frequency, taste, decoction pieces combination and decoction pieces association. By using entropy clustering rules to analyze the main combination and clustering rules of new combined prescriptions. Results:A total of 561 prescriptions were included, involving 113 kinds of pieces. The top 5 picecs with high frequency were Zhishi, Houpo, Dangshen, Fuling and Chuanlianzi in order of frequency, and the meridians were mainly spleen meridians, stomach meridians and liver meridians. There were 25 combined pieces with high-frequency, and the top 3 were Zhishi and Laifuzi and Houpo, Zhishi and Houpo and Chuanlianzi, as well as Zhishi and Laifuzi and Houpo and Chuanlianzi. There were 18 core combinations and 9 new prescriptions, including 4 prescriptions (44.4%) for promoting qi, such as prescriptions composed of Qingpi, Quangualou, Chenpi, Houpo, Laifuzi, Shengma, Zhishi and Chuanlianzi; 2 prescriptions for invigorating the spleen and eliminating dampness (22.2%), such as prescriptions composed of Fuling, Shengdihuang, Foshou, Jinyinhua, Dangshen and Baizhu; 2 prescriptions (22.2%) for promoting blood circulation and removing blood stasis, such as Danshen, Guanghuoxiang, Moyao and Danggui, one prescription (11.1%) for nourishing yin and qi was composed of Shihu, Shouwuteng, Huangqi, Fuling and Foshou. Conclusions:Regulating spleen and stomach, regulating qi and eliminating dampness, and promoting blood circulation are the main ideas of Professor Cao Yongqing in treating constipation.

Impact of gestational diabetes mellitus on vascular endothelial function in pregnant women / 中国医学影像技术

Objective: To explore the impact of gestational diabetes mellitus (GDM) on vascular endothelial function in pregnant women with endothelium-dependent flow-mediated dilatation (FMD) technology, and to observe the clinical value of FMD. Methods: Totally 29 pregnant women with GDM (observation group) and 34 normal pregnant women (control group) were collected. Endothelium-dependent FMD technology was used to obtain the right brachial artery FMD value before pregnancy, on the metaphase of pregnancy and 12 weeks postpartum. Clinical data, including pregnant women's age, heart rate, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride and oral glucose tolerance test (OGTT) results were recorded and compared between 2 groups. FMD values were analyzed between groups and within group at different time points, and the impact factors of FMD values were explored. Results: FMD values showed first downward and then rising trend in both 2groups. Statistical differences of FMD values were found between observation group (F=85.50) and control group (F=89.59) at all 3 time points (all P0.05), while FMD of metaphase pregnancy (F=16.88) and 12 weeks postpartum (F=60.83) in control group were both larger than in observation group (both P<0.05).Blood glucose 2 hours after taking sugar and diastolic blood pressure had obvious impact on FMD value. Conclusion: GDM may lead to irreversible vascular endothelial dysfunction in pregnant women. Using FMD technology can noninvasively evaluate vascular endothelial function of GDM, which is expected to provide a new way for screening postpartum cardiovascular and cerebrovascular diseases in GDM pregnant women.

CRISPR/Cas9 knockout plin1 enhances lipolysis in 3T3-L1 adipocytes / 生物工程学报

We used CRISPR/Cas9 to delete plin1 of 3T3-L1 preadipocyte, to observe its effect on lipolysis in adipocytes and to explore regulatory pathways. We cultured 3T3-L1 preadipocytes, and the plin1 knockout vectors were transfected by electroporation. Puromycin culture was used to screen successfully transfected adipocytes, and survival rates were observed after transfection. The optimized "cocktail" method was used to differentiate 3T3-L1 preadipocytes. The glycerol and triglyceride contents were determined by enzymatic methods. The changes in lipid droplet form and size were observed by Oil red O staining. The protein expression of PLIN1, PPARγ, Fsp27, and lipases was measured by Western blotting. RT-PCR was used to measure the expression of PLIN1 and lipases mRNA. After the adipocytes in the control group were induced to differentiate, the quantity of tiny lipid droplets was decreased, and the quantity of unilocular lipid droplets was increased and arranged in a circle around the nucleus. Compared with the control group, the volume of unilocular lipid droplets decreased, and the quantity of tiny lipid droplets increased after induction of adipocytes in the knockout group. The expression of PLIN1 mRNA and protein in the adipocytes was significantly inhibited (P<0.05); glycerol levels increased significantly (0.098 4±0.007 6), TG levels decreased significantly (0.031 0±0.005 3); mRNA and protein expression of HSL and ATGL increased (P<0.05); PPARγ and Fsp27 expression unchanged in adipocytes. The above results indicate that the knockout of plin1 enhances the lipolysis of 3T3-L1 adipocytes by exposing lipids in lipid droplets and up-regulating lipases effects.

Clinical effect of linear mastoplasty in treatment of mastoptosis / 中华医学美学美容杂志

Objective To evaluate the effect of Lejours' procedure in the treatment of breast prolapse.Methods From July 2014 to July 2018,the Second People's Hospital of Guangdong Prov ince accepted 36 female patients with breast prolapse and correction failure,aged 25 42 years,with an average age of 32.1 years.According to the preoperative design,the pedicel epidermis,the redundant skin,the prosthesis and capsule were removed,and the mammary flap was fixed on the fascia of pectoralis major muscle,and the nipple and areola were fixed and sutured layer by layer.Results In 36 cases,the shape of breast was improved,the scar of incision was smaller,and the color of scar became lighter with time.There were no serious complications such as nipple and areola necrosis.The breast was straight and round after operation.After 6-24 months follow-up,one patient had delayed wound healing and received repeated dressing changes for 7 days.Conclusions The design of the op eration is simple,with little scar,few complications and good long term effect.The shape of the breast after repair is round and straight,which can be used as one of the feasible operation methods for the repair of breast ptosis.