Surveillance of adverse events following immunization with human papillomavirus vaccines in Hangzhou City from 2017 to 2021 / 预防医学

Objective@#To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines.@*Methods@#The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed.@*Results@#Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. @*Conclusions@#Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

Network pharmacology analysis and molecular docking verification of the mechanism of Zhenqi Fuzheng Capsule in the adjuvant treatment treatment of AIDS / 国际中医中药杂志

Objective:To analyze the molecular mechanism of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS by network pharmacology method and molecular docking technology.Methods:The active components and targets of Zhenqi Fuzheng Capsules were obtained through TCMSP, and the AIDS-related targets were obtained through GeneCards, OMIM and DrugBank databases. The intersection target PPI network was constructed through STRING 11.5 database, and Cytoscape 3.9.1 software was used for network topology analysis; Metascape database was used for GO function and KEGG pathway enrichment analysis of core targets; Cytoscape 3.9.1 was used to construct Zhenqi Fuzheng Capsules component-target-pathway network; Autodock Tools software was used to carry out molecular docking of core targets and active components.Results:Totally 31 active components and 180 targets of Zhenqi Fuzheng Capsules were screened out. TNF, IL6, AKT1, IL1B, TP53, VEGFA, RELA, EGFR and CASP3 were identified as the core targets. GO functional enrichment analysis obtained 1 436 biological processes, 53 cellular components, and 117 molecular functions. KEGG pathway enrichment analysis obtained 167 pathways, which were related to pathways in cancer, AGE-RAGE signaling pathway in diabetic complications, and IL-17 signaling pathway was closely related. Molecular docking results showed that core targets such as AKT1 and TNF had good binding activity to quercetin, kaempferol, and luteolin.Conclusion:The main active components of Zhenqi Fuzheng Capsules in the adjuvant treatment of AIDS are quercetin, kaempferol and luteolin, which may treat AIDS through the IL-17 signaling pathway.

Genetic testing and clinical analysis of a patient with Dilated cardiomyopathy due to variant of FLNC gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a patient with Dilated cardiomyopathy.@*METHODS@#A patient admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University in April 2022 was selected as the study subject. Clinical data and family history of the patient was collected. Targeted exome sequencing was carried out. Candidate variant was verified by Sanger sequencing and bioinformatic analysis based on guidelines of the American College of Medical Genetics and Genomics (ACMG).@*RESULTS@#DNA sequencing revealed that the patient has harbored a heterozygous c.5044dupG frameshift variant of the FLNC gene. Based on the ACMG guidelines, the variant was predicted to be likely pathogenic (PVS1+PM2_Supporting+PP4).@*CONCLUSION@#The heterozygous c.5044dupG variant of the FLNC gene probably underlay the pathogenesis in this patient, which has provided a basis for the genetic counseling for his family.

Severe diabetic foot repaired by tibial bone transverse transport combined with flap transfer: Report of 7 cases / 中华显微外科杂志

Objective:To investigate the clinical effect of Ilizarov technique of tibial bone transverse transport combined with flap transfer in the treatment of severe diabetic foot.Methods:From April 2016 to March 2020, 7 patients with severe diabetic foot were treated by Ilizarov technique of tibial bone transverse transport combined with flap transfer in the Department of Hand and Foot Surgery of Foshan Nanhai Public Health Hospital. Diabetes Wagner classification: 2 cases were in Grade 3, in which, 1 case was ulcer in right heel and deep plantar with abscess and infection, and 1 case was ulcer in left great toe and phalanx infection; Other 5 cases were in Grade 4, of them, 2 cases were gangrene in proximal and distal of left great toe, 1 case were gangrene and infection in proximal, middle and distal segment of right 2nd toe, 1 case were gangrene and infection in proximal, middle and distal segment of left 4th toe, and 1 case were gangrene in distal segment of left 4th toe. Wound area was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Sural neurouascular flaps were used in 1 case, dorsal plantar artery flaps in 4 cases and medial plantar artery flaps in 2 cases. Size of flap was 2.0 cm×2.0 cm-6.0 cm×12.0 cm. Follow-up was conducted regularly by outpatient clinic, telephone and WeChat interviews. Content of the follow-up included foot wound healing, skin temperature of dorsal foot, lower limb paralysis, puncture exudation of external fixation stent, and blood supply of calf skin. Foot function was assessed according to the American Orthopedic Foot and Ankle Association (AOFAS) score.Results:All 7 patients entered the follow-up for 6-28 months, with an average of 8.2 months. All the foot ulcers healed. The pain of affected limbs eased off in 5 patients, and 2 patients had significant pain relief in affected limbs. Foot paralysis significantly alleviated in 7 patients, with calf skin temperature increased (1.81±0.56) ℃, and no recurrence of foot ulcers. According to AOFAS score, 3 cases were excellent, 3 cases were good and 1 case was fair.Conclusion:Ilizarov technique of tibial bone transverse transposition combined with flap transfer in the treatment of severe diabetic foot has a good clinical effect and it could be an option in the treatment of diabetic foot.

Analgesic effect of α-cobratoxin on mice and its effect on protein kinase A activity of spinal dorsal root ganglion in mice / 中华行为医学与脑科学杂志

Objective:To study the analgesic effect of α-cobratoxin (α-CbTX) on mice and its effect on protein kinase A (PKA) activity of spinal dorsal root ganglion (DRG) in mice.Methods:Healthy male ICR mice( n=102) were randomly divided into low-, medium-, and high-dose α-CbTX groups (1 mg/kg, 3 mg/kg, 9 mg/kg respectively, gavage, n=21), solvent control group (equivalent volume of 0.9% normal saline, gavage, n=21), morphine positive control group (3 mg/kg, intraperitoneal injection, n=6)or aspirin positive control group(300 mg/kg, gavage, n=12). The analgesic effect of α-CbTX was evaluated by hot plate test, acetic acid twisting test and formalin foot licking test. Formalin plantar injection was used to induce pain and then the L4-L6 DRG was taken 30 minutes later. The expression of PKA C-α in L4-L6 DRG of mice were detected by Western blot.SPSS 16.0 software was used for statistical analysis. Repeated measurement ANOVA was used to evaluate the hot plate experimental data, and one-way ANOVA was used for other experimental data. LSD- t test was used for further pairwise comparison. Results:In the hot plate test, the interaction between group and time of mice paw licking latency was significant ( F=8.902, P<0.05). At 0.5 h after administration, the paw licking latencies of α-CbTX medium-dose group ((11.83±1.47)s)and α-CbTX high-dose group (( 14.33±12.1)s) were both longer than that of solvent control group((8.17±0.75) s) ( t=4.461, 7.053, both P<0.05). The efficacy of α-CbTX medium dose group lasted until 1.5 h after administration (all P<0.05), and that of α-CbTX high dose group lasted until 2 h after administration(all P<0.05). In the acetic acid writhing test, the writhing times in the low-, medium- and high-dose α-CbTX group((34.50±3.62) times, (26.17±2.40) times, (13.83±3.76) times)) were significantly lower than that in solvent control group ((42.50±4.59) times) ( t=3.938, 8.040, 14.112, all P<0.05). In the period of the formalin test phase Ⅱ, the total licking time of α-CbTX low-, medium- and high-dose groups ((71.17±6.46) s), (54.67±6.41) s, (40.50±3.89)s) were significantly shorter than that of the solvent control group ((98.67±11.50) s)( t=6.950, 11.120, 14.700, all P<0.05). In the Western blot experiment, compared with solvent control group (0.22±0.01), the levels of PKA C-α in the DRG of mice in low-, medium- and high-dose α-CbTX groups ((0.31±0.02), (0.41±0.03), (0.44±0.02)) were up-regulated ( t=3.140, 6.471, 7.492, all P<0.05). Conclusion:α-CbTX has obvious analgesic effect, and its analgesic mechanism may be related to the activation of PKA.

Study on quality standard for rice-fired Glehnia littoralis / 中国药房

OBJECTIVE To establish a quality standard for rice-fired Glehnia littoralis . METHODS Appearance observation ， powder microscopic identification and thin-layer chromatography （TLC）identification were performed for the samples of rice-fired G. littoralis decoction piece. According to the relevant methods stated in 2020 edition of Chinese Pharmacopoeia （part Ⅳ），the contents of moisture ，total ash ，acid-insoluble ash ，water-soluble extract and acid-soluble extract were determined. The contents of psoralen，zanthoxylin，bergapten，imperatorin and isoimperatorin were determined by high performance liquid chromatography （HPLC）. RESULTS The rice-fired G. littoralis decoction pieces were round-like small segments ，slightly rough ，yellow（peeled） or dark yellowish brown （with peel ），special gas and slightly sweet taste. The powder was yellowish white. Under the microscope ， secretions and secretory cells ，ducts，gelatinized starch granules ，ray cells ，parenchyma cells ，etc. could be seen. TLC showed the spots developed clearly. In the chromatogram of the test sample ，there was the same blue fluorescent spot at the corresponding position of the chromatogram of isoimperatorin control sample. The moisture ，total ash ，acid-insoluble ash ，water-soluble extract and ethanol-soluble extract from 9 batches of samples were 5.82％-6.27％，3.19％-3.59％，0.21％-0.27％，24.91％-30.30％ and 20.66％ -25.83％ ，respectively. The linear range of psoralen ，zanthotoxin，bergapten，imperatorin and isoimperatorin were 0.240-2.400，0.320-3.200，0.224-2.240，0.292-2.920，0.208-2.080 µg/mL（all r＞0.999 0）. Limits of quantitation were 0.032 0， 0.030 0，0325 0，0.032 0，0.045 0 µg，respectively. Limits of detection were 0.100 8，0.089 6，0.071 5，0.090 0，0.132 0 µg， respectively. RSDs of prescision ，stability（24 h）and reprodu- cibility tests were less than 3％. Average recoveries were 100.56％ （RSD＝1.36％ ，n＝6），100.73％（RSD＝2.25％ ，n＝6）， 100.36％（RSD＝0.98％，n＝6），98.24％（RSD＝0.40％，n＝6） E-mail：853063968@qq.com and 99.40％（RSD＝0.35％，n＝6），respectively. The contents of above five components were 5.85-13.31，8.63-33.38，6.23- E-mail：shixiaofeng2005@sina.com 15.25，6.12-12.98，5.52-10.77 µg/g，respectively. The total contents were 34.20-83.47 µg/g. CONCLUSIONS It is preliminarily proposed that the moisture ，total ash and acid-insoluble ash should not exceed 7.30％，4.10％，0.30％. The water-soluble extract and ethanol-soluble extract are no less than 21.00％ and 18.00％，respectively. The total content of coumarin should not be less than 52.03 µg/g（with peel ）and 26.34 μg/g（peeled）. Established quality standard can be used for the quality control of rice-fired G. littoralis .

Study on the purification technology of total triterpenoid extracts from Inonotus obliquus and their anti -tumor activity in vitro / 中国药房

OBJECTIVE To optimite the purification technology of total triterpenoid extracts from Inonotus obliquus ，and to investigate the anti -tumor activity of its purified products . METHODS Using inotodiol as control ，the method was established for the content determination of total triterpenoid in I. obliquus. The type of macroporous adsorption resin ，sample volume ，sample concentration，sample flow rate ，eluent volume ，eluent dosage and elution flow rate were selected by single factor experiments . The purification technology of the crude extract was determined and verified . The effects of total triterpenoid purified from I. obliquus on the proliferation ，migration and apoptosis of human cervical cancer HeLa cells were detected by cell proliferation test ， migration test ，flow cytometry and AO/EB kit . RESULTS The best purification technology of total triterpenoid crude extracts from I. obliquus was as follows ：AB-8 macroporous adsorption resin was used ；mass concentration of the sample solution was 2.0 mg/mL；sample volume was 140 mL，and the flow rate was 1.0 mL/min；the impurity was removed with 50% ethanol 40 mL， then eluted with 95% ethanol 160 mL，at the elution flow rate of 3.0 mL/min. After purification ，mass concentration of total triterpenoid from I. obliquus increased from 34.36% to 73.39%. The total triterpenoid of I. obliquus could inhibit the proliferation of HeLa cells ，and the 50% inhibitory concentration was 184.20 μg/mL. Compared with control group ，the purified products could significantly inhibit the migratio n and promote the apoptosis of HeLa cells （P＜0.05 or P＜0.01）. CONCLUSIONS The purification technology of total triterpenoids extracts from I. obliquus is successfully optimited . The purified product could inhibit the proliferation and migration of HeLa cells and induce their apoptosis.

Effect of Total Flavonoids in Flower of Paeonia suffruticosa on Uric Acid in Rats with Hyperuricemia / 中国实验方剂学杂志

ObjectiveTo explore the pharmacodynamic effects of total flavonoids of Paeonia suffruticosa flower （TFPFs） on rats with hyperuricemia and provide scientific data support for the research and development of therapeutic drugs for hyperuricemia. MethodThe hyperuricemia model was induced by adenine combined with ethambutol in rats. The rats were randomly divided into a blank control group， a model group， two positive control groups （allopurinol at 42 mg·kg-1 and Tongfengshu tablets at 600 mg·kg-1）， and high-， medium-， and low-dose TFPFs groups （260， 130， and 65 mg·kg-1）. The general conditions of rats were observed and recorded， and the body weight was recorded once every 5 days. The 24-hour urine volume， water intake， uric acid （UA）， and urinary protein of rats were determined after the last administration. The kidney index was calculated. The pathological changes in thymus and spleen tissues of rats were observed by hematoxylin-eosin （HE） staining. The serum activities of UA， creatinine （Cr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， and total antioxidant capacity （T-AOC） of rats were determined. The xanthine oxidase （XOD） and adenosine deaminase （ADA） activities in the liver were detected. The content of uric acid transporter 1 （URAT1）， organic anion transporter 1 （OAT1）， and glucose transporter 9 （GLUT9） in the kidney was detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the results in the model group， TFPFs could improve the mental state of rats， increase the body weight（P<0.01）， promote UA excretion（P<0.01）， reduce the content of urinary protein（P<0.05）， relieve renal glomerular atrophy， renal tubular epithelial cell status， and urate crystal deposition in renal tubules， dwindle 24-hour urine volume， water intake， kidney index（P<0.05）， serum levels of UA， Cr， BUN， and MDA（P<0.05，P<0.01）， inhibit the activities of XOD（P<0.05） and ADA（P<0.05，P<0.01）in the liver， diminish the expression of GLUT9 in the renal homogenate（P<0.05）， and increase serum SOD and T-AOC activities as well as OAT1 expression（P<0.01） in the kidney. The pathological changes of thymus and spleen were improved. ConclusionTFPFs possess a protective effect on the kidney of rats with hyperuricemia， which is achieved by promoting uric acid excretion， inhibiting oxidation and the activity of key enzymes in uric acid synthesis， and regulating the expression of uric acid transporters.

Effect of Total Flavonoids in Flower of Paeonia suffruticosa on Uric Acid in Rats with Hyperuricemia / 中国实验方剂学杂志

ObjectiveTo explore the pharmacodynamic effects of total flavonoids of Paeonia suffruticosa flower （TFPFs） on rats with hyperuricemia and provide scientific data support for the research and development of therapeutic drugs for hyperuricemia. MethodThe hyperuricemia model was induced by adenine combined with ethambutol in rats. The rats were randomly divided into a blank control group， a model group， two positive control groups （allopurinol at 42 mg·kg-1 and Tongfengshu tablets at 600 mg·kg-1）， and high-， medium-， and low-dose TFPFs groups （260， 130， and 65 mg·kg-1）. The general conditions of rats were observed and recorded， and the body weight was recorded once every 5 days. The 24-hour urine volume， water intake， uric acid （UA）， and urinary protein of rats were determined after the last administration. The kidney index was calculated. The pathological changes in thymus and spleen tissues of rats were observed by hematoxylin-eosin （HE） staining. The serum activities of UA， creatinine （Cr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， and total antioxidant capacity （T-AOC） of rats were determined. The xanthine oxidase （XOD） and adenosine deaminase （ADA） activities in the liver were detected. The content of uric acid transporter 1 （URAT1）， organic anion transporter 1 （OAT1）， and glucose transporter 9 （GLUT9） in the kidney was detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the results in the model group， TFPFs could improve the mental state of rats， increase the body weight（P<0.01）， promote UA excretion（P<0.01）， reduce the content of urinary protein（P<0.05）， relieve renal glomerular atrophy， renal tubular epithelial cell status， and urate crystal deposition in renal tubules， dwindle 24-hour urine volume， water intake， kidney index（P<0.05）， serum levels of UA， Cr， BUN， and MDA（P<0.05，P<0.01）， inhibit the activities of XOD（P<0.05） and ADA（P<0.05，P<0.01）in the liver， diminish the expression of GLUT9 in the renal homogenate（P<0.05）， and increase serum SOD and T-AOC activities as well as OAT1 expression（P<0.01） in the kidney. The pathological changes of thymus and spleen were improved. ConclusionTFPFs possess a protective effect on the kidney of rats with hyperuricemia， which is achieved by promoting uric acid excretion， inhibiting oxidation and the activity of key enzymes in uric acid synthesis， and regulating the expression of uric acid transporters.

Epidemiology of overweight and obesity among high school seniors in Beijing / 中国学校卫生

Objective@#To analyze the prevalence and changing trend of overweight and obesity among high school seniors in Beijing from 2009 to 2018, and to provide scientific basis for health and education departments to work out effective measures to prevent and control overweight and obesity among adolescents.@*Methods@#The physical examination data of 700 588 high school seniors in Beijing from 2009 to 2018 were selected to describe the distribution characteristics of the detection rate of overweight and obesity, and to analyze whether there are differences in the prevalence of overweight and obesity among different genders and regions.@*Results@#From 2009 to 2018, the prevalence rate of total overweight and obesity of high school seniors in Beijing showed an increasing trend by year ( χ 2=3.58, P <0.01). After 2016, the rising trend was more stable, and it declined for the first time in 2018. The prevalence of overweight ( χ 2=6 681.34, P <0.01) and obesity ( χ 2=15 663.08, P <0.01) were higher in male than in female. The prevalence of overweight and obesity in urban students was higher than that in suburban students (29.55%,27.95%; χ 2=211.43, P < 0.01 ), the prevalence of obesity in urban students was higher than that in suburban students from 2009 to 2013, and the prevalence of obesity in suburban students was higher than that in urban students from 2014 to 2018. The districts and counties with the highest detection rates of overweight and obesity are Shijingshan District (overweight: 19.06%, obesity: 13.99%), and the districts and counties with the lowest detection rates of overweight and obesity are Yanqing District (overweight: 13.48%, obesity: 7.18%).@*Conclusion@#From 2009 to 2018, the prevalence of overweight and obesity among high school seniors in Beijing has been increasing by year, and tends to be stable after 2016. Significant upward trend in obesity prevalence in suburban areas of Beijing has been observed.

Comparison of the efficacy of unilateral biportal endoscopic and microscopic discectomy in treatment of lumbar disc herniation / 西安交通大学学报(医学版)

【Objective】 To compare the clinical efficacy of unilateral biportal endoscopic （UBE） and microscopic discectomy in the treatment of lumbar disc herniation （LDH） and to explore the safety and effectiveness of this operation. 【Methods】 A total of 87 LDH patients from July 2018 to July 2021 were analyzed retrospectively， including 42 cases of unilateral biportal endoscopic discectomy and 45 cases of microscopic discectomy. Analysis was based on comparison of perioperative metrics， operation time， and estimated blood loss. Clinical outcomes were evaluated using visual analogue scale （VAS）， Oswestry disability index （ODI） and modified Macnab criterion. 【Results】 All patients were followed up for 13.3±1.18 months. In UBE group， operation time （57.12±6.35） min was shorter than that in the microscope group （62.21±7.09） min and estimated blood loss （29.31±3.62） mL was smaller than that in the microscope group （51.77±8.43） mL， with a significant difference （P0.05）. Dural sac tear occurred in 2 cases in UBE group and 3 cases in the microscope group； the incidence was not statistically significant （P>0.05）. Modified MacNab criterion evaluation at the last follow-up showed that 32 cases were excellent in UBE group， 7 cases were good， and 3 cases were fair， with the excellent and good rate of 92.9% （39/42）. The microscope group was excellent in 31 cases， good in 10 cases， and fair in 4 cases， with the excellent and good rate of 91.1% （41/45）. 【Conclusion】 UBE for LDH has a satisfactory short-term clinical efficacy， with the advantages of less trauma， greater efficiency， clear vision， and large operating space. Both UBE and microscopic discectomy can achieve good clinical results in treating LDH， but the former has the advantages of less trauma， high efficiency， and quick postoperative recovery.

Establishment of HPLC Fingerprint and Content Determination of 5 Components in Papaveris Pericarpium / 中国药房

OBJECTIVE：To establish the fingerprint of Papaveris Pericarpium， and to determine the contents of 5 components，such as morphine ，codeine，thebaine，papaverine and narcotine. METHODS ：HPLC method was adopted. The determination was performed on a Agilent ZORBAX Eclipse XDB-C18 column with mobile phase consisted methanol -sodium heptanesulfonate with gradient elution at the flow rate of 1.0 mL/min. The detection wavelength were set at 238 nm（papaverine） and 216 nm（morphine，codeine，narcotine，thebaine）. The column temperature was 20 ℃，and sample size was 10 µL. HPLC fingerprints of 15 batches of Papaveris Pericarpium were established by using the Similarity Evaluation System of TCM Chromatographic Fingerprints （2012 edition），and the common peaks were determined in combination with the spectra of mixed control. The contents of morphine ，codeine，thebaine，papaverine and narcotine were determined simultaneously by the same method. The cluster analysis was conducted by using SPSS 19.0 software. RESULTS ：There were 13 common peaks in 15 batches of Papaveris Pericarpium ，and the similarity was greater than 0.99. Five chromatographic peaks were identified ，which were morphine，codeine，thebaine，papaverine and narcotin. The results of cluster analysis showed that 15 batches of Papaveris Pericarpium could be clustered into two categories ，S1-S7 and S 8-S15，belonging to two cities. The linear ranges of five components were 10.21-102.10，10.43-104.30，1.54-30.70，2.36-47.28，2.32-57.90 μg/mL，respectively（all r＞0.998）. RSDs of precision，stability（24 h）and repeatability tests were all less than 2％. The average recoveries were 99.46％（RSD＝1.08％，n＝ 6），97.84％（RSD＝1.55％，n＝6），91.10％（RSD＝1.74％，n＝6），96.43％（RSD＝1.25％，n＝6）、94.82％（RSD＝1.20％，n＝6）， respectively. The contents of 5 components were 2.342 9-4.082 2，0.430 4-0.889 7，0.055 2-0.090 4，0.299 3-0.558 8，0.343 2- 0.656 2 mg/g. CONCLUSIONS ：The established HPLC fingerprint and content determination method is simple ，feasible，sensitive and accurate. It combined with the cluster analysis could reflect characteristics and int ernal quality of chemical components in Papaveris Pericarpium . Papaveris Pericarpium in different cities possess regionalization characteristics ，but its quality isbasically stable.

Association of antinuclear antibody status with clinical features and malignancy risk in adult patients with dermatomyositis / 中华皮肤科杂志

Objective:To investigate the relationship of antinuclear antibody (ANA) status with clinical features and malignancy risk in adult patients with dermatomyositis.Methods:A retrospective analysis was performed to analyze clinical data from 101 inpatients with dermatomyositis in Department of Dermatology, the First Affiliated Hospital of Soochow University from April 2008 to April 2018. These patients were divided into ANA-positive group and ANA-negative group, and differences in myopathy and malignancy risks as well as other clinical features were analyzed between the 2 groups. A 2-year follow-up was undertaken among 92 patients. Chi-square test was used to analyze and compare clinical features between the 2 groups, and a multivariate regression model was used to analyze the relationship of ANA status with amyopathic dermatomyositis and malignancies.Results:Among the 101 patients with dermatomyositis, there were 42 males and 59 females, aged 55.13 ± 14.63 years; 14 patients had amyopathic dermatomyositis, 6 patients had hypomyopathic dermatomyositis, and 81 patients had myopathic dermatomyositis; 42 (41.58%) cases were positive for ANA, and 59 (58.41%) were negative for ANA. Compared with the ANA-negative group, the ANA-positive group showed significantly decreased incidence of cervical erythema (33.33% vs. 59.32%, P=0.010) and shawl sign (14.28% vs. 35.59%, P=0.017) . Twenty-eight (27.72%) patients with dermatomyositis were complicated by malignancies. Malignancies were found in 5 (11.9%) of ANA-positive patients, and in 23 (38.98%) of ANA-negative patients. Univariate analysis showed that ANA-negative patients with dermatomyositis had a higher risk of malignancies compared with ANA-positive patients with dermatomyositis, with an odds ratio of 7.52 (95% CI: 1.62-13.78, P=0.003) . In the multivariate regression model, the absence of ANA ( OR=4.34, 95% CI: 1.37-13.72, P=0.012) and cervical erythema ( OR=3.27, 95% CI: 1.20-8.91, P=0.020) were associated with high incidence of malignancies, while the absence of ANA was not significantly correlated with the occurrence of amyopathic dermatomyositis ( OR=0.99, 95% CI: 0.32-2.99, P=0.980) . Conclusions:ANA-negative adult dermatomyositis patients with cervical erythema had an increased risk of malignancies. Thus, close follow-up and regular tumor screening are necessary in these patients.

The clinical application of robot-assisted one-step transperitoneal nephroureterectomy for upper urinary tract urothelial carcinoma / 中华泌尿外科杂志

Objective:To explore the clinical application of robot-assisted laparoscopic single-position nephroureterectomy and bladder sleeve resection for upper urinary tract urothelial carcinoma (UTUC).Methods:The clinicopathological data of 15 UTUC patients admitted to Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from October 2018 to May 2020 were retrospectively analyzed. There were 8 males and 7 females, with a median age of 58.6 (ranging 52.6-69.6) years, including 8 cases of renal pelvic cancer, 2 cases of upper ureteral cancer, 5 cases of middle and lower ureteral cancer.The tumor located on the left side in 5 cases and right side in 10 cases. All 15 patients underwent robot-assisted one-step transperitoneal nephroureterectomy and bladder sleeve resection by the same surgeon. The patients were placed in a 70° healthy side lying position with a 10° head lower and foot high position. After routinely dissecting the kidneys and controlling the renal hilum, we continued to dissect the ureter down to the orifice of the bladder. The lymph node dissection was performed when dissecting the kidney and ureter. Then the ureter was resected like a sleeve and the bladder was sutured. Observation indicators, such as operation time, blood loss, postoperative drainage tube and urinary catheter placement days, were recorded.Results:All 15 patients were successfully completed the operation in the same position and the same robot berth without conversion. The median operation time was 103 (ranging 82-185) min, and the intraoperative median blood loss was 60 (ranging 30-120) ml. The postoperative median drainage catheter placement time was 3 (ranging 2-5) d, the postoperative median hospital stay was 5 (ranging 4-7) d, and the postoperative urinary catheters were placed for 14 days. Postoperative pathological examinations of 15 patients showed UTUC without positive margins. The median follow-up time was 15 (ranging 10-30) months. All 15 patients survived. One patient was found a recurrence in the bladder after cystoscopy. There was no tumor progression after bladder tumor resection and bladder perfusion chemotherapy, and no tumor recurrence or metastasis was seen in the remaining 14 cases.Conclusions:Robot-assisted single-position transperitoneal nephroureterectomy for UTUC does not need to change patient position and robot berth, which effectively shortens the operation time, and achieves good tumor control effect. The short-term follow-up results were satisfactory.

Analysis of curative effect of radical surgery for T 4 stage prostate cancer invading bladder neck / 中华泌尿外科杂志

Objective:To investigate the curative efficacy of radical prostatectomy (RP) for T 4 stage prostate cancer invading bladder neck. Methods:The clinical data of 22 patients with T 4 stage prostate cancer invading bladder neck treated with RP from April 2013 to March 2021 were analyzed retrospectively. The mean age of the patients was (64.09±6.33) years, and the preoperative blood PSA was 57.70(39.40, 68.56) ng/ml. Preoperative MRI or PSMA-PET examination revealed bladder neck invasion, including 16 cases (72.73%) of urinary retention. Clinical stage of T 4N 0M 0 accounted for 40.91% (9/22), T 4N 1M 0 accounted for 45.45% (10/22), and T 4N 1M 1 accounted for 13.64% (3/22). Preoperative patients were not treated with neoadjuvant endocrine or chemotherapy. Laparoscopic or robotic assisted laparoscopic radical prostatectomy and pelvic lymph node dissection were performed. Results:The 22 operations were successfully completed without conversion. The operation time was(184.27±34.82) min, the amount of intraoperative bleeding was (210.91±83.03) ml, the retention time of drainage tube was (4.73 ± 1.03) days, the recovery of gastrointestinal function took 3 (2, 3) days, and the postoperative hospital stay was (6.68 ± 1.39) days. Postoperative pathology showed that the Gleason score of 7 points accounted for 4.54% (1/22), 8 points accounted for 13.64% (3/22), and 9 points accounted for 81.82% (18/22). The positive rate of margin was 81.82% (18/22). Pathological stage of T 4N 0M 0 accounted for 22.73% (5/22), T 4N 1M 0 accounted for 63.64% (14/22), and T 4N 1M 1 accounted for 13.64% (3/22), of which extracapsular or seminal vesicle invasion accounted for 90.91% (20/22). The incidence of postoperative complications above grade 3 was 9.09% (2/22), and the rate of urinary control recovery after 3 months of surgery was 90.91% (20/22). 16 patients with preoperative urinary retention were able to urinate normally after operation. All patients were treated with adjuvant androgen deprivation therapy (ADT) with or without antiandrogens, and 13 cases (59.09%) were treated with adjuvant radiotherapy. The postoperative PSA value before adjuvant treatment was 2.53 (0.51, 5.44) ng/ml. The median survival time was not reached. Two patients died of prostate cancer at 71 and 84 months and one patient died of heart disease at 28 months. Conclusions:RP surgery could effectively relieve the condition of urinary retention with low incidence of operative complications. Although the positive rate of surgical margin is high, RP could be used as one of the treatment options for T 4 stage prostate cancer invading bladder neck, while the long-term effect is still needed to be further analyzed.

Effect of anesthesia factor on postoperative outcome in patients undergoing thoracoscopy: a comparison between different analgesic methods / 中华麻醉学杂志

Objective:To evaluate the effect of anesthesia factor on postoperative outcome in patients undergoing thoracoscopy through a comparison between different analgesic methods.Methods:One hundred patients of both sexes, aged 18-64 yr, with body mass index of 18.5-24.0 kg/m 2, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective single-hole thoracoscopic surgery, were divided into 4 groups ( n=25 each) using a random number table method: control group (group C), erector spinae plane block (ESPB) group (group E), thoracic paravertebral nerve block (TPVB) group (group T), and ESPB combined with TPVB group (ET group). Before induction of anesthesia, ultrasound-guided nerve block was performed, and ESPB, TPVB, and ESPB combined with TPVB were performed on the affected side in E, T and ET groups, respectively.The mixture of 0.5% ropivacaine 20 ml and dexamethasone 5 mg was injected in T and E groups, and 0.5% ropivacaine 5 ml was injected into the paravertebral space, the needle tip was retracted to touch the transverse bone, and then another 15 ml was injected in group ET.The block plane was detected by acupuncture at 15 min after completion of the nerve block, and successful nerve block was defined as the block plane reaching T 4-6 in the areas innervated by the spinal nerve.Both groups received patient-controlled intravenous analgesia(PCIA) and were admitted to postanesthesia care unit after surgery.Flurbiprofen axetil 50 mg was intravenously injected as rescue analgesic when the visual analog scale(VAS)score was more than 3.Venous blood samples were collected immediately before nerve block operation (T 0), 30 min after operation (T 1), 30 min after tracheal extubation (T 2), and 24 h after operation (T 3) for determination of the concentrations of plasma cortisol and adrenocorticotropic hormone (ACTH) by enzyme-linked immunosorbent assay.The VAS score for cough was recorded at 15 min after tracheal extubation (T 4) and 6, 12, 24 and 48 h after surgery (T 5-8). The patients were followed up at 48 h after surgery.The pressing times of PCIA, consumption of flurbiprofen, and development of nausea and vomiting were recorded. Results:Compared with group C, VAS scores for cough were significantly decreased at T 4-6, the pressing times of PCIA was reduced, and the consumption of flurbiprofen, and incidence of nausea and vomiting and plasma Cor and ACTH concentrations at T 1-2 were decreased in the other three groups ( P<0.05). Compared with group E, VAS scores for cough at T 4, pressing times of PCIA and consumption of flurbiprofen were significantly decreased in T and ET groups ( P<0.05). There was no significant difference in each index between ET group and T group ( P>0.05). Conclusion:TPVB performs better than ESPB and TPVB combined with ESPB in improving the postoperative outcome of patients undergoing thoracoscopy.

Role of advanced assessment of adrenalectomy in urology standardized residency training / 中华医学教育探索杂志

Objective:To study and train urological resident's laparoscopic operation skills based on retroperitoneal laparoscopic adrenalectomy.Methods:From January 2011 to January 2020, 121 urology residents were selected to complete the basic skills training including laparoscopic simulator, and gradually engaged in and operated laparoscopic minimally invasive surgery for adrenal tumor. The training stage included training and examination of laparoscopic simulator module, establishment of lateral position and puncture hole in lumbar surgery, anatomy of kidney at three levels and exposure and removal of adrenal tumor. The training of four stages was completed by step-by-step advanced assessment.Results:Fifteen doctors could complete laparoscopic adrenalectomy operation under the supervision and guiding of teachers (12.4%), 71 residentss could independently complete the operation requirements in the first three stages (58.7%).Conclusion:The study has proved that the main factors affecting the advanced training of retroperitoneal laparoscopic adrenalectomy were the operation assessment score of laparoscopic simulator, the duration of the standardized residency training in urology department, the case number of participating in retroperitoneal laparoscopic adrenalectomy, and the times that teachers and training residents exchanged the positions of main knife and assistant during the operation.

Preparation of Chelerythrine Solid Dispersion and Study on Its Physicochemical Properties and Antioxidant Activity / 中国药房

OBJECTIVE：To prepare Cheler ythrine （CHE） solid dispe rsion （SD），optimize the formulation technology ， characterize its preparation and investigate its in vitro antioxidant activity. METHODS ：The content of CHE in SD was determined by UV spectrophotometry. Based on single factor tests ，using the product yield as index ，using preparation method ，carrier material type，carrier material proportion （drug-carrier material mass ratio ）as factors ，the formulation technology of SD was optimized by L（9 34）orthogonal test and validated. Based on solubility and accumulative dissolution determination ，the product was characterized with thermal analyssis ，X-ray diffraction and scanning electron microscope. Using ascorbic acid as positive control ，in vitro antioxidant activity of the product was determined by DPPH method. RESULTS ：The linear range of CHE was 2.4-5.6 μg/mL； quantitation limit and detection limit were 0.066 9，0.022 1 μg/mL；RSDs of precision ，stability and reproducibility tests were all lower than 2％；recoveries were 97.50％-99.25％（RSD＜1％， n＝3）. The optimal preparation technology included using PEG 6000 as carrier material ，carrier material ratio of 1 ∶ 3， prepared by solvent method. Three batches of CHE-PEG-SD were prepared. Verification test results showed that the 话：0539-80311889。E-mail：zhenshengao@163.com accumulative dissolution of CHE-PEG-SD was （61.72 ± 0.67）％ at 15 min，and the yield was （99.04±0.83）％. The results of characterization showed that after CHE-PEG-SD prepared ， its solubility （3.725 mg/mL）and accumulative dissolution （61.25％，15 min）were higher than CHE raw material [ 0.098 mg/mL， 6.24％（180 min）]. The endothermic peak and crystal absorption peak moved or even disappeared compared with raw material and the carrier material ，and CHE was uniformly dispersed in the carrier material as an amorphous state. Results of in vitro antioxidation test showed that different concentration of CHE-PEG-SD showed certain ability of DPPH free radical scavenging ，and the IC 50 was 0.124 mg/mL，higher than 0.041 mg/mL of ascorbic acid. CONCLUSIONS ：Established content determination method is simple and accurate. The optimal SD formulation technology is stable and feasible. The solubility of prepared CHE-PEG-SD increases，and the dissolution in vitro increases，showing certain in vitro oxidation resistance.

Content Determination of 17 Kinds of Amino Acids in Sargassum and Its Adulterants / 中国药房

OBJECTIVE：To establish the method for content determination of 17 kinds of amino acids in Sargassum and its adulterants，and to carry out cluster analysis ，so as to provide reference for quality control of Sargassum. METHODS ：Totally of 18 batches of sample （S1-S6 as certified product ，S7-S18 as adulterants ）were collected. After acid hydrolysis ，amino acids contents were detected by using automatic amino acid analyzer. The separation was performed on LCAK 06/Na sulfonic acid cation exchange resin column with mobile phase consisted of buffer-regeneration system （gradient elution ）at the flow rate of 0.45 mL/min （elution pump ）and 0.25 mL/min（derivative pump ）. The detection wavelengths were set at 440 nm（proline）and 570 nm（other amino acids ），and the sample size volume was 50 μL. PASW Statistics 18.0 software was used ，and cluster analysis was conducted by using group connection method of cluster analysis with “square Euclidean distance ”as the measurement standard. RESULTS ：17 kinds of amino acids were well separated without interference from blank sample. The linear relationship between mass concentration and peak area was good （all r were over 0.998），and the upper and lower limits of the linear range were 48.06 μg/L （cystine）and 1.501 μg/L（glycine），respectively；RSDs of precision ，reproducibility and stability tests were lower than 2％. The average recoveries were between 90.60％-101.56％（RSDs were 0.88％-2.15％，n＝6）. 17 kinds of amino acids were detected in Sargassum and its adulterants ，among which the contents of glutamic acid ，aspartic acid ，leucine，alanine，glycine and valine were relatively high . Results of cluster analysis showed that 18 batches of sample were clustered into 4 categories，i.e. S 1-S6 into one category；S7-S9 into one category ；S10-S12，S16-S18 into one category ；S13-S15 into one category ；which was consistent with the identification result of Sargassum and its adulterants . CONCLUSIONS ：The method is simple ， rapid， accurate and reproducible，and can be used for the quantitative analysis and identification of amino acids in Sargassum and adulterants.

Tuber borchii Shapes the Ectomycorrhizosphere Microbial Communities of Corylus avellana

In this study, eight-month-old ectomycorrhizae of Tuber borchii with Corylus avellana were synthesized to explore the influence of T. borchii colonization on the soil properties and the microbial communities associated with C. avellana during the early symbiotic stage. The results showed that the bacterial richness and diversity in the ectomycorrhizae were significantly higher than those in the control roots, whereas the fungal diversity was not changed in response to T. borchii colonization. Tuber was the dominant taxon (82.97%) in ectomycorrhizae. Some pathogenic fungi, including Ilyonectria and Podospora, and other competitive mycorrhizal fungi, such as Hymenochaete, had significantly lower abundance in the T. borchii inoculation treatment. It was found that the ectomycorrhizae of C. avellana contained some more abundant bacterial genera (e.g., Rhizobium, Pedomicrobium, Ilumatobacter, Streptomyces, and Geobacillus) and fungal genera (e.g., Trechispora and Humicola) than the control roots. The properties of rhizosphere soils were also changed by T. borchii colonization, like available nitrogen, available phosphorus and exchangeable magnesium, which indicated a feedback effect of mycorrhizal synthesis on soil properties. Overall, this work highlighted the interactions between the symbionts and the microbes present in the host, which shed light on our understanding of the ecological functions of T. borchii and facilitate its commercial cultivation.