Protective Effect of Zingiberis Rhizoma Recens on LPS-induced Acute Lung Injury in Mice Through TLR4/NF-κB Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the protective effect and mechanism of Zingiberis Rhizoma Recens alcohol extract on lipopolysaccharide （LPS）-induced acute lung injury in mice. MethodBalb/c mice were randomly divided into normal group， model group， dexamethasone group， and low- and high-dose Zingiberis Rhizoma Recens groups. Mice in the normal group were instilled with normal saline through the nose， and the other groups were instilled with normal saline containing LPS （50 μg）. After 30 minutes of modeling， the dexamethasone group was gavaged with 5 mg·kg-1 of dexamethasone acetate solution， the low- and high-dose Zingiberis Rhizoma Recens groups were gavaged with different doses of （7， 14 g·kg-1） of Zingiberis Rhizoma Recens alcohol extract， and the normal group and the model group were gavaged with the same volume of water. After 24 hours of modeling， the total number of white blood cells in bronchoalceolar lavage fluid （BALF） was detected by cell counter， and the levels of the inflammatory factors including tumor necrosis factor （TNF）-α， interleukin （IL）-1β， IL-6， and superoxide dismutase （SOD）， and myeloperoxidase （MPO） was detected by enzyme-linked immunosorbent assay （ELISA）. Haematoxylin-eosin （HE） staining method was used to observe the pathological changes of lung tissue in each group， and the Western blot was used to detect the protein expression of nuclear transcription factor （NF）-κB p65， phosphorylation （p）-NF-κB p65， and Toll-like receptor 4 （TLR4） in lung tissue. ResultCompared with the normal group， the white blood cell count in BALF and the levels of TNF-α， IL-1β， IL-6， and MPO in the model group was increased （P<0.01）， and the level of SOD was decreased （P<0.05）. Pathological damage of lung tissue was obvious， and the protein expression of NF-κB p65， p-NF-κB p65， and TLR4 in lung tissue was increased （P<0.01）. Compared with the model group， the white blood cell count in BALF and the levels of TNF-α， IL-1β， IL-6， and MPO in the treatment group was decreased （P<0.05，P<0.01）， and the level of SOD was increased （P<0.05，P<0.01）. Pathological damage of lung tissue was alleviated， and the protein expression of NF-κB p65， p-NF-κB p65， and TLR4 in lung tissue was decreased （P<0.01）. ConclusionZingiberis Rhizoma Recens alcohol extract may play a protective role in LPS-induced acute lung injury in mice by inhibiting the TLR4/NF-κB signaling pathway.

Effects of iodine excess on antioxidant capacity and blood lipid level in adult / 中华地方病学杂志

Objective:To study the effect of iodine excess on antioxidant capacity and blood lipid in adult.Methods:A survey was conducted in areas with different iodine nutrition levels in Shandong and Shanxi provinces to collect fasting morning urine and venous blood samples of adults. Urinary iodine, serum levels of superoxide dismutase(SOD), malondialdehyde (MDA), total cholesterol (TCHO), triglyceride (TG), apolipoprotein A1 (apoA1) and apolipoprotein B (apoB), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were determined. According to the median urinary iodine of the population in the investigated village, they were divided into appropriate iodine group (100-299 μg/L) and iodine excess group (≥300 μg/L) . Multiple linear regression was used to analyze the effects of iodine nutrition and other factors on oxidative stress indexes and blood lipids. Partial correlation analysis was used to analyze the relationship between iodine nutrition and oxidative stress indexes and blood lipids.Results:A total of 1 049 subjects were included, including 471 in the appropriate iodine group and 578 in the iodine excess group. The median (quartile) urinary iodine of the appropriate iodine group and the iodine excess group was 228.70 (157.02, 341.49) and 558.73 (298.06, 985.06) μg/L, respectively. The serum SOD level of the appropriate iodine group and the iodine excess group was 12.60 (10.83, 14.10) and 11.29 (9.18, 13.10) U/ml, respectively, and the difference between the groups was statistically significant ( U = 92 697.50, P < 0.001). There were statistically significant differences in serum TG, HDL-C and apoB levels between the appropriate iodine group and the iodine excess group ( U = 108 879.50, 96 613.50, 99 050.50, P < 0.05). The results of multiple linear regression showed that after excluding age, gender and body mass index (BMI), there was a negative correlation between iodine nutrition and serum SOD and HDL-C levels [standard regression coefficient ( β) = - 0.196, - 0.294, P < 0.001]. Partial correlation analysis showed that there was a negative correlation between iodine nutrition and serum SOD and HDL-C levels [correlation coefficient ( r) = - 0.16, - 0.09, P < 0.05]. Conclusion:Excessive iodine intake affects oxidative stress and lipid metabolism in human body.

Clinicopathological features and prognostic factors of gastric intermediate-risk gastrointestinal stromal tumor after surgical resection: a retrospective study / 中华病理学杂志

Objective: To investigate the clinicopathological features, treatment and prognosis of gastric intermediate-risk gastrointestinal stromal tumor (GIST), so as to provide a reference for clinical management and further research. Methods: A retrospective observational study of patients with gastric intermediate-risk GIST, who underwent surgical resection between January 1996 and December 2019 at Zhongshan Hospital of Fudan University, was carried out. Results: Totally, 360 patients with a median age of 59 years were included. There were 190 males and 170 females with median tumor diameter of 5.9 cm. Routine genetic testing was performed in 247 cases (68.6%, 247/360), and 198 cases (80.2%) showed KIT mutation, 26 cases (10.5%) showed PDGFRA mutation, and 23 cases were wild-type GIST. According to "Zhongshan Method"(including 12 parameters), there were 121 malignant and 239 non-malignant cases. Complete follow-up data were available in 241 patients; 55 patients (22.8%) received imatinib therapy, 10 patients (4.1%) experienced tumor progression, and one patient (PDGFRA mutation, 0.4%) died. Disease-free survival (DFS) and overall survival rate at 5 years was 96.0% and 99.6%, respectively. Among the intermediate-risk GIST, there was no difference in DFS between the overall population, KIT mutation, PDGFRA mutation, wild-type, non-malignant and malignant subgroups (all P>0.05). However, the non-malignancy/malignancy analysis showed that there were significant differences in DFS among the overall population (P<0.01), imatinib treatment group (P=0.044) and no imatinib treatment group (P<0.01). Adjuvant imatinib resulted in potential survival benefit for KIT mutated malignant and intermediate-risk GIST in DFS (P=0.241). Conclusions: Gastric intermediate-risk GIST shows a heterogeneous biologic behavior spectrum from benign to highly malignant. It can be further classified into benign and malignant, mainly nonmalignant and low-grade malignant. The overall disease progression rate after surgical resection is low, and real-world data show that there is no significant benefit from imatinib treatment after surgery. However, adjuvant imatinib potentially improves DFS of intermediate-risk patients with tumors harboring KIT mutation in the malignant group. Therefore, a comprehensive analysis of gene mutations in benign/malignant GIST will facilitate improvements in therapeutic decision-making.

Clinical significance of pathological diagnosis and genetic abnormalities detection in gastrointestinal stromal tumor using endoscopic biopsy / 中华病理学杂志

Objective: To investigate the clinical significance of pathological diagnosis and genetic abnormalities detection of gastrointestinal stromal tumor (GIST) using endoscopic biopsy. Methods: Patients with GIST diagnosed by endoscopic biopsy (from January 1st, 2016 to August 1st, 2018, at Zhongshan Hospital, Fudan University) were included in this study. This retrospective study evaluated the histopathologic and immunohistochemical (IHC) features, genetic abnormalities of the tumors and the treatment and clinical course of the patients. Results: Totally 4 095 cases of GIST were collected, among which 67 patients (67/4 095, 1.6%) underwent endoscopic biopsy. Forty-eight patients (71.6%) were male and 19 (28.4%) were female, with a mean age of 61 years (range 31-90 years). Fifty-nine lesions were located in stomach and eight in duodenum. Of all the 67 cases, 47 were spindle type, 14 were epithelioid type, and 6 mixed type. IHC staining showed the positive rates were 100.0% (64/64) for DOG1, 98.4% (62/63) for CD117, 87.5% (56/64) for CD34, 3.6% (2/56) for S-100 protein, 12.1% (7/58) for α-SMA, 12.3% (7/57) for desmin and 4.0% (2/50) for CKpan. Morphologically, 34 cases were malignant; three cases (all epithelioid type) were originally misdiagnosed as poorly differentiated carcinoma; missed-diagnosis were found in four cases (spindle type) due to the insufficient diagnostic tumor cells. The genetic abnormality detection rate in the biopsy tissue was 38.8% (26/67),among them two patients were lost to follow up after biopsy, 33 patients received surgical resection, 16 cases underwent operation after neoadjuvant therapy and 16 patients with advanced disease underwent continuous imatinib therapy, with the genetic testing rate of 6.1% (2/33), 10/16 and 14/16, respectively. Conclusions: Endoscopic biopsy is a useful but rare method for the preoperative diagnosis of GIST. For majority of biopsy, accurate pathological diagnosis and auxiliary examination can be completed to guide clinical treatment. A thorough history in combination with endoscopic finding is essential to avoid misdiagnosis (epithelioid type) and missed diagnosis (spindle type) in suspicious cases. Genetic testing should be recommended in patients who will undergo targeted therapy after endoscopic biopsy, and it can provide valuable information and guidance for clinical treatment.

Clinical characteristics of IgE-mediated cow's milk protein allergy in children / 中华儿科杂志

Objective: To analyze the clinical features of IgE-mediated cow's milk protein allergy (CMPA) in children aged 0-5 years. Methods: This cross-sectional study collected the data on children diagnosed with CMPA in the Department of Allergy at the Children's Hospital of the Capital Institute of Pediatrics from October 2019 to November 2020 and improved peripheral blood routine,total IgE defection, milk specific IgE (sIgE) defection,SPT and milk component defection,diagnosis of severe anaphylaxis based on clinical manifestations. Rank-sum test and chi-square test are used for statistical analysis of clinical characteristics between groups. Results: A total of 106 children (67 boys and 39 girls) were enrolled with the age of 15 (8, 34) months, including 42 cases (≤ 1 year of age), 39 cases (>1-<3 years of age) and 25 cases(≥3 years of age), the onset age of 6 (5, 8) months. Among them, 95 cases (89.6%) were reacted after consuming milk or its products, 42 cases (39.6%) had reaction due to skin contact and 11 cases (10.4%) reacted after exclusive breastfeeding. The onset time of milk product consumption was 45 (1, 120) min, skin contact pathway was 10 (5, 30) min and symptoms in breastfeeding pathway was 121 (61, 180) min. There was statistical difference among the time of symptoms (χ2=77.01, P<0.001).The cutaneous reaction was most common (100 cases, 94.3%), followed by digestive (20 cases, 18.9%) and respiratory (16 cases, 15.1%), and the nervous symptoms (1 case, 0.9%) were uncommon and 24 cases (22.6%) had at least one episode of anaphylaxis. There were 87 cases (82.1%) also diagnosed with other food allergies, 94 cases (88.7%) with previous eczema, 57 cases (53.8%) with history of rhinitis, and 23 cases (21.7%) with history of wheezing. The total IgE level was 191.01 (64.71, 506.80) kU/L, and the cow's milk sIgE level was 3.03 (1.11, 15.24) kU/L. The maximum diameter of the wheal in SPT was 8.2 (4.0, 12.0) mm. Component resolved diagnosis showed that 77 cases (81.9%) were sensitized to at least one out of 4 main components, including casein, α lactalbumin, β lactoglobulin and bovine serum albumin.The possibility of anaphylaxis in children with milk sIgE grade Ⅳ-Ⅵ was higher than that in children with grade 0-Ⅲ (57.7% (15/26) vs. 12.5% (10/80), OR=9.545, 95%CI 3.435-26.523). Children with milk SPT ≥+++ had a higher probability of anaphylaxis than those with milk SPT ≤++ (34.4% (11/32) vs. 11.5% (3/26), OR=4.016, 95%CI 0.983-16.400). Anaphylaxis were more common in α lactalbumin positive children than in negative children (34.3% (13/38) vs. 14.2% (8/56), χ2=1.23，P=0.042). Conclusions: CMPA in children has early onset and diversified clinical manifestations, which are mainly cutaneous symptoms. Most children are sensitized to at least one allergen component. Serum sIgE level, SPT reaction and allergen components play important roles in the diagnosis and evaluation of CMPA, and higher milk sIgE level may predict a higher risk of anaphylaxis.

Early effect of extracorporeal membrane oxygenation and factors related to early outcome in adult patients with fulminant myocarditis / 中华心血管病杂志

Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.

General situation of salt iodization and iodine nutritional status of people in major countries and regions in the world / 中华地方病学杂志

Salt iodization is the most fundamental, safe, economical and simple measure to eliminate iodine deficiency disorders (IDD). About 120 countries (regions) around the world have adopted the strategy of compulsory salt iodization. Although most countries (regions) in the world have implemented the strategy of salt iodization, IDD is still an important public health problem threatening human health due to the health strategy of promoting low salt diet. In addition, there are excessive iodine intakes in some countries (regions). Therefore, scientific iodine supplement has become a public health issue of common concern all over the world. It is necessary to scientifically formulate the iodine content in salt in combination with the dietary structure of residents and the iodine level of natural environment.

Changes of Th17/Treg proportion and the expressions of related cytokines in peripheral blood of patients with Hashimoto's thyroiditis / 中华地方病学杂志

Objective:To observe the ratio of helper T cells 17 (Th17)/regulatory T cells (Treg) in peripheral blood of patients with Hashimoto's thyroiditis (HT) and the expression changes of related cytokines in serum, and to explore their role in the occurrence and development of HT.Methods:Using the case-control study method, 35 HT patients examined in the General Hospital of Heilongjiang Beidahuang Group from February to November 2019 were selected as HT group, and 39 healthy people in the same period were selected as control group. Early morning fasting venous blood samples of the two groups were collected to test the levels of thyroid stimulating hormone (TSH), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The expressions of serum interleukin (IL)-6, IL-17 and transforming growth factor β (TGF-β) were tested by enzyme-linked immunosorbent assay (ELISA); the number of Th17, Treg in peripheral blood were determined by flow cytometry. Results:The levels of TPOAb, TgAb and TSH in HT group [130.60 (43.37, 714.40), 368.10 (136.90, 1 103.00) U/ml, 9.05 (6.62, 15.23) μU/ml] were significantly higher than those in control group [2.66 (1.52, 4.69), 12.63 (11.43, 14.60) U/ml, 1.87 (1.36, 2.23) μU/ml, U = 6.87, 6.62, 4.85, P < 0.001], and the FT 4 level [0.76 (0.63, 1.04) ng/dl] was lower than that in control group [1.14 (1.02, 1.26) ng/dl, U = 7.39, P < 0.001]. The expressions of IL-6, IL-17 and TGF-β in HT group were higher than those in control group ( t = 2.41, 9.04, 2.44, P < 0.05). The number of Th17 and the ratio of Th17/Treg in HT group were higher than those in control group ( t = 4.20, 3.50, P < 0.05), and the number of Treg was lower than that in control group ( t = 4.45, P = 0.001). Conclusion:In HT patients, Th17 are increased, Treg decreased, Th17/Treg ratio increased, and the expressions of IL-6, IL-17 and TGF-β are increased.

Rotating Scarf osteotomy in treating hallux valgus combined with the first metatarsal rotation / 中国骨伤

OBJECTIVE@#To explore clinical effect of rotational Scarf osteotomy in treating hallux valgus (HV) with rotation of the first metatarsal bone.@*METHODS@#From January 2018 to October 2019, 35 patients (40 feet) with HV and rotation deformity of the first metatarsal were treated with rotational Scarf osteotomy, including 5 males and 30 females;aged from 25 to 76 years old with an average of (40.32±5.43) years old. Hallux valgus angle(HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), the first metatarsal length (FML) were observed and compared, American Orthopedic Foot and Ankle Society(AOFAS) of hallux metatarsophalangeal interphalangeal joint score and visual analogue scale (VAS) were used to evaluate functional evaluation.@*RESULTS@#Thirty-five patients(40 feet) were followed up from 12 to 36 months with an average of (14.35±3.62) months. HVA, IMA and DMAA were corrected from (36.32±4.51) °, (14.21±3.22) ° and (28.35±4.32) ° before operation to (14.32±5.71) °, (5.83±3.97) ° and (7.32±2.14) ° after operation respectively (P<0.05). There was no satistical difference in FML before and after operation (P>0.05). AOFAS score and VAS improved from (57.00±4.31) and (6.00±1.21) before operation to (90.31±3.28) and (1.42±0.83) after operation, respectively, and had significant difference(P<0.05);according to AOFAS score, 23 feet got excellent results, 15 feet good and 2 feet fair.@*CONCLUSION@#Rotational Scarf osteotomy with strong correction and high dimension could effectively correct HV combined with rotation deformity of the first metatarsal bone, improve function of the forefoot, and obtain good clinical results.

Cement augmented pedicle screw combined with vertebroplasty for the treatment of Kümmell's disease with type Ⅲ / 中国骨伤

OBJECTIVE@#To explore clinical effect of cement-augmented pedicle screw combined with vertebroplasty in treating Kümmell disease with type Ⅲ.@*METHODS@#From January 2015 to December 2018, 37 patients with type Ⅲ Kümmell disease were retrospectively analyzed, including 11 males and 26 females, aged from 61 to 84 years old with an average of (68.6±4.2) years old, and the courses of disease ranged from 2 to 10 months with an average of(6.5±2.3) months. Nine patients were grade C, 20 patients were grade D and 8 patients were grade E according to Frankle grading. All patients were treated by cement-augmented pedicle screw combined with vertebroplasty. Operation time, blood loss, postoperative drainage, hospital stay and complicationswere observed after oeprtaion. Visual analogue scale(VAS), Oswestry Disability Index(ODI), height of anterior vertebral body, Cobb angle before and after operation were compared.@*RESULTS@#All patients were followed up from 12 to 60 months with an average of (22.4±10.9) months. Operation time was (240.9±77.4) min, blood loss was (315.0±149.2) ml, postoperative drainage was (220.8±72.0) ml, hospital stay was (12.6±4.7) days. One patient occurred incision redness and 1 patient occurred infection after opertaion. No loosening of bone cement occurred. Postopertaive VAS and ODI were lower than that of before opertaion(@*CONCLUSION@#Cement-augmented pedicle screw combined with vertebroplasty is a safe and effective method for the tretament of Kümmell disease with type Ⅲ.

Serum biomarkers of differential metabolism in high iodine diet intervention population / 中华地方病学杂志

Objective:To explore the serum different metabolites in population of dietary intervention with high iodine.Methods:Thirty-eight healthy volunteers were recruited in Harbin Medical University, all women, aged > 20 years. Dietary intervention was carried out by eating iodine-rich food (kelp) for 11 consecutive days. The effect of intervention was evaluated through urinary iodine test. Peripheral blood was collected, the metabolic alterations associated with high iodine intake before and after intervention were investigated using ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF MSMS). Multivariate statistical analysis was used to screen potential biomarkers. And disturbed metabolic pathway analysis was performed.Results:The medians urinary iodine before and after intervention were 129.48 and 795.94 μg/L, respectively. A total of 20 serum biomarkers were screened and their chemical structures were identified. Glycerol phospholipid metabolic pathway, tryptophan metabolic pathway and pentose and glucuronate interconversions pathway were closely related with high iodine intake (impact value > 0.1).Conclusions:After the intervention of high iodine diet, there are obvious differential metabolites in peripheral blood, which may be used as biomarkers for evaluation of population iodine nutrition. High iodine intake has an impact on metabolic pathway of glycerol phospholipid in human body.

Effect of Gegen Qinliantang on Structure of Intestinal Flora in Dysbacterial Diarrhea Rats Based on 16S rRNA Sequencing / 中国实验方剂学杂志

Objective:To study the effect of Gegen Qinliantang （GQT） on the structure of intestinal flora in dysbacterial diarrhea rats by 16S rRNA sequencing. Method:Sixty healthy SD rats were randomly and equally divided into a control group， a model group， high-， medium-， and low-dose GQT groups， and a Bifidobiogen group. The rat model was induced in the five groups except the control group by administration of mixed antibiotics （178.6 mg·kg^-1 cefradine and 31.25 mg·kg^-1gentamicin sulfate） according to the dose. Drug intervention was carried out in each group （7.02， 3.51， and 1.755 g·kg^-1 GQT for the high-， medium-， and low-dose GQT groups， 0.125 g·kg^-1 bifidobacterium capsules for the Bifidobiogen group， and sterile distilled water for the control and model groups） with a volume of 10 mL·kg^-1 for seven days. Colon contents of rats were obtained under anesthesia. The extracted fecal DNA underwent 16S rRNA high-throughput sequencing and the results were analyzed. Result:GQT was proved capable of adjusting the species number and Alpha and Beta diversity， improving the biological richness and diversity of the flora， and positively regulating three differential phyla （Firmicutes， Proteobacteria， and Bacteroidetes） and 14 differential genera （<italic>Bacteroides</italic>，<italic> Parabacteroides</italic>，<italic> Blautia</italic>， etc.） in rat model of dysbacterial diarrhea. Conclusion:The present study confirmed the regulatory effect of GQT on intestinal flora of dysbacterial diarrhea rats， and revealed the physiological and pathological mechanism between intestinal flora and dysbacterial diarrhea.

Molecular Mechanism Analysis of Jiangtang Xiaozhi Tablets in Treatment of NAFLD / 中国实验方剂学杂志

Objective:To explore the molecular mechanism of Jiangtang Xiaozhi tablets （JTXZT） in the treatment of non-alcoholic fatty liver disease （NAFLD） by means of network pharmacology and molecular docking. Method:With the help of traditional Chinese medicine （TCM） Systems Pharmacology Database and Analysis Platform （TCMSP）， TCMs Integrated Database （TCMID）， Encyclopedia of TCM （ETCM） and Bioinformatics Analysis Tool for Molecular Mechanism of TCM （BATMAN-TCM）， the chemical compositions of medicinal materials in JTXZT were obtained， the compound targets were predicted in SwissTargetPrediction database and STITCH database. The targets of NAFLD were searched by The Human Gene Database （GeneCards）， Online Mendelian Inheritance in Man （OMIM）， Therapeutic Target Database （TTD） and DisGeNET， and intersection analysis was performed with the targets of the active ingredients to obtain the targets of JTXZT for treatment of NAFLD. Based on STRING 11.0 database， the protein-protein interaction （PPI） network of therapeutic targets was constructed， and the enrichment analysis of therapeutic targets was carried out by DAVID 6.8. Finally， the interaction characteristics of key components and core therapeutic targets of JTXZT for treatment of NAFLD were verified based on molecular docking. Result:The key components of JTXZT for treatment of NAFLD were quercetin， luteolin， kaempferol， berberine， isorhamnetin， betulinic acid， oleanolic acid， ursolic acid. formononetin and hexitol， and the core targets of JTXZT for treatment of NAFLD were mitogen-activated protein kinase 1 （MAPK1）， Jun proto-oncogene， activator protein-1 （AP-1） transcription factor subunit （JUN）， MAPK3， protein kinase B1 （AKT1 or Akt1）， tumor protein p53 （TP53）， E1A binding protein p300 （EP300）， Fos proto-oncogene， AP-1 transcription factor subunit （FOS）， tumor necrosis factor （TNF），amyloid beta precursor protein （APP） and cytochrome P450 family 2 subfamily E member 1 （CYP2E1）. Biological function and pathway enrichment analysis showed that JTXZT mainly through xenobiotic metabolic process， oxidation-reduction process， cholesterol metabolic process and other biological processes， regulating phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， MAPK signaling pathway， NAFLD and insulin signaling pathway to play a role in the treatment of NAFLD. The results of molecular docking showed that the active components of JTXZT had a good affinity with the core targets of JTXZT for the treatment of NAFLD. Conclusion:JTXZT treats NAFLD through multiple active components， multiple key targets and multiple action pathways.

The Prognostic Value of 18F-Fluorodeoxyglucose PET/CT in the Initial Assessment of Primary Tracheal Malignant Tumor: A Retrospective Study

Objective@#To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. @*Materials and Methods@#An analysis of FDG PET/CT findings in 37 primary tracheal malignant tumor patients with a median follow-up period of 43.2 months (range, 10.8–143.2 months) was performed. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18F-FDG PET/CT parameters, other clinic-pathological factors, and overall survival (OS). A risk prognosis model was established according to the independent prognostic factors identified on multivariate analysis. A survival curve determined by the Kaplan-Meier method was used to assess whether the prognosis prediction model could effectively stratify patients with different risks factors. @*Results@#The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p 5.19, a TLG > 16.94 on PET/CT scans, squamous cell carcinoma, and non-E1 were more likely to have a reduced OS.

Detection of Asymptomatic Carotid Artery Stenosis in High-Risk Individuals of Stroke Using a Machine-Learning Algorithm / 中国医学科学杂志(英文版)

Objective Asymptomatic carotid stenosis (ACS) is closely associated to the incidence of severe cerebrovascular diseases. Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke. This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors. The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data. All of the original data were retrieved from the China National Stroke Screening and Prevention Project (CNSSPP), including demographic, clinical and laboratory characteristics. The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1. The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled, 326 (11.6%) were diagnosed as ACS by ultrasonography. The top five risk factors contributing to ACS in this model were identified as family history of dyslipidemia, high level of low-density lipoprotein cholesterol (LDL-c), low level of high-density lipoprotein cholesterol (HDL-c), aging, and low body mass index (BMI). Their weights were 11.8%, 7.6%, 7.1%, 6.1%, and 6.1%, respectively. The total weight of the top 15 risk factors was 85.5%. The AUC values of the model for detecting ACS with training dataset and testing dataset were 0.927 and 0.888, respectively.Conclusions This study demonstrated that the machine-learning algorithm could be used to identify the risk factors for ACS among high risk population of stroke. Family history of dyslipidemia may be the most important risk factor for ACS. This model could be a suitable tool to optimize the clinical approach for the primary prevention of stroke.

Two-dimensional shear wave elastography for assessment of liver stiff in rats with acute liver failure / 中国医学影像技术

Objective: To explore the application value of two-dimensional shear wave elastography (2D-SWE) in detection of acute liver failure (ALF) and evaluation on prophylactic drug use in rats. Methods: Totally of 28 male SD rats were divided into four groups, i.e. control group (n=8), model group (n=8), lactulose group (n=6) and Medilac-s group (n=6). From the 1st to the 8th day of the experiment, rats in Medilac-s group were treated with intragastric administration of Medilac-s after dilution, in lactulose group were given lactulose, while in control group and model group were given the same amount of normal saline. On the 6th and 7th day of the experiment, rats in model group, lactulose group and Medilac-s group were intraperitoneally injected with thioacetamide, while in control group were injected with normal saline. On the 8th day of the experiment, 2D-SWE was used for liver stiffness measurement (LSM) in all 4 groups. ROC curve was constructed, and the most accurate LSM value was selected according to AUC used for inter-group comparison. On the 9th day of the experiment, the liver of rats were taken for pathological examination. Results: The main pathological manifestations in model group were inflammation and necrosis, in Medilac-s group and lactulose group were inflammation and necrosis less than in model group, whereas normal liver tissue was found in control group. Among ROC curves constructed by LSM value of the model group, the diagnostic efficiency of LSMmean was the best. Taken 8.44 kPa as the cut-off value, the AUC, sensitivity and specificity was 0.768, 100% and 62.50%, respectively. LSMmean in model group was significantly higher than that in the other 3 groups (all P<0.05). Conclusion: Liver stiffness increases in ALF rats. 2D-SWE has application value for diagnosis of ALF and evaluation after prophylactic drug use.

Chest High-resolution Computed Tomography Imaging Features of Lung Involvement in Rheumatoid Arthritis / 中国医学科学院学报

To explore the chest high-resolution computed tomography (HRCT) features in patients with rheumatoid arthritis (RA) complicated with pulmonary involvement. Totally 161 patients with RA with lung involvement were collected from June 2014 to May 2018. The chest HRCT findings were retrospectively analyzed. According to the imaging features as well as the results of history taking,pulmonary function test,pathology,and bronchoalveolar lavage fluid test,RA-related lung diseases (RA-LD) were classified and their clinical characteristics were compared. These 161 RA-LD patients (56 males and 105 females) whose mean age at diagnosis was (60.7±12.8) years (14-85 years) included 87 cases of usual interstitial pneumonia (UIP) (including 16 cases of possible UIP),44 cases of non-specific interstitial pneumonia (NSIP),10 cases of organizing pneumonia,7 cases of lymphocytic interstitial pneumonia,9 cases of small airway disease (SAD) (including 8 cases of bronchiolitis obliterans and 1 case of follicular bronchiolitis),and 4 other lung manifestations (including 3 cases of diffuse alveolar hemorrhage and 1 case of rheumatoid nodules). The UIP group had the oldest average age [(63.3±12.1) years old] and the highest smoking rate (41.4%). The SAD group had the youngest average age [(54.7±15.1) years old] and there was no smoking history. There were significant differences between these two groups (=0.020,<0.001). Seventy patients (43.5%) with RA-LD were complicated with pleural lesions. RA involving the lung is common and has varied imaging manifestations,with interstitial lung diseases (mainly UIP and NSIP) being the most important manifestations. RA patients should undergo lung HRCT as early as possible to identify the lung involvement and related types.

The influence of maternal attachment and alexithymia on risk of non-suicidal self-injury in adolescents / 中华行为医学与脑科学杂志

Objective:To explore the influence of maternal attachment and alexithymia on risk of non-suicidal self-injury in adolescents.Methods:Fifty-seven outpatients and inpatients from Anhui Mental Health Center with non-suicidal self-injury (NSSI) and their mothers were involved as the case group, and fifty-three age-, gender-, and education-matched adolescents and their mothers as the normal controls.They were assessed with the experience in close relationship inventory(ECR), the 20-item Toronto alexithymia scale (TAS-20) and the adolescents self-harm scale.SPSS 22.0 software was used for correlation analysis and Logistic regression analysis.Results:There were significant differences in attachment avoidance ((3.7±0.6), (3.0±0.6)), attachment anxiety ((4.0±0.7), (3.1±0.9)), difficulty identifying feelings ((2.9±0.7), (2.3±0.7)), difficulty describing feelings((3.0±0.6), (2.4±0.5)) and alexithymia ((57.2±8.3), (49.5±9.5))between the two mother groups ( t=6.53, 5.79, 4.01, 5.50, 4.56, all P<0.05). NSSI of adolescents was positively correlated with the scores of attachment anxiety, attachment avoidance, alexithymia, difficulty identifying feelings, difficulty describing feelings( r=0.487, 0.532, 0.401, 0.360, 0.468, all P<0.05). Logistic regression analysis showed that unsafe maternal attachment( B=2.57, OR=3.07, 95% CI=1.01-169.54, P=0.024)and the higher alexithymia level( B=1.95, OR=2.14, 95% CI=1.29-3.58, P=0.003)could lead to higher risk of NSSI in adolescents. Conclusion:Unsafe maternal attachment and the higher alexithymia level may be the risk factors for adolescents with NSSI.

Relationship of psychotic symptoms with childhood abuse and psychological resilience in patients with depression / 中华行为医学与脑科学杂志

Objective To explore relationship of psychotic symptoms with childhood abuse and psy-chological resilience in patients with depression. Methods According to whether the psychotic symptoms ex-ist,160 patients with depression were divided into psychotic major depression (PMD group,n=80) and non-psychotic major depression (NMD group,n=80). All patients were assessed with general information ques-tionnaire,the childhood trauma questionnaire(CTQ) and the Conner-Davidson resilience scale( CD-RISC). Using logistic regression analysis to explore the influencing factors of psychiatric symptoms in depressive pa-tients. Results There were significant differences in the emotional abuse (( 17. 80 ± 2. 78), ( 10. 14 ± 1. 46)),the physical abuse ((16. 98±3. 21),(8. 31±1. 24)),the sexual abuse ((8. 74±1. 87),(7. 85± 1. 71)),the emotional neglect (( 21. 46 ± 1. 95), ( 15. 71 ± 2. 12)) and total score of childhood abuse ((81. 98±9. 88),(54. 10±4. 36)) between the two group (F=68. 88,70. 91,2. 91,45. 93,77. 28,all P<0. 01). There were significant differences in the resilience (F=4. 47,P<0. 01),the power ( F=5. 59,P<0. 01),the optimism (F=2. 35,P=0. 033) and total score of psychological resilience ( F=7. 23,P<0. 01) between the two group. Logistic regression analysis showed that attack in early age( B=2. 57,P=0. 024,OR (95%CI)=13. 07(1. 01-169. 54)) was a risk factor for psychotic symptoms in patients with depression. No experience of childhood abuse (B=-1. 95,P=0. 003,OR( 95% CI)= 0. 14(0. 04-0. 52)),the higher psy-chological resilience level(B=-2. 54,P<0. 01,OR(95%CI)=0. 08(0. 02-0. 27)),mild to moderate depres-sion (B=-1. 33,P=0. 013,OR(95%CI)=0. 27(0. 09-0. 76))were protective factors of psychotic symptoms in patients with depression. Conclusion Psychological resilience may be the protective factor for psychotic symptoms in patients with depression while childhood abuse may be a risk factor.

Effects of different water iodine level on iodine nutrition and thyroid function in pregnant women / 中华地方病学杂志

Objective To understand the effects of different water iodine level on iodine nutrition and thyroid function in pregnant women,and provide a reference for prevention and treatment of iodine deficiency disorders in the future.Methods According to the background material of water iodine in provinces given non-iodized salt,the administrative villages with water iodine content ＜ 10,10-49,50-99,100-299 and ≥ 300 μg/L were selected as survey sites in Shandong,Shanxi,Hebei,Henan,Jiangsu and Anhui provinces.Urine,blood,drinking water and salt samples were collected from pregnant women at the site of investigation,and urinary iodine,serum iodine,thyroid function and antibody index,water iodine,and salt iodine were measured;thyroid volume was also examined.Results A total of 575 pregnant women were investigated.The medians urinary iodine of pregnant women with water iodine ＜ 10,10-49,50-99,100-299 and ≥300 μg/L groups were 175.55,180.90,139.70,330.15 and 817.70 μg/L,respectively,and the differences were statistically significant in different water iodine groups (H =152.593,P ＜ 0.01).The levels of serum iodine and free thyroxine (FT4) were significantly different among pregnant women in different water iodine groups (H =82.843,F =3.070,P ＜ 0.01 or ＜ 0.05).However,there was no significant difference in serum thyroid stimulating hormone (TSH) levels (H =1.774,P ＞ 0.05).And with the increase of water iodine levels,the abnormal rate of TSH showed the phenomenon of middle low and both ends high ("U" type,x2 =16.729,P ＜ 0.01).There were no significant differences in the positive rates of serum thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),any antibody and double antibodies in pregnant women among different water iodine groups (P ＞ 0.05).And there was a statistically significant difference in the detection rate of subclinical hypothyroidism (x2 =11.869,P ＜ 0.05).The rates of goiter in pregnant women among different water iodine groups were less than 5％.The difference in detection rates of thyroid nodules was statistically significant (x2 =13.591,P ＜ 0.05),and the rate was the highest in water iodine ≥300 μg/L group (21.33％,16/75).Conclusions In water iodine ≥300 μg/L group,urinary iodine level of pregnant women is in the level of iodine excess,and serum iodine level,FT4 level,thyroid nodules detection rate are higher.The abnormal rate of serum TSH and the detection rate of hypothyroidism show a "U" curve that increases at iodine deficiency and iodine excess.