High risk factors in images for infiltrating lung adenocarcinoma manifesting as peripheral ground-glass nodules / 中国胸心血管外科临床杂志

@#Objective     To explore the correlation between the imaging features of peripheral ground-glass pulmonary nodules and the invasion degree of lung adenocarcinoma, and the high risk factors for infiltrating lung adenocarcinoma under thin-slice CT, which provides some reference for clinicians to plan the surgical methods of pulmonary nodules before operation and to better communicate with patients, and assists in building a clinical predictive model for invasive adenocarcinoma. Methods    Clinical data of the patients with peripheral ground-glass pulmonary nodules (diameter≤3 cm) in thin-slice chest CT in the First Affiliated Hospital of Soochow University from January 2019 to January 2020 were continuously collected. All patients underwent thin-slice CT scan and thoracoscopic surgery in our center. According to the pathological examination results, they were divided into two groups: an adenocarcinoma lesions before infiltration group, and an invasive lung adenocarcinoma group. The thin-slice CT imaging parameters of pulmonary nodules were collected. The nodular diameter, mean CT value, consolidation tumor ratio (CTR), nodular shape, vacuolar sign, bronchial air sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign and other clinical data were collected. Univariate and multivariate analyses were conducted to analyze the independent risk factors for the infiltrating lung adenocarcinoma, and to analyze the threshold value and efficacy of each factor for the identification of infiltrating lung adenocarcinoma. Results     Finally 190 patients were enrolled. There were 110 patients in the adenocarcinoma lesions before infiltration group, including 21 males and 89 females with a mean age of 53.57±10.90 years, and 80 patients in the invasive lung adenocarcinoma group, including 31 males and 49 females with a mean age of 56.45±11.30 years. There was a statistical difference in the mean CT value, nodular diameter, CTR, gender, smoking, nodular type, nodular shape, vacuolar sign, lobulation sign, burr sign, lesion boundary, pleural depression sign, vascular cluster sign between the two groups (P<0.05). However, there was no statistical difference between the two groups in age (P=0.081), lesion site (P=0.675), and bronchial air sign (P=0.051). Multiple logistic regression analysis showed that nodular diameter, mean CT value, CTR and lobulation sign were independent risk factors for differentiating preinvasive adenocarcinoma from invasive adenocarcinoma. At the same time, the threshold value was calculated by Youden index, indicating that the CTR was 0.45, the nodal diameter was 10.5 mm and the mean CT value was –452 Hu. Conclusion     In the peripheral ground-glass pulmonary nodules, according to the patient's CT imaging features, such as mixed ground-glass nodules, irregular shapes, vacuoles, short burrs, clear boundaries, pleural indentations, and vascular clusters, have a certain reference value in the discrimination of the invasion degree of ground-glass pulmonary nodules. At the same time, it is found in this research that peripheral ground-glass pulmonary nodules with diameter greater than 10.5 mm, CT value greater than –452 Hu, CTR greater than 0.45 and lobulation sign are more likely to be infiltrating lung adenocarcinoma.

Direct-to-implant breast reconstruction after bilateral mastectomy: A comparison between endoscopic and conventional open surgery / 中国胸心血管外科临床杂志

@#Objective    To compare the differences of clinical effects between the bilateral endoscopic breast reconstruction and the open breast reconstruction. Methods    The clinical data of 28 female patients who underwent bilateral breast graft reconstruction in the Department of Breast Surgery of West China Hospital from January 2017 to January 2021 were analyzed retrospectively. The patients were divided into two groups: an endoscopic group (n=12, aged 41.3±8.9 years) and an open group (n=16, aged 41.6±8.8 years). The clinical data of the two groups of patients were compared. Results     There was no significant difference in demographic and oncological data between the two groups (P>0.05). There was a significant difference in the implants between the two groups (P=0.008). The operation time (298.2±108.6 min vs. 326.5±95.8 min, P=0.480) and anesthesia time (373.4±91.2 min vs. 400.3±97.1 min, P=0.463) were not significantly different. The total complications (P=0.035) and major complications (P=0.024) in the open group were more than those in the endoscopic group. For the comparison of breast satisfaction, psychosocial well-being and sexual well-being, the scores at six months and one year after surgery were higher in the endoscopic group than those in the open group (P<0.05). Conclusion    The endoscopic reconstruction is safe and effective, with high satisfaction rates regarding  breast reconstruction and quality of life, and is superior to conventional open surgery.

Analyzing the relevant factors affecting the clinical outcome of periodontal regeneration surgery / 中华口腔医学杂志

Periodontitis can lead to periodontal tissue defect, tooth mobility and loss, which seriously affects the quality of life. Periodontal regeneration surgery is an important treatment method for repairing periodontal defects, and it is also the hotspot of current periodontal clinical and basic research. A comprehensive understanding of the factors affecting the efficacy of periodontal regenerative surgery can improve clinicians' periodontal treatment concepts, increases the predictability of treatment results, and enhances the level of clinical diagnosis and periodontal treatment. In order to instruct the clinicians, this article will explain the basic principles of periodontal regeneration and the key points of periodontal wound healing, and analyze the elements of periodontal regeneration surgery, which including the patient-related factors, local factors, surgical factors and regenerative material selection.

Application of digital bone block in bone augmentation / 中华口腔医学杂志

Alveolar ridge augmentation is a common method to solve the problem of insufficient bone mass during implant treatment, while shaping bone substitutes during surgery, maintaining space and stability remain challenging. Digital bone block refers to a digital method for making bone grafts suitable for personalized defect shape. With the advancement of digital technology and the development of materials science, the means of realizing digital bone blocks have also undergone a series of updates. This paper summarizes the relevant researches in the past, systematically introduces the workflow, implementation methods, development history and future prospects of digital bone blocks, and provides suggestions and references for clinicians to use digital methods to improve the predictability of bone augmentation outcome.

Prognostic analysis of children with Philadelphia chromosome-like acute lymphoblastic leukemia common genes / 中华儿科杂志

Objective: To summarize the clinical data and prognosis of children with Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) common genes. Methods: This was a retrospective cohort study.Clinical data of 56 children with Ph-like ALL common gene cases (Ph-like ALL positive group) treated from January 2017 to January 2022 in the First Affiliated Hospital of Zhengzhou University, Henan Children's Hospital, Henan Cancer's Hospital and Henan Provincial People's Hospital were collected, 69 children with other high-risk B cell acute lymphoblastic leukemia (B-ALL) at the same time and the same age were selected as the negative group. The clinical characteristics and prognosis of two groups were analyzed retrospectively. Comparisons between groups were performed using Mann-Whitney U test and χ2 test. Kaplan-Meier method was used for survival curve, Log-Rank test was used for univariate analysis, and the Cox regression model was used for multivariate prognosis analysis. Results: Among 56 Ph-like ALL positive patients, there were 30 males and 26 females, and 15 cases were over 10 years old. There were 69 patients in Ph-like ALL negative group. Compared with the negative group, the children in positive group were older (6.4 (4.2, 11.2) vs. 4.7 (2.8, 8.4) years), and hyperleukocytosis (≥50×109/L) was more common (25% (14/56) vs. 9% (6/69)), the differences were statistically significant (both P<0.05). In the Ph-like ALL positive group, 32 cases were positive for IK6 (1 case was co-expressed with IK6 and EBF1-PDGFRB), 24 cases were IK6-negative, of which 9 cases were CRLF2 positive (including 2 cases with P2RY8-CRLF2, 7 cases with CRLF2 high expression), 5 cases were PDGFRB rearrangement, 4 cases were ABL1 rearrangement, 4 cases were JAK2 rearrangement, 1 case was ABL2 rearrangement and 1 case was EPOR rearrangement. The follow-up time of Ph-like ALL positive group was 22 (12, 40) months, and 32 (20, 45) months for negative group. The 3-year overall survival (OS) rate of positive group was significantly lower than the negative group ((72±7) % vs. (86±5) %, χ2=4.59, P<0.05). Compared with the 24 IK6-negative patients, the 3-year event free survival (EFS) rate of 32 IK6 positive patients was higher, the difference was statistically significant ((88±9) % vs. (65±14) %, χ2=5.37, P<0.05). Multivariate Cox regression analysis showed that the bone marrow minimal residual disease (MRD) not turning negative at the end of first induction (HR=4.12, 95%CI 1.13-15.03) independent prognostic risk factor for patient with Ph-like ALL common genes. Conclusions: Children with Ph-like ALL common genes were older than other high-risk B-ALL patients at diagnosis, with high white blood cells and lower survival rate. The bone marrow MRD not turning negative at the end of first induction were independent prognostic risk factor for children with Ph-like ALL common gene.

Study of the urban-impact on microbial communities and their virulence factors and antibiotic resistance genomes in the Nandu River, Haikou / 中华流行病学杂志

Objective: To explore the changes in bacterial community structure, antibiotic resistance genome, and pathogen virulence genome in river water before and after the river flowing through Haikou City and their transmission and dispersal patterns and to reveal anthropogenic disturbance's effects on microorganisms and resistance genes in the aquatic environment. Methods: The Nandu River was divided into three study areas: the front, middle and rear sections from the upstream before it flowed through Haikou City to the estuary. Three sampling sites were selected in each area, and six copies of the sample were collected in parallel at each site and mixed for 3 L per sample. Microbial community structure, antibiotic resistance, virulence factors, and mobile genetic elements were analyzed through bioinformatic data obtained by metagenomic sequencing and full-length sequencing of 16S rRNA genes. Variations in the distribution of bacterial communities between samples and correlation of transmission patterns were analyzed by principal co-ordinates analysis, procrustes analysis, and Mantel test. Results: As the river flowed through Haikou City, microbes' alpha diversity gradually decreased. Among them, Proteobacteria dominates in the bacterial community in the front, middle, and rear sections, and the relative abundance of Proteobacteria in the middle and rear sections was higher than that in the front segment. The diversity and abundance of antibiotic resistance genes, virulence factors, and mobile genetic elements were all at low levels in the front section and all increased significantly after flow through Haikou City. At the same time, horizontal transmission mediated by mobile genetic elements played a more significant role in the spread of antibiotic-resistance genes and virulence factors. Conclusions: Urbanization significantly impacts river bacteria and the resistance genes, virulence factors, and mobile genetic elements they carry. The Nandu River in Haikou flows through the city, receiving antibiotic-resistant and pathogen-associated bacteria excreted by the population. In contrast, antibiotic-resistant genes and virulence factors are enriched in bacteria, which indicates a threat to environmental health and public health. Comparison of river microbiomes and antibiotic resistance genomes before and after flow through cities is a valuable early warning indicator for monitoring the spread of antibiotic resistance.

Application of high-speed counter current chromatography in extraction and separation of alkaloids in natural products / 中国中药杂志

Alkaloids, widespread in plants, have a series of pharmacological activities and have been widely used to treat various diseases. Because alkaloids are usually presented in multicomponent mixtures and are deeply low in content, they are very difficult to extract and separate by traditional methods. High-speed counter current chromatography(HSCCC) is a kind of liquid-liquid chromatography without solid support phase, which has the advantages of large injection volume, low cost, and no irreversible adsorption. Compared with the traditional methods of extraction and separation of alkaloids, HSCCC can ensure the separation of many different alkaloids at one time, with a high recovery and large amount. In this paper, the advantages and disadvantages of HSCCC compared with traditional separation methods were discussed and the solvent system and elution mode of HSCCC used to separate alkaloids in recent years were summarized by referring to the relevant literature to provide some references for the separation of alkaloids by HSCCC.

Establishment and evaluation of rabbit model of closed tibial fracture / 中国骨伤

OBJECTIVE@#To explore the effect of a modified three-point bending fracture device for establishing a rabbit model of closed tibial fracture.@*METHODS@#The model of closed tibial fracture was established in 40 6-month-old male New Zealand white rabbits with a body weight of 2.5 to 3.0 kg, and the model was verified at 6 weeks after operation. Five rabbits underwent pre modeling without temporary external fixation before modeling, and then were fractured with a modified three-point bending fracture device;35 rabbits underwent formal modeling. Before modeling, needles were inserted, and splints were fixed externally, and then the fracture was performed with a modified three-point bending fracture device. The fracture model and healing process were evaluated by imaging and histopathology at 2 hours, 4 weeks, and 6 weeks after operation.@*RESULTS@#Two hours after modeling, the prefabricated module showed oblique fracture in varying degrees and the broken end shifted significantly;Except for 1 comminuted fracture, 2 curved butterfly fractures and 2 without obvious fracture line, the rest were simple transverse and oblique fractures without obvious displacement in formal modeling group. According to the judgment criteria, the success rate of the model was 85.71%. Four weeks after modeling, the fixed needle and splint of the experimental rabbits were in good position, the fracture alignment was good, the fracture line was blurred, many continuous callus growths could be seen around the fracture end, and the callus density was high. Six weeks after modeling, many thick new bone trabeculae at the fracture, marginal osteoblasts attached, and a small number of macrophages were seen under the microscope. The intramembrane osteogenesis area was in the preparation bone stage, the medullary cavity at the fracture had been partially reopened, the callus was in the absorption plastic stage, and many osteoclasts were visible. The X-ray showed that the fracture line almost disappeared, part of the medullary cavity had been opened, the external callus was reduced around, the callus was in the plastic stage, and the bone cortex was continuous. It suggests that the fracture model showed secondary healing.@*CONCLUSION@#The improved three-point bending fracture device can establish a stable rabbit model of closed tibial fracture, and the operation is simple, which meets the requirements of closed fracture model in basic research related to fracture healing.

CHD1 deletion stabilizes HIF1α to promote angiogenesis and glycolysis in prostate cancer / 亚洲男科学杂志(英文版)

Chromodomain-helicase-DNA-binding protein 1 (CHD1) deletion is among the most common mutations in prostate cancer (PCa), but its role remains unclear. In this study, RNA sequencing was conducted in PCa cells after clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9 (Cas9)-based CHD1 knockout. Gene set enrichment analysis (GSEA) indicated upregulation of hypoxia-related pathways. A subsequent study confirmed that CHD1 deletion significantly upregulated hypoxia-inducible factor 1α (HIF1α) expression. Mechanistic investigation revealed that CHD1 deletion upregulated HIF1α by transcriptionally downregulating prolyl hydroxylase domain protein 2 (PHD2), a prolyl hydroxylase catalyzing the hydroxylation of HIF1α and thus promoting its degradation by the E3 ligase von Hippel-Lindau tumor suppressor (VHL). Functional analysis showed that CHD1 deletion promoted angiogenesis and glycolysis, possibly through HIF1α target genes. Taken together, these findings indicate that CHD1 deletion enhances HIF1α expression through PHD2 downregulation and therefore promotes angiogenesis and metabolic reprogramming in PCa.

Related factors of negative conversion time of nucleic acid in children with COVID-19 / 中华儿科杂志

Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3rd to May 31st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs.7 (4, 9) d, Z=-4.17, P<0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs.6 (4, 9) d,Z=-2.89,P=0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid (OR=3.74,95%CI 1.69-8.31, P=0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.

Surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection with the help of HUAXI Hole 3 / 中国胸心血管外科临床杂志

@#Objective    To explore the surgical technique and clinical effect of endoscopic assisted transaxillary breast tumor resection in the treatment of benign and malignant breast tumors. Methods    The clinical data of 18 patients received endoscopic breast tumor resection from September 2020 to December 2021 in the Department of Breast Surgery, West China Hospital, Sichuan University, were retrospectively analyzed to evaluate the feasibility, tumor safety and postoperative cosmetic effect. There were 7 patients with benign breast tumors (a benign breast tumor group) and 11 patients with early breast cancer (a malignant breast tumor group). Breast-Q and Scar-Q questionnaires were used to evaluate postoperative quality of life and satisfaction of patients. Results    Endoscopic breast tumor resection was performed successfully in 18 female patients, among whom 12 patients received day surgery. The mean age of benign and malignant breast tumor groups was 29.6±11.6 years and 46.7±14.3 years, the mean tumor size in pathological examination was 3.3±2.1 cm and 2.0±0.8 cm, and the operative time was 138.9±57.0 min and 177.3±46.3 min, respectively. One patient had positive resection margin and underwent intraoperative extended resection in the malignant breast tumor group. All the patients were successfully followed up, and the mean follow-up time of benign and malignant breast tumor groups was 6.8±4.0 months and 8.7±4.9 months, respectively. No complications or tumor recurrence occurred. The scores of psychosocial status, sexual well-being, chest wall status and breast satisfaction decreased one month after surgery and basically recovered to the preoperative level in one year, and the score of scar appearance increased to 64.6±5.9 points one year postoperatively. Conclusion    Endoscopic assisted transaxillary breast tumor resection can effectively improve postoperative cosmetic effect and patient satisfaction on the premise of safety.

The function and drug development progress of free fatty acid receptor 1 in chronic inflammatory diseases / 药学学报

As a member of G protein coupled-receptors superfamily, free fatty acid receptor 1 (FFAR1), is also known as GPR40, has been shown to regulate numerous pathophysiological processes in a variety of tissues and organs. The activated FFAR1 has a variety of biological functions. For instance, it can not only regulate metabolism of fatty acids and glucose, but also play an important role in immune inflammatory response, it may be a potential drug target for the treatment of various chronic inflammatory diseases. In this review, we focus on the recent researches of FFAR1's action in the regulation of pathophysiological processes, its molecular mechanism and new agonists development. At the same time, this review will take the discovery of series FFAR1 agonists as examples, and display the applied prospects of FFAR1.

Clinical research advances in mesenchymal stem cells for the treatment of end-stage liver disease / 临床肝胆病杂志

End-stage liver disease (ESLD) includes decompensated liver cirrhosis and liver failure, which usually have dangerous conditions and a poor prognosis. Liver transplantation is the only effective therapy for ESLD, but its clinical application is limited due to shortage of liver donors, immunological rejection, and expensive costs. Mesenchymal stem cells (MSCs) can differentiate into hepatocyte-like cells and alleviate liver fibrosis by regulating immune function through paracrine, and therefore, MSCs have a wide application prospect in the field of ESLD treatment. A number of clinical studies have shown that MSC infusion is safe and effective in the treatment of ESLD during a short period of time, and there is also certain clinical evidence for its long-term safety and efficacy. MSC-derived exosomes (MSC-Exo) do not have a complete cellular structure and can promote hepatocyte regeneration through a variety of mechanisms, and their clinical value has attracted more and more attention, but there are few studies on this issue. Currently, the core mechanism of MSC therapy for ESLD and the standardized process of MSC preparation are the problems needing to be solved urgently.

Anti-inflammatory Effect and Mechanism of Artesunate： A Review / 中国实验方剂学杂志

Inflammation， the basic pathological process of many diseases， can occur in various tissues and organs of the body and cause many diseases including cancer. So far， there are thousands of anti-inflammatory drugs on the market， but most of these drugs have adverse reactions of gastrointestinal injury， and can even cause greater damage to the body. In recent years， the research on the repurpose of Chinese medicine is in the ascendant， and the innovative research on the specific antimalarial drug artemisinin has attracted extensive attention from scholars in China and abroad. Artesunate is a water-soluble derivative of artemisinin， which has the characteristics of quick effect and low toxicity. In addition to its significant therapeutic effect on malaria， artesunate also has a potential anti-inflammatory effect. In this review， the anti-inflammatory effect and mechanism of artesunate were elaborated in detail by consulting the relevant literature. It was found that artesunate had good anti-inflammatory effects in the respiratory system， liver injury， osteoarthritis， dermatitis， kidney inflammation， colitis， neuroinflammation， and even in novel coronavirus disease 2019 （COVID-19）. It was concluded that artesunate mainly participated in apoptotic signal transduction， mediated immune regulation， and improved oxidative stress to play an anti-inflammatory role by acting on nuclear factor-κB （NF-κB）， nuclear factor E2-related factor 2 （Nrf2）， phosphatidylinositol-3 kinase （PI3K）/protein kinase B （Akt）/mammalian target of rapamycin （mTOR）， Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/tumor necrosis factor receptor-associated factor 6 （TRAF6）， high mobility group box 1 （HMGB1）/receptor for advanced glycation endproduct （RAGE）， and other pathways. Through the review of the anti-inflammatory effect and mechanism of artesunate， it is expected to provide a reference for the application of artesunate in inflammation resistance and further development and utilization of artesunate in the future.

Thinking from the Perspective of Medical Institutions on Measures for Ethical Review of Life Science and Medical Research Involving Humans / 中国医学伦理学

From the perspective of medical institutions, this paper sorted out the background of the promulgation and important changes of Measures for Ethical Review of Life Science and Medical Research Involving Humans, and summarized the changes that may significantly affect the ethical review of medical institutions. It involved terminology changes and expansion of the scope of ethic review, clarification of the responsibilities and independence of the ethics committee, the refinement of the ethical review process, the emphasis on the protection of personal information and the rights and interests of subjects, and first proposal to exempt from ethical review. In addition, based on the concept of strengthening the ethical governance of science and technology in the new version of regulations, this paper shared the consideration on the governance of ethical review within medical institutions, including safeguarding the dignity and rights of subject, clarifying the role and position of ethical review, exempting the implementation of ethical review, and managing entrusted ethical review. With a view to providing a certain reference for the ethics practitioners and researchers in various medical institutions.

Reflection and Practice on the Implementation of "Exemption from Ethical Review" in Medical Institutions / 中国医学伦理学

From the perspective of medical institutions, this paper sorted out the contents of Article 32 of the Measures for Ethical Review of Life Sciences and Medical Research Involving Human regarding "exemption from ethical review". At the same time, combined with domestic and foreign regulations, this paper deeply considered and analyzed the applicable premise and special circumstances of the provisions from the implementation level, and then put forward suggestions from the perspective of practical operation of medical institutions, with a view to providing some practical guidance and reference for ethical practitioners of medical institutions.

The Role and Positioning of Clinical Trial Ethics Review under Pharmaceutical Innovation Strategy / 中国医学伦理学

Ethical review runs through the whole process of drug clinical trials, and is a critical step to ensure the rights and interests of subjects. This paper analyzed and discussed the role and positioning of ethical review in new drug clinical trials, cleared the principles of ethical review, identified the responsibilities of ethical review, and clarified the authority of ethical review approval documents. The ethical review should primarily focus on the ethics of the clinical trials, not replace other professional institutions to review the clinical trials’ legality and scientific nature. Ethical approval is only one of the necessary conditions for conducting clinical trials, not the only factor. It is recommended to strengthen the publicity and popularization of scientific and technological ethics awareness, improve the clinical trial approval mechanism, and optimize the phrasing of ethical review approval documents. It is warranted to further optimize the quality of ethical review, improve the construction of ethical review system, ultimately achieve the unity of promoting innovation and preventing risks, so as to effectively realize the benign interaction between high-quality development of scientific and technological innovation and high-level safety.

Pharmacokinetic effects of metformin hydrochloride, food and alcohol on Ramulus Mori (Sangzhi) alkaloids / 药学学报

Ramulus Mori (Sangzhi) alkaloids (SZ-A) are a group of polyhydroxy alkaloids extracted and isolated from the traditional Chinese medicine mulberry twig, which is mainly used for the treatment of type 2 diabetes mellitus (T2DM). In addition to acting as a glycosidase inhibitor in the small intestine after oral administration, SZ-A can also be absorbed into blood and widely distributed to target organs related to diabetes, exerting multiple pharmacological effects. It is important to elucidate the possible pharmacokinetic influences of SZ-A for its clinical rational applications, such as drug interactions, the effects of food and alcohol on the absorption of SZ-A. However, studies in this area are limited. Therefore, the pharmacokinetic interactions between orally administrated SZ-A (50 mg·kg-1) and metformin hydrochloride (Met, 200 mg·kg-1) in Sprague-Dawley (SD) rats were examined. Then, the effect of food (standard feed) on the pharmacokinetics of SZ-A was investigated using fasting administration of SZ-A (50 mg·kg-1) in rats as a control. Finally, we investigated the pharmacokinetic characteristics of SZ-A (50 mg·kg-1) in different concentrations alcohol solutions using aqueous solution of SZ-A administered to rats as a control to evaluate the effect of alcohol on the bioabsorption of SZ-A. The results showed no significant pharmacokinetic interactions between SZ-A and Met after combination treatment. The standard feed had little effect on the pharmacokinetic profile of SZ-A. Alcohol retarded the absorption of SZ-A, resulting in a significant decrease in the Cmax of SZ-A. The decrease was greater at higher alcohol concentrations; however, no significant difference was observed in the AUC0-t. These results support the clinical rational applications of SZ-A. All animal protocols were approved by the Ethics Committee of Kangtai Medical Laboratory Service Hebei Co., Ltd. (Hebei, China) (No. MDL2022-01-17-1).

Correlation between different clinical manifestations and changes of blood indexes in canine leishmaniasis / 中华地方病学杂志

Objective:To study the main blood parameters of Leishmania-infected dogs with different clinical symptoms in the high incidence area of visceral leishmaniasis in Gansu Province, and to provide scientific basis for early diagnosis and monitoring of canine leishmaniasis. Methods:In May 2019, Wenxian County of Longnan City and Diebu County of Gannan Tibetan Autonomous Prefecture, the historical endemic areas of visceral leishmaniasis in Gansu Province, were selected as the investigation sites, and 40 dogs with positive Leishmania DNA were investigated. According to their clinical symptoms, they were divided into three groups: asymptomatic ( n = 17), minimally symptomatic ( n = 12) and symptomatic ( n = 11). At the same time, 10 healthy dogs were selected as controls. Major blood indexes were detected by an automatic animal blood five-classification cell analyzer. Results:Compared with the control group, the number of red blood cells, hemoglobin content, hematocrit, and the number of lymphocytes, monocytes and eosinophils in the asymptomatic, minimally symptomatic and symptomatic groups were decreased ( P < 0.05), while the number of white blood cells and neutrophils in minimally symptomatic and symptomatic groups were decreased ( P < 0.05). The above blood indexes were lower in the symptomatic group than those in the asymptomatic group. The number of red blood cells (control group vs symptomatic group) decreased from (6.82 ± 0.05) × 10 12/L to (4.19 ± 0.08) × 10 12/L, hemoglobin content decreased from (15.84 ± 0.74) g/L to (9.65 ± 0.18) g/L, hematocrit decreased from (46.41 ± 0.95)% to (27.86 ± 0.42)%, the number of white blood cells decreased from (14.90 ± 0.22) × 10 9/L to (10.23 ± 0.24) × 10 9/L, the number of neutrophils decreased from (7.25 ± 0.18) × 10 9/L to (6.18 ± 0.11) × 10 9/L, the number of lymphocytes decreased from (2.80 ± 0.07) × 10 9/L to (1.64 ± 0.06) × 10 9/L, the number of monocytes decreased from (1.13 ± 0.01) × 10 9/L to (0.53 ± 0.02) × 10 9/L, and the number of eosinophils decreased from (1.70 ± 0.06) × 10 9/L to (0.71 ± 0.03) × 10 9/L. Conclusion:Different clinical symptoms of Leishmania-infected dogs have different blood test results.

Prevalence and spatio-temporal clustering of visceral leishmaniasis in Gansu Province from 2015 to 2021 / 中华地方病学杂志

Objective:To analyze the epidemic status and spatial and temporal cluster distribution of visceral leishmaniasis (VL) in Gansu Province, and to provide evidence for making precise prevention and control measures and epidemic surveillance.Methods:The data of VL cases in Gansu Province reported in the China Disease Prevention and Control Information System Infectious Disease Reporting Information Management System from 2015 to 2021 were collected, descriptive epidemiology analysis was performed (three distribution of the disease). SaTScan v9.6 and ArcMap 10.7 were used for spatio-temporal cluster analysis.Results:A total of 368 VL cases were reported from 2015 to 2021, 89.13% (328/368) were concentrated in Longnan City and Gannan Tibetan Autonomous Prefecture. The number of VL cases increased year by year from 2015 to 2017, reaching a peak in 2017 (79 cases, accounting for 21.47%), and had decreased year by year since 2018. There were cases every month throughout the year, and the peak was in April in spring (38 cases). The ratio of male to female patients was 1.3 ∶ 1.0 (208/160). Scattered children aged less than 5 years old were more common (41.30%, 152/368). The spatio-temporal cluster analysis showed that both the spatial and temporal aggregation zones of VL in Tanchang County and Chengxian County were of statistical significance ( P < 0.05). Conclusion:The incidence of VL in Gansu Province is showing a low epidemic trend, having spatio-temporal aggregation, and precise monitoring and prevention and control should be strengthened in epidemic areas with different prevalence levels.