The optimal dose of oral tranexamic acid in melasma: A network meta-analysis

Background: Melasma is a chronic skin condition that adversely impacts quality of life. Although many therapeutic modalities are available there is no single best treatment for melasma. Oral tranexamic acid has been used for the treatment of this condition but its optimal dose is yet to be established. Objectives: We used network meta-analysis to determine the optimal dose of oral tranexamic acid for the treatment of melasma. Methods: We conducted a comprehensive search of all studies of oral tranexamic acid for the treatment of melasma up to September 2020 using PubMed, EMBASE and the Cochrane Library database. The quality of the studies was evaluated using the Jadad score and the Cochrane’s risk of bias assessment tool. Only high quality randomised controlled trials were selected. Some studies lacked standard deviation of changes from baseline and these were estimated using the correlation coefficient obtained from another similar study. Results: A total of 92 studies were identified of which 6 randomized controlled trials comprising 599 patients were included to form 3 pair-wise network comparisons. The mean age of the patients in these studies ranged from 30.3 to 46.5 years and the treatment duration ranged from 8 to 12 weeks. The Jadad scores ranged from 5 to 8. The optimal dose and duration of oral tranexamic acid was estimated to be 750 mg per day for 12 consecutive weeks. Limitations: Some confounding factors might not have been described in the original studies. Although clear rules were followed, the Melasma Area and Severity Index and the modified Melasma Area and Severity Index were scored by independent physicians and hence inter-observer bias could not be excluded. Conclusion: Oral tranexamic acid is a promising drug for the treatment of melasma. This is the first network meta-analysis to determine the optimal dose of this drug and to report the effects of different dosages. The optimal dose is 250 mg three times per day for 12 weeks, but 250 mg twice daily may be an acceptable option in poorly adherent patients. Our findings will allow physicians to balance drug effects and medication adherence. Personalized treatment plans are warranted.

Network meta-analysis comparing the clinical outcomes and safety of robotic, laparoscopic, and transanal total rectal mesenteric resection for rectal cancer / 中华胃肠外科杂志

Objective: To methodically assess the clinical effectiveness and safety of robot-assisted total rectal mesenteric resection (RTME), laparoscopic-assisted total rectal mesenteric resection (laTME), and transanal total rectal mesenteric resection (taTME). Methods: A computer search was conducted on PubMed, Embase, Cochrane Library, and Ovid databases to identify English-language reports published between January 2017 and January 2022 that compared the clinical efficacy of the three surgical procedures of RTME, laTME, and taTME. The quality of the studies was evaluated using the NOS and JADAD scales for retrospective cohort studies and randomized controlled trials, respectively. Direct meta-analysis and reticulated meta-analysis were performed using Review Manager software and R software, respectively. Results: Twenty-nine publications comprising 8,339 patients with rectal cancer were ultimately included. The direct meta-analysis indicated that the length of hospital stay was longer after RTME than after taTME, whereas according to the reticulated meta-analysis the length of hospital stay was shorter after taTME than after laTME (MD=-0.86, 95%CI: -1.70 to -0.096, P=0.036). Moreover, the incidence of anastomotic leak was lower after taTME than after RTME (OR=0.60, 95%CI: 0.39 to 0.91, P=0.018). The incidence of intestinal obstruction was also lower after taTME than after RTME (OR=0.55, 95%CI: 0.31 to 0.94, P=0.037). All of these differences were statistically significant (all P<0.05). There were no statistically significant differences between the three surgical procedures regarding the number of lymph nodes cleared, length of the inferior rectal margin, or rate of positive circumferential margins (all P>0.05). An inconsistency test using nodal analysis revealed no statistically significant differences between the results of direct and indirect comparisons of the six outcome indicators (all P>0.05). Furthermore, we detected no significant overall inconsistency between direct and indirect evidence. Conclusion: taTME has advantages over RTME and laTME, in terms of radical and surgical short-term outcomes in patients with rectal cancer.

Experimental study of improved sclerotherapy injection in rat model of vertebral arteriocervical spondylopathy / 中国骨伤

OBJECTIVE@#To improve the rat model of cervical spondylosis of vertebral artery type (CSA) induced by injecting sclerosing agent. To evaluate the efficacy of injecting sclerosing agent to induce CSA.@*METHODS@#Forty Health SPF SD rats(20 males and 20 females), were randomly divided into two groups:the model group (20) and the blank group (20). All the animals were followed up for 4 weeks for the observation of general situation, transcranial Doppler(TCD) detection of blood flow velocity, pulsatility index and resistive index of the vertebral artery, measurement of mental distress by open-field test.@*RESULTS@#One to two days after establish the animal model, rats in the model group appeared apathetic with decreased autonomic activities, trembling, squinting, increased eye excrement, etc., and no rats died during the experiment. The mean blood flow velocity of the model group was lower than that of the blank group (P<0.05), and the pulsatilit index and resistive index of the model group were higher than that of the blank group (P<0.05). The mental distress of the model group was significantly higher than that of the blank group.@*CONCLUSION@#The modified injection of sclerosing agent is a practical method to establish the rat model of CSA, with high success rate, high stability, low mortality and simple operation.

External quality assessment of laboratories in blood stations of Hebei Province in 2022: a retrospective analysis of HeBEQA project / 中国输血杂志

【Objective】 To conduct the laboratory quality assessment between 12 blood stations in Hebei province, analyze the results and explore the accuracy and comparability of testing, so as to improve the level of testing ability and quality management. 【Methods】 With reference to the external quality assessment rules of National Center for Clinical Laboratories and combined with the instructions of quality assessment samples, daily testing process of the laboratories were assessed. The quality indicators include blood cell count (WBC, RBC, Hb, HCT, MCV, MCH, MCHC and PLT), biochemical items (TP) and coagulation parameters (FIB and FⅧ). 【Results】 There are still problems in laboratories in terms of personnel operation, instrument maintenance and the impact of different reagent batches, especially in biochemical items and coagulation parameters. The pass rate of biochemical items was the lowest, only 72.75%, and that of blood cell count was the highest, reaching 98.75%. 【Conclusion】 With the progress of the project, the quality monitoring level of daily blood sampling tests in the quality control laboratory of each blood station has been improved. However, it is still necessary for each laboratory to improve the testing ability and quality management to a higher level in Hebei.

Kinome-wide polypharmacology profiling of small molecules by multi-task graph isomorphism network approach

Prediction of the interactions between small molecules and their targets play important roles in various applications of drug development, such as lead discovery, drug repurposing and elucidation of potential drug side effects. Therefore, a variety of machine learning-based models have been developed to predict these interactions. In this study, a model called auxiliary multi-task graph isomorphism network with uncertainty weighting (AMGU) was developed to predict the inhibitory activities of small molecules against 204 different kinases based on the multi-task Graph Isomorphism Network (MT-GIN) with the auxiliary learning and uncertainty weighting strategy. The calculation results illustrate that the AMGU model outperformed the descriptor-based models and state-of-the-art graph neural networks (GNN) models on the internal test set. Furthermore, it also exhibited much better performance on two external test sets, suggesting that the AMGU model has enhanced generalizability due to its great transfer learning capacity. Then, a naïve model-agnostic interpretable method for GNN called edges masking was devised to explain the underlying predictive mechanisms, and the consistency of the interpretability results for 5 typical epidermal growth factor receptor (EGFR) inhibitors with their structure‒activity relationships could be observed. Finally, a free online web server called KIP was developed to predict the kinome-wide polypharmacology effects of small molecules (http://cadd.zju.edu.cn/kip).

Novel mutations identified in the WNT10A gene and implant rehabilitation of patients with severe tooth agenesis / 口腔疾病防治

Objective@#To detect WNT10A gene mutations in patients with oligodontia or anodontia (≥6 teeth missing) and analyze their dental phenotype. @*Methods@#Patients with oligodontia or anodontia were enrolled from the clinic for oral examination, genetic history collection and whole exon sequencing, and patients with WNT10A gene mutations were included. Sanger sequencing was utilized to validate the WNT10A gene variations in probands and family members compared with the normal sequence. The pathogenicity of WNT10A mutations was evaluated by functional prediction, conservation analysis and structure prediction of protein mutants. Implant rehabilitation was applied to restore the patients' oral function.@*Results@# Five WNT10A gene mutations were detected in six unrelated patients, and c.26G>A (p. Trp9X) and c.1036delT (p. Cys346fs) were novel mutations with pathogenic potential. The mean number of missing teeth was (15.33±8.64) per case. The most frequently missing permanent teeth were maxillary canines (100%), and the least frequently missing teeth were mandibular first molars (25%). Implant rehabilitation was applied in five patients, and patients were found to have ideal implant osseointegration and functional restoration.@*Conclusion @# This study identified novel WNT10A gene pathogenic variants, enriching the WNT10A gene spectrum and providing new evidence for genetic diagnosis and prenatal consultation. Implant rehabilitation was also proven to be a treatment option for these patients.

Adrenal cavernous hemangioma: A case report and literature review / 北京大学学报(医学版)

A 57-year-old male patient was referred to our department with complaints of his right adrenal gland occupancy and hypertension about 6 months. When admitted to the hospital, the blood pressure was about 160/100 mmHg, and the heart rate was 110 beats/min. He was no obvious obesity, acne, abnormal mood, without weakness of limbs, acral numbness, palpitation and headache. He presented with type 2 diabetes for more than 3 years, with oral administration of metformin enteric coated tablets and subcutaneous injection of insulin glargine to control blood glucose, and satisfied with blood glucose control. Enhanced CT showed that: the right adrenal gland showed a kind of oval isodense, slightly hypodense shadow, the edge was clear, lobular change, the size was about 5.8 cm×5.4 cm, uneven density, there were nodular and strip calcification, round lipid containing area and strip low density area, and the CT value of solid part was about 34 HU. Enhanced scan showed heterogeneous nodular enhancement in the solid part of the right adrenal gland, nodular enhancement could be seen inside. The CT values of solid part in arterial phase, venous phase and delayed phase were 45 HU, 50 HU and 81 HU, respectively. Considering from the right adrenal gland, cortical cancer was more likely. No obvious abnormality was found in his endocrine examination. After adequate preoperative preparation, retroperitoneal laparoscopic adrenalectomy was performed under general anesthesia. During the operation, the 6 cm adrenal tumor was closely related to the inferior vena cava and liver, and after careful separation, the tumor was completely removed and normal adrenal tissue was preserved. The operation lasted 180 min and the blood loss was 100 mL, and the blood pressure was stable during and after the operation. There was no obvious complication. The results of pathological examinations were as follows: the size of the tumor was 7.5 cm×6.0 cm×3.5 cm, soft, with intact capsule and grayish-red cystic in section. Pathological diagnosis: (right adrenal gland) cavernous hemangioma, secondary intravascular thrombosis, old hemorrhagic infarction with calcification and ossification. After 6 months of observation, no obvious complications and tumor recurrence were found. In summary, cavernous hemangioma of adrenal gland is a rare histopathological change. Its essence is a malformed vascular mass. Blood retention is the cause of thrombosis and calcification in malformed vessels. The imaging findings were inhomogeneous enhancement of soft tissue masses, and the adrenal function examination showed no obvious abnormalities. Retroperitoneal laparoscopic surgery is feasible after adequate preoperative preparation. It is difficult to diagnose the disease preoperatively and needs to be confirmed by postoperative pathology.

Does public pension impact migrant workers' nutrition: evidence from urban pension insurance in China / A previdência pública impacta a nutrição de trabalhadores migrantes: evidências do seguro de pensão urbana na China

ABSTRACT: Based on the data of "employment and food demand of urban migrant workers", this paper empirically analyzed the impact of urban pension insurance on the nutritional intake structure of migrant workers. The results showed that participating in urban pension insurance can change the nutritional intake structure of migrant workers. Additionally, fat and protein replace carbohydrate as the main nutrition sources for migrant workers. After controlling the income and labor intensity of migrant workers and other factors, urban pension insurance has a positive effect on the intake of fat and protein of migrant workers for they increase by 13.5% and 8.8% respectively. There is no significant effect on the intake of carbohydrates of migrant workers. The calorie intake of migrant workers increases by 6.8% accounting for the change of nutritional intake structure. Endogenous and robustness tests showed that the above conclusions are robust. Heterogeneity analysis showed that there is no significant difference in the effect of urban pension insurance on calorie intake of migrant workers in different income levels and age groups.

RESUMO: Este artigo usa os dados da pesquisa de "Emprego e demanda alimentar dos trabalhadores migrantes urbanos" para analisar empiricamente o impacto do seguro patrimonial urbano na estrutura de ingestão nutricional dos trabalhadores migrantes. O estudo constatou que: o seguro-pensão urbano mudou a estrutura de ingestão nutricional dos trabalhadores migrantes. Gordura e proteína substituíram os carboidratos e se tornaram a principal fonte de nutrição dos trabalhadores migrantes. Depois de controlar fatores como a renda e a intensidade do trabalho dos trabalhadores migrantes, o seguro de pensão urbana aumentou significativamente a ingestão de gordura e proteína dos trabalhadores migrantes em 13,5% e 8,8%, respectivamente, enquanto a ingestão de carboidratos dos trabalhadores migrantes não foi afetada. Significativamente afetado. A transformação da estrutura de ingestão nutricional dos trabalhadores migrantes aumentou sua ingestão calórica em 6,8%. Os testes de endogenia e robustez mostram que as conclusões acima são robustas. A análise de heterogeneidade mostra que não há diferença significativa no efeito do seguro previdenciário urbano sobre o aumento da ingestão de calorias para trabalhadores migrantes de diferentes níveis de renda e diferentes grupos etários.

Construction and Evaluation for Model of Goat Intervertebral Disc Degeneration Induced by Axial Compressive Stress / 医用生物力学

Objective To establish the model of goat intervertebral disc degeneration （IDD） induced by controllable axial compressive stress and evaluate its imaging and pathological characteristics. Methods Twenty goats were randomly divided into 4 groups (control group, 4-week pressure group, 8-week pressure group, 12-week pressure group, n=5, 40 N pressure). Disc height index (DHI) was used to evaluate the change of intervertebral disc height by X-ray, Pfirrmann classification method was used to observe the degree of intervertebral disc degeneration by magnetic resonance imaging (MRI), and histopathological observation and evaluation for intervertebral disc were conducted by HE staining and immunohistochemistry. Results DHI in control group showed no significant changes with the extension of pressure time, while DHI in the experimental group gradually decreased. There was no significant change in Pfirrmann classification in control group. In experimental group, with the extension of time, the higher the degeneration aggravated with the Pfirrmann classification increasing. In experimental group, HE staining showed that the disc nucleus pulposus decreased in volume and nucleus pulposus cells, which were gradually replaced by fibrous tissues. Immunohistochemical staining showed that type I collagen in the nucleus pulposus gradually increased, type Ⅱ collagen gradually decreased, and intervertebral disc degeneration occurred. Conclusions A certain axial compressive stress can lead to degeneration of goat lumbar intervertebral disc, and the degree of degeneration is gradually increased with the extension of time.

In vivo therapeutic success of MicroRNA-155 antagomir in a mouse model of pulmonary fibrosis induced by bleomycin

Background/Aims@#MicroRNAs (miRNAs) play critical regulatory roles in the pathogenesis of pulmonary fibrosis. The aim of this study was to explore whether miRNA antagomirs could serve as potential therapeutic agents in interstitial lung diseases. @*Methods@#A mouse model of pulmonary fibrosis was established by intratracheal injection of bleomycin (BLM). Using microarray analysis, up-regulated miRNAs were identified during the development of pulmonary fibrosis. miR-155 was chosen as the candidate miRNA. Fifteen mice were then randomized into the following three groups: BLM + antagomiR-155 group, treated with BLM plus intravenously injected with antagomiR-155; BLM group, treated with intratracheal BLM plus phosphate-buffered saline (PBS); and a control group, treated with PBS only. Lung tissues were collected for histopathological analysis, hydroxyproline measurement, and Western blotting. Enzyme-linked immunosorbent assays were used for the measurement of cytokines associated with pulmonary fibrosis. @*Results@#Histological changes and hydroxyproline levels induced by BLM were significantly inhibited by antagomiR-155. The levels of interleukin 4 (IL-4) and transforming growth factor-β (TGF-β) expression were increased after BLM treatment. However, miR-155 silencing decreased the expression of IL-4, TGF-β, and interferon-γ. TGF-β-activated kinase 1/mitogen-activated protein kinase kinase kinase 7 (MAP3K7)-binding protein 2 (TAB2) of the mitogen-activated protein kinase (MAPK) signaling pathway, was activated by BLM and inhibited by in vivo silencing of miR-155 via antagomiR-155. @*Conclusions@#In vivo treatment with antagomiR-155 alleviated the pathological changes induced by BLM and may be a promising therapeutic strategy for pulmonary fibrosis.

A new fumagillin compound from marine-derived Aspergillus fumigatus MDCW-15 / 中草药

Objective: To study the secondary metabolites of marine-derived Aspergillus fumigatus MDCW-15. Methods: The secondary metabolites were isolated and purified by column chromatography over silica gel. And their structures were identified by the spectroscopic analysis of NMR and MS. The antifungal bioactivities were assayed by paper diffusion. Results: A new fumagillin compound 1 and a known compound 2 were isolated from the fermentation broth of marine-derived Aspergillus fumigatus MDCW-15. The antifungal bioactivities were assayed by paper diffusion. Compounds 1 and 2 showed antifungal activity against Candida albicans with an equal MIC value of 32.0 μg/mL. Conclusion: Compound 1 is a new compound named 2'-cis- fumagiringillin. Compounds 1 and 2 exhibit antifungal activities.

Epidemic trend of hepatitis B in 18 ethnic minorities of Yunnan Province from 2009 to 2018 / 中华疾病控制杂志

Objective To analyze the epidemic trend of hepatitis B virus (HBV) in 18 minority nationalities in Yunnan Province from 2009 to 2018, so as to explore the ethnic differences in the incidence of HBV in Yunnan Province. Methods Based on the reported incidence data of hepatitis B in China's disease prevention and control information system from 2009 to 2018, descriptive epidemiology method was used to describe and analyze the incidence of hepatitis B in different ethnic groups, and K-means clustering method was used to explore and analyze the annual average incidence of hepatitis B in different ethnic groups. Results From 2009 to 2018, the average incidence of hepatitis B in Yunnan Province was 44.26/100 000, which was much lower than the overall level of China every year; the average incidence of hepatitis B in ethnic groups was 41.27/100 000, slightly lower than the overall level of Yunnan every year. The prevalence of hepatitis B was different in different ethnic groups. The average incidence of Wa was significantly higher than others (95.26/100 000), and Jingpo was the lowest (22.51/100 000). According to the incidence of hepatitis B, different ethnic groups were divided into three categories: high incidence ethnic group, middle incidence ethnic group and low incidence ethnic group. Conclusion There are ethnic differences in the incidence of hepatitis B in Yunnan Province. The incidence of hepatitis B in some ethnic groups is higher than that in the whole country all the year round, which is the key population in the prevention and control of hepatitis B.

Genetic factors related to the widespread dissemination of ST11 extensively drug-resistant carbapenemase-producing Klebsiella pneumoniae strains within hospital / 中华医学杂志(英文版)

BACKGROUND@#Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) poses distinct clinical challenges due to extensively drug resistant (XDR) phenotype, and sequence type (ST) 11 is the most dominant blaKPC-2-bearing CP-Kp clone in China. The purpose of this current retrospective study was to explore the genetic factors associated with the success of XDR CP-Kp ST11 strains circulated in the intensive care unit (ICU) of a Chinese tertiary hospital.@*METHODS@#Six ST11 XDR CP-Kp strains were identified between May and December 2014 and validated by minimum inhibitory concentration examination, polymerase chain reaction, and pyrosequencing. The six ST11 XDR CP-Kp, as well as three multi-drug resistant (MDR) and four susceptible strains, were sequenced using single-molecule real-time method. Comprehensively structural and functional analysis based on comparative genomics was performed to identify genomic characteristics of the XDR ST11 CP-Kp strains.@*RESULTS@#We found that ST11 XDR blaKPC-2-bearing CP-Kp strains isolated from inpatients spread in the ICU of the hospital. Functionally, genes associated with information storage and processing of the ST11 XDR CP-Kp strains were more abundant than those of MDR and susceptible strains, especially genes correlative with mobile genetic elements (MGEs) such as transposons and prophages. Structurally, eleven large-scale genetic regions taken for the unique genome in these ST11 XDR CP-Kp strains were identified as MGEs including transposons, integrons, prophages, genomic islands, and integrative and conjugative elements. Three of them were located on plasmids and eight on chromosomes; five of them were with antimicrobial resistance genes and eight with adaptation associated genes. Notably, a new blaKPC-2-bearing ΔΔTn1721-blaKPC-2 transposon, probably transposed and truncated from ΔTn1721-blaKPC-2 by IS903D and ISKpn8, was identified in all six ST11 XDR CP-Kp strains.@*CONCLUSION@#Our findings suggested that together with clonal spread, MGEs identified uniquely in the ST11 XDR CP-Kp strains might contribute to their formidable adaptability, which facilitated their widespread dissemination in hospital.

Generation of a Hutchinson-Gilford progeria syndrome monkey model by base editing

Many human genetic diseases, including Hutchinson-Gilford progeria syndrome (HGPS), are caused by single point mutations. HGPS is a rare disorder that causes premature aging and is usually caused by a de novo point mutation in the LMNA gene. Base editors (BEs) composed of a cytidine deaminase fused to CRISPR/Cas9 nickase are highly efficient at inducing C to T base conversions in a programmable manner and can be used to generate animal disease models with single amino-acid substitutions. Here, we generated the first HGPS monkey model by delivering a BE mRNA and guide RNA (gRNA) targeting the LMNA gene via microinjection into monkey zygotes. Five out of six newborn monkeys carried the mutation specifically at the target site. HGPS monkeys expressed the toxic form of lamin A, progerin, and recapitulated the typical HGPS phenotypes including growth retardation, bone alterations, and vascular abnormalities. Thus, this monkey model genetically and clinically mimics HGPS in humans, demonstrating that the BE system can efficiently and accurately generate patient-specific disease models in non-human primates.

Recent advances and perspectives of nucleic acid detection for coronavirus / 药物分析学报

The recent pneumonia outbreak caused by a novel coronavirus (SARS-CoV-2) is posing a great threat to global public health. Therefore, rapid and accurate identification of pathogenic viruses plays a vital role in selecting appropriate treatments, saving people's lives and preventing epidemics. It is important to establish a quick standard diagnostic test for the detection of the infectious disease (COVID-19) to prevent subsequent secondary spread. Polymerase chain reaction (PCR) is regarded as a gold standard test for the molecular diagnosis of viral and bacterial infections with high sensitivity and specificity. Isothermal nucleic acid amplification is considered to be a highly promising candidate method due to its fundamental advantage in quick procedure time at constant temperature without thermocycler opera-tion. A variety of improved or new approaches also have been developed. This review summarizes the currently available detection methods for coronavirus nucleic acid. It is anticipated that this will assist researchers and clinicians in developing better techniques for timely and effective detection of coro-navirus infection.

Study of inhomogeneous magnetization transfer imaging in multiple sclerosis / 中国医学影像技术

Objective: To observe the value of inhomogeneous magnetization transfer (ihMT) imaging in diagnosis of multiple sclerosis (MS). Methods: Totally 18 patients with clinical diagnosed MS and 16 healthy volunteers were enrolled. ihMT imagings were obtained, while magnetic transfer ratio (MTR), quantitative magnetization transfer (qMT) value, inhomogeneous magnetization transfer ratio (ihMTR) and inhomogeneous quantitative magnetization transfer (qihMT) value of MS lesions and normal white mater of volunteers were measured, respectively. ihMT metrics were compared between MS patients and volunteers. Spearman correlation was conducted to analyze the correlation of MTR, qMT, ihMTR and qihMT values and clinical expanded disability status scale (EDSS) for MS patients. Results: MTR, qMT, ihMTR and qihMT of MS patients were significantly lower than those of volunteers (all P<0.001). There was moderate negative correlation between MTR, qMT and EDSS (r=-0.440, -0.572, P=0.004, 0.002), also significant negative correlation between ihMTR, qihMT and EDSS (r=-0.704, -0.739, both P<0.001). Conclusion: ihMTR and qihMT values are sensitive to detect the changes of myelin content and have good correlation with clinical symptoms, therefore having good prospects for clinical application.

Effect of Liuwei Dihuangwan on Blood Metabolism During Growth and Development of Rats / 中国实验方剂学杂志

Objective: The effect of Liuwei Dihuangwan on blood metabolism during growth and development of rats was investigated by taking the overall metabolic profile and biomarkers of metabolomics as indexes. Method: Ultra performance liquid chromatography-high definition mass spectrometry(UPLC-HDMS) was employed to establish a blood metabolomics study method for characterizing the blood metabolic profile of rats at different time before and after administration. The pattern recognition method was used to integrate and analyze the metabolic profiles, and the differential metabolic markers related to drug action were searched. Based on metabolomics pathway analysis(MetPA) and Kyoto encyclopedia of genes and genomes(KEGG) and other databases, the metabolic pathways related to differential markers were analyzed to study the effect of Liuwei Dihuangwan on blood metabolism during growth and development of rats. Result: Liuwei Dihuangwan significantly affect the blood metabolism profiles during growth and development of rats by regulating 30 blood metabolic markers and 12 related target metabolic pathways, and 8 key metabolic markers were delineated. Conclusion: Liuwei Dihuangwan can significantly regulate the blood metabolic network during the growth and development of rats, thereby affecting the growth and development of rats.

Thevaluationofcombiningapplicationof3DGpCASLandSWIinpredictingtheoutcomesofcerebralischemia / 实用放射学杂志

Objective Toexploretheclinicalvalueofcombiningapplicationofthreedimensionalpseudocontinuousarterialspin labeling (3D-pCASL)andsusceptibilityweightedimaging (SWI)inpredictingtheoutcomsofcerebralischemia.Methods Thirty-two patientswithmoderatetoseverestenosisofunilateralmiddlecerebralartery(MCA)and16healthyvolunteers(asacontrolgroup) underwenttheexaminationsoftheroutineMRI,MRA,3D-pCASL (PLD:1525ms,2525ms)andSWI.Thepatientsweredividedinto twogroups:lowperfusiongroupandequal/highperfusiongroupaccordingtotherCBFof3D-pCASLwithPLD:2525ms.OnSWI, theparametersofdeepmedullaryvein(DMV)includedratioofquantity,totallengthinbilateralunitareaandsubjectivescoreofischemic side.ThedifferencesofthevaluesofDMV parametersamongthegroupswerecompared,andthecorrelationsbetweenrCBFand DMVparameterswereanalyzed.Thereexaminationswereperformed6monthslaterandtheincidenceofinfarctionwascomparedbetween thelowperfusiongroupandtheequal/highperfusiongroup.ThecorrelationbetweenvaluechangeofrCBFandDMV,andthetransformation tendencyfromtheischemiclesiontocerebralinfarctionwerealsoanalyzed.Results Inthelowperfusiongroup,allDMVparameters werehigherthanthoseinthecontrolgroupandtheequal/highperfusiongroup,andthedifferencesbetweengroupswerestatistically significant(P＜0.05),buttherewerenosignificantdifferencesbetweenthevaluesofthecontrolgroupandtheequal/highperfusion group (P＞0.05).Thereexaminationresultsof6monthslatershowedthat4caseswithcerebralinfarctionwereallfromthelowperfusion group.Theincidenceofthecerebralinfarctioninthelowperfusion groupwas25%andwassignificantlyhigherthanthat(0%)in theequal/highperfusiongroup (P＜0.05).Theincidencewas positivelycorrelatedwiththeratioofquantity,totallengthinbilateral unitareaandsubjectivescoreofischemicsideofDMV (r＝0.512,0.43,0.449,P＜0.05),whilenegativelycorrelatedwithrCBF (r＝－0.501,P＜0.05).Conclusion TherearesomechangesofrCBFandDMVincerebralischemicarea,andthereisacorrelationbetween rCBFandDMV.3D-pCASLandSWIcanshowcerebralbloodflowperfusionandDMVinischemicarea,andplayanimportantrolein studyingtheoutcomesofcerebralischemiclesions.

Comprehensive evaluation of medullary thyroid carcinoma before surgery / 中华医学杂志(英文版)

BACKGROUND@#Medullary thyroid carcinoma (MTC) is a rare disease, but it exhibits more aggressive behaviors. The aim of this study was to improve the diagnostic accuracy of MTC before surgery by analyzing the clinical and ultrasonic data of patients with MTC.@*METHODS@#The study included 71 patients (96 lesions) with histopathologically proven MTC between April 2011 and September 2016 in the Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College. The clinical characteristics and sonographic findings were retrospectively reviewed and compared between the ultrasonic correct diagnosis group and the ultrasonic misdiagnosis group with the t test or Mann-Whitney U test for quantitative parameters and the χ test or Fisher exact test for qualitative parameters.@*RESULTS@#Compared with the ultrasonic correct diagnosis group, the proportion of the cystic change in the ultrasonic misdiagnosed group was high (25.0% vs. 4.2%), the uncircumscribed margin and irregular shape proportions were low (20.8%, 58.3% vs. 74.7%, 87.3%), calcification was relatively rare (20.8% vs. 56.3%), and rich vascularity was relatively rare (25.0% vs. 78.9%).@*CONCLUSIONS@#In the case of atypical MTC, such as cystic change, circumscribed margin, regular shape, no calcification, no rich vascularity, and normal cervical lymph nodes, MTC is easily misdiagnosed as benign by ultrasound. Therefore, ultrasound, cytology and serum calcitonin should be comprehensively evaluated for a preoperative diagnosis of MTC.

Analysis of inorganic elements in Guizhi Fuling Capsules by ICP-MS / 中草药

Objective: To establish a method for the simultaneous analysis of 29 inorganic elements in Guizhi Fuling Capsules (GFC), including Li, Be, B, Na, Mg, Al, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Sr, Mo, Cd, Sn, Sb, Ba, Hg, Tl, Pb, and Bi. Methods: The sample of GFC was digested by microwave with concentrated nitric acid, calibrated by internal standard elements, such as Ge and In, with bush branches and leaves as the controlled reference standard, and inlet into ICP-MS to analyze the contents of 29 inorganic elements. Results: The detection limits and quantification limits of the 29 elements were in the range of 0.012—4.105 μg/L and 0.045—14.500 μg/L. The 29 trace elements showed the good linearity in the selected concentration ranges (r ≥ 0.999 4), with the average recovery from 79.88% to 105.76%, while their RSD was below 4.55%. In the 12 batches of samples, the quantities of Ca, Na, and Mg were higher than 300 μg/g. The quantities of Fe, Mn, and Sr were also relatively high, while the amount of Be, As, Cd, Sb, Hg, Tl, and Bi was relatively low, which was below 0.030 μg/g. Conclusion: The method is simple, rapid, and accurate, and can be used for the quality control of trace elements and heavy metals in GFC.