Role of salidroside in a mouse model of non-alcoholic fatty liver disease： A study based on nicotinamide phosphoribosyltransferase / 临床肝胆病杂志

ObjectiveTo investigate the protective effect of salidroside against nonalcoholic fatty liver disease （NAFLD） and its mechanism of action. MethodsA total of 24 male KM mice were randomly divided into normal group， HFD group， HFD+blank control group， and HFD+salidroside group， with 6 mice in each group. The mice in the normal group were given normal diet， and those in the other groups were given high-fat diet. After 14 weeks of modeling， the mice were given salidroside 100 mg/kg/day by gavage， and related samples were collected at the end of week 22. Enzyme-linked immunosorbent assay was used to measure the serum levels of related biochemical parameters including alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C）； HE staining and NAFLD activity score （NAS） were used to observe the liver histopathology of mice； Western blot was used to measure the changes in the expression of NAMPT， Sirt1， AMPKα， and SREBP1 in liver tissue. A one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the normal group， the HFD group had obvious steatosis and extensive large lipid droplets in liver tissue， with significant increases in NAS score （P<0.01） and the content of AST， ALT， TG， TC， and LDL-C in peripheral blood （all P<0.05） and a significant reduction in the content of HDL-C （P<0.05）， as well as significant reductions in the expression levels of NAMPT， AMPKα， and Sirt1 in liver tissue （all P<0.05） and a significant increase in the expression level of SERBP1 （P<0.01）. Compared with the HFD group and the HFD+blank control group， the HFD+salidroside group had reductions in the distribution of vacuolar lipid droplets and intralobular inflammation in liver tissue， alleviation of the ballooning degeneration of hepatocytes， significant reductions in NAS score （P<0.01） and the content of AST， ALT， TG， and LDL-C in peripheral blood （all P<0.05）， and a significant increase in the content of HDL-C （P<0.05）， as well as significant increases in the expression levels of NAMPT， AMPKα， and Sirt1 in liver tissue （all P<0.05） and a significant reduction in the expression level of SERBP1 （P<0.01）. ConclusionSalidroside can significantly improve the pathological state of mice with NAFLD induced by high-fat diet and exert a protective effect against NAFLD by increasing the expression of NAMPT， Sirt1， and AMPKα and reducing the expression of SERBP1.

Evaluation of the effect of mindfulness-based cognitive therapy on the psychological emotions and quality of life of patients undergoing radiotherapy for cancer / 中国实用护理杂志

Objective:To explore the effectiveness of positive cognitive therapy in improving anxiety and depression, psychological distress, positive awareness, and quality of life in cancer patients, with a view to providing an experience for practical clinical application.Methods:This study was a quasi experimental study, in which 96 patients with cancer radiotherapy attending Shanghai Proton Heavy Ion Center from April 2019 to January 2021 were selected as study subjects by convenience sampling, and were divided into 47 cases in the intervention group and 49 cases in the control group according to the district group randomization method. The control group was given conventional psychological care and health education, and instructed to learn the audio and video of positive cognitive therapy at the end of the study; the intervention group was given 8 sessions of positive cognitive therapy over a period of 4 weeks. At the end of the intervention, the Pdistress Thermometer, the Generalized Anxiety Inventory, the Patient Health Questionnaire Depression Inventory, the Brief Version of the Five Factor Positive Thinking Inventory, and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire C30 were used to compare the psychological distress, anxiety and depression, positive cognitive awareness and quality of life of the two groups.Results:After the implementation of the positive cognitive therapy intervention, the incidence rate of anxiety and depression in the intervention group was 12.8% (6/47) and 14.9% (7/47), respectively, both of which were significantly lower than the 30.6% (15/49) and 32.7% (16/49) in the control group, with statistically significant differences ( χ2=3.80, 3.89, both P<0.05); after intervention the scores on the observation, description and perceived action dimensions of the Brief Version of the Five Factor Positive Thinking Scale were (23.8 ± 6.5), (28.6 ± 5.4) and (31.3 ± 5.3) respectively, all significantly higher than those of the control group (20.0 ± 5.1), (23.7 ± 5.5) and (26.9±6.2), the differences were statistically significant ( t=2.79, 3.59, 3.21, all P<0.05); the post-intervention score on the Emotional Functioning dimension of the European Organization for Research and Treatment of Cancer Quality of Life Scale (94.3 ± 7.4) was significantly higher than that of the control group (88.8 ± 11.4), with a statistically significant difference ( t=-2.28, P<0.05). Conclusions:Positive cognitive therapy is effective in relieving anxiety and depression, increasing positive awareness, and improving emotional distress in cancer patients. It can be incorporated into the daily psychological care process of tumor patients, giving them appropriate guidance and support to help improve their psychological and quality of life.

Research progress on the mechanism of promoting fracture healing by traditional Chinese medicine monomer components and compound formulas / 中国药房

Traditional Chinese medicine has the characteristics of multiple components， pathways， and targets in the treatment of fracture healing， and has good therapeutic advantages and potential for fractures with complex pathological mechanisms. Based on this， the author summarized the mechanism of promoting fracture healing by the monomer components and compound formulas of traditional Chinese medicine and found that visfatin A， puerarin， and others can activate the mitogen-activated protein kinase （MAPK） signaling pathway； Xugudan， Guben zenggu formula and others can activate bone morphogenetic protein （BMP） signaling pathway； baicalin， Achyranthes bidentata polysaccharides and others can activate Wnt/β -catenin signaling pathway； apigenin， notoginsenoside and others can activate receptor activator of nuclear factor-κB （NF-κB）/receptor activator of NF-κB ligand/osteoprotegerin （RANK/RANKL/OPG） signaling pathway； Compound huoxue jiegu capsule， Jiangu granule and others can inhibit phosphoinositide 3-kinase/protein kinase B （PI3K/AKT） signaling pathway； icariin can activate Notch signaling pathway； Taohong siwu decoction， crocin and others can activate Hippo signaling pathway； jujuboside A and osthole can inhibit NF-κB signaling pathway， and thus promote fracture healing.

Research progress on pharmacological effects of bilirubin nanoparticles / 中国药房

Bilirubin has good anti-inflammatory， antioxidant and immunomodulatory effects， but its poor water solubility and low bioavailability greatly limit its clinical application. Researchers have developed bilirubin into various nanoparticles， which effectively eliminate the limitation of low solubility of bilirubin with the advantage of dosage form， so that they can maximize its pharmacological activities such as anti-inflammatory， anti-oxidation and immune regulation. Bilirubin nanoparticles have great application potential in a variety of gastrointestinal diseases， liver and kidney diseases， skin diseases， autoimmune diseases， islet transplantation and targeted therapy of tumors （both as a direct anti-tumor drug and as a drug delivery system）. The study of bilirubin nanoparticles will promote the clinical application of bilirubin and the development of related new drugs.

H19 recruited N 6 -methyladenosine (m 6 A) reader YTHDF1 to promote SCARB1 translation and facilitate angiogenesis in gastric cancer / 中华医学杂志(英文版)

BACKGROUND@#Angiogenesis is described as a complex process in which new microvessels sprout from endothelial cells of existing vasculature. This study aimed to determine whether long non-coding RNA (lncRNA) H19 induced the angiogenesis of gastric cancer (GC) and its possible mechanism.@*METHODS@#Gene expression level was determined by quantitative real-time polymerase chain reaction and western blotting. Cell counting kit-8, transwell, 5-Ethynyl-2'-deoxyuridine (EdU), colony formation assay, and human umbilical vein endothelial cells (HUVECs) angiogenesis assay as well as Matrigel plug assay were conducted to study the proliferation, migration, and angiogenesis of GC in vitro and in vivo . The binding protein of H19 was found by RNA pull-down and RNA Immunoprecipitation (RIP). High-throughput sequencing was performed and next Gene Ontology (GO) as well as Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was conducted to analyze the genes that are under H19 regulation. Methylated RIP (me-RIP) assay was used to investigate the sites and abundance among target mRNA. The transcription factor acted as upstream of H19 was determined through chromatin immunoprecipitation (ChIP) and luciferase assay.@*RESULTS@#In this study, we found that hypoxia-induced factor (HIF)-1α could bind to the promoter region of H19, leading to H19 overexpression. High expression of H19 was correlated with angiogenesis in GC, and H19 knocking down could inhibit cell proliferation, migration and angiogenesis. Mechanistically, the oncogenic role of H19 was achieved by binding with the N 6 -methyladenosine (m 6 A) reader YTH domain-containing family protein 1 (YTHDF1), which could recognize the m 6 A site on the 3'-untransated regions (3'-UTR) of scavenger receptor class B member 1 (SCARB1) mRNA, resulting in over-translation of SCARB1 and thus promoting the proliferation, migration, and angiogenesis of GC cells.@*CONCLUSION@#HIF-1α induced overexpression of H19 via binding with the promoter of H19, and H19 promoted GC cells proliferation, migration and angiogenesis through YTHDF1/SCARB1, which might be a beneficial target for antiangiogenic therapy for GC.

Buyang Huanwutang Treats Diabetic Peripheral Neuropathy via Mitochondrial Transport in Rats / 中国实验方剂学杂志

ObjectiveTo investigate the mechanism of Buyang Huanwutang in treating diabetic peripheral neuropathy （DPN） via mitochondrial transport. MethodDiabetes in SD rats was induced by a high-carbohydrate/high-fat diet and intraperitoneal injection of streptozotocin （STZ）. The 45 diabetic rats were randomly assigned into a DPN group， an alpha-lipoic acid （60 mg·kg-1·d-1） group， and a Buyang Huanwutang （15 g·kg-1·d-1） group， with 15 rats in each group. Fifteen normal SD rats were fed with the standard diet and set as the control group. The rats were administrated with corresponding drugs by gavage for 12 weeks. The paw withdraw threshold （PWT） and motor nerve conduction velocity （MNCV） were measured at the end of medication， and the sciatic nerve and the bilateral dorsal root ganglia of L4-5 were collected. The injury model of NSC34 cells was established by treating with 50 mmol·L-1 glucose and 250 μmol·L-1 sodium palmitate. The NSC34 cells were then randomly assigned into a blank （10% blank serum） group， a DPN （10% blank serum） group， an apha-lipoic acid （10% apha-lipoic acid-containing serum） group， a Buyang Huanwutang （10% Buyang Huanwutang-containing serum） group， and a Buyang Huanwutang + Compound C （CC） （10% Buyang Huanwutang-containing serum + 10 μmol·L-1 CC） group. The cell intervention lasted for 24 h. The immunofluorescence method， immunohistochemistry， and Western blot were employed to determine the expression levels of phosphorylated adenosine monophosphate-activated protein kinase （p-AMPK）， phosphorylated cAMP-response element binding protein （p-CREB）， kinesin family member 5A （KIF5A）， and dynein cytoplasmic 1 intermediate chain 2 （DYNC1I2）. ResultCompared with the control group， the DPN group of rats showed increased fasting blood glucose （P<0.01）， decreased MNCV and PWT （P<0.01）， down-regulated expression of KIF5A， p-AMPK/AMPK， and p-CREB/CREB （P<0.01）， and up-regulated expression of DYNC1I2 （P<0.01）. Compared with the DPN group， drug intervention groups showed increased MNCV and PWT （P<0.01）， up-regulated expression of KIF5A， p-AMPK/AMPK， and p-CREB/CREB （P<0.05， P<0.01）， and down-regulated expression of DYNC1I2 （P<0.05， P<0.01）. The Buyang Huanwutang group had higher levels of MNCV and KIF5A （P<0.05） and lower level of DYNC1I2 （P<0.01） than the apha-lipoic acid group. Compared with the blank group， the DPN group of NSC34 cells showed decreased levels of KIF5A， p-AMPK/AMPK， and p-CREB/CREB （P<0.01） and increased level of DYNC1I2 （P<0.01）. The apha-lipoic acid group and Buyang Huanwutang group had higher levels of KIF5A， p-AMPK/AMPK， and p-CREB/CREB （P<0.05， P<0.01） and lower level of DYNC1I2 （P<0.01） in NSC34 cells than the DPN group. Buyang Huanwutang group had higher KIF5A level （P<0.05） in NSC34 cells than the apha-lipoic acid group. Moreover， the Buyang Huanwutang + CC group had lower levels of KIF5A， DYNC1I2， p-AMPK/AMPK， and p-CREB/CREB （P<0.01） in NSC34 cells than the Buyang Huanwutang group. ConclusionBuyang Huanwutang may regulate mitochondrial anterograde transport via the AMPK/CREB pathway to prevent and treat DPN.

Prognostic value of a predictive model based on lower limb skin mottling score in determining the prognosis of patients with sepsis / 中国实用护理杂志

Objective:To develop and analyze the predictive value of a combined predictive model based on the lower limb skin mottling score (SMS) for the outcome of sepsis patients admitted to ICU.Methods:Using a multicenter prospective, observational study, 458 patients admitted to six ICUs in 4 grade A tertiary hospitals in Fujian Province from March 1, 2019 to December 31, 2019 with first diagnosis of sepsis were selected as study subjects. Demographic data, clinical biochemical indexes, lower limb SMS, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) were collected. Binary Logistic regression was used to analyze the outcome of patients with sepsis after admission to ICU, a joint prediction model was constructed, ROC curves were drawn, and a comparison of the predictive efficacy of the lower limb SMS and the joint prediction model was performed.Results:Logistic multifactorial regression analysis showed that lower limb SMS, SOFA score, APACHEⅡscore, lactate, mean arterial pressure were the influencing factors of outcome of patients with sepsis after admission to ICU (all P<0.05). The area under the curve of lower limb SMS predicted ICU outcome risk was 0.718 (95% CI 0.675-0.959, P<0.001) with the sensitivity of 51.96% and specificity of 85.11%. The area under the curve of predictive ability of the combined model based on the lower limb SMS for ICU outcome of sepsis patients was 0.835 (95% CI 0.762-0.878, P<0.01) with the sensitivity of 81.40% and specificity of 73.00%, the difference was significant ( P<0.05). Conclusions:The combined prediction model based on lower limb SMS can more accurately predict the prognosis of sepsis patients after admission to ICU, which can be a new nursing assessment tool for nurses to evaluate the prognosis of sepsis patients and help nurses to make more accurate clinical care decisions and reduce the morbidity and mortality rate.

Effects of pre-pregnancy PM2.5 exposure on vascular remodeling in mother-fetal interface of mice via HIF-1α/VEGF axis / 环境与职业医学

Background Atmospheric fine particulate matter (PM2.5) can induce abnormal early embryo development, resulting in adverse pregnancy outcomes such as embryo damage and spontaneous abortion. The vascular remodeling of maternal-fetal interface regulated by hypoxia inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) axis is a key link in early embryo development. Objective To investigate the effects of pre-pregnancy PM2.5 exposure on the uterine state of mice before conception and the vascular remodeling of maternal-fetal interface after conception, and to further explore the regulatory role of the HIF-1α/VEGF axis. Methods Forty eight-week-old C57BL/6J sexually mature female mice and several males (for mating, without any treatment) were adaptive fed for 1 week. The female mice were divided into a PM2.5 exposure group and a control group, 20 mice per group. The PM2.5 exposure group was given 3 mg·kg−1 PM2.5 suspension by nasal instillation, once every other day for four weeks; the control group were treated with the same dose of blank sampling membrane suspension. Body weight of the mice was recorded every week during the experimental period. At the end of the exposure, six mice from each group were sacrificed. Then the uterus was weighted and its organ coefficients were calculated, a histopathological morphology evaluation was conducted by HE staining, and the mRNA expressions of HIF-1α, VEGF and its receptors Flt-1 and Flk-1 in the uterus samples were further examined. The remaining 14 female mice in each group were caged with male mice overnight with a sex ratio of 2:1, then we calculated the pregnancy rate. On gestation day 10 (GD10), the female mice were decapitated and the uterus was dissected, the histopathological morphology of embryo and placenta were observed by HE staining, and the mRNA expressions of HIF-1α, VEGF and its receptors Flt-1 and Flk-1 were detected as well in the uterus samples. Results Compared with the control group, the pre-pregnancy PM2.5 exposure had no significant effect on body weight gain of the female mice, but decreased uterine organ coefficient, accompanied by pathological damage such as endometrium thinning as well as decreased mRNA expressions of HIF-1α, VEGF and its receptors Flt-1 and Flk-1 (all Ps<0.05). After mating, the pre-pregnancy PM2.5 exposure induced a decrease of the pregnancy rate (control group: 9/14; exposure group: 5/14) and abnormal embryo arrangement, small placenta, narrowing of spiral arteries (control group: 1.00±0.06; exposure group: 0.86±0.08; P=0.01), as well as significant decreases in HIF-1α, VEGF and its receptor Flk-1 mRNA expressions. (all Ps <0.05). Conclusion Pre-pregnancy PM2.5 exposure has adverse effects on the pathological structure and angiogenesis in female mice uterus, leading to abnormal vascular network remodeling at the mother-fetal interface after conception, and the HIF-1α/VEGF axis may play a regulatory role.

Percutaneous transhepatic choledochoscopic lithotripsy versus open hepatectomy for treatment of complicated hepatolithiasis - a propensity score matching study / 中华肝胆外科杂志

Objective:To study minimally invasive treatment using percutaneous transhepatic choledochoscopic lithotripsy (PTCSL) to treat complicated hepatolithiasis.Methods:Patients with complicated hepatolithiasis who were treated at the Second Affiliated Hospital of Kunming Medical University from July 2017 to September 2021, were included into this study. There were 48 patients treated with PTCSL (the PTCSL group) and 150 patients treated with conventional open hepatectomy (the OH group). Propensity score matching (PSM) was used to match 40 patients in the PTCSL group with 40 patients in the OH group. There were 11 males and 29 females, aged 32 to 85 (59.3±12.7) years in the PTCSL group and 15 males and 25 females, aged 20 to 74 (55.4±10.9) years in the OH group. Theoperation time, intraoperative blood loss, hospitalization time, hospitalization cost, incidences of major complications (including pleural effusion, biliary bleeding), residual stone rates and recurrence rates were analyzed.Results:Baseline data were comparable between groups after PSM. For the PTCSL group, the operation time was (135.8±42.6) minutes, intraoperative bleeding volume 32.5(20.0, 50.0) ml, hospitalization time 13.5(11.0, 18.0) days, and hospitalization expense 3.4(2.9, 5.0) wanyuan compared with the corresponding figures in the OH group with operation time (350.7±113.8) minutes, intraoperative bleeding volume 475.0(200.0, 900.0) ml, hospitalization time 24.0(17.3, 28.8) days, and hospitalization expense 6.6(5.0, 8.9) wanyuan. The differences between the two groups were statistically significant (all P<0.05). The overall complication rate was 2.5%(1/40) in the PTCSL group and 22.5%(9/40) in the OH group (χ 2=7.31, P=0.007). The residual stone rate of 20.0%(8/40), stone recurrence rate of 17.5%(7/40), compared with the OH group with the stone residual rate of 27.5%(11/40), stone recurrence rate of 12.5%(5/40). There was no significant difference between the two groups in both the stone residual rates and stone recurrence rates (both P>0.05). Conclusion:In treatment of complex hepatolithiasis, the stone residual rate after repeated PTCSL was comparable to traditional open hepatectomy. PTCSL had the advantages of shorter operation time, less bleeding, lower hospitalization time, lower complication rate and lower hospitalization cost. PTCSL is worthy of wider application and popularization.

Therapeutic Effect of Buyang Huanwutang on Diabetic Peripheral Neuropathy Rats from Perspective of Oxidative Stress / 中国实验方剂学杂志

ObjectiveTo explore the neuroprotective mechanism of Buyang Huanwutang （BYHW） on diabetic peripheral neuropathy （DPN） rats based on oxidative stress and investigate the dosage of Astragali Radix （AR）. MethodNinety SD rats were randomly divided into a normal group， a model group， an α-lipoic acid group （60 mg·kg-1·d-1）， and BYHW groups with high- （15 g·kg-1·d-1）， medium- （8.75 g·kg-1·d-1）， and low-dose （5.625 g·kg-1·d-1） AR groups. The diabetes model was induced in rats except for those in the normal group by the high-sugar/high-fat diet and intraperitoneal injection of streptozotocin （STZ）. Drug intervention lasted for 12 weeks. The paw withdrawal threshold （PWT） and sensory nerve conduction velocity （SNCV） were detected after drug intervention. Gonad-stimulating hormone （GSH） and malondialdehyde （MDA） were determined. The mitochondrial morphology and structure in sensory neurons of L4-5 dorsal root ganglion （DRG） of rats were observed by electron microscopy. Respiratory chain complex Ⅰ， Ⅱ， Ⅲ， and Ⅳ activities and the mitochondrial membrane potential were detected. The main proteins in the adenosine monophosphate-activated protein kinase （AMPK）/nuclear factor-related factor-2 （Nrf2） pathway， such as phosphorylated AMPK （p-AMPK）， phosphorylated Nrf2（p-Nrf2）， heme oxygenase-1 （HO-1）， and quinone NADH dehydrogenase 1 （NQO1）， were detected by immunohistochemistry and Western blot. ResultCompared with the normal group， the model group showed increased fasting blood glucose （P<0.01）， decreased content of SNCV， PWT， and GSH （P<0.01）， elevated MDA content （P<0.01）， obvious mitochondrial damage with vacuolations， reduced activities of respiratory chain complex Ⅰ， Ⅱ， Ⅲ， and Ⅳ and mitochondrial membrane potential （P<0.01）， and declining p-AMPK， p-Nrf2， HO-1， and NQO1 （P<0.01）. Compared with the model group， the α-lipoic acid group and BYHW high-dose group showed increased SNCV， PWT， and GSH， decreased MDA （P<0.05， P<0.01）， alleviated mitochondrial structural damage， increased respiratory chain complex Ⅰ， Ⅱ， Ⅲ， and Ⅳ activities and mitochondrial membrane potential （P<0.01）， and elevated p-AMPK， p-Nrf2， HO-1， and NQO1 （P<0.05， P<0.01）. ConclusionBYHW regulates oxidative stress through the AMPK/Nrf2 pathway to treat DPN. The therapeutic effect of BYHW is related to the dosage of AR. The BYHW group with high-dose AR is superior to the BYHW groups with medium- and low-dose AR groups in inhibiting oxidative stress.

The nephrostomy tube insertion into the vena cava by mistake: a report of 3 cases / 中华泌尿外科杂志

This study reported three patients with inferior vena cava (IVC) injury during percutaneous nephrostomy or nephrostomy catheters exchange. After CT examination, the tube of one case with IVC injury during percutaneous nephrostomy was directly extracted under the supervision of CT. The tube of the other 2 cases with IVC injury during nephrostomy catheters exchange were gradually removed after CT examination. The three patients’ nephrostomy tubes were removed successfully after surgery, without secondary vena cava, renal vein injury, and secondary thrombosis, and then they were all safely reperformed with percutaneous nephrostomy.

Research progress of engineered nanomaterials in the diagnosis and treatment of prostate cancer / 中华泌尿外科杂志

Prostate cancer poses a serious threat to the health of men with an increasing incidence in China. In recent years, great progress has been made in surgical and pharmaceutical treatment, but there are few promising techniques for early diagnosis of prostate cancer or therapeutics for advanced prostate cancer. Engineered nanomaterials have emerged and shown great potential in early diagnosis, precisely targeted therapies and synergistic therapeutics for prostate cancer because of unique physicochemical properties, such as size on the nanoscale, large specific surface area, high drug loading efficiency, fluorescence excitation ability and photothermal/photodynamic effect. This review focused on the new diagnoses and treatment strategies in prostate cancer with engineered nanomaterials, by summarizing the advancement of engineered nanomaterials in improving the sensitivity of molecular biology and imaging diagnosis, targeted guidance in surgery, sensitization of radiotherapy and chemotherapy, and targeted drug delivery.

Association between online social anxiety in middle students with depressive symptoms and sleep quality / 中国学校卫生

Objective@#To identify the latent classes of various online social anxiety among middle school students and further analyze its correlation with depressive symptoms and sleep quality.@*Methods@#From October to December in 2020, a total of 1 402 students were randomly selected from 4 middle schools in Liaoning Province by convenient cluster random sampling method. Students completed the Social Anxiety Scale for Social Media Users(SAS-SMU), the Center for Epidemiologic Studies Depression Scale(CES-D) and Pittsburgh Sleep Quality Index(PSQI). Latent Profile Analysis(LPA) was used to identify online social anxiety types. Logistic regression analysis was used to explore the associations between online social anxiety, sleep quality.@*Results@#Online social anxiety among middle school students was classified into three potential categories: low online social anxiety type (47.00%, 659), medium online social anxiety type (43.37%, 608), and high online social anxiety type(9.63%, 135). Logistic regression analysis revealed that after controlling for demographic variables, medium online social anxiety type and high online social anxiety type significantly and positively predicted depressive symptoms ( β =1.22,2.23, P <0.01) with sleep quality ( β =0.85, 1.68, P < 0.01 ).@*Conclusion@#There is heterogeneity in online social anxiety among middle school students. Schools and families should pay attention to middle school students with high levels of online social anxiety to prevent depressive symptoms and sleep problems and to promote psychologically healthy development.

A comparison of clinicopathological features and prognosis between lymph node dissection extents of pancreatic cancer patients undergoing pancreaticoduodenectomy / 中华普通外科杂志

Objective:To compare the clinical, pathological features and prognosis of patients who underwent pancreaticoduodenectomy with standard or extended lymph node dissection for pancreatic ductal adenocarcinoma.Methods:A retrospective study was performed on 158 pancreatic head cancer patients who underwent radical resection at the First Affiliated Hospital of Nanjing Medical University from Jul 2017 to Feb 2019. The clinicopathological characteristics and prognosis between the standard dissection group and the extended dissection group were compared. The relationship between the number of examined lymph nodes, positive lymph nodes, and the lymph node ratio, together with their relationship with survival were analyzed.Results:Survival analysis showed no statistical difference in survival between the standard resection group and the extended resection group ( P=0.99). There were statistical differences in gender and age composition between the two group, but no significant differences in operation time, blood loss, or postoperative complications were found. Patients with less examined lymph nodes tended to be of stage N0. examined lymph nodes is positively correlated with positive lymph nodes but is not significantly correlated with lymph node ratio. Positive lymph nodes is strongly correlated with lymph node ratio. The location of lymph node metastasis was not survival-related. Conclusions:There is no prognostic difference between standard lymph node dissection and extended lymph node dissection in pancreatic cancinoma patients after Whipple procedure.

The prognostic value of preoperative red cell distribution width to platelet ratio on prostate cancer patients treated with endocrine therapy after radical prostatectomy / 中华泌尿外科杂志

Objective:To evaluate the prognostic value of preoperative red cell distribution width to platelet ratio on prostate cancer patients treated with endocrine therapy after radical prostatectomy.Methods:The clinical data of 349 prostate cancer patients treated with endocrine therapy after radical prostatectomy in our hospital from October 2007 to October 2018 were retrospectively analyzed.Among all the patients, the average age was 67 years old(ranged 42 to 84 years). The preoperative newly diagnosed PSA level was 4.2-499.2 ng/ml(average 30.6 ng/ml). 158 cases had a Gleason score of more than 8. 191 cases had a Gleason score of below than 8. According to tumorous staging, 151 patients were staged less than or equal to stage T 2b, 110 patients were staged as stage T 2c, 88 patients were staged equal or greater than stage T 3a. 295 patients were staged less than 1.15 ng/(ml·cm 3)of prostate specific antigen density, 54 patients were staged equal or greater than 1.15 ng/(ml·cm 3). There were 86 cases of seminal vesicle invasion and 263 cases of non-seminal vesicle invasion. There were 121 patients with low risk of prostate cancer, 83 patients with medium risk, and 145 patients with high risk. All patients received endocrine therapy after radical prostatectomy with androgen deprivation therapy (ADT). End point of observation was biochemical recurrence-free survival (RFS) with PCa patients treated with endocrine therapy after radical prostatectomy. Patients were categorized in two groups with high RPR and low RPR values using a cut-off point as calculated by the receiver-operating curve analysis.Correlations between RPR and clinical characteristics were analyzed.The prognostic analysis of preoperative RPR on prostate cancer patients treated with endocrine therapy after radical prostatectomy was estimated using Kaplan-Meier analysis and Cox proportional hazards models. Kaplan-Meier method was used to draw the survival curve. Meanwhile, univariate and multivariate Cox regression were used to explore factors influencing the prognosis of PCa patients. Results:of the 349 cases, ranging 4-132 months. Biochemical recurrence with PCa patients occurred in 93 cases, and 256 patients were not biochemical recurrence.The ideal cutoff value of preoperative RPR was 0.27(95% CI 0.502-0.653, P<0.05)determined by the ROC curve, by which the 349 patients was divided into the high RPR group of 66 patients(18.9 %) and the low RPR group of 283 patients(81.1 %). Preoperative RPR was significantly associated with Gleason score ( P=0.005), newly diagnosed tPSA value ( P=0.000), tumor T stage ( P=0.031), PCa risk scale ( P=0.037), positive margin ( P=0.030). The RFS in the high RPR group(26.0 months)was shorter than that in the low RPR group(35.0 months)( P<0.001). In univariate analysis, Gleason score ( HR=1.579, 95% CI 1.049-2.376, P=0.028), serum newly diagnosed tPSA ( HR=2.979, 95% CI 1.655-5.362, P=0.000), tumor T stage( HR=1.292, 95% CI 1.009-1.653, P=0.042), preoperative RPR value ( HR=3.555, 95% CI 2.339-5.401, P=0.000) were prognostic factors ( P<0.05). Cox multivariate analysis showed that higher newly diagnosed tPSA value( HR=1.917, 95% CI 1.033-3.558, P=0.039)and higher RPR value( HR=3.086, 95% CI 1.994-4.775, P=0.000) were independent predictors for endocrine therapy after radical prostatectomy of PCa( P<0.05). Conclusions:Preoperative RPR was an independent predictor for poor prognosis in PCa patients treated with endocrine therapy after radical prostatectomy.

Progress of classification and prognosis of diffuse large B-cell lymphoma / 白血病·淋巴瘤

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, with high clinical and biological heterogeneity. Only 60% of patients can benefit from standard immunochemotherapy. Looking for new clinical parameters and biomarkers to better classify and stratify the prognosis of DLBCL patients has been the focused area in recent years. This article reviews the classifications and their prognostic significances of DLBCL by analyzing the related studies of genome and transcriptome.

Identification of Panax notoginseng and Its Processed Products Based on HPLC and IR Spectrum / 中国药房

OBJECTIVE：To identify Panax notoginseng and its processed products . METHODS ：The fingerprint was established by HPLC. Using ginsenoside Rb 1 as reference ，HPLC fingerprints of 15 batches of P. notoginseng and its processed products were drawn and the similarity evaluation was conducted by using the Similarity Evaluation System for TCM Chromatographic Fingerprints（2012 edition）. The common peaks were confirmed by comparing with substance control. SPSS 21.0 and SIMCA 14.1 software were used to perform cluster analysis ，principal component analysis and orthogonal partial least squares-discriminant analysis；taking the variable importance projection （VIP）value greater than 1 as the standard ，the differential marker components causing the quality difference between P. notoginseng and its processed products were screened. IR fingerprints of P. notoginseng and its processed products were established by OMNIC 8.2.0 software，and the spectral similarity was evaluated ；double index sequence analysis was used to analyze absorption peaks of IR fingerprints of 15 batches of P. notoginseng and its processed products. RESULTS ：There were 16 common peaks in the fingerprints of 15 batches of P. notoginseng ， and the similarities were 0.911-1.000；there were 25 common peaks in the fingerprints of processed products ，and the similaritieswere 0.862-1.000. They had 12 identical common peaks ，and wang668@sina.com three of them were ident ified as sanchinoside R 1，ginsenoside Rg1 and ginsenoside Rb 1. Results of cluster analysi s showed that when the distance was 10，15 batches of P. notoginseng could be clustered into two categories ，SW1-SW5 into one category ，SH1-SH5 and SQ 1-SQ5 into one category ，ZW1-ZW5，ZH1-ZH5 and ZQ1-ZQ5 of 15 batches of processed products could be clustered into one category. When the distance was 5，15 batches of P. notoginseng could be clustered into three categories ，SW1-SW5 into one category ，SH2-SH5 and SQ 2 into one category ，SQ1， SQ3-SQ5 and SH 1 into one category. Fifteen batches of processed products could be clustered into two categories ，ZW1-ZW5 into one category ，ZH1-ZH5 and ZQ 1-ZQ5 into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first two principal components was 80.104％ . The results of orthogonal partial least squares-discriminant analysis showed that the VIP values of the five peaks were greater than 1，which were peak H ，peak G ，peak J，peak F （ginsenoside Rg 1）and peak I. The similarity of IR fingerprints of 15 batches of P. notoginseng and its processed products were 0.889 7-1.000 0 and 0.972 8-1.000 0；the common peak rates were 80％-100％，and the variation peak rates were 0-17.65％ and 0-18.75％，respectively. By comparing the wave numbers of absorption peaks ，it was found that there were differences between P. notoginseng at 3 440 and 1 450 cm－1 and processed products at 1 530 and 575 cm－1. CONCLUSIONS ：Established HPLC fingerprint and IR fingerprint have good similarity ，and could effectively distinguish P. notoginseng and its processed products. P. notoginseng and its processed products from different habitats have high common peak rate and low variation rate ，and their chemical components are different ；peak H ，peak G ，peak J ，ginsenoside Rg 1 and peak I are differential marker components causing the quality difference between P. notoginseng and processed products.

Study on Isolation ，Purification and in vitro Antioxidant Activity of the Polysaccharides from Cucumis satiuus / 中国药房

OBJECTIVE：To isolate and purify the polysaccharides from Cucumis satiuus ，and to investigate its in vitro antioxidant activity. METHODS ：The crude polysaccharides （CCL）were extracted from C. satiuus by water extraction and alcohol precipitation. CCL was separated and purified on Amberlite FPA 90Cl anion and Amberlite FPC 3500H cation exchange resin column and DEAE cellulose 52 column，so as to obtain 3 kinds of polysaccharides as CCL-M 2，CCL-M3，CCL-M6. The purity ， molecular weight ，structure and monosaccharide composition of 3 kinds of polysaccharides were analyzed by HPLC-ELSD ， UPLC-QTOF/MS，UV and IR. Using vitamin C （VC）as positive control ，the scavenging activity of CCL-M 2，CCL-M3 and CCL-M6（0.4，0.8，1.2，1.6，2.0 mg/mL）to 1，1-dibenzene-2-trinitrobenzene free radicals （DPPH·），hydroxyl free radicals （·OH） and superoxycyclic anion free radicals （O2－·）were investigated ，and IC50 was calculated. RESULTS ：CCL-M2，CCL-M3 and CCL-M6 were homogeneous polysaccharides in the form of pyranose ，with molecular weights of 9.614×106，2.024×107 and 3.343× 107 Da，respectively. CCL-M 2 monosaccharides were composed of rhamnose ，semi-lactose aldehyde acid ，glucose， semi-lactose and arabic sugar ，with a molar ratio of 5.1∶2.6∶1.7∶1.4∶31.6. CCL-M 3 and CCL-M 6 monosaccharides were composed of mannose， rhamnose，glucose，semi-lactose，arabic sugar ，with a molar ratio of 1.7 ∶ 3.8 ∶ 6.4 ∶ 3.3 ∶ 1.3 and 1.3 ∶ 3.0 ∶ 3.2 ∶ 4.4 ∶ 8.9. The results of antioxidant activity in vitro showed that 3 kinds of homogeneous polysaccharides had certain scavenging activity on DPPH ·，·OH and O 2－·；the order of scavenging activity to DPPH ·was VC ＞CCL-M2＞CCL-M3＞CCL-M6（IC50 was 0.309， 1.240， 1.489 and 1.713 mg/mL）； the order of scavenging activity to ·OH was VC ＞CCL-M2＞CCL-M6＞CCL-M3（IC50 was 0.968，1.032，1.233，1.356 mg/mL）；the order of scavenging activity to O 2 －· was VC ＞CCL-M2＞CCL-M3＞CCL-M6 （IC50 was 0.335， 0.379， 0.812， 1.662 mg/mL）. CONCLUSIONS：3 kinds of monosaccharides in the form of pyranose are isolated from C. satiuus ，and all of them have antioxidant activity in vitro ，and CCL-M 2 is the best.

Progress of long non-coding RNA in diffuse large B-cell lymphoma / 白血病·淋巴瘤

Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma, and its etiology and molecular mechanism has not been fully elucidated. Recently, increasing evidence has indicated that long non-coding RNA (LncRNA) participates in the occurrence, development, invasion and metastasis of DLBCL. This article reviews lncRNA-related genes and signaling pathways as well as the molecular mechanism of DLBCL.

Clinicopathological features of dedifferentiated liposarcomas with meningothelial-like whorls: report of six cases / 中华病理学杂志

Objective@#To investigate the histopathologic, immunohistochemical, molecular genetic characteristics of dedifferentiated liposarcomas with meningothelial-like whorls(DDLMW).@*Methods@#Six cases of DDLMW diagnosed at Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University) from March 2012 to August 2018 were enrolled. The cases were analyzed by routine HE staining, immunohistochemistry(MDM2, CDK4 and p16) and fluorescent in-situ hybridization(FISH) on MDM2 gene. Related literatures were also reviewed.@*Results@#Three of the 6 patients were male.The patient ages ranged from 40 to 77 years (mean, 58 years). Four tumors occurred in the retroperitoneum and two in the mediastinum. Histologically, the tumors showed, in addition to foci of well-differentied liposarcoma, characteristic, scattered meningothelial-like concentrical whorls. The whorls were composed of tightly, concentrically arranged, spindle to ovoid cells with mild to mederate cytological atypia. Metaplastic bone was present within or in their immediate vicinity in four case. The tumors cell also showed strong and diffuse immunoreactivity to MDM2, CDK4 and p16, but no immunoreactivity to S-100 protein, SMA, SOX10, EMA, CD21, CD23 or CD35. The Ki-67 labeling indexes were low, while FISH showed high levels of MDM2 amplification in all cases.@*Conclusions@#DDLMW is a rare morphologic variant of dedifferentiated liposarcoma. The whorls in DDLMW do not represent perineurial or follicular dendritic differentiation. Recognition and familiarity with its existence, as well as combined application of immunohistochemical staining and MDM FISH, are important to avoid confusion with other lesions.