A randomized controlled trial of indobufen versus aspirin in the prevention of bridging restenosis after coronary artery bypass grafting / 中华心血管病杂志

Objective: To compare the efficacy and safety between indobufen and aspirin in the prevention of restenosis of bridge vessels at 1 year after off-pump coronary artery bypass grafting. Methods: This study was a prospective cohort study. We selected 152 patients who received coronary artery bypass grafting in Beijing Anzhen Hospital from December 2016 to December 2018. Patients were divided into the indobufen group and the aspirin group. Patients in the aspirin group were treated with aspirin and clopidogrel, and patients in the indobufen group were treated with indobufen and clopidogrel. During the 1-year follow-up, the rate of restenosis of saphenous vein bridge and internal mammary artery bridge, the rate of adverse cardiac events and adverse reactions were compared between the two groups. The levels of fibrinogen (FIB), D-dimer (D-D), thrombomodulin (TM) and thrombin-activatable fibrinolysis inhibitor (TAFI) were compared before and after antiplatelet therapy. Results: There were 76 cases in the indobufen group, including 57 males (75.0%), aged (60.3±6.6) years. There were 76 cases in the aspirin group, including 62 males (81.6%), aged (59.7±7.2) years. Baseline data were comparable between the two groups (P>0.05). During the follow-up, 3 cases were lost to follow up. Follow-up was completed in 74 patients in the indobufen group and 75 in the aspirin group. A total of 268 bridging vessels were grafted in the indobufen group and 272 in the aspirin group. One year after surgery, the patency rates of great saphenous vein bridge and internal mammary artery bridge were 94.5% (189/200) and 97.1% (66/68) in the indobuphen group, and 91.3% (189/207) and 96.9% (63/65) in the aspirin group, respectively. There was no significant difference in patency rate of great saphenous vein bridge and internal mammary artery bridge between the two groups (χ²=0.282, 0.345, P>0.05). The total incidence of adverse cardiac events was 5.4% (4/74) in the indobufen group and 6.7% (5/75) in the aspirin group (χ²=0.126, P>0.05). The overall incidence of gastrointestinal adverse reactions was significantly lower in the indobufen group than in the aspirin group (4.1% (3/74) vs. 13.3% (10/75), χ²=4.547, P<0.05). The levels of FIB, D-D, TM and TAFI in the two groups were lower than those before surgery (P<0.05), and there was no statistical significance between the two groups at baseline and post-operation (P>0.05). Conclusion: The efficacy of indobufen combined with clopidogrel in the prevention of 1-year restenosis after coronary artery bypass graft is similar to that of aspirin combined with clopidogrel, but the incidence of adverse reactions is lower, and the safety is higher in patients treated with indobufen combined with clopidogrel compared to aspirin combined with clopidogrel strategy.

Observation of binocular visual quality after single-focal and multifocal intraocular lens with different types of implantation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: The clinical outcomes of unilateral single-focal intraocular len(SIOL), contralateral implanted multifocal IOL(MIOL)and the SIOL was implanted in binoculus were compared.METHODS: There were 60 cases with 120 eyes age-related cataract patients in January 2019 to January 2021 underwent phacoemulsification and IOL implantation in Chengdu Aier Eye Hospital. The SIOL has been implanted in the dominant eyes, all patients were divided into three groups according to the types of IOL implanted in the contralateral non-dominant eyes, among them, there were 36 eyes of 18 cases in group A with non-dominant eyes implanted MIOL(SBL-3); 38 eyes of 19 cases in group B were implanted MIOL(SN6AD1)in non-dominant eyes. SIOL was implanted in all 46 eyes of 23 cases of control group. After operation at 3mo,the results of binocular vision and visual quality of the three groups were evaluated and compared.RESULTS: After operationat 3mo, there was no difference in the uncorrected distance vision and corrected distance vision, uncorrected medium vision and corrected near vision among the three groups(P<0.05).The uncorrected near visual acuity and corrected intermediate visual acuity of both eyes in groups A and B were significantly improved in both groups compared with the control group(P<0.05). The scores of Catquest 9SF-CN scale showed that the quality of life of patients in group A and group B(11.11±1.323, 11.89±1.883 scores)was better than that in the control group(14.65±1.722 scores, both P<0.05). The rate of lens removal in group A, B and control group were 88.9%, 84.2% and 39.1%, respectively, and the rate of lens removal in group A was significantly higher than that in the control group(P<0.0167).CONCLUSION: Dominant eye implantation of SIOL in patients with cataract and contralateral non-dominant eye implantation of MIOL(SBL-3/SN6AD1)can obtain better full-range visual acuity than binoculus, less postoperative adverse visual symptoms, and higher patient disengagement rate and satisfaction.

Experience and reflection of financial management in science and technology transfer in public hospitals / 中华医学科研管理杂志

Objective:To explore the development path of improving the intangible assets management, and promoting science and technology transfer of public hospitals.Methods:Analyze and summarize problems and challenges in the identification and disposal of intangible assets related to scientific and technological achievements in the process of technology transfer based on policy research, literature review and practical experience reflection.Results:So far, the identification and measurement norms of intangible assets are not operable enough. Assets evaluation remains controversial and nonstandard.Conclusions:It is recommended to improve the management systems of science and technology transfer and related financial affairs including strengthening the awareness of intangible assets protection, standardizing the management system of intangible assets and optimizing the informatization construction of financial management.

Lipid analysis of coronary atherosclerotic plaques and the mechanism of restenosis after coronary endarterectomy / 中华胸心血管外科杂志

Objective:To analyze the lipid composition of coronary atherosclerotic plaques and explore the mechanism of its influence on the medium and long-term efficacy of coronary endarterectomy(CE).Methods:From January 2018 to December 2019, a total of 50 patients with diffuse coronary artery disease(DCAD)and hyperlipidemia in Beijing Anzhen Hospital were enrolled to undergo coronary artery bypass grafting combined with anterior descending CE. After the informed consent was signed before the operation, the coronary endarterectomy plaque tissue and blood plasma samples were taken during the operation. Patients were further examined by coronary atherosclerosis T1-weighted characterization(CATCH) and power domain non-orthogonal multiple access(NOMA)postoperatively to analyze middle and long-term coronary restenosis risks. They were divided into high-risk group(restenosis rate >25%, study group) and matched low-risk group(control group). Lipid and molecular biological analysis were performed in the two groups to detect the tissue and cytochrome P450 3A4 enzyme(CYP3A4) content of plaque samples.Results:8 patients were enrolled in each group. The lipid analysis showed that and tissue samples from patients in the study group had a significantly higher level of 4α- Hydroxycholesterol(4α-OHC)as compared to the control group(0.050 μmol/g vs. 0.016 μmol/g, P<0.05). Further, 12 months after the operation, CATCH results showed that the patency rate of the control group was better than that of the study group[coronary artery stenosis rate(9.01±1.9)% vs.(22. 31±2.3)%, P<0.05]. Comparison of CYP3A4 content showed that: the CYP3A4 in blood plasma for the study group was higher than that in the control group[immediate(0.88±0.05)ng/ml vs.(0. 45±0.03) ng/ml and(2. 08± 0.40) ng/ml vs.(1. 58± 0.16)ng/ml, P<0.05]. Conclusion:High expression of 4 α- OHC may accelerate atherosclerosis(AS) after CE and cause restenosis in the middle and long term; It was also confirmed that 4 α- OHC is a biomarker of CYP3A4, which suggests for further investigation of the mechanism of progression after CE.

Analysis of clinical data of lower limbs deep vein thrombosis in inpatients with advanced age in internal medicine / 中华老年医学杂志

Objective:To analyze the treatment and prognosis of advanced age inpatients in Medical Department with lower limbs deep venous thrombosis(DVT).Methods:This was a retrospective study of elderly medical inpatients with DVT, including 58 males(54.7%)and 48 females(45.3%), aged from 80 to 99 years old, in Geriatric Medicine of Peking University Third Hospital from March 2016 to March 2019.There were 91 patients(85.9%)with DVT alone and 15 patients(15.2%)with pulmonary embolism.The clinical data of patients were analyzed, and treatment and prognosis within half a year after discharge were followed-up.Results:A total of 106 elderly medical patients were included, the ratio of male to female was 1.2∶1.0, the age range was 80-99 years old, the median age was 86 years old.Of a total of 106 DVT patients, forty-five cases(42.5%)developed symptoms, sixty-one cases(57.6%)were asymptomatic.Twenty-eight cases(26.4%)involved the proximal lower limb deep veins(popliteal veins and above), seventy-eight cases(73.6%)only involved distal deep veins.Except for advanced age, other DVT risk factors included sixty cases(56.6%)of lung infection, 58 cases(54.7%)being bedridden(>3 d), 50 cases(47.2%)of type 2 diabetes, 46 cases(43.4%)of cerebral infarction, 37 cases(34.9%)of heart failure, and 28 cases(26.4%)of active malignancies, etc.Of a total of 106 DVT patients, 80 cases(75.5%)had high risk of venous thrombosis score, and 68 cases(64.2%)had high risk of bleeding.74 cases received anticoagulant treatment, the rate of anticoagulant treatment was 69.8%.Compared with anticoagulant patients, non-anticoagulant group showed that renal insufficiency, being bedridden, heart failure, cerebral infarction prevalence, and all-cause mortality were increased( P<0.05 or P<0.01).The rate of high risk of bleeding was significantly higher in the non-anticoagulation group than in the anticoagulation group( P<0.01).The pulmonary embolism rate, proximal deep vein involvement rate and their improvement rate when timely rechecking were significantly higher in anticoagulation group than in non-anticoagulation group( P<0.05 or P<0.01, respectively).In the anticoagulation group, 26 patients received short term low-molecular heparin(LMH)treatment during hospitalization, 48 patients(45.3%)were prescribed oral anticoagulants at the time of discharge.Anticoagulation treatment rate is 31.1%(33 cases)at 3 months and 24.5%(26 cases)at 6 months.Non-fatal bleeding occurred in 4 patients in anticoagulation group, but there was no significant difference between the two groups( P>0.05). Conclusions:Great attention should be paid to the risk factors such as lung infection, being bedridden, cerebral infarction, and malignant tumor in the elderly medical inpatients.The rate of high risk of bleeding was high in elderly inpatients, and the rate of regular anticoagulant treatment is low.The risk versus benefit of anticoagulant therapy should be comprehensively evaluated, and individualized therapy should be given.

The effect of mentalization-based family therapy on adolescents with depressive disorder and its related brain regions / 中华行为医学与脑科学杂志

Objective:To explor the effects of mentalization-based family therapy (MBFT) on the emotions of anxiety and depression, reflective functions, and related brain regions of adolescents with depression.Methods:Thirty-two adolescent patients with depression were selected in Beijing Huilongguan Hospital.Among them, fifteen patients treated with conventional drugs were defined as the control group, the other seventeen patients served as the observation group.On the basis of routine drug treatment, patients in the observation group were treated with 1.5 h MBFT once a week, for a total of 3 months.Among them, 10 patients underwent resting functional magnetic resonance imaging(rs-fMRI) scans before and after the intervention.SPSS 23.0 was used for statistical analysis of scale evaluation data by using chi-square test and repeated-measure analysis of variance, and pairwise Pearson correlation was used to construct a brain network matrix for the MRI results.The patient's brain network matrix was put into Gretna to calculate, and then use repeated measures analysis of variance and t test for judgment. Results:(1)Repeated measurement analysis of variance showed, over time and group, before and after intervention, the group×time interactions of patients' reflective function, anxiety, depression were statistically significant ( F=5.113, 9.350, 5.264, all P<0.05). Further simple effect analysis showed, in the observation group, there were statistically significant differences in patients' anxiety ((55.09±14.35) vs (30.58±3.62)), depression ((61.58±16.81) vs (31.00±3.48)) before and after intervention (all P<0.01). There was no significant difference in reflective function ((8.71±0.51) vs (8.87±0.50) ) in the observation group before and after intervention( P> 0.05). The reflective function((8.92±0.33) vs (8.73±0.35)) and anxiety((50.67±13.88) vs (45.78±12.89)) scores of the control group were not statistically significant different before and after intervention(all P>0.05), and the depression scores of the control group before and after inter-vention((69.33±9.11) vs (50.94±7.99)) were statistically significant different( P<0.01). (2)rs-fMRI showed that, using the posterior parietal lobe and the medial prefrontal lobe as seed points, the group×time interactions with right inferior frontal gyrus, right fusiform gyrus, right superior temporal gyrus, left middle temporal gyrus and right superior frontal gyrus were statistically significant ( F=29.56, 20.63, 8.69, 9.49, 8.62, all P<0.05). The further simple effect analysis showed in the observation group, the pre-test was less than the post-test, and the difference was statistically significant( P<0.05). In the control group, there were not statistically significant differences in the functional connection strength before and after the test(all P>0.05). (3)The brain network analysis of 264 regions of interest (ROIs) in the whole brain showed that the number of modules in the observation group was less than that in the control group, and the difference was statistically significant ( t=-2.64, P=0.046). Conclusion:MBFT can improve the anxiety and depression of adolescent patients with depression.It enhances the functional link between mentalization related brain regions and the whole brain, and enhances the activity of the whole brain link to become more integrated.

Application of multidisciplinary teams online teaching in the teaching of urology residents based on network platform / 中华医学教育探索杂志

Introducing the multidisciplinary cooperation model into the clinical teaching of residents has gradually been paid attention to, and the relevant multi-disciplinary teaching teams participate in and formulate teaching plan. The Department of Urology of the Peking University Third Hospital carries out multidisciplinary cooperative teaching of residents based on network platform to improve residents' autonomous learning ability and teaching effect. This model has certain advantages in mobilizing students' subjective initiative and cultivating learning interest. It is of great significance for the training of urology residents.

Symphony of nanomaterials and immunotherapy based on the cancer-immunity cycle

The immune system is involved in the initiation and progression of cancer. Research on cancer and immunity has contributed to the development of several clinically successful immunotherapies. These immunotherapies often act on a single step of the cancer-immunity cycle. In recent years, the discovery of new nanomaterials has dramatically expanded the functions and potential applications of nanomaterials. In addition to acting as drug-delivery platforms, some nanomaterials can induce the immunogenic cell death (ICD) of cancer cells or regulate the profile and strength of the immune response as immunomodulators. Based on their versatility, nanomaterials may serve as an integrated platform for multiple drugs or therapeutic strategies, simultaneously targeting several steps of the cancer-immunity cycle to enhance the outcome of anticancer immune response. To illustrate the critical roles of nanomaterials in cancer immunotherapies based on cancer-immunity cycle, this review will comprehensively describe the crosstalk between the immune system and cancer, and the current applications of nanomaterials, including drug carriers, ICD inducers, and immunomodulators. Moreover, this review will provide a detailed discussion of the knowledge regarding developing combinational cancer immunotherapies based on the cancer-immunity cycle, hoping to maximize the efficacy of these treatments assisted by nanomaterials.

A retrospective controlled study on the treatment effect of distraction osteogenesis and maxillomandibular advancement for severe obstructive sleep apnea hypopnea syndrome patients / 中华口腔医学杂志

Objective: To compare the treatment effect of distraction osteogenesis (DO) and maxillomandibular advancement (MMA) for severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients and to guide clinical decisions about treatment of OSAHS. Methods: Thirty-seven OSAHS patients which accepted maxillomandibular advancement (MMA) or distraction osteogenesis (DO) in Stomatological Hospital of the Department of Maxillofacial Trauma and Orthognathic Surgery, School of Stomatology, The Forth Military Medical University from June 2017 to June 2019 were collected. Their preoperative and postoperative data of cephalometry, polysomnography (PSG), Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) scores were collected and analyzed. With propensity score matching method, the treatment effect of MMA and DO was analyzed and compared. Results: According to the statistics of MMA group, only AHI was correlated with operative successful rate and cure rate. With the increase of AHI, the treatment effect of MMA on OSAHS patients gradually decreased. The cut-off point of AHI as a predictor of MMA treatment failure was 78.2 n/h. All the matched cases were severe OSAHS patients. Statistical analysis showed that the mandibular elongation of DO patients[(24.00±4.39) mm] was significantly more than that of MMA group [(11.20±1.37) mm] (t=-6.11, P<0.001), the improvement of PSG index [including lowest oxygen saturation (LSpO2), longest apnea (LA) and longest hypopnea (LH)] in DO group [LSpO2=(93.40±1.82)%; LA=(18.28±8.32) s; LH=(61.84±32.94) s] was significantly higher than that in the MMA group [LSpO2=(86.00±4.06)%, LA=(64.08±21.78) s, LH=(172.40±30.70) s](t=-3.72, P=0.005; t=4.39, P=0.003; t=5.49, P=0.004). The PSQI and the ESS scores of DO group (PSQI=4.20±0.83; ESS=3.40±1.52) were also significantly better than that of MMA group (PSQI=8.80±2.39, ESS=9.40±2.88)(t=4.07, P=0.001; t=4.12, P=0.002). Conclusions: For severe OSAHS patients, the objective and subjective indicators of DO treatment group showed a better therapeutic effect than that of MMA.

Analysis of the whole genome traceability and transmission path simulation experiment of the local cluster COVID-19 epidemic / 中华预防医学杂志

Objective: To trace and characterize the whole genome of SARS-CoV-2 of confirmed cases in the outbreak of COVID-19 on July 31, 2021 in Henan Province. Method: Genome-wide sequencing and comparative analysis were performed on positive nucleic acid samples of SARS-CoV-2 from 167 local cases related to the epidemic on July 31, 2021, to analyze the consistency and evolution of the whole genome sequence of virus. Results: Through high-throughput sequencing, a total of 106 cases of SARS-CoV-2 whole genome sequences were obtained. The results of genome analysis showed that the whole genome sequences of 106 cases belonged to the VOC/Delta variant strain (B.1.617.2 clade), and the whole genome sequences of 106 cases were shared with the genomes of 3 imported cases from Myanmar admitted to a hospital in Zhengzhou. On the basis of 45 nucleotide sites, 1-5 nucleotide variation sites were added, and the genome sequence was highly homologous. Conclusion: Combined with the comprehensive analysis of viral genomics, transmission path simulation experiments and epidemiology, it is determined that the local new epidemic in Henan Province is caused by imported cases in the nosocomial area, and the spillover has caused localized infection in the community. At the same time, it spills over to some provincial cities and results in localized clustered epidemics.

Analysis of epidemiological characteristics of bacillary dysentery with multiple-onset in Henan Province from 2005 to 2020 / 中华预防医学杂志

Objective: To understand the epidemiological characteristics of bacillary dysentery with multiple-onset in Henan province from 2005 to 2020. Methods: The reported cases of bacillary dysentery (including confirmed cases and clinically diagnosed cases) in Henan Province from January 2005 to December 2020 were collected through China's National Disease Supervision Information Management System. The main information included gender, age, home address, date of onset and date of diagnosis. The interval between two episodes of the same case was more than 15 days, which was judged as two episodes. The incidence characteristics of bacillary dysentery patients with two or more cases in Henan Province from 2005 to 2020 were analyzed, and the regional distribution map of cases was drawn using ArcGIS software. Results: From 2005 to 2020, a total of 250 430 cases of bacillary dysentery were reported in Henan Province, with a cumulative incidence rate of 228.66/100 000. There were 2 342 cases with two or more attacks. The incidence of recurrent cases of bacillary dysentery increased year by year (χ2trend=2 932.28, P<0.001). There was no significant difference in the incidence of two or more cases of different sexes (χ2=0.39, P=0.540). There was significant difference in the incidence among different age groups (χ2=438.40, P<0.001). The incidence of two or more cases in the 60-69 age group was relatively high (1.70%). The shortest time interval between the onset of the disease was 16 days, and the longest was 5 579 days, with M (Q1, Q3) about 428 (237, 843) days. Compared with healthy people, those with a history of bacterial diseases had a higher risk of developing bacillary dysentery (RR: 4.12, 95%CI: 3.95‒4.29). Conclusion: The proportion of patients with multiple-onset shows an increasing trend, and there is an age difference.

Down-regulation of SIK2 expression alleviates myocardial ischemia-reperfusion injury in rats by inhibiting autophagy through the mTOR-ULK1 signaling pathway / 南方医科大学学报

OBJECTIVE@#To explore the role of salt-inducible kinase 2 (SIK2) in myocardial ischemia-reperfusion (IR) injury in rats.@*METHODS@#Fifteen male SD rats were randomized equally into sham operation group, myocardial IR model group, and SIK2 inhibitor group (in which the rats were treated with intravenous injection of 10 mg/kg bosutinib via the left femoral vein 24 h before modeling). Ultrasound was used to detect the cardiac function of the rats, and myocardial pathologies were observed with HE staining. Transmission electron microscopy was used to observe autophagy of myocardial cells, and Western blotting was performed to detect the contents of the autophagy-related proteins SIK2, LC3B, Beclin-1, p62 and the expressions of p-mTOR, mTOR, p-ULK1, and ULK1 in myocardial tissue.@*RESULTS@#Myocardial IR injury significantly increased the number of autophagosomes (P < 0.05) and the expression of SIK2 protein (P < 0.01) in the myocardial tissues. Treatment with bosutinib before modeling obviously lowered the expression of SIK2 protein (P < 0.01), alleviated myocardial pathologies, and reduced the number of autophagosomes (P < 0.05) in the myocardial tissue. The rats with myocardial IR injury showed obviously lowered LVEF and FS values (P < 0.001), which were significantly improved by bosutinib treatment (P < 0.05); no significant difference was detected in IVSDd or LVPWDd among the 3 groups (P > 0.05). Myocardial IR injury obviously increased the expressions of LC3-II/LC3-I and Beclin-1 proteins and lowered the expression of p62 protein (P < 0.01), and these changes were significantly rescued by bosutinib treatment (P < 0.05). The rat models of myocardial IR injury showed significantly increased expression of p-ULK1 (Ser757) (P < 0.01) and lowered expression of p-mTOR protein (P < 0.0001) in the myocardium, and these changes were obviously reversed by bosutinib (P < 0.01 or 0.05); there was no significant difference in mTOR and ULK1 expressions among the 3 groups (P > 0.05).@*CONCLUSION@#SIK2 may promote autophagy through the mTOR/ULK1 signaling pathway, and inhibiting SIK2 can reduce abnormal autophagy and alleviate myocardial IR injury in rats.

Progress and thoughts on the regulation of wound repair by growth factors / 中华烧伤杂志

Growth factors play an important role in wound healing, and they mainly accelerate wound healing by activating the related signal pathways. Chinese scientists have been conducting basic and clinical researches on growth factors for 30 years, with a series of growth factor drugs being developed and widely used in the treatment of burns and trauma and chronic refractory ulcers. This paper expounds the frontier progress of growth factors on wound healing from the perspectives of immunity, nerve, fat, and so on, and puts forward the further thoughts of the research team on the regulation of wound healing by growth factors.

Chinese Medicine Monomers Regulate Atherosclerosis Through NF-κB Pathway： A Review / 中国实验方剂学杂志

Cardiovascular diseases are the leading cause of death in the world today. Atherosclerosis （AS） is a chronic inflammatory disease characterized by thickening or functional degeneration of the arterial wall， and in the later stage of the disease， plaque ruptures to induce thrombosis， which in turn causes ischemia in tissues or organs. It is therefore the pathological basis for all types of cardiovascular diseases. Nuclear transcription factor kappa B （NF-κB）， an important nuclear transcription factor in the inflammatory response， is activated to mediate the transcription of inflammatory factors that can trigger or exacerbate the development of AS. Vascular endothelial cells are activated by inflammatory factors. NF-κB mediates related regulatory genes in endothelial cells to secrete adhesion molecules， chemokines， and coagulation factors， promotes selective aggregation of monocytes， up-regulates the expression of adhesion molecules to make adhesion molecules stick to the endothelium and move toward the intima， promotes the degradation of the extracellular matrix， and forms unstable plaques. In recent years， traditional Chinese medicine （TCM） has achieved certain results in the prevention and treatment of AS， and many Chinese medicines have been proved to be effective in resisting AS and can act on multiple targets in the human body， affecting the occurrence and development of AS in different links. This paper mainly introduced the NF-κB pathway and its relationship with AS， reviewed research progress on 75 components of different types in Chinese medicine monomers such as flavonoids， terpenoids， and alkaloids in AS resistance based on the NF-κB pathway， and found that Chinese medicine monomers mainly regulate cholesterol balance， inhibit the inflammatory response， reduce cell proliferation， inhibit intercellular adhesion， and suppress foam cell formation by regulating the NF-κB pathway to provide a reference for the prevention and treatment of AS.

Action Mechanism of Chinese Medicine Polysaccharides in Prevention and Treatment Diabetes and Its Complications：A Review / 中国实验方剂学杂志

Diabetes is a metabolic disease mainly characterized by hyperglycemia due to inadequate insulin secretion. And persistent hyperglycemia can cause chronic damage or dysfunction of eyes， kidneys， heart， blood vessels and nerves. Polysaccharides are high molecular carbohydrates polymerized by glycosidic bonds from more than 10 monosaccharide molecules of the same or different types. They have the advantages of wide sources， high safety and low toxic and so on. As one of the important effective components of traditional Chinese medicine， polysaccharides have biological activities such as immune regulation， anti-oxidation， anti-tumor， lowering blood sugar and so on. The structure is directly related to biological activities， and the advanced structure of polysaccharides is based on the primary structure. Exploring the primary structure of polysaccharides is the key task of lowering blood sugar and improving diabetic complications. This paper summarizes the monosaccharide composition of the primary structure of Chinese medicine polysaccharides， and the mechanism of Chinese medicine polysaccharides improving diabetes is emphasized by increasing the secretion and release of insulin， increasing the islet β cell number， upregulating insulin receptor level， improving glucose and lipid metabolism， inhibiting inflammatory response， improving oxidative stress and regulating phosphatidylinositol-3-kinase（PI3K）/protein kinase B （Akt）， mitogen activated protein kinase， cyclic adenosine monophosphate（cAMP）/protein kinase A（PKA） and adenosine monophosphate activated protein kinase（AMPK） signaling pathways. At the same time， we also summarized the prevention and treatment of Chinese medicine polysaccharides in diabetic nephropathy， diabetic cardiomyopathy， diabetic ophthalmopathy and diabetic peripheral neuropathy， in order to provide a theoretical basis for new drug development and clinical application of Chinese medicine polysaccharides in the intervention of diabetes and its complications.

Waist Circumference of the Elderly over 65 Years Old in China Increased Gradually from 1993 to 2015: A Cohort Study / 生物医学与环境科学（英文）

Objective@#This study aimed to analyze the temporal trends and characteristics associated with waist circumference (WC) among elderly Chinese people.@*Methods@#We used data from 3,096 adults ≥ 65 years who participated in the China Health and Nutrition Survey (CHNS), an ongoing cohort study, between 1993 and 2015. We used longitudinal quantile regression models to explore the temporal trends and characteristics associated with WC.@*Results@#WC increased gradually among the elderly Chinese population during the survey. The WC curves shifted to the right with wider distributions and lower peaks in men and women. All WC percentile curves shifted upward with similar growth rates in the 25th, 50th, and 75th percentiles. The WC means increased from 78 cm to 86 cm during the 22 years of our study. WC significantly increased with age and body mass index and decreased with physical activity (PA). These associations were stronger in the higher percentiles than in the lower percentiles.@*Conclusions@#WC is rising among Chinese adults ≥ 65 years. Factors affecting WC in elderly people may have different effects on different percentiles of the WC distribution, and PA was the most important protective factor in the higher percentiles of the WC distribution. Thus, different interventional strategies are needed.

Research progress on the mechanism of post-stroke anxiety / 生理学报

With the increase in stroke incidence, it has become an important disease threatening human life and health. Some stroke survivors have different degrees of mood and movement disorders in the later stages, such as post-stroke anxiety (PSA) and post-stroke depression (PSD), which seriously endanger the quality of life of patients and their families. The pathogenesis of PSA remains incompletely clear. Current research interest mainly focuses on the dysfunction of hypothalamic-pituitary-adrenergic (HPA) axis, neurotransmitter disorders, neuronal excitability changes, cytokine levels imbalance, stroke lesion site and psychophysiology. This article summarizes the research progress on the pathogenesis of PSA in recent years.

Transplant outcomes of 100 cases of living-donor ABO-incompatible kidney transplantation / 中华医学杂志(英文版)

BACKGROUND@#Although ABO-incompatible (ABOi) kidney transplantation (KT) has been performed successfully, a standard preconditioning regimen has not been established. Based on the initial antidonor ABO antibody titers, an individualized preconditioning regimen is developed, and this study explored the efficacy and safety of the regimen.@*METHODS@#From September 1, 2014, to September 1, 2020, we performed 1668 consecutive living-donor KTs, including 100 ABOi and 1568 ABO-compatible (ABOc) KTs. ABOi KT recipients (KTRs) with a lower antibody titer (≤1:8) were administered oral immunosuppressive drugs (OIs) before KT, while patients with a medium titer (1:16) received OIs plus antibody-removal therapy (plasma exchange/double-filtration plasmapheresis), patients with a higher titer (≥1:32) were in addition received rituximab (Rit). Competing risk analyses were conducted to estimate the cumulative incidence of infection, acute rejection (AR), graft loss, and patient death.@*RESULTS@#After propensity score analyses, 100 ABOi KTRs and 200 matched ABOc KTRs were selected. There were no significant differences in graft and patient survival between the ABOi and ABOc groups (P  = 0.787, P  = 0.386, respectively). After using the individualized preconditioning regimen, ABOi KTRs showed a similar cumulative incidence of AR (10.0% υs . 10.5%, P  = 0.346). Among the ABOi KTRs, the Rit-free group had a similar cumulative incidence of AR ( P  = 0.714) compared to that of the Rit-treated group. Multivariate competing risk analyses revealed that a Rit-free regimen reduced the risk of infection (HR: 0.31; 95% CI: 0.12-0.78, P  = 0.013). Notably, antibody titer rebound was more common in ABOi KTRs receiving a Rit-free preconditioning regimen ( P  = 0.013) than those receiving Rit. ABOi KTRs with antibody titer rebound had a 2.72-fold risk of AR (HR: 2.72, 95% CI: 1.01-7.31, P  = 0.048). ABOi KTRs had similar serum creatinine and estimated glomerular filtration rate compared to those of ABOc KTRs after the first year.@*CONCLUSIONS@#An individualized preconditioning regimen can achieve comparable graft and patient survival rates in ABOi KT with ABOc KT. Rit-free preconditioning effectively prevented AR without increasing the risk of infectious events in those with lower initial titers; however, antibody titer rebound should be monitored.

Innovation, development and application of contemporary fire needling / 中国针灸

Physicians in the past dynasties have improved the theory of fire needling from the aspects of fire needling instruments, clinical efficacy, application scope, operation, precautions, etc., which promoted the clinical application of fire needling. Modern fire needling breaks through the traditional clinical taboos such as heat syndrome, face, forbidden acupoints, and no needle retention. By using modern fire needling with various types, characteristics and functions, multiple needles and multiple methods are used to treat various diseases, which can further exert the therapeutic effect of fire needling and promote the popularization and application of fire needle therapy.

Anticancer effects of metformin in experimental animal models of different types of cancer: a systematic review and meta-analysis / 한국실험동물학회지

To systematically evaluate the effects of metformin on tumors in experimental animal models of different types of cancer. Pubmed, Embase, Cochrane, and Web of Science databases were searched for studies on metformin used in various experimental animal tumor models from 2008 to 2022. Meta-analysis was performed using STATA 16.0 software after screening literature extraction data and methodological quality evaluation by inclusion and exclusion criteria. A total of 24 studies with 1108 model animals were included. Meta-analysis results showed that this study used meta-analysis for quantitative synthesis of study results and found that tumor model animals of different species showed different degrees of reduction in tumor volume, weight, and number after metformin intervention.