Determination of Serum Unbound Bilirubin and Its Clinical Application Value in Neonates / 中山大学学报(医学科学版)

ObjectiveTo investigate the clinical appropriateness and application value of the peroxidase （POD） method for the detection of unbound bilirubin （UB） in neonatal serum. MethodsHydrogen peroxide （0.33 mol/L） and three different final concentrations （0.019， 0.038， 0.075 μg/mL） of horseradish peroxidase （HRP） were added to standard bilirubin solution （1， 2， 3 μmol/L） to obtain a standardized HRP primary rate constant Kp. Then 25 μL of neonatal serum was diluted by 41.6 fold， and measured with 2.4 and 4.8 μg/mL HRP at 37 ℃ under the dark， to determine the UB concentration. The accuracy， precision， and stability of the methodology were validated. The clinical characteristics of 33 jaundiced neonates were collected， including total serum bilirubin （TSB）， indirect bilirubin （IDB）， albumin （ALB）， bilirubin to albumin molar ratio （BAMR）， etc. The experimental data were analyzed by Graphpad Prism 8.0. ResultsA standardized Kp of （7.20±1.08） mL·μg-1·min-1 was determined at pH 7.4±0.2， 37 ℃ in the dark. The HRP activity and UB concentrations remained stable at -20 ℃ for 3 weeks and a week， respectively. The mean intra-day and inter-day coefficients of variation of the serum samples with different UB concentrations were less than 10%. In this study， the UB concentrations in 33 jaundiced neonates （gestational age ≥35 weeks） were measured by the POD method in the range of （0.32～1.20） μg/dL， which was positively correlated with TSB， IDB and BAMR. Of the five infants whose UB concentrations measured more than 1 μg/dL， three received intensive phototherapy （60%）. ConclusionsThe POD method combined with a standard equipment spectrophotometer to detect serum UB concentrations in neonates is easy to operate， rapid to detect， and low cost. This method has good accuracy and precision， which is convenient for clinical implementation. Moreover， the measurement of serum UB may assist us in better management of neonatal jaundice in clinical practice.

Cloning and functional analysis of IPI gene from Fritillaria unibracteata Hsiao et K. C. Hsia / 药学学报

An open reading frame (ORF) of isopentenyl-diphosphate delta isomerase gene (FuIPI) was cloned from Fritillaria unibracteata Hsiao et K. C. Hsia. (F. unibracteata). Furthermore, the bioinformatics and functional analyses of FuIPI were performed in this study. The result showed that, the ORF of FuIPI gene was 825 bp, encoding a polypeptide of 274 amino acids in length, with a relative molecular mass of about 31 kD and a theoretical isoelectric point of 5.61. Sequence analysis showed that FuIPI contained conserved structural domains and key residues involved in the catalyzing process. The phylogenetic analysis exhibited that FuIPI was closely related to IPIs of Dendrobium officinale and Musa acuminate. Real-time PCR analysis showed that FuIPI was distributed in different tissues of F. unibracteata, but had the highest transcriptional level in leaves, followed by stems, bulbs, and flowers. Furthermore, the FuIPI protein was successfully expressed in Escherichia coli BL21(DE3). The purified FuIPI protein successfully catalyzed the conversion from isopentenyl diphosphate (IPP) to dimethylallyl pyrophosphate (DMAPP). The above results provided a theoretical basis for further investigation of the molecular role of FuIPI in the biosynthesis of alkaloids.

Effects of Wenyang jieyu decoction on PI3K/Akt signaling pathway and neurotransmitters in kidney-yang deficiency depressed rats / 中国药房

OBJECTIVE To investigate the effects of Wenyang jieyu decoction on phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway and neurotransmitters in rats with kidney-yang deficiency depression. METHODS The SD rats were divided into blank group， model group， fluoxetine group （positive control of western medicine， 4.17 mg/kg）， Xiaoyao powder group （positive control of TCM， 1.88 g/kg） and Wenyang jieyu decoction low-dose， medium-dose and high-dose groups （1.25， 2.50， 5.00 g/kg）， with 15 rats in each group. Except for blank group， the other groups were treated with corticosterone 20 mg/kg subcutaneously to induce kidney-yang deficiency depressed model， meanwhile the mice were given relevant medicine intragastrically， once a day， for 28 consecutive days. The general conditions of rats were observed. The sucrose preference rate and the static time of forced swimming were detected， and organ indexes of rats were calculated. The levels/contents of neurotransmitters in serum were detected， the expressions of PI3K/Akt pathway-related proteins in hippocampus were detected， and the number of dendritic spines was determined. RESULTS Compared with blank group， model group suffered from the symptoms such as hair loss， fear of cold， curling up； sucrose preference rate， indexes of adrenal gland， thymus gland and spleen，serum levels of cyclic adenosine phosphate （cAMP）， brain-derived neurotrophic factor and gamma-aminobutyric acid， the ratio of cAMP to cyclic guanosine monophosphate， the contents of norepinephrine， dopamine and 5-hydroxy-tryptamine， the expressions of PI3K， Akt， mammalian target of rapamycin， and the number of dendritic spines in the hippocampus were significantly decreased （P＜0.01）. The time of immobility， level of glutamic acid and protein expression of glycogen synthetase kinase-3β were prolonged and increased （P＜0.01）. Compared with model group， depression symptoms of rats in each administration group were improved， and the above indexes were mostly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS Wenyang jieyu decoction can improve depression-like behavior and the deficiency of kidney-yang， regulate the secretion of neurotransmitters， and activate PI3K/Akt signaling pathway， thus playing a role in protecting hippocampal neurons.

Comparison of ARIMA models with and without covariates in the prediction of HIV infection among young students in Dalian / 公共卫生与预防医学

Objective To compare the effect of ARIMA models with and without covariates in predicting the number of HIV infections among young students in Dalian. Methods First, univariate correlation analysis was performed on the network, STD sequence and HIV sequence to understand whether there was a correlation and lag relationship between them. Secondly, variables with the strongest correlation and predictive value and HIV infection numbers were used as the baseline data to establish an ARIMA model with covariates and a general ARIMA model without covariates, and to predict the HIV number from 2019 to 2021. The average absolute errors were used as evaluation indexes to compare the prediction effects of the two models. Results A total of 841 cases of HIV infection among young students were reported in Dalian from 2013 to 2021. The results of univariate correlation analysis showed that the search index of the keyword AIDS in the Baidu Index in a given month from 2013 to 2019 was significantly positively correlated with the number of HIV infections in that month (r=0.302, P=0.006), and gonorrhea was negatively correlated with the number of HIV infections with a lag of 2 months (r=-0.250, P =0.024). Using gonorrhea incidence number and HIV infection number as the basic data, an ARIMA model with covariates and a general ARIMA model without covariates were established to predict the number of HIV infection among young students from 2019 to 2021, and the average absolute errors were 17.621% and 66.17%, respectively. Conclusion Compared with the general ARIMA model without covariates, the ARIMA model based on the combined use of STD incidence and HIV infection is more suitable for predicting the number of HIV infections among young students in Dalian, but the average absolute error of the model is still large, which needs further improvement in the future research.

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (version 2022) / 中华创伤杂志

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Application effect of vector sum concept in fine-tuning posterior column screw placement for bi-column acetabular fracture / 中华创伤杂志

Objective:To investigate the effect of vector sum concept in fine-tuning posterior column screw channel via ilioinguinal approach for the treatment of bi-column acetabular fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 patients with acetabular double column fracture admitted to Weifang People′s Hospital from July 2015 to May 2021, including 22 males and 20 females, aged 23-77 years [(49.3±16.3)years]. The ilioinguinal approach was used in all patients with the anterior column fixed with a plate and posterior column fixed with a lag screw. The vector sum concept was used intraoperatively to fine-tune the posterior column screw channel in 19 patients (channel fine-tuning group): namely, a 2.5 mm Kirschner wire was inserted into the bony channel of the posterior column screw under fluoroscopy of iliac oblique and obturator oblique positions; when the Kirschner wire was not located in the middle of the ischial ramus under single fluoroscopy, the vector only needed to be adjusted in one direction, with zero in the other direction; when the Kirschner wire was not located in the middle of the ischial ramus under fluoroscopy of both the iliac oblique and obturator obturator oblique positions, the sum of the deviation vectors in the two directions was calculated before fine-tuning. The vector sum concept was not used to fine-tune the posterior column channel screw in 23 patients (channel non-fine-tuning group). The time of posterior column screw placement, intraoperative blood loss, frequency of guide wire adjustment and fracture healing time were recorded and compared between the two groups. At 6 months after operation, the quality of fracture reduction and hip function were assessed by Matta score and Merle D′Aubigne-Postel score, respectively. The complications were observed.Results:All patients were followed up for 7-71 months [(35.7±8.5)months]. In channel fine-tuning group, the time of posterior column screw placement was (5.1±1.5)minutes, with intraoperative blood loss of (798.8±83.9)ml, frequency of guide wire adjustment of (1.8±0.5)times and fracture healing time of (12.4±3.2)weeks; while these parameters [(39.8±12.0)minutes, (1 119.3±172.0)ml, (5.6±1.6)times and (15.6±4.2)weeks] were significantly shorter or less in channel non-fine-tuning group ( P<0.05 or 0.01). There were no significant difference in the quality of fracture reduction and hip function between the two groups at 6 months postoperatively (all P>0.05). After operation, symptoms of lateral femoral cutaneous nerve was found in seven patients, superficial incision infection in two who was healed after debridement and dressing change, deep venous thrombosis of lower limbs in three. There was no significant difference in the incidence of postoperative complications between the two groups [channel fine-tuning group: 26%(5/19), channel non-fine-tuning group: 30%(7/23)] ( P>0.05). Conclusion:For bi-column acetabular fractures via ilioinguinal approach, application of vector and concept to fine-tune the posterior column screw channel is beneficial for rapid screw placement into the osseous channel, significant reduction of intraoperative blood loss and early fracture healing.

Application of "hand as foot" teaching method in echocardiographic teaching of patent foramen ovale / 中华医学教育探索杂志

The understanding of heart embryonic development and structure can contribute to improve our leaning of the etiology, pathophysiology and classification of congenital heart disease in humans, which has become the focus of echocardiography teaching. Meanwhile the difficulties and problems formed because of its diverse and fragmented theoretical knowledge. "Hand as foot" teaching method is a kind of teaching method using intuitive body language combined with the thought of analogy, so as to make teaching content relatively simplistic and figurative. Our study has demonstrated this method can be used in a constructive way to improve course content and delivery for echocardiography teaching to assess patent foramen ovale for standardized residency training of cardiac ultrasound, and achieved a good teaching effect. The specific implementation approaches and effect of this method are described in detail. This paper also explores the potential feasibility and benefits of the application of using "Hand as foot" teaching method in echocardiography teaching.

Successful treatment of 3 cases of 22-week extremely premature infants / 中国新生儿科杂志

Objective:To review the treatment experience of extremely premature infants (EPIs) with gestational age (GA) <23 weeks.Methods:From January to November 2021, EPIs with GA<23 weeks treated in our hospital was retrospectively analyzed.Results:A total of 3 patients with GA of 22 weeks were reviewed, including 2 boys and 1 girl. Their birth weight (BW) was 450~498 g. The duration of hospitalization was 112~126 d. The treatment included early "gentle" management strategies, respiratory management, anti-infection, patent ductus arteriosus treatment and parenteral + enteral nutrition. All 3 infants were discharged from the hospital without further oxygen therapy. All had satisfying oral feeding with no neurological sequelae on follow-up.Conclusions:Early "gentle" management is the key to successful treatment and good prognosis for EPIs with GA<23w

Initial clinical experience of left bundle branch pacing after transcatheter aortic valve implantation / 中华心血管病杂志

Objective: To investigate the efficacy and safety of left bundle branch pacing(LBBP) in patients after transcatheter aortic valve implantation (TAVI). Methods: This is a retrospective study. A total of 35 patients underwent TAVI and received pacemaker implantation from January 2018 to December 2020 in Beijing Fuwai Hospital were enrolled. Patients were divided into LBBP group (n=12) and right ventricular apex pacing (RVAP) group (n=23) according to the pacing position. The success rate of operation in LBBP group was calculated, and the occurrence of complications were observed, and the parameters of pacemaker were measured on the 3rd day and 1, 3 and 6 months after operation. The N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiographic and ECG indexes were compared between the two groups on the 3rd day and 1, 3, and 6 months after pacemaker implantation. Result: A total of 35 patients were included, The age was (76.4±7.7) years, including 19 males (54.3%). The procedure time ((86.58±17.10)min vs. (68.74±9.18)min, P<0.001) and fluoroscopy duration ((20.08±4.44)min vs. (17.00±2.26)min, P<0.001) were significantly longer in LBBP group compared with RVAP group. The operation success rate of LBBP group was 11/12. There was no serious operation related complications such as pneumothorax, hemothorax, electrode dislocation, infection, and lower limb bleeding. The patients were followed up for 7.43 (5.21, 9.84) months. The programmed parameters of pacemaker were in the ideal range and stable during follow-up. At 3 and 6 months after operation, the left ventricular ejection fraction in LBBP group was higher than that in RVAP Group (at 3 months: (60.75±2.89)% vs. (57.35±3.33)%, P=0.004; at 6 months: (63.17±3.33)% vs. (56.17±3.97)%, P<0.001), NT-proBNP values was lower in LBBP group than that in RVAP Group (at 3 months: 822 (607, 1 150)ng/L vs. 1 052 (902, 1 536)ng/L, P=0.006; at 6 months: 440 (330,679)ng/L vs. 783 (588, 1 023)ng/L, P=0.001). At 1, 3 and 6 months after operation, the QRS duration was shorter in LBBP group than that in RVAP group (1 month: 99 (97, 107)ms vs. 126(124, 130)ms, P<0.001; 3 months: 98(96, 105)ms vs. 129(128, 133)ms, P<0.001; 6 months: 96(94, 104)ms vs. 130(128, 132)ms, P<0.001). Conclusions: For patients with permanent pacemaker indications after TAVI, LBBP is feasible, safe and reliable. It could improve the cardiac function in the short term, the long-term effect of LBBP needs to be further observed.

Construction and application of remote consultation system for epidemic prevention and control in Henan province / 中华医院管理杂志

The present pandemic prevention and control of 2019 novel coronavirus diseases(COVID-19) is still severe in China and abroad, which is however witnessing a dimensional application and success of the information technology.For example, the remote consultation system of epidemic prevention and control had played a key role in Henan province in its fight against COVID-19. The architecture of the system was composed of software and hardware architecture, data exchange technology, security system design, and data collection specifications. By the end of September 2021, the audio and video systems of 147 designated hospitals for patients of COVID-19 had been constructed, and 98 of which had achieved clinical data sharing and interaction. The remote consultation system effectively guaranteed the real-time sharing of case data, saved diagnosis costs and treatment time, laying a solid foundation for the pandemic prevention and control of COVID-19.

Experience in the treatment of heart kidney transplantation through non-staged transplant: a report of 11 cases / 中华器官移植杂志

Objective:To explore the treatments and outcomes of heart and kidney transplantation(HKTx)and summarize its management experiences.Methods:From October 2016 to October 2020, clinical data, treatment strategies and prognosis of 11 patients received HKTx were analyzed retrospectively.In 11HKTx cases, the ratio of male-to-female was 10∶1, the age(50.6±12.9)years and the preoperative body mass index(26.72±3.29)kg/m 2.The preoperative cardiac function was class Ⅳ and the preoperative left ventricular ejection fraction(29.40±4.48)%.All patients were in uremic state pre-operation and underwent regular dialysis.The mean duration of dialysis was 2.5(0.5-7.0)years, preoperative creatinine 753.5(434-1144)μmol/L and preoperative predictive glomerular filtration rate 5.59(3.93-17.23)ml/(min preop 2). Non-staged transplant was performed and donor heart and kidney were from the same donor.The median time of cold cardiac ischemia 2.75(2.5, 4.0)hours, the median time of cold renal ischemia 9(8.5, 15.0)hours and the median time from the end of heart transplantation to the beginning of kidney transplantation 2(1.0, 3.5)hours.The immunosuppressive regimen was a combination of tacrolimus, mycophenolate mofetil and methylprednisolone. Results:Normal cardiac function and renal function normalized in 9 cases.At Month 6 post-operation, the postoperative left ventricular ejection fraction was(57.55±2.51)%, creatinine 107.7(85-132)μmol/L and urine volume in 24h 1988(1800-2200)ml.The long-term survival time was 6-62 months.No such complications as infection or rejection occurred in 9 patients.The cardiac function was class Ⅰ at Month 6 post-operation.One patient died from pulmonary mucor infection at Month 4 post-operation.Another death was due to gastrointestinal fungal infection at Month 1 after HKTx.Conclusions:HKTx is an effective treatment for end-stage heart disease with renal failure.

Analysis of unknown-origin fever after simultaneous pancreas-kidney transplantation / 中华器官移植杂志

Objective:To explore the clinical features, etiologies and outcomes of unknown origin fever after simultaneous pancreas-kidney transplantation(SPK).Methods:From March 2015 to January 2020, clinical data were retrospectively reviewed for 120 SPK recipients.According to the definite evidence of fever, such as microbial culture, imaging findings or rejection, they were divided into three groups of free-fever(FF, n=41)and defined-fever(DF, n=47)and fever of unknown origin(FUO, n=32). The differences in general clinical features, surgical complications, laboratory tests and prognoses were compared.Logistic regression was employed for analyzing the risk factors of FUO and Kapla-Meier for survival analysis.And P<0.05 was deemed as statistically significant. Results:Multivariate analysis revealed that preoperative diabetic gastroenteropathy was an independent risk factor for unexplained fever.Significant differences existed between FUO and DF groups in leucocyte count[6.50(5.13, 7.36)vs.10.36(6.11, 12.97)×10 9/L], C-reactive protein(CRP)[11.75(6.25, 16.85)vs.35.00(16.30, 75.00)μg/ml], procalcitonin[0.13(0.06, 0.18)vs.0.19(0.11, 1.05)ng/ml]( P<0.001, P<0.001, P=0.025). As compared with DF group, 19 recipients in FUO group only received 1-2 antibiotics and there was a shorter course of treatment[13(40.6%)vs.32(68.1%), P=0.016]. For 6(18.7%)recipients after a diagnosis of FUO, clinical outcome was achieved with only NSAIDs.Length of stay was(48.72±19.51)days in FUO group versus(57.36±27.46)days in DF group and the difference was statistically significant( P<0.001). Hospitalization expenses of two groups were 253 463.25 and 334 605.96 yuan respectively and the difference was also statistically significant( P=0.002). Conclusions:Diabetic gastroenteropathy is an independent risk factor for early FUO after SPK transplantation.Inflammatory markers of leukocytes, CRP and procalcitonin in FUO patients are significantly lower than DF group.And these clinical features can help diagnose FUO in an early stage.

Effect of Wenyang Jieyu Decoction on Hippocampal Neuroplasticity in Depressed Rats Induced by Corticosterone / 中国实验方剂学杂志

ObjectiveTo observe the effect of Wenyang Jieyu decoction （WYJY） on the hippocampal structure of depressed rats with kidney-yang deficiency. MethodThe 105 SD rats were randomly divided into normal group， model group， fluoxetine group （4.17 mg·kg-1）， Xiaoyaosan group （1.88 g·kg-1）， and low-， medium- and high-dose （1.25，2.50，5.00 g·kg-1） WYJY groups，15 in each group. The depression model was induced by subcutaneous injection of corticosterone in rats except for those in the normal group and the rats were orally administered once a day for 28 days. The depression-like behaviors of rats were observed by sucrose preference test， novelty-suppressed feeding test， forced swimming test， and open field test. The morphology of hippocampal neurons was observed by hematoxylin-eosin（HE） staining， and the density of hippocampal neurons was detected by Nissl staining. The ultrastructure of hippocampal synapses was observed by transmission electron microscopy （TEM）. The expression of synaptophysin （SYP）， postsynaptic density-95 （PSD95）， and apoptosis-related protein Caspase-3 in hippocampal neurons was observed by immunohistochemistry， and bromodeoxyuridine （BrdU） and doublecortin （DCX） were used to observe the apoptosis and regeneration of hippocampal neurons. ResultWYJY could improve weight loss in depressed rats. As revealed by the behavioral tests， the model group showed depression-like behaviors， which were relieved in the WYJY groups and the positive drug groups. HE staining showed that the nuclei of hippocampal neurons in the model group were constricted， deeply stained， and sparsely arranged， while the neurons in the WYJY groups and the positive drug groups were significantly improved. Nissl staining demonstrated that the cell density of the model group was lower than that of the normal group （P<0.05）. Compared with model group， the groups with drug intervention showed increased cell density （P<0.05） and compact arrangement. According to the results in TEM， compared with normal group， the model group showed shortened synaptic active zone （P<0.05）， widened synaptic cleft （P<0.05）， and thinned tight zone （P<0.05）. Compared with model group， the groups with drug intervention showed shortened synaptic active zone （P<0.05）， narrowed synaptic cleft （P<0.05）， and thickened tight zone （P<0.05）. As displayed by the results of immunocytochemistry and immunofluorescence， compared with the normal group， the model group showed decreased protein expression of SYP， PSD95， BrdU， and DCX in the hippocampus （P<0.05） and increased protein expression of Caspase-3 （P<0.05）. Compared with the model group， the groups with drug intervention showed increased protein expression of SYP， PSD95， BrdU， and DCX in the hippocampus （P<0.05） and decreased protein expression of Caspase-3 （P<0.05）. ConclusionWYJY can promote the regeneration of hippocampal neurons in rats and improve the depression of rats.

Common Problems of Traditional Chinese Medicine Effervescent Tablets and Prospect Analysis of Powder Modification Technology / 中国实验方剂学杂志

Traditional Chinese medicine （TCM） effervescent tablets have the characteristics of rapid disintegration， good taste， and convenient taking， but there are some technical difficulties in the preparation and storage process， which are mainly reflected in the sticking， easy moisture absorption， poor compressibility， and poor stability. The basic physical properties of TCM powder （extract powder， raw powder） are the main cause of these technical problems， and also the key to control the quality of TCM effervescent tablets. Powder modification technology has shown good effects in solving the above problems. The author intended to review the research in the above aspects in recent years， and proposed the following strategies for applying powder modification technology to solve the problems in the production process of TCM effervescent tablets from the three aspects of raw materials， excipients and preparation intermediates：①The application of co-processing technology to the treatment of raw materials and auxiliary materials can solve the problems of sticking， poor compressibility， delayed disintegration， and poor stability. ②Using surface coating technology to treat raw materials and preparation intermediates can improve poor fluidity， poor compressibility and delayed disintegration. ③The hygroscopicity of the preparation can be reduced by using microencapsulation technology to treat the raw material. ④The inclusion technology can improve the clarity and stability of the preparation.

Research Progress on Mechanism of Active Components of Traditional Chinese Medicine in Therapy of Chronic Obstructive Pulmonary Disease： A Review / 中国实验方剂学杂志

Chronic obstructive pulmonary disease （COPD） is a common and frequently-occurring disease of the respiratory system， characterized by persistent respiratory symptoms and airflow restriction， which is prone to attack repeatedly and affect patients' quality of life seriously. At present， the combination of bronchodilators and inhaled corticosteroids is commonly used in clinic. Although these drugs can alleviate the symptoms of COPD patients， there are certain limitations of the difficulty in controlling the course of the disease effectively and reversing the decline of patients' lung function. Therefore， searching for safer and more effective therapeutic drugs has become a hot research topic nowadays. Traditional Chinese medicine （TCM） has remarkable curative effects and advantages in the prevention and therapy of COPD recently. Based on the increasing research and application of the active components of TCM in the therapy of COPD， studies on their pharmacodynamic mechanism are also more in depth. More and more studies have found that the active components of TCM can treat COPD patients effectively， and the mechanism involved mainly includes the anti-inflammatory， the antioxidant， and the inhibition of apoptosis. By searching and screening the domestic and foreign literatures on the treatment of COPD with the active components of TCM in recent years， the active components of TCM including flavonoids， terpenoids， phenols and saponins have been studied as the research objects， and their effects in improving the pulmonary function and oxidative stress， relieving inflammation and inhibiting apoptosis are expounded. Besides， the mechanism of action， signaling pathways and index molecules have been emphatically summarized， in order to provide the ideas for the clinical therapy and the basic research of COPD.

Systematic Effect of Modified Renshen Wumeitang in Regulation of GABA Signaling Pathway in Rats with Diarrhea / 中国实验方剂学杂志

ObjectiveTo investigate the effect of modified Renshen Wumeitang（MRWT） on the related regulatory factors of the γ-aminobutyric acid （GABA） signaling pathway in colon tissues of rats with diarrhea， and reveal the mechanism of MRWT in invigorating Qi， generating fluid， and checking diarrhea. MethodForty-eight SD immature rats were randomly divided into a blank group （n=12） and an experimental group （n=36）. The diarrhea model was induced in the experimental group by Sennae Folium combined with overstrain and improper diet for 14 days. Subsequently， the model rats were randomly divided into a model group （normal saline， 20 mL·kg-1）， a western medicine group （Medilac-Vita， 0.7 g·kg-1）， and a Chinese medicine group （MRWT， 35 g·kg-1）， with 12 rats in each group. The rats in the blank group received normal saline at 20 mL·kg-1， and those in the other groups were treated correspondingly， once a day for 7 days. The general condition， loose stool rate， and diarrhea index of the rats were observed daily. Immunohistochemistry was used to detect the optical density expression of GABA protein in the colon of rats. The content of phosphatidylinositol-3 kinase （PI3K）， protein kinase B2 （Akt2）， phosphorylated Akt （p-Akt）， and interleukin-1β （IL-1β） was determined by enzyme-linked immunosorbent assay （ELISA）. The mRNA and protein expression levels of PI3K， Akt2， and GABA type A receptor subunit β2 （GABRB2） in the colon of rats were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with the blank group， the model group showed worsened general condition， The difference was not statistically significant of loose stool rate and diarrhea index， increased expression of GABA protein （P<0.05）， elevated expression of PI3K， Akt2， p-Akt， and IL-1β （P<0.05， P<0.01）， and up-regulated PI3K， Akt2， and GABRB2 mRNA and protein expression （P<0.01）. Compared with the model group， the western medicine group and the Chinese medicine group showed the improved general condition， decreased loose stool rate and diarrhea index （P<0.01）， and decreased content of PI3K， Akt2， p-Akt， and IL-1β （P<0.05）. The Chinese medicine group displayed decreased mRNA expression of PI3K， Akt2， and GABRB2 （P<0.05， P<0.01） and down-regulated protein expression of GABA， PI3K， and GABRB2 （P<0.05， P<0.01）. The western medicine group exhibited down-regulated mRNA expression of PI3K，Akt2，and protein of PI3K （P<0.05）. ConclusionMRWT can regulate the GABA signaling pathway， reduce Cl- flow in intestinal epithelial cells to the intestinal lumen， and improve the imbalance of colonic fluid metabolism in the colon of diarrhea rats， thereby exerting its effects of invigorating qi， generating fluid， and checking diarrhea.

Study on mechanism of curcumol against liver fibrosis based on autophagy and apoptosis of hepatic stellate cells / 中国中药杂志

The present study clarified the molecular mechanism of curcumol against liver fibrosis based on its effects on the autopha-gy and apoptosis of hepatic stellate cells. The hepatic stellate cells were divided into a blank control group, a transforming growth factor-β1(TGF-β1)(10 ng·mL~(-1)) group, and low-(12.5 mg·L~(-1)), medium-(25 mg·L~(-1)), and high-dose(50 mg·L~(-1)) curcumol groups. The effect of curcumol on the viability of hepatic stellate cells induced by TGF-β1 was detected by the MTT assay kit. The apo-ptosis in each group was determined by flow cytometry. Real-time fluorescence-based quantitative PCR(RT-PCR) was employed for the detection of mRNA expression of α-smooth muscle actin(α-SMA), type Ⅰ collagen(collagen Ⅰ), and type Ⅲ collagen(collagen Ⅲ). Western blot was used to detect the protein expression of p62, microtubule-associated protein 1 light chain 3(LC3), beclin1, B cell lymphoma 2(Bcl-2), and Bcl-2-associated X protein(Bax). Transmission electron microscopy(TEM) was used to observe cell morphology and autophagosome formation in each group. The autophagic flux was observed after cell infection with adenovirus under double fluorescence labeling. The cell viability assay revealed that compared with the TGF-β1 group, the curcumol groups showed significantly decreased cell viability. The apoptosis assay showed that the apoptosis rates of the curcumol groups were significantly higher than that of the TGF-β1 group. RT-PCR indicated that the mRNA expression of α-SMA, collagenⅠ, and collagen Ⅲ in the curcumol groups was significantly lower than that of the TGF-β1 group. Western blot showed that the expression of p62, LC3, beclin1, Bcl-2, and Bax in the curcumol groups was significantly different from that in the TGF-β1 group. As demonstrated by TEM, compared with the TGF-β1 group, the curcumol groups showed significantly increased autophagosomes. The detection of autophagic flow by the adenovirus under double fluorescence labeling showed that autolysosomes in the curcumol groups were significantly increased compared with those in the TGF-β1 group. Curcumol can induce the autophagy and apoptosis of hepatic stellate cells, which may be one of its anti-liver fibrosis mechanisms.

Xinhui citrus fermentation liquor ameliorates acute ulcerative colitis in mice via regulating intestinal bacteria homeostasis and Nrf2/NLRP3 pathway to repair intestinal mucosa / 药学学报

This study investigated the protective effect and related mechanisms of Xinhui citrus fermentation liquor on mice with ulcerative colitis. Animal experiments follow the rules of Animal Ethics Committee of Southern Medical University. C57BL/6 mice were given 3% dextran sodium sulfate (DSS) for 6 days to induce acute ulcerative colitis. During this period, Xinhui citrus fermentation liquor, decoction of Citrus reticulata blanco (both orally administrated with 300 mg·kg-1·d-1 crude polysaccharide) or positive drug 5-aminosalicylic acid (100 mg·kg-1·d-1) were gavaged continuously for 9 days. Cecal contents were collected for 16S rRNA sequencing analysis. The levels of inflammatory factors, tight junction proteins and nuclear factor erythroid 2 related factor 2 / Nod-like receptor protein 3 (Nrf2/NLRP3) pathway related proteins in the colon were detected by real-time PCR (RT-PCR), immunofluorescence and Western blot. Our results showed that Xinhui citrus fermentation liquor and Citrus reticulata blanco protected against UC-induced weight loss, diarrhea, bloody stool, and colon shortening. The mRNA and protein levels of pro-inflammatory factors, such as interleukin 6 (Il-6) and CXC chemokine ligand 10 (Cxcl10) and NLRP3 inflammasome were significantly decreased; the mRNA levels of colon anti-inflammatory factor (Il-10), tight junction protein [zonula occludens-1 (Zo-1), occludin, claudin-1], mucin 2 (Muc2), Nrf2, as well as the mRNA and protein levels of NAD(P)H quinine oxidoreductase 1 (NQO1) and heme oxygenase 1 (HO-1) were significantly increased. In addition, Xinhui citrus fermentation liquor increased the abundance of Akkermansia and reduced the abundance of harmful bacteria Enterococcus and Streptococcus. The correlation analysis showed that the abundance of Akkermansia was positively correlated with anti-inflammatory factors, tight junction protein and the related genes levels of Nrf2 signaling pathway. In summary, Xinhui citrus fermentation liquor ameliorates acute ulcerative colitis in mice via regulating intestinal bacteria homeostasis and Nrf2/NLRP3 pathway to repair intestinal mucosa.

The evaluation value of antithrombin Ⅲ in decompensated stage of hepatitis B liver cirrhosis and complicated with esophagogastric variceal bleeding / 中华消化杂志

Objective:To investigate the value of antithrombin Ⅲ (AT-Ⅲ) in evaluating patients with decompensated hepatitis B liver cirrhosis and complicated with esophagogastric variceal bleeding (EVB).Methods:From January 1, 2018 to December 31, 2021, clinical data of 193 hospitalized patients with hepatitis B liver cirrhosis diagnosed in the Second Hospital of Shanxi Medical University were retrospectively analyzed, which included coagulation indicator (AT-Ⅲ), liver function indicators (total bilirubin, etc.), abdominal ultrasound results (portal vein diameter, portal vein blood flow velocity), and the occurrence of esophagogastric varices. According to the presence or absence of main complications, 193 patients with hepatitis B liver cirrhosis were divided into compensated group (60 cases) and decompensated group (133 cases). According to the presence or absence of EVB, 133 patients of decompensated group were divided into non-bleeding subgroup (96 cases) and bleeding subgroup (37 cases). The above indicators were compared among compensated group, decompensated group and their subgroups. The independent related factors of decompensated hepatitis B liver cirrhosis and EVB were analyzed. The level of AT-Ⅲ of each group were compared, and the relationship between AT-Ⅲ and Child-Pugh score was analyzed. The diagnostic capability of AT-Ⅲ in decompensated hepatitis B liver cirrhosis and complicated with EVB were analyzed. Mann-Whitney U test, independent sample t test, chi-square test, multiple logistic regression analysis, Pearson correlation analysis and receiver operating characteristic curve (ROC) analysis were used for statistical analysis. Results:The total bilirubin level of the decompensated group was higher than that of the compensated group, the portal vein diameter was larger than that of the compensated group, and the portal vein blood flow velocity was lower than that of the compensated group (31.50 μmol/L (21.90 μmol/L, 48.80 μmol/L) vs. 19.40 μmol/L (15.00 μmol/L, 25.50 μmol/L); (14.31±3.53) mm vs. (12.57±3.83) mm; (13.39±3.49) cm/s vs. (15.08±4.28) cm/s), and the differences were statistically significant ( Z=-5.76, t=-2.78 and 2.40; P<0.001, =0.006 and 0.018). The incidence of esophagogastric varices of the compensated group and the decompensated group was compared (40.0%, 24/60 vs. 87.2%, 116/133), and the difference was statistically significant ( χ2=64.06, P<0.001). The diameter of portal vein of the bleeding subgroup was larger than that of the non-bleeding subgroup, and the portal vein blood flow velocity was lower than that of the non-bleeding subgroup ((15.54±4.23) mm vs. (13.87±3.16) mm; (12.05±3.12) cm/s vs. (13.85±3.51) cm/s), and the differences were statistically significant ( t=-2.15 and 2.23, P=0.034 and 0.028). The AT-Ⅲ levels gradually decreased in the non-bleeding subgroup and bleeding subgroup of the compensated group and decompensated group, which were (79.52±16.02)%, (63.91±19.96)% and (35.92±13.69)%, respectively, the difference was statistically significant ( F=5.71, P=0.018). The AT-Ⅲ level of the compensated group was higher than that of the non-bleeding subgroup and the bleeding subgroup of the decompensated group, and the AT-Ⅲ level of the non-bleeding subgroup of the decompensated group was higher than that of the bleeding subgroup, and the differences were statistically significant ( t=5.11, 13.74 and 7.84, all P<0.001). The results of multivariate logistic regression analysis showed that total bilirubin and AT-Ⅲ were independent related factors of decompensation of hepatitis B liver cirrhosis ( OR (95% confidence interval (95% CI) 1.060 (1.018 to 1.104) and 0.945 (0.922 to 0.970), P=0.005 and <0.001). AT-Ⅲ was an independent related factor of decompensation of hepatitis B liver cirrhosis and complicated with EVB ( OR(95% CI) 0.902 (0.856 to 0.950, P<0.001). AT-Ⅲ was negatively correlated with Child-Pugh score ( r=-0.559, P<0.001). ROC analysis showed that the cut-off values of AT-Ⅲ in the diagnosis of decompensated stage of hepatitis B liver cirrhosis and complicated with EVB were 62.5% and 61.5%, the sensitivity was 88.3% and 89.2%, the specificity was 70.7% and 61.5%, and the area under the curve (95% CI) was 0.815 (0.755 to 0.874, P<0.001) and 0.899 (0.828 to 0.971, P<0.001), respectively. Conclusion:AT-Ⅲ is an important indicator in evaluating the severity of disease progression in patients with hepatitis B liver cirrhosis, and it has a certain clinical value in evaluating the bleeding tendency of patients with decompensated hepatitis B liver cirrhosis and complicated with esophagogastric varices.

The resistance dynamics of Blattella germanica in Yangpu District of Shanghai from 2014 to 2020 / 上海预防医学

Objective To investigate the resistance dynamics of Blattella germanica to commonly used insecticides in Yangpu District of Shanghai during 2014‒2020， and to provide the basis for the rational use of insecticides against cockroaches. Methods Blattella germanica was captured in two farmer’s markets in 2014， 2017 and 2020. The residual film method recommended by WHO was used to test resistance of Blattella germanica to the insecticides. Results In 2014， 2017 and 2020， the resistance ratio of Blattella germanica in Yangpu District was 6.96， 4.39， 7.26 to beta-cypermethrin， 10.41， 6.71， 5.24 to permethrin， and 2.28， 3.16， 1.01 to propoxur. Conclusion The resistance of Blattella germanica to permethrin and propoxur decreases， and the resistance to beta-cypermethrin keeps at low level. Comprehensive management and rotation of insecticides should be implemented to delay the increase of resistance.