Ambient dose equivalent in 99mTcO4- single photon emission computed tomography of the thyroid among patients with hyperthyroidism / 预防医学

Objective@#To investigate the changes of ambient dose equivalent rate in 99mTcO4- single photon emission computed tomography (SPECT) of the thyroid among patients with hyperthyroidism, so as to provide insights into radiation protection guidance.@*Methods@#Patients with hyperthyroidism who underwent 99mTcO4- SPECT of the thyroid in a tertiary hospital were enrolled. The ambient dose equivalent rate was measured at different time points following 99mTcO4- infection and at sites with different distances from patients' neck, and the effects of time post-injection, distance from patients' neck, 24-hour thyroidal radioiodine uptake and thyroid weight on the ambient dose equivalent rate were examined using a generalized linear mixed model.@*Results@#Totally 100 patients with hyperthyroidism were enrolled, including 24 men and 76 women and with a mean age of (38.5±14.0) years. The generalized linear mixed model was statistically significant (F=6 610.165, P<0.001), and patients' thyroid weight, time post-injection and distance from patients' neck significantly affected the ambient dose equivalent rate (F=57.967, 15 988.574, 11 200.645, all P<0.001), and the ambient dose equivalent rate positively correlated with patients' thyroid weight and negatively correlated with time post-injection and distance from patients' neck.@*Conclusions@#The ambient dose equivalent rate is affected by patients' thyroid weight, time post-injection and distance from patients' neck among patients with hyperthyroidism undergoing 99mTcO4- SPECT of the thyroid. Delay in contact with patients or keeping distance from patients may be effective for radiation protection.

Mechanism of Cordyceps in Treating Bronchial Asthma and Chronic Renal Failure with Concept of “Same Treatment for Different Diseases” Based on Network Pharmacology and Molecular Docking Technology / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Cordyceps in treating bronchial asthma and chronic renal failure with the concept of "same treatment for different diseases" in traditional Chinese medicine （TCM） by network pharmacology and molecular docking technology. MethodThe active components and potential targets of Cordyceps were collected from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and SwissTargetPrediction. The disease targets were obtained from Therapeutic Target Database （TTD）， DrugBank， GeneCards and other databases. The common targets were obtained from the intersection of potential targets and disease targets. The protein-protein interaction （PPI） network was constructed by STRING11.5， and the ''component-target-diseas'' network of Cordyceps was established by Cytoscape 3.9.0. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were carried out by Metascape， and molecular docking was performed by Autodock 4.2. ResultSixty common targets of disease and drug were screened out. The core targets mainly involved protein kinase B1 （Akt1）， non-receptor tyrosine kinase， sarcoma virus protein （SRC）， TP53， matrix metalloproteinase-9 （MMP-9）， and prostaglandin endoperoxide synthase 2 （PTGS2）. The potential targets were mainly enriched in the signaling pathways of renin-angiotensin system （RAS）， RAP1， phosphoinositide 3 kinase/protein kinase B （PI3K/Akt）， mitogen-activated protein kinase （MAPK）， etc. ConclusionThe active components of Cordyceps inhibited inflammatory response and reduced fibrosis and cell apoptosis in a multi-target and multi-pathway manner. The findings of this study preliminarily revealed the potential targets and modern biological mechanism of Cordyceps in treating bronchial asthma and chronic renal failure with the concept of ''same treatment for different diseases''， and provided references for in-depth experimental verification and clinical application.

Quality value transfer of substance benchmarks in Sanpian Decoction / 中国中药杂志

According to the polarity of different components in Sanpian Decoction, two fingerprints were established. Then the substance benchmark freeze-dried powder of 15 batches of Sanpian Decoction was prepared, followed by the determination of the fingerprints, index component content, and dry extract rates, the identification of attribution of characteristic peaks, and the calculation of similarities between these fingerprints and the reference(R), the content and transfer rate ranges of ferulic acid, sinapine thiocyanate, liquiritin, and glycyrrhizic acid, and the dry extract rate range. The results showed that the similarities of 15 batches of the substance benchmark fingerprints with R were all greater than 0.900.Further summarization of the characteristic peaks revealed that there were a total of 20 characteristic peaks in fingerprint 1, among which, eight were from Sinapis Semen, four from Paeoniae Radix Alba, six from Chuanxiong Rhizoma, and two from Glycyrrhizae Radix et Rhizoma. A total of 16 characteristic peaks were observed in fingerprint 2, including one from Sinapis Semen, three from Paeoniae Radix Alba, eight from Chuanxiong Rhizoma, and four from Glycyrrhizae Radix et Rhizoma. The average dry extract rate of 15 batches of substance benchmarks was 18.25%, with a dry extract rate range of 16.28%-20.76%. The index component content and transfer rate ranges were listed as follows: 0.15%-0.18% and 38.81%-58.05% for ferulic acid; 0.26%-0.42% and 36.51%-51.02% for sinapine thiocyanate; 0.09%-0.15% and 48.80%-76.61% for liquiritin; 0.13%-0.24% and 23.45%-35.61% for glycyrrhizic acid. The fingerprint, dry extract rate, and index component content determination was combined for analyzing the quality value transfer of substance benchmarks in the classic prescription Sanpian Decoction.The established quality evaluation method for the substance benchmarks was stable and feasible, which has provided a basis for the quality control of Sanpian Decoction and the follow-up development of related preparations.

Components of drugs in acupoint sticking therapy and its mechanism of intervention on bronchial asthma based on UPLC-Q-TOF-MS combined with network pharmacology and experimental verification / 中国中药杂志

UPLC-Q-TOF-MS combined with network pharmacology and experimental verification was used to explore the mechanism of acupoint sticking therapy(AST) in the intervention of bronchial asthma(BA). The chemical components of Sinapis Semen, Cory-dalis Rhizoma, Kansui Radix, Asari Radix et Rhizoma, and Zingiberis Rhizoma Recens were retrieved from TCMSP as self-built database. The active components in AST drugs were analyzed by UPLC-Q-TOF-MS, and the targets were screened out in TCMSP and Swiss-TargetPrediction. Targets of BA were collected from GeneCards, and the intersection of active components and targets was obtained by Venny 2.1.0. The potential targets were imported into STRING and DAVID for PPI, GO, and KEGG analyses. The asthma model induced by house dust mite(HDM) was established in mice. The mechanism of AST on asthmatic mice was explored by pulmonary function, Western blot, and flow cytometry. The results indicated that 54 active components were obtained by UPLC-Q-TOF-MS and 162 potential targets were obtained from the intersection. The first 53 targets were selected as key targets. PPI, GO, and KEGG analyses showed that AST presumedly acted on SRC, PIK3 CA, and other targets through active components such as sinoacutine, sinapic acid, dihydrocapsaicin, and 6-gingerol and regulated PI3 K-AKT, ErbB, chemokine, sphingolipid, and other signaling pathways to intervene in the pathological mechanism of BA. AST can improve lung function, down-regulate the expression of PI3 K and p-AKT proteins in lung tissues, enhance the expression of PETN protein, and reduce the level of type Ⅱ innate immune cells(ILC2 s) in lung tissues of asthmatic mice. In conclusion, AST may inhibit ILC2 s by down-regulating the PI3 K-AKT pathway to relieve asthmatic airway inflammation and reduce airway hyperresponsiveness.

Problems and countermeasures on pharmacovigilance system of 15 marketing authorization holders in Shanghai / 中国药房

OBJECTIVE To provide policy referen ce for local marketing authorization holder （MAH）to implement their main responsibility of drug life cycle supervision and the Guiding Principles of Pharmacovigilance Inspection to be officially released. METHODS Taking 15 MAH in Shanghai who recently underwent pharmacovigilance inspection as the research objects ，the social network analysis was used to explore the logical relationship between MAHs ’enterprise attributes and inspection problems ， summarize the problems found ，analyze the causes ，and put forward corresponding countermeasures. RESULTS & CONCLUSIONS The problems found in this pharmacovigilance inspection were mainly in aspects of organization ，personnel management ，quality management system ，report quality and so on. The reasons for these problems included light punishment ，which lead to the enterprise management ’s lack of attention to the pharmacovigilance system ，unclear problem handling and risk control mechanism ， imperfect quality management system documents ，inadequate personnel training ，etc. MAH needs to pay more attention to pharmacovigilance，allocate corresponding human and resources ，constantly improve the pharmacovigilance quality management system，and improve the enforceability and effectiveness of the pharmacovigilance system. At the same time ，it is suggested that government departments should strengthen policy guidance ， publicity and implementation ， and combine with third-party institutional platforms such as industry associations to promote the smooth implementation of Good Validation Practice .

Role of IL-6 trans-signaling pathway in perioperative neurocognitive disorder in mice / 中华麻醉学杂志

Objective:To investigate the role of IL-6 trans-signaling pathway in perioperative neurocognitive disorder in mice.Methods:Eighty-four SPF healthy male C57BL/6 wild-type mice and 84 SPF healthy male IL-6R -/- mice, aged 12-14 weeks, weighing 25-35 g, were used.The 84 wild-type mice were divided into 4 groups ( n=21 each) using a random number table method: sham group (SH group), surgery group (S group), sgp130Fc (specific IL-6 trans-signaling pathway blocker) group (F group), and sgp130Fc+ surgery group (FS group). In S group and FS group, internal fixation was performed under general anesthesia with sevoflurane after tibial fracture.Mice only received anaesthesia with sevoflurane in SH group and F group.In FS group and F group, sgp130Fc 10 mg/kg was intraperitoneally injected before anesthesia.Blood samples were collected from the celiac vein at 24 h after surgery for determination of the concentrations of interleukin 6 (IL-6), IL-1β and tumor necrosis factor (TNF)-α in plasma by enzyme-linked immunosorbent assay (ELISA). Then the mice were sacrificed, brains were removed, and hippocampal tissues were obtained for measurement of the contents of IL-6, IL-1β and TNF-α (by ELISA) and for observation of activation of microglias in the hippocampal DG region (by immunofluorescence staining, n=6). Cognitive function was evaluated by contextual fear conditioning test ( n=15) on 3 days after surgery.Eighty-four IL-6R -/- mice were randomly divided into 4 groups ( n=21 each): sham group (KO-SH group), surgery group (KO-S group), saline group (KO-C group), and hyper IL-6 (specific IL-6 trans-signaling pathway activator) group (KO-H group). The treatment in KO-SH group and KO-S group was the same as those previously described in SH group and S group, respectively.0.9% NaCl solution 100 μl was intraperitoneally injected in KO-C group, 100 μl hyper IL-6 40 μg/kg was intraperitoneally injected in KO-H group, and 24 h later blood was collected from the celiac vein for measurement of the concentrations of IL-6, IL-1β and TNF-α in plasma by ELISA.Then the mice were sacrificed, brains were removed, and hippocampal tissues were obtained for determination of the contents of IL-6, IL-1β and TNF-α (by ELISA) and for observation of activation of microglias in the hippocampal DG region (by immunofluorescence staining, n=6). Cognitive function was evaluated by contextual fear conditioning test ( n=15) on 3 days after surgery. Results:Compared with SH group, the percentage of freezing time in the contextual fear conditioning test was significantly decreased, and the activation of microglias in the hippocampal DG region and levels of IL-6, IL-1β and TNF-α in plasma and hippocampi were increased in S group ( P<0.05). Compared with S group, the percentage of freezing time in the contextual fear conditioning test was significantly increased, and the activation of microglias in the hippocampal DG region and levels of IL-6, IL-1β and TNF-α in plasma and hippocampus were decreased in FS group ( P<0.05). There were no significant differences in the percentage of freezing time, activation of microglias in the hippocampal DG region, and levels of IL-6, IL-1β and TNF-α in plasma and hippocampi between KO-S group and KO-SH group ( P>0.05). Compared with KO-C group, the percentage of freezing time in the contextual fear conditioning test was significantly decreased, and the activiation of microglias in the hippocampal DG region and levels of IL-6, IL-1β and TNF-α in plasma and hippocampus were increased in KO-H group ( P<0.05). Conclusions:IL-6 trans-signaling pathway is involved in the process of perioperative neurocognitive disorder in mice.

Combined posteromedial and anterolateral approach for reduction and internal fixation in the treatment of Wahlquist type C medial tibial plateau fracture with coronal subluxation of knee joint / 中华骨科杂志

Objective:To compare the efficacy of posteromedial and anterolateral approach and single posteromedial reversed L approach for reduction and internal fixation in the treatment of Wahlquist type C medial tibial plateau fracture (mTPF) with coronal subluxation of knee joint.Methods:A retrospective analysis was conducted on 44 surgically treated Wahlquist type C mTPFs from January 2010 to April 2021. They were divided into single-approach group (21 cases, 12 males and 9 females with mean age of 50.71±11.28 years) and combined-approach group (23 cases, 16 males and 7 females with mean age of 51.00±10.07 years) according to their surgical approach. The single-approach group contained 14 left limbs and 7 right limbs, and there were 19 anteromedial-posteromedial-posterolateral mTPF and 2 posteromedial-posterolateral mTPF. The combined-approach group contained 18 left limbs and 5 right limbs, and there were 22 anteromedial-posteromedial-posterolateral mTPF and 1 posteromedial-posterolateral mTPF. The intraoperative blood loss and incidence of blood transferring were assessed according to the anesthetic recording. The incidence of residual knee subluxation and articular surface step, medial proximal tibial angle (MPTA) and posterior proximal tibial angle (PPTA) were measured on the postoperative plain radiograph and the function recovery of the affected knee was evaluated by the short musculoskeletal function assessment (SMFA) and the visual analogue scale (VAS).Results:The intraoperative blood loss in combined-approach group was 597.83±89.79 ml and 516.67±79.58 ml in single-approach group, there was a significant difference between the two groups ( t=3.16, P=0.003). The incidence of blood transferring was 17% (4/23) in the combined-approach group and 14% (3/21) in the single-approach group, with no significant difference (χ 2=0.08, P=0.78). All 44 patients were followed up for 8 to 133 months (mean 54 months). The rate of the residual knee subluxation and unsatisfied articular surface reduction in the combined-approach group was lower than that in the single-approach group (34.8% vs. 76.2%, χ 2=7.59, P=0.006; 30.4% vs. 61.9%, χ 2=4.39, P=0.036). There was no significant difference between the combined-approach group and single-approach groups in the postoperative MPTA (86.67°±3.31° vs. 85.86°±4.36°, t=0.88, P=0.386) and PPTA (81.57°±3.22° vs. 83.90°±6.80°, t=1.44, P=0.162). The SMFA and VAS score sin the combined-approach group were significantly better than single-approach groups (20.52±11.04 vs. 31.19±16.79; t=2.51, P=0.016; 2.74±1.32 vs. 3.76±1.04; t=3.13, P=0.007). Conclusion:The efficacy of combined posteromedial and anterolateral approach in the treatment of Wahlquist type C mTPF with coronal subluxation of knee joint is superior to that of traditional single posteromedial reversed L approach.

Changes and significance of T lymphocyte subsets and cytokines in hyperlipidemia-induced acute pancreatitis / 中华急诊医学杂志

Objective:To explore the characteristics of T lymphocyte subsets and cytokines in hyperlipidemia-induced acute pancreatitis (HLAP) and its prognostic value.Methods:This study included 184 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Xiamen University from January 2018 to May 2021. Based on disease etiology, there were 92 HLAP cases and 92 non-hyperlipidemia-induced AP (NHLAP) cases. Stratified by disease severity according to 2012 Atlanta classification criteria, the patients were divided into the severe subgroup (SAP) and non-severe subgroup (NSAP). Peripheral venous blood samples were taken from all patients on day 1, 3, and 5 after admission. T lymphocyte subsets were determined by flow cytometry, and cytokines were detected by flow fluorometry. The number of CD4 +% and CD8 +% and the expression of cytokines were compared by Student’s t test or Mann-Whitney U analysis. Logistic regression analyses were performed to identify risk factors for severe AP, and a receiver operating characteristic (ROC) curve was constructed to predict severe AP. Statistical significance was taken as P<0.05. Results:Compared with the NHLAP group, patients in the HLAP group had lower CD4 +%, while higher levels of IL-2 on day 1 ( P<0.05), and had also lower CD4 +%, while higher levels of IL-4, IL-6, and IL-10 on day 3 ( P<0.05). Furthermore, IL-6 and IL-10 levels of the HLAP group were significantly increased compared to the NHLAP group on day 5 ( P<0.05). IL-10 levels in the SAP subgroup were significantly higher than those in the NSAP subgroup on day 1 ( P<0.05). Compared with the NSAP subgroup, the SAP subgroup had elevated levels of IL-2, IL-4, IL-6, IL-10 and IFN-γ on day 3 (all P<0.05), and had lower CD4 +%, while increased levels of IL-6 and IL-10 on day 5 (all P<0.05). Multivariate Logistic regression analysis showed that IL-10 was an immune indicator of independent risk factor for severe AP in the HLAP group on day 1 ( OR=1.139, 95% CI: 1.038-1.251, P<0.05). Finally, ROC analysis showed that the area under the curve of IL-10 to assess HLAP with severe AP was 0.772, and the best cut-off value for predicting severe AP was 5.6 pg/mL, with a sensitivity of 83.3% and a specificity of 68.8%. Conclusions:Changes of CD4 +% and cytokines are different between the HLAP and NHLAP groups. IL-10 can be used as a predictor of early disease severity in patients with HLAP.

Clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns / 中华烧伤杂志

Objective: To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods: A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14th day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. Results: On the 14th day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14th day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions: Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.

Prevalence and risk factors of Giardia lamblia infections among colorectal cancer patients in Henan Province / 中国血吸虫病防治杂志

Objective To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province. Methods A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients’ stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients. Results A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%). Conclusions The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.

Ketogenic diet therapy in the epilepsy of infancy with migrating focal seizures associated with TBC1D24 gene mutation: two case reports and literature review / 中华神经科杂志

Objective:To investigate the efficacy and safety of ketogenic diet (KD) therapy in the epilepsy of infancy with migrating focal seizures (EIMFS) associated with TBC1D24 gene mutation.Methods:Clinical data of two children with TBC1D24 gene-related EIMFS were collected retrospectively, who were admitted to Department of Pediatrics, Fujian Medical University Union Hospital from 2019 to 2020. Their clinical characteristics and the efficacy and safety of KD therapy were analyzed, and literature review was conducted.Results:Seizures were onset before six months old in the two children with TBC1D24 gene-related EIMFS. Multifocal myoclonic seizures were manifested and happened frequently, lasting for more than 30 minutes sometimes. Developmental retardation was obvious in the two children. A small amount of focal sharp, spike, sharp-slow complex, and spike-slow complex waves were showed in the interictal electroencephalography (EEG). TBC1D24 gene mutations were found in the two children, one with a compound heterozygous mutation (c.1025C>T, p.S342L; c.229_c.240delATCGTGGGCAAG,p.I77_K80del), and the other with a homozygous mutation [c.119G>A,p.R40H(Arg40His)]. Both of those were potentially pathogenic. A variety of anti-epileptic drugs showed poor outcome for the two children. The epilepsy was drug-refractory one. After four to 17 months of KD therapy, the epilepsy in the two children was controlled effectively. There was not obvious adverse reactions. Among six children with TBC1D24 gene-related EIMFS in the literature review, four cases were effective or partially effective for KD therapy, one was discontinued due to insufficient ketogenic ratio, and one was discontinued without effect. There were no obvious adverse reactions in the six children.Conclusions:TBC1D24 gene-related EIMFS is mostly drug-refractory epilepsy. Early KD therapy may help to control seizures.

The mechanism by which Ginkgo biloba extract induces the apoptosis of human laryngeal cancer Hep-2 cells by reducing reactive oxygen species level and activating JNK signaling pathway / 中国基层医药

Objective:To investigate the apoptosis-inducing effect of Ginkgo biloba extract (Ginaton) on human laryngeal cancer Hep-2 cells and the underlying molecular mechanism.Methods:Human laryngeal cancer Hep-2 cells were cultured in vitro and human laryngeal cancer Hep-2 cells in the log phase were treated with Ginaton in time and concentration gradients. The cell counting kit-8 (CCK-8) assay was performed to investigate the inhibitory effects of Ginaton on Hep-2 cells. Flow cytometry was performed to detect apoptosis and determine the level of reactive oxygen species (ROS). Western blot assay was performed to detect apoptosis and signaling pathway-related protein expression. Results:Ginaton inhibited the proliferation of Hep-2 cells in a time-dependent and concentration-dependent manner. Malondialdehyde level decreased gradually in a time-dependent manner, and decreased to 2.98 μmol/g after 24 hours of Ginaton treatment. Superoxide dismutase level increased gradually in a time-dependent manner and increased to 90.35 U/g after 24 hours of Ginaton treatment. ROS level decreased gradually in a time-dependent manner and deceased to 18.7% of the level before treatment after 24 hours of Ginaton treatment. There was no significant difference in ROS level between before and after 24 hours of Ginaton treatment ( F = 14.98, 19.65, 11.47, all P < 0.001). After 3, 6, 12 and 24 hours of Ginaton treatment, the expression of phosphorylated N-terminal protein kinase increased to 1.98, 2.57, 2.91 and 3.28 in a time-dependent manner. There was significant difference in the expression of phosphorylated N-terminal protein kinase between before treatment and after 3, 6, 12 and 24 hours of Ginaton treatment ( F = 16.37, P < 0.001). Conclusion:Ginaton can effectively inhibit the proliferation and induce apoptosis of human laryngeal cancer Hep-2 cells in vitro, which may be related to regulating ROS level and activating JNK signaling pathway.

Application of micro-classes combined with flipped classrooms based on short videos and images in "early rehabilitation nursing of stroke patients with hemiplegia" / 中华医学教育探索杂志

Objective:To explore the application effect of micro-classes combined with flipped classrooms based on short videos and images in "early rehabilitation nursing of stroke patients with hemiplegia".Methods:A total of 70 nursing students who were interns in our department from June 2019 to April 2021 were selected as the research objects, among which, 35 nursing students who entered the department from June 2019 to March 2020 were selected as the control group, using traditional teaching, and 35 nursing students who entered the department from July 2020 to April 2021 were selected as the research group, adopting the micro-classes combined with flipped classrooms teaching based on short videos and images. After the teaching, the test scores of the two groups of students, the students' satisfaction with the teaching methods, their critical thinking ability and the students' autonomous learning ability were evaluated. SPSS 17.0 was used for independent-sample t test and paired-sample t test. Results:After the teaching, the theoretical scores and clinical practice assessment scores of the research group were better than those of the control group, and the difference was statistically significant ( P<0.05); the students in the research group were more satisfied with the teaching method than those in the control group. After the teaching, the scores of 7 dimensions of critical thinking ability of the students in the research group were higher than those of the students in the control group; the scores and total scores of 4 dimensions of the self-learning ability evaluation were higher in the research group than those in the control group. Conclusion:Micro-classes combined with flipped classrooms teaching based on short videos and images can improve the teaching effect of "early rehabilitation nursing for patients with stroke and hemiplegia".

Application of interactive 3D PDF in the teaching of neurology cerebrovascular disease / 中华医学教育探索杂志

In order to discuss the role and significance of the three-dimensional portable document format(3D PDF) in the learning of cerebrovascular disease, this study created 3D PDF of complex cerebrovascular disease models to aid the teaching of cerebrovascular disease. The cerebral blood vessels, skull and brain tissue were segmented using the CTA image of the patient's brain. Then the 3D models were reconstructed, smoothed, and simplified. Based on this, Deep Exploration and Acrobat software were used to integrate these models into a 3D PDF file, which was used as an auxiliary tool for the teaching of cerebrovascular diseases for medical undergraduates. Finally, the feedback information of questionnaires was collected and analyzed statistically. The questionnaire results showed that the students have a strong interest in interactive 3D PDF. They believe that 3D PDF is more visual and intuitive than 2D CT or MRI images, and greatly agree with the positive effects of 3D PDF in the teaching of cerebrovascular disease and in clinical application.

Establishment of inflammatory model induced by Pseudorabies virus infection in mice

Background@#Pseudorabies virus (PRV) infection leads to high mortality in swine. Despite extensive efforts, effective treatments against PRV infection are limited. Furthermore, the inflammatory response induced by PRV strain GXLB-2013 is unclear. @*Objectives@#Our study aimed to investigate the inflammatory response induced by PRV strain GXLB-2013, establish an inflammation model to elucidate the pathogenesis of PRV infection further, and develop effective drugs against PRV infection. @*Methods@#Kunming mice were infected intramuscularly with medium, LPS, and different doses of PRV-GXLB-2013. Viral spread and histopathological damage to brain, spleen, and lung were determined at 7 days post-infection (dpi). Immune organ indices, levels of reactive oxygen species (ROS), nitric oxide (NO), and inflammatory cytokines, as well as levels of activity of COX-2 and iNOS were determined at 4, 7, and 14 dpi. @*Results@#At 105 –106 TCID50 PRV produced obviously neurological symptoms and 100% mortality in mice. Viral antigens were detectable in kidney, heart, lung, liver, spleen, and brain. In addition, inflammatory injuries were apparent in brain, spleen, and lung of PRVinfected mice. Moreover, PRV induced increases in immune organ indices, ROS and NO levels, activity of COX-2 and iNOS, and the content of key pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6, tumor necrosis factor-α, interferon-γ and MCP-1. Among the tested doses, 10 2 TCID 50 of PRV produced a significant inflammatory mediator increase. @*Conclusions@#An inflammatory model induced by PRV infection was established in mice, and 102 TCID50 PRV was considered as the best concentration for the establishment of the model.

Distribution of pathogenic bacteria and analysis of drug sensitivity in acute dacryocystitis / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the pathogenic bacteria and drug resistance of acute dacryocystitis, and to provide a guide for rational clinical medication.<p>METHODS: Lacrimal sac pus samples from 80 acute dacryocystitis cases were collected for bacterial culture and drug sensitivity test in Hebei Provincial Eye Hospital from January 2014 to October 2019. The change of detection rate of pathogenic bacteria in different years, the species of pathogenic bacteria of acute dacryocystitis, the main pathogenic bacteria, drug sensitivity and drug resistance of acute dacryocystitis, and the average detection rate of pathogenic bacteria in acute dacryocystitis were analyze.<p>RESULTS:Totally 56 samples were positive for pathogenic bacteria, including 55 cases of bacteria and 1 case of fungi. The average detection rate was 70%. The detection rate of pathogenic bacteria strains was gradually decreasing year by year, and there were various types of pathogenic bacteria strains detected from samples. In addition, Gram-positive cocci was the main pathogenic bacteria of acute dacryocystitis, accounting for 68%(38 cases), of which, staphylococcus aureus accounted for 38%(21 cases). What's more, most Gram-positive cocci were sensitive to rifampin, levofloxacin, and chloramphenicol, and Gram-negative bacilli were more sensitive to tobramycin, levofloxacin, ciprofloxacin, and gentamicin. Fifty-five cases of bacterial samples were obviously resistant to the first and second generation cephalosporins.<p>CONCLUSION: Gram-positive cocci constitute the main pathogenic bacteria of acute dacryocystitis, and levofloxacin can be used as the first choice of topical antibiotics for the treatment of acute dacryocystitis.

Atypical MSCT pleomorphic signs in metastatic adenocarcinoma and squamous cell carcinoma of the lung / 国际肿瘤学杂志

Objective:To investigate the correlations between multi-slice spiral CT (MSCT) atypical pleomorphic signs and pathological findings of lung metastases.Methods:From January 2012 to July 2019, the MSCT chest imaging data of 168 metastatic tumor of lung from the General Hospital of Central Theater Command of the Chinese People′s Liberation Army and Shaanxi Provincial Tumor Hospital were collected. According to the pathological type, they were divided into metastatic adenocarcinoma group ( n=88) and metastatic squamous cell carcinoma group ( n=80). The atypical imaging signs of MSCT of the two groups were observed and recorded, and classified after labeling one by one. The difference of atypical MSCT imaging features between the two groups was compared, and the correlations between lesion size and atypical imaging features of MSCT in the metastatic adenocarcinoma group and metastatic squamous cell carcinoma group were analyzed. Results:The spicule sign in metastatic adenocarcinoma and metastatic squamous cell carcinoma were 61 (69.32%) and 28 (35.00%), with a statistically significant difference ( χ2=19.811, P<0.001). The pleural depression sign in the two groups were 48 (54.55%) and 16 (20.00%), and there was a statistically significant difference ( χ2=21.206, P<0.001). The vacuole/cavity sign in the two groups were 10 (11.36%) and 61 (76.25%), and there was a statistically significant difference ( χ2=72.303, P<0.001). The air bronchial sign in the two groups were 43 (48.86%) and 13 (16.25%), with a statistically significant difference ( χ2=20.057, P<0.001). The halo sign/ground glass shadow in the two groups were 58 (65.91%) and 37 (46.25%), with a statistically significant difference ( χ2=6.591, P=0.010). The results of the Spearman rank correlation analysis indicated a positive correlation between the size of metastatic adenocarcinoma and spicule sign, pleural depression sign ( r=0.270, P=0.011; r=0.226, P=0.035). There was no correlation between the nodule size and atypical MSCT imaging features in metastatic squamous cell carcinoma (all P>0.05). Conclusion:The atypical MSCT of metastatic lung adenocarcinoma are mostly spicule sign, pleural depression sign, air bronchial sign and halo sign/ground glass shadow. The characteristic atypical imaging of metastatic squamous cell carcinoma is vacuole/cavity sign. The spicule sign and pleural depression sign are related to the size of metastatic lung adenocarcinoma nodules.

Sudden sensorineural hearing loss and ischemic stroke / 国际脑血管病杂志

Sudden sensorineural hearing loss (SSNHL) refers to the sudden and unexplained sensorineural hearing loss within 72 h and a decrease in hearing of ≥30 dB affecting at least 3 consecutive frequencies. It is one of the common emergencies in neurology and otolaryngology. Early etiological evaluation and systematic and targeted treatment are very important for delaying the progression of SSNHL and restoring hearing. Recent studies have shown that SSNHL overlaps with vascular risk factors of ischemic stroke, and may predict the risk of ischemic stroke. SSNHL may be one of the clinical manifestation and even the prodromal symptoms of ischemic stroke, especially the infarction of the blood supply area of the anterior inferior cerebellar artery or its branch internal auditory artery. Although these factors can not fully reveal the relationship between SSNHL and ischemic stroke, they are enough to warn clinicians that they should consider the possibility of ischemic stroke when receiving patients with SSNHL. Screening of vascular risk factors for patients with SSNHL as early as possible is helpful to avoid the risk of recurrence of ischemic stroke.

Effect of Modified Shiquan Dabutang on Inflammatory and Bone Metabolism Indexes in Elderly Patients with Osteoporotic Intertrochanteric Fractures Due to Qi and Blood Deficiency / 中国实验方剂学杂志

Objective:To explore the application value of modified Shiquan Dabutang in the treatment of elderly patients with osteoporotic intertrochanteric fractures （OIFs） due to Qi and blood deficiency by observing its impacts on inflammatory and bone metabolism indexes. Method:Ninety-eight elderly patients admitted to our hospital for OIFs of Qi and blood deficiency syndrome from April 2018 to April 2020 were randomized into an observation group （<italic>n</italic>=49） and a control group （<italic>n</italic>=49）. Following the proximal femoral nail antirotation （PFNA） fixation， patients in the control group were treated with Guipiwan， while those in the observation group received the modified Shiquan Dabutang. The clinical efficacy， inflammatory and bone metabolism indexes， and complications were compared between the two groups after four weeks of treatment. Result:The levels of such serum indexes as fibroblast growth factor-2 （FGF-2）， osteoprotegerin （OPG）， transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁）， <italic>β</italic>-endorphin （<italic>β</italic>-EP）， bone-specific alkaline phosphatase （BALP）， and osteocalcin （BGP） in the observation group after treatment were significantly elevated as compared with those in the control group （<italic>P</italic><0.05）， whereas the serum tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and <italic>D</italic>-dimer （<italic>D</italic>-D） declined （<italic>P</italic><0.05）. The TCM symptom score in the observation group after treatment was obviously lower than that in the control group， while the Harris Hip Score （HHS） was higher （<italic>P</italic><0.05）. The overall response rate of the observation group was 93.88% （46/49）， higher than 75.51% （37/49） of the control group （<italic>χ²</italic>=6.376， <italic>P</italic><0.05）. The total incidence of incision infection， deep vein thrombosis of lower limbs， and pulmonary infection in the control group was 24.49% （12/49）， significantly higher than 6.12% （3/49） in the observation group （<italic>χ²</italic>=6.607， <italic>P</italic><0.05）. Conclusion:The modified Shiquan Dabutang is able to alleviate inflammation， regulate bone metabolism， promote bone repair， and reduce the incidence of complications in elderly patients with OIFs due to Qi and blood deficiency.

Textual Research on Ancient and Modern Literature of Xiao Chengqitang / 中国实验方剂学杂志

Xiao chengqitang is recorded in Treatise on Febrile Diseases written by ZHANG Zhong-jing in the Eastern Han dynasty. It is composed of Rhei Radix et Rhizoma， Magnoliae Officinalis Cortex and Aurantii Fructus Immaturus， which is mainly used to treat mild exogenous Yangming Fu-viscera excess syndrome. This formula has been included in the Catalogue of Ancient Classical Prescription （The First Batch）. However， the processing specifications and doses recorded in the original formula are different from the modern usage， which results in some difficulties in the research and development of Xiao Chengqitang granules. For clarifying the key information， such as historical evolution of prescription， dose conversion， the origin and processing specifications of each medicine in the prescription， the paper systematically analyzes the ancient medical books and related literature in the past dynasties and refers to the life experience of ZHANG Zhong-jing. Then the modern prescription and decocting methods of Xiao Chengqitang were determined as follows：composing 55.2 g of Rhei Radix et Rhizoma （Rheum officinale） washed with wine， 27.6 g of Magnoliae Officinalis Cortex （Magnolia officinalis） processed with ginger and 39.0 g of stir-fried Aurantii Fructus Immaturus （Citrus aurantium）， adding 800 mL of water， decocting to 240 mL and filtrating.