Effect of omeprazole on pharmacokinetic parameters of imatinib in rats / 中国药房

OBJECTIVE To investigate the effects of omeprazole on pharmacokinetic parameters of imatinib in rats. METHODS According to body weight， the rats were divided into imatinib+low-dose， medium-dose， and high-dose omeprazole groups， imatinib group， with 6 rats in each group. They were given omeprazole suspension at the doses of 1.8， 3.6 and 7.2 g/kg， or 0.5% sodium carboxymethyl cellulose solution intragastrically respectively； one hour later， imatinib suspension was administered by oral gavage at a the dose of 10 mg/kg. Blood sample （100 μL） was taken from the orbit before and 0.5， 1， 2， 2.5， 3， 4， 5， 6， 8， 12， 24 and 36 hours after intragastric administration of imatinib. Using imatinib-d3 as internal standard， the plasma concentrations of imatinib and its metabolite N-desmethyl imatinib in rat were determined by high performance liquid chromatography-tandem mass spectrometry. The pharmacokinetic parameters were calculated by DAS 2.0 software and compared. RESULTS Compared with imatinib group， AUC0－∞ and AUMC0－∞ of imatinib in rat plasma of imatinib+medium-dose omeprazole group， cmax， t1/2， AUC0－∞ and AUMC0－∞ of imatinib in rat plasma of imatinib+high-dose omeprazole group were all increased or prolonged significantly （P＜0.05）. Compared with imatinib group， AUC0－∞ and AUMC0－∞ of N-desmethyl imatinib in rat plasma of imatinib+medium-dose omeprazole group， and cmax and AUC0→∞ of N-desmethyl imatinib in rat plasma of imatinib+high-dose omeprazole group were decreased significantly （P＜0.05）. CONCLUSIONS Omeprazole may increase the plasma concentration of imatinib in rats and reduce the plasma concentration of N-desmethyl imatinib in rats， which may be associated with inhibiting the metabolism of imatinib.

A nomograph model for prediction of central lymph node metastasis of papillary thyroid carcinoma / 预防医学

Objective@#To establish a nomograph model for prediction of cervical central lymph node metastasis (CLNM) among patients with thyroid papillary carcinoma (PTC), so as to provide the evidence for designing personalized treatment plans for PTC.@* Methods @#The data of patients that underwent thyroidectomy and were pathologically diagnosed with PTC post-surgery in the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from 2018 to 2021 were collected. Patients' data captured from 2018 to 2020 and from 2021 were used as the training set and the validation set, respectively. Predictive factors were screened using a multivariable logistic regression model, and the nomograph model for prediction of CLNM risk was established. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve and the adjusted curve.@* Results@#Totally 1 820 PTC cases were included in the training set, including 458 cases with CLNM (25.16%), and 797 cases in the validation set, including 207 cases with CLNM (25.98%). The prediction model is p=ey/(1+ey), y=0.761 + 0.525 × sex + (-0.039) ×age + 0.351 × extrathyroid invasion + 0.368 × neck lymph node enlargement + 1.021×maximum tumor diameter + (-0.009) × TT4 + (-0.001) × anti-TPOAb. The area under the ROC curve was 0.732 for the training set and 0.731 for the validation set, and Hosmer-Lemeshow test showed a good fitting effect (P=0.936, 0.722).@*Conclusion@# The nomograph model constructed in this study has a high predictive value for CLNM among patients with PTC.

Mechanism of Traditional Chinese Medicine in Prevention and Treatment of Ulcerative Colitis： Based on Intestinal Microenvironment / 中国实验方剂学杂志

Ulcerative colitis （UC）， a chronic inflammatory bowel disease affecting the colorectum with high morbidity and prevalence， has become a global burden. However， the causes and pathogenesis are still unclear. Available studies have verified that the imbalance of intestinal microenvironment is crucial in the occurrence and development of UC. Intestinal microenvironment is mainly composed of intestinal microbiota and intestinal mucosal cells， which are involved in the physiological and pathological activities of the body through the intestinal microbial barrier， chemical barrier， mechanical barrier， and immune barrier. Thus， probiotic agents， 5-aminosalicylic acid preparations， corticosteroids， immunosuppressants， biological preparations and other drugs are commonly used in western medicine for the treatment of UC， which， however， have limitations. Therefore， it is the key task for the prevention and treatment of UC to find new therapies. In recent years， it has been found that traditional Chinese medicine （TCM） has unique advantages in the prevention and treatment of UC. Chinese medicine compounds and Chinese medicine monomers can regulate the intestinal microenvironment through multiple pathways and targets， thereby intervening the occurrence and development of UC. It has gradually become a hot spot in the prevention and treatment of UC and attracted extensive attention. Therefore， this study first discussed the correlation between intestinal microenvironment imbalance and UC and then summarized the mechanisms of TCM against UC from the aspects of regulating intestinal flora， improving chemical barrier， protecting mechanical barrier， and inhibiting immune inflammatory response， in order to provide new ideas for the research on TCM in the treatment of UC.

Microbial contamination characteristics of centralized air conditioning systems in star-rated hotels based on metagenomic sequencing / 环境与职业医学

Background The use of heating and ventilation air conditioning (HVAC) in public places is conducive to improving indoor air quality and increasing the users comfort level. However, HVAC may also become potential carriers of indoor airborne microbial contamination. Objective To understand the characteristics of microbial pollution and distribution of related pathogenic microorganisms in HVAC of star-rated hotels, and to provide a basis for effective control of such pollution. Methods According to the requirements of the Hygienic specification of central air conditioning ventilation system in public buildings (WS 394-2012), two sets of HVAC in two star-rated hotels (A and B, inaugurated in 2002 and 1998, respectively) in the central area of Shanghai were randomly selected on September 9, 2020 for the hygienic evaluation of microorganisms in the air supply and respirable particulate matter (PM10) in the air supply, dust accumulation and microorganisms on the inner surface of the ducts, as well as Legionella pneumophila in cooling water and condensate water. At the same time, 3 samples from the inner surface of ducts, 1 sample from the surface of the filter, 1 sample from the condensate, and 1 sample from the cooling water were collected from each set of HVAC, a total of 12 sample from 2 sets of HVAC, for Illumina HiSeq metagenomic sequencing，and the samples are divided into 3 groups according to their types: duct group, filter group, and water sample group. The α-diversity indices (Shannon index, Simpson index, Chao1 index, ACE index, and goods_coverage index) were calculated to reflect the microbial community composition; and the β-diversity of the three groups were studied by principal component analysis to determine the similarity of the microbial communities. Results The maximum total number of bacteria and fungi in the air supply of the HVAC were 1158 CFU·m−3 and 344 CFU·m−3 for Hotel A respectively; and 2000 CFU·m−3 and 532 CFU·m−3 for Botel B respectively. β-hemolytic streptococci were negative in all samples; the respirable particulate matter, microorganisms and dust accumulation on the inner surface of air ducts, Legionella pneumophila IN cooling water and condensate samples all met the standards. The results of Illumina HiSeq sequencing showed that a total of 17322 microorganisms were reported in the 12 samples, with bacterial microbiota accounting for 97.31% of the classified genes and the remaining 2.69% were from fungi, viruses, and parasites. At the species level, Staphylococcus epidermidis, Pseudomonas, Alternaria, and Malassezia were the dominant microbial taxa measured in this survey. The results of α-diversity analysis showed that the values of Shannon index, Simpson index, and Chao1 index for the three groups of samples were duct > filter > water sample. The goods coverage indices of all sample groups s were close to 1. The principal component analysis showed that the contributions of two principal components were 19.27% and 14.25%, respectively, in which the samples of the filter and duct groups were better clustered into one category. Conclusion The overall hygiene conditions of the two hotels are good, except for the serious microbial contamination in the air supply of HVAC. Metagenomic sequencing reveals complex microbial communities of HVAC, including bacteria, fungi, viruses, and parasites. The species composition vary by sample groups, particularly the species compositions of the samples from filters and ducts are close and dominated by pathogenic microorganisms of human origin, suggesting that the potential biosafety hazards of HVAC should not be ignored.

Variations and health risk of polycyclic aromatic hydrocarbons in ambient PM2.5 in industrial and residential areas in Fuzhou City / 环境与职业医学

Background PM2.5 pollution has become a widely concerned environmental health problem. Polycyclic aromatic hydrocarbons(PAHs) are the main harmful components of PM2.5, and their sources and carcinogenic risk deserve attention. Objective To analyze the source apportionment of PAHs in ambient PM2.5 in Fuzhou, and to evaluate the potential carcinogenic risk through inhalation due to exposure to PAHs. Methods In this study, two sampling sites were set up in Cangshan (industrial area) and Taijiang (commercial and residential area) districts in Fuzhou City. PM2.5 was collected from 10th to 16th of each month from 2017 to 2020 by membrane filtration method. The concentrations of ambient PM2.5 were measured by weighing, and the concentrations of 16 PAHs, including naphthalene(NAP), acenaphthylene(ACY), acenaphthene(ACE), fluorene(FLU), phenanthrene(PHE), anthracene(ANT), fluoranthene(FLT), pyrene(PYR), benzo[a]anthracene(BaA), chrysene(CHR), benzo[b]fluoranthene(BbF), benzo[k]fluoranthene(BkF), benzo[a]pyrene(BaP), indeno[1,2,3-cd]pyrene(IcdP), dibenzo[a,h]anthracene(DahA), and benzo[g,h,i]perylene(BghiP), were determined by ultra-high performance liquid chromatography coupled with diode array detector and fluorescence detector. The concentrations of PM2.5 and PAHs were compared in the two districts and the concentrations of PAHs were also compared in different seasons. The diagnostic ratio [FLT/(FLT+PYR), IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP] method and positive matrix factorization (PMF) analysis were used to determine the sources of PAHs in PM2.5 in Fuzhou. The excess carcinogenic risk (ECR) model was used to assess the potential health risk of inhalation exposure to PAHs. Results During 2017–2020, the M (P25, P75) concentration of ambient PM2.5 in Cangshan and Taijiang districts of Fuzhou were 35.0 (25.0, 47.5) and 34.0 (25.5, 46.0) μg·m−3 respectively, and the percentages of PM2.5 exceeding the national standard in Cangshan and Taijiang were 2.68% and 4.17%, respectively, without significant differences (P＞0.05). The M (P25, P75) concentrations of ΣPAHs in Cangshan was 5.03 (3.07, 7.67) ng·m−3, higher than that in Taijiang, 3.20 (2.05, 5.59) ng·m−3 (P＜0.05). The M (P25, P75) concentrations of PAHs monomers except ACY, FLU, and ACE in Cangshan were higher than those in Taijiang (P＜0.05). The concentrations of ΣPAHs in PM2.5 in four seasons in Cangshan were higher than those in Taijiang (P＜0.05). In both districts, the concentration of ΣPAHs in winter was higher than those in spring, summer, and autumn (P＜0.05). According to the diagnostic ratio method, the median ratios of FLT/(FLT+PYR) in the two districts ranged from 0.4 to 0.5, and those of IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP were from 0.2 to 0.5, from 0.2 to 0.35, and less than 0.6, respectively. The results of PMF analysis showed the proportions of four factors in Cangshan were 37.9%, 13.2%, 24.0%, and 24.9%, respectively. The major load contributors to factor 1 included FLT, PHE, and PYR; to factor 2, FLU, ACY, and ACE; to factor 3, DahA; to factor 4, BghiP, IcdP, and BaP. The proportions of four factors in Taijiang were 23.6%, 19.3%, 22.0%, and 35.1%, respectively. The main load contributor to factor 1 was DahA; to factor 2, BghiP; to factor 3, FLT, PHE, and PYR; to factor 4, IcdP, BaP, BbF, BkF, CHR, and BaA. The benzo[a]pyrene equivalences (BEQ) in Cangshan and Taijiang districts were 1.87 ng·m−3 and 1.61 ng·m−3, respectively. The excess carcinogenic risks of PAHs through inhalation exposure was 3.83×10−6 and 3.30×10−6, respectively. Conclusion The complex sources of PAHs in ambient PM2.5 include dust, vehicle emissions, industrial emissions in Fuzhou, and are different in selected two districts. The level of PAHs in ambient PM2.5 may pose a potential carcinogenic risk to local population.

Mechanism of miR-21 targeting Smad7 in pulmonary fibrosis of A549 cells induced by beryllium sulfate / 环境与职业医学

Background The pathogenesis of beryllium-induced pulmonary fibrosis is unknown and there is no specific treatment for the disease as yet. MicroRNA (miRNA) may play a role in the process of beryllium-induced pulmonary fibrosis. Objective To construct a microRNA-21 (miR-21) interfering cell line, and to investigate the effect of miR-21 on beryllium sulfate (BeSO4)-induced fibrosis in human lung adenocarcinoma alveolar basal epithelial cells (A549 cells) and its potential mechanism. Methods The miR-21 target genes were predicted by the online database miRBase and verified by experiments using dual luciferase reporter gene. After transfecting A549 with miR-21interference lentivirus, puromycin was used to select a stable cell line. An in vitro model of pulmonary fibrosis was established using BeSO4 infecting A549 cells with a concentration of 10 μmol·L−1 and an exposure time of 48 h. Then the treated cells were divided into control group, model group, miR-21 interference group, and miR-21 interference control group. Real-time fluorescent quantitative PCR (RT-qPCR) was used to detect the relative expression level of miR-21 gene. Western blotting was used to detect the relative expression levels of TGF-β1/Smads pathway related proteins [Smad2, Smad3, p-Smad2, p-Smad3, Smad7, and transforming growth factor-β1 (TGF-β1)], myofibrosis cell marker α-smooth muscle actin (α-SMA), andextracellular matrix collagen-I (COL-I) and collagen-Ⅲ (COL-Ⅲ). Results The miRBase predicted that miR-21 had a binding site with Smad7, and the results of the dual luciferase reporter gene experiment showed that the target gene of miR-21 was Smad7. The construction of miR-21 interfered with A549 cell line was successful. Compared with the control group, the relative expression of miR-21 gene in the model group increased by 97.57%; the relative expression of Smad7 protein in the model group decreased by 15.48%; the relative protein expression of Smad2, Smad3, p-Smad2, p-Smad3, TGF-β1, α-SMA, COL-I, and COL-Ⅲ increased by 13.55%, 35.72%, 18.35%, 35.75%, 25.52%, 31.58%, 24.61%, and 11.66% respectively (P<0.05). Compared with the interference control group, the miR-21 gene expression level in the interference group decreased by 28.96%; the relative expression of Smad7 protein increased by 19.07%; the relative protein expression of Smad2, Smad3, p-Smad2, p-Smad3, TGF-β1, α-SMA, COL-I, and COL-Ⅲ decreased by 8.01%, 19.95%, 14.56%, 19.37%, 11.95%, 10.96%, 18.81%, and 31.36% repectively (P<0.05). There was no statistically significant difference in the gene abd protein expression levels of each gene between the model group and the interference control group (P>0.05). Conclusion In an in vitro model of pulmonary fibrosis induced by beryllium compounds, miR-21 may promote fibrosis by targeting Smad7 to regulate the TGF-β1/Smad signaling pathway.

Impact of graft/recipient weight ratio on the prognosis of infants with whole liver transplantation / 中华器官移植杂志

Objective:To explore the impact of graft recipient weight ratio(GRWR)on pediatric whole liver transplantation in infants aged under 1 year.Methods:From January 2014 to December 2019, clinical data were retrospectively reviewed for 140 children aged under 1 year with whole liver transplantation.They were divided into 3 groups of low GRWR(GRWR<2.5%, 48 cases), middle GRWR(2.5%≤GRWR<5%, 73 cases)and high GRWR(GRWR≥5%, 19 cases). Basic profiles, major postoperative complications and survival rate of graft/recipient were compared.Results:There were 62 males and 78 females with an average age of (7.34±1.81)months and an average weight of(6.81±1.09)kg.The median GRWR was 3.27%(1.33%~8.12%). The higher level of GRWR, the greater age, weight and graft weight of donor in three groups and there was statistical difference ( P<0.05); operative duration, postoperative ICU stay and hospital stay were longer in low GRWR group than those in middle GRWR group and there was statistical difference( P<0.05); The incidence of postoperative hepatic artery thrombosis was higher in low GRWR group than that in middle GRWR group(31.3%vs 8.2%)and there was statistical difference( P<0.05); 4 cases of small-for-size syndrome occurred in low GRWR group, it was significantly different from the other two groups and there was statistical difference( P<0.05); the median follow-up period was(50.7±23.4)months.The survival rates of grafts at 3-month and 1/5-year were 89.6%, 91.8%, 100%; 87.5%, 87.7%, 100%; 87.5%, 87.7%, 100%and there was no inter-group difference( P>0.05). The survival rates of recipients at 3 months, 1 year and 5 years post-operation were 93.8%, 91.8%, 100%; 91.7%, 87.7%, 100%; 91.7%, 87.7%, 100%and there was no inter-group difference( P>0.05). Conclusions:Different from pediatric living donor transplantation, GRWR≥5%does not affect the survival rate of recipient/graft during whole liver transplantation.And GRWR<2.5%may boost the postoperative incidence of hepatic artery thrombosis and small liver syndrome.

Impact of left hepatic vein classification on hepatic vein reconstruction and prognosis after pediatric living-donor liver transplantation using left lateral liver segments / 中华肝胆外科杂志

Objective:To study the impact of donor left hepatic vein classification and the reconstruction methods on hepatic venous outflow obstruction (HVOO) after pediatric living-donor liver transplantation using left lateral liver segments.Methods:A retrospective study was performed on the clinical data of 653 children recipients who underwent living-donor liver transplantation with left lateral liver segments from January 2014 to December 2020 at Tianjin First Central Hospital. There were 309 males and 344 females, aged 7.0 (6.0, 10.0) months, with an age range of 3-121 months. Based on the left hepatic vein on preoperative donor enhancement CT as well as the intraoperative reconstruction methods, the recipients were divided into 3 groups: type Ⅰ group ( n=514), anastomosis using a single opening was performed directly between the donor and the recipient; type Ⅱ group ( n=118), angioplasty was performed on two adjacent recipient venous orifices before anastomosis, and type Ⅲ group ( n=21), an interposition vessel was anastomosed to two widely spaced openings or the two veins were anastomosed separately. The preoperative general status of the patient, postoperative HVOO incidences, and graft and recipient survival rates were compared among the three groups. The patients were followed up by outpatient reexamination or telephone. Results:Graft to recipient weight ratio in the type Ⅲ group was smaller than that in the type Ⅰ group and the type Ⅱ group ( P<0.05). For all the 653 patients, the incidence of postoperative HVOO was 4.59% (30/653), with the incidences of HVOO in the 3 groups of patients were 4.1% for the type Ⅰ group (21/514), 5.1% for the type Ⅱ group (6/118), and 14.3% for the type Ⅲ group (3/21), respectively. There was no significant difference among the groups ( P>0.05). The recipient cumulative survival rates at 1 and 3 years after surgery in the type I group were 97.8% and 97.0%, and the corresponding rates in the type Ⅱ group were 96.5% and 94.2%, and in the type Ⅲ group were 94.1% and 86.9%, respectively. There was a significant difference between the type Ⅰ and type Ⅲ groups ( P=0.048). The graft cumulative survival rates at 1 and 3 years in the type Ⅰ group were 97.4% and 96.9%, and the corresponding rates in the type Ⅱ group were 94.9% and 92.5%, and in the type Ⅲ group were 94.1% and 86.9%, respectively. The difference in the postoperative graft cumulative survival rates between the type Ⅰ group and type Ⅱ group was significant ( P=0.044). Conclusions:The anatomy of the left hepatic vein supplying the left lateral liver segment was highly variable, and the majority of the variations could be reconstructed. A reasonable reconstructive method could reduce the incidence of postoperative HVOO and improved the outcomes of the graft.

Eye movement study on facial emotion processing in patients with Alzheimer's disease / 中华行为医学与脑科学杂志

Objective:To explore the effect of visual processing patterns on emotional face processing in patients with Alzheimer's disease (AD).Methods:From June 2020 to August 2021, twenty-two AD patients (AD group) who met the conditions of this study were selected from the memory impairment clinic of the First Affiliated Hospital of Anhui Medical University, and demographically matched twenty-one elderly healthy people (control group) were selected from the patients' family members and community residents. The two groups of subjects performed emotional face visual scanning and facial recognition experiments after completing the evaluation of the cognitive scale and eye movement data were recorded in the emotional face visual scanning task. Statistical analysis of the obtained results was performed using SPSS 23.0 Windows version software. The data that conformed to the normal distribution were tested by independent samples t-test and variance analysis, and the data that did not conform to the normal distribution were tested by nonparametric test. Results:(1)In the emotional face recognition task, the total accuracy of facial emotion recognition of AD patients(0.52(0.42, 0.59)) was lower than that of the normal control group(0.67(0.64, 0.69)), and the difference was statistically significant( Z=-4.023, P<0.01), which was mainly manifested in recognizing complex facial emotion. (2) In the emotional face visual processing task, the saccade count ((1.96±0.97), (2.50±0.44)), fixation count ((3.93±2.58), (6.37±2.08))and fixation time ((1 205.89±727.32)s, (1 761.38±525.54)s)of AD patients were lower than those of the control group( t=-2.314, -3.402, -2.880, all P<0.05), and the surrounding facial fixation time (384.95 (276.51, 587.78)s, 276.06 (190.03, 384.55)s) was higher than that of the control group( Z=-2.478, P=0.013). Patients with AD had a lower fixation count than that in the control group on the eye area of surprise ((3.76±2.90), (6.25±2.19)), anger ((4.48±2.72), (7.06±2.55)) and disgust ((4.10±2.45), (6.67±2.45)), and the differences were statistically significant ( t=-3.164, -3.207, -3.436, all P<0.05). Patients with AD had a lower fixation time than those of the control group on the eye area of surprise ((1 150.26±753.22)s, (1 779.91±551.66)s), angry ((1 430.85±869.52)s, (1 944.51±612.63)s) and disgust ((1 266.14±765.67)s, (1 898.33±676.02)s), and the differences were statistically significant ( t=-3.115, -2.247, -2.865, all P<0.05). (3) Spearman correlation analysis showed that the accuracy of overall emotional face recognition was positively correlated with the fixation time in the eye area in AD patients ( r=0.429, P<0.05). Conclusion:The impaired visual processing of AD patients causes emotional face recognition disorders. Therefore, AD patients have different visual processing patterns in emotional face processing than age-matched normal controls, mainly manifested as the decreased fixation on the eye area.

Glucose-6 phosphatase catalytic subunit inhibits the proliferation of liver cancer cells by inducing cell cycle arrest / 中华肝脏病杂志

Objective: To investigate the effects of glucose-6-phosphatase catalytic subunit (G6PC) recombinant adenovirus on proliferation and cell cycle regulation of liver cancer cells. Methods: Recombinant adenovirus AdG6PC was constructed. Huh7 cells and SK-Hep1 cells were set as Mock, AdGFP and AdG6PC group. Cell proliferation and clone formation assay were used to observe the proliferation of liver cancer cells. Transwell and scratch assay were used to observe the invasion and migration of liver cancer cells. Cell cycle flow cytometry assay was used to analyze the effect of G6PC overexpression on the proliferation cycle of liver cancer cells. Western blot was used to detect the effect of G6PC overexpression on the cell-cycle protein expression in liver cancer cells. Results: The recombinant adenovirus AdG6PC was successfully constructed. Huh7 and SK-Hep1 cells proliferation assay showed that the number of proliferating cells in the AdG6PC group was significantly lower than the other two groups (P < 0.05). Clone formation assay showed that the number of clones was significantly lower in AdG6PC than the other two groups (P < 0.05), suggesting that G6PC overexpression could significantly inhibit the proliferation of liver cancer cells. Transwell assay showed that the number of cell migration was significantly lower in AdG6PC than the other two groups (P < 0.05). Scratch repair rate was significantly lower in AdG6PC than the other two groups (P < 0.05), suggesting that G6PC overexpression can significantly inhibit the invasion and migration of liver cancer cells. Cell cycle flow cytometry showed that G6PC overexpression had significantly inhibited the Huh7 cells G(1)/S phase transition. Western blot result showed that G6PC overexpression had down-regulated the proliferation in cell-cycle related proteins expression. Conclusion: G6PC inhibits the proliferation, cell-cycle related expression, and migration of liver cancer cells by inhibiting the G(1)/S phase transition.

Investigation and analysis of underground noise in Sichuan coal mines / 中华劳动卫生职业病杂志

Objective: To understand the harm degree of underground noise and provide basis for noise control. Methods: In November 2019, 13 typical coal mines in Sichuan Province were selected as the research objects, and a total of 1203 sites and 609 jobs of noise exposure were investigated. Results: The noise intensity P75 >80 dB (A) was measured. The noise intensity of the inspection place of the air compressor is >86 dB (A) , the noise intensity of the inspection place of the gas drainage and the operation place of the main fan is between 80-85 dB (A) . Conclusion: Besides the harm of dust, noise exposure should also be paid attention to, and the measures of sound absorption and sound insulation should be taken or personal protection should be strengthened.

Treatment and prognosis analysis of perineural invasion on sinonasal adenoid cystic carcinoma / 中华肿瘤杂志

Objective: To analyze the efficacy of sinonasal adenoid cystic carcinoma (ACC) with perineural invasion (PNI), and explore the prognostic value of PNI on sinonasal adenoid cystic carcinoma. Methods: The clinical data of 105 patients with sinonasal ACC admitted to Cancer Hospital, Chinese Academy of Medical Sciences from January 2000 to December 2016 were retrospectively reviewed. All patients were restaged according to American Joint Committee on Cancer 8th edition. Follow-up visits were conducted to obtain information of treatment failure and survival outcome. The Log rank test was used for univariate analysis of prognostic factors, and Cox regression model was used for multivariate prognostic analysis. Results: The maxillary sinus (n=59) was the most common primary site, followed by the nasal cavity (n=38). There were 93 patients with stage Ⅲ-Ⅳ. The treatment modalities included surgery alone (n=14), radiotherapy alone (n=13), preoperative radiotherapy plus surgery (n=10), and surgery plus postoperative radiotherapy (n=68). The median follow-up time was 91.8 months, the 5-year local control (LC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates were 72.6%, 73.0%, 52.9% and 78.0%, respectively. There were 33 patients (31.4%) with PNI-positive. The 5-year DMFS, PFS, and OS rates of PNI-positive group were 53.7%, 29.4% and 56.5%, respectively, which were significantly inferior to those of PNI-negative group (80.8%, 63.0% and 86.8%, respectively, P<0.05), while there was no significant difference in the 5-year LC rate between both groups (64.5% vs 76.5%, P=0.273). The multivariate Cox regression analysis showed PNI was one of the poor prognostic factors of DMFS (HR=3.514, 95%CI: 1.557-7.932), PFS (HR=2.562, 95%CI: 1.349-4.866) and OS (HR=2.605, 95%CI: 1.169-5.806). Among patients with PNI-positive, the 5-year LC, PFS and OS rates of patients received surgery combined with radiotherapy were 84.9%, 41.3% and 72.7%, respectively, which were significantly higher than 23.3%, 10.0% and 26.7% of patients receiving surgery or radiotherapy alone (P<0.05). Conclusion: The presence of PNI increases the risk of distant metastasis in patients with sinonasal ACC. Compared with patients with PNI-negative, the prognosis of patients with PNI-positive is relatively poor, and surgery combined with radiotherapy for PNI-positive sinonasal ACC results in good clinical outcomes.

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.

A pretest model of obstructive coronary artery disease based on machine learning: from the C-Strat study / 中华内科杂志

Objective:To develop a pretest probability model of obstructive coronary artery disease with machine learning based on multi-site Chinese population data.Methods:Chinese regiStry in early deTection and Risk strAtificaTion of coronary plaques (C-Strat) study is a prospective multi-center cohort study, in which consecutive patients with suspected obstructive coronary artery disease and ≥64 detector row coronary computed tomography angioplasty (CCTA) evaluation were included. Data from the patients were randomly split into a training set (70%) and a test set (30%). More than 50% of coronary artery stenosis by CCTA was defined as positive outcome. A boosted ensemble algorithm (XGBoost), 10-fold cross-validation and Bayesian optimization were used to establish a new prediction model-CARDIACS(pretest probability model from Chinese registry in eARly Detection and rIsk stratificAtion of Coronary plaques Study), and a logistic regression was used to establish a model-LOGISTIC in training set. The test set was used for validation and comparison among CARDIACS, LOGISTIC, UDFM (updated Diamond-Forrester Model) and DFCASS(Diamond-Forrester and CASS).Results:The study population included 29 455 patients with age of (57.0±9.7) years and 44.8% women, of whom 19.1% (5 622/29 455) had obstructive coronary artery disease. For CARDIACS, the age, the reason for visit and the body mass index (BMI) were the most important predictive variables. In the independent test set, the area under the curve (AUC) of CARDIACS was 0.72 (95% CI 0.70-0.73), which was significantly superior to that of LOGISTIC (AUC 0.69, 95% CI 0.68-0.71, P=0.015), UDFM (AUC 0.64, 95% CI 0.62-0.65, P<0.001) and DFCASS (AUC 0.66, 95% CI 0.64-0.67, P<0.001), respectively. Conclusion:Based on Chinese population, the study developed a new pretest probability model--CARDIACS, which was superior to the traditional models. CARDIACS is expected to assist in the clinical decision-making for patients with stable chest pain.

Comparison of detection success rate of different kinds of near-infrared spectrum non-invasive hemoglobin monitors in high-altitude environments / 中华麻醉学杂志

Objective:To compare the detection success rates (DSRs) of different kinds of near-infrared spectrum non-invasive hemoglobin monitors in high-altitude environments.Methods:One hundred and forty-four healthy volunteers of either sex, aged 18-50 yr, were assigned to one of 3 groups using a random number table method: simulated high-altitude 3 500 meter group ( n=35), 4 000 meter group ( n=55) and 4 500 meter group ( n=54). Hemoglobin was detected by Radical-7, NW-9002SHM, A5 and TensorTip MTX type hemoglobin monitors in plain environment and simulated environment at different altitudes, and the DSRs were compared.Logistic regression analysis was conducted to identify the risk factors affecting the success rate of instrument detection, and the cut-off value was determined by ROC curve and the Youden index. Results:In the simulated high-altitude environment of 3500, 4000 and 4500 m, the DSR of TensorTip MTX was significantly higher than that of Radical-7, NW-9002SHM and A5 ( P<0.001), and there was no significant difference in the DSR among Radical-7, NW-9002SHM and A5 ( P>0.05). Low SpO 2 was the main factor affecting the DSRs of the Radical-7, NW-9002SHM and A5 type hemoglobin monitor in high-altitude environment ( P<0.001), and the cut-off value of SpO 2 in determining the success of detection was 88.5%, 87.5% and 89.5%, respectively.The DSR of TensorTip MTX was not affected by low SpO 2. Conclusions:The DSR of TensorTip MTX hemoglobin monitor is minimally affected by the high-altitude environment and can be preferred in the absence of oxygen supply; when Radical-7, NW-9002SHM or A5 hemoglobin monitor applied in high-altitude environments, oxygen saturation needs to be increased to ensure a high DSR.

Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews / 中西医结合学报

BACKGROUND@#Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.@*OBJECTIVE@#In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.@*SEARCH STRATEGY@#The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.@*INCLUSION CRITERIA@#SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.@*DATA EXTRACTION AND ANALYSIS@#Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers.@*RESULTS@#Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.@*CONCLUSION@#Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.@*SYSTEMATIC REVIEW REGISTRATION@#PROSPERO CRD42020189173.

Bibliometric analysis for research hotspot and frontier of ursolic acid / 中国药房

OBJECTIVE To e xplore the research hots pots and development frontiers of ursolic acid in recent 20 years，and to provide reference for researchers in this field. METHODS Research literatures related to ursolic acid in Web of Science from Jan. ， 1，2002 to Dec. 31，2021 were collected ，and visualization analysis was performed on countries or regions ，research institutions ， authors，journals and keywords involved in the literatures using CiteSpace software ，to obtain the spatial and temporal distribution of ursolic acid and research frontiers. The research status and development frontier of ursolic acid were further analyzed by analyzing keywords co-occurrence ，keyword emergence ，keyword clustering ，etc. RESULTS & CONCLUSIONS Totally 3 528 valid papers were included in this study ，and the top three countries were China ，India and the United States. Analysis of publishing institutions showed that Chinese Academy of Sciences ，Univisity of Karachi and China Medical University were the top 3 research institutions in the list of publication amount. Analysis of published journals showed that Molecules （127 articles），Journal of Ethnopharmacology（90 articles），Journal of Agricultural and Food Chemistry （75 articles）had high number of literatures on ursolic acid. The analysis of keyword analysis showed that pharmacological effects ，such as antitumor activity of ursolic acid ， antioxidant activity ，antibacterial activity and anti-inflammatory activity ，are always the focus of the research ；the mechanism ursolic acid induced apoptosis ，oxidative stress and autophagy ，the research on ursolic acid signaling pathway ，drug delivery of ursolic acid nanoparticles were the research direction in the future.

Clinical Study on Modified Guipitang Combined with Xuefu Zhuyutang in Treating Mild Cognitive Impairment After Cerebral Infarction / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and anti-inflammatory and anti-oxidant effect of modified Guipitang combined with Xuefu Zhuyutang in the treatment of mild cognitive impairment （MCI） after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral. MethodA total of 114 eligible patients were randomly divided into a control group and an observation group，with 57 cases in each group. Patients in the control group were given red deer ginseng tablets （po），4 tablets/time，2 times/day. Patients in the observation group were given modified Guipitang combined with Xuefu Zhuyutang （po，1 dose/day）for continuous 8 weeks. This study compared the scores of montreal cognitive assessment （MoCA） scale，Rivermead behavioral memory test （RBMT），activities of daily living （ADL），trail making test B （TMT-B），neuropsychiatric inventory questionnaire （NPI） and scores of traditional Chinese medcine（TCM） syndrome with syndromes of heart and spleen deficiency and blood stasis blocking collateral before and after treatment. Then we further detected the levels of 8-hydroxydeoxyguanosine （8-OHDG），malondialdehyde （MDA），oxidized low density lipoprotein （ox-LDL），superoxide dismutase （SOD），homocysteine （Hcy），interleukin-8 （IL-8），C-reactive protein （CRP） and fibrinogen （FIB） levels before and after treatment. ResultThe total effective rate for the treatment of cognitive function impairment in the observation group was 92.98% （53/57），which was higher than 78.95% （45/57） in the control group （χ2＝4.653，P<0.05）. The recovery rate of cognitive function in the observation group was 54.39% （31/57），which was higher than 33.33% （19/57） in the control group （χ2＝5.130，P<0.05）. The MoCA，RBMT and ADL scores of the observation group were higher than those of the control group （P<0.01），and the TMT-B time of the former was shorter than that of the latter （P<0.01）. In addition， the observation group showed lower scores of TCM syndrome，NPI-1 and NPI-2 scores than the control group （P<0.01）. The SOD level of the observation group was higher than that of the control group （P<0.01），and the levels of 8-OHDG，ox-LDL，MDA，Hcy，IL-8，CRP and FIB were lower than those of the control group （P<0.01）. ConclusionModified Guipitang combined with Xuefu Zhuyutang can improve cognitive function in MCI patients after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral， with anti-inflammatory and anti-oxidant effect， and yield superior efficacy than red deer ginseng tablets.

Research progress of DNA methylation in the diagnosis of early colorectal cancer / 国际外科学杂志

Colorectal cancer is a common tumor of the digestive system with a high degree of malignancy. Most patients are in the advanced stages of the disease when they develop symptoms. Although the detection rate of traditional screening methods is improving with advances in imaging and the popularity of colonoscopy, the diagnosis of early, asymptomatic colon cancer is still unsatisfactory. Therefore, it is particularly important to further study the occurrence and development mechanism of colorectal cancer and obtain new ideas for the diagnosis and treatment.? In recent years, with the deepening of epigenetics research, the role of DNA methylation in the pathogenesis of colorectal cancer has gradually attracted attention. This paper will review the research progress of DNA methylation in colorectal cancer′s diagnosis and treatment.

The gut microbial metabolite, 3,4-dihydroxyphenylpropionic acid, alleviates hepatic ischemia/reperfusion injury via mitigation of macrophage pro-inflammatory activity in mice

Hepatic ischemia/reperfusion injury (HIRI) is a serious complication that occurs following shock and/or liver surgery. Gut microbiota and their metabolites are key upstream modulators of development of liver injury. Herein, we investigated the potential contribution of gut microbes to HIRI. Ischemia/reperfusion surgery was performed to establish a murine model of HIRI. 16S rRNA gene sequencing and metabolomics were used for microbial analysis. Transcriptomics and proteomics analysis were employed to study the host cell responses. Our results establish HIRI was significantly increased when surgery occurred in the evening (ZT12, 20:00) when compared with the morning (ZT0, 08:00); however, antibiotic pretreatment reduced this diurnal variation. The abundance of a microbial metabolite 3,4-dihydroxyphenylpropionic acid was significantly higher in ZT0 when compared with ZT12 in the gut and this compound significantly protected mice against HIRI. Furthermore, 3,4-dihydroxyphenylpropionic acid suppressed the macrophage pro-inflammatory response in vivo and in vitro. This metabolite inhibits histone deacetylase activity by reducing its phosphorylation. Histone deacetylase inhibition suppressed macrophage pro-inflammatory activation and diminished the diurnal variation of HIRI. Our findings revealed a novel protective microbial metabolite against HIRI in mice. The potential underlying mechanism was at least in part, via 3,4-dihydroxyphenylpropionic acid-dependent immune regulation and histone deacetylase (HDAC) inhibition in macrophages.