Anemia among rural children aged 3-6 in central China and its association with dietary behaviors / 中国学校卫生

Objective@#To understand the status of anemia among rural children aged 3-6 in central China and its relationship with dietary behavior, and to provide reference for prevention and intervention of anemia in rural children.@*Methods@#From April to June 2021, stratified cluster sampling was used to select 1 246 preschool children aged 3 to 6 years old in rural areas in central China. Peripheral blood of the ring finger was collected. Dietary behaviors regarding consumption of cereals and potatoes, fruits, vegetables, soy products, milk, animal foods, food diversity, and drinking water were investigated. Logistic regression analysis was used to analyze the association between anemia and dietary behaviors.@*Results@#The detection rate of anemia in rural children aged 3-6 in central China was 13.88%. The anemia detection rate of left behind children (19.00%) was higher than that of non left behind children (11.27%), and the difference was statistically significant ( χ 2=13.93, P <0.01). Logistic regression analysis showed that the proportion of left behind children ( OR=1.28, 95%CI =1.16-1.56) with anemia was higher than that of non left behind children ( P <0.01). Consumption of animal food intake ≥3 times/week ( OR=0.82, 95%CI =0.69-0.91), and ≥2 kinds of vegetables ( OR= 0.86, 95%CI =0.71-0.93) were associated with lower rate of anemia ( P <0.05).@*Conclusion@#The detection rate of anemia in rural children aged 3-6 years in central China is relatively high, especially in left behind children. Dietary literacy of caregivers should be further improved regarding increased intake of animal foods and vegetables to reduce the risk for anemia in preschoolers.

Analysis of hitting method and wrist strength of student tennis players / Análise sobre o método de tacada e a força do pulso de tenistas estudantes / Análisis del método de golpeo y de la fuerza de la muñeca de estudiantes de tenis

ABSTRACT Introduction: Wrist joint strength is important in tennis for angle control and racquet direction. Objective: Study the changes in muscle strength in the wrist region and the characteristics of joint movement under different tennis stroke styles. Methods: 50 students from a professional tennis club team at a university were selected as study subjects, and systematic professional wrist strength training was performed in the experimental group. In contrast, routine training was performed in the control class. The experimental training lasted for six weeks. During this period, the learning time of all groups remained the same, and no additional training or learning was added. Results: The experimental group's stability increased significantly, from 1.78 ± 0.67 to 2.25 ± 1.34 before training, and backstroke strength increased significantly, from 6.21 to 10.21; total stroke score also increased from 8.02 to 12.69. Conclusion: Improving wrist strength in tennis students may improve overall sports performance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A força da articulação do pulso é de grande importância no esporte do tênis para controle de ângulo e a direção da raquete. Objetivo: Estudar as alterações da força muscular na região do pulso e as características de movimentação articular sob diferentes estilos de tacadas no tênis. Métodos: 50 alunos de uma equipe profissional de um clube de tênis de uma universidade foram selecionados como sujeitos de estudo e o treinamento profissional sistemático da força do pulso foi realizado no grupo experimental, enquanto o treinamento de rotina foi realizado na classe de controle. O treinamento experimental durou 6 semanas. Durante este período, o tempo de aprendizado de todos os grupos permaneceu o mesmo, e nenhum treinamento ou aprendizado adicional foi acrescentado. Resultados: A estabilidade do grupo experimental aumentou significativamente, de 1,78 ± 0,67 para 2,25 ± 1,34 antes do treinamento, e a força de tacada de costas aumentou significativamente, de 6,21 para 10,21; a pontuação total da tacada também aumentou de 8,02 para 12,69. Conclusão: A melhoria da força no pulso dos estudantes de tênis pode aprimorar o desempenho esportivo global. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La fuerza de la articulación de la muñeca es de gran importancia en el deporte del tenis para el control del ángulo y la dirección de la raqueta. Objetivo: Estudiar los cambios de la fuerza muscular en la región de la muñeca y las características del movimiento articular bajo diferentes estilos de golpe de tenis. Métodos: Se seleccionaron 50 estudiantes de un equipo profesional de un club de tenis universitario como sujetos de estudio y se realizó un entrenamiento profesional sistemático de la fuerza de la muñeca en el grupo experimental, mientras que en la clase de control se realizó un entrenamiento rutinario. El entrenamiento experimental duró 6 semanas. Durante este periodo, el tiempo de aprendizaje de todos los grupos siguió siendo el mismo y no se añadió ninguna formación o aprendizaje adicional. Resultados: La estabilidad del grupo experimental aumentó significativamente, de 1,78 ± 0,67 a 2,25 ± 1,34 antes del entrenamiento, y la fuerza en la brazada de espalda aumentó significativamente, de 6,21 a 10,21; la puntuación total de brazada también aumentó de 8,02 a 12,69. Conclusión: Mejorar la fuerza de la muñeca en los estudiantes de tenis puede mejorar el rendimiento deportivo en general. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Risk factors of acute kidney injury in patients with diabetic nephropathy and the prognostic value of urine NGAL / 中华内分泌外科杂志

Objective:To study the risk factors of acute kidney injury in patients with diabetic nephropathy and the prognostic value of urinary neutrophil gelatinase associated lipocalin (NGAL) .Methods:The data of 80 patients with diabetic nephropathy in the First Hospital of Shanxi Medical University from Mar. 2016 to Dec. 2020 were retrospectively studied. According to the random selection of numbers + artificial arrangement, they were divided into observation group and control group according to the presence or absence of acute kidney injury (AKI) . The observation group included patients with diabetic nephropathy complicated by acute kidney injury, and the control group included patients with diabetic nephropathy. The urinary albumin/creatinine ratio (ACR) , blood routine, left ventricular ejection fraction (LVEF) , NGAL, etc. were compared between the two groups. The correlation and influencing factors of acute kidney injury in patients with diabetic nephropathy and age, eGFR, severe infection, antibiotics, heart failure, respiratory failure, ACR, LVEF, and NGAL were studied. At the same time, the prognostic value of urinary NGAL was analyzed.Results:Single factor screening: There was no significant difference in gender or body weight between the two groups ( P>0.05) . However, there were differences in age, epidermal growth factor receptor (eGFR) , severe infection, antibiotics, heart failure, respiratory failure, ACR, LVEF, and NGAL ( P<0.05) . Correlation: Acute kidney injury in patients with diabetic nephropathy was very weakly correlated with gender, age, and body weight, moderately correlated with eGFR, heart failure, respiratory failure, ACR, and LVEF, and highly correlated with NGAL, severe infection, and antibiotics. Risk factors: The independent risk factors for acute kidney injury in patients with diabetic nephropathy included severe infection, eGFR, antibiotics, ACR, LVEF, and NGAL. The prognostic value of urinary NGAL: AUC=0.967, standard error 0.021, Youden index 0.967, sensitivity 0.967, specificity 1, and zero cutoff point 30.00. Conclusion:The main influencing factors of DN complicated with AKI are severe infection, eGFR, antibiotics, ACR, LVEF, NGAL, and urinary NGAL has prognostic value for DN complicated with AKI, and it is worthy of clinical application.

Characteristic and implementation of medical support for space station mission at Dongfeng landing site / 中华急诊医学杂志

Objective:To discuss the medical support strategy by summarizing the experience of medical support in Dongfeng landing site.Methods:According to the current situation of medical support at Dongfeng landing site and the practice and experience of previous medical support, a retrospective summary study was conducted.Results:The main methods were summarized: (1) formulate a feasible plan; (2) strictly screen skilled personnel; (3) provide reasonable medicinal materials and equipments; (4) complete the modification of the rescue carrier; (5) attach importance to the training of first aid techniques; (6) strengthen political and ideological education; (7) carry out physical fitness training; (8) seriously participate in actual combat training. Three points of experience were put forward: (1) the importance of thinking and action is the premise of completing the task; (2) the cooperation between training and actual combat is the basis for completing the task; (3) equal emphasis on education and management is the bottom line for completing the task.Conclusions:The medical support experience of the Dongfeng landing site is summarized to provide support and experience for the long-term in-orbit operation of China's space station and on-site medical rescue after the landing of the manned spacecraft.

Redefinition to bilayer osmotic pump tablets as subterranean river system within mini-earth via three-dimensional structure mechanism

Defining and visualizing the three-dimensional (3D) structures of pharmaceuticals provides a new and important tool to elucidate the phenomenal behavior and underlying mechanisms of drug delivery systems. The mechanism of drug release from complex structured dosage forms, such as bilayer osmotic pump tablets, has not been investigated widely for most solid 3D structures. In this study, bilayer osmotic pump tablets undergoing dissolution, as well as after dissolution in a desiccated solid state were examined, and visualized by synchrotron radiation micro-computed tomography (SR-μCT). In situ formed 3D structures at different in vitro drug release states were characterized comprehensively. A distinct movement pattern of NaCl crystals from the push layer to the drug layer was observed, beneath the semi-permeable coating in the desiccated tablet samples. The 3D structures at different dissolution time revealed that the pushing upsurge in the bilayer osmotic pump tablet was directed via peripheral "roadways". Typically, different regions of the osmotic front, infiltration region, and dormant region were classified in the push layer during the dissolution of drug from tablet samples. According to the observed 3D microstructures, a "subterranean river model" for the drug release mechanism has been defined to explain the drug release mechanism.

The cell cycle inhibitor P21 promotes the development of pulmonary fibrosis by suppressing lung alveolar regeneration

The cell cycle inhibitor P21 has been implicated in cell senescence and plays an important role in the injury-repair process following lung injury. Pulmonary fibrosis (PF) is a fibrotic lung disorder characterized by cell senescence in lung alveolar epithelial cells. In this study, we report that P21 expression was increased in alveolar epithelial type 2 cells (AEC2s) in a time-dependent manner following multiple bleomycin-induced PF. Repeated injury of AEC2s resulted in telomere shortening and triggered P21-dependent cell senescence. AEC2s with elevated expression of P21 lost their self-renewal and differentiation abilities. In particular, elevated P21 not only induced cell cycle arrest in AEC2s but also bound to P300 and β-catenin and inhibited AEC2 differentiation by disturbing the P300-β-catenin interaction. Meanwhile, senescent AEC2s triggered myofibroblast activation by releasing profibrotic cytokines. Knockdown of P21 restored AEC2-mediated lung alveolar regeneration in mice with chronic PF. The results of our study reveal a mechanism of P21-mediated lung regeneration failure during PF development, which suggests a potential strategy for the treatment of fibrotic lung diseases.

68Ga-PSMA ligand PET/CT integrating indocyanine green-guided salvage lymph node dissection for lymph node metastasis after radical prostatectomy / 亚洲男科学杂志(英文版)

To efficiently remove all recurrent lymph nodes (rLNs) and minimize complications, we developed a combination approach that consisted of 68Gallium prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET)/computed tomography (CT) and integrated indocyanine green (ICG)-guided salvage lymph node dissection (sLND) for rLNs after radical prostatectomy (RP). Nineteen patients were enrolled to receive such treatment. 68Ga-PSMA ligand PET/CT was used to identify rLNs, and 5 mg of ICG was injected into the space between the rectum and bladder before surgery. Fluorescent laparoscopy was used to perform sLND. While extensive LN dissection was performed at level I, another 5 mg of ICG was injected via the intravenous route to intensify the fluorescent signal, and laparoscopy was introduced to intensively target stained LNs along levels I and II, specifically around suspicious LNs, with 68Ga-PSMA ligand PET/CT. Next, both lateral peritonea were exposed longitudinally to facilitate the removal of fluorescently stained LNs at levels III and IV. In total, pathological analysis confirmed that 42 nodes were rLNs. Among 145 positive LNs stained with ICG, 24 suspicious LNs identified with 68Ga-PSMA ligand PET/CT were included. The sensitivity and specificity of 68Ga-PSMA ligand PET/CT for detecting rLNs were 42.9% and 96.6%, respectively. For ICG, the sensitivity was 92.8% and the specificity was 39.1%. At a median follow-up of 15 (interquartile range [IQR]: 6-31) months, 15 patients experienced complete biochemical remission (BR, prostate-specific antigen [PSA] <0.2 ng ml-1), and 4 patients had a decline in the PSA level, but it remained >0.2 ng ml-1. Therefore, 68Ga-PSMA ligand PET/CT integrating ICG-guided sLND provides efficient sLND with few complications for patients with rLNs after RP.

Application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students / 中华医学教育探索杂志

Objective:To explore the application of flipped classroom combined with case workshop in general surgical practice teaching of undergraduate nursing students.Methods:The subjects of this study were nursing undergraduates practicing in general surgery department of a "three A" hospital. The experimental group included 44 interns from July 2019 to January 2020 who were taught by the flipped classroom combined with case workshop teaching mode. The control group included 45 interns from July 2018 to January 2019 who were given the traditional teaching mode. The two groups of students were evaluated for their clinical ability before and after the internship, and their out-department theoretical and operational performances were assessed and the survey of internship satisfaction was conducted. SPSS 19.0 was used for t test and chi-square test. Results:Before the internship, there was no statistical significance in the scores of clinical ability between the two groups ( P > 0.05). After the internship, the overall evaluation scores of clinical ability of the experimental group were (7.11±0.54) points, which were significantly higher than that of the control group (6.42±0.58) points ( t=-5.81, P < 0.001); the total satisfaction scores of the experimental group were (3.46±0.25) points, which were significantly higher than that of the control group (3.09±0.32) points ( t=-6.04, P < 0.001). The operation scores of the experimental group were (90.22±4.70) points, which were significantly higher than that of the control group (86.99±7.39) points ( t=-2.46, P=0.024). Conclusion:The teaching mode of flipped classroom combined with case workshop in nursing undergraduate general surgery practice can improve students' clinical ability and internship satisfaction, and improve the teaching effect of internship effectively.

Values of Ki-67 expression level and 4 molecular types for risk classification of prognosis in medulloblastoma / 肿瘤研究与临床

Objective:To investigate the values of Ki-67 expression level and 4 molecular types for risk classification of prognosis in patients with medulloblastoma (MB).Methods:A retrospective study of 92 MB patients who underwent surgery and were confirmed by postoperative pathology in the First Affiliated Hospital of Zhengzhou University from January 2009 to January 2018 was performed. The clinical data and survival data of the patients were collected and sorted out. The overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method, and the log-rank test was performed. Risk stratification of prognosis of patients was performed according to the Ki-67 expression level combined with molecular typing, the low-risk group had Ki-67 positive index ≤50% and WNT or SHH subtype, the medium-risk group had Ki-67 positive index ≤50% and GROUP 3 or GROUP 4 subtype, or Ki-67 positive index >50% and WNT or SHH subtype), and the high-risk group had Ki-67 positive index >50% and GROUP 3 or GROUP 4 subtype. The differences in OS and PFS among different risk groups were compared. A multivariate Cox proportional hazards model was used to assess factors affecting the survival of patients.Results:There were 50 cases (54.3%) with Ki-67 positive index ≤50% and 42 cases (45.7%) with Ki-67 positive index >50%. The 5-year PFS rate and OS rate of patients with Ki-67 positive index ≤50% were 46.9% and 63.1%, and patients with Ki-67 positive index >50% were 28.5% and 32.0%, there were statistical differences in PFS and OS between the two groups ( P values were 0.020 and 0.028). There were 16 cases (17.4%) of WNT subtype, 14 cases (15.2%) of SHH subtype, 40 cases (43.5%) of GROUP 3 subtype and 22 cases (23.9%) of GROUP 4 subtype, their 5-year PFS rates were 78.0%, 76.0%, 19.2% and 19.9%, respectively, and their 5-year OS rates were 82.1%, 76.0%, 40.2% and 0, respectively. MB patients with GROUP 3 or GROUP 4 subtype had poorer PFS and OS than patients with WNT or SHH subtype ( P values were 0.003 and 0.039). Ki-67 expression level and molecular typing were combined to carry out risk classification of prognosis. There were 12 cases (13.0%) in the low-risk group, 56 cases (60.9%) in the medium-risk group, and 24 cases (26.1%) in the high-risk group . There were statistical differences in PFS and OS among MB patients in low-, medium- and high-risk groups (both P < 0.001). Multivariate Cox regression analysis showed that radiotherapy and risk classification of prognosis as medium risk and low risk were independent protective factors for PFS (radiotherapy vs. no radiotherapy: OR = 0.263, 95% CI 0.124-0.556, P < 0.001; medium-risk group vs. high-risk group: OR = 0.069, 95% CI 0.008-0.581, P = 0.014; low-risk group vs. high-risk group: OR = 0.260, 95% CI 0.131-0.514, P < 0.001); radiotherapy and risk classification of prognosis as low risk were independent protective factors for OS (radiotherapy vs. no radiotherapy: OR = 0.221, 95% CI 0.097-0.503, P < 0.001; low-risk group vs. high-risk group: OR = 0.328, 95% CI 0.150-0.717, P = 0.005). Conclusions:The expression level of Ki-67 and 4 molecular types are related to the prognosis of MB patients. The combination of the two can be used to classify the prognosis risk of MB patients, which has reference significance for the prediction of prognosis of patients and the selection of individualized treatment plans.

Observation of intestinal flora in patients with depression before and after antidepressant treatment based on 16S rDNA high-throughput sequencing analysis / 中国医师杂志

Objective:To observe the results of 16S rDNA high-throughput sequencing analysis of intestinal flora in patients with depression before and after antidepressant treatment.Methods:94 patients with major depression treated in the First Hospital of Shanxi Medical University from January 2020 to December 2020 were selected as the research objects. All patients were treated with paroxetine hydrochloride for 12 weeks. Fecal samples were collected before and after treatment. The patients were divided into effective group and ineffective group according to the treatment effect. 16S rDNA high-throughput sequencing was used to detect the changes of flora before and after treatment.Results:There was significant difference in age and gender between the two groups (all P<0.05). There was no significant difference in α diversity index such as Chao1, PD and Shannon index between effective group and ineffective group before and after treatment (all P>0.05). β diversity analysis showed that there was a graphical difference between the effective group and the ineffective group at baseline, but it did not show statistical significance after adjusting for age and gender (Adonis, P=0.078). Compared with the ineffective group, the effective group had fecal bacilli enrichment at baseline. β-diversity analysis showed that there was no clear pattern of microbiota changes in the effective group ( P=0.142) and ineffective group ( P=0.127) from baseline to post-treatment. After treatment, the abundance of Roche bacteria in the effective group increased significantly ( P=0.013, Cohen′s d=1.90), while the abundance of Flavonifractor decreased significantly ( P=0.01, Cohen′s=5.84). Before and after treatment, the samples of the ineffective group did not identify the genus with diversity through DESeq2. The logarithm ratio of the top ranked genera (top 12%) to the bottom ranked genera (bottom 12%) in the ineffective group increased significantly ( P=0.027, Cohen′s=1.1). Conclusions:The baseline fecal microbiota status may have an impact on the treatment outcome of depression, and improving the intestinal microbiota status may contribute to the remission of depression.

A study on the correlation among clinical ability, professional commitment, and academic self-efficacy of nursing undergraduate interns / 中华医学教育探索杂志

Objective:To understand the current situation of clinical ability, professional commitment, and academic self-efficacy of undergraduate nursing interns, explore the correlation among them, and provide theoretical basis for improving the clinical competence of undergraduate nursing students.Methods:The method of convenient sampling was adopted to select 325 nursing undergraduates who had internships in a three-A hospital from July 2018 to July 2020 as the research objects. General data questionnaire, nursing mini-clinical exercise assessment scale, college student professional commitment survey scale and academic self-efficacy scale were used to investigate and evaluate the students at the end of their practice. SPSS 19.0 was used to conduct Pearson correlation analysis and multiple stepwise regression analysis.Results:The total scores of clinical ability, professional commitment and self-efficacy were (51.46±7.64) points, (88.11±5.02) points and (74.20±7.95) points respectively. The results of correlation analysis showed that the clinical ability of nursing undergraduates was significantly positively correlated with professional commitment and academic self-efficacy ( P<0.05). The multiple stepwise regression analysis further showed that the latter two factors had a positive predictive effect on clinical ability, and professional commitment was the strongest factor. Conclusion:Clinical practice teaching should pay attention to the cultivation of the professional commitment and academic self-efficacy of nursing undergraduates and thus promote the development of their clinical ability.

Application of PCMC and PBL teaching method in obstetric nursing practice teaching / 中华医学教育探索杂志

Objective:To explore the value of problem-originated clinical medical curriculum (PCMC) and problem-based learning (PBL) in obstetric nursing teaching.Methods:A total of 80 rotary nursing interns from the Department of Obstetrics, Affiliated Hospital of Jining Medical University between July 2018 and June 2019 were selected as the research subjects, and were divided into observation group (40 cases, taking PCMC and PBL teaching method) and control group (40 cases, taking traditional teaching). The periodic assessment results of interns, theoretical results and operational results of the out-department examination, nursing-mini-clinical evaluation exercise (Nursing-Mini-CEX) and students' evaluation of teaching work were compared after departure from the department. SPSS 21.0 was used for t test and chi-square test. Results:①After intervention, the theoretical results of term interpretation, judgment question, fill-in-blank question and case analysis question were higher in observation group than those in control group ( P<0.05). ② After intervention, the scores of operational assessment results such as clothing, operational purpose, supplies preparation, evaluation, operational process, precautions and health education in observation group were higher compared with those in control group ( P<0.05). ③After intervention, the scores of eight dimensions such as nurse-patient communication, nursing skills, humanitarian spirit, counseling and patient teaching skill, nursing observation, organizational effectiveness, record reporting and overall competence were higher in observation group than those in control group ( P<0.05). ④The teaching evaluation (in addition to theoretical practical learning ability and comprehensive quality) of interns in observation group after intervention was higher than that of interns in control group ( P<0.05). Conclusion:The implementation of PCMC and PBL teaching method can significantly improve the clinical comprehensive abilities and teaching evaluation of nursing interns, and it is helpful to guide the clinical improvement of teaching model.

The prevalence and associated factors of metabolic syndrome among Tibetan pastoralists in transition from nomadic to settled urban environment / 中华流行病学杂志

Objective: To study the prevalence and associated factors of metabolic syndrome (MS) among Tibetan pastoralists in transition from high altitude nomadic to settled urbanized environment, especially dietary factors. Methods: The community-based cross-sectional study included 920 Tibetan adults (men 419, women 501). Data were collected using questionnaires, anthropometric measurements, and biomarker tests. Questionnaires included socio-economic, lifestyle characteristics and food consumption. Principal component analysis was used to identify dietary patterns. The risk factors of MS and its components were analyzed by logistic regression model. Results: The prevalence rates of MS and its components were 32.8% (MS), 83.7% (decreased HDL-C), 62.1% (central obesity), 36.7% (elevated blood pressure), 11.8% (elevated TG), and 7.9% (elevated blood glucose), respectively. The prevalence of overweight was 31.2%, obesity 30.3%. Multivariate analysis showed smoking was associated factor for both of decreased HDL-C (OR=1.239, 95%CI: 1.025-1.496) and elevated TG (OR=1.277, 95%CI: 1.038-1.571). Alcohol drinking appeared as associated factor of elevated TG (OR=1.426, 95%CI: 1.055-1.927). However, physical activity showed as a protective factor for central obesity, decreased HDL-C, and elevated TG. With the increase of age, the adherence to the urban and western dietary patterns decreased, and that to the pastoral dietary pattern increased. By quintiles of dietary pattern scores, the urban dietary pattern was significantly associated with MS (trend test P=0.016). Conclusions: Tibetan pastoralists had high prevalence of both MS and obesity. Smoking, alcohol drinking, the transition from pastoral dietary pattern to urban dietary pattern and inadequate physical activity served as associated factors for MS and its components.

Artificial intelligence-based literature data warehouse for vaccine safety / 中华流行病学杂志

Objective: To establish a sustainable updated literature data warehouse for global vaccine safety assessment, and provide data support for evidence-based vaccine safety assessment. Methods: Semi-automated construction and updating of a literature data warehouse were achieved through the continuous integration of standard operating steps of evidence-based reviews with artificial intelligence technologies. Following the standard procedure of a systematic literature review, the literatures about vaccine safety assessment published before November 29, 2020 were retrieved from 9 databases including OVID, Scopus, Web of Science, Cochrane Library, and ClinicalTrails.org in English and Wanfang, CNKI, VIP, and SinoMed in Chinese. Literatures were screened for two rounds in a semi-automatic manner (by artificial intelligence literature processing system and manual work) according to the inclusion/exclusion criteria. Furthermore, the literatures were classified according to the types of vaccines and adverse events. The updating strategy was established, and the literature data warehouse was updated regularly. Experts were organized to select specific vaccine safety topics and carry out special demonstration studies. Results: More than 0.41 million articles were retrieved. According to the inclusion/exclusion criteria, 23 304 articles were included after two rounds of screening. At present, we have selected and completed three prior topics as demonstration studies, including the systematic review of "DPT (diphtheria, pertussis and tetanus) vaccine and encephalopathy/encephalitis", and the classified management of literatures about allergic purpura and brachial plexus neuritis. Conclusions: The sustainable updated literature data warehouse of vaccine safety can provide high-quality research data for vaccine safety research, including evidence support for immunization related policy-making and adjustment and vaccine safety-related methodological research or clinical tool development; and further demonstration studies can provide references for building a new methodological framework system for timely and efficient completion of the evidence-based assessment of vaccine safety.

Screening for anti-inflammatory components of Astragalus polysaccharide and metabolomics research based on molecular weight distribution / 药学学报

Molecular mass distribution of Astragalus polysaccharides is wide. Astragalus polysaccharides prepared by conventional water extraction and alcohol precipitation are mostly mixture of macromolecules. Although studies have shown that Astragalus polysaccharides have two-sided immunomodulation, the relationship between anti-inflammatory components and molecular mass distribution of Astragalus polysaccharides is not clear. Therefore, Astragalus polysaccharides were extracted by water extraction and alcohol precipitation. The relative molecular weight of them was determined by high performance gel permeation chromatography (HPGPC). Astragalus polysaccharides with different molecular weights were separated and prepared by membrane separation. RAW 264.7 cells were induced by lipopolysaccharide (LPS) to establish an inflammatory cell model in vitro and the anti-inflammatory polysaccharide were screened. The anti-inflammatory regulation mechanism of Astragalus polysaccharides was analyzed by the LC-MS/MS metabonomics technology. The results showed that APS was composed of APS-Ⅰ ( > 2 000 kDa) and APS-Ⅱ (10 kDa). APS-Ⅰ was composed of mannose, rhamnose, galacturonic acid, glucose, galactose, arabinose and the molar ratios of these monosaccharide of APS-I were 0.54∶0.26∶12.24∶17.24∶8.46∶1. APS-II was composed of rhamnose, galacturonic acid, glucose, galactose, arabinose and the molar ratios of these monosaccharide of APS-II were 0.26∶0.14∶24.04∶0.62∶1. APS-Ⅰ and APS-Ⅱ had no cell toxicity to RAW 264.7 macrophage in the range of 0-100 μg·mL-1. Compared with the model group, APS-I at a concentration of 0-100 μg·mL-1could significantly inhibit the secretion of NO and TNF-α by RAW 264.7, and can significantly promote the secretion of IL-10. APS-I had better anti-inflammatory activity than APS-II in vitro. The metabolomics results showed that 32 different metabolites were found between the model group and blank group; APS-I group can significantly callback 18 different metabolites; mainly related to arginine biosynthesis, arginine and proline metabolism, pyrimidine metabolism, citric acid cycle (TCA cycle), cysteine and methionine acid metabolism, tryptophan metabolism. This study found that APS-I had better anti-inflammatory activity than APS-II in vitro, and its mechanism may be closely related to amino acid metabolism and energy metabolism, which indicated the direction for further clarifying the pharmacodynamic material basis of Astragalus polysaccharides.

Advances in understanding leukemia bone marrow microenvironments / 药学学报

The bone marrow microenvironment, also known as the bone marrow niche, plays a critical role in maintaining the functions of hematopoietic stem cells. Under physiological conditions, various bone marrow cells regulate each other to sustain hematopoietic homeostasis. However, bone marrow cells gain abnormal function under pathological conditions to cause and promote the occurrence of leukemia and induce drug resistance. Recent findings indicate that abnormal proliferation and differentiation are not the sole reason to cause leukemia. Different types of bone marrow cells also induce intercellular adhesion, abnormally secrete cytokines and chemokines, accelerating leukemia's progress. This article reviews the multiple signaling pathways that regulate the formation and progress of leukemia bone marrow niche, such as C-X-C motif chemokine ligand 12/C-X-C motif chemokine receptor 4 signaling pathway, et al. It emphasizes that targeting leukemia bone marrow niche is a vital strategy for improving the leukemia treatment.

Clinical research progress and implications of therapeutic vaccines for cervical cancer and precancerous lesions: a qualitative systematic review / 中华肿瘤杂志

Objective: To systematically summarize and analyze the clinical research progress of therapeutic vaccines for cervical cancer or precancerous lesions. Methods: English databases (PubMed, Embase, Web of Science, Cochrane library, Proquest, and ClinicalTrails.gov) and Chinese databases (SinoMed, CNKI, WanFang, and VIP Database) were systematically searched to collect literature on therapeutic vaccines for cervical cancer or precancerous lesions from inception to February 18, 2021. After screening, we evaluated the risk of bias of included studies, and combed the basic information of the literature, research designs, information of vaccines, study patients, outcome indicators and so on, qualitatively summarized the clinical research progress. Results: A total of 71 studies were included in this systematic review, including 14 random controlled trials, 15 quasi-random controlled trials, 4 cohort studies, 1 case-control study, 34 case series studies and 3 case reports. The study patients included women aged 15~79 with cervical cancer or precancerous lesions in 18 countries from 1989 to 2021. On the one hand, there were 40 studies on therapeutic vaccines for cervical precancerous lesions (22 867 participants), involving 21 kinds of vaccines in 6 categories. Results showed 3 marketed vaccines (Cervarix, Gardasil, Gardasil 9) as adjuvant immunotherapies were significant effective in preventing the recurrence of precancerous lesions compared with the conization only. In addition, MVA E2 vaccine had been in phase Ⅲ clinical trials as a specific therapeutic vaccine, with relative literature showing it could eliminate most high-grade precancerous lesions. Therapeutic vaccines for precancerous lesions all showed good safety. On the other hand, there were 31 studies on therapeutic vaccines for cervical cancer (781 participants), involving 19 kinds of vaccines in 7categories, with none had been marketed. 25 studies were with no control group, showing the vaccines could effectively eliminate solid tumors, prevent recurrence, and prolong the median survival time. However, the vaccines effectiveness couldn't be statistically calculated due to the lack of a control group. As for the safety of therapeutic vaccines for cervical cancer, 9 studies showed that patients experienced serious adverse events after treatments, where 7 studies reported that serious adverse events occurred in patients couldn't be ruled out as the results of therapeutic vaccines. Conclusions: The literature review shows that the literature evidence for the therapeutic vaccines for cervical precancerous lesions is relatively mature compared with the therapeutic vaccines for cervical cancer. The four kinds of vaccines on the market are all therapeutic vaccines for precancerous lesions, but they are generally used as vaginal infection treatments or adjuvant immunotherapies for cervical precancerous lesions, not used for the specific treatments of cervical precancerous lesions. Other specific therapeutic vaccines are in the early stage of clinical trials, mainly phase Ⅰ/Ⅱ clinical trials with small sample size. The effectiveness and safety data are limited, and further research is still needed.

Genistein attenuates LPS-induced inflammatory injury of rat dorsal root ganglion neuron via down-regulating HDAC6 / 中南大学学报(医学版)

OBJECTIVES@#Neuropathic pain (NP) is a chronic pain caused by somatosensory neuropathy or disease, and genistein (Gen) might be a potential drug for the treatment of NP. Therefore, this study aims to investigate the effect of Gen on lipopolysaccharide (LPS)-induced inflammatory injury of dorsal root ganglion neuron (DRGn) in rats and the possible molecular mechanism.@*METHODS@#The DRGn of 1-day-old juvenile rats were taken for isolation and culture. The DRGn in logarithmic growth phase were divided into a control group, a LPS group, a tubastatin hydrochloride (TSA)+LPS group, a Gen1+LPS group, a Gen2+LPS group, a Gen2+LPS+TSA group, a Gen2+pcDNA-histone deacetylase 6 (HDAC6)+LPS group, and a Gen2+pcDNA3.1+LPS group. The LPS group was treated with 1 μg/mL LPS for 24 h; the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group were treated with 5 μmol/L TSA, 5 μmol/L Gen, 10 μmol/L Gen respectively for 0.5 h, and then added 1 μg/mL LPS for 24 h; the Gen2+TSA+LPS group was treated with 10 μmol/L Gen and 5 μmol/L TSA for 0.5 h and then added 1 μg/mL LPS for 24 h; the Gen2+pcDNA-HDAC6+LPS group and the Gen2+pcDNA3.1+LPS group received 100 nmol/L pcDNA-HDAC6 and pcDNA3.1 plasmids respectively, and 24 h after transfection, 10 μmol/L Gen was pretreated for 0.5 h, and then added 1 μg/mL LPS for 24 h. Real-time RT-PCR was used to detect the HDAC6 mRNA expression in DRGn; CCK-8 method was used to detect cell viability of DRGn; flow cytometry was used to detect cell apoptosis of DRGn; ELISA was used to detect the levels of IL-1β, IL-6, and TNF-α in DRGn culture supernatant; Western blotting was used to detect the protein expression of HDAC6, Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), and NF-κB p65 in DRGn.@*RESULTS@#Compared with the control group, the expression levels of HDAC6 mRNA and protein, the expression levels of TLR4 and MyD88 protein in DRGn of LPS group rats were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, and the activity of DRGn was significantly decreased, the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05). Compared with the LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the TSA+LPS group, the Gen1+LPS group, the Gen2+LPS group and the Gen2+TSA+LPS group were significantly down-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly decreased, the activity of DRGn was significantly increased, the apoptosis rate was significantly decreased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly decreased (all P<0.05), and the above changes were most obvious in the Gen2+TSA+LPS group. Compared with the Gen2+LPS group, the expression levels of HDAC6 mRNA and protein, TLR4 and MyD88 protein expression levels in DRGn of the Gen2+pcDNA-HDAC6+LPS group were significantly up-regulated, the ratio of p-NF-κB p65/NF-κB p65 was significantly increased, the activity of DRGn was significantly decreased, and the apoptosis rate was significantly increased, and the levels of IL-1β, IL-6 and TNF-α in the DRGn culture supernatant were significantly increased (all P<0.05).@*CONCLUSIONS@#Gen can alleviate LPS-induced DRGn inflammatory injury in rats, which might be related to down-regulating the expression of HDAC6 and further inhibiting the activation of TLR4/MyD88/NF-κB signaling pathway.

Identification and activity evaluation of Astragalus Radix from different germplasm resources based on specific oligosaccharide fragments / 中草药·英文版

Objective: Based on trifluoroacetic acid (TFA) hydrolysis, polyacrylamide gel electrophoresis (PAGE) and high performance thin layer chromatography (HPTLC) analysis, the carbohydrate responsible for immunomodulatory activity are used as quality indicators for Astragalus Radix (AR). Methods: In this study, 24 batches of AR from different germplasm resources were selected as the research object, and AR polysaccharides were extracted. PAGE and HPTLC methods were used to analyze the partial acid hydrolyzate of AR polysaccharides and obtain a series of saccharide fingerprints. The data were analyzed by principal component analysis to obtain the difference between AR from different germplasm resources. Results: The results showed that trisaccharide and tetrasaccharide could be used as differential fragments to distinguish AR of different cultivation methods; Disaccharides and trisaccharides can be used as differential fragments to distinguish different species of AR. The immunological activity analysis of the specific oligosaccharide fragment of AR showed that the specific oligosaccharide fragment of AR could promote the secretion of TNF-α, IL-1β, IL-6, and NO in THP-1 cells in a concentration-dependent manner. Conclusion: Both PAGE and HPTLC methods can be used to evaluate AR from different germplasm resources. This study laid the foundation for the quality evaluation of AR medicinal herbs.

Risk factors and predictors of neurosyphilis / 中华皮肤科杂志

Neurosyphilis is a serious clinical stage of syphilis caused by Treponema pallidum invading the nervous system, and risk and predictive factors of neurosyphilis are different between syphilis patients with and without HIV infection. The risk factors for neurosyphilis in HIV-negative patients with syphilis mainly include gender, age, clinical stage of syphilis, treatment, etc.; the predictive factors include serological titers, changes in some indicators of cerebrospinal fluid, neurological or ophthalmic symptoms. HIV viral load, CD4 + T cell counts and antiretroviral treatment are the main predictors and risk factors for neurosyphilis in HIV-positive patients with syphilis.