Ethyl Acetate Fraction of Dicliptera chinensis (L.) Juss. Ameliorates Liver Fibrosis by Inducing Autophagy via PI3K/AKT/mTOR/p70S6K Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate the molecular mechanism underlying the anti-hepatic fibrosis activity of ethyl acetate fraction Dicliptera chinensis (L.) Juss. (EDC) in human hepatic stellate cells (HSCs) in vitro and in a carbon tetrachloride (CCl4)-induced hepatic fibrosis mouse model in vivo.@*METHODS@#For in vitro study, HSCs were pre-treated with platelet-derived growth factor (10 ng/mL) for 2 h to ensure activation and treated with EDC for 24 h and 48 h, respectively. The effect of EDC on HSCs was assessed using cell counting kit-8 assay, EdU staining, transmission electron microscopy, immunofluorescence staining, and Western blot, respectively. For in vivo experiments, mice were intraperitoneally injected with CCl4 (2 ° L/g, adjusted to a 25% concentration in olive oil), 3 times per week for 6 weeks, to develop a hepatic fibrosis model. Forty 8-week-old male C57BL/6 mice were divided into 4 groups using a random number table (n=10), including control, model, positive control and EDC treatment groups. Mice in the EDC and colchicine groups were intragastrically administered EDC (0.5 g/kg) or colchicine (0.2 mg/kg) once per day for 6 weeks. Mice in the control and model groups received an equal volume of saline. Biochemical assays and histological examinations were used to assess liver damage. Protein expression levels of α -smooth muscle actin (α -SMA) and microtubule-associated protein light chain 3B (LC3B) were measured by Western blot.@*RESULTS@#EDC reduced pathological damage associated with liver fibrosis, downregulated the expression of α -SMA and upregulated the expression of LC3B (P<0.05), both in HSCs and the CCl4-induced liver fibrosis mouse model. The intervention of bafilomycin A1 and rapamycin in HSCs strongly supported the notion that inhibition of autophagy enhanced α -SMA protein expression levels (P<0.01). The results also found that the levels of phosphoinositide (PI3K), p-PI3K, AKT, p-AKT, mammalian target of rapamycin (mTOR), p-mTOR, and p-p70S6K all decreased after EDC treatment (P<0.05).@*CONCLUSIONS@#EDC has anti-hepatic fibrosis activity by inducing autophagy and might be a potential drug to be further developed for human liver fibrosis therapy.

Relationships between perioperative depression, anxiety symptoms and fear of cancer recurrence in breast cancer patients / 中国实用护理杂志

Objective:To investigate the predictive effect of perioperative depression and anxiety symptoms in breast cancer patients on the fear of cancer recurrence.Methods:A total of 194 patients with breast cancer during perioperative period from May 2019 to May 2020 in Qilu Hospital of Shandong University were selected. The depression, anxiety and fear of cancer recurrence were investigated by the general information questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9) and the Fear of Progression Questionnaire-Short Form (FOR-Q-SF) at admission and two weeks after surgery, respectively.Results:Perioperative depression and anxiety symptoms of breast cancer patients were significant predictors of fear of cancer recurrence ( B value was 2.325, OR value was 10.22, P<0.05; B value was 2.570, OR value was 13.07, P<0.05), and patients with depression and anxiety symptoms after surgery were at higher risk of fear of cancer recurrence ( OR values were 7.653-25.403, P<0.01). Conclusions:For breast cancer patients with negative emotions and fear of disease progression, it is necessary to help them improve their psychological coping ability, encouraging patients to actively cooperate with follow-up treatment, improving the prognosis, and improving their overall quality of life.

Effect of Enpagliflozin on left ventricular function, blood glucose and lipid level in T2DM patients / 国际生物医学工程杂志

Objective:To study the effects of Empagliflozin on left ventricular function and the level of blood glucose and lipid in type 2 diabetes mellitus (T2DM) patients.Methods:A total of 120 patients with T2DM complicated with cardiac function impairment were selected from Chu Hsien-I Memorial Hospital, Tianjin Medical University from December 2020 to May 2021. The diabetic patients were randomly divided into the observation group (60 cases) and control group (60 cases) by random number table method. Patients in the observation group were treated with Empagliflozin, while the control group underwent original hypoglycemic treatment. After the treatment, 6 cases were eliminated and 114 cases were completed, with 57 cases in each group. The changes of echocardiographic left ventricular function related indexes such as E/ e', left atrial volume index (LAVI), tricuspid regurgitation speed, left ventricular ejection fraction (LVEF) and laboratory indexes in the two groups were observed before and after treatment. The laboratory indexes checked include fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and how density lipoprotein (HDL). Results:The E/ e', LAVI of the observation groups was significantly lower than that of the control group, and the differences were statistically significant (all P<0.05). There were no significant changes in tricuspid regurgitation speed, LVEF, TG, TC, LDL and HDL levels between the two groups after the treatment (all P>0.05). After the treatment, the levels of FBG and HbA1c in the two groups decreased, but there was no significant difference between the two groups (all P>0.05). Conclusions:Empagliflozin can effectively control the E/ e', LAVI of T2DM patients, and can early significant improvement of left ventricula diastolic function, which is very favorable for the patients. Along with good safety, Empagliflozin is suitable for clinical recommendation.

Clinical value of improved sequential organ failure assessment in predicting the prognosis of Klebsiella pneumoniae sepsis / 中华传染病杂志

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

Therapeutic silencing miR-146b-5p improves cardiac remodeling in a porcine model of myocardial infarction by modulating the wound reparative phenotype

Fibrotic remodeling is an adverse consequence of immune response-driven phenotypic modulation of cardiac cells following myocardial infarction (MI). MicroRNA-146b (miR-146b) is an active regulator of immunomodulation, but its function in the cardiac inflammatory cascade and its clinical implication in fibrotic remodeling following MI remain largely unknown. Herein, miR-146b-5p was found to be upregulated in the infarcted myocardium of mice and the serum of myocardial ischemia patients. Gain- and loss-of-function experiments demonstrated that miR-146b-5p was a hypoxia-induced regulator that governed the pro-fibrotic phenotype transition of cardiac cells. Overexpression of miR-146b-5p activated fibroblast proliferation, migration, and fibroblast-to-myofibroblast transition, impaired endothelial cell function and stress survival, and disturbed macrophage paracrine signaling. Interestingly, the opposite effects were observed when miR-146b-5p expression was inhibited. Luciferase assays and rescue studies demonstrated that the miR-146b-5p target genes mediating the above phenotypic modulations included interleukin 1 receptor associated kinase 1 (IRAK1) and carcinoembryonic antigen related cell adhesion molecule 1 (CEACAM1). Local delivery of a miR-146b-5p antagomir significantly reduced fibrosis and cell death, and upregulated capillary and reparative macrophages in the infarcted myocardium to restore cardiac remodeling and function in both mouse and porcine MI models. Local inhibition of miR-146b-5p may represent a novel therapeutic approach to treat cardiac fibrotic remodeling and dysfunction following MI.

Huayu Pill () Promotes Fluorescent Doxorubicin Delivery to Tumors in Mouse Model of Lung Cancer / 中国结合医学杂志

OBJECTIVE@#To study the effect and mechanism of Huayu Wan (, HYW) in combination of chemotherapy of tumor treatment.@*METHODS@#HYW serum was added in Lewis cells to assess its impact on fluorescent doxorubicin delivery in vitro. Then, Lewis tumor cells was implanted in C57BL/6 mice via xenograft transplantation. Tumor growth was measured and signal intensity corresponding to blood flow was assessed by laser doppler perfusion imaging (LDPI). Finally, the effect of HYW on the effificacy of doxorubicin was studied.@*RESULTS@#HYW can improve the transfer of fluorescent doxorubicin into cells. The blood flow signal in the tumor tissues of the HYW group was higher than that of the control group (P<0.01). Furthermore, HYW improved drug delivery of doxorubicin to tumor tissues, and this activity was associated with HYW-induced microvascular proliferation (P<0.01).@*CONCLUSIONS@#HYW can promote microangiogenesis and increase blood supply in tumor tissues, which in turn may increase the risk of metastasis. At the same time, HYW increases drug delivery and improves the effificacy of chemotherapy drugs through vascular proliferation. Therefore, rational judgment must be exercised when considering applying HYW to an antitumor regimen.

Clinical study on endoscopic surgery for soft tissue necrosis of cranial base after radiotherapy for nasopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the diagnosis and surgical treatment of patients with soft tissue necrosis of cranial base after radiotherapy for nasopharyngeal carcinoma (NPC). Methods: The clinical data of 7 NPC patients with soft tissue necrosis but not bone necrosis after radiotherapy were retrospectively analyzed.They were treated in Xiangya Hospital from 2015 to 2019. The clinical manifestations, diagnosis, treatment and prognosis were analyzed. The major clinical symptoms of the 7 patients were headache in 7 cases, hearing loss in 7 cases, long-term nasal malodor in 5 cases and epistaxis in 2 cases. All patients underwent high-resolution CT, MR and magnetic resonance angiography (MRA) before operation. All cases were treated with extended transnasal endoscopic approach under general anesthesia for resection of necrotic tissue. Five cases had their affected cartilaginous segments of the eustachian tubes partially or completely resected, 7 cases were treated with myringotomy and tube insertion, and 1 case was treated with pansinusectomy. Anti-inflammatory treatment were carried out during the perioperative period. The recovery of patients was observed and recorded through regular follow-up (from 6 months to 3 years) after the operation. Results: Nasopharynx soft tissue lesions can be seen in seven patients with bone cortex integrity by CT, and small bubble shadow can be seen at junction area between skull base soft tissue lesions and skull base bone surface.MR and MRA examination showed extensive inflammatory changes of nasopharynx. Parapharyngeal irregular necrotic cavity was found in 6 cases without central enhancement, demonstrating edema of surrounding soft tissue. The necrotic tissue of all 7 patients was surgically removed. Postoperative pathological examinations confirmed that all of them were necrotic soft and cartilaginous tissue, without tumor recurrence. The symptoms of all patients were significantly alleviated after operation. Headache was cured in 5 cases and relieved in 2 cases. Nasal malodor was cured in 4 cases and alleviated in 1 case. During the follow-up period, 5 patients survived, and 2 patients who had their eustachian tube reserved died. One of them died of nasopharyngeal hemorrhage caused by recurrent nasopharyngeal necrosis 3 months after the operation. Another case died of severe intracranial infection 6 months after operation. Conclusions: The diagnosis of skull base soft tissue necrosis after radiotherapy for nasopharyngeal carcinoma needs comprehensive analysis of radiotherapy history, clinical manifestations and imaging examination. High resolution CT, MR and MRA of skull base are very important for diagnosis. Early active removal of large-scale necrotic lesions under endoscope and partial or total resection of eustachian tube cartilage according to the involvement of eustachian tube cartilage is effective means of controling skull base soft tissue necrosis after radiotherapy. The effective means of necrosis can improve the quality of life of patients.

Clinical Efficiency of Rituximab Combined with Autologous Hematopoietic Blood Stem Cell Transplantation for Treatment of CD20 / 中国实验血液学杂志

METHODS@#From January 2005 to December 2013, 83 patients with refractory/recurrent CD20@*RESULTS@#All the patient achieved complete response. The median follow.up time was 39 months. Both the two groups collected peripheral blood stem cells successfully, and had no difference in hematopoietic reconstitution time. Three patients in treatment group and six patients in control group relapsed and the three year overall survival and EFS in treatment group was significantly higher than that in control group, that is（93.0% vs 73.1%, P=0.037） and （89.5% vs 65.4%, P=0.034）, respectively. Subgroup analysis showed that: compared with the treatment group in which using R in the whole courses(before and after transplantation, and collection of stem cells) was superior to the control group in both OS and EFS, with the OS 97% vs 87.5% (P>0.05) and EFS 97% vs 76.2% (P=0.05) respectively. While stratified by the different courses of rituximab, the OS was 88.9% (1-2 courses, 9 cases), 93.1% (3-4 courses, 29 cases), 94.7%(more than 5 courses,19 cases), and EFS was 77.8%, 89.7% and 94.7%, respectively.@*CONCLUSION@#For the patients with refractory/recurrent CD20

Development of molecular markers of Mycobacterium tuberculosis rifampicin resistance gene rpoB by PARMS technology / 生物工程学报

The purpose of this study is to provide a simple and reliable genetic typing approach for molecular drug susceptibility test of Mycobacterium tuberculosis, through the developing of fluorescence molecular marker of rifampicin resistance gene rpoB. Eleven fluorescent molecular markers of the rpoB gene were established by using the sequence difference between the amino acid positions 531, 526, 516, 511 and 513 of rpoB gene of rifampicin-resistant strains and the alleles of rifampicin-sensitive strains, combined with the PARMS technique (Penta-primer amplification refractory mutation system). We used 104 clinical isolates of Mycobacterium tuberculosis to validate this marker and it was verified by sequencing as 100% correct. These samples were also tested with proportional drug sensitivity test. The coincidence rate was 94.23%. The molecular markers had high reliability for genotyping of rpoB gene. It can also detect low-concentration drug-resistant samples (511/533 unit point mutations) whose phenotypic susceptibility cannot be detected. The eleven sets of fluorescent molecular markers could cover 92%-96% of rpoB gene mutation types of rifampicin-resistant strains, and provide new idea for rapid detection of rifampin-resistant Mycobacterium tuberculosis.

Rehabilitation Approaches from European Physiotherapy Guideline for Parkinson's Disease: A Comment / 中国康复理论与实践

This paper introduced European Guidelines for Physiotherapy of Parkinson's Disease, especially the form, content and selection, to give a reference of evidence-based practice in China.

Interpretation of 2019 International Working Group on Diabetic Foot guidelines on the prevention and management of diabetic foot disease / 中国修复重建外科杂志

The 8th World International Symposium on the Diabetic Foot (ISDF) Conference which was sponsored by the International Working Group on Diabetic Foot (IWGDF) was held in the Hague between May 22nd and May 25th, 2019. The conference issued the 2019 IWGDF guidelines on the prevention and management of diabetic foot disease. The update to the 2015 edition of the guidelines involves the following 6 chapters: prevention of foot ulcers in patients with diabetes; offloading foot ulcers in patients with diabetes; diagnosis, prognosis, and management of peripheral arterial disease in patients with a foot ulcer and diabetes; diagnosis and treatment of foot infection in patients with diabetes; interventions to enhance healing of foot ulcers in patients with diabetes; classification of diabetic foot ulcers. This guideline has been changed more than the previous edition. In this paper, the guidelines will be interpreted to provide cutting-edge information for domestic diabetic foot researchers.

Active constituents and mechanisms of Respiratory Detox Shot, a traditional Chinese medicine prescription, for COVID-19 control and prevention: Network-molecular docking-LC-MS analysis / 中西医结合学报

OBJECTIVE@#Lung-toxin Dispelling Formula No. 1, referred to as Respiratory Detox Shot (RDS), was developed based on a classical prescription of traditional Chinese medicine (TCM) and the theoretical understanding of herbal properties within TCM. Therapeutic benefits of using RDS for both disease control and prevention, in the effort to contain the coronavirus disease 2019 (COVID-19), have been shown. However, the biochemically active constituents of RDS and their mechanisms of action are still unclear. The goal of the present study is to clarify the material foundation and action mechanism of RDS.@*METHODS@#To conduct an analysis of RDS, an integrative analytical platform was constructed, including target prediction, protein-protein interaction (PPI) network, and cluster analysis; further, the hub genes involved in the disease-related pathways were identified, and the their corresponding compounds were used for in vitro validation of molecular docking predictions. The presence of these validated compounds was also measured in samples of the RDS formula to quantify the abundance of the biochemically active constituents. In our network pharmacological study, a total of 26 bioinformatic programs and databases were used, and six networks, covering the entire Zang-fu viscera, were constructed to comprehensively analyze the intricate connections among the compounds-targets-disease pathways-meridians of RDS.@*RESULTS@#For all 1071 known chemical constituents of the nine ingredients in RDS, identified from established TCM databases, 157 passed drug-likeness screening and led to 339 predicted targets in the constituent-target network. Forty-two hub genes with core regulatory effects were extracted from the PPI network, and 134 compounds and 29 crucial disease pathways were implicated in the target-constituent-disease network. Twelve disease pathways attributed to the Lung-Large Intestine meridians, with six and five attributed to the Kidney-Urinary Bladder and Stomach-Spleen meridians, respectively. One-hundred and eighteen candidate constituents showed a high binding affinity with SARS-coronavirus-2 3-chymotrypsin-like protease (3CL), as indicated by molecular docking using computational pattern recognition. The in vitro activity of 22 chemical constituents of RDS was validated using the 3CL inhibition assay. Finally, using liquid chromatography mass spectrometry in data-independent analysis mode, the presence of seven out of these 22 constituents was confirmed and validated in an aqueous decoction of RDS, using reference standards in both non-targeted and targeted approaches.@*CONCLUSION@#RDS acts primarily in the Lung-Large Intestine, Kidney-Urinary Bladder and Stomach-Spleen meridians, with other Zang-fu viscera strategically covered by all nine ingredients. In the context of TCM meridian theory, the multiple components and targets of RDS contribute to RDS's dual effects of health-strengthening and pathogen-eliminating. This results in general therapeutic effects for early COVID-19 control and prevention.

Effect of consolidation before allogeneic hematopoietic stem cell transplantation for non-favorable acute myeloid leukemia patients with first complete remisson and negative minimal residual disease / 中华血液学杂志

Objective@#To probe the prognostic value of consolidation chemotherapy in non-favorable acute myeloid leukemia (AML) patients who were candidates for allogeneic hematopoietic stem cell transplantation (allo-HSCT) with first complete remission (CR1) and negative minimal residual disease (MRD-) .@*Methods@#A retrospective analysis was conducted on 155 patients with non-favorable AML who received allo-HSCT in CR1/MRD- from January 2010 to March 2019. The survival data were compared between patients who received and those not received pre-transplant consolidation chemotherapy.@*Results@#A total of 102 patients received pre-transplant consolidation chemotherapy (consolidation group) , and 53 cases directly proceeded to allo-HSCT when CR1/MRD- was achieved (nonconsolidation group) . The median ages were 39 (18-56) years old and 38 (19-67) years old, respectively. Five-year post-transplant overall survival [ (59.3±7.5) % vs (62.2±6.9) %, P=0.919] and relapse-free survival [ (53.0±8.9) % vs (61.6±7.0) %, P=0.936] were not significantly different between the two groups (consolidation vs nonconsolidation) . There was a weak relationship between consolidation therapy and cumulative incidence of relapse [consolidation: (21.9±5.4) % vs nonconsolidation: (18.3±6.0) %, P=0.942], as well as non-relapse mortality [consolidation: (22.4±4.3) % vs nonconsolidation: (28.4±6.5) %,P=0.464]. Multivariate analysis indicated that pre-transplant consolidation and the consolidation courses (< 2 vs ≥2 courses) did not have an impact on allo-HSCT outcomes.@*Conclusion@#Allo-HSCT for candidate patients without further consolidation when CR1/MRD- was attained was feasible.

Effect of Betulic Acid on RAGE/NF-κB/iNOS Signaling Pathway Expression in Steatosis Cell / 中国实验方剂学杂志

Objective::To investigate the effect of betulic acid(BA) on steatosis LO2 cells. Method::LO2 cells were intervened with BA at different gradient concentrations (0, 10, 20, 40, 80, 160, 250 μmol·L-1) for 24 hours. methyl thiazolyl tetrazolium(MTT) staining was used to observed cell viability to determine the final concentration of BA. The cells were divided into control, model, dimethylsulfoxide (DMSO) and BA groups, as well as BA groups intervened with low, middle and high concentrations. First, model, DMSO and BA group's cells were cultured in 10% Lipid Mix 1 medium for 24 hours to establish a nonalcoholic fatty liver model. Then, DMSO group and low, medium and high-concentration groups were separately cultured with 0.1%DMSO medium and 20, 40, 80 μmol·L-1 BA medium for 24 hours. And control and model groups were cultured in drug-free medium for 24 hours. Oil red O staining and Nile red staining were used to observe the intracellular lipid droplets. Immunofluorescence was used to detect the protein expression of inducible nitric oxide synthase (iNOS). Western blot was used to detect the protein expression levels of receptor for advanced glycation end-products (RAGE), nuclear factor κB p65 (NF-κB p55) and iNOS. Result::BA within the concentration of 80 μmol·L-1 had no significant toxicity on LO2 cells. Compared with control group, the intracellular lipid droplets were significantly increased in the model group, and the expressions of oxidative stress-related proteins RAGE, NF-κB p65 and iNOS also increased significantly(P<0.05). Compared with model group, the intracellular lipid droplets in DMSO group were similar to those in model group, with no significant difference in the three protein expressions between the two groups. However, the intracellular lipid droplets deposition in the BA group was significantly decreased. And the expressions of RAGE, NF-κB p65 and iNOS proteins in high-concentration BA group were significantly decreased(P<0.05, P<0.01). Conclusion::BA can significantly improve the intracellular fat deposition in LO2 cells, which was probably related to the inhibition of the expressions of oxidative stress-related proteins RAGE, NF-κB p65 and iNOS.

Study on the differences between moxibustion at different points in the effects on the anti-fatigue ability of rats undergoing one-time exhaustive swimming / 针灸推拿医学（英文版）

Objective: To observe the effects of moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) on the energy metabolism and endocrine metabolism indicators of rats undergoing one-time exhaustive swimming, and to explore the differences between moxibustion at different points in the effects on anti-exercise fatigue. Methods: Forty-eight male SPF rats were randomly divided into a blank group, a model group, a non-meridian and non-acupoint group, a Shenshu (BL 23) group, a Zusanli (ST 36) group, and a Shenque (CV 8) group using random number table method, with eight rats in each group. Except for the blank group, rats in the other groups were subjected to replicating the one-time exhaustive model using the weight-bearing swimming experiment. Except for the model group, the other model rats received mild moxibustion immediately after swimming. Rats in the non-meridian and non-acupoint group received mild moxibustion at bilateral subcostal non-meridian and non-acupoint points, those in the Shenshu (BL 23) group received mild moxibustion at bilateral Shenshu (BL 23), those in the Zusanli (ST 36) group received mild moxibustion at bilateral Zusanli (ST 36), and those in the Shenque (CV 8) group received mild moxibustion at Shenque (CV 8) for 15 min. Four hours after the exhaustive swimming, femoral artery blood was collected to detect blood lactate (BLA), lactate dehydrogenase (LDH), creatine kinase (CK), creatinine (CRE), blood urea nitrogen (BUN), cortisol (C) and testosterone (T) levels, and calculate the T/C ratio. Results: Compared with the blank group, rat's serum levels of BLA, LDH, CK, BUN and C in the model group and the non-meridian and non-acupoint group were increased, and serum levels of CRE and T, and T/C ratios were decreased (P<0.01 or P<0.05); compared with the model group and the non-meridian and non-acupoint group, the serum levels of BLA, LDH, CK, BUN and C in the Shenshu (BL 23) group, Zusanli (ST 36) group and Shenque (CV 8) group were decreased, and the serum CRE and T levels, and the T/C ratios were increased (all P<0.01); compared with the Shenshu (BL 23) group, the serum CK level was decreased in the Shenque (CV 8) group (P<0.01), the serum levels of T and C were decreased in the Zusanli (ST 36) group and Shenque (CV 8) group (P<0.01 or P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.01); compared with the Zusanli (ST 36) group, the serum CK and BUN levels were decreased (P<0.01, P<0.05), and the T/C ratio was increased in the Shenque (CV 8) group (P<0.05). Conclusion: Moxibustion at Shenshu (BL 23), Zusanli (ST 36) and Shenque (CV 8) shows different anti-fatigue effects by regulating the energy metabolism and endocrine metabolism in rats undergoing one-time exhaustive swimming. Moxibustion at Shenshu (BL 23) is better in promoting energy synthesis. Moxibustion at Shenque (CV 8) is more effective in regulating synthesis and decomposition of the skeletal muscle proteins.

Correlation between hyperuricemia and obesity in young college students / 中华内分泌代谢杂志

Objective:To analyze the correlation between hyperuricemia and obesity in young college students.Methods:A total of 19 673 students receiving enrolment physical examinations in Nanjing University from 2018 to 2019 were included in the study. The subjects were divided into underweight, normal, overweight, and obesity groups according to their body mass index. Fasting blood were taken to detect alanine aminotransferase (ALT), serum uric acid, urea nitrogen, and creatinine. The differences between serum uric acid and metabolic parameters among different groups as well as the correlation between body mass index and hyperuricemia were analyzed by using multivariate linear regression and logistic regression analysis.Results:The prevalence of hyperuricemia was 32.35% for the college students, while for the males it reached up to 57.30% that was significantly higher than female ones (6.51%, P<0.01). With the increasing of body mass index, the prevalence of hyperuricemia increased significantly( Ptrend<0.01), as well as serum uric acid in both male and female students ( Ptrend<0.01). Serum uric acid was positively correlated with body mass index in both genders( P<0.01). The odds ratio ( OR) and 95% confidence interval( CI) for overweight, obesity, and underweight body mass index groups were 2.30(95% CI 1.99-2.66), 4.35(95% CI 3.22-5.89), and 0.70(95% CI 0.60-0.82), respectively, compared to the normal body mass index group by adjusting possible factors such as gender, age, ALT, urea nitrogen, creatinine, as well asestimated glomerular filtration rate. Conclusion:The prevalence of hyperuricemia in young students is high. Obesity seems to be an independent risk factor of hyperuricemia.

Study on differentiation of bone marrow mesenchymal stem cells into neurons induced by bone morphogenetic protein 7 in vitro / 中华骨科杂志

Objective:To explore the role of BMP7 in inducing the differentiation of BMSCs into neurons in vitro.Methods:BMSCs were isolated and cultured by whole bone marrow adherence method. Adipogenic induction and osteogenic differentiation were used to test the multi-directional differentiation ability of BMSCs. BMSCs were randomly divided into control group and BMP7 groups (25 ng/ml, 50 ng/ml, 75 ng/ml and 100 ng/ml). The effect of BMP7 on the proliferation of rat BMSCs was measured by MTT assay. BMP7 induced morphological changes in rat BMSCS under an inverted phase contrast microscope. The relative expression levels of NF200, SYN1, MAP2 and GFAP mRNA in induced cells were measured by qRT-PCR. Immunofluorescence was used to measure the expression of NSE protein.Results:Rat BMSCs showed lipid droplets in the cytoplasm after adipogenic induction, and oil red O staining was positive; rat BMSCs showed opaque mineral nodules after osteogenic induction, and alizarin red stained was positive. At 2 d, 3 d, 4 d, 5 d, and 6 d after induction, the cell absorbance values of each group were statistically different ( P < 0.05). On the 6th day of induction, the absorbance values of the control group, 25 ng/ml BMP7 group, 50 ng/ml BMP7 group, 75 ng/ml BMP7 group and 100 ng/ml BMP7 group were 0.370±0.003, 0.399±0.003, 0.404±0.003, 0.410±0.003, 0.397±0.001, respectively. Cells absorbance value of 75 ng/ml BMP7 group was significantly higher than the other groups ( P< 0.05). The 75 ng/ml BMP7 group had the most significant changes in cell morphology, similar to neurons in cell morphology. The relative expression of NF200, SYN1, MAP2, and GFAP mRNA of 75 ng/ml BMP7 group (5.47±0.59, 1.48±0.38, 2.86±1.65, 4.41±0.13) was significantly higher than that of the control group ( P< 0.05). The positive rate of NSE immunofluorescence staining in the 75 ng/ml BMP7 group was higher than that in the control group (32.94%±1.62% vs 0). Conclusion:BMP7 has the ability to induce the differentiation of rat BMSCs into neurons in vitro.

Study on the safety and effectiveness of postpyloric feeding in elderly patients with severe diseases / 中国基层医药

Objective:To investigate the clinical efficacy and safety of postpyloric feeding in elderly patients with severe disease.Methods:From March 2017 to December 2019, 66 elderly severe patients hospitalized in Taishan Sanatorium of Shandong Province were selected in the study.The patients were divided into control group and observation group according the random digital table method, with 33 cases in each group.The control group received routine nasogastric tube feeding nutrition support, while the observation group received post pylorus feeding nutrition support.The feeding time of both two groups was 14 days.The nutritional status, improvement and complications of the two groups were observed.Results:On the 14th day after feeding, the total serum protein(TP), albumin(ALB), transferrin(TF), prealbumin(PA) in the observation group were (62.75±4.22)g/L, (35.38±2.63)g/L, (2.09±0.13)g/L, (221.52±26.62)g/L, respectively, which were higher than those in the control group [(54.53±4.16)g/L, (32.34±2.83)g/L, (1.85±0.10)g/L, (197.85±25.73)g/L]( t=7.969, 4.520, 8.406, 3.673, all P<0.05). On the 3rd, 7th and 14th day after feeding, the ApacheⅡ scores of the observation group were (14.04±2.17)points, (10.95±2.21)points, (8.95±2.21)points, respectively, which were significantly lower than those of the control group [(15.98±2.45)points, (13.75±2.25)points, (10.75±2.25)points]( t=3.405, 5.100, 3.279, all P<0.05). The incidences of vomiting, gastric retention, dominant aspiration and aspiration pneumonia in the observation group were 3.03%(1/33), 12.12%(4/33), 0.00%(0/33), 12.12%(4/33) , respectively, which were significantly lower than those in the control group [18.18%(6/33), 33.33%(11/33), 12.12%(4/33), 33.33%(11/33)](χ 2=3.995, 4.227, 4.258, 4.227, all P<0.05). Conclusion:Postpyloric feeding used in elderly patients with severe illness can improve the nutritional status and condition of patients, and reduce the incidence of complications such as gastric retention and aspiration pneumonia.It has high efficacy and safety.

Application of artificial intelligence teaching-picture system to improve the bone marrow cell morphological reading ability of clinical medical students / 中华医学教育探索杂志

Objective:To explore the effect of artificial intelligence teaching-picture system in training the bone marrow cell morphological reading ability of clinical medical students.Methods:A total of 110 five-year undergraduate students were divided into experimental group (artificial intelligence picture teaching method) and control group (traditional teaching method) in the bone marrow cell morphology reading ability training. On the basis of multimedia teaching, the experimental group was given the teaching by using the bone marrow cell morphology picture storage and transmission system for retrieval, learning and computer adaptive test. Then objective evaluation of image recognition ability and questionnaire were used to compare the teaching effect.Results:The image recognition ability was significantly better in the experimental group than in the control group [(89.6±5.7) vs. (81.4±4.9), P<0.01]. Furthermore, the experimental group showed more obvious advantages in cell morphology recognition [(74.7±4.0) vs. (68.7±4.9)] and diagnosis of hematological diseases [(14.9±3.0) vs. (12.9±2.4)] than the control group (both P<0.01). Questionnaire survey showed that the students expressed their affirmation and support for the artificial intelligence teaching-picture system in the bone marrow cell morphological reading ability training. Conclusion:The application of artificial intelligence teaching-picture system can greatly improve the teaching effect, mobilize students' learning enthusiasm and expand learning resources, which is worthy of further promotion and application.

Efficacy of Hyper-CVAD/MA and CHALL-01 regimens in the treatment of Philadelphia chromosome-positive adult acute lymphoblastic leukemia patients under 60 years old / 中华血液学杂志

Objective@#To compare the difference of efficacy between traditional Hyper-CVAD/MA regimen and the adolescents inspired chemotherapy regimen, CH ALL-01, in treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) .@*Methods@#In this study we retrospectively analyzed 158 Ph+ ALL patients receiving Hyper-CVAD/MA regimen (n=63) or CHALL-01 regimen (n=95) in our center and Changzheng hospital from January 2007 to December 2017, excluding patients with chronic myeloid leukemia in blast crisis. Tyrosine kinase inhibitor (TKI) was administered during induction and consolidation chemotherapy. Patients who underwent hematopoietic stem cell transplantation received TKI as maintenance therapy.@*Results@#Of them, 91.1% (144/158) patients achieved complete remission (CR) after 1-2 courses of induction. CR rate was 90.5% (57/63) for patients in Hyper-CVAD/MA group and 91.6% (87/95) for patients in CHALL-01 group. There was no difference in CR rates between the two groups (χ2=0.057, P=0.811) . The last follow-up was June 2018. A cohort of 134 CR patients could be used for further analysis, among them, 53 patients received Hyper-CVAD/MA regimen and other 81 patients received CHALL-01 regimen. The molecular remission rates were significantly higher in CHALL-01 group (complete molecular response: 44.4%vs 22.6%; major molecular response: 9.9% vs 18.9%) (χ2=7.216, P=0.027) . For the patients in Hyper-CVAD/MA group, the 4-year overall survival (OS) was 44.81% (95%CI: 30.80%-57.86%) and the 4-year disease free survival (DFS) was 37.95% (95%CI: 24.87%-50.93%) . For patients received CHALL-01 regimen, the 4-year OS was 55.63% (95%CI: 39.07%-69.36%) (P=0.037) and 4 year DFS was 49.06% (95%CI: 34.24%-62.29%) (P=0.015) , while there was no significant difference in 4 year cumulative incidence of relapse (CIR) (P=0.328) or cumulative incidence of nonrelapse mortality (CI-NRM) (P=0.138) . The rate of pulmonary infection was lower in patients received CHALL-01 regimen compared with patients received Hyper-CVAD regimen (43.4% vs 67.9%, χ2=7.908, P=0.005) .@*Conclusions@#Outcome with CHALL-01 regimen appeared better than that with the Hyper-CVAD/MA regimen in Ph+ ALL, which has lower incidence of pulmonary infection, higher molecular remission rate and better OS and DFS.