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Sleep disorders are common in children and adolescents, especially in those with neurodevelopmental and mental disorders, but treatment strategies remain limited.The main therapeutic methods for sleep disorders in children and adolescents include cognitive behavioral therapy, surgical therapy, drug therapy, and physical therapy.Conventional cognitive behavioral therapy is expensive; plus, the number of qualified sleep physicians and therapists is limited, and patient′s compliance is low.Drug therapy is the most commonly used treatment for insomnia in children and adolescents, but it lacks evidence-based indications and safety and has many adverse reactions, and its long-term efficacy is unknown.Physical therapy that changes the activity of central and peripheral nerves through physical stimulation such as magnetism, electricity, sound and light can provide valuable alternative or complementary treatment for individuals with sleep disorders who can′t get conventional treatment, have poor tolerance or are ineffective.In this paper, 4 common clinical physical therapies (transcranial magnetic stimulation, transcranial direct current stimulation, light therapy, and hyperbaric oxygen therapy) and their application in treating sleep disorders in children and adolescents are reviewed, providing scientific basis and new ideas for the future clinical treatment of sleep disorders in children and adolescents.
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Objective:To find benefit of adaptive challenges in age-related macular degeneration (AMD) patients of long-term treatment in the challenge of vision decline, and provide new ideas for improving the quality of life of patients.Methods:It was a phenomenological study from qualitative research, selected by purpose sampling method and semi-structured interview which involved 20 AMD patients who received intravitreal treatment of drug in the Ophthalmology Department of Affiliated Hospital of Nantong University from January to March 2023.Two interviewees comprehensively read and analyzed the transcript of the interview and its meaning, subsequently Colaizzi seven-step analysis method was used to classify and encode the transcribed data.Results:Among 20 patients, there were 9 males and 11 females, aged 56-81 years old. Patients with AMD experience a sense of benefit in their long-term management of the condition, adapting to the challenges posed by declining strength, which could be summarized into four main themes: moderate sense of decision control, satisfactory social support, active self-management of the disease, and an improvement in quality of life.Conclusions:Patients with AMD experience a sense of disease-related benefit during the long-term management of visual acuity challenges. Healthcare professionals should guide patients to seek this benefit from adverse events, identify the adaptive challenges patients face, and leverage their adaptive leadership skills. Furthermore, offering multi-channel low vision rehabilitation services can assist patients in enhancing their adaptive capabilities, ultimately contributing to further improving their quality of life.
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BACKGROUND:Most of the formulas for the clinical treatment of premature ovarian insufficiency have evolved from the basic formula of Liuwei Dihuang Pills,and have achieved good therapeutic efficacy.Currently,most of the experimental studies on Liuwei Dihuang Pills focus on morphological observations and physiological and biochemical detection of in vivo animal models,while fewer studies on molecular mechanisms have been reported. OBJECTIVE:To explore the molecular mechanism of Liuwei Dihuang Pills in the treatment of premature ovarian insufficiency based on the receptor gamma coactivator-1 alpha/mitochondrial transcription factor A/reactive oxygen species pathway. METHODS:Premature ovarian insufficiency model was established in mice by intraperitoneal injection of cyclophosphamide 120 mg/kg combined with busulfan 12 mg/kg,and then Liuwei Dihuang Pill suspension was used to intervene in premature ovarian insufficiency mice.After 12 weeks of intervention,the levels of follicle-stimulating hormone,luteinizing hormone,estradiol,anti-Mullerian hormone,8-hydroxydeoxyguanosine,total antioxidant capacity and reactive oxygen species in serum of mice were detected by ELISA method.The morphological changes in mouse ovaries were observed by hematoxylin-eosin staining.The ultrastructure of mouse follicular granulosa cells and the apoptosis of granulosa cell mitochondria were observed by transmission electron microscopy.The expression levels of receptor gamma coactivator-1 alpha and mitochondrial transcription factor A in mouse ovarian granulosa cells were detected by immunohistochemistry. RESULTS AND CONCLUSION:Compared with the model group,serum levels of follicle-stimulating hormone,luteinizing hormone,reactive oxygen species,and 8-hydroxydeoxyguanosine were decreased in the experimental group(P<0.05),and the levels of estradiol,anti-Mullerian hormone,and total antioxidant capacity were increased(P<0.05).Hematoxylin-eosin staining showed that in the model group,there were more atretic follicles and corpus luteum forms,some secondary follicles,and interstitial fibrosis and hyperplasia;in the experimental group,a large number of atretic follicles,few corpus luteum forms,primordial follicles were observed at the edges but there were few secondary follicles and no mature follicles.Transmission electron microscopy showed that the organelles in ovarian granulosa cells of mice in the experimental groups were relatively intact.Immunohistochemical results showed that compared with the model group,the expression level of receptor gamma coactivator-1 alpha in the ovarian tissue of mice increased slightly in the experimental group at the 4th week,and there was no significant change at the 8th and 12th weeks.The expression level of mitochondrial transcription factor A in the ovarian tissues of mice in the experimental group was transiently increased at the 4th week,and then slightly decreased,which were all significantly different from those of the model group.To conclude,Liuwei Dihuang Pills inhibit ovarian granulosa cell apoptosis in mice with premature ovarian insufficiency to a certain extent through the receptor gamma coactivator-1 alpha/mitochondrial transcription factor A/reactive oxygen species signaling pathway,thereby improving the endocrine function of the ovary,enhancing the antioxidant capacity,and attenuating the degree of oxidative stress damage.
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Objective:To evaluate the cognitive information processes in children with autism spectrum disorder(ASD)based on the Das-Naglieri Cognitive Assessment System(DN: CAS)and to explore the characteristics of these cognitive processes.Methods:Thirty-two children with ASD and thirty-two healthy controls matched 1∶1 by gender and age were enrolled in this study.The cognition of all individuals was evaluated by the DN: CAS.SPSS 26.0 software was used for statistical analysis and Mann-Whitney U test was conducted to analyze the data. Results:Compared with the healthy control group, children with ASD had significantly lower scores in planning subtest of DN: CAS(23.50(19.00, 25.00) vs 30.50(27.00, 35.75), Z=-5.014, P<0.01), attention subtest of DN: CAS(25.50(20.25, 27.75) vs 33.00(28.00, 36.00), Z=-4.317, P<0.01), and the DN: CAS total score(115.00(106.00, 132.25) vs 139.00(127.00, 143.00), Z=-3.849, P<0.01). And there were significant differences in matching numbers(9.00(6.25, 10.00) vs 12.00(10.00, 13.75), Z=-4.317, P<0.01), planned codes(7.00(5.25, 8.00) vs 9.00(7.00, 11.00), Z=-3.404, P<0.01), planned connections(7.00(4.25, 9.75) vs 10.00(9.00, 12.00), Z=-4.383, P<0.01)in planning and expressive attention(8.00(6.25, 10.75) vs 11.50(8.25, 13.75), Z=-3.251, P<0.01), number detection(8.00(6.25, 10.00) vs 10.00(9.00, 12.00), Z=-3.628, P<0.01), receptive attention(8.00(6.00, 9.00) vs 10.00(9.00, 13.00), Z=-3.351, P<0.01)in attention between ASD children and healthy controls. Conclusion:ASD children have the planning and attention deficits.
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OBJECTIVE@#To explore the carrier rate, genotype and phenotype of α-thalassemia fusion gene in Huadu district of Guangzhou, Guangdong province of China, and provide data reference for the prevention and control of thalassemia.@*METHODS@#A total of 10 769 samples who were screened for thalassemia in Maternal and Child Health Hospital of Huadu District from July 2019 to November 2020 were analyzed retrospectively. Blood cell analysis and hemoglobin (Hb) electrophoresis were performed. Thalassemia genes were analyzed by gap-PCR and PCR-reverse dot blot hybridization (PCR-RDB).@*RESULTS@#A total of 9 cases with α-thalassemia fusion gene were detected in 10 769 samples (0.08%). There were 7 cases with fusion gene heterozygote, 1 case with compound of α-thalassemia fusion gene and Hb G-Honolulu, 1 case with compound of α-thalassemia fusion gene and Hb QS. The MCV results of 4 samples of blood cell analysis were within the reference range, the Hb A2 value of 1 case was decreased, and there were no other abnormalities found.@*CONCLUSION@#The α-thalassemia fusion gene is common in Huadu district of Guangzhou, and heterozygotes are more common, and current screening methods easily lead to misdiagnosis.
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Humans , alpha-Thalassemia/genetics , Retrospective Studies , beta-Thalassemia/genetics , Genotype , Phenotype , Heterozygote , China , MutationABSTRACT
To explore the mechanism of the active ingredients of Qishiwei Zhenzhu Pills in inhibiting the hepatorenal toxicity of the zogta component based on serum pharmacochemistry and network pharmacology, thereby providing references for the clinical safety application of Qishiwei Zhenzhu Pills. The small molecular compounds in the serum containing Qishiwei Zhenzhu Pills of mice were identified by high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS). Then, by comprehensively using Traditional Chinese Medicines Systems Pharmacology(TCMSP), High-throughput Experiment-and Reference-guided Database(HERB), PubChem, GeneCards, SuperPred, and other databases, the active compounds in the serum containing Qishiwei Zhenzhu Pills were retrieved and their action targets were predicted. The predicted targets were compared with the targets of liver and kidney injury related to mercury toxicity retrieved from the database, and the action targets of Qishiwei Zhenzhu Pills to inhibit the potential mercury toxicity of zogta were screened out. Cytoscape was used to construct the active ingredient in Qishiwei Zhenzhu Pills-containing serum-action target network, and STRING database was used to construct the protein-protein interaction(PPI) network of intersection targets. The Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses were carried out on the target genes by the DAVID database. The active ingredient-target-pathway network was constructed, and the key ingredients and targets were screened out for molecular docking verification. The results showed that 44 active compounds were identified from the serum containing Qishiwei Zhenzhu Pills, including 13 possible prototype drug ingredients, and 70 potential targets for mercury toxicity in liver and kidney were identified. Through PPI network topology analysis, 12 key target genes(HSP90AA1, MAPK3, STAT3, EGFR, MAPK1, APP, MMP9, NOS3, PRKCA, TLR4, PTGS2, and PARP1) and 6 subnetworks were obtained. Through GO and KEGG analysis of 4 subnetworks containing key target genes, the interaction network diagram of active ingredient-action target-key pathway was constructed and verified by molecular docking. It was found that taurodeoxycholic acid, N-acetyl-L-leucine, D-pantothenic acid hemicalcium, and other active ingredients may regulate biological functions and pathways related to metabolism, immunity, inflammation, and oxidative stress by acting on major targets such as MAPK1, STAT3, and TLR4, so as to inhibit the potential mercury toxicity of zogta in Qishiwei Zhenzhu Pills. In conclusion, the active ingredients of Qishiwei Zhenzhu Pills may have a certain detoxification effect, thus inhibiting the potential mercury toxicity of zogta and playing a role of reducing toxicity and enhancing effect.
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Animals , Mice , Medicine, Tibetan Traditional , Network Pharmacology , Molecular Docking Simulation , Tandem Mass Spectrometry , Toll-Like Receptor 4 , Medicine, Chinese Traditional , Mercury , Drugs, Chinese Herbal/toxicityABSTRACT
This study aims to investigate the efficacy and possible mechanism of Liuwei Dihuang Pills in the treatment of diminished ovarian reserve(DOR) by using proteomic techniques. Firstly, cyclophosphamide(60 mg·kg~(-1)) combined with busulfan(6 mg·kg~(-1)) was injected intraperitoneally to establish the mouse model of DOR. After drug injection, the mice were continuously observed and the success of modeling was evaluated by the disturbance of the estrous cycle. After successful modeling, the mice were administrated with the suspension of Liuwei Dihuang Pills by gavage for 28 days. At the end of the gavage, four female mice were selected and caged together with males at a ratio of 2∶1 for the determination of the pregnancy rate. Blood and ovary samples were collected from the remaining mice on the next day after the end of gavage. Hematoxylin-eosin(HE) staining and transmission electron microscopy(TEM) were then employed to observe the morphological and ultrastructural changes in the ovaries. The serum levels of hormones and oxidation indicators were measured by enzyme-linked immunosorbent assay. Quantitative proteomics techniques were used to compare the ovarian protein expression before and after modeling and before and after the intervention with Liuwei Dihuang Pills. The results showed that Liuwei Dihuang Pills regulated the estrous cycle of DOR mice, elevated the serum levels of hormones and anti-oxidation indicators, promoted follicle development, protected the mitochondrial morphology of ovarian granulosa cells, and increased the litter size and survival of DOR mice. Furthermore, Liuwei Dihuang Pills negatively regulated the expression of 12 differentially expressed proteins associated with DOR, which were mainly involved in lipid catabolism, inflammatory response, immune regulation, and coenzyme biosynthesis. These differentially expressed proteins were significantly enriched in sphingolipid metabolism, arachidonic acid metabolism, ribosomes, ferroptosis, and cGMP-PKG signaling pathway. In summary, the occurrence of DOR and the treatment of DOR with Liuwei Dihuang Pills are associated with multiple biological pathways, mainly including oxidative stress response, inflammatory response, and immune regulation. "Mitochondria-oxidative stress-apoptosis" is the key to the treatment of DOR by Liuwei Dihuang Pills. YY1 and CYP4F3 may be the key upstream targets that trigger mitochondrial dysfunction and ROS accumulation, and the metabolism of arachidonic acid is the main signaling pathway of drug action.
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Female , Male , Pregnancy , Animals , Mice , Arachidonic Acid , Ovarian Reserve , Proteomics , Ovary , Lipid MetabolismABSTRACT
Wuzhi tablet (WZ) is a prescribed herbal medicine extracted from Schisandra sphenanthera, which is widely used to protect the liver injury and drug-induced hepatotoxicity in clinical practices. Previous studies showed that WZ significantly increased the blood concentrations of tacrolimus, cyclosporine A, paclitaxel by inhibiting the cytochrome P450 3A (CYP3A)-mediated metabolism. CYP3A4 and CYP3A5 are the most important isoenzymes among the CYP3A subfamily. However, there are some differences in the catalytic and inhibitory activities between CYP3A4 and CYP3A5, which may lead to different risk of drug-drug and herb-drug interactions, and the risks may be further amplified in vivo. Currently, few reports have compared the herbal medicine inhibitory effects between CYP3A4 and CYP3A5 mediated metabolic reactions. Therefore, detailing the inhibitory effect of WZ on CYP3A4 and CYP3A5 will help understand and predict the potential herb-drug interaction. The results showed that WZ inhibited CYP3A4 and CYP3A5 in a NADPH-, time- and concentration- dependent manner. WZ showed more potent inhibition on CYP3A5 than CYP3A4. Cautions warranted when combining WZ with other therapeutic drugs to avoid the potential herb-drug interaction.
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OBJECTIVE@#To compare the clinical efficacy and its effect on serum levels of tumor necrosis factor α(TNF-α), interleukin 1β(IL-1β), interleukin 6 (IL-6) and prostaglandin E2 (PGE2) between short needling (close-to-bone needling) and conventional acupuncture for knee osteoarthritis (KOA) with blood stasis obstruction.@*METHODS@#A total of 68 KOA patients with blood stasis obstruction were randomized into a short needling group (34 cases, 3 cases dropped off) and a conventional acupuncture group (34 cases, 3 cases dropped off). The same acupoints (Dubi [ST 35], Neixiyan [EX-LE 4], Binzhong [Extra], Liangqiu [ST 34], etc. on the affected side) were selected in the two groups. In the short needling group, short needling technique was adopted, the needles were slowly inserted and the needle bodies were shaken, thus gradually penetrated to the bone. In the conventional acupuncture group, conventional acupuncture was adopted, the needles were penetrated to the muscle. After qi-arrival, Dubi (ST 35) and Neixiyan (EX-LE 4), Zusanli (ST 36) and Liangqiu (ST 34) were connected with CMNS6-1 electronic acupuncture instrument, with disperse-dense wave, 2 Hz/10 Hz in frequency, the current intensity was based on patients' feeling, the needles were retained for 30 min, at the same time, the knee joint was irradiated for 30 min with a special electromagnetic wave apparatus in the two groups. Once every other day, 3 times a week for 4 weeks. Before and after treatment, the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, knee joint pain visual analogue scale (VAS) score, inflammatory response related indexes (serum TNF-a, IL-1β, IL-6 and PGE2) and knee joint ultrasound were observed,and the clinical effect was evaluated in the two groups.@*RESULTS@#After treatment,the pain, stiffness, function scores and total scores of WOMAC were decreased as compared with those before treatment in the two groups (P<0.05), except for the pain score, the changes of above scores in the short needling group were greater than the conventional acupuncture group (P<0.05). After treatment, the VAS scores, serum levels of TNF-a, IL-1β, IL-6, PGE2 and knee joint synovium thickness, intra-articular effusion were decreased as compared with those before treatment in the two groups (P<0.05), the levels of TNF-a, IL-1β, IL-6 in the short needling group were lower than the conventional acupuncture group (P<0.05). The total effective rate in the short needling group was 87.1% (27/31), which was superior to 83.9% (26/31) in the conventional acupuncture group (P<0.05).@*CONCLUSION@#Short needling could improve the knee joint function, relieve the pain and inflammatory response, improve the knee joint synovium inflammatory response, reduce the knee joint intra-articular effusion for KOA patients, its effect is better than conventional acupuncture.
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Humans , Acupuncture Points , Inflammation , Interleukin-6 , Osteoarthritis, Knee/therapy , Pain , Prostaglandins EABSTRACT
Objective:To analyze the plasma levels of soluble immune checkpoint molecules in patients with primary liver cancer and their prognostic significance.Methods:The levels of sCD28, sCD80, sCD137, sCD27, sGITR, sTIM3, sCTLA4, sHVEM, IDO, sLAG3, sBTLA, sPD1, sPDL1 and sPDL2 in plasma samples of 58 patients with primary liver cancer and 30 healthy controls were detected by liquid chip technology and compared between different groups. The relationship between the plasma levels of soluble immune checkpoint molecules and tumor recurrence was analyzed.Results:The levels of sCD28 and sCD80 were higher in patients in Barcelona Clinic Liver Cancer (BCLC) stage 0/A and B than in healthy controls and patients in BCLC-C stage ( P<0.05). However, the levels of sCD27 and sHVEM in BCLC-C patients were significantly lower than those in BCLC-0/A and BCLC-B patients, and even lower than healthy control group. The levels of sCD137, IDO and sPD1 in BCLC-0/A and BCLC-B patients were higher than those in healthy controls. The levels of sPDL1 and sPDL2 in different BCLC stages were all higher than those in healthy controls, and maintained at high level in the three stages, but there was no significant difference between different stages. After 24 months of interventional treatment, the preoperative sCD28 level was lower in patients with recurrent tumor recurrence than in patients without recurrence ( t=2.843, P=0.007). The optimal cut-off value of sCD28 based on the receiver operating characteristic (ROC) curve for predicting tumor recurrence was 101.42 pg/ml and the area under the ROC curve was 0.771 (95%CI: 0.611-0.931) with a sensitivity of 0.889 and a specificity of 0.666. The cumulative recurrence rate in patients with high sCD28 level (≥101.41 pg/ml) was 57.9% at 24 months after surgery, which was lower than the rate (95.5%) in patients with low sCD28 level (<101.41 pg/ml). The difference in the cumulative recurrence rate between the two groups was statistically significant (χ 2=15.777, P=0.000). Conclusions:The expression patterns of soluble immune checkpoint molecules varied in patients at different stages of primary liver cancer, suggesting that there were differences in their immune status and sCD28 could be used as a prognostic marker for postoperative recurrence of liver cancer.
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Objective:To explore the influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD).Methods:From January 2018 to July 2021, 62 ADHD children who were treated with tomoxetine hydrochloride for the first time for(8±4) weeks were selected as the ADHD group.And 62 healthy children matched with age and sex were selected as the healthy control group.Pre-test and post-test by the Das-Naglieri: Cognitive Assessment System(DN: CAS) were performed to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group were compared with those in healthy control group.The difference between before and after treatment of ADHD group was also compared.SPSS 26.0 statistical software was adopted for statistical analysis.The scores of ADHD group pre-treatment and post-treatment were compared by paired sample t-test, and the scores of ADHD group pre-treatment and post-treatment were compared with those of healthy control group by independent sample t-test. Results:Compared with healthy control group, there were lower of planning score((18.77±5.92) vs (28.56±5.55)), attention score((22.24±5.93) vs (29.56±6.16)), simultaneous processing ((34.21±7.75) vs (37.61±6.29)), successive processing((30.37±7.12) vs (33.74±5.43)), and the total scores((105.60±21.29) vs (134.84±22.87)) in ADHD group before treatment, and there were significant differences( t=9.49, 6.74, 2.68, 2.96, 7.36, all P<0.05). Compared with healthy control group, there were lower of planning score ((22.13±5.99)s), attention score((25.26±7.11) with significant difference( t=6.20, 3.60, both P<0.05) in ADHD group after treatment.And there was no significant difference in the simultaneous processing test and the successive processing test after treatment compared with the healthy control group(both P>0.05). In ADHD group, the scores of planning, simultaneous processing, attention, successive processing and the total score were significantly higher after treatment than those before treatment and there were significant differences( t=-6.03, -4.13, -4.77, -5.48, -8.59, all P<0.05). (2) Compared with the healthy control group, there were lower of matching number score and other 8 sub-test scales in DN: CAS test in ADHD group before treatment, and the differences were statistically significant (all P<0.05). Meanwhile, there were still lower of matching number score and other 4 sub-test scales in DN: CAS test in ADHD group after treatment, and the differences were statistically significant (all P<0.05). The matching number score and other 10 sub-test scales in DN: CAS test in ADHD group after treatment were all higher than those of before treatment(all P<0.05). Conclusion:The planning, attention, simultaneous processing, successive processing and total cognitive function of ADHD children were significantly improved after treatment with tomoxetine hydrochloride, special for simultaneous processing and successive processing.
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Aim To evaluate the pharmacokinetics and bioequivalence of two osmotic pump tablets of hydrochloride venlafaxine in Chinese healthy volunteers.Methods The fed test each enrolled twenty-six Chinese healthy volunteers in a randomized-sequence, open-label, two-period crossover single-dose oral test and reference preparations of hydrochloride venlafaxine extended-release tablets.The plasma concentrations of venlafaxine and its active metabolites O-desmethylvenlafaxine were determined by a validated liquid chromatography-tandem mass spectrometry(LC-MS/MS)method, and the pharmacokinetic parameters and bioequivalence of the two tablets were analyzed using PhoenixTM WinNonlin 6.4 software.Results The pharmacokinetic parameters of venlafaxine after single dose for the test and reference tablets were as follows: Cmax(58.50±19.47)vs(60.14±22.18)μg•L-1, AUC0-t(1 074.1±526.7)vs(1 057.9±539.7)μg•h•L-1, AUC0-∞(1 084.7±536.8)vs(1 067.8±554.0)μ g•h•L-1.The pharmacokinetic parameters of O-desmethylvenlafaxine were as follows: Cmax(101.63±29.64)vs(101.45±31.62)μg•L-1, AUC0-t(2 694.0±834.5)vs(2 702.9±946.4)μg• h•L-1, AUC0-∞(2 753.9±885.5)vs(2 753.2±988.4)μg•h•L-1.The 90% confidence intervals of the geometric mean ratios of Cmax, AUC0-t, AUC0-∞ for the test preparation and the reference preparationwere all within the equivalent interval of 80.00%-125.00%.Conclusion The test and reference preparations of hydrochloride venlafaxine extended-release tablets are bioequivalent in Chinese healthy volunteers under fed conditions.
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Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females,with age range of 25-57 years[(48.6 ± 11.9)years]. Segments of injury were located at T 11 in 18 patients,at T 12 in 26,at L 1 in 21,at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all,51 patients received conventional postural nursing from June 2018 to May 2019(control group),and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020(verification group). The incidence of postoperative complications including stress injury,brachial plexus injury,ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale(VAS)and Oswestry disability index(ODI)were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months[(10.5±0.9)months]. Verification group and control group showed significant differences in the incidence of stress injury(4%∶29%),brachial plexus injury(4%∶16%)and ocular discomfort consisiting of tears(2%∶12%),foreign body sensation(0%∶4%)and dryness(4%∶16%)( P < 0.05),not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was(7.0±1.3)days,significantly shorter than that in control group[(9.9±1.9)days]( P < 0.05). Satisfaction of patients in verification group and control group was 85%(47/55)and 69%(35/51),respectively( P < 0.05). At 3 months postoperatively,VAS in verification group[(1.9 ± 0.8)points]was significantly lower than that in control group[(3.5±1.1)points]( P < 0.05),and ODI was similar between the two groups( P > 0.05). Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position,nursing checklist helps reduce occurrence of the related complication,shorten length of hospital stay,improve patient satisfaction,reduce postoperative pain and promote rehabilitation.
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Objective:To study the efficacy and mechanism of Zishenwan (ZSW) against pyroptosis and epithelial-mesenchymal transition (EMT) of renal tubular epithelial cells in diabetic nephropathy (DN) mice, so as to provide evidence for the treatment of DN with ZSW. Method:The <italic>db/db</italic> mice with spontaneous diabetes were randomly divided into the model group, dapagliflozin (1.0 mg·kg<sup>-1</sup>) group, and high-, medium-, and low-dose (6.0, 3.0, 1.5 g·kg<sup>-1</sup>) ZSW groups. The non-diabetic <italic>db/m</italic> mice were classified into the normal group. The ones in the model and normal groups were given an equal volume of deionized water by gavage, while those in the other groups were intervened with the corresponding drugs for 12 weeks. The fasting blood glucose (FBG) level was tested at tail vein once every two weeks. The levels of urine albumin-creatinine ratio (ACR), <italic>β</italic>-N-acetyl-D-glucosaminidase (NAG), and cystatin C (CysC) were detected once every four weeks. After 12 weeks of administration, the blood sampled from eyeballs was used for measuring the blood urea nitrogen (BUN) and serum creatinine (SCr). The pathological changes in renal tissues were observed by light microscopy and transmission electron microscopy. The expression of EMT markers in the renal tubular epithelium was analyzed by immunohistochemistry (IHC). The in situ terminal end-labeling (TUNEL) staining was conducted to analyze the nuclear damage of renal tubular epithelial cells. The protein and mRNA expression levels of EMT markers, nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and pyroptosis-related inflammatory cytokines in renal tissues were separately assayed by Western blot and Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). Result:Compared with the normal group, the model group displayed significantly increased FBG, BUN, serum SCr, ACR, NAG, and CysC (<italic>P</italic><0.01), impaired renal tissues, altered EMT marker expression intensities and levels (<italic>P</italic><0.01), and elevated TUNEL-positive rate and protein and mRNA expression levels of pyroptosis-related inflammatory cytokines and NLRP3 inflammasome (<italic>P</italic><0.01). Compared with the model group, ZSW and dapagliflozin significantly decreased the levels of FBG, BUN, serum SCr, ACR, NAG, and CysC (<italic>P</italic><0.01), relieved the pathological injuries in renal tissues, changed the EMT marker expression intensities (<italic>P</italic><0.01) and protein and mRNA expression levels (<italic>P</italic><0.05, <italic>P</italic><0.01), and down-regulated the TUNEL-positive rate (<italic>P</italic><0.01) of renal tubular epithelial cells as well as the protein and mRNA expression levels of pyroptosis-related inflammatory cytokines (<italic>P</italic><0.01) and NLRP3 inflammasome (<italic>P</italic><0.05, <italic>P</italic><0.01). Conclusion:ZSW alleviates DN possibly by inhibiting pyroptosis and EMT in renal tubular epithelial cells.
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Objective:To study the clinical efficacy of orthopedics No.1 prescription combined with celecoxib in the treatment of knee osteoarthritis (KOA) with middle stage of cold-dampness syndrome and investigate its effect on serum cytokines levels. Method:The 72 patients were randomly divided into control group and observation group, with 36 cases each. Patients in both groups were given basic treatment with oral celecoxib capsules (0.2 g/ time, 1 time/day). On the basis of western medicine treatment, patients in observation group were treated with orthopedics No.1 prescription decoction-free granules by fumigation, 1 bag/time, 1 time/day, 5 times/week. Both groups received treatment for 4 weeks. The visual analog pain score (VAS), American knee society knee score (KSS), serum interleukin-1<italic>β </italic>(IL-1<italic>β</italic>), tumor necrosis factor-<italic>α </italic>(TNF-<italic>α</italic>), and transforming growth factor-<italic>β</italic><sub>1 </sub>(TGF-<italic>β</italic><sub>1</sub>) levels were observed before and after treatment, and their clinical efficacy was evaluated. Result:After treatment, VAS score significantly decreased in both groups (<italic>P</italic><0.01), and KSS score significantly increased (<italic>P</italic><0.01), with better clinical effect in observation group. After treatment, serum IL-1<italic>β</italic> and TNF-<italic>α</italic> levels decreased significantly in both groups (<italic>P</italic><0.01), and the levels in observation group were lower than those in control group after treatment (<italic>P</italic><0.05). TGF<italic>-β</italic><sub>1 </sub>content was significantly higher than that before treatment in two groups (<italic>P</italic><0.01). Conclusion:Orthopedics No.1 prescription combined with celecoxib for the treatment of KOA with middle stage of cold-dampness syndrome can effectively relieve the clinical symptoms of patients with KOA, improve joint function, improve quality of life, reduce the contents of inflammatory factors IL-1<italic>β</italic> and TNF-<italic>α</italic> in serum, and increase the expression of TGF-<italic>β</italic><sub>1</sub> level.
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Objective:To explore the active components, targets, and signaling pathways responsible for Bushen Zhuyun prescription in treating the recurrent spontaneous abortion (RSA) based on network pharmacology and uncover its potential mechanism by molecular docking and in vitro cell experiments. Method:The active components of Bushen Zhuyun prescription were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Traditional Chinese Medicine Integrated Database (TCMID) and the published articles, followed by the prediction of drug action targets based on such platforms as DrugBank and SwissTargetPrediction. GeneCards and Online Mendelian Inheritance in Man (OMIM) were searched to obtain the RSA targets, which were then intersected with the targets of Bushen Zhuyun Decoction. Following the plotting of Bushen Zhuyun prescription-compound-target-RSA network by Cytoscape 3.7.1, the protein-protein interaction (PPI) network was then constructed with STRING for screening the core network. The resulting common targets were then subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis using R software. Autodock Vina 1.1.2 was used for molecular docking. The activation of phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway by Bushen Zhuyun prescription was verified in human umbilical vein endothelial cells (HUVEC) <italic>in vitro</italic>. Result:It was found that 49 potential active components of Bushen Zhuyun prescription might act on 133 RSA targets. GO enrichment analysis yielded 470 biological processes, with angiogenesis, vascular development, cellular proliferation, and oxidative activity mainly involved. KEGG enrichment analysis revealed 103 signaling pathways (<italic>P</italic><0.05), and the PI3K/AKT signaling pathway, advanced glycation end product (AGE)/receptor for advanced glycation end product (RAGE) signaling pathway, and tumor necrosis factor (TNF) signaling pathway were the main ones. As indicated by molecular docking, the Vina scores of the main active component kaempferol with AKT1 and vascular endothelial growth factor A (VEGFA) were the lowest and similar. It was confirmed <italic>in vitro</italic> cell experiments that Bushen Zhuyun prescription activated the PI3K/AKT signaling pathway and up-regulated the expression of VEGFA and downstream AKT protein to promote angiogenesis. Conclusion:Bushen Zhuyun prescription promotes angiogenesis at the maternal-fetal interface by regulating angiogenesis and cellular proliferation, activating the PI3K/AKT pathway, and up-regulated the VEGFA expression, which is beneficial to the formation of placenta in early pregnancy and the maintenance of early pregnancy. This study has provided ideas for new drug development.
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Momordica charantia has been a traditional Chinese medicine (TCM) and food since ancient times. The discussions on its nature, taste and efficacy in ancient books of TCM are almost the same. With a high nutritional value, M. charantia is rich in a variety of vitamins and minerals, and has been widely used in the production of a wide range of dietary supplements and functional foods. At the same time, M. charantia is one of the most deeply studied natural medicines in traditional alternative medicine, with a wide range of pharmacological effects, especially in the treatment of metabolic diseases. Clinical trials have confirmed that M. charantia has a hypoglycemic effect, and could reduce blood lipids and weight loss, so as to improve metabolism in a comprehensive manner. According to the study on the mechanism of M. charantia in the treatment of diabetes, M. charantia could reduce blood sugar by improving islet β-cell function, improving insulin resistance, inhibiting intestinal glucose absorption and resisting inflammation and oxidative stress. However, at present, there is a lack of unified standards for the hypoglycemic effects and various mechanisms of action of M. charantia, and the safety has not been fully confirmed. Further studies shall be conducted to investigate the hypoglycemic effect and mechanisms of M. charantia, explore active components of M. charantia, define the pharmacodynamics material basis, extract monomer compounds with a clear structure and confirm its effectiveness and safety, which is helpful to develop and utilize the homologous value of medicine and food of M. charantia and further apply it in clinic. The application of the hypoglycemic effect of M. charantia in clinic has important economic benefits and a social significance.
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Sleep takes an important role in maintaining typical development, neural plasticity, and language development. Not only poorer performance in memory and cognitive functions, but also obvious delayed language development are seen in children and adolescents with sleep problem. Previous research found that sleep duration affects children and adolescents' ability in comprehensive vocabulary, expressive vocabulary, and vocabulary retention. Children and adolescents with poor sleep quality usually show language developmental delay, however, there is no integrated evaluation tool for sleep and language, and a consistent conclusion is therefore not reached. Daytime naps are beneficial to consolidate vocabulary learning in infants, and it’s also relevant to vocabulary retention and generalization in children and adolescents. Children with sleep related breathing disorders show lower ability in receptive language comprehension and lower lexical level, and with the increase of their age, the severity of their language disorder becomes higher. Besides, sleep can promote language learning in children with neuro-developmental disorder.The neuro-physiological mechanism underlying sleep and language remains unknown, and one of the possible explanations is that sleep problem harms the information processing in frontal lobe and hippocampus, and interferes with neural plasticity. The injury includes memory, attention, executive function, auditory processing, and so on, and finally language development is damaged. Further research is necessary to clarify the relation and mechanism between these two elements, this will be helpful in finding out an effective way to promote language function in children with language retardation and/or combined with neuro-developmental disorder.
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Objective:To understand the swallowing function of the elderly in welfare homes of Wenzhou City,Zhejiang Province and to analyze the related factors of swallowing dysfunction. Methods:A total of 507 elderly people aged 60 years and over were surveyed by questionnaires in three welfare homes of Wenzhou City from January 2018 to January 2020.Hinds time-limited water drinking test was used to screen dysphagia. Multivariate unconditional logistic regression analysis was used to analyze the related factors of swallowing dysfunction. Results:The incidence of swallowing dysfunction was 26.04% (132 out of 507). Univariate analysis showed that there were significant differences in the incidence of swallowing dysfunction among the elderly in terms of age, spouse condition, self-care ability, health status, taking sleeping pills, cerebrovascular disease, nervous system disease and depression (P<0.05). Multivariate logistic regression analysis showed that the following factors were related to swallowing dysfunction among the elderly: age ≥80 years old, taking sleeping pills, cerebrovascular diseases, nervous system diseases and depression. Conclusion:The incidence of swallowing dysfunction in elderly people in welfare homes of Wenzhou City is high, especially those aged ≥80 years who need more attention. In addition, taking sleeping pills, cerebrovascular diseases, nervous system diseases and depression all increase the risk of swallowing dysfunction. Corresponding preventive and intervention measures should be formulated.
ABSTRACT
Circadian clock is an internal autonomous time-keeping system, including central clocks located in the suprachiasmatic nucleus (SCN) and peripheral clocks. The molecular circadian clock consists of a set of interlocking transcriptional-translational feedback loops that take the clock-controlled genes 24 h to oscillate. The core mechanism of molecular circadian clock is that CLOCK/BMAL1 dimer activates the transcription of cryptochromes (CRYs) and Periods (PERs), which act as transcriptional repressors of further CLOCK/BMAL1-mediated transcription. In addition to this basic clock, there is an additional sub-loop of REV-ERBα and RORα regulating the transcription of BMAL1. Approximately 80% protein-coding genes demonstrate significant rhythmicity. The earth rotation is responsible for the generation of the daily circadian rhythms. To coordinate metabolic balance and energy availability, almost all organisms adapt to the rhythm. Studies have shown that circadian clock integrating with metabolic homeostasis increases the efficiency of energy usage and coordinates with different organs in order to adapt to internal physiology and external environment soon. As the central organ of metabolism, the liver performs various physiological activities nearly all controlled by the circadian clock. There are multiple interactive regulation mechanisms between the circadian clock and the regulation of liver metabolism. The misalignment of metabolism with tissue circadian is identified as a high-risk factor of metabolic diseases. This article reviews the recent studies on circadian physiological regulation of liver glucose, lipid and protein metabolism and emphasizes oscillation of mitochondrial function. We also take an outlook for new methods and application of circadian clock research in the future.