Optimization of the preparation process of ethanol extracts from Centipeda minima and study on its anti-inflammatory activity of different extraction sites / 中国药房

OBJECTIVE To optimize the preparation technology of ethanol extracts from Centipeda minima， and investigate the anti-inflammatory activities of different extraction sites. METHODS Single factor test and response surface methodology were adopted to investigate the effects of ethanol volume fraction， extraction time， solid-liquid ratio and extraction times on the heating reflux extraction technology of total triterpenoids ethanol extract using the extraction rate of total triterpenoids of C. minima as indexes， optimize the extraction technology and carry out validation. Using dexamethasone as positive control drug， the effects of different extraction sites of C. minima （petroleum ether part， ethyl acetate part， n-butanol part， water part） on nitric oxide （NO） production in mononuclear macrophage RAW 264.7 cells of mice induced by lipopolysaccharide （LPS） were compared； the half inhibitory concentration （IC50） was calculated. RESULTS The optimal extraction technology of total triterpenoids ethanol extracts of C. minima was as follows： ethanol volume fraction of 70%， solid-liquid ratio of 1∶40 （g/mL）， extraction time of 2.0 h and extraction times of 3 times. The 3 times of validation tests showed that average extraction rate of total triterpenoids of C. minima was 1.134%， relative error of which with the predicted value was 0.02%. The petroleum ether part and ethyl acetate part of C. minima could inhibit the generation of NO in RAW 264.7 cells induced by lipopolysaccharide to different degrees. IC50 values of NO production were 2.44 μg/mL and 2.22 μg/mL， respectively， and both of them were lower than those of positive control drug dexamethasone （7.65 μg/mL）. CONCLUSIONS The optimized preparation process of ethanol extracts from C. minima is stability and feasibility. The petroleum ether part and ethyl acetate part have obvious anti-inflammatory effects.

Management of anastomotic leakage after laparoscopic surgery for adenocarcinoma of esophagogastric junction / 中华胃肠外科杂志

The incidence of adenocarcinoma of esophagogastric junction (AEG) is increasing at home and abroad. Laparoscopic surgery has gradually become the main means of surgical treatment of this kind of tumor. However, due to the special anatomical position of the tumor, the high position away from the broken esophagus and the narrow space in the mediastinum, laparoscopic anastomosis has the characteristics of difficult anastomosis and high anastomosis position. There is a high risk of anastomotic leakage after operation, which may cause serious consequences. Early identification of anastomotic leakage and unobstructed drainage by various means are the key to treatment. With the development of endoscopic technology, endoscopic methods such as covered stent and vacuum-assisted closure further improve the treatment efficacy. As a salvage measure, surgical treatment can achieve good treatment outcome, while accompanied by risk of complications and mortality, so we must strictly grasp the indications.

Impact of number and location of metastatic lymph nodes on prognosis in patients after resection for intrahepatic cholangiocarcinoma / 中华肝胆外科杂志

Objective:To study the impact of number and location of metastatic lymph nodes on prognosis of patients after radical resection for intrahepatic cholangiocarcinoma (ICC).Methods:A retrospective study was conducted on 105 patients who underwent radical resection and lymphadenectomy for ICC at the First Affiliated Hospital of Xi’an Jiaotong University from January 2010 to December 2020. There were 49 males and 56 females, with age of (58±10) years old. These patients were divided into 2 groups using the TNM staging (8th edition) into the N0 stage group ( n=62) and N1 stage group ( n=43). Using the NMLN staging, those with 0, 1-2, and >3 number of metastatic lymph nodes (NMLN) were divided into 3 groups: the stage 0 group ( n=62), stage 1 group ( n=24), and stage 2 group ( n=19). Of the 43 patients with lymph node metastasis, they were divided into 2 groups according to whether the lymph node metastasis was limited to the first lymph node station: the first station metastasis group ( n=11) and the non-first station metastasis group ( n=32). The general data, extent of lymph node dissection, pathological examinations, and postoperative survival outcomes of these patients were collected. Determination of risk factors for prognosis of ICC after radical resection was carried out. Results:The median number of lymph node harvested, or the detection of N0 and N1 staging were 6 (3, 8) and 6 (3, 10), respectively. There were no significant differences between the two groups ( Z=-1.10, P>0.05). Overall survival of patients in the N0 stage group was better than the N1 stage group (32.0 vs. 9.0 months, χ 2=23.99, P<0.001). The median survival times of patients in the stage 0, stage 1 and stage 2 groups were 32.0, 14.0 and 6.0 months, respectively. There was a significant difference in overall survival among the 3 groups (χ 2=32.18, P<0.001). The time-dependent receiver operating characteristic curves showed that NMLN staging had better prognostic predictive ability than the N staging. The median survival times of the first station metastasis group and the non-first station metastasis group were 18.0 and 7.0 months, respectively. There was no significant difference between the two groups (χ 2=2.21, P>0.05). Multivariate analysis showed that tumor carbohydrate antigen 125>35.0 U/ml ( HR=4.297, 95% CI:2.418-7.634), hepatolithiasis ( HR=2.713, 95% CI:1.499-4.911), T4 staging ( HR=2.934, 95% CI:1.478-5.825), NMLN stage 1 ( HR=2.759, 95% CI:1.500-5.077) and NMLN stage 2 ( HR=7.376, 95% CI:3.553-15.312) were independent risk factors affecting prognosis of ICC after radical resection ( P<0.05). Conclusion:Lymph node metastasis was an important poor prognostic risk factor after radical resection of intrahepatic cholangiocarcinoma. The prognosis of ICC patients was related to the NMLN, but it was not related to the location of metastatic lymph nodes.

Harder maintained than achieved: Challenges of maintaining malaria-free in China / 中国血吸虫病防治杂志

On June 2021, China was certified malaria-free by WHO. However, the global number and death of malaria cases have recently increased, and the malaria vectors will continue to inhabit in China, resulting in a high difficulty in consolidation of malaria elimination achievements. Hereby, we analyze the current challenges and propose the future priority of the national malaria control program in China, in order to provide insights into prevention of re-establishment of imported malaria in the country.

Pathological Mechanism of HSOS in Rats Induced by Different Doses of Monocrotaline / 中国实验方剂学杂志

ObjectiveTo observe the pathological changes of hepatic sinusoidal obstruction syndrome （HSOS） induced by different doses of monocrotaline （MCT） in rats， investigate the dose and duration of modeling， and elucidate the mechanism. MethodA total of 72 male SD rats were randomized into normal group （n=12）， and low-， medium-， and high-dose MCT groups （n=20 per group， 80，120，160 mg·kg-1， respecctively）. In the model groups， different doses of MCT were intragastrically administered to induce the HSOS in rats. After 48 h and 120 h separately， rats in each group were sacrificed and sampling was performed. The survival rate of rats in each group was calculated， and the body weight， liver weight， and and serum liver function indexes of the rats were examined. The histopathological changes of the liver were observed based on scanning electron microscopy， hematoxylin and eosin （HE） staining， and Sirius red （SR） staining. Glutathione S-transferase （GST） activity， total superoxide dismutase （T-SOD） activity， and malondialdehyde （MDA） content of liver tissue homogenate were measured with microplate method. The expression of liver tissue-related indexes was detected by real-time polymerase chain reaction （PCR）， Western blot， and immunohistochemistry. ResultThe activity of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in MCT groups rose with the increase in MCT dose （P<0.05， P<0.01） compared with that in the normal group. With the extension of modeling time， the activity of serum ALT and AST in the low-dose group decreased （P<0.01）， while the activity of them in the medium-dose and high-dose groups increased （P<0.01）. HE staining showed that hepatocyte necrosis， inflammatory cell infiltration， and erythrocyte accumulation in MCT groups. Electron microscopy demonstrated that fenestrae of liver sinusoidal endothelial cells widened and the sieve plates disappeared. Morever， the injury was worsened with the increase in MCT dose. In addition， the expression of CD44 in MCT groups was significantly reduced compared with that in the normal group （P<0.05， P<0.01）. SR staining showed that no positive staining was found in model groups after 48 h， while collagen deposition in portal areas and liver sinusoids could be seen in model groups after 120 h. MCT groups showed increase in MDA content and GST activity and decrease in T-SOD activity compared with the normal group， particularly the medium-dose and high-dose groups （P<0.01）， and the changes were dose-dependent after 120 h （P<0.01）. The protein expression of CD68 （pro-inflammatory macrophage marker） was raised with the increase in dosage， which was consistent with the results of immunohistochemistry （P<0.01）， while CD163 （anti-inflammatory macrophage marker） protein and mRNA expression was significantly decreased with the increase in dosage （P<0.01）. Western blot results showed that the expression of phosphorylated nuclear factor-κB/nuclear factor-κB （p-NF-κB/NF-κB） and phosphorylated protein kinase B/protein kinase B （p-Akt/t-Akt） was significantly increased in medium-dose and high-dose MCT groups （P<0.05，P<0.01）. The protein expression of α-smooth muscle actin （α-SMA） in liver tissues in MCT groups was significantly increased over time and with the increase in dose， and the mRNA expression of α-SMA， collagen type I α1 （Col1a1）， and collagen type Ⅳ α1 （Col4a1） showed the same trend （P<0.05， P<0.01）. The results of TUNEL staining showed that apoptotic cells were increased with the rise of MCT dose， while B-cell lymphoma-2（Bcl-2） /Bcl-2 associated X protein （Bax） was remarkably decreased （P<0.01）. ConclusionHSOS in rats induced by intragastric administration of different doses of MCT was aggravated with the increase of dosage. In the low-dose （80 mg·kg-1） MCT group， the liver healed spontaneously over time. However， liver damage caused by MCT of 120 mg·kg-1 and 160 mg·kg-1 aggravated over time， and even fibrosis and death occurred. The pathological mechanism of MCT-induced HSOS in rats may be that MCT triggered intense oxidative stress in liver tissue， thus activated pro-inflammatory macrophages to secrete large amounts of inflammatory factors， and further activated the NF-κB/Akt signalling pathway， leading to severe cell damage and death.

Correlation analysis between corneal biomechanical parameters and high-order aberrations in myopia children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the correlation between corneal biomechanical parameters measured by the corneal visualization Scheimpflug Technology(Corvis ST)and corneal high-order aberrations(HOAs)in children with mild to moderate myopia.METHODS:A cross-sectional study. A total of 255 pediatric patients with myopia enrolled from April to July 2021 in Tianjin Medical University Eye Hospital were continuously collected, and all the right eyes were taken for analysis. Corneal biomechanical parameters were obtained from Corvis ST. Pentacam three-dimensional anterior segment analyzer was used to measure total corneal higher-order aberrations(RMSh), third order aberrations(RMS3)and fourth order aberrations(RMS4).RESULTS:RMS3 was positively correlated with the second applanation time(A2T)(r=0.175, P=0.009)and negatively correlated with the axis length(AL)(r=-0.155, P=0.014). RMS4 was negatively correlated with the highest concavity radius(HCR)(r=-0.165, P=0.009). RMSh was negatively correlated with HCR and AL(r=-0.152, P=0.037; r=-0.175, P=0.005).CONCLUSION:There is a correlation between corneal biomechanical parameters and HOAs in children with myopia. Cornea with higher stiffness and stronger deformation resistance has smaller RMS3, RMS4 and RMSh.

Problems in randomized controlled trial on acupuncture and moxibustion for migraine in the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine / 中国针灸

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.

Effects of unrestricted area soft tissue manipulation on pain severity in patients with chronic neck pain: a systematic review and Meta-analysis / 中国医师进修杂志

Objective:To systematically evaluate of the impact of non-specific soft tissue manipulation on pain severity in patients with chronic neck pain.Methods:Trials included in Meta-analysis were determined by searching PubMed, Embase, Cochrane Library, Web of Science and 5 English databases in the U.S. Clinical Trial Registry. The search terms include the subject terms of neck pain, soft tissue treatment, massage, and myofascial release. Two reviewers independently selected studies, extracted data and assessed the quality of the studies. The included trials were assessed by using the Cochrane risk-of-bias tool. STATA statistical software 16.0 was used for statistical analysis. Additionally, subgroup analysis and sensitivity analysis were performed to analyze the sources of heterogeneity and assess the stability of research results. Begg funnel plot and Egger′s publication bias plot were used to assess potential publication bias.Results:This systematic review included a total of 12 randomized controlled trials (566 patients in total). The participants were 18 to 85 years old. Most of the included studies were of medium quality. This Meta-analysis validated the effectiveness of soft tissue manual therapy on alleviating pain symptoms in patients with chronic neck pain ( ES =-0.83, 95% CI -1.15 to -0.51, P = 0.001). The Begg funnel plot indicated that there may be potential publication bias. Conclusions:This Meta-analysis found that soft tissue manual therapy has a significant effect on alleviating the pain of patients with chronic neck pain. However, different pain assessment tools could have a certain impact on the Meta-analysis results.

Effects of SKP1 gene interference on apoptosis and regulation mechanism of ubiquitin-proteasome system in Parkinson's disease cell model / 中华行为医学与脑科学杂志

Objective:To investigate the effect of interfering S-phase kinase associated protein 1 (SKP1) gene on apoptosis in Parkinson's disease(PD) cell model induced by 1-methyl-4-phenyl-pyridine ion (MPP+ ) and the mechanism of ubiquitin proteasome system degradation of α-synuclein (α-syn) influence.Methods:SH-SY5Y cells were divided into control group, MPP+ group, SKP1 interference group, and SKP1 interference+ MG132(UPS inhibitor) group.The cells in the control group were cultured normally. The cells in the latter three groups were incubated with MPP+ (0.5 mmol/L) for 24 h as PD model cells.The cells in SKP1 interference group were transfected with lentivirus SKP1-siRNA, and the cells in SKP1 interference+ MG132 group were transfected with lentivirus SKP1 siRNA and added with MG132 (0.5 μmol/L) for 24 h. The protein levels and mRNA levels of SKP1, microtubule-associated protein light chain 3 (LC3), lysosome-associated membrane protein (LAMP), α-syn, ubiquitin activating enzyme E1 (UBE1), parkin, and p27 in cells were detected by Western blot and RT-PCR.Flow cytometry was used to detect cell apoptosis and cycle level, and CCK-8 method was used to detect cell proliferation level.Co-immunoprecipitation method was used to explore the interaction between SKP1 and p27. SPSS 23.0 software was used for statistical analysis. One-way ANOVA was used for comparison among groups, and LSD test was used for further pairwise comparison.Results:RT-PCR and Western blot results showed that the mRNA levels and protein levels of autophagy related proteins and ubiquitin related proteins LC3, LAMP2, α-syn, UBE1, parkin and p27 in the four groups were statistically significant(mRNA: F=99.155, 43.028, 138.464, 28.200, 22.009, 28.147, all P<0.05; F=245.517, 157.634, 315.920, 2 336.472, 477.429, 2 350.201, all P<0.05). The mRNA and protein levels of LC3, Lamp2, α-syn and p27 in SKP1 interference group were lower than those in MPP+ group (all P<0.05), while the mRNA and protein levels of UBE1 and parkin were higher than those in MPP+ group (all P<0.05). The mRNA and protein levels of LC3, α-syn and p27 in SKP1 interference+ MG132 group were higher than those in SKP1 interference group (all P<0.05), and the mRNA and protein levels of UBE1 and parkin were lower than those in SKP1 interference group (all P<0.05). The results of flow cytometry and CCK-8 method showed that the apoptosis rate and cell inhibition rate among the four groups were significantly different( F=2 749.420, 171.508, both P<0.05). The apoptosis rate of SKP1 interference group was lower than that of MPP+ group ((8.22±0.25)%, (15.30±0.21)%, P<0.05), while the cell inhibition rate of SKP1 interference group was lower than that of MPP+ group((26.31±3.73)%, (55.05±3.84)%, P<0.05). The apoptosis rate of SKP1 interference+ MG132 group ((9.49±0.07)%) was higher than that of SKP1 interference group, and the cell inhibition rate ((36.06±2.85)%) was higher than that of SKP1 interference group (both P<0.05). The results of immunoprecipitation method showed that P27 decreased after SKP1 immunoprecipitation. Conclusion:After SKP1 gene was interfered, the autophagy function of PD cells decreased, which may be related to parkin promoting α-syn ubiquitination, activating UBE1/ Parkin-mediated UPS pathway to degrade α-syn, and mediating P27 to inhibit apoptosis.

Field evaluation and future applications of the world’s first malaria vaccine / 中国血吸虫病防治杂志

This paper describes the safety, efficacy and operability of the world’s first malaria vaccine (RTS, S/AS01) in latest field pilot studies and the recommendations from the WHO expert group for its use. In addition, further studies to examine the associations of inoculation rate and full-dose rate with the reduction in morbidity and mortality of malaria among target children and explore the scientific evidence for seasonable preventive vaccination with 5 doses and more among children at ages of below 5 years are recommended.

Differences between male and female leaves of Schisandra sphenanthera: based on RNA-Seq / 中国中药杂志

Schisandra sphenanthera is dioecious and only the fruits of female plants can be used as medicine and food. It is of great significance for the cultivation and production of S. sphenanthera to explore the differences between male and female plants at the non-flowering stage and develop the identification markers at non-flowering or seedling stage. In this study, the transcriptome of male and female leaves of S. sphenanthera at the non-flowering stage was sequenced by Illumina high-throughput sequencing technology and analyzed based on bioinformatics. A total of 236 682 transcripts were assembled by Trinity software and 171 588 were chosen as unigenes. Finally, 1 525 differentially expressed genes(DEGs) were identified, with 458 up-regulated and 1 067 down-regulated in female lea-ves. The down-regulated genes mainly involve photosynthesis, photosynthesis-antenna protein, carbon fixation in photosynthetic or-ganisms, and other pathways. Real-time quantitative PCR(qPCR) identified two genes between male and female leaves and one of them was a HVA22-like gene related to floral organ development and abscisic acid(ABA). Enzyme linked immunosorbent assay(ELISA) was applied to determine the content of ABA, auxin, gibberellin, and zeatin riboside(ZR) in leaves of S. sphenanthera. The results showed that the content of ABA and ZR in male leaves was significantly higher than that in female leaves. The involvement of down-regulated genes in female leaves in the photosynthesis pathway and the significant differences in the content of endogenous hormones between male and female leaves lay a scientific basis for analyzing the factors affecting sex differentiation of S. sphenanthera.

Functional evaluation after function-preserving gastrectomy / 中华胃肠外科杂志

With the increase of people's health awareness and the progress of medical diagostic technology in recent years, the diagnosis rate of early gastric cancer is increasing year by year. Although radical surgery has good efficacy, how to maximize the preservation of the normal anatomy and function of the stomach and improve the quality of life of patients in the pursuit of radical surgery has become a more important issue in the treatment of early gastric cancer. Under the condition of ensuring radical lymph node dissection, function-preserving gastrectomy can fully preserve gastric function by reducing the resection extent and preserving the pylorus and the vagus nerve, which has advantage of improving quality of life and has great potential in the treatment of early gastric cancer. However, there is no functional evaluation standard for function-preserving gastrectomy at present. Most of the patients are evaluated by quality of life scale, which is relatively subjective. Even though the evaluation of endoscopy, hematology and other objective means can indicate the benefit degree in quality of life brought by functional reconstruction, the evidence level is limited. Therefore, this paper discusses the research status of function-preserving gastrectomy evaluation, postoperative complications, postoperative nutritional status, auxiliary examination and other items in the evaluation of gastric function, and analyzes the prospects of research direction in this field.

Analysis of the results of international demand survey on / 中国针灸

The survey is conducted prior to the development of international standard,

The reliability and validity of the Chinese version of the Orebro musculoskeletal pain questionnaire / 中华物理医学与康复杂志

Objective:To evaluate the reliability and validity of the Chinese version of the Orebro musculoskeletal pain questionnaire (OMPQ-CHN) using patients with non-specific lower back pain.Methods:The OMPQ was translated into simplified Chinese according to the Beaton cross-cultural translation guidelines, and then 186 patients with acute or subacute lower back pain were asked to respond to its questions. Based on the results, the internal consistency and test-retest reliability were quantified, and its validity was assessed using content, criterion-related and predictive validity.Results:The Cronbach′s α for the instrument was 0.804. Its ICC was 0.833 (95% CI: 0.683-0.915). I-CVI ranged from 0.86 to 1, S-CVI/Ave=0.99. The correlation between the OMPQ-CHN and other questionnaires ranged from r=0.419 to r=0.646. The AUCs predicting pain, dysfunction and sick leave ranged from 0.723 to 0.810. Conclusions:The OMPQ-CHN has good reliability and validity, and suitably assesses the psychosocial risk factors of Chinese patients with low back pain.

Risk scoring system for bronchopulmonary dysplasia in very and extremely preterm infants / 中华围产医学杂志

Objective:To investigate the risk factors and establish a risk scoring system for bronchopulmonary dysplasia (BPD) in very and extremely preterm infants.Methods:From December 2013 to December 2018, 254 very and extremely preterm infants with less than 32 weeks of gestation hospitalized for 28 d and above in the Third Staff Hospital of Baotou Steel Group were retrospectively enrolled. According to the diagnostic criteria of BPD, they were divided into　the BPD group ( n=129) or the non-BPD group ( n=125). Clinical data and the risk factors for BPD were analyzed with univariate t-test, Chi-square test, rank-sum test, and multivariate logistic regression analysis. Based on the results, the risk scoring system was evaluated by receiver operating characteristic (ROC) curve, sensitivity, and specificity. Results:Logistic regression analysis showed that gestational age, neonatal respiratory distress syndrome (NRDS), ventilator-associated pneumonia (VAP), and duration of ventilation >7 d were the risk factors for BPD (all P<0.05). When the area under the ROC curve was 0.868 (95% CI: 0.823-0.913, P<0.001) and the maximum Youden index was 0.644, the sensitivity of the scoring systems for BPD was 0.884 (95% CI: 0.812-0.931), and the specificity was 0.760 (95% CI: 0.674-0.830). Conclusions:Gestational age, NRDS, VAP, and prolonged duration of ventilation were the risk factors for BPD. The risk scoring system established has the prediction value on BPD in very and extremely preterm infants.

Interpretation of guideline on adrenaline autoinjector application: European Academy of Allergy and Clinical Immunology anaphylaxis guideline (2021 update) / 中华实用儿科临床杂志

Anaphylaxis is a hypersensitivity reaction that is rapid in onset, multi-system involved and can be fatal.Adrenaline is the first-line treatment of anaphylaxis.Adrenaline autoinjector is an important device in emergent situation.In European Academy of Allergy and Clinical Immunology anaphylaxis guideline updated in 2021, adrenaline autoinjector is systemically described and recommended.The following interpretation is focused on adrenaline autoinjector, including advantages, indications for prescription, pharmacokinetic data, dose and long-term management, aimed to enhance understanding of this device and standardize future application.

Monogenetic disorders associated with eczema and elevated immunoglobulin E / 中华实用儿科临床杂志

Eczema and elevated blood immunoglobulin E are not only characteristics of atopic dermatitis, but may also be a manifestation of skin-related monogenic diseases and certain syndromes or inborn error of immunity, such as hyper IgE syndrome, Wiskott-Aldrich syndrome, immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome, Omenn syndrome, atypical DiGeorge syndrome, Comèl-Netherton syndrome, severe dermatitis-multiple allergies-metabolic wasting syndrome, and prolinase deficiency.These monogenic diseases are present as severe eczema or eczema-like rash in childhood, and some of them may have an elevated IgE phenotype from infancy.Besides eczema-like rash and elevated IgE, these monogenic diseases also have other associated phenotypes.Therefore, acquaintance with the phenotypic characteristics of these diseases contributes to better identification in clinical practice.Early identification and effective management of these diseases conduce to the improvement in the prognosis.In this paper, the phenotypes of these diseases would be summarized from a clinical perspective in an attempt to provide a basis for clinicians to identify and further manage these diseases.

Effect of Modified Bazhentang on Nutritional Status and Immune Function of Gastric Cancer Patients with Neoadjuvant Chemotherapy / 中国实验方剂学杂志

Objective:To observe the effect of modified Bazhentang on the nutritional status and immune function of patients with Qi and blood deficiency syndrome in neoadjuvant chemotherapy （NAC） for gastric cancer. Method:One hundred and ten patients were randomly divided into observation group and control group with 55 cases each. Both groups accepted FOLFOX6 protocol. Patients in control group took Jianpi Shengxue tablets orally， 3 tablets/time， 3 times/day. Patients in observation group received modified Bazhentang， 1 dose/day. The course of treatment was six weeks in both groups. Before and after treatment， scores were graded according to patient generated-subjective global assessment （PG-SGA）， Qi and blood deficiency syndrome， and the Revised Piper Fatigue Scale （PFS-R）. Levels of serum total protein （TB）， albumin （ALB）， prealbumin （PAB）， CD4⁺， CD8⁺， helper T lymphocyte 17 （Th17）， regulatory T cell （Treg）， immunoglobulin G （IgG）， IgM， and IgA were detected before and after therapy. Body mass index （BMI） and fat free mass index （FFMI） were measured before and after treatment. Weight loss was recorded， and the acute or subacute toxicity of anticancer drugs was evaluated. Result:The degree of malnutrition in the observation group was lower than that in the control group （<italic>Z</italic>=2.401，<italic>P</italic><0.01）. The levels of TB， ALB and PAB in the observation group were higher than those in the control group （<italic>P</italic><0.01）. The CD4⁺， Treg and CD4⁺/CD8⁺ levels in the observation group were higher than those in the control group （<italic>P</italic><0.01）. The CD8⁺， Th17 and Th17/Treg levels were lower than those in the control group （<italic>P</italic><0.01）. Besides， the levels of IgM and IgA in the observation group were higher than those in the control group （<italic>P</italic><0.01）. The PG-SGA score and weight loss in the observation group were lower than those in the control group （<italic>P</italic><0.01）. The BMI and FFMI data of the observation group were higher than those of the control group （<italic>P</italic><0.05）. The scores of PFS-R and Qi-blood deficiency syndrome were lower than those of the control group （<italic>P</italic><0.01）. The incidence of nausea and vomiting in the observation group was 45.45% （25/55）， lower than 65.45% （36/55） in the control group （<italic>χ</italic>²=4.452，<italic>P</italic><0.05）. Conclusion:Modified Bazhentang can be used to assist gastric cancer patients with NAC， which can improve nutritional status and immune function， promote immune balance， reduce clinical symptoms and fatigue， and reduce chemotherapy toxicity and side effects， so it is worthy of clinical use.

Effect of Polysaccharides from Plantaginis Semen on Renal Injury and Gut Microbiota in Rats with Membranous Nephropathy / 中国实验方剂学杂志

Objective:To study the protective effect of polysaccharides from Plantaginis Semen （PSP） against renal injury in rats with membranous nephropathy （MN） and its influence on the gut microbiota to provide a theoretical basis for the further investigation of PSP in the treatment of MN. Method:The MN model was induced by tail vein injection of cationic bovine serum albumin （C-BSA， 3.5 g·L^-1） in rats with a modeling period of seven weeks. At the 4th week of modeling， the model rats were divided into a model group， a positive drug group （benazepril hydrochloride， 10 mg·kg^-1·d^-1）， a PSP high-dose group （PSP-H， 800 mg·kg^-1·d^-1）， a PSP medium-dose group （PSP-M， 400 mg·kg^-1·d^-1）， and a PSP low-dose group （PSP-L， 200 mg·kg^-1·d^-1） according to the random number table， with 10 in each group. Ten healthy rats were assigned to the normal control group. The rats in the normal control group and the control group received an equal amount of physiological saline by gavage， and those in the groups with drug intervention were administered correspondingly，once a day，for consecutive four weeks. The pathological changes of rat kidney and colon tissues were observed by optical microscopy. The enzyme-linked immunosorbent assay （ELISA） was used to detect the content of tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>） and interleukin-1<italic>β </italic>（IL-1<italic>β</italic>） in the serum and colon tissues. The immunohistochemistry （IHC） was used to detect the protein expression of TNF-<italic>α </italic>and IL-1<italic>β </italic>in renal tissues. The 16S rRNA sequencing method was used to investigate the effect of PSP on the gut microbiota in MN rats. Result:Compared with the normal control group， the model group showed enlarged glomeruli， thickened basement membrane， atrophied colonic gland， increased TNF-<italic>α</italic> and IL-1<italic>β</italic> in the serum and colon tissues （<italic>P</italic><0.05）， and elevated protein expression of TNF-<italic>α</italic> and IL-1<italic>β </italic>（<italic>P</italic><0.01）. Compared with the model group， the positive drug group and the PSP-H group displayed shrunk glomerular capsules， relieved basement membrane thickening， and neatly arranged colonic mucosa in colon tissues， while the PSP-M and PSP-L groups were inferior in improving renal tissues and colon tissues. Additionally， the PSP-H and PSP-M groups showed declining TNF-<italic>α</italic> and IL-1<italic>β</italic> in the serum and colon tissues （<italic>P</italic><0.05） and dwindled protein expression of TNF-<italic>α</italic> and IL-1<italic>β </italic>in the renal tissues （<italic>P</italic><0.01）. No significant difference was observed in the PSP-L group. Compared with the normal control group， the model group showed increased abundance of Firmicutes and decreased abundance of Bacteroidetes. After PSP intervention， the abundance of Firmicutes was decreased， while that of Bacteroidetes was increased， and such changes were predominant in the PSP-H group. Conclusion:PSP can effectively alleviate renal injury， reduce the expression of inflammatory factors， regulate the structure of gut microbiota， and improve the damaged intestinal barrier of MN rats.

Effect of early postoperative systemic inflammatory response syndrome (SIRS) on the short-term outcome of patients with acute Stanford type A aortic dissection / 中国胸心血管外科临床杂志

@#Objective    To investigate the effect of early postoperative systemic inflammatory response syndrome (SIRS) on the short-term outcome of patients with acute Stanford type A aortic dissection (ATAAD). Methods    The clinical data of 88 patients with ATAAD who were treated in our hospital from January 2018 to January 2020 were retrospectively analyzed. Patients were divided into a SIRS group (n=37) and a non-SIRS group (n=51) according to whether SIRS occurred within 24 hours after surgery. The perioperative data of the two groups were compared. Results    There was no significant difference between the two groups in general clinical data, preoperative left ventricular ejection fraction, white blood cell (WBC) and body temperature (P>0.05). Compared with the non-SIRS group, the cardiopulmonary bypass time in the SIRS group was significantly longer (P<0.05), and the WBC and body temperature within 1 day after surgery in the SIRS group were higher (P<0.01). A significant difference was revealed in the mechanical ventilation time, ICU stay, total hospitalization time and hospitalization costs between two groups (P<0.01). Patients in the SIRS group had higher postoperative acute physiology and chronic health evaluationⅡscores, sequential organ failure assessment score as well as a greater risk of developing postoperative acute lung injury, acute kidney injury, continuous renal replacement therapy, delirium, liver dysfunction and morbidity (P<0.05). Conclusion    Early postoperative SIRS significantly increases the incidence of major adverse complications and the mortality rate of patients with ATAAD.