Effect of repetitive transcranial magnetic stimulation on walking of stroke patients at recovery stage / 中国康复理论与实践

ObjectiveTo investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on walking function of stroke patients at recovery stage. MethodsFrom January, 2021 to January, 2022, 60 stroke inpatients at recovery stage from Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine were randomly divided into group A (n = 20), group B (n = 20) and group C (n = 20). All the groups accepted conventional rehabilitation therapy and lower limb robot-assisted training, while group B accepted pseudo-rTMS, and group C accepted high-frequency rTMS, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT) and gait analysis before and after treatment. ResultsThe score of FMA-LE, TUGT, pace, stride width, stride, double support phase time, affected side support phase time, affected side swing phase time, healthy side support phase time and healthy side swing phase time improved after treatment in all the groups (|t| > 5.990, P < 0.001), and all the indexes improved the most in group C (F > 3.210, P < 0.05), except double support phase time. ConclusionHigh-frequency rTMS could facilitate the recovery of lower limb function and walking of stroke patients at recovery stage.

The expression of oxidative stress genes related to myocardial ischemia reperfusion injury in patients with ST-elevation myocardial infarction / 世界急诊医学杂志（英文）

@#BACKGROUND: We aimed to investigate the gene expression of myocardial ischemia/reperfusion injury (MIRI) in patients with acute ST-elevation myocardial infarction (STEMI) using stress and toxicity pathway gene chip technology and try to determine the underlying mechanism. METHODS: The mononuclear cells were separated by ficoll centrifugation, and plasma total antioxidant capacity (T-AOC) was determined by the ferric reducing ability of plasma (FRAP) assay. The expression of toxic oxidative stress genes was determined and verified by oligo gene chip and quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, gene ontology (GO) enrichment analysis was performed on DAVID website to analyze the potential mechanism further. RESULTS: The total numbers of white blood cells (WBC) and neutrophils (N) in the peripheral blood of STEMI patients (the AMI group) were significantly higher than those in the control group (WBC: 11.67±4.85 ×109/L vs. 6.41±0.72 ×109/L, P<0.05; N: 9.27±4.75 ×109/L vs. 3.89±0.81 ×109/ L, P<0.05), and WBCs were significantly associated with creatine kinase-myocardial band (CK-MB) on the first day (Y=8.945+0.018X, P<0.05). In addition, the T-AOC was significantly lower in the AMI group comparing to the control group (12.80±1.79 U/mL vs. 20.48±2.55 U/mL, P<0.05). According to the gene analysis, eight up-regulated differentially expressed genes (DEGs) included GADD45A, PRDX2, HSPD1, DNAJB1, DNAJB2, RAD50, TNFSF6, and TRADD. Four down-regulated DEGs contained CCNG1, CAT, CYP1A1, and ATM. TNFSF6 and CYP1A1 were detected by polymerase chain reaction (PCR) to verify the expression at different time points, and the results showed that TNFSF6 was up-regulated and CYP1A1 was down-regulated as the total expression. GO and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis suggested that the oxidative stress genes mediate MIRI via various ways such as unfolded protein response (UPR) and apoptosis. CONCLUSIONS: WBCs, especially neutrophils, were the critical cells that mediating reperfusion injury. MIRI was regulated by various genes, including oxidative metabolic stress, heat shock, DNA damage and repair, and apoptosis-related genes. The underlying pathway may be associated with UPR and apoptosis, which may be the novel therapeutic target.

Ultrasound analysis for pancreatic panniculitis: A case report / 中南大学学报(医学版)

Pancreatic panniculitis (PP) is a necrotizing inflammation of subcutaneous fat that is a rare complication of pancreatic disease appearing in 2% to 3% of all patients. It is more common in the elderly and often affects the extremities. It presents as skin inflammation with pain and erythema nodules. We report a case of acute pancreatitis associated with PP in an old female. She was admitted for vomiting and abdominal pain for 3 days and presented with a 2-week history of erythematous subcutaneous nodules on her legs. Laboratory and ultrasonic findings revealed acute pancreatitis. High frequency ultrasound showed hypoechoic foci in subcutaneous soft tissue layer and adipose layer. Histopathological examination confirmed the diagnosis of PP. Nodules disappeared with the resolution of acute pancreatic inflammation. PP may be the first manifestation of pancreatic disease. Imaging features of this pathology are seldom described and ultrasonic diagnosis experience is worth to be accumulated.

Qishen Taohong Granule () as Adjuvant Therapy for Improving Cardiac Function and Quality of Life in Patients with Chronic Heart Failure: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To confirm the improvement of cardiac function and quality of life (QOL) in patients with chronic heart failure (CHF) via Chinese medicine (CM) Qishen Taohong Granule (, QTG).@*METHODS@#This study was a single-center, prospective, randomized, controlled clinical trial. Seventy-six patients from 27 to 84 years old diagnosed with CHF New York Heart Association (NYHA) class II or III in stage C were enrolled and randomly assigned at a 1:1 ratio to receive QTG or trimetazidine (TMZ), in addition to their standard medications for the treatment of CHF. The study period was 4 weeks. The primary outcomes included cardiac function evaluated by NYHA classification and left ventricular ejection fraction (LVEF), as well as QOL evaluated by CHF Integrated Chinese and Western Medicine Survival Scale (CHFQLS). The secondary outcomes included 6-min walking test (6MWT), CM syndrome score, symptom and sign scores and N-terminal pro-B-type natriuretic peptide (NT-proBNP). All indices were measured at baseline and the end of the trial.@*RESULTS@#At the 4-week follow-up period, the effective rate according to NYHA classification in the QTG group was better than that in the TMZ group (74.29% vs. 54.29%, P<0.05). But there was no significant difference in post-treatment level of LVEF between the two groups (P>0.05). The CHFQLS scores improved by 13.82±6.04 vs. 7.49±2.28 in the QTG and TMZ groups, respectively (P<0.05). Subgroup analysis of the CHFQLS results showed that physiological function, role limitation and vitality were significantly higher in the QTG group than in the TMZ group (15.76±7.85 vs. 7.40±3.36, P<0.05; 16.00±8.35 vs. 10.53±4.64, P<0.05; 15.31±8.09 vs. 7.89±4.60, P<0.05). Compared with TMZ group, treatment with QTG also demonstrated superior performance with respect to 6MWT, CM syndrome, shortness of breath, fatigue, gasping, general edema and NT-proBNP level. No significant adverse reactions or adverse cardiac events occurred during treatment in either group.@*CONCLUSION@#In addition to conventional treatments, the use of QTG as an adjuvant therapy significantly improved cardiac function and QOL in patients with CHF class II or III in stage C. [Registration No. ChiCTR1900022036 (retrospectively registered)].

Progress in hepatic fibrinogen storage disease / 国际儿科学杂志

Hepatic fibrinogen storage disease(HFSD)is a rare autosomal dominant disease, belonging to the group of endoplasmic reticulum(ER) storage diseases.It is characterized by the accumulation of abnormal fibrinogen in the ER of hepatocytes, leading to different degrees of chronic liver disease, severe cirrhosis, and a lack of plasma fibrinogen, which is related to mutations in genes encoding fibrinogen-related peptides.This article will review the molecular structure and genes of fibrinogen and the clinical manifestations, histopathology, molecular genetics and treatment of HFSD.

Reconstruction of multiple metatarsus and soft tissue defects with fibular flap and fibular artery chimeric: A case report / 中华显微外科杂志

In May 2019, a patient who suffered with multiple foot metatarsus injury with soft tissues defect was treated in the Hand and Foot Microsurgery of Xi'an Fengcheng Hospital, by using chimeric peroneal artery for phase-1 reconstruction of metatarsus with folded fibular flap, foot cross arch and soft tissue defects. After 2 years, the arch of foot as intact without collapse. There was no arthritic lesions. The height, arc and width of metatarsus were very close to the healthy side. The flap and plantar were smooth without abrasion and ulceration. The patient could walk, run and stand with single-foot stand, and able to carry out heavy physical work continuously.

Effect of acupuncture for dysphagia after stroke based on fiberoptic endoscopic swallowing function evaluation / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture combined with regular treatment and swallowing function training on pharyngeal motor, sensory function and penetration-aspiration function in patients with dysphagia after stroke.@*METHODS@#A total of 60 patients with dysphagia after stroke were randomly divided into a control group and an observation group, 30 patients in each group. Both groups were treated with conventional treatment and swallowing function training; in addition, the observation group was treated with acupuncture at Lianquan (CV 23), Fengfu (GV 16), Yifeng (TE 17). All the treatments were given once a day, 5 days a week, for totally 4 weeks. In the two groups, the pharyngeal motor and sensory function, penetration-aspiration scores were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES), and the Kubota water swallowing test scores were assessed before and after treatment, and the clinical effects were compared.@*RESULTS@#After treatment, the pharyngeal motor and sensory function in the two groups were all higher than those before treatment (P<0.05), and those in the observation group were better than the control group (P<0.05). After treatment, the penetration-aspiration scores and Kubota water swallowing test scores in the two groups were all lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate was 93.3% (28/30) in the observation group, which was better than 73.3% (22/30) in the control group (P<0.05).@*CONCLUSION@#Acupuncture combined with regular treatment and swallowing training could improve the pharyngeal motor and sensory function, and penetration-aspiration scores in patients with dysphagia after stroke.

SUV39H1 is a New Client Protein of Hsp90 Degradated by Chaetocin as a Novel C-Terminal Inhibitor of Hsp90

Hsp90 is often overexpressed with activated form in cancer cells, and many key cellular proteins are dependent upon the Hsp90 machinery (these proteins are called “client protein”). Nowadays, more client proteins and more inhibitors of Hsp90 are being discovered. Chaetocin has been identified as an inhibitor of histone methyl transferase SUV39H1. Herein, we find that Chaetocin is an inhibitor of Hsp90 which binds to the C-terminal of Hsp90α. Chaetocin inhibited a variety of Hsp90 client proteins including AMl1-ETO and BCL-ABL, the mutant fusion-protein in the K562 and HL-60 cells. SUV39H1 mediates epigenetic events in the pathophysiology of hematopoietic disorders. We found that inhibition of Hsp90 by Chaetocin and 17-AAG had ability to induce degradation of SUV39H1 through proteasome pathway. In addition, SUV39H1 interacted with Hsp90 through co-chaperone HOP.These results suggest that SUV39H1 belongs to a client protein of Hsp90. Moreover, Chaetocin was able to induce cell differentiation in the two cells in the concentration range of Hsp90 inhibition. Altogether, our results demonstrate that SUV39H1 is a new client protein of Hsp90 degradated by Chaetocin as a novel C-terminal inhibitor of Hsp90. The study establishes a new relationship of Chaetocin and SUV39H1, and paves an avenue for exploring a new strategy to target SUV39H1 by inhibition of Hsp90 in leukemia.

Postoperative hypoalbuminemia is an independent risk factor for acute kidney injury after cardiac surgery under cardiopulmonary bypass / 中华肾脏病杂志

Objective:To investigate the effect of postoperative hypoalbuminemia on acute kidney injury (AKI) after cardiac surgery under cardiopulmonary bypass (CPB).Methods:The clinical data of adult patients undergoing cardiac surgery under CPB were retrospectively analyzed. The difference between preoperative and postoperative serum albumin level was compared. The patients were divided into hypoalbuminemia group (≤35 g/L) and non-hypoalbuminemia group (>35 g/L) according to the lowest serum albumin concentration within 48 hours after surgery. The incidence and severity of postoperative AKI were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to evaluate the effect of postoperative hypoalbuminemia on the incidence of postoperative AKI.Results:Among the 749 patients, the serum albumin level after cardiac surgery was significantly lower than that before surgery ( Z=-15.739, P<0.001), and the proportion of patients with hypoalbuminemia increased from 9.6% to 27.6% ( χ2=83.516, P<0.001). Postoperative AKI occurred in 273 patients, including 109 cases (52.7%) in hypoalbuminemia group and 164 cases (30.3%) in non-hypoalbuminemia group. The incidence of AKI in hypoalbuminemia group was significantly higher than that in non-hypoalbuminemia group ( χ2=32.443, P<0.001), and the severity of AKI in hypoalbuminemia group increased than that in non-hypoalbuminemia group ( Z=-2.098, P=0.036), and the time of hospital stay extended ( Z=-2.442, P=0.015). After adjusted by gender, age, preoperative hypoalbuminemia, comorbidities (hypertension, hyperuricemia, diabetes mellitus, cerebrovascular disease), renal insufficiency, preoperative heart function, coronary angiography, CPB time, aorta blocking time, type of heart surgery and postoperative hypotension, binary logistic regression analysis revealed that postoperative hypoalbuminemia was an independent risk factor for CPB-associated AKI ( OR=2.319, 95% CI 1.586-3.392, P<0.001). Conclusions:AKI is a common complication following cardiac surgery under CPB. Serum albumin after CBP is significantly lower than that before CBP, and postoperative hypoalbuminemia within 48 hours after surgery is an independent risk factor for AKI.

Correlation between eosinophil of stool and infant milk protein allergic enteritis / 中华实用儿科临床杂志

Objective:To investigate the changes of eosinophil(EOS) in feces of children with allergic enteritis caused by milk protein, and to provide basis for diagnosis and treatment of allergic enteritis.Methods:From July 2018 to June 2019, 70 children with milk protein allergic enteritis (allergic group), 50 children with non allergic common diarrhea (non-allergic group) and 50 children with healthy physical examination (healthy control group) were selected from Children′s Hospital of Nanjing Medical University.White blood cell(WBC), hemoglobin(Hb), blood platelet(PLT), EOS and the percentage of EOS(EOS%) of the 3 groups were counted by automatic hematology analyzer.The EOS in the feces of the 3 groups and the allergic group after treatment were counted by Gomori staining, and the correlation between EOS in the feces and milk protein allergic enteritis was analyzed.Results:For allergic group, EOS count in peripheral blood was(0.71±0.74)×10 9/L, EOS% was (7.56±5.96)%, and PLT was (382.96±85.98)×10 9/L.For non-allergic group, EOS was (0.31±0.18)×10 9/L, EOS% was (3.53±2.26)%, PLT was(315.12±69.81)×10 9/L.For healthy control group, EOS was(0.31±0.15)×10 9/L, EOS% was (3.66±1.65)%, and the PLT was(307.56±85.20)×10 9/L.The number of EOS, EOS% and PLT in allergic group were higher than those in non-allergic group and healthy control group ( F=13.606, 19.055, 16.074, all P<0.05). The number of EOS in feces of allergic group[(10.75 ±17.17)/ 50 fields at ×1 000]was significantly higher than that of non-allergic group[(1.16±3.09)/50 fields at ×1 000], the difference was statistically significant ( F=17.25, P<0.05), and there was no EOS in feces of healthy control group.After 4 weeks of avoidance of milk, EOS in feces decreased significantly in allergic group [(2.26±5.32)/50 fields at ×1 000], the difference was statistically significant ( t=5.822, P<0.05), while EOS in blood decreased [(0.56±0.47)×10 9/L], the difference was not statistically significant ( t=1.981, P>0.05). Conclusions:EOS in fecal of children with milk protein allergic enteritis increased obviously and decreased after treatment, is helpful to guide the clinical diagnosis and may become a new indicator of efficacy monitoring.

Correlation between body mass index and prognosis of gallbladder cancer / 国际外科学杂志

Objective:To explore the relationship between body mass index (BMI) and clinicopathological features and prognosis of gallbladder cancer.Methods:The clinical and follow-up data of three hundred and eighty-six patients of gallbladder carcinoma were retrospectively, who were treated from January 2008 to December 2013 in the Department of Hepatobiliary Surgery, Eastern Hepatobiliary Hospital, Second Military Medical University. According to the guidelines for prevention and control of overweight and obesity in Chinese adults, the patients were divided into three groups: normal weight group(BMI<23.5 kg/m 2, 239 cases, accounting for 61.9%), overweight group (23.5 kg/m 2≤BMI<27.5 kg/m 2, 127 cases, accounting for 32.9%) and obesity group(BMI≥27.5 kg/m 2, 20 cases, accounting for 5.18%). The clinicopathological factors(gender, age, diabetes mellitus, hypertension, gallbladder related diseases, jaundice, tumor location, TMN, postoperative days, tissue differentiation, liver invasion, intraoperative blood transfusion, complications) of the three groups were compared, and the relationship between BMI and 5-year survival rate was analyzed. Measurement data with normal distribution were indicated as mean±standard deviation( Mean± SD), measurement data with skewed distribution were represented as M( P25, P75). Nonparametric rank sum test was used for measurement data. Categorical variables were compared by the chi-square test or Fisher probability method. The survival curve was drawn by the Kaplan-Meier method. The univariate analysis and multivariate analysis of prognosis were respectively done using the Log-rank test and COX regression model. Results:The median survival time of 386 patients with gallbladder cancer was 12.1 months. The overall survival rates of 1, 3 and 5 years were 51.8%, 25.2% and 16.8%, respectively. Univariate survival analysis showed that age, jaundice, accidental gallbladder cancer, tumor location, TMN, surgical method, tissue differentiation, liver invasion, intraoperative blood transfusion, and complications affected the 5-year survival rate ( χ2=12.24, 30.87, 37.01, 7.92, 104.23, 118.76, 12.05, 49.12, 6.85, 12.24, P<0.05). BMI was related to hypertension, but it had no significant effect on the 5-year survival rate. However, with the increase of BMI, the 5-year survival rate increased (16.3% vs 16.7% vs 23.3%, P=0.774). Multivariate survival analysis showed that surgical method( OR=1.441, 95% CI: 1.219-1.705), liver invasion( OR=1.625, 95% CI: 1.264-2.091), M stage( OR=1.664, 95% CI: 1.070-2.587), and N stage( OR=1.511, 95% CI: 1.218-1.875) were independent risk factors for prognosis in this group of patients ( P<0.05), and BMI was not an independent risk factor ( P=0.901). Conclusions:BMI has no significant effect on the prognosis of patients with gallbladder cancer. Obese patients with gallbladder cancer do not need to wait for weight loss before surgery.

Distribution of the COVID-19 epidemic and correlation with population emigration from Wuhan, China / 中华医学杂志(英文版)

BACKGROUND@#The ongoing new coronavirus pneumonia (Corona Virus Disease 2019, COVID-19) outbreak is spreading in China, but it has not yet reached its peak. Five million people emigrated from Wuhan before lockdown, potentially representing a source of virus infection. Determining case distribution and its correlation with population emigration from Wuhan in the early stage of the epidemic is of great importance for early warning and for the prevention of future outbreaks.@*METHODS@#The official case report on the COVID-19 epidemic was collected as of January 30, 2020. Time and location information on COVID-19 cases was extracted and analyzed using ArcGIS and WinBUGS software. Data on population migration from Wuhan city and Hubei province were extracted from Baidu Qianxi, and their correlation with the number of cases was analyzed.@*RESULTS@#The COVID-19 confirmed and death cases in Hubei province accounted for 59.91% (5806/9692) and 95.77% (204/213) of the total cases in China, respectively. Hot spot provinces included Sichuan and Yunnan, which are adjacent to Hubei. The time risk of Hubei province on the following day was 1.960 times that on the previous day. The number of cases in some cities was relatively low, but the time risk appeared to be continuously rising. The correlation coefficient between the provincial number of cases and emigration from Wuhan was up to 0.943. The lockdown of 17 cities in Hubei province and the implementation of nationwide control measures efficiently prevented an exponential growth in the number of cases.@*CONCLUSIONS@#The population that emigrated from Wuhan was the main infection source in other cities and provinces. Some cities with a low number of cases showed a rapid increase in case load. Owing to the upcoming Spring Festival return wave, understanding the risk trends in different regions is crucial to ensure preparedness at both the individual and organization levels and to prevent new outbreaks.

Warming acupuncture combined with moxibustion at Yongquan (KI 1) for knee osteoarthritis with kidney-marrow deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect between warming acupuncture combined with moxibustion at Yongquan (KI 1) and simple warming acupuncture for knee osteoarthritis with kidney-marrow deficiency.@*METHODS@#A total of 66 patients of knee osteoarthritis with kidney-marrow deficiency were randomized into an observation group and a control group, 33 cases in each one. Warming acupuncture was applied at Neixiyan (EX-LE 4), Dubi (ST 35), Zusanli (ST 36) and Xuanzhong (GB 39) on the affected side in both of the groups. In the observation group, mild moxibustion at bilateral Yongquan (KI 1) was adopted additionally. Each treatment lasted for 30 min, 3 times a week (once every other day), and the consecutive 6 weeks of treatment were required. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (such as joint pain, stiffness and physical function), the amount of joint effusion and the serum contents of interleukin-1β(IL-1β), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were observed before and after treatment in the two groups.@*RESULTS@#The total effective rate in the observation group was 93.3% (28/30), which was superior to 87.1% (27/30) in the control group (<0.05). Compared before treatment, the pain scores, stiffness scores, physical function scores, the amount of joint effusion and the contents of IL-1β, TNF-α and hs-CRP after treatment were significantly reduced in the two groups (<0.05), and the improvements of these indices in the observation group were superior to the control group (<0.05).@*CONCLUSION@#Warming acupuncture combined with moxibustion at Yongquan (KI 1) can improve joint function, reduce the amount of joint effusion and the contents of inflammatory response indices for knee osteoarthritis with kidney-marrow deficiency. The therapeutic effect of warming acupuncture combined with moxibustion at Yongquan (KI 1) is better than simple warming acupuncture.

Acupuncture combined with cinesiotherapy cupping for knee osteoarthritis with stagnation and blood stasis syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between acupuncture combined with cinesiotherapy cupping and acupuncture combined with conventional cupping for knee osteoarthritis (KOA) with stagnation and blood stasis syndrome, and to seek a better solution for KOA.@*METHODS@#A total of 78 patients of KOA with stagnation and blood stasis syndrome were randomly divided into an observation group and a control group, 39 cases in each group (3 cases in the observation group and 2 cases in the control group lost contact). Both groups were treated with acupuncture at Neixiyan (EX-LE 4), Dubi (ST 35), Xuehai (SP 10), Liangqiu (ST 34), Heding (EX-LE 2), Zusanli (ST 36), Yinlingquan (SP 9), Yanglingquan (GB 34) and Xuanzhong (GB 39). Based on the acupuncture treatment, the control group was treated with conventional cupping. The No. 4 cupping glass was used for Xuehai (SP 10), Liangqiu (ST 34) and Fengshi (GB 31), while the No. 3 cupping glass was used for Yinlingquan (SP 9), while the cupping with appropriate size was used for points; the cupping glass was retained for 5 min. Based on the acupuncture treatment, the observation group was treated with cinesiotherapy cupping. The selection of acupoint and cupping glass was identical as the control group. The patients were instructed to perform knee flexion-extension, hip abduction-adduction, weight-bearing and other active exercise while cupping; the treatment was given once a day, 10 times as a course of treatment; totally three courses were given with an interval of 2 days between the courses. The patient's symptom scores, pain scores and knee function scores were recorded before and after treatment. The amount of joint effusion was measured by ultrasound; the level of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) in joint effusion were measured by ELISA.@*RESULTS@#After treatment, the total effective rate in the observation group was 94.4% (34/36), which was significantly higher than 86.5% (32/37) in the control group (0.05).@*CONCLUSION@#The acupuncture combined with cinesiotherapy cupping could alleviate pain, improve joint function and reduce joint effusion, which is superior to acupuncture combined with conventional cupping.

Experimental study on Yiqifumai mixture in treatment of arrhythmia induced by isoproterenol / 中国中西医结合急救杂志

Objective To evaluate the effect of Yiqifumai mixture on ventricular arrhythmia induced by isoproterenol. Methods Forty spontaneous hypertensive rats (SHR) were randomly divided into a control group and a Chinese medicine (TCM) group with 20 rats in each group. The control group was given distilled water 3.48 mL·kg-1·d-1, and the TCM group was given Yiqifumai mixture (composition: Codonopsis pilosula, Rhizoma coptidis, Pinellia ternate, Euonymus alatus, Rhizome of chuanxiong, Salvia miltiorrhiza, Radix paeoniae rubra, Radix paeonia alba, Licorice, Zizyphus jujuba, Polygala tenuifolia) 3.48 mL·kg-1·d-1, both groups were administered continuously for 7 days. Arrhythmia was induced by subcutaneous injection of isoproterenol 100 mg/kg into the neck 1 hour after the last administration in both groups. ECG telemetry was carried out for 2 hours to record whether single premature ventricular contraction (SP), paired premature ventricular contraction (PP) and ventricular tachycardia (VT) occurred in the control group and the TCM group, and the incidences, numbers and times of their occurrences were registered. Results There were no statistical significant differences in SP incidence (SPR), PP incidence (PPR), VT incidence (VTR) between the control group and TCM group at 1 hour and 2 hours [1 hour SPR was 90% (18/20) vs. 80% (16/20), PPR was 65% (13/20) vs. 65% (13/20), VTR was 45% (9/20) vs. 40% (8/20); 2 hours SPR was 100% (20/20) vs. 100% (20/20), PPR was 75% (15/20) vs. 75% (15/20), VTR was 65% (13/20) vs. 60% (12/20); all P > 0.05]. After 1 hour of ECG telemetry, the number of SP in the TCM group was significantly lower than that in the control group [numbers: 10.00 (4.00, 11.00) vs. 16.00 (8.50, 42.50), P < 0.05]; after 2 hours of ECG telemetry, the numbers of SP, PP and VT in the TCM group were significantly lower than those in the control group [SP (numbers), 27.00 (15.50, 38.00) vs. 37.50 (24.00, 74.50), PP (numbers), 5.00 (3.00, 8.00) vs 7.00 (5.00, 11.00), VT (numbers), 2.50 (1.25, 4.00) vs. 7.00 (4.50, 11.00), all P <0.05]. After 1 hour and 2 hours of ECG telemetry, the occurrence times of SP, PP and VT were slightly longer than those in cintrol group, but there were no significant differences between the two groups [1 hour: SP (minutes) was 4.35 (3.65, 9.90) vs. 3.66 (1.12, 9.52), PP (minutes) was 35.56 (26.78, 46.42) vs. 23.39 (11.74, 43.42), VT (minutes) was 22.31 (6.25, 30.02) vs. 14.27 (8.79, 31.38); 2 hours: SP (minutes) was 7.06 (3.65,12.29) vs. 4.09 (1.38, 14.11), PP (minutes) was 46.40 (33.88, 71.39) vs. 33.81(14.54, 46.20), VT (minutes) was 75.49 (59.37, 96.63) vs. 60.55 (24.65, 86.48), all P > 0.05]. Conclusion Yiqifumai mixture has the effect of anti-arrhythmia induced by isoproterenol and its effect in longer term use is more significant.

Independent association of preoperative hyperuricemia with acute kidney injury after cardiac surgery with cardiopulmonary bypass / 中华肾脏病杂志

Objective To investigate the impact of preoperative hyperuricemia on acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB).Methods A total of 567 adult patients undergoing cardiac surgery with CPB were enrolled to conduct a retrospective cohort database analysis.The patients were divided into hyperuricemia group and non-hyperuricemia group according to preoperative serum uric acid,and the incidence of AKI in two groups were compared.Binary logistic regression analysis was used to evaluate the relationship between preoperative hyperuricemia and AKI.Results Among 567 patients after cardiac surgery with CPB,hyperuricemia occurred in 303 cases (53.4％),and AKI occurred in 217 cases (38.3％).There was significantdifference in the incidence of AKI between hyperuricemia group and non-hyperuricemia group (44.6％ vs 31.1％,x2=10.874,P=0.001).The duration of intensive care unit (ICU) stay and the length of stay were longer in hyperuricemia group than those in non-hyperuricemia group (both P ＜ 0.05).After adjusting for age,gender,comorbidities (hypertension,diabetes mellitus,cerebrovascular disease),preoperative renal function,preoperative heart function,CPB time,intraoperative aortic block time,type of cardiac surgery and postoperative hypotension,binary logistic regression analysis showed that preoperative hyperuricemia was an independent risk factor of AKI after cardiac surgery with CPB (OR=1.912,95％ CI 1.270-2.879,P=0.002).Conclusion AKI is a common complication following cardiac surgery with CPB,and hyperuricemia is independently associated with CPB-associated AKI.Hyperuricemia may be involved in the pathogenesis of AKI,and intervention before cardiac surgery may be beneficial to prevent postoperative AKI.

Therapy strategy and prognosis in pediatric patients with severe Henoch-Sch(o)nlein purpura nephritis / 国际儿科学杂志

Henoch-Sch(o)nlein purpura nephritis (HSPN) is one of the most common types of secondary glomerulonephritis in children.Patients with severe HSPN are at distinctively higher risk of poor prognosis.Currently,no unified therapeutic method is adopted to treat severe HSPN,and disagreements exist in prognostic factors.This paper reviews the treatment measures including steroid,multiple immunosuppressive agents,rituximab and plasmapheresis for severe HSPN.Relevant factors for long-term prognosis of HSPN are discussed,which provide reference for clinical treatment and management.

Renal protective effect of Ganoderma lucidum / 中国药理学与毒理学杂志

OBJECTIVE Non-alcoholic fatty liver disease(NAFLD) encompasses a series of patho-logic changes ranging from steatosis to steatohepatitis,which may progress to cirrhosis and hepatocel-lular carcinoma.The purpose of this study was to determine whether Ganoderma lucidum polysaccha-ride peptide (GLPP) has therapeutic effect on NAFLD. METHODS ob/ob mouse model and ApoC3 transgenic mouse model were used for exploring the effect of GLPP on NAFLD. Key metabolic path-ways and enzymes were identified by metabolomics combining with KEGG and PIUmet analyses and key enzymes were detected by Western blotting. Hepatosteatosis models of HepG2 cells and primary hepatocytes were used to further confirm the therapeutic effect of GLPP on NAFLD. RESULTS GLPP administrated for a month alleviated hepatosteatosis, dyslipidemia, liver dysfunction and liver insulin resistance. Pathways of glycerophospholipid metabolism, fatty acid metabolism and primary bile acid biosynthesis were involved in the therapeutic effect of GLPP on NAFLD. Detection of key enzymes revealed that GLPP reversed low expression of CYP7A1,CYP8B1,FXR,SHP and high expression of FGFR4 in ob/ob mice and ApoC3 mice. Besides, GLPP inhibited fatty acid synthesis by reducing the expression of SREBP1c, FAS and ACC via a FXR-SHP dependent mechanism. Additionally, GLPP reduced the accumulation of lipid droplets and the content of TG in HepG2 cells and primary hepato-cytes induced by oleic acid and palmitic acid. CONCLUSION GLPP significantly improves NAFLD via regulating bile acid synthesis dependent on FXR-SHP/FGF pathway, which finally inhibits fatty acid synthesis,indicating that GLPP might be developed as a therapeutic drug for NAFLD.

Comparison of domestic video intubationscope and Macintosh direct laryngoscope in nasal intubation / 中国内镜杂志

Objective To compare the clinical effect of nasal intubation with domestic video intubationscope and Macintosh direct laryngoscope. Methods One hundred patients scheduled for oro-maxillo-facial operation, American Society of Anesthesiologists (ASA) grade I or II, aged 19 ~ 67 years, were randomly divided into the domestic video intubationscope group (group V) and the Macintosh direct laryngoscope group (group M), with 50 cases in each group. Nasal intubation was respectively performed with domestic video intubationscope (Group V) and Macintosh direct laryngoscope (group M). Cormark-Lehane grade (C-L classification), tracheal intubation time, first-time intubation success rate and tracheal intubation complications were recorded.Mean arterial pressure (MAP) and heart rate (HR) of before induction of anesthesia (T0), after induction of anesthesia (T1), at glottic exposure (T2), at intubation (T3), 1 min after intubation (T4) and 3 min after intubation (T5) were recorded. Results C-L classification in group V was significantly lower than that in group M (P < 0.05), intubation time in group V was significantly shorter than that in group M (P < 0.05), first-time intubation success rate in group V was significantly higher than that in group M (P < 0.05). Compared with T1, MAP was significantly higher at T3~ T4and HR was significantly faster at T3in group V, MAP was significantly higher at T2~ T4and HR was significantly faster at T2~ T3in group M (P < 0.05). Compared with group M, MAP and HR in group V were significantly lower at T2~ T4 (P < 0.05). The incidence of tracheal intubation complications in group V was significantly lower than that in group M (P < 0.05). Conclusions Compared with Macintosh direct laryngoscope,domestic video intubationscope in nasal intubation is better in glottic exposure,it could shorten tracheal intubation time ,increase first-time intubation success rate, maintain stable hemodynamics, has fewer tracheal intubation complications and is worthy of clinical application.

Effect of High-frequency Repetitive Transcranial Magnetic Stimulation on Hand Function in Pa-tients after Stroke / 中国康复理论与实践

Objective To observe the effect of high-frequency repetitive transcranial magnetic stimulation(rTMS)on hand function in patients after stroke. Methods From June,2016 to September,2017,30 stroke patients were randomly divided into control group(n=30)and experimental group(n=30).Both groups received routine training after sham rTMS or 3 Hz rTMS.Fugl-Meyer Assessment(FMA),modified Ashworth Scale(MAS)and modified Barthel Index(MBI)were used to evaluate the hand function and the activities of daily living before and after treatment. Results Finally 27 patients completed the experiment.After treatment, the FMA score increased in both groups (Z>2.070, P<0.05), and the difference value was higher in the experimental group than in the control group (Z=-2.296,P<0.05);the MAS score improved in the experimental group(Z=-2.456,P<0.05),no difference was found in the control group(Z=-0.816,P>0.05),and the difference value was higher in the experimental group than in the control group(Z=-2.792,P<0.01);the MBI score improved in both groups(t>3.085,P<0.01),howev-er,no difference was found in the MBI score and the difference value between two groups(t<0.246,P>0.05). Conclusion High-frequency rTMS could promote the hand function in patients after stroke.