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The morbidity of inflammatory bowel diseases (IBD) is rising rapidly but no curative therapies to prevent its recurrence. Cell death is crucial to maintaining homeostasis. Necroptosis is a newly identified programmed cell death and its roles played in IBD need to be explored. Necroptosis is mediated by receptor interacting protein kinase 1 (RIPK1), RIPK3, and mixed lineage kinase domain-like protein (MLKL), which resulted in cell swelling, plasma membrane rupture, intracellular content leaking, and eventually cell death as well as the promotion of inflammation. Studies have found that inhibiting necroptosis alleviated IBD in animal models and IBD patients with an increased level of necroptosis in inflammatory tissues, indicating that necroptosis is related to the pathogenesis of IBD. However, due to the complexity in regulation of necroptosis and the involvement of multiple functions of relevant signaling molecules, the specific mechanism remains elusive. Necroptosis may play a vital regulatory role in the pathogenesis of IBD, which provides a new idea and method for further exploring the therapeutic target of IBD.
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Objective:To explore the clinical efficacy of lenalidomide combined with second-line immunochemotherapy as a salvage regimen in the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 37 relapsed/refractory DLBCL patients receiving lenalidomide combined with second-line immunochemotherapy as a salvage regimen who had recurrence after autologous hematopoietic stem cell transplantation or who were not eligible for transplantation or had no intention to transplant between January 2016 and December 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. Among 37 patients, 6 cases with primary central nervous system (CNS) lymphoma and 3 cases with secondary CNS lymphoma. The short-term efficacy after treatment was evaluated. Kaplan-Meier method was used to analyze the overall survival (OS) and progression-free survival (PFS), and log-rank test was used for subgroup comparison.Results:The median follow-up time of 37 patients was 20.4 months (2.7-37.0 months). At the end of treatment, the overall response rate (ORR) of all patients was 64.9% (24/37), the complete response (CR) rate was 45.9% (17/37), and the median duration of response (DOR) of 24 patients who responded to treatment was 17.7 months (3.6-33.6 months). The median PFS time of all patients was 11.2 months, and the 1-year PFS rate was 48.6% (95% CI 32.5%-64.7%). The median OS time of all patients was not reached, and the 1-year OS was 67.6% (95% CI 52.5%-82.7%). Among 24 responding patients, 17 cases who received lenalidomide maintenance therapy after remission tended to have a better response compared with 7 cases who did not receive lenalidomide maintenance therapy after remission, although there was no significant difference in OS and PFS between both groups (both P > 0.05). Additionally, neutropenia was the most common adverse reaction with an incidence of 81.1% (30/37). Conclusions:Lenalidomide combined with the second-line immunochemotherapy may be an effective salvage therapy for patients with relapsed/refractory DLBCL, especially for patients with CNS involvement. The patients achieving remission after salvage therapy continue to receive lenalidomide maintenance therapy and could have a better prognosis.
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Ovarian cancer seriously threats women's health. The emergence of poly adenosine diphosphate ribose polymerase inhibitor (PARPi) has broken the barrier for ovarian cancer treatment. PARPi has been widely used and along with it comes the problem of drug resistance. Fully understanding the drug resistance mechanism of PARPi is expected to be an important way to reverse PARPi resistance. The combination of PARPi and other drugs for ovarian cancer may expand the benefits of patients using PARPi. This article reviews the drug resistance mechanism of PARPi and combined medication.
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Objective:According to the characteristics and common problems of hematology analysis in cancer patients, an autoverification scheme for cancer patients was formed, and the effectiveness and efficiency of the autoverification scheme were verified.Methods:The hematology review of international consensus and ourselves were respectively combined with Chinese multicenter autoverification rules to form two autoverification schemes. 10 063 blood samples (460 cases reviewed by microscope) were selected as the establishment group. Retrospective judgment was made in the instrument middleware, and various indexes such as autoverification pass rate and missed detection rate of different schemes were compared. By analyzing the data of missed cases one by one, the autoverification rules are adjusted according to the characteristics of diagnosis and treatment of cancer patients. By analyzing the platelet count variation range within 7 days in 19 300 cases, the Delta rules of platelet count were established. The platelet count Delta rules and the adjusted autoverification rules were combined to form the autoverification rules of our hospital and then combined with our hematology review rules to form the autoverification scheme of our hospital. The establishment group and verification group (10 876 cases, including 1 740 cases of microscopic examination) of the autoverification schemes were judged. The recognition function of Ethylenediaminetetraacetic acid-dependent pseudo thrombocytopenia (EDTA-PTCP) and PLT Delta check were programmed in the laboratory information system (LIS), and other rule judgment functions are performed in middleware. After four months of clinical trial application of 61 602 specimens, the effectiveness of our autoverification scheme was comprehensively evaluated.Results:The autoverification pass rates of international hematology review rules, our review rules, and Chinese multicenter autoverification rules are 46.36%, 52.26%, and the missed detection rates are 2.02%, 1.06%, respectively. The autoverification pass rates of our hospital autoverification scheme in the establishment group and the verification group are 51.19% and 52.78%, the missed detection rates are 0% and 0.03%, and the true positive rate are 100% and 99.95%, respectively. 56.06% of cases were passed automatically during the clinical trial application, and there were no missing cases, the true positive rate is 100%. The performance of our autoverification scheme is superior to the current autoverification schemes combined with mainstream hematology review rules and autoverification rules. The median time of TAT by autoverification was shortened by 15 minutes, and the 90th percentile time was shortened by 58 minutes, which was significantly lower than that of the same period last year. The marker function of "EDTA-PTCP" identified 31 special patients and 68 samples had been analyzed in total. After correction, the median increase of PLT was 76.5×10 9/L ( Z=-7.17, P<0.001). Conclusions:This study has established an autoverification scheme that combined by rules of hematology review and autoverification rules. It is suitable for cancer patients with high pass rate and very low rate of missed detection. This autoverification scheme can ensure the accuracy of the hematology analysis of cancer patients in our hospital and improve work efficiency.
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Objective:To explore the efficacy and safety of Ganhai Weikang capsule (GWC) in the treatment of functional dyspepsia (FD).Methods:A randomized, double-blind, placebo-controlled parallel, multi-center, superiority clinical trial was conducted. From March 2018 to April 2020, totally 324 patients with dyspepsia symptoms, who were diagnosed as chronic non-atrophic gastritis by endoscopy and pathology and met the Rome Ⅳ diagnostic criteria for FD from 7 top hospitals were enrolled, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Heilongjiang Hospital of Traditional Chinese Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Qilu Hospital of Shandong University, the First Affiliated Hospital of Zhejiang University, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University and the Third Xiangya Hospital of Central South University. The patients were randomly divided into the GWC group and the placebo group according to the ratio of 1∶1. The patients of GWC group were given GWC and the patients of placebo group were given GWC capsule simulant. The patients of both groups orally took capsules before meals, 2.4 g each time and 3 times per day, and the course of treatment was 4 weeks. The main efficacy index was the total clinical effective rate after 4 weeks, and the secondary efficacy index was the changes of clinical symptom scores of upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety. The safety index included laboratory tests and adverse events. Chi-square test and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 320 FD patients were enrolled in the full analysis set (FAS), which included 161 cases in GWC group and 159 cases in placebo group. A total of 298 cases were in the per-protocol set (PPS), 149 cases each in GWC group and placebo group. The results of FAS and PPS both showed that the total clinical effective rates of the GWC group were higher than those of the placebo group (84.5%, 136/161 vs. 44.0%, 70/159 and 83.9%, 125/149 vs. 46.3%, 69/149), and the differences were statistically significant ( χ2=57.07 and 46.32, both P<0.001). In addition, the differences of the total score of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (FAS: 10 (7, 14) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 3); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs. 1 (0, 3). PPS: 10 (7, 13) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 2); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs.1 (0, 3)), and the differences were statistically significant (FAS: Z=5.80, 5.91, 3.19, 3.72 and 3.30; PPS: Z=5.14, 5.11, 2.86, 3.21 and 2.84; all P<0.01). The results of FAS and PPS indicated that the improvement rates of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) of GWC group were all higher than those of the placebo group (FAS: 77.8% (54.6%, 91.3%) vs. 42.9% (28.6%, 61.5%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 60.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 41.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%). PPS: 77.8% (54.2%, 89.5%) vs. 44.0% (28.6%, 65.0%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 46.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%)), and the differences were statistically significant (FAS: Z=8.60, 7.72, 4.98, 4.24 and 5.61; PPS: Z=7.90, 7.03, 4.49, 3.88 and 4.83; all P<0.001). After 2 weeks of treatment, the differences of the total score of main symptoms and score of each symptom (upper abdominal pain, upper abdominal burning and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0); 2.0 (1.0, 2.0) vs. 2.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0)), and the differences were statistically significant ( Z=2.95, 3.44, 2.43 and 2.79, all P<0.05). There was no significant difference in the incidence of adverse events between the GWC group and the placebo group (0.6%, 1/163 vs. 0, 0/159). Conclusion:The clinical total effective rate of GWC in the treatment of FD is superior to that of placebo and it has good safety.
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Objective:To analyze the epidemiological trends and population characteristics of inflammatory bowel disease(IBD)in China by searching keywords related to IBD through Google Trends, Baidu index, and WeChat index, so as to provide a reference for national epidemiological studies on IBD.Methods:IBD-related hot words such as "inflammatory bowel disease" , "Crohn′s disease" , "ulcerative colitis" , "gastroesophageal reflux disease (GERD)" , "irritable bowel syndrome (IBS)" and " Helicobacter pylori ( H. pylori)" were selected. The search volume and trends of the above keywords in the world and China were analyzed through Google Trends, Baidu index and WeChat index. The epidemiological characteristics of IBD in China were summarized. Descriptive methods were used for statistical analysis. Results:The results of Google Trends analysis showed that among 5 common digestive diseases (GERD, IBS, H. pylori infection, IBD and peptic ulcer), GERD was the most concerned disease, while IBD was not the focus among the common digestive diseases. When the global searching scope was limited to IBD related hot words, Crohn′s disease was the disease of primary concern among IBD-related diseases. In South America, South Asia, and parts of Africa, ulcerative colitis was mainly concerned, and in China and countries of Southeast Asia, IBD was more concerned. The searching results of Baidu index indicated that among the national search for IBD-related hot words, the 3 keywords of "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were all highly searched, the overall daily average of the search indexes of the 3 keywords were 325, 1 320 and 2 559, respectively, and the searching volume of "Crohn′s disease" was higher than "inflammatory bowel disease" and "ulcerative colitis" . The national wide trends of search volume for "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were similar, the search heat gradually decreased from the east coast to the northwest of China, which basically coincided with the three-level ladder trend of China′s economic development, suggesting that the level of economic development was related to the incidence of IBD. The results of Baidu index analysis showed that the main populations who searched IBD-related keywords were young adults and women aged from 20 to 39 years old. The results of WeChat index analysis revealed that the searching volume of "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were 205 000, 195 000 and 120 000, respectively, and the search volume for " inflammatory bowel disease" was the highest. The official account (90.27%) and the video account (7.43%) occupied the main sources of IBD-related information on mobile terminals. Conclusions:The IBD-associated internet activities reveal a global lack of public awareness of IBD. China also faces the same problem. The search trend is consistent with the epidemiology of IBD, which may be helpful for future epidemiological research of IBD in China. Mobile media will be a potential force in promoting the patient education and disease management of IBD in China.
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Objective:To develop the modified medication regimen complexity index of Chinese version (mMRCI-C)and test its reliability and validity.Method:The Chinese version of MRCI was developed by modification,translation and back translation. The MRCI was interculturally adapted by 2-rounds of expert consultation and pilot study to ensure the semantics, content and conceptual equivalence. The validation of the mMRCI-C scale was tested among 420 community-dwelling elderly patients with type 2 diabetes mellitus(T2DM) in Shanghai Changfeng Community Health Service Center from October to December 2020. SPSS 23.0 was used to analyze the reliability and validity of the scale.Results:The mMRCI-C scale included 3 dimensions, namely drug dosage form (14 entries), medication frequency (5 entries), and additional instructions (6 entries), with a total of 25 entries. Among 420 valid questionnaires collected,the respondents were 212 males (50.4%) and 208 females (49.6%) with a mean age of (71.4±8.1) years. The test-retest reliability was 0.999 and internal consistency reliability was 0.849. The content validity exceeded 0.80,the convergent validity was 0.932; and discriminant validity P<0.001. Conclusion:The preliminary testing results show that the reliability and validity of the mMRCI-C scale are satisfactory.
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Objective:To investigate the effects of family integrated care(FICare) on positive feelings and readiness for hospital discharge among mothers of premature.Methods:From January to October 2021, a total of 100 premature infants were admitted to the neonatal intensive care unit(NICU) of General Hospital of Ningxia Medical University, and their mothers were admitted to this program.They were divided into research group (52 cases) and control group (48 cases) randomly.The premature infants in the control group received NICU routine care during hospitalization, meanwhile the premature infants and the mothers in the research group were given FICare on the routine care during hospitalization.On the 2nd day of admission (before the intervention) and 1 day before discharge (after the intervention), the positive aspects of caregiver (PAC) and the readiness for hospital discharge scale (RHDS) were used to evaluate the positive feelings and readiness for discharge of premature infants' mothers in the two groups.The t-test of two independent samples was used for measurement data between the two groups, and the paired t-test was used for intra-group comparison by SPSS 22.0 statistical software.The comparison of enumeration data between the two groups was carried out by chi-square test. Results:There were no significant differences in the scores of PAC and discharge readiness (both P>0.05) between the two groups before intervention.After the intervention, the premature mothers' total score of PAC in the research group and control group were((32.00±2.79), (27.40±3.37)), the self-affirmation dimension were ((18.55±2.39), (16.10±1.77)), the life outlook dimension were( (13.45±1.93), (11.30±2.20)), and all the scores in the research group were higher than those of the control group (all P<0.05). The total scores of readiness for hospital discharge in the research group and control group were ((106.75±6.11), (100.40±10.41)), personal status dimension were ((26.92±2.37), (25.11±3.32)), adaptability dimension were ((43.50±2.70), (40.64±4.65)), and the anticipatory support dimension were ((36.33±2.16), (34.29±3.29)). The total scores and each dimensions of the mothers' readiness for hospital discharge in the research group were higher than those in the control group (all P<0.05). After the intervention, the positive feeling total score and all dimensions score of the two groups of premature mothers were higher than before intervention (all P<0.05). After intervention, the total score of readiness for hospital discharge and the scores of all dimensions of premature mothers in the research group were higher than before intervention (all P<0.05). And there were no significant difference in the total scores of readiness for hospital discharge and other dimensions in the control group comparison before and after intervention(all P>0.05), except adaptability dimensions ( P<0.05). Conclusion:The findings suggest that FICare can improve the positive feelings of mothers of premature infants and hospital discharge readiness especially.
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Objective To synthesize the natural cyclopeptide auyuittuqamide A by Fmoc-based solid phase linear synthesis and liquid phase cyclization. Methods Using 2-chlorotriphenylmethyl chloride (CTC) resin as the solid support, 1,3-diisopropylcarbodiimide (DIC) and 1-hydroxybenzotriazole (HOBt) as the condensing agents, 9-fluorenylmethoxycarbonyl (Fmoc) to protect amino acids were assembled in sequence, and then the linear peptide bearing the protected groups was obtained in presence of trifluoroethanol (TFE) cutting reagent. The protected linear peptide was cyclized with the aid of benzotriazole hexafluorophosphate (PyBOP) and 1-hydroxybenzotriazole (HOBt) in dichloromethane (DCM) solution, followed by trifluoroacetic acid (TFA) deprotection to obtain the cyclic peptide, auyuittuqamide A that was purified by preparative HPLC and characterized by HR-MS and 500MHz 1H-NMR. Results The purity of auyuittuqamide A was more than 95% and the total yield was 5.48%. Conclusion This method has simple synthesis steps and high yield. It is the first to establish a fully synthesis method for the natural cyclic peptide auyuittuqamide A, which lays the foundation for further research of auyuittuqamide A.
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Photobiomodulation, also known as photochemical modulation, refers to the use of low-power light from various sources to induce photophysical and photochemical modulation without thermal injury in the body. Photobiomodulation is related to the wavelength and energy of light. Target chromophores for light of different wavelengths include cytochrome C oxidase, opsin, porphyrin, etc., and the parameters such as power density, spot size, and energy density determine the energy of light. At present, many in vivo and in vitro studies have confirmed the application potential of photobiomodulation in the treatment of various skin diseases.
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Objective:To test the reliability and validity of the Chinese version of Dietary Sodium Restriction Questionnaire in patients with chronic kidney disease.Methods:From July 2020 to February 2021, a total of 120 patients with chronic kidney disease admitted to the Zhongda Hospital Affiliated to Southeast University were assessed with the Chinese version of Dietary Sodium Restriction Questionnaire, and its reliability and validity were analyzed.Results:Exploratory factor analysis showed that KMO value was 0.783, three common factors were extracted, namely attitude and subjective norms, perceptual behavior control and cognition, which could explain 58.83% of the total variation. Cronbach α coefficient of internal consistency was 0.777, and Cronbach α coefficient of three common factors were 0.849, 0.824 and 0.752 respectively. Six experts scored the questionnaire, the CVI of each item were 0.83-1.00, and the average CVI was 0.968. The correlation coefficient between each item and the total score were 0.322-0.648 ( P<0.01). Conclusions:The Chinese version of Dietary Sodium Restriction Questionnaire has good reliability and validity in the study of sodium restriction diet compliance of patients with chronic kidney disease, and can be used as a tool to evaluate the cognition, attitude and behavior of patients with chronic kidney disease.
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OBJECTIVE：To study the effects of the main active components of Naoxintong capsule （NXTC）on the proliferation of human umbilical vein endothelial cell（HUVEC） and its key protein JAK/STAT signal pathway ， vasoactive substances ，adhesion molecules and inflammatory factors so as to clarify the m echanism of NXTC for promoting blood circulation and removing blood stasis. METHODS ：The effects of different concentration of 12 active components [caffeic acid（1.56-200 μmol/L），ferulic acid （1.56-200 μmol/L），senkyunolide H （3.125-200 μmol/L），n-butylidenephthalide（3.125-200 μmol/L），ligustilide（1.56-200 μmol/L），cryptotanshinone（0.625-80 μmol/L），tanshinol sodium （1.56-200 μmol/L），paeoniflorin （1.56-200 μmol/L），formononetin（1.56-200 μmol/L），salvianolic acid B （1.56-200 μmol/L），catechin（1.56-200 μmol/L）and astragaloside Ⅳ（1.56-200 μmol/L）] on the proliferation of HUVECs were evaluated by CCK- 8 assay. The effects of above active components（3 dose groups ，setting up 0 μmol/L blank control group，hereinafter）on mRNA expression of key proteins JAK 2， STAT3，Akt，ERK in JAK/STAT signal pathway were measured by RT-PCR. The effects of each active component on the expression of PAI- 1，VCAM-1，ICAM-1，VEGF and NF-κB p65 were detected by ELISA. RESULTS ：Ferulic acid （6.25，25-200 μg/mL），senkyunolide H （6.25-200 μmol/L），ligustilide（200 μmol/L），cryptotanshinone（10-80 μmol/L），paeoniflorin（1.56， 6.25，12.5 μmol/L），salvianolic acid B （1.56-12.5 μmol/L，200 μmol/L）and catechin （25 μmol/L）could significantly inhibit the proliferation of HUVECs ；caffeic acid （1.56，12.5 μmol/L），ligustilide（50 μmol/L），trashinol sodium （6.25 μmol/L）and paeoniflorin（1.56，100，200 μmol/L）could significantly promote the proliferation of HUVECs （P＜0.05 or P＜0.01）. Compared with blank control group ，mRNA expression of JAK 2，STAT3 and Akt were decreased significantly in some dose groups of ferulic acid，formononetin，salvianolic acid B and astragaloside Ⅳ（P＜0.05 or P＜0.01）；the expression of PAI- 1 were significantly decreased in some dose groups of caffeic acid ，ferulic acid and n-butylphthalide；the expression of ICAM- 1 and VCAM- 1 were decreased significantly in some dose groups of caffeic acid ，ferulic acid ，n-butenylphthalide，cryptotanshinone，formononetin and catechin；the expression of NF-κB p65 were decreased significantly in some dose groups of ferulic acid ，n-butenylphthalide， formononetin，salvianolic acid B and astragaloside Ⅳ；the expression of VEGF were increased significantly in some dose groups of caffeic acid and catechin （P＜0.05 or P＜0.01）. CONCLUSIONS ：The active components of Naoxintong capsule may play the role of promoting blood circulation and removing blood stasis by inhibiting the expression of JAK/STAT signal pathway key protein mRNA and PAI- 1，ICAM-1，VCAM-1，NF-κB p65 in HUVEC ，and promoting the expression of VEGF.
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OBJECTIVE： To establish pre- column derivatization-HPLC fingerprint of polysaccharide from Achyranthes bidentata，and to determine the contents of monosaccharide components ，so as to provide reference for quality evaluation of A. bidentata decoction pieces. METHODS ：Taking 10 batches of A. bidentata decoction pieces from different manufacturers as samples，the polysaccharides were extracted by water extraction and alcohol precipitation ，hydrolyzed by trifluoroacetic acid ，and then derivatized by 1-phenyl-3-methyl-5-pyrazolone for HPLC analysis. The determination was performed on Hanbon Hedera C 18 column with column temperature of 30 ℃ at the flow rate of 1.2 mL/min. The mobile phase consisted of acetonitrile- 0.02 mol/L ammonium acetate solution （gradient elution ）. The detection wavelength was set at 250 nm，and sample size was 20 μL. HPLC fingerprint was established and similarity evaluation was performed for 10 batches of A. bidentata polysaccharide by using TCM Chromatogramic Fingerprint Similarity Evaluation System （2012A edition ）. The common peak was identified by comparing with the reference substance ，and cluster analysis was performed by using SPSS 25.0 software. The contents of identified monosaccharides were determined by HPLC. RESULTS ：The similarity of 10 batches of A. bidentata polysaccharide were all higher than 0.95. Nine common peaks were fixed and a total of 5 common peaks were identified ，namely anhydrous glucose （peak 1）， mannose（peak 2），rhamnose（peak 4），galacturonic acid （peak 5）and arabinose （peak 7）. Results of cluster analysis showed that S1 sample was classified into one category ；S2，S5，S8 and S 9 samples were clustered into one category ；S3，S4，S6，S7 and S10 samples were clustered into one category. Results of content determination showed that the contents of anhydrous glucose in 10 batches of samples ranged from 6.17 to 17.55 mg/g；those of mannose ranged from 3.31 to 7.66 mg/g；those of rhamnose ranged from 38.80 to 73.97 mg/g；those of galacturonic acid ranged from 2.49 to 8.95 mg/g；those of arabinose ranged from 11.30 to 28.58 mg/g. CONCLUSIONS ：Established pre-column derivatization HPLC fingerprints and content determination method can provide reference for quality evaluation of A. bidentata decoction pieces.
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Objective:To investigate the diagnostic value of serum miRNA-9-5p (miR-9-5p), miRNA-21-5p (miR-21-5p) and miRNA-3923 (miR-3923) in patients with cervical cancer.Methods:The data of 100 cervical cancer patients in Shanxi Provincial Cancer Hospital from July 2016 to June 2018 (the experimental group) and 100 healthy subjects (the healthy control group) during the same period were collected. The real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) combined with probe hybridization was used to detect the expression levels of human papillomavirus (HPV) E6/E7 mRNA in paraffin-embedded tissues of patients with cervical cancer and in cervical exfoliated cells of the healthy control people. Ct value ≤ 40 cycles was considered as HPV E6/E7 positive. Serum samples from 3 patients with cervical cancer and 3 healthy people were taken out; microRNA (miRNA) Array was used to detect the expression level of 384 miRNA; the differential expression of miRNA was screened out and cluster analysis was performed, and then the screened miRNAs was verified by using qRT-PCR. Finally, the receiver operation characteristics (ROC) curves of screened miRNAs alone and HPV E6/E7 alone or the combination of three miRNAs and HPV E6/E7 in the diagnosis of cervical cancer were drawn to make comparison of diagnostic efficacy.Results:Among the paraffin-embedded tissues from 100 patients with cervical cancer, there were 65 cases (65%) HPV E6/E7 positive; in the healthy control group, HPV E6/E7 in cervical exfoliated cells of 100 people was negative. A total of 248 differentially expressed miRNAs were detected from the serum samples in 3 patients with cervical cancer and 3 healthy people. The cluster analysis finally identified 16 abnormally regulated miRNAs. qRT-PCR verification confirmed that differences in the expression levels of miR-9-5p, miR-21-5p and miR-3923 in the healthy control group and cervical cancer group were statistically significant (all P < 0.01), and then the three were selected to make diagnosis of cervical cancer. The expression levels of miR-9-5p, miR-21-5p and miR-3923 in HPV E6/E7 positive cervical cancer group were higher than those in the healthy control group (all P < 0.05), expression levels of miR-21-5p and miR-3923 in HPV E6/E7 negative cervical cancer group were increased ( P = 0.008, P = 0.038); expression levels of the three miRNAs in HPV E6/E7 positive group were higher than those in HPV E6/E7 negative group (all P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of miR-3923 was the biggest (0.843), the specificity was the highest (82%, the cut-off value was 2.88) and the sensitivity of miR-21-5p was the highest (85%, the cut-off value was 4.08) when miR-9-5p, miR-21-5p and miR-3923 were respectively applied to diagnose the cervical cancer; AUC (0.924), the sensitivity and the specificity (85%, 94%; the cut-off value was 4.04) of the combination of the three indicators were higher than those of the single indicator in the diagnosis of cervical cancer. AUC was 0.766 when HPV E6/E7 was kused alone to diagnose. The diagnostic efficacy of HPV E6/E7 combined with miR-9-5p, miR-21-5p, miR-3923 respectively was further improved, the corresponding AUC was 0.914, 0.848, 0.932, respectively; the diagnostic efficacy of the combination of the four indicators was the highest (AUC was 0.942). Conclusion:miR-9-5p, miR-21-5p and miR-3923 may be helpful in the diagnosis of cervical cancer.
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Objective:To analyze the cognition and willingness of family physicians on contracted service, and to explore the implementation obstacles and feasible strategies of implementing contracted service of family physicians from the perspective of suppliers.Methods:From July to October 2020, 850 family physicians in community health service centers or township health centers in three cities of Shandong Province were investigated by questionnaire survey and key person interview. Descriptive analysis and binary logistic regression model were used to analyze the willingness of family physicians to provide contracted service. Through questionnaire survey and key person interview, the implementation obstacles and service optimization strategies of family physicians were discussed.Results:791 valid questionnaires were obtained, of which 688(87.0%) approved the implementation of family physician contract service, and 679(85.8%) expressed willingness to provide family physician contract service. Marital status, recognition of service policy, satisfaction of service operation effect, optimistic degree of service development prospect and residents′ first choice of illness were the factors influencing family physician′s service willingness.Conclusions:We should effectively improve the family doctor′s service intention and promote the efficient and orderly implementation of family doctor′s contract service policy through enriching policy supporting measures, innovating the application of " Internet plus" , increasing personnel training, optimizing performance appraisal work and creating favorable public opinion environment.
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Objective:To investigate the effect of bilateral repetitive transcranial magnetic stimulation (rTMS) on the pre-attentive processing of methamphetamine addicts.Methods:Forty methamphetamine addicts were screened and equally divided into the intervention group and the control group by random number table method.The intervention group was treated with bilateral simultaneous stimulation with 10 Hz on the left DLPFC and 1 Hz on the right DLPFC with 7 days of continuous intervention.The same scheme was used to intervene the control group, but with pseudo-stimulation. The changes of amplitude and latency of mismatch negative wave(MMN) before and after intervention were compared. SPSS 24.0 software was used for statistical analysis. Independent sample t-test was used for inter group comparison, and paired sample t-test was used for intra group comparison before and after intervention. Results:Before rTMS, there were no significant differences in MMN(F3, Fz, F4) amplitude (intervention group: (-0.90±0.28)μV, (-0.98±0.19)μV, (-0.96±0.19)μV; control group: (-0.92±0.21)μV, (-0.89±0.20)μV, (-0.94±0.16)μV)and latency(intervention group: (184.16±33.07)ms, (179.20±25.35)ms, (184.95±28.22)ms; control group: (184.91±26.96)ms, (180.99±25.29)ms, (181.55±23.19)ms) between the two groups (all P>0.05). After the intervention, there were significant differences in MMN(Fz, F4) amplitude(intervention group: (-1.38±0.16)μV, (-1.17±0.19)μV; control group: (-0.91±0.17) μV, (-0.99±0.16)μV) between the two groups (both P<0.01), but there were no significant differences in MMN (F3) amplitude(intervention group: (-1.01±0.59)μV; control group: (-0.80±0.50)μV), and in MMN (F3, Fz, F4) latency(intervention group: (177.38±26.45)ms, (172.17±23.87)ms, (179.84±23.60)ms; control group: (182.08±24.95)ms, (177.94±21.30)ms, (179.18±21.62)ms)between the two groups (all P>0.05). There were statistically significant differences in MMN( Fz, F4) amplitude (before-intervention: (-0.98±0.19)μV, (-0.96±0.19)μV; after-intervention: (-1.38±0.16)μV, (-1.17±0.19)μV)before and after intervention in the intervention group (both P<0.05), but there was no significant difference in MMN(F3) amplitude(before-intervention: (-0.90±0.28)μV; after-intervention: (-1.01±0.59)μV)before and after intervention in the intervention group ( P>0.05), and there were statistically significant differences in MMN(F3, Fz, F4) latency (before-intervention: (184.16±33.07)ms, (179.20±25.35)ms, (184.95±28.22)ms; after-intervention: (177.38±26.45)ms, (172.17±23.87)ms, (179.84±23.60)ms)before and after intervention in the intervention group(all P<0.05). After pseudo-stimulation, there were no statistically significant differences in MMN( F3, Fz, F4) amplitude(before-intervention: (-0.92±0.21)μV, (-0.89±0.20)μV, (-0.94±0.16)μV; after-intervention: (-0.80±0.50)μV, (-0.91±0.17)μV, (-0.99±0.16)μV)and latency (before-intervention: (184.91±26.96)ms, (180.99±25.29)ms, (181.55±23.19)ms; after-intervention: (182.08±24.95)ms, (177.94±21.30)ms, (179.18±21.62)ms) before and after intervention in the control group (all P>0.05). Conclusion:After repeated transcranial magnetic stimulation, the pre-attentive processing of the intervention group is improved, which shows that bilateral simultaneous stimulation of the rTMS program is effective.
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Estrogen receptor (esr) mediates the effects of estrogen on the expression of related genes, thereby regulating the growth and reproduction of mammals. To investigate the effect of retrotransposon insertion polymorphism (RIP) of the porcine esr gene on porcine growth performance, retrotransposon insertion polymorphism of the esr gene were predicted by comparative genomics and bioinformatics, and PCR was used to verify the insertion polymorphisms in different porcine breeds. Finally, the correlation analysis between the genotypes and performance of Large White pigs was conducted. The results showed that four retrotransposon polymorphic sites were identified in the esr1 and esr2 genes, which are esr1-SINE- RIP1 located in intron 2 of the esr1 gene, esr1-LINE-RIP2 and RIP3-esr1- SINE located in intron 5 of the gene, and esr2-LINE-RIP located in intron 1 of the esr2 gene, respectively. Among them, insertion of a 287 bp of SINE into intron 2 of the esr1 gene significantly affected (P<0.05) the live back fat thickness and 100 kg body weight back fat thickness of Large White pigs. Moreover, the live back fat thickness and back fat thickness at 100 kg body weight of homozygous with insertion (SINE+/+) was significantly greater than that of heterozygous with insertion (SINE+/-) and homozygous without insertion (SINE-/-). Therefore, esr1-SINE-RIP1 could be used as a molecular marker to assist the selection of deposition traits in Large White pigs.
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Animals , Genotype , Introns/genetics , Phenotype , Polymorphism, Genetic/genetics , Retroelements/genetics , Swine/geneticsABSTRACT
Objective:In this study, the clinical data of biliary atresia(BA) and infant intrahepatic cholestasis(IHC) was reviewed, and the utility of gamma-glutamyl transpeptidase(GGT) and liver Young′s modulus in the differential diagnosis of BA and IHC in infants was discussed.Methods:Based on the clinical data of 120 infants with cholestasis treated in the Children′s Hospital Affiliated to Xi′an Jiaotong University, from September 2017 to December 2019, the infants were divided into two groups according to the results of intraoperative cholangiography and follow-up: BA group( n=50); IHC group( n=70). The age, clinical manifestations, laboratory examination results, gallbladder contraction rate, hepatobiliary scintigraphy, liver Young′s modulus, and medical treatment effects were compared between the two groups.The utility of GGT and liver Young′s modulus in the differential diagnosis of BA and IHC was analyzed. Results:The age, alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bile acid, fasting blood glucose, blood ammonia and splenomegaly between the two groups were compared and the results showed no statistical significance( P>0.05). In contrast, there were statistically significant differences( P<0.001) in stool color, liver size, total bilirubin(TB), direct bilirubin(DB), GGT, liver Young′s modulus, positive hepatobiliary scintigraphy, gallbladder contraction rate at 1 hour after meal, and medical treatment effect between the two groups.TB, DB, GGT, liver Young′s modulus and GGT combined with liver Young′s modulus were analyzed using ROC curves, and the area under the curve(AUC) were 0.820, 0.809, 0.906, 0.876 and 0.926, respectively.When GGT exceeded the cut-off value of 198.85 U/L, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 82.0%, 84.3%, 78.8%, 86.8% and 83.3%, respectively.When liver Young′s modulus exceeded the cut-off value of 8.6 kPa, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 88.0%, 80.0%, 75.9%, 90.3% and 83.3%, respectively.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of GGT combined with liver Young′s modulus in diagnosing BA were 98.0%, 68.6%, 69.0%, 98.0% and 80.8%, respectively.Multivariate logistic regression analysis found that DB>115.55 μmol/L, GGT>198.85 U/L, and liver Young′s modulus>8.6 kPa were risk factors for BA( OR=9.510, P=0.001; OR=24.634, P<0.001; OR=21.469, P<0.001). Conclusion:GGT and liver Young′s modulus are useful in the differential diagnosis of BA and IHC.If GGT and liver Young′s modulu sexceed the threshold values of 198.85 U/L and 8.6 kPa respectively, it can effectively indicate that the child is BA.
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Objective:To investigate the value of serum insulin-like growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS), anti-Müllerian hormone (AMH) and bone morphogenetic protein 6 (BMP-6) in prediction of rapidly progressive puberty(RPP) in girls.Methods:The data of 750 girls who visited the Department of Endocrinology, Metabolism and Genetic Disorders, Children′s Hospital of Soochow University from August 2017 to October 2018 because of breast development were retrospectively analyzed.After following up these girls for 6 months to 1 year, those who were lost to follow up, received early treatment and failed to meet the inclusion criteria were excluded.The remaining 138 girls were divided into the central precocious puberty group (CPP, 32 cases), the early puberty with RPP group (EP-RPP, 33 cases), the early puberty with slow progression puberty group (EP-SPP, 32 cases) and RPP group (41 cases) according to the inclusion criteria.The healthy control group consisted of 33 undeveloped girls aged 8 to 9 who underwent physical examination in the same hospital over the same period.The serum concentrations of IGF-1, DHEAS, AMH and BMP-6 were measured.The general information, clinical manifestations, laboratory examination results and radiological features were compared among different groups.Statistical analysis was performed by using SPSS 22.0, and the receiver operating characteristic curve (ROC) was drawn to investigate the value of IGF-1, DHEAS, AMH and BMP-6 in prediction of RPP.Results:(1)The serum follicle stimulating hormone(FSH) peak value was 15.10(13.86-19.80) IU/L in the EP-SPP group, 11.99(9.18-16.16) IU/L in the EP-RPP group and 11.43(9.37-15.63) IU/L in the RPP group.The ratio of serum FSH/luteinizing hormone(LH) peak values was 3.20(2.44-4.58) in the EP-SPP group, 1.86(1.05-3.16) in the EP-RPP group and 0.76(0.49-0.99) in the RPP group.The serum FSH peak value and the ratio of serum FSH/LH peak values in the EP-SPP group were significant higher than those in the EP-RPP group(all P<0.05). There was no significant difference in the serum FSH peak value between the EP-RPP group and the RPP group( P>0.05). (2)The serum IGF-1 levels of the healthy control group, EP-SPP group, EP-RPP group, CPP group and RPP group were 166.00(126.50-188.00) μg/L, 199.00(170.50-262.50) μg/L, 252.00(233.00-291.50) μg/L, 288.00(252.00-376.00) μg/L and 382.00(264.0-499.50) μg/L, respectively.The serum IGF-1 levels of the EP-SPP group, EP-RPP group, CPP group and RPP group were all significantly higher than those in the healthy control group (all P<0.05). The serum IGF-1 levels in the EP-RPP group were higher than those in the EP-SPP group( P<0.01). As the puberty rapidly progressed, the serum IGF-1 levels gradually increased.The RPP group had the highest IGF-1 levels, and the difference in IGF-1 levels between the RPP group and EP-RPP group was statistically significant( P<0.01). (3)The serum DHEAS levels were 41.65(14.80-59.88) μg/L in the healthy control group, 42.50(30.15-79.83) μg/L in the EP-SPP group, 52.32(43.08-98.54) μg/L in the CPP group, 63.30(34.00-81.55) μg/L in the EP-RPP group and 70.89(51.85-100.02) μg/L in the RPP group.The DHEAS levels of the healthy control group, EP-RPP group and RPP group gradually increased.The RPP group had the highest DHEAS levels.There was significant difference in DHEAS levels among the healthy control group, EP-RPP group and RPP group ( P<0.05). There was no significant difference in DHEAS levels among the EP-SPP group, CPP group and EP-RPP group( P>0.05). (4)The serum AMH and BMP-6 levels in the EP-RPP group, EP-SPP group, RPP group, CPP group and healthy control group were not significantly different( P>0.05). (5)The area under the ROC curve of serum IGF-1 levels was 0.765, the cut-off value was 232.5 μg/L, the specificity for the cut-off value was 83.30%, and the sensitivity was 75.00%.The combined area under the ROC curve of the serum FSH peak value and the ratio of serum FSH/LH peak values was 0.795. Conclusions:Serum IGF-1 levels and the combination of the serum FSH peak value and the ratio of serum FSH/LH peak values can be used as effective indicators of slowly and rapidly progressive puberty in early adolescent girls.Serum DHEAS cannot be used as an early warning index of RPP, but it plays a critical role in the regulation of puberty initiation and process.Serum DHEAS levels may be related to the Tanner stage.
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OBJECTIVE@#To analyze the clinical and genetic characteristics of five Chinese pedigrees affected with short stature.@*METHODS@#A retrospective analysis was carried out for the clinical data and results of genetic testing for the probands. A literature search was also conducted.@*RESULTS@#The five probands have all featured short stature with a family history. Genetic testing has revealed that they have harbored variants of the ACAN gene, including p.Val2042Argfs*6, p.Val1597del, c.630-1G>A, c.23delT and c.2026+1G>A(previously reported).@*CONCLUSION@#Except for short stature, children harboring heterozygous variants of the ACAN gene may have no involvement of other systems. Some of these children may response to short-term growth hormone treatment.