Prediction of diffuse glioma grade and tumor cell proliferative activity by synthetic MRI combined with three dimensional arterial spin labeling imaging / 中华放射学杂志

Objective:To evaluate the value of synthetic MRI combined with three dimensional-arterial spin labeling (3D-ASL) imaging in the grading of diffuse glioma and its correlation with tumor cell proliferative activity (Ki-67).Methods:This study was prospective. The clinical and imaging manifestations of 66 patients with diffuse glioma who underwent synthetic MRI combined with 3D-ASL imaging from August 2020 to June 2021 in General Hospital of Ningxia Medical University were analyzed. Among 66 patients, there were 36 males and 30 females, aged 4-76 years, and divided into low grade glioma (LGG) group ( n=25) (WHO Ⅱ) and high grade glioma (HGG) group ( n=41) (WHO Ⅲ and vⅣ). T 1, T 2, proton density (PD) and cerebral blood flow (CBF) of tumor parenchyma were measured by GE ADW4.7 postprocessing software. The Ki-67 label index (Ki-67 LI) in postoperative pathological sections was detected by immunohistochemistry. Independent sample t test or Mann-Whitney U test was used to compare the differences of quantitative parameters between HGG group and LGG group. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of T 1, PD, CBF and the combination. Spearman test was used to analyze the correlation between the parameters and Ki-67 label index (LI). Results:T 1[(1 573±173)ms], PD[(86.2±2.4)pu] and CBF[(129±48)ml·100 g -1·min -1] in HGG group were significantly higher than those in LGG group [(1 376±134)ms, (83.0±2.5)pu and (77±49)ml·100g -1·min -1 respectively], and difference had statistical significance ( t=-4.86, -5.08, -4.24, P<0.01). ROC confirmed that the area under curve (AUC) of T 1, PD and CBF in differentiating HGG from LGG were 0.847, 0.843 and 0.777, respectively. In multi-parameter analysis, the combination of three parameters had the best diagnostic efficiency (AUC=0.973) and the sensitivity and specificity were 87.8% and 100%, respectively. In LGG and HGG groups, there was no correlation between T 1, T 2, PD, CBF and Ki-67 LI. In the overall cohort, T 1, PD and CBF had slight positive correlation with Ki-67 LI ( r=0.394, 0.411 and 0.406, respectively, all P<0.01). There was no correlation between T 2 and Ki-67 LI ( r=-0.100, P=0.423). Conclusion:Synthetic MRI and 3D-ASL can noninvasively evaluate the pathological grade of glioma and predict the expression of Ki-67, among which T 1 and PD are novel imaging marks.

Quality evaluation of Xin ’an capsules by combination of fingerprint ，multi-component quantitative analysis and chemical pattern recognition analysis / 中国药房

OBJE CTIVE To establish a method for quality evaluation of Xin ’an capsule by combining fingerprint ， multi-component quantitative analysis and chemical pattern recognition analysis. METHODS High performance liquid chromatography（HPLC）combined with Similarity Evaluation System of TCM Chromatogram Fingerprint （2012 edition）were used to establish the fingerprints of 24 batches of Xin ’an capsules and evaluate the similarity. The common peaks were determined. The contents of glucosylvitexin ，rhamnosylvitexin，vitexin，hyperoside and isoquercetin in Xin ’an capsules were determined by the same HPLC method. Taking the common peak area of fingerprint as the variable ，MetaboAnalyst 5.0 tool was used to draw the cluster analysis （CA）heat map. SIMCA 14.1 software was used to perform principle component analysis （PCA）and partial least squares-discriminant analysis （PLS-DA）. RESULTS Twelve common peaks were identified with the similarity greater than 0.97. Six common peaks were identified as chlorogenic acid ，glucosylvitexin，rhamnosylvitexin，vitexin，hyperoside and isoquercetin.The linear range of glucosylvitexin ，rhamnosylvitexin，vitexin， hyperoside and isoquercetin were 2.36-151.35，9.15-585.20， 1.20-76.50， 0.68-43.20， 0.44-27.90 µg/mL（all r＞0.999）.RSDs of precision ，repeatability and stability （24 h）tests were 163.com all less than 2.00％ . The average recoveries were 95.80％（RSD＝0.96％ ，n＝6），102.10％ （RSD＝0.93％ ，n＝6）， 103.26％（RSD＝1.28％，n＝6），103.89％（RSD＝0.73％，n＝6） and 102.09％（RSD＝1.79％，n＝6），respectively. The contents of the five components were 0.988 8-1.559 1，4.336 6-11.220 1， 0.065 1-0.830 5，0.043 8-0.692 5 and 0.023 2-0.427 2 mg/grain，respectively. The results of CA and PCA showed that 24 batches of samples could be divided into three categories ，i.e. S 1-S15，S16-S18 and S 19-S24. PLS-DA showed that variable importance in projection values of the corresponding component of peak 6 and glucosylvitexin （peak 7），rhamnosylvitexin（peak 8），hyperoside （peak 10） and isoquercetin （peak 11） were greater than 1. CONCLUSIONS The established HPLC fingerprint and multi-component quantitative method are simple and feasible. Combined with chemical pattern recognition analysis ，it can be used for the quality control of Xin ’an capsules. Glucosylvitexin ，rhamnosylvitexin and other components may be differentital markers affecting the quality of each batch of samples.

The expression of leucine zipper EF-hand domain transmembrane protein 1, sodium hydrogen exchange protein 1 and adenylate cyclase related protein 2 in gastric cancer tissues and their predictive value for postoperative recurrence / 中国医师进修杂志

Objective:To investigate the expression of leucine zipper EF-hand domain transmembrane protein 1 (LETM1), sodium hydrogen exchange protein 1 (NHE-1) and adenylate cyclase related protein 2 (CAP2) in gastric cancer tissues and the predictive value for postoperative recurrence.Methods:The clinical data of 92 patients with early gastric cancer who underwent surgical treatment from January 2017 to January 2020 in Jiangsu Haimen People′s Hospital were retrospectively analyzed. According to the recurrence condition 6 months after operation, the patients were divided into recurrence group (16 cases) and non recurrence group (76 cases). The expression levels of LETM1, NHE-1 and CAP2 mRNA in cancer tissues and adjacent tissues were detected by real time fluorescent quantitative polymerase chain reaction. Multifactor Logistic regression analysis was used to analyze the related influencing factors of postoperative recurrence. The receiver operating characteristic (ROC) curve was drawn, and the effectiveness of LETM1, NHE-1 and CAP2 mRNA in predicting recurrence was analyzed. The Kaplan-Meier survival curve was drawn, and the survival rate was analyzed in patients with different expression levels of LETM1, NHE-1 and CAP2 mRNA.Results:The LETM1, NHE-1 and CAP2 mRNA in cancer tissues were significantly higher than those in adjacent tissues (0.41±0.12 vs. 0.22±0.07, 0.85±0.27 vs. 0.49±0.15 and 0.31±0.10 vs. 0.19±0.06), and there were statistical differences ( P<0.01). The proportion of N 1 stage in recurrent group was significantly higher than that in non recurrent group: 9/16 vs. 22.37% (17/76), and there was statistical difference ( P<0.05); the LETM1, NHE-1 and CAP2 mRNA of cancer tissues in recurrent group were significantly higher than those in non recurrent group (0.61±0.20 vs. 0.37±0.13, 1.24±0.38 vs. 0.77±0.21 and 0.60±0.19 vs. 0.25±0.10), and there were statistical differences ( P<0.01). Multifactor Logistic regression analysis result showed that, after controlled N stages, the LETM1, NHE-1 and CAP2 mRNA were still independent risk factors for postoperative recurrence in patients with gastric cancer ( OR = 1.52, 3.11 and 1.21; 95% CI 1.26 to 1.82, 2.36 to 4.09 and 1.04 to 1.41; P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of LETM1, NHE-1 and CAP2 mRNA for predicting postoperative recurrence in patients with gastric cancer were 0.768, 0.802 and 0.850, respectively. The AUC of combination the indexes for predicting postoperative recurrence in patients with gastric cancer was 0.965. According to the cut-off value of ROC curve, the patients were divided into LETM1 mRNA high expression (>0.54, 30 cases) and low expression (≤0.54, 62 cases), NHE-1 mRNA high expression (>1.09, 35 cases) and low expression (≤1.09, 57 cases), CAP2 mRNA high expression (>0.49, 28 cases) and low expression (≤0.49, 64 cases). Kaplan-Meier survival curve analysis result showed that the survival rates in patients with high expression of LETM1, NHE-1 and CAP2 mRNA were significantly lower than those in patients with low expression (73.33% vs. 98.39%, 80.00% vs. 96.49% and 78.57% vs. 95.31%), and there were statistical differences ( χ2 = 15.08, 6.95 and 6.75, P<0.01). Conclusions:LETM1, NHE-1 and CAP2 mRNA are related to the recurrence of early gastric cancer after surgery. The detection of the 3 markers is expected to provide a new strategy for the prediction of postoperative recurrence.

Polysaccharide Krestin Prevents Alzheimer's Disease-type Pathology and Cognitive Deficits by Enhancing Monocyte Amyloid-β Processing / 神经科学通报·英文版

Deficits in the clearance of amyloid β protein (Aβ) by the peripheral system play a critical role in the pathogenesis of sporadic Alzheimer's disease (AD). Impaired uptake of Aβ by dysfunctional monocytes is deemed to be one of the major mechanisms underlying deficient peripheral Aβ clearance in AD. In the current study, flow cytometry and biochemical and behavioral techniques were applied to investigate the effects of polysaccharide krestin (PSK) on AD-related pathology in vitro and in vivo. We found that PSK, widely used in therapy for various cancers, has the potential to enhance Aβ uptake and intracellular processing by human monocytes in vitro. After administration of PSK by intraperitoneal injection, APP/PS1 mice performed better in behavioral tests, along with reduced Aβ deposition, neuroinflammation, neuronal loss, and tau hyperphosphorylation. These results suggest that PSK holds promise as a preventive agent for AD by strengthening the Aβ clearance by blood monocytes and alleviating AD-like pathology.

Application Progress of Plant Growth Regulator in Production of Chinese Medicinal Materials / 中国实验方剂学杂志

Plant growth regulator （PGR） is mostly a class of chemical synthesis substance with physiological activities similar to plant hormones，which can promote cell elongation，induce vascular differentiation or accelerate tissue aging via regulating the physiological processes such as photosynthesis，respiration，transpiration，signal transduction，substance absorption and operation. PGR has the advantages of small dosage，high efficiency，low toxicity and less residue，and it is widely used in the planting of Chinese medicinal herbs. By consulting the relevant literature published in recent years，this paper briefly summarizes the main types of PGR，e.g.auxins，gibberellins，cytokinins，abscisic acid and ethylene，etc. On the other hand，this article analyzes and sums up the specific applications of PGR in the manufacture of Chinese herbal medicine，for instance，promoting seed germination，improving seed setting rate or fruit setting rate，dwarfing plants，inhibiting reproductive growth，regulating gender differentiation，stimulating fruit falling，enhancing resistance and so on. The problems existing in the practical use of PGR are pointed out，non-differentiation of specific species，unreasonable combination，not paying attention to the operation method，arbitrarily increasing the dose，lack of residue limit standard and reducing the content of some effective components，for example.Meanwhile，some feasible suggestions are put forward.Not only the suitable types of PGR should be selected in a reasonable and standardized manner，but also the appropriate concentration，dosage and period of application should be chosen carefully； the dual effects of PGR on plant growth and active ingredients in medicinal organs should be concerned，so as to improve the yield and avoid the loss of effective components on the basis of ensuring the quality of Chinese medicinal materials； it is necessary to strengthen the registration of PGR in the production of Chinese medicinal materials and establish residue limit standards to provide a monitoring basis for ensuring the safety of Chinese medicine in the future.The scientific use of PGR can promote the increase of agricultural yield and farmers' income，and make the healthy development of Chinese herbal medicine planting industry.

Mechanism of Yiqi Jiedu Prescriptions in Protection of Mitochondria in PC12 Cells Against Hypoxia Injury Based on Energy Metabolism / 中国实验方剂学杂志

ObjectiveTo establish an evaluation method for mitochondrial energy metabolism with Seahorse analyzer and investigate the protective effect of Yiqi Jiedu prescriptions （YQ） on mitochondria in rat adrenal pheochromocytoma （PC12） cells against hypoxia injury. MethodThe PC12 cell injury model was induced in vitro using hypoxic chambers. Five groups were set up， ie， a control group， a model group （model）， high- （25 µmol·L-1）， medium- （5 µmol·L-1） and low-dose （1 µmol·L-1） YQ groups， and a positive drug trimetazidine （TMZ） group， with three replicate wells in each group. The experiment was repeated three times. The established method for energy metabolism analysis was used to assay the activity of mitochondrial complex in cells and screen the optimal dosing concentration. Subsequently， the YQ group and modified YQ groups were set up， and the aerobic respiration and glycolysis function were assayed by the Seahorse analyzer. According to the non-mitochondrial oxygen consumption， proton leakage， basal respiration， maximum respiration， ATP production， and potentially improved respiration， the effects of modified YQ groups on the aerobic respiration of mitochondria damaged by hypoxia were evaluated by principal component analysis （PCA） and variable importance in projection （VIP）. The expression of cytochrome C， B-cell lymphoma-2 （Bcl-2）， and Bcl-2-associated X protein （Bax） was detected by Western blot. ResultCompared with the groups of other concentrations， the optimal dosing concentration of carbonyl cyanide-4 （trifluoromethoxy）phenylhydrazone （FCCP） was 2 µmol·L-1. Compared with the model group， the medium-dose YQ group showed enhanced mitochondrial complex activity （P<0.05）. The YQ groups were superior to the model group in improvement （P<0.01）. The combination of ginsenoside and geniposide showed the optimal effect among the modified YQ groups （P<0.01）. VIP analysis revealed that for the improvement of mitochondrial respiratory function， the contribution of geniposide in YQ was the greatest. Compared with the model group， the high-dose YQ group displayed reduced leakage of mitochondrial cytochrome C （P<0.01）， decreased expression of Bax protein （P<0.01）， and increased expression of Bcl-2 protein （P<0.05， P<0.01）. ConclusionA cellular， high-throughput quantitative evaluation method for mitochondrial energy metabolism was established， which demonstrated that YQ could significantly improve the impaired mitochondrial energy metabolism in PC12 cells damaged by hypoxia， and the underlying mechanism might be related to the protection against mitochondrial apoptosis.

Chinese Medicine Monomers Regulate Autophagy of Cervical Cancer Cells： A Review / 中国实验方剂学杂志

Autophagy is a lysosome-mediated catabolic process that captures and degrades dysfunctional organelles and useless proteins during cellular stress process， which plays a dual role in cervical cancer. In the early stage of cervical cancer， autophagy inhibits the occurrence and development of cervical cancer by prohibiting the accumulation of oncogenic p62 protein. In the advanced stage of cervical cancer， inhibition of autophagy of cancer cells enhances the sensitivity of cancer cells to chemotherapeutic drugs， thus inhibiting their proliferation. In recent years， the research on Chinese medicine monomers regulating autophagy in the treatment of cervical cancer has attracted extensive attention from scholars at home and abroad. Chinese medicine monomers regulate the autophagy of cervical cancer cells through multiple pathways and multiple targets， so as to increase the apoptosis rate and reduce the resistance of cancer cells to chemotherapeutic drugs. Therefore， this paper reviewed the mechanism of Chinese medicine monomers in inhibiting cervical cancer through autophagy， expecting to find new breakthroughs in the discovery and development of preventive and therapeutic drugs for cervical cancer. By reviewing the literature， it was found that in the early stage of cervical cancer， Chinese medicine monomers activated autophagy to promote apoptosis of cancer cells， and the main mechanism was to increase lysosomal membrane permeability and chemotherapeutic sensitivity and activate intact autophagy flow. In the advanced stage of cervical cancer， inhibition of autophagy reduced the sensitivity of cancer cells to chemotherapy drugs by inhibiting the formation of autophagosomes and autolysosomes. The treatment of cervical cancer by Chinese medicine monomers regulating autophagy has achieved certain effect， but there are few clinical experimental studies and lack of reliable clinical theoretical basis. Therefore， it is essential to carry out more clinical experimental studies on Chinese medicine monomers regulating autophagy to treat cervical cancer， thus finding more reliable theoretical basis for the treatment of tumors.

Chinese Medicine Monomers Regulate Autophagy of Cervical Cancer Cells： A Review / 中国实验方剂学杂志

Autophagy is a lysosome-mediated catabolic process that captures and degrades dysfunctional organelles and useless proteins during cellular stress process， which plays a dual role in cervical cancer. In the early stage of cervical cancer， autophagy inhibits the occurrence and development of cervical cancer by prohibiting the accumulation of oncogenic p62 protein. In the advanced stage of cervical cancer， inhibition of autophagy of cancer cells enhances the sensitivity of cancer cells to chemotherapeutic drugs， thus inhibiting their proliferation. In recent years， the research on Chinese medicine monomers regulating autophagy in the treatment of cervical cancer has attracted extensive attention from scholars at home and abroad. Chinese medicine monomers regulate the autophagy of cervical cancer cells through multiple pathways and multiple targets， so as to increase the apoptosis rate and reduce the resistance of cancer cells to chemotherapeutic drugs. Therefore， this paper reviewed the mechanism of Chinese medicine monomers in inhibiting cervical cancer through autophagy， expecting to find new breakthroughs in the discovery and development of preventive and therapeutic drugs for cervical cancer. By reviewing the literature， it was found that in the early stage of cervical cancer， Chinese medicine monomers activated autophagy to promote apoptosis of cancer cells， and the main mechanism was to increase lysosomal membrane permeability and chemotherapeutic sensitivity and activate intact autophagy flow. In the advanced stage of cervical cancer， inhibition of autophagy reduced the sensitivity of cancer cells to chemotherapy drugs by inhibiting the formation of autophagosomes and autolysosomes. The treatment of cervical cancer by Chinese medicine monomers regulating autophagy has achieved certain effect， but there are few clinical experimental studies and lack of reliable clinical theoretical basis. Therefore， it is essential to carry out more clinical experimental studies on Chinese medicine monomers regulating autophagy to treat cervical cancer， thus finding more reliable theoretical basis for the treatment of tumors.

Incidence and risk factors of acute kidney injury in preterm infants: a multicenter retrospective study / 中国小儿急救医学

Objective:To estimate the incidence and risk factors of acute kidney injury (AKI) in preterm infants, and provide basis for better evaluation and treatment of renal function in preterm infants.Methods:All the hospitalized premature infants who were admitted to three research centers (Department of Neonatology at Beijing Children′s Hospital; Department of Neonatology at Beijing Obstetrics and Gynecology Hospital; Department of Neonatology at Shunyi Maternal and Children′s Hospital of Beijing Children′s Hospital)from January 1, 2017 to June 30, 2019 and had more than two serum creatinine values or urine output were included.The incidence of AKI in preterm infants was calculated and the difference among different gestational weeks was compared.Preterm infants were divided into AKI and non-AKI groups according to AKI diagnostic criteria, and the clinical characteristics between two groups were compared, and the risk factors of AKI in preterm infants were analyzed.Results:A total of 763 premature infants were included in the analysis.Twenty two cases were diagnosed with AKI.The incidence of AKI in premature infants was 2.9%.The incidence of AKI was 33.3% (3/9), 3.7% (5/134), and 2.3% (14/620) in the 24-27 + 6 weeks, 28-31 + 6 weeks, and 32-36 + 6 weeks gestational age, respectively, and the difference was statistically significant ( χ2=31.010, P<0.001). Preterm infants in AKI group had a higher proportion of males(77.3% vs. 53.3%), lower gestational weeks[29(27, 33) weeks vs.31(29, 33)weeks], higher proportions of infants with diabetic mothers(40.9% vs.19.4%), lower Apgar scores at 1 and 5 minutes[8(7, 10) vs.9(8, 10), 9(9, 10) vs.10(9, 10), respectively], higher proportions of invasive and noninvasive respiratory support(45.5% vs.11.3%, 63.6% vs.19.2%, respectively), longer duration of invasive respiratory support[260(136, 742)h vs.72(18, 160)h], longer hospital stays[66(19, 88)d vs.42(26, 58)d], and higher rates of sepsis (27.3% vs. 6.5%), respiratory distress syndrome(40.9% vs. 11.6%), and patent ductus arteriosus that requiring ibuprofen or surgical closure(13.6% vs. 3.0%), diuretic(27.3% vs. 3.9%), and vasoactive drug use (22.7% vs. 3.6%) than those in non-AKI group, and the differences were statistically significant(all P<0.05). Multivariate regression analysis showed that sepsis was an independent risk factor for AKI in preterm infants ( P=0.039, OR=3.498, 95% CI 1.065-11.490) after adjustment of gestational age and birth weight. Conclusion:The incidence of AKI is relatively high in preterm infants with gestational age<28 weeks.Compared with preterm infants without AKI, preterm infants with AKI have smaller gestational weeks and longer hospital stay.Sepsis is an independent risk factor for AKI in preterm infants.

Multilevel analysis of factors influencing mental health of nursing staff in four provinces in China / 环境与职业医学

Background Nursing staff are often exposed to a variety of occupational risk factors in the working environment, such as long working hours and heavy workload, which associated with adverse mental health outcomes. And these factors may not be randomly distributed across different levels. Objective To explore mental health risk factors of nursing staff by multilevel analysis. Methods A cross-sectional survey of nursing staff in Shanghai Municipality, Zhejiang Province, Guangxi Zhuang Autonomous Region, and Xinjiang Uygur Autonomous Region was conducted through convenience sampling from 2018 to 2021. Data were collected by self-report questionnaires. The mental component summaries of 12-Iitem Short Form Health Survey were used to evaluate the mental health status of nursing staff, and related factors were collected atindividual level, including gender, body mass index (BMI), smoking status, drinking status, working years, pain intensity of musculoskeletal disorders, and working hours per week, and at regional level, including gross domestic product (GDP) level of each province. A two-level model was established by incorporating both individual and regional factors, and deviance was used to test the goodness of fit of the model. A traditional generalized linear model was also established, and then compared with the multilevel model. Results A total of 567 nurses participated in this study, and the valid rate of questionnaire was 80.08%. The results of the multilevel model showed that the regional factor contributed 12.1% to the mental component summaries. As to the regional factor, GDP was negatively correlated with mental health of nursing staff, the adjusted OR (AOR) was −0.53 (95%CI: −0.66-−0.28). Among the factors at individual level, the mental component summaries of females were lower than those of males (AOR=−3.25, 95%CI: −4.73-−0.35); the longer the working years, the higher the mental health score (AOR=0.11, 95%CI: 0.06-0.20); working hours per week (AOR=−0.10, 95%CI: −0.14-−0.03) and pain intensity of musculoskeletal disorders (AOR=−0.05, 95%CI: −0.06-−0.03) were negatively correlated with mental component summaries. The results of the generalized linear model included the same factors as the multilevel model, but the 95%CIs of AOR of the factors in the multilevel model were narrower, and the deviation value of the multilevel model was the smallest, indicating that the goodness of fit of the multilevel model was better than that of the traditional linear model. Conclusion The mental health of nursing staff is not only affected by individual level factors, but also affected by regional level factors. It suggests that combining different levels of intervention measures can upscale the effect of improving mental health in nursing staff.

A clinical outcomes assessment tool based on the International Classification of Functioning, Disability and Health / 中华物理医学与康复杂志

Objective:To confirm items included in a tool for assessing clinical outcomes based on International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set.Methods:The item pool was established based on the ICF Rehabilitation Set. Then 15 experts were invited to participate in three rounds of expert Delphi consensus-building to choose items with high importance in assessing clinical outcomes. The reliability of the tool was examined by analyzing the experts′ positive coefficients, authority coefficients and degree of agreement.Results:The assessment tool which emerged from the three rounds comprised 17 items, including 8 Body Functions items (b130 Energy and drive functions, b134 Sleep functions, b152 Emotional functions, b280 Sensation of pain, b455 Exercise tolerance functions, b620 Urination functions, b710 Mobility of joint functions and b730 Muscle power functions), d230 Carrying out daily routine from General Tasks and Demands, 3 Mobility items (d410 Changing basic body position, d450 Walking and d465 Moving around using equipment), 4 Self-care items (d510 Washing oneself, d530 Toileting, d540 Dressing and d550 Eating) and 1 item of Interpersonal Interactions and Relationships (d710 Basic interpersonal interactions). All had 100% positive coefficients after the three rounds, with an authority coefficient of 0.81 and coefficients of variation between 0.054 and 0.412.Conclusion:The assessment tool constructed in this study provides a new direction for quality control in clinical practice and medical insurance assessments.

Analysis of related risk factors for the refracture of adjacent vertebral body after percutaneous kyphoplasty / 中国骨伤

OBJECTIVE@#To investigate the risk factors of vertebral refracture after percutaneous kyphoplasty (PKP) for osteoprotic vertebral compression fractures (OVCFs), and to provide reference for clinical prevention.@*METHODS@#A retrospective analysis of 228 OVCFs patients who met the inclusion criteria admitted from November 6, 2013 to December 14, 2018. There were 35 males and 193 females, with a male-to-female ratio of 3∶20, and aged 58 to 91 years with an average of (69.70±7.03) years. All patients were treated with PKP and had complete clinical data. According to whether refracture occurred after operation, they were divided into refracture group (24 cases) and non refracture group (204 cases). Factors that may be related to refracture (including gender, age, surgical segment, number of vertebral bodies in the surgical segment, whether combined with degenerative scoliosis, whether anti-osteoporosis treatment) were included in the univariate analyses, and the single factor analysis of statistically significant risk factors was carried out with multiple Logistic regression analysis to further clarify the independent risk factors for vertebral body refracture after PKP. Survival analysis was performed using the time of vertebral refracture after PKP as the end time of follow up, the occurrence of refracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor.@*RESULTS@#All 228 patients were followed up for 1.8 to 63.6 months with an average of (28.8±15.6) months, and the refracture rate was 10.5%(24/228). There were statistically significant differences between two groups in age, number of operative vertebral bodies, whether combinedwith degenerative scoliosis and whether anti osteoporosis treatment (@*CONCLUSION@#Combined scoliosis is an independent risk factor for refracture after OVCFs vertebroplasty, and it is also a possible high-risk factor for refracture after surgery.

Three-Dimensional Heterogeneity of Cerebellar Interposed Nucleus-Recipient Zones in the Thalamic Nuclei / 神经科学通报·英文版

The cerebellum is conceptualized as a processor of complex movements and is also endowed with roles in cognitive and emotional behaviors. Although the axons of deep cerebellar nuclei are known to project to primary thalamic nuclei, macroscopic investigation of the characteristics of these projections, such as the spatial distribution of recipient zones, is lacking. Here, we studied the output of the cerebellar interposed nucleus (IpN) to the ventrolateral (VL) and centrolateral (CL) thalamic nuclei using electrophysiological recording in vivo and trans-synaptic viral tracing. We found that IpN stimulation induced mono-synaptic evoked potentials (EPs) in the VL but not the CL region. Furthermore, both the EPs induced by the IpN and the innervation of IpN projections displayed substantial heterogeneity across the VL region in three-dimensional space. These findings indicate that the recipient zones of IpN inputs vary between and within thalamic nuclei and may differentially control thalamo-cortical networks.

Correlation of gut microbiota and ischemic stroke: a review / 中国中药杂志

With the widespread application of next-generation sequencing(NGS), especially 16 S rRNA and shotgun sequencing, researchers are no longer troubled with massive data on the gut microbiota, and the correlation between the gut microbiota and the brain(central nervous system) has been gradually revealed. Research on the microbiota-gut-brain axis(MGBA) based on the gut microbiota have provided insights into the exploration of the pathogenesis and risk factors of ischemic stroke(IS), a cerebrovascular disease with high disability and mortality rates, and also facilitate the selection of therapeutic targets of this class of drugs. This study reviewed the application of NGS in the study of gut microbiota and the research progress of MGBA in recent years and systematically collated the research papers on the correlation between IS and gut microbiota. Furthermore, from the bi-directional regulation of MGBA, this study also discussed the high-risk factors of IS under the dysregulation of gut microbiota and the pathophysiological changes of gut microbiota after the occurrence of IS and summarized the related targets to provide a reliable reference for the therapeutic research of IS from the gut microbiota.

Advances in formation and application of self-assembled nanoparticles from traditional Chinese medicine / 中国中药杂志

Due to the diverse sources and unique structures, the chemical components of Chinese medicinal materials are easy to self-assemble to form nanoparticles. The formation of self-assembled nanoparticles(SAN) can not only affect the absorption and distribution of the effective ingredients in Chinese medicinal materials but also may improve the biological activity of the effective ingredients or their simple mixtures, which is of great significance for revealing the compatibility mechanism of Chinese medicine prescription, developing new Chinese medicine products, and producing new nanomaterials. This paper reviews the formation, isolation, characterization, and application of SAN of Chinese medicines, and discusses the problems and development trends of the relevant research, which can provide reference for the further study and promote the innovation and application of such SAN.

Clinicopathological features and prognosis of gastrointestinal stromal tumors with KIT/PDGFRA gene "homozygous mutation": a multicenter retrospective cohort study / 中华胃肠外科杂志

Objective: To investigate the clinicopathological features of gastrointestinal stromal tumor (GIST) with KIT/PDGFRA "homozygous mutation", the efficacy of targeted therapy and the prognosis. Methods: A retrospective cohort study and propensity score matching were used. "Homozygous mutation" was defined as the detection of KIT/PDGFRA gene status of GIST by Sanger sequencing, which showed that there was only mutant gene sequence in the sequencing map, lack of wild-type sequence or the peak height of mutant gene sequence was much higher than that of wild-type gene sequence (> 3 times). "Heterozygous mutation" was defined as the mutant gene sequences coexisted with wild type gene sequences, and the peak height was similar (3 times or less). The clinicopathological data and follow-up information of 92 GIST patients with KIT/PDGFRA "homozygous mutation" were collected from 4 hospitals in Shanghai from January 2008 to May 2021 (Renji Hospital, Shanghai Jiaotong University School of Medicine: 70 cases; Zhongshan Hospital, Fudan University: 14 cases; Changhai Hospital, Naval Military Medical University: 6 cases and Ruijin Hospital, Shanghai Jiaotong University School of Medicine: 2 cases). Patients with perioperative death, other malignancies, and incomplete clinicopathological information were excluded. The clinicopathological features of the patients and the efficacy of targeted drug therapy were observed and analyzed. The efficacy was evaluated using Choi criteria, which were divided into complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). In addition, a total of 230 patients with high-risk GIST with "heterozygous mutation" in exon 11 of KIT gene and 117 patients with recurrent or metastatic GIST with "heterozygous mutation" in exon 11 of KIT gene were included. The propensity score matching method was used to match GIST patients with "heterozygous" and "homozygous" mutations in exon 11 of KIT gene (1∶1) for survival analysis. The disease-free survival (DFS) between two groups of high-risk GIST patients who underwent complete surgical resection were compared. And progression-free survival (PFS) in patients with recurrent or metastatic GIST were compared. Results: Of the 92 GIST cases with KIT/PDGFRA "homozygous mutation", 58 were males and 34 were females, with a median onset age of 62 (31-91) years. Primary GIST 83 cases. Primary high-risk GIST (53 cases), metastatic GIST (21 cases) and recurrent GIST (9 cases) accounted for 90.2% (83/92). There were 90 cases of KIT gene"homozygous mutation" (exon 11 for 88 cases, exon 13 for 1 case, exon 17 for 1 case), and 2 cases of PDGFRA gene "homozygous mutation" (exon 12 for 1 case, exon 18 for 1 case). The median follow-up time was 49 (8-181) months. Among the 61 cases of primary localized GIST undergoing complete surgical resection, 2 cases were intermediate-risk GIST, 5 cases were low-risk GIST, and 1 case was very low-risk GIST, of whom 1 case of intermediate-risk GIST received 1-year adjuvant imatinib mesylate (IM) therapy after operation, and no tumor recurrence developed during the follow-up period. The remaining 53 cases were high-risk GIST, and follow-up data were obtained from 50 cases, of whom 22 developed tumor recurrence during follow-up. Of 9 patients directly receiving neoadjuvant targeted therapy (IM or avapritinib), 5 had complete imaging follow-up data, and the evaluation of efficacy achieved PR. Of all the 92 GIST cases with KIT/PDGFRA "homozygous mutation", 50 (54.4%) had tumor metastasis or tumor recurrence or progression during follow-up, and 12 (13.0%) died of the tumor. Survival analysis combined with propensity score showed that in 100 cases of high-risk GISTs with complete resection, GISTs with "homozygous mutation" in exon 11 of KIT gene had shorter disease-free survival (DFS) than GISTs with "heterozygous mutation" in exon 11 of KIT gene (median DFS: 72 months vs. 148 months, P=0.015). In 60 cases of recurrent or metastatic GISTs with KIT gene exon 11 mutation, IM was used as the first-line treatment, and the progression-free survival (PFS) of GISTs with "homozygous mutation" was shorter compared to GISTs with "heterozygous mutation" (median PFS: 38 months vs. 69 months, P=0.044). The differences were statistically significant. Conclusions: "Homozygous mutation" in KIT/PDGFRA gene is associated with the progression of GIST. The corresponding targeted therapeutic drugs are still effective for GIST with KIT/PDGFRA gene "homozygous mutation". Compared with GIST patients with "heterozygous mutation" in KIT exon 11, GIST patients with "homozygous mutation" in KIT exon 11 are more likely to relapse after surgery and to develop resistance to IM. Therefore, it is still necessary to seek more effective treatment methods for this subset of cases.

Effect of self-assembled nanoparticles from Shaoyao Gancao Decoction on release and absorption of main components of Baishao / 中国中药杂志

To study the effect of self-assembled nanoparticles from Shaoyao Gancao Decoction(SGD-SAN) on the encapsulation, in vitro release and intestinal absorption of the main components of Baishao. Particle size analysis and morphological observation were used to verify the formation of SGD-SAN in the decoction. The entrapment efficiency(EE) of SGD-SAN on the main components of Baishao was determined by ultrafiltration centrifugation. The dialysis bag method was used to study the in vitro release of the main components of Baishao with pH 6.8 phosphate buffer solution as the release media. Single-pass intestinal perfusion study was performed to investigate the effect of SGD-SAN on the absorption of the main components of Baishao. The results showed that there were nanoparticles in the SGD, and the particle sizes and PDI of SGD-SAN were about 200 nm and 0.38, respectively. SGD-SAN was irregularly spherical under transmission electron microscope(TEM). The EEs of albiflorin, paeoniflorin and benzoylpaeoniflorin in SGD-SAN were 33.78%±1.03%,33.61%±0.90%,88.53%±0.58%, respectively. The release characteristics of albiflorin, paeoniflorin and benzoylpaeoniflorin from SGD-SAN showed a slow-release effect on pH 6.8 phosphate buffer solution media. SGD-SAN could significantly enhance the absorption of albiflorin, paeoniflorin and benzoylpaeoniflorin in the ileum. The results of this study indicated that SAN could be formed during the mixed decoction of Baishao and Gancao, and SGD-SAN could encapsulate the components of Baishao, with a certain slow-release effect, and the formation of SAN facilitated the absorption of drugs in the ileum.

Comparison of Determination Methods of Saccharides in Polygonatum cyrtonema and Optimization of Its Wine- steaming Technology / 中国药房

OBJECTIVE：To compare the methods for the con tent determination of polysaccharide and reducing sugar in Polygonatum cyrtonema， and to optimize the wine-steaming technology of P. cyrtonema . METHODS ： The contents of polysaccharide in P. cyrtonema were determined by anthrone-sulfuric acid method and phenol-sulfuric acid method. The contents of reducing sugar in P. cyrtonema were determined by anthrone-sulfuric acid method ， phenol-sulfuric acid method and 3， 5-dinitrosalicylic acid （DNS）method，respectively. Taking appearance and property scores of processed products ，the contents of polysaccharide，reducing sugar and total sugar as indicators ，the amount of alcohol added ，steaming time and moistening time as factors，the wine-steaming technology of P. cyrtonema was optimized by Latin square design. The contents of polysaccharide ， reducing sugar and total sugar were compared before and after steaming. RESULTS ：The linear ranges of polysaccharide and reducing sugar obtained by anthrone-sulfuric acid method were both 0.006 6-0.033 mg/mL（R2＝0.999 9）. RSDs of precision ， stability（90 min）and reproducibility tests were all lower than 3％ and 2％，respectively. Average recoveries were 99.75％（RSD＝ 0.48％，n＝6）and 103.40％（RSD＝1.25％，n＝6），respectively. The linear ranges of polysaccharide and reducing sugar obtained by phenol-sulfuric acid method were both 0.002 5-0.025 mg/mL（R2＝0.999 2）. RSDs of precision ，stability （90 min） and reproducibility tests were all lower than 5％ and 6％，respectively. Average recoveries were 112.80％（RSD＝2.36％，n＝6）and 99.20％（RSD＝3.47％，n＝6）. The linear range of reducing sugar obtained by DNS method was 0.01-0.18 mg/mL（R2＝0.999 9）. RSDs of precision ，stability（90 min）and reproducibility tests were all lower than 2％. Average recoveries was 96.95％（RSD＝ 1.19％，n＝6）. The optimal wine-steaming technology of P. cyrtonema included the amount of alcohol added of 20％，moistening time of 2 h and steaming time of 7 h. RSDs of average contents of polysaccharide ，reducing sugar and total sugar in wine-steamed products were all lower than 3％ in 3 times of validation tests （n＝3）. The average contents of polysaccharide ，reducing sugar and total sugar in 4 batches of P. cyrtonema were 16.3％，11.2％ and 27.4％；those of 4 batches of wine-steamed products were 3.4％， 61.0％ and 64.4％，respectively. CONCLUSIONS ：The anthrone- ） sulfuric acid method is the best for the determination of poly- saccharide in P. cyrtonema ；DNS method is the best for the pandongmei1228@126.com determination of reducing sugar in P. cyrtonema. The content ofpolysaccharide in wine-steamed products is decreased signifi- cantly，while the contents of reducing sugar and total sugar are increased significantly.

Cognition of Ovarian Cancer Microenvironment in Traditional Chinese Medicine from Perspective of "Yin-Yang Balance" / 中国实验方剂学杂志

Ovarian cancer， one of gynecological malignancies， is often diagnosed at the late stage because of the atypical early symptoms and has become a major killer of women. Research has found that the co-evolution of tumor cells and their surrounding microenvironment is an important cause for the occurrence and development of ovarian cancer. It is believed in traditional Chinese medicine （TCM） that Yin and Yang are the roots of everything， and their balance， namely Yin being at peace and Yang being compact （“Yin Ping Yang Mi”） is a sign of good health. The mutual opposition， restriction， and rooting of Yin and Yang as well as their waning and waxing and transformation are the keys to maintaining the balance. In TCM， ovarian cancer falls into the category of abdominal mass， which results from the struggle between healthy Qi and evil Qi. When the healthy Qi is deficient and the evil Qi is excessive， the balance between Yin and Yang will be destroyed， triggering the body and ovarian cancer microenvironment as well as the relevant factors in the inflammatory microenvironment to be mutually opposed， restricted， and transformed， highly consistent with the dynamic development of Yin and Yang. At present， the studies concerning TCM intervention in the inflammatory microenvironment of ovarian cancer mostly focus on the signaling pathways to reveal the advantages of TCM multiple components against cancer cells via multiple targets， but they fail to explain the TCM efficacy from the perspective of Yin-Yang balance. Therefore， guided by the concept of Yin-Yang balance， this paper macroscopically and microscopically explored the effects of the changed factors in inflammatory microenvironment on the occurrence and development of ovarian cancer， and put forward that the prevention and control principles of ovarian cancer should lie in the "adjustment of Yin-Yang balance"， accompanied by healthy Qi reinforcement and pathogen elimination. This paper has laid the foundation for the elucidation of modern research achievements regarding the ovarian cancer microenvironment with TCM theory and provide a theoretical basis for the clinical treatment of ovarian cancer with integrated TCM and western medicine.

Category and working mechanisms of SARS-CoV-2 vaccines and their effectiveness in clinical trials / 上海预防医学

Since the pandemic outbreak of the COVID-19， there had been about 121 million confirmed cases and more than 2.6 million deaths， which had significantly affected the economies and health resources in more than 233 countries and regions. Currently， no effective therapeutic option is available for the COVID-19， andimplementation of public health interventions suffers inconvenience. Consequently， the development of COVID-19 vaccines remains crucial. This review updates the current research progression， advantages and disadvantages of inactivated vaccine， live attenuated vaccine， recombinant subunit vaccine， recombinant virus-vectored vaccine， DNA vaccine， and RNA vaccine for the COVID-19. It warrants joint research and development of vaccines on multiple platforms， which would facilitate better control and prevention of the COVID-19 epidemic.