Material basis and mechanism of Curcuma longa tuberous roots with and without vinegar processing in treating primary dysmenorrhea / 中国中药杂志

Liquid chromatography-mass spectrometry was employed to analyze the chemical components in Curcuma longa tuberous roots(HSYJ), C. longa tuberous roots processed with vinegar(CHSYJ), and rat serum after the administration. The active components of HSYJ and CHSYJ absorbed in serum were identified based on the secondary spectrum of database and literature. The targets of primary dysmenorrhea was screened out from database. The protein-protein interaction network analysis, gene ontology(GO) functional annotation, and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed for the common targets shared by the drug active components in serum and primary dysmenorrhea, and the component-target-pathway network was constructed. AutoDock was used to conduct molecular docking between the core components and targets. A total of 44 chemical components were identified from HSYJ and CHSYJ, including 18 absorbed in serum. On the basis of network pharmacology, we identified 8 core components(including procurcumenol, isobutyl p-hydroxybenzoate, ferulic acid, and zedoarondiol) and 10 core targets \[including interleukin-6(IL-6), estrogen receptor 1(ESR1), and prostaglandin-endoperoxide synthase 2(PTGS2)\]. The core targets were mainly distributed in the heart, liver, uterus, and smooth muscle. The molecular docking results showed that the core components were well bound to the core targets, indicating that HSYJ and CHSYJ may exert therapeutic effect on primary dysmenorrhea via estrogen, ovarian steroidogenesis, tumor necrosis factor(TNF), hypoxia-inducible factor-1(HIF-1), IL-17 and other signaling pathways. This study clarifies the HSYJ and CHSYJ components absorbed in serum, as well as the corresponding mechanism, providing a reference for further elucidating the therapeutic material basis and clinical application of HSYJ and CHSYJ.

Effect of processing with vinegar on efficacy of Curcuma longa in treatment of dysmenorrhea in rats with syndrome of liver depression and Qi stagnation / 中国中药杂志

This study compared the effects of Curcuma longa before and after processing with vinegar on the rat model of dysmenorrhea with the syndrome of liver depression and Qi stagnation to reveal the mechanism of vinegar processing in improving the role of C. longa in soothing liver and relieving pain. The rat model of dysmenorrhea with the syndrome of liver depression and Qi stagnation was established according to the Preparation of the Animal Model of Dysmenorrhea(Draft) and the chronic unpredictable stress me-thod. The changes in the body weight, organ indexes, writhing latency, writhing score, and serum levels of six liver function indicators, sex hormones, pain factors, and blood rheological indicators were measured to evaluate the efficacy of C. longa processed with vinegar or not in treating dysmenorrhea in the rats with syndrome of liver depression and qi stagnation. Compared with the model group, the C. longa group(processed with vinegar or not) showed slow weight loss, increase in writhing latency, and decrease in writhing response(P<0.05). The inhibition rates on writhing in raw C. longa, vinegar-processed C. longa, and positive groups were 33.780%, 64.611%, and 62.466%, respectively. The significantly higher inhibition rate of the vinegar processing group indicated that vinegar-processed C. longa demonstrated more significant therapeutic effect. The vinegar-processed C. longa group showed lower levels of alanine aminotransferase(ALT), alkaline phosphatase(ALP), aspartate aminotransferase(AST), direct bilirubin(DBIL), and total bilirubin(TBIL) and higher level of albumin(ALB)(P<0.05), which indicated that vinegar processing enhanced the therapeutic effect of C. longa on liver injury. The serum levels of estradiol(E_2) and oxytocin(OT) were lower in the vinegar-processed C. longa group(P<0.05), indicating that the vinegar-processed C. longa could regulate the sex hormone levels, reduce the activity of uterine smooth muscle and contraction of uterus, and alleviate the symptoms of dysmenorrhea in rats. Moreover, the vinegar-processed C. longa group showed lower interleukin-6(IL-6) and arginine vasopressin(AVP) levels and higher beta-endorphin(β-EP) level(P<0.05), which indicated that vinegar-processed C. longa regulated the levels of pain factors to exert the pain-relieving effect. Drug intervention decreased the whole blood viscosity low-cut, medium-cut and high-cut values, plasma viscosity, whole blood reduction viscosity low-cut and high-cut values, erythrocyte cumulative pressure, and equation K value of erythrocyte sedimentation rate(P<0.05), and the vinegar-processed C. longa group outperformed other groups. This result indicated that vinegar processing enhanced the function of C. longa in improving the local blood rheology. C. longa processed with vinegar can enter the liver to relieve the da-mage to the heart, liver, kidney, and uterus, repair the liver function, and recover the sex hormone levels and immune function by regulating the levels of sex hormones and pain factors and improving the blood rheology. It activates the pain-relieving mechanism to relieve the pain, protect the liver, and fight inflammation, which is consistent with the theory that vinegar processing facilitates C. longa entering the liver to sooth liver and relieve pain.

Efficacy analysis of autologous facet joint bone block in lumbar interbody fusion of osteoporosis patients / 北京大学学报(医学版)

OBJECTIVE@#To compare and analyze the feasibility of autologous facet joint bone block as an alternative to polyetheretherketone (PEEK) cage in lumbar intervertebral fusion surgery for patients with osteoporosis.@*METHODS@#From December 2018 to June 2021, the case data of patients with osteoporosis (T value ≤ -2.5 on dual energy X-ray bone density) who underwent posterior lumbar interbody fusion in the Fourth Medical Center, Chinese PLA General Hospital were retrospectively reviewed. All the cases were followed up for no less than 12 months and were divided into two groups according to the differences of interbody fusion materials: the autologous facet joint bone block group (autogenous bone group) and the PEEK cage group (PEEK group). The general data [such as age, gender, body mass index (BMI), primary diagnosis, distribution of fusion segments, bone mineral density of lumbar (BMD), incidence of preoperative complications], the perioperative data (such as duration of operation, intraoperative blood loss, postoperative drainage, perioperative allogeneic blood transfusion rate), and the incidence of postoperative complications were compared between the two groups. Imaging parameters (disc height, lumbar lordosis angle, segment lordosis angle, segmental lordosis angle, disc height improvement rate, and fusion rate) and lumbar functional scores [visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedics Association (JOA) score for lower back pain] were compared to evaluate the clinical efficacy between the kinds of intervertebral fusion materials 1 week, 3 months and 6 months postoperative and at the last follow-up.@*RESULTS@#A total of 118 patients were enrolled, including 68 cases in the autogenous bone group and 50 cases in the PEEK group, there were no statistical differences in age, gender, BMI, primary diagnosis, distribution of fusion segments, BMD, incidence of preoperative complications, duration of operation, intraoperative blood loss, postoperative drainage, perioperative allogeneic blood transfusion rate, incidence of postoperative complications, all the preoperative imaging parameters and all the lumbar function scores between the two groups (P>0.05). Postoperative superficial surgical site infections occurred in 3 patients in the autogenous bone group and 2 patients in the PEEK group. At the last follow-up, 3 cases of intervertebral graft collapse occurred in the autogenous bone group and 5 cases in the PEEK group, 1 case of graft subsidence in the autogenous bone group and 1 case in the PEEK group. All the imaging parameters showed significant differences between postoperation and preoperation (P < 0.05), and all the imaging parameters showed significant differences between 1 week and 3 months postoperative in both groups (P < 0.05). The height, angle of fusion gap in the autogenous bone group were lower than those in the PEEK group 1 week postoperatively (P < 0.05), and the fusion gap height improvement rate in the autogenous bone group was lower than that in the PEEK group (P < 0.05). The cases in both groups started to show final fusion 3 months after surgery, and the fusion rate in the autogenous bone group was 75% 6 months postoperatively, which was significantly higher than the rate of 56% in the PEEK group (P < 0.05), and there was no statistically significant difference in the final fusion rate between the two groups (P>0.05). The ODI, the postoperative VAS score was significantly lower than that in preoperation, while the postoperative JOA score was significantly higher than that in preoperation (P < 0.05). The ODI was lower while the JOA score was higher of the autogenous bone group than that of the PEEK group 6 months postoperatively (P < 0.05).@*CONCLUSION@#In osteoporosis patients, good interbody fusion rate and improvement of lumbar vertebral function can be obtained by using autologous facet joint bone block or PEEK cage, while the fusion rate and the improvement of lumbar function with autologous facet joint bone block are better than those with PEEK cage 6 months post-operatively. PEEK cage is superior to autologous facet joint bone block in intervertebral distraction and improvement of lumbar lordosis. Significant disc space subsidence occurred in osteoporotic patients within 3 months after lumbar interbody fusion, and the subsidence of PEEK cage was more obvious than that of autologous facet joint bone block.

Effect of Clkl gene on level of Aβ-induced autophagy in Alzheimer's disease / 中国药理学通报

Aim To investigate the effect of siRNA transfection of silencing Clkl gene on autophagy levels in AD model cells. Methods The Clkl gene was silted using siRNA transfection techniques. MTT was used to observe the effects of Aβ

Analysis of influencing factors of quality of life of patients with pneumoconiosis in Chongqing based on a structural equation model / 中国职业医学

@#Objective To analyze the influencing factors of quality of life of patients with occupational pneumoconiosis in Methods Chongqing using a structural equation model. A total of 1 181 pneumoconiosis patients in Chongqing were selected - as the research subjects using convenient sampling method. The Chinese version of the SF 36 Scale was used to investigate the quality of life of the patients. Amos 24.0 software was used to construct a structural equation model reflecting the quality of life of Results ， （ ），（ ） （ ）， patients. The scores of physical health mental health and quality of life were 61.7±18.5 68.7±20.5 and 64.7±16.8 respectively. The scores of the eight dimensions of the quality of life of the research subjects were lower than that of the （ P ） Chongqing City municipal and national norms all <0.01 . Multiple linear regression results showed that personal monthly ， ， ， income pneumoconiosis stage complications employment status and smoking were the influencing factors of the quality of life （ P ） ， of pneumoconiosis patients all <0.05 . The results of the structural equation model showed that the stage of pneumoconiosis ， ， complications personal monthly income and pulmonary rehabilitation treatment could directly affect the physical and mental （ P ） ， health of the research subjects all <0.05 . In addition the stage of pneumoconiosis and complications indirectly affected the （ P ）Conclusion physical and mental health of patients by affecting pulmonary rehabilitation treatment all <0.05 . The structural equation model can be used to verify the influencing factors of the quality of life of patients with occupational pneumoconiosis. ， Complications personal monthly income and pneumoconiosis stage are the main factors affecting the quality of life of patients with occupational pneumoconiosis.

Clinical features of 71 patients with acute brucellosis in Zaozhuang City of Shandong Province / 中华地方病学杂志

Objective:To analyze the epidemiological characteristics and clinical manifestations of patients with acute brucellosis in Zaozhuang City of Shandong Province, and to improve the understanding of brucellosis.Methods:The demographic characteristics, epidemiological characteristics, clinical manifestations and laboratory examination results of patients with acute brucellosis diagnosed in Zaozhuang Municipal Hospital from January 2019 to December 2020 were retrospectively analyzed.Results:Most of the 71 patients with acute brucellosis were male, with a male-to-female ratio of 2.2 ∶ 1.0 (49 ∶ 22) and an average age of (53.23 ± 14.12) years old, mainly in Yicheng District (32.39%, 23/71); 80.28% (57/71) of patients had a history of epidemiological contact; the disease occurred throughout the year, mainly from April to October (76.06%, 54/71); the main symptoms were fever (100.00%, 71/71), muscle and joint pain (80.28%, 57/71), fatigue (54.93%, 39/71), hyperhidrosis (39.44%, 28/71), hepatosplenomegaly (18.31%, 13/71) and orchitis (4.23%, 3/71), etc. Laboratory examination results showed that decreased white blood cells accounted for 12.68% (9/71), decreased red blood cells accounted for 21.13% (15/71), thrombocytopenia accounted for 8.45% (6/71), decreased lymphocyte percentage accounted for 12.68% (9/71), increased C-reactive protein accounted for 67.61% (48/71), and accelerated erythrocyte sedimentation rate accounted for 50.70% (36/71). Some patients were accompanied by elevated alanine aminotransferase (50.70%, 36/71) and aspartate aminotransferase (42.25%, 30/71), 57 patients (80.28%) with positive blood culture.Conclusions:The clinical manifestations of acute brucellosis are atypical in Zaozhuang City. Brucellosis screening should be carried out for patients with long-term unexplained fever and an epidemiological exposure history, especially those with muscle joint pain, hepatosplenomegaly and orchitis.

Analysis on the influencing factors of low back pain in the occupational workers of key industries in China / 中国职业医学

OBJECTIVE: To explore the influencing factors of low back pain and the relationship of the influence of bad working posture, weight load and frequency of load and the dose-response relationship among the occupational workers of key industries in China. METHODS: A total of 57 501 employees from 15 key industries in China were selected as research subjects using stratified cluster sampling method. The occurrence of low back pain in the past one year, as well as occupational factors such as job type, labor organization and work posture were investigated by using the Chinese version Musculoskeletal Disorders Questionnaire. RESULTS: The prevalence of low back pain in the occupational population of key industries in China was 16.4%(9 448/57 501). Multivariate Logistic regression analysis showed that the risk of low back pain in females was higher than that in males(P<0.01). Married, obese, occasional and frequent smokers, and a history of lower back disease were associated with increased risk of low back pain(all P<0.05). The risk of low back pain was associated with older age, higher education level, and lower frequency of physical exercise(all P<0.01). The risk of low back pain was higher with longer working time, greater back curvature, and the high frequency of long standing and sitting position work, uncomfortable working posture, repeated operation per minute, and lifting>5 kg weight(all P<0.01). CONCLUSION: The influencing factors of low back pain in the occupational population of key industries in China include bad working posture, high frequency load, weight load and other individual factors. There is a dose-response relationship with low back posture load and frequency of load.

Study on Regulatory Action of Addition and Subtraction of Therapy of Zidiantang to Mmune Inflammatory Factors of Children with Purpura Nephritis / 中国实验方剂学杂志

Objective:To observe clinical effect of addition and subtraction therapy of Zidiantang to purpura nephritis in children （syndrome of blood fever） and regulatory action to immune inflammatory factors. Method:One hundred and twenty-five patients were randomly divided into control group （61 cases） and observation group （64 cases） by random number table. A total of 57 patients in control group completed the therapy （2 patients were falling off or missing visit and 2 was eliminated）， 59 patients in observation group completed the therapy （3 patients were falling off or missing visit and 2 was eliminated）. Both groups' patients got comprehensive measures of western medicine. Patients in control group got Xueniaoan capsule， 1 to 4 grains/time， 3 times/day. Patients in observation groups got addition and subtraction therapy of Zidiantang， 1 dose/day. The treatment was continued for 2 months and the follow up was recorded for a month. Purpura and urinalysis were recorded for every week. And disappearance of purpura， hematuria and proteinuria were compared for 3 months. Before treatment， and at the first， second and during the follow up， scores of 24 h urine protein quantification （24 hup） and syndrome of blood fever were graded. Levels of microalbuminuria （mAlb）， urinary <italic>β</italic>₂-microglobulin （<italic>β</italic>₂-MG）， cystatin C（CysC）， globulin A1（IgA1）， IgG， complement C3， Th17 cells， Treg cells， interleukin-17 （IL-17）， IL-21， IL-10 and transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁） were detected before and after treatment. Result:At the first month of treatment， disappearance rate of purpura in observation group was higher than that in control group （<italic>P</italic><0.05）. Before treatment， and at the first， second and during the follow up， disappearance rate of hematuria and albuminuria were higher than those in control group （<italic>P</italic><0.05）， and scores of 24 h urine protein quantification （24 hup） and syndrome of blood fever were lower than those in control group （<italic>P</italic><0.01）. Levels of mAlb， <italic>β</italic>₂-MG， CysC， IgA1， IgG， Th17， Th17/Treg， IL-17， IL-21 and TGF-<italic>β</italic>₁ were lower than those in control group （<italic>P</italic><0.01）， and levels of C3， CD4⁺， Treg and IL-10 were higher than those in control group （<italic>P</italic><0.01）. Conclusion:On the basis of conventional western medicine treatment， addition and subtraction therapy of Zidiantang can promote the purpura to subside， improve the syndrome symptoms of blood fever， regulate the immune inflammatory reaction， reduce the inflammatory damage of kidney， thus reduce the hematuria and proteinuria， and play a role in protecting the renal function.

Effects of di-2-ethylhexyl phthalate exposure on liver and glycolipid metabolism in male diabetic rats / 上海预防医学

Objective:Phthalates （PAEs） are common environmental endocrine disruptors. In this study， the effects of oxidative stress on liver and nutrient metabolism were determined in male diabetic rats exposed to di-2-ethylhexyl phthalate （DEHP）， and the mechanism of DEHP toxicity was explored. Methods:Thirty-two SPF male Wistar rats aged five weeks， weighing 150-170 g， were fed adaptively for one week to establish the model of type 2 diabetes. The model was established by intraperitoneal injection of streptozotocin （STZ） （25 mg/kg） after feeding with high sugar and high fat diet for four weeks. Second STZ injection was given two days later. The model was considered to be established successfully when the random blood glucose level was found to be higher than 16.7 mmol/L in two separate tests. Twenty diabetic rats were then randomly divided into four groups， including control group （corn oil）， 100， 300 and 900 mg/kg DEHP groups. The rats were treated with DEHP by gavage （5 mL/kg） once a day for 30 days. They were fed with normal diet during the treatment period. Caudal venous blood was collected on the 1st， 14th， and 28th days to measure the random blood glucose level. The changes of glucose tolerance were determined by oral glucose tolerance test on the 29th day. Fasting blood glucose （FPG） was measured on the next day of the last exposure. After the rats were anesthetized with pentobarbital and killed， the liver was weighed， the liver coefficient was calculated and the liver pathological section was made. Blood was taken from the abdominal aorta. The levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， triacylglycerol （TG） and albumin （ALB） in serum were measured by spectrophotometry， and the levels of insulin， glutathione （GSH）， H2O2， malondialdehyde （MDA） and superoxide dismutase （SOD） in fasting serum were measured by radioimmunoassay. Results:There was no significant difference in body weight and random blood glucose in the type 2 diabetic rats exposed to different concentrations of DEHP （all P>0.05）. At each time point of the glucose tolerance curve， the blood glucose value of the exposure groups was higher than that of the control group. A "false plateau period" appeared after the blood glucose value reached or exceeded the upper limit at 15 minutes， and the blood glucose level in each group was higher than that of the control group at 120 minutes. The liver organ coefficient of 300 and 900 mg/kg DEHP groups was higher than that of the control group （both P<0.01）， and the liver organ coefficient was positively correlated with the exposure concentration of DEHP （r=0.80，P<0.000 1）. Under the microscope， the liver cells in diabetic rats were swollen， the cytoplasm was light stained， and there were vacuoles in the cells. The serum ALP level in diabetic rats of 900 mg/kg DEHP group was significantly higher than that in the control group （P<0.01）. The serum ALP level was positively correlated with the concentration of DEHP （r=0.75， P<0.01）. The serum MDA level in diabetic rats of 300 mg/kg and 900 mg/kg DEHP groups was significantly higher than that of the control group （both P<0.01）， and the serum MDA level was positively correlated with the concentration of DEHP （r=0.84， P<0.000 1）. The serum SOD level of 900 mg/kg DEHP group was significantly higher than that of control group （P<0.01）. Conclusion:DEHP exposure could lead to liver damage， abnormal glycolipid metabolism， and increase the level of oxidative stress and antioxidant level in male diabetic rats， but did not show a significant effect on insulin resistance.

Cognition and Ability of Emergency Physicians for Palliative Care in Tertiary Hospitals / 中国医学科学院学报

Objective To understand the cognition and related abilities of emergency physicians for palliative care in China. Methods A total of 115 emergency physicians were selected by convenient sampling to conduct a questionnaire survey.The questionnaire included the physicians' basic information,feelings and attitudes towards end-stage patients and their families,cognition of palliative care,and personal ability for palliative care. Results 25.2%,59.1%,and 15.7% of the emergency physicians considered they had "no understanding","partial understanding",and "full understanding" of palliative care,respectively.32(27.8%)physicians participated in palliative care-related lectures and they showed higher self-rated cognition levels(

Practical experience and lessons learnt on COVID-19 prevention and control in Huangpu District, Shanghai / 上海预防医学

Corona virus disease 2019 (COVID-19) quickly spread from Wuhan, Hubei Province to other provinces in China since December 2019.Huangpu District of Shanghai was one of the areas where COVID-19 was found at an earlier time in people coming from Wuhan.By summarizing and reviewing the experience and lessons learnt in Huangpu District, the article explores the working mode for public health interventions to prevent and control COVID-19, providing reference for other cities in this regard.

Effect of Modified Yiweitang on Fatigue Symptom of Primary Sjörgren′s Syndrome / 中国实验方剂学杂志

Objective:To observe the effect of modified Yiweitang on fatigue symptom and immunological indicators in primary Sjörgren′s Syndrome (pSS). Method:By random, control, single-blind method, 116 cases of patients with pSS were divided into treatment group and control group, with 58 cases in each group. The treatment group was given modified Yiweitang, a dose a day, twice a day， and the control group was given hydroxychloroquine sulfate (HCQ) 200 mg/time, twice a day. The treatment lasted for six months. Visual analogue scale (VAS) of fatigue symptoms, total traditional Chinese medicine (TCM) syndrome score, TCM fatigue score, rheumatoid factor (RF) and serum immunoglobulin G (IgG) were used to compare two groups before and after treatment. Result:After treatment, the treatment group had a better efficacy on TCM syndromes than control group (Z=3.712, P<0.05). After treatment, the treatment group were superior to control group in improvement of TCM fatigue score and VAS score of fatigue symptom (P<0.05). After 6 months of treatment, IgG level in treatment group decreased significantly compared with before treatment, with statistical differences (P<0.05), but no difference between treatment group and control group. After treatment, RF in two groups showed no significant decrease compared with before treatment. The incidence of adverse reactions in the treatment group and the control group were 1.75%（1/57） and 25.49%（13/51）, respectively. Conclusion:Compared with HCQ, modified Yiweitang can significantly alleviate fatigue and overall symptoms of patients of pSS, both of which can reduce serum IgG, and the efficacy of modified Yiweitang is more obvious than hydroxychloroquine sulfate. Both drugs had no significant effect on RF level of pSS patients. After long-term administration, modified Yiweitang is safer than hydroxychloroquine sulfate in the treatment of pSS.

Clinical observation of the therapeutic effect on posterior circulation ischemic vertigo treated with "xiao xingnao kaiqiao" acupuncture / 针刺研究

OBJECTIVE: To observe the short-term and long-term clinical effect on posterior circulation ischemic vertigo treated with "xiao xingnao kaiqiao" acupuncture (minor regaining consciousness and opening orifice) and explore its effect mechanism. METHODS: Ninety patients with posterior circulation ischemic vertigo were randomly divided into a treatment group and a control group, 45 cases in each group. The patients of the two groups were all treated on the base of neurological medicine. In the control group, Flunarizine Hydrochloride was prescribed for oral administration (5 mg, once daily, for 21 days totally). In the treatment group, acupuncture of "xiao xingnao kaiqiao" was provided at Yintang (EX-HN3), bilateral Neiguan (PC6), bilateral Sanyinjiao (SP6), Baihui (GV20), bilateral Fengchi (GB20), bilateral Wangu (GB12) and bilateral Tianzhu (BL10). The needles were retained for 30 min, once daily for 21 days totally. The changes in vertigo score of traditional Chinese medicine (TCM) were observed, and the changes in the mean blood velocity (Vm) of the left vertebral artery (LVA), the right vertebral artery (RVA) and the basilar artery (BA) as well as the vascular pulsatility index (PI) were monitored and determined by transcranial Doppler (TCD). Additionally, the recurrence rate was followed up after 3 months to evaluate the long-term clinical effects. RESULTS: After treatment, the total effective rate of the treatment group was 91.11% (41/45) and 75.56% (34/45) in the control group. The total effective rate in the treatment group was higher than that in the control group (P<0.05). Compared with their own pre-treatment, the vertigo scores of TCM were reduced in either the treatment group or the control group after treatment (P<0.05) and the score in the treatment group was lower than that in the control group (P<0.05). Compared with their own pre-treatment, Vm and PI were all improved after treatment in either group (P < 0.05). After treatment, the improvements in Vm and PI of LVA、RVA and BA in the treatment group were better than those in the control group (P<0.05). In the follow-up after 3 months, the recurrence rate was 19.51% (8/41) in the treatment group and was 50.00% (17/34) in the control group. The recurrence rate in the treatment group was lower than that in the control group (P<0.05). CONCLUSION: "Xiao xingnao kaiqiao" acupuncture obviously relieves the clinical symptoms of posterior circulation ischemic vertigo. The mechanism of acupuncture is potentially related with its effects in improving Vm and PI of LVA,RVA and BA, as well as improving blood supply of brain tissue.

Predictive research of 5-hydroxytryptamine in severity of severe community-acquired pneumonia / 基础医学与临床

Objective To search for potential prognostic markers for severe community-acquired pneumonia（SCAP）using non-targeted metabolomics. Methods Testing plasma samples from 30 healthy people and 68 SCAP patients (all collected from January 2015 to June 2019 at Peking Union Medical College Hospital) by liquid chromatography mass spectrometry(LC-MS ).According to clinical prognosis，patients were divided into survive group (n=49)and non-survive group(n=19).OPLS-DA(multivariate statistical analysis)and Kruskal Wallis Test (single variable statistical analysis) were used to identify differential metabolites. Correlation analysis of clinical indicators and prognostic analysis were also used for differential metabolites. Results Totally 3463 metabolites were detected in healthy people and SCAP patients by LC-MS. Among them, 126 metabolites were screened out by OPLS-DA andKruskal Wallis Test analysis methods. Prognostic analysis showed that the quantity of 5-hydroxytryptamine(5-HT) was significantly different between survive group and non-survive group(P<0.05，AUC>0.75).Correlation analysis of clinical indicators showed that 5-HT was positively correlated with oxygenation index (OI) and negatively cor-related with acute physiology and chronic health evaluation(APACHE II)score. Conclusions The 5-HT as a potential prognostic marker for SCAP，may predict the prognosis of SCAP patients.

Postnatal germ cell development in cryptorchid boys / 亚洲男科学杂志(英文版)

Cryptorchidism is associated with infertility in adulthood. Early orchiopexy is suggested to reduce the risk. Information is lacking on the potential link between infant germ cell maturation and the risk of future infertility. The objective of the study was to evaluate age-related germ cell development in cryptorchidism. Immunostaining for markers of germ cell development (octamer-binding transcription factor 3/4 [OCT3/4], placental alkaline phosphatase [PLAP], KIT proto-oncogene [C-KIT], podoplanin [D2-40], Lin-28 homolog A [LIN28], and G antigen 7 [GAGE-7]) was performed in testicular biopsies from 40 cryptorchid boys aged 4-35 months. Germ cell numbers and distributions were evaluated in cross sections of seminiferous tubules, with and without immunostaining. OCT3/4, D2-40, and LIN28 were generally expressed in the early stages of germ cell development, as shown by positive expression in germ cells in the central region of seminiferous tubules. In contrast, PLAP and GAGE-7 were expressed in both central and peripheral parts of the tubules in the early stages of development and expressed mainly in a peripheral position with advancing age. Germ cell maturation was delayed in this study population as compared with that observed in our previous study on germ cell markers in a healthy population. The number of GAGE-7-positive germ cells per tubular cross section obtained by immunostaining was significantly higher than that obtained by standard hematoxylin and eosin staining. Double immunostaining revealed heterogeneity in germ cell development in cryptorchid testes. These results shed light on the pathophysiology of germ cell development in boys with cryptorchidism.

Inhibitory effects of iridoid glycosides from Boschniakia rossica combined with 5-fluorouracil on human hepatoma HepG2 and SK-Hep1 cells epithelial-mesenchymal transition / 中草药

Objective: To study the inhibitory effect of iridoid glycosides from Boschniakia rossica (IGBR) combined with 5-Fu on epithelial-mesenchymal transition induced by TGF-β1 in human hepatoma SK-Hep1 and HepG2 cells, and compare the efficacy of drugs. Methods: The survival ability of HepG2 and SK-Hep1 cells was detected by MTT and the combination index (Q value) was calculated to judge the interaction of combined drugs. The EMT model of HepG2 and SK-Hep1 cells was established. The cell adhesion rate was detected by MTT. The expression of matrix metalloproteinase (MMP) MMP2, MMP7, MMP9, Snail, and Slug was detected by Western blotting. The localization and expression intensity of E-cadherin and Vimentin was detected by immunofluorescence. Results: MTT showed that compared with the control group, the 5-FU group, IGBR group and combination group cell survival ability were decreased (P < 0.05) at 48 h after administration; IGBR and 5-Fu had an additive or synergistic effect. Compared with the model group, the adhesion rate of 5-FU group, IGBR group and combination group was reduced (P < 0.05). Western blotting results showed that compared with the control group, the expression of MMP2, MMP7, MMP9, Snail, Slug were up-regulated (P < 0.05) in the model group. Compared with the model group, the expression of MMP2, MMP7, MMP9, Snail and Slug were down-regulated (P < 0.05) in 5-FU group, IGBR group and combination group. Compared with the control group, immunofluorescence showed that the E-cadherin fluorescence intensity was decreased in the model group, but the Vimentin fluorescence intensity was increased. Compared with the model group, the E-cadherin fluorescence intensity was increased in 5-FU group, IGBR group and combined group, but the Vimentin fluorescence intensity was decreased. Conclusion: IGBR and 5-Fu can inhibit human hepatoma EMT. The combined drugs have the combined effect on HepG2 cells and synergistic effect on SK-Hep1 cells. The therapeutic effect on SK-Hep1 cells is better than HepG2 cells.

Early effects of low-level long-term occupational chromate exposure on workers'health / 北京大学学报(医学版)

OBJECTIVE@#To explore the effects of low-level long-term occupational exposure to chromate on the health of workers, and the potential biomarkers of early health effects in terms of lung function, immune toxicity and genetic damage.@*METHODS@#A total of 22 chromate contact workers and 44 non-chromate contact workers from an electroplating enterprise with long-term occupational environment monitoring in line with the national standards in Inner Mongolia were investigated. The questionnaire survey was conducted to collect the basic situation, the history of smoking, drinking, diseases and so on. The portable lung function instrument, inductively coupled plasma mass spectrometry and cytokinesis-blocked micronucleus test were performed to measure the chromate contact workers'lung function, whole blood Cr (WB-Cr) and micronuclei frequency (MNF) of peripheral blood lymphocytes respectively. The cytometric bead array was used to detect the levels of IL-1β, IL-6, IL-8, IL-10, IL-12P70 and TNFα in the serum among the two groups. The effects of chromate exposure on the above-mentioned indexes involved biological exposure, lung function, immune response and genetic damage, and their correlation were analyzed with different statistical methods.@*RESULTS@#(1) the average length of service for chromate contact workers was 31 years, and their concentration of WB-Cr was 1.11-4.19 μg/L. They were divided into high and low exposure groups according to the median of 1.72 μg/L. The WB-Cr in the high exposure group (2.17 μg/L) was higher than that in the low exposure group (1.58 μg/L) as well as the reference value of the healthy population (1.74 μg/L, P<0.05); (2) the lung function test showed 10 (45.45%) chromate exposure workers had single or multiple abnormal lung function indexes, among which large airway injury index PEF, and small airway injury indexes MVV and FEF25%-75% were all negatively correlated with WB-Cr (r=-0.53, P<0.05; r=-0.52, P<0.05; r=-0.44, P<0.05); (3) IL-1β, IL-6, IL-8 and TNFα in the serum of chromate contact workers were higher than those in the control group (P<0.05), and there was a positive correlation between TNFα and WB-Cr, and among these cytokines (P<0.05); (4) the average lymphocyte MNF in chromate contact workers was 1.341%, higher than the reference value of the general population (0.436%, P<0.01). Poisson regression analysis showed MNF in thehigh exposure group was higher than that in the low exposure group, OR (95%CI) =1.323 (1.049, 1.669); (5) multiple linear regression analysis showed that the lung function index FEF25%-75% decreased with the increase of TNFα (P<0.05), no significant correlation was found between other cytokines, MNF and lung function indexes.@*CONCLUSION@#Long-term low-level occupational exposure to chromate can cause the decline of lung function, immune inflammatory reaction and genetic damage in workers, in which local or systemic inflammatory response is associated with decreased lung function. Lung function indexes PEF, FEF25%-75% and MVV, serum cytokines IL-1β, IL-6, IL-8, and TNFα, and peripheral blood lymphocyte MNF may be used as early health effects biomarkers of chromate exposure.

Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China / 世界急诊医学杂志（英文）

BACKGROUND@# For emergency department (ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism (VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE.@*METHODS@# We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.@*RESULTS@# In this survey, 180 questionnaires were distributed and 174 valid responses (response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no significant differences were found with respect to job (doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years (n=83) scored significantly higher on the questionnaire than those under 5 years (n=91) (95.75 vs. 79.97, P=0.039). There was a significant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.@*CONCLUSION@# Our survey has shown deficiencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events (including VTE).

A survey of ventilation strategies during cardiopulmonary resuscitation / 世界急诊医学杂志（英文）

BACKGROUND@# Many controversies still exist regarding ventilator parameters during cardiopulmonary resuscitation (CPR). This study aimed to investigate the CPR ventilation strategies currently being used among physicians in Chinese tertiary hospitals.@*METHODS@# A survey was conducted among the cardiac arrest team physicians of 500 tertiary hospitals in China in August, 2018. Surveyed data included physician and hospital information, and preferred ventilation strategy during CPR.@*RESULTS@# A total of 438 (88%) hospitals completed the survey, including hospitals from all 31 Chinese mainland provinces. About 41.1% of respondents chose delayed or no ventilation during CPR, with delayed ventilations all starting within 12 minutes. Of all the respondents who provided ventilation, 83.0% chose to strictly follow the 30:2 strategy, while 17.0% chose ventilations concurrently with uninterrupted compressions. Only 38.3% respondents chose to intubate after initiating CPR, while 61.7% chose to intubate immediately when resuscitation began. During bag- valve-mask ventilation, only 51.4% of respondents delivered a frequency of 10 breaths per minute. In terms of ventilator settings, the majority of respondents chose volume control (VC) mode (75.2%), tidal volume of 6–7 mL/kg (72.1%), PEEP of 0–5 cmH2O (69.9%), and an FiO2 of 100% (66.9%). However, 62.0% of respondents had mistriggers after setting the ventilator, and 51.8% had high pressure alarms.@*CONCLUSION@#There is a great amount of variability in CPR ventilation strategies among cardiac arrest team physicians in Chinese tertiary hospitals. Guidelines are needed with specific recommendations on ventilation during CPR.

Application of apparent diffusion coefficient in children aged 2-12 years with intellectual disability/global developmental delay who have normal conventional brain MRI findings / 中国当代儿科杂志

OBJECTIVE@#To study the value of fast spin-echo diffusion weighted imaging (TSE-DWI) apparent diffusion coefficient (ADC) in children aged 2-12 years with intellectual disability (ID)/global developmental delay (GDD) who have normal conventional brain MRI findings.@*METHODS@#A total of 578 children with normal conventional brain MRI findings who met the diagnostic criteria for ID/GDD and 375 normal children were enrolled. Their imaging and clinical data were collected. All children underwent scanning with brain TSE-DWI sequence and routine sequence. ADC values of each brain region were compared between normal children with different ages, as well as between children with different degrees of ID/GDD in each age group. The influence of Adaptive Behavior Assessment System-II (ABAS-II) score on ADC values of each brain region was analyzed.@*RESULTS@#For the normal children, the ADC values of the frontal and temporal white matter, the corpus callosum, the inner capsule, the centrum semiovale, the cerebellar dentate nucleus, the optic radiation, the thalamus, the lenticular nucleus, and the caudate nucleus gradually decreased with age (P<0.05). ADC values of the deep white matter, the shallow white matter, the deep gray matter nuclei, and the shallow gray matter increased with the increase in the degree of ID/GDD in the ID/GDD children aged 4-6 years (P<0.05). In the children with ID/GDD, the ADC values of the deep white matter, the shallow white matter, and the deep gray matter nuclei decreased with age (P<0.05). The ADC values of the children with ID/GDD decreased with the increase in ABAS-II score (P<0.05).@*CONCLUSIONS@#ADC can reflect the subtle structural changes of brain regions in children with ID/GDD who have normal conventional brain MRI findings. It may be associated with social adaptation. It can provide an objective basis for the quantitative diagnosis of ID/GDD in children.