Active Ingredients of Chinese Medicines Induce Ferroptosis in Tumor Cells： A Review / 中国实验方剂学杂志

Ferroptosis， a new form of programmed cell death different from apoptosis， necrosis， and autophagy， is closely associated with a variety of physiological and pathological processes. Iron-mediated accumulation of reactive oxygen species is the main inducement of ferroptosis， the mechanism of which is related to intracellular lipid metabolism， iron metabolism， and antioxidant defense pathways. Multiple signaling axes and regulators jointly regulate the occurrence and disruption of ferroptosis. Studies have demonstrated that ferroptosis regulates the growth and proliferation of tumor cells. Inducing ferroptosis in tumor cells can control the growth， metastasis， and multi-drug resistance of tumors. Therefore， the effect and mechanism of ferroptosis on tumor cells have become a hot topic in anti-cancer research. As the research advances， a variety of ferroptosis inducers has been used in the clinical chemotherapy for cancers and demonstrate significant efficacy. Accordingly， the development of ferroptosis-inducing anticancer drugs has become a new research direction for tumor treatment. Some active ingredients such as lycorine， oleanolic acid， dihydroartemisinin， pseudolaric acid B， and ophiopogonin B of Chinese medicines can induce ferroptosis in tumor cells via lipid metabolism， iron metabolism， system Xc-， and GPX4/GSH to regulate the development of tumors， demonstrating a promising prospect in clinical treatment. Based on the theory of the mechanism of ferroptosis， this paper reviews the research progress in ferroptosis induced by active ingredients of Chinese medicines in tumor cells and describes the metabolic regulatory network of ferroptosis from signaling pathways and regulatory factors， providing new strategies for applying active ingredients of Chinese medicines in the treatment of tumors.

Total Saponins in Paridis Rhizoma： A Review / 中国实验方剂学杂志

Paridis Rhizoma possesses the functions of clearing heat and detoxifying， alleviating swelling and relieving pain， cooling the liver and calming the convulsion. Saponins are the main active components of Paridis Rhizoma. Studies have shown that total saponins in Paridis Rhizoma have obvious inhibitory effect on solid tumors such as breast cancer， lung cancer， gastric cancer， and liver cancer and non-solid tumors such as leukemia. The saponins may exert the anti-tumor effects by inhibiting the proliferation， migration， and invasion of tumor cells， regulating cell cycle， inducing apoptotic and non-apoptotic death pathways， and regulating metabolism and tumor microenvironment. Furthermore， total saponins in Paridis Rhizoma showed anti-inflammatory， antioxidant， antimicrobial， hemostatic， and uterus-contracting activities. At the same time， they may induce apoptosis of normal cells， inflammation and oxidative stress， and metabolic disorders. In recent years， the reports of liver injury， reproductive injury， gastrointestinal injury， hemolysis， and other adverse reactions caused by total saponins in Paridis Rhizoma have been increasing. Pharmacokinetic studies have shown that there are significant differences in the metabolism of total saponins in Paridis Rhizoma administrated in different ways. Injection has a fast clearance rate， while oral administration may have hepatoenteric circulation. Meanwhile， due to the low solubility and activation of P-glycoprotein （P-gp） molecular pump， the prototype absorption， intestinal permeability， and recovery rate of total saponins in Paridis Rhizoma are poor， which affects the bioavailability. The bioavailability can be improved to some extent by preparing new dosage forms or new drug delivery systems with advanced technology. This paper reviews the pharmacological effect， pharmacokinetics， and adverse reactions of Rhizoma Paridis total saponins by searching the China National Knowledge Infrastructure （CNKI）， VIP， and Web of Science with ''Rhizoma Paridis total saponins'' as the keywords， hoping to provide references for the research， development， and clinical application of such components.

Stigmasterol protects human brain microvessel endothelial cells against ischemia-reperfusion injury through suppressing EPHA2 phosphorylation / 中国天然药物

Stigmasterol is a plant sterol with anti-apoptotic, anti-oxidative and anti-inflammatory effect through multiple mechanisms. In this study, we further assessed whether it exerts protective effect on human brain microvessel endothelial cells (HBMECs) against ischemia-reperfusion injury and explored the underlying mechanisms. HBMECs were used to establish an in vitro oxygen and glucose deprivation/reperfusion (OGD/R) model, while a middle cerebral artery occlusion (MCAO) model of rats were constructed. The interaction between stigmasterol and EPHA2 was detected by surface plasmon resonance (SPR) and cellular thermal shift assay (CETSA). The results showed that 10 μmol·L-1 stigmasterol significantly protected cell viability, alleviated the loss of tight junction proteins and attenuated the blood-brain barrier (BBB) damage induced by OGD/R in thein vitro model. Subsequent molecular docking showed that stigmasterol might interact with EPHA2 at multiple sites, including T692, a critical gatekeep residue of this receptor. Exogenous ephrin-A1 (an EPHA2 ligand) exacerbated OGD/R-induced EPHA2 phosphorylation at S897, facilitated ZO-1/claudin-5 loss, and promoted BBB leakage in vitro, which were significantly attenuated after stigmasterol treatment. The rat MCAO model confirmed these protective effects in vivo. In summary, these findings suggest that stigmasterol protects HBMECs against ischemia-reperfusion injury by maintaining cell viability, reducing the loss of tight junction proteins, and attenuating the BBB damage. These protective effects are at least meditated by its interaction with EPHA2 and inhibitory effect on EPHA2 phosphorylation.

Expert consensus on clinical application of Lixuwang~® Xuesaitong Soft Capsules / 中国中药杂志

Lixuwang~® Xuesaitong Soft Capsules(referred to as "Xuesaitong Soft Capsules") have the effects of promoting blood circulation, resolving blood stasis, and dredging meridians and collaterals. They are widely used in the prevention and treatment of cardiovascular and cerebrovascular diseases in clinical practice. Through years of clinical observation, they have shown significant efficacy in ischemic stroke, coronary heart disease, and other diseases, and have been recommended by multiple guidelines, consensus statements, and monographs. Based on the summary of clinical application experience by doctors and existing evidence-based research, following the Technical Specifications for Consensus Development of Chinese Patent Medicine by Clinical Experts issued by Standardization Office of the Chinese Association of Traditional Chinese Medicine, a nominal group method was used to reach 19 recommended opinions/consensus suggestions. This document proposes the timing of medication, syndrome differentiation for medication, therapeutic effects, dosage and administration, treatment duration, economic considerations, and safety considerations in the use of Xuesaitong Soft Capsules for the treatment of ischemic stroke and angina pectoris in coronary heart disease. It is intended for doctors in internal medicine, encephalopathy(neurology), cardiovascular medicine, geriatrics, emergency medicine, general practice, and traditional Chinese medicine departments of various medical institutions, as well as pharmacists in hospitals and pharmacies, as a medication reference when using Xuesaitong Soft Capsules. It is hoped that the widespread application of this consensus can improve the clinical efficacy of Xuesaitong Soft Capsules in the treatment of ischemic stroke and coronary heart disease, promote rational drug use, and reduce medication risks. This consensus has been reviewed and published by the China Association of Traditional Chinese Medicine, with the identification number GS/CACM 323-2023.

Evaluation of Dominant Diseases of Traditional Chinese Medicine： A Case Study of Ischemic Stroke / 中国实验方剂学杂志

The present study explored the effective approaches to realize the leading role of traditional Chinese medicine （TCM） in preventing diseases， the synergistic role in treating serious diseases， the core role in the rehabilitation of diseases and summarized the experience to provide feasible plans for the evaluation of other dominant diseases of TCM. To evaluate the effectiveness， safety， and economy of TCM in the treatment of ischemic stroke， encephalopathy project team of the China Center for Evidence-based Traditional Chinese Medicine（CCEBTCM） established an evaluation group to determine the work plan and complete the evaluation work. The concepts of the evaluation involved high-quality evidence， expert opinion survey， expert interview， and drug catalog. Under the guidance of clinical experts and methodologists， the evaluation work was completed in accordance with four steps， i.e.， plan making， data collection and data extraction， evidence synthesis and evaluation， and report writing with the rapid review method. Through the review of TCM and western medicine experts， the advantage of TCM in the treatment of ischemic stroke was positioned in the convalescence period with the predominant effects of improving the neurological function defect and improving the daily living ability. In the convalescence period of stroke， TCM treatment could improve post-stroke motor dysfunction， post-stroke cognitive impairment， consciousness disorder， swallowing disorder， aphasia， constipation， urinary function， diplopia， etc.， and the advantages of acupuncture， Chinese medicine， and traditional exercise were more prominent. In terms of safety， TCM treatment of ischemic stroke showed lower incidence of adverse reactions， fewer adverse events， and a milder degree of related symptoms. In terms of economic performance， the combined treatment of TCM and western medicine played a synergistic role and made the treatment cost more reasonable. Compared with conventional intervention， the integrated TCM and western medicine rehabilitation program showed more economic and social benefits.

Clinical observation of sodium hyaluronate in the treatment of chronic periodontitis and its influence on serum inflammatory factors / 中国医师进修杂志

Objective:To investigate the effect of sodium hyaluronate on chronic periodontitis and its influence on serum hyper sensitive C-reactive protein(hs-CRP), interleukin 8(IL-8) and tumor necrosis factor-α(TNF-α).Methods:Using the random number table method, 98 patients with chronic periodontitis from March 2017 to March 2019 in Hangzhou Xixi Hospital were randomly divided into observation group (49 cases) and control group (49 cases). The control group was treated with tinidazole tablets, and the observation group was treated with sodium hyaluronate on the basis of the control group. The course of treatment was 4 weeks. The total effective rate was compared and the gingival index(GI), sulcus bleeding index (SBI), plaque index (PLI), and the levels of serum hs-CRP, IL-8, TNF-α before and 4 weeks after treatment were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group:93.88%(46/49) vs. 71.43%(35/49), the difference was statistically significant ( χ2=8.612, P<0.05). After treatment of 4 weeks, the scores of GI, SBI and PLI in the observation group were lower than those in the control group: (1.10 ± 0.23 vs. 1.63 ± 0.36, 0.38 ± 0.10 vs.0.71 ± 0.15, 0.83 ± 0.29 vs. 1.36 ± 0.21), the differences were statistically significant ( P<0.05). After treatment of 4 weeks, the levels of hs-CRP, IL-8 and TNF-α in the observation group were lower than those in the control group: (4.53 ± 1.29) mg/L vs. (7.65 ± 1.82) mg/L, (6.17 ± 1.08) ng/L vs. (9.98 ± 1.56) ng/L, (2.27 ± 0.26) μg/L vs. (3.98 ± 0.32) μg/L, the differences were statistically significant ( P<0.05). No obvious adverse reactions occurred in the two groups. Conclusions:Sodium hyaluronate has a significant clinical effect on chronic periodontitis. It can reduce the levels of hs-CRP, IL-8, TNF-α and alleviate the inflammatory reaction.

Network Meta-analysis of oral or nasal feeding with Chinese patent medicine in treatment of hypertensive intracerebral hemorrhage / 中国中药杂志

The effect of oral or nasal feeding with Chinese patent medicine on hypertensive intracerebral hemorrhage was systematically evaluated by using the method of network Meta-analysis. Four Chinese databases(CNKI, VIP, Wanfang, CBM), three English databases(Medline, EMbase, Cochrane Library) and ClinicalTrials.gov were retrieved through computers. According to the inclusion criteria and exclusion criteria, randomized controlled trials(RCTs) of Chinese patent medicine combined with Western medicine in the treatment of hypertensive intracerebral hemorrhage were screened out according to the inclusion criteria and exclusion criteria. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Stata 16.0 software was used to analyze the outcome indicators. A total of 3 888 literatures were retrieved, and 30 studies involving 6 kinds of Chinese patent medicines were finally included. The total sample size was 2 758 cases, including 1 401 cases in the treatment group and 1 357 cases in the control group. According to the results of network Meta-analysis,(1)in terms of improving the degree of nerve function defect, the order of Chinese patent medicines was conventional Western medicine combined with Xiaoyukang Capsules>combined with Tongxinluo Capsules>combined with Naoxuekang Oral Liquid>combined with Naoxueshu Oral Liquid>combined with Angong Niuhuang Pills>conventional Western medicine;(2)in terms of reducing the amount of residual cerebral hematoma, the order of Chinese patent medicines was conventional Western medicine combined with Naoxueshu Oral Liquid>combined Xiaoyukang Capsules>combined Naoxuekang Oral Liquid>conventional Western medicine;(3)in terms of improving ability of daily living, the order of Chinese patent medicines was conventional Western medicine combined with Shenzhi Huoxue Capsules>combined with Angong Niuhuang Pills>combined with Naoxueshu Oral Liquid>conventional Western medicine;(4)in terms of improving total effective rate, the order of Chinese patent medicines was conventional Western medicine combined with Naoxueshu Oral Liquid>combined with Xiaoyukang Capsules>combined with Angong Niuhuang Pills=combined with Naoxuekang Oral Liquid>combined Tongxinluo Capsules>conventional Western medicine treatment. The results showed that in addition to conventional Western medicine therapy, the combined use with Chinese patent medicine can improve the clinical efficacy in the treatment of hypertensive intracerebral hemorrhage. However, due to the differences in the number and quality of various Chinese patent medicines included in the studies, and the lack of direct comparison of Chinese patent medicines, the ranking results still need to be verified by multi center, large-sample-size randomized double-blind trials in the future, so as to provide more reliable evidence support for clinical drug use.

Association between glycosylated hemoglobin and non-alcoholic fatty liver in the elderly / 中华老年医学杂志

Objective:To investigate an association between glycosylated hemoglobin(HbA1c)level and non-alcoholic fatty liver(NAFL)in the elderly.Methods:In this retrospective case-control study, 5 186 elderly individuals aged 65 years and over meeting the inclusion conditions via health physical examination were successively selected from January to December 2018.They were divided into NAFL group(n=1 731)and non-NAFL group(n=3 455). Waist circumference, body mass index, smoking history, diastolic blood pressure, glomerular filtration rate, serum levels of triglyceride, low density lipoprotein cholesterol, alanine aminotransferase, aspartic aminotransferase, fasting blood glucose and HbA1c were compared between the two groups, and their correlations with NAFL were analyzed.Results:The prevalence of NAFL was 33.4%(1, 731/5, 186). The values of waistline, body mass index, smoking history, diastolic blood pressure, triglyceride, total cholesterol, low density lipoprotein cholesterol, glomerular filtration rate, alanine aminotransferase, aspartate aminotransferase, fasting glucose and HbA1c were higher in the NAFL group than in non-NAFL group(all P<0.05). While levels of creatinine, urea nitrogen and age were lower in the NAFL group than in non-NAFL group( P<0.05). According to the quartile of HbA1c level, these subjects were divided into Q1 to Q4 groups(HbA1c<5.7%, 5.7≤HbA1c<6.0%, 6.0%≤HbA1c<6.5%, HbA1c≥6.5%), and the prevalence of NAFL in the Q1 to Q4 were 22.8%(225/1 120), 27.9%(398/1 429), 36.5%(514/1 409), 45.9%(564/1 228)respectively.The prevalence of NAFL was increased along with the increase in the level of HbA1c( P<0.01). Multivariate Logistic regression analysis showed that after adjusting for age, gender and metabolic components, the risk for developing NAFL was gradually increased in Q2 group, Q3 group, Q4 group versus Q1 group as the following OR value: OR=1.274, 95% CI: 1.004-1.616; OR=1.639, 95% CI: 1.294-2.077; OR=1.787, 95% CI: 1.337-2.389, respectively, all P<0.01. Conclusions:The prevalence of NAFL is positively associated with HbA1c levels in the elderly and HbA1c is an independent risk factor for NAFL disease.

Systematic review and Meta-analysis of efficacy and safety of Toutongning Capsules in treatment of tension-type headache / 中国中药杂志

This study aims to systematically evaluate the clinical efficacy and safety of Toutongning Capsules in the treatment of tension-type headache(TTH), so as to provide a corresponding basis for clinical treatment. Eight commonly used medical research databases and two clinical trial registration systems were retrieved with the time interval from the establishment of the database or system to November 2020. The randomized controlled trials of Toutongning Capsules in the treatment of TTH were screened out according to the pre-set criteria. The quality of the included papers was evaluated by the bias risk assessment tool in Cochrane Reviewers Handbook 6.1 and the data were statistically analyzed by RevMan v5.4 provided by Cochrane collaboration. A total of 13 studies were included and the quality of methodology was generally low. Meta-analysis showed that Toutongning Capsules assisted with western medicine therapy can effectively reduce the pain intensity(MD_(VAS)=-1.94,95%CI[-2.50,-1.38],P<0.000 01;MD_(NRS)=-0.83,95%CI[-0.86,-0.80],P<0.000 01), headache duration(SMD=-0.98,95%CI[-1.17,-0.79],P<0.000 01), headache frequency(MD=-1.01,95%CI[-1.16,-0.85],P<0.000 01), headache index(MD=-11.13,95%CI[-12.10,-10.16],P<0.000 01), anxiety and depression scale score(MD_(HAMA)=-4.02,95%CI[-6.58,-1.46],P=0.002;MD_(HAMD)=-2.67,95%CI[-4.04,-1.29],P=0.000 1), while Toutongning Capsules as monotherapy only reduced the headache score(MD=-2.24,95%CI[-2.97,-1.51],P<0.000 01). The available clinical studies demonstrate that Toutongning Capsules combined with western medicine in the treatment of TTH can improve the related outcome indicators, but the clinical safety and efficacy of Toutongning Capsules alone remain unclear. Due to the small number and low quality of the included studies, large-sample, multi-center, high-quality and strictly designed randomized controlled trials are still needed to verify the clinical efficacy in the future.

Systematic review and Meta-analysis of efficacy and safety of gastrodin in treatment of tension-type headache / 中国中药杂志

The efficacy of gastrodin as a Chinese herbal medicine extract in the treatment of tension-type headache has been confirmed. This paper systematically reviewed the efficacy and safety of gastrodin in the treatment of tension-type headache, aiming to provide a new choice for the treatment of this disease. In this study, four Chinese databases, four English databases and two trial registries were searched from the date of establishment to September 2020. The related randomized controlled trials(RCTs) were screened out according to the predetermined criteria. The bias risk assessment tool developed by Cochrane collaboration was used to evaluate the quality of the reports. RevMan 5.4.1 was used for Meta-analysis, and GRADE system for the evidence-based evaluation on the quality of outcome indicators. A total of 177 articles were retrieved and 8 articles were finally included for analysis, with a total sample size of 1 091 cases, which included 565 cases in the treatment group and 526 cases in the control group. The overall quality of included stu-dies was not high. The results of Meta-analysis are as follows:(1)In terms of headache frequency, gastrodin group was better than wes-tern medicine group(MD=-2.90, 95%CI[-3.76,-2.03], P<0.000 01).(2)In terms of number of abnormal blood vessels in TCD, gastrodin group was better than western medicine group(MD=-88.96, 95%CI[-102.36,-75.55], P<0.000 01).(3)In terms of effective rate, gastrodin group was better than western medicine group(RR=1.47, 95%CI[1.29, 1.68], P<0.000 01). The results of subgroup analysis are as follows:(1)Effective rate based on age, for the patients upper age limit 40-46 years old, gastro-din group was better than western medicine group(RR=1.69, 95%CI[1.50, 1.90], P<0.000 01); for the patients upper age limit 55-60 years old, gastrodin group was better than western medicine group(RR=1.27, 95%CI[1.16, 1.38], P<0.000 01).(2)Effective rate based on dosage form, both the gastrodin capsules and injection groups were better than western medicine group(RR_(capsules)=1.42, 95%CI[1.08, 1.88], P=0.01; RR_(injection)=1.50, 95%CI[1.26, 1.77], P<0.000 01). GRADE evaluation showed that the above outcomes had low quality of evidence. Only one article detailed the occurrence of adverse reactions and thus the present study cannot make a positive conclusion on the safety of gastrodin in the treatment of tension-type headache. The small number and low quality of the included reports affected the reliability of the results. In the future, more high-quality randomized controlled trails are needed to improve the evaluation on the efficacy and safety of gastrodin in the treatment of tension-type headache.

Outcome indicators in randomized controlled trials on traditional Chinese medicine intervention for tension-type headache in recent five years / 中国中药杂志

To evaluate the application of outcome indicators in randomized controlled trials(RCTs) concerning the treatment of tension-type headache(TTH) with traditional Chinese medicine(TCM) in recent five years, so as to provide a basis for the study of core outcome set(COS) for TCM intervention in TTH. The RCTs on TCM treatment of TTH in recent five years were systematically retrieved from CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov and China Clinical Trial Registry. After literature screening, data extraction and evaluation of the risk of bias, the outcome indicators in the included RCTs were subjected to qualitative analysis. The preliminary search yielded 19 042 articles, and 10 983 were left after the elimination of duplication. Finally, 52 RCTs(48 in Chinese and 4 in English) were included for qualitative analysis. The outcome indicators of RCTs included in this study were classified into seven domains: TCM syndrome, symptom and sign, physical and chemical detection, quality of life, long-term prognosis, economic evaluation, and safety event. The findings demonstrated that headache characteristic index in the symptom and sign domain was the index with the highest reporting frequency and reporting rate. Seventeen RCTs used TCM syndrome score as the outcome indicator. Further analysis revealed that there existed such problems in research design as non-distinction between primary and secondary outcome indicators, great difference in the adopted measurement tools for outcome indicators, and the neglect of measurement time of outcome indicators. Moreover, the syndrome indicators reflecting TCM advantages, objective evaluation indicators, safety and health-economic indicators were lacking. These limitations have affected the quality and reliability of RCTs on TTH treatment with TCM. It is suggested that the efficacy and characteristics of TCM should be combined into current clinical research, and the COS in RCTs regarding TCM treatment of TTH should be established according to internationally recognized standard procedures.

Effects of gibberellin priming on seedling emergence and transcripts involved in mesocotyl elongation in rice under deep direct-seeding conditions / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Mesocotyl elongation is a key trait influencing seedling emergence and establishment in direct-seeding rice cultivation. The phytohormone gibberellin (GA) has positive effects on mesocotyl elongation in rice. However, the physiological and molecular basis underlying the regulation of mesocotyl elongation mediated by GA priming under deep-sowing conditions remains largely unclear. In the present study, we performed a physiological and comprehensive transcriptomic analysis of the function of GA priming in mesocotyl elongation and seedling emergence using a direct-seeding

Biomedical applications of bionic untethered micro-nano robots / 生物医学工程学杂志

Bionic untethered micro-nano robots, due to their advantages of small size, low weight, large thrust-to-weight ratio, strong wireless mobility, high flexibility and high sensitivity, have very important application values in the fields of biomedicine, such as disease diagnosis, minimally invasive surgery, targeted therapy, etc. This review article systematically introduced the manufacturing methods and motion control, and discussed the biomedical applications of bionic untethered micro-nano robots. Finally, the article discussed the possible challenges for bionic untethered micro-nano robots in the future. In summary, this review described bionic untethered micro-nano robots and their potential applications in biomedical fields.

Prevention and control of HIV/AIDS in China: lessons from the past three decades / 中华医学杂志(英文版)

In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.

Evaluation and classification of dissolution behavior and capability of Chinese medicine granules based on an inline turbidity sensor / 中国中药杂志

In this paper, the inline turbidity sensor technology was used to quantify the turbidity of the solution during the dissolution of Chinese medicine granules. The probe measurement position and the magnetic stirring speed were optimized. As a result, the stirring speed was 400 r·min~(-1), and the probe position was at 1/4 of the diameter of the beaker. The measurement results were accurate and reliable. Totally 105 batches of commercially available Chinese medicine granules were collected and dissolved according to the requirements of the Chinese Pharmacopoeia. At the time point of 5 min, 57 batches of granules were completely dissolved, and the corresponding turbidity values ranged between 0-70 FTU; 32 batches of granules showed a slight turbidity, and the corresponding turbidity values ranged between 70-350 FTU; 14 batches of granule solution were turbid, and the corresponding turbidity values ranged between 350-2 000 FTU; two batches of granule solution were heavily turbid, and the corresponding turbidity values were >2 000 FTU. Among the above results, the number of batches in line with the pharmacopoeia dissolution requirement was 84.76%, and the dissolution of some granules still needed to be improved. The turbidity sensor recorded the change curve of turbidity value over time(solubility behavior curve). The degree of important of disintegration and dissolution during the dissolution process showed disintegration > dissolution, disintegration≈dissolution, disintegration < dissolution. The dissolution behavior of the granules can be classified into three categories. The analysis of the mechanism in the process of granule solubility provides a basis for product process improvement.

Periodontal disease and cognitive deficits: A systematic review and meta-analysis

@#Background: Previous studies showed controversial findings for correlation of periodontal disease and cognitive deficits. Methods: We searched systematically for studies pertaining to correlation of periodontal disease and cognitive deficits published between August 1980 and December 2019 on Web of Science and PubMed. We combined the data extracted from the included studies to determine the correlation between periodontal disease and cognitive deficits. Results: Our analysis indicated a higher risk of cognitive deficits in those with moderate to severe periodontal disease when compared to those with mild or no periodontal disease (odds ratio (OR) = 1.38 (95% confidence intervals (CI): 1.28-1.48). Subgroup analysis showed significant correlations in only case-control and cohort studies (case-control studies: OR = 1.49 (95% CI: 1.24-1.80); cohort studies: relative risk (RR) = 1.33 (95% CI: 1.22-1.45)). Subgroup analysis also indicated that moderate to severe periodontal disease was correlated to increased dementia and Alzheimer disease risks, whereas no significant correlation was found between periodontal disease and mild cognitive impairment (dementia: OR/RRs = 1.32 (95% CI: 1.22-1.44); Alzheimer disease: OR/RRs = 1.51 (95% CI: 1.20-1.90); Mild cognitive impairment: OR/RRs = 1.31 (95% CI: 0.89-1.94)). Furthermore, subgroup analysis showed significant correlations between cognitive deficits and tooth loss, periodontitis, whereas no significant correlation was found between deep periodontal pockets and cognitive deficits (tooth loss: OR/RRs = 1.57 (95% CI: 1.39- 1.77); periodontitis: OR/RRs = 1.43 (95% CI: 1.03-2.00); deep periodontal pockets: OR/RRs = 1.24 (95% CI: 0.77-2.00)). Conclusions: This review suggests a significant correlation between periodontal disease and cognitive deficits. Interventional studies for periodontal disease may be beneficial for patients with cognitive deficits

Clinical characteristics and prognosis of acute myocardial infarction with or without cardiovascular risk factors / 中国医师杂志

Objective:To investigate the clinical features and prognosis of acute myocardial infarction with or without cardiovascular risk factors.Methods:22 780 patients with acute myocardial infarction registered with the National Health Commission from November 2015 to December 2018 were analyzed. After excluding 3 432 patients, the patients were divided into two groups according to whether there were cardiovascular risk factors. The control group (2 840 cases) had no cardiovascular risk factors, and the observation group (16 508 cases) had cardiovascular risk factors. The clinical characteristics, cardiac function indexes, complications and prognosis were observed between the two groups.Results:There were significant differences in age, symptoms, blood pressure, heart rate, blood glucose, creatinine, total cholesterol, triglyceride, high density lipid-cholesterol (HDL-C) and low density lipid-cholesterol (LDL-C) between the two groups ( P<0.05). The results of coronary angiography showed that there were significant differences in single vessel disease, left main or multiple vessels, left anterior descending branch, left circumflex branch, right coronary artery and left main artery between the two groups ( P<0.05). There was no difference in mortality (2.6% vs 3.1%, P=0.450) and complications (20.6% vs 20.0%, P=0.647) between the observation group and the control group. One year later, the clinical results showed that the all-cause mortality of the control group was 2.0% (57/2 840) and that of the observation group was 1.3% (215/16 508), with statistically significant difference ( P=0.031). Conclusions:Even without cardiovascular risk factors, elderly patients are prone to acute myocardial infarction. Therefore, patients without any cardiovascular risk factors still need to be given full monitoring.

Application of pneumonia pre-ward in corona virus disease 2019 (COVID-19) / 医学研究生学报

Corona virus disease 2019 (COVID-19) is an emerging respiratory infectious disease first reported in Wuhan, China, with subsequent spread worldwide. Except for a professional medical team sending to the affected area, fever clinics, fever wards, as well as expert groups were set up by Jinling hospital at the first time. Meanwhile, a pneumonia pre-ward was established according to the needs of epidemic prevention and control. To date, a total of 22 pneumonia patients negative for COVID-19 nucleic acid test have been treated in this pneumonia pre-ward, of which 6 are still under treatment, 16 are cured and discharged, with the medical staff free from infection. This article discusses the application and value of pneumonia pre-ward in COVID-19 from aspects of ward setting and management, work flow, treated cases, experience in diagnosis and treatment, etc.

Ethical considerations of cellular immunotherapy for cancer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

With the rapid development of immunology, molecular biology, and associated technologies such as next-generation sequencing, cellular immunotherapy has recently become the fourth major cancer treatment. Immunotherapies based on T cells, natural killer cells, and dendritic cells play key roles in cancer immunotherapy. However, their application in clinical practice raises several ethical issues. Thus, studies should focus on proper adherence to basic ethical principles that can effectively guide and solve related clinical problems in the course of treatment, improve treatment effects, and protect the rights and interests of patients. In this review, we discuss cellular immunotherapy-related ethical issues and highlight the ethical practices and current status of cellular immunotherapy in China. These considerations may supplement existing ethical standards in cancer immunotherapy.

Effect evaluation of perioperative nursing process optimization plus enhanced recovery after surgery for post-traumatic bone infection of lower limb / 中华创伤杂志

Objective To investigate the clinical efficacy of optimizing perioperative nursing process and applying enhanced recovery after surgery (ERAS) model in the treatment of post-traumatic bone infection of lower limb using the membrane induction technique.Methods A retrospective case control study was conducted to analyze the clinical data of 225 patients with post-traumatic bone infection of lower limb admitted to the First Affiliated Hospital of Army Medical University from January 2015 to December 2016.There were 184 males and 41 females,aged 19-63 years,with an average age of 41.8 years.There were 123 patients with tibia infection,80 with femur infection and 22 with fibula infection.A total of 125 patients received process optimization plus ERAS (test group),and 100 patients received traditional treatment (control group).Visual analogue scale (VAS) before operation and 1,3 and 7 days after operation,incidence of deep venous thrombosis (DVT),bedridden time,sleep time,ambulation distance,length of stay in hospital and patient satisfaction were compared between the two groups.Results The VAS scores in the test group were (4.5 ± 0.7) points,(3.7 ± 0.6) points,and (2.7 ± 0.5) points at 1,3 and 7days after operation,which were lower than those in the control group (5.7 ± 0.8) points,(5.5 ± 0.8) points,(3.6 ± 0.5) points (P ＜ 0.05 or 0.01).There was no significant difference in VAS 10 days after operation between the two groups (P ＞ 0.05).The incidence of DVT in test group was 16.0％,which was significantly lower than that in the control group 39.0％ (P ＜ 0.01).The bedridden time of the test group was (3.5 ± 0.1) days,and that of the control group was (7.0 ± 0.4) days (P ＜0.05).The sleep time at 1,2,and 3 days after operation as well as the ambulation distance at 3,4,and 5 days after operation in the test group were significantly longer than those in the control group (P ＜0.05).The hospitalization time was (13.4 ± 1.2) days in the test group and (17.6 ± 1.9) days in the control group (P ＜ 0.05).The satisfaction rate was 99.2％ in the test group and 87.0％ in the control group (P ＜ 0.05).Conclusion During treatment of post-traumatic bone infection of lower limb using the membrane induction technique,nursing process optimization plus ERAS intervention program can effectively alleviate postoperative pain,improve daily activity abilities,shorten hospitalization time,improve patient satisfaction and better promote patient rehabilitation.