The Practice Path of Integrating the Red Doctor’s Spirit into the Cultivation Environment of Humanistic Spirit in Medical Colleges / 中国医学伦理学

The integration of red doctor’s spirit into the cultivation environment construction of medical humanistic spirit is an important way to promote the cultivation of medical humanistic spirit in the new era. By excavating the educational resources of red doctor’s spirit, create the cultural environment atmosphere of educating people; integrating the spirit, culture and history of red doctor’s to enhance students’ Party spirit and concept; practicing the spiritual and cultural connotation of red medicine, carry out rich humanistic quality activities and other practical paths, and cultivate the professional spirit of medical students to remain true to our original aspiration and keep our mission firmly in mind, and strive for the development of medical and health undertakings and the people’s physical and mental health for life.

Identification of Dalbergia odorifera and Its Counterfeits by HS-GC-MS / 中国实验方剂学杂志

ObjectiveTo screen the differential markers by analyzing volatile components in Dalbergia odorifera and its counterfeits， in order to provide reference for authentication of D. odorifera. MethodThe volatile components in D. odorifera and its counterfeits were detected by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and the GC conditions were heated by procedure（the initial temperature of the column was 50 ℃， the retention time was 1 min， and then the temperature was raised to 300 ℃ at 10 ℃ for 10 min）， the carrier gas was helium， and the flow rate was 1.0 mL·min-1， the split ratio was 10∶1， and the injection volume was 1 mL. The MS conditions used electron bombardment ionization（EI） with the scanning range of m/z 35-550. The compound species were identified by database matching， the relative content of each component was calculated by the peak area normalization method， and principal component analysis（PCA）， orthogonal partial least squares-discrimination analysis（OPLS-DA） and cluster analysis were performed on the detection results by SIMCA 14.1 software， and the differential components of D. odorifera and its counterfeits were screened out according to the variable importance in the projection（VIP） value>2 and P<0.05. ResultA total of 26， 17， 8， 22， 24 and 7 volatile components were identified from D. odorifera， D. bariensis， D. latifolia， D. benthamii， D. pinnata and D. cochinchinensis， respectively. Among them， there were 11 unique volatile components of D. odorifera， 6 unique volatile components of D. bariensis， 3 unique volatile components of D. latifolia， 6 unique volatile components of D. benthamii， 8 unique volatile components of D. pinnata， 4 unique volatile components of D. cochinchinensis. The PCA results showed that， except for D. latifolia and D. cochinchinensis， which could not be clearly distinguished， D. odorifera and other counterfeits could be distributed in a certain area， respectively. The OPLS-DA results showed that D. odorifera and its five counterfeits were clustered into one group each， indicating significant differences in volatile components between D. odorifera and its counterfeits. Finally， a total of 31 differential markers of volatile components between D. odoriferae and its counterfeits were screened. ConclusionHS-GC-MS combined with SIMCA 14.1 software can systematically elucidate the volatile differential components between D. odorifera and its counterfeits， which is suitable for rapid identification of them.

Association between telomere length in the DNA of peripheral blood leukocytes and the propofol dose in anesthesia induction: an observational study

Abstract Introduction: Propofol is a widely used anesthetic and its dose is closely related to aging. Telomere length (TL) is a unique heritable trait, and emerging as a biomarker of aging, health and disease. Telomerase RNA component (TERC) plays an important role in maintaining TL. We proposed a hypothesis that propofol dose in general anesthesia can be predicted by measuring TL before operation, which greatly reduced the risk of anesthesia, especially the elderly. Methods: The association between the propofol dose in anesthesia induction and: TL in the DNA of peripheral blood leukocytes; body weight; sex; difference of the Bispectral Index (BIS) before and after anesthesia induction in patients was evaluated by multivariable linear regression analyses. The mutation at the 5'end or 3'end of TERC was detected. We recruited 100 patients of elective surgery. Results: We found that propofol dose in anesthesia induction was clearly correlated significantly with TL (r = 0.78, p < 0.001), body weight (r = 0.84, p = 0.004), sex (r = 0.83, p= 0.84, p = 0.004), sex (r = 0.83, p = 0.004), and difference of BIS before and after anesthesia induction (r = 0.85, p = 0.029). By comparing the absolute values of standardized regression coefficients (0.58, 0.21, 0.19, and 0.12) of the four variables, it can be seen that TL contributes the most to the propofol dose in anesthesia induction. However, the mutation at the 5' end or 3' end of TERC was not found. Conclusions: These findings provide preliminary evidence that the propofol dose in anesthesia induction was clearly correlated with genetically determined TL. TL may be a promising predictor of the propofol dose, which is beneficial to improve the safety of anesthesia and reduce perioperative complications.

Effects of evodiamine on the proliferation, migration and invasion of neuroblastoma SK-N-SH cells / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨吴茱萸碱（Evo）是否通过调控lncRNA LINC00858表达调控神经母细胞瘤SK-N-SH细胞的增殖、迁移及侵袭。方法：在体外以3、6、12 μmol/L Evo处理人神经母细胞瘤SK-N-SH细胞，利用RNA干扰技术分别将si-NC、si-LINC00858转染至SK-N-SH细胞，将pcDNA、pcDNA-LINC00858转染至SK-N-SH细胞并经12 μmol/L Evo处理，实验分为对照组、Evo低剂量组、Evo中剂量组、Evo高剂量组、si-NC组、si-LINC00858组、Evo+pcDNA组、Evo+pcDNA-LINC00858组。采用qPCR法检测各组细胞LINC00858的表达量，MTT、Transwell实验分别检测细胞的增殖、迁移、侵袭能力，WB法检测细胞中cyclinD1、MMP-2、MMP-9和p21蛋白的表达。结果：与对照组相比，Evo低、中、高剂量组SK-N-SH细胞中LINC00858表达均显著降低（均P<0.05），细胞增殖抑制率显著升高、迁移及侵袭细胞数显著减少（均P<0.01），cyclinD1、MMP-2、MMP-9蛋白表达降低、p21蛋白表达升高（均P<0.01）。与si-NC组相比，si-LINC00858组细胞的增殖抑制率、迁移和侵袭细胞数及相关蛋白表达变化同Evo低、中、高剂量组。与Evo+pcDNA组相比，Evo+pcDNA-LINC00858组细胞的增殖抑制率显著降低、迁移及侵袭细胞数均显著增多（均P<0.01），cyclinD1、MMP-2、MMP-9蛋白表达升高、p21蛋白表达降低（均P<0.05）。结论：Evo通过下调LINC00858表达抑制神经母细胞瘤SK-N-SH细胞的增殖、迁移及侵袭。

Clinical management of hyperthyroidism complicated with liver failure / 中华内分泌代谢杂志

Clinical data from 11 previously diagnosed and treated patients with hyperthyroidism(Graves′ disease) complicated by liver failure were collected. Among them, 4 cases were drug-induced liver injury leading to liver failure, 1 case had a history of schistosomal liver cirrhosis combined with hyperthyroidism, and 6 cases had hyperthyroidism-induced liver injury(HILI) leading to liver failure. During hospitalization, all patients received supportive therapy and symptomatic treatment with β-blockers. Nine patients were treated with glucocorticoids and artificial liver support therapy. Among the 11 patients, 2 died, 8 patients achieved normal thyroid and liver function within 1-12 months after treatment, and 1 patient with liver cirrhosis had stable liver function in the later stage. After improvement in liver function, 7 patients received isotope therapy, 1 patient underwent total thyroidectomy, and 1 patient received medication. These results indicate that the clinical characteristics differ for drug-induced liver injury and HILI-related liver failure. Early initiation of artificial liver support therapy, in addition to β-blockers and glucocorticoids, is important in alleviating thyroid toxicity and liver damage, thus creating an opportunity for subsequent radioactive iodine or surgical treatment.

Endoscopic treatment of gastric adenocarcinoma of the fundic gland: a report of three cases and a literature review / 中华老年医学杂志

Objective:To analyze and summarize the clinical characteristics, endoscopic manifestations, pathology and treatment of gastric adenocarcinoma of the fundic gland(GA-FD)to promote clinicians' understanding of this disease.Methods:The clinical data of 3 patients with GA-FD admitted to Beijing Hospital from May 2020 to January 2022 were retrospectively analyzed.Among them, 2 presented with abdominal distension or abdominal pain.The other case was diagnosed during follow-up endoscopy after gastrectomy for gastric cancer.A diagnosis of GA-FD was made based on the results of white light imaging, magnifying endoscopy, pathology and immunohistochemistry.In addition, we reviewed the literature about GA-FD between January 1990 and April 2021 from both national and international reports of 195 cases.We analyzed and summarized the endoscopic and pathological characteristics of the disease and insights on its diagnosis and treatment.Results:Of all 198 cases, patients had a male/female ratio of 1.6/1.0 and an average age of 65.3 years(range: 39-87 years).79.82%(91/114)of the patients were negative for Helicobacter pylori.Gastroscopy showed that the average diameter was 8.97 mm, and 89.9%(178/198)of the patients had lesions infiltrating into the submucosa.91.98%(149/162)of the patients had gastric chief cells as the predominant cell type, 98.86%(130/140)had no lymphovascular invasion, and 97.6%(162/166)had no recurrence or metastasis.Conclusions:GA-FD is a rare gastric cancer, with low-grade atypia and highly differentiated tissues.The mechanisms of GA-FD are not clear and the disease is more commonly seen in the elderly.There is no obvious correlation between Helicobacter pylori infections and GA-FD.Gastric chief cells make up the predominant cell type.The results of endoscopy, pathology and immunohistochemistry can help confirm the diagnosis.The prognosis of most cases is good.

Application of Gagne's teaching theory combined with scene teaching method in practice teaching of nursing students in department of respiratory and critical care medicine / 中华医学教育探索杂志

Objective:To explore the effects of practice teaching based on Gagne's teaching theory combined with scene teaching method on core competency of nursing students in department of respiratory and critical care medicine.Methods:A total of 42 nursing students from the Respiratory and Critical Care Medicine Department of Beijing Jishuitan Hospital were enrolled and divided into observation group (21 cases) and control group (21 cases) using a random number table. Traditional teaching method was used in the control group, while Gagne's teaching theory combined with scene teaching method was used for teaching the observation group. After teaching, theoretical knowledge and actual operation ability of nursing students were assessed. The core competency of nursing students was evaluated by core competency assessment scale. The independent learning ability of nursing students was evaluated using an assessment tool. The self-evaluation of teaching effect in the two groups was compared. The t test or chi-square test was performed in SPSS 22.0. Results:The scores of theoretical knowledge and actual operation ability in the observation group were (88.10±7.52) and (90.81±4.88), respectively. These scores were significantly higher than those in the control group [(83.62±6.58) and (72.57±8.94), t=2.06, 8.21, P<0.05]. The scores of core competency and independent learning ability were significantly higher in the observation group than in the control group [(185.53±20.19) and (129.09±16.14) vs. (170.52±20.32) and (105.86±12.23), t=2.40, 5.10, P<0.05]. The score of self-evaluation on teaching effect was significantly higher in the observation group than in the control group [28 (25, 29) vs. 21 (20, 22), Z=5.39, P<0.05]. Conclusion:Gagne's teaching theory combined with scene teaching method in practice teaching of nursing students in the department of respiratory and critical care medicine should be promoted because this combined method improves the mastery of theoretical knowledge and actual operation skills, the independent learning ability and core competency of nursing students, and the effect of nursing teaching.

Construction of core competence evaluation index system for in-service nurses in the imaging department / 中华医学教育探索杂志

Objective:To construct an evaluation index system for core competence of nurses in the imaging department.Methods:The literature research and the opinions of the research team were integrated to develop indicators for core competence of imaging nurses at all levels. Delphi method was used to conduct 2 rounds of consultation with 20 experts, and analytic hierarchy process (AHP) was used to determine the index weights at all levels. The indicators were converted into a self-assessment scale, and 31 imaging in-service nurses in a third-level hospital were selected for questionnaire survey. SPSS 21.0 software was used to analyze the consultation results.Results:Through 2 rounds of consultation, the evaluation index system for core competence of nurses in the imaging department was formed, including 5 first-level indicators, 18 second-level indicators, and 78 third-level indicators. The effective response rates of the two rounds of expert consultation were 100%, and the authority coefficients were 0.933 and 0.923. In the second round, the expert opinion coordination coefficients of the first, second and third grade indexes were 0.46, 0.53 and 0.47, respectively ( P < 0.01). The core competence scores of the 31 respondents ranged from 3.08 to 4.45 in each dimension. Conclusion:After 2 rounds of expert consultation, the expert opinions tended to be consistent and the degree of coordination was high. The constructed indicators can be used for the core competence training and teaching evaluation of in-service nurses in the imaging department.

Effect of the multidisciplinary diagnosis and treatment nursing on postoperative psychological state and quality of life in patients with lateral skull base tumor / 中国实用护理杂志

Objective:To explore the application effect of the multidisciplinary diagnosis and treatment nursing in improving postoperative anxiety and depression and quality of life in patients with lateral skull base tumor, so as to provide a constructive template for the multidisciplinary diagnosis and treatment nursing.Methods:This was a prospective cohort study design. A total of 100 patients who underwent lateral skull base tumor surgery in Shandong Second Provincial General Hospital from January 2021 to April 2022 were selected as the research objects. The patients were divided into observation group and control group by random digits table method with 50 cases in each group. The control group was given routine nursing care after operation of lateral skull base tumor and routine follow-up management. The observation group received the multidisciplinary diagnosis and treatment nursing on the basis of the control group. The intervention time was 3 months. The psychological state and quality of life of the two groups before and after intervention were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Short Form Health Questionnaire (SF-36).Results:There was no significant difference in SAS, SDS, and SF-36 scores before intervention between the two groups ( P>0.05). The scores of SAS, SDS and SF-36 after the intervention were (44.58 ± 5.61), (41.66 ± 8.48), (75.66 ± 13.65) points in the observation group, and (50.86 ± 4.91), (45.80 ± 9.32), (68.43 ± 14.34) points in the control group, there were statistically significant differences between the two groups( t values were -5.95, -2.32, 2.58, all P<0.05). Conclusions:The multidisciplinary diagnosis and treatment nursing can significantly improve anxiety, depression and quality of life of patients with lateral skull base tumor after surgery.

Progress in diagnosis and treatment of autoimmune pancreatitis / 国际外科学杂志

Autoimmune pancreatitis (AIP) is a chronic inflammatory disease of the pancreas associated with autoimmune and characterized by pancreatic enlargement and irregular stenosis of the pancreatic duct. Due to its similar characteristics with pancreatic cancer, and some AIP patients complicated with pancreatic cancer, it has become a difficulty in clinical diagnosis and treatment. Its pathogenesis is unknown and its curative effect is uncertain. In recent years, the pathological mechanism, diagnostic system and therapeutic methods of this disease have been updated constantly. This paper summarizes the research progress of the above aspects.

Control stability analysis of long-term standardized treatment and management for children aged under 6 years with asthma / 国际儿科学杂志

Objective:To evaluate the outcome and stability of control statuses in children under 6 years old with bronchial asthma(abbreviated asthma)who were received long-term standardized treatment and management, and to analyze the factors affecting the control stability.Methods:Using the case registration study, a total of 173 asthmatic children under 6 years old were selected from January 2014 to December 2020 in the department of allergy of Beijing Children′s Hospital.All the patients were received asthma long-term standardized treatment and management for 1 year to 2 years.Control statuses were evaluated at 1 year and 2 years follow up visits respectively.According to the changes of stage evaluations of control statuses, the control stabilities were decided, and patients were divided into stable control group and unstable control group.The parameters of exacerbation, repeated respiratory tract infection, pneumonia, concomitant diseases, allergen sensitization, pulmonary function, initial treatment level, delivery mode, feeding method and family history of allergic diseases were compared between the two groups at 1 year and 2 years respectively.Results:Of the 173 patients included, 17.9%(31/173)were younger than 3 years old and 82.1%(142/173)were 3 to 5 years old.After treatment and management for 1 year and 2 years, the proportions of asthma control levels assessed as good control were 51.6%(16/31)and 70.0%(21/30)respectively in the patients younger than 3 years old, and they were 74.6%(106/142)and 76.7%(79/103)respectively in the patients aged 3 to 5 years old.At 1 year and 2 years of treatment and management, the proportions of stable control and unstable control in 173 patients were 28.9%(50/173), 71.1%(123/173)and 26.3%(35/133), 73.7%(98/133), respectively.Asthma control stability status assessment and analysis showed that in the stable control group than that in the unstable control group, at 1 year and 2 years follow up visits, the percentages of exacerbations were lower(28.0% and 54.3% vs 64.2% and 72.4%), and the differences were statistically significant( χ2=18.768 and 3.889, all P<0.05).At 1 year follow up visits, the egg sensitization rate was higher(53.1% vs 32.9%), and the difference was statistically significant( χ2=3.921, P<0.05); the initial treatment level was higher, and the proportions of level 2, 3, 4 initial treatment were(4.0%, 22.0% and 74.0% vs 20.3%, 34.1% and 45.5%), and the difference was statistically significant( Z=-3.608, P<0.05).At 2 years follow up visits, the egg and milk sensitization rates were higher(61.9% and 42.9% vs 26.2% and 18.0%), and the differences were statistically significant( χ2=8.698 and 5.220, all P<0.05).There were no significant differences on the distributions in repeated respiratory tract infection, pneumonia, concomitant diseases, pulmonary function, delivery mode, feeding method and family history of allergic diseases. Conclusion:Stable asthma control is more likely to be achieved in children aged under 6 years with asthma who are manifesting no asthma exacerbation, presenting food sensitization and using the initial treatment at a high level.

Risk factors for progression to severe pneumonia in children visiting the emergency department with pneumonia / 中华危重病急救医学

OBJECTIVE@#To determine the risk factors for developing severe pneumonia in children under 5 years old with pneumonia.@*METHODS@#A case-control study was conducted 246 children with pneumonia between 2 and 59 months old who were admitted to the department of emergency of the Children's Hospital of Nanjing Medical University from May 2019 to May 2021 were enrolled. The children with pneumonia were screened according to the diagnostic criteria of the World Health Organization (WHO). Case information of the children was reviewed to obtain relevant socio-demographic, nutritional status and potential risk factors. The independent risk factors for severe pneumonia were analyzed by univariate analysis and multivariate Logistic regression respectively.@*RESULTS@#Among the 246 patients with pneumonia, 125 were male and 121 were female. The average age was (21.0±2.9) months, 184 children with severe pneumonia. The results of population epidemiological characteristics showed that there were no significant differences in gender, age and place of residence between the severe pneumonia group and the pneumonia group. Prematurity, low birth weight, congenital malformation, anemia, length of intensive care unit (ICU) stay, nutritional support, treatment delay, malnutrition, invasive treatment, history of respiratory infection were all related factors affecting the occurrence of severe pneumonia (severe pneumonia group vs. pneumonia group: the proportion of premature infants was 9.52% vs. 1.23%, low birth weight was 19.05% vs. 6.79%, congenital malformation was 22.62% vs. 9.26%, anemia was 27.38% vs. 16.05%, length of ICU stay < 48 hours was 63.10% vs. 38.89%, enteral nutritional support was 34.52% vs. 20.99%, treatment delay was 42.86% vs. 29.63%, malnutrition was 27.38% vs. 8.64%, invasive treatment was 9.52% vs. 1.85%, respiratory tract infection history was 67.86% vs. 40.74%, all P > 0.05). However, breastfeeding, type of infection, nebulization, use of hormones, use of antibiotics, etc. were not risk factors affecting severe pneumonia. Multivariate Logistic regression analysis showed that history of premature birth, low birth weight, congenital malformation, treatment delay, malnutrition, invasive treatment, and history of respiratory infection were independent risk factors for severe pneumonia [history of premature birth: odds ratio (OR) = 2.346, 95% confidence interval (95%CI) was 1.452-3.785; low birth weight: OR = 15.784, 95%CI was 5.201-47.946; congenital malformation: OR = 7.135, 95%CI was 1.519-33.681; treatment delay: OR = 11.541, 95%CI was 2.734-48.742; malnutrition: OR = 14.453, 95%CI was 4.264-49.018; invasive treatment: OR = 6.373, 95%CI was 1.542-26.343; history of respiratory infection: OR = 5.512, 95%CI was 1.891-16.101, all P < 0.05].@*CONCLUSIONS@#Premature birth history, low birth weight, congenital malformation, delayed treatment, malnutrition, invasive treatment, and history of respiratory infection are independent risk factors for severe pneumonia in children under 5 years old.

Association between serum alkaline phosphatase and type 2 diabetes mellitus with nonalcoholic fatty liver disease / 临床肝胆病杂志

Objective To investigate the association between serum alkaline phosphatase (ALP) and type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD). Methods A total of 599 patients with T2DM who were hospitalized in Department of Endocrinology, Affiliated Hospital of Jiangsu University, from July 2016 to December 2018 were enrolled as subjects. According to the presence or absence of NAFLD, the patients were divided into NAFLD group with 286 patients and non-NAFLD group with 313 patients, and according to the results of abdominal ultrasound, the patients with NAFLD were divided into mild group with 111 patients, moderate group with 105 patients, and severe group with 70 patients. General clinical data were compared between groups. The independent samples t - test was used for comparison of normally distributed continuous data between two groups, and an analysis of variance was used for comparison between three groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between three groups; the chi-square test was used for comparison of categorical data between groups. Pearson correlation analysis and Spearman correlation analysis were used to investigate the correlation between ALP and clinical indices, and a logistic regression analysis was used to investigate the influencing factors for NAFLD. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher proportion of patients with history of hypertension ( χ 2 =7.864, P < 0.05), systolic blood pressure ( t =-2.226, P < 0.05), diastolic blood pressure ( t =-3.800, P < 0.05), body mass index (BMI) ( t =-11.842, P < 0.05), waist circumference (WC) ( t =-9.150, P < 0.05), fasting insulin (FINS) ( Z =-6.173, P < 0.05), fasting C-peptide ( t =-5.419, P < 0.05), serum uric acid ( t =-4.957, P < 0.05), low-density lipoprotein cholesterol ( t =-2.702, P < 0.05), triglyceride ( Z =-9.376, P < 0.05), total cholesterol (TC) ( t =-3.016, P < 0.05), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) ( Z =-5.794, P < 0.05), alanine aminotransferase (ALT) ( Z =-6.737, P < 0.05), aspartate aminotransferase (AST) ( Z =-4.389, P < 0.05), gamma-glutamyl transpeptidase (GGT) ( Z =-7.764, P < 0.05), and ALP ( t =-2.833, P < 0.05), as well as significantly lower age ( t =2.184, P < 0.05) and high-density lipoprotein cholesterol ( Z =-5.273, P < 0.05). The severity of NAFLD (mild, moderate or severe) was positively correlated with age ( r s =0.140, P < 0.05), BMI ( r s =0.239, P < 0.05), WC ( r s =0.222, P < 0.05), FINS ( r s =0.191, P < 0.05), HOMA-IR ( r s =0.218, P < 0.05), ALT ( r s =0.188, P < 0.05), AST ( r s =0.279, P < 0.05), GGT ( r s =0.202, P < 0.05), and ALP ( r s =0.361, P < 0.05). In the patients with T2DM and NAFLD, ALP was positively correlated with HbAlc ( r =0.149, P < 0.05), fasting plasma glucose ( r =0.146, P < 0.05), HOMA-IR ( r s =0.132, P < 0.05), TC ( r =0.151, P < 0.05), ALT ( r s =0.210, P < 0.05), AST ( r s =0.192, P < 0.05), and GGT ( r s =0.297, P < 0.05). The logistic regression analysis showed that ALP was an influencing factor for NAFLD in patients with T2DM (odds ratio=1.013, 95% confidence interval: 1.004-1.023, P < 0.05). Conclusion Elevated serum ALP is a risk factor for T2DM with NAFLD and is closely associated with hyperglycemia, insulin resistance, and hyperlipemia, and ALP may play a role in the development and progression of T2DM and NAFLD.

The Risk and Survival Analysis of Multiple Malignancies in Hematologic Malignancy Patients: A Single Chinese Center Retrospective Study, 2009 through 2017 / 中国实验血液学杂志

OBJECTIVE@#To explore the risk and location of multiple malignancies in patients with hematologic malignancies who were followed up for 9 years in Jiangsu Province Hospital and to evaluate the impact of the second primary malignancy on survival of patients.@*METHODS@#The incidence and survival of multiple malignancies in 7 921 patients with hematologic malignancies from 2009 to 2017 were analyzed retrospectively.@*RESULTS@#A total of 180 (2.3%, 180/7 921) patients developed second malignancy, of whom 58 patients were diagnosed with hematologic malignancies as the first primary malignancy, and 98 patients developed hematologic malignancies as second primary malignancy, and the other 24 cases were diagnosed with the second malignancy within 6 months after the first primary malignancy was diagnosed, which was difined as multiple malignancies occurring simultaneously. In 180 patients, 18 cases developed two hematologic malignancies successively, and 11 patients developed more than 3 primary cancers (among them, 2 female patients were diagnosed with 4 primary cancers). Patients with lymphoma and multiple myeloma (MM) as the second primary malignancy had poorer survival than patients with lymphoma and MM as the first primary malignancy. Patients with chronic myeloid leukemia as the second primary malignancy were also associated with inferior overall survival.@*CONCLUSION@#In this study, 2.3% of hematologic malignancy patients had multiple mali-gnancies, lymphoma and MM as the second primary malignancy had poor survival.

Mechanism of Qilongtian Capsules in treatment of acute lung injury based on network pharmacology prediction and experimental validation / 中国中药杂志

This study aimed to explore the mechanism of Qilongtian Capsules in treating acute lung injury(ALI) based on network pharmacology prediction and in vitro experimental validation. Firstly, UPLC-Q-TOF-MS/MS was used to analyze the main chemical components of Qilongtian Capsules, and related databases were used to obtain its action targets and ALI disease targets. STRING database was used to build a protein-protein interaction(PPI) network. Metascape database was used to conduct enrichment analysis of Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG). AutoDock software was used to perform molecular docking verification on the main active components and key targets. Then, the RAW264.7 cells were stimulated with lipopolysaccharide(LPS) for in vitro experiments. Cell viability was measured by MTT and ROS level was measured by DCFH-DA. NO content was measured by Griess assay, and IL-1β, IL-6, and TNF-α mRNA expression was detected by RT-PCR. The predicted targets were preliminarily verified by investigating the effect of Qilongtian Capsules on downstream cytokines. Eighty-four compounds were identified by UPLC-Q-TOF-MS/MS. Through database retrieval, 44 active components with 589 target genes were screened out. There were 560 ALI disease targets, and 65 intersection targets. PPI network topology analysis revealed 10 core targets related to ALI, including STAT3, JUN, VEGFA, CASP3, and MMP9. KEGG enrichment analysis showed that Qilongtian Capsules mainly exerted an anti-ALI effect by regulating cancer pathway, AGE-RAGE, MAPK, and JAK-STAT signaling pathways. The results of molecular docking showed that the main active components in Qilongtian Capsules, including crenulatin, ginsenoside F_1, ginsenoside Rb_1, ginsenoside Rd, ginsenoside Rg_1, ginsenoside Rg_3, notoginsenoside Fe, notoginsenoside G, notoginsenoside R_1, notoginsenoside R_2, and notoginsenoside R_3, had good binding affinities with the corresponding protein targets STAT3, JUN, VEGFA, CASP3, and MMP9. Cellular experiments showed that Qilongtian Capsules at 0.1, 0.25, and 0.5 mg·mL~(-1) reduced the release of NO, while Qilongtian Capsules at 0.25 and 0.5 mg·mL~(-1) reduced ROS production, down-regulated mRNA expression of IL-1β, IL-6, TNF-α, and inhibited the inflammatory cascade. In summary, Qilongtian Capsules may exert therapeutic effects on ALI through multiple components and targets.

Effect of altitude hypoxia on blood-brain barrier after subarachnoid hemorrhage based on phosphatidylinositol 3-kinase/protein kinase B/nuclear factor κB pathway in rats / 解剖学报

Objective To investigate the effect of plateau hypoxia on the blood-brain barrier after subarachnoid hemorrhage (SAH) in rats. Methods Adult male SD rats (n = 78) were randomly divided into 4 groups: sham group (sham), SAH model group (SAH), plateau hypoxia sham group (Hp sham) and plateau hypoxia SAH model group (Hp SAH). The rat model of plateau hypoxia was established through low-pressure simulation chamber (altitude 5000 m), and the SAH model was established by endovascular perforation method. At 24 hours after SAH, neurobehavior score and SAH grade were assessed. The morphological changes of neurons and apoptosis of nerve cells in the CA1 region of hippocampal were observed by the staining of Nissl and TUNEL. The expression of phosphorylated PI3K (p-PI3K), PI3K, phosphorylated Akt (p-Akt), Akt, phosphorylated nuclear factor κB (p-NF-κB), NF-κB, matrix metalloproteinase-9 (MMP-9), occludin and claudin-5 in hippocampal were detected by the method of Western blotting. The expression of occludin and claudin-5 proteins in the CA1 region of hippocampal were observed by immunofluorescent staining. Results At 24 hours after SAH, the neurobehavior score decreased significantly and SAH grade increased significantly in the SAH and Hp SAH group (P< 0.05). Neurobehavior score decreased significantly in the Hp SAH group compared with the SAH group (P < 0.05). In the SAH group, neurons in the CA1 region of hippocampus were atrophied and deformed, the arrangement were disordered, the number of neurons decreased significantly, and the apoptosis of nerve cells increased significantly(P< 0.05). Plateau hypoxia could aggravate the morphological damage of neurons and apoptosis of nerve cells. The expression of p-PI3K/PI3K, p-Akt/Akt, occludin and claudin-5 proteins decreased significantly, while the expression of p-NF-κB/NF-κB and MMP-9 proteins increased significantly in the SAH and Hp SAH group (P< 0.05). The expression of p-PI3K/PI3K and MMP-9 proteins increased significantly in Hp SAH group compared with the SAH group. The expression of claudin-5 protein increased significantly in Hp sham group compared with the sham group (P < 0.05). Immunofluorescent staining showed that the expression of occludin and claudin-5 proteins in the CA1 region of hippocampus decreased in the SAH group. Plateau hypoxia could further decreased the expression of occludin and claudin-5 proteins. Conclusion Plateau hypoxia aggravates blood-brain barrier disruption after subarachnoid hemorrhage in rats through inhibiting PI3K/Akt/NF-κB pathway.

Effects of hypoxia preconditioning on hematology-related indexes through hypoxia inducible factor-1α/ stromal cell-derived factor-1 pathway in rats / 解剖学报

[Abstract] Objective To study the role of hypoxia inducible factor-1α (HIF-1α) / stromal cell-derived factor-1 (SDF-1) pathway in high altitude hypoxia preconditioning in rat. Methods Seventy-six adult male SD rats, which through fed in low-pressure oxygen chamber (altitude 5000 m) and Xining (altitude 2260 m) to establish the rat model of hypoxia preconditioning. Rats randomly divided into 6 groups: control group (Ctrl), high altitude hypoxic preconditioning 1 day group (HHP-1d), high altitude hypoxic preconditioning 4 days group (HHP-4d), high altitude hypoxic preconditioning 15 days group (HHP-15d), high altitude hypoxic preconditioning 30 days group (HHP-30d), medium altitude hypoxic preconditioning group (MHP). 7. 0 T small animal MRI was used to observe the intracranial structure, diameter of basilar artery and cerebral blood flow in the hippocampus and brainstem regions by the sequences of T2 weighted images (T2WI) and arterial spin labeling (ASL) in the groups of Ctrl, HHP-4d, HHP-30d and MHP. In each group, blood routine was tested, the concentrations of HIF-1α, SDF-1 in serum, platelet activating factor (PAF)and P-selectin (SELP) in plasma were detected by the method of ELISA. Results In the hypoxia preconditioning groups, intracranial structure and diameter of basilar artery had no significant difference, while cerebral blood flow in the regions of brainstem and hippocampus increased significantly (P<0. 05). Meanwhile, red blood cell and white blood cell increased significantly, while platelet decreased significantly in the groups of hypoxia preconditioning (P<0. 05). Red blood cell and platelet in MHP group were closer to Ctrl group. The concentrations of HIF-1α and SDF-1 (except HHP-1d group) increased significantly in hypoxia preconditioning groups (P<0. 05).The concentrations of PAF and SELP increased significantly in HHP-1d and HHP-15d groups. The concentration of PAF decreased significantly in the HHP-4d and HHP-30d groups, and SELP decreased significantly in HHP-4d group (P<0. 05). Conclusion Hypoxia preconditioning can increase oxygen storage and immune defense capacity, improve brain reserve capacity and play the effect of brain protection through HIF-1α/ SDF-1 pathway. The best effect preconditioning was feed at medium altitude (altitude 2260 m) for 30 days.

Regulation of Dracocephalum Moldavica total flavonoids on foaming and inflammatory response of RAW264. 7 maerophages / 中国药理学通报

Aim To investigate the effeets of Dracocephalum Moldavica total flavonoids (TFDM) on the foaming lipoprotein (ox-LDL), and to further elucidate the mechanism of anti-atherosclerosis (AS) of TFDM. Methods RAW264. 7 maerophages were cultured in vitro and induced to become foam cells by ox-LDL stimulation, and inflammation of mouse monocyte macrophage leukemia cells (RAW264. 7) induced by oxi-dized low density TFDM(25, 50, 100 mg • L"

Effect of human urinary kallidinogenase on cognitive function of SAMP8 mouse model and its mechanism / 中国药理学通报

Aim To study the effect of human urinary kallidinogenase(HUK)on the cognitive function of SAMP8 mouse model and its mechanism. Methods SAMP8 mice were divided intofive groups:SAMP8 group,treatment group(giving 8.75×10-3,1.75×10-2,3.5×10-2,7.0×10-2 HUK),and the SAMR1 vehicle group was used as blank control. Each group was performed Morris water maze to detect spatial cognition. Afterwards the group with the most obvious cognitive improvement(HUK group)was selected for the follow-up experiments. Immunohistochemical detection of ChAT expression in CA3 area was further verified by RtPCR. Western blot was used to detect the expression of PSD95,SYN,BDNF,and pCREB protein. The activity of MPO and the content of IL-1β and IL-18 were determined. Results The passing times in the SAMP8 group was less than that of the SAMR1 group(P<0.05). The passing times of treatment group increased compared with the SAMP8 group(P<0.05 or P<0.01),and the spatial probe time of the target quadrant was shorter(P<0.05 or P<0.01). We conducted follow-up experiments with group d(HUK group). The expression of ChAT positive cells in CA3 area of SAMP8 group was significantly lower than that of SAMR1 group; the expression of positive cells in HUK group significantly increased; RtPCR showed that ChAT expression in SAMP8 group was lower than that in SAMR1 group,and ChAT expression was significantly higher than that in SAMP8 group after HUK treatment. Compared with the SAMR1 group,the levels of IL-1β,IL-18 and MPO activity in the CA3 area of SAMP8 group significantly increased,and the protein expressions of PSD95,SYN,BNDF and pCREB decreased. After HUK treatment,the content of IL-1β,IL-18 and MPO activity decreased,and the expression of PSD95,SYN,BNDF and pCREB increased. Conclusions HUK can improve the spatial cognition of SAMP8 mice. The mechanism may be achieved by promoting the expression of ChAT in CA3 area,reducing the oxidative stress and increasing synapse-related proteins.

The differential effect of AICAR on c-Myc expression and proliferation in specific tumor cell lines / 中国药理学通报

Aim To investigate the effect of AICAR on the expression of the proto-oncogene c-Myc and cell proliferation rates in specific cancer cell lines. Methods The mRNA levels of c-Myc were evaluated using fluorescence-based qRT-PCR to examine the effect of AICAR treatment on c-Myc mRNA expression levels. Western blot was used to evaluate the protein levels of c-Myc following AICAR treatment. RNA interference was employed to determine whether the regulatory effect of AICAR on c-Myc was dependent on AMPK and the downstream metabolic enzymes relating to AICAR. Actinomycin D and cycloheximide were used to assess the effect of AICAR on the stability of cMyc mR-NA and protein. Western blot was used to examine the regulatory effect of AICAR on c-Myc in various cancer cell lines. The MTT assay was used to determine the effect of AICAR on cell viability in these cell lines. Results AICAR significantly up-regulated c-Myc at both mRNA and protein levels. The protein level of c-Myc reached a plateau 12 h after the AICAR treatment. The up-regulatory effect of c-Myc induced by AICAR was not dependent on either the AMPK signaling pathway or the downstream metabolites of AICAR. AICAR could significantly enhance the mRNA stability of c-Myc but did not affect the protein stability. The up-regulation of c-Myc induced by AICAR was cell-type specific. AICAR up-regulated c-Myc in SW1990, 786-0, and A549, while down-regulated c-Myc in HepG2, MCF7, and U20S. In HepG2 cells, AICAR treatment decreased cell viability. However, in SW1990 and A549 cells, AICAR treatment did not lead to any significant difference in cell viability. AICAR decreased the cell viability only when c-Myc was knocked down in SW1990 and A549 cells. Conclusions AICAR directly up-regulates c-Myc expression in an AMPK-independent manner. The up-regulation effect is cell-type dependent. The regulation of c-Myc expression by AICAR is linked to the inhibitory effect of AICAR on tumor cell proliferation.