Pharmacological Effect of Phellodendri Chinensis Cortex and Active Components on Gout： A Review / 中国实验方剂学杂志

Gout is a metabolic disease closely associated with hyperuricemia and urate deposition. Because of the complex pathogenesis， high morbidity， multiple complications， and increasingly young patients， gout has received worldwide attention. Currently， western medicine mainly treats gout by lowering the uric acid level and reducing inflammation， which， however， causes serious adverse reactions and has contraindications. Phellodendri Chinensis Cortex （PCC） is the dried bark of Phellodendron chinense， with the effects of clearing heat， drying dampness， purging fire， detoxifying， and treating sores. Studies have shown that PCC and its active components have anti-inflammatory， pain-relieving， uric acid-lowering， and anti-gout activities， with extensive sources and high safety. PCC and its active components could prevent and treat gout through multi-targets and multi-pathways， whereas the systematic review remains to be carried out. Therefore， this paper summarized the pharmacological activities and mechanisms of PCC and its active components in the treatment of gout. The available studies have shown that PCC and its active components exert the anti-gout effect by lowering the uric acid level， reducing inflammation， alleviating oxidative stress， and regulationg intestinal flora， and protecting the kidneys. Particularly， the active components represented by alkaloids contribute obviously to the therapeutic effect of of PCC. Herein， we analyzed the problems and future development of the research on PCC， aiming to provide theoretical support and a scientific basis for the research and development of new drugs against gout.

Bibliometric analysis of ESKAPE drug‑resistant bacteria / 上海预防医学

ObjectiveTo conduct a bibliometric visual analysis of studies on Enterococcus faecium， Staphylococcus aureus， Klebsiella pneumoniae， Acinetobacter baumannii， Pseudomonas aeruginosa and Enterobacter species （ESKAPE） in the past 10 years at home and abroad， and to analyze current research status and future research directions in this field based on the concept of “One health”. MethodsRelated literature on ESKAPE drug resistant bacteria from 2013 to 2022 was searched on CNKI and WoS， respectively. Furthermore， a metrological visualization analysis of authors， source of agencies， countries， and keywords was conducted by the CiteSpace 6.1.R6 software. ResultsA total of 2 991 pieces of Chinese-language and 24 497 pieces of English-language literature were included in this study. Although the number and growth rate of English-language publications were higher than those of Chinese-language publications， the number of English-language papers authored by Chinese scholars showed a significant upward trend. The level of collaboration between authors and institutions in Chinese-language publications was weaker than that in English-language publications. Overall， the country with the highest number of publications was the United States （6 623）， followed by China （3 776）. However， China’s annual publication volume （851） exceeded that of the United States （600） in 2022. China had collaborations with 25 countries， indicating good global cooperation， but its level of international cooperation was still slightly weaker than that of the United States. High-frequency keywords in Chinese-language literature mainly included drug resistance， nosocomial infection， and antibiotics， while high-frequency keywords in English-language literature included Staphylococcus aureus， Klebsiella pneumoniae， and methicillin-resistant. ConclusionCarbapenem-resistant Klebsiella pneumoniae， carbapenem-resistant Enterobacteriaceae， and "One health" are research hotspots. In the future， cross-sectoral and multi-regional collaboration should be deepened to strengthen the control of infections of important drug-resistant bacteria， and infection treatment strategies should be optimized as well.

Effect and Mechanism of Menispermi Rhizoma Total Alkaloids on Antiviral Infection / 中国实验方剂学杂志

ObjectiveTo investigate the antiviral effect of Menispermi Rhizoma total alkaloids and its relationship with the type Ⅰ interferon （IFN-Ⅰ） signaling pathway. MethodThe effects of Menispermi Rhizoma total alkaloids on the intracellular replication of influenza A virus （H1N1）， vesicular stomatitis virus （VSV）， and cerebral myocarditis virus （EMCV） were detected by fluorescent inverted microscope， flow cytometry， Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）， and Western blot. A mouse model infected with H1N1 was constructed， and the mice were divided into a control group， H1N1 model group， Menispermi Rhizoma total alkaloids groups （10， 20， 30 mg·kg-1）， and oseltamivir group （40 mg·kg-1）， so as to study the effects on the weight and survival rate of infected mice. Real-time PCR was used to detect the activation effect of Menispermi Rhizoma total alkaloids on the IFN-Ⅰ pathway in cells， and the relationship between the antiviral effect of Menispermi Rhizoma total alkaloids in IFNAR1 knockout A549 cells （IFNAR1-/--A549） and IFN-Ⅰ pathway was detected. ResultCompared with the control group， the virus proliferated significantly in the model group （P<0.01）. Compared with the model group， Menispermi Rhizoma total alkaloids could significantly inhibit the replication of H1N1， VSV， and EMCV in vitro （P<0.01）， inhibit the weight loss of the mice infected with the H1N1 in vivo， and improve the survival rate of mice （P<0.05）. In addition， Menispermi Rhizoma total alkaloids activated the IFN-I pathway and relied on this pathway to exert the function of antiviral infection. ConclusionMenispermi Rhizoma total alkaloids exert antiviral effects in vivo and in vitro by activating the IFN-Ⅰ pathway.

Diallyl disulfide augments sensitivity of DJ-1 overexpressed human gastric cells to 5-FU / 中国药理学通报

Aim To investigate whether diallyl disul-fide (DADS) augments the sensitivity of DJ-1 (protein/ nucleic acid deglycase) overexpressed human gastric SGC7901 cells to 5-FU (5-fluorouracil). Methods The experimental groups include control group, DADS group, VCR (vincristine) group, VCR + DADS group, DJ-1 group, DJ-1 + DADS group. MTT was used to analyze the effect of DADS on 5 -FU (5 -fluorou- racil) induced proliferation inhibition. Flow cytometry was performed to examine the effect of DADS on cell apoptosis. RT-PCR, Western blot, and immunofluo-rescence were used for determine the effect of DADS on the drug resistance associated gene expression. Results DADS enhanced the proliferation inhibitory effect of 5-FU on DJ-1 overexpressed cells and VCR resistant cells. DADS could induce apoptosis in VCR-resistant cells. DADS downregulated the expression of DJ-1 while inducing apoptosis in DJ-1 overexpressed cells. DJ-1 overexpression upregulated the expression of P-gp (P-glycoprotein), Bcl-2, and XIAP (X-linked inhibitor of apoptosis protein), downregulated the expression of caspase-3. DADS decreased the expression of P-gp, Bcl-2, and XIAP, while increased the expression of caspase-3 in DJ-1 overexpressed cells and VCR-resistant cells. Conclusions DADS can augment the sensitivity of DJ-1 overexpressed cells to 5-FU, which is related to its antagonism against DJ-1 mediated upregula- tion of P-gp, Bcl-2, XIAP, and downregulation of caspase-3.

Intervention effect of kushenol F on ulcerative colitis mice / 中国药房

OBJECTIVE To investigate the intervention effect of kushenol F （KSC-F） on ulcerative colitis （UC） mice. METHODS Totally 30 male C57BL/6J mice were randomly divided into the normal group， model group， positive drug group （sulfasalazine， 703 mg/kg）， KSC-F 50 mg/kg group （KSC-F50 group）， and KSC-F 100 mg/kg group （KSC-F100 group）， with 6 mice in each group. Except for the normal group， the mice in the remaining groups were given 3% dextran sulfate sodium solution continuously for 7 days to induce UC model. Concurrently， administration groups received corresponding drug solution intragastrically， once a day， for 10 consecutive days. During the experiment， the changes in body weight and bowel movements of the mice were observed. Disease activity index scoring was performed after the last administration. The histopathological morphology of colonic tissue was examined. The levels of inflammatory factors in the serum and colon tissue were measured. Additionally， the mRNA expression of inflammatory factors， and the protein expressions of inflammation-related proteins [interleukin-1β （IL-1β）， forkhead box O1（FOXO1）， phosphoinositide 3-kinase（PI3K）， phosphorylated PI3K（p-PI3K）， p38 mitogen-activated protein kinase（p38 MAPK）， phosphorylated p38 MAPK（p-p38 MPAK） and phosphorylated protein kinase B（p- Akt）] were determined in colonic tissue. RESULTS KSC-F could alleviate weight loss and colonic tissue damage in UC mice. KSC- F reduced the levels of IL-1β， IL-6， IL-8 and tumor necrosis factor-α （TNF-α） in serum， as well as IL-1β， IL-6， IL-17 and TNF- α in colonic tissue to varying degrees and increased the levels of IL-10 in both serum and colonic tissue （P＜0.05 or P＜0.01）. Moreover， KSC-F decreased the expression levels of IL-1β， IL-17 and TNF-α mRNA， as well as p-PI3K， p-p38 MAPK， and p- Akt proteins in colonic tissue to varying degrees， and increased the expression levels of IL-10 mRNA and FOXO1 protein in colonic tissue （P＜0.05 or P＜0.01）. CONCLUSIONS KSC-F effectively alleviates UC symptoms in mice by inhibiting PI3K， Akt and p38 MAPK activation， mitigating the release of pro-inflammatory factors such as IL-1β， IL-6， TNF- α，promoting the anti-inflammatory factor IL-10 secretion， and reducing inflammation-induced colonic tissue damage.

Mapa de evidências sobre a efetividade clínica da acupuntura: informe executivo. / Evidence map on clinical effectiveness of acupuncture: executive report

Este informe executivo apresenta os principais achados do mapa de evidências sobre os efeitos da Acupuntura para desfechos em saúde, que representa a evidência de 163 estudos de revisão que analisaram o efeito da acupuntura como intervenção para pelo menos um dos 96 desfechos de saúde organizados em 14 grupos: Câncer e Neoplasias; Dor; Doenças Cardiovasculares; Doenças Respiratórias; Doenças Reumáticas e Musculoesqueléticas; Doenças Nutricionais, Metabólicas e Endócrinas; Doenças do Sistema Nervoso; Dermatopatias; Gastroenteropatias; Indicadores Metabólicos e Fisiológicos; Oftalmopatias e Otorrinolaringopatias; Sinais e Sintomas; Transtornos Mentais; e Outros desfechos. No todo foram 201 associações entre acupuntura e os desfechos de saúde. Para cada associação intervenção-desfecho foi incluído o efeito reportado pelo estudo de revisão.

This executive report presents the main findings of the evidence map on the effects of acupuncture for health outcomes, representing evidence from 163 review studies that analyzed the effect of acupuncture as an intervention for at least one of the 96 health outcomes organized into 14 groups: Cancer and Neoplasms; Pain; Cardiovascular Diseases; Respiratory Diseases; Rheumatic and Musculoskeletal Diseases; Nutritional, Metabolic, and Endocrine Diseases; Diseases of the Nervous System; Dermatopathies; Gastroenteropathies; Metabolic and Physiological Indicators; Ophthalmopathies and Otorhinolaryngopathies; Signs and Symptoms; Mental Disorders; and Other outcomes. In total, there were 201 associations between acupuncture and health outcomes. For each intervention-outcome association, the reported effect by the review study was included.

Este informe ejecutivo presenta los principales hallazgos del mapa de evidencia sobre los efectos de la acupuntura en los resultados de salud, representando la evidencia de 163 estudios de revisión que analizaron el efecto de la acupuntura como intervención para al menos uno de los 96 resultados de salud organizados en 14 grupos: Cáncer y Neoplasias; Dolor; Enfermedades Cardiovasculares; Enfermedades Respiratorias; Enfermedades Reumáticas y Musculoesqueléticas; Enfermedades Nutricionales, Metabólicas y Endocrinas; Enfermedades del Sistema Nervioso; Dermatopatías; Gastroenteropatías; Indicadores Metabólicos y Fisiológicos; Oftalmopatías y Otorrinolaringopatías; Signos y Síntomas; Trastornos Mentales; y Otros resultados. En total, hubo 201 asociaciones entre la acupuntura y los resultados de salud. Para cada asociación intervención-resultados se incluyó el efecto informado por el estudio de revisión.

Cost-utility analysis of denosumab and teriparatide in the treatment of postmenopausal osteoporosis in Chinese women / 中国药房

OBJECTIVE To evaluate the cost-effectiveness of denosumab and teriparatide in the treatment of postmenopausal osteoporosis in Chinese women， and provide reference for relevant decision-making. METHODS From the perspective of health system in China， Excel 2003 was used to establish Markov model， and cost-utility analysis was used to evaluate the cost- effectiveness of denosumab or teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women. Pharmacotherapy effects were obtained with network meta-analysis， and cost and health utility value data were obtained from published literature. The model cycle was 1 year， and the simulation time limit was the patient’s lifetime. Univariate sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the effects of model parameter changes on the robustness of the results. Through scenario analysis， the cost-effectiveness of domestic drug cost used as drug cost of terlipatide group was discussed； the influence of residual effects of teriparatide on the results and the cost-effectiveness of sequential use of desumamab after terlipatide withdrawal were also discussed. RESULTS The effect of denosumab regimen was better than that of terlipatide regimen [13.24 quality-adjusted life years （QALYs） vs. 12.96 QALYs]， with lower cost （51 224.64 yuan vs. 167 102.67 yuan）， denosumab regimen was the absolutely superior regimen. The results of single factor sensitivity analysis showed that the cost and discount rate of Terlipatide injection had greater impact on the results. The results of probability sensitivity analysis showed that when three times of China’s per capita gross domestic product （GDP） in 2021 was used as the threshold of willingness to pay， the probability of cost-effectiveness of denosumab regimen was 93.5%. The results of scenario analysis showed that， whether the drug cost of terlipatide regimen which was replaced by domestic drugs， or the residual effect of terlipatide was considered， or desulmonab was used sequentially after two years of terlipide treatment， denosumab regimen was always the absolute advantage regimen. CONCLUSIONS Denosumab combined with Calcium carbonate D3 tablets is more cost-effective than teriparatide combined with Calcium carbonate D3 tablets in the treatment of postmenopausal osteoporosis in Chinese women.

Gender differences in antidepressant effect of raw Rehmanniae Radix / 中国中药杂志

For the first time, this study evaluated the gender differences and mechanisms of the antidepressant effects of raw Rehmanniae Radix(RRR) based on the classic depression model with traditional Chinese medicine syndrome of Yin deficiency and internal heat. The depression model with Yin deficiency and internal heat was established by the widely recognized and applied method of thyroxine induction of the classic depression model with Yin deficiency and internal heat(chronic unpredictable mild stress). Male and female mice were simultaneously treated with RRR. The study analyzed indicators of nourishing Yin and clearing heat, conventional antidepressant efficacy test indicators, and important biomolecules reflecting the pathogenesis and prevention and treatment mechanisms of depression, and conducted a correlation analysis of antidepressant efficacy, Yin-nourishing and heat-clearing efficacy, and biological mechanism in different genders, thereby comprehensively assessing the antidepressant effects of RRR on depression of Yin deficiency and internal heat, as well as its gender differences and mechanisms. RRR exhibited antidepressant effects in both male and female mouse models, and its antidepressant efficacy showed gender differences, with a superior effect observed in females. Moreover, the effects of RRR on enhancing or improving hippocampal neuronal pathology, nucleus-positive areas, postsynaptic dense area protein 95, and synaptophysin protein expression were more significant in females than in males. In addition, RRR significantly reversed the abnormal upregulation of nuclear factor(NF)-κB/cyclooxygenase 2(COX2)/NOD-like receptor thermal protein domain associated protein 3(NLRP3) pathway proteins in the hippocampus of both male and female mouse models. The antidepressant effects of RRR were more pronounced in depression female mice with Yin deficiency and internal heat syndrome, possibly due to the improvement of neuronal damage and enhancement of neuroplasticity. The antidepressant mechanisms of RRR for depression with Yin deficiency and internal heat syndrome may be associated with the downregulation of the NF-κB/COX2/NLRP3 pathway to reduce neuronal damage and enhance neuroplasticity.

Comparison on anti-inflammatory activity of Gynostemma pentaphyllum processed with different methods / 中国中药杂志

The aim of this study is to investigate the effects of Gynostemma pentaphyllum dried with two different methods(air drying and heating) on inflammation in acute lung injury(ALI) mice in vivo and in vitro. Lipopolysaccharide(LPS) was sprayed into the airway of wild type C57BL/6J male mice to establish the model, and the drug was injected into the tail vein 24 h after modeling. Lung function, lung tissue wet/dry weight(W/D) ratio, the total protein concentration, interleukin 6(IL-6), IL-1β, and tumor necrosis factor-α(TNF-α) in the bronchoalveolar lavage fluid(BALF), and pathological changes of the lung tissue were used to evaluate the effects of different gypenosides on ALI mice. The results showed that total gypenosides(YGGPs) and the gypenosides substituted with one or two glycosyl(GPs_(1-2)) in the air-dried sample improved the lung function, significantly lowered the levels of IL-1β and TNF-α in BALF, and alleviated the lung inflammation of ALI mice. Moreover, GPs_(1-2) had a more significant effect on inhibiting NO release in RAW264.7 cells. This study showed that different drying methods affected the anti-inflammatory activity of G. pentaphyllum, and the rare saponins in the air-dried sample without heating had better anti-inflammatory activity.

Research progress on anti-tumor effects by traditional Chinese medicine based on "soothing" or "blockage" regulation of tumor vessels / 中国中药杂志

Regulation of tumor vessels has become one of the most common strategies for clinical anti-tumor therapy. In recent years, studies have found that the anti-tumor effect of limotherapy, which routinely inhibits tumor angiogenesis, is not ideal and may even deteriorate the tumor microenvironment, causing tumor resistance and distal metastasis and increasing the risk of tumor metastasis and recurrence. However, the proper use of anti-angiogenic drugs can promote the normalization of tumor vessels, improve the structure and function of tumor vessels, increase the number of functional vessels in the tumor, and reduce the number of ineffective vessels. It is beneficial to promote the penetration of anti-tumor drugs into the tumor, improve the microenvironment of tumor hypoxia and immunosuppression, and enhance the anti-tumor effect. Traditional Chinese medicine(TCM) has a long history of understanding the etiology and pathogenesis of tumors and has accumulated rich experience in tumor treatment, with significant clinical advantages and broad application prospects. In this study, from the perspective of bidirectional "soothing" or "blockage" regulation of tumor vessels, the commonly used molecular targets were sorted out, and the research status of anti-tumor regulation of tumor vessels by monomer-single herb-compound(herb pair) of TCM in recent years was summarized. The research on the anti-tumor effects of TCM compounds and active ingredients by regulating tumor vessels combined with other therapies was analyzed and sorted out, so as to provide ideas for the clinical application of TCM in regulating functions and anti-tumor effects of tumor vessels.

Effect of acetylalkannin from Arnebia euchroma on proliferation, migration, and invasion of human melanoma A375 cells / 中国中药杂志

This study aimed to explore the effect and mechanism of acetylalkannin from Arnebia euchroma on the proliferation, migration, and invasion of human melanoma A375 cells. A375 cells were divided into a blank group, and low-, medium-, and high-dose acetylalkannin groups(0.5, 1.0, and 2.0 μmol·L~(-1)). The MTT assay was used to detect cell proliferation. Cell scratch and transwell migration assays were used to detect cell migration ability, and the transwell invasion assay was used to detect cell invasion ability. Western blot was used to detect the protein expression of migration and invasion-related N-cadherin, vimentin, matrix metalloproteina-se-9(MMP-9), and Wnt/β-catenin pathway-related Wnt1, Axin2, glycogen synthase kinase-3β(GSK-3β), phosphorylated GSK-3β(p-GSK-3β), β-catenin, cell cycle protein D_1(cyclin D_1), and p21. Real-time fluorescence-based quantitative polymerase chain reaction(real-time PCR) was used to detect the mRNA expression of E-cadherin, matrix metalloproteinase-2(MMP-2), N-cadherin, vimentin, β-catenin, snail-1, and CD44. MTT results showed that the cell inhibition rates in the acetylalkannin groups significantly increased as compared with that in the blank group(P<0.01). The results of cell scratch and transwell assays showed that compared with the blank group, the acetylalkannin groups showed reduced cell migration and invasion, and migration and invasion rates(P<0.05, P<0.01) and weakened horizontal and vertical migration and invasion abilities. Western blot results showed that compared with the blank group, the high-dose acetylalkannin group showed increased expression of Axin2 protein(P<0.05), and decreased expression of N-cadherin, vimentin, MMP-9, Wnt1, p-GSK-3β, β-catenin, cyclin D_1, and p21 proteins(P<0.05, P<0.01). The expression of GSK-3β protein did not change significantly. PCR results showed that the overall trend of MMP-2, N-cadherin, vimentin, β-catenin, snail-1, and CD44 mRNA expression was down-regulated(P<0.01), and the expression of E-cadherin mRNA increased(P<0.01). Acetylalkannin can inhibit the proliferation, migration, and invasion of human melanoma A375 cells, and its mechanism of action may be related to the regulation of Wnt/β-catenin signaling pathway.

Predictive value of postoperative serum procalcitonin concentration for moderate to severe acute respiratory distress syndrome in patients undergoing cardiopulmonary bypass surgery / 中华危重病急救医学

OBJECTIVE@#To explore the changes of serum procalcitonin (PCT) level in patients with moderate and severe acute respiratory distress syndrome (ARDS) after cardiac surgery under cardiopulmonary bypass (CPB), and try to find out the best cut-off of PCT to predict the progression to moderate and severe ARDS.@*METHODS@#Medical records of patients undergoing cardiac surgery with CPB in Fujian Provincial Hospital from January 2017 to December 2019 were retrospectively analyzed. Adult patients who were admitted in intensive care unit (ICU) for more than 1 day and had PCT values on the first postoperative day were enrolled. Clinical data such as patient demographics, past history, diagnosis, and New York Heart Association (HYHA) classification, and the operation mode, procedure duration, CPB duration, aortic clamp duration, intraoperative fluid balance, calculation of 24 hours postoperative fluid balance and vasoactive-inotropic score (VIS); 24 hours postoperative C-reactive protein (CRP), N-terminal B-type natriuretic peptide precursor (NT-proBNP) and PCT levels were collected. Two clinicians independently made the diagnosis of ARDS according to the Berlin definition, and the diagnosis was established only in patients with a consistent diagnosis. The differences in each parameter were compared between patients with moderate to severe ARDS and those without or with mild ARDS. Analysis of the ability of PCT to predict moderate to severe ARDS was evaluated by receiver operator characteristic curve (ROC curve). Multivariate Logistic regression was conducted to determine the risk factors of the development of moderate to severe ARDS.@*RESULTS@#108 patients were finally enrolled, including 37 patients with mild ARDS (34.3%), 35 patients with moderate ARDS (32.4%), 2 patients with severe ARDS (1.9%), and 34 patients without ARDS. Compared with patients with no or mild ARDS, patients with moderate to severe ARDS were older (years old: 58.5±11.1 vs. 52.8±14.8, P < 0.05), with a higher proportion of combined hypertension [45.9% (17/37) vs. 25.4% (18/71), P < 0.05], longer operative time (minutes: 363.2±120.6 vs. 313.5±97.6, P < 0.05), and higher mortality (8.1% vs. 0, P < 0.05), but there were no differences in the VIS score, incidence of acute renal failure (ARF), CPB duration, aortic clamp duration, and intraoperative bleeding, transfusion volume, and fluid balance between the two groups. Serum PCT and NT-proBNP levels in patients with moderate to severe ARDS at postoperative day 1 were significantly higher than those in patients with no or mild ARDS [PCT (μg/L): 16.33 (6.96, 32.56) vs. 2.21 (0.80, 5.76), NT-proBNP (ng/L): 2 405.0 (1 543.0, 6 456.5) vs. 1 680.0 (1 388.0, 4 667.0), both P < 0.05]. ROC curve analysis showed that the area under the curve (AUC) for PCT to predict the occurrence of moderate to severe ARDS was 0.827 [95% confidence interval (95%CI) was 0.739-0.915, P < 0.05]. When PCT cut-off value was 7.165 μg/L, the sensitivity was 75.7% and the specificity was 84.5%, for differentiating patients who developed moderate to severe ARDS from who did not. Multivariate Logistic regression showed that age and the elevated PCT concentration were independent risk factors for the development of moderate to severe ARDS [age: odds ratio (OR) = 1.105, 95%CI was 1.037-1.177, P = 0.002; PCT: OR = 48.286, 95%CI was 10.282-226.753, P < 0.001].@*CONCLUSIONS@#Patients with moderate to severe ARDS undergoing CPB cardiac surgery have a higher serum concentration of PCT than patients with no or mild ARDS. Serum PCT level may be a promising biomarker to predict the development of moderate to severe ARDS, the cut-off value is 7.165 μg/L.

Effects of general anesthesia combined with serratus anterior plane block on quality of life and postoperative pain in patients undergoing breast cancer surgery / 中国医师杂志

Objective:To observe the effect of general anesthesia combined with serratus anterior plane block (SAPB) on the quality of life and postoperative pain of patients undergoing breast cancer surgery.Methods:The clinical data of 80 patients with breast cancer undergoing elective modified radical mastectomy admitted to the Affiliated Hospital of Guilin Medical College from January 2020 to March 2021 were retrospectively analyzed. According to different anesthesia methods, they were divided into control group and observation group, with 40 cases in each group. The control group received simple general anesthesia, while the observation group received general anesthesia combined with SAPB. The degree of postoperative pain in the two groups at 3, 6, 12 and 24 h after surgery was evaluated with the Numerical Rating Scale (NRS) score, and the postoperative recovery at 24 h after surgery and quality of life at 3 h and 6 months after surgery were evaluated with the Quality of Recovery-40 (QoR-40) score and the Short Form of Health Survey (SF-36). The serum levels of pain related cytokines[neuropeptide Y (NPY), prostaglandin E2 (PGE2), and 5-hydroxytryptamine (5-HT) ] in the two groups were compared. The complications of the two groups were recorded.Results:The NRS score in the observation group at 6 h and 12 h after operation were lower than those in the control group (all P<0.05). The QoR-40 score at 24 h after operation and SF-36 score at 6 months after operation in the observation group were higher than those in the control group (all P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). The NPY, PGE2 and 5-HT levels of patients in the observation group were lower than those in the control group at 24 h after operation (all P<0.05). Conclusions:The use of general anesthesia combined with SAPB in modified radical mastectomy for breast cancer can alleviate postoperative pain and improve long-term quality of life, which may be related to the reduction of pain related cytokine secretion.

Effects of neuroendoscopic hematoma removal versus soft channel drainage in the treatment of chronic subdural hematoma / 中国基层医药

Objective:To investigate the clinical efficacy of neuroendoscopic hematoma removal versus soft channel drainage in the treatment of chronic subdural hematoma. Methods:The clinical data of 102 patients with chronic subdural hematoma who received treatment in Jincheng People's Hospital from May 2018 to May 2020 were retrospectively analyzed. They were divided into the neuroendoscopy group ( n = 50) and the soft channel group ( n = 52) according to different surgical methods. Perioperative indexes, hematoma clearance rate, China Stroke Scale score, the activity of daily living score, and oxidative stress indexes were compared between the two groups. All patients were followed up for 3 months. The incidence of complications during the follow-up period was calculated. Results:The retention time of the drainage tube in the neuroendoscopy group was shorter than that in the soft channel group [(2.45 ± 0.63) days vs. (3.30 ± 0.78) days, t = 6.06, P < 0.001]. The length of hospital stay in the neuroendoscopy group was shorter than that in the soft channel group [(7.14 ± 1.65) days vs. (9.07 ± 2.11) days, t = 5.15, P < 0.001]. The hematoma clearance rate at postoperative 7 days in the neuroendoscopy group was higher than that in the soft channel group [(93.45 ± 5.50)% vs. (81.86 ± 7.24)%, χ2 = 9.12, P < 0.001]. There were no significant differences in operation time and intraoperative blood loss between the two groups (both P > 0.05). At postoperative 30 days, the China Stroke Scale score in the neuroendoscopy group was lower than that in the soft channel group [(12.74 ± 2.23) points vs. (18.67 ± 2.45) points, t = 12.79, P < 0.001]. The activity of daily life score in the neuroendoscopy group was significantly higher than that in the soft channel group [(77.69 ± 7.11) points vs. (91.35 ± 7.25) points, t = 9.60, P < 0.001]. At postoperative 7 days, glutathione peroxidase level in the neuroendoscopy group was significantly lower than that in the soft channel group [(130.75 ± 13.66) U/L vs. (148.60 ± 14.64) U/L, t = 6.37, P < 0.001]. Malondialdehyde level in the neuroendoscopy group was significantly lower than that in the soft channel group [(5.11 ± 0.65) nmol/L vs. (6.19 ± 0.74) nmol/L, t = 7.83, P < 0.001]. Superoxide dismutase level in the neuroendoscopy group was significantly higher than that in the soft channel group [(275.60 ± 22.33) U/L vs. (254.60 ± 18.55) U/L, t = 5.15, P < 0.001]. There was no significant difference in the incidence of complications between the two groups ( P > 0.05). Conclusion:Compared with soft channel drainage, neuroendoscopic hematoma removal can obtain better short-term curative effects and less oxidative stress response in the treatment of chronic subdural hematoma. Neuroendoscopic hematoma removal does not increase the incidence of postoperative complications and is highly safe.

Triaging patients in the outbreak of COVID-2019 / 中国感染控制杂志

In the outbreak of COVID-19,triage procedures based on epidemiology were implemented in a local hospital in Changsha to control the transmission of SARS-CoV-2 and avoid healthcare-associated infection.This re-trospective study analyzed the data collected during the triage period and found that COVID-19 patients were en-riched 7 folds into the Section A designated for patients with obvious epidemiological history.On the other side,nearly triple amounts of visits were received at the Section B for patients without obvious epidemiological history.8 COVID-19 cases were spotted out of 247 suspected patients.More than 50％of the suspected patients were submi-tted to multiple rounds of nucleic acid analysis for SARS-CoV-2 infection.Of the 239 patients who were diagnosed as negative of the virus infection,188 were successfully revisited and none was reported as COVID-19 case.Of the 8 COVID-19 patients,3 were confirmed only after multiple rounds of nucleic acid analysis.Besides comorbidities,delayed sharing of epidemiological history added complexity to the diagnosis in practice.The triaging experience and strategy will be helpful for the control of infectious diseases in the future.

Observation on the teaching effect of mind mapping on interns in nephrology department / 中华医学教育探索杂志

Objective:To improve the critical thinking ability of interns in nephrology department based on electronic "Spot" mind mapping teaching method.Methods:In the control group, the traditional clinical teaching method was adopted. Each kidney disease unit was divided into 3 courses. ①The clinical practice teacher dictated or demonstrated his/her experience to the student in the first class. ②Students could exchange questions and answers in the second class. ③In the third class, according to the homework situation, the teacher presided over the discussion, guided the students to express their difficulties and help them solve the problems. The research group adopted the electronic "Spot" mind mapping teaching method: ①Grouping: the students were divided into groups, 6 to 8 people in each group, a total of 16 groups. ②Preparation: each group established a WeChat group, and teachers guided them download the Mindmanager software and learn its mapping method. ③In class: each kidney disease unit was divided into 3 sessions. In the first class, based on what the instructor taught, the students summarized the contents and drew a mind map, and then explain their understanding according to the map. In the second class, "Spot" in the group was conducted based on standards, reading each other in the group, actively discussing with each other, further improving and reconstructing the core knowledge points of the chapter, and encouraging each student to actively participate in enhancing their subjective initiative in learning. In the third class, teachers evaluated students according to their learning situation, and students filled in the gaps according to their opinions, perfected their mind maps, and finally posted to the WeChat group. ④Review: the final versions were sent to the WeChat groups as review materials, which was convenient for learning together. SPSS 24.0 was used for Chi-square test.Results:There was no significant difference between the two groups before study ( P>0.005). After the research, the scores of theory test ( t=2.52, P=0.015), clinical skill test ( t=2.22, P=0.034) and total score ( t=3.53, P=0.003) in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of critical thinking ability between the two groups before research ( P>0.05). Six months after research, the total scores of critical thinking ability in the experimental group were significantly higher than those in the control group ( P<0.05). Conclusion:The introduction of electronic "Spot" mind mapping teaching method into clinical practice teaching can realize the cross-linking of related knowledge points and systematize the knowledge. At the same time, it is interesting and can stimulate students' learning interest, and is helpful to cultivate the clinical critical thinking ability of students.

Effects of different ventilation modes on respiratory mechanics, hemodynamics and biochemical metabolism in patients undergoing laparoscopic colorectal cancer surgery / 中国医师进修杂志

Objective:To compare the effects of pressure controlled ventilation (PCV) and volume controlled ventilation (VCV) on respiratory mechanics, hemodynamics and biochemical metabolism in patients undergoing laparoscopic colorectal cancer surgery.Methods:The clinical data of 78 patients underwent laparoscopic colorectal cancer surgery from August 2019 to June 2020 in Inner Mongolia People′s Hospital were retrospectively analyzed. Among them, 39 patients were treated with PCV (PCV group), and 39 were treated with VCV (VCV group). The respiratory mechanics, hemodynamics and biochemical metabolism indexes 10 min after anesthesia induction (T 1), 10 min after pneumoperitoneum + low head and foot height (T 2), 60 min after pneumoperitoneum + low head and foot height (T 3) and 120 min after pneumoperitoneum + low head and foot height (T 4) were recorded. The respiratory mechanical indexes included mean airway pressure (P mean), airway peak pressure (P peak), pressure of end tidal carbon dioxide (P ETCO 2) and dynamic lung compliance (C Ldyn); hemodynamic indexes included mean arterial pressure (MAP) and heart rate; and biochemical metabolic indexes included base excess, serum natrium, serum potassium, negative logarithm of the hydrogen ion concentration (pH) and blood glucose. Results:The P mean, P peak and P ETCO 2 T 1 to T 4 in PCV group were significantly lower than those in VCV group, P mean: (7.12 ± 1.37) cmH 2O (1 cmH 2O = 0.098 kPa) vs. (8.54 ± 1.84) cmH 2O, (9.80 ± 2.26) cmH 2O vs. (11.63 ± 2.87) cmH 2O, (9.51 ± 2.17) cmH 2O vs. (11.72 ± 2.90) cmH 2O, (7.04 ± 1.34) cmH 2O vs. (8.65 ± 1.88) cmH 2O; P peak: (13.41 ± 2.68) cmH 2O vs. (15.06 ± 3.05) cmH 2O, (20.92 ± 3.11) cmH 2O vs. (23.45 ± 4.02) cmH 2O, (21.14 ± 3.50) cmH 2O vs. (23.69 ± 4.26) cmH 2O, (15.03 ± 2.74) cmH 2O vs. (16.45 ± 3.21) cmH 2O; P ETCO 2: (30.59 ± 1.57) mmHg (1 mmHg = 0.133 kPa) vs. (32.04 ± 2.11) mmHg, (35.02 ± 4.15) mmHg vs. (39.88 ± 4.76) mmHg, (35.90 ± 4.22) mmHg vs. (40.11 ± 4.87) mmHg, (34.33 ± 4.17) mmHg vs. (37.65 ± 2.69) mmHg; the C Ldyn was significantly higher than that in VCV group: (40.68 ± 3.98) ml/cmH 2O vs. (35.47 ± 2.56) ml/cmH 2O, (30.25 ± 3.21) ml/cmH 2O vs. (22.40 ± 2.75) ml/cmH 2O, (29.78 ± 3.06) ml/cmH 2O vs. (22.60 ± 2.81) ml/cmH 2O, (40.32 ± 4.25) ml/cmH 2O vs. (33.61 ± 2.81) ml/cmH 2O, and there were statistical differences ( P<0.01 or <0.05). The MAP and heart rate T 1 to T 4 in PCV group were significantly lower than those in VCV group, and there was statistical difference ( P<0.01 or <0.05). The base excess, serum natrium, serum potassium and pH T 1 to T 4 in PCV group were significantly higher than those in VCV group, while the blood glucose was significantly lower than that in VCV group, and there was statistical difference ( P<0.01 or <0.05). Conclusions:Compared with VCV, PCV can promote the recovery of respiratory mechanics index, stabilize hemodynamics and improve biochemical metabolism index in patients undergoing laparoscopic colorectal cancer surgery.

The application of bladder stimulation technique in clean-catch urine collection of late newborns / 中国新生儿科杂志

Objective:To study the clinical value of bladder stimulation technique (BST) for clean-catch urine collection in late newborns.Methods:From November 2020 to March 2022, relatively stable late newborns hospitalized in the Department of Neonatology of our hospital were enrolled in the prospective randomized controlled trial. The newborns were assigned into BST group and control group. In BST group, urine was collected using BST (suprapubic tapping alternating with lumbosacral massage for 5 min) 20~30 min after feeding and specimen were collected using urine bag before and after BST. In the control group, urine was collected using urine bag method. The urine collection was considered successful if >1 ml of urine not contaminated by faeces were collected within 60 min. The t-test and χ 2 test were used for data analysis. Results:A total of 231 late newborns were included with 117 cases in BST group and 114 in control group. The rate of successful urine collection in BST group was higher than control group (65.8% vs. 39.4%).The time needed for successful urine collection [(30.2±8.5) min vs. (40.7±12.9) min], the incidences of faeces contamination (2.5% vs. 21.1%) and urine contamination (11.7% vs. 26.7%) in BST group were all significantly lower than control group(all P<0.05). Male and female newborns in BST group had similar success rates of urine collection (65.6% vs. 66.0%). Male newborns in BST group had similar urine contamination rate with control group (9.5% vs. 11.5%) and female newborns in BST group had significantly lower urine contamination rate than control group (14.3% vs. 47.4%, P<0.05). Urine was successfully collected in 71 newborns in BST group with median duration of BST for 81 (61,132) s. No adverse effects were observed except for transient consolable crying. Conclusions:Compared with urine bag collection method, BST improves successful urine collection rates and reduces the time needed for urine collection and urine contamination rates (especially for females).

Risk factors, diagnosis and treatment of transient hyperinsulinemic hypoglycemia in newborns / 中国新生儿科杂志

Objective:To study the risk factors, diagnosis and treatment of transient hyperinsulinemic hypoglycemia (HH) in newborns.Methods:From January 2016 to December 2020, newborns with transient HH (HH group) admitted to our hospital were enrolled in this retrospective nested case-control study. Newborns with similar gestational age (GA) (differences of GA<2 w) without HH were matched with 1∶2 ratio as the non-HH group. Clinical characteristics of the two groups were compared and the risk factors and therapeutic results of HH in newborns were analyzed using SPSS 20.0 statistical software.Results:A total of 39 cases were included in the HH group and 75 cases were matched in the non-HH group. The proportion of small for gestational age (SGA) [51.3%(20/39) vs. 32.0%(24/75)], the amount of amino acids (AA) in intravenous infusion[1.0(0.0,1.0) g/(kg·d) vs. 0.0(0.0,1.0) g/(kg·d)], the incidence of hypoglycemia [(4.3±1.9) times vs. (3.6±1.3) times] and the maximum glucose infusion rate (GIR)[(8.3±2.5) mg/(kg·min) vs. (7.4±1.1) mg/(kg·min)] in the HH group were higher than the non-HH group (all P<0.05). The platelet count in the HH group were lower than the non-HH group [(186.9±60.9)×10 9/L vs. (215.3±61.7)×10 9/L, P<0.05]. SGA ( OR=2.535, 95% CI 1.077~5.971), the amount of intravenous AA ( OR=2.180, 95% CI 1.029~4.619) and the maximum GIR ( OR=1.405, 95% CI 1.088~1.815) were independent risk factors for transient HH. In the HH group, 28/39 cases were treated with Diazoxide or Octreotide and the therapeutic effects were good with few adverse drug reactions (ADR). 37/39 cases were recovered within 28 d of birth and the other 2 cases were recovered at 2.5 m and 3.5 m, respectively. Conclusions:SGA, the amount of intravenous AA and higher GIR are risk factors for transient HH in newborns. Diazoxide or Octreotide are effective with few ADR in the treatment of transient HH. Most patients will recover from transient HH in 2 w to 3 m.

Qualitative study on maternal and infant care experience and needs of spouses of puerperal women / 中国实用护理杂志

Objective:To explore the real maternal and infant care experience and needs of spouses of puerperal women, so as to provide a basis for improving maternal and infant care capacity and participation of spouses and promoting maternal and infant health.Methods:Guided by dyadic coping theory, the semi-structured interviews were conducted among 18 spouses of puerperal women who gave birth at the First Affiliated Hospital of Soochow University from July to September 2022 using the phenomenological research method, and the recording data were analyzed by Colaizzi phenomenon analytical method.Results:Three themes were extracted, including positive experience of maternal and infant care of spouses of puerperal women (positive psychological emotions, adjustment of perceptions and behaviors, understanding of social support), negative experience of maternal and infant care of spouses of puerperal women (negative psychological emotions, poor care competence, imbalance during life and work), diversified needs for maternal and infant care of spouses of puerperal women (the need for multidimensional knowledge and skills, the suggestion of building continuous health education platform, the expectation of support from family).Conclusions:Medical staff should provide the spouses of puerperal women with diversified maternal and infant care and professional continuing nursing according to their experience and needs. Meanwhile, the family support system should be improved to enhance their sense of competence and participation in maternal and infant care and promote maternal and infant health.