Robot-assisted laparoscopic enucleation in the treatment of leiomyosarcoma of urinary bladder: A case report / 中南大学学报(医学版)

Leiomyosarcoma of urinary bladder (LMS-UB) is a highly malignant mesenchymal tumor, accounting for less than 0.5% of all bladder malignancies, with a predominant clinical presentation of hematuria. Here we report a case of low-grade LMS-UB. A 44-year-old male patient was admitted to the hospital with urodynia for 2 weeks. The patient's pelvis CT showed a mass on the right part of the bladder. For this reason, he was initially diagnosed with bladder cancer. We performed a robot-assisted laparoscopic enucleation of the bladder tumor and low-grade LMS-UB was diagnosed with the histopathological examination. He underwent 5 cycles of adjuvant chemotherapy after surgery. At 19months postoperative follow-up, the patient had no symptoms, recurrence, or distant metastasis. There is no report on the treatment of LMS-UB with minimally invasive enucleation worldwide. This case provides a new comprehensive treatment method of enucleation combined with adjuvant chemotherapy for early low-grade LMS-UB to reduce complications and improve patients' quality of life after surgery.

Quality analysis of Rosae Radix et Rhizoma / 中国中药杂志

Rosae Radix et Rhizoma is a herbal medicine in a variety of famous Chinese patent medicines, while the quality standard for this medicine remains to be developed due to the insufficient research on the quality of Rosae Radix et Rhizoma from different sources. Therefore, this study comprehensively analyzed the components in Rosae Radix et Rhizoma of different sources from the aspects of extract, component category content, identification based on thin-lay chromatography, active component content determination, and fingerprint, so as to improve the quality control. The results showed that the content of chemical components varied in the samples of different sources, while there was little difference in the chemical composition among the samples. The content of components in the roots of Rosa laevigata was higher than that in the other two species, and the content of components in the roots was higher than that in the stems. The fingerprints of triterpenoids and non-triterpenoids were established, and the content of five main triterpenoids including multiflorin, rosamultin, myrianthic acid, rosolic acid, and tormentic acid in Rosae Radix et Rhizoma was determined. The results were consistent with those of major component categories. In conclusion, the quality of Rosae Radix et Rhizoma is associated with the plant species, producing area, and medicinal parts. The method established in this study lays a foundation for improving the quality standard of Rosae Radix et Rhizoma and provides data support for the rational use of the stem.

Comparison of initial periodontal therapy and its correlation with white blood cell level in periodontitis patients with or without diabetes mellitus / 北京大学学报(医学版)

OBJECTIVE@#To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts.@*METHODS@#In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model.@*RESULTS@#At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×109/L vs. (7.14±1.99)×109/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P < 0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P < 0.05; (7.06±0.78)% vs. (7.64±1.16)%, P < 0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P < 0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×109/L vs. (6.01±1.26)×109/L, P < 0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×109/L vs. (7.14±1.99)×109/L, P < 0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P < 0.05).@*CONCLUSION@#Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.

Studies on newly recognized chronic sialadenitis / 北京大学学报(医学版)

Some kinds of chronic sialadenitis were recognized during the recent years. They have specific pathogenesis, clinical and histopathologic appearances, and require specific treatment. IgG4-related sialadenitis (IgG4-RS) is one of the immune-mediated diseases, characterized by tumefactive lesions. The incidence of IgG4-RS obviously increased during the past 30 years. The study on the potential relationship between occupational exposure to chemical substances and the incidence of IgG4-RS showed that subjects with occupational exposure to agents known to cause IgG4-RD had an increased risk for IgG4-RS. Surgical excision of involved SMG could not control the disease progression, which is not recommended for treatment of IgG4-RS. The combination of glucocorticoid and steroid-sparing agents is effective for treating IgG4-RS, and restores salivary gland function. Radioiodine induced sialadenitis (RAIS) is one of the common complications of postoperative adjuvant treatment of differentiated thyroid cancer by 131I. The incidence of the disease is related to radiation dosage. Clinically, the patients suffered from swelling and tenderness in the buccal or submandibular regions, especially during the mealtime. Imaging appearances are similar to those of chronic obstructive sialadenitis. Conservative managements, such as gland massage, sialagogues, are the mainstream methods in the treatment of RAIS. Sialendoscopy is feasible for RAIS, but not as effective as conventional obstructive sialadenitis (COS). Therefore the prevention of RAIS is crucial. Eosinophilic sialodochitis (ES) is a new type of chronic inflammatory disease of the salivary gland related to allergy. It has characteristics of swelling of multiple major salivary glands, strip-like gelatinous plugs discharged from the duct orifice of the gland, elevated level of serum IgE and eosinophils in peripheral blood, infiltration of eosinophils and IgE positive plasma cells in the tissues, allergic history, increased expression of allergy-related cytokines, such as IL-4, IL-5, IL-13, and eotaxin, which suggest allergic reactions as a potential pathogenesis of the disease. The clinical, laboratory, histological, and immunohistochemical characteristics of ES are significantly different from conventional obstructive sialadenitis (COS). Therefore, it is suitable to separate ES from COS. Conservative managements, such as self-maintenance therapy and anti- allergic modality are the choices of treatment for ES. Based on the results of our comprehensive studies a new classification of chronic sialadenitis is suggested.

Exploring Hypertension from "Collateral" and "Wind" of Jueyin / 中国实验方剂学杂志

Hypertension is the most important risk factor for cardiovascular and cerebrovascular diseases， affecting the structures and functions of important organs of the body， such as the heart， brain， and kidney. At present， the prevalence of hypertension in China remains high. How to effectively curb the incidence of hypertension and reduce target organ damage in patients with hypertension is an urgent challenge that needs to be addressed. Traditional Chinese medicine （TCM）， by virtue of its unique efficacies and advantages， is increasingly applied around the world. In TCM， "wind" is considered as a major constant factor in the development of hypertension. Some scholars believe that hypertension is located in collaterals， and the lesions of collaterals are also important reasons for the occurrence and development of hypertension. Collateral diseases and pathogenic wind are closely related to the development of hypertension as well as target organ damage in the heart， brain， and kidney. From the six-meridian syndrome differentiation for febrile diseases， "collateral" and "wind" are closely related to the Jueyin， with collateral diseases classified into Jueyin diseases and pathogenic wind beginning in the Jueyin. The occurrence， development， and persistence of hypertension are closely related to Jueyin diseases. The present study analyzed the pathogenesis and treatment of hypertension from "collateral" and "wind" of the Jueyin， and specifically discussed the relationship between hypertension and "collateral" and "wind" of the Jueyin. It is believed that the internal depression of wind and fire in the Jueyin results in the upward impulse of liver fire， and the deficiency of Jueyin can trigger the internal movement of liver wind and stirring wind due to collateral deficiency. External contraction in the Jueyin due to the induction of external wind is the important pathogenesis of the development of hypertension and the damage to target organs such as the heart， brain， and kidney. The therapeutic methods for both "collateral" and "wind" were also discussed based on the primary prescription for Jueyin， Wumei Pills. Six-meridian syndrome differentiation can guide the therapeutic principles for all diseases and inspire posterity. Exploring the pathogenesis and treatment of hypertension from “collateral" and "wind" of the Jueyin is of great significance in guiding the prevention and treatment of hypertension， reducing target organ damage in patients with hypertension， and improving the prognosis of cardiovascular and cerebrovascular diseases.

Meaning， Efficacy and Mechanism of Huoxin Pills in Treating Coronary Heart Disease with Qi Deficiency and Blood Stasis Syndrome / 中国实验方剂学杂志

Cardiovascular diseases， with high incidence and high mortality， belong to the category of "chest impediment and heart pain" in traditional Chinese medicine （TCM）. Chinese medicines have unique effect on the prevention and treatment of cardiovascular diseases with little side effects. Huoxin pills， one of the National Essential Drugs， is formulated based on the basic pathogenesis of weak pulse at Yang and wiry pulse at Yin and the pathological basis of myocardial ischemia and hypoxia and used for treating angina pectoris of coronary heart disease （Qi deficiency and blood stasis syndrome）. This medicine is derived from the classic famous prescription and is composed of ten precious Chinese medicinal herbs. It can replenish Qi， activate blood， and warm collaterals to diffuse impediment by enhancing myocardial contractility and cardiac output to improve micro-circulation and increase coronary blood flow， regulating immune functions， alleviating inflammation， detoxifying， and tranquilizing mind. Clinically， it is suitable for patients with angina pectoris caused by the lack of heart Yang， chest tightness， shortness of breath， palpitation， fear of cold for limbs and so on， especially for the elderly with Yang deficiency or the patients with a history of myocardial infarction. On the basis of the available research reports， this paper explains the formula meaning of Huoxin pills from the perspective of the basic pathogenesis of coronary heart disease and predicts its action targets， location and links. Furthermore， we expound the mechanism of action of Huoxin pills based on basic research and clinical evidence-based research， aiming to provide data support and evidence for the clinical application of this medicine.

Clinical efficacy of combined therapy in children with stage 4 neuroblastoma / 中国当代儿科杂志

OBJECTIVES@#To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma.@*METHODS@#A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021.@*RESULTS@#The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years.@*CONCLUSIONS@#Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.

Investigation on in Vitro Antioxidant Activity and Chemical Composition of Different Polar Parts of Extract of Rosa cymosa Roots / 中国实验方剂学杂志

Objective:To investigate the antioxidant activity and chemical composition of 75% ethanol extract of <italic>Rosa cymosa</italic> roots and its different polar parts. Method:The 75% ethanol extract of <italic>R. cymosa</italic> roots was divided into dichloromethane， ethyl acetate， <italic>n</italic>-butanol and water parts by organic solvent extraction. <italic>In vitro</italic> antioxidant activity of each fraction was determined by 1，1-diphenyl-2-picrylhydrazyl （DPPH） and 2，2'-azino-bis（3-ethylbenzothiazoline-6-sulfonic acid） （ABTS） free radical scavenging assays， as well as ferric reducing antioxidant power （FRAP） test. The contents of total triterpenes， total phenols， total tannins and condensed tannins in each fraction were determined by spectrophotometry. SPSS 24.0 software was used to conduct Pearson correlation analysis between the antioxidant activity of each fraction and the content of the main components， and then the main active fraction and the main active components were determined. The chemical constituents of the active fraction was analyzed by ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS/MS）， and the structures of the main chromatographic peaks were predicted. Result:Each fraction of <italic>R. cymosa</italic> roots had certain antioxidant activity， and there was a significant dose-effect relationship within a certain concentration range， but the antioxidant activity of different polar parts was different. In DPPH and ABTS free radical scavenging tests， the antioxidant activity of each fraction and vitamin C （VC， the positive drug） was ranked as ethyl acetate fraction>VC><italic>n</italic>-butanol fraction>ethanol extract>water fraction>dichloromethane fraction. In FRAP test， the activity of ethyl acetate fraction was weaker than that of VC， and the other order was unchanged. The contents of total triterpenes， total phenols， total tannins and condensed tannins in ethyl acetate fraction were 3.81%， 50.33%， 3.32%， and 39.79%， in <italic>n</italic>-butanol fraction were 0.88%， 41.42%， 2.25% and 23.55%， in ethanol extract were 2.90%， 41.95%， 3.43% and 20.14%， in water fraction were 0， 26.80%， 16.90% and 7.57%， and in dichloromethane fraction were 21.23%， 12.90%， 1.59%， and 6.17%， respectively. Correlation analysis results showed that the contents of total phenols and condensed tannins were positively correlated with the antioxidant activity， the contents of total triterpenes were negatively correlated with the antioxidant activity， and the correlation between total tannins and antioxidant activity was not obvious. A total of 26 compounds were identified from the ethyl acetate fraction by UPLC-Q-TOF-MS/MS， including 11 condensed tannins， 4 hydrolysable tannins， 6 triterpenes， 3 flavonoids， 1 benzoic acid derivative and 1 chlorogenic acid analogue. Conclusion:Ethyl acetate fraction is the main antioxidant active site of <italic>R. cymosa</italic> roots， and phenols mainly composed of condensed tannins are the main active components. The results can provide experimental basis for the development of natural antioxidants.

Spatial heterogeneity and physical structure basis of antibacterial activity of Ma-Xing-Shi-Gan Decoction / 药学学报

Ma-Xing-Shi-Gan Decoction is a classic prescription. However, the interaction among multiple components of the decoction and the change of phase state are not clear. Moreover, the relationship between the physical phase state aggregated by multiple components and the efficacy still needs to be studied. In this study, we monitored the particle size changes of Ma-Xing-Shi-Gan Decoction in real time. Then we isolated different phase states by centrifugation, analyzed their composition distribution and tested their antibacterial activity. We added chemical interference agents to investigate the interaction of multi-component physical phase states accompanied by the observation of particle size change and morphology. We also studied the correlation between antibacterial activity and physical structure of phase states. The results showed during boiling process the degree of hybridization of particles was decreased and the particle size distribution was narrowed and stabilized at 170 nm. The distribution of organic and inorganic components was heterogeneous among different phase states. S-13500, supernatant isolated by 13 500 ×g centrifugation, constituted by ephedrine, amygdalin, glycyrrhizic acid and inorganic components Ca, K, Mg, etc., had the strongest antibacterial activity. The molecular interaction force in the active physical phase state was mainly hydrophobic and hydrogen bond. The destruction of the interaction force will lead to the change of phase structure and the decrease of antibacterial activity in vitro and in vivo. This study confirms that, in the boiling process of the Ma-Xing-Shi-Gan Decoction, the chemical components interweave and interact to form new physical phase states, leading to heterogeneous distribution of components. The antimicrobial activity of the active phase depends on both chemical composition and physical structure, which provides a direct evidence for the physical basis of the efficacy of traditional Chinese medicine.

Research progress of tannins in traditional Chinese medicines in recent ten years / 中国中药杂志

In this paper, the newly isolated tannins were sorted after a review of the literature concerning tannins in recent 10 years, and their research progress was summarized in terms of extraction, isolation, pharmacological activity and metabolism. Hydrolysable tannins and condensed tannins are the main structural types. Modern research shows that tannins have many pharmacological effects, such as bacteriostasis, antioxidation, antitumor, antivirus and blood glucose reduction, and have broad development prospects. They are usually extracted by water, ethanol and acetone and isolated and purified by macroporous resin and gel column chromatography. The packings commonly adopted for the column chromatography mainly included Sephadex LH-20, Diaion HP-20, MCI-gel CHP-20 and Toyopearl HW-40. Modern analytical techniques such as nuclear magnetic resonance spectroscopy(NMR), fast atom bombardment mass spectrometry(FAB-MS) and circular dichroism(CD) are generally used for the structural identification of tannins. Howe-ver, their isolation, purification and structural identification are still challenging. It is necessary to use a variety of high-throughput screening methods to explore their pharmacological activities and to explore the material basis responsible for their functions through experiments in vivo.

Clinical application of transient elastography in liver cirrhosis and its complications / 临床肝胆病杂志

Liver cirrhosis is a pathological stage in which most chronic liver diseases progress to the advanced stages, and the main complications of liver cirrhosis include portal hypertension, gastroesophageal variceal bleeding, and liver cancer. Transient elastography (TE) uses acoustic waves to obtain liver stiffness measurement (LSM) noninvasively and is currently widely used in clinical practice. At present, various studies on LSM and liver cirrhosis and its complications suggest that TE has the ability to identify liver cirrhosis and its complications and can thus reduce unnecessary invasive procedures to a certain degree. This article summarizes and elaborates on the advances in the clinical application of TE in liver cirrhosis and its complications.

Clinical study on intradermal needle therapy in treating urinary retention after cervical cancer surgery / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of intradermal needle therapy for urinary retention after cervical cancer surgery. Methods: A total of 100 patients with urinary retention after cervical cancer surgery were randomized into a control group and an observation group, with 50 cases in each group. The control group was treated with basic nursing only, and the observation group was treated with additional intradermal needle therapy. Both groups were treated for 2 courses of treatment. The main symptom scores and residual urine volume of the two groups were observed before and after treatment, and the inpatient time, catheter indwelling time and the clinical efficacy were compared between the two groups. Results: The total effective rate was 96.0％ in the observation group and 88.0％ in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the main symptom scores and residual urine volume in both groups decreased significantly (all P<0.05), and the scores and residual urine volume in the observation group were significantly lower than those in the control group (all P<0.05). The inpatient time and catheter indwelling time in the observation group were significantly shorter than those in the control group (both P<0.05). Conclusion: Intradermal needle therapy has an obvious effect in improving symptoms of urinary retention after cervical cancer surgery, and the effect is significantly more persistent than that of simple basic nursing.

Research Status on Animal Models for Melasma / 中国实验方剂学杂志

Melasma， as a kind of melanosis， often occurs over the face of young and middle-aged women， which seriously affects the physical and mental health of patients. At present， it is believed that the occurrence of melasma is related to various factors such as ultraviolet radiation and changes in sex hormone levels in the body. However， the exact pathogenesis of melasma is still unclear and its clinical efficacy is not ideal. Therefore， it is of great clinical significance and social value to carry out basic researches on melasma diseases. Among them， the animal model of melasma acts as an important tool for studying melasma， and it is particularly important to clarify the pathophysiological mechanism of the occurrence and development of melasma. The common modeling methods include ultraviolet modeling， progesterone modeling and ultraviolet combined with progesterone modeling. However， there are still some problems in the practical application of animal models of melasma due to many influencing factors in the preparation of such animal models， and there is still a lack of a more complete and recognized model preparation scheme to this day， which reduces the success rate of model preparation and limits its application and popularization to some extent. In view of the key problems in the establishment and application of animal models of melasma， we comprehensively summarized the research status of the models from such aspects as experimental animals， modeling methods and model evaluation， and discussed the effects of different modeling methods and animal species， animal age and other factors on animal model of melasma by referring to and sorting out the recent literatures at home and abroad in recent years. This is to provide references for the preparation of more scientific， reasonable， economic and convenient animal models of melasma， lay a foundation for in-depth researches on the pathogenesis， prevention and treatment of melasma， and also provide reference for other animal model research.

The clinical experience of transurethral columnar balloon dilation of prostate for benign prostatic hyperplasia / 中华泌尿外科杂志

Objective:To summarize the clinical experience of transurethral columnar balloon dilation of prostate (TUCBDP) in the treatment of patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis of 379 BPH clinical data from the Hubei Provincial Hospital of Traditional Chinese Medicine using TUCBDP was performed between June 2015 and June 2018.Their age was (71.3±14.5)years old. The history of disease ranged from 1 month to 36 years. The prostate volume was(47.4±2.1) ml. Preoperative maximum urinary flow rate was (Q max)(9±4) ml/s, postvoid residual urine(PVR) was (123.1±72.4) ml. Their international prostate symptom score (IPSS) was (21±6) points. The quality of life score (QOL)was (5±1) points. The international index erectile function questionnaire (IIEF-5)in 32 patients, who had sex before surgery, was 15±4. We set the time of catheter structure improvement in June 2016 as the boundary, including the early stage (June 2015 to May 2016, 121 cases) and the recent stage (June 2016 to June 2018, 258 patients). In the early stage, the principle of operation is the inner balloon of the catheter to dilate the membrane urethra, and the outer balloon to dilate the urethra of the prostate and the bladder neck. The main surgical steps include the insertion of a dilatation catheter, localization by touching the skin of the scrotum bottom, the inner and outer balloon are filled with water, the first time of drainage and decompression in the inner and outer balloon, the catheter continuous irrigation, drainage and decompression of the inner and outer balloon again, removing the dilatation catheter, and the ordinary urinary catheter was replaced and continuous irrigation. In the recent stage, the principle of surgery is that the inner balloon only served for positioning and fixation. The outer balloon is used to dilate the membrane urethra, prostate urethra, and bladder neck. The inner and outer balloon are drained and decompressed at one time after surgery. The main surgical steps are that the resectoscope was used to examine the bladder and urethra and to guide the dilatation catheter into the bladder. The apex of the prostate touching was used to conform the location. The inner balloon water filling was used for fix the positioning. The inner and outer balloon are filled with water, decompressed and pulled out for urination test, the gland expansion is observed under the resectoscope, and ordinary urinary catheter is replaced for continuous flushing. We observed the changes in Q max, PVR, IPSS, and QOL at 1, 3, 6, 12, and 24 months after the operation. the complications differences in two-stage patien, including the International Incontinence Advisory Committee Urinary Incontinence Questionnaire (ICI-Q-SF) score; those who had sex before surgery were recorded changes in the IIEF-5 score, was compared. Results:There were no deaths during and after operation in this study. The operation time was (18.5±6.7) min. The number of follow-up cases at 1, 3, 6, 12, and 24 months after operation were 326, 253, 201, 194, and 181, respectively. The Q max at 1, 3, 6, 12, and 24 months after operation were (17±9)ml/s, (15±2)ml/s, (12±4)ml/s, (13±6)ml/s and (13±4)ml/s, respectively. The PVR were (17.4± 11.6) ml, (20.6±9.8)ml, (25.4±13.1)ml, (31.5±11.5)ml, and (29.1±12.4)ml, respectively. The IPSS were(7±5) points, (4±4) points, (4±4) points, (6±5) points, (4±4) points, respectively. The QOL were (2±1) points, (2±1) points, (2±1) points, (2±1) points, and (2±1), respectively. All those results that were significantly different from those before surgery ( P<0.05). There were 32 patients who had sex before the operation. The postoperative IIEF-5 score was (17± 6), which was not significantly different from that before the operation ( P>0.05). Two patients had transient retrograde ejaculation, which relieved spontaneously within the 6 month. 4 cases with pseudourinary incontinence in the recent stage (1.5%) were not statistically different from 6 cases (4.9%) in the early stage ( P>0.05). one case(0.4%) of major bleeding in the recent stage was statistically different from 6 cases (4.9%) in the early stage ( P<0.05). 2 cases (0.7%) of patients with acute urinary retention in the recent stage were significantly different from 15 cases (12.4%) in the early stage ( P<0.05). Conclusions:TUCBDP has a positive overall effect and high safety. The major complications of surgery in the recent stage, except for pseudo-urinary incontinence, are significantly lower than that in the early stage, which may be related to the improvement of the catheter structure and the accumulation of clinical experience.

Research advances in proton pump inhibitor and complications of liver cirrhosis / 临床肝胆病杂志

Proton pump inhibitor (PPI) is often used for the prevention and treatment of digestive system diseases, and the adverse outcomes caused by the use of PPI are increasingly concerned by scholars. This article elaborates on the association of the complications of liver cirrhosis, such as upper gastrointestinal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatocellular carcinoma, and infection, and the change in gut microbiota with the use of PPI, and points out that in clinical practice, it is important to master the medication rules of PPI, understand the risk of complications caused by PPI, and actively improve the complications caused by medication.

Effect of Different Compatibility of Menthae Haplocalycis Herba-Schizonepetae Herba on Influenza Virus / 中国实验方剂学杂志

Objective:To research optimum compatibility components ratio for the anti-influenza virus effect of different compatibility of Menthae Haplocalycis Herba-Schizonepetae Herba. Method:The 228 SPF grade ICR rats of half male and half female were randomly divided into 19 groups, with 12 rats in each group. In each group, the ratio of flavonoids and volatile oil was determined. ICR rats were anesthetized with ether and infected with influenza A virus A/PR/8/34 (H1N1) with A 10-fold lethal dose（LD50）50 μL nasal drip infection. Than the blank control group was treated with the same amount of normal saline nasal drip control, and the rats were given the drug by gavage on the day after virus infection, the blank group and model group were given the same amount of distilled water, and the positive control group were given Oseltamivirphosphate and compound Jinyinhua granules by gavage, and once a day for 7 days. Different compatibility of volatile oil and flavonoids in Menthae Haplocalycis Herba and Schizonepetae Herba are applied to rats infected with influenza A/PR8/34 (H1N1) virus to study the pharmacodynamic screening by lung index of influenza-infected mice and histopathological examination. And antiviral effects as well as the expression of interleukin-6（IL-6）, interleukin-1β（IL-1β）, tumor necrosis factor-α (TNF-α) is studied. Result:Lung infection injury was prepared by infecting mice with influenza A virus A/ pr8/34(H1N1). Lung mass increased at the end of the experiment in the model group, and lung index was compared with that in the blank group(P<0.01). And the experimental lung weight of oseltamivirphosphate group, compound Jinyinhua granules group, volatile oil 1-volatile oil 2 group, volatile oil 1 group and volatile oil 2 group were compared with that of the model group (P<0.05). Lung index of Oseltamivirphosphate group and volatile oil group was compared with that of model group (P<0.01).Lung index of compound Jinyinhua granules group, volatile oil 1-volatile oil 2 group, volatile oil 2-flavonoids 2 group, volatile oil 1-volatile oil 2-flavonoids 1 group, volatile oil 1-volatile oil 2-flavonoids 2 group, volatile oil 1-volatile oil 2-flavonoids 2 group, volatile oil 1-volatile oil 2-flavonoids 2 group and volatile oil 2 group were compared with the model group (P<0.05). And antiviral effect as well as the expression of IL-6, IL-1β, TNF-α is studied. The expression levels of IL-6, IL-1β, TNF-α in volatile oil 1-flavonoids 1 group, volatile oil 1-flavonoids 2 group, volatile oil 1-volatile oil 2 group, volatile oil 1-volatile oil 2-flavonoids 1 group, volatile oil 1-volatile oil 2-flavonoids 2 group, volatile oil 2 groups, flavonoids 2 groups were decreased, compared with the model group (P<0.01). Conclusion:It is found that different combinations have better biological effects and good antiviral effects. This study explores the synergies compatibility rule and mechanism of action on Menthae Haplocalycis Herba and Schizonepetae Herba pairs, which will not only develop the theory of Chinese medicine compatibility but also contribute to laying a foundation for the innovation of the influenza virus drug development.

Role of NOX4⁃related signaling pathways in the pathogenesis of hepatic fibrosis / 医学研究生学报

Reduced nicotinamide adenine dinucleotide phosphate oxidase (NDAPH oxidase, NOX) is a complex composed of multiple protein subunits and the main enzyme produced by reactive oxygen species (ROS). It has been confirmed that NOXs-mediated oxidative stress is closely related to the occurrence and development of liver fibrosis, and its subunit NOX4 plays a key role. Nox4-derived ROS can not only directly affect the main cell of liver fibrosis ells (HSCs) with significant activation effects but also participate in the continuous activation of HSCs, abnormal proliferation of extracellular matrices(ECMs), apoptosis of hepatocytes, and migration of myofibroblasts(MFBs) by mediating a variety of intracellular signaling pathways including HSCs, which ultimately lead to the occurrence and development of liver fibrosis. This article reviews the role of NOX4-related signaling pathways in the pathogenesis of hepatic fibrosis.

Influence of delivering methods of drug on bronchodilation test with tidal lung function / 中国实用儿科杂志

OBJECTIVE: To investigate the factors influencing the improvement of tidal lung function bronchodilation test,and to provide evidence for the diagnosis of infant asthma. METHODS: Totally 71 infant patients diagnosed with asthma were included from clinic of Children's Hospital of Capital Institute of Pediatrics and alternativley assigned into two groups,who respectively received bronchodilator via pM DI(pMDI group)or nebulization(nebulization group),and bronchodilation test was performed. The effects of drug delivering methods on the bronchodilation test was compared,and the main observation indexes were respiratory rate(RR),VT/kg,inspiratory time(Ti),expiratory time(Te),Ti/Te,time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPEF/VE)and peak tidal expiratory flow(PTEF). Further analysis was carried within each group. RESULTS: Twenty patients received bronchodilator via pM DI,and fifty-one patients received bronchodilator via nebulization. After drug delivery,the RR of the children in the pMDI group decreased significantly(P=0.003),and the Ti increased significantly(P=0.011). The VT/kg,Ti,Ti/Te,TPTEF/TE and VPEF/VE increased significantly in nebulization group(all P<0.05). In the nebulization group,the improvement rate of TPTEF/TE and VPEF/VE were significantly higher than that of pMDI group(all P<0.05). In the pMDI group,the Te,Ti/Te,TPTEF/TE and VPEF/VE significantly improved in patients with severe airway obstruction(all P<0.05). The above parameters also improved after bronchodilation test in nebulization group. Compared in difference age groups,TPTEF/TE and VPEF/VE in children over 2 years improved more significantly than those in children under 1 year(all P<0.05). CONCLUSION: The effects of nebulization are better than pMDI in tidal lung function bronchodilation test. The improvement rate of tidal lung function is related to the degree of airway obstruction and the age of patients.

Early complications after robot-assisted laparoscopic radical cystectomy and their risk factors / 中南大学学报(医学版)

To identify risk factors for early complications in patients after robot-assisted laparoscopic radical cystectomy (RARC) and a standardized reporting model to predict complications precisely and recommend reasonable prophylaxis.
 Methods: A total of 90 patients with bladder cancer, who underwent RARC in the Second Xiangya Hospital and the Third Xiangya Hospital of Central South University from January 2016 to January 2018, were enrolled for this study. Their clinical information, preoperative examination and follow-up data within 90 d after RARC were collected. Univariable and multivariable logistic regressions were performed to identify risk factors for early complications after RARC.
 Results: The overall incidence of complications within 90 d after RARC was 48.9% (44/90), including 9 cases of Clavien grade 1, 17 cases of Clavien grade 2, 4 cases of Clavien grade 3, 12 cases of Clavien grade 4, and 2 cases of Clavien grade 5. Acute renal injury (22.2%), intestinal obstruction (16.7%), urinary tract infection (14.4%) and lymphatic leakage (10.0%) were the most common complications within 90 d after the operation. Two patients (2.2%) died within 90 d after the operation. Preoperative BMI (OR=1.16, 95% CI 1.02 to 1.32), postoperative instant (≤30 min) serum creatinine (OR=1.02, 95% CI 1.00 to 1.03), and pT stage (OR=1.67, 95% CI 1.05 to 2.68) were the risk factors for early complications after RARC. 
 Conclusion: The incidence of early complications after RARC is high. Preoperative hemodialysis, correction of anemia, intraoperative protection of renal function, and early recovery after surgery are helpful to prevent early complications after RARC.

Clinicopathological characteristics and diagnosis of IgG4related sialadenitis / 北京大学学报(医学版)

Immunoglobulin G4-related sialadenitis (IgG4-RS) is a newly recognized immune-mediated disease and one of immunoglobulin G4-related diseases (IgG4-RD). Our multidisciplinary research group investigated the clinicopathological characteristics and diagnosis of IgG4-RS during the past 10 years. Clinically, it showed multiple bilateral enlargement of major salivary glands (including sublingual and accessory parotid glands) and lacrimal glands. The comorbid diseases of head and neck region including rhinosinusitis, allergic rhinitis, and lymphadenopathy were commonly seen, which could occur more early than enlargement of major salivary glands. Internal organ involvements, such as autoimmune pancreatitis, sclerosing cholangitis, and interstitial pneumonia could also be seen. Thirty-five (38.5%) patients had the symptom of xerostomia. Saliva flow at rest was lower than normal. Secretory function was reduced more severely in the submandibular glands than in the parotid glands. Serum levels of IgG4 were elevated in almost all the cases and the majority of the patients had increased IgE levels. CT, ultrasonography, and sialography showed their imaging characteristics. Histologically it showed marked lymphoplasmacytic inflammation, large irregular lymphoid follicles with expanded germinal centers, prominent cellular interlobular fibrosis, eosinophil infiltration, and obliterative phlebitis. Their immunohistological examination showed marked IgG-positive and IgG4-positive plasma cell infiltration and high IgG4/IgG ratio. The disease could be divided into three stages according to severity of glandular fibrosis. The serum IgG4 level was higher and the saliva secretion lower as glandular fibrosis increased. IgG4-RS should be differentiated from other diseases with enlargement of major salivary gland and lacrimal gland, such as primary Sjögren syndrome, chronic obstructive submandibular sialadenitis, and eosinophilic hyperplastic lymphogranuloma.