Utilizing ultra-small volume graft in auxiliary liver transplantation for portal hypertension / 中华外科杂志

Objective: To examine the clinical effect of auxiliary liver transplantation with ultra-small volume graft in the treatment of portal hypertension. Methods: Twelve cases of portal hypertension treated by auxiliary liver transplantation with small volume graft at Liver Transplantation Center,Beijing Friendship Hospital, Capital Medical University between December 2014 and March 2022 were studied retrospectively. There were 8 males and 4 females,aged 14 to 66 years. Model for end-stage liver disease scores were 1 to 15 points and Child scores were 6 to 11 points. The grafts was derived from living donors in 9 cases,from split cadaveric donors in 2 cases,from whole cadaveric liver of child in 1 case. The graft recipient body weight ratios of 3 cadaveric donor livers were 0.79% to 0.90%, and of 9 living donor livers were 0.31% to 0.55%.In these cases, ultra-small volume grafts were implanted. The survivals of patient and graft, complications, portal vein blood flow of residual liver and graft, abdominal drainage and biochemical indexes of liver function were observed. Results: All the grafts and patients survived. Complications included outflow tract torsion in 2 cases, acute rejection in 1 case, bile leakage in 1 case, and thyroid cancer at the later stage of follow-up in 1 case, all of which were cured. The torsion of outflow tract was attributed to the change of anastomotic angle after the growth of donor liver. After the improvement of anastomotic method, the complication did not recur in the later stage. There was no complication of portal hypertension. The measurement of ultrasonic portal vein blood flow velocity showed that the blood flow of residual liver decreased significantly in the early stage after operation, and maintained a very low blood flow velocity or occlusion in the long term after operation, and the blood flow of transplanted liver was stable. Conclusions: Auxiliary liver transplantation can implant ultra-small donor liver through compensation of residual liver. This method may promote the development of living donor left lobe donation and split liver transplantation. However, the auxiliary liver transplantation is complex, and it is difficult to control the complications. Therefore, this method is currently limited to centers that are skilled in living related liver transplantation and that have complete ability to monitor and deal with complications.

Risks of and response to cluster outbreak of imported malaria during malaria post-elimination era in China / 中国热带医学

@#Abstract: Objective　To analyze the recent cluster outbreaks of imported malaria and explore the risks, challenges and countermeasures for dealing with such events during malaria post-elimination era of malaria, and to provide reference for effectively addressing the risks and consolidating the achievements of malaria elimination. Methods　The individual malaria case data from "The Information System for Infectious Disease Surveillance" and "The Information System For Parasitic Diseases Prevention And Control" were collected，and the diagnosis classification, infection source, time and space distribution of cases were analyzed. Results　From January 1 to August 11, 2022, a total of 429 malaria cases were reported nationwide, an 18.9% decrease compared to the same period last year (529 cases), all of which were imported cases. The overall weekly trend of the outbreak remained stable, but since Week 31 (July 25-31), there has been a significant increase in the number of cases, with a peak on August 5. From July 25 to August 11, 2022, a total of 162 malaria cases were reported nationwide, up 315.4% from 39 cases in the same period last year, accounting for 37.8% of the total cases up to August 11, 2022. The main source of imported infections was Guinea (95 cases, 58.6%), with most cases reported in Longgang District, Shenzhen City, Guangdong Province (30 cases), Shilin County, Kunming City, Yunnan Province (21 cases), Chaoyang District, Beijing (11 cases), and Xiaoshan District, Hangzhou City, Zhejiang Province (7 cases). Conclusions　Due to the concentration of returnees to China, several entry port cities simultaneously experienced cluster outbreaks of imported malaria, which brought immense pressure and challenges to local medical and health institutions. Health facilities at all levels need to maintain high vigilance and sensitivity, be well prepared, and avoid death and secondary transmission caused by imported cases.

Diagnosis of nasopharyngeal carcinoma with convolutional neural network on narrowband imaging / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the diagnostic accuracy of the convolutional neural network（CNN） in diagnosing nasopharyngeal carcinoma using endoscopic narrowband imaging. Methods:A total of 834 cases with nasopharyngeal lesions were collected from the People's Hospital of Guangxi Zhuang Autonomous Region between 2014 and 2016. We trained the DenseNet201 model to classify the endoscopic images, evaluated its performance using the test dataset, and compared the results with those of two independent endoscopic experts. Results:The area under the ROC curve of the CNN in diagnosing nasopharyngeal carcinoma was 0.98. The sensitivity and specificity of the CNN were 91.90% and 94.69%, respectively. The sensitivity of the two expert-based assessment was 92.08% and 91.06%, respectively, and the specificity was 95.58% and 92.79%, respectively. There was no significant difference between the diagnostic accuracy of CNN and the expert-based assessment （P=0.282, P=0.085）. Moreover, there was no significant difference in the accuracy in discriminating early-stage and late-stage nasopharyngeal carcinoma（P=0.382）. The CNN model could rapidly distinguish nasopharyngeal carcinoma from benign lesions, with an image recognition time of 0.1 s/piece. Conclusion:The CNN model can quickly distinguish nasopharyngeal carcinoma from benign nasopharyngeal lesions, which can aid endoscopists in diagnosing nasopharyngeal lesions and reduce the rate of nasopharyngeal biopsy.

Research progress in nephrotoxicity and prevention of arsenic trioxide / 中国药理学通报

Aim Arsenic trioxide (ATO, As203 ) can effectively treat acute promyelocyte leukemia (APL) and other malignant tumors.However.ATO has been found to have nephrotoxic effects during the treatment process, which limits the clinical application of ATO.Studies have shown that the use of ATO can interfere with the body's oxidation, causing to oxidative stress, damage DNA repair pathways, and induce DNA mutations.leading to cell cancer.This is currently one of the important mechanisms of ATO nephrotoxicity.Apoptosis, DNA methyl a- tion caused by ATO are also causes of nephrotoxicity.This article summarizes the research and prevention of ATO nephrotoxicity mechanism.

Difference Analysis of Chemical Constituents in Different Varieties of Puerariae Flos by UPLC-Q-TOF-MS / 中国实验方剂学杂志

Objective:To compare the chemical constituents of Puerariae Flos from three different varieties of <italic>Pueraria montana</italic> var. <italic>lobata</italic>， <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>. Method:Ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS） was used with the mobile phase of 0.1% formic acid aqueous solution （A）-acetonitrile （B） for gradient elution （0-20 min， 10%-30%B； 20-30 min， 30%-55%B； 30-35 min， 55%-95%B； 35-37 min， 95%B； 37-40 min， 95%-10%B）， the flow rate was 0.25 mL·min^-1. Electrospray ionization （ESI） was used to scan and collect MS data in positive and negative ion modes with scanning range of <italic>m</italic>/<italic>z</italic> 50-1 500. The chemical components from different sources of Puerariae Flos were identified in combination with the chemical composition database and literature information. After the obtained data were normalized by MarkerView^TM 1.2.1， they were imported into SICMA-P 14.1 software for principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） to select the main differentiated components among the three different varieties. Result:A total of 35 compounds were identified from three different varieties of Puerariae Flos， including 22 isoflavones， 6 flavonoids and 7 saponins. The flowers of <italic>P</italic>. <italic>lobata</italic>， <italic>P. montana</italic> var. <italic>thomsonii</italic> and <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> contained 32， 35， 33 compounds， respectively. And 18 differential compounds were screened under the positive and negative ion modes， including kakkalide， tectoridin， 6″-<italic>O</italic>-xylosyl-tectoridin， 4'-methyltectorigenin-7-glucoside， glycitin， 6″-<italic>O</italic>-xylosyl-glycitin， irisolidone， kaikasaponin Ⅲ， 6″-<italic>O</italic>-malonylglycitin， kakkalidone， tectorigenin， rutin， soyasaponin BB， vitexin， biochanin A， genistin， kakkatin， azukisaponin Ⅱ. Conclusion:This research is the first to systematically study the chemical constituents of the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic>， although the flower of <italic>P</italic>. <italic>montana</italic> var<italic>. montana</italic> is used as adulterants， it has high contents of tectoridin and 6″-<italic>O</italic>-xylosyl-tectoridin， which has great potential for development. The efficacy components such as kakkalide and tectoridin in Puerariae Flos from the three sources of varieties are obviously different， and it is necessary to carefully consider the application of these three varieties as Puerariae Flos.

Pueraria lobate advances in molecular pharmacognosy / 中国中药杂志

Molecular pharmacognosy is a science of classification and identification, cultivation and protection, and production of active ingredients of graduated drugs at the molecular level. The proposal of molecular pharmacognosy allows the research of crude drugs to advance from the microscopic level to the genetic level. Pueraria lobata root, as a medicinal and edible plant, has high application value and economic value. There are many varieties that are easy to cause confusion, and it is not easy to distinguish and identify according to traditional identification methods. Moreover, the research of P. lobate root at the genetic level is still relatively shallow. the study received extensive attention of scholars. This article reviews recent research on molecular identification of P. lobate, transcriptome sequencing, cloning and synthesis of functional genes of P. lobate root in recent years in order to provide references for further promoting the development and utilization of P. lobate root and its active ingredients.

Study on ulcerative colitis activity and its chemical constituents in effective part of Gardeniae Fructus / 中国药理学通报

Aim To study the therapeutic effect of 35% and 70% ethanol elution sites of Gardeniae Fructus extract on 2,4,6-trinitrobenzene sulfonic acid (TNBS)/ethanol induced ulcerative colitis (UC) in rats, and to identify the chemical composition of the active elution site using mass spectrometry. Methods The UC model induced by TNBS was used in rats, and the different eluted parts were administered by gavage at a dose of 2. lg/kg for 7 days. Body weight measurement , disease activity index (DAI) score, and pathological score of colon tissues were compared. Myeloperoxidase (MPO) , superoxide dismutase (SOD), malondialdehyde ( MDA ) , nitric oxide ( NO ) , tumor necrosis factor-a (TNF-a) , interleukin in mouse colon tissue -6 (IL-6), interleukin-1 (3 (IL-ip) levels were compared among groups. Liquid-mass spectrometry was used to identify the chemical components of the parts with better efficacy. Results Compared with model group, the weight loss in 35% elution site group was significantly improved, the DAI and histopathology scores were markedly reduced, and the contents of MPO, NO, MDA, TNF-a, IL-6 and IL-1(3 in tissues were apparently reduced. SOD content increased significantly (P <0. 01). A total of 19 chemical components were identified by LC-MS, 11 of which were iri- doids. Conclusions The 35% elution site of Gardeni- a has obvious therapeutic effect on UC rats, and the iridoid component may be the material basis for its function.

Spectrum-effect Relationship of Choleretic Effect of Gardeniae Fructus Extract Based on Principal Component Analysis and Gray Correlation Analysis / 中国实验方剂学杂志

Objective:To investigate the effective substance of the choleretic effect of Gardeniae Fructus，and analyze the relationships between its choleretic effect and the HPLC fingerprint chromatogram. Method:HPLC method was applied to establish the fingerprint chromatography of 8 batches of Gardeniae Fructus at different harvest periods. The flow，the content of bile acid，bilirubin and cholesterol in bile were tested，and then the principal component analysis was used to comprehensively evaluate the total choleretic effects of Gardeniae Fructus. After the relationships between the relative peak area of the common peaks and the choleretic effects were explored using grey relationship analysis method，the spectrum-effect relationship of Gardeniae Fructus was established. Result:The order of the contribution of the chemical components to the choleretic effect at the common peaks was as follow（r>0.8）：P9>P14>P26>P4>P30>P6>P1>P10>P5>P24. Among all peaks，the full wavelength scanning results implied that the peaks 9，14 and 4 might be iridoids, and the peaks 26，30 and 24 might be crocins. By comparing with the standard substances，the peak 9 was finally identified as geniposide. Conclusion:The choleretic effect of Gardeniae Fructus may be the results of multiple components and pathways，and the main components in Gardeniae Fructus with the choleretic effect was from geniposide. In conclusion，these results provide a reference for investigating the material basis of choleretic effect of Gardeniae Fructus.

Histomorphological Identification of Nandina domestica / 中国实验方剂学杂志

Objective::Histomorphological study of the Nandinae Radix, Nandinae Caulis, Nandinae Folium, Nandinae Fructus were conducted to provide the basis for the identification of its authenticity and falsehood. Method::The origin and macroscopic identification were used to describe the plant morphology and the appearance characteristics of all medicinal parts. The microscopic characteristics of the medicinal parts, such as roots, stems, leaves, flowers, fruits, were observed and photographed by paraffin section and powder preparation techniques. Result::It was found that the morphological characteristics of the original plant were consistent with the descriptions in herbaceous books. There was no pith on the cross-section of roots. In the transverse section of stems, there were intermittent circular fiber bundles in the cortex and a cap-shaped fibrous bundle in the inner part of the xylem. In the transverse section of the leaves, the palisade tissue was wider and the fiber bundles around the main vascular bundles formed a ring. In the transverse section of petiole, the fiber bundles were arranged intermittently into rings. In the transverse section of fruit, multi-layered sclereids formed a ring in the mesocarp. The powder characteristics of root and stem mainly contained crystalliferous sclereids. There were crystal sheath fibers and stomatal infinitive in the leaf powder, and pollen grains in the flower powder, with 3-hole grooves, obvious reticulate engraving pattern in the outer wall and more reticulate cells. There were a large number of branched sclereids and calcium oxalate square crystals in the fruit powder. Conclusion::The above-mentioned morphological and microscopic features have identification significance, and provide scientific basis for the authenticity identification, the quality standard and the utilization of resources of Nandina domestica.

Protective Effect of Different Medicinal Parts of Nandina domestica on Arsenic Trioxide Hepatotoxicity and Hephrotoxicity / 中国实验方剂学杂志

Objective::To compare the effect of different medicinal parts of Nandina domestica in reducing toxicity of anti-tumor drug arsenic trioxide, so as to provide the scientific basis for its further development and application. Method::Chronic arsenic trioxide poisoning model was used in this paper. Totally 56 SD rats were randomly divided into normal group, model group (arsenolite 40 mg·kg-1), sodium 2, 3-dimercapto-1-propanesulfonate group (sodium 2, 3-dimercapto-1-propanesulfonate 25 mg·kg-1+ arsenolite 40 mg·kg-1), Nandinae Radix group (Nandinae Radix 20 g·kg-1+ arsenolite 40 mg·kg-1), Nandinae Caulis group (Nandinae Caulis 20 mg·kg-1+ arsenolite 40 mg·kg-1), Nandinae Folium group (Nandinae Folium 20 g·kg-1+ arsenolite 40 mg·kg-1), and Nandinae Fructus group (Nandinae Fructus 20 g·kg-1+ arsenolite 40 mg·kg-1). The intragastric administration lasted for 10 days. After the last administration, urine was collected within 24 hours, serum, kidney and liver tissue samples were collected after operation, and serum creatinine (SCr) and urine creatinine (UCr) levels were measured, in order to calculate endogenous creatinine clearance rate (CCr). At the same time, the levels of malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in liver and kidney of rats in each group were detected. Some kidneys and livers were fixed with formaldehyde, and the histopathological changes were observed under microscope after hematoxylin-eosin staining. Result::Compared with the model group, the rats in combination group of Nandinae Radix, Nandinae Caulis, Nandinae Fructus have a heavier body mass (P<0.01), the kidney coefficient was lower (P<0.01), the levels of UCr and CCr were significantly increased (P<0.01), the content of MDA in renal tissue was decreased significantly (P < 0.01), the level of MDA in liver tissue was decreased (P < 0.05), whereas the activities of SOD and CAT were significantly increased (P<0.01), the pathological damage of liver and kidney was alleviated. There was no significant difference in the activity of SOD in the liver between the Nandinae Folium combination group and the model group, but the changes of the other indexes were consistent with those of the above three groups. Conclusion::Nandinae Radix, Nandinae Caulis, Nandinae Fructus have significant protective effects on liver and kidney toxicity induced by arsenic trioxide oxidative stress, and Nandinae Folium was the least effective among them.

Analysis of chloroquine-resistant gene polymorphisms in Plasmodium falciparum imported into China in 2012 and 2018 / 中国血吸虫病防治杂志

Objective To detect the chloroquine-resistant molecular marker polymorphisms in Plasmodium falciparum imported into China, investigate the mutation types of P. falciparum chloroquine resistant transporter (Pfcrt) gene at positions 72 to 76, and analyze the specificity of the P. falciparum specimens with different origins. Methods A total of 674 filter paper blood samples were collected from the National Malaria Diagnosis Reference Laboratory of China in 2012 and 2018. The amino acid po- sitions 72 to 76 of the Pfcrt gene on chromosome 7 were amplified using nested PCR assay and sequenced, and the sequencing results of the target gene fragment and the geographical region-specific prevalence of the mutations in the Pfcrt gene were analyzed. Results Among the 674 imported P. falciparum malaria cases in China in 2012 and 2018, 99.5% (644/674) were from Africa, which were predominantly from western and central Africa (80.4%, 518/644), and 4.5% (30/674) from Southeast Asia and Oceania (Papua New Guinea). A total of 4 site mutations (C72S, M74I, N75E and K76T) and 5 haplotypes (CVMNK, CVIET and SVMNT and two mixed types) were identified, with haplotypes CVMNK and CVIET present in parasites of both African and Southeast Asian origins, SVMNT detected in Southeast Asia (Myanmar) and Papua New Guinea isolates, the mixed type of haplo- types CVMNK/CVIET detected in P. falciparum of African and Southeast Asian origins, and the mixed type of haplotypes CVMNK/SVMNT detected only in the Myanmar isolate. Most P. falciparum parasites of the African origin carried the wild-type Pfcrt allele (77.7%, 478/615), and 68.0% (17/25) of the P. falciparum parasites of the Southeast Asian and Papua New Guinea or- igins harbored chloroquine resistant molecular markers (χ2 = 28.5, P < 0.05). The constituent ratio of the wild- and mutant-type Pfcrt allele varied in different geographical regions of Africa (P < 0.01), and the lowest prevalence of the wild-type Pfcrt allele was seen in western Africa. Conclusion Among the 674 imported malaria cases in China in 2012 and 2018, the P. falciparum imported from Sotheast Asia habors a higher proportion of resistance to chloroquine and a higher molecular polymophism at ami- no acid positions 72 to 76 of the Pfcrt gene than the parasite of the African origin.

Metabolic abnormalities associated with ketamine-associated bladder toxicity based on metabolomics / 药学学报

The aim of the present study was to determine the metabolic changes and possible toxic mechanisms of ketamine-associated bladder toxicity. Twenty-four male Sprague-Dawley (SD) rats were randomly allocated into a control group, a low-dose group and a high-dose group. The behavior of these rats was observed every day. In addition, the weight, 2 h urinary frequency and organ coefficient of the bladder were measured. Serum IL-6 and TNF-α levels were measured using an enzyme-linked immunosorbent assay (ELISA). Urinary metabolites were analyzed using gas chromatography-mass spectrometry (GC-MS). This research was approved by the Ethics Committee of the Animal Experiment Center of Southwest Medical University (No. 201901-98). After 12 weeks of administration, the frequency of 2 h urination and the bladder mass index were significantly different in the low-dose and high-dose groups compared with the control group. Serum IL-6 and TNF-α levels were higher than those of the control group (P<0.05). Bladder HE staining showed that long-term administration of ketamine could induce cystitis. The concentrations of the three common differential metabolites, including 3-aminoisobutyric acid, citric acid and uric acid in the low-dose and the high-dose groups were increased compared with those in the control group. This study indicates that 3-aminoisobutyric acid, citric acid and uric acid and their related metabolic pathways may be closely related to ketamine-associated bladder toxicity.

Correlation between color and content of eight components of Gardeniae Fructus at different harvest time / 中国中药杂志

This research is to establish an HPLC method for determination of geniposidic acid, genipin-1-β-D-gentiobioside, geniposide, p-trans-coumaroylgenipin gentiobioside, chlorogenic acid, crocin-Ⅰ, crocin-Ⅱ and crocin-Ⅲ in Gardeniae Fructus at different harvest time. The detection wavelength was 238, 320 and 440 nm. Principal component analysis(PCA), correlation analysis, regression analysis and partial least squares(PLS) analysis were used to explore the relationship of color and content of eight components in Gardeniae Fructus. The result showed that the trend of the eight components in Gardeniae Fructus at harvest time in different three years was varied similarly. According to the variation of eight components at different harvest time, the mature and immaturate Gardeniae Fructus were discriminated. The content of crocin-Ⅰwas correlated positively with a~* of color significance. The redder color of Gardeniae Fructus showed the higher value of a~* and content of crocin-Ⅰ, indicating the better quality of Gardeniae Fructus. This method provided reference for justifying the color and quality of Gardeniae Fructus and scientific evidence for "assessing quality by distinguishing color".

Comparision between portosystemic shunts and endoscopic therapy for prevention of variceal re-bleeding: a systematic review and meta-analysis / 中华医学杂志(英文版)

Background:@#Portosystemic shunts, including surgical portosystemic shunts and transjugular intra-hepatic portosystemic shunt (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.@*Methods:@#Using the terms "variceal hemorrhage or variceal bleeding or variceal re-bleeding" OR "esophageal and gastric varices" OR "portal hypertension" and "liver cirrhosis," the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Risk ratio (RR) estimates with 95% confidence interval (CI) were calculated using random effects model by Review Manager. The quality of the included studies was evaluated using the Cochrane Collaboration’s tool for the assessment of the risk of bias.@*Results:@#Twenty-six publications comprising 28 RCTs were included in this analysis. These studies included a total of 2845 patients: 496 (4 RCTs) underwent either surgical portosystemic shunts or TIPS, 1244 (9 RCTs) underwent either surgical portosystemic shunts or ET, and 1105 (15 RCTs) underwent either TIPS or ET. There was no significant difference in overall mortality and 30-day or 6-week survival among three interventions. Compared with TIPS and ET, separately, surgical portosystemic shunts were both associated with a lower bleeding-related mortality (RR = 0.07, 95% CI = 0.01–0.32; P < 0.001; RR = 0.17, 95% CI = 0.06–0.51, P < 0.005) and rate of variceal re-bleeding (RR = 0.23, 95% CI = 0.10–0.51, P < 0.001; RR = 0.10, 95% CI = 0.04–0.24, P < 0.001), without a significant difference in the rate of postoperative hepatic encephalopathy (RR = 0.52, 95% CI = 0.25–1.00, P = 0.14; RR = 1.09, 95% CI = 0.59–2.01, P = 0.78). TIPS showed a trend toward lower variceal re-bleeding (RR = 0.46, 95% CI = 0.36–0.58, P < 0.001), but a higher incidence of hepatic encephalopathy than ET (RR = 1.78, 95% CI = 1.34–2.36, P < 0.001).@*Conclusions:@#The overall analysis revealed that there seem to be no short-term and long-term survival advantage, but surgical portosystemic shunts are with the lowest bleeding-related mortality among the three therapies. Surgical portosystemic shunts may be the most effective without an increased risk of hepatic encephalopathy and TIPS is superior to ET but at the cost of a higher incidence of hepatic encephalopathy. However, some of findings should be interpreted with caution due to the lower level of evidence and the existence of significant heterogeneity.

Comparision between portosystemic shunts and endoscopic therapy for prevention of variceal re-bleeding: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Portosystemic shunts, including surgical portosystemic shunts and transjugular intra-hepatic portosystemic shunt (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.@*METHODS@#Using the terms "variceal hemorrhage or variceal bleeding or variceal re-bleeding" OR "esophageal and gastric varices" OR "portal hypertension" and "liver cirrhosis," the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Risk ratio (RR) estimates with 95% confidence interval (CI) were calculated using random effects model by Review Manager. The quality of the included studies was evaluated using the Cochrane Collaboration's tool for the assessment of the risk of bias.@*RESULTS@#Twenty-six publications comprising 28 RCTs were included in this analysis. These studies included a total of 2845 patients: 496 (4 RCTs) underwent either surgical portosystemic shunts or TIPS, 1244 (9 RCTs) underwent either surgical portosystemic shunts or ET, and 1105 (15 RCTs) underwent either TIPS or ET. There was no significant difference in overall mortality and 30-day or 6-week survival among three interventions. Compared with TIPS and ET, separately, surgical portosystemic shunts were both associated with a lower bleeding-related mortality (RR = 0.07, 95% CI = 0.01-0.32; P < 0.001; RR = 0.17, 95% CI = 0.06-0.51, P < 0.005) and rate of variceal re-bleeding (RR = 0.23, 95% CI = 0.10-0.51, P < 0.001; RR = 0.10, 95% CI = 0.04-0.24, P < 0.001), without a significant difference in the rate of postoperative hepatic encephalopathy (RR = 0.52, 95% CI = 0.25-1.00, P = 0.14; RR = 1.09, 95% CI = 0.59-2.01, P = 0.78). TIPS showed a trend toward lower variceal re-bleeding (RR = 0.46, 95% CI = 0.36-0.58, P < 0.001), but a higher incidence of hepatic encephalopathy than ET (RR = 1.78, 95% CI = 1.34-2.36, P < 0.001).@*CONCLUSIONS@#The overall analysis revealed that there seem to be no short-term and long-term survival advantage, but surgical portosystemic shunts are with the lowest bleeding-related mortality among the three therapies. Surgical portosystemic shunts may be the most effective without an increased risk of hepatic encephalopathy and TIPS is superior to ET but at the cost of a higher incidence of hepatic encephalopathy. However, some of findings should be interpreted with caution due to the lower level of evidence and the existence of significant heterogeneity.

Application of a self designed oral-nasal double channel mask in painless gastroscopy / 中国内镜杂志

Objective To evaluate the feasibility and safety of self designed oral-nasal double channel mask in painless gastroscopy. Methods 400 patients who were given intravenous injection Sublimaze followed by Propofol were divided equally at random into two groups. The patients in control group (n = 200) were inhaled oxygen with snuffle tube (4.0 ~ 5.0 L/min) and the patients in experimental group (n = 200) were inhaled oxygen with a self designed oral-nasal double channel mask. Respiration rate, SpO2, duration of operation and dosage of anaesthetic were recorded before and during operation. Result The SpO2decreased markedly and duration of operation obviously prolonged in group I during operation (P < 0.05), there was no statistical difference between the two groups of the respiration rate and dosage of anaesthetic. Conclusion The application of oxygen inhalation with the self designed oral-nasal double channel mask in painless gastroscopy appeared safer than that of oxygen inhalation via snuffle tube. It can be safely used in painless gastroscopy.

Varieties textual research, resource investigation and identification of commercial drugs on Cuscutae Semen / 中国中药杂志

Through the textual research, resource investigation, literature reviews (including Flora of China, municipal Flora, pharmacopoeia of China and municipal drug standards) and identification of commercial drugs on Cuscutae Semen, it was found the species described in the herbal textual was Cuscuta chinensis, with good quality from Shandong and Henan Province. The identification of commodities showed the majority drugs were from C. australis, varied from the ancient herbal textuals .Mordern literature reviews indicate that it was necessary to strengthen the research on Cuscutae Semen from C. australis, C. chinensis and C. japonica because of their differences in resources, macroscopical and microscopical characters, while wrong descriptions in some literatures. It was suggested that the two species (C. australis and C. chinensis) should be separated in pharmacopoeia of China. The study provides scientific basis for the development and utilization of Cuscutae Semen.

Influence of prehospital emergency care connected green channel on rescue effect in patients with acute myocardial infarction / 心血管康复医学杂志

Objective:To explore rescue effect of prehospital emergency care connected green channel on patients with acute myocardial infarction (AMI).Methods:A total of 122 emergency AMI patients treated in our hospital were selected.Ac-cording to hospitalization order,they were divided into routine emergency care group (the first 61 inpatients)and green channel group (the following 61 inpatients,received prehospital emergency care connected green channel besides routine e-mergency care).Rescue effective rate,myocardial perfusion time,time of in-hospital stay and nursing satisfaction were compared between two groups.Results:Total effective rate of green channel group was significantly higher than that of routine emergency care group (78.69% vs.68.85%,P =0.028);compared with routine emergency care group,there were significant reductions in myocardial perfusion time [(100.72±10.40)min vs.(56.02±5.49)min]and time of in-hospital stay [(14.34 ± 3.46)d vs.(11.86 ± 4.24)d](P < 0.01 both),and significant rise in nursing satisfaction (81.82% vs.96.67%,P =0.028)in green channel group.Conclusion:Prehospital emergency care connected green chan-nel can improve rescue effective rate,reduce time of in-hospital stay and improve nursing satisfaction in patients with acute myocardial infarction,which is worth extending in clinic.

Effect of genistein on ammonia-induced NF-κB activation in astrocytes / 中国病理生理杂志

AIM:To explore the effect of genistein on ammonia-induced nuclear factor-κB (NF-κB) activation and the underlying mechanism.METHODS:Primary astrocyte cultures were prepared and challenged with NH4Cl to establish a hyperammonemic model.The activation of ERK,Akt and NF-κB was examined by Western blot.RESULTS:AG1478 and genistein significantly inhibited ammonia-induced activation of ERK and Akt.Ammonia-induced NF-κB nuclear translocation was significantly inhibited by the pretreatment of LY294002,genistein and AG1478.CONCLUSION:Genistein significantly inhibited ammonia-induced ERK activation and Akt-mediated NF-κB activation,which might represent the important mechanism by which this naturally occurring substance exerts its swelling-inhibiting effect.

Influence of prehospital emergency care connected green channel on rescue effect in patients with acute myocardial infarction / 心血管康复医学杂志

Objective:To explore rescue effect of prehospital emergency care connected green channel on patients with acute myocardial infarction (AMI).Methods:A total of 122 emergency AMI patients treated in our hospital were selected.Ac-cording to hospitalization order,they were divided into routine emergency care group (the first 61 inpatients)and green channel group (the following 61 inpatients,received prehospital emergency care connected green channel besides routine e-mergency care).Rescue effective rate,myocardial perfusion time,time of in-hospital stay and nursing satisfaction were compared between two groups.Results:Total effective rate of green channel group was significantly higher than that of routine emergency care group (78.69% vs.68.85%,P =0.028);compared with routine emergency care group,there were significant reductions in myocardial perfusion time [(100.72±10.40)min vs.(56.02±5.49)min]and time of in-hospital stay [(14.34 ± 3.46)d vs.(11.86 ± 4.24)d](P < 0.01 both),and significant rise in nursing satisfaction (81.82% vs.96.67%,P =0.028)in green channel group.Conclusion:Prehospital emergency care connected green chan-nel can improve rescue effective rate,reduce time of in-hospital stay and improve nursing satisfaction in patients with acute myocardial infarction,which is worth extending in clinic.