Mechanism of regulating immune dysfunction of sepsis based on network pharmacology and experimental verification / 中国药理学通报

Aim To verify the role of Shengjiang Powder in sepsis and explore its molecular mechanism. Methods The targets of drug active ingredients and disease-related targets were searched by TCMSP, Disgenet and other databases, and the intersection of the two was selected. DAVID database was used to carry out enrichment analysis of GO and KEGG pathways for intersection targets, and molecular docking was performed between drug active ingredients and core genes of key pathways. Mouse model of sepsis was constructed by cecal ligation puncture (CLP). Spleen tissue and serum of mice were collected. The percentage of T cell subsets in spleen was detected by flow cytometry, and IL-6 and IL-10 levels in serum were detected by ELISA. Results A total of 25 active ingredients, 238 targets of active ingredients, 2797 disease-related targets, 90 genes of intersection between active ingredients and disease-related targets, potential targets were AKT, JUN, EGFR, MMP9, etc. GO enrichment analysis showed 1021 items, including 942 biological processes, 23 cell compositions and 55 molecular functions. KEGG pathway analysis found that the intersection genes were mainly enriched in THE PD-1/PD-L1 signaling pathway, HIF-1 signaling pathway, TNF signaling pathway and inflammatory mediators signaling pathway, indicating that the therapeutic effect may be related to these pathways. The molecular docking results showed that quercetin, kamanol, emodin and other core compounds could be well combined with key genes. Flow cytometry results showed that after seven days of CLP, the proportion of CD4 T cells in spleen decreased, the proportion of CD4 PD-1 T cells increased, the release of IL-6 decreased, the content of IL-10 increased, and the mice were immunosuppressed. The percentage of CD4 T cells in spleen increased, the number of CD4 PD-1 T cells decreased, the release of IL-6 was enhanced, the content of IL-10 decreased, and the immunosuppression was improved. Conclusions It is proved that Shengjiang Powder can increase the release of pro-inflammatory cytokine IL-6, increase the ratio of CD4 T/CD8 T cells, and decrease the expression of anti-inflammatory cytokine IL-10 in the late stage of sepsis, so as to improve immune suppression in the late stage of sepsis and improve the survival rate of mice.

Nanopolyphenol rejuvenates microglial surveillance of multiple misfolded proteins through metabolic reprogramming

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.

Investigation of potential pharmacodynamic substances and mechanism of Qingxin-zishen prescription decoction in treatment of menopause syndrome based on HPLC-Q-TOF-MS/MS and network pharmacology / 中国临床药理学与治疗学

AIM: To analyze the chemical ingredients of Qingxin-zishen prescription decoction (QZPD) and predict its main pharmacodynamic substances and mechanism in the prevention and treatment of menopause syndrome (MPS) with the help of high performance liquid chromatography-quadrupole-time of flight mass spectrometry (HPLC-Q-TOF/MS) combined with network pharmacology. METHODS: The chemical ingredients of QZPD were identified after analyzing the retention time, exact mass, secondary mass spectrometry fragmentation and other information obtained from HPLC-Q-TOF/MS and comparing them with the established chemical ingredients database and the literatures. The targets of ingredients in QZPD were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction database. The disease targets of MPS were obtained through Online Mendelian Inheritance in Man (OMIM) and GeneCards Database. Gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of potential targets were analyzed with the Metascape database. Cytoscape 3.7.2 software was used to construct the network of active components-key targets-pathways. AutoDockTools 4.2.5 software was applied in the molecular docking verification between the key active components and key targets. RESULTS: A total of 83 components were identified in QZPD and 847 drug targets were predicted. After intersection them with 3 050 disease targets, 395 common targets were obtained. After network topology analysis, 74 key targets were obtained, involving mitogen-activated protein kinase (MAPK), phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt), transforming growth factor-β (TGF-β) and other signaling pathways. Molecular docking analysis results indicated that 23 key active components, such as berberine, epiberberine, coptisine, geissoschizine methyl ether, liensinine, norcoclaurine, palmatine, quercetin, and luteolin, had good binding activity with several of the key targets. CONCLUSION: This study preliminarily identifies the potential effective chemical ingredients of QZPD, predicts its targets in the prevention and treatment of MPS, which provides supporting information for the further study of the pharmacodynamic substances and mechanisms of QZPD.

Analysis of related factors of optical quality in healthy Chinese adults: a community-based population study / 中华医学杂志(英文版)

BACKGROUND@#In recent years, visual quality has been extensively investigated in various conditions. In this community-based population study, we analyzed the effects of aging, refraction, and Lens Opacification Classification System III (LOCSIII) score on retinal imaging quality in healthy Chinese adults.@*METHODS@#This cross-sectional study was conducted on sub-group subjects from The Handan Eye Study between October 2012 and January 2013. Healthy subjects over 30-years-old with logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) less than 0 were included. Retinal image quality was measured by optical quality analysis system (OQAS) and recorded as modulation transfer function cutoff frequency (MTFcutoff), OQAS value (OV) 100%, OV20%, OV9%, Strehl ratio (SR), and objective scatter index (OSI). The correlation between age, spherical equivalent refraction (SE), LOCSIII score, and optical quality parameters were investigated by multivariate analysis.@*RESULTS@#Among 1108 verified subjects, 690 subjects (1380 eyes) met the inclusion criteria. Their age ranged from 30 to 76 years, SE ranged from -4.75 to 2.75 D. They were divided into five age groups (30-39, 40-49, 50-59, 60-69, and ≥70 years) for further analysis. After multivariate analysis by mixed-effect linear model, SR (t =  -3.03, P = 0.002), OV20% (t = -2.39, P = 0.017), and OV9% (t = -3.16, P = 0.001) significantly decreased with the increasing age, whereas logMAR BCVA (t = 4.42, P < 0.001) and OSI (t = 4.46, P < 0.001) significantly increased with age. As SE increased, SR (t = 2.74, P = 0.01), OV20% (t = 2.31, P = 0.02), and OV9% (t = 2.79, P = 0.005) significantly elevated, and OSI (t = -3.38, P < 0.001) significantly decreased. With the increase in cortical opacity score, all optical quality parameters except for SR significantly decreased, including MTFcutoff (t = -2.78, P = 0.01), OV100% (t = -2.78, P = 0.005), OV20% (t = -2.60, P = 0.009), and OV9% (t = -2.05, P = 0.040). As posterior sub capsular opacity score increased, MTFcutoff (t = -2.40, P = 0.02) and OV100% (t = -2.40, P = 0.01) significantly decreased, while OSI (t = 7.56, P < 0.001) significantly increased.@*CONCLUSIONS@#In healthy Chinese adult population, optical quality-related parameters significantly decrease with the increasing age, and OSI significantly increases with age. In normal BCVA subjects, optical quality is significantly impacted by cortical and posterior sub capsular opacity rather than by nuclear opacity.

Biosynthetic pathways of Polygonatum cyrtonema polysaccharide and diosgenin based on its transcriptomic data / 中国中药杂志

Polygonatum cyrtonema belongs to the plant family Liliaceae, and its dried rhizome is one of the sources of Chinese traditional medicine of Polygonati Rhizoma. It possesses the dual function as both medicine and food. Its main chemical components are polysaccharides and saponins. In order to understand the biosynthesis pathway of polysaccharides and diosgenin in P. cyrtonema, the corresponding transcriptomic data were obtained by extracting and sequencing the RNA of four parts of P. cyrtonema, namely, leaves, stems, rhizomes and roots. By adopting BGISEQ-500 sequencing platform, 42.03 Gb data were retrieved. Subsequently, the de novo assembly was carried out by Trinity software to obtain 137 233 transcripts, of which 68.13% of unigenes were annotated in seven databases including KEGG, GO, NR, NT, SwissProt, Pfam and KOG. Transcripts that may be involved in the biosynthesis of polysaccharides and diosgenin were analyzed by data mining. With help of qPCR, we validated expression data of four genes that were possibly involved in the biosynthesis of target metabolites. This experiment provides data for the study of biosynthetic pathways of P. cyrtonema secondary metabolites and the clarification of related structural gene functions.

Application of modified transperineal template-guided prostate biopsy in the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective@#To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer.@*Methods@#A total of 217 patients were enrolled in this study. All the patients were randomly divided into 2 groups. The control group (n=112) underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy. On the basis of the control group, the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB). The positive rate of apex and the incidence of complications were analyzed. The prostatic specimens from the radical prostatectomy underwent whole mount sections examination. The prostate biopsy results were compared with the postoperative pathological results.@*Results@#The average age of the control group and the observation group were (68.5±7.9) years and (67.3±8.5) years, PSA were (31.2±18.9) ng/ml and (29.7±19.5) ng/ml, prostate volume were (44.6±15.2) ml and (41.3±17.3) ml, respectively. In the control group, the positive rates of prostate cancer in 1-10 region were 24.1% (27/112), 27.7%(31/112), 23.2% (26/112), 28.6% (32/112), 26.8% (30/112), 25.0% (28/112), 26.8% (30/112), 19.6% (22/112), 25.9% (29/112), 25.0% (28/112), respectively, with an average of 25.3%. In the observation group, the positive rates in 1-10 region were 27.6% (29/105), 28.6% (30/105), 22.9% (24/105), 26.7% (28/105), 25.7% (27/105), 24.8% (26/105), 27.6% (29/105), 21.9% (23/105), 27.6% (29/105), 26.7% (28/105), respectively, with an average of 26.0%. There was no statistical difference between the two groups (P=0.904). The positive rate of apical prostate cancer in the control group and observation group was 37.5% (42/112) and 44.8% (47/105), respectively, and there was no statistical difference between the two groups (P=0.277). Patients were grouped according to PSA>20 ng/ml and PSA≤20 ng/ml. When PSA>20 ng/ml, the positive rate of apex was 58.6% (34/58) and 56.6% (30/53) respectively in the control group and the observation group, and there was no statistical difference between the two groups (P=0.830). When PSA≤20 ng/ml, the positive rate of apex was 14.8% (8/54) in the control group and 32.7% (17/52) in the observation group, with statistically significant differences (P=0.030). Before radical prostatectomy, 12 cases (57.1%) in the control group and 19 cases (73.1%) in the observation group showed apical invasion by biopsy. Results of whole mount sections examination in the control group showed that there were 19 cases (90.5%) with apical invasion, which was statistically different from that before surgery (P=0.035). The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5%) with apex invasion, which had no statistical difference compared with that before surgery (P=0.291). There were no significant differences in the incidence of hematuria, fever, urinary retention and perineal discomfort between the observation group and the control group (all P>0.05).@*Conclusions@#mTTPB can significantly improve the detection rate of apical prostate cancer without increasing the incidence of complications, especially for patients with PSA≤20 ng/ml. Hence is safe and efficacious.

Application of modified transperineal template-guided prostate biopsy in the diagnosis of prostate cancer / 中华泌尿外科杂志

Objective To investigate the clinical value of modified transperineal template-guided prostate biopsy (mTTPB) in the detection of prostate cancer.Methods A total of 217 patients were enrolled in this study.All the patients were randomly divided into 2 groups.The control group (n =112)underwent transperineal template-guided prostate biopsy (TTPB) which was traditional transperineal template-guided 11-region biopsy.On the basis of the control group,the apex of prostate was divided into four areas for biopsy in the observation group (mTTPB).The positive rate of apex and the incidence of complications were analyzed.The prostatic specimens from the radical prostatectomy underwent whole mount sections examination.The prostate biopsy results were compared with the postoperative pathological results.Results The average age of the control group and the observation group were (68.5 ± 7.9) years and (67.3 ± 8.5) years,PSA were (31.2 ± 18.9) ng/ml and (29.7 ± 19.5) ng/ml,prostate volume were (44.6 ± 15.2) ml and (41.3 ± 17.3) ml,respectively.In the control group,the positive rates of prostate cancer in 1-10 region were 24.1％ (27/112),27.7％ (31/112),23.2％ (26/112),28.6％ (32/112),26.8％ (30/112),25.0％ (28/112),26.8％ (30/112),19.6％ (22/112),25.9％ (29/112),25.0％ (28/112),respectively,with an average of 25.3％.In the observation group,the positive rates in 1-10 region were 27.6％ (29/105),28.6％ (30/105),22.9％ (24/105),26.7％ (28/105),25.7％ (27/105),24.8％ (26/105),27.6％ (29/105),21.9％ (23/105),27.6％ (29/105),26.7％ (28/105),respectively,with an average of 26.0％.There was no statistical difference between the two groups (P =0.904).The positive rate of apical prostate cancer in the control group and observation group was 37.5％ (42/112) and 44.8％ (47/105),respectively,and there was no statistical difference between the two groups (P =0.277).Patients were grouped according to PSA ＞ 20 ng/ml and PSA ≤ 20 ng/ml.When PSA ＞ 20 ng/ml,the positive rate of apex was 58.6％ (34/58) and 56.6％ (30/53)respectively in the control group and the observation group,and there was no statistical difference between the two groups (P =0.830).When PSA≤20 ng/ml,the positive rate of apex was 14.8％ (8/54) in the control group and 32.7％ (17/52) in the observation group,with statistically significant differences (P =0.030).Before radical prostatectomy,12 cases (57.1％) in the control group and 19 cases (73.1％) in the observation group showed apical invasion by biopsy.Results of whole mount sections examination in the control group showed that there were 19 cases (90.5％) with apical invasion,which was statistically different from that before surgery (P =0.035).The results of whole mount sections examination in the observation group showed that there were 23 cases (88.5％) with apex invasion,which had no statistical difference compared with that before surgery (P =0.291).There were no significant differences in the incidence of hematuria,fever,urinary retention and perineal discomfort between the observation group and the control group (all P ＞ 0.05).Conclusions mTTPB can significantly improve the detection rate of apical prostate cancer without increasing the incidence of complications,especially for patients with PSA≤20 ng/ml.Hence is safe and efficacious.

Efficacy and Safety of Tacrolimus versus Cyclosporine A for Idiopathic Membranous Nephropathy:A Network Meta-analysis / 中国医学科学院学报

Objective To compare the efficacy and safety of tacrolimus with those of cyclosporine in treating idiopathic membranous nephropathy (IMN) via network meta-analysis. Methods Databases including PubMed,Embase,CENTRAL (Cochrane),Wanfang Database,CNKI,and VIP citation database were searched for relevant studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Package Meta 4.5.0 and Gemtc 0.8.1 in R 3.3.1 were used to analyze the included studies. Results In this network meta-analysis,the complete remission rate (RR=0.98,95% CI:0.70-1.40)and the total remission rate (RR=1.00,95% CI:0.90-1.20)of idiopathic membranous nephropathy did not differ significantly between IMN patients treated with cyclosporine A or tacrolimusand,nor did the incidences of hepatic dysfunction(RR=1.40,95% CI:0.52-4.00),infection(RR=0.75,95% CI:0.18-3.10),or gastrointestinal syndrome(RR=2.1,95% CI:0.36-28.00). Conclusion Cyclosporine A seems to have similar effectiveness and safety to tacrolimus in treating IMN.

Molecular mechanisms of castration-resistant prostate cancer progressed from prostate cancer by androgen deprivation treatment / 国际肿瘤学杂志

Androgen deprivation treatment (ADT) is the gold standard of care for patients with locally advanced or metastatic hormone-sensitive prostate cancer.However,most of these patients have developed to the castration-resistant prostate cancer (CRPC) after months or years through a series of different molecular mechanisms during ADT.So far,CRPC is still incurable and deadly,therefore,it is very important for researchers to study different molecular mechanism in the occurrence and development of CRPC,which may provide some new directions for targeted therapy.

125I seeds implantation in patients with castration resistant prostate cancer / 中华核医学与分子影像杂志

Objective To evaluate the clinical efficacy of brachytherapy with 125I seeds implantation in patients with castration resistant prostate cancer (CRPC).Methods Twenty-eight patients with CRPC from February 2010 to December 2015 in Northern Jiangsu People's Hospital were analyzed retrospectively.Patients were divided into 2 groups according to different treatment methods.Control group (n =13) received endocrine therapy,and study group (n =15) underwent brachytherapy combined with endocrine therapy.The progression was defined as posttreatment prostate specific antigen (PSA) ≥ 125％ PSA of baseline level.PSA-progression-free survival (PFS),overall survival (OS) and quality of life (physical functioning,social functioning,general health,general physical discomfort,urinary symptoms and treatment-related symptoms) of 2 groups were compared using Kaplan-Meier analysis and log-rank test.Results The median PSA-PFS and OS of study group were 29(24,37) months and 37(32,50) months respectively,both of them were longer than those of control group (13(7,21) months,19(14,23) months;x2 =13.300,19.362,both P＜0.01).Comparing with control group,the physical functioning,social functioning,general health and general physical discomfort of study group were improved.Conclusion Brachytherapy can effectively prolong the survival of CRPC patients and improve the patients' life quality.

Effects of sIL-13Rα2 on the nasal mucosa goblet cell apoptosis of allergic rhinitis of rats / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the effects of sIL-13Rα2 on the apoptosis of goblet cell in nasal mucosa of allergic rhinitis rats.@*Methods@#Forty healthy male Wistar rats were randomly divided into 4 groups (10 rats per group): control group (group A), AR group (group B), sIL-13Rα2 group (group C) and triamcinolone acetonide group (group D). Ovalbumin (OVA) and aluminum hydroxide were used to establish the AR rat model. After the establishment of AR rat models, 50 μl PBS, 100 μg/50 μl IL-13Rα2 and 3.5 μg/50 μl triamcinolone acetonide were respectively dropped into each nasal cavity of every rat two times a week from 4 to 10 week in group B, group C and group D. Group A was operated with saline instead of OVA. The nasal mucosa tissues were collected at 24 h after the final administration. AB-PAS staining method was used to detect the quantity and secretion of goblet cells in the nasal mucosa tissue of all groups. Immunohistochemistry method was used to detect the expression of Bax proteins.Apoptosis was detected by TUNEL method.ANOVA analysis was used to compare multiple groups, and LSD-t test was used to compare the two groups.Pearson correlation analysis was used to analyze the correlation between the Bax positive cell rate of goblet cells and the rate of apoptotic cells. The difference was statistically significant with P<0.05.@*Results@#Compared with group A, there were more goblet cells and hypersecretion of mucus in the nasal mucosa tissue of rats in group B while fewer in group C. The goblet cells in group C and group D were significantly fewer than that in group B (0.639 00±0.831 vs 0.956 7±0.980, 0.661 90±0.657 vs 0.956 7±0.980, t value was 2.748, 2.767, respectively, all P<0.05). The immunohistochemistry results showed that the positive expression rates of Bax protein in goblet cells of group C and group D were significantly higher than that in group B (0.880 2±0.125 vs 0.568 7±0.953, 0.938 4±0.200 vs 0.568 7±0.953, t value was -2.292, -2.685, respectively, all P<0.05). The apoptosis rates of goblet cell in nasal mucosa of group C and group D were also significantly higher than that in group B (0.516 0±0.079 vs 0.274 0±0.056, 0.535 4±0.829 vs 0.274 0±0.056, t value was -17.671, -2.225, respectively, all P<0.05). The expression of Bax protein and apoptosis of goblet cells were positively correlated (r=0.859, P<0.01).@*Conclusion@#sIL-13Rα2 can induce apoptosis of the goblet cells in nasal mucosa of allergic rhinitis rats, by inhibiting IL-13 and up regulating Bax.

The influence of transperineal template-guided prostate saturation biopsy on erectile function / 中华泌尿外科杂志

Objective To evaluate the erectile function following transperineal template-guided prostate saturation biopsy (TFPSB).Methods From June 2013 to October 2015,patients underwent prostate biopsy.All patients were indicated for biopsy according to the criteria of "Guidance on diagnosis and treatment of urology in China".Exclusion criteria include medical history of PCa,severe urinary tract infection,severe cardiovascular and cerebrovascular diseases or abnormal blood coagulation.All patients were divided into observation group (TT'PSB) or control group (traditional trans-perineal template-guided prostate biopsy,TTPB) according to patients' condition,pubic anatomy,PSA abnormality,rectal examination,imaging examination and pain tolerance,etc.Patients were evaluated for pre-biopsy erectile function with the international index of erectile function (IIEF-5).All pathology confirmed prostate cancer patients were excluded.Concomitant systemic diseases and medications that would interfere with erectile function were recorded.Patients who withdrew from the trial or used the drugs such 5-phosphodiesterase inhibitors for sexual activity improvement were excluded.Ninety-seven patients in observation group and 84 patients in control group underwent further evaluation with the IIEF-5 questionnaire at 1,3 and 6 months post-biopsy.Results The average age of the observation group and the control group were (64.1 ± 7.9) years and (61.8 ±8.9) years,PSA were (7.2 ± 3.7) ng/ml and (6.7 ± 3.4) ng/ml,prostate volume were (47.8 ±21.5)ml and (49.2 ±22.2) ml,and the BMI were (21.4 ±3.1) kg/m2 and (20.6 ±3.4) kg/m2,respectively.There was no significant difference between the two groups (P ＞ 0.05) in term of above patients' characteristics.The pre-biopsy IIEF-5 score of the observation group and the control group were 19.1 ±4.5 and 19.7 ±4.3,which had no significant difference (t =-0.890,P=0.375).One month after biopsy,the IIEF-5 of two groups were 17.4 ±4.8 and 18.2 ±4.5 respectively and both group had statistically significant difference when compared with pre-biopsy (both P ＜ 0.05),however,there was no statistical significance at 3 and 6 months after biopsy.Besides,no significant difference of the IIEF-5 score was detected between two groups in 1,3 and 6 months.Conclusions Although TTPSB may resulted in temporary (1 month) post-biopsy erection dysfunction,the erectile function recovered to pre-biopsy level at 3-6 months post-biopsy.TTPSB did not increase the risk of ED compared with traditional TTPB.

Role of new strategy in transmission control of schistosomiasis in Poyang Lake region / 中国血吸虫病防治杂志

Objective To evaluate the role of new strategy in the transmission control of schistosomiasis in Poyang Lake re-gion. Methods The information and epidemic data of schistosomiasis control were collected and analyzed in Poyang Lake re-gion from 2005 to 2016. Results After eleven years of carrying out the new strategy,thirteen counties achieved the objective of transmission control in Poyang Lake region. In 2016,the number of schistosomiasis cases and human infection rate were 10301 and 0.03％,decreased by 89.64％and 99.45％compared with those in 2005,respectively. The number of cattle and schistosome-infected cattle were 68152 and 5,decreased by 50.84％and 99.83％compared with those in 2005,respectively. The average density of Oncomelania hupensis snails was decreased by 61.52％. No schistosome-infected snails were found since 2014. Con-clusion The new strategy accurately locates the key points and targets of schistosomiasis transmission chain ,which has con-trolled the human and animal's fecal eggs from polluting grassland,and cut off the transmission chain,reduced both the infec-tion rates of human and animal and the re-infection risk,and promoted to achieve the target of schistosomiasis transmission con-trol in Poyang Lake region.

Rural chronic disease patient treatment flow and cost based on intervention study in Jiangsu Province / 中国卫生政策研究

Objective:To analyze the situation of seeking medical treatment and assess the impact of interven-tion on rural chronic disease patients.A comprehensive intervention strategy was developed and implemented in rural area of Jiangsu province.Methods:According to the implementation plan,a random sampling method was adopted in Gaochun,Jingjiang and Huaiyin districts of Jingsu province to select a total of 4 261 people to be surveyed on the baseline,with 2116 people were in the intervened group and 2 145 in the controlled group,which was conducted for one year.The changes of flow tendency,times and expenses of seeking medical treatment before and after the inter-vention were analyzed.Results:After intervention,patients with chronic disease choosing primary health institutions for medical treatment has obviously improved, which was observed to be significant when compared with the con-trolled group.The average times of seeking medical treatment in primary health institutions is exceeding 10 times and which is significantly higher than before the intervention and the controlled group.After the intervention, patients, medical expenses reduced,which is significantly lower than that of the controlled group.Conclusions: Through one year of intervention,more and more patients with chronic diseases were choosing primary health institutions for medi-cal treatment.But the medical expenses have not yet achieved good control.So the support of national policy to fur-ther standardize the patients,behavior of seeking medical treatment is still needed.

The influence of transperineal template-guided prostate saturation biopsy on erectile function / 中华泌尿外科杂志

Objective To evaluate the erectile function following transperineal template-guided prostate saturation biopsy (TFPSB).Methods From June 2013 to October 2015,patients underwent prostate biopsy.All patients were indicated for biopsy according to the criteria of "Guidance on diagnosis and treatment of urology in China".Exclusion criteria include medical history of PCa,severe urinary tract infection,severe cardiovascular and cerebrovascular diseases or abnormal blood coagulation.All patients were divided into observation group (TT'PSB) or control group (traditional trans-perineal template-guided prostate biopsy,TTPB) according to patients' condition,pubic anatomy,PSA abnormality,rectal examination,imaging examination and pain tolerance,etc.Patients were evaluated for pre-biopsy erectile function with the international index of erectile function (IIEF-5).All pathology confirmed prostate cancer patients were excluded.Concomitant systemic diseases and medications that would interfere with erectile function were recorded.Patients who withdrew from the trial or used the drugs such 5-phosphodiesterase inhibitors for sexual activity improvement were excluded.Ninety-seven patients in observation group and 84 patients in control group underwent further evaluation with the IIEF-5 questionnaire at 1,3 and 6 months post-biopsy.Results The average age of the observation group and the control group were (64.1 ± 7.9) years and (61.8 ±8.9) years,PSA were (7.2 ± 3.7) ng/ml and (6.7 ± 3.4) ng/ml,prostate volume were (47.8 ±21.5)ml and (49.2 ±22.2) ml,and the BMI were (21.4 ±3.1) kg/m2 and (20.6 ±3.4) kg/m2,respectively.There was no significant difference between the two groups (P ＞ 0.05) in term of above patients' characteristics.The pre-biopsy IIEF-5 score of the observation group and the control group were 19.1 ±4.5 and 19.7 ±4.3,which had no significant difference (t =-0.890,P=0.375).One month after biopsy,the IIEF-5 of two groups were 17.4 ±4.8 and 18.2 ±4.5 respectively and both group had statistically significant difference when compared with pre-biopsy (both P ＜ 0.05),however,there was no statistical significance at 3 and 6 months after biopsy.Besides,no significant difference of the IIEF-5 score was detected between two groups in 1,3 and 6 months.Conclusions Although TTPSB may resulted in temporary (1 month) post-biopsy erection dysfunction,the erectile function recovered to pre-biopsy level at 3-6 months post-biopsy.TTPSB did not increase the risk of ED compared with traditional TTPB.

Identification of fudosteine-related substances by HILIC-MS / 药学学报

To study the substances in fudosteine, one synthetic by-product and five forced degradation products were detected by hydrophilic interaction chromatography (HILIC). Quadrupole-time-of-flight mass spectrometry (Q-TOF MS) was used for accurate mass determination and product ion scanning. Five related substances were identified in the products of mass spectra fragmentations elucidation, and verified further according to synthetic process and stress testing results. The results obtained are valuable for fudosteine manufacturing process control and quality assurance.

Analysis of salvage radical prostatectomy after radiotherapy / 中华泌尿外科杂志

Objective To investigate the efficacy and safety of salvage radical prostatectomy for men with recurrent prostate cancer (PCa) after radiotherapy.Method Ten pathologically confirmed PCa patients who relapsed after radiotherapy from Jan.2008 to Dec.2013 were retrospectively reviewed.The mean age was (64.7 ±3.7) years,with range from 56 to 72 year.Local recurrence was confirmed by retransrectal biopsy.All patients had increased PSA and/or lower urinary tract symptoms.Pelvis MRI and bone scan were performed to detect lymph node involvement and bone metastasis.All patients received radical prostatectomy with standard pelvic lymphadenectomy.Seven received open surgery (open group),three patients underwent laparoscopic surgery (laparoscopic group).Postoperative complication and PSA level were compared.Results Salvage radical prostatectomies with lymph node dissection were performed in all patients without major complications.The mean operation time of open group versus laparoscopic group were (225 ± 57)min vs.(210 ± 80)min and the mean blood loss was (275 ± 49)ml vs.(260 ± 93) ml,both of which were with no significant difference (P ＞ 0.05).The average length of stay was (14 ± 4) vs.(8 ± 2) day with significant difference (P ＜ 0.05).No rectal injury was observed.Two (20％) patients were with positive margin,and three (30％) patients had postoperative complications,including one case of deep vein thrombosis,one case of incision infection and and one case of anastomotic leakage.After a mean of 20.6 months'follow-up,two patients (25％) reached biochemical recurrence.Conclusion Both open and laparoscopic salvage radical prostatectomies after radiotherapy failure were feasible.Largescaled prospective studies were needed to verify the long-term effectiveness.

Effect and mechanism of IL-1β/JNK transduction pathway on the nasal mucosa remodeling in allergic rhinitis rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the role of JNK (c-Jun N-terminal kinase) signal transduction pathway on the nasal mucosa remodeling in allergic rhinitis rats, to explore whether IL-1β participates the nasal mucosa remodeling in allergic rhinitis by JNK signal transduction pathway.@*METHOD@#Totally 60 male Wistar rats (weighing about 200-250 g)were randomly divided into A (AR group) and B group (control group). The rats in A group were sensitized for inducing AR by intraperitoneal injection ovalbumin and Al(OH)₃. Ovalbumin was respectively dropped in each nasal cavity of every rat for 4,8,12 weeks(A4,A8,or A12 group) each had 10 rats. The rats in B group were sensitized by intraperitoneal injection saline. Saline was respectively dropped in each nasal cavity of every rat for 4,8, 12 weeks(B4, B8, or B12 group), and each had 10 rats. The concentration of IL-1β in serum and nasal lavage fluid were tested by ELASA. The protein expressions of P-JNK and P-c-Jun were detected by immunohistochemical technique. Linear correlation analysis showed the correlation between levels of IL-1β in serum and P-JNK protein, levels of IL-1β in nasal lavage fluid and P-JNK protein.@*RESULT@#The concentrations of IL-1β in serum and nasal lavage fluid of A group were all significantly higher than those of the corresponding B group (all P 0.05). Mean absorbance values of P-JNK and P-c-Jun in A group were significantly higher than those in corresponding B group (all P < 0.01) and compared with A4 group and A8 group, those of A12 group were significantly increased (all P < 0.01). Strong positive correlation were found between P-JNK and concentration of IL-1β in serum or nasal lavage fluid (r = 0.835 and r = 0.902, all P < 0.01).@*CONCLUSION@#JNK signal transduction pathway plays important role in the nasal mucosa remodeling in allergic rhinitis rats. IL-1β participates in AR nasal mucosa remodeling possibly partly through activating JNK signal transduction pathway.

The significance of transrectal ultrasound guided transperineal seminal vesicle biopsy in evaluating the clinical stage of prostate cancer / 中华泌尿外科杂志

Objective To explore the safty and feasibility of transrectal ultrasound guided transperineal seminal vesicle biopsy in the evaluation of clinical staging of prostate cancer.Methods Retrospectively study 57 suspected prostate cancer patients with seminal abnormality during 2010.7-2015.1,age ranged from 50 to 78 years,average 65 ±7 years,serum total prostate specific antigen (tPSA) 3.2-131.1 μg/L, average (23.7 ± 11.3) μg/L.Twenty-two cases had palpable prostate nodules through rectal examination.All the 57 patients underwent ultrasound and template guided transperineal prostate and seminal vesicle puncture biopsies.Results Forty-four cases out of 57 found prostate cancer cells in biopsies, and 32 cases had seminal vesicle invasion (positive group) while the other 12 were negative.Twenty cases had been performed prostatectomy in the positive group and their post-operative pathological examination all showed prostate cancer with seminal vesicle invasion.Eleven cases in the negative group had been performed prostatectomy ,and 2 cases showed seminal vesicle invasion.The clinical stages of all cases in the positive group were considered as T3b both pre-operatively and post-operatively.In the negative group however, 11 cases were considered as T2 stage pre-operatively,while 2 cases were increased to T3b stage post-operatively.The sensitivity of puncturing seminal vesicle was 91％ (20/22) ,specificity was 100.0％ (9/9).Positive predictive value was 100.0％ (20/20),while negative predictive value was 82％ (9/11).All the 57 cases did not present fever after puncture biopsies, while 23 cases presented hematuria (40％) ,20 cases presented hemospermia (35％) and 1 case presented urinary retention (2％).Conclusions Transrectal ultrasound-guided transperinealseminal vesicle puncture is safe and reliable, it helps to improve the accuracy of pre-operative staging.

Hyperthermia Combined with Chemotherapy for Ovarian Cancer:A Meta-analysis / 中国医科大学学报

Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.