Exploration of potential active ingredients and mechanism of action of Xihuang pill-medicated serum against glioma based on HPLC-Q-TOF-MS/MS, network pharmacology and experimental verification / 药学学报

Qualitative analysis of the ingredients absorbed into blood and their metabolites of Xihuang pill (XHP) were conducted using high-performance liquid chromatography quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS/MS) technology. Network pharmacology was used to explore the potential anticancer mechanisms of the ingredients against glioma, and their specific mechanisms were validated through molecular docking and experimental verification. SD rats were intragastrically administered with XHP, and rat serum samples were collected. Ingredients absorbed into blood and their metabolites were identified based on the retention time of chromatographic peaks, accurate molecular mass, characteristic fragment ions, and comparisons with reference substances and literature data. PharmMapper and SwissTarget Prediction databases were used to obtain the targets of the XHP-medicated serum, while GeneCards, OMIM, PharmGKB, TTD, and DrugBank databases were used to obtain glioma disease targets. The "component-target" network relationship diagram was constructed using Cytoscape 3.9.1 software. The protein-protein interaction (PPI) network diagram was constructed using the STRING database, and the targets were analyzed using GO and KEGG analyses. Molecular docking was used to verify the binding ability of core targets with their corresponding compounds in XHP-medicated serum. The potential mechanism of the anti-glioma effect of 11-keto-β-boswellic acid (KBA), a representative component of XHP-medicated serum, was verified using CCK-8 and Western blot assays. A total of 40 compounds were identified in the XHP-medicated serum, including 28 prototype components and 12 metabolites. The network pharmacology results showed that elemonic acid, 3-acetyl-β-boswellic acid, KBA, α-boswellic acid, and other 5 compounds might be the active ingredients of XHP-medicated serum in the treatment of glioma. Glutathione reductase (GSR), glucose-6-phosphate dehydrogenase (G6PD), ATP-citrate lyase (ACLY), aldo-keto reductase family 1 member B1 (AKR1B1) and glutaredoxin (GLRX) were identified as key targets, involving pathways such as glutathione metabolism and the pentose phosphate pathway. Further cell experiments showed that KBA significantly inhibited the proliferation of T98G cells with an IC50 of 30.96 μmol·L-1, and KBA (30 μmol·L-1) significantly downregulated the protein expression levels of GSR in T98G cells. In summary, XHP-medicated serum may exert its anti-glioma effect by regulating GSR and G6PD-targeted pathways involved in glutathione metabolism. These results provide valuable evidence for further investigating the mechanism of XHP in treating glioma. The animal welfare and experimental procedures were approved by the Ethical Committee of Laboratory Animals at Nanjing University of Chinese Medicine (approval No. ACU221001).

Effective substances and mechanism of Yishen Guluo Mixture in treatment of chronic glomerulonephritis based on metabolomics and serum pharmacochemistry / 中国中药杂志

This study aimed to investigate the effective substances and mechanism of Yishen Guluo Mixture in the treatment of chronic glomerulonephritis(CGN) based on metabolomics and serum pharmacochemistry. The rat model of CGN was induced by cationic bovine serum albumin(C-BSA). After intragastric administration of Yishen Guluo Mixture, the biochemical indexes related to renal function(24-hour urinary protein, serum urea nitrogen, and creatinine) were determined, and the efficacy evaluations such as histopathological observation were carried out. The serum biomarkers of Yishen Guluo Mixture in the treatment of CGN were screened out by ultra-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry(UPLC-Q-TOF-MS) combined with multivariate statistical analysis, and the metabolic pathways were analyzed. According to the mass spectrum ion fragment information and metabolic pathway, the components absorbed into the blood(prototypes and metabolites) from Yishen Guluo Mixture were identified and analyzed by using PeakView 1.2 and MetabolitePilot 2.0.4. By integrating metabolomics and serum pharmacochemistry data, a mathematical model of correlation analysis between serum biomarkers and components absorbed into blood was constructed to screen out the potential effective substances of Yishen Guluo Mixture in the treatment of CGN. Yishen Guluo mixture significantly decreased the levels of 24-hour urinary protein, serum urea nitrogen, and creatinine in rats with CGN, and improved the pathological damage of the kidney tissue. Twenty serum biomarkers of Yishen Guluo Mixture in the treatment of CGN, such as arachidonic acid and lysophosphatidylcholine, were screened out, involving arachidonic acid metabolism, glycerol phosphatide metabolism, and other pathways. Based on the serum pharmacochemistry, 8 prototype components and 20 metabolites in the serum-containing Yishen Guluo Mixture were identified. According to the metabolomics and correlation analysis of serum pharmacochemistry, 12 compounds such as genistein absorbed into the blood from Yishen Guluo Mixture were selected as the potential effective substances for the treatment of CGN. Based on metabolomics and serum pharmacochemistry, the effective substances and mechanism of Yishen Guluo Mixture in the treatment of CGN are analyzed and explained in this study, which provides a new idea for the development of innovative traditional Chinese medicine for the treatment of CGN.

Integration of plasma metabolomics and spectrum-effect correlation for profiling the mechanism and pharmacodynamic substances on attenuating hepatic fibrosis of Bupleuri Radix and Paeoniae Radix Alba before and after vinegar-processing and compatibility / 药学学报

Plasma metabolomics based on UHPLC-Q-TOF-MS/MS technique was developed for profiling the mechanism on attenuating hepatic fibrosis of Bupleuri Radix (BR) and Paeoniae Radix Alba (PRA) before and after vinegar-processing and compatibility, and to screen potential pharmacodynamic substances by spectrum-effect correlation method in this study. Firstly, SD rats with CCl4-induced hepatic fibrosis were used as an in vivo model. The blood and tissue samples were collected for the analyses of pharmacodynamic indexes and plasma metabolomics after six weeks’ administration of BR, vinegar-processed BR (VPBR), PRA, vinegar-processed PRA (VPPRA), BR-PRA herb-pair, and VPBR-VPPRA herb-pair. The experiment was approved by the experimental animal ethics committee from Nanjing University of Chinese Medicine (No.202103A002). The results of pharmacodynamics indicated that the levels of alanine aminotransferase (ALT, P < 0.01), aspartate aminotransferase (AST, P < 0.01), and hydroxyproline (HYP, P < 0.01) were decreased significantly, while the level of glutathione peroxidase (GSH-Px, P < 0.05) was increased obviously after administration of all treatment groups. Next, UHPLC-Q-TOF-MS/MS was performed to characterize the endogenous metabolites. A total of 20 differential endogenous metabolites related to the pathogenesis of hepatic fibrosis were identified in positive and negative ion modes, mainly involving five metabolic pathways of retinol metabolism, glycerol phospholipid metabolism, glyceride metabolism, fatty acid biosynthesis, and arachidonic acid metabolism. Meanwhile, a concept named correction rate was introduced to evaluate the back-regulation effects of all treatment groups on differential metabolites, and 10 differential metabolites were corrected by all treatment groups. The correction effects of the vinegar-processed herb groups were better than those of the crude ones, and the correction effects of the herb-pair groups were better than those of the single ones. Interestingly, the best correction effect was found in the VPBR-VPPRA herb-pair group, which further verified the efficacy improvement through vinegar-processing and compatibility. Partial least square method and VIP analysis combined with spectrum-effect correlation were applied for screening pharmacodynamic markers, and 38 ingredients with higher correlation with four classical pharmacodynamic indexes (ALT, AST, HYP, and GSH-Px) were identified as pharmacodynamic markers of the anti-hepatic fibrosis effects of BR and PRA before and after vinegar-processing and compatibility. The results of the investigation could not only lay a foundation for clarifying the pharmacodynamic materials and mechanism of vinegar-processing and compatibility of BR and PRA in the treatment of hepatic fibrosis as well as provide a theoretical basis for demonstrating the scientific connotation of processing and compatibility, but also provide a reference for further drug design and development of BR and PRA in clinic.

Analysis on Components Absorbed into Blood of Citri Reticulatae Pericarpium in Rats Based on Sequential Metabolism and UPLC-HRMS / 中国实验方剂学杂志

ObjectiveTo study the metabolism of chemical components from Citri Reticulatae Pericarpium（CRP）in different parts of rats by sequential metabolism and ultra performance liquid chromatography-high resolution mass spectrometry（UPLC-HRMS）. MethodSD male rats were employed as experimental subjects， and blood samples of intestinal metabolism and hepatic metabolism were prepared after administration of CRP ethanol extract by in situ intestinal perfusion， and comprehensive metabolic samples were collected after intragastric administration. UPLC-HRMS was used to analyze the samples with acetonitrile（A）-0.1% formic acid aqueous solution（B）as the mobile phase for gradient elution（0-10 min， 10%-30%A； 10-30 min， 30%-95%A； 30-31 min， 95%-10%A； 31-35 min， 10%A）at a flow rate of 0.35 mL·min-1， using a heated electrospray ionization with positive and negative ion mode scanning in the range of m/z 100-1 500. Under these conditions， the differences in the profiles of CRP ethanol extract， blank plasma and drug-containing plasma under different treatment groups were compared， and the chemical components of each sample were analyzed and identified based on the retention time， accurate relative molecular mass， primary and secondary ion fragments， and the information of reference substances. ResultA total of 44 chemical components were identified in the CRP ethanol extract， including flavone-O-glycosides， flavone-C-glycosides and polymethoxyflavonoids， etc. The results of sequential metabolism showed that 22 chemical components in CRP were detected in the intestinal metabolic sample， 18 chemical components were detected in the hepatic metabolic sample， and 9 identical chemical components（narirutin， hesperidin， meranzin， 5，7，8，3ʹ，4ʹ，5ʹ-hexamethoxy-flavone， isosinensetin， sinensetin， 3，5，6，7，8，3ʹ，4ʹ-heptamethoxyflavone， nobiletin and tangeretin）could be detected in all three metabolic samples， with a total of 22 compounds entering the blood in prototype form. ConclusionThe identified 21 components with well-defined structures entering the blood as prototypes may be potential active components of CRP， and differences in the components at different metabolic parts can provide an experimental basis for elucidating the in vivo biotransformation process of the metabolic components of CRP.

Establishment of An Animal Model of Acute B Lymphoblastic Leukemia with Minimal Residual Disease / 中国实验血液学杂志

OBJECTIVE@#To establish an animal model of acute B lymphoblastic leukemia (B-ALL) with minimal residual disease.@*METHODS@#The transplanted tumor was formed by subcutaneous injection of 2×107 Nalm-6 cells, and the body weight, activity status and tumor formation status of nude mice were observed. Peripheral blood, bone marrow, liver and spleen and other tissues of nude mice were taken for pathological examination to understand whether the success of subcutaneous modeling was accompanied by systemic metastasis.@*RESULTS@#There were 2×107 Nalm-6 cells injected subcutaneously in nude mice, (11.0±2.5) days later, the tumors of (3-4) × (3-4) mm were observed, the body weight of the nude mice was reduced and activity showed no limited. Infiltration of tumor cells in liver, spleen and bone marrow were observed in pathological sections.@*CONCLUSION@#The animal model of subcutaneous tumor of B-ALL was successfully established in nude mice.

Effect and Mechanism of "Liver-Soothing and Spleen-Invigorating" Therapies Against Liver Injury in Rats： An Exploration Based on TGR5 and Intestinal Mucosal Barrier Function / 中国实验方剂学杂志

ObjectiveTo explore the effects of different treatment methods of "soothing liver， invigorating spleen， soothing liver and invigorating spleen， soothing liver first and then soothing liver and invigorating spleen， as well as invigorating spleen first and then soothing liver and invigorating spleen" on liver depression combined with liver injury in rats and their action mechanisms. MethodA six-week rat model of liver depression combined with liver injury was established by restraint stress and subcutaneous injection of carbon tetrachloride （CCl4， 5.89 g·kg-1， once every three days）. At the same time， the drugs were given by gavage. Forty-eight male SD rats of clean grade were randomly divided into eight groups， namely the normal group， model group， bicyclol （0.2 g·kg-1） group， Sinisan （4.32 g·kg-1） group， Liu Junzitang （9.26 g·kg-1） group， Chaishao Liu Junzitang A （Chai A， soothing liver and invigorating spleen，13.57 g·kg-1） group， Chaishao Liu Junzitang B （Chai B， soothing liver first and then soothing liver and invigorating spleen， 13.57 g·kg-1） group， and Chaishao Liu Junzitang C （Chai C， invigorating spleen first and then soothing liver and invigorating spleen， 13.57 g·kg-1） group， with six rats in each group. The pathological changes in liver and colon tissues of each group were observed under light microscope and electron microscope. The serum biochemical indexes of the liver were detected using an automatic biochemical analyzer. The relative mRNA expression levels of Takeda G protein-coupled receptor 5 （TGR5） and intestinal mucosal zona occluden-1 （ZO-1）， Occludin， and Claudin-1 in the liver and colon were detected by reverse-transcription polymerase chain reaction （RT-PCR）. The positive expression rate of proliferating cell nuclear antigen （PCNA） in the colon was detected by immunohistochemistry. ResultCompared with normal group， the model group exhibited significantly elevated serum alkaline phosphatase （ALP）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， total bilirubin （TBIL）， and direct bilirubin （DBIL） （P<0.01）， lowered TGR5 mRNA expression in liver tissue， up-regulated TGR5 mRNA expression in the colon tissue （P<0.05，P<0.01）， and down-regulated ZO-1， Occludin， and tight junction protein-1 (Claudin-1) mRNA expression and PCNA in the colon tissue （P<0.01）. Compared with the model group， bicyclol and Chai C remarkably decreased the levels of serum ALP， ALT， AST， TBIL， and DBIL （P<0.05，P<0.01）， while Liu Junzitang， Chai A， Chai B， and Chai C significantly up-regulated the TGR5 mRNA expression in the liver and down-regulated its expression in the colon （P<0.01）. Bicyclol， Chai A， Chai B， and Chai C enhanced the ZO-1 and Claudin-1 mRNA expression in the colon （P<0.05，P<0.01）. Bicyclol， Sinisan， and Chai C increased PCNA expression （P<0.01）. The comparison with the Chai C group showed that the TGR5 mRNA expression in the liver and ZO-1 mRNA expression in the colon of the bicyclol and Sinisan groups were lower， whereas the TGR5 mRNA expression in the colon was higher （P<0.01）. However， the PCNA expression in the colon of the Liu Junzitang and Chai B groups declined significantly （P<0.05）. ConclusionIn the presence of liver injury， invigorating spleen first helps to relieve the liver injury， and the efficacy of "spleen-invigorating" therapy in increasing the intestinal mucosal tight junction proteins and improving the gastrointestinal function is related to its activation of TGR5 to improve the intestinal mucosal barrier function， promote the renewal of intestinal stem cells， and drive the regeneration after injury.

Estratégia saúde da família: contribuições das equipes de saúde no cuidado nutricional da criança / Family health strategy: contributions of health teams in the nutritional care of children

Resumo O objetivo deste artigo é avaliar a estrutura e o processo de trabalho de equipes de saúde da Estratégia Saúde da Família relacionados ao cuidado nutricional da criança. Pequisa avaliativa de 136 equipes de saúde em 45 municípios paraibanos. Os dados de estrutura (disponibilidade de equipamentos antropométricos, suplementos e documentos técnicos) e processo (gestão, intersetorialidade e atividades da Estratégia Amamenta e Alimenta Brasil) foram sintetizados em escores e classificados como incipiente, intermediário ou avançado. Realizaram-se análises segundo características contextuais do município (porte populacional e desenvolvimento humano) e da equipe de saúde (se do Programa Mais Médicos ou convencional e se ampliada ou não com nutricionista). O cuidado nutricional foi classificado no nível intermediário, sendo a disponibilidade de documentos técnicos, o uso do SISVAN ou do e-SUS e a implantação da Estratégia Amamenta e Alimenta Brasil os itens mais deficitários. Municípios de porte grande e equipes de saúde ampliadas com nutricionista apresentaram melhores condições de estrutura e processo, respectivamente. A implantação fragmentada do cuidado nutricional demanda melhorias de estrutura e processo para sua qualificação.

Abstract The scope of this article is to evaluate the structure and work processes of Family Health Strategy teams related to the nutritional care of children. It involved an assessment survey of 136 health teams in 45 municipalities in the State of Paraíba. The data on structure (availability of anthropometric equipment, supplements and technical documents) and processes (management, intersectoriality and activities of the Brazilian Breastfeeding and Feeding Strategy) were summarized in scores and classified as incipient, intermediate or advanced. Analyses were performed according to contextual characteristics of the municipality (population size and human development) and the health team (whether from the Programa Mais Médicos or conventional teams, and whether accompanied by a nutritionist or not). Nutritional care was classified at the intermediate level, with the availability of technical documents, the use of SISVAN or the e-SUS and the implementation of the Brazilian Breastfeeding and Feeding Strategy being the most deficient items. Large municipalities and expanded health teams with nutritionists had better structure and process conditions, respectively. The fragmented implementation of nutritional care calls for improvements in structure and processes for due fitness for purpose.

Capacidades para la investigación en políticas y sistemas de salud en enfermería / Capacities for research in health policies and systems in nursing

Introducción: La realización de investigaciones en políticas y sistemas de salud por los profesionales de enfermería requiere la definición de capacidades en tres niveles de acción. Objetivos: Describir capacidades a desarrollar, en los tres niveles de acción, para la realización de investigaciones en políticas y sistemas de salud por los profesionales de enfermería. Métodos: Se realizó un estudio descriptivo en el periodo 2017-2019. Para la recogida de la información se diseñó y validó un cuestionario. Se consultaron 22 expertos cubanos e internacionales vinculados con el desarrollo de investigaciones en políticas y sistemas de salud. Se exploraron las variables capacidades individuales, institucionales y nacionales. Los resultados se presentan en frecuencias absolutas y porcentajes a través de tablas. Resultados: Se identificaron 27 capacidades: 12 individuales, nueve institucionales y seis nacionales. Las primeras, incluyen los conocimientos de referentes teóricos y la negociación para aplicación de resultados. Las segundas están relacionadas con la identificación de líneas y temáticas prioritarias, así como con la designación de un profesional que medie en su gestión. En el caso de las terceras se identificó la necesidad de definir una proyección estratégica que incluya el uso de sus resultados. Conclusiones: La realización de las investigaciones en políticas y sistemas de salud por los profesionales de enfermería requiere la integración de capacidades en tres niveles: individual, institucional y nacional, en tanto permite la sostenibilidad de las acciones en un grupo profesional cuyos referentes prácticos y teóricos no están vinculados con este tipo de estudio. Las capacidades identificadas constituyen una primera propuesta que puede contribuir a su seguimiento y a la medición de las acciones, en cada nivel, de forma individual e integrada(AU)

Introduction: Conducting research on health policies and systems by nursing professionals requires the definition of capacities in three levels of action. Objectives: Describe capacities to be developed, at all three levels of action, for conducting research in health policies and systems by nursing professionals. Methods: A descriptive study was carried out in the period 2017-2019. A questionnaire was designed and validated for the collection of information. 22 Cuban and international experts linked to the development of research in health policies and systems were consulted. The variables called individual, institutional and national capacities were explored. The results are presented in absolute frequencies and percentages through tables. Results: 27 capacities were identified: 12 individuals, nine institutional and six national. The first ones include knowledge of theoretical benchmarks and negotiation for the application of results. The second ones are related to the identification of priority lines and themes, as well as the appointment of a professional who mediates in their management. In the case of the third ones, the need to define a strategic projection that includes the use of their results was identified. Conclusions: Conducting research in health policies and systems by nursing professionals requires the integration of capacities at three levels: individual, institutional and national, as long as it allows the sustainability of actions in a professional group whose practical and theoretical references are not linked to this type of study. The identified capacities are an initial proposal that can contribute to their monitoring and actions measurement, at each level, in an individual and integrated way(AU)

Alucinose, hipérbole e a diferenciação neurose/psicose no pensamento de Bion e na teoria do campo analítico / Hallucinosis, hyperbole, and the differentiation neurosis/psychosis in Bion's thinking and in the analytic field theory / Alucinosis, hipérbole y diferenciación de neurosis/psicosis en el pensamiento de Bion y en la teoría del campo analítico

O autor retoma a diferenciação efetuada por Bion entre personalidades neuróticas e psicóticas, discutindo-a à luz dos desenvolvimentos sucessivos do seu pensamento. A hipótese deste trabalho é que Bion tenha mitigado cada vez mais a distinção entre neurose e psicose, uma vez que esta distinção não funciona mais como escudo em relação à busca do desconhecido na psicanálise, mas induz a adotar, de forma apressada, teorias causais. Para demonstrar tal hipótese, o autor enfoca os conceitos de transformação em alucinose como um dos meios ­ assim escreveu Bion ­ das transformações em movimento rígido (neuróticas) e das transformações projetivas (psicóticas). De modo especial, este trabalho põe em destaque o plano metateórico de Transformações: desconstruir as oposições clássicas é tanto uma maneira de tratar o paciente na sala de análise quanto uma forma de tratar a doença da psicanálise (AU)

The author re-approaches the differentiation made by Bion between neurotic and psychotic personalities, discussing them under the light of the subsequent developments of his thoughts. The hypothesis of this paper is that Bion progressively mitigated the distinction between neurosis and psychosis, since this distinction no longer works as a shield for the search for the unknown in psychoanalysis, instead leading to the hurried adoption of causal theories. In order to demonstrate such hypothesis, the author approaches the concepts of transformation in hallucinosis as one of the media, this is how Bion wrote it, for the transformations into rigid motion (neurotic) and into projective transformations (psychotic). Above all, this paper highlights the meta-theoretical role of Transformations: deconstruct the classic oppositions is a way of treating the patient in the analytic space as much as a way of treating the disease of psychoanalysis (AU)

El autor retoma la diferenciación hecha por Bion entre personalidades neuróticas y psicóticas para discutir a la luz de los desarrollos posteriores de su pensamiento. La hipótesis de trabajo es que Bion ha desdibujado cada vez más la distinción entre neurosis y psicosis porque termina funcionando como escudo con relación a la búsqueda de lo desconocido en el psicoanálisis y, en cambio, induce a adoptar precipitadamente teorías causales. Para demostrar la hipótesis, el autor enfoca los conceptos de transformación en alucinosis como uno de los medios, escribe Bion, de transformaciones de movimiento rígido (neurótico) y transformaciones proyectivas (psicótico). Sobre todo, subraya el plan metateórico de Transformaciones: la deconstrucción de las oposiciones clásicas es una forma tanto de tratar al paciente en la sala de análisis como de curar la enfermedad del psicoanálisis (AU)

A systematic strategy for screening therapeutic constituents of (Turcz) Baill infiltrated blood-brain barrier oriented in lesions using ethanol and water extracts: a novel perspective for exploring chemical material basis of herb medicines

, a widely used Chinese herbal medicine, was considered as central nervous system (CNS) drug for years. Both ethanol extracts (EES) and water extracts (WES) of it were applied clinically. Unfortunately, the difference of their efficacy and even effective material foundation of remains obscure. In this study, to explore the active constituents of , we compared pharmacodynamics and chemical profiles / of EES/WES for the first time using multiple chemical analysis, pharmacological and data processing approaches. It was proved that there was no significant difference in the anti-depressive effects between WES and EES. However, the contents of most components and in plasma were higher in EES than those in WES, which was unconvincing for their similar efficacy. Therefore, we further explored components of targeted onto brain and the results showed that 5 lignans were identified with definite absorptivity respectively both in EES and WES caused by the limitation of blood-brain barrier. Moreover, bioinformatic analysis predicted their anti-depressive action. Above all, the systematic strategy screened 5 brain-targeted effective substances of and it was suggested that exploring the components into nidi would promote the studies on herbs effective material basis.

Relationship between thoracic and lumbar vertebral posterior wall morphology and bone cement leakage into the spinal canal during the percutaneous kyphoplasty / 中国组织工程研究

BACKGROUND: Percutaneous kyphoplasty (PKP) is an effective method for treating osteoporotic vertebral compression fracture. Although satisfactory clinical outcomes can be achieved, bone cement leakage is still one of the main complications of PKP. Based on previous studies, there are many high risk factors for bone cement leakage into the spinal canal; however, less attention to the posterior wall morphology of different vertebral bodies may be an important reason for bone cement leakage into spinal canal. OBJECTIVE: To investigate the effect of thoracic and lumbar vertebral posterior wall morphology in the patients with osteoporotic vertebral compression fracture on bone cement leakage into the spinal canal during the PKP. METHODS: The clinical data of osteoporotic vertebral compression fracture patients with PKP were selected. There were 98 osteoporotic vertebral compression fracture patients with CT scan and three-dimensional reconstruction image data from T6 to L5. The three-dimensional reconstruction of CT and multiplanar reconstruction were used to measure the depth of the concave vertebral posterior wall (OC) and the corresponding middle-sagittal diameter of the vertebra (PC) of the non-fractured vertebral body, the ratio of OC to PC was calculated. All subjects were divided into thoracic group (T6-T12) and lumbar group (L1-L5) based on the location of measured vertebral, and the differences of the OC between groups were compared. 357 patients (548 vertebrae) with osteoporotic vertebral compression fracture without CT three-dimensional reconstruction underwent PKP within the same period. They were also divided into thoracic vertebra and lumbar vertebra groups. The degree of bone cement leakage into the spinal canal was compared between thoracic and lumbar vertebra groups. RESULTS AND CONCLUSION: (1)The morphological parameters of posterior vertebral wall in 98 patients showed that the depth of the concave vertebral posterior wall gradually (OC) deepened from T6toT12, with an average of 4.6 mm. The depth became gradually shallow from L1 to L5, with an average of 0.6 mm. The ratio of the depth of the concave vertebral posterior wall to the corresponding middle-sagittal diameter of the vertebra was approximately 16% (1/6) from T6toT12. The average value of ratios from Li to U was 3%. The ratios in lumbar vertebra were significantly decreased compared with thoracic vertebra (16%, 1/6). (2) Results form 357 patients who underwent PKP at the same time showed that the rate of bone cement leakage into spinal canal was 10.2% (31/304) in the thoracic vertebra group during the PKP, and the rate of lumbar vertebra group was 3.7% (9/244). In the thoracic group, the average maximal sagittal diameter of the bone cement intruded spinal canal was (3.1 ±0.2) mm, the average maximal area of the bone cement intruded spinal canal was (30.8±0.3) mm2, and the spinal canal encroachment rate was (22.5±0.2)%. In the lumbar group, the average maximal sagittal diameter of the bone cement intruded spinal canal was (1.4±0.1) mm, the average maximal area of the bone cement intruded spinal canal was (14.9±0.2) mm2, and the spinal canal encroachment rate was (11,4±0.3)%. There was significant difference between thoracic and lumbar groups (P<0.05). (3) The above results imply that due to the presence of OC structure in the middle and lower thoracic vertebra, it is possible to reduce the occurrence of bone cement leakage into spinal canal through avoiding bone cement distribution over the posterior 1/6 (16%) of vertebral body in PKP. The effect of the difference between thoracic and lumbar vertebral posterior wall morphology in osteoporotic vertebral compression fracture patients on bone cement leakage into the spinal canal during the PKP may be one of the reasons why the rate of bone cement leakage into spinal canal in thoracic vertebra significantly higher than that in lumbar vertebra. The study protocol was approved by the Ethics Committee of the Affiliated Hospital of Southwest Medical University (approval No. K2018008).

Modern research on theory of “salt-processing enhancing drug into kidney meridian” proposed by healer Jia-mo Chen from Xinan / 中草药

Jia-mo Chen who was a Xinan medical scientist put forward the theory of “Salt-processing enhancing drug into kidney meridian” recorded in “Enlightening Primer of Materia Medica”, which has great significance for the clinical application of Chinese medicine processing excipients. In recent years, scholars have done a lot of research work on the chemical composition and pharmacological effect changes of Chinese medicines and related prescriptions before and after salt-processing, and preliminarily explained the scientific connotation of the processing theory of “salt-processing enhancing drug into kidney meridian” of Chinese materia medica (CMM). According to the literatures of recent years studies, the research progress on processing theory of “Salt-processing enhancing drug into kidney meridian” of CMM was summarized and concluded from the perspective of chemical composition and pharmacological effects changes, and the problems of the present study were analyzed, which put forward new research idea for the theory of “salt-processing enhancing drug into kidney meridian” combined with modern research methods.

Stent Graft Implantation into a False Lumen of a Chronic Type B Aortic Dissection after Surgical Abdominal Aortic Fenestration / 日本心臓血管外科学会雑誌

A 57-year-old man, who had suffered chest, back and right leg pain about 10 years before, underwent CT and was found a chronic type B aortic dissection with an enlarged false lumen and a narrowed true lumen that was occluded at the infrarenal abdominal aorta. A conventional surgical repair seemed to be too high risk considering his comorbidities, thus we chose a staged hybrid repair. First, surgical repair of the abdominal aorta with an abdominal aortic fenestration was performed. Then, one month after the first operation, zone 2 thoracic endovascular aortic repair with left carotid-axillary artery bypass was performed. At the second operation, the stent graft was purposely deployed from zone 2 into Th12 level of a false lumen through the fenestration followed by coil embolization of a true lumen just distal to the entry tear. The postoperative course was uneventful and he had no complications at 6 months follow-up. Deploying stent graft into a false lumen could be a feasible option in case deploying into a true lumen is not suitable if the anatomical condition permits.

Pulled into two syndrome (PITS) in a case of congenital fibrosis of the extraocular muscle

A four-year-old child with a clinical diagnosis of unilateral congenital fibrosis of extraocular muscles (CFEOM) was planned for inferior and medial rectus muscle recession surgery, adjusted with the status of forced duction test. Due to pathological changes within the muscles subsequent to innervational abnormality, intraoperatively the inferior rectus muscle was pulled into two following the insertion of muscle hook. Moreover, the snapped muscle fibers could not be identified, thus further surgery was abandoned and an observation was commenced. At the end of 6 weeks, there was a significant reduction in the amount of hypotropia but clinically significant perverted convergence with esotropia necessitated further surgical intervention. A second surgical intervention consisting of medial rectus transposition to superior rectus with 3 mm recession was performed to achieve acceptable results in the primary gaze.

Study on the influence and intervention strategy of nursing staff rushing to plateau on sleep quality / 中国实用护理杂志

Objective To understand the changing characteristics of sleep quality of acute plateau nursing staff during the period of assistance to Tibet, formulate comprehensive intervention measures, improve the support ability of nursing staff, and provide the basis for effectively completing the work of plateau assistance to Tibet. Methods From November to December 2017, 12 nurses who participated in the assistance work for Tibet in Lhasa region with an altitude of 3,650 m were selected as the emergency group, and 12 nurses from a hospital in Tibet were selected as the plateau group. Pittsburgh sleep quality index (PSQI) was used to investigate the sleep quality of the acute group before and after Tibet entry and the plateau group respectively. A sleep quality survey scale was designed to investigate the sleep quality of nursing staff in the emergency group and the plateau group at 5 different shifts on the same night after admission to Tibet. Results The scores of total sleep score, sleep quality, sleep time, sleep time, sleep efficiency and daytime dysfunction in the acute group were 3.77 ± 1.79, 0.89 ± 0.47, 0.78 ± 0.36, 0.76 ± 0.41, 0.19 ± 0.05, 0.54 ± 0.07, and 5.37 ± 1.23, 1.57 ± 0.36, 1.53 ± 0.43, 1.21 ± 0.38, 0.72 ± 0.10, 0.99 ± 0.91 respectively. The differences before and after Tibet were statistically significant (t=2.327-4.399, P <0.05).The scores of sleep time, sleep time, sleep efficiency and sleep disorder in the acute group were 1.53±0.43, 1.21±0.38, 0.72±0.19, 1.16 ± 0.21, and 1.04 ± 0.21, 0.86 ± 0.32, 0.39 ± 0.31 and 0.76 ± 0.33 respectively. The differences between the two groups were statistically significant (t=2.441-3.547, P<0.05 or 0.01).Radical groups after Tibet plateau and nursing staff sleep quality scale scores compare, radical group day shift, middle shift, night after night under three different shifts the total score of sleep quality, respectively 11.76 ± 0.12, 11.98 ± 0.23, 12.43 ± 0.52, higher than that of plateau group 11.18 ± 0.04 11.23 ± 0.57, 11.98±0.54, the difference between two groups was statistically significant (t=15.554, 4.227, 2.07, P<0.01 or 0.05). The sleep quality score (11.38±0.36) in the night of the rest class was lower than that of the plateau group (11.92±0.38), and the difference was statistically significant (t=-3.574, P=0.002). The score of sleep quality and sleep delay of the acute group were 1.87±0.57, 1.93±0.61, and 1.39± 0.39, 1.25±0.42 respectively. The difference between the two groups was statistically significant (t=2.408, 3.181, P<0.05 or 0.01). Conclusions It is a common sleep problem for medical and nursing personnel in Tibet who rush into the plateau. Comprehensive intervention measures should be taken in advance, scientific popularization, education and health technical guidance should be carried out in the early stage, mental health conditions should be improved, and drug prevention should be taken when necessary to help medical and nursing personnel in Tibet sleep quality.

Study on the influence and intervention strategy of nursing staff rushing to plateau on sleep quality / 中国实用护理杂志

Objective@#To understand the changing characteristics of sleep quality of acute plateau nursing staff during the period of assistance to Tibet, formulate comprehensive intervention measures, improve the support ability of nursing staff, and provide the basis for effectively completing the work of plateau assistance to Tibet.@*Methods@#From November to December 2017, 12 nurses who participated in the assistance work for Tibet in Lhasa region with an altitude of 3,650 m were selected as the emergency group, and 12 nurses from a hospital in Tibet were selected as the plateau group. Pittsburgh sleep quality index (PSQI) was used to investigate the sleep quality of the acute group before and after Tibet entry and the plateau group respectively. A sleep quality survey scale was designed to investigate the sleep quality of nursing staff in the emergency group and the plateau group at 5 different shifts on the same night after admission to Tibet.@*Results@#The scores of total sleep score, sleep quality, sleep time, sleep time, sleep efficiency and daytime dysfunction in the acute group were 3.77±1.79, 0.89±0.47, 0.78±0.36, 0.76±0.41, 0.19±0.05, 0.54±0.07, and 5.37±1.23, 1.57±0.36, 1.53±0.43, 1.21±0.38, 0.72±0.10, 0.99±0.91 respectively. The differences before and after Tibet were statistically significant (t=2.327-4.399, P <0.05).The scores of sleep time, sleep time, sleep efficiency and sleep disorder in the acute group were 1.53±0.43, 1.21±0.38, 0.72±0.19, 1.16±0.21, and 1.04±0.21, 0.86±0.32, 0.39±0.31 and 0.76±0.33 respectively. The differences between the two groups were statistically significant (t=2.441-3.547, P<0.05 or 0.01).Radical groups after Tibet plateau and nursing staff sleep quality scale scores compare, radical group day shift, middle shift, night after night under three different shifts the total score of sleep quality, respectively 11.76±0.12, 11.98±0.23, 12.43±0.52, higher than that of plateau group 11.18±0.04 11.23±0.57, 11.98±0.54, the difference between two groups was statistically significant (t=15.554, 4.227, 2.07, P<0.01 or 0.05). The sleep quality score (11.38±0.36) in the night of the rest class was lower than that of the plateau group (11.92±0.38), and the difference was statistically significant (t=-3.574, P=0.002). The score of sleep quality and sleep delay of the acute group were 1.87±0.57, 1.93±0.61, and 1.39±0.39, 1.25±0.42 respectively. The difference between the two groups was statistically significant (t=2.408, 3.181, P< 0.05 or 0.01).@*Conclusions@#It is a common sleep problem for medical and nursing personnel in Tibet who rush into the plateau. Comprehensive intervention measures should be taken in advance, scientific popularization, education and health technical guidance should be carried out in the early stage, mental health conditions should be improved, and drug prevention should be taken when necessary to help medical and nursing personnel in Tibet sleep quality.

Study on absorbed components of Aconitum kusnezoffii under Yunnan Baiyao compatibility in effect of activating blood circulation and removing blood stasis / 中国中药杂志

Rat model of blood stasis syndrome was prepared by subcutaneous injecting of epinephrine hydrochlorid,then the model rats were administrated by Yunnan Baiyao for 15 days. Blood rheology,coagulation function and histopathology were chosen as indicators to evaluate the successful replication of blood stasis syndrome model and the treatment effect of Yunnan Baiyao. UPLC-Q-TOF-MS was used to rapidly analyze the serum samples of blood stasis syndrome rat after 15 days Yunnan Baiyao treatment,Progenesis QI software was employed to identify the alkaloids components. The results showed that Yunnan Baiyao reduced the plasma viscosity and whole blood viscosity of rats with blood stasis syndrome,prolonged thrombin and prothrombin time,reduced fibrinogen content,and effectively improved pathological state such as inflammatory cell infiltration,blood stasis,congestion and edema of various organs in rats with blood stasis syndrome. Seven alkaloids components from Aconitum kusnezoffii,including karacolidine,senbusine B,isotalatizidine,karakoline,denudatine,talatisamine and chasmanine were found in the rat serum after Yunnan Baiyao treatment. Based on the effectiveness of Yunnan Baiyao in the treatment of blood stasis syndrome induced by epinephrine hydrochloride in rats,alkaloids components from the root of A. kusnezoffii absorbed into blood after Yunnan Baiyao treatment were clarified rapidly and accurately with the help of UPLC-Q-TOF-MS. Karacolidine,senbusine B,isotalatizidine,karakoline,denudatine,talatisamine and chasmanine are the pharmacodynamic material basis of the root of A. kusnezoffii for activating blood circulation and removing blood stasis.

O instinto de morte e o "além do princípio do prazer": um diálogo entre Sabina Spielrein e Gilles Deleuze / Death instinct and "beyond the pleasure principle": a discussion between Sabina Spielrein and Gilles Deleuze

Em um artigo de 1912, Spielrein apresenta ideias que se tornarão fundamentais para Freud a partir de 1920: o instinto de morte e a suposição de que haveria um funcionamento psíquico mais primitivo do que aquele regido pelo princípio do prazer. Já no final dos anos 1960, o filósofo Deleuze apoia-se nos argumentos de Freud, particularmente no texto Além do princípio de prazer (1920), para conceber o instinto de morte como princípio transcendental. O objetivo deste artigo é aproximar estes dois autores, Spielrein e Deleuze, que se conectam por meio do conceito de instinto de morte, justamente no ponto em que mais parecem se afastar das concepções freudianas. Apesar de desenvolverem suas ideias em diálogo com Freud, tanto Spielrein como Deleuze divergem dele ao insistirem na proposição de um inconsciente impessoal e na dissolução do eu como fundamento da criação.

In an article of 1912, Spielrein presents ideas that will become fundamental to Freud in 1920: the death instinct and the assumption that there would be a more primitive psychic operation than the one governed by the pleasure principle. In the late 1960s, the philosopher Deleuze relies on Freud's arguments (more specifically on the 1920's essay Beyond the Pleasure Principle) to conceive the death instinct as a transcendental principle. The aim of this article is to bring together Spielrein and Deleuze, who are connected through the concept of the death instinct precisely at the point where they seem to most distance themselves from Freudian conceptions. Although they develop their ideas in dialogue with Freud, both Spielrein and Deleuze diverge from him by insisting on the proposition of an impersonal unconscious and on the dissolution of the self as the foundation of creation.

Effect of percutaneous nailing combined with unilateral fenestration and decompression for bilateral lumbar spinal stenosis / 实用医学杂志

Objective Clinical study on the treatment of bilateral lumbar spinal stenosis with percutane-ous fixation combined with unilateral open-ended spinal canal decompression. Methods 126 patients with bilater-al lumbar spinal stenosis admitted to our hospital were randomly divided into two groups.The observation group was treated by percutaneous nail combined with unilateral laminar fenestration,and the control group was treated by open reduction combined with bilateral hemi laminectomy and spinal canal decompression.The two groups of pa-tients with general surgical complications after treatment,index,lumbago and leg pain VAS score and ODI score were compared.Results The operation time of the observation group,the amount of bleeding,the time of hospital-ization and the cost of hospitalization were less than those of the control group.There were no complications such as incision infection after operation in the two groups.The two groups were statistically significant postoperative pain and leg pain VAS score and ODI score compared with preoperative difference.The two groups had statistical signifi-cance between low back and leg pain VAS score and ODI score after 6 and 12 months and last follow-up phase dif-ference.But the two groups after 3 months of lumbago and leg pain VAS score and ODI score had no significant dif-ference.Conclusions Percutaneous minimally invasive nail combined with unilateral laminar fenestration and de-compression for bilateral lumbar spinal stenosis has the advantages of less trauma,less bleeding,shorter hospitaliza-tion time and quicker recovery.It is worthy of clinical promotion.