Análisis FODA: fortalecimiento de la prevención y el control de la tuberculosis en post pandemia de COVID-19, Hospital Muñiz, Buenos Aires / SWOT analysis: strengthening tuberculosis prevention and control in post COVID-19 pandemic, Hospital Muñiz, Buenos Aires

Resumen Introducción : El proyecto de fortalecimiento en Vigi lancia Epidemiológica en Tuberculosis (VET) del Hospital Muñiz, Buenos Aires (Argentina), busca mejorar los re sultados operacionales relacionados en mayor medida al diagnóstico precoz de la enfermedad, estableciendo como objetivo la identificación oportuna de personas enfermas de tuberculosis (TB) que consultan posterior a la pandemia por COVID-19. Métodos : Se realizó un análisis FODA (Fortalezas, Oportunidades, Debilidades, Amenazas): una herramien ta esencial en la planeación estratégica, que proporciona información necesaria para la implementación de accio nes y medidas correctivas, generación de nuevos pro yectos de mejora, donde se evaluó la situación interna de la institución para determinar las FODA presentadas después de la pandemia COVID-19, a fin de desarrollar un fortalecimiento en VET, mediante vigilancia epide miológica de campo. Resultados : Se cuenta con personal capacitado, posi bilidad de diagnóstico precoz y control oportuno, gene rado desde la Unidad Febril de Urgencias. El servicio de guardia presenta adecuado control de la población con TB, que posibilita la coordinación y trabajo en conjunto con otros programas ministeriales. Existe capacidad de respuesta de la institución ante los brotes, epidemias y pandemias. Discusión : La aplicación de este proyecto incorporará una actividad de fortalecimiento en vigilancia epidemio lógica, donde el Hospital Muñiz, mediante el abordaje integral y la identificación de casos nuevos de respuesta a las necesidades de la población con TB. Se proporcio nará así información válida y confiable para la preven ción y control de la TB en la institución después de la pandemia por COVID-19.

Abstract Introduction : The Hospital Muñiz's "Strengthening Epidemiological Surveillance in Tuberculosis (VET) Proj ect" is focused on improving operational outcomes, spe cifically by enhancing early TB diagnosis. Our primary aim is to promptly identify individuals with tuberculo sis (TB) who seek care at our institution following the COVID-19 pandemic. Methods : A SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats) was carried out. It is an essential tool in strategic planning, which provides information for the implementation of actions and corrective measures in the generation of new improvement projects. The internal situation of the institution was evaluated to determine SWOT after the COVID-19 pandemic, in order to strengthen VET, through field epidemiological surveillance. Results : There are trained personnel, the possibility of early diagnosis and its opportune control generated from the Febrile Emergency Unit. The on-call service has an adequate control of the TB population that enables coordination and joint work with other programs (HIV), response capacity of the institution to outbreaks, epi demics and pandemics. Discussion : The application of this project will in corporate a strengthening activity in epidemiological surveillance, where the Muñiz Hospital, through a com prehensive approach and the identification of new cases, responds to the needs of the local population with TB. This will provide valid and reliable information for the prevention and control of TB in the institution after the COVID-19 pandemic.

Formulation Rules in Medical Heart Enlightenment for Treatment of Heart Pain from Perspective of "Tangye Jingfa Tu" / 中国实验方剂学杂志

ObjectiveTo explore the formulation rules for the treatment of heart pain in the Medical Heart Enlightenment （《医学心悟》） from the perspective of the "Tangye Jingfa Tu"， thereby providing a way of thinking about the treatment of heart pain in traditional Chinese medicine （TCM） and the study of the Medical Heart Enlightenment. MethodThe "Tangye Jingfa Tu" contained in the Secrets for Auxiliary Cultivation Life： The Essential Method of Using Herbal Medicine for the Differential Treatment of the Five Zang Organs （《辅行诀五脏用药法要》） was used to analyze the nine prescriptions for heart pain in Volume Ⅲ of the Medical Heart Enlightenment by CHENG Guopeng in the Qing dynasty. A "table for analyzing the formulation of the nine prescriptions for heart pain" was developed. The analysis diagrams for decoction and meridian rules in nine prescriptions for heart pain were plotted and the compatible structure of the medicinal flavors was analyzed. ResultThe composition of Chenxiang Jiangqisan for the treatment of Qi-induced heart pain is "five pungent， four bitter， and two sweet drugs"， the composition of Shouniansan for the treatment of blood-induced heart pain is "five bitter， four pungent， three sweet， and one salty drugs"， the composition of Qingzhongtang for the treatment of heat-induced heart pain is "six bitter， three pungent， and two sweet drugs”， the composition of Jiangfutang with Cinnamomi Cortex for cold-induced heart pain is "three pungent and two sweet drugs"， the composition of Xiaobanxia modified with Fuling Tang for treating fluid retention-induced heart pain is "two pungent and two sweet drugs"， the composition of Baohetang for treating heart pain due to dietary stagnation is "five sweet， four pungent， four bitter， and one sour drugs"， the composition of Guipitang for the treatment of deficiency-induced heart pain is "eight sweet， four bitter， three pungent， and one sour drugs"， the combination of Huachongwan for the treatment of worm-induced heart pain is "seven bitter， six pungent， and four sweet drugs"， the composition of Shenzhusan， Congbaijiu， and Shengjiangtang for the treatment of resistance-induced heart pain is "eight pungent， four bitter， and two sweet drugs". ConclusionFrom the perspective of the "Tangye Jingfa Tu"， the Medical Heart Enlightenment is based on the compatibility principle of "pungent-bitter-sweet drugs" in the treatment of heart pain， with heart deficiency treated with salty drugs for tonifying， or bitter-sweet-salty drugs， and heart excess treated with bitter drugs for purging， or sweet-pungent-bitter drugs， mostly applying the transformation rules of five medicinal flavors， i.e.， "sweet-pungent-bitter drugs" and promoting the action of the pungent and sweet drugs acting on the spleen into the heart to relieve and purge the heart. In most cases， the treatment focuses on harmonizing the heart， liver， spleen， and kidneys， with an emphasis on the mother-child relationship and the application of the principles of the five elements generating and controlling each other. If the progression of the disease involves both the mother and child organs， the formulation should adhere to the compatibility rule of "the child organ makes the mother organ excess and the mother organ makes the child organ deficient".

Tu-Xian Decoction ameliorates diabetic cognitive impairment by inhibiting DAPK-1 / 中国天然药物

Tu-Xian decoction (TXD), a traditional Chinese medicine (TCM) formula, has been frequently administered to manage diabetic cognitive impairment (DCI). Despite its widespread use, the mechanisms underlying TXD's protective effects on DCI have yet to be fully elucidated. As a significant regulator in neurodegenerative conditions, death-associated protein kinase-1 (DAPK-1) serves as a focus for understanding the action of TXD. This study was designed to whether TXD mediates its beneficial outcomes by inhibiting DAPK-1. To this end, a diabetic model was established using Sprague-Dawley (SD) rats through a high-fat, high-sugar (HFHS) diet regimen, followed by streptozotocin (STZ) injection. The experimental cohort was stratified into six groups: Control, Diabetic, TC-DAPK6, high-dose TXD, medium-dose TXD, and low-dose TXD groups. Following a 12-week treatment period, various assessments-including blood glucose levels, body weight measurements, Morris water maze (MWM) testing for cognitive function, brain magnetic resonance imaging (MRI), and histological analyses using hematoxylin-eosin (H&E), and Nissl staining-were conducted. Protein expression in the hippocampus was quantified through Western blotting analysis. The results revealed that TXD significantly improved spatial learning and memory abilities, and preserved hippocampal structure in diabetic rats. Importantly, TXD administration led to a down-regulation of proteins indicative of neurological damage and suppressed DAPK-1 activity within the hippocampal region. These results underscore TXD's potential in mitigating DCIvia DAPK-1 inhibition, positioning it as a viable therapeutic candidate for addressing this condition. Further investigation into TXD's molecular mechanisms may elucidate new pathways for the treatment of DCI.

Clinical observation of pediatric Tuina plus oral Chinese medication for pediatric anorexia due to spleen failing in transportation / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of pediatric Tuina (Chinese therapeutic massage) plus oral administration of Chinese medication for pediatric anorexia due to spleen failing in transportation. Methods: A total of 94 children with anorexia due to spleen failing in transportation were randomized into an observation group and a control group by the random number table method at a ratio of 1:1, with 47 cases in each group. The control group was treated with modified Bu Huan Jin Zheng Qi San, and the observation group was treated with additional Tuina manipulation of Yun Shui Ru Tu based on the treatment in the control group. After 4 weeks of treatment, the clinical efficacy of the two groups was observed, and the traditional Chinese medicine (TCM) symptom score, serum leptin, neuropeptide Y, and serum zinc and calcium levels were compared. Results: After 4 weeks of treatment, the total effective rate of the observation group was 87.2％, and that of the control group was 74.5％. The difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups decreased significantly (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). After treatment, the serum leptin level in both groups decreased, and the level in the observation group was lower than that in the control group (P<0.05). The serum neuropeptide Y, zinc, and calcium levels in both groups increased after treatment, and the levels in the observation group were higher than those in the control group (P<0.05). Conclusion: Tuina manipulation of Yun Shui Ru Tu plus oral administration of Chinese medication is significantly effective in treating pediatric anorexia due to spleen failing in transportation, which can improve the appetite of children and improve the symptoms of anorexia, and the curative effect is better than that of oral administration of Chinese medication alone.

Expression of lncRNA DNM3OS in laryngeal squamous cell carcinoma tissues and cells and its clinical and biological significance / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：检测lncRNA DNM3OS在喉鳞状细胞癌（laryngeal squamous cell carcinoma，LSCC）组织和LSCC细胞株中的表达及其临床意义，探讨其对LSCC TU177细胞体外增殖、迁移及侵袭的影响，并分析DNM3OS与EMT的关系。方法：从河北医科大学第四医院生物标本库选取2014年3月至2018年12月收治的68例LSCC患者手术切除的癌及癌旁组织标本，应用qPCR法检测DNM3OS在LSCC组织和细胞株中的表达水平。采用siRNA敲低TU177细胞中DNM3OS的表达，应用MTS、克隆形成及Transwell小室等方法分别检测敲低DNM3OS表达对TU177细胞增殖、迁移和侵袭等生物学行为的影响。应用qPCR和WB法检测转染si-DNM3OS后对EMT标志物上皮钙黏素（E-cadherin）、神经钙黏素（N-cadherin）、波形蛋白（vimentin）、扭曲蛋白（twist）、锌指转录因子2（SNAI2）mRNA和蛋白的变化。结果：LSCC组织中DNM3OS表达水平明显高于癌旁组织（P<0.01），并与患者的TNM分期、淋巴结转移及生存期有关联（P<0.05或P<0.01）。DNM3OS在LSCC细胞株（Hep-2、AMC-HN-8、TU177、TU212及TU686）中均呈现不同程度的高表达（P<0.05或P<0.01），转染si-DNM3OS后TU177细胞中DNM3OS的表达显著降低（P<0.01）。与对照组相比，DNM3OS表达敲低可抑制TU177细胞的体外增殖、迁移和侵袭能力（P<0.05或P<0.01），可上调TU177细胞中E-cadherin的表达而下调N-cadherin、vimentin、twist和SNAI2的表达（均P<0.01）。结论： DNM3OS高表达与LSCC的恶性进展有关，其可能为预测LSCC患者预后的潜在指标；DNM3OS可能通过影响EMT进程促进LSCC细胞的侵袭和转移。

Textual Research on Illustrations of Medicinal Materials Named After Geographical Names of Jiangsu Province in Illustrated Classic of Materia Medica / 中国实验方剂学杂志

Illustrated Classic of Materia Medica （Ben Cao Tu Jing）， compiled in 1061， is regarded as the crystallization of the second national survey of Chinese medicinal resources in the history of China after the Newly Revised Materia Medica （Xin Xiu Ben Cao）， which serves as a precious source for exploring the Chinese medicinal resources in the Song Dynasty. The Illustrated Classic of Materia Medica （Ben Cao Tu Jing） covers 50 illustrations for Chinese medicinal materials named after geographical names of Jiangsu Province， 39 of which have been verified in today's Jiangsu Province. To be specific， Chinese medicinal materials in 32 illustrations can be traced back to their species， those in four illustrations to genera， and those in three illustrations to family. The remaining 12 illustrations remain to be further verified. The origins of most Chinese medicinal materials in the illustrations can be traced， which is attributed to their exquisiteness and lifelikeness as well as the detailed descriptions of the characters of the original plants and animals. In the textual research of these illustrations， we have noticed that there are inconsistencies between pictures and texts， and different illustrations may be derived from the same origin. This is believed to be related to SU Song's principle of collation that "for all Chinese medicinal materials presented as examples， if their shapes and categories recorded are not consistent with those in the literature， they will be retained. If there is any connection with the literature， they will be annotated according to literature to make their origins clear". As revealed by the distribution of Chinese medical materials in Jiangsu Province reported in the Illustrated Classic of Materia Medica （Ben Cao Tu Jing）， the utilization and development of Jiangsu medicinal materials during the Northern Song Dynasty were mainly concentrated in the low-altitude valleys and coastal areas. It could be seen from the illustrations of Chinese medicinal materials named after geographical names of today's Jiangsu Province that the production areas with a large number of illustrations were relatively developed in politics， economy， and transportation at that time， which enabled the medicinal resources to be fully utilized.

Tumor papilar sólido-quístico pancreático / Solid pseudopapillary tumor of the pancreas

RESUMEN Antecedentes: la neoplasia sólida pseudopapilar del páncreas es una entidad rara, que típicamente se presenta en mujeres jóvenes. Suele presentar síntomas abdominales inespecíficos. Es un tumor maligno de bajo grado de malignidad. Objetivos : el objetivo del siguiente informe de serie de casos es presentar 9 casos tratados en un cen tro y realizar una revisión bibliográfica del tema. Material y métodos: estudio retrospectivo descriptivo de los casos con diagnóstico anatomopatoló gico de neoplasia sólida pseudopapilar en el Servicio de Cirugía General, desde febrero de 2013 hasta septiembre de 2019. Se contemplaron como variables: edad, sexo, localización del tumor, tratamiento quirúrgico realizado, tiempo operatorio, complicaciones, estancia hospitalaria y seguimiento alejado. Resultados: fueron 9 casos, todos de sexo femenino con media de edad de 30 años (rango 20 a 70 años). La localización más frecuente fue en cola de páncreas en 4 casos (45%). Todas las pacientes fueron sometidas a cirugía, con abordaje laparoscópico en el 60% de los casos (n = 5); la resección pancreática distal con preservación esplénica fue la conducta más utilizada (n = 6). Se constataron tres complicaciones, de las cuales dos fueron colecciones abdominales como consecuencia de una fístula pancreática que se abordaron por vía percutánea, y la restante fue un retardo del vaciamiento gástrico por lo cual la paciente requirió internación prolongada. Conclusión: la neoplasia sólida pseudopapilar pancreática es una enfermedad poco frecuente, ma ligna pero con bajo riesgo de malignidad. Presenta buena sobrevida cuando se somete a cirugía de carácter curativo; la laparoscopia es la vía de abordaje de elección en centros con experiencia.

ABSTRACT Background: Solid pseudopapillary tumor of the pancreas is a rare condition that affects young women. The most common symptom is unspecific abdominal pain. It is a malignant tumor of low malignant potential. Objective: The aim of this study is to report a case series of patients treated in a single center and perform a bibliographic review. Material and methods: We conducted a retrospective study of the cases with pathological diagnosis of solid pseudopapillary tumor of the pancreas treated in the Department of General Surgery between February 2013 and September 2019. The following variables were analyzed; age, sex, tumor location, surgical treatment, operative time, complications, length of hospital stay and long-term follow-up. Results: Nine patients were included; all of them were women with mean age of 30 years (range: 20 - 70 years). The most common location of the tumor was the tail of the pancreas (n = 4; 45%). Surgery was performed in all the cases; five cases underwent video-assisted laparoscopy and spleen-preserving distal pancreatectomy was the technique more commonly used (n = 6). Three complications were recorded: two abdominal collections due to biliary leaks were trated by percutaneous approach and the other patient presented delayed gastric emptying and required prolonged hospitalization. Conclusion: Solid pseudopapillary tumor pf the pancreas is a rare low-grade malignant neoplasm. The prognosis is favorable after surgery and laparoscopy is the preferred approach in centers with experience.

Analysis of medicine paintings of fruit, vegetable and rice sections of Ben Cao Tu Jing / 中国中药杂志

Ben Cao Tu Jing is the earliest version of block-printed edition for herbals so far, with 933 medicinal paintings. In this paper, it analyzed the medicine paintings in the Fruit, Vegetable and Rice Sections of Ben Cao Tu Jing, as well as discussed the types of medicine paintings and relevant information when they were drawn. There are a total of 76 paintings in the fruits, vegetables and rice sections of Ben Cao Tu Jing, which can be divided into four types: broken branch paintings, ground paintings, rootless plant paintings and the whole plant with root paintings. The first three paintings were similar to the paintings of Tang and Song, and the paintings of the whole plant with root can be called the type of medicine paintings with Chinese characteristics created by Ben Cao Tu Jing. These four types of paintings had a profound impact on the later illustrations of medicinal materials, such as Lv Chan Yan Ben Cao, Jiu Huang Ben Cao, Ben Cao Pin Hui Jing Yao, Zhi Wen Ben Cao, Zhi Wu Ming Shi Tu Kao. The two types that had the greatest impact on later generations are the broken branch paintings and the whole plant with roots paintings, which had been inherited and developed in contemporary Chinese pharmacy books such as Zhong Yao Cai Pin Zhong Lun Shu and Zhong Hua Ben Cao. The paintings of the fruits, vegetables and rice sections are highly realistic and artistic, not only carrying the role of conveying medicinal knowledge, but also having unique aesthetic value. It can be inferred that the fruits, vegetables and rice sections had the participation of professional painters at least. In addition, through the highly consistent drawing styles of several sets of paintings, it is concluded that the paintings without place names were likely to be drawn uniformly by the editing team, and the local paintings may have been revised and improved by the editing team lately.

Effect of laminaria japonica polysaccharides on laryngeal carcinoma cell proliferation and apoptosis in vitro / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the effect and its mechanism of laminaria japonica polysaccharides(LJP) on human laryngeal carcinoma cell Tu212 growth. METHODS The laryngeal squamous cell Tu212 in logarithmic growth phase were treated by laminaria japonica polysaccharides(80, 160, 320 μg/ml) and cisplatin(1.8 mg/L). The MTT assay was used to evaluate cell growth inhibition rate after 24h, 48h and 72h. The flow cytometry with PI staining were used to estimate cell cycle distribution after 48h. The fluorescent microscopy was used to estimate cell apoptosis after 48h. The western blot was used to evaluate the expressions of Cyclin B1 and Bcl-2. RESULTS The cell proliferation was inhibited by cellular LJP in a dose and time dependent manner. Tu212 cells proliferation were stopped at the G2/M phase treated with LJP after 48h. Cell apoptosis was observed clearly by f luorescent microscope after 48h. The expressions of Cyclin B1 and Bcl-2 were suppressed significantly treated with LJP after 48 h. All of the differences were significant(P <0.05). CONCLUSION LJP has inhibitive effects on the Tu212 cells, this mechanism was probably through inhibition of the proliferation and promotion of the apoptosis.

Surgical management of concomitant pancreatic neuroendocrine tumors inhereditary tumor syndromes / 中国实用外科杂志

Pancreatic neuroendocrine neoplasms(pNENs)might present as part of complex hereditary(familial)syndromes caused by germline mutations such as multiple endocrine neoplasia type 1(MEN1),von Hippel-Lindau disease(VHL),tuberous sclerosis,and neurofibromatosis type1(NF1).Increasing knowledge of hereditary pNENs in both their genetic underpinnings and clinical implications has affected the entire spectrum of their surgical management.However,the appropriate surgical timing and management of concomitant pNENs inhereditary tumor syndromes is still debated.

To Study The Adverse Drug Reactions (ADR) & To Find Out The Effect Of Adr In Tb Patients Registered Under Rntcp In Karad Tu

BACKGROUND: Anti tubercular treatment (ATT) exhibit greater level of a efficacy with a satisfactory degree of toxicity, however combination treatment may produce severe adverse drug reaction (ADR). ADR leads to decrease in patient compliance & adherence .So close monitoring of ADR & it‘s effective management needed. Objective- To study of adverse drug reactions (ADR) in tuberculosis (TB) patients registered under RNTCP and the effect of adverse drug reaction. Material & Methods- This is longitudinal (Prospective) study done during January2008 to June2009 Total 806 patients who registered in 9 PHCs, Sub District Hospital, Krishna Hospital & 6DMCs with 3 ICTCs under Karad TU as study subjects. Result & Observations - It was 513 (63.6%) patients had adverse reactions while 293 (36.35%) had no adverse reactions. Out of 513 patients 486 (60.30%)had gastritis, 33 (4.09%) had gastritis and joint pain, 49 (6.09%) had gastritis and skin rash, 62 (7.69% ) had itching, 43 (5.33%) had joint pain. Thus gastritis was being the most common adverse Conclusion- There was no any significantly association seen between ADR and gender in this study. It was observed that 147(21.4%) patients continued DOTS treatment after giving treatment for ADR, 240(34.9%) continued DOTS treatment even if they were not treated for their ADR, 301(43.8%) continued DOTS treatment after given reassurance foe ADR. Conclusion- Gastritis 480 (60.30%) was the most commonest adverse reaction seen as well as most of the adverse reactions was seen in intensive phase i.e. in first 2 months. There was not association in ADR and gender. In this study, 147(21.4%) patients continued DOTS treatment after giving treatment for ADR, 240(34.9%) continued DOTS treatment even if they were not treated for their ADR, 301(43.8%) continued DOTS treatment after given reassurance for ADR. Most of the adverse reactions were in intensive phase of treatment i.e. that in first 2 months. Gastritis was present in intensive phase as well as initial months of continuation phase treatment.

Protective effects of shenfu injection on cerebral ischemia reperfusion injury in rats / 中国医师杂志

Objective To study the protective effect of shenfu injection on cerebral ischemia reperfusion injury in rats.Methods 120 male Sprague Dawley (SD) rats(320-350 g) were randomly divided into sham operation group,model control group,Nimodipine injection group,low,medium and high dose group of shenfu injection according to gender weight.20 males in each group were given medicine once a day for 7 days before operation.The cerebral ischemia model was established by thread embolization after 5 days of administration.In the sham operation group,the other operations were the same as those in the model group except for carotid artery ligation and thread insertion.After 24 hours of perfusion,the neurological score,abdominal aorta blood flow,malondialdehyde (MDA),superoxide dismutase (SOD) and glutathione (GHS) levels in brain tissues were measured.Triphenyltetrazolium chloride (TTC) staining was used to calculate the area of cerebral infarction and pathological examination of brain tissues.Results Compared with the model control group,the middle and high dosage of shenfu injection could obviously improve the nerve function and increase the percentage of cerebral infarction area (P ＜ 0.05);the high dosage group of shenfu injection could obviously decrease the whole blood viscosity (P ＜ 0.01);the middle and high dosage of shenfu injection could obviously reduce the level of MDA in rat brain tissue (P ＜ 0.01) while increasing the levels of SOD and GSH (P ＜0.01),finally could significantly improve the pathological changes of brain tissues such as mild swelling of nerve fibers,mild neuronal degeneration,inflammatory interstitial edema and inflammation.Conclusions Shenfu injection has obvious protective effect on cerebral ischemia reperfusion model in rats.

Correlation between UGT1A6 rs2070959 gene polymorphism and VPA metabolism in epileptic patients / 中国医师杂志

Objective To investigate the relationship between uridine diphosphate glucuronosyltransferases (UGT) 1A6 rs2070959 polymorphism and serum concentration of valproic acid (VPA) in patients with epilepsy.Methods We selected 200 cases of epilepsy patients treated in our hospital from June 2014-January 2017.All the patients were treated with VPA monotherapy ＞ 3months.When the VPA of patients reached steady state,we detected the VPA blood level.The genotypes and allele frequencies of UGT1A6 rs2070959 in 200 epilepsy patients were determined.The average standard deviation of 1-fold VPA was used as high VPA group and vice versa as low VPA group.The genotype and allele frequencies of UGT1A6 rs2070959 were compared between the two groups,and the influencing factors of VPA concentration in epileptic patients were analyzed.Results The frequencies of A genotype,AG genotype and GG genotype were 77.01％,18.39％ and 4.60％ in the high VPA group,67.26％,19.47％ and 13.27％ in the low VPA group,with no significant difference between the two groups (P ＞ 0.05);the allele G frequency in the high VPA group was significantly lower than that in the low VPA group (13.79％).The age and weight of the high VPA group were significantly higher than those of the low VPA group (P ＜ 0.05),and the gender composition of the high VPA group was not significantly different from that of the low VPA group (P ＞0.05).Logistic regression analysis showed that age and weight gain were positively correlated with VPA concentration (P ＜ 0.05),allele G expression was negatively correlated with VPA concentration (P ＜0.05).Conclusions Allele G expression at UGT1 A6 rs2070959 is associated with decreased VPA concentration in epileptic patients,which may require a higher dose of VPA.

The basic research of Xuezhikang combined with rosuvastatin lipid-lowing therapy for atherosclerosis renal artery stenosis / 中国医师杂志

Objective To observe the therapeutic effects and adverse effect of different lipid-lowering regimens in Atherosclerosis renal artery stenosis (ARAS) rat model and select the optimal treatment.Methods 90 Wister rats were randomly divided into sham operation group (group F) and operation group.The operation group was divided into normal feed group (group N) and high-fat feed group (group T).We established the rat model in operatino group by narrowing the renal artery with acupuncture needle and 8 weeks of high-fat feeding.According to the different lipid-lowing therapeutic schedules,the T group rats were randomly divided into five groups:the blank group (T0 group),the Xuezhikang group (T1 group),the rosuvastatin group (T2 group),the regular dose of rosuvastatin combined with Xuezhikang (T3 group),the low dose of rosuvastatin combined with Xuezhikang (T4 group).Mter 6 weeks of intervention,the serum lipids [total cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoproteincholesterol (LDL-C)],liver function [alanine aminotransferase (ALT),aspartate aminotransferase (AST)],kidney function [blood urea nitrogen (BUN),serum creatinine (Scr)] and pathological changes of aorta and kidney were detected before and after treatment.Results (1) The blood pressure,BUN and Scr were significantly increased in N group and T group compared with F group (P ＜ 0.05).TC,TG,LDL-C were significantly increased (P ＜ 0.05) and HDL-C were significantly decreased (P ＜ 0.05) in T group compared with N,T group.According to the pathological section,the aorta in T group had visible atherosclerosis change,the renal tubules were atrophied and decreased.All above,the rat model of ARAS was successfully established.(2) After 6 weeks of drug intervention,compared with prior treatment,TC,TG,LDL-C,BUN and Scr were significant decrease (P ＜ 0.05),while HDL-C was significantly increased (P ＜ 0.05) in all treatment groups,and the most remarkable change was in T3,T4 group,T3 group was better than T4 group but with no significant difference between T3 and T4 group (P ＞ 0.05).We found that ALT and AST were significantly increased in T2 and T3 group (P ＜ 0.05) after treatment.Compared with T0 group,pathological lesions of aorta and kidney were reduced best in T3 and T4 group.Conclusions Low dose of rosuvastatin combined with Xuezhikang can achieve ideal lipid-lowing effects.At the same time,it has a protective effect on kidney,and has little damage to liver function.

Research progress of zoledronic acid combined with other anti-tumor methods in the treatment of tumor bone metastases / 中国医师杂志

Tumor bone metastasis is one of the common complications of advanced tumor and one of the signs of poor prognosis.There are many targeted drugs for bone metastasis in the clinic,which play a very important role in the antitumor treatment and prevention of bone related events.Among them,zoledronic acid,a representative bisphosphonate drug,has been extensively studied.It has been found that zoledronic acid combined with other anti-tumor therapies can more effectively inhibit the occurrence of tumor and bone-related events.This article reviews the latest research on zoledronic acid combined with other antitumor methods to guide clinical use and provide research ideas.

The protective effect of dexmedetomidine on acute lung injury induced by lipopolysaccharide / 中国医师杂志

Objective To investigate whether dexmedetomidine (Dex) has a protective effect against acute lung injury (ALI) in lipopolysaccharide (LPS) induced mice model.Methods Mice were randomly allocated into three groups as follows:LPS group (LPS administration),LPS + Dex group1 (LPS administration +50 μg/kg Dex),and LPS + Dex group2 (LPS administration +25 μg/kg Dex).Lung tissue sections were stained with hematoxylin and eosin (HE) to observe the pathological changes.The c-reactive protein was measured with automatic biochemical analyzer.The apoptotic marker Caspase-3 expression was detected by Western blot.Results HE staining showed pulmonary interstitial congestion,edema and inflammatory cell infiltration in LPS group.Intraperitoneal injection of dexmedetomidine could significantly improve the pathological changes of lung tissue.Compared with LPS group,C-reactive protein and Caspase3 were significantly reduced in dexmetomidine group.Conclusions Dexmedetomidine attenuates LPS-induced inflammatory reaction and apoptosis in mice.

Meta-analysis of corticosteroid therapy for IgA nephropathy / 中国医师杂志

Objective To evaluate the efficiency and safety of corticosteroid therapy for IgA nephropathy.Methods Pubmed,Medline/embase,and Te Cochrane Library databases were searched for randomized controlled trials (RCTs) of hormone therapy for IgA nephropathy from database establishment to September 2017.According to the Cochrane system evaluation method,two reviewers independently screened the literature,extracted data,evaluated the quality of the included studies and cross-checked them according to inclusion and exclusion criteria.The Cochrane bias risk method was used to evaluate the quality of the included studies.The fixed effect model was used to assess the risk of serum creatinine change and progression to end-stage renal disease (ESRD).The random-effect models were used to assess 24-hour urinary protein quantification and the incidence of adverse events leading to drug withdrawal or hospitalization.The data were pooled using RevMan 5.3 software.The quadratic variables were odds ratio (OR) and the continuous variables were mean difference (MD).The odds ratio was used as the effect variable for the two variables,and the mean variance was used as the effect variable for the continuous variable data.Results A total of 9 RCTs were enrolled.Meta-analysis showed that compared with the control group,the steroid treatment group could slow down the increase of serum creatinine by more than 50％ in IgA nephropathy patients (OR =0.15,95％ CI:0.04-0.53,P =0.003) and delay the progression to ESRD (OR =0.38,95％ CI:0.16-0.87,P =0.02),but there was no significant difference in the level of serum creatinine (MD =-0.03,95％ CI:-0.29-0.24,P =0.85),the 24 hour urinary protein quantification (MD =-0.55,95％ CI:-1.42-0.31,P =0.21),and the incidence of adverse reactions (OR =1.68,95％ CI:0.69-4.11,P =0.26).Conclusions The meta analysis showed that there was no significant difference in the safety of steroid treated IgA nephropathy compared with the control group,and may be beneficial to the long-term prognosis of patients with IgA nephropathy.

Study on glycosaminoglycan from Apostichopus Japonius on cellular immuno-regulation function of peripheral blood cells from pulmonary tuberculosis patients in vitro / 中国医师杂志

Objective To investigate the effects of glycosaminoglycans (HGAG) on the immune function of peripheral blood cells from patients with pulmonary tuberculosis.Methods Peripheral blood monouclear cells (PBMC) were isolated from peripheral blood of 40 healthy people (healthy group) and 30 tuberculosis patients (tuberculosis group) and cocultured with HGAG in vitro for 24 hours.Flow cytometry was used to detect the expression of CD45RA and CD45RO,as well as the expression of CD1a and CD83.Results The results showed that the expression of CD45RA and CD45RO in the tuberculosis group was the most significant (P ＜ 0.05) at the concentration of 50 μg/m coculturing with HGAG.The expression of CD45RA and CD45RO were most obvious in the healthy group at the concentration of 10 μg/ml and 50 μg/ml respectively (P ＜0.001).The difference of CD45RA between the two groups was no significant (P ＞0.05),while the difference of CD45RO was statistically significant (P ＜ 0.01) before co-culturing.The expression of CD45RA and CD45RO at 10 μg/ml and 50 μg/ml after co-culturing with HGAG were statistically significant (P ＜ 0.05).There was no statistical difference in CD1a and CD83 in healthy group before and after co-culturing (P ＞ 0.05),while there was statistically difference (P ＜ 0.05) before and after culturing in tuberculosis group.Before co-culturing,there was no significant difference in the expression of CD1a between the healthy group and the tuberculosis group (P ＞ 0.05),but CD83 expression was statistically different (P ＜ 0.001).After co-culturing,there were no significant differences in CD1a and CD83 expression between healthy and healthy groups (P ＞ 0.05).Conclusions HGAG can down-regulate the expression of CD45RA and up-regulate the expression of CD45RO in a certain concentration range,and promote the maturation of dendritic cells (DC) in tuberculosis patients and regulate the cellular immunity of patients with pulmonary tuberculosis in vitro.

Protective effect of all-transretinoic acid on renal ischemia-reperfusion injury in rats / 中国医师杂志

Objective To study the protective effect of total trans retinoic acid (ATRA) on renal injury induced by ischemia-reperfusion in rats.Methods 24 Sprague Dawley (SD) rats were divided into 4 groups of (1) Normal control group,(2) Sham operation group,(3) Model group:the model of renal ischemia-reperfusion was established.(4) Retinoic acid treatment Group:ATRA were given by gavage for 7 consecutive days.The rats were killed 24 hours after the model,and the serum and renal tissue were collected.Serum creatinine,tumor necrosis factor-α (TNF-αx) and interferon-γ (IFN-γ) levels,kidney biopsy,renal tubular score,renal damage and renal tissue apoptosis were detected.Results Compared with the model group,the serum creatinine level decreased and the creatinine clearance rate increased in ATRA treated group (P ＜ 0.05);the damage of renal tubular epithelial cells was alleviated in the pathological slices;and the apoptosis rate of renal tubular epithelial cells was decreased (P ＜ 0.05).Serum levels of TNF-α and IFN-γ decreased (P ＜ 0.05).Conclusions ATRA can protect the renal ischemia-reperfusion injury through inhibiting inflammatory reaction and apoptosis.

Effect of Yupingfeng granule on Th17/Treg balance in children with milk protein allergy / 中国医师杂志

Objective To observe Thl7 cells,Treg cells and their related factors in peripheral blood of children with milk protein allergy and explore the influence of Yupingfeng granule on Th17 / Treg imbalance and its clinical effect.Methods 40 children with milk protein allergy were divided into two groups randomly:the conventional treatment group (n =20),Yupingfeng granule group (n =20).The conventional treatment group received conventional treatment for 2 months.On the basis of routine treatment,Yupingfeng granule group was additionally treated with Yuping feng granule.The serum Th17,Treg cell counts,interleukin (IL)-17 and transforming growth factor-β1 (TGF-β1) levels were detected,and the eczema area and severity index (EASI) score of rash in children was recorded.Results The levels of Th17 cells and IL-17 in allergy children were obviously increased compared with those of the normal children,while the Treg cells,and the TGF-β1 level were lower than those of the normal children (P ＜ 0.05).After treatment,the Thl7 cells,the IL-17 levels and ESAI scores of the conventional treatment group and the Yupingfeng granule group were lowered,while the Treg cells and the TGF-β1 levels were increased (P ＜ 0.05).Compared with the conventional treatment group,these indexes increased and decreased more significantly in the Yupingfeng granule group (P ＜ 0.05).Conclusions Milk allergy children have obvious imbalance of Thl7/Treg;the Yupingfeng granule can adjust this imbalance and alleviate the allergic symptoms of milk protein.