Chemical constituents from the leaves of Cyclocarya paliurus and their α-glucosidase inhibitory activities / 中成药

AIM To study the chemical constituents from the leaves of Cyanocarya paliurus(Batalin)Iljinskaja and their α-glucosidase inhibitory activities.METHODS The 95%ethanol extract from the leaves of C.paliurus was isolated and purified by macroporous resin,silica gel,Sephadex LH-20,polyamide,C18 reversed-phase silica gel and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their α-glucosidase inhibitory activities were evaluated by PNPG.RESULTS Fifteen compounds were isolated and identified as cyclopaloside C(1),cyclopaloside A(2),juglanosides E(3),vaccinin A(4),ent-murin A(5),kaempferol 3-O-α-L-rhamnopyranoside(6),kaempferol-3-O-β-D-glucopyranoside(7),kaempferol-3-O-β-D-glucuronide methyl ester(8),kaempferol-3-O-β-D-glucuronide ethyl ester(9),kaempferol-3-O-β-D-glucuronide butyl ester(10),quercetin-3-O-α-L-rhamnopyranoside(11)quercetin-3-O-β-D-glucopyranoside(12),quercetin-3-O-β-D-galactopyranoside(13),quercetin-3-O-β-D-glucuronide butyl ester(14),dihydrokaempferol(15).The IC50 value of total extracts ihibited α-glucosidase was(1.83±0.04)μg/mL,and the IC50 values of compounds 1,4-5 were(29.48±1.86),(0.50±0.07),(0.71±0.07)μmol/L,respectively.CONCLUSION Compound 1 is a new tetrahydronaphthalene glycoside.Compounds 4-5,8-10 and 14 are isolated from the leaves of C.paliurus for the first time.Compounds 4-5 are relatively rare flavonoid lignans with potential inhibitory activities against α-glucosidase.

MiR-340 mediates the involvement of high mobility group box 1 in the pathogenesis of liver fibrosis / 中华肝脏病杂志

Objective: To explore the pathogenic mechanism of the miR-340/high mobility group box 1 (HMGB1) axis in the formation of liver fibrosis. Methods: A rat liver fibrosis model was established by injecting CCl(4) intraperitoneally. miRNAs targeting and validating HMGB1 were selected with gene microarrays after screening the differentially expressed miRNAs in rats with normal and hepatic fibrosis. The effect of miRNA expressional changes on HMGB1 levels was detected by qPCR. Dual luciferase gene reporter assays (LUC) was used to verify the targeting relationship between miR-340 and HMGB1. The proliferative activity of the hepatic stellate cell line HSC-T6 was detected by thiazolyl blue tetrazolium bromide (MTT) assay after co-transfection of miRNA mimics and HMGB1 overexpression vector, and the expression of extracellular matrix (ECM) proteins type I collagen and α-smooth muscle actin (SMA) was detected by western blot. Statistical analysis was performed by analysis of variance and the LSD-t test. Results: Hematoxylin-eosin and Masson staining results showed that the rat model of liver fibrosis was successfully established. Gene microarray analysis and bioinformatics prediction had detected eight miRNAs possibly targeting HMGB1, and animal model validation had detected miR-340. qPCR detection results showed that miR-340 had inhibited the expression of HMGB1, and a luciferase complementation assay suggested that miR-340 had targeted HMGB1. Functional experiments results showed that HMGB1 overexpression had enhanced cell proliferation activity and the expression of type I collagen and α-SMA, while miR-340 mimics had not only inhibited cell proliferation activity and the expression of HMGB1, type I collagen, and α-SMA, but also partially reversed the promoting effect of HMGB1 on cell proliferation and ECM synthesis. Conclusion: miR-340 targets HMGB1 to inhibit the proliferation and ECM deposition in hepatic stellate cells and plays a protective role during the process of liver fibrosis.

Expert consensus on late stage of critical care management / 中华内科杂志

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.

Efficacy of radiofrequency ablation combined with ozone therapy under CT guidance in the treatment of lumbar disc herniation / 中国基层医药

Objective:To investigate the efficacy of radiofrequency ablation combined with ozone therapy under CT guidance in the treatment of lumbar disc herniation.Methods:A total of 93 patients with lumbar disc herniation who were admitted to The First Hospital of Jiaxing from January 2019 to May 2022 were included in this study. They were randomly divided into an observation group ( n = 47) and a control group ( n = 46). The control group was treated with radiofrequency ablation and the observation group was treated with radiofrequency ablation combined with ozone therapy. Efficacy was compared between the two groups at 3 months after surgery. The pain was compared between the two groups before and 7 days and 3 months after surgery. Inflammatory factors were compared between the two groups before and 7 days after surgery. The lumbar spine function was compared between the two groups before and 3 months after surgery. Results:At 3 months after surgery, the excellent and good rate in the observation group was significantly higher than that in the control group [89.36% (42/47) vs. 71.74% (33/47), χ2 = 4.63, P < 0.05). At 7 days and 3 months after surgery, Visual Analogue Scale scores in the observation group were (2.91 ± 0.54) points and (1.32 ± 0.31) points, respectively, which were significantly lower than (3.76 ± 0.62) points and (2.08 ± 0.47) points in the control group ( t = 7.06, 9.22, both P < 0.001). At 7 days after surgery, serum interleukin-1β, interleukin-6, and tumor necrosis factor-α in the observation group were (0.24 ± 0.05) μg/L, (18.49 ± 3.47) ng/L, and (97.94 ± 17.43) ng/L, respectively, which were significantly lower than (0.37 ± 0.09) μg/L, (24.31 ± 4.12) ng/L, and (148.87 ± 20.13) ng/L, respectively in the control group ( t = 8.63, 7.37, 13.05, all P < 0.05). At 3 months after surgery, the Japanese Orthopedic Association score in the observation group was significantly higher than that in the control group [(25.68 ± 2.28) points vs. (21.17 ± 3.24) points, t = -7.78, P < 0.001], and the Oswestry Disability Index in the observation group was significantly lower than that in the control group [(9.84 ± 1.43) points vs. (13.46 ± 2.18) points, t = 9.49, P < 0.001]. Conclusion:Radiofrequency ablation combined with ozone therapy under CT guidance is highly effective on lumbar disc herniation. The combined therapy can reduce pain and inflammatory reactions in patients and improve lumbar function.

Progress in treatment of anti-hepatitis B virus drug nucleoside analogues in preventing mother-to-child transmission / 中国药理学通报

Mother-to-child transmission of hepatitis B virus (HBV) is one of the main ways of transmission and the main cause of chronic hepatitis B after infection. Therefore, preventing mother-to-child transmission of HBV is particularly important in reducing the incidence of chronic hepatitis B. Currently, nucleoside ( acid) analoids ( Nas ) used for mother-to-child blocking of HBV include lamivudine (LAM) , tibivudine (LdT) and tenofovir fumarate ( TDF). Propofol tenofovir fumarate (TAF) has also been used in pregnant chronic hepatitis B pa- tients. This paper summarizes the efficacy, safety and antiviral treatment indications and termination time of the above-mentioned drugs in mother-to-child preventing to provide suggestions for the selection and rational application of mother-to-child preventing Nas.

Evaluation of chemosensory function in patients with upper respiratory tract post-viral olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective: To observe the changes of olfactory function, intranasal trigeminal nerve function and taste function in patients with upper respiratory tract post-viral olfactory dysfunction (PVOD), and to explore the correlation of chemosensory function. Methods: The clinical data of 42 patients with PVOD who visited to the Olfactory and Taste Center of Otorhinolaryngology Head and Neck Surgery Department of Beijing Anzhen Hospital from January to December of 2019 were analyzed retrospectively, including 20 males and 22 females, aging (48.86±11.47) years (x¯). Twenty subjects in normal control group were selected according to the sex ratio of PVOD patients. Sniffin' Sticks olfactory tests were performed on the subjects, including threshold test (T), discrimination test (D) and identification test (I), and the sum of the above three test scores was the TDI value. At the same time, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs) and taste function test were performed. According to the taste function test, the patients were divided into normal gustation (NG) group and gustatory dysfunction (GD) group. The results of olfaction, taste and intranasal trigeminal nerve function tests were compared among different groups, and the correlation analysis was carried out. SPSS statistical software was used for statistical analysis. Results: GD was present in 14 (33.3%) of 42 PVOD patients with a course of PVOD of 5 (3, 6) months (M (Q1, Q3)). The gustatory function of patients with PVOD was related to gender (r=0.565, P<0.001), smoking status (r=-0.512, P=0.001), duration (r=-0.357, P=0.020) and olfactory function (all P<0.05). The olfactory function of GD group was worse than that of NG group, and the differences of TDI value and T value between the two groups were statistically significant (10.25±4.58 vs 13.35±3.61, 1.54±0.66 vs 2.10±0.88, t value was 2.40 and 2.10 respectively, both P<0.05). The amplitudes of oERPs and tERPs were significantly lower in GD group than those in NG group (all P<0.05). Conclusion: In patients with PVOD, the subjective and objective olfactory function, intranasal trigeminal nerve function and taste function were decreased, and there was a correlation, suggesting that there was a synergistic effect between the chemosensory functions of PVOD patients.

Analysis of whole-mouth taste function test results in 584 healthy adults / 中华耳鼻咽喉头颈外科杂志

Objective: To assess the taste function of healthy Chinese adults with the reliable whole-mouth taste test, and to analyze the correlation of taste function with age and gender. Methods: The clinical data of 584 participants reporting the normal sense of smell and taste from March 2019 to January 2020 in the Physical Examination Center of Beijing Anzhen Hospital were analyzed in the study, including 297 males and 287 females, aging (46.9±16.6) years. The subjects were divided into youth group (19-35 years old), middle aged group (36-50 years old), middle-elderly aged group (51-65 years old) and elderly group (66-80 years old). The taste test involved 5 tastants (sour, sweet, salty, umami and bitter) and 7 concentrations. The perception and recognition scores of five tastes were obtained through the whole-mouth taste test. SPSS 22.0 software was used for statistical analysis. Results: The intra-class correlation coefficients of the whole-mouth taste test were 0.751 to 0.828, which showed high test-retest reliability. The total score of perception and recognition of five tastes showed the significant negative correlation with age (r value was -0.49 and -0.44, respectively, both P<0.001). Compared with the other two groups, taste function of middle-elderly aged and elderly group decreased significantly (all P<0.001). There was no significant difference in total perception scores and total recognition scores between youth and middle aged group (all P>0.05). The perception scores and recognition scores of sour, salty, umami, bitter and total scores in females were higher than those in males (all P<0.05), but there was no significant difference in perception scores and recognition scores for sweet between them (P value was 0.584 and 0.223, respectively). Conclusions: The taste function is significantly negatively correlated with age. Except the sweet, females are more sensitive to the sour, salty, umami and bitter tastes than males.

Research progress on chemical constituents and pharmacological activities of Potentilla / 中国中药杂志

There are 200-500 species of Potentilla(Rosaceae) worldwide, among which 90 species are widely distributed in China and have a long history of ethnic medicinal use. According to our statistics, a total of 367 compounds have been isolated and identified from plants of this genus, including terpenoids, flavonoids, phenolic acids, tannins, and phenylpropanoids. The medicinal materials made from these plants mainly have antioxidative, blood sugar-lowering, anti-inflammatory, anti-tumor, cardiovascular system-protecting, neuroprotective, and hepatoprotective activities. This study systematically reviews the research progress on chemical constituents and pharmacological activities of Potentilla plants to provide a basis for further research and clinical application.

Advances in diagnosis and treatment of primary hemifacial spasm / 中华全科医师杂志

Primary hemifacial spasm is a motor disorder of facial muscles related to facial nerve. During the attack, the facial muscles present irregular and involuntary clonus, which can be induced or aggravated by emotional excitement, mental tension and random facial movement, seriously affecting daily work and life. The pathogenesis, diagnosis, differential diagnosis and treatment of the primary hemifacial spasm have been studied extensively in recent years. This article reviews the progress in these aspects.

Analysis of the development trend and severity of the COVID-19 panidemic in the global world / 北京大学学报(医学版)

OBJECTIVE@#To analyze the recent severity of COVID-19 in various countries.@*METHODS@#Data were ollected on the epidemic situation of COVID-19 in various countries as of January 16, 2021, and the scale and overall trend of the epidemic were retrospectively described; combined with the recent trend of newly confirmed cases, from January 10 to 16 (the 54th week) and the newly confirmed cases indexes, such as the number and incidence density the severity of the epidemic was classified. Feasible suggestions were put forward based on the variation of the virus, actual data of vaccine research and development and possible existence in many countries.@*RESULTS@#Up to January 16, 2021, there were 92 510 419 confirmed cases worldwide; 4 849 301 new confirmed cases were confirmed in the 54th week, and they were still growing. Among all the continents, the cumulative number of confirmed cases in Europe, North America, and Asia has exceeded 21 million, and the number of new confirmed cases in a single week in North America, South America and Asia were all increasing. Among the countries, the cumulative number of confirmed cases in 18 countries including the United States, India, and Brazil was more than 1 million, accounting for 77.04% of the total number of cumulative confirmed cases in the world. Eleven countries including the United States, Brazil, France, Spain, Colombia, The United Kingdom, Russia, Germany, South Africa, Italy, and India are at higher risk of the epidemic; The United States, Brazil, France, Spain, and Colombia were still experiencing new confirmed cases and increasing status, the risk of the epidemic was greater. Novel coronavirus mutates frequently, up to February 2021, there had been 3 931 mutant genotypes in the world. At the same time, a total of 11 vaccines were successfully launched, however we were still facing some troubles, such as the global shortage of vaccines, the public's willingness to vaccinate needed to be improved, and equity in the distribution of vaccines.@*CONCLUSION@#The global epidemic situation is still getting worse, with repeated epidemics in all the continents and countries, and has not been fundamentally controlled. At the continent level, North America, South America, and Europe have the most severe epidemics; at the national level, The United States, Brazil, France, Spain, Colombia and other countries have higher epidemic risks. Focusing on the severely affected countries will help bring the global epidemic under control as soon as possible. Under the premise of ensuring the safety and effectiveness of the vaccines, it is a key and feasible direction to improve the yield and vaccination rate of the vaccines, shorten the onset time of the vaccines and prolong the immune persistence.

Mechanism of Xinfeng Capsules improving rheumatoid arthritis based on CD19~+B cells regulating FAK/CAPN/PI3K pathway / 中国中药杂志

To observe the effect of Xinfeng Capsules on rheumatoid arthritis (RA) B lymphocytes,inflammatory mediators,FAK/CAPN/PI3K pathway,in order to explore the mechanism of Xinfeng Capsules in improving clinical symptoms of RA.Joint and systemic symptoms of RA patients were observed,and laboratory indicators[hemoglobin (HGB),platelet count (PLT),erythrocyte sedimentation (ESR),immunoglobulin (Ig) G,Ig A,Ig M,rheumatoid factor (RF),anti-cyclic citrulline antibody (CCP-AB),C-reactive protein (CRP)]were detected.ELISA was used to detect serum interleukin (IL)-1β，IL-10,IL-33,chemokine 5 (CCL5),and vascular endothelial growth factor (VEGF).CD3~-CD19~+B cells were measured by flow cytometry.Western blot was used to detect FAK,p-FAK,CAPN,PI3K protein.The results showed that Xinfeng Capsules could significantly alleviate RA joint and systemic symptoms and improve clinical efficacy.And Xinfeng Capsules could increase HGB,decrease PLT,CCP-AB,CRP,ESR index,upregulate IL-10 expression,and down-regulate IL-1β，IL-33,CCL5,VEGF,CD3~-CD19~+B cells,FAK,p-FAK,CAPN,PI3K expressions (P<0.01).Based on the above results,Xinfeng Capsules may reduce the expression of CD3~-CD19~+,regulate the balance of inflammatory cytokines and chemokines,inhibit abnormal activation of FAK/CAPN/PI3K pathway,and improve clinical symptoms of RA.

Dose-response relationship of anhydrous ethanol for celiac plexus block performed under CT guidance in treating intractable upper abdominal cancer pain / 中华麻醉学杂志

Objective:To determine the dose-response relationship of anhydrous ethanol for celiac plexus block performed under CT guidance in treating intractable upper abdominal cancer pain.Methods:One hundred patients of both sexes with intractable upper abdominal cancer pain, aged 39-89 yr, weighing 37-64 kg, of visual analog scale score≥7, scheduled for elective celiac plexus block performed under CT guidance, were divided into 5 groups ( n=20 each) by a random number table method: mixture of different doses of anhydrous ethanol plus iohaeol groups (R 1-R 5 groups). T 12-L 1 interspace was located first.The needle was inserted at the level of T 12-L 1 interspace.The points of needle entry were determined by CT.On the left side, a needle was inserted, and the tip slid off the vertebral body anterolaterally until it reached the left slide of aorta and left crus of diaphragm.On the right side, a needle was inserted and advanced until the anterior side of the vertebral body between the right crura of diaphragm.One percent lidocaine hydrochloride 2 ml containing contrast agent (30% iodohydramol injection 0.4 ml) was injected through the left and right needle.At 20 min after CT showed that the liquid injected had been met and wrapped around the abdominal aorta, the mixture of anhydrous ethanol 8 ml (R 1 group), 10 ml (R 2 group), 12 ml (R 3 group), 14 ml (R 4 group), 16 ml (R 5 group) and iodinitol (iodinitol∶anhydrous ethanol=1∶5) was injected through the left and right needle.Effective block was defined as the visual analog scale score of superior abdominal pain≤3 and decrease in systolic pressure by more than 20% compared with the preoperative level at 10 min after the abdominal plexus block with anhydrous ethanol.The ED 50, ED 95 and 95% confidence interval of celiac plexus block in treating intractable upper abdominal cancer pain were calculated by Probit analysis. Results:The ED 50 and ED 95 (95% confidence interval) of celiac plexus block in treating refractory upper abdominal cancer pain were 11.937 (10.959-12.939) ml and 19.665 (17.448-24.212) ml, respectively. Conclusion:The ED 50 and ED 95 of anhydrous ethanol for celiac plexus block performed under CT guidance in treating intractable upper abdominal cancer pain are 11.937 ml and 19.665 ml, respectively.

Prevention of pneumothorax in CT-guided thoracic sympathetic nerve block / 中华全科医师杂志

Objective:To explore the measures for prevention of pneumothorax in CT-guided thoracic sympathetic block.Methods:The clinical data of 769 patients with hyperhidrosis or Raynaud syndrome treated with CT-guided chemical destructive block of thoracic sympathetic nerve chain in Jiaxing First Hospital from January 2010 to December 2017 were retrospective analyzed. The CT-guided thoracic sympathetic nerve block puncture was performed with a special blunt needle outside the wall pleura above the caput costae following the principle of "safe distance" and "advance only". After exclusion of pneumothorax by CT scan, 2.5 ml of absolute ethanol mixed with 30% iohexol 0.25 ml was injected on both sides of thoracic sympathetic nerve chain.Results:The punctures were successfully performed in all 769 patients (1 538 nerve chain segments) and no pneumothorax occurred. After treatment with absolute ethanol injection, Horner syndrome occurred in 31 patients, which disappeared after injecting saline into the stellate ganglion; and intercostal neuralgia occurred in 188 patients after surgery, which was healed in 1 to 3 months.Conclusion:It is suggested that pneumothorax can be avoided through CT guidance, using appropriate needles and puncture techniques during the procedure of thoracic sympathetic nerve chain block.

CT-guided intervertebral foramen puncture and radiofrequency thermocoagulation through the superior margin of costotransverse joint for the treatment of refractory post-herpetic neuralgia in the upper thoracic segment / 中华全科医师杂志

Objective:To evaluate the efficacy of radiofrequency thermocoagulation with CT-guided transforaminal puncture of intervertebral foramen through the superior margin of costotransverse joint for refractory post-herpetic neuralgia (PHN) in the upper thoracic segment.Methods:Thirty patients with PHN in the upper thoracic segment underwent radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture. The visual analogue scale and self-rating depression scale were used to evaluate the degree of postoperative pain and mental state before and after treatment, and patients were followed by telephone or outpatient visit.Results:No infection occurred after radiofrequency thermocoagulation in all 31 PHN patients. After operation, all patients had hypoesthesia in skin of the original pain area, the pain was significantly relieved, and the mental state improved significantly. The VAS scores were 5.94±0.93, 2.74±0.69, 2.68±0.70 and 2.45±0.51 before and 3 hours, 1 week, 1 month after treatment( t=18.80, t=18.80, t=16.44, all P<0.01). The SDS scores were 58.6±12.2, 47.7±4.4, 48.1±4.8 before and 1 week, 1 month after treatment( t=6.75, t=5.86, all P<0.01). There were 13 patients with moderate or severe depression before treatment, while no patients with moderate or severe depression after treatment; only 5 patients had mild depression one month after surgery. There was no hypoxemia under nasal catheter during the operation. Intraoperative hypertension was found in 19 cases; after treatment with Urapidil (12.5 - 50.0 mg), the blood pressure was not higher by 20% of the basal blood pressure and<180/100 mmHg (1 mmHg=0.133 kPa). No pneumothorax, perioperative cardiovascular and cerebrovascular accidents occurred. Conclusion:Radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture through the superior margin of costotransverse joint can effectively relieve refractory PHN of the upper thoracic segment with safety.

Progress on IFV drug targets and small molecule inhibitors / 药学学报

The outbreak of the influenza viruses (IFV) caused significant harm to our health and life. Human infections caused by pathogenic avian influenza virus (AIV) have continually brought great panic and death threats to people all over the world. With the in-depth study of the biological characteristics of influenza viruses and the rapid development of drug discovery screening technology, a new generation of anti-influenza drug targets and their inhibitors have been continuously discovered, providing more options for the treatment of influenza. From the point of view of medicinal chemistry, this review summarizes and discusses current endeavours towards the discovery and development of novel inhibitors and also provides examples illustrating new methodologies that contribute to the identification of novel anti-influenza drugs.

Electroacupuncture protects septic rats from acute lung injury through the JAK1/STAT3 pathway / 南方医科大学学报

OBJECTIVE@#To explore the protective effect of electroacupuncture against acute lung injury (ALI) in septic rats and explore the mechanism.@*METHODS@#Sixty male SD rats were randomly divided into cecal ligation and puncture (CLP)-induced sepsis group (@*RESULTS@#Compared with those in the sham operation group, the rats in ALI group showed obvious lung pathologies with significantly increased lung W/D ratio (@*CONCLUSIONS@#Electroacupuncture can inhibit the release of inflammatory mediators and cell apoptosis via the JAK1/STAT3 pathway to reduce lung injuries in septic rats.

Influence regulation of inflammatory immune response by interleukin-17 lipopolysaccharide-induced acute lung injury in mice / 中华危重病急救医学

To explore the immunomodulatory effects of interleukin-17 (IL-17) on acute lung injury (ALI) induced by lipopolysaccharide (LPS). Methods Thirty-six SPF-class C57BL/6 mice were divided into normal saline control group (NS group) and LPS-induced ALI model group (LPS group, LPS 5 mg/kg intratracheal drip) according to random number table method, with 18 mice in each group. Six mice were sacrificed at 2, 6 and 24 hours after model reproduction, and peripheral blood, lung and spleen tissues were harvested. After staining with hematoxylin-eosin (HE), the pathological changes of lung tissue were observed under microscope and the infiltration level of lymphocytes, neutrophils and macrophages in the alveolar wall and tracheal wall were detected. Immunohistochemistry was used to detect the protein expression of IL-17 in alveolar wall and tracheal wall, and the correlation between IL-17 expression and lymphocytes, neutrophils and macrophages infiltration in alveolar wall and tracheal wall were analyzed. The level of IL-17 in lung tissue homogenate was determined by enzyme linked immunosorbent assay (ELISA). Flow cytometry was used to detect the proportion of CD4+IL-17+ helper T cells (Th17 cells) in CD4+ T cells in peripheral blood, lung tissue and spleen tissue. Results ① Microscopy showed that the lung tissue structure of NS group was basically normal at each time after model reproduction, and there was no obvious inflammatory cell infiltration, while the lung tissue edema and inflammatory reaction were gradually aggravated in the LPS group, and the lung injury score was significantly higher than that in NS group at each time (2 hours: 4.47±1.42 vs. 1.10±0.55, 6 hours: 7.93±2.14 vs. 1.23±0.50, 24 hours:12.67±2.67 vs. 1.20±0.61, all P < 0.01). ② Immunohistochemistry showed that the protein expression of IL-17 in alveolar wall and tracheal wall of LPS group increased gradually with time, while that in NS group was negative or weak positive. Quantitative analysis showed that the immunohistochemical staining score of IL-17 protein in alveolar wall and tracheal wall of LPS group were higher than those of NS group (alveolar wall: 2.70±1.40 vs. 0.90±0.37 at 2 hours, 5.10±1.76 vs. 1.17±0.59 at 6 hours, 9.67±1.32 vs. 1.10±0.45 at 24 hours; tracheal wall: 2.87±0.89 vs. 0.90±0.39 at 2 hours, 4.97±1.48 vs. 1.10±0.41 at 6 hours, 8.67±1.54 vs. 1.03±0.29 at 24 hours; all P < 0.05). ③ Correlation analysis showed that the protein expression of IL-17 in alveolar wall and tracheal wall were positively correlated with the degree of lymphocyte, neutrophil and macrophage infiltration (alveolar wall: r value was 0.632, 0.550, 0.466; tracheal wall: r value was 0.695, 0.662, 0.575, respectively; all P < 0.01). ④ IL-17 content (μg/L) in lung tissue homogenate was significantly higher than that in NS group at each time after model reproduction (2 hours: 1.37±0.14 vs. 1.01±0.18, 6 hours: 1.65±0.19 vs. 1.11±0.18, 24 hours: 1.92±0.36 vs. 1.17±0.24, all P < 0.01). ⑤ The proportion of Th17 cells in the peripheral blood, lung tissue and spleen tissue of the LPS group were higher than those of the NS group at each time after model reproduction [peripheral blood: (2.62±0.62)% vs. (1.42±0.40)% at 2 hours, (3.74±0.43)% vs. (1.27±0.32)% at 6 hours, (4.44±0.65)% vs. (1.59±0.45)% at 24 hours; lung tissue: (2.32±0.44)% vs. (1.50±0.25)% at 2 hours, (3.66±0.36)% vs. (1.33±0.24)% at 6 hours, (4.60±0.54)% vs. (1.60±0.27)% at 24 hours; spleen tissue: (1.49±0.36)% vs. (0.69±0.21)% at 2 hours, (2.58±0.55)% vs. (0.59±0.18)% at 6 hours, (3.76±0.57)% vs. (0.65±0.26)% at 24 hours; all P < 0.01]. Conclusion IL-17 is involved in the inflammatory immune regulation of ALI mice.

Application study on improving the methods of endotracheal cuff pressure measurement to prevent ventilator-associated pneumonia / 中华危重病急救医学

To compare the intra cuff pressure changes during improved and the traditional method of cuff pressure measurement, then evaluate the effects of ventilator-associated pneumonia (VAP) prevention. The results highlighted practical recommendations in the process of ETT cuff pressure measurement. Methods① Experimental studies were carried out on the tracheal model with two groups: traditional pressure measurement group and improved pressure measurement group. The traditional pressure measurement group was connected to a handheld pressure gauge with the indicate cuff to get the intra-cuff pressure. The improved method was to insert a 3-way stopcock between the handheld pressure gauge and the indicate cuff. The 3-way stopcock to stabilize handheld pressure gauge reading at 32 cmH2O (1 cmH2O = 0.098 kPa) before measure the intra-cuff pressure. The pressure loss caused by two pressure measurement methods and the leakage of liquid on the balloon after 10 minutes was compared.② Clinical researches: a historic cohort study, patients with mechanical ventilation (MV) admitted to intensive care unit (ICU) of Guangxi Medical University Cancer Hospital from June 2014 to May 2018 were enrolled. The control group (249 cases) was treated with traditional method during June 2014 to May 2016, and the observation group (314 cases) was treated with improved method during June 2016 to May 2018. Clusters of strategies and actions of VAP prevention were applied in both groups. Incidence of VAP, duration of MV, and the length of ICU stay were compared between the two groups. Results ① Experimental study: the pressure leakage of the traditional pressure measurement group was (10.18±0.47) cmH2O, and that of the improved pressure measurement group was (1.33±0.42) cmH2O, with statistically significant difference between the two groups (t = 32.535, P = 0.000). All fluid on the cuffs leak after 10 minutes of traditional ways of measurement, however, no visible fluid on the cuffs leaked with improved procedures. ② Clinical research: the incidence of VAP in the observation group was slightly lower than that in the control group, however there was no significant difference [5.10% (16/314) vs. 8.43% (21/249), P > 0.05]. The duration of MV and the length of ICU stay in the observation group were significantly shorter than those in the control group (days: 9.93±3.14 vs. 16.77±5.45, 11.63 ±2.28 vs. 19.12±5.10, both P < 0.01). Conclusion The improved procedures of intra-cuff pressure measurement is a practical method to avoid the pressure leakage and fluid leakage, and the clinical course of MV patients can be significantly improved by combining the clusters of nursing strategies and actions.

Radiofrequency neurolysis in foramen ovale with extracranial non-semilunar ganglion for treatment of trigeminal neuralgia of mandibular branch / 中华神经医学杂志

Objective To observe the clinical effect of extracranial radiofrequency thermocoagulation in foramen ovale on trigeminal neuralgia of mandibular branch.Methods The clinical data of 107 patients with primary trigeminal neuralgia of mandibular branch,admitted to our hospital from January 2016 to December 2017,were collected.With oxygen inhalation and vital signs monitoring,percutaneous radiofrequency thermocoagulation of foramen ovale was performed under CT guidance.The inclination angle,puncture angle and depth,puncture operation time,intra-operative complications,and short-term and long-term results after operation were observed.Results All patients were punctured to the inside and the outside foramen of foramen ovale precisely under the guidance of CT location,and the inclination angle (angle between the puncture needle and the coronal plane),puncture angle (angle between the puncture needle and the sagittal plane),average puncture depth and average puncture operation time were (18.2±7.6)°,(15.9±4.6)°,(63.48±11.7) mm and (13.6±5.7) min,respectively.The pain in mandibular branch dominant area disappeared completely in 104 patients after radiofrequency thermocoagulation at 90 ℃ 120 seconds,and the sensation of needling in this area decreased;two patients had residual pain in anterior ear and temporal area,and one patient had residual pain in lingual tip side,which was cured after radiofrequency treatment again.No intracranial hemorrhage and infection complications occurred except for 21 with facial hematoma during operation.Follow up for 12-24 months showed 9 were recurrence.Conclusion For patients with primary trigeminal neuralgia of mandibular branch,the target of radioffequency therapy should be transferred from intracranial ganglion to extracranial trigeminal foramen (foramen ovale) for extracranial non-semilunar radiofrequency thermocoagulation therapy,which can obtain satisfactory results and improve the safety of radiofrequency therapy for trigeminal neuralgia.

CT-guided percutaneous puncture of stylomastoid foramen and radiofrequency ablation for treatment of primary hemifacial spasm / 中华神经医学杂志

Objective To observe the clinical effect of CT-guided percutaneous puncture of stylomastoid foramen and radiofrequency ablation on primary hemifacial spasm. Methods Twenty-seven patients with primary hemifacial spasm, admitted to and accepted CT-guided percutaneous puncture of stylomastoid foramen and radiofrequency ablation in our hospital from August 2018 to May 2019, were chosen in our study. Clinical data and efficacy of the patients were retrospectively analyzed. Results All patients were punctured to the stylomastoid foramen precisely under the guidance of CT localization; 21 could detect facial muscle twitch with 0.1-0.5 mA current, and positive results were also found in 6 patients with 0.5 mA current after adjusting the position of the needle tip. After standard radio frequency ablation (mean 83.3 ℃ for 23.7 seconds), 26 patients had complete disappearance of facial spasm, but left grade II (n=18) or grade III (n=8) facial paralysis; one patient with disappearance of abnormal electromyographic response waveform as the end criterion only partially relieved, but no facial paralysis. No facial hematoma, intracranial hemorrhage, infection, or death occurred. Follow-up for 2-12 months showed no recurrence or aggravation of facial paralysis. Conclusion CT-guided percutaneous puncture of stylomastoid foramen by radio frequency ablation can effectively treat primary hemifacial spasm, but there will be mild facial paralysis.