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Chinese materia medica has a wide range of clinical applications， but it has many active ingredients with different physicochemical properties， and the target organs， action pathways and mechanisms for different ingredients to exert their efficacy are not the same. Therefore， it is difficult to design and develop a co-delivery system loading multiple components of Chinese materia medica to maximize the synergistic therapeutic efficiency. Based on the characteristics of effectiveness and functionality of active ingredients， the strategies for multi-component co-delivery of Chinese materia medica can be categorized into two types：firstly， based on the effectiveness of active ingredients， new carriers such as liposomes， nanoparticles can be constructed to load multi-components of Chinese materia medica. secondly， based on the functionality of some active ingredients of Chinese materia medica， they are employed in the construction of co-delivery system， which can give play to the dual characteristics of their own efficacy and preparation functions. In this paper， we summarized the relevant research progress of the above two types of multi-component co-delivery strategies， and mainly discussed the pharmaceutical functions of the active ingredients in co-delivery systems， in order to find a more suitable multi-component co-delivery strategy， promoting the design and development of new delivery systems of Chinese materia medica.
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The gene GeDRP1E encoding dynamin-related protein 1E in Gastrodia elata was cloned by specific primers which were designed based on the transcriptome data of G. elata. Bioinformatics analysis on GeDRP1E gene was carried out by using ExPASy, ClustalW, MEGA, etc. Positive transgenic Arabidopsis plant and potato minituber were obtained with the genetic transformation system of Arabidopsis and potato. The plant height and seed setting rate of transgenic Arabidopsis, and agronomic characters, such as size, weight and starch content of potato minituber of transgenic potato were tested and analyzed. And GeDRP1E gene function was preliminarily investigated. The results showed that the open reading frame of GeDRP1E gene was 1 899 bp in length and 632 amino acids residues were encoded, with a relative molecular weight of 69.90 kDa and a molecular formula of C3079H4973N883O933S19. It was predicted that the theoretical isoelectric point was 7.27, the instability coefficient was 43.34, and the average hydrophilicity index was -0.259, which was indicative of an unstable hydrophilic protein. GeDRP1E has no transmembrane structure and signal peptide, and was localized in the cytoplasm. The phylogenetic tree showed that GeDRP1E was highly homologous with DRP1E proteins of other plant species, among which GeDRP1E had the highest homology with DcDRP1E (XP_020689662.1) in Dendrobium candidum, reaching 90.05%. GeDRP1E plant expression vector pCambia1300-35Spro-GeDRP1E was constructed by double digests, and Arabidopsis complementary mutant and potato overexpression strain of GeDRP1E gene were obtained by Agrobacterium-mediated gene transformation. Compared with the Arabidopsis AtDRP1E mutant, the height and seed setting rate of the GeDRP1E complementation mutant were rescued. The minituber of GeDRP1E overexpression potato had larger size, heavier weight and higher starch content, comparing to wild-type potato. It was preliminarily induced that GeDRP1E was involved in mitochondrial morphology regulation, which related to the growth and development of Arabidopsis plants and potato miniature. The research results laid a foundation for further elucidating the molecular mechanisms underlying the growth and development of G. elata tuber development.
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ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.
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@#Objective To assess mid- and long-term outcomes and share our clinical method of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods We retrospectively analyzed clinical data of 41 adult patients with aortic valve disease and ascending aortic dilatation before and after operation of RAA+AVR in Fuwai Hospital from January 2010 to July 2017. There were 28 male and 13 female patients aged 28-76 (53.34±12.06) years. Twenty-three patients received AVR+RAA using the sandwich technique (a sandwich technique group), while other 18 patients received AVR+ascending aorta wrap (a wrapping technique group). Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results There was no perioperative death. The mean preoperative AAD in the sandwich technique group and the wrapping technique group (47.04±3.44 mm vs. 46.67±2.83 mm, P=0.709) was not statistically different. The mean postoperative AAD (35.87±3.81 mm vs. 35.50±5.67 mm, P=0.804), and the mean AAD at the end of follow-up (41.26±6.54 mm vs. 38.28±4.79 mm, P=0.113) were also not statistically different between the two groups. There were statistical differences in AAD before, after operation and at follow-up in each group. All 41 patients were followed up for 23-108 (57.07±28.60) months, with a median follow-up of 51.00 months. Compared with that before discharge, the AAD growth rate at the last follow-up was –1.50-6.78 mm/year, with a median growth rate of 0.70 mm/year, and only 3 patients had an annual growth rate of above 3 mm/year. Conclusion Mid- and long-term outcomes of RAA in adult patients undergoing AVR with both methods are satisfying and encouraging.
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The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.
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Based on the concept of “imbalance of qi movement with the latent cancer toxin”， it is believed that the development process of tumor pre-metastatic niche （PMN） could be summarized as tumor derived secretory factors， exosomes and other “cancer toxin”， which latent in the body， were diffusion-prone by means of meridians and membrane-sources. Besides， the latent toxin induced the imbalance of qi movement， especially the distant weakest qi， and the local sweat pore and collateral vessels were blocked， which resulted in phlegm and blood stasis， and the cross-aggregation of poison. We also proposed therapeutic principles of PMN as first regulating qi and then clearing and expelling toxin， and tried to discuss the theoretical model of traditional Chinese medicine for PMN based on the theory of qi regulation and detoxification， aimed at providing ideas for the future theory construction of traditional Chinese medicine prevention and treatment for malignant tumor metastasis.
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As an important element of medical and health sector innovation, the translation of scientific and technological achievements plays a key role in promoting their clinical application and meeting the medical needs of the people. The authors sorted out the problems in such translation at these affiliated hospitals in terms of " people", " finance", " material", and " system". Starting from 2017, the Tenth People′s Hospital Affiliated to Tongji University has explored such practices as establishing hospital-led clinical medical science and technology innovation parks and technology service limited companies. These practices aimed to address the issues of insufficient hospital scientific and technological innovation capabilities and the gap between the hospital′s operation mechanism to translate its scientific and technological achievements and the enterprises and the market. The clinical medical science and technology innovation park integrating administration, industry, education, research, medicine and application, has taken multiple measures to attract excellent research talents and projects from within and beyond the hospital, promote the implementation of innovative scientific research projects. The hospital also established a health industry mode with engagement of social capital from large enterprises. The Technology Services Co., Ltd. was based on the incubation and translation of hospital achievements, combining market and clinical needs, promoting multi-party cooperation between hospitals and external enterprises, improving the chain operation mechanism of hospital scientific and technological achievements translation work, and alleviating the problem of insufficient research pilot funds and productibility funds by means of hospital-led fundraising. The number of patent authorizations of hospitals had increased from 23 cases in 2018 to 105 in 2022, and the amount of patent conversion had increased from 2 million yuan in 2020 to 11 million yuan in 2022. It is recommended that affiliated hospitals of universities further improve the organizational structure of achievement translation, strengthen their professional talent teams, improve their operation mechanism of achievement translation, build a platform for medical school-enterprise cooperation, and improve the evaluation mechanism of translation assessment, in order to promote a virtuous cycle of hospital′s scientific and technological achievement translation work.
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Objective:To explore the clinical value of aspirin combined with atorvastatin in the prevention of new onset atrial fibrillation after off-pump coronary artery bypass grafting (OPCABG).Methods:208 patients with coronary artery bypass grafting in our hospital from June 2019 to June 2021 were selected as the research subjects and divided by a random number table method into groups. The control group (104 cases) was treated with aspirin before operation, and the observation group (104 cases) was treated with aspirin and atorvastatin before operation. ECG monitoring was carried out continuously for 7 days of patients in the two groups, and the occurrence and duration of AF were recorded. The clinical therapeutic efficacy, incidence and adverse reactions of AF, left atrial diameter and high-sensitivity C-reactive protein (hs-CRP) level were observed before and after treatment.Results:The incidence of AF in the observation group was significantly lower than that in the control group, the difference was statistically significant ( P<0.05). There was no statistical significant difference in the starting time of AF between the two groups after operation ( P>0.05). The duration of AF in the observation group was better than that in the control group, the difference was statistically significant ( P<0.05). Before treatment, there was no statistical significant difference in left atrial diameter and hs-CRP level between the two groups ( P>0.05). After treatment, the left atrial diameter in the observation group returned to that before treatment, and there was no statistical significant difference in the same group ( P>0.05). The left atrial diameter in the control group was higher than that before treatment, and there was statistical significant difference in the same group ( P<0.05). The level of hs-CRP was lower than that in the control group, the difference was statistically significant ( P<0.05). There were no adverse reactions in both groups. Conclusion:Aspirin combined with atorvastatin has a significant effect in preventing new onset AF after OPCABG. It can reduce the incidence of postoperative AF, shorten the duration of AF, effectively control the inner diameter of left atrium, reduce the degree of postoperative inflammatory reaction, and has no adverse effects. It is worthy of clinical application.
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Compared with the traditional transfemoral approach, the transradial approach (TRA) can be used as a new alternative approach in the diagnosis and treatment of neurointervention, and has more advantages in reducing access site complications, improving the comfort of patients, shortening the length of hospital stay, and reducing the overall medical costs, so it has attracted clinical attention. This article mainly reviews the application of TRA in the field of neurointerventional diagnosis and treatment, as well as its advantages, complications and other aspects, and puts forward its application prospects in the field of neurointerventional diagnosis and treatment, so as to provide reference for the development of this technology in the field of neurointerventional diagnosis and treatment and further research in this field.
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Quantitative digital subtraction angiography (DSA) analysis can obtain pixel time density curves through changes in contrast agent concentration, and calculate the corresponding parameters of the contrast agent in the area of interest, achieving semi quantitative analysis of patient hemodynamic, used to evaluate the reperfusion status of intravascular therapy in patients with acute ischemic large vessel occlusion stroke. With the widespread application of artificial intelligence technology, especially deep learning algorithms in medical image processing, it is expected to further excavate the DSA images, which can comprehensively evaluate cerebral vascular diseases in multiple phases, angles, and directions.
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Objective:To explore the prognostic prediction value of quantitative digital subtraction angiography (DSA) parameters in patients with acute anterior circulation ischemic stroke undergoing mechanical thrombectomy, and whether the clinical values vary by stroke etiology.Methods:This study was a post hoc analysis of the Multicenter Prospective Captor Trial. Patients with acute anterior circulation large-vessel occlusion and successful recanalization from April 2018 to July 2019 were screened. Post-processing analysis was performed on the DSA imaging sequence after recanalization, and 4 regions of interest (ROI) were selected in the target vessel: ROI1 (the proximal of the internal carotid artery-C2 segment), ROI2 (the starting point of the internal carotid artery-C7 segment), ROI3 (the end of the middle cerebral artery-M1 segment), and ROI4 (the end of the middle cerebral artery-M2 segment). Time to peak (TTP) was defined as the time at contrast concentration of selected ROI reached its maximum. Relative TTP (rTTP) was calculated by subtracting the TTP of ROI1 from the TTP of distalis ROIs. Successful recanalization was defined as modified Thrombolysis In Cerebral Infarction (mTICI) grade≥2b. Favorable outcomes at 3 months were defined as the modified Rankin Scale score≤2. According to the modified Rankin Scale score, the patients were divided into good prognosis group and poor prognosis group. The differences in clinical characteristics, postoperative hemodynamic parameters, and other data were compared between patients with good and poor prognoses. Univariate and multivariate Logistic regression was used to analyze factors related to a good prognosis. Finally, the prognostic prediction value of hemodynamic parameters was analyzed in patients with different Trial of Org10172 in Acute Stroke Treatment etiological classifications.Results:A total of 245 patients were collected, of which 161 patients [age 69 (60, 76) years, 92 (57.1%) male] were finally included in the analysis, including 36 cases of large artery atherosclerosis (LAA) stroke, 76 cases of cardiogenic embolism (CE), and 49 cases of other causes of stroke. Seventy-one (44.1%) patients had favorable outcomes at 3 months. The post-operative hemodynamic analysis indicated that patients with favorable outcomes ( n=71) had a higher proportion of mTICI grade 3 [54/71 (76.1%) vs 41/90 (45.6%),χ 2=15.26, P<0.001] and lower rTTP 31 [means TTP ROI3-TTP ROI1;0.33 (0.23, 0.54) s vs 0.47 (0.31, 0.65) s, Z=-2.71, P=0.007] than patients with unfavorable outcomes ( n=90). The mTICI score and rTTP 31 were respectively included in multivariate Logistic regression models. It was shown that mTICI grade 3 (adjusted OR=5.97, 95% CI 2.49-14.27, P<0.001) and rTTP 31 (adjusted OR=0.24, 95% CI 0.06-0.99, P=0.048) were significantly associated with favorable outcomes, and the area under the receiver operating characteristic curve of the models had no statistically significant difference ( P=0.170). Subgroup analysis showed that rTTP 31 was significantly associated with the prognosis of patients with LAA stroke ( OR=0, 95% CI 0-0.25, P=0.014), while mTICI grade was associated with the prognosis of patients with CE ( OR=3.91, 95% CI 1.40-10.91, P=0.009) and other etiologies ( OR=7.35, 95% CI 1.92-28.14, P=0.004). Conclusions:In patients with acute anterior circulation ischemic stroke and successful recanalization, both mTICI score and rTTP 31 had significant predictive value for favorable outcomes at 3 months. Moreover, rTTP 31 was significantly associated with the prognosis of patients with LAA stroke, while mTICI score was significantly related to the prognosis of patients with CE and other causes of stroke.
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Objective:To evaluate the practical effect of online teaching based on reflective experience to promote the cultivation of professional core competence of nursing.Methods:A total of 160 intern nurses who entered the clinic from July 2019 to December 2019 in The Affiliated Hospital of Inner Mongolia Medical University were selected as the research subjects, and they were randomized into a control group and an experimental group, with 80 nurses in each group. Both groups were given the creation of clinical practice teaching online classroom under the existing nursing online teaching framework. The control group conducted general online course education, and the experimental group created a problem-solving reflective experience course task and teaching process from the core competence training content of nursing. After the internship, the core competence assessment of the standardized training for nursing major was conducted, and the difference in teaching was evaluated using the "Nurse Core Competency Scale" and the self-designed "Teaching Acceptance Questionnaire". SPSS 22.0 was used for t-test and Chi-square test. Results:The excellent rates of the professional theory and practical skills assessments of the students in the experimental group were 58.75% (47/80) and 51.25% (41/80), which were higher than those in the control group, 48.75% (39/80) and 31.25% (25/80). The differences between the two groups were statistically significant ( P<0.05). In the comparison of the "Core Competency Scale" of nurses between the two groups of nurse students, the total score of the experimental group and the score of each dimension were significantly higher than those of the control group ( P<0.05). They survey of "Teaching Acceptance Questionnaire" showed that the nursing students of the experimental group had higher recognition of the teaching methods of this group, and there were significant differences between the two groups ( P<0.05). Conclusion:Carrying out online training content of clinical practice teaching based on reflective experience is conducive to the establishment of core competence of nursing students and the improvement of clinical practice ability.
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Objective:To observe the effects of blue light intervention on the development of optical defocus-induced myopia in guinea pigs and investigate its underlying mechanisms.Methods:Forty-eight normal-grade two-week-old tricolor guinea pigs were randomly divided into a blue light group and a white light group, with 24 animals in each group.The right eye of guinea pigs was fitted with a -5.00 D lens to establish an optical defocus model as the experimental eye, while the left eye served as the control without any covering.Before the experiment and after 8-week intervention, the refractive power of guinea pigs was measured by streak retinoscopy.The anterior chamber depth, lens thickness, and axial length were measured by A-scan ultrasonography.Corneal curvature radius was determined using a keratometer.After 8-week intervention, the guinea pigs were euthanized through overanesthesia, and the right eyeballs were enucleated and the retinas were isolated.The density of S and M cone cells of the guinea pig retinal sections were observed via immunofluorescence staining.The expression of retinal retinoic acid was assessed by high-performance liquid chromatography.The expressions of retinoic acid receptor (RAR-β) in the retina and matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-2 (TIMP-2), and type Ⅰ collagen in the sclera were detected by real-time fluorescence quantitative PCR.Changes in scleral thickness were observed through hematoxylin-eosin staining.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.The study protocol was approved by the Ethics Committee of Eye and ENT Hospital of Fudan University (No.2022ETKLD10032).Results:After 8 weeks of intervention, guinea pigs in the blue light group showed (0.63±0.12)D of relative hyperopia and a deceleration of axial elongation by (0.08±0.00)mm compared with the white light group in the right eye.In the left eye, guinea pigs in the blue light group showed (0.42±0.09)D of relative hyperopia and a deceleration of axial elongation by (0.08±0.00)mm compared with the white light group.The guinea pigs in blue light group showed (1.52±0.09)D of myopia in the right eye compared with the left eye, with an increase in axial elongation of (0.06±0.00)mm.The guinea pigs in white light group showed (1.66±0.07)D of myopia in the right eye compared with the left eye, with an increase in axial elongation of (0.13±0.00)mm, and the differences were statistically significant (all at P<0.05). The density of M cone cells was lower and density of S cone cells was higher in the blue light group in the dorsal and ventral sides of the retinal sections compared with the white light group, showing statistically significant differences ( t=32.33, 52.23, 42.09, 25.02; all at P<0.05). The deceleration of myopia progression in the blue light group was strongly positively correlated with the increase in S cone cell density on the ventral side ( r=0.95, P<0.01). The expression levels of retinoic acid, RAR-β, and MMP-2 were decreased, and expression levels of TIMP-2 and type Ⅰ collagen were increased in blue light group compared with the white light group, showing statistically significant differences ( t=18.73, 7.45, 3.72, 6.19, 9.03; all at P<0.05). The scleral thickness in the blue light group was (125.0±7.8)μm, which was significantly thicker than (102.0±6.3)μm in the white light group ( t=26.93, P<0.05). Conclusions:Blue light intervention can inhibit the progression of defocus-induced myopia in guinea pigs.Refractive power changes in guinea pigs may be influenced by alterations in retinal cone cell density, retinoic acid expression, and scleral collagen expression.
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Objective:To analyze acupoint massage treatment of diabetic peripheral neuropathy point selection rules and practices for clinical treatment to provide evidence-based.Methods:Data mining was used to retrieve the relevant literature on acupressure for diabetic peripheral neuropathy from China Journal Full Text Database, Wanfang, VIP, and China Biomedical Literature Database, with a search time frame from the date of database creation to April 27, 2022. An Excel thematic database was created, then clustering analysis was performed by SPSS 25.0.Results:A total of 104 articles were included in the literature, with 49 acupoints. The commonly used acupoints in the lower limbs were Zusanli, Sanyinjiao, Taixi, Yongquan, etc. The commonly used acupoints in the upper limbs were Hegu, Quchi and Neiguan. The commonly used acupoints in the trunk were Guanyuan, Zhongwan and Shenshu. The frequency of the five acupoints was the highest, accounting for 59.40%(335/564). The meridians were mainly the spleen meridian of foot Taiyin, the kidney meridian of foot Shaoyin and the stomach meridian of foot Yangming, among them, the frequency of the spleen meridian of foot Taiyin was the highest, accounting for 22.7%(128/564). Three effective clusters were obtained by analyzing massage acupoints and manipulations.Conclusions:According to the analysis, high-frequency acupoints are mainly distributed in the three meridians of foot Taiyin spleen meridian, foot Shaoyin kidney meridian and foot Yangming stomach meridian. In the future, acupoint selection and massage techniques can be further standardized and supplemented by acupoint massage along meridians to explore its clinical effect on diabetic peripheral neuropathy.
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Objective:To analyze the hotspots and frontiers of diabetic peripheral neuropathy nursing research in the past decade in China, and to provide nursing staff with a reference basis for understanding and grasping the direction of research.Methods:The literature related to diabetic peripheral neuropathy nursing from January 1, 2012 to December 31, 2021 was searched through China Journal Full Text Database, China Biomedical Literature Database, CQVIP, and Wanfang, and visualized and analyzed by using CiteSpace software.Results:A total of 763 articles were included in the literature, and the number of articles was analyzed to show a significant upward trend in 2018-2021, with the most articles by authors being 4 each by Liu Dan and An Caixia, and the most articles by institutions being 6 and 5 by Nanjing Chinese Medicine Hospital and Shanghai Jiading District Chinese Medicine Hospital, respectively, with research hotspots being complications related to diabetic peripheral neuropathy, rehabilitation care, and special Chinese medicine care techniques, and research frontiers being quality of life and neurological function.Conclusions:The research base of diabetic peripheral neuropathy is weak, and researchers should focus on the frontiers of international research hotspots in diabetic peripheral neuropathy care to help nursing research produce prospective, high-impact research results and improve patient clinical outcomes.
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Pulmonary fibrosis is a chronic， progressive and irreversible interstitial lung disease. At present， there is no specific drug for the treatment of pulmonary fibrosis， and many TCM monomers have potential therapeutic value for pulmonary fibrosis， among which flavonoids are the main representative. For example， total flavones of Astragalus memeranaceus and scutellarin can reduce inflammatory cell infiltration， lung injury and extracellular matrix （ECM） deposition by interfering with transforming growth factor-β1/drosophila MAD protein signaling pathway. Total flavonoids of Oxytropis falcata Bunge and salidroside can inhibit lung inflammation by mediating JAK/signal transduction and transcriptional activator signaling pathway， and prevent the epithelial interstitial transition （EMT） process. Quercetin and Ginkgo biloba leaf extract can reduce the apoptosis of macrophages by inhibiting the nuclear factor-κB signaling pathway and play an anti-pulmonary fibrosis role. Urushetin and proanthocyanidins can promote the morphological recovery of myofibroblasts and reduce ECM deposition through the phosphatidylinositol 3-kinase/protein kinase B/mammalian target protein of rapamycin signaling pathway. Naringin and luteolin can inhibit scorch death of macrophage and inflammation response， and improve lung function and lung tissue injury through NOD-like receptor heat protein domain related protein 3 signaling pathway. The ethanol extract of Phyllanthus emblica and calycosin can improve the inflammatory injury and fibrosis of lung tissue by activating the signaling pathway of nuclear transcription factor erythro2-related factor 2/antioxidant response element. Isogliquiritin can inhibit the phenotypic transformation of epithelial cells and reverse EMT progression by inhibiting extracellular signal-regulating kinase signaling pathway. In the future， scholars should consider developing appropriate drug carriers to improve their bioavailability and further study drug targets and pathways， to provide evidence for the development of traditional Chinese medicine monomers of flavonoids into clinical practice.
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To investigate the cardioprotective effect of formononetin (FMN) on no-reflow (NR) after myocardial ischemia-reperfusion and its molecular mechanism based on integrated pharmacology and experimental verification, firstly, human breast cancer MCF-7 cells and myocardial NR rats were used to confirm the estrogenic activity and the effect of alleviating NR of FMN, respectively. Male SD rats were divided into Sham, NR, FMN (20 mg·kg-1) and sodium nitroprusside (SNP, 5.0 mg·kg-1) groups, which were administered once a day for one week, the experiment was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (TCM-LAEC2019095). The pharmacological analysis and in vivo study of NR rats were integrated to reveal the mechanism of FMN improving NR. The results showed that FMN had estrogenic effect and reduced NR by improving cardiac structure and function, reducing NR, ischemic myocardial area and pathological injury of cardiomyocytes. Integrated pharmacology predicts that the mechanism of FMN improving NR is mainly related to phosphatidyinositol-3-kinase-protein kinase B (PI3K-Akt) signal pathway. Phytoestrogens play a role in cardiovascular protection mainly by activating G protein-coupled estrogen receptor (GPER). GPER is also an important regulator in the upstream of PI3K-Akt signaling pathway. This study found that FMN can significantly activate GPER, p-PI3K, p-Akt and phospho-endothelial nitric oxide synthase (p-eNOS). It has good binding ability with GPER and eNOS protein. In this study, through the integration of pharmacology and experimental evaluation, it is revealed that FMN activates PI3K/Akt/eNOS signal pathway by activating GPER, thus significantly improving NR.
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@#Objective To investigate the feasibility and effectiveness of using ultrasound to evaluate the internal mammary artery (IMA) and explore the related factors affecting the quality of IMA. Methods From July 2020 to January 2021, for patients who underwent coronary artery bypass grafting at the Department of Cardiovascular Surgery, Fuwai Hospital, ultrasound was applied to measure bilateral IMA at the parasternal second intercostal space. There were 62 males and 18 females with an average age of 59.9±8.3 years. The clinical data of the patients were recorded and analyzed. Results A total of 160 IMA were measured. The IMA was detected in 99.4% (159/160), and the one that was not measured was proved to be occluded by enhanced CT. A total of 157 (98.1%) IMA intima were smooth, 2 (1.3%) were found to have uneven intimal thickening and less smooth, and only 1 (0.6%) was occluded. The intravascular diameter, peak systolic flow rate, peak diastolic flow rate, and blood flow rate of the left second intercostal IMA were 1.9±0.3 mm, 66.8±17.7 cm/s, 6.4 (0.0, 9.7) cm/s, 19.7±9.4 mL/min; and those of the right one were 2.1±0.3 mm, 69.7±18.5 cm/s, 6.0 (0.0, 9.2) cm/s and 22.8±11.5 mL/min, respectively. IMA vessel diameter and blood flow were greater on the right than those on the left side in the same individual (P<0.01). In univariate analysis, sex and body surface area were the factors that influenced the size of the IMA vessel among different individuals, and by linear regression analysis, the size of the IMA vessel was only related to body surface area among different individuals. On univariate analysis, diabetes mellitus was the only factor affecting IMA blood flow, with a mean reduction in blood flow of 18.4% (left) and 21.7% (right) in the diabetic group (P<0.05). Conclusion Preoperative evaluation of the IMA using ultrasound over the parasternal second intercostal space is easy, noninvasive, and has a high success rate. The internal diameter of the IMA is positively correlated with body surface area, and blood flow is significantly reduced in patients with diabetes.
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【Objective】 To investigate the applicability of Beckman PK7300 for TPPA testing on anti-TP reactive specimens from blood donors. 【Methods】 1) The TPPA test using Beckman PK7300 (abbreviated as instrument method) had been established and the performance was verificated by calculating the total compliance rate, positive compliance rate and negative compliance rate as compared with the manual method. The repeatability of this instrument method was also evaluated. 2) The applicability of the instrument method was evaluated by examing 555 TP-reactive samples for 6 consecutive days, so as to analyze the readable reading rate, agglutination strength distribution and other control methods. 【Results】 1) The total, positive, and negative compliance rates of TPPA detection by both instrumental and manual methods were 100% (kappa value =1). The SPC value of samples, read manually as " + + ", was less than or equal to 3 by Beckman PK7300; the SPC value of samples, read manually as " -", was greater than or equal to 20 by Beckman PK7300. The two methods were well consistent. The instrument method was repeated for 12 times for the same samples, and the accuracy rate was 100% (12 / 12), with good repeatability.2) The results of the TPPA test in 555 anti-TP reactivity specimens showed an overall readable rate of 99.82%(554/555). The SPC values of the negative and unsensitized particles of TPPA were distributed on both sides of the determination value without crossover. The control and monitor thoughout the test were carried out automatically by the instrument. 【Conclusion】 The TPPA test conducted by the Beckman PK7300 fully automatic blood group instrument is suitable for the confirmatory experiment of anti-TP reactive specimens in blood center laboratories, which could realize the automation and standardization of TPPA detection.
Résumé
Objective: To explore the dynamic changes in serum lipid levels and nutritional status during BCMA-CAR-T-cell therapy in patients with refractory or relapsed multiple myeloma (R/R MM) based on LEGEND-2. Methods: The data of patients with R/R MM who underwent BCMA-CAR-T therapy at our hospital between March 30, 2016, and February 6, 2018, were retrospectively collected. Serum lipid levels, controlled nutritional status (CONUT) score, and other clinical indicators at different time points before and after CAR-T-cell infusion were compared and analyzed. The best cut-off value was determined by using the receiver operator characteristic (ROC) curve. The patients were divided into high-CONUT score (>6.5 points, malnutrition group) and low-CONUT score groups (≤6.5 points, good nutrition group), comparing the progression-free survival (PFS) and total survival (OS) of the two groups using Kaplan-Meier survival analysis. Results: Before the infusion of CAR-T-cells, excluding triglycerides (TG), patients' serum lipid levels were lower than normal on average. At 8-14 d after CAR-T-cell infusion, serum albumin (ALB), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and apolipoprotein A1 (Apo A1) levels dropped to the minimum, whereas CONUT scores reached the maximum. In addition to TG, apolipoprotein B (Apo B) levels increased compared with baseline. After CAR-T-cell therapy, the patients' serum lipid levels significantly increased with well-improved nutritional status. Spearman's related analysis showed that TC, HDL, and ApoA1 levels after CAR-T-cell injection were significantly negatively correlated with the grade of cytokine-release syndrome (CRS) (r=-0.548, P=0.003; r=-0.444, P=0.020; r=-0.589, P=0.001). Furthermore, survival analysis indicated that the CONUT score was unrelated to PFS, and the median OS of patients with R/R MM in the high-CONUT score group was shorter than that in the low-CONUT score group (P=0.046) . Conclusions: During CAR-T-cell therapy, hypolipidemia and poor nutritional status were aggravated, which is possibly related to CRS. The patients' serum lipid levels and nutritional status were significantly improved after CAR-T-cell treatment. The CONUT score affected the median OS in patients treated with CAR-T-cells. Therefore, specific screening and intervention for nutritional status in patients receiving CAR-T-cell therapy are required.