Methodological Evaluation of Advantages of Traditional Chinese Medicine Treatment of Sjögren's Syndrome / 中国实验方剂学杂志

Screening and evaluating the diseases responding specifically to traditional Chinese medicine （TCM） will help to highlight the advantages of TCM treatment， and the evaluation method should be standardized with consideration to the unique characteristics of the diseases. The incidence of Sjögren's Syndrome （SS） is increasing year by year， while the pathogenesis of this disease remains unclear. Modern therapies for this disease include biological agents and immunosuppressants， which generally have unsatisfactory efficacy. The TCM treatment of SS focuses on the harmony of the physical and mental health. The Rheumatology Branch of the China Association of Chinese Medicine organizes experts in TCM， Western medicine， and evidence-based medicine to form working groups. Delphi method and bibliometric method were used for analysis， and SS was selected as a disease responding specifically to TCM. Furthermore， the evaluation system was established for this disease， and the consensus regarding this disease was reached after seminar discussion. This paper summarized the whole process of the evaluation of the advantages of TCM treatment of SS. First， because TCM atomization is widely used in clinical practice and enriches TCM administration methods， this therapy is included after other non-drug therapies were taken as characteristic therapies. Second， the evaluation indicators of therapeutic effect should be determined with consideration to international acceptance and the current research status. Third， the expression method should be accurate， standardized， and objective， highlight the natural advantages of TCM， and avoid arbitrary extension. This paper provides a reference for clinicians to explore other diseases responding specifically to TCM.

Oxamate alleviates silicotic fibrosis in mice by inhibiting senescence of alveolar type II epithelial cells / 环境与职业医学

Background The senescence of alveolar type II epithelial cells is an important driving factor for the progression of silicotic fibrosis, and the regulatory effects of oxamate on the senescence of alveolar type II epithelial cells is still unclear. Objective To explore whether lactate dehydrogenase inhibitor oxamate can alleviate silicotic fibrosis in mice by inhibiting senescence of alveolar type II epithelial cellsMethods This study was divided into two parts: in vivo experiments and in vitro experiments. In the first part, forty SPF C57BL/6J male mice were randomly divided into four groups with 10 in each group: control group, silicosis model group, low-dose oxamate treatment group, and high-dose oxamate treatment group. The silicotic mouse model was established by intratracheal instillation of 50 μL SiO2 suspension (100 mg·mL−1). The treatment models were prepared by intraperitoneal injection of 100 μL oxamate (225 mmol·L−1 and 1125 mmol·L−1). In the second part, induction of MLE-12 mouse alveolar type II epithelial cells was conducted with SiO2. The in vitro experimental groups were ① SiO2 induction groups: control group, 50 μg·mL−1 SiO2 group, 100 μg·mL−1 SiO2 group, and 200 μg·mL−1 SiO2 group, and ② oxamate treatment groups: control group, SiO2 group (100 μg·mL−1), low-dose oxamate (25 mmol·L−1) treatment group, and high-dose oxamate (50 mmol·L−1) treatment group. Pathological morphology of lung tissues was evaluated after hematoxylin-eosin (HE) staining; deposition of collagen in lung tissues was evaluated after sirius red staining; positive co-expression of prosurfactant protein C (Pro-SPC) and β-galactosidase was detected by immunofluorescence staining; positive expression of β-galactosidase in MLE-12 cells was detected by immunofluorescence staining. The protein expression levels of collagen type I (CoL I), fibronectin1 (FN1), hexokinase 2 (HK2), pyruvate kinase isozyme type M2 (PKM2), lactate dehydrogenase A (LDHA), p-ataxia telangiectasia and Rad3-related kinase (ATR), and cyclin-dependent kinase inhibitors p21, and p16 were detected by Western blotting. Results Compared with the control group, the protein expression levels of HK2, PKM2, LDHA, p-ATR, p21, and p16 were significantly upregulated in the silicosis model group and the SiO2-induced MLE-12 cells (P＜0.05). The in vivo studies showed that, compared with the control group, the silicon nodule area, the collagen deposition area, the proportion of β-galactosidase positive cells, and the protein expression levels of CoL I, FN1, LDHA, p-ATR, p21, and p16 were significantly upregulated in the silicosis model group (P＜0.05). Compared with the silicosis model group, the oxamate treatment groups showed significant downregulation of the silicon nodule area, the collagen deposition area, the proportion of β-galactosidase positive cells, and the the CoL I, FN1, LDHA, p-ATR, p21, and p16 protein expression levels, and the high-dose oxamate treatment group showed a higher efficacy on these indicators than the low-dose oxamate treatment group (P＜0.05). The in vitro studies showed that, compared with the control group, the proportion of β-galactosidase positive cells and the protein expression levels of p-ATR, p21, and p16 were significantly upregulated in the SiO2-induced group (P＜0.05). Compared with the SiO2 group, the proportion of β-galactosidase positive cells and the LDHA, p-ATR, p21 and p16 protein expression levels were significantly downregulated in the oxamate treatment groups, and the high-dose oxamate treatment group showed a higher efficacy on these indicators than the low-dose oxamate treatment group (P＜0.05). Conclusion Lactate dehydrogenase inhibitor oxamate can alleviate silicotic fibrosis in mice by inhibiting the senescence of alveolar type II epithelial cells.

Intervention effect of physical exercise on silicotic mice / 环境与职业医学

Background Pneumoconiosis is the most serious occupational disease in China, and silicosis accounts for about half of it. Any intervention effect of physical exercise as the key and core of lung rehabilitation training on silicosis is still unclear. Objective To explore potential intervention effect of physical exercise on silicotic mice. Methods Forty SPF C57BL/6 male mice were randomly divided into four groups, 10 in each group, including a control group, a physical exercise group, a silicosis model group, and a silicosis model + physical exercise intervention group. Silicotic mouse model was established by using 50 μL SiO2 suspension (200 mg·mL−1). A treadmill was used to prepare mice receiving physical exercise at 0° inclination, 12.3 m·min−1, 60 min·d−1, 5 d·week−1 for 4 weeks. Pathological morphology of lung tissues was evaluated after hematoxylin-eosin (HE) staining; deposition of collagen in lung tissues was evaluated after Van Gieson (VG) staining; expression of p-protein kinase R-like endoplasmic reticulum kinase (PERK) was detected by immunofluorescence staining; expressions of cyclin dependent kinase inhibitors (p21) and p-p38 mitogen activated protein kinase (p38) were detected by immunohistochemistry. The protein expressions of endoplasmic reticulum stress signal factors [p-inositol-requiring enzyme-1α (p-IRE-1α), p-PERK, and p-eukaryotic initiation factor-2α (p-eIF-2α)], senescence signal factors (p-p53, p21, and p16), mitogen-activated protein kinase (MAPK) signal factors [p-p38, p-extracellular regulated protein kinases (p-ERK), and p-stress-activated protein kinase (p-JNK)] were detected by Western blotting. Results After designed acute SiO2 exposure, the images of micro computed tomography (CT) showed high density shadows in lung tissues of the silicotic mice and less shadows in lung tissues of the physical exercise intervention mice. After HE staining, the proportions of silicotic nodule area in lung tissues was (18.67±3.89) % in the silicosis model group, and significantly decreased to (8.78±1.05) % in the silicosis model + physical exercise intervention group (P<0.05). After VG staining, the proportion of collagen fiber area of lung tissues was (10.37±2.18) % in the silicosis model group, and significantly decreased to (4.35±0.89) % in the silicosis model + physical exercise intervention group (P<0.05). The results of immunofluorescence staining showed that in the silicosis model group, the expression of p-PERK increased at the location of silicotic nodules, while in the silicotic model + physical exercise intervention group, the expression of p-PERK decreased. The immunohistochemical staining results showed that the expression of p21 and p-p38 increased in the lung tissues of the silicosis model group; the expression of p21 and p-p38 decreased in the lung tissues of the silicosis model + physical exercise intervention group. The results of Western blotting showed that compared with the control group, the expression levels of p-IRE-1α (0.11±0.03), p-PERK (0.95±0.40), p-eIF-2α (3.53±0.91), p-p53 (1.78±0.07), p21 (1.98±0.10), p16 (1.26±0.17), p-p38 (0.41±0.09), p-ERK (0.42±0.05), and p-JNK (3.20±1.23) of the silicosis model group were all upregulated (P<0.05). Compared with the silicosis model group, the expression levels of p-IRE-1α (0.03±0.01), p-PERK (0.31±0.12), p-eIF-2α (0.30±0.06), p-p53 (0.76±0.08), p21 (0.18±0.11), p16 (0.70±0.24), p-p38 (0.03±0.00), p-ERK (0.19±0.03), and p-JNK (0.46±0.21) of the silicosis model + physical exercise intervention group were downregulated (P<0.05). Conclusion Physical exercise may alleviate pulmonary fibrosis in silicotic mice, and inhibit abnormal expressions of endoplasmic reticulum stress signal, MAPK signal, and senescent signal.

Necrolytic Migratory Erythema—A Case Report of Pancreatic Occupying Lesion / 罕见病研究

Glucagonoma is a rare neuroendocrine tumor of α cells of the pancreas. The tumor excessively secretes glucagon and causes glucagonoma syndrome.70%-90% of patients with glucagonoma will develop necrolytic migratory erythema (NME). We reported a patient of glucagonoma syndrome who was presented to the dermatology outpatient clinic with a 2-year-history of recurrent erythema and scaling on the skin migrating throughout the body. A skin biopsy was performed and resulting features matched with NME, whilst imaging examinations suggested a soft tissue density tumor present in the tail of the pancreas with somatostatin receptor expression and laboratory tests found an elevated levels of serum glucagon. After the diagnosis was confirmed, the patient was treated with surgical resection of the glucagonoma and the skin eruptions resolved rapidly in 4 days. Meanwhile, we reviewed relevant literature published in recent years and summarized its clinical characteristics in order to improve its understanding by clinicians, including clinical manifestations, laboratory and imaging examinations, diagnosis and treatments.

Online pharmaceutical process analysis of Chinese medicine using a miniature mass spectrometer:Extraction of active ingredients as an example / 药物分析学报

The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.

Analysis of laboratory characteristics and evaluation of prognostic value of patients with NPM1 mutated acute myeloid leukemia / 中华检验医学杂志

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.

Correlation between preoperative platelet parameters and clinicopathological features of differentiated thyroid cancer / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the correlation between preoperative platelet parameters and the clinicopathological features of differentiated thyroid cancer. Methods:We retrospectively analyzed the medical records of patients with thyroid tumors admitted to Zhongda Hospital affiliated to Southeast University and healthy adults with normal physical examination results in our hospital from January 2019 to December 2020, and collected their general information and preoperative blood routine data. Patients with undifferentiated thyroid cancer, diabetes, coronary heart disease, hematological diseases, kidney diseases, autoimmune diseases, genetic diseases, infectious diseases, other systemic tumors, hepatitis or cirrhosis, or those taking anticoagulants were excluded. The exclusion criteria for healthy adults were the absence of the above diseases and normal physical examination results. Differences in platelet parameters among the three groups were compared, and the correlation between clinicopathological characteristics of thyroid cancer, accompanying cervical lymph node metastasis, and platelet parameters of patients was analyzed. A multivariate logistic regression model was used to analyze the risk factors of thyroid cancer with cervical lymph node metastasis. Results:A total of 117 cases of differentiated thyroid cancer were collected, including 33 males and 84 females, with an average age of （41.64±12.25） years; 46 patients had benign thyroid tumors, including 15 males and 31 females, with an average age of （41.35±12.52） years; 50 healthy adults with normal physical examination results in our hospital during the same period were also included, including 18 males and 32 females, with an average age of（42.02±9.62） years, without underlying diseases. The platelet count of the differentiated thyroid cancer group was higher than that of the benign thyroid tumor group（t=-2.219, P=0.028） and the normal control group（t=2.069, P=0.04）, while the platelet distribution width of the differentiated thyroid cancer group was lower than that of the benign thyroid tumor group（t=2.238, P=0.027） and the normal control group（t=-2.618, P=0.002）. These differences were statistically significant. Preoperative age ≤45 years（χ²=4.225, P=0.04）, tumor diameter>1 cm（χ²=4.415, P=0.036）, PLT（t=-4.018, P<0.01） increase, and PDW（t=4.568, P<0.01） decrease were significantly correlated with cervical lymph node metastasis of thyroid cancer and had statistical significance. Univariate analysis showed that age ≤45 years（OR=0.447, 95%CI 0.206-0.970, P=0.042）, tumor diameter>1 cm（OR=2.3, 95%CI 1.050-5.039, P=0.037）, PLT（OR=1.012, 95%CI 1.005-1.019, P=0.001）, and PDW（OR=0.693, 95%CI 0.518-0.827, P<0.01） were risk factors for cervical lymph node metastasis of thyroid cancer. The results of multifactorial logistic regression analysis showed that PLT（OR=1.008, 95%CI 1.001-1.016, P=0.026） and PDW（OR=0.692, 95%CI 0.564-0.848, P<0.01） were independent risk factors for thyroid cancer with cervical lymph node metastasis. Conclusion:PLT and PDW may be useful predictive factors for the differentiation of thyroid cancer malignancy and central lymph node metastasis.

Retrospective Study of Anesthesia Recovery after Knee Arthroscopy under Spinal Anesthesia / 中国运动医学杂志

Objective To observe the recovery of superficial sensation and movement of lower limbs,the first urination and exhaust of patients after knee arthroscopy under spinal anesthesia.Methods Sev-enty-two patients undergoing arthroscopic knee surgery under subarachnoid anesthesia in the Sports Medicine Department of a class-3 grade-A hospital in Beijing between May and November 2020 were selected,including 56 males and 16 females,ranging in age from 13 to 59.The recovery time of su-perficial sensation and movement,first urination and exhaust were observed and recorded respectively.Then,the correlation of the above indexes to gender,age,weight,operation duration,tourniquet time and anesthesia time was analyzed.Results The patients regained their superficial feeling and lower limbs mobility 333.40±115.04 and 263.13±84.48 min after the anesthesia,with the recovery of the lower limbs movement 100 minutes earlier than the superficial feeling.Moreover,the first urina-tion and exhaust time were 358.33±111.78 min and 354.51±130.16 min after the lumbar anesthe-sia,respectively.In addition,the superficial feeling,lower limbs mobility and first urination of the males were 352.05±115.18 min,274.55±84.77 min and 376.43±113.25 min after the anesthe-sia,significantly later than the females(268.13±90.29 min,t=2.684,P=0.009;223.13±72.36 min,t=2.205,P=0.031;295.00±81.34 min,t=2.679,P=0.009).However,no significant differences were found between different sexes in their first exhaust(P>0.05).Moreover,superficial sense and motion re-covery were not correlated with the age and weight,as well as the durationof surgery,hemostatic band application and anesthesia(P>0.05).Conclusion The motion recovery after knee arthroscopy under subarachnoid anesthesia is earlier than the superficial sensation,followed by the first urination and first exhaust.Female patients regain their superficial sensation,movement and the first urination about 4～6 hours after anesthesia,earlier than males as they do about 6～8 hours after it.

Clinical value of endoscopic biliary drainage for biliary fistula / 中华消化内镜杂志

Objective:To evaluate the efficacy and safety of endoscopic biliary drainage for biliary fistula.Methods:Data of consecutive 409 biliary fistula patients who were treated and diagnosed at the First Medical Center of Chinese PLA General Hospital from November 2002 to November 2022 were reviewed, and 53 patients who received endoscopic retrograde cholangiopancreatography (ERCP) drainage were finally included. General information, procedural conditions, clinical outcomes and adverse events were analyzed. The patients were categorized into two groups: the endoscopic retrograde biliary drainage (ERBD) group ( n=46) and the endoscopic nasobiliary drainage (ENBD) group ( n=7). Procedural characteristics, operation outcomes, and operation time were compared between the two groups. Results:There were 36 males and 17 females, with the age of 52.2±12.7 years, among whom 58.5% (31/53) were secondary to cholecystectomy. Clinical success was achieved in 83.0% (44/53) patients, with the operation time of 27.0 (13.5, 33.5) minutes and the treatment session of 1 (1, 2). The time to resolution was 89 (47, 161) days. The success rate of ERCP for low-grade biliary fistula was higher compared with that of high-grade biliary fistula [96.4% (27/28) VS 68.0% (17/25), χ2=7.57, P=0.006]. Bridging drainage achieved higher success rate compared with that of non-bridging drainage [91.7% (33/36) VS 64.7% (11/17), χ2=5.95, P=0.015], while different diameters of stents (≥10 Fr VS <10 Fr) achieved similar success rate [81.8% (27/33) VS 84.6% (11/13), χ2=0.05, P=0.822]. Adverse events occurred in 10 patients (18.9%), including 6 pancreatitis, 2 bleeding, 1 cholangitis and 1 death. Except for 1 death, 9 other adverse events were mild and managed with conservative treatment without interventions. There was no significant difference in clinical success rate [6/7 VS 82.6% (38/46), χ2=0.04, P=0.838] or the median operation time [28.0 min VS 23.0 min, Z=0.38, P=0.774] between ENBD group and ERBD group. Conclusion:Endoscopic biliary drainage is safe and effective for biliary fistula. ENBD and ERBD have comparable clinical efficacy. ERCP for low-grade biliary fistula may achieve a higher success rate, and bridging drainage may facilitate fistula resolution.

Effects of resistance training on weight in college students / Efeitos do treinamento de resistência sobre o peso em universitários / Efectos del entrenamiento de resistencia sobre el peso en estudiantes universitarios

ABSTRACT Introduction: Obesity has a great negative impact on college students, affecting their physical and mental health. It is believed that resistance training, as an aerobic exercise that promotes muscle hypertrophy, can promote an obesity-reducing effect in this class of individuals. Objective: Assess the effects of resistance training with loads on weight in college students. Methods: 120 obese college student volunteers were equally and randomly divided into groups for the experiment. The experimental groups A and B received resistance training with different loads, while the control group received only regular aerobic training. For statistical analysis and discussion, body indices such as perimetry and BMI were collected before and after the intervention. Results: After the experiment, the body weight of experimental group A changed from 81.62±4.12 to 76.20±5.49, BMI from 27.22±1.67 to 25.98±1.74, waist circumference from 89.11±5.62 to 87, 27±6.34, hip circumference from 101.61±5.43 to 98.45±5.62, waist/hip ratio from 0.89±2.34 to 0.87±2.13, and body fat ratio from 27.58±3.83 to 22.61±2.99. Significant changes were also noticed in the data of experimental group A after resistance training with different loads. These changes were similar to those of the experimental group B, but changes in the control group data were not evidenced. Conclusion: Resistance training with loads can help obese college students improve their body composition and physical quality. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A obesidade tem um grande impacto negativo sobre os estudantes universitários, tanto sobre a saúde física, quanto também na saúde mental. Acredita-se que o treinamento de resistência, como um exercício aeróbico promotor de hipertrofia muscular, possa promover um efeito redutor da obesidade nessa classe de indivíduos. Objetivo: Verificar os efeitos do treinamento de resistência com cargas sobre o peso em estudantes universitários. Métodos: 120 estudantes universitários obesos voluntários foram divididos igual e aleatoriamente em grupos para o experimento. Os grupos experimentais A e B receberam treinamento de resistência com cargas diferentes, enquanto o grupo de controle recebeu apenas o treinamento aeróbico comum. Índices corporais como perimetria e IMC foram coletados antes e após da intervenção para análise estatística e discussão. Resultados: Após o experimento, o peso corporal do grupo experimental A alterou de 81,62±4,12 para 76,20±5,49, o IMC de 27,22±1,67 para 25,98±1,74, a circunferência da cintura de 89,11±5,62 para 87,27±6,34, circunferência do quadril de 101,61±5,43 para 98,45±5,62, relação cintura/quadril de 0,89±2,34 para 0,87±2,13, e relação de gordura corporal de 27,58±3,83 para 22,61±2,99. Também forma notadas alterações significativas nos dados do grupo experimental A após o treinamento de resistência com cargas distintas. Essas alterações foram similares às do grupo experimental B, porém as alterações nos dados do grupo controle não foram evidenciadas. Conclusão: O treinamento de resistência com cargas pode efetivamente ajudar aos estudantes universitários obesos a melhorarem a sua composição corporal e qualidade física. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La obesidad tiene un gran impacto negativo en los estudiantes universitarios, tanto en la salud física como mental. Se cree que el entrenamiento de resistencia, como ejercicio aeróbico promotor de hipertrofia muscular, puede promover un efecto reductor de la obesidad en esta clase de individuos. Objetivo: Verificar los efectos del entrenamiento de resistencia con cargas sobre el peso en estudiantes universitarios. Métodos: 120 estudiantes universitarios obesos voluntarios fueron divididos equitativa y aleatoriamente en grupos para el experimento. Los grupos experimentales A y B recibieron entrenamiento de resistencia con diferentes cargas, mientras que el grupo de control sólo recibió entrenamiento aeróbico regular. Se recogieron índices corporales como la perimetría y el IMC antes y después de la intervención para su análisis estadístico y discusión. Resultados: Tras el experimento, el peso corporal del grupo experimental A pasó de 81,62±4,12 a 76,20±5,49, el IMC de 27,22±1,67 a 25,98±1,74, la circunferencia de la cintura de 89,11±5,62 a 87, 27±6,34, el perímetro de la cadera de 101,61±5,43 a 98,45±5,62, el cociente cintura/cadera de 0,89±2,34 a 0,87±2,13, y el cociente de grasa corporal de 27,58±3,83 a 22,61±2,99. También se observaron cambios significativos en el grupo experimental A tras el entrenamiento de resistencia con diferentes cargas. Estas alteraciones fueron similares a las del grupo experimental B, sin embargo, no se evidenciaron alteraciones en los datos del grupo control. Conclusión: El entrenamiento de resistencia con cargas puede ayudar eficazmente a los estudiantes universitarios obesos a mejorar su composición corporal y su calidad física. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Application of Endoscopic Parathyroidectomy in the Treatment of Primary Hyperparathyroidism / 中华内分泌外科杂志

Objective:To summarize the experience and the clinical data of patients with primary hyperparathyroidism undergoing endoscopic parathyroidectomy.Methods:A total of 24 patients who underwent endoscopic parathyroidectomy for primary hyperparathyroidism in Peking Union Medical College Hospital during Feb. 2021 to May. 2022 were concluded in this study (20 cases of parathyroidectomy via axillary approach and 4 cases of parathyroidectomy via thoracic and breast approach) . The operation time, postoperative drainage, length of stay, level of parathyroid hormone and serum calcium of those patients were collected. Postoperative complications and recurrence of hyperparathyroidism were also observed.Results:The postoperative levels of serum parathyroid hormone and serum calcium were significantly reduced (over 50%) compared with preoperative level ( P<0.05) . The average operation time was (96±22) min (64-157 min) . The mean postoperative drainage volume was (47±16) ml on day 1, (46±11) ml on day 2, and (30±9) ml on day 3, respectively. The average length of postoperative hospital stay was (2.8±1.1) days (2-6 days) . In one case of parathyroidectomy via axillary approach, the operation was converted to open surgery because of the low position of lesion. Other cases completed endoscopic surgery and obtained satisfactory cosmetic results. There were no postoperative complications such as bleeding, permanent hoarseness, coughing while drinking water, or surgical site infection. The mean follow-up time was (7.4±4.2) months (1-16 months) . There was no obvious discomfort and no recurrence during follow-up. Conclusion:Endoscopic parathyroidectomy is safe and effective in the treatment of primary hyperparathyroidism, which can be used as a surgical option for patients with cosmetic requirements.

A case of application of metagenomic next generation sequencing technology in a case of Cyanobacteria marneffei infection / 中华检验医学杂志

On September 15, 2020, a patient came in to Peking Union Medical College Hospital after suffering from chest pain, rash and lymphadenopathy for more than 2 years, and expericing general pain for 8 months. He also lost 15 kilograms of weight in the past half a year. For chest pain, cough, and expectoration symptons, cephalosporins and symptomatic treatments were empirically used and the symptoms were relieved. However, drug-induced rash occurred. After anti-allergic treatments, the rash was relieved but the swelling of cervical lymph nodes was not relieved. Diagnostic antituberculosis therapy was employed after biopsy result showed multifocal granulomatous inflammation. The therapy reduced the lymph nodes, but the condition repeated, and the whole body pain appeared. Further examinations showed that lung cancer in the right upper lobe was accompanied by obstructive pneumonia and whole body metastasis to multiple sites. The patient had no history of immunosuppression, and the γ interferon antibody was strongly positive, adult-onset immunodeficiency syndrome was considered. In order to confirm the diagnosis, bone and tissue biopsy were necessary, but the patient failed to cooperate. The histopathological examination results of the right cervical lymph node and the left iliac bone biopsy were weakly acid fast staining positive, Nocardia infection was suspected. The clinical symptoms improved after using sulfanilamide and imipenem empirical treatments against Nocardia. The content of cyanobacteria marneffei, which was detected by metagenomic next generation sequencing, was low. More laboratory pathogenic examinations were actively confirmed for this rare pathogen. The antifungal treatment (amphotericin B plus itraconazole) was used after successfully cultivating the cyanobacteria marneffei pathogen. After two months, the body nodules and masses disappeared and the skin wounds healed. It is of great significance to the diagnosis and treatment of patients to obtain qualified samples, maintain timely communication between the laboratory and the clinic, and construct reasonable interpretations of the results of metagenomic next generation sequencing technology.

Research Progress of Antibacterial Biliary Stent / 中国医疗器械杂志

Biliary stent has been widely used in the treatment of biliary stricture and obstruction, it can relieve the pain of patients effectively, but bacterial infection and stent obstruction are still troublesome after surgery. We introduce the mechanism of infection and stent blockage caused by bacterial invasion after biliary stent implantation, and expound the formation mechanism of bacterial biofilm and bile sludge in this review. Antibacterial biliary stent is an effective way to inhibit biliary tract infection, the literatures on antibacterial modification of biliary stent with different antibacterial methods in domestic and abroad are reviewed, and the research prospect of antibacterial biliary stent is summarized and prospected.

Transforming growth factor-β1-induced N-cadherin drives cell-cell communication through connexin43 in osteoblast lineage / 国际口腔科学杂志·英文版

Gap junction (GJ) has been indicated to have an intimate correlation with adhesion junction. However, the direct interaction between them partially remains elusive. In the current study, we aimed to elucidate the role of N-cadherin, one of the core components in adhesion junction, in mediating connexin 43, one of the functional constituents in gap junction, via transforming growth factor-β1(TGF-β1) induction in osteoblasts. We first elucidated the expressions of N-cadherin induced by TGF-β1 and also confirmed the upregulation of Cx43, and the enhancement of functional gap junctional intercellular communication (GJIC) triggered by TGF-β1 in both primary osteoblasts and MC3T3 cell line. Colocalization analysis and Co-IP experimentation showed that N-cadherin interacts with Cx43 at the site of cell-cell contact. Knockdown of N-cadherin by siRNA interference decreased the Cx43 expression and abolished the promoting effect of TGF-β1 on Cx43. Functional GJICs in living primary osteoblasts and MC3T3 cell line were also reduced. TGF-β1-induced increase in N-cadherin and Cx43 was via Smad3 activation, whereas knockdown of Smad3 signaling by using siRNA decreased the expressions of both N-cadherin and Cx43. Overall, these data indicate the direct interactions between N-cadherin and Cx43, and reveal the intervention of adhesion junction in functional gap junction in living osteoblasts.

School physician in primary and secondary schools in Yichang of Hubei Province during 2019-2020 / 中国学校卫生

Objective@#To understand school physician in primary and secondary schools in Yichang City, Hubei Province from 2019 to 2020, and to provide a reference for strengthening the school physician team in primary and secondary schools.@*Methods@#149 and 102 primary and secondary schools from 6 municipal districts in Yichang City, Hubei Province, were randomly selected in November 2019 and November 2020, respectively, and were administered by questionnaire survey.@*Results@#The proportion of school physicians increased from 39.6% in 2019 to 65.7% in 2020. In the past two years, the equipment rate of school physician in both central and fringe urban areas increased, especially the fringe urban areas, number of school physician increased from 38 to 96. A total of 93 and 141 school physicians were selected to pariticipate in questionaire survey in 2019 and 2020 respectively. The survey showed that more than 90% of school physicians in primary and secondary schools in Yichang received training, and 74.5% had college education level. However, most of them lack professional qualification and medical background.@*Conclusion@#School physician of primary and secondary of Yichang is well development over the past two years, and the proportion substantially increased. However, there is still room for improvement in the quantity and quality of school physicians, and professional qualification needs to be improved. More attention should be paid to the marginal urban areas to achieve a balance between quantity and quality.

Effect of Williams life skills training on posttraumatic growth and care ability for parents of children with leukemia / 中国实用护理杂志

Objective:To explore the effect of Williams life skills training on posttraumatic growth and care ability for parents of children with leukemia.Methods:A total of 86 parents of children with leukemia were assigned to Children′s Hospital Affiliated to Nanjing Medical University from January to December 2019 who were devided into experimental group and control group according to the enrolled time, there were 43 cases in each group. The parents in the control group recieved routine nursing, the experimental group carried out 4-week Williams life skills training. The effect was assessed by Posttraumatic Growth Inventory (PTGI) and Family Caregiver Task Inventory (FCTI), respectively.Results:Finally, 41 cases were included in the experimental group and 40 cases in the control group. After intervention, the personal strength, relating to others, spiritual change scores and total scores in PTGI were (21.10 ± 4.47), (19.95 ± 6.18), (5.12 ± 0.95), (73.41 ± 8.37) points in the experimental group, significantly higher than (18.38 ± 4.50), (17.60 ± 3.30), (4.65 ± 1.05), (66.13 ± 6.31) points in the control group, the differences were statistically significant ( t values were 2.117-4.420, P<0.05 or 0.01). The disease cognitive ability, basic care skills, emotional management ability, ability to seek support scores and total scores in FCTI were (5.41 ± 1.76), (4.10 ± 1.09), (6.71 ± 1.12), (5.56 ± 1.16), (38.00 ± 3.92) points in the experimental group, significantly lower than (6.60 ± 1.58), (4.63 ± 1.10), (7.58 ± 1.74), (6.33 ± 1.53), (41.18 ± 4.72) points in the control group, the differences were statistically significant ( t values were 2.164-3.286, P<0.05 or 0.01). Conclusions:Williams life skills training can effectively promote posttraumatic growth and care ability in parents of children with leukemia.

Early dectection and prediction hepatotoxic risk in vitro / 中国临床药理学与治疗学

Drug-induced liver injury (DILI) is a major cause of drug failure in clinical trial and market withdrawal. Animal models are utilized to predict the risk of drug-induced liver injury. However, due to species differences, the accuracy of animal models is poor. Multiple human-derived hepatotoxic prediction models have been developed to assess this potential risk. This article reviews commonly used in vitro hepatotoxic models, as well as the latest improvement of hepatocyte culture protocols, especially hepatic co-culture system and 3D culture system in order to improve the accuracy of hepatotoxic risk prediction, which may also guide the liver toxicity mechanistic investigation in clinic.

Establishment of HPLC Fingerprint and Content Determination of Two Components of Oxalis corniculata / 中国药房

OBJECTIVE：To establish the HP LC fing erprints of Oxalis corniculata and to simultaneously determine the contents of isovitexin and swertisin. METHODS ：HPLC method was adopted. The determination was performed on ACE Excel- 5-C18column with mobile phase consisted of methanol- 0.1％ phosphoric acid water （gradient elution ）at the flow rate of 1 mL/min. The column temperature was 35 ℃，and detection wavelength was set at 280 nm. The sample size was 10 μL. Using isovitexin peak as reference，HPLC fingerprints of 12 batches of sample were drawn. The similarity evaluation was performed by using Similarity Evaluation System of Chromatogram Fingerprint of TCM （2012 edition）to determine common peaks. The contents of isovitexin and swertisin were determined by same method of above chromatogram. RESULTS ：There were 19 common peaks in HPLC chromatogram of 12 batches of O. corniculata ，with the similarity above 0.89. Two common peaks including isovitexin and swertisin were identified. The linear range of two components were 3.91-117.36 μg/mL（r＝0.999 4）and 9.88-118.56 μg/mL（r＝ 0.999 2），respectively. The limits of quantitation were 0.675 and 3.587 μg/mL；the limits of detection were 0.205 and 1.087 μg/mL， respectively. RSDs of precision ，stability and reproducibility tests were all lower than 2％. The recoveries were 95.46％-99.10％ （RSD＝1.23％ ，n＝6），95.34％ -101.23％（RSD＝2.74％ ，n＝6），respectively. The average contents were 0.227-1.654， 0.641-2.052 mg/g，respectively. CONCLUSIONS ：Established fingerprints can be used for the quality control of O. corniculata ； the content determination method is simple and accu rate，and can be used for simultaneous determination of two components.

Advances in biosynthesis of cordycepin from Cordyceps militaris / 生物工程学报

Cordycepin as the main active ingredient of Cordyceps militaris, a traditional medicinal fungus in China, has many physiological functions such as anti-cancer, anti-tumor and anti-virus activity. The most potential route for effective cordycepin production has been considered as liquid fermentation of C. militaris though with low productivity at present. Thus, it is urgent to apply both process engineering strategy and metabolic engineering strategy to enhance the productivity of cordycepin. In this review, the effects of medium components (i.e. the carbon/nitrogen source, precursor substances and metal ions) and operation factors (i.e. pH, dissolved oxygen and light) on cordycepin biosynthesis in liquid fermentation system are summarized. Besides, separation of cordycepin, the gene cluster involved and predicted biosynthesis pathways of cordycepin are also discussed, providing possible solutions of finally realizing efficient production of cordycepin.

Gap junction-mediated cell-to-cell communication in oral development and oral diseases: a concise review of research progress / 国际口腔科学杂志·英文版

Homoeostasis depends on the close connection and intimate molecular exchange between extracellular, intracellular and intercellular networks. Intercellular communication is largely mediated by gap junctions (GJs), a type of specialized membrane contact composed of variable number of channels that enable direct communication between cells by allowing small molecules to pass directly into the cytoplasm of neighbouring cells. Although considerable evidence indicates that gap junctions contribute to the functions of many organs, such as the bone, intestine, kidney, heart, brain and nerve, less is known about their role in oral development and disease. In this review, the current progress in understanding the background of connexins and the functions of gap junctions in oral development and diseases is discussed. The homoeostasis of tooth and periodontal tissues, normal tooth and maxillofacial development, saliva secretion and the integrity of the oral mucosa depend on the proper function of gap junctions. Knowledge of this pattern of cell-cell communication is required for a better understanding of oral diseases. With the ever-increasing understanding of connexins in oral diseases, therapeutic strategies could be developed to target these membrane channels in various oral diseases and maxillofacial dysplasia.