History and Modern Clinical Application of Classical Formulas Renshen Baidusan / 中国实验方剂学杂志

ObjectiveTo summarize the history and modern clinical application of Renshen Baidusan. MethodThe bibliometric method was used to retrieve the relevant publications of Renshen Baidusan from the ancient book database and China National Knowledge Infrastructure （CNKI）. The publications were screened according to the inclusion and exclusion criteria. The information of dynasty， book title， function， dosage and so on was extracted， on the basis of which the history， composition， dosage， decocting method， original medicinal plants， processing， and modern clinical application of this prescription were analyzed. ResultRenshen Baidusan was first recorded in the Formulary of the Bureau of Taiping People's Welfare Pharmacy， consisting of Bupleuri Radix， Glycyrrhizae Radix et Rhizoma， Platycodonis Radix， Ginseng Radix et Rhizoma， Chuanxiong Rhizoma， Poria， Aurantii Fructus， Peucedani Radix， Notopterygii Rhizoma et Radix， Angelicae Pubescentis Radix， Zingiberis Rhizoma Recens， and Menthae Haplocalycis Herba and with the effect of dispersing cold， removing dampness， reinforcing Qi， and relieving exterior. Later generations of physicians used this prescription on the basis of the record in Formulary of the Bureau of Taiping People's Welfare Pharmacy to treat cold （frequency of 112， 22.63%） and seasonal cold （frequency of 83， 16.77%）. Renshen Baidusan is widely used in modern clinical practice to treat respiratory diseases （frequency of 42， 17.65%）， skin diseases （frequency of 34， 14.29%）， and infectious diseases （frequency of 33， 13.87%）. This prescription is often modified to treat the syndrome of internal deficiency and external contraction， or external contraction of wind， cold and damp pathogens without deficiency of healthy Qi， which fully embodies the concept of treating different diseases with the same method in traditional Chinese medicine. ConclusionThe textual research reveals the key information of the classical prescription Renshen Baidusan， providing a basis for the subsequent development and application of compound preparations.

Renshen Baidusan Protects Mucosal Barrier in Ulcerative Colitis via AMPK/ULK1 Autophagy Pathway / 中国实验方剂学杂志

ObjectiveTo study the mechanism of Renshen Baidusan in regulating adenylate-activated protein kinase （AMPK）/Unc-51-like kinase 1 （ULK1） autophagy pathway to inhibit mucosal barrier damage in the mouse model of ulcerative colitis （UC）. MethodSixty SD rats were randomized into normal， model， sulfasalazine enteric-coated tablets （0.312 5 g·kg-1， western medicine）， and high-， medium-， and low-dose （31.2， 15.6， 7.8 g·kg-1， respectively） Renshen Baidusan groups. The UC model was induced by 2，4，6-trinitrobenzenesulfonic acid （TNBS）/50% ethanol. The drugs were administrated by gavage for 2 weeks， and then the histopathological changes of the colon were examined. Real-time quantitative polymerase chain reaction was conducted to measure the mRNA level of AMP-activated protein kinase subunit alpha （AMPKα）. Western blot was employed to determine the protein levels of closure protein （Occludin）， compact linking protein-2 （Claudin-2）， autophagy marker p62， microtubule-associated protein 1 light chain 3B （LC3B）， phosphorylated AMPK （p-AMPK）， and phosphorylated ULK1 （p-ULK1）. ResultCompared with the normal group， the model group showed increased colon injury score （P<0.05）， down-regulated mRNA level of AMPKα （P<0.05） and protein levels of p-AMPK， p-ULK1， and Occludin， decreased LC3Ⅱ/Ⅰ ratio （P<0.05）， and up-regulated protein levels of p62 and Claudin-2 （P<0.05）. Compared with the model group， all the doses of Renshen Baidusan lowered the colon injury score， up-regulated the mRNA level of AMPKα and the protein levels of p-AMPK， p-ULK1， and Occluding， increased LC3Ⅱ/Ⅰ ratio， and down-regulated the protein levels of p62 and Claudin-2. Moreover， the medium-dose group showed a significant intervention effect （P<0.05）. ConclusionRenshen Baidusan can protect the intestinal mucosal barrier from damage， and the medium dose showed the best efficacy. It may activate the AMPK/ULK1 pathway to accelerate the transformation of LC3Ⅰ to LC3Ⅱ and promote the degradation of p62， so as to improve the function of Occludin and Claudin-2 and repair the mechanical damage of the intestinal barrier.

Renshen Baidusan Combined with Yurui Enema Treats Intestinal Mucosal Injury in Rat Model of Ulcerative Colitis via PI3K/Akt/NF-κB Pathway / 中国实验方剂学杂志

ObjectiveTo explore the mechanisms of internal treatment （Renshen Baidusan）， external treatment （Yurui Enema）， and combination of the two methods in treating intestinal mucosal injury in the rat model of ulcerative colitis （UC） from the changes of phosphatidylinositol-3 kinase （PI3K）/protein kinase B （Akt）/nuclear factor-κB （NF-κB） pathway. MethodFifty SPF-grade SD rats were randomized into blank， model， Renshen Baidusan （15.6 g·kg-1）， Yurui Enema （25 g·kg-1）， and combined treatment （15.6 g·kg-1 Renshen Baidusan + 25 g·kg-1 Yurui Enema） groups （n=10）. The rat model of UC was established in other groups except the blank group by 2，4， 6-trinitrosulfonic acid （TNBS）/ethanol. The rats were administered with corresponding drugs once a day for 14 consecutive days since the 8th day after modeling. The histopathological changes of colon were observed by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of tumor necrosis factor （TNF）-α， interferon （IFN）-γ， interleukin （IL）-4， and IL-10 in the colon tissue. The apoptosis of colon epithelial cells was detected by terminal deoxynucleotidyl transferase-mediated nick end labeling （TUNEL）. The location and expression of B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， TNF-α， and IL-6 in the colon tissue were examined by immunohistochemistry. Real-time quantitative fluorescence polymerase chain reaction （Real-time PCR） and Western blot were employed to determine the mRNA and protein levels， respectively， of the proteins in the PI3K/Akt/NF-κB pathway in the colon tissue. ResultIn the model group， HE staining showed a large number of inflammatory cell infiltration in the mucosa and submucosa. Compared with the blank group， the model group showed elevated levels of TNF-α and IFN-γ and lowered levels of IL-4 and IL-10 in the colon tissue， increased apoptosis rate of colon epithelial cells， increased positive expression of Bax， TNF-α， and IL-6， and decreased positive expression of Bcl-2 （P<0.05）. Moreover， the model group showed up-regulated mRNA levels of PI3K， Akt， and NF-κB and protein levels of PI3K， p-PI3K， Akt， p-Akt， p65， p-p65， Bax， and cleaved Caspase-3， increased Bax/Bcl-2 and cleaved Caspase-3/Caspase-3 ratios， and down-regulated protein levels of NF-κB suppressor protein α（IκBα）， Bcl-2， and Caspase-3 in the colon tissue （P<0.05）. Compared with the model group， the internal treatment， the external treatment， and the combination （referred to as the three groups） alleviated the colonic mucosal injury， lowered the levels of TNF-α and IFN-γ and elevated the levels of IL-4 and IL-10 in the colon tissue， decreased the apoptosis rate of colon cells， inhibited the positive expression of Bax， TNF-α， and IL-6， and promoted the positive expression of Bcl-2 （P<0.05）. Furthermore， the combination group down-regulated the mRNA level of PI3K （P<0.05）. The three groups down-regulated the mRNA levels of Akt and NF-κB and the protein levels of p-PI3K， Akt， p-Akt， p65， p-p65， Bax， and cleaved Caspase-3 in the colon tissue， decreased the Bax/Bcl-2 and cleaved Caspase-3/Caspase-3 ratios， and up-regulated the protein levels of IκBα， Bcl-2， and Caspase-3 （P<0.05）. ConclusionRenshen Baidusan， Yurui Enema， and their combination may inhibit the activation of PI3K/Akt/NF-κB signaling pathway and regulate the expression of genes and proteins related to this pathway to achieve anti-inflammatory and anti-apoptotic effects， thus restoring the intestinal mucosal barrier function of UC rats.

Renshen Baidusan Regulates Autophagy to Repair Mucosa in Ulcerative Colitis / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Renshen Baidusan in repairing intestinal mucosa in ulcerative colitis （UC） by regulating autophagy to scavenge peroxides. MethodThe mouse model of UC was induced by free drinking of 3.0% dextran sulphate sodium （DSS） solution. Sixty male C57BL/6J mice were randomized into normal， model， mesalazine （0.3 g·kg-1）， and high-， medium-， and low-dose （12.35， 8.22， 4.11 g·kg-1， respectively） Renshen Baidusan groups （n=10）. The mice were administrated with corresponding drugs by gavage for 7 consecutive days. The colon tissue was stained with hematoxylin-eosin （HE） to reveal the pathological changes， and Alcian blue-Periodic acid Scheff （PAS/AB） staining was employed to observe the goblet cell changes. The fluorescence expression of reactive oxygen species （ROS） in the colon tissue was detected by the immunofluorescence assay. The activity of superoxide dismutase （SOD） and the content of malondialdehyde （MDA） were measured by the biochemical methods. Western blot was employed to determine the expression levels of proliferating cell nuclear antigen （PCNA）， microtubule-associated protein 1 light chain 3 （LC3）， leucine-rich repeat-containing G protein-coupled receptor 5 （LGR5）， and p62. ResultDestroyed mucosal epithelial structure， intestinal gland destruction， loss of goblet cells， and massive infiltration of inflammatory cells appeared in the model group. Compared with the normal group， the model group showed increased tissue damage injury （TDI） score of the colon tissue， decreased SOD activity and LC3Ⅱ/Ⅰ， PCNA value， and elevated levels of p62， MDA， ROS， and LGR5 （P<0.05）. Compared with the model group， different doses of Renshen Baidusan decreased the TDI score， promoted the generation of new goblet cells， elevated the levels of PCNA， LGR5， SOD， and LC3Ⅱ/Ⅰ， and lowered the levels of p62， MDA， and ROS （P<0.05）. Moreover， the low dose group showed the best performance （P<0.05）. ConclusionRenshen Baidusan can promote intestinal epithelial repair by activating intestinal autophagy， alleviating oxidative stress， and promoting intestinal stem cell proliferation and differentiation.

Application of neoadventitia technique in root repair of acute type A aortic dissection / 中华胸心血管外科杂志

Objective:To evaluate the safety and efficacy of the neoadventitia technique for root repair in acute type A aortic dissection(ATAAD).Methods:From January 2019 to February 2022, a total of 94 patients with ATAAD who underwent surgical treatment in Beijing Anzhen Hospital were retrospectively analyzed. According to the different treatment methods for the aortic root, the patients were divided into the neoadventitia technique group(58 cases) and the Bentall group(36 cases). The perioperative data and postoperative follow-up results of the two groups were compared, and the efficacy of the new adventitia technique in acute type A aortic dissection was analyzed.Results:There were no intraoperative deaths. The 30-day mortality was 3.4% and 5.6% in the neoadventitia group and Bentall group, respectively ( P=0.636). The cardiopulmonary bypass time[(154.3±29.8)min, P<0.001] and aortic clamp time[(94.7±20.6)min, P<0.001)]were significantly shorter in the neoadventitia group, compared with the Bentall group. Aortic regurgitation was significantly improved after the operation (0.33±0.50 vs. 1.02±0.80, P<0.001). No aortic root-related secondary intervention occurred during follow-up. There was no significant difference in mortality between the two groups( P=0.248). Conclusion:Neoadventitia root repair is a safe and feasible method for the treatment of ATAAD, which has good short-term and mid-term efficacy.

Research on the Value Implications of Ethics Education of Science and Technology in Medical Colleges and Universities / 中国医学伦理学

In the new era, with the accelerated evolution of the information technology revolution and industrial transformation, scientific and technological innovation not only brings dividends and benefits to the world, but also brings serious challenges to human beings. To effectively cope with ethical challenges and avoid ethical risks effectively, systematically carrying out ethics education of science and technology in accordance with the times and circumstances to cultivate medical students’ upward and forward-looking ethics of science and technology for medical colleges and universities is necessary, feasible, scientific, and sustainable. Ethics education of science and technology in medical colleges and universities should take the guidance of respecting and seeking truth, adhere to the development concept of righteousness and innovation, take the red line and bottom line as the core action points, and regard the equal importance of the country and the people as the values adherence.

Validation of the Pollard' s classification criteria (2010) for rheumatoid arthritis patients with fibromyalgia / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the sensitivity and specificity of Pollard' s classification criteria(2010) for the diagnosis of rheumatoid arthritis (RA) patients withfibromyalgia (FM) in Chinese patients, and to assess the clinical features and psychological status of RA-FM patients in a real-world observational setting.@*METHODS@#Two hundred and two patients with rheumatoid arthritis were enrolled from the outpatients in Rheumatology and Immunology Department in Peking University People' s Hospital. All the patients were evaluated whether incorporating fibromyalgia translation occured using the 1990 American College of Rheumatolgy (ACR)-FM classification criteria. Forty two RA patients were concomitant with FM, while the other one hundred and sixty RA patients without FM were set as the control group.@*RESULTS@#There was no significant difference in general demography between the two groups (P>0.05). In this study, the Pollard' s classification criteria (2010) for RA-FM in Chinese patients had a high sensitivity of 95.2% and relatively low specificity of 52.6%. Compared with those patients without FM, RA patients with FM (RA-FM patients) had higher Disease Activity Scale in 28 joints (DAS-28) score (5.95 vs. 4.38, P=0.011) and much more 28-tender joint counts (TJC) (16.5 vs.4.5, P < 0.001).RA-FM patients had worse Health Assessment Questionnaire (HAQ) score (1.24 vs. 0.66, P < 0.001) and lower SF-36 (28.63 vs. 58.22, P < 0.001). Fatigue was more common in RA-FM patients (88. 1% vs. 50.6%, P < 0.001) and the degree of fatigue was significantly increased in RA-FM patients (fatigue VAS 5.55 vs. 3.55, P < 0.001). RA-FM patients also had higher anxiety (10 vs.4, P < 0.001) and depression scores (12 vs.6, P < 0.001). erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), morning stiffness time and 28-swollen joint counts (SJC) showed no difference between these two groups.@*CONCLUSION@#The Pollard' s classification criteria (2010) for RA-FM are feasible in Chinese rheumatoid arthritis patients. The Pollard' s classification criteria is highly sensitive in clinical application, while the relativelylow specificity indicates that various factors need to be considered in combination. RA patients with FM result in higher disease activity, worse function aland psychological status. RA patients with FM also have poorer quality of life. DAS-28 scores may be overestimated in RA patients with FM. In a RA patient thatdoes not reach remission, the possibility of fibromyalgia should be con-sidered.

Significance of "Qingfei" and "Paidu" of Qingfei Paidu Decoction in Treatment of COVID-19 / 中国实验方剂学杂志

Traditional Chinese medicine （TCM） has played an important role in the prevention and treatment of novel coronavirus disease 2019 （COVID-19）. Qingfei Paidu decoction，as a general prescription of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia from the sixth to eighth versions，has been proved effective clinically and is suitable for mild，moderate，severe，and critical patients. It can significantly improve clinical symptoms such as fever， cough，asthma，fatigue， etc. On the basis of the findings of relevant research papers，this paper summarized the TCM understanding of COVID-19， including etiology，pathogenesis， disease location， and treatment，and concluded that the disease is caused by the pestilential Qi，localized in the lungs， and can affect the five organs. It is mainly characterized by coldness，dampness，heat，toxicity，stasis，and deficiency. In response to the etiology and pathogenesis of the disease，the therapeutic principles at all stages are dominated by the elimination of pathogens and removal of toxicity. According to the stages of disease development，the treatment should combine the severity of the disease and the course of the disease with the TCM syndromes. Furthermore，from the clinical application of Qingfei Paidu decoction，this paper discussed the therapeutic intention of "Qingfei （clearing of lungs）" and "Paidu （removal of toxicity）". Qingfei Paidu decoction can clear the pathogenic toxin in the lungs and eliminate external pestilential Qi，which is in line with the therapeutic principles for this pandemic by regulating the triple energizer and protecting healthy Qi using both coldness and warmth to treat both the symptoms and the root cause. Additionally，the experimental research progress on Qingfei Paidu decoction and its modified prescriptions were summarized. As studied， this prescription can inhibit cytokine storm，moderate the overactive immune response，potentiate the immune function and anti-viral ability of the body，and exert its effect on COVID-19 with multiple components，multiple targets，multiple pathways， and multiple biological functions. In conclusion，Qingfei Paidu decoction，as a core prescription for the treatment of COVID-19，can rapidly contain the development of COVID-19， which has been confirmed in terms of TCM theory，clinical efficacy， and experimental research.

Analysis of the Effcacy and Safety of Amivantamab in Non-small Cell Lung Cancer Patients with EGFR/MET Gene Abnormalities: A Single Center's Experience / 中国肺癌杂志

BACKGROUND@#Epidermal growth factor receptor (EGFR) and cellular-mesenchymal to epithelial transition factor (c-Met) are widely expressed on cancer cells. There is a synergistic effect of EGFR and HGF/c-Met pathways on proliferation, downstream activation of signal transduction and an additive effect. Studies show that combination of both signaling pathways could potentially be targeted in a synergistic fashion. Amivantamab, a bispecific monoclonal antibody targeting EGFR and c-Met, yielded robust and durable responses in a variety of clinicals trials. However, few researches have reported its efficacy in Chinese non-small cell lung cancer (NSCLC) patients. This study was conducted to evaluate the effectiveness and tolerance of Amivantamab in NSCLC patients with EGFR/MET gene abnormalities at Peking University Cancer Hospital.@*METHODS@#The study enrolled NSCLC patients who received Amivantamab in our hospital between August 2020 and December 2021, and analyzed the response, survival, and treatment-related adverse events.@*RESULTS@#Fifteen patients were enrolled in this research, and six of them received Amivantamab treatment and the other nine patients received Amivantamab plus Lazertinib treatment. The rates of partial response (PR), stable disease (SD), and progressive disease (PD) were 46.7% (7/15), 46.7% (7/15) and 6.7% (1/15), respectively. The overall response rate (ORR) and disease control rate (DCR) were 28.6% (2/7) and 100.0% (7/7) in seven patients with EGFR exon 20 insertion, respectively. The ORR and DCR were 40.0% (2/5) and 100.0% (5/5) in five post-osimertinib EGFR-mutant patients, respectively. After a median follow-up of 8.7 months, the median progression-free survival and overall survival were not reached. The most common treatment-related adverse events were rash (86.7%), paronychia (80.0%), and infusion-related reactions (60.0%), and most of them were graded as 1 to 2. Grade 3 to 4 adverse events included rash (33.3%), alanine aminotransferase elevation (13.3%), gamma-glutamyl transpeptidase elevation (13.3%), peripheral edema (6.7%), thromboembolism (6.7%), interstitial lung disease (6.7%), and thrombocytopenia (6.7%).@*CONCLUSIONS@#Amivantamab was effective in Chinese NSCLC patients with EGFR exon 20 insertion and post-Osimertinib EGFR-mutant patients, similar to the results of clinical trials conducted in western countries. Amivantamab was well tolerated and emphases should be put on adverse events such as rash, paronychia, and infusion-related reactions.

Salivary biochemical indices related to early childhood caries / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare the salivary biochemical indices between caries-free individuals and those with early childhood caries (ECC), and construct a saliva-based caries diagnostic model by analyzing the correlation between salivary biochemical indices and caries severity.@*METHODS@#A total of 120 children aged 4-6 years were selected and divided into two groups: individuals with ECC (C group, @*RESULTS@#The NO@*CONCLUSIONS@#Salivary biochemical indices can contribute to the diagnosis and risk assessment of ECC.

Comparison of acquired immure deficiency syndrome-related knowledge and behavior between persons with and without human immunodeficiency virus- infection among young male students who have sex with men / 北京大学学报(医学版)

OBJECTIVE@#To understand the differences between young male students who have sex with men (MSM) with and without human immunodeficiency virus (HIV)-infection in acquired immure deficiency syndrome (AIDS)-related knowledge and behavior, and to provide a scientific reference to make targeted and effective measures in AIDS prevention.@*METHODS@#Using snow balling sampling combined with participants' referral, we conducted a questionnaire survey among 548 young MSM students (in whom there were both HIV-positive and HIV-negative) in Harbin, Tianjin, Xi'an, and Chongqing cities from April 2017 to March 2018. The chi-square test and binary Logistic regression were used to compare the differences in AIDS-related knowledge and behavior between males with and without HIV-infection.@*RESULTS@#A total of 583 questionnaires were obtained, of which 548 were valid, with an effective rate of 94.0%. Having a junior college education or below (P=0.002), a monthly consumption level of less than 2 000 RMB (P=0.021), and living off campus (P=0.004) were associated with being tested positive for HIV. In any period of schooling, receiving AIDS prevention education was a protective factor for HIV infection [Primary school OR=0.203 (0.073－0.561), junior high school OR=0.287 (0.142－0.581), senior high school OR=0.271 (0.142－0.518), and university OR=0.322 (0.168－0.616)]. There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public"(P=0.907) and "AIDS-related Knowledge for Youth"(P=0.782), with the awareness rate all about 90%. There was a statistical difference in the need for some specific knowledge (For "AIDS prevention and treatment policy", P=0.012, for "Ways to identify and prevent high-risk sexual behavior", P < 0.001). HIV-positive males had a younger age of first sexual activity (P=0.006), had more sexual partners in the early (P < 0.001) and had lower frequency of condom use (P < 0.001). However, there was no statistical difference in the later number of sexual partners (P=0.247) and the frequency of condom use (For regular sex partners, P=0.735, and for casual sex partners, P=0.765), which might be related to the change of sexual behavior characteristics caused by HIV infection (For regular sex partners, P < 0.001, and for casual sex partners, P=0.006).@*CONCLUSION@#There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public" and "AIDS-related Knowledge for Youth", which were both lower than 95% required by the state. However, the specificity in the knowledge needs was certainly shown. There was no significant difference in the recent sexual behavior between the two groups, but HIV positive students were more likely to have high-risk sexual behaviors in the early stage, so we should strengthen and move forward the sex education and AIDS prevention education with adjusted contents, and prevent high-risk sexual behaviors within young MSM students in the early stage.

One-year clinical results of accelerated epithelium-off corneal collagen cross-linking for teenagers with keratoconus / 中华实验眼科杂志

Objective:To assess the safety and efficacy of riboflavin/ultraviolet-A-induced accelerated epithelium-off corneal collagen cross-linking (CXL) for teenagers with keratoconus.Methods:In this case series study, 25 eyes of 18 patients with primary keratoconus who underwent riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL in Zhengzhou Second People's Hospital from January 2017 to February 2018 were included, and the average age of patients was (14.4±1.3) years.The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical equivalent (SE), maximum keratometry reading (K max), thinnest corneal thickness (TCT), posterior corneal elevation (PCE) and endothelial cell density (ECD) were measured before and after CXL.The patients were followed up for one year.The complications and adverse reactions were recorded.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhengzhou Second People's Hospital (No.KY2017002). Written informed consent was obtained from each patient and their guardian prior to the surgery. Results:The mean UCVA (LogMAR) was 0.96±0.35 at baseline, which was significantly improved to 0.84±0.33 at 1 year postoperatively ( t=-5.765, P<0.01). The mean BCVA (LogMAR) was 0.45±0.22 preoperatively, which was significantly improved to 0.34±0.26 at 1 year postoperatively ( t=-4.843, P<0.01). The mean SE was (8.66±5.11)D at baseline, which was significantly higher than (8.07±5.21)D at 1 year postoperatively ( t=-3.253, P=0.003). The K max was reduced from (58.58±9.07)D preoperatively to (56.25±9.98)D at 1 year postoperatively, with significant difference between the two time points ( t=-4.357, P<0.01). The K max was reduced more than 1 D in 17 eyes (68%), was stable in 6 eyes(24%), and was increased more than 1 D in 2 eyes (8%). The TCT was reduced from (485.0±32.5)μm at baseline to (475.3±35.5)μm at 1 year postoperatively, with significant difference between the two time points ( t=-4.266, P<0.01). The differences of PCE and ECD between preoperative and postoperative 1 year were not statistically significant ( t=1.023, P=0.316; t=-1.424, P=0.167). There was one eye suffering peripheral sterile corneal infiltrate 2 days postoperatively, and favorable prognosis was achieved after the topical steroids application.No complication was encountered in other subjects. Conclusions:Riboflavin/ultraviolet-A-induced accelerated epithelium-off CXL is safe and effective in teenagers with keratoconus during the 1-year follow-up.The long-term effects need further observation.

Establishing emergency medical system of classified treatment to alleviate the overload medical needs after the community outbreak of corona virus disease 2019 in Wuhan City / 中华传染病杂志

Wuhan is the city with the most serious outbreak of corona virus disease 2019 (COVID-19) in China. The outbreak of community has exhausted the current medical resources. With integrating local and support medical resources from other province, Wuhan City has rapidly rebuilt a new emergency medical system of classified treatment, and effectively responded to the overload medical demand after the outbreak in the community.

Effect of Straumann implant on crown appearance in immediate implant restoration of maxillary anterior teeth / 南方医科大学学报

OBJECTIVE@#To investigate the effect of Straumann implant on crown appearance in the immediate implant restoration of maxillary anterior teeth.@*METHODS@#This study was conducted among 86 patients undergoing immediate implant restoration of maxillary anterior teeth between January and December, 2018. We randomized the patients into control group for treatment with immediate implant restoration and study group receiving additional Straumann implant. The effects of restoration, bone absorption at 6 months, implant length, implant diameter, root protrusion, gingival color, far and middle gingival papilla, lip side gingival height, near and middle gingival papilla, and lip side gingival curve were compared between the two groups.@*RESULTS@#The repair effect in the study group was better than that in the control group ( < 0.05). The implant length and implant diameter were significantly greater in the study group than in the control group. The root protrusion, gingival color, far and middle gingival papilla, lip side gingival height, near and middle gingival papilla, and lip side gingival curve were all better in the study group. The height of marginal bone in the study group was significantly higher than that in the control group ( < 0.05).@*CONCLUSIONS@#Straumann implant can be used in immediate implant restoration of maxillary anterior teeth to achieve a better aesthetic effect.

Effect of lupeol on invasion and metastasis of human hepatoma HepG2 and SK-HEP-1 cells and its mechanism / 中国中药杂志

Epithelial-mesenchymal transformation(EMT) exists in embryonic development and is closely related to cell migration and invasion. The increased EMT level in tumors showed that E-cadherin was replaced by N-cadherin, and the expression of interstitial markers such as α-SMA and vimentin was up-regulated. It has been reported that lupeol can reduce the expression of matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9) and N-cadherin to inhibit the metastasis of osteoma cells. However lupeol has been less studied in liver cancer. Therefore, this paper investigated the effect of lupanol on invasion and metastasis of human hepatoma cell line HepG2 and SK-HEP-1 and its possible mechanism. MTT assay and Annexin V/PI double staining were used to investigate the effect of lupeol on activity and apoptosis of HepG2 cells and SK-HEP-1 cells. Moreover, the effect of lupeol on the invasion of HepG2 cells and SK-HEP-1 cells were evaluated by Transwell assay. The expressions of E-cadherin, N-cadherin, α-SMA, vimentin and MMP-9 were measured by Western blot. The model of subcutaneous transplantation of nude mice and the lung metastasis model of H22 hepatocellular carcinoma cells were established to evaluate the efficacy of lupeol in vivo on tumor growth and lung metastasis by HE staining combined with immunohistochemical assay. The results showed that lupeol inhibited the activity and invasion of HepG2 cells and SK-HEP-1 cells in a dose-dependent manner and induced apoptosis. Western blot showed that the expression of E-cadherin, a landmark protein for EMT, was induced by lupeol, and the expressions of N-cadherin, α-SMA, vimentin and MMP-9 were decreased. In vivo experiments showed that lupeol inhibited tumor growth in mice bearing xenograft. In addition, immunohistochemical experiments confirmed that lupeol could up-regulate the expression of E-cadherin in tumor tissues of nude mice, reduce the expression of N-cadherin, and inhibit the metastasis of liver cancer H22 cells in the lungs of mice. The above results indicated that the mechanism of lupeol inhibiting the invasion and metastasis of HCC cells may be related to the regulation of EMT process.

Effects of ulnar styloid and sigmoid notch fractures on postoperative wrist function of patients with distal radius fracture / 北京大学学报(医学版)

OBJECTIVE@#To study the effects of ulnar styloid and sigmoid notch fractures on postoperative wrist function in patients with distal radius fracture.@*METHODS@#In total, 139 patients treated for distal radius fracture in the Department of Orthopedic Trauma at Peking University People's Hospital from Jan. 2006 to June 2016 were selected for outpatient follow-ups. Evaluation was based on Sartiento's modification of the Gartland and Werley scores. Efficacy was assessed with wrist pain as the focus.@*RESULTS@#The excellent and good efficacy rate was 97.1% (excellent: n=107, 77.0%; good: n=28, 19.4%; and fair: n=4, 2.9%). Gender, age, and whether the ulnar styloid fracture achieved union did not significantly impact the scores (P>0.05). The scores of the basal fracture group were significantly different (P=0.001). Internal fixation of ulnar styloid fracture was associated with a significant difference in scores (P=0.005). The effect of sigmoid notch fracture was also associated with a significant difference in scores (P=0.024). This study included 22 cases of ulnar wrist pain, and the overall incidence of ulnar wrist pain was 15.8%. Gender, age, whether the ulnar styloid fracture achieved union, and whether internal fixation was conducted for ulnar styloid fracture and sigmoid notch fracture had no significant effect on the occurrence of ulnar wrist pain (P>0.05). The incidence of ulnar wrist pain was higher in basal fractures than that in tip fractures. Among ulnar styloid fractures, the union rate of basal fracture was higher than that of tip fractures. The union rates of basal fracture and tip fracture were significantly different (P<0.001). Basal fractures were significant risk factors for ulnar wrist pain (P=0.028). Basal fracture of the ulnar styloid group and sigmoid notch fracture group had poor wrist function scores. Wrist function score improved significantly after internal fixation of ulnar styloid fracture. The incidence of ulnar wrist pain was higher in basal fracture group. The union rate in basal fracture group was higher than in tip fracture group.@*CONCLUSION@#The overall effect of surgical treatment of distal radius fracture is satisfactory. Ulnar styloid basal fracture and sigmoid notch fracture are risk factors for postoperative wrist dysfunction in patients with distal radius fracture, and the basal fracture is one of the risk factors of ulnar wrist pain. The union rate of ulnar styloid basal fractures is better than that of tip fractures. Internal fixation of ulnar styloid fracture can improve wrist function.

Measurement of the Chinese's social health and its influencing factors:Based on MIMIC struc-tural equation model / 中国卫生政策研究

In order to measure the current social health status of China,this article uses the method of factor analysis to measure the social health of Chinese population based on the data of CGSS2012,which has a mean score of 3.13 and the factor loading weighted score of 8.03. The social health of residents in economically developed prov-inces such as the six provinces Shanghai, Tianjin, Beijing, Liaoning, Zhejiang and Guangdong ranked among the first to sixth from the bottom,which demonstrated that there was an opposite trend between the people's social health and economy growth. The results of the MIMIC model indicate that the male,married,elder,pension or medical in-sured people and participating in social donations and voluntary activities would have higher social health level. The education and income have a reversed U-shaped relationship with the social health. This article also uses the CLDS2014 data to duplicate the above research, which indicates a robust result. Based on the above findings, this article finally proposes some policy suggestions to promote the social health of Chinese people.

Dynamic Model on Determining the Appropriate Premium Rate for Basic Medical Insurance of Urban Employee and the Calculation on Reduction to Current Premium Rate for Basic Medical Insurance of Urban Employee during the Period of the 13th Five-year Plan / 中国卫生经济

Objective:Study the dynamic model on determining the appropriate premium rate for basic medical insurance of urban employee(BMlUE) and the calculation of reduction to current premium rate for BMIUE in the period of the 13th Five-Year Plan.Methods:It developed a quantitative model to explore the objective.Results:There were 8 parameters all determined the appropriate premium for BMIUE.Conclusion:The results of calculation showed that in the period of the 13th Five-Year Plan,the current premium rate for BMIUE could be cut from 8％ into 7.9％ if keeping the current financial institutional arrangement named individual account and social pooling constant.If cancelling individual account,the current premium rate for BMIUE could be cut from 8％ into 7％.

Distribution of Modic changes and its relationship with cervical degeneration in patients with neck and shoulder pain / 中国组织工程研究

BACKGROUND: There are many studies on Modic changes in patients with lumbar degenerative disease and low back pain. However, few studies facus on epidemiological distribution and related factors of Modic changes in cervical spine, and its epidemiology and influencing factors remain unclear.OBJECTIVE: To study the morbidity and distribution of Modic changes in patients with cervical and shoulder pain and its correlation with gender, age and cervical degeneration. METHODS: Totally 430 patients admitted in the Second Affiliated Hospital of Inner Mongolia Medical University and undergoing cervical MRI and CT examination due to neck and shoulder pain between December 2014 and December 2016 were retrospectively analyzed, involving 197 males and 233 females, aged 19-78 years (mean age: 50.3 years). The morbidity and segmental distribution of Modic changes and its correlation with age, sex, cervical intervertebral disc degeneration and facet joint degeneration were analyzed. RESULTS AND CONCLUSION: (1) Among 2 150 disc segments of 430 patients, 348 segments (16.2%) of 67 patients (15.6%) appeared with Modic changes:73(3.4%)segments were type I,243(11.3%)were type II,and 32(1.5%)were type III.(2)By application of chi-square test, Modic changes were most common at the C5/6segment; older than 40 years and Pfirrmann disc degeneration grade III were relevant factors, while gender and facet joint degeneration were not.

Expression Profile of CircularRNA in Tongue Squamous Cell Carcinoma / 中山大学学报(医学科学版)

[Objective]To analyze the expression profile variation of circle RNA(circRNA)in tongue squamous cell carcinoma(TSCC)tissue and para-carcinoma tissue.[Methods]CircRNA microarray technology was performed to in-spect the difference of circRNA expression in 4 cases of TSCC tissues and 4 cases of para-carcinoma tissues,and then make analysis after the quality control and homogenization of raw data,to identify which have more than 2 times variation and significant difference(P<0.05)by statistical analysis as circRNA with differential expression. To perform functional analysis on circRNA with differential expression.[Results]Compared with para-carcinoma tissue,there were 17171 circRNA differentially expressed in TSCC tissue,while 9982 increase more than 2 times and 7189 reduce more than 2 times.[Conclusion]circRNA expression profile in TSCC changes significantly comparing with the para-carcinoma tis-sue,some differentially expressed circRNA may regulate the occurrence and progression of TSCC through a competitive combination of miRNA.