Mechanism of Wen Shen Xuan Bi Tang in treatment of osteoporosis based on network pharmacology and animal experimental verification / 中国药理学通报

Aim To predict and validate the mechanism of wenshen xuanbi tang(WSXBT) in treatment of osteoporosis (OP) based on network pharmacology, molecular docking techniques and in vivo experimental techniques. Methods Network pharmacology was used to screen the key ingredients and core targets of WSXBT for the treatment of osteoporosis. Metascape database was used for gene ontology (GO) biological process enrichment analysis and kyoto encyclopedia of genes and genomes (KEGG) signaling pathway enrichment analysis of core targets. AutoDockTools 1. 5. 7 software was applied in molecular docking to simulate the binding activity of key active ingredients to core targets. To study the efficacy of WSXBT on rats with osteoporosis and to verify the related targets and pathways, rat models of osteoporosis were established by excising the bilateral ovaries of rats. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum OPG, PINP and RANKL content. Biomechanical tester was applied to test the biomechanics of rat femurs. Micro-CT was applied to detect the femoral bone density. Then, Western blot was employed to measure the protein expression levels of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt). Results A total of 156 active ingredients of WSXBT were screened, involving 229 potential targets, 23 core targets and 145 signaling pathways. The molecular docking results showed that five key ingredients, including quercetin, kaempferol, naringenin, isobavachin and licochalcone a, possessed good binding ability to the core targets of PIK3R1 and AKT1. The results of in vivo experiments showed that WSXBT could significantly increase bone density, improve bone tissue microstructure, enhance femur biomechanics and increase PINP expression and OPG/RANKL ratio in rats with osteoporosis. Results of WB showed that WSXBT significantly increased p-PI3K/PI3K and p-Akt/Akt ratios. Conclusions WSXBT could improve bone mineral density in postmenopausal osteoporotic rats through PI3K/ Akt signaling pathway and increasing OPG/RANKL ratio.

Influence factors of bone mineral density and its correlation with insulin resistance in obese children in Qianjiang area / 公共卫生与预防医学

Objective To explore the influencing factors of bone mineral density (BMD) in obese children in Qianjiang area and analyze the correlation between BMD and insulin resistance. Methods The data on pediatric cases from the outpatient department of Jianghan Oilfield General Hospital in Qianjiang from January 2018 to December 2022 were collected. A total of 183 obese children who met the inclusion and exclusion criteria were included in the study and selected in the observation group. A total of 352 children undergoing physical examination during the same period were selected as the control group. Results The body mass, waist circumference, waist to hip ratio, and BMI of obese children were significantly higher than those of the control group (P<0.001). Biochemical indexes including FBG, FINS, Home-IR, ALP, and LDL-C in obese children were significantly higher than those in the control group (P<0.05), while bone mineral density, Ca, P, sOC and HDL-C were significantly lower than those in the control group (P<0.001). The bone mineral density of obese children was significantly correlated with their exercise intensity, sunshine exposure duration, sitting time, intake of milk and dairy products, intake of sweets, supplementation of trace elements, BMI, Home-IR, and sex (all P<0.05). BMI, Home-IR, sex, exercise intensity, and sunshine exposure length were independent risk factors affecting bone mineral density of obese children (all P<0.05). Bone mineral density was negatively correlated with BMI and Home-IR (P=0.028 and0.017, respectively), and positive correlation with exercise intensity and sunlight exposure (P=0.033). Conclusion BMD of obese children in Qianjiang area is affected by gender, body mass index, diet, vitamin intake, and physical activity, and is negatively correlated with insulin resistance. Home-IR can be used as a reference for screening BMD of obese children.

Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry / 대한뇌졸중학회지

Background@#and Purpose To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. @*Methods@#This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. @*Results@#Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). @*Conclusion@#In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.

Comparison of clinical efficacy between percutaneous endoscopic transforaminal discectomy and coblation nucleoplasty in the treatment of inclusive lumbar disc herniation / 中国骨伤

OBJECTIVE@#To observe clinical efficacy of percutaneous endoscopic transforaminal discectomy (PETD) and target radioffrequency thermal coblation nucleoplasty(CN) on inclusive lumbar disc herniation(LDH) in different age groups, and provide a basis for clinical formulation of precise and individualized treatments.@*METHODS@#A retrospective analysis of 219 patients with lumbar disc herniation treated with PETD and CN between January 2018 and June 2021 was performed, in which 107 patients were treated with PETD and 112 with CN. Patients were stratified by age into young group(≤45 years old), middle-aged group(>45 years old and <60 years old) and older group(≥60 years old). Before treatment, 3 days, 1 month and 6 months after treatment, visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, infrared thermal imaging temperature difference (△T) and lumbar range of motion (ROM) were evaluated and clinical efficacy were compared in the different age groups between two treatment methods.@*RESULTS@#①VAS and JOA score outcomes, in the same age group and the same treatment method, the VAS and JOA scores at different time points postoperatively were obviously improved (P<0.05). For the same age group and the different treatment methods, the older group had lower VAS and higher JOA scores after PETD than after CN (P<0.05), and there was no significant difference between the young group and middle-aged group (P>0.05). There was no significant difference in VAS and JOA scores at the same time between age groups by PETD treatment (P>0.05). The VAS was higher and the JOA score was lower in older group than in young group and middle-aged group at 1, 6 months after CN treatment(P<0.05). ②△T and ROM outcomes, in the same age group and same treatment method, postoperative △T and ROM at different time points were obviously improved(P<0.05). There was no significant difference in △T between two methods of PETD and CN at the same age(P>0.05), there was no significant difference in ROM between young group and middle-aged group(P>0.05), ROM was higher after PETD treatment than after CN treatment(P<0.05). There was no significant difference in △T and ROM at the same time between age groups by PETD treatment(P>0.05). There was no significant difference in △T between age groups by CN treatment, but the ROM was smaller in older group than in young group and middle-aged group after CN treatment(P<0.05).@*CONCLUSION@#Both PETD and CN for inclusive LDH have good efficacy, the curative benefit for older patients receiving PETD within 6 months after surgery more than CN, and CN is more appropriate for young and middle-aged patients.

Clinical effect of cosmetic reconstruction for partial defect of distal segment of thumb and finger / 中华显微外科杂志

Objective:To explore the clinical effect of cosmetic reconstruction for partial defect of distal segment of digits.Methods:Form January 2018 to January 2021, the Department of Hand Surgery of Institute for Hygiene of Ordnance Industry(The 521 Hospital of Weapon Industry) admitted 129 patients with partial defect of distal segment of thumb or fingers with phalange or tendon exposure. The patients were 111 males and 18 females with an average age of 34(17-59) years old. The sizes of nailbed defect were 0.4 cm×1.1 cm-1.8 cm×2.0 cm, the length of phalange defect was 0.4-1.8 cm, and the sizes of the soft tissue defect were 1.6 cm×1.8 cm-3.2 cm×4.8 cm. Great toe tissue flaps were used to reconstruct the partial defect of distal segment of thumb or fingers after debridement. Wounds of fibular flap of great toe in 77 cases were directly sutured in 17 patients. The donor sites in rest 60 great toes were narrowed first and then repaired with skin grafts in 10 cases, with artificial dermis in 28 cases and with transverse V-Y advancement flaps of ipsilateral great toes for 22 cases. Forty-nine of 52 donor site wounds for hallux toenail flap were repaired with artificial dermis and 3 with free peroneal artery perforator flaps. The method was outpatient follow-up. Postoperative follow-up lasted until July 2022. The check-items for follow-up included: occurrence of necrosis, appearance, shape and texture of the flap, appearance of the reconstructed nails, TPD of the reconstructed digit pulps, tolerance to cold on the scars of flaps, flexion and extension of the reconstructed digits. The healing time of phalanges of the reconstructed digits was evaluated by X-rays. The appearance, sensation, the tolerance to cold of great toe and the movement of donor foot were also assessed.Results:Postoperative follow-up lasted for 18 to 24 months, with an average of 21 months. A total of 128 flaps survived. Necrosis occurred in 1 fibular hallux flap, the necrosis was cured with a reverse digital proper artery island flap. Thereafter, all flaps healed well. The appearance, shape, texture and nails of reconstructed digits were close to the contralateral digits. The reconstructed thumb and finger were evaluated according to Zook, 127 cases were excellent and 2 cases were good.TPD of the pulps of the reconstructed digits was 4-10 mm. The mean score of the Vancouver scar scale(VSS) was 0.6 for scars of the reconstructed digits. The mean score of the Visual analog scale(VAS) was 0.3 for the tolerance to cold. Flexion and extension function recovered well in all the reconstructed digits. According to the Evaluation Criteria of Upper limb Function Hand Surgery Society of Chinese Medical Association, the function of hand was excellent in 127 cases and 1 in each of good and fair. X-rays of all digits showed the phalange healing of the reconstructed digits, with an average healing time of 2 months after surgery, without phalange resorption, infection, nonunion nor stress fracture. There was no difference between the length of the donor great toe and the contralateral toe, except the donor site of the great toe nail root. There was no significant visual difference between the appearance of the donor great toe and the contralateral toe. TPD of the pulps of donor great toe was 4-8 mm. The mean score of the VSS was 1.4 for scars in the donor great toe. The mean score of the VAS was 0.7 for the tolerance to cold of the donor great toe. There was no stress fracture at donor site, and the functions of donor foot were not affected when walking, running, jumping and tiptoeing in all patients.Conclusion:It is an ideal method for reconstructing a partial defect of distal segment of digit by great toe flap. It can not only reconstruct the partial defect of distal segment of the digit, but also results in a good appearance and satisfactory functions of the reconstructed digit. Damage to the donor site is minimum. The length of the donor great toe is unchanged, and it has little impact on sensation and appearance of the donor great toe. Meanwhile, there is no adverse effect on walking, running and jumping with the donor foot.

Intrathecal delivery of nusinersen using the Ommaya reservoir in a spinal muscular atrophy type 2 patient: a case report / 中华神经科杂志

Ommaya reservoir implantation is generally used in the treatment of hydrocephalus and intraventricular drug administration. Ommaya reservoir implantation in the subarachnoid space of the spinal cord for the intrathecal drug administration has not been carried out in China, and only several reports can be retrieved from PubMed. About 60%-90% of untreated patients with spinal muscular atrophy type 2 (SMA2) who survive to adulthood often have complex scoliosis and joint deformities. Nusinersen is an effective drug for the treatment of SMA2. And the route of administration is intrathecal injection, which is difficult for patients with severe scoliosis. This article summarizes the process of Ommaya reservoir implantation and postoperative drug administration in a patient with complex scoliosis type SMA2, which provides a new method for clinical treatment of this disease.

ARID1A expression in intrahepatic cholangiocarcinoma and its relationship with tumor recurrence,metastasis and tumor-specific immunomarkers / 中华普通外科杂志

Objective:To investigate the expression level between AT-Rich Interaction Domain 1A(ARID1A) in intrahepatic cholangiocarcinoma (ICC) and the correlation with tumor microenvironment.Methods:The clinicopathological and survival data of 110 ICC patients undergoing radical hepatectomy in Peking University People's Hospital from Jan 2015 to May 2021 were retrospectively analyzed. Immunohistochemical staining was used to detect the expressions of ARID1A , programmed cell death 1 ligand 1( PD-L1) in tumor tissues , programmed cell death protein 1(PD-1) and cluster of differentiation 8(CD8) in the microenvironment. The relationship between ARID1A expression and PD-L1, PD-1, CD8 protein expression was analyzed.Results:Twenty seven patients did not express ARID1A, absence of ARID1A was associated with high PD-L1, PD-1 and CD8 expression ( P<0.05). Multivariate analysis showed ARID1A expression, preoperative CEA level,preoperative CA19-9 level, lymph node metastasis and tumor number were independent risk factors. Conclusion:Absent expression of ARID1A suggests poor prognosis of ICC patients, high expression of PD-L1,PD-1 and CD8 protein in ICC tumor microenvironment with ARID1A-deficient expression suggests a possible prognosis benefit by using anti-PD-1, anti-PD-L1 and other immunotherapy regimens.

Comparative study of the surgical treatment for supraduodenal distal cholangiocarcinoma and Bismuth-Corlette type I hilar cholangiocarcinoma / 中华普通外科杂志

Objective:To analyze the surgical efficacy and prognosis of supraduodenal distal cholangiocarcinoma (SDC) and Bismuth-Corlette type I hilar cholangiocarcinoma (BIC), and to explore the clinical characteristics of cholangiocarcinoma at different sites.Methods:The clinical data of 33 patients with SDC and 25 patients with BIC undergoing surgical treatment at the First Affiliated Hospital of Anhui Medical University from Jan 2009 to Dec 2016 were analyzed retrospectively.Results:In the BIC group, four patients (16.0%) had combined caudate lobectomy, while in SDC group no caudate lobectomy was needed ( P=0.030). The incidence of pancreatic fistulae in SDC group and BIC group was 18.2% (6/33) and 0 (0/25), respectively ( P=0.032). The cumulative survival rates 1, 3, and 5 years after operation were 94.0%, 54.5%, and 30.3% in SDC group and 88.0%, 28.0%, and 16.0% in BIC group, respectively ( P=0.045). Univariate analysis showed that location of cholangiocarcinoma, residual status and AJCC stage were correlated with postoperative prognosis of cholangiocarcinoma patients. Multivariate analysis showed that BIC, non-R 0 resection and AJCC stage Ⅲ/Ⅳ were independent risk factors for overall survival after surgery. Conclusion:The overall survival rate of SDC patients after radical surgical resection was significantly higher than that of the BIC group.

Clinical features of patients with local recurrence and secondary operation after partial nephrectomy for renal cancer / 中华泌尿外科杂志

Objective:To investigate the clinical features of patients with local recurrence and secondary operation after partial nephrectomy for renal cancer.Methods:The clinical data of 14 patients who underwent secondary operation for local recurrence of renal cancer after partial nephrectomy in the First Affiliated Hospital and the Second Affiliated Hospital of Naval Medical University from January 2000 to January 2022 were retrospectively analyzed. There were 12 males and 2 females. Nine patients had a body mass index ≥24 kg/m 2. At first diagnosis of renal cancer, nine patients’ R. E.N.A.L. score of renal mass were at least 7. Partial nephrectomy was performed in the first operation of each patient, including 4 cases of open surgery, 6 cases of laparoscopic surgery, and 4 cases of robot-assisted laparoscopic surgery. The pathological stage of nine patients was pT 1aN 0M 0 and that of five patients was pT 1bN 0M 0. Twelve cases were clear cell carcinoma, 1 case was sarcomatoid carcinoma and 1 case was chromophobe cell carcinoma. The mean time from the first operation to local recurrence was (29.3±16.8) months. All recurrence lesions were found by abdominal CT or MRI. Thirteen patients had no clinical symptom at the time of tumor recurrence. The location of recurrence was clear. No sign of invasion of peripheral organs and tissues was observed. There was no other suspicious lesion. The tumor was considered to be completely resectable in all patients. All 14 cases underwent secondary operation. Ten patients underwent radical nephrectomy [tumor size was (2.8±0.9) cm]. Partial nephrectomy was performed in 4 cases [tumor size was (1.8±0.9) cm]after full evaluation by surgeons, including 2 cases of anatomic solitary kidney, and 2 cases of recurrent tumor less than 2 cm with clear tumor margin. Results:Eleven of the 14 cases underwent minimally invasive surgery, and no cases were converted to open surgery. The other 3 cases underwent open surgery. Seven patients had severe adhesions in the operation area. The blood loss in the partial nephrectomy group and the radical nephrectomy group was (100.0±70.7) ml and (143.0±81.2) ml, respectively. According to the Clavien-Dindo classification of surgical complications, Grade Ⅰ and Grade Ⅱ complication occurred in 1 patient respectively, and no patient had Grade Ⅲ or above complication. No tumor cell was found at the surgical margin. The pathological type and nuclear grade were the same as those in the first operation. There were 10 cases of pT 1aN 0M 0 stage, 3 cases of pT 3aN 0M 0 stage and 1 case of pT 3aN 1M 0stage. The follow-up time of 13 patients with complete follow-up data was (21.4±14.9) months after local recurrence resection. The tumor recurred in 3 patients and metastasized in 2 patients. The disease-free survival time of the above 5 patients was (13.2±8.8) months. Of the 4 patients who underwent partial nephrectomy, 3 had recurrence or metastasis. Among the 9 patients who underwent radical nephrectomy, 2 had postoperative recurrence or metastasis, and 7 patients survived without tumor until the last follow-up. Conclusions:For patients with local recurrence after partial nephrectomy who are in good condition and the recurrent lesions can be completely resected, the second operation is safe, feasible and effective. Patients with secondary radical nephrectomy have better prognosis. If the patient has a solitary kidney, the recurrent tumor is small and the margin is clear, partial nephrectomy can also be selected for the second operation. But the postoperative follow-up should be emphasized, and the adjuvant drug therapy should be given if necessary.

Research and progress of three-dimensional printing in the field of hepatopancreatobiliary surgery / 中华肝胆外科杂志

Three-dimensional (3D) printing is an additive manufacturing technology, which is widely used in automobile, aerospace, food, medicine and other fields. 3D printing technology brings novel solutions for precision medicine. In the field of hepatopancreatobiliary surgery, 3D printing is used in medical education, surgical simulation, patient-specific liver models printing in hepatectomy and liver transplantation. In the future, with the discovery and application of high-tech materials, 3D printing technology will be further developed in hepatopancreatobiliary surgery, and hepatobiliary surgery will usher in a new spring. This paper will review the application and future prospects of 3D printing technology in hepatopancreatobiliary surgery.

Research and practice of integrating curriculum ideology and politics into the teaching of Chinese Materia Medica Processing / 中华医学教育探索杂志

As an elective or compulsory professional course for traditional Chinese medicine related majors in colleges and universities, Chinese Materia Medica Processing plays a role in imparting professional knowledge and skills. More importantly, the Chinese Materia Medica Processing also has a recessive role in the cultivation of professional ethics. Through in-depth excavation of the rich ideological and political education elements in the teaching of Chinese Materia Medica Processing, the seamless connection between the ideological and political elements and the knowledge module of the course is realized, and the modern Chinese Materia Medica Processing teaching mode with the organic unity of value guidance, knowledge teaching and ability training is built, so as to achieve the unity of knowledge teaching and value guidance while highlighting the professional skills training.

A clinical research on relationship between sepsis-induced coagulopathy and prognosis in patients with sepsis / 中华急诊医学杂志

Objective:To evaluate the prognostic value of sepsis-induced coagulopathy (SIC) in patients with sepsis.Methods:From January 2019 to December 2021, patients with sepsis admitted to the Intensive Care Unit of our hospital were retrospectively classified into the SIC group and non-SIC group according to SIC diagnostic criteria. The baseline clinical data, severity score, total length of hospital stay, length of ICU stay and 28-day survival were compared between the two groups. Kaplan-Meier was used to compare the 28-day survival of patients with sepsis between the two groups. Cox proportional hazard regression model was employed to analyze the risk factors of prognosis in patients with sepsis.Results:Totally 274 patients with sepsis were included in the analysis, including 139 patients in the SIC group and 135 patients in the non-SIC group. The two groups were compared in the perspectives of the Platelet count (PLT), prothrombin time (PT) , procalcitonin (PCT), D dimer, hematocrit, red blood cell distribution width, hemoglobin, acute kidney injury (AKI), the use of continuous renal replacement treatment (CRRT), the use of vasoactive drugs, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACHEⅡ) score were compared between the two groups and the difference were statistically different (all P<0.05). Kaplan-Meier analysis showed that the 28-day mortality rate in the SIC group was significantly higher than that in the non-SIC group (32.4% vs. 14.1%, P<0.05). COX proportional hazard model showed that SIC score ( HR= 2.17, 95% CI: 1.15-3.91, P<0.05), APACHEⅡ score ( HR= 1.13, 95% CI: 1.09-1.17, P<0.05) and the use of vasoactive drugs ( HR=3.66, 95% CI: 1.53-8.75, P<0.05) were independent influencing factors for 28-day death in patients with sepsis. Conclusions:Patients with sepsis and SIC have more severe disease and increased mortality risk. SIC score exhibits good clinical value in predicting the prognosis of patients with sepsis.

Effects of dopamine on oxidative stress and VEGF expression in retinal tissues of rats with diabetic retinopathy model / 国际生物医学工程杂志

Objective:To investigate the effect of dopamine on oxidative stress and vascular endothelial growth factor (VEGF) expression in the retinal tissue of diabetic retinopathy (DR) model rats.Methods:Ninety rats were randomly divided into three groups: the control group, the model group, and the dopamine group, with 30 rats in each group. In the dopamine group, the DR model was established by a high-sugar and high-fat diet for four consecutive weeks, and no drug intervention was given to the control or model groups. The eyes of rats in the dopamine group were injected intravitreally with 50 mg/kg dopamine solution. The retinal tissues of the rats in the three groups were observed under a light microscope after hematoxylin-eosin staining. The levels of catalase (CAT), superoxide dismutase (SOD), malondialdehyde (MDA), monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), and VEGF were detected by enzyme-linked immunosorbent assay (ELISA) in the retinal tissues of the rats in the three groups. Western blot was used to detect VEGF expression in the three groups of rats.Results:In the control rats, the inner retinal border membrane was flat, with fewer neovascular endothelial cells protruding into the vitreous, and no neovascularization connected to the inner membrane reaching the intravitreous was observed. Compared with the control group, rats in the model group had more vascular endothelial cells breaking through the inner border membrane, and significant cellular proliferation was observed under the inner border membrane. Compared with the model group, rats in the dopamine group had a less flat inner retinal border membrane, fewer neovascularized endothelial cells protruding into the vitreous, and less cellular proliferation under the inner border membrane. Compared with the control group, CAT and SOD levels were decreased, while MDA, MCP-1, IL-6, and VEGF levels were increased in the model group, and the differences between the two groups were statistically significant (all P < 0.05). Compared with the model group, CAT and SOD levels were increased in the dopamine group, while MDA, MCP-1, IL-6, and VEGF levels were decreased, and the differences between the two groups were statistically significant (all P < 0.05). Conclusions:Dopamine up-regulated CAT and SOD levels and down-regulated MDA, MCP-1, IL-6 levels, and VEGF expression in the retinal tissues of DR rats.

Medication Rules and Academic Experience of Professor WANG Xingkuan in Treatment of Chest Stuffiness and Pain Based on Data Mining / 中国实验方剂学杂志

ObjectiveTo study the medication rules of Professor. WANG Xingkuan and inherit his academic experience in the treatment of chest stuffiness and pain with the aid of the Traditional Chinese Medicine Inheritance Computing Platform V3.0 （TCMICS V3.0）. MethodThe original medical records of patients with angina pectoris in coronary heart disease （CHD） diagnosed and treated by Prof. WANG in the outpatient department of Hunan University of Chinese Medicine from 2017 to 2020 were collected and entered into the TCMICS V3.0. The rules of prescriptions and drugs were analyzed by the software. ResultA total of 1 044 prescriptions of Prof. WANG for the treatment of chest stuffiness and pain were collected. Most of the drugs were sweet and bitter in flavor and mainly acted on the lung meridian， followed by heart， spleen， liver， stomach， and kidney meridians. Among the prescriptions， Shengmaisan was the most commonly used classic prescription， and Xintongling No. Ⅲ was the top experienced prescription. High-frequency drugs mainly included Ophiopogonis Radix， Pinelliae Rhizoma， Salviae Miltiorrhizae Radix et Rhizoma， Trichosanthis Pericarpium， Coptidis Rhizoma， Schisandrae Chinensis Fructus， and Bupleuri Radix. The common doses of drugs were 3， 5， 10， and 15 g. The analysis of formulation rules revealed 129 combinations of common drugs， 58 combinations with confidence > 0.99， and the core drugs of common syndromes. Six core drug combinations were obtained by drug clustering. ConclusionProfessor WANG treats chest stuffiness and pain based on syndrome differentiation following the principles of benefiting Qi， nourishing Yin， eliminating phlegm， resolving stasis， soothing liver， and promoting bile secretion， reflecting his academic idea of "regulation of multiple organs and comprehensive treatment". The core prescriptions can be used for reference by clinical practitioners， but further clinical and experimental studies are still needed to verify their efficacy.

Surveillance of adverse events following immunization with combined attenuated live measles, mumps and rubella vaccines in Huzhou City from 2015 to 2021 / 预防医学

Objective@#To monitor the adverse events following immunization (AEFI) with combined attenuated live measles, mumps and rubella vaccines (MMR) in Huzhou City from 2015 to 2021, so as to provide insights into the implementation of the MMR immunization strategy.@*Methods@#All AEFI caused by MMR immunization in Huzhou City from 2015 to 2021 were captured from the AEFI Monitoring Information Management System of the Immunization Planning System of Chinese Disease Control and Prevention Information System, and the incidence, clinical features and epidemiological features of AEFI were analyzed descriptively.@*Results@#The reported incidence of AEFI caused by MMR immunization appeared a tendency towards a rise in Huzhou City from 2015 to 2021 (χ2trend=124.126, P<0.001). Totally 324 386 doses of MMR vaccines were immunized, and 317 cases with AEFI were reported, with an reported incidence rate of 9.77/104 doses. Following two-dose immunization, the reported incidence of AEFI caused by two-dose MMR immunization was significantly lower than by one-dose immunization (6.01/104 doses vs. 25.43/104 doses; χ2=113.692, P<0.001). The incidence rates of general reactions, abnormal reactions and coincidental events were 6.20/104 doses, 3.42/104 dose and 0.15/104 doses, respectively. Fever and allergic rash were predominant clinical manifestations of AEFI, and no vaccine quality accident, inoculation accident or psychogenic reaction were reported. There were 246 (77.60%) cases with AEFI within 24 hours following vaccination, and among children with AEFI, there were 173 boys (54.57%), and 200 children (63.09%) age ages of less than one year (63.09%). AEFI was reported in each quarter, and 99 cases (31.23%) were reported in the fourth quarter. The largest number of children with AEFI was reported in Wuxing District (78 cases, 24.61%).@*Conclusions@#The safety of MMR vaccination is high in Huzhou City. General reaction is the predominant AEFI, which mainly occurs within 24 hours following vaccination. Two-dose MMR vaccination does not increase the risk of AEFI.

Effects of single nucleotide polymorphism of drug metabolizing enzyme cytochrome P450 on the efficacy of inhaled cortisol hormone in asthmatic children / 中国临床药理学与治疗学

AIM: To elucidate the relationship between childhood asthma susceptibility and clinical efficacy of inhaled glucocorticoids (ICS) in children with different genotypes of asthma by exploring rs776746 and rs15524 single nucleotide polymorphisms (SNPs) of cytochrome P450 enzyme 3A5 (CYP3A5) gene in asthmatic children and healthy children. METHODS: The CYP3A5 gene rs776746 and rs15524 polymorphic sites were detected in 79 children (Case group) with asthma of Han nationality and 100 healthy children (Control group) who met the inclusion criteria admitted to the Northern Theater General Hospital in Northeast China from October 2016 to October 2020, and genotype, allele and linkage analysis were performed. The case group was given inhaled glucocorticoids by nebulised inhalation for 3 months, and lung function and exhaled breath nitric oxide (FeNO) were measured at entry and after treatment, and asthma control score C-ACT/ACT was done after treatment, so as to compare the prevalence of different genotypes and the differences in the above test index scores. RESULTS: There was complete linkage disequilibrium at rs776746 and rs15524 loci. There were three genotypes of T/T, T/C and C/C at rs776746 locus of CYP3A5 gene. There were significant differences in the frequency of different genotypes between the case group and the control group (χ

Screening of key targets for diabetic cardiomyopathy based on transcriptomics and proteomics / 中国药理学通报

Aim To explore a potential new target for the prevention and treatment of diabetic cardiomyopathy ( DCM) in mice. Methods The myocardial proteomics of normal and diabetic mice was studied. The GEO database GSE161931 dataset was analyzed using R language with P < 0.05 and I log

Regulation of gluconeogenesis in liver, kidney and intestine by glucagon / 中国药理学通报

Aim To investigate the regulatory effect of glucagon on gluconeogenesis in liver, kidney and intes¬tine during different fasting periods and the underlying mechanism. Methods The 8-week-old male C57BIV 6J mice were randomly divided into six groups ( n = 6) :control group, control + glucagon group, fasting 18 h group, fasting 18 h + glucagon group, fasting 36 h group, and fasting 36 h + glucagon group. Glucose, triglyceride ( TG) and free fatty acids ( FFAs ) kits were used to detect their serum contents in mouse in-traperitoneal injection of glucagon at different fasting time points. Besides, liver/muscle glycogen assay kit and PAS staining were used to detect the glycogen con¬tents in liver tissue. RT-PCR method was used to observe the effects of glucagon on the gene expressions of peroxisome proliferators-activated receptor y coactivator la (PGC-1α), glucose-6-phosphatase (G6Pase) and phosphoenol pyruvate carboxykinase 1 (PEPCK) in liver, kidney and intestine of mice at different fasting time. Western blot was employed to detect the protein expressions of PGC-1α, G6Pase, PEPCK, phosphoryl-ase protein kinase A ( p-PKA) , protlein kinase A (PKA) , phosphorylase cAMp-response element binding protein (p-CREB) and cAMp-response element binding protein (CREB) in liver, kidney and intestine of mice were. Results (1) Glucagon increased the serum glucose level, reduced serum TG and FFAs levels, and reduced the hepatic glycogen content. (2) Glucagon promoted gluconeogenesis via upregulation of PGC-1α. On the stimulation of glucagon, PGC-1α gene and protein expressions in liver were significantly raised by glucagon when the mice were fasted 18 h and 36 h, while the gene and protein expressions of PGC-1α in kidney were obviously up-regulated by glucagon after fasting 18 h. However, PGC-1α gene and protein expressions in intestine were significantly elevated by glucagon at 36 h after fasting. (3 ) Glucagon induced gene and protein expressions of gluconeogenesis-related enzymes G6Pase and PEPCK in liver, kidney and intestine after fasting. (4 ) Glucagon upregulated p-PKA/PKA and p-CREB/CREB in liver. Conclusions Glucagon shows temporal difference in the gluconeo-genic response of liver, kidney and intestine in mice. Glucagon promotes the gene and protein expressions of key gluconeogenic enzymes G6Pase and PEPCK by increasing PGC-1α gene and protein expression, and thus increasing fasting blood glucose. Besides, glucagon promotes hepatic gluconeogenesis via PKA/CREB signaling pathway.

Advances in the study of natural small molecules to protect the intestinal epithelial tight junction barrier in inflammatory bowel disease / 中国药理学通报

Inflammatory bowel disease (IBD), as an idiopathic inflammatory disease of the intestinal tract, consisting mainly of Crohns disease and ulcerative colitis, which can involve the rectum, colon and ileum, and whose pathogenesis is still not fully understood. The initiation of intestinal inflammation associated with IBD and its chronieity begins with increased intestinal permeability caused by intestinal epithelial barrier disruption. The anti-permeability of the intestinal epithelial barrier is maintained by tight junction in the apical region of the intestinal epithelial cells, and disruption of the tight junction structure is closely associated with intestinal epithelial barrier damage and the development of IBD. Therefore, it is significant to find drugs for the prevention and treatment of IBD using tight junctions as regulatory targets. In recent years, many small molecules of natural product origin have been reported to improve the effects of IBD. In particular, we review the compounds that have the function of repairing intestinal epithelial barrier and protecting tight junction structure, in order to provide research ideas for the design and development of new drugs for the prevention and treatment of IBD.

Obstetric Clinical Analysis in 8 Cases With Cushing’s Syndrome / 中山大学学报(医学科学版)

ObjectiveTo summarize and analyze the clinical characteristics， diagnosis process， treatment process， and obstetric outcomes of pregnant women with Cushing's syndrome， helping to optimize pregnancy management. MethodsA retrospective study was conducted on 8 pregnant women with Cushing’s syndrome who were hospitalized in the First Affiliated Hospital， Sun Yat-sen University between January 2006 and August 2022. The clinical characteristics， management and obstetric outcomes were recorded. ResultsPreeclampsia was detected in 4 cases，pre-gestational diabetes mellitus in 2 cases， gestational diabetes mellitus in 5 cases， and hypokalemia in all 8 cases. Elevated serum cortisol， disappearance of day-night rhythm of cortisol， increased 24-hour urine cortisol and decrease in serum ACTH were found in 8 cases by laboratory examination. Furthermore， adrenal adenoma was detected in all 8 cases by ultrasonography or Magnetic Resonance Imaging. Three cases underwent laparoscopic adrenalectomy in the second trimester and 4 cases received surgery after delivery. The diagnosis of adrenal cortical adenoma was confirmed by pathological report. Six cases had preterm birth， while one patient delivered after 37 weeks of gestation and one patient suffered from spontaneous abortion. Among 7 cases of live birth， 6 patients underwent cesarean section and 1 patient had vaginal delivery. Of all newborns， 3 had low birth weight. One case had a birth defect. Four infants were transferred to the neonatal intensive care unit， and two infants died. One child was diagnosed with nephrotic syndrome at 2 years of age. ConclusionsCushing's syndrome is rare and high risk during pregnancy. It requires multidisciplinary diagnosis， treatment， and long-term follow-up. Drug therapy carries a risk of progression and requires intensive care during pregnancy， postpartum follow-up， and specialist treatment.