Association between congenital hypothyroidism and in-hospital adverse outcomes in very low birth weight infants / 中华儿科杂志

Objective: To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI). Methods: This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1st, 2019 to December 31st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results: A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) (OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above (OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above (OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion: There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Efficacy observation on prevention of chemotherapy-related anemia by combined therapy of traditional Chinese medicine in malignant tumors / 肿瘤研究与临床

Objective:To explore the effect of combined therapy of traditional Chinese medicine on prevention of chemotherapy-related anemia in malignant tumors.Methods:Seventy-nine patients with malignant tumors diagnosed in Zibo Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected, and the patients were divided into experimental group (40 cases) and control group (39 cases) according to the random number table method. The control group received chemotherapy and the experimental group received chemotherapy and combined therapy of traditional Chinese medicine (Wuhong Tang combined with moxibustion). The hemoglobin (Hb) level, Karnofsky score and adverse effects were recorded before and on days 7, 14 and 21 after chemotherapy in the two groups.Results:The Hb level in the experimental group was higher than that in the control group [(117±28) g/L vs. (100±31) g/L] on day 21 after chemotherapy, and the difference was statistically significant ( t = -3.08, P = 0.030). The total effective rate of the experimental group was higher than that of the control group [85% (34/40) vs. 66.7% (26/39)], but the difference was not statistically significant ( χ2 = 4.96, P = 0.084). Karnofsky scores were (77±9) points and (77±12) points before and on day 21 after treatment in the experimental group, with no statistical difference ( t = -0.50, P = 0.623); Karnofsky scores were (78±10) points and (67±9) points in the control group, with statistical difference ( t = 8.32, P < 0.001). There was no statistical difference in Karnofsky score before treatment between the two groups ( t = 1.85, P = 0.068), but the experimental group was higher than the control group on day 21 after treatment ( t = 4.88, P < 0.001). The difference in the incidence of nausea and vomiting between the two groups was not statistically significant ( P > 0.05), and no chemotherapy-related hepatic, renal or cardiac adverse reactions were observed in either group. Conclusions:Combined therapy of traditional Chinese medicine could effectively prevent chemotherapy-related anemia and improve the quality of life of patients.

Protective effects of Moutan Cortex polysaccharides components on renal injury in diabetic nephropathy rats / 中国中药杂志

This study investigated the protective effects of Moutan Cortex polysaccharides components(MCPC) on the renal tissues of diabetic nephropathy(DN) rats and explored their regulation effect on inflammatory response and oxidative stress. The DN rat model was induced by high-glucose and high-fat diet combined with streptozotocin(STZ), and then the rats were randomly divided into control group, model group, positive group and MCPC high(120 mg·kg~(-1)·d~(-1)), low(60 mg·kg~(-1)·d~(-1)) dose groups. After 12 weeks treatment, blood was taken from the orbit of the rats, and then they were sacrificed before the kidney tissues were collected. The serum and tissues were detected for related biochemical indicators and pathological changes of the kidney. Immunohistochemical methods were used to determine the expression of FN and ColⅣ in the kidney tissue of DN rats. Compared with the model group, blood glucose, serum creatinine, blood urea nitrogen and 24 h urine protein in the MCPC high-dose group were significantly reduced(P<0.01). The results of HE, PAS, Masson staining showed that glomerular basement membrane thickening, Bowman's capsule narrowing and inflammatory cell infiltration in DN rats were improved in the MCPC high-dose group; the activity of T-SOD and GSH-Px in serum significantly increased(P<0.001), and the expression level of FN significantly decreased(P<0.001). The high-dose MCPC treatment could effectively inhibit the abnormal expression of Col Ⅳ(P<0.001) and significantly reduce the levels of AGEs and RAGE in serum(P<0.001), the content of VCAM-1 and IL-1β in serum(P<0.001), and the levels of IL-1β mRNA in kidney tissue(P<0.001), but failed to effectively reduce VCAM-1 mRNA levels in kidney tissues. The high-dose MCPC could significantly improve pathological injury of renal tissue and related renal indicators in DN rats, and achieve renal protection in DN rats mainly by regulating oxidative stress and inflammatory factors.

Effect of hypochloric acid on Escherichia coli biofilm and the clinical efficacy of hypochloric acid for wounds with Escherichia coli infection / 中华烧伤杂志

Objective: To investigate the effect of hypochloric acid on Escherichia coli biofilm and the clinical efficacy of hypochloric acid for wounds with Escherichia coli infection. Methods: One strain of Escherichia coli with the strongest bacterial biofilm forming ability among the strains isolated from specimens in 25 patients (16 males and 9 females, aged 32-67 years) from five clinical departments of the 940th Hospital of the Joint Logistic Support Force was collected for the experimental study from September to December 2019. The Escherichia coli was cultured with hypochloric acid at 162.96, 81.48, 40.74, 20.37, 10.18, 5.09, 2.55, 1.27, 0.64, and 0.32 μg/mL respectively to screen the minimum bactericidal concentration (MBC) of hypochloric acid. The Escherichia coli was cultured with hypochloric acid at the screened MBC for 2, 5, 10, 20, 30, and 60 min respectively to screen the shortest bactericidal time of hypochloric acid. The biofilm formation of Escherichia coli was observed by scanning electron microscopy at 6, 12, 24, 48, 72, and 96 h of incubation, respectively. After 72 h of culture, hypochloric acid at 1, 2, 4, 8, and 16 times of MBC was respectively added to Escherichia coli to screen the minimum biofilm eradicate concentration (MBEC) of hypochloric acid against Escherichia coli. After hypochloric acid at 1, 2, 4, and 8 times of MBEC and sterile saline were respectively added to Escherichia coli for 10 min, the live/dead bacterial staining kit was used to detect the number of live and dead cells, with the rate of dead bacteria calculated (the number of samples was 5). From January to December 2020, 41 patients with infectious wounds meeting the inclusion criteria and admitted to the Department of Burns and Plastic Surgery of the 940th Hospital of Joint Logistic Support Force of PLA were included into the prospective randomized controlled trial. The patients were divided into hypochloric acid group with 21 patients (13 males and 8 females, aged (46±14) years) and povidone iodine group with 20 patients (14 males and 6 females, aged (45±19) years) according to the random number table. Patients in the 2 groups were respectively dressed with sterile gauze soaked with hypochloric acid of 100 μg/mL and povidone iodine solution of 50 mg/mL with the dressings changed daily. Before the first dressing change and on the 10th day of dressing change, tissue was taken from the wound and margin of the wound for culturing bacteria by agar culture method and quantifying the number of bacteria. The amount of wound exudate and granulation tissue growth were observed visually and scored before the first dressing change and on the 3rd, 7th, and 10th days of dressing change. Data were statistically analyzed with one-way analysis of variance, Dunnett-t test, independent sample t test, Mann-Whitney U test, Wilcoxon signed-rank test, chi-square test, or Fisher's exact probability test. Results: The MBC of hypochloric acid against Escherichia coli was 10.18 μg/mL, and the shortest bactericidal time of hypochloric acid with MBC against Escherichia coli was 2 min. Escherichia coli was in a completely free state after 6 and 12 h of culture and gradually aggregated and adhered with the extension of culture time, forming a mature biofilm at 72 h of culture. The MBEC of hypochloric acid against Escherichia coli was 20.36 μg/mL. The Escherichia coli mortality rates after incubation with hypochloric acid at 1, 2, 4, and 8 times of MBEC for 10 min were significantly higher than that after incubation with sterile saline (with t values of 6.11, 25.04, 28.90, and 40.74, respectively, P<0.01). The amount of bacteria in the wound tissue of patients in hypochloric acid group on the 10th day of dressing change was 2.61 (2.20, 3.30)×104 colony forming unit (CFU)/g, significantly less than 4.77 (2.18, 12.48)×104 CFU/g in povidone iodine group (Z=2.06, P<0.05). The amounts of bacteria in the wound tissue of patients in hypochloric acid group and povidone iodine group on the 10th day of dressing change were significantly less than 2.97 (2.90, 3.04)×106 and 2.97 (1.90, 7.95)×106 CFU/g before the first dressing change (with Z values of 4.02 and 3.92, respectively, P<0.01). The score of wound exudate amount of patients in hypochloric acid group on the 10th day of dressing change was significantly lower than that in povidone iodine group (Z=2.07, P<0.05). Compared with those before the first dressing change, the scores of wound exudate amount of patients in hypochloric acid group on the 7th and 10th days of dressing change were significantly decreased (with Z values of -3.99 and -4.12, respectively, P<0.01), and the scores of wound exudate amount of patients in povidone iodine group on the 7th and 10th days of dressing change were significantly decreased (with Z values of -3.54 and -3.93, respectively, P<0.01). The score of wound granulation tissue growth of patients in hypochloric acid group on the 10th day of dressing change was significantly higher than that in povidone iodine group (Z=2.02, P<0.05). Compared with those before the first dressing change, the scores of wound granulation tissue growth of patients in hypochloric acid group on the 7th and 10th days of dressing change were significantly increased (with Z values of -3.13 and -3.67, respectively, P<0.01), and the scores of wound granulation tissue growth of patients in povidone iodine group on the 7th and 10th days of dressing change were significantly increased (with Z values of -3.12 and -3.50, respectively, P<0.01). Conclusions: Hypochloric acid can kill Escherichia coli both in free and biofilm status. Hypochloric acid at a low concentration shows a rapid bactericidal effect on mature Escherichia coli biofilm, and the higher the concentration of hypochloric acid, the better the bactericidal effect. The hypochloric acid of 100 μg/mL is effective in reducing the bacterial load on wounds with Escherichia coli infection in patients, as evidenced by a reduction in wound exudate and indirect promotion of granulation tissue growth, which is more effective than povidone iodine, the traditional topical antimicrobial agent.

Prognosis factors for death within 90 days of discharge in patients with acute kidney injury requiring continuous renal replacement therapy after surgery for Stanford type A acute aortic dissection / 中华外科杂志

Objective: To investigate the prognosis factors for death within 90 days after discharge in patients with acute kidney injury(AKI) treated requiring continuous renal replacement therapy(CRRT) undergoing surgery for acute Standford type A aortic dissection. Methods: The clinic data of 126 patients undergoing CRRT for postoperative AKI after acute type A aortic dissection surgery in the Center for Cardiac Intensive Care, Beijing Anzhen Hospital from July 2016 to February 2019 were analyzed retrospectively. There were 83 males and 43 females, aging (52.9±11.2) years(range: 25 to 70 years). The patients' demographic characteristics, disease-related information, perioperative data, laboratory indexes during CRRT, complications, and survival information within 90 days after discharge were recorded. Independent prognosis factors for death within 90 days of discharge were determined by Kaplan-Meier survival analysis, univariate and multifactorial Cox regression analysis. Results: Totally 57 of 126 patients(45.2%) died over the first 90 days after discharge. Kaplan-Meier survival analysis and univariate Cox regression analysis showed that there were significant differences between the non-survival and survival group including ≥65 years old, high lactate values 12 hours after CRRT, pulmonary infection, liver dysfunction, presence of permanent neurological complications, and postoperative ejection fraction(EF)<45%. Multifactorial Cox regression analysis revealed that ≥65 years old(HR=2.14, 95%CI: 1.09 to 4.21, P=0.03), high lactate values 12 hours after CRRT(HR=1.13, 95%CI: 1.06 to 1.20, P=0.01) and postoperative EF<45%(HR=2.21, 95%CI: 1.09 to 4.51, P=0.03) were independent prognosis factors for patients' death within 90 days after hospital discharge. Conclusions: ≥65 years old, high lactate values 12 hours after CRRT and postoperative EF<45% are independent prognosis factors for death within 90 days after discharge in patients undergoing CRRT for AKI after acute type A aortic dissection surgery. Proper identification and management of prognosis factors could be beneficial to improve patients' outcomes.

A comparative analysis of the distribution of the high-risk population of upper gastrointestinal cancer and endoscopic screening compliance in two urban areas and two rural areas in China / 中华肿瘤杂志

Objective: To analyze and compare the distribution of the high-risk population of upper gastrointestinal (UGI) cancer and the factors influencing the compliance rate of endoscopic screening in urban China and rural China. Methods: From 2015 to 2017, an epidemiological survey was conducted on residents aged 40-69 in two rural areas (Luoshan county of Henan province, Sheyang county of Jiangsu province) and two urban areas (Changsha city of Hunan province, Harbin city of Heilongjiang province). As a result, high-risk individuals were recommended for endoscopic screening. Chi-square χ(2) test was used to compare the high-risk rate of UGI cancer between urban and rural residents. In addition, the multivariate logistic regression model was used to analyze the factors influencing the compliance rate of endoscopic screening. Results: A total of 48, 310 residents aged 40-69 were enrolled in this study, including 22 870 (47.34%) residents from rural areas and 25 440 (52.66%) residents from urban areas. A total of 23 532 individuals were assessed with a high risk of UGI cancer, with an overall risk rate of 48.71%. A higher proportion of participants with high risk was observed in rural China (56.17%, 12 845/22 870) than in urban China (42.01%, 10 687/25 440). A total of 10 971 high-risk individuals with UGI cancer participated in endoscopic screening, with an overall compliance rate of 46.62% (10 971/23 532), 45.15% (5 799/12 845) in rural China, and 48.40% (5 172/10 687) in urban China. In rural population, the compliance rate of endoscopic screening was higher in those of females, aged 50-69 years, primary school education or above, high income, a family history of UGI cancer, history of gastric and duodenal ulcer, history of reflux esophagitis, and history of superficial gastritis, but lower in smokers (P<0.05). Among the urban population, the compliance rate of endoscopic screening was higher in those aged 40-49 years, uneducated, low income, family history of UGI cancer, history of reflux esophagitis, history of superficial gastritis, but lower in smokers (P<0.05). Conclusions: The proportion of participants with high risk of UGI cancer in rural areas is higher than that of urban areas. The compliance rates of endoscopic screening in urban and rural areas are low, and influencing factors of endoscopic screening exhibit some differences in rural China and urban China.

Establishment of a deep learning-based visual model for intelligent recognition of Oncomelania hupensis / 中国血吸虫病防治杂志

Objective To establish a deep learning-based visual model for intelligent recognition of Oncomelania hupensis, the intermediate host of Schistosoma japonicum, and evaluate the effects of different training strategies for O. hupensis image recognition. Methods A total of 2 614 datasets of O. hupensis snails and 4 similar snails were generated through field sampling and internet capture, and were divided into training sets and test sets. An intelligent recognition model was created based on deep learning, and was trained and tested. The precision, sensitivity, specificity, accuracy, F1 score and Youden index were calculated. In addition, the receiver operating characteristic (ROC) curve of the model for snail recognition was plotted to evaluate the effects of “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies on the accuracy of the model for snail recognition. Results Under the “transfer learning + data enhancement” strategy, the precision, sensitivity, specificity, accuracy, Youden index and F1 score of the model were 90.10%, 91.00%, 97.50%, 96.20%, 88.50% and 90.51% for snail recognition, which were all higher than those under both “new learning” and “transfer learning” strategies. There were significant differences in the sensitivity, specificity and accuracy of the model for snail recognition under “new learning”, “transfer learning” and “transfer learning + data enhancement” training strategies (all P values < 0.001). In addition, the area under the ROC curve of the model was highest (0.94) under the “transfer learning + dataenhancement” training strategy. Conclusions This is the first visual model for intelligent recognition of O. hupensis based on deep learning, which shows a high accuracy for snail image recognition. The “transfer learning + data enhancement” training strategy is helpful to improve the accuracy of the model for snail recognition.

Cyclization of α-conotoxin A10LPnIA with lysine assisted cyanuric chloride linker / 药学学报

The cyanuric chloride linkers have been used for cyclizing polypeptide, but not used for α-conotoxin, the peptides with rich disulfide bonds and more amino acid residues. In this study, cyclic peptides c[A10L]PnIA-1-4 were synthesized efficiently by lysine assisted cyanuric chloride linkers with 28.92%-52.00% yields. The activity evaluation showed that the IC50 values of c[A10L]PnIA-1 against α7 and α3β2 nAChR subtypes were 5 and 7 times higher than [A10L]PnIA respectively, and the subtype selectivity was maintained. The results of circular dichroism show that this cyclization method had no significant effect on its secondary structure. Compared with the commonly used head-to-tail cyclization in conotoxin cyclization, this method has the advantages of rapid reaction and high yield, which is expected to be further applied to the cyclization study of various α-conotoxins.

Rapid screening of Salmonella by loop-mediated isothermal amplification combined with lateral flow dipstick / 上海预防医学

Objective:To establish a specific and sensitive method using loop-mediated isothermal amplification for rapid screening of Salmonella. Methods:The invA gene sequence of Salmonella was downloaded from GenBank. After homology comparison with DNAMAN software， amplification primers were designed in the conserved region， and a LAMP-LFD detection method was established. The reaction system was optimized， and the specificity and sensitivity of the method were verified. Results:The sensitivity of this method to detect Salmonella DNA was up to 1.0×101 copies/μL. The positive rate of anal swabs was the same as that of fluorescent PCR. Meanwhile， LAMP-LFD was easy to operate and did not need expensive instruments. The detection result could be obtained within 30 minutes. Conclusion:The LAMP-LFD method established in this study is rapid， simple， sensitive and specific， which is suitable for rapid screening of Salmonella.

Pre-treatment drug resistance of newly reported HIV-1 infected individuals in Wenzhou / 预防医学

Objective@#To know the pre-treatment drug resistance ( PDR ) status of newly reported human immunodeficiency virus type 1 ( HIV-1 ) infected individuals in Wenzhou, so as to provide guidance for antiretroviral therapy ( ART ). @*Methods@# Totally 232 plasma samples of newly reported HIV-1 infected individuals who had not received ART were collected in Wenzhou in 2019. Virus ( HIV-1 ) RNA was extracted, followed by reverse transcription PCR and nested PCR to amplify the pol region and sequence. Resistance mutations and resistance to non-nucleoside reverse transcriptase inhibitors ( NNRTIs ), nucleoside reverse transcriptase inhibitors ( NRTIs ) and protease inhibitors ( PIs ) was analyzed.@*Results@#The pol region sequences from 199 infected patients were obtained and the incidence of PDR was 8.04% ( 16/199 ). Eight genotypes were detected, including circulating recombinant forms ( CRFs ) CRF07_BC ( 47.24%, 94/199 ) and CRF01_AE ( 29.15%, 58/199 ) which were the dominant types. Two unique recombinant forms ( URFs ) were detected, namely URF( CRF01_AE/BC ) and URF( B/C ) . Thirty-one cases ( 15.58% 31/199 ) had drug-resistant mutations. For NNRTIs, NRTIs and PIs, 20 cases ( 64.52% ) , 2 cases ( 6.45% ) and 9 cases ( 29.03% ) with drug resistance mutations were detected, respectively. The resistance mutations to NNRTIs included K101E, K103N/R, V106I, E138K, V179D/E/T, Y181C, G190A and H221Y. Four cases each had two resistance mutations to NNRTIs. The resistance mutations to NRTIs were V75M and M184V. The resistance mutations to PIs were M46I, L33F and Q58E. For the newly released NNRTI drug Doravirine ( DOR ), two cases were found to have mutations of resistance. @*Conclusions@#The incidence of PDR among newly reported HIV-1 patients in Wenzhou is 8.04%, mainly caused by NNRTIs drug-resistant mutation. Resistance to the new drug DOR has emerged. The surveillance of drug resistance should continue to be strengthened.

Spatio-temporal patterns of Oncomelania hupensis snail habitats in Suzhou, Wuxi and Changzhou cities along the Taihu Lake region / 中国血吸虫病防治杂志

Objective To investigate the spatio-temporal distribution characteristics of Oncomelania hupensis snail habitats in three cities of Suzhou, Wuxi and Changzhou along the Taihu Lake region, so as to provide technical supports for establishing a sensitive and highly effective surveillance and forecast system for schistosomiasis. Methods Snail distribution data were collected from Suzhou, Wuxi and Changzhou cities from 1950 to 2018, and the changing trend for snail habitats were described over years. In addition, the clusters of snail habitats were detected using Kernel density analysis and SaTScan space-time scan analysis. Results The number of snail habitats appeared a single-peak distribution in Suzhou, Wuxi and Changzhou cities from 1950 to 2018, which peaked in 1970 and then declined rapidly. There were 62.68% of snail habitats eliminated within 10 years after identification, of which 38.24% were eliminated at the year of identification. Kernel density analysis and SaTScan space-time scan analysis revealed that high-density clusters of snail habitats were mainly distributed in Kunshan City, Wuzhong District and Xiangcheng District from 1970 to 1980, and in Yixing City in 1990; since then, the clusters gradually shrank, and overall appeared a move from northeast to west of Taihu Lake. A total of 4 new clusters were detected after 1970, as revealed by space-time scanning of snail habitats. In current snail habitats, emerging snail habitats are mainly identified in Huqiu District (Dongzhu Town), Wuzhong District (Guangfu Town), Taicang City (Shaxi Town) and Jintan District, and re-emerging snail habitats are scattered in 7 districts. Conclusions The distribution of snail habitats are spatio-temporal aggregation in Suzhou, Wuxi and Changzhou cities. The monitoring and prediction of emerging and re-emerging snail habitats are the key points in the future.

Practice and development of structural characteristics and quality control of multi-dimensional structure of basic components of genuine material of Moutan Cortex / 中国中药杂志

Traditional Chinese medicine is the product of clinical medication practice of the Chinese nation for thousands of years. Its material basis is the key to reveal the essence of the roles of traditional Chinese medicine, and the fundamental guarantee to solve the difficulties in the quality control of traditional Chinese medicine. However, the material basis of traditional Chinese medicine is to exert the overall pharmacodynamic effect through multi-targets, multi-approaches and mutual cooperation, resulting in unclear quality control index. In recent years, the quality control standards of traditional Chinese medicine have experienced great changes by shifting the focus from the appearance characteristics to the internal material basis, which however is limited to the control of a single com-ponent or multiple components. In other words, the intrinsic effectiveness and safety could not be guaranteed without the characteristics of the integrity of traditional Chinese medicine. With Moutan Cortex as an example, this paper analyzed the evolution of Moutan Cortex quality standards based on Chinese Pharmacopoeia, and comprehensively summarized the material basis of Moutan Cortex. Based on the theory of "component structure", this study analyzed current quality control of the material basis of Moutan Cortex and its preparations, and expounded the development trend of multi-dimensional quality control, so as to lay a foundation for establishing a more rational quality control system for traditional Chinese medicine in the future.

Structural characteristics of pharmacodynamical components in genuine Moutan Cortex / 中国中药杂志

Guided by the theory of "component structure", we analyzed the structural characteristics of pharmacodynamical components in genuine Moutan Cortex. The compositions of organic small molecules were determined by high performance liquid chromatography(HPLC) for 20 batches of genuine Moutan Cortex and 12 batches of non-genuine Moutan Cortex. By means of similarity analysis, clustering analysis(CA), principal component analysis(PCA) and orthogonal partial least-squares discriminant analysis(OPLS-DA), the elements in structural characteristics of the pharmacodynamical components were extracted as follows: terpene glycosides components(oxidized paeoniflorin, paeoniflorin,galloyl paeoniflorin, benzoyloxy paeoniflorinand benzoyl paeoniflorin), tannin components(1,3,6-tri-O-galloside acyl glucose, pentagalloyl glucose), and phenolic acid components(methyl gallate, paeonol). The contents and quantity ratios of terpene glycoside component, tannin component and phenolic acid components in genuine Moutan Cortex were determined as 14.1, 12.5, 21.7 mg·g~(-1), 1.00∶0.89∶1.54. The contents and quantity ratios of the oxidized paeoniflorin, paeoniflorin and benzoylpaeoniflorin in the terpene glycoside components were characteristic and determined as 2.05, 7.05, 3.30 mg·g~(-1), 1.00∶3.44∶1.61. The unique structural characteristics of genuine Moutan Cortex provide scientific basis for the formulation of quality standards.

Comparative analysis and study on component characteristics of inorganic elements in genuine Moutan Cortex and their differences from other areas / 中国中药杂志

Based on the theory of "component structure", the component structure characteristics of 17 inorganic elements in 20 batches of genuine Moutan Cortex and 12 batches of non-genuine Moutan Cortex were analyzed. The analytical method of inductively coupled plasma mass spectrometry(ICP-MS) for inorganic elements in Moutan Cortex was established, and the fingerprint of inorganic elements was drawn. Through correlation analysis and principal component analysis, the constituent elements of inorganic elements in Moutan Cortex were excavated, namely characteristic elements As, Cr, Pb, Se, K, Cu and Cd. The amount and the quantity relative ratio between the components of genuine and non-genuine Moutan Cortex samples were analyzed. It was found that the amount of characteristic elements in the bulk genuine Moutan Cortex samples was 0.33, 1.42, 1.33, 0.11, 4 385.78, 4.87, 0.49 mg·kg~(-1), with the quantity relative ratio of 1.00∶4.30∶4.03∶0.33∶13 290.24∶14.76∶1.48. The amount of characteristic elements in sub-packaged genuine Moutan Cortex was 0.24, 1.96, 0.36, 0.05, 5 122.01, 4.81, 0.05 mg·kg~(-1), with the quantity relative ratio of 1.00∶8.17∶1.50∶0.21∶21 341.71∶20.04∶0.21. The unique structural characteristics of inorganic elements in genuine Moutan Cortex are studied to provide a basis for the quality control and safety evaluation of Moutan Cortex.

Effects of dendritic cell-based adoptive immunotherapy with over-expressed SOCS1 on Th17- and Treg-related cytokines in the BALF of COPD mice / 医学研究生学报

Objective　Dendritic cells (DCs), helper T cells 17 (Th17) and regulatory T cells (Treg) are closely related to the pathogenesis of chronic obstructive pulmonary disease (COPD). This study aimed to investigate the changes of Th17- and Treg-related cytokines in the bronchoalveolar lavage fluid (BALF) of COPD mice after DC-based adoptive immunotherapy with over-expressed suppressor of cytokine signaling protein 1 (SOCS1) and provide some new ideas for the treatment of COPD.　Methods　A total of 48 male C57BL/6 mice were randomly divided into 5 groups: healthy control, COPD model control, immature DC (imDC), DC-SOCS1 1×106, and DC-SOCS1 2×106. The healthy controls were exposed to air and fed normally, the COPD model controls injected with normal saline at 0.5 mL/ on the first day of modeling by fumigation, the mice of the imDC group injected via the tail vein with 1 ×106 imDCs, and those of the DC-SOCS1 groups injected with 1 ×106 or 2 ×106 DCs with over expressed SOCS1, all via the tail vein on the 1st and 7th day of modeling. Then the lung tissues were collected from the mice for preparation of paraffin sections and HE staining, and ELISA was employed for determination of the levels of Th17-related IL-17 and IL-23 and Treg-related IL-10 and TGF-β in the BALF of the model mice.　Results　Compared with the COPD model controls, the mice in the imDC, DC-SOCS1 1×106 and DC-SOCS1 2×106 groups showed significantly decreased levels of IL-17 on the 1st day ([78.87 ± 1.08] vs [46.46 ± 0.77], [34.09 ± 3.98] and [24.12 ± 0.57] pg/mL, P < 0.05) and 7th day after modeling ([78.87 ± 1.08] vs [55.69 ±0.35], [35.65 ± 0.54] and [27.00 ± 0.58] pg/mL, P < 0.05), and IL-23 on the 1st day ([200.62 ± 0.65] vs [150.19 ± 0.53], [121.09 ± 0. 53] and [70.21 ± 0.91] pg/mL, P < 0.05) and 7th day ([200.62 ± 0.65] vs [167.70 ± 1.73], [136.34 ± 0.90] and [99.35 ± 1.83] pg/mL, P < 0.05), but remarkably increased levels of IL-10 on the 1st day ([39.46 ± 3.88] vs [50.74 ± 1.77], [58.71 ± 3.84] and [70.12 ± 2.62] pg/mL, P < 0.05) and 7th day ([39.46 ± 3.88] vs [44.56 ± 2.63], [54.78 ± 1.43] and [63.00 ± 2.57] pg/mL, P < 0.05), TGF-β on the 1st day ([24.98 ± 0.43] vs [36.46 ± 0.98], [42.40 ± 0.62] and [50.55 ± 0.53] pg/mL, P < 0.05) and 7th day ([24.98 ± 0.43] vs [33.27 ± 0.92], [40.12 ± 0.83] and [44.98 ± 0.52] pg/mL, P < 0.05). The contents of IL-17 and IL-23 were markedly lower while those of IL-10 and TGF-β higher in the DC-SOCS1 1×106 than in the imDC group (P < 0.05), and the levels of the former two significantly higher and those of the latter two lower in the DC-SOCS1 2×106 than in the DC-SOCS1 1×106 group (P < 0.05).　Conclusion　Transfusion of DCs with over-expressed SOCS1 can inhibit the secretion of Th17-related cytokines in COPD, and the effect is better than that of imDCs alone and related to the concentration and time.

Investigation and analysis on anorexia in patients with malignant tumor after chemotherapy treated from spleen and kidney point of view / 中国中西医结合急救杂志

Loss of appetite is called anorexia in traditional Chinese medicine (TCM), and it is one of the most common adverse reactions in the course of chemotherapy for treatment of patients with malignant tumor. Anorexia results in severe malnutrition and delay of the recovery of physical strength, that lead to the patients' intolerance to chemotherapy, incompliance with the treatment, no guarantee in quality of life, loss of confidence in treatment effect and finally, the therapeutic efficacy is seriously affected. According to an old classical TCM book: The " Kidney is the Gate of Stomach" is discussed in the book, so the author of this article has used tonifying spleen and kidney method to improve anorexia after tumor chemotherapy,and the efficacy is satisfactory. Most doctors believe that the formation of tumor is"due to deficiency". Mainly, the internal visceral organs are responsible for the weakness of healthy qi, particularly the Spleen and kidney. The basis of tumor formation is the weakness of the viscera, especially the deficiency of spleen and kidney. Based on clinical experiences, the spleen and kidney tonification method is discussed and used as the guidance to treat the anorexia after chemotherapy for malignant tumor patients, showing that the method is important for treatment of anorexia in such patients.

A study of community-acquired Mycoplasma pneumoniae in Yantai, China / Estudio de Mycoplasma pneumoniae adquirido en la comunidad en Yantai, China

Abstract Introduction: Community-acquired pneumonia (CAP) is a global disease responsible for a large number of deaths, with significant economic impact. As diagnostic tools have increased in sensitivity, understanding of the etiology of CAP has begun to change. Mycoplasma pneumoniae is one of the major pathogens causing CAP. Macrolides and related antibiotics are first-line treatments for M. pneumoniae. Macrolide resistance has been spreading for 15 years and now occurs in worldwide. We undertook the first study on macrolide resistance of M. pneumoniae in Yantai. This may be helpful to determine the appropriate therapy for CAP in this population. Objective: To investigate the rate and mechanism of macrolide resistance in Yantai. Methods: Pharyngeal swab samples were collected from adult CAP patients. Samples were assayed by polymerase chain reaction (PCR) and cultivated to test for M. pneumoniae. Nested PCR was used to specifically amplify M. pneumoniae 23S rRNA gene fragments containing mutations, and amplicons were analyzed by CE-SSCP for macrolide resistance mutations. Results were confirmed by sequencing. Twenty-seven strains of M. pneumoniae were isolated and the activities of nine antibiotics against M. pneumoniae were tested in vitro. Results: Out of 128 samples tested, 27 were positive for M. pneumoniae. Mycoplasma 100% macrolides resistance to Mycoplasma pneumoniae. The mechanism of macrolides resistance was A2063G point mutation in the sequence directly binding to macrolides in the 23S rRNA V domain in vitro. The mean pyretolytic time for the fluoroquinolone group was 4.7 ±2.9 d, which was significantly shorter than 8.2 ±4.1 d for the azithromycin group. Conclusions: Macrolides are not the first-line treatment for M. pneumoniae respiratory tract infections in Yantai.

Resumen Introducción: Neumonía adquirida por en la comunidad (NAC) es una enfermedad responsable por un gran número de muertes y un impacto económico importante. Debido a que el diagnostico incrementó la sensibilidad, se cambió la etiología de la NAC. Adicionalmente, Mycoplasma pneumoniae es uno de los patógenos que causan la NAC. Los macrólidos y antibióticos relacionados son la primera línea de tratamiento para M. pneumoniae. La resistencia a macrólidos se aumentó en los últimos 15 años y ahora se encuentra distribuido en todo el mundo. Nosotros realizamos el primer estudio de resitencia a M. pneumoniae a los macrólidos en Yantai. Esto podría ser útil para determinar una terapia apropiada para NAC en esta población. Objetivo: Investigar la tasa y el mecanismo para la resitencia a los macrólidos en Yantai. Métodos: Se colectaron muestras faringeas usando un hisopo. Las muestras se analizaron mediante la reacción en cadena de la polimerasa (PCR) y por cultivo para M. pneumoniae. Se uso una PCR anidad para amplificar fragmentos del gen 23S rRNA especifico con las mutaciones para M. pneumoniae. Se analizaron amplicomes por CE-SSCP para determinar la resitencia a los macrólidos. Estos resultados se confirmaron por secuenciación. Se aislaron 27 cepas de M. pneumoniae y se probaron nueve antibióticos in vitro. Resultados: De 128 muestras, 27 fueron positivas para M. pneumoniae. Se determinó una resistencia a macrólidos por Mycoplasma del 100%. Los mecanismos de esta resitencia fue una mutacion punctual A2063G en la secuencia que se une directamente a los macrólidos en el dominio 23S rRNA V in vitro. El tiempo piotolítico medio para el grupo de fluoroquinolonas fue 4.7 ±2.9 d, que fue significativamente más corto que para el grupo de azitromicina: 8.2 ±4.1 d. Conclusiones: Los macrólidos no son la primera linea de tratamiento para las infecciones del tracto respiratorio contra M. pneumoniae respiratory tract infections en Yantai.

Observation on the effect of hybrid surgery in the treatment of type D arteriosclerotic occlusion of lower extremity by Trans-Atlantic Cooperative Organization / 中国基层医药

Objective To explore the effect of hybrid surgery in the treatment of TASC (Trans －Atlantic Cooperation Organization consensus)type D lower limb arteriosclerosis occlusion,thus to provide guidance for clinic. Methods From January 2014 to January 2017,60 patients with TASC type D lower limb arteriosclerosis occlusion syndrome in the People's Hospital of Lishui were selected.All 60 cases received hybridization surgical treatment,and the clinical data of 60 cases were analyzed retrospectively.The patients were followed up for six months,the curative effect was observed.Results After treatment,the ankle brachial index (ABI)[(0.82 ±0.38)],intermittent claudi-cation distance[(532.24 ±42.78)m]of 60 patients were significantly increased compared with those before treat-ment[(0.32 ±0.20),(159.78 ±12.61)m][t(ABI)＝9.019,t(intermittentclaudicationdistance)＝64.687,all P＜0.05].The Fontaine classification after treatment was significantly better than that before treatment (P＜0.05 ).The vascular patency rate of grade Ⅱ(96.00%)was significantly higher than grade Ⅲ(81.92%)and grade Ⅳ(77.78%) (χ2＝9.265,P＜0.05),but the vascular patency rate between grade Ⅲ and grade Ⅳ had no statistically significant difference (P＞0.05 ).The incidence rate of complications among grade Ⅱ,grade Ⅲ and grade Ⅳ group had no statistically significant difference(χ2＝0.659,P＞0.05).Conclusion Hybrid surgery in the treatment of TASC type D lower limb arteriosclerosis occlusion has remarkable curative effect,especially suitable for treatment of high risk patients.

Correlation of the single nucleotide polymorphism rs662 of PON1 with the risk of male infertility / 中华男科学杂志

<p><b>Objective</b>To investigate the correlation between the single nucleotide polymorphism (SNP) rs662 of the paraoxonase 1 gene (PON1) and the risk of male infertility.</p><p><b>METHODS</b>This case-control study included 403 male idiopathic infertility patients aged 29.00 ± 4.48 years in the case group and 329 normal fertile men aged 28.28 ± 4.08 years as healthy controls. We obtained DNA from the peripheral venous blood of the subjects, genotyped the SNP rs662 of PON1 by Sequenom MassArray, and analyzed the association between different genotypes of PON1 rs662 and male infertility using the logistic regression model.</p><p><b>RESULTS</b>Compared with the normal controls, the infertility patients showed a significantly increased level of follicle-stimulating hormone (FSH) (［16.30 ± 17.76］ vs ［4.72 ± 2.51］ U/L, P < 0.01) but a decreased percentage of progressively motile sperm (PMS) (［7.40 ± 14.17］ % vs ［41.93 ± 9.06］ %, P < 0.01) and sperm concentration (［2.74 ± 3.64］ vs ［75.83 ± 63.66］ ×10⁶/ml, P < 0.01). Statistically significant differences were not found in the other parameters between the two groups of subjects, nor in the correlation of male infertility with the heterozygous genotype GA versus the wild homozygous genotype GG (OR = 0.98, 95% CI: 0.63－1.53, P = 0.923) or the homozygous genotype AA versus the wild homozygous genotype GG (OR = 0.87, 95% CI: 0.56－1.34, P = 0.525).</p><p><b>CONCLUSIONS</b>The SNP rs662 of PON1 was not correlated with male infertility, which, however, needs to be confirmed by further studies with larger samples from a larger area.</p>

Correlation of the single nucleotide polymorphisms rs34349826 and rs6521 of the LHB gene with male infertility in Chinese men / 中华男科学杂志

<p><b>Objective</b>To study the relationship of the single nucleotide polymorphisms (SNP) rs34349826 (c.104 A>G) and rs6521 (c.114 C>G) of the luteinizing hormone beta-subunit (LHB) gene with male infertility in Chinese men.</p><p><b>METHODS</b>This case-control study included 405 males with primary infertility (the infertility group) and 424 normal fertile men (the control group), the former again divided into subgroups of oligospermia, severe oligozoospermia and azoospermia according to the sperm concentration. Clinical data were collected from all the subjects and genomic DNA obtained from their peripheral blood for genotyping rs34349826 and rs6521 of the LHB gene by Sequence MassArray. We analyzed the correlation of male infertility with the SNPs of the two loci using the logistic regression model as well as its association with their haplotype combination with the SHEsis online software.</p><p><b>RESULTS</b>There were statistically significant differences between the control and infertility groups in the semen volume (［3.51 ± 1.36］ vs ［3.74 ± 1.71］ ml, P <0.05), sperm concentration (［79.21 ± 61.60］ vs ［27.37 ± 30.80］ ×10⁶/ml, P <0.01), percentage of progressively motile sperm (［39.40 ± 9.64］ % vs ［11.90 ± 14.72］ %, P <0.01), and levels of serum luteinizing hormone (LH) (［3.29 ± 1.39］ vs ［6.25 ± 4.83］ IU/L, P <0.01) and follicle-stimulating hormone (FSH) (［4.56 ± 2.31］ vs ［15.64 ± 17.03］ IU/L, P <0.01). Logistic regression analysis revealed no correlation between male infertility and the genotypes of the rs34349826 and rs6521 loci of the LHB gene, and similar results were found in the subgroups of the infertile males. SHEsis analysis on the haplotypes of the rs34349826 and rs6521 loci showed the GG genotype combination to be a protective factor against male infertility.</p><p><b>CONCLUSIONS</b>The rs34349826 and rs6521 loci of the LHB gene were not related to male infertility, which can be further confirmed by larger-sample studies. The GG genotype combination is a protective factor against male infertility.</p>