The effect of virtual reality technology in children after surgery for concomitant strabismus

Purpose: This study aimed to investigate the effect of virtual reality (VR) technology in children after surgery for concomitant strabismus. Methods: A total of 200 children with concomitant exotropia or concomitant esotropia were randomly divided into a training group and a control group according to the single even number random method (100 cases in each group). Patients in the training group received VR intervention training within 1 week after surgery. Patients in the control group did not receive any training. Results: Six months after the surgery, the orthophoria (the far or near strabismus degree was ?8?) rate was significantly higher in the training group than in the control group (P = 0.001), while the eye position regression rate (compared to the strabismus degree within 1 week after the surgery, the amount of regression >10?) was significantly lower in the training group than in the control group (P = 0.001). Six months after the surgery, the number of children with simultaneous vision and remote stereovision was significantly higher in the training group than in the control group (P = 0.017 and 0.002, respectively). The differences in the number of patients with peripheral stereopsis, macular stereopsis, and stereopsis in macular fovea centralis at 1, 3, and 6 months after the surgery between the training and the control groups were not statistically significant (P = 0.916, 0.274, and 0.302, respectively). Conclusion: The intervention of VR technology after strabismus correction effectively improved children’s visual function and maintained their eye position

Prospective association between physical activity and mortality in patients with chronic kidney disease / 中华流行病学杂志

Objective: To investigate the prospective association of physical activity with all-cause, cardiovascular disease (CVD), and chronic kidney disease (CKD) mortality in CKD patients in China. Methods: Cox proportional hazard models were used to evaluate the association of total, domain-specific, and intensity-specific physical activity with the risk of all-cause, CVD, and CKD mortality based on data from the baseline survey of China Kadoorie Biobank. Results: During a median follow-up of 11.99 (11.13, 13.03) years, there were 698 deaths in 6 676 CKD patients. Compared with the bottom tertile of total physical activity, participants in the top tertile had a lower risk of all-cause, CVD, and CKD mortality, with hazard ratios (HRs) (95%CIs) of 0.61 (0.47-0.80), 0.40 (0.25-0.65), and 0.25 (0.07-0.85), respectively. Occupational, commuting, and household physical activity were negatively associated with the risk of all-cause and CVD mortality to varying degrees. Participants in the top tertile of occupational physical activity had a lower risk of all-cause (HR=0.56, 95%CI: 0.38-0.82) and CVD (HR=0.39, 95%CI: 0.20-0.74) mortality, those in the top tertile of commuting physical activity had a lower risk of CVD mortality (HR=0.43, 95%CI: 0.22-0.84), and those in the top tertile of household physical activity had a lower risk of all-cause (HR=0.61, 95%CI: 0.45-0.82), CVD (HR=0.44, 95%CI: 0.26-0.76) and CKD (HR=0.03, 95%CI: 0.01-0.17) mortality, compared with the bottom tertile of corresponding physical activity. No association of leisure-time physical activity with mortality was observed. Both low and moderate-vigorous intensity physical activity were negatively associated with the risk of all-cause, CVD and CKD mortality. The corresponding HRs (95%CIs) were 0.64 (0.50-0.82), 0.42 (0.26-0.66) and 0.29 (0.10-0.83) in the top tertile of low intensity physical activity, and the corresponding HRs (95%CIs) were 0.63 (0.48-0.82), 0.39 (0.24-0.64) and 0.23 (0.07-0.73) in the top tertile of moderate-vigorous intensity physical activity. Conclusion: Physical activity can reduce the risk of all-cause, CVD, and CKD mortality in CKD patients.

Leukemia Genotype Analysis of Children with Acute Lymphoblastic Leukemia in Yunnan Area / 中国实验血液学杂志

OBJECTIVE@#To analyze 43 leukemia genes in children with acute lymphoblastic leukemia (ALL) in Yunnan province, and provide the basis for the diagnosis and treatment of children with ALL in this area.@*METHODS@#The clinical data of 428 children with newly diagnosed ALL in Yunnan area from January 2015 to December 2020 were retrospectively analyzed. Multiple nested PCR technology was used to detect 43 common leukemia genes.@*RESULTS@#Among the 428 children with ALL, 159 were positive for leukemia genes, with a positive rate of 37.15% (159/428), and a total of 15 leukemia genes were detected. Among the 159 leukemia gene-positive children, ETV6-RUNX1+ accounted for 25.79% (41/159), followed by E2A-PBX1+ and BCR-ABL+, accounting for 24.53% (39/159) and 23.27% (37/159) respectively. MLL+ accounted for 6.29% (10/159), WT1+ accounted for 4.40% (7/159), IKZF1 gene deletion and CRLF2+ accounted for 3.77% (6/159) respectively. The positive rate of MLL (46.15%) was the highest in ＜1-year old group, the positive rate of ETV6-RUNX1 (10.56%) was the highest in 1-10-year old group, and BCR-ABL+ rate (23.65%) was the highest in >10-year old group. The distribution of leukemia genes in different age groups was statistically significant (P <0.05).@*CONCLUSION@#The most common fusion gene of children with ALL in Yunnan is ETV6-RUNX1, followed by E2A-PBX1 and BCR-ABL.

Prevalence of chronic kidney disease and its association with lifestyle factors in adults from 10 regions of China / 中华流行病学杂志

Objective: To investigate the distribution of chronic kidney disease (CKD) in participants from the China Kadoorie Biobank (CKB) study and evaluate the association between lifestyle risk factors and CKD. Methods: Based on the baseline survey data and follow-up data (as of December 31, 2018) of the CKB study, the differences in CKD cases' area and population distributions were described. Cox proportional hazards regression model was used to estimate the association between lifestyle risk factors and the risk of CKD. Results: A total of 505 147 participants, 4 920 cases of CKD were recorded in 11.26 year follow up with a incidence rate of 83.43/100 000 person-years. Glomerulonephropathy was the most common type. The incidence of CKD was higher in the urban area, men, and the elderly aged 60 years and above (87.83/100 000 person-years, 86.37/100 000 person-years, and 132.06/100 000 person-years). Current male smokers had an increased risk for CKD compared with non-smokers or occasional smokers (HR=1.18, 95%CI: 1.05-1.31). The non-obese population was used as a control group, both general obesity determined by BMI (HR=1.19, 95%CI: 1.10-1.29) and central obesity determined by waist circumference (HR=1.27, 95%CI: 1.19-1.35) were associated with higher risk for CKD. Conclusion: The risks for CKD varied with area and population in the CKB cohort study, and the risk was influenced by multiple lifestyle factors.

Chinese Guideline on the Management of Polypoidal Choroidal Vasculopathy (2022) / 中国医学科学杂志(英文版)

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.

Effects of long-term wearing of orthokeratology lens on corneal and visual quality of patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of long-term orthokeratology lens wearing on corneal morphology, corneal biomechanics and objective visual quality.METHODS: A retrospective study was conducted to collect 33 myopic patients(60 eyes), including 19 males(35 eyes)and 14 females(25 eyes), mean age 11.80±1.51 years old, with an average equivalent spherical lens of -3.25±0.69D, who had been wearing orthokeratology lens for 2a from October 2019 to December 2020 in our hospital. Relevant data were collected before wearing and 2a after wearing. The radius of curvature(ARC and PRC), the thickness of the thinnest cornea(THP)and the index of comprehensive deviation analysis of corneal dilation(BADD)were measured by Pentacam anterior segment analysis system. Corvis ST biomechanical analyzer measured non-contact biomechanical corrected intraocular pressure(blOP), maximum deformation amplitude(DA), maximum reverse radius(HCR), ratio of deformation amplitude between apex and 1mm(DR), hardness parameters(SPA1), and corneal biomechanical parameters(CBI). The biomechanical index(TBI)of CT scan was obtained by the combined diagnosis system of Pentacam and Corvis ST. OQAS-II objective visual quality analysis system measured modulation transfer function cutoff frequency(MTF cutoff), Stryl ratio(SR), objective scattering coefficient(OSI)and OV value(OV100%, OV20% and OV9%). The above parameters were compared before and continuously wearing orthokeratoscope for 2a. RESULTS: After 2a of wearing orthokeratology, ARC increased, THP decreased, and BADD increased(<i>t</i>=-9.38, 2.85, -13.08; all <i>P</i><0.05), while there was no significant difference between PRC and before wearing(<i>t</i>=1.49, <i>P</i>>0.05). DA increased and HCR decreased compared with before wearing orthokeratology lens(<i>t</i>=-2.37, 2.28; all <i>P</i><0.05), but bIOP, DR, SPA1, CBI and TBI showed no difference(<i>t</i>=1.36, -1.87, 1.27, -0.95, -1.49; all <i>P</i>>0.05). SR was higher than before, OV20% and OV9% were lower than before(<i>t</i>=-5.31, 8.37, 2.34; all <i>P</i><0.05), MTF cutoff, OSI and OV100% had no difference compared with before(<i>t</i>=-1.57, -1.35, 1.11; all <i>P</i>>0.05).CONCLUSION: Long-term wearing of orthokeratology lens changed the morphology of the anterior corneal surface, but had no significant effect on the corneal biomechanics, and the objective visual quality of patients was improved during the day, but decreased at night.

Quality value transfer of material benchmark of Guizhi Jia Gegen Decoction / 中国中药杂志

A total of 15 batches of the substance reference of Guizhi Jia Gegen Decoction(GZGGD) were prepared and the characteristic fingerprints of them were established. Furthermore, the similarity of the fingerprints and peak attributes were explored. The extraction rate, and the content and the transfer rate ranges of the index components, puerarin, paeoniflorin, liquiritin, and ammonium glycyrrhizate were determined for the analysis of the quality value transfer. The result demonstrated that the fingerprints of the 15 batches of the samples showed high similarity(>0.99). A total of 15 characteristic peaks were identified from the fingerprints, with 10 for Puerariae Lobatae Radix, 1 for Cinnamomi Ramulus, 2 for Paeoniae Radix Alba, and 2 for Glycyrrhizae Radix et Rhizoma. The content of puerarin was 11.05-18.35 mg·g~(-1) and the average transfer rate was 21.27%-39.49%. The corresponding figures were 7.95-10.90 mg·g~(-1) and 23.28%-43.23% for paeoniflorin, 3.25-4.95 mg·g~(-1) and 32.31%-61.27% for ammonium glycyrrhizate, and 3.65-5.80 mg·g~(-1) and 14.57%-27.05% for liquiritin. The extraction rate of the 15 batches of samples was in the range of 16.85%-21.78%. In this paper, the quality value transfer of the substance reference of GZGGD was analyzed based on characteristic fingerprint, content of index components, and the extraction rate. This study is expected to lay a basis for the quality control and further development of GZGGD.

Effects of Gelsemium elegans Combined with Mussaenda pubescens on Transporter BCRP and Drug-metabolizing Enzyme CYP3A11 / 中国实验方剂学杂志

ObjectiveTo explore the effect of Gelsemium elegans combined with Mussaenda pubescens on efflux transporter breast cancer resistance protein （BCRP） and cytochrome P450 3A11 （CYP3A11） and their attenuation mechanism， and to investigate whether the nuclear receptors were involved in such regulation by intervening it with nuclear receptor activators. MethodC57BL/6 mice were divided into the blank group， G. elegans （GE， 0.25 g·kg-1）group， GE + M. pubescens （MP） （0.25 g·kg-1+10 g·kg-1） group， GE + pregnane X receptor （PXR） activator （rifampicin）（GE + Rif，0.25 g·kg-1+50 mg·kg-1） group， GE + MP + Rif （0.25 g·kg-1+10 g·kg-1+50 mg·kg-1） group， GE + constitutive androstane receptor （CAR） activator （1，4-Bis ［2-（3，5-Dichloropyridyloxy）］ benzene， TCPOBOP）（GE + TCP， 0.25 g·kg-1+0.5 mg·kg-1） group， and GE + MP + TCP （0.25 g·kg-1+10 g·kg-1+0.5 mg·kg-1） group. The medication lasted for 14 successive days. One hour after the last administration， the mice were sacrificed by cervical dislocation and the liver tissue was harvested. The left liver tissue was stained with hematoxylin- eosin （HE） for observing the pathological changes. The right liver tissue was used for BCRP and CYP3A11 mRNA and protein expression detection by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultThe survival rates of mice in the GE + Rif group， GE group， and GE + MP group were 25% （the lowest）， 40%， and 80%， respectively， and no death was observed in the other groups. Compared with the obvious lesions in the liver cells of the GE group， the pathological changes in liver cells of the GE + MP group were alleviated， while those in the GE + Rif group were worsened. Compared with the GE + Rif group， the GE + MP + Rif group exhibited relieved pathological changes in liver cells. Both the GE + TCP group and the GE + MP + TCP group showed mild liver lesions. The comparison with the GE + MP group revealed that the pathological changes in the GE + MP + TCP group were slightly relieved. Compared with the blank group， the expression of BCRP protein and mRNA in GE group were significantly decreased （P<0.05，P<0.01）.The expression of CYP3A11 protein in GE group were significantly decreased （P<0.01）. Compared with the GE group， the GE + MP group displayed remarkably up-regulated BCRP protein and mRNA expression （P<0.05，P<0.01） and CYP3A11 protein expression （P<0.05）， but slightly up-regulated CYP3A11 mRNA expression. Compared with the GE group， the GE + Rif group exhibited down-regulated BCRP protein expression （P < 0.05）. The protein and mRNA expression levels of BCRP were lower in the GE + MP + Rif group than in the GE + MP group （P<0.05，P<0.01）. The PXR activator rifampicin regulated BCRP before and after the combination of G. elegans with M. pubescens. The CYP3A11 protein and mRNA expression levels in the GE + TCP group were higher than those in the GE group （P<0.05，P<0.01）. Compared with the GE + MP group， the GE + MP + TCP group showed up-regulated CYP3A11 protein and mRNA expression （P<0.05，P<0.01）. CAR activator TCPOBOP also had a regulatory effect on CYP3A11 before and after the compatibility of G. elegans with M. pubescens. ConclusionThe attenuated toxin after the combination of G. elegans with M. pubescens is closely related to the efflux transporter BCRP and the drug-metabolizing enzyme CYP3A11.

Synthetic drug use，sexual behavior and associated factors among men who have sex with men in Shanghai / 上海预防医学

Objective:To understand the status of synthetic drug use， high-risk sexual behavior and associated factors among men who have sex with men （MSM） in Shanghai. Methods:MSM subjects were recruited， by a team of non-governmental organizations （NGO）， at MSM places and voluntary counseling and testing clinics from May to December 2018. The subjects completed a self-administered questionnaire survey on social-demographic， ways to make friends， synthetic drug use， high-risk sexual behavior， and HIV/STD testing history. They also received tests of HIV and syphilis. According to the use of synthetic drugs， they were divided into user group and non-user group. Results:A total of 209 subjects were recruited. Among them， 43.1% （90/209） used at least one synthetic drug. 81.3% （170/209） of MSM used internet dating software. The proportion of synthetic drug use was higher among the subjects in 30-34 age group， residence registered in other provinces， with university degree or above， occupation of cadres and staff members， monthly income of more than 10 000 yuan， making friends through gay bars， and acquaintance with male partners. The registered residence in other provinces （OR=3.006） and making friends through gay bars （OR=3.588） were independent factors. The top three synthetic drugs were Rush （90.0%， 81/90）， Viagra （8.9%， 8/90） and “capsule 0” （7.8%， 7/90）. The proportion of having sex after using synthetic drugs was 89.5% （17/19）. The frequency of high-risk sexual behaviors such as oral sex， anal sex without condom and group sex was once a day per person on average. Conclusion:The use of synthetic drugs is prevalent among MSM， and the frequency of high-risk sexual behaviors after use is high. Warning education on the dangers of synthetic drug use and mobilization for HIV testing should be carried out with the help of new media technology. Special attention should be paid to MSM people in high-income occupations and gay bars.

Effect of Chuanxiong Rhizoma on the absorption and clearance of four coumarins in Angelicae Dahuricae Radix / 药学学报

To study the changes in the pharmacokinetic behavior of four coumarins (bergapten, oxypeucedanin, imperatorin and isoimperatorin) in rats before and after combinating Angelicae Dahuricae Radix with Chuanxiong Rhizoma. The plasma concentrations of the drugs were determined by ultra performance liquid chromatography-fluorescence detection (UPLC-FLD) for dose response and time dependent curves. The pharmacokinetic parameters were calculated by DAS 3.2.8, and SPSS 20.0 was used to analyze the differences of main pharmacokinetic parameters between the two groups. The result showed: comparing with Angelicae Dahuricae Radix group, the area under drug time curve (AUC0-24 h) of bergapten, oxypeucedanin and imperatorin increased by 177.2%, 97.14% and 54.43% respectively, AUC0-∞ increased by 282.3%, 104.2%, and 75.40% respectively, and clearance rate (CLZ/F) decreased by 68.26%, 51.08% and 43.98% respectively; the peak drug concentration (Cmax) of four coumarins was significantly increased; the distribution volume (VZ/F) of bergapten was significantly decreased. These data indicated that Chuanxiong Rhizoma can promote the absorption of coumarins in Angelicae Dahuricae Radix, slow down the elimination of coumarins, and increase their bioavailability in vivo. The animal experiment scheme in this study has been approved by the Experimental Animal Ethics Committee of Beijing University of Chinese Medicine (approval number: BUCM-4-2020083105-3072).

Systematic review and Meta-analysis on chemotherapy-induced bone marrow suppression treated with acupuncture / 中国针灸

OBJECTIVE@#To review systematically the effectiveness of acupuncture in treatment of chemotherapy-induced bone marrow suppression.@*METHODS@#From the date of database establishment to April 1, 2020, the articles on randomized controlled trials of chemotherapy-induced bone marrow suppression were retrieved by computer from the following databases, i.e. PubMed, Cochrane central register of controlled trials (CENTRAL), EMbase, cumulative index to nursing & allied health literature (CINAHL), JBI database of systematic reviews and implementation reports, CNKI, Wanfang, VIP and SinoMed. Using RevMan5.3, Meta-analysis was conducted. With GRADEpro GDT, the evidence quality was evaluated.@*RESULTS@#A total of 12 articles were included, 10 articles of which were analyzed by quantitative Meta-analysis. Compared with the control group, the improvements in the decrease of post-chemotherapy leukocyte (@*CONCLUSION@#Acupuncture alleviates the decrease of leukocyte, platelet, neutrophile granulocyte and erythrocyte counts and improves the survival quality of patients with chemotherapy-induced bone marrow suppression.

Multislice spiral computed tomography imaging in evaluating hemophilic arthropathy / 中华医学杂志(英文版)

BACKGROUND@#Certain hemophilia patients are unable to cooperate with or afford magnetic resonance imaging (MRI) examinations. The purpose of our study was to explore the value of multislice spiral computed tomography (MSCT) in evaluating hemophilic arthropathy (HA).@*METHODS@#Thirty-eight patients with 73 joints of HA were consecutively selected from January 2016 to May 2018 for this prospective study. All 73 joints were examined by X-ray, CT, and MRI within 2 days. The MRI scores of the joints were determined by the International Prophylaxis Study Group (IPSG) standard. The CT findings were quantified according to the IPSG standard, except for cartilage injury, which was quantified by joint space narrowing using the X-ray Pettersson score. The CT and MRI scores were compared by the paired Wilcoxon signed-rank test. The correlations between the CT score of joint space narrowing and MRI score of cartilage injury and the total CT and MRI scores were analyzed by Spearman rank correlation. The kappa test was used to compare the consistency of CT and MRI scores.@*RESULTS@#MRI was superior to CT based on the scores for small amount of effusion (P  0.05), and there was a high degree of consistency between the two scores (kappa > 0.81). The consistency between the Pettersson scores of joint space narrowing on CT and the IPSG scores of cartilage injury on MRI was high (kappa = 0. 774, P < 0.05).@*CONCLUSION@#The image scores of MSCT are generally consistent with MRI except for mild synovitis, which can be used as an alternative for the evaluation of HA.

Efficacy and Safety of Guilingji Capsules () for Treating Mild-to-Moderate Cognitive Impairment: Study Protocol for A Randomized, Double-Blind, Positive-Controlled, Multicenter and Noninferiority Trial / 中国结合医学杂志

BACKGROUND@#The incidence of cognitive impairment (CI) is gradually increasing, which has attracted more attention from medical researchers worldwide. Definitive mechanisms of pathogenesis remain elusive, and there are few medications that have been proven effective for CI. The utilization of Chinese herbal medicine has shown positive therapeutic effects for a broad spectrum of diseases, including CI.@*OBJECTIVE@#The purpose of this study is to evaluate the safety and efficacy of Guilingji Capsules (GLJC, ) in treating mild-to-moderate CI with Shen (Kidney) and marrow deficiency syndrome.@*METHODS@#This is a randomized, double-blind, positive-controlled, multicenter clinical trial with a noninferiority design that included 348 participants randomly divided into an experimental arm and an active comparator arm. Individuals in the experimental arm (174 cases) took 0.6 g of GLJC once a day and 19.2 mg of Gingko biloba extract mimetic 3 times a day. Individuals in the active comparator arm (174 cases) took 0.6 g of GLJC mimetic once a day and 19.2 mg of Gingko biloba extract in tablet form 3 times a day. The intervention period included two sessions over 24 weeks. The primary outcome be the effectiveness of GLJC on cognitive improvement after 24 weeks of treatment, which was defined as an increase in the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) Scale. The secondary outcomes were improvement in independence, daily living ability, and Chinese medicine (CM) syndrome, which were measured with the Alzheimer's disease Rating Scale-Cognitive Project (ADAS-Cog), Clinical Dementia Rating (CDR) Total Score, Activities of Daily Living (ADL) Total Score and the Chinese Medicine Symptom Scale (CM-SS), respectively. Serum acetylcholine, acetylcholinesterase, bax and bcl-2 were monitored to explore the mechanism of GLJC on CI. In addition, safety measures, including vital signs, electrocardiography, laboratory indicators (full blood count, kidney and liver function tests, routine urine test and routine stool test) and adverse events, were also recorded.@*DISCUSSION@#The purpose of this trial is to evaluate the efficacy and safety of GLJC in patients with mild-to-moderate CI with kidney and marrow deficiency syndrome. If successful, the results would provide a viable treatment for patients with mild-to-moderate CI. (Clinical Trials.gov. ID: NCT03647384. Registered on 23 August 2018).

Dendrobium officinale Kimura et Migo and American ginseng mixture: A Chinese herbal formulation for gut microbiota modulation / 中国天然药物

Dendrobium officinale Kimura et Migo (D. officinale) is a famous traditional Chinese medicine (TCM). A mixture of D. officinale and American ginseng has been shown to enhance cell-mediated immunity, humoral immunity, and monocyte/macrophage functions in mice. Here, the effects of a D. officinale and American ginseng mixture on the structure of gut microbial community in dogs were examined using high-throughput 16S rRNA gene amplicon sequencing. The data revealed that while the mixture did not change the diversity of gut microbial community significantly, differences among individuals were significantly reduced. Furthermore, the mixture-responsive operational taxonomic units (OTUs) exhibited a phase-dependent expression pattern. Fifty-five OTUs were found to exhibit a mixture-induced expression pattern, among which one third were short-chain fatty acid (SCFA)-producing genera and the others were probiotic genera included Lactobacillus spp., Sutterella, Alistipes, Anaerovorax, Bilophila, Coprococcus, Gordonibacter, Oscillibacter, among others. By contrast, 36% of the OTUs exhibiting a mixture-repressed expression pattern were disease-associated microorganisms, and six genera, namely Actinomyces, Escherichia/Shigella, Fusobacterium, Slackia, Streptococcus and Solobacterium, were associated with cancer. In addition, five genera were closely associated with diabetes, namely Collinsella, Rothia, Howardella, Slackia and Intestinibacter. Our results indicate that this D. officinale and American ginseng mixture may be used as a prebiotic agent to enhance SCFA-producing genera and prevent gut dysbiosis.

Role of swiprosin-l/efhd2 in regulating immune inflammatory response / 中国药理学通报

Swiprosin-1 (also known as EFhd2) is one of the earliest adaptor proteins found in T lymphocytes. Subsequent studies have found that it is also expressed on macrophages, B lymphocytes, mast cells and other immune cells, and affects the activation, migration, apoptosis and inflammatory response of immune cells, and participates in many signaling pathways 9uch as NF-kB, JAK-STAT, MAPK and calcium signaling. This arti cle briefly reviews the role and mechanism of EFhd2 reported in the regulation of immune inflammatory response in recent years, and provides a theoretical basis for further clarifying EFhd2 as a potential target for new immune regulation.

Analysis of clinical application characteristics of Xingnaojing Injection in treating cerebral hemorrhage in real world / 中国中药杂志

To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was > 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.

Efficacy and safety of the long-acting fusion inhibitor albuvirtide in antiretroviral-experienced adults with human immunodeficiency virus-1: interim analysis of the randomized, controlled, phase 3, non-inferiority TALENT study / 中华医学杂志(英文版)

BACKGROUND@#Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs.@*METHODS@#We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%.@*RESULTS@#At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group.@*CONCLUSIONS@#The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure.@*TRIAL REGISTRATION@#ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx.

Clinical Efficacy of Gandouling Decoction in Improving Hepatic Function with Phlegm and Blood Stasis Type Wilson' s Disease / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of Gandouling decoction on hepatic function of patients with phlegm and blood stasis type Wilson's disease. Method::From January 2015 to December 2017, totally 72 cases of phlegm and blood stasis type Wilson's disease admitted to Encephalopathy Center in the First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into treatment group and control group, with 36 cases in each group. Patients in both groups were injected with sodium dimercaptopropane sulfonate for routine treatment. At the same time, patients in control group received Hugan Tablets, and patients in treatment group received Gandouling decoction for a total of 6 treatment courses. Before and after treatment, traditional Chinese medicine(TCM)syndrome effective rate, serum enzyme index [alanine aminotransferase(ALT), aspartate aminotransferase (AST), alkaline phosphatase(AKP)], bilirubin metabolism index [total bilirubin(TBIL)], liver fibrosis index [laminin(LN), hyaluronic acid(HA), collagen type IV(CⅣ), procollagen type Ⅲ peptide(PⅢP)]and blood coagulation index [fibrinogen (FBG), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) ]were observed. Result::TCM syndrome effective rates of treatment group and control group were 86.11%(31/36) and 63.98%(23/36) respectively, with a significant difference between two groups (P<0.05). ALT, AST, AKP, TBIL decreased in two groups after treatment (P<0.01), and the effects of ALT, AST, AKP, TBIL in treatment group were significantly better than those in control group (P<0.01), liver fibrosis index decreased in both groups after treatment (P<0.01), and the effect in treatment group was significantly better than that in control group (P<0.01). Blood coagulation indexes were improved to different degrees in both groups (P<0.05, P<0.01), and there were significant differences between treatment group and control group in decreasing PT, APTT, TT levels (P<0.05, P<0.01) and increasing FBG level (P<0.01). Conclusion::Gandouling decoction can significantly improve hepatic function of patients with phlegm and blood stasis type Wilson's disease, which is manifested in improving serum enzymes and bilirubin indexes, reversing liver fibrosis, promoting clotting factors and reducing bleeding tendency, in order to delay the progress of the disease and improve the life quality of patients.

Material Basis Analysis of Toxicity Attenuation and Efficacy Reservation of Processing of Gelsemium elegans Rhizomes / 中国实验方剂学杂志

Objective::On the basis of previous research, to detect the changes of six main alkaloids in Gelsemium elegans rhizomes before and after being processed, so as to reveal its internal mechanism of processing. Method::The contents of gelsemine, humantenidine, koumine, gelsenicine, gelsevirine and humantenine in G. elegans rhizomes was determined simultaneously by HPLC, the content changes of these components before and after processing and its reasons were analyzed by cluster analysis and principal component analysis. The mobile phase was methanol (A)-0.1%formic acid aqueous solution (B) for gradient elution (0-10 min, 22%A; 10-20 min, 22%-30%A; 20-30 min, 30%-40%A). The flow rate was 1.0 mL·min-1. The detection wavelength was set at 254 nm, the injection volume was 10 μL, and the column temperature was 30 ℃. Result::Before processing, contents of the above six components in raw products were 1.444, 1.129, 3.590, 1.603, 2.376, 1.631 mg·g-1, after processing, the contents of these six components were 2.258, 0.343, 1.176, 0.115, 0.459, 0.281 mg·g-1, respectively. Gelsenicine, the most toxic ingredient of G. elegans rhizomes, decreased most significantly with a decreasing rate of 92.83%, while the less toxic ingredient, gelsemine, increased by 56.37%after processing. The contents of other four components in G. elegans rhizomes decreased to varying degrees after processing. The results of cluster analysis indicated that G. elegans rhizomes were clearly divided into two categories before and after processing. Principal component analysis showed that the first principal component before and after processing was changed from koumine to gelsemine. Conclusion::The degradation of toxic components and content changes of other components may be one of the intrinsic mechanism of toxicity attenuation and efficacy reservation of G. elegans rhizomes being processed.

Intervention of Shenma Yizhi Prescription on Learning and Memory in Rats with Vascular Cognitive Impairment Induced by Chronic Cerebral Ischemia / 中国实验方剂学杂志

Objective:To observe the effects of Shenma Yizhi prescription（SMYZ）on learning and memory， inflammatory factors and oxidative stress related indexes of rats with chronic cerebral ischemia inducing vascular dementia caused by bilateral common carotid artery ligation. Method:The chronic cerebral ischemia model of SPF grade SD rats was prepared by bilateral common carotid artery ligation. After successful surgery， the rats with cognitive impairment were randomly divided into 5 groups，model， donepezil（0.45 mg·kg-1）， SMYZ-low， medium and high dose（2.97，5.94，11.88 g·kg-1）， with 10 rats in each group， and 10 rats in sham operation group were established. Intragastric administration were given for 8 weeks respectively then followed Morris water maze test. The pathomorphological changes of hippocampus CA1 were observed. The serum levels of acetylcholine(Ach)and acetylcholinesterase (AChE)were detected， and the levels of inflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the serum of rats were detected. The contents of glutathione (GSH)， malondialdehyde (MDA)， superoxide dismutase (SOD) and glutathione peroxidase reductase (GSH-Px) were observed. Result:Compared with sham operation group， the escape latency increased significantly in the model group， and the frequency of platform search， the frequency of crossing the original platform and the percentage of swimming time in the original platform quadrant decreased significantly （P<0.05，P<0.01）. The contents of Ach and the contents of GSH and GSH-Px were significantly decreased （P<0.05，P<0.01）. The contents of AChE， IL-1β and TNF-α and the contents of MDA were significantly increased （P<0.05，P<0.01）. Compared with model group， the escape latency of rats in the in the low， medium and high dose groups of SMYZ prescription was significantly reduced （P<0.05，P<0.01）.The frequency of looking for a platform， the frequency of crossing the original platform and the percentage of swimming time in the original platform quadrant of the rats in the low， medium and high dose groups of SMYZ prescription increased significantly （P<0.05，P<0.01）. The content of AChE in high dose group were significantly reduced（P<0.01）， and the content of Ach in high dose group were significantly increased（P<0.05）， the rat serum IL-1β， TNF-α levels and MDA content were significantly reduced（P<0.05，P<0.01）. The GSH， SOD and GSH-Px levels were significantly increased （P<0.05，P<0.01）. Conclusion:SMYZ can improve the learning and memory ability of rats with vascular cognitive disorder caused by chronic cerebral ischemia caused by ligation of bilateral common carotid artery， bilateral common carotid artery ligation， improve the pathological morphology of hippocampal tissue， inhibit inflammatory response， improve cholinergic level and oxidative stress state.