Retrospective clinical study of hip replacement in the treatment of traumatic arthritis secondary to acetabular fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of total hip replacement (THA) in the treatment of traumatic arthritis secondary to acetabular fracture.@*METHODS@#From October 2019 to June 2022, 15 patients with secondary traumatic arthritis of acetabulum fracture were treated with THA. There were 8 males and 7 females, aged from 40 to 76 years old with an average of (59.20±9.46) years old. Prosthesis loosening, dislocation of hip joint, range of motion of hip joint, nerve injury and other conditions were recorded before and after surgery. Harris score, visual analogue scale (VAS) and imaging were used to evaluate hip joint function and surgical effect.@*RESULTS@#Follow-up time ranged 6 to 39 months with an average of (18.33±9.27) months. All the 15 patients successfully completed the operation, no nerve and blood vessel injury during the operation, postoperative wound healing was stageⅠ, no infection, one case of acetabular side prosthesis loosening at half a year after operation, and recovered well after revision surgery, one case of hip dislocation was cured after open reduction treatment, no adverse consequences. Harris score at the last postoperative follow-up was (88.60±4.01) points, compared with the preoperative (47.20±11.77) points, the difference was statistically significant (P<0.05), and VAS at the lateat postoperative follow-up was 1 (1) points, compared with the preoperative 8 (2) points, the difference was statistically significant (P<0.05). At the last follow-up, the pain symptoms were relieved or disappeared, and the joint function was satisfactory. The imaging data of the latest follow-up showed joint was well pseudoradiated, no abnormal ossification occurred, and the prosthesis was not loose.@*CONCLUSION@#THA is effective in the treatment of traumatic arthritis secondary to acetabular fracture and can effectively improve the quality of life of patients. Preoperative comprehensive evaluation and bone defect evaluation of patients, and intraoperative management of acetabulum, femur, internal fixation and bone defect are key factors for the success of surgery.

Diagnostic and Prognostic Value of 18F-FDG PET/CT in Bone Marrow Infiltration of Newly Diagnosed Diffuse Large B-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the diagnostic value of 18F-FDG PET/CT in bone marrow infiltration (BMI) of newly diagnosed diffuse large B-cell lymphoma (DLBCL), compared with the results of bone marrow biopsy (BMB) and investigate whether the BMI diagnosed by 18F-FDG PET/CT and other factors have independent prognostic values.@*METHODS@#Ninety-four newly diagnosed DLBCL patients who underwent PET/CT in Clinical Medical College of Shanghai General Hospital of Nanjing Medical University were included. BMB was performed within 2 weeks before or after PET/CT, and standardized treatment was performed after PET/CT. The manifestations of bone marrow (BM) FDG uptake were recorded. The diagnostic criteria of BMI were BMB positive or focal BM FDG uptake confirmed by imaging follow-up. The relationship between clinical features and BM FDG uptake and the values of PET/CT and BMB in the diagnosis of BMI was analyzed. The progression-free survival (PFS) was analyzed by Kaplan-Meier survival curves, log-rank test was used to compare PFS rate, and Cox regression model was used to analyze the independent risk factors affecting PFS.@*RESULTS@#Among 94 DLBCL patients, 34 patients showed focal BM uptake (fPET), 7 patients showed super BM uptake (sBMU), 11 patients showed diffuse homogenous uptake higher than liver (dPET), and the other 42 patients had normal BM uptake (nPET) (lower than liver). BMB positive was found in all sBMU patients, in 20.6%(7/34) of fPET patients, and in 27.3% (3/11) of dPET patients. All nPET patients had negative BMB results. dPET patients were associated with lower hemoglobin level and leukocyte count compared with nPET group (P < 0.001, P =0.026). Compared with fPET patients, sBMU patients were more likely to have B symptoms and elevated lactate dehydrogenase (LDH). A total of 44 patients were diagnosed BMI, including 17 cases with BMB+. The sensitivity and specificity of BMB in the diagnosis of BMI was 38.6% (17/44) and 100% (50/50), respectively. Using fPET and sBMU as criteria of PET BMI, the diagnostic sensitivity and specificity of PET/CT was 93.2% (41/44) and 100% (50/50), respectively. Kaplan-Meier analysis showed that there was no significant difference in 2-year PFS rate between nPET and dPET patients (P >0.05), while sBMU patients had lower 2-year PFS rate compared with fPET patients (P < 0.001). Multivariate analysis showed that higher Ann Arbor stage (HR=9.010, P =0.04) and sBMU (HR=3.964, P =0.002) were independent risk factors affecting PFS.@*CONCLUSIONS@#Increased BM FDG uptake of DLBCL can be manifested as dPET, fPET and sBMU. fPET and sBMU can replace BMB to diagnose BMI. Although dPET cannot completely exclude the possibility of BMI, it does not affect the prognosis, so it can be diagnosed as PET BMI negative. sBMU is an independent prognostic risk factor.

Analysis of endoscopic characteristics in 93 cases of early gastric cancer and precancerous lesions after Helicobacter pylori eradication / 中华消化杂志

Objective:To analyze the endoscopic characteristics of early gastric cancer and precancerous lesions after Helicobacter pylori ( H. pylori) eradication. Methods:From May 2019 to June 2022, at Shanghai Sixth People′s Hospital affiliated to Shanghai Jiaotong University School of Medicine, the medical data of patients diagnosed with differentiated early gastric cancer and precancerous lesions were collected. A total of 93 patients with early gastric cancer and precancerous lesions who had previous history of H. pylori infection and had undergone standardized eradication treatment were selected, and their endoscopic characteristics were retrospectively analyzed. Independent sample t-test, chi-square test, and Fisher′s exact test were used for statistical analysis. Results:Among 93 patients with early gastric cancer and precancerous lesions after H. pylori eradication, there were 56 males and 37 females, with an average age of (66.9±8.2) years old. The time after H. pylori eradication was 3.4 years (range 1.0 to 7.0 years). A total of 109 early gastric cancer and precancerous lesions were found, including 79 patients with single lesion and 14 patients with multiple lesions (30 lesions). There were 60 cases with 73 lesions in the early gastric cancer group and 33 cases with 36 lesions in the precancerous group. Among 93 patients, 89 cases (95.7%) were diagnosed with atrophy level above C-2 according to Kimura-Takemoto classification under endoscopy. The long diameter of 109 lesions was (1.38±0.70) cm and the short diameter was (1.04±0.53) cm. A total of 80 lesions (73.4%) were located in the lower 1/3 part of the stomach, and 53 lesions (48.6%) were located in the lesser curvature. A total of 106 lesions (97.2%) were superficial type (0-Ⅱ) under the endoscopy. The long diameter and short diameter in the early gastric cancer group after H. pylori eradication were both greater than those in the precancerous lesion group ((1.54±0.78) cm vs. (1.06±0.35) cm, (1.16±0.58) cm vs. (0.78±0.33) cm), and the differences were statistically significant ( t=3.53 and 3.73, both P<0.001). There was statistically significant difference in the morphological types between early gastric cancer group after H. pylori eradication and precancerous lesion group ( χ2=11.01, P=0.012). The main morphological type of early gastric cancer after H. pylori eradication was superficial depression type (0-Ⅱc), accounting for 45.2% (33/73), while the precancerous lesions were mainly superficial protruded and flat type, both accounting for 38.9% (14/36). Conclusions:After H. pylori eradication, the endoscopic atrophy range of early gastric cancer and precancerous lesions is mostly above C-2. And the lesions are mostly located in the middle and lower 1/3 part of the stomach, long diameter of lesions <20 mm. The main morphological type is superficial type, especially superficial depression type.

Analysis of research hotspots and frontiers in the training of health management talents in China based on knowledge mapping / 中华健康管理学杂志

Objective:To analyze the research hotspots and frontiers in the training of health management talents in China based on knowledge mapping.Methods:The literature related to talent training in health management was retrieved from the databases of CNKI, Wanfang Data, and VIP Journals from 2007 to 2022. The keywords used for retrieval included “health management” “curriculum system” “health manager” “evaluation system” “health service and management” and “talent training”. The time distribution of the literature was analyzed using Excel. Bibliometric analysis was conducted to visually analyze the research in health management talent training, focusing on authorship and collaboration, research institutions, high-frequency keywords, and research hotspots. A knowledge map was created to outline the research framework.Results:A total of 378 journal articles were retrieved. Over the past decade, there has been an overall increasing trend in the number of research publications related to health management talent training. The highest number of articles was published in 2021 (63 articles). In terms of spatial distribution, highly productive authors were relatively concentrated, and research institutions were mostly universities, with Hangzhou Normal University having the highest number of publications (14 articles). The research hotspots included health managers, practice teaching modes, cross-cultivation, and discipline construction. The research frontiers concentrated on talent training modes, health service and management professions, talent demand, and curriculum system construction.Conclusions:In the past decade, health management talents training in China has received more attention and importance. However, there is limited exchange and cooperation among authors and research institutions, and the research hotspots continue to extend in the direction of specialization and diversification. The transformation from vocational education to academic education and strengthening professional construction are the frontiers of the research.

Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis

The initial presentation of non-alcoholic steatohepatitis (NASH) is hepatic steatosis. The dysfunction of lipid metabolism within hepatocytes caused by genetic factors, diet, and insulin resistance causes lipid accumulation. Lipotoxicity, oxidative stress, mitochondrial dysfunction, and endoplasmic reticulum stress would further contribute to hepatocyte injury and death, leading to inflammation and immune dysfunction in the liver. During the healing process, the accumulation of an excessive amount of fibrosis might occur while healing. During the development of NASH and liver fibrosis, the gut-liver axis, adipose-liver axis, and renin-angiotensin system (RAS) may be dysregulated and impaired. Translocation of bacteria or its end-products entering the liver could activate hepatocytes, Kupffer cells, and hepatic stellate cells, exacerbating hepatic steatosis, inflammation, and fibrosis. Bile acids regulate glucose and lipid metabolism through Farnesoid X receptors in the liver and intestine. Increased adipose tissue-derived non-esterified fatty acids would aggravate hepatic steatosis. Increased leptin also plays a role in hepatic fibrogenesis, and decreased adiponectin may contribute to hepatic insulin resistance. Moreover, dysregulation of peroxisome proliferator-activated receptors in the liver, adipose, and muscle tissues may impair lipid metabolism. In addition, the RAS may contribute to hepatic fatty acid metabolism, inflammation, and fibrosis. The treatment includes lifestyle modification, pharmacological therapy, and non-pharmacological therapy. Currently, weight reduction by lifestyle modification or surgery is the most effective therapy. However, vitamin E, pioglitazone, and obeticholic acid have also been suggested. In this review, we will introduce some new clinical trials and experimental therapies for the treatment of NASH and related fibrosis.

Focal thalamus alterations and their associations with cognitive impairment in patients with amyotrophic lateral sclerosis / 西安交通大学学报(医学版)

【Objective】 To investigate changes in thalamus structure and function and their associations with cognitive impairment in patients with amyotrophic lateral sclerosis (ALS). 【Methods】 3D high-resolution structural imaging and resting-state fMRI were applied in 78 ALS patients and 49 healthy volunteers. The shape of the thalamus was assessed using a vortex analysis and functional connectivity between the thalamus subregion and cortex was evaluated by a seed-based correlation analysis. Partial correlation analysis was used to evaluate the correlation between focal thalamus alterations and clinical assessments. 【Results】 Compared with the control group, vertex analysis showed significant atrophy in the prefrontal and temporal subregions of bilateral thalamus in the ALS group. Patients exhibited increased functional connectivity of motor-sensory ROI with the right motor cortex, of temporal ROI with the bilateral lateral occipital cortex, precuneus and right temporal subregion. In contrast, decreased function connectivity was found mainly between temporal ROI and paracingulate gyrus, left dorsomedial prefrontal lobe and left caudate. Partial correlation analysis showed that the functional connectivity of the precuneus, paracingulate cortex, left caudate nucleus and left prefrontal lobe was correlated with multiple cognitive performances. 【Conclusion】 Selective damage of thalamic structure and function in ALS plays an important role in cognitive and behavioral disorders.

Features of white matter degeneration in ALS patients with different onset and spreading pattern by using DTI / 西安交通大学学报(医学版)

【Objective】 To explore the characteristics of white matter degeneration in amyotrophic lateral sclerosis (ALS) patients with different onset and spreading patterns by using diffusion tensor imaging (DTI). 【Methods】 We enrolled 86 ALS patients and 44 healthy controls. The patients were divided into bulbar- and spinal-onset subgroups according to their onset site, as well as horizon, vertical, interpose/skip, and caudal-rostral subgroups based on the spreading direction of the involved regions. The white matter fiber tracts corresponding to the motor network were set as the region of interest. We used tract-based spatial statistics to evaluate differences between the above groups and the normal controls, with family-wise error (FWE) correction and P<0.05 as statistical significance. 【Results】 The white matter degeneration of ALS patients with bulbar onset was mainly limited to the corona radiation part of the corticospinal tract, while those with spinal onset showed extensive degeneration of corticospinal tract and corpus callosum Ⅲ area (FWE correction, P<0.05). In patients with horizontal and vertical dissemination, decreased integrity of the entire corticospinal tract was found, with patients in the latter group showed extra degeneration in the Ⅲ part of the corpus callosum. Restricted degeneration of the corticospinal tract within bilateral corona radiata was detected in patients with caudal-rostral and interposed/skip spreading pattens (FWE correction, P<0.05). 【Conclusion】 Different onset and disease spread patterns of ALS patients correspond to divergent brain degeneration patterns. The diagnosis, treatment, and management of ALS should fully consider the heterogeneity of the disease.

Research progress on potential effects of noise on glycolipid metabolism / 环境与职业医学

Noise pollution has become a common public health problem. The harm of noise exposure to human health cannot be ignored. Exposure to noise not only damages the auditory system but also affects the non-auditory system. At present, accumulating domestic and international epidemiological studies have suggested that noise exposure may be related to glycolipid metabolism disturbance. This article summarized recent epidemiological evidence of the association between noise exposure and glucose and lipid metabolism disorders, such as type 2 diabetes, obesity, metabolic syndrome, and hyperlipidaemia. The potential biological mechanisms connecting noise exposure to glucolipid metabolism were also introduced, e.g. noise as a stressor, sleep disorders, and intestinal flora regulation. This study discussed the impacts of noise exposure on glycolipid metabolism related diseases, providing a basis for further identifying noise related risk factors, conducting future related research, and formulating scientific and effective prevention and control measures.

The diagnostic value of active inflammatory changes of the symphysis pubis on magnetic resonance imaging scans in patients with axial spondyloarthritis and clinical factors analysis / 中华风湿病学杂志

Objective:To evaluate the correlation of active inflammatory changes of the symphysis pubis on magnetic resonance imaging (MRI) scans with clinical factors in patients with axial spondyloarthritis.Methods:We retrospectively evaluated 112 patients with axial spondyloarthritis (ax-SpA) in our hospital from February 2014 to November 2020. Patients were divided into 4 groups: symphysis pubis + sacroiliac arthritis, symphysis pubis + non-sacroiliac arthritis, non-symphysis pubis + sacroiliac arthritis, and non symphysis pubis + non-sacroiliac arthritis group. Intra-group correlation coefficient ( ICC) was used to analyze the correlation between MRI active inflammation of the symphysis pubis and the sacroilioarthritis. Age, sex, symptom duration, smoking, body mass index, human leukocyte antigen (HLA)-B27 positive rate, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) among the four groups were compared by one-way analysis of variance (ANOVA) and Chi-square test. Results:The proportion of active inflammation of the symphysis pubis was 35.7% (40/112). There was no correlation between active inflammation of the symphysis pubis and sacroilioarthritis ( r=-0.06, P=0.559). Twenty-four patients of the 69 patients with sacroilioarthritis had active inflammation of the symphysis pubis, 16 patients of the 43 patients without sacroilioarthritis had active inflammation of the symphysis pubis. In patients without active inflammation of the sacroiliac joint, the CRP and ESR of the active inflammation of the symphysis pubis group was (49±60) mg/L, (40±19) mm/1 h, statistically higher than that of the non-active inflammation group (19±22) mg/L, (22±37) mm/1 h ( t=2.36, P=0.023; t=2.88, P=0.006). In patients who had active inflammation of the symphysis pubis, the symptom duration of the non-active inflammation of the sacroiliac joint, was (14±9) years, which was significantly longer than that of the active inflammation group (5±4) years ( t=4.07, P=0.001). Conclusion:There is no correlation between active inflammatory changes of the symphysis pubis and bone marrow edema of the sacroiliac joint. Therefore, in ax-SpA patients with inflammatory low back pain and/or hip/groin pain, and also with high levels of CRP, ESR, but no active inflammatory changes of the sacroiliac joint on MRI scans, active inflammation of the symphysis pubis should be considered.

Clinical study of using constant temperature vaginal mould to prevent radiation vaginal stenosis in patients with cervical cancer treated with radiotherapy / 中国辐射卫生

Objective to investigate the clinical effect of constant temperature vaginal mould in preventing vaginal stricture in patients with cervical cancer treated with radiotherapy. Methods from January 2017 to December 2018, 80 patients with cervical cancer were selected and divided into vaginal irrigation control group (n = 40) and observation group (n = 40). The incidence of vaginal stricture was compared between the two groups. Results the incidence of vaginal stenosis was 32.50% in the observation group and 70.00% in the control group (P < 0.05). Conclusion vaginal mould is helpful to reduce the incidence of vaginal stenosis caused by external irradiation and close irradiation, which is worth popularizing in the future.

Construction of a drug screening model for miscarriage from induced pluripotent stem cells in vitro / 药学学报

Drug use during pregnancy is unavoidable. Therefore, it is vitally important for medical workers to help pregnant women take drugs correctly to reduce the incidence of spontaneous abortion, premature birth, and low birth weight. In our study, drug screening model with induced pluripotent stem cells (iPSCs) was used to find some improper drugs which will result in woman's abortion. With 3D culture in vitro, iPSCs can form embryoid bodies (EBs) and cerebral organoids, which simulated in vitro development of early embryos, from inner cell mass to germ-layer differentiation. In the experiment, EBs were exposed to mifepristone (RU486), and three experimental groups were divided randomly. They were control group (without RU486), low-dose group (L-RU486, 10 μg·mL-1), and high-dose group (H-RU486, 20 μg·mL-1). After mifepristone exposure, EBs were observed at days 5, 8, and 11, including size of EB, cell apoptosis, and differentiation of germ layers, by using inverted optical microscope, TUNEL assay, and immunofluorescent staining. The results showed that through 3D culture, iPSCs could develop into embryoid bodies, neural rosettes, and finally cerebral organoids. After mifepristone exposure, EBs' sizes were decreased (P < 0.01); the levels of cell apoptosis in EBs were increased after mifepristone exposure (P < 0.01); the development of EBs' germ layer was affected. Mifepristone exposure could inhibit the proliferation of embryonic stem cells, reduce the differentiation of ectoderm (P < 0.01) and promote the development of mesoderm (P < 0.05). In conclusion, iPSCs can be used as a screening model for abortion drug, and EBs’ diameter, cell apoptosis, and differentiation changes of the germ layers can serve as criteria of abortion drug screening.

Clinical value of heparin binding protein level in BALF for diagnosis and differential diagnosis of bacterial pneumonia / 中华临床感染病杂志

Objective:To explore the clinical value of heparin binding protein (HBP) in bronchoalveolar lavage fluid (BALF) for diagnosis and differential diagnosis of bacterial pneumonia.Methods:Eighty eight patients with pulmonary infection from the respiratory department of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to January 2021 were enrolled in the study, including 48 cases of bacterial pneumonia and 40 cases of non-bacterial pneumonia; meanwhile, 40 non-pulmonary infection patients were also enrolled as the control group. The BALF levels of HBP, procalcitonin (PCT), interleukin-6 (IL-6) were measured, and the clinical values of the above indexes in differential diagnosis of bacterial and non-bacterial pneumonia were analyzed.Results:The BALF levels of HBP and IL-6 in bacterial pneumonia group were significantly higher than those of the non-bacterial pneumonia group and the control group ( P<0.05). ROC curve showed that the areas under the curve (AUC) of HBP and IL-6 were 0.930 and 0.893 for the early diagnosis of bacterial pneumonia; and the sensitivity was 88.5% and 82.7%, the specificity was 92.5% and 92.5%, respectively. Combined detection of HBP and IL-6, the AUC was 0.942 and the sensitivity was 94.2% and the specificity was 95.0%. When they were used to distinguish bacterial pneumonia, the AUC of HBP and IL-6 were 0.890 and 0.777, and the sensitivities were 80.8% and 71.2%, and the specificity were 91.7% and 75.0%, respectively. Combined detection of HBP and IL-6, the AUC was 0.902, and the sensitivity was 96.2% and the specificity was 79.2%. Conclusions:BALF HBP and IL-6 have good clinical value in the early diagnosis and distinguishing bacterial pulmonary infection and the joint value of the two is better.

Bibliometrics and visualization analysis of quality control research of health checkup / 中华健康管理学杂志

Objective:To understand the research status, research hotspots and research frontiers of quality control of health checkup in the past 15 years.Methods:Journal literatures with the theme of "Health checkup and Quality control" from China National Knowledge Infrastructure (CNKI) database from 2006 to 2020 were retrieved and analyzed. Excel was used to analyze the time and sequence and discipline distribution of literatures. CiteSpace V software was used for visual analysis of institutions and keywords.Results:A total of 306 literatures were obtained, and the number of literatures published in the past 15 years showed an overall growth trend, with the highest number of literatures published in 2019 (36). They mainly focused on the research of medical and health policies and laws and regulations, clinical medicine, preventive medicine and hygiene and other disciplines, with a few literatures belonging to interdisciplinary disciplines. The top three institutions were Physical Examination Center of Naval General Hospital, Health Management Center of the General Hospital of Tianjin Medical University, Health Management Research Institute of PLA General Hospital. The institutions with high centrality were Physical Examination Center of Naval General Hospital, Editorial Board of Chinese Journal of Health Management, and Chinese Health Management Association and so on. There were fewer cooperative links between institutions. The high-frequency keywords found in 306 literatures were"quality control","health checkup","quality management","health management","physical examination center","Deming Cycle (Plan-Do-Check-Action Cycle, PDCA Cycle)","quality of health checkup", etc."Health management"was the key emergence word in the recent three years.Conclusions:In the past 15 years, the attention on the quality control of health checkup in China has gradually increased, but there is less cross-connection between disciplines and institutions. The research focuses on the internal quality control and the application of advanced management theories in health examination institutions. The transformation from simple health checkup to health management service is the research frontier.

Comparative effectiveness and safety of 32 pharmacological interventions recommended by guidelines for coronavirus disease 2019: a systematic review and network meta-analysis combining 66 trials / 中华医学杂志(英文版)

BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.

Applications of stem cell disease models in liver metabolic research and drug development / 生理学报

The high failure rate of the new drug development has been well recognized. Relying on the pre-clinical data obtained from animal experiments will inevitably cause a low concordance with human clinical trials, which will eventually lead to new drug development failure. Employing human induced pluripotent stem cells (iPSCs) or adult stem cells to simulate disease models can not only provide an unlimited cell materials, but also faithfully represent the genetic background of a certain disease, when iPSCs or adult stem cells derived from patients with a specific disease genetic variation are applied. In addition, gene editing methods can be used to introduce genetic variants of interest into stem cells to generate disease models. Furthermore, by establishing a cell bank with a population of iPSCs in petri dish, in vitro human genetic studies can be carried out in these cells, with GWAS and QTL studies applied to identify genetic variants that are associated with drug sensitivity or cytotoxicity. These efforts may offer valuable information for the recruitment of suitable patients for clinical trials. Therefore, stem cell-derived disease models can provide valuable resources for the pathophysiological studies of diseases as well as the drug development. In this review, we will briefly introduce the development of the liver disease models derived from stem cells and their applications in disease study and drug development.

Research on regularity of traditional Chinese medicine in treatment of Alzheimer's disease based on data mining / 中国中药杂志

To explore prescription medication regularity in the treatment of Alzheimer's disease with traditional Chinese medicine(TCM). With Alzheimer's disease or senile dementia as the subject, collecting and sorting out the journal papers in CNKI were collected as the data source to establish the literature research database of Alzheimer's disease prescriptions, and then the association rule analysis, factor analysis and systematic cluster analysis on the included TCM were conducted. Among the 113 prescriptions included in the standard, the single herb Acori Tatarinowii Rhizoma was the most common. The herbs were mainly warm and flat among four pro-perties, mainly sweet, bitter and spicy among five flavors. The drugs were mainly distributed in five internal organs, and the most commonly used drugs were deficiency tonifying drugs as well as blood activating and stasis removing drugs. In the association rule analysis, it was found that there were 6 drug pairs with the highest association strength. Eight common factors were extracted from the factor analysis, and they were classified into 6 categories in the systematic cluster analysis. The results have shown that the overall principles in treating Alzheimer's disease with modern Chinese medicine are tonifying deficiency, invigorating circulation, activating blood and dispelling phlegm.

Current situation on the global distribution of hepatitis B virus subtypes / 中华疾病控制杂志

Hepatitis B virus (HBV) infection is an important global public health concern and a major cause of chronic hepatitis, cirrhosis and liver cancer. Many studies have shown that different genotypes and subtypes have significant differences in pathogenicity, thus affecting the disease progression and prognosis of infected individuals. So far, a total of 10 HBV genotypes and more than 40 subtypes have been reported across the world, and these subtypes have shown distinct distribution characteristics. In the present review, we systematically summarized the current situation on the global distribution of HBV genotypes.

Effects of Incretin-based Therapies on Weight-related Indicators among Patients with Type 2 Diabetes: A Network Meta-analysis / 生物医学与环境科学（英文）

Objective@#To evaluate the effects of incretin-based therapies on body weight as the primary outcome, as well as on body mass index (BMI) and waist circumference (WC) as secondary outcomes.@*Methods@#Databases including Medline, Embase, the Cochrane Library, and clinicaltrials.gov (www.clinicaltrials.gov) were searched for randomized controlled trials (RCTs). Standard pairwise meta-analysis and network meta-analysis (NMA) were both carried out. The risk of bias (ROB) tool recommended by the Cochrane handbook was used to assess the quality of studies. Subgroup analysis, sensitivity analysis, meta-regression, and quality evaluation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were also performed.@*Results@#A total of 292 trials were included in this study. Compared with placebo, dipeptidyl-peptidase IV inhibitors (DPP-4Is) increased weight slightly by 0.31 kg [95% confidence interval ( ): 0.05, 0.58] and had negligible effects on BMI and WC. Compared with placebo, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lowered weight, BMI, and WC by -1.34 kg (95% : -1.60, -1.09), -1.10 kg/m (95% : -1.42, -0.78), and -1.28 cm (95% : -1.69, -0.86), respectively.@*Conclusion@#GLP-1 RAs were more effective than DPP-4Is in lowering the three indicators. Overall, the effects of GLP-1 RAs on weight, BMI, and WC were favorable.

Effect of Modified Dihuang Yinzi on Learning and Memory Ability and Neuron Damage in Hippocampal CA1 Area in Rats with Vascular Dementia / 中国实验方剂学杂志

Objective::To observe the effect of modified Dihuang Yinzi on the learning and memory ability and on the neurons in CA1 area of hippocampus of rats suffering from vascular dementia. Method::The 84 male SD rats were randomly selected to form the sham operation group of 12 rats, and the other 72 rats were chosen for the vascular dementia model by means of Bivascular occlusion, and among which 60 were chosen randomly into 6 groups of 12 rats, namely, the model group, the nimodipine group (0.011 g·kg-1), and the high, medium and low dose modified Dihuang Yinzi (4.54, 2.27, 1.14 g·kg-1) respectively. After 30 days of continuous gavage, Morris water maze was used to detect the learning and memory ability of rats, hematoxylin eosin (HE) was used to observe the morphological changes of hippocampal CA1 neurons, transmission electron microscopy was used to observe the ultrastructural changes of hippocampal CA1 neurons, TUNEL was used to detect the apoptosis level of hippocampal CA1 neurons, immunohistochemical(IHC) was used to detect the expression level of phosphatidylinositol-3(PI3K), protein kinase B (Akt), Caspase-3 in hippocampal CA1 tissues. Result::Compared with sham operation group, the escape latency of the model group was significantly prolonged, the number of times of crossing the original platform was significantly reduced (P<0.01), the neuronal morphology of hippocampal CA1 area was damaged to varying degrees, the apoptosis rate was significantly increased (P<0.01), the integral optical density and average optical density of PI3K, Akt were significantly reduced (P<0.01), and the integral optical density and average optical density of Caspase-3 were significantly reduced (P<0.01). Compared with model group, the escape latency was shortened (P<0.05, P<0.01), the number of crossing the original platform was increased (P<0.05, P<0.01), the integrated optical density and average optical density of PI3K and Akt were significantly increased (P<0.01), and the integrated optical density and average optical density of Caspase-3 were decreased in different degrees (P<0.05, P<0.01). Conclusion::Modified Dihuang Yinzi can improve the learning and memory ability of vascular dementia model rats and the damaged neurons in the hippocampal CA1 area. The potential mechanism may be related to the activation of PI3K/Akt signal transduction pathway and the inhibition of apoptosis of neurons in hippocampal CA1 area of rats.

Therapeutic Effect and Mechanism of Taohong Siwu Granule on Rats with Dysmenorrhea Due to Cold Coagulation and Blood Stasis / 中国实验方剂学杂志

Objective:To observe the effect of Taohong Siwu granule on dysmenorrhea rats. Method:Forty-eight healthy SD female rats were randomly divided into six groups: control group, model group, Taohong Siwu granule groups (18, 9, 4.5 g·kg-1) and Fuke Qianjin tablet group (0.08 g·kg-1). The rats were given Bugaorer (0.35 mg·kg-1) every day and ice-water bath for 8 minutes for 10 consecutive days. Oxytocin was injected intraperitoneally on the 11th day. The writhing reaction of rats was observed, and the effect of Taohong Siwu granules on hemorheology was measured. The levels of 6-ketoprostacyclin F1α(6-keto-PGF1α), thromboxane B2(TXB2), prostaglandinF2α（PGF2α）, PGE2 of rats were detected by enzyme-linked immunosorbent assay (ELISA). Ca2+ in uterine tissues was scanned by laser confocal microscopy. Result:Each dose of Taohong Siwu granule group reduced the number of writhing, the time of writhing and the incidence of writhing in dysmenorrhea rats, which were significantly lower than those in model group (P<0.05，P<0.01). Compared with the model group, high, medium and low-dose Taohong Siwu granules groups could reduce blood viscosity and plasma viscosity, and Taohong Siwu granules can significantly reduce the content of TXB2, Ca2+，PGF2α, and significantly increase the content of 6-keto-PGF1α，PGE2 (P<0.05，P<0.01). Conclusion:Taohong Siwu granule can significantly alleviate dysmenorrhea symptoms in rats. The mechanism may be correlated with the contents of 6-keto-PGF1α, TXB2 and PGF2α, PGE2 and Ca2+.