Research advances in transcatheter arterial chemoembolization combined with targeted agents or anti-PD-1/PD-L1 monoclonal antibody in treatment of patients with unresectable hepatocellular carcinoma / 临床肝胆病杂志

Transcatheter arterial chemoembolization (TACE) is recommended by domestic and international guidelines for the treatment of patients with unresectable hepatocellular carcinoma (uHCC), and it is one of the most common treatment methods for patients with uHCC. The chemotherapy drugs commonly used in TACE for HCC include epirubicin, cisplatin, and fluorouracil, while it is still unclear which chemotherapy drug has a better clinical effect. This article summarizes the studies of different TACE regimens using different chemotherapy drugs in the treatment of patients with uHCC in the recent five years. TACE combined with sorafenib can significantly improve the survival of patients with advanced HCC and has been recommended for the treatment of such patients by Chinese Society of Clinical Oncology guidelines, and the efficacy of TACE combined with other tyrosine kinase inhibitors (TKI) has become a research hotspot. Studies have shown that compared with TACE combined with sorafenib in the treatment of patients with advanced HCC, TACE combined with lenvatinib can achieve a significantly longer progression-free survival time and a tendency of increase in median overall survival time. However, due to the variation of target receptors or downstream signals, resistance to molecular-targeted agents is still a challenging problem. TKI combined with immune checkpoint inhibitors may be a promising strategy for the treatment of patients with uHCC. Some studies suggest that triple therapy using TACE combined with TKIs and anti-PD-1/PD-L1 monoclonal antibody has better efficacy in improving the survival of patients with uHCC. This article reviews the studies of the efficacy and safety of TACE combined with targeted agents and TACE combined with anti-PD-1/PD-L1 monoclonal antibody in the treatment of patients with uHCC in the recent five years.

Tajectories of the self-efficacy of HIV testing among MSM based on latent class growth model / 中华预防医学杂志

Objective: To analyze the trajectories of HIV testing self-efficacy among men who have sex with men (MSM) based on latent class growth model. Methods: From August 2019 to May 2021, 404 MSM were recruited in Shandong Province and subjected to a 1-year follow-up study with individual intervention (pushing intervention pictures and videos in WeChat and follow-up questionnaires) and community intervention (forwarding to friends and sharing and discussing HIV testing-related information in WeChat groups). The level of HIV testing self-efficacy among MSM was measured. The long-term trend of HIV testing self-efficacy was analyzed using the latent class growth model (LCGM), and the influencing factors of the trend were analyzed. Results: A total of 404 MSM were (28.25±8.95) years old, with the oldest being 58 and the youngest being 18. The scores of HIV testing self-efficacy M(Q1, Q3) at baseline and 4 follow-ups were 18.00 (17.00, 21.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00), 19.00 (18.00, 22.00) and 19.00 (18.00, 22.00). The results of the freely estimated two-category LCGM model showed that the trend of HIV testing self-efficacy among MSM could be divided into two classes, "intervention response group" [255(63.1%)] and "intervention non-response group" [149(36.9%)]. The former had a higher level of HIV testing self-efficacy which tended to increase at first and then decrease over time, while the latter had a lower and more stable level. The results of the multifactorial logistic regression analysis showed that the OR values of MSM in business or service and jobless or unemployed were 0.261 (95%CI: 0.108-0.633) and 0.186 (95%CI: 0.057-0.610), respectively, using the students as the reference group. Conclusion: There is a group heterogeneity in the trend of HIV testing self-efficacy in the intervention conditions among MSM, and occupation may be an influencing factor.

Clinical comprehensive evaluation of recombinant Mycobacterium tuberculosis fusion protein / 中国药房

OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.

ZJU index and the risk of nonalcoholic fatty liver disease in the Uygur population in the rural area of Xinjiang Uygur Autonomous Region： A cohort study / 临床肝胆病杂志

ObjectiveTo investigate the association between ZJU index and the onset of nonalcoholic fatty liver disease （NAFLD） in the Uygur population and the value of ZJU index in predicting the risk of NAFLD. MethodsThe Uighur community of The 51st Regiment of The Third Division of Xinjiang Kashgar Corps was selected as the investigation site， and the Uygur residents who lived in this area and had an age of >18 years were selected as subjects. Follow-up studies were conducted in 2019， 2020， and 2021， and the investigation of outcomes was completed in June to August of 2021. Finally 10 597 subjects were enrolled for analysis. The Kruskal-Wallis H test was used for comparison of continuous variables between groups， and the chi-square test was used for comparison of categorical variables between groups. The subjects were divided into Q1-Q4 groups according to the level of ZJU index. The Kaplan-Meier curve was used to predict the incidence rate of NAFLD， and the Cox regression model was used to analyze the association between ZJU index and the risk of NAFLD； the area under the ROC curve （AUC） was used to evaluate the value of ZJU index in predicting the risk of NAFLD. ResultsDuring the median follow-up time of 4.92 years， the incidence rate of NAFLD was 9.4% （992/10 597） among the study population. After adjustment for multiple factors， there was a significant increase in the risk of NAFLD with the increase in ZJU index， with a hazard ratio of 2.55 （95% confidence interval ［CI］： 1.60‍ — ‍4.06）， 7.32 （95%CI： 4.78‍ — ‍11.20）， and 21.74 （95%CI： 14.32‍ — ‍33.00）， respectively （all Ptrend<0.001）. The ROC curve showed that ZJU index had a higher value in predicting NAFLD （AUC=0.816）， and the male subgroup had a significantly higher predictive accuracy of ZJU index than the female subgroup （AUC： 0.829 vs 0.809）. ConclusionZJU index is a predictive factor for the onset of NAFLD in the Uygur population in rural areas of Xinjiang and has a good value in predicting the risk of NAFLD.

Comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma / 临床肝胆病杂志

Objective To investigate the comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma, and to lay a foundation for further research on the influence of hepatic cystic echinococcosis on HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma. Methods A retrospective analysis was performed for the data of 401 patients with hepatic cystic echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from 2003 to 2019, and the state of comorbidity of hepatic cystic echinococcosis with HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma was clarified. The patients with hepatic cystic echinococcosis and chronic HBV/HCV infection were selected as comorbidity group, and the patients with HBV/HCV infection alone were matched as control group. The chi-square test and the Fisher's exact test were used to analyze the state of viral infection and the disease composition of liver cirrhosis and hepatocellular carcinoma. Results Of all 401 patients, 38(9.5%) were included in the comorbidity group and 2(0.5%) had liver cirrhosis after HBV/HCV infection, while no patient had hepatocellular carcinoma after HBV/HCV infection. Among the patients with chronic hepatitis B virus infection in the comorbidity group, non-active HBsAg carriers accounted for 81%, HBeAg-positive chronic hepatitis B patients accounted for 9.5%, and HBeAg-negative chronic hepatitis B patients accounted for 9.5%; among the patients with hepatitis B virus infection in the control group, non-active HBsAg carriers accounted for 43%, HBeAg-positive chronic hepatitis B patients accounted for 33%, and HBeAg-negative chronic hepatitis B patients accounted for 19%, with a significant difference between the two groups ( P =0.033). There was a significant difference in the HBV RNA clearance rate of the patients with HCV infection between the comorbidity group and the control group ( χ 2 =4.447, P =0.035). In the comorbidity group, the patients with liver cirrhosis accounted for 5.2% and there were no patients with hepatocellular carcinoma, while in the control group, the patients with liver cirrhosis accounted for 18.4% and those with hepatocellular carcinoma accounted for 5.2%; the comorbidity group had significantly lower proportions than the control group ( P =0.048). Conclusion The proportion of liver cirrhosis patients with hepatic cystic echinococcosis and HBV/HCV infection is lower than that of liver cirrhosis patients with viral hepatitis alone, and there are no cases of hepatocellular carcinoma after HBV/HCV infection. Further multicenter studies are needed to investigate the influence of hepatic cystic echinococcosis on chronic HBV/HCV infection, liver cirrhosis, and hepatocellular carcinoma.

Apoptosis of small cell lung cancer cells H1688 and H446 induced by nitidine chloride through PI3K/Akt/Bcl-2/caspase-3/PARP pathway / 中国药理学通报

Aim To explore the apoptosis of small eell lung eancer ( SCLC ) eells HI688 and H446 induced by nitidine chloride and its possible mechanism.Methods The effect of nitidine chloride or cisplatin ( DDP ) on the activity of SCLC cells was detected by j J MTT method; the morphological changes of cells trea¬ted with nitidine chloride or DDP were observed by in- verted fluorescence microscope and HE staining; the effect of nitidine chloride or DDP on apoptosis was de¬tected by flow cytometry; the effect of apoptosis inhibi¬tor Z-VAD-FMK on apoptosis induced by nitidine chlo¬ride or DDP was detected by MTT method.The expres¬sions of Bax , Bcl-2, caspase-3 , PARP, p-PI3K and p- Akt in the cells treated with nitidine chloride or DDP were detected by Western blot.Results MTT results showed that the viability of SCLC cells was significantly reduced after 48 hours of treatment with nitidine chlo¬ ride; compared with DDP, nitidine chloride could in¬hibit SCLC cells with less IC50; inverted fluorescence microscope and HE staining showed that nitidine chlo¬ride could induce apoptosis in SCLC cells, similar to DDP; flow cytometry showed that nitidine chloride J J could induce apoptosis in SCLC cells.The results of MTT assay showed that the inhibitory effect of nitidine chloride on apoptosis of SCLC cells could be partially antagonized by apoptosis inhibitor Z-VAD-FMK.West¬ern blot results showed that, similar to DDP, nitidine chloride could inhibit the expression of PI3K and Akt, increase Bax, inhibit Be 1-2, and promote the cleavage of caspase-3 and PAH P.Conclusion Nitidine chlo¬ride can induce apoptosis of SCLC cells by inhibiting the activation of P13K and Akt.

Research progresses on correlation between connexin subcellular distribution and tumorigenesis and development / 中国药理学通报

Connexin (Cx), a multigene-encoded transmembrane protein family, forms either gap junctions ( GJ) or hemichannels (HC) to mediate intercellular communication in plasma mem¬brane between adjacent cells or interacts with proteins by its car- boxyl terminal in the cytoplasm to participate in the process of tumor cell proliferation, apoptosis, necrosis, invasion, metasta¬sis, drug resistance and stem cell characteristics.However, mi- slocalization of Cx in cytoplasm or nucleus often occurs in many tumors, and involved in the occurrence and development of tumors.Subcellular localization of Cx is affected by post-transla- tional modifications, including phosphorylation, ubiquitination, and acetylation.In this paper the classification and function of Cx, the relationship between subcellular localization of Cx and tumorigenesis and the regulation of post-translational modifica¬tion on Cx are reviewed in order to provide new ideas for the study of Cx as a potential target for cancer therapy.

Effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen: a prospective randomized controlled study / 中国当代儿科杂志

OBJECTIVES@#To study the effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen.@*METHODS@#A total of 102 children with acute abdomen who underwent surgery in Xuzhou Children's Hospital from August 2019 to June 2021 were enrolled as subjects and were randomly divided into an observation group and a control group, with 51 children in each group. The children in the control group were given conventional treatment such as hemostasis and anti-infective therapy after surgery, and those in the observation group were given somatostatin in addition to conventional treatment. Peripheral blood samples were collected from both groups before surgery and on days 1 and 5 after surgery. The two groups were compared in terms of the serum levels of endothelin-1 (ET-1), adrenocorticotropic hormone (ACTH), cortisol, gastrin, and motilin, postoperative recovery, and the incidence rate of complications.@*RESULTS@#There was no significant difference in the serum levels of ET-1, ACTH, cortisol, gastrin, and motilin between the two groups before surgery (P>0.05). Compared with the control group, the observation group had significantly lower serum levels of ET-1, ACTH, and cortisol on days 1 and 5 after surgery (P<0.05) and significantly higher levels of motilin and gastrin on day 5 after surgery (P<0.05). Compared with the control group, the observation group had significantly shorter time to first passage of flatus, first bowel sounds, and first defecation after surgery, as well as a significantly shorter length of hospital stay (P<0.05). The incidence rate of complications in the observation group was significantly lower than that in the control group (6% vs 24%, P<0.05).@*CONCLUSIONS@#In children with acute abdomen, somatostatin can significantly reduce postoperative stress response, improve gastrointestinal function, and reduce the incidence rate of complications, thereby helping to achieve a good prognosis.

Application value of liquid crystal digital display goniometer in total hip arthroplasty / 中国骨伤

OBJECTIVE@#To investigate the application value of liquid crystal digital display goniometer in total hip arthroplasty.@*METHODS@#From January 2018 to December 2019, 83 patients underwent primary total hip arthroplasty, including 28 males and 55 females, aged 42 to 81 (70.4±7.9) years. There were 63 cases of femoral neck fracture and 20 cases of avascular necrosis of femoral head. All patients used liquid crystal digital goniometer to control the anteversion of acetabular cup prosthesis during operation, and CT scanning was used to measure the anteversion of acetabular cup after operation. The two methods were compared to understand the accuracy of using liquid crystal digital goniometer.@*RESULTS@#Postoperative CT measurement showed that the acetabular anteversion of all patients was in the safe area advocated by Lewinnek. The anteversion angle of acetabular cup measured by liquid crystal digital goniometer was 14.20(12.80 to 15.40)°, and the anteversion angle of acetabular cup measured by postoperative CT scan was 14.20 (13.40 to 15.50)°. There was no significant difference between the two (@*CONCLUSION@#It is an accurate and reliable method to control the anteversion of acetabular cup with liquid crystal digital display angle instrument, which has a good auxiliary reference value.

Mechanism of Liuwei Dihuangtang on Learning and Memory in Depressive Rats / 中国实验方剂学杂志

Objective::To investigate the effect and possible mechanism of Liuwei Dihuangtang on memory impairment in rats with chronic depression. Method::Female Wistar rats were randomly divided into normal group (normal saline), chronic unpredictable mild stress (CUMS) model group (normal saline), and low, medium and high-dose Liuwei Dihuangtang groups (2.60, 7.81, 23.50 g·kg-1·d-1). Except for the normal group, all of the other groups were included in the chronic unpredictable mild stress model. Weight were measured every week, changes in their behavioral indicators were observed. The mRNA expressions of G protein-coupled estrogen receptor (GPR30), phosphatidylinositol 3-kinase(PI3K), cyclic adenosine monophosphate response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in the rat hippocampus were determined by real-time fluorescence quantification polymerase chain reaction (Real-time PCR). The concentration of serum estrogen was detected by enzyme-linked immunosorbent assay (ELISA) method. Result::Compared with normal group, model group showed decreases in weight, activity and interest. Liuwei Dihuangtang (2.60, 7.81, 23.50 g·kg-1) significantly increased the sucrose preference of CUMS rats (P<0.01) and standing times in the open field test (P<0.01), doses of 7.81, 23.50 g·kg-1 significantly increased the total distance of the open field test (P<0.05, P<0.01), doses of 2.60, 7.81 g·kg-1 shortened the latency of water maze experiment (P<0.01), and dose of 7.81 g·kg-1 increased serum estrogen concentration (P<0.05). The mRNA expressions of GPR30, PI3K, CREB and BDNF in hippocampus of CUMS model group decreased significantly (P<0.05, P<0.01), but the mRNA expression levels of GPR30, CREB in hippocampus of 2.60 g·kg-1 dose Liuwei Dihuangtang group increased significantly (P<0.05, P<0.01), and the mRNA expression levels of GPR30, PI3K, CREB, BDNF in hippocampus of 7.81 g·kg-1 dose group increased significantly as well (P<0.05, P<0.01). Conclusion::Liuwei Dihuangtang has effect in resisting depression, and reversing depression-like behavior and learning and memory impairment in CUMS rats, with the best effect in the medium-dose Liuwei Dihuangtang group. Its mechanism may be related to increase of serum estrogen and mRNA expressions of GPR30, PI3K, CREB and BDNF in rat hippocampus.

Visits of fever clinic during the epidemic of coronavirus disease 2019: A preliminary analysis / 第二军医大学学报

Objective To observe the visits of fever clinic during the epidemic of coronavirus disease 2019 (COVID-19) and the epidemic characteristics of COVID-19, so as to analyze the disease development trend. Methods The clinical data of fever outpatients (including COVID-19 patients) in Gongli Hospital affiliated to Naval Medical University (Second Military Medical University) from Jan. 15, 2020 to Feb. 29, 2020 were collected for epidemiological descriptive analysis. Results Among the 2 193 patients visiting our hospital between Jan. 15, 2020 and Feb. 29, 2020, 97.08% had respiratory system infection, followed by digestive system infection and urinary system infection. Eighty-one suspected cases and 10 confirmed cases of COVID-19 were identified. Among the suspected cases, there were 38 males (46.91%) and 43 females (53.09%). Among the confirmed cases, four were males and six were females. The onset age of the suspected cases ranged from 20 to 69 years old (83.95%), and all the 10 confirmed patients were ≥50 years old. The suspected patients were mainly employees (31 cases, 38.27%) and retirees (14 cases, 17.28%). Among the 10 confirmed patients, eight cases were retirees. Of the suspected cases, 15 (18.52%) had lived in Hubei province and 52 (64.20%) had an epidemiological history. Of the confirmed cases, seven had lived in Hubei province and all had an epidemiological histories. The onset cycles of suspected and confirmed cases were mainly from Jan. 21, 2020 to Feb. 10, 2020. The main clinical symptoms of the suspected cases were fever (66 cases, 81.48%) and cough (50 cases, 61.73%). The blood routine showed normal white blood cell (65 cases, 80.25%), normal lymphocyte (49 cases, 60.49%) and decreased lymphocyte (24 cases, 29.63%). Chest CT showed COVID-19 characteristics in 13 cases (16.05%). Among the 10 confirmed patients, the main clinical manifestations were also fever (nine cases) and cough (eight cases). The blood routine showed normal white blood cells (10 cases), normal lymphocytes (six cases) and decreased lymphocytes (four cases). Chest CT showed COVID-19 characteristics in seven cases. Conclusion COVID-19 is more common in middle-aged and elderly retirees, with significant epidemiological and family clustering characteristics.

Effect and Possible Mechanism of Kaempferol on Acute Kidney Injury in LPS-Stimulated Mice / 中国药学杂志

OBJECTIVE: To investigate the effect of kaempferol (KAE) on acute kidney injury induced by lipopolysaccharide (LPS) in mice and its mechanism. METHODS: BALB/c mice were randomly divided into normal control group, LPS model group, KAE 25, 50, 100 mg•kg-1 treatment groups. After 7 d of administration, mice in LPS model group and KAE administration groups were injected with LPS 5 mg•kg-1 intraperitoneally, and serum and kidney tissues were collected for detection after LPS injection 6 h. The levels of urea nitrogen (BUN) and creatinine (CRE) in serum were measured to evaluate renal function; the levels of IL-1β, IL-6, TNF-α and ICAM-1 in kidney tissues were detected by ELISA, and the expression of inflammatory pathway-related proteins was detected by Western blot. RESULTS: Compared with the normal control group, the levels of BUN and CRE in serum of LPS model group were increased significantly, while KAE treatment decreased the levels of BUN and CRE in a dose-dependent manner. Compared with the normal control group, the levels of inflammatory related factors and proteins IL-1β, IL-6, TNF-α, ICAM-1, HMGB1, TLR4 and P2X7 in kidney tissues were significantly increased, while KAE treatment could decrease the release of proinflammatory factors and adhesion molecules in kidney tissue in a dose-dependent manner, and down-regulate the expression of inflammatory proteins including HMGB1, TLR4 and P2X7. CONCLUSION: Kaempferol can improve renal function and inhibit acute inflammatory responses induced by LPS stimulation in mice, and the mechanism may be related to down-regulation of HMGB1, TLR4 and P2X7 inflammatory proteins.

Effect of abnormal oligonucleotide binding folding domain protein gene on the initiation of DNA replication in hepatocellular carcinoma / 医学研究生学报

ObjectiveThere are few reports about abnormal oligonucleotide binding fold domain protein genes (OBGs) affecting the initiation of DNA replication in hepatocellular carcinoma through the microchromosome maintenance (MCM) complex. This study aims to explore the roles of reverse-transcription-related genes (RTGs) in Hepatocellular Carcinoma cells (HCC) and the correlation between gene polymorphisms and abnormal gene expression.Methods We created a mouse model by injecting hepatocellular carcinoma cell line H22 (logarithmic growth phase) and dissected the tumor bodies from tumor-forming mice. The control group was treated by isotonic saline without H22. The healthy liver tissue cells were taken from the control mice. The total RNA of the H22 group and control group were extracted, and differentially expressed genes were analyzed. Screening of differentially expressed reverse transcription-related DEGs (RDEGs), GO and KEGG analysis of RDEGs. The interaction analysis of RDEGs encoded proteins, and the correlation analysis of RDEGs polymorphism and gene expression.ResultsThere were 193 differentially expressed RTGs in HCCs, which were involved in two biological procedures, three cell components, one molecular function, three signal pathways, and three functional sites; Its function is mainly concentrated in DNA replication, especially the construction of MCM complex and telomere complex in which OBGs participate in the initiation of replication. Most related genes had OB fold domains. The results also showed that both AS and SNV caused gene polymorphism was positively correlated with gene expression, and most OBGs in HCC had SNV phenomenon, but not occurred in healthy liver tissue.Conclusion Collectively, AS and SNV may be important regulatory factors for gene expression. SNV may particularly affect the function of OBGs in the MCM complex to abnormally initiate DNA replication in HCC.

The Influence of Drill Bit Structure and Drilling Parameters on Bone Drilling Process / 医用生物力学

Objective To make drilling mechanical and thermal analysis of bones with different drill bits and drilling parameters, so as to reduce the drilling force and drilling temperature in drilling process and decrease the damage to surrounding bone tissues. Methods The bone drilling model was established by finite element simulation software AdvantEdge. By comparison with the pig femur drilling experiment, the simulated and experimental results of standard twist driII and three standard multi-facet drills at different speeds and feed rates were analyzed. Results The simulation and experiment comparison showed that the influences of driII bit structure, drilling speed, feed rate on drilling force and drilling temperature were consistent, and the established simulation model was credible. Conclusions Under the same drilling conditions, the multi-facet driII for drilling rubber had lower drilling force and drilling temperature than the standard twist drill. The research findings provide theoretical basis for the application of multi-facet driII in fracture surgery.

Evaluation of "Overwork" of medical workers and the influencing factors at county hospitals / 中华医院管理杂志

Objective To scientifically assess the degree of " overwork" and its influencing factors of doctors and nurses at county hospitals. Methods Six county hospitals were selected as the research objects. Descriptive analysis, chi-square test and ordered multi-class regression were used to analyze the degree of " overwork" and its influencing factors of doctors and nurses. Results 48. 3％ (156 / 323)of the doctors at these hospitals were working more than 60 hours per week. Work hours per week of the doctors were significantly longer than those of the nurses. At the same time, the workload of doctors based on the fatigue self-assessment scale was also significantly higher than that of the nurses, while 61. 9％ (200 / 323) of the doctors were exposed to a very high workload, and so were 33. 3％ (118 / 354) of the nurses. There were significant differences in the workload of doctors and nurses in terms of their gender, age, education level, seniority and number of children. And the work hours per week were an important factor affecting the workload of doctors and nurses. Conclusions We should formulate a reasonable work hours for doctors and nurses, especially focusing on young and middle-aged doctors.

Diagnostic Utility of Interferon-Gamma Release Assay in Tuberculous Lymphadenitis / 中国医学科学杂志(英文版)

Objective The aim of this study was to evaluate the diagnostic performance of T-SPOT.TB for tuberculous lymphadenitis. Methods Suspected tuberculous lymphadenitis patients between September 2010 and September 2018 who had both peripheral blood T-SPOT.TB test and lymph node biopsy were retrospectively enrolled in this study. The cutoff value of T-SPOT.TB test for peripheral blood was set as 24 spot forming cell (SFC)/10 6 periphreral blood monocyte cell (PBMC) according to the instruction of testing kits. The gold standard for diagnosis of TBL was the combination of microbiology results, histopathology results and patient's response to anti-TB treatment. Diagnostic efficacy of T-SPOT.TB was evaluated, including sensitivity, specificity, accuracy, predictive values, and likelihood ratio. Results Among 91 patients who met the inclusion criteria, we excluded 8 cases with incomplete clinical information and 6 cases who lost to follow-up. According to the gold standard, there were 37 cases of true TBL (9 confirmed TBL and 28 probable TBL), 30 cases of non-TBL, and 10 cases of clinically indeterminate diagnosis who were excluded from the final analyses. The T-SPOT.TB tests yielded 43 cases of positive response and 24 cases of negative response. The sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of peripheral blood T-SPOT.TB for diagnosing TBL were 89.2%, 66.7%, 79.1%, 76.7%, 83.3%, 2.68 and 0.16, respectively. The number of SFCs of T-SPOT.TB in TBL patients [432(134-1264)/10 6 PBMCs] was higher than that in non-TBL patients [0 (0-30) /10 6PBMCs] with a significant difference (Z=-5.306, P <0.001). Conclusion T-SPOT.TB is a rapid and simple diagnostic test for TBL with a high sensitivity and negative predictive value.

Value of S100A8 in evaluating the prognosis of children with acute lymphoblastic leukemia / 中国当代儿科杂志

OBJECTIVE@#To study the association between S100A8 expression and prognosis in children with acute lymphoblastic leukemia (ALL).@*METHODS@#The clinical data of 377 children with ALL who were treated with the CCLG-2008-ALL regimen were retrospectively reviewed. ELISA and PCR were used to measure serum protein levels and mRNA expression of S100A8. The Kaplan-Meier method was used for survival analysis and a Cox regression analysis was also performed.@*RESULTS@#The children were followed up for 56 months, and the overall survival rate of the 377 children was 89.1%. The prednisone good response group had significantly lower S100A8 protein and mRNA levels than the prednisone poor response group (P<0.01). In the children with standard or median risk, both S100A8 protein and mRNA levels were associated with event-free survival rate (P<0.05). There were significant differences in S100A8 protein and mRNA levels between the children with different risk stratifications (P<0.01). The children who experienced events had significantly higher S100A8 protein and mRNA levels than those who did not (P<0.01). The Kaplan-Meier survival analysis and the Cox regression model suggested that S100A8 overexpression was an independent risk factor for the prognosis of children with ALL.@*CONCLUSIONS@#High S100A8 expression may be associated with the poor prognosis of children with ALL and is promising as a new marker for individualized precise treatment of children with ALL.

Analysis of Serum Transcriptome Characteristics of Patients with Yin and Yang Syndromes of Acute Ischemic Stroke / 中国实验方剂学杂志

Objective:To obtain the regulatory relationship between genes by screening the differentially expressed long non-coding ribonucleic acid(lncRNA), microRNA(miRNA) and messenger RNA(mRNA) in serum of patients with Yin and Yang syndromes of acute ischemic stroke, and to discuss the material basis and biological mechanism of formation of Yin and Yang syndromes of acute ischemic stroke from the transcriptome level. Method:The microarray chips were adopted to detect expression of lncRNA, mRNA and miRNA in serum of ischemic stroke patients with Yin and Yang syndromes and non-stroke subjects(10 cases each). Differential expression profiles related to Yin and Yang syndromes were selected by conjoint analysis. Further, the obtained differential genes were subjected to antisense lncRNA and mRNA co-expression analysis, gene ontology(GO) and Kyoto encyclopedia of genes and genomes(KEGG) functional pathway analysis, and the intergenic regulatory relationship was obtained to predict the target genes of lncRNA. Partial differential genes in 40 patients(10 with Yang syndrome and 30 with Yin syndrome) were verified by real-time fluorescence quantitative polymerase chain reaction(Real-time PCR). Result:The expression of 227 lncRNA, 54 mRNA and 4 miRNA were closely related to Yang syndrome, 394 lncRNA and 206 mRNA were closely related to Yin syndrome. Antisense lncRNA RP11-647P12.1 and RP11-677M14.2 may regulate the expression of neuron-derived neurotrophic factor(NDNF) and neurogranin(NRGN) by up-regulating the expression level in Yang syndrome. The differential expression of mRNA between Yin syndrome and Yang syndrome was mainly related to neurotransmitter receptor activity regulation, endocrine hormone regulation, inflammatory response, renin-angiotensin system and other pathways. Conclusion:There are differences in the expression profiles of lncRNA, miRNA and mRNA between Yin syndrome and Yang syndrome in acute ischemic stroke, which may be regulated by multiple pathways, such as blood pressure regulation, adrenergic receptor regulation, renin-angiotensin system and γ-aminobutyric acid(GABA). The transcriptome characteristics provide scientific basis for studying the biological basis of Yin syndrome and Yang syndrome in acute ischemic stroke.

Adenanthin Induces Differentiation of Acute Promyelocytic Leukemia Cells by Targeting Peroxiredoxin III / 中国实验血液学杂志

OBJECTIVE@#To investigate the differentiation of acute promyelocytic leukemia (APL) cells induced by adenosine targeting Prx III.@*METHODS@#HL-60 cells were divided into four groups: control group, all-trans retinoic acid (ATRA) group, adenanthin group and ATRA+adenanthin group. Cell morphologic changes were observed under optical microscope. The influence of adenanthin on the differentiation of HL-60 was observed by nitro blue tetrazolium chloride (NBT) test. Cell surface differentiation antigens CD11b expression was measured by flow cytometry. The protein expression of Prx III was detected by immunohistochemical assay.@*RESULTS@#Adenanthin could induce the differentiation of HL-60 cells; the NBT reduction positive rate in ATRA+adenanthin group was significantly higher than that in ATRA group and adenanthin group (P＜0.05). The percentage of CD11b positive cells in ATRA+adenanthin group (43.62％±1.38％) was higher than that in adenanthin group (28.15％±1.78％), ATRA group (36.72％±1.33％) and control group (7.99％±1.78％) (P＜0. 05). The content of Prx Ⅲ protein in adenanthin group was significantly higher than that in control group and ATRA group (P＜0.05).@*CONCLUSION@#Adenanthin and ATRA have a synergistic effect on the differentiation and maturation of HL-60 cells, and its mechanism may be related with regulation of Prx III expression.

Fumigaclavine C attenuates adipogenesis in 3T3-L1 adipocytes and ameliorates lipid accumulation in high-fat diet-induced obese mice

Fumigaclavine C (FC), an active indole alkaloid, is obtained from endophytic Aspergillus terreus (strain No. FC118) by the root of Rhizophora stylosa (Rhizophoraceae). This study is designed to evaluate whether FC has anti-adipogenic effects in 3T3-L1 adipocytes and whether it ameliorates lipid accumulation in high-fat diet (HFD)-induced obese mice. FC notably increased the levels of glycerol in the culture supernatants and markedly reduced lipid accumulation in 3T3-L1 adipocytes. FC differentially inhibited the expressions of adipogenesis-related genes, including the peroxisome proliferator-activated receptor proteins, CCAAT/enhancer-binding proteins, and sterol regulatory element-binding proteins. FC markedly reduced the expressions of lipid synthesis-related genes, such as the fatty acid binding protein, lipoprotein lipase, and fatty acid synthase. Furthermore, FC significantly increased the expressions of lipolysis-related genes, such as the hormone-sensitive lipase, Aquaporin-7, and adipose triglyceride lipase. In HFD-induced obese mice, intraperitoneal injections of FC decreased both the body weight and visceral adipose tissue weight. FC administration significantly reduced lipid accumulation. Moreover, FC could dose-dependently and differentially regulate the expressions of lipid metabolism-related transcription factors. All these data indicated that FC exhibited anti-obesity effects through modulating adipogenesis and lipolysis.