Exploring Modern Mechanism of Treating Diabetic Retinopathy and Coronary Heart Disease from Perspective of Blood Stasis Under Viewpoint of Treating Different Diseases with the Same Method / 中国实验方剂学杂志

Diabetic retinopathy（DR） and coronary heart disease（CHD） are both major chronic vascular complications that seriously jeopardize the health of the population and often occur together in clinical practice， it is of great clinical value to actively explore the association between the two in the process of disease development and methods of prevention and treatment of modern medicine and traditional Chinese medicine（TCM）. According to TCM， the heart and eyes physiologically communicate with each other by taking Qi， blood and veins as bridges， blood stasis obstructing collaterals is the common TCM etiology of DR and CHD， whose mechanism involves inflammation， oxidative stress and endothelial dysfunction. Promoting blood circulation and removing blood stasis plays an important role in the same treatment for different diseases and prevention and treatment of comorbidities， possibly by inhibiting the expression of interleukin-1β（IL-1β）， endothelin-1（ET-1） and hypoxia inducible factor-1α/vascular endothelial growth factor（HIF-1α/VEGF）， regulating phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） pathway， initiating adenosine monophosphate（AMP）-activated protein kinase/silent information regulator 1（AMPK/SIRT1） and nuclear transcription factor erythroid 2-related factor 2/heme oxygenase-1（Nrf2/HO-1） signaling pathways， inhibiting Hippo/Yes-associated protein（Hippo/YAP） signaling pathway， inhibiting mitochondrial permeability transition pore and anti-platelet agglutination for treating DR and CHD， which provides a multi-component， multi-pathway and multi-target selection strategies and ideas for the prevention and treatment of DR and CHD by TCM from a biological perspective. Based on this， subsequent studies should focus on constructing clinically relevant comorbidity models， conducting multicenter prospective studies， and fully utilizing artificial intelligence technology to gain a deeper understanding of the relationship between the two diseases， so as to elucidate the mechanism of promoting blood circulation and removing blood stasis in preventing and treating panvascular diseases.

Improvement of Colonic Mucosa Inflammatory Response in Mice with Ulcerative Colitis by Xiezhuo Jiedu Recipe Through miRNA-155-5p/JAK2/STAT3 Pathway / 中国实验方剂学杂志

ObjectiveThe differential expression of microRNAs （miRNAs） between the active stage and the remission stage of ulcerative colitis （UC） was analyzed by bioinformatics method， and the regulatory relationship was constructed by screening the differentially expressed genes （DEGs）. The mechanism of Xizhuo Jiedu recipe in the treatment of UC was speculated and verified by animal experiments. MethodThe miRNAs data set of colonic mucosa tissue of UC patients was obtained from the gene expression database （GEO）， and the most differentially expressed miRNAs were screened by GEO2R， Excel， and other tools as research objects. TargetScan， miRTarbase， miRDB， STRING， TRRUST， and Matescape databases were used to screen key DEGs， predict downstream transcription factors （TFs）， gene ontology （GO）， and conduct Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis. The key signaling pathways were selected for animal experiments. In animal experiments， the UC mouse model was prepared by making the mouse freely drink 2.5% dextran sodium sulfate （DSS）. Xiezhu Jiedu recipe and mesalazine were given by gavage for seven days， and the inflammatory infiltration of colonic mucosa was observed by hematoxylin-eosin （HE） staining. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of miR-155-5p in colon tissue. Immunohistochemistry and Western blot were used to detect the protein expression levels of cytokine signal transduction inhibitor （SOCS1）， phosphorylated transcriptional signal transductor and activator 3 （p-STAT3）， phosphorylated Janus kinase 2 （p-JAK2）， and retinoic acid-associated orphan receptor-γt （ROR-γt）. The expression levels of transforming growth factor-β （TGF-β）， interleukin-17 （IL-17）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） in serum were detected by enzyme linked immunosorbent assay （ELISA）. ResultThe GSE48957 dataset was screened from the GEO database， and miR-155-5p was selected as the research object from the samples in the active and remission stages. 131 DEGs were screened. The GO/KEGG enrichment analysis was closely related to biological processes such as positive regulation of miRNA transcription and protein phosphorylation， as well as signaling pathways such as stem cell signaling pathway， IL-17 signaling pathway， and helper T cell 17 （Th17） cell differentiation. The Matescape database was used to screen out 10 key DEGs， among which SOCS1 was one of the key DEGs of miR-155-5p. Further screening of the TFS of key DEGs revealed that STAT3 was one of the main TFs of SOCS1. The results of animal experiments showed that Xiezhu Jiedu Recipe could effectively down-regulate the mRNA expression of miR-155-5p and protein expression of p-STAT3， p-JAK2， and ROR-γt in colon tissue of UC mice and the expression of IL-17 and IL-6 in serum of UC mice， up-regulate the protein expression of SOCS1 and the expression of TGF-β and IL-10， increase the level of anti-inflammatory factors， and reduce inflammatory cell infiltration. ConclusionIt is speculated that Xizhuo Jiedu recipe may interfere with SOCS1 by regulating the expression of miR-155-5p in UC mice， inhibit the phosphorylation of STAT3， inhibit the differentiation of CD4+ T cells into Th17 cells， reduce the levels of pro-inflammatory factors （IL-17 and IL-6）， and increase the levels of anti-inflammatory factors （TGF-β and IL-10）. As a result， the inflammation of colon mucosa in UC mice was alleviated.

Finite element analysis of effect of proximal fibular fracture on knee joint stress in an extended state / 中国组织工程研究

BACKGROUND:The traditional view is that proximal fibular fractures do not require fixation.Others and our research suggest that the proximal fibular structure plays an important role in the stability of the posterolateral structure of the knee joint,and its mechanism of action is worth studying. OBJECTIVE:To investigate the biomechanical effects of proximal fibular fractures on various structures of the knee joint in an extended state. METHODS:Finite element method was used to conduct simulated biomechanical experiments.A healthy young male volunteer was selected to establish a finite element model of the knee joint in an extended state using MRI and CT image data,and four proximal fibular shapes were simulated(Model A:intact,Model B:1 cm fracture below the fibular head,Model C:1 cm tip defect fracture from the proximal end of the fibula to the distal end,and Model D:2 cm bone defect from the proximal end of the fibula).A longitudinal concentrated load of 1 500 N was applied to the femoral shaft to compare and analyze the distribution and changing trend of the maximum equivalent stress and maximum first principal stress of each structure of the knee joint in an extended state under four working conditions. RESULTS AND CONCLUSION:(1)In Model A,the maximum equivalent stress in the tibial cartilage and lateral compartment of the meniscus was greater than that in the medial compartment,while the maximum first principal stress in the tibial plateau and medial compartment of the meniscus was greater than that in the lateral compartment.The maximum equivalent stress of the medial condyle of the femoral cartilage was greater than that of the lateral condyle,and the maximum first principal stress of the medial condyle of the femoral cartilage was greater than that of the medial condyle.(2)Compared to Model A,there was no significant difference in the magnitude and distribution of the maximum equivalent stress and maximum first principal stress in the cartilage and meniscus of Model C.(3)Compared to Model A,the maximum equivalent stress increase amplitude of Model B was in the order of medial tibial cartilage(14.9％),medial condyle of femoral cartilage(13.6％),and medial meniscus(6.6％).The maximum first principal stress increase amplitude was the medial meniscus(11.06％),the medial tibial cartilage(8.65％),and the medial condyle of the femoral cartilage(7.46％).The maximum equivalent stress increase amplitude of the ligament was as follows:popliteal arch ligament(33.2％)>anterior cruciate ligament(21.3％)>fibular collateral ligament(17％)>posterior cruciate ligament(14.3％)>anterior lateral collateral ligament(13.2％)>medial collateral ligament(10.1％).(4)Compared to Model A,the maximum equivalent stress increasing trend of Model D followed the medial tibial cartilage(19.5％),femoral cartilage medial condyle(17.9％),and medial meniscus(9.9％).The maximum first principal stress in sequence was the medial meniscus(14.04％),the medial tibial cartilage(13.03％),and the medial condyle of the femoral cartilage(11.37％).The increasing trend of maximum equivalent stress in ligaments was as follows:anterior cruciate ligament(25.2％)>posterior cruciate ligament(18.9％)>medial collateral ligament(18.5％)>anterior lateral collateral ligament(12.7％).(5)It is suggested that when the knee joint is extended,a 1 cm fracture below the fibular head and a 2 cm fibular tip bone defect have a significant impact on the structure of the medial ventricular cartilage,anterior cruciate ligament,and posterior lateral ligament complex.

Comparison on Rat Models of Acute Cerebral Infarction Due to Stasis Combined with Toxin Complicated with Cerebral-cardiac Syndrome / 中国实验方剂学杂志

ObjectiveTo observe and compare the electrocardiogram index， myocardial morphology， and connexin 43 （Cx43） expression of two rat models of acute cerebral infarction （ACI） due to stasis combined with toxin complicated with cerebral-cardiac syndrome （CCS）， and to provide experimental evidence for the research on the occurrence mechanism of cardiac diseases induced by ACI and the clinical diagnosis and treatment of CCS. MethodSixty SPF-grade male SD rats were randomized into six groups （n=10）： normal ， syndrome of stasis combined with toxin induced by carrageenin combined with dry yeast （CA/Y）， multi-infarct induced by micro-embolism （ME）， middle cerebral artery occlusion （MCAO）， CA/Y+ME， and CA/Y+MCAO groups. The model of syndrome of stasis combined with toxin was established by intraperitoneal injection with carrageenan （CA） at 10 mg·kg-1 on the first day and subcutaneous injection with dry yeast （Y） suspension （2 mg·kg-1） on the second day of modeling. Twenty-four hours after the modeling of ACI， the electrocardiograms （ECGs） of rats in each group were collected and the number/percentage （%） of abnormal ECG was calculated. The infarct area of the brain was evaluated by 2，3，5-triphenyltetrazolium chloride （TTC） staining， and myocardial injury was assessed by hematoxylin-eosin （HE） staining. Immumohistochemical staining and Western blot were employed to determine the expression of Cx43 in the myocardium. ResultA certain number of rats in each model group presented abnormal ECG. Compared with the normal group and CA/Y group， CA/Y+MCAO group had the highest rate of abnormal ECG （P<0.01）. Compared with the normal， CA/Y， ME， and CA/Y+ME groups， the CA/Y+ME and CA/Y+MCAO groups showed decreased amplitudes of P-wave and T-wave， shortened P-R interval， and extended Q-T interval， which were particularly obvious in the CA/Y+MCAO group （P<0.05， P<0.01） and in accordance with the cerebral infarction area and pathological changes. The expression of Cx43 was up-regulated in both CA/Y+ME and CA/Y+MCAO groups， especially in the CA/Y+MCAO group （P<0.01）. ConclusionThe two rat models of ACI due to stasis combined with toxin complicated with CCS can be used to study the mechanism of heart diseases caused by cerebrovascular diseases and the therapeutic effects of Chinese medicines with the functions of resolving stasis and detoxifying. Moreover， the CA/Y+MCAO method has higher abnormal electrocardiogram rate， severer myocardial pathological injury， and higher expression of Cx43 protein. The models can be chosen according to specific experimental purpose.

Effect of lidocaine regulating the Hippo-YAP signaling pathway on ischemia-reperfusion injury in orthotopic liver transplantation rats / 中国比较医学杂志

Objective To explore the effect of lidocaine(LID)on ischemia-reperfusion injury in orthotopic liver transplantation(OLT)rats and to analyze its mechanism of action.Methods Sixty rats were randomly divided into Verteporfin group,high-dose LID(High LID),medium-dose LID(Medium LID),low-dose LID(Low LID),Model and Control groups,on average.The rest of the rats except the control rats were used to establish OLT models.Observe the pathological changes in liver tissue were with hematoxylin-eosin staining.Serum aspartate transaminase(AST),total bilirubin(TBIL),lactate dehydrogenase(LDH)activities and alanine transaminase(ALT)were detected.Measure liver tissue levels of proinflammatory factors tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β,and IL-10 with enzyme-linked immunosorbent assays.Reactive oxygen species(ROS)was detected by a fluorescence probe.Malondialdehyde(MDA)was detected by the thiobarbituric acid colorimetric method.Superoxide dismutase(SOD)was detected by nitrogen blue tetrazole colorimetry.Glutathione peroxidase(GSH-Px)was detected by a spectrophotometry method.Apoptosis of liver histiocytes was detected by in situ end labeling.Detect the expression of mammalian STE20 like protein kinase(MST1),phosphorylation(p)-MST1,large tumor suppressor factor 1(LATS1),p-LATS1,Yes associated protein(YAP),p-YAP,and apoptosis-related proteins B-cell lymphoma 2(Bcl-2)and Bcl-2 related X protein(Bax)with Western blot.Results Compared with the Control group,liver tissue in Model group rats showed injury,liver cell necrosis,and a large degree of inflammatory cell infiltration.Moreover,the cell apoptosis rate;serum AST,ALT,TBIL,and LDH activities;and liver tissue levels of TNF-α,IL-6,IL-1β,MDA,ROS,and Bax were significantly increased.Furthermore,liver tissue levels of IL-10,SOD,GSH-Px,Bcl-2,p-MST1/MST1,p-LATS1/LATS1,and p-YAP/YAP proteins were significantly reduced(P＜0.05).Compared with the Model group,liver tissue injury was reduced in Low LID,Medium LID,and High LID groups.The cell apoptosis rate;serum AST,ALT,TBIL,and LDH activities;and liver tissue levels of TNF-α,IL-6,1L-1β,MDA,ROS,and Bax were significantly reduced.Moreover,liver tissue levels of IL-10,SOD,GSH-Px,Bcl-2,p-MST1/MST1,p-LATS1/LATS1,and p-YAP/YAP proteins were significantly increased(P＜0.05).Hippo-YAP signaling pathway inhibitor verteporfin reversed the improving effect of LID on ischemia-reperfusion injury in OLT rats(P＜0.05).Conclusions LID may activate the Hippo-YAP pathway,which reduces the inflammatory response,oxidative stress,and liver cell apoptosis,and improves liver ischemia-reperfusion injury in OLT rats.

Mechanism of brain-spleen inflammation coupling in a rat model of acute ischemic stroke stasis toxin syndrome / 中国比较医学杂志

Objective To investigate the correlation between brain injury and spleen damage in a rat model of acute ischemic stroke and stasis interaction,and its effect on the MCP-1/CCR2 axis,and to provide an experimental basis for the mechanism of brain-spleen inflammatory coupling in spleen lesions caused by acute ischemic stroke.Methods Forty male SD rats were randomly divided into a sham group,carrageenan/yeast stasis syndrome group(carrageenan/yeast,CA/Y),middle cerebral artery occlusion group(MCAO),and middle cerebral artery stasis syndrome group(MCAO CA/Y)with 10 rats in each group.CA/Y and MCAO CA/Y groups were injected with 10 mg/kg carrageenan and 10 mg/kg intraperitoneally on the first day of modeling.2 mg/kg of dry yeast suspension were injected subcutaneously on the second day.MCAO and MCAO CA/Y groups were established by wire embolism on the second day.At 24 h after cerebral infarction modeling,the neurological deficit score was calculated in each group,the percentage of the cerebral infarction area was determined by TTC staining,the spleen weight was measured,and the correlation between the percentage of the cerebral infarction area and spleen weight was analyzed by the Spearman correlation coefficient.Furthermore,the pathological morphology of brain and spleen tissues was observed by hematoxylin-eosin(HE)staining,and chemotactic protein 1(MCP-1)and interferon-γ(IFN-γ)contents were measured in rat plasma by enzyme-linked immunosorbent assays.Western blot was used to detect chemokine C-C-motif receptor 2(CCR2)protein expression in the ischemic side of brain tissue.Results Compared with the sham group,the neurological deficit score,cerebral infarction area,and MCP-1 and IFN-γ contents in plasma were significantly increased(P＜0.01),spleen weight was decreased significantly(P＜0.01),and CCR2 protein expression in brain tissue was significantly upregulated(P＜0.05)in MCAO and MCAO CA/Y groups.Moreover,the area of cerebral infarction was increased significantly(P＜0.01),the spleen weight was decreased significantly(P＜0.01),and CCR2 protein expression in brain and spleen tissues was significantly upregulated(P＜0.05)Compared with the MCAO group,the area of cerebral infarction in the MCAO CA/Y group was significantly increased(P＜0.01)and the spleen weight was decreased significantly(P＜0.05).Spearman correlation analysis showed that the spleen weight was negatively correlated to the percentage of the cerebral infarction area(P＜0.01,r=-0.9711).Pathological morphology observation revealed that the pathological changes in the MCAO CA/Y group were the most serious,cerebral liquefaction necrosis foci were seen in the brain tissue cortex,arrangement of neuronal cells in the lesions was sparse and disordered with volume atrophy and a small number of vacuoles and nuclear solidification,most neuronal cells were degenerated and necrotic,microglia hyperplasia was obvious,small blood vessels were significantly increased,and interstitial lipid degeneration was severe.The density of periarterial lymph sheath cells in some of the spleen tissue was reduced and the marginal area is widened.Conclusions A correlation between brain and spleen injury was found after acute ischemic stroke with stasis and toxin syndrome,and the chemokine signaling axis of MCP-1/CCR2 might be involved in the mechanism of brain-spleen inflammation coupling.

Research progress on biological mechanism of interferon-inducible protein 16 / 中国药理学通报

Interferon γ-inducible protein 16(IFI16)is one member of human pyrin and HIN domain-containing protein(PYHIN)family(also known as interferon-inducible p200 pro-tein family),which is widely present in human organs and tis-sues,and is involved in cell cycle regulation,senescence and ap-optosis,even in immune reaction.The content and localization of IFI16 may change under different physiological and pathological conditions,and recent studies have revealed that it may play an important role in the development of antiviral,tumor,inflammato-ry diseases and other diseases.In this paper,we review its mechanism and the current status of its research in diseases,with the aim of providing a reference for the in-depth study of IFI16.

Study on Zhang Yunling's Medication Law in Treating Headache Based on Data Mining / 中国中医药信息杂志

Objective To study the medication law of Professor Zhang Yunling in the treatment of headache based on data mining technology;To provide ideas for the clinical treatment of headache.Methods Professor Zhang Yunling's outpatient TCM prescription data for the treatment of headache from Sep.2017 to Dec.2020 were collected,and the Ancient and Modern Medical Record Cloud Platform 2.3.5 was used to mine the selected TCM prescriptions for herbal medicine frequency statistics,property,taste and meridian tropism statistics,herbal medicine efficacy statistics,correlation analysis,clustering analysis,complex network analysis,etc.Results Through collection and screening,totally 332 prescriptions were included,involving 178 kinds of Chinese materia medica,with a total frequency of 5 380 times.The top 10 kinds of Chinese materia medica were Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Testudinis Carapax et Plastrum,Bambusae Caulis in Taenia,Glycyrrhizae Radix et Rhizoma,Astragali Radix,Amomi Fructus Rotundus,Pinelliae Rhizoma Praeparatum,and Polygalae Radix.They were mainly warm,mild and slightly cold in properties,sweet,pungent and bitter in tastes,and liver,lung,spleen meridian in meridian tropism.In the statistics of herbal medicine efficacy,expelling wind and relieving pain,suppressing liver yang,promoting blood circulation and qi,clearing heart and relieving restlessness,clearing heat and detoxifying,softening liver and relieving pain were used more frequently.The combinations in herbal medicines association included"Atractyodis Macrocephalae Rhizoma-Chuanxiaong Rhizoma","Testudinis Carapax et Plastrum-Paeoniae Radix alba","Glycyrrhizae Radix et Rhizoma-Paeoniae Radix alba","Testudinis Carapax et Plastrum-Chuanxiaong Rhizoma","Bambusae Caulis in Taenia-Chuanxiaong Rhizoma".Herbal medicines clustering clustered 32 kinds of high-frequency herbal medicines used more than 60 times into 6 categories.Complex network analysis screened out the core formula for the treatment of headache:Chuanxiaong Rhizoma,Paeoniae Radix alba,Atractyodis Macrocephalae Rhizoma,Bambusae Caulis in Taenia,Pinelliae Rhizoma Praeparatum,Testudinis Carapax et Plastrum,Astragali Radix,Amomi Fructus Rotundus,and Glycyrrhizae Radix et Rhizoma.Conclusion In the treatment of headache,Professor Zhang Yunling holds that the pathogenesis of headache is deficiency in origin and excess in superficiality,deficiency of qi and blood,loss of nourishment of brain collaterals,stagnation of phlegm and dampness,disturbance of wind pathogen,obstruction of brain collaterals,and the location of the disease is related to the five viscera and involves the stomach.Focuses on tonifying deficiency and reducing excess,treats exterior and interior separately,and gives consideration to both the symptoms and the root causes,which often uses drugs to treat headache,such as dispelling wind and relieving pain,promoting blood circulation and relieving pain,relieving spasm and relieving pains,eliminating phlegm and dampness,invigorating qi and spleen,nourishing blood and yin,eliminating dampness and regulating stomach,relieving depression and restlessness,which can provide some reference for the clinical treatment of headache.

Prediction of potential mechanism of curcumin combined with berberine in improving drug-induced liver injury based on network pharmacology / 中国现代医生

@#Objective The potential mechanism of curcumin(CUR)combined with berberine(BBR)in improving drug-induced liver injury(DILI)was preliminarily predicted by a method of in vivo experiment in combination with network pharmacology.Methods The animal model was established by acetaminophen(APAP)-induced DILI and the levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were detected in serum of mice.The network pharmacological approach was used to collect related targets of CUR,BBR,and DILI;Wayne mapping was carried out to screen intersection targets,followed by establishment of a protein-protein interaction(PPI)network of CUR-BBR-DILI.Functional enrichment analysis of gene ontology(GO)and pathway enrichment analysis of Kyoto Encyclopedia of Genes and Genomes(KEGG)were conducted finally.Results The in vivo experimental results showed that the combination of CUR and BBR can significantly reduce the serum ALT and AST levels in mice,which is better than administration alone;Network pharmacology experiment results exhibited that 291 related targets of CUR and 208 related targets of BBR were collected by PharmMapper database,and 904 related targets of DILI were collected by Genecards database;77 intersection targets were screened by Venny 2.1.0 database;52 gene functions and 20 signal pathways possibly in connection with the improvement of DILI via drug combination were obtained by GO and KEGG analysis,respectively;nine of the top ten core targets according to degree in PPI network were enriched to PI3K/AKT signaling pathway,which were in order as follows:SRC,EGFR,HSP90AA1,IGF1,HRAS,MAPK14,ESR1,CASP3,and PTK2.Conclusion DILI might be synergistically improved by CUR combined BBR through multi-target and multi-pathway manner,providing a theoretical basis for the elucidation of the mechanism of drug combination against DILI.

Pathogenesis and Traditional Chinese Medicine Prevention and Treatment Strategy of Diabetic Vascular Calcification Based on Theory of Stasis-toxin-deficiency / 中国实验方剂学杂志

Vascular complications are the primary cause of the high disability and mortality in diabetic patients. Vascular calcification is a pathological basis of diabetic vascular complications and increases the risk of adverse cardiovascular events and the difficulty of revascularization in diabetic patients. It is of great clinical value to explore the measures for prevention and treatment of diabetic vascular calcification with integrated traditional Chinese and Western medicine. This paper explores the intrinsic association of stasis， toxin， and deficiency with diabetic vascular calcification to reveal the pathogenesis of diabetic vascular calcification. Stasis and toxin are causally affected by and combined with each other； deficiency refers to the deficiency of healthy Qi and the loss of Qi and blood. The three elements are associated with the occurrence and development of blood vessel diseases. This paper proposes the evolutional law of stasis， toxin， and deficiency in traditional Chinese medicine （TCM） for diabetic vascular calcification. Specifically， diabetic vascular calcification is rooted in the stasis of meridians and collaterals， develops due to the combination of stasis and toxin， and is aggravated by middle Qi deficiency. Furthermore， this paper proposes the TCM intervention principle of activating blood， removing toxin， tonifying deficiency， and dredging collaterals for the prevention and treatment of diabetic vascular calcification. The aim is to provide a theoretical basis for clinical and translational research on the prevention and treatment of diabetic vascular calcification with integrated Chinese and Western medicine.

Association between air quality index and brachial-ankle pulse wave velocity in Beijing / 环境与职业医学

Background Few studies have investigated the association between air pollution and arterial stiffness in Chinese population, and the findings are inconsistent. The problem of multicollinearity exists when modeling multiple air pollutants simultaneously. Objective To investigate potential association between air quality index (AQI) and population brachial-ankle pulse wave velocity (baPWV) in Beijing. Methods This study retrieved medical examination data of 2971 participants from the Beijing Health Management Cohort, who were under 60 years old and not yet retired, from January 1, 2015 to December 31, 2019. The most recent medical examination data available were utilized for this analysis. AQI data from 35 air pollution monitoring sites in Beijing and meteorological data (including atmospheric pressure, air temperature, wind speed, and relative humidity) from 16 meteorological monitoring stations from January 1, 2014 to December 31, 2019 were collected. An average AQI exposure level for 365 d before the date of physical examination for each participant was computed using inverse distance weighting. Multiple linear regression analysis was employed to investigate the relationship between AQI and baPWV in Beijing, after adjusting for confounding variables including age, gender, body mass index, mean arterial pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting blood glucose, atmospheric pressure, temperature, wind speed, relative humidity, medication history of diabetes, medication history of hypertension, cardiovascular disease, education, smoking status, drinking status, and physical activity intensity. Subgroup analysis was performed by age, sex, presence of diabetes, and presence of hypertension. Results AQI demonstrated an overall decreasing trend during the study period and was lower in the northern regions and higher in the southern regions of Beijing. After adjusting the confounding variables, each 10 unit increase in AQI was associated with 6.18 (95%CI: 1.25, 11.10) cm·s−1 increase in baPWV in all participants, 8.05 (95%CI: 2.32, 13.79) cm·s−1 increase in the participants <50 years, 15.82 (95%CI: 8.33, 23.31) cm·s−1 increase in the female group, 10.10 (95%CI: 4.66, 15.55) cm·s−1 increase in the participants without diabetes, and 9.41 (95%CI: 4.21, 14.62) cm·s−1 increase in the participants without hypertension. However, there was no statistically significant association observed between AQI and baPWV in the age group ≥50 years, the male group, the diabetic group, and the hypertensive group (P>0.05). Conclusion An increase in long-term AQI levels is associated with an elevation in the degree of arterial stiffness. Individuals under 50 years old, females, without hypertension or diabetes are susceptible populations to arterial stiffness when being exposed to air pollution. Improving air quality may contribute to prevent arterial stiffness.

Dietary Patterns for Prevention and Treatment of Cardiometabolic Disease： Interpretation and Thinking Based on Traditional Chinese Medicine Theory / 中国实验方剂学杂志

Cardiometabolic disease （CMD） is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic （Huang Di Nei Jing） to the widespread application of modern dietary patterns such as dietary restriction， plant-based diets， and Jiangnan cuisine， dietary regulation plays a significant role in preventing diseases， early treatment of existing diseases， and recovery. This article systematically reviewed the traditional Chinese medicine （TCM） theory related to dietary patterns， elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD， and explored the strategy of integrating TCM theory with dietary patterns， aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.

O-arm real-time guidance in cervical pedicle screw fixation / 中国骨伤

OBJECTIVE@#To explore the technical aspects of the accuracy of cervical pedicle screw placement with O-arm guidance.@*METHODS@#The clinical data of 21 patients who underwent cervical pedicle screw fixation by O-arm real-time guidance from December 2015 to January 2020 were analyzed retrospectively. There were 15 males and 6 females, aged from 29 to 76 years old with an average of (45.3±11.5) years. The postoperative CT scan was utilized to evaluate the placement of the pedicle screw and classified according to the Gertzbein and Robbins classification.@*RESULTS@#A total of 132 pedicle screws were implanted in 21 patients, 116 at C3-C6 and 16 at C1 and C2. According to Gertzbein & Robbins classification, the overall breach rates were found to be 11.36% (15/132) with 73.33% (11 screws) Grade B, 26.67% (4 screws) Grade C, and no Grade D or E screw breaches. There were no pedicle screw placement related complications at final follow-up.@*CONCLUSION@#The application of O-arm real-time guidance technology can make cervical pedicle screw placement reliable. High accuracy and better intra-operative control can increase surgeon's confidence in using cervical pedicle instrumentation. Considering the high-risk nature of anatomical area around cervical pedicle and the possibility of catastrophic complications, the spine surgeon should have sufficient surgical skills, experience, ensures stringent verification of the system, and never relies solely on the navigation system.

Clinical Application of Supplementing Essence and Boosting Marrow Method in the Treatment of Encephalopathy Based on the Marrow Sea Theory / 中医杂志

As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine （TCM）， The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years， analyzed the treatment method and effects from eight aspects in terms of stroke， dizziness， insomnia， headache， constraint syndrome， dementia， tremor syndrome， and atrophy syndrome， and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow， the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes， which can effectively improve the symptoms of the disease， delay the progression， increase the daily life ability of the patients， and improve the quality of life. Based on the marrow sea theory， the method of supplementing essence and boosting marrow， rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.

Coronary Heart Disease and Obstructive Sleep Apnea Syndrome： Interpretation and Reflection Based on Simultaneous Treatment of Heart and Lung in Traditional Chinese Medicine / 中国实验方剂学杂志

As the overweight and obese population is growing， the incidence of obstructive sleep apnea is rising， and most of the cases are complicated with coronary heart disease and other cardiovascular diseases. The two diseases affect each other and seriously endanger the patients' health， becoming a major public health problem of global concern. It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome. Researchers have explored the relationship between the two based on traditional Chinese medicine（TCM） theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring， respectively， and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs. The failure of the heart to govern blood leads to the generation of blood stasis， and that of the lung to govern Qi movement leads to the generation of phlegm. The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway. This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation. Furthermore， this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm， aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.

Study on the Medication Rule of the National Patent of Traditional Chinese Medicine Compound Formula in the Treatment of Depression / 中医杂志

ObjectiveTo explore the medication rules of traditional Chinese medicine compounds for depression in the National Patent Database using data mining， and to provide ideas for the clinical treatment and the development of new drugs for depression. MethodsThe patent data of traditional Chinese medicine compounds for the treatment of depression were searched from inception to July 1st， 2022 on the Patent Publication Announcement website of China National Intellectual Property Administration. The selected traditional Chinese medicine compounds were analyzed by using the data mining section of the ancient and modern medical record cloud platform （V2.3.5） for drug frequency， and based on this， the nature， flavor， channel entry and function of the medicinals were analyzed. Representative high-frequency herbal combinations were obtained through correlation analysis， while the classification of Chinese medicine compounds for depression was analyzed by cluster analysis， and the core combinations of herbs for the treatment of depression were screened out using complex network analysis. ResultsA total of 325 Chinese medicine compounds were included， involving 452 herbs， with a total frequency of 3532 times. The top 10 mostly used herbs were Yujin （Radix Curcumae， 122 times）， Chaihu （Radix Bupleuri， 122 times）， Baishao （Radix Paeoniae Alba， 109 times）， Suanzaoren （Spina Date Seed， 95 times）， Fuling （Poria， 94 times）， Danggui （Radix Angelicae Sinensis， 94 times）， Yuanzhi （Radix Polygalae， 84 times）， Baizhu （Rhizoma Atractylodis Macrocephalae， 72 times）， Shichangpu （Rhizoma Acori Graminei， 71 times）， and Danshen （Salvia Miltiorrhiza， 61 times）. The natures of the herbs were mainly warm （998 times）， neutral （944 times）， slightly cold （596 times） and cold （497 times）； the flavors were mainly sweet （1648 times）， acrid （1392 times）， and bitter （1337 times）； the channels of entry were mainly liver （1695 times）， heart （1521 times）， spleen （1326 times） and lung （1268 times）. The medicinals with the function of soothing liver to relieve constraint， moistening the intestines to promote defecation， calming the heart and the mind， moving qi to relieve constraint were used more frequently. The high frequency herbal combinations by association analysis included “Chaihu （Radix Bupleuri）→ Baishao （Radix Paeoniae Alba）”， “Danggui （Radix Angelicae Sinensis）→Chaihu （Radix Bupleuri）” and “Baishao （Radix Paeoniae Alba）→ Yujin （Radix Curcumae）”. The 22 high frequency medicinals used more than 40 times could be clustered into six categories. Complex network analysis found the core herbal combination for the treatment of depression was the formula of Chaihu （Radix Bupleuri）， Yujin （Radix Curcumae）， Baishao （Radix Paeoniae Alba）， Danggui （Radix Angelicae Sinensis）， Fuling （Poria）， Suanzaoren （Spina Date Seed）， and Xiangfu （Cyperi Rhizoma）. ConclusionTraditional Chinese medicine compounds for the treatment of depression is mainly based on the pathogenesis of constraint， stasis and deficiency， focusing on the liver， heart， spleen and lung， commonly using medicinals with the function of soothing liver to relieve constraint， fortifying spleen and nourishing heart， regulating qi and invigorating blood， and moistening the intestines to promote defecation， which can provide a reference for the clinical treatment and new drug research and development for depression.

Construction of Doctor-Nurse-Patient shared decision-making framwork for breast cancer patients undergoing surgery / 中国实用护理杂志

Objective:To construct Doctor-Nurse-Patient shared decision-making framwork for breast cancer surgery patients, so as to provide a foundation for clinical practice.Methods:The content of the shared decision-making framwork were initially constructed through systematic literature search and group discussion. From March to May 2021, 24 experts were consulted by the Delphi method, and the weight of each element would be determined by the analytic hierarchy process.Results:A total of 2 rounds of expert letter questionnaires were implemented. The authority coefficient of the experts in this study was 0.832, the Kendall coefficient of the experts in the first round was 0.130-0.261 ( P<0.01), and the Kendall coefficient of the experts in the second round was 0.130-0.272 ( P<0.01). The final shared decision-making framwork includes 5 first-level indicators, 15 second-level indicators and 52 third-level indicators. Conclusions:The Doctor-Nurse-Patient shared decision-making framwork of breast cancer surgery patients constructed in this study is scientific and practical, and provides a reference for clinical practice of shared decision-making in the future.

Construction of glioma prognosis model with n7-methylguanosine related long non-coding RNA based on transcriptome / 中国医师进修杂志

Objective:To investigate the relationship between n7-methylguanosine (m7G) related long non-coding RNA (lncRNA) expression and glioma prognosis, and to construct a prognosis model with m7G-related lncRNA in patients with glioma.Methods:Data related to the test set and validation set were downloaded from the Cancer and Tumor Genome Atlas (TCGA) database and the China Glioma Genome Atlas (CGGA) database. LASSO regression and random forest algorithm were used to establish the glioma prognosis model with m7G related lncRNA. Individualized risk scores were calculated using the weighted expression levels of the 12 extracted lncRNA coefficients, and test set and validation set glioma patients were categorized into high and low risk groups based on median risk score. Kaplan-Meier survival curve was drawn, the comparison method used log rank test. The efficacy of risk score in predicting the 1-, 2- and 5-year survival rate in patients with glioma was evaluated using the receiver operating characteristics (ROC) curve.Results:A total of 12 lncRNA associated with m7G were obtained, with a risk score = 1.026 × AC002454.1 + 1.086 × AC131097.4 + 1.039 × AC147651.3 + 1.01 × AGAP2-AS1 + 1.036 × CRNDE + 0.733 × GDNF-AS1 + 1.321 × HOXD-AS2 + 0.934 × LINC00641 + 1.183 × PAXIP1-AS2 + 1.258 × PVT1 + 0.909 × SOX21-AS1 + 0.754 × TTC28-AS1, with a median risk score of - 0.45 scores. Kaplan-Meier survival curve analysis result showed that the median survival time in high risk group was significantly shorter than that in low risk group (1.98 years vs. 9.51 years, log-rank χ2 = 131.78, P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of risk score in predicting the 1-, 2- and 5-year survival rate in patients with glioma was 0.891, 0.923 and 0.912. In the validation set of glioma patients, Kaplan-Meier survival curve analysis result showed that the median survival time in high risk group was significantly shorter than that in low risk group (1.29 years vs. 6.88 years, log-rank χ2 = 103.27, P<0.01); ROC curve analysis result showed that the AUC of risk score in predicting the 1-, 2- and 5-year survival rate in patients with glioma was 0.724, 0.795 and 0.762. In the test set and validation set, multivariate Cox regression analysis result showed that the risk score was the independent risk factors of prognosis in patients with glioma ( HR = 1.992 and 1.247, P<0.01 or <0.05). Conclusions:A risk score model with m7G related lncRNA based on transcriptome is a novel approach to predict the prognosis of glioma patients.

Application research on multi-mode teaching guided by objective management in the standardized training of nursing students in the department of oncology / 中华医学教育探索杂志

Objective:To explore the application effect of multi-mode teaching guided by objective management in the standardized training of nursing students.Methods:A total of 39 standardized training nursing students from April 2019 to April 2020 in the department of oncology of a tertiary hospital were selected as the control group by cluster sampling method and they received traditional teaching; 40 standardized nursing students in the department of oncology from June 2020 to June 2021 were selected as the experimental group and the group adopted multi-mode teaching guided by objective management. The differences of theoretical and operational assessment scores, teaching satisfaction, critical thinking ability and nurse-patient communication ability between the two groups were studied. SPSS 20.0 was used for t-test and Chi-square test. Results:The scores of theoretical assessment [(86.17±3.74) vs. (83.92±4.93)] and operational assessment [(92.83±2.19) vs. (90.74±3.52)] in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The teaching satisfaction of the experimental group was higher than that of the control group [(46.10±2.96) vs. (42.67±2.45)], and the difference was statistically significant ( P<0.05). There were statistically significant differences in critical thinking, intellectual curiosity and analytical skills ( P<0.05). In terms of nurse-patient communication ability, except that there was no difference in collecting information, the rest were statistically significant( P<0.05). Conclusion:Multi-mode teaching guided by objective management can improve the theoretical and operational ability of nurses, nurse-patient communication ability, and teaching satisfaction.

Analysis of regional homogeneity and functional connectivity among the depression and bipolar disorder with mixed features patients / 中华放射学杂志

Objective:To investigate the regional homogeneity (ReHo) among the major depressive disorder patients without mixed features (MDD noMF), major depressive disorder with mixed features (MMF), bipolar disorder with mixed features (BMF) and bipolar disorder patients without mixed features (BD noMF) patients, and to explore the brain activity and functional connectivity patterns of the MMF and BMF patients. Methods:This was a cross-sectional study. The MDD noMF patients (MDD noMF group), MMF patients (MMF group), BMF patients (BMF group), BD noMF patients (BD noMF group), and age-and gender-matched healthy controls (HC group) were recruited from Beijing Anding Hospital, Capital Medical University between April, 2021 and June, 2022. All the participants underwent resting-state functional MRI scanning. The ReHo values was computed with the DPABI software based on the MATLAB. Firstly, the difference in ReHo among the patients with MDD noMF, MMF, BMF, BD noMF and HC group were estimated by the analysis of covariance and the post-hoc method (LSD or Games-Howell). And then, the brain regions with significant different ReHo values were selected as the seeds to calculate the functional connectivity with the whole brain. Results:A total of 29 cases in the MDD noMF group, 24 cases in the MMF group, 26 cases in the BMF group, 29 cases in the BD noMF group, and 42 in the HC group were included. The differences in ReHo values in the left fusiform and the left precuneus of the 5 groups were statistically significant ( P<0.05). Among of them, the ReHo values of the left fusiform were lower in the MMF, BMF and BD noMF groups compared with the HC group ( P<0.05), while the ReHo values of the left precuneus in MDD noMF, MMF, BMF and BD noMF groups were higher than that in the HC group ( P<0.05). The ReHo value of the left fusiform was lower in the MMF group compared with the MDD noMF group ( P=0.001); the ReHo value of the left fusiform was lower in the BMF group compared with the MDD noMF and BD noMF groups ( P<0.05). The functional connectivity between the left fusiform and vermis, left insula, right putamen, and left medial superior frontal gyrus, and functional connectivity between the left precuneus and right superior frontal gyrus (dorsolateral) showed significant difference among the MDD noMF, MMF, BMF, BD noMF and HC groups ( P<0.05). Compared with HC group, MDD noMF, MMF, BD noMF groups showed higher functional connectivity between the left fusiform and the vermis, and MDD noMF, MMF, BMF, BD noMF group showed higher functional connectivityy between the the left fusiform and the left insula, left medial superior frontal gyrus and right putamen ( P<0.05). Compared with the MDD noMF group, the MMF, BMF and BD noMF groups showed higher functional connectivity between the left fusiform and the left insula ( P<0.05). Compared with the MDD noMF group, the BMF and BD noMF groups had higher functional connectivity between the left fusiform and the left medial superior frontal gyrus ( P<0.05). The BMF group showed higher functional connectivity of the left fusiform with the right putamen than the MDD noMF and BD noMF groups. Additonally, the BMF and BD noMF groups showed higher functional connectivity between the left precuneus and the right superior frontal gyrus (dorsolateral) than HC, MDD noMF and MMF groups ( P<0.05). Conclusions:MMF and BMF patients have local abnormalities of functional activity synchronization in the left fusiform and precuneus and abnormal functional connectivity patterns with multiple brain regions. MMF and BMF patients have specific neuroimaging features compared to MDD noMF or BD noMF patients and also share similar neuroimaging pathogenesis.