Evaluation of gastric emptying after drinking carbohydrates before cesarean section by gastric ultrasonography / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of gastric antrum ultrasonography in evaluating gastric emptying after oral administration of 300 mL carbohydrates two hours before cesarean section, and to analyze the risk factors of gastric emptying in pregnant women.@*METHODS@#From August 2020 to February 2021, a total of 80 patients, aged 22-43 years, body mass index (BMI) < 35 kg/m2, gestational age≥36 weeks, falling into American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for cesarean sections in Peking University International Hospital were recruited and divided into two groups: the intervention group (n=40)and the control group (n=40). In the intervention group, solid food was restricted after 22:00, the patients were required to take 300 mL carbohydrates two hours before cesarean section. In the control group, solid food and liquid intake were restricted after 22:00 the night before surgery. All the patients received assessment of preoperative feeling of thirst and starvation with visual analogue scale (VAS). The cross-sectional area (CSA)of gastric antrum was measured in supine position and right supine position before anesthesia, the gastric volume (GV)and the gastric volume/weight(GV/W)of the two groups was further calculated. Perlas A semi-quantitative grading assessments were performed in each patient. The blood pressure and heart rate were recorded at admission(T0), 5 minutes after anesthesia (T1), immediately after fetal delivery (T2) and at the end of the surgery (T3). The occurrence of nausea and vomiting during the operation and 24 hours after the operation were recorded.@*RESULTS@#One case in each group was excluded because the antrum was not clearly identified during the ultrasound assessments. In the semi-sitting position, the CSA was (5.07±1.73) cm2 in the intervention group vs. (5.24±1.96) cm2 in the control group, respectively; in the right lateral decubitus position, CSA was (7.32±2.17) cm2 in the intervention group vs. (7.25±2.24) cm2 in the control group, GV was (91.74±32.34) mL vs. (90.07±31.68) mL, GV/W was (1.27±0.40) mL/kg vs. (1.22±0.41) mL/kg, respectively; all the above showed no significant difference between the two groups (P > 0.05). Perlas A semi-quantitative grading showed 0 in 20 patients (51.3%), 1 in 16 (41%), 2 in 3 (7.7%)in the intervention group and 0 in 22 (56.4%), 1 in 15 (38.5%), 2 in 2 (5.1%)in the control group, the proportion of Perlas A semi-quantitative grading showed no significant difference between the two groups (P > 0.05). For the patients with Perlas A semi-quantitative grade 2 (3 cases in the intervention group and 2 cases in the control group), metoclopramide 0.2 mg/kg was intravenously injected before anesthesia. No aspiration case was observed in this study. The intervention group was endured less thirst and hunger (P < 0.05). There was no significant difference in blood pressure and heart rate between the two groups at each time point (P > 0.05). There was no significant difference in the incidence of intraoperative hypotension between the two groups (P > 0.05). There was no significant difference in the incidence of nausea intraoperatively and postoperatively between the two groups (P > 0.05).@*CONCLUSION@#Ultrasonography of gastric antrum can provide objective basis for evaluating gastric emptying of pregnant women perioperatively. 300 mL carbohydrates intake two hours before surgery, which does not increase GV and the risk of reflux aspiration, and is helpful in minimizing disturbance to the patient's physiological status, therefore leading to better clinical outcome.

Effect of preoperative carbohydrates intake on the gastric volume and the risk of reflux aspiration in patients positioning in trendelenburg undergoing gynecological laparoscopic procedures / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effect of 300 mL carbohydrates intake two hours before sur-gery on the gastric volume (GV) in patients positioning in trendelenburg undergoing gynecological laparoscopic procedures by using gastric antrum sonography, and further assess the risk of reflux aspiration.@*METHODS@#From June 2020 to February 2021, a total of 80 patients, aged 18-65 years, body mass index (BMI) 18-35 kg/m2, falling into American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for gynecological laparoscopic procedures positioning in trendelenburg were recruited and divided into two groups: the observation group (n =40) and the control group (n=40). In the observation group, solid food was restricted after 24:00, the patients were required to take 300 mL carbohydrates two hours before surgery. In the control group, solid food and liquid intake were restricted after 24:00 the night before surgery. The cross-sectional area (CSA) of gastric antrum was measured in supine position and right lateral decubitus position before anesthesia. Primary outcome was gastric volume (GV) in each group. Secondary outcome included Perlas A semi-quantitative grading and gastric volume/weight (GV/W). All the patients received assessment of preoperative feeling of thirsty and hunger with visual analogue scale (VAS).@*RESULTS@#Complete data were available in eighty patients. GV was (58.8±23.6) mL in the intervention group vs. (56.3±22.1) mL in the control group, GV/W was (0.97±0.39) mL/kg vs. (0.95±0.35) mL/kg, respectively; all the above showed no significant difference between the two groups (P > 0.05). Perlas A semi-quantitative grading showed 0 in 24 patients (60%), 1 in 15 patients (37.5%), 2 in 1 patient (2.5%) in the intervention group and 0 in 25 (62.5%), 1 in 13 (32.5%), 2 in 2 (5%) in the control group, the proportion of Perlas A semi-quantitative grading showed no significant difference between the two groups (P > 0.05). A total of 3 patients (1 in the intervention group and 2 in the control group) with Perlas A semi-quantitative grading 2 were treated with special intervention, no aspiration case was observed in this study. The observation group endured less thirst and hunger (P＜0.05).@*CONCLUSION@#Three hundred mL carbohydrates intake two hours before surgery along with ultrasound guided gastric content monitoring does not increase gastric volume and the risk of reflux aspiration in patients positioning in trendelenburg undergoing gynecological laparoscopic surgery, and is helpful in minimizing disturbance to the patient's physiological needs, therefore leading to better clinical outcome.

Population structure of food-borne Staphylococcus aureus in China / 中华流行病学杂志

Objective: To understand the population structure of food-borne Staphylococcus (S.) aureus in China. Methods: Whole genome sequencing was used to analyze 763 food-borne S. aureus strains from 16 provinces in China from 2006 to 2020. Multilocus sequence typing (MLST), staphylococcal protein A gene (spa) typing, and staphylococcal chromosome cassettemec (SCCmec) typing were conducted, and minimum spanning tree based on ST types (STs) was constructed by BioNumerics 7.5 software. Thirty-one S. aureus strains isolated from imported food products were also included in constructing the genome phylogenetic tree. Results: A total of 90 STs (20 novel types) and 160 spa types were detected in the 763 S. aureus isolates. The 72 STs (72/90, 80.0%) were related to 22 clone complexes. The predominant clone complexes were CC7, CC1, CC5, CC398, CC188, CC59, CC6, CC88, CC15, and CC25, accounting for 82.44% (629/763) of the total. The STs and spa types in the predominant clone complexes changed over the years. The methicillin-resistant S. aureus (MRSA) detection rate was 7.60%, and 7 SCCmec types were identified. The ST59-t437-Ⅳa (17.24%, 10/58), ST239-t030-Ⅲ (12.07%, 7/58), ST59-t437-Ⅴb (8.62%, 5/58), ST338-t437-Ⅴb (6.90%, 4/58) and ST338-t441-Ⅴb (6.90%, 4/58) were the main types in MRSA strains. The genome phylogenetic tree had two clades, and the strains with the same CC, ST, and spa types clustered together. All CC7 methicillin sensitive S. aureus strains were included in Clade1, while 21 clone complexes and all MRSA strains were in Clade2. The MRSA strains clustered according to the SCCmec and STs. The strains from imported food products in CC398, CC7, CC30, CC12, and CC188 had far distances from Chinese strains in the tree. Conclusions: In this study, the predominant clone complexes of food-borne strains were CC7, CC1, CC5, CC398, CC188, CC59, CC6, CC88, CC15, and CC25, which overlapped with the previously reported clone complexes of hospital and community-associated strains in China, suggesting that close attention needs to be paid to food, a vehicle of pathogen transmission in community and food poisoning.

Prediction of superantigen active sites and clonal expression of staphylococcal enterotoxin-like W / 中华流行病学杂志

Objective: The docking and superantigen activity sites of staphylococcal enterotoxin-like W (SElW) and T cell receptor (TCR) were predicted, and its SElW was cloned, expressed and purified. Methods: AlphaFold was used to predict the 3D structure of SElW protein monomers, and the protein models were evaluated with the help of the SAVES online server from ERRAT, Ramachandran plot, and Verify_3D. The ZDOCK server simulates the docking conformation of SElW and TCR, and the amino acid sequences of SElW and other serotype enterotoxins were aligned. The primers were designed to amplify selw, and the fragment was recombined into the pMD18-T vector and sequenced. Then recombinant plasmid pMD18-T was digested with BamHⅠand Hind Ⅲ. The target fragment was recombined into the expression plasmid pET-28a(+). After identification of the recombinant plasmid, the protein expression was induced by isopropyl-beta-D- thiogalactopyranoside. The SElW expressed in the supernatant was purified by affinity chromatography and quantified by the BCA method. Results: The predicted three-dimensional structure showed that the SElW protein was composed of two domains, the amino-terminal and the carboxy-terminal. The amino-terminal domain was composed of 3 α-helices and 6 β-sheets, and the carboxy-terminal domain included 2 α-helices and 7 antiparallel β-sheets composition. The overall quality factor score of the SElW protein model was 98.08, with 93.24% of the amino acids having a Verify_3D score ≥0.2 and no amino acids located in disallowed regions. The docking conformation with the highest score (1 521.328) was selected as the analysis object, and the 19 hydrogen bonds between the corresponding amino acid residues of SElW and TCR were analyzed by PyMOL. Combined with sequence alignment and the published data, this study predicted and found five important superantigen active sites, namely Y18, N19, W55, C88, and C98. The highly purified soluble recombinant protein SElW was obtained with cloning, expression, and protein purification. Conclusions: The study found five superantigen active sites in SElW protein that need special attention and successfully constructed and expressed the SElW protein, which laid the foundation for further exploration of the immune recognition mechanism of SElW.

Effect of Gegen Qinliantang-medicated Serum on Nonalcoholic Steatohepatitis Based on Nrf2/TXNIP Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Gegen Qinliantang （GGQLT）-medicated serum on free fatty acid （FFA）-induced nonalcoholic steatohepatitis （NASH） in vitro model of human hepatoma cells HepG2. MethodNASH model of HepG2 cells was established in vitro， and the cells were intervened with different volume fractions of GGQLT-medicated serum and resveratrol. Intracellular lipid deposition in each group was detected by oil red O staining， the level of reactive oxygen species （ROS） in each group were detected by flow cytometry， the levels of glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， triglyceride （TG） and malondialdehyde （MDA） in each group were detected by kits. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to measure the mRNA expression levels of nuclear transcription factor （NF）E2-related factor 2 （Nrf2）， heme oxygenase-1 （HO-1）， quinone oxidoreductase 1 （NQO1）， Kelch-like epichlorohydrin-associated protein-1 （Keap1）， NF-κB， thioredoxin interacting protein （TXNIP）， interleukin-1β （IL-1β） in HepG2 cells of each group. The protein expression of Nrf2， TXNIP in cells of each group was detected by Western blot. ResultFFA induced large accumulation of intracellular lipids. Compared with the normal group， the activities of GSH-Px and SOD were significantly decreased （P<0.01） and the contents of TG， ROS and MDA were significantly increased （P<0.05， P<0.01） in the model group. Compared with the model group， all GGQLT groups and resveratrol group could elevate intracellular SOD activity to different degrees （P<0.05， P<0.01） and significantly reduce the levels of intracellular ROS and MDA （P<0.05， P<0.01）， GGQLD high- and medium-dose groups and resveratrol group significantly elevated GSH-Px activity （P<0.01）， GGQLD medium- and low-dose groups and resveratrol group significantly decreased TG content （P<0.05， P<0.01）. Compared with the model group， GGQLT high- and medium-dose groups and resveratrol group could significantly upregulate the mRNA expression levels of Nrf2， HO-1 and NQO1 （P<0.01）， all GGQLT groups and resveratrol group could significantly downregulate the TXNIP protein expression level， as well as significantly downregulate the mRNA expression levels of Keap1， NF-κB （P<0.05， P<0.01）. Nrf2-siRNA transfection of cells revealed that Nrf2 expression was significantly downregulated （P<0.01） in the Nrf2-siRNA group of cells by comparing with NC-siRNA group at the corresponding dose of drugs， and the inhibitory effects of GGQLT and resveratrol on TXNIP， IL-1β were attenuated. ConclusionFFA induces the production of ROS and inflammatory factors in HepG2 cells， and GGQLT can improve the anti-inflammatory and antioxidant capacities of cells， and its mechanism may be related to the regulation of Nrf2/TXNIP signaling pathway， so as to improve NASH.

A cohort study of association between sleep duration and cognitive impairment in the elderly aged 65 years and older in China / 中华流行病学杂志

Objective: To explore the effect of sleep duration on the risk of cognitive impairment in the elderly in China. Methods: Baseline data of 9 679 elderly individuals with intact cognition were collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2005, and followed up was conducted until 2018. Cox proportional hazards model was used to analyze the association between different sleep durations and the risk for cognitive impairment in the elderly. Results: Compared with elderly with sleep duration of 6 hours per day, those with sleep duration less than 5 hours had increased risk for cognitive impairment by 30% (HR=1.30, 95%CI: 1.05-1.62), and those with sleep durations of 7 hours, 8 hours and more than 9 hours had increased risk for cognitive impairment by 34% (HR=1.34,95%CI: 1.09-1.64), 40% (HR=1.40,95%CI: 1.17-1.69) and 43% (HR=1.43,95%CI: 1.19-1.70), respectively. Trend test showed that the risk of cognitive impairment increased with the extension of sleep duration (>6 h), and there was a dose-response relationship (P<0.001). However, self-rated sleep quality was not associated with the risk for cognitive impairment in the elderly. Conclusions: The shorter and longer sleep duration were associated an increased risk of cognitive impairment in the elderly aged ≥65 years in China, suggesting that optimizing sleep duration might delay the occurrence of cognitive impairment.

A cohort study on the influence of the chronic diseases on falls among middle-aged and older Chinese / 中华流行病学杂志

Objective: To analyze the influence of chronic diseases on falls among middle-aged and older Chinese. Methods: Baseline data of 13 670 middle-aged and older adults recruited from China Health and Retirement Longitudinal Study (CHARLS) in 2011 were used and followed up to 2018, among those were 7 443 (54.45%) middle-aged people aged 45-59 and 6 227 (45.55%) older adults aged 60 and above. The Cox proportional hazards model was used to analyze the effects of different types, the number of chronic diseases and the interaction between chronic illness and other factors on the fall risk of middle-aged and older people. Results: After adjusting for confounding factors, respiratory diseases increased the risk of falls by 21% (HR=1.21, 95%CI:1.02-1.45), and arthritis increased the risk of falls by 27% (HR=1.27,95%CI: 1.12-1.43) in the group aged 45-59, kidney disease increased the risk of falls by 26% (HR=1.26, 95%CI: 1.03-1.53) in the group aged 60 and above. A linear dose-response relationship between the number of chronic diseases and fall risk (χ2=133.61, P<0.001) was found in all the age groups. The interaction between having chronic diseases and the factors of females (HR=1.64, 95%CI: 1.43-1.89), impaired activities of daily living (ADL) (HR=1.66, 95%CI: 1.39-1.99), and having a fall history (HR=2.58, 95%CI: 2.24-2.97) increased the risk of falls. Conclusions: There is a positive linear relationship between the number of chronic diseases and the fall risk among Chinese aged 45 and above. The female middle-aged and elderly patients with chronic diseases and the middle-aged and elderly patients with impaired ADL or a history of falls are the high-risk groups for falls that need to be focused on intervention. The window of fall injury prevention should be moved forward to the middle-aged stage in time.

Chemical constituents of soft coral Sarcophyton glaucum collected from Xisha and their anti-inflammatory activity / 药学学报

The crude Et2O extract of soft coral Sarcophyton glaucum, collected off the Xisha, the South China Sea, were investigated. A new cembrane-type diterpenoid, namely 15-dehydroxy-sarcophytrol D (1), together with twenty-five known compounds, namely ximaoglaucumin C (2), (11S,12S,1E,3E,7E)-11,12-epoxycembra-1,3,7-triene (3), sarcophytol W (4), cembrene (5), sarcophytol B (6), sarcophytol K (7), sarcophytol J (8), pentaene-cembrene (9), sarcophytol E (10), (+)-marasol (11), (2S)-sarcophytoninsarcophytoxide (12), (-)-17-hydroxydeepoxysarcophytoxide (13), (+)-sarcophytoxide (14), 13-acetoxysarcophytoxide (15), bophynin B (16), 16-oxosarcophytoxide E (17), sarcophinone (18), 7α-8β-dihydroxydeepoxysarcophine (19), (+)-sarcophine (20), 14-dehydroxy-sarcophytol L (21), sarcophytol L (22), 13α-hydroxy-sarcophytol L (23), trocheliophol C (24), trocheliophol E (25) and trocheliophol L (26), were isolated and purified by comprehensive chromatography methods of silica gel column, Sephadex LH-20 gel column, TLC, and semi-preparative high-performance liquid chromatography (HPLC). In anti-inflammatory bioassay, compound 4 exhibited inhibitory effects on lipopolysaccharide (LPS)-induced inflammatory responses in BV-2 microglial cells.

Design and semisynthesis of oleanolic acid derivatives as VEGF inhibitors: Inhibition of VEGF-induced proliferation, angiogenesis, and VEGFR2 activation in HUVECs / 中国天然药物

Angiogenesis inhibitors targeting the VEGF signaling pathway are developed into drugs for the treatment of vaious diseases, such as cancer, rheumatoid arthritis, and age-related macular degeneration. Recent studies have revealed that oleanolic acid (OA), a natural pentacyclic triterpenoid, inhibited the VEGF/VEGFR2 signaling pathway and angiogenesis in HUVECs, which may represent an attractive VEGF inhibitor. In this paper, rational structural modification towards OA was performed in order to improve its inhibitory effects aganist VEGF and anti-angiogenesis potential. As a result, a series of novel OA derivatives, possessing α,β-unsaturated ketone system in ring A and amide functional group at C-28, were prepared and evaluated for cytotoxicity and their ability to inhibit VEGF-induced abnormal proliferation of HUVECs. The results showed that two promising derivatives, OA-1 and OA-16, exhibited no in vitro cytotoxicity against HUVECs but showed more potent inhibitory activity against VEGF-induced proliferation and angiogenesis in HUVECs, compared with OA. The results of Western blot indicated that OA-1 and OA-16 inhibited VEGF-induced VEGFR2 activation. Furthermore, small interfering RNA experiments were performed to confirm that both compounds inhibited VEGF-induced angiogenesis via VEGFR2. Thus, the present study resulted in the discovery of new promising OA-inspired VEGF inhibitors, which can serve as potential lead compounds for the treatment of angiogenesis-related diseases.

Diversity-oriented synthesis of marine sponge derived hyrtioreticulins and their anti-inflammatory activities / 中国天然药物

Diversity-oriented synthesis is aimed to increase the chemical diversity of target natural products for extensive biological activity evaluation. Indole ring is an important functional group in a large number of drugs and other biologically active agents, and indole-containing natural products have been frequently isolated from marine sources in recent years. In this paper, a series of indole-containing marine natural hyrtioreticulin derivatives, including 19 new ones, were designed, synthesized through a key Pictet-Spengler reaction, and evaluated for their inflammation related activity. Compound 13b displayed the most promising activity by inhibiting TNF-α cytokine release with an inhibitory rate of 92% at a concentration of 20 μmol·L-1. A preliminary structure-activity relationship analysis was also discussed. This research may throw light on the discovery of marine indole alkaloid derived anti-inflammatory drug leads.

Efficacy of inactivated EV71 vaccine in preventing severe hand, foot, and mouth disease of eligible children / 公共卫生与预防医学

Objective To investigate the vaccine efficacy (VE) of two doses of inactivated enterovirus 71 (EV71) vaccine on severe hand, foot, and mouth disease (HFMD) in eligible children. Methods A retrospective case-control study was conducted in this project. A total of 109 patients with EV71 severe HFMD aged between 6 months to 5 years old who were admitted to the Pediatric Intensive Care Unit (PICU) of Guangxi Maternity and Child Health Hospital from September 2016 to September 2020, and reported to the Chinese Disease Prevention and Control Information System were selected as the case group. According to 1:1 matching,109 healthy children aged between 6 months to 5 years old were selected as the control group. The vaccine efficacy of EV71 inactivated vaccine was calculated. Results The vaccination rate of the two doses of inactivated EV71 vaccine in the case group was significantly lower than that in the control group（9.17% to 54.13%，χ2=50.911, P<0.05；OR=0.086(95%CI:0.040-0.182)). The vaccine efficacy of two doses of inactivated EV71 vaccine was 91.44% (95% CI:81.8%-96%). Conclusion The inactivated EV71 vaccine has a good protective effect on hand, foot, and mouth disease caused by EV71. The vaccination of EV71 inactivated vaccine should be continuously promoted.

Epidemiological characteristics of septic shock in children and risk factors for prognosis / 中国小儿急救医学

Objective:To explore the epidemiological characteristics of septic shock in children and analyse the risk factors for prognosis.Methods:Retrospective study was conducted to collect the clinical data of 90 children with septic shock admitted to PICU from January 2017 to July 2020.Logistic regression analysis was used to analyze the epidemiological characteristics and risk factors of death of children with septic shock.Results:Among the 90 children with septic shock, 27 patients died, with a fatality rate of 30.0%.The primary infection sites were mainly in lungs and gastrointestinal/abdominal cavity, and the mortality rate of children with septic shock caused by primary gastrointestinal/abdominal infection was higher than that of lungs infection(48.1% vs.23.7%, χ2=6.049, P<0.05), and the time of death was shorter than that of lungs infection[2.1(0.9, 6.5)d vs.8.0(2.2, 13.5)d, H=2.052, P<0.05]. With the prognosis of children as dependent variable, the sex, age, pediatric critical illness score, glasgow coma scale, hypotension, combination with basic diseases, high lactic acidosis as well as severe pneumonia, gastrointestinal function failure, liver failure, acute kidney injury, and stress hyperglycemia were introduced to Logistic regression equation.The results showed that pediatric critical illness score, hypotension, combination with basic diseases, gastrointestinal function failure, liver failure, and acute kidney injury were related to the prognosis of children with septic shock, and hypotension, gastrointestinal function failure and combination with basic diseases were independent risk factors for death in children with septic shock. Conclusion:It is necessary to strengthen early intervention for primary gastrointestinal/abdominal infection, combined with underlying diseases and septic shock in compensatory stage.

Clinical Value of Ultrasound in Evaluating Stent Placement for Managing Graft Stenosis after Meso-rex Bypass / 中国医学科学院学报

Objective To explore the feasibility of using ultrasound to evaluate stent placement for managing graft stenosis after Meso-rex bypass for cavernous transformation of the portal vein in adults. Methods This study enrolled the patients who underwent Meso-rex bypass due to cavernous transformation of the portal vein,were diagnosed graft stenosis by postoperative ultrasound,and then underwent percutaneous portal vein puncture portography and stent placement.We then compared the ultrasonic measurement indicators and sonographic manifestations before and after stent placement,and evaluated the alleviation of portal hypertension symptoms after stent placement and related clinical indexes. Results Finally,8 patients were enrolled in this study,including 5 males and 3 females,with an average age of(32.4±14.7)years.The median duration of follow-up was 26 months after stent placement.The mean diameter of graft stenosis was(2.74±0.23)mm after Meso-rex bypass and became wider[(7.23±0.68)mm]after stent placement(

Transcatheter arterial chemoembolization followed by surgical resection for hepatocellular carcinoma: a focus on its controversies and screening of patients most likely to benefit / 中华医学杂志(英文版)

Surgical resection (SR) is recommended as a radical procedure in the treatment of hepatocellular carcinoma (HCC). However, postoperative recurrence negatively affects the long-term efficacy of SR, and preoperative adjuvant therapy has therefore become a research hotspot. Some clinicians adopt transcatheter arterial chemoembolization (TACE) as a preoperative adjuvant therapy in patients undergoing SR to increase the resection rate, reduce tumor recurrence, and improve the prognosis. However, the findings of the most relevant studies remain controversial. Some studies have confirmed that preoperative TACE cannot improve the long-term survival rate of patients with HCC and might even negatively affect the resection rate. Which factors influence the efficacy of preoperative TACE combined with SR is a topic worthy of investigation. In this review, existing clinical studies were analyzed with a particular focus on several topics: screening of the subgroups of patients most likely to benefit from preoperative TACE, exploration of the optimal treatment regimen of preoperative TACE, and determination of the extent of tumor necrosis as the deciding prognostic factor.

New lobane-type diterpenoids from the Xisha soft coral Sinularia polydactyla / 中国天然药物

Lobane-type diterpenoids are not frequently discovered from marine soft corals. In this paper, three new lobane type diterpenes, 13-methoxyloba-8,10,15(16),17(18)-tetraene (1), 8,10,13(15)Z,16E-lobatetraene (2) and 19-hydroxy-lobatetraene (3), and a new natural compound, 17,18-epoxyloba-16-acetoxy-8,10,13(15)-trien (4), co-occurring with a known related diterpenoid, 18-methoxyloba-8,10,13(15),16(17)-tetraene (5), were isolated from the South China Sea soft coral Sinularia polydactyla. The structures of new compounds were determined by extensive spectroscopic analysis and by comparison with those reported in the literature. In bioassay, all the isolates were inactive on antibacterial, PTP1B inhibitory, and immunological activities. This study increased the chemical diversity of marine diterpenoids.

Changes of HPLC Fingerprint and Main Flavonoids Content of Aurantii Fructus Before and After Processing / 中国实验方剂学杂志

Objective::To establish HPLC fingerprints of Aurantii Fructus and its processed products, and to quantitatively analyze the contents of four flavonoids in these products. Method::HPLC was employed with Inertsil ODS-3 C18 column (4.6 mm×250 mm, 5 μm), the mobile phase of acetonitrile-0.1%phosphoric acid aqueous solution for gradient elution, the detection wavelength of 283 nm, and the flow rate of 1.0 mL·min-1. HPLC fingerprints of raw products, stir-fried bran products and processing products of Aurantii Fructus were established. Similarity evaluation and cluster analysis were used to analyze the chromatographic data. At the same time, the contents of narirutin, naringin, hesperidin and neohesperidin were determined. Result::HPLC fingerprints of Aurantii Fructus and its processed products were established, taking naringin as the reference peak, 8, 15, 11 common peaks were demarcated for raw products, stir-fried bran products, processing products, respectively, the similarities of fingerprints were >0.95.Contents of the above four flavonoids in raw products were 0.574 7%, 5.986 3%, 0.302 2%and 3.574 7%, respectively. After processing, the contents of these four components in stir-fried bran products turned into 0.948 4%, 5.103 4%, 0.549 3%and 3.533 7%, their contents in processing products turned into 0.605 3%, 4.762 3%, 0.404 7%and 3.264 9%, respectively. Conclusion::The HPLC fingerprint of Aurantii Fructus changes significantly before and after processing. The contents of four flavonoids change to a certain extent before and after processing. The order of contents of narirutin and hesperidin in samples was stir-fried bran products>processing products>raw products, while the order of contents of naringin and neohesperidin was raw products>stir-fried bran products>processing products.

The effect of specialized team in the treatment of septic shock in children with continuous blood purification / 中国小儿急救医学

Objective:To investigate the effect of specialized continuous blood purification team (SCT) in the treatment of septic shock in children.Methods:The clinical data of 68 children with septic shock treated with continuous blood purification (CBP) from January 2012 to June 2019 were retrospectively analyzed.Choosing the date of SCT established(January 1, 2017) as the bound, the children were divided into the control group (before the establishment of SCT) and the observation group (after the establishment of SCT) according to whether the CBP was implemented by SCT.The CBP implementation rate, CBP time to get on the machine, the incidence of CBP-related adverse events and the prognosis of the two groups were compared.Results:There were no significant differences between two groups about baseline data such as gender, age and pediatric critical illness score( P>0.05). The CBP implementation rate of the observation group was higher than that in control group (96.7% vs.73.7%, P<0.05), and the CBP time to get on the machine was shorter than that in control group[(1.93±0.65)h vs.(6.25±2.38) h, P<0.01]. The overall incidence of CBP-related adverse events was lower than that in control group (18.7% vs.66.2%, P<0.01), and the 28 d survival was higher than that in control group(83.3% vs.60.5%, P<0.05). Conclusion:SCT can significantly improve the implementation rate and efficiency of CBP treatment in children with septic shock, reducing the incidence of CBP-related adverse events, and improving the survival rate.

Serum proteomics analysis of feline mammary carcinoma based on label-free and PRM techniques

Background@#Feline mammary carcinoma is the third most common cancer that affects female cats. @*Objectives@#The purpose of this study was to screen differential serum proteins in feline and clarify the relationship between them and the occurrence of feline mammary carcinoma. @*Methods@#Chinese pastoral cats were used as experimental animals. Six serum samples from cats with mammary carcinoma (group T) and six serum samples from healthy cats (group C) were selected. Differential protein analysis was performed using a Label-free technique, while parallel reaction monitoring (PRM) was performed to verify the screened differential proteins. @*Results@#A total of 82 differential proteins were detected between group T and group C, of which 55 proteins were down regulated and 27 proteins were up regulated. Apolipoprotein A-I, Apolipoprotein A-II (ApoA-II), Apolipoprotein B (ApoB), Apolipoprotein C-III (ApoC-III), coagulation factor V, coagulation factor X, C1q, albumen (ALB) were all associated with the occurrence of feline mammary carcinoma. Differential proteins were involved in a total of 40 signaling pathways, among which the metabolic pathways associated with feline mammary carcinoma were the complement and coagulation cascade and cholesterol metabolism. According to the Label-free results, ApoB, ApoC-III, ApoA-II, FN1, an uncharacterized protein, and ALB were selected for PRM target verification. The results were consistent with the trend of the label-free. @*Conclusions@#This experimen is the first to confirm ApoA-II and ApoB maybe new feline mammary carcinoma biomarkers and to analyze their mechanisms in the development of such carcinoma in feline.

Effect of early continuous blood purification on the prognosis of children with septic shock: a prospective randomized controlled clinical trial / 中国当代儿科杂志

OBJECTIVE@#To study the effect of early continuous blood purification (CBP) on the prognosis of children with septic shock.@*METHODS@#A prospective analysis was performed for the children with septic shock who did not reach the 6-hour initial recovery target and/or had a fluid overload of >10%. According to the treatment time of CBP, they were divided into an early group with 30 children and a conventional group with 28 children. The two groups were compared in terms of the start time of CBP and 28-day mortality rate, as well as the related indexes in the children who were cured.@*RESULTS@#The early group had a significantly earlier start time of CBP than the conventional group (P0.05). The children who were cured in the early group had significantly shorter correction time of lactic acid, urine volume, and fluid overload than those in the conventional group (P10%, early CBP treatment can quickly control the disease, shorten the course of disease, and accelerate immune reconstruction.

Screening of G-quadruplex ligands from Macleaya cordata extract by contrast ultrafiltration with liquid chromatography-mass spectrometry and molecular docking / 中国中药杂志

G-quadruplex DNA has become an important target for tumor therapy and anti-tumor development. Modern pharmacology has proved that Macleaya cordata has anti-inflammatory, antibacterial, anti-tumor and other pharmacological effects. Affinity ultrafiltration method can screen active ingredients from compounds rapidly, but G-quadruplex DNA ligands are difficult to dissociate, which is a key step in conventional ultrafiltration method. In this paper, the filtrates after ultrafiltration were determined by HPLC-MS in substitution. The peaks with 20% reduction of MS response from the incubation vs control were considered to be ligand components to G-quadruplex. Two of the peaks with the relative abundance above 30% were identified as sanguinarine(SAN) and chelerine(CHE). Their circular dichroism conformations further proved that SAN and CHE are active ligands of HT4. In addition, another two gradients with high relative abundance were identified as protopine(PRO) and allpcryprotopine(ALL). The binding rate of SAN, CHE, PRO and ALL was calculated according to the HPLC-MS results, and the results showed a consistency with that of the molecular docking method. The proposed method can be used to screen active components from mixture.