Analysis of the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and the factors of postoperative brain dysfunction / 国际外科学杂志

Objective:To observe the efficacy of 3D printing-assisted hematoma puncture and drainage in the treatment of hypertensive intracerebral hemorrhage and to explore the factors affecting postoperative brain dysfunction.Methods:A retrospective Case-control study was conducted to select 168 hypertensive intracerebral hemorrhage patients who were treated with 3D printing assisted hematoma puncture and drainage in the People′s Hospital of Yuechi County from January 2020 to September 2022 as the observation group, and 125 hypertensive intracerebral hemorrhage patients who were treated with CT guided hematoma puncture and drainage in the People′s Hospital of Yuechi County at the same time as the control group. The clinical efficacy of the two groups of patients was compared. According to the occurrence of postoperative brain dysfunction, the patients in the observation group were divided into normal brain function group ( n=121) and brain dysfunction group ( n=47). The clinical data of age, preoperative cerebral hernia, blood loss, ventilator-assisted ventilation, postoperative Glasgow coma index score (GCS) and postoperative complications were compared between the two groups. Multivariate Logistic regression was used to analyze the factors affecting postoperative brain dysfunction in the observation group, and a line chart model was constructed and its predictive efficiency was evaluated. The measurement data of normal distribution is expressed as mean ± standard deviation ( ± s), and independent sample t-test is used for inter group comparison. Chi-square test was used for comparison between count data groups. Results:The proportion of the drainage tube in the hematoma, hematoma clearance rate at 3 and 7 days after surgery, total effective rate of treatment, and GCS score at 1 week after surgery in the observation group were 88.69%(149/168), 54.17%(91/168), 96.43%(162/168), 92.86%(156/168), and 10.72±3.45, respectively, the control group was 75.20%(94/125), 36.80%(46/125), 81.60%(102/125), 76.80%(96/125), and 9.08±3.22, respectively, the difference between the two groups was statistically significant ( P<0.05). Advanced age ( OR=1.983, 95% CI: 1.169-2.732, P=0.017), preoperative cerebral hernia ( OR=1.532, 95% CI: 1.113-2.139, P=0.029), bleeding volume ≥ 50 mL ( OR=2.538, 95% CI: 1.802-3.347, P=0.003), postoperative GCS score 3-5 ( OR=2.874, 95% CI: 2.265-3.449, P<0.001), postoperative hypoxemia ( OR=2.251, 95% CI: 1.673-2.842, P=0.010) and postoperative chronic hydrocephalus ( OR=1.642, 95% CI: 1.214-2.021, P=0.022) were risk factors for postoperative brain dysfunction, while ventilator-assisted ventilation ( OR=0.656, 95% CI: 0.132-0.828, P=0.038) was protective factors. The internal verification of the line chart model by Bootstrap resampling method shows that the model has high differentiation, accuracy and validity. Conclusion:The application of 3D printing-assisted localization in hematoma puncture and drainage can improve the puncture condition and the hematoma clearance rate and clinical effect of patients with hypertensive intracerebral hemorrhage. Advanced age, preoperative cerebral hernia and bleeding volume are related to postoperative brain dysfunction. Clinical attention should be paid to patients with risk indicators of postoperative brain dysfunction.

Progress of injection sites of local infiltration analgesia in total knee arthroplasty / 中国修复重建外科杂志

OBJECTIVE@#To review the research progress of injection sites of local infiltration analgesia (LIA) in total knee arthroplasty (TKA).@*METHODS@#The relevant domestic and foreign literature in recent years was extensively reviewed. The neuroanatomy of the knee, and the research progress of the selection and the difference of effectiveness between different injection sites of LIA in clinical studies were summarized.@*RESULTS@#Large concentrations of nociceptors are present throughout the various tissues of the knee joint. Patellar tendon, subpatellar fat pad, lateral collateral ligament insertions, iliotibial band insertions, suprapatellar capsule, and posterior capsule were more sensitive to pain. Most current studies support injections into the lateral capsule, collateral ligament, retinaculum, quadriceps tendon, fat pad, and subcutaneous tissue. Whether to inject into the back of the knee and subperiosteum is controversial.@*CONCLUSION@#The relative difference of knee tissue sensitivity to pain has guiding significance for the selection of LIA injection site after TKA. Although researchers have conducted clinical trials on injection site and technique of LIA in TKA, there are certain limitations. The optimal scheme has not been determined yet, and further studies are needed.

Medication rules of traditional Chinese medicine compounds for pain / 中国中药杂志

The present study collected data on traditional Chinese medicine(TCM) compounds effective in relieving pain from the patent database of the State Intellectual Property Office(SIPO), sorted out the TCM compounds against pain in patents, and analyzed the medication rules to provide references for the research and development of new TCM drugs against pain. The data were subjected to frequency statistics, association rules, cluster analysis, and complex network analysis by IBM SPSS Modeler 18.3 and SPSS Statistical 26.0. The results showed that among the 101 oral prescriptions included in the statistics, the top 5 drugs were Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Chuanxiong Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma, and among the 49 external prescriptions included in the statistics, the top 5 drugs were Myrrha, Olibanum, Angelicae Dahuricae Radix, Borneolum Syntheticum, and Chuanxiong Rhizoma. Whether oral or external prescriptions, the drugs were mainly warm in nature, and bitter, pungent, and sweet in flavor. According to TCM complex network analysis, the core drugs were Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, and Chuanxiong Rhizoma in oral prescriptions, and Olibanum, Myrrha, Glycyrrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Angelicae Sinensis Radix in external prescriptions. Overall, the therapeutic principles of oral prescriptions were mainly replenishing Qi, nourishing blood, and promoting Qi and blood circulation, while those of external prescriptions were activating blood, resolving stasis, promoting Qi flow, and relieving pain on the basis of the oral prescriptions. In the future research and development of TCM compounds against pain, the prescriptions should be modified with mind-tranquilizing and depression-relieving drugs. With the modernization of TCM, the development of new pain-relieving TCM compound patents based on ancient methods and clinical experience adhering to the guidance of TCM treatment based on syndrome differentiation can meet the new demand for pain treatment in the current society and give full play to the advantages of TCM in pain treatment.

Research Progress in Application of Patient-Reported Outcome Measures in Total Knee Arthroplasty / 中国医学科学院学报

To summarize the clinical application of patient-reported outcome measures (PROM) in total knee arthroplasty (TKA) and provide reference for the application of PROM in perioperative evaluation of the patients receiving TKA,we reviewed the recent studies about the application of PROM in TKA and analyzed the contents and application characteristics of the PROM.The common PROM in TKA,such as the Western Ontario and McMaster Universities Osteoarthritis Index,Oxford Knee Score,and Forgotten Joint Score,principally focus on patients' subjective feelings about pain,function and other aspects of their knees.However,they have diverse ranges of application and each of them has their own advantages and disadvantages.There is a variety of PROM applied in TKA,which makes it challenging to select the proper measurement for evaluation.The PROM in TKA remains to be improved for broader use.

Comparison of short-term clinical outcomes and patient satisfaction between robotic-assisted and conventional total hip arthroplasty / 中华骨科杂志

Objective:To compare short-term clinical outcomes and patient satisfaction between robotic-assisted total hip arthroplasty (THA) and conventional THA.Methods:Patient data of unilateral primary THA with the same prosthesis by the same operator due to osteoarthritis, osteonecrosis of the femoral head, and other diseases in Peking University Third Hospital from September 2019 to February 2022 was retrospectively analyzed. Patients were divided into robot-assisted THA group and conventional THA group according to surgical methods. The preoperative general data, operation time, intraoperative complications and other intraoperative data were collected. Anteroposterior X-ray of pelvis and cross-table X-ray of hip were taken. Main outcome measures consisted of total blood loss, blood transfusion rate, hospitalization stay, postoperative complications, and the inclination and anteversion angle of the acetabular cup, while the dislocation rate outside the Lewinnek and Callanan safe zone was also analyzed. Other outcomes measures included visual analogue scale, Harris score, quality of life score (QOL) and satisfaction score.Results:There was no significant difference in gender, age, height, weight, body mass index (BMI), operation side, preoperative blood volume and Harris score between the two groups ( P>0.05); Loosening of positioning screws occurred in 2 patients due to osteoporosis in robot-assisted THA group, so conventional THA was performed. Therefore, 84 cases in robot-assisted THA group and 87 cases in conventional THA group were enrolled in this study at last. There was no significant difference in follow-up time between conventional THA group and robot-assisted THA group (19.7±6.8 months vs. 18.6±5.4 months, t=1.16, P=0.249); The operation time of robot-assisted THA group was longer than that of conventional THA group (106.99±31.91 min vs. 73.79±29.48 min, t=7.07, P<0.001), but there was no significant difference in hospitalization stay between conventional THA group and robot-assisted THA group (6.40±2.40 d vs. 6.49±1.95 d, t=0.26, P=0.796). There was also no significant difference in total blood loss and blood transfusion rate between the two groups ( P>0.05). There was no significant difference in inclination angle (38.79°±6.93° vs. 39.41°±3.01°, t=0.58, P=0.449) and anteversion angle (14.81°±6.49° vs. 13.33°±4.32°, t=3.06, P=0.082) between conventional THA group and robot-assisted THA group, while the percentage in Lewinnek safe zone (96.4% vs. 73.6%, χ 2=15.60, P<0.001) and Callanan safe zone (92.9% vs. 65.5%, χ 2=17.61, P<0.001) was significantly higher in conventional THA than that of robot-assisted THA. There were no significant differences in postoperative VAS, Harris score and QOL score between the two groups ( P>0.05), but the excellent and good rate of Harris score of conventional THA group was lower than that of robot-assisted THA group (83.91% vs. 95.24%, χ 2=5.83, P=0.016); The overall satisfaction of patients in robot-assisted THA group was better than that in conventional THA group ( Z=-3.47, P=0.001), and 95.2% (80/84) of patients in robot-assisted THA group were very satisfied, which was higher than that in conventional THA group (75.86%, 66/87). The satisfaction of patients in robot-assisted THA group on pain relief ( Z=-2.44, P=0.015) and improvement of leisure activity ( Z=-2.12, P=0.034) was better than that in conventional THA group, but there was no significant difference in the satisfaction of ability of doing house work between the two groups ( Z=-0.49, P=0.626). Conclusion:Compared with conventional THA, robot-assisted THA has longer operation time but better short-term clinical outcomes and higher patient satisfaction after surgery.

The Efficacy of Rh Phenotype Matched Blood Transfusion / 中国实验血液学杂志

OBJECTIVE@#To analyze and evaluate the efficacy of Rh phenotype matched blood transfusion.@*METHODS@#The increasing of hemoglobin (Hb) and hemolysis tests in the patients treated by Rh matched red blood cells or not, as well as the first time unmatched transfusions and the unmatched transfusions happened again after a period (≥10 d) were retrospectively analyzed.@*RESULTS@#A total of 674 times transfusions in 120 patients were evaluated. The increasing of Hb in each unit was higher in the patients treated by Rh matched blood transfusion (vs unmatched) [(33.397±1.475) g/U vs (29.951±1.304) g/U, P=0.033], while the increasing of Hb at first time unmatched transfusion and the second time unmatched transfusion was not statistically different[ (28.942±2.083) g/U vs (30.686±1.737) g/U, P=0.589]. The level of lactate dehydrogenase were related to erythrocyte washing, irradiation, period of validity and the second time unmatched transtusion (all P<0.05); the levels of total bilirubin (TBil), direct bilirubin (DBil) and indirect bilirubin (IBil) between the first time unmatched transfusion and the second time unmatched transfusion were statistically different (all P<0.05).@*CONCLUSION@#For the patients need multiple blood transfusions, Rh phenotype matched blood transfusion can reduce the exposure to Rh allogenic antigens, improve the efficacy and ensure the safety of blood transfusion.

Efficacy and Safety of the Safe Triangular Working Zone Approach in Percutaneous Vertebroplasty for Spinal Metastasis

Objective@#This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. @*Materials and Methods@#We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31–76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29–81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan–Meier curves. @*Results@#The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (v< 0.001). Cement leakage was not significantly different between groups A and B (p= 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan–Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). @*Conclusion@#The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.

Preparation of purified proteins from fresh Pheretima and their inhibitory effect against pulmonary fibrosis in mice / 南方医科大学学报

OBJECTIVE@#To develop a convenient method for rapid purification of fresh Pheretima proteins and assess the inhibitory effect of these proteins against pulmonary fibrosis.@*METHODS@#The crude extract of fresh Pheretima was obtained by freeze-drying method and then purified by size exclusion chromatography. The composition of the purified proteins was analyzed by mass spectrometry. MRC-5 cells were treated with 5 ng/mL TGF-β1 alone (model group) or in combination with SB431542 (2 μmol/L) or the purified proteins (13.125 μg/mL), and the cytotoxicity of purified proteins and their inhibitory effects on cell proliferation were detected with CCK8 assay. Flow cytometry was used to detect the changes in cell apoptosis, and the cellular expressions of α-SMA, Vimentin, E-cadherin, collagen I, Smad2/3 and P-Smad2/3 were detected using RT-PCR and Western blotting. In the animal experiment, adult male C57BL/6 mice were subjected to intratracheal instillation of bleomycin followed by treatment with the purified proteins (5 mg/mL) for 21 days, after which HE and Masson staining was used to observe the pathological changes in the lung tissue of the mice.@*RESULTS@#We successfully obtained purified proteins from fresh Pheretima protein by size exclusion chromatography. Treatment with the purified proteins significantly inhibited TGF-β1-induced proliferation of MRC-5 cells (P < 0.01), reduced the cellular expressions of α-SMA, Vimentin and collagen I (P < 0.001 or P < 0.01), increased the expression of E-cadherin (P < 0.01), and inhibited the expressions of Smad2/3 and P-Smad2/3 (P < 0.001 or P < 0.01). In male C57BL/6 mice models of bleomycin-induced pulmonary fibrosis, treatment with the purified proteins obviously reduced the number of inflammatory cells and fibrotic area in the lungs.@*CONCLUSION@#The purified proteins from fresh Pheretima obtained by size exclusion chromatography can inhibit pulmonary fibrosis in mice by regulating the TGF-β/ Smad pathway.

Effects of isorhyncophylline on hippocampal metabolism using 1H NMR-based metabolomics combined with molecular docking analysis / 药学学报

The purpose of this study was to investigate the effect of isorhyncophylline on hippocampal endogenous metabolites in spontaneously hypertensive rats (SHR) by 1H NMR metabolomics and molecular docking. Twelve SHR were randomly divided into a model group and a treatment group. Six Wistar-Kyoto rats were selected as a control group. The rats in the treatment group were administered isorhyncophylline (0.3 mg·kg-1) while the rats in the other two groups were treated with the same amount of sterilized saline solution. Animal experiment was authorized by the Ethics Committee of Shandong University of Traditional Chinese Medicine (No. SDUTCM20210721002). Hippocampal tissues were removed after administration for 8 weeks and assayed by 1H NMR based metabolomics technology combined with a pattern recognition method to find characteristic metabolites, and the metabolic targets were retrieved from the Kyoto Encyclopedia of Genes and Genomes database. Molecular docking technology was used to evaluate binding of isorhyncophylline to the core targets. The results of a principal components analysis (PCA) and partial least squares discriminant analysis (PLS-DA) showed a clear cluster of samples among three groups. There were seven differentially altered metabolites, and glucose metabolism and glutamate metabolism were the principal related pathways. Molecular docking indicated that isorhyncophylline had good binding properties with nine key candidate target proteins. According to the above research results, isorhyncophylline can influence energy metabolism and glutamate metabolism in the hippocampus.

Discrimination of quality markers of Shujin Huoxue Capsules based on five principles coupled with cobweb model / 中国中药杂志

The quality markers(Q-markers) of Shujin Huoxue Capsules were comprehensively discriminated based on the five principles of transfer and traceability, specificity, compatibility, effectiveness and measurability. The compounds that could be transferred from the original medicinal materials to the preparation were selected with the principle of transfer and traceability. The specific components in the prescription were screened by reviewing literature with the principle of specificity. According to the principle of compatibility, the attributes of compounds were evaluated by the sovereign, minister, assistant and guide combination rules of the original medicinal materials in the prescription. According to the principle of measurability, the measurable components were summarized by reference to the pharmacopoeia and literature combined with the content. The mechanism of Shujin Huoxue Capsules in the treatment of osteoporosis was studied through network pharmacology based on the principle of effectiveness, which was the evaluation index of effectiveness. The chemical components screened out above were regarded as candidate Q-markers, and the cobweb model was plotted to obtain the comprehensive score of Q-markers. Hydroxysafflor yellow A, trachelosid, eleutheroside B, α-cyperone, protocatechuic acid, protocatechualdehyde and 4-methoxy salicylaldehyde were discriminated as the Q-markers of Shujin Huoxue Capsules based on the five principles combined with cobweb model.

Application of transjugular liver biopsy in the diagnosis and treatment of complicated and severe liver diseases / 临床肝胆病杂志

Objective To investigate the application value of transjugular liver biopsy (TJLB) in the diagnosis and treatment of complicated and severe liver diseases. Methods A retrospective analysis was performed for the clinical data of 31 patients who underwent TJLB in The Fifth Medical Center of Chinese PLA General Hospital, including indication for puncture, success rate, and final diagnosis. Results Among the 31 patients, there were 15 male patients and 16 female patients. Percutaneous liver biopsy was unsuitable for 8 patients with liver failure and disturbances of blood coagulation, 13 with liver cirrhosis and ascites, and 10 with liver cirrhosis and thrombocytopenia (< 50×10 9 /L), which were the indications for TJLB. The success rate of TJLB puncture was 100%, with 2-4 passes for puncture. No serious adverse event was observed. Of all 31 patients, 26 (83.87%) had a definite diagnosis at discharge, among whom there were 5 patients with idiopathic portal hypertension, 9 patients with drug-induced liver failure or liver cirrhosis, 5 patients with autoimmune liver disease, and 7 patients with liver cirrhosis or liver failure due to other causes, and 5 patients had unknown etiology. In addition, 3 patients underwent biopsy to confirm the diagnosis and decision of whether liver transplantation should be performed. Conclusion TJLB plays an important role in the diagnosis and treatment of complicated and severe liver diseases and still has certain limitations, and therefore, suitable patients should be selected in clinical practice.

Comparison of alignment and operative time between portable accelerometer-based navigation device and computer assisted surgery in total knee arthroplasty / 北京大学学报(医学版)

OBJECTIVE@#To explore the differences of alignment and operative time between portable accelerometer-based navigation device (PAD) and computer assisted surgery (CAS) in total knee arthroplasty (TKA).@*METHODS@#Data of patients using iASSIST (a kind of PAD) and OrthoPilot (a kind of CAS) for TKA in Peking University Third Hospital from December 2017 to December 2019 were retrospectively collected. The differences of preoperative general data, preoperative alignment, operative time and postoperative alignment were studied between the two groups.@*RESULTS@#A total of 82 patients were enrolled in our study, including 40 patients in the PAD group and 42 patients in the CAS group. Gender, age, body mass index (BMI), surgical side, preoperative hip-knee-ankle (HKA) angle and preoperative HKA angle deviation didn't show statistically significant difference between the PAD group and the CAS group (P>0.05). Postoperative HKA angle (180.8°±2.2° vs.181.8±1.6°, t=－2.458, P=0.016) and postoperative coronal femoral-component angle (CFA, 90.6°±1.8° vs. 91.6°±1.6°, t =－2.749, P=0.007) of the PAD group were smaller than those of the CAS group, but there was no significant difference in coronal tibia-component angle (CTA, 90.0°±1.3° vs.89.6°±1.4°, t=1.335, P=0.186) between the two groups. There was no significant difference in the rate of outliers (varus or valgus > 3°) for postoperative HKA angle (10.0% vs.11.9%, χ2 =0.076, P=0.783), CFA (12.5% vs. 14.3%, χ2=0.056, P=0.813) and CTA (2.5% vs. 0%, χ2=1.063, P=0.303). There was no significant difference in the accuracy of postoperative HKA angle (2.1° vs. 2.0°, t=0.055, P=0.956), CFA (1.4° vs. 1.8°, t=－1.365, P=0.176) and CTA (1.0° vs. 1.1°, t=－0.828, P=0.410) between the two groups. The precision of postoperative HKA angle (1.1° vs. 1.3°, F=1.251, P=0.267), CFA (1.3° vs. 1.4°, F=0.817, P=0.369) and CTA (0.8° vs. 0.9°, F=0.937, P=0.336) were also not significantly different. We also didn't find statistically significant difference in operative time between the two groups [(83.4±25.6) min vs. (86.5±17.7) min, t=－0.641, P=0.524].@*CONCLUSION@#PAD and CAS had similar accuracy and precision in alignment in TKA, and there was no significant difference in operative time, which indicates that PAD has a broad application prospect in TKA.

Meta-analysis of effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention / 中国中药杂志

To systemically evaluate the effect of Qishen Yiqi Dripping Pills combined with Western medicine on adverse cardiovascular events and quality of life after percutaneous coronary intervention(PCI). A total of 7 Chinese and English databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and Web of Science were searched by computer to collect the randomized controlled trials(RCTs) on Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients with coronary heart disease after PCI with the retrieval time from the database establishment to April 1, 2020. Two researchers independently conducted li-terature screening, data extraction and bias risk assessment. Then, Meta-analysis was performed by using RevMan 5.3 software. A total of 31 RCTs were included, involving 3 537 patients. The results of Meta-analysis showed that in terms of major adverse cardiovascular events(MACE) after PCI, the combination of Qishen Yiqi Dripping Pills could significantly reduce the recurrence of angina pectoris, incidence of arrhythmia, heart failure and re-revascularization, and the effect was better than that of Western medicine treatment alone. However, there was no significant difference between the two groups in the improvement of non-fatal myocardial infarction, cardiac death, stent restenosis, stroke and other adverse cardiovascular events. In terms of improving left ventricular ejection fraction(LVEF), 6 min walking test(6 MWT), high-sensitivity C-reactive protein(hs-CRP) and Seattle angina pectoris scale(SAQ), the combination of Qishen Yiqi Dripping Pills and Western medicine treatment had obvious advantages over Western medicine treatment alone in increasing LVEF, 6 MWT and SAQ, and reducing the level of hs-CRP, with statistically significant differences. There were few adverse reactions in both groups, and there was no significant difference between the two groups. The main manifestations were gastrointestinal reactions, rash, gingiva and other small bleeding, and no serious adverse reactions occurred. The above reactions could disappear after drug withdrawal or symptomatic treatment. The application of Qishen Yiqi Dripping Pills combined with Western medicine in the treatment of patients after PCI could reduce the occurrence of MACE, improve the clinical efficacy, quality of life and prognosis in a safe and reliable manner. However, due to the quantity and quality limitations of included studies, more standardized, rigo-rous and high-quality clinical studies are still needed to further verify the above conclusions.

Mechanisms of rapamycin on regulating rat mesangial cell proliferation and cell cycle through mTORC1/p70S6K pathways / 药学学报

To explore the affect and mechanisms of rapamycin on mesangial cell proliferation and cell cycle, rat mesangial cells (HBZY-1) were cultured and divided into the six groups: normal; normal with platelet derived growth factor (PDGF) 20 ng·mL-1; PDGF + rapamycin 1, 10, 100, 1 000 nmol·L-1. The cell proliferation was measured by MTT in 24 and 48 h; flow cytometry was used to detect the cell cycle phase. Western blot was performed to determine cyclin D1,cyclin E, cyclin-dependent kinase 2 (CDK2), cyclin-dependent kinase 4 (CDK4), p27, p70S6K/p-p70S6K protein expression. The p27 mRNA was detect by Real-time PCR. The results showed that rapamycin significantly suppressed PDGF induced glomerular mesangial cells (MCs) proliferation in a dose and time-dependent manner, but with the dose increased (1 to 1 000 nmol·L-1), the time dependence gradually weakened. Rapamycin inhibited mesangial cell proliferation and arrested the cell cycle in the G0/G1 phase. PDGF at 20 ng·mL-1 significantly increased the expression of cyclin D1, cyclin E and CDK2, CDK4 (P < 0.05), but rapamycin did not affect the expression of cyclin D1, cyclin E and CDK2, CDK4. Rapamycin can significantly inhibited p70S6K phosphorylation, up-regulated the expression of p27 protein and mRNA. Collectively, rapamycin has the effect of inhibiting the glomerular mesangial cells proliferation of mesangial cells by regulating the transcription of p27 mRNA, increasing its protein expression through the mTORC1/p70S6K pathway, resulting in decreased activity of cyclin-CDK, and blocking cell cycle in G0/G1 phase.

A new lignan glucoside from root of Paeonia lactiflora / 中国中药杂志

A new lignan glucoside,(+)-fragransin A_2-4-O-β-D-glucopyranoside(1), has been isolated from the dry root of Paeonia lactiflora by column chromatography on silica gel, Sephadex LH-20, and MCI-gel resin, as well as preparative RP-HPLC. The structure of the new compound was elucidated by spectroscopic data analysis(MS, UV, IR, CD, 1 D and 2 D NMR) and chemical method. Compound 1 showed moderate inhibition against lipopolysaccharide induced nitric oxide production in RAW264.7 macrophages, with an IC_(50) value of 21.3 μmol·L~(-1).

Role of adjuvant (chemo)radiotherapy for resected extrahepatic cholangiocarcinoma: a meta-analysis / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

BACKGROUND@#Adjuvant (chemo)radiotherapy (A(C)RT) may be an important supplement to surgery for extrahepatic cholangiocarcinoma (EHCC). However, whether all patients would achieve benefits from A(C)RT and which adjuvant regimen, adjuvant radiotherapy (ART) or adjuvant chemoradiotherapy (ACRT), would be preferred, are still undetermined. The low incidence of EHCC makes it difficult to carry out randomized controlled trials (RCTs); therefore, almost all clinical studies on radiotherapy are retrospective. We have conducted a meta-analysis of these retrospective studies.@*METHODS@#We conducted a meta-analysis of current retrospective studies using PubMed, Embase, and ClinicalTrials databases. All studies published in English that were related to A(C)RT and which analyzed overall survival (OS), disease-free survival (DFS), or locoregional recurrence-free survival (LRFS) were included. Estimated hazard ratios (HRs) were calculated for OS, DFS, and LRFS.@*RESULTS@#Data from eight studies including 685 patients were included. Our analysis showed that A(C)RT significantly improved OS (HR 0.69, 95% confidence interval (CI) 0.48-0.97, P=0.03), DFS (HR 0.60, 95% CI 0.47-0.76, P<0.0001), and LRFS (HR 0.27, 95% CI 0.17-0.41, P<0.00001) of EHCC overall. In subgroups, patients with microscopically positive resection margin (R1) could achieve a benefit from A(C)RT (HR 0.44, 95% CI 0.27-0.72, P=0.001). No statistically OS difference was observed in negative resection margin (R0) subgroup (HR 0.98, 95% CI 0.30-3.19, P=0.98).Significant OS benefit was found in patients who received concurrent ACRT (HR 0.40, 95% CI 0.26-0.62, P<0.0001), while the result of ART without chemotherapy showed no significant benefit (HR 1.14, 95% CI 0.29-4.50, P=0.85). In the distal cholangiocarcinoma subgroup, no significant difference was seen when ACRT and ART were included (HR 0.61, 95% CI 0.14-2.72, P=0.52), but a significant difference was seen when analyzing the concurrent ACRT only (HR 0.29, 95% CI 0.13-0.64, P=0.002).@*CONCLUSIONS@#A(C)RT may improve OS, DFS, and LRFS in EHCC patients, especially in those with R1 resection margins. ACRT may be superior to ART especially in distal patients.

The clinical significance of Msi1 gene and its biological role in colon cancer / 医学研究生学报

Objective　At present, the clinical significance and biological function of Msi1 (Musashi1) in colon cancer are still not very clear. So, a comprehensive understanding of the expression and role of Msi1 in colon cancer has important clinical and theoretical significance. This study is to investigate the clinical significance of Msi1 gene and its biological role in colon cancer by lentiviral vector to interfere with Msi1 gene expression in colon cancer SW480 cells.　Methods　20 colon cancer specimens were collected from the Second Surgery Department of the Fourth Hospital of Hebei Medical University from October 2013 to May 2014. Each specimen was collected from the cancer tissue and the adjacent intestinal wall tissue. Western blot was performed to determine the protein expression of Msi1 in tumor tissues and adjacent normal tissues from colon cancer patients. The relationship between Msi1 protein expression and clinical characteristics was further analyzed. The lentiviral vector was used to construct a stable SW480 cell line with low expression of Msi1. The lentivirus containing two different interference sequences (shmsi1-1 and shmsi1-2) was transfected into the target cells, and the colon cancer cells were divided into control group (without any treatment), shMsi1-1 group (transfected shMsi1-1) and shMsi1-2 group (transfected shMsi1-2). The two lentivirus silencing effects were detected by Western blot. Cell proliferation was detected by CCK-8 assay, Clone formation assay was conducted to detect the colony forming ability, and Flow cytometry analysis was used to examine the apoptosis rate.　Results　The protein expression of Msi1 in colon cancer tissue(0.863±0.208) was significantly higher than that in adjacent normal tissues(0.272±0.078), and the difference was statistically significant(P<0.001). The relative expression of Msi1 protein in shMsi1-1 and shMsi1-2 groups (0.299±0.111 and 0.207±0.087) was significantly lower than that in the control group (1.000±0.149) (P<0.001). The proliferation rate of shMsi1-1 and shMsi1-2 at 48 h and 72 h was significantly lower than that of the control group (P<0.01). Compared with the control group (296.33±64.04), shMsi1-1 group (92.00±43.31) and shMsi1-2 group (78.67±32.87) were significantly decreased (P<0.01). Compared with the control group [(4.01±0.26) %], the apoptosis rate of shMsi1-1 group, shMsi1-2 group [(10.22±1.04) %, (10.87±1.27) %] was significantly increased (P<0.001).　Conclusion　Interference with Msi1 gene expression inhibits proliferation of colon cancer SW480 cells and promotes tumor cell apoptosis. This finding provides a new intervention target for the clinical treatment of colon cancer.

The molecular mechanism by which the circadian rhythm regulates body metabolism and research progress on intervention in the circadian rhythm by traditional Chinese medicine / 药学学报

Circadian rhythm is an internal regulatory mechanism that allows organisms to adapt to circadian changes in the external environment, and can regulate the body's steady state by affecting the metabolic pathways of multiple organs. When exogenous factors such as eating time, worktime changes, and sleep disturbances cause the body's circadian rhythm to be disrupted, the risk of developing metabolic syndrome is significantly increased. This article explores the relationship between circadian rhythm and body metabolism and summarizes the molecular mechanisms by which circadian rhythm regulates the digestive system, liver and bile acid production, and kidney function. We review research progress on intervention in the circadian rhythm by traditional Chinese medicine and provide a reasonable and valuable basis for follow-up studies on the role of traditional Chinese medicine in research on the molecular mechanisms of regulation of circadian rhythm.

Research progress on animal models of chronic pain and its application in traditional Chinese medicine research / 中国中药杂志

The classification of chronic pain is complex and its pathogenesis is not clear, which led to the limited progress of treatment measures.Traditional Chinese medicine(TCM) has certain advantages in the treatment of chronic pain, and its mechanism needs further exploration. The ideal animal model is helpful to elucidate the key mechanism of the occurrence and development of chronic pain and play an important role in the discovery of new drug targets, the development of new therapies and the research on the analgesic mechanism of TCM.In recent years, many scholars at home and abroad have done a lot of research to explore the pathogenesis of chronic pain and the mechanism of TCM, which have achieved some results. On this basis, this study summarizes the selection of experimental animals for chronic pain and the commonly evaluation methods of animal models. According to the latest international classification of diseases, this review organizes the induced methods, evaluation indicators, advantages and disadvantages of seven kinds of chronic pain animal models, such as chronic primary pain, chronic cancer-related pain and so on. Next, this review introduces the chronic pain animal models commonly used in TCM research, in order to provide guidance for the targeted selection of animal models when carrying out relevant experiments in the future.

Research progress of natural non-alkaloids with analgesic activity / 中国中药杂志

Pain is a complex, unpleasant feeling and emotional experience associated with actual or potential tissue damage, and manifests itself in certain autonomous psychological and behavioral responses. The commonly used opioid and non-steroidal anti-inflammatory analgesics(NSAIDs) may cause adverse reactions to the kidney, liver, cardiovascular or gastrointestinal system and cause problems of drug abuse. Therefore, it is necessary to study new analgesic drugs with less side effects and significant analgesic effects. A variety of natural products derived from terrestrial plants, microorganisms, marine organisms and fungi have been an important source of clinical medicines and provide an inexhaustible resource for the development and innovation of modern medicines. Therefore, this paper mainly reviews the natural non-alkaloids with analgesic activity in order to provide reference for the research and development of analgesic drugs derived from natural products.