Research progress on the stress-strain index of Corvis ST / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal visualization Scheimpflug technology(Corvis ST)is currently the most commonly used clinical device for assessing in vivo corneal biomechanics. The new parameter stress-strain index(SSI)has been a hot topic of clinical research in recent years, which not only directly reflect corneal biomaterial stiffness, but also closely correlates with the progression of certain diseases. SSI was generated based on the predictions of corneal behavior using finite element(FE)numerical modeling to simulate the effects of intraocular pressure and Corvis ST jets. The SSI algorithm does not change with central corneal thickness(CCT), intraocular pressure, or biomechanically corrected intraocular pressure(BIOP), but it is clearly associated with altered collagen fibres in the corneosclera. The principles of SSI, the relationship between age and SSI, the relationship between axial length and SSI, the relationship between myopia and SSI, and the application of SSI are summarized and concluded.

Environmental and meteorological factors on the risk of lipid-abnormal dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the impact of meteorological factors in different environments in the eastern and western regions of China on the incidence of lipid-abnormal dry eye.METHODS: This is a multicenter retrospective study. From March 1, 2021 to February 28, 2022, all patients with dry eye were selected from the ophthalmology clinic of Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine and Friendship Hospital of Xinjiang Yili Kazakh Autonomous Prefecture. General data(gender, age, employment and education)and climate data for outdoor environments(temperature, humidity, air quality index and wind)on the day of the visit were collected. Patients who met the inclusion and exclusion criteria were selected. Single factor, multiple factors and nonlinear model analysis were applied to identify environmental factors of lipid-abnormal dry eye in both regions.RESULTS: There was no significant difference in the incidence of lipid-abnormal dry eye between Nanjing and Yili in different seasons. The incidence of lipid-abnormal dry eye in Yili was significantly higher in all seasons than in Nanjing(P<0.001). The results of univariate research showed that the factors affecting the incidence of lipid-abnormal dry eye were gender, employment, humidity, air quality, and wind. The results of multivariate Logistic regression analysis showed that humidity, temperature and air quality were statistically significant, and remained significant after adjusting for the three confounding factors of age, gender and employment situation. Nonlinear analysis showed that the probability of lipid-abnormal dry eye increased with the decrease of temperature when the temperature was below 10℃; within the range of 10℃～15℃, the probability of lipid-abnormal dry eye tended to stabilize. When the temperature exceeded 15℃, the probability of lipid-abnormal dry eye increased with the increase of temperature. Humidity was negatively correlated with the onset of lipid-abnormal dry eye. As humidity increased, the probability of lipid-abnormal dry eye decreased.CONCLUSIONS: The risk of lipid-abnormal dry eye in Yili is higher than that in Nanjing throughout the four seasons. Humidity, temperature, air quality and other environmental and meteorological factors can all affect the incidence of lipid-abnormal dry eye.

Efficacy and safety of trabeculectomy at the inferior limbus for patients of intraocular pressure after failed glaucoma filtration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy and safety of trabeculectomy at the inferior limbus for patients of intraocular pressure(IOP)after failed glaucoma filtration.METHODS: A retrospective analysis was conducted to identify 51 glaucoma patients with 61 eyes that had undergone trabeculectomy at the inferior limbus for patients of IOP after failed glaucoma filtration. The preoperative and postoperative IOP, visual acuity and number of IOP-lowering drugs, as well as intraoperative and postoperative complications were extracted. Surgical success rates were calculated using Kaplan-Meier survival analysis.RESULTS: The postoperative follow-up time ranged from 6-76(mean 30.15±14.10)mo. The preoperative IOP of 61 eyes was 35.98±10.01mmHg, the IOP after the surgery at 1wk, 1, 3, 6mo, 1a and the IOP of last follow-up visit were 9.62±4.90, 13.15±4.51, 16.05±7.37, 16.48±6.81, 16.68±6.42, 16.77±7.56 mmHg respectively, all of these were different compared to the preoperative IOP(P<0.001). The postoperative complete success rates at 6mo, 1 and 2a were 62%, 49% and 36%, respectively and the partial success rates were 93%, 85% and 81%, respectively. There were 34 eyes(56%)formed functional filtration blebs. There were 3.33±0.77 kinds of IOP-lowering eye drops used before surgery, and it was decreased to 1.41±1.44 kinds of eye drops(t=9.86, P<0.001)at 3mo after surgery. There was no severe complication observed such as filtering bleb infection and endophthalmitis.CONCLUSION: Trabeculectomy at the inferior limbus offers the opportunity for patients with uncontrolled IOP after failed glaucoma filtration, and it can still be used as a safe and effective treatment for patients, although it is relatively difficult to operate.

Comparison between frontalis suspension and levator resection in treatment of blepharoptosis: a meta-analysis / 中华医学美学美容杂志

Objective:To compare the postoperative efficacy and complications of frontalis suspension and levator resection in the treatment of blepharoptosis.Methods:According to the Cochrane systematic review method, we searched PubMed, Medline, Cochrane Library, Wanfang database, VIP Database, and China Knowledge Network database. The randomized and non-randomized controlled trials for comparing frontalis suspension and levator resection in the treatment of blepharoptosis were included. Revman 5.3 Meta analysis software was used.Results:A total of 13 clinical trials were involved in this study, including 1308 patients. Frontalis suspension was performed in the experimental group and levator resection was performed in the control group. The OR value of postoperative efficacy between the 2 groups was 2.91, 95% CI (1.57-5.39), P<0.01, the difference was statistically significant. Postoperative lagophthalmos after frontalis suspension was better [ MD=-1.05, 95% CI (-1.43--0.68), P<0.01], the difference was statistically significant. The OR value of undercorrection between the 2 groups was 0.24, 95% CI(0.16-0.36), P<0.01, the difference was statistically significant. Conclusions:The postoperative efficacy after frontalis suspension is higher. Postoperative complications after frontalis suspension are less.

Effects of sarcopenia on the clinical efficacy and prognosis of radical radiotherapy in elderly patients with esophageal cancer / 国际肿瘤学杂志

Objective:To explore the relationships between sarcopenia and the clinical efficacy and prognosis of elderly patients with esophageal cancer who were treated by radical radiotherapy.Methods:The clinicopathological data of 134 elderly patients with esophageal cancer who received radical radiotherapy in Department of Radiotherapy, Affiliated Hospital of Yangzhou University from January 2013 to December 2018 were retrospectively analyzed. The muscle cross-sectional area at the level of the third lumbar vertebra was measured by using computed tomography (CT) images. These patients were divided into sarcopenia group ( n=56) and non-sarcopenia group ( n=78) according to the skeletal muscle index before radiotherapy. The efficacy and incidence of adverse reactions of the two groups were compared. Kaplan-Meier method was used to plot the survival curve, and Cox regression model was used to analyze prognostic factors. Results:There was a significant difference in the objective response rate between the sarcopenia and non-sarcopenia group at 1 month after radiotherapy [53.57% (30/56) vs. 71.79% (56/78) , χ2=4.71, P=0.030]. There was no significant difference in the disease control rate between the two groups [94.64% (53/56) vs. 91.03% (71/78) , χ2=0.21, P=0.651]. There was a significant difference in the total incidence of adverse reactions between the sarcopenia and non-sarcopenia group [67.86% (38/56) vs. 47.44% (37/78) , χ2=5.52, P=0.019]. By the end of the follow-up, the 1-, 3- and 5-year overall survival (OS) rates of 134 elderly patients with esophageal cancer who received radical radiotherapy were 91.0%, 73.1% and 55.2% respectively. The median OS of patients in the sarcopenia and non-sarcopenia group were 14 months and 26 months respectively, with a statistically significant difference ( χ2=9.84, P=0.002) . The median progression-free survival (PFS) of the two groups were 7 months and 18 months respectively, with a statistically significant difference ( χ2=9.91, P=0.002) . Univariate analysis showed that cT stage ( HR=2.45, 95% CI: 1.26-4.74, P=0.008) , cN stage ( HR=1.63, 95% CI: 1.06-2.50, P=0.027) , cTNM stage ( HR=2.04, 95% CI: 1.28-3.27, P=0.003) , body mass index (BMI) ( HR=2.23, 95% CI: 1.01-4.90, P=0.046) , pre-radiotherapy sarcopenia ( HR=2.45, 95% CI: 1.27-4.72, P=0.007) and chemotherapy ( HR=0.30, 95% CI: 0.11-0.83, P=0.020) were prognostic factors for OS; cT stage ( HR=2.27, 95% CI: 1.18-4.39, P=0.015) , cN stage ( HR=1.61, 95% CI: 1.04-2.47, P=0.030) , cTNM stage ( HR=1.90, 95% CI: 1.19-3.02, P=0.007) , BMI ( HR=1.98, 95% CI: 1.06-3.79, P=0.032) , pre-radiotherapy sarcopenia ( HR=1.79, 95% CI: 1.06-3.04, P=0.031) and adverse reactions ( HR=0.60, 95% CI: 0.38-0.97, P=0.037) were prognostic factors for PFS. Multivariate analysis showed that pre-radiotherapy sarcopenia ( HR=1.91, 95% CI: 1.22-3.00, P=0.005) was an independent prognostic factor for OS; BMI ( HR=1.80, 95% CI: 1.03-3.15, P=0.039) and pre-radiotherapy sarcopenia ( HR=2.00, 95% CI: 1.27-3.14, P=0.003) were independent prognostic factors for PFS. Conclusion:Sarcopenia before radiotherapy can be a useful predictor for prognosis in elderly patients with esophageal cancer who received radical radiotherapy, and patients with sarcopenia benefit less from treatment.

Risk factors for syncope in children with severe idiopathic pulmonary arterial hypertension / 中华儿科杂志

Objective: To explore the risk factors for syncope in children with severe idiopathic pulmonary arterial hypertension (IPAH). Methods: Forty-four patients (age<18 years) with IPAH admitted to the Department of Pediatric Cardiology, Beijing Anzhen Hospital between May 2011 and October 2021 were retrospectively included. Patients were devided into syncope group and non-syncope group. Clinical manifestation and hemodynamic parameters including echocardiography, blood tests, right heart catheterization and acute pulmonary vascular expansion test were compared between two groups. Comparisons between groups were performed with unpaired Student t test, or Mann-Whitney U test or chi-square test. Logistic regression was used to calculate the odds ratio (OR) for parameters with statistically significant differences between groups and analyze the statistical correlation. Results: Among the 44 patients, 16 were males, the onset age was (7.2±3.9) years. Twenty-four (55%) children presented with 1 to 11 times of episodes of syncope, and 18 cases of whom induced by physical activity. Syncope group had a larger proportion of New York Heart Association (NYHA) heart function class Ⅲ-Ⅳ (67% (16/24) vs. 25% (5/20), χ2=7.59, P=0.006), higher brain natriuretic peptide (BNP) value ((251±39) vs. (61±40) pg/L, t=-2.18, P=0.035), higher pulmonary-to-aorta diameter ratio (1.6±0.4 vs. 1.4±0.2, t=-2.25, P=0.030) and larger pulmonary vascular resistance index ((22±11) vs. (16±7) WU/m2, t=-2.13, P=0.039) compared with non-syncope group. The proportion of patent foramen ovale (4% (1/24) vs. 45% (9/20), χ2=10.36, P=0.001), left ventricular ejection fraction (LVEF) ((68±5)% vs. (72±8)%, t=2.23, P=0.031) and the positive rate of acute pulmonary vascular expansion test (8% (2/24) vs. 35% (7/20), χ2=4.77, P=0.029) of syncope group were significantly lower than those of non-syncope group. Multiple Logistic regression analysis showed that NYHA heart function Ⅲ-Ⅳ (OR=6.787, 95%CI 1.445-31.880), pulmonary vascular resistance index (OR=1.247, 95%CI 1.020-1.525) and BNP (OR=1.036, 95%CI 1.007-1.066) were independent risk factors for syncope. The patent foramen ovale (OR=0.010, 95%CI 0.000-0.586) was a protective factor for syncope. Conclusions: NYHA cardiac function grade, pulmonary vascular resistance index and BNP are independent risk factors for syncope. Patent foramen ovale is a protective factor for syncope. Exercise is the main inducement of syncope in children with IPAH.

Surgical treatment of primary acute angle-closure glaucoma during COVID-19 disease outbreak in Wuhan / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To summarize the characteristics and treatment of primary acute angle-closure glaucoma during the outbreak of corona virus disease 2019(COVID-19)in Wuhan.<p>METHODS: Five patients(9 eyes)with primary acute angle-closure glaucoma(APACG)of our hospital were enrolled. Eight eyes with sustained high intraocular pressure(IOP)were given phacoemulsification with goniosynechialysis and one eye in preclinical phase was given YAG laser iridectomy from March 3-20, 2020. The preoperative and postoperative IOP, visual acuity, hospitalization days and complications were reviewed and analyzed.<p>RESULTS: Three out of five APACG cases were binocular attack. The onset time was 12-40(25.2±11.82)d. The IOP(48.38±3.22mmHg)of eight eyes decreased significantly after surgeries(12.63±1.68mmHg), the difference was statistically significant(<i>t</i>=12.192, <i>P</i><0.01). The hospitalization time was 2-6(3.8±1.48)d. No COVID-19 infection or severe complications were observed. <p>CONCLUSION:During the epidemic of COVID-19, phacoemulsification with goniosynechialysis is able to reduce IOP of APACG patients who suffered from longer, heavier and binocular attack in the epidemic area effectively and safely. Strict prevention management can effectively ensure the safety of medical staff and patients, but also increase the difficulty of the surgeries meanwhile.

Analysis of risk of endobronchial biopsy-induced bleeding in different locations of lung cancer / 中国医师杂志

Objective:To investigate risk of endobronchial biopsy (EBB)-induced bleeding in different locations of lung cancer.Methods:The clinical data of 643 patients diagnosed with lung cancer were collected from January 2014 to February 2018. The association of lesions of location with the risk of EBB-induced bleeding was evaluated using multivariate regression analysis adjusted for demographics, tumor characteristics, and comorbidities.Results:After adjusting for sex, age, smoking history, pathological type and stage of tumor, complications [chronic obstructive pulmonary disease (COPD), hypertension, diabetes and coronary heart disease], platelet count, prothrombin time and activated partial thromboplastin time, multivariate regression analysis showed that compared to incidence of EBB-induced bleeding in right lower bronchus, the odds ratio (95% confidence interval) of left main bronchus, left upper bronchus, left lower bronchus, right main bronchus, right upper bronchus, right middle bronchus, right middle lobar bronchus and the trachea were 5.24(2.23, 12.31), 2.08(1.14, 3.80), 1.93(1.01, 3.67), 2.92(1.14, 7.47), 1.81(1.00, 3.30), 4.91(1.94, 12.45), 1.33(0.48, 3.63) and 2.19(0.58, 8.30).Conclusions:Patients with lung cancer located in the central airways were more likely to bleed upon EBB when compared lesions located in the peripheral bronchi. Lesions located in left main bronchus, left upper bronchus were the most likely to bleed upon EBB among the central airways and peripheral bronchi, respectively.

Study on the mechanism of Yishen-Qingli granule in treating IgA nephropathy based on network pharmacology / 国际中医中药杂志

Objective:To explore the molecular mechanism of Yishen-Qingli granules in treating IgA nephropathy through network pharmacology. Methods:The relevant components and functional targets of 8 Chinese herbs of Yishen-Qingli granules were screened through the TCMSP. The functional targets were converted into genes in the Uniprot database. Cytoscape 3.6.0 was used to construct the active ingredients-target network; screening IgA nephropathy-related targets through the Human Genome Database (GeneCards), importing drug and disease targets data into Venny2.1 software for intersection, and uploading the shared targets to the STRING platform to build a protein interaction network. With the help of bioinformatics resource database, GO and KEGG enrichment analysis were carried out on the generated results, and the multi-dimensional network of " Yishen-Qingli granule composition target signal pathway" was constructed. Results:69 active ingredients were screened, including ginsenoside, beta-sitosterol, sitosterol, and quercetin. There were 94 Yishen-Qingli granules for IgA nephropathy, including 30 core targets, including JUN, TNF, TP53, AKT1, and IL-6. KEGG enrichment analysis mainly involve three pathways, namely PI3K-Akt pathway, TNF inflammation pathway and MAPK pathway. Conclusions:Yishen-Qingli granules can treat IgA nephropathy in multi-component, multi-target and multi-pathway way. This study initially explored the therapeutic mechanism of Yishen-Qingli granules through network pharmacological analysis, and laid the foundation for further experimental research.

Clinical analysis of 19 mullerian adenosarcoma of uterus / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the clinical characteristics and treatment experience of mullerian adenosarcoma ofuterine.METHODS:A retrospective analysis was conducted on the clinical data of 19 women with Mullerianadenosarcoma of uterus between January 2005 and December 2015.RESULTS:The patients were 28 to 70 years old,withan average of 51.9 years old.9 were premenopause and 10 were postmenopause.The main clinical features are abnormalvaginal bleeding and cervical neoplasms.Preoperative b-ultrasound examination showed abnormal findings in 11 patientsand MRI examination in 8 patients.Sixteen patients received preoperative pathological examination(diagnosticcurretage or cervical biopsy),and the diagnosis accuracy reached 87.5%.Seventeen patients received surgical treatmentand 7 patients received postoperative chemotherapy.The patients were followed up until June 2018,for 11 to 148 months,and 7 died,of which one died from complicated renal failure and 6 died in 5 years after surgery.4 were lost to follow-up,and 8 survived.CONCLUSION:Clinical symptoms of Mullerian adenosarcoma of the uterus are not typical,and abnormalvaginal bleeding is often the first symptom.Endometrial curettage or cervical biopsy can improve the clinical diagnosisrate,and surgery and chemotherapy are the main treatment.

Correlation between galectin-3 level in bronchoalveolar lavage fluid and cellular immunity in children with refractory Mycoplasma pneumoniae pneumonia / 中国当代儿科杂志

OBJECTIVE@#To study the correlation of galectin-3 level in bronchoalveolar lavage fluid (BALF) with Mycoplasma pneumoniae (MP) load and cellular immunity of neutrophils and macrophages in the airway in children with refractory MP pneumonia (RMPP).@*METHODS@#A total of 64 children with RMPP who were hospitalized from January 2013 to January 2017 were enrolled. In addition to the conservative medical treatment, all the 64 children with RMPP were given bronchoalveolar lavage in the acute stage (5-7 days after admission) and 48 out of the 64 children were given bronchoalveolar lavage in the recovery stage (10-14 days after admission). Four milliliters of BALF of the affected lung lobe or segment were collected. ELISA was used to measure the level of galectin-3 in BALF supernatant. RT-PCR was used to measure MP load. Hematoxylin and eosin staining was used to measure the percentage of neutrophils and macrophages. Six children with bronchial foreign bodies were enrolled as the control group.@*RESULTS@#The RMPP group had a significantly higher level of galectin-3 in BALF in both the acute and recovery stages than the control group (P0.05). The RMPP group had a significantly higher MP load in BALF in both the acute and recovery stages than the control group (P<0.01), and the MP load in the acute stage was significantly higher than in the recovery stage (P<0.01). In the children with RMPP, galectin-3 level in BALF in the acute stage was positively correlated with MP load and the percentage of neutrophils (r=0.789 and 0.726 respectively; P<0.01).@*CONCLUSIONS@#Galectin-3 is involved in the process of airway inflammation in children with RMPP, and the level of galectin-3 in BALF is positively correlated with MP load. RMPP is a cellular immune inflammatory lesion with the increase of neutrophils and the reduction in macrophages. Galectin-3 is closely associated with neutrophil chemotaxis and luminal infiltration in children with RMPP. MP load gradually decreases with the recovery from RMPP, but it is not completely eliminated by the immune system in the recovery stage. MP infection can increase the consumption of macrophages in children with RMPP.

Clinical effects of the in-situ microinvasive revision surgery on the fibrotic filtering bleb with the guidance of UBM / 眼科新进展

Objective To investigate the clinical effects of microinvasive revision surgery on the patients of the fibrotic filtering bleb with the guidance of ultrasound biomicroscopy (UBM).Methods A prospective,nonrandomized clinical controlled trial was conducted,which had 2 groups according to the results from UBM during the same period in our hospital,including the patients with the microinvasive revision surgery (28 patients of 28 eyes,group A) and the in-situ traditional revision surgery of larger incision (27 patients of 27 eyes,group B).The clinical data of the patients were collected and the main observation targets were the change of the postoperative visual acuity (VA),intraocular pressure (IOP),the operation success rate and the complications.Results There were no significant differences in the gender,age,glaucoma types,primary operation modes,postoperative follow-up time and preoperative VA (all P ＞0.05).The average duration of hospital stay,postoperative VA and the postoperative complications of group A were better than those of group B and the differences were statistically significant (all P ＜ 0.05).There was no significant difference in IOP at different time points between the two groups (all P ＞ 0.05).The operative successful rates of the two groups were 64.3％ and 66.6％,respectively(P ＞ 0.05).Conclusion The in-situ microinvasive revision surgery on the basis of the UBM examination is a good choice for patients with the fibrotic filtering bleb of the unlocked inner passageway in the filter aisle and a latent liquid dark cavity that is interlinked with the anterior chamber under the scleral flap or the liquid dark cavity of the capsule.

A longitudinal study about the correlation of cervical length and preterm delivery / 中国医师杂志

Objective To investigate the correlation between cervical length and preterm birth rate in pregnant women with cervical shortening.Methods A group of pregnant women who had had two children in our hospital were included.Both lengths of 24-28 weeks were measured by transvaginal ultrasound during both pregnancies.According to the length of the cervix measured by the vagina during the first trimester and whether it is full-term production,it can be divided into the cervical shortening full-term group,the cervical shortening premature delivery group,the normal cervical full-term group (control group),and the clinical and ultrasound measurements are statistically analyzed.Results The cervical shortening in the preterm group and the cervical shortening in the full-term group were more likely to have cervical reduction in the second pregnancy than in the normal cervical full-term group (P ＜ 0.05).The rate of spontaneous preterm birth in the second trimester of the cervix shortened in the preterm group was the highest (P ＜ 0.05).There was no significant difference in the preterm birth rate of the second pregnancy between the normal uterine cervix group and the cervical shortened term group (P ＞ 0.05).Conclusions In the pregnant women with cervical shortening,cervix shortening occurs.Whether the first child is full-term is the key factor in predicting the second premature birth rate.

Study on prevention effect of Zishen Yutai pill combined with progesterone for threatened abortion in rats

OBJECTIVE@#To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats.@*METHODS@#After pregnancy, 50 SPF female SD rats were selected and divided into control group, model group, progesterone group, Zishen Yutai pill group, and progesterone plus Zishen Yutai pill group (combination group), with 10 rats in each group. The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days. Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days. Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin, continuous for 10 days. Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days, and other treatments were the same as previous two groups. Abortion model were established then and live births, numbers of abortion and average rate of abortion were compared between the five groups. Peripheral blood was collected to detect the estradiol (E2) and progestational hormone (P), and obtain ratio of Th1/Th2 cytokines (IL-2, INF-γ, IL-4, IL-10).@*RESULTS@#Significant more live births of rats were found in the control group compared with other four groups (P  0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group (P < 0.05). The maternal-fetal interface IL - 4/IL - 2, IL - 10/IL - 2 of model group were balanced deviating to Th1, while the IL-4/IL-2, IL-10/IL-2 of progesterone group, Zishen Yutai pill group and joint group were balanced deviating to Th2, and joint group' deviation was better than progesterone group and Zishen Yutai pill group (P < 0.05).@*CONCLUSIONS@#Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion, which can obviously increase contents of maternal serums E2 and P, and regulate the Th1/Th2 balance with a remarkable effect.

Study on prevention effect of Zishen Yutai pill combined with progesterone for threatened abortion in rats

Objective To observe preventive and therapeutic effects and the mechanism of actions on Zishen Yutai pill combined with progesterone on threatened abortion in rats. Methods After pregnancy, 50 SPF female SD rats were selected and divided into control group, model group, progesterone group, Zishen Yutai pill group, and progesterone plus Zishen Yutai pill group (combination group), with 10 rats in each group. The rats of control group and abortion model group were lavaged with 2 mL/kg normal saline on pregnancy day 1 for continuous 10 days. Rats in Zishen Yutai pill group were given 1.575 g/kg/d of Zishen Yutai pill for intragastric administration for continuous 10 days. Rats in progesterone group were given intramuscular injection treatment of 0.1 mL/d progestin, continuous for 10 days. Rats in combination group were given injection therapy of aqueous solution of Zishen Yutai pill for continuous 10 days, and other treatments were the same as previous two groups. Abortion model were established then and live births, numbers of abortion and average rate of abortion were compared between the five groups. Peripheral blood was collected to detect the estradiol (E2) and progestational hormone (P), and obtain ratio of Th1/Th2 cytokines (IL-2, INF-γ, IL-4, IL-10). Results Significant more live births of rats were found in the control group compared with other four groups (P 0.05) but these levels in the control group and Zishen Yutai pill group were significant lower than that of progesterone group and joint group (P < 0.05). The maternal–fetal interface IL – 4/IL – 2, IL – 10/IL – 2 of model group were balanced deviating to Th1, while the IL-4/IL-2, IL-10/IL-2 of progesterone group, Zishen Yutai pill group and joint group were balanced deviating to Th2, and joint group’ deviation was better than progesterone group and Zishen Yutai pill group (P < 0.05). Conclusions Zishen Yutai pill combined with progesterone has a significant control effect for threatened abortion, which can obviously increase contents of maternal serums E2 and P, and regulate the Th1/Th2 balance with a remarkable effect.

Research on the treatment of blood-stasis syndrome of liver meridian with acupuncture based on ancient medical records / 国际中医中药杂志

Objective To discusse the acupuncture treatment of blood-stasis syndrome of liver meridian based on the ancient medical records. Methods Medical records on treatment of blood stasis syndrome of liver meridian were searched in Chinese Medical Classics. Frequency analysis and comprehending analysis were used to study the treatment strategies and methods. Results Among 231 medical records, single acupoint treatment accounts for 47.28%, followed by multi-acupoints treatment accounting for 32.16%. The most used single points are Taichong (15.96%) and Ganshu (11.70%). Yanglingquan point and Zusanli point are used mostly in two-combined acupoints treatment, while Sanyinjiao is mainly used in multi-acupoints treatment. And the liver channel of foot-Jueyin is mainly used in the meridians, accounting for 24%, followed by the bladder meridian of foot-Taiyin. Conclusions The acupuncture treatment is very effective, while the single acupoint and two-combined acupoints are easily used. It can improve the clinical effects.

Clinical features and individualized treatment of 39 cases of adefovir dipivoxil-induced renal hypophosphatemia and osteomalacia / 中华传染病杂志

Objective To investigate the clinical features,early diagnosis and individualized treatment of renal hypophosphatemia and osteomalacia induced by adefovir dipivoxil (ADV) in patients with chronic hepatitis B (CHB).Methods Thirty-nine CHB or hepatitis B virus (HBV)-related cirrhosis patients of renal hypophosphatemia and osteomalacia induced by ADV were consecutively collected.The clinical features were analyzed and treatment outcome was followed up.Results The mean age of the 39 patients was 54 (27-71) years old.There were 26 male and 13 female patients,and 19 patients with cirrhosis.The mean ADV treatment duration was 69 (range 18-116) months,and 31 patients were treated for 36-96 months.The mean serum phosphate was 0.68 (0.42-0.79) mmol/L.Twenty-six cases developed renal hypophosphatemic osteomaolacia,of which 14 had bone pain and 19 had abnormally elevated alkaline phosphatase (ALP).Three patients had increased serum creatinine and 24 patients had decreased estimated glomerular filtration rate (eGFR).After individualized treatment,patients gained normal serum phosphate in mean of 2.0 (range 0.5-6.0) months,and had bone pain remission in the mean of 0.8 (range 0.2-1.0) month and bone pain disappeared in the mean of 1.5 (range 0.5-5.0) months.Function indices of liver and kidney were improved gradually,and the bone mineral density examination improved slowly.Conclusions CHB and HBV-related cirrhosis patients treated with longterm ADV could develop renal hypophosphatemia and hypophosphatemic osteomalacia,which is partially reversible.Monitoring serum phosphate,creatinine and cystatin C is necessary during long-term ADV therapy.After confirmed diagnosis,withdrawal or dosage reduction of ADV,and switch to telbivudine or entecavir should be considered.Meanwhile,serum phosphate and HBV DNA level should be monitored.

Perineuronal net, CSPG receptor and their regulation of neural plasticity / 生理学报

Perineuronal nets (PNNs) are reticular structures resulting from the aggregation of extracellular matrix (ECM) molecules around the cell body and proximal neurite of specific population of neurons in the central nervous system (CNS). Since the first description of PNNs by Camillo Golgi in 1883, the molecular composition, developmental formation and potential functions of these specialized extracellular matrix structures have only been intensively studied over the last few decades. The main components of PNNs are hyaluronan (HA), chondroitin sulfate proteoglycans (CSPGs) of the lectican family, link proteins and tenascin-R. PNNs appear late in neural development, inversely correlating with the level of neural plasticity. PNNs have long been hypothesized to play a role in stabilizing the extracellular milieu, which secures the characteristic features of enveloped neurons and protects them from the influence of malicious agents. Aberrant PNN signaling can lead to CNS dysfunctions like epilepsy, stroke and Alzheimer's disease. On the other hand, PNNs create a barrier which constrains the neural plasticity and counteracts the regeneration after nerve injury. Digestion of PNNs with chondroitinase ABC accelerates functional recovery from the spinal cord injury and restores activity-dependent mechanisms for modifying neuronal connections in the adult animals, indicating that PNN is an important regulator of neural plasticity. Here, we review recent progress in the studies on the formation of PNNs during early development and the identification of CSPG receptor - an essential molecular component of PNN signaling, along with a discussion on their unique regulatory roles in neural plasticity.

The value of serum procalcitonin and C-reactive protein in the differentiation of the cause of fever in cancer patients / 国际检验医学杂志

Objective To evaluate the value of serum procalcitonin(PCT ) and C-reactive protein(CRP) analysis in the differenti-ation of the cause of fever in cancer patients .Methods 218 cases with fever enrolled were divided into three groups ,including bacte-rial infection group ,viral infection group and tumor related fever group .The positive rates of white blood cell(WBC) count ,percent-age of neutrophil ,PCT and CRP were determined and there correlations were analyzed .Results The positive rates of WBC count , percentage of neutrophil ,PCT and CRP in bacterial infection group were significantly increased compared to viral infection group and tumor related fever group(P<0 .05) .The positive rate of PCT in tumor related fever group was also statistically significant difference compared to viral and bacterial infection group(P<0 .05) .The sensitivity of PCT was 97 .83% and the specificity of PCT was 83 .33% .Conclusion PCT and CRP can help identify causes of fever in cancer patients .PCT has better sensitivity and specific-ity ,it can help anti-infective and provide experimental evidence for tumor treatment ,and also help determine the disease outcome and clinical deterioration .

Survey on common pediatric drugs for renal diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>Development and use of better medicine for children is a worldwide problem recently, especially in China. The current situation of drugs for children's renal diseases is far from well-understood now. This survey focused on drugs for pediatric renal diseases including immunosuppressants, corticosteroids, diuretics, anticoagulants, hypotensives and antilipemic agents.Information regarding the dosage, form, precaution, usage and administration in inserts was collected in this study.</p><p><b>METHOD</b>Drugs for pediatric renal diseases were selected according to the guidelines established by the Chinese Society of Pediatric Nephrology. The detailed information about the dosage, form of drugs was searched on the website of China-State Food and Drug (SFDA). The information of the precaution, usage and administration was obtained from the China Pharmaceutical Reference, the first edition.</p><p><b>RESULT</b>In this study, there were 5 categories of medicine including immunosuppressants, corticosteroids, diuretics, anticoagulants, hypotensives and antilipemic agents, and 89 kinds of medicine for renal diseases. Among these medicines, 65.2% were found not suitable for children in terms of drug dosage and form, 19.1% did not indicate the precaution, 51.7% did not indicate clearly the safety and effectiveness for children, and 56.2% lacked the detailed information about the usage and administration for children. There were only 4 kinds of these medicines which were studied via clinical trials in children population.</p><p><b>CONCLUSION</b>There is a lack of drugs for children with renal diseases. Most of the time, the medicines used by doctors are not specially manufactured for children. The safety and efficacy of drugs that are currently used to treat pediatric renal diseases are not clear and definite.In addition, few clinical trials have been conducted for evaluation of drugs for pediatric renal diseases.In clinic, the situation of off-label drug treatment is very serious.</p>