Electroacupuncture improves motor function of rats with osteoarthritis by alleviating joint inflammation through the Wnt-7B/β-catenin signaling pathway / 南方医科大学学报

OBJECTIVE@#To investigate the effect of electroacupuncture on osteoarthritis in rats and explore the possible mechanism.@*METHODS@#Thirty SD rats were randomly divided into osteoarthritis model group, electro-acupuncture group and control group (n=10), and in the former two groups, early osteoarthritis was induced using a modified DMM surgical modeling method. After successful modeling, the rats in the electro-acupuncture group were treated with electro-acupuncture at bilateral "Housanli" and "Anterior knee point". Behavioral tests of the rats were performed and scored using the LequesneMG scale. Subchondral bone degeneration was observed in each group, and serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP were measured using ELISA. The mRNA and protein expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7, and MMP-3 in the cartilage tissue of the knee joints were detected using RT-PCR and Western blotting.@*RESULTS@#In behavioral tests, the rats in the model and electroacupuncture groups had significantly higher LequesneMG scores after modeling than those in the control group (P < 0.05). After 20 days of treatment, LequesneMG scores were significantly lowered in rats in the electroacupuncture as compared with the model rats (P < 0.05). Imaging examination revealed obvious subchondral bone damage in both the electroacupuncture group and the model group, but the damages were significantly milder with former group. Compared with the model rats, the rats receiving electroacupuncture had significantly lower serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP (P < 0.05) with also lower expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7 and MMP-3 in the cartilage tissues at both the mRNA and protein levels (P < 0.05).@*CONCLUSION@#Electroacupuncture can alleviate joint pain and improve subchondral bone damage in rats with osteoarthritis by reducing IL-1β levels in the joint cartilage tissue and serum to alleviate joint inflammation and by reducing such cytokines as ADAMTS-7 and MMP-3 via regulating the Wnt-7B/β-catenin signaling pathway.

Inhibitory Effect of Liuwei Dihuangwan on Triple-negative Breast Cancer Through MAPKKK1 and KLF4 / 中国实验方剂学杂志

ObjectiveTo study the underlying mechanism of Liuwei Dihuangwan in inhibiting triple-negative breast cancer through mitogen-activated protein kinase kinase kinase 1 （MAPKKK1） and Krüppel-like factor 4 （KLF4）. MethodFour hundreds SPF female Kunming mice aged 11.5 months were palpated once every 3 days. The model mice of spontaneous tumors were randomly divided into a model group （normal saline）， a paclitaxel group （0.025 g·kg-1·d-1， ip， 21 days）， and high-， medium- and low-dose Liuwei Dihuangwan groups （7.2， 3.6， 1.8 g·kg-1·d-1， ig）. Tumor tissues were separated until the moribund stage. The tumor volume and weight were measured， and the tumor inhibition rate and the survival time of the tumor mice were calculated （after 6 months， tumor-free mice were assigned into the normal group）. SPF SD rats were selected to prepare serum samples containing Liuwei Dihuangwan of different concentrations for cell culture， and MAPKKK1 in MDA-MB-231 cells was silenced. The protein expression of MAPKKK1 and KLF4 was detected by immunofluorescence and Western blot. ResultThe in vivo experimental results showed that compared with the conditions of the normal group， the protein expression of MAPKKK1 and KLF4 in tumor tissues of the model group dropped （P<0.01）. Compared with the model group， all medication groups showed reduced tumor volume and weight （P<0.05， P<0.01）， increased tumor inhibition rate， prolonged survival time of tumor mice （P<0.05）， and increased protein expression of MAPKKK1 （P<0.01）. Additionally， the paclitaxel group and the high-dose Liuwei Dihuangwan group exhibited increased protein expression of KLF4 （P<0.01）. The in vitro experiments showed that compared with the conditions of the normal group， the fluorescence intensities of MAPKKK1 and KLF4 in MDA-MB-231 cells in all medication groups were potentiated， and the protein expression of MAPKKK1 in the paclitaxel group and the high- and medium-dose Liuwei Dihuangwan groups， and the protein expression of KLF4 in the paclitaxel group and high-dose Liuwei Dihuangwan group increased （P<0.01）. After silencing of MAPKKK1， compared with the conditions of the negative plasmid group （unsilenced MAPKKK1）， the fluorescence intensities of MAPKKK1 and KLF4 and the protein expression decreased in the RNAi-27 positive plasmid group （silenced MAPKKK1） （P<0.05， P<0.01）. Compared with the RNAi-27 positive plasmid group， all medication groups had enhanced fluorescence intensities of MAPKKK1 and KLF4 and protein expression to different degrees （P<0.05， P<0.01）. ConclusionLiuwei Dihuangwan can inhibit the growth of triple-negative breast cancer， and the underlying molecular mechanism is related to the up-regulation of MAPKKK1 and activation of KLF4 expression.

Application analysis of quantitative fecal immunochemical test in opportunistic screening of colorectal cancer / 中华消化杂志

Objective:To analyze and evaluate the application of quantitative fecal immunochemical test(FIT) in opportunistic screening of colorectal cancer in asymptomatic population undergoing health checkups.Methods:From January 1, 2018 to December 31, 2021, at the Health Management Center of the First Affiliated Hospital of Soochow University, 53 319 subjects who underwent routine health checkups and with quantitative FIT opportunistic screening for colorectal cancer were selected. Those with positive quantitative FIT results and received colonoscopy were enrolled in the FIT positive group, and those with negative quantitative FIT results and received colonoscopy were enrolled in the FIT negative group. The participation rate and positive rate of quantitative FIT were analyzed. The results of colonoscopy and pathological findings were taken as the gold standard, including normal, non-polyposis lesions, polyposis (hyperplastic and(or) inflammatory polyps, non-advanced adenoma, advanced adenoma), and colorectal cancer, the detection rates of various lesions of the FIT positive and negative groups, the quantitative FIT measurement value of subjects, and the sensitivity and negative predictive value of quantitative FIT for colorectal cancer and advanced adenoma were analyzed. The receiver operating characteristic curve (ROC) was drawn and the area under the curve (AUC) was calculated, the screening efficacy of quantitative FIT for colorectal cancer and advanced adenoma was evaluated. Chi-square test or Fisher exact probability method and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 51 420 cases had completed quantitative FIT, and the total participation rate was 96.44% (51 420/53 319). Quantitative FIT was positive in 2 483 cases (4.83%). The participation rate of colonoscopy in FIT positive group was 26.22% (651/2 483), of which 540 cases were enrolled in FIT positive group. The colonoscopy participation rate of FIT negative group was 1.18% (576/48 937), of which 523 cases were enrolled in the FIT negative group. The detection rates of colorectal cancer and advanced adenoma in FIT positive group were both higher than those of the FIT negative group(3.9%, 21/540 vs. 0, 0/523; 16.1%, 87/540 vs. 3.3%, 17/523), and the differences were statistically significant(Fisher exact probability method and χ2=49.79; both P<0.001). Populations with quantitative FIT values from high to low were those with colorectal cancers, advanced adenomas, non-polyp lesions, non-advanced adenomas, normal, and hyperplastic and (or) inflammatory polyps (1 052.0 ng/mL(390.5 ng/mL, 3 058.0 ng/mL); 294.5 ng/mL (116.8 ng/mL, 951.8 ng/mL); 131.5 ng/mL (10.5 ng/mL, 327.3 ng/mL); 97.0 ng/mL (11.0 ng/mL, 238.0 ng/mL); 20.0 ng/mL (0.0 ng/mL, 175.3 ng/mL); 14.0 ng/mL (0.0 ng/mL, 171.0 ng/mL)), and the difference was statistically significant( H=120.53, P<0.001). The sensitivities(95% confidence interval (95% CI)) of quantitative FIT in colorectal cancer and advanced adenoma were 100.0%(80.8% to 100.0%) and 83.6%(74.8% to 89.9%), respectively. The negative predictive values (95% CI) were 100.0%(99.1% to 100.0%) and 96.7%(94.7% to 98.0%), respectively. The results of ROC analysis showed that the AUCs(95% CI) of quantitative FIT in colorectal cancer and advanced adenoma were 0.874(0.820 to 0.928) and 0.723(0.675 to 0.770), respectively. Conclusions:In this study, the participation rate of quantitative FIT is high. More patients with advanced adenomas and colorectal cancers are found in the high risk popolation with positive quantitative FIT. Quantitative FIT has a good sensitivity and a negative predictive value for colorectal cancer and advanced adenoma. Therefore, positive quantitative FIT-colonoscopies sequential screening should be advocated in population undergoing health checkups for colorectal cancer screening, and it may be applicable to large-scale population screening in China.

A child suffering from severe acute respiratory distress syndrome due to multiple trauma was treated with veno-veous extracorporeal membrane oxygenation with the dual lumen cannula: a case report / 中华危重病急救医学

Veno-veous extracorporeal membrane oxygenation (VV-ECMO) has been widely used in the treatment for severe acute respiratory distress syndrome (ARDS). Up to now, the routine access to establish VV-ECMO involves two-sites single lumen cannula via femoral vein and internal jugular venous in adult and children, while few studies about the dual lumen cannula (DLC) in VV-ECMO implemented in adult and children have been reported. On December 16, 2021, an unconscious child with severe ARDS due to multiple trauma caused by fatal falling from a height was admitted to Taihe Hospital. The initial diagnosis was hemorrhagic shock, bilateral hemopneumothorax, sternal fracture, cavity organ perforation, splenic rupture, and pelvic fracture and severe ARDS. Despite mechanical ventilation, he progressed to refractory hypoxemia and was treated with VV-ECMO after successful DLC placement in the right internal jugular vein by the mobile ECMO team of intensive care unit of the Union Hospital eventually. In addition, he received endoscopic sputum aspiration, prone position ventilation, anti-infection and nutritional treatment. His oxygenation gradually improved and he was successfully weaned from ECMO after 11 days. In this case, DLC simplified the process without any related complications, suggesting that it can be safely and effectively used in the treatment of Child's severe ARDS.

Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

Forensic Application of Plant Evidence / 法医学杂志

With the increasingly obvious role of plant evidence in case detection, forensic botany, which provides clues and evidence in crime scene investigation by using botanical research method has attracted growing attention. The common experimental techniques used in forensic botany are morphological examination, physical and chemical examination, molecular genetic examination, and so on. This paper briefly expounds the advantages and disadvantages of different test methods, summarizes the problems that need to be paid attention to in the application of forensic botany by arranging the related literatures and cases of forensic botanical research, in order to provide reference for scene investigation of cases.

Clinical Efficacy on Erchentang Combined with Sanzi Yangqintang in Treatment of Cough Variant Asthma in Children with Phlegm Evil Accumulation Lung Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Erchentang combined with Sanzi Yangqintang in the treatment of cough variant asthma （CVA） in children with phlegm-evil accumulation lung syndrome and its influence on airway inflammation and airway hyperresponsiveness （AHR）. Method:A total of one hundred and sixteen children were randomly divided into observation group and control group 58 cases in each group. Patients in both groups took montelukast sodium chewable tablets orally， 5 mg/time， once daily， at night before bedtime. In observation group， patients took Erchentang and Sanzi Yangqintang modified granules orally. While patients in control group took Erchentang and Sanzi Yangqintang placebo granules orally. Treatment course continued six weeks for two groups. Before and after treatment， the cough symptom scores and phlegm evil accumulating lung syndrome scores were recorded every week. The cough remission time and cough disappearance time were recorded， followed up for 24 weeks to record cough recurrence. Leicester Cough quality of life questionnaire （LCQ） was scored before and after treatment. The ratio of induced sputum eosinophils （EOS） and the levels of interleukin-4 （IL-4）， IL-5， IL-12， IL-13 were measured before and after treatment. The cumulative doses of exhaled nitric oxide （FeNO） and methacholine （PD20） were measued before and after therapy. Safety evaluation was conducted. Result:The scores of cough symptom and phlegm-evil accumulation lung syndrome at different time points were decreased gradually in two groups of children after treatment （<italic>F</italic>_{control group}=5.277， <italic>F</italic>_{observation group}=7.636，<italic>P</italic><0.01）. The scores of cough symptom and phlegm-evil accumulation in the lung syndrome of observation group were lower than those in control group （<italic>P</italic><0.01） at the same period. The durations of cough relief and cough disappearance in observation group were shorter than those in control group （<italic>P</italic><0.01）. Within 24 weeks of follow-up， the recurrence rate of children in observation group was 68.97% （40/58）， lower than 84.48% （49/58） in control group （<italic>χ</italic>²=3.917，<italic>P</italic><0.05）. Children in observation group had fewer relapses than those in control group （<italic>P</italic><0.01）. The total LCQ scores and scores of all dimensions in observation group were higher than those in control group （<italic>P</italic><0.01）. The EOS， IL-4， IL-5 and IL-13 levels in observation group were lower than the data in control group， and IL-12 level was higher than that in control group （<italic>P</italic><0.01）. FeNO of children in observation group was lower than that in control group （<italic>P</italic><0.01）， while PD20 was more than that of control group （<italic>P</italic><0.01）. The total effective rate of clinical curative effect of children in observation group was 96.55% （56/58）， which was higher than 82.76% （48/58） in control group （<italic>χ</italic>²=5.948，<italic>P</italic><0.05）. Conclusion:Erchentang combined with Sanzi Yangqintang for children with CVA phlegm evil accumulation lung syndrome can further control the symptoms of cough， shorten the course of cough， improve the quality of life， and reduce airway inflammation and AHR， reduce the recurrence rate. The clinical efficacy is better than using montelukast only， and it is safe and has good clinical value.

The long-term effect of hip replacement and vitamin D in the treatment of elderly osteoporotic femoral neck fractures and its effect on the level of BMP-7/25- (OH) -D-3 / 中华内分泌外科杂志

Objective:To explore the long-term effect of hip replacement and vitamin D in treatment of elderly osteoporotic femoral neck fractures and the transfection of bone morphogenetic protein-7 (BMP-7) /25 hydroxy vitamin D3[ (25- (OH) ) -D3] level.Method:Data of 108 elderly osteoporotic femoral neck fracture patients admitted from Jan. 2018 to Jan. 2020 were selected, and they were divided them into the observation group (hip replacement adjuvant vitamin D treatment) and control group (hip replacement treatment) , 54 cases in each group. All subjects were followed up for 1 year to observe the long-term treatment efficacy and SF-36 scores of the two groups of patients. Before treatment and 1, 3, 6, and 12 months after treatment, the differences in the changes in lumbar and hip bone mineral density, hip joint Harris score, BMP-7, and 25- (OH) -D3 levels were compared between the two groups.Results:12 months after treatment, the long-term treatment effect of the observation group was significantly higher than that of the control group ( P<0.05) ; 1, 3, 6, 12 months after treatment, for the lumbar and hip bone mineral density, SF-36 score, hip Harris score, BMP-7, 25- (OH) -D3 levels of the two groups of patients over time, the degree of increase was not equal, but the treatment group had the greater degree of improvement ( P<0.01) . Conclusion:Hip joint replacement and vitamin D have a good long-term effect in treatment of elderly osteoporotic femoral neck fractures, which can significantly increase bone density and improve BMP-7 and 25- (OH) -D3 levels.

Establishment and internal validation of preoperative nomograms for predicting the possibility of testicular salvage in patients with testicular torsion / 亚洲男科学杂志(英文版)

This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage (TS) in patients with testicular torsion. The clinical data of 204 patients with testicular torsion diagnosed at Xijing Hospital and Tangdu Hospital (Xi'an, China) between August 2008 and November 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the independent predictors of TS. Based on multivariate regression coefficients, nomograms to predict possibility of TS were established. The predictive ability of the nomograms was internally validated by receiver operating characteristic (ROC) curves and calibration plots. The duration of symptoms ranged from 2 h to 1 month, with a median of 3.5 days. Thirty (14.7%) patients underwent surgical reduction and contralateral orchiopexy, while the remaining 174 (85.3%) underwent orchiectomy and contralateral orchiopexy. Finally, long symptom duration was an independent risk predictor for TS, while visible intratesticular blood flow and homogeneous testicular echotexture under color Doppler ultrasound were independent protective predictors. Internal validation showed that the nomograms, which were established by integrating these three predictive factors, had good discrimination ability in predicting the possibility of TS (areas under the ROC curves were 0.851 and 0.828, respectively). The calibration plots showed good agreement between the nomogram-predicted possibility of TS and the actual situation. In conclusion, this brief preoperative prediction tool will help clinicians to quickly determine the urgency of surgical exploration.

Value of lactate dehydrogenase in predicting refractory Mycoplasma pneumoniae pneumonia in children: an evaluation based on decision curve analysis and dose-response analysis / 中国当代儿科杂志

OBJECTIVE@#To study the value of lactate dehydrogenase (LDH) in predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children.@*METHODS@#Propensity score matching was used to select 73 children with RMPP (refractory group) and 146 children with non-refractory Mycoplasma pneumoniae pneumonia (common group). The logistic regression analysis, restricted cubic spline model, and decision curve analysis were used to analyze the clinical value of LDH in predicting RMPP.@*RESULTS@#There were significant differences in the incidence of high fever, white blood cell count, platelet count, percentage of neutrophils, and serum levels of C-reactive protein, procalcitonin, hemoglobin, albumin, glutamic-pyruvic transaminase, aspartate aminotransferase and LDH (P<0.05). There were also significant differences between the two groups in the Mycoplasma pneumoniae-DNA load in nasopharyngeal aspirates and the incidences of pleural effusion, pulmonary consolidation, atelectasis, shortness of breath and skin lesions (P<0.05). The multivariate logistic regression analysis showed that high fever, hemoglobin level, LDH level, and pulmonary consolidation were independent predictive factors for RMPP (OR=10.097, 0.956, 1.006, and 3.756; P<0.05). The results of the restricted cubic spline analysis showed a non-linear dose-response relationship between the continuous changes of LDH and the development of RMPP (P<0.01). The decision curve analysis showed that LDH had an important clinical value in predicting RMPP.@*CONCLUSIONS@#LDH is an independent predictive factor for the development of RMPP and its intensity of association with the development of RMPP exhibits a non-linear dose-response relationship.

Clinical application of new donor blood biomarker in the evaluations of delayed graft function after donor-after-cardiac-death kidney transplantation / 中华器官移植杂志

Objective:To explore the relationship between new biomarkers in donor blood and delayed graft function after kidney transplantation and evaluate the clinical value of new biomarkers in the diagnosis of DGF (delayed graft function).Methods:For recipients of donor kidney transplantation from August 2016 to December 2017, blood samples were collected from operations of donor organ resection within 12 hours of the day. Enzyme-linked immunosorbent assay (ELISA) was employed for detecting neutrophil gelatinase-associated lipocalin (NGAL), L-type fatty acid binding protein (L-FABP), kidney injury molecule-1 (KIM-1) and interleukin-18(IL-18). They were divided into DGF and EGF (early graft function) groups according to the diagnosis of DGF. The inter-group differences of four new biomarkers were calculated. Receiver operating characteristic curve (ROC curve) was plotted for finding the best positive cutoff value and the sensitivity and specificity of new donor blood marker for diagnosing delayed graft function were calculated.Results:Among them, 8 had postoperative DGF and 62 had none. The overall incidence of DGF was 11.43%. The serum concentration of NGAL was 521.01±132.84 ng/ml in DGF group versus (299.99±100.03) ng/ml in EGF group ( P<0.001). The ROC curve was plotted. With a NGAL concentration >425.15 ng/ml, the sensitivity and specificity for diagnosing DGF were 87.5% and 90.3% respectively. The area under the curve (AUC) was 0.891. The serum concentration of IL-18 was (14.10±12.36) ng/ml in DGF group and (4.61±1.83) ng/ml in EGF group ( P=0.047). With a IL-18 concentration of >5.345 ng/ml, the sensitivity and specificity for diagnosing DGF were 100% and 64.5% respectively. The AUC was 0.914. No significant inter-group difference existed in serum L-FABP/KIM-1. The sensitivity of donor creatinine in the diagnosis of DGF was 62.5%, specificity 75.8% and AUC 0.692. Conclusions:With an excellent level of sensitivity and specificity, an elevated concentration of NGAL/IL-18 in donor blood is superior to traditional creatinine in the diagnosis of DGF after renal transplantation.

De novo donor specific antibody affect the prognosis of kidney transplant recipients:retrospective study / 中华器官移植杂志

Objective To explore the relationship between positive rate of de novo donor specific antibody (dnDSA ) and human leukocyte antigen (HLA ) mismatch after kidney transplantation and explore the impact of dnDSA upon long-term graft survival and rejection .Methods Retrospective analysis was conducted for clinical data of 101 kidney transplant recipients .Based upon HLA antibody and dnDSA ,they were divided into three groups of HLA-(n=70) ,dnDSA- (n=23) and dnDSA+(n=8) .Rejection and graft survival were recorded for evaluating the impact of dnDSA on rejection and graft survival and observing the differences among all groups .Results The mismatchs of HLA-A/B and HLA-DR were more frequent than HLA-and dnDSA-groups(P=0 .047 , P=0 .010)and graft survival was lower in dnDSA+ group than HLA-and dnDSA-groups (P=0 .001) .The rejection rate was higher in dnDSA+ group (62 .5％ ) than HLA- group (8 .57％ ) and dnDSA-group (8 .69％ ) . The difference was statistically significant (P=0 .013) . Pathological examination indicated microcirculatory inflammation (glomerulonephritis & trichodangiitis ) and damage (multilayer change of capillary basement membrane) occurred frequently in dnDSA + group and C4d remained positive . However ,scar ,arterial fibrosis or tubulointerstitial inflammation was not correlated with dnDSA . Conclusions HLA mismatch is correlated with dnDSA positivity . And dnDSA may reduce graft survival and enhance rejection rate . Rejection mediated by dnDSA is often accompanied by microcirculatory inflammation and C4d positivity .

The prevent miscarriage effects of Yun Kang oral liquid on threatened abortion rat induced by kidney deficiency and luteum inhibition / 中国应用生理学杂志

OBJECTIVE@#Yun Kang oral liquid is a listed proprietary Chinese Medicine. To further evaluate its efficacy, this experiment established a kidney deficiency and luteum inhibition threatened abortion rat model to observe the effects of Yun Kang oral liquid.@*METHODS@#Sixty pregnant rats were randomly divided into normal control group (NC), model group (MG), dydrogesterone group (DT, 3.02 mg/kg), and Yun Kang oral liquid low-dose group (YK-L, 4 ml/kg), medium dose group (YK-M, 6 ml/kg), high dose group (YK-H, 9 ml/kg), 10 in each group. On the first day of pregnancy, each administration group was treated with the test drug at the prescribed dose every morning, and the NC group and the MG group were given an equal volume of purified water for 10 days; the rats were intragastrically administrated every afternoon, except for the NC group. In addition, the other groups were intragastrically administered with hydroxyurea at a dose of 450 mg/kg for 9 days, and mifepristone was administered at a dose of 4.0 mg/kg on the 10th day. On the 9th day of pregnancy, behavioral signs such as back temperature, grasping force, pain threshold, and autonomic activity were measured in each group. On the 11th day of pregnancy, blood was collected from the abdominal aorta in each group to determine serum levels of estradiol (E) , progesterone (P) and thromboxane B (TXB) . Ovary and fetal uterus were removed, the number and diameter of embryos were observed, and the ovary and uterus indexes were calculated.@*RESULTS@#Compared with the NC group, the back temperature, grip, pain threshold, number of spontaneous activities, number of embryos, embryo diameter, uterus index and serum E, P, TXB levels in the MG group were decreased significantly (P＜0.05, 0.01). Compared with the MG group, the back temperature, grasping force, number of embryos, embryo diameter and serum E and P levels were increased significantly in each dose group (P＜0.05, 0.01); the pain threshold, autonomic activity, and uterus index of YK-M and YK-H group were increased significantly (P＜0.05); serum level of TXB in YK-H group were increased significantly (P＜0.05).@*CONCLUSION@#Yun Kang oral liquid has a clear kidney-filling effect on rats with threatened abortion caused by kidney deficiency-luteal suppression. The mechanism may be related to raising serum E, P, TXB levels, improving kidney deficiency and improving embryo quality.

Rapamycin-eluting stents for unprotected left main coronary artery stenosis in coronary atherosclerosis in the older adults: study protocol for a prospective, non-randomized, controlled trial and preliminary results / 中国组织工程研究

BACKGROUND: Coronary artery bypass grafting (CABG) is the gold standard therapy for unprotected left main coronary artery (ULMCA) stenosis in coronary atherosclerosis. However, the treatment of ULMCA stenosis using drug-eluting stents has recently been reported to lead to a relatively low incidence of cardiovascular events.Thus,drug-eluting stents are a potential surrogate for CABG,and could become the new gold standard treatment for ULMCA stenosis; however, this issue remains controversial. OBJECTIVE: To explore the safety and efficacy of CABG versus rapamycin-eluting stents for ULMCA stenosis in older adult patients with degenerative coronary atherosclerosis. METHODS: The proposed prospective, non-randomized, controlled trial will include 224 older adult patients with degenerative coronary atherosclerosis with ULMCA stenosis being treated at the Department of Cardiology at Taihe Hospital and Renmin Hospital of Shiyan, China. Patients will be divided into two groups in accordance with each patient’s treatment choice and indications (n=112/group): the stent group will receive rapamycin-eluting stents, while the CABG group will undergo CABG.All patients will be followed up at 9, 12, 24, and 36 months postoperatively. The primary outcome measure will be the rate of repeat revascularizations in the target lesion at 36 months postoperatively.The secondary outcome measures will be the rates of repeat revascularizations in the target lesion at 9, 12, and 24 months postoperatively, the rate of restenosis, mortality, causes of death, and survival at 9, 12, 24, and 36 months postoperatively, and the angiographic appearance of the diseased vessels preoperatively and at 9, 12, 24, and 36 months postoperatively. The safety indicator will be the incidence of major adverse cardiac and cerebrovascular events at 9, 12, 24, and 36 months postoperatively. Eighty-six older adult patients with degenerative coronary atherosclerosis who underwent treatment of ULMCA stenosis between January 2016 and December 2017 were included in a pilot study. Pilot study results showed that the stent group (n=48) had a significantly reduced waiting time for surgery, hospitalization time, and rate of complete revascularizations in the target lesion compared with the CABG group (n=38) (P ＜ 0.05). At 6 months postoperatively, there were no significant differences between the two groups in mortality, and incidences of myocardial infarction, repeat revascularizations in the target lesion, and cardiovascular events. The trial was approved by the Ethics Committee of Taihe Hospital (approval No. TH005X) in July 2017 and by the Ethics Committee of Renmin Hospital of Shiyan (approval No. RM011X) in July 2017. All the patients will provide written informed consent with the premise of fully understanding the treatment plan. The study protocol will follow the relevant laws and regulations of the Declaration of Helsinki and relevant hospital’s ethical principles. Design of the trial was completed in January 2018. Recruitment will be initiated in August 2018 and it is expected to be completed in August 2019. Data analysis will be conducted in October 2022 and the trial will be completed in December 2022. The results of the study will be disseminated through presentations at scientific meetings and/or in peer-reviewed publications. The trial has been registered with the Chinese Clinical Trial Registry (registration No. ChiCTR1800016413) and the version number is 1.0 DISCUSSION: The results of this study will indicate the medium-and long-term efficacy and safety of rapamycin-eluting stents versus CABG in older adult patients with ULMCA stenosis, and then identify which of these two treatments has better prognosis, thereby screening out the optimal strategy for treating ULMCA.

Tannic acid enhances cisplatin-induced apoptosis of hepatocellular carcinoma HepG2 cells by activating ATF6-CHOP pathway / 实用医学杂志

Objective To detect the activation levels of endoplasmic reticulum stress ATF6-CHOP pathway,and to investigate the molecular mechanism of tannic acid (TA) combined with cisplatin (CDDP) against hepatocellular carcinoma.Methods HepG2 cells were cultured with 180 μM TA or/and 0.9 μg/ml CDDP for 24 h or 48 h.The levels of ATF6 (ATF6α),ATF6B (ATF6β) and CHOP were analyzed by real-time fluorescence quantitative PCR (q-RT-PCR) and western blot.Results We found that after 24 h or 48 h,compared with the control group,ATF6 mRNA and protein levels,ATF6B protein level,CHOP mRNA and protein levels were significantly increased in the TA group,CDDP group or combination group (P ＜ 0.01 or P ＜ 0.05).Conclusion TA can combine with CDDP to increase the levels of endoplasmic reticulum stress ATF6-CHOP pathway,and the ATF6-CHOP pathway may be one of the molecular mechanisms synergistic anti-hepatocellular carcinoma effect of TA and CDDP on HepG2 cells.

Tannic acid enhances cisplatin effect against hepatocellular carcinoma HepG2 by endoplasmic reticulum stress pathway / 重庆医学

Objective To investigate the synergistic effects of tannic acid(TA) and cis-dichlorodiamine platinum(CDDP) on hepatocellular carcinoma HepG2 cells and its activation situation of endoplasmic reticulum stress(ERS) pathway.Methods Human hepatocellular carcinoma HepG2 cells were divided into the control group,TA group,CDDP group and TA+CDDP group,and were cultured in vitro for 24 h.The growth inhibitory effect of medication on HepG2 cells was detected by MTT assay.The pharmacodynamics synergistic effect between the two drugs was analyzed by the drug interaction index,drug dose reduction index and equivalent graphical method.The nucleus changes were observed by DAPI staining.Real time fluorescent quantitative PCR(q-RT-PCR) and Western blot were used to detect the levels of ERS markers glucose regulated protein (GRP)78 and GRP94.Results TA and CDDP had dose-dependent growth inhibition effect on HepG2 cells,their median effective concentrations(IC50) were 360.00 μmol/L and 1.80 μg/mL respectively.The combination treatment of 180.00 μmol/L TA and 0.90 μg/mL CDDP on HepG2 cells could enhance the inhibitory effect on cell growth.Ta and CDDP had synergistic effect for inhibiting hepatocellular carcinoma cells growth.Compared with the TA group and CDDP group,cell shrinkage and rounding were accelerated in the combined group,apoptotic cells were increased,nuclear had pyknosis,irregular edge and dense staining,nuclear fragmentations were increased and the expressions of GRP78 and GRP94 were up-regulated.Conclusion TA can enhance the effect of CDDP on anti-hepatic carcinoma HepG2 cells,and the synergy mechanism may be related to the activation of ERS pathway.

Effects of U50488H on postoperative cognitive dysfunction induced by cardiopulmonary bypass in rats / 中华麻醉学杂志

Objective To investigate the effect of U50488H on postoperative cognitive dysfunction induced by cardiopulmonary bypass (CPB) in rats.Methods Forty-eight adult male Sprague-Dawley rats,weighing 400-450 g,were divided into 3 groups (n=16 each) using a random number table:sham operation group (group S),CPB group and CPB plus U50488H group (group U).CPB was performed for 60 min in group CPB.U50488H 1.5 mg/kg was injected into the left lateral cerebral ventricle at 30 min prior to CPB,and then CPB was performed for 60 min in group U.Eight rats in each group were selected at 1 day after CPB,and venous blood samples were collected for determination of serum S100β protein,interleukin-lbeta (IL-1 β) and tumor necrosis factor-alpha (TNF-α) concentrations (by enzyme-linked immunosorbent assay).Then the rats were sacrificed and right hippocampi were removed for examination of the pathological changes after haematoxylin and eosin staining.Eight rats were selected from each group at 7 days after CPB for assessment of cognitive function.Results Compared with group S,the concentrations of serum S100β protein,IL-1β and TNF-α were significantly increased in group CPB,and the escape latency was prolonged,the number of crossing original platform was reduced,and the swimming distance in target quadrant and time of staying at target quadrant were shortened in CPB and U groups (P＜0.05).Cormpared with group CPB,the concentrations of serum S100β protein,IL-1β and TNF-α were significantly decreased,the escape latency was shortened,the number of crossing original platform was increased,the swimming distance in target quadrant and time of staying at target quadrant were prolonged (P＜0.05),and the pathological changes of hippocampal tissues were significantly attenuated in group U.Conclusion U50488H can mitigate the postoperative cognitive dysfunction induced by CPB in rats.

Effect of enteral nutrition support containing equal non-protein calories but different protein contents on protein metabolism of elderly patients with severe pneumonia / 中国中西医结合急救杂志

Objective To study the enteral nutritional (EN) approach to decrease the risk of developing hypo-albuminemia in elderly patients with severe pneumonia. Methods Sixty elderly patients with severe pneumonia admitted to the intensive care unit (ICU) of Hangzhou Geriatric Hospital from January 2016 to January 2017 were enrolled, and they were given EN support with different protein contents but the same non-protein calories (125.52 kJ·kg-1·d-1). Thirty patients given standard EN formula [supplied as nutrition fibre, thermal nitrogen ratio (HRN) = 130:1] were assigned as the standard EN group, another 30 patients fed with high-protein EN formula (supplied as fresubin 750 MCT, HRN = 100:1) were arranged as the high-protein EN group, and the clinical efficacy in the two groups was evaluated after treatment for 14 days. The serum levels of total protein (TP), albumin (Alb), pre albumin (PA), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) of both groups were compared at admission and after treatment. Results The levels of TP, Alb, PA, TC, HDL, LDL in two groups on 7 and 14 days after treatment were lower than those on admission, but the degrees of reduction in high-protein EN group were not as significant as those in standard EN group; the levels of blood glucose (Glu) in the standared EN group after treatment were lower than those on admission, Glu in high-protein EN group were higher than those on admission;after treatment for 14 days, the levels of TP (g/L: 62.1±7.6 vs. 60.1±5.2), Alb (g/L: 33.0±4.8 vs. 32.0±4.2), PA (mg/L: 226.79±79.22 vs. 202.79±71.78), TC (mmol/L: 4.88±1.09 vs. 4.09±0.80), HDL (mmol/L: 1.07±0.2 vs. 0.92±0.20), LDL (mmol/L: 3.16±0.76 vs. 2.50±0.56), Glu (mmol/L: 7.68±2.44 vs. 6.72±1.75) in high-protein EN group were significantly higher than those in standard EN group; after treatment, TG showed a trend of firstly decreasing and then increasing, while TG in high-protein EN group manifested continuously increasing, after 7 days of treatment, TG in the high-protein EN group was significantly higher than that in the standard EN group (mmol/L: 3.56±1.43 vs. 2.78±0.81, P < 0.05). Within 14 days after disease onset, the incidence of hypoalbuminemia in high-protein EN group was significantly lower than that in standard EN group in patients with acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score > 19 score [66.67% (10/15) vs. 100.00% (13/13), P < 0.05]; there was no statistical significant difference in the incidence of hypoalbuminemia between the two groups in patients with APACHE Ⅱ score < 19 score [54.54% (6/11) vs. 44.44% (4/9), P > 0.05]. Compared with standard EN group, the 3-month mortality in high-protein EN group showed a trend of decreasing [14 days: 13.3% (4/30) vs. 26.7% (8/30), 28 days: 20.0% (6/30) vs. 30.0% (9/30), 60 days: 30.0% (9/30) vs. 33.3% (10/30), 90 days: 36.7% (11/30) vs. 40.0% (12/30)], but there was no statistical significant difference between the two groups (all P > 0.05). Conclusion Application of high-protein EN in elderly patients with severe pneumonia can improve protein metabolism, and reduce the incidence of hypoalbuminemia.

Effects of Yun Kang oral liquid on rats model of embryo implantation disorder / 中国应用生理学杂志

OBJECTIVE@#Through the establishment of abortion model caused by embryo implantation difficulties, exploring the role of Yun Kang oral liquid in protecting embryos.@*METHODS@#The pregnant rats were divided into 6 groups:normal control group (NC), model group (MG), dydrogesterone group (DT), and three dose groups of low, medium and high levels of Yun Kang oral liquid (YK-L, YK-M, YK-H), 11 in each group.From the first day of pregnancy, daily intragastric administration, the dose of DT group was 3.02 mg/kg, and the doses of Yun Kang oral liquid were 4, 6, and 9 ml/kg, respectively.The rats in NC and MG were treated with an equal volume of purified water for 10 days.On the third day of pregnancy, except for the NC group, the other groups were injected with mifepristone subcutaneously at the back of the neck at a dose of 5 mg/kg to cause an embryo implantation barrier model.On the 10th day of pregnancy, blood was collected from the abdominal aorta in each group.Serum follicle stimulating hormone (FSH), interferon-γ (IFN-γ) and interleukin (IL-4) were measured by enzyme-linked immunosorbent assay.The number of embryo implantation was observed in the uterus, and the pathological changes of the uterus were observed by HE staining.@*RESULTS@#Compared with the NC group, the number of embryo implantation and the serum levels of FSH and IL-4 in the MG group were decreased significantly (< 0.05, 0.01), and pathological changes such as uterine glandular epithelial hyperplasia and inflammatory cell infiltration in the glandular cavity were observed.Compared with MG group, the number of embryo implantation and serum FSH and IL-4 levels of rats in YK-M and YK-H groups were increased significantly (<0.05, 0.01).The pathological changes such as uterine glandular epithelial hyperplasia and inflammatory cell infiltration in the gland were also improved.There was no significant difference in serum IFN-γ levels between the groups.@*CONCLUSIONS@#Yun Kang oral liquid may improve the endometrial pathological changes and increase the number of embryo implantation by increasing the levels of serum sex hormone FSH and immune cytokine IL-4 in embryo implantation impediment rats.