Efficacy and safety of glucokinase activators for type 2 diabetes mellitus therapy：a meta-analysis / 中国药房

OBJECTIVE To systematically evaluate the efficacy and safety of glucokinase activators in the treatment of type 2 diabetes mellitus. METHODS PubMed， Cochrane Library， Web of Science， Embase and CNKI databases were searched from the inception to March 2022. Randomized controlled trials about glucokinase activators versus placebo （or other oral hypoglycemic agents） in the treatment of type 2 diabetes were included， data were extracted and meta-analysis was analyzed using RevMan 5.4 software. RESULTS A total of 9 studies with 215 0 patients were included. In terms of hypoglycemic effect， compared with control group， glucokinase activators significantly reduced glycosylated hemoglobin （HbA1c） [MD＝－0.40， 95%CI（－0.53， －0.26）， P＜0.000 01]， fasting blood glucose[MD＝－0.53， 95%CI（－0.85， －0.20）， P＝0.001] and 2 h postprandial blood glucose [MD＝－2.28， 95%CI（－2.68， －1.88）， P＜0.000 01] in diabetic patients. In terms of safety， the incidence of hypoglycemia caused by glucokinase activators was higher than control group on the whole [RR＝1.55， 95%CI（1.20，2.01）， P＝ 0.000 8]. According to the subgroup analysis of organs activated by glucokinase activator， the incidence of hypoglycemia in the pancreas-liver dual activator group [RR＝1.44， 95%CI（1.11，1.89）， P＝0.007] and liver-selective activator group [RR＝2.26， 95%CI（1.02，5.03）， P＝0.05] was higher than that in the control group， the difference was statistically significant. CONCLUSIONS Glucokinase activators can effectively reduce HbA1c， fasting blood glucose and 2 h postprandial blood glucose in patients with type 2 diabetes， but the risk of hypoglycemia remains to be addressed.

Herbal medicines for insomnia through regulating 5-hydroxytryptamine receptors: a systematic review / 中国天然药物

Insomnia is a common sleep disorder without effective therapy and can affect a person's life. The mechanism of the disease is not completely understood. Hence, there is a need to understand the targets related to insomnia, in order to develop innovative therapies and new compounds. Recently, increasing interest has been focused on complementary and alternative medicines for treating or preventing insomnia. Research into their molecular components has revealed that their sedative and sleep-promoting properties rely on the interactions with various neurotransmitter systems in the brain. In this review, the role of 5-hydroxytryptamine (5-HT) in insomnia development is summarized, while a systematic analysis of studies is conducted to assess the mechanisms of herbal medicines on different 5-HT receptors subtypes, in order to provide reference for subsequent research.

Advances in methodologies for preparation and analysis of new biochromatic stationary phase / 药学实践杂志

Biochromatography is a new chromatographic technology with great development potential. It has been widely used in drug screening and biomolecular interaction analysis. The core of this technology is the chromatographic stationary phase of biomolecules. Nowadays, it mainly develops cell membrane chromatography, artificial biomimetic membrane chromatography and the various immobilization strategies to directly immobilizes proteins on the stationary phase carrier. This paper reviews the research progress of new biochromatographic stationary phase and the application of biochromatographic analysis based on new stationary phase. And, the applications of biochromatographic stationary phase and micro biochromatographic analysis system based on monolithic column are prospected.

UHPLC-Q-TOF/MS analysis of chemical constituents in compound Jinqiancao granules / 药学实践杂志

Objective To qualitatively analyze the main chemical components in compound Jinqiancao granules by ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF/MS). Methods XBridge BEH C18 column (2.1 mm×100 mm, 2.5 µm) was used for chromatographic separation. The mobile phase was composed of 0.1% formic acid water and 0.1% formic acid-acetonitrile, gradient elution, and the flow rate was 0.4 ml/min. Mass spectrometry was characterized by Quadrupole time-of-flight mass spectrometry (Q-TOF/MS) and positive ion mode scanning. Results Under the optimized LC/MS condition, 47 components in compound Jinqiancao granules were identified. The isomers were distinguished by software calculation. The source of medicinal materials was assigned. Conclusion A rapid and efficient analytical method was established for the identification of chemical components in compound Jinqiancao granules by UHPLC-Q-TOF/MS.

Screening potential P-glycoprotein inhibitors by combination of a detergent-free membrane protein extraction with surface plasmon resonance biosensor

P-glycoprotein (P-gp) highly expressed in cancer cells can lead to multidrug resistance (MDR) and the combination of anti-cancer drugs with P-gp inhibitor has been a promising strategy to reverse MDR in cancer treatment. In this study, we established a label-free and detergent-free system combining surface plasmon resonance (SPR) biosensor with styrene maleic acid (SMA) polymer membrane proteins (MPs) stabilization technology to screen potential P-gp inhibitors. First, P-gp was extracted from MCF-7/ADR cells using SMA polymer to form SMA liposomes (SMALPs). Following that, SMALPs were immobilized on an SPR biosensor chip to establish a P-gp inhibitor screening system, and the affinity between P-gp and small molecule ligand was determined. The methodological investigation proved that the screening system had good specificity and stability. Nine P-gp ligands were screened out from 50 natural products, and their affinity constants with P-gp were also determined. The in vitro cell verification experiments demonstrated that tetrandrine, fangchinoline, praeruptorin B, neobaicalein, and icariin could significantly increase the sensitivity of MCF-7/ADR cells to Adriamycin (Adr). Moreover, tetrandrine, praeruptorin B, and neobaicalein could reverse MDR in MCF-7/ADR cells by inhibiting the function of P-gp. This is the first time that SMALPs-based stabilization strategy was applied to SPR analysis system. SMA polymer can retain P-gp in the environment of natural lipid bilayer and thus maintain the correct conformation and physiological functions of P-gp. The developed system can quickly and accurately screen small molecule ligands of complex MPs and obtain affinity between complex MPs and small molecule ligands without protein purification.

Development of a surface plasmon resonance biosensor for accurate and sensitive quantitation of small molecules in blood samples / 药物分析学报

Therapeutic drug monitoring(TDM)has played an important role in clinical medicine for precise dosing.Currently,chromatographic technology and immunoassay detection are widely used in TDM and have met most of the needs of clinical drug therapy.However,some problems still exist in practical appli-cations,such as complicated operation and the influence of endogenous substances.Surface plasmon resonance(SPR)has been applied to detect the concentrations of small molecules,including pesticide residues in crops and antibiotics in milk,which indicates its potential for in vivo drug detection.In this study,a new SPR-based biosensor for detecting chloramphenicol(CAP)in blood samples was developed and validated using methodological verification,including precision,accuracy,matrix effect,and extraction recovery rate,and compared with the classic ultra-performance liquid chromatography-ultraviolet(UPLC-UV)method.The detection range of SPR was 0.1-50 ng/mL and the limit of detec-tion was 0.099±0.023 ng/mL,which was lower than that of UPLC-UV.The intra-day and inter-day ac-curacies of SPR were 98％-114％and 110％-122％,which met the analysis requirement.The results show that the SPR biosensor is identical to UPLC-UV in the detection of CAP in rat blood samples;moreover,the SPR biosensor has better sensitivity.Therefore,the present study shows that SPR technology can be used for the detection of small molecules in the blood samples and has the potential to become a method for therapeutic drug monitoring.

Screening of immune cell activators from Astragali Radix using a comprehensive two-dimensional NK-92MI cell membrane chromatography/C18 column/time-of-flight mass spectrometry system / 药物分析学报

Astragali Radix(AR)is a clinically used herbal medicine with multiple immunomodulatory activities that can strengthen the activity and cytotoxicity of natural killer(NK)cells.However,owing to the complexity of its composition,the specific active ingredients in AR that act on NK cells are not clear yet.Cell membrane chromatography(CMC)is mainly used to screen the active ingredients in a complex system of herbal medicines.In this study,a new comprehensive two-dimensional(2D)NK-92MI CMC/C18 column/time-of-flight mass spectrometry(TOFMS)system was established to screen for potential NK cell acti-vators.To obtain a higher column efficiency,3-mercaptopropyltrimethoxysilane-modified silica was synthesized to prepare the NK-92MI CMC column.In total,nine components in AR were screened from this system,which could be washed out from the NK-92MI/CMC column after 10 min,and they showed good affinity for NK-92MI/CMC column.Two representative active compounds of AR,isoastragaloside Ⅰ and astragaloside Ⅳ,promoted the killing effect of NK cells on K562 cells in a dose-dependent manner.It can thus suggest that isoastragaloside Ⅰ and astragaloside Ⅳ are the main immunomodulatory compo-nents of AR.This comprehensive 2D NK-92MI CMC analytical system is a practical method for screening immune cell activators from other herbal medicines with immunomodulatory effects.

CENPF Promotes EMT in Non-small Cell Lung Cancer by Up-regulating ACKR3/CXCR7 / 肿瘤防治研究

Objective To investigate the relationship between the expression of CENPF in NSCLC adenocarcinoma (LUAD) and the clinical prognosis of patients and its effect on the metastasis of lung adenocarcinoma cells. Methods The expression of CENPF in LUAD and its relationship with patient prognosis were analyzed by online bioinformatics. The expression of CENPF was verified by LUAD tissue microarray immunohistochemical staining. Kaplan-Meier analysis was performed to analyze the relationship between the expression of CENPF and the prognosis of patients with lung adenocarcinoma. Cox survival hazard ratio was used to analyze the factors affecting the survival of patients. Chi-square analysis was adopted to examine the relationship between CENPF expression and clinicopathological stage and grade of patients. The expression of CENPF in NCI-H2126 cells were knocked out by lentivirus, and then the proliferation, invasion, and migration abilities of the cells were detected. Changes in mRNA expression profiles after CENPF knockout were detected by RNA-seq. Bioinformatics analysis of downstream signaling pathways and the target genes of CENPF was also performed. Western blot was used to verify the target gene. Results CENPF was significantly upregulated in LUAD tumor tissue (P < 0.05) and significantly correlated with pathological stage (P=0.013). The higher expression of CENPF, the worse the prognosis of patients (P=0.01, P=0.027). After the expression was CENPF of knocked out, the cell proliferation, migration, and invasion abilities significantly reduced (P < 0.01). The expression of chemokine pathway genes in cells was enriched significantly (P < 0.001). ACKR3/CXCR7 and CDH2/N-cadherin were significantly downregulated, whereas CDH1/E-cadherin was significantly upregulated. After CENPF was knocked out, ACKR3/CXCR7 and N-cadherin were significantly downregulated, whereas E-cadherin significantly increased. Conclusion The expression of CENPF is negatively correlated with the clinical prognosis of patients with LUAD, and it promotes the occurrence of EMT by regulating the expression levels of N-cadherin and E-cadherin related to EMT through ACKR3/CXCR7.

Anesthetic effects of inhalational sevoflurane versus intravenous ketamine in pediatric surgical anesthesia / 中国基层医药

Objective:To investigate the anesthetic effects of inhalational sevoflurane versus intravenous ketamine in pediatric surgical anesthesia. Methods:A total of 100 patients with appendicitis who underwent appendectomy in Ningbo Ninth Hospital between June 2017 and August 2018 were included in this study. They were randomly assigned to receive either inhalational anesthesia with sevoflurane (observation group, n = 50) or intravenous anesthesia with ketamine (control group, n = 50). Hemodynamic indexes at different time periods (T1: 5 minutes after entering the room, T2: after anesthesia induction, T3: immediately after skin incision, T4: operation completion), anesthesia induction, duration for anesthesia induction and recovery from anesthesia, liver function, and adverse reactions were compared between the observation and control groups. Results:There was no significant difference in peripheral oxygen saturation (SpO 2) level at different time periods between the observation and control groups (all P > 0.05). At T1, there were no significant differences in mean arterial pressure and heart rate between the two groups (both P > 0.05). At T2, T3 and T4, mean arterial pressure in the observation group was (67.25 ± 1.32) mmHg, (67.52 ± 1.32) mmHg, and (66.28 ± 1.31) mmHg, respectively, and heart rate was (115.21 ± 2.32) beats/minute, (112.21 ± 1.34) beats/minute and (111.25 ± 1.32) beats/minute, respectively. There were significant differences in mean arterial pressure and heart rate measured at T2, T3 and T4 between the observation and control groups ( t = 19.176, 16.817, 30.015, 58.797, 51.649, 2.617, all P < 0.05). The time to pain reflex disappearance and the time to eyelash reflex disappearance in the observation group were (2.32 ± 0.21) minutes and (1.26 ± 0.32) minutes, respectively, which were significantly longer than those in the control group ( t = 9.247, 4.251, both P < 0.05). The time to eye opening or body movement and the time to getting out of operation room were (3.21 ± 1.32) minutes and (5.52 ± 1.13) minutes respectively, which were significantly shorter than those in the control group ( t = 91.851, 109.641, both P < 0.05). After surgery, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and bilirubin levels in the observation group were (26.01 ± 1.32) U/L, (22.02 ± 1.32) U/L, (486.32 ± 2.74) U/L, (0.66 ± 0.02) U/L, respectively. There were significant differences in these indexes between observation and control groups ( t = 6.036, 6.798, 23.741, 3.500, all P < 0.05). The incidence of adverse reactions in the observation group was significantly lower than that in the control group ( χ2 = 9.470, P < 0.05). Conclusion:Inhalational sevoflurane is advantageous over and safer than intravenous ketamine in pediatric surgical anesthesia.

Identifying potential anti-COVID-19 pharmacological components of traditional Chinese medicine Lianhuaqingwen capsule based on human exposure and ACE2 biochromatography screening

Lianhuaqingwen (LHQW) capsule, a herb medicine product, has been clinically proved to be effective in coronavirus disease 2019 (COVID-19) pneumonia treatment. However, human exposure to LHQW components and their pharmacological effects remain largely unknown. Hence, this study aimed to determine human exposure to LHQW components and their anti-COVID-19 pharmacological activities. Analysis of LHQW component profiles in human plasma and urine after repeated therapeutic dosing was conducted using a combination of HRMS and an untargeted data-mining approach, leading to detection of 132 LHQW prototype and metabolite components, which were absorbed

Research progress on chemical composition and clinical efficacy of Lianhua Qingwen (LHQW) capsule, a traditional Chinese medicine (TCM) used to treat COVID-19 / 药学实践杂志

The outbreak of COVID-19 posed a huge threat to human health and social stability. With the rapid spread of the virus around the world, the drug development and related research of novel coronavirus (SARS-CoV-2) have become an urgent issue in the medical field. COVID-19 fails into the category of epidemics in the theory of TCM. LHQW capsule has repeatedly played an important role in many major epidemics. Previous studies have shown that LHQW capsule can inhibit the biological activity of varied viruses including MERS-CoV and SARS-CoV. The paper summarizes the relevant research data and achievements of LHQW capsule in the past few years, reviews the chemical constituents, clinical efficacy and pharmacological effects of LHQW capsule, and provides scientific basis for the anti-virus mechanism of LHQW capsule and clinical treatment of COVID-19.

Assessment of left atrial volume and function by real-time three-dimensional speckle tracking imaging in end-stage renal disease patients with different dialysis methods / 中华超声影像学杂志

Objective:To discuss the value of real-time three-dimensional speckle tracking imaging(RT3D-STI) in the evaluation of the left atrial (LA) volume and function in end-stage renal disease (ESRD) patients with different dialysis methods.Methods:Eighty-three ESRD patients who were treated in the Affiliated Hospital of Qingdao University from February to August 2019 were enrolled and divided into non-dialysis group ( n=25), hemodialysis group (HD group, n=31) and peritoneal dialysis group (PD group, n=27). And 30 healthy volunteers were enrolled as control group. Subsequently, the LA volume indexs including LA maximal volume index (LAVImax), LA minimal volume index (LAVImin) and LA presystolic volume index (LAVIpre), the LA function parameters including LA ejection fraction (LAEF), LA passive ejection fraction(LApEF) and LA active ejection fraction (LAaEF) and the LA global strain parameters including global longitudinal strain(GLS), global radial strain(GRS) and global circumferential strain(GCS) were obtained by RT3D-STI. The differences of the parameters among these groups were compared and the correlations between the myocardial strain parameters and dialysis time were analyzed. Results:①The LAVImax, LAVImin and LAVIpre of the non-dialysis group, PD group and HD group were higher than those in the control group, while the LAEF, LApEF, GLS, GRS and GCS were lower than those in the control group(all P<0.05); the LAVImin of the PD group as well as the LAVImin, LAVIpre and LAVImax of HD group were higher than those of non-dialysis group, while the LAEF, LApEF, GLS, GCS of the PD group and the LAEF, LApEF, GLS, GRS, GCS of HD group were lower than those of non-dialysis group (all P<0.05). The LAVImax, LAVImin, LAVIpre of HD group were higher than those of PD group, while the LAEF, LApEF, GLS, GRS and GCS of HD group were lower than those of PD group (all P<0.05). ②The GLS and GCS in PD group were negatively correlated with the dialysis time( r=-0.670, -0.596, all P<0.05), and the GLS, GCS and GRS in HD group were negatively correlated with the dialysis time( r=-0.624, -0.631, -0.551, all P<0.05). Conclusions:RT3D-STI can assess the LA volume and function of ESRD patients with different dialysis methods effectively and can further evaluate the prognosis of patients and guide timely clinical intervention.

Determination of Zinc gluconate and citric acid in Shanpu-Jianpi granule / 国际中医中药杂志

Objective:To develop a method for the determination of Zinc gluconate and citric acid in Shanpu-Jianpi granule. Methods:The air-acetylene was selected as flame type, the detection wavelength was 213.9 nm, the gas flow rate was 0.9 L/min, the burner height was 7.2 mm, and deuterium lamp was used as background correction. The width of passband was 1.0 nm. Titration, sodium hydroxide was used to determine the citric acid with phenolphthalein as an indicator.Results:The content of Zinc Meletin, exhibited good linearity ( r=0.999 8) among the ranges of 0.1-2.0 μg/ml and the average recovery was 94.06% ( RSD=1.67%). The average recovery of citric acid was 94.65% ( RSD=0.91%). Conclusions:The method is simple, accurate and high sensitivity which can be used for determination of Zinc gluconate and citric acid in Shanpu-Jianpi granule.

Three-dimensional speckle tracking imaging combined with SYNTAX score in evaluating complex coronary artery disease / 中国医学影像技术

Objective: To explore the value of three-dimensional speckle tracking imaging (3D-STI) combined with coronary artery SYNTAX scores (SS) in evaluating the left ventricular function of patients with complex coronary artery disease (CAD). Methods: Totally 78 patients with complex CAD were divided into low score subgroup (SS<23, n=26), medium score subgroup (23≤SS<33, n=25) and high score subgroup (SS≥33, n=27) according to SS. The global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global three-dimensional strain (G3DS) and longitudinal strain (LS), radial strain (RS), circumferential strain (CS) as well as three-dimensional strain (3DS) of segments were obtained with 3D-STI. Then LS, RS, CS, 3DS of basal segment, middle segment and apical segment were further calculated. The above indexes were compared among groups. Results: ①GLS, GRS, GCS and G3DS all decreased in turn among low score, medium score and high score subgroups (all P<0.05). LS, 3DS of basal segment, LS, RS, CS and 3DS of middle segment and apical segment also decreased gradually (all P<0.05). ②ROC curve showed that GLS, GRS, GCS and G3DS had a certain value in detecting degrees of complex CAD, and GLS and G3DS had larger AUC. ③GLS, GRS, GCS and G3DS were negatively correlated with SS in the group of complex CAD (r=-0.548, -0.366, -0.411, -0.556, all P<0.05). 3D-STI had good interobserver and intraobserver consistency. Conclusion: 3D-STI can reflect the complexity of coronary artery lesions, which has a certain guiding significance combined with SS in diagnosis and treatment of complex CAD.

Optimization of the compound herba lysimachiae extraction prosess based on orthogonal experiment and response surface method / 药学实践杂志

Objective To optimize the extraction process of the compound herba lysimachiae by orthogonal experiment and response surface method. Methods The sum of the peak areas of multiple representative components in the compound herba lysimachiae was used as the evaluation index. The ultrasonic extraction time, ultrasonic temperature and ethanol ratio were analyzed to optimize the extraction process conditions by orthogonal experiment and Box-Behnken response surface analysis method. Results Ultrasonic extraction time and ethanol ratio are important factors in the extraction process of the compound herba lysimachiae. The effect of ultrasonic temperature in the extraction process is not significant. The optimal extraction condition for compound herba lysimachiaeare is 10 min ultrasonic extraction time at 55 ℃ with 55% ethanol. Conclusion The optimal extraction process parameters obtained by combining orthogonal experiment and Box-Behnken response surface method can be used for the extraction of representative components from the compound herba lysimachiae and pharmaceutical research in the future.

Methodology of drug screening and target identification for new necroptosis inhibitors / 药物分析学报

Apoptosis has been considered as the only form of regulated cell death for a long time. However, a novel form of programmed cell death called necroptosis was recently reported. The process of necroptosis is regulated and plays a critical role in the occurrence and development of multiple human diseases. Thus, the study on the molecular mechanism of necroptosis and its effective inhibitors has been an attractive field for researchers. Herein, we introduce the molecular mechanism of necroptosis and focus on the literature about necroptosis drug screening in recent years. In addition, the identification of the critical drug targets of the necroptosis is also discussed.

Reproducibility of intravoxel incoherent motion in body DWI technique for normal lumbar disc scanning / 实用放射学杂志

Objective To investigate the reproducibility of magnetic resonance intravoxel incoherent motion in body diffusionG weighted imaging (IVIMGDWI)for normal lumbar disc scanning.Methods 50 healthy volunteers were enrolled with informed consent,30 males and 20 females,2 5.20±2.04 years old.Using 3.0T MR on the lumbar spine,the sagittal T1 WI,the sagittal,axial T2 WI and sagittal IVIMGDWI sequences were scanned once,then the second sagittal IVIMGDWI sequence was scanned after 4 hours.The IVIMGDWI sequence used 10 b values (0,10,20,40,60,80,100,200,400,600 s/mm2 ).The discs were graded according to the Pfirrmann grading standard.The ADCfast ,ADCslow ,and f values of each intervertebral disc were measured by two doctors at the postGprocessing workstation.Paired tGtest was used to analyze whether there was a difference between the two scans.The intraGgroup correlation coefficient (ICC)was used to analyze the consistency of the ADCfast ,ADCslow ,and f values of the two acquisitions (P＜0.05)and the consistency of the ADCfast ,ADCslow,and f values between the different doctors (P＜0.05).The IVIMGDWI imaging was evaluated to measure the repeatability of normal lumbar discs. Results Of the 50 healthy volunteers,230 intervertebral discs matched the criteria(Pfirrmann gradeⅠandⅡ).The ADCslowvalue between the two scans was significantly different (t＝2.460,P＜0.05),and the differences in ADCfast and f values were not significant (t＝－0.418,1.273,P＞0.05). The consistency of ADCfast ,ADCslow ,and f values for the two scans were generally (ICC＝0.478,0.306,0.316,P＜0.05 ).Different observers had good consistency in the measurement of interverG tebral disc ADCfast ,ADCslow,and f values (ICC＝0.929,0.909, 0.9 1 1 ,P＜0.05).Conclusion The IVIMGDWI imaging has good consistency in the measurement of normal lumbar disc between different observers.The consistency of IVIMGDWI in two scans of normal lumbar intervertebral discs is general,which may be due to the time interval between the two scans.Because ADCslow represents the diffusion of water molecules in tissues,the microenvironment in the lumbar intervertebral disc has changed,resulting in the difference of ADCslow value.As for the problem that different scanning time may lead to the change of IVIMGDWI data,we will study it further.

Effect of enteral nutrition on accidental upper gastrointestinal injury in children / 中华儿科杂志

Objective@#To evaluate the effectiveness of enteral nutrition in children with accidental upper gastrointestinal injury.@*Methods@#The medical records of 128 patients with mechanical or chemical gastrointestinal mucosal injury, who were hospitalized in Department of Gastroenterology, Children's Hospital of Zhejiang University School of Medicine from January 1, 2011 to December 30, 2017, were collected. All cases were treated with enteral nutrition. The clinical features and etiologies were retrospectively analyzed. Weight-for-age Z score and lab findings including white blood cells, C-reactive protein, neutrophils, albumin, prealbumin, urea nitrogen and hemoglobin before and after treatment were extracted. The clinical characteristics, the duration of enteral nutrition and gastrointestinal mucosal healing between different etiologies were further analyzed. Normal distribution variables and categorized variables were compared with t test and χ2 test respectively, and abnormal distribution data was compared with Wilcoxon test.@*Results@#Among all the cases, 77 were males and 51 were females. The average age was (29±22) months. The mean duration of hospitalization and enteral nutrition were (11±7)d and (27±20)d respectively. Vomiting was the most common clinical presentation (72 cases, 56.3%). In 79 cases the problems were caused by mechanical injury, among which coins were most commonly seen. The rest 49 cases were caused by chemical injury. However, the duration of hospitalization ((13±8) d vs. (10±6)d, t=-3.089, P=0.002) and enteral nutrition ((39±22) vs. (19±14) d, t=-5.365, P=0.000) were longer in children with chemical injury than those with mechanical injury. A total of 112 cases got complete blood count and C-reactive protein both before and after enteral nutrition. Inflammatory markers, including leukocytes ((7.7±2.7) ×109/L vs. (13.7±5.0) ×109/L, t=12.244, P <0.05), neutrophils ((3.4±1.9)×109/L vs. (9.4±4.6) ×109/L, t=13.655, P<0.05), and C-reactive proteins (5.0(3.0,7.8) vs. 13.5(6.0,40.5) mg/L, Z=7.776, P <0.05) were significantly decreased. The nutritional markers, including the weight-for-age z score (-0.1 ± 1.0 vs. 0.0 ± 1.0, t=-2.622, P=0.010) and the prealbumin (0.1 ± 0.1 vs. 0.2 ± 0.0 g/L, t=-3.671, P=0.001) were significantly increased. Fifty-five (82.1%) children in mechanical injury group recovered in 4 weeks, while 27 (79.4%) children in chemical injury group recovered in 7 weeks.@*Conclusion@#Enteral nutrition can provide adequate nutritional requirements for children with upper gastrointestinal injury, and may help to decrease imflammation and improve mucosal healing.

Dvelopment of a DNA-based microarray for detection of human adenovirus serotypes / 军事医学

Objective To develop a chemiluminescence imaging DNA microarray method for simultaneous,quick and accurate detection of serotypes of human adenovirus (HAdV ),namely,HAdV3,HAdV7,HAdV11,HAdV14 and HAdV55.Methods Based on the specific gene sequences in the conserved region of adenovirus from GenBank, oligonucleotide primers and probes were designed and synthesized to prepare the oligonucleotide microarray.The specific genomic sequences were amplified by multiplex PCR method.The multiplex PCR amplification products were hybridized with the specific probes of microarray that was scanned after washing and chemiluminescenceb before the result was analyzed.After optimization of the multiple PCR system,hybridization reactions and conditions of chemiluminescence,the specificity,sensitivity and reproducibility of the chip were evaluated.Results The microarray displayed high sensitivity, specificity and reproducibility.The minimum detection limit of plasmidg DNA was 3 ×103 copies/reaction.The microarray detection results of 38 clinical samples were approximately consistent with those using the direct sequencing method(37 /38).Conclusion A chemiluminescence imaging DNA microarray method for quick,sensitive and specific detection of five serotypes of HAdV is established,which can provide a new means for detecting serotypes of HAdV.

Discussion on a new opened course combining complexity science and medicine in medical colleges / 中华医学教育探索杂志

Complexity science is a new type of scientific research method, and the combination of complexity science, life science, and medicine is still in the initial stage of exploration, and domestic medi-cal colleges do not offer correlative course currently. In order to broaden students' vision, transform their traditional thinking model, and prepare the future of multidisciplinary cooperation, medical colleges should open complexity science and medicine correlative course for senior undergraduate and graduate students. Course content should start by the famous fablebutterfly infect, followed by the introduction of chaos and fractal, self-organization and complex system theory concept, theoretical framework, and their application in the medical field The teaching material should refer to some popular science books, such as Mystery of the butterfly effect. The teaching method should draw lessons from metaphor.