A mendelian randomization study of the causal association between gastroesophageal reflux and atrial fibrillation / 公共卫生与预防医学

Objective In this study，we performed two sampie Mendelian Randomization to infer a causal association between Gastroesophageal reflux(GERD) and Atrial fibrillation(AF)，it can effectively avoid the problems such as reverse causation and confounds in traditional epidemiology. Methods We used the Summary data of GERD and AF from published Genome wide association study(GWAS) of European Individuals. Single Nucleotide Polymorphisms (SNPs) were extracted as Instrumental Variables (IVs).The main MR methods include Inverse Variance [] Weighted(IVW)，Weighted Median(WME)，MR-Egger，Simple Mode，and Weighted Mode.In addition，we used the sensitivity analysis such as MR-PRESSO，Cochran's Q test etc. Results The IVW shows a causal association between GERD and AF(P<0.0001，OR=1.16，95%CI:1.10-1.23).The WME shows P＜0.0001，OR=1.20，95%CI:1.11-1.30；Simple Mode shows P=0.01，OR=1.34，95%CI:1.07-1.69；Weighted Mode shows P=0.02，OR=1.33，95%CI:1.06-1.66. Conclusion This study based on genetic data supports the causal association between GERD and AF. The occurrence of GERD could increase the risk of AF.

One case of Mycoplasma hominis-related intracranial infection after craniocerebral injury / 中华检验医学杂志

The patient, a 50-year-old male, was admitted to the hospital on April 1, 2020 with the chief complaint of "confusion with vomiting for 1 hour due to falling from height ", and the emergency craniotomy was performed. Intermittent fever with a maximum temperature of 38 ℃ occurred 3 days after the surgery, and the inflammation indexes were all higher than the upper limit of the reference values. Recurrent fever remained despite after empirical anti-infection treatment. On April 12, the patient was treated with vancomycin combined with meropenem after cerebrospinal fluid specimens routine and biochemical tests suggested intracranial infection. After 48 hours of cultivating the cerebrospinal fluid and blood specimens, some small, clear, needle-like colonies were found and they were identified as Mycoplasma humanum by using 16S rRNA gene. Eventually, the patient died due to the severity of the disease and complications.

Clinical significance of serum homocysteine on peripheral vascular plaque in type 2 diabetes mellitus with subclinical hypothyroidism / 中国医师杂志

Objective:To investigate the effect of homocysteine (Hcy) on peripheral vascular plaque formation in patients with type 2 diabetes mellitus (T2DM) combine subclinical hypothyroidism (SCH), and to provide guidance for clinical medication and prognosis judgement.Methods:A total of 125 patients with type 2 diabetes admitted to the NO.3201 Hospital from 2018 Jan to Dec 2019 were selected. 125 patients with type 2 diabetes mellitus were divided into T2DM without plaque group (40 cases), plaque group (23 cases), T2DM with SCH without plaque group (25 cases) and plaque group (37 cases) according to thyroid function and whether they had peripheral vascular plaque. Data were collected to analyze the influencing factors of peripheral vascular disease.Results:(1) The incidence of vascular plaque in T2DM group and T2DM with SCH group was 36.5%(23/63) and 59.7%(37/62), respectively, with significant difference ( P<0.05). (2) There were significant differences in serum thyroid stimulating hormone (TSH), apolipoprotein A (ApoA), triglyceride (TG) and Hcy between T2DM group and T2DM with SCH group ( P<0.05); there was significant difference in low-density lipoprotein (LDL-C) and Hcy between T2DM groups with or without plaque ( P<0.05); there were significant differences in ApoA and Hcy between T2DM with SCH group with or without plaque ( P<0.05). (3) Logistic regression analysis showed that Hcy was the risk factors for the occurrence of vascular plaque in T2DM and T2DM with SCH group ( OR=1.640, 2.695, P<0.05). (4) Receiver operating characteristic (ROC) curve showed that the area under the curve of Hcy in T2DM group was 0.842 and Youden index was 15.75 μmol/L; The Hcy's area under ROC curve was 0.945 and Youden index was 12.9 μmol/L in T2DM with SCH. Conclusions:Hcy is closely related to the presence of peripheral vascular plaque in T2DM patients with subclinical hypothyroidism. The detection of blood Hcy level can provide new ideas for early diagnosis and treatment of peripheral vascular lesions in T2DM patients with SCH.

Analysis of Related Factors of Adverse Transfusion Reactions / 中国实验血液学杂志

OBJECTIVE@#To investigate the related factors of adverse reactions of blood transfusion, and clinical precautions so as to reduce the adverse reactions.@*METHODS@#Data of 2108 patients with allogeneic transfusion in our hospital from January 2017 to June 2017 collected and analyzed.@*RESULTS@#These patients received 15 244 time of blood transfusion, and 213 time of adverse reactions occurred in 178 patients in totality, the incidence is 1.4%, and there was no significant difference between the male (1.31%) and female (1.53%). The main type of transfusion reaction were allergy (73.23%), FNHTR (11.74%) and TACO (10.80%). Among all kinds of blood components, the incidence of adverse reactions of apheresis platelet transfusion was the highest (4.31%), significantly higher than that of cryoprecipitate and other blood components. The incidence rate of adverse reactions of blood transfusion in the hematopathy patients was 2.56%, significantly higher than that of immune diseases (1.48%), cancer diseases (1.28%) and other diseases (1.08%), (P＜0.01). The rate of transfusion history of apheresis platelets was 42.67% (the incidence of adverse reactions was 4.31%), significantly higher than other groups (P＜0.01); the rate of transfusion history of cryoprecipitate was 4.11% (the incidence of adverse reaction was 0.45%), significantly lower than other groups (P＜0.05). Among the disease types, the rate of transfusion history in the hematopathy patients was 48.79% (the incidence of adverse reaction was 2.56%), significantly higher than that of other groups (P＜0.01). The incidence of drug allergy in patients with the adverse reactions to blood transfusion was 11.25%, significantly higher than that of patients without adverse reactions (4.71%) (P＜0.01).@*CONCLUSION@#The main risk factors of adverse reactions of blood transfusion are as follows: blood varieties, disease type, transfusion history and drug allergy history. For the patients with transfusion, multiple factors should be controlled, so as to reduce the adverse reactions.

Clinical observation on gastroesophageal reflux asthma treated with needling technique / 中国针灸

OBJECTIVE@#To compare the clinical effect on gastroesophageal reflux asthma between the needling technique of acupuncture (acupuncture for promoting the circulation of the governor vessel and reducing the reversed ) and omeprazole enteric capsules (OME).@*METHODS@#A total of 60 patients with gastroesophageal reflux asthma were randomized into an acupuncture group and a western medication group, 30 cases in each one. The basic treatment for anti-bronchial asthma was provided in both of the groups. Additionally, OME was prescribed for oral administration in the western medication group, twice a day, 20 mg each time, for 8 weeks. In the acupuncture group, the needling technique of acupuncture was added. The needles were inserted at the sites inferior to the spinous processes of T to T. Acupuncture was given once in the morning on Tuesday, Thursday and Saturday respectively, totally for 8 weeks. Separately, before and after treatment, the score of reflux disease diagnostic questionnaire (RDQ), the score of asthma control test (ACT) and the tenderness threshold at the sites inferior to the spinous processes of T to T were observed and the clinical effect was evaluated in the two groups.@*RESULTS@#①The remarkably effective and curative rate was 46.7% (14/30) in the acupuncture group, higher than 3.3% (1/30) in the western medication group (<0.01). The asthma control rate was 66.7% (20/30) in the acupuncture group, higher than 13.3% (4/30) in the western medication group (<0.01). ②RDQ score after treatment was lower than that before treatment in either group (<0.05). The decrease range of RDQ score in the acupuncture group was larger than that of the western medication group (<0.05). After treatment, ACT score was increased as compared with that before treatment in either group (<0.05) and the increase range of ACT score in the acupuncture group was larger than that of the western medication group (<0.05). ③The tenderness thresholds at the sites inferior to the spinous processes of T to T and T to T were all increased after treatment as compared with those before treatment in the acupuncture group separately (<0.05). In the western medication group, the thresholds were only increased at the sites inferior to the spinous processes of T, T and T after treatment as compared with those before treatment separately (<0.05). After treatment, the tenderness thresholds at T to T in the acupuncture group were all higher than the western medication group (<0.05).@*CONCLUSION@#The needling technique of acupuncture effectively relieves the symptoms of gastroesophageal reflux asthma and improves the quality of life in the patients and its effect is better than omeprazole enteric capsules.

Professor 's concept and experience in the diagnosis and treatment of gastroesophageal reflux disease / 中国针灸

In view of the five major misunderstandings in the clinical understanding of gastroesophageal reflux disease in traditional Chinese medicine, that is, wrong main symptoms, wrong position of the disease, wrong character of the disease, treating acid with acid, and attaching importance to drugs and neglecting acupuncture-moxibustion in treatment, Professor has proposed the corresponding solving strategies, which includes grasping the main disease, carefully examining the disease position, distinguishing the character of disease, and no acid suppression for acid regurgitation. In addition, Professor highly values the external treatment of traditional Chinese medicine. In particular, the acupuncture therapy of " (promote the circulation of the governor vessel and reduce the reversed )" based on many years of clinical experience provides new ideas and methods for the diagnosis and treatment of gastroesophageal reflux disease in traditional Chinese medicine.

Relationship between Helicobacter pylori infection and carotid atherosclerosis in the elderly / 中华老年医学杂志

Objective:To investigate the relationship between Helicobacter pylori(Hp)infection and carotid atherosclerosis(CAS)in the elderly, in order to provide an empirical basis for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly.Methods:A total of 287 patients aged 60 years and over admitted to the First Affiliated Hospital of Guangxi Medical University, who underwent the 13C-urea breath test( 13C-UBT), carotid color and two-dimensional Doppler ultrasonography from October 2015 to January 2019, were retrospectively enrolled.Patients were divided into the Hp infection group(n=137)and the non-Hp infection group(n=150). Common high-risk pathogenic factors, blood biochemical indicators, carotid intima-media thickness(IMT)and detection rate of carotid plaque were compared between the two groups. Results:Common high-risk pathogenic factors including age, gender, hypertension, diabetes, obesity, smoking, alcohol consumption, dyslipidemia, and hyperuricemia showed no significant difference between the two groups( P>0.05). The level of high-density lipoprotein cholesterol(HDL-C)was lower in the Hp infection group than in the non-Hp infection group( P<0.05). There was no difference in levels of white blood cells, neutrophils, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine, fasting blood glucose, creatinine or uric acid between the two groups( P>0.05). The detection rates of increased carotid IMT and carotid plaques were higher in the Hp infection group than in the non-Hp infection group(65.0% or 89 cases vs.48.7% or 73 cases, 76.6% or 105 cases vs.64.7% or 97 cases, P<0.01 and 0.05). The detection rate of carotid plaques in the Hp-infected group was higher than that in the non-Hp-infected group( P<0.05). The combined detection rate of increased carotid IMT and plaques was higher in the Hp infection group than in the non-Hp infection group(56.2% or 77cases vs.32.7% or 49 cases, P<0.01). Conclusions:Hp infection may play a role in the occurrence and progression of carotid atherosclerosis through initiating abnormal lipid metabolism.Early intervention and treatment may reduce the incidence of carotid atherosclerosis in patients with Hp infection.

Clinical Characteristics and Mutation Landscape of Chinese Mucosal Melanoma / 中山大学学报(医学科学版)

@#【Objective】 To use next generation sequencing （NGS） for examing 295 gene mutations in Chinese mucosal melanoma，and explore the mutation landscape of Chinese mucosal melanoma for potential therapeutic targets. 【Methods】The specimens were from 25 mucosal melanoma patients from September 2017 to September 2018 in Biotherapy Center，Sun Yat-sen University Cancer Center. Mutations of 295 genes were detected by NGS sequencing in the Department of Molecular Diagnostics in our hospital. 【Results】 The mutation frequency of major driver genes of melanoma was：BRAF 20%（5/25），KIT 20%（5/25），NRAS 12%（3/25），and NF1 8%（2/25），respectively. The most common mutation was an increase copy number in MYC（9/25，36%），followed by an increase in KDR copy number，24%（6/25）. DNA damage repair，cell cycle，PI3K-mTOR，growth factor receptor，MAPK，immune response and WNT/NOTCH related pathways were widely mutated. Mutation rates were 76%（19/25），72%（18/25），56%（14/25），60%（15/25），36%（9/25），28%（7/25），and 24%（6/25），respectively. Multiple therapeutic targets were observed，such as ATM，ATRX，EMSY， FANCI，RAD52，MET，PDGFRA，KDR，FLT4，ALK，ERBB3 and ROS1.【Conclusion】Gene mutations in Chinese mucosal melanoma were different from that of Chinese cutaneous melanoma and that of Caucasians. NGS could provide potential therapeutic targets for the treatment of Chinese mucosal melanoma.

Cabozantinib Combined with Anti-PD-L1 Antibody Produced Antitumor Effect on Mice Melanoma Xenograft and its Mechanism / 中山大学学报(医学科学版)

@#【Objective】The aim of this study was to investigate the effect and mechanism of cabozantinib combined with anti-PD-L1 antibody on the growth of subcutaneous transplanted malignant melanoma in mice.【Methods】Established mouse subcutaneous xenograft model using mouse melanoma cell line B16- F10，and then randomly divided into five groups：saline control group，vehicle control group，anti PD- L1 antibody group，cabozantinib group，cabozantinib in combined with anti- PD- L1 antibody group （combination group）. Tumor growth was observed and tumor volume was measured every 2 days. The research endpoint was defined as when the tumor volume reached 2 000 mm3 or the difference between the groups was statistically significant. Then the mice were sacrificed and tissue samples were taken at the endpoint of the study. Infiltrating immune cells including CD4 + ，CD8 + T lymphocytes and myelogenous suppressor cells （MDSC）were detected by flow cytometry. In addition，B16-F10 cells cultured in vitro were treated with different drugs， the apoptosis was detected by flow cytometry ，and the protein expressions of AKT ，p-AKT ，mTOR and p-mTOR were detected by western blot assay.【Results】B16- F10 melanoma xenograft model showed that anti- PD- L1 antibody group had no obvious antitumor effect ，while both cabozantinib group and combination group produced significant antitumor effect，and the combination group had more obvious antitumor effect compared to cabozantinib group（P=0.001 5）. B16- F10 cells were treated with different drugs in vitro，and the apoptosis rate of the combination group was significantly higher than that of cabozantinib group at 24 h and 48 h，respectively（24 h:P=0.003 5；48 h:P=0.002 9）. Western blot assay showed that the combination group and cabozantinib group had no significant effect on the protein expression of AKT and mTOR，but both could reduce their phosphorylation levels，and the combination group was more remarkable. 【Conclusion】Cabozantinib in combined with anti-PD-L1 antibody had synergistic anti-tumor effect，which might be achieved by promoting B16-F10 cells apoptosis and inhibiting of AKT/mTOR pathway.

Curcumin-loaded Amphiphilic Star-Shaped Polyester-Based Nanoparticles for Drug Delivery System by Microchannels / 中国药学杂志

OBJECTIVE: To prepare the curcumin-loaded amphiphilic star-shaped polyester nanoparticles(Cur-NPs) and evaluate its physicochemical property, toxicity and release behavior in vitro. METHODS: Poly(pentaerythrotol)-poly (ε-Caprolactone)(abbreviated as PET-PCL), a new amphiphilic star-shaped poly ester material, as drug carrier was successfully synthesized by ring-opening polymerization. The toxicity of PET-PCL was determined by MTT method. Drug-loading nanoparticles were prepared by microchannel interface precipitation, and the optimal prescription was screened by single factor experiment. The particle size and the particle dispersion index was measured by dynamic light scattering(DLS) techniques. The encapsulation efficiency and drug loading content were determined by UV spectrophotometry. The in vitro release behavior was investigated by dynamic dialysis. RESULTS: The optimal preparation for nanoparticles was listed as followswater flow rate was 0.5 mL·min-1, lipid phase flow rate was 0.5 mL·min-1, aqueous phase concentration was 1 mg·mL-1, lipid phase concentration was 6.0 mg·mL-1, and drug concentration was 0.6 mg·mL-1. The particle size was (180.3±4.05) nm, the Zeta potential was (-12.1±1.04)mV; drug encapsulation efficiency was (90.12±0.824)%; drug loading content was (4.40±0.080)%; the amount of cumulated drug released in 96 h was (72.89±3.001)%. Survival rate of L929 cells with PET-PCL were (81.05±1.223)%. CONCLUSION: The curcumin-loaded amphiphilic star-shaped polyester nanoparticles prepared by this method are simple and feasible, and have a better controlled release property, have potential application value in the field of drug delivery.

Combination of R848 and Poly（I:C）promotes antigen presentation by DC and enhances killing effect of CTL on lung adenocarcinoma A549 cells / 中国病理生理杂志

AIM: To investigate the effect of R848(a Toll-like receptor 7/8 agonist)combined with poly-inosinic:polycytidylic acid [Poly(I:C),a Toll-like receptor 3 agonist] on dendritic cell(DC)maturation,and the killing effect of DC-induced cytotoxic T-lymphocytes(CTL)on human lung adenocarcinoma A549 cells.METHODS:Mononu-clear cells were isolated from human peripheral blood and induced to differentiate into DC.The whole-cell lysate of A549 cells,namely tumor cell lysate(TCL), was used as antigen.R848 combined with Poly(I:C)was used as adjuvant to stimulate the DC.DC surface markers were analyzed by flow cytometry.The DC stimulated by antigen was co-cultured with T-lymphocytes for 7 d to induce CTL.The culture supernatant and CTL were collected.The levels of interleukin-12(IL-12)p70,interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α)in the supernatant were measured by ELISA.The CTL and A549 cells were co-cultured for 16 h,and the cytotoxicity was observed by LDH assay.RESULTS:The expres-sion of CD83 and CD80 on the DC surface,and the secretion of IL-12 p70 in DC-R848+Poly(I:C)group were significant-ly increased compared with DC-TCL group(P<0.01).In addition,the cytotoxicity of CTL for A549 cells in DC-R848+Poly(I:C)group was significantly enhanced compared with DC-TCL group(P<0.01).The secretion levels of IFN-γand TNF-αin DC-R848+Poly(I:C)group were significantly elevated compared with DC-TCL group(P<0.01).CONCLU-SION:R848 combined with Poly(I:C)significantly promotes DC maturation and activation, and enhances the antigen-presenting effect of DC and the cytotoxicity of DC-induced CTL.

The effectiveness of attachment on global pain in chronic pain sufferers: the mediating effect of pain self-efficacy / 中国实用护理杂志

Objective To identify global pain and attachment in chronic pain sufferers, and explore the mediating effect of pain self-efficacy. Methods There were 193 patients recruited from Pain Department in West China Hospital of Sichuan University between February 2017 and June 2017. The Global Pain Scale, Experiences in Close Relationships Questionnaire-Revised and Chronic Pain Self-efficacy Scale were used to collect data. Results The score of global pain, attachment avoidance and attachment anxiety were(79.55±15.82),(2.98±0.81)and(3.22±0.89)points respectively.52.8%(102/193) participants were secure attachment.Mediating effect analyses revealed that self-efficacy exerted a partial mediating effect between global pain and attachment, with the mediating effect of 33.3% in total effect. Conclusions Health professionals should improve the self-efficacy in the management of chronic pain, especially in those with strong relationship needs,promote the positive pain adjustment,and improve the quality of life.

Association between copy number variations and risk of overweight/obesity among Han, Uyghur, and Kazak children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the association between the prevalence of overweight/obesity and copy number variations (CNVs) among Han, Uyghur, and Kazak children in Xinjiang, China.</p><p><b>METHODS</b>The kindergartens in Ili, Altay, and Karamay in Xinjiang were selected as research sites, and stratified cluster sampling was used to select the children aged 3-7 years. Body height and body weight were measured, and exfoliated buccal mucosa cells were collected. CNVplex® was used to measure the CNVs of FTO_1, IRX3_1, IRX3_2, MC4R_1, and MC4R_2.</p><p><b>RESULTS</b>A total of 603 children were surveyed (307 boys and 296 girls). There were 261 Han children, 194 Uyghur children, and 148 Kazak children. The overweight/obesity rates in Han, Uyghur, and Kazak children were 28.3%, 10.3%, and 31.1%, respectively (P<0.001). In Kazak children, the CNVs of IRX3_1 and MC4R_2 were associated with overweight/obesity (P<0.05). The multivariate logistic regression analysis showed that the risk of overweight/obesity in Han and Kazak children was 3.443 times (95%CI: 2.016-5.880) and 3.924 times (95%CI: 2.199-7.001), respectively, that in Uyghur children. The CNV of IRX3_1 was a risk factor for overweight/obesity (P=0.028, OR=2.251, 95%CI: 1.418-5.651).</p><p><b>CONCLUSIONS</b>The CNV of IRX3_1 is associated with overweight/obesity in Han, Uyghur, and Kazak children, and the association between the CNV of IRX3_1 and overweight/obesity in Kazak children should be taken seriously.</p>

Rapid detection of alpha-globin gene αααtriplets with droplet digital PCR / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rapid method for detection of alpha-globin gene αααbased on droplet digital PCR (ddPCR) technique.</p><p><b>METHODS</b>The differential sequence between the X1 and Y1 box of α1 gene was selected as the amplicon of the target gene with β-actin as the reference gene. The specific primers and TaqMan probes were designed, and then a quantitative method for detecting the copy number was established based on ddPCR technique. The sensitivity and accuracy of the method were evaluated by detecting 28 samples of known genotypes and 60 clinical samples.</p><p><b>RESULTS</b>The ddPCR-based method accurately identified the genotypes of all the 28 samples with known genotypes and detected 5 cases of αα/αααfrom the 60 clinical samples, and the results were verified by MLPA. The sensitivity and accuracy of this method were both 100% for detecting alpha-globin gene ααα.</p><p><b>CONCLUSION</b>This ddPCR-based method for detecting αααtriplet can be applied for population screening and in routine clinical molecular diagnosis with simple operation, rapid analysis and accurate results.</p>

Effect of Cervical Rotatory Manipulation on Displacement and Intra-stress of Cervical Disc in Different Positions / 中国康复理论与实践

Objective To simulate the cervical rotatory manipulation(CRM)in flexion,neutral and extension positions using three-di-mensional finite element,so as to investigate the effect of this manipulation on the displacement and intra-stress of cervical disc in different positions.Methods By using the method of reverse engineering with Mimics 10.01,Geomagic Studio and Solidworks 14.0,a three-dimen-sional geometric CAD model of C5-6was developed from the CT scan images of a normal adult female aged 25 years.The model was import-ed into Ansys Workbench 14.5,and a three-dimensional finite element model was verified and simulated the CRM.The CRM was decom-posed by principium of manipulation in flexion,neutral and extension,respectively.The parameter of mechanics was analyzed with the fi-nite element system.The change of displacement and intra-stress distribution in cervical disc simultaneous were displayed during simulating the manipulation.Results The posterior part of opposite rotary side of annulus fibers was all retracted,and the displacement was toward an-terior,maximal in flexion position,followed as neutral position and minimal in extension position.In the meantime,the posterior part of the rotary side of annulus fibers was expanded into posterior,minimal in flexion position,followed as neutral position and maximal in extension position.The intra-stress in cervical disc was focused on posterior part of opposite rotary side,opposite rotary side and posterior part of the rotary side in flexion position,neutral position and extension position,respectively,maximal in flexion position,followed as extension posi-tion and minimal in neutral position. Conclusion To treat with cervical spondylotic radiculopathy in the perspective of safety of cervical disc,the CRM should rotate to the unaffected side,first in neutral position,second in flexion position if with poor efficacy.Patients with cer-vical spinal stenosis should not be treated with the CRM.

Dictamni Cortex powder-induced liver injury based on integrated evidence chain / 中国中药杂志

A typical clinical case of taking Dictamni Cortex(Baixianpi) powder was analyzed to study liver damage caused by Dictamni Cortex. Liver damage was diagnosed according to the integrated evidence chain method recommended by the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury. By analyzing clinical history and biochemistry and imaging examinations, underlying diseases, such as viral hepatitis, autoimmune liver disease and alcoholic liver disease, were excluded. Through the investigation of medication history, we made it clear that the patient only took Dictamni Cortex powder during the period, and thus suspected that the liver injury was induced by Dictamni Cortex. Furthermore, the quality of the drug was tested, and the results showed it was consistent with the quality standard of Chinese Pharmacopoeia. DNA barcoding showed that the drug was 100% similar with Dictamnus dasycarpus. Moreover, exogenous harmful substances and chemical drug additions were tested, and the results showed that the content of heavy metal, pesticide residues and microbial toxin were consistent with the required standards, and no chemical drug additions were found in Agilent Fake TCM-Drugs database. In summary, we confirmed that the clinical case of drug-induced liver injury was induced by D. dasycarpus with the dose of 15 g•d⁻¹, which exceeded the prescribed amount of Chinese Pharmacopoeia. According to the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury, the case of drug-induced liver injury induced by D. dasycarpus was confirmed, which provided a direct and reliable evidence for the study of risk of liver injury induced by D. dasycarpus and its relevant preparations.

Preparation and characterization of salvianolic acids-tanshinones composite powder for inhalation via co-micronized method / 中国中药杂志

Salvianolic acids and tanshinones are main hydrophilic and lipophilic extracts from Salvia Miltiorrhiza with significant anti-pulmonary fibrosis effects. The aim of this study was to prepare a co-micronized salvianolic acids-tanshinones composite powder for inhalation using a planetary ball mill. The micronization process parameters were optimized by central composite design (CCD) and response surface methodology (RSM). Treatment time, rotation speed and the ball/sample weight ratio were selected as the independent variables, and the volume fraction of particle size in 1-5 μm was taken as the dependent variable. The powder properties were evaluated by scanning electron microscopy (SEM), laser diffraction and X-ray powder diffraction (XRPD). The powder flow and hygroscopicity were determined with repose angle, compressibility index and critical relative humidity(CRH). According to the results, the salvianolic acids-tanshinones composite powder produced in optimal conditions had a narrow and unimodal particle size distribution and a smaller D₅₀ of 2.33 μm. The volume fraction of particle size in 1-5 μm was 80.82%. The repose angle was (50.60±1.13) °, and the critical relative humidity is about 77%. After being micronized, the particle size significantly reduced, and the number of amorphous substances slightly increased, with no significant changes in powder flow and hygroscopicity. These findings indicate that the grinding method with a planetary ball mill can be used to co-micronize various components with different properties and prepare composite drug powders for dry powder inhalation.

Expression of Aquaporin 4 in Diffuse Brain Injury of Rats / 法医学杂志

OBJECTIVE@#To observe the expression of aquaporin 4 (AQP4) in diffuse brain injury (DBI) of rats and to explore the corresponding effect of AQP4 for brain edema.@*METHODS@#The rat model of DBI was established using Marmarou's impact-compression trauma model. Brain water content was measured by dry-wet weight method. Blood-brain barrier permeability was evaluated by Evans blue (EB) staining. Immunohistochemical method was used to observe the expression of AQP4.@*RESULTS@#Brain water content increased after 3 h and peaked at 24 h after DBI. Brain EB content significantly increased and peaked at 12 h after DBI. The expression of AQP4 significantly increased after 3 h and peaked at 24 h after DBI, and the number of AQP4 positive astrocytes increased.@*CONCLUSION@#The increment of the permeability of blood-brain barrier and the expression of AQP4 may contribute to the development of brain edema in rat DBI. The change of AQP4 expression in astrocytes may also contribute to determine DBI.

Molecular mechanism of tumor necrosis factor-alpha monoclonal antibody in hepatopulmonary syndrome in rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the molecular mechanism of tumor necrosis factor-alpha (TNF-a) monoclonal antibody (McAb) in hepatopulmonary syndrome using a rat model.</p><p><b>METHODS</b>Sixty adult male Sprague-Dawley rats, weighing 250 ± 25 g, were randomized to a sham operation group, a common bile duct ligation (CBDL) group, or a CBDL+TNF-alphat McAb treatment group. The CBDL operation group was further divided into five subgroups, and the CBDL+TNF-alpha McAb treatment group was further divided into four subgroups. After the experimental period, all rats were sacrificed for excision of lung and liver tissues. Hematoxylin-eosin (HE) and Masson staining were performed to observe the extent of liver fibrosis,and HE staining was used to histopathologically assess changes in the lung tissue. Immunohistochemistry and western blotting were used to investigate the changes in expression levels of FAK, p-FAK and PTEN in lung.</p><p><b>RESULTS</b>The extent of inflammatory responses and fibrosis in the liver was significantly lower in the CBDL+TNF-alpha McAb treatment group as compared to those in the CBDL group. The inflammatory responses in the lung were also significantly lower in the CBDL+TNF-alpha McAb treatment group as compared to that in the CBDL group. The CBDL+TNF-alpha McAb treatment group also showed less extensive distribution of FAK and p-FAK protein in lung tissues,but more extensive distribution of PTEN protein.</p><p><b>CONCLUSION</b>FAK and PTEN are associated with hepatopulmonary syndrome in rats. The therapeutic effect of TNF-alpha McAb may involve modulation of the expression of FAK and PTEN.</p>

The research progress of primary liver cancer treated by integrative Chinese and western medicine / 国际中医中药杂志

Integrative Chinese and western medicine therapy exhibited their achievements in reducing adverse reactions, improving the quality of life and prolonging the survival of the primary liver cancer (PLC) patients, which are reflected in the results of surgery, interventional therapy, chemotherapy, radiotherapy, recurrence and metastasis, promoting the liver cell apoptosis, and enhancing the effect of western medicine therapy. This article mainly overviews the current situation of clinical and experimental researches.