UPLC-Q-TOF-MS/MS combined with network pharmacology for exploring antiinflammatory mechanism of Eurycoma longifolia / 南方医科大学学报

OBJECTIVE@#To explore the mechanisms that mediate the anti-inflammatory activity of Eurycoma longifolia.@*METHODS@#Kunming mouse models of xylene-induced ear swelling and lipopolysaccharide (LPS)-induced acute pneumonia were used to compare the anti- inflammatory activities of aqueous and ethanol extracts of Eurycoma longifolia. UPLC-Q-TOF-MS/MS was used to identify the chemical composition in the ethanol extract of Eurycoma longifolia, based on which the potential antiinflammatory targets of Eurycoma longifolia were screened using the databases including SwissADME, SwissTargetPrediction, and Genecards. The String database was used to generate the protein-protein interaction (PPI) network, and Cytoscape was used for network topology analysis and screening the core targets. The enrichment of the core targets was analyzed using Metascape database, the core components and targets were docked with Autodock software, and the docking results were visualized using Pymol software. In a RAW264.7 cell model of LPS-induced inflammation, the Griess reagent was used to measure NO level, and Western blotting was performed to detect the expression levels of MAPK1, JAK2, and STAT3 proteins to verify the anti- inflammatory mechanism of Eurycoma longifolia.@*RESULTS@#The ethanol extract (75%) of Eurycoma longifolia (ELE) was the active site, which contained a total of 37 chemical components. These chemical compounds and diseases had 541 targets, involving the JAK/STAT3, cAMP and other signaling pathways. Twelve indicator components were identified, which all showed good results of molecular docking with two core targets involved in the signaling pathways. In the cell validation experiment, treatment of the cells with low-, medium-, and high-dose ELE significantly reduced NO release in the cells, and ELE at the medium dose significantly decreased the cellular expressions of JAK2 and STAT3.@*CONCLUSION@#The anti-inflammatory activity of Eurycoma longifolia is attributed primarily to its active ingredients bitter lignin and alkaloids, which may regulate the JAK/STAT3 signaling pathway by targeting JAK2 and STAT3.

Etiology and drug sensitivity of bacterial keratitis in recent 40 years in China: a Meta-analysis / 中华实验眼科杂志

Objective:To evaluate the distribution and drug sensitivity of pathogenic bacteria in patients with bacterial keratitis in recent 40 years in China.Methods:A Meta-analysis was conducted.Five databases including PubMed, ScienceDirect, Embase, CNKI and Wanfang Data Knowledge Service Platform were searched.The research was limited to the hospital-based cross-sectional studies published in Chinese and English between 1980 and 2020, without limitations of subject.Two researchers followed the inclusion and exclusion criteria to complete literature retrieval, data extraction and methodological quality evaluation.The literature quality was assessed with reference to a methodological scoring system for rates. Q test and I2 test were used to quantify the degree of heterogeneity of the included literature.According to the heterogeneity, the fixed effects model or random-effects model was used to calculate the combined rates indicators to perform the Meta-analysis. Results:Twenty-seven original studies were incorporated, including 50 046 cases of bacterial keratitis.A random-effects model for the Meta-analysis showed that the positive rate of bacterial culture in bacterial keratitis was 28% (95% CI: 0.24-0.32). Among the culture-positive bacteria, the percentages of gram-positive cocci and gram-negative bacilli were 57% (95% CI: 0.52-0.62) and 32% (95% CI: 0.28-0.37), respectively.The percentages of gram-positive bacilli and gram-negative cocci were 8% (95% CI: 0.06-0.10) and 1% (95% CI: 0.01-0.02), respectively.In the recent 40 years, the proportion of gram-positive cocci isolated from corneas in China was on the rise, and the proportion of gram-negative bacilli was on the decline.Among them, coagulase-negative Staphylococcus accounted for 23% (95% CI: 0.17-0.30), followed by Pseudomonas aeruginosa 18% (95% CI: 0.14-0.23), Streptococcus pneumoniae 8% (95% CI: 0.06-0.12), Staphylococcus aureus 6% (95% CI: 0.04-0.08), Corynebacterium 4% (95% CI: 0.03-0.07), and Escherichia coli 4% (95% CI: 0.02-0.06). The results of the drug sensitivity test showed that gram-positive cocci were highly sensitive to vancomycin, moxifloxacin, levofloxacin and ofloxacin. Pseudomonas aeruginosa was most sensitive to tobramycin, and Escherichia coli was most sensitive to ofloxacin. Conclusions:This Meta-analysis indicates that the proportion of gram-positive cocci isolated from corneas in China has been on the rise, while the proportion of gram-negative bacilli was on the decline during the recent 40 years.Coagulase-negative Staphylococcus and Pseudomonas aeruginosa have become the most common pathogens of bacterial keratitis in China.The sensitivity of various bacteria to commonly used antibiotics shows a downward trend.The sensitive antibiotics should be selected correctly according to the drug sensitivity results.

Characteristics of high cardiovascular risk in 360 000 adults in Northwest China / 西安交通大学学报(医学版)

【Objective】 To assess the prevalence and treatment of high cardiovascular disease （CVD） risk， and identify individual characteristics related to high CVD risk. 【Methods】 Based on the data of the China Patient-Centered Evaluative Assessment of Cardiac Events （PEACE） Million Persons Project （MPP） from 2016 to 2019， this study enrolled local residents aged 35 to 75 years from 39 counties or districts in Northwest China. Rates of high CVD risk and individual characteristics were assessed in the overall study population. Statin and aspirin use was also evaluated among those at high risk for CVD. Multivariable mixed models were fitted to evaluate the relationship between individual characteristics and high CVD risk. 【Results】 Among 364 537 participants， the average age was （54.6±9.7）years， and 5.8% was at a high risk for CVD. Multivariate mixed models showed that individuals who were currently using alcohol， overweight or obese tended to have a high risk for CVD， while married persons， those with a higher education level or a higher household income were correlated with a lower risk for CVD （all P<0.05）. Among high-risk persons， hypertension was the most prevalent risk factor （98.1%）， and only 1.3% and 3.5% reported their use of statins and aspirin， respectively. 【Conclusion】 Of the 364 537 participants， about 1 in 17 had a high risk for CVD. Among those at a high CVD risk， only less than 4% reported taking statins or aspirin. These findings indicate that there is still much room for risk mitigation in this population in China.

Association between Use of Qingfei Paidu Tang and Mortality in Hospitalized Patients with COVID-19: A national retrospective registry study

BackgroundQingfei Paidu Tang (QPT), a formula of traditional Chinese medicine, which was suggested to be able to ease symptoms in patients with Coronavirus Disease 2019 (COVID-19), has been recommended by clinical guidelines and widely used to treat COVID-19 in China. However, whether it decreases mortality remains unknown. PurposeWe aimed to explore the association between QPT use and in-hospital mortality among patients hospitalized for COVID-19. Study designA retrospective study based on a real-world database was conducted. MethodsWe identified patients consecutively hospitalized with COVID-19 in 15 hospitals from a national retrospective registry in China, from January through May 2020. Data on patients characteristics, treatments, and outcomes were extracted from the electronic medical records. The association of QPT use with mortality was evaluated using Cox proportional hazards models based on propensity score analysis. ResultsOf the 8939 patients included, 28.7% received QPT. The crude mortality was 1.2% (95% confidence interval [CI] 0.8% to 1.7%) among the patients receiving QPT and 4.8% (95% CI 4.3% to 5.3%) among those not receiving QPT. After adjustment for patient characteristics and concomitant treatments, QPT use was associated with a relative reduction of 50% in in-hospital mortality (hazard ratio, 0.50; 95% CI, 0.37 to 0.66 P <0.001). This association was consistent across subgroups by sex and age. Meanwhile, the incidence of acute liver injury (8.9% [95% CI, 7.8% to 10.1%]vs. 9.9% [95% CI, 9.2% to 10.7%]; odds ratio, 0.96 [95% CI, 0.81% to 1.14%], P =0.658) and acute kidney injury (1.6% [95% CI, 1.2% to 2.2%] vs. 3.0% [95% CI, 2.6% to 3.5%]; odds ratio, 0.85 [95% CI, 0.62 to 1.17], P =0.318) was comparable between patients receiving QPT and those not receiving QPT. The major study limitations included that the study was an observational study based on real-world data rather than a randomized control trial, and the quality of data could be affected by the accuracy and completeness of medical records. ConclusionsQPT was associated with a substantially lower risk of in-hospital mortality, without extra risk of acute liver injury or acute kidney injury among patients hospitalized with COVID-19.

Application of three-dimensional cell model in tumor research / 中国药科大学学报

@#The three-dimensional cell model cultures different types of cells in vitro. By means of special materials or carriers, the cells can grow, migrate and differentiate in a three-dimensional environment. The three-dimensional cell model provides the cells with an in vitro environment that is close to in vivo, making the gene expression and signal exchange of the cells more physiologically relevant. This paper starts with the concept and classification of three-dimensional cell model, then summarizes the applications and progresses of three-dimensional cell model in tumor micro-environment, cancer metastasis and anti-tumor drug development in recent years. Based on the current shortcomings of the three-dimensional cell model, this paper presents the assumptions and prospects for the application of three-dimensional cell model in tumor therapy.

Length of stay for acute myocardial infarction patients in eastern rural area in China from 2001 to 2011 / 中国医师杂志

Objective To describe the average hospital length of stay (LOS) and its trend and variation in rural areas of eastern China,and to analyze the hospital characteristics associated with LOS.Methods We collected the data of representative in-patients with acute myocardial infarction (AMI) in eastern rural areas in 2001,2006 and 2011 by random sampling.The hospital length of stay and its changing trend were described.Hospitals were divided into tertiles-high,middle,low-based on the median LOS;the characteristics of patients,AMI treatment,as well as outcome were compared across the tertiles of hospitals.The association between the hospital characteristics and LOS was analyzed after adjusting for patient-level characteristics.Results We examined the medical records of 2 361 patients hospitalized with AMI from 32 hospitals in the eastern rural areas.The average LOS were (14.7 ± 10)days in 2001,(12.4 ± 10.1)days in 2006,and (11.9 ± 6.5) days in 2011,decreasing annually (F =15.41,P ＜ 0.001).When looking at the cohort on the three time points (2001,2006,and 2011) with ruling out the factors of complication during hospitalization and the LOS outliers,the average LOS still indicated an trend of decline (F =5.44,P =0.02).However,after adjusting for the differences in patient factors,few marked differences in LOS were found over the years (P =0.89).Across the three tertiles of hospitals,categorized as high,middle and low based on the average LOS,a statistical difference existed in the use rate of statin during hospitalization (P ＜0.05).After adjusting for patient-level characteristics,the hospital characteristics were not significantly associated with the average LOS.Conclusions This study showed a trend of an annual decrease of LOS in patients hospitalized with AMI from the eastern rural areas in China.There is nevertheless still significant room for further improvement.Therefore,it is crucial to effectively advance the standardization for AMI patients of diagnosis and treatment,improve healthcare quality,and reduce patient LOS,which is the very key to enhancing the AMI treatments in the rural region of Eastern China.

Application and Affecting Factor Analysis of Clopidogrel Loading Therapy in STEMI Patients With Percutaneous Coronary Intervention in China in 2006 and 2011 / 中国循环杂志

Objective: To explore the application and affecting factors of clopidogrel loading therapy in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in china in 2006 and 2011. Methods: Based on “China patient-centered evaluative assessment of cardiac events retrospective study of acute myocardial infarction”, we collected clinical information of STEMI patients with PCI in 2006, 2011 and analyzed clopidogrel loading therapy status in different years and different hospitals. According to clopidogrel doses, the patients were divided into 2 groups: Clopidogrel 300mg group, the patients received a single dose of clopidogrel ≥300mg while 0.05. In 2006, the hospital median rate of clopidogerl application was 44.4% (IQR 21.8% to 69.0%) and in 2011, it was 48.1% (IQR 25.0% to 70.8%),P=0.940. Binary logistic regression analysis showed that the patients were admitted within 12 hours of onset, with primary PCI and treated in central region had the higher rates of clopidogrel loading therapy. Conclusion: Clopidogrel loading therapy was seriously inadequate in STEMI patients with PCI, variation was across hospitals and the status was similar between 2006 and 2011. Clopidogrel loading therapy should be improved.

Silicosis:The Evaluation of Pulmonary Function Damage with Multi-slice Spiral CT / 实用放射学杂志

Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.

Scientifically understanding and appropriately promoting the core competitiveness of the hospital / 中华医院管理杂志

By analyzing the situation of market competition by modern hospitals, the paper identifies the core competitiveness of the hospital as the key force to be nurtured and promoted by the hospital in its competition in the medical services market; the basic force that spaces out service levels and profits of hospitals at the same level; the unique cultural force shaped by the hospital in a long period of time; the dynamic force rising constantly to mans needs for medical and health care; the main force driving the sustainable development of the hospital in market competition. The paper also proposes five major core competitive capacities to be especially nurtured and promoted by the hospital, viz. the integrative capacity in management, the influencing capacity of specialized fields, the fighting capacity of the team, the cohesive capacity of culture, and the scheming capacity for marketing.