Predictive value of presepsin and acylcarnitines for severity and biliary drainage in acute cholangitis.

BACKGROUND: Bacteremia, which is a major cause of mortality in patients with acute cholangitis, induces hyperactive immune response and mitochondrial dysfunction. Presepsin is responsible for pathogen recognition by innate immunity. Acylcarnitines are established mitochondrial biomarkers. AIM: To clarify the early predictive value of presepsin and acylcarnitines as biomarkers of severity of acute cholangitis and the need for biliary drainage. METHODS: Of 280 patients with acute cholangitis were included and the severity was stratified according to the Tokyo Guidelines 2018. Blood presepsin and plasma acylcarnitines were tested at enrollment by chemiluminescent enzyme immunoassay and ultra-high-performance liquid chromatography-mass spectrometry, respectively. RESULTS: The concentrations of presepsin, procalcitonin, short- and medium-chain acylcarnitines increased, while long-chain acylcarnitines decreased with the severity of acute cholangitis. The areas under the receiver operating characteristic curves (AUC) of presepsin for diagnosing moderate/severe and severe cholangitis (0.823 and 0.801, respectively) were greater than those of conventional markers. The combination of presepsin, direct bilirubin, alanine aminotransferase, temperature, and butyryl-L-carnitine showed good predictive ability for biliary drainage (AUC: 0.723). Presepsin, procalcitonin, acetyl-L-carnitine, hydroxydodecenoyl-L-carnitine, and temperature were independent predictors of bloodstream infection. After adjusting for severity classification, acetyl-L-carnitine was the only acylcarnitine independently associated with 28-d mortality (hazard ratio 14.396; P < 0.001) (AUC: 0.880). Presepsin concentration showed positive correlation with direct bilirubin or acetyl-L-carnitine. CONCLUSION: Presepsin could serve as a specific biomarker to predict the severity of acute cholangitis and need for biliary drainage. Acetyl-L-carnitine is a potential prognostic factor for patients with acute cholangitis. Innate immune response was associated with mitochondrial metabolic dysfunction in acute cholangitis.

Clinical Significance of Thrombospondin Type 1 Domain-Containing 7A and Neural Epidermal Growth Factor-Like 1 Protein in M-Type Phospholipase A2 Receptor-Negative Membranous Nephropathy / 中国医学科学院学报

Objective To investigate the clinical significance of thrombospondin type 1 domain-containing 7A (THSD7A) and neural epidermal growth factor-like 1 protein (NELL1) in phospholipase A2 receptor (PLA2R)-negative membranous nephropathy (MN). Methods A total of 116 PLA2R-negative MN patients treated in Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University from 2014 to 2021 were enrolled in this study.Immunohistochemistry was employed to detect THSD7A and NELL1 in the renal tissue.The pathological characteristics,treatment,and prognosis were compared between positive and negative groups. Results The 116 PLA2R-negative MN patients included 23 THSD7A-positive patients and 9 NELL1-positive patients.One patient was tested positive for both proteins.The THSD7A-positive group showed higher positive rate of IgG4 (P=0.010),more obvious glomerular basement membrane (GBM) thickening (P=0.034),and higher proportion of stage Ⅱ MN and lower proportion of stage I MN (P=0.002) than the THSD7A-negative group.The NELL1-positive group had lower positive rates of C1q and IgG2 (P=0.029,P=0.001),less obvious GBM thickening (P<0.001),more extensive inflammatory cell infiltration (P=0.033),lower proportion of deposits on multi-locations (P=0.001),and lower proportion of atypical MN (P=0.010) than the NELL1-negative group.One patient with THSD7A-positive MN was diagnosed with colon cancer,while none of the NELL1-positive patients had malignancy.Survival analysis suggested that THSD7A-positive MN had worse composite remission (either complete remission or partial remission) of nephrotic syndrome than the negative group (P=0.016),whereas NELL1-positive MN exhibited better composite remission of nephrotic syndrome than the negative group (P=0.015).The MN patients only positive for NELL1 showed better composite remission of nephrotic syndrome than the MN patients only positive for THSD7A (P<0.001). Conclusions THSD7A- and NELL1-positive MN is more likely to be primary MN,and there is no significant malignancy indication.However,it might have a predictive value for the prognosis of MN.

Dynamic blood presepsin levels are associated with severity and outcome of acute pancreatitis: A prospective cohort study.

BACKGROUND: Acute pancreatitis (AP) is an inflammatory disorder of the pancreas with an unpredictable course of illness. A major challenge of AP is the early identification of patients at high-risk for organ failure and death. However, scoring systems are complicated and time consuming, and the predictive values for the clinical course are vague. AIM: To determine whether the dynamic changes in presepsin levels can be used to evaluate the severity of disease and outcome of AP. METHODS: In this multicentric cohort study, 133 patients with AP were included. Clinical severity was dynamically evaluated using the 2012 revised Atlanta Classification. Blood presepsin levels were measured at days 1, 3, 5 and 7 after admission by chemiluminescent enzyme immunoassay. RESULTS: The median concentration of presepsin increased and the clearance rate of presepsin decreased with disease severity and organ failure in AP patients. The presepsin levels on days 3, 5 and 7 were independent predictors of moderately severe and severe AP with time-specific area under the curve (AUC) values of 0.827, 0.848 and 0.867, respectively. The presepsin levels positively correlated with bedside index of severity in AP, Ranson, acute physiology and chronic health evaluation II, computed tomography severity index and Marshall scores. Presepsin levels on days 3, 5 and 7 were independent predictors of 28-d mortality of AP patients with AUC values of 0.781, 0.846 and 0.843, respectively. CONCLUSION: Blood presepsin levels within 7 d of admission were associated with and may be useful to dynamically predict the severity of disease course and 28-d mortality in AP patients.

Alternative splicing analysis showed the splicing factor polypyrimidine tract-binding protein 1 as a potential target in acute myeloid leukemia therapy.

Alternative splicing (AS) is a universal post-transcriptional regulation process in cells, and increasing evidences have validated its crucial role in tumors. We collected AS event, gene expression, and clinical data of 178 AML patients from The Cancer Genome Atlas (TCGA) project. More than 1,000 AS events were found associated with overall survival (OS), and alternate promoter (AP) events were the most significant. The expression of the KIAA0930 transcript was the most significantly different AS event selected from AP events and significantly correlated with the expression of the splicing factor (SF) polypyrimidine tract-binding protein 1 (PTBP1). Then, the roles of PTBP1 on AS of the KIAA0930 and the proliferation of AML cells were confirmed. KIAA0930 variant 1 (KIAA0930-1) was upregulated and variant 2 (KIAA0930-2) downregulated with knockdown PTBP1 expression of AML cells by specific shRNA. A low level of PTBP1 can decrease the proliferation ability of AML cells. In conclusion, the results showed that PTBP1 might be a potential target for AML therapy.

Increasing angiotensin-converting enzyme (ACE) 2/ACE axes ratio alleviates early pulmonary vascular remodeling in a porcine model of acute pulmonary embolism with cardiac arrest.

BACKGROUND: Acute pulmonary embolism (APE) with cardiac arrest (CA) is characterized by high mortality in emergency due to pulmonary arterial hypertension (PAH). This study aims to determine whether early pulmonary artery remodeling occurs in PAH caused by massive APE with CA and the protective effects of increasing angiotensin-converting enzyme (ACE) 2-angiotensin (Ang) (1-7)-Mas receptor axis and ACE-Ang II-Ang II type 1 receptor (AT1) axis (ACE2/ACE axes) ratio on pulmonary artery lesion after return of spontaneous circulation (ROSC). METHODS: To establish a porcine massive APE with CA model, autologous thrombus was injected into the external jugular vein until mean arterial pressure dropped below 30 mmHg (1 mmHg=0.133 kPa). Cardiopulmonary resuscitation and thrombolysis were delivered to regain spontaneous circulation. Pigs were divided into four groups of five pigs each: control group, APE-CA group, ROSC-saline group, and ROSC-captopril group, to examine the endothelial pathological changes and expression of ACE2/ACE axes in pulmonary artery with or without captopril. RESULTS: Histological analysis of samples from the APE-CA and ROSC-saline groups showed that pulmonary arterioles were almost completely occluded by accumulated endothelial cells. Western blotting analysis revealed a decrease in the pulmonary arterial ACE2/ACE axes ratio and increases in angiopoietin-2/angiopoietin-1 ratio and expression of vascular endothelial growth factor (VEGF) in the APE-CA group compared with the control group. Captopril significantly suppressed the activation of angiopoietin-2/angiopoietin-1 and VEGF in plexiform lesions formed by proliferative endothelial cells after ROSC. Captopril also alleviated endothelial cell apoptosis by increasing the B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X (Bax) ratio and decreasing cleaved caspase-3 expression. CONCLUSION: Increasing the ACE2/ACE axes ratio may ameliorate pulmonary arterial remodeling by inhibiting the apoptosis and proliferation of endothelial cells after ROSC induced by APE.

Effect of Modified Chaihu Shugansan and Its Disassembled Formulas on ACE2- Ang （Ⅰ-Ⅶ）-MasR Axis in Rats with Myocardial Ischemia and Depression / 中国实验方剂学杂志

ObjectiveTo observe the effects of modified Chaihu Shugansan（CHSG） and its disassembled formulas on angiotensin-converting enzyme 2 （ACE2）-angiotensin （Ⅰ-Ⅶ） ［Ang （Ⅰ-Ⅶ）］-mitochondrial assembly receptor （MasR） axis in hyperlipidemic rats with myocardial ischemia and depression， and to explore the underlying mechanism of its prevention and treatment of myocardial ischemia and depression. MethodA total of 108 male SD rats were randomly divided into a normal group， a model group， a modified CHSG group （11.7 g·kg-1）， a Quyu Huatan disassembled formula group （4.05 g·kg-1）， a Shugan Xingqi disassembled formula group （3.15 g·kg-1）， a Jianpi Yangxue disassembled formula group （4.5 g·kg-1）， a fluoxetine group （0.001 8 g·kg-1）， a trimetazidine group （0.005 4 g·kg-1）， and a simvastatin group （0.001 8 g·kg-1）， with 12 rats in each group. The hyperlipidemia model with myocardial ischemia and depression was induced with a high-fat diet combined with injection of isoproterenol （ISO） and chronic unpredictable mild stress （CUMS） in rats in the model group and groups with drug intervention for eight weeks. The rats in each group with drug intervention were treated correspondingly by gavage from the first day of modeling， while those in the normal group and the model group received the same amount of normal saline. The behavioral changes of rats in each group were observed by open field test and forced swimming test. Left ventricular fractional shortening （LVFS） and left ventricular ejection fraction （LVEF） were measured by echocardiography. The serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were detected by the enzyme-labeled apparatus. Hematoxylin-eosin （HE） staining was used to observe the histomorphological changes of the heart. The serum levels of angiotensin Ⅱ （AngⅡ）， ACE2， and Ang（Ⅰ-Ⅶ） were detected by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA expression of ACE2 and MasR in the hippocampus and the heart was detected by real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCompared with the normal group， the model group showed reduced movement time， distance， and average speed in the central area of the open field （P<0.01）， prolonged immobility time of rats in the forced swimming test （P<0.01）， decreased LVFS and LVEF （P<0.01）， inflammatory exudation and disorderly arranged fiber in heart tissues， elevated serum levels of TC， LDL-C， AngⅡ， ACE2 and Ang（Ⅰ-Ⅶ）， diminished HDL-C （P<0.01）， dwindled mRNA and protein expression of ACE2 in the hippocampus and the heart and MasR in the hippocampus， and up-regulated mRNA and protein expression of MasR in the heart （P<0.01）. Compared with the model group， the modified CHSG group displayed increased movement time， distance， and average speed in the center area of the open field （P<0.01）， shortened immobility time in the forced swimming test （P<0.01）， increased LVFS and LVEF （P<0.01）， relieved heart injury， reduced serum levels of TC， LDL-C， AngⅡ， ACE2， and Ang（Ⅰ-Ⅶ）， elevated level of HDL-C （P<0.01）， up-regulated mRNA and protein expression of ACE2 in the hippocampus and the heart and MasR in the hippocampus， and down-regulated mRNA and protein expression of MasR in the heart （P<0.01）. Each disassembled formula could improve the above indexes to a certain extent （P<0.05， P<0.01）， but the effect of the whole formula was optimal. ConclusionThe modified CHSG and its disassembled formulas have the effects of resisting depression， improving myocardial injury， and reducing blood lipid. Due to the synergistic effects of stasis-resolving/phlegm-eliminating drugs， liver-smoothing/Qi-moving drugs， and spleen-tonifying/blood-nourishing drugs in the formula， the modified CHSG is superior to each disassembled formula in efficacy. Its mechanism may be related to the activation of the ACE2-Ang （Ⅰ-Ⅶ）-MasR axis.

Vitamin D has an effect on airway inflammation and Th17/Treg balance in asthmatic mice.

Asthma is regarded as a chronic inflammation of the airway. Research has highlighted the significance of Vitamin D in asthma. This study explored the mechanism of vitamin D on asthma. The asthma mouse model was established by ovalbumin (OVA) sensitization and treated with vitamin D (50 or 100 ng/ml). The morphological changes of the airway were observed by HE staining. The serum IgE contents and MDA, ROS, and SOD expressions in the bronchoalveolar lavage fluid (BALF) were detected by ELISA. The Th17 and Treg cells were detected using flow cytometry. The RORγt and Foxp 3 expressions were detected by Reverse transcription quantitative polymerase chain reaction (RT-qPCR). IL-17, IL-10, and TGF-ß1 expressions were detected using ELISA. The NF-κB pathway was blocked using the NF-κB pathway inhibitor, Andrographolide sulfonate. The NF-κB pathway-related indexes were detected by western blotting. After blockade of the NF-κB pathway, the IL-17, IL-10, and TGF-G1 expressions were detected. OVA-sensitized asthma induced airway remodeling and elevated IgE content in mice, which was downregulated after vitamin D treatment. MDA and ROS were upregulated and SOD was downregulated in asthmatic mice, while vitamin D inverted the changes. Th17/Treg ratio was imbalanced, RORγt and IL-17 were upregulated, and Foxp 3, IL-10, and TGF-ß1 were downregulated after OVA sensitization, while vitamin D treatment inverted these changes and inhibited the NF-κB-p65 phosphorylation level. After blockade of the NF-κB pathway, IL-17 was downregulated and IL-10 and TGF-ß1 were upregulated. In conclusion, vitamin D rectified the Th17/Treg balance and alleviated airway inflammation by inhibiting the NF-κB pathway in asthmatic mice.

Impulse Control Disorder in Parkinson's Disease: A Scoping Review / 中国康复理论与实践

Objective:To explore the epidemiology, pathogenesis, risk factors, screening and evaluation, diagnostic strategies and treatment of impulse control disorder after Parkinson's disease (PD). Methods:Studies related to Parkinson's disease complicated with impulse control disorder were retrieved using subject search from PubMed, Medline, Embase, Cochrane Library, CNKI, VIP and Wanfang Data, until December, 2020, and supplemented by reference backtracking and manual retrieval. Results:A total of 2355 studies were returned first, and 30 were included, from ten countries, mainly published in journals about medicine, neurology, psychiatry, sleep medicine and movement disorders, etc., between 2010 and 2020. The researches mainly involved the pathogenesis, risk factors, screening and evaluation, diagnostic strategies and treatment. Conclusion:There are many risk factors for impulse control disorder in PD patients, mostly the dopaminergic drugs, especially dopamine receptor agonists. Interventions for impulse control disorders emphasize prevention and early identification. Individualized and symptomatic treatments based on adjustment of dopamine receptor agonists are needed.

Coping Behaviors and Its Influential Factors for Caregivers of Children with Disabilities in Developed Areas in China / 中国康复理论与实践

Objective:To investigate the current status of coping behaviors among caregivers of children with disabilities in the context of rehabilitation and its influencing factors. Methods:From December, 2019 to January, 2020, and August to September, 2020, a total of 358 caregivers (parents) of children with disabilities were surveyed in Shanghai. They were evaluated in the context of rehabilitation of children with disabilities with Coping Health Inventory for Parents (CHIP). Multiple linear stepwise regression analysis was used to explore the influencing factors. Results:The total score of CHIP was (106.00±23.45) and the average score of CHIP was (2.36±0.52). Among the caregiver factor, mothers (B = 7.607, 95%CI 2.477 to 12.737, P = 0.004), and caregivers who didn't need to care for others (B = 5.758, 95%CI 1.174 to 10.343, P = 0.014) reported higher CHIP score. Among the child factors, higher CHIP score was reported in caregivers who had more partners (B = 2.925, 95%CI 1.233 to 4.618, P < 0.001), participated in public space activities more frequently (B = 3.906, 95%CI 1.743 to 6.068, P < 0.001) and perceived changes in rehabilitation outcomes (B = -16.832, 95%CI -31.471 to -2.193, P = 0.024); CHIP score was lower in thoses of 3 to < 6 years old (B = -7.914, 95%CI -15.157 to -0.671, P = 0.032) and with intellectual disability children (B = -11.153, 95%CI -21.360 to -0.947, P = 0.032). Among the environmental factors, caregivers who perceived more friendly social attitude (B = 2.560, 95%CI 0.615 to 4.505, P = 0.010) reported higher CHIP score. Conclusion:It is proposed to learn the coping needs of caregivers of children with disabilities in the context of rehabilitation. The coping behaviors of caregivers are influenced by multiple factors, such as children's individual, caregivers and environment.

Depression and Its Influencing Factors of Caregivers for Children with Disabilities / 中国康复理论与实践

Objective:To investigate the depression status of caregivers of children with disabilities and analyze the influencing factors. Methods:From August to September, 2020, a one-to-one interview was conducted using a convenience sampling method to determine the depression status of 334 caregivers of children with disabilities in Shanghai. Patient Health Questionnaire 9 Item (PHQ-9) was used to evaluate the depression status. The data were analyzed with univariate analysis from three aspects: caregiver, care recipient and environment. Then, the statistically significant variables were included in a dichotomous logistic regression. Results:The depression rate of 334 caregivers of children with disabilities was 35.9%. Among the caregiver factors, female caregivers had a higher risk of depression than male (OR = 2.193, 95%CI 1.131 to 4.254, P = 0.002). Among the care recipient factors, poor sleep quality (OR = 1.942, 5%CI 1.113 to 3.386, P < 0.05), emotional instability (OR = 17.456, 95%CI 2.534 to 120.240, P < 0.05) and types of disability (ORintelligence = 5.401, 95%CI 1.995 to 14.624; ORmental = 3.712, 95%CI 1.615 to 8.530; ORphysical = 2.913, 95%CI 1.330 to 6.379; P < 0.05) were associated with the depression of caregivers. Among the environmental factors, caregivers in rented housing had a higher risk of depression than those in owner-occupied housing (OR = 1.727, 95%CI 1.135 to 2.627, P < 0.05). Conclusion:The depression status of caregivers of children with disabilities is not optimistic, with higher rates of reported depression among female caregivers, caregivers in rented housing; caregivers of children with intellectual, mental and physical disabilities, and poor sleep quality and emotional instability.

Geographic variations in the incidence of congenital hypothyroidism in China: a retrospective study based on 92 million newborns screened in 2013-2018 / 中华医学杂志(英文版)

BACKGROUND@#Although congenital hypothyroidism (CH) has been widely studied in Western countries, CH incidence at different administrative levels in China during the past decade remains unknown. This study aimed to update the incidence and revealed the spatial pattern of CH incidence in the mainland of China, which could be helpful in the planning and implementation of preventative measures.@*METHODS@#The data used in our study were derived from 245 newborns screening centers that cover 30 provinces of the Chinese Newborn Screening Information System. Spatial auto-correlation was analyzed by Global Moran I and Getis-Ord Gi statistics at the provincial level. Kriging interpolation methods were applied to estimate a further detailed spatial distribution of CH incidence at city level throughout the mainland of China, and Kulldorff space scanning statistical methods were used to identify the spatial clusters of CH cases at the city level.@*RESULTS@#A total of 91,921,334 neonates were screened from 2013 to 2018 and 42,861 cases of primary CH were identified, yielding an incidence of 4.66 per 10,000 newborns screened (95% confidence interval [CI]: 4.62-4.71). Neonates in central (risk ratio [RR] = 0.84, 95% CI: 0.82-0.85) and western districts (RR = 0.71, 95% CI: 0.69-0.73) had lower probability of CH cases compared with the eastern region. The CH incidence indicated a moderate positive global spatial autocorrelation (Global Moran I value = 0.394, P  < 0.05), and the CH cases were significantly clustered in spatial distribution. A most likely city-cluster (log-likelihood ratio [LLR] = 588.82, RR = 2.36, P  < 0.01) and 25 secondary city-clusters of high incidence were scanned. The incidence of each province and each city in the mainland of China was estimated by kriging interpolation, revealing the most affected province and city to be Zhejiang Province and Hangzhou city, respectively.@*CONCLUSION@#This study offers an insight into the space clustering of CH incidence at provincial and city scales. Future work on environmental factors need to focus on the effects of CH occurrence.

Correlation of Color Vision to Anxiety and Depression in Patients with Parkinson's Disease / 中国康复理论与实践

Objective:To investigate the correlation between the change of color vision and anxiety or depression in patients with Parkinson's disease (PD). Methods:From November, 2018 to November, 2019, 63 PD patients from the PD database of Department of Neurology, Dalian Friendship Hospital were selected, and they were tested with Farnsworth-Munsell 100 Hue Test (FMT), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Hospital Anxiety and Depression Scale (HADS). Their age, gender, course of disease, education level, Hoehn-Yahr (H-Y) stage, Unified Parkinson's Disease Rating Scale part III (UPDRSIII), levodopa dose, and scores of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were collected as related factors, and anlyzed with correlation analysis and multivariate regression. Results:The score of FMT was correlated with the scores of HAMA, SAS, HAMD, SDS, and both HADS anxiety and depression (r > 0.561,P < 0.001). Age, H-Y stage, course of disease, score of UPDRSIII, levodopa dose and scores of MMSE and MoCA were related with the score of FMT independently. Conclusion:Color vision dysfunction in PD patients is correlated to the severity of anxiety and depression, and it is affected with age, severity of PD and cognitive impairment.

Advance in Visual Dysfunction for Alzheimer's Disease (review) / 中国康复理论与实践

In recent years, it is found that β-amyloid deposites in the retina of patients with Alzheimer's disease (AD), synchronizing with intracranial changes. AD patients lose their visual acuity and visual contrast sensitivity and demonstrate glaucoma-like visual field loss, color vision disorder, visual hallucination and visual space damage, etc. The retinas become thinner, the latency of electroretinogram prolongs with amplitude decrease, and the latency of visual-evoked potential prolongs.

Research progress of endogenous bone marrow-derived mesenchymal stem cells in pulmonary fibrosis / 生理学报

Pulmonary fibrosis is a chronic, diffuse, interstitial lung disease involving the pulmonary interstitium, alveoli, and bronchioles caused by various causes. There is no effective treatment. Currently, exogenous bone marrow-derived mesenchymal stem cells (BM-MSCs) transplantation has attracted much attention as a new stem cell therapy in the treatment of pulmonary fibrosis. Less attention has been paid to the functional status of endogenous BM-MSCs during pulmonary fibrosis. Based on summary on the anti-pulmonary fibrosis effect of BM-MSCs and its mechanism, this review further discusses the abnormal changes of bone marrow function in animals with pulmonary fibrosis and the role of glutamate NMDA receptor overactivation in mediating the functional inhibition of endogenous BM-MSCs induced by pulmonary fibrosis. This will provide potential ideas for finding effective treatments for pulmonary fibrosis.

Research on grade evaluation method of Paeoniae Radix Rubra based on correlation of "biological activity-quality marker" / 中草药

Objective: A logistic regression model for grade evaluation of Paeoniae Radix Rubra medicinal slices was constructed based on the quality control idea of traditional Chinese medicines that "ingredients reflect activity and activity expresses effect". Methods: Q-marker content of paeoniflorin was tested by ultra-high performance liquid chromatography (UPLC). Anticoagulation valence, inhibition rate of hydroxyl radical and DPPH clearance rate were used as evaluation indexes of biological activity. Correlations between paeoniflorin content in different batches and bioactivity indexes were analyzed by the logistic algorithm. Finally, a "principal component analysis-Logistic regression" model for grade evaluation of Paeoniae Radix Rubra was constructed. Results: According to grade evaluation results, the grade probability of different batches of Paeoniae Radix Rubra was higher than 95%. Among 16 batches of Paeoniae Radix Rubra, 15 batches were evaluated excellent, good and moderate (five for each), and one batch was evaluated poor. Conclusion: A new grade evaluation method for Paeoniae Radix Rubra medicinal slices is constructed preliminarily. It is applicable to quality evaluation of Paeoniae Radix Rubra medicinal slices.

Imbalance of angiotensin-converting enzymes affects myocardial apoptosis during cardiac arrest induced by acute pulmonary embolism in a porcine model.

Acute pulmonary embolism (APE) with cardiac arrest (CA) is associated with a high mortality rate. Even upon return of the spontaneous circulation (ROSC), APE­CA survivors are prone to myocardial cell apoptosis, a key cellular mechanism that induces heart failure. A recent study by our group discovered a post­resuscitation imbalance in the serum angiotensin­converting enzyme (ACE)2/ACE axis of the renin­angiotensin system (RAS), as well as regressive cardiac function in a porcine model of APE­CA. However, it has remained elusive how this imbalance in the ACE2/ACE axis affects myocardial cell apoptosis. In the present study, western blot and immunohistochemical analyses demonstrated that the RAS was only activated in the left myocardium, as evidenced by a decreased ACE2/ACE ratio following APE­CA and ROSC, but not the right myocardium. Ultrastructural analysis confirmed myocardial apoptosis in the left and right myocardium. Furthermore, B­cell lymphoma 2 (Bcl­2)­associated X protein (Bax) and caspase­3 levels were elevated and Bcl­2 levels were decreased in the left myocardium following APE­CA and ROSC. Treatment with the ACE inhibitor captopril for 30 min after initiation of ROSC prevented the increase in Bax and the decrease in Bcl­2 in the left myocardium compared with that in saline­treated pigs. Captopril also inhibited the activation of extracellular signal­regulated kinase (ERK)1/2 in the left myocardium. The results of the present study suggest that an imbalance in the ACE2/ACE axis has an important role in myocardial apoptosis following APE­CA, which may be attributed to decreased ERK1/2 activation. In addition, it was indicated that captopril prevents apoptosis in the left myocardium after ROSC.

Effect of vacancies on the structural and electronic properties of Ti2CO2.

Ti2CO2 MXene is widely considered as a potential candidate material for sensors and optical devices. In this paper, first-principles calculations are performed to investigate the structural and electronic properties of pristine and vacancy defect Ti2CO2 monolayer. The results indicate that C-vacancy is energetically more favorable than Ti-vacancy and O-vacancy because of the smaller formation energy of C vacancy. The introduction of vacancy defects results in the transition from semiconductor to metal, and improves the electronic conductivities of Ti2CO2 monolayer. The introduction of C and O vacancies causes the Ti-d state to split into several peaks in the energy range of 0 to 2 eV, while the introduction of Ti vacancy makes the Ti-d state weaker and the C-p state stronger. Furthermore, the work function can be effectively engineered by vacancy defects.

Advance in Exercise and Related Mechanisms for Parkinson's Disease (review) / 中国康复理论与实践

Parkinson's disease is a common degenerative disease of central nervous system. Exercise for Parkinson's disease includes Taiji Quan, treadmill, dance and balance training, etc. Taiji Quan exercise is mainly for balance function, and treadmill training for gait obstacles. Dance can improve not only balance and gait, but also cognition and emotion. The possible molecular mechanism may involve to adjust the content of dopaminergic neurons in the nigrostatin, increase the content of non-dopaminergic transmitters, increase brain-derived neurotrophic factors, promote the plasticity of nerve cells, reduce oxidative stress, enhance mitochondrial activity, and activate the immune system, etc., to slow the degeneration of dopaminergic neurons and improve the symptoms of Parkinson's disease.

Evaluation for Parkinson's Disease with Chinese Version of MDS-UPDRS and Original UPDRS / 中国康复理论与实践

Objective:To evaluate the reliability and validity of Chinese version of International Parkinson and Movement Disorder Society (MDS)-Unified Parkinson's Disease Rating Scale (UPDRS), and then do comparative analysis with original UPDRS. Methods:From May, 2016 to December, 2018, 225 patients with Parkinson's disease were respectively evaluated by MDS-UPDRS and UPDRS, and then the reliability and validity of MDS-UPDRS were evaluated. Correlation between two scales was analyzed. Results:The Cronbach's coefficient of the total MDS-UPDRS was 0.734. Rank correlation's coefficient was 0.905. For factor analysis, KMO was 0.728. Pearson's correlation analysis showed that the correlation's coefficient of the common factor of the two scales was 0.969, while the correlation's coefficient of the total score of the two scales was 0.972. Compared with UPDRS, MDS-UPDRS added a number of non-motor symptoms, which adjusted the standard of measurement and increased the accuracy degree of evaluation at early stage of disease. Besides, MDS-UPDRS added a lot of instructions to evaluate the standards to make the evaluation normatively. Conclusion:Chinese version of MDS-UPDRS has high reliability and validity, and highly correlate with the original UPDRS. It is more suitable for Chinese patients with Parkinson's disease in clinical evaluation than UPDRS.

Effect of Electroacupuncture on Blood-brain Barrier in SAMP8 Mice / 中国康复理论与实践

Objective:To investigate the effects of electroacupuncture on blood-brain barrier to promote intake of drugs into brain of SAMP8 mice. Methods:The male SAMP8 mice (30-week-old) were randomly divided into model group (n = 7), drug group (n = 7), acupuncture group (n = 7) and combined group (n = 7). Other SAMR1 mice were as control group (n = 7). The acupuncture group and the combined group accepted electroacupuncture at Baihui (DU20) and Yintang (EX-HN3), the drug group and the combined group accepted Donepezil, for four weeks. They were observed hippocampus tight junction (TJ) under transmission electron microscope. The activities of acetylcholinesterase (AChE) in hippocampus were detected with immunohistochemistry. The mRNA expression of ZO-1, Claudin-5 and Occludin was detected with real-time quantitative polymerase chain reaction. Results:TJ and basement membrane in the control group, the acupuncture group and the combined group were better than those in the model group and the drug group. AChE was the most in the combined group, and then the drug group and the control group, the acupuncture group and the model group (P < 0.001). The expression of mRNA of ZO-1, Claudin-5 and Occludin was more in the acupuncture group and the combined group than in the drug group (P < 0.01). Conclusion:Electroacupuncture could ameliorate blood-brain barrier disruption and promote drug to enter the brain in SAMP8 mice, which may relate to the adjustion of ZO-1, Claudin-5 and Occludin.