Study on the Distribution of Traditional Chinese Medicine Syndrome Types in Patients with Diabetic Kidney Disease at Stages Ⅲ and Ⅳ / 广州中医药大学学报

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in diabetic kidney disease(DKD),and to explore the correlation between TCM syndrome types and laboratory indices,so as to provide an objective basis for the TCM syndrome differentiation and treatment of DKD.Methods Syndrome differentiation was carried out in the 157 patients with DKD at stages Ⅲ and Ⅳ,and then the distribution of the syndromes of deficiency in the origin and the syndromes of excess in the superficiality was explored.The levels of 24-hour urinary total protein(24hUTP),serum creatinine(Scr),blood urea nitrogen(UREA),plasma albumin(Alb),total cholesterol(TC),and triglyceride(TG)of the patients were detected,and then the relationship between the TCM syndrome types and the biochemical indexes was analyzed.Results(1)The distribution of the syndromes of deficiency in the origin in DKD patients at different stages showed that DKD patients at stage Ⅲ were mainly differentiated as yin deficiency and dryness-heat syndrome[58.57％(41/70)],qi and yin deficiency syndrome[28.57％(20/70)],yin and yang deficiency syndrome[10.00％(7/70)],and spleen and kidney qi deficiency syndrome[2.86％(2/70)];DKD patients at stage Ⅳ were mainly differentiated as yin deficiency and dryness-heat syndrome[40.23％(35/87)],qi and yin deficiency syndrome[29.89％(29/87)],spleen and kidney qi deficiency syndrome[18.39％(16/87)],and yin and yang deficiency syndrome[11.49％(10/87)].The differences in the distribution of the syndromes of deficiency in the origin among the DKD patients at different stages were statistically significant(P<0.05).However,with the progression of the disease,DKD patients at different stages in general showed a trend of the decrease in the proportion of yin deficiency and dryness-heat syndrome while the increase in the proportions of qi and yin deficiency syndrome,spleen and kidney qi deficiency syndrome,and yin and yang deficiency syndrome.(2)The distribution of the syndromes of excess in the superficiality in DKD patients at different stages showed that DKD patients at stage Ⅲ were mainly differentiated as damp-heat syndrome[54.29％(38/70)],phlegm-stasis syndrome[27.14％(19/70)],blood-stasis syndrome[10.00％(7/70)],and cold-damp syndrome[8.57％(6/70)];DKD patients at stage Ⅳ were mainly differentiated as damp-heat syndrome[44.83％(39/87)],phlegm-stasis syndrome[35.63％(31/87)],cold-damp syndrome[14.94％(13/87)],and blood-stasis syndrome[4.60％(4/87)].There were no significant differences in the distribution of the syndromes of excess in the superficiality among the DKD patients at different stages(P>0.05).(3)The analysis of relationship between TCM syndrome type and biochemical indexes showed that Scr and UREA levels of DKD patients with spleen and kidney qi deficiency syndrome were significantly higher than those of patients with yin deficiency and dryness-heat syndrome,and the differences were statistically significant(P<0.05);Scr and 24hUTP levels of DKD patients with cold-damp syndrome were significantly higher than those of patients with damp-heat syndrome,and the differences were statistically significant(P<0.05).Conclusion DKD patients at stages Ⅲ and Ⅳ are all predominantly suffering from yin deficiency and dryness-heat syndrome,and with the progression of the disease,the syndrome of yin deficiency and dryness-heat develops into qi and yin deficiency syndrome,spleen and kidney qi deficiency syndrome,and yin and yang deficiency syndrome sequentially.Pathogenic dampness and blood stasis are the main pathogenic factors of DKD.And Scr,UREA,and 24hUTP are correlated with the TCM syndrome types of DKD,which will be helpful for the differentiation of TCM syndrome types of DKD.

Evaluation of knee cartilage based on MRI artificial intelligence reconstruction model of knee joint / 中华骨科杂志

Objective:To explore the feasibility of the AI intelligent reconstruction model based on knee joint magnetic resonance data developed by Nuctech Company Limited for evaluating knee cartilage injury.Methods:Thirty-three patients (a total of forty-one knees) who were hospitalized with severe knee osteoarthritis in Beijing Tsinghua Changgung Hospital from May 2021 to April 2022 were selected. All of them were planned to be performed total knee arthroplasty (TKA) for the treatment of knee osteoarthritis. Fifteen males with an average age of 71±5 years old and twenty six females with an average age of 71±9 years old were included in this study. There were 19 cases of left knee and 22 cases of right knee. Thin layer MRI examination on the patients' knee joints was performed before the surgery, and artificial intelligence model based on the thin layer MRI data of the knee joint was reconstructed. The cartilage part of the model was selected and corrected by Principal Component Analysis (PCA) in order to realize model straightening. The tibial plateau cartilage of knee joint which intercepted during operation was classified according to the International Cartilage Repair Society (ICRS). Finally the results were compared with the ICRS classification results of knee artificial intelligence reconstruction model and artificial recognition of knee joint MRI images.Results:Compared with the grade of cartilage injury intercepted during our operation which was according to the ICRS classification, the sensitivity of artificial intelligence reconstruction model for the diagnosis of cartilage injury with ICRS classification grade four was 93.1%. The specificity of artificial intelligence reconstruction model was 91.4%. The positive predictive value (PPV) of artificial intelligence reconstruction model was 92.2%. And the negative predictive value (NPV) of artificial intelligence reconstruction model was 80.3%. The area under ROC curve (AUC) was 0.92. The ICRS classification consistency between artificial intelligence model and physical inspection results was good with kappa value 0.81 ( P<0.001) . In the aspect of artificial recognition of cartilage injury grading in MRI images, the sensitivity of artificial recognition was 92.10% compared with the manual identification of cartilage injury classification in MRI images. The specificity of artificial recognition was 91.60%. The positive predictive value (PPV) of artificial recognition was 97.20% and the negative predictive value (NPV) of artificial recognition was 78.8%. The kappa value of the cartilage injury classification in MRI images consistency between artificial recognition and manual identification was 0.79 ( P<0.001). Conclusion:Based on the evaluation of cartilage injury by AI reconstruction model of knee joint, the sensitivity and specificity of the diagnosis of ICRS grade IV cartilage injury can be acceptable, but still needs to be improved.

BMSCs inhibit inflammation in mice with LPS-induced acute lung injury by regulating TLR4/MyD88/NF-κB signaling pathway / 安徽医科大学学报

Objective To investigate the effect of bone marrow mesenchymal stem cells(BMSCs)on the inflamma-tory response of lipopolysaccharide(LPS)induced acute lung injury(ALI)in mice.Methods 32 SPF KM mice,aged 4 weeks were randomly divided into four groups,control group,LPS group,dexamethasone treatment group(LPS+DEX)and BMSCs treatment group(LPS+BMSCs).The latter three groups were injected with LPS by tra-cheal puncture to establish mouse ALI model 24 h after modeling,BMSCs isolated from the femur of mice were in-jected into the caudal vein,and DEX were injected into caudal vein at the same time in LPS+DEX group for 3 consecutive days.On the 4th day after cell transplantation or 24 h after DEX injection,the survival quantity of mice was recorded,lung function was detected,and the wet/dry weight ratio(W/D)of lung was measured.Then in-flammatory cells in bronchoalveolar lavage fluid(BALF),lung pathological changes and serum inflammatory cyto-kines were collected.Green fluorescent protein(GFP)staining was used to observe the homing of BMSCs in lung tissues.The mRNA and protein expression of TLR4,MyD88 and NF-κB in lung tissues were detected by RT-PCR and Western blot assay respectively.Results Compared with the control group,LPS model group showed de-creased lung function,significantly increase in the W/D weight ratio of lung,inflammatory cytokines in serum and inflammatory cells in BALF,and severe damage in lung tissue.Compared with LPS group,LPS+DEX group and LPS+BMSCs group showed improved lung function,reduced lung tissue damage,significantly decrease in the W/D weight ratio of lung,inflammatory cytokines in serum and inflammatory cells in BALF.And the expression of TLR4-MyD88-NF-κB signaling pathway-related genes and proteins decreased,the survival quantity increased.Conclusion Homologous BMSCs transplantation can effectively treat LPS-induced acute lung injury,and the mechanism may be related to the regulation of TLR4-MyD88-NF-κB signaling pathway and the reduction of inflam-matory response.These findings provide the experimental basis for BMSCs homologous transplantation for ALI.

Research progress of diabetic renal fibrosis / 中国药理学通报

Diabetic nephropathy (DN) is one of the most common and serious microvascular complications in patients with diabetes mellitus. Diabetic renal fibrosis ( DRF) is a major pathological change in the development of DN. In recent years the incidence of renal fibrosis (RF) has remained high. For diabetic patients, RF may expose them to kidney transplantation or even death, which brings a great burden to themselves and their families. Therefore, learning the pathogenesis and the current treat ment status of DRF is crucial for the treatment of the disease and the development of new drugs. Here we review the general situa¬tion of DN, the general situation, molecular mechanism, and the treatment of DRF,looking forward to providing a reference for the research and treatment of DRF.

Influence of axial rotation on measurement of medial proximal tibial angle / 中国骨伤

OBJECTIVE@#To measure and compare medial proximal tibial angle (MPTA) of lower limbs under different axial rotation angles(neutral position, 30° internal rotation, 30° external rotation) on the load position radiographs, and explore changes and significance of MPTA measured within and between groups of tibia at different axial rotation positions.@*METHODS@#From January 2018 to December 2018, 40 patients with knee osteoarthritis (KOA) were selected, with a total of 80 limbs, including 12 males and 28 females, aged from 29 to 73 years old with an average of (59.6±12.7) years old. Full length radiographs of the lower limbs were taken on neutral tibia position, 30° internal rotation and 30° external rotation, respectively. MPTA was measured and the results were compared between groups and within groups.@*RESULTS@#MPTA measured on the left lower extremity of neutral tibia, 30° internal rotation and 30° external rotation were (86.08±2.48) °, (88.62±2.94) ° and (83.47±3.10) °, respectively. MPTA measured on the right lower limb were (86.87±1.97) °, (89.02±2.39) ° and (83.80±2.77) °, respectively, and there were no significant difference in MPTA measured between rotation angle group (P>0.05). While there were statistical difference in MPTA on the same limb between groups (P<0.05). On 30° internal rotation, MPTA of left and right lower limbs increased by (2.54±1.74) ° and (2.15±1.78) ° compared with tibia neutral position. On 30° external rotation, MPTA of left and right lower limbs decreased (2.61±2.03) ° and (3.07±1.75) ° compared with tibial neutral position.@*CONCLUSION@#When a full-length X-ray film is taken on the weight-bearing position of both lower limbs, if there is axial rotation or external rotation of tibia, MPTA will increase or decrease compared with neutral position, which may cause a certain degree of deviation in clinical operation based on the accurate measurement of MPTA. However, the extent to which this bias affects the clinical operation effect remains to be verified. In addition, limited by the total number of samples and the number of measurement groups, whether there is a linear relationship between MPTA deviation and tibial axial rotation needs to be further studied.

Nemaline myopathy type 8 caused by KLHL40 gene in a twin: case report and literature review / 中华围产医学杂志

Objective:To investigate the clinical, genetic, and pathological features of nemaline myopathy type 8 (NEM8) caused by KLHL40 gene variation. Methods:The clinical data, gene sequencing results, and musculoskeletal pathophysiology of two cases (a pair of twins) with NEM8 admitted to our hospital in July 2022 were collected. CNKI, VIP, Wanfang, Yiigle, PubMed, Embase, and Web of Science Database were searched with the English and Chinese terms "nemaline myopathy type 8", "nemaline body myopathy type 8", and " KLHL40" from January 2007 to February 2023. The clinical, genetic, and musculoskeletal characteristics of the NEM8 cases were summarized using the descriptive statistical analysis method. Results:(1) Case report: The mother (G2P2) of the twins (Ⅳ-2 and Ⅳ-3) was conceived by IVF-embryo transfer and delivered at 37 +1 gestational weeks. The two cases were dizygotic twins whose maternal grandmother had lip and palate cleft. The first baby (Ⅳ-1) of the woman exhibited absent left pinna, contracture at the end of both fingers, talipes equinovarus in both feet and died of respiratory failure two hours after birth. Fetal edema and fetal movement delay in the twins and varus right foot in one twin were found during pregnancy. Both cases developed intrapartum asphyxia with the clinical manifestations of generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fractures. The families withdrew the treatment and the twins died after maintaining life with ventilators for 53 days after birth. Whole exome sequencing of the pedigree found c.1779G>T (p.W593C) homozygous variants of the KLHL40 gene in the twins and c.1779G>T (p.W593C) heterozygous variants of the KLHL40 gene in the parents, both were de novo. Musculoskeletal pathophysiology indicated that muscle fibers are thin and round with a fetal shape and absent rod. (2) Literature review: Among the 29 cases of NEM8, including two current cases and 27 cases retrieved from 15 papers, eight cases terminated the pregnancies, and 21 were live births; seven cases (24.1%) with positive family history; 19 cases (65.5%) were found with abnormalities during pregnancy, including abnormal fetal movements, polyhydramnios, joint contracture, and fetal edema. Of the 21 live births, 20 cases had intrapartum asphyxia, 21 had postnatal respiratory failure, 20 had generalized muscle weakness, and 19 had dysphagia. Among the 29 cases, 17 cases (58.6%) were homozygous variants of the KLHL40 gene, and 12 cases (41.4%) were compound heterozygous variants. The detection rate of c.1516A>C(p.Thr506Pro) was the highest [72.4% (21/29)], followed by c.602G>A(p.Trp201*) [17.2% (5/29)]. Out of the 15 cases who underwent musculoskeletal pathological examination, all had abnormal muscle fiber size and morphology; 10 cases had rods. Conclusions:NEM8 should be considered for those with abnormal fetal movements, polyhydramnios, joint malformation, fetal edema during the fetal period and failure to establish respiration at birth as well as postnatal generalized muscle weakness, respiratory failure, dysphagia, multiple joint contractures, and fracture. Moreover, genetic detection should be performed as soon as possible. NEM8 can be diagnosed in ones with KLHL40 gene homozygous or compound heterozygous variants and musculoskeletal pathological results of abnormal size and shape of muscle fibers, regardless of the presence of rods.

Evaluation of acetabular anteversion after total hip arthroplasty / 中国骨伤

OBJECTIVE@#To investigate whether the anteversion angle of acetabular prosthesis can be evaluated on the anteroposterior X-ray film of common double hip joint.@*METHODS@#Total 32 patients(41 hips) after total hip arthroplasty were selected, including 18 males and 14 females, aged(66.2±4.1) years. All patients completed the positive X-ray film of both hips and plain CT scan of pelvis after operation. Acetabular anteversion was measured by plain CT scan of pelvis, and measured by Saka and other measurement formulas on X-ray film.@*RESULTS@#The acetabular anteversion measured by X-ray film was(16.2±5.0)° and that measured by CT was (31.8±9.7)°(P=0.00). In addition, there was a significant linear correlation between X-ray film and CT(Pearson correlation coefficient (r=0.84, P=0.00).@*CONCLUSION@#CT can accurately measure the acetabular anteversion, but it has obvious disadvantages, such as large radiation, high cost, phantom CT artifact and so on. Although Saka measurement formula can not directly obtain the accurate acetabular anteversion as CT measurement, it has a high correlation with the acetabular anteversion measured by CT. Therefore, the method proposed in this study can also preliminarily evaluate the acetabular anteversion.

Bax inhibitor 1 inhibits vascular calcification in mice by activating optic atrophy 1 expression / 南方医科大学学报

OBJECTIVE@#To investigate the effects of Bax inhibitor 1 (BI- 1) and optic atrophy protein 1 (OPA1) on vascular calcification (VC).@*METHODS@#Mouse models of VC were established in ApoE-deficient (ApoE-/-) diabetic mice by high-fat diet feeding for 12 weeks followed by intraperitoneal injections with Nε-carboxymethyl-lysine for 16 weeks. ApoE-/- mice (control group), ApoE-/- diabetic mice (VC group), ApoE-/- diabetic mice with BI-1 overexpression (VC + BI-1TG group), and ApoE-/- diabetic mice with BI-1 overexpression and OPA1 knockout (VC+BI-1TG+OPA1-/- group) were obtained for examination of the degree of aortic calcification using von Kossa staining. The changes in calcium content in the aorta were analyzed using ELISA. The expressions of Runt-related transcription factor 2 (RUNX2) and bone morphogenetic protein 2 (BMP-2) were detected using immunohistochemistry, and the expression of cleaved caspase-3 was determined using Western blotting. Cultured mouse aortic smooth muscle cells were treated with 10 mmol/L β-glycerophosphate for 14 days to induce calcification, and the changes in BI-1 and OPA1 protein expressions were examined using Western blotting and cell apoptosis was detected using TUNEL staining.@*RESULTS@#ApoE-/- mice with VC showed significantly decreased expressions of BI-1 and OPA1 proteins in the aorta (P=0.0044) with obviously increased calcium deposition and expressions of RUNX2, BMP-2 and cleaved caspase-3 (P= 0.0041). Overexpression of BI-1 significantly promoted OPA1 protein expression and reduced calcium deposition and expressions of RUNX2, BMP-2 and cleaved caspase-3 (P=0.0006). OPA1 knockdown significantly increased calcium deposition and expressions of RUNX2, BMP-2 and cleaved caspase-3 in the aorta (P=0.0007).@*CONCLUSION@#BI-1 inhibits VC possibly by promoting the expression of OPA1, reducing calcium deposition and inhibiting osteogenic differentiation and apoptosis of the vascular smooth muscle cells.

The inhibitory effect of compound Q-l on proliferation of MH7A induced by TNF-α and its significance / 中国药理学通报

Aim To investigate the effect of compound Q-L on MH7A based on NF-KB and MAPK signaling pathways and its mechanism. Methods Human rheumatoid arthritis fibroblast synovial cell line (MH7A) was selected as the experimental object. The effect of compound Q-l on the proliferation of MH7A cells was determined by CCK-8 method. The effect of compound Q-l on the migration ability of MH7A cells was detected by Transwell assay. TNF-α solution was used as inducer, and the content of TNF-α and IL-6 in cell supernatant was determined by ELISA. The protein expressions of p65, p-p65, IκBα, P-IκBα, p38, p-p38, ERK, p-ERK, JNK and p-JNK in the cells were determined by Western blot. Results Compound Q-l at different concentrations significantly inhibited the activity of MH7A cells. Compound Q-l significantly inhibited the migration of MH7A cells. Compound Q-l significantly reduced the contents of TNF-α and IL-6 in cell supernatant. Compound Q-l could significantly down-regulate the protein expression levels of p65, p-p65, P-IκBα, p38, p-p38 induced by TNF-α, but had no marked effects on IKBCX, ERK, p-ERK, JNK and p-JNK proteins. Conclusion Compound Q-l can significantly inhibit the proliferation of MH7A cells, reduce the expression of inflammatory cytokines TNF-α and IL-6 in cell supernatant, and down-regulate the protein expressions of p65, p-p65, IKBCX, p-LKBA, p38, p-p38 induced by TNF-α. The possible mechanism of action is related to NF-κB and p38MAPK sig-naling pathways.

The Relationship between Plasma sST2/Reg3α Levels and Acute Graft-Versus-Host Disease in Children After Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To explore the relationship between plasma sST2/Reg3α levels and acute graft-versus-host disease (aGVHD) in children after allogeneic hematopoietic stem cell transplantation (allo-HSCT).@*METHODS@#The clinical data of 29 pediatric patients received allo-HSCT treatment in Department of Hematology and Oncology of Wuhan Children's Hospital from January 2019 to January 2020 were collected. Peripheral blood samples were collected at 14 and 28 day after allo-HSCT. The plasma concentrations of sST2 and Reg3α were detected by Luminex assay.@*RESULTS@#Among 29 patients there were 15 males and 14 females with a median age of 53 (29-117) months. After allo-HSCT, 18 patients developed grade 0-I aGVHD; while 11 patients developed grade II-IV aGVHD. These included skin aGVHD in 6 cases, gastrointestinal aGVHD (GI-aGVHD) in 3 cases and gastrointestinal/skin aGVHD in 5 cases. Plasma sST2 level in II-IV aGVHD group showed significantly higher than that in 0-I aGVHD group at 28 days after allo-HSCT [101.81 (73.94-150.77) ng/ml vs 48.97 (28.82-56.69) ng/ml, P=0.021]. Also, the plasma sST2 level was significantly higher in GI-aGVHD group than that in no-aGVHD group at 28 days after allo-HSCT [118.74 (87.00-243.36) ng/ml vs 48.97 (23.55-61.40) ng/ml, P=0.004]. Plasma sST2 level ≥65.34 ng/ml at 28 days after allo-HSCT showed a sensitivity of 85.7% and a specificity of 87.5% in predicting II-IV aGVHD. And the patients with a plasma sST2 level ≥65.34 ng/ml showed a significantly higher incidence of II-IV aGVHD than those with plasma sST2 level of < 65.34 ng/ml after allo-HSCT (P=0.021). There was no significant difference in plasma Reg3α level between the patients with II-IV aGVHD and the non-aGVHD ones.@*CONCLUSION@#The increasing plasma sST2 level after allo-HSCT in children indicates the development of II-IV aGVHD, so sST2 is promising as a biomarker for predicting II-IV aGVHD.

Advances in biosynthesis of indigo in plants / 中国中药杂志

Natural indigo, as one of the oldest dyes, is also a pivotal dye utilized in cotton fabrics today. A diversity of plants rich in indigo compounds belong to traditional Chinese herbal medicines. Indigo compounds have a variety of biological and pharmacological activities, including anticonvulsant, antibacterial, antifungal, antiviral and anticancer activities. A substantial progress in indigo biosynthesis has been made lately. This paper summarizes the value of indigo from the aspects of cultural history, biosynthetic pathways and the medicinal activities of its related derivatives involved in the pathways. In addition, the latest research advancements in indigo biosynthetic pathways is demonstrated in this paper, which would lay the theoretical foundation for the exploration and utilization of natural indigo.

UPLC-MS/MS determination of active components from Wuzhuyu Decoction in plasma and brain tissues of nitroglycerin-induced migraine rats / 中国中药杂志

A sensitive and specific ultra-performance liquid chromatography-mass spectrometry(UPLC-MS/MS) method was deve-loped for analysis of rutaecarpine(Ru), evodiamine(Ev), rutaevine(Rv), limonin(Li), ginsendside Rb_1(Rb_1), ginsendside Re(Re) in rat plasma and brain tissues of nitroglycerin-induced migraine rats. Male healthy Sprague-Dawley(SD) rats were orally given multiple dose of optimized(OS) and un-optimized Wuzhuyu Decoction(UNOS), and their blood samples and brainstem were collected at different time points after injection of nitroglycerin(10 mg·kg~(-1)) into the frontal region. The drug concentrations of the 6 analytes in plasma and brainstem were determined by UPLC-MS/MS method. Subsequently, the main pharmacokinetics parameters of plasma were calculated by using Phoenix WinNolin 5.2.1 software. The methodological test showed that all of analytes in both plasma and brainstem homogenate exhibited a good linearity within the concentration range(r>0.994 7). The intra-day and inter-day accuracy, precision, matrix effect, stability of the investigated components meet the requirements for biopharmaceutical analysis. The developed method was successfully applied in pharmacokinetic studies on abovementioned ingredients in rat plasma and brain stem. The plasma pharmacokinetic parameters of active ingredients in two different Wuzhuyu Decoction group were compared, it was found that Rb_1 had higher t_(1/2), T_(max), C_(max), AUC_(0-24 h) and AUC_(0-∞ )in OS group. Meanwhile, Ev had higher t_(1/2) and T_(max) but lower C_(max), AUC_(0-24 h) and AUC_(0-∞), Ru has higher t_(1/2 )but lower C_(max), AUC_(0-24 h) and AUC_(0-∞ )in OS group. The brain tissue distribution of each component were compared between the two groups, the component with higher content in OS, such as Ru at 30 min and 2 h after administration, Ev at 30 min, Rb_1 at 30 min and Rb_1 at 2 h after administration have lower brain tissue distribution than those in UNOS group, while the component with higher content in UNOS, such as Rv at 30 min, 2 h and 12 h after administration had higher brain tissue distribution than those in OS group.

Effect of the Risk Factors for Treatment-Related Death in Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the possible risk factors of death in children with acute lymphoblastic leukemia (ALL) after treatment.@*METHODS@#The clinical data of 31 children with newly diagnosed acute lymphoblastic leukemia and dead after treatment in the Hematology Oncology Department of Wuhan children's Hospital from January 1, 2016 to December 31, 2019 were retrospectively analyzed. Univariate factor analysis and multivariate Cox regression analysis were used to analyze the each indexes of ALL children, and the possible risk factors causes of death in ALL children after treatment were analyzed.@*RESULTS@#Among 230 newly diagnosed ALL children, 31 (13.4%) cases were dead. Among them, there were 12 male and 19 female. The mortality rates were 9%(12/133) for male and 19.5%(19/97) for female, which showed a significantly difference（P=0.02）； among the dead ALL children, 6 were less than 1 year old, 23 were 1-10 years old, and 2 was more than 10 years old. The mortality rates in different age groups were 46.1 % (6/13), 11.7%(23/195) and 9%(2/22), respectively, which showed a significantly difference（P=0.00）； the mortality rates of the ALL children in standard risk group, medium risk group and high risk group were 6.7% (4/59), 11.9% (13/10@*CONCLUSION@#The female, less than 1 year old at initial diagnosis, high risk ALL, WBC>50×10

Allelopathic Effect of Water Extracts from Rhizosphere Soil of Three Medicinal Plants on Polygala tenuifolia Seeds and Their Seedlings / 中国实验方剂学杂志

Objective:To investigate the allelopathic effects of water extracts from rhizosphere soil of three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica on seed germination and seedling growth of Polygala tenuifolia， screen the stubble varieties suitable for crop rotation with P. tenuifolia， and provide some scientific basis for continuous cropping obstacles of P. tenuifolia. Method:The bioassay method was used to study the effects of rhizosphere soil water extracts from three medicinal plants Rehmannia glutinosa，Pinellia ternata and Isatis indigotica at concentrations of 0.3，0.6，0.9 g·mL-1 on the germination of P. tenuifolia seed and seedling growth. Result:The rhizosphere soil water extracts of Rehmannia glutinosa and Pinellia ternata showed basically low-promotion and high-inhibition concentration effects on the final germination rate，germination potential，and germination index of P. tenuifolia seeds，while the water extract of Isatis indigotica showed significant allelopathic inhibition effect. All three rhizosphere soil water extracts showed significant allelopathic inhibition effects on the growth index of P. tenuifolia seedlings. Among them，the rhizosphere soil water extract of Rehmannia glutinosa showed lower inhibitory effect on the plant height and root length of P. tenuifolia seedlings than the other two water extracts. The photosynthetic pigment content，proline（Pro） content，and soluble sugar content of P. tenuifolia chinensis seedlings were the highest under 0.3 g·mL-1 soil water extract of Rehmannia glutinosa， with relatively higher content of soluble protein， and relatively lower content of hydrogen oxide（H2O2）. Under the treatment of 0.9 g·mL-1 soil water extract of Rehmannia glutinosa，P. tenuifolia seedlings had the highest peroxidase（POD） and superoxide dismutase（SOD） activities，low catalase（CAT） activity，and lowest content of malondialdehyde（MDA）. Conclusion:Based on the comprehensive analysis of the above experimental data and allelopathic effects，the water extract of rhizosphere of Rehmannia glutinosa can promote the germination of P. tenuifolia seeds to a certain extent，and lay the foundation for seedling resistance to biochemical stress. Therefore， Rehmannia glutinosa is more suitable for crop rotation with P. tenuifolia.

Clinical Efficacy of Wenfei Jianpi Decoction on Moderate to Severe Persistent Allergic Rhinitis with Lung Qi Deficiency and Cold Syndrome / 中国实验方剂学杂志

Objective::To observe the efficacy of Wenfei Jianpi decoction on moderate to severe persistent allergic rhinitis (AR) with Lung Qi deficiency and cold syndrome and its effect on substance P (SP) in nasal secretions and peripheral blood proinflammatory factors. Method::One hundred and sixty-six patients were randomly divided into control group and observation group by random number table. Patients in control group got budesonide nasal spray, 2 times/days, and cetirizine hydrochloride tablets, 10 mg/days. And patients in observation group got Wenfei Jianpi decoction for oral, 1 dose/day. A course of treatment was 8 weeks. Before and after treatment, nasal obstruction, itching, sneezing, runny nose, itchy eyes, tears and nasal sign were scored, nasal airway resistance was detected, and rhinoconjunctivits quality of life questionnaire (RQLQ) were scored. Before and after treatment, levels of SP immunoglobulin E (IgE) in peripheral blood, interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected, and eosinophil (EOS) were calculated. Result::By rank sum test, the clinical efficacy in observation group was better than that in control group (Z=2.073, P<0.05). Before and after treatment, scores of total score of nasal symptoms, ocular symptoms and subjective symptoms and nasal sign score were all lower than those in control group (P<0.05). Except sleep and emotion, scores of other dimensions and the total scores of RQLQ were all lower than those in control group (P<0.05). EOS in observation group was less than that in control group (P<0.05). And nasal resistance declined in observation group (P<0.05), and levels of IgE, SP, IL-4, IL-5, IL-6, TNF-α and nasal resistance were lower than those in control group (P<0.05, P<0.01). Conclusion::Wenfei Jianpi decoction can be used to treat moderate to severe persistent allergic rhinitis by relieving subjective symptoms and signs, improving quality of life, inhibiting inflammatory factors and reducing allergic reaction.

Three-Dimensional Garnet Framework-Reinforced Solid Composite Electrolytes with High Lithium-Ion Conductivity and Excellent Stability.

We report a three-dimensional (3D) garnet framework-reinforced solid composite electrolyte with enhanced Li-ion conductivity and excellent thermal, mechanical, and electrochemical stabilities. The 3D garnet framework is fabricated via the polymeric sponge method, using low-cost polyurethane foam as the template. The interconnected 3D garnet framework not only reinforces the composite electrolyte but also forms continuous Li-ion transport pathways, thereby increasing the ionic conductivity. The 3D garnet composite electrolyte shows an ionic conductivity of 1.2 × 10-4 S cm-1 at 30 °C, about two times as high as that of the garnet particle-reinforced composite electrolyte. The Li-Li symmetric cell based on the 3D garnet composite electrolyte can be cycled more than 360 h without short circuit, suggesting an improved ability to suppress Li-dendrites. The Li/3D garnet composite electrolyte/LiFePO4 battery demonstrates stable cycling performance at 0.5 C. Owing to the cost-saving characteristics, the 3D garnet-reinforced solid composite electrolyte is promising for mass production.

Hematogenous infection of total hip arthroplasty due to clostridium perfringens: a case report / 中华骨科杂志

A case report of periprosthetic hip clostridium perfringens infection 13 years after total hip arthroplasty, the patient had hip pain with fever for one week. Physical examination and imaging examination confirmed the periprosthetic joint infection. The pathogenic bacterium was clostridium perfringens according to bacterial culture, and the pathogenic bacterium of clostridium perfringens was suspected relating to the gallbladder disease in this patient. Considering such periprosthetic joint infection was early stage hematogenous periprosthetic joint infection, treatment of debridement, retention of the prosthesis, irrigating, and indwelling drainage tube were conducted. By reviewing literature about periprosthetic clostridium perfringens infection, only seven reports of periprosthetic joint infection were caused by clostridium perfringens, which were all case reports. From the previous case reports and our case, we found that the infection around the prosthesis caused by clostridium perfringens was limited to the area around the joint, and prognosis of such cases may not be as severe as the natural gas gangrene which developed very rapidly, but great attention should be paid to. The hematogenous periprosthetic joint infection caused by clostridium perfringens who had gastrointestinal symptoms in the early stage should be highly suspicious of gallbladder lesions and thorough debridement, retention of the prosthesis, irrigating and indwelling drainage tube maybe a treatment method.

Hematogenous infection of total hip arthroplasty due to clostridium perfringens: a case report / 中华骨科杂志

A case report of periprosthetic hip clostridium perfringens infection 13 years after total hip arthroplasty, the pa?tient had hip pain with fever for one week. Physical examination and imaging examination confirmed the periprosthetic joint infec?tion. The pathogenic bacterium was clostridium perfringens according to bacterial culture, and the pathogenic bacterium of clos?tridium perfringens was suspected relating to the gallbladder disease in this patient. Considering such periprosthetic joint infection was early stage hematogenous periprosthetic joint infection, treatment of debridement, retention of the prosthesis, irrigating, and in?dwelling drainage tube were conducted. By reviewing literature about periprosthetic clostridium perfringens infection, only seven reports of periprosthetic joint infection were caused by clostridium perfringens, which were all case reports. From the previous case reports and our case, we found that the infection around the prosthesis caused by clostridium perfringens was limited to the ar?ea around the joint, and prognosis of such cases may not be as severe as the natural gas gangrene which developed very rapidly, but great attention should be paid to. The hematogenous periprosthetic joint infection caused by clostridium perfringens who had gastrointestinal symptoms in the early stage should be highly suspicious of gallbladder lesions and thorough debridement, retention of the prosthesis, irrigating and indwelling drainage tube maybe a treatment method.

Role of NF-κB-MMP-9 signaling pathway on delayed encephalopathy after acute carbon monoxide poisoning / 实用医学杂志

Objective To investigate the role of nuclear transcription factor kappa B (NF-κB) -matrix metalloproteinase-9 (MMP-9) signaling pathway in delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods 150 male SD rats were randomly assigned to air control group (AC group) , CO poisoning group (CO group) , pyrrolidine thiocarbamate (PDTC) + CO poisoning group (PC group). DEACMP model was reconstructed by modified intraperitoneal injections. The 1, 3, 7, 14, and 21 d after intraperitoneal injection were observed here by different approaches. Morris water maze test was used to test the learning and memory ability of rats.HE staining was used to observe the morphology of hippocampal CA3 cells. Immunofluorescence and Western Blot methods were used to detect the expression of NF-κB and MMP-9. RT-PCR was used to measure the expression of MMP-9 mRN A. Transmission electron microscopy was used to observe the ultrastructure of synapses. Results After14 days, the average intubation period of CO group was longer than that of AC group (P < 0.05) , and that of PC group was shorter than that of CO group (P < 0.05). However, average intubation period of PC group was longer than that of AC group (P< 0.05). In CO group, the expression of NF-κB in hippocampus increased (day 1). At day 3, the expression of NF-κB rapidly increased. The expression of MMP-9 gene and protein increased in the first three days and then decreased thereafter. The expression of NF-κB and MMP-9 in PC group was lower than that in CO group (P < 0.05) , while it was higher than AC group (P < 0.05). The peak value of apoptosis in CO group was delayed to 7-14 d after exposure, the apoptotic cells in PC group decreased significantly, and it was obvious on the 14 th day.Electron microscopy showed that the damage of synapses ultrastructure in CO group was significantly heavier than that in PC group on the 14 th day. Conclusions NF-κB-MMP-9 signal pathway leads to DEACMP, and PDTC could alleviate the impairment of learning and memory ability in rats with acute CO poisoning.

Effect of tBHQ on expression of Nrf2 and HO-1 in delayed encephalopathy in rats after acute carbon monoxide poisoning / 中国免疫学杂志

Objective:Preliminary study on rats with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) model intervention agent tBHQ before and after the nuclear factor E2-related factor 2(Nrf2) and its downstream target genes of heme oxygenase 1(HO-1) change in hippocampus associated,in order to further study the pathogenesis of DEACMP,at the same time for the targeted therapy of provide a certain experimental basis.Methods: One hundred and twenty rats were randomly divided into carbon monoxide poisoning group(CO group),air control group(AC group),carbon monoxide+3% ethanol group(EC group),carbon monoxide+tBHQ group(group TC),then the rats in exposure after 1 d,3 d,7 d,14 d,21 d,28 d,with the machine was divided into 6 sub groups,followed by the Morris water maze test to observe the behavior of rats,immunohistochemistry and protein Western blot method of chemical(Western blot) detecting expression of Nrf2 and HO-1 mploying intervention agent tBHQ before and after,and then TUNEL staining was detected cell apoptosis.Results: CO group,EC group,TC group Nrf2 in hippocampus of rats and the expression of HO-1 were increased in the first day and reach a peak at the third day,then gradually decreased,and at each time point in AC group were statistically significant,TC group and CO group Nrf2 and HO-1 were increased in each sub group and the deffirences were statistically meaning.Comparison apoptotic cells in CO group,EC group,TC group with AC group rats increased significantly over time,and showed higher peak(7-14 d)-decreased.TC group compared with CO group,the apoptotic cells(7-14 d) decreased,the difference was statistically significant.Conclusion: The Nrf2/ARE/HO-1 pathway plays an important role in the development of DEACMP,and the tBHQ specific activation of the Nrf2 pathway achieves early protection and is expected to reduce or mitigate DEACMP.