Diagnostic Stability in Psychiatric Patients From Hospital Admission to Discharge: A 10-Year Retrospective Study

Objective@#This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade. @*Methods@#A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy. @*Results@#From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations. @*Conclusion@#Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.

Protective effects of equol on the cartilage and subchondral bone in ovariectomized rats with osteoarthritis.

Objectives: This study aimed to determine the therapeutic effect of equol (EQ) on osteoporotic osteoarthritis (OP OA). Materials and Methods: Thirty-six 12-week-old female Sprague-Dawley rats were randomly divided into sham group, OP OA group, and EQ group (n=12). OP OA was induced by anterior cruciate ligament transection (ACLT) combined with ovariectomy (OVX). EQ was orally administrated (10 µg/g/day) after the operation for 12 weeks. The efficacy was evaluated by gross pathology and histopathologic evaluation. The underlying mechanism was investigated by immunohistochemical analysis, micro-computed tomography (micro-CT) scanning, and tartrate-resistant acid phosphatase (TRAP) staining. Results: EQ effectively retarded cartilage degeneration, decreased the levels of matrix metalloproteinases-13 (MMP-13), a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), nuclear factor-kappa B P65 (NF-κB P65) and caspase-3, and increased the levels of collagen type II (Col-II), Col-I, aggrecan (AGG), and inhibitor of NF-κB α (IκBα) in the cartilage. In addition, EQ increased bone mineral density, improved the microstructural parameters of the subchondral bone (SB), and decreased the number of osteoclasts. Conclusion: EQ exerted a chondroprotective effect on OP OA in rats, associated with inhibition of the NF-κB signaling pathway and chondrocyte apoptosis. Furthermore, EQ showed an osteoprotective effect on SB via inhibiting osteoclastic activities.

Bioinformatics-based identification of key genes CDC5L and related pathways in osteosarcoma and Ewing's sarcoma / 中国骨伤

OBJECTIVE@#Osteosarcoma(OS) and Ewing's sarcoma (EWS) are the two most common primary malignant bone tumors in children. The aim of the study was to identify key genes in OS and EWS and investigate their potential pathways.@*METHODS@#Expression profiling (GSE16088 and GSE45544) were obtained from GEO DataSets. Differentially expressed genes were identified using GEO2R and key genes involved in the occurrence of both OS and EWS were selected using venn diagram. Gene ontology and pathway enrichment analyses were performed for the ensembl. Protein-protein interaction (PPI) networks were established by STRING. Further, UCSC was used to predict the transcription factors of the cell division cycke 5-like(CDC5L) gene, and GEPIA was used to analyze the correlation between the transcription factors and the CDC5L gene.@*RESULTS@#The results showed that CDC5L gene was the key gene involved in the pathogenesis of OS and EWS. The gene is mainly involved in mitosis, and is related to RNA metabolism, processing of capped intron-containing pre-mRNA, mRNA and pre-mRNA splicing.@*CONCLUSION@#CDC5L, as a key gene, plays a role in development of OS and EWS, which may be reliable targets for diagnosis and treatment of these primary malignant tumors.

Raloxifene retards the progression of adjacent segmental intervertebral disc degeneration by inhibiting apoptosis of nucleus pulposus in ovariectomized rats.

BACKGROUND: Adjacent segmental intervertebral disk degeneration (ASDD) is a major complication secondary to lumbar fusion. Although ASSD pathogenesis remains unclear, the primary cause of intervertebral disk degeneration (IVDD) development is apoptosis of nucleus pulposus (NP). Raloxifene (RAL) could delay ASDD by inhibiting NP apoptosis. METHODS: An ASDD rat model was established by ovariectomy (OVX) and posterolateral spinal fusion (PLF) on levels 4-5 of the lumbar vertebrae. Rats in the treatment groups were administered 1 mg/kg/d RAL by gavage for 12 weeks, following which, all animals were euthanized. Lumbar fusion, apoptosis, ASDD, and vertebrae micro-architecture were evaluated. RESULTS: RAL maintained intervertebral disk height (DHI), delayed vertebral osteoporosis, reduced histological score, and inhibited apoptosis. The OVX+PLF+RAL group revealed upregulated expression of aggrecan and B-cell lymphoma-2 (bcl2), as well as significantly downregulated expression of a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4), metalloproteinase-13 (MMP-13), caspase-3, BCL2-associated X (bax), and transferase dUTP nick end labeling (TUNEL) staining. Micro-computed tomography (Micro-CT) analysis revealed higher bone volume fraction (BV/TV), bone mineral density (BMD), and trabecular number (Tb.N), and lower trabecular separation (Tb.Sp) in OVX+PLF+RAL group than in the OVX+PLF group. CONCLUSIONS: RAL can postpone ASDD development in OVX rats through inhibiting extracellular matrix metabolic imbalance, NP cell apoptosis, and vertebral osteoporosis. These findings showed RAL as a potential therapeutic target for ASDD.

Raloxifene inhibits the overexpression of TGF-ß1 in cartilage and regulates the metabolism of subchondral bone in rats with osteoporotic osteoarthritis.

Overexpression of transforming growth factor-beta 1 (TGF-ß1) and subchondral bone remodelling play key roles in osteoarthritis (OA). Raloxifene (RAL) reduces the serum level of TGF-ß1 in postmenopausal women. However, the effect of RAL on TGF-ß1 expression in articular cartilage is still unclear. Therefore, we aimed to investigate the protective effect of RAL on osteoporotic osteoarthritis via affecting TGF-ß1 expression in cartilage and the metabolism of subchondral bone. Osteoporotic osteoarthritis was induced by a combination of anterior cruciate transection (ACLT) and ovariectomy (OVX). Rats were divided into five groups (n = 12): The sham group, the ACLT group, the OVX group, the ACLT + OVX group, and the RAL group (ACLT + OVX + RAL, 6.25 mg/kg/day for 12 weeks). Assessment was performed by histomorphology, microcomputed tomography (micro-CT) scan, immunohistochemistry, and tartrate-resistant acid phosphatase (TRAP) staining. We found that severe cartilage degeneration was shown in the ACLT + OVX group. The histomorphological scores, the levels of TGF-ß1, and its related catabolic enzymes and osteoclasts numbers in the ACLT + OVX group were higher than those in other groups (p < 0.05). Furthermore, structure model index (SMI) and trabecular spacing (Tb.Sp) were decreased (p < 0.05), while bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular number (Tb.N) were increased by RAL compared with the ACLT + OVX group (p < 0.05). Our findings demonstrated that RAL in clinical doses retards the development of osteoporotic osteoarthritis by inhibiting the overexpression of TGF-ß1 in cartilage and regulating the metabolism of subchondral bone. These results provide support for RAL in the expansion of clinical indication for prevention and treatment in postmenopausal osteoarthritis.

Protective effect of astragaloside on renal injury induced by radiation through toll-like receptor 4/nuclear factor kappa B pathway / 解剖学报

Objective To explore whether astragaloside IV (AS-IV) can protect radiation-induced kidney injury through toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB)-mediated signaling pathway. Methods The mice were randomly divided into normal control group, DMSO solvent group, irradiation group (IR), IR + AS-IV 20 mg/kg group and IR + AS-IV 40 mg/kg group. One month after intraperitoneal injection of AS-IV, the mice were irradiated with 8 Gy 60Coγ and to the content of serum creatinine (Cr) and uric acid (BUA) in serum were determined, HE and immunohistochemical staining, and expression of TLR4/NF-κB signaling pathway related protein in kidney were performed. Results Compared with the control group, the levels of Cr and BUA in the serum of the radiation group increased significantly (P<0.001), glomerular atrophy and tubular expansion, TLR4 and myeloid differentiation factor 88(MyD88) positive expression increased significantly (P< 0.001), and the expression of TLR4/NF-κB signaling pathway-related proteins[ TLR4, MyD88, NF-κB, interleukin-1 β (IL-Iβ), tumor necrosis factor α (TNF-α)] increased significantly (P< 0.01); AS-IV pretreatment can reduce the content of Cr and BUA in serum (P<0.05, P<0.01 or P<0.001), significantly improve the pathological response caused by radiation, and reduce the expression of TLR4/NF-κB signaling pathway-related proteins (P<0.05 or P<0.01). Conclusion AS-IV may down-regulate the release of inflammatory factors through the TLR4/NF-κB signaling pathway, thereby improving radiation-induced kidney injury in mice and playing a protective role.

Protective effect of Pai-Nong-San against AOM/DSS-induced CAC in mice through inhibiting the Wnt signaling pathway / 中国天然药物

Pai-Nong-San (PNS), a prescription of traditional Chinese medicine, has been used for years to treat abscessation-induced diseases including colitis and colorectal cancer. This study was aimed to investigate the preventive effects and possible protective mechanism of PNS on a colitis-associated colorectal cancer (CAC) mouse model induced by azoxymethane (AOM)/dextran sodium sulfate (DSS). The macroscopic and histopathologic examinations of colon injury and DAI score were observed. The inflammatory indicators of intestinal immunity were determined by immunohistochemistry and immunofluorescence. The high throughput 16S rRNA sequence of gut microbiota in the feces of mice was performed. Western blot was used to investigate the protein expression of the Wnt signaling pathway in colon tissues. PNS improved colon injury, as manifested by the alleviation of hematochezia, decreased DAI score, increased colon length, and reversal of pathological changes. PNS treatment protected against AOM/DSS-induced colon inflammation by regulating the expression of CD4

COVID-19 Outpatient Screening: a Prediction Score for Adverse Events

BackgroundWe sought to develop an automatable score to predict hospitalization, critical illness, or death in patients at risk for COVID-19 presenting for urgent care during the Massachusetts outbreak. MethodsSingle-center study of adult outpatients seen in respiratory illness clinics (RICs) or the emergency department (ED), including development (n = 9381, March 7-May 2) and prospective (n = 2205, May 3-14) cohorts. Data was queried from Partners Enterprise Data Warehouse. Outcomes were hospitalization, critical illness or death within 7 days. We developed the COVID-19 Acuity Score (CoVA) using automatically extracted data from the electronic medical record and learning-to-rank ordinal logistic regression modeling. Calibration was assessed using predicted-to-observed ratio (E/O). Discrimination was assessed by C-statistics (AUC). ResultsIn the development cohort, 27.3%, 7.2%, and 1.1% of patients experienced hospitalization, critical illness, or death, respectively; and in the prospective cohort, 26.1%, 6.3%, and 0.5%. CoVA showed excellent performance in the development cohort (concurrent validation) for hospitalization (E/O: 1.00, AUC: 0.80); for critical illness (E/O: 1.00, AUC: 0.82); and for death (E/O: 1.00, AUC: 0.87). Performance in the prospective cohort (prospective validation) was similar for hospitalization (E/O: 1.01, AUC: 0.76); for critical illness (E/O 1.03, AUC: 0.79); and for death (E/O: 1.63, AUC=0.93). Among 30 predictors, the top five were age, diastolic blood pressure, blood oxygen saturation, COVID-19 testing status, and respiratory rate. ConclusionsCoVA is a prospectively validated automatable score to assessing risk for adverse outcomes related to COVID-19 infection in the outpatient setting.

Development and Prospective Validation of a Transparent Deep Learning Algorithm for Predicting Need for Mechanical Ventilation

IMPORTANCEObjective and early identification of hospitalized patients, and particularly those with novel coronavirus disease 2019 (COVID-19), who may require mechanical ventilation is of great importance and may aid in delivering timely treatment. OBJECTIVETo develop, externally validate and prospectively test a transparent deep learning algorithm for predicting 24 hours in advance the need for mechanical ventilation in hospitalized patients and those with COVID-19. DESIGNObservational cohort study SETTINGTwo academic medical centers from January 01, 2016 to December 31, 2019 (Retrospective cohorts) and February 10, 2020 to May 4, 2020 (Prospective cohorts). PARTICIPANTSOver 31,000 admissions to the intensive care units (ICUs) at two hospitals. Additionally, 777 patients with COVID-19 patients were used for prospective validation. Patients who were placed on mechanical ventilation within four hours of their admission were excluded. MAIN OUTCOME(S) and MEASURE(S)Electronic health record (EHR) data were extracted on an hourly basis, and a set of 40 features were calculated and passed to an interpretable deep-learning algorithm to predict the future need for mechanical ventilation 24 hours in advance. Additionally, commonly used clinical criteria (based on heart rate, oxygen saturation, respiratory rate, FiO2 and pH) was used to assess future need for mechanical ventilation. Performance of the algorithms were evaluated using the area under receiver-operating characteristic curve (AUC), sensitivity, specificity and positive predictive value. RESULTSAfter applying exclusion criteria, the external validation cohort included 3,888 general ICU and 402 COVID-19 patients. The performance of the model (AUC) with a 24-hour prediction horizon at the validation site was 0.882 for the general ICU population and 0.918 for patients with COVID-19. In comparison, commonly used clinical criteria and the ROX score achieved AUCs in the range of 0.773 - 0.782 and 0.768 - 0.810 for the general ICU population and patients with COVID-19, respectively. CONCLUSIONS and RELEVANCEA generalizable and transparent deep-learning algorithm improves on traditional clinical criteria to predict the need for mechanical ventilation in hospitalized patients, including those with COVID-19. Such an algorithm may help clinicians with optimizing timing of tracheal intubation, better allocation of mechanical ventilation resources and staff, and improve patient care.

Interaction between homologous functional food Astragali Radix and intestinal flora / 中国中药杂志

Traditional Chinese medicine(TCM) is the treasure of our culture, and TCM theory is the core of traditional Chinese medicine. Many of its concepts can be unified and balanced with modern functional food ideas. Even in ancient days, people had already found that medicine and food have the same source. Nowadays, homology between drug and food has been accepted widely. Astragali Radix and some other herbs have been used both as food and medicine, with a variety of bio-active substances, so such herbs can be used as characteristics resources to be developed into functional food. It's a combination of traditional medicine and modern ideas. Flavonoids, polysaccharides and saponins, the main compositions of Astragali Radix, can keep intestinal microenvironment homeostasis and human health by influencing the population structure, metabolism and intestinal cell function of intestinal flora. On the other hand, intestinal flora is also involved in the absorption, metabolism, transformation and other steps of these active ingredients in the body, which has an impact on their effectiveness and improves their bioavailability, playing an essential role in the relevant mechanism of their effectiveness. In this paper, we summarize the interaction between the above three functional ingredients in Astragali Radix and intestinal flora, sum up the interaction between these three functional ingredients of other homologous drugs and intestinal flora, provide a theoretical basis for the mechanism and application of functional food materials, and propose some suggestions and prospects for their future development.

Study on the construction and countermeasure of health-centered integrated health care service system / 中华医院管理杂志

Building an integrated health care service system is key to the Healthy China strategy. Based on the integrated health care service conceptual framework, the authors took two pilots regions of health-centered medical alliances in Zhejiang province as an example, and analyzed their conception framework, organizational structure, operation elements and effects. The study found initial success of the two alliances in terms of the contents, capabilities, effects and satisfaction of primary health care service. Such alliances feature a health-centered multi-entity participation mechanism, carry out health care and prevention integration leveraging the information platform, hence conducive to the effective governance of the alliances. However, the contents of their health related services are expected to be broadened and deepened; functionalities of health-related institutions need to be clarified and refined, while their performance appraisal needs to be further improved.

Analysis on performance of primary medical service in Zhejiang′s county-level medical alliances from the perspective of supply and demand balance / 中华医院管理杂志

Objective:Based on the perspective of supply and demand balance, to analyze the implementation effects of primary-feature medical services measures in medical alliances.Methods:From July to September 2019, two regions with different levels of economic development were chosen, and from each region one leading hospital and two community health service centers/township hospitals were selected from its medical alliance. A total of 213 medical staff and 703 residents were surveyed, to learn their awareness and performance appraisal of these feature services.Frequency and proportion were calculated in a descriptive statistical analysis. The scores of the performance appraisal of both supply and demand sides were tested by independent sample t. Results:In the performance appraisal of such measures, the average scoring by medical staff was 4.39±0.07, and that by residents was 3.85±0.06; the residents were more concerned with service capabilities and contents, while medical staff were more concerned with service content and delivery mode; supply and demand sides were found with consensus in terms of improving the medical service quality of chronic diseases in primary level and service accessibility.Conclusions:The county-level medical alliances should focus on enhancing their capacity of primary medical services, and improving their primary service mode with the help of medical insurance institutions. Meanwhile, it is imperative to optimize the primary medical service policy in view of supply and demand balance.

Effects of iodine nutrition during pregnancy and lactation on postpartum thyroid function in women with subclinical hypothyroidism / 中华内分泌代谢杂志

Objective To evaluate the effects of maternal iodine nutrition levels on postpartum thyroid function, and to provide clinical evidence for accurate iodine supplementation in women with subclinical hypothyroidism during pregnancy. Methods This study collected single-pregnant women who had no history of thyroid diseases before pregnancy in our city. Thyroid function and urinary iodine results were continuously recorded during pregnancy and lactation. All subjects were divided into subclinical hypothyroidism group and euthyroidism group according to their thyroid function during pregnancy. The relationship between urinary iodine levels during pregnancy and lactation with postpartum thyroid function were analyzed. Results A total of 148 maternal women were collected, including 41 cases of subclinical hypothyroidism group and 107 cases of euthyroidism group. The urinary iodine level in pregnant women was higher than that in lactation ( median 174.75 vs 149.89μg/L, P<0.05) . However, the iodine deficiency ratio(23.6％) during pregnancy was higher than that during lactation (5.4％). There were significant differences in the change of urinary iodine in each time interval during pregnancy and lactation ( P<0.05). A total of 56 maternal women developed postpartum thyroiditis ( PPT). The incidence of PPT in pregnant women with TPOAb-positive in early pregnancy was higher than that in TPOAb-negative patients (χ2=10.811, P=0.001) . The urinary iodine concentration in the 12-month postpartum period was lower in women with PPT than that in womenwithoutPPT(P<0.05).Coxregressionanalysisshowedthatiodinedeficiencyduringlactation(HR=3.870, 95％CI 1.595-9.392, P=0.003) and TPOAb positive in early pregnancy (HR=3.679, 95％ CI 1.466-9.233, P<0.05) increased the risk of PPT. Subgroup analysis also showed a similar risk increase of PPT in women with hypothyroidism during pregnancy (HR=8.318, 95％CI 2.383-29.029, P<0.05). However, this association was not found in euthyroidism group. Conclusion The urinary iodine level of women during pregnancy and lactation in our iodine suitable areas is within normal range, but attention should still be paid to the effect of iodine deficiency on breast-feeding women, especially among those with subclinical hypothyroidism.

Monitoring intra-abdominal pressure to assist enteral nutrition supporting treatment for patients with high risk of IAH/ACS / 肠外与肠内营养

Objective:To evaluate the practical application of intra-abdominal pressure (IAP) monitoring product in patients receiving enteral nutrition (EN) and with high risk of intra-abdominal hypertension/abdominal compartment syndrome (IAH/ACS).Methods:Patients receiving EN treatment from Changzheng hospital were randomly divided as experimental group (measuring IAP with pressure monitoring product,n =60) and control group (measuring IAP with conventional method,n =60).The clinical data of gastrointestinal complications,gastric residual volume,IAP and completion of target infusions were collected and analyzed.Results:The incidence of gastrointestinal complications in experimental group patients significantly decreased comparing with the control group patients (7.92％ vs 28.33％,P ＜ 0.01).The levels of gastric residual volume and IAP in experimental group patients were lower than those in control group patients[(50.12 ± 10.66) ml vs.(101.54 ± 25.81) ml,(7.17 ± 1.84) cmH2O vs (12.36 ± 2.51) cmH2O,P ＜0.05].Moreover,The experimental group patients had a shorter period to achieve target infusions and higher proportion of completion treatments [88.3％ vs 71.7％,(2.94 ± 0.78)d vs (3.78 ± 1.02)d,P ＜ 0.05)].Conclusion:As utilizing pressure monitoring products to assist EN treatment for patients with high risk of IAH/ACS could achieve lower incidence of gastrointestinal complications,excellent EN tolerance,and improve target feeding,its clinical application should be extended.

Associations of urinary iodine and blood selenium levels with subclinical hypothyroidism and thyroid antibodies during the first half pregnancy in Tianjin women / 中华内分泌代谢杂志

Objective To investigate the associations of urinary iodine concentration ( UIC) and blood selenium levels with subclinical hypothyroidism and thyroid antibodies during the first half pregnancy in women. Methods A total of 239 pregnant women(7-20 weeks)were selected. The baseline data were collected, and serum TSH, FT4 , thyroid peroxidase antibody ( TPOAb), thyroglobulin antibody ( TgAb), blood selenium, and urinary iodine concentration(UIC) levels were measured. Results The median level of urinary iodine among 239 women was 156. 96 μg/ L. The distributions of pregnant women with iodine deficiency, iodine adequate, more-than-adequate or excessive iodine intake were 43. 9％ , 38. 9％ , 17. 2％ , respectively. The percentage of more-than-adequate and excessive iodine in women with subclinical hypothyroidism was higher than that in women with euthyroidism. The serum TSH level in women with UIC≥250 μg/ L was higher than those with 150≤UIC<250 μg/ L and UIC<150 μg/ L (P<0. 05). The serum TSH level in women with blood selenium<95 μg/ L was higher than those with selenium≥95μg/ L(P<0. 05). Logistic regression analysis showed that the risk of subclinical hypothyroidism in women with UIC≥250 μg/ L was increased by 3. 498 fold(95％ CI 1. 588-7. 704)as compared with those with 150≤UIC<250 μg/ L. The risk of subclinical hypothyroidism in women with blood selenium <80 μg/ L was increased by 2. 667 fold (95％ CI 1. 123-6. 331) compared with those with 90 ≤ selenium < 100 μg/ L. After adjusting for age, gestational weeks, residential district, TPOAb, TgAb, taking compound nutritional supplements, more-than-adequate and excessive iodine still increased the risk of subclinical hypothyroidism(OR= 3. 014, 95％ CI 1. 310-6. 938). Women with UIC≥250 μg/ L and blood selenium <95 μg/ L revealed the increased risk of subclinical hypothyroidism as compared to those with 150≤UIC<250 μg/ L and selenium≥95 μg/ L(OR=5. 429, 95％ CI 1. 929-15. 281). After adjusting for age, gestational weeks, residential district, TPOAb, TgAb, taking compound nutritional supplements, the fingdings still existed. Conclusion The nutrient condition of iodine and selenium of the pregnant women in Tianjin during the first half pregnancy should be noticed. The individualized supplement of iodine and selenium, if needed, should be performed to decrease the risk of subclinical hypothyroidism.

Metformin reverses bFGF-induced epithelial-mesenchymal transition in HCC cells.

Metformin had exerted important inhibitory effects in multiple cancers. However, the correlation between metformin and hepatocellular carcinoma (HCC) metastasis, and the relevant mechanisms are still unclear. By quantitative proteomics analysis technique, we found metformin could suppress FGF signalling significantly. In FGF signalling basic fibroblast growth factor (bFGF) is a crucial member, it initially binds to its receptors, the complex of bFGF and receptors activate FGF signallings, and promote many cancers progressions. When treating HCC cell lines HepG2 and Huh7 with bFGF, we observed the cells exhibited epithelial mesenchymal transition (EMT) and these cells metastasis potential was enhanced dramaticlly. However, when treating with metformin and bFGF together, EMT and metastasis induced by bFGF could be inhibited in these cells. Furthermore, bFGF could activate AKT/GSK-3ß signalling, sequentially decrease the interaction between GSK-3ß and Twist1 and decrease ubiquitination of Twist1 leading to Twist1 degradation reducing. While metformin could repress the bFGF-mediated activation in AKT/GSK-3ß signalling, inhibition on interaction between GSK-3ß and Twist1, enhancement of Twist1 stability. Taken together, our findings suggested that metformin had prominent negative effects on bFGF-induced EMT and metastasis in HCC cells.

Changes in bone mineral density in a rabbit model of steroid-induced osteonecrosis of the femoral head / 中国组织工程研究

BACKGROUND:The rabbit model of osteonecrosis of the femoral head (ONFH) has been successfully established by glucocorticoid combined with lipopolysaccharide.OBJECTIVE:To observe the dynamic changes of bone mass in the early steroid-induced ON FH.METHODS:Twenty-four adult New Zealand white rabbits were randomly divided into experimental and control groups (n=12 per group).Rabbits in the experimental group were injected with lipopolysaccharide and glucocorticoid to establish the model of ONFH,while those in the control group given the same volume of normal saline.The changes in the femoral head structure,morphology and distribution of the trabecular bone at 5,1 0,15 and 20 days after modeling were observed through multi-slice spiral CT,micro-CT and hematoxylin-eosin staining;the bone mineral density and rate of empty lacunae were detected.RESULTS AND CONCLUSION:The imaging examinations showed that the rabbit femoral head was intact and smooth in both groups;on days 15 and 20,in the experimental group,the cortical bone became thinner,the trabecular bone became sparse and discontinuous,and the bone mineral density,tissue mineral density and bone volume/total volume were significantly lower than those in the control group (P ＜ 0.01).The histological observation indicated that there were more empty lacunae and adipocytes,as well as less osteocytes and hematopoietic cells in the experimental group;the rate of empty lacunae in the experimental group was significantly higher than that in the control group on days 15 and 20 (P ＜ 0.01).These findings suggest that in the early stage of ONFH,necrotic osteocytes increase in number,accompanied by trabecular micro-fractures,which leads to a decrease in bone mineral density,eventually resulting in bone remodeling disturbance.

Revascularization strategy for STEMI patients with multivessel disease / 天津医药

ST-segment elevation myocardial infarction (STEMI) in patients with multivessel disease is a common situation, and suggests poor prognosis. After the reperfusion of infarct-related blood vessels in the primary PCI (PPCI), how to deal with the non-infarct related vessel has been a hot issue. In recent years, more and more evidence suggests that compared with treatment of infarct-related vessels only, revascularization of non-infarct related vessels will result in a better prognosis. But the timing and the choice of non-infarct-related vessel revascularization are still controversial. This article reviews the latest clinical evidence to improve the diagnosis and treatment of STEMI patients with multivessel disease.

On-line detection of concentration process of Ganmaoling granules by near infrared spectroscopy combined with automatic control system / 药学学报

Our research was designed for on-line detection of multi-index in the concentration process of Ganmaoling granules by integration of near infrared spectroscopy and automatic control system. First, on-line detection system was set up in the concentration tank for Ganmaoling granules production. Spectra were scanned and values of chlorogenic acid, linarin, solid content and relative density were measured. Models of partial least squares regression were built and imported into near infrared workstation. By connecting the control system, real-time multi-index values were determined automatically in the concentration process. Results showed that correlation coefficients of chlorogenic acid, linarin, solid content and relative density models were 0.963, 0.989, 0.993 and 0.918, respectively. Relative standard errors of prediction were 3.71%, 4.28%, 4.17% and 0.24%, respectively, indicating a good performance and high accuracy of the models. Real-time data collection during the whole process was measured by the near infrared detecting system in the control system. In conclusion, the near infrared detection system is able to perform real-time automatic determination of multi-index in the concentration process of Ganmaoling granules with significant advantages.

Effects of traditional Chinese medicine colquhounia root tablet on the expression of tight junction protein ;claudin-2 and ZO-1 in bronchial epithelium tissue of rats with acute lung injury induced by oleic acid / 中华危重病急救医学

Objective To investigate the effects of traditional Chinese medicine colquhounia root tablet on the expression of tight junction protein claudin-2 and ZO-1 in bronchial epithelium tissues of rats with acute lung injury (ALI), and to study the mechanism of protective effect of colquhounia root tablet on ALI. Methods Twenty-four healthy male Sprague-Dawley (SD) rats were randomly divided into control group, ALI group and colquhounia root tablet pretreatment group, with 8 rats in each group. The model of ALI was reproduced by intravenous injection of oleic acid 0.04 mL/kg, and the rats in cont rol group were given the same amount of normal saline (NS) instead. The rats in colquhounia root tablet pretreatment group were intragastric administrated with colquhounia root tablet of 600 mg·kg-1·d-1 (2 mL) for 10 days before model reproduction, and the rats in control group and ALI group were given the same amount of NS. At 4 hours after model reproduction, the blood was drawn from abdominal aorta, and bronchoalveolar lavage fluid (BALF) was collected for determination of protein content in plasma and BALF, and the lung permeability index (LPI) was calculated. The rats were sacrificed to collect lung tissues for determination of lung wet/dry weight ratio (W/D), the changes in pathology of lung tissue were observed after hematoxylin and eosin (HE) staining with light microscope, and lung injury score (LIS) was evaluated. The immunohistochemic al staining was used to detect the expression and localization of claudin-2 and ZO-1 in bronchial epithelium tissues. The protein expressions of claudin-2 and ZO-1 in bronchial epithelium tissues were determined by Western Blot. Results Compared with control group, the lung injury in ALI group was more obvious including cellular edema and structural disorder of intercellular connection by optical microscope, and LIS, W/D ratio, and LPI were significantly increased (LIS: 3.81±0.42 vs. 0.40±0.08, W/D: 7.68±0.64 vs. 4.44±0.39, LPI: 0.89±0.15 vs. 0.38±0.05, all P < 0.01). Claudin-2 and ZO-1 were mainly expressed in the bronchial epithelium cell, and the expression degrees were significantly weakened in ALI group as compared with control group. It was shown by Western Blot results that compared with control group, the protein expressions of claudin-2 and ZO-1 were significantly down-regulated in ALI group [claudin-2 protein (gray value): 0.43±0.31 vs. 2.16±1.33, ZO-1 protein (gray value): 1.25±0.41 vs. 2.82±0.76, both P < 0.01]. Compared with ALI group, colquhounia root pretreatment could effectively diminish the degree of ALI (LIS: 1.22±0.39 vs. 3.81±0.42, W/D: 4.62±0.84 vs. 7.68±0.64, LPI: 0.46±0.07 vs. 0.89±0.15, all P < 0.01), and the protein expressions of claudin-2 and ZO-1 were significantly up-regulated [claudin-2 protein (gray value): 2.98±0.91 vs. 0.43±0.31, ZO-1 protein (gray value): 2.35±0.51 vs. 1.25±0.41, both P < 0.01]. Conclusion Administration of colquhounia root table could attenuate lung injury induced by oleic acid with improving epithelial barrier function via up-regulate the expression claudin-2 and ZO-1, which play a protective effect on the lung of rats with ALI.