Comparative study on clinicopathological features and prognosis of IgA vasculitis nephritis and IgA nephropathy in children.

BACKGROUND: IgA vasculitis nephritis (IgAVN) and IgA nephropathy (IgAN) share several clinical and pathological characteristics, though distinctions also exist. Their interrelation, however, remains undefined. This study investigates the clinicopathological divergences and prognostic disparities in pediatric patients with IgAVN and IgAN. METHODS: Our study encompasses 809 pediatric patients with IgAVN and 236 with IgAN, all of whom underwent kidney biopsy. We utilized the Semiquantitative Classification (SQC) scoring system to juxtapose the pathologies of the two conditions, and performed a COX regression analysis to examine factors influencing their prognoses. RESULTS: Both patient groups demonstrated a predominance of males. A seasonality was observed, with a higher incidence of IgAN in the summer, and IgAVN in the fall (P < 0.0001). Patients with IgAN exhibited more severe tubulointerstitial injury, higher chronicity index, and total biopsy scores compared to those with IgAVN (P < 0.0001). Mesangial deposition intensity of complement C3, and the rate of pure IgA deposition, were found to be greater in patients with IgAVN compared to those with IgAN (P < 0.0001). The intensity of IgA deposition was also significantly higher in IgAVN patients (P = 0.003). IgAVN demonstrated a superior prognosis, with a higher rate of kidney remission (P < 0.0001). COX regression analysis indicated that interstitial fibrosis, as identified in the SQC pathology system, was associated with the prognosis of both conditions. Furthermore, the findings suggest that IgA deposition levels (IgA + + and IgA + + +) could potentially influence the prognosis of IgAVN. CONCLUSIONS: Compared to IgAVN, IgAN manifests more severely with regard to renal impairment, interstitial damage, and prognosis. The disparities in immune complex deposition levels and locations within the kidneys support the hypothesis of IgAVN and IgAN as distinct diseases. Interstitial fibrosis may serve as a key pathological indicator within the SQC system associated with kidney prognosis in children with IgAVN and IgAN. The degree of IgA deposition could also be linked with the prognosis of IgAVN.

Effect of Butylphthalide combined with Oxiracetam on cognitive function, Intellectual recovery and serum inflammatory factors in patients with cognitive impairment after cerebral infarction.

Objective: To evaluate the effect of butylphthalide combined with oxiracetam on cognitive function, intellectual recovery and serum inflammatory factors in patients with cognitive impairment after cerebral infarction. Methods: This is a Clinical comparative study. A total of 80 patients with cognitive impairment after cerebral infarction who visited Renmin Hospital, Hubei University of Medicine from January 2020 to January 2022 were enrolled and randomly divided into two groups. Patients in the control group were treated with oral oxiracetam combined with routine treatment. Patients in the study group were given butylphthalide combined with oxiracetam on the basis of routine treatment. Compare the clinical effect, cognitive function and intellectual recovery, inflammatory factor level changes, CBV, CBF, MTT and other cerebral blood flow perfusion indicators, as well as post-treatment incidence of adverse drug reactions in the two groups of patients. Results: The efficacy of the study group was significantly higher than that of the control group (p=0.03). After treatment, the levels of CBV and CBF in the study group were higher than those in the control group, the levels of TNF-α, CRP and IL-6 were significantly lower than those of the control group, while MTT was shorter than that in the control group, with statistically significant difference (p=0.00). Furthermore, there was a statistically significant difference that the MMSE score and MOCA score of the study group were higher than those of the control group (p=0.00). Conclusion: Butylphthalide combined with oxiracetam has an obvious curative effect in the treatment of patients with cognitive impairment after cerebral infarction. It is a safe and effective therapeutic option that can significantly recover cognitive function and intelligence, improve cerebral blood flow perfusion and reduce inflammatory factors, without an obvious increase in adverse reactions.

[Clinical characteristics, pathology, and prognosis of children with diffuse endocapillary proliferative Henoch-Schönlein purpura nephritis]. / å„¿ç«¥å¼¥æ¼«æ€§æ¯›ç»†è¡€ç®¡å† å¢žç”Ÿæ€§ç´«ç™œæ€§è‚¾ç‚Žçš„ä¸´åºŠã€ç— ç†åŠé¢„åŽ.

OBJECTIVES: To investigate the clinical characteristics, pathology, and prognosis of children with diffuse endocapillary proliferative Henoch-Schönlein purpura nephritis (DEP-HSPN). METHODS: A retrospective analysis was performed on the clinical, pathological, and prognosis data of 44 children with DEP-HSPN and 765 children without DEP-HSPN. The children with DEP-HSPN were diagnosed by renal biopsy in Jiangxi Provincial Children's Hospital from January 2006 to December 2021. RESULTS: Among the 809 children with purpura nephritis, 44 (5.4%) had DEP-HSPN, with a mean age of (8±3) years, and there were 29 boys (65.9%) and 15 girls (34.1%). Compared with the non-DEP-HSPN group, the DEP-HSPN group had a significantly shorter time from onset to renal biopsy and a significantly higher proportion of children with respiratory infection or gross hematuria, and most children had nephrotic syndrome. The DEP-HSPN group had significantly higher levels of 24-hour urinary protein, urinary protein grading, microscopic hematuria grading, serum creatinine, and blood urea nitrogen and significantly lower levels of serum albumin and complement C3 (P<0.05). The DEP-HSPN group had a higher pathological grading, with predominant deposition of IgA in the mesangial area and capillary loops, and higher activity scores in the modified semi-quantitative scoring system (P<0.05). The Kaplan-Meier survival analysis showed that there was no significant difference in the renal complete remission rate between the two groups (P>0.05). CONCLUSIONS: Children with DEP-HSPN have a rapid onset, severe clinical manifestations and pathological grading, and high activity scores in the modified semi-quantitative scoring system. However, most of the children with DEP-HSPN have a good prognosis, with a comparable renal complete remission rate to the children without DEP-HSPN.

EIF4A3-induced circCCNB1 (hsa_circ_0001495) promotes glioma progression by elevating CCND1 through interacting miR-516b-5p and HuR.

To explore the functions of circRNA cyclin B1 (circCCNB1) in glioma and its possible mechanisms. The expression of circCCNB1, eukaryotic translation initiation factor 4A3 (EIF4A3), cyclin D1 (CCND1) and miR-516b-5p was determined by qRT-PCR, western blot or immunohistochemistry (IHC) assay. The feature of circCCNB1 was analyzed by Actinomycin D (ActD), RNase R and subcellular fraction assays. The molecule relationships were analyzed by RIP, dual-luciferase reporter and RNA pull-down assays. CCK-8, EdU and colony formation assays were performed to analyze cell proliferation. Flow cytometry analysis was executed to estimate the cell cycle. Murine xenograft model assay was used for the role of circCCNB1 in vivo. CircCCNB1 was overexpressed in glioma tissues and cells. EIF4A3 positively regulated circCCNB1 expression. CircCCNB1 knockdown repressed glioma cell proliferation and cell cycle process in vitro and blocked tumor growth in vivo. CircCCNB1 knockdown reduced CCND1 expression in glioma cells and CCND1 overexpression bated the effect of circCCNB1 knockdown on glioma cell growth. CircCCNB1 interacted with HuR to elevate CCND1 expression. miR-516b-5p could interact with circCCNB1 and CCND1. CircCCNB1 regulated glioma cell progression and CCND1 expression by miR-516b-5p and HuR. CircCCNB1 aggravated glioma cell growth by elevating CCND1 through targeting miR-516b-5p and HuR.

Influence of butyphthalide combined with urinary kallikrein in ACI treatment on neuro-cytokines and vascular endothelial function and its clinical effect.

Objective: To study the influence of butyphthalide combined with urinary kallikrein in acute cerebral infarction (ACI) treatment on neuro-cytokines and indicators of vascular endothelial function, observe the curative effect and adverse effects, and discuss its safety and feasibility.Method: 110 ACI patients were chosen as the objects, and classified into observation group (55 cases) and control group (55 cases) according to the method of random number table. Butyphthalide injection combined with urinary kallikrein was adopted for the observation group based on conventional treatment, while cinepazide maleate injection combined with alprostadil injection was applied for the control group based on conventional treatment. The following indicators of both groups were compared before and after treatment: neurotrophic factor (NTF), nerve growth factor (NGF), neuron specific enolase (NSE); content of CXC chemotactic factor ligand 16 (CXCL16), soluble CD ligand (CD40L), Fibulin-5 and high mobility group box B1 (HMGB1); the content of indicators of vascular endothelial function including plasma endothelin -1 (ET-1) and no therapeutic effects and adverse effects were recorded.Results: NSE of both groups after treatment decreased obviously, and the content of NTF and NGF increased obviously. NSE content of observation group was lower than that of control group. NTF content and NGF content of observation group were higher than those of control group. The differences had statistical significance (p < 0.05). The levels of CXCL16, CD40L, Fibulin-5 and HMGB1 declined obviously, compared with pre-treatment, and the levels of observation groups were significantly lower than those of control grip. The differences had statistical significance (p < 0.05). ET-1 level rose significantly after treatment, and NO level declined obviously after treatment. ET-1 level of observation group was significantly higher than that of control group, and NO level of observation group was significantly lower than that of control group. The difference had statistical significance (p < 0.05). Clinical effect of observation group was significantly higher than that of control group. The difference had statistical significance (p < 0.05). The comparison difference of both groups in the occurrence rate of adverse effects had no statistical significance (p > 0.05).Conclusion: The application of butyphthalide combined with urinary kallikrein in ACI treatment can effectively inhibit secretion and release of neuro-cytokines, and improve patients' vascular endothelial function, with significant treatment effect and high safety. Therefore, it deserves to be promoted clinically.

The Molecular Mechanism of EPO Regulates the Angiogenesis after Cerebral Ischemia through AMPK-KLF2 Signaling Pathway.

OBJECTIVE: In this study, the molecular mechanism by which EPO regulates the angiogenesis after cerebral ischemia through AMPK-KLF2 signaling pathway was investigated. METHODS: Sixty healthy, male, C57BL/6 mice were randomly divided into three groups of 20 mice: a sham group, the middle cerebral artery occlusion (MCAO) group, and a MCAO+EPO treatment group. The MCAO model was established using a modified ZeaLonga method. Mice in the EPO treatment group were injected with EPO immediately after reperfusion (5000 IU/kg), and EPO was injected the following day. The number of mouse deaths and neurologic function scores were recorded during the experiment. On day 7 after cerebral ischemia, brain tissue proteins were extracted. The following proteins expressions were detected by western blot assay: EPO, vascular endothelial growth factor (VEGE), vascular endothelial growth factor receptor (KDR), adenosine activated protein kinase (AMPK), and alpha HIF-1α alpha (HIF-1α), KLF2 and nitric oxide synthase (eNOS). RESULTS: Compared with the MCAO group, the survival rate of mice in the EPO group was significantly improved and neurological function was significantly improved (P < 0.01). Western blot results showed that the content of EPO in brain tissue in MCAO group significantly increased compared with sham group. The content of EPO in the brain tissue of mice in the MCAO+EPO treatment group was significantly higher than in that of the MCAO group, which indicates that EPO increased the content of EPO in mouse brain tissue. Compared with the sham group, the protein expression of vascular endothelial growth factor (VEGE) and its receptor (KDR) in brain tissue of the MCAO group significantly decreased. However, the protein expression of VEGE and its receptor KDR in brain tissue of rats treated with MCAO+EPO was significantly higher than in that of the MCAO group. Thus, in this study, EPO was associated with vascular endothelial differentiation after cerebral ischemia in mice. The results of AMPK and KLF2 showed that the expression levels of AMPK and KLF2 in brain tissues of MCAO group mice significantly decreased compared with the sham group. However, the expression levels of AMPK and KLF2 in brain tissues of mice treated with MCAO+EPO were significantly higher than those in the MCAO group. Thus, EPO can activate AMPK and upregulate the expression of the transcription factor KLF2. The protein expression of HIF-1α in the brain tissue of mice in the MCAO group significantly increased compared with the sham group. However, the expression of HIF-1α in mice brain tissues in the MCAO+EPO treatment group was significantly lower than in that of the MCAO group, indicating that EPO was involved in regulating HIF-1α expression. The eNOS results showed that, compared with Sham group, the protein expression of eNOS in brain tissue of MCAO group mice significantly decreased. In the MCAO+EPO treatment group, the protein expression of eNOS was significantly higher in the brain tissue of the mice than in that of the MCAO group, indicating that EPO was involved in the synthesis of NO and promoted the angiogenesis. CONCLUSION: EPO promotes VEGE and its receptor (KDR) expression and participates in the regulation of HIF-1α and eNOS protein expression through the activation of AMPK-KLF2 signaling pathways to promote new vascular development after cerebral ischemia.

Comparative studies on the effects of different doses of atorvastatin combined with aspirin on inflammatory cytokines and carotid plaques in patients with ischemic cerebrovascular disease.

Objective: To make comparative studies on the effects of different doses of atorvastatin combined with aspirin on inflammatory cytokines, blood lipids, blood glucose, other biochemical indexes and carotid plaques in patients with ischemic cerebrovascular disease (ICVD) and carotid plaques. Method: One hundred and twenty patients with ICVD and carotid plaques admitted by Renmin Hospital, Hubei University of Medicine Hospital from December 2016 to December 2017 were selected and randomly divided into experimental group and control group, 60 cases in each group. Patients in the control group was asked to orally take standard dose of atorvastatin (20 mg/d) combined with aspirin enteric-coated tablets (100 mg/d). Patients in the experimental group was asked to orally take high-dose atorvastatin (40 mg/d) combined with the same amount of aspirin enteric-coated tablets. Patients in two groups were treated for 6 months averagely. The levels of inflammatory factors, changes in blood biochemical parameters and carotid plaque degrees of patients in two groups before and after treatment were inspected and compared. Results: The levels of serum high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF-a), interleukin-6 (IL-6) and homocysteine (Hcy) in patients of the experimental group after treatment were higher than those in the control group, difference with statistical significance (p < .05). The total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in patients of the experimental group after treatment were lower than those in the control group and before treatment. The high-density lipoprotein cholesterol (HDL-C) was higher than that of the control group and before treatment, the levels of fasting blood glucose (FBS) and glycosylated hemoglobin (HbAIc) in patients of the experimental group significantly increased compared to those before treatment, difference with statistical significance (p < .05). There was no significant change in the control group. The carotid intima-media thickness (IMT) and plaque area in patients of the experimental group were lower than those in the control group and before treatment, difference with statistical significance (p < .05). Conclusion: High-dose atorvastatin combined with aspirin for treatment of patients with ICVD can effectively reduce inflammatory inflammatory cytokine levels in serum and reduce IMT and carotid plaque area. With more obvious effect than lower dose of atorvastatin combined with aspirin, it is easy to cause blood glucose abnormality. So, it is necessary to pay attention to monitoring blood sugar during medication period.

Demonstration of Coherent Terahertz Transition Radiation from Relativistic Laser-Solid Interactions.

Coherent transition radiation in the terahertz (THz) region with energies of sub-mJ/pulse has been demonstrated by relativistic laser-driven electron beams crossing the solid-vacuum boundary. Targets including mass-limited foils and layered metal-plastic targets are used to verify the radiation mechanism and characterize the radiation properties. Observations of THz emissions as a function of target parameters agree well with the formation-zone and diffraction model of transition radiation. Particle-in-cell simulations also well reproduce the observed characteristics of THz emissions. The present THz transition radiation enables not only a potential tabletop brilliant THz source, but also a novel noninvasive diagnostic for fast electron generation and transport in laser-plasma interactions.

Suspended sediment dynamics and the related environmental risk assessment in a sensitive water area.

Suspended sediment (SS) is a natural component of aquatic environments. It is characterized by the adsorption of pollutants, and its physical properties can affect water volume quality. In this study, SS dynamics were simulated using a 2D hydrodynamic model in the Nanji Mountain Nature Reserve (NNR), and the fluxes of pollutants caused by SS were calculated to assess the biological risks during the wet (May-August) and dry (November-March) seasons. High spatial and temporal variability in SS load within the NNR was found in this study. The average SS load in the reserve increased and then decreased during the year, and the SS input from Ganjiang significantly affected the SS load in the NNR (p < 0.01). The SS load uptrend in the NNR occurred later than that of Ganjiang during the wet season because of the SS sedimentation in the NNR. And the suspension of SS in the NNR during the dry season resulted in a later SS load downtrend compared to Ganjiang. High SS load from Ganjiang during the wet season was responsible for the high nutrient and microplastic fluxes in the NNR, which were 8.38 and 10.61 times higher than those in the dry season, respectively. And the pollutant fluxes during the wet season were almost all from Ganjiang. In contrast, higher waterbird diversity and population during the dry season is the main reason for the increased biological risk of contaminants. Therefore, monitoring and managing SS and its contamination concentrations in rivers entering the lake is helpful for the protection of ecologically sensitive areas and key species in the lake.

Applying water environment capacity to assess the non-point source pollution risks in watersheds.

Comprehension of the spatial and temporal characteristics of non-point source (NPS) pollution risk in watersheds is essential for NPS pollution research and scientific management. Although the concept of water functional zones (WFZ) has been considered in the NPS pollution risk assessment process. However, no comprehensive study of the NPS pollution risk has been conducted to effectively protect water quality in watersheds with different water environment capacity. Therefore, this study proposes a new NPS pollution risk assessment method that integrates water functional zoning, receiving water body environmental capacity, and space-time distribution of pollution load for quantifying the impact of pollution discharge from sub-catchment on nearby water body quality. Based on the NPS nutrient loss process modeled by the Soil and Water Assessment Tool (SWAT), this method was used to assess the NPS pollution risk in the Le 'an River Watershed at annual and monthly scales. The results showed that the NPS pollution risk is characterized by seasonal and spatial variability and is influenced clearly by the water environment capacity. High NPS pollution loads are not necessarily high pollution risks. Conversely, a low NPS nutrient pollution load does not represent a low regional risk sensitivity. In addition, NPS risk assessment based on the water environment capacity could also distinguish the differences in risk levels that were masked by similar NPS pollutant loss and the same water function zoning to achieve accurate control of NPS pollution management in watersheds.

How climate change and land-use evolution relates to the non-point source pollution in a typical watershed of China.

The water quality of Le 'an River Watershed (LRW) is crucial to the water environmental safety of Poyang Lake, especially the concentration of nitrogen and phosphorus. The effect of climate and land use change on watershed water quality has always been under the attention of local managers. More importantly, the lack of detailed studies on climate and land use impact on river water quality has prevented sustainable water security management in the LRW. Therefore, this study aimed to quantify the weight of climate and land use on nutrient loss in the LRW, respectively. We divided the historical period (1990-2020) into six scenarios and a baseline scenario. TN and TP losses in the watershed were simulated using Soil and Water Assessment Tool (SWAT), and the weight of climate and land use were quantified in overall, by period, and by region. The results showed that the weight of climate was greatly higher than land use with values around 90%. However, the weight of land use had a positive cumulative effect in a certain period, and its influence could not be neglected. The climate in all scenarios led to a reduction in nutrient loss, while land use was found to slightly increase the nutrient loss yield. In addition to, unique regional topographic features, urbanization rates, and climatic conditions could cause spatial heterogeneity in the climatic and land use weights.

How does Three Gorges Dam regulate heavy metal footprints in the largest freshwater lake of China.

Herein, a two-dimensional (2-D) vertically-averaged hydrodynamic model was applied to study the heavy metal particle footprints pre- and post-Three Gorges Dam (TGD) in Poyang Lake. Two defined indexes-Reserve Impact Index (σRII) and Species Impact Index (ηSII) were applied to assess the potential impact of the copper footprint on nature reserves and sensitive species quantitatively. The results demonstrated that the movement speed, distribution, and trajectory of copper particle footprints differed enormously pre- and post-TGD. By contrast, the post-TGD footprints were more complex because of the dam-induced variations in hydrology and meteorology. TGD had both pros and cons for the copper footprint on the reserves based on the results of σRII. It had changed the way for the transport of heavy metals and altered the patterns of exposure risk in the reserves. Sustainable management of Poyang Lake could be achieved by optimizing daily monitoring works. The ηSII for Finless Porpoises do not differ significantly between scenarios, but the ηSII for Siberian White Cranes increased by 0.92 and 0.83 for the two periods pre- and post-TGD, respectively. Heavy metals in food sources and the excreta of Siberian White Cranes could be of great concern in future studies. This study provides a theoretical basis for the in-depth study of the TGD-induced impact on Poyang Lake and provides a reference for the long-term treatment of Poyang Lake and the protection of key species.

Demonstration of laser-produced neutron diagnostic by radiative capture gamma-rays.

We report a new scenario of the time-of-flight technique in which fast neutrons and delayed gamma-ray signals were both recorded in a millisecond time window in harsh environments induced by high-intensity lasers. The delayed gamma signals, arriving far later than the original fast neutron and often being ignored previously, were identified to be the results of radiative captures of thermalized neutrons. The linear correlation between the gamma photon number and the fast neutron yield shows that these delayed gamma events can be employed for neutron diagnosis. This method can reduce the detecting efficiency dropping problem caused by prompt high-flux gamma radiation and provides a new way for neutron diagnosing in high-intensity laser-target interaction experiments.

30+ year evolution of Cu in the surface sediment of Lake Poyang, China.

Poyang Lake, the largest freshwater lake in China, is increasingly experiencing Cu crises. Combining field data, laboratory experiments, and long-term simulations, we retrieved 30 + year evolution of Cu in surface sediments (SCu). SCu evolution between 1983 and 2015 may be separated into two distinguishable periods. During the first period (1983-2003), SCu underwent a continuous increase at a mean rate of 1.80 mg/kg/yr; however, since 2003 it displayed a stepwise reduction tendency. The average SCu concentration of the entire lake in 2015 fell to 54.26 mg/kg, which is approximately 30.01% lower than that in 2003. The operation of Three Gorges Dam (TGD) markedly altered the river-lake relationship, pulled more deposited Cu along with sediment out toward the Yangtze River, and made the regions of high SCu emanate from the southeastern lake extend northwestward between 2003 and 2015. SCu in the reserves showed significant inter-annual variations, with the exception of the Jiangxi Whitebait Spawning Reserve (JWSR), where SCu generally has not been significantly impacted and has displayed no departure from the 30 + year mean of 30.57 mg/kg. The National Germplasm Reserve (NGR) and Nanjishan National Nature Reserve (NNNR) were detected with the highest SCu, with the peak concentrations, respectively, of 123.15 mg/kg and 103.1 mg/kg.

Notch signaling in cerebrovascular diseases (Review).

The Notch signaling pathway is a crucial regulator of numerous fundamental cellular processes. Increasing evidence suggests that Notch signaling is involved in inflammation and oxidative stress, and thus in the progress of cerebrovascular diseases. In addition, Notch signaling in cerebrovascular diseases is associated with apoptosis, angiogenesis and the function of blood­brain barrier. Despite the contradictory results obtained to date as to whether Notch signaling is harmful or beneficial, the regulation of Notch signaling may provide a novel strategy for the treatment of cerebrovascular diseases.

A two-dimensional angular-resolved proton spectrometer.

We present a novel design of two-dimensional (2D) angular-resolved spectrometer for full beam characterization of ultrashort intense laser driven proton sources. A rotated 2D pinhole array was employed, as selective entrance before a pair of parallel permanent magnets, to sample the full proton beam into discrete beamlets. The proton beamlets are subsequently dispersed without overlapping onto a planar detector. Representative experimental result of protons generated from femtosecond intense laser interaction with thin foil target is presented.

Fluctuation of the water environmental carrying capacity in a huge river-connected lake.

A new method, with the non-fully mixed coefficient (NFMC) considered, was put forward to calculate the water environmental carrying capacity (WECC) for huge river-connected lakes, of which the hydrological conditions always vary widely during a year. Poyang Lake, the most typical river-connected lake and the largest freshwater lake in China, was selected as the research area. Based on field investigations and numerical simulation, the monthly pollutant degradation coefficients and non-fully mixed coefficients of different lake regions were determined to explore the WECCs of COD, TN and TP of Poyang Lake in a common water year. It was found that under the hydrological conditions of a common water year the total WECCs of COD, TN and TP in the lake were respectively 181.9 × 104 t, 33.3 × 104 t and 1.86 × 104 t. Due to the varied lake water volume and self-purification ability, an evident temporal fluctuation of WECCs in Poyang Lake was observed. The dry seasons were characterized by a higher NFMCs but lower WECCs owing to the lower water level and degradation ability. Variation coefficients of COD and TN WECC were close to each other, of which the average level was about 58.5%, a little higher than that of TP.

[Efficacy on chronic obstructive pulmonary disease at stable stage treated with cutting method and western medication].

OBJECTIVE: To compare the difference in clinical efficacy on chronic obstructive pulmonary disease (COPD) at stable stage in the patients among the combined therapy of cutting method and western medication (combined therapy), simple cutting method and simple western medication. METHODS: One hundred and twenty cases of COPD were randomized into three groups, 40 cases in each one. In the cutting method group, for excessive phlegm pattern/syndrome, Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1) and Yuji (LU 10) were selected as the main acupoints, and Lieque (LU 7) and Pianli (LI 6) were as the supplementary acupoints. For the pattern/syndrome of failure to consolidate kidney primary, Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4) and Yuji (LU 10) were selected as main acupoints, and Jueyinshu (BL 14) and Zusanli (ST 36) were as the supplementary acupoint. Three acupoints were selected alternatively in each treatment and the cutting method was applied once every 10 days. Three treatments made one session. Two sessions of treatment were required. In the western medication group, salbutamol sulfate aerosol, one press (200 µg/press) was used each night, as well as salmeterol xinafoate and fluticasone propionate powder for inhalation, one inhalation each night. The treatment of 1 month made one session. Two sessions were required. In the combined therapy group, the cutting method and western medication were applied in combination. The results of clinical symptom score, lung function test, arterial blood gas analysis, degree of inflation as well as clinical efficacy were observed before and after treatment in each group. RESULTS: Except the degree of lung inflation, the clinical symptom score, indices of lung function test, partial pressure of arterial blood gas (PaO2) and partial pressure of carbon dioxide (PaCO2) were all obviously improved after treatment as compared with those before treatment in each group (all P<0.05). They were apparently improved after treatment in the combined therapy group and the cutting method group as compared with those in the western medication group (all P<0.05). The total effective rate was 77.5% (31/40) in the combined therapy group and was 75.0% (30/40) in the cutting method group, both better than 60.0% (24/40) in the western medication group (both P<0.05). CONCLUSION: The simple cutting method based on syndrome differentiation and the combined therapy with western medication achieve the superior efficacy on COPD at stable stage as compared with the simple western medication. The effect mechanism is possibly related to the improvement of bronchial airway function through constant acupoint stimulation.

Surface water quality monitoring site optimization for Poyang Lake, the largest freshwater lake in China.

In this paper, we propose a coupled method to optimize the surface water quality monitoring sites for a huge freshwater lake based on field investigations, mathematical analysis, and numerical simulation tests. Poyang Lake, the largest freshwater lake in China, was selected as the research area. Based on the field investigated water quality data in the 5 years from 2008 to 2012, the water quality inter-annual variation coefficients at all the present sites and the water quality correlation coefficients between adjacent sites were calculated and analyzed to present an optimization scheme. A 2-D unsteady water quality model was established to get the corresponding water quality data at the optimized monitoring sites, which were needed for the rationality test on the optimized monitoring network. We found that: (1) the water quality of Piaoshan (No. 10) fluctuated most distinguishably and the inter-annual variation coefficient of NH3-N and TP could reach 99.77% and 73.92%, respectively. The four studied indexes were all closely related at Piaoshan (No. 10) and Tangyin (No. 11), and the correlation coefficients of COD and NH3-N could reach 0.91 and 0.94 separately. (2) It was suggested that the present site No. 10 be removed to avoid repeatability, and it was suggested that the three sites of Changling, Huzhong, and Nanjiang be added to improve the representativeness of the monitoring sites. (3) According to the rationality analysis, the 21 optimized water quality monitoring sites could scientifically replace the primary network, and the new monitoring network could better reflect the water quality of the whole lake.