Effects of PM2.5 sub-chronic exposure on liver metabolomics in mice / 环境与职业医学

Background Atmospheric fine particulate matter (PM2.5) can disrupt the metabolic homeostasis of the liver and accelerate the progression of liver diseases, but there are few studies on the effects of sub-chronic PM2.5 exposure on the liver metabolome. Objectives To investigate the effects of sub-chronic exposure to concentrated PM2.5 on hepatic metabolomics in mice by liquid chromatography-mass spectrometry (LC-MS), and to identify potentially affected metabolites and metabolic pathways. Methods Twelve male C57BL/6J (6 weeks old) mice were randomly divided into two groups: a concentrated PM2.5 exposure group and a clean air exposure group. The mice were exposed to concentrated PM2.5 using the "Shanghai Meteorological and Environmental Animal Exposure System" at Fudan University. The exposure duration was 8 h per day, 6 d per week, for a total of 8 weeks. The mice's liver tissues were collected 24 h after the completion of exposure. LC-MS was performed to assess changes in the hepatic metabolome. Orthogonal partial least squares discriminant analysis and t-test were employed to identify differentially regulated metabolites between the two groups under the conditions of variable important in projection (VIP)≥1.0 and P<0.05. Metabolic pathway enrichment analysis was performed using MetaboAnalyst 5.0 software and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Results A total of 297 differentially regulated metabolites were identified between the concentrated PM2.5 exposure group and the clean air group. Among these metabolites, 142 were upregulated and 155 were downregulated. A total of 38 metabolic pathways were altered, with 7 pathways showing significant perturbation (P<0.05). These pathways involved amino acid metabolism, glucose metabolism, nucleotide metabolism, as well as cofactor and vitamin metabolism. The 7 significant metabolic pathways were pantothenic acid and coenzyme A biosynthesis; purine metabolism; amino sugar and nucleotide sugar metabolism; arginine biosynthesis; alanine, aspartate and glutamate metabolism; aminoacyl-tRNA biosynthesis; and fructose and mannose metabolism. Conclusion The results from metabolomics analysis suggest that sub-chronic exposure to PM2.5 may disrupt hepatic energy metabolism and induce oxidative stress damage. Aspartic acid, succinic acid, ornithine, fumaric acid, as well as purine and xanthine derivatives, were identified as potential early biomarkers of hepatic response to sub-chronic PM2.5 exposure.

Treatment of tibial insertion avulsion fracture of anterior cruciate ligament involving anterior root of lateral meniscus with multi-point fixation with anchor and suture / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of arthroscopic multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of anterior cruciate ligament (ACL) involving the anterior root of lateral meniscus (LM).@*METHODS@#A retrospective analysis was conducted on the clinical data of 28 patients with tibial insertion avulsion fracture of ACL involving the anterior root of LM who were treated with arthroscopic multi-point fixation with anchor and suture between October 2017 and January 2023. There were 12 males and 16 females with the mean age of 26 years (range, 13-57 years). There were 20 cases of sports injury and 8 cases of traffic accident injury. In 2 cases of old fracture, the time from injury to operation was 45 days and 90 days, respectively; in 26 cases of fresh fracture, the time from injury to operation was 3-20 days (mean, 6.7 days). According to the Meyers-McKeever classification, there were 4 cases of type Ⅱ, 11 cases of type Ⅲ, and 13 cases of type Ⅳ. The preoperative Lysholm knee function score was 42.1±9.0, the International Knee Documentation Committee (IKDC) score was 40.0±7.3, and the Tegner score was 0.7±0.7.@*RESULTS@#All operations were successfully completed, and the incisions healed by first intention. All the 28 patients were followed up 5-60 months (mean, 20.4 months). During the follow-up, there was nocomplication such as infection, vascular or nerve injury, loosening or breakage of internal fixator, or stiffness of knee joint. Postoperative X-ray films showed satisfactory fracture reduction and firm fixation. All fractures healed clinically, and the healing time was 8-16 weeks (mean, 10.3 weeks). At last follow-up, Lachman test and anterior drawer test were negative. At last follow-up, Lysholm knee function score was 92.4±5.5, IKDC score was 91.6±4.4, and Tegner score was 5.2±1.1, which significantly improved when compared with preoperative scores ( t=-22.899, P<0.001; t=-29.870, P<0.001; t=-19.979, P<0.001).@*CONCLUSION@#Multi-point fixation with anchor and suture in the treatment of tibial insertion avulsion fracture of ACL involving the anterior root of LM can not only fix the LM, but also effectively reduce and fix the avulsion fracture, which can obtain good effectiveness.

Systematic review of the research on rational drug use among the elderly in Chinese elderly care facilities / 中国药房

OBJECTIVE To understand the current status of the research on rational drug use among the elderly population in Chinese elderly care facilities， and to provide ideas for future related research. METHODS Retrieved from PubMed， Web of Science， Embase， CNKI， Wanfang database and VIP， relevant literature about the research on rational drug use among the elderly population in Chinese elderly care facilities were collected to evaluate the current status of research on the rational drug use among the elderly population in elderly care facilities. RESULTS A total of 14 cross-sectional studies were included. All included studies were completed before 2019 and focused on the eastern coastal areas of China. The AXIS quality scores of the included studies showed a mean score of 11.14±2.25， with six studies having a quality score ＞10. The 14 studies examined a total of 5 770 older adults in elderly care facilities， involving 181 elderly care facilities. Eight studies reported the type of chronic disease in the older adult population of the elderly care facilities； seven studies reported the type of medication used. Nine studies had medication compliance as an outcome， among which seven studies used different analytical methods to analyze the factors influencing medication compliance. The results showed that age， education， duration of illness， type of elderly care facilities， and level of staff attention had significant influence on medication compliance in the elderly population in the elderly care facilities. CONCLUSIONS There is insufficient research related to rational drug use among the elderly population in the elderly care facilities in China， and there is a lack of interventional studies to assess the effectiveness of the rational drug use service in the elderly population in the elderly care facilities. Most of the current research is based on cross-sectional studies， focusing on medication compliance.

Safety and efficacy of left atrial appendage closure combined with patent foramen ovale closure for atrial fibrillation patients with patent foramen ovale / 中华心血管病杂志

Objective: To analyze the safety and efficacy of combined left atrial appendage (LAA) and patent foramen ovale (PFO) closure in adult atrial fibrillation (AF) patients complicating with PFO. Methods: This study is a retrospective and cross-sectional study. Seven patients with AF complicated with PFO diagnosed by transesophageal echocardiography (TEE) in Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences from June 2017 to October 2020 were selected. Basic data such as age, gender and medical history were collected. The atrial septal defect or PFO occluder and LAA occluder were selected according to the size of PFO, the ostia width and depth of LAA. Four patients underwent left atrial appendage closure(LAAC) and PFO closure at the same time. PFO closure was performed during a one-stop procedure of cryoablation combined with LAAC in 2 patients. One patient underwent PFO closure at 10 weeks after one-stop procedure because of recurrent transient ischemic attack (TIA). All patients continued to take oral anticoagulants. TEE was repeated 8-12 weeks after intervention. In case of device related thrombus(DRT), TEE shall be rechecked 6 months after adjusting anticoagulant and antiplatelet drug treatment. Patients were follow-up at 1, 3, 6, 12, 24 months by telephone call, and the occurrence of cardio-cerebrovascular events was recorded. Results: Among the 7 patients with AF, 2 were male, aged (68.0±9.4) years, and 3 had a history of recurrent cerebral infarction and TIA. Average PFO diameter was (3.5±0.8)mm. Three patients were implanted with Watchman LAA occluder (30, 30, 33 mm) and atrial septal defect occluder (8, 9, 16 mm). 2 patients were implanted with LAmbre LAA occluder (34/38, 18/32 mm) and PFO occluder (PF1825, PF2525). 2 patients were implanted with LACbes LAA occluder (24, 28 mm) and PFO occluder (PF2525, PF1825) respectively. The patients were followed up for 12 (11, 24) months after operation. TEE reexamination showed that the position of LAA occluder and atrial septal defect occluder or PFO occluder was normal in all patients. DRT was detected in 1 patient, and anticoagulant therapy was adjusted in this patient. 6 months later, TEE showed that DRT disappeared. No cardiovascular and cerebrovascular events occurred in all patients with AF during follow-up. Conclusions: In AF patients complicated with PFO, LAAC combined with PFO closure may have good safety and effectiveness.

Epidemiological and clinical characteristics of melioidosis in Haikou City in 2000 - 2020 / 中华地方病学杂志

Objective:To understand the epidemiological and clinical characteristics of melioidosis in Haikou City, to rise the people's awareness of melioidosis and to provide basis for prevention and control of the disease.Methods:The clinical data of 254 patients with melioidosis treated in 4 Class A tertiary hospitals in Haikou City from January 2000 to September 2020 were collected, and the epidemiological characteristics, clinical manifestations, infection site, prognosis and drug sensitivity were retrospectively analyzed.Results:Among 254 patients with melioidosis, 226 males (88.98%) and 28 females (11.02%), and the gender ratio was 8.07 ∶ 1.00. Farmers were the main occupation, accounting for 37.80% (96/254). The median age was 53 years old, mainly in 41 - 80 years old, accounting for 83.46% (212/254). Han nationality was the most, accounting for 89.76% (228/254). The onset season was mainly in summer and autumn, and the peak was from August to October (117 cases). Patients were mainly distributed in coastal areas, among which Haikou City (49 cases) was the most, followed by Dongfang City (46 cases), Danzhou City (23 cases) and Wenchang City (21 cases). Totally 196 cases (77.17%) had basic diseases, diabetes was the most common (162 cases). The main symptoms of admission were fever (211 cases), followed by cough (108 cases) and expectoration (88 cases). The infection sites were mainly blood (104 cases, 40.94%), lung (60 cases, 23.62%), liver and spleen (32 cases, 12.60%). Totally 195 patients were treated with sensitive antibiotics, at discharge, 37 cases (18.97%) were cured, 129 cases (66.15%) improved, 18 cases (9.23%) did not heal, 7 cases (3.59%) died and 4 cases (2.05%) were discharged voluntarily. Results of drug sensitivity tests from 2010 to 2020 showed that the sensitivity rates of Burkholderia pseudomallei to imipenem (142 cases), meropenem (16 cases) and ceftazidime (141 cases) were all 100.00%, and the sensitivity rates of doxycycline (25 cases) and compound sulfamethoxazole (142 cases) were 92.00% (23/25) and 99.30% (141/142), respectively. Conclusions:Males, farmers, middle-aged and elderly people and people with diabetes and other basic diseases are the high incidence population of melioidosis in Haikou City. The incidence peak is in summer and autumn. The common clinical manifestations are fever, pulmonary infection, abscess of liver and spleen, etc. In the treatment, Burkholderia pseudomallei is more sensitive to imipenem, meropenem and ceftazidime.

Advances in Research on Pharmacological Effect of Astragaloside Ⅳ on Cardiovascular and Cerebrovascular Diseases / 中国实验方剂学杂志

Astragalus membranaceus has the effect of tonifying Qi and solid surface， diuretic support poison， discharging pus and astringent sores to produce muscle. It is not only used for syndromes such as deficiency of lung and temper， deficiency of spleen and diarrhea， but also for stroke， chest obstruction and other diseases. Due to the complex chemical composition and diverse pharmacological effect of Astragalus membranaceus， and the main role in invigorating qi and activating blood circulation has not been clarified. Astragaloside Ⅳ is one of its main active ingredients. In recent years， more and more studies on Astragaloside Ⅳ have been conducted at home and abroad. It has been reported that it has the medicinal value of enhancing immune function， strengthening heart and lowerin blood glucose， diuresis， anti-aging and anti-fatigue， et al， and has extensive pharmacological activity. Among them， the role of cardiovascular and cerebrovascular diseases in particular has attracted increasing attention. Cardiovascular and cerebrovascular diseases are ischemic or hemorrhagic diseases occurring in the heart， brain and systemic tissues due to blood viscosity， atherosclerosis， hypertension， hyperlipidemia， etc.， including cardiovascular and cerebrovascular diseases. Such diseases are a serious threat to mankind and are the leading cause of death worldwide. At present， western medicine is the main treatment， with many adverse reactions and poor long-term prognosis. TCM believes that the imbalance of qi and blood is the basic pathogenesis of this kind of disease. Qi deficiency and blood stasis are more common.At present， Astragaloside Ⅳ in the treatment of cardiovascular and cerebrovascular diseases in a number of studies， and achieved some results， but this review in recent years， Astragaloside Ⅳ in the treatment of cardiovascular and cerebrovascular diseases play the pharmacological activity， in order to explore whether Astragaloside Ⅳ is the main role of astragalus qi to find a theoretical basis for material basis， but also for the innovation of traditional Chinese medicine drug research and development of theoretical basis and practical guidance.

Summary on / 中国针灸

The thinking and experience of professor

Nitrogen metabolism and secondary metabolism regulation of Atropa belladonna by exogenous NO under NaCl stress / 中国中药杂志

Atropa belladonna seedlings were used as experimental materials and cultivated by soil culture method. Different concentrations(0,0.05,0.1,0.2,0.5 mmol·L~(-1))of NO donor sodium nitroprusside(SNP) were sprayed on the leaves. The effects of different concentrations of SNP and different treatment time(4,8,12,16 d) on nitrogen metabolism, secondary metabolite content, precursor content of tropane alkaloid synthesis pathway and expression of key enzyme genes under 100 mmol·L~(-1) NaCl stress were studied. The results showed that with the prolongation of salt stress, the nitrogen metabolism and the accumulation of secondary metabolites of A. belladonna were inhibited to some extent. After treatment with different concentrations of exogenous SNP, the ammonium nitrogen content decreased dramatically, and the contents of nitrate nitrogen, free amino acid, soluble protein and the activities of key enzymes of nitrogen metabolism(NR, GS, GDH) were all greatly improved; the contents of precursor amino acids(ornithine, arginine) and polyamines(Put, Spd, Spm) in the secondary metabolic pathway have increased to varying degrees. The qRT-PCR analysis showed that exogenous SNP treatment can effectively promote the high expression of key enzyme genes PMT, TRⅠ and H6H in the secondary metabolic pathway of A. belladonna, and the production of hyoscyamine and scopolamine were increased notably. In summary, the application of appropriate concentration of SNP can effectively alleviate the inhibition of salt stress on the nitrogen metabolism and secondary metabolism of Atropa belladonna, and enhance its salt tolerance. Overall, 0.1 mmol·L~(-1) and 0.2 mmol·L~(-1) SNP treatment achieved the most remarkable effect.

Analysis of 16 618 Prescriptions of Chinese Patent Medicine Containing Aconiti Lateralis Radix Praeparata Based on Three Data Mining Models / 中国实验方剂学杂志

Objective::Through data mining analysis of Chinese patent medicine prescription containing Aconiti Lateralis Radix Praeparata (CPMCA) in a hospital, the characteristic rules of clinical medication of this kind of Chinese patent medicine were analyzed from the perspective of traditional Chinese medicine (TCM) syndrome differentiation and treatment, and the application prospect of data mining in TCM prescription analysis was explored. Method::CPMCA in the hospital outpatient clinics from November 2017 to October 2018 was conducted. The clinical application of this kind of Chinese patent medicine was retrospectively analyzed from the aspects of basic situation of patients, TCM diseases, TCM syndromes and so on. The clinical application of CPMCA was reviewed and analyzed. Three kinds of data mining algorithms in Microsoft SQL Server Analysis Services 2012 were used to analyze the characteristics of prescription medication. Result::A total of 8 kinds of Chinese patent medicines containing Aconiti Lateralis Radix Praeparata were used in a hospital, and most of them were used by patients under 14 years old, among them, the dosage of Xiaoer Feike granules was the largest. The TCM diseases were mostly cough, cold and asthma, while the TCM syndromes were mostly cold-heat complicated syndrome, wind-phlegm syndrome and external contraction of wind evil. The CPMCA for nourishing and warming kidney-Yang included Jingui Shenqiwan, Longlu capsules, Wangbi capsules and Guifu Dihuang pills. The TCM diseases were mostly arthralgia syndrome, vertigo, and consumptive disease, meanwhile, the syndromes were mainly deficiency of liver and kidney, kidney deficiency and blood stasis, and deficiency of spleen and kidney. Decision tree analysis showed that the CPMCA had the characteristics of age distribution, among which TCM diseases and syndromes were the main decision points. According to the age, sex, diagnosis of Chinese and western medicine, and TCM syndromes of this type of prescription, the CPMCA were divided into 10 categories by cluster analysis. Correlation analysis showed that the combination of Xiaoer Feike granules was the most common, but the correlation was not high. And Jingui Shenqiwan, Qili Qiangxin capsules, Longlu capsules and Wangbi capsules had their own strong associated medication. Conclusion::The application of data mining algorithm in multi-factor analysis of clinical prescription is close to the clinical dialectical treatment thinking of TCM. Combined with the basic statistics, it can be seen that the CPMCA in a hospital is consistent with the characteristics of TCM syndrome differentiation and treatment.

Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden: A subgroup analysis of a nationwide survey in China / 中华医学杂志(英文版)

BACKGROUND@#Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income.@*METHODS@#This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction.@*RESULTS@#When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P 50% subgroup (all P 50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032).@*CONCLUSION@#Higher disease severity and higher financial burden were associated with lower patient satisfaction.

Effect of Baicalin on the Necroptosis of Mouse Colon Cancer in Vitro / 医药导报

Objective To investigate the effect of baicalin on CT26.WT cells of colon cancer in mice, and to discuss the cell death form. Methods CT26.WT cells were divided into four groups including of control group , routine cultured in fresh medium, the baicalin group, added with concentration of 100 μmol·L-1 baicalin, the z-VAD-fmk group, was added with final concentration of 20 μmol·L-1 z-VAD-fmk, and the combination group, added final concentration of 20 μmol·L-1 z-VADfmk,1 h before adding 100 μmol·L-1 baicalin. Then the inhibitory effect of baicalin on cell proliferation and cell viability were detected by CCK-8 method. The changes of nucleus were detected by DAPI staining, the ultrastructure of cells was observed by TEM, and the effect of baicalin on the expression of RIP3 gene and protein in cells was detected by QPCR method and Western blotting. Results Compared with control group, the differences of baicalin group and combination group had statistically significance (P<0.05) . cell death rate for control group was (10.54±0.19) ％ ,for baicalin group was (34.93±0.16) ％ ,for z- VAD group was (11.23±0.59) ％, and combination group was (23.27±1.20) ％ (P<0.01) . Compared with the normal control group, baicalin group showed nuclear concentration and fragmentation. there was obvious nuclear fragmentation in the combination group against baicalin group. The results of electron microscopy showed that the cells of baicalin were necrotic, cell swelling, mitochondria swelling and contents leaking. Baicalin group significantly up - regulated RIP3 mRNA expression (P < 0. 01) and enhanced RIP3 protein expression (P < 0. 05) . Conclusion Baicalin induces the necrosis of ct26. WT cells, and can significantly increase the gene and protein expression of RIP3.

Expression and significance of SCIN in breast cancer tissue / 中华内分泌外科杂志

Objective To investigate the expression of Scinderin(SCIN myoprotein) in breast cancer tissues and adjacent tissues,and to explore the relationship between the expression of Scinderin and different molecular subtypes of breast cancer as well as the clinical factors.Methods Immunohistochemical staining method was used to detect the expression of SCIN in 120 cases of breast carcinoma and 30 adjacent tissues.The relation between SCIN expression in breast cancer tissue and molecular subtypes,pathologic stage,age,tumor size,lymph node metastasis was analyzed.Results SCIN expression level in breast cancer tissue was lower than in the tissues adjacent to carcinoma (6.06±3.32 vs 7.77±3.32,P＜0.05).SCIN expression was associated with breast cancer molecular subtypes (P＜0.05),and it was irrelevant with age,tumor size,histological grade,lymph node metastasis,or clinical stage (P＞0.05).Conclusions The expression of SCIN in breast cancer tissues was lower than in the adjacent tissues.It is associated with breast cancer molecular subtypes.SCIN could become the protein markers of breast cancer molecular targeted therapy.

Prognostic factor analysis of elderly patients with small-cell lung cancer / 中华老年医学杂志

Objective To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors.Methods Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression.Results A total of 143 patients were enrolled,the median overall survival(OS)was 17.9 months,with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED).For LD patients,age(HR =18.688,95 ％CI:3.237-107.889),smoking index (HR =2.783,95％ CI:1.196-6.475),thoracic irradiation (HR =0.305,95 ％ CI:0.120-0.779),chemotherapy efficacy (HR =0.210,95 ％ CI:0.065-0.685) were the independent risk factors for the prognosis.For ED patients,chemotherapy cycles (HR =0.461,95 ％ CI:0.229 0.927)and performance status (HR =0.422,95 ％ CI:0.218-0.818) were the independent risk factors for prognosis.Conclusions Smoking index,tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients,who were aged less than 75 years,with smoking index less than 1000,receiving thoracic irradiation and achieving remission with chemotherapy,show a longer OS.For ED patients,a good performance status and sufficient chemotherapy can predict an improved OS.

Cloning and expression analysis of calmodulin gene from Pinellia ternate / 中国中药杂志

According to the data of Pinellia ternate transcriptome,two calmodulin genes were cloned and named as Pt Ca M1 and PtCa M2 respectively. The results of bioinformatics analysis showed that Pt Ca Ms genes contained a 450 bp open reading frame,encoding149 amino acids.The identity of the coding sequences was 80%,and the identity of amino acids sequence was 91%. Pt Ca Ms genes contained EF-hand structure domain,belonging to the Ca M families. The Real-time PCR analysed the expression patterns of Pt Ca Ms in different tissues and different treatments. RESULTS:: showed that Pt Ca M1 and Pt Ca M2 gene were the highest expression level in tuber. Under Ca Cl2 treatment,the expressions of Pt Ca Ms were significantly higher than the control. Under EGTA,La Cl3 and TFP treatments,the expression level of Pt Ca Ms decreased gradually. In this study,the Pt Ca Ms gene were successfully cloned from P. ternate,which laid a foundation for the functional characteristic of Pt Ca Ms gene and the synthesis of alkaloids from P. ternata for further study.

Design and application of spectacle frame for eye moxibustion / 中国针灸

The new style spectacle frame for eye moxibustion is designed, which is characterized by adjustable direction, constant temperature and smoke absorption. Combined with mechanical structure design and physical and chemical technology, a new style of moxibustion spectacle frame is designed by means of spring mechanism, damping bearing, filter cotton, etc. The moxibustion spectacle frame includes the right and left eye frames, spectacle legs, nose mask, eye mask, slide rod, screw rod, spring structure, damping bearing, support rod and pin. The eye mask can prevent from the risks induced by the burning moxa stick. A ventilate hole is designed in the lower part of the nose mask to keep breathing unobstructed. In the upper end of the ventilate hole, a filter cotton is placed to prevent from moxa smoke penetrating to the nasal cavity. The spring structure can keep relatively the fixed distance between the combustion area and the acupoints. Such device ensures the safety of eye moxibustion, reduces the complexity of operation and is suitable for moxibustion treatment for all kinds of eye diseases.

Usage and Dosage of Kaihoujian Throat Spray (for Children) in Treatment of Acute Pharyngitis and Acute Tonsillitis / 中国实验方剂学杂志

Objective:To explore the effective dose range of Kaihoujian throat spray (for children) in treating acute pharyngitis and acute tonsillitis, in order to provide the reference for the usage and dosage in clinic. Method:A total of 160 juvenile SD rats were divided into 16 groups according to the body mass grade, namely normal group, model group, amoxicillin or ribavirin group, compound Yizhi Huanghua group and different doses of Kaihoujian (for children) groups. The different doses of Kaihoujian (for children) groups were divided into 12 treatment groups based on 2 sprays/time, 4 times/day, 4 sprays/time, 4 times/day, 6 sprays/time, 4 times/day, 8 sprays/time, 4 times/day, 2 sprays/time, 6 times/day, 4 sprays/time, 6 times/day, 6 sprays/time, 6 times/day, 8 sprays/time, 6 times/day, 2 sprays/time, 8 times/day, 4 sprays/time, 8 times/day, 6 sprays/time, 8 times/day, and 8 sprays/time, 8 times/day. Except for normal group, all of the remaining groups were included in three animal models, namely 5%ammonia-induced acute pharyngitis in rat, B type streptococcus haemolyticus-induced acute pharyngitis and tonsillitis in rabbit, and adenovirus-induced acute pharyngitis in mice. Then the optimal usage and dosage of Kaihoujian throat spray (for children) were evaluated based on pharyngeal lesion score and htoxylin eosin(HE) staining. Result:There were significant differences in pharyngeal and tonsil lesions between the model group and the normal group (PPPConclusion:The clinical usage and dosage of Kaihoujian throat spray (for children) in treating acute pharyngitis and tonsillitis were suggested to be 2 sprays/times, 6~8 times/day for 1~3 year-old children; 3~6 sprays/times, 6~8 times/day for 4~6 year-old children and 5~8 sprays/times, 6~8 times/day for 7~12 year-old children.

Prognostic factor analysis of elderly patients with small-cell lung cancer / 中华老年医学杂志

Objective@#To retrospectively analyze clinical data of elderly patients with small-cell lung cancer(SCLC)in order to investigate their prognostic factors.@*Methods@#Clinical data of SCLC patients aged 65 years and over in our hospital from January 2006 to February 2017 were analyzed.Survival data were analyzed by Kaplan-Meier method.Univariate analysis of prognosis was conducted by Log rank test.Multivariate analysis was performed by Cox regression.@*Results@#A total of 143 patients were enrolled, the median overall survival(OS)was 17.9 months, with 21.3 months for limit stage(LD)and 9.6 months for extensive stage(ED). For LD patients, age(HR=18.688, 95%CI: 3.237-107.889), smoking index(HR=2.783, 95%CI: 1.196-6.475), thoracic irradiation(HR=0.305, 95%CI: 0.120-0.779), chemotherapy efficacy(HR=0.210, 95%CI: 0.065-0.685)were the independent risk factors for the prognosis.For ED patients, chemotherapy cycles(HR=0.461, 95%CI: 0.229-0.927)and performance status(HR=0.422, 95%CI: 0.218-0.818)were the independent risk factors for prognosis.@*Conclusions@#Smoking index, tumor stage and treatment mode can influence the survival of SCLC patients.The LD patients, who were aged less than 75 years, with smoking index less than 1000, receiving thoracic irradiation and achieving remission with chemotherapy, show a longer OS.For ED patients, a good performance status and sufficient chemotherapy can predict an improved OS.

Efficacy of S-1 in Advanced Non-small Cell Lung Cancer Patients Treated with More Than Two Lines of Chemotherapy / 中国肺癌杂志

BACKGROUND@#There is no standard treatment for advanced non-small cell lung cancer (NSCLC) after the failure of two lines of chemotherapy, S-1 as the third generation of fluorouracil derivate with well safety and low toxicity, presented some efficacy in lung cancer treatment. The aim of this study is to explore the efficacy of S-1 for advanced NSCLC patients treated with two or more prior chemotherapy regimens.@*METHODS@#We performed a retrospective analysis of 105 NSCLC patients treated with S-1 monotherapy or S-1 contained chemotherapy as the third or more line of treatment in our hospital from January 2014 to April 2017. S-1 was administrated orally twice daily for 2 weeks, followed by one week of rest, the dose of drug was determined by body surface area (<1.25 m2, 80 mg/d; 1.25 m2-1.5 m2, 100 mg/d; ≥1.5 m2, 120 mg/d), platinum or the third-generation chemotherapy drugs could be combinedly used. Clinical response was assigned every cycle according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, Kaplan-Meier analysis was used to estimate progression-free survival (PFS).@*RESULTS@#42 patients received S-1 monotherapy, the other 63 patients received combined regimens, the median treatment line was 4 (3-11) and the median treatment cycle was 2 (1-14). No complete response (CR) were observed, there were 4 patients with partial response (PR), 34 patients with stable disease (SD) and 67 patients with progressive disease (PD), the objective response rate (ORR) was 3.81%, disease control rate (DCR) was 36.19%. The median PFS was 1.90 months (0.67 months-10.83 months), no difference between monotherapy and combined group (DCR: 28.56% vs 41.27%, P=0.185), the liver metastasis showed poorer PFS (1.40 months vs 1.93 months , P=0.042).@*CONCLUSIONS@#S-1 presented some activity in advanced NSCLC treated with more than two lines of treatment. The addition of other drugs cannot improve efficacy. S-1 monotherapy can be used as a choice for heavily-treated patients.

Effects of nitrogen form on accumulation of alkaloids and expression of relative genes in Atropa belladonna / 中国中药杂志

Hyoscyamine and scopolamine are two main alkaloids in Atropa belladonna with great medicinal value. In this paper, the contents of hyoscyamine and scopolamine, the upstream products in alkaloid synthesis, and the expression levels of key enzyme genes PMT, TRⅠ and H6H in secondary metabolism of A. belladonna seedlings were measured to clarify the mechanism of nitrogen forms regulating alkaloids synthesis.The results showed that the 50/50 (NH⁺₄/NO⁻₃) treatment was more favorable for the accumulation of alkaloids and the conversion of hyoscyamine to scopolamine. The content of putrescine was almost consistent with the change of key enzymes activities in the synthesis of putrescine, they both increased with the rise of ammonium ratio, reaching the highest at 75/25 (NH⁺₄/NO⁻₃). The detection of signaling molecule nitric oxide (NO) showed that the NO concentration decreased with the decrease of nitrate proportion. Further detection of gene expression levels of PMT, TRⅠ and H6H in TAs synthesis pathway showed that a certain amount of ammonium promoted the expression of PMT and H6H in roots. When the ratio of ammonium to nitrate was 50/50, PMT, TRⅠ and H6H in leaves and roots had higher expression levels. It can be speculated that the regulation of the formation of hyoscyamine to scopolamine by nitrogen forms mainly through affecting the expression of key enzyme genes. 50/50 (NH⁺₄/NO⁻₃) treatment increased the gene expression of TRⅠ in both leaves and roots as well as PMT and H6H in roots, promoting the synthesis of putrescine to hyoscyamine and the conversion of hyoscyamine to scopolamine.

Effects of methyl jasmonate on metabolism of topical alkaloids and expression of relate genes in Atropa belladonna / 中国中药杂志

Hyoscyamine and scopolamine are important secondary metabolites of tropane alkaloid in Atropa belladonna with pharmacological values in many aspects.In this study, the seedlings of A.belladonna were planted by soil culture and treated with different concentrations of methyl jasmonate (MeJA). The contents of hyoscyamine and scopolamine,the upstream products in alkaloid synthesis,and the expression levels of key enzyme genes PMT, TR Ⅰ and H6H in secondary metabolites of A. belladonna seedlings were measured to clarify the mechanism of MeJA regulating alkaloids synthesis.The results showed that MeJA(200 μmol·L⁻¹) treatment was more favorable for the accumulation of alkaloids.The content of putrescine was almost consistent with the change of key enzymes activities in the synthesis of putrescine,the both increased first and then decreased with the increased MeJA concentration and the content of putrescine reached the highest at 200 μmol·L⁻¹ MeJA.Further detection of gene expression of PMT, TR Ⅰ and H6H in TAs synthesis pathway showed that no significant trend in PMT gene expression levels.The expression levels of TR Ⅰ and H6H in leaves and roots under 200 μmol·L⁻¹ MeJA were the highest.It can be speculated that the regulation of the formation of hyoscyamine and scopolamine by MeJA mainly through affecting the expression of key enzyme genes.Appropriate concentration of MeJA increased the gene expression of TR Ⅰ in both leaves and roots as well as H6H in roots,promoting the accumulation of alkaloids and the conversion of hyoscyamine to scopolamine.