Clinical evaluation of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture / 现代泌尿外科杂志

【Objective】 To evaluate the safety and efficacy of long-term indwelling of Allium ureteral stent in the treatment of ureteral stricture. 【Methods】 The clinical data of patients who underwent endoscopic Allium ureteral stent implantation for ureteral stricture in our hospital during Aug.2020 and Dec.2022 were retrospectively analyzed, and the surgical conditions and adverse events were recorded. The data of serum creatinine, blood urea nitrogen, glomerular filtration rate (GFR) and renal pelvis width under ultrasound were compared before surgery and 1, 3, 6 and 12 months after surgery. 【Results】 A total of 52 patients with ureteral stricture of 1.1 (0.7, 2.0)cm were included. All operations were successful. The operation time was 82.5 (70, 114)min, intraoperative blood loss 20 (10, 20)mL, and postoperative hospitalization stay 1 (1, 2) day. During the follow-up of (13.2±7.8) months, 14 patients had stent displacement, 5 had stone obstruction of stent tubes, 7 had occasional hematuria after movement, 9 had intermittent lumbar and abdominal pain, and 1 had recurrent urinary tract infection. The serum creatinine, blood urea nitrogen and renal pelvis width of 1 month, 3, 6 and 12 months after surgery were significantly decreased, while GFR was significantly increased. 【Conclusion】 Long-term indwelling of Allium ureteral stent is effective in the treatment of ureteral stricture, but the high incidence of stent displacement should arouse attention.

Sleep status and influencing factors among higher vocational college students / 四川精神卫生

BackgroundSleep disorder can adversely affect human physical and mental health， with important implications for socioeconomic development. And higher vocational college students are subject to various pressures and stimuli exerted by academic studies， job seeking and family socioeconomic status， which may contribute to the onset insomnia symptom or sleep disorder. ObjectiveTo discuss the sleep status and influencing factors among higher vocational college students， and to provide references for improving their sleep status. MethodsIn January and February， 2022， a stratified random sampling method was utilized to enroll 3 300 students from five higher vocational colleges in Wenjiang district of Chengdu city. All the participants were assessed using Insomnia Severity Index （ISI）， Patient Health Questionnaire Depression Scale-9 item （PHQ-9） and Generalized Anxiety Disorder Scale-7 （GAD-7）. Pearson correlation analysis was conducted to test the correlation of ISI with PHQ-9 and GAD-7 scores， and the Logistic regression analysis was performed to identify the influencing factors of insomnia symptom in higher vocational college students. ResultInsomnia symptom was detected in 81.90% （2 497 / 3 300） of higher vocational college students. The detection rate of insomnia symptom among vocational college students yielded statistical difference in terms of gender， family socioeconomic status， being an only child or having siblings， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom （χ2=21.032， 22.172， 8.983， 75.939， 36.781， 32.350， 54.512， 86.561， P<0.01 or 0.05）. Among higher vocational college students， ISI score was positively correlated with GAD-7 and PHQ-9 scores （r=0.620， 0.714， P<0.01）， and GAD-7 score was positively correlated with PHQ-9 score （r=0.824， P<0.01）. Gender， family socioeconomic status， degree of psychological pressure exerted by academic studies or job seeking， amount of hours spent on Internet per day， frequency of physical exercise， and the presence or absence of anxiety symptom and depression symptom were effective factors in predicting the insomnia symptom in higher vocational college students （P<0.01 or 0.05）. ConclusionFemale gender， average and below average family socioeconomic status， moderate-to-severe degree of psychological pressure exerted by academic studies or job seeking， spending 2~5 h， 5~7 h or >7 h on Internet per day， inadequate physical exercise and presence of depressive symptom are the risk factors for insomnia symptom in higher vocational college students.［Funded by Sichuan Provincial Primary Health Development Research Center in 2022， North Sichuan Medical College （number， SWFZ22-C-89）］

Clinical and genetic characteristic in patients with disorders of sex development caused by Y chromosome copy number variant / 中华儿科杂志

Objective: To investigate the clinical phenotype and genetic characteristics of disorders of sex development (DSD) caused by Y chromosome copy number variant (CNV). Methods: A retrospective analysis was performed on 3 patients diagnosed with DSD caused by Y chromosome CNV admitted to the First Affiliated Hospital of Zhengzhou University from January, 2018 to September, 2022. Clinical data were collected. Clinical study and genetic test were performed by karyotyping, whole exome sequencing (WES), low coverage whole genome copy number variant sequencing (CNV-seq), fluorescence in situ hybridization (FISH) and gonadal biopsy. Results: The 3 children, aged 12, 9, 9 years, the social gender were all female, presented with short stature, gonadal dysplasia and normal female external genital. No other phenotypic abnormality was found except for case 1 with scoliosis. The karyotype of all cases were identified as 46, XY. No pathogenic vraiants were found by WES. CNV-seq determined that case 1 was 47, XYY,+Y(2.12) and case 2 was 46, XY,+Y(1.6). FISH concluded that the long arm of Y chromosome was broken and recombined near Yq11.2, and then produced a pseudodicentric chromosome idic(Y). The karyotype was reinterpreted as mos 47, X, idic(Y)(q11.23)×2(10)/46, X, idic(Y)(q11.23)(50) in case 1. The karyotype was redefined as 45, XO(6)/46, X, idic(Y)(q11.22)(23)/46, X, del(Y)(q11.22)(1) in case 2. 46, XY, -Y(mos) was found by CNV-seq in case 3, and the karyotype of 45, XO/46, XY was speculated. Conclusions: The clinical manifestations of children with DSD caused by Y chromosome CNV are short stature and gonadal dysgenesis. If there is an increase of Y chromosome CNV detected by CNV-seq, FISH is recommended to classify the structural variation of Y chromosome.

Influence of Serum TGF-β1 and EGFR Levels on the Therapeutic Effect of High-Dose AraC in Patients with Acute Myeloid Leukemia Based on the Decision Curve / 中国实验血液学杂志

OBJECTIVE@#To analyze the influence of serum levels of transforming growth factor-β1 (TGF-β1) and epidermal growth factor receptor (EGFR) on the therapeutic effect of high-dose cytarabine (HD-AraC) in patients with acute myeloid leukemia (AML).@*METHODS@#98 patients with AML treated in our hospital from January 2019 to June 2020 were selected as the research subjects, all patients were treated with HD-AraC for 1 course of treatment every week. The effect of 2 groups were evaluated during after one course of treatment and divided into effective group and ineffective group, statistical table of baseline data was designed, the baseline data of 2 groups were counted in detail, the baseline data and serum levels of TGF-β1 and EGFR of 2 groups were compared, Logistic regression analysis was used to examine the relationship between the levels of serum TGF-β1, EGFR and the therapeutic effect of HD-AraC in patients with AML, the value of serum TGF-β1 and EGFR levels in predicting the therapeutic effect of HD-AraC in AML patients was analyzed based on ROC curve and decision curve.@*RESULTS@#After 1 course of treatment, among the 98 patients, 26 cases had complete remission, 38 cases had partially remission and 34 cases no remission, the total effective rate was 65.31% (64/98); after comparing data of 2 groups, Logistic regression analysis showed that the overexpression of serum EGFR before treatment might be a risk factor for the ineffective treatment of HD-AraC in AML patients (OR>1, P<0.05), overexpression of serum TGF-β1 before treatment might be a protective factor for the ineffective treatment of HD-AraC in AML patients (OR<1, P<0.05); the ROC curve results showed that the AUC of serum EGFR and TGF-β1 before treatment in predicting the risk of ineffective HD-AraC treatment in AML patients were >0.70, which had certain predictive value. The decision curve results showed that in the threshold range of 0.15-044, the prediction model combined with serum EGFR and TGF-β1 levels in predicting the net benefit rate of HD-AraC treatment in AML patients was better than that of serum EGFR or serum TGF-β1 alone.@*CONCLUSION@#The levels of serum TGF-β1 and EGFR affect the therapeutic effect of HD-AraC in patients with AML and increase the risk of ineffective treatment, serum TGF-β1 and EGFR can be used to predict the risk of ineffective HD-AraC treatment in AML patients, and the combined prediction of net benefit rate is higher.

Expression and Clinical Significance of CD73 in Acute Myeloid Leukemia Patients with NPM1 Mutation / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression of CD73 in acute myeloid leukemia (AML) patients with NPM1 mutant and wild-type, and to evaluate the therapeutic efficacy and prognosis of CD73 to the AML patients.@*METHODS@#160 patients with AML treated in our hospital from June 2015 to June 2019 were enrolled, and 40 non-AML bone marrow samples from healthy people were selected as controls during the same period. The expression of CD73 in healthy people, NPM1 mutation and NPM1 wild-type AML patients were compared, and the relationship between the expression of CD73 and its clinicopathological characteristics, as while as efficacy in AML patients were analyzed. The patients were followed up, and the influence of CD73 to the prognosis of different AML patients was analyzed.@*RESULTS@#The positive expression rate of CD73 in AML patients (23.75%) was significantly higher than that in the healthy control group (0.62%), and the positive expression rate of CD73 in AML patients with NPM1 mutation (74.75%) was significantly higher than that with NPM1 wild-type (25.51%) (both P<0.001). AML patients with CD73 positive expression was associated with age, FAB typing, disease risk classification, and NPM1 gene mutation (both P<0.05). The overall survival rate of AML patients with NPM1 gene mutation was 75.98%, which was significantly higher than the patients with NPM1 wild-type (34.68%)(P<0.001), the median survival time of AML patients with NPM1 gene mutation in the CD73@*CONCLUSION@#The expression of CD73 was increased in AML patients with NPM1 gene mutation, and CD73 showed different prognostic significance in AML patients with different NPM1 gene mutation. The combination of clinicopathologic features, CD73 expression and NPM1 gene in AML patients is helpful to determine their prognosis and guide the formulation of relevant treatment plans.

Relationship between serum microRNA-1 and microRNA-155 expression and disease severity and prognosis of acute cerebral infarction / 中国基层医药

Objective:To investigate the relationship between serum microRNA-1 (miR-1) and microRNA-155 (miR-155) expression and disease severity and prognosis of acute cerebral infarction (ACI) in patients.Methods:A total of 173 patients with ACI who received treatment in Taizhou Municipal Hospital between April 2018 and August 2019 were included in this study. These patients were divided into mild ( n = 78), moderate ( n = 54) and severe ( n = 41) groups according to the National Institutes of Health Stroke Scale (NIHSS) score. A total of 180 patients who concurrently received physical examination were included in the control group. Serum miR-1 and miR-155 expression was determined in all participants using quantitative reverse transcription-polymerase chain reaction. The included patients were divided into poor prognosis and good prognosis groups according to modified Rankin scale score within 90 days after treatment. The efficacy of serum miR-1 and miR-155 expression in the prediction of ACI prognosis and the risk factors for poor prognosis of ACI were evaluated. Results:The history of hypertension, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, serum miR-1 and miR-155 expression in the study group were 56.65% (98/173), (134.02 ± 27.35) mmHg, (88.45 ± 9.52) mmHg, (3.78 ± 0.82) mmol/L, (2.08 ± 0.73) mmol/L, (2.07 ± 0.37) and (1.56 ± 0.32), respectively, which were significantly higher than those in the control group [39.44% (71/180), (119.37 ± 22.14) mmHg, (81.46 ± 14.13) mmHg, (3.59 ± 0.68) mmol/L, (1.74 ± 0.69) mmol/L, (1.01 ± 0.22), (1.02 ± 0.24)], high density lipoprotein cholesterol in the study group was significantly lower than that in the control group [(1.24 ± 0.22) mmol/L vs. (1.31 ± 0.26) mmol/L, χ2 = 10.462, t = 5.542, 5.429, 2.373, 4.498, 32.865, 17.982 and 2.725, all P < 0.05]. Serum miR-1 and miR-155 expression in patients with ACI gradually increased with the increase of disease severity ( t = 10.212, 13.050, 3.092, 7.027, 3.983 and 4.099, all P < 0.05). The proportion of patients having a history of hypertension in the poor prognosis group was significantly higher than that in the good prognosis group [64.47% (49/76) vs. 42.27% (41/97), χ2 = 8.419, P < 0.05]. Systolic blood pressure, diastolic blood pressure, NIHSS score, serum miR-1 and miR-155 expression in the poor prognosis group were (136.51 ± 12.56) mmHg, (89.53 ± 6.65) mmHg, (7.26 ± 0.58) points, (1.32 ± 0.15), (1.21 ± 0.12), respectively, which were significantly higher than those in the good prognosis group [42.27% (41/97), (132.19 ± 9.32) mmHg, (86.34 ± 5.62) mmHg, (6.44 ± 0.62) points, (1.01 ± 0.07) (0.99 ± 0.05), t = 2.597, 3.418, 8.880, 10.695 and 4.633, all P < 0.05]. The receiver operating characteristic curve (ROC curve) analysis results showed the area under the curve of serum miR-1 and miR-155 expression alone in predicting ACI prognosis was 0.814 (95% CI: 0.745-0.884) and 0.839 (95% CI: 0.780-0.897), respectively. The area under the curve of miR-1 and miR-155 expression in combination in predicting ACI prognosis was 0.944 (95% CI: 0.912-0.976). Logistic regression analysis results showed that increases in admission NIHSS score, miR-1 and miR-155 expression were the risk factors for poor prognosis of ACI ( P < 0.05). Conclusion:miR-1 and miR-155 expression levels are related to the severity of ACI and therefore may be the predictors of poor prognosis of ACI.

Effect of Zero-valent Iron Nanoparticles and Melatonin on Yield and Quality of Fritillaria przewalskii in Domesticated Cultivation Conditions / 中国实验方剂学杂志

Objective:To investigate the effect of iron nanoparticles and melatonin on yield and quality of <italic>Fritillaria przewalskii</italic> and provide technical support for its domesticated cultivation. Method:Hundred grain weight was measured by conventional method；alkaloid content was detected according to protocols of the edition of 2020 <italic>Chinese Pharmacopoeia</italic>，chlorophyll，hydrogen peroxide，malondialdehyde，superoxide dismutase （SOD），peroxidase （POD） and catalase （CAT） were detected by spectrophotometric analysis，auxins，cytokinins，gibberellins，salicylic acid，jasmonic acid and abscisic acid were detected by ultra performance liquid chromatography tandem mass spectrometry analysis. Result:Zero-valent iron nanoparticles and melatonin significantly increased the hundred grain weight without affecting the quality. The effect of the two treatments on physiological and biochemical indexes in different stages were quite different，but the effects on content of endogenous hormones were basically the same. Correlation analysis showed that hundred grain weight was negatively correlated with malondialdehyde content，SOD activity and jasmonic acid content，but positively correlated with POD activity，salicylic acid content，gibberellins content，auxin content and abscisic acid content. The two treatments were separated effectively by principal component analysis，indicating that there were some differences in the mechanisms of growth promoting. The treatment of zero-valent iron nanoparticles mainly affected auxins，salicylic acid and abscisic acid. The treatment of melatonin mainly affected SOD，malondialdehyde and gibberellins. Conclusion:Zero-valent iron nanoparticles and melatonin can be used as a simple and practical technology to improve the stress resistance and yields of <italic>F. przewalskii</italic> in domesticated cultivation conditions.

Isolation of Growth-Promoting Bacteria and Effect of Compound Bacteria on Yield of Fritillaria przewalskii / 中国实验方剂学杂志

Objective:To explore the effects of anti-microbial compound （T1） from<italic> Bacillus </italic>（Phylum Firmicutes） and anti-microbial compound （T2） from <italic>Pseudomonas</italic> and <italic>Rhizobium</italic>， two growth-promoting agents， on the physiological characteristics and growth of <italic>Fritillaria przewalskii</italic>， in order to lay a foundation for the development of functional microbial agents and the promotion of ecological planting. Method:The endophytic bacteria of <italic>F. przewalskii</italic> were isolated and identified using conventional methods. The leaves of three-year-old <italic>F. przewalskii</italic> were sprayed with T1 and T2， followed by yield determination. The enzyme activities and physiological and biochemical indexes in the plant and microorganisms were measured using the corresponding assay kits， and the contents of related hormones by liquid chromatography-mass spectrometry （LC-MS）. Result:The isolated endophytic bacteria were classified into Firmicutes，Proteobacteria， and Actinomycetes. The activities of superoxide dismutase（SOD） and peroxidase（POD） and auxin content after T2 treatment were significantly higher than those after T1 treatment， while the contents of siderophore，salicylic acid， and gibberellin were lower. Compared with the blank （CK） group， T1 and T2 increased the contents of endogenous gibberellin，cytokinin， and auxin in <italic>F. przewalskii</italic> leaves，but did not significantly change jasmonic acid and abscisic acid. T1 promoted the accumulation of endogenous salicylic acid in <italic>F. przewalskii</italic> leaves， but there was no significant change after T2 treatment. Compared with CK，T1 and T2 enhanced the activities of SOD， POD， and catalase （CAT） and decreased the content of malondialdehyde. T2 promoted the accumulation of hydrogen peroxide in <italic>F. przewalskii</italic> leaves， but no significant difference was observed after T1 treatment. Compared with CK，both T1 and T2 increased chlorophyll，average iron content in rhizosphere soil， and 100-plant weight. Conclusion:T1 and T2 treatments help to increase the yield，and their specific mechanisms differ from each other. T1 exhibits better effect than T2.

Comparison of efficacy between laparoscopic and open proximal gastrectomy with double-tract reconstruction for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction / 中华胃肠外科杂志

Objective: To compare the efficacy between laparoscopic and open proximal gastrectomy with double-tract reconstruction for Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). Methods: A retrospective cohort study was conducted. Inclusion criteria: (1) 18 to 80 years old; (2) Siewert II and III AEG was confirmed by preoperative gastroscopy and biopsy, which could not be resected by endoscopy; patients undergoing radical proximal gastrectomy with double-tract reconstruction; (3) contrast-enhanced abdominal CT staging was cT1-2N0M0; (4) Eastern Cooperative Oncology Group (ECOG) physical status score <2 points, American Association of Anesthesiologists (ASA) grade 1 to 2; (5) patients agreed to perform proximal gastrectomy and signed an informed consent. Those who had undergone neoadjuvant radiochemotherapy, suffered from serious mental diseases and had incomplete data were excluded. According to the above criteria, clinical data of 84 consecutive patients with Siewert II and III AEG undergoing surgery at General Surgery Department of The Affiliated Tumor Hospital of Zhengzhou University from October 2010 to December 2018 were collected and analyzed. Of 84 patients, 61 underwent open proximal gastrectomy with double-tract reconstruction (OPG group), while 23 underwent laparoscopic proximal gastrectomy with double-tract reconstruction (LPG group). The perioperative complications and postoperative reflux esophagitis of two groups were compared. A P-value of <0.05 was considered to be statistically significant. Results: Among 84 cases, 74 were male and 10 were female. There were 43 cases of Siewert type II and 41 cases of Siewert type III. There were no significant differences in age, gender, body mass index, comorbidities, Siewert type, and tumor staging between the two groups (all P>0.05). As compared to the OPG group, the LPG group had longer operation duration [(223±21) minutes vs. (161±14) minutes, t=15.352, P<0.001], less intraoperative blood loss [195 (150, 215) ml vs. 208 (192, 230) ml, Z=2.143, P=0.032], and shorter time to flatus [(2.8±0.7) days vs. (3.3±0.9) days, t=2.477, P=0.015]. There were no significant differences in the number of harvested lymph nodes, time to the first meal and postoperative hospital stay between the two groups (all P>0.05). Postoperative complications developed in 2 cases (8.7%, 1 case each for anastomotic leakage and intestinal obstruction) in the LPG group and 5 cases (8.2%, 1 case each for anastomotic leakage, anastomotic bleeding, and anastomotic stenosis, 2 cases of incision infection) in the OPG group (χ(2)=5.603, P=0.231). The median follow-up was 41.2 (12.8-110.5) months. One patient (1.6%,1/61) had obvious reflux symptoms in the OPG group, compared with none in the LPG group (χ(2)=0.644, P=0.422). Esophagitis occurred in 1 case (4.8%, 1/21) in LPG group, compared with 4 patients (7.1%, 4/56) in the OPG group, without significant difference between the two groups (χ(2)=0.505, P=0.477). Conclusion: Laparoscopic proximal gastrectomy with double-tract reconstruction is safe and feasible without increasing the risk of postoperative complication and reflux esophagitis.

Expert consensus on ShenqiJiangtang Granule in clinical application of type2 diabetes / 中草药

ShenqiJiangtang Granule is composed of Panax ginseng, Astragali Radix and other valuable Chinese herbal medicines and extract, which has the effect of replenishing qi and nourishing yin, nourishing spleen and kidney, and it is also widely used in the treatment of type 2 diabetes and complications. After more than 20 years of clinical application, abundant research data have been accumulated. In order to accurately locate the clinical position and promote the rational use of drugs, a project was established by the Chinese Society of Traditional Chinese Medicine and experts organized by the Diabetes Branch to compile this consensus. This consensus defines the application of ShenqiJiangtang Granule in the clinical treatment of prediabetes, type 2 diabetes and its complications. It is suitable for clinicians at all levels of hospitals and grass-roots medical and health institutions across the country (traditional Chinese medicine, Western medicine, integrated traditional Chinese and Western medicine).

Psychological Adjustment During Outbreak of COVID-19 Based on Traditional Chinese Medicine Emotion Therapy / 中国实验方剂学杂志

The outbreak of corona virus disease-2019 (COVID-19) not only endangers the public life and health, but also poses threats to the public mental health. Under the atmosphere of tension and fear, the public often produces adverse emotional reactions to psychological stress, and even has extreme behaviors, which seriously affects physical and mental health. Traditional Chinese medicine （TCM） emotional therapy is based on the TCM consciousness theory in adherence to the holistic view of "integration of mind and body". It adopts safe and effective emotional conditioning methods to regulate mood, eliminate bad emotions, maintain mental health, and enhance the body's immunity to achieve the effect of treating or preventing physical and mental diseases. It has differentiated applications in many medical fields, such as post-traumatic stress disorder, generalized anxiety disorder, cancer and hospice, with good clinical efficacy. By analyzing the theoretical origin, research status, application range of TCM sentiment therapy, as well as the current public psychological state of the COVID-19 epidemic, we innovatively proposed TCM sentiment therapies, such as calm emotion method, diversion of attention method, suggestive induction method, obedient mind method, music delight method, TCM refreshing method and auricular pressing method, and comprehensively applied them in the public psychological adjustment during the outbreak, with the aim to provide rational and effective psychological guidance, help the public to correctly understand various bad emotions during the outbreak, enhance their abilities to cope with it and adjust psychological problems, maintain a good mentality, and pass the epidemic period smoothly. At the same time, in order to make better use of the advantages of TCM sentiment therapy and benefit the public, it is advocated to widely apply TCM sentiment therapy in similar public health events and public psychological care in the daily life, for the purpose of preventing before disease outset and preventing progress of disease, and effectively protecting the physical and mental health of the people.

Mechanism of Inflammatory Storm Induced by Novel Coronavirus Pneumonia and Intervention Measures of Traditional Chinese Medicine / 中国实验方剂学杂志

Some patients with corona virus disease-2019 (COVID-19) experienced a severe exacerbation of the disease due to the occurrence of inflammatory storm during the development of the disease. They are complicated with acute respiratory distress, multiple organ dysfunction syndrome and other serious complications, with a poor prognosis and a high mortality. For the inflammation storm, western medicine mostly adopts glucocorticoids, nutritional support, artificial ventilation assistance and other measures at present. The development of artificial liver, blood purification therapy, extracorporeal membrane oxygenation and other technologies have also reduced the mortality of patients to some extent. However, due to the high requirements for equipment, the measures have not yet been widely carried out. From the perspective of traditional Chinese medicine(TCM), the basic pathogenesis of COVID-19 is epidemic toxin invasion, lung and spleen being affected by pathogens, damaging vital Qi, and pathological properties involving dampness, heat, poison, stasis and deficiency. At the stage of inflammation storm, the pathogens are abundant, while the vital Qi is deficient， and the pathogens occlude lung, and disturb the heart and mind, and blood stasis and toxicity are combined with Qi-Yin deficiency. In severe cases, even both Yin and Yang exhaustion occurs. At present, a number of studies have shown that a variety of Chinese herbal medicines have multi-target immunomodulatory effect on viral pneumonia and cytokine storm. TCM participates in whole process of the occurrence and development of inflammation storm, mainly eliminating pathogens in early stage, controlling inflammation and blocking occurrence of inflammation storm， eliminating pathogens and strengthening the body resistance to eliminate the pathological products of the inflammation storm, and promoting the dissipation and absorption of inflammation in the middle stage， and saving lives in late stage by benefiting Qi and relieving depletion, and restoring Yang and rescuing from collapse. On the basis of pathophysiological mechanism of COVID-19 inflammation storm and the theory of TCM syndrome differentiation and treatment, this paper summarized the pharmacological studies on intervention on inflammatory storm with relevant Chinese herbal medicine, Chinese medicine prescriptions and Chinese medicine preparations, and discussed the intervention measures of TCM in different development stages of inflammatory storm, in expectation of providing the guidance for clinical treatment.

Syndrome Differentiation-based Treatment of COVID-19 Based on Theory of Wenyilun / 中国实验方剂学杂志

The outbreak of corona virus disease-2019 (COVID-19) in Wuhan, China, in December 2019, is highly contagious and epidemic, and belongs to the category of "plague" in traditional Chinese medicine, which seriously threatens human life and health. In the face of this sudden public health event, based on the theory of Wenyilun, this paper analyzes the onset characteristics, transmission, and syndrome differentiation-based treatment of COVID-19 in clinical practice. According to the characteristics of this epidemic, the pathogeny of COVID-19 is "epidemic pathogenic factors", and the pathogenesis is that the epidemic suppresses the dampness. Its transmission follows the regularity of "nine transmissions between exterior and interior" recorded in Wenyilun, which can be divided into sequential transmission and reverse transmission. The course of the disease has certain regularity and stages. In the early stage, the pathogen hides in the pleurodiaphragmatic interspace, and the epidemic suppresses the dampness， the treatment shall reach the pleurodiaphragmatic interspace, clear the dampness and turbidness, diffuse the lungs and dredging the lung meridian. In the middle stage, the pathogen can be transmitted to the exterior， the treatment shall be pungent in flavor and cool in property and could relieve the exterior syndrome, so as to remove the pathogen by shivering and sweating. If the dampness toxin enters the interior and be transmitted into the heat, and caused damage to the lung meridian, obstruction of Qi in the lungs, interior excess and heat accumulation, the treatment shall dredge bowel and purge heat, and expel the pathogen out. Any delay in treatment, mistreatment or excessive pathogen can lead to pathogenic invasion into the pericardium, and cause delirium, dysphoria, reversal cold of limbs, barely palpable pulse and other critical manifestations of internal blocking causing external depletion. The treatment shall focus on both attack and supplement, open blocking and relieve depletion. In the recovery period, due to the residual pathogen and the Yin and Qi impairment caused by fever, the treatment shall prevent the recurrence of the residual pathogen, nourish Yin and blood, and restore the vital energy. During the treatment, WU You-ke put forward three principles of "removing the pathogen as the priority, and then avoiding false sweating, and caring for the spleen and stomach". The theory of Wenyilun has a systematic understanding of the pathogeny, pathogenesis, and syndrome differentiation-based treatment of "the epidemic", and provides valuable experience for fight against plagues in later generations, which is also of great significance for the prevention and treatment of COVID-19.

Discussing Differences of Different Traditional Chinese Medicine Schemes of COVID-19 Based on Principle of "Treatment in Accordance with Three Categories of Etiologic Factors" / 中国实验方剂学杂志

Since the outbreak of corona virus disease-2019 (COVID-19), the timely intervention of Chinese medicine has played an important role， it can significantly improve the clinical symptoms of patients, alleviate fever, cough, shorten the course of disease and reduce the conversion rate of mild disease to severe disease， moreover, it has obvious advantages in improving survival rate, prognosis and quality of life in patients. In order to make better use of the therapeutic effect of Chinese medicine and overcome the epidemic situation as soon as possible, various provinces, municipalities and autonomous regions have introduced local Chinese medicine treatment schemes in accordance with the geography, climate and epidemic situation. In this article, we have analyzed the similarities and differences among treatment schemes from the perspective of three factors, and it is believed that the onset season is the same for this disease, and the differences between treatment schemes mainly depend on geographical and climatic factors. The results showed that in seven regions of China, the early symptoms in warm and humid regions such as Central China, South China, East China and Southwest China were characterized by "wet, warm, hot, and toxic", and treatment schemes mainly adopted the recipes with clearing heat and detoxifying, strengthening spleen and removing dampness functions. The early symptoms in cold regions such as Northeast China, North China, and Northwest China were mostly characterized by "cold, wet, wind, and toxic", and the therapeutic recipes emphasized on the effects of expelling wind and cold, removing toxicity and dampness. Among them, the national plan with the Hubei epidemic situation as an important reference has gradually evolved from a single syndrome attribute of each period to both cold and hot syndromes with multiple treatment methods. With the development of the disease, epidemic toxin and toxic heat in the lungs are the main characteristics in the medium term, when the treatment mainly focuses on purging heat and removing toxins. In severe cases and advanced stage, internal block and outward desertion are the main symptoms, when the treatment mainly focuses on block dredging and relieving desertion. In the recovery period, deficiency of lung and spleen Qi, and deficiency of Qi and Yin are the main symptoms, when the treatment is mainly used to invigorate the spleen, tonify the lungs, and nourish Qi and Yin. The physical factors are mostly reflected in the prevention program, so they are rarely mentioned in the treatment program. The Chinese medicine treatment schemes of COVID-19 in different regions show obvious differences. It is of great significance to analyze these differences and sum up the corresponding laws for the differential prevention and treatment of infectious diseases like COVID-19.

Effect of Paiteling on HeLa Cell Proliferation and Metastasis Ability and PI3K/Akt Signal Transduction Pathway / 中国实验方剂学杂志

Objective:To explore the effect of Paiteling on the proliferation，metastasis and invasion of HeLa cells and relevant proteins of phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. Method:① HeLa cells were divided into blank group and Paiteling concentration gradient groups (3.906，2.604，1.953，1.563，1.302，1.116，0.977 g·L-1). After drug intervention for 24 h，the cell morphological changes were observed under microscope. The cell viability was measured by thiazole blue (MTT) colorimetry，and the half inhibitory concentration (IC50) of Paiteling on HeLa cells was calculated. ② HeLa cells were divided into blank group，cisplatin group (0.01 g·L-1)，Paiteling high-dose group (2.974 g·L-1)，Paiteling medium-dose group (1.487 g·L-1) and Paiteling low-dose group (0.991 g·L-1). Cell proliferation and toxicity test (CCK-8) method was used to detect the effect of Paiteling on the proliferation ability of HeLa cells，scratch test was used to detect cell migration，and invasion test (Transwell) was used to detect changes in cell invasion ability. ③ Inhibitor LY294002 group (0.006 g·L-1) was added. Western blot (WB) was used to detect the expressions of Paiteling on PI3K，Akt，recombinant human B-cell lymphoma factor-xl (Bcl-xl)，and B-cell lymphoma/leukemia associated D protein (Bad). Result:① Compared with the blank group，microscopic observation showed that the number of cells in the treatment group was significantly reduced, and the cell morphology was incomplete. MTT experiments showed that Paiteling has a significantly inhibitory effect on HeLa cell proliferation (P<0.01). The IC50 of Paiteling on HeLa cells was calculated as 2.974 g·L-1. ② The CCK-8 experiment showed that compared with the blank group，all the drug-treated groups had an inhibitory effect on HeLa cell proliferation at 24，36，48 h (P<0.01), compared with the cisplatin group，middle and low-dose Paiteling groups showed a reduced inhibitory effect on HeLa cell proliferation at each time point (P<0.01). The scratch test showed that，compared with the blank group，each drug-added group could inhibit the migration ability of HeLa cells (P<0.01)，and the cell migration rate of the high-dose Paiteling group was lower than that of the cisplatin group (P<0.05). Transwell experiments showed that compared with the blank group，the number of membranes permeated by HeLa cells in each drug-treated group was decreased (P<0.01)，and the number of membranes permeated in the middle and low-dose Paiteling groups was increased compared with the cisplatin group (P<0.01). ③ Western blot showed that compared with the blank group，the expression levels of PI3K，Bcl-xl，and Akt in the high，medium，and low-dose Paiteling groups and the LY294002 group decreased (P<0.05，P<0.01)，while the expression of Bad increased (P<0.01). Compared with the high-dose Paiteling group，the PI3K，Akt，and Bcl-xl protein expressions were increased in the low-dose Paiteling group (P<0.01)，whereas Bad expression was decreased (P<0.01). Conclusion:Paiteling can inhibit HeLa cell proliferation，metastasis and invasion ability in a dose-dependent and time-dependent manner，which may be related to its effect on the expressions of PI3K/Akt signaling pathway-related proteins.

Relationship between Cervical Curvature and Spinal Drift Distance after Laminectomy with Screw Fixation and Its Effect on Clinical Outcome / 中国康复理论与实践

Objective:To observe the relationship between cervical curvature and spinal drift distance after laminectomy with lateral mass screw fixation, and its effect on clinical outcome. Methods:From January, 2017 to October, 2018, a total of 117 patients with cervical spondylotic myelopathy (CSM) underwent laminectomy with lateral mass screw fixation, and 90 of them completed the follow-up. According to the patients' cervical curvature (CC), they were divided into three groups: those CC between 0° to 5° were in Group A (n = 28), 5° to 16.5° in Group B (n = 36) and CC > 16.5° in Group C (n = 26). The spinal drift distance, nerve recovery, axial symptoms and C5 palsy were recorded and analyzed. Results:There were significant differences in CC and spinal drift distance (F > 152.119,P < 0.001), and no significant difference was found in laminectomy width and incidence of C5 palsy (P > 0.05) among three groups. The Japanese Orthopaedic Association (JOA) score significantly increased in all the groups post operation and at the last follow-up (t > 8.869,P < 0.001), and no significant difference was found among there groups at the same time (P > 0.05), as well as the incidence of C5 palsy (F = 0.472,P = 0.625). There was significant difference in the score of Visual Analogue Scale of axial symptoms among three groups (F > 34.800,P < 0.001), which was lower in groups B and C than in group A (t > 5.845,P< 0.001), and no significant differene was found between group B and group C. Conclusion:On the basis of the same laminectomy width, the greater the CC was, the more favorable the spinal drift went backwards. The loss of CC was related to the occurrence of axial symptoms, but was not correlated with the neurological recovery and C5 palsy.

Inhibitory Effect of Lnc-1708 on Osteogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells in vitro / 中山大学学报(医学科学版)

@#【Abstract】 【Objective】To investigate the differential expression of long non-coding RNA-1708(lncRNA-1708)in osteogenic differentiation of human bone marrow mesenchymal stem cells(hBMSC)and its effect on osteogenic differentiation of hBMSC.【Methods】Purchased 3 groups of hBMSC from different sources and cultured in vitro. qRT-PCR was used to detect the expression of lncRNA-1708 after osteogenic differentiation of three groups of hBMSC,and the relationship between lncRNA-1708 and hBMSC osteogenic differentiation was analyzed. LncRNA-1708 overexpressing lentivirus and lncRNA-1708 interferenced plasmid were transfected respectively,to obtain stable hBMSC cell line. After 14-day osteogenic differentiation on transfected hBMSC,RT-PCR was used to detect the expressions of runt-related transcription factor 2(RUNX2)and alkaline phosphatase(ALP)mRNA,and alkaline phosphatase staining was made.【Results】The expression of lnc-1708 decreased after osteogenic differentiation of hBMSC for 7 d(P < 0. 001).Two cell lines,which respectively express high lncRNA-1708 and low lncRNA-1708,were constructed successfully. In lnc-1708-overexpressed BMSC,the mRNA levels of osteogenic markers RUNX2 and ALP were both significantly down-regulated(0.46±0.03 vs.1.00±0.02,0.15±0.07 vs. 1.02±0.28,P < 0.01). On the contrary,in the lnc-1708-silencing BMSC,the expressions of RUNX2 and ALP mRNA level were significantly up-regulated(1.62±0.18 vs. 1.00±0.04,1.58±0.11 vs. 1.01±0.18,P < 0.01).【Conclusion】LncRNA-1708 may have an inhibitory effect on osteogenic differentiation of hBMSC.

Molecular Mechanism of Tangshenping Capsule in Intervening Apoptosis of Podocytes Induced by High Glucose+LPS Through PI3K/Akt Signaling Pathway / 中国实验方剂学杂志

Objective: To observe effect of Tangshenping capsule on lipopolysaccharide (LPS)-stimulated podocytes apoptosis under high glucose conditions of podocyte in rats with diabetic nephropathy (DN), and discuss possible mechanism. Method: With cultured rat podocytes as object of study,the podocytes model was established with high glucose and LPS,and divided into 7 groups:control group,high glucose group,high glucose plus LPS group,irbesartan group,and low,moderate and high-dose Tangshenping capsule groups.Protein and mRNA expressions of CD2-associated protein (CD2AP), nephrin, phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) and B-cell lymphoma-2 associated death protein (Bad protein) of podocyte in each group were detected by Western blot and reverse transcription polymerase chain reaction (RT-PCR). Result: Compared with control group,the protein and mRNA expressions of podocyte CD2AP, nephrin, PI3K, Akt decreased definitely (PPPPPPPPPPPPConclusion: Tangshenping capsule can maintain a stable protein expression of Slit diaphragm (SD) in podocyte, inhibit podocyte apoptosis by activating PI3K/Akt signaling pathway. This is one of mechanisms for preventing and treating diabetic nephropathy.

Renal Protective Effect of Tangshiping Capsule on Diabetic Nephropathy Kkay Mice and Its Effect on Wnt/β-catenin Signal Transduction Pathway / 中国实验方剂学杂志

Objective:To investigate the renal protective effect of Tangshenping capsule (Tangshenping) on diabetic nephropathy (DN) KKAy mice and its effect on Wnt/β-catenin signaling pathway. Method:Sixty female Sprague-Dawley KKAy mice aged 10 weeks old were induced with KKAy rat feed for 10 weeks. The DN animal model was successfully determined with blood glucose (>16.7 mmol·L-1) and 24 hour urine protein (>0.4 mg). The model mice were randomly divided into a model group, an irbesartan group, and low, medium and high-dose Tangshenping group, with 10 female C57BL/6J mice as a control group. The treatment groups were given the corresponding drugs by gavage. The normal group and the model group were given an equal volume of deionized water by gavage. The intragastric dose was 0.01 mL·g-1 body weight coefficient once a day. The general conditions of the mice were observed, the body mass was weighed every 4 weeks, and 24 h urine protein was quantified. At the 26th week, the blood was collected from eyeballs, and the mice were put to death. The quality of the kidneys, serum blood urea nitrogen (BUN), serum creatinine (SCr), triglyceride (TG), malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase (SOD) content were measured. In situ hybridization and immunohistochemistry were used to detect the expressions of Wnt4, glycogen synthase kinase 3β(GSK3β) and β-catenin in kidney tissues. Result:Compared with model group, body mass, kidney mass/body mass, and 24 h urine protein were significantly lower in high-dose Tangshenping group (PPPβ and β-catenin were decreased (PConclusion:Tangshenping may inhibit the activation of Wnt/β-catenin signaling pathway, reverse the transdifferentiation of renal tubular epithelial cells in DN KKAy mice, delay the progression of renal interstitial fibrosis, and then exert renal protection.

Structure-activity relationship analysis of novel farnesyl transferase inhibitors / 药学学报

Farnesyltransferase (FTase) was selected as a target for virtual screening of inhibitors using the Glide v4.0 program in the Schrödinger software package. We discovered 13 novel structures as farnesyltransferase inhibitors (FTIs) with moderate potency. By analyzing the binding modes of representative compounds 8 (IC50 = 2.29 μmol·L-1) and 18 (IC50 = 0.41 μmol·L-1) with farnesyltransferase, it was found that compounds 8 and 18 didn't coordinate with Zn2+, indicating that the coordination between FTIs with Zn2+ is not essential for the bioactivity of the inhibitors. The structure-activity relationship was summarized by analyzing the predicted binding modes of representative compounds. It was found that the scaffolds of the discovered FTIs had room for structural optimization, which lay foundation for obtaining highly active and selective FTIs.