Mechanism of Dahuangtang pellets in regulating podocyte autophagy of diabetic nephropathy mice through AMPK/mTOR/ULK1 signaling pathway / 中国临床药理学与治疗学

AIM: To explore the intervention effect of Dahuangtang pellets (DHT) on diabetic nephropathy (DN) based on the AMP-activated protein kinase/mammalian target of rapamycin/unc-51-like kinase 1 (AMPK/mTOR/ULK1) signaling pathway. METHODS: Eight mice were randomly assigned to the model group, the dapagliflozin group, and the DHT (high, medium, and low dosage) group out of a total of 40 C57BL/KSJ-db/db (hereafter referred to as db/db) mice; another 10 C57BL/KSJ-db/dm mice were used as the normal group, saline was provided to the normal and model groups, and the mice in the treatment group received the appropriate medications. The medications were given for 10 consecutive weeks, once per day, to the mice in the treatment group. At weeks 0, 4, 8, and 10 of administration, fasting blood glucose (FBG) was assessed by drawing blood at a predetermined time from the tail vein; Urine samples were taken at 0, 5, and 10 weeks after treatment to evaluate the levels of albumin and creatinine, and the urinary albumin-creatinine ratio (ACR) was computed. After 10 weeks, mice in each group were assayed for 24 h total urine protein, serum creatinine (Scr), urea nitrogen (BUN) levels; Western blotting analysis was conducted to detect the expression of p-AMPK, p-mTOR, and p-ULK1, as well as the expression of autophagy related proteins homolog of yeast Atg6 (Beclin-1), autophagy-related proteins microtubule-associated protein 1 light chain 3 (LC3), P62 in renal tissue; Immunohistochemistry was used to measure the expression of podocyte lacunar membrane proteins (Nephrin, Podocin) in renal tissues; The pathological morphology of renal tissue was observed by light microscopy and transmission electron microscopy. RESULTS: Compared with the model group, FBG, ACR, and 24 h total urine protein were reduced in the dapagliflozin group and DHT groups of mice, and there was no statistically significant difference in Scr and BUN; In renal tissues, there is increased expression of p-AMPK and p-ULK1, decreased expression of p-mTOR, increased expression of LC3II / LC3I and Beclin-1, and decreased expression of P62 (P<0.01, P< 0.05); differentially upregulated in glomeruli are the podocyte lacunar membrane proteins Nephrin and Podocin (P<0.01, P<0.05); renal pathologic damage was reduced to varying degrees; transmission electron microscopy showed an increase in the number of autophagic vesicles and autophagic lysosomes. CONCLUSION: DHT can delay the development of DN by regulating the AMPK / mTOR / ULK1 signaling pathway, enhancing podocyte autophagy, and protecting glomeruli.

Research advances in noninvasive diagnosis of liver fibrosis in autoimmune liver diseases / 临床肝胆病杂志

Autoimmune liver diseases （ALD） are a group of chronic inflammatory liver diseases mediated by autoimmune response and can progress to liver fibrosis， liver cirrhosis， and even liver failure. Early diagnosis， early treatment， and dynamic follow-up of liver fibrosis in ALD may help to improve the prognosis of the disease and even reverse early-stage liver cirrhosis. Due to the limitations and potential risks of liver biopsy， the search for noninvasive techniques has become a research hotspot in the field of liver fibrosis. This article reviews the recent research advances in serum markers and imaging techniques for liver fibrosis in ALD and analyzes the advantages and disadvantages of each detection method and their development trends.

Clinical study of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine in the treatment of ischemic stroke with qi-deficiency blood stasis syndrome / 国际中医中药杂志

Objective:To evaluate the effect of Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine on ischemic stroke.Methods:Prospective cohort study. According to random number table method, 120 patients with ischemic stroke who met inclusion criteria in the hospital were divided into control group and treatment group, 60 in each group. The control group was given routine western medicine, while the treatment group was additionally given Banxia Baizhu Tianma Decoction and modified Buyang Huanwu Decoction. All were treated for 4 weeks. The severity of neurological deficits was evaluated by National Institute of Health Stroke Scale (NIHSS). The activities of daily living were evaluated by Barthel index. The high blood shear viscosity (HWBV), low blood shear viscosity (LWBV), plasma fibrinogen (FIB) and plasma viscosity (PV) were detected by full-automatic blood rheometer. The levels of MDA, SOD and NO were detected by ELISA. The clinical responsive rate was assessed.Results:The differences in total response rate between treatment group and control group were statistically significant [93.3% (56/60) vs. 75.0% (45/60), χ2=7.56, P=0.006]. After treatment, NIHSS score in treatment group was significantly lower than that in control group ( t=2.38, P=0.019), while Barthel index was significantly higher than that in control group ( t=13.28, P<0.01). After treatment, HWBV [(5.02±0.13) mPa?s vs. (6.18±0.28) mPa?s, t=29.11], LWBV [(1.18±0.21) mPa?s vs. (1.73±0.32) mPa?s, t=11.13], FIB [(2.26±0.28) g/L vs. (3.13±0.39) g/L, t=14.04] and PV [(8.87±1.44) mPa?s vs. (10.34±1.31) mPa?s, t=5.85] in treatment group were significantly lower than those in control group ( P<0.01), and the MDA [(4.14±1.23) mmol/L vs. (5.23±1.35) mmol/L, t=204.30] in treatment group was significantly lower than that in control group ( P<0.01), and levels of SOD [(113.34±0.28) mg/L vs. (96.59±0.57) mg/L, t=4.62] and NO [(26.01±3.26) μmol/L vs. (20.84±3.74) μmol/L, t=8.07] in treatment group were significantly higher than those in control group ( P<0.01). Conclusion:The Banxia Baizhu Tianma Decoction combined with modified Buyang Huanwu Decoction and routine western medicine can repair nerve function, improve hemorheology, oxidative stress indexes, clinical curative effect and activities of daily living in patients with ischemic stroke.

Angelica polysaccharides improve hepatic endoplasmic reticulum stress by inhibiting the expression of GRP78, p-PERK and p-Eif2α in diabetic KK-Ay mice / 中国临床药理学与治疗学

AIM: To investigate the regulatory mechanism of Angelica polysaccharide on hepatic endoplasmic reticulum stress in diabetic KK-Ay mice. MEHTODS: Forty diabetic KK-Ay mice were randomly divided into model group, metformin group, and angelica polysaccharide high, medium, and low dose groups, with 8 mice in each group. 8 C57BL/6J mice were used as blank control group. The mice were gavaged with 400 mg/kg, 200 mg/ kg and 100 mg/kg of angelica polysaccharide in the high, medium and low dose groups, respectively, and 200 mg/kg of metformin hydrochloride in the metformin group, while the normal and model groups were gavaged with equal volume of saline, and fasting blood glucose and body weight were measured weekly. After 4 weeks of gavage, triglyceride (TG), cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels were measured in mice serum; RT-PCR was performed to observe the expression of glucose-regulated protein 78 (GRP78), phosphorylated pancreatic endoplasmic reticulum kinase (p-PERK) and phosphorylated α-subunit eukaryotic initiation factor 2 (p-Eif2α) in liver tissues. mRNA expression; Western blot, immunohistochemistry to detect the protein expression of GRP78, p-PERK, p-Eif2α in mouse liver tissues. HE staining: to observe the histopathological changes in the liver. RESULT: Compared with the blank group, the levels of TC, TG and LDL-C were significantly increased (P<0.01) and the levels of HDL-C were significantly decreased (P<0.01) in the model group; compared with the model group, the levels of TC, TG and LDL-C were significantly decreased (P <0.05, P<0.01) and the levels of HDL-C were significantly increased in the metformin group, angelica polysaccharide high and medium dose groups. Compared with the blank group, the expression of GRP78, p-PERK and p-Eif2α in the model group was significantly upregulated (P<0.01), and the expression of GRP78, p-PERK and p-Eif2α in the angelica polysaccharide high, medium and low dose groups was significantly downregulated (P<0.05, P<0.01), and the high dose group had the best effect compared with the model group. Compared with the model group, the mice in the angelica polysaccharide group showed dense liver tissue, reduced vacuole-like degeneration, reduced liver steatosis, gradually aligned hepatocytes, and clear hepatic sinusoidal structure, and the effect was dose-dependent. CONCLUSION: Angelica polysaccharide significantly improved liver injury in diabetic KK-Ay mice, and its mechanism of action may be related to the inhibition of endoplasmic reticulum stress-related proteins and factors GRP78, p-PERK and p-Eif2α expression by Angelica polysaccharide and improvement of endoplasmic reticulum stress.

Research progress of JAK/STAT signaling pathway in the intervention of diabetic microvascular complications / 中国临床药理学与治疗学

Diabetic microvascular complications are the main reason for the high mortality of diabetic patients. There is still a great shortage of existing therapeutic drugs, so there is an urgent need for more effective new drugs. Janus kinase/signal transducer and activator of transcription (JAK/STAT) is involved in the progression of diabetic microvascular complications, which can be improved by regulating this pathway. Therefore, this article reviews the progress of JAK/STAT in diabetic microvascular complications (diabetic kidney disease, diabetic retinopathy, diabetic peripheral neuropathy), and summarizes the potential drugs that intervene JAK/ stat to improve diabetic microvascular complications in recent years from three aspects of therapeutic drugs, preclinical drugs, and traditional Chinese medicine, in order to provide ideas for drug development and treatment of diabetic microvascular complications.

Active Components in Chinese Medicinal Herbs Regulate AMPK/mTOR Pathway to Mediate Autophagy in Diabetic Kidney Disease： A Review / 中国实验方剂学杂志

Diabetic kidney disease （DKD） is one of the typical microvascular complications in patients with diabetes and a major cause of end-stage renal disease， with the pathogenesis remains to be elucidated. It may be associated with hemodynamic effects， genetic factors， kidney inflammatory injury， oxidative stress， autophagy dysregulation， metabolic disorders and so on. Because of its complex mechanism， there are no specific prevention and treatment measures in clinical practice. AMP-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway is a classical pathway involved in the regulation of autophagy. This pathway can be activated for treating DKD. Recent studies have demonstrated that the active components in Chinese medicinal herbs play a role in the prevention and treatment of DKD by directly acting on targeted cells and autophagy targets， which has attracted extensive attention. Researchers have extensively studied the occurrence and development of DKD and the mechanism of drug intervention in DKD， and the results prove that AMPK/mTOR pathway plays a role in the development of this disease. The active components in Chinese medicinal herbs regulate the AMPK/mTOR signaling pathway to affect autophagy， alleviate oxidative stress， inflammation， and extracellular matrix aggregation， and promote the generation of autophagosomes， thus mitigating kidney injury. This paper mainly reviews the relationship between AMPK/mTOR signaling pathway， autophagy， and DKD and the mechanism of active components in Chinese medicinal herbs in mediating autophagy via the AMPK/mTOR pathway， aiming to provide a theoretical basis for the clinical prevention and treatment of DKD.

Effects of Angelica sinensis polysaccharide on the apoptosis of cardiomyocytes in diabetic KK-Ay mice / 中国药房

OBJECTIVE To investigate the effects of Angelica sinensis polysaccharide on the apoptosis of cardiomyocytes in diabetic KK-Ay mice. METHODS KK-Ay mice were randomly divided into model group， metformin group （200 mg/kg） and A. sinensis polysaccharide high-dose， medium-dose and low-dose groups （400， 200 and 100 mg/kg）； C57BL/6J mice were included in blank group， with 8 mice in each group. Each group was given relevant medicine intragastrically or normal saline， once a day， for consecutive 4 weeks. After the final administration， the levels of fasting glucose， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C） and insulin （INS） were detected； the protein expressions of B-cell lymphoma 2 （Bcl-2）， cleaved- caspase-3， apoptosis signal-regulated kinase 1 （ASK1）， phosphorylated c-Jun N-terminal kinase （p-JNK）， phosphorylated inositol- requiring enzyme 1α （p-IRE1α） in myocardium， and apoptosis in cardiomyocytes were also detected. RESULTS Compared with model group， the fasting glucose， TC and LDL-C content， apoptotic rate of cardiomyocyte， protein expressions of p-JNK and p- IRE1α， ASK1， cleaved-caspase-3 were significantly lower in the metformin group and A. sinensis polysaccharide medium-dose， high-dose groups； INS level and relative expression of Bcl-2 protein were significantly increased （P＜0.05 or P＜0.01）. CONCLUSIONS A. sinensis polysaccharide can improve the levels of blood glucose and blood lipid and inhibit cardiomyocyte apoptosis in diabetic KK-Ay mice， and the mechanism may be related to the inhibition of IRE1/ASK1/JNK signaling pathway.

Effects of N-acetylcysteine on endoplasmic reticulum stress and oxidative stress in cerebral micro-vascular endothelial cells / 中华行为医学与脑科学杂志

Objective:To investigate the effect of N-acetylcysteine (NAC) on endoplasmic reticulum stress (ERS) and oxidative stress(OS) induced by tunicamycin (Tm) and its mechanism.Methods:Mouse derived brain microvascular endothelial cells cultured in vitro were divided into control group (normal cell culture), TM group (cells were intervened with 5 μg/mL Tm for 24 h), NAC + TM group (cells were pretreated with 1 mmol/L NAC for 1 h, then were intervened with 5 μg/mL Tm for 24 h) and NAC group (cells were intervened with 1 mmol/L NAC for 24 h) according to different intervention methods.CCK-8 and FITC-Annexin V/PI were used to detect the survival rate and apoptosis rate of cells.Western blot was used to detect the expression of GRP78、CHOP、p-eNOS and caspase-12 protein. Laser confocal microcopy was used to detect the expression of ROS, and colorimetry was used to detect the activity of MDA and SOD.Results:There were significant differences in apoptosis rate and survival rate among the four groups ( F=62.57, 35.00, both P<0.05). The apoptosis rate of TM group ((25.49±1.55)%) was higher than that of Control group ((13.76±1.48)%)( P<0.01), while the apoptosis rate of NAC+ TM group ((17.65±1.00)%) was lower than that of TM group ( P<0.01). The survival rate of TM group ((66.33±5.69)%) was lower than that of Control group ((100.00±2.12)%)( P<0.01), while the survival rate of NAC+ TM group ((85.67±4.04)%) was higher than that of TM group ( P<0.01). Western blot showed that there were significant differences in the expression levels of GRP78、CHOP and p-eNOS among the four groups ( F=32.39, 68.66, 13.12, all P<0.01). The expression levels of GRP78 and CHOP protein in TM group were higher than those of Control group (both P<0.05), while the expression level of p-eNOS was lower than that of Control group ( P<0.01). The expression levels of GRP78 and CHOP protein in NAC+ TM group were lower than those of TM group (both P<0.05), while the expression level of p-eNOS was higher than that of TM group ( P<0.01). There was no significant difference in the expression level of caspase-12 protein among the four groups ( F=0.33, P>0.05). Laser confocal showed that there was significant difference in the average fluorescence intensity of ROS among the four groups ( F=77.66, P<0.01). The average fluorescence intensity of ROS in TM group (32.67±1.53) was higher than that in Control group (12.67±2.08) and NAC+ TM group (18.33±1.53) (both P<0.01). Colorimetry showed that there were significant differences in the activity of SOD and the concentration of MDA among the four groups ( F=40.53, 34.99, both P<0.01). The results of colorimetry showed that the activity of SOD in TM group((41.60±1.53)U/mg) was lower than that in Control group((65.39±4.60)U/mg) and NAC+ TM group((58.72±1.64)U/mg)(both P<0.01). The concentration of MDA in TM((2.27±0.11)μmol/mg) group was higher than that in Control group((1.39±0.13)μmol/mg) and NAC+ TM group((1.44±0.11)μmol/mg) (both P<0.01). Conclusion:NAC can reduce Tm-induced apoptosis of cerebral micro-vascular endothelial cells, which may be related to its inhibition of ERS/ OS-related pathways.

Elastase injection into the cerebellomedullary cistern to induce a model of vertebrobasilar dolichoectasia in mice and evaluation of magnetic resonance angiography / 国际脑血管病杂志

Objective:To investigate the effect of magnetic resonance angiography (MRA) in evaluating the mouse model of vertebrobasilar dolichoectasia (VBD) induced by injection of elastase into cerebellomedullary cistern.Methods:Twenty-four male C57/BL6 mice were selected. The mice in the elastase group ( n=12) were injected in the cerebellomedullary cistern with 2.5 μl of phosphate buffer containing 25 mU elastase, and the mice in the saline control group ( n=12) were injected with the same volume of normal saline. MRA examination of the brains of living mice was performed 2 weeks after modeling. Successful modeling was defined as the basilar artery bending angle ≤170°, or the basilar artery bending length accounts for ≥10%, or the basilar artery deviated from the midline by more than 1 grade, or the percentage increase in artery diameter was ≥25%. Results:In the elastase group and the saline control group, 2 mice and 1 mouse did not wake up normally or died, respectively. The 11 surviving mice in the saline control group had no obvious vertebral artery and basilar artery abnormalities. The success rate of modeling in the 10 surviving mice in the elastase group was 80%, and the difference in the success rate between the two groups was statistically significant ( P<0.05). There were significant differences in mean basilar artery diameter (0.30 mm vs. 0.22 mm; P<0.05), mean basilar artery bending angle (115° vs. 170°; P<0.05), and proportion of mean basilar artery bending length (31% vs. 5%; P<0.05) of the surviving mice between the elastase group and the saline control group. Conclusion:MRA can better evaluate the mouse VBD model induced by elastase injection in the cerebellomedullary cistern.

Effect of continuous care on cognitive function and quality of life in patients with Alzheimer's disease / 中国实用护理杂志

Objective:To explore the influence of continuous care on cognitive function and quality of life of AD patients.Methods:A total of 76 patients with AD admitted to our hospital from January 2019 to January 2020 were prospectively selected and randomly divided into 2 groups by simple number random table method. The control group (38 cases) received routine nursing care and the observation group (38 cases) received continuous nursing care based on routine nursing. Mini-mental State Examination (MMSE), Quality of Life-Alzheimer′s Disease (QOL-AD), Barthel Index (BI) and Activity of Daily Living scale (ADL) scores were compared between the two groups.Results:The MMSE score of the observation group before nursing was 11.26±1.40, 11.28±1.35 in the control group, and the difference between the two groups was not statistically significant ( t value was 0.063, P>0.05).After nursing, MMSE score of patients in the observation group after nursing was 21.03±2.46, significantly higher than that of the control group 18.66±2.32 ( t value was 4.321, P<0.05). After nursing, the QOL-AD strongest items, stronger items, ordinary items, weak items scores in the post-nursing observation group were 10.70±1.22, 14.34±1.33, 10.44±1.08, 10.53±1.31, and 43.17±2.66, respectively. All of them were significantly higher than the control group (7.26±0.78, 9.37±0.90, 7.44±0.69, 7.48±0.74, 30.27±2.25), the difference between the two groups was statistically significant ( t value was 12.496-22.825, all P<0.05). After nursing, the BI score of the observation group was 68.06±16.51, which was significantly higher than that of the control group 51.04±15.56, the difference between the two groups was statistically significant ( t value was 7.018, P<0.05). The ADL score of the observation group was 16.19±7.22, which was significantly lower than that of the control group 20.52±8.79, the difference between the two groups was statistically significant ( t value was 22.347, P<0.05). Conclusion:Continuous nursing care for AD patients can improve cognitive function, improve quality of life, and improve the ability of daily life of patients.

Characteristics of African swine fever virus and difficulties in vaccine development / 生物工程学报

African swine fever (ASF) is a devastating disease of pigs caused by African swine fever virus (ASFV), which is considered to be the No. 1 killer to the global pig industry. Highly virulent strains are usually responsible for the peracute and acute forms that provoke high mortality rates that may reach 100%. Since ASF was first introduced in August 2018 into China, 137 outbreaks in domestic and wild pigs had been reported from 32 provinces by June 06, 2019, causing severe socioeconomic consequences. Efforts to develop an ASFV vaccine began in the 1960s, but all failed, the major reason is the lack of in-depth research on the biological characteristics of ASFV. It will be a great challenge for China to control the spread of current ASF, develop safe and effective vaccines. In this review, we outline the biological characteristics of ASFV, including its morphology and basic structure, transmission routes, pathogenicity, genome and proteins, entry mechanism, immune escape, and analyzed the difficulties in vaccine development. We hope to provide basic information for the control of current ASF and understanding of etiology in China.

Value of serum level of microRNA-494 in predicting prognosis of acute renal injury after cardiac surgery in children / 中华危重病急救医学

Objective@#To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children.@*Methods@#116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1.@*Results@#After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increased after operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (μg/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95% confidence interval (95%CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95%CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95%CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95%CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95%CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95%CI was 0.908-0.997), with a high sensitivity and specificity of 97.0% and 91.8%. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r1 = 0.902, r2 = 0.873, both P < 0.01).@*Conclusion@#Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.

Value of serum level of microRNA-494 in predicting prognosis of acute renal injury after cardiac surgery in children / 中华危重病急救医学

Objective To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children. Methods 116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1. Results After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increasedafter operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (μg/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95％ confidence interval (95％CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95％CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95％CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95％CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95％CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95％CI was 0.908-0.997), with a high sensitivity and specificity of 97.0％ and 91.8％. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r1 = 0.902, r2 = 0.873, both P < 0.01). Conclusion Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.

Efficacy and safety of active transfer of plaque versus provisional stenting with drug-eluting stents for the treatment of coronary bifurcation lesions / 中华心血管病杂志

Objective@#To compare the efficacy and safety of active transfer of plaque (ATP) versus provisional stenting (PS) with drug-eluting stents (DES) for the treatment of coronary bifurcation lesions.@*Methods@#A total of 1 136 patients with bifurcation lesions hospitalized in 6 selected hospitals between January 2010 and January 2014 were included in this prospective observational trial, patients were divided into either ATP (n=560) or PS group (n=576) accordingly. The primary endpoint was target lesion revascularization within 1 year, and the second endpoints were all-cause death, cardiogenic death, myocardial infarction, stent thrombosis, stroke, recurrent angina within 1 year.@*Results@#There were no significant differences in age, sex, hypertension, diabetes, hyperlipidemia and smoking history between the two groups (P>0.05). The incidence of TIMI blood flow <3 grade in the side branch (1.6%(9/560) vs. 7.5% (43/576), P<0.01), acute occlusion of the side branch (1.3%(7/560) vs. 7.1%(41/576), P<0.01) and implanted stents of side branch (1.8%(10/560) vs. 7.8% (45/576), P<0.01) were significantly lower in the ATP group than those in the PS group. During the one year follow up, the rate of target lesion revascularization was similar between ATP group and PS group (4.6%(26/560) vs. 4.0%(23/576), P=0.66).@*Conclusions@#The effectiveness and safetyof ATP techniquein the patients with coronary bifurcation lesions is comparable to the PS technique. However, ATP technique is superior to PS technique on effectively reducing the incidence of implanted stents in the side branch.

Trends of in-hospital mortality and constituent ratio of patients with acute myocardial infarction / 中华心血管病杂志

Objective@#To analyze the trends on constituent ratio of non-ST-segment-elevation (NSTEMI) and ST-segment-elevation myocardial infarction (STEMI) and related in-hospital mortality in acute myocardial infarction (AMI) patients hospitalized in Beijing Anzhen Hospital from 2004 to 2014.@*Methods@#This is a single-center, retrospective study. We reviewed all patients hospitalized for AMI in Beijing Anzhen Hospital from January 1 2004 to December 31 2014, and collected all related information including hospitalization stay, the type of AMI, revascularization and in-hospital mortality. We analyzed the trends of constituent ratio of NSTEMI and STEMI, and their in-hospital mortalities during the 11 years.@*Results@#Data from a total of 23 864 patients with AMI, including 5 539 STEMI and 18 325 NSTEMI, were analyzed. Compared with STEMI patients, NSTEMI patients were older, less likely to be male (P<0.001), had higher prevalence of hypertension, hyperlipidemia, diabetes (P<0.001), and lower prevalence of smoking (P<0.001). Additionally, patients with NSTEMI were more likely to have prior history of MI (12.6% (695/5 539) vs. 7.4% (1 354/18 325), P<0.001) and coronary artery bypass graft surgery (2.7% (152/5 539) vs. 0.7% (124/18 325), P<0.001). The constituent ratio of NSTEMI was significantly increased during the observation period, rising from 15.8% (107/802) in 2004 to 35.7% (1 273/3 583) in 2014 (P value for trend <0.001). The in-hospital mortality of NSTEMI patients was significantly lower compared with those with STEMI (1.84% (102 cases) vs. 2.74% (502 cases), P<0.001). The mortality of both STEMI and NSTEMI were significantly decreased during the 11 years (both P value for χ2 trend test <0.001). After adjusting for other risk factors, NSTEMI was independently associated with lower in-hospital mortality (OR=0.50, 95%CI 0.40-0.63, P<0.001).@*Conclusions@#In patients with AMI, the constituent ratio of NSTEMI versus STEMI is increased during the 11 years. The in-hospital mortality is decreased for both STEMI and NSTEMI patients in the past 11 years, and the in-hospital mortality rate of NSTEMI patients is lower than STEMI patients in this patient cohort during the observation period.

Rapid test of heavy metal cadmium content in rice of some region by X-ray fluorescence spectrometer / 医疗卫生装备

Objective To determinate the heavy metal cadmium content in rice to ensure food safety.Methods Several brands and batch numbers of rice were collected and divided into groups A and B.Group A contained 24 pieces of rice from the canteens,and group B involved in 22 pieces from the farm product markets.Cadmium content in rice was detected quantitatively with X-ray fluorescence spectrometer,and then evaluated according to GB 2762-2012 which determined rice was not qualified in case cadmium content was more than 0.2 mg/kg.Results Group A had cadmium content between 0.00 and 0.477 mg/kg,the times of ultra standard being 2.385 and the disqualification rate being 29.2％ (7/24),and group B had cadmium content between 0.065 and 0.619 mg/kg,the times of ultra standard being 3.095 and the disqualification rate being 68.2％ (15/22).Excessive cadmium content in rice occurred in both canteens and markets,while the canteens was better than the markets.Conclusion X-ray fluorescence spectrometer detects cadmium content in rice rapidly and simply,and is worthy promoting in elementary facilities.

Research Progress in Prevention and Treatment of Diabetic Nephropathy with TCM Polysaccharides / 中国中医药信息杂志

Diabetic nephropathy (DN) is one of the most important microvascular complications of diabetes, which is one of the most important causes of death in diabetic patients. Because of its high efficiency and few adverse reactions, TCM has been widely studied and used in the treatment of DN, with unique advantages. The recent research showed that a variety of TCM polysaccharides have the effects of reduce blood sugar and protect kidney. This article reviewed the research on TCM polysaccharides on the prevention and treatment of DN, which can provide references for further study and application.

Clinical features of Mycoplasma pneumoniae infection complicated with extrapulmonary digestive system lesion in different age / 中国基层医药

Objective To investigate the clinical features of Mycoplasma pneumoniae infection complicated with extrapulmonary digestive system damage in patients of different age.Methods 260 children with Mycoplasma pneumonia and extrapulmonary digestive system damage were chosen.Among them,84 cases ＜ 3 years old were infants and young children group,176 children aged ≥3 years were children group.The clinical data of children were analyzed and compared.Results The rates of nausea (69.0％ vs.36.4％),vomiting (88.1％ vs.55.7％) and diarrhea (83.3％ vs.53.4％) in infants were significantly higher than those in children.The percentage of abdominal pain(16.7％ ％ vs 52.3％) was significantly lower than that in children (x2 =24.389,26.681,29.853,21.862,all P ＜ 0.05).The proportion of intestinal gas accumulation in infants and young children was significantly higher than that in children group (31.0％ vs.5.7％) (x2 =4.996,P ＜ 0.01).The proportion of Mycoplasma 1 ∶ 40 titer in infants group was significantly higher than that in children group(52.4％ vs.21.6％),and the proportion of 1 ∶ 80 and 1 ∶ 160 titers was significantly lower than that in children group (28.6％ vs.48.9％,11.9％ vs.25.6％,x2 =24.966,9.593,6.365,all P ＜ 0.05).Conclusion In infants and young children with Mycoplasma pneumoniae infection complicated with extrapulmonary digestive system damage,nausea,vomiting and diarrhea are common,and the proportion of intestinal tract gas accumulation is higher.The laboratory test is mainly based on the 1 ∶ 40 titer.In children,abdominal pain was more common,and laboratory tests showed a higher proportion of 1 ∶ 80 and 1 ∶ 160 titers.

Improvement of instrument for preparation of medical patch material / 医疗卫生装备

Objective To modify the existing preparation instrument for medical patch material to realize its scale and automatic production.Methods The instrument had its shaking table improved and a cylindrical processing system added with comprehensive analysis on raw materials and kinds of process flows.A spreading and fixation mechanism for animal materials was placed in the cylindrical processing system,which had the holes for liquid inlet and outlet respectively on its top and bottom.The cylindrical processing system was fixed to the base of the shaking table.Results The instrument enhanced preparation efficiency significantly,and had the raw material utilization rate increased by 20％,product qualification rate raised by 35％,preparation cycle reduced by 33％ and total cost saved by 40％.Conclusion The instrument behaves well in adaptability to multi animals,preparation process,inter-assay difference,raw material utilization rate,product qualification rate and cost reduction,which is of great significance to promote the clinical application of medical biological patch.

Academic origin, development and characteristic of Xujiang acupuncture school / 中国针灸

The origin time, representative physicians and medical works of Xujiang acupuncture school were traced, so as to explore the academic origin and development and summarize the academic characteristic of Xujiang acupuncture school, which could make a better inheritance of academic essence and prompt the innovation and development of Xujiang acupuncture school.