Analysis of depressive symptoms and influencing factors among middle and high school students from 2018 to 2021 in Zhejiang Province / 中国学校卫生

Objective@#To investigate the prevalence and associated factors of depressive symptoms among middle and high school students in Zhejiang Province, so as to provide scientific basis for the implementation of depressive intervention.@*Methods@#Based on the health status and associated factors of middle and high school students in the project "Monitoring of Common Diseases and Health Influencing Factors of Students" during 2018 to 2021, a total of 73 309 students including middle school, ordinary high school and vocational high school surveyed in 11 cities of Zhejiang Province were selected by multi stage stratified cluster random sampling method. From 2018 to 2021, there were 6 008, 21 917, 23 712 and 21 672 students, respectively. The Chi square test and Logistic regression model were used to analyze the influencing factors of depressive symptoms in middle and high school students.@*Results@#From 2018 to 2021, depressive symptoms detection rate of middle school students was 14.8%, with higher rate in girls (17.1%) than in boys (12.7%), higher rate in high school (17.1% in ordinary high school, 17.6% in vocational high school) than middle school (12.5%)( χ 2=278.77, 327.22, P <0.05). Univariate analysis showed that there were statistically significant differences in depressive symptoms detection rate among middle school students with different years (2018: 16.7%，2019: 17.9% , 2020: 13.1%, 2021: 13.0%), residence (yes: 16.3%, no:13.5%), body mass index classification (not overweight or obesity: 14.8%, overweight: 14.2%, Obesity: 15.7%), weekly exercise days (0-2 d: 17.1%, 3-5 d: 12.5%, 6-7 d: 13.1%) and bullying (yes: 35.5%, no: 10.7%) ( χ 2=293.40, 118.35, 7.83, 287.24, 4 978.84, P <0.05). Multivariate Logistic regression analysis showed that female students, ordinary high schools, vocational high schools, obesity, school bullying were positively correlated with depression ( OR =1.65, 1.70, 1.60, 1.12, 5.21), exercise 3 to 5 days per week, exercise 6 to 7 days per week were negatively correlated with depression ( OR=0.77, 0.81, P <0.01).@*Conclusions@#Depressive symptoms among middle and high school students in Zhejiang Province are prominent. Strengthening mental health education for students and providing attention and support from families, schools, and society are essential steps to reduce the occurrence of depressive symptoms among these students.

Correlation between geriatric nutritional risk index and adverse events in elderly hemodialysis patients / 中华老年心脑血管病杂志

Objective To explore the relationship between geriatric nutritional risk index(GNRI)and adverse outcomes in elderly patients undergoing maintenance hemodialysis(MHD).Methods A prospective cohort trial was conducted on 337 MHD patients aged ≥60 years in hemodialysis centers of 11 hospitals in Beijing from April to June 2017.Their baseline data were collected,and they were divided into non-malnutrition(GNRI≥98,226 cases),mild malnutrition(92≤GNRI＜98,81 cases),and major malnutrition groups(GNRI＜92,30 cases).All of them were followed up until June 2018.The endpoint events were all-cause mortality and cardiovascular disease(CVD)mortality.Kaplan-Meier survival analysis was used to compare the cumulative survival rate among the 3 groups.Multivariate Cox regression model was employed to analyze the relationship of GNRI with all-cause and CVD mortality.Results The mild and major malnutrition groups had significantly lower BMI,serum albumin level and GNRI(P＜0.01).During the median follow-up of 52(4.4-52.0)weeks,56(16.6％)patients died of all-cause death and 25(44.6％)of CVD death.Kaplan-Meier survival curve showed significant differences in all-cause mortality(x2=30.484,P＜0.01)and CVD mortality(x2=22.398,P＜0.01)in the 3 groups.Multivariate Cox regression analysis indicated that,as a continuous variable,elevated GNRI was a protective factor for all-cause mortality(HR=0.910,95％CI:0.870-0.952,P=0.000)and CVD mortality(HR=0.895,95％CI:0.852-0.940,P=0.000),and as a categorical variable,mild and major malnutri-tion were independently correlated with all-cause and CVD mortality(P＜0.05).Conclusion GNRI is an independent risk factor for all-cause and CVD mortality in elderly MHD patients.Mo-nitoring the nutritional status using GNRI can predict the risk of adverse prognosis.

Diagnosis and treatment of cervical bronchogenic cysts in 14 cases / 中华普通外科杂志

Objective:To analyze the clinical characteristics and surgical treatment of patients with cervical bronchogenic cyst.Methods:This study enrolled 14 cases of cervical bronchogenic cysts confirmed by surgery and pathology in our hospital from Sep 2015 to Sep 2020 to discuss clinical, imaging features and diagnosist.Results:Cysts lay in the left neck in 8 cases and in the right side in 6 cases, with the largest diameter of 5.8 cm and the smallest of 0.8 cm (3.4±1.7) cm. Cysts were closely related to the thyroid in 10 cases, adjacent to the recurrent laryngeal nerve in 2 cases. The postoperative pathology established the diagnosis of bronchogenic cyst, and no patients suffered from recurrence during the follow-up period.Conclusions:Cervical bronchogenic cyst is a rare congenital malformation of extrathoracic bronchogenic cyst. Final diagnosis is dependent upon pathology. Complete surgical resection is the key to prevent recurrence.

Humanized anti-CD25 monoclonal antibody as a salvage therapy for steroid-refractory acute graft-versus-host disease after hematopoietic stem cell transplantation / 中华血液学杂志

Objective: To investigate the efficacy of humanized anti-CD25 monoclonal antibody for steroid-refractory acute graft-versus-host disease (SR-aGVHD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients. Methods: A total of 64 patients with SR-aGVHD between June 2019 and October 2020 in Suchow Hopes Hematology Hospital were enrolled in this study. Humanized anti-CD25 monoclonal antibodies 1 mg·kg(-1)·d(-1) were administered on days 1, 3, and 8, and then once per week according to the disease progression. Efficacy was assessed at days 7, 14, and 28 after humanized anti-CD 25 treatment. Results: Of the 64 patients with a median age of 31 (15-63) years, 38 (59.4%) were male and 26 (40.6%) were female. The overall response (OR) rate of the humanized CD25 monoclonal antibody in 64 patients with SR-aGVHD on days 7, 14, and 28 were 48.4% (31/64), 53.1% (34/64), and 79.7% (51/64), respectively. Liver involvement is an independent risk factor for poor efficacy of humanized CD25 monoclonal antibody for SR-aGVHD at day 28 (OR=9.588, 95% CI 0.004-0.291, P=0.002). The median follow-up time for all patients was 17.1 (0.2-50.8) months from the start of humanized CD25 monoclonal antibody therapy. The 1- and 2-year OS rates were 63.2% (95% CI 57.1% -69.3%) and 52.6% (95% CI 46.1% -59.1%), respectively. The 1- and 2-year DFS rates were 58.4% (95% CI 52.1% -64.7%) and 49.8% (95% CI 43.4% -56.2%), respectively. The 1- and 2-year NRM rates were 28.8% (95% CI 23.1% -34.5%) and 32.9% (95% CI 26.8% -39.0%), respectively. The results of the multifactorial analysis showed that liver involvement (OR=0.308, 95% CI 0.108-0.876, P=0.027) and GVHD grade Ⅲ/Ⅳ (OR=9.438, 95% CI 1.211-73.577, P=0.032) were independent risk factors for OS. Conclusion: Humanized CD25 monoclonal antibody has good efficacy and safety for SR-aGVHD. This study shows that SR-aGVHD with pretreatment grade Ⅲ/Ⅳ GVHD and GVHD involving the liver has poor efficacy and prognosis and requires early intervention.

Clinical and molecular biological characterization of patients with accelerated chronic lymphocytic leukemia / 中华血液学杂志

Objective: To investigate the clinical and molecular biological characteristics of patients with accelerated chronic lymphocytic leukemia (aCLL) . Methods: From January 2020 to October 2022, the data of 13 patients diagnosed with aCLL at The First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed to explore the clinical and molecular biological characteristics of aCLL. Results: The median age of the patients was 54 (35-72) years. Prior to aCLL, five patients received no treatment for CLL/small lymphocytic lymphoma (SLL), while the other patients received treatment, predominantly with BTK inhibitors. The patients were diagnosed with aCLL through pathological confirmation upon disease progression. Six patients exhibited bulky disease (lesions with a maximum diameter ≥5 cm). Positron emission tomography (PET) -computed tomography (CT) images revealed metabolic heterogeneity, both between and within lesions, and the median maximum standardized uptake value (SUVmax) of the lesion with the most elevated metabolic activity was 6.96 (2.51-11.90). Patients with unmutated IGHV CLL accounted for 76.9% (10/13), and the most frequent genetic and molecular aberrations included +12 [3/7 (42.9% ) ], ATM mutation [6/12 (50% ) ], and NOTCH1 mutation [6/12 (50% ) ]. Twelve patients received subsequent treatment. The overall response rate was 91.7%, and the complete response rate was 58.3%. Five patients experienced disease progression, among which two patients developed Richter transformation. Patients with aCLL with KRAS mutation had worse progression-free survival (7.0 month vs 26.3 months, P=0.015) . Conclusion: Patients with aCLL exhibited a clinically aggressive course, often accompanied by unfavorable prognostic factors, including unmutated IGHV, +12, ATM mutation, and NOTCH1 mutation. Patients with CLL/SLL with clinical suspicion of disease progression, especially those with bulky disease and PET-CT SUVmax ≥5, should undergo biopsy at the site of highest metabolic uptake to establish a definitive pathological diagnosis.

Analysis of target and mechanism of rhynchophylline in treatment of inflammatory bowel disease / 中国药理学通报

Aim To investigate the feasibility and mechanism of rhynchophylline in the treatment of in-rhynchophylline flammatory bowel disease (IBD) based on network pharmacology combined with in vivo and in vitro experiments. Methods The target of rhynchophylline-IBD intersection was obtained from the database, and GO and KEGG enrichment analysis were performed. The binding of key target proteins was screened by molecular docking. In vivo the IBD model of mice was induced by sodium dextran sulfate (DSS). After seven days of rhynchophylline intervention, the signs of mice in each group were observed and DAI scores were recorded. The levels of interleukin-1β (3 (IL-1 β), my-eloperoxidase (MPO) and other inflammatory factors in colon tissue of mice were detected by ELISA. The intestinal permeability of each group was detected. In vitro experiments were conducted to establish the inflammatory model of Caco2 cells induced by DSS, and to clarify the regulatory effect of leptosinine on key targets. Results A total of 70 rhynchophylline-IBD intersection targets were screened, and enrichment analysis showed that they were related to the inflammatory prooess, PI3K-Akt and Hippo signaling pathway s. Molecular docking results showed that was most stable in binding with JAK2 and JAK1. In vivo experiment results showed that compared with model group, body weight, colon length and weight of rhynchophylline group significantly increased (P < 0. 05). DAI score, IL-1β, MPO and other inflammatory factors in colon tissue and intestinal permeability significantly decreased (P < 0. 01). In vitro experiment results showed that compared with model group, rhynchophylline group significantly promoted the proliferation of Caco2 cells (P < 0. 05). The levels of IL-6 and NO were significantly reduced (P < 0. 05). Western blot results showed that rhynchophylline could decrease the expressions of JAK2 and JAK1 (P < 0. 05). Conclusion Rhynchophylline may play a role in the treatment of IBD by inhibiting the expression of JAK2 and JAK1 proteins and reducing inflammatory response in body.

Clinical evaluation of combined geriatric nutritional risk index and modified creatinine index predicting all-cause mortality in middle-aged and older patients undergoing maintenance hemodialysis / 中华肾脏病杂志

Objective:To explore the relationship between geriatric nutritional risk index (GNRI) and modified creatinine index (mCI) and all-cause mortality in maintenance hemodialysis (MHD) patients.Methods:It was a prospective cohort study. The MHD patients aged≥50 years old at hemodialysis centers of eleven hospitals in Beijing from April to June 2017 were selected as subjects. Baseline clinical data of the patients were collected. The patients were divided into high GNRI group (≥98) and low GNRI group (<98), and high mCI group (≥20.16 mg·kg -1·d -1) and low mCI group (<20.16 mg·kg -1·d -1), and further divided into 4 groups: G1 group (high GNRI and high mCI), G2 group (high GNRI and low mCI), G3 group (low GNRI and high mCI) and G4 group (low GNRI and low mCI). The differences of clinical characteristics among the four groups were compared. The patients were followed-up until June 2018 or death or loss, and the endpoint event was all-cause mortality. Kaplan-Meier survival analysis was used to compare the differences of the cumulative survival rates among the four groups. A multivariate Cox regression model was used to analyze the relationship between GNRI and mCI and all-cause mortality. Results:A total of 613 patients were included in the study, aged (63.65±7.78) years old (ranged from 50 to 81 years old), with 355 males (57.91%). The GNRI and mCI were (99.35±5.75) and (20.16±2.79) mg·kg -1·d -1, respectively. There were 232 patients (37.85%) in the G1 group, 177 patients (28.87%) in the G2 group, 95 patients (15.50%) in the G3 group, and 109 patients (17.78%) in the G4 group. There were statistically significant differences in age, sex, proportion of diabetes, proportion of coronary heart disease, body mass index, serum albumin and serum creatinine among the four groups (all P<0.05). A total of 69 patients (11.26%) died during a median follow-up time of 52(4, 52) weeks. Kaplan-Meier survival curve results showed that the mortality of patients with low GNRI was higher than that of patients with high GNRI (log-rank χ 2=26.956, P<0.001), and the mortality of patients with low mCI was higher than that of patients with high mCI (log-rank χ 2=25.842, P<0.001). The mortality was 3.45% in group G1, 10.73% in group G2, 9.47% in group G3, and 30.28% in group G4, and the differences among the four groups were statistically significant (log-rank χ 2=57.153, P<0.001). Multivariate Cox regression analysis results showed that as continuous variables, GNRI ( HR=0.911, 95% CI 0.882-0.941, P<0.001) and mCI ( HR=0.873, 95% CI 0.797-0.956, P=0.003) were correlated with all-cause death. As categorical variables, compared with high GNRI group and high mCI group, patients with low GNRI ( HR=3.469, 95% CI 2.125-5.665, P<0.001) and low mCI ( HR=3.255, 95% CI 1.879-5.640, P<0.001) had higher risks of death. Compared with G1 group, patients in G2 group ( HR=2.488, 95% CI 1.079-5.738, P=0.033) and G4 group ( HR=9.449, 95% CI 4.362-20.470, P<0.001) had higher risks of death. Conclusions:GNRI and mCI are independent predictive factors of all-cause mortality in MHD patients. The combination of GNRI and MCI can more accurately predict the risk of all-cause death in middle-aged and elderly MHD patients.

Construction of performance evaluation index system for outpatient capitation based on value-based payment / 中华医院管理杂志

Objective:To construct a performance evaluation index system of outpatient capitation under basic medical insurance in China based on the concept of value-based payment, so as to provide reference for the medical insurance departments to evaluate the performance of outpatient capitation.Methods:From January to February 2023, the initial index system was constructed based on literature research and expert discussion. Twenty experts were invited for 2 rounds of Delphi consultation and the index system was revised and improved, and the weight value of the index was determined by using analytic hierarchy process.Results:Seventeen experts completed the consultation. The final performance evaluation index system of outpatient capitation included 4 first-level indicators, 9 second-level indicators and 20 third-level indicators. In the first-level indicators, the weights of service delivery, medical costs, quality of care, and health outcomes were 0.234, 0.262, 0.262 and 0.242, respectively. The second-level indicators mainly included basic medical services, cost control, fund operation, quality of chronic disease management, etc. The index system not only included medical quality and cost control indicators, but also included several value-based indicators such as health outcomes and patient satisfaction.Conclusions:A performance evaluation index system for outpatient capitation has been successfully constructed, which simultaneously assesses the process and results of capitation, and can provide theoretical reference for the medical insurance departments to carry out performance evaluation.

Bioinformatics analysis and validation of key genes in transformation of idiopathic membranous nephropathy to end-stage renal disease and traditional Chinese medicines for prevention and treatment / 中国中药杂志

This study used bioinformatics analysis to screen out key genes involved in the transformation of idiopathic membranous nephropathy to end-stage renal disease and to predict targeted Chinese herbs and medicines and active ingredients with preventive and curative effects. The GSE108113 microarray of idiopathic membranous nephropathy and GSE37171 microarray of were downloaded from the comprehensive gene expression database, and 8 homozygous differentially expressed genes for the transformation of idiopathic membranous nephropathy into end-stage renal disease of were screened out by R software. GraphPad Prism was used to verify the expression of homozygous differentially expressed genes in GSE115857 microarray of idiopathic membranous nephropathy and GSE66494 microarray of chronic kidney disease, and 7 key genes(FOS, OGT, CLK1, TIA1, TTC14, CHORDC1, and ANKRD36B) were finally obtained. The Gene Ontology(GO) analysis was performed. There were 209 functions of encoded proteins, mainly involved in regulation of RNA splicing, cytoplasmic stress granule, poly(A) binding, etc. Thirteen traditional Chinese medicines with the effect of preventing the transformation of idiopathic membranous nephropathy to end-stage renal disease were screened out from Coremine Medical database, including Ginseng Radix et Rhizoma, Lycopi Herba, and Gardeniae Fructus, which were included in the Chinese Pharmacopoeia(2020 edition). The active ingredient quercetin mined from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) had ability to dock with the key gene FOS-encoded protein molecule, which provided targets and research ideas for the development of new traditional Chinese medicines.

Rapid identification and differential markers of Curcumae Radix decoction pieces of different sources based on Heracles Neo ultra-fast gas phase electronic nose / 中国中药杂志

Since Curcumae Radix decoction pieces have multiple sources, it is difficult to distinguish depending on traditional cha-racters, and the mixed use of multi-source Curcumae Radix will affect its clinical efficacy. Heracles Neo ultra-fast gas phase electronic nose was used in this study to quickly identify and analyze the odor components of 40 batches of Curcumae Radix samples from Sichuan, Zhejiang, and Guangxi. Based on the odor fingerprints established for Curcumae Radix decoction pieces of multiple sources, the odor components was identified and analyzed, and the chromatographic peaks were processed and analyzed to establish a rapid identification method. Principal component analysis(PCA), discriminant factor analysis(DFA), and soft independent modeling cluster analysis(SIMCA) were constructed for verification. At the same time, one-way analysis of variance(ANOVA) combined with variable importance in projection(VIP) was employed to screen out the odor components with P<0.05 and VIP>1, and 13 odor components such as β-caryophyllene and limonene were hypothesized as the odor differential markers of Curcumae Radix decoction pieces of diffe-rent sources. The results showed that Heracles Neo ultra-fast gas phase electronic nose can well analyze the odor characteristics and rapidly and accurately discriminate Curcumae Radix decoction pieces of different sources. It can be applied to the quality control(e.g., online detection) in the production of Curcumae Radix decoction pieces. This study provides a new method and idea for the rapid identification and quality control of Curcumae Radix decoction pieces.

Evaluation of porcine urine-derived cells as nuclei donor for somatic cell nuclear transfer

Background@#Somatic cell nuclear transfer (SCNT) is used widely in cloning, stem cell research, and regenerative medicine. The type of donor cells is a key factor affecting the SCNT efficiency. @*Objectives@#This study examined whether urine-derived somatic cells could be used as donors for SCNT in pigs. @*Methods@#The viability of cells isolated from urine was assessed using trypan blue and propidium iodide staining. The H3K9me3/H3K27me3 level of the cells was analyzed by immunofluorescence. The in vitro developmental ability of SCNT embryos was evaluated by the blastocyst rate and the expression levels of the core pluripotency factor. Blastocyst cell apoptosis was examined using a terminal deoxynucleotidyl transferase dUTP nick end-labeling assay. The in vivo developmental ability of SCNT embryos was evaluated after embryo transfer. @*Results@#Most sow urine-derived cells were viable and could be cultured and propagated easily. On the other hand, most of the somatic cells isolated from the boar urine exhibited poor cellular activity. The in vitro development efficiency between the embryos produced by SCNT using porcine embryonic fibroblasts (PEFs) and urine-derived cells were similar.Moreover, The H3K9me3 in SCNT embryos produced from sow urine-derived cells and PEFs at the four-cell stage showed similar intensity. The levels of Oct4, Nanog, and Sox2 expression in blastocysts were similar in the two groups. Furthermore, there is a similar apoptotic level of cloned embryos produced by the two types of cells. Finally, the full-term development ability of the cloned embryos was evaluated, and the cloned fetuses from the urine-derived cells showed absorption. @*Conclusions@#Sow urine-derived cells could be used to produce SCNT embryos.

MiR-375-3p enhanced radiosensitivity of colorectal cancer cells by inhibiting homologous recombination repair of DSBs / 中华放射医学与防护杂志

Objective:To investigate the effect of miR-375-3p on DNA damage repair and radioresistance of colorectal cancer cells.Methods:After overexpression of miR-375-3p in HCT116 and HT29, cell proliferation ability was detected by CCK-8 assay, clone formation ability was detected by clone formation assay, apoptosis was detected by Annexin V-FITC/PI double staining method and cell cycle distribution was detected by flow cytometry, and the formation of γ-H2AX foci were used to analyze homologous recombination (HR) repair efficiency. Bioinformatics was used to predict the downstream target genes of miR-375-3p in the HR repair pathway. A dual luciferase reporter gene assay was used to validate the regulation effect of miR-375-3p on Rad51 gene. The expression of miR-375-3p in HCT116 cells irradiated with 60Co γ-rays at 2 and 6 Gy was measured by RT-qPCR. The inhibition effect of miR-375-3p on the radiosensitivity of HCT116 cells was analyzed after irradiation with different doses of 0, 1, 2, 4 and 6 Gy. Results:Overexpression of miR-375-3p inhibited the proliferation and colony formation ability, induced G1 phase cycle arrest and cell apoptosis of colorectal cancer cells, enhanced DSBs formation, inhibited Rad51 expression, and significantly decreased HR repair efficiency ( t = 10.055, P < 0.05). Dual luciferase reporter gene assay demonstrated that miR-375-3p bound to Rad51 3′UTR region ( t = 5.013, P< 0.05). In addition, irradiation increased miR-375-3p expression, and inhibition of miR-375-3p expression reduced radiosensitivity of colorectal cancer cells ( t=6.460, 5.619, 10.150, P<0.05). Conclusions:miR-375-3p inhibited the homologous recombination repair efficiency of DSBs and enhanced the radiosensitivity of colorectal cancer cells.

Preparation of Rehmanniae Radix Juice for Baihe Dihuangtang Based on UPLC-Q-TOF-MS / 中国实验方剂学杂志

ObjectiveTo compare the four preparation methods of Rehmanniae Radix juice described in ancient literature and find the method that is most suitable for the preparation of Rehmanniae Radix juice used in Baihe Dihuangtang. MethodThe ancient medical books record four methods for preparing Rehmanniae Radix juice： crushing fresh Rehmanniae Radix for juice， steaming fresh Rehmanniae Radix for juice， boiling fresh Rehmanniae Radix for juice， and boiling dry Rehmanniae Radix for juice. Ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS） was employed to detect the compounds in the four juice samples， followed by principal component analysis （PCA）. Result① Totally 27 compounds were identified in the juice samples， including 10 iridoid glycosides， 14 phenylethanoid glycosides， 2 phenolic acids， and 1 irisone. Among them， 15 common compounds were shared by the four juice samples， including 7 iridoid glycosides， 7 phenylethanoid glycosides， and 1 phenolic acid. ② Five common compounds in the four juice samples can be matched with the reference standards， which were catalpol， aucubin， rehmannioside D， ajugol， and purpureaside C. ③ Verbascoside and isoacteoside were not detected in the juice prepared by crushing fresh Rehmanniae Radix， while it was detected in the other three juice samples， which indicated that the two components were produced after heating rather than being the original components in fresh Rehmanniae Radix. ④ The comparison of the ion fragments demonstrated that verbascoside was produced from purpureaside C after the cleavage of the glycosidic bond and removal of a molecule of mannose. ⑤ Isoacteoside could be isomerized from verbascoside， and its relative content increased with the extension of heating time. However， the relative content of verbascoside and purpureaside C did not decrease significantly. Therefore， it was hypothesized that purpureaside C was produced from its upstream component. ConclusionThe juice prepared by crushing fresh Rehmanniae Radix has the chemical composition significantly different from the juice samples prepared with the other 3 methods， while the latter 3 juice samples had similar chemical composition. Although all the four methods can be used， it is more suitable to prepare Rehmanniae Radix juice by steaming fresh Rehmanniae Radix， boiling fresh Rehmanniae Radix， and boiling dry Rehmanniae Radix.

Research progress on epigenetics of interferon in systemic lupus erythematosus / 中国药理学通报

Systemic lupus erythematosus (SLE) is an autoimmune disease with various clinical manifestations and complex pathogenesis, characterized by loss of immune tolerance to autoantigens and production of large amounts of autoantibodies. Interferon (I F N) signaling pathway is one of the pathogenetic pathways widely recognized at present. In recent years, the correlation between IFN signaling and epigenetic modification in the occurrence and development of SLE has beena research hotspot. And in this paper, the relevant studies are reviewed in order to provide new research ideas for the pathogenesis of SLE.

Ultrasound features of 91 cases of medullary thyroid cancer / 中华内分泌外科杂志

Objective:To summarize the ultrasound features of medullary thyroid cancer (MTC) and analyze its diagnosis value for MTC.Methods:91 patients with medullary thyroid carcinoma (103 nodules) in Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from Apr. 2013 to Nov. 2018 were retrospectively analyzed, including 36 males and 55 females. Preoperative ultrasound features and serum calcitonin levels were recorded. SPSS 22.0 was used and the measurement data of normal distribution was expressed as ± s, and the enumeration data was described by ratio or rate. The comparison between groups was performed by single factor ANOVA and rank sum test. Results:83.5% (86/103) of the MTC nodules were located in the middle and upper thyroid gland. Hypoechoic accounted for 78.6% (80/103) . 81.6% (84/103) of them had calcification and 74.8% (77/103) of these nodules had abundant blood flow signals (color Doppler flow imaging, CDFI Ⅱ-Ⅲ) . 91.3% (94/103) of them had aspect ratio less than 1, 87.4% (90/103) were solid and 35.0% (36/103) had comet tail sign. The positive rate of preoperative serum calcitonin was 86.8% (79/91) . There were significant differences in shape ( P=0.001) , margin ( P=0.012) , cystic ( P=0.004) , comet-tail ( P<0.001) , lymph node ( P<0.001) and color Doppler flow imaging ( P=0.001) through comparing MTC nodules in different TI-RADS grades. Conclusions:MTC can behave as single, solid, hypoechoic, large round nodule located in the middle or upper thyroid gland, with thick calcification and abundant blood flow signals in ultrasound. The surrounding area may be accompanied with comet tail sign, and the probability of lymph node metastasis is high. The suspicious nodules screened by ultrasound can be further diagnosed by serum calcitonin.

Clinical investigation of the risk factors of aortic arch calcification and its association with long term prognosis among the patients undergoing maintenance hemodialysis / 中华肾脏病杂志

Objective:To explore the related risk factors of aortic arch calcification (AoAC) and the relationship between AoAC and long-term outcome in maintenance hemodialysis patients.Methods:The patients who underwent hemodialysis in the Blood Purification Center of Beijing Shijitan Hospital Affiliated to Capital Medical University from March to June 2015 were recruited. Calcification of the aortic arch was estimated with plain chest radiology. The patients were divided into AoAC group and no-AoAC group. Multivariate binary logistic regression was used to analyze the influencing factors of AoAC. Kaplan-Meier analysis and Cox regression model were used to examine the association between AoAC and adverse prognostic events (all-cause death and cardiovascular events).Results:There were 157 hemodialysis patients included in this study, with age of (62.63±15.05) years (30-90 years old) and 85 males (54.14%). The median follow-up time was 54(20, 54) months. There were 99 cases (63.06%) in AoAC group and 58 cases (36.94%) in no-AoAC group. The age, proportion of diabetes history, serum corrected calcium and triglyceride levels in AoAC group were higher than those in no-AoAC group (all P<0.05), while the proportion of using active vitamin D, serum albumin and intact parathyroid hormone level were lower than those in no-AoAC group (all P<0.05). Multivariate logistic regression analysis showed that older age ( OR=1.109, 95% CI 1.067-1.152, P<0.001), diabetes ( OR=4.110, 95% CI 1.551-10.890, P=0.004), longer dialysis duration ( OR=1.026, 95% CI 1.010-1.043, P=0.001), higher systolic pressure ( OR=1.039, 95% CI 1.012-1.067, P=0.005) and higher triglycerides levels ( OR=1.932, 95% CI 1.148-3.125, P=0.013) were the independent risk factors of AoAC, and higher hemoglobin was a protective factor ( OR=0.967, 95% CI 0.938-0.998, P=0.035) of AoAC. Sixty-three cases (63.64%) died, and 78 cases (78.79%) had cardiovascular events in AoAC group. Fourteen cases (24.14%) died, and 12 cases (20.69%) had cardiovascular events in no-AoAC group. Kaplan-Meier analysis showed higher incidence rate of all-cause death (Log-rank χ2=22.499, P<0.001) and cardiovascular events (Log-rank χ2=50.797, P<0.001) in patients with AoAC. Multivariate Cox regression analysis showed AoAC was the independent risk factor of all-cause death ( HR=2.003, 95% CI 1.039-3.859, P=0.038) and cardiovascular events ( HR=5.642, 95% CI 3.003-10.600, P<0.001). Conclusions:Older age, diabetes mellitus, longer dialysis duration, hypertension, higher triglyceride levels and lower hemoglobin are significantly associated with AoAC. AoAC is the independent risk factor of all-cause death and cardiovascular events in maintenance hemodialysis patients.

A cross-sectional study of overweight and obesity among 7-22 year-old students in Zhejiang Province / 预防医学

Objective @#To understand the prevalence of overweight and obesity, and the influencing factors among students aged 7-22 years in Zhejiang Province. @*Methods @#Stratified random cluster sampling was used to randomly select students aged 7-22 years in 11 prefectures of Zhejiang Province in 2019. Height and weight were measured. The general information, dietary habits and living habits of students were collected using the Student Health Status and Influencing Factors Questionnaire. The multivariate logistic regression model was used to analyze the influencing factors of overweight and obesity. @*Results @#A total of 33 800 respondents were included, 7 685 (22.74%) were overweight/obese, 4 729 ( 13.99% ) were overweight, and 2 956 ( 8.75% ) were obese. The multivariate logistic regression analysis suggested that boys ( OR=2.059, 95%CI：1.949-2.175), not living on campus( OR=1.306, 95%CI: 1.214-1.405), history of alcohol consumption ( OR=1.158, 95%CI：1.083-1.238 ), average daily consumption of sugar-sweetened beverages in the past week ( less than once, OR=1.214, 95%CI: 1.103-1.336; once and more, OR=1.431, 95%CI: 1.259-1.626 ), average daily consumption of fries in the past week ( less than once, OR=1.171, 95%CI: 1.065-1.288; once and more, OR=1.266, 95%CI: 1.102-1.454 ), and average daily consumption of sweets in the past week (less than once, OR=0.727, 95%CI: 0.658-0.802; once and more, OR=0.504, 95%CI: 0.444-0.572) were associated with overweight and obesity in students. @*Conclusion @#The prevalence rates of overweight and obesity among students aged 7-22 years in Zhejiang Province are 13.99% and 8.75%, respectively, which are associated with boys, not living on campus, and consumption of sugar-sweetened beverages, fries, sweets and alcohol.

Gene mutations of esophageal squamous cell carcinoma based on next-generation sequencing / 中华医学杂志(英文版)

BACKGROUND@#Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive cancers without effective therapy. To explore potential molecular targets in ESCC, we quantified the mutation spectrum and explored the relationship between gene mutation and clinicopathological characteristics and programmed death-ligand 1 (PD-L1) expression.@*METHODS@#Between 2015 and 2019, 29 surgically resected ESCC tissues and adjacent normal tissues from the Fourth Hospital of Hebei Medical University were subjected to targeted next-generation sequencing. The expression levels of PD-L1 were detected by immunohistochemistry. Mutational signatures were extracted from the mutation count matrix by using non-negative matrix factorization. The relationship between detected genomic alterations and clinicopathological characteristics and PD-L1 expression was estimated by Spearman rank correlation analysis.@*RESULTS@#The most frequently mutated gene was TP53 (96.6%, 28/29), followed by NOTCH1 (27.6%, 8/29), EP300 (17.2%, 5/29), and KMT2C (17.2%, 5/29). The most frequently copy number amplified and deleted genes were CCND1/FGF3/FGF4/FGF19 (41.4%, 12/29) and CDKN2A/2B (10.3%, 3/29). By quantifying the contribution of the mutational signatures to the mutation spectrum, we found that the contribution of signature 1, signature 2, signature 10, signature 12, signature 13, and signature 17 was relatively high. Further analysis revealed genetic variants associated with cell cycle, chromatin modification, Notch, and Janus kinase-signal transducer and activator of transcription signaling pathways, which may be key pathways in the development and progression of ESCC. Evaluation of PD-L1 expression in samples showed that 13.8% (4/29) of samples had tumor proportion score ≥1%. 17.2% (5/29) of patients had tumor mutation burden (TMB) above 10 mut/Mb. All samples exhibited microsatellite stability. TMB was significantly associated with lymph node metastasis (r = 0.468, P = 0.010), but not significantly associated with PD-L1 expression (r = 0.246, P = 0.198). There was no significant correlation between PD-L1 expression and detected gene mutations (all P > 0.05).@*CONCLUSION@#Our research initially constructed gene mutation profile related to surgically resected ESCC in high-incidence areas to explore the mechanism underlying ESCC development and potential therapeutic targets.

Quality evaluation of fried Glycyrrhizae Radix et Rhizoma pieces by HPLC fingerprint and multicomponent quantitative analysis / 中国中药杂志

To establish the HPLC fingerprint and multi-component determination method of fried Glycyrrhizae Radix et Rhizoma pieces. HPLC analysis was performed on Thermo Acclaim ~(TM)120 C_(18) column(4.6 mm×250 mm, 5 μm). Acetonitrile-0.1% phosphoric acid aqueous solution was taken as the mobile phase for gradient elution. The flow rate was 1 mL·min~(-1),the column temperature was maintained at 30 ℃, and the detection wavelength was 237 nm and 360 nm. The similarity of 15 batches of fried Glycyrrhizae Radix et Rhizoma pieces was higher than 0.849, and 17 common peaks were identified. Liquiritin, isoliquiritin apioside, isoliquiritin, liquiritigenin, isoliquiritigenin and glycyrrhizic acid were identified; among them, the mass fractions of Liquiritin, isoliquiritin apioside, isoliquiritin, liquiritigenin, glycyrrhizic acid were were 0.519%-3.058%, 0.227%-0.389%, 0.070%-0.439%, 0.038%-0.173%, 1.381%-4.252%, respectively. According to the cluster analysis, the 15 batches of decoction pieces were classified into three categories; principal component analysis screened out four principal components, with the cumulative variance contribution rate of 86.630%, indicating that the principal components contained most information of original data. Partial least squares discriminant ana-lysis marked 6 differential components in the decoction pieces. The established fingerprint and multicomponent determination are stable and reliable, and can provide a reference for the quality control of Radix Glycyrrhizae Radix et Rhizomae and fried Glycyrrhizae Radix et Rhizoma pieces.

Micro-particulate Ganoderma lucidum spore β-glucanin enhances the antitumor activity of gemcitabin via remodeling immunosuppressive microenvironment in Lewis lung cancer / 药学学报

Gemcitabine (GEM) is a commonly used drug in the clinical treatment of non-small cell lung cancer. Due to the accumulation of cells mediating immune escape and T cell depletion after chemotherapy, tumor microenvironment (TME) tends to be immunosuppressive status, which ultimately leads to tumor metastasis. The experimental protocol was approved by the Medical Laboratory Animal Ethics Committee of Jiangsu Provincial Academy of Chinese Medicine. Therefore, we observed the immunomodulatory effects of micro-particulate Ganoderma lucidum spore β-glucan (PGSG) on macrophages in vitro experiments. Next, mice subcutaneous Lewis lung cancer models were established to observe the anti-tumor effects of PGSG through oral administration of PGSG combined with GEM. Flow cytometry analysis was used to analyze the ratio of anti-tumor T cells in tumors and spleen, as well as the proportion of myeloid-derived suppressor cells (MDSC), tumor-associated macrophages (TAM) and regulatory cells (Tregs). The results showed that PGSG can up-regulate the expression of major histocompatibility antigens (MHC-II), CD40, CD86 and CD80 on the surface of macrophages, enhance the ability to phagocytosis of neutral red and further mediate the release of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and interleukin-10 (IL-10). In vivo experiments, combined administration can significantly decrease the volume and weight of tumors, reduce the ratio of MDSC (CD11b+Gr-1+), M-MDSC (CD11b+Ly6G-Ly6Chigh) and Treg (CD4+Foxp3+). At the same time, PGSG promoted the conversion of M2 (F4/80+CD206+) to M1 (F4/80+MHC-II+) and enhanced the response of helper T cell-1 (Th1) (CD4+IFN-γ+) and cytotoxic T lymphocyte (CTL) (CD8+IFN-γ+), which is of great significance for killing tumors. These results suggest that PGSG can regulate innate and adaptive antitumor immune responses, reshape the immunosuppressive microenvironment and enhance the anti-lung cancer effect of GEM.