Influence of Modified Shashen Maidong Decoction Combined with Camrelizumab Immunotherapy Plus Chemotherapy on the Efficacy,Survival Status,and Serum CYFRA21-1 and NSE Levels in Patients with Advanced Non-Small Cell Lung Cancer / 广州中医药大学学报

Objective To investigate the influence of modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy on the efficacy,survival status and serum cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)levels in patients with advanced non-small cell lung cancer(NSCLC).Methods Forty patients with advanced NSCLC of lung-stomach yin deficiency with intense heat-toxin type were randomly divided into a control group and a study group,with 20 patients in each group.The patients in the control group were given Camrelizumab immunotherapy plus chemotherapy,and the patients in the study group were given modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy,with 21 days as a course of treatment and for a total of 4 courses of treatment.The changes of serum NSE and CYFRA21-1 levels in the two groups before and after treatment were observed,and the clinical efficacy,survival status and the incidence of toxic and side effects were compared between the two groups.Results(1)After 4 courses of treatment,the total effective rate of the study group was 70.00%(14/20),which was significantly higher than that of the control group(9/20,45.00%),but the intergroup comparison(tested by chi-square test)showed that the difference was not statistically significant(P＞0.05).(2)After 2 years of follow-up,the overall survival(OS),time to progression(TTP),and progression-free survival(PFS)of the patients in the study group were significantly prolonged compared with those in the control group(P＜0.01).(3)After treatment,the serum NSE and CYFRA21-1 levels of the patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease of serum NSE and CYFRA21-1 levels in the study group was significantly superior to that in the control group(P＜0.01).(4)The incidence of toxic and side effects in the study group was 25.00%(5/20),which was significantly lower than that of 65.00%(13/20)in the control group,and the intergroup comparison showed that the difference was statistically significant(P＜0.05).Conclusion Modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy has satisfactory therapeutic effect on patients with advanced NSCLC,which can reduce the toxic and side effects of chemotherapy,lower the level of serum tumor markers,and prolong the survival period and time to progression(TTP)of the patients.

Drug resistance and genomic characteristics of a strain of O139 Vibrio cholerae isolated from human bloodstream infection / 中华预防医学杂志

Objective: To analyze the drug resistance and genomic characteristics of a strain of serogroup O139 Vibrio cholerae producing cholera toxin isolated from the bloodstream of a person with bacteremia. Methods: The broth dilution method and automatic drug sensitivity analyzer were used to determine the antibiotic sensitivity of the strain. The complete genome sequence of the strain was obtained by using second-generation gene sequencing and nanopore sequencing. BLAST software was used for comparison and analysis with CARD, Resfinder, ISfinder, VFDB, and other databases. The drug-resistant genes, insertion sequences and virulence genes carried by the strain were identified. MEGA 5.1 software was used to construct a genetic phylogenetic tree based on the core genomic single nucleotide polymorphisms. Results: V. cholerae SH400, as the toxigenic strain, carried multiple virulence-related genes and four virulence islands. The strain was resistant to streptomycin, tetracycline and cotrimoxazole, carrying corresponding drug-resistant genes. The strain also carried IncA/C plasmid with the size of 172914 bp and contained 10 drug-resistant genes. Combined with the genomic evolutionary relationship, this study found that the drug-resistant genes and drug-resistant plasmids carried among strains showed certain aggregation. The traditional ST type of strain SH400 was ST69, and the cgMLST type was a new type highly similar to cgST-252. Conclusion: This strain of serogroup O139 V. cholerae carries the ctxAB gene, multiple drug-resistant genes and IncA/C plasmid, and there are multiple drug-resistant islands.

Qirong Tablets inhibits apoptosis of ovarian granulosa cells via PI3K/Akt/ HIF-1 signaling pathway / 中国中药杂志

This study aims to observe the effect and explore the mechanism of Qirong Tablets in the treatment of premature ovarian insufficiency(POI) in mice via the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/hypoxia inducible factor 1(HIF-1) signaling pathway. Sixty SPF female BALB/c mice were randomly divided into normal group, model group, positive control group, Qirong Tablets low-, medium-and high-dose group. The normal group was intraperitoneally injected with the same amount of normal saline, and the other groups were intraperitoneally injected with cyclophosphamide 120 mg·kg~(-1)·d~(-1) once to establish a POI animal model. After the model was successfully established, the low-, medium-and high-dose groups of Qirong Tablets were administered orally with 0.6, 1.2, 2.4 mg·kg~(-1)·d~(-1) respectively. The positive control group was given 0.22 mg·kg~(-1)·d~(-1) Clementine Tablets by intragastric administration, and the normal group and model group were given intragastric administration with the same amount of normal saline, and the treatment was 28 d as a course of treatment. After drug intervention, enzyme-linked immunosorbent assay(ELISA) was employed to measure the levels of estradiol(E_2), follicle-stimulating hormone(FSH), luteinizing hormone(LH), and anti-mullerian hormone(AMH) in peripheral blood, and hematoxylin-eosin(HE) staining to observe the ovarian tissue. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) assay was used to detect the apoptosis of granulosa cells, and Western blot to determine the expression levels of B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), caspase-3, PI3K, Akt, and HIF-1. Compared with the normal group, the modeling of POI caused loose or destroyed ovarian tissue with vacuolar structures, edema and fibrosis in the ovarian interstitium, disordered or loose arrangement of granulosa cells, and reduced normal follicles. Compared with the model group, drug interventions restored the ovarian tissue and follicles at all the development stages and reduced atretic follicles. Compared with the normal group, the modeling of POI lowered the serum level of E_2 and AMH(P<0.01), and elevated the level of FSH and LH(P<0.01). Compared with the model group, high-dose Qirong Tablets elevated the levels of E_2 and AMH(P<0.05), and lowered the levels of FSH and LH(P<0.05). Compared with the normal group, the modeling of POI up-regulated the protein levels of PI3K, Akt, HIF-1, Bax, and caspase-3 and down-regulated the protein level of Bcl-2 in the ovarian tissue(P<0.01). Compared with the model group, low-, medium-, and high-dose Qirong Tablets down-regulated the protein levels of PI3K, Akt, HIF-1, Bax, and caspase-3 proteins and up-regulated the protein level of Bcl-2 in the ovarian tissue(P<0.05). In conclusion, Qirong Tablets can up-regulate the expression Bcl-2, down-regulate the expression of Bax and caspase-3 in POI mice. Qirong Tablets may inhibit the apoptosis of follicular granulosa cells in mice, thereby delaying ovarian aging, improving reproductive axis function, and strengthening ovarian reserve capacity, which may be associated with the inhibition of PI3K/Akt/HIF-1 pathway.

Metformin improves polycystic ovary syndrome and activates female germline stem cells in mice / 生理学报

Polycystic ovary syndrome (PCOS) is a common disease caused by complex endocrine and metabolic abnormalities in women of childbearing age. Metformin is the most widely used oral hypoglycemic drug in clinic. In recent years, metformin has been used in the treatment of PCOS, but its mechanism is not clear. In this study, we aimed to investigate the effect of metformin on PCOS and its mechanism through PCOS mouse model. Female C57BL/6J mice aged 4-5 weeks were intragastrically given letrozole (1 mg/kg daily) combined with a high-fat diet (HFD) for 21 days to establish the PCOS model. After modeling, metformin (200 mg/kg daily) was intragastrically administered. One month later, the body weight and oral glucose tolerance test (OGTT) were measured. Hematoxylin eosin (H&E) staining was used to detect the pathological changes of ovary. The serum levels of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), E2 and testosterone (T) were measured by ELISA. The expression of DDX4/MVH was detected by immunohistochemistry. DDX4/MVH and PCNA were co-labeled by immunofluorescence. The protein levels of DDX4/MVH, PCNA, cyclin D2, AMPK and mTOR were detected by Western blot. The results showed that after metformin treatment, the body weights of PCOS mice were gradually returned to normal, glucose tolerance was significantly improved, serum E2 levels were increased, while AMH, LH, T levels and LH/FSH ratio were decreased. Ovarian polycystic lesions were reduced with reduced atresia follicles. Furthermore, the number of proliferative female germline stem cells (FGSCs) and levels of proliferation related proteins (PCNA, cyclin D2) were significantly increased, and the p-mTOR and p-AMPK levels were markedly up-regulated. These results suggest that metformin treatment not only improves hyperandrogenemia, glucose intolerance and polycystic ovarian lesions in PCOS, but also activates the function of FGSCs. The underlying mechanism may be related to the phosphorylation of AMPK and mTOR. These findings provide new evidence to use metformin in the treatment of PCOS and follicular development disorder.

Comparative Study of the Genetic Diversity, Antimicrobial Resistance, and Pathogenicity of / 生物医学与环境科学（英文）

Objective@#This study was performed to compare the genetic diversity, virulence, and antimicrobial resistance of @*Methods@#A total of 38 clinical strains and 19 strains from healthy individuals were isolated from the samples collected in Ma'anshan City, Anhui Province. Their taxonomy was investigated using concatenated @*Results@#The 57 @*Conclusions@#The taxonomy, virulence properties, and antibiotic resistance of

New effect of G-protein coupled receptors on blood pressure regulation / 中国中药杂志

Hypertension is a clinical syndrome characterized by elevated systemic arterial blood pressure, which may be accompanied by functional or organic damage of heart, brain, kidney and other organs. The pathogenesis and development of hypertension are affected by genetic, environmental, epigenetic, intestinal microbiota and other factors. They are the result of multiple factors that promote the change of blood pressure level and vascular resistance. G protein coupled receptors(GPCRs) are the largest and most diverse superfamily of transmembrane receptors that transmit signals across cell membranes and mediate a large number of cellular responses required by human physiology. A variety of GPCRs are involved in the control of blood pressure and the maintenance of normal function of cardiovascular system. Hypertension contributes to the damages of heart, brain, kidney, intestine and other organs. Many GPCRs are expressed in various organs to regulate blood pressure. Although many GPCRs have been used as therapeutic targets for hypertension, their efficacy has not been fully studied. The purpose of this paper is to elucidate the role of GPCRs in blood pressure regulation and its distribution in target organs. The relationship between GPCRs related to intestinal microorganisms and blood pressure is emphasized. It is proposed that traditional Chinese medicine may be a new way to treat hypertension by regulating the related GPCRs via intestinal microbial metabolites.

Evaluation of Off-label Use of Oral Glucocorticoids in Outpatients / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the off-label use of oral glucocorticoids in outpatients.</p><p><b>METHODS</b>The information of outpatient glucocorticoids prescriptions from January 1st to June 30th in 2012 were collected from the information system in our hospital, then the software of Excel was employed to statistically analyze the data including the amount of drugs used in different departments,as well as the age, sex, and diagnosis of the patients. The diagnoses were compared with those included in the labels approved by China Food and Drug Administration and US Food and Drug Administration and domestic and foreign guidelines.</p><p><b>RESULTS</b>It was found that 16.53% of the cases were off-label use,and dexamethasone had the highest proportion (60.50%) of off-label use. Most of the off-label use had evidence support, such as multiple myeloma and myasthenia gravis, while some cases did not, such as epilepsy and sudden deafness.</p><p><b>CONCLUSION</b>The management of off-label use should be further strengthened to promote the safe and rational use of glucocorticoids.</p>

Overexpression of p-Stat3 and Mcl-1, and their correlation with differentiation and apoptotic resistance in esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To detect the expression of phosphorylated-signal transducer and activator of transcription 3 (p-Stat3) and myeloid leukemia-1 (Mcl-1) as well as their correlation, and to investigate the functional role of Stat3 and Mcl-1 in the pathogenesis of esophageal squamous cell carcinoma (ESCC).</p><p><b>METHODS</b>Stat3 activity in ESCC cells was inhibited with JAK/Stat3 inhibitors (AG490 or JSI-124). Specific siRNA was used to inhibit the Stat3 expression. Cell apoptosis was detected by flow cytometry. Expression of Mcl-1 protein was determined by Western blotting. Expression of phospho-Stat3 (Tyr705) and myeloid leukemia-1 (Mcl-1) proteins in ESCC tissues was detected by tissue microarray and immunohistochemistry. The relationship between p-Stat3 or Mcl-1 aberrant expression and clinicopatholohical features of ESCC was analyzed. The correlation of their expression was also analyzed.</p><p><b>RESULTS</b>Suppression of the Stat3 signaling activation in ESCC cells led to marked apoptosis, and dramatic reduction of Mcl-1 protein. The positive rate of phospho-Stat3 (Tyr705) expression was 45.0% in 50/111 of the ESCC tissue samples. The lower the degree of tumor differentiation, the higher the positive rate of phospho-Stat3 (Tyr705), showing a significant difference (P = 0.018). The positive rate of Mcl-1 protein expression was 72.1% (80/111), and the lower the degree of tumor differentiation was, the higher there was the positive rate of Mcl-1, with a significant difference (P = 0.026). There was a positive correlation between the expressions of p-Stat3 and Mcl-1 proteins (P = 0.012).</p><p><b>CONCLUSIONS</b>In a subset of ESCC tissues, p-Stat3 (Tyr705) and Mcl-1 are overexpressed and positively correlated with each other, and both are correlated with tumor differentiation. Persistent activation of Stat3 contributes to apoptotic resistance in ESCC cells, and may be at least partly mediated through upregulation of Mcl-1.</p>

Study on the relationship between hypertension management and the risk of stroke at community level / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe whether the community-based management for patients with hypertension can reduce the incidence of stroke.</p><p><b>METHODS</b>Sample of this study included 36 863 people aged 35 years or more who came from a cohort consisting three communities from Tiantan Hospital, Puren Hospital and the Gymnasium Road Hospital in Beijing, based on the surveys on the Integrated Community Intervention Measures of Cerebro-vascular Diseases. Some patients with hypertension in this cohort were followed up and under management. First-ever stroke was considered as the end-point event.</p><p><b>RESULTS</b>In both groups diagnosed as borderline hypertension or definite hypertension group, the rates of management and control showed an annual increase. The management rate for women was higher, but the control rate was lower (P < 0.05) than that for men. In the third year of this study, the control rate was nearly 18%. With the qualification of control rate, the risk factors of overall stroke, ischemic stroke or hemorrhagic stroke reduced gradually, and the qualification of control rate showed more effects on hemorrhagic stroke. The qualification of control rate in the three years could cause the risk factors of total stroke, ischemic stroke or hemorrhagic stroke to reduce by 25.7%, 19.1%, 27.4%, respectively. When comparing with blood pressure level at < 160/95 mm Hg (1 mm Hg = 0.133 kPa), the level of < 140/90 mm Hg could reduce the risk factors as: 12.3% to total stroke, 12.8% to ischemic stroke and 14.9% to hemorrhagic stroke.</p><p><b>CONCLUSION</b>Programs as long-term followed-up and management for patients with hypertension, and control the blood pressure at low level etc. could significantly reduce the incidence of stroke.</p>

Evaluation on a community-based intervention program among people with different risk factors of stroke / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of a long-term community-based intervention program on risk factors of stroke among people with different risk factors.</p><p><b>METHODS</b>In 1987,2 geographically separated communities with 10 000 registered residents of each, were selected as either intervention or control communities in Beijing and Changsha. A cohort containing 2700 subjects at the age of 35 years or older,and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects at high risk for intervention and there were 5319 and 5506 subjects enrolled in intervention and control cohorts,respectively. Then,a program for controlling the risk factors of stroke was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted in 1999. The information on incidence and mortality of stroke was collected.</p><p><b>RESULTS</b>Comparing with the control cohort, the risk of incidence and mortality of stroke decreased by 22 % ( HR = 0.78,95 % CI:0. 66-0.92) and 73 % (HR = 0.27,95 % CI:0. 17-0.42) in intervention cohort. The risks of stroke were lower in intervention cohort than in control cohort among almost all of the sub-groups with or without risk factors of stroke except for being male,current smokers and current alcohol drinkers. The risk of death caused by stroke decreased significantly in those with or without the risk factors of stroke.</p><p><b>CONCLUSION</b>The long-term community intervention on the risk factors of stroke could effectively reduce the risk of incidence and mortality of stroke among people with or without the risk factors of stroke. More attention should be paid to the males and those who smoke or drink alcohol.</p>

Up-regulated manganese superoxide dismutase expression increases apoptosis resistance in human esophageal squamous cell carcinomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Esophageal cancer is one of the most common malignancies in the world. In order to identify the proteins associated with esophageal squamous cell carcinomas (ESCC), we analyzed the protein profiles of ESCC cases with tumor and matched adjacent normal tissues.</p><p><b>METHODS</b>Two-dimensional electrophoresis (2-DE) was carried out to analyze the protein profiles. Dysregulated protein spots were identified by Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) and verified by liquid chromatography/electrospray ionization ion trap-mass spectrometry/mass spectrometry (LC-ESI-IT MS). RT-PCR and immunohistochemistry on tissue microarray were performed to confirm the gene dysregulation in esophageal cancerous tissues. RNA interference (RNAi) was used to knock down the gene expression in ESCC cell lines. Apoptosis assay with annexin V-FITC/PI staining was conducted and cells were analyzed by flow cytometry.</p><p><b>RESULTS</b>2-DE showed that two protein spots with approximate molecular weights and different pI were elevated in 12 out of 18 ESCCs as compared to the corresponding normal tissues. Both the two spots were identified as MnSOD by MALDI-TOF and were verified by LC-ESI-IT MS. MnSOD overexpression was detected in 14 tumors out of 24 cases by RT-PCR and 52 tumors out of 116 cases by immunohistochemistry comparing to normal epithelia. siRNA-mediated silencing of MnSOD in KYSE450 and KYSE150 cell lines revealed that MnSOD protected ESCC cells from apoptosis induced by ultraviolet (UV) and doxorubicin (DOX).</p><p><b>CONCLUSIONS</b>These findings suggest that there existed two isoforms of MnSOD protein in normal and tumor esophageal tissues. MnSOD was overexpressed in ESCC and its up-regulation in esophageal cancer cells was associated with apoptosis resistance.</p>

Highly expressed protein in cancer (Hec 1) and chromosome instability / 中国医学科学院学报

Highly expressed in cancer (Hec 1), locating at centromere during cell mitosis, plays an important role in the pathway of spindle checkpoint. Hec 1-Nuf 2 complex is the structural basis for the recruitment of Mad 1/Mad 2 complex of spindle checkpoint. Hec 1 can interact with the subunit of 26S proteasome and inhibit the degradation of cyclins. It was initially identified as a protein interacting with Rb by yeast two-hybridization assay. Rb interacts with Hec 1 to regulate the binding ability of Smc 1 with DNA and participates in the regulation of M phase. Hec 1 mainly expresses at G2/M phase and functions through the phosphorylation by kinase Nek 2. Hec 1 is over expressed in some cancer cell lines and amplified in tumor tissues. The dysfunction of Hec 1 gene may cause severe impediment of chromosome separation and finally lead to chromosome instability, which is closely associated with the occurrence and development of tumors. Therefore, Hec 1 may become a new target of tumor gene therapy.

Studies on chemical constituents in roots of Euphorbia soongarica / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of the roots of Euphorbia soongarica (Xinjiang origin).</p><p><b>METHOD</b>Compounds were isolated and purified by repeated normal column chromatography, preparative thin layer chromatography and Sephadex LH - 20 chromatography. The chemical structures were elucidated by NMR and MS spectra.</p><p><b>RESULTS</b>Ten chemical constituents were isolated from the n-BuOH fraction and identified as ellagic acid (1) , 3, 3'-di-O-methylellagic acid (2) , 3, 3'-di-O-methylellagic acid-4'-O-alpha-D-arabinfuranoside (3), 3, 3'-di-O-methylellagic acid-4'-O-beta-D-xylopyranoside (4), 3, 3'-di-O-methylellagic acid-4-O-beta-D-glucopyranoside (5), 3, 3', 4'-tri-O-methylellagic acid (6), 3-O-methylellagic acid-4'-O-beta-D-xylopyranoside (7), 3, 3', 4-tri-O-methylellagic acid-4'-O-beta-D-glucopyranoside (8), brevifolin (9) and ethyl brevifolin carboxylate (10).</p><p><b>CONCLUSION</b>All of above compounds were obtained from this plant for the first time.</p>

Community intervention on hypertension and stroke / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the community-based intervention on reduction of hypertension and stroke in different age groups and subtypes hypertension.</p><p><b>METHODS</b>In 6 cities, 2 geographically separated communities with a registered population about 10 000 of each were selected as either intervention or control communities. A cohort containing 2 700 subjects, 35 years or older, and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects for intervention. In each city, a program for control of hypertension, heart diseases and diabetes was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted 3 years later.</p><p><b>RESULTS</b>Within 3 years, the prevalence of hypertension increased in both intervention and control cohorts, as well as in the middle and elderly cohorts, especially in the middle aged in control group. Among hypertensives in the intervention cohort, the rates of awareness, treatment and control of hypertension got improved. The incidence of stroke was 29% lower (HR = 0.71, 95% CI: 0.58 - 0.87) and mortality of stroke was 40% lower (HR = 0.60, 95% CI: 0.42 - 0.86) in the intervention cohort than the control cohort. The intervention was most effective in reduction of stroke for those with isolated systolic hypertension and combined systolic and diastolic hypertension (All P < 0.05). Meanwhile, all-cause mortality was 11% lower (HR = 0.89, 95% CI: 0.78 - 0.99) in the intervention cohort than in the control cohort.</p><p><b>CONCLUSION</b>The community-based intervention was effective in controlling the development of hypertension and stroke, while the elderly people benefit more than the middle aged people from the intervention.</p>