Clinicopathological analysis of superior mediastinal lymph node metastases in medullary thyroid carcinoma / 中华肿瘤杂志

Objective: To investigate the clinicopathological characteristics of superior mediastinal lymph node metastases (sMLNM) in medullary thyroid carcinoma (MTC). Methods: This retrospective analysis enrolled the patients who were treated for sMLNM of MTC in our hospital from May 2012 to January 2021. All patients were suspected of sMLNM due to preoperative imaging. According to the pathological results, the patients were divided into two groups named sMLNM group and the negative superior-mediastinal-lymph-node group. We collected and analyzed the clinical features, pathological features, pre- and post-operative calcitonin (Ctn), and carcinoembryonic antigen (CEA) levels of the two groups. Logistic regression analysis was used to analyze risk factors, and receiver operation characteristic (ROC) curves were drawn to determine the optimal cut-off values of preoperative Ctn and preoperative CEA for predicting sMLNM. Results: Among the 94 patients, 69 cases were in the sMLNM group and 25 cases were in the non-SMLNM group. Preoperative Ctn level (P=0.003), preoperative CEA level (P=0.010), distant metastasis (P=0.022), extracapsular lymph node invasion (P=0.013), the number of central lymph node metastases (P=0.002) were related to sMLNM, but the multivariate analysis did not find any independent risk factors. The optimal threshold for predicting sMLNM by pre-operative Ctn is 1500 pg/ml and AUC is 0.759 (95% CI: 0.646, 0.872). The sensitivity, specificity, positive predictive value, and negative predictive value of diagnosis are 61.2%, 77.3%, 89.1%, 39.5%, respectively. In patients who underwent mediastinal lymph node dissection through transsternal approach, the metastatic possibility of different levels from high to low were level 2R (82.3%, 28/34), level 2L (58.8%, 20/34), level 4R (58.8%, 20/34), level 3 (23.5%, 8/34), level 4L (11.8%, 4/34). Postoperative complications occurred in 41 cases (43.6%), and there was no perioperative death in all cases. 14.8% (12/81) of the patients achieved biochemical complete response (Ctn≤12 pg/ml) one month after surgery, 5 of these patients were in sMLNM group. Conclusions: For patients who have highly suspicious sMLNM through imaging, combining with preoperative Ctn diagnosis can improve the accuracy of diagnosis, especially for patients with preoperative Ctn over 1 500 pg/ml. The superior mediastinal lymph node dissection for the primary sternotomy should include at least the superior mediastinal levels 2-4 to avoid residual lesions. The strategy of surgery needs to be cautiously performed. Although the probability of biochemical cure in sMLNM cases is low, nearly 40% of patients can still benefit from the operation at the biochemical level.

Incidence of adverse transfusion reactions in Chinese children: a meta-analysis / 中国输血杂志

【Objective】 To systematically evaluate the incidence of adverse transfusion reactions in Chinese children, so as to provide scientific basis for prevention and early intervention. 【Methods】 Literature databases such as PubMed, EMbase, The Cochrane Library, CNKI, Wanfang and VIP were searched in terms of the incidence of adverse transfusion reactions in Chinese children from January 2000 to December 2022. Two researchers extracted literature data independently according to the inclusion and exclusion criteria and conducted quality evaluation of included studies according to AHRQ quality evaluation scale. Statistical analysis was performed using Stata 14.0 software. 【Results】 A total of 870 literatures were retrieved, and 13 were included in the study, with a total of 181 274 cases with blood transfusion. Meta-analysis showed that the overall incidence of adverse transfusion reactions in Chinese children was 0.79%[95%CI (0.54%, 1.04%)]. The incidence of adverse reactions of red blood cells, platelets and plasma were 0.34%[95%CI (0.15%, 0.54%)], 2.94%[95%CI (1.60%, 4.28%)] and 0.31%[95%CI (0.19%, 0.43%)], respectively. The incidence of fever reaction and anaphylaxis reaction were 0.22%[95%CI (0.13%, 0.31%)] and 0.46%[95%CI (0.30%, 0.61%)] respectively. 【Conclusion】 The overall incidence of adverse transfusion reactions in Chinese children is low, but the incidence of adverse reactions of platelet transfusion is high, which needs further prevention and control.

Construction and anti-tumor efficiency evaluation of redox-responsive micelles for the co-delivery of IR-780 and 18β-glycyrrhetinic acid / 药学学报

Photothermal therapy (PTT) is a highly effective anti-tumor method. However, when laser radiation was used to ablate tumors, it usually triggers a series of inflammatory reactions, promoting the further development of tumors and affecting the effect of anti-tumor therapy. Therefore, it is an effective method to improve the anti-tumor effect by suppressing the inflammatory response through the precise targeted delivery of anti-inflammatory drug while realizing the photothermal treatment of tumors. To this end, the redox-responsive linker 3,3'-dithiodipropionic acid was used to bond the classic hydrophobic anti-inflammatory drug 18β-glycyrrhetinic acid (18β-GA) and the hydrophilic fragment methoxy-polyethylene glycol (mPEG-NH2) to obtain redox-responsive amphiphilic polymer PEG-DA-GA in this study. Then, photothermal agent IR-780 was encapsulated to prepare redox-responsive polymer micelle PDG/IR-780 NPs. The PDG/IR-780 NPs exhibited uniform particle size of 80.2 ± 5.3 nm and the polydispersity index (PDI) was 0.215 ± 0.079. All animal experiments followed the ethical requirements formulated by the Ethics Committee of Sichuan University. The results showed that PDG/IR-780 NPs could respond to the abundant glutathione (GSH) in tumor cells to promote the disintegration of nanoparticle and the release of 18β-GA, thus significantly improved the killing efficiency on 4T1 cells, when compared with the non-redox-responsive control PSG/IR-780 NPs. When the concentration of 18β-GA was 50 μg·mL-1, the cell viability of 4T1 cells in the PDG/IR-780 NPs group was only (19.29 ± 1.80) %, which was significantly lower than the result of in PSG/IR-780 NPs group (29.30 ± 1.37) %. The results of frozen sections of tumor tissues showed that the designed PDG NPs can promote the tumor-targeted distribution of drugs compared with the free drug group. Eventually, PDG/IR-780 NPs achieved wonderful anti-tumor efficacy on 4T1 triple-negative breast cancer model, revealing the new possibility of the combined therapy strategy of photothermal and anti-inflammatory therapy.

Umeclidinium bromide and vilanterol trifenatate in the treatment of COPD ：an overview of systematic review and meta-analysis / 中国药房

OBJECTIVE To re-eval uate the systematic review and meta-an alysis of umeclidinium bromide and vilanterol trifenatate（UMEC/VIL）in the treatment of chronic obstructive pulmonary disease （COPD），so as to provide evidence-based basis for the treatment of COPD. METHODS Retrieved from PubMed （Medline），the Cochrane library ，Embase，CNKI，CBM，VIP and Wanfang database ，etc.，the systematic review and meta-analysis of UMEC/VIL in the treatment of COPD were collected from the inception to Apr. 2021. Two reviewers independently screened the literatures and extracted the data. AMSTAR 2 scale，PRISMA statement，and GRADE evaluation system were used to evaluate the methodological quality of the included studies ，the quality of reports and the grade of outcome indexes. The efficacy and safety of UMEC/VIL in the treatment of COPD were reported. RESULTS Six systematic reviews were finally included. The results of AMSTAR 2 scale showed that 1 study was of high quality ， 2 were of medium quality and 3 were of low quality. The score of PRISMA statement was between 21.5 and 27，and the quality of the report was relatively perfect. The results of GRADE evaluation showed that more than 60％ of the 134 outcome indicators were of medium to high quality of evidence. Comparison of effectiveness and safety showed that UMEC/VIL was superior to placebo ， unilateral bronchodilator and salmeterol fluticasone in improving forced expiratory volume in one second （FEV1）trough，FEV1 peak and forced vital capacity （FVC）. In the improvement of transition dyspnea index （TDI），SGRQ and SOBDA scores ，UMEC/ VIL was better than placebo ，unilateral bronchodilator and fluticasone propionate/salme terol. The adverse reaction rate ，acute exacerbation rate ，mortality rate ，withdrawal rate ，pneumonia rate and other negative indicators of UMEC/VIL were not inferior to placebo，unilateral bronchodilator and fluticasone propionate/salme terol. CONCLUSIONS Compared with placebo and unilateral bronchodilator，UMEC/VIL can significantly improve lung function ，symptoms and quality of life ，and has non-inferior effect for negative indicators. Compared with β2 adrenoceptor agonists combined with glucocorticoid ，UMEC/VIL can improve lung function of COPD patients ，but they are similar in other aspects.

Fucoidan-functionalized activated platelet-hitchhiking micelles simultaneously track tumor cells and remodel the immunosuppressive microenvironment for efficient metastatic cancer treatment

Tumor metastasis is responsible for most mortality in cancer patients, and remains a challenge in clinical cancer treatment. Platelets can be recruited and activated by tumor cells, then adhere to circulating tumor cells (CTCs) and assist tumor cells extravasate in distant organs. Therefore, nanoparticles specially hitchhiking on activated platelets are considered to have excellent targeting ability for primary tumor, CTCs and metastasis in distant organs. However, the activated tumor-homing platelets will release transforming growth factor-β (TGF-β), which promotes tumor metastasis and forms immunosuppressive microenvironment. Therefore, a multitalent strategy is needed to balance the accurate tumor tracking and alleviate the immunosuppressive signals. In this study, a fucoidan-functionalized micelle (FD/DOX) was constructed, which could efficiently adhere to activated platelets through P-selectin. Compared with the micelle without P-selectin targeting effect, FD/DOX had increased distribution in both tumor tissue and metastasis niche, and exhibited excellent anti-tumor and anti-metastasis efficacy on 4T1 spontaneous metastasis model. In addition, due to the contribution of fucoidan, FD/DOX treatment was confirmed to inhibit the expression of TGF-β, thereby stimulating anti-tumor immune response and reversing the immunosuppressive microenvironment. The fucoidan-functionalized activated platelets-hitchhiking micelle was promising for the metastatic cancer treatment.

One case of Creutzfeldt-Jakob disease with restless leg syndrome as the first symptom and literature analysis / 中国基层医药

Objective:To analyze the clinical features and auxiliary examination results of sporadic Creutzfeldt-Jakob disease (sCJD) with restless leg syndrome (RLS) as the first symptom.Methods:The clinical features and auxiliary examination results of one case of sCJD who received treatment in Sichuan Mianyang 404 Hospital were analyzed based on relevant literature.Results:A 59-year-old woman of Han nationality who had sCJD with restless leg-like manifestation of the left lower limb for 18 days was included in this study. The patient was first treated in orthopedic department, but her symptom did not improve after treatment. Twenty days later, she was transferred to neurology department for further treatment. Her daily life and activities were not affected. Head magnetic resonance imaging, electroencephalography, cerebrospinal fluid routine examination and biochemical test results were normal. Five days later, the patient had mild left-sided ataxia, which then progressed rapidly, followed by right-sided ataxia, left-leg spasticity and adduction, involuntary movement, myoclonia, cognitive decline, akinetic mutism, repeated hyperthermia, repeated complex partial seizures. Two weeks later, head magnetic resonance imaging examination revealed hyperintense signal of the cingulate gyrus, frontal cortex and right island cortex on DWI, with cerebellar atrophy and three-phase electroencephalography wave. Four weeks later, CSF14-3-3 protein was positive, and no related genetic mutation in the prion protein gene was found. The duration from onset to death was about 8 months.Conclusion:sCJD is a common subtype of prion protein disease, and the condition can be stabilized for more than 1 month after the onset of RLS. There is no specificity in early clinical and auxiliary examinations, and neither dobutazine treatment nor neurotrophic treatment is effective. The disease progresses rapidly after 1 month, head MRI and EEG reexamination can reveal clues, and CSF14-3-3 protein can assist clinical diagnosis.

Effect of acupuncture on retinal and choroidal thickness in patients with optic atrophy / 中国针灸

OBJECTIVE@#To observe the effect of acupuncture on visual acuity, intraocular pressure, visual field, retinal and choroidal thickness on optic disc and macular area in patients with optic atrophy.@*METHODS@#A total of 33 patients with optic atrophy were treated with acupuncture. Acupuncture was given at Chengqi (ST 1), Shangjingming (Extra), Qiuhou (EX-HN 7) and Fengchi (GB 20) etc., 30 min each time, once a day, for 14 days. The visual acuity, intraocular pressure, visual field indexes (mean deviation [MD], pattern standard deviation [PSD] and visual field index [VFI]), optic disc retinal nerve fiber layer thickness, macular retinal thickness and choroidal thickness of optic disc and sub-foveal were compared before and after treatment.@*RESULTS@#Compared before treatment, the visual acuity was increased (P<0.05), the MD value was decreased (P<0.05), the thickness of nerve fiber layer on the upper temporal side of optic disc was thinner (P<0.05), and the choroidal thickness of average, nasal side and lower temporal side of optic disc was increased (P<0.05). There was significant correlation between visual field MD and retinal nerve fiber layer thickness in different quadrants before and after treatment (P<0.01).@*CONCLUSION@#Acupuncture could improve visual acuity, increase choroidal thickness in part of optic disc area in patients with optic atrophy.

A study on the rapidly non-destructive detection method of Huoxiang Zhengqi oral liquid using near infrared spectroscopy / 药学学报

Based on near infrared spectroscopy and high performance liquid chromatography, this paper established the regression relationship between near infrared spectroscopy and index component content of Huoxiang Zhengqi oral liquid, so as to realize the rapid detection of index component content based on near infrared spectroscopy. Magnolol, honokiol and hesperidin were used as the quality indexes of Huoxiang Zhengqi oral liquid. After using the first derivative and normalization pretreatment method, characteristic variables were screened by CARS, and the correction model was finally established by partial least-squares regression (PLSR) method. The method accuracy was evaluated with the external validation, and the prediction results were tested for significance. The results indicated that when the near infrared spectrum was scanned through the bottle, the model's correlation coefficients of prediction (Rp) were higher than 0.99, the root mean square errors of the prediction models (RMSEP) were all less than 0.008 4, and the relative standard errors of prediction set (RSEP) were all less than 2.83%. There was no significant difference in the predicted results between these two kinds of model. The models established in the non-destructive way have good performance and high prediction accuracy. The rapid and nondestructive way has application value in the quality control of Huoxiang Zhengqi oral liquid.

Effect of Wenshen Yangxue Prescription on Outcome of In Vitro Fertilization- embryo Transfer in Patients with Poor Ovarian Response / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of Wenshen Yangxue prescription （WSYX） on the outcome of in vitro fertilization-embryo transfer （IVF-ET） in poor ovarian responders and the safety. MethodA total of 116 eligible patients who were admitted to Beijing Obstetrics and Gynecology Hospital in June 2016-June 2019 were randomized into the experimental group and the control group with random number table method （58 in either group）. Conventional controlled ovarian hyperstimulation （COH） was directly implemented in the control group， while the experimental group was intervened with WSYX for 3 menstrual cycles before the COH. The pregnant patients were observed till childbirth and the non-pregnant patients for 12 months. Gonadotropins （Gn） dosage and the days of use were recorded. Serum levels of follicle-stimulating hormone （FSH）， basal FSH （bFSH）， basal luteinizing hormone （bLH）， and basal estrogen （bE2）， endometrial thickness， and antral follicle count （AFC） before and after treatment were measured. The serum levels of estrogen （E2）， progesterone （P）， and luteinizing hormone （LH） on the day of human chorionic gonadotropin （HCG） injection， and levels of FSH， LH， E2， testosterone （T）， and P in follicular fluid 36 h after HCG injection were determined. Number of fertilization， rate of fertilization， number of high-quality embryos， cycle cancellation rate， clinical pregnancy rate， and live birth rate were evaluated. The traditional Chinese medicine （TCM） syndrome scores before and after treatment were recorded. Liver and kidney functions were detected before and after treatment， and adverse reactions during treatment were recorded. ResultCompared with the control group， the experimental group showed the decrease in the days of Gn use and dosage of Gn （P<0.05）， endometrium thickening （P<0.05）， and increase in oocytes obtained， levels of E2 and LH on the day of HCG injection， and ovarian reserve function. Moreover， in follicular fluid 36 h after HCG injection， the reduction in level of FSH （P<0.05）， rise of levels of LH and E2 （P<0.05）， and insignificant changes in levels of T and P in the experimental group were observed as compared with those in the control group. In addition， larger number of fertilization， more available embryos， and higher rate of high-quality embryos were observed in the experimental group than in the control group （P<0.05）. The experimental group demonstrated improvement in quality of oocytes， decrease in cycle cancellation rate ， and increase in clinical pregnancy rate and live birth rate compared with the control group. The TCM syndrome score in experimental group was decreased after treatment compared with that before treatment （P<0.05）. No serious adverse reactions occurred in two groups during treatment and the safety indexes before and after treatment were all within the normal ranges. ConclusionWSYX can reduce the use duration and dosage of Gn in infertile patients receiving IVF-ET， improve the quality of oocytes， increase the rate of high-quality embryos， and improve the pregnancy outcome of IVF-ET patients.

Application of near infrared spectroscopy to predict contents of various lactones in chromatographic process of Ginkgo Folium / 中国中药杂志

This study established a method for rapid quantification of terpene lactone, bilobalide, ginkgolide C, ginkgolide A and ginkgolide B in the chromatographic process of Ginkgo Folium based on near infrared spectroscopy(NIRS). The effects of competitive adaptive reweighting sampling(CARS), random frog(RF), and synergy interval partial least squares(siPLS) on the performance of partial least squares regression(PLSR) model were compared to the reference values measured by HPLC. Among them, the correlation coefficients of prediction(Rp) of validation sets of terpene lactone, bilobalide, and ginkgolide C were all higher than 0.98, and the relative standard errors of prediction(RSEPs) were 5.87%, 6.90% and 6.63%, respectively. Aiming at ginkgolide A and ginkgolide B with relatively low content, the genetic algorithm joint extreme learning machine(GA-ELM) was used to establish the optimized quantitative analysis model. Compared with CARS-PLSR model, the CARS-GA-ELM models of ginkgolide A and ginkgolide B exhibited a reduction in RSEP from 15.65% to 8.52% and from 21.28% to 10.84%, respectively, which met the needs of quantitative ana-lysis. It has been proved that NIRS can be used for the rapid detection of various lactone components in the chromatographic process of Ginkgo Folium.

Survey on blood donation related self-efficacy and blood donation willingness with different demographic characteristics / 中国输血杂志

【Objective】 To investigate the effect of blood donation related self-efficacy on blood donation intention, in order to provide valuable reference for formulating the recruitment and service strategy for blood donors with different demographic characteristics. 【Methods】 A questionnaire was designed based on psychological self-efficacy theory, and respondents in Nanchong city were taken as the research objects. The data of demographic characteristics, blood donation related self-efficacy measurement and blood donation intention measurement of the respondents who were randomly selected by convenient sampling method were collected and analyzed by rank sum test. 【Results】 The number of previous blood donation was significantly correlated with blood donation related self-efficacy and blood donation intention, and there was a strong positive correlation between blood donation related self-efficacy and blood donation intention (r=0.618). There are significant differences in blood donation related self-efficacy or blood donation intention of respondents with different blood donation experiences (P0.05). 【Conclusion】 Blood donation intention can be increased by enhancing the blood donation related self-efficacy of respondents. We can focus on the recruitment of respondents with high self-efficacy in the areas covered by the survey during the practice of blood donor recruitment and service to achieve higher recruitment efficiency. In the meantime, special attention should also be paid to the people with relatively low self-efficacy and high-quality services should be provided t to expand blood donor team. Furthermore, blood donor recruitment and services can be appropriately expanded to the countryside as needed.

Obstetric Diseases Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

In recent years， with the change in life style， social environment， and national childbearing policy， the proportion of high-risk pregnant women has increased significantly， triggering the spectrum of obstetric diseases to constantly change， which has brought new challenges to the diagnosis and treatment of obstetrics. Traditional Chinese medicine （TCM） has been proved effective in dealing with a variety of obstetric diseases， and various treatment methods are available， which can serve as alternative means for solving refractory obstetric diseases. However， most obstetric clinicians are currently less aware of the therapeutic effects of TCM， which has significantly hindered its participation in clinical treatment. Therefore， the China Association of Chinese Medicine （CACM） organized the outstanding young obstetricians of TCM and western medicine to discuss 15 obstetric diseases responding specifically to TCM or integrated TCM and western medicine， including hyperemesis gravidarum， threatened abortion， ectopic gestation， cough during pregnancy， pregnancy-induced hypertension syndrome， maternal-fetal ABO incompatibility， postpartum hypogalactia， residual pregnancy tissue in uterine cavity， puerperal infection， pantalgia after childbirth， hematoma/undesirable healing after caesarean section， postpartum urinary retention， ileus after cesarean section， pelvic floor dysfunction， and postnatal depression. The suggestions for their treatment with TCM or integrated TCM and western medicine were also proposed， aiming to provide patients with effective and personalized treatments in clinical practice and improve the diagnosis and treatment effects of obstetric diseases， thus benefiting the public. At the same time， more obstetrical clinicians are expected to understand the therapeutic effects and advantages of TCM and draw on the strengths of both TCM and western， thereby promoting the establishment of an obstetric diagnosis and treatment system with Chinese characteristics.

Mechanism of Wenshen Yangxue Prescription Improving Endometrial Receptivity of Aged Female Mice by Regulating PI3K/Akt/FoxO3A Signaling Pathway / 中国实验方剂学杂志

Objective:To explore the effective components， targets， and possible mechanisms of Wenshen Yangxue prescription in improving endometrial receptivity of aged female mice based on network pharmacology and experimental verification. Method:Based on Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine （BATMAN-TCM） and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine， the components and targets of Wenshen Yangxue prescription were retrieved， and the targets of ovulatory dysfunctional infertility were collected from the Online Mendelian Inheritance in Man （OMIM） and GeneCards with "anovulatory sterility" and "anovulatory infertility" as keywords. The protein-protein interaction （PPI） network was constructed based on STRING and the core targets of Wenshen Yangxue prescription against ovulatory dysfunctional infertility were screened by Cytoscape， followed by Gene Ontology （GO） term enrichment and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment of the core targets in DAVID database. Then， the "medicinal-component-target-pathway" network was established and the core targets were verified by animal experiment. Result:A total of 253 components and 326 targets of Wenshen Yangxue prescription， 819 disease targets， and 74 common targets were screened out. The common targets were mainly involved in the biological processes such as positive regulation of nitric oxide biosynthetic process， positive regulation of cell proliferation， response to estradiol， aging， response to oxidative stress， and angiogenesis. The GO term of response to oxidative stress and five of the top 20 KEGG pathways were analyzed. According to the "medicinal-component-target-biological process/pathway" network， 41 chemical components in 20 medicinals participated in hypoxia inducible factor-1 （HIF-1） signaling pathway， tumor necrosis factor （TNF） signaling pathway， forkhead box O （FOXO） signaling pathway， Toll-like receptor （TLR） signal pathway， and phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway by affecting 35 targets. The results of animal experiment showed that the prescription could increase the expression of PI3K， phosphorylated PI3K （p-PI3K）， Akt， phosphorylated Akt （p-Akt）， forkhead box O3A （FoxO3A）， and phosphorylated FoxO3A （p-FoxO3A） in uterus of aged female ICR mice. Conclusion:Wenshen Yangxue prescription interferes with oxidative stress and PI3K/Akt/FoxO3A signaling pathway by influencing Akt1， dual oxidase 2 （DUOX2）， epidermal growth factor receptor （EGFR）， heme oxygenase-1 （HMOX1）， myeloperoxidase （MPO）， and other targets， thereby improving endometrial receptivity of aged female mice.

Machine Learning Models for Early Prediction of Vascular Cognitive Impairment / 中国康复理论与实践

Objective:To explore the predictive performance of machine learning model based on vascular risk factors in early prediction of vascular cognitive impairment. Methods:From April to September, 2020, 70 subjects were enrolled and collected information of the demographics and vascular risk factors. They were assessed with Montreal Cognitive Assessment (MoCA), and then divided into normal group, vascular mild cognitive impairment (VaMCI) group and dementia group. The differences of vascular risk factors among the three groups were detected with one-way ANOVA, and the significant factors were selected to establish predictive models with support vector machine (SVM) and extreme learning machine (ELM). The predictive performance of two models was compared with Receiver Operating Characteristic Curve. Results:There were 32 cases in the normal group, 23 in VaMCI group and 15 in dementia group. Systolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein and blood uric acid were significantly different among the three groups (F > 3.318, P < 0.05). The area under curve was the most (0.911) in SVM model predicting for VaMCI (P < 0.01), and the predictive efficacy was better for SVM model. Conclusion:SVM predictive model based on vascular risk factors may be more effective for predicting VaMCI.

Emerging nanomedicine-based therapeutics for hematogenous metastatic cascade inhibition: Interfering with the crosstalk between "seed and soil"

Despite considerable progresses in cancer treatment, tumor metastasis is still a thorny issue, which leads to majority of cancer-related deaths. In hematogenous metastasis, the concept of "seed and soil" suggests that the crosstalk between cancer cells (seeds) and premetastatic niche (soil) facilitates tumor metastasis. Considerable efforts have been dedicated to inhibit the tumor metastatic cascade, which is a highly complicated process involving various pathways and biological events. Nonetheless, satisfactory therapeutic outcomes are rarely observed, since it is a great challenge to thwart this multi-phase process. Recent advances in nanotechnology-based drug delivery systems have shown great potential in the field of anti-metastasis, especially compared with conventional treatment methods, which are limited by serious side effects and poor efficacy. In this review, we summarized various factors involved in each phase of the metastatic cascade ranging from the metastasis initiation to colonization. Then we reviewed current approaches of targeting these factors to stifle the metastatic cascade, including modulating primary tumor microenvironment, targeting circulating tumor cells, regulating premetastatic niche and eliminating established metastasis. Additionally, we highlighted the multi-phase targeted drug delivery systems, which hold a better chance to inhibit metastasis. Besides, we demonstrated the limitation and future perspectives of nanomedicine-based anti-metastasis strategies.

Hepatic protective effects of Shenling Baizhu powder, a herbal compound, against inflammatory damage via TLR4/NLRP3 signalling pathway in rats with nonalcoholic fatty liver disease / 中西医结合学报

OBJECTIVE@#High-fat diet (HFD) and inflammation are two key contributors to nonalcoholic fatty liver disease (NAFLD). Shenling Baizhu powder (SLBZP), a classical herbal compound, has been successfully used to alleviate NAFLD. However, its specific mechanisms are not fully understood. In this study, we assessed the anti-NAFLD effect of SLBZP in vivo.@*METHODS@#Rats were fed an HFD with or without SLBZP or with probiotics. At the end of week 16, an echo magnetic resonance imaging (EchoMRI) body composition analyser was used to quantitatively analyse body composition; a micro-computed tomography (micro-CT) imaging system was used to evaluate whole body and liver fat; and the Moor full-field laser perfusion imager 2 was used to assess liver microcirculation, after which, all rats were sacrificed. Then, biochemical indicators in the blood and the ultrastructure of rat livers were evaluated. Protein expression related to the liver Toll-like receptor 4 (TLR4)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) signalling pathway was assessed using Western blot analysis. Further, high-throughput screening of 29 related inflammatory factors in liver tissue was performed using a cytokine array.@*RESULTS@#SLBZP supplementation reduced body weight, serum free fatty acid, and insulin resistance index (P < 0.05). It also ameliorated liver microcirculation and ultrastructural abnormalities. EchoMRI and micro-CT quantitative analyses showed that treatment with SLBZP reduced fat mass and visceral fat (P < 0.05 and P < 0.01, respectively). In addition, SLBZP decreased the expression of lipopolysaccharide (LPS)-activated TLR4/NLRP3 signalling pathway-related proteins and altered the expression levels of some inflammatory cytokines in liver tissues.@*CONCLUSION@#SLBZP can inhibit NLRP3 inflammasome activation and interleukin-1β release by suppressing LPS-induced TLR4 expression in rats with HFD-induced NAFLD. Thus, SLBZP may be beneficial for the prevention and treatment of inflammatory damage and associated diseases.

Nucleocytoplasmic transport and neurodegenerative diseases / 药学学报

Nucleocytoplasmic transport is the basic cellular activity of eukaryotic cells, which plays a role in cell physiological and pathological processes. A large amount of evidences indicate that impaired nucleocytoplasmic trafficking has emerged as a mechanism contributing to the pathology of neurodegenerative diseases. The regulation of nucleocytoplasmic transport is crucial to elucidate the pathogenesis and intervention in the neurodegenerative diseases. This article summarizes the evidences in disturbed nucleocytoplasmic transport of neurodegenerative diseases in the past two decades, further explores the directions and provides a theoretical basis for the pathogenesis and drug targets in neurodegenerative diseases.

Content determination of five flavonoids in Tibetan medicine Rhododendron anthopogonoides by quantitative analysis of multi-components by single marker (QAMS) / 中国中药杂志

To establish a quantitative analysis of multi-components by single marker(QAMS) method for five flavonoids in Rhododendron anthopogonoides and verify its feasibility and applicability in the medicinal materials of R. anthopogonoides. With hyperoside as the internal reference, relative correction factors(RCF) of rutin, quercetin, quercitrin and kaempferol were established by high-performance liquid chromatography(HPLC) analysis. RCFs were used to calculate the content of each component, system durability and relative retention time. Simultaneously, QAMS and external standard method(ESM) were used to determine the content of five flavonoids in 12 batches of R. anthopogonoides from different origins. The results were statistically analyzed to verify the accuracy and feasibility. The fingerprints and cluster analysis data of R. anthopogonoides analyzed and discussed differences among the batches. According to the results, the RCFs of rutin, quercetin, quercetin and kaempferol in R. anthopogonoides were 1.242 6, 0.990 5, 0.535 0, and 0.781 3, respectively. The RCFs represented a good reproducibility under different experimental conditions. Besides, there was no significant difference between QAMS and ESM. Besides, the fingerprint and cluster analysis data showed the consistency between the classification and with the origin distribution of the herbs. In conclusion, the QAMS method shows a good stability and accuracy in the quality control of R. anthopogonoides.

Research progress of continuous manufacturing and process knowledge system of traditional Chinese medicine / 中国中药杂志

In the past few years, continuous manufacturing(CM) has been put forward by the FDA. Pharmaceutical enterprises are encouraged to promote the implementation of CM, which has become a hot research direction of pharmaceutical technology. In February 2019, the FDA issued a draft guideline for the implementation of CM, which greatly promoted the development of CM and provided reference for continuous manufacturing of traditional Chinese medicine(TCM). The production process of TCM is a complex system. With the innovation of production equipment and the promotion of automation and informatization of TCM production, the exis-ting policies, regulations and traditional production control capacity are difficult to meet the market demand for high-quality TCM pro-ducts. In this paper, we reviewed the new technologies and methods of quality control in accordance with the characteristics of TCM production by referring to modern manufacturing technology, information technology and quality control technology. Based on the "QbD" theory and "PAT" technology, process knowledge system(PKS), an advanced control strategy, was proposed to provide a reference for the implementation of CM in TCM production.

Clinicopathological features of dedifferentiated liposarcomas with meningothelial-like whorls: report of six cases / 中华病理学杂志

To investigate the histopathologic, immunohistochemical, molecular genetic characteristics of dedifferentiated liposarcomas with meningothelial-like whorls(DDLMW). Six cases of DDLMW diagnosed at Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University) from March 2012 to August 2018 were enrolled. The cases were analyzed by routine HE staining, immunohistochemistry(MDM2, CDK4 and p16) and fluorescent in-situ hybridization(FISH) on MDM2 gene. Related literatures were also reviewed. Three of the 6 patients were male.The patient ages ranged from 40 to 77 years (mean, 58 years). Four tumors occurred in the retroperitoneum and two in the mediastinum. Histologically, the tumors showed, in addition to foci of well-differentied liposarcoma, characteristic, scattered meningothelial-like concentrical whorls. The whorls were composed of tightly, concentrically arranged, spindle to ovoid cells with mild to mederate cytological atypia. Metaplastic bone was present within or in their immediate vicinity in four case. The tumors cell also showed strong and diffuse immunoreactivity to MDM2, CDK4 and p16, but no immunoreactivity to S-100 protein, SMA, SOX10, EMA, CD21, CD23 or CD35. The Ki-67 labeling indexes were low, while FISH showed high levels of MDM2 amplification in all cases. DDLMW is a rare morphologic variant of dedifferentiated liposarcoma. The whorls in DDLMW do not represent perineurial or follicular dendritic differentiation. Recognition and familiarity with its existence, as well as combined application of immunohistochemical staining and MDM FISH, are important to avoid confusion with other lesions.