Effect of traditional Chinese medicine in attenuating chronic kidney disease and its complications by regulating gut microbiota-derived metabolite trimethylamine N-oxide: a review / 中国中药杂志

Trimethylamine N-oxide(TMAO), a metabolite of gut microbiota, is closely associated with chronic kidney disease(CKD). It can aggravate the kidney injury and promote the occurrence of complications of CKD mainly by inducing renal fibroblast activation, vascular endothelial inflammation, macrophage foaming, platelet hyperreactivity, and inhibition of reverse cholesterol transport. Thus it is of great significance for clinical treatment of CKD to regulate circulating TMAO and alleviate its induced body damage. Currently, therapeutic strategies for TMAO regulation include dietary structure adjustment, lifestyle intervention, intestinal microflora regulation, and inhibition of intestinal trimethylamine synthesis and liver trimethylamine oxidation. Chinese medicinal herbs have the clinical advantage of multi-component and multi-target effects, and application of traditional Chinese medicine(TCM) to synergistically regulating TMAO and improving CKD via multiple pathways has broad prospects. This study systematically reviewed the clinical relevance and mechanism of TMAO in aggravating CKD renal function deterioration and complication progression. In addition, the effect and mechanism of TCM in improving TMAO-induced kidney injury, cardiovascular disease, hyperlipidemia, thrombosis and osteoporosis were summarized. The results provided a theoretical basis for TCM in attenuating gut microbiota-derived metabolite TMAO and improving CKD, as well as a basis and direction for in-depth clinical development and mechanism research in the future.

Evaluation of the effect of comprehensive prevention and management of diabetes mellitus of two cross-sectional surveys based on community population / 中华预防医学杂志

To investigate the prevalence of diabetes mellitus (DM) among residents in Chongchuan district, Nantong city in 2012 and 2018, and evaluate the effectiveness of community comprehensive management of DM. Based on the data of 17 780 and 13 382 residents in the cross-sectional surveys of the " National Demonstration Area for Comprehensive Prevention and Control of Chronic Diseases " project in Chongchuan District of Nantong City, Jiangsu Province in 2012 and 2018, 4 583 and 3 996 DM-related information were obtained. The population of Jiangsu Province in 2012 and 2018 was used as the reference for standardization. The rates of prevalence and management (including awareness, treatment, treatment of patients who knew their diabetic situation, control and control of patients under treatment) of DM in the two surveys were compared using chi-square test. The results showed that in 2012 and 2018, the prevalence rates of DM were 12.0% and 15.7% (χ²=24.25, P<0.05), and the standardized rates were 10.1% and 10.8% (χ²=1.05, P=0.306). The incidence rates were 5.7% and 2.3%, respectively (χ²=55.60, P<0.05). The standardized prevalence rates in the two surveys were 9.7% and 11.6% for males (χ²=3.66, P=0.056) and 10.5% and 9.9% for females (χ²=0.50, P=0.481), 7.2% and 6.5% (χ²=0.85, P=0.357) for people aged 18-59 years old and 20.6% and 21.9% (χ²=0.91, P=0.339) for people aged 60 years and over, respectively. The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, control, and control of patients under treatment in 2018 were 84.4%, 80.3%, 95.2%, 58.4%, and 70.2%, respectively, higher than 47.2%, 23.4%, 44.8%, 30.4% and 59.4% in 2012 (χ²=183.33, χ²=380.65, χ²=282.99, χ²=93.24, χ²=6.22, all P<0.05). Among men, the standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control in 2018 were 85.8%, 78.8%, 91.8% and 62.7%, higher than 50.5%, 37.5%, 72.3% and 32.6% in 2012 (χ²=78.40, χ²=96.17, χ²=27.55, χ²=48.96, all P<0.05). Similarly, the standardized management rates in 2018 were 83.0%, 81.7%, 98.5%, 54.1% and 65.1%, higher than 44.0%, 10.0%, 18.3%, 28.2% and 48.8% in 2012 among women (χ²=105.52, χ²=326.36, χ²=317.22, χ²=43.34, χ²=3.87, all P<0.05). The standardized rates of awareness, treatment, treatment of patients who knew their diabetic situation, and control of people aged 18-59 and 60 years and over were 82.9%, 79.7%, 96.1%, 55.0% and 88.0%, 81.8%, 93.0% and 67.2%, higher than 42.6%, 19.8%, 42.2%, 27.5% and 63.9%, 36.8%, 53.9%, 40.8% in 2012 (χ²=44.51, χ²=102.17, χ²=57.78, χ²=21.65, all P<0.05; χ²=71.18, χ²=181.55, χ²=146.26, χ²=59.23, all P<0.05). The comprehensive prevention and control system of chronic diseases, which comprehensively covered the life of community residents, had good management effect on DM, and effectively promoted health education and health promotion.

Mechanism of Mayuan tongbian zhitong decoction on improving slow-transmission constipation in rats by regulating AMPK/eNOS signaling pathway / 中国药房

OBJECTIVE To investigate the mechanism of Mayuan tongbian zhitong decoction on improving slow-transmission constipation（STC）in rats by regulating AMP activated protein kinase （AMPK）/endothelial nitric oxide synthase （eNOS）signaling pathway. METHODS The rats were randomly divided into blank group ，model group ，Mayuan tongbian zhitong decoction low-dose，medium-dose and high-dose groups （6，12，18 mg/kg），with 10 rats in each group. Except for blank group ，other groups were given Compound diphenoxylate suspension to induce STC model. After modeling ，blank group and model group were given normal saline intragastrically ，and Mayuan tongbian zhitong decoction groups were given relevant medicine intragastrically ， once a day ，for consecutive 2 weeks. The number of feces and water content of feces in each group were observed before and after treatment；the carbon powder propulsion rate of rats in each group was calculated ；the pathological structure of colon in each group was observed ；the levels of nitric oxide （NO）and nitric oxide synthase （NOS）in colon tissues of rats in each group were detected；the expressions of AMPK ，eNOS，mammalian target of rapamycin （mTOR），tuberous sclerosis complex 1（Tsc-1）， Tsc-2 and eukaryotic promoter 4E binding protein （4ebp）were also detected. The active ingredients of Cannabis sativa ，Citrus aurantium and Rehmannia glutinosa were screened from Mayuan tongbian zhitong decoction. The active ingredients with high Degree value were docked with AMPK and eNOS ，to verify the interaction. RESULTS Compared with before treatment ，the number and water content of feces were increased significantly in Mayuan tongbian zhitong decoction groups （P＜0.05）. Compared with blank group ，carbon powder propulsion rate of model group was decreased significantly （P＜0.05）； colonic structure was disordered ，and a large number of inflammatory cells were seen in submucosa ；the levels of NO and NOS in colon tissue as well as the protein expressions of AMPK ，eNOS，mTOR，Tsc-1，Tsc-2 and 4ebp were increased significantly （P＜0.05）. Compared with model group ，above indexes of Mayuan tongbian zhitong decoction groups （except for NOS in low-dose group ）were reserved significantly （P＜0.05）. In the molecular docking experiment ，the active components with the highest Degree values in C. sativa ，C. aurantium and R. glutinosa were（Z）-3-（4-hydroxy-3-methoxy-phenyl）-N-[2-（4-hydroxyphenyl）ethyl] acrylamide，nobiletin and stigmasterol. The binding energies of AMPK with these three components were －5.15，－4.61 and －4.83 kJ/mol，the binding energies of eNOS with these three components were －6.11，－5.40 and －5.91 kJ/mol. The conformations of these three compounds with AMPK and eNOS were stable and their binding activities were high. CONCLUSIONS Mayuan tongbian zhitong decoction can improve the constipation symptoms and intestinal function in STC model rats ，and its specific mechanism may be related to the inhibition of AMPK/eNOS signaling pathway.

The phenotypic and genetic spectrum of colony-stimulating factor 1 receptor gene-related leukoencephalopathy in China / 中华神经科杂志

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

A Single-cell Transcriptome Atlas of Cashmere Goat Hair Follicle Morphogenesis / 基因组蛋白质组与生物信息学报·英文版

Cashmere, also known as soft gold, is produced from the secondary hair follicles (SHFs) of cashmere goats. The number of SHFs determines the yield and quality of cashmere; therefore, it is of interest to investigate the transcriptional profiles present during cashmere goat hair follicle development. However, mechanisms underlying this development process remain largely unexplored, and studies regarding hair follicle development mostly use a murine research model. In this study, to provide a comprehensive understanding of cellular heterogeneity and cell fate decisions, single-cell RNA sequencing was performed on 19,705 single cells of the dorsal skin from cashmere goat fetuses at induction (embryonic day 60; E60), organogenesis (E90), and cytodifferentiation (E120) stages. For the first time, unsupervised clustering analysis identified 16 cell clusters, and their corresponding cell types were also characterized. Based on lineage inference, a detailed molecular landscape was revealed along the dermal and epidermal cell lineage developmental pathways. Notably, our current data also confirmed the heterogeneity of dermal papillae from different hair follicle types, which was further validated by immunofluorescence analysis. The current study identifies different biomarkers during cashmere goat hair follicle development and has implications for cashmere goat breeding in the future.

Anatomical Location of Cricopharyngeus in Patients with Swallowing Disorder / 中国康复理论与实践

Objective:To further clarify the location of cricopharyngeus in human body. Methods:From September, 2018 to December, 2019, 19 inpatients with swallowing disorders received video fluoroscopic swallowing study (VFSS).The videoes were used to measure the position of cricopharyngeus with Uniweb 4.0 software. Water model simulating the structure of an adult's neck was established to restore the real measurement scene, and obtain the scale ratio between the actual measurement and the computer measurement, then obtain the accurate actual position of the cricopharyngeus. Six adult specimens were dissected. The intersection point of the intended treatment plane and the long axis of cricopharyngeus was taken as the origin, the horizontal axis as X axis, and the sagittal axis as Y axis, to locate the position of cricopharyngeus precisely. Results:Cricopharyngeus was closest to the sixth cervical vertebra. The scaling ratio of the actual measurement obtained from the water model to the computer measurement was about 1∶1.340. The intended treatment plane was closest to the upper edge of the sixth cervical vertebra; on lateral edge of thyroid, cricopharyngeus was (33.47±2.21) mm deep to epidermis, with the angle of (43.37±1.34)° to sagittal axis; and it was (34.59±1.29) mm and (46.32±0.93)° on medial edge of internal jugular vein. Conclusion:The the accurate location of cricopharyngeus in human body has been measured, which can help for the rehabilitation for cricopharyngeal dysfunction.

Predictive value of serum histone deacetylase 3 on major adverse cardiovascular events in patients with stable coronary artery disease after percutaneous coronary intervention / 中国医师进修杂志

Objective:To investigate the predictive value of serum histone deacetylase 3(HDAC3) on major adverse cardiovascular events (MACE) in patients with stable coronary artery disease after percutaneous coronary intervention (PCI).Methods:Eighty patients with stable coronary artery disease who underwent PCI in Jinshan Branch of Shanghai Sixth People′s Hospital from October 2017 to October 2018 were selected as the research subjects, which were divided into the MACE group (26 cases) and non-MACE group (54 cases) according to the occurrence of MACE. The clinical data, blood lipid index, HDAC3, C-reactive protein(CRP) and other indicators of the patients between two groups were compared, independent risk factors for MACE after PCI were analyzed by Logistic regression analysis, and the predictive value of various indicators on MACE were analyzed by receiver operating characteristic(ROC) curve.Results:There were no statistical differences between the two groups in general information such as gender, age, body mass index (BMI), smoking history, drinking history, history of heart failure, hypertension, hyperlipidemia, diabetes and vascular lesion count ( P>0.05). The Gensini scores in the MACE group was significantly higher than that in the non-MACE group [(18.47 ± 3.23) vs. (14.46 ± 3.62)]( P<0.05). There were no statistical differences in total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterin(LDL-C), high density lipoprotein cholesterin (HDL-C) levels between the two groups ( P>0.05). The levels of HDAC3 and CRP in the MACE group were significantly higher than those in the non-MACE group [(3.93 ± 0.50) mg/L vs. (2.92 ± 0.56) mg/L, (22.06 ± 4.56) mg/L vs. (17.56 ± 3.28) mg/L] ( P<0.05). Logistic multivariate regression analysis showed that HDAC3, CRP and Gensini scores were independent risk factors for MACE in patients with stable coronary artery disease after PCI ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum HDAC3,CRP and Gensini scores predicted MACE in patient with stable coronary artery disease after PCI were 0.924, 0.785, 0.803. The diagnostic efficacy of serum HDAC3 was significantly higher than that of CRP and Gensini scores ( Z=2.019, 2.147, P<0.05). Conclusions:The up-regulation of serum HDAC3 expression has correlation with MACE in patients with stable coronary artery disease after PCI, which can be used as a predictor of MACE.

Screening of G-quadruplex ligands from Macleaya cordata extract by contrast ultrafiltration with liquid chromatography-mass spectrometry and molecular docking / 中国中药杂志

G-quadruplex DNA has become an important target for tumor therapy and anti-tumor development. Modern pharmacology has proved that Macleaya cordata has anti-inflammatory, antibacterial, anti-tumor and other pharmacological effects. Affinity ultrafiltration method can screen active ingredients from compounds rapidly, but G-quadruplex DNA ligands are difficult to dissociate, which is a key step in conventional ultrafiltration method. In this paper, the filtrates after ultrafiltration were determined by HPLC-MS in substitution. The peaks with 20% reduction of MS response from the incubation vs control were considered to be ligand components to G-quadruplex. Two of the peaks with the relative abundance above 30% were identified as sanguinarine(SAN) and chelerine(CHE). Their circular dichroism conformations further proved that SAN and CHE are active ligands of HT4. In addition, another two gradients with high relative abundance were identified as protopine(PRO) and allpcryprotopine(ALL). The binding rate of SAN, CHE, PRO and ALL was calculated according to the HPLC-MS results, and the results showed a consistency with that of the molecular docking method. The proposed method can be used to screen active components from mixture.

Advances in quality research of Cinnamomum cassia / 中国中药杂志

Cinnamomum cassis is one of the commonly used traditional Chinese medicines in China. Its genuine producing areas distribute in Guangdong and Guangxi provinces. As an important edible herb and export variety of China, the quality control and internationalization of quality standards of C. cassis is extremely significant. In the recent years, with the development of the cinnamon industry, relevant academic research and the upgrade of the international standards, it is necessary to summarize the quality-related progress of C. cassis. In the present review, the germplasm resources, specific quality marker(Q-marker) and quality standards of C. cassis were summarized on the basis of published research during the last 10 years.

Establishing the Blood Donor Deferral Criterion in TP ELISA Test / 中国实验血液学杂志

OBJECTIVE@#To Establish the shielding threshold value of TP antibody ELISA for unpaid blood donors, so as to shield true positive blood donors from returning to team management.@*METHODS@#The real serological status of 517 samples with anti-TP ELISA reactivity was determined by confirmation test of Treponema pallidum particle agglutination (TPPA). The shielding threshold of TP antibody was preliminarily determined by using 99% specificity of ROC and 95% positive predictive value of percentile method, respectively. 283 TP antibody reactivity specimens routinely tested in our laboratory were selected to determine the applicability of the initial shielding values obtained by the two methods, and finally to determine the shielding threshold values of TP antibody donors.@*RESULTS@#The specific S/CO values of reagent A 99% were 13.33-16.18, that of reagent B 99% was 6.34, that of reagent B 99% was 13.17-19.85, and that of 95% was 6.62. Empirical evidence: 99% specific threshold shielding true positive rates of reagents A and B were 100%, 95% positive expected value shielding true positive rates were 98.4%, 99%. Final determination of 99% specific shielding threshold as a low value of blood donors shielding threshold. The shielding limits of reagent A and B were 13.33 and 13.17.@*CONCLUSION@#The shielding threshold of TP antibody ELISA for blood donors established in this study can help to reduce the number of blood donors returning to team management.

Analysis of PDHA1 gene variant in a patient with pyruvate dehydrogenase E1alpha deficiency and pyramidal tract involvement / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a patient with episodic ataxia and pyramidal tract signs.@*METHODS@#The patient was subjected to high-throughput sequencing, Sanger sequencing and analysis of dynamic variant site associated with spinocerebellar ataxias (SCA).@*RESULTS@#The patient was an adolescent male presenting with episodic ataxia, bilateral knee hyper-reflexia and ankle clonus. By genetic testing, he was found to harbor a c.1159-1162dupAAGT variant of PDHA1 gene. The same variant was not found in his parents and elder sister. No abnormalities were found by SCA dynamic variant screening. The patient was diagnosed as pyruvate dehydrogenase E1alpha deficiency due to variant of the PDHA1 gene.@*CONCLUSION@#The de novo c.1159-1162dupAAGT variant of the PDHA1 gene probably underlies the disease in the proband. Patients with pyruvate dehydrogenase E1alpha deficiency have complex phenotypes and very few have pyramidal tract involvement, which may be attributed to abnormal early neuronal development.

Changes of HPLC Fingerprint and Main Flavonoids Content of Aurantii Fructus Before and After Processing / 中国实验方剂学杂志

Objective::To establish HPLC fingerprints of Aurantii Fructus and its processed products, and to quantitatively analyze the contents of four flavonoids in these products. Method::HPLC was employed with Inertsil ODS-3 C18 column (4.6 mm×250 mm, 5 μm), the mobile phase of acetonitrile-0.1%phosphoric acid aqueous solution for gradient elution, the detection wavelength of 283 nm, and the flow rate of 1.0 mL·min-1. HPLC fingerprints of raw products, stir-fried bran products and processing products of Aurantii Fructus were established. Similarity evaluation and cluster analysis were used to analyze the chromatographic data. At the same time, the contents of narirutin, naringin, hesperidin and neohesperidin were determined. Result::HPLC fingerprints of Aurantii Fructus and its processed products were established, taking naringin as the reference peak, 8, 15, 11 common peaks were demarcated for raw products, stir-fried bran products, processing products, respectively, the similarities of fingerprints were >0.95.Contents of the above four flavonoids in raw products were 0.574 7%, 5.986 3%, 0.302 2%and 3.574 7%, respectively. After processing, the contents of these four components in stir-fried bran products turned into 0.948 4%, 5.103 4%, 0.549 3%and 3.533 7%, their contents in processing products turned into 0.605 3%, 4.762 3%, 0.404 7%and 3.264 9%, respectively. Conclusion::The HPLC fingerprint of Aurantii Fructus changes significantly before and after processing. The contents of four flavonoids change to a certain extent before and after processing. The order of contents of narirutin and hesperidin in samples was stir-fried bran products>processing products>raw products, while the order of contents of naringin and neohesperidin was raw products>stir-fried bran products>processing products.

Effects of SSRI antidepressant sertraline on ocular surface function in patients with postpartum depression / 中国临床药理学与治疗学

AIM: To investigate the effect of SSRI antidepressant sertraline on ocular surface function in patients with postpartum depression.METHODS: This was a prospective case-control study. Forty-three patients diagnosed as postpartum depression receiving sertraline for the first time were investigated with the HAMD, OSDI, TBUT, SIT, FL, tear osmolarity and IL-6, MMP-9 before medication and 2 months after medication. The changes of dry eye indexes before and after medication were compared.RESULTS:After 2 months of medication, HAMD score was significantly decreased, with statistically significant differences (P0.05). After 2 months of medication, OSDI score increased, TBUT time shortened significantly, tear secretion decreased, FL score increased, tear osmolarity increased. The differences were statistically significant (P0.05), which indicated that tear osmolarity, tear inflammatory factor and tear metalloproteinase expression level increased when dry eye occurred. CONCLUSION:Sertraline can effectively relieve and cure postpartum depression, but long-term administration can cause damage to ocular surface function, leading to an increase in the incidence of dry eye.

Dosimetric comparison of target-segmented plan versus conventional IMRT plan for post-mastectomy left-sided breast cancer patients / 中华放射医学与防护杂志

Objective@#To compare the dosimetric differences among Target-Segmented Plan (TSP), Non-TSP, and conventional static 8-field intensity modulated radiation therapy (8F-IMRT) plan for post-mastectomy irradiation of left-sided breast cancer patients.@*Methods@#This study enrolled thirty consecutive breast cancer patients who underwent radical mastectomy and treated with post-op radiation in Department of Radiation Oncology, Renmin Hospital of Wuhan University from June 2017 to November 2018.The clinical target volume (CTV) included the ipsilateral chest wall, supra/infra-clavicular, high-risk partial axillary in high risk, and internal mammary nodes (IMN). The organs at risk (OARs) near the targets, including ipsilateral lung, heart, contralateral breast, ipsilateral humeral head and spinal cord, were contoured as well. The maximum distance of PTV′s tangent to the outermost side of the affected lung was more than 2 cm. Depending on the maximum distance, the patients were classified into three groups: A(<3 cm), B(3~4 cm) and C(>4 cm), respectively. Three types of treatment plans (TSP, Non-TSP and 8F-IMRT) were created for each patient using the Eclipse treatment planning system with the same dose optimization objective . The dose-volume histograms were compared for the PTVs and OARs.@*Results@#All plans achieved the intended dose criteria.The D98% of TSP was lower than that of Non-TSP and 8F-IMRT (Z=-3.294, -3.266, P<0.05). However, the homogeneity index (HI) and conformal index (CI) of the three plans had no statistically significant difference among the three plans (P>0.05). Non-TSP required more Monitor Units (MUs)than the other two plans (Z=-3.04, -2.669, P<0.05). The Dmean of TSP was higher than that of 8F-IMRT (Z=-3.181, P<0.05). Compared with Non-TSP and 8F-IMRT plans, TSP significantly reduced V5 Gy, V10 Gy, V20 Gy and Dmeanof ipsilateral lung and heart in all patients (lung: V5 Gy: Z=-3.408, -3.408; V10 Gy: Z=-3.408, -3.408; V20 Gy: Z=-3.408, -3.124; Dmean: Z=-3.408, -3.408, P<0.05; heart: V5 Gy: Z=-3.408, -3.408; V10 Gy: Z=-3.408, -3.408; V20 Gy: Z=-2.499, -3.067; Dmean: Z=-3.408, -3.408, P<0.05). The Dmean of contralateral breast in Non-TSP was higher than that in TSP and 8F-IMRT (Z=-2.954, -2.215, P<0.05), and the Dmaxhas no significant difference in (P>0.05). There was no significant difference in spinal cord Dmax among the three plans, but the Dmean of humeral head in 8F-IMRT was higher than that in TSP and Non-TSP (Z=-3.01, -2.442, P<0.05). In the three groups, the mean amplitude of difference comparing Non-TSP and 8F-IMRT with TSP in ipsilateral lung(V5 Gy, V10 Gy, V20 Gy) and heart(V5 Gy, V10 Gy, Dmean) satisfied the relation: D(N-T, A)<D(N-T, B) <D(N-T, C)和D(8F-T, A)<D(8F-T, B) <D(8F-T, C).@*Conclusions@#For post-mastectomy left-sided breast cancer patients, TSP is not only dosimetrically feasible as Non-TSP and 8F-IMRT treatment techniques, but also could effectively reduce the irradiation volume of the ipsilateral lung and heart in the low dose area with minimum adverse dosimetric impact on the treatment targets and other OARs.The advantage of TSP is more prominent with increasing curvature of the clinic target volume.

Study on pharmacodynamic material basis of Naomaitong to protect neuronal cells based on PK-PD model / 中国中药杂志

The PK-PD correlation models by using pharmacodynamics and pharmacokinetics were applied to study the material basis of Naomaitong,a clinical empirical prescription for the treatment of cerebral apoplexy,in inhibiting the death of PC12 nerve cells induced by Na_2S_2O_4 and Glu. In this experiment,PC12 cell death models induced by Na_2S_2O_4 and Glu were established respectively.With LDH lateral leakage and NO content as pharmacodynamic indexes,PK-PD model was established by SVM algorithm to evaluate the effective components of Naomaitong in inhibiting neural cell death. The results showed that the positive correlation of emodin methyl ether-8-O-β-D-glucopyranoside,aloe emodin,chrysophanol,rhein,emodin,ginsenoside Rg1,ginsenoside Rc,3'-methoxypuerarin and ligustilide was significant,obviously improving the LDH release and NO content. The results indicated that the contribution of Radix Puerariae Lobatae Radix and Rhei Radix et Rhizoma in Naomaitong could protect the nerve cell death induced by Na_2S_2O_4 and Glu respectively. PK-PD model was used to screen the neuroprotective components in Naomaitong,revealing the possible pharmacodynamic material basis of Naomaitong in the treatment of cerebral ischemia injury.

Study on genotype-associated HPV infection in cervical lesions / 中华疾病控制杂志

Objective To explore the association of genotypes of human papillomavirus (HPV) with cervicitis, cervical intraepithelial neoplasia (CIN) and carcinoma in situ of cervix. Methods A total of 464 patients with cervical biology admitted to Hefei women and child health care hospital from October, 2014 to October, 2015 were selected. Among them, there were 242 cases of cervicitis, 222 cases of CIN (76 of group Ⅰ, 71 of group Ⅱ, and 66 of group Ⅲ), and 9 cases of cervical cancer. Hybrid chip technology was used to detect cervical secretions of patients, and 21 kinds of HPV DNA were typed according to histopathological biopsy. Results The HPV infection was found in 464 patients with cervical lesions. Among them, 354 cases (76.3%) had HPV infection with 232 cases (65.5%) of single HPV infection and 122 cases (34.5%) of multiple infections included. The rate of HPV infection was 64.9% in the group of cervicitis, while the rate was 86.8% in group I of CIN and in group II of CIN, the rate of HPV infection was 87.3%. Surprisingly, the HPV infection rate in group III of CIN was as high as 90.9%. The infection rate of HPV in the patients with CIN was significantly higher than those with cervicitis (P<0.001). All patients with cervical cancer were infected with HPV. Conclusions Persistent infection of high-risk HPV subtypes increases the hazard of cervical tumor and CIN. Therefore, genotyping of HPV DNA is helpful for screening and prediction of cervical cancer.

Relationship of atrial fibrillation with hip fractures caused by falls in the elderly / 中华老年医学杂志

Objective To explore the relationship between atrial fibrillation and hip fractures caused by falls in the elderly.Methods All patients aged 65 years or older who underwent surgical treatment for hip fractures caused by falls in our department from January 2015 to December 2017 were enrolled.The relationships of atrial fibrillation as well as chronic medical history with hip fractures were retrospectively analyzed.The control group was matched 1 to 1 by age,sex,and admission time.Chi-square test and Logistic regression analysis were used to calculate the odds ratio (ORvalue) of fractures in patients with atrial fibrillation.Results There was no significant difference in the history of smoking,drinking,diabetes,coronary heart disease,heart failure,chronic kidney disease,chronic obstructive pulmonary disease(COPD),and Parkinson's disease between the two groups.A total of 37 patients had a history of atrial fibrillation in the fracture group,compared to 18 patients with atrial fibrillation in the control group.The incidence of atrial fibrillation in the fracture group and the control group were 9.6％ and 4.7％,respectively,with crude OR=2.18,95％CI(1.32-4.15),P=0.008 and adjusted OR=2.27,95％CI(1.37-5.20),P=0.02.Compared with the control group,the incidence of stroke (x2 =14.06,P ＜ 0.05),osteoporosis (x2 =200.64,P ＜ 0.01) and cognitive impairment(x2 =8.23,P ＜0.01)increased in the fracture group.When classified by age and sex in the fracture group,the incidence of atrial fibrillation had no significant difference between different gender and age subgroups.Conclusions Atrial fibrillation is an independent risk factor for hip fractures caused by falls in the elderly.There is no significant difference in the incidence of atrial fibrillation in hip fracture patients between the different ages(65-74 years,75-84 years,≥of 85 years)and genders.In addition,stroke,osteoporosis,and cognitive impairment increase the risk of hip fractures caused by falls in elderly patients.

Chemical constituents in chloroform fraction of Houttuynia cordata / 中国中药杂志

Nine compounds were isolated from chloroform fraction of Houttuynia cordata,and the isolates were identified as follows:( S)-5,6,6 a,7-tetrahydro-2,10-dimethoxy-4 H-dibenzo [DE,G] quinoline-1,9-diol( 1),( +)-isoboldine β-N-oxide( 2),liriotulipiferine( 3),telitoxinone( 4),isoboldine( 5),(-)-clovane-2β,9α-diol( 6),benzoic acid( 7),acantrifoside E( 8),and dibutyl phthalate( 9). Among them,compound 1 was new,and compounds 2-9 were reported from this species for the first time.

Evaluation of the Cutoff of Anti-HCV Antibody Enzyme-Linked Immunosorbent Assay in 7 Blood Station Laboratories / 中国实验血液学杂志

OBJECTIVE@#To evaluate the necessity and suitability of the anti-HCV ELISA teot gray zone setted up by 7 blood station laboratories.@*METHODS@#7 blood station laboratories were coded as 1, 2, 3, 4, 5, 6 and 7 respectively; 8 kinds of ELISA reagents were coded as A, B, C, D, E, F, G and H respectively. 1 or 2 of 8 ELISA reagents produced by different manufactories were used to detect the anti-HCV in specimens of same group by 7 blood station laboratories; the Westen blot was used to detect the specimens with difference of detected results so as to difine the serological status of specimens. The true positive rate of specimens detected by laboratories and gray zone-comfirined positive rate of specimens were accounted so as to analyze the necessity of setting up the gray zone for anti-HCV ELISA test of 7 blood station laboratories; the optimal cut-off value for anti-HCV ELISA test was determined in 7 blood station laborafories by ROC curve and the changes of sensitivity and specificity of 3 different cut-off value(laboratory work cut-off value, manifactory-recommended cun-off value and optimal cut-off value) were compared so as to analyze the suitability of gray zone for anti-HCV ELISA test in 7 blood station laboratories.@*RESULTS@#The true positive rate detected by 7 blood station laboratories, out of which coded 1 laboratory used 2 kinds of coded A, B reagents was 95.40%(1A), 99.23% (1B), 94.25% (2C), 96.17% (3D), 98.08% (4E), 96.93% (5F), 97.32%(6G) and 93.10%(7H). Except for 2C(94.25%) and 7H(93.10%), the true positive rate detected by laboratoies which not sutted up gray zone, the gray zone-con-firmed positive rate in 6 blood station laboratories setted up gray zone: was 0.00%, 0.00%, 21.43%, 0.00%, 0.00%, 0.00% and 38.89%. The comparison of 3 different cut-off valuces by ROC curve showed that the anti-HCV cut-off values in 5 laboratories(1B, 2C, 4E, 5F and 6G) were as follows: optimal cut-off value＞manufactory recommeded cut-off value＞laboratory work cut-off value, thus use of manufactory-recommeded cut-off value abreadly has reached the high sensitivity requinements for laboratory screening; however, the optimal cut-off value in laboratories 1A, 3B and 7H, thas the appropriate gray zone should be used. In 6 laboratories setting up gray zone, the gensitivity in 3D, 7H laboratories only a little improved (1.60% and 2.70% raspectively) in Eamparison between laboratory work cut-off value and manufactorg-recommeded cut-off value; moreover, the sensitivity in other laboratories not is changed, but the specificity decreased (0.20%-0.50%).@*CONCLUSION@#In addition to setting up the appropriate gray zone in laboratories 1A, 3D and 5H, the gray zone in other laboratories may be cancelled. Even in the same laboratory, the setting up the gray zone also should be scientifically assessed, the same scale cannot be blindly used, thus appropniate strategies should be established.

Clinical characteristics and risk factors of occult pneumonia in advanced elderly patients / 中华老年医学杂志

Objective To explore the clinical characteristics and risk factors of occult pneumonia in advanced elderly patients.Methods A total of 170 advanced elderly patients with community-acquired pulmonary infection in geriatric department of Xijing hospital from January 2014 to October 2017 were enrolled.Patients were divided into two groups:the observation group (with occult pneumonia,n=80)and the control group(without occult pneumonia,n =90).Clinical data of patients were collected,and clinical characteristics and related risk factors of occult pneumonia in elderly patients were analyzed.Results There was no statistically significant difference in the positive rate of sputum culture and the distribution of pathogenic bacteria between the two groups (P ＞ 0.05).Gram-negative bacteria predominated in pathogenic bacteria.The hospitalization time was longer in the observation group than in the control group[(17.3 ± 3.0) d vs.(10.3 ± 3.9) d,P ＜ 0.05].The mortality rate was higher in the observation group than in the control group(10.0 ％ vs.3.3 ％,P ＜ 0.05).The age was older in the observation group than in the control group[(87.0± 1.7) years vs.(82.0± 2.4) years,P ＜ 0.05].The incidences of diabetes,Alzheimer's disease,hypothyroidism and long-term bed rest were higher in the observation group than in the control group (P ＜ 0.05).Multivariate logistic regression analysis showed that age (OR =6.93),dementia (OR =4.32),hypothyroidism(OR =4.89) were independent risk factors for occult pneumonia (P ＜ 0.05).Conclusions The pathogenic bacteria in advanced elderly patients with occult pneumonia are mainly gram-negative bacteria.The positive rate of CT scan confirmed-occult pneumonia is much higher than that by chest X-ray.The advanced elderly patients with occult pneumonia have longer hospitalization time and higher mortality rates.Old age,senile dementia and hypothyroidism are independent risk factors for occult pneumonia in advanced elderly patients.