Inhibition of Sonic Hedgehog signaling inhibits fibrous scar formation and adversely affects functional outcome after ischemic brain injury in rats / 南方医科大学学报

OBJECTIVE@#To investigate the effects of inhibiting Sonic Hedgehog (Shh) signaling on fibrous scar formation and functional outcome after ischemic brain injury.@*METHODS@#Adult SD rats were randomized into sham-operated group, middle cerebral artery occlusion (MCAO) and reperfusion (I/R) group, I/R with intraventricular empty adenoviral vector (rAd-NC) injection group, and I/R with adenovirus-mediated Shh knockdown (rAd-ShShh) group. After the treatments, the neurological deficits of the rats were assessed, and the protein and mRNA expressions of fibronectin (Fn), α-SMA, and Shh in the ischemic hemisphere were detected with immunofluorescence assay and qPCR; TUNEL staining was used for detecting neural cell apoptosis. In the cell experiment, primary meningeal fibroblasts isolated from neonatal SD rats were pretreated for 24 h with TGF-β1 or TGF-β1 plus cyclopamine (CYC) before oxygen-glucose deprivation for 150 min followed by reoxygenation for 72 h (OGD/R). CCK-8 assay and scratch test were performed to examine the changes in cell proliferation and migration, and immunofluorescence assay, qPCR and Western blotting were used for detecting cell transformation and the expressions of Shh, α-SMA, and Fn.@*RESULTS@#Cerebral I/R injury significantly increased the protein and mRNA expressions of Shh, α-SMA, and Fn in the ischemic hemisphere of the rats, but their expression levels were significantly lowered by intraventricular injection of rAd-Shshh (P < 0.05), which obviously increased cell apoptosis in the ischemic hemisphere (P < 0.05) and improved modified mNSS and modified Bederson scores of the rats (P < 0.05). In the cell experiment, pretreatment with TGF-β1 and TGF-β1+CYC both increased the viability of the primary meningeal fibroblasts after OGD/R. TGF-β1 significantly enhanced the migration ability and induced obvious transformation of the exposed cells (P < 0.05), but these effects were significantly attenuated by co-treatment with CYC (P < 0.05). The expressions of Shh, α-SMA and Fn in the TGF-β1 group were all significantly higher in TGF-β1-treated cells (P < 0.05) and were obviously lowered by co-treatment with CYC (P < 0.05).@*CONCLUSION@#Inhibition of Shh signaling may inhibit fibrous scar formation and functional recovery in rats after ischemic brain injury.

Transforming growth factor-β1 induces transformation of rat meningeal fibroblasts into myofibroblasts by upregulating Shh signaling / 南方医科大学学报

OBJECTIVE@#To investigate the effect of TGF-β1 on Shh signaling pathway during the transformation of meningeal fibroblasts into myofibroblasts.@*METHODS@#Primary meningeal fibroblasts were isolated from neonatal (24 h) SD rats and purified using type Ⅳ collagenase. The isolated cells were treated with 10 ng/mL TGF-β1 alone or in combination with 20 μmol/L SB-431542 (a TGF-β1 receptor inhibitor) for 72 h, and the changes in proliferation and migration abilities of the fibroblasts were assessed with CCK-8 assay and cell scratch test. The expression of fibronectin (Fn) was detected with immunofluorescence assay, and Western blotting was performed to examine the expressions of Fn, α-SMA and Shh protein in the cells; the expression of Shh mRNA was detected with real-time fluorescence quantitative PCR.@*RESULTS@#TGF-β1 treatment obviously enhanced the proliferation and migration of primary meningeal fibroblasts (P < 0.05), and promoted the transformation of meningeal fibroblasts into myofibroblasts and the secretion of Fn (P < 0.05). TGF-β1 treatment also upregulated the expression of Shh at both protein and mRNA levels (P < 0.05). Treatment with SB-431542 partially blocked the effect of TGF-β1 on the transformation of meningeal fibroblasts (P < 0.05).@*CONCLUSION@#TGF-β1 can induce the transformation of meningeal fibroblasts into myofibroblasts by up-regulating Shh expression in Sonic Hedgehog signaling pathway.

Azidothymidine Downregulates Insulin-Like Growth Factor-1 Induced Lipogenesis by Suppressing Mitochondrial Biogenesis and Mitophagy in Immortalized Human Sebocytes

Background@#Increased sebum secretion is considered the main causative factor in the pathogenesis of acne. There is an unmet pharmacological need for a novel drug that can control sebum production with a favorable adverse effect profile. @*Objective@#To investigate the effect of azidothymidine on lipid synthesis in sebocytes and to identify the underlying mechanism of the inhibitory effect of azidothymidine on insulin-like growth factor (IGF)-1-induced lipid synthesis in sebocytes. @*Methods@#Immortalized human sebocytes were used for the analysis. Thin-layer chromatography (TLC) and Oil Red O staining were performed to evaluate lipid synthesis in the sebocytes. The differentiation, lipid synthesis, mitochondrial biogenesis, and mitophagy in sebocytes were investigated. @*Results@#TLC and Oil Red O staining revealed that azidothymidine reduced IGF-1 induced lipid synthesis in the immortalized human sebocytes. Azidothymidine also reduced IGF-1-induced expression of transcriptional factors and enzymes involved in sebocyte differentiation and lipid synthesis, respectively. Moreover, we found that IGF-1 upregulated the levels of peroxisome proliferator-activated receptor-gamma coactivator-1α, LC-3B, p62, and Parkin, major regulators of mitochondrial biogenesis and mitophagy in immortalized human sebocytes. In contrast, azidothymidine inhibited IGF-1 induced mitochondrial biogenesis and mitophagy in the sebocytes. @*Conclusion@#These results suggest that azidothymidine downregulates IGF-1-induced lipogenesis by dysregulating the quality of mitochondria through suppression of mitochondrial biogenesis and mitophagy in immortalized human sebocytes. Our study provides early evidence that azidothymidine may be an effective candidate for a new pharmacological agent for controlling lipogenesis in sebocytes.

Epidemiology and factors predicting survival of amyotrophic lateral sclerosis in a large Chinese cohort / 中华医学杂志(英文版)

BACKGROUND@#Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder associated with loss of motor neurons. Our objective was to explore the epidemiology, clinical features, and survival factors of 1809 patients with ALS.@*METHODS@#We analyzed 1809 ALS patients, who were recruited from the Peking University Third Hospital from January 2005 to December 2015. Demographic data and disease-related parameters were collected. Kaplan-Meier curves were used to compare survival time. Cox proportional hazards function and the hazard ratio were used to identify adjusted prognostic predictors.@*RESULTS@#The results showed that the average annual incidence in Beijing alone was 0.38 cases/100,000 person-years and the mean age of onset was 48.88 ± 11.35 (95% confidence interval [CI]: 48.17-49.85) years. The median survival time from onset to death/tracheostomy was 58.89 ± 33.03 (95% CI: 51.46-63.84) months. In the adjusted Cox proportional hazard model, age of onset, diagnosis delay, rate of disease progression (Amyotrophic Lateral Sclerosis Functional Rating Scale Revised decline [points/month]), and body mass index all had an independent effect on survival in ALS.@*CONCLUSIONS@#Our study provides information on epidemiology, clinical features, and survival factors of patients with ALS in China. These results can be helpful in clinical practice, clinical trial design, and validation of new tools to predict disease progression.

Effects of Chinese Medicine on Symptoms, Syndrome Evolution, and Lung Inflammation Absorption in COVID-19 Convalescent Patients during 84-Day Follow-up after Hospital Discharge: A Prospective Cohort and Nested Case-Control Study / 中国结合医学杂志

OBJECTIVE@#To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process.@*METHODS@#This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed.@*RESULTS@#All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026-8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased.@*CONCLUSIONS@#Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430).

Azidothymidine Downregulates Insulin-Like Growth Factor-1 Induced Lipogenesis by Suppressing Mitochondrial Biogenesis and Mitophagy in Immortalized Human Sebocytes

Background@#Increased sebum secretion is considered the main causative factor in the pathogenesis of acne. There is an unmet pharmacological need for a novel drug that can control sebum production with a favorable adverse effect profile. @*Objective@#To investigate the effect of azidothymidine on lipid synthesis in sebocytes and to identify the underlying mechanism of the inhibitory effect of azidothymidine on insulin-like growth factor (IGF)-1-induced lipid synthesis in sebocytes. @*Methods@#Immortalized human sebocytes were used for the analysis. Thin-layer chromatography (TLC) and Oil Red O staining were performed to evaluate lipid synthesis in the sebocytes. The differentiation, lipid synthesis, mitochondrial biogenesis, and mitophagy in sebocytes were investigated. @*Results@#TLC and Oil Red O staining revealed that azidothymidine reduced IGF-1 induced lipid synthesis in the immortalized human sebocytes. Azidothymidine also reduced IGF-1-induced expression of transcriptional factors and enzymes involved in sebocyte differentiation and lipid synthesis, respectively. Moreover, we found that IGF-1 upregulated the levels of peroxisome proliferator-activated receptor-gamma coactivator-1α, LC-3B, p62, and Parkin, major regulators of mitochondrial biogenesis and mitophagy in immortalized human sebocytes. In contrast, azidothymidine inhibited IGF-1 induced mitochondrial biogenesis and mitophagy in the sebocytes. @*Conclusion@#These results suggest that azidothymidine downregulates IGF-1-induced lipogenesis by dysregulating the quality of mitochondria through suppression of mitochondrial biogenesis and mitophagy in immortalized human sebocytes. Our study provides early evidence that azidothymidine may be an effective candidate for a new pharmacological agent for controlling lipogenesis in sebocytes.

A new antiviral isoquinoline alkaloid from Thalictrum glandulosissimum / 中国中药杂志

A new isoquinoline alkaloid(1) has been isolated from the whole plant of Thalictrum glandulosissimum by using various chromatographic techniques, including silica gel, sephadex, MCI-gel resin, and RP-HPLC, and its structure was determined as 1-(6-hydroxy-7-methylisoquinolin-1-yl) ethantone by physicochemical properties and spectroscopic data. This compound was evaluated for anti-tobacco mosaic virus(TMV) activity. The results showed that it had prominent anti-TMV activity with inhibition rates of 28.4%. This rate was closed to that of positive control.

Correlation Analysis of HPLC Fingerprint of Pieces, Standard Decoction, Intermediates and Dispensing Granules of Rehmanniae Radix Praeparata / 中国实验方剂学杂志

Objective::To establish HPLC fingerprint spectra of the pieces, standard decoction, intermediates, dispensing granules of Rehmanniae Radix Praeparata, and assess the quality correlation among them, then to evaluate the scientificity and rationality of preparation process based on the yields of dry extract and the transfer rate of acteoside. Method::Fingerprints of several batches of the pieces, standard decoction, intermediates and dispensing granules of Rehmanniae Radix Praeparata were detected by HPLC, and the content of acteoside was determined according to the method of ChP 2015.The fingerprint chromatographic separation was carried out on Phenomenex Luna 100A C18(2) chromatographic column (4.6 mm×250 mm, 5 μm). The mobile phase was acetonitrile-0.1% phosphoric acid for gradient elution, with a flow rate of 1 mL·min-1, and the detection wavelength was 330 nm. At the same time, the correlation analysis of quality transmission during the preparation of dispensing granules was carried out based on the yields of dry extract and the transfer rates of acteoside. Result::The contents of acteoside pieces, standard decoction and intermediates were basically consistent. The yield of dry extracts of intermediates and dispensing granules, and the transmission rate of acteoside were all within the range of standard decoction, and basically consistent with standard decoction. There were 7 common peaks in all fingerprint spectra of 17 batches of pieces, 17 batches of standard decoction, 10 intermediates and 10 dispensing granules of Rehmanniae Radix Praeparata, with a good correlation. The 13 main chromatographic peaks in the dispensing granules were identified by UPLC-Q-TOF-MS analysis, and 4 of the 7 fingerprint common peaks were identified as 5-hydroxymethyl furfural, acteoside, isoacteoside and martynoside. Conclusion::The main chemical constituents of Rehmanniae Radix Praeparata pieces, standard decoction, intermediates and dispensing granules are basically identical. The established HPLC fingerprint method can be used for the quality control of preparation process of Rehmanniae Radix Praeparata dispensing granules.

Application of Contrast-enhanced Ultrasound in Evaluation of Renal Function for Patients with Spinal Cord Injury Complicated with Hydronephrosis / 中国康复理论与实践

Objective:To apply contrast-enhanced ultrasound in renal function evaluation for patients with spinal cord injury complicated with hydronephrosis. Methods:From October, 2015 to November, 2018, 23 patients with spinal cord injury complicated with hydronephrosis and renal disfunction (spinal cord injury group) and 19 cases of normal kidneys (control group) accepted contrast-enhanced ultrasonography and the image was analyzed with software. The region of interest (ROI) in the renal cortex, and the time intensity curve was drawn. Logistic regression was performed with time to initial peak (TTP), peak intensity (DPI), slope of ascending time (A), area under the curve (AUC) as the independent variable and renography as the dependent variable. The data was analyzed with ROC. Results:There was no significant difference in serum creatinine and ureophil between two groups (P > 0.05). TTP was longer (t = 5.068, P < 0.001), and A and AUC were lower (t > 3.784, P < 0.01) in the spinal cord injury group than in the control group. AUC was the factor related to renography (P < 0.01). The smaller the AUC was, the greater the likelihood of kidney damage was. The sum of sensitivity and specificity was 1.759 and the corresponding AUC was 982.518 dBS. Conclusion:Contrast-enhanced ultrasound can evaluate renal function of patients with spinal cord injury complicated with hydronephrosis. The decrease in AUC of the time-intensity curve indicates that the renal function is impaired.

Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke / 中国康复理论与实践

Objective:To apply the ultrasonic shear wave elastography to evaluate triceps surae and Achilles tendon for patients with lower extremity dyskinesia after stroke. Methods:Thirty-two inpatients during 2018 and 2019 with unilateral lower extremity dyskinesia after stroke were studied with 2-D ultrasound and shear wave elastography on the bilateral triceps surae and Achilles tendons before and after rehabilitation. Shear wave velocity (SWV) of the triceps surae and the Achilles tendons, the length and thickness of Achilles tendon (soleus tendon) were measured. Results:Before rehabilitation, the SWV of the Achilles tendons and the triceps surae increased more in the affected side than in the unaffected side (t > 2.426, P < 0.05), as well as the length of the Achilles tendons (t = 11.801, P < 0.001). After rehabilitation, the SWV of the triceps surae decreased (t > 2.447, P < 0.05), as well as the length of the Achilles tendons (t = 8.577, P < 0.001). Conclusion:Ultrasound shear wave elastography can be used to evaluate the elastic characteristics of the Achilles tendon and the triceps surae, to guide the rehabilitation for stroke patients.

HPLC Fingerprint and Chemical Constituents of Menthae Haplocalycis Herba Standard Decoction / 中国实验方剂学杂志

Objective: To establish an HPLC fingerprint of Menthae Haplocalycis Herba standard decoction,in order to identify the main chemical component of common peaks,and determine the content of rosmarinic acid. Method: The chromatographic fingerprints of 10 batches of Menthae Haplocalycis Herba standard decoction from different areas were determined,and the chromatographic separation was carried out on Kromasil C18 (4.6 mm×250 mm,5 μm) at the temperature of 30℃. The mobile phase was acetonitrile and 0.1%formic acid solution for gradient elution,with a flow rate of 1 mL·min-1,and the detection wavelength was 330 nm. The 10 batches of fingerprints were imported into Similarity Evaluation System for Chromatographic Fingerprint of TCM (2012.130723) for chromatographic peak matching, the reference fingerprint was established with the average method,and the similarities of 10 batches were evaluated. Result: The HPLC fingerprint of Menthae Haplocalycis Herba showed 13 common peaks. The similarities of 10 batches from different areas were all more than 0.90.At the same time,9 common peaks of the fingerprint were identified by using Q-TOF-MS spectrometry. Rosmarinic acid content was also determined by using the HPLC fingerprint method. Conclusion: The method is simple,rapid and accurate,with a good reproducibility, and can be used to rapidly and effectively evaluate the quality of Menthae Haplocalycis Herba standard decoction and lay a foundation for the quality control of Menthae Haplocalycis Herba formula granules.

Interactive effect of Hyperglycemia and Hyperuricemia on abnormal alanine aminotransferase / 中华疾病控制杂志

Objective To investigate interaction effect of hyperglycemia and hyperuricemia on the patients with abnormal alanine aminotransferase(ALT). Methods From March to November 2018, 5 223 cases with complete and suitable data were enrolled in the physical medical examination in Yichang, Hubei Province of China. The metabolic characteristics of the two groups (508 ALT anomaly cases and 513 normal cases) were compared and analysed, Logistic regression model was used to study the independent effects of risk factors, and the interaction between risk factors was analyzed by additive model and multiplicative model. Results Levels of uric acid, triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index, aspartate aminotransferase were significantly higher than that of the control group(all P<0.05). After adjusting some confounding factors, multivariate Logistic regression analysis showed that risk of abnormal ALT was 5.62 times higher in subjects with hyperglycemia and hyperuricemia than in subjects without them(95% CI:1.65-19.73, P=0.004). Interaction analysis of risk factors for abnormal ALT showed that there was no multiplicative interaction between hyperglycemia and hyperuricemia, but with additive interaction, the synergy index was 3.02, the relative excess risk due to interaction was 3.09, the attributable proportion due to interaction was 54.98% and pure factor attribution interaction was 66.87%. Conclusions There are several abnormal metabolic indices in individuals with abnormal ALT. The positive interaction between hyperglycemia and hyperuricemia are among the important risk factors for abnormal ALT patients. They can significantly increase the risk of illness.

Comparison on local dengue fever outbreaks in public place in Shenzhen and Hong Kong in 2018 / 中华疾病控制杂志

Objective To compare epidemiology characteristics and control measures of dengue fever (DF) outbreaks in public places in Shenzhen and Hong Kong and integrate the advantages for better response to DF outbreaks. Methods Data of DF cases and mosquito vector surveillance in Shenzhen and Hong Kong were collected for descriptive epidemiological analysis and measures of mosquito control were compared. Results A total of 19DF cases were recorded in 13 d among six districts of Hong Kong, the male: female ratio was 1 ∶〗0.9. In Shenzhen, 20 cases were recorded in 33 d, the cases were distributed in three sub-districts, the Male: female ratio was 1 ∶〗0.82; Age difference between Shenzhen and Hong Kong was statistically significant (Z=-2.855, P=0.004). The time interval between date of onset and laboratory confirmation ranging from 5.5 to 8.5 d (median:7d) in Hong Kong, and ranged from 1.5 to 5.4 d (median:2 d) in Shenzhen, the difference was statistically significant (Z=-3.818, P<0.001). On the 4th day of the outbreak, Hong Kong declared 30 d closure for anti-mosquito operations with a range of 500 m, and monthly area ovitrap index (AOI) was used to monitor the territory-wide situation of Aedes albopictus. On the 2nd day of the outbreak, Shenzhen declared source closure for mosquito control with a range of 400 m and emergency vector surveillance was conducted, using Breteau Index (BI) and Human-baited double net trap(HDN) every 3 d. Conclusions The nature, scale, time and place of the two local DF outbreaks in Shenzhen and Hong Kong are similar. The prevention and control system is more sensitive and prompt, the ability of early detection is stronger, mosquito vector surveillance program is more comprehensive and the frequency is higher in Shenzhen. The epidemic information dissemination and risk communication with media is more active, mosquito management and control is more professional in Hong Kong.

Effect of different feeding initiation formulas on very low birth weight infants / 中国当代儿科杂志

OBJECTIVE@#To explore the effect of feeding initiation with different formulas on the growth, development, and feeding tolerance in very low birth weight infants.@*METHODS@#A total of 86 preterm infants with a gestational age of 0.05). The SPF and eHF groups had a significantly shorter transition time from meconium to yellow stool than the control group (P0.05).@*CONCLUSIONS@#Both eHF and SPF can be used for feeding initiation for very low birth weight preterm infants with a gestational age of <34 weeks without increasing the incidence rate of EUGR.

Effect of Glucocorticoid Pulse Therapy on Short-term Prognosis of Anti-neutrophil Cytoplasmic Antibodies-associated Glomerulonephritis / 中国医学科学院学报

Objective To investigate the prognosis predictors of anti-neutrophil cytoplasmic antibody(ANCA)-associated glomerulonephritis treated with glucocorticoid(GC).Methods The clinicopathological data of patients with biopsy-confirmed ANCA-associated glomerulonephritis were retrospective analyzed by retrieving the medical database in Peking Union Medical College Hospital from January 2000 to May 2015. Pathological categories were re-classified. Renal remission rates,infection rates,and death events were compared between intravenous glucocorticoid(GC)pulse therapy group and non-pulse group. Logistic regression analysis was performed to analyze factors influencing the short-term prognosis.Results Among the 81 patients with ANCA-associated glomerulonephritis,49(60.5%)received GC pulse therapy and 32(39.5%)did not. The GC pulse group had significantly lower estimated glomerular filtration rate at baseline(eGFR0)than the non-pulse group(t=3.003,P=0.015)but significantly higher 24-hour urinary protein(24 hUP)(t=2.394,P=0.002)and Birmingham Systemic Vasculitis Activity Score(BVAS)(t=0.049,P=0.013). There was no significant difference in the cumulative amount of cyclophosphamide(CTX)(t=1.336,P=0.245)between these two groups. The overall renal remission rate of GC pulse group in the 6 month was significantly lower(48.7% vs. 79.3%;χ =6.591,P=0.024). Univariate analysis showed that baseline 24 hUP(t=6.222,P=0.017),eGFR0(t=3.727,P=0.046),and pathological category(χ =7.654,P=0.045)were associated with the overall renal remission rate in the 6 month. Multivariate analysis showed the crescent category was an independent factor(OR=20.63,95%CI:2.217-191.973,P=0.008;compared with sclerotic category)for overall renal remission rate in the 6 month,while GC pulse therapy was not an predictor(OR=0.271,95%CI:0.062-1.179,P=0.082). A total of 37 patients experienced infections within 6 months. The infection rate in GC pulse group(55.1%,27/49)was significantly higher than that of non-pulse group(31.3%,10/32)(P=0.042). Univariate regression analysis showed that eGFR0(t=1.912,P=0.049),baseline BVAS(t=-3.360,P=0.001)and GC pulse(χ =6.249,P=0.014)were associated with infection events within 6 months. Multivariate analysis showed that the baseline BVAS was the only predictor with 1.089 times for every 1 point increase in BVAS(OR=1.089,95%CI:1.006-1.179,P=0.034). Conclusions Crescentic category favors renal remission independently compared with sclerotic category. Patients with crescentic category may benefit more from intensive treatment. BVAS acts as an independent risk factor of infection.

Evaluation of Vocal Cord Paralysis after Stroke with Laryngeal Ultrasound / 中国康复理论与实践

Objective:To evaluate the vocal cord movement after stroke with laryngeal ultrasound. Methods:From January, 2017 to March, 2019, 41 patients with stroke following hoarseness were examined with laryngeal ultrasound and direct laryngoscope. The movement was graded from I to III, in which grades II and III were considered as vocal cord paresis or palsy. The results under ultrasound were compared to laryngoscope (gold standard). Results:For 82 sides vocal cords in 41 patients, 78 sides were consistent grading between laryngeal ultrasound and laryngoscopy, and the coincidence rate was 95.1%. The difference was mainly found in patients with bilateral vocal cord paralysis, two cases in total. Under ultrasound, one case was graded III (right) and I (left), and the other was graded II (right) and III (left); while under laryngoscopy, they were graded as III (right) and II (left), and III (right) and II (left), respectively. The specificity of ultrasound was 97.1%, and sensitivity was 85.7%, respectively.Kappa = 0.911, P < 0.001. Conclusion:Laryngeal ultrasound can be used for the diagnosis and evaluation of vocal cord movement after stroke.

Preparation of neogambogic acid nanoliposomes and its pharmacokinetics in rats

Objective: to prepare neogambogic acid nanoliposomes [GNA-NLC] and study its pharmacokinetics [PK] in rats

Study Design: an experimental study

Place and Duration of Study: mudanjiang Medical University, Mudanjiang, China, from January 2016 to October 2017

Methodology: GNA-NLC was prepared by emulsion evaporation-low temperature solidification. The entrapment efficiency, average particle size, and zeta potential were investigated. Male Wistar rats were injected with 1 mg/mL gambogic acid and GNA-NLC into the caudal vein respectively, and the plasma concentration was determined by UPLCMS/MS. The pharmacokinetic parameters of the two agents were compared

Results: GNA-NLC prepared in this study were mostly spherical spheroids with an average particle size of 146.35 +/- 1.72 nm, polydispersity coefficient of 0.26 +/- 0.02, zeta potential of -28.24 +/- 0.13 MV, entrapment efficiency of 84.63%, and drug loading capacity of 4.23%. DSC showed that neogambogic acid nanoparticles had formed and neogambogic acid was amorphous in the matrix. The pharmacokinetics results in rats showed that GNA-NLC plasma concentration was significantly higher than that of common preparation of gambogic acid, with a half-life period of 10.14 +/- 0.03 hours, 4.57 times that of gambogic acid. AUC0 - 24hof gambogic acid in GNA-NLC lipidosome was 58.36 +/- 0.23 [micro]g/h/mL, 4.83 times that of gambogic acid

Conclusion: GNA-NLC can be prepared successfully by emulsion evaporation-low temperature solidification. The method is simple and easy to control. The GNA-NLC has a long cycle, and high blood concentration, sustained release compared with the raw material gambogic acid

Chinese patent medicines with function of resolving hard lump for cyclomastopathy: network Meta-analysis / 中国中药杂志

This systematic review aims to systematically evaluate the efficacy and safety of Chinese patent medicines with resolving hard lump function for the treatment of cyclomastopathy. We searched CNKI, WanFang, SinoMed, PubMed, EMbase, and The Cochrane Library from the inception to January 3 2018, to collect the randomized controlled trials（RCTs）on Chinese patent medicines with resolving hard lump function in treating cyclomastopathy. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, statistical analysis was performed by using Stata 12.0 and WinBUGS 1.4.3 software. A total of 52 RCTs involving 9 605 patients were finally included. The inventions included 11 commercial Chinese patent medicines with functions of resolving hard lump, such as Rupi Sanjie Capsules, Xiaoru Sanjie Capsules, Ruhe Sanjie Pills, and Hongjin Xiaojie Capsules. The result of direct Meta-analysis showed that: as compared with the simple western medicine group, the Chinese patent medicines such as Hongjin Xiaojie Capsules, Ruhe Sanjie Pills, Rupi Sanjie Capsules, Xiaoru Sanjie Capsules and Xiakucao Oral Liquid could significantly improve the clinical efficacy. In addition, the incidence of adverse reactions of Chinese patent medicines with resolving hard lump function was lower than that in Western medicine group in gastrointestinal reactions, menstrual disorders, leucorrhea abnormalities, liver dysfunction and estrogen-like effect. The network Meta-analysis showed that: Xiaoru Sanjie Capsules, Ruhe Sanjie Pills, Yanlu Rukang Capsules, Quyu Sanjie Capsules, and Hongjin Xiaojie Capsules were the top five in terms of treatment effect. Chinese patent medicines with resolving hard lump function had better clinical efficacy. Due to the low quality of included studies， more high quality RCTs are needed to verify the above conclusion.

Fibronectin Glomerulopathy Caused by the Y973C Mutation in Fibronectin: A Case Report and Literature Review / 中国医学科学杂志(英文版)

Fibronectin glomerulopathy is a rare autosomal dominant inherited glomerular disease associated with massive deposition of fibronectin. We recently diagnosed fibronectin glomerulopathy in a 29-year-old woman presenting nephrotic syndrome. Genetic analysis of fibronectin 1 gene showed heterozygosity for the Y973C mutation. However, this mutation was not found in her parents. She had stable renal function but persistent nephrotic proteinuria after one-year follow-up.

A Cohort Study of Incidences and Risk Factors for Thromboembolic Events in Patients with Idiopathic Membranous Nephropathy / 中国医学科学杂志(英文版)

Objective The aims of this study were to assess incidences and characteristics of arterial thromboembolic events (ATEs) and venous thromboembolic events (VTEs) in Chinese patients with idiopathic membranous nephropathy (IMN), and to identify the predisposing risk factors of them.Methods A total of 766 consecutive Chinese patients with IMN were enrolled in this retrospective cohort study. The cumulative incidences of newly diagnosed ATEs and VTEs were calculated using Kaplan-Meier methods. Univariable risk prediction model analysis followed by multivariable survival analysis was used to evaluate the potential risk factors of ATE and VTE.Results At 0.5, 1, 2, 3, and 5 years after biopsy diagnosis of IMN, the cumulative incidence of newly diagnosed ATEs were 4.3%, 5.7%, 6.3%, 7.1%, and 8.0%, and of newly diagnosed VTEs were 5.9%, 6.8%, 6.9%, 7.0%, and 7.2%, respectively. In 78 ATEs events (71 patients), cardiovascular diseases, thrombotic ischemic stroke (IS) and peripheral artery disease accounted for 50%, 45% and 5% respectively; in 60 VTEs events(53 patients), the deep vein thrombosis, renal vein thrombosis and pulmonary embolism accounted for 60%, 13% and 27% respectively. At the time of event, 42.1% patients with ATEs and 81.5% patients with VTEs were at nephrotic syndrome(NS) status (χ =18.1, P<0.001). Severe proteinuria, aging, smoking, hypertension and prior ATE history were associated with ATEs. Aging was demonstrated as the independent risk factor for ATEs (P=0.001), and hypoalbuminemia was the dominant independent risk factor for VTEs (P=0.03). Conclusions Patients with IMN have increased incidences of ATEs and VTEs, and most of events occurred within the first 6 months of the disease. IS was very common in ATEs in our cohort. Severe proteinuria and classic risk factors for atherosclerosis were associated with onset of ATEs. Hypoalbuminemia independently predicted VTEs. Risks of both ATEs and VTEs were particularly high in the status of NS, particularly VTEs.