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Yigongsan is derived from Xiaoer Yaozheng Zhijue written by QIAN Yi in the Northern Song dynasty, which is the No. 3 formula in the Catalogue of Ancient Famous Classical Formulas(The Second Batch of Pediatrics) released by the National Administration of Traditional Chinese Medicine(TCM) in September 2022, and it can be developed as a class 3.1 new TCM drug. By referring to ancient medical books and modern literature, this study conducted herbal textual research on Yigongsan from five aspects, including historical evolution, origin and processing, dosage conversion, usage and preparation methods, and functional application, then formed the key information table of this formula, in order to provide reference for the development of reference samples and preparations of Yigongsan. Based on the results of the study, it is recommended that Panax ginseng should be removed the basal part of stem(rhizoma), Poria cocos should be removed the peel, Citrus reticulata should be cut into shreds and Glycyrrhiza uralensis should be used. According to 4.13 g/Qian(钱), 1 g/slice for ginger, 3 g for each jujube and 300 mL/Zhan(盏), the doses of Ginseng Radix, Poria, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Citri Reticulatae Pericarpium, Zingiberis Rhizoma Recens, Jujubae Fructus were 1.652, 1.652, 1.652, 1.652, 1.652, 5, 6 g, and the total amount was 19.26 g. The decocting method was to crush the medicinal materials into fine powder with 50-80 mesh, add 300 mL of water and decoct to 210 mL for each dose, then remove the dregs and take it warmly. This formula was recorded in ancient books as the main treatment for the cold-deficiency of spleen and stomach, and Qi stagnation in children with vomiting and diarrhea and lack of appetite. It has been flexibly applied by later generations of physicians, and is often used to treat anorexia, inflammation of the digestive tract, diarrhea and other diseases in children.
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Objective:To investigate the predictive value of fluid-attenuated inversion recovery (FLAIR) signal strength ratio (SIR) in onset time≤4.5 h in patients with acute ischemic stroke.Methods:A retrospective analysis was performed; 180 acute ischemic stroke patients admitted to Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University from January 2020 to June 2023 were chosen. Hypoperfusion intensity ratio (HIR) was used to evaluate the collateral circulation (poor collateral circulation: HIR≤0.4; good collateral circulation: HIR>0.4); clinical data and imaging indexes between poor collateral circulation and good collateral circulation groups were compared. Univariate and multivariate Logistic regressions were used to analyze the influencing factors for onset time≤4.5 h in patients with acute ischemic stroke. Correlation between SIR and onset time was analyzed in patients with acute ischemic stroke. Role of HIR as agency between SIR and onset time was explored. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of SIR and diffusion weighted imaging (DWI)-FLAIR mismatch in onset time≤4.5 h in acute ischemic stroke patients.Results:Of the 180 patients, 100 were into the good collateral circulation group and 80 were into the poor collateral circulation group; compared with the good collateral circulation group, the poor collateral circulation group had significantly higher percentage of patients with hyperlipidemia, larger DWI infarction volume before treatment, larger perfusion weighted imaging (PWI)-DWI mismatch volume and higher SIR ( P<0.05). In these 180 patients, 76 had onset time≤4.5 h and 104 had onset time>4.5 h. Univariate Logistic regression analysis showed that hyperlipidemia, DWI infarct volume before treatment, DWI-FLAIR mismatch, HIR and SIR were influencing factors for onset time≤4.5 h in acute ischemic stroke patients ( P<0.05). Multivariate Logistic regression analysis showed that hyperlipidemia ( OR=6.654, 95% CI: 5.751-8.824, P<0.001), HIR ( OR=0.724, 95% CI: 0.521-1.321, P=0.041) and SIR ( OR=739.881, 95% CI: 383.296-14 258.065, P<0.001) were independent influencing factors for onset time≤4.5 h in acute ischemic stroke patients. Pearson correlation analysis showed that SIR was positively correlated to onset time in patients with acute ischemic stroke ( r=0.420, P<0.05), and SIR was positively correlated to onset time in patients from poor collateral circulation group ( r=0.781, P<0.05). ROC curve showed that AUC of SIR in predicting onset time≤4.5 h was 0.917 (95% CI: 0.814-1.000, P<0.001) and that of DWI-FLAIR mismatch in predicting onset time≤4.5 h was 0.530 (95% CI: 0.509-0.757, P=0.075) in poor collateral circulation group, enjoying significant difference in predictive efficacy. Conclusion:Acute ischemic stroke patients with low HIR and SIR have higher odds of onset time≤4.5 h; SIR can more accurately predict the onset time in these patients with poor collateral circulation.
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OBJECTIVE@#To investigate the effect of miR-22 targeting formin-like protein 2 (FMNL2) on the migration and apoptosis of childhood acute myeloid leukemia (AML) cells.@*METHOD@#Peripheral blood samples from 11 children with AML, 10 children with immune thrombocytopenia, human AML cell lines TF-1a, HL-60, THP-1 and human bone marrow stromal cells HS-5 were used as the research objects. UniCel DxH 800 automatic hematology analyzer detected platelet count, hemoglobin, and white blood cell count in peripheral blood samples, and RT-qPCR detected miR-22 expression in peripheral blood samples and AML cells. HL-60 cells were transfected with LipofectamineTM 2000 kit, the experiments were divided into seven groups: blank (no cells transfected), miR-NC, miR-22 mimics, si-NC, si-FMNL2 , miR-22 mimics+OE-NC and miR-22 mimics+OE-FMNL2 . RT-qPCR was used to detect the expression of miR-22 in each group. Transwell was used to detect cell migration. Flow cytometry was used to detect cell apoptosis. Dual-luciferase reporter gene detection experiments verified the targeting relationship between miR-22 and FMNL2 . Western blot was used to detect the expression of FMNL2 protein.@*RESULTS@#Compared with the control group, the number of leukocytes in the peripheral blood of children with AML was significantly increased (P <0.001), while the concentration of hemoglobin and the number of platelets were significantly decreased P <0.001). The expression level of miR-22 in peripheral blood of children with AML was significantly lower than that in control group (P <0.001). Compared with HS-5 cells, the expression levels of miR-22 in TF-1a, HL-60, and THP-1 cells were significantly decreased (P <0.05), and in HL-60 cells was the lowest. Therefore, HL-60 cells were selected for subsequent experiments. Up-regulation of miR-22 or silencing of FMNL2 could reduce the number of migrating cells and increase apoptosis rate (P <0.05). MiR-22 targeted and negatively regulated the expression of FMNL2 . FMNL2 overexpression reversed the effects of up-regulated miR-22 on migration and apoptosis of HL-60 cells.@*CONCLUSION@#MiR-22 can inhibit the migration and promote apoptosis of HL-60 cells by down regulating the expression of FMNL2 .
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Humans , Child , MicroRNAs/metabolism , Leukemia, Myeloid, Acute/metabolism , Cell Proliferation , Apoptosis , Myeloproliferative Disorders , Cell Movement , Hemoglobins , Cell Line, Tumor , ForminsABSTRACT
OBJECTIVES@#To investigate the value of CCKBRfl/fl villin-Cre mice as a mouse model of salt-sensitive hypertension (SSH).@*METHODS@#In the first part, 2-month-old CCKBRfl/fl villin-Cre mice (CKO) and control CCKBRfl/fl mice (WT) were fed with normal diet (0.4% NaCl) or high salt diet (4% NaCl), separately for 6 weeks. In the rescue study, one week of hydrochlorothiazide or saline injection were treated with the CKO mice fed high salt diet. The blood pressure, biochemical indexes, and the expression of small intestinal sodium transporters (NHE3, NKCC1, eNaC) was detected. The organ injury markers (MMP2/MMP9) and the histopathological changes of kidneys were observed, whereas the changes of duodenal sodium absorption were detected by small intestinal perfusion in vivo.@*RESULTS@#The CCKBRfl/fl villin-Cre mice with high salt intake exhibited high blood pressure, increased duodenal sodium absorption and urinary sodium excretion, and with renal injury. The protein expression of NHE3, NKCC1 and eNaC were also significant increase in the intestine of CKO-HS mice. Treatment with hydrochlorothiazide remarkably attenuated the elevated blood pressure by high salt absorption in the CCKBRfl/fl villin-Cre mice, but no significant histopathological changes were observed.@*CONCLUSIONS@#These results support a crucial role of intestinal Cckbr deficiency on SSH development and the diuretic antihypertension effect in CCKBRfl/fl villin-Cre mice. The CCKBRfl/fl villin-Cre mice with the high salt intake may serve as a stable model of salt-sensitive hypertensive induced by sodium overloading.
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OBJECTIVE@#To explore the mechanism underlying the hepatoprotective effect of dihydromyricetin (DMY) against lipid accumulation in light of the lipophagy pathway and the inhibitory effect of DMY on HepG2 cell proliferation.@*METHODS@#LO2 cells were cultured in the presence of 10% FBS for 24 h and treated with 100 μg/mL DMY, or exposed to 50% FBS for 24 h followed by treatment with 50, 100, or 200 μg/mL DMY; the cells in recovery group were cultured in 50% FBS for 24 h and then in 10% FBS for another 24 h. Oil red O staining was used to observe the accumulation of lipid droplets in the cells, and the levels of TC, TG, and LDL and activities of AST, ALT and LDH were measured. The expression of LC3 protein was detected using Western blotting. AO staining and transmission electron microscopy were used to determine the numbers of autophagolysosomes and autophagosomes, respectively. The formation of autophagosomes was observed with MDC staining, and the mRNA expression levels of LC3, ATG7, AMPK, mTOR, p62 and Beclin1 were determined with q-PCR. Flow cytometry was performed to analyze the effect of 50, 100, and 200 μg/mL DMY on cell cycle and apoptosis of HepG2 cells; DNA integrity in the treated cells was examined with cell DNA fragmentation test.@*RESULTS@#DMY treatment and pretreatment obviously inhibited lipid accumulation and reduced the levels of TC, TG, LDL and enzyme activities of AST, ALT and LDH in LO2 cells (P < 0.05). In routinely cultured LO2 cells, DMY significantly promoted the formation of autophagosomes and autophagolysosomes and upregulated the expression of LC3 protein. DMY obviously attenuated high FBS-induced inhibition of autophagosome formation in LO2 cells, up- regulated the mRNA levels of LC3, ATG7, Beclin1 and AMPK, and downregulated p62 and mTOR mRNA levels (P < 0.05 or 0.01). In HepG2 cells, DMY caused obvious cell cycle arrest, inhibited cell proliferation, and induced late apoptosis and DNA fragmentation.@*CONCLUSION@#DMY reduces lipid accumulation in LO2 cells by regulating the AMPK/ mTOR-mediated lipophagy pathway and inhibits the proliferation of HepG2 by causing cell cycle arrest and promoting apoptosis.
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Humans , AMP-Activated Protein Kinases/metabolism , Autophagy , Beclin-1 , Cell Proliferation , Flavonols , Hep G2 Cells , Lipids , RNA, Messenger , Signal Transduction , TOR Serine-Threonine Kinases/metabolismABSTRACT
OBJECTIVE@#To observe the occurrence time of neuralgia and the expression of purinergic ligand-gated ion channel 7 receptor (P2X7R) in the dorsal horn of the spinal cord after intraperitoneal injection of streptozotocin (STZ) in diabetic rats, and to explore the effect of electroacupuncture (EA) and pretreatment of EA on the heat pain threshold and expression of P2X7R in the spinal dorsal horn in rats with diabetic neuropathic pain (DNP), and to explore the possible mechanism of EA for DNP.@*METHODS@#PartⅠ: Thirty male SD rats were randomly selected from 64 male SD rats as the control group; the remaining rats were given intraperitoneal injection of STZ (10 mg/mL) at a dose of 65 mg/kg to establish the diabetes model, and 30 rats were successfully modeled as the model group. The control group and the model group were divided into three subgroups respectively at 7, 14 and 21 days, with 10 rats in each subgroup. Body mass, fasting blood glucose (FBG) and thermal pain threshold were recorded at 7, 14 and 21 days after injection; the expression of P2X7R in spinal dorsal horn was detected by Western blot. PartⅡ: Eight SD rats were randomly selected from 35 male SD rats as the blank group, and the remaining 27 rats were given intraperitoneal injection of STZ (10 mg/mL) at a dose of 65 mg/kg to establish the diabetes model. The 24 rats with successful diabetes model were randomly divided into a DNP group, an EA group and a pre-EA group, 8 rats in each group. Fifteen to 21 days after STZ injection, the EA group received EA at "Zusanli" (ST 36) and "Kunlun" (BL 60), continuous wave, frequency of 2 Hz, 30 min each time, once a day; the intervention method in the pre-EA group was the same as that in the EA group. The intervention time was 8 to 14 days after STZ injection. The body mass, FBG and thermal pain threshold were recorded before STZ injection and 7, 14 and 21 days after STZ injection; the expression of P2X7R in spinal dorsal horn was detected by Western blot 21 days after injection.@*RESULTS@#PartⅠ: Compared with the control group, in the model group, the body mass was decreased and FBG was increased 7, 14 and 21 days after STZ injection (P<0.01), and the thermal pain threshold was decreased 14 and 21 days after STZ injection (P<0.05), and the expression of P2X7R in spinal dorsal horn was increased 7, 14 and 21 days after STZ injection (P<0.05, P<0.01). PartⅡ: Compared with the blank group, in the DNP group, the body mass was decreased and fasting blood glucose were increased 7, 14 and 21 days after STZ injection (P<0.01). Compared with the DNP group, in the pre-EA group, the heat pain threshold was increased 14 and 21 days after STZ injection (P<0.05), while in the EA group, the heat pain threshold was increased 21 days after STZ injection (P<0.01), and the expression of P2X7R in the dorsal horn in the EA group and the pre-EA group was decreased (P<0.01).@*CONCLUSION@#The diabetic neuropathic pain is observed 14 days after STZ injection. EA could not only treat but also prevent the occurrence of DNP, and its mechanism may be related to down-regulation of P2X7R expression in the dorsal horn of the spinal cord.
Subject(s)
Animals , Male , Rats , Diabetes Mellitus, Experimental/therapy , Electroacupuncture , Neuralgia/therapy , Rats, Sprague-Dawley , Spinal Cord , Spinal Cord Dorsal HornABSTRACT
Objective:To evaluate the effect of deep learning based on DWI and fluid attenuated inversion recovery (FLAIR) to construct a prediction model of the onset time in acute stroke.Methods:A total of 324 cases of acute stroke with clear onset time, from January 2017 to May 2020 in Nanjing First Hospital, were retrospectively enrolled and analyzed. The patients were divided into a training set of 226 patients and a test set of 98 patients according to the complete randomization method using a 7∶3 ratio, and the patients were divided into ≤ 4.5 h and >4.5 h according to symptom onset time in each group. The acute infarction areas on DWI and the corresponding high signal area on FLAIR were manually outlined by physician. Using the InceptionV3 model as the basic model for image features extraction, the deep learning prediction model based on single sequence (DWI, FLAIR) and multi sequences (DWI+FLAIR) were established and verified. Then the area under curve (AUC), accuracy of human readings, single sequence model and multi sequence model in predicting the acute stroke onset time from imaging were compared.Results:DWI-FLAIR mismatch was found in 94 cases (94/207) of patients with symptom onset time from imaging ≤ 4.5 h, while in 28 cases (28/117) of patients with symptom onset time from imaging >4.5 h. ROC analysis showed that the AUC of DWI-FLAIR mismatch in predicting acute stroke onset time from imaging was 0.607, and the accuracy was 60.2%. The prediction model of deep learning based on single sequence showed that the AUC of FLAIR was 0.761 and the accuracy was 71.4%; the AUC of DWI was 0.836 and the accuracy was 81.6%. The AUC of predicting stroke onset time based on the multi-sequence (DWI+FLAIR) deep learning model was 0.852, which was significantly better than that of manual identification ( Z = 0.617, P = 0.002), FLAIR sequence deep learning model ( Z = 2.133, P = 0.006) and DWI sequence deep learning model ( Z = 1.846, P = 0.012). Conclusion:The deep learning model based on DWI and FLAIR is superior to human readings in predicting acute stroke onset time from imaging, which could provide guidance for intravenous thrombolytic therapy for acute stroke patients with unknown onset time.
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Objective:To evaluate spectral CT metal artifacts reduction (MAR) technique in reducing metal artifacts of spinal implants in a phantom.Methods:Ovine spines were chosen as anthropomorphic phantom. The phantom including the pedicle screws, 3D-printed vertebral body (VB) and mesh cage were examined using spectral CT. Postoperative CT images were reconstructed at 70—140 keV with 10 keV interval of MAR and non-MAR. Artifact index (AI) and signal-to-noise ratio (SNR) were evaluated by CT and SD values in ROIs around the implants. Visibility of bony structures, the artifacts of pedicle screw, 3D-printed VB and mesh cage were subjectively evaluated. Plotting curves of AI and SNR with the increasing keV were drawn. The AI and SNR were compared at lower (70 keV), medium (100 keV) and high (130 keV) level between MAR and non-MAR images using the paired t-test, and the subjective scores were compared using Wilcoxon signed rank-sum test. Results:The AI values around pedicle screws (anterior, posterior and lateral), 3D-printed VB and mesh cage decreased with the increase of keV, while SNR improved in MAR and non-MAR images. The AI values in the anterior, lateral and posterior pedicle screws and lateral titanium implants were significantly lower in MAR than those in non-MAR ( P<0.05). The AI value in posterior 3D-printed vertebral was lower in MAR than that of non-MAR only at 70 keV ( P<0.001). The SNR values in the anterior and posterior pedicle screws, 3D-printed VB increased with the increase of keV, but decreased in other ROIs. In the subjective evaluation, the image scores of MAR were higher than those of non-MAR ( P<0.05). Conclusion:Spectral CT using the MAR reconstruction can effectively reduce metal artifacts of spinal implants. The effect is better in pedicle screw and mesh cage than 3D-printed VB.
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Objective:To explore the inhibitory effect of dihydroartemisinin (DHA) on the proliferation of HepG2 cells, elucidate the mechanism from the perspectives of oxidative damage and energy metabolism, and discuss the possibility of combined use of DHA with sorafenib (Sora). Method:Cell counting kit-8 (CCK-8) assay was used to obtain the 50% inhibitory concentration (IC<sub>50</sub>) of DHA and Sora on HepG2 and SW480 cells and Chou-Talalay method was used to obtain the combination index (CI) of DHA and Sora. HepG2 cells were classified into the control group, DHA group (10 µmol·L<sup>-1</sup>), Sora group (5 µmol·L<sup>-1</sup>), and DHA + Sora group (DHA 10 µmol·L<sup>-1</sup>, Sora 5 µmol·L<sup>-1</sup>) and then incubated with corresponding drugs for 8-12 h. Seahorse XF glycolytic rate assay kit and cell mito stress test kit were employed to respectively detect the glycolysis function of cells and oxidative phosphorylation function of mitochondria. DCFH-DA and lipid peroxidation MDA assay kit were separately used to analyze the intracellular levels of reactive oxygen species (ROS) and malondialdehyde (MDA). Western blot was applied to determine the intracellular levels of heme oxygenase-1 (HO-1) and glutamate-cysteine ligase catalytic subunit (GCLC). Result:Compared with the control group, DHA alone inhibited the ATP synthesis in mitochondrial oxidative phosphorylation and glycolysis (<italic>P</italic><0.01), increased the levels of intracellular ROS and MDA (<italic>P<</italic>0.05), and decreased the levels of HO-1 and GCLC (<italic>P<</italic>0.05) in HepG2 cells. DHA and Sora had synergistic inhibitory effect on proliferation of HepG2 and SW480 cells, with CI < 0.90. The DHA + Sora group showed stronger suppression of ATP synthesis in mitochondrial oxidative phosphorylation and glycolysis (<italic>P</italic><0.01), higher levels of intracellular ROS and MDA (<italic>P<</italic>0.01), and lower levels of intracellular antioxidation-related proteins HO-1 and GCLC in HepG2 cells (<italic>P<</italic>0.01) than the DHA group. Conclusion:DHA may increase the level of MDA by reducing HO-1 and GCLC and increasing ROS in HepG2 cells, which results in mitochondria oxidative damage, restricts cell glycolysis and mitochondrial oxidative phosphorylation, and thus finally inhibits the proliferation of HepG2 cells. DHA and Sora have synergistic inhibitory effect on the proliferation of HepG2 and SW480 cells, and the mechanism may be related to the synergistic oxidative damage that affects the mitochondrial electron transport chain and suppresses cell energy metabolism.
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It is known that LINC01018 and CDK6 are associated with the occurrence, progression and recurrence of malignant tumor. Our preliminary data showed that the expression of LINC01018 was down-regulated and that of CDK6 was up-regulated, which were related with the malignancy grade. Bioinformatics suggested that E2F1 binding site exist in the CDK6 promoter region, and LINC01018 might interact with E2F1. Thus we speculate that the expression of LINC01018 in malignant tumor is decreased. The interaction between LINC01018 and E2F1 activates E2F1, promotes the transcription activation of CDK6, and affects tumor proliferation, invasion and metastasis. All these are expected to reveal the effect and mechanisms of LINC01018 in the development and regulation of malignant tumor, and provide new ideas and evidences for its treatment.
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Oligonucleotides have attracted the widespread attention in disease diagnosis and gene therapy. At present, the nucleic acid drugs are at the forefront of biomedical and pharmaceutical research. The bioanalysis of therapeutic oligonucleotides has been slow, however, due to the requirements for pharmacokinetic/toxicokinetic and pharmacodynamic studies in pharmaceutical development. Conventionally, the hybridization-enzyme linked immunosorbent assay (hybridization-ELISA) is widely used in the bioanalysis of therapeutic oligonucleotides. Recentlly, many technologies such as real-time quantitative PCR (qPCR) and high performance liquid chromatography (HPLC)-based technologies have also showed a broad application prospects in the bioanalysis of therapeutic oligonucleotides. However, each technology has its own advantages and limitations. This review summarizes the currently used techniques in the bioanalysis of oligonucleotide therapeutics and reviews the challenges of regulated bioanalysis.
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As a unicellular organism, Plasmodium displays a panoply of lipid metabolism pathways that are seldom found together in a unicellular organism. These pathways mostly involve the Plasmodium-encoded enzymatic machinery and meet the requirements of membrane synthesis during the rapid cell growth and division throughout the life cycle. Different lipids have varied synthesis and meta-bolism pathways. For example, the major phospholipids are synthesized via CDP-diacylglycerol-dependent pathway in prokaryotes and de novo pathway in eukaryotes, and fatty acids are synthesized mainly via type Ⅱ fatty acid synthesis pathway. The available studies have demonstrated the impacts of artemisinin and its derivatives, the front-line compounds against malaria, on the lipid metabolism of Plasmodium. Therefore, this article reviewed the known lipid metabolism pathways and the effects of artemisinin and its derivatives on these pathways, aiming to deepen the understanding of lipid synthesis and metabolism in Plasmodium and provide a theoretical basis for the research on the mechanisms and drug resistance of artemisinin and other anti-malarial drugs.
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Humans , Antimalarials/pharmacology , Artemisinins/therapeutic use , Lipid Metabolism , Malaria/drug therapy , PlasmodiumABSTRACT
Hyperlipidemia is a common disease with abnormal blood lipids and is an important risk factor for various cardiovascular diseases. Traditional Chinese medicine has the advantages of dependable lipid-lowering effects with few side effects and is widely used in the prevention and treatment of hyperlipidemia in China. However, due to the complex composition of traditional Chinese medicine and the many targets for treating hyperlipidemia, the mechanisms by which these medicines lower lipid levels are not well resolved. Lipidomics is a discipline that studies lipids and the interaction of lipids in biological systems. Lipidomics can identify and quantify the lipids in vivo under physiological and pathological conditions, helping to discover the potential biomarkers related to the lipid-lowering effects of traditional Chinese medicine and providing a basis for systematically studying the lipid-lowering effect of traditional Chinese medicine. This review introduces the principal research methods used in lipidomics and summarizes the results and prospects of application of lipidomics in the research on the lipid-lowering effects of traditional Chinese medicine.
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It is to determine the effect mechanism and therapeutic method of the idea as "guiding meridian sinew
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Acupuncture Points , Acupuncture Therapy , Meridians , Qi , RunningABSTRACT
OBJECTIVE@#To systematically evaluate the efficacy and safety of conventional therapy combined with moxibustion in the treatment of chronic obstructive pulmonary disease (COPD) in stable phase based on Meta-analysis medicine.@*METHODS@#The randomized controlled trials (RCTs) of moxibustion as adjuvant therapy for COPD were retrieved from the databases of CNKI, Wanfang, SinoMed, PubMed, Web of Science, Cochrane Library and Ebsco. RevMan5.3 software was used for Meta analysis, and the quality of evidence was evaluated according to GRADE standards.@*RESULTS@#A total of 16 RCTs were included, involving 1425 patients. The results of Meta-analysis showed that: compared with the conventional treatment, ①the adjuvant therapy with moxibustion had advantages in reducing the number of acute exacerbations [@*CONCLUSION@#The efficacy of moxibustion as adjuvant therapy for COPD in stable phase is better than that of simple conventional therapy. Due to insufficient clinical evidence and the limitations of this study, clinical safety is unclear and further evidence is needed to support the results.
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Humans , Lung , Moxibustion , Pulmonary Disease, Chronic Obstructive/therapy , Treatment OutcomeABSTRACT
BACKGROUND@#Nitinol-containing devices are widely used in clinical practice. However, there are concerns about nickel release after nitinol-containing device implantation. This study aimed to compare the efficacy and safety of a parylene-coated occluder vs. a traditional nitinol-containing device for atrial septal defect (ASD).@*METHODS@#One-hundred-and-eight patients with ASD were prospectively enrolled and randomly assigned to either the trial group to receive a parylene-coated occluder (n = 54) or the control group to receive a traditional occluder (n = 54). The plugging success rate at 6 months after device implantation and the pre- and post-implantation serum nickel levels were compared between the two groups. A non-inferiority design was used to prove that the therapeutic effect of the parylene-coated device was non-inferior to that of the traditional device. The Cochran-Mantel-Haenszel chi-squared test with adjustment for central effects was used for the comparison between groups.@*RESULTS@#At 6 months after implantation, successful ASD closure was achieved in 52 of 53 patients (98.11%) in both the trial and control groups (95% confidence interval (CI): [-4.90, 5.16]) based on per-protocol set analysis. The absolute value of the lower limit of the 95% CI was 4.90%, which was less than the specified non-inferiority margin of 8%. No deaths or severe complications occurred during 6 months of follow-up. The serum nickel levels were significantly increased at 2 weeks and reached the maximum value at 1 month after implantation in the control group (P 0.05).@*CONCLUSIONS@#The efficacy of a parylene-coated ASD occluder is non-inferior to that of a traditional uncoated ASD occluder. The parylene-coated occluder prevents nickel release after device implantation and may be an alternative for ASD, especially in patients with a nickel allergy.
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Humans , Cardiac Catheterization , Heart Septal Defects, Atrial/surgery , Polymers , Prospective Studies , Prosthesis Design , Septal Occluder Device/adverse effects , Treatment Outcome , XylenesABSTRACT
The resistance to artemisinin generated by plasmodium is defined as follows: After being treated with ACTs for three days, the time to clear plasmodium from the blood of patients with malaria becomes prolonged. The elimination rate of plasmodium in vivo is not only related to the parasiticidal efficacy of antimalarial drugs, but also affected by biological factors such as the mutation of plasmodium themselves, the regulation of human immune function(such as the recognition and processing of phagocytes) , and the efflux of foreign l>odies from immune organs. This article primarily reviews the mutation of plasmodium themselves , the physical and biochemical process of the spleen eliminating plasmodium, including K13 changes, the two blood circulation pathways of the spleen. Since the endothelial cell gap of the splenic venous sinus is elastic, plasmodium or red blood cell debris can be trapped by physical and mechanical sensing methods. The red pulp is the main venue to filter blood, where the immune cells are responsible for the removal of the residues of plasmodium. The physical process of the splenic venous sinus trapping plasmodium is called pitting, and its incidence is influenced by the growth cycle of plasmodium and therapeutic drugs. In this paper, the function of the spleen to eliminate plasmodium will be explained, in an attempt to provide a reference for the biological nature of the artemisinin resistance generated by plasmo-dium.
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Objective To observe the protective effect of Xinmailong injection ( XML ) on myocardial ischemia reperfusion (I/R) injury in rats model. Methods The levels of SPF 60 successful acute myocardial ischemia rat models were randomly divided into control group, I/R group and XML group( Different drug concentrations 50 mg/L, 100 mg/L, 200 mg/L, 400 mg/L). The control group was continuously given K-H nutrient solution for 2 hours, the other group was given respective different drug concentrations or K-H nutrient solution by Langendorff isolated heart perfusion method after ischemia 30 minutes. The following indicators were detected: Hemodynamics included heart rate (HR), left ventricular development pressure (LVDP) and ±dp/dtmax; the myocardial enzymes included creatine kinase (CK), creatine minase- MB (CK-MB), troponin-1 (Tn-I) and myoglobin (MYO), coronary flow and myocardial infarct size were observed. The expression of Bax and Bcl-2 in each group was detected by Western blotting and immunofluorescence. Results Xinmailong injection could alleviate LVDP and ±dp/dtmax; decrease the release of CK, CK-MB, Tn-I, MYO and the shrink area of myocardial infarction; increase the coronary flow; enhance heart rate fast and certain inhibition of myocardial apoptosis. Conclusion Xinmailong injection can alleviate the damage of cardiac function caused by myocardial ischemia/reperfusion injury.
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Bcr-Abl threonine 315 to isoleucine 315 (T315I) gatekeeper mutation induced drug resistance remains an unmet clinical challenge for the treatment of chronic myeloid leukemia (CML). Chemical degradation of Bcr-Abl
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Objective:to review the clinical features, diagnosis and treatment of spinal Rosai-Dorfman disease(RDD).Methods:we conducted a systemic review and collected the cases reported from 2010. The key words were Rosai-Dorfman disease, spine/central nervous system. We screened both English and Chinese database. There were 43 reports finally included in the study, containing 52 cases. We distracted the information of interest and, subsequently, analyzed the harvested data using specific statistical software packages. The study focused on the summary and description of the clinical features, diagnosis and treatment and prognosis of spinal RDD.Results:The included articles reported 52 cases. The average age was 32.1±17.1 years (ranging from 6 to 76 years old). The ratio of male to female was 1.9/1. The median follow-up period was 19.9 months. The initial symptoms of 41 patients (78.8%) were spinal lesion-related. The cases with painless lymph nodes enlargement, other organ lesions and abnormal lab tests were 11.5%, 36.5% and 23.1%, respectively. The frequent infringed segments were cervical (43.1%) and thoracic (39.2%) spine. 53.2% lesions were dura-based, while 17.0% and 10.6% for bone and cord, respectively. Surgery was the mainstream of the treatment armamentarium, composing 83.7% cases, among which 46.3% underwent total resection. Cases only treated with radiotherapy, chemotherapy and steroids were 10.2%. Very Few cases remitted spontaneously (2.0%). The risk of recurrence and occurrence at other vertebral levels was 22.0%.Conclusion:It is rare for spinal involvement of RDD. This entity has no pathognomonic clinical and imaging features. RDD has a tendency of multi-organ involvement and recurrence. Surgery remains the mainstay of the treatment, but the efficacy of other adjuvant therapies is not sure. A wait and watch strategy is employed for asymptomatic patients.