Establishment of ultrasound-guided incomplete ablation model of ectopic implanted tumor of liver cancer in nude mice / 中华超声影像学杂志

Objective:To establish a good model of incomplete ablation of ectopic implanted tumor of liver, and explore the changes in the molecular landscape of residual cancer, cancer in nude mice.Methods:Eight immunodeficient BALB/c nude mice were used to establish an ectopic tumor model with the MHCC97-H hepatoma cell line, and they were randomly divided into experimental group and control group, with 4 mice in each group. The experimental group underwent simulated clinical incomplete ablation, and the control group only underwent false ablation. The differences between the models were evaluated by ultrasonic diagnostic equipment, thermal imaging cameras, HE staining and high-throughput whole transcriptome sequencing.Results:Liver cancer ectopic implantations in nude mices were all successful. The experimental group showed that the temperature of the tumor around the tip of the needle monitored by the thermal imaging camera was at 50-73.9 ℃. Compared with the control group, the HE staining of the experimental group mostly showed the coexistence of necrotic area-degeneration area-tumor cell area. The necrosis area was (23.75±13.77)%, and the degeneration area was 50%(30%). High-throughput whole transcriptome sequencing revealed that there were hundreds of overlapping stable molecular landscapes in the incomplete ablation simulation model both in vivo and in vitro.Conclusions:By establishing an ectopic implantion model of nude mice with incomplete ablation of residual liver cancer, it can provide a basis for studying the biological characteristics of incomplete ablation of residual cancer at the molecular level.

Recent progress of nanoparticle-enabled modulation of macrophages for cancer immunotherapy / 药学学报

Macrophages play an important role in maintaining homeostasis of the body, and they are also one of the most abundant immune cells in the tumor microenvironment (TME). These macrophages are often called tumor-associated macrophages (TAMs), which play an important role in the development of tumor and are an important target for tumor therapy. Studies have shown that tumor growth and metastasis can be inhibited by regulating the function of macrophages, but the therapeutic efficacy was often hampered by the poor performance of the drugs such as lack of targeting, poor solubility, low bioavailability, and severe side effects. After introduction of the background of macrophage and tumor therapy, this review focuses on the research progress of nano-drug delivery systems in the modulation of the function of macrophages to enhance tumor immunotherapy. Nano-drug delivery systems are diverse in structures and functions, and can regulate macrophage functions through a variety of mechanisms. Four important aspects of macrophage modulation, which included TAMs depletion, repolarization of TAMs, promoted phagocytosis of TAMs, and combinational modulation of TAMs were summarized. Each strategy together with typical examples was reviewed and future directions in this field were also prospected.

Effect of Qinggan Zishen Prescription on Metabolic Disorder in Obesity-related Hypertension and Its Mechanism Based on Network Pharmacology / 中国实验方剂学杂志

ObjectiveTo explore the effect of Qinggan Zishen prescription on metabolic disorders in obesity-related hypertension （OBH） patients and analyze the potential pharmacological mechanism based on network pharmacology. MethodA total of 85 eligible OBH patients who were treated in the outpatient or wards of Jiangsu Province Hospital of Chinese medicine from September 2018 to January 2020 were selected and randomized into the observation group （45 cases） and control group （40 cases）. All patients were treated with western medicine during a four-week introduction period， and then the observation group was treated with Qinggan Zishen prescription on the basis of western medicine. The study lasted 6 months， and indicators， such as triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， glycosylated hemoglobin （HbA1c）， fasting blood glucose （FBG）， fasting insulin （FINS）， waist circumference （W）， hip circumference （H） were detected and homeostasis model assessment of insulin resistance （HOMA-IR），body mass index （BMI）， waist-hip ratio （WHR） were calculated before and after intervention. At the same time， the regulation network of the Qinggan Zishen prescription was visualized and the protein-protein interaction （PPI） network was constructed. The core targets of the network were obtained for Gene Ontology （GO） term enrichment and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. ResultAfter intervention for 6 months， the levels of W， H， WHR， FINS， and HOMA-IR in the observation group were reduced as compared with those in the control group （P<0.05， P<0.01）. According to network pharmacology， the main components of Qinggan Zishen prescription in treating OBH were luteolin， quercetin， and berberine and the key targets were amyloid precursor protein （APP）， vascular endothelial growth factor A （VEGFA）， and estrogen receptor 1 （ESR1）. Moreover， the key biological pathway was advanced glycation end product （AGE）/advanced glycation end product receptor （RAGE） signaling pathway. ConclusionQinggan Zishen prescription can improve the metabolic disorder of OBH patients through multiple components， multiple targets， and multiple pathways， which provides new mindset for follow-up studies.

Review and updates on physical activity load assessment in preschool children / 中国学校卫生

Abstract@#With the increasing attention paid to preschool physical activity in recent years, physical activity load assessment of preschool children has evolved with the development of theory and the wide application of microelectronic technology. In this paper, relevant literature from PubMed, Web of Science, and CNKI database were collected and analyzed, aiming to provide review and updates on physical activity load assessment in preschoolers. Given the characteristics of children s physical activities, effective measurement methods should be chosen and integrated from these tools, to improve the accuracy and effectiveness of children s physical activity load assessment.

Survival of mother and infant following treatment of acute Stanford type B aortic dissection with endovascular repair under local anesthesia in second trimester: a case report / 中华围产医学杂志

We report the diagnosis and treatment of a pregnant woman with acute Stanford type B aortic dissection in the second trimester who underwent thoracic endovascular aortic repair under local anesthesia and later gave birth to a live neonate. The patient was admitted due to acute upper back pain at 27 weeks of gestation, who was diagnosed as acute Stanford type B aortic dissection. Thoracic endovascular aneurysm repair was performed with low radiation dose under local anesthesia. A live neonate was born through cesarean section at 33 +6 gestational weeks due to the flat baseline of the fetal heart monitor, with a birth weight of 1 840 g and Apgar score of 9 at 1 min. The neonate was discharged after a 20-day treatment. During the follow-up of 12 months, the infant grew and developed well, and covered stent was well placed in the mother without leakage in the distal or proximal ends of the stent or any other complications.

Effect of parent-child bibliotherapy on symptom management and self-management behaviors in school-age children with asthma / 中国实用护理杂志

Objective:To investigate the effect of parent-child bibliotherapy on symptom management and self-management behaviors in school-age children with asthma.Methods:From January 2018 to December 2019, a total of 130 school-age asthma children were randomly divided into experiment group ( n=65) and control group ( n=65) by random number table method. Children in the control group received routine care, experiment group carried out parent-child bibliotherapy based on the routine care and assessed after three months of intervention. The times of asthma attack and emergency treatment were recorded between two groups, the daytime and nighttime symptom scores were assessed according to the Guidelines for the diagnosis and treatment of bronchial asthma in children, and self-management behaviors was measured by Self-management Behavior Questionnaire for Asthmatic Children. Results:After three months of intervention, the average frequency of asthma and emergency treatment in the experiment group (1.84±0.51), (1.16±0.58) times were reduced, compared to (2.53±0.85), (1.34±0.32) times in the control group, the difference was statistically significant ( t values were 2.281, 2.084, P<0.05). After three months of intervention, the daytime and nighttime symptom scores were (1.54±0.35) points and (1.40±0.17) points, lower than (2.15±0.43) and (1.98±0.52) points in the control group, the difference was statistically significant ( t values were 2.632, 2.338, P<0.05).; the total self-management behaviors scores and diet, avoidance of allergens, recognition and treatment of asthma attack, exercise, drug scores were (3.08±0.32), (3.02±0.83), (2.54±0.66), (3.46±0.50), (3.09±0.79), (3.23±0.85) points, higher than (2.74±0.34), (2.68±0.65), (2.18±0.88), (2.97±0.79), (2.77±0.78), (2.81±0.69) points in the control group, the difference was statistically significant ( t values were 2.187, to 5.588, P<0.05). Conclusion:The parent-child bibliotherapy can effectively improve the self-management behaviors and relieve the symptom of asthma and reduce the times of attacks and emergency treatment of school-age children with asthma.

Assessment of left ventricular function and hemodynamics in infantile pneumonia by ultrasonic cardiac output monitor / 中华实用儿科临床杂志

Objective:To assess the left ventricular function and hemodynamic status in infantile pneumonia by ultrasonic cardiac output monitor (USCOM).Methods:The clinical data of 74 children with infantile pneumonia hospitalized in the Department of Pediatrics of Affiliated Hospital of North Sichuan Medical College from October 2018 to January 2020 were collected in this study, and those cases were divided into the mild pneumonia group (45 cases) and the severe pneumonia group (29 cases). USCOM was employed to measure such data of patients in both groups as heart rate (HR), flow time corrected (FTc), stroke volume variability (SVV), stroke volume index (SVI), cardiac index (CI), inotropy index(INO), and systemic vascular resistance index (SVRI). The specific values of CI and SVRI in all ages were employed to determine the hemodynamic type.According to values of CI, they were grouped into normal, high and low output; according to values of SVRI, they were grouped into normal, high and low resistance.The left ventricular function and hemodynamic status of infants with pneumonia in both groups were compared.Results:(1) In the mild pneumonia group, 42.22% of infants (19/45 cases) presented with abnormal hemodynamic status, of which 94.74% were high-output and low-resistance type.In the severe pneumonia group, 79.31%(23/29 cases) of infants presented with abnormal hemodynamic status, of which 86.96%(20/23 cases) were non-high-output and non-low-resistance type.The proportion of different hemodynamic types from high to low in order is as follows: low-output and high-resistance (39.13%), high-output and normal-resistance (26.09%), low-output and low-resistance (13.04%), and normal-output and low-resistance (8.70%). (2)Before treatment, HR, SVI, CI, INO and SVRI in the severe pneumonia group and the mild pneumonia group were (153.2±19.3) times/min, (32.0±5.8) mL/m 2, (4.3±1.0) L/(min·m 2), (1.1±0.4) W/m 2, (1 139.0±280.6) d·s·cm -5·m 2 and(140.2±13.2) times/min, (39.2±4.1) mL/m 2, (5.1±0.8) L/(min·m 2), (1.4±0.2) W/m 2, and (904.7±175.8) d·s·cm -5·m 2, respectively.SVI, CI and INO in the severe pneumonia group were lower than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). HR and SVRI in the severe pneumonia group were higher than those in the mild pneumonia group, which indicated that the difference was statically significant (all P<0.05). There was no significant difference in cardiac preload between both groups before treatment ( P>0.05). HR in the severe pneumonia group after treatment[(137.6±9.3) times/min] were significantly lower than before treatment, while SVI and CI[(36.2±3.4) mL/m 2, (4.7±0.3)L/(min·m 2)] were higher than before treatment, which indicated that the differences were statistically significant (all P<0.05). Conclusions:The USCOM provided a rapid approach for the dynamic measurement of left ventricular function and hemodynamic status.As per the findings with USCOM, more infants with mild pneumonia presented with hemodynamic abnormalities, and most of them were high-output and low-resistance types.The majority of infants with severe pneumonia presented with different types of hemodynamic abnormalities, and most of them were non-high-output and non-low-resistance types, which can return to normal after treatment.

Saikosaponin A Changes Drug Resistance of A549/DDP Cells Through Wnt/β-Catenin Pathway / 中国实验方剂学杂志

Objective:To investigate the effect and mechanism of saikosaponin A （SSA） on the reversal of cisplatin （DDP） resistance in human lung cancer cell line A549/DDP. Methods:The resistance of A549 and A549/DDP cells to DDP and the inhibitory effects of SSA against the proliferation of A549 and A549/DDP cells were detected using cell counting kit-8 （CCK-8）. The apoptosis rates of A549/DDP cells treated with SSA or DDP or SSA combined with DDP and the changes in reactive oxygen species （ROS） were determined by flow cytometry. The mRNA expression levels of C-myc， B-cell lymphoma 2 （Bcl-2） and cysteinyl aspartate-specific protease-3 （Caspase-3） were detected by real-time polymerase chain reaction （Real-time PCR）， followed by the determination of <italic>β</italic>-catenin transcriptional activity using the TopFish dual-luciferase reporter assay system and the measurement of <italic>β</italic>-catenin protein expression in A549/DDP cells by Western blot. Results:The results of CCK-8 assay showed that the DDP resistance of A549/DDP cells was 12.82 times that of A549 cells （<italic>P</italic><0.05）. SSA inhibited the viability of A549 cells with the half maximal inhibitory concentration （IC₅₀） being 34.9 μmol·L^-1， and also suppressed the viability of A549/DDP cells in a concentration-dependent manner. Since the inhibition rate of 20 μmol/L SSA against A549/DDP cells was less than 10%， the reversal concentration was set at 20 μmol/L. Flow cytometry revealed that compared with the control， DDP alone increased the apoptosis rate of A549/DDP cells （<italic>P</italic><0.05）， stimulated the accumulation of intracellular ROS （<italic>P</italic><0.05）， down-regulated the mRNA expression levels of C-myc and Bcl-2 in A549/DDP cells， up-regulated Caspase-3 mRNA expression， and reduced the transcriptional activity of <italic>β</italic>-catenin （<italic>P</italic><0.05）. Compared with the DDP group， the SSA+DDP group exhibited obviously increased apoptosis of A549/DDP cells， enhanced accumulation of intracellular ROS， down-regulated C-myc and Bcl-2 mRNA expression， up-regulated Caspase-3 mRNA expression （<italic>P</italic><0.05）， and weakened <italic>β</italic>-catenin transcription （<italic>P</italic><0.05）. DDP combined with SSA better decreased the <italic>β</italic>-catenin protein expression in contrast to that of control or DDP （<italic>P</italic><0.05）. Conclusions:SSA enhances the sensitivity of A549/DDP cells to DDP possibly by inhibiting the activation of Wnt/<italic>β</italic>-catenin pathway.

Research Progress in Genetic Research of Fatigue / 中国实验方剂学杂志

Fatigue refers to the manifestation of disorders in the process of carrying out or maintaining random activities， which can be regarded as an independent disease or as a symptom in a variety of chronic diseases. The high incidence of fatigue has seriously affected people's physical and mental health， and the prevention and treatment of fatigue has become an important problem to be solved urgently. The pathogenesis of fatigue mainly includes energy consumpation， accumulation of metabolites， abnormal secretion of neurotransmitters， decline of mitochondrial function， dysfunction of hypothalamus pituitary adrenal axis， etc. At present， there is no unified understanding about the pathogenesis of fatigue at home and abroad. The gene research of fatigue is the current research frontier. Gene expression profiling provides a new method for the study of the mechanism of fatigue. The combination of gene chip technology and traditional Chinese medicine（TCM） theory is expected to bring a breakthrough in the study of the pathogenesis of fatigue. In the study of fatigue gene chip， messenger RNA（mRNA） and microRNA（miRNA） are the common research objects， but few explorations are focused on the gene expression rule of fatigue by a specific signaling pathway and the effective regulation targets of TCM for treating fatigue. In recent years， the dysfunction of reward and inhibition mechanism in the central nervous system has become a research hotspot. In particular， gamma amino butyric acid （GABA） and dopamine （DA） have attracted much attention as the main substances of inhibition and reward mechanism， respectively. GABA and DA are used as inhibition and reward mechanisms to maintain the balance， and the body will not feel fatigue. Once the balance is broken， the fatigue will be formed. At the same time， DA and GABA receptors can also regulate cyclic adenosine monophosphate signaling pathway（cAMP） to affect fatigue. The research on key genes in GABA/DA balance mechanism and related cAMP signaling pathway by gene chip technology is expected to reveal the pathogenesis of fatigue in depth. The gene chip method is used to detect the changes of key genes in GABA/DA pathway and the related cAMP signaling pathway in the fatigue population and the normal population， so as to further explore the pathogenesis of fatigue. In this paper， the key genes in GABA/DA balance mechanism and cAMP signaling pathway related to fatigue were summarized by using the review method， so as to provide the basis for further study on the pathogenesis of fatigue and effective prevention and treatment from the perspective of genetics.

Resource Value Discovery and Utilization of Wastes in Industrialization of Rhei Radix et Rhizoma / 中国实验方剂学杂志

The recycling of traditional Chinese medicine （TCM） wastes is an important research topic to be solved urgently in the industrialization of TCM resources. Rhei Radix et Rhizoma is a bulk Chinese herb mainly derived from Rheum palmatum，R. tanguticum，and R. officinale. At present，these three medicinal plants have been cultivated on a large scale and widely used in the fields of medicine，health care，food，cosmetics，and veterinary medicine，with an annual demand of more than 5 500 tons（1 ton=1 000 kg）. However，a large number of wastes such as non-medicinal parts and residues produced in the production and deep processing are discarded because there is no effective way of utilization，resulting in serious waste of resources and environmental pollution. The non-medicinal parts contain not only the chemical components and pharmacological effects similar to those of roots and rhizomes but also a variety of amino acids，mineral elements，and conventional nutrients. They have a long history of use，and the content of some resource components is higher than that in roots and rhizomes. In particular，their stems and leaves exhibit great potential to be consumed as food and medicine due to high safety. Besides，the content of anthraquinones in Rhei Radix et Rhizoma residue is high and it possesses good antibacterial activity. It can be seen that the waste from the industrialization of Rhei Radix et Rhizoma has high utilization value. Hence，based on the relevant literature and investigation on the application of producing areas in China and abroad，the paper summarized the utilization status of their medicinal and non-medicinal parts，the waste production in the industrialization，as well as the active substances and utilization ways and put forward the multi-level and multi-path utilization strategy of Rhei Radix et Rhizoma wastes，in order to provide reference for the rational development and application of Rhei Radix et Rhizoma resources and promote the effective utilization and green development of the corresponding wastes.

Epidemiological investigation of tinnitus in Sichuan and Chongqing / 中华耳鼻咽喉头颈外科杂志

Objectives: To investigate the prevalence and associated risk factors of tinnitus in Sichuan and Chongqing. Methods: We designed a tinnitus epidemiological questionnaire. The multi-stage stratified cluster random sampling methods was applied to obtain study subjects in six areas (Nanchong, Jiangjin, Fengdu, Yunyang, Suining and Ya'an), which were selected for epidemiological investigation. Home visit completion of epidemiological questionnaires was conducted. The trained investigators guided the respondents to fill in the tinnitus epidemiological questionnaires, and the epidemiological status of six areas on prevalence and risk factor was investigated. SPSS 22.0 software was used for statistical analysis. Results: Sampling population were 10 289, in which 9 273 were valid questionnaires. There were 4 281 males and 4 992 females, with an average age of 47.3 years, among which 34.83% (3 230/9 273) had tinnitus. 3.99% (370/9 273) were diagnosed with bothersome tinnitus. In a multivariable logistic regression mod, the following factors were associated with onsetting of tinnitus: sleep disorder [Odds Ratio(OR)=3.74] and noise exposure(OR=1.99). The risk of disease was lowest in the age of 30-40 years old, while the risk of disease was higher for people under 30 and over 40. In another multivariable logistic regression mode, the following factors were associated with having bothersome tinnitus: older people were more likely to suffer from tinnitus, sleep disorders (OR=4.68) and noise exposure (OR=1.56). Conclusions: The prevalence of tinnitus in Sichuan and Chongqing is about 34.83%, but most of the tinnitus is short-lived and has low loudness, which will not affect the patients. Only a small number of patients with tinnitus (3.99%) persist and affect their health and need treatment. The occurrence and exacerbation of tinnitus may be related to sleep, age, and noise exposure.

Modified single-needle arthroscopic repair technique for the treatment of longitudinal meniscal tear / 中国骨伤

OBJECTIVE@#To compare therapeutic efficacy of modified single-needle arthroscopic repair technique and Fast-Fix technique in repairing longitudinal meniscus injuries.@*METHODS@#From July 2016 to July 2017, patients with longitudinal meniscus injuries who underwent meniscal repair surgery were retrospectively analyzed. Ninety-one patients treated with modified single-needle technique and 77 patients were treated with Fast-Fix technique, the average age were (26.7±7.6) and (27.9±6.1) years old respectively, the average lengths of follow-up were (32.5±9.2) and (33.2±11.9) months, respectively. Operation cost, suture time, intraoperative failure rate and postoperative failure rate were used as clinical outcomes, MRI of knee joint was used as main diagnosis and evaluation basis; 2000 IKDC subjective score, Lysholm score and Tegner activity scale were compared between two groups preoperatively, 12 months after operation and at the latest follow-up. Intraoperative and postopertaive complications were observed.@*RESULTS@#Compared with Fast-Fix group, patients in modified single-needle technique group had lower operation costs [(645.7±133.1 vs.(12 184.8±4 709.8), @*CONCLUSION@#Modified single-needle arthrscopicrepair technique could achieve the similar therapeutic efficacy as Fast-Fix technique, and it has advantageds of simple opertion and more economical. This study recommends clinical application of modified single-needle arthrscopic repair technique in treating meniscus injuries.

Expert consensus on Antiviral Oral Liquid in treatment of influenza in clinical practice / 中国中药杂志

Antiviral Oral Liquid is modified on the basis of Baihu Decoction in Treatise on Febrility Diseases by ZHANG Zhongjing and Qingwen Baidu Yin in Qing Dynasty, with effects in clearing toxic heat, repelling dampness and cooling blood. It is widely used in clinical treatment of common colds, influenza and upper respiratory tract infection, mumps, viral conjunctivitis and hand-foot-mouth disease, with a good clinical efficacy and safety. Based on a questionnaire survey of clinicians and a systematic review of study literatures on Antiviral Oral Liquid, the international clinical practice guidelines development method was adopted to analyze the optimal available evidences and expert experiences in the "evidence-based, consensus-based and experience-based" principles. The consensus was jointly reached by more than 30 multidisciplinary experts nationwide, including clinical experts of traditional Chinese and Western medicine in the field of respiratory diseases and infectious diseases, and methodological experts. In the study, literatures were retrieved based on clinical problems in the clinical survey as well as PICO clinical problems. The GRADE system was used for the classification and evaluation of evidence, and fully combined with clinical expert experience, so as to reach expert consensus by the nominal grouping method. This expert consensus recommended or suggested indications, usage and dosage, course of treatment, intervention time for treatment, and the safety and precautions of Antiviral Oral Liquid for treatment of influenza, and can provide reference for the rational use of this drug in clinical practice.

Rule of point selection in treatment of cerebral palsy in children with acupuncture based on data mining of 1584 electronic medical records / 中国针灸

OBJECTIVE@#To explore the rule of point selection in treatment of cerebral palsy with acupuncture in preschool children.@*METHODS@#Based on the electronic medical records of Xi'an Encephalopathy Hospital of TCM, through structuring medical record text, acupuncture prescriptions were extracted. Using the data mining tools of the ancient and modern medical record cloud platform V2.2.3 and the clinical effective prescription and molecular mechanism analysis system of traditional Chinese medicine V2.0, the cluster analysis and complex network analysis were conducted on acupuncture prescriptions.@*RESULTS@#Of 1584 acupuncture prescriptions for cerebral palsy in children, there were 84 acupoints and stimulating areas of scalp acupuncture, of which, foot-motor-sensory area, balance area and Sanyinjiao (SP 6) were the top 3 acupoints with the highest use rate. With cluster analysis, 5 groups of common supplementary acupoints and stimulating areas were found, named, Weizhong (BL 40) and Waiguan (TE 5), Shousanli (LI 10), Xingjian (LR 2), Xuanzhong (GB 39) and Chengfu (BL 36), foot-motor-sensory area, balance area and Sanyinjiao (SP 6), Xuehai (SP 10) and Fenglong (ST 40), Pishu (BL 20), motor area and Yanglingquan (GB 34). With complex network analysis on core prescriptions, 13 core acupoints and stimulating areas of scalp acupuncture were obtained, including 3 core main points, i.e. Sanyinjiao (SP 6), balance area and foot-motor-sensory area and 10 sub-core points, i.e. Taichong (LR 3), motor area, Xuehai (SP 10), Ganshu (BL 18), Pishu (BL 20), Yanglingquan (GB 34), Sishencong (EX-HN 1), Baihui (GV 20), Fengchi (GB 20) and Shenshu (BL 23).@*CONCLUSION@#In treatment of acupuncture for cerebral palsy in preschool children, the core prescriptions reveal the simultaneous treatment of exterior and interior, the mutual regulation of

Attention and Its Relationship with Anxiety in Primary Open Angle Glaucoma Patients / 中山大学学报(医学科学版)

@#【Objective】 To explore the attention and its relationship with anxiety in patients with glaucoma.【Methods】A prospective case-control study was done on 20 primary open angle glaucoma（POAG）patients and 28 normal subjects. Response time with and without disturbance was examined by using Matlab software. Anxiety was assessed with State Anxiety Inventory（S- AI）and Trait Anxiety Inventory（T- AI）. Response time and inhibiting effects between two groups were compared by t test and Mann- Whitney U test ，respectively. Spearman correlation analysis was applied to determine the relationship between inhibiting effect and anxiety.【Results】The scores of S-AI and T-AI in POAG group were significantly higher than those in normal subjects（t = -3.912，P = 0.001；t = -2.127，P = 0.042）. There were statistically significant differences in the scores between groups even after gender was adjusted by using line regression model（β = 9.449，P = 0.000；β = 7.089，P = 0.018）. The average response time in POAG group（0.84±0.15）s was significantly longer than that in normal participants（0.75±0.14）s（t = -2.127，P = 0.039）. The difference was statistically insignificant when gender was adjusted by using line regression model（β = 0.063，P = 0.210）. The inhibiting effect in POAG group（0.126±0.089）s was longer than that in normal subjects（0.085±0.066）s（Z = -1.715，P = 0.086）. The inhabiting effect wasn′ t statistically significantly correlated with scores of S- AI and T- AI（P＞0.05）.【Conclusions】Patients with POAG showed severer anxiety than normal subjects but attention was comparable. There was no significant correlation between attention and anxiety.

Discussion on registry study of acupuncture-moxibustion for malignant pleural effusion / 中国针灸

Malignant pleural effusion (MPE) is one of the common complications of tumor. Acupuncture-moxibustion therapy has several advantages for treatment of MPE. Acupuncture is regarded as a complex individualized intervention, and its characteristics of TCM is difficult to be reflected by strict randomized controlled trials. The registry study provides more possibilities for the data collection of individualized diagnosis and treatment under the guidance of the overall concept and syndrome differentiation, and is more suitable for data management and collection of large samples and multi-center trials in the real-world study. It has become an opportunity to carry out real-world study of acupuncture for MPE. There are many challenges in the registry study of acupuncture for MPE. However, it is of great significance to collect real-world data of acupuncture for MPE to improve the clinical effect of MPE and provide a new clinical research method for acupuncture in tumors and related complications.

Discussion on Pathogenesis and Treatment of Type 2 Diabetes from Perspective of Intestinal Microecology / 中国实验方剂学杂志

Diabetes is a kind of disease which poses a great threat to human health. Its occurrence and development are often related to many factors such as heredity and environment. According to the eighth edition of Diabetes Federation's diabetes map in 2017， there are about 425 million diabetics in the world. It is estimated that by 2045， the number of diabetics will increase to 700 million， becoming a health problem that has attracted increasing attention all over the world， among which the number of type 2 diabetics （T2DM）accounts for more than 90% of the total. Therefore， it is of great significance to study the pathological mechanism for the effective prevention and treatment of diabetes. Intestinal microflora coexists with human beings and forms an important micro ecosystem， which is involved in the metabolism of substance and energy. In recent years， with the development of high-throughput sequencing technology， a large number of studies have shown that in addition to obesity， genetic and insulin dysfunction， intestinal flora disorder may also lead to diabetes. The unbalanced diet structure of T2DM patients destroys the balance of intestinal flora. It is generally believed that the occurrence and development of T2DM may be one of the results of the intestinal microbial disorder caused by over nutrition. However， there is no clear mechanism of how intestinal flora participates in the development of T2DM. At present， it is generally believed that the intestinal flora may affect the metabolism of the body through the participation in bile acid metabolism， short chain fatty acid metabolism， low-level inflammatory response and other ways. At present， the prevention and treatment of T2DM is mainly based on drug control. Through surgical operation， increasing the number of probiotics， fecal transplantation and other methods to intervene the intestinal microflora to adjust the intestinal microflora， it provides a new means for the prevention and treatment of T2DM. This paper discusses the interaction between T2DM and intestinal microflora in recent years and the possible treatment measures in the future.

Effect of Liuwei Dihuangtang on Mitochondrial Apoptotic Pathway in Rats with Chronic Renal Failure / 中国实验方剂学杂志

Objective:To observe the effect of Liuwei Dihuangtang on the mitochondrial apoptotic pathway in rats with chronic renal failure. Method:The 45 male SD rats were randomly divided into normal group （n=10）， sham group （n=10） and operation group （n=25）. The operation group received 5/6 nephrectomy， and the rats in operation group were randomly divided into the model group and the treatment group after successful modeling. The treatment group received Liuwei Dihuangtang by gavage administration， while the rest of the three groups received equal volume of distilled water by gavage administration， with a treatment course of 8 weeks. The quantitative levels of serum creatinine （SCr）， blood urea nitrogen （BUN） and urine protein in each group were determined. Hematoxylin eosin （HE） staining and Masson staining were used to observe the histopathological changes of rat kidney. The structural changes of mitochondria in renal tubular epithelial cells were observed under electron microscope. The apoptotic rate was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling（TUNEL）. The expression of B cell lymphoma -2 （Bcl-2）， Bcl-2 associated X protein （Bax）， cytochrome C （Cyt C） and cysteine aspartic acid protease -3 （Caspase-3） were analyzed by Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Result:As compared with the normal group， the quantitative levels of SCr， BUN and urinary protein in the model group were significantly increased （P<0.01）， and the above indicators were improved in the treatment group as compared with the model group （P<0.05）. No significant pathological changes and damage of mitochondrial structure were observed in the kidney tissues of the control group and the sham group. In the model group， there were different degrees of renal tubular atrophy and dilatation， interstitial inflammatory cell infiltration and collagen deposition， and mitochondria swelling and breaking， but such lesions were significantly alleviated in the treatment group. As compared with the normal group， apoptotic rate was increased significantly in model group （P<0.01）， the expression of Bax and Caspase-3 was significantly increased （P<0.01）， and the expression of Bcl-2 was significantly decreased （P<0.01）. As compared with the model group， apoptotic rate was significantly reduced in the treatment group （P<0.01）， the expression of Bax and Caspase-3 was significantly decreased （P<0.01）， and the expression of Bcl-2 was significantly increased （P<0.01）. In the normal group and sham group， Cyt C was mainly located in mitochondria. The expression of Cyt C in the cytoplasm of the model group was increased significantly （P<0.01）， while that of the treatment group was decreased （P<0.01）. Conclusion:Liuwei Dihuangtang can alleviate renal fibrosis and delay the progression of renal function. The mechanism of reducing apoptosis may be associated with protecting mitochondrial structure and regulating the expression of proteins related to mitochondrial apoptotic pathway.

Evolution of blood lipids and risk factors of dyslipidemia among people living with human immunodeficiency virus who had received first-line antiretroviral regimens for 3 years in Shenzhen / 中华医学杂志(英文版)

BACKGROUND@#Lipid abnormalities are prevalent among people living with human immunodeficiency virus (HIV) (PLWH) and contribute to increasing risk of cardiovascular events. This study aims to investigate the incidence of dyslipidemia and its risk factors in PLWH after receiving different first-line free antiretroviral regimens.@*METHODS@#PLWH who sought care at the Third People's Hospital of Shenzhen from January 2014 to December 2018 were included, and the baseline characteristics and clinical data during the follow-up were collected, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The risk factors of dyslipidemia after antiretroviral therapy were analyzed with the generalized estimating equation model.@*RESULTS@#Among the 7623 PLWH included, the mean levels of TC, HDL-C and LDL-C were 4.23 ± 0.85 mmol/L, 1.27 ± 0.29 mmol/L and 2.54 ± 0.65 mmol/L, respectively, and the median TG was 1.17 (IQR: 0.85-1.68) mmol/L. Compared with that in PLWH receiving tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) + ritonavir-boosted lopinavir (LPV/r), zidovudine (AZT) + 3TC + efavirenz (EFV), and AZT + 3TC + LPV/r, the incidence of dyslipidemia was lower in PLWH receiving TDF + 3TC + EFV. In multivariate analysis, we found that the risks of elevations of TG, TC, and LDL-C were higher with TDF + 3TC + LPV/r (TG: odds ratio [OR] = 2.82, 95% confidence interval [CI]: 2.55-3.11, P < 0.001; TC: OR = 1.24, 95% CI: 1.14-1.35, P < 0.001; LDL: OR = 1.06, 95% CI: 1.00-1.12, P = 0.041), AZT + 3TC + EFV (TG: OR = 1.41, 95% CI: 1.28-1.55, P < 0.001; TC: OR = 1.43, 95% CI: 1.31-1.56, P < 0.001; LDL: OR = 1.18, 95% CI: 1.12-1.25, P < 0.001), and AZT + 3TC + LPV/r (TG: OR = 3.08, 95% CI: 2.65-3.59, P < 0.001; TC: OR = 2.40, 95% CI: 1.96-2.94, P < 0.001; LDL: OR = 1.52, 95% CI: 1.37-1.69, P < 0.001) than with TDF + 3TC + EFV, while treatment with TDF + 3TC + LPV/r was less likely to restore HDL-C levels compared with TDF + 3TC + EFV (OR = 0.95, 95% CI: 0.92-0.97, P < 0.001). In addition to antiretroviral regimens, antiretroviral therapy duration, older age, overweight, obesity and other traditional factors were also important risk factors for dyslipidemia.@*CONCLUSION@#The incidence of dyslipidemia varies with different antiretroviral regimens, with TDF + 3TC + EFV having lower risk for dyslipidemia than the other first-line free antiretroviral regimens in China.

Efficacy and safety of the long-acting fusion inhibitor albuvirtide in antiretroviral-experienced adults with human immunodeficiency virus-1: interim analysis of the randomized, controlled, phase 3, non-inferiority TALENT study / 中华医学杂志(英文版)

BACKGROUND@#Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs.@*METHODS@#We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%.@*RESULTS@#At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group.@*CONCLUSIONS@#The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure.@*TRIAL REGISTRATION@#ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx.