Clinical Study on Dingxuan Decoction Combined with Vestibular Function Rehabilitation Training in the Treatment of Meniere's Disease / 广州中医药大学学报

Objective To investigate the efficacy of Dingxuan Decoction combined with vestibular function rehabilitation training in the treatment of Meniere's disease and to observe its effect on clinical symptoms and blood flow of vertebral artery.Methods A total of 100 patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type were randomly divided into an observation group and a control group,with 50 patients in each group.The control group was given conventional treatment and vestibular function rehabilitation training,and the observation group was treated with Dingxuan Decoction on the basis of treatment for the control group.The two groups were treated for 4 weeks and then were followed up for 6 months.The changes of traditional Chinese medicine(TCM)syndrome score,Dizziness Handicap Inventory(DHI)score,Tinnitus Handicap Inventory(THI)score,hearing visual analogue scale(VAS)score and vertebral artery blood flow in the two groups were observed before and after the treatment.After treatment,the TCM syndrome efficacy,hearing improvement and follow-up results were compared between the two groups.Results(1)After 4 weeks of treatment,the total effective rate for TCM syndrome efficacy of the observation group was 86.00%(43/50),and that of the control group was 62.00%(31/50),and the intergroup comparison showed that the TCM syndrome efficacy in the observation group was significantly superior to that in the control group(P＜0.01).(2)After 4 weeks of treatment,the hearing of patients in both groups was improved,and the total effective rate for the efficacy of hearing improvement in the observation group was 76.00%(38/50),while that in the control group was 46.00%(23/50).The intergroup comparison showed that the efficacy of hearing improvement in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the TCM syndrome scores,DHI score,THI score and hearing VAS scores in the two groups were all decreased compared with those before treatment(P＜0.05 or P＜0.01),and the decrease in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the average blood flow velocity of the left vertebral artery(LVA)and the right vertebral artery(RVA)in the two groups were both increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)The results of 6-month follow-up after treatment showed that the incidence of Meniere's disease and the frequency of attack in the observation group were significantly reduced compared with those in the control group,and the episode duration in the observation group was significantly shorter than that in the control group,the differences being all statistically significant(P＜0.05 or P＜0.01).Conclusion Dingxuan Decoction combined with vestibular function rehabilitation training exert certain effect in treating patients with Meniere's disease of liver-kidney yin deficiency complicated with wind-water upward stirring type,and the therapy is effective on improving patients'clinical symptoms and vertebral artery blood flow,reducing the risk of recurrence and improving the quality of life of the patients.

Analysis of recognition sites and application for commercial and homemade antibodies to aquaporin 9 / 解剖学报

Objective To analyze the antigen recognition sites of commercial and homemade antibodies against aquaporin(AQP)9,and to identify the application effect.Methods Western blotting was used to compare the efficacy of three commercial antibodies and self-made antibody in identifying AQP9 genotypes.The antigen recognition sites of four antibodies and their specificities in practical applications were analyzed.Results Western blotting showed that protein bands of three commercial antibodies were detected in both WT and Aqp9-/-mice.The keyhole limpet hemocyanin(KLH)conjugated synthetic peptides corresponding to the three commercial antibodies were derived from rat,human and human,respectively.And The sequences of these three synthetic peptides were different from those of mice.AQP3/7 and AQP9 have similar molecular weight and were expressed in the liver with high homology.An obvious band of self-made antibody was observed at the 27 kD position in WT mice,but no band was observed at the corresponding position in Aqp9-/-mice.Conclusion Commercial antibodies 1 and 3 can be used to assist in the identification of genotypes in Aqp9-/-mice.Homemade antibodies can accurately identify genotypes at the protein level.

Evaluation of analgesic effect of nalbuphine in patients with non-mechanical ventilation in intensive care unit: a multi-center randomized controlled trail / 中华急诊医学杂志

Objective:To analyze the efficacy and safety of nalbuphine for analgesia in patients with non-mechanical ventilation in intensive care unit (ICU).Methods:From December 2018 to August 2021, a multicenter randomized controlled clinical study was conducted to select non-mechanical ventilation patients with analgesic needs admitted to ICU of four hospitals in Henan Province and Guizhou Province. Patients were randomly assigned to nalbuphine group and fentanyl group. The nalbuphine group was given continuous infusion of nalbuphine [0.05~0.20 mg/(kg·h)], and the fentanyl group was given continuous infusion of fentanyl [0.5~2.0 μg/(kg·h)]. The analgesic target was critical-care pain observation tool (CPOT) score<2. The observation time was 48 hours. The primary endpoint was CPOT score, the secondary endpoints were Richmond agitation-sedation score (RASS), ICU length of stay, adverse events, and proportion of mechanical ventilation. The quantitative data of the two groups were compared by t test or Mann-Whitney U test. The enumeration data were compared by chi square test or Fisher exact probability method. The data at different time points between groups were compared by repeated measures analysis of variance. Results:A total of 210 patients were enrolled, including 105 patients in the nalbuphine group and 105 patients in the fentanyl group. There was no significant difference in baseline data between the two groups (all P>0.05). There was no significant difference in CPOT score between nalbuphine group and fentanyl group at each time point after medication ( P>0.05), the CPOT score of both groups at each time point after medication was significantly lower than that before medication, and the analgesic target could be achieved and maintained 2 hours after medication. There was no significant difference in RASS between the two groups at each time point after medication ( P>0.05), which was significantly lower than that before medication, and the target sedative effect was achieved 2 hours after medication. There was no significant difference in ICU length of stay between nalbuphine group and fentanyl group [5.0(4.0,7.5) d vs. 5.0(4.0,8.0) d, P=0.504]. The incidence of delirium, nausea and vomiting, abdominal distension, pruritus, vertigo and other adverse events in the nalbuphine group was lower than that in the fentanyl group (all P<0.05). There was no significant difference in the incidence of other adverse events such as deep sedation, hypotension and bradycardia between the two groups (all P>0.05). The incidence of respiratory depression in nalbuphine group was not significantly different from that in fentanyl group ( P>0.05), but the proportion of mechanical ventilation was significantly lower than that in the fentanyl group [1.9% (2/105) vs. 8.6%(9/105), P=0.030]. Conclusions:Nalbuphine could be used for analgesia in ICU patients with non-mechanical ventilation. The target analgesic effect could be achieved within 2 hours, and it had a certain sedative effect with a low incidence of adverse reactions.

Internal experiences of financial toxicity in cancer patients: a Meta-synthesis / 中国实用护理杂志

Objective:This study aims to investigate the inner experiences of cancer patients when confronting financial toxicity through a Meta-analytical approach. The goal is to provide evidence-based insights and theoretical references for clinical healthcare professionals to fully understand the feelings and experiences associated with financial toxicity in cancer patients, thereby laying a foundation for targeted interventional measures.Methods:A computerized search was conducted across databases including CINAHL, PubMed, PsycINFO, Embase, Scopus, Web of Science, CNKI, WanFang, VIP, Sinomed and other databases, collecting qualitative studies related to the inner experience of financial toxicity among cancer patients, up until April 12, 2023. Quality appraisal of the included literature was carried out according to JBI′s standards for qualitative research, and results were synthesized using Meta-aggregation methods.Results:Twenty-three studies were included, from which 82 specific outcomes were extracted. These were categorized into 11 new thematic groups and ultimately synthesized into four integrated findings: the impact of objective costs, subjective burden, and unreasonable expectations; diverse cognitive attitudes and management coping strategies; multiple pressures and challenges on patients and their families; and the articulation of needs and perceptions of beneficial growth.Conclusions:Healthcare professionals should pay attention to the financial toxicity issues that patients face at the initial stage of cancer diagnosis. Timely communication about economic issues between patients and healthcare providers is essential to help patients have a preliminary understanding of the impending financial toxicity at the onset of the disease. A comprehensive intervention that emphasizes different aspects of objective and subjective financial toxicity, coupled with multi-dimensional mitigation strategies, can promote active coping in patients, enhance familial emotional and financial support to overcome challenges together, and prioritize patients′ needs and expectations to guide them towards reinforcing positive experiences and minimizing the impact of financial toxicity.

Streamlined modular teaching based on organ system in standardized residency training in emergency department / 中华医学教育探索杂志

Objective:To explore the effectiveness of streamlined modular teaching based on the organ system in standardized residency training in emergency medicine.Methods:We enrolled residents on standardized training in the Second Clinical College of Tongji Medical College of Huazhong University of Science and Technology from July 2020 to July 2021. They were randomly divided in a 1∶1 ratio into conventional group (25 trainees, adopting a traditional standardized teaching method) and modular group (25 trainees, adopting streamlined modular teaching based on the organ system in addition to the method of the conventional group). At the end of training, all the trainees were assessed for academic performance and teaching-related indicators through an exam and questionnaire survey, and the teachers were surveyed for the degree of satisfaction with the teaching method. Data were analyzed by the t-test and chi-squared test using SPSS 21.0 software. Results:The modular group had a significantly higher total final exam score than the conventional group [(93.52±0.49) vs. (84.44±0.57), t=12.02, P<0.001]. Specifically, the modular group had significantly higher scores than the conventional group in emergency medicine theory, medical history taking and writing, physical examination and procedures, interpretation of examination results, and treatment and management ( t=3.62, 4.29, 4.22, 10.09, 7.56, all P<0.001). The modular group was also superior to the conventional group in terms of teaching-related indicators (all P<0.05). All participating teachers were satisfied with the new teaching method. Conclusions:The streamlined modular teaching method based on the organ system is beneficial for the standardized training of residents in emergency medicine, which is worthy of promotion.

The characteristics and implication of WHO Essential Medicines Model List 2023 / 中国卫生政策研究

The present analysis was based on the iteration of the 2023 WHO Essential Medicines Model List(23rd list)and Essential Medicines Model List for Children(9th list).In a methodological fashion,the adjustment procedure of the basic drug list and the materials required to submit the application were sorted out.Subsequently,a comprehensive synthesis of predominant features characterizing the 2023 edition of the EML and EMLc are summarized(offered).Notably,this edition boasts the highest count of medicines ever included featuring extensive inclusion of innovative drugs to fill the gap,select medicines for children carefully,and the emphasizing on clinical benefit evidence and public health affordability.It is suggested that China should update the NEML according to the national conditions and the experience of WHO as soon as possible,pay attention to the difference and connection between the list of essential medicines and the list of medical insurance,and play a meticulous role for establishing effective linkages between two lists.Such measures are envisaged to meet the basic drug needs,and ensure the accessibility and affordability of drugs,thereby optimizing the allocation of health resources.

Heart sound classification using energy distribution features extracted with wavelet packet decomposition / 中国医学物理学杂志

Objective To propose a distribution feature extraction algorithm based on wavelet packet coefficients to reconstruct the signal energy sequence for effectively identifying the pathological features of heart sounds,thereby realizing the early screening of heart diseases.Methods The original heart sound signal was decomposed into 10 layers using wavelet packet decomposition algorithm.After obtaining the wavelet packet coefficients of each layer,each coefficient was reconstructed,and the energy of the reconstructed signal was calculated and arranged in the original order to form the energy sequence.The distribution characteristics of the energy sequence of the reconstructed signals at each layer were analyzed,and distribution features were taken as classification features.Support vector machine,K-nearest neighbor,and decision tree were used to classify and recognize normal heart sounds and the heart sound signals of various diseases.Results The combination of the distribution features of the reconstructed signal energy sequence and decision tree classifier had an accuracy of 93.6%for classifying 5 types of heart sounds on the public dataset,and the accuracy was 95.6%for identifying normal heart sounds and hypertrophic cardiomyopathy heart sounds.Conclusion The proposed algorithm can extract the effective pathological information of abnormal heart sounds,providing a reference for clinical cardiac auscultation.

Research on the value of quantitative evaluation system of medical equipment procurement in the management of hospital asset allocation / 中国医学装备

Objective:To establish a quantitative evaluation system for medical equipment procurement and to explore its application value in the allocation and management of hospital assets.Methods:Based on theoretical research and on-site evaluation,an evaluation index system was developed from four levels of clinical demand,technical level,procurement process and service capabilities.The quantitative evaluation of the procurement process was conducted by using covariance-analytic hierarchy process(Cov-AHP),and a"6-stage"optimization process of medical equipment procurement was developed.A total of 257 sets of medical equipment purchased by Beijing Shunyi Hospital from August 2019 to July 2023 were selected,and the expert demonstration model(126 units)and the quantitative evaluation model(131 units)were used for medical equipment asset allocation management.The standardization of the medical equipment procurement process,effectiveness of performance objectives and satisfaction of clinical services of medical equipment procurement under different management methods were compared.Results:The standardization degrees of the procurement process of the medical equipment in the quantitative evaluation model in terms of startup,demonstration,implementation,installation and use stages were(98.42±2.83)%,(98.97±2.45)%,(96.24±3.87)%,(96.42±2.54)% and(94.82±5.31)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.741,4.385,6.551,7.620,4.563,P<0.05).The achievement rates of quality index,progress index,social benefit index and cost-benefit index of medical equipment procurement in the quantitative evaluation model were(96.15±4.08)%,(96.41±2.37)%,(92.77±3.89)% and(93.06±4.33)%,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=4.156,4.562,5.014,4.069,P<0.05).The clinical satisfaction scores of medical equipment users of medical equipment in the quantitative evaluation model for large medical equipment,life support and first aid equipment,laboratory testing equipment,surgical treatment equipment and other medical equipment were(90.24±1.89)points,(93.45±2.64)points,(95.67±3.64)points and(93.82±2.55)points and(97.25±3.89)points,respectively,which were higher than those in the expert demonstration model,the difference was statistically significant(t=3.678,4.079,2.845,3.628,5.023,P<0.05).Conclusion:The quantitative evaluation system can standardize the procurement process of medical equipment,improve the achievement rate of the performance target of medical equipment procurement,and improve the clinical service level of medical equipment.

Circ-ABCA1 promotes oxidized low-density lipoprotein-induced inflammation and phenotypic switch in vascular smooth muscle cells

Abstract Objectives Atherosclerosis (AS) is a chronic inflammatory disease of the arterial wall, in which Human Vascular Smooth Muscle Cells (HVSMCs) are involved. Nevertheless, the functions and mechanisms of circRNAs in oxidized Low-Density Lipoprotein (ox-LDL)-induced vascular smooth muscle cells remain unclear. Methods Circ-ABCA1 expression was measured in the models of AS. Then, in the vitro model, oligonucleotide transfection was performed, followed by an analysis of VSMC proliferation, migration, inflammation, and phenotypic switch. Also, in the in vivo model, mice were injected with shRNA lentivirus, followed by histological examination of aortic tissues. Finally, the interaction of circ-ABCA1, miR-885-5p, and ROCK2 was identified. Results Circ-ABCA1, was confirmed to be overexpressed in ox-LDL-induced VSMCs and mouse models of AS. Functionally, silencing circ-ABCA1 via oligonucleotide transfection suppressed VSMC proliferation, migration, inflammation, and phenotypic switch in vitro and prevented AS development in mice in vivo. Mechanistically, circ-ABCA1 absorbed miR-885-5p, which targeted ROCK2. Conclusion Taken together, the data from this study suggest that circ-ABCA1 mediates cellular inflammation and phenotype switching through the miR-885-5p/ROCK2 axis in ox-LDL-induced VSMCs, and the circ-ABCA1/miR-885-5p/ROCK2 axis is a new potential biomarker for the treatment of AS.

Nutritional risk and malnutrition in patients with gastrointestinal malignant tumors in day wards:a cross-sectional analysis / 肠外与肠内营养

Objective:This study investigated the nutritional risk and malnutrition of patients with digestive system malignant tumors in the day ward and evaluated the risk of comorbidity with nutritional risk and the risk factors of malnutrition in this population.Methods:A cross-sectional study was conducted to collect patients with malignant tumors of the digestive system who were admitted to the day ward of our hospital from November 23,2020,to December 14,2020.The Nutritional Risk Screening Form(NRS 2002)was used for nutritional risk screening,and the Subjective Assessment of Overall Nutritional Status(PG-SGA)was used to assess malnutrition,to investigate nutritional risk and prevalence of malnutrition,and to analyze potential influencing factors.Results:Among the 464 patients with malignant tumors of the digestive system in the day ward,the incidence of nutritional risk was 26.9％,the incidence of malnutrition was 34.7％,and the incidence of severe malnutrition was 14.2％.Multivariate analysis showed that patients with Karnofsky Performance Status(KPS)score＜90 and hypoproteinemia were more likely to have nutritional risk(P＜0.05).Patients with KPS score＜90 and chemotherapy cycles＞6 were more likely to be malnourished(P＜0.05).Conclusions:Digestive system malignant tumor patients in the day ward still have a high proportion of nutritional risks and malnutrition.For patients with KPS score＜90,hypoalbuminemia,and chemotherapy cycles＞6,nutrition issues should be given special attention.

Effects of platelet-rich plasma injection therapy combined with muscle strength training on ankle function in patients with traumatic ankle arthritis / 中国基层医药

Objective:To investigate the effects of platelet-rich plasma injection therapy combined with muscle strength training on ankle function in patients with traumatic ankle arthritis.Methods:The clinical data of 98 patients with traumatic ankle arthritis admitted to The 906 Hospital of PLA Joint Logistics Support Force from January 2020 to January 2021 were retrospectively analyzed. These patients were grouped according to different treatment methods. Patients in the control group ( n = 31) received muscle strength training. Patients in the sodium hyaluronate group ( n = 33) received muscle strength training and intraarticular injection of sodium hyaluronate. Patients in the platelet-rich plasma group ( n = 34) received muscle strength training and intraarticular injection of platelet-rich plasma. Ankle function, excellent and good recovery rate, and muscle strength were compared among the three groups before and after treatment. Results:After treatment, the American Orthopaedic Foot & Ankle Society scores in the control, sodium hyaluronate, and platelet-rich plasma groups were (38.22 ± 3.02) points, (41.55 ± 2.04) points, and (44.22 ± 2.69) points respectively, pain scores were (26.98 ± 4.05) points, (31.22 ± 4.20) points, and (34.44 ± 2.44) points respectively, on-line scores were (6.11 ± 1.41) points, (7.39 ± 1.06) points, and (8.25 ± 1.03) points respectively. There were significant differences in the American Orthopaedic Foot & Ankle Society scores, pain scores, and online scores among the three groups ( F = 43.01, 34.30, 27.21, all P < 0.001). In the control, sodium hyaluronate, and platelet-rich plasma groups, dorsiflexor strength was (103.66 ± 10.69) N·m, (129.33 ± 12.37) N·m, (133.69 ± 10.58) N·m, respectively, plantar flexor strength was (121.36 ± 15.69) N·m, (140.23 ± 14.66) N·m, (144.55±13.55) N·m, respectively, ankle function score was (84.22 ± 2.69) points, (88.55 ± 3.01) points, (92.56 ± 3.55) points, respectively. There were significant differences in dorsiflexor strength, plantar flexor strength, and ankle function score among the three groups ( F = 66.37, 22.70, 58.05, all P < 0.001). There was no difference in adverse reactions among the three groups ( Z = 1.05, P > 0.05). Conclusion:Platelet-rich plasma injection therapy combined with muscle strength training is highly effective on traumatic ankle arthritis and can markedly improve ankle function and prognosis.

Processing Magnoliae Officinalis Cortex with ginger juice: process optimization based on AHP-CRITIC weighting method and composition changes after processing / 中国中药杂志

The weight coefficients of appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol were determined by analytic hierarchy process(AHP), criteria importance though intercrieria correlation(CRITIC), and AHP-CRITIC weighting method, and the comprehensive scores were calculated. The effects of ginger juice dosage, moistening time, proces-sing temperature, and processing time on the quality of Magnoliae Officinalis Cortex(MOC) were investigated, and Box-Behnken design was employed to optimize the process parameters. To reveal the processing mechanism, MOC, ginger juice-processed Magnoliae Officinalis Cortex(GMOC), and water-processed Magnoliae Officinalis Cortex(WMOC) were compared. The results showed that the weight coefficients of the appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol determined by AHP-CRITIC weighting method were 0.134, 0.287, and 0.579, respectively. The optimal processing parameters of GMOC were ginger juice dosage of 8%, moistening time of 120 min, and processing at 100 ℃ for 7 min. The content of syringoside and magnolflorine in MOC decreased after processing, and the content of honokiol and magnolol followed the trend of GMOC>MOC>WMOC, which suggested that the change in clinical efficacy of MOC after processing was associated with the changes of chemical composition. The optimized processing technology is stable and feasible and provides references for the modern production and processing of MOC.

A preliminary prediction model of depression based on whole blood cell count by machine learning method / 中华预防医学杂志

This study used machine learning techniques combined with routine blood cell analysis parameters to build preliminary prediction models, helping differentiate patients with depression from healthy controls, or patients with anxiety. A multicenter study was performed by collecting blood cell analysis data of Beijing Chaoyang Hospital and the First Hospital of Hebei Medical University from 2020 to 2021. Machine learning techniques, including support vector machine, decision tree, naïve Bayes, random forest and multi-layer perceptron were explored to establish a prediction model of depression. The results showed that based on the blood cell analysis results of healthy controls and depression group, the accuracy of prediction model reached as high as 0.99, F1 was 0.975. Receiver operating characteristic curve area and average accuracy were 0.985 and 0.967, respectively. Platelet parameters contributed mostly to depression prediction model. While, to random forest differential diagnosis model based on the data from depression and anxiety groups, prediction accuracy reached 0.68 and AUC 0.622. Age, platelet parameters, and average volume of red blood cells contributed the most to the model. In conclusion, the study researched on the prediction model of depression by exploring blood cell analysis parameters, revealing that machine learning models were more objective in the evaluation of mental illness.

A preliminary prediction model of depression based on whole blood cell count by machine learning method / 中华预防医学杂志

This study used machine learning techniques combined with routine blood cell analysis parameters to build preliminary prediction models, helping differentiate patients with depression from healthy controls, or patients with anxiety. A multicenter study was performed by collecting blood cell analysis data of Beijing Chaoyang Hospital and the First Hospital of Hebei Medical University from 2020 to 2021. Machine learning techniques, including support vector machine, decision tree, naïve Bayes, random forest and multi-layer perceptron were explored to establish a prediction model of depression. The results showed that based on the blood cell analysis results of healthy controls and depression group, the accuracy of prediction model reached as high as 0.99, F1 was 0.975. Receiver operating characteristic curve area and average accuracy were 0.985 and 0.967, respectively. Platelet parameters contributed mostly to depression prediction model. While, to random forest differential diagnosis model based on the data from depression and anxiety groups, prediction accuracy reached 0.68 and AUC 0.622. Age, platelet parameters, and average volume of red blood cells contributed the most to the model. In conclusion, the study researched on the prediction model of depression by exploring blood cell analysis parameters, revealing that machine learning models were more objective in the evaluation of mental illness.

A family with early onset myopathy caused by MEGF10 gene defect and literature review / 中华儿科杂志

Objective: To summarize the genetic and clinical phenotypic characteristics of patients with early-onset myopathy, areflexia, respiratory distress and dysphagia (EMARDD) caused by multiple epidermal growth factor 10 (MEGF10) gene defect. Methods: The clinical data of 3 infants in 1 family with EMARDD caused by MEGF10 gene defect diagnosed in the Department of Neonatology, Xiamen Children's Hospital in April 2022 were analyzed retrospectively. Using "multiple epidermal growth factor 10" "myopathy" or "MEGF10" "myopathy" as the key words, and searching the relevant literature reports of CNKI, Wanfang Database and PubMed Database from the establishment of the database to September 2022. Combined with this family, the main clinical information and genotype characteristics of EMARDD patients caused by MEGF10 gene defect were summarized. Results: The proband, male, first infant of monozygotic twins, was admitted to hospital 7 days after birth "due to intermittent cyanosis with weak sucking". The infant had dysphagia accompanied with cyanosis of lips during feeding and crying after birth. Physical examination on admission revealed reduced muscle tone of the extremities, flexion of the second to fifth fingers of both hands with limited passive extension of proximal interphalangeal joints, and limited abduction of both hips. He was diagnosed as dysphagia of newborn, congenital dactyly. After admission, he was given limb and oral rehabilitation training, breathing gradually became stable and oral feeding fully allowed, and discharged along with improvement. The younger brother of the proband was admitted to the hospital at the same time, and his clinical manifestations, diagnosis and treatment process were the same as those of the proband. The elder brother of the proband died at the age of 8 months due to the delayed growth and development, severe malnutrition, hypotonia, single palmoclal crease and weak crying. A whole exon sequencing of the family was done, and found that the 3 children were all compound heterozygous variations at the same site of MEGF10 gene, with 2 splicing variants (c.218+1G>A, c.2362+1G>A), which came from the father and mother respectively, and the new variation was consistent with the autosomal recessive inheritance model. Three children were finally diagnosed as EMARDD caused by MEGF10 gene defect. There are 0 Chinese literature and 18 English literature that met the search conditions. Totally 17 families including 28 patients were reported. There were 31 EMARDD patients including 3 infants from this family. Among them, there were 13 males and 18 females. The reported age of onset ranged from 0 to 61 years. Except for 5 patients with incomplete clinical data, 26 patients were included in the analysis of phenotypic and genotypic characteristics. The clinical features were mainly dyspnea (25 cases), scoliosis (22 cases), feeding difficulties (21 cases), myasthenia (20 cases), and other features including areflexia (16 cases) and cleft palate or high palatal arch(15 cases). Muscle biopsy showed non-specific changes, with histological characteristics ranging from slight muscle fiber size variation to minicores change which was seen in all 5 patients with at least 1 missense mutation of allele. In addition, the adult onset was found in patients with at least 1 missense variant of MEGF10 gene. Conclusions: MEGF10 gene defect related EMARDD can occur in the neonatal period, and the main clinical features are muscle weakness, breathing and feeding difficulties. Patients with myopathy who have at least 1 missense mutation and muscle biopsy indicating minicores change may be relatively mild.

Testicular exosomes disturb the immunosuppressive phenotype of testicular macrophages mediated by miR-155-5p in uropathogenic Escherichia coli-induced orchitis / 亚洲男科学杂志(英文版)

Male reproductive infections are known to shape the immunological homeostasis of the testes, leading to male infertility. However, the specific pathogenesis of these changes remains poorly understood. Exosomes released in the inflammatory microenvironment are important in communication between the local microenvironment and recipient cells. Here, we aim to identify the immunomodulatory properties of inflammatory testes-derived exosomes (IT-exos) and explore their underlying mechanisms in orchitis. IT-exos were isolated using a uropathogenic Escherichia coli (UPEC)-induced orchitis model and confirmed that IT-exos promoted proinflammatory M1 activation with increasing expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in vitro. We further used small RNA sequencing to identify the differential miRNA profiles in exosomes and primary testicular macrophages (TMs) from normal and UPEC-infected testes, respectively, and identified that miR-155-5p was highly enriched in IT-exos and TMs from inflammatory testes. Further study of bone marrow derived macrophages (BMDMs) transfected with miR-155-5p mimic showed that macrophages polarized to proinflammatory phenotype. In addition, the mice that were administrated IT-exos showed remarkable activation of TM1-like macrophages; however, IT-exos with silencing miR-155-5p showed a decrease in proinflammatory responses. Overall, we demonstrate that miR-155-5p delivered by IT-exos plays an important role in the activation of TM1 in UPEC-induced orchitis. Our study provides a new perspective on the immunological mechanisms underlying inflammation-related male infertility.

Antioxidant and anti-inflammatory activities of four kinds of Huangshan chrysanthemum / 药学实践与服务

Objective To investigate the antioxidant and anti-inflammatory activities of four kinds of Huangshan chrysanthemum. Methods ABTS, FRAP and DPPH were used to detect the antioxidant activities of Huangshan golden silk chrysanthemum, Huangshan chrysanthemum, Huangshan gongju, and Huangshan dendranthema. Their anti-inflammatory activities were evaluated by NF-κB reporter gene assay and rat foot swelling models. Results The outcomes of ABTS，FRAP and DPPH showed that the water extracts of four kinds of chrysanthemum all had certain antioxidant activities and the activities of Huangshan golden silk chrysanthemum were strongest, followed by Huangshan chrysanthemum , Huangshan gongju , and Huangshan dendranthema. Results of NF-κB reporter gene assay and rat foot swelling models showed that four extracts of chrysanthemum morifolium could inhibit the transcription of NF-κB induced by LPS and alleviate foot swelling of rat induced by carrageenan, with the strongest activity of Huangshan chrysanthemum, followed by Huangshan golden silk chrysanthemum, Huangshan gongju, and Huangshan dendranthema. Conclusion The antioxidant activities of Huangshan golden silk chrysanthemum were strongest, followed by Huangshan chrysanthemum, Huangshan gongju, and Huangshan dendranthema. The anti-inflammatory activities of Huangshan chrysanthemum were strongest, followed by Huangshan golden silk chrysanthemum, Huangshan gongju, and Huangshan dendranthema.

Herbal Textual Research on Rhapontici Radix in Famous Classical Formulas / 中国实验方剂学杂志

This article systematically sorted out and researched the name， origin， harvesting and other aspects of Rhapontici Radix by referring to ancient materia medica， medical books and prescription books， combined with modern literature， in order to provide a reference basis for the development of the famous classical formulas containing this herb. According to the results of the herbal textual research， it can be seen that all the generations of the materia medica have taken Loulu as the proper name， and there are also aliases such as Luligen， Laowenghua and Jiahao. The mainstream base of Rhapontici Radix recorded in the past dynasties was the present Compositae plant Rhaponticum uniflorum， which is mostly used as medicine with roots. Since the Tang dynasty， the stems and leaves of Siphonostegia chinensis have been used as Rhapontici Radix in the northern region. Until modern times， Qizhou Pharmacognosy began to differentiate it into two categories， Qizhou Loulu and Yuzhou Loulu， according to the commodity circulation at that time， producing area and origin， of which Yuzhou Loulu is the roots of Echinops latifolius， a plant of Compositae family. In ancient times， the quality of Loulu was based on "the one that comes out of Shanzhou is the best". However， in modern times， the quality of Qizhou Loulu is better if the surface is black， neat， sturdy， firm， not broken， and without a withered heart， while the quality of Yuzhou Loulu is better if the branches are thick and long with an earthy-brown surface， solid texture and neat in length. In ancient times， most of the harvesting and processing of Loulu was "harvesting the roots in lunar August and drying them in the shade"， while in modern times， the roots are mostly excavated in the spring and autumn， and dried in the sun. Its ancient method of processing is to mix and steam with licorice， nowadays， it is prepared by removing impurities， washing， moistening thoroughly， cutting into thick slices and drying in the sun， and then taking the raw products as medicine. Based on the research conclusion， it is suggested that when developing and utilizing the famous classical formulas containing Loulu， the background of the formula should be verified， and if the original formula indicated the requirement of processing， it should be processed according to the requirement， but if not， it is recommended to use raw products as medicine.

Effect of amantadine dimer adjuvant on humoral immune response induced by SARS-CoV-2 protein vaccine in mice / 中国生物制品学杂志

Effect of amantadine dimer adjuvant on humoral immune response induced by SARS-CoV-2 protein vaccine in mice@#Objective To investigate the effect of amantadine dimer adjuvant on humoral immune response induced by SARS-CoV-2 crown protein vaccine in mice.Methods The amantadine dimer was synthesized by substitution reaction ligation,hydrolytic acidification reaction ligation and amide condensation reaction ligation,with which as adjuvant,female BALB/c mice were immunized with the receptor-binding domain(RBD).The mice were randomly divided into five groups,six for each as follows:R6A+RBD group[21 μg(0.033 μmol)amantadine dimer+10 μg RBD],Ada+RBD group[10 μg(0.066 μmol)amantadine+10 μg RBD],Alu+RBD group(35 μg aluminum adjuvant+10 μg RBD),RBD group(10 μg RBD)and Blank group(0.9% normal saline),which were immunized i.m.on day 0,14 and 28 respectively.Serum samples were collected from tail vein of mice 7 d after the second dose and 14 d after the last dose and determined for specific IgG antibody levels by ELISA.Results The amantadine dimer was purified by thin layer chromatography(TLC)and identified by electrospray ionization-MS(ESI-MS)positive/negative ion mode.After two times of immunization,the antibody levels in sera at various dilutions of mice in R6A+RBD group were all higher than those of Ada+RBD group,while lower than those of Alu+RBD group.However,after three times of immunization,the antibody levels in sera at various dilutions of mice in R6A+RBD group were all significantly higher than those of Ada+RBD and Alu+RBD groups(each F > 30,each P < 0.000 1 and each P < 0.01).Conclusion Amantadine dimer adjuvant enhanced humoral immune response induced by SARS-CoV-2 protein vaccine in mice with good adjuvant effect,which may be used as an alternative adjuvant.This strategy based on existing drug transformation provided a new idea for the development of novel adjuvants.

Study on the clinical comprehensive evaluation of blood lipid-regulating drugs in five provinces and regions in Northwest China / 中国药房

OBJECTIVE To explore standardized evaluation process for clinical comprehensive evaluation of blood lipid- regulating drugs and perform rapid assessment of clinical comprehensive evaluation of blood lipid-regulating drugs with different mechanisms so as to provide reference for the drug catalogue selection and rational drug use of medical institutions. METHODS Referring to guidelines and consensus such as the guideline for the management of comprehensive clinical evaluation of drugs， the methods such as literature research， expert interviews， and Delphi expert consultation were used to establish a multi-dimensional and multi-criteria clinical comprehensive evaluation index system and quantitative scoring table for blood lipid-regulating drugs around the two main lines of technical evaluation and policy evaluation. Then 13 blood lipid-regulating drugs with different mechanisms in 21 third-grade class-A medical institutions from five provinces and regions of Northwest China were scored from both technical and policy dimensions to form a comprehensive evaluation result. RESULTS The clinical comprehensive evaluation index system and corresponding rapid evaluation quantitative scoring table were constructed for blood lipid-regulating drugs in the five northwest provinces and regions. The technicalevaluation section included 6 primary indicators， 13 secondary indicators， and 34 tertiary indicators， totaling 110 points. The policy evaluation section included 4 primary indicators and 6 secondary indicators， with a total score of 40 points （30 points for some drugs） and a total score of 150 points （or 140 points）. The scoring results showed that the highest score was atorvastatin， followed by rosuvastatin and simvastatin. CONCLUSIONS Statins are still the cornerstone of drug therapy for patients with dyslipidemia； the rapid evaluation quantitative scoring table constructed in this study is comprehensive， systematic and operable. The evaluation process in this study can provide empirical references for other groups to exploring the standardized path and quality control mechanism of clinical comprehensive evaluation of drugs.