Advances on pathogenesis of acquired peritoneal ultrafiltration failure in peritoneal dialysis / 中华肝脏病杂志

Peritoneal ultrafiltration failure is a common reason for peritoneal dialysis (PD) withdrawal as well as mortality in PD patients. Based on the three-pore system, inter-cellular small pores and trans-cellular ultra-small pores (aquaporin-1) are mainly responsible for water transfer across the peritoneum. Both small and ultra-small pores-dependent water (free water) transport decline accompanied with time on PD, with more significant decrease in free water, resulting in peritoneal ultrafiltration failure. The reduction of free water transport is associated with fast peritoneal solute transfer, reduced crystalloid osmotic gradient due to increased interstitial glucose absorption, and declined osmotic conductance to glucose resulted from impaired aquaporin-1 function and peritoneal interstitial fibrosis. The decline of small pore-based water is mainly because of fast loss of crystalloid osmotic gradient, decrease of hydrostatic pressure mediated by peritoneal vasculopathy, as well as reduced absolute number of small pores. The current review discusses the advance on pathogenesis of acquired peritoneal ultrafiltration failure in long-term PD.

Chemical constituents from stems and leaves of Cratoxylum cochinchinense and their inhibitory effects on proliferation of synoviocytes in vitro / 中国中药杂志

The chemical constituents from the stems and leaves of Cratoxylum cochinchinense were isolated and purified using silica gel, ODS gel, and Sephadex LH-20 gel column chromatography, as well as preparative HPLC. The chemical structures of all isolated compounds were identified on the basis of their physicochemical properties, spectroscopic analyses, and the comparison of their physicochemical and spectroscopic data with the reported data in literature. As a result, 21 compounds were isolated from the 90% ethanol extract of the stems and leaves of C. cochinchinense, which were identified as cratocochine(1), 1-hydroxy-3,7-dimethoxyxanthone(2), 1-hydroxy-5,6,7-trimethoxyxanthone(3), ferrxanthone(4), 3,6-dihydroxy-1,5-dimethoxyxanthone(5), 3,6-dihydroxy-1,7-dimethoxyxanthone(6), 1,2,5-trihydroxy-6,8-dimethoxyxanthone(7), securixanthone G(8), gentisein(9), 3,7-dihydroxy-1-methoxyxanthone(10), pancixanthone B(11), garcimangosxanthone A(12), pruniflorone L(13), 9-hydroxy alabaxanthone(14), cochinchinone A(15), luteolin(16), 3,5'-dimethoxy-4',7-epoxy-8,3'-neolignane-5,9,9'-triol(17), N-benzyl-9-oxo-10E,12E-octadecadienamide(18), 15-hydroxy-7,13E-labdadiene(19), stigmasta-4,22-dien-3-one(20), and stigmast-5-en-3β-ol(21). Among these isolates, compound 1 was a new xanthone, compounds 2-5, 7, 8, 12, and 16-21 were isolated from the Cratoxylum plant for the first time, and compounds 11 and 13 were obtained from C. cochinchinense for the first time. Furthermore, all isolated compounds 1-21 were appraised for their anti-rheumatoid arthritis activities by MTS method through measuring their anti-proliferative effect on synoviocytes in vitro. As a result, xanthones 1-15 displayed notable anti-rheumatoid arthritis activities, which showed inhibitory effects on the proliferation of MH7A synoviocytes with the IC_(50) values ranging from(8.98±0.12) to(228.68±0.32) μmol·L~(-1).

Research progress on the application of Gegen Qianlian Decoction and its effect on the intestinal barrier / 中国感染控制杂志

Gegen Qinlian Decoction is a classical prescription with the function of relieving exterior and interior syndromes.The formula contains complex chemical components and is prepared into several dosage forms regulating the function of the gut.The review discusses the chemical components,common dosage forms,clinical application and effect on the intestinal barrier of Gegen Qinlian Decoction,so as to provide a basis for its further development and utilization.

Onset and Recurrence Characteristics of Chinese Patients with Noncardiogenic Ischemic Stroke in Chinese Medicine Hospital / 中国结合医学杂志

OBJECTIVE@#To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China.@*METHODS@#A prospective, multicenter and registry study was carried out in 2,558 patients at 7 representative clinical sub-centers during November 3, 2016 to February 17, 2019. A questionnaire was used to collect information of patients regarding CM syndromes and constitutions and associated risk factors. Additionally, stroke recurrence was defined as a primary outcome indicator.@*RESULTS@#A total of 327 (12.78 %) patients endured recurrence events, 1,681 (65.72%) were men, and the average age was 63.33 ± 9.45 years. Totally 1,741 (68.06%) patients suffered first-ever ischemic stroke, 1,772 (69.27%) patients reported to have hypertension, and 1,640 (64.11%) of them reported dyslipidemia, 1,595 (62.35%) patients exhibited small-artery occlusion by The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Specifically, 1,271 (49.69%) patients were considered as qi-deficient constitution, and 1,227 (47.97%) patients were determined as stagnant blood constitution. There were 1,303 (50.94%) patients diagnosed as blood stasis syndrome, 1,280 (50.04%) patients exhibited phlegm and dampness syndrome and 1,012 (39.56%) patients demonstrated qi deficiency syndrome. And 1,033 (40.38%) patients declared intracranial artery stenosis, and 478 (18.69%) patients reported carotid artery stenosis. The plaque in 1,508 (41.36%) patients were of mixed. Particularly, 41.09% of them demonstrated abnormal levels of glycated hemoglobin levels.@*CONCLUSIONS@#Recurrence in minor and small-artery stroke cannot be ignored. Hypertension, dyslipidemia, abnormal HbA1c, intracranial artery stenosis and carotid plaque were more common in stroke patients. Particularly, phlegm-dampness and blood stasis syndromes, as well as qi deficiency and blood stasis constitutions, were still the main manifestations of stroke. (Trial registration at ClinicalTrials.gov No. NCT03174535).

Application of limiting antigen avidity enzyme immunoassay for estimating HIV-1 incidence in men who have sex with men / 中华流行病学杂志

Objective: To estimate the incidence of HIV-1 infection in men who have sex with men (MSM) in key areas of China through HIV-1 limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA), analyze the deviation from the actual results and identify influencing factors, and provided reference for improving the accuracy of estimation results. Methods: Based on the principle of the cohort randomized study design, 20 cities were selected in China based on population size and the number of HIV-positive MSM. The sample size was estimated to be 700 according to the HIV-1 infection rate in MSM. MSM mobile phone app. was used to establish a detection appointment and questionnaire system, and the baseline cross-sectional survey was conducted from April to November 2019. LAg-Avidity EIA was used to identify the recent infected samples. The incidence of HIV-1 infection was calculated and then adjusted based on the estimation formula designed by WHO. The influencing factors were identified by analyzing the sample collection and detection processes. Results: Among the 10 650 blood samples from the participants, 799 were HIV-positive in initial screening, in which 198 samples (24.78%) missed during confirmation test. Only 621 samples were received by the laboratory. After excluding misreported samples, 520 samples were qualified for testing. A total of 155 samples were eventually determined as recent infection through LAg-Avidity EIA; Based on the estimation formula , the incidence of HIV-1 infection in MSM in 20 cities was 4.06% (95%CI:3.27%-4.85%), it increased to 5.53% (95%CI: 4.45%-6.60%)after the adjusting for sample missing rate. When the sample missing rate and misreporting rate were both adjusted, the incidence of HIV-1 infection in the MSM increased to 5.66% (95%CI:4.67%-6.65%). The actual incidence of HIV-1 infection in MSM in the 20 cities might be between 4.06% and 5.66%. Conclusions: Sample missing and misreporting might cause the deviation of the estimation of HIV-1 infection incidence. It is important to ensure the sample source and the quality of sample collection and detection to reduce the deviation in the estimation of HIV-1 infection incidence.

Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China / 中华流行病学杂志

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.

Prevention of preeclampsia recurrence with low dose aspirin during pregnancy / 中国基层医药

Objective:To investigate the clinical efficacy of low-dose aspirin in the prevention of preeclampsia recurrence during pregnancy.Methods:Thirty-six women in the first trimester of pregnancy who received examination in Hangzhou Women's Hospital from January 2018 to June 2019 were included in this study. All included women had a history of preeclampsia or severe preeclampsia and met the indications of oral aspirin. They were randomly divided into A ( n = 14) and B ( n = 22) groups. An additional 51 pregnant women who had no history of preeclampsia or severe preeclampsia were included in the control group. The A group was given oral aspirin 50-100 mg/d starting from the second trimester of pregnancy. The other two groups were not given oral aspirin at the same time. Pregnancy outcomes (including delivery weeks, cesarean delivery, placental abruption, preeclampsia, postpartum hemorrhage and gestational hypertension) and urine protein were compared between groups. Neonatal outcomes in different groups were analyzed. Results:The incidence of eclampsia in B group was [40.91% (9/22)], which was significantly higher than [7.14% (1/14)] in A group and [0.00% (0/51)] in control group ( χ2 = 9.872, 12.031, both P < 0.05). The cesarean delivery rate in B group was [22.73% (5/22)], which was significantly higher than 7.14% (1/14) in A group and 5.88% (3/51) in control group ( χ2 = 8.072, 10.810, both P < 0.05). Delivery weeks in A and control groups were (42.78 ± 1.32) weeks and (43.14 ± 1.17) weeks, respectively, which were significantly longer than (35.08 ± 2.03) weeks in group B ( F = 13.765, P < 0.05). The amount of blood loss in A and control groups was (217.62 ± 19.85) mL and (211.37 ± 18.56) mL, respectively, which was significantly less than (233.05 ± 22.37) mL in B group ( F = 18.873, P < 0.05). The Apgar score of newborns in B group was (6.03 ± 0.54) points, which was significantly lower than (9.58 ± 0.86) points in A group and (9.73 ± 0.85) points in control group ( F = 9.037, P < 0.05). The incidence of intrauterine growth restriction [7.14% (1/14), 5.88% (3/51)] and the incidence of preterm birth [7.14% (1/14), 5.88% (3/51)] in A and control groups were significantly lower than those in B group [22.73% (1/22), 15.00% (3/22), χ2 = 10.651, 14.040, 11.715, 13.602, all P < 0.05]. There were no significant differences in the incidence of neonatal death and hemorrhagic diseases among the three groups ( χ2 = 2.020, 3.606, both P > 0.05). Conclusion:Aspirin enteric coated tablets 50-100 mg/d per day for management of pregnant women at a high risk for preeclampsia at 12 weeks of gestation can decrease the incidence of preeclampsia to a certain extent, which is worthy of clinical application.

Expression and Clinical Significance of miRNA-152 in Hepatocellular Carcinoma / 肿瘤防治研究

Objective To investigate the expression of microRNA-152 in hepatocellular carcinoma, and analyze the correlation of miR-152 expression with the clinicopathological characteristics of hepatocellular carcinoma(HCC) patients. Methods Real-time PCR was used to detect the expression of miR-152 in tissue specimens from HCC and the adjacent non-cancerous hepatic tissues collected from 56 patients who underwent surgical treatment for primary HCC. The association between the expression of miR-152 and the clinical pathological characteristics and prognosis of HCC patients was analyzed. Results The relative expression of miR-152 in hepatocellular carcinoma and corresponding adjacent non-carcinoma tissues were 0.616±0.041 and 0.768±0.042 (P=0.011). The expression of miR-152 was significantly associated with TNM stages (P=0.042), tumor differentiation (P=0.035), metastasis (P=0.048) and venous invasion (P=0.042). There was no significant association between the miR-152 expression and gender, age, AFP level, tumor number or tumor grade. The OS (P=0.035) and PFS (P=0.012) in the low miR-152 expression group were obviously shorter than those in the high miR-152 expression group. Multivariate Cox regression analysis showed that the low expression of miR-152, tumor recurrence and pathological classification were significant independent prognostic factors for the prognosis of hepatocellular carcinoma patients. Conclusion The expression of miR-152 is decreased in hepatocellular carcinoma tissues, and the low expression of miR-152 is significantly associated with TNM stages, tumor differentiation, metastasis, venous invasion and the prognosis of HCC patients.

Xinglou Chengqi Decoction improves neurological function in experimental stroke mice as evidenced by gut microbiota analysis and network pharmacology / 中国天然药物

The current study was designed to explore the brain protection mechanism of Xinglou Chengqi Decoction (XCD) based on gut microbiota analysis and network pharmacology. A transient middle cerebral artery occlusion (MCAO) model of mice was established, followed by behavioral evaluation, TTC and TUNEL staining. Additionally, to investigate the effects of gut microbiota on neurological function after stroke, C57BL/6 mice were treated with anti-biotic cocktails 14 days prior to ischemic stroke (IS) to deplete the gut microbiota. High-throughput 16S rDNA gene sequencing, metabonomics technique, and flow multifactor technology were used to analyze bacterial communities, SCFAs and inflammatory cytokines respectively. Finally, as a supplement, network pharmacology and molecular docking were applied to fully explore the multicomponent-multitarget-multichannel mechanism of XCD in treating IS, implicated in ADME screening, target identification, network analysis, functional annotation, and pathway enrichment analysis. We found that XCD effectively improved neurological function, relieved cerebral infarction and decreased the neuronal apoptosis. Moreover, XCD promoted the release of anti-inflammatory factor like IL-10, while down-regulating pro-inflammatory factors such as TNF-α, IL-17A, and IL-22. Furthermore, XCD significantly increased the levels of short chain fatty acids (SCFAs), especially butyric acid. The mechanism might be related to the regulation of SCFAs-producing bacteria like Verrucomicrobia and Akkermansia, and bacteria that regulate inflammation like Paraprevotella, Roseburia, Streptophyta and Enterococcu. Finally, in the network pharmacological analysis, 51 active compounds in XCD and 44 intersection targets of IS and XCD were selected. As a validation, components in XCD docked well with key targets. It was obviously that biological processes were mainly involved in the regulation of apoptotic process, inflammatory response, response to fatty acid, and regulation of establishment of endothelial barrier in GO enrichment. XCD can improve neurological function in experimental stroke mice, partly due to the regulation of gut microbiota. Besises, XCD has the characteristic of "multi-component, multi-target and multi-channel" in the treatment of IS revealed by network pharmacology and molecular docking.

Analysis of two cases of glycogen storage disease type III due to compound heterozygous variants of AGL gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genetic basis of two children with glycogen storage disease type III (GSD III).@*METHODS@#The probands and their parents were subjected to genetic testing, and the pathogenity of candidate variants was analyzed by using bioinformatic tools.@*RESULTS@#Sequencing has identified compound heterozygous variants of the AGL gene in both children, namely c.1423+1G>A and c.3701-2A>G in case 1, and c.4213_c.4214insA (p.Glu1405Glufs*17) and c.3589-3C>G in case 2. Both children were diagnosed with GSD III. Literature review suggested that the main type variant among Chinese patients with GSD III involve splice sites of the AGL gene, with c.1735+1G>T being the most common. Based on the American College of Medical Genetics and Genomics standards and guidelines,c.1423+1G>A, c.3701-2A>G and c.4213_c.4214insA variants of AGL gene were predicted to be of pathogenic (PVS1+PM2+PM3, PVS1+PM2+PM3, PVS1+PM2+PP5), and c.3589-3C>G variant was predicted to be of uncertain significance (PM2+PM3+PP3).@*CONCLUSION@#The compound heterozygous variants of the AGL gene probably underlay the GSD III in both children. Above findings have enriched the spectrum of genetic variants underlying this disease.

Analysis of influencing factors of screened myopia in primary school students in seven provinces / 中国学校卫生

Objective@#To understand the current situation and associated factors of myopia among primary school students, and to provide scientific basis for prevention and control of myopia among primary school students.@*Methods@#In Gansu, Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi and other provinces, 1 prefecture was selected, and a number of primary schools were selected from each region. All the students in the class were selected as the object of this survey. A total of 8 365 middle school students were examined for their eyesight, and the data of general population economic indicators and natural environment indicators were obtained through the statistical yearbook of various provinces and cities. The influencing factors of primary school students myopia were analyzed by chi-square test and multivariate Logistic regression.@*Results@#Univariate analysis showed that different provinces and different sex, different nationalities, different grade, parents average salary, sunshine duration, air temperature, altitude, longitude, latitude, different economic zone(χ2=116.22, 18.08, 26.33, 1 059.04, 14.86, 10.28, 16.95, 10.01, 23.15, 29.43, 88.14, P<0.05). Multivariate analysis results showed that gender, grade, sunshine duration, longitude were risk factor for poor vision(OR=1.31, 1.71, 1.45, 1.54, P<0.05); Economic zone and parents salary were protective factors for poor eyesight of students (OR=0.65, 0.86, P<0.05).@*Conclusion@#Myopia of primary school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening.

Effects of low molecular weight chitosan and its nanoparticles on intestinal permeability of Panax notoginseng saponins / 中草药

Objective: To evaluate the effect of low molecular weight chitosan (LMW-CTS) and its nanoparticles (LMW-CTS-NPs) on the intestinal permeability of Panax notoginseng saponins (PNS) by using Caco-2 cell model. Methods: LMW-CTS was prepared by combining chitosanase hydrolysis combined with ultrafiltration separation technology, and molecular weight of LMW-CTS was determined by using permeation gel chromatography (GPC). LMW-CTS-NPs were prepared by ionic gel method, and characterized by scanning electron microscopy, nano particle sizer, and flourier transformation infrared spectroscopy. Caco-2 cell model was established and validated to evaluate the effects of LMW-CTS and LMW-CTS-NPs on the intestinal permeability of PNS. Results: LMW-CTS has a molecular weight of 5 760 and a polydispersity coefficient of 1.42. LMW-CTS-NPs have a round shape and narrow particle size distribution, with an average particle size of 115.5 nm and zeta potential of +37.1 mV. The apparent permeability coefficients (Papp, AB→BL) of PNS was less than 1 × 10-6 cm/s, indicating a poor permeability. In LMW-CTS group, the Papp of R1 and Rg1 was increased by 17.83% and 20.29%, respectively, but no significant effect of promotion was observed on other components. However, the Papp of R1, Rg1, Re, Rb1, and Rd in LMW-CTS-NPs group was increased by 35.66%, 23.28%, 29.41%, 37.99%, and 36.00%, respectively, compared tothe control group. Conclusion: LMW-CTS can significantly promote the intestinal mucosal permeability of R1 and Rg1 in PNS, but has no significant effect on Re, Rb1, and Rd. LMW-CTS-NPs significantly increased the permeability of the major monomer saponin components in PNS. Namely, the intestinal permeability of PNS can be further improved by transforming LMW-CTS into LMW-CTS-NPs.

Associated factors of screened myopia of junior middle school students in six provinces of China / 中国学校卫生

Objective@#To understand the current situation and associated factors of myopia in junior middle school students, and to provide scientific basis for prevention and control of myopia in junior middle school students.@*Methods@#A total of 5 393 junior middle school students were selected from middle schools in Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi provinces. The visual acuity of middle school students was examined, and the data of general population, economy, sociology and natural environment were obtained through statistical yearbook of each province. The influencing factors of myopia of middle school students were analyzed by univariate and multivariate Logistic regression.@*Results@#The results of single factor analysis showed that the myopia rate of junior high school students was different by gender, grades, parents average wage, sunshine duration, temperature, altitude, longitude and latitude(χ2=47.76，59.05，10.79，106.19，53.56，85.02，76.23，107.07，P<0.05). The results of multi factor analysis showed that gender, grade, average wage, temperature and latitude was positively associated with myopia vision; sunshine duration and longitude were negatively associated with the risk for myopia(OR=1.54，1.34，1.62，7.58，27.10，0.42，0.39，P<0.05).@*Conclusion@#The myopia of junior high school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening of sexual myopia in junior high school students. Economic and social factors and natural environmental factors should be taken into account in the formulation of myopia prevention and control measures.

Regulatory mechanisms and therapeutic potential of microglial inhibitors in neuropathic pain and morphine tolerance / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Microglia are important cells involved in the regulation of neuropathic pain (NPP) and morphine tolerance. Information on their plasticity and polarity has been elucidated after determining their physiological structure, but there is still much to learn about the role of this type of cell in NPP and morphine tolerance. Microglia mediate multiple functions in health and disease by controlling damage in the central nervous system (CNS) and endogenous immune responses to disease. Microglial activation can result in altered opioid system activity, and NPP is characterized by resistance to morphine. Here we investigate the regulatory mechanisms of microglia and review the potential of microglial inhibitors for modulating NPP and morphine tolerance. Targeted inhibition of glial activation is a clinically promising approach to the treatment of NPP and the prevention of morphine tolerance. Finally, we suggest directions for future research on microglial inhibitors.

Simultaneous Determination of Gallic Acid ，Cinnamic Acid and Catechin in 3 Processed Products of Rheum officinale by RP- HPLC / 中国药房

OBJECTIVE： To establish a method for simultaneous determination of gallic acid， cinnamic acid and catechin in 3 processed products of Rheum officinale. METHODS： RP-HPLC method was established. The determination was performed on Thermo ScientificTM Hypersil GOLD Dim column with mobile phase consisted of methanol-0.1％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 278 nm， and the column temperature was 30 ℃. The sample size was 10 μL. RESULTS： The linear range of gallic acid， cinnamic acid and catechin were 0.126 2-1.262 0 μg（r＝0.999 9）， 0.036 2-0.362 0  μg（r＝0.999 9） and 0.177 9-1.779 4 μg（r＝0.999 8）， respectively. Quantitative limits were 25.4， 28.2， 62.5 ng， and detection limits were 6.2， 3.6， 11.8 ng， respectively. RSDs of precision， stability， repeatability and durability tests were all less than 3％. The recoveries ranged from 94.64％-102.71％（RSD＝2.74％， n＝9）， 95.35％-102.49％（RSD＝2.44％， n＝9）， 93.56％-103.66％（RSD＝3.27％， n＝9）. The determination results showed that the contents of gallic acid and cinnamic acid in prepared R. officinale were higher， and the order of both were prepared R. officinale＞steamed R. officinale＞raw R. officinale. The content of catechin in raw R. officinale was higher， and the order of it was raw R. officinale＞ steamed R. officinale＞prepared R. officinale. CONCLUSIONS： The method is sensitive， reliable and reproducible. It can be used to determine the contents of gallic acid， cinnamic acid and catechins in 3 processed products of R. officinale simultaneously.

Experts consensus statement on Qilong Capsules in clinical practice / 中国中药杂志

Qilong Capsules is the representative Chinese patent medicine of the theory of " invigorating Qi and activating blood circulation" in traditional Chinese medicine( TCM),with distinct characteristics of TCM in clinical application. Qilong Capsules indication on package insert is ischemic stroke( cerebral infarction),which is a complex disease and has many pathological links. The treatment principles and methods at various stages are different. Inappropriate time of intervention,dosage and course of treatment make it difficult to give full play to the efficacy,but also cause adverse reactions,such as bleeding. In order to promote the rational use of Qilong Capsules,the project team invited frontline clinical experts,pharmaceutical experts and methodologist of evidence-based medicine around China to develop the consensus. The consensus is based on a combination of clinical research evidence and expert experi-ence to give recommendations for clinical problems with evidence support and expert consensus suggestions for clinical problems without evidence support. The consensus recommends the indication,timing of intervention,dosage,course of treatment,combined medication and contraindications of Qilong Capsules in clinical application,and introduced its safety characteristics,in order to guide clinical medical workers( involving Chinese medicine,Western medicine,combining traditional Chinese and Western medicine) to use Qilong Capsules reasonably in the treatment of cerebral infarction.

Effect of Serum Free Light Chain on Renal Function and Prognosis in Patients with Newly Diagnosed Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To analyze the effect of serum free light chain (sFLC) on renal function and prognosis in patients with newly diagnosed multiple myeloma (MM).@*METHODS@#The clinical data of 70 newly diagnosed MM patients who received sFLC examination in Fujian Medical University Union Hospital were retrospectively analyzed from April 2012 to November 2016. Univariate analysis was used to analyze the risk factors that associated with renal impairment (RI) and prognosis. Logistic regression and Kaplan-Meier analyze were used to analyze the roles of sFLC in RI and the prognosis.@*RESULTS@#Out of the 70 patients, 20 patients had RI at the initial diagnosis. Compared to normal renal function group, RI group had lower level of hemoglobin, elevated levels of serum uric acid, corrected calcium, serum creatinine, serum β2 microglobulin, and involved sFLC, higher proportion of patients with ISS stage III, involved sFLC≥500 mg/L, hemodialysis (all P＜0.05). Multivariate logistic regression analysis showed that serum uric acid≥430 μmol/L, ISS stage III and a involved sFLC≥500 mg/L were all the independent risk factors for RI in patients with newly diagnosed MM patients (all P＜0.05). Receiver operating characteristic (ROC) curves analysis showed that the involved sFLC was 705.0 mg/L, which was a best cut-off value area under curve (AUC) for prediting RI in patients with MM was 0.727 (P=0.003), sensitivity was 65.0% and specificity was 82.0%). After a median follow-up period of 31 (1-84) months, the median overall survival (OS) of patients with involved sFLC≥500mg/L and involved sFLC＜500 mg/L were 52.0 and 27.0 months, respectively, there was no statistically significant difference (P=0.137). There was also no statistically significant difference in median OS between the high sFLC ratio group (κ/λ＞32 or ＜0.03) and the low sFLC ratio group (0.03≤κ/λ≤32) (27 months vs 40 months, P=0.436).@*CONCLUSION@#The involved sFLC in the RI group is significantly higher than that in the normal renal function group in newly diagnosed MM patients. Serum uric acid≥430 μmol/L, ISS stage III and involved sFLC≥500 mg/L are the independent risk factors for RI. Monitoring sFLC in newly diagnosed MM patients is helpful to the prediction of RI, and the involved sFLC level or sFLC ratio may not affect the prognosis of newly diagnosed MM patients.

Effects of Different Dose Compatibility of Scutellaria baicalensis-Rheum palmatum-Coptis chinensis Based on Sanhuang Xiexin Decoction on Dissolution Rate of Baicalin and Baicalein / 中国药房

OBJECTIVE: To investigate the effects of different dose compatibility of Scutellaria baicalensis-Rheum palmatum-Coptis chinensis based on Sanhuang Xiexin decoction (shorted for Xiexin decoction) on dissolution rate of baicalin and baicalein, and to provide reference for studying chemical mechanism of TCM compound dose composition compatibility. METHODS: HPLC method was used to determine the contents of baicalin and baicalein. By fixing the dose of S. baicalensis (3 g), using the dose of R. palmatum and C. chinensis as factors, dissolution rate of baicalin and baicalein as response value, two-factor and five-level central composite test was designed. The optimal dose compatibility of S. baicalensis-R. Palmatum-C. chinensis was optimized by response surface method, and compared with the dissolution rate of baicalin and baicalein in classic dose Xiexin decoction (S. baicalensis 3 g, R. Palmatum 6 g, C. chinensis 3 g). RESULTS: When the doses of S. baicalensis, R. palmatum, C. chinensis were 3, 1. 76, 0. 17 g, total dissolution rate of baicalin and baicalein was the highest in extract. The average total dissolution rate of baicalin and baicalein in validation test was 21. 89％ (RSD=0. 46％, n=3),and the relative error was 2. 88％ with the predicted value of 22. 54％. Compared with the classical dose of Xiexin decoction, the total dissolution rate of baicalin and baicalein in the optimum dose of S. baicalensis-R. Palmatum-C. chinensis in extract was increased by 47. 21％. CONCLUSIONS: The different dose compatibility of S. baicalensis-R. Palmatum-C. chinensis based on Xiexin decoction influence the dissolution of baicalin and baicalein to certain extent. When the doses of S. baicalensis, R. palmatum, C. chinensis are 3, 1. 76, 0. 17 g, dissolution rate of baicalin and baicalein are higher than that of classic dose.

Effect of Progestin-primed Ovarian Stimulation Protocol on Outcomes of Aged Infertile Women Who Failed to Get Pregnant in the First IVF/ICSI Cycle: A Self-controlled Study / 华中科技大学学报（医学）（英德文版）

This study aimed to explore the outcomes of progestin-primed ovarian stimulation protocol (PPOS) in aged infertile women who failed to get pregnant in the first IVF/ICSI-ET cycles with GnRH-a long protocol.A self-controlled study was conducted to retrospectively investigate the clinical outcomes of 104 aged infertile patients who didn't get pregnant in the first IVF/ICSI-ET treatment by stimulating with GnRH-a long protocol (non-PPOS group),and underwent PPOS protocol (PPOS group) in the second cycle between January 2016 and December 2016 in the Center for Reproductive Medicine,Renmin Hospital of Wuhan University.The primary outcomes included clinical pregnancy rate of frozen-thawed embryos transfer (FET) in PPOS group,and good-quality embryo rate in both groups.The secondary outcomes were fertilization rate,egg utilization rate and cycle cancellation rate.The results showed that there were no significant differences in basal follicle stimulating hormone (bFSH),antral follicle count (AFC),duration and total dosage of gonadotropin (Gn),number of oocytes retrieved,intracytoplasmic sperm injection (ICSI) rate,fertilization rate,and cycle cancellation rate between the two groups (P＞0.05).However,the oocyte utilization rate and good-quality embryo rate in PPOS group were significantly higher than those in non-PPOS group (P＜0.05).By the end of April 2017,62 FET cycles were conducted in PPOS group.The clinical pregnancy rate and embryo implantation rate were 22.58％ and 12.70％,respectively.In conclusion,PPOS protocol may provide better clinical outcomes by improving the oocyte utilization rate and good-quality embryo rate for aged infertile patients who failed to get pregnant in the first IVF/ICSI-ET cycles.

Artificial Cycle with or without a Depot Gonadotropin-releasing Hormone Agonist for Frozen-thawed Embryo Transfer: An Assessment of Infertility Type that Is Most Suitable / 华中科技大学学报（医学）（英德文版）

The clinical outcomes of five groups of infertility patients receiving frozenthawed,cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed.A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed,cleavage-stage embryo transfers from January 1,2012 to June 31,2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region.Based on the infertility etiologies of the patients,the 1003 cycles were divided into five groups:tubal infertility,polycystic ovary syndrome (PCOS),endometriosis,male infertility,and unexplained infertility.The main outcome was the live birth rate.Two groups were set up based on the intervention:group A was given a GnRH agonist with exogenous estrogen and progesterone,and group B (control group) was given exogenous estrogen and progesterone only.The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B.The live birth rates in groups A and B were 41.67％ and 29.29％,respectively (P＜0.05).The live birth rates in patients with PCOS in groups A and B were 56.25％ and 30.61％,respectively (P＜0.05).The clinical pregnancy,implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B.The ectopic pregnancy rate was significantly lower in group A than in group B.We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer.The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested,especially for women with PCOS.