Analysis of micronucleus rate in 394 radiation workers with cytokinesis-block micronucleus method / 中国辐射卫生

Objective To analyze the micronucleus rate of radiation workers and to provide accurate occupational health monitoring basis in radiation workers exposed to low-level ionizing radiation for a long time. Methods The radiation group consisted of 353 radiation workers who had been exposed to ionizing radiation during work, while the control group consisted of 41 radiation workers who had not yet been exposed to ionizing radiation before work. The cytokinesis-block micronucleus method was used to determine the micronucleus rate. Results The average micronucleus rate in the radiation group was significantly higher than that in the control group (t = −2.95, P < 0.05). In the radiation group, the micronucleus rate gradually increased with age, and the difference was statistically significant (F = 8.36, P < 0.05). The micronucleus rates of workers with > 10 and > 30 years of service were significantly higher than those of workers with < 10 years of service (χ2 = −44.79, −60.47, P < 0.05). The micronucleus rate in females was significantly higher than that in males (t = 3.93, P < 0.05). The micronucleus rates in the diagnostic radiology group and the industrial detection group were significantly higher than that in the control group (t = 3.51, 3.65, P < 0.05). Conclusion The micronucleus rate has increased among the radiation workers exposed to low-level ionizing radiation for a long time. It is necessary to further strengthen occupational health monitoring and radiation protection education for radiation workers, especially the medical workers that constitute the largest population of radiation exposure workers.

Research progress on application of multi-enzyme-catalyzed cascade reactions in enzymatic synthesis of natural products / 中国中药杂志

As a biocatalyst, enzyme has the advantages of high catalytic efficiency, strong reaction selectivity, specific target products, mild reaction conditions, and environmental friendliness, and serves as an important tool for the synthesis of complex organic molecules. With the continuous development of gene sequencing technology, molecular biology, genetic manipulation, and other technologies, the diversity of enzymes increases steadily and the reactions that can be catalyzed are also gradually diversified. In the process of enzyme-catalyzed synthesis, the majority of common enzymatic reactions can be achieved by single enzyme catalysis, while many complex reactions often require the participation of two or more enzymes. Therefore, the combination of multiple enzymes together to construct the multi-enzyme cascade reactions has become a research hotspot in the field of biochemistry. Nowadays, the biosynthetic pathways of more natural products with complex structures have been clarified, and secondary metabolic enzymes with novel catalytic activities have been identified, discovered, and combined in enzymatic synthesis of natural/unnatural molecules with diverse structures. This study summarized a series of examples of multi-enzyme-catalyzed cascades and highlighted the application of cascade catalysis methods in the synthesis of carbohydrates, nucleosides, flavonoids, terpenes, alkaloids, and chiral molecules. Furthermore, the existing problems and solutions of multi-enzyme-catalyzed cascade method were discussed, and the future development direction was prospected.

Distribution and Drug Sensitivity Analysis of Pathogenic Bacteria Isolated from Patients in Hematology Department / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution and drug sensitivity of pathogenic bacteria isolated from patients in hematology department, in order to provide evidence for rational use of antibiotics in clinic.@*METHODS@#The distribution of pathogenic bacteria and drug sensitivity data of patients in the hematology department of The First Affiliated Hospital of Nanjing Medical University from 2015 to 2020 were retrospectively analyzed, and the pathogens isolated from different specimen types were compared.@*RESULTS@#A total of 2 029 strains of pathogenic bacteria were isolated from 1 501 patients in the hematology department from 2015 to 2020, and 62.2% of which were Gram-negative bacilli, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Acinetobacter baumannii. Gram-positive coccus accounted for 18.8%, mainly Coagulase-negative staphylococcus (CoNS) and Staphylococcus aureus. Fungi (17.4%) were mainly candida. The 2 029 strains were mainly isolated from respiratory tract (35.1%), blood (31.8%) and urine (19.2%) specimens. Gram-negative bacilli were the main pathogenic bacteria in different specimen types (>60%). K. pneumoniae, S. maltophilia and A. baumannii were the most common pathogens in respiratory specimens, E. coli, CoNS, K. pneumoniae and P. aeruginosa were common in blood samples, and E. coli and Enterococcus were most common in urine samples. Enterobacteriaceae had the highest susceptibility to amikacin and carbapenems (>90.0%), followed by piperacillin/tazobactam. P. aeruginosa strains had high sensitivity to antibiotics except aztreonam (<50.0%). The susceptibility of A. baumannii to multiple antibiotics was less than 70.0%. The antimicrobial resistance rates of E. coli and K. pneumoniae in respiratory tract specimens were higher than those in blood specimens and urine specimens.@*CONCLUSION@#Gram-negative bacilli are the main pathogenic bacteria isolated from patients in hematology department. The distribution of pathogens is different in different types of specimens, and the sensitivity of each strain to antibiotics is different. The rational use of antibiotics should be based on different parts of infection to prevent the occurrence of drug resistance.

miRNA-128-3p inhibits malignant behavior of glioma cells by downregulating KLHDC8A expression / 南方医科大学学报

OBJECTIVE@#To determine whether miRNA-128-3p regulates malignant biological behavior of glioma cells by targeting KLHDC8A.@*METHODS@#Dual-luciferase reporter assays, qRT-PCR and Western blotting were used to verify the targeting of miRNA-128-3p to KLHDC8A. Edu assay, flow cytometry, Transwell assay and would healing assay were used to determine the effects of changes in miRNA-128-3p and KLHDC8A expression levels on malignant behavior of glioma cells. Rescue experiment was carried out to verify that miRNA-128-3p regulated glioma cell proliferation, apoptosis, invasion and migration by targeting KLHDC8A.@*RESULTS@#The expression level of KLHDC8A was significantly increased in high-grade glioma tissue and was closely related to a poor survival outcome of the patients. Overexpression of KLHDC8A promoted glioma cell proliferation, migration and invasion, and miRNA-128-3p overexpression inhibited proliferative and metastatic capacities of glioma cells. Mechanistically, KLHDC8A expression was directly modulated by miRNA-128-3p, which, by targeting KLHDC8A, inhibited malignant behavior of glioma cells.@*CONCLUSION@#Upregulation of miRNA-128-3p inhibits uncontrolled growth of glioma cells by negatively regulating KLHDC8A expression and its downstream effectors, suggesting that the miRNA-128-3p-KLHDC8A axis may serve as a potential prognostic indicator and a therapeutic target for developing new strategies for glioma treatment.

Summary of the best evidence for pain management in emergency adult patients with trauma / 中华急诊医学杂志

Objective:To retrieve,evaluate and integrate the best evidence of pain management in emergency adult patients with trauma,and to provide references for clinical nursing practice.Methods:The best evidence of pain management in emergency adult patients with trauma were systematically searched in domestic and international databases.The retrieval period is from the establishment of databases to December,2022.There were 2 researchers evaluating the quality of the literature and extracting the data.Results:Total of 16 articles were selected,including 5 top clinical decisions,6 guidelines,3 expert consensuses,2 systematic review. 36 pieces of best evidence were formed from 6 aspects,including pain management principles, pain assessment methods, pain medication principles, pharmacological interventions, non pharmacological interventions and dynamic monitoring of pain management.Conclusions:Medical staff can formulate corresponding nursing measures in clinical applications based on the actual situation of trauma patients, and use scientific methods to solve the pain problem of emergency adult trauma patients and improve their quality of life.

Study on the status quo and influencing factors of post-traumatic growth in patients with benign central airway stenosis undergoing interventional therapy / 中国实用护理杂志

Objective:To investigate the post-traumatic growth status of patients with benign central airway stenosis undergoing interventional therapy, and analyze the influencing factors, so as to provide basis for the formulation of measures to improve the treatment tolerance and quality of life of patients.Methods:Patients with benign central airway stenosis treated by interventional therapy in the First Affiliated Hospital of Second Military Medical University from May 2020 to May 2022 were selected by convenient sampling. The general information questionnaire, Chinese Version of Post-traumatic Growth Inventory, Perceived Social Support Scale and Chronic Disease Patients′ Health Literacy Management Scale were used to conduct a cross-sectional survey. Multivariate linear regression was used to analyze the influencing factors of patients′ posttraumatic growth.Results:A total of 183 questionnaires were distributed, and 172 questionnaires were effectively collected, with an effective recovery rate of 93.99% (172/183). The posttraumatic growth score of 172 patients was (62.66 ± 9.54) points; Pearson correlation analysis showed that perceived social support, health literacy and post-traumatic growth were positively correlated ( r=0.483, 0.246, both P<0.05). Multivariate linear regression analysis showed that the degree of stenosis, the number of interventional therapy, social support, and health literacy were the main influencing factors for the post-traumatic growth of patients with benign central airway stenosis undergoing interventional therapy ( t values were -3.46-4.55, all P<0.05), could jointly explain 38.9% of the variation in post-traumatic growth scores. Conclusions:The post-traumatic growth of patients with benign airway stenosis undergoing interventional therapy is at a moderate level. The degree of stenosis and the number of interventional therapy are the limiting factors for post-traumatic growth. Systematic health education, social support and health literacy are conducive to more post-traumatic growth of patients. Medical staff can enhance patients' disease awareness, and provide more channels for acquiring disease knowledge through WeChat groups and WeChat official account, so as to promote patients' post-traumatic growth and reduce their painful experience during treatment.

The effects of nucleotide-binding oligomerization domain-like receptor 3 inflammasome on obstructive sleep apnea and its complications / 中华预防医学杂志

Obstructive sleep apnea (OSA) is a sleep disorder with a high incidence and severe impact on the human body, which can induce systemic chronic inflammatory responses. Chronic inflammation is an important cause of exacerbation of OSA and its associated complications. Nucleotide-binding oligomerization domain-like receptor 3 (NLRP3) is an inflammasome that is widely found in epithelial cells and immune cells and plays an important role in inflammatory diseases as an important component of innate immunity. Research evidence suggests that the activation of NLRP3 inflammasomes can exacerbate the damage to neurons, endothelial cells, lung and kidney caused by OSA, and these effects can be eliminated by genetic or pharmacological deletion of NLRP3. Targeting inhibition of NLRP3 inflammasome may serve as a co-therapeutic strategy for OSA-induced related complications. This article reviews NLRP3 inflammasome and its mechanism in OSA-related concurrent diseases, which can provide scientific basis for prevention and intervention of OSA and its related complications.

The effects of nucleotide-binding oligomerization domain-like receptor 3 inflammasome on obstructive sleep apnea and its complications / 中华预防医学杂志

Obstructive sleep apnea (OSA) is a sleep disorder with a high incidence and severe impact on the human body, which can induce systemic chronic inflammatory responses. Chronic inflammation is an important cause of exacerbation of OSA and its associated complications. Nucleotide-binding oligomerization domain-like receptor 3 (NLRP3) is an inflammasome that is widely found in epithelial cells and immune cells and plays an important role in inflammatory diseases as an important component of innate immunity. Research evidence suggests that the activation of NLRP3 inflammasomes can exacerbate the damage to neurons, endothelial cells, lung and kidney caused by OSA, and these effects can be eliminated by genetic or pharmacological deletion of NLRP3. Targeting inhibition of NLRP3 inflammasome may serve as a co-therapeutic strategy for OSA-induced related complications. This article reviews NLRP3 inflammasome and its mechanism in OSA-related concurrent diseases, which can provide scientific basis for prevention and intervention of OSA and its related complications.

A bibliometric analysis of feeding intolerance in critically ill patients based on CiteSpace / 中华临床营养杂志

Objective:To reveal the research hotspos and the dynamic frontier in feeding intolerance in critically ill patients.Method:We took feeding intolerance and critical illness as the theme, the CNKI and WOS core database as the research object, and used CiteSpace software as research tool, to conduct a visual atlas analysis on the research status and hotspos evolution at home and abroad. Results:There were totally 2 426 feeding intolerance related papers published, and quantity of publications increased year by year. Australia and some European and American countries are in a leading position. The institutions in the lead regarding scientific research level were Royal Adelaide Hospital, Adelaide University, Louisville University, Repatriation General Hospital and Queens University. The researches mainly focused on the investigation of mechanism, symptom evaluation, and management of feeding intolerance .Conclusion:The feeding of critically ill patients has attracted more and more attention. In the future, we should further carry out high-quality and large-scale empirical research, explore new technologies and big data, and develop evidence-based prevention and management strategies for feeding intolerance.

The mechanism research of Xiaoyan Lidan formula for the intervention of chronic intrahepatic cholestasis based on metabolomics combined with molecular docking analysis / 药学学报

In this study, the mechanism of Xiaoyan Lidan formula (XYLDF) against 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine (DDC)-induced chronic intrahepatic cholestasis (CIHC) in mice was investigated based on metabolomics, molecular docking and pharmacological methods. In the pharmacodynamics study, a dosage of 5 g·kg-1 (clinical equivalent) XYLDF was administered in DDC-induced mice, then the effect of XYLDF against CIHC was evaluated by measuring the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (AKP) as well as total bilirubin (TBIL) in serum and observing liver histopathological changes. All experiments were approved by the Ethical Committee Experimental Animal Center of Guangzhou University of Chinese Medicine (ZYD-2021-001). The serum metabolites of mice in each group were detected and identified based on ultra-performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry, and the relevant biological pathways and molecular key targets were further enriched. Molecular docking technology was used to further evaluate the binding activity of the main active ingredients of XYLDF with potential targets. Subsequently, the in vitro experiment was conducted for the validation of the vital target. The results showed that compared with the model group, XYLDF significantly decreased the levels of ALT, AST, AKP and TBIL in the serum of CIHC mice, as well as alleviated inflammatory infiltration and hepatocyte necrosis in liver tissue. According to the metabonomic study, a total of 35 differential metabolites was identified as biomarkers associated with cholestasis, 12 of which were significantly recovered by XYLDF treatment. These biomarkers were involved in the pathways of primary bile acid biosynthesis and linoleic metabolism, which are closely related to the mechanism of XYLDF against CIHC. Protein-protein interaction network indicated that cytochrome P450 3A4 (CYP3A4) and cytochrome P450 1A1 (CYP1A1) are significant potential targets with good binding properties with six major active ingredients of XYLDF. Furthermore, it was found that 4-methoxy-5-hydroxycanthin-6-one, dehydroandrographolide and isodocarpin, three of the main active components in XYLDF, markedly induced the expression of CYP3A4 mRNA in vitro. This study revealed that XYLDF mainly mediates the biosynthesis of bile acids in CIHC mice to improve liver tissue lesions and bile efflux disorders, among which, CYP3A4 is the key target in the protection of XYLDF against CIHC. This research provides a reference for further elucidation of the pharmacological mechanism of XYLDF.

The effect of the quality improvement project of admission hypothermia on short-term outcomes of preterm infants less than 34 weeks gestational age / 中国小儿急救医学

Objective:To study the high risk factors of hypothermia in premature infants with gestational age ≤34 weeks, and to analyze the incidence of hypothermia before and after the implementation of the quality improvement program of hypothermia in hospital and its influence on various systemic complications, aiming to improve the early identification of hypothermia and to reveal the important clinical significance of temperature management in time.Methods:Clinical data of preterm infants born in Maternal and Child Health Hospital of Hubei Province from May 2017 to December 2018, with gestational age ≤34 weeks, and admitted within 1 hour after birth were collected.According to the admission temperature, the infants were divided into normal temperature group (36.5-37.5 ℃), mild hypothermia group (36.0-36.4 ℃), moderate hypothermia gsroup (32.0-35.9 ℃), and severe hypothermia group (<32.0 ℃). The high risk factors of hypothermia in premature infants were analyzed.The incidence and degree of hypothermia and the effects on the systemic complications before and after the implementation of the hypothermia quality improvement program were compared.Results:A total of 306 premature infants were enrolled in the study, including 63(20.6%)cases in the normal temperature group, 115(37.6%) cases in the mild hypothermia group, and 128(41.8%) cases in the moderate hypothermia group, without severe hypothermia.Infants with birth asphyxia were at higher risk for hypothermia( OR=0.195, 95% CI 0.046-0.833, P=0.027); the lower the Apgar score at 1 min( r=0.123, P=0.032)and 5 min after birth( r=0.136, P=0.017), the higher the risk of admission hypothermia.After the quality improvement project, the incidence of admission hypothermia decreased from 82.3% to 73.8%( χ2=32.67, P<0.001), and the use of pulmonary surfactant in infants with respiratory distress syndrome was significantly reduced(70.0% vs. 32.0%, χ2=40.11, P<0.001), and the incidence of hypotension within 72 hours after birth decreased(11.8% vs. 4.9%, χ2=3.87, P<0.049). Conclusion:Birth asphyxia is a risk factor for admission hypothermia in premature infants, and Apgar score is associated with admission hypothermia in premature infants.Temperature management of preterm infants can significantly reduce the incidence of hypothermia and hypotension, and reduce the use of pulmonary surfactant in respiratory distress syndrome infants.

Dynamic two-dimensional characterization technique and influencing factors analysis of the hygroscopicity of Chinese medicine extracts / 药学学报

This study aims to construct a dynamic two-dimensional characterization technique for the hygroscopicity of traditional Chinese medicine extracts and investigate the effect of material properties of powders on hygroscopicity. The dynamic hygroscopicity-time curves of the powders were measured at 25 ℃ and 75% humidity, and the semi-equilibrium hygroscopicity time (t1/2) and equilibrium hygroscopicity (F∞) were derived as two-dimensional evaluation indicators. Finally, the correlation between the material properties and the hygroscopic behavior was analyzed by principal component analysis (PCA) and partial least squares analysis (PLS). The results showed that the dynamic two-dimensional characterization system of hygroscopicity constructed with 1/t1/2 = 0.1 h-1 and F∞ = 15% as the center can classify the hygroscopic behavior of traditional Chinese medicine extracts into four categories: fast hygroscopicity with strong hygroscopicity, slow hygroscopicity with strong hygroscopicity, fast hygroscopicity with weak hygroscopicity and slow hygroscopicity with weak hygroscopicity. The moisture absorption was negatively correlated with D50, D90, ρb and ρt; the moisture absorption rate was negatively correlated with D10, D50, D90, ρb, ρt, and positively correlated with moisture content. The hygroscopicity dynamic two-dimensional characterization indicators of Chinese medicine extracts (CMEs) constructed in this study matched with the physical properties. The method of dynamic multi-dimensional characterization technology is feasible and scientific, and the idea has strong promotional value.

Research progress of gut microbiota in the antidepressant effect of traditional Chinese medicine / 药学学报

Depression is a common emotional mental disorder. Patients not only continuously showed depression, pessimism and apathy in mood, but also have gastrointestinal symptoms such as anorexia and constipation in body. Widely attention has been also received in the potential biological role of gut microbiota in the pathogenesis of depression. It plays an important role in the interaction between the intestine and the brain, not only affecting the intestinal barrier function, but also maintaining the homeostasis of host through the microbiota-gut-brain axis. In recent years, the traditional Chinese medicine (TCM) has the advantages of obvious therapeutic effects and few side effects when treating neuropsychiatric diseases, such as depression. The pharmacological mechanism of TCM exerting antidepressant effects by regulating the structure of gut microbiota, reducing displacement, and maintaining the normal function of gut microbiota has been also widely concerned. By investigating the relevant literature in recent years, this paper summarizes the antidepressant effect of TCM in different directions such as Chinese medicine monomer, single medicine and compound medicine. And this paper reviews the antidepressant effects and mechanisms of TCM at different levels, such as the correction of gut microbiota structure, the regulation of immunity, the transplantation of gut microbiota and the regulation of its metabolites. This paper will provide a basis for further explaining the mechanism of gut microbiota in depression and the mechanism of antidepressant effect of TCM.

Reeducation of medical research ethics based on medical staff's cognition and practice of medical research ethics / 中华医学科研管理杂志

Objective:To investigate and analyze the cognition of medical staff on medical research ethics in a grade A tertiary hospital, combined with the current situation of practice, to provide a basis and ideas for exploring new educational models of medical research ethics.Methods:Medical staff in a grade A tertiary hospital were investigated through an anonymous questionnaire to collect and analyze their cognition of medical research ethics and the current situation of practice.Results:There were statistically significant differences ( P<0.05) in the cognition of medical research ethics among different educational backgrounds, majors, and professional titles. The survey results showed that doctors, medical staff with graduate degrees or above, and senior title personnel had better cognition of medical research ethics than nurses, medical staff with bachelor degrees or below, and intermediate or junior title personnel. Conclusions:The medical staff's cognition and practice of medical research ethics are still insufficient. Hospitals should pay attention to the education of medical research ethics and enrich the content and form of training to improve the ethical literacy of medical personnel.

Effect of ABCA1 on epithelial-mesenchymal transition in gastric cancer by activating the EGFR / STAT3 signaling pathway / 安徽医科大学学报

Objective @#To explore the effect of ATP binding cassette subfamily A member 1 (ABCA1) on the inva- sion，migration and epithelial-mesenchymal transition(EMT) of human gastric cancer and investigate the underlying mechanism．@*Methods @#The expression of ABCA1 in human gastric cancer and its relationship with the prognosis of gastric cancer patients were analyzed by Bioinformatics analysisbased on network databases. RT-qPCR was per- formed to detect the expression of ABCA1 in 25 pairs of clinical gastric cancer tissue samples ; RT-qPCR and West- ern blot were used to analyze the expression of ABCA1 in different human gastric cancer cell lines ; Gene silencing technology was used to construct stable low-expressing ABCA1 gastric cancer cell line．Cell migration and invasion were determined by transwell assay ; Western blot was used to detect the expression of related marker proteins in EMT and epidermal growth factor receptor (EGFR) / signal transducer and activator of transcription(STAT3) signa- ling pathway. @*Results @#The results of bioinformatics analysis indicated that ABCA1 was highly expressed in gastric cancer，which was positively correlated with advanced grade and stage as well as the poor prognosis of gastric canc- er patients. RT-qPCR results showed that ABCA1 was highly expressed in gastric cancer tissues and gastric cancer cells HGC-27 ; The results of Transwell indicated that knockdown of ABCA1 could inhibit the invasion and migra- tion of HGC-27 cells．Western blot results showed that the expression of mesenchymal cell marker proteins (Vimen- tin，N-Cadherin) and EMT-related transcription factors (Twist，Zeb1 and Snail) in the ABCA1 knockdown group was down-regulated，while the expression of epithelial cell marker protein E-Cadherin was up-regulated．Western blot results showed that compared with the control group，knockdown of ABCA1 inhibited the expression of EGFR downstream molecule STAT3，and reduced the phosphorylation level of EGFR and its downstream molecule STAT3 . @*Conclusion @#ABCA1 is up-regulated in gastric cancer and is correlated with cell invasion，migration，EMT and in- dicate poor prognosis of gastric cancer patients．ABCA1 may affect the expression and activation of STAT3 by regu- lating EGFR , thereby inhibiting the invasion，migration and EMT of gastric cancer cells.

Analysis of epidemic characteristics of COVID-19 clusters in Chenzhou， Hunan Province / 上海预防医学

Objective:To analyze the epidemiological characteristics of 8 clusters of coronavirus disease 2019 （COVID-19） in Chenzhou City， and provide scientific basis for epidemic prevention and control. Methods:Descriptive epidemiological analysis was conducted for 8 COVID-19 clusters， comparing and analyzing the differences of infection rates among close contacts within and outside the family， and emphatically describing two typical cases. Results:8 COVID-19 clusters were reported in Chenzhou with a total of 31 cases from January to February， 2020. The main source of infection of the family index cases was Hubei Province. Cough symptoms were observed in 67.74% of the cases， followed by fever （54.84%）. The infection rate of close contacts within the family （55.00%） was higher than that outside the family （2.56%）， and the difference was statistically significant （χ2=28.177， P<0.001）. The infection rate of spouse of the family index cases was 85.71%， higher than that of parents （77.78%）， other family members （44.44%） and children （40.00%）， and the difference was not statistically significant （χ2=6.004， P=0.120）. Two typical cases suggested that both COVID-19 pre-symptomatic and asymptomatic patients have the potential to excrete the virus from the body and become sources of infection. Conclusion:Effective family prevention and control measures and early sampling and screening of people in key epidemic areas are conducive to early detection， early isolation and early treatment of infected people， so as to avoid the occurrence and spread of family clusters.

Determination of digoxin in human plasma by LC-MS/MS and its application in pediatric patients / 中国药科大学学报

@#The aim of the study was to develop a simple, rapid and accurate LC-MS/MS method for the determination of digoxin.Digoxin-d3 was taken as the internal standard (IS), and sample preparation was achieved by liquid-liquid extraction.Chromatographic separation was performed on a Kinetex C18 column (2.1 mm × 50 mm, 2.6 μm; Phenomenex) using an isocratic elution with merely 2 min for each sample.The mobile phase consisted of water and acetonitrile solutions, both containing 1 mmol/L ammonium acetate and 1 mmol/L formic acid (55∶45).The detection was conducted on a TripleQuadTM 4500MD mass spectrometer coupled with electrospray ionization interface under positive-ion multiple reaction monitoring mode.The transitions were m/z 798.5 → 651.3 and m/z 801.6 → 654.4 for digoxin and digoxin-d3, respectively.Results showed that the method was linear over the range of 0.100-20.0 ng/mL.The selectivity, accuracy and precision, recovery and stability of the method were all within the acceptable limits with no matrix effect.This method was successfully applied to a girl treated with digoxin with substantial improvement of therapeutic effect and elimination of toxic reaction, so it can provide valuable fuidance and reference for individualized medication in clinical practice.

Mechanism study of CeRNA regulatory network mediating malignant tumor phenotype / 国际肿瘤学杂志

Competing endogenous RNAs (CeRNAs) are crisscrossing regulatory networks. CeRNAs networks can mediate malignant tumor cell phenotypes, including proliferation and inhibition, autophagy, infinite growth, induction of angiogenesis and angiogenic mimicosis, immune escape, etc.. It is expected to provide new diagnostic markers and therapeutic targets for malignant tumors to master the regulation and function of CeRNAs mediated phenotype in malignant tumors.

Comparison of therapeutic effect for diabetic macular edema based on different optical coherence tomography patterns / 中华实验眼科杂志

Objective:To evaluate the efficacy of intravitreal ranibizumab (IVR) injection and/or laser photocoagulation on diabetic macular edema (DME) of different morphologic patterns based on optical coherence tomography (OCT).Methods:A non-randomized controlled clinical trial was conducted.A total of 79 diabetic patients (108 eyes) who were diagnosed as DME in Affiliated Hospital of Nanjing University of Chinese Medicine from March 2017 to February 2018 were enrolled.The subjects were divided into diffuse macular edema (DRT) group (41 eyes), cystoid macular edema (CME) group (37 eyes) and serous retinal detachment (SRD) group (30 eyes) according to the morphological characteristics of OCT, and received intravitreal injection of 0.05 ml (0.5 mg) ranibizumab and/or laser photocoagulation according to treatment guidelines.Best corrected visual acuity (BCVA), central macular thickness (CMT) of the subjects were recorded before treatment and 1 month, 3, 6 and 12 months after treatment.The morphologic changes of macular edema and complications were recorded.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Affiliated Hospital of Nanjing University of Chinese Medicine (No.2017NL-13-03). Written informed consent was obtained from each patient before any medical examination and treatment.Results:The 1-, 3-, 6- and 12-month post-treatment average BCVA (LogMAR) of the DRT, CME and SRD groups were improved in comparison with before treatment, and the average CMT of the three groups at various time points after treatment was reduced than that before treatment (all at P<0.05). For the 39 eyes who received IVR treatment, the 12-month post-treatment average BCVA (LogMAR) of the DRT group was 0.41±0.40, which was significantly better than 0.60±0.40 of the CME group ( P=0.039). The 12-month post-treatment CMT of the DRT group was (286.05±109.56) μm, which was significantly thinner than (338.30±101.87)μm of the SRD group ( P=0.045). For the 69 eyes who received IVR combined with laser photocoagulation treatment, the 6- and 12-month post-treatment average BCVA (LogMAR) of the DRT group were significantly better than those of the CME group ( P=0.048, 0.043), and the average CMT at 12 months after treatment in the DRT group was (304.59±106.66)μm, which was significantly smaller than (369.34±107.80)μm in the SRD group, showing a statistical significance ( P=0.041). During the follow-up, 5 eyes with SRD turned to DRT, and 3 SRD eyes turned to CME.No eye changing from DRT and CME to SRD was found. Conclusions:Intravitreal ranibizumab injection and/or laser photocoagulation can significantly improve BCVA and reduce CMT of DME patients, and the efficacy is better in eyes with DRT than eyes with SRD or CME.

Postoperative analgesic efficacy of nabuprofen combined with femoral nerve block in older adult patients subjected to knee arthroplasty / 中国基层医药

Objective:To investigate the postoperative analgesic efficacy of nabuprofen combined with femoral nerve block in older adult patients subjected to knee arthroplasty and its effects on cognitive function and serum S-100β protein level.Methods:Ninety-one older adult patients subjected to knee arthroplasty between March 2018 and March 2020 in Zhoushan Hospital of Traditional Chinese Medicine were included in this study. They were randomly divided into observation ( n = 45) and control ( n = 46) groups. Patients in both groups received femoral nerve block and catheterization. Naborphine and equal amount of 0.9% sodium chloride injection were intravenously administered in the observation and control groups, respectively for postoperative analgesia. Before and after surgery, Mini-Mental State Examination (MMSE) score, S-100β protein level and Visual Analogue Scale score, and adverse reactions were compared between the observation and control groups. Results:Before surgery, there was no significant difference in MMSE score between the two groups ( P > 0.05). At 3 days after surgery, MMSE score in each group was significantly decreased compared with before surgery (both P < 0.05). At 3 days after surgery, MMSE score in the observation group was significantly higher than that in the control group [(25.34 ± 1.31) points vs. (23.67 ± 1.53) points, t = 5.34, P < 0.05]. Before surgery, there was no significant difference in serum S-100β protein level between the two groups ( P > 0.05). At 1 and 3 days after surgery, serum S-100β protein level in each group was significantly increased compared with before surgery (both P < 0.05). At 7 days after surgery, serum S-100β protein level in each group recovered to pre-operative level. At 1 and 3 days after surgery, serum S-100β protein level in the observation group was significantly lower than that in the control group ( t = 10.20, 9.21, both P < 0.05). At 1, 3, 6, 12 and 24 hours after surgery, the Visual Analogue Scale score in the observation group was (1.14 ± 0.22) points, (1.43 ± 0.25) points, (1.87 ± 0.21) points, (3.56 ± 0.20) points, and (2.63 ± 0.23) points respectively, which was significantly lower than that in the control group [(2.53 ± 0.24) points, (2.53 ± 0.24) points, (3.56 ± 0.20) points, (3.98 ± 0.25) points, (4.23 ± 0.21) points, t = 5.10, 8.15, 9.41, 10.18, 11.42, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [13.33% (6/45) vs. 30.43% (14/46), χ2 = 3.88, P = 0.049]. Conclusion:Naborphine combined with femoral nerve block can effectively improve the postoperative cognitive function of older adult patients undergoing knee arthroplasty, provides good postoperative analgesia, and is highly safe.