Effects of Zhoufei Pingchuan Capsules on Th17/Treg Balance and Related Inflammatory Factors in Peripheral Blood of Patients with Stable Chronic Obstructive Pulmonary Disease with Lung-kidney Qi Deficiency Syndrome / 中国中医药信息杂志

Objective To investigate the effects of Zhoufei Pingchuan Capsules on the balance of peripheral blood helper T lymphocyte 17 cell/regulatory T lymphocyte cell(Th17/Treg)and related inflammatory factors in peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD)with lung-kidney qi deficiency syndrome.Methods Totally 40 COPD patients were randomly divided into the study group and the control group,with 20 cases in each group.Another 20 cases were in the healthy group.The control group was given tiotropium bromide powder inhalation,18 μg/time,1 time/d,inhalation;on the basis of the control group,the study group was given Zhoufei Pingchuan Capsules,3 pills/time,3 times/d,orally.All patients were treated for 8 weeks.The healthy group was not given any intervention.Forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),maximum mid-expiratory flow(MMEF),carbon monoxide diffusing capacity/alveolar ventilation(DLCO/VA),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),COPD assessment test(CAT)score,Th17/Treg ratio,cytokines interleukin(IL)-17,IL-22,IL-10,and transforming growth factor-β1(TGF-β1)were compared before and after treatment.Results Compared with before treatment,the lung function indexes(FEV1,FEV1/FVC,MMEF,DLCO/VA),blood gas indexes(PaO2,PaCO2)and CAT score in the study group after treatment were significantly improved(P<0.05).After treatment,the mean values of MMEF,DLCO/VA,PaCO2 and CAT score in the study group were better than those in the control group(P<0.05).Compared with before treatment,the levels of Th17,IL-17 and IL-22 in the study group were significantly lower,and the levels of Treg,IL-10 and TGF-β1 were significantly higher(P<0.05).After treatment,there were significant differences in Th17,Treg,IL-17,IL-22,IL-10 and TGF-β1 among the three groups(P<0.01).Further pairwise comparison showed that Th17 ranked in the order of high and low was control group>study group>healthy group,Treg in the order of high and low was healthy group>study group>control group,the levels of IL-17 and IL-22 in the order of high and low were control group>study group>healthy group,and the levels of IL-10 and TGF-β1 in the order of high and low were healthy group>study group>control group,with statistical significance(P<0.05).Conclusion Zhoufei Pingchuan Capsules can improve the lung function,arterial blood gas and symptom score of patients with lung-kidney qi deficiency syndrome in stable stage of COPD.Its mechanism may be related to regulating the balance of Th17/Treg,down-regulating the levels of Th17,IL-17 and IL-22,and up-regulating the levels of Treg,IL-10 and TGF-β1,in order to reduce airway inflammation and regulate immune homeostasis.

The value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly patients with hip fractures / 中华老年医学杂志

Objective:To analyze the value of the modified 5-factor frailty index in assessing postoperative complications and mortality in elderly hip fracture patients.Methods:In this retrospective study, clinical data were collected of hip fracture patients aged 60 years and above surgically treated at Beijing Luhe Hospital affiliated to Capital Medical University between January 2015 and December 2019.Patients' group assignment was based on whether the modified frailty index score was ≤1 or ≥2, and a post-surgery follow-up was conducted for survival at 30 days, 1 year, 2 years, and 4 years, which was analyzed by the Kaplan-Meier method.Multivariate Cox regression analysis was used to identify factors affecting death in elderly patients.Results:A total of 1 208 patients were included, with 890 in the group with the index score ≤1 and 318 in the group with the index score ≥2.There was no difference in mortality at 30 days(1.6% or 14/890 vs.1.9% or 6/318, P=0.707), 1-year(11.3% or 99/874 vs.11.6% or 36/310, P=0.917), 2-years(19.7% or 168/852 vs.24.3% or 73/300, P=0.099)and 4-years(44.0% or 238/541 vs.51.5% or 106/206, P=0.071). The incidence of postoperative complications in the group with the score ≥2 was higher(14.8% or 47/318 vs.9.7% or 86/890, P=0.012), including the incidence of stroke(6.3% or 20/318 vs.1.8% or 16/890, P<0.001)and the incidence of postoperative pneumonia(6.0% or 19/318 vs.3.1% or 28/890, P=0.029), and the differences were statistically significant.Multivariate Cox regression analysis showed that age, being female, the Charlson comorbidity index score and low hemoglobin at admission were risk factors for 1-year, 2-year and 4-year mortality post-surgery(all P<0.05), while the modified frailty index score had no correlation with postoperative mortality. Conclusions:A modified frailty index ≥2 is predictive of increased risk of postoperative pneumonia and stroke in patients with hip fractures, but is not correlated with the risk of postoperative mortality.

Mechanism of Qingfei Huatan Zhuyu Decoction in Treatment of COPD Based on "Lung and Intestinal Co-treatment" / 中国实验方剂学杂志

ObjectiveTo observe the effect of Qingfei Huatan Zhuyu decoction on the lung and intestinal function of rats with chronic obstructive pulmonary diseases （COPD） and explore the deep-seated mechanism of its embodiment of lung and intestinal co-treatment. MethodA total of 60 Wistar rats were randomly divided into six groups， with 10 rats in each group， and the groups were control group， model group， acute syrup group （10 g·kg-1·d-1）， and low， medium， and high-dose groups （10， 15， 20 g·kg-1·d-1） of Qingfei Huatan Zhuyu decoction. The COPD rat model was established by lipopolysaccharide tracheal drip combined with the smoke inhalation method， and the acute syrup group and the Qingfei Huatan Zhuyu decoction group were administered by gavage with corresponding dose concentrations respectively， while the rest groups were controlled by saline gavage， and the lung function and blood gas indexes of rats were monitored after the last administration. The histopathological changes in the lung and intestine were observed microscopically. The expression of serum interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and secretory immunoglobulin A （IgA） in colon tissue were measured by enzyme-linked immunosorbent assay （ELISA）. The biochemical indexes such as serum diamine oxidase （DAO）， D-lactic acid， and malondialdehyde （MDA） were measured. Immunohistochemistry was used to detect the expression of tight junction protein （Occludin） in rat colon tissue. The expression of F4/80 positive alveolar macrophages in rat lung tissue， and the expression of α-actin （α-SMA） and colonic atresia small band protein-1 （ZO-1） were determined by immunofluorescence. The protein expression of p-NF-κB p65， NF-κB p65， p-p38 MAPK， and p-p38 MAPK and the expression of Occludin and ZO-1 in colon tissue were detected in rat lung tissue by Western blot. ResultCompared with the normal group， the model group had pulmonary dysfunction， reduced forced vital capacity （FVC）， arterial partial oxygen pressure （PaO2）， arterial oxygen saturation （SaO2）， and dynamic lung compliance （Cdyn） （P<0.01）， and the pathological changes in the lung and intestine were obvious. The expressions of IL-6， TNF-α， DAO， D-lactic acid， and MDA in serum were increased （P<0.05，P<0.01）， and the protein expression ratio of p-NF-κB p65/NF-κB p65 and p-p38 MAPK/p38 MAPK in lung tissue was increased. The expression of F4/80 positive macrophages in lung tissue was enhanced. The expression of IgA， Occludin， and ZO-1 in colon tissue decreased （P<0.05，P<0.01）. Compared with the model group， the pulmonary function of the rats in the acute syrup group and groups of Qingfei Huatan Zhuyu decoction was significantly improved， and the FVC， PaO2， SaO2， and Cdyn were increased （P<0.05， P<0.01）. The pathological changes in the lung and intestine were significant. The expressions of IL-6， TNF-α， DAO， D-lactic acid， and MDA in serum were decreased （P<0.05，P<0.01）， and the expressions of F4/80 positive macrophages in lung tissue were decreased （P<0.01）. The protein expression ratio of p-NF-κB p65/NF-κB p65 and p-p38 MAPK/p38 MAPK in lung tissue decreased （P<0.01）， and the expression of IgA， Occludin， and ZO-1 in colon tissue increased （P<0.01）. ConclusionQingfei Huatan Zhuyu decoction can effectively reduce the symptoms of COPD rats， and its mechanism of action is related to inhibiting the inflammatory response of lung tissue and improving the barrier function of the intestinal mucosa.

Clinical Observation on Treatment of Diabetic Foot Ulcer of Wagner Grade 1-2 by Compound Huangbai Liquid Fomentation / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of compound Huangbai liquid fomentation on diabetic foot ulcer of Wagner grade 1-2. MethodPatients were classified into the observation group and control group， with 41 cases in either group. The observation group received routine therapy and compound Huangbai liquid fomentation， while the control group was treated by routine therapy and medical silver nanoparticles-containing dressing. Ulcer area， ulcer depth， traditional Chinese medicine （TCM） syndrome score， ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6， erythrocyte sedimentation rate， and adverse events were observed before and after treatment in two groups. ResultAfter treatment， the ulcer area， ulcer depth， TCM syndrome score， vascular endothelial growth factor， epidermal growth factor， advanced glycation end product， high-sensitivity C-reactive protein， interleukin-6（IL-6）， and erythrocyte sedimentation rate were lower than those before treatment in two groups （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher than those before treatment in two groups （P<0.05）. After treatment， the ulcer area， ulcer depth， TCM syndrome score， advanced glycation end product， high-sensitivity C-reactive protein， IL-6， and erythrocyte sedimentation rate were lower in the observation group than in the control group （P<0.05）， and ankle-brachial index， transcutaneous oxygen pressure， vascular endothelial growth factor， and epidermal growth factor were higher in the observation group than in the control group （P<0.05）. The clinical efficacy of observation group was better than that of the control group （P<0.05）. There was no significant difference in the incidence of adverse events and endpoint events between two groups. ConclusionCompound Huangbai liquid fomentation is effective for diabetic foot ulcer of Wagner grade 1-2， as it is beneficial to the healing of the ulcer. This study provides clinical evidence for the further promotion of Chinese medicine fomentation.

Relationship between BRAF V600E, TERT promoter mutations and the clinicopathological features of papillary thyroid carcinoma / 中国肿瘤临床

Objective: To explore the relationship between TERT promoter mutations and BRAF V600E as well as their coexistence with the clinicopathological features of papillary thyroid cancer (PTC). Methods: A total of 728 patients enrolled in Shanxi Cancer Hospital from December 2014 to December 2016 with PTC were retrospectively analyzed. We reviewed and analyzed the clinical results, pathology records, ultrasound results, and BRAF V600E and TERT status. Results: BRAF V600E mutations were found in 42.3% (308 of 728) of patients, and TERT C228T and C250T promoter mutations were found in 10.7% (78 of 728) and 0.5% (4 of 728) of patients, respectively. The TERT promoter mutation was significantly associated with old age (P=0.034), extrathyroidal invasion (P=0.026), large tumor size (P=0.028), cervical lymph node metastasis (P=0.012), distant metastasis (P=0.001), advanced disease stages (P<0.001), histological type (P=0.003) and recurrence (P=0.002). The BRAF V600E mutation was significantly associated with extrathyroidal invasion (P= 0.001), large tumor size (P<0.001), Hashimoto thyroiditis (P<0.001), distant metastasis (P=0.010), advanced disease stages (P=0.009) and recurrence (P=0.001). The coexistence of BRAF V600E and TERT promoter mutations was particularly associated with high-risk clinicopathological features, such as old age (P=0.024), extrathyroidal invasion (P=0.022), Hashimoto thyroiditis (P=0.005), the cervical lymph node (P=0.018), and advanced disease stages (P=0.002). Conclusions: Our study demonstrates that BRAF V600E and TERT promoter mutations play a significant role in the aggressiveness of PTC, particularly when the two mutations coexist. The results reveal the significant role of these mutations in the treatment and prognosis prediction of PTC.

The analysis of prevalence and its related factors of thyroid nodules in the elderly in Tongzhou District of Beijing / 中华老年医学杂志

Objective:To investigate the prevalence and its related factors of thyroid nodules in elderly residents in Tongzhou District of Beijing.Methods:This is a cross-sectional study with cluster sampling.A total of 3 639 elderly volunteers aged 60 years and over receiving annual multiphasic health checkups were enrolled in Yongshun, Tongzhou District of Beijing from June to December 2017.A uniformly designed questionnaire was used to investigate the subject's basic information and previous medical history.All volunteers received a B-ultrasound examination of the thyroid gland, and were divided into the nodular group and non-nodular group based on the results of the B-ultrasound.The differences between the two groups in blood pressure, body mass index, triglycerides, total cholesterol, fasting blood glucose, thyroid peroxidase antibodies, urine iodine and other indicators were compared so as to analyze the risk factors for thyroid nodules.Results:A total of 3 639 elderly residents were included.The prevalence of thyroid nodules was 49.68%(1 808/3 639). Univariate analysis showed that there were significant differences between nodule group and non-nodule group in the age, gender, systolic blood pressure, body mass index, urea nitrogen, uric acid, aspartate aminotransferase, triglycerides, thyroid stimulating hormone and carcinoembryonic antigen( P<0.05). Multivariate Logistic regression analysis showed that women( OR=1.577, 95% CI: 1.358-1.832), age( OR=1.025, 95% CI: 1.012-1.038), body mass index( OR=1.032, 95% CI: 1.013-1.052)were risk factors for thyroid nodules.Increasing levels of urea nitrogen( OR=0.945, 95% CI: 0.902-0.990), thyroid stimulating hormone( OR=0.925, 95% CI: 0.882-0.970)and carcinoembryonic antigen( OR=0.967, 95% CI: 0.941-0.994)were protective factors for thyroid nodules. Conclusions:Women and obesity are risk factors for thyroid nodules and increasing levels of thyroid stimulating hormone, urea nitrogen and carcinoembryonic antigen may be unique protective factors for thyroid nodules in the elderly.

Circulation miR-193 cluster serves as a promising biomarker for diagnosis of breast cancer / 临床检验杂志

Objective@#To evaluate circulating miR-193 cluster as a biomarker for diagnosis of breast cancer (BC). @*Methods@#A total of 130 BC patients and 45 healthy controls (HCs) were enrolled. The level of miR-193 cluster was analyzed by using GEO database. RT-qPCR was used to evaluate the level of miR-193 cluster in serum of participants. Receivers operating characteristic (ROC) curve analysis was manipulated to investigate their diagnostic value for BC. @*Results@#In the screening stage, the results of GEO database indicated the expression of miR-193a-5p and miR-193b were decreased in the serum of BC patients with prior diagnostic value, and the significant decreased expressions of miR-193 cluster members, miR-193a-3p, -5p and miR-193b-3p, were observed in serum of BC patients compared with those in healthy controls by the determination of RT-qPCR（all P ＜0.01）. In the validation stage, the AUCROC of miR-193a-5p and miR-193b-5p were 0.888 (95% CI :0.808-0.969) and 0.954 (95% CI :0.902-1.000), respectively. In addition, the combined AUCROC of these two miRNAs was 0.982 (95% CI :0.966-0.999). @*Conclusion@#miR-193a-5p and miR-193b-5p in serum could be served as diagnostic biomarker for screening of breast cancer, and the combined detections of the two miRNAs may exhibit more diagnostic efficiency and good clinical application potential.

Analysis of 36 cases of diabetic ketoacidosis with increased trypsin / 中国基层医药

Objective To explore the rising degree of hemodiastase,lipase and the relationship with acute pancreatitis with diabetic ketoacidosis(DKA).Methods 36 diabetic ketoacidosis patients with increased trypsin were divided into non pancreatitis group(20 cases)and pancreatitis group(16 cases)based on the results of abdominal CT.And the blood amylase,urine amylase,blood fat enzyme levels of the two groups were measured and compard.Results The blood amylase of the pancreatitis group was(275.0±10.5)U/L,and that of pancreatitis group was(615.4±17.8)U/L,the difference between two groups was obvious(P＜0.01);The blood lipase of pancreatitis group was(2125.0±50.4)U/L,and that of pancreatitis group was(2021.0±19.8)U/L,there was no significant difference between the two groups(P＞0.05).The blood amylase and abdominal CT results compliance high.Conclusion Pure DKA can cause diabetes pancreatic enzyme increases,and in the diagnosis of acute pancreatitis,the specificity of blood amylase is high.

Maternal antepartum fever and early-onset bacterial sepsis in neonates in Shanghai / 中华围产医学杂志

Objective To evaluate the relationship between maternal antepartum fever and early-onset neonatal bacterial sepsis.Methods A retrospective multi-centred clinical study of 404 neonates including 103 new borns with maternal antepartum fever and 311 neonates without was conducted.Results The frequency of early-onset neonatal bacterial sepsis was significantly higher in neonate with maternal antepartum fever than those without(4.9% vs 0.3%,P=0.001).Both maternal antepartum temperature ≥39℃ and maternal postpartum fever lasting several days was higher suggested the possibility of neonatal sepsis.Conclusions The neonates born with high risk factor of early-onset neonate bacterial sepsis require comprehensive lab evaluation including blood culture and uterine culture,clinical observation and aggressive treatment to decrease the mortality.