[Application progress of clinical outcome assessment measures in patients with gastric cancer].

Gastric cancer is a common tumor of the gastrointestinal tract, and the global trend in morbidity and mortality are not encouraging. Especially in advanced gastric cancer, patient survival outcome is an essential clinical concern and a vital outcome indicator in clinical outcome assessment. This article reviews the definition of clinical outcome assessment and the measurement tools that can be applied in gastric cancer patients, describes the detailed classification of clinical outcome assessment tools, and reviews the current status of the application of clinical outcome assessment in gastric cancer, analyzing the effects and shortcomings of its application, to provide a reference for the clinical staff in choosing the appropriate tools, and assisting in the comprehensive and holistic assessment of clinical outcomes for the promotion of the development of precision medicine.

[Research on the formulation and revision of radiological parameters in the "Standards for Drinking Water Quality（GB5749-2022）" in China].

The radioactive safety of drinking water has attracted increasing public concern. The newly issued Standards for Drinking Water Quality (GB5749-2022) in China has revised the radiological parameters. This article provides an overview of the main sources, levels of radionuclides in drinking water, and summarized the individual doses criterion and adverse health effects associated with exposure of the public to radionuclides from drinking-water. It analyzes and discusses the relevant revision content of radiological parameters, including the guidance values for screening gross α and gross ß, subtracting the contribution of potassium-40 from gross ß activity when the gross ß activity concentration exceeds the screening level, and the basis for establishing the limit values of reference indices uranium and radium-226. Specific implementation and evaluation suggestions are also proposed.

[A real-world study of the effects of endocrine therapy on liver function in breast cancer].

Objective: To compare the effect of different endocrine therapy drugs on liver function in patients with early breast cancer. Methods: A retrospective cohort study was conducted to include 4 318 patients with early breast cancer who received adjuvant endocrine therapy in Department of Breast Surgery, Peking Union Medical College Hospital from January 1, 2013 to December 31, 2021. All the patients were female, aged (51.2±11.3) years (range: 20 to 87 years), including 1 182 patients in the anastrozole group, 592 patients in the letrozole group, 332 patients in the exemestane group, and 2 212 patients in the toremifene group. The mixed effect model was used to analyze and compare the liver function levels of patients at baseline, 6, 12, 18, 24, 36, 48, 60 months of medication, and 1 year after drug withdrawal among the three aromatase inhibitors (anastrozole, letrozole, exemestane) and toremifene. Results: ALT and AST of the 4 groups were significantly higher than the baseline level at 6 months (all P<0.01), and there were no significant differences in total bilirubin, direct bilirubin and AST levels among all groups one year after drug withdrawal (P: 0.538, 0.718, 0.061, respectively). There was no significant difference in the effect of all groups on AST levels (F=2.474, P=0.061), and in the effect of three aromatase inhibitors (anastrozole, letrozole, and exemestane) on ALT levels (anastrozole vs. letrozole, P=0.182; anastrozole vs. exemestane, P=0.535; letrozole vs. exemestane, P=0.862). Anastrozole and letrozole had significantly higher effects on ALT levels than toremifene (P<0.01, P=0.009). The proportion of abnormal liver function in each group increased significantly at 6 months compared with baseline, and then the proportion showed a decreasing trend over time. Conclusions: Three aromatase inhibitors (anastrozole, letrozole, and exemestane) and toremifene can significantly increase the level of ALT and AST in patients with breast cancer, and the levels can gradually recover to the baseline after 1 year of drug withdrawal. The effect of non-steroidal aromatase inhibitors (anastrozole, letrozole) on ALT levels is greater than toremifene.

[A Japanese classic book on materia medica Ben Cao Quan].

Ben Cao Quan is an ancient classic book on materia medica compiled by Goku Yoshida, a Japanese scholar in the Edo period (1603-1867). A total of 568 materia medica in 53 categories in Ben Cao Quan came from Ben Cao Gang Mu compiled by Li Shizhen in the Ming Dynasty. These materia medica were introduced with some of his own interpretations of Goku Yoshida. The main characteristics of Ben Cao Quan reflected as follows. It attached importance to the comparison of translation from Chinese into Japanese and selected those materia medica commonly used in Japan, in particular, from 'spicific explanation' (Ji Jie) and 'smell' (Qi Wei) in Ben Cao Gang Mu.It focused on application and integrated local practice, and interpreted the personal insights of Goku Yoshida.Goku Yoshida's personal understanding and perception of these material medica were shown in terms of their origin and quality, analysis of their properties and collection, interpretation of their identification and selection, their local names, their Japanese names, and review of the changes when these materia medica were introduced into Japan.The purpose of Ban Cao Quan was to attempt to help Japanese identify materia medica and distinguish quality and interpret materia medica with Japanese characteristics. The book is valuable literature for the research of the impact of Ben Cao Gang Mu on the development of materia medica in Japan.

[The illustrations in the works of traditional Chinese medicine in the period of the Republic of China: indicating the integrated thinking of Chinese and western medicine].

Some works of traditional Chinese medicine in the period of the Republic of China were influenced by the integrated thinking of Chinese and Western medicine to some extent. This was reflected in the illustrations in the works of the time. A total of 1,932 illustrations or diagrams found in sixteen institution's book collections in China illustrated the integration of medical thinking. The illustrations and diagrams were classified into eleven categories. The categories were theoretical illustration, medical charts, viscera diagrams, disease diagrams, acupoint diagrams, apparatus diagrams, human body diagrams, fetal birth charts, drug diagrams, figure pictures, and experimental diagrams. It was found that these illustrations or diagrams had their own characteristics at the time and greatly influenced anatomy. However, the author has argued that most of the influence was on the surface.

[Clinical features of long segmental myelopathy caused by nitrous oxide].

OBJECTIVE: To analyze the clinical and imaging characteristics of the neurological damage caused by nitrous oxide (N2O). METHODS: In the study, 10 patients in the Department of Neurology of China-Japan Friendship Hospital from October 2015 to February 2018 were retrospectively analyzed for the demographic data, the history of inhaled N2O, clinical features, blood examination, electrophysiological examination, spinal magnetic resonance imaging and therapeutic efficacy profiles. RESULTS: The male-to-female ratio was 4:6 and it presented with an age-of-onset 17-26 years [the average age: (20.80±3.12) years]. The time from inhaled N2O to onset was 1 month to 1 year [the average time: (6.95±4.19) months]. Paralysis in all the patients and numbness in 9 patients were the main clinical features, while positive Lhermitte's sign in 3 patients, urinary and defecation disturbance in 4 patients were also found. Blood examination indicated anemia in 2 patients, giant cell anemia in 1 case and small cell hypochromic anemia in 1 case. 3 cases had been treated with vitamin B12 in an external hospital, and the other 7 cases had abnormal increase in homocysteine levels. Electrophysiological examinations showed sensory and motor nerve involvement in 9 patients, and motor nerve involvement in 1 patient. The severity of lower extremity lesion was significantly heavier than that of upper extremity. Spinal magnetic resonance imagings showed that long segmental lesions were present in the cervical spinal cord of all the patients, 3 cases with long segmental lesions of the thoracic cord and 2 cases with spinal cord swelling. In 6 cases, the horizontal axis had an "inverted V-type" T2 high signal, 1 case was classified as "crescent", and 3 cases were "eight-shaped". The symptoms in these 10 cases were alleviated in varying degrees after stopping the inhalation of nitrous oxide, actively supplementing high doses of vitamin B12 and doing early rehabilitation exercises. CONCLUSION: Myelopathy with nitrous oxide presents as paralysis and numbness in limb extremities. In imaging, cervical spinal cord damage is common, accompanied by thoracic spinal cord damage. The horizontal axis is more common in the "inverted V-type". Treatment with high doses of vitamin B12 is effective.

Acute effect of multiple ozone metrics on mortality by season in 34 Chinese counties in 2013-2015.

BACKGROUND: Although numerous multicentre studies have estimated the association between ozone exposure and mortality, there are currently no nationally representative multicentre studies of the ozone-mortality relationship in China. OBJECTIVE: To investigate the effect on total (nonaccidental) and cause-specific mortality of short-term exposure to ambient ozone, and examine different exposure metrics. METHODS: The effects of short-term exposure to ozone were analysed using various metrics (daily 1-h maximum, daily 8-h maximum and daily average) on total (nonaccidental) and cause-specific (circulatory and respiratory) mortality from 2013 to 2015 in 34 counties in 10 cities across China. We used distributed lag nonlinear models for estimating county-specific relative risk of mortality and combined the county-specific relative rates by conducting a random-effects meta-analysis. RESULTS: In all-year analyses, a 10 µg m-3 increase in daily average, daily 1-h maximum and daily 8-h maximum ozone at lag02 corresponded to an increase of 0.6% (95% CI: 0.33, 0.88), 0.26% (95% CI: 0.12, 0.39) and 0.37% (95% CI: 0.2, 0.55) in total (nonaccidental) mortality, 0.66% (95% CI: 0.28, 1.04), 0.31% (95% CI: 0.11, 0.51) and 0.39% (95% CI: 0.16, 0.62) in circulatory mortality, and 0.57% (95% CI: -0.09, 1.23), 0.11% (95% CI: -0.22, 0.44) and 0.22% (95% CI: -0.28, 0.72) in respiratory mortality, respectively. These estimates had a different seasonal pattern by cause of death. In general, the seasonal patterns were consistent with the times of year when ozone concentrations are highest. CONCLUSIONS: Our findings suggest that in China, the acute effects of ozone are more closely related to daily average exposure than any other metric.

Effect of alpha-lipoic acid on relieving ammonia stress and hepatic proteomic analyses of broilers.

Ammonia in poultry houses not only affects worker health but also induces a variety of poultry diseases. Alpha-lipoic acid (LA) is an effective antioxidant that protects cells against oxidative injury during various toxic and pathological processes. This study was designed to evaluate the mitigating effects of LA supplementation on ammonia stress and hepatic proteome changes in broilers. Male broilers (22 d old) were allocated to 3 groups: (1) a control group without ammonia stress (CTRL); (2) exposure to 70 ppm ammonia (AM); and (3) exposure to 70 ppm ammonia and dietary administration of 300 mg/kg LA (AM+LA). Ammonia exposure significantly decreased broiler growth performance and plasma glutathione peroxidase activity (P < 0.05), and increased plasma malondialdehyde content and glutamic-pyruvic transaminase activity (P < 0.05). These negative effects were eliminated by LA supplementation. Comparative proteomic analyses revealed 291 differentially expressed proteins in the AM group compared to the CTRL and AM+LA groups. A total of 30 proteins were differentially expressed between the AM/CTRL and (AM+LA)/AM groups. The addition of LA restored 24 of these proteins to control levels; these proteins were mainly related to transcription regulation, detoxification, protein translation and degradation, and immune and stress responses. The differentially expressed proteins included the high mobility group box (HMGB) and glutathione S-transferase (GST), which is closely related to immune response and oxidative stress, and collagens, which are implicated in liver injury. The addition of LA to broiler diet may reduce ammonia toxicity by maintaining the antioxidant system, xenobiotic metabolism, and metabolic pathways.

Consumption of soy foods and isoflavones and risk of type 2 diabetes: a pooled analysis of three US cohorts.

BACKGROUND/OBJECTIVES: Evidence regarding the consumption of soy foods and isoflavones in relation to risk of type 2 diabetes (T2D) is scarce. Our study was to evaluate the association between soy food and isoflavone consumption and risk of T2D in US men and women. SUBJECTS/METHODS: We followed 63 115 women in the Nurses' Health Study (1998-2012), 79 061 women in the Nurses' Health Study II (1999-2013) and 21 281 men in the Health Professionals Follow-Up Study (2002-2010). Diet was assessed by a validated food-frequency questionnaire and was updated every 4 years. Self-reports of incident T2D were confirmed by a validated supplementary questionnaire. RESULTS: During 1 966 321 person-years of follow-up, 9185 incident T2D cases were documented. After multivariate adjustment for covariates, consumption of soy foods (tofu and soy milk) was not associated with a lower T2D risk. Compared with non-consumers of soy foods, the hazard ratio (HR) was 1.00 (95% confidence interval (CI): 0.93, 1.07) for <1 serving/week and 0.93 (95% CI: 0.83, 1.03) for ⩾1 serving/week of soy foods (P for trend=0.14). In contrast, intake of total isoflavones was inversely associated with T2D risk. Comparing extreme quintiles of isoflavones, the HR was 0.89 (95% CI: 0.83, 0.96; P for trend=0.009). Inverse associations were also found for consumption of major individual isoflavones, including daidzein and genistein, with risk of T2D. CONCLUSIONS: Intake of isoflavones was associated with a modestly lower T2D risk in US men and women who typically consumed low-to-moderate amounts of soy foods. These findings warrant replications in other populations with similar soy intake levels.

Electrophysiological Characteristics and Radiofrequency Catheter Ablation of Accessory Pathway Connecting the Right Atrial Appendage and the Right Ventricle.

BACKGROUND: The accessory pathway (AP) connecting the right atrial appendage (RAA) and the right ventricle (RV) is rare. OBJECTIVE: We sought to investigate the feature of the AP connecting the RAA and the RV and the efficacy of radiofrequency catheter ablation via the endocardial access. METHODS: We retrospectively analyzed 14 consecutive patients with 14 APs connecting the RAA and the RV managed by 15 procedures between January 2003 and December 2014. RESULTS: Ten patients presented as preexcitation during sinus rhythm. All APs had retrograde conduction. None had either antegrade or retrograde decremental conduction property. Ablation targeting the sites at the tricuspid annulus failed in all patients. They were successfully managed by ablating the atrial insertion sites with a median of 10.5 (range 5-28) radiofrequency applications. Electrograms at the successful target showed high amplitude atrial electrogram and low amplitude or no ventricular electrogram. The atrial insertion sites were at the floor of the RAA in 10 patients and inside the lower lobe of the RAA in the remaining 4 patients. The shortest distance between the successful target and the tricuspid annulus in the right anterior oblique projection was 19.7 ± 4.0 mm. There were no complications or recurrences during a median follow-up period of 4.3 (range 0.2-11.8) years. CONCLUSION: The APs connecting the RAA and the RV had typical conduction properties. The atrial insertion site favored the floor and the lower lobe of the RAA. Ablation targeting the atrial insertion sites was effective and safe, albeit multiple radiofrequency applications were needed.

Calcium supplement intake and risk of cardiovascular disease in women.

UNLABELLED: Some recent reports suggest that calcium supplement use may increase risk of cardiovascular disease. In a prospective cohort study of 74,245 women in the Nurses' Health Study with 24 years of follow-up, we found no independent associations between supplemental calcium intake and risk of incident coronary heart disease (CHD) and stroke. INTRODUCTION: Some recent reports suggest that calcium supplements may increase cardiovascular disease (CVD) risk. The objective was to examine the independent associations between calcium supplement use and risk of CVD. METHODS: We conducted a prospective cohort study of supplemental calcium use and incident CVD in 74,245 women in the Nurses' Health Study (1984-2008) free of CVD and cancer at baseline. Calcium supplement intake was assessed every 4 years. Outcomes were incident CHD (nonfatal or fatal MI) and stroke (ischemic or hemorrhagic), confirmed by medical record review. RESULTS: During 24 years of follow-up, 4,565 cardiovascular events occurred (2,709 CHD and 1,856 strokes). At baseline, women who took calcium supplements had higher levels of physical activity, smoked less, and had lower trans fat intake compared with those who did not take calcium supplements. After multivariable adjustment for age, body mass index, dietary calcium, vitamin D intake, and other CVD risk factors, the relative risk of CVD for women taking >1,000 mg/day of calcium supplements compared with none was 0.82 (95% confidence interval [CI] 0.74 to 0.92; p for trend <0.001). For women taking >1,000 mg/day of calcium supplements compared with none, the multivariable-adjusted relative risk for CHD was 0.71 (0.61 to 0.83; p for trend < 0.001) and for stroke was 1.03 (0.87 to 1.21; p for trend = 0.61). The relative risks were similar in analyses limited to non-smokers, women without hypertension, and women who had regular physical exams. CONCLUSIONS: Our findings do not support the hypothesis that calcium supplement intake increases CVD risk in women.

Antioxidant capacity and meat quality of broilers exposed to different ambient humidity and ammonia concentrations.

To investigate the effect of humidity and ammonia on the antioxidative capacities and meat qualities of broilers, 192 broilers were divided into 2 groups: high (H, 70 ppm) and low (L, 30 ppm) ammonia concentration. These groups were divided into 30% (Treatment humidity, T) and 60% (Control humidity, C) humidity, giving 4 treatments: C+L, C+H, T+L, and T+H. Blood and muscle antioxidative capacities and meat quality were measured. In the H group, body weight (BW), average daily feed intake (ADFI), average daily weight gain (ADG), blood and muscle antioxidative capacities, and postmortem pectoral muscle a* of broilers were significantly decreased (P < 0.05), and pectoral muscle thiobarbituric acid reactive substance (TBARS) contents and drip losses, postmortem pectoral muscle b* (P < 0.05) and L* (P = 0.054), and pectoral muscle shear forces (P = 0.075) increased. In the T condition, BW, ADFI, pectoral muscle superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities, and pectoral muscle L* decreased (P = 0.053), and pectoral muscle shear forces and TBARS contents increased (P < 0.05). In the T+H group, BW, ADFI, ADG, blood antioxidative capacities, pectoral muscle SOD and GSH-Px activities, and postmortem pectoral muscle a* were significantly lower than those of the C+L group, but postmortem pectoral muscle TBARS contents and pectoral muscle drip losses and shear forces significantly increased (P < 0.05). These results revealed that T+H could significantly reduce growth performance, antioxidative capacities, and meat quality of broilers; T intensified these negative effects.

Curcumin acts via transient receptor potential vanilloid-1 receptors to inhibit gut nociception and reverses visceral hyperalgesia.

BACKGROUND: An antinociceptive effect has been reported for curcumin in animal models and in humans, but the molecular mechanisms of curcumin's effect remain undefined. In this study, we explored the possibility that curcumin inhibit visceral nociception via antagonizing the transient receptor potential vanilloid-1 (TRPV1) receptor. METHODS: The effects of curcumin were explored using two experimental models: viscero-motor response (VMR) to colorectal distension (CRD) in rats and jejunal afferent firing in the ex vivo mouse jejunum preparations [TRPV1 knockout (KO) and wild-type mice, naive and trinitrobenzene sulfonic acid (TNBS)-treated Kunming mice]. In addition, capsaicin-induced calcium transients and whole-cell currents were examined in acutely dissociated dorsal root ganglia (DRG) neurons. KEY RESULTS: In the anesthetized rat, curcumin (4 mg kg(-1)  min(-1) for 3 min) caused a marked and rapidly reversible inhibition of CRD-induced VMRs. In the mouse jejunum, the mesenteric afferent nerve response to ramp distension was attenuated by curcumin (3, 10 µmol L(-1) ), an effect that was significantly reduced in TRPV1 KO mice compared with wild-type (WT) controls. Moreover, in WT mice, curcumin (1-30 µmol L(-1) ) was found to inhibit the afferent responses to capsaicin in a concentration-dependent manner. Trinitrobenzene sulfonic acid-induced hypersensitivity of jejunal afferents was also attenuated by curcumin. Curcumin potently inhibited capsaicin-induced rise in intracellular calcium and inward currents in mouse or rat DRG neurons. CONCLUSIONS & INFERENCES: Our results provide strong evidence that curcumin inhibit visceral nociception via antagonizing TRPV1 and may be a promising lead for the treatment of functional gastrointestinal diseases.

Effects of tetra-arsenic tetra-sulfide on BXSB lupus-prone mice: a pilot study.

Systemic lupus erythematosus (SLE) is an autoimmune disease of uncertain etiology that affects multiple tissues and organs. Arsenic trioxide (ATO) has been used in lupus-prone mice with a regulatory effect on immune abnormality. Tetra-arsenic tetra-sulfide (As4S4), a traditional Chinese medicine, is effective on acute promyelocytic leukemia with mild side effects than ATO. In this study, a pilot study was performed to investigate the effects and the mechanism of As4S4 on the lupus-prone BXSB mice. Improvement of monocytosis (p<0.05) in spleen and decreased serum interleukin-6 (IL-6) (p=0.0277) were observed with As4S4 treatment. As4S4-treated mice exhibited amelioration of skin, liver and renal disease with mild side effects. Histological analysis revealed that As4S4 suppressed immune complex deposition, mesangial proliferation and inflammatory cell infiltration in kidney and liver. Our study support that As4S4 selectively suppresses cutaneous lupus and nephritis in BXSB mice and might be a potential treatment for SLE.

Study on genes with altered expression in alpha-amanitin poisoned mice and evaluation on antagonistic effects of traditional Chinese medicines against toxicity of alpha-amanitin.

The forward and reverse cDNA subtractive libraries before and after the toxic effect of alpha-amanitin were constructed by suppression subtractive hybridization and randomly selected clones from each subtractive library were screened by PCR and dot blot hybridization. A total of 85 genes with altered expression were finally identified, with 41 genes from the forward library and 44 from the reverse library. Subsequently, the antagonistic effects of candidate traditional Chinese medicines were evaluated based on the genetic transcription levels of the genes with significant altered expression, including Catnbeta, Flt3-L, IL-7r and Rpo2-4. The results indicated that Silybum marianum (L.) Gaert and Ganoderma lucidum had significant down-regulated effects on the transcription level of Catnbeta that was up-regulated by alpha-amanitin, and the two herbs also up-regulated the transcription levels of Flt3-L and Rpo2-4. Silybum marianum (L.) had significant up-regulated effects on the IL-7r that was down-regulated by alpha-amanitin. These preliminary studies suggested that Silybum marianum (L.) and Ganoderma lucidum were effective antagonists against the toxicity of alpha-amanitin.

A new phenanthraquinone from the stems of Bauhinia variegata L.

A new phenanthraquinone, named bauhinione (1), has been isolated from Bauhinia variegata L., and its structure has been elucidated as 2,7-dimethoxy-3-methyl-9,10-dihydrophenanthrene-1,4-dione on the basis of spectroscopic analysis.

Current perspectives on the therapeutic utility of VR1 antagonists.

This review gives a brief overview of the expression patterns, molecular pharmacology and physiological roles of the vanilloid receptor 1 (VR1). Particular emphasis is given to the therapeutic utility of VR1 modulators. Small molecule agonists of VR1, including capsaicin and RTX, are currently utilized for a number of clinical syndromes, including intractable neuropathic pain, spinal detrusor hyperreflexia, and bladder hypersensitivity; however, antagonists of VR1 have yet to reach the clinic. While the classic VR1 antagonist, capsazepine has proven a useful tool for unraveling the molecular pharmacology of VR1, in vivo studies with this compound have had limited success due to poor pharmacokinetic properties and species selectivity issues. With the cloning of VR1 in 1997, the pharmaceutical community has been provided a molecular target for high throughput screening and small molecule lead discovery and optimization. As a result, resurgence in the interest of VR1 antagonists has given way to many new pharmacological agents that may provide better tools to probe VR1 physiology, and ultimately yield promising therapeutic agents.

Inhibitory effects of flavonoids from Hypericum perforatum on nitric oxide synthase.

The inhibitory effects of six flavonoids from Hypericum perforatum were assessed spectrophotometrically using nitric oxide synthase (NOS) in blood and cerebral homogenate of rats. Of the assayed compounds, quercetin and hyperoside showed concentration-dependent enzyme inhibitory actions. The IC50 values of quercetin for inhibiting NOS in rat cerebral homogenate and blood were 63.06 and 57.54 microM, and those of hyperoside 56.23 and 158.49 microM, respectively. The competitive patterns were discerned with the inhibition of the two flavonoids on NOS in serum and cerebral homogenate (except a mixed type inhibition was observed with quercetin in inhibiting cerebral NOS). Furthermore, similar inhibitions were found for quercetin upon NOS in cerebral homogenate and blood. However, a stronger inhibitory effect of hyperoside on the enzyme was discerned in cerebrum than in blood. These results suggested that the galactose moiety in hyperoside may be associated with the selectivity of the NOS inhibition.