A 28-Year-Old Man with Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, and Dissociative Identity Disorder Responding to Aripiprazole Augmentation of Clomipramine Combined with Psychoeducation and Exposure and Response Prevention.

BACKGROUND We report the case of a 28-year-old man with comorbidity of OCD, PTSD, and DID responding to aripiprazole augmentation of clomipramine combined with psychoeducation and exposure and response prevention (ERP). CASE REPORT A 28-year-old, well-educated man presented with depression, obsessive thoughts, behavioral impulsivity, and suicidal thoughts/behavior. He was known to be stubborn and sensitive to criticism since childhood. The obsessive thoughts and compulsive behaviors also started at an early age. He had 4 past psychiatric hospitalizations, mostly for dissociative episodes and bizarre behaviors, complicated with significant anxiety and distress from traumatic experiences during doctoral study. He had no-to-minimal responses to various psychotropics and traditional Chinese medicine. A thorough assessment showed he met the diagnostic criteria for OCD, PTSD, and DID. He was then treated with clomipramine in combination with aripiprazole, plus psychoeducation and exposure and response prevention (ERP). His anxiety and irritability significantly improved within 2 months and his obsessive thoughts faded away. At 6-month follow-up, the patient achieved clinical remission. One year later, he remained stable and reported having a normal life. CONCLUSIONS The case illustrates both how impairing the comorbidity of OCD, PTSD, and DID can be and how concurrent use of tricyclic antidepressant (TCA) clomipramine and partial dopamine agonist aripiprazole, together with psychoeducation and ERP, can improve outcomes when other treatment choices fail to be effective.

[Mechanism of action and exogenous supplementation of vitamin D in Crohn's disease]. / ç»´ç”Ÿç´ Dåœ¨å ‹ç½—æ©ç— ä¸­çš„ä½œç”¨æœºåˆ¶åŠå¤–æºæ€§è¡¥å 作用.

Vitamin D can not only regulate calcium and phosphorus metabolism, but also exert an immunoregulatory effect. Vitamin D deficiency is common in patients with Crohn's disease (CD). Studies have shown that vitamin D is associated with CD and other autoimmune diseases and can improve the condition of patients with CD and promote their recovery by regulating intestinal immunity, repairing the intestinal mucosal barrier, inhibiting intestinal fibrosis, enhancing the response to infliximab, and regulating intestinal microbiota. Exogenous vitamin D supplementation can induce disease remission while increasing the serum level of vitamin D. However, only a few randomized, double-blind, and placebo-controlled trials have investigated the therapeutic effect of vitamin D in CD, and the optimal form of vitamin D supplementation, the specific dosage of vitamin D supplementation, and the optimal serum maintenance concentration of vitamin D remain to be clarified. This article mainly discusses the mechanism of action of vitamin D in CD and the beneficial effect of exogenous vitamin D supplementation on CD.

Developing TCM clinical practice guidelines: A comparison between traditional Chinese medicine and western medicine.

Clinical practice guidelines in Traditional Chinese Medicine (CPG-TCM) is the recommendation that aims to provide the best service to users by identifying and summarizing the rules of prevention, diagnosis, treatment, rehabilitation, and regression of diseases based on systematic reviews of evidence and balancing the advantages and disadvantages of different interventions for clinical questions of Traditional Chinese Medicine. Over the past 30 years, the concept and methods of evidence-based medicine have had a significant impact on the development of clinical practice guidelines in Western Medicine (CPG-WM), and their standardized guideline development methods are being adapted and used in the development of CPG-TCM. However, the quality of CPG-TCM is far from CPG-WM, and the methodological system for developing CPG-TCM is not yet fully established. Therefore, this study aims to explore the methodological differences between CPG-TCM and CPG-WM and to inform the development of high-quality CPGTCM.

Responses of biomass accumulation and nutrient utilization along a phosphorus supply gradient in Leymus chinensis.

Phosphorus (P) deficiencies are widespread in calcareous soils. The poor availability of nitrogen (N) and P in soils often restricts crop growth. However, the effects of P addition on plant growth and plant nutrient transport changes during the establishment of Leymus chinensis fields in Xinjiang are not clear. We investigated the responses of Leymus chinensis biomass and nutrient absorption and utilization to changes in soil N and P by adding P (0, 15.3, 30.6, and 45.9 kg P ha-1 year-1) with basally applied N fertilizer (150 kg N ha-1 year-1). The results showed that (a) Principal component analysis (PCA) of biomass, nutrient accumulation, soil available P, and soil available N during the different periods of Leymus chinensis growth showed that their cumulative contributions during the jointing and harvest periods reached 95.4% and 88%, respectively. (b) Phosphorus use efficiency (PUE) increased with the increase of P fertilizer gradient and then decreased and the maximum PUE was 13.14% under moderate P addition. The accumulation of biomass and nutrients in Leymus chinensis can be effectively improved by the addition of P fertilizer at 30.6 kg ha-1. Different P additions either moderately promoted or excessively inhibited Leymus chinensis growth and nutrient utilization.

Emergence of Antifungal Resistant Subclades in the Global Predominant Phylogenetic Population of Candida albicans.

Candida albicans remains the most common species causing invasive candidiasis. In this study, we present the population structure of 551 global C. albicans strains. Of these, the antifungal susceptibilities of 370 strains were tested. Specifically, 66.6% of the azole-nonsusceptible (NS)/non-wild-type (NWT) strains that were tested belonged to Clade 1. A phylogenetic analysis, a principal components analysis, the population structure, and a loss of heterozygosity events revealed two nested subclades in Clade 1, namely, Clade 1-R and Clade 1-R-α, that exhibited higher azole-NS/NWT rates (75.0% and 100%, respectively). In contrast, 6.4% (21/326) of the non-Clade 1-R isolates were NS/NWT to at least 1 of 4 azoles. Notably, all of the Clade 1-R-α isolates were pan-azole-NS/NWT that carried unique A114S and Y257H double substitutions in Erg11p and had the overexpression of ABC-type efflux pumps introduced by the substitution A736V in transcript factor Tac1p. It is worth noting that the Clade 1-R and Clade 1-R-α isolates were from different cities that are distributed over a large geographic span. Our study demonstrated the presence of specific phylogenetic subclades that are associated with antifungal resistance among C. albicans Clade 1, which calls for public attention on the monitoring of the future spread of these clones. IMPORTANCE Invasive candidiasis is the most common human fungal disease among hospitalized patients, and Candida albicans is the predominant pathogen. Considering the large number of infected cases and the limited alternative therapies, the azole-resistance of C. albicans brings a huge clinical threat. Here, our study suggested that antifungal resistance in C. albicans could also be associated with phylogenetic lineages. Specifically, it was revealed that more than half of the azole-resistant C. albicans strains belonged to the same clade. Furthermore, two nested subclades of the clade exhibited extremely high azole-resistance. It is worth noting that the isolates of two subclades were from different cities that are distributed over a large geographic span in China. This indicates that the azole-resistant C. albicans subclades may develop into serious public health concerns.

Analysis of Risk Factors and Nursing Intervention Measures Affecting Nutritional Status of Children with Crohn's Disease.

In recent years, the incidence of Crohn's disease (CD) in the Asia-Pacific region is gradually increasing, and the onset age is decreased at the same time. The relapse of illness and long course of disease easily lead to malnutrition, which will affect the treatment effect of the disease and even worsen the disease. Therefore, it is very important to find the risk factors affecting the nutritional status of children with CD and to carry out effective nursing intervention accordingly. In our study, a total of 180 children with CD who were admitted to our hospital from April 2017 to April 2020 were analyzed retrospectively. The multivariate analysis showed that Pediatric Crohn's Disease Activity Index (PCDAI), platelet (PLT), hemoglobin (HB), hematocrit (HCT), and albumin (ALB) were independent risk factors affecting the nutritional status of children with CD. The results of AUC showed that combined monitoring of the PCDAI score and the expression of PLT, HB, HCT, and ALB indexes was of great value to evaluate the nutritional status of children with CD. Finally, a series of nursing intervention measures were proposed based on these results. It provides a theoretical basis for improving the nutritional status of children with CD and promoting the clinical outcome.

Bioactive effects of nonthermal argon-oxygen plasma on inorganic bovine bone surface.

As a commonly used bone substitute material in the clinic, inorganic bovine bone has the characteristics of osteoconduction but not osteoinduction. This study aimed to treat inorganic bovine bone using nonthermal argon-oxygen plasma (NTAOP) to obtain greater bioreactivity for enhancing adhesion, proliferation and differentiation of mouse preosteoblast MC3T3-E1 cells. In this study, inorganic bovine bone was activated by NTAOP, and the surface characteristics were analyzed. MC3T3-E1 cells were then seeded onto the surface of inorganic bovine bone. Cell morphology, proliferation and osteogenic differentiation were examined. There was no obvious change in the surface morphology of specimens between the two groups. Regarding the elemental composition of the material, the amount of surface carbon was reduced, whereas oxygen, phosphorus and calcium levels were increased in the NTAOP group. Further studies showed that the NTAOP groups performed better than their untreated counterparts in terms of supporting cell proliferation and differentiation. Inorganic bovine bone treated with NTAOP can promote preosteoblast adhesion, proliferation and differentiation.

Alisol A is potentially therapeutic in human breast cancer cells.

Recent developments in breast cancer therapy have significantly improved patient survival rate; however, recurrence remains a major problem. Systemic treatment of breast cancer with available therapies is not curative. Natural products can be potentially used for treating cancer. Recently, a wide range of pharmacological activities has been reported for Alismatis Rhizoma, a popular traditional Chinese medicine. However, the mechanisms via which its compounds act on breast cancer remain unclear. The present study aimed to investigate the potential of natural therapeutic agents from Alismatis Rhizoma for treating breast cancer. Human breast cancer MDA­MB­231 cells were treated with four main protostane triterpenes from Alismatis Rhizoma, including alisol A, alisol A 24­acetate, alisol B and alisol B 23­acetate. Among these, alisol A significantly inhibited cell viability. Alisol A induced cell apoptosis, G1 phase cell cycle arrest, autophagy, and intracellular reactive oxygen species (ROS) generation in MDA­MB­231 cells. The number of APE1­/γH2AX­/LC3­II positive cells was also significantly higher compared with that of negative control cells. All these results were dose­dependent. Cleaved caspase­3, cleaved caspase 9, Bcl­2, and p­p38 expression indicated cell apoptosis after alisol A treatment. The changes in cyclin A and cyclin D1 expression was associated with cell cycle arrest upon alisol A treatment. Furthermore, LC3­II expression upon alisol A treatment was indicative of autophagy. Alisol A treatment can induce autophagy­dependent apoptosis in human breast cancer cells via induction of ROS and DNA damage. Thus, Alisol A might serve as a new therapeutic agent against breast cancer.

A target-group-change couple with mass defect filtering strategy to identify the metabolites of "Dogel ebs" in rats plasma, urine and bile.

"Dogel ebs" was known as Sophora flavescens Ait., a classical traditional Chinese Mongolian herbal medicine, which had the effects on damp-heat dysentery, scrofula, and syndrome of accumulated dampness toxicity. Although the chemical constituents have been clarified by our previous studies, the metabolic transformation of "Dogel ebs" in vivo was still unclear. To explore the mechanism of "Dogel ebs," the metabolites in plasma, bile, and urine samples were investigated. A fast positive and negative ion switching technology was used for the simultaneous determination of flavonoids and alkaloids in "Dogel ebs" in a single run. And a target-group-change coupled with mass defect filtering strategy was utilized to analyze the collected data. 89 parent compounds and 82 metabolites were characterized by high-performance liquid chromatography with quadrupole exactive Orbitrap mass spectrometry. Both phase I and phase II metabolites were observed and the metabolic pathways involved in oxidation, demethylation, acetylation, and glucuronidation. 69 metabolites of "Dogel ebs," including three hydroxyls bonding xanthohumol, formononetin-7-O-glucuronide, 2'-hydroxyl-isoxanthohumol decarboxylation metabolite, oxysophocarpine dehydrogen, 9α-hydroxysophoramine-O-glucuronide, etc. were reported for the first time.

[Effect of glutamine-supplemented enteral nutrition on the apoptosis of colonic mucosal cells in young rats with inflammatory bowl disease].

OBJECTIVE: To study the effect of glutamine-supplemented enteral nutrition in regulating the apoptosis of intestinal mucosal cells and promoting mucosal healing in young rats with inflammatory bowl disease (IBD). METHODS: A total of 80 male Sprague-Dawley rats aged 4-5 weeks were randomly divided into 4 groups: blank control, IBD model, short peptide, and short peptide+glutamine (n=20 each). The IBD model was prepared by a single colon perfusion of 3-nitrobenzene sulfonic acid. At 3 days after modeling, the rats in the short peptide group were fed with short peptide formula (100 mL/kg), and those in the short peptide+glutamine group were fed with short peptide formula (100 mL/kg) and glutamine (0.5 g/kg). The course of intervention was 1 week. General conditions were observed after the experiment and their intestinal mucosal tissue was obtained. Hematoxylin-eosin staining was used to observe the pathological change of the intestinal mucosa. RT-PCR was used to measure the expression of apoptosis-regulating genes (bax and bc1-2) and apoptotic signal transduction factors (Caspase-3 and Caspase-9) in the intestinal mucosa. Western blot was used to measure the expression of insulin-like growth factor-1 (IGF-1) in the colonic mucosa. RESULTS: The IBD model group had poorer general conditions than the other three groups (blank control, short peptide and short peptide+glutamine), and the short peptide+glutamine group had better general conditions than the IBD model and short peptide groups. The IBD model group had significantly higher mRNA expression of bax than the other three groups (P<0.05). There was no significant difference in the mRNA expression of bcl-2, Caspase-3 and Caspase-9 among the 4 groups (P>0.05). The short peptide group had a significantly higher level of IGF-1 than the short peptide+glutamine, blank control and IBD model groups (P<0.05). CONCLUSIONS: Glutamine-supplemented enteral nutrition can effectively improve the general nutritional status of young rats with IBD, but it is not better than exclusive enteral nutrition in inhibiting the apoptosis of colonic mucosal cells and stimulating the synthesis of IGF-1 in the intestinal mucosa.

Targeting of mTORC1/2 by dihydroevocarpine induces cytotoxicity in acute myeloid leukemia.

Interactions between the tumor cells and bone marrow (BM) microenvironment promote survival, growth, and chemoresistance of acute myeloid leukemia (AML). The mTOR pathway plays a key role in mediating the AML-BM microenvironment interactions. Here, we report the anti-AML activity of a natural monomer extracted from the Chinese medicinal herb Evodia rutaecarpa, dihydroevocarpine. Our results showed that dihydroevocarpine-induced cytotoxicity, apoptosis, and G0/G1 arrest in AML cells, and inhibited the tumor growth in an AML xenograft model. Importantly, our study revealed that the dihydroevocarpine treatment inhibited the mTOR pathway via suppressing the mTORC1/2 activity, and thus overcame the protective effect of the BM microenvironment on AML cells. Taken together, our findings suggest that dihydroevocarpine could be used as a potential anti-AML agent alone or a therapeutic adjunct in AML therapy, particularly in the presence of the BM microenvironment.

A new galloyl glycoside from Lotus corniculatus.

A new galloyl glucoside, 2,6-di-O-acetyl 1-O-galloyl ß-D-glucose (1), along with five known phenolic compounds were isolated from the whole plants of Lotus corniculatus. Their structures were elucidated by means of extensive spectroscopic analysis. Compound 1 was assessed for its cytotoxicity against five human tumour lines (HL-60, SMMC-7721, A-549, MCF-7 and SW-480), and the result showed that it had no activity.

A new abietane mono-norditerpenoid from Podocarpus nagi.

A new abietane mono-norditerpenoid, nagiol A (1), along with three known diterpenoids were isolated from the leaves of Podocarpus nagi. Their structures were elucidated by means of extensive spectroscopic analysis. This is the first report of abietane mono-norditerpenoid separated from plant of the genus Podocarpus. Compound 1 was assessed for its cytotoxicity against five human tumour lines (HL-60, SMMC-7721, A-549, MCF-7 and SW-480), and the result showed that it had no activity.

Icariin Acts as a Potential Agent for Preventing Cardiac Ischemia/Reperfusion Injury.

Myocardial infarction is a leading cause of mortality and morbidity worldwide. Although essential for successful recovery, myocardium reperfusion is associated with reperfusion injury. Icariin, a major flavonoid of Epimedium koreanum Nakai, has been proven to exert efficacy for improving cardiovascular function. We investigated the molecular effect and signal pathway of icariin on cardiac ischemia/reperfusion injury. In an in vivo model of infarct in rats, icariin (10 mg/kg) significantly attenuated myocardial infarct size induced by ischemia/reperfusion (I/R). From the TUNEL assay, icariin reduced the apoptotic cell induced by I/R and decreased blood indicators of creatine kinase, ischemia-modified albumin, and lactate dehydrogenase. All this effect was antagonized by the PI3K inhibitor LY294002. Meanwhile, icariin activated the PI3K/Akt/eNOS pathway. The PI3K inhibitor LY294002 suppressed icariin-mediated protective effect. These results suggest that icariin protects against myocardial ischemia reperfusion injury in rats by activating the PI3K/Akt/eNOS-dependent signal pathways and may be a useful drug for angiogenic therapy.

Three unusual sesquineolignans from Alpinia conchigera.

Three unusual sesquineolignans conchignans A, B, and C, together with two known compounds vanillin and phloroglucinol, were isolated from the whole plants of Alpinia conchigera. Their structures were established by spectroscopic analysis, including 2D NMR spectroscopic techniques.

[Denitrifying phosphate uptake of biological phosphorous removal granular sludge in SBR].

The denitrification and excessive P removal can be realized by denitrifying phosphate-accumulating organisms (DNPAOs) under low carbon condition. DNPAOs use poly-3-hydroxy- butyrate (PHB) as electron donor, and use nitrate and nitrite as electron acceptor during the denitrifying phosphate uptake. In this study the biological phosphorus removal granular sludge was induced into the denitrifying and phosphate uptake granular sludge under an anaerobic/anoxic/aerobic alternating operation (referred to as an A/A/O) in a sequencing batch reactor (SBR). When the system is stable, the P and N removal ratio is over 90% and 93% respectively; the release phosphorus is 25-33 mg/L at anaerobic stage; 1g NOx-N approximately takes up P 1.3 g at anoxic stage. In the typical cycle the anaerobic maximum specific release phosphorus rate (max. SRPR) is 18.39 mg/(g x h); the anoxic max. specific uptake phosphorus rate (SUPR) and the max. specific denitrification rate (SDNR) is 23.72 mg/(g x h) and 18.19 mg/(g x h) respectively; the aerobic max. SUPR is 17.15 mg/(g x h). The fraction of DNPAOs rises from 14.9% to 80.7%. Compared with the physical-chemical property of the biological phosphorus removal granular sludge, the settling velocity and the specific gravity of the denitrifying phosphate uptake granular sludge is elevated 0.16-0.7 times and 0.0031 respectively.