Anion/Cation Co-Doping to Improve the Thermoelectric Performance of Sn-Enriched n-Type SnSe Polycrystals with Suppressed Lattice Thermal Conductivity.

Enhancing the thermoelectric performance of n-type polycrystalline SnSe is essential, addressing challenges posed by elevated thermal conductivity and compromised power factor inherent in its intrinsic p-type characteristics. This investigation utilized solid-state reactions and spark plasma sintering techniques for the synthesis of n-type SnSe. A significant improvement in the figure of merit (ZT) is achieved through strategic reduction in Se concentration and optimization of crystal orientation. The co-doping with Br and Ge further improves the material; Br amplifies carrier concentration, enhancing electrical conductivity, while Ge introduces effective phonon scattering centers. In the Br/Ge co-doped SnSe sample, thermal conductivity dropped to 0.38 Wm⁻¹K⁻¹, yielding a remarkable power factor of 662 µW mK- 2 at 773 K, culminating in a ZT of 1.34. This signifies a noteworthy 605% improvement over the pristine sample, underscoring the pivotal role of Ge doping in enhancing n-type material thermoelectric properties. The enhancement is attributed to Br doping introducing additional electronic states near the valence band, and Ge doping modifying the band structure, fostering resonant states near the conduction band. The Br/Ge co-doping further transforms the band structure, influencing electrical conductivity, Seebeck coefficient, and thermal conductivity, advancing the understanding and application of n-type SnSe materials for superior thermoelectric performance.

P2X7 receptor is essential for ST36-attenuated cardiac fibrosis upon beta-adrenergic insult.

P2X7 receptor (P2X7R) plays an important role in modulating inflammation and fibrosis, but information is limited whether Zusanli (ST36) can inhibit inflammation and fibrosis by regulating P2X7R. Isoprenaline at 5 mg/kg was subcutaneously injected to wild-type and P2X7R knockout mice for 7 days, while treatment groups received electroacupuncture (EA) stimulation at ST36 for 7 sessions. Following 7-session treatment, Masson's trichrome staining was performed to assess the fibrosis. Morphology, electrocardiogram, and echocardiography were carried out to evaluate the cardiac function and structure. Western blotting, hematoxylin and eosin staining, immunohistochemistry, and biochemical analysis of inflammatory cytokine and transmission electron microscopy were carried out to characterize the effect of ST36 on inflammation. P2X7R was overexpressed in ISO-treated mice. EA at ST36, but not at non-points, reduced ISO-induced cardiac fibrosis, increases in HW/BW, R+S wave relative to mice in ISO groups. In addition, EA at ST36 downregulated ISO-upregulated P2X7R and NLRP3 in ventricle. Moreover, EA reduced cytokines of IL-1ß, IL-6, and IL-18 in serum, and inhibited foam cell gathering, inflammatory cell infiltration, and autophagy. However, EA at ST36 failed to attenuate the cardiac fibrosis and hypertrophy in P2X7R knockout mice. In conclusion, EA at ST36 attenuated ISO-induced fibrosis possibly via P2X7R.

Nrf2, gp91phox and IL-17 are associated with severity and clinical outcomes of patients with subclinical hypothyroidism: a comparative study.

The mechanisms underlying subclinical hypothyroidism (SCH) remain unclear, making timely and accurate differentiation between hypothyroidism and SCH, as well as severity assessment, challenging. This study aimed to investigate the role of NFE2 like bZIP transcription factor 2 (Nrf2), gp91phox, and interleukin-17 (IL-17) in the pathogenesis of SCH. In this prospective comparative study, 105 SCH patients, 105 hypothyroidism patients, and 105 healthy individuals were enrolled from January 2022 to August 2023. SCH patients were categorized into mild-moderate and severe groups based on thyroid-stimulating hormone (TSH) levels. Levels of TSH, free T4 (FT4), free T3 (FT3), thyroglobulin antibodies (TG-Ab), thyroid peroxidase antibodies (TPO-Ab), cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-ch), and low-density lipoprotein-cholesterol (LDL-ch) were measured. Nrf2, IL-1ß, IL-6, IL-17, and gp91phox levels were tested using ELISA. Nrf2, IL-17 and gp91phox were significantly higher in SCH and hypothyroidism patients compared to the healthy controls, with hypothyroidism patients showing the highest levels. Nrf2 levels were negatively correlated with TSH, TG-Ab and IL-17, but not gp91phox. Nrf2, IL-17 and gp91phox could be used for diagnosis of SCH and severe SCH. Only TG-Ab, IL-17 and gp91phox were independent risk factors for severe SCH. This study demonstrates a negative correlation between serum Nrf2 levels and SCH severity. TG-Ab, IL-17, and gp91phox are independent risk factors, and their associations with SCH pathology suggest their potential roles in the disease mechanism. These findings provide insights into SCH pathogenesis and highlight the need for further research to elucidate their diagnostic or prognostic significance.

[Comparative study of purgative pharmacological effects and mechanisms of Moringa oleifera leaves and Rhei Radix et Rhizoma].

Moringa oleifera leaves are known for their "Virechana"(purgative) effect in Ayurvedic medicine in India. This study compared the purgative effects and mechanisms of M. oleifera leaves with the reference Rhei Radix et Rhizoma to establish a foundation for the further application of M. oleifera leaves in traditional Chinese medicine(TCM). Using network pharmacology and molecular docking methods, this study identified the material basis, common targets, and signaling pathways through which Rhei Radix et Rhizoma and M. oleifera leaves exerted their purgative pharmacological effects. A low-fiber diet-induced constipation mouse model was established to measure fecal parameters and small intestinal propulsion rate, and histological changes in the colon were observed using HE staining. Relative expression levels of relevant genes and target proteins were assessed using RT-qPCR and immunohistochemistry, respectively. The results showed that mapping the targets of Rhei Radix et Rhizoma and M. oleifera leaves onto the biological process network of constipation revealed close proximity, indicating that they may exert their therapeutic effects on constipation through similar biological processes. Molecular docking results indicated that compounds such as sennoside C and isoquercitrin could target serine/threonine protein kinases(AKT1) and mitogen-activated protein kinase 3(MAPK3), thereby affecting MAPK and calcium signaling pathways to promote defecation. Animal experiments demonstrated that both M. oleifera leaves and Rhei Radix et Rhizoma increased the number of fecal pellets and water content in constipated mice, improved small intestine motility, colon mucosal thickness, and muscle layer thickness, upregulated the gene expression levels of AKT1 and MAPK3 in the colon, and downregulated the expression of AQP3 protein. These findings suggest that M. oleifera leaves and Rhei Radix et Rhizoma share similarities in their therapeutic efficacy and mechanisms for treating constipation. Using Rhei Radix et Rhizoma as a reference can provide a better understanding of the characteristics of the "Virechana"(purgative) effect of M. oleifera leaves in TCM.

Molecular structure and characterization of the Thermochromatium tepidum light-harvesting 1 photocomplex produced in a foreign host.

Purple phototrophic bacteria possess light-harvesting 1 and reaction center (LH1-RC) core complexes that play a key role in converting solar energy to chemical energy. High-resolution structures of LH1-RC and RC complexes have been intensively studied and have yielded critical insight into the architecture and interactions of their proteins, pigments, and cofactors. Nevertheless, a detailed picture of the structure and assembly of LH1-only complexes is lacking due to the intimate association between LH1 and the RC. To study the intrinsic properties and structure of an LH1-only complex, a genetic system was constructed to express the Thermochromatium (Tch.) tepidum LH1 complex heterologously in a modified Rhodospirillum rubrum mutant strain. The heterologously expressed Tch. tepidum LH1 complex was isolated in a pure form free of the RC and exhibited the characteristic absorption properties of Tch. tepidum. Cryo-EM structures of the LH1-only complexes revealed a closed circular ring consisting of either 14 or 15 αß-subunits, making it the smallest completely closed LH1 complex discovered thus far. Surprisingly, the Tch. tepidum LH1-only complex displayed even higher thermostability than that of the native LH1-RC complex. These results reveal previously unsuspected plasticity of the LH1 complex, provide new insights into the structure and assembly of the LH1-RC complex, and show how molecular genetics can be exploited to study membrane proteins from phototrophic organisms whose genetic manipulation is not yet possible.

Low-dose Ultra-high-resolution Photon-Counting Detector CT for Visceral Artery CT Angiography: A Preliminary Study.

RATIONALE AND OBJECTIVES: To validate the image quality of low-dose ultra-high-resolution (UHR) scanning mode of photon-counting detector CT (PCD-CT) for visceral artery computed tomography angiography (CTA). MATERIAL AND METHODS: We prospectively enrolled 57 patients each in the full dose (FD) and low-dose (LD) protocols, respectively, to undergo abdominal CT scans using the UHR mode on a PCD-CT system (NAEOTOM Alpha), between April 2023 and September 2023. Both the FD data and LD data were then reconstructed into two series of images: (a) 0.2 mm slice thickness, reconstruction kernel Bv48, quantum iterative reconstruction (QIR) 4; (b)1 mm slice thickness, Bv40, QIR 3. The signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of seven arteries were objectively measured. The image noise, vessel sharpness, overall quality, and visibility of nine arteries were subjectively assessed by three radiologists. RESULTS: The SNRs and CNRs of 0.2 mm reconstruction set was inferior to that of 1 mm reconstruction set (p < 0.001 for all the arteries and noise), however, the image quality of 0.2 mm reconstruction set was higher than that of 1 mm reconstruction set in qualitative evaluation especially for tiny arteries in Volume-rendered (VR) image (p < 0.001). The SNRs and CNRs were not significantly higher for FD group than LD group on the same slice thickness except for SNRs of common hepatic artery, splenic artery and bilateral renal arteries in 0.2 mm reconstruction set. In the comparison on image quality between normal weight and overweight patients within the same reconstruction set, the results showed that low-dose scan did not significantly impact the image quality in overweight patients. The ratings of visibility of nine visceral arteries were not significantly different among FD and LD at the same thickness reconstruction set except for superior mesenteric artery (p = 0.002 and 0.007 for 0.2 mm and 1 mm reconstruction set in axial image; p = 0.002 and 0.007 for 0.2 mm and 1 mm reconstruction set in coronal image, respectively) and left gastric artery (p = 0.002 and p < 0.001 for 0.2 mm and 1 mm reconstruction set in VR image, respectively). CONCLUSION: The low-dose UHR scanning mode of PCD-CT has proven to be adequate for the clinical evaluation of visceral arteries. Utilizing a reconstruction with a slice thickness of 0.2 mm could enhance arterial depiction, particularly for small vessels.

The association between blood lipids and cognitive impairment in type 2 diabetes mellitus.

OBJECTIVE: The study was performed to explore the association between blood lipids and cognitive impairment in patients with type 2 diabetes mellitus (T2DM). METHODS: This study included 336 patients with T2DM. Relevant clinical data including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), apolipoprotein A1, apolipoprotein B were collected, and the Mini-Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score were used to assess the cognitive function in patients with T2DM. RESULTS: Serum apolipoprotein A1 levels were significantly increased in T2DM patients with cognitive impairment compared with T2DM patients without cognitive impairment (p = 0.017). Serum apolipoprotein A1 levels were significantly negatively correlated with MoCA score (r = - 0.143, p = 0.009) and MMSE score (r = - 0.132, p = 0.016) in patients with T2DM. In multivariable-adjusted regression model, serum apolipoprotein A1 was independently associated with cognitive impairment in patients with T2DM (OR = 5.201, p = 0.024). CONCLUSION: Serum apolipoprotein A1 is associated with cognitive impairment in patients with T2DM, but not TC, TG, HDL-C, LDL-C, and apolipoprotein B, indicating that increased serum apolipoprotein A1 may be a risk factor of cognitive impairment in patients with T2DM.

Angelicin: A leading culprit involved in fructus Psoraleae liver injury via inhibition of VKORC1.

ETHNOPHARMACOLOGICAL RELEVANCE: The adverse effects of Fructus Psoraleae (FP), especially liver injury, have attracted wide attention in recent years. AIM OF THE STUDY: To establish a system to explore potential hepatotoxic targets and the chief culprit of liver injury based on clinical experience, network pharmacological method, molecular docking, and in vitro and in vivo experiments. MATERIALS AND METHODS: Clinical applications and adverse reactions to FP were obtained from public literatures. Components absorbed in the blood were selected as candidates to search for potential active targets (PATs) of FP. Subsequently, potential pharmacological core targets (PPCTs) were screened through the "drug targets-disease targets" network. Non-drug active targets (NPATs) were obtained by subtracting the PPCTs from the PATs. The potential hepatotoxic targets (PHTs) of FP were the intersection targets obtained from Venn analysis using NPATs, hepatotoxic targets, and adverse drug reaction (ADR) targets provided by the databases. Then, potential hepatotoxic components and targets were obtained using the "NPATS-component" network relationship. Molecular docking and in vitro and in vivo hepatotoxicity experiments were performed to verify the targets and related components. RESULTS: Overall, 234 NPATs were acquired from our analysis, and 6 targets were identified as PHTs. Results from molecular docking and in vitro and in vivo experiments showed that angelicin is the leading cause of liver injury in FP, and VKORC1 plays an important role. CONCLUSION: The results indicate that six targets, especially VKORC1, are associated with the PHTs of FP, and angelicin is the leading culprit involved in FP liver injury via inhibition of VKORC1.

Pharmacoeconomic evaluation of trastuzumab biosimilars versus original drug in the treatment of recurrent/metastatic HER-2 positive breast cancer / 中国药房

OBJECTIVE To evaluate the cost-effectiveness of trastuzumab biosimilars （Hanquyou） versus original drug （Hesaiting） in the treatment of recurrent/metastatic human epidermal growth factor receptor-2 （HER-2） positive breast cancer. METHODS A partitional survival model was constructed based on the NCT03084237 trial data. The simulation period was 3 weeks， and the simulation time was 10 years. Using costs and quality-adjusted life year （QALY） as the output indicator， the cost- utility analysis method was used to evaluate the cost-effectiveness of the two schemes mentioned above. Univariate and probabilistic sensitivity analyses were performed to verify the robustness of the basic analysis. RESULTS The costs of the trastuzumab biosimilars group and original drug group were 111 516.72 yuan and 111 122.30 yuan respectively， with health utility values of 1.52 QALYs and 1.36 QALYs， and ICER of 2 465.12 yuan/QALY， which were less than 3 times China’s per capita gross domestic product （GDP） in 2023 as the threshold for willingness-to-pay （WTP） （268 200 yuan/QALY）. Univariate sensitivity analysis showed that the cost of the trastuzumab biosimilars and original drug had a great impact on the ICER. The probabilistic sensitivity analysis showed that the probability of trastuzumab biosimilars being cost-effective was 100% at WTP threshold of 14 902 yuan/QALY. CONCLUSIONS When WTP threshold is 3 times China’s GDP in 2023 （268 200 yuan/QALY）， compared with original drug， trastuzumab biosimilars have good cost-effectiveness in the treatment of recurrent/metastatic HER-2 positive breast cancer.

Clinical Observation on Therapeutic Effect of Huatan Jieyu Anshen Decoction Combined with Abdominal Vibration Tuina Manipulations on Chronic Insomnia in the Elderly / 广州中医药大学学报

Objective To investigate the therapeutic effect of Huatan Jieyu Anshen Decoction(mainly with the actions of resolving phlegm,relieving depression and calming mind)combined with abdominal vibration tuina manipulations on chronic insomnia in the elderly.Methods Ninety-four cases of elderly patients with chronic insomnia of phlegm-heat harassing the interior type were randomly divided into the observation group and the control group,with 47 cases in each group.The control group was given Huatan Jieyu Anshen Decoction orally,while the observation group was given oral use of Huatan Jieyu Anshen Decoction combined with abdominal vibration tuina manipulations.The course of treatment for the two groups lasted for 4 weeks.Before and after the treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Pittsburgh Sleep Quality Index(PSQI)score,Athens Insomnia Scale(AIS)score,Fatigue Scale-14(FS-14)score,World Health Organization Quality-of-Life Brief Scale(WHOQOL-BREF)score,and the serum levels of melatonin(MT),dopamine(DA),and cortisol(CORT).After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 97.88%(46/47),while that of the control group was 87.23%(41/47),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the observation group was superior to that of the control group(P＜0.01).(2)After treatment,the scores of primary and secondary TCM symptoms in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the scores of primary and secondary TCM symptoms in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the PSQI scores,AIS scores,and FS-14 scores in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the WHOQOL-BREF scores were significantly increased compared with those before treatment(P＜0.05).The decrease of the PSQI scores,AIS scores and FS-14 scores as well as the increase of the WHOQOL-BREF scores in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the serum MT level of both groups was significantly higher than that before treatment(P＜0.05),and the serum DA and CORT levels were significantly lower than those before treatment(P＜0.05).The increase in serum MT level and the decrease in serum DA and CORT levels of the observation group were significantly superior to those of the control group(P＜0.01).Conclusion The combined therapy of Huatan Jieyu Anshen Decoction combined with vibration tuina manipulations can achieve satisfactory efficacy in the elderly patients with chronic insomnia of phlegm-heat harassing the interior syndrome.The therapy is effective on regulating the central nervous system of the patients,improving the quality of the sleep,and promoting the relief of fatigue and the enhancement of the quality of life,which has great significance to the enhancement of the overall therapeutic efficacy of insomnia.

Evaluation on the stability of positioning precision of the leaves of accelerator MLC under different gantry angles / 中国医学装备

Objective:To evaluate the stability of the positioning precisions of the leaves of accelerator multi-leaf collimator(MLC)at different gantry angles,so as to determine whether the positioning precision of leaf is affected by the gantry angle.Methods:The HD 120 MLC of American Varian Edge medical linear accelerator at our hospital was selected,and the Varian Eclipse radiotherapy planning system was used to design test cases.One test plan included 5 dynamic subfields(named PMLCE)was designed,which ray amount was 100MU,and small machine head was kept at 0°position,and the numbers of the positions of corresponding leaves of each control point were respectively-20,-15,-10,-5,0,5,10 and 12 that were 8 in total,and the dose rate was set at 500MU/min.In test,all leaves slid as uniform velocity from one extreme position to the opposite extreme position,and the movement distance of leaves between the adjacent control points was 5 cm.The PMLCE test plan was executed on the EDGE linear accelerator by using the IEC1217 coordinate system,and each test was conducted at eight different gantry angles(0°,45°,90°,135°,180°,225°,270° and 315°),and a total of 8 treatment log files of accelerator were obtained.A program was written by using Matlab2016a(MathWorks,USA)software to read the log files of accelerator,and extract out leaf position data,and calculate the deviation between the actual position and planned position of all leaves,and record a total of 960 data of positioning deviations of 120 leaves at 8 leaves positions which included in each file.The above acquisition scheme of data was performed per three days for 10 times,and then the average value was obtained.There were the data of positioning deviations of a total of 8 groups of HD 120 MLC at different gantry angles.The above 8 groups of data were analyzed as statistical method.Results:Under various angles,the range of the percentage of"leaf positioning deviations≤10 μm"was between 45.7%and 58.3%,and that of"leaf positioning deviations≤30 μm"was between 95.6%and 99.2%.When the gantry angle was at 0° and 180°,the leaf positioning accuracy was relatively higher,and the percentages of"leaf positioning deviations≤10 μm"were respectively 58.3%and 57.9%.The maximum positioning error of the HD 120 MLC did not exceed 43.3 μm.The results of the one-way ANOVA showed that there were significant differences in the average positioning precisions between 0° and each one of 45°,90°,135°,225°,270° and 315°,and between 90° and 180°,and between 135° and 180°,and between 180° and each one of 225°,270° and 315° under the gantry angles were respectively 0°,45°,90°,135°,180°,225°,270° and 315°,and under the observation values of the positioning precision of 8 leaf positions(F=4.32,F=5.67,F=3.98,F=3.85,F=6.14,F=2.87,F=4.89,F=4.56,F=4.12,F=5.01,F=6.77,P<0.05).There were no significant differences in the positioning precision among other gantry angles.Conclusion:The positioning precisions of HD 120 MLC leaf under different gantry angles can be kept at higher level,but the influences of gantry angles on the positioning precision of leaf indeed existed.Therefore,doctors and physicists should fully consider these factors under the design stage of treatment plan,so as to optimize the dose distribution and enhance the treatment outcomes.

Exploring of Transformation Rule of Saponins in Polygalae Radix Before and After Processing Based on Simulated Processing Technology / 中国实验方剂学杂志

ObjectiveTo investigate the transformation mechanism and content variation of saponins from Polygalae Radix before and after being boiled with licorice juice and water. MethodSimulated licorice juice boiled products and simulated water boiled products of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ were prepared by simulated processing technology， and analyzed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap/MS）. Then the contents of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin in Polygalae Radix， licorice-boiled Polygalae Radix and water-boiled Polygalae Radix were determined by UPLC-triple quadrupole tandem mass spectrometry（UPLC-QQQ-MS/MS）. ResultDuring the boiling process with licorice juice and water， onjisaponin B could be hydrolyzed to produce 4-methoxycinnamic acid， desacylsenegin Ⅲ， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin Z could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin TF， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin F could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin G， polygalasaponin ⅩⅩⅧ and tenuifolin， and polygalasaponin ⅩⅩⅧ was hydrolyzed to produce tenuifolin. After being boiled with licorice juice or water， the content of onjisaponin B decreased significantly（P<0.05， P<0.01）， but the contents of onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin increased significantly（P<0.05， P<0.01） in Polygalae Radix. Compared with the water-boiled products， the contents of onjisaponin Z and tenuifolin increased significantly（P<0.05， P<0.01）， and the change of tenuifolin content was the most significant in the licorice-boiled products.However， there was no significant difference in the content of onjisaponin B， onjisaponin F and polygalasaponin ⅩⅩⅧ between the water-boiled products and the licorice-boiled products. ConclusionBeing boiled with licorice juice or water can hydrolyze onjisaponin B， onjisaponin Z， onjisaponin F and polygalasaponin ⅩⅩⅧ， and generate secondary glycosides and aglycones（organic acids） through deglycosylation， which leads to obvious changes in the contents of onjisaponins after Polygalae Radix being processed.It is inferred that licorice juice can promote the hydrolysis of some onjisaponins in Polygalae Radix to onjisaponin Z and tenuifolin.This study provides an experimental basis for revealing processing mechanism of Polygalae Radix.

Regulation of Yes associated protein in diabetic nephropathy mice by Yishen Huashi Granule / 中国药理学通报

Aim To explore the protective effect of Yishen Huashi Granule (YSHS) on streptozotocin (STZ) - indueed diabetes nephropathy (DN) in mice and its possible mechanism. Methods The STZ induced DN mice model was established, which was randomly divided into model group, YSHS group and YAP inhibitor Vertepofin group, and the eontrol group was also established. The intervention was started eight weeks after the successful modeling with the course of four weeks. Urine protein concentration before and after intervention in each group as well as serum creatinine (Scr) and blood urea nitrogen (Bun) levels after intervention were measured. After the treatment, the mice were sacrificed, and the pathological changes of glomeruli were observed by light microscope HE staining. The protein expression of YAP, p-YAP S127 and CTGF were detected by Western blot, and the mRNA expressions of YAP, CTGF and podocyte functional proteins nephrin, podophyxin and WT1 were detected by RT-PCR. Results The biochemical indexes of YSHS group were better than those of model group, and HE staining showed that the pathological injury of glomeruli was improved. In the model group the protein expression of YAP, p-YAP (S127) and CTGF as well as the mRNA expression of YAP and CTGF increased, while the mRNA expression of nephrin, podocalyxin and WT1 decreased. After YSHS treatment, the protein expression of YAP, p-YAP S127, CTGF and the mRNA expression of YAP and CTGF decreased, while the mRNA expression of nephrin, podocalyxin and WT1 increased. Conclusions YSHS can reduce urinary protein, protect renal function and alleviate glomerular pathological injury in DN mice. Its possible mechanism may be related to the down-regulation of YAP in renal tissue, the reduction of CTGF expression level and the up-regulation of podocyte protein mRNA expression.

Research on the competence of hospital pharmacists in pharmaceutical care based on factor analysis and fuzzy comprehensive evaluation / 中国药房

OBJECTIVE To provi de reference for scholars to carry out the research on the competency of pharmacists in pharmaceutical care and the human resource management of hospital pharmaceutical personnel. METHODS The questionnaire was designed with Pharmacist Pharmaceutical Service Competency Evaluation Standard （Trial）as the competency evaluation indexes. The convenient sampling method was used to investigate the pharmaceutical technicians from two third-class grade A hospitals in Harbin. Exploratory factor analysis was used to judge whether each dimension and item of competency index system needed to be adjusted；the final weight of each evaluation index was calculated by analytic hierarchy process ；fuzzy comprehensive evaluation method was used to evaluate the competency of pharmacists in pharmaceutical care. RESULTS Totally 152 questionnaires were collected and 142 valid questionnaires were collected ，with an effective recovery rate of 93.42％. In this study ，women accounted for 76.8％，those aged 40 and below accounted for 60.6％，those with bachelor ’s degree and above accounted for 84.5％，those with intermediate professional title accounted for 45.1％，and those with 10 years of work or below accounted for 60.6％. Four common factors were extracted in exploratory factor analysis ，and the cumulative variance contribution rate was 78.841％，which were named knowledge and skills ，motivation，personal literacy and professional ethics. The average score of the pharmacist ’s pharmaceutical care competency was （5.884±0.810），and the development of various dimensions of competency was not balance ； honesty and trustworthiness ，conscientiousness and responsibility and dedication scored higher ，while the scores of statistical knowledge，foreign language knowledge and drug treatment evaluation ability were lower. According to the evaluation method of fuzzy comprehensive evaluation ，the final comprehensive evaluation result was “consistent”. CONCLUSIONS The evaluation indexes of pharmacist competency have good reliability and validity in the competency evaluation of pharmacists in medical institutions. At the same time ，the basic knowledge of 32 hospital pharmacists and their ability to participate in clinical rational drug use need to be further improved.

Investigation and study of the professional identity and its correlation with mentoring function and professional competency among clinical medicine postgraduates / 中华医学教育探索杂志

Objective:To investigate the current status of professional identity among the clinical medical postgraduates and its correlation with mentoring function and professional competency, so as to provide reference for optimizing the training mode of clinical medicine postgraduates.Methods:A questionnaire survey was conducted among 217 academic and professional full-time postgraduates from Batch 2016 to 2018 majoring in clinical medicine in Peking University Health Science Center in 2019. The contents included four aspects: basic information, preliminary questionnaire of professional identity, mentoring function scale and professional competency. SPSS 26.0 was used for t test, one-way ANOVA, Kruskal-Wallis H test, and Pearson correlation analysis to analyze the status of professional identity and its correlation with professional competency and mentoring function. Results:Both professional and academic clinical medicine postgraduates had high scores of the overall level and four factors, and there was no statistical significance in the scores between the two groups ( P >0.05). There were significant differences in the overall level, behavior and appropriateness of professional identity among different grades of professional postgraduates ( P<0.05). Correlation study showed that the professional identity was significantly positively correlated with the total score of professional competency and mentoring function ( P<0.001). Further interview survey showed that the role of supervisor and employment prospects also played an important role in the elevation of professional identity. Conclusion:The overall degree of professional identity of academic and professional postgraduates is good and closely related to professional competency and mentoring function and for professional postgraduates, the overall level of professional identity of senior students is better. It is suggested that besides focusing on their professional competency, it is necessary to further optimize the employment policy of academic postgraduates and the training of tutors for professional postgraduates.

CT Characteristics of Consolidation Type of Pulmonary Cryptococcosis in Immunocompetent Patients / 中国医学科学院学报

Objective To analyze the CT characteristics of consolidation type of pulmonary cryptococcosis in immunocompetent patients,and thus improve the diagnosis of this disease. Methods A total of 20 cases with consolidation-type pulmonary cryptococcosis confirmed by pathological examinations were studied.Each patient underwent breath-hold multislice spiral CT,and 10 patients underwent contrast enhanced CT.The data including lesion number,lesion distribution,lesion density,performance of enhanced CT scan,accompanying signs,and prognosis were analyzed. Results The occurrence rates of single and multiple lesions were 80.0%(n=16)and 20.0%(n=4),respectively.In all the 16 multiple-lesion patients,the occurrence rate of unilateral lobar distribution was 56.0%(n=9).The 76 measurable lesions mainly presented subpleural distribution(71.1%,n=54)and lower pulmonary distribution(75.0%,n=57).A total of 39 lesions were detected in the 10 patients received contrast enhanced CT,in which 31 lesions(79.5%)showed homogeneous enhancement,34 lesions(87.2%)showed moderate enhancement,and all the lesions manifested angiogram sign.Consolidation lesions were accompanied by many CT signs,of which air bronchogram sign had the occurrence rate of 63.2%(n=48),including types Ⅲ(n =37)and Ⅳ(n=11).Other signs included halo signs(43/76,56.6%),vacuoles or cavities(9/76,11.8%),pleural thickening(14/20,70.0%),and pleural effusion(2/20,10.0%).After treatment,the lesions of 7 patients were basically absorbed and eventually existed in the form of fibrosis. Conclusions The lesions in the immunocompetent patients with consolidation type of pulmonary cryptococcosis usually occur in the lower lobe and close to the pleura,mainly presenting unilateral distribution.The CT angiogram signs,proximal air bronchogram signs,and halo signs are the main features of this disease,which contribute to the diagnosis.

Transcriptional Profile Alteration of Peripheral Blood in Chronic Hypoxia / 中国医学科学杂志(英文版)

Objective Many physiological and pathological conditions, including cyanotic congenital heart diseases (CCHD), are accompanied by chronic hypoxia, which might interfere with the transcription process. However, the transcriptome profile in peripheral blood under hypoxia is still unidentified. The present work aimed to explore the transcriptional profile alteration of peripheral blood in chronic hypoxia. Methods The present study used a chronic hypoxia rat model to simulate the hypoxic state of CCHD patients. Two groups of Sprague-Dawley rats (n=6 per group) were either exposed to hypoxia (10% O2) or normoxia (21% O2) for 3 weeks. Body weight was measured weekly. Peripheral blood was collected and total RNA was extracted for RNA-Seq at the end of the hypoxia treatment. After quality assessment, the library was sequenced by the Illumina Hiseq platform. The differentially expressed genes were screened (false discovery rate<0.05 and fold change>2). The functional annotation analysis and cluster analysis of differentially expressed genes were performed based on the adjusted P-value (padj<0.05). Results Compared with the control group, the body weight of the rats in the hypoxia group was significantly lowered (P<0.01). RNA-Seq results showed that the transcriptome patterns of the two groups had significant differences. In total, 872 genes were identified as differentially expressed. Among all, 803 genes were down-regulated, while only 69 genes were up-regulated in the hypoxia group. The functional enrichment analysis of the 872 genes showed that multiple biological processes involved, such as porphyrin-containing compound metabolic process, hemoglobin complex and oxygen transporter activity. Conclusions Our study demonstrated the transcriptional profile alteration in peripheral blood of chronic hypoxia rat model. This study provided basic data and directions to further understand the physiological and pathological changes in patients with CCHD.

Exploration of Active Ingredients and Anti-breast Cancer Mechanism of Glycyrrhizae Radix Et Rhizome and Aurantii Fructus Based on Network Pharmacology / 中国实验方剂学杂志

Objective::To explore the potential active ingredients and possible anti-breast cancer mechanism of Glycyrrhizae Radix et Rhizome and Aurantii Fructus based on the method of network pharmacology. Method::The main potential targets of Glycyrrhizae Radix et Rhizome and Aurantii Fructus on breast cancer were summarized by comparing the Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients screened from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and breast cancer targets searched in Therapeutic Target Database (TTD). Cytoscape 3.7.1 software was used to establish a Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients-target-disease network and perform topology analysis based on the network. Result::According to related conditions of drug-like (DL) and oral bioavailability (OB), the network of Glycyrrhizae Radix et Rhizome-Aurantii Fructus active ingredients-breast cancer target was obtained, covering a total of 133 nodes, 116 chemical components and 17 breast cancer drug targets, 109 active components of Glycyrrhizae Radix et Rhizome interacting with breast cancer drug target, 6 active ingredients of Aurantii Fructus interacting with breast cancer drug targets, and 1 common active ingredient of Aurantii Fructus and Glycyrrhizae Radix et Rhizome interacting with breast cancer targets. There were 400 breast cancer target-interaction target pairs in the network diagram. Conclusion::The anti-breast cancer effect of Glycyrrhizae Radix et Rhizome and Aurantii Fructus is based on the overall pharmacodynamic effect of multi-component, multi-pathway and multi-target, the investigation of its potential anti-breast cancer mechanism provides theoretical basis for further experimental research.

The clinical research of biofeedback electrical stimulation plus PFMT in the treatment of stress urinary incontinence after total hysterectomy / 中国医师杂志

Objective To explore the clinical efficacy of biofeedback electrical stimulation plus pelvic floor muscle training (PFMT) in the treatment of stress urinary incontinence (SUI) after total hysterectomy.Methods The research objects who underwent total hysterectomy and complicated SUI were selected from January 2014 to December 2017 in our hospital.They were randomly divided into two groups:the study group (n =55) received biofeedback electrical stimulation plus PFMT treatment,while the control group (n=55) received PFMT treatment only.To record and compare the efficacy related indicators of the two groups.Results The indexes and scores of 3/6 months in the two groups were significantly improvedafter treatment.After 3 months the treatment,the study group had less leakage of urine [(4.3 ± 1.2)g vs (5.7 ± 1.9) g],better recovery of muscle strength of Ⅰ/Ⅱ muscle fibers [(3.5 ± 0.9) grade vs (2.8 ± 1.1) grade &(3.7 ± 0.6) grade vs (3.2 ± 1.2) grade],and better score of international consultation on incontinence questionnaire-short form (ICI-Q-SF) questionnaire [(2.7 ± 1.4) vs (4.5 ± 2.2)] compared with the control group,with statistically significant difference (P ≤ 0.05).After 6 months treatment,compared with the contiol group,the study group had less leakage of urine pad test [(1.4 ± 0.7) g vs (2.6 ± 1.1) g],better recovery of muscle strength of type Ⅰ/Ⅱ muscle fiber [(4.2 ±0.8) grade vs (3.5 ± 1.1)grade & (4.7 ±0.5) grade vs (4.0 ±0.9)grade],and better ICI-Q-SF score [(2.7 ± 1.4) vs (4.5 ±2.2)] (P ≤0.05).Conclusions Compared with using the PFMT alone,biofeedback electrical stimulation plus PFMT treatment had less leakage,better pelvic floor muscle strength and better subjective symptoms.

Pathogens and clinical features of preterm infants with sepsis / 中国当代儿科杂志

OBJECTIVE@#To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants.@*METHODS@#A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis).@*RESULTS@#There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05).@*CONCLUSIONS@#Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.