Visualization analysis of traditional Chinese medicine and pharmacy combined with TACE in the treatment of hepatocellular carcinoma based on CiteSpace / 中国现代医生

Objective To analyze the current status,hotspots,and trends in the research field of traditional Chinese medicine and pharmacy combined with transcatheter arterial chemoembolization(TACE)for the treatment of hepatocellular carcinoma.Methods The relevant literatures on traditional Chinese medicine and pharmacy combined with TACE treatment for hepatocellular carcinoma collected by China National Knowledge Infrastructure from January 1994 to December 2022,and use CiteSpace 6.1.R6 software to analyze its publication volume,authors,research institutions,and key words.Results This study included a total of 686 articles.The publication volume showed a fluctuating upward trend from 1994 to 2015,but it had decreased since 2016,indicating that further breakthrough research was needed in this field.The communication between authors and research institutions needed to be strengthened,with low levels of cross institutional and cross regional cooperation and uneven geographical distribution.Cooperation should be strengthened.High frequency key words included hepatocellular carcinoma,Chinese materia medica,interventional therapy,therapeutic,etc.,resulting in 9 key word clustering labels.Conclusion Currently,there is a lack of experimental research and related mechanism research,the future research hotspots of traditional Chinese medicine and pharmacy combined with TACE treatment for hepatocellular carcinoma will focus more on traditional Chinese medicine and pharmacy,interventional therapy,clinical observation,and cell apoptosis,which provides new ideas for researchers conducting related research in the future.

Visualization analysis of research status and hot spots of Yinchenhao decoction based on CiteSpace / 中国现代医生

Objective By using the bibliometrics method,the literature about Yinchenhao decoction was visualized and analyzed to explore its research hot spot and frontier.Methods The related literatures on Yinchenhao decoction were retrieved from CNKI database,and CiteSpace 6.1.R6 software was used to analyze the authors,institutions and key words,and the key words were clustered to draw a visual atlas.Results A total of 856 articles were included,and the number of articles showed a fluctuating upward trend.There were 764 authors and 513 related key words,including clinical application,experimental study and signaling pathway of Yinchenhao decoction.Conclusion Although Yinchenhao decoction is a commonly used clinical prescription for liver disease,there is a lack of studies on the mechanism of action and molecular level.Future research hot spot should focus more on large sample randomized controlled clinical studies and experimental studies,so as to provide new directions for researchers.

Research on the regulation of food therapy prescription of Traditional Chinese medicine in treating children′s stagnation based on data mining / 中国实用护理杂志

Objective:Data mining technology was used to analyze the regulation of food therapy prescriptions in treating children′s stagnation.Methods:Collect the therapy prescriptions used for regulating children's stagnation in the Dictionary of Traditional Chinese Medicine Prescriptions, the Complete Record of Dietary Therapy Prescriptions of Traditional Chinese Medicine and the Dictionary of Chinese Medicinal Diet, extract the information of prescription name, composition, etc, and use SPSS 22.0 for frequency analysis, and use Weka for correlation analysis. Results:A total of 99 dietary prescriptions for children with hysteria were included, involving a total of 62 foods, with a total use frequency of 224 times, among which the food with high use frequency were chicken gizzard, japonica rice, hawthorn, etc. The four characteristics of food were mainly concentrated in the flat, the five tastes were mainly concentrated in the sweet, the return channel was mainly concentrated in the spleen and stomach channel, and the effect was mainly concentrated in the absorption of food and tonic deficiency. The main symptoms of the therapeutic prescription for children's accumulation of stagnation were internal accumulation of milk and food and combination of spleen deficiency. The commonly used food combination for children's accumulation of stagnation of milk and food was "fructus amomi - chicken gizzard". The commonly used food combination of children with spleen deficiency and accumulation of stagnation was "lentil bean-yam-japonica rice" and "millet-yam".Conclusions:Traditional Chinese medicine diet prescription for the treatment of children's accumulation of stagnation pay attention to harmony and regulation, sweet and slow tonifying, emphasizing the adjustment of the spleen and stomach, taking into account the regulation of lung, following the "eliminating and supplementing both, according to the cause of treatment" rule, advocate syndrome differentiation of food.

Analysis of the status and risk factors of in stent restenosis in patients with acute myocardial infarction and diabetes mellitus one year after percutaneous coronary intervention / 中国医师杂志

Objective:To analyze the status of in stent restenosis (ISR) in patients with acute myocardial infarction (AMI) and diabetes mellitus (DM) one year after percutaneous coronary intervention (PCI), and explore the risk factors.Methods:From December 2019 to December 2020, 158 patients with AMI and DM who were treated by PCI in Qionghai Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Hainan Medical College were selected. They were followed up for one year after surgery to calculate the incidence of ISR. The patients were divided into ISR group and non ISR group according to whether ISR occurred. The difference of clinical data between the two groups was compared. Logistic regression was used to analyze the risk factors for the occurrence of ISR in AMI patients with DM 1 year after PCI.Results:55 patients were followed up for 1 year, and the incidence of ISR was 34.81% (55/158). There were significant difference between ISR group and non ISR group in hypertension history, old myocardial infarction history, smoking, exercise ratio, preoperative low density lipoprotein cholesterol (LDL-C), total bilirubin (TBIL), blood uric acid (UA), plasma fibrinogen (FIB), glycosylated hemoglobin (HbA 1c) levels, coronary artery lesion number, stenosis degree, stent length, stent diameter (all P<0.05). Multivariate logistic regression analysis showed that hypertension history, smoking, LDL-C, FIB, HbA 1c and stent length were independent risk factors for ISR in AMI patients with DM after PCI, and exercise and appropriate increase of stent diameter were protective factors (all P<0.05). Conclusions:The incidence of ISR in AMI patients with DM at 1 year after PCI is relatively high, and its occurrence is related to many factors. In order to reduce the risk of ISR after PCI, we should encourage smoking cessation, exercise, strengthen the monitoring of biochemical indicators, and appropriately increase the diameter of stent during PCI.

Development of a risk prediction model for cardiac arrest of sepsis in the emergency department / 中华急诊医学杂志

Objective:To develop a risk prediction model for early cardiac arrest in emergency sepsis utilizing a machine learning algorithm to enhance the quality and efficiency of patient treatment.Methods:This study focused on patients with sepsis who received treatment at the emergency room of the First Medical Center of Chinese PLA General Hospital from January 1, 2020 to June 1, 2023. The basic clinical characteristics such as vital signs and laboratory results were collected. Patients who fulfilled the specified inclusion criteria were allocated randomly into a training group and a testing group with a ratio of 8:2. A CatBoost model was constructed using Python software, and the prediction efficiency of the model was assessed by calculating the area under the receiver operating characteristic curve (AUC). Furthermore, the performance of the model was compared to that of other widely employed clinical scores.Results:This study included a cohort of 2 131 patients diagnosed with sepsis, among whom 449 experienced cardiac arrest. The CatBoost model demonstrated an AUC of 0.760, surpassing other scores. Notably, the top 10 predictors in the model were identified as age, lactate, interleukin -6, oxygen saturation, albumin, N-terminal pro-B-type natriuretic peptide, potassium, sodium, creatinine, and platelets.Conclusions:The utilization of this machine learning algorithm-based prediction model offers a more precise basis for predicting cardiac arrest in emergency sepsis patients, thereby potentially improving the treatment efficacy for this disease.

Clinical applications of preservative-free intraocular pressure-lowering drugs: the future prospects / 中华实验眼科杂志

Long-term use of topical intraocular pressure-lowering medications, particularly those containing preservatives, may cause or worsen ocular surface diseases, which may ultimately reduce patient tolerance and compliance, increase surgical risk, and compromise treatment efficacy.Therefore, long-term management of glaucoma requires the consideration of various factors such as efficacy, safety, and cost-effectiveness.Recently, the use of preservative-free (PF) intraocular pressure-lowering drugs has been gaining considerable attention in research as a means to avoid the toxicity of preservatives on ocular health.These drugs have similar pharmacokinetic properties and bioequivalence to their corresponding preservative-containing drugs.In addition, the manufacturing process of PF medications can reduce the incidence of ocular surface diseases, improve patient symptoms, and increase treatment effectiveness, indicating extensive potential applications.This review focuses on the development and clinical use of PF intraocular pressure-lowering drugs, aiming to deepen clinicians' understanding of their use.

Influence of LIC mode on medical students' post competency / 中华医学教育探索杂志

Objective:To explore whether a longitudinal integrated clerkship (LIC) model is more conducive to medical students' post competency and satisfaction with clerkships compared with the traditional block rotation clerkship.Methods:We selected 72 students who participated in graduating clerkships at The First Affiliated Hospital of Harbin Medical University from June 2018 to June 2019. They were equally divided into experimental group and control group to adopt LIC and traditional block rotation clerkship models, respectively. After completing the clerkships, the two groups were evaluated for post competency through objective testing of theoretical medical knowledge and basic clinical skills and rating of the other five competence items by the students themselves and their teachers. At the same time, a questionnaire was delivered to both groups for the degree of satisfaction with clerkships. The t-test and chi-squared test were performed using SPSS 23.0. Results:The objective tests and students' self-evaluation showed that the experimental group had significantly higher scores of theoretical medical knowledge [(8.02±1.11) vs. (7.50±0.97)], basic clinical skills [(7.63±0.90) vs. (6.93±0.73)], medical professional responsibility [(7.74±0.56) vs. (7.31±0.78)], clinical communication [(8.10±1.06) vs. (7.22±0.60)], team work [(7.84±0.62) vs. (7.11±0.69)], literature searching [(6.25±0.60) vs. (4.78±0.84)], and scientific research ability [(4.26±0.88) vs. (2.46±1.20)] compared with the control group (all P<0.05). The experimental group had significantly higher teacher-rated scores of medical professional responsibility [(8.03±0.74) vs. (6.59±0.70)], clinical communication [(7.95±0.73) vs. (6.87±0.67)], team work [(7.96±0.75) vs. (6.95±0.69)], literature searching [(4.84±0.84) vs. (3.30±0.69)], and scientific research ability [(4.53±1.03) vs. (2.70±1.05)] than the control group (all P<0.01). The scores of satisfaction were all higher in the experimental group than in the control group in terms of course arrangement satisfaction [(7.17±0.91) vs. 6.56±0.84)], teacher-student interaction satisfaction [(7.08±0.69) vs. (6.28±0.82)], self-improvement satisfaction [(7.28±0.45) vs. (6.36±0.49)], and clinical work smoothness [(7.72±0.82) vs. (6.81±0.71); all P<0.01]. Conclusion:Compared with the traditional block rotation model, the LIC model is more helpful for improving the post competency of medical students. LIC is a new clinical clerkship model that can potentially replace the traditional block rotation clerkship.

Effects of cleavage factor Im25 downregulation in vascular smooth muscle cells on hyperlipidemia in mice / 中华老年医学杂志

Objective:To investigate the impact of cleavage factor Im25(CFIm25)on VSMCs-specific knockdown in the context of hyperlipidemia.Methods:Mice models were constructed with specific knockout of CFIm25 in VSMCs(CFIm25f/+ TaglnCre)and control mice(TaglnCre).The mice were fed a normal diet or high-fat diet(HFD)for 18 weeks and their body weight changes were monitored.ELISA was used to measure serum total cholesterol(TC), triacylglycerol(TG), high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)levels.The extent of aortic lipid deposition in mice was assessed by oil red O staining.Results:During the feeding of a high-fat diet, CFIm25f/+ TaglnCre mice showed a significant increase in body weight compared to the control group[Male(1.01±0.06)g and(0.87±0.31)g, t=7.53, P<0.05; Female: (0.64±0.02)g and(0.35±0.04)g, t=9.68, P<0.05].After 18 weeks of high-fat diet feeding, CFIm25f/+ TaglnCre mice had significantly higher levels of TC[(6.80±0.35)mmol/L and(3.76±0.87)mmol/L, t=5.63, P=0.004], TG[(0.97±0.21)mmol/L and(0.42±0.10)mmol/L, t=4.08, P=0.015], and LDL-C[(5.20±0.30)mmol/L and(2.00±0.98)mmol/L, t=5.40, P=0.006]compared to the TaglnCre group.Specifically, TC levels increased by 80.72%, TG increased by 132.79%, and LDL-C increased by 160.32%.There was a significant increase in aorta lipid deposition and atherosclerotic plaque area in CFIm25f/+ TaglnCre mice( P<0.05). Conclusions:The research indicated that VSMCs-specific CFIm25 knockdown in mice further worsened hyperlipidemia and atherosclerotic lesions.

Therapeutic effect of retention enema with compound rhubarb decoction on a rat model of minimal hepatic encephalopathy based on bile acid metabolomics / 临床肝胆病杂志

ObjectiveTo investigate the therapeutic effect of rhubarb decoction （RD） retention enema on a rat model of minimal hepatic encephalopathy （MHE） and its mechanism of action based on bile acid （BA） metabolomics. MethodsA total of 55 male Sprague－Dawley rats were randomly divided into blank group （NC group with 10 rats）， hepatic encephalopathy group （HE group with 15 rats）， MHE group with 15 rats， and MHE+rhubarb decoction treatment group （MHEY group with 15 rats）. Intraperitoneal injection of carbon tetrachloride （CCl4） and thioacetamide （TAA） was performed to establish a rat model of MHE or HE， and the rats were sacrificed after 2 weeks of administration. The serum levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， total bilirubin （TBil）， and total bile acid （TBA） and the concentration of blood ammonia were measured； the colonic contents were collected to measure pH value； liver and brain tissue samples were collected， and HE staining was used to observe the histopathological changes of the liver； the bile was collected， and liquid chromatography－mass spectrometry was used to perform BA－targeted metabolomics analysis. Continuous data were expressed as mean±standard deviation； a one－way analysis of variance was used for comparison between multiple groups， and the least significant difference t－test was used for further comparison between two groups. ResultsCompared with the NC group， the HE group and the MHE group had a significant increase in searching platform latency （after modelling and after administration） and a significant reduction in the number of platform crossings （all P<0.05）； compared with the MHE group， the MHEY group had a significant reduction in searching platform latency （after administration） and a significant increase in the number of platform crossings， and the HE group had a significant increase in searching platform latency and a significant reduction in the number of platform crossings （all P<0.05）. Compared with the NC group， the HE group and the MHE group had significant increases in AST， ALT， ALP， TBil， TBA， blood ammonia， and colon pH value （all P<0.05）； compared with the MHE group， the MHEY group had significant reductions in AST， ALT， ALP， TBil， TBA， blood ammonia， and colon pH value （all P<0.05）， and the HE group had significant increases in AST， ALT， ALP， TBil， TBA， blood ammonia， and colon pH value （all P<0.05）. The MHE group had significantly lower TBA， primary BA， and secondary BA than the NC group （all P<0.05）； compared with the MHE group， the HE group had significantly lower TBA and primary BA （all P<0.05）， and the MHEY group had significantly higher TBA and primary BA （all P<0.05）. Compared with the NC group， the MHE group had significant reductions in GCDCA， GUDCA， GHDCA， TCDCA， TUDCA， GLCA， and TLCA （all P<0.05） and significant increases in γ－MCA， THCA， 7－KDCA， AlloLCA， and α－MCA （all P<0.05）， and compared with the MHE group， the MHEY group had significant increases in THDCA， TMCA， TCDCA， TUDCA， and TLCA （all P<0.05）. ConclusionRD retention enema can improve liver injury and cognitive function in a rat model of MHE induced by CCl4 and TAA by regulating the enterohepatic circulation of BA， possibly by increasing the synthesis of taurine－binding BA.

Causes of HLA-A2 reactive antibodies and analysis of their eplets / 中国输血杂志

【Objective】 To analyze differences of eplets between the patient who generated HLA allele-specific antibodies after platelet transfusion with donors. 【Methods】 The HLA genotypes of the patient and donors were detected by PCR-SBT, and the Luminex single antigen beads coating was used to screen HLA-Ⅰ antibodies in the patient’s serum. HLA Matchmaker was utilized to analyze different amino acids and eplets. 【Results】 The patient carried HLA-A*02∶03 allele, and HLA-A2 antibodies were found in his serum after platelet transfusion (A*02∶01, A*02∶06, and A*02∶07). Sequence alignment showed that the patient′s A*02∶03 has a difference in position 149, which resulted in a different eplet between A*02∶03 and A*02∶01, A*02∶06, A*02∶07 and then induced the production of antibodies. 【Conclusion】 HLA antibodies are specific for HLA epitopes that have structural differences due to amino acid differences between HLA alleles, suggesting that high-resolution typing of HLA-A, -B need to be conducted in patients and donors, and the acceptable mismatch of HLA should be determined based on epitopes rather than antigens, so as to reduce alloimmune response and improve platelet count after transfusion.

Effects of exosome －derived LncRNA ESCCAL－1 /miR - 874 / ITGBL1 on the proliferation and apoptosis of colorectal cancer cells / 安徽医科大学学报

Objective@#To explore the mechanism of exosome-derived LncRNA ESCCAL-1 regulating the miR-874 /ITGBL1 axis in the progression of colorectal cancer ( CRC) ．@*Methods @#The differentially expressed genes in CRC were analyzed using the Gene Expression Omnibus( GEO) database．Expressions of LncRNA ESCCAL-1，miR-874 and ITGBL1 in CRC tissues and cell lines (SW480，SW620，HCT116 and HT29) and adjacent normal tissues and NCM460 cell lines were detected by qRT-PCR ; 3-( 4，5-dimethylthiazol-2-yl ) -2，5diphenyltetrazoliumbromide (MTT) ，clone formation and flow cytometry was used to detect cell proliferation，colony formation and apoptosis ; dual luciferase reporter assays were used to verify the interaction between miR-874 and ESCCAL-1，ITGBL1 ; fluorescence in situ hybridization was used to determine the subcellular localization of LncRNAESCCAL-1 ．Exosomes were isolated from serum using the Exosome extraction kit. @*Results @#The expressions of ESCCAL-1 and ITGBL1 in CRC tissues and cell lines were higher than those in adjacent normal tissues and NCM460 cell lines，while the opposite was true for miR-874 (P＜0. 05) ．Knockdown of ESCCAL-1 can inhibit CRC cell proliferation and colony formation and promote apoptosis．There are specific binding sites formiR-874 and ESCCAL-1，and miR-874 inhibitor could partially reverse the effect of knockdown ESCCAL-1 in CRC (P＜0. 05) ．ESCCAL-1 upregulates ITGBL1 by adsorbing miR-874．The serum levels of ESCCAL-1 and exo-ESCCAL-1 in CRC patients were higher than those in the control group．Serum exo-ESCCAL-1 may be a valuable diagnostic indicator for CRC treatment (P＜0. 05) . @*Conclusion @#ESCCAL-1 promotes CRC progression by regulating the miR-874/ ITGBL1 axis，and ESCCAL-1 may be an effective molecular target for CRC therapy.

Mining intrinsic information of convalescent patients after suffering coronavirus disease 2019 in Wuhan.

OBJECTIVE: To summarize the potential characteristics of convalescent patients with coronavirus disease 2019 (COVID-19) in China based on emerging clinical tongue data and guide the treatment and recovery of COVID-19 patients from the perspective of Traditional Chinese Medicine tongue diagnosis. METHODS: In this study, we developed and validated radiomics-based and lab-based methods as a novel approach to provide individualized pretreatment evaluation by analyzing different features to mine the orderliness behind tongue data of convalescent patients. In addition, this study analyzed the tongue features of convalescent patients from clinical tongue qualitative values, including thick and thin, fur, peeling, fat and lean, tooth marks and cracked, and greasy and putrid fur. RESULTS: We included 2164 tongue images in total (34% from day 0, 35.4% from day 14 and 30.6% from day 28) from convalescent patients. The significance results are shown as follows. Firstly, as the recovery time prolongs, the L average values of tongue and coat decrease from 60.21 to 57.18 and from 60.06 to 57.03 respectively. Secondly, the decrease of abnormality rate of tongue coat, included greasy tongue fur, putrid fur, teeth-mark, thick-thin fur, are of significant statistical difference ( < 0.05). Thirdly, the average value of gray-level co-occurrence matrices increases from 0.173 to 0.194, the average value of entropy increases from 0.606 to 0.665, the average value of inverse difference normalized decrease from 0.981 to 0.979, and the average value of dissimilarity decrease from 0.1576 to 0.1828. The details of other radiomics features are describe in results section. CONCLUSIONS: Our experiment shows that patients in different recovery periods have a relationship with quantitative values of tongue images, including L color space of the tongue and coat radiomics features analysis. This relationship can help clinical doctors master the recovery and health of patients as soon as possible and improve their understanding of the potential mechanisms underlying the dynamic changes and mechanisms underlying COVID-19.

A single-center retrospective analysis of surgical strategy and clinical outcome of pulmonary nodules using pulmonary subsegments as anatomical unit / 中国胸心血管外科临床杂志

@#Objective    To analyze the results and rationality of the lesion-focused strategy with subsegment as the pulmonary anatomical unit for pulmonary nodules with a diameter of ≤2 cm which require surgery. Methods    Clinical data of 246 patients with pulmonary nodules who underwent surgery in the Department of Thoracic Surgery of The First Affiliated Hospital of Nanjing Medical University from January 2017 to October 2018 were retrospectively analyzed, including 76 males and 170 females, with an average age of 53.30±11.82 years. The patients were divided into four groups, a single segmentectomy group, a segmentectomy combined with adjacent subsegmentectomy group, a single subsegmentectomy group and a combined subsegmentectomy group, according to the different surgical approaches, to compare preoperative, intraoperative, and postoperative related data. Results    There was no perioperative death. Among the four groups, there was no statistical difference in gender (P=0.163), age (P=0.691), diameter of the nodule (P=0.743), longitudinal position of the nodule (depth ratio, P=0.831), postoperative pulmonary leakage (P=0.752), intraoperative blood loss (P=0.135), pathological type (P=0.951) or TNM stage (P=0.995); there were statistical differences in transverse position of the nodule (P<0.001) and number of subsegments involved (P<0.001). The results of multivariate logistic regression analysis showed that compared with combined subsegmentectomy, the odds ratio (OR) of the lung nodule in segmentectomy combined with adjacent subsegmentectomy as intersegment nodules was 5.759 (95%CI 1.162 to 28.539, P=0.032). Conclusion     The surgical strategy of lesion  focused and subsegment as anatomical unit is safe and feasible for surgical treatment of pulmonary nodules with diameter ≤2 cm. The transverse position of the nodules is an important factor affecting the choice of surgical method for the middle and lateral nodules with a diameter of ≤2 cm, and the longitudinal location of the nodule is not an influencing factor. For nodules in inner zone, the diameter also is one of the factors influencing the choice of surgical method.

Research Status of Tumor-associated Fibroblasts Regulating Immune Cells / 中国肺癌杂志

Cancer-associated fibroblasts (CAFs) and tumor-infiltrating immune cells are the most essential components of the tumor microenvironment (TME). They communicate with each other in tumor microenvironment and play a critical role in tumorigenesis and development. CAFs are very heterogeneous and different subtypes of CAFs display different functions. At the same time, it can contribute to the regulation of the function of tumor-infiltrating immune cells and eventually result in the carcinogenesis, tumor progression, invasion, metastasis and other biological behaviors of tumors by producting various growth factors and cytokines etc. Based on the current research results at home and abroad, this paper reviews the recent research progress on the regulation of CAFs on infiltrating immune cells in tumor microenvironment.
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Pathogenic bacteria distribution and antimicrobial resistance in children aged 0 to 14 years with urinary tract infections in a single center in Shanghai / 中华传染病杂志

Objective:To investigate the distribution and antimicrobial resistance patterns of common pathogens in children with urinary tract infections in a single center in Shanghai, and to provide basis for the selection of empirical antibiotics in the clinical practice.Methods:The clinical data, urine culture and drug sensitivity tests results of children with urinary tract infections between 0 to 14 years admitted to the Children′s Hospital of Fudan University from January 2016 to December 2019 were retrospectively analyzed. According to the time of onset and the complicated factors, the patients were divided into different groups. The distributions and antimicrobial resistance patterns of common pathogens were compared among the groups. The chi-square test was used for statistical analysis.Results:Among the 1 832 children, 1 042 cases had positive urine culture, with the culture positive rate of 56.9%. The top five pathogens detected were Escherichia coli (375 strains, 36.0%), Enterococcus faecium (164 strains, 15.7%), Klebsiella pneumoniae (133 strains, 12.8%), Enterococcus faecalis (95 strains, 9.1%) and Pseudomonas aeruginosa (44 strains, 4.2%). The annual detection rates of gram-negative bacteria (65.3% to 72.9%) were always higher than those of gram-positive bacteria (22.6% to 30.1%). The distributions of pathogens among the years were not significantly different ( χ2 =27.79, P=0.146). In patients with complicated urinary tract infections, the detection rates of Pseudomonas aeruginosa (5.8%(40/688) vs 1.1%(4/354)) and fungi (6.5%(45/688) vs 1.7%(6/354)) were significantly higher than those in patients with simple urinary tract infections ( χ2=12.68 and 11.79, respectively, both P<0.050). Both of Escherichia coli and Klebsiella pneumoniae had the highest resistance rates to ampicillin, which were 87.2%(301/345) and 87.1%(115/132), respectively. The resistance rates of Escherichia coli to amikacin, nitrofurantoin, fosfomycin, cefmetazole, piperacillin/tazobactam, ertapenem, imipenem and meropenem were 1.4%(5/345), 6.1%(21/345), 6.1%(21/345), 8.3%(11/132), 11.6%(40/345), 6.4%(22/345), 4.6%(16/345) and 4.6%(16/345), respectively. The resistance rates of Klebsiella pneumoniae to these drugs were 6.1%(8/132), 37.9%(50/132), 15.2%(20/132), 23.2%(13/56), 26.5%(35/132), 23.5%(31/132), 17.4%(23/132) and 16.7%(22/132), respectively, which were all higher than those of Escherichia coli, and the differences were all statistically significant ( χ2=6.02, 76.17, 9.99, 7.94, 16.04, 28.29, 20.79 and 18.84, respectively, all P<0.050). The resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam, piperacillin/tazobactam and ceftazidime were 6.8%(3/44), 4.5%(2/44) and 2.3%(1/44), respectively, while those to carbapenems, amikacin and ciprofloxacin were all 0(0/44). The resistance rate of Enterococcus faecium to ampicillin was 96.8%(153/158), while that of Enterococcus faecalis was 9.1%(8/88). There was no Enterococcus strain resistant to vancomycin, teicoplanin or linezolid. When dynamically comparing the trends of the antimicrobial resistance from 2016 to 2019, the resistance rates of Escherichia coli and Klebsiella pneumoniae to β-lactams (including carbapenems) antimicrobial agents had shown a downward trend. Conclusions:Gram-negative bacteria are still the main pathogens of urinary tract infections in children, with a downward trend of drug resistance rates to β-lactams (including carbapenems) antimicrobial agents.

Clinical risk factors for fracture risk prediction in patients with type 2 diabetes using adjusted FRAX / 中华内分泌外科杂志

Objective:To study the clinical risk factors for osteoporotic fracture (OF) risk prediction in patients with type 2 diabetes mellitus (T2DM) using adjusted fracture risk assessment tool (FRAX) .Methods:A cross-sectional study of 429 patients with T2DM who were hospitalized in the Department of Endocrinology and Geriatrics of the Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University from Sep. 2019 to Sep. 2020 was conducted. Participants were divided into OF low-risk group and OF high-risk group. Participant characteristics (age, gender, height, weight, waist, blood pressure, history of drug treatment, serum glucose, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol (LDL-C) , high-density lipoprotein cholesterol (HDL-C) , triglyceride, serum uric acid, alkaline phosphatase, and thyroid stimulating hormone levels, urine protein/creatinine ratio, urea, creatinine and TPOAB) and dual energy x-ray absorptiometry results were obtained and analyzed. Logistic regression model was used to investigate the relationship between the OF risk of T2DM assessed by adjusted FRAX and clinical risk factors.Results:Patients in the OF high-risk group accounted for 9.09% of the subjects. After adjustment for other variables, the duration of diabetes was still positively associated with significantly elevated risk of OF assessed by adjusted FRAX ( OR 7.660, 95% CI 1.661-35.334, P=0.009) , whereas the blood uric acid was negatively associated with significantly elevated risk of OF assessed by adjusted FRAX ( OR 0.345, 95 % CI 0.128-0.928, P=0.035) .Likewise, LDL-C levels decreased the odds of the risk of OF assessed by adjusted FRAX ( OR 0.316, 95 % CI 0.114-0.881, P=0.028) . There was no significant relationship between alkaline phosphatase ( OR 1.902, 95 % CI 0.904-4.004, P=0.090) as well as total cholesterol ( OR 0.297, 95% CI 0.056~1.560, P=0.151) levels and the elevated risk of OF assessed by adjusted FRAX. Conclusion:Diabetes duration could be a risk factor for OF risk prediction in patients with T2DM using adjusted FRAX, and serum uric acid and LDL-C could be protective factors for OF risk prediction in patients with T2DM using adjusted FRAX.

Bie Jia Jian pill enhances the amelioration of bone mesenchymal stem cells on hepatocellular carcinoma progression.

BACKGROUND: The therapeutic efficiency of Traditional Chinese Medicine (TCM) in suppressing the recurrence and metastasis of hepatocellular carcinoma (HCC) has been well proved. OBJECTIVE: The aim of this study is to investigate the role of Bie Jia Jian pill (BJJP) combined with bone mesenchymal stem cells (BMSCs) in HCC progression. METHODS: Flow cytometry was used to identify BMSCs isolated from BALB/c mice. The expressions of biomarkers and apoptosis rate of cancer stem cells (CSCs) enriched from Huh7 cells were also measured. The osteogenic differentiation and adipogenic differentiation ability of isolated BMSCs was determined by oil red O staining and Alizarin Red Staining. CSCs were used to establish the orthotopic HCC model. Histological changes in the liver tissues were examined by hematoxylin-eosin (H&E) staining and Van Gieson (VG) staining. The cell apoptotic rate in the cancer tissues was detected by TUNEL staining. The cell proliferation antigen Ki67 in the cancer tissues were detected by immunofluorescence assay and PCR, respectively. The levels of CSCs cellular surface markers (CD24, CD133 and EpCAM) and Wnt/ß-catenin signal pathway related proteins were detected by PCR and western blot. RESULTS: Treatment of BJJP or BMSCs both improved the morphology induced by HCC and suppressed the differentiation ability of CSCs, as evidenced by down-regulated expressions of CD24, CD133, EpCAM and Ki67. The protective effect of BJJP or BMSCs in cancer tissues can be enhanced by the combination of BJJP and BMSCs. In addition to that, BJJP or BMSCs alone was found to increase the expression of miR-140 and promote cell apoptosis in CSCs, while down-regulation of miR-140 partially reversed the protective effect of BMSCs or BJJP + BMSCs on cancer tissues. BJJP + BMSCs treatment together also can down-regulate the expressions of Wnt3a and ß-catenin. CONCLUSIONS: These results proved the inhibitory role of BJJP + BMSCs in HCC development through regulating miR-140 and Wnt/ß-catenin signal pathway.

The effects of Shexiang Baoxin pills combined with intracoronary injection of nicorandil on myocardial blood perfusion and short-term prognosis for STEMI patients after PPCI / 药学实践杂志

Objective To observe the effects of Shexiang Baoxin pill combined with intracoronary injection of nicorandil on myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Methods 151 patients with acute myocardial infarction after PPCI were enrolled in this study. Those patients were admitted to our hospital during January 2017 to January 2018. According to the numerical randomization method, 51 patients were selected as routine treatment group (group A), 50 patients with intracoronary injection of nicorandil (group B) and 50 patients received intracoronary injection of nicorandil plus oral Shexiang Baoxin pills (group C). Intra-operative corrected TIMI frame count (cTFC), postoperative TIMI grade 3 blood flow ratio, 2-hour ECG ST segment fallback >50% index, the incidence of major adverse cardiovascular events (MACE) during hospitalization and the incidence of angina and MACE within 3 months after surgery were evaluated. Results cTFC, 2 hours postoperative ECG ST segment fall >50% index in group B and C were better than group A (P<0.05). The results from group C were better than group B. Group C exhibited better results than group B and C in post-operative angina pectoris 3 months after surgery (P<0.05). Conclusion Shexiang Baoxin pills combined with intra-coronary injection of nicorandil can improve myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

Characteristics of clinical symptoms in multiple system atrophy patients with white matter hyperintensities / 中风与神经疾病杂志

@#Objective　To explore the relationship between white matter hyperintensity (WMH) and clinical symptoms in patients with multiple system atrophy (MSA),and the risk factors of WMH in patients with MSA.Methods　A total of 88 patients with MSA were included.The periventricular white matter hyperintensity (PVH) and deep white matter hyperintensity (DWMH) were assessed according to MRI and the Fazekas scale.The patients were divided into three groups according to the severity of PVH or DWMH.The baseline data,motor symptoms,cognitive function,urinary symptoms and constipation were compared among different groups.Logistic regression was used to analyze the risk factors of WMH in patients with MSA.Results　A significant difference was detected in age at admission,age at onset,hypertension,coronary heart disease,UMSARS total score,UMSARS Ⅱ score and UMSARS Ⅳ score between different PVH grades.A significant difference was detected in age at admission,age at onset,hypertension,coronary heart disease,UMSARS total score,UMSARS Ⅰ score,UMSARS Ⅱ score and UMSARSⅣ score between different DWMH grades.Logistic regression analysis showed that age at admission and hypertension were independent risk factors for WMH in patients with MSA.Conclusion　WMH is present in some MSA patients and related to motor symptoms and severity of the disease.Age and hypertension influence the occurrence of WMH.

Ultrapotent SARS-CoV-2 neutralizing antibodies with protective efficacy against newly emerged mutational variants

Accumulating mutations in the SARS-CoV-2 Spike (S) protein can increase the possibility of immune escape, challenging the present COVID-19 prophylaxis and clinical interventions. Here, 3 receptor binding domain (RBD) specific monoclonal antibodies (mAbs), 58G6, 510A5 and 13G9, with high neutralizing potency blocking authentic SARS-CoV-2 virus displayed remarkable efficacy against authentic B.1.351 virus. Each of these 3 mAbs in combination with one neutralizing Ab recognizing non-competing epitope exhibited synergistic effect against authentic SARS-CoV-2 virus. Surprisingly, structural analysis revealed that 58G6 and 13G9, encoded by the IGHV1-58 and the IGKV3-20 germline genes, both recognized the steric region S470-495 on the RBD, overlapping the E484K mutation presented in B.1.351. Also, 58G6 directly bound to another region S450-458 in the RBD. Significantly, 58G6 and 510A5 both demonstrated prophylactic efficacy against authentic SARS-CoV-2 and B.1.351 viruses in the transgenic mice expressing human ACE2 (hACE2), protecting weight loss and reducing virus loads. These 2 ultrapotent neutralizing Abs can be promising candidates to fulfill the urgent needs for the prolonged COVID-19 pandemic.