Associations of exposure to bisphenol-A or parabens with markers of liver injury/function among US adults in NHANES 2011-2016.

BACKGROUND: Bisphenol-A (BPA) and parabens are common endocrine-disrupting compounds (EDCs) that are used extensively in consumer products worldwide and are widely found in the environment. OBJECTIVE: The purpose of this study was to comprehensively explore the correlations between urinary BPA/parabens levels and liver injury/function markers. METHODS: In this cross-sectional study, we used National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2016. The exposure variables were urinary BPA and four urinary parabens [methylparaben (MPB), ethylparaben (EPB), propylparaben (PPB), and butylparaben (BPB)], while the outcome variables were indicators of liver function/injury [alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ ALT, albumin (ALB), total protein (TP), total bilirubin (TBIL), alkaline phosphatase (ALP), and the fibrosis-4 index (FIB-4)]. Multiple linear regression and weighted quantile sum (WQS) regression analyses were applied to explore the relationships between the individual/combined exposure variables and the liver injury/function indicators, respectively. Furthermore, stratified analysis was employed to detect the associations influenced by age and sex. RESULTS: A total of 2,179 adults were eligible for the present analysis. Multivariate linear regression analysis revealed positive associations of EPB with AST, ALT, TP, and FIB-4 scores and negative associations of BPA with TP and ALB. The effects of urinary parabens on adverse outcomes in the liver (AST and ALT) were significant in the female and middle-aged subgroups. In addition, the WQS analysis revealed that the mixture of four compounds was negatively associated with ALB. BPA had the greatest effect on the serum ALB concentration (weight = 0.688). IMPACT: Our present study provided novel evidence of significant associations between BPA or certain parabens and numerous markers of liver injury/function indicators. We found that higher urinary BPA concentrations were associated with worse liver function. Exposure to high EPB/PPB ratios was significantly associated with biomarkers of liver injury.

The Alarming Situation of Highly Pathogenic Avian Influenza Viruses in 2019-2023.

Avian influenza viruses (AIVs) have the potential to cause severe illness in wild birds, domestic poultry, and humans. The ongoing circulation of highly pathogenic avian influenza viruses (HPAIVs) has presented significant challenges to global poultry industry and public health in recent years. This study aimed to elucidate the circulation of HPAIVs during 2019 to 2023. Specifically, we assess the alarming global spread and continuous evolution of HPAIVs. Moreover, we discuss their transmission and prevention strategies to provide valuable references for future prevention and control measures against AIVs.

Emergence of chimeralike oscillation modes in excitable complex networks with preferentially cutting-rewiring operation.

In this paper, the preferentially cutting-rewiring operation (PCRO) consisting of the cutting procedure and the rewiring procedure is proposed and is applied on an excitable Erdös-Rényi random network (EERRN), by which the structure of the initially homogeneous network changes dramatically, and lots of common leaves (CLs) are formed between the two hubs. Subsequently, besides the single-mode oscillations that can be usually observed in homogeneous excitable systems, a new kind of multi-mode oscillations composed of synchronous and asynchronous parts can self-organize to emerge, which are similar to the coherent and incoherent clusters in traditional chimera states and are consequently named as the chimeralike oscillation modes (CLOMs). Importantly, by utilizing the dominant phase-advanced driving method, both the mechanisms for the formation and the emergence of CLOMs in EERRNs with PCRO are well explained, among which the CL is exposed to play a key role in forming the CLOMs. Furthermore, the PCRO-induced CLOM phenomena can also be observed in other paradigmatic network models or with other paradigmatic excitable dynamics, which definitely confirms that the PCRO is an universal method in inducing the CLOMs in excitable complex networks. Our contributions may shed lights on a new perspective of the emergence of CLOMs in complex systems and would have great impacts in related fields.

Analyzing the methanation thermodynamic feasibility of steel plant byproduct gases.

To improve the utilization of byproduct gases in the steel plant, the coke oven gas (COG) methanation combined with blast furnace gas (BFG) and basic oxygen furnace gas (BOFG) was proposed in viewpoint of economy and environment. The optimization mathematics model based on Gibbs free energy minimization was established to predict the thermodynamic feasibility of the proposed methanation. To solve the proposed model, the convenient method was implemented by using the Gibbs module in Aspen Plus software. Effects of operation parameters on the methanation performance were revealed to identify the optimized conditions. To reduce the solid carbon concentration, it was found that the optimized conditions of temperature, pressure and stoichiometric number were 650 °C, 30 bar and 3.0, respectively. Moreover, it was discovered that 10 mol% of BFG or BOFG could be mixed into COG to obtain the maximum methane yield. In addition, it was testified that there were the good agreements between calculated results and industrial and published data, which indicated that the proposed methanation was thermodynamically feasible. Therefore, the simple and easy method was developed to evaluate the methanation operating conditions from the aspect of thermodynamic equilibrium, which provided the basic process conditions of byproduct gases methanation to enhance the steel plant efficiency and reduce carbon emissions.

Nanoplastic propels diet-induced NAFL to NASH via ER-mitochondrial tether-controlled redox switch.

Nonalcoholic steatohepatitis (NASH) is multifactorial that lifestyle, genetic, and environmental factors contribute to its onset and progression, thereby posing a challenge for therapeutic intervention. Nanoplastic (NP) is emerged as a novel environmental metabolism disruptor but the etiopathogenesis remains largely unknown. In this study, C57BL/6 J mice were fed with normal chow diet (NCD) and high-fat diet (HFD) containing 70 nm polystyrene microspheres (NP). We found that dietary-derived NP adsorbed proteins and agglomerated during the in vivo transportation, enabling diet-induced hepatic steatosis to NASH. Mechanistically, NP promoted liver steatosis by upregulating Fatp2. Furthermore, NP stabilized the Ip3r1, and facilitated ER-mitochondria contacts (MAMs) assembly in the hepatocytes, resulting in mitochondrial Ca2+ overload and redox imbalance. The redox-sensitive Nrf2 was decreased in the liver of NP-exposed mice, which positively regulated miR26a via direct binding to its promoter region [-970 bp to -847 bp and -318 bp to -176 bp]. NP decreased miR26a simultaneously upregulated 10 genes involved in MAMs formation, lipid uptake, inflammation, and fibrosis. Moreover, miR26a inhibition elevated MAMs-tether Vdac1, which promoted the nucleus translocation of NF-κB P65 and Keap1 and functionally inactivated Nrf2, leading to a vicious cycle. Hepatocyte-specific overexpressing miR26a effectively restored ER-mitochondria miscommunication and ameliorated NASH phenotype in NP-exposed and Keap1-overexpressed mice on HFD. The hepatic MAM-tethers/Nrf2/miR26a feedback loop is an essential metabolic switch from simple steatosis to NASH and a promising therapeutic target for oxidative stress-associated liver damage and NASH.

Effect of Liuwei Dihuang Tang on ferroptosis pathway in retinal tissue of aging model rats / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the effects of Liuwei Dihuang Tang on the expression levels of ferritin, recombinant solute carrier family 7 member 11(SLC7A11), glutathione(GSH), and glutathione peroxidase 4(GPX4)in retinal of aging model rats.METHODS: A total of 45 SD rats were randomly divided into a blank group, a model group, and a traditional Chinese medicine(TCM)group, with 15 rats in each group. The blank group was intraperitoneally injected with physiological saline, while the model group and TCM group were intraperitoneally injected with D-galactose [500 mg/(kg·d)]. At the same time, the TCM group was orally administered with Liuwei Dihuang Tang [6.75 g/(kg·d)], while the blank group and model group were orally administered with equal volume of physiological saline for 8 consecutive wk. The expression levels of ferritin, SLC7A11, GSH, and GPX4 in the retinal tissues of rats in each group were detected.RESULTS: The expression of ferritin in the retinal tissue of the model group was increased compared to the blank group(P<0.05), while the expression of GSH, SLC7A11, and GPX4 was reduced(P<0.05). The expression of GSH, SLC7A11, and GPX4 in the retina tissue of rats in the TCM group was higher than that in the model group(P<0.05).CONCLUSIONS: Liuwei Dihuang Tang may exert a delaying effect on retinal aging by regulating the ferroptosis pathway.

Activation of cGAS-STING signaling pathway promotes liver fibrosis and hepatic sinusoidal microthrombosis.

Inflammation plays an essential role in the development liver fibrosis.The Cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS) is a central cytoplasmic DNA sensor which can recognize cytoplasmic DNA, known to trigger stimulator of interferon genes (STING) and downstream proinflammatory factors. Here, we investigated the role of cGAS-STING signaling pathway in the pathogenesis of liver fibrosis.Differentially expressed genes (DEGs) in human liver tissue were identified using RNA-Seq analysis. As models of liver fibrosis, chronic Carbon tetrachloride (CCl4) exposure were applied in cGAS-knockout mice. LX-2 cells were co-cultured with human liver sinusoidal endothelial cells (LSECs) to explore the underlying mechanisms of hepatic sinusoidal microthrombosis in an inflammatory microenvironment. The endoscopic ultrasound-guided portal vein pressure gradient (EUS-PPG) method was used to analyze the associations between hepatic sinusoidal microthrombosis and PPG in patients with liver fibrosis and portal hypertension (PTH). The RNA-seq analysis results showed that DEGs were enriched in inflammation and endothelial cell activation. The upregulation of the cGAS-STING signaling exacerbated liver fibrosis and intrahepatic inflammation. It also exacerbated LSECs impairment and increased the contribution of hepatic sinusoidal microthrombosis to liver fibrosis in vivo and in vitro. Prothrombotic mediators and proinflammatory factors were associated with PPG in patients with liver fibrosis and portal hypertension. Therefore, activating cGAS-STING signaling pathway promotes liver fibrosis and hepatic sinusoidal microthrombosis, which may lead to increased portal vein pressure.

The ubiquitin-binding protein MdRAD23D1 mediates drought response by regulating degradation of the proline-rich protein MdPRP6 in apple (Malus domestica).

RAD23 (RADIATION SENSITIVE23) proteins are a group of UBL-UBA (ubiquitin-like-ubiquitin-associated) proteins that shuttle ubiquitylated proteins to the 26S proteasome for breakdown. Drought stress is a major environmental constraint that limits plant growth and production, but whether RAD23 proteins are involved in this process is unclear. Here, we demonstrated that a shuttle protein, MdRAD23D1, mediated drought response in apple plants (Malus domestica). MdRAD23D1 levels increased under drought stress, and its suppression resulted in decreased stress tolerance in apple plants. Through in vitro and in vivo assays, we demonstrated that MdRAD23D1 interacted with a proline-rich protein MdPRP6, resulting in the degradation of MdPRP6 by the 26S proteasome. And MdRAD23D1 accelerated the degradation of MdPRP6 under drought stress. Suppression of MdPRP6 resulted in enhanced drought tolerance in apple plants, mainly because the free proline accumulation is changed. And the free proline is also involved in MdRAD23D1-mediated drought response. Taken together, these findings demonstrated that MdRAD23D1 and MdPRP6 oppositely regulated drought response. MdRAD23D1 levels increased under drought, accelerating the degradation of MdPRP6. MdPRP6 negatively regulated drought response, probably by regulating proline accumulation. Thus, "MdRAD23D1-MdPRP6" conferred drought stress tolerance in apple plants.

Tumor-associated macrophages-derived exo-let-7a promotes osteosarcoma metastasis via targeting C15orf41 in osteosarcoma.

BACKGROUND: Osteosarcoma (OS) immune environment is complexed and the immune factors-related to OS progression need to be explored. Tumor-associated macrophages (TAMs) are regarded as immune suppressive and tumor-promoting cells. However, the underlying mechanisms through which TAMs function are still fragmentary. Here, we aim to explore the underlying mechanisms by which TAMs regulate OS progression. METHODS: TAMs from OS tissues were isolated by flow cytometry. Exosomes derived from TAMs were separated using ultracentrifugation and western blotting. Transmission electron microscopy (TEM), and flow cytometry were constructed to characterize TAMs-derived exosomes. Additionally, the differential MicroRNAs (miRNAs) and genes were detected through RNA sequencing, and further validated using real-time PCR (RT-PCR). OS cell metastasis ability was assessed using transwell invasion and scratch wound healing assays. MiRNAs mimic and lentiviral vectors were utilized to explore the effects on OS progression. RESULTS: Exosome secreted by TAMs accelerated the OS metastasis. Let-7a level was upregulated in TAMs derived exosomes, which downregulated C15orf41 by targeting 3'-untranslated region (UTR). Furthermore, overexpressing let-7a enhanced invasion and migration by blocking the transcription of C15orf41. In consistent, up-regulating let-7a promoted OS progression and made the prognosis to be worse, which can be reversed by C15orf41 overexpression. CONCLUSION: This study highlighted the critical role of TAMs-derived exosomes in OS progression and explored the potential value of the let-7a/C15orf41 axis as an indicator or target for OS.

The Prognostic Value of a lncRNA Risk Model Consists of 9 m6A Regulator-Related lncRNAs in Hepatocellular Carcinoma (HCC).

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver. Although the RNA modification N6-methyladenine (m6A) has been reported to be involved in HCC carcinogenesis, early diagnostic markers and promising personalized therapeutic targets are still lacking. In this study, we identified that 19 m6A regulators and 34 co-expressed lncRNAs were significantly upregulated in HCC samples; based on these factors, we established a prognostic signal of HCC associated with 9 lncRNAs and 19 m6A regulators using LASSO Cox regression analysis. Kaplan-Meier survival estimate revealed correlations between the risk scores and patients' OS in the training and validation dataset. The ROC curve demonstrated that the risk score-based curve has satisfactory prediction efficiency for both training and validation datasets. Multivariate Cox's proportional hazard regression analysis indicated that the risk score was an independent risk factor within the training and validation dataset. In addition, the risk score could distinguish HCC patients from normal non-cancerous samples and HCC samples of different pathological grades. Eventually, 232 mRNAs were co-expressed with these 9 lncRNAs according to GSE101685 and GSE112790; these mRNAs were enriched in cell cycle and cell metabolic activities, drug metabolism, liver disease-related pathways, and some important cancer related pathways such as p53, MAPK, Wnt, RAS and so forth. The expression of the 9 lncRNAs was significantly higher in HCC samples than that in the neighboring non-cancerous samples. Altogether, by using the Consensus Clustering, PCA, ESTIMATE algorithm, LASSO regression model, Kaplan-Meier survival assessment, ROC curve analysis, and multivariate Cox's proportional hazard regression model analysis, we established a prognostic marker consisting of 9 m6A regulator-related lncRNAs that markers may have prognostic and diagnostic potential for HCC.

Comparation of resting brain regional homogeneity between patients with major depressive disorder and their healthy siblings / 中华行为医学与脑科学杂志

Objective:To explore differences of resting brain regional homogeneity (ReHo) between patients with major depressive disorder (MDD) and their siblings.Methods:From January to December 2013, the resting-state functional magnetic resonance imaging (fMRI) data of 87 patients with MDD and 21 healthy siblings were collected.DPABI v5.1 software was used to preprocess the resting-state fMRI data, and ReHo maps of each subject was obtained. A two-sample t-test was used to compare differences between the patients with MDD and their siblings in ReHo values throughout the brain. ReHo values within the significant brain regions were extracted out, and used to calculate Spearman correlation with the total score of 17-items Hamilton depression rating scale(HAMD-17) in the patients with MDD and their siblings respectively.The software of SPSS 20.0 was used for statistical analysis. Results:The patients with MDD exhibited lower ReHo values in the precuneus extending to the posterior cingulate cortex (PCu/PCC) compared with their siblings (cluster-size=126 voxel, cluster-level PFDR=0.033; MNI: x=-4, y=-58, z=38, t=4.30). ReHo values of the PCu/PCC in patient with MDD were positively correlated with the severity of depressive symptoms ( r=0.255, P=0.021). Conclusion:Compared with the siblings, local brain activity of the PCu/PCC in the patients with MDD was decreased, and related to the severity of depressive symptoms. It is helpful to further reveal the intrinsic neural mechanism of MDD.

Application of "group-based" TA guidance model in the construction of homogenized clinical skill training system / 中华医学教育探索杂志

Objective:To evaluate the application effect of the "group-based" teaching assistant (TA) guidance model in homogenized clinical skill training.Methods:A pilot study was conducted on the cardiopulmonary resuscitation training course, and 32 students majoring in clinical integrative Chinese and Western medicine (five-year program) who were admitted to Shanghai University of Traditional Chinese Medicine in 2018 were randomly divided into control group ( n = 16) and TA group ( n = 16). The control group received traditional teaching methods, and the TA group was further divided into subgroups A, B, C, and D, with four graduate TAs providing group-based teaching. The groups were compared in terms of their satisfaction and test scores. SPSS 25.0 was used for t-test and analysis of variance. Results:The satisfaction survey showed that compared with the control group, the TA group had significantly higher degree of satisfaction with the increased practical opportunities, clinical skill practical ability, learning effect, and overall satisfaction. The immediate test showed that there was no significant difference in test score between the TA group (85.19±2.93) points and the control group (82.75±4.52) points. The test 30 days later showed that the TA group (83.50±5.13) points had a significantly higher test score than the control group (74.68±3.87) points, and the control group had a significantly lower test score than that in the immediate test ( P <0.001); however, there was no significant difference in the TA group's score between the immediate test and the test 30 days later. Conclusion:The "group-based" TA guidance model has a good effect in homogenized clinical skill training, and has a stable long-term effect, with high student satisfaction.

Reform and exploration of teaching methods for eight-year program medical students' early exposure to clinical practice / 中华医学教育探索杂志

Objective:To explore the effect of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students.Methods:Experimental control method was used in this study. A total of 120 eight-year program medical students in the third year of Batch 2014 to 2016 from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected as the research objects. The students of each grade were randomly selected by computer and divided into experimental group and control group, with 20 students in each group. Before early clinical exposure, the experimental group received 16 class hours of early clinical clerkship training, while the control group did not receive early clinical clerkship training. After the early clinical exposure, the clinical diagnosis and treatment ability of the two groups of students was compared. SPSS 24.0 software was used for t test. Results:The scores of medical history inquiry of experimental group and control group were [(17.45±1.96) points and (15.95±1.93) points; (18.30±1.03) points and (16.75±1.86) points; (17.95±1.36) points and (16.40±1.60) points, respectively]. The physical examination scores were [(17.75±1.65) points and (16.05±1.64) points; (17.85±1.18) points and (16.80±1.47) points; (18.25±1.16) points and (16.85±1.63) points, respectively]. The clinical judgment scores were [(18.15±1.42) points and (16.35±2.41) points; (18.20±1.24) points and (16.65±1.53) points; (18.35±1.35) points and (16.25±1.83) points, respectively]. Diagnosis and treatment scheme scores were [(17.15±1.57) points and (14.55±2.56) points; (17.30±1.42) points and (15.90±1.48) points; (17.80±1.06) points and (16.35±1.87) points, respectively]. The scores of communication skills were [(17.95±1.15) points and (17.00±1.19) points; (18.55±0.83) points and (17.45±1.50) points; (18.45±1.00) points and (17.45±1.23) points, respectively], with statistically significant differences (all P<0.05). Conclusion:The application of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students can improve the quality of students' clerkship.

The distribution of total IgE in patients with allergic and their correlation with allergens and peripheral blood eosinophils / 中国医师进修杂志

Objective:To investigate the distribution of the total IgE, and their relationship with allergens and peripheral blood eosinophils in patients with allergic.Methods:The cross-sectional study was used, and 1 417 patients with allergic in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were selected. The serum total IgE was detected by enzyme-linked immunosorbent assay (ELISA), and the total IgE>60 kU/L was increased. The blood routine was detected by automated hematology analyzer. Using inhalant allergens and food allergens specific IgE antibody detection kits, the serum or plasma allergen-specific IgE antibodies were detected by Oumeng imprinting in vitro semi quantitative method.Results:Among 1 417 patients with allergic, elevated total IgE was in 617 cases (43.54%), normal total IgE in 800 cases (56.46%); 749 cases (52.86%) were allergic, the most common inhalation allergen was dust mite (38.72%, 218/563), and the most common food allergen was peanut (24.01%, 109/454). The rate of normal total IgE, eosinophils and non allergic was 19.20% (272/1 417). The male proportion, ratio of eosinophils, eosinophils count, total index of inhaled allergens, total index of non inhaled allergens, number of positive allergens, total positive index and average positive index in patients with elevated total IgE were significantly higher than those in patient with normal total IgE, the age was significantly lower than that in patients with normal total IgE, and there were statistical differences ( P<0.01). The total IgE<60 kU/L (normal total IgE) was in 800 cases, total IgE from 60 to 499 kU/L (mild elevation of total IgE) in 487 cases, total IgE from 500 to 999 kU/L (moderate elevation of total IgE) in 78 cases, total IgE≥1 000 kU/L (severe elevation of total IgE) in 52 cases. The male proportion and age in patients with sever elevation of total IgE and moderate elevation of total IgE were significantly higher than those in patients with mild elevation of total IgE and normal total IgE, and there were statistical differences ( P<0.05). The compound allergy rate in patients with severe elevation of total IgE was significantly higher than that in patients with moderate elevation of total IgE, mild elevation of total IgE and normal total IgE: 73.08% (38/52) vs. 60.26% (47/78), 38.40% (187/487), 17.00% (136/800), and there was statistical difference ( P<0.05). The ratio of eosinophils, eosinophils count and number of positive allergens increased with increasing total IgE level, and there was statistical difference ( P<0.05). The number of dermatophagoides/dermatophagoides culinae allergic in patients with moderate elevation of total IgE was significantly more than that in patients with sever elevation of total IgE, mild elevation of total IgE and normal total IgE, and there was statistical difference ( P<0.05). Conclusions:Allergic disease may show a normal level of total IgE. Males are more likely to be troubled with high level of IgE. Patients with total IgE ≥1 000 kU/L should be alert to the possibility of poly-sensitization. Total IgE was no longer correlated with individual allergy severity in patients with total IgE≥500 kU/L.

Effects of extrafine-particle versus fine-particle inhaled corticosteroids combined with formoterol on large and small airway function in patients with bronchial asthma / 中国医师进修杂志

Objective:To compare the effects of extrafine-particle versus fine-particle inhaled corticosteroids (ICS) combined with formoterol on clinical symptoms, airway inflammation and airway function in patients with bronchial asthma (referred to as asthma).Methods:This prospective, randomized controlled clinical trial enrolled a total of 111 patients diagnose of asthma and cough variant asthma with forced expired volume in one second (FEV 1) percentage of predicted (FEV 1%pred) >70% in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from November 2020 to October 2022. The patients were divided into observation group (57 cases) and control group (54 cases) by random digits table method. The patients in observation group were treated with extrafine-particle ICS combined with formoterol, while the patients in control group were treated with fine-particle ICS combined with formoterol. Both groups were treated for 4 weeks. During treatment 10 patients lost follow up and a total of 101 patients complete the final study: 52 cases in observation group and 49 cases in control group. At baseline, the asthma control test (ACT) score was calculated to evaluate the clinical symptoms, fractional exhaled nitric oxide (FeNO) was applied to evaluate the airway inflammatory level, and the pulmonary function test and bronchodilation test were perfromed. The symptom relief time was record. After treatment, all of the parameters were reevaluated. Results:The FEV 1, peak expiratory flow (PEF), forced expired flow at 50% of forced vital capacity (MEF 50), forced expired flow at 25% of forced vital capacity (MEF 25), maximal expiratory flow-volume curve (MMEF) and ACT score after treatment in both groups were significantly improved compared to baseline, and there were statistical differences ( P<0.01). The improvement of ACT score in observation group was significantly higher than that in control group: (5.90 ± 2.25) scores vs. (4.10 ± 2.18) scores, and there was statistical difference ( P<0.01); there were no statistical differences in the symptom relief time and the improvement rates of FEV 1, PEF, MEF 50, MEF 25, MMEF between the two groups ( P>0.05). Further subgroup analysis was performed on 78 patients with small airway dysfunction, 39 patients were treated with extrafine-particle ICS combined with formoterol (observation subgroup), and 39 patients were treated with fine-particle ICS combined with formoterol (control subgroup). The improvement of ACT score in observation subgroup was significantly higher than that in control subgroup: (6.05 ± 2.22) scores vs. (3.95 ± 2.19) scores, and there was statistical difference ( P<0.01); there were no statistical differences in the symptom relief time and the improvement rates of FEV 1, PEF, MEF 50, MEF 25, MMEF between the two subgroups ( P>0.05). Spearman correlation analysis result showed that the improvement rates of MEF 50, MEF 25 and MMEF after treatment were positive correlated with baseline bronchodilator responses of FEV 1, FEV 1/FVC, MEF 50, MEF 25, MMEF ( r = 0.22 to 0.58, P<0.05), but not with baseline bronchodilator responses of PEF ( P>0.05). In terms of safety, neither of the two treatments had major adverse reactions that affect treatment. Conclusions:For asthma patients with baseline FEV 1%pred>70%, the extrafine-particle ICS combined with formoterol has more significantly improved of clinical symptoms compared to fine-particle ICS combined with formoterol, and potentially with better safety profile. The improvement ratio of small airway function parameters in baseline bronchodilation test could potentially predict treatment response.

Treatment outcome of laparoscopic partial nephrectomy in patients with renal tumors of moderate to high complexity / 北京大学学报(医学版)

OBJECTIVE@#To investigate the treatment outcome of laparoscopic partial nephrectomy in the patients with renal tumors of moderate to high complexity (R.E.N.A.L. score 7-10).@*METHODS@#In the study, 186 patients with a renal score of 7-10 renal tumors who underwent laparoscopic partial nephrectomy in Peking University Third Hospital from February 2016 to April 2021 were selected. Laparoscopic partial nephrectomy was performed after examination. The patients were followed-up, and their postoperative hemoglobin, creatinine, complications, and length of hospital stay recorded. The data were represented by mean±standard deviation or median (range).@*RESULTS@#There were 128 males and 58 females in this group, aged (54.6±12.8) years, with body mass index of (25.4 ± 3.4) kg/m2; The tumors were located in 95 cases on the left and 91 cases on the right, with maximum diameter of (3.1±1.2) cm. The patient's preoperative hemoglobin was (142.9±15.8) g/L, and blood creatinine was 78 μmol/L (47-149 μmol/L). According to preoperative CT images, the R.E.N.A.L. score was 7 points for 43 cases, 8 points for 67 cases, 9 points for 53 cases, and 10 points for 23 cases. All the ope-rations were successfully completed, with 12 cases converted to open surgery. The operation time was 150 minutes (69-403 minutes), the warm ischemic time was 25 minutes (3-60 minutes), and the blood loss was 30 mL (5-1 500 mL). There were 9 cases of blood transfusions, with a transfusion volume of 800 mL (200-1 200 mL). Postoperative hemoglobin was (126.2±17.0) g/L. The preoperative crea-tinine was 78 μmol/L (47-149 μmol/L), the postoperative creatinine was 83.5 μmol/L (35-236 μmol/L), the hospital stay was 6 days (3-26 days), and surgical results achieved "the trifecta" in 87 cases (46.8%). In the study, 167 cases were followed up for 12 months (1-62 months), including 1 case with recurrence and metastasis, 4 cases with metastasis, and 2 cases with other tumors (1 case died).@*CONCLUSION@#Laparoscopic partial nephrectomy is safe and effective in the treatment of renal tumors with R.E.N.A.L. score of 7-10. Based on the complexity of the tumor, with the increase of difficulty, the warm ischemia time and operation time tend to increase gradually, while "the trifecta" rate gradually decreases. The complications of this operation are less, and the purpose of preserving renal function to the greatest extent is achieved.

Combination of acupuncture and medication for dry eye complicated with computer vision syndrome: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of acupuncture, Chinese medication and combination of acupuncture and medication in the treatment of dry eye complicated with computer vision syndrome (CVS).@*METHODS@#A total of 152 patients with dry eye complicated with CVS were randomly divided into an acupuncture-medication group (38 cases, 1 case was removed), an acupuncture group (38 cases, 1 case dropped off), a Chinese medication group (38 cases, 1 case was removed), and a western medication group (38 cases, 1 case dropped off). In the western medication group, sodium hyaluronate eye drop combined with esculin and digitalis glycosides eye drop were used. In the acupuncture group, acupuncture was applied at bilateral Taiyang (EX-HN 5)， Cuanzhu (BL 2), Fengchi (GB 20), Qimen (LR 14) , and Hegu (LI 4) etc., once a day. In the Chinese medication group, Yiqi Congming decoction formula ganule was given orally, one dose a day. In the acupuncture-medication group, acupuncture combined with Yiqi Congming decoction formula granule were used. All groups were treated for 14 d. The non-invasive first tear film break-up time (NIBUT f), non-invasive average tear film break-up time (NIBUT av), tear meniscus height (TMH), ocular surface disease index (OSDI) score, and CVS symptom score were compared between the patients of each group before and after treatment.@*RESULTS@#After treatment, the NIBUT f, NIBUT av, and TMH were increased compared with those before treatment in the patients of the 4 groups (P<0.01); the NIBUT f and NIBUT av in the acupuncture-medication group and the acupuncture group were higher than those in the Chinese medication group and the western medication group (P<0.05), and the TMH in the acupuncture-medication group and the Chinese medication group were higher than those in the acupuncture group and the western medication group (P<0.05). After treatment, the OSDI scores, the various scores and total scores of CVS (except for head symptom score in the western medication group) were decreased compared with those before treatment in the patients of the 4 groups (P<0.01). The OSDI score, total score, eye symptom score, and body symptom score of CVS in the acupuncture-medication group were lower than those in the acupuncture group, the Chinese medication group, and the western medication group (P<0.01, P<0.05), the head symptom score of the acupuncture-medication group was lower than that in the western medication group (P<0.05), and the CVS physical symptom scores and mental cognitive symptom scores of the acupuncture-medication group and the acupuncture group were lower than those in the Chinese medication group and the western medication group (P<0.05).@*CONCLUSION@#Acupuncture has advantages in improving NIBUT f, NIBUT av, and CVS physical symptoms and cognitive symptoms, and the Chinese medication has advantage in improving TMH. The combination of acupuncture and Chinese medication has better effects compared with monotherapy.

Analysis on the current situation of clinical blood fees exemption for blood donors and their family members in Henan / 中国输血杂志

【Objective】 To analyze the current situation of direct exemption of clinical blood fess for voluntary blood donors and their family members in Henan Province, in order to improve and fully implement the policy. 【Methods】 According to the policy on blood fees exemption issued by China and Henan Province in 2019,the data of hospitals in 18 prefecture-level cities in Henan from 2020 to 2021 were continuously collected from the system of clinical blood fees exemption,including the way of exemption,the number of people (times) of exemption,exemption amount, the proportion of blood fees exemption and the total exemption rate. The experience gained in the past two years after the implementation of the policy was summarized,and the existing problems and causes were analyzed. 【Results】 The rates of direct exemption of blood fees in Henan Province in 2020 and 2021 were 34.53% (8 709/25 221) and 71.68%(23 587/32 906) (P<0.05) ,respectively. In 2021, the direct exemption rate of blood fees in 18 cities was 6.20% (83/1 370) to 88.50% (1 332/1 505) [ (47.35±41.15)%],and increased month by month from 43.19% (1 183/2 507) in January to 83.15% (2 097/2 522) in August, then remained stable at a similar level to August from September to December, with 83.43% (2 744/3 289) in December as the highest for the year. 【Conclusion】 The implementation of the policy of blood fees exemption showed significant effectiveness, which has effectively promoted the development of voluntary blood donation in Henan. However, there is still room for improving the policy in some cities, which is expected to further increase the direct exemption rate of the city and the whole province.

Advances in taste masking technology based on preparation technology / 药学学报

Good medicine tastes bitter, but it is often difficult to swallow because the drug is bitter and astringent, so that the compliance of patients with medication is poor. However, the use of taste masking technology can better improve this situation. Appropriate and effective taste masking technology can improve the drug compliance of patients, especially children, it can also improve the curative effect and the clinical value of drugs. Herein, we summarize the latest research progress of taste masking technology, and summarize the traditional taste masking technology from the aspects of action mechanisms and application scopes. Finally, the novel and efficient taste masking technologies were presented.

Taste masking pharmaceutical excipients and their applications / 药学学报

The taste of drugs has an important impact on the compliance of patients, but most of the active drug ingredients have an uncomfortable taste, especially traditional Chinese medicine. Through a variety of pharmaceutical excipients with taste masking properties combined with corresponding technologies can improve the taste of drugs and the characteristics of other dosage forms, so as to improve patient compliance. Here, we mainly summarize the auxiliary materials used for taste masking, explain the mechanism of taste masking from the point of view of excipients and introduces related uses, so as to provide reference for further research on taste masking of pediatric preparations.