Danggui-Shaoyao San alleviates cognitive impairment via enhancing HIF-1α/EPO axis in vascular dementia rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Invigorating blood circulation to remove blood stasis is a primary strategy in TCM for treating vascular dementia (VaD). Danggui-Shaoyao San (DSS), as a traditional prescription for neuroprotective activity, has been proved to be effective in VaD treatment. However, its precise molecular mechanisms remain incompletely understood. AIM OF THE STUDY: The specific mechanism underlying the therapeutic effects of DSS on VaD was explored by employing network pharmacology as well as in vivo and in viro experiment validation. MATERIALS AND METHODS: We downloaded components of DSS from the BATMAN-TCM database for target prediction. The intersection between the components of DSS and targets, PPI network, as well as GO and KEGG enrichment analysis were then performed. Subsequently, the potential mechanism of DSS predicted by network pharmacology was assessed and validated through VaD rat model induced by 2VO operation and CoCl2-treated PC12 cells. Briefly, the DSS extract were first quantified by HPLC. Secondly, the effect of DSS on VaD was studied using MWM test, HE staining and TUNEL assay. Finally, the molecular mechanism of DSS against VaD was validated by Western blot and RT-QPCR experiments. RESULTS: Through network analysis, 137 active ingredients were obtained from DSS, and 67 potential targets associated with DSS and VaD were identified. GO and KEGG analysis indicated that the action of DSS on VaD primarily involves hypoxic terms and HIF-1 pathway. In vivo validation, cognitive impairment and neuron mortality were markedly ameliorated by DSS. Additionally, DSS significantly reduced the expression of proteins related to synaptic plasticity and neuron apoptosis including PSD-95, SYP, Caspase-3 and BCL-2. Mechanistically, we confirmed DSS positively modulated the expression of HIF-1α and its downstream proteins including EPO, p-EPOR, STAT5, EPOR, and AKT1 in the hippocampus of VaD rats as well as CoCl2-induced PC12 cells. HIF-1 inhibitor YC-1 significantly diminished the protection of DSS on CoCl2-induced PC12 cell damage, with decreased HIF-1α, EPO, EPOR expression. CONCLUSION: Our results initially demonstrated DSS could exert neuroprotective effects in VaD. The pharmacological mechanism of DSS may be related to its positive regulation on HIF-1α/EPO pathway.

A 1-year analysis from a natural history study in Chinese individuals with Duchenne muscular dystrophy.

Background: Duchenne muscular dystrophy (DMD) is a disabling and life-threatening, X-linked recessive disorder caused by mutations in dystrophin. Natural history studies can inform the disease characteristics of DMD, and data from these studies can be used to plan and design clinical trials and as external controls for long-term studies. We report 12-month results from the largest natural history study of individuals with DMD in China receiving standard of care treatment. Methods: This ongoing, multicentre, prospective, single-cohort study (ClinicalTrials.gov: NCT03760029) was conducted in Chinese male participants with DMD (ambulatory aged <6 years [Group 1; n = 99]; ambulatory aged ≥6 years [Group 2; n = 177], and non-ambulatory of any age [Group 3; n = 36]. The follow-up period is ≥24 months, with some participants followed for 30 months. The primary endpoint was time to clinical milestones due to DMD disease progression, and motor, pulmonary, and cardiac function. Secondary endpoints were quality of life (QoL) assessments. Findings: Mean (standard deviation [SD]) age at screening was 3.4 (1.2), 8.6 (2.0), 12.3 (2.7) and 7.4 (3.5) years in Groups 1, 2, 3 and total respectively. Mean (SD) North Star Ambulatory Assessment (NSAA) total score at baseline was 21.2 (5.8) in Group 1, 19.5 (8.3) in Group 2 and 20.0 (7.7) in ambulatory total. Overall, the time to clinical milestones due to DMD disease progression was consistent with previous findings, in which loss of ambulation occurred at 13 years. There was a trend towards a decline over 12 months in NSAA and timed motor function from age 6 years, with the greatest reductions observed thereafter. There were no consistent trends in measures of QoL, although participants of any age generally had poorer outcomes at Month 12 versus their domain scores at baseline. Interpretation: This study improves the understanding of DMD progression according to the current standards of care in the Chinese DMD population and may inform selected endpoints and patient populations in clinical trials. Funding: Pfizer Inc.

The structural and electronic properties of (001) surface of 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) with first-principles calculations.

CONTEXT: 1,3,5-triamino-2,4,6-trinitrobenzene (TATB) is a typical insensitive energetic material. It can be used in explosive formulations, such as PBX-9502 and LX-17-0. TATB is an intriguing and unusual explosive for another reason: it crystallizes into a wide array of planar hydrogen bonds, forming a graphite-like layered structure. Therefore, TATB is one of the important research objects, and its surface structure needs to be deeply understood. In this research work, the electronic and energetic properties of TATB (001) surface are explored. METHODS: In this paper, the structural, electronic, energetic properties and impact sensitivity of TATB (001) surface structure at 0 and -3 GPa along with x-axis were calculated in this study using the first-principles calculations. The calculations in this paper are performed in the CASTEP code, which is based on the density functional theory with the first-principles calculation method using the plan-wave pseudopotential approach. The exchange-correlation interaction was adopted by the generalized gradient approximation (GGA) with the Perdew-Burke-Ernzerhof (PBE) functional. The DFT-D method with the Grimme correction accurately models van der Waals interactions. To model the surface structures of TATB, the planar slab method was employed. We constructed TATB (001) periodic slabs including three layers with a 15-Å vacuum layer.

Association of body mass index with asthma occurrence and persistence in adolescents: A retrospective study of NHANES (2011-2018).

Objective: To investigate the association of body mass index (BMI) with asthma and analyze the risk factors of asthma persistence among overweight/obese adolescents and those with a high risk for obesity. Methods: In this cross-sectional study, adolescents aged 11-17 years with complete general information and asthma diagnoses were selected from the National Health and Nutrition Examination Survey database. For adolescents without self-reported asthma, we performed matching according to age and sex at a case-to-control ratio of 1:3. Logistic regression analysis was employed to identify independent predictors of asthma occurrence followed by constructing a nomogram and comparing its efficacy to independent factors in predicting asthma occurrence. Besides, associations of BMI with asthma occurrence and persistence were evaluated. Finally, we obtained risk factors for asthma persistence in overweight/obese individuals and those at a high risk for obesity. Results: Totally 753 adolescents with asthma and 2259 adolescents without asthma were included to analyze the occurrence of asthma. BMI and Hispanic Ethnicity were independent predictors of asthma occurrence and were included in nomogram construction. BMI had an efficiency comparable to that of the nomogram model in predicting asthma occurrence, which is superior to that of Hispanic Ethnicity. Of the 753 adolescents diagnosed with asthma, 464 were still diagnosed with asthma of at least a year's duration. Interestingly, BMI may have the ability to predict asthma persistence. Further, Hispanic Ethnicity and household income were significantly related to asthma occurrence among overweight/obese and high-risk obese individuals. Conclusions: High BMI could independently predict increased asthma occurrence. Additionally, BMI may play an essential role in predicting asthma persistence. This study may help improve the diagnosis and reduce the occurrence of asthma.

Peroxido-bridged chiral double-decker dysprosium macrocycles.

Lanthanide peroxides show high reactivity in oxidative coupling of methane (OCM). However, the number of isolated and structurally characterized molecular species remains relatively small. To the best of our knowledge, homochiral molecule-based lanthanide peroxides have not been reported. Herein, two pairs of side-on peroxido-bridged dinuclear hexaazamacrocyclic dysprosium enantiomers with formulas [Dy2(LES/R)2L2O2](BPh4)2·CH3OH·CH3CN (where LE is derived from the condensation reaction between (1S,2S)/(1R,2R)-1,2-diphenylethylenediamine and 2,6-diformylpyridine; HL = 2,6-diphenylphenol) (1/2) and [Dy2(LES/R)2Cl2O2](BPh4)2·2CH3CN (3/4) are specially designed and created with the help of hydrogen peroxide. The out-of-phase alternating-current magnetic susceptibility of 1/2 gives rise to frequency-dependent peaks between 6 and 32 K under a zero applied direct current (dc) field, while no peak at any temperature and frequency was observed for 3/4 implying the presence of a weak axial crystal field (CF).

[Effects of Microplastic Exposure on the Community Structure and Function of Symbiotic Bacteria in Sinularia microclavata].

Microplastics are widely distributed in the marine environment and are harmful to the health of marine organisms (including corals). However, studies on the impact of microplastics on coral have been very limited, and the specific mechanism of their impact is not clear. Therefore, in this study, microplastic PA, which is common in the marine environment, was selected to conduct a 7-day microplastic exposure experiment on Sinularia microclavata. The effects of microplastic exposure at different times on the diversity, community structure, and function of the symbiotic bacterial community of coral were analyzed using high-throughput sequencing technology. The α-diversity of the symbiotic bacterial community of coral first decreased and then increased with the exposure time of microplastics. The analysis of ß-diversity and microbial community composition showed that microplastic exposure caused significant changes in the symbiotic bacterial community of coral, and the bacterial community composition also changed with the exposure time. A total of 49 phyla, 152 classes, 363 orders, 634 families, and 1390 genera were detected. At the phylum level, Proteobacteria was the dominant taxa in all samples, but the relative abundance varied among samples. Microplastic exposure increased the abundance of Proteobacteria, Chloroflexi, Firmicutes, Actinobacteriota, Bacteroidota, and Acidobacteriota. At the genus level, Ralstonia, Acinetobacter, and Delftia were the dominant taxa of symbiotic bacteria of coral after microplastic exposure. PICRUSt functional prediction indicated that functions of the coral symbiotic bacterial community, including signal transduction, cellular community prokaryotes, xenobiotics biodegradation and metabolism, and cell motility, decreased after microplastic exposure on coral. BugBase phenotype predictions indicated that microplastic exposure altered three phenotypes (pathogenic, anaerobic, and oxidative stress-tolerant) of the coral symbiotic bacterial community. FAPROTAX functional predictions indicated that microplastic exposure caused significant changes in functions such as the symbiotic relationship between coral symbiotic bacteria and the host, carbon and nitrogen cycling, and photosynthesis. This study provided basic data on the mechanism of microplastic impacts on corals and microplastics ecotoxicology.

Three-component acyloxylation of diazo compounds with carboxylic acids and azadienes.

Despite many studies on benzofuran-derived azadiene being reported, multi-component studies have scarcely been reported on this heterocyclic skeleton. The first cascade three-component acyloxylation of diazos with acids and azadienes has been reported under mild conditions. The reaction is applicable to various (A/A) diazo compounds, generating diverse complex benzofuran derivatives.

Mechanisms of self-control on health behavior change / 中华行为医学与脑科学杂志

Self-control brings important effects on the process and maintenance of health behavior change in individuals, but its mechanism is unclear.Healthy behavior change could be divided into goal-oriented behavior initiation stage, combating habit rejection stage, and habit acquisition and maintenance stage.Established theories of health behavior change mainly focus on the conflict between the goal-directed behavior initiation phase and habitual behavior.It is also indicated that disgust is the key mechanism to restrain the implementation of goal-oriented behavior, but ignore the mechanisms in the action implementation and new behavior acquisition phases.In fact, goal-directed and habitual behaviors work together to ensure that individuals adapt efficiently to their environment.However, when goal-oriented behavior becomes habitual, old habit and new goal-oriented behavior begin to compete, causing conflicts and aversion.The core phase of self-control functioning is just in the confrontation with habit rejection phase.On the one hand, self-control directly assists individual goal-directed behavior habituation through conflict sense adaptation.On the other hand, intensive management and stimulus control indirectly assist goal-directed behavior habituation through the relief of conflict sense.Further exploration of the theory and clinical practice of self-control affecting healthy behavior change is needed in the future.

Current Status and Ethical Considerations of Data Collection and Application in Rare Disease Research / 中国医学伦理学

The research on rare diseases in China started relatively late, with scattered research resources and weak data foundation in epidemiology, diagnosis and treatment, and medication, which hinders its research progress. The rare disease data system is the foundation of rare disease research, and the ethical constraint on rare disease data collection is not only the protection of rare disease population, but also the need for the safety and quality of rare disease data. By analyzing and prospecting the current status of the construction of rare disease data systems, including the data of epidemiology, clinical diagnosis and treatment, drug trials, and follow-up to provide reference for the improvement of rare disease data systems. This paper explored the ethical issues to be followed in the process of rare disease data collection from the perspectives of justice, no harm, respect, sharing, and legalization, so as to improve the standardization of rare disease data collection and the understanding of data ethical review.

Diagnosis of periprosthetic joint infection based on semi-quantitative detection of synovial fluid calprotectin by MALDI-TOF MS / 中华检验医学杂志

Objective:To explore the clinical value of synovial fluid calprotectin for the diagnosis of periprosthetic joint infection (PJI).Methods:Based on prospective cohort study design, a total of 82 patients suspected of PJI after hip and knee arthroplasty in the First Medical Center of the PLA General Hospital from July 2021 to June 2022 were selected. Patients were divided into infection group (PJI, n=39) and non-infection group (non-PJI, n=43) according to the diagnostic criteria proposed by the Second International Consensus Conference in 2018. The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was used for double-blind detection of calprotectin and internal reference standard (IRS) in synovial fluid of patients. The peaks of target protein and IRS were recorded for further analysis. Mann-Whitney U test was used to compare the concentrations of S100A8 and S100A9 between the two groups, and receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy of S100A8 and S100A9 for PJI. Results:Calprotectin was detected as monomers S100A8 and S100A9. Synovial fluid S100A8 was significantly higher in the PJI group than that in the non-PJI group [1.57 (0.48, 4.17) vs 0.00 (0.00, 0.05), Z=?7.221, P<0.05]. Synovial fluid S100A9 was also significantly higher in the PJI group than that in the non-PJI group [0.74 (0.29, 1.70) vs 0.06 (0.00, 0.10), Z=?6.255, P<0.05]. When using S100A8 and S100A9 to diagnose PJI, the sensitivity were 97.4% and 87.2%, the specificity were 86.0% and 88.4%, and the area under the ROC were 0.964 (95% CI 0.929-0.998) and 0.902 (95% CI 0.924-0.996), respectively. Conclusion:The detection of synovial fluid S100A8 and S100A9 by MALDI-TOF MS can make a satisfactory diagnosis for PJI.

Prenatal phenotypic analysis and genetic counseling for 22q11.21 microdeletion and microduplication syndrome / 中华围产医学杂志

Objective:To analyze the prenatal clinical phenotypes and pregnancy outcomes of fetuses with 22q11.21 microdeletion and microduplication syndrome to provide a basis for clinical genetic counseling.Methods:This retrospective study involved the cases diagnosed with 22q11.21 microdeletion or microduplication by chromosomal microarray analysis (CMA) due to abnormal ultrasound findings, advanced maternal age, or high-risk pregnancies indicated by serum screening in the Prenatal Diagnosis Center of the First Affiliated Hospital of Air Force Medical University from January 2015 to January 2022. Clinical phenotypes and pregnancy outcomes of the fetuses were analyzed and described.Results:Among 9 141 cases referred for CMA during the study period, 77 cases (0.8%) were diagnosed as 22q11.21 microdeletion or microduplication, including 62 (80.5%) with 22q11.21 microdeletion and 15 (19.5%) with microduplication. In the 22q11.21 microdeletion cases, 58 had typical deletion, and four had atypical deletions, but all fetuses carried TBX1 gene that was clearly associated with congenital heart disease. The 15 fetuses with 22q11.21 microduplication including 14 in the typical region and one in the atypical region. Forty-eight (77.4%) out of the 62 fetuses with 22q11.21 microdeletion were complicated by congenital heart defects, including 28 with conotruncal defects. Five of the 15 fetuses with 22q11.21 microduplication were complicated by congenital heart defects. The cases were followed up on telephone at three to six months after the expected date of delivery. Among the 62 cases with 22q11.21 microdeletion, 52 terminated pregnancies, five were lost to follow-up, and five were delivered (one died after one month of premature delivery, one was born with anal advancement and growth retardation, and three were followed up without obvious abnormality). Among the 15 cases with 22q11.21 microduplication, four terminated pregnancies, two were lost to follow-up, and nine gave birth (eight were followed up without obvious abnormality, one grew slowly). Conclusions:The application of CMA in the prenatal diagnosis of 22q11.21 microdeletion and microduplication fetuses, and the comprehensive analysis of clinical manifestations and pregnancy outcome combined with ultrasonic diagnosis are of great significance in guiding the treatment and rehabilitation after birth of an affected child. Genetic counseling for cases with 22q11.21 microdeletion and microduplication syndrome should be cautious and consider ultrasound findings.

Comparison of efficacy and safety of rituximab at different doses in the treatment of idiopathic membranous nephropathy / 中华肾脏病杂志

It was a retrospective cohort study. Patients diagnosed with idiopathic membranous nephropathy (IMN) and received rituximab (RTX) alone for one course of treatment during hospitalization in the Department of Nephrology of the First Hospital of Jilin University from March 2020 to March 2022 were enrolled. The patients were divided into 1 g standard treatment group (once 1 g every 2 weeks for twice) and 375 mg/m 2 experimental treatment group (375 mg/m 2 once a week for 4 weeks) according to the different methods of drug administration, and the efficacy and safety of different doses of RTX in the treatment of IMN were compared between the two groups to provide a reference for optimizing the clinical treatment protocol. The patients were followed up regularly for more than 9 months after treatment and the data were complete. A total of 69 patients were included with age of (51.7±11.8) years old, and 46 males (66.7%). There were 31 patients in the 1 g standard treatment group and 38 patients in the 375 mg/m 2 experimental treatment group. The proportion of first-treatment patients in the 1 g standard treatment group was higher than that in the 375 mg/m 2 experimental treatment group (87.1% vs. 65.8%, χ2=4.174, P=0.041). There were no statistically significant differences in the general data, clinical characteristics and baseline laboratory parameters between the two groups (all P>0.05). At the end of 3 months of treatment, 22 patients (31.9%) experienced remission, including 9 patients (29.0%) in the 1 g standard treatment group and 13 patients (34.2%) in the 375 mg/m 2 experimental treatment group ( χ2=0.211, P=0.646). At 6 months, 30 patients (43.5%) experienced remission, including 12 patients (38.7%) in the 1 g standard treatment group and 18 patients (47.4%) in the 375 mg/m 2 experimental treatment group ( χ2=0.521, P=0.470). At 9 months, 38 patients (55.1%) achieved remission, including 18 patients (58.1%) in the 1 g standard treatment group and 20 patients (52.6%) in the 375 mg/m 2 experimental treatment group ( χ2=0.204, P=0.652). At 9 months, the 24 h urine protein of 1 g standard treatment group and 375 mg/m 2 experimental treatment group decreased by 7.93 (6.24, 8.46) g and 7.45 (5.66, 8.67) g (both P<0.05), respectively, and serum albumin increased by 16.4 (15.5, 17.5) g/L and 15.5 (9.0, 15.8) g/L (both P<0.05), respectively, from the baseline value. Kaplan-Meier survival analysis result showed that there was no significant difference in the time of phospholipase A2 receptor titer decreasing to <5 RU/ml between the two groups (Log-rank χ2=3.653, P=0.056). Twenty-three non-serious adverse events occurred in the 1 g standard treatment group, involving 16 patients, and 10 non-serious adverse events occurred in the 375 mg/m 2 experimental treatment group, involving 10 patients. There was better safety in the 375 mg/m 2 experimental treatment group than that in the 1 g standard treatment group ( Fisher value=8.593, P=0.015). Both 375 mg/m 2 regimen and 1 g regimen of RTX in IMN patients are effective in relieving proteinuria and elevating serum albumin. The 375 mg/m 2 regimen of RTX has a lower incidence of adverse events compared with the 1 g regimen.

Association of intraperitoneal pressure and clinical symptoms in peritoneal dialysis patients / 中华肾脏病杂志

Objective:To explore the association between the intraperitoneal pressure (IPP) and clinical symptoms in peritoneal dialysis (PD) patients.Methods:It was a cross-sectional study. PD patients of Peking University First Hospital from January 1, to October 31, 2021, were enrolled according to the inclusion and exclusion criterion. The gold standard—Durand method was used to measure the IPP of PD patients for 2 L intraperitoneal volume, and clinical and laboratory data were collected. According to whether the IPP ≥ 18 cmH 2O or not, the participants were divided into elevated IPP group and normal IPP group. A self-designed semi-quantitative questionnaire was used to investigate the frequency and degree of five clinical symptoms, including abdominal distension, bloating, acid reflux, hiccup and chest tightness or suffrage, as well as the degree of symptom relief after emptying peritoneal dialysate. Pearson or Spearman correlation analysis was used to analyze the correlation between each variable and intraperitoneal pressure. Results:A total of 194 PD patients were enrolled, with age of (51.6±12.9) years old. Of them, there were 123 males (63.4%), 71 females (36.6%) and 60 patients (30.9%) with diabetes. The median dialysis vintage was 24.0 (10.0, 54.0) months. The IPP was (16.2±4.3) cmH 2O, and 70 (36.1%) patients had elevated IPP. Correlation analysis results showed that IPP was positively correlated with body weight ( r=0.23, P<0.001), body mass index ( r=0.41, P<0.001), body surface area ( r=0.15, P=0.030), triglyceride ( r=0.22, P=0.001), high-sensitivity C-reactive protein ( r=0.20, P<0.001), and negatively correlated with diabetes ( r=-0.14, P=0.034) and serum calcium ( r=-0.15, P=0.034). There was no significant correlation between IPP and the total frequency score of five clinical symptoms ( r=0.122, P=0.092). The frequency of stomach distension in elevated IPP group was significantly higher than that in normal IPP group ( P=0.002), and there were no significant differences in the degree and relief degree of stomach distension between the two groups (all P>0.05). There were no statistically significant differences in the extent, frequency and degree of relief of other four clinical symptoms between the two groups (all P>0.05). Conclusion:The increased IPP has little correlation with clinical symptoms, suggesting that it may be unreliable to adjust the infusion volume only by the subjective feeling of patients. It is necessary to monitor IPP as an objective variable.

Risk factors for early acute kidney injury after classic orthotopic liver transplantation / 中华器官移植杂志

Objective:To explore the risk factors affecting the incidence of acute kidney injury(AKI)after liver transplantation(LT).Methods:From November 2019 to November 2022, clinical data were retrospectively reviewed for 105 recipients of classic orthotopic LT.There are 89 males and 16 females with an age range of(50.52±10.35)years.They are assigned into two groups of AKI(66 cases)and non-AKI(39 cases)according to the AKI diagnostic and staging criteria of Global Kidney Disease Prognosis Organization in 2012.General profiles and clinical data(e.g.previous medical history, MELD score, total bilirubin, albumin, serum creatinine level, coagulation function, anhepatic phase and time to surgery)of two groups of recipients are compared.The factors with statistically significant differences are included into multivariate Logistic regression analysis for obtaining independent risk factors for early AKI post-LT.Results:Among them, 66 patients developed AKI within 7 days post-operation with an incidence rate of 62.86%(66/105).The clinical stages of AKI are Ⅰ(46 cases, 69.70%), Ⅱ(10 cases, 15.15%)and Ⅲ(10 cases, 15.15%).Statistically significant inter-group differences exists in age, abdominal surgery history, preoperative serum level of creatinine, operative duration, anhepatic phase and intraoperative plasma transfusion(all P<0.05).Multivariate Logistic regression analysis indicated that abdominal surgery history( OR=5.803, 95% CI: 1.008~33.401, P=0.049), anhepatic phase( OR=1.054, 95% CI: 1.008~1.101, P=0.020)and preoperative serum level of creatinine( OR=0.968, 95% CI: 0.943~0.994, P=0.016)are independent risk factors for early AKI after classical orthotopic LT recipients. Conclusions:Abdominal surgery history, anhepatic phase, and preoperative serum level of creatinine are independent risk factors for early AKI in classic orthotopic LT recipients.

Liver transplantation under the COVID-19 / 中华肝胆外科杂志

Novel coronavirus infection (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since 2019, the disease has spread worldwide and has become a public health epidemic of international concern. In 2022, the infection of SARS-CoV-2 variant Omicron reached its peak, posing a huge challenge to organ donation and transplantation. Organ transplant recipients have a high risk of immunosuppression and face with high risk of SARS-CoV-2 infection. There are some particularities in the diagnosis and treatment of COVID-19 in organ transplant recipients. This article reviewed the diagnosis and treatment of COVID-19 in liver transplantation recipients, and the progression of liver donation under the COVID-19.

Role and potential significance of peroxisome proliferator-activated receptors in liver diseases / 临床肝胆病杂志

Peroxisome proliferator-activated receptors (PPAR) are members of the nuclear estrogen receptor family, and they are involved in a variety of physiological and pathological processes in the human body and play important roles in cellular metabolism, inflammation, and cancer. At present, there are three known subtypes of PPAR, i.e., α, β/δ, and γ. Studies have shown that PPARs are highly expressed in the liver and are widely involved in various physiological and pathological activities such as liver energy metabolism, oxidative stress, and inflammation, and they are also closely associated with the progression of liver diseases. This article reviews the role of PPAR in common liver diseases such as viral hepatitis, metabolic associated fatty liver disease, cholestatic liver disease, liver fibrosis, and primary liver cancer, and the current status of their application in the treatment of liver diseases.

Effect and Mechanism of Cuscutae Semen Total Flavonoids Combined with Tripterygium wilfordii Polyglycoside Tablets on Ovarian Germline Stem Cells of Physiological Mice by Notch Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effect of Cuscutae Semen total flavonoids combined with Tripterygium wilfordii polyglycoside tablets （TWPT） on ovarian germline stem cells of female physiological mice through neurogenic locus notch homolog （Notch） signaling pathway. MethodSixty female Kunming mice （5 weeks old） were randomly divided into normal group， Tripterygium wilfordii polyglycoside tablets low-， high-dose groups （13.65 mg·kg-1·d-1 and 27.3 mg·kg-1·d-1， 1 and 2 times clinical equivalent dose）， Cuscutae Semen total flavonoids low- and high-dose groups （150 mg·kg-1·d-1 and 300 mg·kg-1·d-1）， and combination group （13.65 mg·kg-1·d-1 TWPT and 150 mg·kg-1·d-1 Cuscutae Semen total flavonoids）， with 10 in each group. After 3 weeks of continuous administration， the uterus/brain and ovarian/brain indexes were calculated， and the pathological changes of ovarian tissue were observed under light microscope. The content of estradiol in serum was determined by enzyme linked immunosorbent assay （ELISA）. Immunofluorescence assay was performed to observe the expressions of germline stem cell markers in ovarian epithelium， including mouse vasa homologue （Mvh）， octamer-binding transcription factor 4 （Oct4）， tyrosine-protein kinase receptor （c-kit）， Nanog， Notch signaling pathway molecules， neurogenic locus notch homolog protein 1 （Notch1）， hes family BHLH transcription factor 1（Hes1）， and jagged canonical Notch ligand 1 （JAG1）. ResultCompared with the normal group， low and high doses of TWPT had no significant effect on the uterus/brain and ovary/brain indexes and the uterus and ovary morphologies of mice， while only the number of atretic follicles was increased （P<0.01）. The expressions of ovarian germline stem cell markers and Notch signaling pathway molecules had a decreasing trend in TWPT low-dose group， while the expressions of Mvh， c-kit， and Nanog were down-regulated （P<0.05， P<0.01） and the expressions of Notch1 and Hes1 were also reduced （P<0.01） in TWPT high-dose group. However， the above indexes were increased in Cuscutae Semen total flavonoids low-dose group （P<0.05， P<0.01）. Compared with the low does of TWPT group， the combination group had a decrease in the increased number of atretic follicles （P<0.01）， an improvement in the down-regulated expressions of Mvh and Nanog （P<0.01）， and an increase in the expressions of Notch1 and Hes1 （P<0.05， P<0.01）. ConclusionOvarian germline stem cells are the source target of the reproductive toxicity of TWPT. Cuscutae Semen total flavonoids participate in the regulation of the germline stem cell pathways to alleviate the reproductive toxicity caused by TWPT， and its mechanism of action may be related to the Notch signaling pathway.

The formula for orogastric tube insertion length in preterm infants based on growth indicators and gestational age / 中国新生儿科杂志

Objective:To develop a formula for estimating the insertion length of orogastric (OG) tube for preterm infants based on growth indicators and gestational age (GA).Methods:From January 2020 to December 2021, preterm infants admitted to the neonatal intensive care unit of our hospital were retrospectively reviewed. OG tubes were inserted within 24 h of admission and the lengths of OG tubes were adjusted according to chest and abdominal X-ray results. The formula for OG tube placement was developed using stepwise regression analysis method with GA, body weight (BW) and body length (BL) as the independent variables and the corrected length of OG tube as the dependent variable. The weight-based formula developed by Freeman et al. were compared.Results:A total of 180 preterm infants were included, with 90 cases GA<32 weeks, 84 cases GA 32~35 weeks and 6 cases GA 36 weeks. No significant differences ( P>0.05) existed in the incidences of misplacement of OG tube and the specific types of misplacement among GA groups. For infants with GA≤35 weeks, the insertion length of OG tube was positively correlated with BW and BL and for preterm infants with GA 36 weeks, the insertion length of OG tube was positively correlated with BW only. Stepwise regression analysis showed the formula as OG tube length (cm)=11.8+2.1×BW (kg) or OG tube length (cm)=9.5+1.6×BW (kg)+0.091×GA (week). Comparing with the formula developed by Freeman et al., the differences of OG tube length estimated using our formula were more prominent as BW increased. Conclusions:The length of OG tube is positively correlated with BW and GA with BW shows more influence.

Smart Hip Ultrasound Technology in Screening for Infant Developmental Dysplasia of the Hip / 中山大学学报(医学科学版)

ObjectiveTo develop a deep learning system for early ultrasound screening of developmental dysplasia of the hip （DDH）， a new smart-hip ultrasound technique （S-hip）， and to validate its clinical application. MethodsWe selected 11，100 annotated and reviewed coronal ultrasound images of infant hips between November 2021 and August 2022， 8，100 of which were used for the training set and 3，000 for the test set， to build a S-hip deep learning system. To verify the consistency between the automated measurement by S-hip and the manual measurements by sonographers， 174 standard coronal ultrasound images of 87 infants' bilateral hips were acquired， then α angle， β angle and femoral head coverage （FHC） were measured by S-hip， an ultrasound expert and a resident. The measurement data and the time required for the measurements were recorded and statistically analyzed. Another 100 standard coronal ultrasound images of the hips were randomly selected and measured twice respectively by the ultrasound expert and resident to assess the intra-sonographer repeatability. ResultsThe intraclass correlation coefficient （ICC） （95% CI） values of α angle， β angle and FHC results measured by S-hip and ultrasound expert were 0.799 （0.738， 0.847）， 0.798 （0.737， 0.846） and 0.934 （0.954， 0.975）， respectively. Those values measured by the ultrasound expert and resident were 0.725 （0.645， 0.789）， 0.674 （0.583， 0.748） and 0.931 （0.908， 0.949）， respectively. The mean absolute errors （MAE） of α angle， β angle and FHC results between measurements by S-hip and ultrasound expert were 2.69 °， 4.43 ° and 2.47%， respectively. The time required for measurements by S-hip， ultrasound expert and resident was （1.59±0.36） s， （18.76±2.23） s and （19.45±2.76） s， respectively. The automated measurement by S-hip cost much shorter time than the manual measurements by sonographers and the difference was statistically significant （P<0.001）. The ICC （95% CI） values of α angle， β angle and FHC results between two measurements by the ultrasound expert were 0.943 （0.916， 0.961）， 0.959 （0.940， 0.972）， and 0.981 （0.971， 0.987）， respectively. Those values by the ultrasound resident were 0.884 （0.833， 0.921）， 0.921 （0.884， 0.946）， and 0.962 （0.944， 0.974）. ConclusionThe S-hip based on a deep learning system is a highly reliable automated technique to accurately measure α angle， β angle and FHC. Compared with ultrasound residents， S-hip allows for a more simplified and significantly quicker measurement， which may enhance the widespread use of hip ultrasound screening in infants.

Attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation / 器官移植

Objective To investigate the attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation. Methods From June 2022 to January 2023, stratified random sampling was performed from patients awaiting kidney transplantation, patients after kidney transplantation, patients' relatives and medical students. Four hundred subjects were collected from each population and 1600 subjects were investigated using a self-designed questionnaire. Baseline data of the respondents, their attitudes towards kidney xenotransplantation and the reasons of rejecting kidney xenotransplantation were analyzed. The influencing factors of attitudes towards kidney xenotransplantation were also identified. Results A total of 1 493 valid questionnaires were collected, and the questionnaire retrieval rate was 93.31%. About 93.10% of the respondents accepted allogeneic kidney transplantation, and 66.78% had heard of kidney xenotransplantation. Seven hundred and ninety-five respondents suggested that they could accept kidney xenotransplantation "when kidney xenotransplantation and allogeneic kidney transplantation yielded the same results and risks". Six hundred and ninety-eight respondents indicated that they were "unable" or "uncertain" whether they could accept kidney xenotransplantation (χ2=16.409，P=0.001). Among these 698 respondents, the proportion of them who were willing to accept kidney xenotransplantation when they did not meet the conditions of allogeneic kidney transplantation was 10.9%. About 35.8% of respondents were willing to accept kidney xenotransplantation if it yielded less risk and better prognosis compared with allogeneic kidney transplantation. If the time of awaiting kidney xenotransplantation was shorter than that of allogeneic kidney transplantation, 21.2% were willing to accept kidney xenotransplantation. If the cost of kidney xenotransplantation was less than that of allogeneic kidney transplantation, 24.5% of them were willing to accept kidney xenotransplantation. The main reasons of rejecting kidney xenotransplantation included surgical risk and other unknown risks. Multivariate analysis showed that respondents residing in cities and towns for a long period of time, those who accept allogeneic kidney transplantation and those who have heard of kidney xenotransplantation showed more positive attitudes towards kidney xenotransplantation. Conclusions Different transplantation-related populations have different attitudes towards kidney xenotransplantation, and the overall attitudes are positive. Active promotion of kidney xenotransplantation research and carrying out relevant popular science education contribute to improving public attitudes towards the acceptance of kidney xenotransplantation.