Investigating the causal association between gut microbiota and type 2 diabetes: a meta-analysis and Mendelian randomization.

Background: Studies have shown that gut dysbiosis contributes to the pathophysiology of type 2 diabetes mellitus (T2DM). Identifying specific gut microbiota dysbiosis may provide insight into the pathogenesis of T2DM. Purpose: This study investigated the causal relationship between gut microbiota and T2DM using meta-analysis and Mendelian randomization (MR). Methods: In the first part, we searched for literature on gut microbiota and T2DM, and conducted a meta-analysis. We observed differences in glycosylated hemoglobin and fasting blood glucose levels in both groups. Second, we obtained GWAS data from genome-wide association study database 19 (GWAS). We used two-sample MR analysis to verify the forward and reverse causal associations between gut microbiota and T2DM. Additionally, we selected the European GWAS data from the European Bioinformatics Institute (EBI) as a validation set for external validation of the MR analysis. In the third part, we aimed to clarify which gut microbiota contribute to the degree of causal association between group disorders and T2DM through multivariate MR analysis and Bayesian model averaging (MR-BMA). Results: 1. According to the meta-analysis results, the glycated hemoglobin concentration in the gut probiotic intervention group was significantly lower than in the control group. Following treatment, fasting blood glucose levels in the intervention group were significantly lower than those in the control group. 2. The results of two samples MR analysis revealed that there were causal relationships between six gut microbiota and T2DM. Genus Haemophilus and order Pasteurellaceae were negatively correlated with T2DM. Genus Actinomycetes, class Melanobacteria and genus Lactobacillus were positively correlated. Reverse MR analysis demonstrated that T2DM and gut microbiota did not have any reverse causal relationship. The external validation data set showed a causal relationship between gut microbiota and T2DM. 3. Multivariate MR analysis and MR-BMA results showed that the independent genus Haemophilus collection had the largest PP. Conclusion: Our research results suggest that gut microbiota is closely related to T2DM pathogenesis. The results of further MR research and an analysis of the prediction model indicate that a variety of gut microbiota disorders, including genus Haemophilus, are causally related to the development of T2DM. The findings of this study may provide some insight into the diagnosis and treatment of T2DM. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO.

Astragaloside IV Alleviates Podocyte Injury in Diabetic Nephropathy through Regulating IRE-1α/NF-κ B/NLRP3 Pathway.

OBJECTIVE: To investigate the effects of astragaloside IV (AS-IV) on podocyte injury of diabetic nephropathy (DN) and reveal its potential mechanism. METHODS: In in vitro experiment, podocytes were divided into 4 groups, normal, high glucose (HG), inositol-requiring enzyme 1 (IRE-1) α activator (HG+thapsigargin 1 µmol/L), and IRE-1α inhibitor (HG+STF-083010, 20 µmol/L) groups. Additionally, podocytes were divided into 4 groups, including normal, HG, AS-IV (HG+AS-IV 20 µmol/L), and IRE-1α inhibitor (HG+STF-083010, 20 µmol/L) groups, respectively. After 24 h treatment, the morphology of podocytes and endoplasmic reticulum (ER) was observed by electron microscopy. The expressions of glucose-regulated protein 78 (GRP78) and IRE-1α were detected by cellular immunofluorescence. In in vivo experiment, DN rat model was established via a consecutive 3-day intraperitoneal streptozotocin (STZ) injections. A total of 40 rats were assigned into the normal, DN, AS-IV [AS-IV 40 mg/(kg·d)], and IRE-1α inhibitor [STF-083010, 10 mg/(kg·d)] groups (n=10), respectively. The general condition, 24-h urine volume, random blood glucose, urinary protein excretion rate (UAER), urea nitrogen (BUN), and serum creatinine (SCr) levels of rats were measured after 8 weeks of intervention. Pathological changes in the renal tissue were observed by hematoxylin and eosin (HE) staining. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to detect the expressions of GRP78, IRE-1α, nuclear factor kappa Bp65 (NF-κBp65), interleukin (IL)-1ß, NLR family pyrin domain containing 3 (NLRP3), caspase-1, gasdermin D-N (GSDMD-N), and nephrin at the mRNA and protein levels in vivo and in vitro, respectively. RESULTS: Cytoplasmic vacuolation and ER swelling were observed in the HG and IRE-1α activator groups. Podocyte morphology and ER expansion were improved in AS-IV and IRE-1α inhibitor groups compared with HG group. Cellular immunofluorescence showed that compared with the normal group, the fluorescence intensity of GRP78 and IRE-1α in the HG and IRE-1α activator groups were significantly increased whereas decreased in AS-IV and IRE-1α inhibitor groups (P<0.05). Compared with the normal group, the mRNA and protein expressions of GRP78, IRE-1α, NF-κ Bp65, IL-1ß, NLRP3, caspase-1 and GSDMD-N in the HG group was increased (P<0.05). Compared with HG group, the expression of above indices was decreased in the AS-IV and IRE-1α inhibitor groups, and the expression in the IRE-1α activator group was increased (P<0.05). The expression of nephrin was decreased in the HG group, and increased in AS-IV and IRE-1α inhibitor groups (P<0.05). The in vivo experiment results revealed that compared to the normal group, the levels of blood glucose, triglyceride, total cholesterol, BUN, blood creatinine and urinary protein in the DN group were higher (P<0.05). Compared with DN group, the above indices in AS-IV and IRE-1α inhibitor groups were decreased (P<0.05). HE staining revealed glomerular hypertrophy, mesangial widening and mesangial cell proliferation in the renal tissue of the DN group. Compared with the DN group, the above pathological changes in renal tissue of AS-IV and IRE-1α inhibitor groups were alleviated. Quantitative RT-PCR and Western blot results of GRP78, IRE-1α, NF-κ Bp65, IL-1ß, NLRP3, caspase-1 and GSDMD-N were consistent with immunofluorescence analysis. CONCLUSION: AS-IV could reduce ERS and inflammation, improve podocyte pyroptosis, thus exerting a podocyte-protective effect in DN, through regulating IRE-1α/NF-κ B/NLRP3 signaling pathway.

LncRNA MTC-p65 Protein Mediates Skin Fibroblast Proliferation in Liaoning Cashmere Goat by Regulating the Nuclear Factor-Kappa B Signaling Pathway.

The aim of this study is to investigate the activation of NF-κB signaling pathway and the regulation of the expression of genes related to chorionic villus growth by the binding of LncRNA MTC (XLOC_005914) and p65 (transcription factor p65 [Capra hircus], XP_017898873.1). In addition, the regulation of LncRNA MTC and p65 binding on the proliferation of Liaoning Cashmere Goat skin fibroblasts is investigated. The upregulation of LncRNA MTC promoted the proliferation of skin fibroblasts, and the NF-κB signaling pathway played an important role in this process. Compared with the negative control (NC group), the expression of TNFα and NFKB2(NF-κB) genes was highly significantly up-regulated (P < 0.001), and NFKBIA(IκBɑ) genes were highly significantly down-regulated (P < 0.01) after LncRNA MTC overexpression (OE group). The expression levels of TNFα and NFκB-P-p65 proteins were upregulated in the OE group; NF-κB-p65 expression levels were upregulated in the nucleus, IκBα expression levels were downregulated in the cytoplasm, and P-IκBα expression levels were upregulated. LncRNA MTC and p65 proteins were co-localized in the cells. Meanwhile, LncRNA MTC and p65 protein showed significant nucleation in the OE group. RNA pull-down and LC-MS/MS verified that p65 protein was indeed an interacting protein of LncRNA MTC. LncRNA MTC binds to p65 protein, upregulates the expression of TNFα protein, nucleates p65 protein, and activates NF-κB signaling pathway to promote the proliferation of skin fibroblasts in Liaoning Cashmere Goat.

Cultural Dimensions Moderate the Association between Loneliness and Mental Health during Adolescence and Younger Adulthood: A Systematic Review and Meta-Analysis.

Cultural factors, such as country or continent, influence the relationship between loneliness and mental health. However, less is known about how cultural dimensions moderate this relationship during adolescence and younger adulthood, even if these dimensions manifest as country or continent differences. This study aims to examine the potential influence of Hofstede's cultural dimensions on this relationship using a three-level meta-analysis approach. A total of 292 studies with 291,946 participants aged 10 to 24 were included in this study. The results indicate that cultural dimensions, such as individualism vs. collectivism, indulgence vs. restraint, power distance, and long-term vs. short-term orientation, moderated the associations between loneliness and social anxiety, stress, Internet overuse, and negative affect. The association between loneliness and mental health was not moderated by cultural dimensions, such as masculinity and uncertainty avoidance. These findings suggest that culture's influence on the association between loneliness and mental health is based on a domain-specific mechanism.

Structure-based drug discovery of novel fused-pyrazolone carboxamide derivatives as potent and selective AXL inhibitors

As a novel and promising antitumor target, AXL plays an important role in tumor growth, metastasis, immunosuppression and drug resistance of various malignancies, which has attracted extensive research interest in recent years. In this study, by employing the structure-based drug design and bioisosterism strategies, we designed and synthesized in total 54 novel AXL inhibitors featuring a fused-pyrazolone carboxamide scaffold, of which up to 20 compounds exhibited excellent AXL kinase and BaF3/TEL-AXL cell viability inhibitions. Notably, compound 59 showed a desirable AXL kinase inhibitory activity (IC50: 3.5 nmol/L) as well as good kinase selectivity, and it effectively blocked the cellular AXL signaling. In turn, compound 59 could potently inhibit BaF3/TEL-AXL cell viability (IC50: 1.5 nmol/L) and significantly suppress GAS6/AXL-mediated cancer cell invasion, migration and wound healing at the nanomolar level. More importantly, compound 59 oral administration showed good pharmacokinetic profile and in vivo antitumor efficiency, in which we observed significant AXL phosphorylation suppression, and its antitumor efficacy at 20 mg/kg (qd) was comparable to that of BGB324 at 50 mg/kg (bid), the most advanced AXL inhibitor. Taken together, this work provided a valuable lead compound as a potential AXL inhibitor for the further antitumor drug development.

Bazi Bushen Capsules on Anti-aging： A Review / 中国实验方剂学杂志

The decline of body function and senile diseases caused by aging seriously affect human health and life span， which is an important topic in the field of life science. Bazi Bushen capsules is a representative Chinese patent medicine for tonifying essence， invigorating Qi and anti-aging， guided by Qiluo doctrine， and essence， Qi and spirit theory. Previous pharmacological and clinical studies have confirmed that this preparation has the comprehensive advantages of anti-aging， and prevention and treatment of aging-related diseases. Among them， pharmacological studies showed that Bazi Bushen capsules had the effect of improving the appearance status of mice， improving the level of sex hormones， inhibiting the formation of atherosclerosis， improving cardiac function， improving learning and memory cognitive ability， improving neurological function， improving osteoporosis and muscle function， improving sperm count and quality. The mechanism was related to the up-regulation of the recombinant sirtuin （SIRT6） level， down-regulation of the levels of aging-related proteins p53 and p16， up-regulation of telomerase reverse transcriptase level， and alleviation of inflammation and oxidative response. Clinical studies have proved that it can improve the symptoms of patients with kidney essence deficiency， improve exercise ability， and improve the sexual function of impotence patients. Anti-aging research of Bazi Bushen capsules based on Qiluo doctrine fully embodies the new mode of academic innovation and transformation of traditional Chinese medicine （TCM） with the combination of "theory-new drug-experiment-clinic"， which has made a demonstration for the anti-aging research of TCM.

Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial / 中西医结合学报

BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.

Design, synthesis and biological evaluation of pyrazolo3,4-

Fibroblast growth factor receptors (FGFRs) have emerged as promising targets for anticancer therapy. In this study, we synthesized and evaluated the biological activity of 66 pyrazolo[3,4-

Predictive value of soluble urokinase-type plasminogen activator receptor combined with alpha-fetoprotein and model for end-stage liver disease score in short-term prognosis assessment of patients with chronic hepatitis B related acute-on-chronic liver failure / 中华传染病杂志

Objective:To investigate the predictive value of serum soluble urokinase-type plasminogen activator receptor (suPAR) combined with alpha-fetoprotein (AFP) and model for end-stage liver disease (MELD) score in short-term prognosis assessment of patients with chronic hepatitis B (CHB) related acute-on-chronic liver failure (ACLF).Methods:From January 2018 to May 2020, 66 patients with CHB related ACLF from Fuzhou First People′s Hospital were enrolled. After 90 days of follow-up, the patients with CHB related ACLF were divided into death group and survival group according to the outcome. Meanwhile, 30 patients with CHB were enrolled by simple random sampling method. The differences of serum suPAR in patients with CHB related ACLF and patients with CHB were analyzed. The values of suPAR, AFP and MELD score were compared between death group and survival group in patients with CHB related ACLF. The predictive value of suPAR, AFP, MELD score, Child-Turcotte Pugh score (CTP score) and suPAR combined with AFP and MELD score in the short-term prognosis of patients with CHB related ACLF were analyzed by area under the receiver operator characteristic curve (AUROC). Data were analyzed by two independent sample t test or non-parametric test. Results:The serum suPAR level of patients with CHB related ACLF was (9.6±0.8) ln ng/L, which was higher than that of patients with CHB ((8.0±0.3) ln ng/L). The difference was statistically significant ( t=14.533, P<0.01). The suPAR and MELD score of patients with CHB related ACLF in the death group were (9.9±0.7) ln ng/L and 29.6 (7.1) points, respectively, which were higher than those in the survival group ((9.4±0.7) ln ng/L and 21.0 (5.0) points, respectively). The AFP level in the death group was 45.9 (108.1) μg/L, which was lower than that in the survival group (209.3 (187.1) μg/L). There were significant differences in suPAR ( t=2.895, P=0.005), MELD score ( Z=4.708, P<0.01) and AFP ( Z=3.051, P<0.01) between the death group and the survival group. AUROC of suPAR (0.741, P=0.001), AFP (0.724, P=0.002) and MELD score (0.885, P<0.01) had predictive value for death in patients with CHB related ACLF. The sensitivities of suPAR, AFP, MELD score, CTP score and suPAR combined with AFP and MELD score were 84.6%, 73.1%, 88.5%, 96.2% and 84.6%, respectively, and the specificities were 75.0%, 72.5%, 70.0%, 52.5% and 92.5%, respectively. The AUROC of suPAR combined with AFP and MELD score was 0.871 ( P<0.01), which was higher than that of CTP score (0.793, P<0.01). Conclusions:Serum suPAR is increased in patients with CHB related ACLF. SuPAR combined with AFP and MELD score could apply in the prognostic value for patients with CHB related ACLF.

Effectiveness and cost-effectiveness of public health measures to control COVID-19: a modelling study

BackgroundThe Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first reported in China, which caused a respiratory disease known as Coronavirus Disease 2019 (COVID-19). Since its discovery, the virus has spread to over 160 countries and claimed more than 9800 deaths. This study aimed to assess the effectiveness and cost-effectiveness of various response public health measures. MethodsThe stochastic agent-based model was used to simulate the process of COVID-19 outbreak in scenario I (imported one case) and II (imported four cases) with a series of public health measures, involving the personal protection, isolation-and-quarantine, gathering restriction, and community containment. The virtual community was constructed following the susceptible-latent-infectious-recovered framework. The epidemiological and economic parameters derived from the previous literature and field investigation. The main outcomes included avoided infectors, cost-effectiveness ratios (CERs), and incremental cost-effectiveness ratios (ICERs). The sensitivity analyses were undertaken to assess uncertainty. ResultsIn scenario I and II, the isolation-and-quarantine averted 1696 and 1990 humans infected respectively at the cost of US$12 428 and US$58 555, both with negative value of ICERs. The joint strategy of personal protection and isolation-and-quarantine could avert one more case than single isolation-and-quarantine with additional cost of US$166 871 and US$180 140 respectively. The effectiveness of isolation-and-quarantine decreased as lowering quarantine probability and increasing delay-time. Especially in scenario II, when the quarantine probability was less than 25%, the number of infections raised sharply; when the quarantine delay-time reached six days, more than a quarter of individuals would be infected in the community. The strategy including community containment could protect more lives and was cost-effective, when the number of imported cases was no less than 65, or the delay-time of quarantine was more than five days, or the quarantine probability was below 25%, based on current assumptions. ConclusionsThe isolation-and-quarantine was the most cost-effective intervention. However, personal protection and isolation-and-quarantine was the optimal strategy averting more infectors than single isolation-and-quarantine. Certain restrictions should be considered, such as more initial imported cases, longer quarantine delay-time and lower quarantine probability.

Pulsed radiofrequency alleviated neuropathic pain by down-regulating the expression of substance P in chronic constriction injury rat model / 中华医学杂志(英文版)

BACKGROUND@#Pulsed radiofrequency (PRF), as a non-invasive treatment of neuropathic pain (NP), has been widely administered clinically. Previous studies have shown that PRF has the potential to improve hyperalgesia in animal models of NP. However, there have been few reports to clarify whether the mechanism of PRF treatment of NP involves intervention in the expression of substance P (SP). Therefore, this study administered PRF treatment to chronic constriction injury (CCI) model rats and observed the sciatic nerve mechanical pain threshold and SP expression in the spinal cord to explore the mechanism of PRF treatment.@*METHODS@#A total of 96 Sprague-Dawley rats were randomly divided into the sham-surgery-sham-treatment group (S-S group), the sham-surgery-PRF group (S-P group), the CCI-sham-treatment group (C-S group), and the CCI-PRF group (C-P group). The C-S group and the C-P group underwent sciatic nerve CCI, while the other groups received a sham operation. At 14 days after the operation, the C-P group and the S-P group were treated with PRF for 300 s. We recorded the hindpaw withdrawal threshold (HWT) and the thermal withdrawal latency (TWL) of rats in the various groups at baseline, before treatment (0 days), and at 1, 7, 14, and 28 days after treatment. L4 to L6 spinal cord tissues were taken before treatment (0 days) and 1, 7, 14, and 28 days after treatment. The transcription and translation of SP were measured by quantitative polymerase chain reaction and Western blotting, respectively.@*RESULTS@#The HWT and the TWL in the C-P group 28 days after PRF treatment were significantly higher than those in the C-S group (95% confidence interval [CI]: 5.84-19.50, P < 0.01; 95% CI: 2.58-8.69, P = 0.01). The expression of SP in the C-P group 28 days after PRF treatment was significantly lower than that in the C-S group (95% CI: 1.17-2.48, P < 0.01).@*CONCLUSIONS@#PRF may alleviate CCI-induced NP by down-regulating the expression of SP in the spinal cord of CCI model rats.

Discovery of a series of dimethoxybenzene FGFR inhibitors with 5pyrrolo2,3-pyrazine scaffold: structure-activity relationship, crystal structural characterization and study

Genomic alterations are commonly found in the signaling pathways of fibroblast growth factor receptors (FGFRs). Although there is no selective FGFR inhibitors in market, several promising inhibitors have been investigated in clinical trials, and showed encouraging efficacies in patients. By designing a hybrid between the FGFR-selectivity-enhancing motif dimethoxybenzene group and our previously identified novel scaffold, we discovered a new series of potent FGFR inhibitors, with the best one showing sub-nanomolar enzymatic activity. After several round of optimization and with the solved crystal structure, detailed structure-activity relationship was elaborated. Together with metabolic stability tests and pharmacokinetic profiling, a representative compound () was selected and tested in xenograft mouse model, and the result demonstrated that inhibitor was effective against tumors with FGFR genetic alterations, exhibiting potential for further development.

Effects of Niaoduqing Particles () on Delaying Progression of Renal Dysfunction: A Post-trial, Open-Label, Follow-up Study / 中国结合医学杂志

OBJECTIVE@#To follow up the participants of the randomized clinical trial "Efficacy and Safety of Niaoduqing Particles () for Delaying Moderate-to-Severe Renal Dysfunction", and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction.@*METHODS@#Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period.@*RESULTS@#After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (-13.0-24.1) and 11.7 (-2.6-42.9) μmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were-0.2 (-4.3-2.7) and-2.21 (-5.7-0.8) mL•min•1.73 m, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (-10.0-41.9) and 17.5 (-6.0-50.0) μmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were-2.3 (-6.4-1.9) and-3.7 (-7.5-1.1) mL•min•1.73 m, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min•1.73 m per year.@*CONCLUSION@#Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448).

The effectiveness of nutritional risk assessment and interventions in patients with oral cancer / 中国实用护理杂志

Objective To evaluate the effect of nutritional risk screening and interventions on postoperative nutritional status in patients with oral cancer. Methods A total of 83 oral cancer patients with mild or moderate nutritional risk rated by patient-generated subjective global assessment(PG-SGA) from January 2015 to June 2017 were randomized into an experimental group(43 cases) and a control group (40 cases). The patients in the experimental group received 2-week nutritional intervention before the operation,while the patients in the control group received routine preoperative treatment and diet guidance. The biochemical measurements of postoperative nutritional indicators, peripheral blood immunoglobulin indicators, postoperative complications and hospital stays were compared between the two groups. Results The levels of prealbumin, retinol- binding protein, total lymphocyte count and transferrin were (218.5±34.6) mg/L, (23.5±4.3)μg/L, (1.82±0.45)×109/L, (2.07±0.63 )μg/L on the day of admission in the experimental group, and at 1 day before the operation were (237.3±36.5) mg/L, (27.7±4.8)μg/L, (2.02±0.39)×109/L, (2.43±0.54)μg/L, there was no significant difference(P<0.05). IgM, IgG, IgA at 1 day before the operation were significantly higher than those on the day of admission in the experimental group(P<0.05), and the levels of prealbumin, retinol-binding protein, total lymphocyte count,transferrin, IgM, IgG, IgA and body mass index at 8 days after the operation in the experimental group were significantly higher than those in the control group(t=1.574-3.418, P<0.05). The total rate of postoperative complications was 11.6％(5/43) in the experimental group, 30.0％(12/40) in the control group, and there was significant difference between the two groups (χ2=6.840, P<0.01). The incidence of infection-associated complications such as pneumonia and incision infection was 7.0％(3/43) in the experimental group, 20.0％(8/40) in the control group, and there was significant difference between the two groups (χ2=5.096, P<0.05). Conclusions Preoperative nutritional support can effectively improve the perioperative nutritional status,decrease postoperative complications and operative risk in esophageal cancer patients with mild or moderate nutritional risk.

Acute kidney injury induced by hypothyroidism myopathy: a clinical analysis of 24 cases / 中华全科医师杂志

Clinical data of 24 patients with acute kidney injury (AKI) induced by hypothyroidism myopathy admitted in our hospital from January 2014 to December 2016 were analyzed retrospectively.There were 9 patients classified as AKI stage Ⅰ and 15 patients as AKI stage Ⅱ according to the Kidney Disease Improving Global Outcomes (KDIGO),21 hypothyroidism myopathy patients without AKI were selected as control group.ANOVA and chi-square test were used to compare the general data and laboratory results among three groups;artificial neural network analysis and multi-factor stepwise regression method were used to analyze the factors related to AKI.There were significant differences in serum creatinine (Scr) (F=34.3,P＜0.01),BUN(F=29.1,P＜0.01),ALB(F=5.27,P=0.01),CK(F=8.61,P=0.01),creatin kinase isoenzyme(CK-MB)(F=33.1,P＜0.01),LDH(F=7.78,P=0.01),ALT(F=34.3,P＜0.01) and AST (F=28.1,P＜0.01) among three groups.Artificial neural network analysis showed that myoglobin was closely related to serum creatinine,suggesting its importance for AKI in patients with primary hypothyroidism myopathy.Multivariate regression analysis showed that serum creatinine was correlated with CK-MB(B=2.10,SE=0.38,β=0.96,t=5.52),LDH(B=0.18,SE=0.06,β=0.34,t=3.00)and AST(B=0.16,SE=0.09,β=0.32,t=2.62).This study indicates that hypothyroidism myopathy may be one of the causes of AKI,and the severity of AKI might be closely related to the severity of hypothyroidism myopathy.

Microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin: a split-face study / 中华皮肤科杂志

Objective To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.Methods A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology,Dermatology Hospital of Southern Medical University from January to June in 2018,and were divided into 3 groups by using a random number generator and a residue-based method:high-pressure jet injection group (n =23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 2 weeks,microneedle injection group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side)and microneedle-mediated injection with 0.9％ sodium chloride solution on the left side of the face (control side) once every 4 weeks,combination group (n =15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks.All the patients in the above 3 groups received 4 consecutive sessions of treatment.Before the initial treatment and 2 weeks after the final treatment,erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system,lactic acid stinging test was performed,and skin sensitivity including severity of itching,dryness,erythema and scaling was evaluated.Two weeks after the final treatment,the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS)by clinicians and patients.Adverse reactions were recorded during and after treatment.Statistical analysis was carried out by using paired t test,Wilcoxon sign rank sum test and chi-square test.Results Two weeks after the final treatment,the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t =2.19,P =0.03),while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t =1.10,P =0.27);in the microneedle injection group,the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t =2.47,3.02,both P =0.01);in the combination group,the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively,the improvement of erythema score in the treatment side was superior to that in the control side (t =5.02,P ＜ 0.01),while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P ＞ 0.05).Two weeks after the final treatment,the severity of itching,dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P ＜ 0.05),while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z =-2.236,-2.887,respectively,both P ＜ 0.05).Moreover,both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z =-2.646,-2.887,respectively,both P ＜ 0.05).Two weeks after the final treatment,the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (x2 =4.821,P =0.028),but showed no significant changes in the other groups (all P ＞ 0.05).No severe adverse reactions were observed during or after the treatment.Conclusion Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema,skin pore and sensitive symptoms in patients with sensitive skin.

Spatial-temporal characteristics of other infectious diarrhea in Jiangsu province, 2010-2017 / 中华流行病学杂志

Objective@#To analyze the spatial-temporal characteristics of other infectious diarrhea (OID) in Jiangsu province from 2010 to 2017, and to provide evidence for setting up prevention and control programs of the disease.@*Methods@#Data was from the Chinese Center for Disease Control and Prevention and the Statistics Bureau of Jiangsu province. Descriptive methods were used to illustrate the epidemiological characteristics of OID from 2010 to 2017. Global autocorrelation statistics method (Moran’s I) was used to detect the spatial autocorrelation of OID, annually. Kulldorff M spatiotemporal scan statistics was used to analyze the spatial-temporal clustering of OID. ArcGIS 10.0 software, SaTScan 9.4 software and Excel 2017 software were also applied.@*Results@#A total of 126 341 OID cases were found in Jiangsu province from 2010 to 2017 with an average annual incidence as 19.96/100 000. Children under five accounted for 55.08% (69 590/126 341) of the total cases. Obvious seasonal backshift with the increasing trends of the OID was noticed. There appeared four areas with high incidence of OID in the whole province, including Wuxi, Suzhou, Yancheng and Xuzhou. OID showed positive spatial autocorrelation at the county level with higher Moran’s I from 0.19 to 0.33 (P<0.01). There appeared four positive clusters, all occurred in the high incidence period of OID, including the cluster area from the intersection areas of Changzhou and Wuxi (RR=7.61, LLR=2 605.80, P<0.01), respectively.@*Conclusion@#With the increasing trends and the seasonal backshift of OID cases, pathogen surveillance programs set for those scattered children under five, in clustered regions and epidemic seasons should be strengthened.

Microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin: a split-face study / 中华皮肤科杂志

Objective@#To evaluate clinical efficacy and safety of microneedle-mediated intradermal injection with hyaluronic acid for the treatment of sensitive skin.@*Methods@#A total of 53 female patients aged 21-54 years and diagnosed with sensitive skin were enrolled from Department of Cosmetic Dermatology, Dermatology Hospital of Southern Medical University from January to June in 2018, and were divided into 3 groups by using a random number generator and a residue-based method: high-pressure jet injection group (n = 23) receiving high-pressure jet injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 2 weeks, microneedle injection group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and microneedle-mediated injection with 0.9% sodium chloride solution on the left side of the face (control side) once every 4 weeks, combination group (n = 15) receiving microneedle-mediated injection with hyaluronic acid on the right side of the face (treatment side) and high-pressure jet injection with hyaluronic acid on the left side of the face (control side) once every 4 weeks. All the patients in the above 3 groups received 4 consecutive sessions of treatment. Before the initial treatment and 2 weeks after the final treatment, erythema and skin pore scores were determined on the right and left sides of the face by using VISIA facial imaging system, lactic acid stinging test was performed, and skin sensitivity including severity of itching, dryness, erythema and scaling was evaluated. Two weeks after the final treatment, the overall improvement was evaluated with the Global Aesthetic Improvement Scale (GAIS) by clinicians and patients. Adverse reactions were recorded during and after treatment. Statistical analysis was carried out by using paired t test, Wilcoxon sign rank sum test and chi-square test.@*Results@#Two weeks after the final treatment, the improvement of skin pore score in the treatment side was superior to that in the control side in the high-pressure jet injection group (t = 2.19, P = 0.03) , while no significant difference in the improvement of erythema score was observed between the treatment side and control side (t = 1.10, P = 0.27) ; in the microneedle injection group, the improvement of erythema and skin pore scores was greater in the treatment side than in the control side (t = 2.47, 3.02, both P = 0.01) ; in the combination group, the VISIA erythema score in the treatment and control sides was 0.59 ± 0.25 and 0.85 ± 0.31 respectively, the improvement of erythema score in the treatment side was superior to that in the control side (t = 5.02, P < 0.01) , while there was no significant difference in the improvement of skin pore score between the treatment side and control side (P > 0.05) . Two weeks after the final treatment, the severity of itching, dryness and scaling was significantly improved in both the treatment and control sides in the 3 groups compared with those before the initial treatment (P < 0.05) , while the severity of erythema was significantly improved only in the treatment side in the microneedle injection group and combination group when compared with that before the initial treatment (Z = -2.236, -2.887, respectively, both P < 0.05) . Moreover, both the microneedle injection group and combination group showed significantly decreased severity of erythema in the treatment side compared with that in the control side two weeks after the final treatment (Z = -2.646, -2.887, respectively, both P < 0.05) . Two weeks after the final treatment, the positive rate of the lactic acid stinging test significantly decreased in the treatment side compared with that before the initial treatment in the microneedle injection group (χ2 = 4.821, P = 0.028) , but showed no significant changes in the other groups (all P > 0.05) . No severe adverse reactions were observed during or after the treatment.@*Conclusion@#Microneedle intradermal injection with hyaluronic acid can effectively and safely improve erythema, skin pore and sensitive symptoms in patients with sensitive skin.

Study on the correlation of Ureaplasma urealyticum and Chlamydia trachomatis infection with tubal infertility / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the relationship of Ureaplasma urealyticum(UU)and Chlamydia trachomatis(CT)infections with reproductive tract microenvironment changes and clinical infertility.METHODS: From July 2018 to May2019,85 cases of tubal infertility were collected as the infertility group from the Outpatient Department of Reproductive Medicine Center,the Seventh Affiliated Hospital of Sun Yat-sen University.The ultrasonography and hysterosalpingography(HSG)showed normal size and shape of uterine cavity,and complete or incomplete obstruction of one or both fallopian tubes;infertility caused by other factors was excluded. The control group consisted of 45 normal women during the same period who had no previous pregnancy history and HSG showed no obvious abnormal fallopian tube. Vaginal and cervical secretions were collected to detect vaginal cleanliness and UU and CT infection.RESULTS: The vaginal cleanliness（Ⅲ-Ⅳ）of infertility group(18.82%)was more than that of control group(4.4%)(P<0.05).CT(18.82%),U(38.82%),CT+UU(15.29%)and total infection rates(72.94%)in infertility group were higher than those in control group(4.44%,8.89%,2.22% and 15.56%). The difference was statistically significant(P<0.01). Multivariate logistic regression analysis showed that tubal infertility was closely related to CT,UU and CT+UU infection(CT:P=0.046,OR=3.291;UU:P=0.025,OR=2.789;CT+UU:P=0.017,OR=7.528).CONCLUSION: CT and UU infections are strongly associated with tubal infertility. It is necessary to screen all women at childbearing age,especially infertile women,in order to clarify the relationship between these pathogens and impaired fertility and adverse pregnancy outcomes.

Analysis of virulence genes and the chromosomal 16S rRNA gene polymorphism of Yersinia enterocolitic in Jiangsu Province,2015 / 中华传染病杂志

Objective To reveal the virulence genes and the polymorphisms of chromosomal 16S rRNA gene of Yersinia enterocolitic strains isolated from different districts in Jiangsu Province,2015. Methods Five virulence genes(ail,virF,yadA,ystA and ystB)of Yersinia enterocolitic strains isolated from different districts in Jiangsu Province were detected by using polymerase chain reaction(PCR),and phylogenetic analysis of chromosomal 16S rRNA gene was performed by amplification and sequencing. Results In this study,73 Yersinia enterocolitic strains were collected in Jiangsu Province in 2015.Among them,56(76.7%)strains carried virulence genes,and ail-virF-yadA -ystA -ystB+were the dominate types in diarrhea patients and other hosts.All strains can be clustering into 4 groups according to the phylogenetic analysis of chromosomal 16S rRNA gene.Conclusions The non-pathogenic Yersinia enterocolitic(ystB+)is the dominant strain in Jiangsu province,and the pathogenic strains are also found in this region.The result of phylogenetic analysis of chromosomal 16S rRNA gene and the profiles of virulence genes are highly consistent.