Association between Yang Deficiency Syndrome and the End-point Events of Diabetic Kidney Disease： A Retrospective Cohort Study / 中医杂志

ObjectiveTo investigate the impact of yang deficiency syndrome on the progression to end-point events of diabetic kidney disease （DKD）. MethodsA retrospective study among patients with stage Ⅳ DKD admitted to Dongzhimen Hospital of Beijing University of Chinese Medicine from September 1st， 2016 to September 30th， 2021 was conducted. Data on the patients' general information， clinical indicators including duration of diabetes， duration of proteinuria， history of smoking and drinking， hemoglobin （HGB）， fasting blood glucose （FBG）， albumin （ALB）， serum creatinine （Scr）， urea nitrogen （BUN）， uric acid （UA）， cholesterol （TC） ， triglycerides （TG）， low-density lipoprotein （LDL）， 24-hour urine protein quantification （24h-UTP） and estimated glomerular filtration rate （eGFR）， and TCM syndromes including symptoms， tongue and pulse， and syndrome scores were collected. The patients were divided into exposure group （yang-deficiency group） and non-exposure group （non-yang-deficiency group）. The general information， clinical indicators and incidence rates of end-point events were compared， and the impact of yang deficiency syndrome on the end-point events of stage Ⅳ DKD was analyzed. Survival analysis was performed using Kaplan-Meier method， and multivariate Cox proportional risk models were used to identify independent predictors of end-point events. ResultsA total of 160 patients with stage Ⅳ DKD were included in the study， including 43 cases of yang deficiency syndrome and 117 cases of non-yang deficiency syndrome. Compared to those in the non-yang deficiency group， the waist circumference， BUN and the incidence of end-point events in the yang deficiency group were significantly higher （P＜0.05 or P＜0.01）. Spearman correlation analysis showed that yang deficiency syndrome was positively correlated with incidence of end-point events of stage Ⅳ DKD （r = 0.167， P = 0.035）. Furthermore， 24h-UTP and BUN levels were also positively correlated with end-point events in stage Ⅳ DKD patients （P＜0.01）， while ALB and HGB levels were negatively correlated （P＜0.01）. Kaplan-Meier survival curves showed that yang deficiency syndrome was associated with an increased risk of end-point events （Log Rank P = 0.011）. Moreover， 24h-UTP levels ≥3500 mg， BUN level ≥8 mmol/L， ALB level ＜30 g and HGB level ＜11 g were all associated with the increase of the risk of end-point events （P＜0.05 or P＜0.01）. Multivariate Cox regression analysis showed that yang deficiency syndrome was an independent risk factor for patients with stage Ⅳ DKD to progress into end-point events （HR = 2.36， 1.32 to 4.21； P = 0.004）， as well as 24h-UTP ≥ 3500 mg， BUN ≥ 8 mmol/L， HGB＜11 g and ALB＜30 g （P＜0.05 or P＜0.01）. ConclusionsFor stage Ⅳ DKD， patients with yang deficiency syndrome are more likely to have end-point events， which is an independent risk factor for the progression into end-point events.

Differentiation and Treatment of Urinary Tract Infection based on the Theory of 'Seminal Orifice' / 中医杂志

In the differentiation and treatment of recurrent urinary tract infection （rUTI） from the perspective of the seminal orifice， it is proposed that the urinary tract belongs to the category of "seminal orifice"， and the physiological process of urination is closely related to the function of the seminal orifice. From the three dimensions of orifice body， orifice pivot and orifice spirit， the physiological relationship between seminal orifice and the function of five zang-organs （脏） is constructed， that is， lung heat， yin damage and pathogen counter-restriction lead to malnutrition of orifice body； burning heart fire and spirit disorder lead to unfavorable orifice spirit， and kidney deficiency， liver constraint and spleen stagnation lead to unfavorable orifice pivot. In the early stage of rUTI， there is usually unfavo-rable orifice pivot， for which the treatment principle should be treating the root and the branch simultaneously， consi-dering both deficiency and excess， and paying attention to the management of accompanied symptoms. Zishui Qinggan Beverage （滋水清肝饮） and Modified Shenzhuo Decoction （肾着汤加减） are often selected based on syndrome differentiation. In the middle stage， lack of nourishment of the orifice body and unfavorable orifice spirit and pivot coexist， and the treatment should be draining the orifice and unblocking strangury， commonly withmodified Qingxin Lianzi Beverage （清心莲子饮）. In the late stage， loss of nourishment of the orifice body is the main pathogenesis， and it is necessary to further nourish the orifice body to prevent recurrence， and modifed Wuzi Yanzong Pills and Erxian Decoction （五子衍宗丸合二仙汤） is often used. Furthermore， the specific medicinals should be selected targeting at the orifice body， orifice pivot， and orifice spirit， so as to nourish orifice body by dispelling external pathogens and rectify healthy qi， to drain orifice pivot by freeing emotions and minds and unblocking qi movement， and to calm orifice spirit by unblocking heart and kidney and nourishing heart spirit.

A comparative study on the efficacy and adverse reactions of nituzumab and bevacizumab combined with synchronous ra-diotherapy and chemotherapy in the treatment of locally advanced cervical cancer / 实用肿瘤学杂志

Objective The objective of this study was to compare the short-term efficacy and adverse reactions of nituzum-ab combined with synchronous radiotherapy and chemotherapy and bevacizumab combined with synchronous radiotherapy and chemo-therapy in the treatment of locally advanced cervical cancer.Methods A total of 100 locally advanced cervical cancer patients with pathological type of squamous cell carcinoma were collected from 1 September 2020 to 31 December 2021.They were divided into a control group(synchronous radiotherapy and chemotherapy group),a nituzumab group(nituzumab combined synchronous radiotherapy group)and a bevacizumab group(bevacizumab combined synchronous radiotherapy and chemotherapy group).The total effective rate of short-term treatment,changes in tumor volume before and after treatment,serum squamous cell carcinoma antigen(SCC)levels be-fore and after treatment,and adverse reactions after treatment were compared among patients of the three groups.Results The short-term total effective rates of the Nitro group,Bevar group and control group were 90.3％,87.2％and 60.0％,respectively.The total effective rates of the Nitro and Bevar groups were significantly higher than those of the control group,and the differences were statisti-cally significant(P＜0.001).There was no statistically significant difference in the total effective rates of the Nitro and Bevar groups(P＞0.05);The degree of tumor volume reduction and SCC reduction in the Nituo group and Bevac group after treatment was higher than those in the control group(P＜0.05),and there was no statistically significant difference between the two groups(P＞0.05).The incidence of hypertension in the Bevar group was 33.4％,significantly higher than that in the control group(10.0％)and the Ni-tro group(12.9％)(P＜0.05).There was no statistically significant difference in the incidence of hypertension between the Nito group and the control group(P＞0.05);There was no statistically significant difference in the incidence of adverse reactions among the three groups except hypertension(P＞0.05).Conclusion Nituzumab combined with synchronous radiotherapy and chemothera-py,as well as bevacizumab combined with synchronous radiotherapy and chemotherapy,can improve the short-term efficacy of locally advanced cervical cancer,effectively reduce tumor volume and inhibit the expression of tumor markers,both of which are superior to synchronous radiotherapy and chemotherapy alone.Compared to bevacizumab,nituzumab has fewer adverse reactions.For patients with locally advanced cervical cancer,the combination of nituzumab and concurrent radiotherapy and chemotherapy is more reliable in terms of safety.

Effect of Tripterygium wilfordii Polyglycoside on Expression of NFAT2/COX-2 in Kidney Tissues of Rats with Diabetic Nephropathy / 中国实验方剂学杂志

ObjectiveTo explore the underlying mechanism of Tripterygium wilfordii polyglycoside tablets （TWPT） in the prevention and treatment of kidney injury in diabetic nephropathy （DN） through the nuclear factor of activated T-cells 2（NFAT2）/cyclooxygenase-2（COX-2） pathway. MethodForty-two male SD rats of SPF grade were selected and randomly divided into a normal group （n=8） and an experimental group （n=34） after one week of adaptive feeding. The rats in the normal group were fed conventionally. The DN model was established in rats of the experimental group by intraperitoneal injection of streptozotocin （STZ） following one week of feeding on a high-fat and high-glucose diet. After the death and failure cases during modeling were eliminated， the remaining 24 model rats were randomly divided into model group， valsartan （8.33 mg·kg-1·d-1） group， and TWPT （5 mg·kg-1·d-1） group. Rats in normal group and model group were given equal amounts of normal saline by gavage. After six weeks， body weight was measured and urine samples were collected. Blood samples were collected from the abdominal aorta， and then the rats were sacrificed for sampling. Biochemical indicators， such as serum blood urea nitrogen （BUN）， serum creatinine （SCr）， alanine aminotransferase （ALT）， blood lipid， blood glucose， and 24-hour urine total protein （24 h UTP）， were determined. Hematoxylin-eosin （HE） staining and Masson staining were used to observe the pathology of the kidney. Enzyme-linked immunosorbent assay （ELISA） was used to detect NFAT2 and COX-2 expression levels in the serum. Western blot and Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）were adopted to detect NFAT2， COX-2 protein and mRNA expression in kidney tissues， respectively. ResultCompared with the normal group， the model group showed elevated 24 h UTP， BUN， SCr， CHO， TG， and FBG， increased serum NFAT2 and COX-2 production and expression （P<0.01）， and elevated protein and mRNA expression of NFAT2 and COX-2 in kidney tissues （P<0.01）. In addition， the pathology of the kidney showed enlarged glomeruli， mild proliferation of mesangial cells， and widened mesangial stroma. Compared with the model group， the TWPT group showed decreased 24 h UTP， BUN， SCr， CHO， TG， and FBG （P<0.05，P<0.01）， basically normal glomerular morphology， decreased expression of serum NFAT2 and COX-2 （P<0.01）， and down-regulated protein and mRNA expression of NFAT2 and COX-2 in kidney tissues （P<0.01）. ConclusionTWPT can alleviate 24 h UTP in DN model rats， protect renal function， and improve renal pathology， and its mechanism of action may be related to the down-regulation of NFAT2/COX-2 expression in the serum and kidney tissues.

Interrupted time series trial for prevention of cardiovascular toxicity induced by chemotherapy in cervical cancer / 实用肿瘤学杂志

Objective The aim of this study was to establish a practical and feasible prevention,and a treatment scheme of cardiovascular toxicity(CVT)induced by chemotherapy in cervical cancer based on known effective measures and to provide scientific guidance and basis for clinical treatment. Methods The risk of pre-chemotherapy CVT and post-chemotherapy CVT were evalua-ted in 164 subjects from November 2016 to January 2018. The Interrupted time series(ITS)model of CVT incidence before and after intervention was established. The CVT biomarkers and results of clinical examination before and after chemotherapy were compared in selected patieds. The effects of measures were evaluated. Results There was no difference in the ITS model of CVT incidence before and after intervention(P>0. 05). Among echocardiography examination results,the E peak velocity of mitral valve and E/A ratio in-creased,and the difference was statistically significant(P<0. 05),LVEF、FS、SV and A peak velocity of mitral valve had no differ-ences(P>0. 05). There were no differences in ECG and double lower extremities arteriovenous ultrasonography results(P>0. 05). The level of sICAM-1,sTM,vWF and h-FABP decreased(P<0. 05),the levels of NO and eNOS increased(P<0. 05);there was no significant difference in the levels of hs-CRP and E-selectin(P>0. 05). Conclusion The comprehensive prevention and treat-ment program established in this study can improve the cervical cancer chemotherapy CVT microscopically, and further research should be carried out by expanding the sample size.

Emodin induces apoptosis of human cervical cancer hela cells via intrinsic mitochondrial and extrinsic death receptor pathway.

BACKGROUND: Emodin is a natural anthraquinone derivative isolated from the Rheum palmatum L. AIM: The aim of the present study was to investigate the effect of emodin on the apoptosis of the human cervical cancer line HeLa and to identify the mechanisms involved. METHODS: Relative cell viability was assessed by MTT assay after treatment with emodin. Cell apoptosis was detected with TUNEL, Hoechst 33342 staining and quantified with flow cytometry using annexin FITC-PI staining. RESULTS: The percentage of apoptotic cells was 0.8, 8.2, 22.1, and 43.7%, respectively. The mRNA levels of Caspase-9, -8 and -3 detected by Real-time PCR after treatment with emodin were significantly increased. Emodin increased the protein levels of Cytochome c, Apaf-1, Fas, FasL, and FADD but decreased the protein levels of Pro-caspase-9, Pro-caspase-8 and Pro-caspase-3. CONCLUSION: We conclude that the emodin inhibited HeLa proliferation by inducing apoptosis through the intrinsic mitochondrial and extrinsic death receptor pathways.

Comparative analysis of ligasure vessel sealing system and bipolar electric coagulation in the laparoscopic hysterectomy / 中国基层医药

Objective To investigate the clinical value of different treatments of uterine artery and vein in laparoscopic hysterectomy. Methods In 184 patients accepting lapaxoscopie hysterectomy, ligasttre vessel sealing system ,was applied to uterine vessels, while bipolar electric coagulation to coagulate the uterine vessels during the operation. Results Among the groups, women undergoing ligasure hand the smaller amount of estimated blood loss and was associated with shorter operating time, there were statistically significant differences among the two groups( P＜0.01). Conclusion Each of the two operative ways is feasible or laparoacopic hysterectomy. The way of dissociating uteri arteriovenous completely before they were cut off with ligasure in laparoscopic panhysterectomy has many important clinical value such as easy appliance, safety, convenient operation, clear operation field and so on.

The expression of VEGF-C,CD31 and the clinical significance of MVD in epithelial ovarian carcinoma / 中国基层医药

Objective To investigate the expression of VEGF-C,CD31 and MVD,in human ovarian epithelial carcinoma tissues,development and metastasis of epithelial ovarian carcinoma by observing their expression and analyzing their correlation.Methods 40 samples of ovarian epithelial carcinoma tissues and 20 samples normal ovary tissues were selected from 2004 to 2005 in the third affiliated hospital of Harbin Medical University,as well as 20 cases of normal ovarian tissues samples as control using immunohisrochemical staining assay,we analyzed the expression of VEGF-C,MVD detected by CD31.The relationship of these three factors with patients age tumor stage,differentiation,pathohistological type,were analyzed.Results 67.5%(27/40)had high expression of VEGF-C,15%(3/14)had low espression.The survival of patients with high VEGF-C expression was significantly worse than that of patients with low and negative expression.Conclusion VEGF-C and CD31 may play an important role in the occurrence and development of epithelial ovarian tumors,while MVD maybe associated with the ivasion and metastasis of carcinoma.The detection of VEGF-C combined with CD31 and MVD can objectively reflect the biological behavior of epithelial ovarian tumor.

Dependability Research on Differentiation of Symptoms and Signs for Classification of Syndrome and Pathology of IgA Nephropathy / 中华中医药杂志

Objective:To investigate the traditional Chinese medicine(TCM) and its pathology relationship in IgA nephropathy(IgAN),so as to deduce the pathogenetic condition and prognosis,and guide the clinic therapy.Methods: 53 cases of IgAN were analyzed retrospectively,syndrome differentiations were concluded by the diagnosis criteria of TCM syndrome in the clinic research and guiding principe of the curment new herd in chronic nephritis in 2002 into deficiency of spleen and kidney qi,deficiency of liver and kidney yin,deficiency of both qi and yin,and the accompanied syndrome as affection of exogenous wind-heat,endoretention of damp-heat and blood stagnation.The relationship among pathological parameters,pathological stages and the above syndromes were observed.Results:Compared the three clinical syndromes of deficiency of spleen and kidney qi,deficiency of liver and kidney yin and deficiency of both qi and yin of 53 cases of patients,pathology change and pathological stage were the lightest in deficiency of spleen and kidney qi,on the contrary,the heaviest in deficiency of both qi and yin,P