Changes in Notified Incidence of Pulmonary Tuberculosis in China, 2005-2020 / 生物医学与环境科学（英文）

OBJECTIVE@#To evaluate the trend of notified incidence of pulmonary tuberculosis (PTB) in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.@*METHODS@#Using pooled data on TB cases reported by the TB Information Management Reporting System (TBIMS) from 2005 to 2020, we calculated the annual percentage change (APC) using the Joinpoint regression model.@*RESULTS@#From 2005 to 2020, a total of 16.2 million cases of PTB were reported in China, with an average notified incidence of 75.5 per 100,000 population. The age standardization rate (ASR) continued to decline from 116.9 (/100,000) in 2005 to 47.6 (/100,000) in 2020, with an average annual decrease of 5.6% [APC = -5.6, 95% confidence interval ( CI): -7.0 to -4.2]. The smallest decline occurred in 2011-2018 (APC = -3.4, 95% CI: -4.6 to -2.3) and the largest decrease in 2018-2020 (APC = -9.2, 95% CI: -16.4 to -1.3). From 2005 to 2020, the ASR in males (159.8 per 100,000 in 2005, 72.0 per 100,000 in 2020) was higher than that in females (62.2 per 100,000 in 2005, 32.3 per 100,000 in 2020), with an average annual decline of 6.0% for male and 4.9% for female. The average notified incidence was the highest among older adults (65 years and over) (182.3/100,000), with an average annual decline of 6.4%; children (0-14 years) were the lowest (4.8/100,000), with an average annual decline of 7.3%, but a significant increase of 3.3% between 2014 and 2020 (APC = 3.3, 95% CI: 1.4 to 5.2); middle-aged (35-64 years) decreased by 5.8%; and youth (15-34 years) decreased by an average annual rate of 4.2%. The average ASR in rural areas (81.3/100,000) is higher than that in urban areas (76.1/100,000). The average annual decline in rural areas was 4.5% and 6.3% in urban areas. South China had the highest average ASR (103.2/100,000), with an average annual decline of 5.9%, while North China had the lowest (56.5/100,000), with an average annual decline of 5.9%. The average ASR in the southwest was 95.3 (/100,000), with the smallest annual decline (APC = -4.5, 95% CI: -5.5 to -3.5); the average ASR in the Northwest China was 100.1 (/100,000), with the largest annual decline (APC = -6.4, 95% CI: -10.0 to -2.7); Central, Northeastern, and Eastern China declined by an average of 5.2%, 6.2%, and 6.1% per year, respectively.@*CONCLUSIONS@#From 2005 to 2020, the notified incidence of PTB in China continued to decline, falling by 55%. For high-risk groups such as males, older adults, high-burden areas in South, Southwest, and Northwest China, and rural regions, proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases. There is also a necessity to be vigilant about the upward trend of children in recent years, the specific reasons for which need to be further studied.

[Analysis of the causes of residual back pain in the early and late stages after percutaneous vertebral augmentation].

OBJECTIVE: To explore the influencing factors of the residual back pain in patient with osteoporotic vertebral compression fractures(OVCFs) in the early and late stages after percutaneous vertebral augmentation(PVA), and analyze the correlation between these factors and the residual back pain after PVA. METHODS: From March 2018 to December 2019, 312 patients with OVCFs who treated with PVA were collected. According to the inclusion and exclusion criteria, a total of 240 patients were included in this retrospective study. There were 59 males and 181 females, aged from 50 to 95 years old with an average of (76.11±10.72) years old, and 50 cases of fractures located in the thoracic region (T5-T10), 159 cases in the thoracolumbar region (T11-L2), and 31 cases in the lumbar region (L3 and below). The first day after PVA was regarded as the early postoperative period, and the seventh day was regarded as the late postoperative period. According to the visual analogue scale (VAS), the patients were divided into 4 groups:early postoperative pain relief group(group A, VAS≤4 scores), there were 121 patients, including 29 males and 92 females, aged from 50 to 90 years with an average of (75.71±11.00) years;early postoperative pain relief was not an obvious group (group B, VAS >4 scores), there were 119 patients, including 30 males and 89 females, aged from 53 to 95 years with an average of (76.51±10.46) years; late postoperative pain relief group (group C, VAS≤ 4 scores), there were 172 patients, including 42 males and 130 females, aged from 50 to 95 years with an average of (76.20±10.68) years; late postoperative pain relief was not obvious group (group D, VAS>4 scores), there were 68 patients, including 17 males and 51 females, aged from 53 to 94 years old with an average of (75.88±10.91) years old. The age, gender, bone mineral density(BMD), injured vertebral segment, preoperative thoracolumbar fascial condition, surgical methods, single or bilateral puncture, the amount of bone cement injection, anterior vertebral height recovery rate and central vertebral height recovery rate in the 4 groups were analyzed by univariate analysis. The statistically significant factors were put into a Logistic regression to analyze the correlation between these factors and residual back pain after PVA. RESULTS: Univariate analysis showed that the residual back pain in the early stage after PVA was correlated with BMD, preoperative thoracolumbar fascial injury, single or bilateral puncture, the amount of bone cement injection, anterior vertebral height recovery rate and central vertebral height recovery rate(P<0.05). The residual back pain in the late postoperative period was related to BMD, injured vertebral segment, surgical methods, the amount of bone cement injection, anterior vertebral height recovery rate and central vertebral height recovery rate(P<0.05). Multivariate Logistic regression analysis showed that thoracolumbar fascial injury(OR=4.938, P=0.001), single or bilateral puncture(OR=5.073, P=0.002) were positively correlated with the residual back pain in the early stage after PVA(B>0), which were risk factors;the BMD (OR=0.211, P=0.000) and anterior vertebral height recovery rate (OR=0.866, P=0.001) were negatively correlated with the residual back pain in the early stage after PVA(B<0), which were protective factors. In the late stage after PVA, the BMD(OR=0.448, P=0.003), the amount of bone cement injection (OR=0.648, P=0.004) and anterior vertebral height recovery rate (OR=0.820, P=0.000) were negatively correlated with residual back pain(B<0), which were protective factors. CONCLUSION: The decrease of BMD, injury of the thoracolumbar fascia, single or bilateral puncture, poor recovery of anterior vertebral height and insufficient injection of bone cement are closely related to the occurrence of residual back pain after PVA, which affect the relief of residual back pain in the early and late postoperative periods.

Construction of visual prediction model for no reflow phenomenon in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention / 中华急诊医学杂志

Objective:To build a simple, rapid and accurate visual prediction model for identifying the ST-segment elevation myocardial infarction (STEMI) patients with high risk of no reflow during the primary percutaneous coronary intervention (PPCI).Methods:A retrospective study of STEMI patients treated by PPCI in China-Japan Friendship Hospital from January 2018 to June 2019 was performed. The clinical data including sex, age, comorbidities, personal history, Killip classification and laboratory examinations were collected. Whether the patients had no reflow during the PPCI were retrospective observed. Multivariable logistic regression analysis was used to identify risk factors. A nomogram was developed to predict no reflow risk among STEMI patients. C-index and Hosmer-Lemeshow goodness-of-fit test were used to verify the differentiation, consistency and clinical applicability of the model. Internal verification of the model was used by Bootstrap validation.Results:Of the included 280 patients, the prevalence of no flow rate was 30.7%. Killip class Ⅲ or Ⅳ ( OR=3.537, 95% CI: 1.665-7.514, P=0.002), mean platelet volume≥9 fL ( OR=4.003, 95% CI: 1.091-14.689, P=0.037), Glucose ≥7.8 mmol/L ( OR=2.315, 95% CI: 1.318-4.066, P=0.003) and time from symptoms to hospital ( OR=5.594, 95% CI: 2.041-15.328, P=0.002) were the independent risk factors of no flow (all P<0.05). The AUC of ROC curve in the prediction model was 0.731 (95% CI: 0.668-0.795). The calibration curves were close to the standard curve. Conclusions:The visual prediction model constructed in this study can early identify STEMI patients with high risk of no reflow, and may be helpful for physicians to provide prospective pre-treatment before the occurrence of no reflow during PPCI.

One Year of Evidence on Mental Health in the COVID-19 Crisis - A Systematic Review and Meta-Analysis

This paper provides a systematic review and meta-analysis on the prevalence rate of mental health issues of general population, general and frontline healthcare workers (HCWs) in China over one year of the COVID-19 crisis. We systematically searched PubMed, Embase, Web of Science, and Medrxiv at November 16th, 2020, pooled data using random-effects meta-analyses to estimate the prevalence rates, and ran meta-regression to tease out the heterogeneity. The meta-regression results uncovered several predictors of the prevalence rates, including severity, type of mental issues, population, sampling location, and study quality. Pooled prevalence rates are significantly different from, yet largely between, the findings of previous meta-analyses, suggesting the results of our larger study are consistent with yet more accurate than the findings of the smaller, previous meta-analyses. The prevalence rates of distress and insomnia and those of frontline HCWs are higher suggest future research and interventions should pay more attention to those mental outcomes and populations. Our findings suggest a need to examine the prevalence rates at varying levels of severity. The one-year cumulative evidence on sampling locations (Wuhan vs. non-Wuhan) corroborates the typhoon eye effect theory. Trial registrationCRD4202022059

Association of serum SIRT1 with extent of coronary artery lesion in acute coronary syndrome patients / 中华急诊医学杂志

Objective:To investigate the potential factors influencing the extent of coronary artery lesion in acute coronary syndrome (ACS) patients with an emphasis on the role of serum SIRT1.Methods:We assessed the clinical data from 81 ACS patients admitted to China-Japan Friendship Hospital. Serum SIRT1 was detected by enzyme linked immunosorbent assay (ELISA), and the extent of coronary artery lesion was evaluated by SYNTAX score before revascularization. All the patients were divided into two groups: high SYNTAX score (severe coronary artery lesion, n=38) and low SYNTAX score (moderate coronary artery lesion, n=43), by means of the median of SYNTAX score. Potential factors influencing SYNTAX score were analyzed through multiple linear regression analysis. Results:Compared with the low SYNTAX score group, patients in the high SYNTAX score group had higher serum SIRT1 level [379.38 (490.14) ng/L vs. 242.95 (173.85) ng/L, P<0.001] and frequency of coronary artery disease family history (42.11% vs. 20.93%, P=0.039). There was no statistical difference among other factors between the two groups. Serum SIRT1 was positively correlated with SYNTAX score in ACS patients ( R=0.452, P<0.010). Serum SIRT1 (ln adjusted), age and estimated glomerular filtration rate were independently correlated with SYNTAX score (ln adjusted) in multiple linear regression analysis (Adjusted R2=0.330, P<0.001). Conclusions:For the first time, we discussed the correlation of serum SIRT1 with extent of coronary artery lesion in ACS patients. Cardiologists should pay more attention to high-risk patients in order to improve the prognosis of ACS patients through timely revascularization strategies.

Postoperative Complications and Survival Analysis of Surgical Resection for Hilar Cholangiocarcinoma: A Retrospective Study of Fifty-Nine Consecutive Patients.

Objective Hilar cholangiocarcinoma (HC) is invariably fatal without surgical resection. The primary aim of the current study was to determine the safety of variable surgical resections for patient with HC and their survival after surgical resection. In addition, prognostic factor for the overall survival was also evaluated. Methods The study included 59 consecutive patients who were newly diagnosed with HC and underwent surgical resections with curative intend between February 2009 and February 2017. Patients were followed up at 3-6 months intervals after hospital discharge. Postoperative complications and overall survival were determined. Associations of clinicopathologic and surgeon-related factors with overall survival were evaluated through univariate analysis and Cox regression analysis. Results Of patients with Bismuth and Corlette (B & C) type Ⅲ (n=19) and Ⅳ (n=25) HC lesions, 33 (55.9%) were treated with hilar resection combined with major liver resection (MLR), while the other 11 patients with type Ⅲ and Ⅳ, and those with type Ⅰ (n=8) and Ⅱ (n=7) HC lesions were treated with hilar resection. The overall surgical mortality was 5.1% and surgical morbidity was 35.6%. There was no statistical difference in the mortality between MLR group and hilar resection group (6.1% vs. 3.8%; X2=0.703, P=0.145). The median follow-up period was 18 months (range, 1-94 months). The 1-, 3-, 5-year survival rate was 59.3%, 36.5%, and 17.7%, respectively. The overall survival after resections was 18 months. In HC patients with B & C type Ⅲ and Ⅳ lesions, the median survival was 23 months for hilar resection with MLR and 8 months for hilar resection alone; the 1-, 3-, 5-year cumulative survival rate was 63.9%, 23.3%, and 15.5%, respectively for hilar resection with MLR, and 11.1%, 0, and 0, respectively for hilar resection alone, with significant differene observed (HR, 9.902; 95% CI, 2.636-19.571, P=0.001). Four factors were independently associated with overall survival: preoperative serum Ca19-9 (HR, 7.039; 95% CI, 2.803-17.678, P<0.001), histopathologic grade (HR, 4.964; 95% CI, 1.046-23.552, P=0.044), surgical margins (P=0.031), and AJCC staging (P=0.015). Conclusions R0 resection is efficacious in surgical treatment of HC. MLR in combination with caudate lobe resection may increase the chance of R0 resection and improve survival of HC patients with B & C type Ⅲ and Ⅳ lesions. Preoperatively prepared for biliary drainage may ensure the safety of MLR in most HC patients. Novel adjuvant therapies are needed to improve the survival of HC patients with poor prognostic factors.

Study on the correlation and predictive value of serum pregnancy-associated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is a concern due to its rapid increase in incidence in recent years. AIM: To investigate the correlation and predictive value of serum pregnancy-associated plasma protein A (PAPP-A), triglyceride (TG), and 25-hydroxyvitamin D [25-(OH)D] with GDM in early pregnancy. METHODS: A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included, and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy. Of these cases with GDM, 51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B. Serum PAPP-A, TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed. In addition, their diagnostic value in GDM was determined using receiver operating characteristic (ROC) curve analysis. RESULTS: Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B, with statistical significance (P < 0.05). Furthermore, Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose (FBG) levels (r = -0.605, P < 0.001), (r = -0.597, P < 0.001), while TG and FBG levels were positively correlated (r = 0.628, P < 0.001). The sensitivity, specificity, area under the curve (AUC) and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%, 82.35%, 0.861 and 16.340, respectively, while the sensitivity of TG in diagnosing GDM was 86.27%, the specificity was 66.67%, the AUC was 0.813, with an optimal cut-off value of 1.796. The corresponding sensitivity, specificity, AUC and optimal cut-off value of serum 25-(OH)D were 64.71%, 70.59%, 0.721 and 23.140, respectively. Moreover, multivariate logistic regression analysis revealed that FBG, vascular endothelial growth factor, Flt-1, serum PAPP-A, TG, and 25-(OH)D were related risk factors leading to GDM in patients. CONCLUSION: Serum PAPP-A, TG, and 25-(OH)D levels are all correlated with blood glucose changes in GDM, and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Epidemic trend of hepatitis B in 18 ethnic minorities of Yunnan Province from 2009 to 2018 / 中华疾病控制杂志

Objective To analyze the epidemic trend of hepatitis B virus (HBV) in 18 minority nationalities in Yunnan Province from 2009 to 2018, so as to explore the ethnic differences in the incidence of HBV in Yunnan Province. Methods Based on the reported incidence data of hepatitis B in China's disease prevention and control information system from 2009 to 2018, descriptive epidemiology method was used to describe and analyze the incidence of hepatitis B in different ethnic groups, and K-means clustering method was used to explore and analyze the annual average incidence of hepatitis B in different ethnic groups. Results From 2009 to 2018, the average incidence of hepatitis B in Yunnan Province was 44.26/100 000, which was much lower than the overall level of China every year; the average incidence of hepatitis B in ethnic groups was 41.27/100 000, slightly lower than the overall level of Yunnan every year. The prevalence of hepatitis B was different in different ethnic groups. The average incidence of Wa was significantly higher than others (95.26/100 000), and Jingpo was the lowest (22.51/100 000). According to the incidence of hepatitis B, different ethnic groups were divided into three categories: high incidence ethnic group, middle incidence ethnic group and low incidence ethnic group. Conclusion There are ethnic differences in the incidence of hepatitis B in Yunnan Province. The incidence of hepatitis B in some ethnic groups is higher than that in the whole country all the year round, which is the key population in the prevention and control of hepatitis B.

Postoperative Complications and Survival Analysis of Surgical Resection for Hilar Cholangiocarcinoma: A Retrospective Study of Fifty-Nine Consecutive Patients / 中国医学科学杂志(英文版)

Objective Hilar cholangiocarcinoma (HC) is invariably fatal without surgical resection. The primary aim of the current study was to determine the safety of variable surgical resections for patient with HC and their survival after surgical resection. In addition, prognostic factor for the overall survival was also evaluated. Methods The study included 59 consecutive patients who were newly diagnosed with HC and underwent surgical resections with curative intend between February 2009 and February 2017. Patients were followed up at 3-6 months intervals after hospital discharge. Postoperative complications and overall survival were determined. Associations of clinicopathologic and surgeon-related factors with overall survival were evaluated through univariate analysis and Cox regression analysis. Results Of patients with Bismuth and Corlette (B & C) type Ⅲ (=19) and Ⅳ (=25) HC lesions, 33 (55.9%) were treated with hilar resection combined with major liver resection (MLR), while the other 11 patients with type Ⅲ and Ⅳ, and those with type Ⅰ (=8) and Ⅱ (=7) HC lesions were treated with hilar resection. The overall surgical mortality was 5.1% and surgical morbidity was 35.6%. There was no statistical difference in the mortality between MLR group and hilar resection group (6.1% 3.8%; =0.703, =0.145). The median follow-up period was 18 months (range, 1-94 months). The 1-, 3-, 5-year survival rate was 59.3%, 36.5%, and 17.7%, respectively. The overall survival after resections was 18 months. In HC patients with B & C type Ⅲ and Ⅳ lesions, the median survival was 23 months for hilar resection with MLR and 8 months for hilar resection alone; the 1-, 3-, 5-year cumulative survival rate was 63.9%, 23.3%, and 15.5%, respectively for hilar resection with MLR, and 11.1%, 0, and 0, respectively for hilar resection alone, with significant differene observed (, 9.902; 95% , 2.636-19.571, =0.001). Four factors were independently associated with overall survival: preoperative serum Ca19-9 (, 7.039; 95% , 2.803-17.678, <0.001), histopathologic grade (, 4.964; 95% , 1.046-23.552, =0.044), surgical margins (=0.031), and AJCC staging (=0.015). Conclusions R0 resection is efficacious in surgical treatment of HC. MLR in combination with caudate lobe resection may increase the chance of R0 resection and improve survival of HC patients with B & C type Ⅲ and Ⅳ lesions. Preoperatively prepared for biliary drainage may ensure the safety of MLR in most HC patients. Novel adjuvant therapies are needed to improve the survival of HC patients with poor prognostic factors.

Analysis and strategies of rapid response team in the Fourth People's Hospital of Shenyang / 中华危重病急救医学

Objective:To explore the effective ability and strategy of improving in-hospital emergency in large general hospitals through investigating and analyzing the epidemiological characteristics and outcomes of patients treated by rapid response team (RRT) in the Fourth People's Hospital of Shenyang.Methods:The clinical data of 145 patients treated by RRT in the Fourth People's Hospital of Shenyang from April 1st to June 30th in 2019 were retrospectively analyzed. The clinical data including gender, age, RRT response time, disease type, direct cause of RRT initiation, the incidence of cardiac arrest, intensive care unit (ICU) admission rate and outcome were statistically analyzed. The correlation between indicators was analyzed by Pearson correlation. Pareto diagram was used to analyze the direct cause of RRT initiation.Results:A total of 145 patients were treated by RRT within 3 months. The ratio of male ( n = 85) to female ( n = 60) was 1.42∶1. The age of patients treated by RRT was (72.83±14.84) years old, and the response time was (3.27±1.42) minutes. The incidence of cardiac arrest was 23.4% (34/145), and the ICU admission rate was 29.7% (43/145). The hospital mortality was 40.0% (58/145), and the rescue success rate was 60.0% (87/145). Correlation analysis showed that there was a significant positive correlation between the incidence of cardiac arrest and hospital mortality ( r = 0.545, P < 0.01). According to the disease type of patients treated by RRT analysis, respiratory system diseases ( n = 44, 30.3%) accounted for the most, followed by circulatory system diseases ( n = 43, 29.7%), nervous system diseases ( n = 25, 17.2%), digestive system diseases ( n = 19, 13.1%), trauma ( n = 5, 3.4%), endocrine system diseases ( n = 3, 2.1%), urinary system diseases ( n = 2, 1.4%) and others ( n = 4, 2.8%). Further analysis showed that patients aged between 85 years old and 94 years old were prone to the respiratory system diseases, accounting for 48.5% (16/33) of the population in this age group, while the cardiovascular system diseases were the most common in patients older than 55 years old, accounting for 31.0% (40/129) of the population in this age group. Pareto diagram showed that the percentages of direct causes of RRT initiation ranked from high to low, the cumulative percentage of pneumonia ( n = 30, 20.7%), acute myocardial infarction ( n = 26, 17.9%), stroke ( n = 20, 13.8%), septic shock ( n = 14, 9.7%), heart failure ( n = 10, 6.9%), respiratory and cardiac arrest ( n = 9, 6.2%), and gastrointestinal bleeding ( n = 7, 4.8%), which were the main direct causes of RRT initiation with a total of 80%. Conclusions:Respiratory system and circulatory system diseases are the main causes for RRT treatment in first-aid patients in the Fourth People's Hospital of Shenyang. The hospital mortality significantly increases once patients suffered cardiac arrest. The RRT can provide effective intervention earlier and faster, and establish a complete RRT emergency strategy, which is helpful to improve the in-hospital emergency ability in large general hospitals.

Effect of traditional Chinese medicine invigorating spleen unit therapy on inflammatory markers in patients with osteoarthritis based on random walk model / 中国中药杂志

To evaluate the effect of traditional Chinese medicine(TCM) invigorating spleen unit therapy on inflammatory markers of osteoarthritis(OA) patients by random walk model. The patient information was collected by the data processing system of medical records of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine. In-patient information of the department of rheumatology of the hospital between June 2012 and December 2016 was collected and summarized. Based on the use of traditional Chinese medicine decoction and hospital-prepared compound Qiyi Capsules(Xinfeng Capsules),the patients were divided into the unit therapy group and the simple endotherapy group. The random walk model was used to evaluate the effect of traditional Chinese medicine invigorating spleen unit therapy on TCM spleen therapy unit(ESR) and high sensitive C reactive protein(hs-CRP). A total of 3 517 cases of OA patients met the study requirements. The simple endotherapy group had 1 771 cases(50. 36%),while the unit therapy group had 1 746 cases(49. 64%). The baseline data analysis showed that the general information of the cases,the TCM oral intake frequency and the core prescription information had no statistically significant difference,with comparability. The unit therapy group showed the maximum ESR stochastic volatility at 924,walking step number of 1 771,forward walking growth rate at 0. 264 5,ratio at3. 78,random fluctuation power law at 0. 306 5± 0. 076 8,positive increase rate of comprehensive evaluation index at 0. 264 5,and comprehensive evaluation index record number of 1 771; whereas the simple endotherapy group showed the maximum ESR random fluctuation value at 478,walking step number of 1 399,forward walking growth rate at 0. 152 4,ratio at 6. 56,random fluctuation power law at 0. 347 4±0. 101 7,positive increase rate of comprehensive evaluation index at 0. 152 4,and comprehensive evaluation index record number of 1 399. The unit therapy group showed the maximum hs-CRP random fluctuation value at 391,walking step number of1 081,forward walking growth rate at 0. 178 1,ratio at 5. 62,random fluctuation power law at 0. 343 6±0. 094 7,positive increase rate of comprehensive evaluation index at 0. 178 1,and comprehensive evaluation index record number of 1 081; while the simple endotherapy groups showed the maximum hs-CRP random fluctuation value at 210,walking step number of 797,forward walking growth rate at0. 113 2,ratio at 8. 83,random fluctuation power law at 0. 382 6±0. 109,positive increase rate of comprehensive evaluation index at0. 113 2,and comprehensive evaluation index record number of 797. According to our department of rheumatism,there was a longrange correlation between the two groups in the comprehensive evaluation index and the intervention measures. TCM spleen strengthening unit therapy has a better effect in alleviating the inflammatory index of OA than traditional Chinese medicine.

Effect of triptolide in improving platelet activation in patients with ankylosing spondylitis by regulating VEGFA,SDF-1,CXCR4 pathway / 中国中药杂志

The effect of triptolide( TP) on VEGFA,SDF-1,CXCR4 pathway were investigated in vitro to explore the mechanism in improving platelet activation in patients with ankylosing spondylitis( AS). Peripheral blood mononuclear cells( PBMC) were used for the experiment and divided into 4 groups: normal group( NC),model group( MC),triptolide group( TP),and AMD3100 group. The optimal concentration of TP was measured by the MTT method. The expressions of TNF-α,IL-1β,IL-4,IL-10,VEGFA and VEGFR were detected by ELISA. The expressions of SDF-1,CXCR4 and VEGFA were detected by real-time quantitative PCR( RT-qPCR).The expressions of SDF-1,CXCR4,VEGFA and VEGFR were detected by Western blot. The expression levels of CD62 p,CD40 L and PDGFA were detected by immunofluorescence. MTT results showed that medium-dose TP had the strongest inhibitory effect on cells at24 h. The results of ELISA and PCR showed that TP inhibited mRNA expressions of IL-1β,TNF-α,VEGFA,VEGFR and SDF-1,CXCR4 and VEGFA. The results of Western blot indicated that TP inhibited SDF-1,CXCR4 and VEGFA,VEGFR protein expressions; immunofluorescence results indicate that TP can inhibit the expressions of CD62 p,CD40 L,PDGFA. TP may regulate platelet activation by down-regulating SDF-1,CXCR4,VEGFA and VEGFR mRNA expressions,thereby down-regulating IL-1β and TNF-αexpressions,and up-regulating the expressions of IL-4 and IL-10 cytokines.

Effect of Tripterygium Glycosides Tablets on immune-induced liver and kidney function in patients with rheumatoid arthritis based on data mining / 中国中药杂志

This paper aims to investigate the effect of oral administration of Tripterygium Glycosides Tablets combined with traditional Chinese medicine on immune inflammatory index in patients with rheumatoid arthritis,in order to explore the compatibility mode of traditional Chinese medicine in the treatment of rheumatoid arthritis. Medical records of hospitalized patients with rheumatology at the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from June 2012 to December 2017 were collected. The combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine was adopted for the experimental group,while the simply administration of Tripterygium Glycosides Tablets were adopted for the control group. SPSS 21. 0 was used to analyze the changes of general conditions and immune inflammatory metabolic indexes in the two groups of RA patients. The association rules were analyzed by SPSS Clementine 14. 2 software Apriori module,and the random walk model was evaluated by ORACLE 10 g tool. The results showed that a total of 1 220 patients with rheumatoid arthritis met the requirements of this study,including 322 in the experimental group and 898 in the control group. Before treatment,there was no significant difference in age and duration between the two groups. The difference value of Ig A,Ig G,RF,CCP-AB,hs-CRP and ESR in the two groups of RA patients decreased before and after treatment,and the experimental group was superior to the control group in reduction of Ig A,Ig G,RF,CCP-AB,hs-CRP and ESR.The control group was superior to the experimental group in reduction of Ig M( P<0. 01 or P<0. 05). Compared with before treatment,ALT,AST,ALP,GGT,CREA,BUN,b-MG,MA,TRU and Ig U all increased,with statistically significant differences( P<0. 01).The UA of the two groups of RA patients decreased after treatment,with statistically significant differences( P<0. 01). The experimental group was superior to the control group in reduction of UA,with statistically significant differences( P < 0. 05 or P < 0. 01). The herbs adopted in the prescriptions of 1 220 patients were mainly classified into four categories,namely spleen-sweating herbs,blood-activating and stasis-relieving herbs,phlegm and phlegm-relieving herbs,and heat-clearing and antidote herbs. The results of association rule analysis indicated a significant correlation between the single-flavored Tripterygium Glycosides Tablets,oral Chinese medicine and immune inflammation,and improvement of liver and kidney function indexes. The results of the random walk model analysis indicated that the experimental group's Ig M and hs-CRP were superior to those of the control group in terms of random fluctuation maximum,walking positive growth rate,comprehensive evaluation index increasing rate,comprehensive improvement rate,comprehensive evaluation index recording times,and expected improvement value. The results of this study showed that the single administration of Tripterygium Glycosides Tablets can effectively improve the immune inflammatory metabolic index of patients with rheumatoid arthritis,and the combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine could alleviate the immune inflammatory index of RA patients and reduce liver and kidney dysfunction compared with simple oral administration. The comprehensive evaluation Ig M and hs-CRP in the group of combined administration of Tripterygium Glycosides Tablets and traditional Chinese medicine were better than those in the group of the Tripterygium Glycosides Tablets. There was a long-term correlation between the comprehensive evaluation index and the intervention measures of the two groups of patients.

Effect of Dingzhi Xiaowan on miR-16 expression and 5-HT reuptake / 中国中药杂志

This study is to investigate the effect of antidepressant medicine prescription Dingzhi Xiaowan (DZ) on miR-16 expression levels in vitro and in vivo, and to explore the mechanism of DZ elevated levels of 5-HT from the perspective of post transcriptional regulation. Firstly, a chronic unpredictable mild moderate stimulation (CUMS) combined with solitary rising depression rat model was established, the behavior changes were detected after different doses of DZ (600, 300, 150 mg·kg⁻¹) given for 3 weeks, high performance liquid chromatography (HPLC) was used to detect 5-HT level in hippocampal, PCR method was used to observe the effect of DZ on the expression of SERT mRNA and miR-16 in hippocampus of CUMS rat. The effects of DZ (10, 100, 200, 500 mg·L⁻¹) on the expression of miR-16 and SERT mRNA in the cell model induced by miR-16 silencing and corticosterone or glutamate injury were observed in primary cultured hippocampal neurons of rats in vitro. It was found that 300 mg·kg⁻¹ and 600 mg·kg⁻¹ DZ could significantly improve the behavioral score of CUMS rats, increase the level of 5-HT in hippocampus, and increase the expression of miR-16 and decrease the expression of SERT in the hippocampus of rats. At the same time, in primary cultured hippocampal neurons, 100, 200, 500 mg·L⁻¹ of DZ could significantly increase the expression level of miR-16 in miR-16 silencing and corticosterone or glutamate injury cell model, and decrease the expression level of SERT significantly. So DZ could inhibit the reuptake of 5-HT by inhibiting the expression of SERT by up regulating the expression level of miR-16, and finally increase the level of 5-HT in the brain and exert antidepressant effect.

Discussion on the relationship between injury and disease / 复旦学报（医学版）

Objective To study on quantitative analysis of the participation degree of injury and disease in forensics.Methods So far,There is no based and standard authentic explanations about the relationship between injury and disease.This paper attempt to make it clear by the literlly meaning of chinese based on many files and arguments.So as to clarify the primary and secondary.Results The relationship explanation between injury and desease is approved by the court by using the "five causes" (revoked,stimulated,triggered,secondary and coincident).Conclusions It's significantly effiective that using the literlly meaning of chinese to explain the relationship between injury and desease in judicatory practice.

Effect of the hand-and-knee position on the second stage of labor under continuous epidural block anesthesia / 现代临床护理

Objective To compare the fetal and maternal outcomes of labor undergoing epidural block anesthesia with and without using hand-and-knee position in the second stage of labor.Methods A total of 1,158 subjects were included in the study.There were 560 subjects in the study group and 598 cases in the control group.All the subjects were divided into study and control group according to the randomized numbers.Both groups underwent epidural block anesthesia and used the same labor way in stage I and stage 3.In the study group,the hand-and-knee position was used for 15～30 minutes combined with uterine contractions and the delivery was done in the lithotomy position.In the control group,the gradidea took the semi-recumbent position with bent knees and bed elevated 40°,combined with uterine contractions until the delivery was done in the lithotomy position.The labor time of stage1,stage2,stage3 and all abor,labor way,perinaueum,complications and newborns were compared.Results The average time of the second stage labor and all labor in the observation group were significantly shorter than those of the control group (P＜0.05).The labor ways in the observation group was better than that of the control group (P＜0.05).The incidence of postpartum urinary retention in the observation group was significantly lower than that of the control group (P＜0.05).The differences of labor time for stage 1,stage2,perinaueum,blood loss rate,newboms' s tomor and neonatal asphyxia between two groups were not statistically significant (P＞0.05).Conclusions Under continuous epidural block anesthesia,the use of the hands-and-knees position in the second stage of labor can reduce the incidence of operative delivery,shorten the labor process,and reduce maternal complications.The method is worthy of promotion.

Effect of six class of Kaixin San formulas on pharmacological and preliminary mechanism of Alzheimer's disease mice / 中国中药杂志

The efficacy of Chinese herbal formulas in treating Alzheimer has been proved in many studies. In this study, six different Kaixin San formulas were compared to investigate their effects on learning and memory decline, brain-derived neurotrophic factor (BDNF) in the hippocampus, tau protein, acetylcholinesterase (AChE) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Kunming mice were selected and established a mouse model of Alzheimer's by intraperitoneal injection of D-galactose and sodium nitrite, continued intragastric 4 weeks, using the ability of learning and memory in Morris water maze test to evaluate the animals in each group; the content of BDNF in the hippocampus of mice with Western blotting detected; ELISA method for the detection of each group of mice hippocampal tau protein,p-Tau protein, Aβ,Ach,AchE and serum NT-proBNP levels. The results showed that, Kaixin San of Qianjin Yaofang three dose recorded significantly improved learning and memory ability of mice; increased the content of BDNF and Ach in the hippocampus; decreased the content of Aβ, Tau protein, p-Tau protein in the hippocampus; high, middle dose significantly decreased the serum NT-proBNP and AchE in hippocampus, the effect is most significant. Part dose of Kaixin San of Yixin Fang, Kaixin Wan of Yimen Fang, Dingzhi Xiaowan of Beji Qianjin Yaofang and Dingzhi Wan of Guji Luyan could improve the learning and memory ability evaluation indicators, significantly increased BDNF and Ach in the hippocampus of AD model mice, reduced the Aβ, Tau protein, p-Tau protein in hippocampus of AD model mice, decreased the NT-proBNP and AchE in serum of AD mice, the effect is more significant. Three does of Buxin Tang of Qianjin Yi had no effects of treatment in Alzheimer's disease. The results showed the treatment in AD of Kaixin San of Qianjin Yaofang is the most significant.

Anti-radiation effect and mechanism studies of ethanol extracts from Spatholobus suberectus and its active component catechin / 中国中药杂志

To study the anti-radiation effect and mechanism of ethanol extracts from Spatholobus suberectus and its active component catechin, ICR mice were exposed to 6Gy irradiation and randomly divided into normal group, model group, positive control group (amifostine, 43.6 mg•kg⁻¹, iv 30 min before irradiation), SSD group (10, 20, 40 g•kg⁻¹) and catechin group (50, 100, 200 mg•kg⁻¹). The mice were administered the appropriate drugs once a day after irradiation for 28 consecutive days. Blood samples were collected from the tail end and the number of peripheral blood cells was counted before irradiation and on day 1, 3, 7, 14, 21 and 28 using a microcell counter. Changes of thymus and spleen index of mice on day 7 were observed. The serum SOD, GSH-Px activity and MDA level were detected by the colorimetric method. The colony forming ability of bone marrow hematopoietic progenitor cells on day 7 was detected by semi solid culture method. The HE staining was adopted to observe the pathological changes. The apoptosis of bone marrow cells was detected by flow cytometry. The expression of cleaved caspase-3 and Bax of bone marrow cells were measured separately by western-blotting and immunohistochemistry method. SSD and catechin can both significantly revert the irradiated-induced decline in hematological parameters (RBC, WBC, PLT, Hb), improve thymus and spleen index, significantly enhance serum SOD and GSH-Px activity and decrease the MDA level. The proliferation and differentiation of hematopoietic progenitor cells in bone marrow were promoted, the apoptosis of bone marrow cells was significantly up-regulated and the expression of cleaved caspase-3 and Bax was significantly reduced in SSD and catechin group. SSD and catechin have significant anti-radiation effect and its mechanism may be related to hematopoietic promoting, antioxidant and anti-apoptotic effects.

Effect of Kaixinsan on monoamine oxidase activity / 中国中药杂志

To observe the effect of antidepressant medicine prescription, Kaixinsan (KXS) on monoamine oxidase (MAO) activity, and explore the mechanism of KXS in elevating the levels of monoamine neurotransmitter from the perspective of metabolism, in vitro enzyme reaction system and C6 neuroglial cells, the effect of KXS at different concentrations on MAO-A and MAO-B activity was observed. In animal studies, the effect of KXS at different concentrations on MAO-A and MAO-B activities of brain mitochondrialin normal rats and solitary chronic unpredictable moderate stress (CMS) model rats after intragastric administration for 1, 2, 3 weeks. Results showed that 10 g•L⁻¹ KXS could significantly reduce the activity of MAO-A and MAO-B in enzyme reaction system; and in C6 cells, KXS within 0.625-10 g•L⁻¹ concentration range had no significant effect on the activity of MAO-A, but had obvious inhibitory effect on the activity of MAO-B in a dose dependent manner. KXS had no significant effect on the activity of MAO-A and MAO-B in brains of normal rats after action for 1, 2, 3 weeks. After 2 and 3 weeks treatment with 338 mg•kg⁻¹ dose KXS, MAO-A activity in the brain of CMS rats was decreased as compared with the model group (P<0.05), while KXS had no significant effect on MAO-B activity after 1, 2, 3 weeks of treatment. The results indicated that KXS had certain effect on in vitro MAO-A and MAO-B activity, had no effect on brain MAO-A and MAO-B activity in vivo in normal rats, and had certain inhibitory effect on MAO-A activity in brains of CMS rats.

The expression of phenylalanine hydroxylase in the brain of ragworm Neanthes japonica (Polychaeta, Annelida) / 生物工程学报

Phenylalanine hydroxylase (PAH) is a member of aromatic amino acid hydroxylase (AAAHs) family, and catalyze phenylalanine (Phe) into tyrosine (Tyr). Using immunological and RT-PCR methods to prove the existence of phenylalanine hydroxylase (PAH) gene in the brain of Neanthes japonica in protein and nucleic acid level. Using Western blotting to detect the pah immunogenicity of Neanthes japonica. Making paraffin sections and using immunohistochemical technique to identify the presence and distribution of the phenylalanine hydroxylase gene in the brain of Neanthes japonica. Clone pah gene from the brain of Neanthes japonica by RT-PCR, constructing plasmid and transferring into E. coli to amplification, picking a single homogeneous colony, double digesting then making sequence and comparing homology. Western blotting results showed that the expression of the protein is present in Neanthes japonica brain, immunohistochemistry technique results showed that phenylalanine hydroxylase mainly expressed in abdominal of forebrain, dorsal and sides of midbrain. RT-PCR technique results showed that the phenylalanine hydroxylase exist in the brain of Neanthes japonica and has a high homology with others animals. PAH is present in the lower organisms Neanthes japonica, in protein and nucleic acid level. Which provide the foundation for further study the evolution of aromatic amino acid hydroxylase genes in invertebrate.