Chinese Medicine Regulates Signaling Pathways Related to Esophageal Cancer： A Review / 中国实验方剂学杂志

Esophageal cancer is a common malignant tumor of the digestive tract. At present， the pathogenesis of esophageal cancer has not been fully clarified. Although surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy have achieved good clinical results in the treatment of esophageal cancer， there are still many complications and severe adverse reactions. As an important part of traditional Chinese medicine （TCM）， in recent years， many basic experiments and clinical studies have proved that Chinese medicine has a good effect in treating esophageal cancer. At the same time， the multi-component and multi-target characteristics of Chinese medicine and unclear pathogenesis of esophageal cancer determine that there are some problems such as unclear mechanisms of Chinese medicine in preventing and treating esophageal cancer. It is necessary to start with modern medicine and reveal the mechanism of Chinese medicine in preventing and treating diseases from the aspects of molecular biology and network pharmacology. It is believed in TCM that the occurrence of esophageal cancer is mostly attributed to stagnation of liver Qi， phlegm stasis and Qi stagnation， fluid consumption and heat accumulation， the decline of healthy Qi， and the cementation of cancer toxicity. According to the literature review， Chinese medicinal compounds mainly include tonic formulae （such as Liu Junzitang）， drying and moistening formulas （such as Qigesan）， and heat-clearing formulas （such as Fufang Kushen injection）. Chinese medicinal monomers mainly include drugs potent in attacking poison and killing insects， clearing heat， activating blood and resolving stasis， and regulating Qi， which is consistent with the etiology and pathogenesis of esophageal cancer in TCM. It is also found that Chinese medicine can promote cell apoptosis and autophagy， block cell cycle， and reverse cell resistance by regulating phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， neurogenic locus notch homolog protein （Notch）， Wnt/β-catenin， mitogen-activated protein kinase （MAPK）， nuclear factor-κB （NF-κB）， Janus kinase 2/signal transducer and activator of transcription 3 （JAK2/STAT3）， and other related signaling pathways， but there is no systematic summary. This study systematically summarized the relevant signaling pathways of Chinese medicine in regulating esophageal cancer， which is helpful to clarify the relevant mechanisms of Chinese medicine in the process of esophageal cancer occurrence， development， invasion， and metastasis， so as to provide new targets and new perspectives for the treatment of esophageal cancer and promote the modernization of TCM.

A qualitative study of the difficulties faced by adolescents with depression in the treatment and rehabilitation / 中国学校卫生

Objective@#Based on a qualitative research method, the present study aims to explore the negative experiences and real dilemmas of adolescent with depression in the treatment and rehabilitation process, so as to provide references to promote the improvement of the treatment system for adolescent depression in China.@*Methods@#From August 2022 to November 2022, 30 adolescents with depression were selected for in-depth interviews in the inpatient department of child and adolescent psychiatry at Beijing An Ding Hospital affiliated with Capital Medical University by using the purposive sampling method, and the interview data were analyzed by using the Colaizzi method to summarize the themes.@*Results@#The real dilemmas faced by depressed adolescent during treatment and recovery included three aspects:inappropriate family coping (caregivers lacking of correct disease cognition; caregivers lacking of effective coping methods), difficulties in disease diagnosis and treatment (low rate of identification and adverse effect of treatment; medical service failing to satisfy the demands), and barriers to continued schooling (barriers to academic progress and interpersonal communication).@*Conclusion@#Adolescents with depression face real dilemmas in the process of disease treatment and rehabilitation at home, school and medical care. Caregivers disease literacy and caregiving skills should be improved. A collaborative disease management system among family, school, community and medical institutions should be established to promote adolescent depression treatment and social function recovery.

Expressions of serum thyroid stimulating hormone, thyroid peroxidase antibody and thyroglobulin antibody in papillary thyroid carcinoma and their clinical significances / 肿瘤研究与临床

Objective:To explore the relationship between serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) and the development of papillary thyroid carcinoma.Methods:The clinical data of 574 patients with thyroid nodules who received surgical treatment in Tengzhou Central People's Hospital from January to December 2021 were retrospectively analyzed. Using histopathological diagnosis as the gold standard, the patients were divided into papillary thyroid carcinoma group (malignant group, 267 cases) and benign thyroid nodules group (benign group, 307 cases). The clinical data and the preoperative serum TSH, TPO-Ab and Tg-Ab levels were compared between the two groups. The correlation between preoperative serum TSH, TPO-Ab and Tg-Ab levels and papillary thyroid cancer was analyzed by logistic regression.Results:There were no statistical differences in the age and gender of patients between the malignant group and the benign group (all P > 0.05). TSH [2.37 mIU/L (1.43 mIU/L, 5.09 mIU/L)], TPO-Ab [17.84 IU/ml (11.94 IU/ml, 40.68 IU/ml)] and Tg-Ab [15.69 IU/ml (10.57 IU/ml, 132.00 IU/ml)] in the malignant group were higher than those in the benign group [TSH 1.60 mIU/L (0.88 mIU/L, 2.57mIU/L), TPO-Ab 14.29 IU/ml (10.00 IU/ml, 21.17 IU/ml), Tg-Ab 12.23 IU/ml (10.00 IU/ml, 16.51 IU/ml)], and the differences were statistically significant ( Z values were -6.43, -4.60 and -6.15, all P < 0.05). Multivariate logistic regression analysis showed that positive TPO-Ab ( OR = 0.996, 95% CI 0.993-0.999, P = 0.013) and positive Tg-Ab ( OR = 0.996, 95% CI 0.994-0.998, P < 0.05) were independent risk factors for papillary thyroid cancer. Conclusions:Preoperative serum TSH, TPO-Ab and Tg-Ab levels are closely related to papillary thyroid cancer, among which positive serum TPO-Ab and positive Tg-Ab are independent risk factors for papillary thyroid cancer and have important values in the differential diagnosis of benign and malignant thyroid nodules.

Effects of oxidative stress, PSMB5, TFEB, and lysosomes on sodium arsenite-induced liver injury in rats / 环境与职业医学

Background Liver damage presented in endemic arsenic poisoning is usually serious. Studies have shown that oxidative stress, proteasome beta 5 subunit (PSMB5), regulatory transcription factor EB (TFEB), and lysosomes are associated with liver injury, but their specific links to arsenic-induced liver injury remain unclear. Objective Using a sodium arsenite (NaAsO2)-induced rat liver injury model established earlier by the research group, the expressions of PSMB5, TFEB, and lysosomal associated membrane protein 1 (LAMP1) in liver tissues were detected. Methods Twenty-four SPF Wistar rats were randomly divided into control group, and low, medium, and high dose groups, with 6 rats in each group, half male and half female. The exposure concentrations were 0, 25, 50, and 100 mg·L−1 NaAsO2 solutions for 24 weeks. At the end of the experiment, liver was dissected after rats were anesthetized. The levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), total bile acid (TBA), and catalase (CAT) in liver tissues were detected by chemical colorimetry, and the levels of lipid peroxide (LPO), 4-hydroxynonenal (4-HNE), LAMP1, and cathepsin D (CTSD) in liver tissues were detected by enzyme-linked immunosorbent assay (ELISA); the transcriptional expression levels of PSMB5 and TFEB in liver tissues were detected by real-time fluorescence quantitative PCR (RT-qPCR), and the protein expressions of PSMB5, TFEB, and phosphorylated TFEB (p-TFEB) in liver tissues were detected by immunohistochemistry. Results The results of chemical colorimetry and ELISA showed that compared with the control group, the liver homogenate levels of ALP, TBA, and LAMP1 of each arsenic-exposed group, the ALT and LPO in the medium and high concentration groups, the 4-HNE and CTSD in the high concentration group were increased, while the CAT activity of each arsenic-exposed group was decreased (P<0.05). The results of real-time fluorescence quantitative PCR showed that the transcription levels of PSMB5 and TFEB in the liver tissues of each arsenic-exposed group were decreased compared with those of the control group (P<0.05). The results of immunohistochemistry showed that compared with the control group, the expression of PSMB5 of each arsenic-exposed group were decreased, the expression of TFEB in the medium and high concentration groups was decreased, while the expression of p-TFEB of each arsenic-exposed group was increased (P<0.05). The expression of TFEB protein gradually decreased in the nucleus, while the expression of p-TFEB protein gradually increased in the cytoplasm, but no expression of p-TFEB was found in the nucleus. The results of Pearson correlation analysis showed that PSMB5 in liver tissues was positively correlated with CAT (r=0.818, P＜0.05), and negatively correlated with 4-HNE and p-TFEB (r=−0.582, r=−0.899; P＜0.05); TFEB was negatively correlated with CTSD and LAMP1 (r=−0.457, r=−0.564; P＜0.05); CTSD was positively correlated with ALT and ALP (r=0.529, r=0.485; P＜0.05). Conclusion Long-term exposure to NaAsO2 can induce oxidative stress, inhibit the expression of PSMB5 and TFEB, promote the accumulation of p-TFEB in the cytoplasm, decrease the nuclear entry of active TFEB, damage the lysosome, and cause liver damage.

Risk factors for complications after endoscopic retrograde cholangiopancreatography in super-aged patients / 中华消化内镜杂志

Objective:To study the risk factors for complications after endoscopic retrograde cholangiopancreatography (ERCP) in super-aged patients (≥80 years).Methods:Clinical data of 512 super-aged patients with pancreaticobiliary diseases who underwent 638 ERCP procedures at the Digestive Endoscopy Center, Zhongnan Hospital of Wuhan University, from July 2011 to June 2021, were studied retrospectively. Indications and results of the ERCP operations were analyzed. Multivariate logistic regression model was used to analyze the risk factors for ERCP-related complications.Results:The total success rate of ERCP cannulation in super-aged patients was 94.0% (600/638), which showed no difference compared with that of patients of <60 years old (2 433/2 557, 95.2%) or patients of 60~<80 years old (2 815/3 004, 93.7%) ( χ2=5.49, P=0.064). The overall incidence of post-ERCP complications was 15.2% (97/638), and the in-hospital mortality was 2.1% (11/512), which showed significant difference compared with patients of <60 years old (8/1 809, 0.4%) and patients of 60-<80 years old (21/2 127, 1.0%) ( χ2=13.39, P=0.002). Multivariate regression analysis showed that hypertension ( HR=1.94, 95% CI: 1.237-3.041, P=0.004), history of upper gastrointestinal reconstruction ( HR=2.28, 95% CI: 1.064-4.891, P=0.034), endoscopic sphincterectomy ( HR=1.65, 95%CI: 1.012-2.679, P=0.045), early procedure period ( HR=0.57, 95% CI: 0.352-0.923, P=0.022), operation time >30 minutes ( HR=1.74, 95% CI: 1.094-2.759, P=0.019), preoperative white blood cell count >9.5×10 9/L ( HR=2.66, 95% CI: 1.661-4.257, P<0.001) and procalcitonin ≥0.05 ng/L ( HR=2.54, 95% CI: 1.172-5.513, P=0.018) were independent risk factors for post-ERCP complications. Conclusion:ERCP is safe and effective for super-aged patients. However, much attention should be paid to post-ERCP complications of patients with hypertension, history of upper gastrointestinal reconstruction, endoscopic sphincterectomy, operation time >30 minutes, preoperative white blood cell count >9.5×10 9/L and procalcitonin ≥0.05 ng/L to avoid serious adverse events such as mortality.

Evaluation of a China-made disposable peroral cholangioscope in an animal experiment / 中华消化内镜杂志

Objective:To evaluate the efficacy and safety of a China-made disposable peroral cholangioscope in animal cholangioscopy.Methods:Six healthy Bama minipigs underwent the domestic disposable peroral cholangioscopy after anesthesia. The operation performance and image quality of the products were evaluated, and intraoperative and postoperative complications were recorded.Results:All 6 animals received the domestic disposable peroral cholangioscopy. The cholangioscope showed good operating performance and could smoothly enter the biliary tract through the duodenoscope. The water injection, suction and instrument channels were unobstructed. The cholangioscopic image was clear, the color resolution was good, and there was no image distortion. The lumen and the mucosal surface could be accurately assessed. During the examination, there was no operative injuries such as bleeding, perforation, or adverse events such as respiratory depression or cardiac arrest. All pigs survived the operation with no adverse reaction.Conclusion:The China-made disposable peroral cholangioscope is safe, with good operability and high-quality image.

Clinical evaluation of malnutrition in maintenance hemodialysis patients / 国际生物医学工程杂志

Objective:To study the evaluation method of protein energy wasting (PEW) in maintenance hemodialysis patients.Methods:A total of 166 maintenance hemodialysis patients were selected. Their medical records, physical indicators, as well as NS2002, PG-SGA, and MUST nutrition scale scores were also collected. The patients were divided into PEW and non-PEW groups according to whether PEW occurred or not, and the differences in each index between the two groups were compared to analyze the diagnostic efficacy of each index and nutrition score scale results on the occurrence of PEW.Results:The differences in body mass, body mass index(BMI), body surface area, abdominal circumference, triceps skinfold thickness, upper arm circumference, and calf circumference between the PEW and non-PEW groups were statistically significant(all P<0.05). The diagnostic efficacy of a single physical index or nutrition score for PEW was limited. A simplified formula for the PEW risk was obtained by logistic model analysis. The formula had a sensitivity of 67.7% and a specificity of 94.4% for the diagnosis of PEW, as analyzed by the subject's working characteristic curve. Conclusions:Four indicators, including abdominal circumference, primary hand grip strength, BMI, and upper arm circumference, can be combined to comprehensively assess the presence of PEW to improve the diagnostic efficacy of the occurrence of malnutrition in maintenance hemodialysis patients.

Influencing factors of protein energy wasting in maintenance hemodialysis patients / 国际生物医学工程杂志

Objective:To explore the main risk factors of protein energy expenditure (PEW) in maintenance hemodialysis (MHD) patients.Methods:According to diagnostic criteria, 166 patients with MHD were divided into PEW group and control group. The general clinical data, physical indexes, and physical and chemical analysis results of all patients was collected, and the differences in indexes between the two groups of patients were compared. Logistic analysis was used to find the risk factors of MHD combined with PEW.Results:There were statistically significant differences in blood pressure, protein intake, vitamin intake, and uric acid, creatinine, blood calcium levels between the PEW group and the control group (all P<0.05). Multivariate logistic regression analysis showed that blood pressure, daily sleep time, whether to take vitamins, body mass index (BMI), creatinine and parathyroid hormone (PTH) were the risk factors of MHD combined with PEW. Conclusions:In clinical practice, more attention should be paid to controlling blood pressure, improving sleep, and supplementing vitamins in patients with MHD.

Role of oxidative stress-induced AMPK/ULK1 pathway activation and lysosomal dysfunction in arsenic-induced liver injury in rats / 环境与职业医学

Background A prominent feature of endemic arsenic poisoning is severe liver damage. Studies have found that liver injury is closely related to oxidative stress, lysosomes, and autophagy. Objective Through establishing a liver injury model of rats by sodium arsenite (NaAsO2)administration in drinking water, this experiment is designed to explore the roles of oxidative stress, lysosomes, and AMP activated protein kinase (AMPK)/Unc-51 like kinase 1 (ULK1) pathway in this model. Methods Twenty-four Wistar rats were randomly divided into four groups with six rats in each group (half male and half female), including control group and 25, 50, 100 mg·L−1 NaAsO2 groups. A rat liver injury model was established by drinking water containing NaAsO2 freely for 24 weeks. Then liver of rats was dissected after sacrificed, and the levels of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bile acid (TBA), catalase (CAT), lipid peroxidation (LPO), and total antioxidant capacity (T-AOC) in liver tissues were detected by assay kits. The levels of lysosomal-associated membrane protein 2 (LAMP2), cathepsin B (CTSB), and acid phosphatase (ACP2) were determined by enzyme linked immunosorbent assay. The mRNA transcriptional expressions of AMPK, ULK1, microtubule-associated protein light chain 3 (LC3), and sequestosome 1 (p62) were detected by real-time fluorescence quantitative PCR (RT-qPCR). The protein expressions of p-AMPK, p-ULK1, LC3, and p62 were detected by immunohistochemistry. Results Following the NaAsO2 administration, significant differences were found in the levels of ALT, ALP, and TBA among the designed groups (F=12.09, 72.11, and 23.58, P<0.05). Compared with the control group, the levels of ALT in the 50mg·L−1 and 100 mg·L−1 NaAsO2 groups were increased (P<0.05); the levels of ALP and TBA in the 25, 50, and 100 mg·L−1 NaAsO2 groups were increased (P<0.05); the level of LPO in the 100 mg·L−1 group was increased (P<0.05); the levels of CAT and T-AOC in the 25, 50, and 100 mg·L−1 NaAsO2 groups were decreased (P<0.05). According to the results of enzyme linked immunosorbent assay, the levels of ACP2 in the 25, 50, and 100 mg·L−1 NaAsO2 groups, the level of CTSB in the 100 mg·L−1 NaAsO2 group, and the levels of LAMP2 in the 50 and 100 mg·L−1 NaAsO2 groups were decreased compared with the control group (P<0.05). Based on the results of RT-qPCR and immunohistochemistry, the mRNA transcriptional and protein expressions of AMPK, ULK1, and LC3 in some arsenic groups were elevated to varying degrees compared with the control group, and the increment in the 100 mg·L−1 NaAsO2 group was significant for all the indicators (P<0.05); the mRNA transcriptional expressions of p62 in the three arsenic groups and the protein expressions of p62 in the 50 and 100mg·L−1 NaAsO2 groups also increased compared with the control group (P<0.05). Besides, the results of Pearson correlation analysis showed that there was a positive correlation of T-AOC with LAMP2, CTSB, and ACP2 (r=0.651, 0.673, 0.626; P<0.05), a negative correlation of LPO with CTSB and ACP2 (r=−0468, −0.482; P<0.05), a negative correlation of p62 with LAMP2, CTSB, and ACP2 (r=−0.57, −0.626, −0.591; P<0.05), and a positive correlation of p62 with ALT, ALP, and TBA (r=0.709, 0.897, and 0.857, P<0.05). Conclusion Long-term arsenic exposure may induce oxidative stress, damage lysosomes, and activate the AMPK/ULK1 pathway, which can lead to the blockage of autophagy process, and eventually result in liver damage.

Epidemiological characteristics of coronavirus disease 2019（COVID-19）cases in Zhoushan / 预防医学

Objective @#To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19.@*Methods @#All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. @*Results @#By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts.@*Conclusions @#The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Expression and significance of TNF?α and M?CSF in placenta tissue of early severe preeclampsia / 中国综合临床

Objective To investigate the expression and clinical significance of macrophage colony stimulating factor ( M?CSF ) and tumor necrosis factor α ( TNF?α ) in placenta of early onset severe preeclampsia (PE)??Methods Immunohistochemical SP method was used to detect the expression of M?CSF and TNF?α in 77 cases paraffin specimens from Department of Pathology,First Affiliated Hospital of Henan University of Science and Technology from September 2015 to September 2017,including 35 cases of early?onset severe PE,42 cases of late?onset severe PE and 30 cases of normal pregnant women??Results (1)The positive expression rates of M?CSF in control group,late?onset severe PE group and early?onset severe PE group were 30%(9／30),61??90%(26／42),82??86%(29／35),respectively??The difference was statistically significant ( χ2 ＝ 18??90, P＜0??05)??The positive expression rates of early?onset severe PE group were significantly higher than those in control group (χ2＝18??59,P＜0??05),and the difference was statistically significant????The positive expression of early?onset severe PE group was higher than that of late?onset severe PE group,and the difference was statistically significant (χ2＝4??017,P＜0??05)??(2) The positive expression rates of TNF?α in control group,late?onset severe PE group and early?onset severe PE group were 33??33%(10／30),69??05%(29／42),91??43%(32／35),respectively??The difference was statistically significant (χ2＝30??21,P＜0??05)??The positive expression of TNF?α in early?onset severe PE group was significantly higher than that in control group (χ2＝21??37,P＜0??05),and the difference was statistically significant??The positive expression of M?CSF and TNF?a in early?onset severe PE group was higher than that in late?onset severe PE group,and the difference was statistically significant (χ2＝4??529,P＜0??05); (3) The expression of M?CSF and TNF?α was positively correlated in PE (r＝0??441,P＝0??000)??Conclusion Placental damage is higher in early?onset severe PE,and is related to the severity of the disease??The levels of M?CSF and TNF?alpha in placenta of PE patients may play a synergistic role in the occurrence and development of PE??

Risk factors of acute pancreatitis after endoscopic retrograde cholangiopancreatography / 中华全科医师杂志

Objective To investigate the risk factors of acute pancreatitis after endoscopic retrograde chloangiopancreatography (ERCP).Methods Clinical date of 1 041 patients who underwent therapeutic ERCP from January 2016 to August 2017 in department of gastroenterology,Zhongnan Hospital of Wuhan University,were retrospectively studied.Among them post-ERCP pancreatitis developed in 53 patients (PEP group) and the remaining 988 patients were assigned in the non-PEP group.The clinical characteristics,procedures of ERCP,gastrointestinal symptoms and laboratory findings after ERCP were compared between two groups.The SPSS software (version 22.0) was applied to analyze the risk factors of PEP.Results The overall incidence rate of PEP was 5.09％ (53/1 041).There were statistic difference in the number of white cells [8.56(5.43,12.23)× 109/L vs.7.12(5.58,9.20)× 109/L,Z=-2.122] and the ratio of neutrophils [0.82 ± 0.11 vs.0.76 ± 0.12,t=-3.612] after ERCP operation;the incidence of endoscopic sphincterotomy (EST) [60.37％(32/53) vs.43.72％(432/988),x2=5.646] and endoscopic papillary balloon dilation (EPBD)[50.94％(27/53) vs.33.00％(326/988),x2=7.230] during operation,and periampullary diverticula [35.85％(19/53) vs.52.98％(523/988),x2=4.619] (all P＜0.05).Logistic analysis indicated that the ratio of neutrophils was independent risk factor of PEP(OR=1.058,95％CI:1.019-1.098,P=0.003).Conclusion The number of white cells,the ratio of neutrophils after ERCP and endoscopic sphincterotomy,endoscopic papillary balloon dilation and periampullary diverticula are associated with PEP,while the ratio of neutrophils is the independent risk factor of PEP.

Efficacy and Safety of TCM Prescription for Gout versus Allopurinol in the Treatment of Gout: A Systematic Review / 中国药房

OBJECTIVE: To evaluate therapeutic efficacy and safety of allopurinol versus (vs.) TCM prescription for gout in the treatment of gout, and to provide evidence-based reference for clinical treatment of gout. METHODS: Retrieved from PubMed, Embase, Medline, The Cochrane library, Chinese Journal Full-text Database (CJFD), China Scientific Journal Database (CSJD) and Wanfang database, randomized controlled trials (RCTs) about therapeutic efficacy (total response rate, level of uric acid) and safety (the occurrence of ADR) of TCM prescription for gout alone or combined with allopuinol (trial group) vs. allopurinol (control group) in the treatment of gout were collected. After data extraction of clinical studies meeting inclusion criteria, Cochrane system evaluator manual 5. 1. 0 was used to evaluate the quality of included studies, and Meta-analysis was conducted by using Rev Man 5. 3 statistical software. RESULTS: A total of 20 RCTs were included, involving 1 961 patients. Results of Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=2. 29, 95％ CI(1. 84, 2. 84), P<0. 001], uric acid level was significantly lower control group [MD= -27. 99,95％ CI(-33. 04, -22. 93),P<0. 001],with statistical significance. The incidence of ADR in trial group was significantly lower than control group, with statistical significance (P<0. 05). CONCLUSIONS: Therapeutic efficacy and safety of TCM prescription are better than those of allopuinol for gout.

Phenols from Plantaginis Semen / 中成药

AIM To study the phenols from Plantaginis Semen.METHODS The 65％ and 95％ ethanol extracts of Plantaginis Semen were isolated and purified by macroporous resin,silica,ODS,Sephadex and preparative column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as (+)-(7R,7'R,8S,8'S)-neo-olivil (1),erythro-guaiacylglycerol-β-ferulic acid ether (2),eriodictyol (3),luteolin (4),chrysoeriol (5),hydroxytyrosol (6),4-(3,4-dihydroxyphenyl)-(E)-3-buten-2-one (7),ferulic acid (8),5,7-dihydroxychromone (9).CONCLUSION Compounds 2-3,6-7 and 9 are isolated from genus Plantago for the first time,compound 5 is first obtained from this plant.

Advancements in Pharmacological Material Basis and Quality Control of Tibetan MedicineLiu-Wei Mu-XiangPill / 世界科学技术-中医药现代化

Tibetan medicineLiu-Wei Mu-Xiang(LWMX) pill, a traditional compound medicine, has special therapeutic effects in the treatment of gastrointestinal anabrosis, especially chronic gastric ulcer. It has been widely applied in the clinics in Tibetan region. Nevertheless, the current standards for quality control are insufficient and incomplete, which makes it difficult to ensure its quality. This review focused on two closely related perspectives, which were the effective material basis and quality control, to summarize and review the recent advancement in relevant studies. This review also pointed out that the burning questions for Tibetan medicine standards were the origin confusion and“different medicines with the same name”. It offered meaningful suggestions for the consideration to improve its quality standards.

Effect on short and long term clinical outcome of attenuated plaque in patients with acute coronary syndrome ;after percutaneous coronary intervention / 中华超声影像学杂志

Objective To explore the effect on prognosis of attenuated plaque (AP)in patients with acute coronary syndrome (ACS)after percutaneous coronary intervention(PCI).Methods This study was a prospective study which included 225 ACS patients who admitted to the cardiology and met the conditions between January 2009 and December 2011.Clinical data,intravascular ultrasound characteristics of plaque, blood flow in coronary angiography and cardiovascular complications within 30 days after PCI were recorded.The main form of follow-up was telephone follow-up,supplemented by patient follow-up and out-patient follow-up.Endpoint was major adverse cardiac events (MACE).Kaplan-Meier method was used to estimate survival rate.The survival difference between the two groups was compared using the Log-Rank test.Results Extravascular elastic membrane area (EEMA),plaque area (PA),plaque burden,remodeling index in AP group were significantly increased than those in non-AP group.Corrected TIMI frame count (CTFC)immediately after the balloon dilatation was significantly higher in AP group than in non-AP group. Recent overall complications were more frequently documented in AP group than in non-AP group,but long-term follow-up outcome of MACE-free survival curves showed no significant difference between the two groups.Conclusions Recent prognosis,not long-term prognosis,is affected by attenuated plaque in ACS patients after PCI,which help to stratify risk further and guide treatment in ACS patients.

Analysis of risk factors for acute kidney injury in patients with decompensated cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for and the prognosis of acute kidney injury (AKI) in decompensated cirrhotic patients.</p><p><b>METHODS</b>A total of 126 patients with decompensated cirrhosis and with (n =60) or without (n =66, control group) AKI were enrolled in this retrospective analysis. Follow-up was carried out on all patients, with durations ranging from less than 1 year to up to 4 years. Blood biochemistry, liver and renal functional parameters and prognosis of these patients were recorded. Logistic regression analysis was used to evaluate possible risk factors for decompensated cirrhotic patients developing AKI.</p><p><b>RESULTS</b>The patients with AKI had a significantly lower survival rate than the patients without AKI (55.0% vs.83.3%, x2 =13.270, p =0.001). Unconditional multivariate logistic regression analysis identified risk factors of AKI development in decompensated cirrhotic patients as increased serum creatinine (odds ratio (OR):1034), increased total bilirubin (OR:1.005), increased international normalized ratio (INR; OR:2.471), decreased plasma sodium concentration (OR:0.910), decreased serum cholinesterase (OR:0.999), and decreased glomerular filtration rate (GFR; OR:0.972) (all P less than 0.05).</p><p><b>CONCLUSION</b>The development of acute kidney injury represents an adverse prognosis in decompensated cirrhotic patients. An increase in serum creatinine, total bilirubin or INR or a decrease in plasma sodium concentration, serum cholinesterase or GFR may be early-warning factors of development of AKI in decompensated cirrhotic patients.</p>

Study on the correlation between plasma homocysteine,folate acid and vitamin B12 levels and vascular de-mentia / 中国基层医药

Objective To study on the correlation between plasma homocysteine (Hcy),folate acid(FA) and vitamin B12(VitB12) levels and vascular dementia (VD).Methods To measure plasma Hcy, FA and vitamin B12 in 96 patients with VD ,in 152 non-dementia cerebrovascular disease ( NDCVD ) and in 80 normal controls re-spectively,and results werw compared between each two groups by using student test .Cognitive status was evaluar by using mini mentai state examination(MMSE).The effect of Hcy,FA and VitB12 on VD and its cognitive function were analyzed.Results The levels of plasma Hcy in VD and NDCVD were higher than those in normal control grop ,and there was significantly difference (t=3.26,3.14,all P<0.01),and the best high one is VD;The levels of plasma FA and VitB12 in VD and NDCVD were lower than those in normal control grop ,and there was significantly difference ( t=3.16,2.98,3.21,2.91,all P<0.01),and the best low one is VD.The levels of plasma Hcy concentrations were in-creased and MMSE scores were decreased with severity of dementia , and there were negative correlation between MMSE scores and plasma Hcy concentrations (r=-0.69,P<0.05).Conclusion The levels of plasma Hcy corre-lated with VD.High-Hcy is one of possible rise factor for VD in senior .Both low-FA and low-VitB12 were indirect fac-tors for VD.

Prevention of pancreatitis after endoscopic retrograde cholangiopancreatography with different methods:a Meta analysis / 中华消化外科杂志

Objective To evaluate the efficacy of different methods in preventing pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Methods Databases including PubMed,EMBASE,Cochrane Library,Chinese Journal Full-text Database,China Biomedicine Database were searched with key words including endoscopic retrograde cholangiopancreatography,ERCP,post-ERCP pancreatitis,pancreatitis,pancreatic duct stent,non-steroid anti-inflammatory drugs,indometacin,diclofenac,protease inhibitors,nafamostat,ulinastatin,gabexate,somatostain,内镜逆行胰胆管造影,内镜逆行胰胆管造影术后胰腺炎,胰腺炎,胰管支架置入,非甾体类抗炎药,吲哚美辛,双氯芬酸,抑酶剂,萘莫司他,乌司他丁,加贝酯and生长抑素.Literatures published between January 2000 and January 2014 were searched.Randomized controlled studies on prevention of pancreatitis after ERCP which were enrolled in this study were analyzed by 2 independent reviewers.The quality of the literatures was evaluated.All data were analyzed using the RevMan 5.0 software.Data were expressed in odds ratio (OR) and 95％ confidence interval (95％ CI).The heterogeneity of the studies was analyzed using the I2 test.Results Twenty-seven literatures were enrolled in the study.There were 4 701 patients in the experimental group (including patients who were treated by pancreatic stent installation,non-steroidal antiinflammatory drugs,nafamostat,ulinastatin,gabexate,intravenous infusion of somatostain for more than 6 hours,intravenous infusion of somatostain for less than 6 hours,bolus injection of somatostain) and 3 592 patients in the control group (including patients treated without pancreatic duct installation or placebo).The results of Meta analysis showed that pancreatic stent installation,non-steroid anti-inflammatory drugs,nafamostat,intravenous infusion of somatostain for more than 6 hours and bolus injection of somatostain could significantly decrease the incidence of pancreatitis after ERCP (OR =0.18,0.45,0.31,0.33,0.25,95％ CI:0.09-0.35,0.33-0.61,0.19-0.52,0.20-0.56,0.11-0.55,P ＜ 0.05).Conclusion Pancreatic stent installation,non-steroid anti-inflammatory drugs,nafamostat,intravenous infusion of somatostain for more than 6 hours and bolus injection of somatostain could effectively prevent the incidence of pancreatitis after ERCP.

Effect of cyclic stretch on the proliferation of C2C12 myoblasts / 中国组织工程研究

BACKGROUND:Mechanical stimulation triggers a muscle tissue remodeling, during which, myoblast process is a multi-stage development process. Many signals in extracellular matrix are involved in myoblast process, and mechanical signals are considered as important external factors for muscle formation and regeneration. Numerous studies concerning cyclic tensile stress effects on myoblast proliferation and apoptosis have been reported, but the specific mechanism underlying the mechanical stimulation in muscle formation is stil unclear. OBJECTIVE:To study the effects of cyclic stretch on proliferation of C2C12 myoblasts and its mechanism. METHODS:C2C12 myoblasts were cultured in vitro under 10%cyclic stretch for 6, 12 and 24 hours. RESULTS AND CONCLUSION:The results of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay showed that with the time of cyclic stretch, the proliferation of C2C12 myoblasts and the rate of S-phase fraction were gradual y increased and peaked at 12 hours (P<0.05), and then decreased. Western blot assay showed that the expression of nuclear transcription factorκB protein was decreased with time, which was inversely correlated to the proliferation of C2C12 myoblasts, but increased at 24 hours under the cyclic stretch. These findings indicate that the cyclic stretch can induce C2C12 myoblasts proliferation and alter the cellcycle. Nuclear transcription factorκB may be involved in this process.