Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical insurance fund operations data in Gansu, China.

BACKGROUND: In China, enhancing the pooling levels of basic health insurance has consistently been regarded as a pivotal measure to promote the refinement of the healthcare insurance system. From 2020 to 2022, the widespread outbreak of COVID-19 posed new challenges to China's basic health insurance. METHODS: The research utilizes Data Envelopment Analysis (DEA), Malmquist index assessment, and fixed-effects panel Tobit models to analyze panel data from 2020 to 2022, assessing the efficiency of basic health insurance in Gansu Province. RESULTS: From 2020 to 2022, the average overall efficiency of the municipal pooling of Basic Medical Insurance for Urban and Rural Residents was 0.941, demonstrating a stable trend with a modest increase. The efficiency frontier regions have expanded from 5 (35.71%) to 7 (50%). Operational efficiency exhibited a negative correlation with per capita hospitalization expenses and per capita fund balance but a positive correlation with per capita accumulated fund balance and reimbursement rates for hospitalized patients. In 2021, compared to 2020, the county-pooling Basic Medical Insurance for Urban Employees saw a decline of 0.126 in overall efficiency, reducing the efficiency frontier regions from 8 to 3. However, from 2021 to 2022, the municipal-coordinated Basic Medical Insurance for Urban Employees experienced a 0.069 increase in overall efficiency, with the efficiency frontier regions expanding from 3 to 5. Throughout 2020 to 2022, the operational efficiency of the Urban Employee Basic Medical Insurance showed a consistent negative correlation with per capita fund balance. CONCLUSION: From 2020 to 2022, the overall operational performance of basic health insurance in Gansu Province was satisfactory, and enhancing the pooling level is beneficial in addressing the impact of unforeseen events on the health insurance system.

Analysis on the Effects of PPARγ Gene-silenced Human Bone Marrow Stromal Cells on Hematopoietic Function in Mice with Bone Marrow Suppression / 华中科技大学学报(医学版)

Objective To investigate the effects of peroxisome proliferator activated receptor-gamma(PPARγ)gene silen-cing in human bone marrow stromal cells(HS-5)on hematopoietic function in bone marrow-suppressed mice,and to explore the potential mechanisms involved.Methods A bone marrow-suppressed mouse model was established by whole-body X-ray irradi-ation.Two hours after modeling,the mice were randomly divided into three groups:experimental group(intravenous injection of PPARγ RNAi-interfered HS-5 cells through the tail vein),control group(intravenous injection of PPARγ RNAi-uninterfered HS-5 cells through the tail vein),and blank group(intravenous injection of an equal amount of saline through the tail vein),with 5 mice in each group.Peripheral blood routine tests were performed before,24 hours after,1 week after,and 2 weeks after radio-therapy.In vitro osteogenic and adipogenic induction was performed in cells,and the cells were divided into experimental group(PPARγ RNAi-interfered HS-5 cells),control group(PPARγ-uninterfered HS-5 cells),and blank group(HS-5 cells without os-teogenic/adipogenic induction).Osteogenic/adipogenic staining was observed.The effects of PPARγ gene-silenced HS-5 cells on mouse bone marrow hematopoietic stem cells(HSCs)were detected by CCK-8 proliferation assay.The groups included experi-mental group(PPARγ RNAi-interfered HS-5 cells were co-cultured with mouse HSCs after 3 days of osteogenic induction dif-ferentiation),positive control group(HS-5 cells treated with 50 μmol/L PPARγ inhibitor were co-cultured with mouse HSCs af-ter 3 days of osteogenic induction differentiation),negative control group(PPARγ RNAi-uninterfered HS-5 cells were co-cul-tured with mouse HSCs after 3 days of osteogenic induction differentiation),and blank group(Mouse HSCs were cultured alone without co-culturing with HS-5 cells).Results After radiotherapy,the hematological parameters of mice in each group showed a decreasing trend initially,and then increased.One week after radiotherapy,there were significant differences in platelet and white blood cell levels among the three groups(experimental group＞control group＞blank group,all P＜0.05).Two weeks after radiotherapy,there were significant differences in the percentage of adipocyte vacuole area among the three groups(experi-mental group＜control group＜blank group,all P＜0.05).Pearson correlation analysis showed a negative correlation between hematological parameters and PPARγ expression levels(all P＜0.05),as well as a negative correlation between hematological parameters and the percentage of adipocyte vacuole area(all P＜0.05).After in vitro osteogenic/adipogenic induction differenti-ation,compared to the control group,the experimental group showed a significantly lower proportion of orange-red cells and a significantly higher proportion of red calcium nodules.After 3 days of osteogenic induction differentiation,the experimental group,positive control group,and negative control group of human bone marrow stromal cells were co-cultured with mouse HSCs,while HSCs were solely cultured in the blank group.The results showed that after 24 h,48 h and 72 h of co-culture,the A values of mouse HSC cells in the experimental group and positive control group were higher than those in the negative control group and blank group(all P＜0.05).Conclusion Silencing of the PPARγ gene in HS-5 cells implanted into bone marrow-sup-pressed mice contributes to enhanced hematopoietic function in mice.After interference and silencing of the PPARγ gene,the os-teogenic differentiation ability of HS-5 cells is enhanced,while the adipogenic differentiation ability is weakened.Furthermore,osteogenic-induced HS-5 cells can further enhance the proliferation capacity of mouse HSCs.

Oral Administration of Bovine Lactoferrin-Derived Lactoferricin (Lfcin) B Could Attenuate Enterohemorrhagic Escherichia coli O157:H7 Induced Intestinal Disease through Improving Intestinal Barrier Function and Microbiota.

Lactoferricin (Lfcin) B, derived from lactoferrin in whey, has attracted considerable attention because of its multiple biological functions. Zoonotic enterohemorrhagic Escherichia coli (EHEC) O157:H7 has adverse effects on intestinal epithelial barrier function, leading to serious intestinal disease. In this study, the EHEC O157:H7-induced intestinal dysfunction model was developed to investigate the effects of Lfcin B on EHEC O157:H7-induced epithelial barrier disruption and microbiota dysbiosis. Results showed that the inflammatory infiltration indexes in the jejunum of Lfcin B-treated animals were significantly decreased. Lfcin B administration also significantly improved ZO-1 and occludin expression following O157:H7-induced injury. Finally, microbiota analysis of the cecal samples revealed that Lfcin B inhibited the O157:H7-induced abnormal increase in Bacteroides. Therefore, Lfcin B efficiently attenuated O157:H7-induced epithelial barrier damage and dysregulation of inflammation status, while maintaining microbiota homeostasis in the intestine, indicating that it may be an excellent food source for prevention and therapy of EHEC O157:H7-related intestinal dysfunction.

Optimization of Phenylphthalein and Phenolic Acid Components Extracts from Angelicae Sinensis Radix-Chuanxiaong Rhizoma Decoction Pieces by Central Combination Design Response Surface Methodology / 中国中医药信息杂志

Objective To optimize the optimal extraction process for phthalein and phenolic acid components in Angelicae Sinensis Radix-Chuanxiaong Rhizoma decoction pieces.Methods On the basis of a single factor experiment,central combination design-response surface methodology was adopted,and the extraction time,ethanol concentration,and ethanol dosage were used as influencing factors,and the total normalized values of the content of Senkyunolide I,Senkyunolide A and ligustilide,and extract yield were used as evaluation indicators to optimize the extraction process of phthalein components in Angelicae Sinensis Radix-Chuanxiaong Rhizoma decoction pieces;the total normalized values of chlorogenic acid,caffeic acid,ferulic acid,and extract yield were used as evaluation indicators to optimize the extraction process of phenolic acids components in Angelicae Sinensis Radix-Chuanxiaong Rhizoma decoction pieces.Results The optimal extraction process was to add 7 times the amount of 90%ethanol to the phthalein components,extract for 130 minutes each time,and extract twice;phenolic acid components were extracted twice with 7.5 times the amount of 65%ethanol for 120 minutes each time.Conclusion The optimized extraction process for phthalein and phenolic acids in Angelicae Sinensis Radix-Chuanxiaong Rhizoma decoction pieces is stable and feasible,which can provide a basis for subsequent research.

Clinical heterogeneity and cluster analysis of multiple system atrophy / 中华老年医学杂志

Objective:To examine the clinical subtypes of patients with multisystem atrophy(MSA)that may indicate the prognosis of patients.Additionally, we aim to compare the ability to perform daily activities among patients of each subtype using cluster analysis.Methods:The retrospective analysis included demographic data, clinical symptoms and signs, scale scores, and ancillary examinations of 94 patients diagnosed with multisystem atrophy at Xuanwu Hospital of Capital Medical University.The study aimed to analyze the clinical characteristics of each subtype obtained through clustering.Additionally, a comparison was made between patients with traditional motor subtypes and those with new subtypes in terms of activities of daily living.The study consisted of 94 MSA patients, with an average age of 61 years and a female representation of 51.1%.Using the data collected on the continuum, a full linkage hierarchical cluster analysis was performed to classify MSA patients into four clinical subtypes: gait disorder(17 cases, 18.1%), malignant tonic hyperkinetic with premature haircut(25 cases, 26.6%), intermediate(43 cases, 45.7%), and autonomic benign type(9 cases, 9.6%).Each subtype exhibited various clinical motor and non-motor symptoms, including UPDRS-Ⅲ( χ2=27.90, P<0.001), gait disturbance( χ2=33.23, P<0.001), MoCA( χ2=10.98, P=0.012), HAMA( χ2=12.14, P=0.007), HAMD( χ2=13.62, P=0.003), smell score( χ2=10.16, P=0.017), postural hypotension( χ2=14.59, P=0.028), and a statistically significant difference in the ability to perform daily living score( χ2=25.35, P<0.001).No statistically significant differences in non-motor symptoms and activities of daily living abilities were observed between the cerebellar and Parkinsonian types of traditional motor typing( P>0.05). Conclusions:The hierarchical clustering analysis conducted in this study reveals that the clinical phenotype of MSA provides a more accurate reflection of patients' clinical characteristics and their impact on quality of life compared to the traditional motor phenotype.Additionally, it may help predict variations in the underlying pathological impairment and the rate of disease progression.These findings offer a foundation for precise diagnostic interventions in patients with MSA.

Effect of Fuzhengquxie prescription on epigenetic regulatory protein EZH2 in ovarian cancer cells and its mechanism / 中国医科大学学报

Objective To investigate the effect of Fuzhengquxie prescription on the proliferation,apoptosis,invasion,and migration of ovarian cancer cells and its associated mechanism.Methods After Fuzhengquxie prescription was applied to human ovarian cancer SKOV3 cells,the effects on cell proliferation,apoptosis,invasion,and migration were detected by 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl tetrazolium bromide,cell cloning,cell scratch,and Transwell assay experiments.Quantitative reverse transcription-polymerase chain reaction(qRT-PCR)and Western blotting were used to determine the expression levels of the negative epigenetic regulatory protein,EZH2;its related protein,E-cadherin;and the apoptosis-related proteins,Bax and Bcl-2.Results Fuzhengquxie prescription inhibited the growth rate of SKOV3 cells in a concentration-and time-dependent manner,and significantly inhibited the proliferation,invasion,and migration of SKOV3 cells.Western blotting and qRT-PCR results showed that Fuzhengquxie prescription combined with GSK126 inhibited the transcription of EZH2and Bcl-2,promoted the transcription of Baxand E-cadherin,down-regulated the expression of EZH2 and Bcl-2 proteins,and promoted the expression of Bax and E-cadherin proteins.Conclusion Fuzhengquxie prescription inhibited the proliferation,invasion,and migration of SKOV3 cells and induced their apoptosis.It may be involved in regulating the E-cadherin-mediated proliferation,invasion,and migration of ovarian cancer cells by inhibiting the epigenetic regulatory protein EZH2,and regulating the apop-tosis of ovarian cancer cells mediated by Bcl-2 and Bax.

Cathelicidin- derived PR39 protects enterohemorrhagic Escherichia coli O157:H7 challenged mice by improving epithelial function and balancing the microbiota in the intestine.

The zoonotic enterohaemorrhagic Escherichia coli (EHEC) O157:H7 can disrupt intestinal epithelial barrier function and in turn leading to serious intestinal and systemic disease. PR39 could effectively inhibit the growth of Gram-negative bacteria, but there is little knowledge of its effects on intestinal barrier function and the microbiota in E. coli-challenged mice. In this study, an intestinal disease caused by EHEC O157:H7 was established, to analyze the effect of PR39 on EHEC O157:H7 induced intestinal epithelial barrier injury and disorder. Interestingly, PR39 attenuated EHEC O157:H7-induced systemic symptoms and significantly decreased mortality and the degree of E. coli shedding in faeces. Furthermore, the infiltration index of macrophages and neutrophils in intestine of the PR39 treatment group were obviously attenuated, along with the level of apoptosis. PR39 treatment group had distinctly improved tight junction associated proteins' expression after EHEC O157:H7 caused injury. Additionally, the sequencing analysis of cecum microbiota showed that PR39 altered the abnormal increase in Bacteroides caused by EHEC O157:H7 and promoted the growth of probiotics such as Lactobacillus. In conclusion, cathelicidin-derived PR39 could effectively improve EHEC O157:H7-induced epithelial barrier injury, and dysfunction of immune and microbiota homeostasis in the intestinal tract, indicating that PR39 could be an excellent potential drug for zoonotic EHEC O157:H7-related intestinal disease.

Effects and mechanism of knocking down lncRNA H19 to inhibit lipid accumulation in human THP-1 cells-derived macrophages / 细胞与分子免疫学杂志

Objective To investigate the effects of long noncoding RNA H19 on lipid accumulation of macrophages under high fat stress and its mechanism. Methods Human THP-1 cells-derived macrophages were incubated with ox-LDL, and the effects of H19 siRNA intervention on lipid accumulation was observed. The THP-1 cells were divided into control group (conventional culture), ox-LDL group, siRNA negative control (NC siRNA) combined with ox-LDL treatment group, and H19 siRNA combined with ox-LDL treatment group. Oil red O staining was used to determine the lipid accumulation in cells, and cholesterol concentration was analyzed by enzymatic method; ATP assay kit for detecting celluar ATP content; colorimetry was used to detect the levels of oxidative stress indicators and ELISA was used to detect the levels of monocyte chemoattractant protein-1 (MCP-1) in the cell supernatant. Western blot analysis was used to detect the protein expression of ATP binding cassette transporter A1 (ABCA1), peroxisome proliferator-activated receptor α (PPARα), peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and nuclear factor κB p-p65 (NF-κB p-p65). Results Knockdown H19 significantly inhibited intracellular lipid accumulation, decreased total cholesterol (TC) and cholesterol ester (CE) content, and decreased CE/TC ratio. Knockdown H19 significantly alleviated cell damage including an increase in ATP content, a decrease in oxidative stress levels and a decrease in MCP-1 levels, which caused by high-fat stress. H19 siRNA upregulated expression of ABCA1, PPARα and PGC-1α in THP-1 derived macrophages, downregulated NF-κB signal pathway. Conclusion Knockdown H19 upregulates PGC-1α expression in THP-1 cells and downregulates NF-κB pathway, which promotes cholesterol reverse transport, reduces inflammatory reaction and inhibits lipid accumulation.

Recent advance in genetics of epilepsy of infancy with migrating focal seizure / 中华神经医学杂志

Epilepsy of infancy with migrating focal seizure (EIMFS) is a rare drug-resistant epilepsy syndrome with characteristic migrating EEG presentation. In recent years, with increased discovery of new pathogenic genes in this syndrome, our knowledge and understanding on pathophysiological mechanisms of this syndrome have been broadened. This article systematically summarizes the genes associated with EIMFS that have been reported at home and abroad to expand clinicians' understanding of the disease and provide references for identifying the disease.

Effect of esketamine on cesarean section under epidural anesthesia / 临床麻醉学杂志

Objective To evaluate the effect of esketamine for cesarean section under epidural an-esthesia and maternal and fetal outcome.Methods The parturients all were singleton pregnancies at term and scheduled for elective cesarean delivery.Ninety parturients undergoing elective cesarean delivery under epidural anesthesia,aged 20-40 years,BMI 18-35 kg/m2,ASA physical status Ⅱ,were randomly alloca-ted into two groups:esketamine group(group K)and control group(group C),45 cases in each group.When the targeted upper sensory block level was achieved,esketamine 0.15 mg/kg was administered intra-venously for 1 minute before skin incision in group K,the same volume of normal saline was intravenously injected in group C.Visceral traction reaction during the operation was recorded.Apgar score was assessed 1 minute and 5 minutes after birth.The pH value,partial pressure of carbon dioxide,oxygen partial pressure,and lactic acid value of the neonatal umbilical vein blood were recorded.Adverse events such as nausea,vomiting,hallucination,dizziness and nightmare were monitored in the two groups.Results Compared with group C,visceral traction reaction was significantly lower in group K(P＜0.05).The neonatal Apgar score,pH value,carbon dioxide partial pressure,oxygen partial pressure,and lactic acid value of the neo-natal umbilical vein blood did not differ between the two groups.There were no differences in the incidence of nausea,vomiting and dizziness between the two groups.Hallucinations and nightmares were not encoun-tered in either group.Conclusion Esketamine 0.15 mg/kg can effectively reduce visceral traction reaction during cesarean delivery under epidural anesthesia.There was no significant effect on neonatal Apgar score and blood gas analysis,with no noticeable maternal and neonatal adverse effect.

NLRP3 inflammasome mediated macrophage polarization in ITP / 安徽医科大学学报

Objective@#To investigate the activation level of NLRP3 inflammasome in immune thrombocytopenia ( ITP) and the effect of inhibiting NLRP3 mediated inflammasome activation on polarization and immune function of M1 macrophages.@*Methods @#The expression of NLRP3 mRNA in peripheral blood mononuclear cells (PBMC) and CD14 + monocytes of ITP patients (ITP group) and Control group (Control group) was detected by RT⁃qPCR. The levels of IL⁃1β and IL⁃18 in serum of the two groups were determined by ELISA. M0 macrophages (MDMs) from ITP group were divided into 4 groups : IgG control group ( IgG group) , MCC950 treatment group ( MCC950 group) , LPS , IFN⁃γ and IgG treatment group (LPS + IFN⁃γ + IgG group) and LPS , IFN⁃γ and MCC950 treatment group (LPS + IFN⁃γ + MCC950 group) ; mRNA and protein levels of M1 macrophage markers CD86 , iNOS and MCP⁃ 1 were detected by RT⁃qPCR and Western blot. Western blot was used to detect the expression of NLRP3 inflammasome associated protein , ASC , Cleaved caspase⁃1 and IL⁃ β . Flow cytometry was used to detect the phagocytosis of MDMs on platelets in each group , and CFSE was used to detect the proliferation of CD4 + T and CD8 + T.@*Results@#Compared with the control group , the expression of NLRP3 mRNA in PBMC and CD14 + monocytes , and the concentration of IL⁃1β and IL⁃18 in serum of ITP group increased significantly ( P < 0. 05 ) . Platelet counts were negative correlated with NLRP3 mRNA expression in CD14 + monocyte and the concentration of IL⁃1β , IL⁃18 in serum in patients with ITP ( P < 0. 05) . Compared with IgG group , the mRNA and protein expressions of M1 macrophage markers CD86 , iNOS , MCP⁃1 , and the protein expression level of NLRP3 , ASC , cleaved caspase⁃1 and IL⁃ β , the platelet phagocytosis and the proliferation promoting ability of CD4 + T and CD8 + T cells significantly increased in LPS + IFN⁃γ + IgG group and LPS + IFN⁃γ + MCC950 group ( all P < 0. 05) . Compared with LPS + IFN⁃γ + IgG group , the above indexes significantly decreased in LPS + IFN⁃γ + MCC950 group (P < 0. 05) .@*Conclusion @#The activation level of NLRP3 inflammasome in ITP is abnormally elevated , which was related to the excessive M1 polarization of MDMs. Inhibiting NLRP3 mediated inflammasome activation could attenuate the M1 polarization and immune function of macrophages.

Evaluation of teaching effect of opening experiments on occupational health and occupational medicine / 中华医学教育探索杂志

Objective:To carry out opening experiments on occupational health and occupational medicine for students majoring in preventive medicine, reform the experimental teaching mode, and explore the teaching methods to improve students' professional quality and scientific research ability.Methods:Opening experiments were carried out in the experimental course of occupational health and occupational medicine for students of preventive medicine major. A total of 147 students majoring in preventive medicine of Batch 2016 were classified as the control group, and the routine confirmatory experiment was carried out in the group; 176 students majoring in preventive medicine of Batch 2017 were classified as the experimental group, and this group carried out opening experiment. The evaluation was made from three aspects: comprehensive evaluation results, teacher self-evaluation and student satisfaction survey. SPSS 22.0 software was used for analysis and comparison by independent-samples t-test and Chi-square test. Results:The theoretical scores of the experimental group and the control group students were (84.37±10.45) vs. (81.44±9.22) ( t=2.68, P=0.008), and the experimental skills scores were (93.66±3.89) vs. (88.41±5.67) ( t=9.51, P<0.001). Questionnaire investigation showed that the students in the opening experimental group were more satisfied with the courses arrangement ( χ2=8.31, P=0.004), group cooperation ( χ2=21.10, P<0.001), assessment form ( χ2 =7.92, P=0.005), improvement of the writing ability of scientific research papers ( χ2 =17.56, P<0.001), improvement of practical skills ( χ2=11.70, P=0.001), logical thinking, language organization and expression ability ( χ2=10.33, P=0.001). They considered the opening experiment was helpful to cultivate innovative thinking and ability, but it had limited effect on the cultivation of employment advantages. And the students considered the opening experiments of setting up professional courses was sufficient and necessary. Conclusion:Carrying out opening experiments for students majoring in preventive medicine is helpful to improve students' professional quality and cultivate their practical ability and scientific research ability.

Recent advance in sialidosis / 中华神经医学杂志

Sialidosis is a rare autosomal recessive genetic disorder, and has a series of clinical symptoms and signs caused by neuraminidase 1 ( NEU1) gene mutations. This article reviews the etiology, clinical features, diagnoses, treatments and prognoses of sialidosis in order to improve the understanding and diagnosis of this disease and reduce the misdiagnosis of this disease.

Correlation between lesion volume ratio and cognitive function in ischemic leukoaraiosis / 中国医师进修杂志

Objective:To investigate the relationship between the volume ratio of ischemic leukoaraiosis (LA) and cognitive level and arterial perfusion.Methods:Fifty-four patients, who was hospitalized in Dalian Central Hospital and diagnosed as LA clinically during the time of March to December in 2012, were selected to collect the information of the volume ratio of white matter disease, MoCa score and the average flow rate of carotid artery. The correlation between the volume ratio of white matter disease and MoCa score, cognitive impairment and the average flow rate of carotid artery were analyzed.Results:The volume ratio of LA lesions was negatively correlated with MOCA score ( r = -0.59, P<0.01); the volume ratio of LA lesions was negatively correlated with the mean flow rate of internal carotid artery ( r = -0.37, P<0.01). Quantity order of the area under receiver operating characteristic (ROC) curve of MoCA cognitive subgroup was as following: delayed memory (1.000)> visual space/executive function (0.970) = abstract force (0.970)> language ability (0.960)> attention (0.888). Conclusions:The larger the volume ratio of leukopathy in LA patients, the more serious the cognitive impairment, especially the cognitive impairment of impairment of memory delay, visual space/executive function, abstract ability and language ability.

Preliminary study on 99Tc m-3PRGD 2 imaging to verify the anti-angiogenesis mechanism and efficacy of Mongolian medicine Sendeng-4 decoction for rheumatoid arthritis / 中华核医学与分子影像杂志

Objective:To explore the therapeutic mechanism of Mongolian medicine Sendeng-4 decoction for rheumatoid arthritis by 99Tc m-hydrazinonicotinamide-(polyethylene glycol) 4-E[(polyethylene glycol) 4-c((Arg-Gly-Asp)fk)] 2 (3PRGD 2) imaging. Methods:A total of 200 female SD rats (age: 6-7 weeks) were divided into collagen-induced arthritis (CIA) group ( n=176) and blank control group ( n=24). Rats in the CIA group were divided into Sendeng-4 decoction treatment group ( n=24), etanercept treatment group ( n=24), and negative control group ( n=24) by simple random sampling method. 99Tc m-3PRGD 2 SPECT/CT imaging was performed before and after modeling and treatment. The differences of target/non-target (T/NT) ratio and serological, pathological, and immunohistochemical results among groups were compared by one-way analysis of variance or Kruskal-Wallis rank sum test. The correlation was analyzed by Pearson correlation or Spearman correlation analysis. Results:There were 95 (95/176) CIA models successfully established. The T/NT ratios of Sendeng-4 decoction treatment group and etanercept treatment group were lower than that of negative control group (0.260± 0.094, 0.238±0.099, 0.766±0.144 ; F=163.00, P<0.001), while there was no significant difference between the two drug treatment groups ( P>0.05). After drug treatment, serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α) and α vβ 3 were significantly lower than those of negative control group ( F values: 49.43-92.36, all P<0.001), pathological score was also lower than that of negative control group ( H=34.25, P<0.001), and levels of immunohistochemical makers (VEGF, TNF-α, α vβ 3, CD31, CD34) were also lower than those of negative control group ( H values: 13.51-26.84, all P<0.001), while there were no significant differences between the two drug treatment groups (all P>0.05). The T/NT ratios were positively correlated with above indictors in Sendeng-4 decoction treatment group ( r values: 0.56-0.59, rs values: 0.49-0.69), etanercept treatment group ( r values: 0.50-0.55, rs values: 0.46-0.70) and negative control group ( r values: 0.55-0.80, rs values: 0.58-0.86, P<0.001 or P<0.05). Conclusion:Verified by 99Tc m-3PRGD 2 SPECT/CT imaging and molecular pathology, Mongolian medicine Sendeng-4 decoction can inhibit neovascularization by down-regulating vascular factors such as VEGF, resulting in delaying the progression of the disease and improving clinical symptoms.

Efficacy of chemotherapy combined with sorafenib for FLT3-ITD-positive acute myeloid leukemia / 中国基层医药

Objective:To investigate the effect of chemotherapy combined with sorafenib on the prognosis of FLT3 internal tandem duplication (FLT3-ITD)-positive acute myeloid leukemia and to find a more effective treatment.Methods:The clinical data of 60 patients who were newly diagnosed with acute myeloid leukemia and who received treatment in The Second Affiliated Hospital of Qiqihar Medical University from January 2015 to January 2017 were retrospectively analyzed. The patients were divided into three groups according to whether they were positive for FLT3-ITD and the treatment method they used. The observation group (FLT3-ITD-positive, n = 19) were treated with sorafenib based on routine chemotherapy. The control group 1 (FLT3-ITD-positive, n = 21) was treated only with routine chemotherapy. The control group 2 (FLT3-ITD-negative, n = 20) was treated only with routine chemotherapy. After the first and fourth courses of treatment, clinical efficacy was compared among the three groups. Results:After the first course of treatment, the complete remission rate in control group 2 was 50.0% (10/20), which was significantly higher than 15.8% (3/19) in the observation group and 4.8% (1/21) in the control group 1 ( H = 13.39, P < 0.05). After the fourth course of treatment, the complete remission rate in the observation group, control group 2, and control group 1 was 63.2% (12/19), 60.0% (12/20), and 4.8% (1/21), respectively, and the differences were statistically significant ( H = 19.21, P < 0.05). Four-year follow-up results showed that the median survival time in the observation group, control group 1, and control group 2 was 36.63, 24.15, and 45.00 months respectively. The event-free survival in the observation group, control group 1, and control group 2 was 18.00, 9.82, and 24.90 months, respectively. The median survival time and the event-free survival in the control group 2 were significantly longer than those in the observation group and control group 1 ( χ2 = 19.93, 23.04, both P < 0.001). Conclusion:Chemotherapy combined with sorafenib for treating newly-diagnosed FLT3-ITD-positive acute myeloid leukemia can provide comprehensive benefits and have advantages for survival over chemotherapy without sorafenib and chemotherapy alone.

New progress in clinical research of SPECT quantitative techniques / 中华核医学与分子影像杂志

The traditional SPECT has been considered unable to quantitatively analyze due to the limitations of device performance and reconstructing algorithm. Because of the development of SPECT devices, the emergence of SPECT/CT, and the improvement of reconstructive algorithms, SPECT can be used for quantitative analysis like PET. The current quantitative SPECT researches focus on the usefulness of quantitative SPECT technology in clinical diagnosis and the guidance and evaluation of radionuclide therapy. This review summarizes the development of SPECT quantification, the current status of quantitative SPECT researches in clinical diagnosis and radionuclide therapy, as well as the limitations and advantages of SPECT quantification.

Analysis of psychological distress and influencing factors of patients with gastrointestinal tumors after repeated chemotherapy / 中国实用护理杂志

Objective:To investigate the degree of psychological pain in patients with gastrointestinal cancer after multiple chemotherapy, and analyze the influencing factors of psychological pain.Methods:Totally 130 patients with gastrointestinal tumors admitted from December 2017 to December 2019 admitted to the People′s Hospital of Jiangsu Province were included, and all patients received multiple chemotherapy. Using the psychological pain screening tools to evaluate the degree of psychological pain of patients. The data of patients were collected and statistically analyzed by single factor and binary logistics regression model.Results:Among the 130 patients, 32 cases(24.62%) had no psychological pain and 98 cases (75.38%) had psychological pain. There were differences in the age, pathological stage, distant metastasis, monthly family income, accompanying staff, hospitalization time, and personality type of the mentally distressed and psychologically distressed ( χ2 values were 4.598-12.404, P<0.05). Binary logistics regression model analysis suggested that age, pathological stage, distant metastasis, family monthly income, accompany status, length of hospital stay, and personality type were the influencing factors of patients' psychological pain ( P<0.05). Conclusions:Psychological pain of patients with gastrointestinal tumors after multiple chemotherapy is more common, and its occurrence is mainly related to the patient′s age, pathological stage, distant metastasis, family monthly income, accompanying staff, hospitalization time and personality type.

The role of the gut microbiome and its metabolites in metabolic diseases

It is well known that an unhealthy lifestyle is a major risk factor for metabolic diseases, while in recent years, accumulating evidence has demonstrated that the gut microbiome and its metabolites also play a crucial role in the onset and development of many metabolic diseases, including obesity, type 2 diabetes, nonalcoholic fatty liver disease, cardiovascular disease and so on. Numerous microorganisms dwell in the gastrointestinal tract, which is a key interface for energy acquisition and can metabolize dietary nutrients into many bioactive substances, thus acting as a link between the gut microbiome and its host. The gut microbiome is shaped by host genetics, immune responses and dietary factors. The metabolic and immune potential of the gut microbiome determines its significance in host health and diseases. Therefore, targeting the gut microbiome and relevant metabolic pathways would be effective therapeutic treatments for many metabolic diseases in the near future. This review will summarize information about the role of the gut microbiome in organism metabolism and the relationship between gut microbiome-derived metabolites and the pathogenesis of many metabolic diseases. Furthermore, recent advances in improving metabolic diseases by regulating the gut microbiome will be discussed.

Clinical value of two-dimensional shear wave elastography in predicting esophageal varices in patients with hepatitis B cirrhosis by evaluating liver and spleen stiffness / 临床肝胆病杂志

ObjectiveTo investigate the value of two-dimensional shear wave elastography (2D-SWE) in the noninvasive evaluation of the presence or absence of esophageal varices (EV) in patients with hepatitis B cirrhosis by liver stiffness measurement (LSM) and spleen stiffness measurement (SSM). MethodsA total of 172 patients who were diagnosed with hepatitis B cirrhosis in Beijing Ditan Hospital, Capital Medical University, from April 2019 to February 2020 were enrolled in a prospective study, and according to the results of gastroscopy, they were divided into non-EV group and EV group. The two groups were compared in terms of spleen thickness (ST), spleen diameter (SD), LSM, and SSM. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data. The receiver operating characteristic (ROC) curve was used to investigate the value of LSM and SSM in the diagnosis of EV, and the Z test was used to compare the diagnostic accuracy of LSM and SSM. ResultsThere were 121 patients in the EV group and 51 patients in the non-EV group. There were significant differences between the two groups in ST (t=8143, P＜0.001), SD (t=7.363, P＜0.001), LSM (Z=3.024, P=0.002), SSM (t=15.142, P＜0.001), and presence or absence of ascites (χ2=22.101, P＜0.001). LSM had an area under the ROC curve (AUC) of 0.646 (95% confidence interval ［CI］: 0570-0.718) in the diagnosis of EV, with a sensitivity (Se) of 83.47%, a specificity (Sp) of 47.06%, a positive predictive value (PPV) of 78.9%, and a negative predictive value (NPV) of 54.5% at the optimal cut-off value of 13.16. SSM had an AUC of 0.951 (95% CI: 0.907-0.978) in the diagnosis of EV, with an Se of 80.99%, an Sp of 96.08%, a PPV of 98.0%, and an NPV of 68.1% at the optimal cut-off value of 38.08. SSM had a better diagnostic accuracy than LSM (Z=6.096, P＜0.001). ConclusionLSM and SSM can be used to predict the presence or absence of EV in patients with hepatitis B cirrhosis. SSM has a higher accuracy than LSM and can provide accurate diagnostic information for clinical practice.