Aim To investigate the combined effect of mangiferin and ephedrine as well as explore its underlying mechanism in mouse model of allergic asthma.Methods The mouse model of asthma was sensitized and challenged with ovalbumin(OVA).The behaviors of mice during the challenging period were observed.Continuous autonomic activities of mice after 1 h of drug treatment were monitored with the autonomic activity recorder for 14 days.The total and differential cells in peripheral blood were counted.Histological study of lung sections on airway inflammation was carried out with haematoxylin and eosin(HE) staining.The levels of ovalbumin-specific immunoglobulin E(OVA-sIgE) and(Cyclic Adenosine monophosphate) cAMP in serum were detected by enzyme-linked immunosorbent assay(ELISA).The mRNA expression of cytokines mainly produced by Th1/Th2 lymphocytes such as IFN-γ and IL-4, IL-5 were semi-quantitatively analyzed with reverse transcription polymerase chain reaction(RT-PCR).Results Combination treatment and mangiferin could reduce the aberrantly autonomic activity caused by ephedrine in mice.Compared with the model group, asthmatic symptoms in all treatment groups could be significantly relieved, the pathological changes of lung tissue were improved and airway inflammation was reduced.The effect of combined treatment was better than that of mangiferin treatment alone.Compared with the model group, the total number of white blood cells(WBC) and the eosinophils(EOS) ratio in peripheral blood in all treatment groups decreased, the level of OVA-sIgE declined and the level of cAMP increased in serum.Combination treatment could lower mRNA expressions of IL-4 and IL-5 from Th2 lymphocytes and increase the mRNA expressions of IFN-γ released by Th1 lymphocytes.Conclusions The effect of combined therapy of mangiferin and ephedrine is better than that of mangiferin treated alone, meanwhile it can reduce the side effects caused by ephedrine.The underlying mechanism is mainly associated with attenuating Th1/Th2 cytokine imbalance and increasing the level of cAMP.

Objective:To study the effect of quality control circle(QCC)on the reasonable ratio of clinical prescriptions. Methods:The dispensed prescriptions in orthopedic emergency department were reviewed in our hospital,and the reasons of unreasonable prescriptions were analyzed. According to the QCC technique,the activities were implemented,the standardized work process was made out and the results were studied. Results:After the six-month QCC activities,the unreasonable ratio of emergency orthopedics prescriptions was reduced from 70% to 21% ,and the target yield rate was 140% and the improvement rate was 70% . Conclusion:The QCC has obvious effect on the improvement of reasonable ratio of emergency orthopedics prescriptions.

Objective:To study the clinical characteristics and management strategies of patients with chronic obstructive pulmonary disease (COPD) in high-altitude areas.Methods:An observational cross-sectional study was conducted in 79 stable COPD patients who visited the outpatient of Respiratory Medicine at Tibet Autonomous Region People′s Hospital and Peking University Third Hospital from August 3 rd 2020 to November 30 th 2020. Patients were divided into Lhasa group ( n=44) and Beijing group ( n=35). The differences of clinical characteristics including demographic characteristics, risk factors, respiratory symptoms, comorbidities, medications and spirometry were analyzed. Further comparative analysis was conducted on the clinical characteristics of smokers ( n=15) and non-smokers ( n=29) in Lhasa group. Results:The proportion of female patients and biofuel exposure in Lhasa group was significantly higher than Beijing group (56.8% vs 0, 86.4% vs 0, both P<0.001). The proportion of smokers in Lhasa group was significantly lower than Beijing group (34.1% vs 100%, P<0.001). The mean score of COPD assessment test (CAT) in Lhasa group was significantly higher than Beijing group (21.27 vs 9.17, P<0.001). The proportion of acute exacerbations ≥2 in the past year in Lhasa group was significantly higher than Beijing group (31.8% vs 11.4%, P=0.032). The median percentage of forced vital capacity in the first second of predicted value (FEV 1%pred) of patients in Lhasa group was significantly higher than Beijing group (63% vs 38%, P<0.001). The proportion of patients treated by inhaled corticosteroid/long-acting β 2-agonist (ICS/LABA) and inhaled long-acting muscarinic antagonists (LAMA) in Lhasa group was significantly lower than Beijing group (4.5% vs 60.0%, 0 vs 65.7%, both P<0.001). There were no significant differences in CAT score, number of acute exacerbations in the past year and lung function between smokers and non-smokers in Lhasa group. Conclusions:Compared with those patients in Beijing, the majority of patients with COPD living in Lhasa are female, with a low proportion of smokers and a high proportion of biofuel exposure. Although their lung function is better, their respiratory symptoms are more severe with more acute exacerbations in the past year, and most patients do not receive standardized medication.

Objective:To explore the material basis and molecular mechanism of Liu-He-Dan (LHD) in treating acute pancreatitis (AP).Methods:Active chemical components of LHD, their corresponding targets and related AP pathogenic genes were searched and selected in the Encyclopedia of Traditional Chinese Medicine (ETCM) and disease information related databases (OMIM, DisGeNET, HPO, and NCBI), respectively. The protein-protein interaction (PPI) was analyzed through the STRING database. Enrichment analysis on those targets was performed by using CPBD and STRING databases to examine the function and pathway involved in the treatment of AP by active chemical components of LHD. Finally, " Chinese medicinal materials-active chemical components-targets-pathways" network was constructed by Cytoscape 3.6.0.Results:Network analysis showed that a total of 111 active chemical components of LHD were correlated with 39 targets of AP. The gene ontology functional enrichment analysis of 39 targets by CPBD and STRING databases obtained 575 enrichment results of biological process, 49 results of molecular function and 26 results of cellular components; Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis obtained 46 enrichment results involved in pancreatic secretion, bile secretion, RRAR signaling pathway, arachidonic acid metabolism and calcium signaling.Conclusions:The molecular mechanism of LHD in the treatment of AP by multiple components, multiple targets and multi-signaling pathways was preliminarily determined, which provides a basis for further analysis on active chemical components of LHD and molecular function.

Objective To rapidly screen patients with novel coronavirus pneumonia (COVID-19) infection including asymptomatic ones. Method Established a rapid detection test kit, and evaluated analytical and clinical performance of it. Result The minimum limit of detection of the reagent was 9.75×10² TCID₅₀/mL; there was no cross-reaction and interference in the high-concentration samples of 29 common respiratory pathogens tested. The diagnostic sensitivity of clinical samples was 98.56%, specificity was 99.00%, and the total coincidence rate was 98.85%; the consistency test Kappa value is 0.974 5. The stratified analysis of positive samples with different Ct values showed that the coincidence rate within each stratum was greater than 95%. Conclusion This COVID-19 antigen test kit with excellent detection performance, fast detection speed, and portable operation. It can be used as a supplementary method for existing nucleic acid detection methods for early screening of new coronavirus.
Humans ; COVID-19 ; COVID-19 Testing ; Sensitivity and Specificity ; SARS-CoV-2

Objective:To assess the diagnostic efficacy of upper gastrointestinal endoscopic image assisted diagnosis system (ENDOANGEL-LD) based on artificial intelligence (AI) for detecting gastric lesions and neoplastic lesions under white light endoscopy.Methods:The diagnostic efficacy of ENDOANGEL-LD was tested using image testing dataset and video testing dataset, respectively. The image testing dataset included 300 images of gastric neoplastic lesions, 505 images of non-neoplastic lesions and 990 images of normal stomach of 191 patients in Renmin Hospital of Wuhan University from June 2019 to September 2019. Video testing dataset was from 83 videos (38 gastric neoplastic lesions and 45 non-neoplastic lesions) of 78 patients in Renmin Hospital of Wuhan University from November 2020 to April 2021. The accuracy, the sensitivity and the specificity of ENDOANGEL-LD for image testing dataset were calculated. The accuracy, the sensitivity and the specificity of ENDOANGEL-LD in video testing dataset for gastric neoplastic lesions were compared with those of four senior endoscopists.Results:In the image testing dataset, the accuracy, the sensitivity, the specificity of ENDOANGEL-LD for gastric lesions were 93.9% (1 685/1 795), 98.0% (789/805) and 90.5% (896/990) respectively; while the accuracy, the sensitivity and the specificity of ENDOANGEL-LD for gastric neoplastic lesions were 88.7% (714/805), 91.0% (273/300) and 87.3% (441/505) respectively. In the video testing dataset, the sensitivity [100.0% (38/38) VS 85.5% (130/152), χ2=6.220, P=0.013] of ENDOANGEL-LD was higher than that of four senior endoscopists. The accuracy [81.9% (68/83) VS 72.0% (239/332), χ2=3.408, P=0.065] and the specificity [ 66.7% (30/45) VS 60.6% (109/180), χ2=0.569, P=0.451] of ENDOANGEL-LD were comparable with those of four senior endoscopists. Conclusion:The ENDOANGEL-LD can accurately detect gastric lesions and further diagnose neoplastic lesions to help endoscopists in clinical work.

Objective:To construct a real-time artificial intelligence (AI)-assisted endoscepic diagnosis system based on YOLO v3 algorithm, and to evaluate its ability of detecting focal gastric lesions in gastroscopy.Methods:A total of 5 488 white light gastroscopic images (2 733 images with gastric focal lesions and 2 755 images without gastric focal lesions) from June to November 2019 and videos of 92 cases (288 168 clear stomach frames) from May to June 2020 at the Digestive Endoscopy Center of Renmin Hospital of Wuhan University were retrospectively collected for AI System test. A total of 3 997 prospective consecutive patients undergoing gastroscopy at the Digestive Endoscopy Center of Renmin Hospital of Wuhan University from July 6, 2020 to November 27, 2020 and May 6, 2021 to August 2, 2021 were enrolled to assess the clinical applicability of AI System. When AI System recognized an abnormal lesion, it marked the lesion with a blue box as a warning. The ability to identify focal gastric lesions and the frequency and causes of false positives and false negatives of AI System were statistically analyzed.Results:In the image test set, the accuracy, the sensitivity, the specificity, the positive predictive value and the negative predictive value of AI System were 92.3% (5 064/5 488), 95.0% (2 597/2 733), 89.5% (2 467/ 2 755), 90.0% (2 597/2 885) and 94.8% (2 467/2 603), respectively. In the video test set, the accuracy, the sensitivity, the specificity, the positive predictive value and the negative predictive value of AI System were 95.4% (274 792/288 168), 95.2% (109 727/115 287), 95.5% (165 065/172 881), 93.4% (109 727/117 543) and 96.7% (165 065/170 625), respectively. In clinical application, the detection rate of local gastric lesions by AI System was 93.0% (6 830/7 344). A total of 514 focal gastric lesions were missed by AI System. The main reasons were punctate erosions (48.8%, 251/514), diminutive xanthomas (22.8%, 117/514) and diminutive polyps (21.4%, 110/514). The mean number of false positives per gastroscopy was 2 (1, 4), most of which were due to normal mucosa folds (50.2%, 5 635/11 225), bubbles and mucus (35.0%, 3 928/11 225), and liquid deposited in the fundus (9.1%, 1 021/11 225).Conclusion:The application of AI System can increase the detection rate of focal gastric lesions.