Objective To investigate the different compatibility of tripterygium wilfordii on its attenuation and synergistic effects through applying Leigongteng decoction and its demolition decoctions on nephrosis rats,and to select the optimizing decoction to treat nephrotic syndrome.Methods 110 Wister rats were divided into 11 groups randomly,which were 9 groups of nephrosis model groups (including Leigongteng group,Leihe group,Leigui group,Leiqi group,Leigongteng ecoction group,Leijin group,Leigan group,prednisone group and nephrosis model group) and 2 blank groups (normal control group and normal Leigongteng group),10 rats in each group.The normal control group and normal Leigongteng group was intravenous injected with 0.65 ml sodium chloride in caudal vein; 9 groups of nephrosis model groups were injected with 0.65 ml adriamycin.The prednisone group was selected for positive control,24h urine protein,total protein,albumin,urea nitrogen,and creatinine were tested with automatic biochemistric meter.Results ALB (27.58±2.62)g/L,Leigan group Compared with(92.60± 18.12) mg in Leigongteng group,the urine protein in Leigongteng diction group(48.60± 11.75) mg,Leiqi group (53.20± 13.21) mg,and Leigan group (56.40 ±16.52) mg were reduced.Compared with the Leigongteng group TPR(58.98±4.84) g/L,ALB (20.98 ± 3.49) g/L,the Leigongteng decoction group [TPR (68.47 ± 5.25) g/L,ALB (28.97± 3.01) g/L],TPR and ALB in Lei-Qi group TPR(68.21 ±4.19) g/L,TPR(67.51 ± 5.42) g/L,ALB (26.56± 1.89) g/L were all elevated.Compared with Leigongteng group chol (1.48 ± 0.65) mmol/L TG (1.70 ± 1.58) mmol/L,chol and TG in the Leigongteng decoction group chol(0.78±0.13)mmol/L,TG(0.56±0.14)mmol/L,Lei-Qi group chol (0.70±0.13) mmol/L,TG (0.65±0.12) mmol/L,and Leigan group chol (0.97±0.33) mmol/L,TG(0.66±0.18) mmol/L were lowered; compared with Leigongteng group,UN (14.20 ± 2.12) mmol/L,Cr (78.10 ± 6.14) μmol/L,UN and Cr in the Leigongteng decoction group UN(7.59±0.78) mmol/L,Cr(39.60±8.33) μmol/L,Leigan group UN (9.48 ± 0.82) mmol/L,Cr(38.30±7.89)μmol/L,and Leijin group UN(9.71±1.33) mmol/L,Cr(41.40±6.45) μmol/L,Leigui group UN(8.30±1.12) mmol/L,Cr(36.90±6.15) μmol/L were all reduced with significant differences (all P＜0.05).The changes of Kidney morphology and ultrastructure pathology in Leigongteng different combination groups were lighter than the control groups.Conclusion Leigongteng decoction group,Leiqi group,Leigan group had synergistic actions,while Leigongteng decoction group,Leigan group,Leijin group,and Leigui group had kidney toxicity-reducing actions.

Objective:To observe the application effect of respiratory stepwise management in patients with septic shock combined with acute lung injury (ALI).Methods:100 patients with septic shock combined with ALI were selected as the research objects in Haikou Hospital Affiliated to Xiangya Medical College of Central South University from January 2018 to June 2020. Fifty patients were given endotracheal intubation or invasive ventilation on the basis of conventional treatment (conventional treatment group). According to the respiratory situation and blood gas, 50 patients were given systematic respiratory support step-by-step treatment according to the principle of simple to complex, and appropriate and scientific respiratory support was given according to the sequence from unarmed to mechanical (respiratory stepwise management group). The differences of cardiac index (CI), central venous pressure (CVP), mean arterial pressure (MAP), extravascular lung water index (EVLWI), arterial partial pressure of carbon dioxide (PaCO 2), arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2) before and after treatment were compared between the two groups, the therapeutic effects of the two groups were evaluated, and the resuscitation effect, postoperative complications rate, tracheotomy rate, utilization rate of invasive ventilator of the two groups were recorded. Results:After treatment, CI, CVP, EVLWI, PaO 2, PaO 2/FiO 2 levels of the two groups were significantly higher than before treatment, MAP and PaCO 2 levels were significantly lower than before treatment; MAP and PaCO 2 levels after treatment of the respiratory stepwise management group were significantly lower than those of the conventional treatment group [MAP (mmHg, 1 mmHg = 0.133 kPa): 68.2±7.0 vs. 74.4±6.8, PaCO 2 (mmHg): 37.82±4.05 vs. 41.76±4.59], the levels of EVLWI, PaO 2 and PaO 2/FiO 2 in the respiratory stepwise management group were significantly higher than those in the conventional treatment group [EVLWI (mL/kg): 15.34±3.03 vs. 13.64±3.32, PaO 2 (mmHg): 84.44±4.83 vs. 79.03±5.54, PaO 2/FiO 2 (mmHg): 452.42±51.32 vs. 431.73±50.03, all P < 0.05]. There was no significant difference in CI or CVP after treatment between respiratory stepwise management group and conventional treatment group [CI (mL·s -1·m -2): 70.01±21.67 vs. 66.68±18.34, CVP (mmHg): 11.1±3.2 vs. 12.3±3.2, both P > 0.05]. Compared with the conventional treatment group, the average recovery time of the respiratory stepwise management group was earlier (hours: 2.04±0.54 vs. 4.29±0.20, P < 0.05), the stable breathing time was shorter (hours: 3.07±0.22 vs. 5.36±0.35, P < 0.05), the total effective rate and the success rate of recovery were significantly improved [86.0% (43/50) vs. 60.0% (30/50), 94.0% (47/50) vs. 74.0% (37/50), both P < 0.05], the incidence of ventilator associated pneumonia (VAP) and airway complications were significantly reduced [14.0% (7/50) vs. 32.0% (16/50), 12.0% (6/50) vs. 40.0% (20/50), both P < 0.05], and the tracheotomy rate and the utilization rate of invasive ventilator were significantly reduced [8.0% (4/50) vs. 28.0% (14/50), 30.0% (15/50) vs. 60.0% (30/50), both P < 0.05]. Conclusion:Respiratory stepwise management can effectively improve the resuscitation effect of septic shock patients with ALI, improve cardiopulmonary function, blood gas index and the treatment efficiency, effectively reduce the incidence of iatrogenic trauma and complications.

Objective To investigate the chemical constituents of Wedelia trilobata.Methods The chemical constituents were separated by chromatography and their structures were determined by physico-chemical constants and spectral analyses.Results Eleven compounds were isolated and identified as grandiflorenic acid(1),1?-acetoxy-6?,9?-dihydroxy-4,10?-dimethyl-5?H,7?H,8?H-endesm-3-en-8,12-olide(2),1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide(3),16?-hydroxy-ent-kauran-19-oic acid(4),(3R,4R,6R)-3,4-dihydroxy-1-menthene(5),trilobolide-6-O-isobutyrate(6),1?-acetoxy-4?,9?-dihydroxy-6?-isobutyroxyprostatolide(7),16?,17-dihydroxy-ent-kauran-19-oic acid(8),daucosterol(9),protocatechualdehyde(10),and caffeic acid(11).Conclusion All the compounds are isolated from W.trilobata for the first time except compounds 6 and 7.Compounds 2 and 3 are new sesquiterpene lactones,named as trilobolide A and 1?-acetoxy-4?-hydroxy-6?-isobutyryloxy-9?-isovaleryloxyprostatolide,respectively.

Objective To explore the effects of mirror therapy combined with Tongdu Xingshen acupuncture on the upper extremity function of stroke survivors.Methods Sixty stroke survivors were randomly divided into a mirror group (n =20),an acupuncture group (n =20) and a combined group (n =20).In addition to routine rehabilitation treatment,those in each group received mirror therapy,acupuncture or both for 4 weeks.Before the treatment and after 2 and 4 weeks of treatment,all of the patients were assessed using the Fugl-Meyer motor function assessment (FMA),Brunnstrom upper limb and hand staging (BSULH),the Barthel Index (BI) and in terms of the active range of motion in the wrist contralateral to their hemiplegia (AROM).The combined group was also evaluated using functional magnetic resonance imaging (fMRI) before treatment and after the 4 weeks.Results After 2 and 4 weeks of the treatment,the average BI,AROM,FMA and BSULH results had improved significantly compared with before the treatment.The improvements in the combined group were significantly greater than in the other groups after 2 and 4 weeks.The fMRI demonstrated that there were high-intensity signals in the primary motor area,the premotor area and the supplementary motor area on the affected side after 4 weeks of treatment.Conclusions Mirror therapy combined with Tungdu Xingshen acupuncture can improve the functional performance of the upper extremities of stroke survivors.

Objective To evaluate the effects of low molecular weight heparin(LMWH)and heparin-binding epidermal growth factor(HB-EGF)on the biological function of human trophoblast in first trimester.Methods From Feb.2011 to Nov.2011,the trophoblast isolated from human first trimester chorionic villi was cultured in vitro.Based on variation of LMWH concentration,the trophoblast was classified into 0.025 U/ml group,0.25 U/ml group,2.5 U/ml group,25 U/ml group and 250 U/ml group.In the mean time,based on treatment of heparin,the trophoblast was classified into LMWH group (0.25 U/ml),HB-EGF group(10 μg/L),combination group(LMWH at 0.25 U/ml + HB-EGF at 10 μg/L)and add with DMEM as control group.Cell prolferation was assessed by the methyl thiazolyl tetrazolium(MTY)test,which was showed with the mean absorbance as A value.Cell invasion was measured by transwell,which counted the number of cells migrated to the superficies inferia of filter membrane.Cell differentiation was assessed by the concentration of hCG secretion.Results Compared with control group,the trophoblast proliferation and invasion treated by LMWH at 0.025 U/ml did not show significant difference (P ＞ 0.05).When treated by LWMH at 0.25 U/ml and 2.5 U/ml,trophoblast proliferation and invasion was increased significantly(P ＜ 0.05).When LMWH at 25 U/ml and 250 U/ml,it could inhibit trophoblast proliferation and invasion(P ＜ 0.05).When compared with A value of 0.44 ± 0.04 in control group,the increased A value were 0.51 ± 0.05 in LMWH group,0.56 ± 0.04 in HB-EGF group and 0.69 ± 0.06 in combination group(P ＜ 0.05).In the transwell test,the cell number were 511 ± 78 in LMWH group,669 ± 67 in HB-EGF group and 872±64 in combination group,which were significantly higher than 405 ± 67 in control group(P ＜ 0.05),respectively.And the hCG concentration were(7143 ± 649)U/L in LMWH group,(11 762 ± 1059)U/L in HB-EGF group and(11 015 ± 1084)U/L in combination group,which showed statistical difference with(8182 ± 666)U/L in control group(P ＜ 0.05).Conclusion LMWH could modulate trophoblast proliferation,invasion,and differentiation.HB-EGF is one of important factors involved in effects of LMWH on trophoblast function.

Objective To explore the prevalence of self reposed mania/hypomania symptoms of depressive disorders and the difference between the two self-rating symptoms questionnaires in setting of psychiatric clinic of a general hospital.Methods 102 outpatients who were diagnosed with depressive disorders by ICD-10 in department of psychiatry of Tongji Hospital of Tongji University were continuously investigated and fulfilled the Chinese Version mood disorder questionnaire(CV-MDQ)and the Chinese Version 32 items hypomania check list(CVHCL-32).The positive mania symptoms were elevated with at least seven positive mania items reported by the CVMDQ.The positive hypomania symptoms were elevated with at least fourteen positive hypomania items reported by the CV-HCL-32.Results The internal consistency(Cronbach alpha)of the CV-MDQ was 0.808(95% CI=0.767～0.845,P<0.01).The internal consistency(Cmnbach alpha) of the CV-HCL-32 was 0.916(95% CI=0.898～0.930,P<0.01).11 patients(10.8%) reported positive mania symptoms by the CV-MDQ.14 patients (13.7%)had been reported positive hypomania symptoms through the CV-HCL-32.The ability of discriminating mania or hypomania between the two scales was significantly different(Kappa=0.227,P<0.05).Compared to the patients who were reported negative hypomania symptoms by the CV-HCL-32.the 11 patients with positive hypomania symptoms by the CV-HCL-32 had much earlier age in first episode(35.0 vs 50.5,z=-2.065,P<0.05),much longer months in total disease course(60.0 vs 22.0,z=-2.102,P<0.05)and present episode (12.0 vs 6.0,z=-2.180,P<0.05),and much higher frequency of relapse(2.5 vs 1.0,z=-2.168,P<0.05),but no significant differences at age,gender and education.No significant differences appeared between CV-MDQ positive and negative group.Conclusion Mania or hypomania symptoms may be screened by CV-MDQ and CV-HCL-32 from the outpatients with depressive disorders who are diagnosed by ICD-10 in general hospital.whether CV-HCL-32 is superior to CV-MDQ when screening bipolar Ⅱ disorder is worthly further study.

We wished to ascertain the prevalence as well as the genetic and antigenic variation of infectious bronchitis viruses (IBVs) circulating in the Guangxi Province of China in recent years. The S1 gene of 15 IBV field isolates during 2012-2013 underwent analyses in terms of the similarity of amino-acid sequences, creation of phylogenetic trees, recombination, and serologic identification. Similarities in amino-acid sequences among the 15 isolates of the S1 gene were 54.3%-99.6%, and 43.3%-99.3% among 15 isolates and reference strains. Compared with the vaccine strain H120, except for GX-YL130025, the other 14 isolates showed a lower similarity of amino-acid sequences of the S1 gene (65.1-81.4%). Phylogenetic analyses of the S1 gene suggested that 15 IBV isolates were classified into eight genotypes, with the predominant genotype being new-type II. Recombination analyses demonstrated that the S1 gene of the GX-NN130048 isolate originated from recombination events between vaccine strain 4/91 and a LX4-like isolate. Serotyping results suggested that seven serotypes prevailed during 2012-2013 in Guangxi Province, and that only one isolate was consistent with the vaccine strain H120 in serotype (which has been used widely in recent years). The serotype of recombinant isolate GX-NN130048 was different from those of its parent strains. These results suggested that not only the genotype, but also the serotype of IBV field isolates in Guangxi Province had distinct variations, and that increasing numbers of genotypes and serotypes are in circulation. We showed that recombination events can lead to the emergence of new serotypes. Our study provides new evidence for understanding of the molecular mechanisms of IBV variations, and the development of new vaccines against IBVs.
Animals ; Antibodies, Viral ; blood ; Chickens ; China ; Coronavirus Infections ; blood ; veterinary ; virology ; Genetic Variation ; Genotype ; Infectious bronchitis virus ; classification ; genetics ; immunology ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Poultry Diseases ; blood ; virology ; Sequence Homology, Amino Acid ; Spike Glycoprotein, Coronavirus ; chemistry ; genetics ; immunology

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P<0.05) in the data at the four time points. There was no statistically significant difference (P > 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P<0.05). Repeated measurement data analysis showed that there was no statistically significant difference (P>0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P<0.05), And it suggested that time and group interaction, namely effect of time factor (1 d, 7 d, 30 d, 90 d), was not decided by the division of groups. In comparison of main effect, the difference was statistically significant (all P < 0.01) in the moderate and high-risk group, which indicated the main effect (intervention) playing main role. However, there was no statistically significant difference (P>0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

ObjectiveTo investigate the correlation of miR-181c expression in peripheral blood mononuclear cells (PBMCs) with interferon-γ (IFN-γ), chemokine (C-X-C motif) ligand 10 (CXCL10), and Toll-like receptor 4 (TLR4) in children with autoimmune hepatitis (AIH). MethodsA total of 27 children with AIH who were admitted to The Affiliated Hospital of Yanbian University from March 2015 to May 2019 were enrolled as AIH group, and 30 healthy children who underwent physical examination during the same period of were enrolled as control group. The expression of miR-181c in PBMCs and the expression of IFN-γ, CXCL10, and TLR4 were measured for the two groups. The t-test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank-sum 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 between two groups. The Pearson correlation coefficient was used to investigate the correlation of miR-181c expression with each index, and a logistic regression analysis was used to investigate the influence of each factor on AIH. ResultsCompared with the control group, the AIH group had significantly higher levels of the liver function parameters aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), and total bilirubin (TBil) (t=14.445,20.064，11.728,13.822, all P＜0.001). The AIH group also had significantly higher levels of IgA, IgM, and IgG than the control group (t=7.772, 5147, and 6771, all P＜0.05). The AIH group had significantly lower relative expression of miR-181c in PBMCs than the control group (0.784±0173 vs 1.106±0.224, t=5.819, P＜0.05). Compared with the control group, the AIH group had significantly higher levels of IFN-γ and CXCL10 and mRNA expression of TLR4 (t=6.949, 12.303, and 13.835, all P＜0.05). The correlation analysis showed that in the children with AIH, the expression of miR-181c in PBMCs was negatively correlated with IFN-γ, CXCL10, TLR4, AST, ALT, GGT, TBil, and IgG (r=-0.316, -0.348, -0.322, -0.427, -0.442, -0.408, -0.396, and -0.321, all P＜0.05). The univariate logistic regression analysis showed that AST, ALT, GGT, TBil, IFN-γ, CXCL10, TLR4 mRNA, and miR-181c were all included in the regression model (all P＜0.05) and were the influencing factors for the onset of AIH. ConclusionChildren with AIH have downregulated expression of miR-181c in PBMCs, which is closely associated with IFN-γ, CXCL10, and TLR4, suggesting that miR-181c may affect the development of AIH in children by regulating the immune system.

Objective: To investigate the survival time of multidrug-resistant tuberculosis (MDR-TB) patients and the influential factors in Wuhan. Methods: The relevant information were collected from TB management information system, cause of death reporting system and medical records by trained doctors. The univariate and multivariate Cox proportional hazards model were applied to analyze the factors affecting survival time of patients. Results: A total of 552 patients with MDR-TB were included in the analysis. After the diagnosis of MDR-TB, the cumulative survival rates from the first year to the third year were 0.94, 0.88, and 0.80, respectively. The mortality density of MDR-TB patients was 6.52/100 person-years, and the median survival time was (89.52±1.85) months. Kaplan-Meier analysis showed that the cumulative survival rate of the standardized treatment group was significantly higher than that of the non-standardized treatment group (Log rank=101.070, P<0.001). Compared with the patients aged <30 years, the HR of the patients aged 30-years and ≥60 years were 2.987 (95%CI: 1.268-7.036), 4.957 (95%CI: 1.942-12.653). Compared with the patients with the education level of high school and above, the HR of the patients with education level of junior high school/primary school and below were 1.908 (95%CI: 1.152-3.160), 1.681(95%CI: 1.033-2.735). Compared with the patients without diabetes, the HR of the patients with diabetes was 1.961(95%CI: 1.347-2.854). Compared with the patients without other serious diseases, the HR of the patients with other serious diseases was 2.597 (95%CI: 1.820-3.706). Compared with the patients who had been treated less than one time, the HR of the patients having previous treatment with more than 2 times was 1.611 (95%CI: 1.077-2.409). Compared with patients receiving standard MDR regimen treatment, the HR of the patients receiving no standard MDR regimen treatment was 3.155 (95%CI: 2.132-4.670). Conclusions The cumulative survival rate of MDR-TB patients without standard treatment was significantly lower than that of patients with standard treatment. Older age, low educational level, diabetes mellitus, other serious diseases, more than two times treatment in the past, and receiving no multi-drug resistance regimen treatment were the risk factors affecting the survival of MDR-TB patients.