Allergic asthma is a chronic obstructive disease of the airways characterized by airway hyperresponsiveness,inflammation and remodeling.Exhaled nitric oxide (eNO) level is highly correlated with eosinophilic airway inflammation.Since the advantage of noninvasion,convenience,and specificity of eNO measurement,it has been widely used as a biomarker.In this article eNO metabolism and its effects on airway physiology and pathophysiology are described.The usefulness of eNO in asthma diagnosis and management is discussed in detail.

Mitochondrial dynamics refers to the constant fission,fusion,docking,transportation,and mitophagy of mitochondria within cells.These dynamic processes are not only critical to regulating mitochondrial morphology and function,but also playing key roles in cell survival,metabolism and function.Retinal ganglion cells (RGCs) are special and important neurons in retina and are exquisitely sensitive to disturbances in mitochondrial dynamics.Recent studies on autosomal dominant optic atrophy have demonstrated that genes which encode a mitochondrial protein involved in mitochondrial fusion are closely associated with the function of RGCs.In experimental glaucoma models,increased intraocular pressure induced mitochondrial fission,changes of optic atrophy 1 (OPAl) mRNA and protein expression,and resulted in RGCs death.The normal transportation and distribution of mitochondria in RGCs are critical for the function of axons.The studies on inherited and experimental optic neuropathies suggest that mitochondrial dynamics plays a central role in regulating the survival of RGCs.Manipulating mitochondrial dynamics has emerged as a promising strategy in RGCs protection.This paper reviewed the main content of mitochondrial dynamics and the role of mitochondrial dynamics in RGCs.

Objective:To explore the relationship between serum and cerebrospinal fluid levels of progranulin (PGRN) and prognosis in children with purulent meningitis (PM).Methods:Sixty children with PM (PM group) and 60 children without central nervous system infection (suspected central nervous system infection, or having indications for lumbar puncture; control group) in Zhuji People′s Hospital of Zhejiang Province from January 2014 to December 2018 were selected. The serum and cerebrospinal fluid PGRN, C-reactive protein (CRP) and procalcitonin (PCT) levels were detected. The correlation was analyzed by Pearson method; the receiver operating characteristic (ROC) curve was drawn, and the prognostic value of serum and cerebrospinal fluid PGRN were evaluated.Results:The serum and cerebrospinal fluid PGRN, CRP and PCT in PM group were significantly higher than those in control group, serum: (42.61 ± 4.79) ng/L vs. (26.13 ± 4.26) ng/L, (58.46 ± 3.74) mg/L vs. (1.34 ± 0.37) mg/L, (7.48 ± 0.24) μg/L vs. (0.31 ± 0.06) μg/L; cerebrospinal fluid: (3.52 ± 0.43) ng/L vs. (1.47 ± 0.36) ng/L, (23.06 ± 0.67) mg/L vs. (2.17 ± 0.45) mg/L, (4.13 ± 0.25) μg/L vs. (0.18 ± 0.07) μg/L, and there were statistical differences ( P<0.01). The correlation analysis result showed that serum and cerebrospinal fluid PGRN were positively correlated with CRP and PCT in children with PM (serum: r = 0.517 and 0.546, P<0.01; cerebrospinal fluid: r = 0.541 and 0.528, P<0.01). Among the 60 children with PM, 44 had good prognosis and 16 had poor prognosis. The serum and cerebrospinal fluid PGRN, CRP and PCT in children with poor prognosis were significantly higher than those in children with good prognosis, serum: (48.78 ± 4.65) ng/L vs. (34.15 ± 5.12) ng/L, (67.15 ± 3.84) mg/L vs. (47.02 ± 4.23) mg/L, (8.46 ± 0.35) μg/L vs. (6.23 ± 0.31) μg/L; cerebrospinal fluid: (3.93 ± 0.49) ng/L vs. (3.12 ± 0.37) ng/L, (27.62 ± 0.74) mg/L vs. (18.53 ± 0.81) mg/L, (4.97 ± 0.28) μg/L vs. (3.24 ± 0.31) μg/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the area under curve of serum and cerebrospinal fluid PGRN for assessing the prognosis of children with PM was 0.821 (95% CI 0.818 to 0.824) and 0.913 (95% CI 0.910 to 0.916), with a sensitivity of 81.23% and 89.46%, and a specificity of 72.34% and 79.58%, cut-off value of PGRN was 41.53 and 3.54 ng/L. Conclusions:Serum and cerebrospinal fluid PGRN levels in children with PM are significantly increased, which are closely related to the prognosis of children with PM, and are potential indicators for evaluating the prognosis of PM.

OBJECTIVETo compare the difference in the clinical efficacy on endometriosis (EM) between electroacupuncture (EA) and western medication.

METHODSSeventy-two EM patients were divided into an EA group and a western medication group according to visiting departments, 36 cases in each one. In the EA group, acupuncture was applied to Qihai (CV 6), Guanyuan (CV 4), Zhongji (CV 3), Zigong (EX-CA 1), Diji (SP 8), Sanyinjiao (SP 6), Hegu (LI 4) and Taichong (LR 3). After qi arrival, G6805-I pulse electronic apparatus was attached to bilateral Zigong (EX-CA 1), Guanyuan (CV 4) and Zhongji (CV 3), with continuous wave, 70 Hz in frequency, 3 mA in intensity. The EA was given once every two days. In the western medication group, mifepristone tablets were prescribed for oral administration, 12. 5 mg per treatment, once a day, for 6 months. The pain degree was observed before and after treatment and the clinical efficacy and recurrence rate were evaluated in the two groups. The enzyme-linked immunoassay (ELISA) was adopted to determine the tumor marker serum CA125 before and after treatment in the two groups.

RESULTSThe total effective rate was 94. 4% (34/36) in the EA group and was 91. 7% (33/36) in the western medication group, without significant difference (P>0. 05). The pain score after treatment was lower than that before treatment in the two groups (both P< 0. 01), but the score after treatment in the EA group was lower than that in the western medication group (P<0. 05). Serum CA125 was reduced after treatment in the patients of the two groups (both P<0. 01), and serum CA125 after treatment in the EA group was lower than that in the western medication group (P<0. 05). In the follow-up visit of one year, the reoccurrence rate was 17. 6% (6/34) in the EA group and was 33. 3% (11/33) in the western medication group, indicating the significant difference (P<0. 05).

CONCLUSIONEA achieves the significant clinical efficacy and the reoccurrence rate in 1 year in the EA group is obviously lower than that in the western medication group. This therapy could be promoted in clinical practice of acupuncture and moxibustion.

Acupuncture Points ; Adult ; Electroacupuncture ; Endometriosis ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Young Adult

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Alopecia ; physiopathology ; therapy ; Female ; Hair ; growth & development ; Humans

Objective] The article summarizes the experience of using sanren decoction to treat pediatric diseases by Professor Liu Lin, the famous TCM physician of Hubei. [Methods] Through following Professor Liu Lin clinical diagnosis, organize his medical records, summarize the experience and thoughts of using Sanren decoction to treat pediatric diseases, and for some cases. [Results] Professor Liu Lin believes that the physiological and pathological characteristics of children prone to cause hot and humid accumulation, pediatric Chih-Yin is not substantial, with their lungs often delicate and spleens often inadequate, they prone to get hot and humid accumulation after sick, and later appear a variety of symptoms including upper burner, center burner and lower burner. Therefore, the treatment of pediatric disease should take the heat into account, bearing in mind the residence site of heat evil and syndrome differentiation. Professor Liu Lin makes good use of Sanren decoction to treat a variety of pediatric diseases, judging the residence site of heat evil and clinical manifestations, giving the corresponding treatment flexibly. Such as the treatment of bronchitis with almonds as the monarch herb to expectorant cough, treatment of infantile anorexia with White Kou Ren as the monarch herb to activate spleen and remove dampness, treatment of children with nephrotic syndrome with Yiyiren as the monarch herb for penetration of water, treatment of HFMD with the Sanren to regulate Qi of triple burner, according to the symptoms to medicate and always has good clinical effect. [Conclusion] Professor Liu Lin using Sanren decoction to treat pediatric diseases is effective, his thought is worthy of depth study and promotion.

The high mutation rate during hepatitis B virus (HBV)replication leads to HBV quasispecies.The study of HBV quasispecies has an important significance for the hepatitis B pathogenesis,prognosis,and outcome prediction.Recently,the next-generation sequen-cing (NGS)is extensively used in many biological and medical fields due to its high throughput,ultra-deep coverage,and high sensitivity, which also brings new strategies to HBV quasispecies studies.This article describes the working principles and features of several commonly used NGS technologies,reviews the application of NGS technologies in HBV quasispecies detection in recent years,and particularly discus-ses the variations in different regions of HBV genome and the population characteristics of HBV quasispecies.For now,NGS technologies used in HBV variation detection mainly presents the advantages of high sensitivity and high throughput.However,how to lower the cost,in-crease the accuracy of sequencing,and standardize the procedure of massive sequencing data management and personalized analysis are still challenging problems.The issue about NGS that matters at present and urgently needs to be solved is how to overcome its limitations,and then put it into HBV-related studies and ultimately clinical application.

The knowledge and understanding of myeloproliferative neoplasms (MPN) over the last hundred years has been reviewed in this article,focusing on clinical practice.The identification of JAK2 V617F gene mutation leads Philadelphia chromosome-negative (Ph) MPN into a new era of molecular biology.These advances not only provide a reliable diagnostic tool and important evidence for diagnosis of MPN,also induce a lot of investigation and manufacture of targeting drugs to JAK2 mutation.However,JAK2 V617F mutation is not the gold standard for the diagnosis of MPN,as unique as bcr-abl in CML.Certain routine lab results and differentiation with some other diseases are still necessary.A JAK1/JAK2 inhibitor,ruxolitinib,has been approved for clinical use,but indication should be followed.Further follow-up is needed to assess the longterm outcomes with respect to efficacy and safety.It is not time to give up conventional medicine,such as hydroxyurea or aspirin.

Specific detection of amatoxins and phallotoxins in body fluids is necessary for an early diagnosis of an intoxication with mushrooms.In this study, a rapid method for the simultaneous determination of α-, (β-and γ-amanitin, phalloidin and phallacidin in human urine and plasma was first developed by ultra-perform ance liquid chromatography-tandem mass spectrometry.Urine sample was directly injected into the separation system and plasma sample was initially prepared by precipitation of proteins with 1% acetic acid in acetoni trile.The toxin was analyzed on an ACQUITY UPLC HSS T3 column using a gradient program with a cycle time of 9 min, and detected by positive electrospray ionization tandem mass spectrometry in the MRM mode, and quantified by matrix-match standard solution.The detection limits (S/N = 3) of the toxins were within 0.2-1 μg/L and 0.1-0.5 μg/L for urine and plasma, respectively.The standard curves were linear in the range of 2-100 μg/L for urine and 1-100 μg/L for plasma.The average recoveries were 92.0%-108.0% and 85.0%-100.0% for the toxins spiked in urine and plasma, with RSDs of 1.0%-22.0% and 2.0%-22.0% (n = 6), respectively.The method was simple, selective and sensitive to detect the amatoxins and phallotoxins in urine and plasma for both clinical and forensic purposes.

A rapid method for the detection of tetrodotoxin(TTX) in human plasma and urine was developed by hydrophilic interaction liquid chromatography-tandem mass spectrometry. After a simple protein precipitation step was undertaken, the subsequent analysis of TTX was achieved on a TSK-gel amide-80 column using an ammonium formate-methanol-acetonitrile gradient with a cycle time of 13 min, and detected by positive electrospray ionization tandem mass spectrometry in the MRM mode, and quantified by matrix-match standard solution. It was found that linearity in urine was observed within concentration ranged from 3 μg/L to 500 μg/L, that in plasma 1 μg/L to 200 μg/L and that limits of detection(S/N=3) for urine and plasma were 1 and 0.3 μg/L, respectively. The average recoveries were 96%-108% and 100%-105% for TTX spiked in urine and plasma, respectively, with relative standard deviations of 1.7%-8.6% and 8.9%-16%(n=6). This method was simple, selective and sensitive to detect TTX in urine and plasma for both clinical and forensic purposes.