Objective To investigate the clinical efficacy ofHejie Fenxiao Decoction on damp-heat patients with acute kidney injury (AKI).Methods Totally 68 patients were divided into the control group and the treatment group according to the patients’ willings. Both groups were given treatment, such as elimination of the incentives and symptomatic treatment. Besides, patients of the treatment group acceptedHejie Fenxiao Decoction for 30 days. The changes of renal function indexes, such as serum creatinine (SCr), blood urine nitrogen (BUN), uric acid (UA), albumin (ALB) and integral of TCM syndrome, were observed, and recovery ratio and clinical endpoints were compared.Results SCr and eGFR of both group were improved on day 14 (P<0.05). After treatment, the renal function recovery ratio and renal replacement ratio in the two groups showed obvious differences (P<0.05);although survival rate of treatment group was higher than control group, it showed no statistical significance (P>0.05);clinical endpoints analysis of the two groups showed statistical significance (P<0.05). The difference of integrals of TCM syndrome between the two groups showed statistical significance (P<0.05) on day 14.ConclusionHejie Fenxiao Decoction combined with basic regular Western medicine can better improve the clinical symptom, recover the renal function, and decrease the rate of renal replacement and death of AKI damp-heat patients.

Objective To study interleukin-23 (IL-23) levels in serum and dendritic cells of acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B (CHB) and to explore its relationship with the prognosis.Methods Peripheral blood mononuclear cells and serum were collected from 40 ACLF patients with CHB (including survival group 27 cases and non-survival group 13 cases) and 26 healthy controls.Monocytes were induced to immature dendritic cell in vitro and TNF-α was added to induce dendritic cell maturation.IL-23 mRNA of dendritic cells was detected by real time polymerase chain reaction (PCR), and serum IL-23 level was measured by enzyme-linked immuno sorbent assay (ELISA).Differences among the parameters with normal distribution were compared using t test, those with non-normal distribution were compared using non-parametric Mann-Whitney U-test, and the relationship between two variables was assessed by Spearman′s rank correlation.Results International normalized rate (INR) and model for end-stage liver disense (MELD) scores in non-survival group of ACLF were higher than those in survival group (INR: 2.32 vs 1.64, U=69.00, P=0.002 2;MELD:36 vs 30, U=64.50, P=0.001 4).However, there were no significant differences between two groups at gender, age, alanin aminotransferase (ALT), aspartate aminotrans ferase (AST), bilirubin, creatinine, hepatitis B virus (HBV) DNA, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and serum IL-23.IL-23 mRNA level in dendritic cells at baseline in non-survival group of ACLF was significantly higher than that in survival group (76 vs 43, U=71.50, P=0.002 8).After treatment, serum IL-23 was significantly declined in survival group ([160±75] ng/L vs [91±49] ng/L, t=4.012, P=0.000 2), but not in non-survival group.Significant positive correlation was observed between IL-23 mRNA level in dendritic cells and MELD score at baseline (r=0.7198,P<0.01).Conclusions Persistent high serum IL-23 level suggests poor prognosis in ACLF patients with CHB.IL-23 mRNA expression in dendritic cells has good consistency with MELD score and the patients with high IL-23 mRNA expression has poor outcome.

A simple, reliable and sensitive liquid chromatography-isotope dilution mass spectrometry (LC-ID/MS) was developed and validated for quantification of olanzapine in human plasma. Plasma samples (50 microL) were extracted with tert-butyl methyl ether and isotope-labeled internal standard (olanzapine-D3) was used. The chromatographic separation was performed on XBridge Shield RP 18 (100 mm x 2.1 mm, 3.5 microm, Waters). An isocratic program was used at a flow rate of 0.4 m x min(-1) with mobile phase consisting of acetonitrile and ammonium buffer (pH 8). The protonated ions of analytes were detected in positive ionization by multiple reactions monitoring (MRM) mode. The plasma method, with a lower limit of quantification (LLOQ) of 0.1 ng x mL(-1), demonstrated good linearity over a range of 0.1 - 30 ng x mL(-1) of olanzapine. Specificity, linearity, accuracy, precision, recovery, matrix effect and stability were evaluated during method validation. The validated method was successfully applied to analyzing human plasma samples in bioavailability study.

OBJECTIVE: The periaqueductal gray matter (PAG), a small midbrain structure, presents dysfunction in migraine. However, the precise neurological mechanism is still not well understood. Herein, the aim of this study was to investigate the texture characteristics of altered PAG in episodic migraine (EM) patients based on high resolution brain structural magnetic resonance (MR) images. MATERIALS AND METHODS: The brain structural MR images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) patients using a 3T MR system. A PAG template was created using the International Consortium Brain Mapping 152 gray matter model, and the individual PAG segment was developed by applying the deformation field from the structural image segment to the PAG template. A grey level co-occurrence matrix was used to calculate the texture parameters including the angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. RESULTS: There was a significant difference for ASM, IDM and entropy in the EM group (998.629 ± 0.162 × 10−3, 999.311 ± 0.073 × 10−3, 916.354 ± 0.947 × 10−5) compared to that found in the NC group (998.760 ± 0.110 × 10−3, 999.358 ± 0.037 × 10−3 and 841.198 ± 0.575 × 10−5) (p < 0.05). The entropy was significantly lower among the patients with CM (864.116 ± 0.571 × 10−5) than that found among patients with EM (p < 0.05). The area under the receiver operating characteristic curve was 0.776 and 0.750 for ASM and entropy in the distinction of the EM from NC groups, respectively. ASM was negatively related to disease duration (DD) and the Migraine Disability Assessment Scale (MIDAS) scores in the EM group, and entropy was positively related to DD and MIDAS in the EM group (p < 0.05). CONCLUSION: The present study identified altered MR image texture characteristics of the PAG in EM. The identified texture characteristics could be considered as imaging biomarkers for EM.
Biomarkers ; Brain ; Brain Mapping ; Entropy ; Gray Matter ; Humans ; Magnetic Resonance Imaging ; Mesencephalon ; Migraine Disorders ; Periaqueductal Gray ; ROC Curve

Objective To explore the clinical features of cerebral hemorrhage associated with nephrotic syndrome (NS) as well as its underlying pathogenesis. Methods The clinical material of seven NS patients with cerebral hemorrhage were analyzed. Results The age of the seven patients was ranged from 5 to 56 years, including four male and three female. There were four patients with coagulopathy, six patients with elevated level of D-dimer and four patients with renal function impairment. Six patients had hyperlipidemia and four patients had severe proteinuria (>5 g/d). In the acute phase of hemorrhage onset, five patients developed cerebral hemorrhage in the lobes, two patients in the basal ganglia. Three patients were in coma on the first day of hemorrhage. On the 30th day after cerebral hemorrhage onset, four patients died and two patients had moderate cognitive dysfunction (modifed Rankin Scale, 3-5). Conclusion The patients of cerebral hemorrhage associated with NS may be in a serious illness state and have poor prognosis. Most of patients have elevated level of D-dimer, hyperlipidemia, and severe proteinuria, the biochemical abnormalities associated with NS. Most hemorrhages occur in the lobes which may be caused by coagulopathy.

Objective:To explore the etiology, pathogenesis and prescription of treatment methods of COVID-19 in traditional Chinese medicine (TCM), and to evaluate the value of integrated Chinese and western medicine for the treatment of the disease.Methods:According to the theory of five Yun and six Qi, regional climate characteristics and clinical evidence, the etiology and pathogenesis of COVID-19 were analyzed, and TCM treatment was established for clinical practices for 30 patients with COVID-19 in Huanggang Central hospital, during December 2019 and Janual 2020. Results:It is considered that COVID-19 belongs to the range of Plague in TCM theory, the etiology and pathogenesis are cold and dampness directly attacking the three yin channels, and internal constraint of deficient fire, so the disease name is called by cold-dampness pestilence. The prescription was Wumeiwan (Mume Pill) combined with Mahuang-Shengma Decoction (Ephedra and Cimicifuga Decoction) and Dayuanyin (Dayuan Beverage), and the treatment was modified according to pattern differentiation. A total of 30 patients were treated with pattern differentiation and treatment of TCM. Among which, one patient was treated only with herbal medicine, and the other 29 were treated based on the routine treatment of Western medicine. After treatment, 25 of the 30 patients had improved symptoms after taking 1 dose of TCM. After taking 7-10 doses, all patients had major symptoms ranging from improvement (8+4 cases) to complete disappearance (18 cases), 13 cases met the discharge criteria, including the one who was treated only with herbal medicine. Among all the patients, 5 of the 6 severe turned to moderate and 1 turned to mild. Conclusions:The pathogenesis of COVID-19 is cold and dampness directly attacking the three yin channels, and internal constraint of deficient fire, and then Jue-Yin Disease, which belongs to the category of cold-damp pestilence. The method of integrated Chinese and Western medicine can rapidly improve the symptoms and the clinical effect is satisfactory.

Objective:To investigate the expression of PC4 and SFRS1 interacting protein 1 (PSIP1) in oral squamous cell carcinoma cells and the effects of PSIP1 silencing on the migration and invasion of oral squamous cell carcinoma cells, and to preliminarily explore its mechanism.Methods:The PSIP1 gene of oral squamous cell carcinoma cell line HN30 was silenced by RNA interference technique. HN30 cells were divided into si-NC group (transfected with siRNA-NC) and si-PSIP1 group (transfected with siRNA-PSIP1). Quantitative real-time PCR was used to detect the expression of PSIP1 mRNA. Scratch test and Transwell invasion test were used to detect the migration and invasion abilities of HN30 cells, and Western blotting was used to detect the expression levels of epithelial-mesenchymal transformation (EMT) related proteins in HN30 cells of the two groups.Results:The relative expression levels of PSIP1 of HN30 cells in the si-NC group and si-PSIP1 group were 1.00±0.00 and 0.21±0.06 respectively, with a statistically significant difference ( t=22.30, P=0.002). The scratch healing rates of the si-NC group and si-PSIP1 were (48.21±4.66)% and (42.05±11.74)% at 12 h respectively, with no statistically significant difference ( t=1.46, P=0.173), and the scratch healing rates of the two groups were (86.61±6.06)% and (67.76±3.62)% at 24 h respectively, with a statistically significant difference ( t=8.01, P<0.001). The invasion numbers of HN30 cells in the si-NC group and si-PSIP1 group were 91.00±7.05 and 23.34±4.98, and there was a statistically significantly difference ( t=19.20, P<0.001). Compared with the si-NC group, the migration and invasion abilities of HN30 cells in the si-PSIP1 group decreased significantly (all P<0.001). The expression levels of E-cadherin of the si-NC group and si-PSIP1 group were 1.06±0.02 and 1.43±0.13 respectively, with a statistically significant difference ( t=-4.94, P=0.036), and the expression levels of N-cadherin were 1.00±0.04 and 0.57±0.14 respectively, with a statistically significant difference ( t=5.03, P=0.007). Compared with the si-NC group, the expression level of E-cadherin in the si-PSIP1 group increased, while the expression level of N-cadherin decreased. Conclusion:Silencing the expression of PSIP1 can significantly inhibit the migration and invasion of HN30 cells, and the mechanism may be related to the effect of PSIP1 on the EMT pathway of oral squamous cell carcinoma.

Objective:To design and implement a registration system based on Elasticsearch,so as to solve the problems of the conventional registration system included single method of appointment and registration,and one-sidedness information of search registration platform,and to meet the growing needs of patients for diversified and intelligent medical registration and treatment.Methods:The browser/server(B/S)architecture was used to implement the design of registration system.The front-end used the neuron organic object description language(NOODL)language to render the interface,and implemented interaction between function methods and interface data through Typescript.The Elasticsearch search engine implemented high efficient search functions.The back-end processed the requirements of data through the(edge-based cloud object storage)ECOS system,and stored business data in the MySQL database.The system included a three-layer architecture with application layer,service layer and storage layer,which can realize a series of functions such as login and registration,search for appointments,link appointments,scan code for appointments,and setting appointment information by doctors.Results:The registration system based on Elasticsearch can realize multiple methods of appointment registration such as online search appointment,exclusive link appointment of hospital,appointment by scanning code,etc.,which was suitable to multiple platforms such as Web and mobile device.It has been applied in many overseas medical institutions.As of June 2023,the system possessed 219 doctors,and had serviced for 19,903 patients,and had completed 62,737 appointments,which saved a lot of time for patients to seek medical treatment,and improved operation efficiency of hospital.Conclusion:The registration system based on Elasticsearch can meet the diversified and intelligent needs of patients for medical treatment,which can provide comprehensive,accurate and intelligent services of appointment and treatment for patients,and can effectively improve the efficiency of appointment and treatment.

Objective To discuss the clinical efficacy of absolute ethanol and foam hardening agent in the treatment of large venous malformations(VM)in child patients.Methods The clinical data of a total of 60 child patients with solitary large VM were retrospectively analyzed.The child patients were divided into group A(n=30)and group B(n=30).Patients in group A received absolute ethanol injection followed by foam hardening agent injection,while patients in group B received foam hardening agent injection followed by absolute ethanol injection.The clinical efficacy,complications,mean number of injections and mean dosage of absolute ethanol were compared between the two groups.Results The total effective rate in both group A and group B was 100%.The markedly effective rate in group A and group B was 63.33%(19/30)and 90%(27/30)respectively,and the difference was statistically significant(P＜0.05).In group A and group B,the mean dosage of absolute ethanol was(10.30±3.19)mL and(6.73±2.06)mL respectively,the mean number of injection was(3.57±1.01)times and(2.63±0.61)times respectively,and the differences in the above two indexes were statistically significant(both P＜0.05).No serious complications occurred in either group.The incidence of blisters in group A and group B was 30%(9/30)and 6.67%(2/30)respectively,and the difference was statistically significant(P＜0.05).Conclusion For large VM in child patients,combination use of absolute ethanol and foam hardening agent can improve the curative efficacy,reduce the dosage of absolute ethanol,and lower the incidence of complications.In addition,the therapeutic mode of foam hardening agent injection followed by absolute ethanol injection can achieve better efficacy.(J Intervent Radiol,2024,32:28-32)

Objective To investigate the protective effects of N-acetyl-L-tryptophan (L-NAT) on intestinal damage after rat hepatic ischemia reperfusion.Methods Twenty-four healthy adult rats were divided into the sham operation group (Sham),ischemia reperfusion group (IR),ischemia reperfusion and N-acetyl-L-tryptophan group(IR+L-NAT).The hepatic ischemia reperfusion model was established by occluding the afferent vessels of the left and middle lobes.The morphological structures of the small intestine were observed by hematoxylin-eosin (HE) staining.The expressions of active caspase-3,Bax and Bcl-2 were detected by immunohistochemistry staining.Results (1) In the IR group,the structure of intestinal villis was destroyed,the intestinal mucosa showed congestion and exfoliation,the epithelial cells had degeneration and necrosis,and infiltration of inflammatory cells appeared;which could be alleviated by L-NAT.(2)The immunohistochemistry showed that compared with the Sham group,the expression of active caspase-3,Bcl-2 and Bax in the IR group was increased,after L-NAT intervention,the Bax and caspase-3 expression was decreased,while the Bcl-2 expression was further increased.Conclusion L-NAT could inhibit the apoptosis of small intestinal epithelial cells caused by liver ischemic reperfusion and attenuates intestinal epithelial damage.