OBJECTIVETo observe the fetus protection effects of Zhixue Baotai Decoction (ZBD) on women of early threatened abortion with dark area surrounding pregnancy sac.

METHODSThe 105 patients with early threatened abortion, in whom vaginal bleeding was shown already, were randomly assigned to the treatment group and the control group, who were treated respectively with ZBD and progesterone to protect fetus. The efficacy of treatment was evaluated by dynamic monitoring of serum hormone and B-ultrasonic examination.

RESULTSAmong the 54 cases in the treatment group the fetus was protected successfully, showing a fetus protecting rate of 81.5%; while among the 51 cases in the control group, the protection was effective in 22 cases (43.1%), the success rate in the former was better (P<0.01). The dark area was absorbed in 16 out of 19 cases (84.2%) in the treatment group, while in the control group absorption occurred only in 6 out of 17 (35.3%).

CONCLUSIONThe effect of ZBD is superior to that of progesterone in treating women of early threatened abortion with dark area surrounding pregnancy sac.

Abortion, Threatened ; diagnostic imaging ; drug therapy ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Extraembryonic Membranes ; diagnostic imaging ; Female ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Trimester, First ; Treatment Outcome ; Ultrasonography ; Young Adult

Avian influenza virus H6N1 subtype has been circulating in aquatic bird and terrestrial bird,and is the most frequently detected subtype of influenza A virus in those hosts.Genetic analysis results suggested that this virus might be the progenitor of the highly pathogenic avian influenza H5N1 virus,as seven of eight gene segments of those viruses had a common source.As continuing evolution of H6N1,it could spread across species barriers to mammals and had strong infection ability in mice,swine and ferrets.Serological epidemiological survey showed that a few people were positive for H6 avian influenza virus antibody and then the world's first human infection with influenza virus H6N1 subtype was reported in May 2013.Therefore,with the expansion of the host range of the virus,gene mutation and gene reassortment of H6N1 virus can occur in these hosts,and then it may evolve into novel variant strain with infected human potential.

Wu Mengchao summarized his life experience with "being honest in life, being down-to-earth in doing things, being solid in learning, and having your own struggle goals and life ideals". His "three 'shi'" outlook on life has important enlightenment for medical students’ growth and success. Medical students should cultivate a correct personality and good professional ethics, a diligent and diligent habit and down-to-earth quality, and a scientific research concept and spirit of seeking truth from facts, strive for a healthy China by honing their character and learning skills well.

Background Di(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP) are representative environmental endocrine disruptors of phthalate esters (PAEs). Some studies have shown that PAEs exposure may have an impact on lipid metabolism. Objective To investigate the effects of DEHP and/or DBP on lipid metabolism in rats and their possible mechanisms of action. Methods Thirty-six weaned healthy SD male rats, 3 weeks old, weighing 50-70 g, were divided into four groups, i.e., a corn oil control group, a DEHP (750 mg·kg⁻¹) group, a DBP (500 mg·kg⁻¹) group, and a DEHP+DBP (750 mg·kg⁻¹+500 mg·kg⁻¹) group. The rats were exposed to DEHP and/or DBP by oral gavage for 8 weeks, and weighed once a week. The rats were anesthetized 24 h after the last dose, and blood was taken from the apical part of the heart. Serum high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) were detected. Liver tissues and perigenital adipose tissues were collected, weighed, and one portion of the tissues was fixed in 10% neutral formalin for pathomorphological observation, and another portion was used for mRNA detection of lipid metabolism-related genes such as Janus kinase 3 (JAK3), signal transducer and activator of transcription 5b (STAT5b), and peroxisome proliferator-activated receptor γ (PPARγ). Results During the DEHP and/or DBP exposure period, the rats in all groups were free to eat and drink without death or injury observed. Compared with the control group: The body weight gain in the DEHP+DBP group was lower at all time points from the 2nd week onwards (P<0.05); the liver organ coefficients of the DEHP and the DEHP+DBP groups were higher (P<0.05); the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). Compared with the DEHP+DBP group: The body weight gains in the DEHP group at the 2nd, 4th, 5th, and 8th weeks were higher (P<0.05), and the body weight gains in the DBP group were higher at all time points except the 1st week (P<0.05); the liver organ coefficients in the DEHP group and the DBP group were lower (P<0.05); the serum TG level in the DEHP group was higher(P<0.05), and the serum LDL-C levels in the DEHP and the DBP groups were higher (P<0.05). The pathomorphological results of liver tissues showed that the hepatocytes in the DEHP, DBP, and DEHP+DBP groups were disordered with loss of cord-like arrangement, swelling (suggesting change of cell proliferation), and presented bilirubin pigmentation. The pathomorphological results of rat perigenital adipose tissues showed had irregular alignment, sizes, and arrangement of adipocyte in the DEHP, DBP, and DEHP+DBP groups. The results of rat liver lipid metabolism-related gene mRNA levels showed that the liver JAK3, STAT5b, and PPARγ mRNA levels in the DEHP, DBP, and DEHP+DBP groups were lower than those in the control group (P<0.05); the rat liver PPARγ mRNA levels in the DEHP and DBP groups were lower than those in the DEHP+DBP group (P<0.05). Conclusion DEHP and/or DBP can inhibit the increase of body weight to varying degrees, induce inflammatory damage to liver tissues, and cause abnormal lipid metabolism in rats, and the associated mechanism may be related to inhibiting the activation of JAK3/STAT5b/PPARγ signaling pathway in rat liver tissues.

OBJECTIVE：To overview the systematic review on the effectiveness of indomethacin in the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis （PEP），and to provide reliable evidence-based reference for the prevention of PEP. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，CBM，CNKI，Wanfang database and VIP，systematic review on indomethacin in the prevention of PEP were collected during the inception to Nov. 2020. The methodological quality ，report quality and evidence quality of the included studies were evaluated by AMSTAR 2 scale，PRISMA statement and GRADE method. The effectiveness of PEP prevention was described. RESULTS ：Finally，23 systematic reviews were obtained ，including 12 in Chinese and 11 in English. Tweenty-two systematic reviews showed that compared with placebo ， indomethacin could effectively reduce the incidence of PEP. Eight systematic reviews showed that indomethacin significantly reduced the incidence of moderate and severe PEP compared with placebo. Five systematic reviews showed that indomethacin could reduce the incidence of postoperative hyperamylasemia compared with placebo. Three systematic reviews showed that indomethacin also had a good preventive effect on people with high risk of PEP. PRISMA score of included systematic reviews ranged from 15 to 25. The quality evaluation of AMSTAR 2 methodology included in systematic reviews was low ，and the key items of complete report were 4，9，11 and 13. The GRADE evidence quality evaluation of the included systematic reviews showed that the quality of the evidence was concentrated in the low level. CONCLUSIONS ：Indomethacin has a certain effect in the prevention of PEP ，but the overall evidence quality of the included literatures is generally not high. It needs to be further validated by high-quality clinical research.

Objective:To investigate the effect of intervention on oral health of pre-pregnancy women before and after oral health education. Methods:A total of 40 pre-pregnancy women were selected from the Reproductive Medicine Center of General Hospital of Ningxia Medical University according to the inclusion criteria， general conditions， clinical evaluation of plaque and oral health education. Their oral health conditions were evaluated before and after oral health intervention. Results:Based on the oral health status survey， there were significant differences between before and after intervention （all P<0.001） in the following five items： “bleeding from brushing teeth”， “difficulty biting or chewing food”， “sensitivity of teeth or gums to cold， hot， or sweet stimuli”， "restriction of the type and amount of food eaten for dental reasons” and “medication for oral pain or discomfort”. There were significant differences between before and after intervention （all P<0.001） in four items of oral health care behavior including “How often do you brush your teeth？”， “How do you brush your teeth？”， “gargle after meals”， and “floss use or not” but showed no significant difference in toothbrush replacement （P=0.467）. There were significant differences （all P<0.001） in five items of oral health knowledge including “periodontal disease can lead to premature delivery of newborns”， “periodontal disease can lead to low birth weight of newborns”， “need oral examination before pregnancy”， “pregnancy prone to oral diseases”， “mid-pregnancy is the best period for the treatment of oral diseases”. The oral plaque index before intervention was 5.47±1.08 and reduced to 4.37±0.94 after intervention （t=7.93， P=0.001）. Conclusion:Through education intervention， the oral health status of pre-pregnancy women can be improved. The knowledge of oral health can be improved and the level of oral health care can be enhanced. Oral health intervention can effectively reduce the level of plaque in pre-pregnancy women and improve the efficiency of plaque clearance.

OBJECTIVE: To evaluate the value of anti-carbamylated protein (CarP) antibody in the diagnosis of rheumatoid arthritis-associated intersitial lung diseas (RA-ILD). METHODS: Clinical and laboratory data and serum samples of patients with RA between December 2017 and June 2019 in Department of Rheumatology, General Hospital of Ningxia Medical University were collected. The patients were subclassified as RA-ILD and RA-without ILD based on computed tomography scans of the chest, Enzyme 1inked immunosorbent assay (ELISA) was used to assess anti-CarP antibody in the serum of each group. The occurrence of ILD and other laboratory indexes were analyzed. Comparison of measurement data between the 2 groups was performed by two independent sample t-test or Mann-Whitney U nonparametric test, while the count data were compared by Chi square test; Receiver operating characteristic curve (ROC) was drawn to determine the cut-off value of anti-CarP antibody to RA-ILD diagnosis and to analyze its diagnostic efficacy. RESULTS: The anti-CarP antibody level in the RA-ILD group was 21.14 (12.29, 29.75), which was significantly higher than that in the RA-without ILD group 11.6 (6.66, 19.05) (P=0.000). The difference was statistically significant (P<0.05). The positive rate of anti-CarP antibody in RA-ILD group (53%) was significantly higher than that in RA-without ILD group (16%) (P<0.05); There was no significant differences in the levels of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) between the two groups (P>0.05). The age and disease activity score (DAS28) in the RA-ILD group were significantly higher than those in the RA-withhout ILD group (P<0.05). The proportion of men and smoking in the RA-ILD group was higher than that in the RA-without ILD group, but the difference was not statistically significant. The ROC curve showed that the anti-CarP antibody had a cut off value of 20.56 U/mL, with the sensitivity of 53.50%, and specificity of 84.20%, the area under the ROC curve were 0.76. Spearman correlation analysis showed that rheumatoid factor (RF) and age were positively correlated with anti-CarP antibody (r=0.172, P=0.043; r=0.200, P=0.006). Anti-CarP antibody level was not associated with the DAS28 score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-CCP antibody, swollen joint count, and tender joint count (P>0.05). CONCLUSION The anti-CarP antibody level in RA-ILD patients is higher than that in RA-without ILD, suggesting that anti-CarP antibody may have a role in the development of RA-ILD.
Arthritis, Rheumatoid ; Autoantibodies ; Blood Sedimentation ; Humans ; Lung Diseases ; Male ; Peptides, Cyclic ; Rheumatoid Factor

Neuropathic pain is a debilitating pathological condition that presents significant therapeutic challenges in clinical practice. Unfortunately, current pharmacological treatments for neuropathic pain lack clinical efficacy and often lead to harmful adverse reactions. As G protein-coupled receptors (GPCRs) are widely distributed throughout the body, including the pain transmission pathway and descending inhibition pathway, the development of novel neuropathic pain treatments based on GPCRs allosteric modulation theory is gaining momentum. Extensive research has shown that allosteric modulators targeting GPCRs on the pain pathway can effectively alleviate symptoms of neuropathic pain while reducing or eliminating adverse effects. This review aims to provide a comprehensive summary of the progress made in GPCRs allosteric modulators in the treatment of neuropathic pain, and discuss the potential benefits and adverse factors of this treatment. We will also concentrate on the development of biased agonists of GPCRs, and based on important examples of biased agonist development in recent years, we will describe universal strategies for designing structure-based biased agonists. It is foreseeable that, with the continuous improvement of GPCRs allosteric modulation and biased agonist theory, effective GPCRs allosteric drugs will eventually be available for the treatment of neuropathic pain with acceptable safety.

Objective: Review the independent risk factors of postoperative recurrence in surgical treatment of bladder cancer patients to construct a model of bladder cancer recurrence. Methods : A total of 240 surgically treated bladder cancer patients were followed up for at least 1 year and divided into recurrence ( n = 54) and non⁃recurrence (n = 186) . The general data of patients were comparative analyzed , and the different and statistically significant data were further analyzed by ROC curve , and the statistically significant data were included in the multivariate analysis after logistic obtaining univariate analysis results. Risk factors were included in the model construction , and the model correction curve and clinical net benefit analysis were analyzed. The model could be used to predict postoperative recurrence in bladder cancer patients. Results: The ROC curves of the statistically significant continuous variables were analyzed in the general data , and the results showed that the AUC of PNI , BLCA⁃4 , BTA , NMP22 and CEA were 0. 932 , 0. 979 , 0. 998 , 0. 677 and 0. 981 , respectively , and the optimal truncation values were ≤40. 18% , > 140. 04 ng/mg , ≤7. 22 U/mg , > 7. 68 μg/mg , and > 1. 99 ng/mg, respectively. Statistically significant data from univariate analysis were incorporated into the logistic regression model , and the results showed that PNI ≤40. 18% , BLCA⁃4 > 140. 04 ng/mg , BTA≤7. 22 U/mg , NMP22 > 7. 68 μg/mg was a risk factor for recurrence in patients with bladder cancer. Subsequently , PNI , BLCA⁃4 , BTA , and NMP22 were incorporated into the construction of the model as predictors of recurrence in patients with bladder cancer. Based on the model correction curve and clinical net benefit analysis , the internal verification results showed that the C ⁃index of the model predicting bladder cancer recurrence was 0. 296 (95% CI: 0. 078 - 1. 329) . The calibration curve showed good consistency between the observed and predicted values. The model predicted a risk threshold > 0. 128 for patients with bladder cancer, and the model provided a clinical net benefit; in addition , the model had a higher clinical net benefit than PNI ,BLCA⁃4 , BTA , and NMP22. Conclusion The model correction curve and clinical net benefit analysis , the results of internal verification show that the model can be used to predict recurrence in patients with bladder cancer.

Objective: To explore if conventional protein kinase C (cPKC: PKCα and PKCβ) contributes to paraquat (PQ) -induced abnormal permeability of mouse brain microvascular endothelial cells (BMECs) via the regulation of tight junction (TJ) proteins. Methods: The immortalized mouse brain endothelial cell line (bEnd.3) was used to establish a monolayer blood-brain barrier (BBB) model. In order to evaluate the function of the in vitro BBB model, the transendothelial electrical resistance (TEER) and permeability were measured by a Millicell-ERS volt-ohmmeter and sodium fluorescent (Na-FLU) , respectively. MTT assay was used to determine the relative survival rate of cells. The dose-response relationship was determined by treating cells with 0, 50, 100, 200, and 300 μmol/L PQ for 24 hours. The time-response relationship was determined by treating cells with 200 μmol/L PQ for 6, 12, 24, 48, and 72 hours. After the treatment of cells with 0, 100, 200, and 300 μmol/L PQ for 24 hours, the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were measured by immunofluorescence (IF) and quantitative real-time RT-PCR (qRT-PCR) , respectively; the expression of PKCα, PKCβ, phosphorylated (p) -PKCα, and p-PKCβ was determined by Western blot. After the treatment of cells with 200? mol/L PQ for 24 hours following the pretreatment with a classical PKC inhibitor (Go 6983, 1 μmol/L) for 1 hour, the protein expression of ZO-1, Occludin, Claudin-5, p-PKCα, and p-PKCβ was measured by Western blot. Results: The TEER of the bEnd. 3 cells increased gradually with the cell culture time, and reached a peak value of 114.3±6.9 Ω·cm² on day 6. According to the permeability analysis by Na-FLU, cell permeability gradually decreased with the cell culture time, and reached 1.7±0.2 cm/min on day 6, suggesting a well-behaved barrier function of cells. Compared with the control group, the survival rates of the bEnd.3 cells were significantly reduced after exposure to 100, 200, or 300 μmol/L PQ for 24 hours (P<0.05) , or after exposure to 200 μmol/L PQ for 6, 12, 24, 48, or 72 hours (P <0.05) , indicating a dose-and time-dependent relationship. The IF and qRT-PCR results showed that the protein and mRNA expression levels of ZO-1, Occludin, and Claudin-5 were significantly reduced with the increase in the concentration of PQ (P<0.05) . The Western blot analysis showed that compared with the control group, cells exposed to PQ had significantly higher protein expression of p-PKCα and p-PKCβ and significantly lower protein expression of ZO-1, Occludin, and Claudin-5 (P<0.05) . Compared with the PQ treatment group, the Go 6983 intervention group had significantly higher protein expression of ZO-1, Occludin, and Claudin-5 and significantly lower protein expression of p-PKCα and p-PKCβ (P<0.05) . Conclusion By activation of cPKC (PKCα and PKCβ) , PQ reduces the protein and mRNA expression of TJ proteins and enhances the permeability of murine BMECs.