OBJECTIVE: To probe into the utilization characteristics and the consumption of oral traditional Chinese medicinal decoctions in our hospital.METHODS: The department of internal medicine in our hospital was subdivided into 8 special divisions.6 physicians of senior professional title(associated professor or above) from each subdivision were randomly selected for analysis of the prescriptions of oral traditional Chinese medicinal decoctions prescribed by the 48 physicians.The ingredients and their dosages in the prescriptions were recorded to database and analyzed by Weka data mining software.RESULTS: The drug use frequency of no less than 5% was noted in 68 kinds of oral traditional Chinese medicinal decoctions,with the drugs for reinforcing deficiency showing the highest drug use frequency,followed by drug for clearing heat,drugs for blood-activating and stasis-dissolving,drugs for eliminating sputum and relieving cough and asthma etc.The drug use frequency of no less than 1% was noted in 193 kinds,of which,160(83%) whose doses exceeded the specified limit value specified in Chinese Pharmacopeia,and in 52 kinds(27%),the proportion of prescriptions involving overdosing was no less than 50%.CONCLUSION: The concerned departments should attached great importance to the widespread phenomenon that the dosages of oral traditional Chinese medicinal decoctions in our hospital exceed the specified dosages in Chinese Pharmacopeia.

Objective To evaluate the cause and the treatment of the vagus nerve reflex in patients with hemoptysis during bron-chial artery embolization (BAE).Methods 1 12 patients with much hemoptysis were enrolled,9 of whom represented vagus nerve reflex in the process of interventional embolization.Results In 9 patients with mixed vagal reflex,5 occurred in the process of bron-chial artery embolization,1 in removing of sheath,1 in hemostasis by compression and 2 in returning to the ward.The intraoperative vagus reflex during BAE was related to over tension and unnormolized operation,and it improved by block of vagus nerve,raising blood pressure and fluid expansion without serious complications.Conclusion Vagus nerve reflex during BAE should be noticed, and early detection and timely intervention may improve its prognosis.

Objective To immunologically characterize the binding activity of a genetic engineering human antibody against keratin. Methods The specific anti-keratin Fab was screened from a phage antibody library. After Fab monoclonal antibody was induced by isopropylthio-?-D-galactoside (IPTG), the binding activity with antigens and antigenic specificity of the antibody were verified by ELISA,Western blot, and competitive inhibition ELISA. Results The antibody possessed good antigenic specificity as well as excellent binding activities with antigens, and could recognize 46 000 keratin specifically. It was identified as anti-keratin 17 antibody. Conclusions The immunologic characteristics of the genetic engineering antibody are very good. It is necessary to further study the biological activities and clinical application of it.

Objective To study the effects of anti-keratin autoantibody (AK auto Ab) on apoptosis of human keratinocytes. Methods Light and electron microscopy were used to observe morphological changes, flow cytometry (FCM) to analyze cell cycle, and electrophoresis to analyze DNA profiles of cultured keratinocytes. Results Typical morphological changes with apoptotic characteristics such as karyopyknosis, chromatin agglutination and apoptosis bodies were found. The subdiploid peaks due to apoptosis were also found in cell cycle analyses. DNA electrophoresis of keratinocytes showed characteristic ladder. Conclusions AK auto Ab could induce apoptosis in cultured human keratinocytes.

Podophyllotoxin (PTOX) is an extremely important plant-derived natural product, of which derivatives, like etoposide and teniposide, have been widely applied in therapies for cancers and venereal wart. A durable, intense plant extraction of podophyllotoxin posed a severe pressure on wild resources; researchers consequently sought to explore new sources, like cultivation, plant cell or organ culture, and chemical synthesis. Understanding biosynthesis of PTOX is one of the basic necessary steps for standard cultivation of medicinal plants and metabolite engineering. An important progress has been made in this field during the last two decades, particularly in the last ten years. Although a number of reviews concerning the related topic have existed, we specifically deal with biosynthesis of podophyllotoxin with an emphasis on the literatures of the past decade, highlighting characterization of genes encoding synthetic enzymes and down-stream metabolism of PTOX. The present review focuses on several key biosynthesis processes, important metabolites, function of related enzymes, and characterization of cDNA encoding the enzymes. Finally, the author proposed a hypothetical biosynthetic scheme of podophyllotoxin and perspectives.
Plants, Medicinal ; metabolism ; Podophyllotoxin ; biosynthesis ; chemistry ; metabolism

Objective To evaluate the effect of mefformin on the human keratinocyte line HaCaT,and to explore its molecular mechanism.Methods HaCaT cells were divided into several groups to be treated with mefformin at different concentrations of 1,2,5,10,20,50 mmol/L for 24,48 and 72 hours.Cell counting kit-8 (CCK-8) assay was performed to evaluate the effect of metformin on the survival rate of HaCaT cells.After 48-hour treatment with metformin at concentrations of 0 (control group),0.5,1,2,5,10 mmol/L,flow cytometry was conducted to evaluate the effect of metformin on cell cycle and apoptosis.Western blot analysis was performed to determine the expression of cell proliferation-and differentiation-related proteins (keratin-16 [K16],K17,K1,involucrin),apoptosis-related proteins (Bax,Bcl-2) and AKT/mTOR/STAT3 pathway proteins.Enzyme-linked immunosorbent assay (ELISA) was conducted to detect the levels of interleukin (IL)-8,tumor necrosis factor (TNF)-α and IL-23 (inflammatory factors) in the culture supernatant of HaCaT cells.Statistical analysis was carried out with SPSS19.0 software using one-way analysis of variance for comparison of the above indices among the 0.5-,1-,2-,5-,10-mmol/L metformin groups and control group,repeated measures analysis of variance for comparisons among different time points or different metformin groups,least significant difference (LSD)-t test for multiple comparisons.Results CCK-8 assay showed that mefformin had inhibitory effects on the proliferation of HaCaT cells (F =116.87,P ＜ 0.05),and the cell survival rates gradually decreased along with the increase in the concentrations of mefformin.After 48-hour treatment with mefformin at concentrations of 0,0.5,1,2,5,10mmol/L,the proportion of HaCaT cells in G2/M phase gradually increased (5.55％ ± 1.03％,6.37％ ±0.93％,8.57％ ± 1.18％,10.05％ ± 0.60％,10.76％ ± 0.87％,13.63％ ± 1.41％,respectively,F =24.98,P ＜0.05),and the early apoptosis rate also gradually increased (0.78％ ± 0.71％,19.18％ ± 1.41％,25.67％ ±1.34％,28.45％ ± 0.92％,34.97％ ± 2.12％,40.41％ ± 1.49％,respectively,F =296.08,P ＜ 0.05).Along with the increase in the concentrations of metformin,there were increasing trends in the expression of K1 and the pro-apoptotic protein Bax (F =8.86,5.38 respectively,both P ＜ 0.05),while there were decreasing trends in the expression of K16,K17 and the apoptotic protein Bcl-2 (F =8.02,4.82,12.10 respectively,all P ＜ 0.05).There was no significant difference in the expression of involucrin among different metformin groups (F =0.57,P ＞ 0.05).After 48-hour treatment with mefformin at different concentrations,the levels of IL-8 and TNF-α in HaCaT cells significantly decreased (F =33.89,14.99 respectively,both P ＜0.05),while there was no significant change in the IL-23 level (F =2.12,P ＞ 0.05).Along with the increase in the concentrations of metformin,the expression of p-AKT,p-mTOR and p-STAT3 significantly decreased (F =11.38,0.35,4.38 respectively,all P ＜ 0.05),but there were no significant changes in the protein expression of AKT,mTOR and STAT3 (F =0.66,0.35,4.24 respectively,all P ＞ 0.05).Conclusion Metformin can inhibit the proliferation,promote the differentiation and apoptosis of HaCaT cells,and inhibit the secretion of inflammatory factors by regulating the AKT/mTOR/STAT3 signaling pathway.

Objective:To explore the application process, efficacy and safety of MR-guided radiotherapy based on MR-linac in esophageal cancer.Methods:The clinical data of patients with esophageal cancer treated with MR-linac at Shandong Cancer Hospital and Institute from September 2021 to July 2022 were retrospectively analyzed, to investigate the treatment process of esophageal cancer with MR-linac, and to analyze the efficacy and safety of patients. All patients received MR-guided radiotherapy, underwent CT and MR localization, target area delineation, and design of the Monaco treatment planning system plan. Adaptation-to-position adjustment was conducted during the pre-treatment evaluation. The median number of fractions was 25, the median single dose of planning target volume was 1.8 Gy, and the median total dose was 50.2 Gy. Median follow-up was 16 months.Results:Among the 12 patients in the whole group, there were 1 case of cervical esophageal cancer, 3 cases of upper thoracic esophageal cancer, 4 cases of middle thoracic esophageal cancer and 4 cases of lower thoracic esophageal cancer, including 3 cases of neoadjuvant radiotherapy and 9 cases of radical radiotherapy. All patients had a smooth treatment process. The median treatment time was 33 min, and the patients had good compliance. For patients with radical radiotherapy, one month after radiotherapy, the number of objective remission cases was 3, and the number of disease-control cases was 9; six months after radiotherapy, the number of objective remission cases was 3, and the number of disease-control cases was 6. All patients treated with neoadjuvant radiotherapy underwent surgery within 2 months, and one patient achieved pathological complete remission. The most common acute adverse reactions were radiation esophagitis (7 cases) and leukopenia in bone marrow suppression (8 cases), with late-stage adverse reactions being radiation pneumonia (1 case). The adverse reactions to radiotherapy were slight, and no grade 4 or above adverse reactions were observed.Conclusion:The clinical treatment process for esophageal cancer under MR-guided radiotherapy based on MR-linac is feasible, with good curative effects and mild adverse reactions.

OBJECTIVE: To evaluate the short-term efficacy and safety of propranolol for problematic infantile hemangiomas. METHODS: Oral propranolol was administered to 68 infants with heamngiomas diagnosed by clinical evaluation and adjuvant examination at 1.0~2.0 mg per kilogram of body weight per day, divided to 2 or 3 times. The patients revisited once a month. The changes of the tumor size, texture, and color were monitored and recorded at a regular interval.The adverse effects after medication were observed and managed accordingly.The short-term results were evaluated using a 4-grade system. RESULTS: All the 68 infants were followed up for 3-13 months, except that 1 infants combined with other diseases and 4 withdrew.The overall response was Scale 1 in 8 infants, Scale II in 13, Scale III in 29, and Scale IV in 13. No serious adverse effects were seen, but none cured entirely as well. CONCLUSION Oral propranolol is safe and effective for infantile heamngioma with good short-term result. It could be used as the primary drug for problematic infantile hemangiomas at the rapid growth stage of hemangiomas.
Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; therapeutic use ; Prospective Studies ; Skin Neoplasms ; drug therapy ; Subcutaneous Tissue

OBJECTIVE To evaluate the efficacy and safety of programmed death-1/programmed death-ligand 1 （PD-1/PD-L1） inhibitors combined with bevacizumab in the treatment of advanced non-small cell lung cancer （NSCLC） based on platinum- containing dual therapy. METHODS Retrieved from CNKI， Wanfang， VIP， Web of Science， PubMed and other Chinese and English databases， cohort studies or randomized controlled trial studies on the treatment of advanced NSCLC with platinum- containing double agents in combination with PD-1/PD-L1 inhibitors and bevacizumab （trial group） versus platinum-containing double agents with or without PD-1/PD-L1 inhibitor or bevacizumab （control group） were collected from the inception to April 25， 2024. After screening literature， extracting data and evaluating quality， meta-analysis and sensitivity analysis were performed by using RevMan 5.4.1 software. RESULTS A total of 15 pieces of literature were included， involving 13 clinical studies with a total of 3 282 patients. Compared with the control group， partial response rate [RR＝0.75，95%CI（0.68，0.82），P＜0.000 01]， complete response rate [RR＝0.47，95%CI（0.29，0.76），P＝0.002]， progressive disease rate [RR＝1.23，95%CI（1.11，1.37），P＜0.000 1]， objective response rate （ORR） [RR＝0.72，95%CI（0.67，0.79），P＜0.000 01] and disease control rate （DCR） [RR＝0.85， 95%CI （0.77，0.95），P＝0.003] were higher in the trial group. There was no statistically significant difference in the stable disease rate [RR＝1.25， 95%CI （0.86， 1.83）， P＝0.25] or overall adverse drug reaction incidence rate [RR＝0.95， 95%CI （0.90， 1.00）， P＝ 0.07] between the two groups of patients. Sensitivity analyses showed robust and reliable results for all outcome indicators. CONCLUSIONS PD-1/PD-L1 inhibitors combined with bevacizumab based on platinum-containing dual therapy in the treatment of advanced NSCLC can improve patients’ clinical benefits， such as ORR and DCR， without increasing the risk of adverse drug reaction.

Objective To explore the value of intravoxel incoherent motion(IVIM)parameters in the diagnosis of ipsilateral thalamic diaschisis(ITD)after unilateral supratentorial cerebral infarction via combination of arterial spin labeling(ASL)and IVIM.Methods A total of 111 patients with cerebral infarction were selected,including 61 patients in the acute stage(＞6 h-3 d),50 patients in the subacute stage(＞3 d-11 d).All patients were subjected to MRI examination,and the diffusion weighted imaging(DWI),ASL,and IVIM image data were uploaded to the GE workstation.The regions of interest(ROI)in the bilateral thalamus were selected,and the cerebral blood flow(CBF),D*,D,and f values were measured,and the asymmetry index(AI)was calculated.ITD was diagnosed according to AI＞10％,and all patients were divided into ITD-positive and ITD-negative groups.The differences of each parameter between the two groups and their relationship with AI were analyzed.Results In acute stage and subacute stage cerebral infarction,the CBF,D*and D values of ipsilateral thalamus were lower than those of contralateral thalamus,while the f value was higher than those of contralateral thalamus.There was no statistical significance in D*,D and f values between ITD-positive and ITD-negative groups after acute stage cerebral infarction(P＞0.05).There were significant differences in CBF,apparent diffusion coefficient(ADC),D and f values in ITD-positive group after subacute stage cerebral infarction(P＜0.05),but no significant differences in D*value of ITD-positive group and CBF,D*,D,f values of ITD-negative group(P＞0.05).AI-D*,AI-D and AI-ADC in subacute stage were positively correlated with AI-CBF,while AI-f was negatively correlated with AI-CBF.The area under the curve(AUC)of AI-D and AI-f in subacute stage were 0.749 and 0.699,respectively.Conclusion The combination of ASL and IVIM has confirmed the phenomenon of ITD after unilateral supratentorial cerebral infarction,with high diagnostic efficacy of quantitative parameters D value and f value.It can non-invasively evaluate the thalamic microstructural and perfusion changes in the early stage after cerebral infarction.