Objective To observe the mechanism of Siwu Decoction (Decoction of four ingredients) on blood deficiency syndrome.Methods Wistar rats were randomized into 3 groups: model group, treatment group, and normal group, 6 ones in each. Rats of the model group and the treatment group were injected 2% acetylphenylhydrazine (APH) saline subcutaneously on the first, forth and seventh day. From the forth day, the model group was treated with saline by gavage, the treatment group was treated with Siwu Decoction by gavage, and the normal group was treated with saline for 7 days in succession. Then the amount of peripheral blood cells, wet weight of liver and spleen were detected. Liver mitochondrial proteome of all rats were extracted. Proteomic technology was used to measure the regulated proteins by Siwu Decoction.Results In the model group, the rats had decreased general status significantly such as pale, enlarged liver and spleen, lowered red blood cells (RBC) and hemoglobin (HGB), increased white blood cells (WBC) and reticulocyte (RCT) (P

ObjectiveTo investigate the value of albumin-bilirubin (ALBI) score in evaluating the prognosis of patients with liver cirrhosis and esophagogastric variceal bleeding, and to compare it with Child-Turcotte-Pugh (CTP) score and Model for End-stage Liver Disease combined with serum sodium concentration (MELD-Na) score. MethodsA retrospective analysis was performed for the clinical data of 155 patients who were diagnosed with liver cirrhosis and esophagogastric variceal bleeding in The First Hospital of Jilin University from August 2018 to April 2019, and according to disease outcome after 1 year of follow-up, these patients were divided into survival group with 98 patients and death group with 57 patients. The influencing factors for prognosis were analyzed, and the value of ALBI score in predicting prognosis was assessed. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U 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. A Spearman correlation analysis was performed to investigate the correlation between two variables. A multivariate logistic regression analysis was used to investigate independent influencing factors for death within 1 year. The receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated; the optimal cut-off value was determined based on Youden index. The Z test was used for comparison of AUC between these three scoring systems. ResultsThere were significant differences between the survival group and the death group in initial blood loss (U=1994.5, P=0.002), presence or absence of hepatic encephalopathy (χ2=14.154, P＜0.001), severity of ascites (χ2=10.537, P=0.005), total bilirubin (U=16940, P＜0.001), albumin (t=-6.633, P＜0.001), aspartate aminotransferase (U=2223.5, P=0.035), Na (U=1859.5, P=0001), international normalized ratio (U=1259.5, P＜0.001), prothrombin time (U=1331.5, P＜0.001), white blood cell count (U=2008.5, P=0.004), red blood cell count (t=-2.633, P=0009), red blood cell volume distribution width (U=1719.5, P＜0001), hemoglobin (U=2150.0, P=0.017), ALBI grade (χ2=48.732, P＜0.001), and CTP class (χ2=34.646, P＜0.001). The death group had a significantly higher ALBI score on admission than the survival group (-1.11±0.59 vs -1.79±0.44, t=7.618, P＜0.001), as well as significantly higher MELD-Na score (18.0［14.5-24.0］ vs 12.0［10.0-16.0］, U=1176.0, P＜0.001） and CTP score （9.0［8.0-11.0］ vs 7.0［6.0-8.0］, U=1078.0, P＜0.001）. The Spearman correlation analysis showed that ALBI score was positively correlated with CTP score and MELD-Na score (r=0.753 and 0.668, both P＜0.001). The multivariate logistic regression analysis showed that ALBI score (odds ratio ［OR］=8.349, 95% confidence interval ［CI］: 2.658-26.232), CTP score (OR=1.586, 95%CI: 1.157-2.175), and MELD-Na score (OR=1.188, 95%CI: 1.062-1.328) were independent risk factors for predicting death within 1 year. The optimal cut-off value was -1.485 for ALBI score, 8.5 for CTP score, and 17.5 for MELD-Na score in predicting the 1-year prognosis of patients, with an AUC of 0.818, 0.807, and 0.789, respectively. There was no significant difference between the three scoring systems in predicting the 1-year mortality rate (P＞0.05). ConclusionThe performance of ALBI score is comparable to that of CTP and MELD-Na scores in predicting the risk of death within 1 year in patients with liver cirrhosis and esophagogastric variceal bleeding, and ALBI score has a good evaluation ability.

AIM: To study the changes of serum levels of nitric oxide (NO) and nitric oxide synthase (NOS) in patients during liver transplantation. METHODS: Samples were obtained from 30 patients in end liver disease at five time points during liver transplantation. NO level and NOS activity were measured by radioimmunoassay and colorimetry, respectively. Arterial and mixed venous blood samples used for blood gas analysis were taken at the same time. Intrapulmonary shunt (Qs/Qt) was calculated according to the standard formula. The hemodynamics parameters including continuous cardic output (CO), HR, MABP, CVP, SVR were measured during liver transplantation. RESULTS: (1) NO_2-/NO_3-level at 10 min before anhepatic period was significantly higher than the baseline level. Compared with NO_2-/NO_3-level at 10 min before anhepatic period, NO_2-/NO_3-level at 30 min after anhepatic period was significantly decreased. NO_2-/NO_3-level at 30 min after neohepatic period was significantly higher than the baseline level and at 30 min after anhepatic period. (2) No significant change of tNOS activity was observed. Compared with the baseline activity of inducible nitric oxide synthase (iNOS), the activity at 10 min before anhepatic period and at 30 min after neohepatic period was significantly increased. The activity at 30 min after neohepatic period was significantly higher than that at 30 min after anhepatic period. (3) MABP decreased significantly when opening the inferior vena cava. CO and CVP decreased in the anhepatic stage and increased in the reperfusion stage. SVR increased during anhepatic stage and decreased significantly during neohepatic period. (4) Qs/Qt decreased significantly during anhepatic stage and increased significantly at 30 min after neohepatic period. CONCLUSIONS: Serum level of NO and NOS activity are significantly changed during liver transplantation. High level of NO may result in low systemic vascular resistance and increasing in intrapulmonary shunt.

Objective To investigate the clinical efficacy of TCM external treatment combined with Dasangju Mixture in treating mycoplasma pneumoniae pneumonia (MPP) in children. Methods One hundred patients with MPP were randomly divided into control group and treatment group by parallel design, with 50 patients in each group. Patients in control group orally took azithromycin combined with other symptomatic treatment when necessary, 7 d for a course and continuously for 3 courses. Based on the treatment for control group, patients in treatment group were added with TCM external treatment (BL13 and RN17) combined with Dasangju Mixture, while azithromycin was sequentially used just for 2 courses. Other types of treatment lasted for 3 courses. The improvement time of symptoms and signs of the patients were recorded and the therapeutic effects of the two groups were evaluated. Moreover, the serum concentrations of mycoplasma pneumoniae-immune gloulin M (MP-IgM) were determined before and after treatment on the 1st and 21st days. Results The improvent time of fever, and cough and lung sign of the treatment group were more obviously shortened than the control group (P<0.05). The total effective rate was 96.0% (48/50) in observation group and 74.0% (37/50) in control group, with statistical significant difference between the two groups (P<0.05). After treatment, the negative rate of the serum concentration of MP-IgM in the treatment group was 82%, and that of the control group was 58%, with statistical significance between the two groups (P<0.05).Conclusion TCM external treatment combined with Dasangju Mixture can not only significantly improve the clinical symptoms and signs of MPP children patients, but also shorten the disease course, and the efficacy was significant. Meanwhile it can reduce the course and side effects of azithromycin, which provides reference to the administration of antibiotics in children.

Objective:To retrieve the evidence of scraping operation in patients with neck, shoulder and low back pain, and evaluate and summarize the evidence.Methods:Identified evidence-based problems based on the population, intervention, professional, outcome, setting and type of evidence (PIPOST) model, and searched UpToDate, British Medical Journal (BMJ) Clinical Evidence, Guidelines International Network, Registered Nurses' Association of Ontario, Scottish Intercollegiate Guidelines Network, New Zealand Guidelines Group, World Health Organization, American College of Physicians Club, BMJ Best Practice, Agency for Healthcare Research and Quality, Joanna Briggs Institute Evidence-Based Health Care Center Database, Nursing Consult, China Guideline Clearinghouse, Cochrane Library, Embase, PubMed, CINAHL, Web of Science, Medlive, China National Knowledge Infrastructure and SinoMed. The retrieval time limit was from March 1, 2012 to April 30, 2022. Four researchers independently evaluated the quality of the article, and two researchers summarized the evidence of the included article.Results:A total of 9 articles were included, including 1 guideline, 2 systematic reviews, and 6 randomized controlled trials. A total of 20 pieces of scraping application evidence were extracted from patients with neck, shoulder and low back pain, including 6 aspects, involving preparation before scraping, scraping intervention methods, scraping degree, precautions, contraindications, and handling of abnormal conditions.Conclusions:The best evidence of scraping therapy to improve patients' neck, shoulder and low back pain summarized in this study can provide a reference for improving the operation practice of medical and nursing staffs and nursing outcomes.

OBJECTIVETo study the effects of warm and tonify kidney-yang herbs on the liver mitochondria proteome of the thyroidectomized kidney-yang deficiency rats.

METHODTwelve rats were divided into normal group, model group and treated group; each group had four rats. The rats of model group and treated group were excised the two side thyroid gland, and the rats of normal group were done the homologous operation, but didn't excise the thyroid gland. After seven days, the rats of model group and treated group appeared the symptoms of kidney-yang deficiency. From the eighth day, the rats of treated group were fed warm and tonify kidney-yang herbs 6.7 g x kg(-1) once daily, and the rats of other two groups were fed the equal normal. All rats of three groups were killed by decollation after six days of treatment, and liver mitochondria proteins were separated. Each liver mitochondria protein sample was labeled with Cy3 or Cy5 randomly, and one Cy3-labeled sample and one Cy5-labeled sample were mixed on the same 2-D gel along with a Cy2-labeled mixture of all samples as an internal standard and run on the same gel. The gels were scanned under different wavelength light after electrophoresis. All images were analyzed by DeCyder 6. 5 software, and the different proteins were identified by mass spectrum.

RESULTThe expression of HSP60, catalase, glutathione peroxidase, carbamoylphosphate synthetase I, ATP synthase, lactotransferrin, H(+)-transporting two-sector ATPase, alpha-ETF and calpain 12 were increased in the thyroidectomized kidney-yang deficiency rats, while the expression of oxoisovalerate dehydrogenase, Acyl-CoA dehydrogenase, ornithine aminotransferase, and GTP-binding regulatory protein were decreased. After the kidney-yang deficiency rats were treated with warm and tonify kidney-yang herbs, the expression of HSP60, catalase, glutathione peroxidase, oxoisovalerate dehydrogenase, Acyl-CoA dehydrogenase, ATP synthase, lacto-transferrin, H(+)-transporting two-sector ATPase, alpha-ETF and GTP-binding regulatory protein were increased, and the expression of carbamoyl-phosphate synthetase I and calpain 12 were decreased.

CONCLUSIONThe warm and tonify kidney-yang herbs perform its therapeutical effect by regulating the metabolism, protecting the stability of mitochondrial membrance and maintaining the signal conduction in the cells.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Kidney ; drug effects ; metabolism ; Male ; Medicine, Chinese Traditional ; Mitochondria, Liver ; drug effects ; metabolism ; Proteome ; drug effects ; metabolism ; Proteomics ; Rats ; Rats, Sprague-Dawley ; Yang Deficiency ; drug therapy ; metabolism

OBJECTIVETo assess the value of detecting the compositional features of carotid atherosclerotic plaques by 3.0T high resolution magnetic resonance imaging (MRI) in patients with coronary artery disease (CAD).

METHODSConsecutive 104 patients with coronary atherosclerosis confirmed by coronary angiography were prospectively recruited from January 2013 to January 2015 in Tiantan hospital. All patients were imaged with 3.0T high resolution MRI system. After exclusion patients with poor image quality, 97 patients were divided into 3 groups according to the degree of coronary artery stenosis: coronary atherosclerosis group (coronary stenosis between 1%-49%, n=16); single-vessel lesion group (single vessel lesion with stenosis between 50%-100%, n=48); multi-vessel lesion group (two or three vessel lesions with stenosis between 50%-100% or left main stem disease, n=33). The prevalence of total carotid plaque, calcified plaque, lipid-rich necrotic core, intra-plaque hemorrhage, plaque ulcer and rupture were compared among 3 groups.

RESULTSThe prevalence of total carotid plaque (81.3%(13/16), 72.9%(35/48), and 93.9%(31/33)) and calcified plaque (50.0%(8/16), 35.4%(17/48), and 42.4%(14/33)) were similar among the 3 groups (both P>0.05). The prevalence of carotid lipid-rich necrotic core in coronary atherosclerosis group was significantly lower than in single-vessel lesion group (18.8%(3/16) vs. 64.6%(31/48), P<0.01) and multi-vessel lesion group(18.8%(3/16) vs. 69.7%(23/33), P<0.01), but there was no significant difference between single-vessel lesion group and multi-vessel lesion group(P>0.05). Intra-plaque hemorrhage was detected in 2 patients of multi-vessel lesion group. There was no plaque ulcer or rupture in this cohort.

CONCLUSIONCarotid plaque features are associated with the severity of coronary atherosclerosis in CAD patients.

Coronary Artery Disease ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Necrosis ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies

[摘 要] 目的：通过分析非小细胞肺癌顺铂敏感株及耐药株的基因芯片表达数据，筛选差异基因及关键通路，构建蛋白相互作用网络，探讨关键集群功能。方法:从GEO数据库获得基因芯片表达数据，利用GEO2R工具筛选差异基因，通过STRING数据库和Cytoscape软件构建蛋白相互作用网络，经DAVID富集得到相关特征基因与信号通路信息。结果：通过芯片分析共获得481个差异表达基因，相比于敏感细胞株，顺铂获得性耐药细胞株中有418个上调基因和63个下调基因。差异基因功能主要富集在piRNA代谢、DNA甲基化修饰、细胞有丝分裂及细胞周期进程等信号通路。蛋白复合物预测得到主要功能集群6个，分别与细胞趋化性、细胞角化性、piRNA代谢过程、细胞因子受体相互作用、细胞因子分泌调节及染色质沉默相关生物进程相关。结论:本研究利用生物信息学方法，发现顺铂耐药细胞株特征基因及信号通路，其中SAA1、KRT5、TDRD9、BCL2A1、CSF1R和HIST1H1A等显著上调基因及其功能集团可能是非小细胞肺癌顺铂耐药的潜在分子机制，为临床精准治疗提供新的理论依据。

Acute-on-chronic liver failure (ACLF) is a syndrome characterized by multiple organ failure and high short-term mortality rate, and it has always been a research hotspot in the field of severe liver diseases. Therefore, early and accurate risk stratification and timely intervention are of great significance to improve prognosis. This article summarizes the serum biomarkers identified in recent years for evaluating the prognosis of patients with ACLF, and it is pointed out that new serum biomarkers have an important guiding significance in the prognostic evaluation of ACLF patients.

Objective     To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods     Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results     We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. Conclusion    It is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.