Calcium calculi account for about 80% of urolithiasis with high incidence and recurrence rate. Recurrent urolithiasis increases the risk of hypertension and chronic kidney disease. Comprehensive metabolic evaluation is of paramount importance for the prevention of calcium calculi. With deepening of the study on the pathogenesis of calculi, we find crystallization inhibitors, inflammation and oxidative stress molecules play an important role in the formation of calculi, and susceptibility gene sites of urinary calculi are identified in succession. These may be used as novel markers for the prevention and evaluation of urinary calculi. Models that predict the risk of kidney stone recurrence can help warn people at high risk.

Objective For selecting and developing the excellent Bupleurum chinense to mass-produce seedlings and seeds in high quality.Methods B.chinense was picked from eight different areas,such as Lingchuan and Wanrong county in Shanxi Province,Longxi county in Gansu Province,and Shangluo in Shaanxi Province,etc.Rapid propagation was done.The testa of Zhongchai No.1 was scrapped or seeds were soaked in different phytohormones.The effects on germination rates of seeds were compared.ResultsThe optimum medium for bud propagation was B5supplemented with 1.0 mg/L 6-BA and 0.2 mg/L KT.The optimum medium for root induction of test-tube plantlets was 1/2 MS added with 0.1 mg/L NAA,0.5 mg/L IBA,and 1.0 mg/L DSC.The annual propagation coefficient of B.chinense plants was more than 1?108,and the survival rate of transplantation reached to 94%—97%.The phytohormone has little effect on seed germination of B.chinense,but scraping the testa could increase the germination percentage of seeds to 20% and shorten the germinating time greatly.Conclusion By tissue culture of excellent B.chinense,a great deal of plants and seeds could be produced in short time.By scrapping testa in a certain extent,the germination of seeds could be increased.

Objective To evaluate the effect of clinical pathway in pulmonary thrombus embolism (PTE) .Methods 60 cases of PTE were admitted department of respiratory from 2011 to 2012 and divided into the experimental group and the control group ,30 cases for each group .The control group was implemented with normal process of hospital management while experimental group de-veloped clinical pathways .The efficacy ,department of respiratory drug costs ,complications and patient satisfaction were recorded and computed .Results The average department of respiratory and drug costs in experimental group respectively was (17 .13 ± 2 .22)days ,(16 545 .04 ± 1 557 .44) RMB and (7 050 .83 ± 372 .74) RMB ;less than (19 .77 ± 3 .41)day ,(17 709 .45 ± 1 902 .05) RMB and (7 345 .75 ± 450 .82) RMB in control group ,there were significant difference between the two groups (P<0 .05) .The satisfaction scores of experimental group and the control group respectively were (93 .47 ± 3 .88)sores and (90 .90 ± 5 .30)scores , there was significant difference between the two groups (P<0 .05) .The therapeutic effect and complication rates between experi-mental group and control group were no significant difference (P>0 .05) .Conclusion The effect of clinical pathway in PTE have a positive role in reducing hospitalization time ,total costs ,drug costs and increasing satisfaction ,it is worth to develop in primary hos-pital .

Adult ; Aged ; Brain ; diagnostic imaging ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Optic Neuropathy, Ischemic ; diagnostic imaging ; physiopathology

Tibetan medicine Edgeworthia gardneri is the flower bud of Edgeworthia gardneri, mainly distributed in the eastern Tibet as well as the northwest and west parts of Yunnan. It is called one of the " Eighteen treasures of Qinghai-Tibet" and has been used in many Tibetan secret recipes for a long time. Nowadays, the local people often drink E. gardneri Meisn tea for blood glucose regulation and health care. In this study, the related papers were searched in CNKI, Wanfang, Weipu, PubMed and other databases by using the keywords " Lv luo hua" and " flower of E. gardneri Meisn" . Then the status quo of the flower of E. gardneri was summarized from three aspects: provenance, chemical compositions and extraction method, as well as efficacy and function. It is found that E. gardneri mainly contains coumarins, flavonoids, polysaccharides and polyphenols. The extraction methods of E. gardneri include ultrasonic extraction, microwave extraction, supercritical CO₂ extraction, and bio-enzyme-assisted extraction method, et al. The extraction of flavonoids and polyphenols is more common. In terms of medicinal efficacy, it has many medicinal effects such as regulating blood sugar, lowering blood fat, anti-oxidation, enhancing immunity and anti-tumor. The flower of E. gardneri has broad pharmacological effect, attracting more and more scholars to research it. However, studies on its medicinal effectiveness both at home and abroad are mainly focusing on it' s crude extractions or extracts, with no in-depth studies on action mechanism. This review aims to summarize the provenance, main chemical compositions and extraction methods, efficacy and effect of the flower of E. gardneri, especially focusing on the research on the medicinal efficacy and mechanism of the flower of E. gardneri, and provide a reference for the further research of the flower of E. gardneri.

The glomerular filtration rate, which reflects the filtration function of kidney, is defined as the amount of plasma filtered from the kidney per unit of time. It cannot be measured directly, but only indirectly by the clearance rate of substances with specific properties. At present, the estimated GFR based on creatinine and(or) cystatin C has been gradually popularized, and its estimated formulas are all mathematical fitting formulas based on measured GFR. Different estimated formulas refer to different GFR measurement methods, which may lead to differences in GFR estimation. In this paper, several factors of GFR measurement by the clearance rate of substances, including material characteristics, clearance types, blood collection times and time points of plasma clearance, and comparison of different GFR measurement methods, are reviewed, and the new GFR measurement materials are briefly introduced. The plasma clearance of iohexol has a good application prospect because of its operability, easy standardization and promotion. Metabolomics has the potential to discover new markers for the measurement of GFR.

Objective:To evaluate the proper blood collection time and calculation formula by measuring the iohexol plasma clearance as a representative of glomerular filtration rate at the same time of routine enhanced computed tomography (CT) examination.Methods:The prospective study method was applied, and 9 subjects with normal renal function, who admitted in Civil Aviation General Hospital from September 2018 to June 2019, were included. A single bolus of a standard dose (5 ml) (iodine concentration: 350 mgI/ml) was injected. The concentration of iohexol was measured from heparin plasma at fasting state of the subject and at nine different times after the injection, respectively. More than 24 hours after the injection of the standard dose, an enhanced CT-level dose (50 ml) of iohexol was injected to the subject and the concentration of iohexol was measured at similar time points as the standard dose. Using a multi-point method of a standard dose as the standard, the clearance rate was calculated by three kinds of formulas including Groth and Aasted formula, Jacobsson formula and Fleming formula with the single-point method to assess iohexol plasma clearance at 0.5 to 8.0 hours post injection of enhanced CT-level dose. The correlation consistency and accuracy of the multi-point method and the single-point method, as well as the dual-point method and the single-point method were compared, and the proper blood collection time and calculation formula of the single-point method at regular enhanced CT-level dose were evaluated. The correlation between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed using Pearson correlation coefficient; the consistency between the multi-point method and the single-point method, as well as the dual-point method and the single-point method were assessed by bias using mean±standard deviation ( SD) and 95% confidence interval ( CI) of mean difference and so on. We assessed the concordance of GFR using GFR±5% ( P5),±10% ( P10) and 1±30% ( P30) intervals. Results:Compared with the multi-point method, the mean deviation of iohexol plasma clearance obtained by the three single-point methods increased gradually from 5 hours after the injection of iohexol ( P<0.05). Compared with the multi-point method, only 3 h results, which was calculated by the Groth and Aasted formula, reached a P value greater than 0.05, a correlation coefficient of 0.938, a mean deviation of (-5.2±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30,77.8% corresponding to P10, and 66.7% corresponding to P5; the 2, 3 and 4 hours results, which was calculated by the Jacobsson formula, reached P values greater than 0.05, when the blood collection time was 3 hours, the correlation coefficient was 0.938, and the mean deviation was the smallest, which was (1.5±6.2) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 88.9% corresponding to P10, and 66.7% corresponding to P5; the 2 and 3 hours results, which was calculated by the Fleming formula, reached P values greater than 0.05, when the blood collection time was 2 h, the correlation coefficient was 0.956, and the mean deviation was the smallest, which was (-4.5±8.8) ml·min -1·1.73 m -2, and the concordances were 100% corresponding to P30, 77.8% corresponding to P10, and 55.6% corresponding to P5,Compared with the dual-point method, when Groth or Aasted formula was used, the mean deviation was the smallest at 3 hours, which was (-5.3±5.7) ml·min -1·1.73 m -2; when Jacobsson formula was used, the mean deviation was the smallest at 2 hours, which was (1.6±1.6) ml·min -1·1.73 m -2; when Fleming formula was used, and the mean deviation was the smallest at 2 hours, which was (-4.6±4.0) ml·min -1·1.73 m -2. Conclusion:At a regular enhanced CT-level dose, one blood collection can accurately measure the glomerular filtration rate, the proper time for blood collection can be 3 hours after iohexol injection, and the appropriate calculation formula can be Jacobsson formula.

ObjectiveTo investigate the efficacy and underlying mechanisms of Gynostemma pentaphyllum alcohol extract in improving glucose and lipid metabolism disorders in db/db mice through transcriptomics and gut microbiota analysis. MethodsEighteen db/db mice were randomly assigned to the model（DM） group， metformin（MET） group， and G. pentaphyllum alcohol extract（GP） group， with six mice in each group， based on stratification of fasting blood glucose and body weight. An additional six db/m mice were selected as the normal control（NC） group. Mice in the NC and DM groups were administered deionized water （10 mL·kg^-1） daily. The MET group received metformin （0.195 g·kg^-1） by gavage. The GP group was treated with G. pentaphyllum alcohol extract （3.9 g·kg^-1） by gavage for six weeks. Fasting blood glucose was measured every two weeks. After six weeks of intervention， serum levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， creatinine （CREA）， and blood urea nitrogen （BUN） were assessed. Enzyme-linked immunosorbent assay （ELISA） was used to measure insulin （FINS）， adiponectin （ADP）， and tumor necrosis factor-α （TNF-α）. Hematoxylin-eosin （HE） staining was used to observe liver histomorphology， periodic acid-Schiff （PAS） staining was employed to assess hepatic glycogen synthesis， and Oil Red O staining was used to detect hepatic lipid deposition. Liver transcriptomic data were used to identify differentially expressed genes in the liver and conduct enrichment analysis. Real-time PCR was employed to verify the expression levels of adiponectin gene （Adipoq）， peroxisome proliferator-activated receptor gamma coactivator-1α （PGC-1α）， AMP-activated protein kinase （AMPK）， peroxisome proliferator-activated receptor α （PPARα）， glucokinase （GCK）， forkhead box （Fox）O1， FoxO3， phosphoenolpyruvate carboxykinase （PEPCK）， and glucose-6-phosphatase （G6PC）. Metagenomic sequencing was conducted to analyze changes in gut microbiota composition. ResultsCompared with the NC group， the DM group exhibited significantly elevated fasting blood glucose （P<0.01）， serum AST， ALT， TC， TG， LDL-C， and HDL-C （P<0.01）. FINS， homeostatic model assessment for insulin resistance （HOMA-IR）， and the inflammatory cytokine TNF-α were significantly increased （P<0.01）， while ADP was significantly decreased （P<0.05）. Histological analysis confirmed severe hepatic steatosis and excessive lipid accumulation in the DM group， along with markedly reduced glycogen synthesis. Compared with the DM group， the GP group showed significantly decreased fasting blood glucose （P<0.01）， reduced serum TC， LDL-C， and HDL-C levels （P<0.05）， significantly decreased serum TG and AST levels （P<0.01）， significantly reduced FINS， HOMA-IR， and TNF-α levels （P<0.01）， and significantly increased ADP （P<0.01）. Hepatic steatosis and lipid deposition were significantly alleviated， while glycogen synthesis was markedly enhanced. Transcriptomic differential and enrichment analyses suggested that the mechanisms by which G. pentaphyllum alcohol extract improved hepatic glucose and lipid metabolism in db/db mice may involve regulation of the AMPK and FoxO signaling pathways. Real-time PCR results confirmed that expression of PGC-1α， PEPCK， G6PC， FoxO1， and FoxO3 was significantly downregulated following treatment with G. pentaphyllum alcohol extract （P<0.05， P<0.01）， whereas mRNA expression of Adipoq， PPARα， GCK， and AMPK was significantly upregulated （P<0.05， P<0.01）. Metagenomic analysis showed that the relative abundance of Lactobacillus， Alistipes， and Akkermansia species was higher in the GP group than in the DM group. ConclusionG. pentaphyllum alcohol extract may improve glucose and lipid metabolism disorders in db/db mice by regulating the hepatic AMPK/PPARα pathway to suppress lipid deposition and alleviate hepatic steatosis， by inhibiting gluconeogenesis through the AMPK/PGC-1α and FoxO pathways to lower fasting blood glucose， and by increasing the abundance of beneficial gut bacteria such as Lactobacillus， Alistipes， and Akkermansia to restore gut microbiota balance.

ObjectiveTo investigate the efficacy and underlying mechanisms of Gynostemma pentaphyllum alcohol extract in improving glucose and lipid metabolism disorders in db/db mice through transcriptomics and gut microbiota analysis. MethodsEighteen db/db mice were randomly assigned to the model（DM） group， metformin（MET） group， and G. pentaphyllum alcohol extract（GP） group， with six mice in each group， based on stratification of fasting blood glucose and body weight. An additional six db/m mice were selected as the normal control（NC） group. Mice in the NC and DM groups were administered deionized water （10 mL·kg^-1） daily. The MET group received metformin （0.195 g·kg^-1） by gavage. The GP group was treated with G. pentaphyllum alcohol extract （3.9 g·kg^-1） by gavage for six weeks. Fasting blood glucose was measured every two weeks. After six weeks of intervention， serum levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， creatinine （CREA）， and blood urea nitrogen （BUN） were assessed. Enzyme-linked immunosorbent assay （ELISA） was used to measure insulin （FINS）， adiponectin （ADP）， and tumor necrosis factor-α （TNF-α）. Hematoxylin-eosin （HE） staining was used to observe liver histomorphology， periodic acid-Schiff （PAS） staining was employed to assess hepatic glycogen synthesis， and Oil Red O staining was used to detect hepatic lipid deposition. Liver transcriptomic data were used to identify differentially expressed genes in the liver and conduct enrichment analysis. Real-time PCR was employed to verify the expression levels of adiponectin gene （Adipoq）， peroxisome proliferator-activated receptor gamma coactivator-1α （PGC-1α）， AMP-activated protein kinase （AMPK）， peroxisome proliferator-activated receptor α （PPARα）， glucokinase （GCK）， forkhead box （Fox）O1， FoxO3， phosphoenolpyruvate carboxykinase （PEPCK）， and glucose-6-phosphatase （G6PC）. Metagenomic sequencing was conducted to analyze changes in gut microbiota composition. ResultsCompared with the NC group， the DM group exhibited significantly elevated fasting blood glucose （P<0.01）， serum AST， ALT， TC， TG， LDL-C， and HDL-C （P<0.01）. FINS， homeostatic model assessment for insulin resistance （HOMA-IR）， and the inflammatory cytokine TNF-α were significantly increased （P<0.01）， while ADP was significantly decreased （P<0.05）. Histological analysis confirmed severe hepatic steatosis and excessive lipid accumulation in the DM group， along with markedly reduced glycogen synthesis. Compared with the DM group， the GP group showed significantly decreased fasting blood glucose （P<0.01）， reduced serum TC， LDL-C， and HDL-C levels （P<0.05）， significantly decreased serum TG and AST levels （P<0.01）， significantly reduced FINS， HOMA-IR， and TNF-α levels （P<0.01）， and significantly increased ADP （P<0.01）. Hepatic steatosis and lipid deposition were significantly alleviated， while glycogen synthesis was markedly enhanced. Transcriptomic differential and enrichment analyses suggested that the mechanisms by which G. pentaphyllum alcohol extract improved hepatic glucose and lipid metabolism in db/db mice may involve regulation of the AMPK and FoxO signaling pathways. Real-time PCR results confirmed that expression of PGC-1α， PEPCK， G6PC， FoxO1， and FoxO3 was significantly downregulated following treatment with G. pentaphyllum alcohol extract （P<0.05， P<0.01）， whereas mRNA expression of Adipoq， PPARα， GCK， and AMPK was significantly upregulated （P<0.05， P<0.01）. Metagenomic analysis showed that the relative abundance of Lactobacillus， Alistipes， and Akkermansia species was higher in the GP group than in the DM group. ConclusionG. pentaphyllum alcohol extract may improve glucose and lipid metabolism disorders in db/db mice by regulating the hepatic AMPK/PPARα pathway to suppress lipid deposition and alleviate hepatic steatosis， by inhibiting gluconeogenesis through the AMPK/PGC-1α and FoxO pathways to lower fasting blood glucose， and by increasing the abundance of beneficial gut bacteria such as Lactobacillus， Alistipes， and Akkermansia to restore gut microbiota balance.

Objective: To investigate the safety and efficacy of the Weitan Waifu patch on the postsurgical gastroparesis syndrome (PGS) of gastrointestinal cancer. Methods: The multi-center, double-blind, randomized controlled trial was conducted with superiority design. Patients with PGS of gastrointestinal cancer diagnosed in 4 AAA hospitals and the abdominal symptom manifested as cold syndrome by Chinese local syndrome differentiation were recruited. These patients were randomly divided into two groups according to 1∶1 proportion. Placebo or Weitan Waifu patch was applied in control group or intervention group, respectively, based on the basic treatments, including nutrition support, gastrointestinal decompression, promoting gastric dynamics medicine.Two acupuncture points (Zhongwan and Shenque) were stuck with placebo in control group or patch in treatment group. The intervention course was 14 days or reached the effective standard. Results: From July 15, 2013 to Jun 3, 2015, 128 participants were recruited and 120 eligible cases were included in the full analysis set (FAS), and 60 cases in each group. 88 cases were included in the per-protocol set (PPS), including 45 cases in the treatment group and 43 cases in the control group. In the FAS, the clinical effective rate in the treatment group was 68.3%, significantly superior than 41.7% of the control group (P=0.003). The medium time of effective therapy in the treatment group was 8 days, significantly shorter than 10 days in the control group (P=0.017). In the FAS, 3 adverse events occurred in the treatment group, including mild to moderate decrustation, pruritus and nausea. The incidence rate of adverse events was 5.0% (3/60) and these symptoms were spontaneously remitted after drug withdrawal. No severe adverse events were observed in the control group. There was no significant difference between these two groups (P=0.244). Conclusion: Weitan Waifu patch is a safely and effectively therapeutic method for patients with PGS (cold syndrome) of gastroenterological cancer. Trial registration International Standard Randomized Controlled Trial Number Register, ISRCTN18291857