ObjectiveTo explore the distribution characteristics of traditional Chinese medicine （TCM） syndromes in postoperative gastric cancer patients， and to analyse the factors associated with yang deficiency syndrome and its severity. MethodsTotally， 173 patients who underwent postoperative gastric cancer surgery and were treated in four centers nationwide from February 22， 2022 to March 21， 2023， were enrolled. General information and TCM syndromes were collected， and Diagnostic Scale for Yang Deficiency Syndrome in Gastric Malignancies was filled in. The frequency of TCM syndromes after gastric cancer surgery was analyzed， and univariate analysis and multivariate logistic regression analysis were performed on the related factors of yang deficiency syndrome versus non-yang deficiency syndrome and between different severity of yang deficiency syndrome. ResultsThe most common syndrome after gastric cancer surgery was qi deficiency （95 cases， 54.91%）， followed by yang deficiency （87 cases， 50.29%）. Patients with yang deficiency syndrome were often suffered from qi deficiency， qi stagnation， and phlegm dampness syndrome. Comparing yang deficiency syndrome with non-yang deficiency syndrome， univariate analysis showed that history of alcohol consumption， pathological stage， degree of differentiation， Lauren grade， signet ring cell carcinoma， vascular cancer thrombus， and nerve invasion were statistically significant （P＜0.05）； and multivariate logistic regression analysis showed that history of alcohol consumption， signet ring cell carcinoma， pathological stage Ⅲ， Ⅳ， and vascular cancer thrombus may be correlated with yang deficiency syndrome in postoperative gastric cancer patients （P＜0.05）. The univariate analysis showed that age， pathological stage， precancerous lesions， and body mass index grade were significantly different when compared between mild and severe yang deficiency syndrome （P＜0.05）； multivariate logistic regression analysis showed that age， low body weight， and pathological stage Ⅲ and Ⅳ might be correlated with severe yang deficiency syndrome after gastric cancer surgery （P＜0.05）. ConclusionQi deficiency and yang deficiency are common TCM syndromes in postoperative patients with gastric cancer. Alcohol consumption history， pathological staging （stage Ⅲ and Ⅳ）， signet ring cell carcinoma， and the presence of vascular cancer thrombus may be correlated with the occurrence of yang deficiency syndrome， and higher age， low body weight， and pathological staging （stage Ⅲ and Ⅳ） may be the correlates of severe yang deficiency syndrome.

Abstract: Objective　To analyze the incidence of pulmonary tuberculosis infection in the elderly(&ge; 65 years old) in Xianning City from 2011 to 2021, and to provide scientific basis for formulating strategies and measures for tuberculosis prevention and treatment in the elderly. Methods　Descriptive epidemiological analysis was used to analyze the epidemic characteristics and influencing factors of elderly (this article studies elderly people aged 65 and above) pulmonary tuberculosis in Xianning City, Hubei Province from 2011 to 2021. Results　From 2011 to 2021, the average annual registration rate of elderly patients with pulmonary tuberculosis in Xianning City, Hubei Province was 211.52/100 000 (5 289/2 500 496), which showed a downward trend （χ2 trend=58.06, P<0.05), and significantly higher than the average registration rate of 96.04/100 000 patients with pulmonary tuberculosis (26 463/27 554 195)(χ2=2 896.69, P<0.05). The average proportion of the registered number of elderly patients with pulmonary tuberculosis in the whole population was 19.99% (5 289/26 463), which showed an upward trend (χ2trend=272.05, P<0.05). The average positive rate of etiology in elderly patients with pulmonary tuberculosis was 51.86% (2 743/5 289), which was significantly higher than that in the whole population 46.41% (12 282/26 463) (χ2=52.53, P<0.05). The average proportion of retreated patients in elderly patients with pulmonary tuberculosis was 8.92% (472/5 289), which was significantly higher than that of retreated patients in the whole population 6.33% (1 674/26 463) (χ2=47.23, P<0.05). The sex ratio of male to female in elderly patients with pulmonary tuberculosis was 2.92∶1. Among the six counties (districts) under the jurisdiction of Xianning City, Hubei Province the registration rate of elderly tuberculosis patients in Xian'an district was the highest 262.20/100 000 (1 267/483 220), and that in Tongcheng County was the lowest 123.83/100 000 (575/464 338), with significant differences (χ2=233.67, P<0.05). Conclusion　The overall incidence of tuberculosis in the elderly in Xianning City , Hubei Province showed a downward trend, but the proportion of the incidence of tuberculosis in the elderly in the whole population has increased year by year, suggesting that the elderly are the key population of tuberculosis prevention and control in Xianning City in the future, and comprehensive prevention and control measures should be taken to reduce the incidence of tuberculosis in the elderly population.

This study investigated the drug delivery performance of oral co-loaded puerarin(PUE) and daidzein(DAZ) mixed micelles(PUE/DAZ-FS/PMMs) from the perspectives of pharmacokinetics, pharmacodynamics, and tissue distribution. The changes in PUE plasma concentration in rats were evaluated based on PUE suspension, single drug-loaded micelles(PUE-FS/PMMs), and co-loaded micelles(PUE/DAZ-FS/PMMs). Spontaneously hypertensive rats(SHR) were used to monitor systolic blood pressure, diastolic blood pressure, and mean arterial pressure for 10 weeks after administration by tail volume manometry. The content of PUE in the heart, liver, spleen, lung, kidney, brain, and testes was determined using LC-MS/MS. The results showed that compared with PUE suspension and PUE-FS/PMMs, PUE/DAZ-FS/PMMs significantly increased C_(max) in rats(P<0.01) and had a relative bioavailability of 122%. The C_(max), AUC_(0-t), AUC_(0-∞), t_(1/2), and MRT of PUE/DAZ-FS/PMMs were 1.77, 1.22, 1.22, 1.17, and 1.13 times higher than those of PUE suspension, and 1.76, 1.16, 1.08, 0.84, and 0.78 times higher than those of PUE-FS/PMMs, respectively. Compared with the model control group, PUE/DAZ-FS/PMMs significantly reduced systolic blood pressure, diastolic blood pressure, and mean arterial pressure in SHR rats(P<0.05). The antihypertensive effect of PUE/DAZ-FS/PMMs was greater than that of PUE suspension, and even greater than that of PUE-FS/PMMs at high doses. Additionally, the distribution of PMMs in various tissues showed dose dependency. The distribution of PMMs in the kidney and liver, which are metabolically related tissues, was lower than that in the suspension group, while the distribution in the brain was higher than that in the conventional dose group. In conclusion, PUE/DAZ-FS/PMMs not only improved the bioavailability of PUE and synergistically enhanced its therapeutic effect but also prolonged the elimination of the drug to some extent. Furthermore, the micelles facilitated drug penetration through the blood-brain barrier. This study provides a foundation for the development of co-loaded mixed micelles containing homologous components.
Rats ; Animals ; Micelles ; Tissue Distribution ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Rats, Inbred SHR ; Isoflavones/pharmacology*

Nowadays potential preclinical drugs for the treatment of nonalcoholic steatohepatitis (NASH) have failed to achieve expected therapeutic efficacy because the pathogenic mechanisms are underestimated. Inactive rhomboid protein 2 (IRHOM2), a promising target for treatment of inflammation-related diseases, contributes to deregulated hepatocyte metabolism-associated nonalcoholic steatohepatitis (NASH) progression. However, the molecular mechanism underlying Irhom2 regulation is still not completely understood. In this work, we identify the ubiquitin-specific protease 13 (USP13) as a critical and novel endogenous blocker of IRHOM2, and we also indicate that USP13 is an IRHOM2-interacting protein that catalyzes deubiquitination of Irhom2 in hepatocytes. Hepatocyte-specific loss of the Usp13 disrupts liver metabolic homeostasis, followed by glycometabolic disorder, lipid deposition, increased inflammation, and markedly promotes NASH development. Conversely, transgenic mice with Usp13 overexpression, lentivirus (LV)- or adeno-associated virus (AAV)-driven Usp13 gene therapeutics mitigates NASH in 3 models of rodent. Mechanistically, in response to metabolic stresses, USP13 directly interacts with IRHOM2 and removes its K63-linked ubiquitination induced by ubiquitin-conjugating enzyme E2N (UBC13), a ubiquitin E2 conjugating enzyme, and thus prevents its activation of downstream cascade pathway. USP13 is a potential treatment target for NASH therapy by targeting the Irhom2 signaling pathway.

Objective:To investigate the clinical features, diagnosis, treatment and prognostic factors of intracranial ependymoma in children.Methods:The clinical data of 32 children with intracranial ependymoma treated in the Department of Neurosurgery, Beijing Children′s Hospital of Capital Medical University from January 2012 to December 2020 were retrospectively analyzed.There were 23 males and 9 females.The median age of diagnosis was 4.5 years old (0.7-10.0 years old). Twelve cases (37.5%) were less than 3 years old and 20 cases (62.5%) were more than 3 years old.Tumors were supratentorial in 14 cases and infratentorial in 18 cases.All patients underwent tumor resection.Eighteen cases received postoperative radiotherapy, and 20 cases received chemotherapy.Four cases took neither radiotherapy nor chemotherapy. Kaplan- Meier method was used to establish the survival curve the intracranial ependymoma patients.Whether the difference of a single variable was significant was examined by the Log- rank test. Results:Of the 32 patients, 30 cases underwent gross total resection and 2 underwent subtotal resection.The mean follow-up time was 24 months (1-62 months). By the time of the last follow-up, 26 cases survived and 6 cases died.The 1-year and 3-year survival rates were 88% and 78%, respectively.Univariate analysis showed that the tumor location ( OR=1.5, 95% CI: 1.082-2.079, P=0.040) greatly affected the overall survival time in children with intracranial ependymoma, and chemotherapy ( OR=0.5, 95% CI: 0.125-1.999, P=0.034) had significant impact on the overall survival time of patients younger than 3 years old. Conclusions:Intracranial ependymoma is more prone to occur in the infratentorial region than the supratentorial region.The tumor location is an important factor affecting the survival of children with ependymoma.For children younger than 3 years old, postoperative chemotherapy can well improve the prognosis, but cannot change the progress of the disease development.

Objective:To classify the symptom characteristics of young and middle-aged peritoneal dialysis patients and to explore the differences of demographic functional status and social function of patients with different symptom categories.Methods:A total of 179 peritoneal dialysis patients from 3 peritoneal dialysis centers in Shanghai were investigated from December 2019 to August 2020 by General Information Questionnaire, Peritoneal Dialysis Symptom Distress Scale. Latent class analysis was used to classify young and middle-aged peritoneal dialysis patients according to symptom characteristics. Multiple Logistic regression was used to explore the differences of demographic and disease characteristics of different categories of patients.Results:Peritoneal dialysis patients could be divided into three potential categories according to symptom characteristics ( P<0.05). According to the conditional probability of each category, they were named "low symptom group" (111 cases,62.0%), "high psychological-moderate physical symptom group" (22 cases, 12.3%), "high symptom group" (46 cases,25.7%). There were differences in working status ( OR=0.029, P<0.01), education level ( OR=152.799, P<0.01), duration ( OR=81.307, P<0.05), diabetic nephropathy ( OR=80.619, P<0.01) and CCI score ( OR=91.188, P<0.01) distribution among different potential categories of young and middle-aged peritoneal dialysis patients. Conclusions:There are three types of potential symptoms in young and middle-aged patients undergoing peritoneal dialysis. In clinical practice, medical staff should focus on the psychological status of young and middle-aged patients with low educational background and early stage of dialysis, and encourage them to return to work; at the same time, they should regularly evaluate the symptom burden of patients with diabetic nephropathy and high complication index peritoneal dialysis patients, in order to provide targeted intervention measures to prevent the progression of the disease.

Endometriosis is frequently associated with infertility. It is believed that the impairment of endometrial receptivity may be one of the mechanisms involved in this condition. Endometriosis results in infertility by affecting the quality of the embryo and decreasing the endometrium tolerance.Among patients with endometriosis and infertility,a large number of clinical applications found that even if the embryo quality was good, the embryo's planting rate was still low, however, in the case of good endometrial receptivity,abnormal embryos have possible bed success.This paper mainly reviews the endometrium receptivity in patients with endometriosis and the correlation between the regulation factors of endometrial receptivity and infertility, with a view to improving the clinical pregnancy rate.

Objective To study the protective effect of vitamin C on UV-induced photoaged skin structure in rats and provide a basis for clinical medicine and health care.Methods Photoaging skin models were set up by chronic ultraviolet radiation in 24 SPF female Sprague-Dawley rats, irradiated twice weekly for 4 weeks.The rat photoaged skin was induced by exposure to a total dose of 123 J/cm2 UVA and 5 J/cm2 UVB for 4 weeks.Vitamin C was administered by gastric gavage in a dose of 50 mg/kg once daily for 30 days during the model development.We compared the pathological changes in the irradiated skin using HE, Masson’ s trichrome and Victoria blue B staining, and compared the ultrastructural changes by electron microscopy.Results Rat models with photoaged skin were developed successfully.The vitamin C group showed significant reduction of pathological severity including erythema, ulcers, epidermal cell proliferation, epidermal thickness, dermis vasodilation, inflammatory cell infiltration, fibroblast proliferation, endoplasmic reticulum dilatation, mitochondrial swelling and vacuolization, elastic fibers degeneration and focal accumulation, collagen fibers swelling with uneven thickness,compared with the rats of model group at the irradiation site.Conclusions Vitamin C is effective in reducing the structural damage of UV-induced photoaged skin in rats.

Objective To explore the clinical curative effect of traditional Chinese medicine enema,amino salicylic acid preparation and probiotics in the treatment of ulcerative colitis.Methods 168 patients were selected as the research objects which were confirmed by endoscopic examination and the diagnosis of ulcerative colitis patients,randomly divided into the control group of 84 cases and observation group of 84 cases.The control group was given with sulfasalazine(SASP) treatment,a dose of 1g,4 times/d,period of treatment was 28d.In the observation group,oral SASP treatment combined with microecological preparation often meian and traditional Chinese medicine enema,Chang An capsule,2 capsules (500mg)/time,3 times/d,postprandial oral; Herbal Enema with angelica,white lentils,flavescent sophora root,cicada,windproof suffering after filtering,every night before bed retention enema.The clinical efficacy was compared between the two groups.Results After the treatment,the Sutherland index of the observation group was (1.82 ± 1.65),which was significantly lower than (5.51 ± 1.59) of the control group (t =10.436,P ＜ 0.05).In observation group,the clinical total effective rate,the total efficiency of endoscopic and histological total effective rate was 88.1％,81％,76.2％,the control group were 66.7％,57.1％,50％,the two groups had significant difference(x2 =4.353,4.512,5.113,P＜0.05).Conclusion The traditional Chinese medicine enema,amino salicylic acid preparation and probiotics in the treatment of ulcerative colitis has good curative effect,can relieve the clinical symptoms of patients,improve the degree of intestinal diseases.

BACKGROUNDOff-label application of drug-eluting stents (DES) during percutaneous coronary intervention (PCI) was not uncommon in daily practice, however DES in treating Chinese patients with complex lesion subset was under-investigated. The primary objective of the FIREMAN registry was to evaluate the long term efficacy and safety of the Firebird sirolimus-eluting stent (SES) in treating patients with complex coronary lesions. Here we report the mid-term of one-year clinical outcomes and eight-month angiographic follow-up results of FIREMAN registry.

METHODSThe FIREMAN registry was a prospective multi-center registry, which included 1029 consecutive patients undergoing PCI with Firebird SES implantation between September 2006 and July 2007 in 45 centers in China. The clinical follow-up was designed to be performed at 1, 6, 12, 18, 24, 30 and 36 months post index procedure, and non-mandatory angiographic follow-up at 8 months was planned. One hundred percent site monitoring was conducted.

RESULTSLong lesions (59.2%), multi-vessel disease (50.4%), and small vessel disease (31.6%) were mostly found in angiography. Major adverse cardiac events (MACE) occurred in 51 (5.1%) patients at 1 year clinical follow-up, including cardiac mortality in 6 (0.6%), non-fatal myocardial infarction in 11 (1.1%), and target lesion revascularization in 36 (3.5%) of the patients. Definite and probable stent thrombosis (ST) by Academic Research Consortium (ARC) definition occurred in 12 (1.36%) patients at one-year clinical follow-up. The 8-month binary restenosis rate was 5.7% in-segment and 4.3% in-stent, respectively. Late lumen loss was (0.21 ± 0.40) mm in-segment and (0.23 ± 0.36) mm in-stent, respectively. Furthermore, Cox regression analysis revealed that diabetes, small vessel diameter, and chronic total occlusion were independent predictors of ST.

CONCLUSIONSThe results showed that the Firebird SES was effective and safe in treating Chinese patients with complex coronary lesions and occurrence of ST rate at one-year clinical follow-up was acceptable, however further long-term follow-up was still necessary. (NCT00552656)

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Asian Continental Ancestry Group ; Coronary Angiography ; Coronary Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sirolimus ; therapeutic use ; Treatment Outcome