Objective To investigate the changes of plasma adrenodullin(ADM) and C-type natriuretic peptide(CNP) level in children with chronic heart failure(CHF) and its clinical implications.Methods Forty-two children with CHF were collected.The patients suffered from dilated cardiomyopathy,congenital heart defects,and other heart diseases.According to a modified scoring system described by Ross and Reithman,16 patients were classified as class Ⅱ,14 as class Ⅲ,and 12 as class Ⅳ.Plasma levels of ADM and CNP were measured by radioimmunoassay assay in these patients and 11 healthy children.Echocardiography was performed to measure left ventricular function and the ratio of E/A.Results Plasma ADM and CNP levels of CHF patients were significantly elevated as compared with those of the control subjects [(218.27?106.53) ng/L vs(74.39?53.99) ng/L,P=0;(190.27?108.38) ng/L vs(92.59?(59.46) ng/L),P0.05).ADM levels were elevated with the advancing severity of CHF determined by a modified scoring system described by Ross.However,the plasma CNP levels in the normal state wasn′t significantly different from those observed in class Ⅱ.Likewise,the plasma CNP level in the class Ⅲ was not significantly different from that observed in class Ⅱ.Conclusions ADM and CNP might play a compensatory and defensive roles in the pathophysiology of the pediatric CHF.ADM may be a biochemical marker for evaluation the severity of the chronic heart failure in children,but also a new prognostic indicator of this syndrome.

Objective To discover the role of interleukin-18(IL-18) and CD_(54) in congestive heart failure(CHF),and evaluate the diagnostic value of IL-18 and CD_(54) in CHF.Methods Blood samples were collected from 52 children with CHF,included 18 cases in classⅡ,17 cases in class Ⅲand 17 cases in class Ⅳ.Fifteen healthy children were normal control group.The levels of IL-18 was(detec-)ted by ELISA method and the expression of CD_(54) was examined by flow cytometry.Results The levels of IL-18 and CD_(54) in CHF were significantly higher than those of control subjects(P0.05),but the levels were respectively significantly higher than that of control subjects(P

Objective To understand the dietary nutrients among rural stranded children.Methods 2551 children aged 2 to 7, including 1278 stranded children in the rural areas and another 1273 children served as controls were selected, using multistage stratified cluster random sampling. Dietary survey was performed with three-day weighing dietary method and questionnaire on food intake. Data on diet were analyzed and evaluated by the Dietary Reference Intakes (DRIs) recommend by Chinese Nutrition Society, to evaluate the levels on energy and nutrient intake among stranded children in the rural areas. Results The dietary pattern among rural stranded children mainly consisted of grains and vegetables, but the intakes of animal products, fruits, and snacks were significantly less than in the control group. The intakes of three major energy-producing nutrients were below the recommend nutrient intake. Minerals as calcium, zinc, selenium, kalium and vitamins as vitamin A, B1, B2were insufficient.Most of the rural stranded children took nutrients insufficiently, with 50% lack of adequate energy and 80% of protein, 90% of minerals (calcium, zinc etc.) and vitamins (vitamin B1 and vitamin B2 etc.).Sources from high quality protein was insufficient, only consisting 35% of the total protein, but overabundant (over 64 % ) from the plants. The intake of plant-sourced iron was overabundant, accounted for 87%. Conclusion The dietary pattern was unsatisfactory with insufficient intake of energy-sourced proteins and some nutrients. The sources of energy, protein, and iron were mostly obtained from underbalaneed foods. It is necessary to improve the dietary nutrients status among rural stranded children aged 2-7 years.

OBJECTIVETo objectively assess the effect of Qiming Granule in the treatment of diabetic retinopathy (DR) by fluorescence fundus angiography (FFA).

METHODSIn a multi-center, randomized, parallel controlled clinical trial, patients with DR were randomly assigned to the control group (calcium dobesilate capsule) and the test group (Qiming Granule). Changes in the retinal blood circulation time were recorded by FFA after 3 months of medication.

RESULTSSignificant reduction was observed in the retinal arterio-venous circulation time (AVCT) in both groups (P<0.01), the value was 7.635+/-3.149 s before treatment and 5.165 +/-3.382 s after treatment in the treated group, and 7.737+/-3.413 s and 5.313+/-3.472 s in the control group respectively. Qiming Granule also reduced the arm-to-retinal circulation time (ARCT, P<0.05). The value was 17.867+/-3.872 s before treatment and 15.643+/-4.648 s after treatment in the treated group, and 17.217+/-3.833 s and 16.312+/-3.613 s in the control group (P>0.05) respectively. The ARCT in the tested group was reduced, with a statistically significant difference post-medication (P<0.01).

CONCLUSIONAs a Chinese medicine complex prescription, Qiming Granule may alleviate retinal hypoxia and ischemia by increasing retinal blood flow and improving the blood circulation.

Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; adverse effects ; pharmacology ; therapeutic use ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vessels ; drug effects ; physiopathology

AIM: To evaluate the clinical efficacy of adalimumab(ADA)with dose-reduced glucocorticoid for the treatment of Vogt-Koyanagi-Harada disease(VKH).METHODS: A total of 21 patients(37 eyes)with VKH who received ADA therapy in the Department of Ophthalmology of our hospital from August 2020 to December 2021 were included. The interval of ADA administration was progressively extended after intraocular inflammation controlled and lasted for 3mo, and it returned to the initial treatment interval once the inflammation recurred. After follow-up for 12mo, anterior chamber cell(ACC)grade, vitreous haze(VH)grade, retinal/choroidal lesions, serous retinal detachment(SRD), best corrected visual acuity(BCVA), central macular thickness(CMT)and doses of glucocorticoid and immunosuppressant were compared before and after the first ADA injection. Treatment failure events and adverse reactions were recorded.RESULTS: Compared with baseline, the proportion of eyes with ACC grade ≤1+ and VH grade ≤1+ increased(P<0.05), the proportion of eyes with retinal/choroidal lesions decreased significantly(P<0.01), BCVA and CMT were significantly improved(P<0.01), and the average dose of glucocorticoid reduced significantly(P<0.01)at 2wk, 1, 3 and 6mo after treatment. At the final follow-up, 82% of patients received glucocorticoid ≤5 mg, and all patients stopped using immunosuppressant. There were 13 treatment failure events during the follow-up period, and 12 patients(57%)extended the ADA treatment interval, with no serious adverse events related to ADA treatment observed.CONCLUSION: ADA is effective and safe for the treatment of VKH, reducing the need for glucocorticoid and immunosuppressant. In addition, extending the interval of ADA treatment is effective, which has a lower recurrence rate.

The function of the central nervous system was significantly altered under high-altitude hypoxia, and these changes lead to central nervous system disease and affected the metabolism of drugs in vivo. The blood-brain barrier is essential for maintaining central nervous system stability and plays a key role in the regulation of drug metabolism, and barrier structure and dysfunction affect drug transport to the brain. Changes in the structure and function of the blood-brain barrier and the transport of drugs across the blood-brain barrier under high-altitude hypoxia are regulated by changes in brain microvascular endothelial cells, astrocytes and pericytes, and are regulated by drug metabolism factors such as drug transporters and drug metabolizing enzymes. This article reviews the effects of high-altitude hypoxia on the structure and function of the blood-brain barrier and the effects of changes in the blood-brain barrier on drug metabolism. We investigate the regulatory effects and underlying mechanisms of the blood-brain barrier and related pathways such as transcription factors, inflammatory factors and nuclear receptors on drug transport under high-altitude hypoxia.

【Objective】 To evaluate the clinical value of 18F-FDG PET/CT features in differentiating lymphovascular infiltration in patients with solid stage I lung adenocarcinoma. 【Methods】 From January 2017 to September 2019, a total of 86 patients [43 males and 43 females; age(59.9 ± 10.3) years; age range: 28-81 years] with surgically and pathologically confirmed stage I lung adenocarcinomas were included. All patients received ¹⁸F-FDG PET/CT examination preoperatively and were divided into positive and negative groups according to the histopathological lymphovascular infiltration status. Patient gender, age, lesion location, HRCT features(size, sharp, lobulated sign, spiculated sign, bubble lucency, air bronchogram sign, pleural traction and para-tumor emphysema) and SUVmax(maximum of standard uptake value) were recorded and compared using univariate analysis between lymphovascular infiltration positive and negative groups, respectively. Logistic regression analysis was used to establish a predictive model between PET/CT parameters and lymphovascular infiltration status. Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance and determined the cutoff values. 【Results】 There were 12 cases [5 males and 7 females; age: (59.0±8.3) years] in the lymphovascular infiltration positive group and 74 cases [38 males and 46 females; age: (60.1±10.6) years] in the negative group. Significant statistical differences were shown in lesion size、sharp and SUVmax between the two groups (Z = -2.505, P = 0.012; P = 0.048; t = -3.625, P = 0.003). SUVmax was an independent risk factor for positive in multivariation logistic regression analysis(OR value: 1.484; 95%CI: 1.195-1.843; P = 0.000). The optimum cut-off value for positive was greater than 7.75 mm in the ROC curve analysis and the area under curve(AUC), sensitivity, specificity and accuracy was 0.840, 75.0%, 79.7% and 79.1%, respectively. 【Conclusions】 The PET/CT characteristics may be useful in differentiating lymphovascular infiltration status in patients with solid stage I lung adenocaricinoma. SUVmax was an independent risk factor and greater than 7.75 were more likely to be lymphovascualr infiltration, which will be helpful for selection of treatment pattern.

The structure and diversity of the intestinal flora in rats exposed to high altitude hypoxia was investigated. Animal experiments strictly follow the regulations of Medical Laboratory Animal Ethics Committee of Qinghai University, School of Medicine. SD rats were randomly divided into a control group, a moderate altitude hypoxia group, and a high altitude hypoxia group. The pH value of the feces was measured and histopathological changes in the small intestine were determined by HE staining, and the intestinal flora were characterized by 16S rDNA high throughput sequencing technology on the 3rd, 7th, 15th, and 30th day of hypoxia exposure. Compared with the control group, the fecal pH value of rats in the moderate altitude hypoxia group and the high altitude hypoxia group was decreased significantly. The lamina propria and submucosa capillaries were slightly dilated and congested on the 3rd day in the moderate altitude hypoxia group. In the high altitude hypoxia group the submembrane capillaries were dilated and congested, the lamina propria of the mucosa showed mild edema, and the lymphatic vessels were dilated on the 7th day. The composition and diversity of intestinal flora in these rats changed significantly with prolonged exposure to the high altitude hypoxic environment. A total of 35 phyla, 87 classes, 205 orders, 337 families, 638 genera, and 256 species were annotated in the three groups of rats, including Firmicutes, Clostridia, Clostridiales, Ruminococcaceae, Akkermansia, and Lactobacillus_murinus. Compared with the control group, the intestinal flora of the hypoxic groups showed the most significant changes by the 15th day. There were 9 microbiota of gut microorganisms with relative abundance in the moderate altitude hypoxia group, of which Rikenellaceae_RC9_gut_group bacteria was the most common, there were 19 different microbiota of gut microorganisms with higher relative abundance in the high altitude hypoxia group, of which Ruminococcaceae bacteria was the most common. The results of this study indicate significant changes in the intestinal flora with high altitude hypoxia, and establish a foundation for further research on the initiation and development of diseases and drug metabolism in high altitude hypoxia.

Bladder cancer is the most common malignancy of the urinary system. Compound Kushen Injection (CKI) is a Chinese medicinal preparation that has been widely used in the treatment of various types of cancers in the past two decades. However, the pharmacological effect of CKI on bladder cancer is not still completely understood. In the current study, network pharmacology combined with bioinformatics was used to elucidate the therapeutic mechanism and potential targets of CKI in bladder cancer. The mechanism by which CKI was effective against bladder cancer was further verified in vitro using human bladder cancer cell line T24. Network pharmacology analysis identified 35 active compounds and 268 target genes of CKI. Bioinformatics data indicated 5500 differentially expressed genes associated with bladder cancer. Common genes of CKI and bladder cancer suggested that CKI exerted anti-bladder cancer effects by regulating genes such as MMP-9, JUN, EGFR, and ERK1. Functional enrichment analysis indicated that CKI exerted therapeutic effects on bladder cancer by regulating certain biological processes, including cell proliferation, cell migration, and cell apoptosis. In addition, Kyoto Encyclopedia of Genes and Genomes enrichment analysis implicated pathways related to cancer, bladder cancer, and the PI3K-Akt signaling pathway. Consistently, cell experiments indicated that CKI inhibited the proliferation and migration of T24 cells, and induced their apoptosis. Moreover, RT-qPCR and Western blot results demonstrated that CKI was likely to treat bladder cancer by down-regulating the gene and protein expression of MMP-9, JUN, EGFR, and ERK1. CKI inhibited the proliferation and migration, and induced the apoptosis of T24 bladder cancer cells through multiple biological pathways and targets. CKI also exhibited significant effects on the regulation of key genes and proteins associated with bladder cancer. Overall, our findings provide solid evidence and deepen current understanding of the therapeutic effects of CKI for bladder cancer, and further support its clinical use.
Computational Biology ; Drugs, Chinese Herbal ; Humans ; Network Pharmacology ; Phosphatidylinositol 3-Kinases ; Urinary Bladder Neoplasms/genetics*

Colon cancer-related anemia (CCRA) is mainly caused by systemic inflammation, intestinal bleeding, iron deficiency and chemotherapy-induced myelosuppression in colon cancer. However, the best therapeutic schedule and related mechanism on CCRA were still uncertain. Studies on blood enrichment and anti-tumor effects of combined Danggui Buxue Decoction (DBD), Fe and rhEPO based on CCRA and gut microbiota modulation were conducted in this paper. Here, CCRA model was successfully induced by subcutaneous inoculation of CT-26 and i.p. oxaliplatin, rhEPO + DBD high dosage + Fe (EDF) and rhEPO + DBD high dosage (ED) groups had the best blood enrichment effect. Attractively, EDF group also showed antitumor activity. The sequencing results of gut microbiota showed that compared to P group, the relative abundances of Lachnospiraceae and opportunistic pathogen (Odoribacter) in ED and EDF groups were decreased. Interestingly, EDF also decreased the relative abundances of cancer-related bacteria (Helicobacter, Lactococcus, Alloprevotella) and imbalance-inducing bacteria (Escherichia-Shigella and Parabacteroides) and increased the relative abundances of butyrate-producing bacteria (Ruminococcaceae_UCG-014), however, ED showed the opposite effects to EDF, this might be the reason of the smaller tumor volume in EDF group. Our findings proposed the best treatment combination of DBD, rhEPO and Fe in CCRA and provided theoretical basis and literature reference for CCRA-induced intestinal flora disorder and the regulatory mechanism of EDF.