Objective: To explore the mechanism of herb-partitioned moxibustion for ulcerative colitis (UC) through observing the colonic mucosal histopathological changes and the expression of nuclear factor kappaB (NF-kB) and peroxisome proliferators-activated receptorγ (PPARγ) mRNA of UC rats. ＜br> Methods: Male SD rats were randomly divided into a normal group and a model group. UC model was established by general immunological plus local irritation method. After model identification, rats in the model group were randomly divided into a model group, a herb-partitioned moxibustion (HPM) group and a Western medicine (Salicylazosulfapyridine, SASP) group. Rats in the HPM group received treatment at bilateral Tianshu (ST 25) and Dachangshu (BL 25), two cones for each point, once a day for 7 d. SASP group rats were gavaged with SASP. The pathological scores were evaluated according to hematoxylin-eosin (HE) staining of colonic tissues. We used light microscopy to observe degree of colonic mucosal damage and the quantitative polymerase chain reaction (QPCR) to detect the expression of NF-κBp65 and PPARγ in colorectal mucosa. ＜br> Results: Compared with the normal group, histopathological scores were significantly higher in the model group (P＜0.05); compared with the model group, the scores were decreased significantly in the HPM group and the SASP group. Compared with the normal group, NF-κBp65 mRNA expression was increased with statistical significance in the model group (P＜0.05); compared with the model group, NF-κBp65 mRNA expressions were decreased significantly in the HPM group and the SASP group. Compared with the normal group, PPARγ mRNA expression was increased significantly in the model group (P＜0.05); compared with the model group, PPARγ mRNA expressions were decreased significantly in the HPM group and the SASP group. ＜br> Conclusion: HPM could improve the mucosa damage of UC rats, which is possibly through down-regulating NF-κBp65 to achieve anti-inflammatory effect. Whether decreasing the PPARγ mRNA is possibly involved in preventing precancerosis will need further study.

Objective To investigate the relationship between C-reactive protein (CRP) and carotid intima-media thickness in pa-tients with impaired glucose tolerance (IGT). Methods Senan CRP was measured with immunoturhidimetry and the carotid intima-media thickness (CAIMT) was measured using color Doppler in 108 patients with impaired glucose tolerance (IGT) and 80 subjects with normal glucose tolerance(NGT).Then we observed all IGT patients for 3 years using prospective follow-up method, Oral Glucose tolerance test (OGGT) and every index were measured in follow-up 1.5 year and 3 year. Results 2 objects were lost to follow-up. IGT group showed a significant higher CAIMT and CRP compared with NGT group. After follow-up 1.5 year and 3 year, the patients with impaired glucose toler-ance (IGT) were divided into type 2 diabetes (T2DM) group and IGT group based on the level of blood glucose. Both T2DM group and IGT group showed a significant higher CAIMT and CRP, compared with NGT group. The level of serum CRP of T2DM group was higher than that of IGT group, and the level of serum CRP of IGT group was higher than that of NGT group. There were great differences between each group.Linear correlation showed that the level of blood glucose was positively correlated with CRP and CAIMT in T2DM group after follow-up 3 year. CAIMT was positively correlated with the level of blood glucose and CRP. Mulfivariant stepwise regression showed that CRP was signifi-canfly correlated with the level of blood glucose and CAIMT. Conclusion Inflammation played an important role in the development of dia-betes, and it had great vessels complication. The patients with impaired glucose tolerance, who have high level of CRP, were facilitated to be diabetes, and they were at risk of getting great vessels complication during the phase of impaired glucose tolerance. So it would be helpful to prevent IGT patients with high CRP or CAIMT with anti-inflammatory therapy.

Objective:To assess the effects of direct moxibustion on 24-hour ambulatory blood pressure (ABP) and clinical symptoms of traditional Chinese medicine (TCM) in elderly patients with essential hypertension, and to explore the antihypertensive effect and influencing factors of moxibustion. Methods:A total of 101 elderly hypertension patients who met the inclusion criteria were randomly assigned to a direct moxibustion I group (n=33), a direct moxibustion II group (n=34), and a control group (n=34). The treatment of calcium antagonist (CCB) orangiotensin II receptor antagonist (ARB) was adopted in the control group. The treatment of direct moxibustion I plus the same medicine as the control group were adopted in the direct moxibustion I group, five cones per acupoint and three times per week, for 5 weeks in total. The treatment of direct moxibustion II plus the same medicine as the control groupwere adopted in the direct moxibustion II group, five cones per acupoint and three times per week, for 5 weeks in total. The changes of 24-hour ABP and clinical symptoms of TCM after treatment were compared in the three groups. Results: The mean 24-hour ambulatory systolic blood pressure (mean 24 h ASBP), night ASBP, percentage of mean 24-hour ambulatory diastolic blood pressure (mean 24 h ADBP)>90 mmHg, and percentage of day ADBP>90 mmHg in the control group were elevated after treatment (P<0.05). The percentage of night ADBP>80 mmHg in the direct moxibustion I group was reduced by treatment (P<0.01). There were no significant differences in the other outcome measures of 24 h ABP, such as day ASBP, percentage of mean 24 h ASBP>140 mmHg, percentage of day ASBP>140 mmHg, percentage of night ASBP>120 mmHg , mean 24 h ADBP, day ADBP, night ADBP, 24 h ambulatory pulse pressure (APP), after treatment in all groups (P>0.05). The degree of improvement of the clinical symptoms of TCM showed significant differences among the three groups of patients (P<0.01). The total effective rate in the direct moxibustion I group was 73.3%, which was superior to those in the direct moxibustion II group and control group (13.3% and 10.0%, respectively). Conclusion:The direct moxibustion has benign regulative effect on blood pressure of elderly patients with essential hypertension, and improves their clinical symptoms. The direct moxibustion method I (burning the next moxa cone after the previous one had totally burnt out) was superior to method II (burning the next moxa cone when the previous one had not totally burnt out ) in lowering blood pressure and improving symptoms of elderly patients with essential hypertension.

OBJECTIVETo investigate the changes in mRNA expression of p53 and related downstream genes in peripheral blood lymphocytes in workers occupationally exposed to arsenic as well as its influencing factors, and to analyze the mechanism of genetic toxicity of arsenic.

METHODSWith cluster random sampling, 79 workers from an arsenic smelting plant were selected as exposure group, and another 24 people without occupational exposure to arsenic were selected as control group. The relative mRNA expression of p53 and related downstream genes in the peripheral blood lymphocytes of the two groups was determined by quantitative realtime PCR. The levels of inorganic arsenic (iAs), monomethylarsonic acid (MMA), and dimethylarsinic acid (DMA) in urine were determined by hydride generation-atomic absorption spectrometry.

RESULTSThe exposure group had significantly higher levels of iAs, MMA, and DMA than the control group (P<0.01); the exposure group had significantly higher relative mRNA expression (2(-ΔΔCt)) of p53 and four related downstream genes in peripheral blood lymphocytes than the control group (P<0.05); the relative mRNA expression of p53 and related downstream genes was positively correlated with each other (P<0.01), with a correlation coefficient greater than 0.4; the levels of arsenic compounds in urine were positively correlated with the relative mRNA expression of p53 and some of its downstream genes (P<0.05).

CONCLUSIONThe changes in mRNA expression of p53 and related downstream genes are closely related to the metabolic transformation of inorganic arsenic in workers occupationally exposed to arsenic, and it also plays an important role in genetic toxicity and carcinogenic effect in people exposed to arsenic.

Arsenic ; adverse effects ; urine ; Arsenicals ; urine ; Cacodylic Acid ; urine ; Case-Control Studies ; Humans ; Lymphocytes ; drug effects ; Occupational Exposure ; RNA, Messenger ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Objective To produce human papillomavirus type 6(HPV-6)virus-like particles with Escherichia coli expression system and study its immunogenicity.Methods HPV-6 L1 gene was inserted into pmkaryotic expression vector pTO-T7 and then expressed in Escherichia coli ER2566.The HPV-6 L1 protein was purified by ammonium sulfate precipitation,ion-exchange chromatography,and hydrophobic interaction chromatography.Then the purified HPV-6 L1 self-assembled into virus-like particle after removing 1,4dithiothreitol(DTr).The morphology of the virus-like particles was investigated with dynamic light scatter and transmission electron microscopy,and the immunogenicity was determined with in vitro pseudownons neutralization as8ay.Results HPV-6 L1 was expressed in soluble form in Escherichia coli.Following the removal of DTT,purified HPV-6 L1 protein could assemble into virus-like particles as 25 am in the radius.And the animal immunization test showed HPV-6 virus-like particles can elite hish titer neutralizing antibodies.Conclusion The bacterially expressed HPV-6 L1 VLP is highly immunogenieity and easy to produce.And it can be good candidate of HPV-6 vaccine.

Objective:To systematically assess the efficacy and safety of acupuncture therapy for essential hypertension.Methods:A computerized literature search of the Chinese National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),China Biology Medicine Disc(CBM),PubMed,Excerpta Medica Database(EMBASE),and Cochrane Library was conducted to retrieve randomized controlled clinical trials on acupuncture as the main intervention for the treatment of essential hypertension published from the inception of the database to 30 January 2021.The risk-of-bias assessment was carried out for each included study according to the Cochrane Handbook.Data analysis was performed using Review Manager 5.4.1 and Stata 15.0.Results:After the screening,46 randomized controlled trials involving a total of 3 859 subjects were included.Primary outcomes included changes in the diastolic blood pressure after intervention[eight studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[mean difference(MD)=1.45,95%confidence interval(CI)(0.48,2.43),P=0.004,fixed effects model;I2=39%]and changes in the systolic blood pressure after intervention{11 studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[MD=8.60,95%CI(7.12,10.07),P<0.00001,fixed effects model;I2=26%]}.The secondary outcome was antihypertensive efficacy,12 studies of acupuncture monotherapy group[risk ratio(RR)=1.20,95%CI(1.12,1.28),P<0.00001,fixed effects model;I2=36%]and 15 studies of acupuncture combined with antihypertensive drug group[RR=1.27,95%CI(1.20,1.34),P<0.00001,fixed effects model;I2=6%]showed better results than the antihypertensive drug monotherapy group in antihypertensive efficacy.In terms of the adverse events,four studies showed that the acupuncture monotherapy group had fewer adverse events than the antihypertensive drug monotherapy group[RR=0.10,95%CI(0.04,0.25),P<0.00001,fixed effects model;I2=0%].Conclusion:Acupuncture combined with antihypertensive drugs is superior to antihypertensive drugs alone in reducing blood pressure,and acupuncture therapy is effective and safe for the treatment of essential hypertension with fewer side effects.However,there is still a lack of high-quality multicenter randomized double-blinded controlled trials in this field.Rigorous large-sample clinical trials are needed to validate these findings.

Objective: To observe the clinical effect and syndrome scores improvements of herbal cake-partitioned moxibustion (HPM) and ginger-partitioned moxibustion (GPM) in treating ulcerative colitis (UC). Methods:A total of 65 eligible cases were randomly divided into a HPM group (n=32) and a GPM group (n=33) according to their visiting order. Bilateral Tianshu (ST 25) and Dachangshu (BL 25) were selected for the HPM or the GPM treatment once daily, 12 d as a treatment course with a 3-day interval, 6 courses in all. The clinical effect, syndrome scale and Mayo scale were evaluated and compared between the two groups. Results:Of the 65 cases enrolled, 2 cases dropped out in the HPM group and 3 cases dropped out in the GPM group, 30 cases of each group finished the treatment courses. The total effective rate is 93.3% in HPM group and 86.7% in the GPM group, there was no statistically significant difference in the total effective rate between the two groups (P>0.05); there were statistically significant differences between the two groups in score evaluation of lasting time of abdominal pain and frequency of diarrhea, HPM is prior to GPM (P=0.032,P=0.044). There are no statistical significant differences between the two groups in scores evaluation of general symptom, three main symptoms, quality of life (QOL), frequency and severity of abdominal pain, times, and pattern of diarrhea (allP>0.05). There was a statistical significant difference in the improvement of Mayo score between the two groups, and HPM was superior to GPM (P=0.048). Conclusion:HPM and GPM are both promising ways to treat UC, and the total effect is quite similar. HPM is superior to GPM in the improvement of lasting time of abdominal pain and frequency of diarrhea, and also the Mayo score.

Objective:This study aimed to revise the Constitution in Chinese Medicine Questionnaire(Elderly Edi-tion)(CCMQ-EE),as well as evaluate its reliability and validity.The objective was to provide a more accurate Chinese medicine constitution identification tool for geriatric health management and help further research on the relationship between geriatric diseases and constitution type,etc.Methods:The Delphi method and a cross-sectional survey of the elderly population were used.From April to October 2021,experts in different fields were invited to participate in the questionnaire,and items were revised through the experts'ratings and feedback.From December 2021 to February 2022,the revised CCMQ-EE was validated in the elderly population.Results:The coefficients of variation of rationality and importance scores decreased to less than 0.25 in the third round of Delphi.The Kendall coordination coefficients of rationality and importance in the third round were 0.15 and 0.17(P=.031 and P=.007,respectively).The revised CCMQ-EE was established with 34 items.The factor loadings of subscales were between 0.39 and 0.92,and the fitting effects of other subscales were acceptable,except for the inherited special constitution.The Cronbach alpha and test-retest reliability coefficients of each subscale ranged from 0.65 to 0.83,and 0.66 to 0.96,respectively.The composite reliability and average variance extraction were between 0.66 and 0.84,and between 0.32 and 0.57,respectively.The reliability and validity of the revised CCMQ-EE were acceptable or satisfactory.Conclusion:The revised CCMQ-EE was developed through a three-round Delphi process and internal team discussion.After the verification in the elderly in Beijing area,its measurement performance was good.The updated questionnaire can probably replace the initial version to better promote health management and help healthy aging by identifying the constitution type of the elderly.

Objective: To investigate the proteomic characteristics of overweight/obesity and related abnormal glucose and lipid metabolism caused by phlegm-dampness retention to identify related biomarkers. Methods: Seventy-one subjects were enrolled in the study. We assessed blood glucose, blood lipids, body mass index (BMI), and phlegm-dampness pattern, which was confirmed by a traditional Chinese med-icine clinician. Of the participants, we included healthy participants with normal weight (NW, n =23), overweight/obese participants with normal metabolism (ONM, n = 19), overweight/obese participants with pre-diabetes (OPD, n = 12), and overweight/obese participants with marginally-elevated blood lipids (OML, n = 17). Among them, the ONM, OPD, and OML groups were diagnosed with phlegm-dampness pattern. The data-independent acquisition (DIA) method was first used to analyze the plasma protein expression of each group, and the relevant differential proteins of each group were screened. The co-expressed proteins were evaluated by Venn analysis. The pathway analyses of the differential proteins were analyzed using Ingenuity Pathway Analysis (IPA) software. Parallel reaction monitoring (PRM) was used to verify the differential and common proteins in each group. Results: After comparing ONM, OPD, and OML groups with NW group, we identified the differentially expressed proteins (DEPs). Next, we determined the DEPs among OPD, OML, and ONM groups. Using Venn analysis of the DEPs in each group, 24 co-expressed proteins were screened. Two co-expressed proteins were verified by PRM. IPA analysis showed that pathways including LXR/RXR activation, acute phase response signaling, and FXR/RXR activation were common to all three groups of phlegm-damp overweight/obesity participants. However, the activation or inhibition of these pathways was different among the three groups. Conclusion: Participants with overweight/obesity have similar proteomic characteristics, though each type shows specific proteomic characteristics. Two co-expressed proteins, VTN and ORM1, are potential biomarkers for glucose and lipid metabolism diseases with overweight/obesity caused by phlegm-dampness retention.

Objective:To investigate the effectiveness and prognosis of using improved domestic neonatal ureteral stents (referred to as improved double-J stents) for thoraco-amniotic shunting (TAS) in treating fetal chylothorax.Methods:A retrospective analysis was conducted on the clinical data of 21 cases of fetal chylothorax treated with TAS using improved double-J stents at Nanjing Drum Tower Hospital, Nanjing University Medical School from April 1, 2018, to September 30, 2023. Surgical complications and perinatal outcomes were summarized, and the development of surviving infants in five domains (communication, gross motor, fine motor, problem-solving, and personal-social) was assessed using the Ages and Stages Questionnaires-Third Edition (ASQ-3). Descriptive statistical analysis was used. Results:(1) The median gestational age at prenatal diagnosis was 28.7 weeks (27.3-30.4 weeks), with 85.7% (18/21) of cases complicated by fetal hydrops, 90.5% (19/21) by polyhydramnios, and 85.7% (18/21) by bilateral pleural effusion. (2) The median gestational age at the first TAS was 30.9 weeks (29.7-32.7 weeks). Of the 21 cases, 10 required repeat stent placement due to dislodgement or blockage, with a total of 49 stent placements. The dislodgement rate within 7 days was 24.5% (12/49), and the blockage rate was 16.3% (8/49). The rate of premature rupture of membranes within one week post-stent placement was 9.5% (2/21), with an overall preterm premature rupture of membranes rate of 28.6% (6/21). The median interval from the first TAS to delivery was 30.0 d (19.8-40.0 d). Of the 21 cases, three opted for selective termination of pregnancy; the remaining 18 cases resulted in live births, with a median gestational age at delivery of 35.6 weeks (34.1-37.1 weeks), and three neonatal deaths. The overall neonatal survival rate was 15/18. Surviving infants were followed up to a median age of 30 months (7-48 months), with 13 showing normal development and two scoring below the ASQ-3 threshold.Conclusion:The improved double-J stent can be used for TAS in the treatment of fetal chylothorax, with generally favorable outcomes.