Objective To clone and sequence the cDNA encoding(S)-N-methylcoclaurine-3'-hydroxylase from Coptis chinensis.Methods The cDNA,encoding(S)-N-methylcoclaurine-3'-hydroxylase,was amplified by RT-PCR with cDNA library of tender leaf as the template.Results The full-length cDNA of(S)-N-methylcoclaurine-3'-hydroxylase(named as CYP80B3) had 1 680 bp with an open reading frame encoding 488 amino acids of protein.The CYP80B3 had 95%,82%,70%,and 68% amino acid sequence homology to the sequence of(S)-N-methylcoclaurine-3'-hydroxylase from C.japonica,Thalictrum flavum,Eschscholzia californica and Papaver somniferum,respectively.The sequence was reported to the GenBank and coded as EF492879.Comparison of sequence with(S)-N-methylcoclaurine-3'-hydroxylase from C.japonica showed CYP80B3 possessed the same functional regions involved with 3'-hydroxylation of(S)-N-methylcoclaurine.Conclusion The cDNA encoding CYP80B3 from C.chinensis was cloned and reported.This work underlays the first step for exploring the pathway of benzylisoquinoline alkaloid biosynthesis and for improving the content of benzylisoquinoline alkaloid in C.chinensis.

OBJECTIVE:To investigate the effects of long-term use of calcium channel blocker-Diltiazem(Dil)on the dosage of ciclosporin A and renal function of renal graft recipients.METHODS:Dil was administed in67renal graft recipi?ents,meanwhile who were orally taking CsA with another59renal graft recipients served as controls.The dosages of ci?closporin A of2group were adjusted to the level within therapeutic window,then the dosage of CsA and serum creatinine change of the2groups36mo after drug administration were observed.RESULTS:12mo,24mo and36mo after operation,the synchronized cyclosporin A dosages in Dil group were lower than the control group respectively by14353mg,9656mg and7817mg.No significant differences were found in serum creatinine levels between the2groups within the first12mo after operation.Thereafter,the creatinine levels in the control group has a faster increase and the creatinine level in Dil group was significantly lower than that of the control group18mo～36mo after operation(P

Objective To explore the effect of low-frequency electroacupuncture (EA) on neuropathic pain induced by spinal nerve injury and its underlying mechanism.Methods Thirty-two male Sprague-Dawley rats were randomly divided into a normal group,a sham spared nerve injury (SNI) group,an SNI group and an SNI+EA group,each of 8.The rats in the SNI and SNI+EA groups were given SNI surgery,while those of the sham-SNI group only had the sciatic nerve and its branches exposed without any lesion.EA at 2 Hz was applied over the ipsilateral Zusanli and Kunlun acupoints daily for 14 days after the surgery.The ipsilateral paw withdrawal threshold (PWT) was measured,along with protein kinase A (PKA) levels in the dorsal horn of the spinal cord,calcitonin gene-related peptide (CGRP) and substance P (SP) levels along with transient receptor potential V1 (TRPV1).Results Compared to the normal group,the SNI groups all showed significant decreases in their PWTs on the affected side and significant increases in PKA,TRPV1,CGRP and substance P on the affected side.Compared to SNI group,the average ipsilateral PWT in the SNI+EA group increased significantly after EA treatment,while PKA levels,TRPV1,CGRP levels and SP expression all decreased significantly.Conclusion Electroacupuncture at low frequency can effectively relieve neuropathic pain,perhaps through down-regulation of PKA in the spinal cord and by decreasing pain hypersensitivity related to CGRP and SP.

Objective To compare the prediction of Functional Gait Assessment (FGA) and Berg balance scale (BBS) for fall among community-dwelling older adults aged 75~85 years old. Methods 162 older adults randomly selected from 3 communities in Beijing were evaluated with FGA and BBS. They were divided as fallers and nonfallers according to the history of fall during the last year. Results The scores of FGA and BBS increased significantly in the nonfallers compared with the fallers (P<0.001). The total scores of FGA correlated with the scores of BBS (r=0.723, P<0.001). The total scores of FGA significantly correlated with the scores of items of FGA (P<0.01), except that of walking with eyes closed (P=0.31). According to the Receiver Operating Characteristic (ROC) Curve, the area under the curve was 0.901 for FGA, and 0.872 for BBS. According to the Youden index, the cutoff value of FGA was 19.5, with sensitivity of 85.5% and specificity of 81.2%. The cutoff value of BBS was 48.5, with sensitivity of 78.3% and specificity of 83.3%. Conclusion FGA is more effective than BBS for predicting the fall in community-dwelling older adults, which is more sensitive and similarly specific.

Embolic strokes of undetermined source (ESUS) is the non-lacunar ischemic stroke without intracranial and extracranial arterial stenosis and overt cardiac embolism. This article reviews the etiology, classification, diagnosis and management of ESUS with related clinical trials and discusses its future research.

Objective: To investigate the prevalence and associated factors of congenital heart defects (CHD) among nursery, primary, and middle school students in Zhaotong, and to provide basis for CHD prevention strategies for children and adolescents. Methods: Using stratified random cluster sampling, a total of 11 343 nursery, primary and middle school students in 4 towns of Zhaotong were investigated with CHD screening and questionnaire during September to November in 2020. Results: The prevalence of CHD among nursery, primary and middle school students in Zhaotong was 11.99‰(95% CI =9.99‰-13.99‰), Yongshan County (14.90‰) > Yanjin County (10.22‰), rural (13.30‰) > urban (8.21‰)( χ 2=4.95, 4.77, P <0.05). Among 136 cases of CHD, the Ventricular Septal Defect (VSD) accounted the highest proportion (41.2%), followed by Atrial Septal Defect (ASD, 32.4% ), Patent Ductus Arteriosus (PDA, 14.0%), and Complex Congenital Heart Disease (CCHD, 5.9%) and the other CHD (others, 6.6%). The proportion of late diagnosed CHD was 50.74%, which was associated with living in rural areas of Yongshan County, low annual household income (10 000-<20 000 yuan), as well as isolated and uncomplicated CHD( OR =0.30, 0.13, 3.67 , 0.17, P <0.05). Conclusion Nursery, primary and middle schools students have the characteristics of high prevalence rate of CHD, large proportion of complex congenital heart disease, large number of late diagnosis and complex influencing factors in Zhaotong. It s in urgent need of strengthening learning prevention of CHD.

Objective: To investigate the analgesic mechanism of Tuina (Chinese therapeutic massage) by observing the effect of the N-methyl-D-aspartate receptor subunit 2B (NR2B)/postsynaptic density-95 (PSD-95) pathway on the dendritic structure of spinal cord dorsal horn in rats with lumbar disc herniation. Methods: Fifty Sprague-Dawley rats were randomly divided into a blank group, a model group, a Tuina group, a blocker agent group, and a blocker agent + Tuina group. The sciatic nerve chronic constriction injury (CCI) model was prepared by the sciatic nerve ligation method. From the 4th day after modeling, rats in the Tuina group and the blocker agent + Tuina group were subject to daily Tuina intervention, and those in the blocker agent group and the blocker agent + Tuina group were daily intrathecally injected with NR2B blocker agent (MK-801). The spontaneous pain score was used to observe the pain behavior of all rats. The expression levels of NR2B and downstream PSD-95 were measured by immunohistochemistry, and the dendritic structure changes were observed by Golgi staining for rat spinal cord dorsal horn after 14 d of continuous intervention. Results: Compared with the blank group, the degree of rat spontaneous pain after CCI was elevated in both the model and the Tuina groups (P<0.01) and was reduced in the Tuina group after the Tuina intervention compared with the model group (P<0.05). Compared with the model group, the rat spontaneous pain level after blocking NR2B was reduced in both the blocker agent group and the blocker agent + Tuina group (P<0.05). The NR2B and PSD-95 protein levels were significantly higher in the model group compared with the blank group (P<0.01); the total number of dendritic branches was increased (P<0.01), and the total dendritic length became longer (P<0.01) in the spinal cord dorsal horn. The rat NR2B and PSD-95 protein levels were significantly decreased in the Tuina group compared with the model group (P<0.01); the total dendritic branch number was reduced (P<0.01) and the total length was shortened (P<0.01) in the spinal cord dorsal horn. After blocking NR2B, the expression levels of NR2B and downstream PSD-95 protein were significantly lower in both the blocker agent group and the blocker agent + Tuina group compared to the model group (P<0.01). The total branch number was significantly reduced (P<0.01), and the total length was significantly shortened (P<0.01) of the dendrites in the spinal cord dorsal horn. Conclusion: Tuina may exert an analgesic effect by remodeling the dendritic structure in the spinal cord dorsal horn in rats with lumbar disc herniation, and its mechanism may be related to the inhibition of NR2B/PSD-95 signaling pathway.

Chronic myelomonocytic leukemia(CMML)complicated with immune thrombocytopenia(ITP)is rare.This article reports the clinical data of a patient with CMML complicated with ITP treated with a combination of venetoclax,ripertamab(an anti-CD20 monoclonal antibody),and hetrombopag.The coexistence mechanism of CMML and ITP needs to be further clarified.Venetoclax combined with anti-CD20 monoclonal antibody and thrombopoietin receptor agonist may be an effective strategy for the treatment of this complication.

Objective To investigate the effects of abdominal tuina on the expression of PI3K and N-methyl-D-aspartate receptor(NMDAR)subunit NR1 in spinal dorsal horn and the morphology of spinal dorsal horn neurons in ulcerative colitis(UC)rats;To explore its mechanism of action in treating UC.Methods Totally 36 SD rats were randomly divided into normal group,model group,abdominal tuina group,mesalazine group,PI3K stimulation group and PI3K stimulation + abdominal tuina group,with 6 rats in each group.The UC model in rats was simulated by drinking dextran sulfate solution freely.The abdominal tuina group and the PI3K stimulation + abdominal tuina group were given abdominal tuina intervention,the mesalazine group was given mesalazine solution for gavage,and the PI3K stimulation group and PI3K stimulation + abdominal tuina group were given intrathecal injection of PI3K agonist,once a day,for consecutive 15 days.Abdominal withdrawal reflex(AWR)score and acetic acid twist were used to observe the abdominal pain symptoms in rats.The expression of PI3K and NR1 in spinal dorsal horn were detected by immunofluorescence staining and Western blot,and the morphological changes of spinal dorsal horn neurons were observed by Nissl staining.Results Compared with the normal group,AWR score and twisting times of rats in model group significantly increased(P<0.01),the expression of PI3K and NR1 protein in spinal dorsal horn significantly increased(P<0.05,P<0.01),the morphology of spinal dorsal horn neurons was disordered,forming a large number of vacuolar like structures,and the Nissl body structure was fuzzy and incomplete.Compared with the model group,AWR scores and twisting times of abdominal tuina group and mesalazine group significantly decreased(P<0.05,P<0.01),and the expression of PI3K and NR1 protein significantly decreased(P<0.05,P<0.01),the edema of spinal dorsal horn neurons was milder,with fewer vacuolar changes and an increase in the number of Nissl bodies;AWR scores and twisting times of PI3K stimulation group and PI3K stimulation + abdominal tuina group significantly increased(P<0.05,P<0.01),and the expressions of PI3K and NR1 protein increased(P<0.05,P<0.01),a large number of neurons underwent pyknosis and necrosis,and the number of Nissl bodies decreased,even dissolving and disappearing.Conclusion Abdominal tuina can effectively improve the symptoms of abdominal pain in UC model rats,and its mechanism may be related to inhibiting the expression of PI3K and NR1 in spinal dorsal horn and improving the morphology of spinal dorsal horn neurons.

Objective:To investigate the effects of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on muscle mass and strength improvement through systematic review and meta-analysis.Methods:Electronic databases, namely Cochrane Library database, MEDLINE, EMBASE, CENTRAL, China National Knowledge Infrastructure, and Wanfang were searched for publications in English and Chinese from database establishment to June 20, 2022. All randomized controlled trials involving any n-3 fatty acid (fish oil capsules, pure fish oil and oral nutritional supplements) interventions for more than 4 weeks among adults aged ≥ 18 years were included in the analysis. The effects of n-3 PUFA on muscle mass and strength were compared with controls using RevMan 5.4. The mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CI) were calculated and pooled effects were assessed. The quality of the included studies was evaluated using the Cochrane risk-of-bias tool.Results:27 trials were included, with both healthy adults and patients with various types of cancer, with chronic obstructive pulmonary disease and on hemodialysis due to chronic renal failure. Most trials were judged as "low" to "high" risk of bias. The meta-analysis showed that n-3 PUFA supplementation significantly improved the lean body mass in the group without physical activity intervention compared to the control group, while showing no significant increase in muscle mass or handgrip strength in overall participants. There was no significant difference between intervention and control groups in subgroup analyses based on health/disease condition, intervention duration, route of administration and dosage and risk of bias. However, significant increases in mid-arm muscle circumference (MAMC) and lower body strength (MD = 0.8, 95% CI: 0.26 to 1.34, P = 0.005; SMD = 0.45, 95% CI: 0.21 to 0.69, P = 0.0002) were observed in n-3 PUFA supplement group. Conclusions:This meta-analysis indicates that n-3 PUFA supplementation does not improve muscle mass or handgrip strength in healthy adults as well as patients, but do improve MAMC and lower body strength. The limited sample size and prominent heterogeneity of the included studies impede the extrapolation to clinical practice and warrants individual analysis based on population characteristics. Well-designed large-scale RCTs are required to verify these findings.