Tripterygium wilfordii has exihibited multiple pharmacological activities, such as anti-inflammatory, immune modulation, anti-tumor and anti-fertility. T. wilfordii have been used for the therapy of inflammation and autoimmune diseases including rheumatoid arthritis, immune complex nephritis and systemic lupus erythematosus clinically. However, it is well known that T. wilfordii has small margin between the therapeutic and toxic doses and could cause serious injury on digestive, reproductive and urogenital systems. Among all the organs, liver is one of the most remarkable targets of T. wilfordii-induced toxicities, and the damage is more serious than others. It is generally accepted that T. wilfordii-induced liver injury is a result of the combined effects of toxic elements of T. wilfordii. It is reported in several studies that the mechanism of T. wilfordii-induced liver injury may be related to lipid peroxidation, cell apoptosis and immune damage, and so on. Licorice is one of the most commonly used Chinese herbal medicine, with effects of heat- clearing and detoxicating, anti-inflammatory and hepatoprotective, reconciling various drugs, and so on. Licorice often accompany T. wilfordii in clinical application which can significantly reduce the liver injury induced by T. wilfordii. The attenuated effect is exact, but the mechanism is still a lack of in-depth study. This paper reviews the studies on T. wilfordii-induced liver injury and the related mechanism as well as licorice and other traditional Chinese medicine accompany T. wilfordii to reduce the injury in recent years, so as to provide reference for related research in the future.
Animals ; Chemical and Drug Induced Liver Injury ; etiology ; prevention & control ; Glycyrrhiza ; Humans ; Inactivation, Metabolic ; Medicine, Chinese Traditional ; Tripterygium

Objective:To investigate the effects of medroxyprogesterone acetate combined with a levonorgestrel-releasing intrauterine contraceptive system (Mirena) on the levels of sex hormone and vascular endothelial growth factor in patients with moderate and severe endometriosis after laparoscopic surgery.Methods:A total of 102 patients with endometriosis who received laparoscopic conservative surgery in Hangzhou Ninth People's Hospital from October 2015 to May 2018 were retrospectively analyzed. They were randomly assigned to undergo either medroxyprogesterone acetate treatment alone (control group, n = 51) or medroxyprogesterone acetate treatment + levonorgestrel-releasing intrauterine contraceptive system application (observation group, n = 51) for 6 successive months. Clinical efficacy, serum luteinizing hormone, follicle-stimulating hormone, estradiol and vascular endothelial growth factor levels, Visual Analogue Scale score, endometriosis recurrence rate, and adverse reactions were compared between the control and observation groups. Results:Total effective rate in the observation group was significantly higher than that in the control group [94.12% (48/51) vs. 80.93% (41/51), χ2 = 4.320, P < 0.05]. At 6 months after surgery, serum luteinizing hormone, follicle-stimulating hormone, estradiol and vascular endothelial growth factor levels in the observation group were (5.72 ± 0.53) U/L, (5.05 ± 0.91) U/L, (156.02 ± 21.80) pmol/L and (155.39 ± 24.72) ng/L respectively, which were significantly lower than those in the control group [(6.51 ± 0.67) U/L, (5.73 ± 0.68) U/L, (177.20 ± 23.20) pmol/L and (186.22 ± 28.14) ng/L, t = 6.604, 4.275, 4.747 and 5.878, all P < 0.05). At 3 and 6 months after surgery, Visual Analogue Scale score in the observation group were (2.39 ± 0.33) points and (1.27 ± 0.20) points respectively, which were significantly lower than those in the control group [(2.72 ± 0.40) points, (1.52 ± 0.25) points, t = 4.545 and 5.577, both P < 0.05]. Two-year follow-up results revealed that endometriosis recurrence in the observation group was significantly lower than that in the control group [1.96% (1/51) vs. 13.73% (7/51), χ2 = 4.883, P < 0.05]. There was no significant difference in total incidence of adverse reactions between the two groups [15.69% (8/51) vs. 13.73% (7/51), χ2 = 0.078, P > 0.05]. Conclusion:Application of medroxyprogesterone acetate combined with a levonorgestrel-releasing intrauterine contraceptive system after laparoscopic surgery for moderate and severe endometriosis can effectively regulate serum levels of sex hormone and vascular endothelial growth factor, decrease endometriosis recurrence rate and is highly safe. This method is worthy of clinical promotion.

Abstract: Objective　To collect and organize malaria case data in Hubei Province from 2017 to 2021, compare and analyze the malaria epidemic characteristics on the before and after malaria elimination, and provide scientific support for Hubei Province to further optimize the comprehensive strategies to prevent re-transmission after the elimination of malaria. Methods The study was conducted by collecting the data of reported malaria cases of Hubei during 2017-2021 from the Infectious Disease Surveillance Reporting and Management System, and conducting the epidemiological characteristics of malaria on pre-elimination (2017-2019) and post-elimination (2020-2021). Results A total of 429 cases of imported malaria were reported in Hubei Province from 2017 to 2021, and the malaria epidemic showed an obvious trend of rising first and then falling. On the pre-malaria elimination, 374 malaria cases were reported, including 262 cases of P.falciparum (70.05%); on the post-malaria elimination, 55 malaria cases were reported, including 25 cases of P.falciparum (45.45%). There was a statistically significant difference in the proportion of infections caused by the four types of malaria parasites before and after the elimination of malaria (χ2=14.248, P<0.05). On the pre-malaria elimination, the peak of disease onset mainly occurred in January, July, and November; on the post-malaria elimination, the peak of disease onset mainly occurred in January to February, and December. Both before and after malaria elimination, the reported cases were mainly concentrated in Wuhan, Yichang, Huangshi, Xiangyang, Shiyan and Huanggang, but the range of cases showed a clear trend of narrowing. Before and after malaria elimination, malaria cases in Hubei Province were mainly among young and middle-aged males aged 30-49. The proportions of workers and migrant workers increased from 37.70% and 9.09% before the elimination to 50.91% and 18.18% after the elimination, respectively, with a statistically significant difference (χ2=17.839, P<0.05). The percentage of interval from onset of illness to initial diagnosis ≥ 5d decreased from 21.66% before the elimination to 10.91% after the elimination (χ2=6.448, P<0.05). The percentage of definitive diagnosis of malaria at initial diagnosis in town clinic increased from 18.18% before the elimination to 50.00% after the elimination. The proportion of malaria cases diagnosed by county-level medical institutions increased from 22.73% before the elimination to 34.55% after elimination. There was no statistically significant difference in the proportion of malaria cases diagnosed by medical institutions at all levels before and after the elimination of malaria (χ2=5.630, P>0.05). The proportion of cases with the interval between initial diagnosis and diagnosis within 24h increased from 43.85% before the elimination to 70.91% after the elimination. There was a statistically significant difference in the proportion of cases with the interval between initial diagnosis and diagnosis before and after the elimination of malaria (χ2=14.006, P<0.05). Before and after malaria elimination, all reported cases were mainly imported from African countries. Conclusions There are imported malaria cases reported every year in Hubei Province before and after the elimination of malaria, which poses a great challenge to the prevention of re-transmission. Therefore, it is necessary to strengthen the surveillance system, detect and standardize the treatment of imported malaria cases in a timely manner, conduct targeted retransmission risk surveys and assessments, and consolidate the achievements of malaria elimination.

Objective To explore the relationship of central obesity and brain-derived neurotrophic factor (BDNF) expression in skeletal muscle.Methods Fifty healthy kunming mice at the neonatal stage were randomly divided into control group (n =20 cases) and test group (n =30 cases).To obtain the obese models,test group mice were injected with 10％ monosodium glutamate (3 mg · g-1 · d-1)for 5 days at cervical subcutaneous.In addition,mice were removed according to the requirements.Finally,we got 12 mice in each group.We detected body weight of the mice every two weeks,then Lee' s index was calculated.Body temperature was detected per week.At the end of 8th week,the blood specimens was collected from the eyeball to detect the serum lipid using automatic biochemistry analyzer.The perirenal white adipose tissue (WAT) and interscapular brown adipose tissue (BAT) were isolated and weighed.Furthermore,the levels of BDNF in skeletal muscle were investigated through western blotting in order to analyze the relationship between BDNF with central obesity.Results At the 6th weekend,the body weight of test and control groups were (39.71±2.55) and (32.83 ±2.30)g,the Lee's indexes were (365.02 ±3.83) and (337.54±4.10) g1/3 · cm-1,at the 8th weekend,the body weight of test and control groups were (48.12 ± 3.61) and (39.51 ± 3.52)g,the Lee's indexes were (361.93 ± 7.12) and (325.17 ± 6.87)g1/3 · cm-1 Above indexes had significant difference between the two groups (P ＜ 0.05,P ＜ 0.01 or P ＜ 0.001).At the 6th weekend,the temperature of the two groups were (36.30 ± 0.07) and (36.67 ± 0.07) ℃,at the 7th weekend,the temperature of the two groups were (36.40 ±0.08)and (36.79 ± 0.10)℃ respectively,at the 8th weekend,the temperature of the two groups were (36.31 ± 0.09)and(36.80 ± 0.10)℃ respectively.Above indexes had significant difference between the two groups.At the 8th weekend,the main indexes in test and control groups were compared:the total cholesterol were(2.91±0.25) and (1.86 ± 0.51) mmol · L-1,the triglyceride were (1.48 ± 0.62) and (0.81 ±0.23)mmol · L-1,the low-density lipoprotein were (0.37 ± 0.06) and (0.29 ± 0.05) mmol · L-1,the WAT were (0.75 ± 0.08) and (0.24 ± 0.05) g,the BAT were (0.31 ± 0.07) and (0.17 ±-0.01) g,the value of the BAT/WAT were (0.41 ±0.08) and (0.71 ± 0.12),the expression of BDNF were (0.63 ± 0.07) and (0.98 ± 0.06).The differences were statistically significant (P ＜ 0.05,P ＜ 0.01 or P ＜ 0.001).Conclusion Down-regulation of BDNF in skeletal muscle may be involved with central obesity of mice by affecting energy metabolism.

BACKGROUNDMutations in fumarylacetoacetate hydrolase (FAH) gene can lead to tyrosinemia type 1 (HT1), a relatively rare autosomal recessive disorder. To date, no molecular genetic defects of HT1 in China have been described. We investigated a Chinese family with a HT1 child to identify mutations in FAH.

METHODSDNA sequencing was used for mutations screening in FAH gene. Real-time polymerase chain reaction (PCR) was performed to determine the FAH gene expression level. To confirm the presence of degradation by the nonsense-mediated mRNA decay pathway (NMD), the fragments containing R237X mutations were analyzed by primer introduced restriction analysis-polymerase chain reaction (PIRA-PCR) and cDNA sequencing. Finally, the effects of the mutations reported in this study were predicted by online softwares.

RESULTSA boy aged 3 years and 8 months was diagnosed clinically with HT1 based on his manifestations and biochemical abnormalities. Screening of FAH gene revealed two heterozygous mutations R237X and L375P transmitted from his mother and father respectively. In this pedigree, the amount of FAH mRNA relative to a healthy control was 0.44 for the patient, 0.77 for his mother and 1.07 for his father. Moreover, both PIRA-PCR and cDNA sequencing showed significant reduction of the FAH mRNA with R237X nonsense mutation. The missense mutation of L375P was not reported previously and prediction software showed that this mutation decreased the stability of protein structure and affected protein function.

CONCLUSIONSThis is the first case of HT1 analyzed by molecular genetics in China. The R237X mutation in FAH down- regulates the FAH gene expression, and the L375P mutation perhaps interrupts the secondary structure of FAH protein.

Child, Preschool ; China ; Humans ; Hydrolases ; genetics ; Male ; Molecular Sequence Data ; Mutation ; Mutation, Missense ; genetics ; Nonsense Mediated mRNA Decay ; genetics ; Real-Time Polymerase Chain Reaction ; Tyrosinemias ; genetics

Objective To evaluate the clinical value of trascranial sonography (TCS) in measuring hyperechogenic substantia nigra ( SN) area and area ratio of SN to midbrain ( S/M) for the diagnosis of Parkinson′s disease( PD).Methods A total of 109 PD patients ( PD group) and 115 normal controls (control group) underwent TCS.The area of midbrain and SN and the area ratio of S/M were measured and compared between PD group and control group .Statistical analysis of the two parameters in predicting PD was performed with receive operating characteristic ( ROC) curves.The sensitivity and specificity of each parameter and their combination were calculated .Results The hyperechogenic SN area and S/M were (0.34 ±0.27)cm 2 and (12.15 ±4.57)%in PD group,whereas (0.14 ±0.08)cm 2 and (6.37 ±3.30)%in control group respectively .The difference between the two groups was statistically significant (t=82.68, 100.83,both P<0.01).ROC analysis showed that using the cut-off of 0.20 cm 2 for SN hyperechogenicity, the sensitivity and specificity were 80.40%and 74.50%.With the cut-off of 7.52%for S/M,the sensitivity and specificity were 89.10% and 63.30%.By using the combination of SN hyperechogenicity≥0.20 cm 2 and S/M>7.52%,the sensitivity was 80.4%and the specificity was 78.6%.Conclusions TCS is a fast, convenient,effective and useful tool for screening PD .The combination of the SN area and S/M provided the best diagnostic parameters.

OBJECTIVETo investigate the effect and possible mechanism of complete Freund's adjuvant induced chronic pain on later function of learning and memory in neonatal rats.

METHODSSixty Sprague-Dewley rat pups (10 litters of 6 pups) were randomly divided into control group and chronic pain group (n = 30 in each group). In the chronic pain group, left hind paws of the rats were treated with subcutaneous injection of 20 microl of CFA on postnatal day-2. The control rat pups received normal saline. The hippocampus of rats were separated on postnatal days 10 and 21 (one rat in each group from every litter, n = 10). The expression of Bcl-2 and BDNF mRNA were investigated by RT-PCR. Morris water maze tests were performed on day 21 (one rat in each group from every litter, n = 10).

RESULTSIn hidden-platform training of Morris water maze, the mean escape latency of rats in the chronic pain group were longer than that of the control rats. In spatial probe tests, the average percentages of the swimming time and distances in the platform quadrant in the pain group rats were less than those in the control group. There was no significant difference in visible-platform training between the two groups. The Bcl-2 and BDNF mRNA expressions in hippocampus of the pain group rats were lower than those in the control at day 10, but no significant difference at day 21.

CONCLUSIONChronic pain stress induced by CFA impairs the spatial learning and memory function in neonatal rats. These effects might exert through down-regulating Bcl-2 and BDNF mRNA expression in the hippocampus.

Animals ; Animals, Newborn ; Brain-Derived Neurotrophic Factor ; genetics ; Chronic Disease ; Disease Models, Animal ; Down-Regulation ; Freund's Adjuvant ; Genes, bcl-2 ; genetics ; Hippocampus ; metabolism ; physiopathology ; Maze Learning ; drug effects ; Memory ; drug effects ; Pain ; chemically induced ; genetics ; physiopathology ; psychology ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Spatial Behavior ; Stress, Physiological ; genetics

OBJECTIVETo explore the effect of auricular points sticking-pressing (APSP) in treating post-cesarean hypogalactia (PCH).

METHODSA randomized, controlled, single-blinded clinical trial on 116 patients with PCH was carried out. They were equally assigned to the treatment group and the control group. The treatment group received APSP, with the pellets pressed for 4 times daily, while the control group was only asked to do lactation to meet infant demand. The therapeutic efficacy and the changes in scores of traditional Chinese medicine (TCM) syndrome, volume of milk secretion, supplementary feeding and serum level of prolactin (PRL) in the two groups were estimated and compared after the patients had been treated for 5 days.

RESULTSThe cured and markedly effective rate in the treatment group was 89.7%, which was significantly higher than that in the control group (27.6%, P<0.05), 95% CI (0.1543, 0.2527). The improvement of TCM syndrome, elevation of milking volume, decrease of the supplementary feeding and increase of PRL level revealed in the treatment group were all superior to those in the control group, showing statistical significance (P<0.01).

CONCLUSIONAPSP shows an apparent efficacy in treating PCH and is worthy of application in clinical practice.

Acupuncture Points ; Acupuncture, Ear ; adverse effects ; methods ; Adult ; Cesarean Section ; adverse effects ; rehabilitation ; Female ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Lactation ; physiology ; Lactation Disorders ; blood ; therapy ; Medicine, Chinese Traditional ; adverse effects ; methods ; Milk, Human ; secretion ; Postoperative Complications ; therapy ; Pregnancy ; Pressure ; Prolactin ; blood ; Treatment Outcome ; Young Adult

AIM To investigate the effects of Shenge Powder (Ginseng Radix et Rhizoma,Gecko) on heart function in rats with heart failure by coarctation of abdominal aorta and its mechanism of action.METHODS The heart failure rats were fed with Shenge Powder [1.89 g/(kg · d)] or bisoprolol [1 mg/(kg · d)] for twelve weeks.The pathological morphology,hemodynamics,cardiographic index and effect on protein expression of PGC-1 α in sham operation group,model group,Shenge Powder group and Bisoprolol group were observed.RESULTS Compared with the model group,Shenge Powder increased ejection fraction (EF) (P ＜ 0.05),decreased left ventricular end-diastolic pressure (LVEDP) (P ＜ 0.01),improved maximal rate of left ventricular pressure development (dp/dtmax) and maximal rate of left ventricular pressure decay (dp/dtmin) (P ＜ 0.01),reduced myocardial tissue lesions and myocardial fibrosis.There was no significant difference in PGC-1α protein expression between the Shenge Powder group and the model group.CONCLUSION Shenge Powder can improve left ventricular function in rats with heart failure,and reduce the pathological changes of myocardium tissue.

Objective:To develop a nomogram model based on clinical and imaging parameters to predict the etiological type of acute ischemic stroke (AIS).Methods:Patients with AIS received endovascular treatment in Beijing Hospital from March 2016 to December 2021 were retrospectively included. According to the etiological type, they were divided into large artery atherosclerosis (LAA) and cardioembolism (CE). The clinical and imaging parameters mostly relevant to the etiological type were selected by LASSO regression, and a nomogram model for predicting the etiological type of AIS was established by multifactorial logistic regression to investigate the predictive value of relevant clinical imaging parameters. In addition, the diagnostic efficacy of the prediction model was assessed by receiver operator characteristic (ROC) curves, calibration curves, and clinical decision curves. Results:A total of 136 AIS patients with anterior circulation large vessel occlusion received endovascular treatment were included, including 62 patients with CE (45.6%) and 74 with LAA (54.4%). Variables with P<0.10 in the univariate analysis were included in LASSO regression to screen for relevant variables. The gender, baseline National Institute of Health Stroke Scale (NIHSS) score, penumbra to ischemic core ratio, brain natriuretic peptide (BNP), and platelet (PLT) count were included into the multivariate logistic regression model. The results revealed that gender (odds ratio [ OR] 2.632, 95% confidence interval [ CI] 1.048-6.607; P=0.039), baseline NIHSS score ( OR 1.078, 95% CI 1.002-1.160; P=0.043), BNP ( OR 1.004, 95% CI 1.002-1.007. P<0.001), PLT ( OR 0.991, 95% CI 0.982-0.999; P=0.031) as the predictors to distinguish LAA from CE. In addition, the penumbra to infarct core ratio ( OR 0.886, 95% CI 0.785-1.000; P=0.050) also played an important role in predicting the model. The diagnostic efficacy of this predictive model was analyzed by the ROC curves, with an area under the curve of 0.881 (95% CI 0.815-0.930, P<0.001). Bootstrap internal validation showed that the good compliance with a mean absolute error of 0.027 for true versus predicted value compliance. Calibration curves, clinical decision curves, and Hosmer-Lemeshow test ( P=0.562) showed good agreement between the predicted and actual values of the model. Conclusion:Patients with CE are more common in women, have higher NIHSS scores and BNP, and have lower PLT and penumbra to ischemic core ratio. The nomogram model combining the above indicators can better identify LAA and CE, and maybe helpful in clinical decision making.