ObjectiveTo investigate the clinical features and pregnant outcomes of the pregnant women with congenital adrenal hyperplasia (CAH) 21-hydroxylase deficiency (21-OHD).MethodsThe clinical features,therapies,pregnant outcomes of the pregnant women with 21-OHD were retrospectively reviewed in Peking Union Medical College Hospital,from January 2005 to April 2011.ResultsThere were 8 pregnant womenwith 21-OHD including 5siinplevirilizing patientsand 3nonclassical 21-OHD women.Eightpatientswereacceptedprogestationalandprenatalcontinuallowerglucocorticoid treatment.During the gestational period,the dosage of glucocorticoid was adjusted in one pregnancy.The serum level of 17-alpha hydroxyprogesterone (17-OHP) were elevated after pregnancy [ (70 ± 38 ) versus (24 ±23) nmol/L,P ＜ 0.05].The fertility and offspring rate of 8 patients was 8/12,the fertility and offspring rate of patients who started treatment at preadolescence was significantly increased (4/5 versus 4/7).Four patients were accepted genital reconstructive surgery ( clitorectomy,clitoroplasty,vulvoplasty) before pregnancy.The incidence of GDM was 1/8.All patients selected caesarean at from 37 +6 gestation weeks to 39+6 gestation weeks.The average newborn birth weight was (3210 ± 447 ) g,and height was (48 ±2) cm of 8 neonates,none of them was CAH.Conclusions Medical and surgical therapy provides satisfactory fertility and pregnancy outcomes for women with 21-OHD.It is safe to pregnant women with 21-OHD and their fetus in continual lower glucocorticoid treatment.The dosage of glucocorticoid should be carefully adjusted during the pregnancy individually according to serum level of 17-OHP.

Protein-protein interactions (PPIs) are not only crucial for the assembly of protein complexes but also fundamental for maintaining normal biological functions. These interactions are vital for protein structure and biological functionality and play a central role in cellular signaling, metabolic pathways, and regulatory networks. The 14-3-3 protein, highly conserved and widely expressed in eukaryotes, primarily recognizes and binds to its partner proteins to participate in essential life processes such as cell cycle control, signal transduction, and energy metabolism. This review discusses the role of dysregulated PPIs between 14-3-3 proteins and their partner proteins such as estrogen receptor α (estrogen receptor α, ERα), RAF proto-oncogene serine/threonine-protein kinase (C-RAF/RAF-1), and p53 in the onset and progression of tumors, focusing on the research progress of 14-3-3/ERα, 14-3-3/C-RAF, and 14-3-3/p53 molecular glues. These molecular glues, by mimicking or enhancing the phosphorylation sites of serine on partner proteins, form covalent bonds, salt bridges, and hydrogen bonds with 14-3-3 proteins, thereby enhancing the stability of PPIs and effectively intervening in protein activity and signaling under pathological conditions. Additionally, this article explores the potential of this chemical intervention strategy in clinically suppressing tumor progression, providing a theoretical foundation and practical guidance for future research directions.

Autophagy is a common phenomenon which widely ex-ists in eukaryotic cells. Researches have shown that autophagy plays a critical role in maintaining cellular hemostasis, cell com-ponents update and keeping a normal physiological state. In re-cent years, the study has found that autophagy is closely related to the growth, the development of cardiovascular diseases and tumors. Further studies show that in different pathological condi-tions, autophagy could both promote angiogenesis and inhibit the formation of blood vessels. Therefore, it is particularly critical to elucidate the mechanisms of autophagy in the regulation of angio-genesis in different pathological conditions. The role of autophagy in cardiovascular diseases especially in the regulation of angio-genesis is discussed in this paper. Besides, the paper also in-cludes the discussion about the mechanisms of autophagy in the regulation angiogenesis, which may provide references for follow-up research and clinical treatment.

To explore a sensitive , stable and handleable method for evaluating phagocytosis of mouse peritoneal macrophages by flow cytometry , and get a set of optimized solutions.Methods: The peritoneal macrophages obtained from ICR mice were divided into two part.One part was used directly ,and another part was 1∶1 diluted.Three fluorescent microsphere concentrations were used (5×106/well,1×107/well and 1.5×107/well).Incubation time were respective 1 h,1.5 h and 2 h.The adherent cells were digested by enzyme or cell scraper.The percentage of phagocytic cells ( PP) and the phagocytic index ( PI) were determined by flow cy-tometry.To verify and confirm the reliability of experiment conditions , effect of JKS on phagocytosis of mouse macrophages were evaluated with flow cytometric assays and chicken red blood-cell method.Results:The higher concentration of fluorescent microspheres meant PP and PI were higher.When cell concentration was 1×105-2×105 ml-1 ,incubation time was 1.5 h,concentration of fluorescent microspheres was 1.5 ×107/well,the PP and PI were the highest (89.87%,1.54).When incubation time was 2 h,the PP and PI declined(57.71%,1.51).Effect of cell concentration on the PP and PI were negatively correlated with fluorescent microspheres .After adherent macrophages were digested by trypsin+EDTA,the PP and PI were 44.51%,0.68.The PP and PI were 37.92%,0.57 after di-gestion by EDTA.The results were lower than using cell scraper.The PP(1 485 mg/kg group) of JKS were higher than control group that were evaluated with flow cytometric assays and chicken red blood-cell method.The difference was statistically significant ( P<0.05 ).Conclusion: These are the optimized solutions for the experiment such as the concentration of peritoneal macrophaes is (1-2)×105,the incubation time is 1 h and the concentration of fluorescent microspheres is 1×107/well.

Objective To analyze the genetic characteristics and the evolution of the influenza A (H3N2) virus strains circulating in Jiangsu province between 2013 and 2014.Methods This study analyzed thirty-one representative strains of influenza A (H3N2) virus, which were isolated in different regions of Jiangsu province and during different time periods from 2013 to 2014.Results Genetic distances in nucleic acid and amino acid between a strain used for vaccine production (A/Texas/50/2012) and the 31 strains were 0.010 5 and 0.012 4.Similarities between them in nucleic acid and amino acid sequences were 97.9%-99.6% and 97.2%-99.3%.Phylogenetic analysis showed that the hemagglutinin (HA) genes of the 31 strains were divided into three different groups.Three strains isolated in 2013 and three strains isolated in 2014 belonged to Group 1 and Group 2, respectively, while the others belonged to Group 3.Three positive selection sites (237, 366 and 367) in HA protein were observed by REL model.Compared with the strain used for vaccine production, the 31 strains were characterized by amino acid substitutions (N128A/T and P198S/A) in HA protein and all of the mutations located in B-cell epitopes.The total number of mutation sites reached 24.Compared with the A/Texas/50/2012 strain, seven strains presented the glycosylation site 126NWT, and three strains showed disappeared glycosylation sites of 45NSS and 144NNS.Evaluation of vaccine efficacy for A(H3N2) virus strains showed that the vaccine efficacy was not very well.Conclusion The HA gene of A(H3N2) virus had undergone a greater variation and the vaccine efficacy was not very well in Jiangsu province during 2013 to 2014, which made the influenza A(H3N2) virus become the circulating strain.

OBJECTIVETo explore the distribution, combination and evolution of various syndromic etiologies of erectile dysfunction (ED) based on the syndrome etiology theory.

METHODSUsing the ED Syndromic Etiology Scale, we collected the clinical data on the Chinese medicine diagnoses of 297 cases of ED, extracted the core syndromic etiologies by analysis of principal components and factors, and analyzed the patterns of distribution, combination, and evolution of ED syndromic etiologies according to the general information of the patients.

RESULTSThrough analysis of principal components and factors, 9 core syndromic etiologies were extracted, i. e. , liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, blood stasis, kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, and phlegm-damp. Each of these syndrome etiologies exhibited its own specific distribution patterns. Of the total number of cases studied, 51.52% had 2 or 3 core syndromic etiologies and 36.03% had only one.

CONCLUSIONIn the early stage of ED, its syndromic etiologies are usually liver constraint with qi stagnation, kidney yin deficiency, damp-heat, liver constraint transforming into liver-fire, and blood stasis. With the natural progres- sion of the disease, its syndromic etiologies gradually evolve into kidney yang deficiency, heart-spleen paired deficiency, qi-yin paired deficiency, phlegm-damp, and blood stasis, and finally into yin-yang deficiency of the heart, spleen and kidneys, combined with phlegm-damp and blood stasis.

Adult ; Erectile Dysfunction ; diagnosis ; drug therapy ; etiology ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged

OBJECTIVESTo investigate the effect of nafate (compound fetal cow liver extract tablets) in hepatic fibrosis patients with chronic liver diseases.

METHODSOne hundred fifteen hepatic fibrosis patients with chronic liver diseases from 3 medical centers were included in this study. All patients were given nafate orally for twenty-four weeks. Before treatment and 12, 24 and 36 weeks after the treatment, serum levels of hyaluronic acid (HA), laminin (LN) and type IV collagen (IV-C) of the patients were measured by radioimmunoassay and their liver biopsy specimens were also assessed.

RESULTSBefore treatment and 24 and 36 weeks after the nafate treatment, serum levels of HA were (279.2+/-81.4) ng/ml, (136.8+/-56.7) ng/ml and (86.9+/-40.7) ng/ml respectively, serum levels of LN were (170.8+/-73.0) ng/ml, (112.5+/-39.5) ng/ml, and (60.8+/-31.8) ng/ml respectively, and IV-C levels were (153.7+/-60.1) ng/ml, (112.4+/-43.1) ng/ml, and (96.3+/-44.1) ng/ml respectively. There was a significant reduction in these serum values after the treatments. Histopathological examinations of the liver biopsies showed that the degree of hepatic fibrosis obviously declined by one or two degrees after the treatments.

CONCLUSIONSnafate has positive effects in treating hepatic fibrosis.

Adult ; Aged ; Animals ; Cattle ; Drug Combinations ; Female ; Humans ; Liver Cirrhosis ; therapy ; Liver Extracts ; therapeutic use ; Male ; Middle Aged ; Young Adult

Objective To evaluate the clinical effect of levothyroxine sodium on serum lipid levels and thyroid function in pregnant women with hypothyroidism.Methods Fifty-two pregnancy patients with hypothyroidism were randomly divided into control group and treatment group,26 cases in each group.The control group was given conventional therapy,including the amount of added salt,plenty of high quality protein,appropriate low-fat diet.Treatment group was treated with levothyroxine sodium 50 μg,qd on the basis of control group.Levels of serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),serum thyroid stimulating hormone (TSH),free thyroid hormone (FT4),free three iodine thyroid acid (FT3) and incidence of pregnancy complications were compared between the two groups.Results After treatment,levels of TC in treatment and control groups were (4.22 ± 0.59),(5.32 _ 0.69) mmol · L-1.Levels of TG in treatment and control groups were respectively (2.11 ±0.25),(2.84 ±0.39) mmol· L-1.Levels of LDL-C in treatment and control groups were (2.18 ±0.31),(3.11 ±0.37) mmol · L-1.Levels of HDL-C in treatment and control groups were (1.82 ±0.26),(1.56 ±0.22) mmol · L-1.Levels of TSH in treatment and control group were (2.03 ± 0.25),(2.45 ± 0.34) pmol · L-1.Levels of FT4 in treatment and control groups were respectively (18.43 ±2.61),(10.84 ± 1.57) pmol · L-1.Levels of FT3 in treatment and control groups were (5.73 ± 0.81),(3.35 ±0.47) pmol · L-1.There were significant difference in TC,TG,LDL-C,HDL-C,TSH,FT4,FT3 between the two groups after treatment (P ＜ 0.05).There were 2 cases of gestational hypertension,1 case of gestational diabetes mellitus,1 case of intrahepatic cholestasis,2 cases of fetal growth restriction,the incidence of pregnancy complications was 23.08％ (6/26).There were 1 case of hypertension,1 case of gestational diabetes mellitus,1 case of intrahepatic cholestasis,and the incidence of pregnancy complications was 11.54％ (3/26),the difference had no statistical significance (P ＞ 0.05).Conclusion Levothyroxine sodium can significantly reduce the levels of blood lipids in pregnancy patients with hypothyroidism,improve thyroid function,and reduce the incidence of pregnancy complications.

Objective To study the influencing factors and understanding situation of Alzheimer' s disease among medical workers.Methods Totals of 200 staffs and nurses were randomly selected from three hospitals.Self-designed questionnaire and Alzheimer' s disease knowledge scale was used to measure the understanding situation of medical workers.Results The average score of ADKS was ( 60.20 ± 11.940 ),and the dimensions score was life influencing (80.83 ± 24.656),treatment and management (76.25 ± 24.137),course of disease ( 62.13± 23.508),risk factors ( 61.75± 21.708 ),assessment and diagnosis ( 61.63 ±23.090),symptom(51.50 ± 26.003 ),care ( 37.40 ± 20.081 ).And multiple linear regressions indicated that working,AD knowledge training,family members with AD/related obstacles,education back ground were the influencing factors of the ADKS score,and those factors were positively correlated with the score of ADKS.Conclusions The understanding situation of Alzheimer' s disease among medical staffs of three hospitals is poor.The scores of all aspects of Alzheimer' s disease knowledge are correlated with many factors,so we can take corresponding measures to improve the understanding of Alzheimer's disease among the medical workers.

The endocannabinoid system(ECS)consists of a variety of long-chain unsaturated fatty acid analogs,mainly anandamide(AEA)and 2-arachidoniyl glycerol(2-AG),along with their specific binding G protein-coupled receptors,cannabinoid receptor 1(CB1R)and cannabinoid receptor 2(CB2R).It affects the life process and biological activity of almost all cells in the body by influencing cell material and energy metabolism.In the liver,the physiological expression of ECS is at a low level.The expression and secretion of ECS in the liver can be strongly stimulated by liver injury factors.ECS acts as a trigger in multiple liver diseases.It is known to be related to the process of hepatocyte steatosis and promote the formation and development of non-alcoholic fatty liver disease(NAFLD)and alcoholic liver disease(ALD).It is involved in the inflammatory processes of liver diseases and greatly affects the immune-inflammatory response in liver tissue.It is also involved in the formation of liver fibers and promotes the occurrence and development of liver fibrosis and cirrhosis.Finally,the role and mechanisms of ECS in the occurrence and development of liver diseases are elaborated in detail by listing lipid metabolism-related liver diseases(NAFLD and ALD)and other liver diseases.