OBJECTIVE To analyze the components migrating to blood and metabolites of Polygonum cuspidatum in rats with acute gouty arthritis （AGA）. METHODS SD rats were randomly divided into blank group， model group and P. cuspidatum group （10 g/kg， by raw material）， with 6 rats in each group. Except for blank group， AGA model was induced in the remaining groups by injecting potassium oxonate and sodium urate； meanwhile， they were administered corresponding drug solutions or water intragastrically， once a day， for 10 consecutive days. The histopathological morphology of the knee joint tissues in rats was observed；rat serum samples were collected， and the components migrating to blood and metabolites of P. cuspidatum were analyzed by using UPLC-Q-Exactive-Orbitrap-MS. RESULTS Following the intervention with P. cuspidatum， the histopathological morphology of the knee joint synovial tissue in AGA rats showed significant improvement， with reduced inflammatory cell infiltration and hyperplasia， and the preservation of the honeycomb-like structure integrity. In both positive and negative ion modes， a total of 67 chemical components were detected in the serum of rats from P. cuspidatum group， including 25 prototype components and 42 metabolites. The involved compound types encompassed stilbenes， anthraquinones， naphthols， and flavonoids， among others. The metabolic reactions identified included methylation， acetylation， sulfation， and glucuronidation. Notably， compounds such as polydatin， resveratrol and emodin were capable of entering the bloodstream in their prototype forms and undergoing in vivo metabolism. CONCLUSIONS Compounds such as polydatin， resveratrol and emodin are likely to be the active components responsible for the anti-AGA effects of P. cuspidatum.

Objective To observe the value of feature pyramid network(FPN)for automatic segmentation and semantic feature classification of spontaneous intracerebral hemorrhage(sICH)hematoma showed on non-contrast CT.Methods Non-contrast CT images of 408 sICH patients in hospital A(training set)and 103 sICH patients in hospital B(validation set)were retrospectively analyzed.Deep learning(DL)segmentation model was constructed based on FPN to segment the hematoma region,and its efficacy was assessed using intersection over union(IoU),Dice similarity coefficient(DSC)and accuracy.Then DL classification model was established to identify the semantic features of sICH hematoma.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of DL classification model for recognizing semantic features of sICH hematoma.Results The IoU,DSC and accuracy of DL segmentation model for 95％sICH hematoma in training set was 0.84±0.07,0.91±0.04 and(88.78±8.04)％,respectively,which was 0.83±0.07,0.91±0.05 and(88.59±7.76)％in validation set,respectively.The AUC of DL classification model for recognizing irregular shape,uneven density,satellite sign,mixed sign and vortex sign of sICH hematoma were 0.946-0.993 and 0.714-0.833 in training set and validation set,respectively.Conclusions FPN could accurately,effectively and automatically segment hematoma of sICH,hence having high efficacy for identifying semantic features of sICH hematoma.

OBJECTIVE: To investigate the diagnostic efficacy of targeted biopsy (TBx), systematic biopsy (SBx), TBx+6-core SBx in prostate cancer (PCa) / clinically significant prostate cancer (cs-PCa) for patients with prostate imaging reporting and data system (PI-RADS) score of 5, and thereby to explore an optimal sampling scheme. METHODS: The data of 585 patients who underwent multiparametric magnetic resonance imaging (mpMRI) with at least one lesion of PI-RADS score 5 at Peking University First Hospital from January 2019 to June 2022 were retrospectively analyzed. All patients underwent mpMRI / transrectal ultrasound (TRUS) cognitive guided biopsy (TBx+SBx). With the pathological results of combined biopsy as the gold standard, we compared the diagnostic efficacy of TBx only, SBx only, and TBx+6-core SBx for PCa/csPCa. The patients were grouped according to mpMRI T-stage (cT2, cT3, cT4) and the detection rates of different biopsy schemes for PCa/csPCa were compared using Cochran's Q and McNemar tests. RESULTS: Among 585 patients with a PI-RADS score of 5, 560 (95.7%) were positive and 25(4.3%) were negative via TBx+SBx. After stratified according to mpMRI T-stage, 233 patients (39.8%) were found in cT2 stage, 214 patients (36.6%) in cT3 stage, and 138 patients (23.6%) in cT4 stage. There was no statistically significant difference in the detection rate of PCa/csPCa between TBx+6-core SBx and TBx+SBx (all P>0.999). Also, there was no statistically significant difference in the detection rate of PCa/csPCa between TBx and TBx+SBx in the cT2, cT3, and cT4 subgroups (PCa: P=0.203, P=0.250, P>0.999; csPCa: P=0.700, P=0.250, P>0.999). The missed diagnosis rate of SBx for PCa and csPCa was 2.1% (12/560) and 1.8% (10/549), and that of TBx for PCa and csPCa was 1.8% (10/560) and 1.4% (8/549), respectively. However, the detection rate of TBx+6-core SBx for PCa and csPCa was 100%. Compared with TBx+SBx, TBx and TBx+6-core SBx had a fewer number of cores and a higher detection rate per core (P < 0.001). CONCLUSION For patients with a PI-RADS score of 5, TBx and TBx+6-core SBx showed the same PCa/csPCa detection rates and a high detection rates per core as that of TBx+SBx, which can be considered as an optimal scheme for prostate biopsy.
Male ; Humans ; Prostatic Neoplasms/pathology* ; Magnetic Resonance Imaging/methods* ; Retrospective Studies ; Prostate/diagnostic imaging* ; Image-Guided Biopsy/methods*

OBJECTIVE: To assess the efficacy and safety of mulberry twig alkaloids (Sangzhi alkaloids, SZ-A) for treatment of type 2 diabetes in a randomized, double-blind, placebo-controlled multicenter clinical trial. METHODS: A total of 200 patients were randomized to receive SZ-A (n=100) or placebo (n=100) for 16 weeks. The data analysis system for electronic data capture clinical trial central randomization system was used for randomization and dispensing of drugs. The primary outcome was the change in glycosylated hemoglobin (HbA1c) level. The secondary outcome included the proportions of cases with HbA1c <7.0% and HbA1c <6.5%, fasting blood glucose (FBG), postprandial blood glucose (PBG), area under curve for the PBG (AUC_0-2h), body weight, and body mass index (BMI). Adverse events (AEs), severe adverse events (SAEs), treatment-related adverse events (TAEs), gastrointestinal disorders (GDs), blood pressure, routine blood tests, and liver and kidney function were monitored. RESULTS: Compared with baseline, the change of HbA1c at week 16 was -0.80% (95% CI: -0.98% to -0.62%) and -0.09% (95% CI: -0.27% to 0.09%) in SZ-A group and placebo group, respectively. The proportion of patients with HbA1c <7% and <6.5% was higher in the SZ-A group than in the placebo group (46.8% vs. 21.6% and 29.9% vs. 10.8%). The observed values and changes in FBG, 1 h-PBG, 2 h-PBG, and AUC_0-2h differed significantly between groups (P<0.001), but differences were not significant in body weight and BMI (P>0.05). The incidence rates of AEs, TAEs, and GDs differed significantly between groups (P=0.010, P=0.005, and P=0.006, respectively), whereas the incidence rates of SAEs showed no significant differences between groups (P=1.000). CONCLUSION SZ-A are effective and safe for treatment of type 2 diabetes. The protocol was registered in http://www.chictr.org.cn/showproj.aspx?proj=60117 (ChiCTR2000038550).
Alkaloids ; Blood Glucose ; Diabetes Mellitus, Type 2/drug therapy* ; Double-Blind Method ; Glycated Hemoglobin A ; Humans ; Hypoglycemic Agents/therapeutic use* ; Morus ; Tablets/therapeutic use* ; Treatment Outcome

OBJECTIVETo investigate the effect of ceftriaxone on the intestinal epithelium and microbiota in mice in the early-life stage, as well as the recovery of the intestinal epithelium and reconstruction of intestinal microbiota in adult mice.

METHODSA total of 36 BALB/C neonatal mice were randomly divided into control group and experimental group, with 18 mice in each group. The mice in the experimental group were given ceftriaxone 100 mg/kg every day by gavage within 21 days after birth. Those in the control group were given an equal volume of normal saline by gavage. Immunohistochemistry was used to measure the expression of Ki67, Muc2, and ZO-1 in the intestinal epithelium. qPCR and next-generation sequencing were used to analyze the overall concentration and composition of fecal bacteria.

RESULTSAfter 21 days of ceftriaxone intervention, the experimental group had a significant reduction in body weight, a significant reduction in the expression of Ki67 and ZO-1 and a significant increase in the expression of Muc2 in intestinal epithelial cells, a significant reduction in the overall concentration of fecal bacteria, and a significant increase in the diversity of fecal bacteria compared with the control group (P<0.05). Firmicutes was the most common type of fecal bacteria in the experimental group, and there were large amounts of Staphylococcus and Enterococcus. The experimental group had a certain degree of recovery of the intestinal epithelium, but there were still significant differences in body weight and the structure of intestinal microbiota between the two groups at 56 days after birth (P<0.05).

CONCLUSIONSEarly ceftriaxone intervention significantly affects the development of the intestinal epithelium and the construction of intestinal microbiota in the early-life stage. The injury of the intestinal microbiota in the early-life stage may continue to the adult stage and affect growth and development and physiological metabolism.

Animals ; Animals, Newborn ; Anti-Bacterial Agents ; pharmacology ; Ceftriaxone ; pharmacology ; Female ; Gastrointestinal Microbiome ; drug effects ; Intestinal Mucosa ; drug effects ; Ki-67 Antigen ; analysis ; Mice ; Mice, Inbred BALB C ; Mucin-2 ; analysis ; Zonula Occludens-1 Protein ; analysis

Intensity-modulated radiotherapy(IMRT)is the first-line treatment for nasopharyngeal carcinoma currently. Previous studies have shown that regression of primary tumor and metastatic lymph nodes or a decrease in body weight causes the contour of normal organs and head-and-neck to shrink during the course of radiotherapy, which may lead to underdose in primary tumor and overdose in organs at risk (OARs)and then adversely affect treatment outcomes. Replanning during the course of radiotherapy can maintain the dose to target volume and reduce the exposure of OARs, which improves outcomes in some patients. For replanning during the course of IMRT, however, the advantages have not been widely recognized and there is still a long way to go before widely accepted timing and frequency of replanning are set up. Further studies are needed to figure out how to identify patients appropriate for plan modification.

Objective To investigate the value of FDG PET-CT in the outcome assessment and prognostic evaluation for recurrent nasopharyngeal carcinoma (rNPC).Methods From January 2008 to December 2013,92 rNPC patients were treated in our center,who were histologically or radiologically diagnosed and re-staged according to the 2008 clinical staging system for nasopharyngeal carcinoma in China.The numbers of patients in stage Ⅰ,stage Ⅱ,stage Ⅲ,and stage Ⅳ were 8,11,39,and 34,respectively.According to the recurrent T stage (rT),the numbers of patients in rT1,rT2,rT3,and rT4 were 10,11,38,and 33,respectively.Twenty-eight patients had recurrence in the neck lymph nodes.All patients underwent pretreatment FDG PET-CT for the whole body or head/neck,and treated by radiotherapy with or without chemotherapy.The relationship of maximum standard uptake value (SUVmax) and clinical factors with clinical outcomes was analyzed.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS),and distant metastasis-free survival (DMFS).The log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox model was used for multivariate prognostic analysis.Results The 3-year OS,DFS,LRFS,RRFS,and DMFS were 33.6％,32.1％,32.8％,31.8％,and 33.7％,respectively.The median SUVmax was 8.35 (2.7-21.5).The SUVmax of 7.0 was taken as the optimal cut-off value for all patients.Patients with SUVmax ≤7.0 had a significantly higher 3-year OS rate than those with SUVm ax ＞7.0 (42.0％ vs.28.3％,P=0.019).The univariate analysis revealed that patient age,SUV and rN were significantly associated with OS (P=0.023,0.019,and 0.002).The multivariate analysis showed that SUVmax and rN were significant influencing factors for OS,DFS,and DMFS (HR=1.68,P=0.045 and HR=2.23,P=0.003;HR=1.67,P=0.042 and HR=2.39,P=0.001;HR=1.77,P=0.025 and HR=2.40,P=0.001).Conclusions SUVmax may be one of the useful prognostic factors for OS,DFS,and DMFS in rNPC patients.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is the integration of functional imaging and anatomic information,which is found to be particularly valuable in TNM staging,tumor volume delineating,post-treatment assessment,identification of recurrent and residual nasopharyngeal carcinoma (NPC).The combination of 18F-FDG PET-CT with other image technologies,different tracer agents,and specific molecular biomarkers can improve the application value of 18F-FDG PET-CT in NPC.

The present study was designed to isolate and purify chemical constituents from solid culture of endophyte Aspergillus terreus LQ, using silica gel column chromatography, gel filtration with Sephadex LH-20, and HPLC. Fumigaclavine I (1), a new alkaloid, was obtained, along with seven known compounds, including fumigaclavine C (2), rhizoctonic acid (3), monomethylsulochrin (4), chaetominine (5), spirotryprostatin A (6), asperfumoid (7), and lumichrome (8). The structure of compound 1 was elucidated by various spectroscopic analyses (UV, MS, 1D and 2D NMR). The in vitro cytotoxicity of compound 1 was determined by MTT assay in human hepatocarcinoma cell line SMMC-7721, showing weaker cytotoxicity, compared with cisplatin, a clinically used cancer chemotherapeutic agent.
Antineoplastic Agents ; chemistry ; isolation & purification ; Aspergillus ; chemistry ; isolation & purification ; Cell Line, Tumor ; Cell Survival ; drug effects ; Endophytes ; chemistry ; isolation & purification ; Ergot Alkaloids ; chemistry ; isolation & purification ; Humans ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Oryza ; microbiology

OBJECTIVETo explore the safety and feasibility of cervical triangulating stapled anastomosis(TSA) for esophagogastric anastomosis(EGA) after minimally invasive esophagectomy (MIE).

METHODSClinical data of 137 patients undergoing MIE for esophageal cancer(EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared.

RESULTSCervical anastomotic leakage occurred in 3 patients(3.9%) of TSA group, but in six(10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively(P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications.

CONCLUSIONSTSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.

Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Neck ; surgery ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome