The identification of the components absorbed in serum of platycosides in total saponins fraction of Platycodonis Radix is great significance, but there are still great challenges. In this study, 8 types of 44 primordial components from Platycodon saponins were firstly identified using the ultra-performance liquid chromatography-linear ion trap electrostatic field orbitrap high resolution mass spectrometry (UPLC-LTQ-Orbitrap-MS) equipped with the software of Compound Discoverer 3.2 and Trace finder 2.1. Then, the platycosides and their deglycosylated metabolites were used as the template molecules to construct the intestinal microbiota mediated method to identify the primary components and the prototypes in serum. As results, 57 components originating from 44 prototypes of platycosides were identified from drug-containing plasma. Those compounds consist of 12 prototypes of platycosides and 45 metabolites, while the prototypes in serum are also deglycosylated metabolites of other platycosides. The results showed that the intestinal microbiota mediated method could be applied to identify the metabolites of platycosides in total saponins fraction of Platycodonis Radix; and reveal the potential existing forms of prototypes of platycosides in plasma; In addition, it could clearly illustrate the one to many and many to one network of the prototypes and metabolites of platycosides. All animal protocols were approved by the Animal Ethics Committee of Jiangxi University of Traditional Chinese Medicine (No.JZLLSC-202100322).

In 2020, the prevalence of abnormal spinal curvature among 54 079 students in Shandong Province was 1.54%. The multivariate logistic regression model analysis showed that, compared with those in primary school, economically underdeveloped areas, and non-residential schools, students in middle and high schools, economically average areas, and residential schools had a higher risk of abnormal spinal curvature, with OR (95%CI) values of 2.029 (1.662-2.476), 2.746 (2.208-3.416), 2.237 (1.740-2.875) and 2.057 (1.705-2.483), respectively. Compared with those in economically underdeveloped areas, who were underweight, who had seat adjustments≤1 time per academic year, and who had physical education classes≤1 per week, students in economically developed areas, who were normal weight, overweight, and obese, who had seat adjustments≥2 times per academic year, and who had physical education classes 2-3 or≥4 per week, had a lower risk of abnormal spinal curvature, with OR (95%CI) values of 0.690 (0.521-0.915), 0.722 (0.546-0.955), 0.535 (0.389-0.735), 0.383 (0.274-0.535), 0.835 (0.711-0.980), 0.561 (0.474-0.663) and 0.491 (0.315-0.766), respectively.
Humans ; Risk Factors ; Prevalence ; Spinal Curvatures ; Schools ; Students

In 2020, the prevalence of abnormal spinal curvature among 54 079 students in Shandong Province was 1.54%. The multivariate logistic regression model analysis showed that, compared with those in primary school, economically underdeveloped areas, and non-residential schools, students in middle and high schools, economically average areas, and residential schools had a higher risk of abnormal spinal curvature, with OR (95%CI) values of 2.029 (1.662-2.476), 2.746 (2.208-3.416), 2.237 (1.740-2.875) and 2.057 (1.705-2.483), respectively. Compared with those in economically underdeveloped areas, who were underweight, who had seat adjustments≤1 time per academic year, and who had physical education classes≤1 per week, students in economically developed areas, who were normal weight, overweight, and obese, who had seat adjustments≥2 times per academic year, and who had physical education classes 2-3 or≥4 per week, had a lower risk of abnormal spinal curvature, with OR (95%CI) values of 0.690 (0.521-0.915), 0.722 (0.546-0.955), 0.535 (0.389-0.735), 0.383 (0.274-0.535), 0.835 (0.711-0.980), 0.561 (0.474-0.663) and 0.491 (0.315-0.766), respectively.
Humans ; Risk Factors ; Prevalence ; Spinal Curvatures ; Schools ; Students

Objective: To investigate the safety, feasibility and short-term efficacy of total laparoscopic loop ileostomy reversal in patients after resection of rectal cancer. Methods: The clinical data of 20 patients who underwent total laparoscopic loop ileoscopic loop ileostomy after radical resection of rectal cancer at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, or Beijing Chaoyang District Sanhuan Cancer Hospital from October 2019 to June 2020 were collected and retrospectively analyzed. Results: All patients had successfully underwent total laparoscopic ileostomy reversal without conversion to open surgery or discontinued operation. No perioperative related death cases were found. In the whole group, the median operation time was 97 (60-145) minutes and the median intraoperative blood loss was 20 (10-100) milliliters. The median Visual Analogue Scale (VAS) score was 1.9 (1-5) one day after the operation. Nobody needed to use additional analgesic drugs. The median time to grand activities was 25 (16-42) hours, the median time to flatus was 44 (19-51) hours, and the median hospitalization after operation was 6.9 (5-9) days. No patients underwent operation related complications such as operative incision infection, abdominal and pelvic infection, intestinal obstruction, anastomotic leakage, bleeding and so on. Conclusions: Total laparoscopic loop ileostomy reversal appears to be safe, feasible and with promising efficacy for selected patients.
Humans ; Ileostomy ; Retrospective Studies ; Laparoscopy ; Rectal Neoplasms/surgery* ; Anastomotic Leak ; Anastomosis, Surgical

BACKGROUND: A deep learning model (DLM) that enables non-invasive hypokalemia screening from an electrocardiogram (ECG) may improve the detection of this life-threatening condition. This study aimed to develop and evaluate the performance of a DLM for the detection of hypokalemia from the ECGs of emergency patients. METHODS: We used a total of 9908 ECG data from emergency patients who were admitted at the Second Affiliated Hospital of Nanchang University, Jiangxi, China, from September 2017 to October 2020. The DLM was trained using 12 ECG leads (lead I, II, III, aVR, aVL, aVF, and V1-6) to detect patients with serum potassium concentrations <3.5 mmol/L and was validated using retrospective data from the Jiangling branch of the Second Affiliated Hospital of Nanchang University. The blood draw was completed within 10 min before and after the ECG examination, and there was no new or ongoing infusion during this period. RESULTS: We used 6904 ECGs and 1726 ECGs as development and internal validation data sets, respectively. In addition, 1278 ECGs from the Jiangling branch of the Second Affiliated Hospital of Nanchang University were used as external validation data sets. Using 12 ECG leads (leads I, II, III, aVR, aVL, aVF, and V1-6), the area under the receiver operating characteristic curve (AUC) of the DLM was 0.80 (95% confidence interval [CI]: 0.77-0.82) for the internal validation data set. Using an optimal operating point yielded a sensitivity of 71.4% and a specificity of 77.1%. Using the same 12 ECG leads, the external validation data set resulted in an AUC for the DLM of 0.77 (95% CI: 0.75-0.79). Using an optimal operating point yielded a sensitivity of 70.0% and a specificity of 69.1%. CONCLUSIONS In this study, using 12 ECG leads, a DLM detected hypokalemia in emergency patients with an AUC of 0.77 to 0.80. Artificial intelligence could be used to analyze an ECG to quickly screen for hypokalemia.
Artificial Intelligence ; Deep Learning ; Electrocardiography ; Humans ; Hypokalemia/diagnosis* ; Retrospective Studies

Objective:To investigate the effects of Daizongfang （DZF） on insulin resistance （IR） of adipocytes induced by different methods. Method:The cocktail induction method was adopted to induce the differentiation and maturity of 3T3-L1 preadipocytes. An IR model in mature adipocytes was established by the induction of palmitic acid （PA）， high-concentration glucose （HG）， and dexamethasone （DEX）. DZF extracts at different concentrations （2.0， 0.5， 0.1 g·L^-1） intervened for 24 hours. A model group， a rosiglitazone （RSG） group， and a blank control group were set up at the same time. The glucose concentration in the culture supernatant was measured by the glucose oxidase-peroxidase （GOD-POD） method. Glucose consumptions under basic conditions （G_Basic） and insulin stimulation （G_Ins） were calculated to evaluate the insulin sensitivity index （ISI）. The mRNA expression of glucose transporter 4 （GLUT4） was detected by the real-time polymerase chain reaction （PCR）. Result:Compared with the model group， the DZF （2.0 g·L^-1） showed increased G_Basic， G_Ins， and ISI in three IR models （P<0.05， P<0.01）. In addition， for the PA-induced IR model， G_Basic and G_Ins in the DZF （0.5 g·L^-1） group were elevated （P<0.01）， and G_Basic， G_Ins， and ISI in the RSG group increased （P<0.05， P<0.01）. For the HG-induced IR model， G_Ins and ISI increased in the DZF （0.5 g·L^-1） group （P<0.05）， and G_Basic， G_Ins， and ISI were elevated in the RSG group （P<0.01）. For the DEX-induced IR model， G_Ins and ISI increased in the RSG group （P<0.01）. In the three models， there were differences among groups with different doses. G_Basic， G_Ins， and ISI in the high-dose DZF group increased in varying degrees compared with those in the medium- and low-dose DZF groups （P<0.05）. In the three models， the DZF （2.0 g·L^-1） group and the RSG group both increased GLUT4 mRNA expression （P<0.05）. Conclusion:DZF can reduce IR of adipocytes induced by HG， DEX， or PA in a dose-dependent manner and increase glucose uptake in an insulin-independent manner， which may be related to the increase in GLUT4 expression.

Objective To investigate the survival period of Yunnan Province-derived smooth-shelled Oncomelania snails bred in laboratory. Methods Oncomelania snails were sampled from Heqing and Yongsheng counties where schistosomiasis is endemic, and uninfected adult snails were collected and bred in laboratory. The survival period of snails sampled from these two counties was compared. Results The 1-, 2-, 3- and 4-year survival rates of laboratory-bred smooth-shelled snails sampled from Yunnan Province were 72.36%, 29.11%, 13.08% and 0.21%, respectively, and were 74.66%, 38.91%, 19.46% and 0.45% for snails derived from Heqing County, and 70.36%, 20.55%, 7.51% and 0 for snails sampled from Yongsheng County, respectively. The mean and median survival period of Yunnan Province-derived adult snails was 20.90 and 20.67 months, and there were significant differences between the snails sampled from Heqing and Yongsheng counties in terms of the mean (22.94 vs. 19.13 months, P < 0.05) and median survival period (21.63 vs. 19.81 months, P < 0.05). Conclusion The mean survival period of Yunnan Province-derived smooth-shelled adult snails is approximately 20 months in laboratory, and the survival varies in geographical areas.

Background:Conventional treatment has limited efficacy in relapsed/refractory B-cell lymphoma.Since chimeric antigen receptor Tcell (CAR-T) technology has shown high safety and results in high remission rates,we investigated its efficacy and safety in B-cell lymphoma treatment and analyzed potential affecting factors to provide evidence for therapeutic strategies and applications.Methods:We searched databases including PubMed,Embase,and Cochrane up to July 2019.Meta-analysis 1 was conducted to study the efficacy of CAR-T cell for treating B-cell lymphoma,measuring the response rate and complete remission rate as outcomes.Sub-group analysis was performed for age,pathological type,target antigen,co-stimulatory molecule,and conditioning chemotherapy.Meta-analysis 2 was undertaken on the safety of the treatment with the incidence rate of toxicity (cytokine-releasing syndrome [CRS],neurotoxicity) as an outcome.Results:Seventeen studies were included in the systematic review and meta-analysis.It was found that CAR-T cells had good therapeutic effects in the following cases:B-cell lymphoma (patients ≥65 years old);diffuse large B-cell lymphoma pathological type;patients with treatment target antigen other than CD 19;patients treated with co-stimulatory molecules other than CD28,including 4-1BB+CD28 or 4-1BB;and patients treated with cyclophosphamide/fludarabine pre-treatment protocol conditioning chemotherapy.Although the CRS and neurotoxicity incidences were high,most were reversible with minimal risk of death.Conclusion:CAR-T cell treatment is safe for clinical annlication:however,toxicity effects should be monitored.

Objective: To observe the effect of an active fraction of Polyrhachis vicina (AFPV) on systemic lupus erythematosus (SLE) and its possible mechanism based on animal and cell models. Method: Totally 60 SD rats were randomly divided into normal control group, model group, prednisone acetate group (5 mg·kg^-1), and high, medium and low-dose AFPV groups (400, 200, 100 mg·kg^-1). SLE model was replicated with bovine serum albumin-Freund's complete (incomplete) adjuvant. Arthus reaction was observed to study the effect of AFPV on the diameter of back skin redness in rats with SLE. The expressions of anti-double-stranded DNA (dsDNA) antibody, complements 3 (C3), complement 4 (C4), immunoglobulin M (IgM), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-31 (IL-31) and interleukin-33 (IL-33) in serum were detected by enzyme-linked immunosorbent assay. CD4⁺T cells were isolated from the spleens of MRL/lpr and C57BL/6J mice at the age of 16 to 18 weeks by immunomagnetic beads method. The expressions of miR-200a and miR-155 and the levels of zinc-finger-enhancer binding protein 1(ZEB1) and suppressor of cytokine signaling1(SOCS1) in CD4⁺T cells were observed to explore the effect of AFPV on SLE and its possible mechanism. Result: Compared with the normal group, the diameter of back skin swelling in the model group was significantly increased (P<0.01). Compared with the model group, the high and medium-dose AFPV groups significantly reduce the skin redness on the back of SLE rats (P<0.05, P<0.01); Compared with the normal group, the serum levels of IgM, IL-6 and IL-33 were significantly increased in the model group (P<0.05). Compared with the model group, the serum levels of IgM, IL-6 and IL-33 were significantly decreased after the intervention of AFPV (P<0.05). Compared with the normal group, the expression of miR-200a was significantly decreased (P<0.01), and its target protein ZEB1 was significantly increased (P<0.01) in the CD4⁺T cells of MRL/lpr lupus mice. Compared with the model group, the expression of microRNA-200a increased significantly, the expression of microRNA-155 decreased significantly (P<0.01), the level of ZEB1 decreased significantly, and the expression of SOCS1 increased significantly after AFPV intervention(P<0.01). Conclusion: AFPV has therapeutic effect on rats with SLE, its mechanism may be related to the regulation of miR-200a/ZEB1 and miR-155/SOCS1.

Objective To assess the effectiveness of infectious source control at various stages of transmission control of schistosomiasis in Eryuan County of Yunnan Province, so as to provide insights into the further monitoring and management of infectious sources of schistosomiasis. Methods Wenbi Village, a plateau subtype region and Qiandian Village, a mountain subtype region in Eryuan County were selected as the study areas. The species, schistosome infection and transmission capability of infectious sources were investigated in Wenbi and Qiandian villages in 2011 and 2018 and were compared. Results Schistosome infections were detected in human, bovine, horse, dog and mouse in Qiandian Village in 2011, with positive rates of 1.19%, 0.91%, 1.25%, 3.13% and 0.95%, respectively, and human, bovine and dog were found to have schistosome infections, with positive rates of 0.76%, 1.66% and 9.30%, respectively. However, no infections were identified in human, bovine, horse, pig, dog, sheep or mouse in these two villages in 2018. A total of 731 wild feces were collected in both villages in 2011. In Qiandian Village, horse, bovine and dog feces accounted for 34.40%, 29.80% and 20.20% of all fecal samples, and dog and horse feces were found to have schistosome infections (11.94% and 6.90% positive rates, respectively). In Wenbi Village, dog, bovine and human feces accounted for 44.59%, 39.83% and 14.29% of all fecal samples, and dog, human and bovine feces were found to have schistosome infections (16.95%, 9.52% and 2.33% positive rates, respectively). In 2018, a total of 204 wild feces were collected in both villages, and no schistosome infections were identified. Sheep, dog and bovine feces accounted for 36.27%, 33.33% and 27.45% of all fecal samples in Qiandian Village, and dog, bovine and human feces accounted for 72.55%, 11.76% and 10.78% of all fecal samples in Wenbi Village. Conclusions A remarkable achievement has been obtained in the control of infectious sources of schistosomiasis in Eryuan County, and the role of human and bovine as the major infectious sources of schistosomiasis has been effectively controlled. In the future, the integrated strategy with emphasis on the control of infectious sources should be intensified, and the management of reservoir hosts including dog and mouse should be strengthened.