To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

OBJECTIVE To understand the safety of Ilaprazole sodium for injection in clinical practice. METHODS From Jan. 1st 2019 to Feb. 29th 2020， the data of 3 926 valid hospitalized patients receiving Ilaprazole sodium for injection were collected prospectively from 5 third-level hospitals through CHPS， and the post-marketing safety analysis was performed by using retrospective multicenter single cohort study. At the same time， a nested case-control study （the ratio of trial group and control group was 1∶4） was used to confirm the baseline stability of this study cohort and the correlation between adverse reactions and Ilaprazole sodium for injection. RESULTS Among 3 926 patients， 3 patients experienced 5 adverse drug events after using Ilaprazole sodium for injection， with the incidence of 0.076%. There was no serious adverse event， and the occurrence time was 2 days after medication； adverse drug events mainly include elevated liver function indicators （alanine transaminase， aspartate transaminase， total bilirubin）， which were mild and untreated， and all adverse drug events were improved. The results of the nested case-control study showed that the trial group and the control group belonged to the same background baseline， and the occurrence of adverse drug events was more closely related to Ilaprazole sodium for injection. CONCLUSIONS The overall safety of Ilaprazole sodium for injection is relatively high， and the occurrence of adverse events is more related to it.

BACKGROUND: Cancer stem-like cells (CSCs) are a small subset of cells in tumors that exhibit self-renewal and differentiation properties. CSCs play a vital role in tumor formation, progression, relapse, and therapeutic resistance. B7-H3, an immunoregulatory protein, has many protumor functions. However, little is known about the mechanism underlying the role of B7-H3 in regulating gastric cancer (GC) stemness. Our study aimed to explore the impacts of B7-H3 on GC stemness and its underlying mechanism. METHODS: GC stemness influenced by B7-H3 was detected both in vitro and in vivo . The expression of stemness-related markers was examined by reverse transcription quantitative polymerase chain reaction, Western blotting, and flow cytometry. Sphere formation assay was used to detect the sphere-forming ability. The underlying regulatory mechanism of B7-H3 on the stemness of GC was investigated by mass spectrometry and subsequent validation experiments. The signaling pathway (Protein kinase B [Akt]/Nuclear factor erythroid 2-related factor 2 [Nrf2] pathway) of B7-H3 on the regulation of glutathione (GSH) metabolism was examined by Western blotting assay. Multi-color immunohistochemistry (mIHC) was used to detect the expression of B7-H3, cluster of differentiation 44 (CD44), and Nrf2 on human GC tissues. Student's t -test was used to compare the difference between two groups. Pearson correlation analysis was used to analyze the relationship between two molecules. The Kaplan-Meier method was used for survival analysis. RESULTS: B7-H3 knockdown suppressed the stemness of GC cells both in vitro and in vivo . Mass spectrometric analysis showed the downregulation of GSH metabolism in short hairpin B7-H3 GC cells, which was further confirmed by the experimental results. Meanwhile, stemness characteristics in B7-H3 overexpressing cells were suppressed after the inhibition of GSH metabolism. Furthermore, Western blotting suggested that B7-H3-induced activation of GSH metabolism occurred through the AKT/Nrf2 pathway, and inhibition of AKT signaling pathway could suppress not only GSH metabolism but also GC stemness. mIHC showed that B7-H3 was highly expressed in GC tissues and was positively correlated with the expression of CD44 and Nrf2. Importantly, GC patients with high expression of B7-H3, CD44, and Nrf2 had worse prognosis ( P = 0.02). CONCLUSIONS B7-H3 has a regulatory effect on GC stemness and the regulatory effect is achieved through the AKT/Nrf2/GSH pathway. Inhibiting B7-H3 expression may be a new therapeutic strategy against GC.
Humans ; Cell Line, Tumor ; Neoplasm Recurrence, Local ; NF-E2-Related Factor 2/metabolism* ; Proto-Oncogene Proteins c-akt/metabolism* ; Signal Transduction ; Stomach Neoplasms

Objectives: The number of schools offering school lunches has increased in China. This study examined the dietary quality of the lunches consumed by Chinese school-age children and adolescents, with a focus on comparing school lunches with home lunches. Methods: The first weekday 24-hour dietary recall data of 6~17-year-old students (n=1,084) from the 2011 China Health and Nutrition Survey were analyzed. The subjects were divided into the school lunch group and the home lunch group, and the dietary quality of lunches was compared between the two groups among 6~11-year-old students (n=634; 177 in the school lunch group and 457 in the home lunch group) and 12~17-year-old students (n=450;144 in the school lunch group and 306 in the home lunch group), respectively. Frequently consumed foods, amount of food group intake, food group intake pattern, Dietary Diversity Score (DDS), and Dietary Variety Score (DVS) were examined. Results: The most frequently consumed foods in both lunch groups were rice and pork. An excessive intake of meat and insufficient intake of seafood were noted in both lunch groups. The school lunch group showed a lower level of vegetable consumption than the home lunch group (P=0.017 in 6~11-year-old students, P=0.003 in 12~17-year-old students).Although more students ate meals with a better dietary pattern in the school lunch group than the home lunch group, there were no significant differences in DDS and DVS between the two groups. Conclusions Overall, the dietary quality of lunches was not superior in the school lunch group compared to the home lunch group. This suggests that much room remain for improving dietary quality of school lunches in China.

Objectives: The number of schools offering school lunches has increased in China. This study examined the dietary quality of the lunches consumed by Chinese school-age children and adolescents, with a focus on comparing school lunches with home lunches. Methods: The first weekday 24-hour dietary recall data of 6~17-year-old students (n=1,084) from the 2011 China Health and Nutrition Survey were analyzed. The subjects were divided into the school lunch group and the home lunch group, and the dietary quality of lunches was compared between the two groups among 6~11-year-old students (n=634; 177 in the school lunch group and 457 in the home lunch group) and 12~17-year-old students (n=450;144 in the school lunch group and 306 in the home lunch group), respectively. Frequently consumed foods, amount of food group intake, food group intake pattern, Dietary Diversity Score (DDS), and Dietary Variety Score (DVS) were examined. Results: The most frequently consumed foods in both lunch groups were rice and pork. An excessive intake of meat and insufficient intake of seafood were noted in both lunch groups. The school lunch group showed a lower level of vegetable consumption than the home lunch group (P=0.017 in 6~11-year-old students, P=0.003 in 12~17-year-old students).Although more students ate meals with a better dietary pattern in the school lunch group than the home lunch group, there were no significant differences in DDS and DVS between the two groups. Conclusions Overall, the dietary quality of lunches was not superior in the school lunch group compared to the home lunch group. This suggests that much room remain for improving dietary quality of school lunches in China.

A "general-special integrated" prevention and treatment model for chronic obstructive pulmonary disease (COPD) patients in the community was preliminarily established with the joint effets of specialists from the terital hospital and general practitioners in the community health service center.During the implementation of the model the general practitioners recieved research training and participanted in the research project of COPD management;and the "general-special integrated" outpatient clinic greatly improved the management for COPD patients.Since the establishment of the model,the number of acute attacks of COPD patients was decreased,and the proportion of standardized medication was increased.The model also improved the research ability and clinical competency of general practitioners.The established model provides experiences for the tiered-management for COPD patients in the community.

Objective To observe the effect ofintravitreal injection ofconbercept in the treatment of retinopathy of premature (ROP) and to analyze the factors related to the therapy.Methods A retrospective study.A total of 57 patients (57 eyes) with pre-threshold type 1 (30 patients,30 eyes),threshold ROP (21 patients,21 eyes) and acute aggressive posterior ROP (APROP,6 patients,6 eyes)) from premature infants by retinal screening in Henan Provincial People's Hospital during October 2017 and June 2018 were enrolled in this study.All children were received routinely intravitreal injected 10 mg/ml conbercept 0.025 ml (0.25 mg) within 24 hours after diagnosis.Fundus examination was performed 7 days after injection.The interval of examination was 1-3 weeks according to fundus conditions.The mean follow-up was 30.1 ± 4.6 weeks.For patients with relapse or no response to treatment,repeated intravitreal injection of conbercept or laser photocoagulation therapy was given.The retinal blood vessels of the affected eyes were observed.Logistic stepwise regression analysis was used for the correlation test of multiple factors.Results Among 57 eyes,49eyes and 8 eyes were treated with 1 or 2 times of intravitreal injection of conbercept.After 24 weeks of treatment,in 57 eyes,26 eyes were cured (45.6％),22 eyes improved (38.6％),8 eyes relapsed (14.0％),and 1 eye aggravated (1.8％).The recurrence time was 12.9± 4.5 weeks after the first injection,and the corrected gestational age was 49.0±6.7 weeks.There were significant differences in initial injection time,lesion range among the cure,improved and recurrence eyes (F=5.124,7.122;P＜0.01,＜ 0.01).Parameters of ROP condition,including ROP diagnosis (pre-threshold type 1,threshold and APROP),zone (zone 1 and 2),stage (stage 2 and 3) and plus lesions,were significant different among the cure,improved and recurrence eyes (x2=l 1.784,14.100,6.896,9.935;P＜0.01,＜0.01,＜0.05,＜0.01).Logistic stepwise regression analysis showed that the recurrence rate was correlated with ROP zone,more likely recurrence at zone 1 than zone 2 (Wald=9.879,OR=27.333,P=0.002).No injection-related complications such as endophthalmitis,cataract and glaucoma were found during treatment and follow-up period.Conclusions Intravitreal injection ofconbercept is effective in the treatment of ROP without obvious adverse reactions.Lesion zoning is associated with recurrence after treatment.

Objective To observe the antioxidative dosage-effect relationship of grape seed proanthocyanidin extract (GSPE). Methods The mice were randomly divided into seven groups:blank group, model group, 5 mg/kg GSPE group, 15 mg/kg GSPE group, 45 mg/kg GSPE group, 135 mg/kg GSPE group and 405 mg/kg GSPE group. The mice in blank group were dealt with saline solution by intraperitoneal injection, the others were dealt with D-galactose (120 mg/kg) by intraperitoneal injection for seven weeks to make oxidative damage model. Meanwhile, the mice were given corresponding dose of the drug. Subsequently the level of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) in the serum were measured to observe the antioxidative dosage-effect relationship of GSPE. Results The 45, 135, 405 mg/kg GSPE group reduced the MDA level, and the 15, 45, 135, 405 mg/kg GSPE group increased the SOD activity. Conclusion GSPE has significant antioxidant activity on mice dealt with D-galactose above the dose of 15 mg/kg, suggesting that the clinical use of GSPE should guarantee a certain dose to play a good antioxidant effect.

This study examined the anti-viral effect of ursolic acid on guinea pig cytomegalovirus (GPCMV) and explored the steps of viral replication targeted by ursolic acid. Cytopathic effect assay and MTT method were employed to determine the 50% cellular cytotoxicity (CC(50)), 50% effective concentration (EC(50)) and therapeutic index (TI) with GPCMV. To investigate the specific anti-viral effect of ursolic acid at different temperatures and time points, two other medicines, ganciclovir and Jinyebaidu (JYBD), serving as controls, were studied for comparison. Our results showed that the CC50 of ganciclovir, JYBD and ursolic acid were 333.8, 3015.6, 86.7 μg/mL, respectively; EC(50) of ganciclovir, JYBD and ursolic acid was 48.1, 325.5 and 6.8 μg/mL, respectively; TI of ganciclovir, JYBD and ursolic acid was 7, 9, 13, respectively. Similar with ganciclovir, ursolic acid could inhibit the viral synthesis, but did not affect the viral adsorption onto and penetration into cells. We are led to conclude that the anti-cytomegalovirus effect of ursolic acid is significantly stronger than ganciclovir or JYBD, and the cytotoxic effect of ursolic acid lies in its ability to inhibit viral synthesis.
Animals ; Antiviral Agents ; pharmacology ; Cells, Cultured ; Guinea Pigs ; Roseolovirus ; drug effects ; Triterpenes ; pharmacology

Objective To identify the prevalence and etiology of kidney disease and the related risk factors in type 2 diabetic patients in rural Shanghai.Methods A cross-sectional study in type 2 diabetic patients was conducted in a community of Shanghai.Questionnaire,clinical examination and laboratory tests were completed to collect the information about sociodemographic and healthcare characteristics.Results A total of 1421 eligible patients with complete information were screened from 1487 type 2 diabetic patients between November 2008 and March 2009.Of them,40.75％ were men,59.25％ were women,aged 37-86 (61.33 ± 9.65 ) years old,with diabetic duration of 0.25-43.92 (7.85 ± 6.34) years.Among them,43.42％ had diabetic retinopathy,21.18％ had neuropathy; 69.95％ met the screening definition for hypertension,76.07％ for hyperlipidemia,15.55％ for hyperuricemia and 23.65％ for cardiovascular disease.The control rates of fasting blood glucose,glycosylated hemoglobin,blood pressure and serum cholesterol were 57.71％,33.99％,14.22％ and 2.46％,respectively.The prevalence of kidney disease,diabetic nephropathy and non-diabetic renal disease was 41.31％,18.51％ and 13.44％,respectively; and 9.36％ were diagnosed as renal insufficiency of unknown reasons.Age,diabetic duration,hyperuricemia,diabetic retinopathy and poor control of blood pressure were independently associated with kidney disease;age and poor control of blood pressure were independently associated with diabetic nephropathy; age and hyperuricemia were independent risk factors of renal insufficiency in patients with diabetic nephropathy.Conclusions Although the diabetic duration of these subjects is relatively short,the prevalence of complications including diabetic nephropathy is high.The high prevalence of non-diabetic renal disease shows the importance of further screening and diagnoses for prevention.Strict control of blood glucose,blood pressure,serum cholesterol and serum uric acid are key points of cutting down the prevalence of diabetic nephropathy and chronic kidney disease.