The gut-brain axis (GBA) is a nerve-endocrine mediated bidirectional communication system between the gut and brain, which links the cognition and emotion in brain to peripheral intestinal function. In recent years, many researches have showed that colonized intestinal microbiota plays an important role in the communication between gut and brain. On one hand, microbiota can influence the development and function of brain via GBA. On the other hand, brain can also change the composition of gut microbiota. These findings gradually become a novel medical research highlight, i.e. the microbiota-gut-brain axis. This paper reviews the interaction between gut microbiota and brain via GBA in order to provide supports for studying functions of gastrointestinal tract and brain, as well as the treatment of related diseases.

The traditional approaches of pharmacokinetics (PK) focused on the dynamic changing process of single or several effective components of drugs in vivo,which was noted as limitations for the complexity studies on PK of multicomponent herbal medicine featuring multi-component,multi-target and multi-effect.It was turned into a bottleneck in the modernization process of traditional Chinese medicine,which could have made misunderstanding of pharmacological and toxicological knowledge of Chinese herbal medicine and its combination drugs.Owing to the advanced high-throughput platforms and various big data mining technology,metabolomics was capable for simultaneously detecting and depicting the variations of hundreds or even thousands of small molecules offering new opportunities for the PK studies on some complicated components.This review summarized recent PK studies over multicomponent drugs and chiefly introduced two remarkable applications to metabolomics in pharmacokinetics research,Chinmedomics and Poly-PK,integrating the theories of both metabolomics and traditional PK.The challenges and strengths of the two new strategies were also expounded.

Objective To determine the effect of unfractionated heparin (UFH) on lipopolysaccharide (LPS)-induced expression of chemokines and nuclear factor-κB (NF-κB) signaling pathway. Methods Human pulmonary microvascular endothelial cells (HPMECs) were cultured in vitro, and the cells between passages 3 and 5 were used in the experiments. The cells were divided into control group, LPS challenge group, 1 kU/L or 10 kU/L UFH+LPS group, and NF-κB inhibitor N-tosyl-L-lysyl chloromethyl-ketone (TLCK) group (TLCK+LPS group). HPMECs in LPS challenge group were treated with 10 mg/L LPS. UFH pretreatment with different dosages groups were treated with 1 kU/L or 10 kU/L UFH 15 minutes before LPS challenge. Cells in the TLCK+LPS group were treated with 10 μmol/L of TLCK 30 minutes before the addition of LPS, and HPMECs in control group were treated with an equal volume of phosphate-buffered saline (PBS) instead. The cells were harvested 1 hour after LPS challenge, and the nuclear translocation of NF-κB was determined by immunofluorescence assay to detect the effect of UFH on NF-κB activation. The levels of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in cell culture supernatants were determined by enzyme linked immunosorbent assay (ELISA) 3 hours and 6 hours after LPS challenge to detect the effect of UFH on LPS induced expression of chemokines and its mechanism of effect on NF-κB signaling pathway in HPMECs. Results ① In the control group, NF-κB was mostly located in the cytosol as shown by immunofluorescence. Treatment of HPMECs with LPS significantly increased the translocation of NF-κB from the cytosol to nucleus. UFH suppressed LPS-induced NF-κB activation both in 1 kU/L and 10 kU/L dosages, and 10 kU/L UFH gave even better results. ② Compared with control group, the levels of IL-8 and MCP-1 in the supernatants in LPS challenge group were significantly increased at 3 hours and 6 hours after LPS challenge [IL-8 (ng/L): 387.1±26.4 vs. 23.8±8.1 at 3 hours, 645.5±69.6 vs. 125.7±18.7 at 6 hours; MCP-1 (ng/L): 3 654.9±467.9 vs. 721.6±61.3 at 3 hours, 8 178.5±792.6 vs. 1 324.7±148.7 at 6 hours, all P < 0.05]. Compared with that of LPS challenge group, in 1 kU/L and 10 kU/L UFH pretreatment groups, the levels of IL-8 and MCP-1 were significantly decreased [IL-8 (ng/L): 315.3±24.8, 275.8±31.1 vs. 387.1±26.4 at 3 hours, 557.8±43.3, 496.9±38.7 vs. 645.5±69.6 at 6 hours; MCP-1 (ng/L): 2 924.1±267.9, 2 668.3±522.6 vs. 3 654.9±467.9 at 3 hours, 7 121.7±557.2, 6 563.9±576.4 vs. 8 178.5±792.6 at 6 hours, all P < 0.05]. The results indicated that 10 kU/L UFH yielded better results. However, inhibition study using the known NF-κB inhibitor TLCK could decrease LPS-induced increase in IL-8 and MCP-1 levels [IL-8 (ng/L): 162.4±21.3 vs. 387.1±26.4 at 3 hours, 274.1±22.6 vs. 645.5±69.6 at 6 hours; MCP-1 (ng/L): 1 478.2±138.5 vs. 3 654.9±467.9 at 3 hours; 3 667.6±259.4 vs. 8 178.5±792.6 at 6 hours, all P < 0.05]. Conclusions The levels of IL-8 and MCP-1 were increased obviously in LPS treated HPMECs. UFH might suppress LPS-activated NF-κB signaling pathway, contributing to the inhibitory effects of chemokines in HPMECs.

Objective To investigate the surgical outcome of cervical spondylotic myelopathy. Methods Twenty -five patients (14 males and 11 females) with cervical spondylotic myelopathy who underwent operative treatment between 2004 and 2007 in our hospital were included in this study. The mean duration of symptoms was 31 months (ranging from 8 days to 10 years) . The follow - up period ranged from 18 months to 4 years (mean 30 months). The study comprised 6 posterior decompression (laminoplasty) and 17 anterior cervical discectomy with fusion and anterior locking plate systems. 2 patients with severe cervical spondylotic myelopathy were treated by operation of the combining anterior and posterior. Results According to COA, the recovery (improving) rate among the tolal patients was classified as exellent in 20 cases, good in 3 cases, fair in 2 cases. The excellend and good rate was 92% . Conculusion Both anterior and posterior surgery were effective for cervical spondylotic myelopathy with effective decompression according to the location of abnormality.

ObjectiveTo investigate prognostic factors in Stage Ⅲ non-small cell lung cancer (NSCLC)treated with definitive radiation therapy (RT) with PET-CT-based radiotherapy planning. MethodsFifty nine patients with Stage Ⅲ NSCLC treated with radiation therapy of 60 Gy or more were enrolled into this study.The impact of prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 98％.Nineteen patients completed 2 years' followed-up. The overall l-year and 2-year survival rate was 66％ and 37％, respectively, with a median survival time of 17 months. At a univariate analysis, cigarette smoking status, T stage, radiation dose, the standardized uptake value, the gross tumor volume and clinical stage were significant prognostic factors ( x2 =7.46,7. 52,8.37,4. 97,5.82,4. 37, P =0. 006,0. 006,0. 004,0. 026,0. 016,0. 037, respectively ).At multivariate analyses, cigarette smoking status, radiation dose, gross tumor volume and clinical stage were significant prognostic factors ( x2 =6. 20, 9. 69, 6. 39, 10. 09, P =0. 013,0. 002, 0. 011,0. 001,respectively). Conclusions Cigarette smoking status, radiation dose, gross tumor volume and clinical stage are significant prognostic factors on survival in patients with Stage Ⅲ NSCLC treated with RT based on PET-CT radiotherapy planning.

Silver nanoparticles (AgNPs) have been widely used in industrial, household, and healthcare-related products due to their excellent antimicrobial activity. With increased exposure of AgNPs to human beings, the risk of safety has attracted much attention from the public and scientists. In review of recent studies, we discuss the potential impact of AgNPs on individuals at the cell level. In detail, we highlight the main effects mediated by AgNPs on the cell, such as cell uptake and intracellular distribution, cytotoxicity, genotoxicity, and immunological responses, as well as some of the major factors that influence these effects in vivo and in vivo, such as dose, time, size, shape, surface chemistry, and cell type. At the end, we summarize the main influences on the cell and indicate the challenges in this field, which may be helpful for assessing the risk of AgNPs in future.
Chemistry ; Family Characteristics ; Humans ; Nanoparticles* ; Risk Assessment ; Silver*

Objective:To study the effect of quality control circle(QCC)on the reasonable ratio of clinical prescriptions. Methods:The dispensed prescriptions in orthopedic emergency department were reviewed in our hospital,and the reasons of unreasonable prescriptions were analyzed. According to the QCC technique,the activities were implemented,the standardized work process was made out and the results were studied. Results:After the six-month QCC activities,the unreasonable ratio of emergency orthopedics prescriptions was reduced from 70% to 21% ,and the target yield rate was 140% and the improvement rate was 70% . Conclusion:The QCC has obvious effect on the improvement of reasonable ratio of emergency orthopedics prescriptions.

Objective·To analyze and explore the influencing factors that lead to cognitive deterioration in individuals with elevated fasting blood glucose(FBG)and the metabolic clues associated with changes in the risk of cognitive deterioration.Methods·Data from the Alzheimer's Disease Neuroimaging Initiative(ADNI)database were downloaded,and the samples with FBG and follow-up data were selected from the database.Clinical information,including age,gender,body mass index,education years,apolipoprotein E4(APOE4)genotype and race,and corresponding metabolic indicator data,including amino acids,fatty acids,proteins and others were obtained.Based on the FBG levels and diagnosis of cognitive impairment stages in Alzheimer's disease,the subjects were categorized into four groups:normal FBG without/with cognitive deterioration,and elevated FBG without/with cognitive deterioration.The univariate analysis method,the Cox proportional hazards model,orthogonal projections to latent structures discriminant analysis(OPLSDA),and Spearman correlation analysis were employed for data analysis.Results·A total of 1 317 subjects were included,among which 1 153 had normal FBG level(>3.9 mmol/L and<6.1 mmol/L)and 164 had elevated FBG level(≥6.1 mmol/L).In the normal FBG group,275 subjects showed cognitive deterioration,while in the elevated FBG group,53 subjects showed cognitive deterioration.Univariate analysis revealed significant differences in gender and race between the normal FBG and elevated FBG group,and significant differences in age,gender,and APOE4 genotype between the groups with and without cognitive deterioration(all P<0.05).Cox regression analysis indicated that primary influencing factors for cognitive deterioration were APOE4 positivity,elevated FBG,and increasing age in order(HR=2.22,HR=1.38,HR=1.02;all P<0.05).In the analysis of baseline metabolic indicators in the groups without and with cognitive deterioration,as well as metabolic indicators before and after cognitive deterioration at different FBG levels,the results of the analysis of variance revealed that in the cognitively deteriorated population,the ratio of phospholipids carried by high-density lipoproteins(HDL)to total lipids was significantly higher;low-density lipoprotein(LDL)particle concentration and the lipids carried by LDL were significantly higher after cognitive deterioration.Correlation analysis showed that valine and leucine were significantly correlated not only with FBG level but also with phosphorylated tau(pTau)level in the plasma in the cognitively deteriorated population.Cholesterol and the ratio of phospholipids to total lipids carried by HDL were significantly correlated with pTau levels in cerebrospinal fluid(CSF).Conclusion·Compared to the individuals with normal FBG level,those with high FBG level have a significantly higher risk of cognitive deterioration.Additionally,different metabolic indicators show significant differences between the groups without and with cognitive deterioration,as well as metabolic indicators before and after cognitive deterioration at different FBG levels.Overall,LDL and its lipid content,and HDL-carried phospholipids show an increasing trend during cognitive deterioration,and the branched-chain amino acids valine and leucine are significantly correlated with pTau levels in CSF and plasma,suggesting that these metabolic markers may play an important role in cognitive deterioration.

Purpose/Significance Based on big data,a cardiovascular and cerebrovascular electronic medical record(EMR)analy-sis platform is developed.By utilizing imaging data analysis techniques and clinical document analysis techniques,the platform provides patients with precise diagnosis,treatment plans,scientific administration,prognosis prediction,smart health education prescriptions and other precise services.Method/Process The medical ontology,knowledge rules and knowledge graph for cardiovascular and cerebrovas-cular diseases are developed and constructed by using Protégé.On the basis of constructing a knowledge graph,a knowledge base for clinical diagnosis,treatment,pathological analysis and prognosis judgment of cardiovascular and cerebrovascular diseases is formed.A EMR analysis platform for cardiovascular and cerebrovascular diseases is designed based on the knowledge base.Result/Conclusion The designed cardiovascular and cerebrovascular EMR analysis platform is conducive to providing personalized diagnosis and treatment plans for different populations,and providing patients with various precise diagnosis and treatment services.

Objective To investigate the clinical application of perioperative human serum albumin(HSA)in cardiac surgery in multiple regions in China,and to evaluate the rationality of its clinical application in conjunction with the clinical guidelines,in order to provide a reference for promoting the rational application of HSA.Methods The medical records of patients who underwent cardiac surgery from April to June 2019 in eight hospitals across the country were retrospectively collected.The statistical information on patients'general information,the dosage,course of treatment,and cost of HSA,and the serum albumin level before and after medication was analyzed to evaluate the use of HSA.Relevant evaluation criteria were established,and the rationality of its medication was evaluated.Results Data from a total of 449 patients were included for analysis,the appropriate rate of medication was 81.1％.The course of medication was mostly＞2-5 days and the total amount of HSA was mostly 50-99 g.The main purpose of medicaiton were improving colloid osmotic pressure,reducing exudation to improve interstitial edema,postoperative volume expansion.Conclusion Clinical attention should be paid to ensure the rational application of HSA in cardiac surgery during the perioperative period and prevent the abuse of blood products.