Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome

OBJECTIVES: To analyze the clinical characteristics of diffuse panbronchiolitis (DPB) in children and to enhance the clinical diagnosis and treatment of this disease. METHODS: A retrospective analysis was conducted on the clinical data of 6 children diagnosed with DPB who were hospitalized at The First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2019. RESULTS: Among the 6 patients, there were 2 males and 4 females; the age at diagnosis ranged from 7 to 12 years. All patients presented with cough, sputum production, and exertional dyspnea, and all had a history of sinusitis. Two cases showed positive serum cold agglutinin tests, and 5 cases exhibited pathological changes consistent with chronic bronchiolitis. High-resolution chest CT in all patients revealed centrilobular nodules diffusely distributed throughout both lungs with a tree-in-bud appearance. Five patients received low-dose azithromycin maintenance therapy, but 3 showed inadequate treatment response. After empirical anti-tuberculosis treatment, non-tuberculous Mycobacteria were found in the bronchoalveolar lavage fluid. Follow-up over 2 years showed 1 case cured, 3 cases significantly improved, and 2 cases partially improved. CONCLUSIONS The clinical presentation of DPB is non-specific and can easily lead to misdiagnosis. In cases where DPB is clinically diagnosed but does not show improvement with low-dose azithromycin treatment, special infections should be considered.
Humans ; Male ; Female ; Bronchiolitis/drug therapy* ; Retrospective Studies ; Child ; Haemophilus Infections/diagnosis*

Sennoside A (SA), a typical prodrug, exerts its laxative effect only after its transformation into rheinanthrone catalyzed by gut microbial hydrolases and reductases. Hydrolases have been identified, but reductases remain unknown. By linking a photoreactive group to the SA scaffold, we synthesized a photoaffinity probe to covalently label SA reductases and identified SA reductases using activity-based protein profiling (ABPP). From lysates of an active strain, Bifidobacterium pseudocatenulatum (B. pseudocatenulatum), 397 proteins were enriched and subsequently identified using mass spectrometry (MS). Among these proteins, chromate reductase/nicotinamide adenine dinucleotide (NADH) phosphate (NADPH)-dependent flavin mononucleotide (FMN) reductase/oxygen-insensitive NADPH nitroreductase (nfrA) was identified as a potent SA reductase through further bioinformatic analysis and The Universal Protein Resource (UniProt) database screening. We also determined that recombinant nfrA could reduce SA. Our study contributes to further illuminating mechanisms of SA transformation to rheinanthrone and simultaneously offers an effective method to identify gut bacterial reductases.

Objective:To investigate the impact of rosacea on patients＇ quality of life and mental health, and to analyze variations across different subtypes, gender, sun exposure, smoking status, ethnicity, and educational levels, as well as patients＇ demands for treatment.Methods:It was a cross-sectional study from October 2022 to January 2024, 177 rosacea patients from the Department of Dermatology, the First Affiliated Hospital of Kunming Medical University were surveyed. The cohort comprised 36 males and 141 females, with a median age of 35 (29, 44) years. Data collected through questionnaires included general information, Dermatology Life Quality Index (DLQI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Patient Need Questionnaire (PNQ). Statistical analysis was conducted on the collected data.Results:The median DLQI score was 10 (3, 15), indicating moderate impact. The median GAD-7 score was 5 (2, 7), suggesting mild anxiety; while the median PHQ-9 score was 6 (2, 9), indicating mild depression. Female patients scored higher in both DLQI and GAD-7 than males ( P<0.05). Papulopustular subtypes had higher DLQI and GAD-7 scores compared to other subtypes ( P<0.01). Patients with lower education levels scored higher in DLQI and GAD-7 than those with higher education ( P<0.01), and non-smokers had higher GAD-7 scores than smokers ( P<0.05). Significant positive correlations were found between DLQI and PHQ-9 ( r=0.39, P<0.01), and DLQI and GAD-7 ( r=0.51, P<0.01), as well as between PHQ-9 and GAD-7 ( r=0.59, P<0.01). Regarding treatment needs, 159 patients (89.8%) expressed a strong desire for a clear diagnosis and treatment plan, and the same number wished for a complete resolution of all skin lesions. Female patients consistently demonstrated significantly stronger demands in all 28 treatment need items (all P<0.05). Conclusions:Rosacea significantly affects patients＇ quality of life and mental health, particularly among females, individuals with papulopustular subtypes, and those with lower education levels. There is a strong demand for definitive diagnostic and therapeutic plans, especially among female patients.

Studies have shown that a variety of diseases such as cardiovascular disease, renal disease and cancer are closely related to trimethylamine oxide (TMAO). Clinically, abnormal elevation of TMAO has been used as an evaluation index of atherosclerosis (AS) prior to imaging. In this study, we investigated the effects of lipid metabolism disorders as well as pharmacological interventions on urinary TMAO using a hyperlipidemic golden gopher model. The study used 48 Syrian golden hamster modeled with a high-fat diet for 2 weeks, and then ezetimibe, simvastatin, ezetimibe and simvastatin groups were administered for 4 consecutive weeks, as well as the clinical trial drug, IMM-H007, for pharmacological intervention. The animal experiment was conducted in accordance with the regulations of the Ethics Committee for Experimental Animal Management and Animal Welfare of Institute of Materia Medica, Chinese Academy of Medical Sciences (approval number: SCXK (Beijing) 2021-0011). Urine from rats was analyzed for 2D band selective heteronuclear single quantum coherence (2D bs-HSQC) at week 2 and 4 after drug administration. The results indicated that, in comparison to the control group, the high-fat diet significantly elevated urinary TMAO levels in the model group of hamsters after both 2 and 4 weeks of treatment (P < 0.05). Urinary TMAO levels were significantly reduced (P < 0.05) in the model group after 2 or 4 weeks of intervention with ezetimibe, simvastatin, combination therapy, and IMM-H007, showing a marked decrease even after 2 weeks of treatment. The detection of TMAO could precede the measurement of serum biochemical indicators, facilitating earlier efficacy assessment. This study evaluated the modulatory effects of clinical drugs and clinical trial drugs on TMAO, which provides useful information for clinical drug use and drug research. It also provides a means of TMAO detection based on 2D NMR technology, which is helpful for the clinical application of TMAO detection index.

Objective To verify the therapeutic effect of platelet lysate(PL)on spinal cord injury in rats.Methods Thirty male SD rats were randomly divided into the sham operation group,the injury group and the treatment group,with 10 rats in each group.Rats in the sham operation group did not smash the spinal cord after exposure;rats in the injury group were established the rat spinal cord injury model by smashing the spinal cord with a 20 g of self-made smashing machine weights from a height of 5 cm for 5 seconds after exposure;rats in the treatment group were given intraperitoneal injection of 2 mL of PL once a day for 19 days after established the spinal cord injury model.The hind limb function was evaluated by Basso Beattie Bresnahan(BBB)score and slope experiment;six rats were randomly selected from each group,and the spinal cords of the rats were taken on the 7th day after surgery for HE staining and electron microscopy scanning to observe their pathological changes.Results There were statistically significant differences in BBB scores on the 3rd,7th and 14th days after surgery among the three groups(P<0.05),and the BBB scores of the treatment group were higher than those of the injury group(P<0.05).There were statistically significant differences in the results of slope experiment on the 7th and 14th days after surgery between the treatment group and the injury group(P<0.01).HE staining showed that the neuronal degeneration and necrosis decreased,the cell swelling improved and the microglial phagocytosis decreased in the treatment group compared with those in the injury group.The results of electron microscopy showed that the astrocyte cytoplasmic swelling and local cell membrane damage were alleviated,and the mitochondrial swelling and degeneration in the treatment group were relieved compared with those in the injury group.Conclusion PL can improve the hind limb function and reduce the pathological changes after spinal cord injury in rats,which has therapeutic effect on spinal cord injury in rats.

This study was aimed at understanding the molecular characteristics of Plasmodium ovale curtisi and Plasmodi-um ovale wallikeri imported cases in Chongqing,to provide data to support monitoring and control efforts.In a retrospective analysis,26 Plasmodium ovale archival blood samples were characterized with respect to five molecular markers(Cox1,Cytb,Tra,Dhfr,and K13)from 2013 to 2023.PCR amplification of partial fragments of the Cox1,Cytb,and Tra genes of Plas-modium ovale was performed to distinguish the two subspecies.The drug-resistance Dhfr and K13 genes of Plasmodium ovale were amplified with PCR assays followed by DNA sequencing,and the sequences were aligned.The differentiation of 26 cases of Plasmodium ovale(14 cases of curtisi subspecies and 12 cases of wallikeri subspecies)according to ssrRNA was consistent with the classification results of Cox1,Cytb,and TRA genes.Thirteen single nucleotide dimorphism sites were identified in Cox 1,including the 145 and 153 loci,with only variations in amino acids M176I and I288V at loci 528 and 862,and N337H mutation in one sample.Twelve base substitutions were found among Cytb gene subspecies,with only the M248I mutation in amino acid 248.A total of 49 nucleotide dimorphism sites in Tra gene,resulting in 18 amino acid mutations,were identified be-tween the two subspecies.In the curtisi type sample,the poc1 type had more PINTINPINTIN and TITPIS amino acid units than the poc2 type.The mutation rate of the Dhfr gene was rel-atively high:25％of the samples showed S58R mutations.The K13 gene subspecies was not homozygous,and one sample was heterozygous.This study confirmed the dimorphism and mutation sites between Plasmodium ovale curtisi and wallikeri sub-species in Cox1,Cytb,Tra,Dhfr,and K13 gene fragments of imported Plasmodium ovale in Chongqing,thus enriching knowledge regarding gene polymorphisms in Plasmodium ovale curtisi and wallikeri imported cases.

Objective:To explore the clinical application value of single pass scanning using muti-slice spiral CT for polytrauma patients.Methods:Totally 60 polytrauma patients treated from January to November in 2023 were randomly enrolled in this study. They were categorized into an experimental group and a control group using a random number table, with 30 patients in each group. The patients in the experimental group underwent single pass scaning for the head, neck, chest, and abdomen, whereas those in the control group receiving separate scanning for various parts. Then, the noise, signal-to-noise ratio (SNR), and contrast-to-noise (CNR) of the CT images of both groups were recorded. Furthermore, the objective and subjective evaluation, volume CT dose index (CTDI vol), effective dose ( E), scanning time, and scan ranges of the images were compared between both groups. Results:Compared to the control group, the test group exhibited lower SNR of the head ( t = -5.47, P < 0.05) and higher SNR and CNR of the chest scans ( t = -5.95, -6.15, P < 0.05). Furthermore, the test group demonstrated decreased ED, CTDIvol, scanning time, and scan range, which dropped from 18.53 mSv to 13.81 mSv ( t = 3.29, P < 0.001), from 15.77 mGy to 10.59 mGy ( t = 4.48, P< 0.001), from 31.68 s to 10.97 s ( t = 6.95, P < 0.001), and from 64.92 cm to 45.21 cm ( t = 9.05, P < 0.001), respectively compared to the control group. Conclusions:Single pass CT scanning can reduce E, scanning time, and scan range in the treatment of polytrauma patients while ensuring the high quality of CT images, thus warranting wide clinical applications.

Objective To investigate the distribution of traditional Chinese medicine(TCM)syndromes in the patients with acute cerebral infarction,and to analyze the correlation of TCM syndromes with collateral circulation,cerebral blood perfusion and prognosis.Methods A total of 300 patients with acute cerebral infarction were selected.All patients underwent head-neck CT angiography(CTA)and CT perfusion imaging(CTP),and then were followed up for 30 days.The prognosis was evaluated by modified Rankin Scale(MRS)score.In addition,the dynamic evolution of TCM syndromes was observed to explore the correlation of TCM syndromes with collateral circulation,cerebral blood flow perfusion in the lesion area and prognosis.Logistic regression analysis was used to explore the influences of TCM syndromes,blood flow perfusion and collateral circulation establishment on stroke outcomes.Results(1)Highest incidences of syndrome elements of phlegm,blood stasis and wind were presented in ACI patients.The syndrome element of qi deficiency was predominated in the patients with anterior/posterior communicating artery opening and extracranial-to-intracranial collateral circulation establishment.On the first day of onset,the incidence of qi deficiency syndrome element in the good collateral circulation group was lower than that in the poor collateral circulation group(P＜0.05).On the 30th day after onset,the incidences of qi deficiency syndrome element and phlegm syndrome element in the good collateral circulation group were significantly lower than those in the poor collateral circulation group(P＜0.01).The results of correlation analysis showed that the score of qi deficiency was negatively correlated with regional cerebral blood volume(rCBV)of region of interest(r=-0.472,P＜0.05),and the score of yin deficiency was positively correlated with rCBV(r=-0.557,P＜0.01)on the first day of onset.The incidence of qi deficiency in the lesion area was relatively high in the patients of decreased rCBV(rCBV＜1.0 score)group(P＜0.01),while the incidence of yin deficiency in the lesion area was relatively high in the patients of elevated rCBV(rCBV＞1.0 score)group(P＜0.05).(2)The distribution of syndrome elements on the first day of onset showed that the incidence of qi deficiency syndrome element in the poor prognosis group was significantly higher than that in the good prognosis group(P＜0.01);on the 30th day after onset,the incidences of qi deficiency syndrome element and phlegm syndrome element in the good prognosis group was significantly lower than those in the poor prognosis group(P＜0.05 or P＜0.01).The incidence of phlegm syndrome element in the good prognosis group was significantly reduced on the 30th day after onset compared with that on the first day of onset(χ2=7.409,P＜0.01),while there was no significant difference shown in the poor prognosis group(P＞0.05).(3)Logistic regression analysis showed that syndrome elements(qi deficiency,phlegm),collateral circulation grading,and rCBV in the lesion area were the independent risk factors for stroke outcomes.Conclusion The acute cerebral infarction patients with poor collateral circulation,decreased blood perfusion and poor prognosis are predominated by qi deficiency syndrome element.Moreover,phlegm syndrome element is presented in the patients with poor prognosis throughout the course of disease.It is indicated that qi deficiency syndrome element and phlegm syndrome element play an important role in the pathogenesis and progression of acute cerebral infarction.