OBJECTIVES: To study the mechanism mediating the protective effect of asiaticoside (AS) against myocardial ischemia-reperfusion injury (MIRI) in rats. METHODS: Fifty SD rats were randomized into sham-operated group, MIRI model group and AS treatment group. AS treatment was administered at low, moderate and high doses by daily gavage for 2 weeks before MIRI modeling (n=10). Serum levels of lactate dehydrogenase (LDH), creatine kinase isoenzyme (CK-MB), interleukin-18 (IL-18) and IL-1β, the volume of myocardial infarction and ischemia, and myocardial pathologies of the rats were determined or observed. The protein expression levels of NLRP3, ASC, caspase-1, GSDMD, GSDMD-N, IL-1β and IL-18 in the myocardial tissues were detected using Western blotting. The changes in the expression levels of these proteins were also detected in H9C2 cells with AS pretreatment prior to hypoxia-reoxygenation (H/R) injury. RESULTS: The rats models of MIRI exhibited significant myocardial infarction and ischemia with increased serum levels of LDH and CK-MB and myocardial expressions of NLRP3, ASC, caspase-1, GSDMD, GSDMD-N, IL-1β and IL-18. AS pretreatment effectively reduced myocardial infarction volume in the rat models and significantly reduced serum LDH and CK-MB levels and the protein levels in the myocardial tissue in a dose-dependent manner. In the H9C2 cell model of H/R injury, AS pretreatment significantly suppressed the elevation of the protein expressions of NLRP3, ASC, caspase-1, GSDMD, GSDMD-N, IL-1β and IL-18. Molecular docking studies showed that AS had a strong binding affinity with NLRP3. CONCLUSIONS Asiaticoside can alleviate MIRI in rats possibly by inhibiting NLRP3 inflammasome-mediated pyroptosis.
Animals ; Myocardial Reperfusion Injury/metabolism* ; NLR Family, Pyrin Domain-Containing 3 Protein/metabolism* ; Pyroptosis/drug effects* ; Rats, Sprague-Dawley ; Rats ; Inflammasomes/metabolism* ; Triterpenes/pharmacology* ; Interleukin-18/metabolism* ; Male ; Interleukin-1beta/metabolism* ; Caspase 1/metabolism*

Narcolepsy （NP） is a rare nervous system disease with the typical symptoms of excessive daytime sleepiness， cataplexy， sleep paralysis， and hypnagogic hallucination. The pathophysiological mechanism of NP remains unclear， and it is currently believed that NP is an immune-related disease closely associated with HLA-DQB1*06∶02 genotype and it can be triggered by environmental factors such as infection and vaccination， while the precise neural pathways leading to degeneration/apoptosis of orexin neurons in the lateral hypothalamic area remain unknown. In recent years， an increasing number of evidence has revealed the association between sleep disturbance and gut microbiota， and in particular， the microbiota-gut-brain axis plays an important role in sleep regulation. This article systematically reviews the regulatory mechanism of gut microbiota in the central nervous system and discusses the potential interaction between gut microbiota and NP， in order to provide new perspectives for both mechanistic research and clinical management of NP.
Narcolepsy

Objective:To learn about the awareness of brucellosis prevention and control knowledge among people in key areas of Ningxia Hui Autonomous Region (Ningxia), and analyze influencing factors.Methods:From February to March 2023, a multi-stage stratified sampling method was adopted to select residents (aged ≥12 years and resident for ≥6 months) from Yanchi County, Litong District, Pingluo County and Yuanzhou District of Ningxia as the survey subjects. Demographic information such as gender, age, education level, marital status, occupation, region, urban-rural status, as well as knowledge of brucellosis prevention and control were obtained through face-to-face questionnaire surveys. The awareness rate of brucellosis prevention and control knowledge among various populations was calculated and the influencing factors were analyzed by binary logistic regression.Results:A total of 1 592 questionnaires were distributed, of which 1 581 were valid, with an effective rate of 99.31%. There were 704 males, accounting for 44.53% (704/1 581); and 877 females, accounting for 55.47% (877/1 581). The age was (54.09 ± 14.81) years old, ranging from 14 to 88 years old. The education level was mainly primary school or below, accounting for 48.07% (760/1 581). The marital status was mainly married or cohabitating, accounting for 91.84% (1 452/1 581). The occupation was mainly farmers and herdsmen, accounting for 61.92% (979/1 581). In Pingluo County, Litong District, Yuanzhou District and Yanchi County, 392, 403, 396 and 390 people were investigated, respectively. In urban and rural areas, 797 and 784 people were investigated, respectively. The overall awareness rate of brucellosis prevention and control knowledge among the population was 47.82% (756/1 581). Univariate analysis showed that there were statistically significant differences in the awareness rates of brucellosis prevention and control knowledge among different age groups, education levels, marital status, occupation, regions and urban and rural populations ( P < 0.05). Binary logistic regression analysis showed that age, education level, marital status, occupation, urban-rural status were the factors influencing the awareness rate of brucellosis prevention and control knowledge among the population ( P < 0.05). Conclusion:The awareness rate of brucellosis prevention and control knowledge in key areas of Ningxia is relatively low, and age, education level, marital status, occupation, and urban-rural status are the main influencing factors.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective:To investigate the clinical efficacy of Omalizumab in the treatment of moderate-to-severe allergic asthma with allergic comorbidities in children.Methods:The clinical data of 50 children with moderate-to-severe allergic asthma and allergic comorbidities, who were treated with Omalizumab and completed 12-month follow-up in the Department of Pediatrics of Peking University First Hospital from July 2018 to March 2022, were retrospectively analyzed.A comparison was performed on the scale scores of childhood allergic asthma and allergic comorbidities including allergic rhinitis (AR) and chronic spontaneous urticaria (CSU), pulmonary function test indices and fractional exhaled nitric oxide (FeNO) concentration before and after treating with Omalizumab.The data were compared by ANOVA, paired t-test, chi- square test and rank sum test. Results:(1)Improvement of clinical symptoms: after 12 months of Omalizumab treatment, the childhood asthma control test score of 42 children aged ≤11 years increased from (20.98±5.03) points to (26.95±0.22) points ( F=18.189, P<0.001). The asthma control questionnaire 7 score of 50 children decreased from (0.89±0.11) points to (0.10±0.02) points ( F=5.662, P=0.006). The score of visual analogue scale of 47 children with AR decreased from (11.00±1.65) points to (0.2±0.14) points ( F=14.901, P<0.001), and the urticaria control test score of 13 children with CSU decreased from (4.82±0.88) points to (1.87±0.61) points ( F=4.329, P=0.018). (2)Improvement of quality of life: compared with those before treatment, the pediatric asthma quality of life questionnaire score in 50 children increased from (124.50±32.13) points to (159.40±6.21) points ( F=12.052, P<0.001), and global evaluation of asthma treatment effectiveness decreased from (2.23±0.70) points to (1.07±0.26) points ( F=68.865, P<0.001) after Omalizumab treatment for 12 months.(3)Improvement of pulmonary function results: after 12 months of Omalizumab treatment, the number of children with forced expiratory volume in one second/forced vital capacity< 80% decreased from 13 cases (26%) to 1 case (2%), and the values increased from (91.39±12.88)% to (96.96±8.54)%( χ2=11.960; t=2.486, all P<0.05). The peak expiratory flow of predicted value increased from (86.73±16.05)% to (94.01±13.11)% ( t=2.445, P<0.05). The number of children with two indicators among the forced expiratory flow at 50% of forced vital capacity exhaled, forced expiratory flow at 75% of forced vital capacity exhaled and maximal mid-expiratory flow lower than 65% decreased from 31 cases (62%) to 7 cases (14%) ( χ2=24.450, P<0.001). There was no significant difference in FeNO concentration before and after treatment ( P>0.05). Safety of Omalizumab: no obvious adverse reactions were found during treatment and follow-up. Conclusions:Omalizumab can significantly improve the clinical symptoms, small airway function and quality of life of children with allergic asthma and concomitant AR or CSU.It is a potential targeted drug for treating a variety of allergic diseases in children.

Objective:To explore the laboratory characteristics and diagnostic methods for therapy-related acute megakaryocytic leukemia (t-AMKL).Methods:The data of one child with acute lymphoblastic leukemia (ALL) in the Blood Disease Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College in September 2014 was retrospectively analyzed. After inducing remission for more than 43 months, the child was diagnosed as t-AMKL.Results:After the diagnosis of ALL, the child was given chemotherapy with standard childhood ALL regimen. After 43 months, t-AMKL was diagnosed by comprehensive morphology, cytogenetics, and molecular biology. Bone marrow morphology showed that the proportion of primitive cells was 0.44; flow cytometry showed the phenotype was abnormal myeloid primitive cells; the pathology result showed that the abnormal cells weakly expressed CD42b and CD61; the electron microscopy showed platelet peroxidase (PPO)-positive and myeloperoxidase (MPO)-negative; the bone marrow immunohistochemistry showed the positive rate of CD41 was 34%; the child had a complex karyotype. After reviewing his medical history, he was diagnosed as t-AMKL.Conclusion:The t-AMKL is relatively rare, and it is helpful to improve the prognosis of patients by completing the relevant examinations for early diagnosis.

Objective:To explore the clinical efficacy and safety of the new targeted anti-immunoglobulin E (IgE) drug Omalizumab in the treatment of children with moderate and severe allergic bronchial asthma in China.Methods:The clinical data of children with moderate and severe allergic asthma who were treated in the Department of Pediatrics of Peking University First Hospital from July 2018 to January 2020 and treated with Omalizumab were retrospectively analyzed.A comparison was performed on the changes of questionnaires, including childhood asthma control test (C-ACT), pediatric asthma quality of life questionnaire (PAQLQ), mini-asthma quality of life questionnaire (Mini-AQLQ) and global evaluation of asthma treatment effectiveness (GETE), pulmonary function test, including forced expiratory volume in the first second (FEV 1), percentage to predicted value (FEV 1% pred) and small airway function, fractional concentration of exhaled nitric oxide (FeNO) and so on, before and after treating with Omalizumab. Results:A total of 15 pediatric patients completed 16 weeks of treatment follow-up.After 16 weeks of Omazumab treatment, the score of C-ACT increased from (16.001.66) scores to (25.38±0.64) scores ( F=11.969, P<0.001), PAQLQ increased from (118.08 ± 23.78) scores to (141.00 ± 11.91) scores ( F=9.289, P=0.001), Mini-AQLQ increased from (78.93±7.43) scores to (97.92±3.12) scores ( F=4.145, P=0.042), and GETE decreased from (2.47±0.27) scores to (1.60±0.19) scores ( t=2.982, P=0.010). The actual value of FEV 1, FEV 1% pred, the maximum expiratory flow percentage of the predicted value (PEF% pred), forced expiratory flow at 25% (MEF 75), forced expiratory flow at 50% (MEF 50) and maximum midexpiratory flow (MMEF 75/25), increased from (1.96±0.12) L to (2.17±0.21) L ( F=0.425, P=0.789), (81.46±2.85)% to (82.64±1.55)% ( F=0.926, P=0.465), (82.05±3.58)% to (91.10±4.67)% ( F=1.909, P=0.128), (60.36±7.43)% to (76.94±4.65)% ( F=2.120, P=0.096), (52.72±3.75)% to (73.80±8.34)% ( F=3.140, P=0.047) and (60.05±8.47)% to (74.86±10.85)% ( F=7.860, P=0.010), respectively.FeNO decreased from 25.0 (14.5, 35.5) μg/L to 20.0 (18.5, 30.0) μg/L ( Z=-0.206, P=0.840). Transient headache was observed in 1 case and evanescent eruption in 2 cases during the treatment, respectively. Conclusions:Omalizumab can significantly improve the clinical manifestations, lung function indicators and quality of life of children with moderate and severe allergic asthma, and has good safety.Thus, it is expected to play an important role in the treatment of children with moderate-to-severe allergic asthma.

Non - alcoholic fatty livOr disOasO is a common, multiplO livOr disOasO, thO pathogOnOsis is complOx,thO typical pathological fOaturOs includO livOr cOll lipid accumulation,sinus fibrosis and so on.MicroRNAs arO singlO-chain non-coding miRNAs and havO a widO rangO of OffOcts on organisms.ThO rOsOarch rOviOwOd thO progrOss of microRNA in thO occurrOncO,dOvOlopmOnt,diagnosis and trOatmOnt of nonalcoholic fatty livOr disOasO.

Through looking up Chinese Pharmacopoeia and searching for unannounced inspection on the website of China food and drug administration and some GMP regulations and gudelines of European Union, the problems existing in the raw materials control of animal original biochemical drugs were discussed, and the relevant suggestions were put forward.

Objective To understand the cleanliness of hands and uniforms of health care workers(HCWs)while they were working in a hospital.Methods Specimens of hands and uniforms of HCWs while they were working were collected and detected.Results A total of 342 specimens were collected, 173 were specimens from hands and 169 were from uniforms, the total qualified rate was 78.65%,qualified rates of hands and uniforms were 76.30% and 81.07% respectively.Qualified rates of hands and uniforms of different HCWs were compared respectively, differences were both statistically significant (both P<0.05);qualified rates of hands and uniforms of nurses were both highest (87.93% and 92.86% respectively), followed by doctors (75.86% and 87.72% respectively), while medical auxiliary persons were the lowest(64.91% and 62.50% respectively).Correlation analysis between qualified rates of hands and uniforms of HCWs in general wards showed that the correlation coefficient was 0.930 (P<0.01).Conclusion Cleanliness of hands and uniforms of HCWs needs to be further improved, especially medical auxiliary persons;cleaning frequency and cleanliness standard of HCWs' uniforms needed to be studied further.