ObjectiveUsing multi-omics technology， we conducted the present study to determine whether dexamethasone has therapeutic effect on pneumonia rats through the regulation of intestinal flora and metabolites. MethodsTotally 18 Sprague-Dawley rats were randomly divided into 3 groups （n = 6 each）： Control group， Model group and Dexamethasone （Dex） group. Lipopolysaccharide （LPS） was continuously injected intraperitoneally into rats at a dose of 4 mg/kg for 7 days to induce pneumonia except the Control group. Then the Dex group was given Dex at a dose of 2 mg/kg via oral gavage for 12 days， and both the other two groups received continuously equal volume of sterile PBS buffer for 12 days. On the 19th day， lung， plasma， feces and intestinal contents of rat were collected. Hematoxylin-eosin （H&E） staining and Bio-plex suspension chip system were applied to evaluate the effect of Dex on pneumonia. Furthermore， metagenomic sequencing and UPLC-Q-TOF-MS/MS technology were employed to determine the intestinal flora and metabolites of rats， respectively. ResultsH&E staining results showed that the lung tissue of the Model group was infiltrated with inflammatory cells， the alveolar septum was increased， alveolar hemorrhage， and histological lesions were less severe in Dex group than in the model group. The levels of 3 inflammatory cytokines including TNF-α （P < 0.000 1）， IL-1α （P = 0.009 6） and IL-6 （P < 0.000 1） in the Model group were increased compared with the Control group， while Dex treatment reduced the levels of the three inflammatory factors. Taken together， Dex treatment effectively reversed the features of pneumonia in rats. Metagenomic analysis revealed that the intestinal flora structure of the three groups of rats was changed. In contrast with the Model group， an increasing level of the Firmicutes and an elevated proportion of Firmicutes/Bacteroidetes were observed after Dex treatment. Dex-treated rats possessed notably enrichment of Bifidobacterium， Lachnospiraceae and Lactobacillus. Multivariate statistical analysis showed a great separation between Model group and Dex group， indicating metabolic profile changes. In addition， 69 metabolites （P < 0.05） were screened， including 38 up-regulated in the Model group and 31 elevated in the Dex group， all of which were mainly involved in 3 metabolic pathways： linoleic acid metabolism， tryptophan metabolism and primary bile acid biosynthesis. ConclusionsIn summary， we demonstrate the beneficial effects of Dex on the symptoms of pneumonia. Meanwhile， integrated microbiome-metabolome analysis reveals that Dex improves LPS-induced pneumonia in rats through regulating intestinal flora and host metabolites. This study may provide new insights into the mechanism of Dex treatment of pneumonia in rats.

OBJECTIVE: This study assesses the impact of iodine-rich processed foods and dining places on the iodine nutritional status of children. METHODS: School-aged children (SAC) in seven provinces in China were selected by school-based multi-stage sampling. Urinary iodine, salt iodine, and thyroid volume (TVOL) were determined. Questionnaires were used to investigate dining places and iodine-rich processed foods. The water iodine was from the 2017 national survey. Multi-factor regression analysis was used to find correlations between variables. RESULTS: Children ate 78.7% of their meals at home, 15.1% at school canteens, and 6.1% at other places. The percentage of daily iodine intake from water, iodized salt, iodine-rich processed foods, and cooked food were 1.0%, 79.2%, 1.5%, and 18.4%, respectively. The salt iodine was correlated with the urinary iodine and TVOL, respectively (r = 0.999 and -0.997, P < 0.05). The iodine intake in processed foods was weakly correlated with the TVOL (r = 0.080, P < 0.01). Non-iodized salt used in processed foods or diets when eating out had less effect on children's iodine nutrition status. CONCLUSION Iodized salt remains the primary source of daily iodine intake of SAC, and processed food has less effect on iodine nutrition. Therefore, for children, iodized salt should be a compulsory supplement in their routine diet.
Humans ; Child ; Nutritional Status ; Cross-Sectional Studies ; Iodine ; Sodium Chloride, Dietary/analysis* ; China ; Water

Cross-Sectional Studies ; Dietary Supplements ; Female ; Humans ; Iodides ; Iodine ; Nutritional Status ; Pregnancy ; Pregnancy Complications ; Pregnant Women ; Thyroid Gland ; Thyrotropin

Cordyceps sinensis(C.sinensis)is a widely used and highly valuable traditional Chinese medicine.Several dipeptides have been detected in C.sinensis,but current scientific knowledge of its chemical makeup remains limited.In this study,an improved approach that integrates offline two-dimensional liquid chromatography(2D LC)separation,precursor ion list,library screening,and diagnostic ion filtering was established to systematically screen and characterize dipeptides in C.sinensis.Offline 2D LC integrating hydrophilic interaction LC and reverse phase separations was established to eliminate interference and identify the target dipeptides.A library containing the potential 400 dipeptides was created,and a precursor ion list with all theoretical precursor ions was adopted to trigger the MS/MS scan with high sensitivity.To identify dipeptides,the type and connection sequence of amino acids were determined according to the product ions.Ile and Leu residues were differentiated for the first time according to the characteristic ion at m/z 69.07.Ultimately,170 dipeptides were identified or tentatively characterized from C.sinensis,and most are reported for the first time in this species herein.In addition,the identified dipeptides were also applied for discrimination among the three Cordyceps species,and 11 markers were identified.The obtained results provide a deeper understanding of the chemical basis of C.sinensis.

Acetaminophen (APAP, also known as paracetamol)-induced liver injury is the leading cause of drug-induced liver injury in the world. Wuzhi Tablet (WZ, an ethanol extract of Schisandra sphenanthera) is widely used in clinical practice to protect liver function. Our previous studies have shown that pretreatment with WZ for 3 days can significantly protect against APAP-induced liver injury; however, the effect of different intervals between APAP and WZ treatment on APAP-induced liver injury remains unclear. In this study, the change in liver injury indexes, APAP metabolites, and the activity of cytochrome P450 (CYP450) enzymes after treatment with WZ and APAP at different intervals were determined. The animal experiment was reviewed and approved by the Animal Ethics Committee of Sun Yat-sen University. The results show that 0 h, 0.5 h, and 2 h pretreatment with WZ significantly protected against APAP-induced liver injury in mice, as evidenced by a significant decrease in biochemical parameters such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malonaldehyde (MDA). WZ inhibited the metabolic activation of APAP mediated by CYP450 enzymes and reduced the formation of APAP metabolites. This study further demonstrates that pretreatment with WZ at different intervals (0 h, 0.5 h, and 2 h before APAP dosing) exerts a significant hepatoprotective effect against APAP-induced liver injury, and a single-dose of WZ inhibits the activity of CYP450 enzymes related to APAP metabolic activation, thereby protecting against APAP-induced hepatotoxicity.

BACKGROUND: Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. OBJECTIVE: To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. METHODS: The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals among Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. DISCUSSION This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622 on ClinicalTrials.gov).

Objective To investigate the clinical efficacy of herbal cake moxibustion plus acupuncture in treating post-stroke urinary incontinence.Methods Fifty patients with post-stroke urinary incontinence were randomized to a treatment group (26 cases) and a control groups (24 cases). The treatment group received herbal cake moxibustion plus acupuncture and the control group, acupuncture alone. Twenty-four-hour urine void number, incontinence severity and the clinical symptom score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in twenty-four-hour urine void number and the clinical symptom score in the two groups (P<0.05). There were statistically significant differences in pre-/post-treatment twenty-four- hour urine void number difference value and clinical symptom score difference value between the treatment and control groups (P<0.05). There was a statistically significant pre-/post-treatment difference in incontinence severity in the two groups (P<0.05). There was a statistically significant post-treatment difference in incontinence severity between the treatment and control groups (P<0.05).Conclusion Herbal cake moxibustion plus acupuncture is an effective way to treat post-stroke urinary incontinence.

A boy aged 4 years and 2 months was found to have delayed language and motor development, instability of gait, poor eye contact, stereotyped behavior, and seizure at the age of 3 years. Physical examination showed special facial features, including plagiocephaly, blepharoptosis, wide nasal bridge, down-turned mouth corners at both sides, and low-set ears. There were only two knuckles at the little finger of the left hand. The anteroposterior and lateral films of the spine showed scoliosis; echocardiography showed ventricular septal defect; the Gesell Developmental Scale showed delayed language development and moderate intellectual disability; there were no abnormalities in the karyotype; genome-wide SNP arrays found a duplication in 12q24.21 region with a size of 1.03 Mb in chromosome 12, while this was not seen in his parents. The boy was diagnosed with MED13L syndrome. Point mutation, deletion, and duplication in the MED13L gene can lead to MED13L syndrome. The patients with different genotypes may have different phenotypes. Genome-wide SNP arrays may help with the diagnosis of this disease.
Child, Preschool ; Chromosome Deletion ; DNA Copy Number Variations ; Humans ; Intellectual Disability ; genetics ; Male ; Mediator Complex ; genetics ; Phenotype ; Polymorphism, Single Nucleotide ; Syndrome

BACKGROUND: There is little information available in the mechanism of radiation-induced salivary gland injury, and its treatment and prevention are still at the exploratory stage.OBJECTIVE: To establish a rat model of radiation-induced xerostomia with 18 Gy electron beam and to observe the pathological changes of the submandibular gland and changes in saliva ingredients.METHODS: Totally 115 Wistar rats were randomly divided into exposure and control groups: the rats in the exposure group were subjected to anesthesia, and the submandibular gland received 18 Gy electron beam radiation to establish the model of radiation-induced xerostomia. The rats in the control group were only anesthetized but not exposed to radiation. The water intake was recorded at 21 dys after modeling. The saliva was collected and the submandibular gland was removed at 1, 3, 7, 14, 21, 28, 35 and 42 days to detect the saliva volume and submandibular gland index,and the morphological changes of the submandibular gland were observed by hematoxylin-eosin staining.RESULTS AND CONCLUSION: At 1-21 days after modeling, the average daily water intake was (6.42±1.91) mL in the exposure group and (4.82±1.20) mL in the control group, respectively (P < 0.05). During 42 days after modeling, the saliva secretion volume in the exposure group was lower than that in the control group, which was the lowest on day 7,and the difference was significant at 7, 21, 28 and 42 days after modeling between two groups (P < 0.05). The submandibular gland index in the exposure group was significantly lower than that in the control group at 1 and 21-42 days after modeling (P < 0.05). Hematoxylin-eosin staining results showed that in the exposure group, the rat submandibular gland appeared with inflammatory infiltration, glandular atrophy and karyopyknosis that were aggravated with time until day 42. To conclude, the rat model of radiation-induced xerostomia is established successfully with 18 Gy beam, characterized as increased water intake, decreased saliva volume and progressive aggravation of pathological injury of the submandibular gland.

Objective At present, modern medicine cannot yet clarifythe mechanism of radiation-induceddamage (RID) to salivary glands and its treatment and protective measures remain in the exploration stage .This study was to explore the mechanism of RIDto the submandibular gland and observe the effect of Dark Plum Spray ( DPS) on the submandibular gland after RID in order to provide some evidence for its further application . Methods Using the random number table , 84 healthy Wistar male rats were divid-ed into a normal, an RID model, and an experimental group ,all fed normally.The rats of the RID model groupwere left untreated , while those of the experimental group were intervened with DPS , tid, after RID.On the 1st, 7th, 14th, and 28th day after irradiation, 7 rats were taken from each group for measurement of the body weight, collection of the saliva , and calculation of the salivary flow rate.The submandibular glands were harvested for determination of the mRNA and protein expressions of autophagy-related Atg5 by RT-PCR and Western blot . Results In the 7th day after irradiation , the average body weight in NG[(239.87±16.50)g] was significantly higher (P<0.05) than UG[(213.84±14.42)g] and EG[(222.71±11.14)g].In the 14th ,28th day after irradiation, the average body weight in UG and EG were significantly lower ( P<0.05) than NG;the average body weight in EG was significantly higher ( P<0.05) than UG.In the 1st , 14th day after irradiation , the salivary flow rate in UG and EG were lower than NG but there were no significantly difference(P>0.05).In the 7th day after irradiation, the salivary flow rate in NG[(49.29±16.90)μL/min] and EG[(50.99±6.79)μL/min] were significantly higher (P<0.05) than UG[(30.13±13.19)μL/min].In the 28th day after irradiation, the salivary flow rate in NG[(69.29±11.32)μL/min] were significantly higher (P<0.05) than UG[(49.26±14.13)μL/min] and EG[(46.56±13.60)μL/min] .In the 1st , 7th and 14th day after irradiation , RT-PCR showed that the expressions of Atg 5 in UG and EG were significantly higher(P<0.05) than NG.In the 1st , 7th and 14th day after irradiation, Western blot showed that the expressions of Atg 5 in UG and EG is on the upper trend than NG;In the 1st , 7th day after irradiation , there were no significantly difference between UG and EG .In the 28th day after irradiation , Western blot showed that the expressions of Atg 5 in UG is on the declining trend than NG . Conclusion The autophagic activity of submandibular gland cells may associated with early radiation -induced injury , and Dark Plum Spray may en-hance the action of theanti-apoptosis cytokine in repairingradiation-induceddamageto the submandibular gland .