Objective To explore the efficacy of the self-formulated Zhuzhang Formula in trea-ting the spleen deficiency with dysfunction of transportation syndrome of idiopathic short stature(ISS)and its effects on the growth rate,disease-related indicators,and bone metabolism indicators in affect-ed children.Methods A total of 80 children with ISS were enrolled as study subjects.They were randomly assigned to control group and observation group using random number table method,with 40 cases in each group.The control group received conventional western medicine treatment,while the observation group was administered self-formulated Zhuzhang Formula in addition to the treatment of the control group.Comparisons were made between the two groups in terms of clinical efficacy,TCM syndrome scores,growth parameters(monthly average height increment,annual growth rate),levels of disease-related indicators[serum insulin-like growth factor-1(IGF-1),bone morphogenetic pro-tein-2(BMP-2),insulin-like growth factor binding protein-3(IGFBP-3)],levels of bone metabo-lism indicators[bone alkaline phosphatase(BAP),type Ⅰ procollagen N-terminal propeptide(PⅠNP),type Ⅰ collagen cross-linked C-terminal telopeptide(β-CTX)],and the incidence of adverse reac-tions.Results The overall effective rate in the observation group was 97.50％,which was significantly higher than the 80.00％ in the control group(P＜0.05).After 3 and 6 months of intervention,the scores for symptoms such as short stature,sallow complexion,loss of appetite,weak voice and shortness of breath,limb weakness,and loose stools,as well as the total TCM syndrome scores,were lower in the observation group than those in the control group,with statistically significant differences(P＜0.05).After 6 months of intervention,the monthly average height increment and annual growth rate were higher in the observation group than those in the control group,and the differences were statistically significant(P＜0.05).After 3 and 6 months of intervention,the levels of IGF-1,BMP-2,IGFBP-3,BAP,and PⅠNP were higher in the observation group than those in the control group,while the level of β-CTX was lower,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-formulated Zhuchang Formula demon-strates remarkable efficacy in treating the spleen deficiency with dysfunction of transportation syndrome of ISS.It can alleviate clinical symptoms by regulating the levels of IGF-1,BMP-2,IGFBP-3,and bone metabolism indicators,thereby promoting the growth and development of affected children,and exhibits high safety.

Objective To investigate the dynamic changes of N-terminal pro-brain natriuretic peptide(NT-proBNP)and high-sensitivity cardiac troponin T(hs-cTnT)during gestation period in women with heart disease,and to evaluate their predictive value for adverse pregnancy outcomes.Methods A total of 221 pregnant women with heart disease undergoing peripartum management were enrolled and divided into adverse outcome group(n=68)and favorable outcome group(n=153)based on pregnancy outcomes.General clinical data and pregnancy outcomes were compared between two groups.Levels of NT-proBNP and hs-cTnT were measured during early pregnancy,mid-pregnan-cy as well as late pregnancy and within 24 hours postpartum.The predictive value of NT-proBNP and hs-cTnT for adverse pregnancy outcomes was evaluated using receiver operating characteristic(ROC)curve analysis.Multivariate Logistic regression analysis was used to screen independent risk factors for adverse pregnancy outcomes.Results There was a statistically significant difference in the New York Heart Association(NYHA)cardiac function classification,left ventricular ejection fraction(LVEF)and pulmonary artery systolic pressure(PASP)between two groups(P＜0.001).In the early stage of pregnancy,the second stage of pregnancy,the third stage of pregnancy and at 24 hours after delivery,the levels of NT-proBNP and hs-cTnT in the adverse outcome group were higher than those in the favorable outcome group,and the differences were statistically significant(P＜0.001).The incidence of maternal complications in the adverse outcome group was higher than that in the favorable outcome group,and the difference was statistically significant(P＜0.01 or P＜0.001).The rates of preterm birth,low birth weight and neonatal asphyxia in the adverse outcome group were higher than those in the favorable outcome group,and the differences were statistically significant(P＜0.01 or P＜0.001).The ROC curve analysis showed that the area under the curve(AUC)of NT-proBNP was 0.892(95％CI,0.845 to 0.939),the AUC of hs-cTnT was 0.857(95％CI,0.802 to 0.912),and the AUC of the combined detection of the two was 0.924(95％CI,0.885 to0.963).The NT-proBNP＞986.5 pg/mL(OR=6.85,95％CI,3.24 to 14.46)and hs-cTnT＞15.8 ng/L(OR=5.62,95％CI,3.24 to 14.46)in the third trimester 2.86 to 11.05)and NYHA class Ⅲ to Ⅳ(OR=4.28,95％CI,1.96 to 9.35)were independent risk factors for adverse pregnancy outcomes.Conclusion The levels of NT-proBNP and hs-cTnT during the perina-tal period in patients with pregnancy complicated with heart disease show dynamic changes.Monito-ring two indicators has important clinical value for predicting adverse pregnancy outcomes.

Objective To investigate the risk factors for multiple organ dysfunction syndrome(MODS)in elderly patients with severe stroke.Methods A total of 112 elderly severe stroke pa-tients admitted to our hospital from January 2020 to December 2022 were recruited prospectively,and then according to the results of sequential organ failure assessment(SOFA)within 14 d after admission,they were divided into MODS group(n=38)and non-MODS group(n=74).Based on their clinical outcomes,they were also assigned into survival group(n=-33)and death group(n=79).General clinical data,acute physiology,chronic health evaluationⅡ(APACHEⅡ)score,Glas-gow coma scale(GCS)score,and head computed tomography parameters were collected.Logistic regression analysis was used to analyze the risk factors of MODS.Results The MODS group had significantly larger proportions of stroke/hemorrhage,chronic obstructive pulmonary disease,cor-onary heart disease and smoking,higher NIHSS and APACHE Ⅱ scores,elevated ratios of multi-vessel disease,urinary tract infection,venous thrombosis,hemorrhage,epilepsy and myocardial in-farction,more patients using acute mechanical ventilation and osmotic therapy,and increased hos-pital mortality,but lower GCS score when compared with the non-MODS group(P＜0.05,P＜0.01).Binary logistic regression analysis showed that NIHSS score,APACHE Ⅱ score,and mul-tivessel disease were independent risk factors for MODS(OR=1.124,95％CI:1.121-1.163,P=0.015;OR=1.265,95％CI:1.296-1.426,P=0.001;OR=2.532,95％CI:1.126-5.013,P=0.026).The MODS score and APACHE Ⅱ score were significantly higher in the death group than the survival group(P＜0.05).Conclusion Elderly severe stroke patients are prone to MODS during the acute period.

Objective:To evaluate the in vitro cross-neutralization of serum antibodies in human and mice immunized with inactivated SARS-CoV-2 vaccine against Delta and Beta variants. Methods:Human serum samples after a second and a third dose of inactivated SARS-CoV-2 vaccine and mouse serum samples after a two-dose vaccination were collected. The neutralizing antibodies in the samples against SARS-CoV-2 strains of prototype, Delta and Beta variants were detected using micro-neutralization assay in biosafety level Ⅲ laboratory. The seroconversion rates and geometric mean titers (GMTs) of antibodies were calculated.Results:The seroconversion rates of antibodies in human serum samples against different SARS-CoV-2 strains were all above 95%. After two-dose vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 109, 41 and 15, respectively. The GMTs decreased by 2.7 folds and 7.3 folds for the Delta and Beta variants as compared with the prototype strain. After the booster vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 446, 190 and 86, respectively. The GMTs of neutralizing antibodies against Delta and Beta variants decreased by 2.3 folds and 5.2 folds as compared with that against the prototype strain. The seroconversion rates of antibodies against different SARS-CoV-2 strains in mouse serum samples were all 100%. The GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 2 037, 862 and 408, respectively. The GMTs decreased by 2.4 folds and 5.0 folds for the Delta and Beta variants.Conclusions:Inactivated SARS-CoV-2 vaccine could induce a certain level of neutralizing antibodies against Delta and Beta variants in both human and mouse models. Moreover, a third dose of vaccine induced higher levels of neutralizing antibodies against Delta and Beta variants in human. This study provided valuable data for the clinical application and protective evaluation of the inactivated SARS-CoV-2 vaccine.

Objective To study the effect of glycine transporter 1 inhibitor M22 on epileptic sei-zures and cognitive dysfunction in epilepsy mice. Methods A total of 110 C57BL/6 mice were randomly divided into Normal control group (CON group,n=10),Model group (Mod group n=20),M22-1 group (n=20),M22-2 group (n=20),M22-3 group (n=20),M22-4 group ( n=20) according to weight. The chronic epileptic model was established by intraperitoneal injection of PTZ(30 mg/kg). The mice in CON group was injected with normal saline(10 mg/kg). The mice in Mod group were intraperitoneally injected with normal saline (10 ml/kg) and were injected with PT2 30 min later. The mice in M22-1 group,M22-2 group,M22-3 group,M22-4 group were intraperitoneally injected with M22 of corresponding dose(10 mg/kg,20 mg/kg,40 mg/kg,80 mg/kg)respectively,lasting for 2 weeks. Epilepsy seizures of mice in each group were recorded. The learning and memory function of epilepsy mice were evaluated by Morris water maze test . Then the mice were sacrificed and the apoptosis related proteins Bcl-2,Bax,Cyt-c in the cerebral cortex of mice were meas-ured by Western blot. Results (1)The mortality kindling rate,epileptic seizure grade and rate of tonic clo-nus in M22-2 and M22-3 group were significantly lower than those in Mod,M22-1 and M22-4 group( all P<0. 05). (2) In the directional navigation experiment,the escape latency of mice in each group decreased with time. On the 4th day,the escape latency of mice in M22-3 group was significantly shorter than that in Mod group,and the difference was statistically significant ((30. 24±9. 46),(16. 05±5. 72),t=20. 36,P<0. 05). In space exploration experiment,compared with Mod group,M22-3 group had more times of crossing platform ((6. 45±3. 62),(3. 23±2. 47),t=38. 63,P=0. 004) and longer time of target quadrant activity((21. 53± 6. 38) s,(11. 52±3. 15) s,t=37. 53,P<0. 05). (3)It was showed by Western blotting that the relative ex-pression levels of Bcl-2 in M22-3 group were significantly higher than those in Mod group(P<0. 05),while the Bax and Cyt-c in M22-3 group were significantly lower than those in Mod group(P<0. 05). There was no significant difference in Bcl-2, Bax and Cyt-c between M22-1 group, M22-4 group and model group ( P>0. 05). Conclusion M22 (40 mg/kg) has significant anti-epileptic effect and can effectively improve the cognitive dysfunction of epileptic mice,which may be related to the inhibition of neuronal apoptosis in mice.[Key words] Epilepsy; Glycine transporter 1 inhibitor; M22; Cognitive function; Pentyle-netetrazole

Monoclonal protein (M protein) is a serum surrogate used to conduct diagnostic, prognostic, and therapeutic evaluations of monoclonal plasma cell proliferative disorders. Two basic methods, namely, serum protein electrophoresis and immunofixation elec-trophoresis, are employed to detect and characterize M protein. Although these techniques have considerably improved, M protein quantification exhibits several drawbacks. In serum protein electrophoresis, M protein can migrate to various locations, and low M pro-tein levels cannot form a typical peak;as a consequence, additional problems in measurements arise. In 2009, a novel immunoassay in-volving a heavy/light chain (HLC) was developed. HLC recognizes immunoglobulins with specific heavy and light chain isotypes. The ra-tio between an involved monoclonal immunoglobulin and an uninvolved background polyclonal immunoglobulin can be calculated through immunoglobulin quantitation by using isotype-specific light chains. This review summarizes relevant parameters that provide diagnostic, prognostic, and therapeutic data regarding monoclonal plasma cell proliferative disorders.

Objective To assessment the effect of autologous mastoid cortical bone to cover the mastoidetomy defect via transmastoid and posterior tympanotomy approach surgical technique during cochlear implantation in a ‐dults .Methods A total of 58 adults patients with profound sensorineural hearing loss accepted cochlear implantation from January 2010 and June 2014 ,which were using autologous mastoid cortical bone to cover the mastoidetomy de‐fect via transmastoid and posterior tympanotomy approach surgical technique .By observing postoperation complica‐tion the effect of surgery was evaluated .ABR were obtained for each patients at first ,third and sixth month after op‐eration .The patients which were not using autologous mastoid cortical bone to cover the mastoidetomy defect via transmastoid and posterior tympanotomy proach surgical technique acted as control group .Results No depression was found in the postauricuhtr site .None of the patients had experienced any immediate or delayed postoperative in ‐fection complication such as wound infection ,post - auricular abscess ,acute otitis media ,chronic otitis media ,in‐tracranial complication and necrotic of cortical bone .Autologous cortical bone cap had grew together with remnant cortical bone in all cochlear implantation patients .All implanted processor were in a good position ,all patients had good results after turning on the implant .The ABR thresholds were elevated about 70 dB compare to pre - operation values(P< 0 .05) .There was no significant difference compare to control group (P> 0 .05) .Conclusion The tech‐nique of autologous mastoid cortical bone to cover the mastoidetomy defect in cochlear implantation surgery can pre ‐vent depression of the postauricuhtr site ,remain stability of the implanted processor ,and have a good aided hearing thresholds after operation .

Objective To explore the bias between the real pressure and the measured values when handheld pressure gauge (HPG) was used to monitor intermittently the pressure in the intubation balloon,so as to provide some measures for the correct use of HPG.Methods In the first part of the study,HPG was used to measure the pressure with the balloon connected with a three-way tube with which to control the inflation and deflation in a laboratory to measure the pressure in the air bag.After gaining the deviation in this in vitro experiment,it was tested and verified in vivo in adult patients undergoing endotracheal intubation.Results After 132 times of measurements,it was found that measurement with a HPG might result in an inherent loss (3.928 ± 0.291) cmH2O (1 cmH2O=0.098 kPa,t =155.273,P =0.000) between inflation value [(30.000 ± 0.000) cmH2O] and measured value [(26.072 ± 0.291) cmH2O].In addition,after 214 times repeated measurements,the pressure loss during disconnection of the gauge was as high as (1.196 ± 0.954) cmH2O (t=18.348,P=0.000) between filled values [(30.000 ± 0.000) cmH2O] and measured values [(28.804 ± 0.954) cmH2O] and it was named as error loss.At last,the total error was verified by clinical test,and it was (5.270 ± 2.583) cmH2O (t=29.632,P=0.000) between pressure of filled value [(30.000 ± 0.000) cmH2O] and measured value [(24.730 ± 2.583) cmH2O].Conclusions When the balloon pressure was Monitored intermittently with HPG,the real value should be the measured value plus the error.In addition,subglottic aspiration should be done before the connection of the balloon to the gauge to prevent the secretions on the cuff falls into the deeper airway,and to maintain the cuff pressure at 30 cmH2O.

BACKGROUND: It is proved that acupuncture can remarkably promote recovery of nervous function after spinal cord injury (SCI). Previous studies in our groups have been proved that electro-acupuncture can inhibit apoptosis in early period of SCI, but the mechanism is unclear yet.OBJECTIVE: To study the effect of electro-acupuncture on expressions of apoptosis inhibitory gene Bcl-2 mRNA and protein with hybridization in situ and immunohistochemistry and discuss the possible mechanism of apoptosis inhibited by electro-acupuncture in early SCI.DESIGN:Opening animal study.SETTING: Department of Anatomy, the Second Military Medical University of Chinese PLA; Shanghai Acupuncture & Moxibustion and Meridian Research Center.MATERIALS:Adult male SD rats of pathogen-free aged 2-3 months were selected in this study. Bcl-2 hybridization in situ kit was provided by Wuhan Boshide Biotechnology Company Limited and Bcl-2 antibody (1:200) was provided by Santa Cruz Biotechnology Company.METHODS: The experiment was completed at the Laboratory of Anatomy of the Second Military Medical University of Chinese PLA from July 2004 to December 2005. All experimental rats were randomly divided into model group, electro-acupuncture group, methylprednisolone group and sham operation group. T10 spinal cord was injuried by the modified Allen's method and treated with electro-acupuncture immediately, and then the expressions of Bcl-2 mRNA and protein were evaluated with hybridization in situ and immunohistochemistry combined with image quantitative analysis.MAIN OUTCOME MEASURES: ① Expressions of Bcl-2 mRNA and protein in early SCI; ② effect of electro-acupuncture on expressions of Bcl-2 mRNA and protein.RESULTS: The rats were supplied when they died during the experiment,and all 42 rats were involved in the final analysis. ① Moderate expression of Bcl-2 mRNA and protein was observed in the sham operation group.Expression of Bcl-2 mRNA was increased in model group at 6 hours after SCI, but expression ofBcl-2 protein was not changed. At 24 hours after SCI, both expressions of Bcl-2 mRNA and Bcl-2 protein were increased.Expression of Bcl-2 mRNA and protein was higher in electro-acupuncture group than that in mo del group (P ＜ 0.05), and there was no significant difference from that in methylprednisolone group. ② Amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and methylprednisolone group at 6 hours after treatment, and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). After 24-hour treatment, amount of positive Bcl-2 mRNA cells was increased in electro-acupuncture group and gray value was decreased.There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01). ③ After 24-hour treatment, amount of immunohistochenistry positive Bcl-2 cells was increased in electro-acupuncture group and gray value was decreased. There was significant and remarkably significant difference from those in sham operation group and model group, respectively (P ＜ 0.05-0.01).CONCLUSION: Electro-acupuncture can up-regulate the expressions of Bcl-2 mRNA and protein so as to inhibit apoptosis in early SCI.

Objective:To establish an Ehrlich reaction-colorimetry method for determining furostanol saponins in saponins extract from Radix Asparagi.Methods: Based on the coloration reaction between furostanol saponins and p-dimethylaminobenzaldehyde,a colorimetry method was established to determine the content of furostanol saponins in saponins extract from Radix Asparagi at 510 nm.Saponins AC-9 was measured as reference in the determination.Results: The standard curve of saponins AC-9 showed good linearity in the range of 0.08-0.40 mg and the average recovery was 99.79%(RSD=(1.05%).) Conclusion: This method is rapid,accurate and easy to be carried out,and it can be used to control the quality of Radix Asparagi.