Objective: To analyze the impact of premature death due to four major chronic diseases on life expectancy in Yangpu District, Shanghai Municipality from 2010 to 2021, so as to provide the evidence for formulating chronic disease prevention and control strategies. Methods : Mortality data of registered residents in Yangpu District from 2010 to 2021 were collected through the Death Information Registration and Management System of the Shanghai Municipal Disease Control and Prevention Information Management Platform. The premature death probability of malignant tumors, diabetes, cardiovascular and cerebrovascular diseases, and chronic respiratory diseases, and life expectancy of residents were calculated using the abridged life table method. Trends in premature death probability for four types of chronic diseases were analyzed using the average annual percent change (AAPC). The impact of premature death probability due to four chronic diseases on life expectancy was assessed by Arriaga's decomposition method. Results : The premature death probability due to four major chronic diseases in Yangpu District decreased from 9.88% in 2010 to 9.22% in 2021, showing an overall declining trend (AAPC=-0.540%, P<0.05). Among females, the premature death probability declined from 6.71% to 4.90% (AAPC=-2.715%, P<0.05), whereas no statistically significant trend was observed in males (P>0.05). Life expectancy increased from 82.52 years in 2010 to 84.50 years in 2021, with an overall upward trend (AAPC=0.244%, P<0.05). Life expectancy rose by 1.71 years for males and 2.34 years for females (AAPC=0.197% and 0.303%,both P<0.05). Declines in premature death probability from malignant tumors (AAPC=-0.967%, P< 0.05) and chronic respiratory diseases (AAPC=-3.071%, P<0.05) contributed to gains in life expectancy of 0.30 years and 0.03 years, with contribution rates of 12.18% and 1.29%, respectively. Changes in premature death probability due to diabetes as well as cardiovascular and cerebrovascular diseases were not statistically significant (both P>0.05), resulting in reductions in life expectancy of 0.05 years and 0.10 years, with contribution rates of -2.40% and -5.05%, respectively. Notably, an increase in premature death probability due to cardiovascular and cerebrovascular diseases among males (AAPC=1.673%) contributed to a decrease of 0.22 years in male life expectancy, whereas a decrease among females (AAPC=-3.824%) contributed to an increase of 0.03 years in female life expectancy, with contribution rates of -13.03% and 1.14%, respectively. Conclusions From 2010 to 2021, Yangpu District experienced an overall decline in premature death probability due to four major chronic diseases and an increase in life expectancy. Greater attention should be paid to the negative impacts of premature death probability from diabetes as well as cardiovascular and cerebrovascular diseases among males on life expectancy.

ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Aim To investigate the therapeutic effect of newly formulated Tadalafil tablets on liver fibrosis in mice induced by carbon tetrachloride(CCl4)and its impact on the activation of hepatic stellate cells(HSCs).Methods Liver fibrosis model was estab-lished by intraperitoneally injecting 20％CCl4 corn oil solution twice a week for eight weeks.After four weeks of modeling,the treatment group was administered ei-ther the newly formulated Tadalafil tablets(1.0 mg·kg-1)or the Cialis(2.5 mg·kg-1)via gavage for the remaining four weeks.We assessed the effects of Tadalafil on collagen deposition,tissue structural dam-age,and HSCs activation markers in the fibrotic liver of mice using serum biochemical analysis,histopathologi-cal staining,and Western blotting following the treat-ment period.LX-2 cells were cultured and treated with tadalafil after TGF β1 stimulation,and the effects of tadalafil on LX-2 cell activation were assessed via Western blot.Results Compared to the normal mice,the model group mice exhibited a significantly higher liver-specific index,increased liver function indicators,and notable hepatocyte necrosis.Additionally,liver lobules were damaged,accompanied by severe infiltra-tion of inflammatory cells.Both smooth muscle actin(α-SMA)and fibronectin(Fn)were elevated,serving as markers of HSCs activation.As a result of treatment with the newly formulated Tadalafil tablets,liver tissue damage was significantly reduced,transaminase levels decreased,necrosis and inflammatory cell infiltration were reduced,and collagen fiber deposition was allevia-ted,and α-SMA and Fn expression was reduced.It was worth noting that low-dose newly formulated Tadalafil tablets were found to be as effective as high-dose Cia-lis.In a cellular model,Tadalafil significantly inhibited the activation of LX-2 cells and reduced the expression of proteins related to cell activation.Conclusions The newly formulated Tadalafil tablets can significantly inhibit HSCs activation,reduce extracellular matrix(ECM)deposition,improve liver fibrosis and liver function damage caused by CCl4.This new formulation offers a significant advantage over Cialis in terms of ef-fectiveness,with a lower effective dose.

Objective:To compare the effects of manual acupuncture(MA),electroacupuncture(EA),and moxibustion on knee joint cartilage morphology,serum inflammatory factors interleukin(IL)-6 and IL-10,matrix metalloproteinase 13(MMP13),and intestinal flora composition in knee osteoarthritis(KOA)model rats.Methods:Forty male specific-pathogen-free Sprague-Dawley rats aged seven weeks were randomly divided into a normal group(n=8)and a KOA modeling group(n=32).The KOA model was established using sodium iodoacetate induction.The KOA modeling rats were further randomly divided into a model group,an MA group,an EA group,and a moxibustion group,with 8 rats in each group.In the MA,EA,and moxibustion groups,interventions targeting the right Futu(ST32)and Zusanli(ST36)were performed for 15 min,once every other day,for 14 sessions.The normal and model groups were bundled on the self-made fixation frame for 15 min.The rat knee joint diameter was measured on the 8th day of adaptive feeding,after successful modeling,and after the 14th intervention.Lequesne behavioral scoring was performed after successful modeling and after the 14th intervention.After the 14th intervention,hematoxylin-eosin(HE)staining and Masson staining were performed with the cartilage sections of the right knee joint.The pathomorphological changes of the rat joint cartilage were observed and quantified by Mankin's score.Enzyme-linked immunosorbent assay was used to detect the rat serum levels of IL-6,IL-10,and MMP13.Additionally,16S rDNA sequencing was used to detect the composition of rat fecal flora.Results:Compared to the normal group,the right knee joint diameter and the Lequesne score were significantly increased in the model group(P<0.01).Compared to the model group,the right knee joint diameter and the Lequesne score of rats in the MA,EA,and moxibustion groups were significantly reduced(P<0.01),with no significant differences among the three intervention groups(P>0.05).HE staining and Masson staining revealed disordered cartilage structure in the model group,which was improved following interventions in the MA group,EA group,and moxibustion group.Mankin's score was significantly higher in the model group versus the normal group(P<0.05)while significantly lower in the MA,EA,and moxibustion groups versus the model group(P<0.05).Serum analysis showed elevated IL-6 and MMP13 levels and reduced IL-10 level in the model group versus the normal group(P<0.05).Compared to the model group,the serum IL-6 level was significantly reduced(P<0.05),and the IL-10 level was significantly increased(P<0.05)in the MA,EA,and moxibustion groups,but without statistical differences among the three intervention groups(P>0.05);moreover,the MMP13 level in the moxibustion group was significantly lower than that in the model group(P<0.05).The alpha diversity analysis of intestinal flora showed no statistical difference in the number of operational taxonomic units(OTUs)and alpha diversity index among groups(P>0.05).Intestinal flora beta diversity analysis revealed significant differences among groups(P<0.05).Intestinal flora composition analysis showed significantly increased relative abundance of Lactobacillus(P<0.05)and significantly decreased relative abundance of Eubacterium_coprostanoligenes(P<0.05)in the model group compared to the normal group;compared to the model group,the relative abundances of Firmicutes,Lactobacillus,and Romboutsia in the MA,EA,and moxibustion groups were significantly reduced(P<0.05);the relative abundance of Bacteroidetes and Lachnospiraceae_NK4A136 in the MA group increased significantly(P<0.05);Bacteroidetes and Ruminococcaceaae_UGC-005 increased significantly in the moxibustion group(P<0.05).Conclusion:MA,EA,and moxibustion effectively reduced knee joint swelling,improved cartilage tissue morphology,optimized intestinal flora composition,down-regulated expression levels of serum pro-inflammatory factors IL-6 and MMP13,and increased expression level of anti-inflammatory factor IL-10 in KOA rats.Among them,moxibustion exhibited the most obvious regulatory effect on inflammatory factors.

Objective To establish a stable liquid chromatography-tandem mass spectrometry(LC-MS/MS)method for detecting gamma-aminobutyric acid(GABA)in plasma,and to evaluate the value of GABA detection in the diagnosis of sleep disorders.Methods GABA was detected using a UPLC Xevo TQs system.The method was pre-validated and its performance was verified to establish a reference range for healthy individuals.The difference in plasma GABA levels between apparently healthy individuals and patients with sleep disorders was compared.Results We employed deuterated compounds as isotopic internal standards and utilized an Amide chromatographic column for separation.The mobile phase was 0.050%formic acid in water and 90%acetonitrile in water containing 0.175%formic acid and 5 mmol/L ammonium acetate with gradient elution in the column temperature of 35℃.The linear range for the detection of GABA by LC-MS/MS was 0.05-10.00 μmol/L,with a lower limit of quantification of 0.02 μmol/L,the inter-day CV<3.00%and intra assay CV<4.00%,respectively,and the recovery rate was 101.06%-109.02%.The reference ranges for plasma GABA were established by analyzing 300 healthy controls stratified by age:18-34 years(0.08-0.15 μmol/L),35-49 years(0.10-0.20 μmol/L),and≥50 years(0.12-0.23 μmol/L).Then plasma GABA was used as a biomarker for auxiliary diagnosis of sleep disorders in analyzing 221 patients and 300 healthy controls,which revealed that AUC values were 0.510(P=0.850),0.686(P=0.002),and 0.890(P<0.001)in the groups of 18-34 years,35-49 years,and≥50 years,respectively,with optimal cut-off values of 0.09,0.10 and 0.11 μmol/L.Conclusion A reliable LC-MS/MS method for detecting GABA has been established,which can detect plasma GABA levels sensitively and accurately and can be used in assisting the clinical diagnosis of sleep disorders.

Objective:To explore the effects of Ziyu Ointment on granulation tissue,TGF-β and downstream Smad protein in the process of wound healing in rats by constructing a rat model of back trauma.Methods:A rat model of back trauma was constructed,and 100 SD male rats were separated into healthy group,back trauma group,Ziyu Ointment treatment group,petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group,with 20 per group.Wound formation surgery was performed,and wound healing of rats in each group was recorded at 5th,10th,and 15th day after operation;the levels of IL-6,IL-1β and TNF-α in the serum of rats in each group were detected;the granulation tissue formed by wound healing at 15th day was selected for HE and Masson staining,the proportion of blood vessel area and collagen area of granulation tissue of rats in each group were analyzed and calculated;the mRNA expression levels of TGF-β1 and Smad3 in granulation tissues of rats in each group were detected by fluorescence quantitative PCR;the expression levels of TGF-β1,Smad3 and p-Smad3 in granulation tissues of rats in each group were detected by Western blot.Results:The healthy group rats had complete epidermal tissue;the levels of serum IL-6,IL-1β,TNF-α,the expression of TGF-β1 mRNA and protein in the wound granulation tissue,and the phosphorylation of Smad3 in the back trauma group were obviously higher than the healthy group(P<0.05);compared with back trauma group,the wound healing rate,proportion of collagen area,and propor-tion of blood vessel area in Ziyu Ointment treatment group and petrolatum treatment group were obviously increased,the serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression,and Smad3 phosphorylation were obviously decreased(P<0.05);compared with Ziyu Ointment treatment group,the petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group had obviously lower wound healing rate,collagen area percentage,and blood vessel area percentage,and obviously lower serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression and Smad3 phosphorylation(P<0.05).Conclusion:Ziyu Ointment can inhibit the expression of related genes and proteins by regulating the TGF-β/Smad signal pathway,thereby alleviating inflammation and promoting wound healing.

Objective:To compare the effects of manual acupuncture(MA),electroacupuncture(EA),and moxibustion on knee joint cartilage morphology,serum inflammatory factors interleukin(IL)-6 and IL-10,matrix metalloproteinase 13(MMP13),and intestinal flora composition in knee osteoarthritis(KOA)model rats.Methods:Forty male specific-pathogen-free Sprague-Dawley rats aged seven weeks were randomly divided into a normal group(n=8)and a KOA modeling group(n=32).The KOA model was established using sodium iodoacetate induction.The KOA modeling rats were further randomly divided into a model group,an MA group,an EA group,and a moxibustion group,with 8 rats in each group.In the MA,EA,and moxibustion groups,interventions targeting the right Futu(ST32)and Zusanli(ST36)were performed for 15 min,once every other day,for 14 sessions.The normal and model groups were bundled on the self-made fixation frame for 15 min.The rat knee joint diameter was measured on the 8th day of adaptive feeding,after successful modeling,and after the 14th intervention.Lequesne behavioral scoring was performed after successful modeling and after the 14th intervention.After the 14th intervention,hematoxylin-eosin(HE)staining and Masson staining were performed with the cartilage sections of the right knee joint.The pathomorphological changes of the rat joint cartilage were observed and quantified by Mankin's score.Enzyme-linked immunosorbent assay was used to detect the rat serum levels of IL-6,IL-10,and MMP13.Additionally,16S rDNA sequencing was used to detect the composition of rat fecal flora.Results:Compared to the normal group,the right knee joint diameter and the Lequesne score were significantly increased in the model group(P<0.01).Compared to the model group,the right knee joint diameter and the Lequesne score of rats in the MA,EA,and moxibustion groups were significantly reduced(P<0.01),with no significant differences among the three intervention groups(P>0.05).HE staining and Masson staining revealed disordered cartilage structure in the model group,which was improved following interventions in the MA group,EA group,and moxibustion group.Mankin's score was significantly higher in the model group versus the normal group(P<0.05)while significantly lower in the MA,EA,and moxibustion groups versus the model group(P<0.05).Serum analysis showed elevated IL-6 and MMP13 levels and reduced IL-10 level in the model group versus the normal group(P<0.05).Compared to the model group,the serum IL-6 level was significantly reduced(P<0.05),and the IL-10 level was significantly increased(P<0.05)in the MA,EA,and moxibustion groups,but without statistical differences among the three intervention groups(P>0.05);moreover,the MMP13 level in the moxibustion group was significantly lower than that in the model group(P<0.05).The alpha diversity analysis of intestinal flora showed no statistical difference in the number of operational taxonomic units(OTUs)and alpha diversity index among groups(P>0.05).Intestinal flora beta diversity analysis revealed significant differences among groups(P<0.05).Intestinal flora composition analysis showed significantly increased relative abundance of Lactobacillus(P<0.05)and significantly decreased relative abundance of Eubacterium_coprostanoligenes(P<0.05)in the model group compared to the normal group;compared to the model group,the relative abundances of Firmicutes,Lactobacillus,and Romboutsia in the MA,EA,and moxibustion groups were significantly reduced(P<0.05);the relative abundance of Bacteroidetes and Lachnospiraceae_NK4A136 in the MA group increased significantly(P<0.05);Bacteroidetes and Ruminococcaceaae_UGC-005 increased significantly in the moxibustion group(P<0.05).Conclusion:MA,EA,and moxibustion effectively reduced knee joint swelling,improved cartilage tissue morphology,optimized intestinal flora composition,down-regulated expression levels of serum pro-inflammatory factors IL-6 and MMP13,and increased expression level of anti-inflammatory factor IL-10 in KOA rats.Among them,moxibustion exhibited the most obvious regulatory effect on inflammatory factors.

AIM To evaluate the quality of Rubi Fructus.METHODS UPLC-Q-TOF-MS/MS was adopted in the component identification,after which the HPLC fingerprints were established,cluster analysis,principal component analysis and orthogonal partial least squares discriminant analysis were used for chemical pattern recognition.and the contents of chlorogenic acid,ferulic acid,ellagic acid,isoquercitrin,kaempferol-3-O-rutinoside,astragalin,tiliroside quercetin,kaempferol were determined.RESULTS Total 34 constituents were identified.There were 19 common peaks in the fingerprints for 31 batches of medicinal materials with the similarities of more than 0.8.Wild varieties and cultivated varieties,and medicinal materials from different producing areas could be distinguished;4 principal components demonstrated the accumulative variance contribution rate of 84.142％;8 differential components were screened,2 of which were ellagic acid and astragalin.Ellagic acid and astragalin displayed higher contents in the wild varieties than those in the cultivated varieties(P＜0.05,P＜0.01).CONCLUSION UPLC-Q-TOF-MS/MS,HPLC fingerprints combined with content determination can be used for the quality control of Rubi Fructus.

Objective To compare the pain relief and long-term clinical success rate of vital pulp therapy and root canal treatment in mature permanent teeth with carious irreversible pulpitis.Methods A total of 90 patients diagnosed with carious irreversible pulpitis in mature permanent teeth were collected at Shanghai Stomatological Hospital from Jan 2021 to Jun 2022.They were randomly divided into two groups:test group(n=45)undergoing vital pulp therapy(VPT)and control group(n=45)undergoing root canal treatment(RCT).Pain scores were recorded before treatment,24 hours after operation and 7 days after operation.We conducted clinical evaluation and imaging analysis at 1,6,and 12 months after the surgery,then compared the pain scores and treatment success rates between the two groups.Results Eighty-one patients,including 39 patients in group VPT aged(31.00±1.43)years old and 42 patients in group RCT aged(30.60±1.54)years old,received follow-up for more than 1 year,and the success rate of the test group and control was 97.44%and 95.24%.The pain degree of the two groups was reduced at 24 hours and 7 days after operation(P<0.05),and the pain score of the test group was reduced compared with that in the control group 7 days after operation(P<0.01).Conclusion Compared with root canal treatment,vital pulp therapy for mature permanent teeth with carious irreversible pulpitis can achieve good results in short-term pain evolution and long-term clinical success.

Objective To establish a stable liquid chromatography-tandem mass spectrometry(LC-MS/MS)method for detecting gamma-aminobutyric acid(GABA)in plasma,and to evaluate the value of GABA detection in the diagnosis of sleep disorders.Methods GABA was detected using a UPLC Xevo TQs system.The method was pre-validated and its performance was verified to establish a reference range for healthy individuals.The difference in plasma GABA levels between apparently healthy individuals and patients with sleep disorders was compared.Results We employed deuterated compounds as isotopic internal standards and utilized an Amide chromatographic column for separation.The mobile phase was 0.050%formic acid in water and 90%acetonitrile in water containing 0.175%formic acid and 5 mmol/L ammonium acetate with gradient elution in the column temperature of 35℃.The linear range for the detection of GABA by LC-MS/MS was 0.05-10.00 μmol/L,with a lower limit of quantification of 0.02 μmol/L,the inter-day CV<3.00%and intra assay CV<4.00%,respectively,and the recovery rate was 101.06%-109.02%.The reference ranges for plasma GABA were established by analyzing 300 healthy controls stratified by age:18-34 years(0.08-0.15 μmol/L),35-49 years(0.10-0.20 μmol/L),and≥50 years(0.12-0.23 μmol/L).Then plasma GABA was used as a biomarker for auxiliary diagnosis of sleep disorders in analyzing 221 patients and 300 healthy controls,which revealed that AUC values were 0.510(P=0.850),0.686(P=0.002),and 0.890(P<0.001)in the groups of 18-34 years,35-49 years,and≥50 years,respectively,with optimal cut-off values of 0.09,0.10 and 0.11 μmol/L.Conclusion A reliable LC-MS/MS method for detecting GABA has been established,which can detect plasma GABA levels sensitively and accurately and can be used in assisting the clinical diagnosis of sleep disorders.