Angong Niuhuang Pills(AGNHP) are effective in clearing heat, removing the toxin, and eliminating phlegm for resuscitation. Clinically, it is widely used to treat various diseases such as febrile convulsion due to heat attacking pericardium, but its therapeutic effects on heart failure(HF) have not been well recognized. In this study, the profiles of differential metabolites regulated by AGNHP were identified by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS). The underlying mechanism of AGNHP against HF was illustrated based on the integrated analysis of pharmacological data and metabolic molecular network. The HF model was induced by isoproterenol in mice. After oral administration of AGNHP for one week, cardiac functions in HF mice were evaluated by echocardiography, and serum samples of mice were collected for metabolomics analysis. Eight differential metabolites of AGNHP against HF were screened out through partial least square discriminant analysis(PLS-DA) and input into MetaboAnalyst for the analysis of metabolic pathways. Moreover, the critical metabolic pathways regulated by AGNHP were enriched according to the potential targets of major compounds in AGNHP. After AGNHP treatment, the recovered index of relative content of some metabolites underwent cross-scale fusion analysis with therapeutic efficacy data, followed by "compound-reaction-enzyme-gene" network analysis. It is inferred that the anti-HF effects of AGNHP may be attributed to the metabolism of arachidonic acid, amino acid, glycerophospholipid, and linoleic acid. The cross-scale polypharmacological analysis method developed in this study provides a new method to interpret scientific principles of AGNHP against HF with modern technologies.
Animals ; Biomarkers ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Heart Failure/drug therapy* ; Metabolomics ; Mice

Objective:The aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population.Methods:The role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up.Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality.Results:There were 1471 deaths after a median follow-up of 20.2 years (a total of 187,374 person-years),including 310 cardiovascular deaths,581 cancer deaths,and 580 other-cause deaths,After adjustment for age,sex,urban or rural,northern or southern of China,types of work,education level,physical exercise,smoking status,drinking status,body mass index,systolic blood pressure,and serum total cholesterol at baseline,the hazard ratios (HRs) and 95％ confidence intervals (CIs) for all-cause mortality in the fasting blood glucose categories of ＜60,60-69,70-79,90-99,100-109,110-125,and ≥126 mg/dl were 1.38 (1.04-1.84),1.20 (1.01-1.43),1.18 (1.03-1.36),1.18 (0.99-1.41),1.48 (1.16-1.88),1.17 (0.84-1.62),and 2.23 (1.72-2.90),respectively,in contrast to the reference group (80-89 mg/dl).The HRs and 95％ CIs for cardiovascular disease mortality in these groups were 2.58 (1.44-4.61),1.41 (0.95-2.10),1.56 (1.15-2.11),1.29 (0.88-1.89),1.36 (0.78-2.37),1.05 (0.52-2.11),and 2.73 (1.64-4.56),respectively.Conclusions:Both low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.

Objective:The aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population.Methods:The role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up.Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality.Results:There were 1471 deaths after a median follow-up of 20.2 years (a total of 187,374 person-years),including 310 cardiovascular deaths,581 cancer deaths,and 580 other-cause deaths,After adjustment for age,sex,urban or rural,northern or southern of China,types of work,education level,physical exercise,smoking status,drinking status,body mass index,systolic blood pressure,and serum total cholesterol at baseline,the hazard ratios (HRs) and 95％ confidence intervals (CIs) for all-cause mortality in the fasting blood glucose categories of ＜60,60-69,70-79,90-99,100-109,110-125,and ≥126 mg/dl were 1.38 (1.04-1.84),1.20 (1.01-1.43),1.18 (1.03-1.36),1.18 (0.99-1.41),1.48 (1.16-1.88),1.17 (0.84-1.62),and 2.23 (1.72-2.90),respectively,in contrast to the reference group (80-89 mg/dl).The HRs and 95％ CIs for cardiovascular disease mortality in these groups were 2.58 (1.44-4.61),1.41 (0.95-2.10),1.56 (1.15-2.11),1.29 (0.88-1.89),1.36 (0.78-2.37),1.05 (0.52-2.11),and 2.73 (1.64-4.56),respectively.Conclusions:Both low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.

Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month′s follow-up, who didn′t accept any treatment because the patient didn′t feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all patients had achieved bone union. According to the modified Merle D′Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.

Objective To evaluate the clinical outcome of bleeding control by preoperative embolization of internal iliac artery with DSA and intra?operative presetting abdominal aorta balloon, combine with the operation techniques of exposure, reduc?tion and internal fixation of pelvic fracture through lateral?rectus approach. Methods From March 2012 to May 2015, 7 patients with type C3 pelvic fractures admitted to our department from March 2012 to May 2015, treated with preoperative embolization of internal iliac artery under digital subtraction angiography 2 h before surgery and presetting abdominal aorta balloon were retrospec?tively reviewed. There were 3 males and 4 females, with an average age of 34 years (range, 16 to 61 years). According to AO classi?fication, all 7 cases belonged to type C3 (3.2:5 cases;C3.3:2 cases), including 5 cases with limb fracture, 2 cases with craniocere?bral trauma, 4 cases with pulmonary contusion, 2 cases with injury of abdominsal organs. Time from injury to operation was 19 days on average (10 to 33 days). Patients received damage control surgery treatment including bleeding control and temporary ex?ternal fixation, and ipsilateral tractions with heavy weight, intensive care and corrections of general situation before operation. The fracture model was manufactured by 3D printing and fracture reduction was simulated on computer preoperatively. Embolization of internal iliac artery was performed in the side of severe displaced sacroiliac joint with DSA 2 hours preoperatively. Reduction was performed to stabilize anterior-posterior pelvic ring and acetabular fractures via the intraoperative lateral?rectus approach. And 2 cases were performed by temporary balloon occlusion of abdominal aorta (≤60 min) for bleeding control in reduction of in the side of sacroiliac joint fractures. Results All the 7 cases had undergone the operations successfully, and the operating time was from 135-320 min with blood loss from 440-3 350 ml. According to Matta radiological evaluation postoperatively, reduction of pelvic fracture was rated as anatomic in 5 cases, satisfactory in 2, without complications. All 7 cases were complicated with lumbosacral plexus injury or lumbosacral trunk injury at different degrees (M0 2 cases, M1 2 cases, M2 2 cases, M3 1 case). According to the BMRC scoring system, 5 cases had well recovered and the other 2 cases had no improvement after three months (M4 2 cases, M5 3 cases). Conclusion Surgical management of pelvic fracture through preoperative internal iliac artery embolization and intra?oper?ative occlusion of abdominal aorta could effective control bleeding and achieve favorable conditions for reduction. Lateral?rectus approach can provide adequate exposure of the anterior and posterior ring, and this approach could also provide excellent visual control of reduction and fixation.

Introduction:Thrombocytosis has been identified as an unfavorable prognostic factor in several types of cancer. This study aimed to evaluate the prognostic value of pretreatment platelet count in association with the TNM staging system and therapeutic regimens in patients with nasopharyngeal carcinoma (NPC). Methods:A total of 2,626 patients with NPC were retrospectively analyzed. Platelet count>300 × 109/L was defined as thrombocytosis. Matched-pair analysis was performed between patients receiving chemoradiotherapy and radiotherapy. Results:Multivariate analysis showed that platelet count was an independent unfavorable prognostic factor for overal survival (OS) [hazard ratio (HR)=1.810, 95%confidence interval (CI)=1.531–2.140, P<0.001] and distant metastasis–free survival (DMFS) (HR=1.873, 95%CI=1.475–2.379, P<0.001) in the entire patient cohort. Further subgroup analysis revealed that increased platelet count was an independent unfavorable prognostic factor for OS and DMFS in patients with NPC stratified by early and advanced T category, N category, or TNM classification (al P≤0.001). Receiver operating characteristic (ROC) curves verified that the predictive value of TNM classification for OS was improved when combined with pretreatment platelet count (P=0.030). Matched-pair analysis showed that chemoradiotherapy significantly improved OS only in advanced-stage NPC with thrombocytosis (HR=0.416, 95%CI=0.226–0.765, P=0.005). Conclusions:Pretreatment platelet count, when combined with TNM classification, is a useful indicator for metastasis and survival in patients with NPC. It may improve the predictive value of the TNM classification and help to identify patients likely to benefit from more aggressive therapeutic regimens.

OBJECTIVETo explore possible interrelationships among resistance to peer pressure, risky decision-making and health risk behaviors among young adolescents.

METHODSBased on the cluster sampling method, the participants who were recruited from 5 junior middle schools in Guangzhou and 3 junior middle schools in Shenyang city on October, 2010, were administered to complete the questionnaire concerned with their experiences with drinking and smoking during the past 30 days preceding the survey, and the hours using computer daily both in weekdays and in weekend. The level of resistance to peer influence and risky decision-making were assessed by Resistance to peer influence scale (RPIS) and Youth decision-making questionnaire (YDMQ). Logistic regression was used to explore possible interrelationships among resistance to peer influence, risky decision-making and health risk behaviors among young adolescents.

RESULTSA total of 1985 questionnaires were valid, including 1001(50.4%) boys and 984 (49.6%) girls. About 27.1% (537/1985) junior middle school students reported having health risk behaviors, boys' (30.7%, 307/1001) was higher than girls' (23.4%, 230/984) with significant gender difference (P < 0.05). The prevalence of smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend were 5.1% (102/1985), 14.3% (284/1985), 3.5% (70/1985) and 13.7% (272/1985), respectively. The rate of drinking, using computer over 3 hours daily in weekdays and in weekend were higher in males (16.4% (164/1001), 4.5% (45/1001), 16.2% (162/1001)) than those in females (12.2% (120/984), 2.5% (25/984), 11.2% (110/984)) (P < 0.05). The scores of RPIS and YDMQ of the two cities adolescents were 2.82 ± 0.39 and 1.68 ± 0.62. The students reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekend gained lower RPIS scores (2.43 ± 0.40, 2.61 ± 0.41, 2.77 ± 0.40) than their counterparts who didn't report these kind of health risk behaviors (2.84 ± 0.38, 2.85 ± 0.38, 2.82 ± 0.39)(P < 0.05). And those reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend gained higher YDMQ scores (2.38 ± 0.66, 2.06 ± 0.66, 1.97 ± 0.72, 1.84 ± 0.64, respectively) than their counterparts who didn't report these kind of health risk behaviors (1.64 ± 0.38, 1.61 ± 0.58, 1.67 ± 0.61, 1.65 ± 0.61, respectively) (P < 0.05). After adjusting gender, area, parental education degree, self-reported family economic condition, multi-variant logistic regression analysis indicated that the low and middle level of resistance to peer influence (low and middle level vs high level, had odds ratios of 2.97 (1.96 - 4.50) and 1.51 (1.05 - 2.16)), and also the middle and high level of risky decision-making (middle and high level vs low level, had odds ratios of 1.62 (1.19 - 2.22) and 3.43 (2.39 - 4.90)) were all the risk factors of adolescent health risk behaviors.

CONCLUSIONAdolescents with poor ability of resistance to peer pressure and high risky decision-making were both the risk factors of adolescent health risk behaviors.

Adolescent ; Child ; Cross-Sectional Studies ; Female ; Health Behavior ; Humans ; Logistic Models ; Male ; Peer Group ; Risk Assessment ; Risk-Taking ; Surveys and Questionnaires

Accidents ; statistics & numerical data ; Adolescent ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Students ; Wounds and Injuries ; epidemiology

Objective To investigate the risk factors and to provide evidence for prevention and reduction of sports injuries in primary and secondary school students in Guangzhou. Methods 1:1 case-control study was conducted on both 349 cases and controls under the same distribution of sex, age and grade. Conditional univariate and multivariate logistic regression were used to explore the relationships between risk factors and injuries. Results Severe soles wear (OR=7.20, 95% CI: 2.37-21.84),tiredness (OR= 14.34,95%CI:2.29-89.66) or sickness (OR=1.96,95%CI: 1.29-3.06) when participating in sports at a high frequency and history of previous injuries (OR=2.11,95%CI: 1.41-3.96) were risk factors related to sports injury while guidance by teachers and physical education provided by teachers during training (OR=0.46, 95%CI: 0.26-0.79) , appropriate protection (OR= 0.36, 95%CI: 0.20-0.64) as well as warming-up exercise (OR=0.31,95%CI: 0.14-0.67) at a high frequency were protective factors for sports injury. Conclusion Prevention and control on sports injury need to improve the awareness on sports safety for students and teachers in order to develop positive behavior on sports safety.

Objective To investigate the effect of immunosuppression agent Everolimus on the viability and function of insuloma cells(INS-1)and pancreatic islet cells cultured in vitro.Methods INS-1 cells and islets were treated with a series of concentrations of immunosuppression agents(Everolimus,Cyclosporin A,Sirolimus and Mycophenolate Mofetil).The viability of INS-1 cells and rat pancreatic islets were determined with MTT and the function of INS-1 cells and rat pancreatic islets was evaluated with Glucose-stimulated insulin secretion assay.Results Above the clinical blood concentration,the inhibition rate of islet cell proliferation in the high concentration group of Everolimus and Sirolimus was significantly lower than that of Cyclosporin A and Mycophenolate Mofetil group(P＜0.05);Everolimus in the blood drug level,like other immunosuppressive agents,can inhibit the function of insulin secretion,and the stimulation index of each group was no significant difference.Conclusion Compared to Mycophenolate Mofetil and Cyclosporin A,Everilimus and Sirolimus demonstrate lower toxicity effect on INS-1 cells and rat pancreatic islets in vitro and Everolimus is expected as a new type of immunosuppressive agent used in clinical islet transplantation.