Objective To explore the potential molecular mechanism of Sangma Xingbei Tang （SMXBT） in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods TCMSP and TCMID databases were searched for the active ingredients of SMXBT, the targets of the active ingredients were predicted by SwissTargetPrediction database, and the AECOPD-related targets were searched by GeneCards and OMIM databases; the drug-active ingredient-target network and protein interaction network were constructed, and the GO enrichment and KEGG pathway enrichment were analyzed by the DAVID database. The drug-active ingredient-target network and protein interaction network were constructed, and the GO enrichment and KEGG pathway enrichment were analyzed by DAVID database, and molecular docking was performed by AutoDock Tools software. Animal experiments were conducted for validation. Results 192 active ingredients were obtained and 1066 targets were predicted in SMXBT. Network analysis showed that the top 3 active ingredients in SMXBT were quercetin, kaempferol, and glycyrrhizin, and the top 3 therapeutic targets were TNF, ALB, and IL-1β, etc. The GO analysis and KEGG showed that the main pathways were the cancer pathway, the MAPK signaling pathway, and the PI3K-Akt signaling pathway. Molecular docking showed that the binding energies of glycyrrhizin and AKT1, IL-1β, GFR, SRC, and quercetin and kaempferol and IL-1β were all <−5 kcal·mol. Animal experiments showed that Sangma Xingbei Decoction could treat AECOPD by anti-inflammatory effects and reduce changes in lung tissue structure. Additionally, it could lower the serum inflammatory levels of TNF-α, IL-6, and IL-8. Conclusion SMXBT may act on the targets of AKT1, IL-1β, EGFR, SRC, etc., reduce the serum inflammation levels of TNF-α, IL-6, IL-8, and improve the lung tissue structure and inflammatory response to achieve the therapeutic effect on AECOPD through the modulation of the PI3K/Akt signaling pathway, the MAPK signaling pathway, the cancer pathway, and other pathways of action.

Objective The study intends to develop a multi－dimensional specific scale for the primary family caregivers of cancer patients,verify its reliability and validity,and reveal the burden level of the primary family caregivers of cancer patients.Methods This study investigated the primary family caregivers of cancer patients by questionnaire survey in Harbin of two medical institutions,finally we recalled 571 valid questionnaires.The study used SPSS 27.0 and AMOS 28.0 software to conduct reliability and validity analysis.The critical value of the burden score was determined by the quartile method to evaluate the burden level.Results The revised scale includes 21 items in 5 dimensions.The Cronbach's α coefficient range of the total scale and each dimension of the scale was 0.798~0.922,the Omega coefficient range was 0.806~0.918,and the split－half reliability range was 0.753~0.862.The average variance extracted(AVE)value and composite reliability(CR)value of the five dimensions of the scale meet the criteria,and the correlation coefficient between each dimension is less than the square root of AVE.Based on the critical value,there are 54.8%of carers suffer from moderate or heavy burdens.Among them,the financial burden and the care burden have the highest scores.Conclusion It shows that the burden scale for primary family caregivers of cancer patients has good reliability and validity.There are more than half of carers suffer from relatively heavy burden.Policymakers should draw up policies to support economic medical expense reimbursement and last comfort service.

Objective The study intends to develop a multi－dimensional specific scale for the primary family caregivers of cancer patients,verify its reliability and validity,and reveal the burden level of the primary family caregivers of cancer patients.Methods This study investigated the primary family caregivers of cancer patients by questionnaire survey in Harbin of two medical institutions,finally we recalled 571 valid questionnaires.The study used SPSS 27.0 and AMOS 28.0 software to conduct reliability and validity analysis.The critical value of the burden score was determined by the quartile method to evaluate the burden level.Results The revised scale includes 21 items in 5 dimensions.The Cronbach's α coefficient range of the total scale and each dimension of the scale was 0.798~0.922,the Omega coefficient range was 0.806~0.918,and the split－half reliability range was 0.753~0.862.The average variance extracted(AVE)value and composite reliability(CR)value of the five dimensions of the scale meet the criteria,and the correlation coefficient between each dimension is less than the square root of AVE.Based on the critical value,there are 54.8%of carers suffer from moderate or heavy burdens.Among them,the financial burden and the care burden have the highest scores.Conclusion It shows that the burden scale for primary family caregivers of cancer patients has good reliability and validity.There are more than half of carers suffer from relatively heavy burden.Policymakers should draw up policies to support economic medical expense reimbursement and last comfort service.

Objective:To evaluate clinical efficacy and safety of topical compound oleum lithospermi in the treatment of mild to moderate diaper dermatitis.Methods:A multicenter, randomized, positive-drug parallel-controlled clinical trial was conducted in 19 hospitals from July 2019 to August 2020. Children aged 0 - 12 months with mild to moderate diaper dermatitis were enrolled and randomly divided into 2 groups using a random number table: test group topically treated with compound oleum lithospermi, and control group topically treated with zinc oxide cream. The treatment was carried out 6 - 8 times a day for 7 days. Visits were scheduled on days 0 and 7, and total response rate and clinical healing time were evaluated. Changes in the dermatitis family impact (DFI) score were compared between the test group and control group, and adverse events were recorded. Statistical analysis was carried out by using independent-sample t test for normally distributed continuous data, Wilcoxon rank sum test for non-normally distributed continuous data, and chi-square test or Fisher′s exact test for unordered categorical data; survival curves were drawn, and log-rank test was used for comparisons between two groups. Results:A total of 343 children with diaper dermatitis were enrolled in this study. Among them, 31 children violated the protocol, so 312 were included in the per protocol set, including 157 in the test group and 155 in the control group, and all completed the visits on days 0 and 7. The total response rate was significantly higher in the test group (87.26%, 137/157) than in the control group (78.71%, 122/155; χ2 = 4.04, P = 0.044) . The clinical healing time was significantly shorter in the test group (5.33 days) than in the control group (6.13 days; χ2 = 4.67, P = 0.025) . After 7-day treatment, the DFI score significantly decreased in both the 2 groups compared with that before the treatment, but there was no significant difference in the DFI score between the 2 groups (test group: 4.02 ± 6.96, control group: 3.58 ± 5.90, Z = -0.39, P = 0.686) . The incidence of adverse events was 2.92% (5/171) and 5.45% (9/165) in the test group and control group respectively, and there was no significant difference between the 2 groups ( χ2 = 0.03, P = 0.865) . Conclusion:Compound oleum lithospermi can markedly reduce the clinical severity of diaper dermatitis, improve the total response rate, shorten the clinical treatment period, and improve the quality of life of children′s families with a favorable safety profile.

OBJECTIVES: Perfluorooctanoic acid (PFOA) can cause lipid metabolism disorders in animal body and affect the lipolysis and synthesis of fatty acids. Peroxisome proliferators-activated receptor (PPAR) plays an extremely important role in this process. This study aims to explore the effects of PFOA on liver lipid metabolism disorders in Sprague Dewley (SD) rats and the expression of PPAR. METHODS: A total of 40 male SD rats were randomly divided into 4 groups (n=10 in each group): a control group (ddH₂O), a low-dose PFOA group [PFOA 1.25 mg/(kg·d)], a middle-dose PFOA group [PFOA 5.00 mg/(kg·d)], and a high-dose PFOA group [PFOA 20.00 mg/(kg·d)]. The rats were fed with normal diet, and PFOA exposure were performed by oral gavage for 14 days, and the rats were observed, weighted and recorded every day during the exposure. After the exposure, the blood was collected, and the livers were quickly stripped after the rats were killed. Part of the liver tissues were fixed in 4% paraformaldehyde for periodic acid-schiff (PAS) staining; the contents of HDLC, LDLC, TG, TC in serum and liver tissues, as well as the activities of their related enzymes were assayed; The expression levels of cyclic adenosine monophosphate-response element binding protein (Cbp), general control of amino acid synthesis 5-like 2 (Gcn5L2), peroxidation peroxisome proliferation factor activated receptor γ (PPAR), silent information regulator 1 (Sirt1) and human retinoid X receptor alpha 2 (Rxrα2) ) were detected by Western blotting. RESULTS: After 14 days of PFOA exposure, the PAS staining positive particles in the cytoplasm and nucleus of SD rats in the medium and high dose groups were significantly reduced compared with the control group. The serum levels of LDLC and TC in the low-dose and middle-dose groups were significantly reduced compared with the control group (all P<0.05), while the high-dose group showed an increasing tendency, without siginificant difference (P>0.05), there was no significant difference in HDLC and TG (both P>0.05). The activities of alkaline phosphatase (AKP) and alanine aminotransferase (ALT) were increased significantly (both P<0.05) compared with control group; the ratio of ALT/aspartate aminotransferase (AST) in the high-dose group was increased significantly (P<0.05), there was no significant difference in LDH and TG (both P>0.05); the HDLC content in the liver tissues in the high-dose group was significantly reduced, compared with the control group (P<0.05); the TC contents in the liver tissues in the low, medium and high-dose groups were significantly increased (all P<0.05), there was no significant difference in LDLC and TG (both P>0.05); the AKP activity in the livers in the medium and high-dose groups was significantly increased (both P<0.05), there was no siginificant difference in LDH, ALT, and the ratio of ALT/AST (all P>0.05); the protein expression levels of Ppar γ, Cbp and Rxrα2 in the liver in the high dose groups were significantly down-regulated compared with the control group (all P<0.05), while the protein expression levels of Sirt1 were significantly up-regulated (all P<0.05). CONCLUSIONS PFOA exposure can cause lipid metabolism disorder and glycogen reduction in SD rat livers, which may be related to the activation of Sirt1 and inhibition of Ppar γ expression, leading to affecting the normal metabolism of fatty acids and promoting glycolysis.
Animals ; Caprylates ; Fatty Acids/pharmacology* ; Fluorocarbons ; Lipid Metabolism ; Lipid Metabolism Disorders/metabolism* ; Liver/metabolism* ; Male ; PPAR gamma ; Rats ; Rats, Sprague-Dawley ; Sirtuin 1/metabolism*

Objective To evaluate the efficacy and safety of desonide 0.05％ cream in the treatment of mild to moderate infantile atopic dermatitis (AD).Methods A multicenter,randomized,openlabeled,active-controlled clinical trial was conducted.A total of 120 infants with AD were enrolled from Department of Dermatology,Beijing Children's Hospital,Capital Medical University,Children's Hospital of Chongqing Medical University and Children's Hospital of Fudan University between December 2016 and November 2017.These patients were randomly divided into 2 groups to be topically treated with desonide 0.05％ cream (test group,n =61) and hydrocortisone butyrate 0.1％ cream (control group,n =59),respectively.After the treatment for 1,2 and 3 weeks,the response rate,improvement of eczema area and severity index (EASI) and infants' dermatitis quality of life (IDQOL) were evaluated,and adverse events and reactions were recorded.Statistical analysis was carried out with SAS 9.4 software using confidence interval method and non-inferiority test for the comparison of response rates between the test group and control group,two-sample t test for the comparison of quantitative data between two groups,paired t test for comparing pre-and post-treatment EASI scores and IDQOL scores.If the data were not normally distributed or there was heterogeneity of variance,Wilcoxon rank sum test was used for the comparisons of pre-and posttreatment EASI scores and IDQOL scores before and after the treatment,and chi-square test was used for the comparison of unordered categorical data between the test group and control group.Results At weeks 1,2and 3 after the initial treatment,analysis of the full analysis set (FAS) showed that 46 (86.79％),49(92.45％) and 51 (96.23％) patients in the test group received improvement respectively,and 36 (83.72％),35 (81.40％) and 41 (95.35％) in the control group received improvement respectively.The non-inferiority test showed that the response rate in the test group was non-inferior to that in the control group (non-inferiority boundary value was-0.15).At the baseline,1,2 and 3 weeks,the EASI scores in the test group were 4.57 ± 3.19,0.72 ± 0.89,0.45 ± 0.87 and 0.18 ± 0.40 respectively,and the EASI scores in control group were 4.50 ± 3.29,1.03 ± 1.81,0.62 ± 0.85 and 0.28 ± 0.82 respectively.Paired Wilcoxon rank sum test showed that the EASI scores in the test group and control group significantly decreased after the treatment for 1,2 and 3 weeks compared with those at the baseline (the test group:T =-715.5,-9.4,-715.5,respectively,all P ＜ 0.001;the control group:T =-437.5,-473.0,-472.0,respectively,all P ＜0.001).However,Wilcoxon rank sum test revealed that there was no significant difference in the EASI scores between the two groups at any of the above time points (P ＞ 0.05).Paired Wilcoxon rank sum test showed that IDQOL scores in the test group significantly decreased at the above time points after the treatment compared with those at the baseline (all P ＜ 0.001),while Wilcoxon rank sum test revealed that there was no significant difference in the IDQOL score between the test group and control group (all P ＞0.05).Adverse reactions were observed in 12 (19.7％) patients in the test group,and 10 (16.9％) in the control group,and there was no significant difference in the adverse reactions between the two groups (x2 =0.029,P ＞ 0.05).Conclusion The efficacy of desonide 0.05％ cream in the treatment of mild to moderate infantile AD is equivalent to that of hydrocortisone butyrate 0.1％ cream,so desonide 0.05％ cream can be a treatment option for mild to moderate infantile AD.

Objective To evaluate the effect of an emollient containing Prinsepia utilis Royle oil extracts and other extracts on clinical symptoms and disease recurrence in children aged 2-12 years with atopic dermatitis (AD) in the remission period.Methods A multicenter,randomized,parallel-group,controlled clinical trial was conducted from December 2017 to September 2018.A total of 297 children aged 2-12 years with moderate AD were enrolled from 5 hospitals in China,and randomly divided into the test group (148 cases) and control group (149 cases).In the acute stage,the two groups were both topically treated with mometasone furoate cream once a day on the skin lesions,and with an emollient containing Prinsepia utilis Royle oil extracts and other extracts twice a day throughout the whole body for 2-4 weeks.The children would be enrolled into the remission stage if their Investigator's Global Assessment (IGA) score was ≤ 1 at following visits.In the remission stage,the test group was only topically treated with the emollient twice a day throughout the whole body,while mometasone furoate cream and the emollient were both withdrawn in the control group.At weeks 4,8 and 12 in the remission stage,the recurrence of AD,eczema area and severity index (EASI),children's dermatology life quality index (CDQOL) and adverse events were evaluated.Statistical analysis was carried out with SAS 9.4 software by using t test for comparison of normally distributed continuous data between two groups,chi-square test for comparison of unordered categorical data,Kaplan-Meier method for analysis of survival rates,Cox regression analysis for evaluating the effect of different therapies on AD recurrence in children in the remission stage,and Logistic regression analysis for analysis of odds ratio (OR) of EASI or CDQOL at week 4 in the remission stage between the test group and control group.Results Of the 297 children with AD,31 breached the clinical trial protocol,and 266 were included in the per protocol set (PPS),including 132 in the test group and 134 in the control group.In the PPS,114 and 106 patients completed the follow-up in the test group and control group respectively,and the recurrence rate was significantly lower in the test group (47,41.23％) than in the control group (84,79.25％;x2 =32.96,P ＜ 0.001).The time to recurrence was significantly longer in the test group(61.99 d ± 2.80 d)than in the control group(39.17 d ± 2.54 d,t =6.03,P ＜ 0.001),and the recurrence risk was significantly lower in the test group than in the control group (Log rank test,x2 =32.02,P ＜ 0.001).After adjustment for age and gender,Cox regression analysis showed that the recurrence risk in the test group was 0.35 times that in the control group (HR =0.35,95％ CI:0.24-0.51,P ＜ 0.01).At week 4 in the remission stage,the EASI score at P50-P75 and P75-P100 in the test group were 0.42,0.25 times that in the control group respectively (95％ CI:0.20-0.86,0.12-0.54 respectively;P =0.02,＜ 0.01respectively).Moreover,the CDQOL score at P75-P100 in the test group was 0.33 times that in the control group (95％ CI:0.17-0.65,P ＜ 0.01).No significant difference in the incidence of adverse events was observed between the two groups (P ＞ 0.05).Conclusion Maintenance treatment with the emollient containing Prinsepia utilis Royle oil extracts and other extracts can markedly reduce the recurrence risk in AD children,improve clinical symptoms,and enhance the quality of life.

Objective: To investigate whether topical mucopolysaccharide polysulfate (MPS) cream can reduce the incidence of eczema and skin atrophy in patients with moderate- or low-risk infantile hemangioma after the treatment with topical beta-blockers or 595-nm pulsed dye laser (PDL) , and to analyze factors influencing the occurrence of eczema and skin atrophy. Methods: A total of 722 patients aged 0- 1 years with moderate- or low-risk infantile hemangioma were enrolled from 5 Children′s Hospitals in China. According to the disease condition and therapy acceptability, these patients were divided into 6 groups to be treated with topical beta-blockers and MPS cream (blocker+ MPS group) , topical beta-blockers (blocker group) , 595-nm PDL and topical MPS cream (PDL+ MPS group) , 595-nm PDL (PDL group) , 595-nm PDL combined with topical beta-blockers and MPS cream (PDL+ blocker+ MPS group) , and 595-nm PDL and topical beta-blockers (PDL+ blocker group) , respectively. All the externally applied agents were applied twice a day, and PDL was performed once every 4 weeks. Efficacy and adverse reactions were evaluated after 3-month treatment. Univariate and multivariate Logistic regression analyses were carried out to analyze factors influencing the incidence of eczema and skin atrophy in patients with infantile hemangioma after treatment, and chi-square test was carried out to compare efficacy among the groups. Results: After 3-month treatment, multivariate Logistic regression analysis for comparing the blocker+ MPS group with blocker group showed that the risk factor for eczema on the surface of hemangiomas was no topical treatment with MPS cream (P= 0.007, OR= 3.887, 95% CI: 1.439-10.493) , while no correlations were observed between the occurrence of skin atrophy on the surface of hemangiomas and analyzed factors. Multivariate Logistic regression analysis for comparing the PDL+MPS group with PDL group showed that no topical treatment with MPS cream (P < 0.001, OR= 7.402, 95% CI: 2.604-21.042) and northern areas (P < 0.001, OR= 67.048, 95% CI: 7.977-563.518) were risk factors for eczema on the surface of hemangiomas, and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P = 0.001, OR = 9.371, 95 CI: 2.590 - 33.900) and abundant blood supply of hemangiomas (P = 0.036, OR = 2.971, 95% CI: 1.075-8.208) . Multivariate Logistic regression analysis for comparing the PDL + blocker+ MPS group with PDL+ blocker group showed that risk factors for eczema on the surface of hemangiomas were no topical treatment with MPS cream (P= 0.005, OR= 3.426, 95% CI: 1.446-8.119) and northern areas (P < 0.001, OR= 31.704, 95% CI: 6.924-145.158) , and risk factors for skin atrophy on the surface of hemangiomas included no topical treatment with MPS cream (P < 0.001, OR= 6.011, 95% CI: 2.558-14.126) and southern areas (P= 0.022, OR= 3.021, 95% CI: 1.177-7.753) . After 3-month treatment, the response rate was significantly higher in the PDL group than in the PDL+ MPS group (χ²= 4.531, P= 0.033) , and significantly higher in the blocker group than in the blocker+ MPS group (χ²= 4.344, P= 0.037) . There were no significant differences in the response rate or cure rate among the other groups (all P > 0.05) . Conclusion During the treatment of moderate- or low-risk infantile hemangioma with topical beta-blockers or 595-nm PDL, the combination with topical MPS cream can reduce the occurrence of eczema and skin atrophy without affecting the therapeutic effect.

Objective: To evaluate the effect of nicotinamide adenine dinucleotide phosphate (NADPH) on myocardial ischemia-reperfusion (I/R) injury in rats. Methods: Fifty-six SPF adult male Sprague-Dawley rats, weighing 220-320 g, aged 1-2 months, were divided into 4 groups (n=14 each) using a random number table method: sham operation group (Sham group), myocardial I/R group (I/R group), NADPH group (N group) and diltiazem group (D group). The model of myocardial I/R injury was established by ligation of the left anterior descending branch for 30 min followed by 2-h reperfusion in anesthetized rats.NADPH 16 mg/kg was intravenously infused over 5 min starting from 5 min of reperfusion in N group.Diltiazem 5 mg/kg was infused through the internal jugular vein starting from 10 min before ischemia until the end of ischemia.At 2 h of reperfusion, blood samples were taken from the internal jugular vein for measurement of serum LDH and cTnI concentrations, and myocardial tissues were taken for determination of infarct size and ROS level. Results: Compared with Sham group, the serum LDH and cTnI concentrations, myocardial infarction size and ROS levels were significantly increased in I/R group (P<0.05). Compared with I/R group, the serum LDH and cTnI concentrations, myocardial infarction size and ROS levels were significantly decreased in N and D groups (P<0.05). Compared with N group, the LDH concentration was significantly decreased (P<0.05), and no significant change was found in the cTnI concentration, myocardial infarction size or ROS level in D group (P>0.05). Conclusion NADPH can reduce myocardial I/R injury through antioxidant effect in rats.

The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood.On the one hand, children′s adverse reactions to drugs are different from adults because of their weight and age characteristics.On the other hand, they can mimic many other skin diseases, especially viral exanthems, frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction.Meanwhile, the tools used for drug eruption management in adults are applied also for children.Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age.The pathogenesis of drug eruption in children is related to virus infection, immune state, drug and metabolic enzyme effect.Most reactions in children are still attributed to betalactams.The practicability and validity of skin test and other diagnostic procedures need further assessment in children.The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis, and specialist support.