Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective:To observe the effect of acupressure and ear acupoint pressure bean on alleviating the adverse reactions of polyethylene glycol electrolyte powder in patients undergoing colonoscopy, and analyze the effect on patients' medication compliance and intestinal cleanliness.Methods:The study was designed as a prospective, single-center, randomized controlled clinical trial. The subjects were selected from patients who planned to undergo colonoscopy in the Endoscopy Center of the Affiliated Hospital of Hangzhou Normal University and were divided into trial group (50 patients) and control group (50 patients) in terms of random number table method. Patients in the control group was given colonoscopy routine nursing, and those in the trial group was treated with acupressure and ear acupoint pressure bean therapy on the basis of routine nursing. The incidence of adverse reactions of polyethylene glycol electrolyte powder, medication compliance (8-item Morisky medication adherence scale), and intestinal cleanliness (Boston bowel preparation scale) in patients were compared between the 2 groups.Results:A total of 100 patients were included initially, 8 fell off during the study, and 92 were finally entered in the analysis, including 46 in the trial group and control group respectively. There were 26 males and 20 females in the trial group, aged (47±6) years with a range from 35 to 56 years, and 25 males and 21 females in the control group, aged (46±6) years with a range from 33 to 57 years. Differences in age, gender, education level, and marital status of patients between the 2 groups were not significant (all P>0.05). The overall incidence of adverse reactions of polyethylene glycol electrolyte powder in the trial group was lower than that in the control group [30.4% (14/46) vs. 65.2% (30/46), χ2=11.152, P=0.001]. Adverse reactions in the trial group included nausea (11 cases), fullness (2 cases), and abdominal pain (1 case), while those in the control group included nausea (17 cases), fullness(5 cases), abdominal pain (4 cases), vomiting (2 cases), anal discomfort and rash (1 case each). The scores of 8-item Morisky medication adherence scale and Boston bowel preparation scale in the trial group were both higher than those in the control group [8 (7, 8) points vs. 6 (6, 6) points, χ2=-7.711, P<0.001; 9 (8, 9) points vs. 7 (7, 7) points, χ2=-6.721, P<0.001]. Conclusion:The addition of acupressure and ear acupoint pressure bean to the routine nursing process in colonoscopy can effectively alleviate the adverse reactions of polyethylene glycol electrolyte powder, and improve patients' medication compliance and intestinal cleanliness.

Objective:To observe the effect of acupressure and ear acupoint pressure bean on alleviating the adverse reactions of polyethylene glycol electrolyte powder in patients undergoing colonoscopy, and analyze the effect on patients' medication compliance and intestinal cleanliness.Methods:The study was designed as a prospective, single-center, randomized controlled clinical trial. The subjects were selected from patients who planned to undergo colonoscopy in the Endoscopy Center of the Affiliated Hospital of Hangzhou Normal University and were divided into trial group (50 patients) and control group (50 patients) in terms of random number table method. Patients in the control group was given colonoscopy routine nursing, and those in the trial group was treated with acupressure and ear acupoint pressure bean therapy on the basis of routine nursing. The incidence of adverse reactions of polyethylene glycol electrolyte powder, medication compliance (8-item Morisky medication adherence scale), and intestinal cleanliness (Boston bowel preparation scale) in patients were compared between the 2 groups.Results:A total of 100 patients were included initially, 8 fell off during the study, and 92 were finally entered in the analysis, including 46 in the trial group and control group respectively. There were 26 males and 20 females in the trial group, aged (47±6) years with a range from 35 to 56 years, and 25 males and 21 females in the control group, aged (46±6) years with a range from 33 to 57 years. Differences in age, gender, education level, and marital status of patients between the 2 groups were not significant (all P>0.05). The overall incidence of adverse reactions of polyethylene glycol electrolyte powder in the trial group was lower than that in the control group [30.4% (14/46) vs. 65.2% (30/46), χ2=11.152, P=0.001]. Adverse reactions in the trial group included nausea (11 cases), fullness (2 cases), and abdominal pain (1 case), while those in the control group included nausea (17 cases), fullness(5 cases), abdominal pain (4 cases), vomiting (2 cases), anal discomfort and rash (1 case each). The scores of 8-item Morisky medication adherence scale and Boston bowel preparation scale in the trial group were both higher than those in the control group [8 (7, 8) points vs. 6 (6, 6) points, χ2=-7.711, P<0.001; 9 (8, 9) points vs. 7 (7, 7) points, χ2=-6.721, P<0.001]. Conclusion:The addition of acupressure and ear acupoint pressure bean to the routine nursing process in colonoscopy can effectively alleviate the adverse reactions of polyethylene glycol electrolyte powder, and improve patients' medication compliance and intestinal cleanliness.

Objective:To analyze the clinical and genetical characteristics of children with Gaucher disease and to explore the relationship between genotype and phenotype.Methods:In this retrospective study, the clinical data of 14 children with Gaucher disease diagnosed in Children′s Hospital of Nanjing Medical University from August 2016 to October 2021 were analyzed. Their general conditions, clinical manifestations, laboratory tests and gene variations were collected, followed by the analysis of the clinical phenotypes and genotypes.Results:Among 14 children diagnosed with Gaucher disease, 9 were males and 5 were females, with the age of diagnosis ranging from 0.7 to 15.8 years. There were 10 patients with type 1 Gaucher disease, 2 patients with type 2, and 2 patients with type 3. The most common clinical manifestations were splenomegaly, thrombocytopenia (14 cases), hepatomegaly (8 cases) and anemia (8 cases). There were 6 patients with growth retardation, and 5 patients lag in height compared with their peers. Bone abnormalities were revealed by magnetic resonance imaging in 7 type 1 Gaucher disease patients, but only 1 patient experienced bone pain. Patients with type 2 and type 3 Gaucher disease also presented with convulsions, nystagmus and hearing loss. Gaucher cells were found in bone marrow smears in 12 patients. The glucocerebrosidase gene variations identified in 13 patients were heterozygous and in 1 type 1 patient was homozygous of L483P. L483P variation accounted for 33%(10/30) of the variation alleles, followed by V414L, D448H and R159W. The variation alleles were L483P and L422R, F252I and L483P in 2 children with severe neurological manifestations of Gaucher disease. A novel variation c.22A>G was detected.Conclusions:Splenomegaly and thrombocytopenia are the main clinical presentations of Gaucher disease in children and bone lesions revealed by radiologic imaging appear prior to the occurrence of bone diseases, type 2 and type 3 Gaucher disease also present growth retardation and neurological manifestation. The most frequent variant allele is L483P, which are detected in all 3 subtypes of Gaucher disease. The L422R, F252I gene variants correlated with the neuronopathic phenotype.

Objective:To investigate the effects of B7-H3 molecule on clear cell renal cell carcinoma (786-O) metastasis.Methods:Lentiviral transfection method was used to construct 786-O cells stably expressing low level of B7-H3 (shB7-H3 group) and a negative control cell line (shNC group). RT-qPCR, flow cytometry and Western blot were used to assess the efficiency of lentiviral transfection. CCK-8 method was used to detect the proliferation of 786-O cells in the two groups. Flow cytometry was performed to detect the changes in cell cycle. Cell scratch test and Transwell assay were used to detect the differences in cell migration and invasion. Western blot was used to detect the expression of marker proteins in the process of epithelial-mesenchymal transition (epithelial-mesenchymal transition, EMT). Changes in the expression of chemokines and their receptors were analyzed by flow cytometry and RT-qPCR. Effects of anti-CCL4 antibody on cell migration and invasion were analyzed by Transwell assay.Results:Flow cytometry showed that 786-O cells highly expressed B7-H3 molecules and the lentiviral transfection method successfully constructed the cell line with lower expression of B7-H3 (786-O-shB7-H3) and control cell line (786-O-shNC). B7-H3 molecule had no significant effect on the proliferation of 786-O cells. No significant difference in cell cycle was found between the two groups. Compared with 786-O-shNC cells, the migration and invasion ability of 786-O-shB7-H3 cells was suppressed. Moreover, the expression of EMT-related marker proteins (fibronectin and N-cadherin) was reduced and the expression of E-cadherin was increased in 786-O-shB7-H3 cells. The expression of CCL4 and its receptor CCR5 in the shB7-H3 group was lower than that in the shNC group. After intervention with anti-CCL4 antibody, the migration and invasion ability of 786-O-shNC cells was reduced, while that of 786-O-shB7-H3 cells had no significant change.Conclusions:Knocking down the expression of B7-H3 molecule had no significant effect on the proliferation of 786-O cells, but could affect the EMT process of 786-O cells and reduce tumor migration and invasion ability, thereby inhibiting tumor progression.

Objective:To explore the effect of the interaction between B7H3 and fibronectin (FN) on the apoptosis of human chronic myeloid leukemia K562 cells.Methods:The expression of B7H3 molecules in K562 cells was detected using flow cytometry and B7H3 overexpressing cells were constructed. The interaction between B7H3 and FN was detected using the co-immunoprecipitation technology. After adding exogenous FN, cell experiments were performed to detect changes in adhesion and cell apoptosis. The changes in apoptosis-related proteins and PI3K/AKT signaling pathway were detected using Western blot.Results:The expression of B7H3 was low in K562, and the cell line K562 OE (overexpression) -B7H3 and the control cell line K562 NC (negative control) -B7H3 were obtained after lentivirus transfection. There is an interaction between B7H3 and FN ( P=0.036) , and this interaction promoted cell adhesion ( P<0.05) , inhibited cell apoptosis ( P<0.05) , and activated the PI3K/AKT signaling pathway ( P<0.05) . Conclusion:B7H3 interacts with FN to promote cell adhesion and may inhibit K562 cell apoptosis by activating the PI3K/AKT signaling pathway.

BACKGROUND/AIMS: Functional dyspepsia (FD) remains a great clinical challenge since the FD subtypes, defined by Rome III classification, still have heterogeneous pathogenesis. Previous studies have shown notable differences in visceral sensation processing in the CNS in FD compared to healthy subjects (HS). However, the role of CNS in the pathogenesis of each FD subtype has not been recognized. METHODS: Twenty-eight FD patients, including 10 epigastric pain syndrome (EPS), 9 postprandial distress syndrome (PDS), and 9 mixed-type, and 10 HS, were enrolled. All subjects underwent a proximal gastric perfusion water load test and the regional brain activities during resting state and water load test were investigated by functional magnetic resonance imaging. RESULTS: For regional brain activities during the resting state and water load test, each FD subtype was significantly different from HS (P < 0.05). Focusing on EPS and PDS, the regional brain activities of EPS were stronger than PDS in the left paracentral lobule, right inferior frontal gyrus pars opercularis, postcentral gyrus, precuneus, insula, parahippocampal gyrus, caudate nucleus, and bilateral cingulate cortices at the resting state (P < 0.05), and stronger than PDS in the left inferior temporal and fusiform gyri during the water load test (P < 0.05). CONCLUSIONS: Compared to HS, FD subtypes had different regional brain activities at rest and during water load test, whereby the differences displayed distinct manifestations for each subtype. Compared to PDS, EPS presented more significant differences from HS at rest, suggesting that the abnormality of central visceral pain processing could be one of the main pathogenesis mechanisms for EPS.
Brain ; Broca Area ; Caudate Nucleus ; Classification ; Dyspepsia ; Functional Neuroimaging ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Parahippocampal Gyrus ; Parietal Lobe ; Perfusion ; Prefrontal Cortex ; Sensation ; Somatosensory Cortex ; Visceral Pain ; Water

BACKGROUND/AIMS: Physical and/or emotional stresses are important factors in the exacerbation of symptoms in irritable bowel syndrome (IBS). Several lines of evidence support that a major impact of stress on the gastrointestinal tract occurs via the enteric nervous system. We aimed to evaluate histological changes in the submucosal plexus (SMP) and myenteric plexus (MP) of the distal ileum in concert with the intestinal motor function in a rat model of IBS with diarrhea. METHODS: The rat model was induced by heterotypic chronic and acute stress (CAS). The intestinal transit was measured by administering powdered carbon by gastric gavage. Double immunohistochemical fluorescence staining with whole-mount preparations of SMP and MP of enteric nervous system was used to assess changes in expression of choline acetyltransferase, vasoactive intestinal peptide, or nitric oxide synthase in relation to the pan neuronal marker, anti-Hu. RESULTS: The intestinal transit ratio increased significantly from control values of 50.8% to 60.6% in the CAS group. The numbers of enteric ganglia and neurons in the SMP were increased in the CAS group. The proportions of choline acetyltransferase- and vasoactive intestinal peptide-immunoreactive neurons in the SMP were increased (82.1 ± 4.3% vs. 76.0 ± 5.0%, P = 0.021; 40.5 ± 5.9% vs 28.9 ± 3.7%, P = 0.001), while nitric oxide synthase-immunoreactive neurons in the MP were decreased compared with controls (23.3 ± 4.5% vs 32.4 ± 4.5%, P = 0.002). CONCLUSIONS: These morphological changes in enteric neurons to CAS might contribute to the dysfunction in motility and secretion in IBS with diarrhea.
Animals ; Carbon ; Choline ; Choline O-Acetyltransferase ; Diarrhea* ; Enteric Nervous System ; Fluorescence ; Ganglia ; Gastrointestinal Motility ; Gastrointestinal Tract ; Ileum ; Intestine, Small* ; Irritable Bowel Syndrome* ; Models, Animal* ; Myenteric Plexus ; Neurons* ; Nitric Oxide ; Nitric Oxide Synthase ; Rats* ; Stress, Psychological ; Submucous Plexus ; Vasoactive Intestinal Peptide

Air Pollution ; Humans

Humans ; Multiple Myeloma ; Spondylitis, Ankylosing