ObjectiveTo systematically review the available studies about Guanxinjing capsules in treating angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis）， evaluate the evidence quality and comprehensive value of Guanxinjing capsules in 6+1 dimensions involving 9 aspects， and clarify the clinical positioning and advantages of this medicine. MethodsA qualitative combined with quantitative evaluation method was adopted， involving clinical medicine， epidemiology， evidence-based medicine， and pharmacoeconomics. Through public data collection， questionnaire surveys， real-world data collection， and literature comprehensive evaluation， an evaluation system involving 9 aspects in 6+1 dimensions was constructed for Guanxinjing capsules. Experts assigned weights to the criterion layer and indicator layer， and the multi-criteria decision analysis （MCDA） model and CSC （V2.0） were employed to measure each dimension and reveal the clinical value of Guanxinjing capsules. Results①The evaluation results showed that Guanxinjing capsules are safe. According to the adverse reactions in the instructions， the systematic evaluation and meta-analysis of clinical safety， and the data collected by the National Center for Adverse Drug Reaction Monitoring， the adverse reactions of Guanxinjing capsules mainly include chest tightness， dyspnea， dizziness， and digestive system-related symptoms， with a standardized score of 0.75 points， which suggests good safety. ②The meta-analysis results suggest that according to the same efficacy standards， the effectiveness of Guanxinjing capsules alone and Guanxinjing capsules combined with conventional Western medicine or Chinese patent medicines is higher than that of conventional Western medicine or the Chinese patent medicine Shenshao capsules alone in treating coronary heart disease. The standardized score of effectiveness is 0.57， which indicates that the effectiveness still requires evidence support. ③With the individual disposable income in 2020 as the expected payment assumption threshold， compared with conventional treatment alone， combining Guanxinjing capsules with conventional treatment is cost-effective and economical for the patients with angina pectoris of coronary heart disease under certain conditions （higher than 106.91 yuan）， which suggests good economy. ④At present， 3 patents for the invention of Guanxinjing capsules have been approved， covering multiple fields such as clinical innovation， service system innovation， and industrial development， which implies good innovation. ⑤In addition， the questionnaire surveys for medical staff involve five different dimensions， and the statistical scores and evaluation results show good suitability of Guanxinjing capsules. ⑥The reimbursement rate of Guanxinjing capsules by residents is high. The sampling survey results show that Guanxinjing capsules are fully equipped in hospitals across China and have good accessibility. ⑦Derived from the theory of activating blood and resolving stasis proposed by Wang Qingren， a famous physician in the Qing Dynasty， Guanxinjing capsules integrate multiple therapies such as replenishing Qi， nourishing Yin， and aromatic warming and unblocking. According to the analysis data in the "6+1" dimensions， the clinical comprehensive evaluation score of Guanxinjing capsules for angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis） was 0.73. ConclusionThe results of comprehensive evaluation of each dimension and clinical value suggest that Guanxinjing capsules in treating angina pectoris of coronary heart disease （syndrome of Qi deficiency and blood stasis） have sufficient clinical evidence， good safety， suitability， and accessibility. It is recommended that Guanxinjing capsules can be included in the documents of basic clinical medication management in accordance with the established procedure.

Objective:To discuss the ameliorative effect of total flavonoids from corn silk(TFCS)on kidney injury in the rats with urate nephropathy,and to clarify the possible mechanism.Methods:Sixty male Wistar rats were randomly divided into control group,model group,positive control group[benzbromarone(BZM)group,5 mg·kg-1·d-1],low dose of TFCS group(20 mg·kg-1·d-1),medium dose of TFCS group(40 mg·kg-1·d-1),and high dose of TFCS group(80 mg·kg-1·d-1),and there were 10 rats in each group.Except for control group,the rats in the other groups were administered potassium oxonate(350 mg·kg-1)and adenine(70 mg·kg-1)by gavage for 4 weeks to establish the hyperuricemic nephropthy models.The rats in different doses of TFCS groups were treated with TFCS for 2 weeks.Speckle blood flow imager was used to detect the renal blood perfusion of the rats in various groups and the kidney coefficients of the rats in various groups were caculated;HE staining and Masson staining were used to observe the pathomorphology and fibrosis degrees of kidney tissue of the rats in various groups and enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of uric acid(UA),creatinine(Cr),blood urea nitrogen(BUN),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)in the serum and levels of β2-microglobulin(β2-MG)and microalbumin(ALB)in the urine of the rats in various groups;Western blotting method was used to detect the expression levels of urate transporter 1(URAT1),glucose transporter 9(GLUT9),and ATP-binding cassette transporter G2(ABCG2)proteins in kidney tissue of the rats in various groups.Results:Compared with control group,the renal blood perfusion volume of the rats in model group was significantly decreased(P<0.01).Compared with model group,the renal blood perfusion volumes of the rats in BZM group and low,medium,and high doses of TFCS groups were significantly increased(P<0.05 or P<0.01).Compared with control group,the kidney weight of the rats in model group was increased,with visible white granular spots on the surface,absence of blood color,and kidney volume was increased.Compared with model group,the kidney volumes of the rats in BZM group and medium and high doses of TFCS groups were decreased,with color tending toward that in control group,and the white granular spots on the surface were significantly reduced.Compared with model group,the kidney coefficients of the rats in BZM group and medium and high doses of TFCS groups were decreased(P<0.01).The HE staining results showed there were no abnormalities in kidney tissue structure in control group,while there were a small amount of brown-yellow urate crystal deposition and interstitial connective tissue hyperplasia in model group;compared with model group,the kidney tissue damage and inflammatory infiltration were alleviated to varying degrees in BZM group and different doses of TFCS groups.The Masson staining results revealed no obvious collagen fiber deposition in control group,whereas significant blue collagen fiber deposition in kidney tissue of the rats was found in model group,and the collagen volume fraction(CVF)was increased compared with control group(P<0.01);compared with model group,the CVFs of the rats in BZM group and different doses of TFCS groups were decreased(P<0.01).The ELISA results showed that compared with control group,the levels of UA,Cr,BUN,IL-6,and TNF-α in serum of the rats in model group were increased(P<0.01);compared with model group,the levels of UA,Cr,BUN,IL-6,and TNF-α in serum of the rats in BZM group and medium and high doses of TFCS groups were decreased(P<0.01).Compared with control group,the levels of β2-MG and ALB in urinary in model group were increased(P<0.01);compared with model group,the levels of β2-MG and ALB in urinary of the rats in different doses of TFCS groups were decreased(P<0.05 or P<0.01).The Western blotting results showed that compared with control group,the expression levels of URAT1 and GLUT9 proteins in kidney tissue of the rats in BZM group and model group were increased(P<0.01),while the expression level of ABCG2 protein was decreased(P<0.01).Compared with model group,the expression levels of URAT1 and GLUT9 proteins in kidney tissue of the rats in different doses of TFCS groups were decreased(P<0.05 or P<0.01),and the expression level of ABCG2 protein was increased(P<0.01).Conclusion:TFCS can significantly alleviate the kidney injury in the rats with urate nephropathy model,and its mechanism may be related to the downregulation of expression of URAT1 and GLUT9 proteins and upregulation of ABCG2 protein expression in kidney tissue.

Objective:To analyze the iodine nutritional status of children aged 8 - 10 in Tongren City, Guizhou Province, and provide a basis for scientific iodine supplementation for children.Methods:From 2020 to 2022, a systematic sampling method was adopted in 10 districts and counties of Tongren City. Each year, each district and county was divided into 5 districts based on east, west, south, north, and center. One township (street) was selected from each district, and 40 non boarding students aged 8 to 10 were selected from each township (street) to measure the iodine content of household salt and urine samples. The content of salt iodine in children of different yesas as well as the distribution of urine iodine in children of different districts and counties and different genders were analyzed and compared. Additionally, B-ultrasound was used to measure the thyroid volume of some children and the situation of thyroid enlargement was analyzed.Results:From 2020 to 2022, a total of 6 000 salt samples were collected and monitored from children's households, and 5 989 samples of iodized salt were detected, the coverage rate of iodized salt was 99.8%; and 5 750 samples of qualified iodized salt were found, the qualified rate of iodized salt was 96.0%, the consumption rate of qualified iodized salt was 95.8%; and the median salt iodine was 27.3 mg/kg, the difference in the median salt iodine among children between different years was statistically significant ( H = 10.04, P < 0.001). A total of 6 000 urine samples from children were tested, the median urinary iodine was 225.2 μg/L, the median urinary iodine among children in different districts and counties were statistically significantly different ( H = 85.73, P < 0.001); 3 077 male and 2 923 female urine samples were tested, and the median urinary iodine between different genders was statistically significant different ( Z = - 67.10, P < 0.001). The median urinary iodine of male samples were higher than those of female samples(227.8 vs 222.9 μg/L). The thyroid gland of 2 000 children was examined, and the rate of goiter was 1.0% (21/2 000). Conclusions:From 2020 to 2022, the consumption rate of qualified iodized salt, urinary iodine content and goiter rate of children in Tongren City have all met the national standard for eliminating iodine deficiency disorders. The overall iodine nutrition level exceeds the appropriate amount (urinary iodine of 200 - 299 μg/L).

Brain metastasis is an uncommon complication that occurs in the advanced stage of gynecologic malignancies. Brain metastasis tends to be one of the major factors contributing to the poor prognosis of patients. There have been more reports about brain metastasis in cervical, ovarian and endometrial cancers in recent years due to the growth of large databases and improved diagnostic methods. Great attention has been paid to the selection of appropriate therapeutic options to improve the survival of gynecologic malignancies patients with brain metastasis. This article reviews the research progress of brain metastasis in cervical, ovarian and endometrial cancers, aiming to provide better options for treatment of patients with common advanced gynecologic malignancies.

Objective:To analyze the pathological findings of ultrasound-guided transplant kidney puncture after renal transplantation and the pathogenesis of different types of diseases.Methods:A retrospective study was conducted to select 257 patients who underwent ultrasound-guided transplant kidney puncture pathology biopsy due to abnormal tests or uncomfortable symptoms at Beijing Friendship Hospital, Capital Medical University from June 2020 to April 2022, and to analyze the pathological results of puncture and the pathogenesis of different types of diseases and puncture-related complications in the post-transplantation patients after transplant kidney puncture biopsy. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used to compare different types of diseases; measurement data did not conform to normal distribution were expressed as median (interquartile distance) [ M( Q1, Q3)], and the comparison between different types of diseases was conducted by non-parametric test. The count data were compared among different types of diseases using Chi-squre test. Results:Among the 257 patients who underwent transplant renal puncture, 93 cases (36.2%) suffered from antibody-mediated rejection (ABMR), 76 cases (29.6%) suffered from IgA nephropathy, 63 cases (24.5%) suffered from T cell-mediated rejection (TCMR), 21 cases (8.2%) suffered from polyomavirus-associated nephropathy (PVAN), and 4 cases (1.6%) suffered from thrombotic microangiopathy (TMA), 16 cases (6.2%) suffered from diabetic nephropathy, and 12 cases (4.7%) suffered from calcineurin inhibitor (CNI) nephropathy. TCMR, TMA and PVAN occurred significantly in the early post-transplantation period (within about 4 years) ( P<0.001), and ABMR occurred significantly in the late post-transplantation period (after about 8 years) ( P<0.001). In terms of time distribution, creatinine abnormality and proteinuria were the main reasons for puncture. Among those diagnosed with PVAN, the time to transplantation was significantly shorter in those who underwent puncture for creatinine abnormality than in those who underwent puncture for proteinuria ( P=0.011). In terms of puncture-related complications, a total of 8 cases were found to have arteriovenous fistulae at the time of review, 2 cases had perinephric hematomas, and 1 case had both of these two puncture-related complications. Conclusions:Transplant renal complications in renal transplant patients mainly include ABMR, IgA nephropathy, TCMR, PVAN, diabetic nephropathy, CNI nephropathy and TMA. In terms of the pathogenesis of different types of diseases after transplantation, post-transplantation PVAN, TMA, and TCMR mostly occur in the early post-transplantation period, while ABMR occurs at a later time. However, it is worth noting that the clinical symptoms of different types of transplantation kidney-related diseases are similar and not typical.

Objective:To investigate the iodine nutrition status of pregnant women in Tongren City, and to provide a basis for scientific iodine supplementation of key population.Methods:From 2020 to 2022, a cross-sectional survey was conducted, and one township (street) was selected from each of the five districts of east, west, south, north, and central in 10 counties (districts) of Tongren City each year. Twenty pregnant women were selected from each township (street) for the determination of iodine level in household salt samples and one random urine sample. The levels of salt iodine and urinary iodine in pregnant women from different years and regions, as well as the distribution of urinary iodine during different pregnancy periods, were compared and analyzed.Results:A total of 3 000 household edible salt samples were collected from pregnant women, with a median salt iodine level of 27.3 mg/kg. The coverage rate of iodized salt was 99.7% (2 991/3 000), the qualified rate of iodized salt was 96.1% (2 875/2 991), and the consumption rate of qualified iodized salt was 95.8% (2 875/3 000). There was a statistically significant difference in the iodine level of household salt consumed by pregnant women in different years ( H = 6.85, P < 0.001). A total of 3 000 urine samples from pregnant women were tested, and the median urinary iodine was 177.4 μg/L. By years, the median urinary iodine levels in different years were 197.8, 169.2, and 168.3 μg/L, with statistically significant differences ( H = 35.46, P < 0.001). By region, there were statistically significant differences in the median urinary iodine levels of pregnant women in different counties (districts, H = 104.00, P < 0.001); among them, Yuping County had the lowest median urinary iodine level, at 149.8 μg/L. By pregnancy periods, there were no statistically significant difference in the median urinary iodine levels of pregnant women in different pregnancy periods ( H = 177.44, P = 0.290). Conclusions:The overall iodine nutrition level of pregnant women in Tongren City is appropriate, and the iodine nutrition of pregnant women in individual areas is insufficient. We should continue to strengthen the monitoring of iodine nutrition level, pay attention to the iodine nutrition status of pregnant women in key areas, and guide pregnant women to supplement iodine scientifically.

Body mass index (BMI) is an index closely related to the total body fat. It is often used to measure the degree of obesity and reflect the nutritional status of the human body to a certain extent. The incidence rate and mortality rate of gynecological malignancies remain high. Some studies have found that BMI has certain value in the incidence and prognosis evaluation of gynecological malignancies, and is crucial to prolong the survival of patients. This review summarizes the recent research progress on the correlation between BMI and common gynecological malignancies and the mechanism of BMI on its occurrence and development.

OBJECTIVE: To carry out genetic analysis for a fetus with confined placental mosaicism (CPM) for trisomy 2 (T2) in conjunct with fetal uniparental disomy (UPD). METHODS: Amniocentesis and chromosomal karyotyping was carried out for a pregnant woman with a high risk for chromosome 2 anomalies indicated by non-invasive prenatal testing (NIPT). Single nucleotide polymorphism array (SNP-array) and trio-whole exome sequencing (Trio-WES) were carried out. Ultrasonography was used to closely monitor the fetal growth. Multifocal sampling of the placenta was performed after delivery for copy number variation sequencing (CNV-seq). RESULTS: The fetus was found to have a normal chromosomal karyotype. SNP-array has revealed multiple regions with loss of heterozygosity (LOH) on chromosome 2. Trio-WES confirmed the presence of maternal UPD for chromosome 2. Ultrasonography has revealed intrauterine growth restriction and oligohydramnios. Intrauterine fetal demise had occurred at 23⁺⁴ weeks of gestation. Pathological examination had failed to find salient visceral abnormality. The placenta was proved to contain complete T2 by CNV-seq. CONCLUSION T2 CPM can cause false positive result for NIPT and may be complicated with fetal UPD, leading to adverse obstetric outcomes such as intrauterine growth restriction, oligohydramnios and intrauterine fetal demise.
Female ; Humans ; Pregnancy ; Amniocentesis ; Chromosomes, Human, Pair 2/genetics* ; DNA Copy Number Variations ; Fetal Death ; Fetal Growth Retardation/genetics* ; Fetus ; Mosaicism ; Oligohydramnios ; Placenta ; Trisomy/genetics* ; Uniparental Disomy/genetics*

Chronic obstructive pulmonary disease (COPD) is a global public health issue, and elderly COPD patients are at high risk of fall. Domestic and foreign clinical practice guidelines for fall prevention in the elderly emphasize that the identification of risk factors is the key to prevent fall. This article reviews the risk factors, risk assessment and fall intervention measures of elderly COPD patients, so as to provid a reference for fall prevention in elderly COPD patients.