Objective:To evaluate the efficacy and safety of tripterygium glycosides (TG) in the adjuvant treatment for patients with lupus nephritis(LN).Methods:A retrospective propensity-matched study was conducted using data collected from LN inpatients who addmitted to nanjing Drum Hospital between January 2010 and June 2022. Patients were divided into TG-treated and non-TG-treated groups according to whether or not they were treated with TG or not in a 1∶2 ratio. Univariate and multivariate analyses corrected for confounders were performed using binary logistic regression models, and odds ratios ( OR) and corresponding 95% confidence intervals ( CI) were calculated. Results:A total of 177 patients with active LN were included, 59 in TG-treated group and 118 in non-TG-treated group, and the baseline data and other medications used in the trial were roughly comparable in both groups. In the TG treatment group, complete remission (CR) and partial remission (PR) patients accounted for 37.3% (22 cases) and 55.9% (33 cases), respectively. Concomitant treatment with TG was contributed to the achievement of CR [an adjusted OR(95% CI) 2.95 (1.27, 6.87), P=0.012]. The doses of TG ≥40 mg/d and treatment for 12 to 42 weeks were associated with improved CR [ OR(95% CI)=2.94(1.16,7.45), P=0.023; adjusted OR(95% CI)=3.42(1.21,9.63), P=0.020 respectively]. In addition, the combination of TG and hydroxychloroquine improved patients′ CR rates compared with monotherapy, no additive interactions between TG and immunosuppressive drugs were found. Concomitant treatment with TG did not cause additional safety concerns. Conclusion:Adjuvant therapy with TG can effectively and safely improve LN remission.

Objective:To investigate whether deltoid ligament (DL) injury produces axial-plane rotational instability of the ankle in patients with chronic ankle instability (CAI).Methods:A retrospective study was conducted to analyze the 33 patients with CAI who had been treated at Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. The cohort consisted of 17 males and 16 females with an age of (31.5±9.9) years. The patients were assigned into 2 groups based on the presence of DL injury: a lateral chronic ankle instability (LCAI) group ( n=17) and a rotational ankle instability (RAI) group ( n=16). Barefoot natural walking trials were performed in all patients. Three-dimensional kinematic data were synchronously collected using an optical motion capture system (12 cameras) and force plates. A lower extremity model was constructed to obtain shank axial rotation (internal/external rotation) and rear-foot inversion/eversion angles. Continuous relative phase (CRP) analysis was employed to assess shank-rearfoot movement coupling. The mean absolute relative phase (MARP) and deviation phase (DP) were calculated. Results:There was no statistically significant difference in the clinical baseline data between the 2 groups, indicating comparability ( P>0.05). Throughout the gait cycle, no significant differences were found in shank rotation angles or rear-foot eversion angles between the RAI group and the LCAI group. However, CRP analysis revealed that during the early stance phase (initial contact and loading response), shank-rearfoot coupling was significantly lower in the RAI group than in the LCAI group. In the early stance phase, the CRP values in the RAI group were significantly higher than those in the LCAI group. The CRP curve changes in the RAI group were consistently higher in the standce phase of the entire gait cycle than those in the LCAI group, and the peak value of the CRP curve was larger in the RAI group. Concurrently, the RAI group exhibited significantly higher MARP and DP values than the LCAI group (27.48°±14.54° versus 15.21°±9.56°; 26.02°±11.73° versus 17.83°±9.82°) (both P<0.05). Conclusion:DL injury significantly damages the axial rotational stability of the ankle joint and significantly exacerbates the mechanical instability of the ankle joint in CAI patients.

Objective:To evaluate the efficacy and safety of tripterygium glycosides (TG) in the adjuvant treatment for patients with lupus nephritis(LN).Methods:A retrospective propensity-matched study was conducted using data collected from LN inpatients who addmitted to nanjing Drum Hospital between January 2010 and June 2022. Patients were divided into TG-treated and non-TG-treated groups according to whether or not they were treated with TG or not in a 1∶2 ratio. Univariate and multivariate analyses corrected for confounders were performed using binary logistic regression models, and odds ratios ( OR) and corresponding 95% confidence intervals ( CI) were calculated. Results:A total of 177 patients with active LN were included, 59 in TG-treated group and 118 in non-TG-treated group, and the baseline data and other medications used in the trial were roughly comparable in both groups. In the TG treatment group, complete remission (CR) and partial remission (PR) patients accounted for 37.3% (22 cases) and 55.9% (33 cases), respectively. Concomitant treatment with TG was contributed to the achievement of CR [an adjusted OR(95% CI) 2.95 (1.27, 6.87), P=0.012]. The doses of TG ≥40 mg/d and treatment for 12 to 42 weeks were associated with improved CR [ OR(95% CI)=2.94(1.16,7.45), P=0.023; adjusted OR(95% CI)=3.42(1.21,9.63), P=0.020 respectively]. In addition, the combination of TG and hydroxychloroquine improved patients′ CR rates compared with monotherapy, no additive interactions between TG and immunosuppressive drugs were found. Concomitant treatment with TG did not cause additional safety concerns. Conclusion:Adjuvant therapy with TG can effectively and safely improve LN remission.

Objective:To investigate whether deltoid ligament (DL) injury produces axial-plane rotational instability of the ankle in patients with chronic ankle instability (CAI).Methods:A retrospective study was conducted to analyze the 33 patients with CAI who had been treated at Department of Orthopaedics, The First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. The cohort consisted of 17 males and 16 females with an age of (31.5±9.9) years. The patients were assigned into 2 groups based on the presence of DL injury: a lateral chronic ankle instability (LCAI) group ( n=17) and a rotational ankle instability (RAI) group ( n=16). Barefoot natural walking trials were performed in all patients. Three-dimensional kinematic data were synchronously collected using an optical motion capture system (12 cameras) and force plates. A lower extremity model was constructed to obtain shank axial rotation (internal/external rotation) and rear-foot inversion/eversion angles. Continuous relative phase (CRP) analysis was employed to assess shank-rearfoot movement coupling. The mean absolute relative phase (MARP) and deviation phase (DP) were calculated. Results:There was no statistically significant difference in the clinical baseline data between the 2 groups, indicating comparability ( P>0.05). Throughout the gait cycle, no significant differences were found in shank rotation angles or rear-foot eversion angles between the RAI group and the LCAI group. However, CRP analysis revealed that during the early stance phase (initial contact and loading response), shank-rearfoot coupling was significantly lower in the RAI group than in the LCAI group. In the early stance phase, the CRP values in the RAI group were significantly higher than those in the LCAI group. The CRP curve changes in the RAI group were consistently higher in the standce phase of the entire gait cycle than those in the LCAI group, and the peak value of the CRP curve was larger in the RAI group. Concurrently, the RAI group exhibited significantly higher MARP and DP values than the LCAI group (27.48°±14.54° versus 15.21°±9.56°; 26.02°±11.73° versus 17.83°±9.82°) (both P<0.05). Conclusion:DL injury significantly damages the axial rotational stability of the ankle joint and significantly exacerbates the mechanical instability of the ankle joint in CAI patients.

BACKGROUND:Grape seed extract has been shown to be effective in inhibiting the growth of androgen-dependent tumors(e.g.,breast cancer),and thus grape seed extract could theoretically inhibit epiphyseal closure induced by estrogen in late adolescence. OBJECTIVE:To screen the effects of grape seed extract on apoptosis of growth plate chondrocytes and epiphyseal closure in rats. METHODS:(1)In vitro experiment:Growth plate chondrocytes from rat large tibia and femur at logarithmic growth stage were obtained and cultured in groups:normal control group,model control group(adding 17β-estradiol to induce apoptosis),positive control group(adding letrozole and 17β-estradiol),grape seed extract group(adding 17β-estradiol and 10 μg/mL grape seed extract),Caspase-9 inhibitor group(adding 17β-estradiol and Caspase-9 inhibitor),Caspase-9 agonist group(adding 17β-estradiol and Caspase-9 agonist).Cell apoptosis was detected by flow cytometry after 48 hours of culture.(2)In vivo experiment:Thirty 3-month-old Sprague-Dawley rats were randomly divided into model control group,positive control group and low-,medium-and high-dose groups,with five rats in each group.All rats were injected subcutaneously with 17β-estradiol(3 times per week)to establish epiphyseal closure models,followed by intragastric administration of letrozole in positive control group and 0.05,0.2 and 0.8 g/kg grape seed extract in low-,medium-and high-dose groups,respectively,once a day until over 2/3 of the epiphyseal plate in the model control group was closed.The length of the tibia was then observed.Another 18 Sprague-Dawley rats were randomly divided into model control group,positive control group,and medium-dose group,with 6 rats in each group,treated as above for 1.5 continuous months.The expression of Caspase-9 protein in rat growth plate cartilage was detected by western blot. RESULTS AND CONCLUSION:(1)In vitro experiment:17β-estradiol could induce apoptosis in growth plate chondrocytes,and letrozole,grape seed extract,and caspase-9 inhibitors could all inhibit apoptosis in growth plate chondrocytes.(2)In vivo experiment:When more than 2/3 of the epiphyseal plate in the model control group was closed,the number of rats with epiphysis closure in the positive control and medium-dose groups was less than that in the model control group(P＜0.05),and the tibial length was longer than that in the model control group(P＜0.05),and the Caspase-9 protein expression in the tibial growth plate was lower than that in the model control group(P＜0.05).To conclude,the appropriate dose of grape seed extract can effectively inhibit the apoptosis of growth plate chondrocytes and delay epiphyseal closure,which has the potential to promote bone growth.

Objective:To establish a foundation for the psychological selection of air combat personnel by studying the cognitive ability measurement methods for air combat personnel.Methods:The tests were done for 390 subjects including 142 radar operators, 117 radar academy students, 45 air combat personnel, and 86 radar trainees. Based on job analysis, 5 cognitive test tasks were developed, including graphic discrimination, working memory test, target tracking, voice anti-jamming, and comprehensive management. The discrimination was evaluated by the distribution graphs and coefficients of variation of the test results. The criterion-related validity was examined by correlating the cognitive test scores with the participants' work performance or academic grades, which served as the criteria. Content validity was determined by a 9-level scoring (1-9) of task necessity that collected from 30 air combat personnel and by the assessments of necessity of tested abilities that came from 30 experts. The parallel forms reliability, test-retest reliability and split-half reliability were tested respectively according to the results of each test.Results:The original scores of each test showed approximate normal distribution. The selected indicators' coefficients of variation were 14.4%-111.0%, reliabilities were 0.764-0.827, and criterion-related validities were 0.186-0.445, all of which were statistically significant (all P<0.05). In 30 air combat personnel, 53.3%-83.3% scored 7-9 to the necessity of test items, and 93.3% of 30 experts gave the required or basically required evaluations to the test items. Conclusions:The series tests show good content validity, and discrimination, reliability and the criterion-related validity meet the requirements of psychometrics. Especially the tests of graphic discrimination, working memory and target tracking expressed higher degree of discrimination, and can be used as cognitive ability assessment tool for the selection of air combat personnel.

Objective:To establish a foundation for the psychological selection of air combat personnel by studying the cognitive ability measurement methods for air combat personnel.Methods:The tests were done for 390 subjects including 142 radar operators, 117 radar academy students, 45 air combat personnel, and 86 radar trainees. Based on job analysis, 5 cognitive test tasks were developed, including graphic discrimination, working memory test, target tracking, voice anti-jamming, and comprehensive management. The discrimination was evaluated by the distribution graphs and coefficients of variation of the test results. The criterion-related validity was examined by correlating the cognitive test scores with the participants' work performance or academic grades, which served as the criteria. Content validity was determined by a 9-level scoring (1-9) of task necessity that collected from 30 air combat personnel and by the assessments of necessity of tested abilities that came from 30 experts. The parallel forms reliability, test-retest reliability and split-half reliability were tested respectively according to the results of each test.Results:The original scores of each test showed approximate normal distribution. The selected indicators' coefficients of variation were 14.4%-111.0%, reliabilities were 0.764-0.827, and criterion-related validities were 0.186-0.445, all of which were statistically significant (all P<0.05). In 30 air combat personnel, 53.3%-83.3% scored 7-9 to the necessity of test items, and 93.3% of 30 experts gave the required or basically required evaluations to the test items. Conclusions:The series tests show good content validity, and discrimination, reliability and the criterion-related validity meet the requirements of psychometrics. Especially the tests of graphic discrimination, working memory and target tracking expressed higher degree of discrimination, and can be used as cognitive ability assessment tool for the selection of air combat personnel.

The outbreak and spread of coronavirus disease 2019 (COVID-19) highlighted the importance and urgency of the research and development of therapeutic drugs. Very early into the COVID-19 pandemic, China has begun developing drugs, with some notable progress. Herein, we summarizes the anti-COVID-19 drugs and promising drug candidates originally developed and researched in China. Furthermore, we discussed the developmental prospects, mechanisms of action, and advantages and disadvantages of the anti-COVID-19 drugs in development, with the aim to contribute to the rational use of drugs in COVID-19 treatment and more effective development of new drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the variants. Neutralizing antibody is an effective approach to overcome COVID-19. However, drug resistance induced by rapid virus mutation will likely to challenge neutralizing antibodies. Taking into account current epidemic trends, small molecule drugs have a crucial role in fighting COVID-19 due to their significant advantage of convenient administration and affordable and broad-spectrum. Traditional Chinese medicines, including natural products and traditional Chinese medicine prescriptions, contribute to the treatment of COVID-19 due to their unique mechanism of action. Currently, the research and development of Chinese anti-COVID-19 drugs have led to some promising achievements, thus prompting us to expect even more rapidly available solutions.

Objective To investigate the effect of prehospital transport mode on delay care in patients withacutestroke.Methods From March 2016 to August 2016,a total of 255 consecutive patients with acute stroke who met the inclusion criteria in Xuanwu Hospital,Capital Medical University were analyzed prospectively. Seven patients were excluded because of incomplete data. A total of 248 valid cases were enrolled. They were divided into either an ambulance transport group (n=88)or a non-ambulance transport group (n=160)according to whether they were transported by ambulance or not. The differences of the baseline data,prehospital status,onset-to-door time,door-to-examination time,door-to-CT scan time,door-to-intravenous thrombolysis time of the 2 groups were compared,and the related factors of ambulance use were analyzed in patients with acute stroke. Results (1)The ambulance utilization rate of 248 patients was 35. 5%. The age,the coronary heart disease rate,National Institutes of Health Stroke Scale (NIHSS)score of the patients in the ambulance transport group were higher than those of the non-ambulance transport group. There were significant differences between the two groups (65 ± 11 vs. 61 ± 11 years,15. 9%[14/88]vs. 5. 6%[9/160],9 [3,17]vs. 2 [1,5];all P <0. 05). The stroke rate of the patients in the ambulance transport group was lower than that of the non-ambulance transport group(23. 9%[21/88]vs. 37. 5%[60/160],P<0. 05). (2)There were significant differences in self-identified acute disease and self-health care consciousness between the ambulance transport group and the non-ambulance transport group (all P<0. 01). (3)Compared with the non-ambulance transport group,the onset-to-door time,door-to-examination time,door-to-CT scan time,door-to-intravenous thrombolysis time were shorter in patients of the ambulance transport group (102[64,150]min vs. 136[86,230]min,3[1,8]min vs. 7[4,11]min, 15[18,23]min vs. 16[22,27]min,and 41 ± 9 min vs. 50 ± 10 min;all P <0. 05). (4)The result of Logistic regression analysis showed that the acute stroke patients with advanced age (OR,1. 04,95%CI 1. 01-1. 08,P =0. 01),higher NIHSS score (OR,1. 13,95%CI 1. 08-1. 19,P <0. 01),they or the insiders thought that the disease was emergent (OR,17. 08,95%CI 5. 78-50. 41,P<0. 01),they would seek medical advice in time when they felt sick (OR,38. 13,95%CI 10. 13-143. 61,P<0. 01),and they would take medicine by themselves when they felt sick (OR,6. 82,95%CI 2. 33-19. 99,P<0. 01)were more likely to be transported to hospital by ambulance.Conclusion Using ambulance can reduce the treatment de-lay for patients with acute stroke. The patients with self-health care consciousness are more likely to choose am-bulance transport. The importance of using ambulance should be strengthened for patients with stroke.

Aim To explore the role of PI3 K/Akt/Sirt1 pathway in cardioprotection of hydrogen sulfide ( H2 S ) postconditioning against ischemia/reperfusion ( I/R) injury. Methods Langendorff perfusion appa-ratus was used to build an isolated rat myocardial I/R model. Isolated rat hearts were subjected to 30 min global ischemia followed by 60 min reperfusion after 20 min of equilibrium. 60 male SD rats were randomly di-vided into 5 groups(n=12):control group(Control), ischemia/reperfusion group( I/R) , H2 S postcondition-ing group( H2 S) , inhibitor LY294002 group( LY) and H2 S with inhibitor group( H2 S+LY) . The left ventric-ular diastolic pressure ( LVEDP ) , the left ventricular developed pressure(LVDP), the maximum rate of in-crease or decrease of left ventricular pressure ( ± dp/dtmax ) were registered at the end of 20 min equilibri-um, 30 and 60 min of reperfusion separately. Triphe-nyl tetrazolium chloride( TTC) staining was used to de-termine the myocardial infarct size. The levels of Sirt1 and PGC-1 mRNA were tested using real-time PCR. The expressions of Sirt1 and PGC-1αwere detected with Western blot analysis. Immunohistochemical method was used to determine the location of Sirt1 . Results There were no differences in equilibrium hemodynamics observed between the experimental groups(P>0. 05). At the end of reperfusion, compared with I/R group, H2 S group had obviously ameliorated functional recov-ery and significantly decreased the myocardial infarct size(26. 9 ± 4. 9)% vs(48. 9 ± 5. 6)%(P <0. 05). Meanwhile, the expression of Sirt1 and PGC-1α in-creased significantly. However,LY294002 reversed the cardioprotective effects provided by hydrogen sulfide postconditioning and reduced the level of Sirt1 and PGC-1α, the percentage of Sirt1-positive nuclei. Con-clusion PI3 K/Akt/Sirt1 signaling pathway mediates the hydrogen sulfide postconditioning-induced protec-tion against I/R injury.