BACKGROUND: Preclinical studies have indicated that Angong Niuhuang Pills (ANP) reduce cerebral infarct and edema volumes. This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke. METHODS: This randomized, double-blind, placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022. Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo (3 g/day for 5 days). The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment. The primary safety outcome was severe adverse events (SAEs) for 90 days. RESULTS: There were 57 and 60 patients finally included in the ANP and placebo groups, respectively for modified intention-to-treat analysis. The median age was 66.0 years, and the median NIHSS score at baseline was 12.0. The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups, respectively (median difference: -7.1 mL; interquartile range [IQR]: -18.3 to 2.3 mL, P = 0.30). The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL, respectively ( median difference: 3.0 mL, IQR: -1.3 to 9.9 mL, P = 0.15). The rates of SAE within 90 days were similar in the ANP (3/57, 5%) and placebo (7/60, 12%) groups ( P = 0.36). Changes in serum mercury and arsenic concentrations were comparable. In patients with large artery atherosclerosis, ANP reduced the cerebral infarct volume at 14 days (median difference: -12.3 mL; IQR: -27.7 to -0.3 mL, P = 0.03). CONCLUSIONS: ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke. Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis. TRAIL REGISTRATION Clinicaltrials.gov , No. NCT04475328.
Aged ; Female ; Humans ; Male ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Ischemic Stroke/drug therapy* ; Pilot Projects ; Stroke/drug therapy* ; Treatment Outcome

OBJECTIVE To comprehensively screen the optimal steaming time of salt-steaming Morinda officinalis （SSMO） based on Q-markers and anti-oxidative activities， and to establish characteristic quality standard of the decoction pieces. METHODS The contents of six Q-markers （1-kestose， nystose， 1F-fructofuranosylnystose， inulotriose， inulotetraose and inulopentaose） in SSMO at different steaming time were determined by HPLC-ELSD method simultaneously. The activity of sample extracts to scavenge 4 kinds of oxidative free radical and their iron reduction abilities were determined by visible UV spectrophotometer. The optimal steaming time of SSMO was screened by gray relevance degree and entropy weight technique for order preference by similarity to an ideal solution （TOPSIS）-fusion model method. The contents of six Q-markers in 10 batches of SSMO prepared at the optimal steaming time were determined. HPLC-ELSD fingerprints of SSMO decoction pieces were established. RESULTS The results showed that the contents of six Q-markers were the highest when SSMO was steamed for 3-5 h； and the ability of scavenging DPPH·， ABTS·， PTIO·， ·OH and iron reduction ability was the best at 5 h. There were 20 common peaks in the fingerprints for 10 batches of samples， and the similarities were higher than 0.990. A total of 9 chromatographic peaks were identified， which were D-fructose （peak 1）， D（+）-glucose （peak 2）， sucrose （peak 3）， 1-kestose （peak 4）， nystose （peak 5）， 1F-fructofuranosylnystose （peak 6）， inulotriose （peak X2）， inulotetraose （peak X3） and inulopentaose （peak X4）. Average contents of six Q-markers were 4.17%， 5.54%， 6.60%， 2.89%， 2.62% and 2.13%， respectively. CONCLUSIONS The optimal steaming time of SSMO is 5 h； the contents of six Q-markers are primarily determined on the basis of dry product， which are no less than 3.03%， 4.11%， 4.87%， 2.15%， 1.96% and 1.58%， respectively. The ratio of Inulin-/Inulo oligosaccharides content is no more than 2.5.

OBJECTIVE: To explore the risk factors of acute respiratory distress syndrome (ARDS) in patients with sepsis and to construct a risk nomogram model. METHODS: The clinical data of 234 sepsis patients admitted to the intensive care unit (ICU) of Tianjin Hospital from January 2019 to May 2022 were retrospectively analyzed. The patients were divided into non-ARDS group (156 cases) and ARDS group (78 cases) according to the presence or absence of ARDS. The gender, age, hypertension, diabetes, coronary heart disease, smoking history, history of alcoholism, temperature, respiratory rate (RR), mean arterial pressure (MAP), pulmonary infection, white blood cell count (WBC), hemoglobin (Hb), platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer, oxygenation index (PaO₂/FiO₂), lactic acid (Lac), procalcitonin (PCT), brain natriuretic peptide (BNP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (SCr), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) were compared between the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of sepsis related ARDS. Based on the screened independent risk factors, a nomogram prediction model was constructed, and Bootstrap method was used for internal verification. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the ROC curve (AUC) was calculated to verify the prediction and accuracy of the model. RESULTS: There were no significant differences in gender, age, hypertension, diabetes, coronary heart disease, smoking history, alcoholism history, temperature, WBC, Hb, PLT, PT, APTT, FIB, PCT, BNP and SCr between the two groups. There were significant differences in RR, MAP, pulmonary infection, D-dimer, PaO₂/FiO₂, Lac, ALB, BUN, APACHE II score and SOFA score (all P < 0.05). Multivariate Logistic regression analysis showed that increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score were independent risk factors for sepsis related ARDS [RR: odds ratio (OR) = 1.167, 95% confidence interval (95%CI) was 1.019-1.336; MAP: OR = 0.962, 95%CI was 0.932-0.994; pulmonary infection: OR = 0.428, 95%CI was 0.189-0.966; Lac: OR = 1.684, 95%CI was 1.036-2.735; APACHE II score: OR = 1.577, 95%CI was 1.202-2.067; all P < 0.05]. Based on the above independent risk factors, a risk nomograph model was established to predict sepsis related ARDS (accuracy was 81.62%, sensitivity was 66.67%, specificity was 89.10%). The predicted values were basically consistent with the measured values, and the AUC was 0.866 (95%CI was 0.819-0.914). CONCLUSIONS Increased RR, low MAP, pulmonary infection, high Lac and high APACHE II score are independent risk factors for sepsis related ARDS. Establishment of a risk nomograph model based on these factors may guide to predict the risk of ARDS in sepsis patients.
Humans ; Retrospective Studies ; Alcoholism ; Prognosis ; Respiratory Distress Syndrome ; Pneumonia ; Sepsis ; Intensive Care Units ; Procalcitonin ; Fibrinogen ; ROC Curve

Background::Keratinocytes play an important role in wound healing; however, less is known about skin keratinocytes in patients with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to search for the transcriptional characteristics of keratinocytes at the single-cell level from T2DM patients, and to provide experimental data for identifying the pathological mechanisms of keratinocytes under pathological conditions.Methods::We performed single-cell RNA sequencing on the skin tissue from two T2DM patients and one patient without diabetes-induced trauma using the BD Rhapsody TM Single-Cell Analysis System. With the help of bioinformatics R-based single-cell analysis software, we analyzed the results of single-cell sequencing to identify the single-cell subsets and transcriptional characteristics of keratinocytes at the single-cell level, including Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analyzes. Results::In this study, we found specific highly expressed signature keratinocyte-related genes. We analyzed the transcriptome of keratinocytes from experimental and control groups and screened a total of 356 differential genes, which were subject to bioinformatics analysis. Enriched pathways included oxidative phosphorylation, antigen processing and presentation, prion and Huntingtons’ diseases, bacterial invasion of epithelial cells, thermogenesis, vasopressin-regulated water reabsorption, and protein processing in the endoplasmic reticulum.Conclusions::This study revealed the characteristics of keratinocytes at the single-cell level and screened a group of differentially expressed genes related to T2DM-associated keratinocytes, oxidative phosphorylation, cytokine receptor interactions, prion diseases, and other signaling pathways.

Objective:To investigate effects of metformin and rosiglitazone in non-obese polycystic ovary syndrome (PCOS) women with insulin resistance.Methods:Totally 200 non-obese PCOS women with insulin resistance in West China Second Hospital of Sichuan University were enrolled into this study from Sep. 2013 to Jun. 2016, and were randomly divided into two treatment groups: metformin group (1 500 mg/d) and rosiglitazone group (4 mg/d). The treatment lasted for 6 months. Their clinical and biochemical parameters were collected and compared.Results:In both groups, menstrual cycles [metformin group (37±4) days, rosiglitazone group (35±4) days] were shorter after treatment for 6 months (both P<0.01). After treatment for 6 months, body mass index [metformin group (21.6±1.6) kg/m 2, rosiglitazone group (21.7±1.7) kg/m 2] decreased in both groups (both P<0.01); decreased LH/FSH ratio (metformin group 1.67±0.80, rosiglitazone group 1.70±0.83) was also observed (both P<0.05). After treatment for 6 months, fasting insulin level [metformin group (13.5±5.1) mU/L, rosiglitazone group (12.7±5.6) mU/L] and homeostasis model assessment-insulin resistance index (metformin group 3.0±1.2, rosiglitazone group 2.8±1.2) were decreased in both groups (all P<0.01). Conclusions:For non-obese PCOS insulin resistance patients, screening of anthropometric and metabolic parameters is necessary. For PCOS with insulin resistance, lifestyle plus insulin sensitizers such as metformin could improve their clinical symptoms, correct the biochemical and metabolic dysfunction.

Due to insidious onset,rapid progress,poor curative effect and poor prognosis,pancreatic cancer is known as a high degree of malignity.the incidence of pancreatic cancer and its clinical detection rate have increased in recent years,and it has become one of the malignant diseases endangering health of people.Therefore,the authors review and summarize the recent important research progress in the diagnosis and treatment of pancreatic cancer.

Objective? To investigate the readability evaluation of the printed health education materials by working nurses, to understand the perception of readability of health education materials and to lay the basis for future research on readability evaluation. Methods? In July 2017, 310 students from 147 hospitals (secondary and above) from all over Anhui Province were trained at Anhui Medical University. This study utilized the first stage of this training opportunity (July 3-14, 2017) to conduct an investigation of all participants. Surveys were conducted using a general survey, a printed health education material quality questionnaire, and a readability perception questionnaire. A total of 310 questionnaires were distributed in this study, and 283 valid questionnaires were returned. The effective response rate was 91.3%. Results? The results of the readability evaluation of the printed health education materials showed that 36 participants reported that there were no health education resources for the patients in their departments. 247 participants reported that they provided printed health education materials in their departments, 56.7% of them believed that the health education materials of their departments had too many medical terminologies, 53.8% thought that the key information was not summarized or emphasized, and 61.9% thought that the content was too old. Compared with the tertiary hospitals, the nurses working in the secondary hospitals thought that the health education materials in their hospitals had "too many medical terms" and "old content", and the difference was statistically significant (P＜0.05). The results of the evaluation of the application of health education materials showed that 247 clinical nurses reported that the existing health education materials were mainly obtained from the following channels, of which 64.8% were self-designed, 79.4% were from external institutions, and 68.4% were from online resources. Compared with the nurses in the tertiary hospitals, the nurses in the secondary hospitals reported more of the fact that their departments provided the same health education materials to patients with different stages, and the difference was statistically significant (P＜ 0.05); Regarding the perception of readability, 48.8% of the participants had heard of the concept of readability; 94.7% considered it necessary to assess the readability of health education materials; but only 20.5% understand the readability assessment method and have readability evaluation ability. Conclusions? At present, the health education materials used in clinical practice have to be improved in terms of readability and application methods, but the ability to evaluate readability is low. Developers of clinical education materials should pay attention to the readability evaluation of materials, learn from the methods and experience of foreign readability research, actively explore the evaluation methods suitable for the readability of health education materials in China, and improve the material based on the readability evaluation results. Hospital administrators should also strengthen the training of first-line health education nurses, improve their ability to assess the readability of health education materials and optimize the health education outcomes.

In the era of outbreaking of antibiotic resistance, the discovery of new antibacterial drugs is emergent.Antimicrobial peptides are important components of the natural defenses of most living organisms against invading pathogens.The unique antibacterial mechanism, direct bactericidal effect, relatively slow of resistance acquirement, and can used alone or combined with antibiotics, make antimicrobial peptides be attractive potential antibacterial drugs.In this paper, we review the physicochemical property of antibacterial peptides, action mechanism and design of antimicrobial peptides, and give a brief introduction of several promising antimicrobial peptides.

Objective To establish the method of the GC fingerprints for Ligusticum chuanxiong essential oil and its quality control.Methods The temperature at both feed inlet and detector was 250℃,the carrier gas was nitrogen,and the flow rate was 2 mL/min.GC of the essential oil in ten batches of L.chuanxiong was analyzed by adopting temprature programmer and the fingerprint peaks were identified by GC-MS.Results To set up the GC fingerprints for L.chuanxiong essential oil,13 peaks were marked out altogether and the GC fingerprints were analyzed by similarity analysis.Conclusion The method is of high degree of presion,reproducibility,and stability.The resolving of each component in the essential oil is good.The established fingerprints could be used as one of the quality control index for L.chuanxiong essential oil.