Objective To observe the therapeutic effect and mechanism of Guhuaisi Kangfu Pills on rats with steroid-induced osteonecrosis of the femoral head(SONFH).Methods Sixty rats were randomly divided into blank group,model group,Xianling Gubao Capsules group and Guhuaisi Kangfu Pills low-,medium-and high-dose groups,10 rats in each group.Except for the blank group,the SONFH model was established by lipopolysaccharide combined with Glucocorticoid induction method in all other groups of rats.At the end of the intervention,for the femoral head,blood vessel radiography was performed to observe the microvascular changes in the bone marrow,and hematoxylin-eosin(HE)staining and calculation of the empty bone trap rate,Micro-CT scanning analysis,and compression experiments were carried out,and the real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the gene expressions of phosphatidylinositol 3-kinase(PI3K),protein kinase B(Akt)1,vascular endothelial growth factor(VEGF)and platelet endothelial cell adhesion molecule 1(CD31)in whole blood.Results Compared with the blank group,the blood supply in the femoral head medullary cavity of the model group was poor,the empty bone lacuna rate was increased(P＜0.05),the bone mineral density and bone volume fraction were significantly decreased(P＜0.05),the maximum load and elastic modulus of the femoral head were decreased(P＜0.05),and the mRNA expression levels of Akt1,PI3K,VEGF and CD31 in whole blood were decreased(P＜0.05).Compared with the model group,the blood supply in the femoral head medullary cavity was relatively good,the empty bone lacuna rate was decreased(P＜0.05),the bone mineral density,bone volume fraction,trabecular number and trabecular thickness were significantly increased(P＜0.05),the trabecular separation was significantly decreased(P＜0.05),the maximum load and elastic modulus of the femoral head were increased(P＜0.05),and the mRNA expression levels of Akt1,PI3K,VEGF and CD31 in the whole blood were increased(P＜0.05)in the high-dose group of Guhuaisi Kangfu Pills and Xianling Gubao Capsules group.There was no significant difference in the above indexes between the high-dose group of Guhuaisi Kangfu Pills and the Xianling Gubao Capsules group(P＞0.05).Conclusion Guhuaisi Kangfu Pills improves SONFH in rats,and its mechanism is related to the promotion of VEGF/PI3K/Akt pathway gene expression,thereby promoting angiogenesis.

Oral solid dosage(OSD) occupies a key position in the market of Chinese patent medicines and new traditional Chinese medicines. Processing route is the foundation for the research and development of traditional Chinese medicine OSDs. On the basis of prescriptions and preparation methods of 1 308 traditional Chinese medicine OSDs recorded in the Chinese Pharmacopoeia, we summarized the patterns of processing routes of both modern dosage forms(tablets, granules, and capsules) and traditional dosage forms(pills and powder) and constructed a manufacturing classification system(MCS) based on the processing routes. Based on the MCS, statistical analyses were conducted respectively on medicinal materials, pharmaceutical excipients, extraction solvents in the pretreatment process, crushed medicinal materials, methods of concentration and purification, and methods of drying and granulation, aiming to uncover the process features. The results showed that each dosage form can be prepared via different routes with different processing methods of decoction pieces and raw materials for dosage preparation. The raw materials for dosage form preparation of traditional Chinese medicine OSDs included total extract, semi-extract, and total crushed powder, which accounted for different proportions. The raw materials for traditional dosage forms are mainly decoction pieces powder. Semi-extracts are the main raw materials for tablets and capsules, which account for 64.8% and 56.3%, respectively. Total extracts are the main raw materials for granules, with a proportion of 77.8%. Compared with tablets and capsules, traditional Chinese medicine granules with dissolubility requirements had a larger proportion of water extraction process, a higher proportion of refining process(34.7%), and a lower proportion of crushed medicinal mate-rials in semi-extract granules. There are four ways to add volatile oil to the modern dosage forms of traditional Chinese medicine. In addition, some new technologies and processes have been used in concentration, filtration, and granulation processes of traditional Chinese medicine OSDs, and the application of pharmaceutical excipients is diversified. The results of this study are expected to provide reference for the processing route design and upgrading of OSDs for new traditional Chinese medicines.
Capsules ; Excipients ; Medicine, Chinese Traditional ; Powders

Animals ; Rats ; Explosions ; Proteomics ; Autophagy

Objective To compare the diagnostic efficacy of 3 lung ultrasound criteria in evaluating cardiogenic pulmonary edema,so as to obtain the optimal diagnostic criterion and to provide effective auxiliary measure for the rapid diagnosis of cardiogenic pulmonary edema.Methods A total of 98 patients who underwent lung ultrasound in the Shanghai Chest Hospital from June 2022 to November 2022 were included.Three positive criteria were defined according to the number and distribution of positive points based on the pleural and B lines:criterion 1 was set as at least 2 positive points;criterion 2 was set as at least 3 positive points;criterion 3 was set as at least 1 positive point on each side.The efficacies of 3 criteria in diagnosis of cardiogenic pulmonary edema,and their consistencies with clinical diagnosis were compared.Results The sensitivities of criterion 1,criterion 2,and criterion 3 were 88%,72%and 79%,the specificities was 89%,100%and 93%,the accuracies was 87%,88%and 87%,respectively.The criteri on 2 showed a higher consistency in the diagnosis of cardiogenic pulmonary edema with clinical diagnosis(Kappa value=0.877);the criterion 1 and criterion 3 were generally consistent in the diagnosis of cardiogenic pulmonary edema with clinical diagnosis(Kappa values were 0.783 and 0.727,respectively).Conclusions The diagnostic efficacies of the 3 positive lung ultrasound criteria for cardiogenic pulmonary edema are high,and"at least 3 positive points"is more helpful for clinical diagnosis.

Catheter Ablation ; Graves Disease/surgery* ; Humans ; Microwaves/therapeutic use* ; Radiofrequency Ablation ; Treatment Outcome ; Ultrasonography ; Ultrasonography, Interventional

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ²=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ²=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.
China/epidemiology* ; Cities ; Drug Resistance ; Drug Resistance, Viral/genetics* ; Female ; Genotype ; HIV Infections/epidemiology* ; HIV Seropositivity/drug therapy* ; HIV-1/genetics* ; Homosexuality, Male ; Humans ; Male ; Phylogeny ; Reverse Transcriptase Inhibitors/therapeutic use* ; Sexual and Gender Minorities

Humans ; Homicide ; Forensic Pathology

The high shear wet granulation(HSWG) process of Chinese medicine has a complicated mechanism. There are many influencing factors that contribute to this process. In order to summarize the manufacturability of different kinds of materials in HSWG, this paper constructed a material library composed of 11 materials, including 4 Chinese medicine extracts and 7 pharmaceutical excipients. Each material was described by 22 physical parameters. Several binders were employed, and their density, viscosity and surface tension were characterized. Combining empirical constraints and the principle of randomization, 21 designed experiments and 8 verification experiments were arranged. The partial least squares(PLS) algorithm was used to establish a process model in prediction of the median granule size based on properties of raw materials and binders, and process parameters. The surface tension and density of binders, as well as the maximum pore saturation were identified as key variables. In the latent variable space of the HSWG process model, all materials could be divided into three categories, namely the Chinese medicine extracts, the diluents and the disintegrants. The granulation of Chinese medicine extracts required low viscosity and low amount of binder, and the resulted granule sizes were small. The diluent powders occupied a large physical space, and could be made into granules with different granule sizes by adjusting the properties of binders. The disintegrants tended to be made into large granules under the condition of aqueous binder. The combination use of material database and multivariate modeling method is conducive to innovate the knowledge discovery of the wet granulation process of Chinese medicine, and provides a basis for the formulation and process design based on material attributes.
Drug Compounding ; Excipients ; Medicine, Chinese Traditional ; Particle Size ; Powders ; Tablets ; Technology, Pharmaceutical

Objective:To analyze the incidence and epidemic characteristics of local cases infected with SARS-CoV-2 in Yangpu District of Shanghai， China， and provide scientific evidence for the prevention and control of coronavirus disease-19 （COVID-19）. Methods:Descriptive epidemiological methods were applied to analyze the epidemic data of all the patients tested positive for SARS-CoV-2 RNA in Yangpu District of Shanghai， China. Results:A total of 9 local cases （7 males and 2 females） were documented in Yangpu District from January 30， 2020 to February 29， 2020. The average age was （48.56±13.85） years old. According to the body mass index， the patients with overweight and obesity accounted for 44.44% of the total cases. All the patients had fever at the onset and radiological findings of pneumonia by CT examination. They were diagnosed during January 24 and February 8， 2020. The median incubation period of the COVID-19 was 9 days and the median course was 22 days. Six cases had travel history in the epidemic areas and the other 3 cases had history of contact with confirmed cases. There were two familial clusters， both of which were husband-wife relationships. One cluster had a clear temporal sequence of onset， while the other one might be co-exposed or mutually infected. No new local case infected with SARS-CoV-2 was evident since February 8， 2020. Conclusion:All the local COVID-19 cases in Yangpu District have clear epidemiological exposure history. It warrants further attention to the family clustering SARS-CoV-2 transmission. Currently， containment of imported cases is crucial for the prevention and control of COVID-19 epidemic.

Objective:To investigate the influence of particle size on density of binary powder mixture of traditional Chinese medicine （TCM）， and to provide reference for formulation design of TCM preparations. Method:Three groups of binary powder mixtures with different particle size ratio （α） were constructed， namely Oroxyli Semen-microcrystalline cellulose PH102 （MCC PH102） （α=0.071 7）， Stellariae Radix-MCC PH200 （α=0.158 7） and Angelicae Sinensis Radix-MCC KG802 （α=0.840 6）. Binary powder mixtures with nine mass ratios （90∶10， 80∶20， 70∶30， 60∶40， 50∶50， 40∶60， 30∶70， 20∶80 and 10∶90） were prepared for each group， and 27 binary powder mixtures containing TCM were obtained. The particle size distribution， density and other parameters of six single materials and 27 binary powder mixtures were characterized. Based on the packing theory and multivariate analysis， the effects of particle size related parameters on the filling structure and density of the binary powder mixtures were elucidated. Result:The α of Angelicae Sinensis Radix-MCC KG802 binary mixture system was larger than the replacement rate （α_r=0.741 0）， and its density had a good linear relationship with the mass ratio， which conformed to the replacement mechanism. The α of Oroxyli Semen-MCC PH102 binary mixture system was smaller than the critical ratio （α_c=0.154 0）， and its density was nonlinear with the mass ratio of components， which conformed to the filling mechanism. The α of Stellariae Radix-MCC PH200 binary mixture system was between α_c and α_r， its density was affected by both of replacement mechanism and filling mechanism. Based on the partial least squares （PLS） model， the variable importance in the projection （VIP） analysis further proved that the mixing mass ratio （VIP value=1.62）， α （VIP value=1.13） and D₁₀ （the corresponding particle size when the particle size distribution accumulated to 10%， VIP value=1.06） were the key factors affecting the density of binary powder mixtures of TCM. Conclusion:In the binary powder mixtures of TCM， the linearity relationship between density and mass ratio is largely depended on particle size difference of components.