Objective This study investigated the regulatory effect of high mobility group protein B1 (HMGB1) in the peripheral blood of patients with primary immune thrombocytopenia (ITP) on myeloid dendritic cells (mDC) and Th17/regulatory T cells (Treg) balance. Methods The study enrolled 30 newly diagnosed ITP patients and 30 healthy controls.Flow cytometry was used to measure the proportion of mDC, Th17, and Treg cells in the peripheral blood of ITP patients and healthy controls. ELISA was conducted to quantify the serum levels of HMGB1, interleukin 6 (IL-6), IL-23, IL-17, and transforming growth factor β(TGF-β). The mRNA levels of retinoic acid-related orphan receptor γt(RORγt) and forehead box P3(FOXP3) were detected by real-time PCR. The correlation between the abovementioned cells, cytokines, and platelet count was assessed using Pearson linear correlation analysis. Results The proportion of Th17 cells and the expression levels of HMGB1, IL-6, IL-23, IL-17 and the level of RORγt mRNA in the peripheral blood of ITP patients were higher than those in healthy controls. However, the Treg cell proportion and TGF-β level were lower in ITP patients than those in healthy controls. In patients with ITP, the proportion of mDC and the level of FOXP3 mRNA did not show significant changes. The proportion of mDC cells was significantly correlated with the expression of IL-6 and IL-23. Moreover, the expression of HMGB1 showed a significant correlation with the expression of mDC, IL-6, IL-23, RORγt mRNA, and IL-17. Notably, both the proportion of mDC cells and the expression of HMGB1 were negatively correlated with platelet count. Conclusion The high expression of HMGB1 in peripheral blood of ITP patients may induce Th17/Treg imbalance by promoting the maturation of mDC and affecting the secretion of cytokines, thereby potentially playing a role in the immunological mechanism of ITP.
Humans ; Th17 Cells/cytology* ; HMGB1 Protein/genetics* ; T-Lymphocytes, Regulatory/cytology* ; Female ; Male ; Dendritic Cells/metabolism* ; Adult ; Middle Aged ; Purpura, Thrombocytopenic, Idiopathic/genetics* ; Nuclear Receptor Subfamily 1, Group F, Member 3/genetics* ; Young Adult ; Interleukin-23/blood* ; Interleukin-17/blood* ; Interleukin-6/blood* ; Forkhead Transcription Factors/genetics* ; Myeloid Cells/cytology* ; Aged

Objective To use feature selection and Likert grading method to quantify the data of lung cancer medical records,to construct a deep extreme learning machine model optimized by the sparrow search algorithm,to classify and predict the syndrome types of traditional Chinese medicine medical record data of lung cancer,and to provide scientific and effective research on syndrome type classification of traditional Chinese medicine.means.Methods The medical records of 497 cases diagnosed with lung cancer from January 2015 to December 2021 were collected from the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,and 412 medical records were screened as the research objects.Syndromic factors of different syndromes were summarized by feature selection and feature importance ranking,and the syndrome factors were quantified by Likert grading method.Build a deep extreme learning machine optimized based on the sparrow search algorithm,and train and test the model.Finally,the model built in this paper is compared with other machine learning models according to three evaluation criteria.Results The average classification accuracy of the SSA-DELM model established in this paper was 88.44%,while the average accuracy of the support vector machine and Bayesian network was 83.39%and 84.53%,respectively.The recall rate and F1 value of the SSA-DELM model on the five syndrome types are mostly above 80%,which is also better than other traditional machine learning models.Conclusion The results of the study show that the use of feature selection combined with Likert grading method to quantify the lung cancer medical record data,compared with the 0-1 processing data,can show the characteristics of the data,improve the accuracy of the classification model,SSA-DELM new Compared with other traditional machine learning classification models,the model has better representation learning ability and learning speed.This model not only provides a scientific and technical means for the clinical treatment of lung cancer,but also provides a useful reference for the informatization and intelligent development of TCM syndrome differentiation and treatment.

【Objective】 To investigate the effect or endoscopic discectomy via interlaminar approach in the treatment of lumbar disc herniation under local or general anesthesia. 【Methods】 We selected 78 patients with lumbar disc herniation （L5-S1） who underwent endoscopic discectomy via interlaminar approach from January 2018 to February 2020. According to the anesthesia method， they were divided into local anesthesia group （40 patients） and general anesthesia group （38 patients）. Baseline data， complications， operation time， length of hospital stay， hospitalization expenses， preoperative and postoperative VAS scores were compared between the two groups to evaluate the difference in clinical outcomes. 【Results】 There was no significant difference between the two groups in gender （23/17 vs. 20/18）， age （38.45±13.59 vs 37.39±13.35） years， preoperative VAS score （7.05±1.32 vs. 6.95±1.47）， or other baseline data （P>0.05）. The operation was completed successfully in both groups， and the operation time （83.57±13.24 vs. 86.28±15.43） minutes did not statistically differ （P>0.05）. No complications such as cerebrospinal fluid leakage， nerve injury， or wound infection occurred. In the local anesthesia group， the VAS pain score at 1d， 1 month and 6 months after surgery was 3.05±1.34， 1.90±0.98 and 1.80±1.09， respectively， which were significantly lower than those before surgery （P<0.001）. The VAS pain scores of the general anesthesia group at the above three time points were 3.24±2.01， 2.03±1.20 and 1.59±1.31， respectively， which were also significantly lower than those before surgery （P<0.001）， but the difference was not statistically significant compared with that of the local anesthesia group at the same time point （P>0.05）. However， compared with the general anesthesia group， the length of hospital stay （2.93±0.92） d and the cost of hospitalization （29 397.97±1 398.09） yuan in the local anesthesia group were decreased by 25.8% and 11.7%， respectively， with statistical significance （P<0.05）. 【Conclusion】 Endoscopic discectomy through interlaminar approach under local or general anesthesia can achieve good clinical outcomes in the treatment of lumbar disc herniation （L5-S1）. Compared with general anesthesia， local anesthesia brings a lower overall cost and a shorter hospital stay.

Objective:To evaluate the efficacy and safety of bendamustine monotherapy in Chinese patients with relapsed/refractory (R/R) B cell non-Hodgkin lymphoma (B-NHL) .Methods:This prospective, multicenter, open label, single-arm, phase Ⅱ study investigated bendamustine’s efficacy and safety in Chinese patients with R/R B-NHL. A total of 78 patients with B-NHL in 11 hospitals in China from March 2012 to December 2016 were included, and their clinical characteristics, efficacy, and survival were analyzed.Results:The median age of all patients was 58 (range, 24-76) years old, and 69 (88.4% ) patients had stage Ⅲ/Ⅳ disease. 61 (78.2% ) patients were refractory to previous treatments. Patients received a median of 4 (range, 1-10) cycles of bendamustine treatment. The overall response rate was 61.5 (95% CI 49.8-72.3) % , the median response duration was 8.3 (95% CI 5.5-14.0) months, and the complete remission (CR) rate was 5.1 (95% CI 1.4-12.6) % . In the full analysis set, median progression-free survival (PFS) and median OS were 8.7 (95% CI 6.7-13.2) months and 25.5 months (95% CI 14.2 months to not reached) , respectively, after a median follow-up of 33.6 (95% CI 17.4-38.8) months. Lymphopenia (74.4% ) , neutropenia (52.6% ) , and leukopenia (39.7% ) , thrombocytopenia (29.5% ) and anemia (15.4% ) were the most common grade 3-4 hematologic adverse events (AE) . The most frequent non-hematologic AEs included nausea (43.6% ) , vomiting (33.3% ) , and anorexia (29.5% ) . Univariate and multivariate analysis showed that <4 cycles of bendamustine treatment was a poor prognostic factor for PFS ( P=0.003) , and failure to accept fludarabine containing regimen was a poor prognostic factor for OS ( P=0.009) . Conclusion:Bendamustine monotherapy has good efficacy and safety in the treatment of patient with R/R B-NHL.

OBJECTIVE：To comprehensi vely evaluate the application progress of network pharmacology methods in TCM compound prescription research ，and to provide reference for modernization of TCM compound prescription research. METHODS ： Taking“network pharmacology ”and“TCM compound prescription ”as keywords ，the literatures were retrieved from CNKI ， Wanfang database and VIP during May 2006 to May 2020. Screening literature ，the databases ，analysis platforms ，and software used of the literature were summarized ；on the basis of quantitative analysis ，the application of network pharmacology in the research of traditional Chinese medicine compound were summarized. RESULTS & CONCLUSIONS ：There were a total of 761 valid literatures ，among which the number of literatures that could be retrieved in 2019 reached 313. In the modernization research of TCM compound prescription ，network pharmacology methods were mainly usedmechanism ，material basis of pharmacodynamics ， compatibility law ，compound optimization ，and“effect-toxic”network. Commonly used databasesand platforms included traditional chinese medicine information database （TCMSP and TCMID ），therapeutic target database （TTD，OMIM），drug targets and target prediction platform （Drugbank，SwissTargetPrediction，TargetNet，PharmMapper），network pharmacology analysis and prediction software and platform （CytoScape），etc. Network pharmacology method was widely used in the field of TCM compound prescription research ，and provided new ideas and methods for the modernization of TCM compound prescription research. In the future，the related research can be combined with the pharmacokinetic parameters ，the efficacy of active compounds and related basic experiments ，use the weighted method to carry out network pharmacology analysis ，and integrate the information of multiple databases to improve the scientificity of research results.

OBJECTIVE: To explore the genetic basis for a fetus with autosomal recessive polycystic kidney disease (ARPKD). METHODS: Fetal tissue and peripheral blood samples were respectively obtained from the abortus and the couple. Following extraction of genomic DNA, genetic testing was carried out. RESULTS: The fetus was found to carry compound heterozygous variants of the PKHD1 gene, namely c.5336A>T (p.N1779I) and c.9455delA (p.N3152Tfs*10), which were respectively inherited from the husband and wife. CONCLUSION The c.5336A>T and c.9455delA variants of the PKHD1 gene probably account for the ARPKD in the fetus. Above results have enabled genetic counseling and prenatal diagnosis for the couple.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Objectives To explore the genetic diagnosis of fructose 1,6 diphosphatase deficiency and analysis of mutation sites of its pathogenic genes. Methods The clinical data and the related results of gene panel screening in one child with fructose 1, 6 diphosphatase (FBPase) deficiency were retrospectively reviewed. Results The 2-year-old girl suffered repeated infection, nausea, vomiting, mental illness, and drowsiness, accompanied by intermittent convulsions. Blood biochemical tests sμggested hypoglycemia and acidosis.The FBP1 gene had a missense mutation,c.355G>A,p.Asp119Asn(isozygoty).Both her parents carried the locus variation (heterozygous). Conclusions Fructose 1, 6 diphosphatase deficiency should be considered when child with hypoglycemia after repeated infection, acidosis, and ketosis.

Objective:To observe the effect of Er Chen Tang on CYP2E1 and mitochondrial energy metabolism in nonalcoholic fat-ty liver disease ( NAFLD) to explore the role of Pinellinae Rhizoma Praeparata ( PRP) and Citri reticulatae pericarpium ( CRP) in the treatment of nonalcoholic fatty liver disease. Methods:Er ChenTang and the prescription without PRP or CRP was respectively given the animal models by gastric gavage. The serum levels of ALT, AST, triglyceride, cholesterol, SOD and MDA in hepatic tissue, and the contents of liver tissue CYP2E1 and ATP were detected in the mice. Results:The CYP2E1 levels in NAFLD mice increased signif-icantly with abnormal mitochondrial energy metabolism. Compared with those in the model group, the levels of ALT, AST, triglyceride and cholesterol were significantly reduced by Er Chen Tang, meanwhile, the content of CYP2E1 was reduced and also restored liver en-ergy metabolism. The treatment effect significantly decreased when the lack of PRP or CRP, and the ability of restoring liver mitochon-drial energy metabolism of Er Chen Tang decreased significantly when the lack of PRP (P<0. 05). After the removal of CRP, the in-hibition ability of Er Chen Tang to CYP2E1 levels significantly decreased (P<0. 05). Conclusion:Er Chen Tang can effectively im-prove nonalcoholic fatty liver diseases, and effectively reduce the content of CYP2E1 in liver tissue of mice and restore the mitochondri-al energy metabolism.

Objective To investigate the etiologic roles of apoptosis-associated genes,environmental factors and their interactions in lumbar disc herniation (LDH).Methods A case-control trial was conducted.We recruited 128 outpatients with LDH as case group and 132 normal people matched by age and gender as control group.Peripheral venous blood samples were collected and DNA was extracted from leukocytes.By using a modified Brucker Autoflex MALDI-TOF mass spectrometer,we analyzed 3 genes with 9 polymorphic sites,namely,Fas-1377G/A rs2234767,Fas-670G/A rs1800682,Fas rs2147420,Fas rs2296603,Fas rs7901 656,Fas rs1 57101 9,FasL-844C/T rs7631 10,CASP-9-1263A > G rs4645978,and CASP-9-712C > T rs4645981.The correlations between polymorphism of Fas,FasL and CASP-9 genes and the risk of LDH were evaluated by non-conditional Logistic regression model.Multiple Logistic regression model was performed to assess the interaction between apoptosis-associated genes and environment factors,such as lumbar vertebral loads,bed type,spare-time exercises and spare-time activities. Results There were preferable balances in case and control groups in age and gender without significant differences.However,the two groups differed significantly (P <0.05)in lumbar vertebral loads,body mass index, bed type, spare-time exercises and spare-time activities. Correlation analysis showed remarkable correlations between LDH and the polymorphisms of FasL-844C/T (rs7631 10)and CASP-9-1263A>G (rs4645978),and FasL-844C/T TT and CASP-9-1263A>G GG genotypes might be the high risk genotypes of LDH.The gene-environment interaction analysis revealed that super-multiplicative and sub-multiplicative interactions respectively between FasL-844TT genotype and lumbar vertebral loads (3-4 level),and between CASP-9-rs4645978 GG and lumbar vertebral loads (3-4 level).Conclusion FasL,CASP-9 genes and lumbar vertebral loads and their interactions play important roles in the pathogenesis of LDH.It suggests that the risk of LDH may be codetermined by environmental factors and inherited susceptibility genes,and that the mechanisms of interactions vary in different genotypes and the same or different environmental factors.