OBJECTIVES: To explore the bioactive components in Jiawei Xiaoyao Pills (JWXYP) and their mechanisms for alleviating depression-like behaviors. METHODS: The active compounds, key targets, and pathways of JWXYP were identified using TCMSP and TCMIP databases. Thirty-six SD rats were randomized equally into 6 groups including a control group and 5 chronic unpredictable mild stress (CUMS)-induced depression groups. After modeling, the 5 model groups were treated with daily gavage of normal saline, 1.8 mg/kg fluoxetine hydrochloride (positive control drug), or JWXYP at 1.44, 2.88, and 4.32 g/kg. The depression-like behaviors of the rats were evaluated using behavioral tests, and pathological changes in the liver and hippocampus were examined with HE staining. The biochemical indicators in the serum and brain tissues were detected using ELISA. Serum metabolomics analysis was performed to identify the differential metabolites using OPLS-DA, and gut microbiota changes were analyzed using 16S rDNA sequencing. RESULTS: Network pharmacology revealed that menthone and paeonol in JWXYP were capable of penetrating the blood-brain barrier to regulate inflammatory pathways and protect the nervous system. In the rat models subjected to CUMS, treatment with JWXYP significantly improved body weight loss, sucrose preference and open field activities, reduced liver inflammation, alleviated structural changes in the hippocampal neurons, decreased serum levels of TNF‑α, IL-1β, IL-6 and LBP, and increased 5-HT and VIP concentrations in the serum and brain tissue, and these effects were the most pronounced in the high-dose group. Metabolomics analysis showed changes in such metabolites as indole-3-acetamide and acetyl-L-carnitine in JWXYP-treated rats, involving the pathways for bile acid biosynthesis and amino acid metabolism. 16S rDNA analysis demonstrated increased gut microbiota diversity and increased abundance of Lactobacillus species in JWXYP-treated rats. CONCLUSIONS JWXYP alleviates depression-like symptoms in rats by regulating the neurotransmitters, inhibiting inflammation and oxidation, and modulating gut microbiota.
Animals ; Drugs, Chinese Herbal/therapeutic use* ; Gastrointestinal Microbiome/drug effects* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Neurotransmitter Agents/metabolism* ; Rats ; Inflammation ; Male ; Hippocampus ; Behavior, Animal/drug effects*

Objective To explore the bioactive components in Jiawei Xiaoyao Pills(JWXYP)and their mechanisms for alleviating depression-like behaviors.Methods The active compounds,key targets,and pathways of JWXYP were identified using TCMSP and TCMIP databases.Thirty-six SD rats were randomized equally into 6 groups including a control group and 5 chronic unpredictable mild stress(CUMS)-induced depression groups.After modeling,the 5 model groups were treated with daily gavage of normal saline,1.8 mg/kg fluoxetine hydrochloride(positive control drug),or JWXYP at 1.44,2.88,and 4.32 g/kg.The depression-like behaviors of the rats were evaluated using behavioral tests,and pathological changes in the liver and hippocampus were examined with HE staining.The biochemical indicators in the serum and brain tissues were detected using ELISA.Serum metabolomics analysis was performed to identify the differential metabolites using OPLS-DA,and gut microbiota changes were analyzed using 16S rDNA sequencing.Results Network pharmacology revealed that menthone and paeonol in JWXYP were capable of penetrating the blood-brain barrier to regulate inflammatory pathways and protect the nervous system.In the rat models subjected to CUMS,treatment with JWXYP significantly improved body weight loss,sucrose preference and open field activities,reduced liver inflammation,alleviated structural changes in the hippocampal neurons,decreased serum levels of TNF-α,IL-1β,IL-6 and LBP,and increased 5-HT and VIP concentrations in the serum and brain tissue,and these effects were the most pronounced in the high-dose group.Metabolomics analysis showed changes in such metabolites as indole-3-acetamide and acetyl-L-carnitine in JWXYP-treated rats,involving the pathways for bile acid biosynthesis and amino acid metabolism.16S rDNA analysis demonstrated increased gut microbiota diversity and increased abundance of Lactobacillus species in JWXYP-treated rats.Conclusion JWXYP alleviates depression-like symptoms in rats by regulating the neurotransmitters,inhibiting inflammation and oxidation,and modulating gut microbiota.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

Objective:To explore clinical features, diagnosis, localization, and therapeutic strategy of migratory pharyngeal and cervical esophageal foreign bodies.Methods:A total 23 cases of pharyngeal and cervical esophageal migratory foreign bodies were admitted between January 2015 and December 2021. There were 14 females and 9 males with the age ranged from 35 to 82 (55.0±12.7)years. In all the cases, esophageal CT was taken to confirm the esophageal foreign body. Multiplanar reconstruction (MPR) was performed to locate the foreign body from the horizontal, coronal and sagittal dimensions as well as the corrected reconstructed MPR. According to the location of the foreign body, appropriate surgical method was selected.The symptoms, complications, types of foreign body, positioning, surgical methods, and relevant information were recorded.Data were analyzed using the descriptive method and SPSS 25.0 software.Results:The clinical symptoms of 23 migrating esophageal foreign bodies included pharyngodynia (20/23), foreign body sensation (6/23), hoarsenss (1/23), difficulty in turning neck(1/23), difficulty in opening mouth (1/23), fever (7/23), poor appetite (1/23), and abdominal pain (1/23). The foreign bodies included 19 fish bones, 2 wires, 1 embroidery needle and 1 chicken bone. There were 9 cases (39.1%) of foreign bodies located in extraluminal cervical esophagus, 2 cases (8.7%) of foreign bodies located in the muscular layer of the cervical esophagus and 12 cases (52.2%) of foreign bodies located in pharynx. Twenty-one cases of foreign bodies were removed by cervical lateral incision, in which 11 were removed by cervical lateral incision directly, 10 by the second lateral cervical incision after the foreign bodies were accurately located by MPR and/or corrected MPR, 1 foreign body was removed by incision of the pharyngeal mucosa under suspension laryngoscope, 1 foreign body was removed by tracheoscopy. Compared with patients with intraluminal foreign bodies ( n=308) treated in the same period, intake of fishbone [19 (19/23) vs. 133 (82.6% (43.2%, 133/308), OR=7.31] and first visit was more than 24 hours [20(87.0%, 20/23) vs. 77(25.0%, 77/308), OR=17.2] were the significant risk factors of migratory esophageal foreign bodies. Conclusions:MPR and the corrected MPR can accurately locate the migrating pharyngeal and cervical esophageal foreign bodies, by providing more intuitive imaging evidence for doctors, which provide imaging basis for formulation of surgical programs. Foreign bodies in pharyngeal and cervical esophagus need to be treated as soon as possible, otherwise they are easy to migrate, leading lead to serious complications.

Objective: To investigate the serum angiopoietin-Ⅱ (Ang Ⅱ) levels in acute pancreatitis (AP) patients and the relationship between AngⅡ levels and the disease severity of AP based on the new Atlanta classification criteria. Methods: Seventy-seven patients with AP who were treated in the Affiliated Baiyun Hospital of Guizhou Medical University were included in this prospective study. According to the revised Atlanta classification, the modified Mashall scoring system was used to divided patients into AP with the persistent organ failure(POF) group and without POF group, and the CECT was used to divided patients into AP with pancreatic necrosis(PN) group and without PN group. The levels of AP 72 h after admission of two groups were compared with t test, and Spearman analysis was used to analyze the correlation between common severity indicators and Ang Ⅱ. The receiver operating characteristic (ROC) was performed to analyze the area under curve(AUC), sensitivity and specificity of Ang Ⅱ in predicting POF and PN. Results: According to the modified Mashall scoring system, there were 18 patients (23.38%) in POF group and 59 patients (76.62%) in without POF group. According to CECT, 22 patients (28.57%)were in PN group and 55 patients(71.43%) in without PN group. The Ang Ⅱ of the POF and PN groups was significantly higher than those without POF and PN groups (P=0.001, 0.011) on day 1 on admission. The cut-off value was 126.44 μg/L, and the AUC, sensitivity and specificity for predicting POF were 0.739, 83.3% and 68.4%, which was significantly better than that of traditional predictive indicators, such as C-reaction protein (CRP), procalcitonin (PCT), blood urea nitrogen (BUN), bedside index for severity in AP (BISAP) score and Ranson score. When the cut-off value was 130.90 μg/L, the AUC, sensitivity and specificity for predicting PN were 0.703, 77.3% and 73.6%, respectively, which was significantly better than that of all traditional single indicator. The predicted value was less than PCT and CRP 2 or 3 day after admission. In addition, the Ang Ⅱlevel 1 day after admission was closely related to the Ranson score, BISAP score, and PCT level which was commonly used indicators of AP severity. Conclusions Under the new Atlanta classification criteria, Ang Ⅱ is superior to the traditional predictive indicators commonly used for predicting POF, and is a better single biochemical indicator for predicting PN in clinic.

Objective To evaluate the effect of 3D printed skeletal model in orthopedic clinical in-ternship teaching . Methods From October 2015 to October 2016 , 30 undergraduate clinical medical internship students were divided into traditional teaching group and 3D model teaching group randomly. 1 teaching ward round was conducted for each student. Teaching rounds were conducted according to routine procedures in traditional teaching group, while the 3D model teaching group used the patient's 3D print skeletal model to assist in teaching rounds and perform simulated surgery. All students were tested in theory and practice, and the teaching evaluation was carried out by questionnaire. Data were imputed into SPSS 19.0 for comparison between the two groups using t-test. Results Students in 3D model teaching group significantly outperformed than those in traditional teaching group in theoretical achievement [(92.27±4.56) vs. (86.87±5.30)] and practical achievement [(90.07±4.61) vs. (82.53±5.03)] (P<0.01). In respects of pro-moting theoretical knowledge, enhancing surgical participation, hands-on ability exercise, teaching attraction and overall satisfaction, students in 3D model teaching group gave a better evaluation of teaching they had received than those in the traditional teaching group (P<0.01). Conclusion 3D printed skeletal model is an effective teaching tool, and its application in clinical internship teaching at basic-level hospital can signifi-cantly improve teaching effectiveness and satisfaction. It is worth further exploration and promotion.

OBJECTIVE:To provide reference for rational drug use and strengthen the management of adjuvant medication man-agement in the hospital. METHODS:1 080 and 860 discharged medical records of 12 Vitamins for injection were selected from our hospital during Jun.-Nov. 2014 (pre-special comment group,i.e. group A) and Jun.-Nov. 2015 (post-special comment group,i.e. group B),respectively. The application of 12 Vitamins for injection,hospitalization stay,drug cost and the incidence of ADR were compared before and after adjuvant medication special comment. RESULTS:After adjuvant medication special comments,the propor-tion of drug use of no indication,unsuitable solvent selection,irrational drug dosage,drug use of drug interaction and contraindica-tion,drug cost and the incidence of ADR in group B were all lower than in group A,with statistical significance(P<0.05). There was no statistical significance in hospitalization stay between 2 groups(P>0.05). CONCLUSIONS:Clinical pharmacists adopt adju-vant medication special comments to effectively standardize clinical application of 12 Vitamins for injection in our hospital.

Purpose To discuss the value of MRI in the diagnosis of placenta implantation abnormality, and to explore preliminarily the relationship between MRI signs and types of placenta implantation abnormality. Materials and Methods The clinical preoperative data and postnatal pathological findings of 54 women at high risk of placenta accreta were collected. All the patients undertook the conventional pelvic MRI examination. The scanning sequences mainly included: sagittal, coronal and axial T2-weighted imaging-turbo spin echo, balance fast field echo. The MRI images were observed and the areas which showed low signal in all the three directions on T2WI were measured. Then the correlation between the areas of low signal on T2WI in placental and the types of placenta implantation abnormality was analyzed. Results The incidence of placenta implantation abnormality was 64.8% in our research (35/54). The main MRI signs were low signal on T2WI (68.5%, 37/54) and heterogeneous signal in placenta (57.4%, 31/54); the main sign of placenta percreta was tenting bladder (75.0%, 6/8). The types of placenta implantation abnormality were positively correlated with the areas of low signal on T2WI (r=0.454, P<0.05). Conclusion Pregnant women at risk of placenta accreta should be evaluated with imaging examinations, particularly with MRI scanning, to improve disease detection rate. The typical indirect signs of placenta implantation abnormality are low signal on T2WI and heterogeneous signal in placenta. The larger size of low signal area on T2WI in placenta, the deeper implantation of placenta.

Purpose To investigate the expression of the protein of CD151 and MT1-MMP in adenocarcinoma of esophagogastric junc-tion tissues and to explore their relationship with the invasiveness and metastasis of the tumor. Methods CD151 and MT1-MMP pro-tein were detected by immunohistochemical staining respectively in 15 cases of paraneoplastic normal gastric mucosa tissue, 40 cases dysplasia and 172 cases of adenocarcinoma of esophagogastric junction tissues. Results All of the expression level of CD151 and MT1-MMP protein were increasing according to the order of normal-dysplsia-carcinoma. The expression rate of CD151 was 6. 67%, 20. 0% and 78. 3%, while the rate of MT1-MMP with 13. 3%, 22. 5% and 79. 1% in the normal, dysplasia and carcinoma subgroup. The expression rate of each protein were significant difference among the three goroups (P<0. 05). In the adenocarcinoma of esopha-gogastric junction tissues, the expression of them in the subgroup of poorly-differentiated with serosa invasion and lymph nodes metasta-sis was significantly higher than the other subgroup of well-differentiated with non serosa invasion or lymph nodes metastasis ( P <0. 05 ) . There was a positive correlation between the expression of CD151 and MT1-MMP protein in adenocarcinoma of esophagogastric junction tissues ( P<0. 05 ) . Conclusions CD151 and MT1-MMP assuredly and highly express in the adenocarcinoma of esopha-gogastric junction tissues and they have close relationships, which could involved in the invasiveness and metastasis synergistically in this tumor.