Objective To explore the clinical efficacy and mechanism of FuKe Yangrong capsule(FKYRC)in treating anovulatory infertility(AI)using network pharmacology and clinical observation meth-ods.Methods A total of 110 AI patients who visited the hospital from January 2023 to July 2024 were select-ed as the research subjects.They were divided into three groups according to the treatment method:traditional Chinese medicine treatment group(n=30,treated only with FKYRC),western medicine treatment group(n=40,treated only with letrozole),and combination treatment group(n=40,treated only with FKYRC+letrozole).After 4 cycles of treatment,the total effective rate,maximum follicle diameter,pre-ovulation endo-metrial thickness,ovulation rate and pregnancy rate,and embryo survival rate of each group were compared af-ter treatment.Using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and GeneCards database,the core active ingredients,target proteins,and AI related targets of FKYRC were obtained,and common targets were screened.Then,a protein-protein interaction(PPI)network was constructed,and gene ontology(GO)function and Kyoto Gene and Genome Database(KEGG)pathway enrichment analysis were performed using a bioinformatics platform for visualization.Finally,three-dimen-sional visualization analysis was performed.Results The total clinical efficacy of the traditional Chinese medi-cine group,western medicine group,and combination therapy group were 90.00％,92.50％,and 97.50％,re-spectively.The ovulation rates were 60.00％,70.00％,and 87.50％,respectively.The pregnancy rates were 33.33％,37.5％,and 60.00％,respectively.The survival rates of embryos were 60.00％,73.30％,and 95.80％,respectively,and the differences between the groups were statistically significant(P＜0.05).The maximum follicle diameter and pre-ovulation endometrial thickness in the combination therapy group were higher than those in the traditional Chinese medicine group and the western medicine group,and the difference was statistically significant(P＜0.05).Network pharmacology discovered 239 active ingredients and 3 977 target genes in FKYRC.After screening,200 active ingredients and 299 target genes were identified.A total of 478 disease target genes,38 potential interaction targets,and 19 core targets were obtained.Molecular func-tions,cellular components,and biological processes mainly involved steroid protein binding,estrogen response elements,estrogen receptor activity,nuclear chromatin,and other aspects.KEGG pathway enrichment analysis showed that FKYRC anti AI core targets were mainly enriched in estrogen signaling pathway,P53 signaling pathway,advanced glycation end product receptor(AGE-RAGE)of diabetes complications and other signaling pathways.The key targets of FKYRC against AI were two estrogen receptors(ESR1 and ESR2),steroid re-ceptor(AR),and peroxisome proliferator activated receptor-γ(PPARG).Conclusion The combined treat-ment of FKYRC and letrozole can improve AI patients' clinical symptoms,increase ovulation rate,pregnancy rate,and embryo survival rate.The active ingredients in FKYRC can comprehensively regulate the core targets of AI,and may promote follicular development and maturation in infertile patients with ovulation disorders through signaling pathways such as estrogen,P53,and AGE-RAGE,thereby increasing pregnancy rate.

OBJECTIVE To establish the fingerprint of Lianhua Qingwen capsule(LHQW) with the HPLC method, and to evaluate the quality by combining with chemical pattern recognition method. METHODS The chromatographic separation was performed on an Agilent Zorbax SB-C18(250 mm×4.6 mm, 5 μm) column with 0.1% phosphoric acid(A)-acetonitrile(B) as the mobile phase for the gradient elution. The detection wavelength was set at 207 nm. The flow rate was set at 1.0 mL·min–1 and the column temperature was 30 ℃. Similarity evaluation, hierarchical clustering analysis(HCA), radar plot analysis, principal component analysis(PCA), and orthogonal partial least-squares discrimination analysis(OPLS-DA) were used for the further assessment of 13 batches of LHQW samples. RESULTS The fingerprint of LHQW was established with 40 common peaks, in which 10 common peaks were identified, and the similarities of 13 batches of LHQW samples were 0.947–1.000. By applying chemical pattern recognition methods such as HCA, and OPLS-DA, 13 batches of samples were classified into three clusters, and the results of classification were correlated with the production date. And 8 major chemical markers causing quality differences were screened. CONCLUSION With good reproducibility and stability, this method could provide the reference for the quality evaluation of LHQW．

Objective To analyze the distribution of ocular bacterial pathogens and their antibiotic resistance status at a tertiary-care hospital and to provide a reference for the appropriate use of antibiotics.Methods Retrospective analysis was conducted with bacteria isolated from the ophthalmic samples sent for lab analysis at a tertiary-care hospital from 2012 to 2021.The suspected bacterial strains were identified with automated systems for microbial identification and susceptibility analysis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometer.VITEK 2 Compact,an automated microbial identification and antibiotic susceptibility analysis system,was used for antimicrobial susceptibility testing.Results A total of 1556 ophthalmology bacteria culture samples were collected,574 of which showed bacterial growth,presenting an overall positive rate of 36.89%.Of the isolated bacteria,Gram-positive cocci,Gram-positive bacilli,Gram-negative bacilli,and Gram-negative cocci accounted for 63.15%(377/597),18.76%(112/597),17.09%(102/597),and 1.00%(6/597),respectively.Among the bacteria isolated in different years over the course of a decade,Gram-positive cocci always turned out to be the main cause of eye infections.Of the Gram-positive cocci,73.47%(277/377)were isolated from patients with endophthalmitis,with the most important species being Staphylococcus epidermidis,which was followed by Streptococcus viridans.The rest,or 26.53%(100/377),of the Gram-positive cocci were isolated from patients with external eye infections,with the main isolated strains being Staphylococcus epidermidis,Streptococcus viridans,and Staphylococcus aureus.More than 70%of Staphylococcus epidermidis isolated from both endophthalmitis and external eye infections were resistant to methicillin.No strains resistant to vancomycin,linezolid,or tigecycline were detected.Staphylococcus epidermidis isolated from patients with external eye infections had a low rate of resistance to levofloxacin(2/27 or 7.41%),whereas those isolated from patients with endophthalmitis had a higher resistance rate(43/127 or 33.86%).The difference in drug resistance rate between the two groups was statistically significant(P<0.05).Conclusion The chief ocular bacterial pathogens identified in a tertiary-care hospital were Gram-positive cocci,among which,Staphylococcus epidermidis was the most common species.The Staphylococcus epidermidis identified in the hospital had a high rate of resistance to oxacillin,but remained highly sensitive to vancomycin,linezolid,and tigecycline.The endophthalmitis caused by Staphylococcus epidermidis in the hospital can be treated empirically with vancomycin and then the treatment plan can be further adjusted according to the results of the drug susceptibility test.However,the establishment of the breakpoint of drug susceptibility test is mainly based on the model of bloodstream infection and has limited reference value for the treatment of eye infection.The required drug distribution concentration at the infection site can be achieved by dose increase or local administration.

OBJECTIVE:To observe clinical efficacy and safety of compound α-ketoacid tablet in the treatment of type 2 dia-letic mellitusc(T2DM)complicated with early diabetic nephropathy. METHODS:A total of 180 T2DM patients with early nephrop-athy during Jan. 2013-Dec. 2015 selected as research objects were divided into group A,B,C according to random number table, with 60 cases in each group. Group C was given basic symptomatic treatment. Group A was additionally given Compound α-ketoac-id tablets 2.52 g orally,tid,on the basis of group C. Group B was additionally given Compound α-ketoacid tablets 5.04 g orally, tid,on the basis of group C. Three groups were treated for consecutive 24 weeks. The renal function indexes (BUN,Cr,GFR, urine ALB),blood glucose indexes (FPG,PPG,HbA1c),blood pressure indexes (SBP,DBP) and nutritional indexes (serum ALB,PA,Hb) were observed in 3 groups before and after treatment. The occurrence of ADR was recorded in 3 groups. RE-SULTS:Before treatment,there was no statistical significance in renal function indexes,blood glucose indexes,blood pressure in-dexes or nutritional indexes among 3 groups(P>0.05). After treatment,urine levels of ALB,HbA1c and SBP were decreased sig-nificantly in 3 groups;the group B was significantly lower than the group A;the group A was significantly lower than the group C. The levels of serum ALB,PA and Hb were decreased significantly in group A and C;the group B was significantly higher than the group A;the group A was significantly higher than group C,with statistical significance (P<0.05). The incidence of ADR in 3 groups were 8.3％,10.0％ and 6.7％ respectively,without statistical significance(P>0.05). CONCLUSIONS:Compound α-keto-acid tablet can significantly improve renal function,control blood glucose and blood pressure levels and complete necessary nutri-ents in T2DM patients with early nephropathy patients with good safety. High dose are more effective.

Precision medicine is a new medical concept and medical model, which is based on personalized medicine, rapid progress of genome sequencing technology and cross application of biological information and big data science. Precision medicine improves the diagnosis and treatment of gastric cancer to provide more convenience through more profound analyses of characteristics, pathogenesis and other core issues in gastric cancer. Cancer clinical database is important to promote the development of precision medicine. Therefore, it is necessary to pay close attention to the construction and management of the database. The clinical database of Sun Yat-sen University Cancer Center is composed of medical record database, blood specimen bank, tissue bank and medical imaging database. In order to ensure the good quality of the database, the design and management of the database should follow the strict standard operation procedure(SOP) model. Data sharing is an important way to improve medical research in the era of medical big data. The construction and management of clinical database must also be strengthened and innovated.
Databases, Factual ; Humans ; Precision Medicine ; Stomach Neoplasms ; diagnosis ; therapy

OBJECTIVETo investigate changes in clinicopathological features and survival of patients with gastrectomy at a single institution in China.

METHODSFrom January 1990 to December 2009, clinicopathological data of 2518 cases of gastric cancer patients who underwent surgical resection in the Sun Yat-sen University Cancer Center were analyzed retrospectively. The overall survival rate was determined using Kaplan-Meier method and log-rank test was used to determine significance. The prognosis was analyzed using univariate analysis and multivariate analysis by Cox proportional hazards model. Clinical features, pathological findings and survival differences were compared in this cohort between two consecutive periods(1990-1999 and 2000-2009).

RESULTSThe 5-year survival rates for the whole cohort and those undergoing radical resection was 48.1% and 53.7%, respectively. In the first period, the 5-year survival rate for the whole cohort and for patients undergoing radical resection was 40.1% and 45.7%. In the second period, the 5-year survival rates for whole cohort and for patients undergoing radical resection was 51.5% and 57.1%, respectively. For those who underwent radical resection, the mean number of lymph node dissection was significantly higher in the recent period (20.1±8.3 vs. 9.5±6.0, P<0.01). On multivariate analysis by means of the Cox proportional hazard model, age, location, tumor size, histological type, radical resection, lymphatic/venous invasion, depth of invasion, nodal status, number of retrieved lymph nodes, and treatment period were independent factors (P<0.05). The constitution, number of retrieved lymph nodes, and survival rate were all improved between the two intervals (P<0.05).

CONCLUSIONThe overall survival rate has gradually increased in gastric cancer patients over the past 20 years.

Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate

Objective:To investigate the number of metastasized lymph node groups (Ng) and the prognosis of gastric cancer pa-tients. Methods:Data from 1 009 patients receiving radical gastrectomy in the Cancer Center and with more than 15 lymph nodes re-trieved between January 2000 and September 2010 were included in the study. Lymph nodes were grouped by using the definition of the Japanese Research Society for Gastric Cancer (13th Japanese edition). Log-rank test and Cox regression analysis were used to ex-plore the relationship between the Ng and overall survival. Results:The metastasized lymph nodes were divided into 5 groups:1 group without lymph node metastasis (Ng0), 1 group with lymph node metastasis (Ng1), 2 groups with lymph node metastasis (Ng2), 3 to 5 groups with lymph node metastasis (Ng3), and more than 6 groups with lymph node metastasis (Ng4). The 3-year survival rates were 91.6%, 84.7%, 72.0%, 59.6%, and 43.0% for Ng0, Ng1, Ng2, Ng3, and Ng4, respectively. The 5-year survival rates were 89.9%, 82.4%, 66.9%, 54.6%, and 38.3%for Ng0, Ng1, Ng2, Ng3, and Ng4, respectively. These 3-and 5-year overall survival rates differed significantly among the groups (P<0.05). Gastric cancer patients with high Ng have low 3-year overall survival rates. Ng is an indepen-dent prognostic factor of gastric cancer. Conclusion:The concept of Ng can be a good supplement to existing UICC N staging.

Currently,three predominant subtypes of influenza virus are prevalent in pig populations worldwide:H1N1,H3N2,and H1N2.European avian-like H1N1 viruses,which were initially detected in European pig populations in 1979,have been circulating in pigs in eastern China since 2007.In this study,six influenza A viruses were isolated from 60 swine lung samples collected from January to April 2011 in eastern China.Based on whole genome sequencing,molecular characteristics of two isolates were determined.Phylogenetic analysis showed the eight genes of the two isolates were closely related to those of the avian-like H1N1 viruses circulating in pig populations,especially similar to those found in China.Four potential glycosylation sites were observed at positions 13,26,198,277 in the HA1 proteins of the two isolates.Due to the presence of a stop codon at codon 12,the isolates contained truncated PB1-F2 proteins.In this study,the isolates contained 591Q,627E and 701N in the polymerase subunit PB2,which had been shown to be determinants of virulence and host adaptation.The isolates also had a D rather than E at position 92 of the NS1,a marker of mammalian adaptation.Both isolates contained the GPKV motif at the PDZ ligand domain of the 3' end of the NS1,a characteristic marker of the European avian-like swine viruses since about 1999,which is distinct from those of avian,human and classical swine viruses.The M2 proteins of the isolates have the mutation (S31N),a characteristic marker of the European avian-like swine viruses since about 1987,which may confer resistance to amantadine and rimantadine antivirals.Our findings further emphasize the importance of surveillance on the genetic diversity of influenza A viruses in pigs,and raise more concerns about the occurrence of cross-species transmission events.

ObjectiveTo study the expression of p27 and its relationship with CpG island methylation phenotype (CIMP) in insulinoma.MethodsExpression of p27 was tested in 27 insulinoma tissues and 11 paired control tissues by immunohistochemistry staining.CpG island methylation of p16,MLH1,RAR-β,MGMT,THBS1 (CIMP) was detected in 27 insulinoma tissues and 11 paired cantrol tissues by methylation specific PCR (MSP).The data of p27 and CIMP expression were correlated with the clinicopathological characteristics.ResultsThe positive expression rate of p27 in insulinoma tissues was significantly lower than that in paired control tissues (48％ vs 91％,P =0.008).High rate of CIMP occurrence in insulinoma tissues was 33％ (9/27),while it was 18％ (2/11) in paired control tissues,and difference between the two groups was not statistically significant ( P =0.350 ).The methylation of MGMT was reversely associated with p16 methylation ( P =0.004).p27 expression in insulinoma tissues was reversely associated high rate of CIMP occurrence but it was not statistically significant ( P =0.420).Neither the expression of p27 nor the occurrence of CIMP was associated with the clinicopathological features.ConclusionsDown-regulation of p27 and high rate of CIMP occurred in insulinomas,suggesting that the inactivation of p27 and epigenetic alterations of several genes might contribute to the carcinogenesis of insulinoma.

To observe the influence of neuregulin-1 on the cardiac function of post-myocardial infarction rats. Methods Left ventricular MI was created in Sprague-Dawley rats by ligation of the left anterior descending coronary. Six months after the operation, rats were evaluated with echocardiology methods. 36 rats that had an infarct area and a EF around 60% were randomized into 3 groups: MI group(n=12) were injected a blank vehicle fluid intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+NRG group(n=12), received NRG-110μg·kg-1 intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+Capt group (n=12) received captopril orally (dissolved in their drinking water 2g/L) for 30days, after which tap water substituted the solution for 5 days. Final echocardiographic and hemodynamic measurements were made at the end of 1 month of therapy. Total RNA was extracted from frozen left ventricular tissues, and was reverse transcribed into firststrand PCR was performed with primers for BNP、 ANP. Results Rats treated with neuregulin had a smaller LVDs (P=0.014), a betterLVEF (P=0.004),and a tendency towards less lung perfusion than untreated rats. Neuregulin decreased the expression of ANP mRNA in the ventricle (P=0.025).Conclusion Neuregulin markedly improved the cardiac function of rats that survived myocardial infarction,and decreased the expression of ANP mRNA in the ventricle.