This paper summarizes professor YANG Chunbo's clinical experience in treating refractory constipation （RC） complicated with melanosis coli （MC） from the perspective of damp-heat theory. Internal accumulation of damp-heat is considered as the core pathogenesis of this condition， and the therapeutic principles should focus on clearing， transforming， tonifying， and resolving. Self-formulated Qinghua Beverage （清化饮） is developed to clear and transform damp-heat， regulate qi， and soothe collaterals. In clinical practice， RC complicated with MC is classified into damp-heat with qi stagnation syndrome and damp-heat with stasis obstruction syndrome. Qinghua Beverage is used as the base prescription with modifications according to syndrome differentiation. For damp-heat with qi stagnation syndrome， medicinals that promote qi movement and unblock the bowels， activate blood and clear collaterals are added， while for damp-heat with stasis obstruction syndrome， herbs that resolve stasis and unblock collaterals are incorporated， with simultaneous consideration of nourishing blood and supporting collaterals.

Objective: To investigate the radon concentration and occupational radon exposure doses in Hangzhou Metro Line 1 and Line 5, so as to provide a basis for assessing potential health risks of radon exposure and protecting the occupational health of metro workers. Methods: From March 2022 to March 2023, radon concentration monitoring was conducted at 53 stations on Hangzhou Metro Lines 1 and 5. Four sampling points were set up at each station: train control room, customer service center, security checkpoint area, and platform. Continuous monitoring was conducted for one year at the train control room, while continuous monitoring at the other sampling points lasted for one quarter. CR-39 cumulative radon detection cups were used to measure radon concentrations, while RAD7 radon detectors were used to measure instantaneous radon concentrations. The annual effective dose to workers from radon and its progeny was estimated. Radon concentrations across different lines, sampling points, and seasons were analyzed. Results: The median radon concentration was 26.8 (interquartile range, 11.2) Bq/m3 in Line 1, and the median instantaneous radon concentration was 4.7 (interquartile range, 8.5) Bq/m3. In Line 5, the radon concentration was (26.1±6.1) Bq/m3, and the median instantaneous radon concentration was 4.7 (interquartile range, 7.4) Bq/m3. No significant differences were found between the two lines in either radon or instantaneous radon concentrations (both P>0.05). The control rooms in both lines showed relatively high radon levels, with a median of 42.5 (interquartile ranges, 24.3) Bq/m3 in Line 1 and a median of 26.8 (interquartile ranges, 6.1) Bq/m3 in Line 5. In the Line 1 control room, the median radon concentrations across four quarters were 37.7 (interquartile range, 27.5), 42.5 (interquartile range, 24.4), 46.8 (interquartile range, 26.0), and 34.9 (interquartile range, 29.0) Bq/m3, respectively. No significant seasonal variation was observed (P>0.05). In the Line 5 control room, the values were 24.8±6.7, 26.6 (5.9), 33.8±7.9, and 22.8 (8.7) Bq/m3, respectively. A significant seasonal difference was found (P<0.05), with the third quarter showing higher radon levels than the first and fourth quarters (both P<0.05). The annual effective doses to workers from radon and its progeny were relatively high in the Line 1 control room (0.305 2 mSv) and the Line 5 platform (0.255 9 mSv). Conclusions The radon concentrations in Hangzhou Metro Lines 1 and 5 were within the low-dose radiation range and met the national standard limits. No significant health risks were identified. However, attention should be paid to radon levels in control rooms and during the third quarter. Enhanced monitoring and ventilation management are recommended.

Objective:To investigate the radioactivity levels and variation trends of 90Sr in drinking water and food around the Qinshan Nuclear Power Plant in operation. Methods:From 2012 to 2022, the source, factory, and tap water was collected within 30 km around the Qinshan Nuclear Power Plant during the wet and dry seasons (i.e., May and October, respectively) each year to determine the 90Sr concentration in water. According to the dietary habits of local residents, four kinds of food, including rice, cabbage, mullet, and crucian carp, were collected to determine and analyze the 90Sr radioactivity concentration in food using the bis-(2-ethylhexyl) phosphoric acid extraction chromatographic method. Results:From 2012 to 2022, the 90Sr radioactivity concentrations in the source, factory, and tap water around the Qinshan Nuclear Power Plant ranged from 3.73 to 11.89 mBq/L, 2.95 to 9.83 mBq/L, and 3.12 to 8.70 mBq/L, respectively, showing nonsignificant fluctuations over the years. The 90Sr radioactivity concentrations in rice, cabbage, mullet, and crucian carp ranged from 0.02 to 0.46 Bq/kg (dry weight), 0.26 to 1.07 Bq/kg (fresh weight), 0.38 to 1.05 Bq/kg (fresh weight), and 0.08 to 1.32 Bq/kg (fresh weight), respectively, all below the national standard limits. Conclusions:From 2012 to 2022, the 90Sr radioactivity levels in drinking water and food around the Qinshan Nuclear Power Plant were at the background level and remained stable.

Objective:To investigate the current situation of nuclear medicine practices, determine the number of nuclear medicine staff, conduct internal exposure monitoring and dose estimation for nuclear mecidine staff engaged in 131I treatment in Zhejiang province. Methods:A survey was conducted over all the 22 hospitals involved in 131I treatment in the province. The 131I activity in thyroid of 96 stafff in 131I treatment workplaces were measured by means of direct method. At the same time, the effective doses from internal exposure were estimated and the influencing factors were analyzed. Results:131I activity in thyroids was found to be above the detection limit for 49 staff (51.04%) in nineteen hospitals. The maximum value of 131I activity was 629.18 Bq. There was no statistically significant difference in 131I detection rate in thyroid of 131I treatment staff between different positions, different genders and different levels of hospitals ( P>0.05). Comparisons of 131I activity of thyroid of nuclear medicine staff for theatment of thyroid cancers had shown that the highest was for nurses, followed by technicians and doctors, and the lowest was for cleaning staff ( H=6.39, P<0.05). The estimated committed effective dose to the nuclear medicine staff ranged from 0.05 to 2.37 mSv, with those below 1 mSv accounting for 93.88% of the total. Logistic regression analysis showed that nursing position was the risk factor contributing to the committed effective dose ( OR=2.805, 95% CI 1.076-7.314). Conclusions:In Zhejiang province, the committed effective dose to thyroid of nuclear medicine staff from 131I internal exposure was not in excess of the dose limit. However, the staff performing iodine therapy still need to strengthen protection against internal exposure and take scientific and effective protective measures to reduce the risk of health hazards from internal exposure.

Objective:To investigate the effect of peripheral white blood cell(WBC) count on adverse pregnancy outcomes.Methods:A retrospective analysis was conducted on pregnant women who delivered at Minhang Hospital affiliated with Fudan University between January 2013 and June 2020. Demographic data, WBC counts, and diagnostic information on gestational diabetes mellitus(GDM), gestational hypertension, and preeclampsia/eclampsia were extracted from electronic medical records. Logistic regression models were used to evaluate the association between WBC counts in the first(WBC-1) and second trimesters(WBC-2) and metabolically related pregnancy outcomes.Results:A total of 24 143 pregnant women were included, with a mean age of(29.1±4.9) years and a mean pre-pregnancy body mass index(BMI) of(21.1±2.8) kg/m 2. The mean WBC counts in the first and second trimesters were 8.1×10 9/L and 8.9×10 9/L, respectively. The incidence rates of GDM, gestational hypertension, and preeclampsia/eclampsia were 5.6%, 4.8%, and 1.8%, respectively. After adjusting for relevant confounders, a core standard deviation( s) increase in WBC-1 was associated with a 6%, 18%, and 14% increased risk of GDM, gestational hypertension, and preeclampsia/eclampsia, respectively( P<0.001). Similarly, a one s increase in WBC-2 was associated with a 10% increased risk for all three adverse outcomes( P<0.001). Conclusion:Elevated peripheral WBC levels in the first and second trimesters are independently associated with increased risk of adverse pregnancy outcomes, independent of traditional risk factors.

Objective To investigate the changes and clinical value of inflammatory derived indices re-lated to myelosuppression caused by chemotherapy in patients with solid tumors.Methods The clinical data of 189 patients with malignant tumor who received chemotherapy in Jiangxi Cancer Hospital from January 2022 to August 2023 were retrospectively analyzed.According to the grade of myelosuppression,they were di-vided into 0 degree(n=35),Ⅰ degree(n=23),Ⅱ degree(n=31),Ⅲ degree(n=21),Ⅳ degree non-infec-tion(n=51)and Ⅳ degree infection(n=28).The levels of inflammatory index[monocyte(MO),lympho-cyte(LY)],reticulocyte(RET),prealbumin(PA),albumin(ALB),inflammatory infection index[C reactive protein(CRP)and serum amyloid A(SAA)]and complex derived inflammatory index[neutrophil to lym-phocyte ratio(NLR),systemic immunoinflammatory index(SII),systemic inflammatory response index(SI-RI),lymphocyte to C reactive protein ratio(LCR),C reactive protein to albumin ratio(CAR)]were collected and compared in patients with different degrees of myelosuppression.The correlation between each index and myelosuppression score was analyzed,and the influencing factors of myelosuppression after chemotherapy in tumor patients were analyzed by multivariate logistic regression.Results With the severity of myelosuppres-sion,the levels of MO,LY,SII,SIRI and LCR decreased gradually and showed a downward trend(P＜0.05).The levels of CRP,SAA and CAR were increased gradually(P＜0.05).RET and PA levels were decreased when myelopathic depression reached Ⅲ degree or above(P＜0.05).When myelosuppression reached gradeⅣ and above,the level of NLR decreased(P＜0.05).CRP,SAA and CAR were positively correlated with my-elosuppression degree,while MO,LY,RET,PA,NLR,SII,SIRI and LCR were negatively correlated with my-elosuppression degree(P＜0.05).The results of multivariate logistic regression analysis showed that LY and NLR were the influencing factors of myelosuppression caused by chemotherapy in tumor patients(P＜0.05).Conclusion Myelosuppression caused by solid tumor chemotherapy can lead to a continuous decline in the body's anti-tumor immunity.Deep myelosuppression is unfavorable to the prognosis of patients,and infection can promote the development of tumors and lead to poor prognosis.

Subarachnoid hemorrhage (SAH) is a serious intracranial hemorrhage characterized by acute bleeding into the subarachnoid space. The effects of shikonin, a natural compound from the roots of Lithospermum erythrorhizon, on oxidative stress and blood–brain barrier (BBB) injury in SAH was evaluated in this study. A rat model of SAH was established by endovascular perforation to mimic the rupture of intracranial aneurysms. Rats were then administered 25 mg/kg of shikonin or dimethylsulfoxide after surgery. Brain edema, SAH grade, and neurobehavioral scores were measured after 24 h of SAH to evaluate neurological impairment. Concentrations of the oxidative stress markers superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in the brain cortex were determined using the corresponding commercially available assay kits. Evans blue staining was used to determine BBB permeability. Western blotting was used to quantify protein levels of tight junction proteins zonula occludens-1, Occludin, and Claudin-5. After modeling, the brain water content increased significantly whereas the neurobehavioral scores of rats with SAH decreased prominently. MDA levels increased and the levels of the antioxidant enzymes GSH and SOD decreased after SAH. These changes were reversed after shikonin administration. Shikonin treatment also inhibited Evans blue extravasation after SAH. Furthermore, reduction in the levels of tight junction proteins after SAH modeling was rescued after shikonin treatment. In conclusion, shikonin exerts a neuroprotective effect after SAH by mitigating BBB injury and inhibiting oxidative stress in the cerebral cortex.

Subarachnoid hemorrhage (SAH) is a serious intracranial hemorrhage characterized by acute bleeding into the subarachnoid space. The effects of shikonin, a natural compound from the roots of Lithospermum erythrorhizon, on oxidative stress and blood–brain barrier (BBB) injury in SAH was evaluated in this study. A rat model of SAH was established by endovascular perforation to mimic the rupture of intracranial aneurysms. Rats were then administered 25 mg/kg of shikonin or dimethylsulfoxide after surgery. Brain edema, SAH grade, and neurobehavioral scores were measured after 24 h of SAH to evaluate neurological impairment. Concentrations of the oxidative stress markers superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in the brain cortex were determined using the corresponding commercially available assay kits. Evans blue staining was used to determine BBB permeability. Western blotting was used to quantify protein levels of tight junction proteins zonula occludens-1, Occludin, and Claudin-5. After modeling, the brain water content increased significantly whereas the neurobehavioral scores of rats with SAH decreased prominently. MDA levels increased and the levels of the antioxidant enzymes GSH and SOD decreased after SAH. These changes were reversed after shikonin administration. Shikonin treatment also inhibited Evans blue extravasation after SAH. Furthermore, reduction in the levels of tight junction proteins after SAH modeling was rescued after shikonin treatment. In conclusion, shikonin exerts a neuroprotective effect after SAH by mitigating BBB injury and inhibiting oxidative stress in the cerebral cortex.

OBJECTIVES: To investigate the expression of CDKN3 in gastric cancer and its impact on prognosis of gastric cancer patients. METHODS: We analyzed CDKN3 expression in clinical specimens from 114 gastric cancer patients and assessed its association with 5-year postoperative survival of the patients. GO and KEGG enrichment analyses were used to predict the biological function and possible mechanism of CDKN3. The effects of lentivirus-mediated CDKN3 knockdown on biological behaviors of gastric cancer cells were evaluated using Transwell assay, CCK-8 assay, TUNEL staining, flow cytometry, and Western blotting. RESULTS: CDKN3 expression was significantly higher in gastric cancer tissues than in the adjacent tissues with significant correlations with CEA level, CA19-9 level, and T and N staging (P<0.05). High CDKN3 expression was an independent risk factor affecting 5-year postoperative survival of the patients and predictive for long-term prognosis (P<0.01). Enrichment analyses suggested a probable association of CDKN3 with apoptosis. In MGC-803 cells, CDKN3 knockdown significantly lowered migration and invasion capacities of the cells, while CDKN3 overexpression produced the opposite effects. TUNEL staining revealed a significantly lower level of cell apoptosis in gastric cancer tissues than in adjacent tissues (P<0.01). CDKN3 knockdown obviously inhibited proliferation and increased apoptosis of MGC-803 cells. CDKN3 overexpression down-regulated the expressions of p53, p21 and Bax and up-regulated the expressions of p-p65 and Bcl-2. CONCLUSIONS CDKN3 is highly expressed in gastric cancer tissues and affects patient prognosis. CDKN3 overexpression promotes proliferation, invasion and migration and suppressed apoptosis of gastric cancer cells possibly through the p53/NF-κB signaling pathway.
Humans ; Stomach Neoplasms/pathology* ; Apoptosis ; Signal Transduction ; Tumor Suppressor Protein p53/metabolism* ; Cell Movement ; Cell Line, Tumor ; NF-kappa B/metabolism* ; Prognosis ; Cyclin-Dependent Kinase Inhibitor Proteins/metabolism* ; Cell Proliferation ; Neoplasm Invasiveness ; Male ; Female ; Dual-Specificity Phosphatases

OBJECTIVES: To explore the expression profile of circular RNAs (circRNAs) and their potential roles in prognosis and progression of Wilms' tumor (WT). METHODS: Four pairs of WT and adjacent tissues were collected for high-throughput circRNA sequencing to identify the differentially expressed circular RNAs. RT-qPCR was used to verify the expression levels of the top 6 candidate circRNAs in the clinical samples. hsa_circ_0001900 was selected for analysis of its correlation with clinicopathological features and prognosis in 34 patients with WT. Sanger sequencing and RNase R digestion experiments were used to verify the cycling site and structural stability of hsa_circ_0001900 molecule. RESULTS: A total of 23 978 circular RNA molecules were identified in WT tissues by high-throughput circular RNA sequencing, and among them 614 were differentially expressed in WT. hsa_circ_0001900 showed the highest expression level among the differentially expressed circRNAs, which was consistent with the findings in clinical tumor samples and the sequencing results. Correlation analysis showed that hsa_circ_0001900 expression level was positively correlated with WT volume, and the children with high hsa_circ_0001900 expression had a lowered recurrence-free survival rate. The results of Sanger sequencing verified the circular splice site sequence of the molecule, and Rnase R digestion assay confirmed its stable covalent structure. CONCLUSIONS This study presents a comprehensive expression profile of circular RNAs in WT, and the expression level of hsa_circ_0001900 is related to the size of WT and the patients' prognosis, suggesting its possible role as a key driving gene in WT progression.
Humans ; RNA, Circular ; Wilms Tumor/pathology* ; Prognosis ; High-Throughput Nucleotide Sequencing ; Kidney Neoplasms/genetics* ; Sequence Analysis, RNA ; Male ; Female