OBJECTIVE To screen t he active component s of Euchresta japonica against nasopharyngeal carcinoma. METHODS Main chemical components of E. japonica were selected ，and their target proteins were predicted in Swiss Target Prediction database. The target proteins of nasopharyngeal cancer were obtained with GeneCards database. Protein-protein interaction（PPI）network was established after the target of chemical components of E. japonica was intersected with the target of nasopharyngeal carcinoma ；PPI network was analyzed by using Cytoscape 3.6.1 software，and the potential active components and key targets of E. japonica against nasopharyngeal carcinoma were screened. The molecular docking technology was used to evaluate binding ability of active component-key target ；active components of E. japonica against nasopharyngeal carcinoma were screened. The anti-nasopharyngeal cancer effect of potential active components of E. japonica was verified by cell proliferation experiment. RESULTS Seven potential active components （tonkinensisol，quercetin，sophoranone，matrine，genistein，coumarin，maackiain） and 10 core targets （SRC，PIK3CA，MAPK1，MAPK3，AKT1，MAPK8，MAP2K1，PTK2，EGFR，JAK3）of E. japonica against nasopharyngeal carcinoma were screened. The molecular docking results showed that above potential active components all possessed certain anti-nasopharyngeal cancer effect. Cell proliferation activity test showed that tonkinensisol ，sophoranone and maackiain had a very significant inhibitory activity on nasopharyngeal carcinoma cells CNE- 1. CONCLUSIONS Tonkinensisol， sophoranone and maackiain might be the main active components of E. japonica against nasopharyngeal carcinoma.

Objective:To investigate the clinical efficacy and safety of biopolysaccharide colloidal solution (Shutaishu) in the prevention of intestinal adhesion after abdominal surgery.Methods:A total of 100 patients scheduled to undergo abdominal surgery in Quzhou Municipal Hospital of Traditional Chinese Medicine from February to October in 2019 were included in this study. They were randomly divided into an observation group and a control group, with 50 patients in each group. Before closing the abdomen after surgery, abdominal cavity and wound were flashed with Shutaishu and 0.9% sodium chloride injection in the observation and control groups, respectively. The recovery of gastrointestinal function, intestinal adhesion, abdominal pain and the incidence of complications were compared between the observation and control groups.Results:The time to first regular bowel sound [(28.81 ± 5.56) h], time to first passage of flatus [(36.34 ± 6.24) h], time to first defecation [(41.65 ± 8.77) h], time taken for walking [(3.78 ± 0.64) d] in the observation group were significantly shorter than those in the control group [(32.75 ± 5.15) h, (41.51 ± 6.84) h, (48.05 ± 9.81) h, (4.27 ± 0.69) d, t = 3.68, 3.95, 3.89, 3.68, all P < 0.001]. At 5 and 30 days after surgery, the incidence of intestinal adhesion in the observation group [10.0% (5/50), 12.0% (6/50)] was significantly lower than that in the control group [26.0% (13/50), 30.0% (15/50), χ2 = 4.34, 4.88, both P < 0.05]. The total incidence of postoperative complications in the observation group was significantly lower than that in the control group [26.0% (13/50) vs. 54.0% (27/50), χ2 = 8.17, P < 0.05]. With time, visual analogue scale score was significantly decreased in both groups ( t = 3.51, 6.18, both P < 0.05). At 1, 3 and 5 days after surgery, visual analogue scale score in the observation group was significantly lower than that in the control group ( t = 4.07, 4.95 and 8.02, all P < 0.05). Conclusion:Biopolysaccharide colloidal solution is of high clinical value in the prevention of intestinal adhesion after abdominal surgery because it can promote the recovery of gastrointestinal function and early functional exercise, and has no obvious adverse reactions and complications.

Objective: To analyze the impact of dual antiplatelet (DAPT) therapy combining with or without proton pump inhibitors (PPI) on the main outcomes after percutaneous coronary intervention (PCI). Methods: The PubMed, EMBASE and Cochrane Library were searched for relevant literature and the references obtained from these sources were retrieved manually from inception till September 2017. Inclusion and exclusion criteria were established follow the Cochrane review standard. A total of 977 literatures were included, 193 duplicates were excluded, 74 reviews, case reports, letters and systematic reviews were excluded, 667 literatures were excluded after reading the title and abstract, 34 literatures were excluded due to non-randomized control studies and unrelated outcome indicators, and 9 literatures were finally included with a total of 16 589 patients. RevMan 5.3 software was used to compare the incidence of major adverse cardiovascular events (MACE), cardiogenic death, recurrent myocardial infarction, target vessel revascularization, all-cause death, stent thrombosis, stroke, gastrointestinal bleeding and gastrointestinal events in patients with DAPT combining with or without PPI after PCI. Results: MACE was observed in 8 out of the 9 included literatures, and the results showed that MACE occurred in 561 out of 6 282 patients receiving DAPT combining with PPI therapy and in 951 out of 9 632 patients using DAPT alone (OR=1.15, 95%CI 0.88-1.51, P>0.05). Cardiogenic death was observed in 7 out of the 9 included literatures, and the results showed that cardiogenic death occurred in 172 out of 6 453 patients receiving DAPT combining with PPI treatment and in 321 out of the 9 839 patients using DAPT alone (OR=0.97, 95%CI 0.80-1.18, P>0.05). Recurrent myocardial infarction was observed in 7 out of the 9 included literatures, the results showed 416 out of 6 282 cases in DAPT combining with PPI therapy group experienced recurrent myocardial infarction and 691 out of 9 632 cases in DAPT group experienced recurrent myocardial infarction (OR=1.01, 95%CI 0.89-1.16, P>0.05). Four out of 9 literatures observed revascularization. The results showed that revascularization was performed in 64 out of 2 173 patients receiving DAPT combining with PPI therapy and in 105 out of the 2 770 patients using DAPT alone (OR=1.33, 95%CI 0.55-3.24, P>0.05). All-cause death was observed in 7 out of the 9 included literatures, and the results showed that all-cause death occurred in 172 out of the 6 453 patients in DAPT combining with PPI therapy group and in 321 out of the 9 839 patients using DAPT alone (OR=0.97, 95%CI 0.80-1.18, P>0.05). Three out of the 9 included articles observed stent thrombosis, and the results showed that stent thrombosis occurred in 99 out of 2 997 patients receiving DAPT combining with PPI therapy and in 245 out of the 6 198 patients treated with DAPT (OR=1.07, 95%CI 0.83-1.37, P>0.05). Stroke was observed in 2 out of the 9 included literatures. The results showed that stroke occurred in 5 out of 2 019 patients receiving DAPT combining with PPI therapy, and in 4 out of the 2 033 patients treated with DAPT (OR=1.00, 95%CI 0.29-3.49, P>0.05). Gastrointestinal bleeding was observed in 6 out of the 9 included literatures. The results showed that gastrointestinal bleeding occurred in 26 out of 3 517 patients receiving DAPT combined with PPI therapy, and in 93 out of the 3 506 patients treated with DAPT, gastrointestinal bleeding was significantly lower in the DAPT combining with PPI group than DAPT alone group (OR=0.27, 95%CI 0.17-0.41, P<0.01). Gastrointestinal events were reported in 6 out of the 9 included articles. Similarly, gastrointestinal events were observed in 51 out of 3 517 patients receiving DAPT combined with PPI therapy, and in 190 out of the 3 506 patients treated with DAPT alone, the incidence of gastrointestinal events in the DAPT combined with PPI group was significantly lower than DAPT alone group (OR=0.24, 95%CI 0.14-0.42, P<0.01). Conclusions The incidence of MACE, cardiogenic death, recurrent myocardial infarction, target vessel revascularization, all-cause death, stent thrombosis and stroke are not affected by DAPT combined with PPI therapy after PCI, while the incidence of gastrointestinal bleeding and gastrointestinal events could be reduced by adding PPI to DAPT in patients undergoing PCI.

Objective? To investigate the knowledge-attitude-practice level of the Intensive Care Unit (ICU) nurses on the Modified Early Warning Score (MEWS) system, and analyze its influencing factors, so as to lay a foundation for the establishment of related knowledge training program later. Methods? From October to November 2018,by convenience sampling, ICU nurses in General Hospital of Ningxia Medical University were selected as objects of the study. Self-designed ICU Nurses' Knowledge-Attitude-Behavior on MEWS System Questionnaire was used to investigate the nurses by means of Wenjuanxing online. The influencing factors were analyzed by single factor analysis and multiple linear regression analysis. Results? Totally 92 valid questionnaires were retrieved. The ICU nurses got the score of (68.42±22.09)in the "knowledge of MEWS", and (52.29±19.75) in the "attitude of MEWS" ,and (56.64±18.99) in the "practice of MEWS"; multiple linear regression analysis results indicated that working length, whether or not had contacted MEWS before, and educational background were the influencing factors of the practice of MEWS(P＜ 0.05). Conclusions? The knowledge, attitude and practice of ICU nurses in Ningxia are generally at the medium and low levels, among which knowledge is still acceptable, while attitude and practice are relatively poor. It suggests that managers should focus on attitudes, guide ICU nurses to recognize and actively apply them to assess patients' condition, and actively explore early warning management mode suitable for ICU critical patients.

Objective To investigate the relationships between tinnitus masking curve types and tinnitus re-sidual inhibition in the patients at different ages with normal hearing ,mild ,moderate severe hearing loss .Methods The minimum masking levels and residual inhibition of 335 patients with normal hearing ,mild to medium ,and mod-erate to severe hearing loss were tested and analyzed using the method of psychological acoustics .Results Ages and the duration of residual inhibition had a corresponding relationship :the 19～30 years old group had corresponding relations with 0～40 seconds of residual inhibition ,while the 31～50 years old group with 81～100 seconds of resid-ual inhibition ,and the 50～63 years old group with 101～200 seconds of residual inhibition ,respectively .The 31～50 years old group and 51％ ～80％ residual inhibition had a corresponding relationship ;0％ ～30％ residual inhibi-tion group and parallel type of tinnitus masking curves had a corresponding relationship ,31％ ～50％ residual inhibi-tion group and separation type of the tinnitus masking curves had a corresponding relationship ,the groups of 51％ ～80％ and 81％ ～100％ residual inhibition with the types of convergent and overlapping tinnitus masking curves had corresponding relationship ,respectively .Conclusion There were different characteristics of tinnitus masking patients at different ages with different levels of hearing loss .The older people are ,the better effects and longer time of residual inhibition are .Those tinnitus patients with the tinnitus masking curve of convergent type and overlapping type showed a better tinnitus masking effect than the others .

Aim TodevelopandvalidateaLC-MS/MS assay to quantify halometasone in rabbit plasma and study pharmacokinetics of halometasone after dermal topical administration of Halometasone Cream.Meth-ods Theplasmasamplewassubmittedtoliquid-liquid extraction using methyl tertiary butyl ether,with dexa-methasone as the internal standard (IS ).Chromato-graphic separations were performed on a Diamonsil C18 column(100 mm ×4. 6 mm,5 μm)with a linear gra-dient of methanol and 2 mmol · L-1 ammonium ace-tate.Halometasone and dexamethasone(IS)were ion-ized with an ESI source operated in negative ion mode, and the detected ions were m/z 503. 1→413. 0 (halo-metasone),m/z 391. 0→361. 0 (dexamethasone ). The test article could be monitored in rabbit plasma when following single dermal topical administration of Halometasone Cream at 1 g/100 cm2 to rabbits by u-singavalidatedLC-MS/MSassay.Results Calibra-tion curve was linear over the concentration range of0. 02~20 μg·L-1 in rabbit plasma.For low,medi-um,high concentration of QC solutions,the intra-and inter-day precision was in the range of 3. 72% ~7. 87%, and the accuracy was within 99. 1% to 103%. The pharmacokinetic parameters in rabbits were as follows:Tmax,Cmax,AUC0-t,T1/2 was (7. 38 ± 1. 06)h,(1. 16 ±0. 527)μg·L-1,(18. 8 ±7. 23)h·μg·L-1 ,(13. 8 ±3. 70)h,respectively.Conclusions ThisLC-MS/MSanalysismethodhashighsensitivi-ty,and sample processing method is simple,which has been rigorously validated.The method could be suc-cessfully applied to the pharmacokinetic study of halo-metasone after skin administration of Halometasone Cream to rabbits.

Objective To investigate the effect of penehyclidine hydrochloride ( PHC) pretreat?ment on nuclear factor erythroid 2?related factor 2∕heme oxygenase?1 ( Nrf2∕HO?1) signaling pathway in re?nal tissues of rats with rhabdomyolysis?induced acute kidney injury ( AKI) . Methods Thirty?six pathogen?free male Sprague?Dawley rats, weighing 200-220 g, were assigned into 3 groups ( n=12 each) using a random number table: control group (group C), group AKI and PHC pretreatment group (group PHC). Rhabdomyolysis was induced by intramuscular injection of 50% glycerol 10 ml∕kg in bilateral hindlimbs. PHC 0?2 mg∕kg was injected intraperitoneally at 30 min before glycerol was injected intramuscularly in group PHC. At 1 and 6 h after glycerol injection, serum was collected for determination of blood urea nitro?gen ( BUN) and creatinine ( Cr) concentrations, and bilateral kidneys were harvested for pathological ex?amination and for determination of HO?1 activity and expression of Nrf2 mRNA and HO?1 mRNA ( by quan?titative real?time polymerase chain reaction) , Nrf2 in nucleoprotein and total protein and HO?1 in total pro?tein in renal tissues ( by Western blot) . The damage to the renal tubules was scored. Results Compared with group C, the BUN and Cr concentrations in serum and renal tubular damage scores were significantly increased, the expression of Nrf2 in nucleoprotein and total protein and HO?1 in total protein was signifi?cantly up?regulated, and HO?1 activity was significantly increased in AKI and PHC groups, the expression of HO?1 mRNA was significantly up?regulated in group AKI, and the expression of Nrf2 mRNA and HO?1 mRNA was significantly up?regulated in group PHC (P<0?01 or 0?05). Compared with group AKI, the BUN and Cr concentrations in serum and renal tubular damage scores were significantly decreased, the ex?pression of Nrf2 in nucleoprotein and total protein and HO?1 in total protein was significantly up?regulated, and HO?1 activity was significantly increased in group PHC ( P<0?01 or 0?05) . Conclusion The mecha?nism by which PHC pretreatment attenuates rhabdomyolysis?induced AKI may be related to activation of Nrf2∕HO?1 signaling pathway in renal tissues of rats.

Objective To evaluate the effect of penehyclidine hydrochloride pretreatment on rhabdomyolysis-induced acute kidney injury (AKI) in rats.Methods Forty-two pathogen-free male SpragueDawley rats,weighing 200-220 g,aged 2 months,were randomly divided into 3 groups using a random number table:control group (group C,n =6),AKI group (n =18),and penehyclidine hydrochloride group (group PH,n =18).The model of rhabdomyolysis-induced AKI was established by injecting 50％ glycerol 10 ml/kg into the lateral muscle of bilateral hindlimbs in AKI and PH groups.The equal volume of normal saline was given in group C.Penehyclidine hydrochloride 0.2 mg/kg was injected intraperitoneally at 30 min before administration of glycerol in group PH.Six rats were selected at 1 h after administration of normal saline in group C,or at 1,6 and 24 h after administration of glycerol,blood samples were collected from the inferior vena cava for determination of the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations by enzymic colorimetric method.The animals were sacrificed,and kidney specimens were obtained for pathologic examination and for determination of the expression of DJ-1 and phosphatase tensin homolog deleted on chromosome 10 (PTEN) encoding protein (by immuno-histochemistry and Western blot).The damage to the renal tubules was scored.Results Compared with group C,the serum BUN and Cr concentrations and renal tubular damage score were significantly increased,the expression of D J-1 was down-regulated,and the expression of PTEN protein was up-regulated in group AKI (P＜0.05 or 0.01).Compared with group AKI,the serum BUN and Cr concentrations and renal tubular damage score were significantly decreased,the expression of DJ-1 was up-regulated,and the expression of PTEN protein was down-regulated in group PH (P＜0.05 or 0.01).Conclusion Penehyclidine hydrochloride pretreatment can reduce rhabdomyolysis-induced AKI probably by up-regulating the expression of DJ-1 and down-regulating the expression of PTEN protein in rats.

Objective To investigate the renal histopathological changes of over training induced acute renal injury in human being.Methods Eight patients treated in our hospital admitted overtraining were observed retrospectively about their clinical and pathological data,including clinical features,laboratory tests and pathological examinations.Results Eight patients with acute kidney injury after overtraining,manifested as urine occult blood positive in 2 cases,3 cases of urinary protein,urinary occult blood and urine protein were positive in 3 cases.Five cases of renal dysfunction,manifested as creatinine,urea nitrogen,uric acid significantly increased; renal ultrasound non-specific changes,manifested as increased echogenicity of the cortex.2 cases of renal pathology glomerular ischemic; Two cases of renal interstitial mild edema,five cases of inflammatory cell infiltration; Three cases of renal tubular epithelial vacuolar degeneration,2 cases of tubular atrophy,4 cases of renal tubular epithelial brush border loss,see intraluminal protein casts can be seen,1 case of calcium deposition.Conclusion The acute renal injury can be induced by overtraining.Kidney pathology ischemic is the most important change and renal tubular show most sensitive features of ischemic.In addition,inflammatory response and striated muscle damage were also induced because of overtraining.

Objective To evaluate the effect of anisodamine on endoplasmic reticulum stress during acute kidney injury (AKI) in rats.Methods Forty-two nale Sprague-Dawley rats,weighing 200-220 g,were randomly divided into 3 groups:control group (group C,n =6),AKI group (n =18) and anisodamine group (group AD,n =18).AKI was induced by intramuscular injection of 50％ (v/v) glycerol 10 ml/kg into bilateral hind limbs in groups AKI and AD.In addition,anisodamine 10 mg/kg was injected intraperitoneally 20 min before intramuscular injection of glycerol in group AD.In group C the rats received intramuscular injection of normal saline 10 ml/kg into bilateral hind limbs.Six rats were chosen immediately after injection of normal saline in group C or at 1,6 and 24 h after glycerol injection in groups AKI and AD and then anethetized with intraperitoneal pentobarbital.The animals were sacrificed and kidney specimens were obtained and cut into sections which were stained with hematoxylin and eosin for pathological examination.The pathological changes of the renal tubules were scored.The expression of glucose-regulated protein 78 (GRP78) and oxygen-regulated protein 150 (ORP150) in renal tissues was determined by immuno-histochemistry and Western blot.Results Compared with group C,the pathological scores were significantly increased and the expression of GRP78 and ORP150 was up-regulated at all time points in groups AKI and AD (P ＜ 0.01).Compared with group AKI,the pathological scores were significantly decreased and the expression of GRP78 and ORP150 was down-regulated at all time points in group AD (P ＜ 0.05 or 0.01).Conclusion Anisodamine can ameliorate AKI through inhibiting endoplasmic reticulum stress in renal tubular epithelial cells and decreasing endoplasmic reticulum stress-induced cell apoptosis in rats.