Male lower urinary tract symptoms is a collective term for a group of symptoms associated with lower urinary tract disorders characterized by frequent urination, urgent urination, and difficulty of urination, of which the common causes are benign prostatic hyperplasia or overactive bladder. With the aging of the global population, the incidence of male lower urinary tract symptoms is increasing year by year. Based on the theoretical connotation of " zang-fu extraordinary connection", the relationship between the lungs and the bladder, the spleen and the small intestine, and the kidneys and the sanjiao with the formation of male lower urinary tract symptoms is explained from three perspectives. It is believed that lung qi depression and closure, disturbance of qi transformation in bladder, and insufficient spleen transport occur, the small intestine is dysfunctional, kidney yang is exhausted, and obstruction of the sanjiao waterway are the basic pathogenesis of male lower urinary tract symptoms. It is emphasized that the location of the disease should be identified. If it is related to the lungs and the bladder, then the disease should be treated by lifting the pot to lift the lid and diffusing the lung qi to benefit the bladder with Wuling Powder plus perilla leaf and bitter apricot seed; if it is related to the spleen and the small intestines, then the disease should be treated by raising the clear and directing the turbid downward and improving the spleen qi in order to support the small intestines with Shenling Baizhu Powder; if it is related to the kidneys and the sanjiao, then the disease should be treated by seeking the yang within the yin and warming and tonifying the kidney qi in order to dredge up the sanjiao with Bawei Shenqi Pill. According to the patient's condition, treatment can be combined with acupuncture, exercise, and other therapies. This paper can provide reference for clinical treatment of male lower urinary tract symptoms.

Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly worldwide and is characterized by degeneration of the photoreceptor, retinal pigment epithelium, Bruch membrane and choriocapillaris complex.Impairment of RPE cell function is an early and critical event in the molecular pathways leading to clinically relevant AMD changes.Programmed cell death (PCD) plays an important role in response to stress and regulation of homeostasis and disease.In recent years, multiple studies have shown that apoptosis, pyroptosis, necroptosis and ferroptosis are likely involved in RPE cell PCD and correlate with the onset and development of AMD.There may be interaction or synergy between the various death pathways.This article reviewed the pathogenic mechanism of apoptosis, pyroptosis, necroptosis and ferroptosis in retinal pigment epithelial cell and their research progress in AMD, which might provide new approaches for the prevention and treatment of AMD.

Objective: Plant hormones act as chemical messengers in the regulation of plant development and metabolism. The production of ginsenosides in Panax hybrid is promoted by auxins that are transported and accumulated by PIN-FORMED (PIN) and PIN-LIKES (PILS) auxin transporters. However, genome-wide studies of PIN/PILS of ginseng are still scarce. In current study, identification and transcriptional profiling of PIN/PILS gene families, as well as their potential relationship with ginsenoside biosynthesis in Panax ginseng were investigated. Methods: PIN/PILS genes in P. ginseng was identified via in silico genome-wide analysis, followed by phylogenetic relationships, gene structure, and protein profiles investigation. Moreover, previously reported RNA-sequence data from various tissues and roots after infection were utilized for PIN/PILS genes expression pattern analysis. The Pearson's correlation analysis of specific PIN/PILS genes expression level and main ginsenoside contents were taken to reveal the potential relationship between auxin transports and ginsenoside biosynthesis in P. ginseng. Results: A genome-wide search of P. ginseng genome for homologous auxin transporter genes identified a total of 17 PIN and 11 PILS genes. Sequence alignment, putative motif organization, and sub-cellular localization indicated redundant and complementary biological functions of these PIN/PILS genes. Most PIN/PILS genes were differentially expressed in a tissue-specific manner, and showed significant correlations with ginsenoside content correspondingly. Eight auxin transporter genes, including both PIN and PILS subfamily members, were positively correlated with ginsenoside content (cor > 0.60; P-value <0.05). The expression levels of eleven auxin transporter genes were increased dramatically in the early stage (0–0.5 DPI) after Cylindrocarpon destructans infection, accompanied with various overall expression patterns, implying the dynamic auxin transport in response to biotic stress. Conclusion: Based on the results, we speculate that the accumulation or depletion in temporal or spatial manner of auxin by PIN/PILS transporters involved in the regulation of HMGR activity and subsequent ginsenoside biosynthesis.

Pharmaceutical analysis is a discipline based on chemical, physical, biological, and information technologies. At present, biotechnological analysis is a short branch in pharmaceutical analysis; however, bioanalysis is the basis and an important part of medicine. Biotechnological approaches can provide information on biological activity and even clinical efficacy and safety, which are important characteristics of drug quality. Because of their advantages in reflecting the overall biological effects or functions of drugs and providing visual and intuitive results, some biotechnological analysis methods have been gradually applied to pharmaceutical analysis from raw material to manufacturing and final product analysis, including DNA super-barcoding, DNA-based rapid detection, multiplex ligation-dependent probe amplification, hyperspectral imaging combined with artificial intelligence, 3D biologically printed organoids, omics-based artificial intelligence, microfluidic chips, organ-on-a-chip, signal transduction pathway-related reporter gene assays, and the zebrafish thrombosis model. The applications of these emerging biotechniques in pharmaceutical analysis have been discussed in this review.

BACKGROUND: The predictive value of hemoglobin A1c (HbA1c) levels in non-diabetic patients with myocardial infarction undergoing percutaneous coronary intervention (PCI) is still controversial. This study aimed to evaluate whether HbA1c levels were independently associated with adverse clinical outcomes in non-diabetic patients with coronary artery disease (CAD) who had undergone PCI by performing a meta-analysis of cohort studies. METHODS: This meta-analysis included non-diabetic patients with CAD who had undergone PCI. A systematic search for publications listed in the PubMed, Embase, and Cochrane Library databases from commencement to December 2018 was conducted. Studies evaluating the adverse clinical outcomes according to abnormal HbA1c levels in non-diabetic patients diagnosed with CAD who had undergone PCI were eligible. The primary outcomes were long-term all-cause deaths and long-term major adverse cardiac events, and the secondary outcome was short-term all-cause deaths. The meta-analysis was conducted with RevMan 5.3 and Stata software 14.0. Odds ratios (ORs) were pooled using a random or fixed-effects model, depending on the heterogeneity of the included studies. Sub-group analysis or sensitivity analysis was conducted to explore potential sources of heterogeneity, when necessary. RESULTS: Six prospective cohort studies involving 10,721 patients met the inclusion criteria. From the pooled analysis, abnormal HbA1c levels were associated with increased risk for long-term all-cause death (OR 1.39, 95% confidence interval [CI] 1.16-1.68, P = 0.001, I = 45%). Sub-group analysis suggested that abnormal HbA1c levels between 6.0% and 6.5% predicted higher long-term major adverse cardiac event (including all-cause deaths, non-fatal myocardial infarction, target lesion revascularization, target vessel revascularization, recurrent acute myocardial infarction, heart failure requiring hospitalization, and stent thrombosis) risk (OR 2.05, 95% CI 1.46-2.87, P < 0.001, I = 0). Contrarily, elevated HbA1c levels were not associated with increased risk of short-term all-cause death (OR 1.16, 95% CI 0.88-1.54, P = 0.300, I = 0). CONCLUSIONS An abnormal HbA1c level is an independent risk factor for long-term adverse clinical events in non-diabetic patients with CAD after PCI. Strict control of HbA1c levels may improve patient survival. Further studies in different countries and prospective cohort studies with a large sample size are required to verify the association.

Objective To investigate the effects of moisture-proof materials and contents on hygroscopicity of Yixinshu Capsules; To improve moisture-proof function of Yixinshu Capsules. Methods The hygroscopicity performance of Yixinshu Capsules was analyzed with the indexes of moisture absorption rate and critical relative humidity (CRH), and effects of soluble starch, maize starch, dextrin, lactose, mannitol, calcium hydrogen phosphate, ethylcellulose, microcrystalline cellulose, hypromellose and low-substituted hydroxypropyl cellulose on hygroscopicity of Yixinshu Capsules were compared. The effects of optimized excipients and capsule contents after granulation on hygroscopicity of Yixinshu Capsules were tested. Results Lactose, microcrystalline cellulose and mannitol were the most appropriate moisture-proof excipients for Yixinshu Capsules with balanced moisture absorption rate of 18.04%, for which the best proportion of Yixinshu Capsules to excipients was 1 to 0.1 (wt%). The balanced moisture absorption rate of the powders were 14.87%, 14.39%, and 15.38%, respectively, whereas the granules were 10.75%, 10.29%, and 11.13%, respectively. Conclusion The selected excipients can effectively reduce the hygroscopic rate of the Yixinshu Capsules, and its granules can promote the moisture resistance of Yixinshu Capsules.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.

Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

In recent years,direct-acting antiviral agents (DAAs) have achieved great success in the treatment of hepatitis C and have replaced interferon/ribavirin.However,since DAAs were launched not long ago,there lacks sufficient knowledge of their toxic and side effects,interactions with other drugs,and safety in patients complicated by other serious chronic diseases.The results of many large-scale clinical trials show that DAAs have good safety in different populations and serious toxic and side effects are rare,but drug interactions need to be taken seriously.The addition of ribavirin in DAA regimen or prolongation of DAA treatment does not increase patients' benefits and may cause more adverse events.Moreover,at the same time of DAA treatment,liver injury caused by HCV cannot be neglected,and continuous treatment should be given.

Objective To evaluate the clinical effectiveness of double balloon dilation in percutaneous kyphonplasty on curing vertebral?compression fractures. Methods From January 2009 to September 2013, 84 patients (94 vertebral bodies) with vertebral compression were treated by percutaneous kyphonplasty. All were fresh fractures and were injured or obvious low back pain 1 month, accompanied by local tenderness, kowtow attack painful, lumbar mobility, but no lower extremity injury numbness, activities and defecation disorders. After randomization, the double balloon dilation in percutaneous kyphonplasty method was used to treat 44 patients (49 vertebrae). In the process of performing percutaneous unilateral pedicle puncture and balloon dilata?tion of the vertebral body, the balloon has been moved some distance in the vertebral body. Then completed the perfusion of bone cement, vertebral body forming. 40 cases (45 vertebrae) were used conventional unilateral percutaneous kyphonplasty to vertebtal compression fractures. Recorded the operation time, amount of bleeding, bone?cement injection volume. Used visual analogue scale (VAS), the height of the vertebral body and Cobb angle to evaluated the curative effect. Results All 84 patients completed the operation, follow?up time was 22 months (18-24 months). In two mobile open expansion group, the operation time was about 48 min. The amount of bleeding was 8-15 ml. The average bone?cement injection volume was 5.1 ml. No patients quit the study and no bone cement?leakage cases or other side effects were observed , and no clinical accidents occurred. In a single stretching group, 40 cases (45 vertebrae) completed conventional vertebroplasty, the time of 44 min, bone cement average injection rate 3.2 ml, bleeding 10-15 ml. In two mobile open expansion group, the VAS score was 8.5 points, the height of the vertebral body height was 2.1cm, and the Cobb angle was 34°. After operation, the VAS score 2.9 points, the height of the vertebral body 2.8 cm, and Cobb 20° . In the other group, the pain was significantly relieved and the relief was satisfactor after operation.Vertebral height of 2 cm turned to the last follow?up of 2.4 cm. The Cobb angle was 32°, and the last follow?up was 27°. The VAS score, operation time and bleeding volume of the two groups were not statistically significant, and a statistically significant difference of the average bone ce?ment injection volume, postoperative vertebral height and cobb angle improved with statistical significance. A single open group were 2 cases of bone cement leakage and leakage, 1 cases of bone cement tail, the complication rate was 5.6%. Conclusion The application of double balloon dilation in percutaneous kyphonplasty to vertebral?compression fractures improve relocation of verte?bral compression fractures, increase recovery of vertebral height, and more effectively strengthen and stiffen pathological vertebral bodies, while improving kyphosis. Moreover, it can reduce pressure during bone?cement injections, minimizing the chance of over?flow and leakage, as well as the related side effects, but it will also result in an increase of bone cement?injection volume.