Tripterygium wilfordii polyglycosides are one of the most commonly used Tripterygium wilfordii preparations， which have anti-inflammatory and immune-regulating effects. Their unique therapeutic effect on some autoimmune diseases and kidney diseases is almost irreplaceable by other similar drugs， but the possible reproductive damage is the bottleneck that hinders their clinical application. In clinical use， female patients often suffer from menstrual cycle disorders， decreased menstrual flow， even amenorrhea， infertility， and other symptoms， and the main toxic mechanism lies in damaging the reproductive and endocrine functions of the ovary and inhibiting the growth and development of follicles. Therefore， it is particularly necessary to understand the toxic and side effects of Tripterygium wilfordii polyglycosides on female reproduction and master the detoxification methods during clinical use. However， there is no clear solution to these problems. According to the theory of traditional Chinese medicine， "kidney governs reproduction"， and the relationship between kidney Yin， kidney essence， and female ovum is close. Therefore， by considering that the damage to the reproductive system caused by Tripterygium wilfordii polyglycosides belongs to the category of kidney deficiency， Yin damage， and essence deficiency， the "strengthening kidney Yin" method is proposed. It points out that the reproductive toxicity damage of Tripterygium wilfordii polyglycosides on the female can be effectively alleviated by tonifying kidney and Yin essence in clinical use. The relevant research on traditional Chinese medicine， classical prescription， test prescription， and acupuncture is summarized to verify the necessity of the "strengthening kidney Yin" method， so as to provide a theoretical basis for the safe and rational clinical use of Tripterygium wilfordii.

Esophageal cancer is a common malignant tumor of the digestive tract. At present， the pathogenesis of esophageal cancer has not been fully clarified. Although surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy have achieved good clinical results in the treatment of esophageal cancer， there are still many complications and severe adverse reactions. As an important part of traditional Chinese medicine （TCM）， in recent years， many basic experiments and clinical studies have proved that Chinese medicine has a good effect in treating esophageal cancer. At the same time， the multi-component and multi-target characteristics of Chinese medicine and unclear pathogenesis of esophageal cancer determine that there are some problems such as unclear mechanisms of Chinese medicine in preventing and treating esophageal cancer. It is necessary to start with modern medicine and reveal the mechanism of Chinese medicine in preventing and treating diseases from the aspects of molecular biology and network pharmacology. It is believed in TCM that the occurrence of esophageal cancer is mostly attributed to stagnation of liver Qi， phlegm stasis and Qi stagnation， fluid consumption and heat accumulation， the decline of healthy Qi， and the cementation of cancer toxicity. According to the literature review， Chinese medicinal compounds mainly include tonic formulae （such as Liu Junzitang）， drying and moistening formulas （such as Qigesan）， and heat-clearing formulas （such as Fufang Kushen injection）. Chinese medicinal monomers mainly include drugs potent in attacking poison and killing insects， clearing heat， activating blood and resolving stasis， and regulating Qi， which is consistent with the etiology and pathogenesis of esophageal cancer in TCM. It is also found that Chinese medicine can promote cell apoptosis and autophagy， block cell cycle， and reverse cell resistance by regulating phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， neurogenic locus notch homolog protein （Notch）， Wnt/β-catenin， mitogen-activated protein kinase （MAPK）， nuclear factor-κB （NF-κB）， Janus kinase 2/signal transducer and activator of transcription 3 （JAK2/STAT3）， and other related signaling pathways， but there is no systematic summary. This study systematically summarized the relevant signaling pathways of Chinese medicine in regulating esophageal cancer， which is helpful to clarify the relevant mechanisms of Chinese medicine in the process of esophageal cancer occurrence， development， invasion， and metastasis， so as to provide new targets and new perspectives for the treatment of esophageal cancer and promote the modernization of TCM.

OBJECTIVE To investigated the anti-de-pressant effects of the fruit Areca catechu L.(ACL)and elucidated its potential underlying mechanism using a rat model of chronic unpredictable mild stress(CUMS).METHODS CUMS was induced in rats to establish a depression animal model for 28 d.According to the baseline sucrose preference,the male rats were divided into six different groups.They were treated with parox-etine hydrochloride,ACL,and water once a day until the behavioral tests were performed.The levels of corticoste-rone(CORT),malondialdehyde(MDA),catalase(CAT),and total superoxide dismutase(T-SOD)in serum were de-tected using a commercial kit,and the concentrations of 5-hydroxytryptamine(5-HT)and dopamine(DA)mono-amine neurotransmitters in the brain tissues were detect-ed by liquid chromatography-tandem mass spectrometry.Doublecortin(DCX)expression in the hippocampal den-tate gyrus(DG)was determined by immunofluorescence,and the relative abundance of brain-derived neurotrophic factor(BDNF),TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β of brain tissues were assayed by West-ern blotting.RESULTS ACL markedly increased sucrose preference,decreased the immobility time,and short-ened the feeding latency of CUMS-induced rats.CUMS induction resulted in marked changes in the contents of the monoamine neurotransmitters(5-HT and DA)in the hippocampus and cortex of brain tissues and the levels of CORT,MDA,CAT,and T-SOD in serum,whereas ACL administration alleviated these considerable changes.ACL promoted DCX expression in DG and increased the protein levels of BDNF,TrkB,PI3K,p-Akt/Akt,PSD-95,and p-GSK-3β/GSK-3β in the brains of CUMS-induced rats.CONCLUSION Our results indicated that ACL may improve depression-like behaviors in CUMS-induced rats by decreasing the hyperfunction and oxidative stress of the hypothalamic-pituitary-adrenal axis,stimulating hippo-campal neurogenesis,and activating the BDNF signaling pathway.

Objective:To evaluate the clinical significance of our self-designed three-column scoring system for postoperative X-ray stability of intertrochanteric fracture after intramedullary nailing.Methods:A retrospective study was conducted of the 378 patients with intertrochanteric fracture who had been treated between January 2015 and June 2019 at Department of Orthopaedics, Linyi People's Hospital by internal fixation with proximal femoral nail antirotation (PFNA). They were 161 males and 217 females, aged from 60 to 97 years (average, 72.5 years). By the AO classification, there were 109 cases of type 31-A1, 188 cases of type 31-A2 and 81 cases of type 31-A3. Anteroposterior and lateral X-ray examinations of the hip were performed immediately after internal fixation to evaluate the fracture stability using our self-designed three-column scoring system by which the medial column is given 4 points, middle column 2 points and lateral column 2 points. A single column scoring full points is rated as stable, 3-column stability as excellent, 2-column stability as good, one-column stability as fair, and 3-column unstability as poor. Rehabilitation programs were carried out according to the results of stability evaluation: full weight bearing at an early stage was indicated for excellent patients, partial weight bearing at an early stage for good patients and weight bearing at an early stage contraindicated for fair or poor patients. Fracture union time and failure of internal fixation were recorded. The relationship between internal fixation failure and our three-column scoring system was calculated.Results:The 378 patients were followed up for 6 to 24 months (mean, 10.4 months). Of them, 365 obtained fracture union after an average time of 4.3 months (from 3 to 7 months). Internal fixation failure occurred in 13 patients, giving a failure rate of 3.4%(13/378).Of the 129 excellent patients by our three-column scoring system for post-operative X-ray stability of intertrochanteric fracture, none failed in internal fixation; of the 193 good patients, 4 failed; of the 56 fair patients, 9 failed. Internal fixation failure was closely related to our three-column scoring system for postoperative X-ray stability of intertrochanteric fracture ( r=-0.986, P=0.006), as well as to the column stability ( r=-1.000, P=0.033). Conclusion:Our self-designed three-column scoring system for postoperative X-ray stability of intertrochanteric fracture after intramedullary nailing can accurately reflect the fracture stability so that it can be used to guide rehabilitation programs for the patients and judge their prognosis.

Objective:In order to compare the effect of ascending medial open-wedge high tibial osteotomy and descending medial open-wedge high tibial osteotomy on patellar height.Methods:Our group analyzed 77 patients of medical cases which were closely associated with medial open-wedge high tibial osteotomy for the treatment of knee varus deformity and medial compartment osteoarthritis from May 2011 to December 2018 and 77 cases were effectively followed up, including 36 males and 41 females with an average age of 59.4±10.5. By the way, there are 51 cases of ascending osteotomy and 26 cases of descending osteotomy. During these treatment, we adopted some scientific methods full-length standing anteroposterior radiograph,Miniaci method, Insall-Salvati index (ISI), Caton-Deschamps index (CDI) and Blackburne-Peel Index (BPI) to measure the corresponding parameters and changes in patellar height (PH) at different stages.Results:77 patients were enrolled, the mean follow-up time was 20.6 months (range, 12-60 months), ascending and descending high tibial osteotomy (HTO) show the average degree of varus correction (10.43°±2.67° and 11.16°± 2.80°) respectively. And at the same time, in these cases of ascending HTO, PH decreased by 8.1% (CDI method), 2 cases of low PH (the patellar height decreased by 10%, which is the low patellar) were measured (ISI method), 7 cases of low PH occurred (CDI and BPI). Instead, PH decreased by 4.5% (CDI method) in descending HTO,the difference was significant ( t=2.101, P=0.040). 22 cases of ascending HTO with varus correction less than 10 degrees, the PH decreased by 6.9%. By the way, the ISI method did not detect the occurrence of low PH, but we found one by CDI and BPI. The 29 cases with varus correction of more than 10 degrees in ascending HTO, and PH decreased by 10.4%. There were 2 low PH (ISI method), and 6 low PH (CDI and BPI), the difference was significant ( t=2.310, P=0.028). Conclusion:In ascending HTO, the low PH is closely related to the degree of varus correction. Conversely, The descending HTO did not influence PH.

Objective:The purpose of this study was to investigate the characteristics of viral pathogen spectrum and the epidemiological characteristics of each viral pathogen in hospitalized cases associated with severe acute respiratory infection (SARI) in Luohe City, Henan Province from 2017 to 2019.Methods:Based the SARI Case Surveillance Platform, SARI cases were collected in Central Hospital of Luohe City, Henan Province from November 2017 to February 2019. In the end, 783 SARI cases were included, whose throat swabs were taken within 24 h of admission, as well as their demographic characteristics, onset time, clinical characteristics and other information recorded. At the same time, viral identification was performed, and the age and time distribution of each virus were analyzed.Results:The age of 783 SARI cases shown as M ( P 25, P 75) was 3 (1, 5) years old, ranging from 1 month to 95 years old. Children under 5 years old were the majority (71.01%). The males (61.81%) were more than females (38.18%). Among the 783 SARI cases, a total of 9 kind of viruses were identified with 64.88% (508/783) of the throat swabs tested positive for at least one virus. The positive rate of influenza virus and human respiratory syncytial virus were both 20.18% (158 cases), which was the highest among all the detected respiratory virus. The co-infection rate was 15.84% (124/783), among which double infection was the most common, accounting for 85.48% (106/124) of the co-infected cases. And human respiratory syncytial virus, human rhinovirus and influenza virus were the most common pathogen in co-infection cases. Moreover, the viral positive rate was 68.71% in children aged 5 years and 63.27% in people aged 60-95 years. Influenza and human respiratory syncytial virus dominated in winter and spring, while human parainfluenza virus was the main infection in summer. Conclusion:Influenza virus and human respiratory syncytial virus were the main viruses in throat swabs of SARI cases from 2017 to 2019 in Luohe City, Henan Province. There were differences in the age and seasonal epidemiological characteristics of each virus.

Objective:The purpose of this study was to investigate the characteristics of viral pathogen spectrum and the epidemiological characteristics of each viral pathogen in hospitalized cases associated with severe acute respiratory infection (SARI) in Luohe City, Henan Province from 2017 to 2019.Methods:Based the SARI Case Surveillance Platform, SARI cases were collected in Central Hospital of Luohe City, Henan Province from November 2017 to February 2019. In the end, 783 SARI cases were included, whose throat swabs were taken within 24 h of admission, as well as their demographic characteristics, onset time, clinical characteristics and other information recorded. At the same time, viral identification was performed, and the age and time distribution of each virus were analyzed.Results:The age of 783 SARI cases shown as M ( P 25, P 75) was 3 (1, 5) years old, ranging from 1 month to 95 years old. Children under 5 years old were the majority (71.01%). The males (61.81%) were more than females (38.18%). Among the 783 SARI cases, a total of 9 kind of viruses were identified with 64.88% (508/783) of the throat swabs tested positive for at least one virus. The positive rate of influenza virus and human respiratory syncytial virus were both 20.18% (158 cases), which was the highest among all the detected respiratory virus. The co-infection rate was 15.84% (124/783), among which double infection was the most common, accounting for 85.48% (106/124) of the co-infected cases. And human respiratory syncytial virus, human rhinovirus and influenza virus were the most common pathogen in co-infection cases. Moreover, the viral positive rate was 68.71% in children aged 5 years and 63.27% in people aged 60-95 years. Influenza and human respiratory syncytial virus dominated in winter and spring, while human parainfluenza virus was the main infection in summer. Conclusion:Influenza virus and human respiratory syncytial virus were the main viruses in throat swabs of SARI cases from 2017 to 2019 in Luohe City, Henan Province. There were differences in the age and seasonal epidemiological characteristics of each virus.

Alpha-keto acid is a bifunctional organic compound containing both carboxyl and ketone groups, and widely applied in the industries of food, pharmaceutical and cosmetics. Based on the demand of eco-friendly process, safety and sustainable development, production of α-keto acids by enzymatic conversion technology has been paid more and more attention. In this article, we review the status of α-keto acids biosynthesis from three aspects: enzymatic screening, enzymatic modification and optimization of enzymatic conversion conditions. Meanwhile, we also indicate future research directions for further improving α-keto acids production.
Keto Acids ; metabolism

Objective To explore the value of multi-modal MRI in the differential diagnosis of pure fibroadenosis and mixed fibroadenosis in the breast. Methods Forty female patients who underwent 3.0 T MRI within 1 week before sugery and confirmed as breast fibroadenosis by pathology in the General Hospital of the PLA Rocket Force from January 2014 to May 2016 were retrospectively analyzed in this study. There were 20 cases of pure fibroadenosis which including mass type and non-tumor type, 10 cases per type. Twenty cases of mixed fibrous adenosis which including 4 cases of mass type and 16 cases of non-mass type. According to the breast imaging reporting and data system-MRI standard, conventional MRI features, time intensity curve (TIC) types and ADC values of the lesions were observed. MRI features and ages of pure fibroadenosis and mixed fibroadenosis were compared using χ2 test (qualitative data) and independent sample t test (quantitative data), P<0.05 was considered statistically significant. Statistically significant parameters were then used to perform logistic regression analysis to evaluate predictive value . The efficacy of each MRI parameter in the differential diagnosis of pure fibroadenosis and mixed fibroadenosis was analyzed by ROC. Results Statistically significant differencein the size(P<0.05) but no differences in the shape, T2WI manifestation, marginal, internal enhancement, early enhancement curve, and late enhancement (P>0.05) were observed between pure fibroadenosis and mixed fibroadenosis. There was no significant differences in distribution, internal enhancement, early enhancement curve and late enhancement curve between non-tumor type pure fibroadenosis and mixed fibroadenosis (P>0.05). There were significant differences in age, ADC value and peak signal intensity(P<0.05) while no significant differences in early enhancement rate, maximum enhancement rate and peak time (P>0.05) between patients with pure fibroadenosis and mixed fibroadenosis. Logistic regression analysis suggested that the peak signal intensity was closely related to age. It revealed a positive correlation between ADC value, peak signal intensity and the possibility of mixed fibroadenosis. The regression coefficient value, Wals value, and P value of the ADC value were 3.652, 4.363 and 0.034, respectively. The regression coefficient value, Wals value, and P value of the peak signal intensity were 0.005, 5.463 and 0.019, respectively. The area under ROC curve of ADC value, peak signal intensity, ADC value combined with peak signal intensity were 0.697, 0.701 and 0.786, respectively. Conclusions Significantly differences of peak signal intensity and ADC value were observed in mixed fibroadenosis compared with pure fibroadenosis. The combination of ADC value and peak signal intensity had the highest efficacy in predicting pure and mixed fibroadenosis.

Objective To investigate the correlation between family cohesion and adaptability and quality of life in patients with enterostomy. Methods Using Chinese version of Family Adaptability and Cohesion Scale (FACESⅡ-CV) and Chinese version of Stoma-Quality of Life (STOMA-QOL-C) to investigate the status of family cohesion and adaptability, family type and their impact on quality of life of 110 patients with enterostomy. Results Scores of family cohesion and adaptability averaged 59.15 ± 11.94, 47.32 ± 9.40,were significantly lower than 63.90 ± 8.00 and 50.90 ± 6.20 in the norm,and the difference was statistically significant (t=-4.171,-3.990, P<0.01).The family cohesion was positively correlated with the score of quality of life, social interaction and psychological burden(r=0.274, 0.284, 0.263, P<0.05), and the family adaptability was positively correlated with the score of quality of life,social interaction and psychological burden(r=0.316, 0.338, 0.228, P<0.05 or 0.01). The balance type family was 30 cases;scores of quality of life averaged 45.10±7.26, the intermediate type family was 50 cases;scores of quality of life averaged 43.48±9.98, the extreme type family was 28 cases;scores of quality of life averaged 43.37 ± 16.68, and difference between the three was no statistically significant(F=0.442, P=0.665). Conclusions In the nursing process of patients with enterostomy, health care workers should pay attention to improve family cohesion and adaptability, as to achieve the purpose of improving the quality of life of the patients.