ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

Objective To investigate the immediate effect of early acupuncture and drug treatment on cerebral arterial blood flow and the degree of nerve damage in patients with acute ischemic stroke.Methods A total of 100 cases acute ischemic stroke patients treated in Quanzhou First Hospital Affiliated to Fujian Medical University were selected from June 2021 to June 2023,using clinical random number table method,the patients were divided into acupuncture treatment group(35 cases),non acupoint acupuncture group(32 cases),and conventional drug treatment group(33 cases).After admission to the hospital,all stroke patients were treated with conventional western medicine treatment,Both acupuncture treatment group and non acupoint acupuncture group received initial acupuncture treatment on the first day of enrollment without using drugs to improve circulation.Three groups of patients were treated continuously for 14 days,and their cerebral hemodynamic indicators before and after treatment were observed,including systolic peak velocity(Vs),diastolic peak velocity(Vd),pulsatile index(PI),resistance index(RI),and mean blood flow velocity(MFV).The levels of brain nerve injury markers in patients before and after treatment were measured,and the degree of neurological impairment were evaluated using National Institute of Health stroke scale(NIHSS).Results Compared with before treatment,the Vs and MFV levels of patients in conventional drug treatment group and non acupoint acupuncture group increased after treatment(P＜0.05),and PI decreased significantly compared with before treatment(P＜0.05);The levels of Vs,Vd,and MFV in acupuncture treatment group were all increased(P＜0.05);PI and RI decreased compared to before treatment(P＜0.05);After comparing the three treatment groups,the improvement of Vs,Vd,PI,RI,and MFV in acupuncture treatment group were better than those in non acupoint acupuncture group and conventional drug treatment group(P＜0.05).The Vs,Vd,PI,RI,and MFV of patients in the acupuncture treatment group improved after the first acupuncture,and the degree of improvement was better than that of the non acupoint acupuncture group(P＜0.05).After treatment in the three groups,the levels of serum S-100 β protein,heart-type fatty acid binding protein(H-FABP),and neuron specific enolase(NSE)were significantly reduced(P＜0.05),among which the index levels in acupuncture group were lower than those in the other two groups(P＜0.05),and the NIHSS score was lower in acupuncture group after 2 weeks of treatment and 30 days of follow-up compared with non acupoint acupuncture group and conventional drug treatment group(P＜0.05).Conclusion Early acupuncture treatment can improve the blood flow of the middle cerebral artery in patients with acute ischemic stroke and reduce the degree of nerve damage.

Alzheimer's disease （AD） is a deleterious neurodegenerative disorder， which has become a significant public health concern and economic burden. The pathogenesis of AD is complex and involves several hypotheses such as amyloid β-protein （Aβ） deposition， Tau protein hyperphosphorylation， oxidative stress， and inflammation. There is an urgent need for a holism-based comprehensive intervention with multi-pathway， multi-level， and multi-target characteristics， which demonstrates the unique advantage of traditional Chinese medicine （TCM）. Therefore， it is of great significance to conduct and promote research on TCM treatment of AD. Danggui Shaoyaosan （DSS） from the Synopsis of Golden Chamber （《金匮要略》） by ZHANG Zhongjing （150 AD-219 AD） was originally designed for reliving gynecological ailments. It is a classic TCM formula that modulates liver and spleen and dispels blood stasis and water retention. Since the late 1980s when Japanese researchers reported its therapeutic effect on AD， it has been widely used in the clinic with clear effects. The elucidation of the mechanism of this formula helps exert its effects. Hereby， this paper reviewed relative research progress and made an analysis in terms of attenuating aberrant accumulation of Aβ and hyperphosphorylated Tau protein， anti-inflammatory and antioxidant activities， mediating neurotransmitters， ameliorating lipid metabolism， modulating gut microbiota， reduced neuron apoptosis， decreasing intracellular Ca²⁺ overloading， and increasing the expression of estradiol. This paper is expected to provide references for understanding the scientific connotation of DDS in the treatment of AD and lay a solid foundation for further investigation.

Objective: To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. Methods: From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. Results: 20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69−2.35) and 4.05 (95%CI: 3.05−5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant′s gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66−2.39) and 1.80 (95%CI: 1.55−2.08), respectively. Conclusion The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.

Objective To examine the association of pre?pregnancy body mass and weight gain during pregnancy with macrosomia. Methods From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre?pregnancy body mass and gestational weight gain indicators with macrosomia. Results 20 321 mother?infant were included in the final analysis. 20 321 pregnant women were (30.09 ± 4.10) years old and delivered at (39.20 ± 1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26 ± 431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre?pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69-2.35) and 4.05 (95%CI: 3.05-5.39), respectively. After adjusting for the age, the pre?pregnancy BMI, delivery weeks, delivery mode and infant's gender, compared to the weight?gain appropriate group, higher weight gain rate in the mid?pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI:1.66-2.39) and 1.80 (95%CI: 1.55-2.08), respectively. Conclusion The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.

Objective To examine the association of pre?pregnancy body mass and weight gain during pregnancy with macrosomia. Methods From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre?pregnancy body mass and gestational weight gain indicators with macrosomia. Results 20 321 mother?infant were included in the final analysis. 20 321 pregnant women were (30.09 ± 4.10) years old and delivered at (39.20 ± 1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26 ± 431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre?pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69-2.35) and 4.05 (95%CI: 3.05-5.39), respectively. After adjusting for the age, the pre?pregnancy BMI, delivery weeks, delivery mode and infant's gender, compared to the weight?gain appropriate group, higher weight gain rate in the mid?pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI:1.66-2.39) and 1.80 (95%CI: 1.55-2.08), respectively. Conclusion The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.

Objective To analyze the clinical characteristics and perinatal outcomes of listeriosis during pregnancy. Methods From July 2010 to April 2017, 70 131 women delivered in West China Second University Hospital.Nineteen cases were confirmed as listeriosis.The clinical symptoms,laboratory results,pathogens,placenta pathology and perinatal outcomes were analyzed retrospectively. Results The median age of the 19 cases was 29.7 (19.0-42.0) years old. The median time before diagnosis was 4.8 (0.5-19.0) days. The main clinical symptoms at first visits were high fever (17/19), increased white blood cells (18/19), abdominal pain (12/19). Listeria was found in samples of mother′s blood (11/19), vaginal secretions(15/19),placenta(1/19),neonatal blood(4/19),neonatal phlegm(5/19)and neonatal ear secretions (1/19),respectively.Inflammation of placenta was identified in all 19 cases.Among the 19 cases,1 was gradeⅠ chorioamnionitis,4 was grade Ⅱ,5 was grade Ⅲand 9 was grade Ⅵ. Only 4 newborn survived after therapy,and others suffered perinatal death,including 8 cases of intrauterine death,3 cases of miscarriage and 6 cases of treatment failure. Conclusions Listeriosis has characteristics of acute onset, quick development and high morbidity during pregnancy. The empiric use of antibiotics might not cover listeria. The understanding of listeriosis should be improved.

Objective To investigate the relationship between sleep status and blood glucose control in the patients withgestational diabetes mellitus (GDM).Methods The pregnant women and parturients clinically newly diagnosed as GDM without starting insulin or glibenclamide treatment were included in this study.The subjects were instructed to correctly use the glucometer and comply with the GDM dietary principles.All subjects recorded the sleep log for consecutive 7 d,including the time going to bed and wake time.The linear mixed model was used to analyze the relationship between the sleep lasting time with morning fasting blood glucose and postprandial 1 h blood glucose level.Results The complete sleep logs of consecutive 7 d and blood glucose detection values were finally collected from 65 subjects.The sleep duration shortening had significantly negative correlation with fasting and postprandial 1 h bloodglucose levels.After adjusting age,gestational age and BMI,every increase 1 h of sleep lasting time,the fasting blood glucose level was significantly decreased,there was significant correlation between them[-2.13 mg/dL,95 ％CI(3.98,-0.20)],meanwhile postprandial glucose level was also decreased,they were significant correlation as well[lunch-4,62 mg/dL,95％CI (-8.75,-0.50) vs.dinner-6.07 mg/dL,95％CI(-9.40,-2.73)].Conclusion The sleep lasting time shortening is closely correlated with poor glucose control in the patients with GDM.Informing GDM patients the importance of sufficient sleep,meanwhile early finding and treating the patients with existing sleep disorder can optimize their blood glucose control level.

OBJECTIVETo assess the association of prostasin gene rs12597511 polymorphism with clinical features and pregnancy outcomes among patients with severe preeclampsia.

METHODSClinical manifestations, pregnancy outcomes and the genotypes of 179 patients with severe preeclampsia [early-onset group (≤34 gestational weeks): 79 cases; Late-onset group (>34 gestational weeks): 100 cases] and 222 normal-term pregnant women (control group) were collected.

RESULTSIn the early-onset group, the patients with TC or CC genotype at rs12597511 had higher incidences of total complications, liver dysfunction, neonatal asphyxia, neonatal intracranial hemorrhage and perinatal mortality compared with those with TT genotype (P>0.05). Multiple logistic regression analysis showed that the complication rates of severe preeclampsia patients are closely related to TC or CC genotypes, 24 h urinary protein and gestational weeks of onset (OR=1.049, 95% CI:1.007-1.093, P=0.021; OR=1.031, 95% CI: 0.350-0.883, P=0.013; OR=0.733, 95% CI: 0.566-0.950, P=0.019), and the perinatal mortality is related to gestational weeks at delivery (OR=0.542, 95% CI: 0.331-0.887, P=0.015).

CONCLUSIONPolymorphism of the prostasin gene is closely associated with poor pregnancy outcomes of early-onset severe preeclampsia.

Adult ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Polymorphism, Single Nucleotide ; Pre-Eclampsia ; enzymology ; genetics ; physiopathology ; Pregnancy ; Pregnancy Outcome ; Serine Endopeptidases ; genetics

Objective To investigate the effects of down-regulation of Beclin 1, which is an autophagy regulatory molecule, expression induced by RNA interference on the proliferation and apoptosis in skin fibroblasts of naked mole rat. Methods The expression levels of Beclin 1 were detected after starvation or H2 O2 treatment.The fibroblasts were transi-ently transfected with specific siRNA targeting Beclin 1 and then screened by real-time PCR and Western blot.Cell prolifer-ation and apoptosis were determined using CCK-8 detection kit and flow cytometry ( FCM ) .The expressions of related genes were detected by Western blot.Results The expression of Beclin 1 gene at mRNA and protein levels was signifi-cantly lower in fibroblasts of the naked mole rat.Starvation and H2 O2 treatment induced changes of the Beclin 1 expression. Inhibition of Beclin 1 gene expression can inhibit cell proliferation and induce early and late apoptosis.The protein levels of p53, BAX, Bcl2, LC3B, p-AKT and mTOR were reduced after transient transfection with Beclin 1-siRNA.Conclusions The expression of Beclin 1 in fibroblasts of naked mole rat are changed in response to starvation or H2 O2 stimulation.Inhi-bition of Beclin 1 gene expression can inhibit cell proliferation and induce apoptosis.Therefore, Beclin1 gene may play a regulatory role in autophagy, proliferation and apoptosis in the skin fibroblasts of naked mole rat.