1.Design, synthesis and antidiabetic activity studies of purine derivatives
Su-mei SHI ; Hui-lan LI ; Wen-qin LIU ; Xi-de YE ; Shao-kun ZHANG ; Jia-hui LI ; Yuan-ying FANG ; Zun-hua YANG
Acta Pharmaceutica Sinica 2023;58(5):1275-1282
		                        		
		                        			
		                        			 Based our previous work, twelve purine derivatives were designed and synthesized as dual modulators of GPR119 and DPP-4by conjugating the GPR119 activating and DPP-4 inhibiting fragments with the position 6 and 9 of purine core 
		                        		
		                        	
2.HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems.
Ping LI ; Ying WU ; Yan XIE ; Feng CHEN ; Shao qiang CHEN ; Yun Hao LI ; Qing Qing LU ; Jing LI ; Yong Wei LI ; Dong Xu PEI ; Ya Jun CHEN ; Hui CHEN ; Yan LI ; Wei WANG ; Hai WANG ; He Tao YU ; Zhu BA ; De CHENG ; Le Ping NING ; Chang Liang LUO ; Xiao Song QIN ; Jin ZHANG ; Ning WU ; Hui Jun XIE ; Jina Hua PAN ; Jian SHUI ; Jian WANG ; Jun Ping YANG ; Xing Hui LIU ; Feng Xia XU ; Lei YANG ; Li Yi HU ; Qun ZHANG ; Biao LI ; Qing Lin LIU ; Man ZHANG ; Shou Jun SHEN ; Min Min JIANG ; Yong WU ; Jin Wei HU ; Shuang Quan LIU ; Da Yong GU ; Xiao Bing XIE
Chinese Journal of Preventive Medicine 2023;57(7):1047-1058
		                        		
		                        			
		                        			Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.
		                        		
		                        		
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Glycated Hemoglobin
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Diabetes Mellitus/diagnosis*
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			;
		                        		
		                        			ROC Curve
		                        			
		                        		
		                        	
3.Epidemiological Survey of Hemoglobinopathies Based on Next-Generation Sequencing Platform in Hunan Province, China.
Hui XI ; Qin LIU ; Dong Hua XIE ; Xu ZHOU ; Wang Lan TANG ; De Guo TANG ; Chun Yan ZENG ; Qiong WANG ; Xing Hui NIE ; Jin Ping PENG ; Xiao Ya GAO ; Hong Liang WU ; Hao Qing ZHANG ; Li QIU ; Zong Hui FENG ; Shu Yuan WANG ; Shu Xiang ZHOU ; Jun HE ; Shi Hao ZHOU ; Fa Qun ZHOU ; Jun Qing ZHENG ; Shun Yao WANG ; Shi Ping CHEN ; Zhi Fen ZHENG ; Xiao Yuan MA ; Jun Qun FANG ; Chang Biao LIANG ; Hua WANG
Biomedical and Environmental Sciences 2023;36(2):127-134
		                        		
		                        			OBJECTIVE:
		                        			This study was aimed at investigating the carrier rate of, and molecular variation in, α- and β-globin gene mutations in Hunan Province.
		                        		
		                        			METHODS:
		                        			We recruited 25,946 individuals attending premarital screening from 42 districts and counties in all 14 cities of Hunan Province. Hematological screening was performed, and molecular parameters were assessed.
		                        		
		                        			RESULTS:
		                        			The overall carrier rate of thalassemia was 7.1%, including 4.83% for α-thalassemia, 2.15% for β-thalassemia, and 0.12% for both α- and β-thalassemia. The highest carrier rate of thalassemia was in Yongzhou (14.57%). The most abundant genotype of α-thalassemia and β-thalassemia was -α 3.7/αα (50.23%) and β IVS-II-654/β N (28.23%), respectively. Four α-globin mutations [CD108 (ACC>AAC), CAP +29 (G>C), Hb Agrinio and Hb Cervantes] and six β-globin mutations [CAP +8 (C>T), IVS-II-848 (C>T), -56 (G>C), beta nt-77 (G>C), codon 20/21 (-TGGA) and Hb Knossos] had not previously been identified in China. Furthermore, this study provides the first report of the carrier rates of abnormal hemoglobin variants and α-globin triplication in Hunan Province, which were 0.49% and 1.99%, respectively.
		                        		
		                        			CONCLUSION
		                        			Our study demonstrates the high complexity and diversity of thalassemia gene mutations in the Hunan population. The results should facilitate genetic counselling and the prevention of severe thalassemia in this region.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			beta-Thalassemia/genetics*
		                        			;
		                        		
		                        			alpha-Thalassemia/genetics*
		                        			;
		                        		
		                        			Hemoglobinopathies/genetics*
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			High-Throughput Nucleotide Sequencing
		                        			
		                        		
		                        	
4.HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province, China, 2014-2020.
De E YU ; Yu Jun XU ; Mu LI ; Yuan YANG ; Hua Yue LIANG ; Shan Mei ZHONG ; Cai QIN ; Ya Nan LAN ; Da Wei LI ; Ji Peng YU ; Yuan PANG ; Xue Qiu QIN ; Hao LIANG ; Kao Kao ZHU ; Li YE ; Bing Yu LIANG
Biomedical and Environmental Sciences 2023;36(9):800-813
		                        		
		                        			OBJECTIVE:
		                        			This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance (HIVDR) in patients with ART failure from 2014 to 2020 in Hainan, China.
		                        		
		                        			METHODS:
		                        			A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan. We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences. Drug resistance mutations (DRMs) were analyzed using the Stanford University HIV Drug Resistance Database.
		                        		
		                        			RESULTS:
		                        			A total of 307 HIV-infected patients with ART failure were included, and 241 available pol sequences were obtained. Among 241 patients, CRF01_AE accounted for 68.88%, followed by CRF07_BC (17.00%) and eight other subtypes (14.12%). The overall prevalence of HIVDR was 61.41%, and the HIVDR against non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) were 59.75%, 45.64%, and 2.49%, respectively. Unemployed patients, hypoimmunity or opportunistic infections in individuals, and samples from 2017 to 2020 increased the odd ratios of HIVDR. Also, HIVDR was less likely to affect female patients. The common DRMs to NNRTIs were K103N (21.99%) and Y181C (20.33%), and M184V (28.21%) and K65R (19.09%) were the main DRMs against NRTIs.
		                        		
		                        			CONCLUSION
		                        			The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Reverse Transcriptase Inhibitors/therapeutic use*
		                        			;
		                        		
		                        			HIV-1/genetics*
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Phylogeny
		                        			;
		                        		
		                        			Anti-HIV Agents/therapeutic use*
		                        			;
		                        		
		                        			Drug Resistance, Viral/genetics*
		                        			;
		                        		
		                        			HIV Infections/epidemiology*
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Genotype
		                        			
		                        		
		                        	
5.Efficacy and safety of stereotactic body radiotherapy combined with karelizumab and apatinib in treatment of advanced hepatocellular carcinoma
Yan-Wen LEI ; Guang-Cheng DING ; De-Hua QIN ; Yan-Wei GUO ; Hai-Xia WANG ; Jian ZHANG ; Jia-Fu CHEN ; Qing-Zhu LUO ; Wen-Jing GUO
Medical Journal of Chinese People's Liberation Army 2023;48(12):1420-1426
		                        		
		                        			
		                        			Objective To investigate the efficacy and safety of stereotactic body radiotherapy(SBRT)combined with camrelizumab and apatinib in treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data were retrospectively analyzed of 85 patients with advanced HCC treated in the Fifth Affiliated Hospital of Zhengzhou University and People's Hospital of Zhengzhou from January 2019 to September 2021.They were divided into observation group(n=31,SBRT combined with camrelizumab and apatinib)and control group(n=54,treated with camrelizumab and apatinib)according to whether they received SBRT.The propensity score matching(PSM)was used to balance the influence of confounding factors.The objective remission rate(ORR)and disease control rate(DCR)were compared between the two groups.The 6-month overall survival rate,1-year overall survival rate and progression-free survival(PFS)were compared between the two groups by Kaplan-Meier method.The safety of the two groups was evaluated by Common Terminology Criteria for Adverse Events(CTCAE)version 5.0.Results Before PSM,there were significant differences in age(P=0.043),number of extrahepatic metastasis(P=0.028),and previous surgical treatment(P=0.038)between the two groups.After PSM,there was no significant difference in baseline characteristics between the two groups(P>0.05).After PSM,27 cases were included in each groups,and three months after treatment,the ORR in observation group and control group were 66.7%and 29.6%,respectively,showed difference with statistically significant(P=0.006);and the DCR in the both groups were 96.3%and 85.2%respectively,showed no statistically significant difference(P=0.175).There were statistical differences in 6-month overall survival rate(96.3%vs.80.9%,P=0.001),1-year overall survival rate(75.0%vs.61.4%,P=0.034)and median PFS(8 months vs.5 months,P=0.003)between the observation group and control group.Multi-factor Cox regression analysis showed that baseline alpha-fetoprotein(AFP)≥400 ng/ml was an independent risk factor for affecting the survival of patients with advanced HCC(HR>1,P<0.05),while the triple therapy and previous targeted drugs therapy were the protective factors for the survival of patients with advanced HCC(HR<1,P<0.05).In the observation group,4 patients had grade 3 adverse reactions,and the common adverse reactions were dyspepsia(14.8%).One case of grade 3 adverse reactions occurred in control group,and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.639).Conclusion SBRT combined with camrelizumab and apatinib is a safe and effective treatment for advanced HCC with significant clinical effect and controllable adverse reactions.
		                        		
		                        		
		                        		
		                        	
6.A multicenter epidemiological study of acute bacterial meningitis in children.
Cai Yun WANG ; Hong Mei XU ; Jiao TIAN ; Si Qi HONG ; Gang LIU ; Si Xuan WANG ; Feng GAO ; Jing LIU ; Fu Rong LIU ; Hui YU ; Xia WU ; Bi Quan CHEN ; Fang Fang SHEN ; Guo ZHENG ; Jie YU ; Min SHU ; Lu LIU ; Li Jun DU ; Pei LI ; Zhi Wei XU ; Meng Quan ZHU ; Li Su HUANG ; He Yu HUANG ; Hai Bo LI ; Yuan Yuan HUANG ; Dong WANG ; Fang WU ; Song Ting BAI ; Jing Jing TANG ; Qing Wen SHAN ; Lian Cheng LAN ; Chun Hui ZHU ; Yan XIONG ; Jian Mei TIAN ; Jia Hui WU ; Jian Hua HAO ; Hui Ya ZHAO ; Ai Wei LIN ; Shuang Shuang SONG ; Dao Jiong LIN ; Qiong Hua ZHOU ; Yu Ping GUO ; Jin Zhun WU ; Xiao Qing YANG ; Xin Hua ZHANG ; Ying GUO ; Qing CAO ; Li Juan LUO ; Zhong Bin TAO ; Wen Kai YANG ; Yong Kang ZHOU ; Yuan CHEN ; Li Jie FENG ; Guo Long ZHU ; Yan Hong ZHANG ; Ping XUE ; Xiao Qin LI ; Zheng Zhen TANG ; De Hui ZHANG ; Xue Wen SU ; Zheng Hai QU ; Ying ZHANG ; Shi Yong ZHAO ; Zheng Hong QI ; Lin PANG ; Cai Ying WANG ; Hui Ling DENG ; Xing Lou LIU ; Ying Hu CHEN ; Sainan SHU
Chinese Journal of Pediatrics 2022;60(10):1045-1053
		                        		
		                        			
		                        			Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ2=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Brain Abscess
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Escherichia coli
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hydrocephalus
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Meningitis, Bacterial/epidemiology*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Streptococcus agalactiae
		                        			;
		                        		
		                        			Streptococcus pneumoniae
		                        			;
		                        		
		                        			Subdural Effusion
		                        			;
		                        		
		                        			beta-Lactamases
		                        			
		                        		
		                        	
7.Efficacy of fenestrated atrial septal defect occulders on pulmonary hypertension dogs.
Li Fan YANG ; Dan Dan CHEN ; Gao Feng WANG ; Yu Liang LONG ; Qin Chun JIN ; De Hong KONG ; Wen Zhi PAN ; Li Hua GUAN ; Da Xin ZHOU ; Jun Bo GE
Chinese Journal of Cardiology 2022;50(2):166-171
		                        		
		                        			
		                        			Objective: To explore the short-term efficacy of fenestrated atrial septal defect (ASD) occulders in the treatment of pulmonary arterial hypertension (PAH). Methods: Thirty-six healthy dogs were divided into the balloon atrial septostomy (BAS)+fenestrated ASD occulders group (n=12), BAS group (n=12) and non-septostomy group (n=12). PAH was induced by intra-atrial injection of dehydrogenized monocrotaline (1.5 mg/kg) in all dogs. Animals in the BAS+fenestrated ASD occulders group underwent atrial septal puncture and fenestrated ASD occulders implantation. Animals in the BAS group underwent balloon atrial septostomy. The non-septostomy group received no surgical intervention. The hemodynamic indexes and blood N-terminal pro-B-type natriuretic peptide (NT-proBNP) of dogs were measured before modeling, 2 months after modeling, 1, 3, and 6 months after surgery, respectively. Echocardiography was performed to observe the patency of the shunt and atrial septostomy of the dogs in the BAS+fenestrated ASD occulders group and BAS group at 1, 3, and 6 months after surgery. Three dogs were sacrificed in each group at 1, 3, and 6 months after surgery, respectively. Atrial septal tissue and fenestrated ASD occulders were removed to observe the patency and endothelialization of the device. Lung tissues were obtained for hematoxylin-eosin (HE) staining to observe the inflammatory cells infiltration and the thickening and narrowing of the pulmonary arterials. Results: Among 36 dogs, 2 dogs died within 24 hours after modeling, and 34 dogs were assigned to BAS+fenestrated ASD occulders group (n=12), BAS group (n=11), and non-septostomy group (n=11). Compared with BAS group, the average right atrial pressure (mRAP) and NT-proBNP of dogs in the BAS+fenestrated ASD occulders group were significantly reduced at 3 months after surgery (P<0.05), and the cardiac output (CO) was significantly increased at 6 months after surgery, arterial oxygen saturation (SaO2) was also significantly reduced (P<0.05). Compared with non-septostomy group, dogs in the BAS+fenestrated ASD occulders group had significantly lower mRAP and NT-proBNP at 1, 3, and 6 months after surgery (P<0.05), and higher CO and lower SaO2 at 6 months after surgery (P<0.05). Compared with the non-septostomy group, the dogs in the BAS group had significantly lower mRAP and NT-proBNP at 1 month after surgery (P<0.05), and there was no significant difference on mRAP and NT-proBNP at 3 and 6 months after surgery (P>0.05). Echocardiography showed that there was a minimal right-to-left shunt in the atrial septum in the BAS group at 1 month after the surgery, and the ostomy was closed in all the dogs in the BAS group at 3 months after the surgery. There was still a clear right-to-left shunt in the dogs of BAS+fenestrated ASD occulders group. The shunt was well formed and satisfactory endothelialization was observed at 1, 3 and 6 months after surgery. The results of HE staining showed that the pulmonary arterials were significantly thickened, stenosis and collapse occurred in the non-septostomy group. Pulmonary microvascular stenosis and inflammatory cell infiltration in the pulmonary arterials were observed in the non-septostomy group. Pulmonary arterial histological results were comparable between BAS+fenestrated ASD occulders group and non-septostomy group at 6 months after surgery . Conclusions: The fenestrated ASD occulder has the advantage of maintaining the open fistula hole for a longer time compared with simple balloon dilation. The fenestrated ASD occulder can improve cardiac function, and it is safe and feasible to treat PAH in this animal model.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Atrial Septum/surgery*
		                        			;
		                        		
		                        			Cardiac Catheterization/methods*
		                        			;
		                        		
		                        			Dogs
		                        			;
		                        		
		                        			Familial Primary Pulmonary Hypertension
		                        			;
		                        		
		                        			Heart Septal Defects, Atrial/surgery*
		                        			;
		                        		
		                        			Hypertension, Pulmonary
		                        			;
		                        		
		                        			Pulmonary Arterial Hypertension
		                        			
		                        		
		                        	
8.Comparative study of three scores in predicting the death risk of severe burn patients.
Zhi Qin XIE ; Guang Hua GUO ; Zhen YANG ; Han Xiao YI ; Shui Lian WANG ; Xin Rong TANG ; De Guang LIU ; Yan De ZENG
Chinese Journal of Burns 2022;38(2):184-189
		                        		
		                        			
		                        			Objective: To explore the predictive values of the modified Baux score, Belgian Outcome in Burn Injury score, and Ryan score on the death risk of severe burn patients. Methods: A retrospective case series study was conducted. From February 2018 to November 2019, 260 severe burn patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University, including 158 males and 102 females, aged 36 (3, 53) years. According to the final outcome, the patients were divided into survival group (n=229) and death group (n=31). Data of patients were compared and statistically analyzed with chi-square test or Mann-Whitney U test between the two groups, including the gender, age, cause of burn, site of burn, total burn area, depth of burn, combined inhalation injury, and combined underlying diseases on admission, and the modified Baux score, Belgian Outcome in Burn Injury score, and Ryan score calculated based on part of the aforementioned data. The Kendall tau-b coefficient method was used to analyze the consistency of the above-mentioned three scores in 260 severe burn patients. The receiver operating characteristic (ROC) curves of the above-mentioned three scores predicting the death risk of 260 severe burn patients were drawn, and the area under the curve (AUC), the optimal threshold, and the sensitivity and specificity under the optimal threshold were calculated. The quality of AUC of the above-mentioned three scores was compared by Delong test. Results: The gender, site of burn, and depth of burn of patients between the two groups were all similar (P>0.05). The age, total burn area, proportion of flame burn, proportion of combined inhalation injury, and proportion of combined underlying diseases of patients in death group were significantly higher than those in survival group (with Z values of 5.53 and 17.78, respectively, χ2 values of 16.23, 15.89, and 17.78, respectively, P<0.01); the modified Baux score, Belgian Outcome in Burn Injury score, and Ryan score of patients in death group were 142 (115, 155), 7 (5, 7), 2 (2, 3), all significantly higher than 64 (27, 87), 1 (0, 3), 0 (0, 1) in survival group (with Z values of 7.91, 7.64, and 7.61, respectively, P<0.01). In 260 severe burn patients, the results between the modified Baux score and Ryan score, modified Baux score and Belgian Outcome in Burn Injury score, Ryan score and Belgian Outcome in Burn Injury score were significantly consistent (with Kendall tau-b coefficients of 0.75, 0.71, and 0.86, respectively, P<0.01). The AUCs of ROC curves of the modified Baux score, Belgian Outcome in Burn Injury score, and Ryan score for predicting the death risk of 260 severe burn patients were 0.92, 0.89, and 0.85, respectively (with 95% confidence intervals of 0.86-0.98, 0.83-0.95, and 0.78-0.93, respectively, P<0.01); the optimal thresholds were 106.5, 4.5, and 1.5 points, respectively; the sensitivity under the optimal threshold were 88.5%, 76.9%, and 73.1%, respectively, and the specificity under the optimal threshold were 88.5%, 87.2%, and 86.3%, respectively. The modified Baux score was similar to Belgian Outcome in Burn Injury score in the AUC quality (z=1.25, P>0.05), which were both significantly better than the AUC quality of Ryan score (with z values of 2.35 and 2.11, respectively, P<0.05). Conclusions: The modified Baux score, Belgian Outcome in Burn Injury score, and Ryan score have good ability in predicting the death risk of severe burn patients. From the perspective of clinical practice, the modified Baux score is more suitable as a predictive tool for the prognosis of severe burn patients.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Burns
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hospitalization
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Prognosis
		                        			;
		                        		
		                        			ROC Curve
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
9.Views on Key Technical Problems in Research and Development of Famous Classical Formulas
Zhi-min WANG ; Ju-yan LIU ; De-qin WANG ; Chun LI ; Li-hua YAN ; Xiao-qian LIU ; Wei-hong FENG ; Hui-min GAO ; Yan TONG ; Jing-jing ZHU ; Yan-hui KUANG ; Liang-mian CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(1):212-217
		                        		
		                        			
		                        			In this paper, the key technical problems in the research and development of famous classical formulas are analyzed. Firstly, the puzzled problem for a long-time, which is conversion relationship from medicinal metrology of Han dynasty (HD) to that of modern (gram,g), is comprehensively expounded that one Liang (两) of HD=3 g is more appropriate. Secondly, the model and principles of quality consistency evaluation are given for the transformation from the quality of authoritative basic sample prepared by casserole (ABS-C) to the quality consistency in Laboratory process, pilot-scale process and industrial production. The consistency evaluation model is ξABS-X=K1(Q1ABS-X/Q1ABS-C)+K2(Q2ABS-X/Q2ABS-C)+……+Ki(QiABS-X/QiABS-C)=∑Ki(QiABS-X/QiABS-C)(i=1,2,3……n). In the formula, ABS-X means laboratory reference sample ABS-C (ABS-L), pilot-scale ABS-C (ABS-mP) or industrial production ABS-C (ABS-P), ξABS-X means the quality consistency rate or similarity degree of ABS-L, ABS-mP and ABS-P processes with ABS-C, Ki means the weight of each quality evaluation index (i), QiABS-X is the data of i in ABS-L, ABS-mP, ABS-P samples, and QiABS-C is the data (or mean) of i in ABS-C sample. Thirdly, in order to control the quality of the herbal medicines whose active ingredients were unknown, their chemical constituents should be studied deeply, and if necessary, the bioassay research should be carried out according to the main efficacy or indication of famous classical formulas. Finally, for the special processing of some herbal medicines, it is difficult to formulate the processing method, technology and standard of prepared slices. It is suggested that the scientific connotation and historical evolution of the special processing method should be thoroughly sorted out, and its technological characteristics are summarized, the modern processing technology and production processes are simulated, and then the corresponding processing methods and quality standards are formulated. 
		                        		
		                        		
		                        		
		                        	
10.Herbal Textual Research on Zingiberis Rhizoma Recens in Famous Classical Formulas and Its Quality Evaluation
Jie GUO ; Shan JIANG ; Yue WANG ; Jia FAN ; Xiao-qian LIU ; Li-hua YAN ; Zhi-min WANG ; Yan-hui KUANG ; De-qin WANG ; Wen-ying LUO
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(2):27-37
		                        		
		                        			
		                        			ObjectiveTo provide references for the selection of Zingiberis Rhizoma Recens on the research of famous classical formulas and the reasonable uses for medicines and foods through herbal textural research and quality analysis of Zingiberis Rhizoma Recens from main producing areas in China. MethodBy consulting the ancient and modern literature, the name, origin, producing areas, harvest time, processing methods of Zingiberis Rhizoma Recens were summarized. According to the 2020 edition of Chinese Pharmacopoeia, the contents of 6-gingerol, 8-gingerol, 10-gingerol, and volatile oil in Zingiberis Rhizoma Recens samples were determined. ResultHerbal textural research indicated that medicinal Zingiberis Rhizoma Recens originated from the fresh rhizome of Zingiber officinale. Before Tang dynasty, Zingiberis Rhizoma Recens produced in Sichuan was the best. In the Song dynasty, Zingiberis Rhizoma Recens produced in Sichuan, Zhejiang, and Anhui was of excellent quality. The cultivation of Zingiberis Rhizoma Recens in Shandong developed during the Ming and Qing dynasties. From ancient times to the present, the harvest period extended from the autumnal equinox to the winter solstice. Quality evaluation standards of Zingiberis Rhizoma Recens were essentially the same in ancient and present documents, as those with little gluten or gluten-free and strong pungency were preferred. After determination, the contents of 6-gingerol, 8-gingerol, and 10-gingerol in 44 samples were qualified in 27 samples, with a qualified rate of 61.4%. Among them, 17 samples were unqualified in the total contents of 8-gingerol and 10-gingerol. Among these qualified samples, the content of 6-gingerol ranged from 0.067% to 0.255%, and the total contents of 8-gingerol and 10-gingerol ranged from 0.040% to 0.131%. The content of volatile oil in 36 samples were qualified in 33 samples, with a qualified rate of 91.7%. Among the qualified samples, the content of volatile oil ranged from 0.175% to 0.410%. ConclusionZingiberis Rhizoma Recens has been used as medicines and foods since ancient times, and the genuine producing areas are consistent in ancient and present times, while the quality of the products, especially the medicinal Zingiberis Rhizoma Recens, should be monitored. Medicinal Zingiberis Rhizoma Recens planted in Leshan city of Sichuan province contains high contents of effective components, followed by Qujing and Wenshan cities of Yunnan province. Zingiberis Rhizoma Recens planted in Shandong and other places is mostly edible. 
		                        		
		                        		
		                        		
		                        	
            
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