Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

Objective To explore the treatment effects and mechanism of Fangji Huangqi Xiaozhong Prescription in metabolic syndrome phenotype osteoarthritis(MS-OA)based on PPARγ/NF-κB signaling pathway.Methods SD rats were randomly divided into sham-operation group,OA group,MS-OA group,Western medicine group,and TCM high-and low-dasage groups.The modified Hulth method was used to make the OA model,and OA model was added with high-carbohydrate high-fat diet to make the MS-OA model.TCM high-and low-dosage groups were given 15.12,7.56 g/kg Fangji Huangqi Xiaozhong Prescription for gavage.The Western medicine group was given 16.2 mg/kg of losoprofen sodium by gavage,while the other groups were given physiological saline by gavage once a day for 6 consecutive weeks.Rat body mass was measured,biochemical detection of blood lipids and blood glucose was conducted,ELISA was used to detect the contents of serum TNF-α,IL-1β,IL-10 and leptin,morphological changes in cartilage tissue were observed using safranin O-fixed green and HE staining,immunohistochemical staining was used to detect expressions of Acan,ColⅩ,MMP13,TNF-α,IL-1β and PPARγ in cartilage tissue,Western blot was used to detected the expression of PPARγ,NF-κBp65 and p-NF-κBp65 protein in cartilage tissue.Results Compared with the sham-operation group,body mass and serum TC,TG,LDL-C,TNF-α,IL-1β and leptin of MS-OA group increased significantly(P<0.01),the contents of HDL-C and IL-10 decreased(P<0.01),cartilage tissue degeneration was significant,and the Mankin score increased(P<0.01),the expression of ColⅩ,MMP13,TNF-α,IL-1β,p-NF-κBp65 protein increased(P<0.05,P<0.01),and the expression of Acan and PPARγ protein decreased(P<0.01).Compared with the MS-OA group,the contents of serum TC,TG,LDL-C,TNF-α and leptin decreased in TCM high-dosage group(P<0.05,P<0.01),the content of IL-10 increased(P<0.05),the pathological damage of cartilage tissue improved,the Mankin score decreased(P<0.01),the expressions of ColⅩ,MMP13,TNF-α,IL-1β and p-NF-κBp65 protein in cartilage tissue decreased(P<0.05,P<0.01),and the protein expressions of Acan and PPARγ protein increased(P<0.01,P<0.05).Conclusion Fangji Huangqi Xiaozhong Prescription can improve lipid metabolism disorder,improve intra-articular inflammatory environment,balance cartilage metabolism,and delay cartilage degeneration in MS-OA rats.Its mechanism may be related to the regulation of PPARγ/NF-κB signaling pathway.

A 3-year-old male patient was diagnosed with neurofibromatosis type 1(NF1) for two years. The patient has multiple neurofibromas in retroperitoneum, lumbococcygeal paravertebral, lumbosacral spinal canal, and foramina. Due to retroperitoneal mass compression, the child suffered from urological complications such as hydronephrosis, ureterdilation, neurogenic bladder, etc., which seriously affected the urination function and resulted in multiple surgical treatments. Currently, the patient has been treated with mitogen activates extracelluar signal-regulated kinases(MEK) inhibitor selumetinib targeted therapy, and has voluntarily urinated, and his general state is better than before medication. The diagnosis and treatment of this case reflects the importance of multidisciplinary collaboration in the diagnosis and treatment of rare diseases.

Objective Using olfactory task functional magnetic resonance imaging (fMRI) to investigate the difference in brain olfactory activation between patients with subjective cognitive decline and normal elderly subjects, and to explore the objective image markers for early identification and evaluation the progression from SCD to Alzheimer′s disease (AD). Methods Twenty patients with SCD (SCD group) and twenty matched normal elderly subjects (NC group) were recruited from the community from March 2017 to December 2018. A full neuropsychological scale tests battery, olfactory behavioral tests and olfactory task?fMRI were performed. The differences between olfactory behavior, neuropsychological scales, and task?fMRI brain activation between the two groups were tested. Further, brain regions, which had significantly different activations under task?fMRI, were used as seeds for resting state functional connectivity (FC) analysis. Finally, the correlations between brain activation and olfactory behavior along with clinical neuropsychological scale tests were examined. Results The results of this study showed SCD had a significant decrease in olfactory behavior (olfactory recognition ability) compared with NC (t=-3.042, P<0.01), and there was no statistically significant difference in olfactory threshold. Significant declines were also observed in the SCD self?rating scale (t=6.973, P<0.01), the immediate (t=-4.623, P<0.01) and delayed (t=-2.746, P<0.01) testing of Philadelphia word learning, while the remaining neuropsychological scales were normal. In the olfactory task?fMRI, activation of bilateral primary olfactory cortical regions was significantly reduced in SCD patients, including bilateral entorhinal cortex, amygdala, piriform cortex, anterior olfactory nucleus, and head of the hippocampus. The resting state functional connectivity with the primary olfactory cortex (POC) as the seed showed that the functional connectivity between the olfactory system and the default model network (DMN) of SCD patients was significantly weakened (AlphaSim correction with voxel level P<0.01 and cluster level P<0.05). The Beta value of the left POC was significantly positively correlated with the olfactory threshold and Montreal cognitive assessment (MoCA) (r=0.329, P=0.041; r=0.317, P=0.046). Partial correlation analysis indicated that there was a significantly positive correlation between the FC of the left POC with the right/left inferior frontal gyrus, the left frontal middle gyrus and the right inferior parietal, and the score of immediate Philadelphia word learning test(r=0.411, P=0.008; r=0.400, P=0.011; r=0.329, P=0.003; r=0.454, P=0.003). The FC between the left POC and the right inferior temporal gyrus was negatively correlated with the score of trail making test (TMT) B, and the FC between the left POC and the right inferior was negatively correlated with score of language fluency test (r=-0.317, P=0.047; r=-0.333, P=0.036). The FC between the right POC and the left inferior parietal was positively correlated with the score of immediate Philadelphia word learning (r=0.315, P=0.048), while the FC between right POC and left middle occipital gyrus was negatively corrected with Language Fluency Test (r=-0.403, P=0.01). Conclusion Olfactory function has been impaired in SCD patients with normal standard cognition and phychiatric rating scales, and the changes in the activation of the primary olfactory cortex, such as the entorhinal cortex, may be an early neural circuit damage biomarker for objective evaluation of SCD.

Middle East respiratory syndrome coronavirus (MERS-CoV) was identified as a novel human coronavirus and posed great threat to public health world wide,which calls for the development of effective and safe vaccine urgently. In the study, peptide epitopes tagrgeting spike antigen were predicted based on bioinformatics methods. Nine polypeptides with high scores were synthesized and linked to keyhole limpet hemocyanin (KLH). Female BALB/C mice were immunized with individual polypeptide-KLH, and the total IgG was detected by ELISA as well as the cellular mediated immunity (CMI) was analyzed using ELIs-pot assay. The results showed that an individual peptide of YVDVGPDSVKSACIEVDIQQTFFDKTWPRPIDVSKADGI could induce the highest level of total IgG as well as CMI (high frequency of IFN-γ secretion) against MERS-CoV antigen in mice. Our study identified a promising peptide vaccine candidate against MERS-CoV and provided an experimental support for bioinformatics-based design of peptide vaccine.
Animals ; Antibodies, Viral ; immunology ; Computational Biology ; Coronavirus Infections ; immunology ; prevention & control ; virology ; Female ; Humans ; Immunization ; Mice ; Mice, Inbred BALB C ; Middle East Respiratory Syndrome Coronavirus ; genetics ; immunology ; Peptides ; administration & dosage ; genetics ; immunology ; Spike Glycoprotein, Coronavirus ; administration & dosage ; genetics ; immunology ; Viral Vaccines ; administration & dosage ; genetics ; immunology

Objective To investigate the development strategy of novel T cell based vaccine against HCV infection.Methods BALB/c mice were primed with pSCK-based DNA vaccine and boosted with type 5 adenoviral vector-based vaccine, which expressed the structural proteins ( Core, E1 and E2) de-rived from a Chinese HCV patient (genotype 1b, Hebei strain).Enzyme linked immunospot assay (ELIS-POT) and intracellular cytokine staining ( ICS) were used to analyze the elicited antigen-specific immune re-sponses and the efficacy of cross-protection.Results Immunization of mice with the prime-boost vaccination strategy elicited stronger T cell immune responses against multiple HCV antigens than using the DNA vac-cines alone, especially the IFN-γ-secreting T cell responses against E1 protein as indicated by ELISPOT as-say.ICS data indicated that the prime-boost regimen elicited more TNF-α-producing CD4+and IFN-γ-produ-cing CD8+T cells against E1 protein and high levels of IFN-γ-producing CD4+and CD8+T cells against E2 protein in comparison with immunization with DNA vaccines.Moreover, the prime-boost vaccination was ca-pable of eliciting effective cross-protection in a surrogate challenge model based on a recombinant heterolo-gous HCV (JFH1, 2a) vaccinia virus.Conclusion The prime-boost vaccination using DNA and rAd5-based vaccine expressing HCV structural antigens induced significant cellular immune response and cross-protection in mice, suggesting the possibility of using it as a promising T cell based vaccine against HCV in-fection.

Objective To assess the effect of variable durations of warm ischemia on renal function early after laparoscopic partial nephrectomy ( LPN ) and make the definite safety duration of renal warm ischemia.Methods The clinical data of 76 patients treated with LPN from October 2012 to June 2014 were retrospectively analyzed.The patients were divided into 3 groups based on warm ischemic time,namely group A (28 cases) with warm ischemia time less than 20 min,group B (34 cases) with warm ischemia time more than 20 min and less than 30 min, group C ( 14 cases ) with warm ischemia time more than 30 min.LPN was performed with renal artery clamping alone in all the patients.Preoperative and postoperative renal scintigraphic scan was performed to access glomerular filtration rate ( GFR) in all patients.The GFR values were compared among before, 1 week, 1 month and 3 months after operation.The factors predicting the early renal injury were assessed by multivariate regression analysis.Results The renal GFR of the kidney underwent LPN decreased 19.43(17.70,22.06) ml/min at 1 week,17.04(13.94,20.70) ml/min at 1 month,13.82(10.72,18.73) ml/min at 3 months after the surgery in group C,respectively.In group A, the renal GFR of the operated-side decreased 12.07(10.91,13.42) ml/min,10.04(9.16,11.75) ml/min, 8.44(7.07,9.72) ml/min,respectively.In group B, the renal GFR of the operated-side decreased 13.64 (12.48,16.72) ml/min,10.29(9.17,14.27)ml/min,9.63(7.85,12.59) ml/min,respectively.The GFR decreased greater in group C than that in group A and B(P<0.05).The total renal GFR decreased (10.70 ± 4.93)ml/min at three months in group C,compared with (5.64 ±4.12)ml/min in group A and (6.37 ± 4.32)ml/min in group B,respectively.The decreased value in group C was greater than that in group A and B(P<0.05).However,the differences of the total renal GFR among the 3 groups were not significant at 1 week and 1 month(P>0.05).The multivariate regression analysis revealed that warm ischemia duration was the independent risk factor of the early renal injury.Conclusions Warm ischemia duration is the major factor regarding the early renal recovery after LPN.Warm ischemia time more than 30 min may not only greatly affect the renal function but also the renal function recovery rate.

Objective To investigate the clinical value of serum VEGF levels in the diagnosis and treatment of colon cancer.Methods Serum VEGF was detected by ELISA,and CEA and CA199 concentration were detected by CLEIA in 66 patients with colon cancer,55 patients with colon benign diseases and 50 health persons.The value of individual and joint detection for VEGF in colon cancer was evaluated.Analysis had been done on relationships between serum VEGF and pathology,treatment effects and prognosis.Results The levels of serum VEGF in colon cancer group [(318.5±148.6) ng/L] were significantly higher than those in control group [(125.7±49.4) ng/L] and benign colon diseases [(136.9±52.6) ng/L] (t =8.830,8.805,all P ＜ 0.01).There was a positive correlation between serum levels of VEGF and depth of tumor size,tumor invasion,lymph node metastasis and TNM stage (P ＜ 0.01).The susceptibilities of VEGF,CEA,CA199 were 61％,45 ％,53 ％.The sensitivity of detection was improved to 86 ％ when the combined detection of VEGF,CEA and CA199 (x2 =11.237,P ＜ 0.01).The serum levels of VEGF in patients with colon cancer was significantly decreased after treatment in the 3,7,10 day compared with that before operation [(272.3±88.1),(236.8±77.4),(173.1±59.9) vs (318.5±148.6) ng/L,t=2.173,P ＜ 0.05; t =3.961,P ＜ 0.01; t=7.464,P ＜ 0.01],respectively.Conclusion The VEGF was related to the onset and progression and metastasis of colon cancer.It has clinical significancy for diagnosis of colon cancer and judgment of curative effect and prognosis.

Objective To compare the immune effects of Coxsackievirus B3 (CVB3) capsid protein VP1 expressed bacterially, recombinant adenovirus rAd/VP1 and recombinant plasmid pcDNA3/VP1which express VP1 protein in mice. Methods After expressed in prokaryotic cells, VP1 protein was purified. Recombinant adenovirus rAd/VP1 and recombinant plasmid pcDNA3/VP1 were amplified and extracted. Six to 8-week-old, male BALB/c mice were divided into four groups randomly. Each group contained 18 mice. The mice of pcDNA3/VP1 group or VP1 protein group were immunized intramuscularly with three injections at three weeks apart, of recombinant plasmid pcDNA3/VP1 at a dose of 100 μg/mouse or recombinant protein VP1 at a dose of 50 μg/mouse. The mice of rAd/VP1 group were immunized intramuscularly twice at two weeks interval with rAd/VP1 at a dose of 1.2 × 107 PFU. The control group was mock-immunized with 100 μl of PBS intramuscularly. Mice were bled from the retroorbital sinus plexus every two weeks after each immunization. ELISA and micro-neutralization test were used to detect levels of CVB3-specific IgG antibody and neutralizing antibody titers in the sera of immunized mice. Three weeks after the last immunization, the cytotoxic T lymphocyte(CTL) killing activity of spleen lymphocytes was detected with CCK-8 assay. Subsequently, virus titers in the sera of immunized mice were determined by the 50% cell culture infective dose( CCID50 ) assay on HeLa cell monolayers and percentage of animals surviving were observed after lethal CVB3 attack over a period of 21 days. Results The titers of specific IgG antibody and neutralizing antibody in sera of VP1 protein immunized mice were higher than other groups( P ＜0.05 ). While CTL killing activity of spleen lymphocytes of VP1 protein immunized mice was lower than mice in rAd/VP1 group( P ＜0. 05). Virus titers in sera of VP1 protein immunized mice were lower than the mice in pcDNA3/VP1 or rAd/VP1 groups ( P ＜ 0.05 ), while survival rate was significantly higher than these two groups ( P ＜ 0.05 ).Conclusion VP1 protein induced higher level of humoral immune response and acquired obvious immune protection effects in mice. The immunizing potency of VP1 protein vaccine surpassed plasmid pcDNA3/VP1or recombinant adenovirus rAd/VP1. It appeared to be a promising candidate among the three different vaccines.

Objective To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD). Methods Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss,diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniquks were compared. The proportions of patients with positive findings using each examination were compared. Results Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66. 00% ), the remaining 17 (34.0%)were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85. 29% ); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30% ); SBF was performed in 39 patients and 26 of small bowel lesion were detected (66. 67% ). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0. 006 ). The combinded positive rates of two methods were: CE + CTE 92. 86% (13/14), SBFT + CTE 90. 91% (20/22), CE + ileocolonoscopy 95. 65% (22/23), CE + SBFT100% (17/17), ileocolonoscopy + CTE 89. 66% ( 26/29 ), ileocolonoscopy + SBFT 77.78% ( 28/36 ), but there were no significant differences between each two examinations. Conclusion CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease,whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFF have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.