The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Objective To investigate the feasibility and clinical experience of kidney transplantation from donors with Marfan syndrome (MFS). Methods Clinical data of 2 recipients undergoing kidney transplantation from the same MFS patient were retrospectively analyzed and literature review of 2 cases was conducted. Characteristics and clinical diagnosis and treatment of kidney transplantation from MFS patients were summarized. Results The Remuzzi scores of the left and right donor kidneys of the MFS patient during time-zero biopsy were 1 and 2. No significant difference was observed in the renal arteriole wall compared with other donors of brain death and cardiac death. Two recipients who received kidney transplantation from the MFS patient suffered from postoperative delayed graft function. After short-term hemodialysis, the graft function of the recipients received the left and right kidney began to gradually recover at postoperative 10 d and 20 d. After discharge, serum creatinine level of the recipient received the left kidney was ranged from 80 to 90 μmol/L, whereas that of the recipient received the right kidney kept declining, and the lowest serum creatinine level was 232 μmol/L before the submission date (at postoperative 43 d). Through literature review, two cases successfully undergoing kidney transplantation from the same MFS donor were reported. Both two recipients experienced delayed graft function, and then renal function was restored to normal. Until the publication date, 1 recipient has survived for 6 years, and the other recipient died of de novo cerebrovascular disease at postoperative 2 years. Conclusions MFS patients may serve as an acceptable source of kidney donors. However, the willingness and general conditions of the recipients should be carefully evaluated before kidney transplantation. Intraoperatively, potential risk of tear of renal arterial media should be properly treated. Extensive attention should be paid to the incidence of postoperative complications.

Objective To evaluate the effect of irregular follow-up during normalized prevention and control of novel coronavirus pneumonia (COVID-19) epidemic on BK virus (BKV) reactivation and clinical prognosis of kidney transplant recipients. Methods Clinical data of 363 kidney transplant recipients were retrospectively analyzed, and they were divided into the pre-epidemic follow-up group and during-epidemic follow-up group according to the follow-up time. All patients were followed up for 1 year. The follow-up interval was compared between two groups. The infection of BKV and the correlation between the infection process of BKV and renal graft function were analyzed in two groups. Results A total of 1 790 preson-times were followed up before COVID-19 epidemic and 2 680 during COVID-19 epidemic. Compared with the during-epidemic follow-up group, the follow-up intervals within 3, 3-6 and 7-12 months after kidney transplantation were shorter in the pre-epidemic follow-up group, and the differences were statistically significant (all P<0.05). Within 1 year after kidney transplantation, 35 cases（32%） were diagnosed with BKV viruria, 3 cases（3%） of BKV viremia and 1 case（1%） of BKV-associated nephropathy (BKVAN) in the pre-epidemic follow-up group, and 53（25%）, 3（1%） and 1（1%） in the during-epidemic follow-up group, with no statistical significance (all P>0.05). In the pre-epidemic follow-up group, the time for the initial diagnosis of BKV viruria was longer and the viral load of the first urinary BKV reactivation was smaller than those in the during-epidemic follow-up group, with statistical significance (both P<0.05). The load of the first urinary BKV reactivation was positively correlated with the peak load of urinary BKV, and the differences between the baseline and serum creatinine levels at 1 and 3 months after BKV reactivation (all P<0.05). Conclusions Irregular follow-up after kidney transplantation may lead to early BKV reactivation and higher detection value of the first viral load of urinary BKV, delay diagnosis and interventions, and lead to poor prognosis. It is urgent to establish a remote follow-up system to meet the follow-up requirements of kidney transplant recipients when public health incidents occur.

Octapeptin has strong antibacterial activity against Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii, while it also has activity against some Gram-positive bacteria. This study used natural octapeptin A3 and B3 as lead compounds for structural modification. Twenty-one peptide derivatives (including A3 and B3) containing eight amino acid residues were prepared by solid-phase synthesis, and evaluated for antibacterial activity and renal cytotoxicity. Among them, three compounds 6, 7 and 17 exhibited broad-spectrum antibacterial activity and significantly enhanced the activity for Gram-positive bacteria while maintaining the activity of Gram-negative bacteria. Several compounds improved the activity for Pseudomonas aeruginosa. Compound 7 was active against all test strains and had relatively low renal cytotoxicity. The results provide a basis for the further development of novel polypeptide antibiotics.

Objective To investigate the predictive value of new simplified insulin resistance(IR)assessment indexes in identifying subclinical left ventricular systolic function impairment in patients with type 2 diabetes mellitus(T2DM).Methods A total of 150 T2DM patients with preserved left ventricular ejection fraction(LVEF≥50%)who were admitted to Department of Endocrinology of the First Affiliated Hospital of Air Force Medical University from June 2021 to December 2021 were retrospectively analyzed.All patients underwent two-dimensional speckle tracking echocardiography to measure left ventricular global longitudinal strain(GLS).According to GLS value,the subjects were divided into the normal group(GLS≥18%group,n=80)and the impaired group(GLS<18%group,n=70).Some new simplified IR assessment indicators were calculated and compared between the two groups,including body mass index(BMI),TG/HDL-C ratio,triglyceride-glucose(TyG)index,TyG-BMI index,TyG-WHR and metabolic score for IR(METS-IR).Correlation between the GLS and the new simplified IR assessment indexes was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of different simplified IR assessment indexes,with the area under the curve(AUC)calculated.Furthermore,according to whether the subjects were complicated with hypertension,binary logistics regression analysis was performed to explore the independent correlation between the simplified IR assessment index and GLS<18%.Results Total 150 were included with aged(54.5±13.7)years with 96(64.0%)men and 54(36.0%)women.Compared with the GLS≥18%group,the TG/HDL-C ratio,TyG index,TyG-BMI,and METS-IR of subjects in the GLS<18%group were significantly increased(P<0.05).Pearson correlation analysis showed that TG/HDL-C ratio,TyG index,TyG-BMI,TyG-WHR,and METS-IR were negatively correlated with GLS(P<0.05).ROC analysis showed that TyG index had a certain predictive value for the evaluation of GLS<18%(AUC=0.678,95%CI 0.591-0.765,P<0.001).Stratification based on hypertension and further adjusting for confounding factors,TyG index remains significantly associated with GLS<18%(OR=3.249,95%CI 1.045-10.103,P=0.042).Conclusions The novel simplified insulin resistance evaluation indexes are closely associated with left ventricular subclinical systolic dysfunction in T2DM patients with preserved ejection fraction.TyG index is an effective index to identify left ventricular subclinical dysfunction in these populations.

Objective:To investigate the clinical efficacy of arthroscopic double-row double-pulley technique in the treatment of Ideberg type IA scapular glenoid fracture.Methods:A retrospective case series study was conducted to analyze the clinical data of 16 patients with Ideberg type IA scapular glenoid fracture admitted to Jiading Branch of Shanghai General Hospital from January 2018 to December 2021, including 10 males and 6 females, aged 25-65 years [(42.9±5.1)years]. The patients were treated with arthroscope-assisted reduction and double-row double-pulley technique. The operation time was recorded. Three-dimensional reconstruction of the shoulder joint with CT was performed to assess fracture displacement and healing. Modified University of California Los Angeles (UCLA) score and Constant-Murley score were used to evaluate shoulder function and Visual Analogue Scale (VAS) score was used to evaluate pain before surgery, at 3, 6, 12 months after surgery and at the last follow-up. The complications were observed.Results:All the patients were followed up for 12-36 months [(20.3±4.4)months]. The operation time was 60-90 minutes [(74.7±8.9)minutes]. Three-dimensional construction of the shoulder joint with CT performed at 3 months after surgery showed that there was no fracture re-displacement and all the patients had bone union. The modified UCLA score, Constant-Murley score and VAS score at 3 months after surgery were (30.4±0.4)points, (84.3±1.4)points and 2.0(1.3, 3.0)points, respectively, which were significantly improved compared with those before surgery [(21.1±0.5)points, (56.4±1.3)points and 5.0(5.0, 6.0)points respectively] ( P<0.05). The modified UCLA score, Constant-Murley score and VAS score at 6 months after surgery were (33.1±0.4)points, (91.0±0.5)points and 1.0(1.0, 2.0)]points respectively, which were significantly improved compared with those at 3 months after surgery ( P<0.05). The modified UCLA score, Constant-Murley score and VAS score at 12 months after surgery were (33.5±0.3)points, (92.6±0.6)points and 1.0(0.3, 1.8)points respectively, showing no significant differences from those at 6 months after surgery ( P>0.05). The modified UCLA score, Constant-Murley score and VAS score at the last follow-up were (33.8±0.8)points, (93.7±1.8)points and 1.0(0.0, 1.0)points respectively, with no significant differences from those at 12 months after surgery ( P>0.05). There were no complications such as wound infection, neurovascular injury or shoulder stiffness after surgery. Conclusion:Arthroscopic double-row double-pulley technique for the treatment of Ideberg type IA scapular glenoid fracture has a short operation time, a high fracture healing rate, good shoulder function recovery, and pain relief, with no common complications.

Objective To observe the therapeutic effect and compatibility mechanism of Wumei Wan on diabetic gastroparesis(DGP)mice.Methods Sixty-nine C57BL/6J mice were randomly divided into normal group(12 mice)and model group(57 mice).The DGP model was constructed by 60％high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).After successful modeling,the mice in the model group were randomly divided into model group,Wumei Wan whole prescription group,Wumei Wan sour medicine group,Wumei Wan bitter medicine group,Wumei Wan sweet medicine group and Wumei Wan pungent medicine group,with nine mice in each group.After 28 days of treatment,the gastric emptying rate and small intestinal propulsion rate of mice were measured.The pathological changes of gastric antrum were observed by hematoxylin-eosin(HE)staining.The fasting blood glucose(FBS)of mice was detected by blood glucose meter.The levels of triglyceride(TG),total cholesterol(TC)and low density lipoprotein cholesterol(LDL-C)were detected by colorimetry.The contents of gastrin(GAS),motilin(MTL)and vasoactive intestinal peptide(VIP)in gastric antrum were detected by enzyme-linked immunosorbent assay(ELISA).Western Blot was used to detect the expression of Kelch-like ECH-associated protein 1(Keap-1),nuclear factor erythroid 2-related factor 2(Nrf-2),NAD(P)H:quinone oxidoreductase 1(Nqo-1)and superoxide dismutase 1(Sod-1)in gastric antrum tissue.Results(1)Compared with the normal group,the levels of serum FBS,TG,TC and LDL-C in the model group were significantly increased(P＜0.05 or P＜0.01 or P＜0.001);compared with the model group,the blood glucose level of the whole prescription group,the sour medicine group and the bitter medicine group was decreased significantly at the end of the third and fourth week(P＜0.05 or P＜0.01 or P＜0.001),the serum TG,TC and LDL-C levels of the whole prescription group were significantly decreased(P＜0.05 or P＜0.01),the serum TC level of the sour medicine group,the bitter medicine group,the sweet medicine group and the pungent medicine group was significantly decreased(P＜0.05),and only the LDL-C level of the sour medicine group was significantly decreased(P＜0.05).(2)Compared with the normal group,the glandular cells in the gastric antrum mucosa and submucosa of the model group were disordered;compared with the model group,the pathological damage of gastric antrum tissue in Wumei Wan whole prescription group was significantly improved,the recovery effect of gastric antrum tissue damage in DGP mice in the sour medicine group and the bitter medicine group was superior to that in the sweet medicine group and the pungent medicine group.(3)Compared with the normal group,the gastric emptying rate and small intestinal propulsion rate of the model group were decreased(P＜0.01 or P＜0.001);compared with the model group,the gastric emptying rate of the whole prescription group,the sour medicine group and the bitter medicine group was significantly increased(P＜0.05 or P＜0.001),and the intestinal propulsion rate of the whole prescription group,the sour medicine group,the bitter medicine group,the sweet medicine group and the pungent medicine group was significantly increased(P＜0.05 or P＜0.01 or P＜0.001).(4)Compared with the normal group,the content of VIP in the gastric antrum tissue of the model group was significantly increased(P＜0.01),and the contents of GAS and MTL were significantly decreased(P＜0.01 or P＜0.001).Compared with the model group,the content of GAS in Wumei Wan whole prescription group,the sour medicine group,the bitter medicine group and the sweet medicine group was significantly increased(P＜0.01 or P＜0.001),the content of MTL in the whole prescription group and the bitter medicine group was significantly increased(P＜0.05 or P＜0.01),and the content of VIP in gastric antrum tissue of mice in Wumei Wan whole prescription group,sour medicine group,bitter medicine group and sweet medicine group was significantly decreased(P＜0.05 or P＜0.01 or P＜0.001).(5)Compared with the normal group,the expression level of Keap-1 in the gastric antrum tissue of the model group was increased(P＜0.05),and the expressions of Nrf-2,Nqo-1 and Sod-1 were decreased(P＜0.05 or P＜0.001).Compared with the model group,the expression level of Keap-1 protein in the whole prescription group and the bitter medicine group was significantly decreased(P＜0.05 or P＜0.001),and the expression levels of Nrf-2,Nqo-1 and Sod-1 in the whole prescription group,the sour medicine group and the bitter medicine group were significantly increased(P＜0.05 or P＜0.001).Conclusion Wumei Wan can effectively regulate glucose and lipid metabolism,improve gastric antrum injury and promote gastrointestinal motility in DGP mice.The efficacy of the whole prescription is superior to that of each disassembled prescription.The mechanism may be related to the synergistic compatibility of sour medicine,bitter medicine,sweet medicine and pungent medicine,and mainly through sour medicine and bitter medicine regulating Nrf-2/Keap-1 pathway further to improve oxidative stress injury.

Objective To investigate the influences and mechanism of X chromosome inactivation specific transcript(XIST)on the proliferation and extracellular matrix synthesis of nucleus pulposus cells in rats with intervertebral disc degeneration(IDD).Methods SD rat intervertebral disc nucleus pulposus cells were isolated and cultured in vitro,and then randomly divided cells into control group,model group,XIST knockdown group,empty plasmid group,and XIST knockdown+miR-132-3p knockdown group.Except for control group,the cells in other groups were induced by interleukin(IL)-1β to establish IDD models.After nucleus pulposus cells were grouped and treated,the expressions of XIST and miR-132-3p in the nucleus pulposus cells of rats were detected by qRT-PCR;the proliferation of intervertebral disc nucleus pulposus cells was detected by MTS method and EdU staining;ELISA was used to measure the levels of inflammatory factors IL-6 and IL-18 in the intervertebral disc nucleus pulposus cells;Immunoblotting was used to detect the expression of extracellular matrix labeled proteins Collagen Ⅱ and Aggrecan in rat nucleus pulposus cells.The targeted regulation of miR-132-3p by XIST in rat nucleus pulposus cells was detected by dual-luciferase reporter gene assay.IDD rat models were established by intramuscular injection of IL-1β and divided into sham operation group,model group,XIST knockdown group,no-load plasmid group,XIST knockdown+miR-132-3p knockdown group,with 12 rats in each group.After treatment in each group,the expressions of XIST and miR-132-3p in intervertebral disc tissues were detected by qRT-PCR;TUNEL staining was used to detect apoptosis of nucleus pulposus cells in intervertebral disc tissue of rats;the morphology of intervertebral disc cartilage was observed by saffron O staining;serum levels of inflammatory factors IL-6 and IL-18 were determined by ELISA;the expressions of Collagen Ⅱ and Aggrecan in intervertebral disc tissues were detected by Western blotting.Results Compared with control group(cells)/sham operation group(rats),XIST expression in intervertebral disc tissue and nucleus pulposus cells,apoptosis rate of intervertebral disc nucleus pulposus cells,levels of inflammatory factors IL-6 and IL-18 in intervertebral disc nucleus pulposus cells culture medium and serum were increased in model group(P＜0.05),the activity and proliferation rate of nucleus pulposus cells and the expressions of miR-132-3p,Collagen Ⅱ and Aggrecan protein in nucleus pulposus cells and intervertebral disc tissues decreased(P＜0.05);compared with model group,the apoptosis rate of nucleus pulposus cells,the levels of inflammatory factors IL-6 and IL-18 in intervertebral disc nucleus pulposus cells culture medium and serum,and the expression of XIST in nucleus pulposus cells and intervertebral disc tissues of rats in XIST knockdown group decreased(P＜0.05),the activity and proliferation rate of nucleus pulposus cells and the expressions of miR-132-3p,Collagen Ⅱ and Aggrecan protein in nucleus pulposus cells and intervertebral disc tissues increased(P＜0.05).Down-regulation of miR-132-3p attenuates the ameliorative effect of knockdown XIST on IL-1β-induced intervertebral disc injury and cartilage matrix loss.XIST was able to target and down-regulate the expression of miR-132-3p in rat nucleus pulposus cells.Conclusion Knockdown of XIST can inhibit inflammation by up-regulating miR-132-3p,thereby inhibiting the apoptosis of IDD nucleus pulposus cells and promoting their proliferation and extracellular matrix synthesis.

Objective To observe the value of intratumoral and peritumoral CT radiomics combined with clinical features for preoperative predicting lymphovascular invasion(LVI)of early lung adenocarcinoma.Methods Totally 252 patients with stage Ⅰ-Ⅱa lung adenocarcinoma were retrospectively enrolled and were divided into positive group(n=63)and negative group(n=189)according to LVI or not,also into training set(n=201)and test set(n=51)at a ratio of 8∶2.Clinical data and CT findings being significantly different between groups were included in multivariate logistic regression analysis to screen independent predictors of early lung adenocarcinoma LVI and to construct CT-clinical model.The best radiomics features were extracted and screened in ROI of tumor(ROI1)and outward of 3(ROI2),5(ROI3)and 7 mm(ROI4)with automatic delineation and expanding algorithm,respectively.K-nearest neighbor(KNN),support vector machine(SVM),decision tree(DT),random forest(RF)and logistic regression(LR)algorithms were used to construct radiomics models.The best classifier algorithm and ROI which could provide more effective radiomics information were selected to construct the best radiomics model,which was used to construct the combined model combining with CT-clinical model.Receiver operating characteristic curves were drawn,and the areas under the curves(AUC)were calculated to evaluate the efficacy of the above models for preoperative predicting early lung adenocarcinoma LVI.Results Solid lesion and CT-N+stage were both independent risk factors for early lung adenocarcinoma LVI(both P＜0.05).Peritumor 5 mm volume(GTPV5)was obtained based on ROI3,and the best radiomics model was the model established based on 14 optimal radiomics feature selected from RFGTPV5.AUC of CT-clinical model,RFGPTV5 model and combined model for preoperative predicting early lung adenocarcinoma LVI was 0.875,0.908 and 0.917 in training set,while was 0.831,0.853 and 0.862 in test set,respectively.Conclusion Intratumoral and peritumoral CT radiomics combined with clinical features had good efficacy for preoperative predicting LVI of early lung adenocarcinoma.Intratumor and peritumor 5 mm ROI could provide more valuable information.

Objective To prepare hyaluronic acid(HA)-based reactive oxygen species(ROS)responsive podophyllotoxin(POD)polymeric prodrug micelle HTP-M,and to investigate its inhibitory activity on oral squamous cell carcinoma(OSCC)SCC-9 cells.Methods The HA-based ROS-responsive POD polymeric prodrug HA-TK-POD was synthesized by a two-step esterification method.The polymer prodrug micelle HTP-M was prepared by dialysis method,and its morphological characteristics,particle size,Zeta potential,and drug loading efficiency were measured.Meanwhile,the ROS-responsive drug release was also investigated.The in vitro and in vivo antitumor efficiency of HTP-M micelles was evaluated using SCC-9 cells and SCC-9-tumor-bearing mice as the models.Results The successful synthesis of HA-TK-POD polymer prodrug was confirmed by 1 H-NMR.The obtained HTP-M micelles have a spherical morphology and uniform distribution,and their particle size and zeta potential were(126.1±3.5)nm and(-26.8±1.9)mV,respectively.Moreover,the HTP-M micelles have a high drug loading efficiency(12.3±0.8)%with good ROS responses.HTP-M can specifically target to CD44 overexpression cancer cells,and showed good anticancer effect in vitro and in vivo.Conclusion A ROS-responsive POD polymer prodrug micelle HTP-M based on HA has been prepared in this paper,which has good ROS response and can effectively inhibit the proliferation of OSCC cells and tumor-bearing mice.This work provides a new strategy for the treatment of clinical OSCC.