Exploring the action targets (groups) of traditional Chinese medicine (TCM) is an important proposition to promote the innovation and development of TCM, but it has attracted a lot of attention as to whether it is related to the efficacy or the disease. Our team found that the metabolomic signature molecules in the development of diabetes mellitus (DM) were significantly associated with the clinical efficacy of Yuquan Pill through a large clinical sample study. Taking this as a clue, our team intends to expand the information on the omics features of DM development, and discover the key targets (groups) and their lead compounds for the hypoglycemic effect of Yuquan Pill. The project includes: ① Based on the retrospective clinical trials, using omics technology integrated with generative artificial intelligence, mining the characteristic information of proteome and microbiome, forming driving factors together with metabolome characteristic molecules, and characterizing the molecular trajectories of diabetes evolution and their interference by Yuquan Pill; ② Taking the evolving molecular trajectories as a link and pointer, using anthropomorphic modeling and molecular biology techniques such as chemical proteomics to discover the key targets (groups) of Yuquan Pill's hypoglycemic effect, with the prospective clinical samples for validation; ③ Evaluate the overall response of key targets (groups) using graph neural network technology, and search for drug-derived/endogenous lead compounds with proven clinical pathologies and clear mechanisms of action, so as to provide a new paradigm and technology for the discovery of complex active ingredient targets (groups) of TCM that are related to their clinical efficacy, as well as for the discovery of innovative medicines.

Bexarotene is a synthetic analogue of retinoic acid and exerts protective effects on the nervous system. However, low bioavailability and poor solubility of the crystal type I form severely limits the application of bexarotene in the clinic. A co-amorphous sample of bexarotene-PVP-K30 was prepared and the structure was characterized by X-ray diffraction and infrared spectroscopy. To determine the pharmacokinetics and tissue distribution of bexarotene, an LC-MS method was established to profile and quantify bexarotene in plasma and tissues of SD rats. In vitro dissolution indicated that the co-amorphous form improved the dissolution of bexarotene in pure water 4.17-fold. After rats were orally administered bexarotene or bexarotene-PVP-K30 co-amorphous (equivalent to 30 mg·kg^-1 bexarotene) the AUC of bexarotene was 7 034.89 and 10 174.03 μg·L^-1·h respectively, the peak time was advanced from 7.33 h to 0.9 h with the amorphous form, and C_max was enhanced from 627.76 to 3 011.88 μg·L^-1. The co-amorphous form yielded higher concentrations of bexarotene in various tissues, especially brain, liver and kidney. Animal welfare and experimental procedures complied with the rules of the Animal Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences. The results indicate that bexarotene-PVP-K30 co-amorphous improves the pharmacokinetic characteristics of bexarotene and provides preclinical data in support of bexarotene-PVP-K30 for the treatment of brain diseases.

Objective To evaluate the effects on Stroke Volume Variation (SVV) during ventilation with selective lobar collapse (SLC) and one-lung ventilation (OLV) in thoracoscopic operation. Methods 60 patients scheduled for thoracoscopic operation to treat lower thoracic esophageal cancer or cardial carcinoma were randomly assigned into two groups: patients in one lung ventilation (OLV) group received right lung ventilation and left lung collapses, patients in selective lobar collapse (SLC) group received right lung and superior lobe of left lung ventilation by the use of endobronchial blocker. The intraoperative blood oxygen saturation (SpO2) and end-tidal carbon dioxide tension (PETCO2) were maintained in normal range. Record SVV, cardiac output (CO), stroke volume (SV), systolic blood pressure (SBP), diastolic blood pressure (DBP), the heart rate (HR), cardiac index (CI) at four time points: 10 min after two lung ventilation in supine position (T1), 10 min after two lung ventilation in lateral position (T2), OLV or SLC for 10 min after the pleura was opened (T3), two lung ventilation for 10 min before the pleura was closed (T4). Results There was no statistically significant difference between the two groups (P > 0.05). Comparison between groups: There was no significant difference between the patients in OLV group and SLC group, including HR, SBP, DBP, CO, CI, SV and SVV (P > 0.05). Comparison in the group: SBP and DBP in OLV group and SLC group were significantly higher than T1at T3(P < 0.05). The SVV of OLV group and SLC group was significantly reduced at T3and T4(P < 0.05). Conclusion There was no significant difference in SVV monitoring of Vigileo monitoring with OLV and SLC in thoracoscopic operation. SVV can be used to monitor blood volume state during ventilation by SLC.

Objective To understand the development situation and existing problems of personnel allocation of assistive device institu-tions during the"Twelfth Five-Year"period in Shanghai,China.Methods A questionnaire was designed and a census was conducted to ob-tain the personnel allocation data from district and street level assistive institutions in 2010 and 2014 about age,education background,ma-jor and years of working, etc. Results During the comparison between 2010 and 2014, there was significant difference only on years of working from district level(P<0.01),and there were significant differences on age,education background,major and years of working from street level (χ2≥43.603, P<0.001). The personnel structures in urban districts and suburban districts were significantly different between 2010 and 2014(χ2≥16.166,P<0.001).Conclusion During the"Twelfth Five-Year"period,the construction of talents for assistive device in-stitutions got remarkable achievement in Shanghai,but it is still necessary to strengthen professional training and reduce the difference of structure.

OBJECTIVE: To explore the effects of vinyl chloride monomer( VCM) on the expression of mir-122 in the liver tissue and serum of rat. METHODS: Specific pathogen free adult male SD rats were randomly divided into 4 groups with 24 rats in each group: the control group,the low-,medium- and high-dose groups. The 4 groups were intraperitoneally injected with VCM exposure levels at 0,5,25 and 125 mg / kg body weight 3 times per week,respectively. Eight rats per group were randomly selected and sacrificed after 6,8 and 12 weeks. Small RNA( < 200 nt) in the liver tissue and total RNA in the serum were isolated and purified. Real-time fluorescent quantitative polymease chain reaction technique was used to detect their expressions of mir-122. RESULTS: Compared with the control group and the low-dose group at the same time points,the relative expressions of mir-122 in the liver tissue of rats in the medium- and high-dose groups were significantly increased after exposed to VCM for 6 weeks( P < 0. 05),and then were significantly decreased after exposed to VCM for 12 weeks( P < 0. 05). The relative expressions of mir-122 in the liver tissue of rats in the medium- and highdose groups were decreased with VCM exposure time( P < 0. 05). Compared with the control group at the same time points,the relative expressions of mir-122 in serum of rats in the three dose groups were significantly increased after being exposed to VCM for 8 weeks( P < 0. 05),and then were significantly decreased after being exposed to VCM for 12 weeks(P < 0. 05). Among the three dose groups,the relative expressions of mir-122 in serum of rats after 12-week exposure were lower than those after 6-week and 8-week exposure in the same group respectively( P < 0. 05). CONCLUSION:s The VCM exposure significantly changes the expression of mir-122 in the liver tissue and serum of rat,which suggested that mir-122 may be one of the effect biomarkers for VCM exposure.

OBJECTIVETo study clinical effects of double plates fixation for the treatment of acromion base fracutres.

METHODSFrom January 2010 to May 2012, 7 patients with acromion base fractures were treated with double plates ORIF surgical treatment. There were 5 males and 2 females, with an average age of 36.3 years old (ranged, 24 to 62 years old). All fractures were acuted and closed injuries. The duration from injury to surgery was 4.6 days (ranged, 2 to 10 days). Hardegger functional criterion, Visual Analogue Scale (VAS) and complications of the patients were documented analysis.

RESULTSAll the patients were followed up,and the duration ranged from 4 to 13 months (averaged 8.9 months). The healing duration of fractures ranged from 8 to 14 weeks without any infection, shoulder instability, subacromial impingement syndrome, nonunion and failure of internal fixation. At the latest follow-up, the VAS ranged from 0 to 5. According to Hardegger criterion, 2 patients got an excellent result, 4 good and 1 poor.

CONCLUSIONDouble plates ORIF plays a positive role in the treatment of acromion base fractures, which reduces complications and maximally restore the function of shoulder.

Acromion ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Visual Analog Scale

OBJECTIVETo investigate the operative reduction techniques and clinical results of surgical treatment of type C1 (AO/ASIF) acetabular fracture by posteroproximal-posteroanterior sequential reduction and internal fixation.

METHODSFrom August 2004 to January 2012, 13 patients with type C1 (AO/ASIF) acetabular fracture were treated by posteroproximal-posteroanterior sequential reduction and internal fixation. Of them, 8 cases were male and 5 cases were female with an average age of 42 years years old (ranged, 18 to 64). Pelvis 3-dimentional CT reconstruction were used to confirmed the classification of fracture, and the operation were performed during from 5 to 20 days with an average of 9.5 days. Operation time, blood loss, complications and reduction were recorded and evaluated. The function of hip joint were accessed at the final follow-up.

RESULTSThe operation time ranged from 190 to 290 min with an average of 240 min. The mean blood loss was 1 800 ml (ranged, 1 300 to 3 000 ml). One case had superficial infection and healed after 3 weeks. According to Matta reduction criteria, 8 cases obtained anatomical reduction, 4 cases got satisfied results and 1 cases got unsatisfied results. Eleven cases were followed up with an average of (24.0 +/- 8.0) months, and 2 cases were lost to follow-up. According to revised Mede d'Aubingne and Postel evaluation system, 7 cases got excellent results, 2 good, 1 moderate and 1 poor.

CONCLUSIONPosteroproximal-posteroanterior sequential reduction and internal fixation for the treatment of type C1 (AO/ASIF) acetabular fracture can achieve satisfied surgical proces and operation quality.

Acetabulum ; diagnostic imaging ; injuries ; surgery ; Adolescent ; Adult ; Female ; Fracture Fixation, Internal ; Hip Fractures ; diagnostic imaging ; surgery ; Hip Joint ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Radiography ; Treatment Outcome ; Young Adult

BACKGROUNDHIV transmission between discordant couples has become an important source of new infections in China. To describe the seroconversion rate among serodiscordant couples and to identify salient behavioral and clinical risk factors including ART that affect heterosexual HIV transmission risk among couples in rural China.

METHODSLongitudinal follow-up of an open cohort of HIV serodiscordant couples took place between 2007 and 2011 in Zhumadian, a city in southern Henan province in China, where blood plasma selling in 1990s led to a regional HIV epidemic. Annual follow-up included separate face-to-face interviews of husbands and wives, and HIV antibody testing for non-index partners. Cox proportional-hazard modeling was used to assess the relationship between HIV seroconversion and covariates of interest.

RESULTSBy the end of 2011, 4499 HIV serodiscordant couples had been enrolled in at least two follow-up interviews; 100 non-index partners seroconverted during the entire observation period for an incidence rate of 0.82 per 100 person-years (95% CI: 0.66-0.99). The incidence rates by the end of 2008, 2009, and 2010 were 2.14, 1.51, and 0.90 per 100 personyears respectively. Always using condoms in the past year of sex, gender of the index partner, frequency of sex, and ART exposure were all significant predictors of HIV seroconversion in the negative spouse. ART was highly protective against seroconversion whether the index partner was actively receiving treatment at the last follow-up (RR = 0.05, 95% CI, 0.01-0.16) or if the index partner had ever received ART (RR = 0.01, 95% CI, 0.00, 0.12). The risk of seroconversion in the nonindex spouse also decreased the longer the duration of the index partner's exposure to ART.

CONCLUSIONSART exposure and always using condom were highly protective against HIV seroconversion in the negative spouse. HIV incidence in serodiscordant couples has been decreasing over time, associated with ART treatment time within 7 years in the index partner. Gender of the index spouse and frequency of sex were also important predictors. Treatment as part of a combination prevention package may be a feasible method of HIV control in this population.

Adult ; Aged ; Anti-Retroviral Agents ; therapeutic use ; China ; epidemiology ; Cohort Studies ; Female ; HIV Infections ; drug therapy ; transmission ; HIV Seropositivity ; Heterosexuality ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Risk Factors

OBJECTIVETo evaluate the effects of two gastric cancer screening schemes for early detection of gastric cancer in a high-risk population.

METHODSA cluster random sampling method was used to select local residents aged 40-69 years from Linqu County, Shandong Province. "Serum pepsinogen initial screening combined with further endoscopic examination (PG scheme)" and "direct endoscopic examination (endoscopy scheme)" were conducted. The associations between screening schemes and detection rates of gastric cancer, and early gastric cancer/high-grade intraepithelial neoplasia were evaluated by unconditional logistic regression analysis.

RESULTSOverall, 3654 and 2290 participants completed PG and endoscopy schemes, respectively. A total of 11 (0.30%) cases of gastric cancer and 10 (0.27%) cases of high-grade intraepithelial neoplasia were detected by PG scheme, of which 7 (0.19%) cases were early gastric cancer. While, 19 (0.83%) cases of gastric cancer and 10 (0.44%) cases of high-grade intraepithelial neoplasia were detected by endoscopy scheme, with 12 (0.52%) cases of early gastric cancer. Compared with the PG scheme, the endoscopy scheme had a significantly higher detection rates of gastric cancer (OR = 2.83, 95%CI 1.34-5.98), and early gastric cancer/high-grade intraepithelial neoplasia (OR = 2.12, 95%CI 1.12-4.02).

CONCLUSIONSThe endoscopy scheme is more effective in the detection of gastric cancer in a high-risk population, particularly for early gastric cancer/high-grade intraepithelial neoplasia than the PG scheme.

Adult ; Aged ; Carcinoma ; blood ; diagnosis ; Carcinoma in Situ ; blood ; diagnosis ; Early Detection of Cancer ; methods ; Female ; Gastroscopy ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Pepsinogen A ; blood ; Stomach Neoplasms ; blood ; diagnosis

OBJECTIVETo analyze the clinical manifestation, diagnosis and treatment of Schwartz-Jampel syndrome (SJS).

METHODThe clinical data, including demographic, laboratory tests (creatase, creatine kinase, etc.) and electromyography of 4 children with SJS were analyzed.

RESULTAll the 4 patients were male. The age of onset was from 0.5 to 1.25 years (average 0.83 years). The onset of 4 patients was insidious, the age to see doctor was from 2.17 to 10 years (average 5.92 years), body height was less than the third percentile rank in the children of same age and gender, they presented with facial expression stiffness, microstomia, difficult in opening mouth, blepharophimosis, limbs stiffness and, so formed a characteristic phenotype. Investigations showed the creatase in serum increased, creatine kinase (CK): 229 - 1039 U/L (normal value < 200 U/L), Creatine Kinase MB (CK-MB): 30 - 45 U/L (normal value < 25 U/L), lactate dehydrogenase (LDH): 455 - 716 U/L (normal value < 240 U/L). General myotonia potential was found in electromyography, osteoarticular deformities in medical imaging, and muscle biopsy in 2 patients showed type I muscle fibers differed in size and were disproportionate. All the patients took oral vitamin B, and received rehabilitation training, 1 patient took carbamazepine for 1 month, blepharophimosis and limbs stiffness was improved.

CONCLUSIONSJS is a rare autosomal recessive inherited disease. Clinical manifestations of SJS are characteristic facies, skeletal abnormalities, generous myotonia and short stature. Carbamazepine is effective for treatment.

Child ; Child, Preschool ; Humans ; Male ; Osteochondrodysplasias ; diagnosis ; pathology