ObjectiveTo compare the protective effects of water extracts from fresh and dried Dendrobium huoshanense on gastric mucosa in chronic atrophic gastritis （CAG）. MethodsMale SD rats （n=72） were randomly divided into 9 groups， with 8 rats in each group， which were normal group， model group， Yangwei Shu （4 g·kg^-1） group， low-， medium-， and high-dose fresh D. huoshanense （3.5， 7， and 14 g·kg^-1） groups， and low-， medium-， and high-dose dried D. huoshanense （0.7， 1.4， 2.8 g·kg^-1） groups. The CAG rat model was successfully established by inducing with N-methyl-N'-nitro-N-nitrosoguanidine （MNNG） and other factors for a total of 11 weeks. Then， the rats were intervened with fresh and dried D. huoshanense for 4 weeks. The serum and gastric tissues of the rats were collected. The changes in gastric juice secretion volume and gastric acid pH value in each group were observed. The gastric mucosal injury was observed by naked eyes and hematoxylin-eosin（HE） staining. The gastric mucus secretion level was determined by Alcian blue and periodic acid-Schiff staining（AB-PAS） staining. The expression levels of tight junction proteins Occludin and ZO-1 in gastric tissues were determined by immunofluorescence. The expression levels of serum pepsinogen Ⅰ （PG Ⅰ）， pepsinogen Ⅱ （PG Ⅱ）， gastrin 17 （G-17）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） were determined by enzyme-linked immunosorbent assay （ELISA）. The expression levels of aquaporin 1 （AQP1）， aquaporin 3 （AQP3）， and aquaporin 4 （AQP4） in gastric tissues were determined by Western blot. ResultsCompared with the normal group， the model group showed an obviously reduced gastric juice secretion volume （P0.05）， significantly increased gastric acid pH value （P0.01）， gastric mucosa with obvious atrophy， and a significantly reduced gastric mucus secretion volume （P0.01）. The expression of Occludin and ZO-1 in the gastric mucosal barrier was significantly decreased （P0.01）. The levels of PG Ⅰ and PG Ⅱ in the serum were obviously decreased （P0.05， P0.01）， and the levels of G-17， IL-1β， IL-6， and TNF-α were significantly increased （P0.01）. The expression level of AQP1 in the gastric tissue was significantly upregulated （P0.01）， and the expression levels of AQP3 and AQP4 were significantly downregulated （P0.01）. Compared with the model group， each drug administration group could improve the gastric mucosal atrophy of CAG model rats to varying degrees， obviously increase the gastric juice secretion volume of the model rats （P0.05， P0.01）， significantly decrease the gastric acid pH value （P0.01）， obviously increase the gastric mucus secretion volume （P0.05， P0.01）， obviously decrease the expression levels of G-17， IL-6， IL-1β， and TNF-α （P0.05， P0.01）， obviously increase the expression levels of Occludin， ZO-1， PG Ⅰ， and PG Ⅱ （P0.05， P0.01）， obviously upregulate the expression levels of AQP3 and AQP4 （P0.05， P0.01）， and obviously downregulate the expression level of AQP1 （P0.05， P0.01）. ConclusionThe water extracts of fresh and dried D. huoshanense can exert therapeutic effects on CAG by improving gastric mucosal injury， reducing inflammation， and regulating water metabolism. Moreover， the dried D. huoshanense has a better effect.

Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective To explore the feasibility and technical tips of the reconstruction of defects around the knee using the reverse-flow thigh flaps based on different branches of the lateral circumflex femoral artery ( LCFA) .A classification method of these flaps was proposed .Methods According to the characteristics of the defects and the LCFA arborizing condition , an optimal reverse-flow thigh flap was chosen for defect reconstruction .Results From 2010 to 2016, 23 patients underwent defect reconstruction using the reverse-flow thigh flaps .The flaps were classified into four different types according to the origin of the perforating vessels on which the flap was based , including the descending ( typeⅠ) , oblique ( typeⅡ) , rectus femoris ( type Ⅲ) , and transverse branches ( type Ⅳ) .In our series of patients , 7 type Ⅰflaps, 10 typeⅡ, 5 typeⅢ, and 1 typeⅣwere included.The reverse flow from the rectus femoris branch was combined and a dual pedicle was formed in 5 patients.The flap size ranged from 8 cm ×7cm to 24 cm × 12 cm.The perforating vessels included septocutaneous in 7 cases and musculocutaneous in the remaining 16.The pedicle length and distance from the pivot point to the superolateral border of the patella were 8.5 cm to 25 cm (mean, 17 cm) and 5 cm to 16 cm (mean, 11.48 cm) respectively.Pre-transfer donor site expansion was conducted in 5 patients.The donor sites were managed by direct closure in 18 cases, free skin grafting in 4, and transferring a pedicled deep inferior epigastric artery perforator flap in the remaining 1.All flaps survived after the surgery except one in which the venous congestion of the flap occurred postoperatively , resolved after using conservative treatment .The patients were followed for 1 to 48 months, tumor recurrence was not noticed and all patients were satisfied with the reconstructive outcomes .Conclusions LCFA-based classification system of the reverse-flow thigh flaps would provide surgeons more options when a defect around knee needs to be reconstructed .

Objective To explore the feasibility and technical tips of the reconstruction of defects around the knee using the reverse-flow thigh flaps based on different branches of the lateral circumflex femoral artery ( LCFA) .A classification method of these flaps was proposed .Methods According to the characteristics of the defects and the LCFA arborizing condition , an optimal reverse-flow thigh flap was chosen for defect reconstruction .Results From 2010 to 2016, 23 patients underwent defect reconstruction using the reverse-flow thigh flaps .The flaps were classified into four different types according to the origin of the perforating vessels on which the flap was based , including the descending ( typeⅠ) , oblique ( typeⅡ) , rectus femoris ( type Ⅲ) , and transverse branches ( type Ⅳ) .In our series of patients , 7 type Ⅰflaps, 10 typeⅡ, 5 typeⅢ, and 1 typeⅣwere included.The reverse flow from the rectus femoris branch was combined and a dual pedicle was formed in 5 patients.The flap size ranged from 8 cm ×7cm to 24 cm × 12 cm.The perforating vessels included septocutaneous in 7 cases and musculocutaneous in the remaining 16.The pedicle length and distance from the pivot point to the superolateral border of the patella were 8.5 cm to 25 cm (mean, 17 cm) and 5 cm to 16 cm (mean, 11.48 cm) respectively.Pre-transfer donor site expansion was conducted in 5 patients.The donor sites were managed by direct closure in 18 cases, free skin grafting in 4, and transferring a pedicled deep inferior epigastric artery perforator flap in the remaining 1.All flaps survived after the surgery except one in which the venous congestion of the flap occurred postoperatively , resolved after using conservative treatment .The patients were followed for 1 to 48 months, tumor recurrence was not noticed and all patients were satisfied with the reconstructive outcomes .Conclusions LCFA-based classification system of the reverse-flow thigh flaps would provide surgeons more options when a defect around knee needs to be reconstructed .

BACKGROUNDTo investigate the diagnostic value of chest CT scan combined with telomerase activity and p16 gene methylation from exfoliated cells of sputum in 55 cases of solitary pulmonary nodules (SPN; ≤30 mm)suspected early peripheral lung cancer.

METHODSThe sputum specimens from 34 cases of cancer nodules and 21 cases of benign lesion were detected for telomerase activity by TRAP-PCR-ELISA and p16 gene methylation by PCR-based methylation analysis.

RESULTSThe qualitative diagnostic accuracy of CT scan was 61.8%(34/55) for SPN provided by pathology. Cytology analysis of sputum was positive in 13 cases (38.2%). Telomerase activity was positive in 29 cases: sensitivity was 79.4%, specificity was 90.5%, accuracy was 83.6%; p16 gene methylation was found in 11 cases: sensitivity was 32.4%, specificity was 100.0%, and accuracy was 58.2%. The sensitivity was increased to 86.1% by combination of telomerase activity and p16 gene methylation. Compared with nodules without malignant CT signs, expression of telomerase activity and p16 methylation of SPN with malignant CT signs (lobulation or spiculate protuberance or spicule sign) had a significant difference (P < 0.01).

CONCLUSIONSThe results suggest that chest CT scan combined with telomerase activity and p16 gene methylation detection in sputum for patients with peripheral lung cancer may enhance the diagnostic value of radiology and conventional cytology.

BACKGROUNDTo investigate the methylation and deletion of p16 gene and its diagnostic value in non-small cell lung cancer.

METHODSA total of 50 lung cancer tissues and 54 normal lung tissues were examined for p16 gene methylation in exon 1 and deletion in exon 2 by PCR based methylation analysis and duplex PCR respectively.

RESULTSOut of 50 lung cancer tissues, 16 were positive for the p16 gene exon 1 methylation (32.0%), and 14 for the p16 gene exon 2 deletion (28.0%). However, in 54 cases of normal lung tissues, only 2 showed the p16 gene exon 1 methylation(3.7%), and none showed the p16 gene exon 2 deletion. There were significant differences in methylation rate (Fisher's exact= 0.000 ) and deletion rate (Fisher's exact= 0.000) between the two groups.

CONCLUSIONSThe methylation and deletion may be important mechanisms for p16 gene inactivation in non-small cell lung cancer. The detection of p16 gene status may contribute to the diagnosis of lung cancer.

BACKGROUNDTo detect the micrometastases status in peripheral blood and regional lymph nodes of lung cancer patients by reverse transcription-polymerase chain reaction (RT-PCR).

METHODSCK19 mRNA expression in peripheral blood and regional lymph nodes was detected in 78 patients with lung cancer, and 30 patients with pulmonary benign lesions and 10 healthy volunteers as controls by RT-PCR. Meanwhile, all lymph nodes were also examined by traditional pathological method.

RESULTSThe positive rate of CK19 mRNA expression was 38.5% in peripheral blood of lung cancer patients, and 6.7% in patients with pulmonary benign lesions (6.7%) (Chi-square=10.505,P=0.001). No positive CK19 mRNA expression was found in peripheral blood of 10 healthy volunteers. The positive rates of CK19 mRNA of lymph nodes were 36.9% and 0 in lung cancer patients and pulmonary benign disease patients respectively (Fisher's exact=0.014). In lung cancer group, the metastatic rate of lymph nodes was 17.9% by traditional pathological examination, which was much lower than that by RT-PCR (Chi-square=7.664, P=0.006).

CONCLUSIONSRT-PCR amplification of CK19 mRNA is an sensitive method to detect early haematogenous and regional lymph nodes dissemination of cancer cells for patients with lung cancer. This method may lead to an earlier diagnosis and treatment of patients with subclinical metastasis in circulation and regional lymph nodes.