Objective To investigate the clinical value of Yishen Gujing Kangyan Prescription(with the actions of benefiting the kidneys,consolidating essence and anti-inflammatory,mainly composed of Imperatae Rhizoma,Codonopsis Radix,Corni Fructus,Moutan Cortex,Lycii Fructus,Cuscutae Semen,Dioscoreae Rhizoma,honey-roasted Astragali Radix,Poria,Rehmanniae Radix Praeparata,etc.)in the treatment of lupus nephritis(LN)of qi and yin deficiency type.Methods A total of 116 patients with LN of qi and yin deficiency type were randomly divided into observation group and control group,58 cases in each group.The control group was given conventional western medicine treatment,and the observation group was treated with the combination of Yishen Gujing Kangyan Prescription on the basis of treatment for the control group.Both groups were treated for a period of 6 months.The changes of traditional Chinese medicine(TCM)syndrome scores,renal function parameters,immune function indicators,serum interleukin 18(IL-18),homocysteine(Hcy),transforming growth factor β1(TGF-β1),cystatin C(Cys C)levels in the two groups were observed before and after the treatment.After treatment,the clinical efficacy and the negative-conversion of anti-double-stranded DNA(ds-DNA)antibody were compared between the two groups.Results(1)After 6 months of treatment,the total effective rate of the observation group was 94.83%(55/58),and that of the control group was 75.86%(44/58).The intergroup comparison showed that the therapeutic effect of the observation group was significantly superior to that of the control group(χ2 = 5.453,P＜0.05).(2)After treatment,the scores of primary symptoms(edema,fatigue)and secondary symptoms(lumbar and knee soreness,loose stools)in the two groups were lower than those before treatment(P＜0.05),and the effect on lowering the scores in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the levels of renal function parameters of blood urea nitrogen(BUN),serum creatinine(Scr),and 24-hour urine protein quantification of the two groups were all lower than those before treatment(P＜0.05),and the effect on lowering renal function parameters in the observation group was significantly superior to that in the control group(P＜0.01).(4)After treatment,serum IL-18,TGF-β1,Hcy and Cys C levels of the two groups of patients were all reduced compared with those before treatment(P＜0.05),and the effect on lowering the levels of inflammatory factors and fibrosis parameters in the observation group was significantly superior to that in the control group(P＜0.01).(5)After treatment,the levels of immune function indicators of T cell subsets CD4+,CD4+/CD8+ and complement C3 in the two groups were increased compared with those before treatment(P＜0.05),and the increase in the observation group was significantly superior to that in the control group,and the differences were all statistically significant(P＜0.05 or P＜0.01).(6)The negative-conversion rate of anti-ds-DNA antibody in the observation group was 77.59%(45/58),which was significantly higher than that in the control group(55.17%,32/58),and the difference was statistically significant between the two groups(P＜0.05).Conclusion For the treatment of patients with LN of qi and yin deficiency type,Yishen Gujing Kangyan Prescription exerts synergistic effect on reducing inflammatory response,regulating immune function,promoting the recovery of renal function,and enhancing clinical efficacy.

Objective:To evaluate the incidence of malnutrition in hospitalized patients with liver cirrhosis using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and to identify the risk factors of malnutrition.Methods:A total of 305 inpatients with liver cirrhosis were included from the Department of Gastroenterology of the People's Hospital of Xiangxi Tujia and Miao Autonomous Prefecture between January 1, 2023 to September 30, 2023. The patient characteristics, clinical indicators, complications, unplanned readmission within 90 days and death outcomes were collected. Malnutrition was diagnosed according to the GLIM criteria, the differences in various indicators were compared between the malnutrition group and the well-nourished group, and the influencing factors of malnutrition were analyzed. The relationship between malnutrition and short-term prognosis was also discussed.Results:Among the enrolled patients, 188 (61.6%) were diagnosed with malnutrition per GLIM criteria, of whom 18 were with Child-Turcotte-Pugh (CTP) Grade A liver function, 108 Grade B, and 62 Grade C. Compared with the well-nourished group, the malnutrition group showed prolonged length of hospital stay ( P<0.001), lower body mass index P=0.003), lower levels of red blood cell count, hemoglobin, serum albumin, serum albumin/globulin ratio, and serum calcium ( P<0.001), higher level of aspartate aminotransferase ( P=0.025), and increased levels of C-reactive protein, total bilirubin, international normalized ratio, plasma prothrombin time and model for end-stage liver disease score ( P<0.001). The proportion of patients with ascites, esophageal gastric varices, upper gastrointestinal bleeding, hepatic encephalopathy and unplanned readmission within 90 days were significantly increased ( P<0.001) in malnutrition group, and the mortality within 90 days was also higher ( P=0.042). Logistic regression analysis identified lower body mass index level ( OR=0.910, P=0.038), ascites ( OR=0.065, P<0.001) and upper gastrointestinal bleeding ( OR=0.184, P=0.001) as the influencing factors of malnutrition in liver cirrhosis patients. Conclusions:The prevalent malnutrition in patients with liver cirrhosis may affect the short-term prognosis. Lower body mass index, ascites and upper gastrointestinal bleeding are influencing factors for malnutrition in liver cirrhosis patients. Therefore, patients with liver cirrhosis should be screened for malnutrition to allow timely nutritional intervention measures.

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.
Humans ; Vibrio parahaemolyticus/genetics* ; Diarrhea/epidemiology* ; Foodborne Diseases/epidemiology* ; Serogroup ; Genomics ; Dysentery ; Vibrio Infections/epidemiology* ; Serotyping

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

The present study aimed to explore the regulatory targets and anti-inflammatory mechanism of Jingfang Mixture based on network pharmacology and animal tests. The active ingredients of Jingfang Mixture and the corresponding targets were screened out by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP). Inflammation-related targets were searched from GeneCards and DisGeNET, and the targets of active ingredients of Jingfang Mixture against inflammation were obtained. The protein-protein interaction(PPI) network was analyzed by STRING and plotted. Gene ontology(GO) function and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analyses were carried out based on DAVID. The results of network pharmacology showed 159 active ingredients and 276 targets of Jingfang Mixture and 664 inflammation-related targets were screened out, and 90 targets of active ingredients of Jingfang Mixture against inflammation were obtained. As revealed by the PPI network, protein kinase B1(AKT1), caspase-3(CASP3), interleukin-1β(IL1 B), prostaglandin-endoperoxide synthase 2(PTGS2), and tumor necrosis factor(TNF) might be the key proteins for the anti-inflammatory effect of Jingfang Mixture. KEGG enrichment analysis demonstrated the pathways involved TNF, nuclear factor-kappa B(NF-κB), and mitogen-activated protein kinase(MAPK). The anti-inflammatory effect of Jingfang Mixture was explored through the mouse model of urticaria. The results indicated that Jingfang Mixture could down-regulate the phosphorylation levels of p38 MAPK, extracellular regulated protein kinases(ERK1/2), and NF-κB. The present study revealed the anti-inflammatory effect of Jingfang Mixture with multi-component and multi-target characteristics, which is expected to provide a scientific basis and important support for further research, development, and application.
Animals ; Mice ; Anti-Inflammatory Agents/therapeutic use* ; Cyclooxygenase 2 ; Drugs, Chinese Herbal/therapeutic use* ; Inflammation/drug therapy* ; Medicine, Chinese Traditional ; Molecular Docking Simulation ; Network Pharmacology ; NF-kappa B/genetics*

Aim To explore the factors on behavior patterns of light/dark box(LDB)as an animal model of state anxiety in Kunming mice.Methods The behavior of adult,male,Kunming mice in LDB was recorded for five minutes,respectively.The following parameters were evaluated:percentage of time in the light area(Ltime%),percentage of squares crossing in the light area(Lcross%),percentage of rears in the light area(Lrear%),total number of squares crossing in the whole apparatus(Cross),total number of rears in the whole apparatus(Rear),total(Cross plus Rear),transitions between two areas(Transition),and number of fecal bolis in light box and dark box(Fbs).Subsequently,the factors,such as day-night rhythm,illumination area(L3/5 or L2/5 for ratio between Light box and Dark box:3:2 or 2:3,respectively),illumination color(in Dark box)and illumination intensity(in Light box),were investigated to screen the best experimental conditions.Results t-test showed that compared with night cycle,there was no significant difference in all LDB parameters during day cycle(P>0.05),while compared with 3/5 and 2/5,LDB parameters during day cycle such as Lcross%(t=5.363,P<0.01)in big area light box(L3/5),Lrear%(t=3.211,P<0.05)in small area light box(L2/5)increased statistically.The factorial design ANOVA showed that there was no significant difference in day-night rhythm on all LDB parameters(P>0.05),but a statistical influence of illumination area on Ltime%(F(1,20)=18.361,P<0.01),Lcross%(F(1,20)=49.148,P<0.01)and Lrear%(F(1,20)=8.424,P<0.01).The single factor ANOVA showed that there was significant influence of illumination color in dark box on Real(F(3,20)=3.746,P<0.05),Fbs(F(3,20)=3.585,P<0.05),and illumination intensity in light box on Cross(F(4,25)=2.569,P<0.05)and Total(F(4,25)=2.588,P<0.05).The Dunnett t test showed that compared with red color group,Rear(MD=-30.833,P<0.05)was significantly lower in yellow color group; while Cross(MD=-173.167,P<0.05)and Total(MD=-93.667,P<0.05)in 100 W group declined statistically compared with 15 W Group.Kruskal-Wallis test showed that there was no significant difference in illumination color and intensity on Fbs(P>0.05).Conclusions LDB as an animal model of state anxiety in Kunming mice can evaluate anxiety-,locomotion-exploration and emotionality- related behaviors,which cannot be affected by day-night rhythm,but illumination area(Ltime%,Lcross%,Lrear%),illumination color(Rear)and illumination intensity(Cross,Total).So it is recommended to adopt the uniform and fixed conditions,such as illumination area,color and intensity(less than 100 W).

BACKGROUND: Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease. OBJECTIVE: This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m MAIN OUTCOME MEASURES: The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment. RESULTS: A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group. CONCLUSION: SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone. TRIAL REGISTRATION NUMBER NCT02063100 on ClinicalTrials.gov.

When this paper was first published the following ethical statement was omitted in error: The experiment was conducted in accordance with the welfare and ethical principles of experimental animals and the laws and regulations of experimental animals. Treat animals kindly, respect animal life, no maltreatment and brutality against animals, and take the least painful method to deal with animals. The authors would like to apologise for any inconvenience caused. DOI of original article: https://doi.org/10.1016/j.chmed.2019.03.005

On the basis of systematic evaluation of 32 provincial capital cities and municipalities in their capacity for preventing and controlling emerging infectious diseases, focus analysis is made on Wuhan in relation to its advantages and disadvantages as follows:There has been a legal basis for epidemic prevention according to law, but it has not translated into effective action.There has been an organizational basis for responding to epidemic, but coordination mechanism has not been effectively established.The management mechanism has been complete, but the division of responsibilities among different departments has not been clear.The monitoring network has been set up, but its role of "predictive warning" has not been played.Insufficiency of public health service delivery was observed owing to lack of financial investment.In cities of China, advantages and disadvantages have been both existent in their capacity to prevent and control of emerging infectious disease.We should be vigilant in this regard. It is imperative to "fill defects, stop leaks and strengthen weakness".There is a Chinese saying:"It is not too late to mend a fold after the sheep have been stolen".

The outbreak of COVID-19 has exposed many shortcomings in disease control and prevention system (DCPS) of China. Resolving the problems and strengthening the DCPS became the top priority in China’s public policy agenda. This paper revealed the problems of the system regarding policy-making, regulations, operation mechanism and staff, and proposed several strategies from three aspects of legal construction, management system, and operation mechanism, including: 'Prevention first' should be incorporated into the national legal system, all the departments should be engaged in 'Healthy China 2030' initiative, laws and regulations should be amended, new disease prevention and control management institutions should be set up, a high-quality professional team should be retained, the regional health information exchange channels should be strengthened, the coordinated mechanism for disease prevention and control should be normalized, the long-term investment mechanism should be established, and the equipment renewal and reserve system should be improved.