Cysathionine γ-lyase (CSE) is a core enzyme for the synthesis of endogenous H

Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.

OBJECTIVE：To identi fy chemical components of Actinidia chinensis root rapidly ，and to provide reference for further material basis and quality control study of the crude medicine. METHODS ：UHPLC-Q-TOF-MS/MS technique was used to detect chemical components of A. chinensis root. The separation was performed on Waters XSelect HSS T 3 column with mobile phase consisted of 0.1％ formic acid acetonitrile solution- 0.1％ formic acid water solution （gradient elution ）at the flow rate of 0.3 mL/min. The column temperature was set at 40 ℃，and sample size was 3 μL. Electrospray ion source was adopted，the data was collected under negative ion mode ；the scanning range was m/z 50-1 500；the drying gas temperature was 350 ℃，the atomizing air pressure was 45 psi，the capillary voltage was 3 500 V，and sheath gas temperature was 350 ℃. According to the information of excimer ion and secondary fragment ion ，the chemical components were identified by combining with the relevant literature ，the retention time of the reference substance and the law of mass spectrometry cracking. RESULTS & CONCLUSIONS ：Totally 58 chemical components was identified ，which included 16 pentacyclic triterpenes （such as hydroxyasiatic acid ，asiatic acid ，maslinic acid，corosolic acid ，oleanic acid ，ursolic acid ，etc.），12 flavonoids（such as rutin ，quercitrin，cynaroside，astragalin，etc.），17 organic acids （such as cryptochlorogenic acid ，chlorogenic acid ，isochlorogenic acid A ，isochlorogenicacid C ，etc.）. There were 9 components（such as procydanidin B 1，B2 and luteolin ，etc.）identified for the first time in A. chinensis root. UHPLC-Q-TOF-MS/ MS technique can be used for the rapid identification of chemical components in A. chinensis root.

Scutellariae Radix is a kind of traditional Chinese medicine, which has the functions of heat-clearing and damp-drying, purging fire and detoxifying, hemostasis and miscarriage prevention. Modern pharmacological studies show that Scutellariae Radix has various effects, such as anti-oxidation, anti-inflammatory, liver protection and antiviral microorganisms. By searching the documents in the past ten years, the author has found that Scutellariae Radix and its active components play an important role in protecting the liver. It can prevent and cure liver injuries caused by different reasons, including acute or chronic hepatitis, liver fibrosis and liver cancer. Among all kinds(chemical, immunological, alcoholic, nonalcoholic, viral, ischemia-reperfusion, etc.) of acute or chronic hepatitis, most studies are on CCl_4 induced chemical liver injury. Scutellariae Radix and its active components can significantly reduce the serum transaminase level in hepatitis animals, and reduce the degree of liver pathological damage. The mechanisms include antioxidant stress, anti-inflammatory, anti-apoptosis, inhibition of immunity, anti-virus and regulation of lipid metabolism, etc. Scutellariae Radix and its active components can significantly inhibit the activation of hepatic stellate cells and reduce extracellular matrix, and its anti-fibrosis mechanism involves antioxidation, anti-inflammatory, inducing apoptosis of hepatic stellate cells and so on. Whether in vivo or in vitro, Scutellariae Radix and its active components show a good anti-hepatocarcinoma effect, especially on hepatocarcinoma. Its prevention and treatment mechanisms for hepatocarcinoma mainly include blocking cancer cell cycle, inhibiting cancer cell metastasis, promoting cancer cell apoptosis and inducing autophagy. It can be seen that Scutellariae Radix has multiple functions and mechanisms in liver protection, and has a great development potential. Therefore, this paper reviews the prevention and treatment effects and mechanism of Scutellariae Radix and its components on different liver diseases, in order to provide reference for in-depth study, development and clinical application in the prevention and treatment of liver disease.
Animals ; Anti-Inflammatory Agents ; Drugs, Chinese Herbal ; Flavonoids ; Medicine, Chinese Traditional ; Scutellaria baicalensis

AIM: To analyze the therapeutic effects of anti-vascular endothelial growth factor(VEGF)drugs on patients with macular edema secondary to central retinal vein occlusion(CRVO-ME)in different age groups.

METHODS: The study retrospectively reviewed 102 patients(102 eyes)with CRVO-ME treated with intravitreal injection of ranibizumab in ophthalmology department of the hospital between February 2017 and March 2019. The subjects were divided into CM1 group(under 50 years old, 50 cases, 50 eyes)and CM2 group(50 years old or older, 52 cases, 52 eyes), and were followed up for 12mo after treatment. The best corrected visual acuity(BCVA), central macular thickness(CMT), intraocular pressure, average injection times, first injection interval, and complications were recorded.

RESULTS: After treatment, the BCVA of both groups was improved, and the CMT decreased. Besides, CM1 group had better BCVA and CMT than CM2 group at 9mo and 12mo(P<0.001). At 1mo, 2mo, and 3mo, the intraocular pressure of both groups was higher than that before treatment(P<0.01). The intraocular pressures of both groups was lower at 6mo and 9mo than at 3mo after treatment(P<0.05), which returned to the pre-treatment level at 12mo(P>0.05). Additionally, CM1 group had lower intraocular pressure than CM2 group at 1mo, 2mo, and 3mo after treatment(P<0.01). The average injection times in CM1 group was(3.24±0.35), more than(2.38±0.26)in CM2 group, and the first injection interval(1.75±0.19mo)was shorter than(4.13±0.42mo)in CM2 group(P<0.01). No serious complications such as cataract aggravation, retinal detachment, and endophthalmitis were observed in the two groups during follow-up.

CONCLUSION: The treatment with anti-VEGF drugs(ranibizumab)for CRVO-ME can significantly improve the patients' visual acuity, and reduce CMT. The condition can be significantly improved within 1mo after injection, without significant influence on intraocular pressure. Compared with patients over 50 years old, patients under 50 years old can obtain better results after treatment with ranibizumab, more significant improvement of visual acuity, significantly thinner CMT, smaller intraocular pressure fluctuations and shorter first injection interval.

Objective     To investigate the early safety and efficacy of transapical transcatheter aortic valve implantation (TAVI) for high-risk elderly patients with pure aortic valve insufficiency. Methods     A prospective multicenter clinical study of domestic J-valveTM TAVI for high-risk native non-calcified aortic valve insufficiency was conducted from April 2014 to May 2018, and the early postoperative results were analyzed. A total of 82 patients were enrolled, including 62 patients from West China Hospital, Sichuan University, 16 patients from Zhongshan Hospital, Fudan University, and 4 patients from Beijing Fuwai Hospital, National Center for Cardiovascular Diseases. There were 55 males and 27 females. The age was 61-90 (73.8±6.3) years. The logistic EuroSCORE was 10.0%-44.4% (17.5%±8.1%). All patients underwent TAVI using J-ValveTM system. Clinical evaluation and echocardiography were performed preoperatively and 1 month postoperatively. Multislice spiral CT was reviewed before discharge. Results     Three patients were transferred to thoracotomy for cardiopulmonary bypass operation, and 1 patient had decreased cardiac function due to leakage of the valve 1 week after surgery. The overall technical and procedural success rate was 95.1% and 93.9%, respectively. During hospitalization, 1 patient died of moderate pericyclosis complicated with multiple organ failure, and 1 patient died of pulmonary infection. Six (7.6%) patients received pacemaker implantation due to new onset Ⅲ° atrioventricular block. Echocardiographic follow-up showed paravalvular leak was observed in the few of patients, mild paravalvular leak was in 13 patients on the 30th day. Two patients showed moderate paravalvular leak. Left ventricular end-diastolic volume decreased from 197.7±66.8 mL (pre-TAVI) to 147.2±53.3 mL (30-day post-TAVI) (P<0.05). Mean pressure gradient was 9.5±4.1 mm Hg (30-day post-TAVI). Conclusion     This multicenter study demonstrates that TAVI with the J-Valve system for the treatment of pure aortic regurgitation is associated with sustained clinical and functional cardiovascular benefits in high-risk patients with symptomatic aortic regurgitation early-term follow-up. Our results further support that TAVI with the specific designed J-Valve system is an acceptable alternative therapy for high-risk patients with pure AR. Our result demonstrates good early-term durability and preserved hemodynamic function. The procedure appears to offer an adequate and lasting resolution for selected patients with pure aortic regurgitation.

Objective To observe the analgesic effect of compound coeruleum methylene blue preparation after thoracoscopic surgery,and to provide a new idea for the choice of analgesic drugs for thoracoscopic patients.Methods The clinical data of 116 patients who underwent selective thoracoscopic surgery in the Department of Cardiothoracic Surgery of Jieyang People's Hospital from January 2016 to May 2018 were analyzed.This study was a prospective study.Research subjects were divided into control group (n =57) and observation group (n =59) by random digital table.In the two groups,no analgesic measures were used in advance,of which the patients in the control group were given the routine injection of piperidine hydrochloride by intramuscular injection after operation.While patients in the observation group were given intercostal nerve block across the upper and lower fibs after operation,and the dosage of compound methylene blue was 1 ml in each rib.on the basis with pethidine hydrochloride.The visual analog score and Ramsay sedation score were compared between the two groups of patients at 4 h,12 h 24 h and 48 h after operation and compared the use of pethidine hydrochloride,adverse drug reactions,ambulation time and hospitalization time.The counting data was expressed in terms of frequency and percentage (％).The measurement data were represented by ((x) ± s).The comparison of different time points within the group was performed by single-factor analysis of variance,and the comparison between the two groups was performed by independent sample t test.Results Compared with the control group's patients [in resting state,12 h:(3.85 ± 1.97) points;24 h:(2.74 ± 1.91) points;48 h:(2.11 ± 1.70) points;in activity state,12 h:(5.02 ± 1.64) points;24 h:(4.89 ± 1.36) points;48 h:(3.83 ± 1.51) points],the VAS scores of the patients in the observation group in resting state [12 h:(2.68 ± 1.24) points;24 h:(1.35 ± 1.16) points;48 h:(0.74 ± 0.63) points] and activity state[12 h:(3.81 ±1.53) points;24 h:(3.25±1.71) points;48 h:(2.42± 1.33)points] were significantly lower at 12 h,24 h and 48h after operation.Compared with the control group's patients 12 h [(2.58 ± 0.41) points] and 24 h [(2.29 ± 0.34) points],the Ramsay scores were significantly higher at 12 h[(2.93 ±0.35)points] and 24 h [(2.79 ±0.30)points] after operation (P＜0.05).The observation group's amount of piperidine hydrochloride was less,and the ambulation and hospitalization time were shorter than the control group's (P ＜ 0.05).The incidence of analgesia-related adverse reactions in the control group and the observation group were 35.09％ and 27.12％,respectively,with no significant difference (P ＞ 0.05).Conclusions Compound coeruleum methylenum's analgesic effect after thoracoscopic surgery is accurate and maintains long time,and the side effects are less and the operation is convenient.It is worthy of clinical application.

Objective: To investigate the effect and related mechanism of homocysteine (Hcy) on calcium overload in neonatal rat atrial cells (NRICs). Methods: NRICs were assigned to 9 groups after culture for 3 days: (1) control group; (2) Hcy group (0, 50, 100, 200, 500 μmol/L for 48 hours); (3) antioxidant group (NAC, 10 μmol/L for 24 hours); (4) Hcy+NAC group (500 μmol/L Hcy for 48 hours, then treated with 10 μmol/L NAC for 24 hours); (5) calcium/calmodulin dependent protein kinase Ⅱδ (CaMKⅡδ) inhibitor group (KN-93, 3 μmol/L KN-93 for 5 hours); (6) specific sodium current inhibitor group (ELE, 1 μmol/L ELE for 5 hours); (7) Hcy+KN-93 group (500 μmol/L Hcy for 48 hours, then treated with 3 μmol/L KN-93 for 5 hours); (8) Hcy+ELE group (500 μmol/L Hcy for 48 hours, then treated with 1 μmol/L ELE for 5 hours; (9) Hcy+KN-93+ELE group (500 μmol/L Hcy for 48 hours, then treated with 3 μmol/L KN-93 and 1 μmol/L ELE for 5 hours). Moreover, NRICs were also treated with CaMKⅡδ-siRNA lentivirus, and Nav1.5-siRNA lentivirus, negative lentivirus carrier containing green fluorescent protein (GFP) for 24 hours. The MOI values of the three groups were 10. Infection efficiency of lentivirus was determined by observing the percentage of GFP fluorescence under inverted fluorescence microscope after transfection for 24 hours, and cultured regularly with simultaneous Puro screening, then cells were grouped as Hcy+CaMKⅡδ-siRNA group, Hcy+Nav1.5-siRNA group and Hcy+negative group. The concentration of Ca²⁺ in NRICs ([Ca²⁺]i) of various groups was detected through Fluo-4/AM fluorescence probe, then 2', 7'- two chlorofluorescein diacetate (DCFH-DA) was used as a probe to detect reactive oxygen species (ROS) in NRICs by flow cytometry. The malondialdehyde (MDA) was detected by the activity of superoxide dismutase (SOD) and xanthine oxidase was detected by thiobarbituric acid colorimetry. The protein and mRNA expression level of CaMKⅡδ and Nav1.5 in NRICs were detected by Western blot and quantitative real-time PCR. Results: (1) ROS, MDA and SOD were similar between NAC group and control group, ROS and MDA were significantly increased, while SOD was significantly reduced in Hcy group in a concentration-dependent manner. (2) [Ca²⁺]i: The level of [Ca²⁺]i was (155.57+7.25), (187.43+13.07), (248.98+27.22) and (307.36+15.09) nmol/L in 50, 100, 200 and 500 μmol/L Hcy groups, which was significantly higher than that in the control group ((123.18+7.24) nmol/L, P<0.01). In addition, the level of [Ca²⁺]i in Hcy+NAC group ((222.87+23.71)nmol/L) was significantly lower than that in Hcy 500 μmol/L group ((305.15+39.45) nmol/L, P<0.05), while [Ca²⁺]i level was similar between NAC group and the control group. (3) The protein expression of CaMKⅡδ and Nav1.5 was significantly upregulated in Hcy groups than in the control group. The protein expression level of CaMKⅡδ-Thr287 was significantly lower in NAC group than in Hcy 500 μmol/L group (P<0.01), however, there was no significant difference on the protein expression levels of CaMKⅡδ-Thr287 and Nav1.5 between NAC group and control group (all P>0.05). (4) The protein expression levels of CaMKⅡδ-Thr287 and the concentration of [Ca²⁺]i were significantly lower in Hcy+KN-93 group and Hcy+KN-93+ELE group than in Hcy 500 μmol/L group (P<0.05). [Ca²⁺]i concentration was significantly lower in Hcy+KN-93 group, Hcy+ELE group and KN-93+ELE+Hcy group than in Hcy 500 μmol/L group (P<0.05). (5) The mRNA and protein expression levels of CaMKⅡδ and Nav1.5 in each group infected with lentivirus: the GFP expression was ideal post lentivirus transfection for 24 hours (up to 90%), which was significantly lower in the CaMKⅡδ-siRNA group and Nav1.5-siRNA group than in the negative infection group (all P<0.05), which was similar between negative infection group and control group (P>0.05). Moreover, the mRNA and protein expression levels of CaMKⅡδ and CaMKⅡδ-Thr287 was significantly lower in Hcy+Nav1.5-siRNA group than in Hcy+negative infection group (P<0.05). The protein and mRNA levels of Nav1.5 were similar between Hcy+CaMKⅡδ-siRNA group and Hcy+negative infection group (P>0.05). Conclusions Hcy can induce calcium overload in NRICs by increasing oxidative stress, upregulating the sodium channel protein, and activating the late sodium current and phosphorylating CaMKⅡδ.

To investigate the expression of microRNA-34a (miR-34a) in patients with chronic lymphocytic leukemia (CLL) in Xinjiang Uygur and Han nationalities and its prognostic significance. Our data showed that miR-34a expression in Uygur and Han CLL patients was significantly higher than that in their respective healthy controls, while miR-34a levels were similar between Uygur and Han patients. By comparing with known prognostic factors, receiver operating characteristic (ROC) curves showed that miR-34a was a good predictive factor for the prognosis of CLL (demarcation value was 3.567 6). Survival analysis was further performed according to miR-34a expression level, that low expression of miR-34a translated into poor prognosis.

OBJECTIVETo study the signal patterns of dual color dual fusion fluorescence in situ hybridization (DCDF-FISH) for detection of genetic abnormality in adult acute lymphoblastic leukemia (ALL) patients and their diagnostic value and clinical application.

METHODSThe clinical data of 68 ALL patients confirmed in our hospital were analyzed retrospectively; The bone marrow samples were detected by DCDF-FISH, flow cytometry, conventional cytogenetics (CCG), reverse transcriptase polymerase chain reaction (RT-PCR), and the correlation of these results was compared. And the reaction of patients to treatment was dynamically observed by DCDF-FISH.

RESULTSSixteen signal patterns were found in DCDF-FISH, including 14 kinds of atypical signal patterns (signal patterns of 1R2G, 2R3G, 2R4G and 3R3G as abnormal signal patterns without BCR/ABL fusion gene. Signal patterns of 1R1G1F, 1R1G3F, 1R1G4F, 1R2G1F, 1R2G2F, 1R2G3F, 1RnG2F (n ≥ 3), 2R2G1F, 1G4F, 1R4F corresponded to t (9;22) karyotype). Ph(+) ALL patients accounted for 17. All cases with Ph chromosome or BCR/ABL positive were B-ALL or My(+)-B-ALL. The Ph chromosome was detected in 12 cases (positive rate was 18%) by CCG. The positive rate was 25% (17/68) by DCDF-FISH and RT-PCR. The DCDF-FISH fluorescence pattern change before and after chemotherapy of the patients showed that the quantity and form of the signal pattern was changed after chemotherapy, and the common characteristics was the Ph chromosome in patients.

CONCLUSIONThe DCDF-FISH is a sensitive and reliable method for the detection of BCR/ABL rearrangement. Analyzing the dynamical change of DCDF-FISH signal patterns has been comfirmed to have a important guiding significance in the diagnosis, and anlysis of response to therapy, drug resistance and the prognosis of ALL patients.

Bone Marrow ; metabolism ; Flow Cytometry ; Fusion Proteins, bcr-abl ; genetics ; Gene Rearrangement ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; genetics ; Reverse Transcriptase Polymerase Chain Reaction