INTRODUCTION:Infectious diarrhea (ID) is a highly prevalent disease worldwide that poses a substantial risk to human well-being. In China, numerous clinical studies have investigated the efficacy of Gegen Qinlian decoction (GGQLD) in treating ID. However, there is a need for additional rigorous and evidence-based medical research to enhance physicians' confidence in their prescribing practices. METHODS:Seven Chinese and English databases were systematically searched. The Cochrane Risk of Bias tool was used to assess the quality of the included studies. Meta-analysis was conducted using RevMan 5.3, and Stata 16.0 was used for the sensitivity analysis. Trial sequential analysis was performed using TSA v0.9, and GRADEprofiler was utilized to evaluate the quality of evidence. RESULTS:A total of 12 randomized controlled trials (RCTs) involving 1,240 patients were included. The meta-analysis demonstrated that the combination of GGQLD with conventional Western medicine had better effects on clinical efficacy (relative risk [RR] = 1.15, 95% confidence interval [CI] [1.10, 1.20]), duration of diarrhea symptoms (weighted mean difference [WMD] = -10.96, 95% CI [-11.97, -9.96]), duration of abdominal pain symptoms (WMD = -12.01, 95% CI [-14.12, -9.90]), duration of fever symptoms (WMD = -11.91, 95% CI [-13.39, -10.43]), interleukin-6 levels (WMD = -113.59, 95% CI [-113.03, -108.14]), and tumor necrosis factor-α levels (WMD = -62.18, 95% CI [-65.25, -59.11]) and that no significant adverse reactions occurred (RR = 0.45, 95% CI [0.10, 1.97]). The sample size of the included studies reached the expected size. The quality of evidence for outcome indicators was rated as low or very low. CONCLUSIONS:The combination of GGQLD with conventional Western medicine demonstrates promising efficacy and safety in treating ID. Nonetheless, more high-quality RCTs are required to confirm this conclusion.

BackgroundBaitouweng decoction (BTW) is a classic botanical drugs formula that has been widely used clinically for the treatment of gut-related disorders in China. However, its role in ameliorating ulcerative colitis (UC) remains to be explored.PurposeThe study aimed to determine the therapeutic efficacy and potential mechanism of action of BTW on dextran sodium sulfate (DSS)-induced colitis mice.MethodsIn vivo: 3.5% DSS-induced experimental colitis mice were treated with BTW (Pulsatilla chinensis (Bunge) Regel, Phellodendron chinense C. K. Schneid, Coptis chinensis Franch and Fraxinus chinensis Roxb), kynurenine or DOPA decarboxylase (DDC) inhibitor (carbidopa). In vitro: Caco-2 cells were stimulated with TNF-α to activate inflammation and later treated with various concentrations of BTW and carbidopa. Model evaluation included body weight, disease activity index (DAI) score, colon length and histopathology. Cytokine levels were measured by flow cytometry. Protein levels were analyzed by proteomics and functionally annotated. The levels of tryptophan metabolites in mouse serum and colon were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Alcian Blue/Phosphate Acid Schiff (AB/PAS) staining, immunohistochemistry and western blot were used to assess the intestinal barrier function and detect the protein expression levels.ResultsBTW significantly reduced the DAI, ameliorated colonic injury and regulated inflammatory cytokines in DSS-induced colitis mice. The botanical drugs formula also promoted intestinal epithelial barrier repair by enhancing the expression of the tight junction (TJ) proteins. Tryptophan metabolic signaling pathway was significantly enriched in DSS-induced UC mice, and BTW decreased the level of kynurenine, increased indole metabolites. The therapeutic effect of BTW was evidently reduced when kynurenine was given to mice. Also, BTW promoted DDC protein expression and activated the aryl hydrocarbon receptor (AHR)/IL-22 signaling pathway.ConclusionBTW improves ulcerative colitis by promoting DDC expression, regulating the conversion of tryptophan metabolism from the kynurenine pathway to the indole metabolism pathway, thereby modulating tryptophan metabolism to increase indole metabolites, and activating AHR receptors to restore intestinal barrier function.

Xing 9 Ling tablet candy (X9LTC) effectively treats alcoholic liver disease (ALD), but its potential mechanism and molecular targets remain unstudied. We aimed to address this gap using network pharmacology. Furthermore, high-performance liquid chromatography (HPLC) and database analysis revealed a total of 35 active ingredients and 311 corresponding potential targets of X9LTC. Protein interaction analysis revealed PTGS2, JUN, and FOS as its core targets. Enrichment analysis indicated that chemical carcinogenesis-receptor activation, IL-17 and TNF signaling pathway were enriched by multiple core targets, which might be the main pathway of action. Further molecular docking validation showed that the core targets had good binding activities with the identified compounds. Animal experiments showed that X9LTC could reduce the high expression of ALT, AST and TG in the serum of ALD mice, alleviate the lesions in liver tissues, and reverse the high expression of PTGS2, JUN, and FOS proteins in the liver tissues. In this study, we established a method for the determination of X9LTC content for the first time, and predicted its active ingredient and mechanism of action in treating ALD, providing theoretical basis for further research.

Background: Fine particulate matter (PM2.5) has been implicated in various health concerns. However, a comprehensive understanding of the specific PM2.5 components affecting depression remains limited. Methods: This study conducted a Cox proportional-hazards model to assess the effect of PM2.5 components on the incidence of depression based on the China Health and Retirement Longitudinal Study (CHARLS). Participants with 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) score of 10 or higher were classified as exhibiting depression. Results: Our findings demonstrated a significant positive correlation between long-term exposure to black carbon (BC), sulfate (SO42-), and organic matter (OM) components of PM2.5 and the prevalence of depression. Per 1 Interquartile Range (IQR) increment in 3-year average concentrations of BC, OM, and SO42- were associated with the hazard ratio (HR) of 1.54 (95 % confidence intervals (CI): 1.44, 1.64), 1.24 (95%CI: 1.16, 1.34) and 1.25 (95%CI: 1.16, 1.35). Notably, females, younger individuals, those with lower educational levels, urban residents, individuals who were single, widowed, or divorced, and those living in multi-story houses exhibited heightened vulnerability to the adverse effects of PM2.5 components on depression. Limitations: Firstly, pollutant data is confined to subjects' fixed addresses, overlooking travel and international residence history. Secondly, the analysis only incorporates five fine particulate components, leaving room for further investigation into the remaining fine particulate components in future studies. Conclusions: This study provides robust evidence supporting the detrimental impact of PM2.5 components on depression. The identification of specific vulnerable populations contributes to a deeper understanding of the underlying mechanisms involved in the relationship between PM2.5 components and depression.

This paper aimed to study the effect of Dalbergia cochinchinensis heartwood on plasma endogenous metabolites in rats with ligation of the left anterior descending coronary artery, and to analyze the mechanism of D. cochinchinensis heartwood in improving acute myocardial ischemic injury. The stability and consistency of the components in the D. cochinchinensis heartwood were verified by the establishment of fingerprint, and 30 male SD rats were randomly divided into a sham group, a model group, and a D. cochinchinensis heartwood(6 g·kg~(-1)) group, with 10 rats in each group. The sham group only opened the chest without ligation, while the other groups established the model of ligation. Ten days after administration, the hearts were taken for hematoxylin-eosin(HE) staining, and the content of heart injury indexes in the plasma creatine kinase isoenzyme(CK-MB) and lactate dehydrogenase(LDH), energy metabolism-related index glucose(Glu) content, and vascular endothelial function index nitric oxide(NO) was determined. The endogenous metabolites were detected by ultra-high-performance liquid chromatography-time-of-flight-mass spectrometry(UPLC-Q-TOF-MS). The results showed that the D. cochinchinensis heartwood reduced the content of CK-MB and LDH in the plasma of rats to relieve myocardial injury, reduced the content of Glu in the plasma, improved myocardial energy metabolism, increased the content of NO, cured the vascular endothelial injury, and promoted vasodilation. D. cochinchinensis heartwood improved the increase of intercellular space, myocardial inflammatory cell infiltration, and myofilament rupture caused by ligation of the left anterior descending coronary artery. The metabolomic study showed that the content of 26 metabolites in the plasma of rats in the model group increased significantly, while the content of 27 metabolites decreased significantly. Twenty metabolites were significantly adjusted after the administration of D. cochinchinensis heartwood. D. cochinchinensis heartwood can significantly adjust the metabolic abnormality in rats with ligation of the left anterior descending coronary artery, and its mechanism may be related to the regulation of cardiac energy metabolism, NO production, and inflammation. The results provide a corresponding basis for further explaining the effect of D. cochinchinensis on the acute myocardial injury.

目的 探讨pipeline栓塞装置(PED)治疗大脑中动脉(MCA)动脉瘤的临床效果.方法 回顾性分析2014年11月至2019年10月我国14个临床中心采用PED治疗的33例MCA动脉瘤的临床资料、影像学资料和随访资料.结果 33例共39个动脉瘤,使用37个PED.33例完成临床随访,30例(36个动脉瘤)完成影像随访;随访时间4～22个月,平均(10.6±6.3)个月;动脉瘤完全或近全闭塞30个(83.3％,30/36);相对于单纯PED治疗组(71.4％),PED辅助弹簧圈栓塞组动脉瘤闭塞率更高(100％;P= 0.031);预后不良(mRS评分>2分)3例(9.1％),预后良好(mRS评分≤2分)30例(90.9％);术后并发症发生率为24.2％(8/33),术前规律服用双抗药物3d以上病人术后并发症发生率明显低于未规律服用双抗药物的病人(P=0.033).结论 MCA动脉瘤可以采用PED治疗,疗效较满意.对于直径大、形态不规则的MCA动脉瘤,可使用PED结合弹簧圈栓塞治疗以获得更高的闭塞率.术前、术后应规范应用双抗药物以减少缺血、出血并发症.

目的 分析 Pipeline血流导向装置(PED)治疗后循环颅内动脉瘤的临床效果.方法 回顾性分析2014 年11 月至2019 年10 月期间中国 14 个临床中心连续纳入的接受PED治疗的后循环颅内动脉瘤患者(156 例,共162 个动脉瘤)的临床资料,按照解剖位置分为椎动脉瘤组和基底动脉瘤组.对比两组患者的一般资料(性别、年龄、烟酒史及既往史)、动脉瘤特点(动脉瘤部位、最大径和瘤颈宽、载瘤动脉直径、动脉瘤形状、是否破裂及是否多发)、治疗情况(重叠PED治疗、弹簧圈辅助栓塞、球囊辅助)、治疗结局(支架贴壁、术后即刻完全闭塞、是否覆盖分支血管)和术后并发症(围手术期和随访期出血、缺血及压迫症状)发生情况,并通过倾向性得分匹配控制混杂因素后对比动脉瘤闭塞效果.依据术后是否发生缺血并发症将所有患者分为缺血并发症组与无缺血并发症组,比较两组患者动脉瘤的特征及治疗结果.结果 椎动脉瘤组129 例,共133 个动脉瘤;基底动脉瘤组27 例,共29 个动脉瘤.两组患者一般资料差异均无统计学意义(均P＞0.05);与椎动脉瘤组比较,基底动脉瘤组动脉瘤最大径更大[14.00(9.00,22.00)mm比 9.76(7.08,13.25)mm,Z =2.921,P =0.003],弹簧圈辅助栓塞治疗比例更高[55.2％(16/29)比 21.1％(28/133),χ2 = 14.010,P＜0.01],术后即刻完全闭塞率更高[24.1％(7/29)比 6.8％(9/133),χ2 =6.238,P = 0.013],总缺血并发症和病死率更高[17.2％(5/29)比 4.5％(6/133),χ2 =4.251,P =0.039;11.1％(3/27)比1.6％(2/129),P =0.037];椎动脉瘤组最终动脉瘤完全闭塞率高于基底动脉瘤组[89.5％(119/133)比58.6％(17/29),χ2 =14.609,P＜0.01].通过倾向性得分匹配控制动脉瘤最大径和是否弹簧圈辅助栓塞治疗后获得22 对椎-基底动脉瘤配对,对比结果表明,椎动脉瘤组最终完全闭塞率明显高于基底动脉瘤组[95.5％(21/22)比 50.0％(11/22),χ2 =11.458,P = 0.001].缺血并发症组的支架调整后释放成功和分支血管狭窄闭塞患者比例均明显高于无缺血并发症组(2/11 比3/151,P =0.038;3/11 比 8/151,P =0.029).结论 多中心临床数据表明,后循环的椎动脉瘤采用PED治疗最终完全闭塞率高于基底动脉瘤.

目的 基于FAERS数据库挖掘达雷妥尤单抗相关的不良事件,为临床安全用药提供参考.方法 收集FAERS数据库中2015年11月1日至2022年3月31日期间达雷妥尤单抗相关不良事件数据,采用报告比值比法(ROR)进行数据挖掘.结果 共获得以达雷妥尤单抗为首要怀疑药物的不良事件报告3011份,其中老年患者(>65岁)报告数最多(994例,33.01％),报告国家以美国和日本为主.达雷妥尤单抗的不良事件涉及26个系统器官分类,频数较高的不良事件与药品说明书基本一致,阳性信号的不良事件共195个.报告数最多的不良事件是输液相关反应,且信号强度较高.达雷妥尤单抗说明书中未记载的不良事件包括骨髓功能衰竭、全血细胞减少症、肿瘤溶解综合征、骨髓抑制及溶血症等.结论 基于FAERS数据库挖掘的达雷妥尤单抗不良事件与药品说明书基本一致,同时还发现潜在新的不良事件信号,有待进一步开展前瞻性研究确认其因果关系.

Background: Azvudine (FNC) is a promising treatment candidate for managing coronavirus disease 2019 (COVID-19). However, drug interactions with azvudine have been poorly studied, especially with no reported cases of azvudine with anticoagulants such as warfarin and rivaroxaban.Case summary: The patient was diagnosed with lower limb venous thrombosis and took warfarin regularly. The international normalized ratio (INR) was stable (2.0–3.0). However, the INR increased to 7.52 after administering azvudine. The patient had no other factors justifying this change. This increase in INR occurred again with the administration of azvudine in combination with rivaroxaban, and the INR increased to 18.91. After azvudine administration was stopped, the INR did not increase when rivaroxaban was used alone.Conclusion: Azvudine, warfarin, and rivaroxaban might have previously unidentified drug interactions that increased the INR. Therefore, the INR must be closely monitored when they are concomitantly administered in COVID-19 patients.

Objective: To screen and identify differential proteins, analyze lipid metabolism-related proteins and pathways, and explore their functions and biological processes in liver tissue of patients with alcoholic liver disease using tandem mass tag (TMT) labeling technology. Methods: Liver tissues that met the inclusion criteria were collected. Eight samples from patients with alcoholic cirrhosis and three samples from the normal control group were screened out. The TMT technique was used to screen differential proteins, perform signaling pathway enrichment analysis, and analyze protein interaction networks to explore the biological processes involved in them. Results: Proteomic analysis identified 2 741 kinds of differentially expressed proteins in the two groups of data with statistical significance (P < 0.05). The standard criteria of P < 0.05 and |log2(foldchange)| > 1 had screened out 106 kinds of differentially expressed proteins. Compared with the control group, the alcoholic liver disease group had 12 kinds of up-regulated proteins and 94 kinds of down-regulated proteins. Among them, there were 2 kinds of up-regulated differential proteins related to lipid metabolism and 14 kinds of down-regulated differential proteins. The results of bioinformatics analysis showed that these proteins were primarily involved in biological processes such as lipid transport, regulation of lipase activity, fatty acid binding, and cholesterol metabolism in lipid metabolism and also had a close link to signal pathways related to lipid metabolism such as peroxisome proliferator-activated receptor signaling pathways, cholesterol metabolism, triglyceride metabolism, and regulation of lipolysis in adipocytes. Conclusion: The 16 kinds of lipid metabolism-related differential proteins may be the key proteins in the pathogenesis of alcoholic liver disease.

目的:探讨支气管肺泡灌洗液(BALF)半乳甘露聚糖(GM)与血清GM对肝衰竭合并侵袭性肺曲霉菌病(IPA)的诊断价值.方法:共纳入肝衰竭合并IPA患者34例(研究组),同期肝衰竭合并肺部感染(非IPA)患者55例(对照组),所有患者均进行血清GM、BALF-GM试验及病原菌培养.结果:研究组BALF-GM和血清GM水平均高于对照组(P均<0.001).BALF-GM用于诊断IPA的ROC曲线下面积(95％CI)为0.845(0.758～0.932),最佳诊断界值为0.745,敏感度为0.706,特异度为0.909,约登指数为0.615;血清GM用于诊断IPA的ROC曲线下面积(95％CI)为0.820(0.730～0.909),最佳诊断界值为0.560,敏感度为0.618,特异度为0.927,约登指数为0.545.BALF-GM和血清GM的诊断效能差异无统计学意义(P=0.695).结论:BALF-GM和血清GM对肝衰竭合并IPA均具有较高的诊断效能.

目的 探讨应用Pipeline血流导向装置(PED)治疗颅内动脉瘤后分支血管狭窄或闭塞情况.方法 回顾性分析血流导向装置治疗颅内动脉瘤中国上市后多中心注册表研究(PLUS)数据库2014年11月至2019年10月期间在中国14个临床中心连续纳入的接受PED介入治疗的1285例颅内动脉瘤患者,根据术后末次DSA随访结果分为分支通畅组和分支狭窄闭塞组,对比两组基线资料、动脉瘤特点、治疗情况、治疗结局和围手术期及随访时并发症(出血、缺血并发症)发生情况,并单独分析分支血管狭窄闭塞组分支血管情况及缺血并发症发生情况.结果 分支狭窄闭塞组患者73例(5.7％),包括48例(3.7％)狭窄和25例(1.9％)闭塞,分支通畅组1212例.与分支通畅组相比,分支狭窄闭塞组术后即刻血管造影分支血管覆盖率更高[覆盖率:100.0％(73/73)比70.6％(856/1212),χ2=29.659,P<0.01];术后应用他汀类降血脂药物比例更高[32.9％(24/73)比18.5％(224/1212),χ2=9.160,P=0.002];随访期缺血并发症[6.8％(5/73)比0.5％(6/1212),P<0.01]、术后总缺血并发症[16.4％(12/73)比6.8％(82/1212),P=0.002]和载瘤动脉闭塞发生率[5.5％(4/73)比1.2％(14/1212),P=0.011]均更高.两组间术前应用双联抗血小板聚集药物比例、弹簧圈辅助栓塞、多支架重叠治疗单个动脉瘤、支架贴壁良好率、术后即刻动脉瘤闭塞率、末次随访动脉瘤闭塞率以及病死率等差异均无统计学意义(均P>0.05).分支狭窄闭塞组共有79根狭窄或闭塞的分支血管,其中31.6％(25根)为完全血管闭塞;狭窄闭塞血管最多为眼动脉(43.0％,34根),其次为后交通动脉(31.6％,25根)和小脑下后动脉(11.4％,9根).分支狭窄闭塞组12例(16.4％)发生术后缺血并发症,其中9例为眼动脉部位分支血管狭窄闭塞,2例为小脑下后动脉,1例为小脑前下动脉;围手术期发生缺血并发症8例,随访期发生缺血并发症5例,1例患者围手术期发生缺血并发症且经药物治疗后完全缓解,但随访期又再次新发缺血症状;12例中,10例末次随访改良Rankin量表评分0～1分.结论 基于多中心临床数据,本研究证实了使用PED治疗颅内动脉瘤后发生分支血管狭窄闭塞的患者缺血并发症发生率高于分支通畅者,需要引起临床医师的注意.

Many natural polysaccharides have been proven to have ameliorative effects on high-fat diet-induced hyperlipidemia with fewer side effects. However, similar data on Gougunao tea polysaccharides remain obscure. In this study, we aimed to investigate the role of Gougunao tea polysaccharides (GTP40) in the alleviation of hyperlipidemia and regulation of gut microbiota in C57BL/6J mice induced by a high-fat diet. The results indicated that GTP40 intervention inhibited the abnormal growth of body weight and the excessive accumulation of lipid droplets in the livers and ameliorated the biochemical parameters of serum/liver related to lipid metabolism in hyperlipidemia mice. The elevated levels of antioxidant enzyme and anti-inflammation cytokine in serum, as well as the up-regulating anti-inflammation gene in the liver, reflected that GTP40 might mitigate the oxidative and inflammatory stress induced by a high-fat diet. In addition, GTP40 could modulate the composition, abundance, and diversity of gut microbiota in hyperlipidemia mice. Besides, Spearman's correlation analysis implied that GTP40 intervention could enrich beneficial bacteria (e.g., Akkermansia, Bacteroides, Roseburia, and Alistipes), and decrease harmful bacteria (e.g., Blautia, Faecalibaculum, Streptococcus, and norank_f_Desulfovibrionaceae), which were correlated with the lipid metabolic parameters associated with hyperlipidemia. Moreover, it also indicated that there was a significant correlation between gut microbiota and SCFAs. Thus, GTP40 may be a novel strategy against fat accumulation, oxidative stress, and inflammation, as well as restoring the normal microbial balance of the gut in hyperlipidemia mice.

A 56-year-old Chinese woman with previous disseminated mycobacterium avium complex infection and recurrent cervical abscesses from Burkholderia cepacia complex visited our hospital. She was diagnosed with adult-onset immunodeficiency (AOID) and tested positive for interferon-γ–neutralizing autoantibody. Ceftazidime was administered as the initial antimicrobial treatment, which was later combined with sulfamethoxazole-trimethoprim (SMZ-TMP). She developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome after SMZ-TMP administration and improved after withdrawal of the culprit antibiotic and systemic glucocorticoids treatment. Her cervical infection was eventually cured after combined therapy of long-term antibiotics and anti–IFN-γ autoantibodies (AIGA) titer-lowering treatments including glucocorticoids, rituximab, and plasmapheresis. This is the first case of DRESS syndrome in the setting of AIGA-induced AOID and is worthy of notice.

ETHNOPHARMACOLOGICAL RELEVANCE:Insomnia is a common form of sleep disorder. Traditional Chinese medicine (TCM) compounds have definite curative effects and a low incidence of adverse reactions, which is recognized to be an effective intervention means for the treatment of insomnia.AIM OF THE STUDY:Based on mining the clinical research data of treating insomnia of yin deficiency syndrome (IYDS) with TCM compounds systematically, the study is to analyze the research hotspots and development trends in this field, explore the medication rule, evaluate the quality of research, so as to provide reference and direction for clinical application and scientific research in this field.MATERIALS AND METHODS:The relevant literature was retrieved and managed by evidence-based medicine strategy and EndNote software respectively. The bibliometric method was used to mine and analyze data characteristics. The VOSviewer software was used to make visual knowledge maps, the IBM SPSS Modeler software was used for association rule analysis of herbs, and the Cochrane tool and MINORS scale were used for quality analysis of literature.RESULTS:(1) A total of 184 related studies were included according to the inclusion and exclusion criteria. (2) The research popularity showed a dynamic upward trend and the research hotspot showed a trend of migration and refinement, etc. (3) The commonly used herbs in this field were Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow, etc; the commonly used TCM prescriptions were Huanglian Ejiao Decoction, etc; the commonly used dosage forms were traditional decoction, etc; the commonly used combinations of herbs included Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow-Poria cocos（Schw.）Wolf, etc. (4) The rate of the studies containing ethical review numbers and clear inclusion standards did not reach 50%, and the risk bias of methodological was high. However, a separate analysis of data showed that the specification of study design was on the rise obviously in recent years, and Meta-analysis and sensitivity analysis could confirm the effectiveness and stability of clinical efficacy which was the key indicator in treating IYDS with TCM prescriptions. There were significant differences among administration protocols of different clinical studies of the same name TCM compounds. However, the scientific significance of each unique dosing regimen were expected to be elaborated or discussed.CONCLUSION:The clinical research number of TCM compounds treating IYDS was in a dynamic upward trend, and the outcome indicators tended to be diversified and detailed. The dosage forms mainly included decoction, supplemented by Chinese patent medicine. The design of clinical studies in this field was not standardized enough, but the key indicators were scientific and stable. We expected that later studies could pay more attention to improving the standardization of trial design, reducing the risk bias in the process of methodological design, conducting high-quality standardized multicenter, large-sample randomized controlled clinical trials to provide scientific evidence with high evidentiary strength, establishing the recognized administration protocols for the same name TCM prescriptions or clarifying the targeting of different protocols, and promoting the application and popularity of TCM compounds in treating IYDS.

目的:分析血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)联合检测诊断胃癌的受试者工作曲线(ROC)及临床指导意义.方法:回顾性收集2019年1月～2021年12月我院收治的89例胃癌患者和77例胃良性病变患者临床资料分别作为恶性组和良性组,选取同期在我院进行体检的79例健康体检者体检资料作为健康对照组.比较三组患者血清CEA、AFP、CA199、CA125水平,根据胃癌患者临床分期将其分为Ⅰ/Ⅱ期组(34例)、Ⅲ/Ⅳ期组(55例),比较两组血清CEA、AFP、CA199、CA125水平.采用ROC曲线分析血清CEA、AFP、CA199、CA125单独及联合检测诊断胃癌的曲线下面积(AUC)、敏感度、特异度.结果:健康对照组、良性组、恶性组患者血清CEA、AFP、CA199、CA125水平呈升高趋势,差异有统计学意义(P<0.05).Ⅲ/Ⅳ期组患者血清CEA、AFP、CA199、CA125水平高于Ⅰ/Ⅱ期组.通过Medcalc软件绘制ROC曲线对各指标单独及联合检验诊断胃癌的AUC进行比较,结果显示血清CEA、AFP、CA199、CA125水平联合检测诊断胃癌的AUC为0.950,高于CEA、AFP、CA199、CA125单一检测.结论:随着患者胃部病变恶性程度升高,血清CEA、AFP、CA199、CA125水平升高,同时四者联合检测诊断胃癌的AUC较高,因此临床可将CEA、AFP、CA199、CA125联合用于胃癌患者的早期诊断,提高胃癌早期检出率.

目的 探索实体瘤序贯双次移植患者自体外周血造血干细胞采集方法及安全性,分析采集效果.方法 选择2019年1月～2021年6月行细胞采集的27名实体瘤患者为研究对象,重组人粒细胞刺激因子及重组人粒细胞巨噬细胞集落刺激因子动员后行采集术.制订个性化方案,采集前全面评估患儿病情及配合程度,建立深静脉通路,以保证采集顺利进行.选择单核细胞采集(MNC)程序,设置机器参数.采集结束后取混匀的标本进行单个核细胞计数及CD34+细胞计数,做回顾性分析.结果 27名患者共进行细胞采集73次,获得的单个核细胞数为12.586(10.22～19.586)×108/kg,CD34+细胞数为13.575(7.275～23.825)×106/kg,满足双次自体造血干细胞移植所需.未发生枸橼酸中毒及其他严重不良反应,随访一般状况良好.结论 我们的采集方法对儿童是有效和安全的,即使体重小也可推荐使用,能为实体瘤患儿采集足够的干细胞,满足序贯双次自体造血干细胞移植需要.

The seeds of Moringa oleifera Lam (MO) in India have various biological properties, such as anti-hyperglycemia, anti-fibrosis, and anti-oxidant. Diabetic nephropathy (DN) is one of the most serious complications in diabetes mellitus. However, the mechanism of renal protection of MO seeds in DN is unclear. In this study, the DN rat model was generated by a single streptozotocin (STZ) intraperitoneal injection, which was used to explore the renal dysfunction effects of MO seeds. Pathological examination of diabetic kidney exhibited a significant change in glomerular and tubular structures. MO seeds treatment in DN rats attenuated these changes dose-dependently. MO seeds could exert anti-inflammatory, anti-fibrosis and anti-oxidative effects by inhibiting the activation of the NF-kappa B and TGF beta 1/Smad2/3 signaling pathways, and activating the Nrf2/HO-1 signaling pathway, finally effectively attenuate renal injury of DN. And 4000 mg/kg MO seeds have the similar level of therapeutic effect as clinical doses of metformin.

Objective:To investigate the transcriptome characteristics and clinical significance of molecular classes of gliomas based on Chinese cohorts.Methods:The clinical information and transcriptome sequencing data of 932 patients with gliomas were retrospectively analyzed in the Chinese Glioma Genome Atlas (CGGA) daatabase. The patients were divided into isocitrate dehydrogenase (IDH, include IDH1 and IDH2) mutation with chromosomal 1p/19q co-deletion (Mut_Co) type (182 cases), IDH mutation with chromosomal 1p/19q co-deletion (Mut_nCo) type (315 cases) and IDH wild (WT) type (435 cases). The age of diagnosis, gender, histopathological type, TCGA (The Cancer Genome Atlas) subtype, CpG island methylation phenotype (G-CIMP) and tumor purity were compared among patients with three molecular classes of gliomas. We explored the transcriptome characteristics of three molecular types of gliomas, the biological pathways involved and their differences in cancer marker scores. A total of 885 patients with transcriptomic data and complete follow-up data were included for survival analysis and Kaplan-Meier curves were drawn to compare the difference in median survival of patients with three molecular classes of gliomas.Results:Compared with Mut_Co and Mut_nCo, the proportion of WT patients with diagnosis age ≥43 years, WHO grade Ⅳ, glioblastoma, TCGA classical type and G-CIMP type was higher, and the tumor purity was the lowest, the differences were statistically significant (all P<0.001). Compared with Mut_Co and Mut_nCo, the intra- and local- invasion scores of WT glioma were higher, and the proportion of cell cycle in DNA synthesis phase (S phase) was higher, with statistical significance (all P<0.001). In WT type, the transcription factor PAX3 was highly expressed and the p53 signaling pathway was lowly expressed. Pathway functional enrichment analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) showed that Mut_Co and Mut_nCo types were widely involved in the interaction of ligand receptors stimulating neural tissue and long-term depression, which were also widely involved in Hedgehog protein signal, WNTβ CATENIN signal and other cancer markers; WT type was mainly involved in p53 signaling pathway, adhesion plaque, apoptosis and other biological pathways and cancer hallmarkers. The log-rank test showed that the median survival time of Mut_Co patients was the longest (most of them survived), followed by Mut_nCo (1 258 d), and WT with the shortest survival time (415 d), and the difference was statistically significant ( P<0.001). Conclusion:The three molecularly classified gliomas based on the Chinese cohorts are associated with different clinical features, different prognosis of patients, specific transcriptomic features, and involve specific biological pathways and cancer hallmarkers.

目的 探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕患者中医证型分布特点及与内分泌代谢指标的关联性.方法 对212例PCOS不孕患者进行中医辨证分型,测定其内分泌代谢相关指标(血清睾酮、LH、FSH、AMH、胰岛素、血糖),分析中医证型的分布特点及与内分泌代谢指标的关联性.结果 (1)212例PCOS不孕患者中,痰湿证52例,肾虚证96例,气滞血瘀证50例,肝经湿热证14例,各证型在不孕时间、月经稀发的分布上差异无统计学意义(P＞0.05),肝经湿热证年龄显著小于其他证型(P＜0.05);(2)PCOS不孕患者超重和肥胖的概率高达56.6％,痰湿证超重和肥胖的概率高达94.2％,显著高于肾虚证、气滞血瘀证、肝经湿热证型,差异有统计学意义(P＜0.05);(3)PCOS不孕患者高雄激素血症的概率高达32.55％,痰湿证、肝经湿热证高雄激素血症的概率显著高于肾虚证、气滞血瘀证(59.6％、57.1％vs 21.9％、18.0％),差异具有统计学意义(P＜0.05);(4)PCOS不孕患者胰岛素抵抗的概率高达52.36％,痰湿证胰岛素抵抗的概率显著高于肾虚证、气滞血瘀证、肝经湿热证(80.8％vs 41.7％、44.0％、50.0％),差异具有统计学意义(P＜0.05).(5)各证型AMH、LH/FSH比值差异无统计学意义(P＞0.05).结论 PCOS不孕患者中医证型与内分泌代谢指标具有一定的关联性,高雄激素血症主要与痰湿证、肝经湿热证相关,胰岛素抵抗主要与痰湿证相关.