Objective miRNAs are considered potential biomarkers that can be used for the grading of chronic hepatitis B (CHB)-related liver fibrosis. This meta-analysis aims to elucidate the diagnostic performance of miRNAs. Methods Databases were used to search for meta-analyses. A bivariate model was used to calculate pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). In addition, the area under the summary receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated. Results A total of 9 studies with 1159 patients with CHB-related liver fibrosis were assessed. For diagnosis of significant liver fibrosis, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.73 (95% CI, 0.68-0.78), 0.78 (95% CI, 0.70-0.84), 3.32 (95% CI, 2.52-4.37), 0.34 (95% CI, 0.30-0.39), 9.70 (95% CI, 7.10-13.24), and 0.81 (95% CI, 0.77-0.84), respectively. Conclusion miRNAs are potential biomarkers of CHB-related liver fibrosis.

本文从肝经"环阴器"理论出发,结合相关临床研究结果,探讨肝与某些生殖系统疾病发生、发展的内在联系;其中尤其"阳痿"一病,基于以上论述,笔者提出肝是该病形成的基本因素,并进一步强调其基本病机为肝气不升,故在该病的临床诊治时宜重视升达肝气.

Objective. To investigate the regulatory role of angiopoietin-1ike protein 2 (Angptl 2) in the pathogenesis of acute respiratory distress syndrome (ARDS). Methods. A high-fat diet (HFD) and tail vein injection of 0.1 ml/kg oleic acid were used to induce acute lung injury (ALI) and ARDS models, and male Kunming mice were randomly divided into four groups: control group (injected with normal saline), ALI group (injected with oleic acid), HFD group (injection of normal saline), and ARDS group (HFD+injection of oleic acid). The degree of lung injury was assessed by lung histopathology score and lung injury index. At the same time, the mRNA and protein expression levels of Angptl 2 in lung tissue were also detected to determine the relationship between Angptl 2 and ARDS. Results. Lee's index of the HFD group and ARDS group was significantly higher than that of the control group and ALI group (P < 0.05), and the lung injury index of the ARDS group was significantly higher than that of the ALI group. The expression of Angptl 2 in the lung tissue of the ALI group and ARDS group was significantly different, and the Angptl 2 mRNA level was the highest in the ARDS group. Immunohistochemistry showed that the alveolar walls of the ALI group and ARDS group were severely collapsed, and the ARDS group had the greatest Angptl 2 aggregation at the site of edema exudation. Conclusion. Collectively, obesity might be mediated by Angptl 2 and promotes lung injury. Immunohistochemistry analysis showed that the expression of the receptor on alveolar walls was correlated with Angptl 2, which increased alveolar wall permeability, edema fluid exudation, and alveolar wall collapse. Thus, Angptl 2 might be a target for improving the treatment of ARDS.

摘要：本文论析了目前中医临床里多见的艾滋病证型，并找到艾滋病患者多数情况下常表现的证型或者常兼有的证型；再从此证型本身出发，联系与其相关脏腑之生理特点以加深对该证型的理解、诊断，故笔者提出以下辨证思路：艾滋病虚证→气虚证→脾肾双亏证，从而对中医临床中艾滋病患者“理、法、方、药”的确定产生一定积极指导意义。

Objective . To investigate the regulatory role of angiopoietin-1ike protein 2 (Angptl 2) in the pathogenesis of acute respiratory distress syndrome (ARDS). Methods . A high-fat diet (HFD) and tail vein injection of 0.1 ml/kg oleic acid were used to induce acute lung injury (ALI) and ARDS models, and male Kunming mice were randomly divided into four groups: control group (injected with normal saline), ALI group (injected with oleic acid), HFD group (injection of normal saline), and ARDS group (HFD+injection of oleic acid). The degree of lung injury was assessed by lung histopathology score and lung injury index. At the same time, the mRNA and protein expression levels of Angptl 2 in lung tissue were also detected to determine the relationship between Angptl 2 and ARDS. Results . Lee’s index of the HFD group and ARDS group was significantly higher than that of the control group and ALI group ( P < 0.05), and the lung injury index of the ARDS group was significantly higher than that of the ALI group. The expression of Angptl 2 in the lung tissue of the ALI group and ARDS group was significantly different, and the Angptl 2 mRNA level was the highest in the ARDS group. Immunohistochemistry showed that the alveolar walls of the ALI group and ARDS group were severely collapsed, and the ARDS group had the greatest Angptl 2 aggregation at the site of edema exudation. Conclusion . Collectively, obesity might be mediated by Angptl 2 and promotes lung injury. Immunohistochemistry analysis showed that the expression of the receptor on alveolar walls was correlated with Angptl 2, which increased alveolar wall permeability, edema fluid exudation, and alveolar wall collapse. Thus, Angptl 2 might be a target for improving the treatment of ARDS.

Abstract Background: Chronic non-atrophic gastritis is the most common type of chronic gastritis. Even if treated with current standard pharmacotherapy, the efficacy is not very satisfactory due to many factors. Traditional Chinese Medicine decoctions are increasingly used in the treatment of chronic gastritis, and many studies have shown that Xiangsha Liujunzi decoction is effective and safe in the treatment of chronic non-atrophic gastritis. However, it is controversy if Xiangsha Liujunzi decoction can provide an evidence-based clinical efficacy and safety in the treatment of chronic non-atrophic gastritis. Methods: We will go through 8 databases, and conduct a systematic review of Xiangsha Liujunzi decoction and health-related outcomes in chronic non-atrophic gastritis patients according to the Preferred Reporting Items for Systematic Reviews. The primary objective is to assess the impact of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on clinical outcomes relevant to chronic non-atrophic gastritis patients, such as clinical effective rate, Helicobacter pylori eradication rate, efficacy under endoscopy, 1-year recurrent rate, and number of reported adverse events. Cochrane Risk Assessment Tool will be used to assess the quality of eligible studies according to the Cochrane handbook. Results: The results of this systematic review will provide a synthesis of current evidence of Xiangsha Liujunzi decoction and we have a specific opportunity to determine the efficacy and safety of it. Conclusion: This study will explore whether or not Xiangsha Liujunzi decoction can be used as one of the complementary and alternative therapies in the treatment of chronic non-atrophic gastritis. Registration number: Identifier: DOI 10.17605/OSF.IO/TX27U (https://osf.io/tx27u/).

目的 探讨加味茵陈蒿汤对急性肝损伤大鼠的保护机制.方法 将42只SPF级雌性SD大鼠,随机分为空白组、模型组、西药组、中药组、TLR4过表达组、西药+TLR4过表达组和中药+TLR4过表达组,每组6只.空白组大鼠给予0.9％生理盐水灌胃;模型组大鼠造模后灌胃同体积生理盐水;西药组大鼠造模后灌胃复方甘草酸苷15.75 mg/kg;中药组大鼠造模后灌胃加味茵陈蒿汤58.8 g/kg;TLR4过表达组大鼠造模后静脉注射0.5 ml腺病毒包装的TLR4过表达载体(pDC-TLR4,1×1011 PFU);西药+TLR4过表达组大鼠造模后灌胃同体积复方甘草酸苷,并给予等量pDC-TLR4静脉注射;中药+TLR4过表达组大鼠造模后灌胃同体积加味茵陈蒿汤,并给予等量pDC-TLR4静脉注射.各组大鼠持续给药2周后,利用生化测定仪测定各组大鼠血清谷丙转氨酶(ALT)和谷草转氨酶(AST)的水平;Western blot分析肝脏组织TNF-α、p-NF-κB、MyD88和TLR4的蛋白表达;另取肝脏行病理学检测.结果 与空白组比较,模型组大鼠血浆ALT、AST及肝组织中TNF-α、p-NF-κB、MyD88、TLR4水平均显著升高(P<0.01),肝细胞呈弥漫性大片状坏死,肝窦结构被破坏,汇管区明显可见炎症细胞浸润.与模型组比较,中药组和西药组大鼠血浆ALT、AST及肝组织TNF-α、TLR4、MyD88、p-NF-κB的水平均显著降低(P<0.01),且中药组与西药组相比,差异虽无统计学意义,但中药对ALT和AST表达的抑制作用更明显.与中药组和西药组相比,中药+TLR4过表达组和西药+TLR4过表达组大鼠血浆ALT、AST及肝组织TNF-α、TLR4、MyD88、p-NF-κB的水平均显著升高(P<0.01).另外,与中药组和西药组相比,中药+TLR4过表达组和西药+TLR4过表达组大鼠肝脏损伤程度明显加重.结论 TNF-α、MyD88、p-NF-κB及TLR4在急性肝损伤中起着重要作用,加味茵陈蒿汤可通过降低TLR4信号通路中TNF-α、MyD88及p-NF-κB等重要细胞因子水平缓解肝细胞损伤.

Background: Acupuncture at Yaotongdian (EX-UE 7) is increasingly used in acute lumbar sprain (ALS), and many studies have published that it is effective in the treatment of ALS. However, it is controversy if acupuncture at (EX-UE 7) can provide an evidence-based clinical benefit in the ALS population. Methods: We will go through 8 databases, and conduct a systematic review of acupuncture on (EX-UE 7) and health-related outcomes in ALS patients according to the Preferred Reporting Items for Systematic Reviews. The primary objective is to assess the impact of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on clinical outcomes relevant to ALS patients, such as effective rate, life-quality evaluation, and adverse events. Cochrane Risk Assessment Tool will be used to assess the quality of eligible studies according to the Cochrane handbook. Results: The results of this systematic review will provide a synthesis of current evidence of Acupuncture at Yaotongdian (EX-UE 7) and we have a specific opportunity to determine the efficacy and safety of it. Conclusion: This study will explore whether or not acupuncture on (EX-UE 7) can be used as one of the non-drug therapies to prevent or treat ALS. Registration number: 10.17605/OSF.IO/29QV7 (https://osf.io/29qv7/)

Background The problems associated with the poor water solubility of anticancer drugs are one of the most important challenges in achieving effective cancer therapy. The present study was designed to evaluate the effect of scutellarein on human colon cancer cells in vitro by using a target α v β3 novel scutellarein (Scu)-loaded niosome nanoparticle (β-CD-CL-Scu-cRGD). Results β-CD-CL-Scu-cRGD has a diameter of 140.2 nm and zeta potential of − 11.3 mV with constant physicochemical stability. The MTT assay showed both Scu and β-CD-CL-Scu-cRGD caused a decrease in cell proliferation and viability of LoVo, but β-CD-CL-Scu-cRGD showed better activity in vitro. Colony formation assay and flow cytometry assay showed that β-CD-CL-Scu-cRGD has a better effect on cell proliferation and apoptosis. In vivo, animal experimental results showed that β-CD-CL-Scu-cRGD can significantly inhibit tumor growth, and the bodyweight of mice decreases during the treatment of scutellarein and its derivatives. β-CD-CL-Scu-cRGD could inhibit the protein levels of Ki67 and αvβ3, thereby inhibiting tumor growth. Conclusions Although further in vitro and in vivo studies are necessary, our results suggested that β-CD-CL-Scu-cRGD could be an outstanding carrier to deliver Scu for potential therapeutic approaches into colon cancer.

Ras-GTPase-activating protein SH3 domain-binding protein 1 (G3BP1) has been reported to be of importance in the occurrence and development of colon cancer. However, the underlying mechanisms remain largely unknown. Therefore, the aim of the present study was to investigate the role of Wnt/beta-catenin signaling in G3BP1-mediated colon cancer progression. The expression of G3BP1 in colon tissues and cells was detected via reverse transcription-quantitative PCR, western blotting and immunohistochemistry. Gain-of-function assays were performed in colon cancer RKO cells, which have a relatively low expression of G3BP1, while loss-of-function assays were performed in SW620 colon cancer cells, which have a relatively high expression of G3BP1. Cell proliferation, apoptosis and tumorigenesis were assessed using Cell Counting Kit-8, flow cytometry and tumor-bearing mice assays, respectively. The results demonstrated that G3BP1 expression was significantly upregulated in colon cancer tissues and cells compared with healthy colon tissues and cells. It was found that high expression of G3BP1 was closely associated with the poor prognosis and advanced clinical process in patients with colon cancer. Overexpression of G3BP1 in RKO cells enhanced their proliferative ability and decreased their apoptosis tendency, while knockdown of G3BP1 inhibited SW620 cell proliferation and induced apoptosis. In addition, G3BP1 interacted with beta-catenin and upregulated its expression and nuclear accumulation. It was identified that beta-catenin knockdown abolished the effects of G3BP1 on the enhancement of cell proliferationin vitroand tumor formationin vivo, as well as the inhibition of cell apoptosis. In conclusion, the present study demonstrated that G3BP1 promoted the progression of colon cancer by activating beta-catenin signaling, which provided novel evidence for the role of G3BP1 in colon cancer.

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肝细胞癌(HCC)是常见的、致命的恶性肿瘤,在所有恶性肿瘤中,发病率居第5位,死亡率居第3位[1].亚洲、非洲和南部欧洲是其高发地区,其中中国HCC新发和死亡病例均占全球的50％以上[2].手术切除和肝移植是早期HCC两个主要的、有效的治疗手段.然而,大多数HCC患者确诊时已处于晚期,无法行手术治疗,则采用系统治疗,如化疗栓塞、靶向治疗、免疫治疗.

Scutellarein has been identified to serve an anti-tumor function in human colon cancer, but the underlying mechanisms remain largely unclear. The present study further investigated the effect and mechanism of scutellarein, extracted from wild chrysanthemum, in the progression of colon cancer. MTT, clone formation, flow cytometry and tumor-bearing mice assays were used to detect cell viability, clone formation, apoptosis and tumorigenesis, respectively. Western blot and quantitative PCR assays were performed for protein and mRNA expression detection. The results revealed that, compared with the control group, scutellarein treatment significantly inhibited the viability and induced the apoptosis of colon cancer cells (P<0.05), with significant decreases in receptor for advanced glycosylation end products (RAGE) protein expression and stability and an increase in RAGE ubiquitination (P<0.05). However, the effects of scutellarein exerted in cell apoptosis and viability were rescued by RAGE overexpression, and accelerated by RAGE knockdown. Additionally, it was observed that scutellarein treatment induced a significant increase in the expression of cell division control protein 4 (CDC4) compared with the control group (P<0.05), which was then verified to interact with RAGE protein and mediate its ubiquitination. Overexpression of CDC4 inhibited colon cancer cell viability and promoted the apoptosis of SW480 and T84 cells, whereas this function was weakened when RAGE was overexpressed. Furthermore, CDC4 downregulation significantly neutralized scutellarein functions in promoting cell apoptosis and inhibiting cell viability and tumorigenesis in colon cancer cells compared with the scutellarein group (P<0.05). In conclusion, the present study revealed that scutellarein inhibited the development of colon cancer through upregulating CDC4-mediated RAGE ubiquitination.

心房颤动(atrial fibrillation,AF)是临床常见的快速型心律失常,也是威胁人们健康的常见问题.我国AF的总患病率在1％左右[1].随着人口老龄化进展,以及高血压、糖尿病、冠心病等疾病的不断增多,AF的患病率也随之增高,年龄≥80岁人群的发病率＞7％.AF常引起脑卒中、心力衰竭、下肢栓塞等严重并发症,导致患者致残或死亡.发现AF的核心调控分子,寻找AF的治疗靶点,成为心血管病研究的重要领域.长链非编码RNA (long noncoding RNA,lncRNA)是长度＞200 nt的RNA,不编码蛋白质,但能和DNA、RNA及蛋白质相互作用,可顺式或反式调控基因的表达.基因组学研究发现,部分lncRNA能调控心血管疾病的发生、发展及转归[2].某些lncRNA在外周血中表现稳定,表达差异与AF的病程密切相关,提示lncRNA作为AF标志物的诊断潜能.将某些lncRNA加入脑卒中风险评分,可优化现行的CHADS2或CHA2DS2-VASc评分的脑卒中风险分层模型.现就国内外AF领域的lncRNA研究做一综述,分析其与心血管病疾病的关系及在AF发生、发展及转归中调控作用.

1 临床资料 患者,男性,54岁,因“间断胸痛2+d,加重2+h”于2019-06-23 23:00入院.患者2+d前无明显诱因出现心前区刺痛,程度轻到中度,伴恶心、大汗,每次持续十几分钟到1h,休息后自行缓解,未行相关诊治.约2h前,患者无明显诱因再次出现心前区疼痛,疼痛较前加重并向左肩放射伴大汗,症状持续不能缓解,遂到自贡市第一人民医院(我院)急诊科就诊.

Background and Aims: Part 2 of our ongoing research with anti-angiogenic effects focuses on Wild chrysanthemum; a heat-clearing and detoxicating Traditional Chinese Medicine (TCM). We screened six heat-clearing and detoxicating TCM and noticed that wild chrysanthemum has a potent anti-angiogenic effect in zebrafish. This study aims to determine the genetic mechanisms underlying the anti-angiogenic effects of wild chrysanthemum. Methods: Wild chrysanthemum was decocted, concentrated, sieved and desiccated to attain the water extract. 200μg/mL wild chrysanthemum water extract (WCWE) was diluted in 0.1% dimethyl sulfoxide (DMSO) and given to zebrafish via fish water. 48h post-fertilization (hpf) fli1a-EGFP transgenic zebrafish were used to assay angiogenesis. mRNA-seq, qRT-PCR assay and a parallel reaction monitor (PRM) were carried out to reveal the underlying mechanisms. Results: WCWE showed a significant anti-angiogenic effect in zebrafish. The results of mRNA-seq showed that there were 1119 genes up-regulated and 1332 genes down-regulated by WCWE. The bioinformatic analysis based on mRNA-seq demonstrated that the proteasome signaling pathway was significantly down-regulated. The results of the qRT-PCR assay were consistent with those of the mRNA-seq assay. The results of the PRM assay showed that nine proteins involved in proteasome signaling and the protein expression level of ctnnb2 were significantly down-regulated. The results of the KEGG pathway analysis based on PRM assay demonstrated that WCWE may have an inhibitory action on the regulatory particle of the proteasome. Conclusion: Wild chrysanthemum has a significant anti-angiogenic effect in zebrafish and it may have an inhibitory action on the regulatory particle of the proteasome. The mechanisms underlying the anti-angiogenic effects of wild chrysanthemum may be related to the down-regulation of proteasome/β-catenin signaling in zebrafish.

乙肝肝硬化是慢性肝病发展的一个终末阶段,临床表现重、并发症多,少数甚至可发展为肝癌.提高患者生活质量、减缓肝硬化的进程是现阶段肝病的治疗的关键.本文从病因病机、治疗及用药方面分析钟森教授的临床经验,为中医治疗乙肝肝硬化提供思路与方法.

腹痛是临床常见的疾病,它的发病没有季节、地区、年龄、性别的限制,所见太多,或自成一病或为它病兼证.文章从其病因病机和分型治疗预后方面讨论腹痛.

Background: Rotavirus infection is the main cause of severe dehydration enteritis in children under 5 years old. It gives rise to malnutrition and even death in children even though there were rotavirus vaccines. However, there is no effective anti-virus drugs for rotavirus, supporting treatments are used in the clinics. Traditional Chinese medicine (TCM) has been treating diarrhea for many years. Gegen Huangqin Huanglian Decoction (GHHD)is a classic prescription for diarrhea in TCM. With the development of clinical trials and basic studies, GHHD has been proved that a good curative effect on diarrhea. Therefore, a systematic review is necessary to improve available evidence for GHHD in therapy of children under 5 years old with rotavirus enteritis. Methods: Different studies from various databases will be involved in this study. Only randomized controlled trials of rotavirus enteritis patients diagnosed with Guidelines for the Treatment of Acute Gastroenteritis in Outpatient Pediatrics, which released by the Washington International Children's Medical Center, Zhu Futang's Practical Pediatrics (7 th Edition), and the 2016 clinical practice guidelines for children with acute infectious diarrhea in China. We will search the literature in the databases from China Conference Paper Database, manual searching. Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, CNKI (China National Knowledge Internet), WanFang, VIP (Chongqing VIP), and CBM (China Biomedical Literature CDROM Database). The primary outcomes include the total effective rate, the time of stopping diarrhea, the level of IL-6 serum concentration, fecal microflora ratio, the conversion of fecal rotavirus antigen. The secondary outcomes include clinical efficacy and the quantitative integral of TCM symptom, recovery time of stool character, treatment period. Besides, incidence of adverse events (such as irritation and toxicity) and costs will be also considered. Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3 and Stata V.12.0. Results: This study will synthesize and provide high-quality evidence based on the data of the currently published GHHD for the treatment of children rotavirus enteritis, in terms of the total effective rate, the time of stopping diarrhea, the level of IL-6 serum concentration, fecal microflora ratio, stool rotavirus antigen, clinical efficacy and the quantitative integral of TCM symptom, recovery time of stool character, treatment period, and safety. Conclusion: This systematic review aims to evaluated the benefits and harms of GHHD for the treatment of children rotavirus enteritis reported in randomized controlled trials, and provide more options for clinicians and patients to treat children rotavirus enteritis. Registration number: INPLASY2020100023

目的 对足头向穿刺路径进行模拟测量并评价在膈肌下方肝肿瘤热消融治疗中的临床应用价值.方法 重建患者上腹部CT图像,选取有代表性的3个矢状面和1个冠状面作为标准层面,在各层面建立膈下标准病灶模型,并采用足头向穿刺路径进行模拟穿刺.测量各平面上膈肌高度、穿刺路径长度及间距.采用可到达性评价模拟穿刺时穿刺针分布于标准病灶中的最理想的位置情况.结果 纳入86例患者行测量研究,多数患者矢状2、3面的膈肌高度低于2cm,仅分别对平面内15.11％的病灶e和8.13％的病灶f进行了测量.标准病灶a、b、c、d、b'的完全到达比例分别为52.43％、60.97％、38.37％、52.94％、63.53％,中位路径长度分别为10.39cm、13.37cm(背侧,腹侧12.66cm)、13.15cm、8.88cm、11.26cm,中位穿刺路径间距分别为2.1cm、2.09cm(背侧,2.14cm腹侧)、2.06cm、2.11cm、2.145cm.结论 采用足头向穿刺路径进行穿刺,标准病灶a、b、d、b'有较高的完全到达比例,穿刺宽容度较高,有进一步在临床中应用的价值.标准病灶c的完全到达率不高.标准病灶e、f需要采用该路径穿刺的比例不高.