M2-like Kupffer cells in fibrotic liver may protect against acute insult

AIM To investigate the mechanism of hepatoprotection conferred by liver fibrosis through evaluating the activation phenotype of kupffer cells.METHODS Control and fibrotic mice were challenged with a lethal dose of D-Gal N/lipopolysaccharide(LPS),and hepatic damage was assessed by histology,serum alanine transferase(ALT)levels,and hepatic expression of HMGB1,a potent pro-inflammatory mediator.The localization of F4/80(a surrogate marker of KCs),HMGB1,and type I collagen(Col-1)was determined by immunofluorescence staining.The phenotype of KCs was characterized by real-time PCR.KCs isolated from control or fibrotic mice were challenged with LPS or HMGB1 peptide,and HMGB1 translocation was analyzed.RESULTS Liver fibrosis protected mice against D-Gal N/LPS challenge,as shown by improved hepatic histology and reduced elevation of ALT compared with the normal mice treated in the same way.This hepatoprotection was also accompanied by inhibition of HMGB1 expression in the liver.Co-localization of F4/80,HMGB1,and Col-1 was found in fibrotic livers,indicating the close relationship between KCs,HMGB1 and liver fibrosis.KCs isolated from fibrotic mice predominantly exhibited an M2-like phenotype.In vitro experiments showed that HMGB1 was localized in the nucleus of the majority of M2-like KCs and that the translocation of HMGB1 was inhibited following stimulation with LPS or HMGB1 peptide,while both LPS and HMGB1 peptide elicited translocation of intranuclear HMGB1 in KCs isolated from the control mice.CONCLUSION M2-like Kupffer cells in fibrotic liver may exert a protective effect against acute insult by inhibiting the translocation of HMGB1.

CPT-11 Chemotherapy Rescued A Patient with Atypical Sclerosing Epithelioid Fibrosarcoma from Emergent Condition

Sclerosing epithelioid fibrosarcoma （SEF） is a rare and poorly defined variant of fibrosarcoma, but generally insensitive to chemotherapy and progresses with poor prognosis. We report the marvelous effect of irinotecan hydrochloride （CPT-11） chemotherapy in rescuing a patient with atypical SEF from emergent condition, who underwent recurrences after several treatment methods. Small dose of CPT-11 was administered to the patient, with which, the size of superficial mass （cervical lymph node） gradually decreased observed by the naked eyes in 5 days. X-ray and CT image proved a marked reduction in the size of the tumor. CPT-11 is valuable for the treatment of this aggressive sarcoma. In condition of emergency caused by sarcoma oppression, administering a tolerable small dose of topoisomerase I-inhibiting drug could be a beneficial choice.

再次经口内镜下肌切开术治疗贲门失弛缓症的疗效观察

目的探讨初次经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)失败后,再次POEM手术的可行性、有效性及安全性。方法选择2018年2月-2020年8月郑州大学第一附属医院收治的10例初次POEM治疗失败再次接受POEM治疗的AC患者,观察手术成功率、手术时间、术后住院时间、并发症、住院费用以及随访情况等相关指标,并对其进行统计学分析。结果所有患者均成功完成了再次POEM手术。与初次POEM相比,再次手术在住院总费用、术后住院时间、手术时间、术后禁食时间等方面无明显差异;先后两次手术均无穿孔、胸腔积液、气体相关并发症等不良事件发生,在黏膜损伤、胸痛、发热、迟发性出血等方面也相当(P>0.05)。中位随访时间8.5个月(5~28个月),再次POEM术前平均Eckardt评分5.6分(4~8分),术后Eckardt评分均≤3分,平均1.4分(1~3分)。3例患者出现临床相关胃食管反流病(GERD),其中1例复查胃镜提示反流性食管炎。结论初次POEM治疗AC失败后,再次POEM手术仍安全有效。

Inhibitory effect of S-adenosylmethionine on the growth of human gastric cancer cells in vivo and in vitro

Background and Objective: S-adenosylmethionine (SAM), the most important methyl donor in human body, is generally used to treat cholestasis in clinic. In recent years, SAM has been found to have inhibitory effects on breast cancer, liver cancer and colon carcinoma. This study was to investigate the inhibitory effects of SAM on human gastric cancer cells in vivo and in vitro, and the antitumor mechanisms. Methods: The effects of SAM on the proliferation of gastric cancer SGC-7901 and MKN-45 cells were determined by MTT assay. After SGC-7901 and MKN-45 cells were treated with 0, 2, and 4 mmol/L SAM for 72 h, the expression and methylation of c-myc and urokinase type plasminogen activator (uPA) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and methylation-specific PCR (MSP). Tumor xenografts were established by injecting SGC-7901 cells subcutaneously in BALB/c nude mice. The mice were randomized into low concentration group [192 μmol/(kg·day)], high concentration group [768 μmol/(kg·day)], and control group [normal saline (NS)], and received peritoneal injection of relative reagents for 15 days. The tumor size was measured, the protein and mRNA expression of c-myc and uPA were detected by immunohistochemistry and RT-PCR, and the methylation of c-myc and uPA genes was detected by MSP. Results: SAM inhibited the growth of SGC-7901 and MKN-45 cells obviously and the effects were enhanced with the increase of SAM concentration and treatment time. The mRNA expression of c-myc and uPA in SGC-7901 cells and that of uPA in MKN-45 cells significantly decreased. The c-myc and uPA genes in SGC-7901 cells and uPA gene in MKN-45 cells were partly or completely methylated after SAM treatment. The tumor volume was significantly lower in low concentration group [(618.51± 149.27) mm3] and high concentration group [(444.32 ± 118.51) mm3] than in control group [(1018.22 ± 223.07) mm3] (both P < 0.01). The inhibitory rates of tumor growth were 39.26% in low concentration group and 56.36% in high concentration group. The protein and mRNA expressions of c-myc and uPA were remarkably reduced (all P < 0.01), and the hypomethylation of c-myc and uPA genes were reversed after SAM treatment. Conclusions: SAM can inhibit the growth of human gastric cancer cells both in vivo and in vitro. The mechanism may be that SAM can reverse the hypomethylation of c-myc and uPA genes, reduce their expression, and then inhibit tumor growth.

Functional and psychosocial effects of pulmonary Daoyin on patients with COPD in China:study protocol of a multicenter randomized controlled trial

BACKGROUND： Chronic obstructive pulmonary disease （COPD） is a major public health problem worldwide. Pulmonary rehabilitation （PR） is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China. METHODS AND DESIGN： A multicenter, randomized, controlled trial will be conducted. A total of 464 patients meeting the inclusion criteria will be enrolled into this study with 232 patients in each of the trial group and the control group. Based on patient education, patients in the trial group will receive pulmonary Daoyin and continue with their usual therapy for three months. In the control group, patients will continue with their usual therapy. The primary outcome measures are exercise capacity assessed by the six-minute walking distance test and lung function. Secondary outcomes include dyspnea and quality of life. Measurements will be taken at baseline （month 0） and after the study period （month 3）. DISCUSSION： It is hypothesized that pulmonary Daoyin will have beneficial effects in improving exercise capacity and psychosocial function of patients with stable COPD, and will provide an alternative form of exercise training that is accessible for the large number of people with COPD. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is NCT01482000.

高暴露{111}晶面Ag2-xO用于高效电化学析氧反应及其活性和机理

析氧反应(OER)是工业上制约水裂解制氢和CO2综合利用的瓶颈,涉及四电子、四质子耦合以及O-O键的形成,是一个复杂的、高活化能(高过电位)的动力学过程.模拟自然界光系统PS Ⅱ,发展高效、稳定、经济的析氧催化剂(OEC)是一个具有挑战性的研究课题.Ag基催化剂因具有以下优势而成为候选:(1)Ag与Ru同属第五周期性质相近,且有经济性且储量丰富;(2) Ag比第三周期过渡金属具有更高的电子密度和更多可调节配位数;(3) Ag存在Ⅰ, Ⅱ, Ⅲ多种氧化态.本课题组前期工作证明, Ag基配合物[H3AgI(H2O)PW11O39]3–在酸性水溶液体系中能够形成高氧化态AgⅡ和AgⅢ配合物,用于OER时展现出高活性和稳定性.受此启发,我们选择简单银基氧化物用于研究电催化OER活性并探究其催化机理.本文通过恒电流沉积法在含有Ag+离子的0.1 M K2B4O7电解质溶液中设计合成了系列Ag2–xO/FTO-i (i=0.5, 1, 2, 3, 4, 7m Acm–2)电极,并通过XRD, SEM和TEM方法对其组成和形貌进行了表征.XRD结果表明,电极膜由Ag2O组成,随着沉积电流密度增加,其{111}晶面衍射峰向高角度移动,推测是由部分Ag+离子氧化成Ag2+离子所致.SEM显示, Ag2–xO/FTO-1电极膜上Ag2–xO主体呈现三角薄片状,拥有比其它电极Ag2–xO/FTO-i(i=0.5,2,3,4,7)暴露更多的{111}晶面.同时,高倍TEM显示晶面间距为0.267 nm,进一步证明存在较多暴露{111}晶面.线性扫描伏安曲线(LSV)显示, Ag2–xO/FTO-1电极具有最高的OER电流密度,通过对Tafel区域进行拟合,得到Tafel方程η=0.37+0.047 log|j|,计算得出在10 m A cm–2电流密度下Ag2–xO/FTO-1电极具有较低的Tafel斜率47 m Vdec–1和过电位417 m Vvs.RHE,可用作高效的OEC.电化学阻抗谱(EIS)表明,相比其它电极, Ag2–xO/FTO-1具有最佳的电荷转移能力.电流–时间(I–t)曲线显示10h内其电流密度仅下降4%,表明电极稳定性良好.通过XPS和拉曼光谱发现, Ag2–xO/FTO-1经过循环伏安(CV)测试后存在O-O键,说明Ag2–xO电催化OER过程中形成了过氧物种.XPS进一步显示催化反应前后Ag+和Ag2+峰面积比由1.46降至0.65,说明反应后Ag2+含量显著增加.通过对Ag2–xO/FTO-1电极电催化OER机理的研究,我们推测其具有优异活性的原因是Ag2–xO表面更高暴露{111}晶面有利于Ag+/Ag2+吸附OH–和H2O,相邻的吸附氧原子在脱去H+的同时,氧原子上活性电子易于转移给Ag2+形成O-O键和Ag+.电极上Ag+进一步被氧化生成Ag2+, Ag2+将过氧物种氧化,放出O2,完成催化剂的循环再利用.

Expression of ornithine decarboxylase in precancerous and cancerous gastric lesions

AIM: To investigate the expression of ornithine decarboxylase (ODC) in precancerous and cancerous gastric lesions. METHODS: We studied the expression of ODC in gastric mucosa from patients with chronic superficial gastritis (CSG,n = 32),chronic atrophic gastritis CAG,n = 43; 15 with and 28 without intestinal metaplasia (IM),gastric dysplasia (DYS,n = 11) and gastric cancer (GC,n = 48) tissues using immunohistochemical staining. All 134 biopsy specimens of gastric mucosa were collected by gastroscopy. METHODS: The positive rate of ODC expression was 34.4%,42.9%,73.3%,81.8% and 91.7% in cases with CSG,CAG without IM,CAG with IM,DYS and GC,respectively (P < 0.01),The positive rate of ODC expression increased in the order of CSG < CAG (without IM) < CAG (with IM) < DYS and finally,GC. In addition,ODC positive immunostaining rate was lower in well-differentiated GC than in poorly-differentiated GC (P < 0.05). CONCLUSION: The expression of ODC is positively correlated with the degree of malignity of gastric mucosa and development of gastric lesions. This finding indicates that ODC may be used as a good biomarker in the screening and diagnosis of precancerous lesions.

Effects of refluxate pH values on duodenogastroesophageal reflux-induced esophageal adenocarcinoma

AIM:To determine the effects of duodenogastric juice pH on the development of esophageal adenocarcinoma (EAC).METHODS:An animal model of duodenogastroesophageal reflux was established using Sprague-Dawley (SD) rats undergoing esophagoduodenostomy (ED).The development of EAC was investigated in rats exposed to duodenogastric juice of different pH.The rats were divided into three groups:low-pH group (group A),highpH group (group B) and a sham-operated group as a control (group C) (n=30 rats in each group).The incidence of esophagitis,Barrett's esophagus (BE),intestinal metaplasia with dysplasia and EAC was observed 40 wk after the treatment.RESULTS:The incidence rate of esophagitis,BE,intestinal metaplasia with dysplasia and EAC was higher in groups A and B compared with the control group after 40 wk (P < 0.01),being 96% and 100% (P > 0.05),88% and 82.4% (P > 0.05),20% and 52.1% (P < 0.05),and 8% and 39% (P < 0.05),respectively.CONCLUSION:Non-acidic refluxate increases the occurrence of intestinal metaplasia with dysplasia and EAC while the low-pH gastric juice exerts a protective effect in the presence of duodenal juice.The non-acid reflux is particularly important in the progression from BE to cancer.Therefore,control of duodenal reflux may be an important prophylaxis for EAC.

Exposure to gastric juice may not cause adenocarcinogenesis of the esophagus

AIM: To determine the effects of gastric juice on the development of esophageal adenocarcinoma (EAC). METHODS: A animal model of duodenogastroesophageal reflux was established in Sprague-Dawley rats undergoing esophagoduodenostomy. The development of EAC and forestomach adenocarcinoma was investigated 40 wk after the treatment. Intraluminal pH and bile of the forestomach were measured. RESULTS: There were no significant differences in pH (t=0.117, P=0.925) or bile (χ2=0.036, P=0.85) in the forestomach before and 40 wk after esophagoduodenostomy. There were also no significant differences between the model and controls during esophagoduodenostomy or 40 wk after esophagoduodenostomy. The incidence of intestinal metaplasia (88%) and intestinal metaplasia with dysplasia and adenocarcinoma (28%) in the esophagus in the model was higher than in the controls 40 wk after surgery (χ2=43.06, P < 0.001 and χ2=9.33, P=0.002, respectively) and in the forestomach in the model (χ2=32.05, P < 0.001 and χ2=8.14, P=0.004, respectively). The incidence rates of inflammation in the esophagus and forestomach were 100% and 96%, respectively (χ2=1.02, P=0.31) in the model, which was higher than in the esophageal control (6.8%) (χ2=42.70, P < 0.001). CONCLUSION: Gastric juice exposure may not cause intestinal metaplasia with dysplasia or adenocarcinoma of the forestomach and may not be related to EAC.

Guideline on Chinese Medicine Rehabilitation for Idiopathic Pulmonary Fibrosis

Foreword Note:Some of the elements of this document may be the subject of patent rights.WFCMS shall not be held responsible for identifying any or all such patent rights.Main drafting organizations:Henan University of Chinese Medicine,The First Affiliated Hospital of Henan University of Chinese Medicine.

Effective-constituent compatibility-based analysis of Bufei Yishen formula, a traditional herbal compound as an effective treatment for chronic obstructive pulmonary disease

Objective:Critical effective constituents were identified from Bufei Yishen formula(BYF),a traditional herbal compound and combined as effective-constituent compatibility(ECC)of BYF I,which may have potential bioactive equivalence to BYF.Methods:The active constituents of BYF were identified using four cellular models and categorised into Groups 1(Bufeiqi),2(Bushen),3(Huatan)and 4(Huoxue)according to Chinese medicinal theory.An orthogonal design and a combination method were used to determine the optimal ratios of effective constituents in each group and the ratios of‘‘Groups 1 to 4"according to their pharmacological activity.We also comprehensively assessed bioactive equivalence between the BYF and the ECC of BYF I in a rat model of chronic obstructive pulmonary disease(COPD).Results:We identified 12 active constituents in BYF.The numbers of constituents in Groups 1 to 4 were 3,2,5 and 2,respectively.We identified the optimal ratios of effective constituents within each group.In Group1,total ginsenosides:Astragalus polysaccharide:astragaloside IV ratio was 9:5:2.In Group 2,icariin:schisandrin B ratio was 100:12.5.In Group 3,nobiletin:hesperidin:peimine:peiminine:kaempferol ratio was4:30:6.25:0:0.In Group 4,paeoniflorin:paeonol ratio was 4:1.An orthogonal design was then used to establish the optimal ratios of Group 1,Group 2,Group 3 and Group 4 in ECC of BYF I.The ratio for total ginsenosides:Astragalus polysaccharide:astragaloside IV:icariin:schisandrin B:nobiletin:hesperidin:peimine:paeoniflorin:paeonol was determined to be 22.5:12.5:5:100:12.5:4:30:6.25:25:6.25.A comprehensive evaluation confirmed that ECC of BYF I presented with bioactive equivalence to the original BYF.Conclusion:Based on the ECC of traditional Chinese medicine formula method,the effective constituents of BYF were identified and combined in a fixed ratio as ECC of BYF I that was as effective as BYF itself in treating rats with COPD.

Guidelines for Chinese Medicine Rehabilitation of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease(COPD)is a common,chronic,frequently occurring,and difficult disease of the respiratory system and is a huge disease burden.Pulmonary rehabilitation is an important part of clinical treatment.Chinese medicine lung rehabilitation(CMLR),which is based on Chinese medicine theory and practice,is a comprehensive rehabilitation measure that can prevent and treat pulmonary diseases and preserve physical and mental functions.Its aim is to promote the return of patients to society as soon as possible.To better guide the clinical practice of COPD rehabilitation,the Specialty Committee of Pulmonary Rehabilitation of World Federation of Chinese Medicine Societies established a panel for formulating guidelines,systematically retrieved domestic and foreign literature,performed systematic evaluation after expert consultation and on-site discussion,and finally,formed the guidelines in accordance with the development standard of international evidence-based guidelines.The guideline has seven parts,which are the preface,introduction,scope,normative references,terms and definitions,types of disease syndromes,diseases assessment,CMLR techniques,and annex.The techniques of CMLR include 11 techniques in seven species,such as Simplified Taijiquan,Baduanjin,and Liuzijue.The guideline defines the technical points(time,frequency,course,etc.),optimal applicable population,use of drugs,common acupoints,operation methods,and so on for each technique.The release of the guidelines is helpful to improve the rehabilitation technique standardization and to improve the curative effect and level of rehabilitation.

International Clinical Practice Guideline of Chinese Medicine: Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major chronic disease that seriously endangers public health. Some remarkable results have shown that Chinese medicine has an obvious clinical effect in preventing and treating COPD. To further promote the normative use of Chinese medicine to better guide the clinical diagnosis and treatment of COPD,the World Federation of Chinese Medicine Societies developed a panel to establish the guidelines by systematically evaluating, based on the revision and transformation of Guidelines for Chinese Medicine Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease released by the China Association of Chinese Medicine in 2019(Standard No:T/CACM 1319-2019), the latest clinical research evidence at home and abroad, formatting the International Clinical Practice Guideline of Chinese Medicine—Chronic Obstructive Pulmonary Disease, and publishing in both Chinese and English. The guidelines consist of 12 parts:preface, introduction, scope, normative references, terms and definitions, disease diagnosis and staging, severity assessment,etiology and pathogenesis, syndrome differentiation and treatment, other treatment, prevention and care, and appendix. They also standardize the contents of traditional Chinese medicine (TCM) etiology and pathogenesis, syndrome differentiation and treatment, and prevention and care of COPD. These guidelines are applicable to clinical respiratory physicians of TCM and integrated traditional Chinese and western medicine.The release of these guidelines will help improve the effect and level of Chinese medicine for COPD.

Efficacy and safety of Kangxian Huanji Granule as adjunctive treatment in acute exacerbation of idiopathic pulmonary fibrosis:An exploratory randomized controlled trial

Background:Acute exacerbation of idiopathic pulmonary fibrosis(AE-IPF)is an important occurrence in the natural history of idiopathic pulmonary fibrosis(IPF),associated with high hospitalization rates,high mortality and poor prognosis.At present,there is no effective treatment for AE-IPF.Chinese herbal medicine has some advantages in treating IPF,but its utility in AE-IPF is unclear.Objective:The treatment of AE-IPF with Kangxian Huanji Granule(KXHJ),a compound Chinese herbal medicine,lacks an evidence-based justification.This study explores the efficacy and safety of KXHJ in patients with AE-IPF.Design,setting,participants and interventions:Wedesigned a randomized,double-blind,placebo-controlled,exploratory clinical trial.A total of 80 participants diagnosed with AE-IPF were randomly assigned to receive KXHJ or a matching placebo;the treatment included a 10 g dose,administered twice daily for 4 weeks,in addition to conventional treatment.Participants were followed up for 12 weeks after the treatment.Main outcome measures:The primary endpoints were treatment failure rate and all-cause mortality.Secondary endpoints included the length of hospitalization,overall survival,acute exacerbation rate,intubation rate,the modified British Medical Research Council(mMRC)score,and the St George’s Respiratory Questionnaire for IPF(SGRQ-I)score.Results:The rate of treatment failure at 4 weeks was lower in the intervention groupcompared to the control group(risk ratio[RR]:0.22;95%confidence interval[CI]:0.051 to 0.965,P=0.023).There was no significant difference in all-causemortality at 16 weeks(RR:0.75;95%CI:0.179 to 3.138;P>0.999)or in the acute exacerbation rate during the 12-week follow-up period(RR:0.69;95%CI:0.334 to 1.434;P=0.317).The intervention group had a shorter length of hospitalization than the control group(mean difference[MD]:–3.30 days;95%CI,–6.300 to–0.300;P=0.032).Significant differences in the mean change from baseline in the mMRC(between-group difference:–0.67;95%CI:–0.89 to–0.44;P<0.001)and SGRQ-I score(between-group difference:–10.36;95%CI:–16.483 to–4.228;P=0.001)were observed after 4 weeks,and also in the mMRC(between-group difference:–0.67;95%CI:–0.91 to–0.43;P<0.001)and SGRQ-I(between-group difference:–10.28;95%CI,–15.838 to–4.718;P<0.001)at 16 weeks.The difference in the adverse events was not significant.Conclusion:KXHJ appears to be effective and safe for AE-IPF and can be considered a complementary treatment in patients with AE-IPF.As a preliminary exploratory study,our results provide a basis for further clinical research.

Quantitative Trait Loci Mapping of Maize Yield and Its Components Under Different Water Treatments at Flowering Time

Drought or water stress is a serious agronomic problem resulting in maize （Zea mays L.） yield loss throughout the world. Breeding hybrids with drought tolerance is one important approach for solving this problem. However, lower efficiency and a longer period of breeding hybrids are disadvantages of traditional breeding programs. It is generally recognized that applying molecular marker techniques to traditional breeding programs could improve the efficiency of the breeding of drought-tolerant maize. To provide useful information for use in studies of maize drought tolerance, the mapping and tagging of quantitative trait loci （QTL） for yield and its components were performed in the present study on the basis of the principle of a mixed linear model. Two hundred and twenty-one recombinant inbred lines （RIL） of Yuyu 22 were grown under both well-watered and water-stressed conditions. In the former treatment group, plants were well irrigated, whereas those in the latter treatment group were stressed at flowering time. Ten plants of each genotype were grown in a row that was 3.00 m × 0.67 m （length × width）. The results show that a few of the QTL were the same （one additive QTL for ear length, two additive QTL and one pair of epistatic QTL for kernel number per row, one additive QTL for kernel weight per plant）, whereas most of other QTL were different between the two different water treatment groups. It may be that genetic expression differs under the two different water conditions. Furthermore, differences in the additive and epistatic QTL among the traits under water-stressed conditions indicate that genetic expression also differs from trait to trait. Major and minor QTL were detected for the traits, except for kernel number per row, under water-stressed conditions. Thus, the genetic mechanism of drought tolerance in maize is complex because the additive and epistatic QTL exist at the same time and the major and minor QTL all contribute to phenotype under water-stressed conditions. In particular, epidemic QTL under water-stressed conditions suggest that it is important to investigate the drought tolerance of maize from a genetic viewpoint.

Traditional Chinese medicine in the treatment of idiopathic pulmonary fibrosis based on syndrome differentiation:Study protocol of an exploratory trial

Background: Idiopathic pulmonary fibrosis(IPF) has a poor prognosis and is often a kind of heavy financial burden to patients. Currently, few treatments are available for IPF. Clinical practice of traditional Chinese medicine(TCM), using a syndrome differentiation approach, offers some treatment success in IPF. However, there is no sufficient evidence-based study of the role of TCM in IPF management to make strong conclusions. This study evaluates the efficacy and safety of TCM in the treatment of IPF.Methods and design: A multicenter, exploratory, randomized, double-blind and placebo-controlled trial is planned. A total of 80 patients will be enrolled in the study, which will include 26 weeks of treatment.Participants will be randomly assigned into TCM group or control group in a 1:1 ratio. The TCM group will be given TCM granules based on syndrome differentiation. Formulae include Bao-fei Hua-xian granule for lung qi deficiency, Jin-shui Huan-xian granule for lung-kidney qi deficiency and Yang-qing Kang-xian granule for yin deficiency and inner heat. The control group will be given a corresponding TCM granule placebo. The efficacy and safety of interventions will be evaluated by the outcome variables,including frequencies of acute exacerbations, pulmonary function, clinical symptoms, dyspnea, healthrelated quality of life(HRQo L), 6-minute walk distance and safety indicators.Discussion: It is hypothesized that TCM will decrease the frequency of adverse events, improve pulmonary function and HRQo L, based on our clinical experience. This trial is the first study of TCM treatment in IPF that is based on syndrome differentiation and will evaluate the efficacy and safety of TCM in IPF.

Mapping of Defense Response Gene Homologs and Their Association with Resistance Loci in Maize

Defense response genes in higher plant species are involved in a variety of signal transduction pathways and biochemical reactions to counterattack invading pathogens. In this study, a total of 366 non-redundant defense response gene homologs （DRHs）, including 124 unigenes/expressed sequence tags, 226 tentative consensuses, and 16 DRH contigs have been identified by mining the Maize Genetics and Genomics and The Institute for Genomic Research maize databases using 35 essential defense response genes. Of 366 DRHs, 202 are mapped to 152 loci across ten maize chromosomes via both the genetic and in silico mapping approaches. The mapped DRHs seem to cluster together rather than be evenly distributed along the maize genome. Approximately half of these DHRs are located in regions harboring either major resistance genes or quantitative trait loci （QTL）. Therefore, this comprehensive DRH linkage map will provide reference sequences to identify either positional candidate genes for resistance genes and/or QTLs or to develop makers for fine-mapping and marker-assisted selection of resistance genes and/or QTLs.