Dry environment on the expression of lacrimal gland S100A9,Anxa1,and Clu in rats via proteomics

●AIM:To investigate the underlying mechanism of dry environment(autumn dryness)affecting the lacrimal glands in rats.●METHODS:Twenty Sprague-Dawley rats were randomly divided into two groups.The rats were fed in specific pathogen free environment as the control group(n=10),and the rats fed in dry environment as the dryness group(n=10).After 24d,lacrimal glands were collected from the rats.The tissues morphology was observed by hematoxylineosin(HE)staining.Tandem mass tags(TMT)quantitative proteomics analysis technology was used to screen the differential expressed proteins of lacrimal glands between the two groups,then bioinformatics analysis was performed.Further,the immunohistochemical(IHC)method was used to verify the target proteins.●RESULTS:In dryness group,the lacrimal glands lobule atrophied,the glandular cavities enlarged,the sparse nuclear distribution and scattered inflammatory infiltration between the acinus were observed.The proteomics exhibited that a total of 195 up-regulated and 236 downregulated differential expressed proteins screened from the lacrimal glands of rats.It was indicated that the biological processes(BP)of differential expressed proteins mainly included cell processes and single BP.The cellular compositions of differential expressed proteins mainly located in cells,organelles.The molecular functions of differential expressed proteins mainly included binding,catalytic activity.Moreover,the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that the differential expressed proteins mainly involved lysosome,complement and coagulation cascade,and ribosome pathway.The IHC result verified that the up-regulated expression proteins of Protein S100A9(S100A9),Annexin A1(Anxa1),and Clusterin(Clu)in lacrimal glands of rats in dryness group were higher than control group.●CONCLUSION:The up-regulated expression proteins of S100A9,Anxa1,and Clu may be the potential mechanisms of dry eye symptoms caused by dry environment.This study provides clues of dry environments causing eye-related diseases for further studies.

Jianpi Gushen Huayu decoction ameliorated diabetic nephropathy through modulating metabolites in kidney,and inhibiting TLR4/NF-κB/NLRP3 and JNK/P38 pathways

BACKGROUND Jianpi Gushen Huayu Decoction(JPGS)has been used to clinically treat diabetic nephropathy(DN)for many years.However,the protective mechanism of JPGS in treating DN remains unclear.AIM To evaluate the therapeutic effects and the possible mechanism of JPGS on DN.METHODS We first evaluated the therapeutic potential of JPGS on a DN mouse model.We then investigated the effect of JPGS on the renal metabolite levels of DN mice using non-targeted metabolomics.Furthermore,we examined the effects of JPGS on c-Jun N-terminal kinase(JNK)/P38-mediated apoptosis and the inflammatory responses mediated by toll-like receptor 4(TLR4)/nuclear factor-kappa B(NF-κB)/NOD-like receptor family pyrin domain containing 3(NLRP3).RESULTS The ameliorative effects of JPGS on DN mice included the alleviation of renal injury and the control of inflammation and oxidative stress.Untargeted metabolomic analysis revealed that JPGS altered the metabolites of the kidneys in DN mice.A total of 51 differential metabolites were screened.Pathway analysis results indicated that nine pathways significantly changed between the control and model groups,while six pathways significantly altered between the model and JPGS groups.Pathways related to cysteine and methionine metabolism;alanine,tryptophan metabolism;aspartate and glutamate metabolism;and riboflavin metabolism were identified as the key pathways through which JPGS affects DN.Further experimental validation showed that JPGS treatment reduced the expression of TLR4/NF-κB/NLRP3 pathways and JNK/P38 pathway-mediated apoptosis related factors.CONCLUSION JPGS could markedly treat mice with streptozotocin(STZ)-induced DN,which is possibly related to the regulation of several metabolic pathways found in kidneys.Furthermore,JPGS could improve kidney inflammatory responses and ameliorate kidney injuries in DN mice via the TLR4/NF-κB/NLRP3 pathway and inhibit JNK/P38 pathwaymediated apoptosis in DN mice.

Seminar结合CBL教学法在冠心病教学中的应用

目的探讨专题讨论课(Seminar)结合案例教学法(case-based learning,CBL)教学法在冠心病教学中的应用价值。方法选取2021年4月至2022年12月在北京市延庆区医院内科实习的临床医学乡医定向班专科学生为研究对象,采用随机数字表法分为对照组和观察组。对照组采用传统讲授法,观察组采用Seminar结合CBL教学。比较两组学生的理论考试成绩、技能操作成绩、教学满意度和教学效果。结果共纳入80名学生,观察组和对照组各40名。观察组理论考试成绩(90.24±5.26 vs.86.31±3.52,P<0.001)、技能操作成绩(81.06±4.53 vs.74.85±4.89,P<0.001)均高于对照组;观察组教学满意度高于对照组(87.50%vs.70.00%,P=0.026);观察组教学效果六个方面均优于对照组,差异有统计学意义(P<0.05)。结论Seminar结合CBL教学法在冠心病教学中优势明显,学生教学满意度高,且有助于提高冠心病教学效果。

Morphological features and endovascular repair for type B multichanneled aortic dissection: A case report

BACKGROUND Among the various types of aortic dissection,multichanneled aortic dissection(MCAD)differs from classic double-channeled aortic dissection and involves the formation of an additional false lumen in the aortic wall or the flaps.It is considered a relatively rare condition with high perioperative mortality and morbidity.However,the morphological characteristic and the optimal therapeutic strategy for MCAD has not been fully determined.CASE SUMMARY A 64-year-old man presented to our hospital with severe epigastric abdominal pain radiating to the back that was associated with nausea without emesis.A computed tomography angiogram was performed that revealed a type B aortic dissection with multiple channels extending from the level of the left subclavian artery to the bilateral femoral arteries.We used a medical three-dimensional modeling(3D)modeling system to identify the location and extension of multiple lumens from different angles.It also precisely located the two primary entries leading to the false lumens,which helped us to exclude the two false lumens with one stent-graft.CONCLUSION By applying medical 3D modeling system,we discover the fragility of aortic wall and the collapse of true lumen caused by the multiple false lumens are the two morphological features of MCAD.

Scutellarin protects oxygen/glucose-deprived astrocytes and reduces focal cerebral ischemic injury

Scutellarin, a bioactive flavone isolated from Scutellaria baicalensis, has anti-inflammatory, anti-neurotoxic, anti-apoptotic and anti-oxidative effects and has been used to treat cardiovascular and cerebrovascular diseases in China. However, the mechanisms by which scutellarin mediates neuroprotection in cerebral ischemia remain unclear. The interaction between scutellarin and nicotinamide adenine dinucleotide phosphate oxidase 2(NOX2) was assessed by molecular docking study, which showed that scutellarin selectively binds to NOX2 with high affinity. Cultures of primary astrocytes isolated from the cerebral cortex of neonatal Sprague-Dawley rats were pretreated with 2, 10 or 50 μM scutellarin for 30 minutes. The astrocytes were then subjected to oxygen/glucose deprivation by incubation for 2 hours in glucose-free Dulbecco's modified Eagle's medium in a 95% N2/5% CO_2 incubator, followed by simulated reperfusion for 22 hours. Cell viability was assessed by cell counting kit-8 assay. Expression levels of NOX2, connexin 43 and caspase-3 were assessed by western blot assay. Reactive oxygen species were measured spectrophotometrically. Pretreatment with 10 or 50 μM scutellarin substantially increased viability, reduced the expression of NOX2 and caspase-3, increased the expression of connexin 43, and diminished the levels of reactive oxygen species in astrocytes subjected to ischemia-reperfusion. We also assessed the effects of scutellarin in vivo in the rat transient middle cerebral artery occlusion model of cerebral ischemia-reperfusion injury. Rats were given intraperitoneal injection of 100 mg/kg scutellarin 2 hours before surgery. The Bederson scale was used to assess neurological deficit, and 2,3,5-triphenyltetrazolium chloride staining was used to measure infarct size. Western blot assay was used to assess expression of NOX2 and connexin 43 in brain tissue. Enzyme-linked immunosorbent assay was used to detect 8-hydroxydeoxyguanosine(8-OHd G), 4-hydroxy-2-nonenal(4-HNE) and 3-nitrotyrosin(3-NT) in brain tissue. Immunofluorescence double staining was used to determine the co-expression of caspase-3 and Neu N. Pretreatment with scutellarin improved the neurological function of rats with focal cerebral ischemia, reduced infarct size, diminished the expression of NOX2, reduced levels of 8-OHd G, 4-HNE and 3-NT, and reduced the number of cells co-expressing caspase-3 and Neu N in the injured brain tissue. Furthermore, we examined the effect of the NOX2 inhibitor apocynin. Apocynin substantially increased connexin 43 expression in vivo and in vitro. Collectively, our findings suggest that scutellarin protects against ischemic injury in vitro and in vivo by downregulating NOX2, upregulating connexin 43, decreasing oxidative damage, and reducing apoptotic cell death.

Laparoscopic hepaticoplasty using gallbladder as a subcutaneous tunnel for hepatolithiasis

AIM:To investigate the feasibility,efficacy and safety of laparoscopic hepaticoplasty using gallbladder as subcutaneous tunnel and sphincter-of-Oddi preservation for hepatolithiasis.METHODS:From January 2010 to July 2013,six patients with hepatolithiasis were treated at our institution.All the patients underwent laparoscopic surgery.The procedures included common hepatic duct exploration,stone clearance by fiberoptic choledochoscopy,hilar bile duct hepaticoplasty with preservation of the sphincter of Oddi,anastomosis between the hilar bile duct and neck of the gallbladder,and establishment of a subcutaneous tunnel with the gallbladder.Two patients underwent left lateral hepatectomy simultaneously.Clinical data including operation time,intraoperative blood loss,operative morbidity,hospital mortality,stone clearance,and recurrence rate were analyzed.RESULTS:All patients successfully completed laparoscopic surgery.The mean length of hospital stay was4.5±0.9 d(range:3-6 d).The mean blood loss of the hepatectomy was 450 mL(range:200-700 mL),and the blood loss of the other four was 137±151 mL (range:50-400 mL).The mean operative time was 318±68 min(range:236-450 min).The operative morbidity and hospital mortality were zero.The immediate stone clearance rate was 100%.All patients were followed up for an average of 17 mo(range:7-36 mo).One of the six patients had abdominal mass with pain,and subcutaneous tunnel cholangiography showed severe gallbladder-biliary anastomotic stricture at 4 mo postoperatively.There was no stone recurrence and no cholangitis during follow-up.CONCLUSION:Laparoscopic hepaticoplasty using gallbladder with a subcutaneous tunnel and preserving the sphincter of Oddi is feasible,safe and effective for hepatholithiasis.

Oddi sphincter preserved cholangioplasty with hepaticosubcutaneous stoma for hepatolithiasis

AIM: To evaluate the long-term outcomes of Oddi sphincter preserved cholangioplasty with hepaticosubcutaneous stoma(OSPCHS) and risk factors for recurrence in hepatolithiasis.METHODS: From March 1993 to December 2012, 202 consecutive patients with hepatolithiasis underwent OSPCHS at our department. The Oddi sphincter preserved procedure consisted of common hepatic duct exploration, stone extraction, hilar bile duct plasty, establishment of subcutaneous stoma to the bile duct. Patients with recurrent stones can undergo stone extraction and/or biliary drainage via the subcutaneous stoma which can be incised under local anesthesia. The long-term results were reviewed. Cox regression model was employed to analyze the risk factors for stone recurrence.RESULTS: Ninety-seven(48.0%) OSPCHS patients underwent hepatic resection concomitantly. The rate of surgical complications was 10.4%. There was no perioperative death. The immediate stone clearance rate was 72.8%. Postoperative cholangioscopic lithotomy raised the clearance rate to 97.0%. With a median follow-up period of 78.5 mo(range: 2-233 mo), 24.8% of patients had recurrent stones, 2.5% had late development of cholangiocarcinoma, and the mortality rate was 5.4%. Removal of recurrent stones and/or drainage of inflammatory bile via subcutaneous stoma were conducted in 44(21.8%) patients. The clearance rate of recurrent stones was 84.0% after subsequent choledochoscopic lithotripsy via subcutaneous stoma.Cox regression analysis showed that residual stone was an independent prognostic factor for stone recurrence.CONCLUSION: In selected patients with hepatolithiasis, OSPCHS achieves excellent long-term outcomes, and residual stone is an independent prognostic factor for stone recurrence.

Protective effects of two Lactobacillus plantarum strains in hyperlipidemic mice

AIM:To investigate the effects of Lactobacillus plantarum(L.plantarum) CAI6 and L.plantarum SC4 on hyperlipidemic mice.METHODS:Male Kunming mice were fed a highcholesterol diet for 28 d to construct hyperlipidemic models.Hyperlipidemic mice and normal mice were assigned to 3 groups which were separately treated with L.plantarum CAI6,L.plantarum SC4,and physiological saline through oral gavage for 28 d.Total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C) levels were measured by commercially available enzyme kits.FACS Calibur flow cytometry was used to examine hepatic and renal nuclear factor-erythroid 2-related factor 2(Nrf2) expression.The morphology of livers was checked by hematoxylin and eosin staining and optical microscope observation.RESULTS:Compared with normal mice,hyperlipidemic mice possessed significantly higher TC(3.50 ± 0.43 vs 2.89 ± 0.36,P < 0.01),TG(1.76 ± 0.07 vs 1.10 ± 0.16,P < 0.01),and LDL-C(1.72 ± 0.20 vs 0.82 ± 0.10,P < 0.01) levels,resulting in an increase of atherogenic index(AI)(2.34 ± 1.60 vs 0.93 ± 0.55,P < 0.05) and LDL-C/HDL-C ratio(1.43 ± 0.12 vs 0.51 ± 0.16,P < 0.05).After treatment with L.plantarum CAI6/L.plantarum SC4,TG(1.43 ± 0.27/1.54 ± 0.10 vs 1.76 ± 0.07,P < 0.01/P < 0.05) and LDL-C(1.42 ± 0.07/1.47 ± 0.12 vs 1.72 ± 0.20,P < 0.01/P < 0.01) in hyperlipidemic mice significantly decreased.In addition,TC,HDL-C,AI,and LDL-C/HDL-C ratio were all positively changed.Meanwhile,the treatment markedly alleviated hepatic steatosis and significantly stimulated Nrf2 expression(73.79 ± 0.80/72.96 ± 1.22 vs 54.94 ± 1.84,P < 0.01/P < 0.01) in hepatocytes of hyperlipidemic mice.CONCLUSION:L.plantarum CAI6 and L.plantarum SC4 may protect against cardiovascular disease by lipid metabolism regulation and Nrf2-induced antioxidative defense in hyperlipidemic mice.

Efficacy of Long-term Selenium Supplementation in the Treatment of Chronic Keshan Disease with Congestive Heart Failure

Few effective treatments for chronic Keshan disease have been available till now.The efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure is inconclusive.This study aimed to determine whether selenium supplementation is associated with a decreased risk of cardiac death in chronic Keshan disease with congestive heart failure by ten years of follow-up.A retrospective long-term follow-up analysis was performed on a monitored cohort consisting of 302 chronic Keshan disease patients with a mean age of 40.8±11.4 years.Of the 302 chronic Keshan disease patients,170(56.3%)were given selenium supplementation until the end point of follow-up.Cox proportional hazards regression models were used to identify the independent predictors of cardiac events.Our results showed that during the follow-up,there were 101 deaths of patients with chronic Keshan disease in the selenium supplementation group(101/170,59.4%)and 98 in non-selenium supplementation group(98/132,74.2%).Multivariate analyses suggested that selenium supplementation was associated with a decreased risk of cardiac death(HR 0.39,95%CI 0.28-0.53)after adjustment for baseline age,sex,cigarette smoking,family history of Keshan disease,body mass index(BMI),heart rate,electrocardiogram(ECG)abnonnalities,blood pressure,initial cardiothoracic ratio,left ventricular可ection fractions(LVEF)and whole-blood selenium concentration.Our ten-year follow-up analysis indicated that selenium supplementation,specifically combined with the use of angiotensinconverting cnzyme inhibitor and beta blocker therapy,improved the survival of patients with chronic Keshan disease with congestive heart failure.BMI,selenium deficiency,male,combined ECG abnonnalities,LVEF,and fast heart rate increased the risk of cardiac events.

Protective effect of omeprazole on gastric mucosal of cirrhotic portal hypertension rats

Objective:To observe the protective effect of omeprazole on gastric mucosal of cirrhotic portal hypertension rats.Methods:All rats were randomly divided into normal control group,cirrhosis and treatment group.Thioacetamide was used to establish rat model of cirrhotic portal hypertension.The necrotic tissue of gastric mucosa ulcer focus,degree of neutrophils infiltration at the ulcer margin,portal pressure,portal venous flow,abdominal aortic pressure,abdominal aortic blood flow at front end,gastric mucosal blood flow(GMBF),glycoprotein(GP)of gastric mucosa,basal acid secretion,H' back-diffusion,gastric mucosal damage index,NO,prostaglandin E_2(PGE_2) and tumor necrosis factor-α(TNF-α) were determined respectively,and the pathological changes of gastric mucosa were also observed by microscope.Results:Compared with cirrhosis group and the control group,the ulcer bottom necrotic material,gastric neutrophil infiltration and UI of the treatment group were all decreased significantly(P<0.01),GMBF value,GP values,serum NO,PGE_2,TNF- a were all significantly increased.Conclusions:Omeprazole has an important protective effect on gastric mucosal and it can increase gastric mucosal blood flow and related to many factors.

Clinical application of plasma shock wave lithotripsy in treating impacted stones in the bile duct system

瞄准：为了验证血浆冲击波的安全和功效，在碎裂的碎石术(PSWL ) 在胆汁管系统影响了石头。方法：从 1988 年 9 月到 2005 年 4 月，有影响石头的 67 个病人(26 个男人和 41 个女人) 与试管经历了各种各样的胆汁的操作(或 T 试管) 排水。在胆管造影术在操作以后发现的胆汁管系统的残余和影响石头被 PSWL 和 choledochofiberscopy 碎裂。201 块影响石头的一个总数被为 PSWL 的每脉搏在 2-3 J 将电压放在 2.5-3.5 kV，和能排出量的 PSWL 碎裂。然后，碎裂的石头被 choledochofiberscopy 提取。PSWL 的安全和功效被观察在期间并且在过程以后。结果：在胆汁管系统的 201 块影响石头(99.0%) 中的 199 个成功地用 PSWL 被碎裂并且由 choledochofiberscopy 提取了。为病人的石头清理率是 97%(65/67 ) 。十个病人在腹部的恰好上面的象限感到了温和疼痛，并且能容忍它很好。十一个病人有从胆汁管的粘膜流血的小数量。流血在生理盐水灌溉的 2 min 以内自发地短暂、停止。没有重要复杂并发症在期间并且在过程以后。结论: PSWL 是一个安全、有效的方法因为碎裂在胆汁管系统影响了石头。

Alpha-GalCer Administration after Allogeneic Bone Marrow Transplantation Improves Immune Reconstitution in Mice

Objective To explore the effect of α-galactosyleramide (α-GalCer) on immune reconstitu-tion under acute graft-versus-host disease (aGVHD). Methods BALB/c mice were transplanted with allogeneic C57BL/6 bone marrow cells and splenocytes (both 1×107) after receiving lethal total-body irradiation. α-GalCer (100 ug/kg) or vehicle (dimethylsulfoxide) was administered intraperitoneally immediately after transplantation. The effects of α-GalCer on immune reconstitution, proliferation of T cells and B cells, hemato-poiesis, and thymic microenvironment were assessed. Results The α-GalCer group exhibited higher percentages of CD3+, CD4+, CD8+, B220+, CD40+, and CD86+ cells compared with the vehicle group. The number of colony forming unit per 1000 CD34+ cells in the α-GalCer group was higher than in the vehicle group (P=0.0012). In vitro proliferation assays showed that the α-GalCer group had higher percentages of CD3+, CD4+, CD8+, and B220+ cells compared with the vehicle group. As for the results of in vivo prolifera-tion assays, the numbers of CD3+, CD4+, CD8+, and B220+ cells were higher in the α-GalCer group than in the normal group, especially the number of B220+ cells (P=0.007). Significant difference was not found in thymocyte count between the α-GalCer group and the vehicle group, nor in the percentages of CD3+, CD4+, and CD8+ cells. Conclusion Administration of α-GalCer after allogeneic bone marrow transplantation may promote immune reconstitution in the presence of aGVHD.

Fluid identification and effective fracture prediction based on frequency-dependent AVOAz inversion for fractured reservoirs

Fluid and effective fracture identification in reservoirs is a crucial part of reservoir prediction.The frequency-dependent AVO inversion algorithms have proven to be effective for identifying fluid through its dispersion property.However,the conventional frequency-dependent AVO inversion algorithms based on Smith&Gidlow and Aki&Richards approximations do not consider the acquisition azimuth of seismic data and neglect the effect of seismic anisotropic dispersion in the actual medium.The aligned fractures in the subsurface medium induce anisotropy.The seismic anisotropy should be considered while accounting for the seismic dispersion properties through fluid-saturated fractured reservoirs.Anisotropy in such reservoirs is frequency-related due to wave-induced fluid-flow(WIFF)between interconnected fractures and pores.It can be used to identify fluid and effective fractures(fluid-saturated)by using azimuthal seismic data via anisotropic dispersion properties.In this paper,based on Rüger’s equation,we derived an analytical expression in the frequency domain for the frequencydependent AVOAz inversion in terms of fracture orientation,dispersion gradient of isotropic background rock,anisotropic dispersion gradient,and the dispersion at a normal incident angle.The frequency-dependent AVOAz equation utilizes azimuthal seismic data and considers the effect of both isotropic and anisotropic dispersion.Reassigned Gabor Transform(RGT)is used to achieve highresolution frequency division data.We then propose the frequency-dependent AVOAz inversion method to identify fluid and characterize effective fractures in fractured porous reservoirs.Through application to high-qualified seismic data of dolomite and carbonate reservoirs,the results show that the method is useful for identifying fluid and effective fractures in fluid-saturated fractured rocks.

Directional Analysis of the Chaotic Superlattice around the Equilibrium Point in the Phase Space

The recently proposed method of our research group named as directional Lyapunov exponents(DLEs) is presented. Then, DLEs are used to analyze the eigenstructure of the output phase space around the equilibrium points. Finally, the impacts of the superlattice parameter changes on the characteristics of the output chaotic signal are analyzed. The experimental results show that parameter changes of the superlattice will affect the eigenstructure around the equilibrium points in the output phase space, and DLEs are sensitive to these changes.

使用Hopfield神经网络的自适应最小预测误差反褶积和震源子波估计

人工神经网络大规模并行处理的优点可用适当的硬件来实现。因此,把人工神经网络应用于地震信号处理问题就可能大大地加速地震信号的处理。常用的人工神经网络-Hopfield神经网络的一项基本用途是实现新的自适应最小预测误差反褶积(AMPED)。它将反褶积和子波估计分解成三项子处理:反射率位置检测;反射率幅值估计以及震源子波提取。这些处理不要求对随机反射率模型做任何假设。本方法的基本思想就是建立反褶积和子波估计问题的价格函数与Hopfield神经网络的能量函数之间的关系,这样,当神经网络达到它们的稳定状态时,即,其能量函数达到局部极小时,从网络的输出就能得到反褶积和子波估计问题的解。为完成这三项子处理,需分别构造三个Hopfield神经网络。这些神经网络以迭代方式相连结以完成全部反褶积和子波估计。本方法应用于合成和实际地震道的结果证实:(1)Hopfield神经网络只需一到四次迭代就能收敛到它的稳定状态,因而能很快地给出反褶积和子波估计问题的解。(2)本方法在低信噪比和非最小相位子波的情况下也工作得相当好。(3)本方法能把反散射作为噪音也可作为有用信号来处理。

Efficacy of blood-letting puncture and cupping in the treatment of periarthritis of shoulder:a systematic review

目的:本文对刺络拔罐治疗肩周炎的疗效进行系统评价,并总结刺络拔罐治疗肩周炎的临床疗效及安全性。方法:按照Cochrane系统评价的方法,在CNKI、VIP、万方数据以及PubMed、EMBase、Medline、Cochrane Library等数据库中检索文献,查找应用刺络拔罐治疗肩周炎的随机对照试验和半随机对照试验。经过筛选纳入符合条件的临床随机对照试验(Randomized controlled trail RCT),对所纳入的研究进行数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析,用Jadad量表对文献质量进行评分,应用GRADE系统对证据质量和等级推荐进行评分。结果:一共纳入30项符合条件的RCT研究,共有2556名患者参加符合条件的临床研究。Meta分析结果显示:总有效率OR=6.21[OR=6.21,95%CI(4.69,8.21),P<0.001]。GRADE系统评价结果显示,证据水平均为B,推荐等级为弱推荐。结论:采用刺络拔罐治疗肩周炎的有效率高于其他治疗方法,且有较高的安全性,无明显的不良反应。由于纳入的临床对照研究质量有不足,仍然需要更多高质量的RCT研究才能得出肯定的结论。

气候因子调节荒漠土壤中丰富和稀有微生物群落的聚集过程

土壤微生物由少数的丰富类群和大量的稀有类群组成,它们对生态系统的功能和服务有不同的贡献。本研究采用高通量测序技术对荒漠土壤样品的物种组成进行DNA测序分析,揭示土壤微生物丰富类群和稀有类群的组成结构。采用相关性分析和随机森林方法进一步分析环境因子对丰富和稀有类群群落的影响。最后,利用基于零模型的β-最近类群指数(βNTI)解析土壤微生物的群落构建机制。研究结果表明,在荒漠土壤中,稀有细菌的群落构建几乎完全由确定性的同质选择过程支配;相比之下,随机过程对丰富细菌的影响更为明显。然而,无论是丰富真菌还是稀有真菌都表现出相似的群落构建模式,即确定性过程和随机过程共同决定了真菌的群落构建过程。这些结果表明,随着平均年降水量(MAP)和平均年气温(MAT)的增加,丰富细菌的群落构建过程从随机性转变为确定性。而对稀有真菌来说,随着MAT的增加,群落构建过程从确定性向随机性转变。该研究提供了MAT和MAP调节荒漠土壤中丰富和稀有微生物群落构建过程的明确证据。这些发现为进一步研究土壤微生物群落结构和生态功能奠定了理论基础。

Synthesis of Chiral α-Benzyl-β^(2)-hydroxy Carboxylic Acids through Iridium-Catalyzed Asymmetric Hydrogenation of α-Oxymethylcinnamic Acids

An asymmetric hydrogenation of α-oxymethylcinnamic acids was developed by using chiral spiro phosphineoxazoline/iridium complexes as catalysts to prepare β^(2)-hydroxycarboxylic acids with high reactivity(TON up to 2000)and excellent enantioselectivity(up to 99.5%ee).By using this highly efficient asymmetric hydrogenation as a key step,a concise total synthesis of natural product homoisoflavone(S)-(+)-4 was accomplished.

Streptococcus galolyticus meningocephalitis in adults: the first case report in China

We report on the first case of a Streptococcus gallolyticus meningocephalitis in China. The bacterium was first isolated from the patient's cerebrospinal fluid and has so far not been associated with human infections of the central nervous system. We hope our case report can give some references for the diagnosis and treatment of the Streptococcus gallolyticus meningocephalitis in China.