Bibliometric analysis and visual atlas of mercury-containing Chinese medicine:Hongfen(hydrargyrum oxydatum crudum)

Objectives In order to provide theoretical support for clinical standardization and promotion of the use of Hongfen(hydrargyrum oxydatum crudum),a mercury-containing Chinese medicine,as well as to make it easier to apply traditional Chinese topical preparations in a more contemporary manner.Methods We screened the topical research literature on Hongfen.Firstly,we analyzed the current research status of Hongfen statistically in terms of disciplinary distribution,research institutions,funding,publication volume,research types,and research focus of the literature;secondly,we analyzed the research status of Hongfen by MeSH term analysis,abstract and combined with the herbal literature,the indications,usage,dosage,and adverse effects of Hongfen were statistically analyzed,and keyword co-occurrence analysis and data visualization were performed using python+pyecharts.Results Early studies on Hongfen were mainly on the evaluation of the formulation process,while the current studies are mainly focused on clinical effectiveness and safety,with a considerable part of the studies also focused on drug toxicology,metabolism of mercury components target organ toxicity studies,while the basic studies on its mechanism of action are less.The clinical application is mainly focused on chronic ulcerated sores,refractory sinus fistula,and other surgical sore diseases,the use of which is mostly in the form of compounding and adding excipients,the use of which requires consideration of the accumulation of drug toxicity and attention to drug dosage and duration of use in order to reduce the occurrence of clinical side effects.Conclusion Hongfen is a type of mineral medicine that is extremely toxic but has a known curative effect.Its clinical use is low-risk,and its advantages greatly outweigh its drawbacks.Molecular biology technology should be actively carried out to analyze the pharmacological mechanism of Hongfen,which will play a positive role in the transmission and promotion of traditional Chinese medicine topical preparations.

Modified procedure for prolapse and hemorrhoids: Lower recurrence, higher satisfaction

BACKGROUND Hemorrhoidal prolapse is a common benign disease with a high incidence.The treatment procedure for prolapse and hemorrhoids(PPH)remains an operative method used for internal hemorrhoid prolapse.Although it is related to less posoperative pain,faster recovery and shorter hospital stays,the postoperative recurrence rate is higher than that of the Milligan-Morgan hemorrhoidectomy(MMH).We have considered that recurrence could be due to shortage of the pulling-up effect.This issue may be overcome by using lower purse-string sutures[modified-PPH(M-PPH)].AIM To compare the therapeutic effects and the patients’satisfaction after M-PPH,PPH and MMH.METHODS This retrospective cohort study included 1163 patients(M-PPH,461;original PPH,321;MMH,381)with severe hemorrhoids(stage III/IV)who were admitted to The 2nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University from 2012 to 2014.Early postoperative complications,efficacy,postoperative anal dysfunction and patient satisfaction were compared among the three groups.Established criteria were used to assess short-and long-term postoperative complications.A visual analog scale was used to evaluate postoperative pain.Follow-up was conducted 5 years postoperatively.RESULT Length of hospital stay and operating time were significantly longer in the MMH group(8.05±2.50 d,19.98±4.21 min;P<0.0001)than in other groups.The incidence of postoperative anastomotic bleeding was significantly lower after MPPH than after PPH or MMH(1.9%,5.1%and 3.7%;n=9,16 and 14;respectively).There was a significantly higher rate of sensation of rectal tenesmus after M-PPH than after MMH or PPH(15%,8%and 10%;n=69,30 and 32;respectively).There was a significantly lower rate of recurrence after M-PPH than after PPH(8.7%and 18.8%,n=40 and 61;P<0.0001).The incidence of postoperative anal incontinence differed significantly only between the MMH and M-PPH groups(1.3%and 4.3%,n=5 and 20;P=0.04).Patient satisfaction was significantly greater after M-PPH than after other surgeries.CONCLUSION M-PPH has many advantages for severe hemorrhoids(Goligher stage III/IV),with a low rate of anastomotic bleeding and recurrence and a very high rate of patient satisfaction.

The mechanism of Jiuyi powder and its effective components in inhibiting the M1 phenotype polarization of macrophages on chronic and refractory wounds infected by MRSA

Objective:To observe the effect of Jiuyi powder and its active components on the bacterial culture and macrophage phenotypic factors of the chronic refractory wound rat model,and to explore its mechanism of removing decay and promoting muscle growth.Methods:SD rats were divided into control group,Jiuyi powder group,Shengdan group,and calcined gypsum group,with 8 rats in each group.MRSA-infected skin lesions and wounds were used to build a model of chronic and difficult-to-heal wounds in rats.After the model was formed,the control group was treated with daily routine nitrofural disinfection and replaced with sterile gauze.On the basis of the control group,quantitative Jiuyi powder,Shengdan powder,and calcined gypsum powder were used for dressing change,once a day for 7 consecutive days.Before and after the last administration,collect rat wound secretions for bacterial culture,inducible monoxide nitrogen synthase content.At the same time,after the last administration,the rat wound tissue was excised for histopathology and immunofluorescence double staining to label macrophages and their M1 phenotype.Results:After the last dressing change,the wound healing of Jiuyi powder group was better than the other groups,and the wound healing rate of each group had significant difference(P<0.05).The histomology showed that the inflammation of Jiuyi powder group was controlled and had a healing trend.After the last drug change,the contents of TNF-α,IL-6 and iNOS in serum of all groups decreased,and the contents of IL-6,TNF-αand iNOS in serum of Jiuyi powder group decreased significantly before and after medication(P<0.05).There was statistical significance in serum IL-6 content between calcined gypsum group and Shengdan group before and after medication(P<0.05).In addition,the results showed that the contents of IL-6 and iNOS in serum of Jiuyi powder group were statistically different from those of the control group(P<0.05).Tissue immunofluorescence double staining showed that the positive rate of M1 macrophages in Jiuyi powder group and Shengdan group was significantly lower than that in control group(P<0.05).The MRSA negative conversion rate of Jiuyi powder group and Shengdan group was better than that of the control group and calcined gypsum group(P<0.05).Conclusion:Jiuyi powder can improve the inflammation of chronic refractory wounds,and has antibacterial,anti-corrosion and myogenic effects.Its mechanism may be related to the inhibition of macrophage M1 phenotype polarization.

Human papillomavirus(HPV) E6/E7 mRNA detection in cervical exfoliated cells:a potential triage for HPV-positive women

Cytology triage has been generally recommended for human papillomavirus （HPV）-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou （Pap） test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus HPV E6/E7 mRNA assay in cervical exfoliated cells. All HPV-positive women underwent colposcopy and further biopsy if indicated. The data were assessed by Pearson＇s Chi-squared test and the receiver operating characteristic curve. A total of 404 eligible HPV-positive women were enrolled. Positive rate of E6/E7 mRNA in high-grade squamous intraepithelial lesion （HSIL） cases was higher than that in low-grade squamous intraepithelial lesion （LSIL） or normal cases. There was no statistical difference found between mRNA and cytological testing with sensitivity （89.52% vs. 86.67%, P=0.671）, specificity （48.96% vs. 48.96%, P=1.000）, positive predictive value （39.00% vs. 38.24%, P=1.000）, and negative predictive value （92.76% vs. 90.97%, P=-0.678） for detecting ≥HSIL. HPV E6/E7 mRNA detection in cervical exfoliated cells shows the same performance as Pap triage for HSIL identification for HPV-positive women. Detection of HPV E6/E7 mRNA may be used as a new triage option for HPV-positive women.

Prognostic value of human papillomavirus 16/18 genotyping in low-grade cervical lesions preceded by mildly abnormal cytology

Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.