Research Progress of Atrial Fibrillation Detection Technology

Atrial fibrillation (AF) is the most common chronic arrhythmia in clinical practice, which can cause high disability and mortality with the progress of the disease. Many studies at home and abroad have shown that the incidence of atrial fibrillation gradually increases with age. Clinically, the onset of most AF patients is insidious, which is difficult to capture by routine electrocardiogram, and there is some difficulty in the diagnosis. In order to make the early diagnosis of atrial fibrillation more efficient and accurate, this paper reviews the current status and research progress of detection technology for atrial fibrillation at home and abroad, in order to provide a scientific basis for the early diagnosis of atrial fibrillation.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Complete degradation of high-loaded phenol using tungstate-based ionic liquids with long chain substituent at mild conditions

Phenol in waste water threatens human health and is difficultly to be decomposed by nature.Efficient degradation of high-loaded phenol in water under mild condition is still a great challenge.Herein,ionic liquids with tungstate anion were designed and prepared.It was found that dodecyltrimethylammonium tungstate could catalyzed degradation of phenol into gases and water thoroughly at 323 k in 8 h.Tungstate anion revealed good catalytic oxidative activity and long carbon chain group connecting with cation of ionic liquids enriched phenol around catalysts,which induced the complete degradation of phenol at mild conditions.Increasing the amounts of hydrogen peroxide benefited to the total degradation of phenol.In addition,the ionic liquid could be reused for its excellent thermal stability.Our work provided a different strategy to treat waste water containing phenol efficiently.

基于望诊的耳部形貌特征与中医体质相关性的探索性分析

目的:通过分析耳部形貌特征及中医九种体质之间的相关性,探索耳部形貌特征在体质辨识中的价值。方法:本研究采用横断面调查的方法。受试者的耳部形貌特征通过《耳部形貌望诊信息表》进行判定,体质通过《中医体质量表》进行辨识。采用单因素Logistic回归及多因素Logistic回归的进行统计分析。结果:共招募到符合纳入和排除标准的受试者888名,其中平和质的有270名(30.41%),其余618名(69.59%)受试者为不同的偏颇体质。结果显示,对平和质而言,厚耳郭(P<0.05)及适中大小的耳垂(P=0.01)为保护性因素,圆形耳垂(P<0.05)为危险性因素。对气虚质而言,耳郭紧贴(P<0.05)是保护性因素,无耳垂褶皱(P<0.05)及圆形耳垂(P<0.05)为危险性因素。对痰湿质而言,耳轮结构清晰(P<0.05)且半耳可见(P=0.024),无耳垂褶皱(P<0.05)是保护性因素,耳郭紧贴(P<0.05)及右耳尖三角形(P=0.029)为危险性因素。对气郁质而言,无耳垂褶皱(P<0.05)及耳屏高低适中(P<0.05)为危险性因素,三角形耳尖(P<0.05),左耳紧贴(P=0.002),耳郭位置高低适中(P<0.05)是保护性因素。结论:耳部形貌特征与中医体质之间可能存在潜在相关性。耳部形貌特征在体质辨识中可能具有参考价值。

Mitogen-activated protein kinase 14-mediated phosphorylation of MaMYB4 negatively regulates banana fruit ripening

Mitogen-activated protein kinase(MAPK/MPK)cascades play crucial parts in plant growth,development processes,immune ability,and stress responses;however,the regulatory mechanism by which MAPK affects fruit ripening remains largely unexplored.Here,we reported that MaMPK14 cooperated with MaMYB4 to mediate postharvest banana fruit ripening.Transient overexpression of individual MaMPK14 and MaMYB4 in banana fruit delayed fruit ripening,confirming the negative roles in the ripening.The ripening negative regulator MaMYB4 could repress the transcription of genes associated with ethylene biosynthesis and fruit softening,such as MaACS1,MaXTH5,MaPG3,and MaEXPA15.Furthermore,MaMPK14 phosphorylated MaMYB4 at Ser160 via a direct interaction.Mutation at Ser160 of MaMYB4 reduced its interaction with MaMPK14 but did not affect its subcellular localization.Importantly,phosphorylation of MaMYB4 by MaMPK14 enhanced the MaMYB4-mediated transcriptional inhibition,binding strength,protein stability,and the repression of fruit ripening.Taken together,our results delineated the regulation pathway of MAPK module during banana fruit ripening,which involved the phosphorylation modification of MaMYB4 mediated by MaMPK14.

Diabetes and cancer: Epidemiological and biological links

The incidence of diabetes and cancer has increased significantly in recent years.Furthermore,there are many common risk factors for both diabetes and cancer,such as obesity,sedentary lifestyle,smoking,and ageing.A large body of epidemiological evidence has indicated that diabetes is considered as an independent risk factor for increased rates of heterogeneous types of cancer occurrence and death.The incidence and mortality of various types of cancer,such as pancreas,liver,colorectal,breast,endometrial,and bladder cancers,have a modest growth in diabetics.However,diabetes may work as a protective factor for prostate cancer.Although the underlying biological mechanisms have not been totally understood,studies have validated that insulin/insulin-like growth factor(IGF)axis(including insulin resistance,hyperinsulinemia,and IGF),hyperglycemia,inflammatory cytokines,and sex hormones provide good circumstances for cancer cell proliferation and metastasis.Insulin/IGF axis activates several metabolic and mitogenic signaling pathways;hyperglycemia provides energy for cancer cell growth;inflammatory cytokines influence cancer cell apoptosis.Thus,these three factors affect all types of cancer,while sex hormones only play important roles in breast cancer,endometrial cancer,and prostate cancer.This minireview consolidates and discusses the epidemiological and biological links between diabetes and various types of cancer.

Genome-wide analysis of expansins and their role in fruit spine development in cucumber(Cucumis sativus L.)

Cucumber is one of the most widely consumed vegetables worldwide,and the fruit spine is an important fruit quality trait.Expansins play critical roles in fruit development;however,the regulation of expansins in cucumber fruit spine development has not been reported.In this study,33 expansin genes were identified in the cucumber genome V3;additionally,expansin genes in Citrullus lanatus,Cucumis melo,Cucurbita maxima,Lagenaria siceraria,and Benincasa hispida were also identified.Phylogenetic analysis of expansin proteins in Cucurbitaceae and Arabidopsis showed that they evolved separately in each plant species.Phylogenetic analysis showed that C.maxima was derived earlier than the other five Cucurbitaceae species.The expression of CsEXPA2,CsEXPA14,and CsEXLA3 varied in cucumber lines with different fruit spine densities.A yeast two-hybrid assay showed that a putative auxin transporter encoded by numerous spine gene(ns)interacts with CsEXLA2,which may be involved in the development of the numerous spines in cucumber.These results provide novel insights into the expansins related to plant development and fruit spine development in cucumber.

Efficacy and Safety of SGLT2 Inhibitors in Patients with Type 1 Diabetes:A Meta-analysis of Randomized Controlled Trials

Objective To assess the efficiency and safety of a novel sodium-glucose co-transporter 2(SGLT2) inhibitor—SGLT2 inhibitors,in combination with insulin for type 1 diabetes mellitus(T1DM). Methods We searched Medline,Embase,and the Cochrane Collaboration Library to identify the eligible studies published between January 2010 and July 2016 without restriction of language. The Food and Drug Administration(FDA) data and Clinical Trials(http://www.clinicaltrials.gov) were also searched. The included studies met the following criteria:randomized controlled trials; T1DM patients aged between 18 and 65 years old; patients were treated with insulin plus SGLT2 inhibitors for more than 2 weeks; patients' glycosylated hemoglobin(HbA1c) levels were between 7% and 12%. The SGLT2 inhibitors group was treated with SGLT2 inhibitors plus insulin,and the placebo group received placebo plus insulin treatment. The outcomes should include one of the following items:fasting blood glucose,HbA1c,glycosuria,or adverse effects. Data were analyzed by two physicians independently. The risk of bias was evaluated by using the Cochrane Collaboration's Risk of Bias tool and heterogeneity among studies was assessed using Chi-square test. Random effect model was used to analyze the treatment effects with Revman 5.3. Results Three trials including 178 patients were enrolled. As compared to the placebo group,SGLT2 inhibitor absolutely decreased fasting blood glucose [mean differences(MD)-2.47 mmol/L,95% confidence interval(CI)-3.65 to-1.28,P<0.001] and insulin dosage(standardized MD-0.75 U,95%CI-1.17 to-0.33,P<0.001). SGLT2 inhibitors could also increase the excretion of urine glucose(MD 131.09 g/24 h,95%CI 91.79 to 170.39,P<0.001). There were no significant differences in the incidences of hyperglycemia [odds ratio(OR) 1.82,95%CI 0.63 to 5.29,P=0.27],urinary tract infection(OR 0.95,95%CI 0.19 to 4.85,P=0.95),genital tract infection(OR 0.27,95%CI 0.01 to 7.19,P=0.43),and diabetic ketoacidosis(OR 6.03,95%CI 0.27 to 135.99,P=0.26) between the two groups. Conclusion SGLT2 inhibitors combined with insulin might be an efficient and safe treatment modality for T1DM patients.

Comparative study on the weight loss and lipid metabolism by tea polyphenols in diet induced obese C57BL/6J pseudo germ free and conventionalized mice

The role of gut microbiota in terms of host health is becoming increasingly important.In this study,the comparative effects of tea polyphenols(TPs)on weight loss and lipid metabolism on conventionalized mice(CVZ)and pseudo germ-free(PGF)mice(treated with antibiotics)were investigated.Our findings revealed that high fat(HF)diet considerably increased the body weight,total fat and upsurge lipid indices in CVZ mice but PGF mice were not sensitive to the effect of HF diet as CVZ mice.After the dietary administration of TP,body weight,perirenal fat and epididymal fat,liver weight,glucose(GLU)level,total chloestrol(TC level),high density lipoprotein-cholesterol(HDL-C)level significantly lowered in PGF mice as compared to CVZ mice group.However,the area of fat cells and triglyceride(TG)level were significantly increased in PGF mice.In CVZ mice,TP intervention resulted in a considerable drop in the Firmicutes/Bacteroides ratio as compared to PGF mice.The intestinal flora of PGF mice was severely reduced after antibiotic treatment,while TP administration restored intestinal diversity;the abundance of Akkermansia and Lactobacillus increased,whereas the abundance of Enterobacteriaceae and Prevotella reduced.Overall,we can assume that PGF obese mice administered with TP have less anti-obesity effects compared to obese CVZ mice.

Phenylfluorenamine-functionalized poly(N-vinylcarbazole)s as dopant-free polymer hole-transporting materials for inverted quasi-2D perovskite solar cells

In order to improve the efficiency and stability of inverted three-dimensional(3D) or quasi-2D perovskite solar cells(PSCs) for future commercialization, exploring high efficient dopant-free polymer holetransporting materials(HTMs) is still desired and meaningful. One simple and efficient way to achieve high performance dopant-free HTMs is to synthesize novel non-conjugated side-chain polymers via rational molecular design. In this work, N-(4-methoxyphenyl)-9,9-dimethyl-9H-fluoren-2-amine(FMeNPh) groups are introduced into the poly(N-vinylcarbazole)(PVK) side chains to afford two nonconjugated polymers PVCz-DFMeNPh and PVCz-FMeNPh as dopant-free HTMs in inverted quasi-2D PSCs. Benefited from the flexible properties of polyethylene backbone and excellent optoelectronic natures of FMeNPh side-chain groups, PVCz-DFMeNPh with more FMeNPh units exhibited excellent thermal stability, well-matched energy levels and improved charge mobility as compared to PTAA and PVCzFMeNPh. Moreover, the morphologies investigation of quasi-2D perovskite on PVCz-DFMeNPh shows more compact and homogeneous perovskite films than those on PTAA and PVCz-FMeNPh. As a result,the dopant-free PVCz-DFMeNPh based inverted quasi-2D PSCs deliver power conversion efficiency(PCE) up to 18.44% as well as negligible hysteresis and favorable long-term stability, which represents as excellent performance reported to date for inverted quasi-2D PSCs. The results demonstrate the great potentials of constructing non-conjugated side-chain polymer HTMs based on phenylfluorenamine-func tionalized PVK for the development of high efficient and stable inverted 3D or quasi-2D PSCs.

HIGH-ORDER NUMERICAL METHOD FOR SOLVING A SPACE DISTRIBUTED-ORDER TIME-FRACTIONAL DIFFUSION EQUATION

This article proposes a high-order numerical method for a space distributed-order time-fractional diffusion equation.First,we use the mid-point quadrature rule to transform the space distributed-order term into multi-term fractional derivatives.Second,based on the piecewise-quadratic polynomials,we construct the nodal basis functions,and then discretize the multi-term fractional equation by the finite volume method.For the time-fractional derivative,the finite difference method is used.Finally,the iterative scheme is proved to be unconditionally stable and convergent with the accuracy O(σ^(2)+τ^(2-β)+h^(3)),whereτand h are the time step size and the space step size,respectively.A numerical example is presented to verify the effectiveness of the proposed method.

Effect of Laser Texturing Parameters on Wettability of Nickel Surface

Wettability is an important characteristic of solid surfaces. Enhancing the surface wettability is very important for improving the properties of materials. Superhydrophobic materials show good prospects for development in areas such as self-cleaning, anti-fog snow, anti-icing, and corrosion resistance. It has become a hot spot to develop a superhydrophobic surface with low surface free energy and good anti-adhesion properties. In this paper, nanosecond pulsed lasers were used to texture the nickel surface, and the different texturing speeds were changed. Combined with the ultrasonic treatment of low surface energy materials, nickel surfaces with different contact angles were obtained. The experimental results show that low surface energy substances can increase the contact angle of nickel surface but the extent of increase is limited. Laser microstructure induces micro & nanostructures. Ultrasonic action can adsorb certain low surface energy substances on the surface, greatly improving the hydrophobic properties of the surface, the contact angle with water up to 152? and the roll angle is less than 2?, and with the increase of the laser texturing speed, the contact angle of the nickel surface shows a decreasing trend.

评价散寒化湿颗粒与奈玛特韦-利托那韦对照治疗轻型/中型新型冠状病毒感染有效性和安全性的随机、开放、多中心临床研究

Sanhan Huashi granules(SHG)demonstrated therapeutic effects against coronavirus disease 2019(COVID-19)in observational studies.In order to compare the effectiveness and safety of SHG and nirmatrelvir–ritonavir in treating adults with mild-to-moderate COVID-19,we conducted a randomized,activecontrolled,open-label,multi-center trial conducted between February and July in 2023.The patients were randomized in a 1:1 ratio to the SHG group and the nirmatrelvir–ritonavir group.A total of 400participants were randomized,among which 200 participants ultimately received SHG and 198 received nirmatrelvir–ritonavir.The primary outcome was time to sustained clinical recovery through day 28.SHG significantly shortened the median time to sustained clinical recovery compared to nirmatrelvir–ritonavir(6.0(95%CI,5.0 to 6.0)vs.8.0(95%CI,6.0 to 9.0)d;P=0.001),particularly for individual symptoms including fever,sore throat,cough and fatigue.No participants in either group died and incidence of severe COVID-19 showed no difference between two groups.Participants who received nirmatrelvir–ritonavir demonstrated a higher rate of virus clearance on day 5 compared to those received SHG(46.4%(95%CI,39.1 to 53.7)vs.65.6%(95%CI,58.3 to 72.4);P<0.001).Most adverse events were mild in both groups.In summary,SHG was superior to nirmatrelvir–ritonavir in shortening the time to sustained clinical recovery in participants with mild-to-moderate COVID-19,despite a lower virus clearance rate observed after 5 d of treatment(Chinese Clinical Trial Registry Identifier:Chi CTR2300067872).

Impaired glymphatic system as evidenced by low diffusivity along perivascular spaces is associated with cerebral small vessel disease:a population-based study

Objective This study aims to investigate the associations of glymphatic system with the presence,severity and neuroimaging phenotypes of cerebral small vessel disease(CSVD)in a community-based population.Method This report included 2219 community-dwelling people aged 50-75 years who participated in the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events cohort.The diffusivity along perivascular spaces based on diffusion tensor imaging(DTI-ALPS index)was measured to assess glymphatic pathway.The presence and severity of CSVD were estimated using a CSVD score(points from 0 to 6)and a modified CSVD score(points from 0 to 4),which were driven by 4 neuroimaging features of CSVD,including white matter hyperintensity(WMH),enlarged perivascular spaces(EPVS),lacunes,cerebral microbleeds.Brain atrophy(BA)was also evaluated.Binary or ordinal logistic regression analyses were carried out to investigate the relationships of DTI-ALPS index with CSVD.Result The mean age was 61.3(SD 6.6)years,and 1019(45.9%)participants were men.The average DTI-ALPS index was 1.67±0.14.Individuals in the first quartile(Q1)of the DTI-ALPS index had higher risks of the presence of CSVD(OR 1.77,95%CI 1.33 to 2.35,p<0.001),modified presence of CSVD(odds ratio(OR)1.80,95%CI 1.38 to 2.34,p<0.001),total burden of CSVD(common OR(cOR)1.89,95%CI 1.43 to 2.49,p<0.001)and modified total burden of CSVD(cOR 1.95,95%CI 1.51 to 2.50,p<0.001)compared with those in the fourth quartile(Q4).Additionally,individuals in Q1 of the DTI-ALPS index had increased risks of WMH burden,modified WMH burden,lacunes,basal ganglia-EPVS and BA(all p<0.05).Conclusion A lower DTI-ALPS index underlay the presence,severity and typical neuroimaging markers of CSVD,implying that glymphatic impairment may interact with CSVD-related pathology in the general ageing population.

Standard:Human intestinal organoids

Organoids have attracted great interest for disease modelling,drug discovery and development,and tissue growth and homeostasis investigations.However,lack of standards for quality control has become a prominent obstacle to limit their translation into clinic and other applications.“Human intestinal organoids”is the first guideline on human intestinal organoids in China,jointly drafted and agreed by the experts from the Chinese Society for Cell Biology and its branch society:the Chinese Society for Stem Cell Research.This standard specifies terms and definitions,technical requirements,test methods,inspection rules for human intestinal organoids,which is applicable to quality control during the process of manufacturing and testing of human intestinal organoids.It was originally released by the Chinese Society for Cell Biology on 24 September 2022.We hope that the publication of this standard will guide institutional establishment,acceptance and execution of proper practical protocols and accelerate the international standardization of human intestinal organoids for applications.

Standard:Human intestinal cancer organoids

Intestinal cancer is one of the most frequent and lethal types of cancer.Modeling intestinal cancer using organoids has emerged in the last decade.Human intestinal cancer organoids are physiologically relevant in vitro models,which provides an unprecedented opportunity for fundamental and applied research in colorectal cancer.“Human intestinal cancer organoids”is the first set of guidelines on human intestinal organoids in China,jointly drafted and agreed by the experts from the Chinese Society for Cell Biology and its branch society:the Chinese Society for Stem Cell Research.This standard specifies terms and definitions,technical requirements,test methods for human intestinal cancer organoids,which apply to the production and quality control during the process of manufacturing and testing of human intestinal cancer organoids.It was released by the Chinese Society for Cell Biology on 24 September 2022.We hope that the publication of this standard will guide institutional establishment,acceptance and execution of proper practocal protocols,and accelerate the international standardization of human intestinal cancer organoids for clinical development and therapeutic applications.

Practice and principle of traditional Chinese medicine for the prevention and treatment of COVID-19

Traditional Chinese medicine(TCM)has played an important role in the prevention and treatment of Coronavirus disease 2019(COVID-19)epidemic in China.The integration of Chinese and Western medicine is an important feature of Chinese COVID-19 prevention and treatment.According to a series of evidence-based studies,TCM can reduce the infection rate of severe acute respiratory syndrome coronavirus 2 in high-risk groups.For patients with mild and moderate forms of COVID-19,TCM can relieve the related signs and symptoms,shorten the period of nucleic-acid negative conversion,and reduce conversion rate to the severe form of the disease.For COVID-19 patients with severe and critical illnesses,TCM can improve inflammatory indicators and blood oxygen saturation,shorten the hospital stay,and reduce the mortality rate.During recovery,TCM can improve patients’symptoms,promote organ function recovery,boost the quality of patients’life,and reduce the nucleic-acid repositive conversion rate.A series of mechanism research studies revealed that capability of TCM to treat COVID-19 through antiviral and anti-inflammatory effects,immune regulation,and protection of organ function via a multicomponent,multitarget,and multipathway approach.

An Oxygen-Independent Photodynamic Therapy Nanoplatform for Combating Anaerobic Infection

Anaerobic bacteria infections remain a major threat to humans.Oxidative stress mediated by photodynamic therapy(PDT)has shown great potential in antimicrobial applications,attributing to its controllability and non-resistance.However,the hypoxic infection microenvironment severely compromises the therapeutic outcomes.Here,we designed a nanoplatform comprising the initiator of alkyl radicals(R-),2,2’-azobis[2-(2-imidazolin-2-yl)propane]dihydrochloride(AIPH)-loaded oxidized mesoporous carbon nanoparticles(OMCN)and then coated with a phase change material(PCM)nanoparticle for oxygen-independent PDT to combat anaerobic infections.Upon near-infrared(NIR)light irradiation,OMCN mediates the generation of heat to melt PCM,which could trigger the liberation and decomposition of AIPH to produce R.and further induce the oxidative damage to bacteria,and cooperate with optothermal effects to eradicate anaerobic bacteria.As results,the nanoplatform displays strong synergistic antibacterial behavior,effectively eliminating anaerobic Propionibacterium acnes(P.acnes)in vitro under hypoxic conditions,and successfully treating P.acnes-infected cutaneous abscess in mice models.Moreover,no distinct toxicity appears through the entire course of treatment.Collectively,this light-activated oxygen-independent PDT offers a novel approach to combat anaerobic bacteria infections.

Rationale and design of a randomised double-blind 2×2 factorial trial comparing the effect of a 3-month intensive statin and antiplatelet therapy for patients with acute mild ischaemic stroke or high-risk TIA with intracranial or extracranial atherosclerosis(INSPIRES)

Background It remains unclear if intensive antiplatelet and statin treatments begun within 24-72 hours of cerebral ischaemic events from intracranial or extracranial atherosclerosis is effective or safe.Methods The Intensive Statin and Antiplatelet Therapy for High-risk Intracranial or Extracranial Atherosclerosis(INSPIRES)trial is a randomised,double-blind,placebo-controlled,multicentre and 2×2 factorial trial.6100 individuals between the ages of 35 and 80 who have experienced a mild ischaemic stroke or high-risk transient ischaemic attack(TIA)within the previous 72 hours that is attributed to≥50%atherosclerotic stenosis of a major intracranial or extracranial artery or multiple infarctions of atherosclerotic origin will be enrolled in the trial.Eligible subjects will be randomised 1:1:1:1 to one of four groups:(1)intensive antiplatelet therapy(combined clopidogrel and aspirin for days 1-21,then aspirin placebo and clopidogrel for days 22-90)plus immediate intensive statin therapy(atorvastatin at a dose of 80 mg daily for the first 21 days,then 40 mg daily for days 22-90);(2)intensive antiplatelet therapy plus delayed intensive statin therapy(atorvastatin placebo for days 1-3,followed by 40 mg per day of atorvastatin for days 4-90);(3)standard antiplatelet therapy(combination of clopidogrel placebo with aspirin for 90 days)plus immediate intensive statin therapy and(4)standard antiplatelet therapy plus delayed intensive statin therapy.The primary efficacy endpoint is any new stroke(ischaemic or haemorrhagic)within 90 days after randomisation.The primary safety endpoint is moderate to severe bleeding at 90 days.Conclusion The INSPIRES trial will assess the efficacy and safety of intensive antiplatelet therapy and immediate intensive statin therapy begun within 72 hours of onset in decreasing the recurrent stroke at 90 days in patients with acute mild ischaemic stroke or high-risk TIA of intracranial or extracranial atherosclerosis origin.

Antidiabetic Effects of Gegen Qinlian Decoction via the Gut Microbiota Are Attributable to Its Key Ingredient Berberine

Gegen Qinlian Decoction(GQD),a traditional Chinese medicine(TCM)formula,has long been used for the treatment of common metabolic diseases,including type 2 diabetes mellitus.However,the main limitation of its wider application is ingredient complexity of this formula.Thus,it is critically important to identify the major active ingredients of GQD and to illustrate mechanisms underlying its action.Here,we compared the effects of GQD and berberine,a hypothetical key active pharmaceutical ingredient of GQD,on a diabetic rat model by comprehensive analyses of gut microbiota,short-chain fatty acids,proinflammatory cytokines,and ileum transcriptomics.Our results show that berberine and GQD had similar effects on lowering blood glucose levels,modulating gut microbiota,inducing ileal gene expression,as well as relieving systemic and local inflammation.As expected,both berberine and GQD treatment significantly altered the overall gut microbiota structure and enriched many butyrate-producing bacteria,including Faecalibacterium and Roseburia,thereby attenuating intestinal inflammation and lowering glucose.Levels of short-chain fatty acids in rat feces were also significantly elevated after treatment with berberine or GQD.Moreover,concentration of serum proinflammatory cytokines and expression of immune-related genes,including Nfkb1,Stat1,and Ifnrg1,in pancreatic islets were significantly reduced after treatment.Our study demonstrates that the main effects of GQD can be attributed to berberine via modulating gut microbiota.The strategy employed would facilitate further standardization and widespread application of TCM in many diseases.