Network pharmacology study and in vitro experimental validation of Xiaojianzhong decoction against gastric cancer

BACKGROUND Cancer is one of the most serious threats to human health worldwide.Conventional treatments such as surgery and chemotherapy are associated with some drawbacks.In recent years,traditional Chinese medicine treatment has been increasingly advocated by patients and attracted attention from clinicians,and has become an indispensable part of the comprehensive treatment for gastric cancer.AIM To investigate the mechanism of Xiaojianzhong decoction(XJZ)in the treatment of gastric cancer(GC)by utilizing network pharmacology and experimental validation,so as to provide a theoretical basis for later experimental research.METHODS We analyzed the mechanism and targets of XJZ in the treatment of GC through network pharmacology and bioinformatics.Subsequently,we verified the impact of XJZ treatment on the proliferative ability of GC cells through CCK-8,apoptosis,cell cycle,and clone formation assays.Additionally,we performed Western blot analysis and real-time quantitative PCR to assess the protein and mRNA expression of the core proteins.RESULTS XJZ mainly regulates IL6,PTGS2,CCL2,MMP9,MMP2,HMOX1,and other target genes and pathways in cancer to treat GC.The inhibition of cell viability,the increase of apoptosis,the blockage of the cell cycle at the G0/G1 phase,and the inhibition of the ability of cell clone formation were observed in AGS and HGC-27 cells after XJZ treatment.In addition,XJZ induced a decrease in the mRNA expression of IL6,PTGS2,MMP9,MMP2,and CCL2,and an increase in the mRNA expression of HOMX1.XJZ significantly inhibited the expression of IL6,PTGS2,MMP9,MMP2,and CCL2 proteins and promoted the expression of the heme oxygenase-1 protein.CONCLUSION XJZ exerts therapeutic effects against GC through multiple components,multiple targets,and multiple pathways.Our findings provide a new idea and scientific basis for further research on the molecular mechanisms underlying the therapeutic effects of XJZ in the treatment of GC.

Epidemiological Analysis of Asymptomatic SARS-CoV-2 Novel Coronavirus Infection Cases in Yinchuan City of Ningxia

Objective:To analyze the epidemiological characteristics of asymptomatic SARS-CoV-2 novel coronavirus infection cases in Yinchuan City,Ningxia.Methods:Cases of asymptomatic SARSCoV-2 novel coronavirus infections discovered in Yinchuan City from February 2020 to April 2020 were taken as the research subjects,epidemiological and laboratory examination data were collected,and statistics and analysis were conducted.Results:Among the 10 cases of asymptomatic infection,6 were males and 4 were females,with an average age of(34.3±2.1)years;2 cases had a history of living in Hubei,8 cases had a history of close contact with confirmed cases;6 cases had no other underlying diseases while the other 4 cases were accompanied by one or more underlying diseases;6 cases were diagnosed as asymptomatic infection by serum-specific IgM antibody detection;4 cases were diagnosed as asymptomatic infection by throat swab testing;there were 4 cases with alanine base transferase level higher than the normal range,2 cases with aspartate aminotransferase level higher than the normal range,and 3 cases with D-dimer level out of the normal range.Conclusion:The asymptomatic SARS-CoV-2 novel coronavirus infection has certain clinical characteristics;it is infectious and has insidious characteristics.Even if medical observation is dismissed,monitoring is still needed to prevent the pandemic from rebounding.

Mesenchymal stem cells-extracellular vesicles alleviate pulmonary fibrosis by regulating immunomodulators

BACKGROUND Pulmonary fibrosis(PF)is a chronic interstitial lung disease characterized by fibroblast proliferation and extracellular matrix formation,causing structural damage and lung failure.Stem cell therapy and mesenchymal stem cells-extracellular vesicles(MSC-EVs)offer new hope for PF treatment.AIM To investigate the therapeutic potential of MSC-EVs in alleviating fibrosis,oxidative stress,and immune inflammation in A549 cells and bleomycin(BLM)-induced mouse model.METHODS The effect of MSC-EVs on A549 cells was assessed by fibrosis markers[collagen I andα-smooth muscle actin(α-SMA),oxidative stress regulators[nuclear factor E2-related factor 2(Nrf2)and heme oxygenase-1(HO-1),and inflammatory regu-lators[nuclear factor-kappaB(NF-κB)p65,interleukin(IL)-1β,and IL-2].Similarly,they were assessed in the lungs of mice where PF was induced by BLM after MSC-EV transfection.MSC-EVs ion PF mice were detected by pathological staining and western blot.Single-cell RNA sequencing was performed to investigate the effects of the MSC-EVs on gene expression profiles of macrophages after modeling in mice.RESULTS Transforming growth factor(TGF)-β1 enhanced fibrosis in A549 cells,significantly increasing collagen I andα-SMA levels.Notably,treatment with MSC-EVs demonstrated a remarkable alleviation of these effects.Similarly,the expression of oxidative stress regulators,such as Nrf2 and HO-1,along with inflammatory regulators,including NF-κB p65 and IL-1β,were mitigated by MSC-EV treatment.Furthermore,in a parallel manner,MSC-EVs exhibited a downregulatory impact on collagen deposition,oxidative stress injuries,and inflammatory-related cytokines in the lungs of mice with PF.Additionally,the mRNA sequencing results suggested that BLM may induce PF in mice by upregulating pulmonary collagen fiber deposition and triggering an immune inflammatory response.The findings collectively highlight the potential therapeutic efficacy of MSC-EVs in ameliorating fibrotic processes,oxidative stress,and inflammatory responses associated with PF.CONCLUSION MSC-EVs could ameliorate fibrosis in vitro and in vivo by downregulating collagen deposition,oxidative stress,and immune-inflammatory responses.

Outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of the Toric implantable collamer lens for high myopic astigmatism

AIM: To assess the visual outcomes and possible risk factors associated with axis alignment and rotational stability after implantation of Toric implantable collamer lens (TICL) for the correction of high myopic astigmatism. METHODS: In this prospective, nonrandomized clinical study, 54 consecutive eyes of 29 patients with high myopic astigmatism received TICL implantation. To evaluate postoperative axis deviation from the intended axis, a digital anterior segment photograph was taken. The ultrasound biomicroscopy(UBM) was used to observe footplate-position. RESULTS: After mean follow-up of 8.6 months, mean manifest refractive cylinder (MRC) decreased 79.3% from (-1.88 +/- 1.49)D preoperatively to (0.39 +/- 0.61)D postoperatively. MRC within 1.00D occurred in 68.5% (37/54) of eyes, whereas 48.1% (26/54) had MRC within 0.50D. Mean manifest refraction spherical equivalent (MRSE) changed from (-1208 +/- 422)D preoperatively to (-0.41 +/- 0.61)D postoperatively. Uncorrected binocular vision of 20/20 or better occurred in 72.2% (39/54) of patients compared with binocular best-corrected visual acuity (BCVA) of 20/20 or better in 44.4% (24/54) preoperatively. The mean difference between intended and achieved TICL axes was (6.96 +/- 8.37)degrees. Footplates of TICLs were in the ciliary sulcus in 22 eyes (46.3%), below the ciliary sulcus in 32 eyes (53.7%). The angle of TICL rotation had significant correlation with the footplates-position (t = 2.127; P=0.045) and the postoperative TICL vaulting (r=-0.516; P=0.000). CONCLUSION: The results of our study further support the safety, efficacy and predictability of TICL for the correct high myopic astigmatism. The footplate-position of TICL and vault value should be taken into consideration as two possible risks factors for TICL rotation.

Relationship between R219K polymorphism of adenosine triphosphate-binding cassette transporter 1 gene and cerebral infarction: A case-controlled analysis

BACKGROUND： Studies have shown that adenosine triphosphate-binding cassette transporter 1 （ABCA1） gene influences atherosclerosis. Studies have also demonstrated that cerebral infarction does not occur often in pre-menopausal women. It has been, therefore, assumed that sex plays a role in R219K polymorphism of ABCA1 gene and cerebral infarction. OBJECTIVE： To explore the relationship between lipid metabolism-correlated R219K polymorphism of ABCA1 gene, risk factors of cerebral infarction and lipid level, and to determine whether there were significant differences in gender between R219K polymorphism of ABCA1 gene and cerebral infarction. DESIGN, TIME AND SETTING： A multicentral and non-randomized, controlled study based on gene polymorphism was performed at the Chinese National Human Genome Center, and lipid concentrations were measured at Beijing Xuanwu Hospital. Patients with cerebral infarction and healthy subjects were enrolled from eight hospitals of six provinces of China between October 2002 and December 2004. PARTICIPANTS： There were 177 patients in the cerebral infarction group, including 119 males and 58 females, with a mean age of （60 -＋ 13） years, and 234 healthy subjects in the normal control group, including 79 males and 155 females, with a mean age of （58 ± 12） years. METHODS： R219K polymorphism of the ABCA1 gene was detected using polymerase chain reaction-restriction fragment length polymorphism, and blood lipid concentrations were simultaneously measured. MAIN OUTCOME MEASURES： Genotype and allele frequency of R219K polymorphic site, and blood lipid concentrations. RESULTS： RR genotype and R allele frequency of males in the cerebral infarction were significantly greater than males in the normal control group [RR genotype： x2 = 5.305, OR （95% CO, 2.326 （1.120 4.828）, P〈 0.05; R allele： x2= 4.219, OR （95% CO, 1.528 （1.019 2.292）, P〈 0.05]. In addition, RR genotype and R allele frequency of males were significantly greater than females in the cerebral infarction group [RR genotype： x2= 5.172, OR （95% C/）, 2.604 （1.120-6.057）, P〈 0.05; R allele： x2= 4.818, OR （95% CO, 1.652 （1.053 2.589）, P〈 0.05]. There were no significant differences between genotype and lipid concentrations between the two groups （P〉 0.05）. CONCLUSION： The RR genotype of ABCA1 R219K might be associated with onset of cerebral infarction in males, but blood lipid concentrations do not relate to R219K polymorphism.

Quantitative Analysis of Fecal Hemoglobin Concentration in Colorectal Cancer Patients-The Values in the Screening and Diagnosis of Colorectal Cancer

Objective:To use immunochemical detection of fecal hemoglobin amount as a technical method,to perform a fecal immunochemical test(FIT)on the fecal specimens of research subjects who were going to undergo colonoscopy.The recorded results are compared and analyzed,and the sensitivity and specificity of the detection method in the diagnosis of colorectal cancer were evaluated.Methods:Three hundred of individuals who were going to undergo colonoscopy were tested for GFOBT and FIT in feces in advance,and 20μg/g was used as the threshold for determining positive FIT result.The results were analyzed and compared with the results of colonoscopy.Results:The sensitivity of FIT to the diagnosis of colorectal cancer was 80.95%,and the specificity was 86.54%.The positive predictive values of FIT test in colorectal cancer screening were 53.1%and 81.77%,respectively.Conclusion:FIT is more sensitive and specific for detecting colorectal cancer and adenoma.The fecal occult blood test(FOBT)is stronger,and FIT test detection is more valuable in colon cancer screening.

The Effect of Respiratory Rehabilitation Training on the Life Quality of Pneumoconiosis Patients

Objective:To explore the effect of respiratory rehabilitation training on the quality of life of pneumoconiosis patients.Methods:76 pneumoconiosis patients who were treated in our hospital from April 2017 to December 2019 were selected as the research object,and randomly divided into 2 groups according to the order of admission by coin tossing,38 cases in each group.The control group carried out health knowledge education on the basis of conventiona1 treatment,and the observation group combined with respiratory rehabilitation training on the basis of the control group to compare the quality of life and lung function of the two groups of patients.Results:After 2 months of nursing care,scores of GQOLI-74 scale and pulmonary ventilation function indexes in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Respiratory rehabilitation training can improve pulmonary ventilation function of pneumoconiosis patients,improve the quality of life of patients,has good clinical application value.

The Efficacy Analysis of Transbronchoscopic Large Volume Lung Lavage in Treatment of Pneumoconiosis Complicated with Chronic Obstructive Pulmonary Disease

Objective:To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease(COPD).Methods:The clinical data of 80 patients with pneumoconiosis complicated with COPD admitted to our hospital from June 2017 to January 2019 were retrospectively analyzed.40 patients in the control group were treated with conventional drugs and 40 patients in the observation group treated with conventional drugs plus transbronchoscopic large-volume lung lavage.Dyspnea score and healthy quality of life were compared between the two groups.Results:the scores of dyspnea in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment,and the(SGRQ)scores of George’s respiratory problems questionnaire in the observation group were significantly lower than those in the control group at 12,24 and 48 weeks after treatment.Conclusion:Thetransbronchoscopic large volume of lung lavage has a significant effect on the treatment of pneumoconiosis patients with COPD,which can effectively reduce the degree of dyspnea and improve the quality of life.

Analysis of Clinical and Imaging Characteristics of Suspected and Confirmed COVID-19 Patients

Objective:To analyze the clinical characteristics and chest CT imaging characteristics of patients with confirmed COVID-19(COVID-19)and patients with suspected COVID-19.Methods:The study time span was from February 2020 to May 2020.The case samples were selected from 72 patients with confirmed covid-19 and suspected covid-19 diagnosed and treated by The First People’s Hospital of Yinchuan and Yinchuan Temporary Emergency Hospital,including 38 patients with confirmed covid-19 and 34 patients with suspected covid-19.All patients underwent laboratory examination and chest CT examination,and the specific examination results were compared and analyzed.Results:There were significant differences in number of white blood cell,percentage of lymphocytes,creatine kinase and erythrocyte sedimentation rate between confirmed and suspected COVID-19 patients(P<0.05).The CT imaging characteristics of COVID-19 patients were compared with those of suspected COVID-19 patients.The lesions of COVID-19 patients were mostly characterized by mixed ground glass density and pure ground glass density.There were vascular thickening and interstitial thickness increase,and accompanied by bronchiectasis or air bronchogram.The distribution of lesions was mostly subpleural without pleural effusion.The lesion area of suspected COVID-19 patients mostly showed solid density and mixed ground glass density.The lesion was distributed along bronchovascular and pleural effusion was observed.Conclusion:There are some differences in biochemical indexes and chest CT images between confirmed and suspected covid-19 patients,which can be used for differential diagnosis.

Analysis on the Clinical Characteristics of 10 Cases of Asymptomatic SARS-CoV-2 Novel Coronavirus Infection

Objective:To analyze the clinical features of asymptomatic patients infected with the SARS-CoV-2 novel coronavirus.Methods:The clinical data of 10 asymptomatic cases and 12 symptomatic cases of COVID-19 diagnosed during February 2020 to April 2020 was collected and the clinical features of the two groups of patients were compared.Results:10 cases of asymptomatic infection and 12 cases of symptomatic patients were tested positive for the novel coronavirus nucleic acid test.There was no significant difference in gender distribution between the two groups(P>0.05);the average age of patients in the asymptomatic group was lower than that of the symptomatic group(P<0.05),the difference in clinical classification between the two groups was statistically significant(P<0.05);there was no statistically significant difference in the results of chest CT examination involving lung lobes between the two groups(P>0.05),and there was no statistically significant difference in mortality between the two groups(P>0.05).Conclusion:The average age of asymptomatic novel coronavirus infections was lower than that of confirmed cases of COVID-19,mainly among young people.There was no significant difference in clinical classification,mortality and chest CT examination results between symptomatic and asymptomatic cases.

Echinococcus Granulosus 14-3-3 Protein:A Potential Vaccine Candidate Against Challenge with Echinococcus Granulosus in Mice

Objective To investigate the protective immunity against Echinococcus granulosus in mice immunized with rEg14-3-3. Methods ICR mice were subcutaneously immunized three times with rEg14-3-3, followed by the challenge with Echinococcus granulosus protoscoleces intraperitoneally and then sacrificed after six months of post-challenge to detect the proliferation of splenocytes by MTT assay, and to measure the secretion of IL-2, IL-4, IL-20, and IFN -y by ELISA. The rate of reduced hydatid cyst and the levels of IgE, igG and IgG subclasses in sera were examined. Results Mice vaccinated with rEg14-3-3 and challenged with protoscoleces revealed significant protective immunity of 84.47%. ELISA analysis indicated that the immunized mice generated specific high levels of IgG and the prevailing isotypes of IgG were IgG1 and IgG2a. Splenocytes from mice immunized with rEg14-3-3 showed a significant proliferation response. The secretion of IFN-V and IL-2 increased significantly in the vaccinated mice whereas there was no significant difference in IL-4 and IL-20 levels between vaccinated and control mice. Conclusion The results indicate that the rEg24-3-3 vaccine could induce a high level of protective immunity as a promising vaccine candidate to prevent cystic echinococcosis.

骨组织中吡嗪酰胺浓度的高效液相色谱测定

背景:测定结核病化疗药物在病变椎体组织中的生物分布对脊柱结核的治疗具有重要价值。目的:建立吡嗪酰胺在骨组织中药物浓度的高效液相色谱分析法并测定其在脊柱结核病椎组织中的浓度。方法:取10例脊柱骨折患者前路椎体次全切除减压的椎骨制备成空白骨匀浆,高效液相色谱法测定吡嗪酰胺骨组织药物浓度。取18例脊柱结核患者(2HRZ/H2R2Z2化疗方案)的病椎硬化骨、亚正常骨、坏死组织以及髂骨为骨组织标本,采用高氯酸蛋白沉淀法获得骨匀浆吡嗪酰胺上清,对方法的专属性、回收率与精密度以及线性范围进行评价。结果与结论:吡嗪酰胺在265nm波长下有较大吸收,保留时间7.48min,无干扰峰出现。在0.048～3.120μg/g骨匀浆浓度范围内吡嗪酰胺峰面积与骨样本浓度线性关系良好(r=0.99991),绝对回收率在89.18%～93.75%,方法回收率为96.30%～100.45%,日内、日间精密度分别为4.26%～8.78%和5.12%～9.01%。应用此方法测得吡嗪酰胺在病椎硬化壁为最低抑菌浓度,壁外亚正常骨及对照髂骨达到有效治疗浓度,壁内核心病灶未检测到分布。提示吡嗪酰胺在脊柱结核病椎中存在明显的组织分布差异,硬化壁是其经正常椎体向核心病灶穿透的组织屏障。

Long-term ex vivo monitoring of in vivo microRNA activity in liver using a secreted luciferase sensor

Technology for monitoring in vivo microRNA (miRNA) activity is extremely important for elucidating miRNA biology.However,in vivo studies of miRNA have been hampered by the lack of a convenient approach to reliably reflect real-time functional changes in miRNAs.Sensors for miRNA were developed by adding miRNA target sequences to the 3'-untranslated region of Gaussia princeps luciferase (Gluc) mRNA.These sensors were then evaluated in vitro and in vivo by measuring Gluc activity in cell supernatants and in peripheral blood.Sensors driven by the CMV promoter were effective for monitoring miR-122 in living cells,but not for the long-term monitoring of miR-122 or miR-142 in mouse liver because of CMV-promoter silencing.Replacing the CMV promoter with a CAG promoter rendered these sensors effective for the long-term monitoring of relevant liver miRNA activities.We subsequently used the CAG-promoter-based sensor for the long-term monitoring of endogenous liver miR-122,miR142 and miR-34a activities,as well as for exogenous miR-34a activity.Our study demonstrates that real-time in vivo activities of miRNAs can be continuously and conveniently detected in mouse liver using the sensors that we have developed.

Lessons Learned from a Case with Valgus Deformity of the Knee Following Partial Removal of Lateral Discoid Meniscus

Few studies have focused on the possible change in the axial alignment of the lower limb after lateral meniscectomy. Here, we present a patient with valgus deformity of the knee following the partial removal of lateral discoid meniscus. With the distal femur osteotomy and fixation, this complication was treated successfully. This case suggested that we should pay more attention to the axial alignment of the lower limb in patients with torn discoid lateral meniscus before meniscectomy, as a severe valgus inclination may develop in some of these patients.

Total body irradiation of donors can alter the course of tolerance and induce acute rejection in a spontaneous tolerance rat liver transplantation model

Liver transplantation is an established therapy for end-stage liver diseases. Graft rejection occurs unless the recipient receives immunosuppression after transplantation. This study aimed to explore the mechanism of acute rejection of liver allografts in rats pre-treated with total body irradiation to eliminate passenger lymphocytes and to define the role of CD4＋CD25＋ regulatory T cells in the induction of immunotolerance in the recipient. Male Lewis rats were used as donors and male DA rats were re- cipients. Rats were randomly assigned to the following four groups： control group, homogeneity liver transplantation group, idio-immunotolerance group and acute rejection group. After transplantation, the survival time of each group, serum alanine aminotransferase, total bilirubin levels, number of Foxp3＋CD4＋CD25＋ regulatory T cells, expression of glucocorticoid-induced tumor necrosis factor receptor on T cell subgroups, histopathology of the hepatic graft and spleen cytotoxic T lymphocyte lytic activity were measured. In the acute rejection group, where donors were preconditioned with total body in＇adiation before liver transplantation, all recipients died between day 17 and day 21. On day 14, serum alanine aminotransferase increased signifi- cantly to （459.2±76.9） U L^- 1, total bilirubin increased to （124.1±33.7） μmol L-1 （P〈0.05） and the ratio of Foxp3＋CD4＋CD25＋ regulatory T cells decreased significantly to 1.50%±0.50% （P〈0.05） compared with the other groups. Analysis of the T cell subpopulations in the acute rejection group varied from the other groups. Histological analysis showed typical changes of acute rejection in the acute rejection group only. Preconditioning of the donors with total body irradiation eliminated passenger lymphocytes of the liver graft, and thus affected the course of tolerance and induced acute rejection after liver transplantation.

Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units： a prospective cohort study

Background Acute kidney injury （AKI） has been recognized as a major healthcare problem affecting millions of patients worldwide.However,epidemiologic data concerning AKI in China are still lacking.The objectives of this study were to characterize AKI defined by RIFLE criteria,assess the association with hospital mortality,and evaluate the impact of AKI in the context of other risk factors.Methods This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across China's Mainland.We excluded patients who were admitted for less than 24 hours （n=1623）,younger than 18 years （n=127）,receiving chronic hemodialysis （n=29）,receiving renal transplantation （n=1） and unknown reasons （n=28）.There were 1255 patients in the final analysis.AKI was diagnosed and classified according to RIFLE criteria.Results There were 396 patients （31.6％） who had AKI,with RIFLE maximum class R,I,and F in 126 （10.0％）,91 （7.3％）,and 179 （14.3％） patients,respectively.Renal function deteriorated in 206 patients （16.4％）.In comparison with non AKI patients,patients in the risk class on ICU admission were more likely to progress to the injury class （odds ratio （OR） 3.564,95％ confidence interval （CI） 1.706-7.443,P =0.001],while patients in the risk class （OR 5.215,95％ CI 2.798-9.719,P ＜0.001） and injury class （OR 13.316,95％ CI 7.507-23.622,P ＜0.001） had a significantly higher probability of deteriorating into failure class.The adjusted hazard ratios for 90-day mortality were 1.884 for the risk group,3.401 for the injury group,and 5.306 for the failure group.Conclusions The prevalence of AKI was high among critically ill patients in Chinese ICUs.In comparison with non-AKI patients,patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F.The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.

Value of Kidney Disease Improving Global Outcomes Urine Output Criteria in Critically III Patients： A Secondary Analysis of a Multicenter Prospective Cohort Study

Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.

Role of platelet-rich plasma in articular cartilage lesions

Articular cartilage has only a limited capacity of selfhealing.Once seriously damaged,articular cartilage lesions will not regenerate;and any joint surface damage,if left untreated,will invariably deteriorate and eventually spread to surrounding areas.1 The end result of such a process is often the development of osteoarthritis （OA）,which often occurs in large load-bearing joints,such as knee and femoral joint.So much attention has been focused on how to eliminate symptoms,repair damaged cartilage,restore the integrity of the articular surface,prevent or halt joint degeneration,and improve joint function.But it still remains a challenging problem for orthopedic surgeons.In recent years,the role of growth factors （GFs） on tissue repair has become a hot research topic.The biological effect of GFs on cartilage repair has been well documented in vivo and in vitro.2-4 At present,most GFs are obtained mainly through genetic engineering technology and extracted from the animals;the preparation process is cumbersome,expensive,and inconvenient.

Traditional Chinese medicines and their active ingredients sensitize cancer cells to TRAIL-induced apoptosis

The rapidly developing resistance of cancers to chemotherapy agents and the severe cytotoxicity of such agents to normal cells are major stumbling blocks in current cancer treatments.Most current chemotherapy agents have significant cytotoxicity,which leads to devastating adverse effects and results in a substandard quality of life,including increased daily morbidity and premature mortality.The death receptor of tumor necrosis factor-related apoptosis-inducing ligand(TRAIL)can sidestep p53-dependent pathways to induce tumor cell apoptosis without damaging most normal cells.However,various cancer cells can develop resistance to TRAIL-induced apoptosis via different pathways.Therefore,it is critical to find an efficient TRAIL sensitizer to reverse the resistance of tumor cells to TRAIL,and to reinforce TRAIL’s ability to induce tumor cell apoptosis.In recent years,traditional Chinese medicines and their active ingredients have shown great potential to trigger apoptotic cell death in TRAIL-resistant cancer cell lines.This review aims to collate information about Chinese medicines that can effectively reverse the resistance of tumor cells to TRAIL and enhance TRAIL’s ability to induce apoptosis.We explore the therapeutic potential of TRAIL and provide new ideas for the development of TRAIL therapy and the generation of new anticancer drugs for human cancer treatment.This study involved an extensive review of studies obtained from literature searches of electronic databases such as Google Scholar and PubMed."TRAIL sensitize"and"Chinese medicine"were the search keywords.We then isolated newly published studies on the mechanisms of TRAIL-induced apoptosis.The name of each plant was validated using certified databases such as The Plant List.This study indicates that TRAIL can be combined with different Chinese medicine components through intrinsic or extrinsic pathways to promote cancer cell apoptosis.It also demonstrates that the active ingredients of traditional Chinese medicines enhance the sensitivity of cancer cells to TRAIL-mediated apoptosis.This provides useful information regarding traditional Chinese medicine treatment,the development of TRAIL-based therapies,and the treatment of cancer.