A comparison of the effect of alendronate and You-Gui-Wan on osteoporosis in female rats with kidney-yang deficiency

Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW.To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency,the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate(ALN)on osteoporosis with kidney-yang deficiency.Methods:SPF female SD rats were randomly divided into control,osteoporosis,osteoporosis with kidney-yang deficiency,osteoporosis with kidney-yang deficiency+YGW and osteoporosis with kidney-yang deficiency+ALN groups.Except for the control group,osteoporosis was induced by the removal of bilateral ovaries.After 12 weeks,rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days.Rats were treated with YGW or ALN for 12 weeks.The weights of rats were recorded.Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae,liver,spleen,and kidneys of rats.Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining.The expression of osteoclast key indices(ACP)and osteoblast key indices(ALP)in the bone tissue of rats in the different groups was observed by immunohistochemical staining.The expression of bone resorption-related indicators(TRAP and NXT-1),bone formation-related indicators(BALP,BGP,and P1NP),and major indicators of kidney-yang deficiency(ACTH,T3,T4,cAMP,and cGMP)were observed using an ELISA detection kit.The expression levels of the main indices of liver function(ALT and AST)were detected in different groups.Results:The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH,T3,T4,and cAMP decreased significantly,and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group.Moreover,both YGW and ALN effectively improved the symptoms of osteoporosis,including the injury of bone trabeculae and growth plates,as well as the expression of bone metabolism-related indicators.However,unlike ALN,YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats.In addition,YGW caused no obvious damage to the liver,spleen,or kidney,whereas ALN led to liver cirrhosis.Conclusion:The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency,increases bone mineral density,and improves bone metabolism indicators,and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency.YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency.Therefore,alendronate should be used cautiously in patients with osteoporosis and poor liver function.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

Pedicle Screw Fixation with Kyphoplasty Decreases the Fracture Risk of the Treated and Adjacent Non-treated Vertebral Bodies:a Finite Element Analysis

Adjacent vertebral fractures are common in patients with osteoporotic vertebral compression fractures（OVCFs） after kyphoplasty.This finite element study was to examine whether short segment pedicle screw fixation（PSF） with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae after kyphoplasty for OVCFs.By simulating cement augmentation with or without short segment pedicle screw fixation（PSF）,two tridimensional,anatomically detailed finite element models of the T10–L2 functional spinal junction were developed.The insertion of pedicle screws into the intact vertebra apparently decreased the stress distribution of the treated vertebra in vertical compression and other load situations.The stress distribution in the bone structures of the intact vertebra adjacent to the intact-screwed vertebra was much less than that in the one adjacent to the treated vertebra.The insertion of pedicle screws into the intact vertebra greatly decreased the maximum displacement of the cortical bones and cancellous bones of the vertebrae.Our results indicated that short segment PSF with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae in the management of OVCFs.

Atypical imaging features of the primary spinal cord glioblastoma:A case report

BACKGROUND Primary spinal cord(PSC)glioblastoma(GB)is an extremely rare but fatal primary tumor of the central nervous system and associated with a poor prognosis.While typical tumor imaging features are generally easy to recognize,glioblastoma multiforme can have a wide range of imaging findings.Atypical GB is often misdiagnosed,which usually delays the optimal time for treatment.In this article,we discuss a clinical case of pathologically confirmed PSC GB under the guise of benign tumor imaging findings,as well as the most recent literature pertaining to PSC GB.CASE SUMMARY A 70-year-old female complained of limb weakness lasting more than 20 d.Irregular masses were observed inside and outside the left foramina of the spinal canal at C7-T1 on medical imaging.Based on the imaging features,radiologists diagnosed the patient with schwannoma.Tumor resection was performed under general anesthesia.The final histopathological findings revealed a final diagnosis of PSC GB,world health organization Grade IV.The patient subsequently underwent a 4-wk course of radiotherapy(60 Gy in 20 fractions)combined with temozolomide chemotherapy.The patient was alive at the time of submission of this manuscript.CONCLUSION Atypical GB presented unusual imaging findings,which led to misdiagnosis.Therefore,a complete recognition of imaging signs may facilitate early accurate diagnosis.

Effect of synoviectomy combined with postoperative radiotherapy on pigmented villonodular synovitis in knee:A meta-analysis

Objective:To evaluate the efficacy of synovectomy combined with postoperative radiotherapy in the treatment of pigmented villonodular synovitis compared with only synovectomy in knee. Methods:The related references were searched from SinoMed,CNKI,Wanfang,VIP,PubMed,Embase,Cochrane Library and Web of Science from date of databases establishment to October 2020,and the studies of synovectomy combined with postoperative radiotherapy were screened. According to the type of research,the corresponding evaluation methods were selected for quality evaluation of the literature. RevMan 5.3 software was used for meta-analysis. The primary outcome was recurrence,while the secondary outcomes included complications,excellent and good rate of function of knee,range of motion of knee,Lysholm score,and IKDC score of knee etcetera. Results:A total of 11 articles were included in meta-analysis,with 510 cases,280 in the combined group and 230 in the control group. The results of meta-analysis showed that:(1)The recurrence rate in the combination group was significantly lower than that in the control group,[OR=0.33,95%CI(0.20,0.55),P<0.000 1];(2)The complications in the combined group were higher than that in the control group[OR=2.70,95%CI(1.16,6.31),P=0.02];(3)The excellent and good rate of the combined group was significantly better than that of the control group[OR=2.86,95%CI(1.23,6.64),P=0.01],and it also may be the result of different evaluation criteria of each study;(4)There was no significant difference range of motion[MD=2.96,95%CI(-0.54,6.47),P=0.10],Lysholm score[MD=3.22,95%CI(-0.51,6.96),P=0.09],or IKDC score[MD=2.88,95%CI(-1.07,6.82),P=0.15]in knee between the two groups. Conclusion:The meta-analysis shows that synovectomy combined with radiotherapy can reduce the recurrence rate of pigmented villonodular synovitis in knee,but compared with only operation,there are higher complications. However,the above conclusions need to be verified by long-term follow-up of more high-quality clinical studies.

Giant cellular leiomyoma in the broad ligament of the uterus:A case report

BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,it is still difficult to achieve a preoperative diagnosis.The majority of cellular leiomyomas are diagnosed by histopathology after surgery.We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.CASE SUMMARY A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time.The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause,and complained of frequent abdominal pain and low-grade fever.Computed tomography of the abdomen showed a solid cystic mass(29.4 cm×18.8 cm×37.7 cm)in the pelvis and abdomen.Moreover,routine blood test results indicated a baseline cancer antigen 125(CA-125)level of 187.7 U/mL and C-reactive protein of 109.58 mg/L.Subsequently,retrograde hysterectomy and bilateral adnexectomy were performed in this patient.On histopathologic examination of the surgical specimen,a rare cellular leiomyoma in the broad ligament was diagnosed.CONCLUSION Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment,differential diagnosis,and surgical management.

Effects of lentinan and thymopentin combined with adjuvant chemotherapy on immunity, oxidative stress, matrix metalloproteinases and related factors in patients with tongue squamous cell carcinoma

Objective:To investigate the effects of lentinan and thymopentin combined with adjuvant chemotherapy on immunity, oxidative stress, matrix metalloproteinases and related factors in patients with tongue squamous cell carcinoma.Methods: Retrospective analysis of 78 patients with tongue squamous cell carcinoma admitted to our hospital from February 2013 to November 2017, according to the postoperative chemotherapy scheme, the patients were divided into control group (n=42) and observation group (n=36). The patients in control group were given PF chemotherapy scheme (cisplatin + compound fluorouracil injection), on this basis, the patients in observation group were given lentinan and thymopentin injection combined treatment. The immune index, oxidative stress, matrix metalloproteinase, cyclin D1 (CyclinD1) and B lymphocyte tumor-2 (BCL-2) were detected and analyzed before and after treatment.Results:After treatment, the immunoglobulin level in the control group was not statistically significant compared with that before treatment (P>0.05);the levels of IgA, IgG and IgM in the observation group were significantly higher than those before treatment (P<0.05), and the levels of IgA, IgG and IgM in the observation group were significantly higher than those in the control group (P<0.05);the level of SOD in control group was significantly lower than that before treatment (P<0.05), and the level of MDA was significantly higher than that before treatment (P<0.05);the observation group was the opposite, and its SOD level was significantly higher than that of the control group (P<0.05), and the MDA level was significantly lower than the control group (P<0.05);the levels of MMP-2 and MMP-9 in the two groups were significantly lower than those before treatment (P<0.05), and the levels of MMP-2 and MMP-9 in the observation group were significantly lower than those in the control group (P<0.05);the levels of CyclinD1 and BCL-2 in the two groups were significantly lower than those before treatment (P<0.05), and the levels of CyclinD1 and BCL-2 in the observation group were significantly lower than those in the control group (P<0.05).Conclusions:Lentinan and thymopentin assisted PF chemotherapy regimen can enhance the immune function of patients with tongue squamous cell carcinoma after radical surgery, improve oxidative stress response, inhibit tumor cell proliferation and metastasis. It has the significance of clinical popularization.

Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung’s disease: A case report and review of literature

BACKGROUND Madelung’s disease(MD)is a chronic alcoholism-associated metabolic syndrome characterized by symmetrical subcutaneous deposition of adipose tissue in the head,neck,shoulders,back,trunk,and nerve roots of the upper and lower limbs.It is relatively rare in Asian individuals and is prone to misdiagnosis.Herein,we report a case of a patient with MD who had undergone surgical management at our hospital,and we discuss the pathogenesis,diagnosis,and treatment of MD.CASE SUMMARY We report a case of MD in a 65-year-old man of Han descent.The patient had multiple,painless progressive masses for more than five years in the neck and more than 30 years in the upper back.Because of neck mobility limitations and progressive cosmetic deformities caused by the masses,he was admitted to our hospital.He drank approximately 500 mL of liquor per day and smoked heavily for more than 30 years.Contrast-enhanced computed tomography of the neck and chest documented abundant unencapsulated,subcutaneous fatty deposits.We prepared a staged operation plan.The patient was diagnosed with MD;he was advised to abstain from alcohol and was followed up regularly.After a 3-month follow-up,no recurrence of fat accumulation was found in the surgical areas.CONCLUSION This report presents a case of surgical treatment for MD to improve clinicians'understanding of the disease.

Entire process of electrocardiogram recording of Wellens syndrome:A case report

BACKGROUND Wellens syndrome is an electrocardiogram(ECG)pattern seen in high-risk patients with unstable angina pectoris.It is characterized by inverted or biphasic T-waves that change into positive or pseudo-normalized waves at precordial leads when the patient experiences an angina attack;however,the mechanism for this condition remains unclear.CASE SUMMARY A 47-year-old male patient experienced repeated,unprovoked episodes of chest pain for>20 d,with worsening during the previous day.On the day of admission,he experienced episodes of paroxysmal chest pain lasting more than 30 min,in addition to radiating pain to the left arm and exertional dyspnea.The patient presented to the emergency department with no chest pain or other discomfort at that time.ECG at presentation showed sinus tachycardia and Twave changes,which were identified as Wellens syndrome when combined with previous ECG findings.ECGs and myocardial enzymology examinations were normal when angina was present,but the ECG showed inverted or biphasic Twaves when angina was absent.After percutaneous coronary intervention,the ECGs demonstrated inverted or biphasic T-waves in the anterior precordial leads on days 0,1,and 2,but normal T-waves on day 3.The ECGs showed no subsequent ischemic ST-T-wave changes.CONCLUSION The Wellens syndrome pseudo-normalized T-waves likely reflect development of unstable angina pectoris into the hyperacute phase of ST-segment elevation myocardial infarction.

Effect of electroacupuncture for Pisa syndrome in Parkinson’s disease:A case report

BACKGROUND Pisa syndrome(PS)refers to marked lateral flexion of the trunk with a Cobb angle greater than 10°,which is typically mobile and can be resolved by lying down.PS is one of the most common postural deformities secondary to Parkinson’s disease(PD)and can aggravate scoliosis in the advanced stages of PD.CASE SUMMARY Here,we present the case of a 53-year-old woman who presented with lateral curvature for 6 mo.Full spine X-ray films in the correct position showed that the thoracolumbar spine was bent to the right without any rotation of the vertebrae.The patient was diagnosed with Pisa syndrome.After receiving a month’s treatment with electroacupuncture,the Cobb angle decreased from 18.14°to 13.41°.CONCLUSION This case demonstrates that electroacupuncture can effectively improve Pisa syndrome secondary to PD with few side effects and a low risk of recurrence.Additionally,early accurate diagnosis and timely intervention are meaningful for the prognosis of PS.

Malignant peritoneal mesothelioma with massive ascites as the first symptom:A case report

BACKGROUND Malignant peritoneal mesothelioma(MPM) is an extremely rare tumor with nonspecific clinical manifestations,which is extremely difficult to diagnose.Herein,we reported a case of MPM in the abdominal cavity with massive shortterm ascites as the first symptom.CASE SUMMARY A 65-year-old woman presented to the hospital with abdominal pain,distention,and shortness of breath that persisted for 15 d.The serum CA-125 level was 1075 U/m L.The abdominal computed tomography showed massive ascites and no obvious tumor lesions.The pathological examination of the ascitic fluid showed numerous heterotypic cells with some papillary structures.The immunohistochemistry and fluorescence in situ hybridization showed the deletion of CDX2(-),WT-1(-),Ki-67(about 10% +),CEA(-),Glut-1(+++),desmin(-),PD-L1(-),and CDKN2A(P16).The final diagnosis was MPM.The patient refused tumor cytoreductive surgery and received two cycles of cisplatin plus pemetrexed bidirectional chemotherapy.In the second cycle,she received an additional cycle of hyperthermic intraperitoneal chemotherapy and immune checkpoint inhibitor therapy due to massive recalcitrant ascites.She died of disease progression 2 mo after diagnosis.CONCLUSION In case of massive unexplained ascites,the possibility of MPM should not be excluded to avoid misdiagnosis and delay in treatment.

Effect of clearing heat and detoxification method on macrophages polarization in patients with acute myocardial infarction and heat toxin syndrome after intervention

Objective:To evaluate the effect of heat-clearing and detoxifying method on the macrophages polarization in patients with acute myocardial infarction with heat toxin syndrome after intervention.Methods:Sixty patients with acute myocardial infarction and undergoing percutaneous coronary intervention with heat toxin syndrome were randomly divided into a control group and a test group with 30 cases each.The control group was given conventional treatment,and the test group was given Huanglian Jiedu Decoction,the representative of the method of clearing heat and detoxification,orally on the basis of the control group.The intervention time of both groups was 2 weeks.Comparing The Seattle Angina Pectoris Scale(SAQ)before and after treatment,creatine kinase(CK),creatine kinase MB isoenzyme(CKMB),high-sensitivity troponin I(hs-TnI),and Lipoprotein-associated phospholipaseA2(LPPLA_2)),the phenotype ratio of M1 and M2 macrophages,and observe the adverse reactions.Results:After treatment,the SAQ scores of the two groups of patients were improved,and the levels of CK,CK-MB,hs-TnI,and LP-PLA_2 decreased significantly.The scores of AS,AF,TS,and DP in the SAQ of the test group were all higher than those of the control group,and the hs-TnI and LP-PLA_2 were better than those of the control Group(P<0.05 or P<0.01).After treatment,the proportion of M1 type macrophages in the two groups of patients'macrophages decreased significantly(P<0.05 or P<0.01),the ratio of M2 type macrophages increased(P<0.05),and the M1/M2 ratio decreased.The ratio of M1/M2 in the test group of the control group was significantly lower than that of the control group(P<0.01).There were no obvious adverse reactions in both groups.Conclusions:The method of clearing heat and detoxifying has a definite effect on patients with acute myocardial infarction of heat toxin syndrome after interventional operation.It can reduce myocardial damage,improve myocardial function,and reduce inflammation.And it is safe for clinical treatment without any increasing risk of bleeding or other risk of cardiovascular events.

Intermittent appearance of right coronary fistula and collateral circulation:A case report

BACKGROUND Congenital coronary artery fistula can lead to symptoms of chest tightness,chest pain,or exertional dyspnea,which is a congenital vascular malformation that should not be ignored.Patients who have such malformations are frequently observed with different concurrent abnormal anatomic structures.Collateral circulation may have a positive effect on improving the patients'symptoms.CASE SUMMARY A 53-year-old female experienced episodic chest discomfort for the past month with symptoms manifesting when she was agitated or overexerted.After a positive treadmill test,the patient underwent coronary angiography.“Ghostlike”intermittent appearance of coronary ventricular fistula and collateral branching were observed.The patient was diagnosed with a right coronary ventricular fistula and collateral circulation.CONCLUSION This case shows the likelihood of collateral circulation in patients with coronary artery fistula.This may provide medical staff with novel solutions to treat insufficiency of myocardial blood supply induced by cardiovascular malformations.

Effective components and signaling pathways of Ranunculi Ternati Radix based on network pharmacology

Objective:This study was designed to find out the active components of Ranunculi Ternati Radix using network pharmacology,and to explore its potential target and pharmacological mechanism.Methods:By the TCMSP database,combined with oral bioavailability(≥30%)analysis and resistance(≥0.18),screening of active ingredients in Ranunculus ternatus Thunb.Retrieve the protein targets of the compounds from the TCMSP database.Associated Proteins and Gene Names were received via UniProt database.The protein interaction network was constructed by applying String database and Cytoscape software.Gene Ontology and Pathway Enrichment Analysis were developed on the basis of DAVID database.Results:10 active compounds including beta-sitosterol,campesterol,Mandenol were selected from Ranunculi Ternati Radix.And it produced its effects on different diseases mainly by regulating targets including PIK3CG,HSP90AA1,BAX and BCL2,which involved signaling pathways containing Pathways in cancer、PI3K-Akt signaling pathway、Hepatitis B、Tuberculosis and so on.Some published papers had confirmed by each other.Meanwhile,this work predics that Ranunculi Ternati Radix had the potential to treat non-alcoholic fatty liver disease.Conclusion:This study preliminarily validated the major targets and pathways of Ranunculi Ternati Radix acting on different diseases,which laid a foundation for further study on its mechanisms.

Mechanism of "Pinelliae rhizoma-Arisaematis rhizoma" in treatment of lung cancer based on network pharmacology

Objective:The study was designed to explore the mechanism of“Pinelliae RhizomaArisaematis Rhizoma”(PR-AP)in treatment of lung cancer based on network pharmacology.Methods:The active components and their targets of“Pinelliae Rhizoma-Arisaematis Rhizoma”were screened out from TCMSP database.The cytoscape3.7.0 software was used to construct the drug-active component-targets network.Searched the DisGeNet database to obtain lung cancer related targets.Bisogenet was used to construct"PPI network of active component target"and"PPI network of lung cancer target",and the intersection of the two networks was taken and the target was screened.AutoDockTools software was used to dock the key active ingredients with the key targets.David database was used to perform Go biological process enrichment analysis and KEGG pathway enrichment analysis.Results:A total of 15 active components were collected,including beta-sitosterol,baicalein,Stigmasterol,Cavidine,coniferin,etc.These active components mainly act on 95 key targets such as ESR1 and CDK2,which enriched in multiple lung cancer related signaling pathways,such as PI3KAkt、MAPK、HIF-1、FoxO、TGF-β、Hippo、TNF、Notch、VEGF、cAMP,etc.The results of molecular docking showed that the active components could regulate the core targets(ESR1 and CDK2).Conclusion:The effect of“Pinelliae Rhizoma-Arisaematis Rhizoma”in the treatment of lung cancer embodies the characteristics of multi-component,multi-target and multi-pathway of traditional Chinese medicine.Its mechanism of action may be to play a role in the treatment of lung cancer by regulating cell cycle,angiogenesis,tumor stem cells,etc.This research can provide ideas and references for further research.

Analysis of auxiliary diagnosis, cell survival, angiogenesis and nutritional support in patients with oral cancer

Objective:To investigate the changes and clinical significance of auxiliary diagnosis, cell survival, angiogenesis and nutritional support in patients with oral cancer.Methods: 50 patients with oral cancer treated in our hospital from June 2016 to September 2017 were selected as the observation group and 50 healthy people as the control group. The expression levels of auxiliary diagnosis [including secretory immunoglobulin A (SIgA), catalase (CAT)], cell survival [including survivin, focal adhesion kinase (FAK)], angiogenesis [including vascular endothelial growth factor (VEGF), hepatocyte growth (HGF), urokinase-type plasminogen activator (uPA)] and nutritional support [including lead (Pb), magnesium (Mg), calcium (Ca), iron (Fe), zinc (Zn) and copper (Cu)] related indicators in the two groups were observed and compared.Results:The levels of SIgA [(83.30±6.05) ug/mL], Mg [(1.21±0.17) mmol/L], Fe [(6.75±1.03)mmol/L] and Zn [(87.11±15.31) ug/L] in the observation group were significantly lower than those in the control group (P<0.05), while the levels of CAT [(39.87±9.18) U/mL], survivin [(131.63±10.53) ng/L], FAK [(62.27±5.20) ng/mL], VEGF[(533.73±150.63)ng/L], HGF[(411.32±181.72)ng/L], uPA[(5.12±1.31)mg/L], Pb[(65.55±20.76)μg/L], Ca[(1.55±0.20)mmol/L] and Cu[(14.90±5.30)μmol/L] were significantly higher than that of the control group. The difference was statistically significant (P<0.05).Conclusions:Patients with oral cancer, the immune function of salivary mucosa decreased and cell survival was abnormal. Oral cancer patients are easy to regenerate tumor blood vessels. Tumor cells and vascular endothelial cells are active in proliferation, migration and invasion. The expression of trace elements is also abnormal, which is not conducive to the nutritional support of the body. The relevant indicators should be strengthened in clinical practice, so as to provide evidence for early diagnosis and treatment of the disease.

Experimental Design and Clinical Observation of Modialysis Apparatus

Objective To evaluate the clinical safety and efficacy of polyethersulfone membrane hollow fiber dialyzer Enttex^(TM)-16LF(E60)in treating patients with end stage renal disease caused by a variety of reasons.Methods This clinical trialwas designed as a randomized,open,two-phase crossover and positive control,non-inferiority study.To evaluate the indicators of blood routine test,serum biochemical indexes,blood gas analysis,vital signsbefore and after hemodialysis,and the adverse events were recorded indetail.Results There was no significant difference in creatinine,urea,creatinine clearance and electrolytes between Enttex TM-16LF dialyzer and control dialyzer before and after hemodialysis,no adverse event associated with the Enttex^(TM)-16LF dialyzer was found during the study.Conclusions The Enttex^(TM)-16LF dialyzeris effective and safe for hemodialysis in patients with end stage renal disease.

Linear-like polypeptide-based micelle with pH-sensitive detachable PEG to deliver dimeric camptothecin for cancer therapy

Nano drug delivery systems have made significant progress in delivering anticancer drugs camptothecin(CPT).However,many challenges for CPT delivery remain,including low drug loading efficiency,premature drug leakage,and poor cellular internalization.Herein,we report a novel dual-sensitive polypeptide-based micelle with remarkably high drug loading of CPT for cancer therapy.This self-assembled micelle possesses the following essential components for CPT:(1)pH-sensitive PEG(OHC-PEG-CHO)for prolonging blood circulation and allowing biocompatibility by shielding the cationic micelles,which can be detached under the tumor acidic microenvironment and facilitates the cellular uptake;(2)polypeptide polylysine-polyphenylalanine(PKF)synthesized via ring-opening polymerization for micelle formation and CPT analogue loading;(3)dimeric CPT(DCPT)with redox-sensitive linker for increasing CPT loading and ensuring drug release at tumor sites.Interestingly,the linear-like morphology of PEG-PKF/DCPT micelles was able to enhance their cellular internalization when compared with the spherical blank PKF micelles.Also,the anticancer efficacy of DCPT against lung cancer cells was significantly improved by the micelle formation.In conclusion,this work provides a promising strategy facilitating the safety and effective application of CPT in cancer therapy.

Assessing myocardial indices and inflammatory factors to determine anxiety and depression severity in patients with chronic heart failure

BACKGROUND Patients with chronic heart failure(CHF)have a progressive disease that is associated with poor quality of life and high mortality.Many patients experience anxiety and depression(A&D)symptoms,which can further accelerate disease progression.We hypothesized that indicators of myocardial function and inflammatory stress may reflect the severity of A&D symptoms in patients with CHF.Changes in these biomarkers could potentially predict whether A&D symptoms will deteriorate further in these individuals.AIM To measure changes in cardiac and inflammatory markers in patients with CHF to determine A&D severity and predict outcomes.METHODS We retrospectively analyzed 233 patients with CHF treated at the Jingzhou Hospital,Yangtze University between 2018-2022 and grouped them according to Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)scores.We compared clinical data in the no-A&D,mild-A&D,moderate-A&D,and severe-A&D groups,the SAS and SDS scores with the New York Heart Association(NYHA)functional classification,and cardiac markers and inflammatory factors between the no/mild-A&D and moderate/severe-A&D groups.Regression analysis was performed on the markers with P<0.05 to determine their ability to predict A&D severity in patients and the area under the receiver operating characteristic curve(AUROC)was used to evaluate their accuracy.RESULTS In the inter-group comparison,the following variables had an effect on A&D severity in patients with CHF:NYHA class,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter,N-terminal pro-brain natriuretic peptide(NT-proBNP),interleukin-6(IL-6),and tumor necrosis factor-alpha(P<0.05).Other variables did not differ significantly between the A&D groups(P>0.05).In addition,we found that higher NYHA classes were associated with higher the SAS and SDS scores(P<0.05).Regression analysis showed that LVEF,NTproBNP,and IL-6 were independent risk factors for A&D severity(P<0.05).Among them,NT-proBNP had the best predictive ability as a single indicator(AUROC=0.781).Furthermore,the combination of these three indicators exhibited a good predictive effect toward discriminating the extent of A&D severity among patients(AUROC=0.875).CONCLUSION Cardiac and inflammatory biomarkers,such as LVEF,NT-proBNP,and IL-6,are correlated with A&D severity in patients with CHF and have predictive value.