Search

Tartary buckwheat is rich in flavonoids. However, the health‐promoting effect of these flavonoids has not been adequately studied. In the present study, we investigated the impact of rutin, quercetin, and Tartary buckwheat on the lipid metabolism of rats on a high‐fat diet. Quercetin could significantly reduce body weight, serum triacylglycerol, low‐density lipoprotein cholesterol, TNF‐α, insulin, and ameliorate glucose tolerance. It was surprising that Tartary buckwheat significantly increased the weight of the rats. Rutin, quercetin, and Tartary buckwheat tended to decreased fat deposition in the liver of rats but have little effect on short‐chain fatty acid production. The changes in the structure and diversity of the microbiota were found to be modulated by these diets. It was concluded that quercetin could attenuate high‐fat diet‐induced obesity, rutin, quercetin, and Tartary buckwheat can shape the specific structure of gut microbiota. Mechanism of Tartary buckwheat on lipid metabolism needs further systematic research., Tartary buckwheat is rich in flavonoids, and however, the health‐promoting effect of these flavonoids has not been adequately studied. This study reports the impact of rutin, quercetin, and Tartary buckwheat on the lipid metabolism and gut microbiota of rats on a high fat diet.

Numerous clinical studies have evaluated the performance of Sanjin tablets (SJTs) in the treatment of acute lower urinary tract infections (ALUTIs) in China. The present meta-analysis aimed to determine the efficacy and safety of SJT combined with antibiotics for the treatment of patients with ALUTIs and to evaluate the quality of evidence. The Cochrane Library, PubMed, EMBASE, Web of Science, Chinese BioMedical Database, China National Knowledge Infrastructure, WanFang and VIP databases were searched for entries added between inception and December 2018 to identify relevant randomized controlled trials (RCTs). The Cochrane risk-of-bias tool and Consolidated Standards of Reporting Trials for Traditional Chinese Medicine were used for assessing the methodological quality and reporting quality of eligible studies, respectively. Meta-analysis and quality of evidence assessment were performed with RevMan 5.3 and Grading of Recommendations, Assessment, Development and Evaluations (GRADE), respectively. A total of 8 RCTs comprising 790 patients with ALUTIs were included in the present meta-analysis. The cure rate of SJTs combined with gatifloxacin tablets (GTs) was higher than that of GTs alone [relative ratio (RR)=1.30, 95% CI=1.07-1.57, P=0.009]. The cure rate of SJTs combined with levofloxacin tablets (LTs) was higher than that of LTs alone (RR=1.13, 95% CI=1.04-1.24, P=0.006). SJTs combined with LTs was better in improving the total effective rate than LTs alone (RR=1.11, 95% CI=1.03-1.19, P=0.005). The recurrence rate for SJTs combined with antibiotics was lower than that associated with antibiotics alone (RR=0.35, 95% CI=0.13-0.97, P=0.04). The bacterial clearance rate achieved with SJTs combined with antibiotics was higher than that obtained with antibiotics alone (RR=1.41, 95% CI=1.09-1.84, P=0.009). The present meta-analysis demonstrated that, compared with the effects of antibiotics treatment, SJTs combined with antibiotics improved the cure rate, total effective rate and bacterial clearance rate, and decreased the recurrence rate. In addition, no serious adverse reactions were observed in patients with ALUTIs. However, the GRADE quality of evidence was low. Thus, further large-scale and rigorously designed clinical trials are required to improve the quality of evidence.

Background Painless gastrointestinal endoscopy under intravenous propofol anesthesia is widely applied in the clinical scenario. Despite the good sedation and elimination of anxiety that propofol provides, low SpO2 may also result. Doxapram is a respiratory stimulant with a short half-life. The primary aim of this study was to investigate the effects of doxapram on alleviating low SpO2 induced by the combination of propofol and fentanyl during painless gastrointestinal endoscopy. Methods In this prospective study, patients scheduled for painless gastrointestinal endoscopy were randomly assigned to group D or S with 55 patients per group. Initially, both groups received a combination of propofol and fentanyl. Patients in group D received 50 mg doxapram after propofol injection, while patients in group S received an equal volume of saline. Vital signs of the patients, propofol dose, examination duration, and incidences of low SpO2 were recorded. Results There were no statistical differences in propofol consumption and examination duration between the two groups. Twenty-six patients in group S experienced low SpO2 versus 10 in group D (P = 0.001). Nineteen patients in group S underwent oxygenation with a face mask in contrast to 8 in group D (P = 0.015). Eighteen patients in group S were treated with jaw lifting compared to 5 in group D (P = 0.002). Four patients in group S underwent assisted respiration compared to 2 in group D (without statistical difference). The average oxygen saturation in group S was significantly lower than that in group D at 1, 2 and 3 min after propofol injection (P P = 0.001 and P = 0.020, respectively). There were no statistical differences in oxygen saturation at other time points. There were no statistical differences in MAP and HR (except for the time point of 1 min after the induction) between the two groups. Conclusions Low dose of doxapram can effectively alleviate low SpO2 in painless gastrointestinal endoscopy with intravenous propofol, without affecting propofol consumption, examination duration, MAP, or HR. Trail registration The study was approved by the Institutional Ethics Committee of Clinical and New Technology of Wuxi People’s Hospital on 20th July, 2018 (KYLLH2018029) and registered in the Chinese Clinical Trial Register on 16th August, 2018 (ChiCTR1800017832).

BACKGROUND This meta-analysis was conducted to evaluate the clinical effectiveness and safety of Salvianolic acids for injection (SAFI) plus conventional treatment (CT) for patients with acute cerebral infarction (ACI) and to assess the evidence to guide clinical practice. MATERIAL AND METHODS PubMed, EMBASE, Cochrane Library, Web of Science, and 4 Chinese electronic databases were searched to identify relevant randomized controlled trials (RCTs). The methodological quality of eligible studies was evaluated using the Cochrane risk of bias tool. The reporting quality of eligible studies was evaluated by Consolidated Standards of Reporting Trials (CONSORT) for traditional Chinese medicine. Meta-analysis and evidence quality were performed using RevMan 5.3 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS A total of 14 RCTs involving 1309 patients were included. Meta-analysis showed that SAFI plus CT was better than CT alone in improving the total effective rate (RR=1.35, 95% CI 1.25 to 1.44, P

The effects of various flavonoids of Tartary buckwheat (rutin‐enhanced flavonoid extract [REFE and quercetin‐enhanced flavonoid extract [QEFE]) and individual flavonoids (rutin, quercetin and kaempferol) on the antioxidant activity, inhibition of α‐glucosidases and α‐amylase and starch digestibility were evaluated. Quercetin possessed the highest antioxidant activity and inhibition of α‐glucosidases and α‐amylase activity followed by kaempferol and rutin. REFE and QEFE have similar antioxidant and inhibition of α‐amylase activities, but QEFE has much higher α‐glucosidases inhibition than REFE. Tartary buckwheat flour has the lowest content of rapidly digestible starch and predicted glycaemic index (pGI) compared to maize flour, wheat flour and rice flour. Addition of rutin and quercetin to wheat flour showed a weak or no effect on digestion inhibition, but they inhibited starch digestion under solid complex conditions. Our results may help explain the benefits of supplementing the diet with food rich in flavonoids.

Limited information is available regarding the effects of arsenic exposure on immune function. We have recently reported that chronic exposure to As was associated asthma, as determined by spirometry and respiratory symptoms. Because T helper 2 (Th2)-driven immune responses are implicated in the pathogenesis of allergic diseases, including asthma, we studied the associations of serum Th1 and Th2 mediators with the As exposure markers and the features of asthma among individuals exposed to As. A total of 553 blood samples were selected from the same study subjects recruited in our previous asthma study. Serum levels of Th1 and Th2 cytokines were analyzed by immunoassay. Subjects' arsenic exposure levels (drinking water, hair and nail arsenic concentrations) were determined by inductively coupled plasma mass spectroscopy. Arsenic exposure levels of the subjects showed significant positive associations with serum Th2-mediators- interleukin (IL)-4, IL-5, IL-13, and eotaxin without any significant changes in Th1 mediators- interferon-γ and tumor necrosis factor-α. The ratios of Th2 to Th1 mediators were significantly increased with increasing exposure to As. Notably, most of the Th2 mediators were positively associated with serum levels of total immunoglobulin E and eotaxin. The serum levels of Th2 mediators were significantly higher in the subjects with asthma than those without asthma. The results of our study suggest that the exacerbated Th2-driven immune responses are involved in the increased susceptibility to allergic asthma among individuals chronically exposed to As.

Salvia Miltiorrhiza Depside Salt (SMDS) was extracted from Salvia miltiorrhiza with high-quality control of active principles. In 2005, China's FDA approved the use of SMDS for stable angina pectoris (SAP), but the evidence of SMDS combined with aspirin remains unclear.The aim of this study was to assess the clinical effectiveness and safety of SMDS combined with aspirin in patients with SAP.A multicenter, pragmatic, three-armed parallel group and an individually randomized controlled superiority trial was designed. Participants aged 35 to 75 years old with SAP were recruited from four "Class Ⅲ Grade A" hospitals in China. Participants who were randomized into the SMDS group were treated with SMDS by intravenous drip. Participants in the control group received aspirin enteric-coated tablets (aspirin). Participants who were randomly assigned to the combination group received SMDS combined with aspirin. All participants received standard care from clinicians, without any restrictions. The primary outcome measure was thromboelastography (TEG). Secondary outcome measures included symptom score of the Seattle Angina Questionnaire (SAQ), visual analogue scale (VAS) score of traditional Chinese medicine (TCM) symptoms, platelet aggregation measured by light transmittance aggregometry (LTA), and fasting blood glucose. Effectiveness evaluation data were collected at baseline and ten days after treatment. Researchers followed up with participants for one month after treatment to determine whether adverse events (AEs) or adverse drug reactions (ADRs) such as bleeding tendency occurred. All statistical calculations were carried out with R 3.5.3 statistical analysis software.A total of 135 participants completed follow-up data on the primary outcome after ten days of treatment. Participants in the SMDS combined aspirin group had the highest improvement rate of sensitivity in AA% [p0.001, 95% CI (0.00-0.00)], from 30.6% before treatment to 81.6% after treatment. Participants with drug resistance (AA%20%) in the SMDS combined with aspirin group also had the highest sensitivity rate [p0.001, 95% CI (0.00-0.00)] after treatment (accounting for 81.0% of the combination group and 60.7% of the sensitive participants). The improvement of TCM symptoms in participants treated with SMDS combined with aspirin was significantly better than that of the aspirin group [MD = 1.71, 95% CI (0.15-3.27), p = 0.032]. There were no significant differences in other indexes (R, TPI, MA, K, CI, α value) of TEG, SAQ, platelet aggregation and fasting blood glucose among the three groups. No bleeding tendency or ADRs occurred in all participants.SMDS combined with aspirin is a clinically effective and safe intervention to treat adults aged 35 and older with SAP. This trial shows that SMDS combined with aspirin can significantly improve the sensitivity rate of AA% in TEG and the VAS score of TCM symptoms. Further large samples and high-quality research are needed to determine if certain participants might benefit more from SMDS combined with aspirin. The study protocol was registered in the Clinical Trials USA registry (registration No. NCT02694848).

Background A large body of evidence has shown a link between arsenic exposure and diabetes, but the underlying mechanisms have not yet been clarified. Objective We explored the association between arsenic exposure and the reduction of skeletal muscle mass as a potential mechanism of insulin resistance for developing arsenic-related hyperglycemia. Methods A total of 581 subjects were recruited from arsenic-endemic and non-endemic areas in Bangladesh and their fasting blood glucose (FBG), serum insulin, and serum creatinine levels were determined. Subjects’ arsenic exposure levels were assessed by arsenic concentrations in water, hair, and nails. HOMA-IR and HOMA-β were used to calculate insulin resistance and β-cell dysfunction, respectively. Serum creatinine levels and lean body mass (LBM) were used as muscle mass indicators. Results Water, hair and nail arsenic concentrations showed significant positive associations with FBG, serum insulin and HOMA-IR and inverse associations with serum creatinine and LBM in a dose-dependent manner both in males and females. Water, hair and nail arsenic showed significant inverse associations with HOMA-β in females but not in males. FBG and HOMA-IR were increased with the decreasing levels of serum creatinine and LBM. Odds ratios (ORs) of hyperglycemia were significantly increased with the increasing concentrations of arsenic in water, hair and nails and with the decreasing levels of serum creatinine and LBM. Females’ HOMA-IR showed greater susceptibility to the reduction of serum creatinine and LBM, possibly causing the greater risk of hyperglycemia in females than males. Path analysis revealed the mediating effect of serum creatinine level on the relationship of arsenic exposure with HOMA-IR and hyperglycemia. Conclusion Arsenic exposure elevates FBG levels and the risk of hyperglycemia through increasing insulin resistance with greater susceptibility in females than males. Additionally, arsenic exposure-related reduction of skeletal muscle mass may be a mechanism underlying the development of insulin resistance and hyperglycemia.

Altered metabolism is one of the hallmarks of cancer cells. Pentose phosphate pathway (PPP) is a fundamental component of cellular metabolism. Glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the PPP, is elevated in many cancers and contributes to tumor growth by producing ribose-5-phosphate and NADPH through PPP. However, the role of G6PD in hepatocellular carcinoma (HCC) metastasis and the clinical significance of G6PD in HCC progression and prognosis have not been well determined. In this study, by investigating tissue samples from HCC patients and HCC cell lines, we found that elevated G6PD expression is significantly associated with HCC metastasis and poor prognosis of HCCs, and that knockdown of G6PD inhibits in vitro proliferation, migration and invasion of HCC cell lines. Further studies reveal that G6PD contributes to HCC migration and invasion of hepatocellular carcinoma cells by inducing epithelial-mesenchymal transition through activation of signal transducer and activator of transcription 3 (STAT3) pathway. Our findings suggest that targeting G6PD could open up possibilities for metastasis intervention and improve the patients' outcomes for HCC.

A series of physical model experiments were performed to investigate the characteristics of the motion responses of a multi-module aquaculture platform. A decay test in calm water and regular wave experiments were performed for the platform in a wave basin. The natural period, damping coefficients of the platform, horizontal stiffness of the mooring system in calm water, and motion responses of the platform modules in regular waves were obtained. Owing to the central enclosed cabin and greater mass, the living module of the platform has a larger natural period and damping coefficient than the aquaculture module. Furthermore, the existence of the nets has a significant effect on the motion characteristics of the modules, and the influence of the nets on the damping of the heave motion is larger than that of the pitch motion. The motion responses of the entire platform system in the surge (sway) and yaw directions exhibit obvious low-frequency characteristics. Under regular waves with two incident angles (45° and 180°), the three-degree-of-freedom motion responses of the two types of modules exhibit the same trend as the wave frequency increases. The surge and heave responses have low-frequency characteristics, whereas the pitch response exhibits wave–frequency characteristics.

Transparent and flexible chitosan-based membranes containing antibacterial drugs were prepared through a casting/solvent evaporation method from suspension of chitosan floccule. To enhance mechanical properties, glycerin was incorporated into the floccule suspension to conjugate chitosan as a plasticizer. The mechanism of membrane formation is attributed to inter- and intro-hydrogen bonding between chitosan and glycerol molecules. The results showed that incorporation of glycerol has a significant influence on the properties of the chitosan membranes. With the increase of glycerol content, the tensile strength, swelling rate, water vapor permeability and wettability of membranes were significantly improved. In vitro enzymatic degradation revealed that the chitosan membrane had long-term stability regardless of the glycerol content. To enhance antibacterial properties, tetracycline hydrochloride (TH) and silver sulfadiazine (AgSD), representing the water-soluble and water-insoluble drug models, were integrated into the membranes, respectively. The results of controlled-release efficacy and inhibition zone indicate that the glycerol toughened chitosan membranes containing drugs have a promising future in treatment of bacterial infection as wound dressing.

Widespread contamination of arsenic (As) has become a global public health concern. Exposure to As causes respiratory complications. Asthma, a major respiratory complication, is increasing worldwide. However, the effect of chronic As exposure on the risk of asthma remains to be clarified. This study aims to examine the associations between As exposure (water, hair and nail As) and the risk of asthma among 842 individuals exposed to a wide range of As concentrations through drinking water in Bangladesh. Subjects' As exposure levels were measured with ICP-MS. Lung function was examined by a handheld spirometer. Characteristic features of asthma were evaluated by bronchodilator-mediated reversibility in airway obstruction and asthma-like symptoms through a structured questionnaire. Total serum immunoglobulin E (sIgE) levels were measured by immunoassay. As exposure metrics showed inverse associations with lung function measures (FEV1, FEV6, and FEV1/FEV6 ratio) and positive associations with the risks of airway obstruction (AO), reversible airway obstruction (RAO), and asthma-like symptoms. The majority of AO patients (70 of 97) were RAO with one or more characteristic symptoms of asthma. Intriguingly, subjects' As exposure levels showed positive associations with total sIgE levels. Total sIgE in RAO patients was significantly (p 0.001) higher than that in the control group. Thus the results revealed that chronic As exposure was associated with the risk of the characteristic features of asthma. Additionally the association between As exposure and subjects' total sIgE levels and an elevated level of total sIgE in RAO group suggested that As exposure-related asthma might be allergic in nature.

Background: Low back pain is a common health problem worldwide, which also is a leading cause of long-term disability and has an important effect on the global economy and society. Usually, conservative therapies are used to treat low back pain. As a kind of Chinese patent medicine, Shujinjianyao pill (SJJYP) has a great curative effect on low back pain. However, its safety has not been studied yet. Therefore, we carried out this clinical trial to observe the safety of SJJYP in the real world. Methods: First, participants need to meet the medication standards according to inclusion and exclusion criteria. Then, participants are conducted safety examination before taking SJJYP. After qualified screening, participants can be enrolled into the group. Second, all enrolled participants will receive SJJJYP for a period of 4 weeks. During the observation period, participants need to return to the hospital for a subsequent visit after 2 weeks of medication, and come to the hospital for safety check after 4 weeks of medication. Third, telephone follow-up is used to investigate any participants’ physical discomfort after 6 to 8 weeks (2–4 weeks after medication withdrawal). After all these steps are completed, clinical observation is finished. If any adverse events occur during this process, we will record them in time. When serious adverse events occur, we will use nested case–control study to explore the causes and mechanisms. Discussion: This study will obtain the safety results of SJJYP in clinical real world, which will offer a scientific basis for clinicians in the treatment of low back pain, and also provide a methodological basis for the safety study of other medicines. Trial registration: ClinicalTrial.gov registration number is NCT03598153. This study was approved by the ethics committee of Wangjing hospital, China Academy of Chinese Medical Sciences (WJEC-KT-2018-012-P002).

Background Acute uncomplicated lower urinary tract infection (UTI) is one of the most common bacterial infections. Patients usually present with dysuria, urinary urgency, urinary frequency, and suprapubic pain or tenderness. Approximately 150 million people are diagnosed with UTI each year worldwide. The high recurrence rate of lower UTI is a common problem of clinical treatment. The misuse of antibiotics has led to the emergence of a number of resistant bacterial strains. Thus, traditional Chinese medicine is considered as an alternative option for treating acute uncomplicated lower UTI. Thus, this study aims to evaluate the efficacy and safety of Sanjin tablets (SJT) for the treatment of acute uncomplicated lower UTI, explore whether SJT can reduce or substitute the use of antibiotics, and reduce the recurrence rate in the treatment of acute uncomplicated lower UTI. Methods/design In this study, a randomized, double-blind, double-dummy, parallel control of positive drug, multicenter clinical study will be established. A total of 252 patients with acute uncomplicated lower UTI (syndrome of dampness-heat in the lower jiao) will be randomly allocated in the ratio of 1:1:1 to three groups: experimental group; control group 1; and control group 2. The experimental group receives Sanjin tablets plus levofloxacin tablets (LT) placebo; the control group 1 receives LT plus SJT placebo; and the control group 2 receives SJT plus LT on the first five days, SJT plus LT placebo on the last two days. Each group will be treated for seven days and followed-up 1–2 times. The primary outcome measures of effective rate and recurrence rate are symptoms. Secondary outcome measures of effective rate and recurrence rate are the urine leukocytes, bacteriology examination, and safety assessment. Outcomes will be assessed at baseline and after treatment. Discussion This study protocol will provide the research data of efficacy and safety of SJT for the treatment of acute uncomplicated lower UTI. The first aim is to determine whether Sanjin tablets can reduce the use of antibiotics; the second aim is to determine whether Sanjin tablets can substitute the use of antibiotics. The recurrence rate will be assessed after cured to determine whether SJT can reduce the recurrence rate. The results of this study will improve the rational use of drugs, especially the rational application of antibiotics. It will also enable safety evaluation from laboratory indices and adverse events, which will provide reliable evidence for clinical treatment. Trial registration ClinicalTrials.gov, NCT03658291. Registered on 4 September 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3539-5) contains supplementary material, which is available to authorized users.

Arsenic (As) toxicity and diabetes mellitus (DM) are emerging public health concerns worldwide. Although exposure to high levels of As has been associated with DM, whether there is also an association between low and moderate As exposure and DM remains unclear. We explored the dose-dependent association between As exposure levels and hyperglycemia, with special consideration of the impact of demographic variables, in 641 subjects from rural Bangladesh. The total study participants were divided into three groups depending on their levels of exposure to As in drinking water (low, moderate and high exposure groups). Prevalence of hyperglycemia, including impaired glucose tolerance (IGT) and DM was significantly associated with the subjects' drinking water arsenic levels. Almost all exposure metrics (As levels in the subjects' drinking water, hair and nails) showed dose-dependent associations with the risk of hyperglycemia, IGT and DM. Among the variables considered, sex, age, and BMI were found to be associated with higher risk of hyperglycemia, IGT and DM. In sex-stratified analyses, As exposure showed a clearer pattern of dose-dependent risk for hyperglycemia in females than males. Finally, drinking water containing low-to-moderate levels of As (50.01–150 μg/L) was found to confer a greater risk of hyperglycemia than safe drinking water (As ≤10 μg/L). Thus the results suggested that As exposure was dose-dependently associated with hyperglycemia, especially in females.

BRCA1 promoter methylation is an essential epigenetic transcriptional silencing mechanism, related to breast cancer (BC) occurrence and progression. We quantified the methylation level of BRCA1 promoter and evaluated its significance as prognostic and predictive factor. BRCA1 promoter methylation level was quantified by pyrosequencing in surgical cancerous and adjacent normal specimens from 154 BC patients. A follow up of 98 months was conducted to assess the correlation between BRCA1-methylation level vs. overall survival (OS) and disease free survival (DFS). The mean methylation level in BC tissues was significantly higher (mean 32.6%; median 31.9%) than in adjacent normal samples (mean 16.2%; median 13.0%) (P < 0.0001). Tumor stage (R = 0.6165, P < 0.0001) and size (R = 0.7328, P < 0.0001) were significantly correlated with the methylation level. Patients with unmethylated BRCA1 had a better OS and DFS compared to the methylated group (each P < 0.0001). BRCA1 promoter methylation level has a statistically significance on survival in BC patients (HazR = 1.465, P = 0.000) and is an independent prognostic factor for OS in BC patients (HazR = 2.042, P = 0.000). Patients with ductal type, HER2 negative, lymph node negative stage 1+2 tumors had a better OS and DFS. Classification of grades and molecular subtypes did not show any prognostic significance. Pyrosequencing is a precise and efficient method to quantify BRCA1 promoter methylation level, with a high potential for future clinical implication, as it identifies subgroups of patients with poorer prognosis.

The aim of this study is to introduce a self-designed, minimally invasive technique for repairing an acute Achilles tendon rupture percutaneously. Comparing with the traditional open repair, the new technique provides obvious advantages of minimized operation-related lesions, fewer wound complications as well as a higher healing rate. However, a percutaneous technique without direct vision may be criticized by its insufficient anastomosis of Achilles tendon and may also lead to the lengthening of the Achilles tendon and a reduction in the strength of the gastrocnemius. To address the potential problems, we have improved our technique using a percutaneous Kirschner wire leverage process before suturing, which can effectively recover the length of the Achilles tendon and ensure the broken ends are in tight contact. With this improvement in technique, we have great confidence that it will become the treatment of choice for acute Achilles tendon ruptures.

Background This meta-analysis was aimed to explore the overall safety and efficacy of balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fracture (OVCF) based on qualified studies. Methods By searching multiple databases and sources, including PubMed, Cochrane, and Embase by the index words updated to January 2018, qualified studies were identified and relevant literature sources were also searched. The qualified studies included randomized controlled trials, prospective or retrospective comparative studies, and cohort studies. The meta-analysis was performed including mean difference (MD) or relative risk (RR) and 95% confidence interval (95% CI) to analyze the main outcomes. Results A total of 16 studies were included in the meta-analysis to explore the safety and efficacy of kyphoplasty versus vertebroplasty for the treatment of OVCF. The results indicated that kyphoplasty significantly decreased the kyphotic wedge angle (SMD, 0.98; 95% CI 0.40–1.57), increased the postoperative vertebral body height (SMD, − 1.27; 95% CI − 1.86 to − 0.67), and decreased the risk of cement leakage (RR, 0.62; 95% CI 0.47–0.80) in comparison with vertebroplasty. However, there was no statistical difference in visual analog scale (VAS) scores (WMD, 0.04; 95% CI − 0.28–0.36) and Oswestry Disability Index (ODI) scores (WMD, − 1.30; 95% CI − 3.34–0.74) between the two groups. Conclusions Kyphoplasty contributes especially to decreasing the mean difference of kyphotic wedge angle and risk of cement leakage and increasing the vertebral body height when compared with vertebroplasty. But radiographic differences did not significantly influence the clinical results (no significant difference was observed in VAS scores and ODI scores between the two groups); thus, kyphoplasty and vertebroplasty are equally effective in the clinical outcomes of OVCF. In addition, more high-quality multi-center RCTs with a larger sample size and longer follow-up are warranted to confirm the current findings.

Summary Metabolic reprogramming plays an important role in supporting tumor growth. However, little is known about the metabolic alterations that promote cancer metastasis. In this study, we identify acyl-CoA thioesterase 12 (ACOT12) as a key player in hepatocellular carcinoma (HCC) metastasis. The expression of ACOT12 is significantly down-regulated in HCC tissues and is closely associated with HCC metastasis and poor survival of HCC patients. Gain- and loss-of-function studies demonstrate that ACOT12 suppresses HCC metastasis both in vitro and in vivo. Further mechanistic studies reveal that ACOT12 regulates the cellular acetyl-CoA levels and histone acetylation in HCC cells and that down-regulation of ACOT12 promotes HCC metastasis by epigenetically inducing TWIST2 expression and the promotion of epithelial-mesenchymal transition. Taken together, our findings link the alteration of acetyl-CoA with HCC metastasis and imply that ACOT12 could be a prognostic marker and a potential therapeutic target for combating HCC metastasis.

In recent years, Chinese patent medicines such as smiltiorrhizadepsidesal(SMDS) injection are combined with western medicine to achieve good clinical efficacy for stable angina pectoris(SAP). SMDS is prepared by the water-soluble active ingredients extracted from Salvia miltiorrhiza, with the functions of promoting blood circulation, removing blood stasis and activating blood vessels, and it is used to treat type ⅠSAP and type ⅡSAP. The efficacy and safety of SMDS combined with simple routine western medicine for SAP were investigated by searching PubMed, EMbase, the Cochrane Library, CNKI, VIP, WanFang Data and CBM Database. SMDS combined with conventional western medicine treatment showed better efficacy for SAP as compared with western medicine alone, and better than other traditional Chinese medicines(such as Danshen injection and compound Danshen injection) combined with conventional western medicine. It was found that SMDS had a positive role in reducing blood viscosity, atherosclerosis, and improving microcirculation. The reported adverse drug reactions (ADRs) of SMDS combined with conventional western medicine therapy in clinical research were basically the same with ADRs reported by spontaneous reporting system(SRS) warning signals. Overall, SMDS combined with conventional western medicine had low incidence of ADR and no serious ADR occurred for SAP treatment in clinical trials. Currently, some drugs related to cardiovascular diseases such as ascinepazidemaleate injection, sodium succinate, propafenone hydrochloride and papaverine hydrochloride injection combined with SMDS have incompatibility, which should be highly emphasized in clinical use.

Prospective, multi-center, large-sample and registered design was used to analyze the drug combination features of Shenqi Fuzheng injection in the real world clinical application, and comprehend the drug combination in the real world. A total of 30 026 patients with the use of Shenqi Fuzheng injection were registered, where the chemical drugs were used for 57 436 times (accounting for 82.76%), and the Chinese patent medicines were used for 11 962 times (accounting for 17.24%), mainly including anti-acid drugs and anti-ulcer drugs, nutritional agent, immune enhancement agent, etc. According to the association rules, drug combinations of 2 drugs were closely related to inhibiting gastric acid secretion and anti-tumor; drug combinations of 3 drugs were closely related to inhibiting gastric acid secretion, antiemetic and anti tumor; drug combinations of 4 drugs were closely related to inhibiting gastric acid secretion, antiemetic, anti-tumor, and immune enhancement. The above results were consistent with the Instruction, providing clues for accurate treatment, and laying the foundation for clinical rational drug use.

Biomolecular network analysis was used to predict the mechanism of Salvianolate injection combined with aspirin for the treatment of stable angina pectoris(SAP). Related genes of Salvianolate injection, aspirin and SAP were obtained from Genecards, STITCH and DisGeNET databases. Agilent literature search software was used to construct biomolecular network; modules were identified by AP, MCODE and MCL methods. DAVID software was used for identification of related KEGG pathways. Results showed that Salvianolate injection and aspirin had a coverage rate of 45.92%, 62.56% respectively for SAP molecular network, and the coverage rate was 71.64% in combined use. The top 10 important nodes of SAP overlapped with Salvianolate injection and aspirin included MAPK14, MAPK8, IL-6 and IL-8. The important SAP nodes overlapped with Salvianolate injection alone included AKT1 and IFNG, and the important SAP nodes overlapped with aspirin included EPHB2 and TP53. Related SAP signaling pathways with combined Salvianolate injection and aspirin included Jak-STAT signaling pathway and MAPK signaling pathway. Related SAP signaling pathways with Salvianolate injection alone included VEGF signaling pathway and type 1 diabetes signaling pathway. Related SAP signaling pathways with aspirin alone included AA metabolism, linoleic acid metabolism signaling pathway, etc. The results showed that Salvianolate injection and aspirin combination had an enhancement effect in treatment of SAP through anti-inflammatory reaction and inhibition of atherosclerosis development; in addition, the combination use may have an additive effect through the antiplatelet aggregation, protecting endothelial cells, regulating blood lipid and regulating glucose metabolism.

Background: Arsenic poisoning is a public health problem worldwide. A few studies have reported the effects of arsenic exposure on adult cognitive function, but with limitations in the subject selection and exposure markers. Moreover, information regarding the association between arsenic exposure and biomarker of cognitive impairment is scarce. Objectives: We examined the associations between arsenic exposure and adult cognitive impairment using the Mini-Mental State Examination (MMSE) and the serum levels of brain-derived neurotrophic factor (BDNF), a potential biomarker of cognitive health status. Methods: We designed a cross-sectional study that recruited 693 adult (18–60 years old) subjects from the areas of low- and high‑arsenic exposure in rural Bangladesh. The subjects' arsenic exposure levels (drinking water, hair, and nail arsenic concentrations) were measured by inductively coupled plasma-mass spectroscopy. The Bangla version of the MMSE was used as a cognitive assessment tool. Serum BDNF (sBDNF) levels were assessed by immunoassay. Results: In this study, we found that average MMSE score and sBDNF level of the subjects in arsenic-endemic areas were significantly (p

Background:Ancient medical practitioners used to encourage dietary supplements and herbal medicine for the treatment of type 2 diabetes mellitus (T2DM). Ginger (Zingiber officinale), is a nontoxic spice with negligible side effects, and is considered safe by the food and drug administration.

To identify novel proteins that might help clarify the molecular mechanisms underlying chondromodulin-I (ChM-I) induction of mesenchymal stem cells (MSCs) differentiate into chondrocytes. MSCs are triggered to differentiate into chondrocytes, which are recognized as important factors in cartilage tissue engineering. ChM-I is a glycoprotein that stimulates the growth of chondrocytes and inhibits angiogenesis in vitro. In this study, the proteomic approach was used to evaluate protein changes between undifferentiated MSCs and ChM-I-transfected MSCs. The expression of the protein spots was analyzed using two-dimensional gel electrophoresis. Then, 14 protein spots were identified between MSCs and ChM-I-transfected MSCs. 309 proteins were identified using mass spectrometry (MS). The differentially regulated proteins were categorized and annotated using Protein Analysis Through Evolutionary Relationships (PANTHER) analysis with the aid of the Database for Annotation, Visualization and Integrated Discovery (DAVID) tool. These proteins are included in a variety of metabolic pathways and signal transduction pathways, such as focal adhesion, glycolysis, actin cytoskeleton regulation, and ribosome. These results demonstrate novel information about the molecular mechanism by which ChM-I induce MSCs to differentiate into chondrocytes. These results also provide a solid foundation for the development of tissue-engineered cartilage.

Combined application of Chinese and western medicine is widespread in clinical real world because national policy emphasizes both Chinese medicine and western medicine. The studies on the combined use of Chinese and western medicine, are conducive to clinical precise positioning, promote self positioning of Chinese patent medicines and Chinese medicine enterprises based on suitable application fields, and provide direction for the deepening development of herbal industry. In addition, the studies on clinical evaluation and mechanism of combined use of Chinese and western medicine can provide basis for formulating national health policies and promoting medical resource fairness.

A 39-year-old farm worker was injured in her right eye by a piece of wire, which resulted in a corneal ulcer unresponsive to antibiotic treatment. The clinical appearance was that of a corneal infiltrate with feathery borders resembling fungal keratitis. Corneal scrapings were collected and the patient was started on natamycin 5% eye drops, fluconazole 0.3% eye drops, and oral fluconazole. A non-sporulating fungus was isolated from the samples. Based upon macroscopic and microscopic morphologic features, it was provisionally identified as a Papulaspora species due to the fact that members of this genus generally do not form diagnostically useful conidia. However, it was found through the use of ITS sequencing that the isolate clustered within the ascomycete genus Chaetomium. The sequence did not fully match with any sequences of available ex-type strains of Chaetomium, Thielavia and Papulaspora and hence might belong to an undescribed specie. However, without diagnostic morphological features the taxon cannot be introduced as a novel member of the genus Chaetomium. Antifungal susceptibility testing was performed according to published standards. The corneal ulcer was successfully treated with six weeks of antifungal therapy.

Conflicting data have been generated from previous studies to determine which kind of relationship exists between HIV-1 specific CD8 Tcell responses and HIV-1 viral load or CD4 count over the course of infection. In this study, 153 HIV-1 infected LTNPs were enrolled to investigate the role of HIV-1 specific CD8 T-cell responses in chronic HIV-1 infection among HIV-1 infected former blood donors.The patients were stratified into three groups according to CD4 count: CD4≥500 cells/μL; 350 cells/μL≤CD4500 cells/μL; CD4350 cells/μL. PBMCs were isolated from the patients' anticoagulated blood samples. IL-2 and IFN-γ secretions of CD 8 T cells against 17 HIV-1 consensus B full peptide pools were analyzed by using ICS assay.An overall inverse correlation were observed between CD4 count and plasma viral load. Although no significant difference was observed during the comparisons of frequency/breadth of HIV-1 specific CD8 T cell responses, CD4 count stratification analysis showed that different correlation pattern existed in three strata: as for patients whose CD4 counts were less than 350 cells/μL, no significant correlations were identified between frequency/breadth of HIV-1 specific CD8 T cell responses and CD4 count/viral load; as for patients whose CD4 counts ranged from 350 cells/μL to 500 cells/μL, significant correlation was only observed between the response breadth of IL-2+IFN-γ+ CD8 T cells and CD4 count; however, as for patients whose CD4 counts were more than 500 cells/μL, direct correlations were identified between IL-2+IFN-γ+/IL-2+/IFN-γ+ CD8 T cells and viral load or CD4 count.Universal consistent inverse correlation was only indentified between CD4 count and viral load. The relationship between HIV-1 specific CD8 T cell responses and CD4 count/viral load varied in different CD4 strata, which showed that better preserved CD4 T cells were correlated with better CD8 T cell functions.

The chloridizing segregation and magnetic separation of low-grade nickel laterites from Yunnan province of China was investigated. The nickel laterites were characterized by microscopic investigations, using X-ray diffractometry (XRD) and energy dispersive spectrometry (EDS) techniques. The pellets, which were prepared with magnesium chloride and coke as chloride agent and reductant respectively, were heated to a high temperature, and the pellets after cooling were crushed for magnetic separation. A series of experiments were conducted to examine the effect of chlorinating agent dosage, reductant dosage, chloridizing temperature and chloridizing time on enrichment grade of Ni and Co. The results indicate that the four factors have significant effects on the extractions of Ni and Co. The optimum conditions are as follows: the amounts of magnesium chloride and coke are 6% and 2%, respectively, chloridizing temperature is 1 253 K, and chloridizing time is 90 min. Under the conditions, extractions of Ni and Co reach 91.5% and 82.3%, respectively.

It is of vital significance to conduct active postmarketing surveillance of Chinese medicine, as an active response to laws, rules and guidelines issued by the China Food and Drug Administration. These will provide technological support in evaluating adverse drug reactions (ADRs) or adverse drug events (ADEs). The expert consensus for postmarketing surveillance focuses on two surveillance designs; one is a large sample registry study to explore general population ADR/ADE characteristics, the other is a nested case-control study to explore the characteristic and mechanisms of ADRs.

OBJECTIVE: To analyze the literature about clinical safety of Shenmai injection and know the adverse reaction characteristics of Shenmai injection. METHOD: Many kinds of information are analyzed. The basic information includes sex, age and disease of patients. The drug information includes dosage and solvent. The time of adverse reaction and symptom is also analyzed. RESULT: The patients' age between 41 and 50 is the most. The adverse reaction happens more on patients with the disease of tumor and out of specification. All the solvent and dosage can cause adverse reaction. Immediate anaphylactic reaction within 30 minutes is the main type and anaphylactic shock is the most. CONCLUSION: The occurrence of adverse reaction of Shenmai injection is closely related to production quality of drug, rational drug use in clinical and individual factors of patients. Conclusion is demanded for clinician to ensure the safe medication.

Eumycetoma is a traumatic fungal infection in tropical and subtropical areas that may lead to severe disability. Madurella mycetomatis is one of the prevalent etiologic agents in arid Northeastern Africa. The source of infection has not been clarified. Subcutaneous inoculation from plant thorns has been hypothesized, but attempts to detect the fungus in relevant material have remained unsuccessful. The present study aims to find clues to reveal the natural habitat of Madurella species using a phylogenetic approach, i.e. by comparison of neighboring taxa with known ecology. Four species of Madurella were included in a large data set of species of Chaetomium, Chaetomidium, Thielavia, and Papulaspora (n = 128) using sequences of the universal fungal barcode gene rDNA ITS and the partial LSU gene sequence. Our study demonstrates that Madurella species are nested within the Chaetomiaceae, a family of fungi that mainly inhabit animal dung, enriched soil, and indoor environments. We hypothesize that cattle dung, ubiquitously present in rural East Africa, plays a significant role in the ecology of Madurella. If cow dung is an essential factor in inoculation by Madurella, preventative measures may involve the use of appropriate footwear in addition to restructuring of villages to reduce the frequency of contact with etiologic agents of mycetoma. On the other hand, the Chaetomiaceae possess a hidden clinical potential which needs to be explored., Author Summary Eumycetoma caused by Madurella mycetomatis is a common subcutaneous, mutilating fungal infection endemic in arid climate zones. Still there are many controversies on the route of infection, but traumatic inoculation of the subcutaneous tissue with the thorn or soil causative organism through minor skin trauma is a popular theory. This is due to the fact that, the origin and natural habitat of Madurella species, the prevalent mycetoma agents are still unknown. In order to predict the natural habitat of M. mycetomatis we investigated its phylogenetic relationships to species with known ecology. Two genes phylogeny based on LSU and ITS was performed for the species of the genus Madurella and representative genera from the family of Chaetomiaceae. Our findings confirmed that Madurella species are phylogenetically member of the family Chaetomiaceae. Members of this family are often found in dung and manure-enriched soil. We therefore suggest that animal dung, abundantly present in endemic villages, could be a possible niche for Madurella and plays an essential role in the onset of eumycetoma. This will help in understanding the origin of the disease and could be a base for future in depth study to investigate the presence of Madurella in dung from endemic areas.

Objective: The expression of B-cell lymphoma 2 (Bcl-2) seems to be influenced by the endocrine environment. Numerous reports demonstrate the diverse expression of Bcl-2 family members under sex steroid regulation. With the exception of estrogen-related tumors, androgen-related tumors have shown their characteristics in Bcl-2 expression. In this study, the status of Bcl-2 expression in male hepatocellular carcinoma (HCC) patients was examined to verify the high incidence of HCC in males.Methods: Tumor tissue microarray was used to examine Bcl-2 expression levels in 374 HCC cases including 306 males and 68 females. Kaplan-Meier method, log-rank test, and Cox proportional hazards model were applied to investigate the predictive value of Bcl-2 in HCC patients.Results: Immunohistochemistry analysis showed that male patients with higher Bcl-2 levels had significantly longer median survival time and recurrence time than those with lower levels. However, no significant differences in outcomes were found between different Bcl-2 levels in female patients. When the male patients were stratified into several age points, the level of Bcl-2 expression showed poorer predictive efficiency in the 45–49 and 55–60 age groups in andropause-age patients compared with other age groups. Bcl-2 was an independent prognostic factor for both overall survival (P < 0.0001) and recurrence time (P = 0.0001) in male patients. After excluding male patients in the 45–60 age group, the predictive efficiency was enhanced (n = 147, OS, P = 0.0002, TTR, P < 0.0001).Conclusions: Bcl-2 expression is an independent predictor of survival and recurrence in male HCC. Bcl-2 levels may also be regulated by androgens or androgen receptors in male HCC patients. Bcl-2 levels change and exhibit poor predictive efficiency when androgen levels vary dramatically (andropause age).

Objective To analyze the literature about clinical efficacy of Shenmai injection for tumor treatment, and understand preliminarily the medicine law and effect of Shenmai injection. Method The included and excluded rules are built, and the literatures about cancer treatment by "Deng feng" Shenmai injection are classified by the rules. Many kinds of information are analyzed such as published years, research types, sample size, sex and age of test-takers, dosage and evaluated parameters. Result The 54 literatures are brought into analysis. The small scale research below 100 people is the main type and lung cancer is the most. The evaluated parameters in these literatures include KPS improvement rate, reduction of toxicity reaction, improvement of total efective rate, improvement of clinical symptoms, improvement of one year survial rate, NK activity, LAK activity, TH/TS value and so on. Conclusion The application of Shenmai injection for tumor treatment is increasingly extensive and some effect is got. But the quality of literature about clinical efficacy is not enough good and it cannot be adopted as evidence. It can support post-marketing reevaluation and improve the research combined with prospective experiment.

Objective To assess the efficacy and safety of Shenmai injection for acute myocardial infarction (AMI). Method All clinical studies of Shenmai for AMI were searched from Cochrane library, Medline, EMbase, CBM, CNKI, Wanfang and VIP. For efficacy analysis of Shenmai, randomized controlled trials (RCTs) and quasi-RCTs were included and the Cochrane Collaboration's RevMan 5.1 was used for data analysis. Result 1) Fifty studies were included for efficacy analysis, in which, only 1 study was true RCT, all of studies did not mention allocation concealment, blind and information of loss to follow-up. The fatality rate during hospitalization (OR 0.43, 95% CI [0.31-0.60]), incidence of heart failure (OR 0.49, 95% CI [0.34-0.70]), incidence of shock (OR 0.53, 95% CI[0.30-0.93]) and incidence of re-infarction (OR 0.16, 95% CI [0.03-0.77]) in Shenmai injection plus conventional treatment group was lower than that in the conventional treatment group, while the rate of recanalization (OR 1.24, 95% CI [0.90-1.71]) was similar between the two groups. 2) For safety analysis, we did not found serious adverse drug reaction/adverse events (ADR/AE) of Shenmai injection for AMI. Conclusion The currently available evidence showed that Shenmai injection plus conventional treatment group may decrease the fatality rate during hospitalization, the incidence of cardiac failure, shock and re-infarction. However, these findings should be carefully interpreted due to the low methodological quality and small sample size of trials. Although serious ADR/AE was did not report of Shenmai injection, the post-marketing safety evaluation is need to be performed.

The establishment of clinical safety monitoring net of traditional Chinese medicine (TCM) injection is the one of the key issues of the monitoring work. The monitoring net is including varieties of types of net, such as clinical monitoring net, multimedia network platform, the net of experts or talents. The paper will introduce the establishing method of clinical safety monitoring net, the establishing of clinical safety monitoring net, and the establishing of network based on the internet, the knowledge network construction of experts, the net construction of talents are all included, to assure the development for clinical safety monitoring work.

OBJECTIVE To research the actual clinical applications of Shenmai injection based on the real world-HIS (hospital information system). METHOD The data of patients injected with Shenmai is analyzed. This information is collected from HIS in twenty hospitals of grade III-A. Many indexes are included such as age, sex, occupation, admission condition, hospitalization days, critical days, diagnosis of traditional and western medicine, dosage of drug, route of administration, drug combination and so on. RESULT The age of patients between 46 and 65 is the most. The hospitalization day between 15 and 28 is the most. The Shenmai injection is more used for such diseases as coronary heart disease, hypertension, arrhythmia, cardiac insufficiency. About 97.55% of route of administration in medical order are consistent with specification. The main combination drugs of Shenmai injection are analyzed for adjuvant therapy of tumor, shock and coronary heart disease. CONCLUSION The Shenmai injection, as a traditional Chinese medicine injection, has the advantages of extensive indication and is used widely in clinical. The researching result based on HIS is objective and real. It can be referenced by researchers and clinician.

The purpose of this study was to assess the value of isocentric C-arm three-dimensional (Iso-C 3D) fluoroscopy for the insertion of an anterior odontoid screw. The results of the Iso-C 3D group were compared with that of an historic control group using conventional fluoroscopy.Twenty-nine patients diagnosed with type II or rostral-type III odontoid fractures were treated with a single anterior screw fixation in this study. The Iso-C 3D group included 13 patients and the other 16 patients were in the historic control group. All operations were performed by a single surgeon using standard procedure and manner. The clinical and radiographic results were recorded and compared between the two groups.The fluoroscopy time in the Iso-C 3D group was 42.9 s as compared to 68.1 s in the control group (P 0.01). The mean operative time was 91.5 min in the Iso-C 3D group when compared with 81.6 min in the control group (P = 0.20). The rate of bony fusion was 96.6% (28/29), the failure rate of reduction or fixation was 13.8% (7.7% in Iso-C 3D group; 18.8% in control group). The Smiley-Webster scale showed that 90% of patients achieved good or better outcomesIn conclusion, this technique can be safely extended to the treatment of technically difficult to treat spinal injuries and at the same time reduce total radiation exposure time both for the patient and the surgeon.

OBJECTIVE To observe the inhibitory effect of extract from Actinidia argutaor on in vivo and in vitro carcinomata, and explore its mechanism. METHOD The in vivo S180 and H22 model were used to observe the effect of A. argutaor on inhibitory rate of carcinomata, organ relative weight of spleen and thymus gland and the release of tumor necrosis factor. A549 cells were exposed to extract from A. argutaor with different concentrations for 24, 48, 72 hours. MTT assay was used to evaluate the inhibiting effects of extract from A. argutaor on the proliferation of the cells. Flow cytometry was applied to detect cell cycle. RESULT The inhibitory effects of the extracts on in vivo and in vitro carcinomata were observed, the inhibitory rate for S180 and H22 line was 33.32% and 34.62% respectively. The extracts could inhibit the proliferation of A549 cells during G0-G1 period and significantly decrease the cell ratio of S stage. CONCLUSION The extracts from A. argutaor showed a good antineoplastic activity.

Arsenic trioxide has been used as a therapeutic agent for acute promyelocytic leukemia and recently for some solid tumors. Although arsenic trioxide has been shown to significantly inhibit the growth of solid tumor cells in vitro, clinical trials indicate that arsenic trioxide alone is pool active against non-hematologic malignant diseases. To understand the mechanisms of arsenic resistance in solid tumor cells, we established two arsenic-resistant solid tumor cell lines, HepG2/AS and SGC7901/AS, isolated from human liver cancer cell line HepG2 and human gastric cancer cell line SGC7901, respectively, by a series of stepwise selections via treatment with increasing concentrations of arsenic trioxide. Three ABC transporter proteins, ABCB1, ABCC1 and ABCC2, were expressed increasingly and differently in two arsenic-resistant cell lines. Further, tumor suppressor p53 was overexpressed in two arsenic-resistant cell lines, but the levels of p53 mediators MDM2 and gankyrin, which regulate the ubiquitination of p53, increased simultaneously. In addition, an increase in the phosphorylation of Rb at Ser795 in the two cell lines might also result from the presence of MDM2 and gankyrin, which suggest that the inactivation of p53 and Rb contribute to drug resistance. These two arsenic-resistant solid tumor cell lines, HepG2/AS and SGC7901/AS, may be useful for studying the mechanism of arsenic resistance in solid tumors and may provide a way to overcome it.

Pseudomyxoma peritonei (PMP) is a rare disease. It refers to a progressive disease process within the peritoneum which originates from the appendix or ovaries and is characterised by the production of copious amounts of mucinous fluid resulting in a "jelly belly". If untreated the condition is fatal. The traditional approach to PMP is based on repeated surgical debulking procedures, often associated with intraperitoneal or systemic chemotherapy. The natural history of this disease has been drastically modified since the introduction of a new surgical approach defined as a peritonectomy procedure. This paper is to review the literature on this treatment strategy.

Objective To systematically research the postmarketing safety of Dengfeng® shenmai injection, identify potential risk factors, and ensure its clinical safety. Methods We investigated a comprehensive series of studies on the production process, quality standards, pharmacology, postmarketing clinical studies, and safety evaluation of Shenmai injection, including literature analysis of adverse drug reaction (ADR) case analysis and systematic review. Data from the hospital information system (HIS) and spontaneous reporting system (SRS) were also analyzed. Results The approximate dosage leading to death in dogs is 45.0-67.5 g raw drug/kg and the toxic reactions are restlessness, skin irritation, salivation, and vomiting. The results of chronic toxicity tests in mice and dogs, and the other tests such as 6-month toxicity, drug safety, genetic toxicity, and reproductive toxicity of rats and dogs, were positive or qualified. Patient ADR history and ADR family history were closely associated with itching based on the data analysis from SRS. There was no damage to renal function from Shenmai injection use at a dosage and a treatment course outside the recommended dosage and treatment course as specified based on data analysis from HIS. The most common ADR from Shenmai injection are difficulty breathing, facial flushing, nausea, vomiting, chest tightness, skin itching, rash, and back pain. Conclusion This study includes complete information on Shenmai injection ADR incidence rate. We found that Shenmai injection is safe and this study can provide clinical, research, and production institutions with an objective, reliable, and scientific basis for use of Shenmai injection.