摘要：
Objective To investigate the mechanism of Xinkang Granule(心康冲剂)regulating long non-coding RNA growth arrest specific transcript 5(LncGAS5)/DNA methyltransferase 3A(DNMT3A)pathway against myocardial fibrosis in rats with chronic heart failure.Methods Among 62 SD rats,6 rats were randomly selected as the normal group,and the remaining 56 rats were intraperitoneally injected with adriamycin to establish the chronic heart failure model.The 52 rats successfully modeled were randomly divided into the model group(12 rats,injected with PBS+normal saline by gavage),GAS5 silence group(10 rats,injec-ted with AAV9-GAS5-RNAi+normal saline by gavage),negative control group(10 rats,injected with AAV NC+normal sa-line by gavage),Xinkang Granule group(10 rats,injected with AAV9-GAS5-RNAi+Xinkang Granule solution by gavage)and Valsartan group(10 rats,injected with AAV9-GAS5-RNAi+Valsartan solution by gavage).After treatment,the cardiac func-tion of each group was detected by cardiac ultrasound.Masson staining was used to observe the morphology of heart tissue.The expression of left ventricular fibrosis protein α-SMA in each group was detected by immunofluorescence staining.Serum Col Ⅰexpression was detected by enzyme-linked immunosorbent assay.lncGAS5 and DNMT3A mRNA were detected by Real-time PCR.The protein expression levels of DNMT3A,phosphatase and tensin homolog deleted on chromosome ten(PTEN)and phos-phorylated protein kinase B(AKT)were detected by Western blot.Results Compared with those of the blank group,the values of left ventricular ejection fractions(LVEF)and left ventricular fractional shortening(LVFS)in the model group were significantly decreased(P＜0.05).The staining results showed serious myocardial fibrosis.Col Ⅰ levels in blood were increased significantly(P＜0.05).lncGAS5 mRNA expression was decreased,DNMT3A mRNA and protein expression was increased,PTEN protein expression was decreased and AKT protein expression was increased(P＜0.05).Compared with the of the model group,the stai-ning or index results of GAS5 silencing group were further decreased or increased.Compared with that of the GAS5 silencing group,the staining results showed that myocardial fibrosis was alleviated after intervention of Xinkang Granule and valsartan,and the values of LVEF and LVFS were increased to varying degrees(P＜0.05).Col Ⅰ levels in serum were decreased.lnc-GAS5mRNA expression increased and DNMT3A mRNA expression decreased.The protein expressions of DNMT3A and AKT were decreased,while the protein expressions of PTEN were increased(P＜0.05).Conclusion Xinkang Granule can improve the cardiac function of rats with chronic heart failure by regulating LncGAS5/DNMT3A/PTEN/AKT pathway and downstream fibrosis factors,thereby improving myocardial fibrosis in rats with chronic heart failure.
作者机构：
[Ma, YM; Ma, Yanmei; Zhang, Yan] Changzhi Med Coll, Heji Hosp, Dept Hematol, Changzhi 046000, Shanxi, Peoples R China.;[Li, Jie] Hunan Univ Chinese Med, Liuyang Hosp Tradit Chinese Med, Dept Oncol & Hematol, Changsha 410300, Hunan, Peoples R China.;[Li, Xi] Changzhi Med Coll, Heping Hosp, Dept Nephrol, Changzhi 046000, Shanxi, Peoples R China.;[Wei, Mingxia; Wei, MX; Xie, Yuqin; Zhang, Guoxiang; Geng, Qianshuang] Changzhi Med Coll, Heping Hosp, Dept Hematol, Changzhi 046000, Shanxi, Peoples R China.
通讯机构：
[Wei, MX ; Ma, YM ] C;Changzhi Med Coll, Heji Hosp, Dept Hematol, Changzhi 046000, Shanxi, Peoples R China.;Changzhi Med Coll, Heping Hosp, Dept Hematol, Changzhi 046000, Shanxi, Peoples R China.
摘要：
Immunosuppressive therapy (IST) is the first choice for severe aplastic anemia (SAA) patients with hematopoietic stem cell transplantation (HSCT) limitation, and the main factor limiting its efficacy is too few residual hematopoietic stem/progenitor cells (HSPC). Eltrombopag (EPAG), as a small molecule thrombopoietin receptor agonist, can stimulate the proliferation of residual HSPC and restore the bone marrow hematopoietic function of patients. In recent years, many studies have observed the efficacy and safety of IST combined with EPAG in the treatment of SAA, but the results are still controversial. The aim of this study is to systematically evaluate the efficacy and safety of IST combined with or without EPGA in the treatment of SAA. We conducted a systematic review of all relevant literature published up to January 19, 2024. Pooled odds ratio (OR) was calculated to compare the rates, along with 95% confidence intervals (CI) and p value to assess whether the results were statistically significant by Review Manager 5.4.1. The p values for the interactions between each subgroup were calculated by Stata 15.1. The Newcastle-Ottawa Scale and the Cochrane bias risk assessment tools were respectively used to evaluate the quality of the literature with cohort studies and randomized controlled trials. The Review Manager 5.4.1 and Stata 15.1 were used to assess bias risk and perform the meta-analysis. A total of 16 studies involving 2148 patients were included. The IST combined with the EPAG group had higher overall response rate (ORR) than the IST group at 3 months (pooled OR = 2.10, 95% CI 1.58–2.79, p < 0.00001) and 6 months (pooled OR = 2.13, 95% CI 1.60–2.83, p < 0.00001), but the difference between the two groups became statistically insignificant at 12 months (pooled OR = 1.13, 95% CI 0.75–1.72, p = 0.55). The results of complete response rate (CRR) (pooled OR at 3 months = 2.73, 95% CI 1.83–4.09, p < 0.00001, 6 months = 2.76, 95% CI 2.08–3.67, p < 0.00001 and 12 months = 1.38, 95% CI 0.85–2.23, p = 0.19) were similar to ORR. Compared with the IST group, the IST combined with the EPAG group had better overall survival rate (OSR) (pooled OR = 1.70, 95% CI 1.15–2.51, p = 0.008), but there were no statistically significant differences in event-free survival rate (EFSR) (pooled OR = 1.40, 95% CI 0.93–2.13, p = 0.11), clonal evolution rate (pooled OR = 0.68, 95% CI 0.46–1.00, p = 0.05) and other adverse events between the two groups. The results of subgroup analysis showed that different ages were a source of heterogeneity, but different study types and different follow-up times were not. Moreover, all p-values for the interactions were greater than 0.05, suggesting that the treatment effect was not influenced by subgroup characteristics. EPAG added to IST enables patients to achieve earlier and faster hematologic responses with a higher rate of complete response. Although it had no effect on overall EFSR, it improved OSR and did not increase the incidence of clonal evolution and other adverse events. This paper aims to perform a meta-analysis analyzing the efficacy and safety of eltrombopag for severe aplastic anemia. Our study suggests that EPAG added to IST is beneficial for patients with SAA.
摘要：
AIMS: This work aims to analyse the current state of the professional identity of Chinese nurses; examine the relationship amongst regulatory focus, organizational silence and professional identity and determine how regulatory focus affects the relationship between professional identity and organizational silence. DESIGN: This study conducted a cross-sectional survey. METHODS: From June to August 2023, 420 nurses from six hospitals in Hunan Province, China, were selected through convenience sampling and surveyed by using a general information questionnaire, the regulatory focus scale, the organizational silence scale and the professional identity scale. The relationship amongst the regulatory focus, organizational silence and professional identity of nurses was examined by utilizing SPSS 25.0 and the mediating role of regulatory focus between organizational silence and nurses' professional identity was examined by applying AMOS 24.0. RESULTS: Nurses had a moderate level of professional identity. Professional identity was positively correlated with regulatory focus and negatively correlated with organizational silence. Regulatory focus was negatively correlated with organizational silence. Mediation effect studies revealed that organizational silence and professional identity were partially mediated by regulatory focus. CONCLUSION: In accordance with research showing that nurses' organizational silence can indirectly affect professional identity via regulatory focus, clinical nursing managers should concentrate on the interaction amongst these three variables to strengthen professional identity. IMPACT: The results of this study serve as a reminder to nurses to select a preventive or promotive focus based on their career objectives and to effectively express their views to enhance their professional identity. This also reminds nursing managers assess nurse-led regulatory focus, identify their underlying qualities and understand their professional aspirations and career orientation, create a good atmosphere for advice and encourage nurses to express their views, so as to improve nurses 'professional identity. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
期刊：
Frontiers in Pharmacology,2024年15:1370444 ISSN：1663-9812
作者机构：
Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, China;Hunan Academy of Traditional Chinese Medicine Affiliated Hospital, China;Department of Spine Surgery and Orthopaedics, China
关键词：
DSTB;NDSTB;HLA;DEPs;MMP9;PLCL1
摘要：
Introduction: The escalating global surge in Rifampicin-resistant strains poses a formidable challenge to the worldwide campaign against tuberculosis (TB), particularly in developing countries. The frequent reports of suboptimal treatment outcomes, complications, and the absence of definitive treatment guidelines for Rifampicin-resistant spinal TB (DSTB) contribute significantly to the obstacles in its effective management. Consequently, there is an urgent need for innovative and efficacious drugs to address Rifampicin-resistant spinal tuberculosis, minimizing the duration of therapy sessions. This study aims to investigate potential targets for DSTB through comprehensive proteomic and pharmaco-transcriptomic analyses.
作者：
Shah, Muhammad Raza;Fatima, Samreen;Khan, Sehrosh Naz;Azam, Zahid;Shaikh, Hafeezullah;...
期刊：
Frontiers in Pharmacology,2024年15:1293272 ISSN：1663-9812
通讯作者：
Shah, MR
作者机构：
[Shah, MR; Fatima, Samreen; Shah, Muhammad Raza; Khan, Sehrosh Naz] Univ Karachi, Ctr Bioequivalence Studies & Clin Res, Dr Panjwani Ctr Mol Med & Drug Res, Int Ctr Chem & Biol Sci, Karachi, Pakistan.;[Shaikh, Hafeezullah; Azam, Zahid] Dow Univ Hlth Sci, Natl Inst Liver & GI Dis NILGID, Karachi, Sindh, Pakistan.;[Majid, Shahid] Indus Hosp Karachi, Karachi, Sindh, Pakistan.;[Zhou, Daijun; He, Chengdong] Hunan Xinhui Pharmaceut Co Ltd, Changsha, Hunan, Peoples R China.;[Wang, Wei] Hunan Univ Chinese Med, Sch Pharm, TCM & Ethnomed Innovat & Dev Int Lab, Changsha, Peoples R China.
通讯机构：
[Shah, MR ] U;Univ Karachi, Ctr Bioequivalence Studies & Clin Res, Dr Panjwani Ctr Mol Med & Drug Res, Int Ctr Chem & Biol Sci, Karachi, Pakistan.
关键词：
Houtou Jianweiling tablet (HTJWT);clinical trial;omeperazole;randomization;traditional Chinese medicine (TCM)
摘要：
Background: Common symptoms of Chronic Non-atrophic Gastritis (CNAG) include nausea, stomach distension, and abdominal pain. The Houtou Jianweiling Tablet (HTJWT) is a chinese patent medicine (CN1368229A) and it has been used clinically for more than 20years with proven clinical efficacy in treating CNAG, prompted us to establish the clinical efficacy and safety of HTJWT on patients with mild to moderate CNAG symptoms in Pakistani population. Methods: This phase II, double-blind, randomized, parallel-controlled trial was conducted in a single center between November 2022 and February 2023 in Pakistan. In a ratio of 1:1, total 240 CNAG patients with erosion identified by pathological biopsy and gastroscopy were randomly assigned to control (Omeprazole) group (n = 120) and the treatment (HTJWT) group (n = 120). Patients in the treatment group received orally four HTJWT (0.38g/tablet), three times a day and one placebo of Omeprazole enteric-coated tablet prior to breakfast, daily. On the other hand, patients in the control group received one Omeprazole enteric-coated tablet (20 mg/tablet) prior to breakfast and four placebo of HTJWT, thrice a day. The patients consumed the investigated drugs (i.e., treatment and control) treatment regimen was followed for a duration of 28days. The safety of the patients were evaluated through adverse events, serious adverse events and laboratory tests such as blood biochemistry, urine analysis, liver and renal function tests. Vital signs like; blood pressure, pulse rate, body temperature, respiratory rate for all the patients were recorded. The cardiac status of the patients were assessed through electrocardiogram (ECG). The primary efficacy indicators were the improvement rate of gastric distention and gastralgia as the main clinical symptoms. Secondary indicators were visual analogue score (VAS); improvement rate of secondary clinical symptoms and signs; improvement rate of total clinical signs and symptoms; the disappearance/remission rate of Gastric pain and, remission/disappearance time of gastric distension; and the negative conversion rate of Helicobacter pylori (H. pylori). The outcomes among each group were compared using the chi-square test. Results: Patients in both groups had good drug compliance (80%-120%), and there was no statistically significant difference in the patients' baseline characteristics. The clinical improvement rate was found to be 91.1% in the treatment group and 91.0% in the control group with negligible variation among the two groups (p = 0.9824; 95% confidence interval: -0.0781-0.0798). Similarly, hardly no difference was found in the negative conversion rate of H. pylori between the treatment group and the control group (i.e., 70.1% and 71.8% respectively, p = 0.8125). There were no significant differences in respiratory rate, vital signs, blood pressure, laboratory results for blood biochemistry, urine analysis, liver and renal function tests between the two groups. The ECG assessment carried out for the treatment and control group revealed no considerable difference. Margin variation in the disappearance time of gastric pain (p = 0.1860) and remission rate (p = 0.5784) between the two groups were observed. The control group exhibited a faster remission period for gastrointestinal discomfort indications as compared to treatment group (p = 0.0430). Only one patient in the control group experienced mild to moderate adverse events, namely,; epigastric pain and dyspepsia. The results were consistent with the intention-to-treat and per-protocol analysis that included patients who were 100% compliant to the assigned therapy. Conclusion: The lower limit of confidence interval (CI, 95%) for the differences in the effective rate between the treatment and the control groups was found to be -0.0781 which is greater than -0.15, hence the treatment group is non-inferior to the control group. The therapeutic dosage used in the trial and treatment period did not cause any significant adverse event, and there were no obvious changes in the ECG profile, vital signs and biochemistry of the patients. Based on the clinical efficacy evaluation and reported adverse events, it can be concluded that the HTJWT is a safe and effective traditional chinese medicine for the treatment of patients suffering from chronic non-atrophic gastritis with mild to moderate symptoms. Clinical Trial Registration: [www.clinicaltrials.gov], identifier [NCT04672018].
摘要：
目的:对中医护理门诊研究现状进行可视化分析，为中医护理门诊的后续研究提供参考。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库与Web of Science核心合集数据库自2012年1月1日—2023年5月27日发表的相关文献。提取文献信息，并对机构、关键词进行预处理，采用CiteSpace 6.2.R2与VOSviewer 1.6.19软件进行可视化分析。结果:纳入中文期刊文献363篇、英文期刊文献149篇，分别形成了以刘杨晨、Schaefert Rainer等为核心的多个合作团体，以及以浙江省中医院、China Medical University （台湾）等科研院校为核心的研究机构。该领域研究热点分为两类，一类是对于中医护理门诊防治疾病的研究，另一类是对于中医护理门诊建设与发展的研究。结论:中医护理门诊研究热度整体呈升温趋势，中医护理门诊的建设为近年来研究热点，护理服务质量、中医护理专科人才培养为今后研究的新热点。
