Search

Background Hepatocellular carcinoma (HCC) is characterized by high morbidity and mortality. Early diagnosis and timely intervention in the precancerous stage can effectively reduce the incidence of HCC, which is of great significance for its prevention and treatment. Modern medical treatment of precancerous lesions of HCC has problems such as difficulties to grasp the timing of intervention and single treatment method, traditional Chinese medicine (TCM) may be a simple and effective new approach to prevent and treat precancerous lesion of HCC. Objective To observe the clinical efficacy and safety of Qizhuhuaji formula in the treatment of precancerous lesion of HCC (liver-depression and spleen-deficiency, phlegm and blood stasis syndrome) . Methods Patients with precancerous lesion of HCC who met the TCM syndrome type "liver-depression and spleen-deficiency, phlegm and blood stasis syndrome" admitted in the hepatology clinic of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Weihai Hospital of Traditional Chinese Medicine and Taian Hospital of Traditional Chinese Medicine from October 2019 to March 2020 were included as the study subjects. General information (gender, age, history of HBV-related cirrhosis, family history of HCC, history of alcohol consumption for more than 10 years), the TCM syndrome score, liver function indicators [alanine transaminase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB), glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) ], tumor marker indexes [alpha-fetoprotein (AFP), alpha-fetoprotein variants-L3 (AFP-L3), des-γ-carboxy-prothrombin (DCP) ], imaging indexes (lesion type, lesion nature, lesion length diameter), safety indexes and adverse reactions were collected. The 64 patients who met the inclusion criteria and completed the study were divided into the observation group (n=34) and the control group (n=30) using the random number tables. The patients in the control group were treated with conventional therapy such as antiviral, anti-inflammatory and liver-protective therapy; the observation group was treated with conventional therapy combined with Qizhuhuaji formula. The treatment course was 48 weeks, and the follow-up period was 48 weeks after drug withdrawal. The incidence of HCC and complications in the treatment cycle and follow-up period of the two group were observed, and the differences in the improvement indexes of TCM syndrome (TCM syndrome scores, total effective rate), liver function indicators, tumor marker indexes, imaging indexes (lesion length diameter, lesion stability rate, lesion improvement rate), and safety index (safety rate) between the two groups before and after treatment. Results After treatment, the TCM syndrome scores, ALT, AST, TBIL, GGT, ALP, and AFP-L3 were lower than those before treatment in both groups, and the ALB level was higher than that before treatment (P0.05) in the rates of lesion improvement (35.3%) and lesion stability (50.0%) in the observation group compared with the control group (20.0%, 43.3%). There was no statistically significant difference in the incidence of HCC between the observation group (8.8%) and the control group (16.7%) at the end of the follow-up period (P>0.05) ; the incidence of complications (8.8%) in the observation group was lower than that of the control group (30.0%) (P0.05) in the safety rate between the observation group (94.1%) and the control group (90.0%) . Conclusion The treatment of precancerous lesions of HCC (liver depression and spleen deficiency, phlegm and blood stasis syndrome) with Qizhuhuaji formula has better clinical efficacy and higher safety in improving TCM syndrome, improving liver function, shrinking lesion nodules, reducing the incidence of long-term HCC and complications of liver cirrhosis.

Background As the main providers of essential pediatric services, the capabilities of community general practitioners (GPs) in managing pediatric patients may directly reflects the overall status of pediatric care services in primary care settings. In China, there are great regional differences in the supply and demand of pediatric services, and the capabilities of primary care settings are unsatisfactory in providing pediatric services. The current encounters and influencing factors of GPs with pediatric patients in suburban districts are worthy of attention. Objective To understand the status and associated factors of clinical encounters of GPs with pediatric patients in a suburban district of Beijing, providing a reference for the development of tiered diagnosis and treatment of pediatric diseases. Methods In June 2021, purposive sampling was used to recruit GPs who participated in a training named "Beijing Miyun District Medical Consortium Construction & General Practitioners' Comprehensive Capability Improvement Project" to attend a semi-structured group interview for understanding the status of clinical encounters of GPs with pediatric patients and related influencing factors. The interview results were recorded, and transcribed, then coded using NVivo 12, and analyzed using thematic analysis. Results Nineteen GPs (5 men and 14 women) in the age range of 24-51 years〔average age of (33.2±7.6) years〕, attended the interview, 18 of whom had a bachelor degree; 9 had a title of attending physician; 1 had participated in the standardized general practice residency program; 8 had participated in the "3+2" assistant general practitioners training program; 8 had participated in the standardized training before making a career change into general practice. The average years of them working a GP was 1-18 years〔 (6.3±4.8) years on average〕. Four themes emerged from the analysis: (1) Both the numbers of pediatric patients and illnesses encountered by suburban GPs were less than those encountered by their urban counterparts, and pediatric patients encountered by suburban GPs aged greater than or equal to 3 years. (2) Suburban GPs generally had a low level of self-confidence in treating pediatric patients. (3) The major factors negatively affected suburban GPs encountering pediatric patients include the pediatric patient's parents with a lower level of trust in their GP, inadequate capabilities of GPs in managing pediatric patients, high risk of managing pediatric patients, underperformance of nurses, inadequate available pediatric medicines and equipments for laboratory tests in the community, and lack of a clear referral system. (4) The major facilitators for suburban GPs to encounter pediatric patients include managing pediatric patients in the community by pediatricians, and increasing pediatric medicines and equipments for laboratory tests. Conclusion The encounters of suburban GPs with pediatric patients in primary care were unsatisfactory due to many problems and challenges. To improve the situation, it is suggested to improve the capabilities of suburban GPs in managing pediatric patients by trainings, the collaboration between GPs and pediatricians, and the tiered system for the diagnosis and treatment of pediatric diseases.

Increasing evidence indicated that protein arginine methyltransferase‐1 (PRMT1) is an oncogene in multiple malignant tumors, including osteosarcoma (OS). The aim of this study was to investigate the underlying mechanism of PRMT1 in OS. The effects of PRMT1 or BCAT1, branched‐chain amino acid transaminase 1 (BCAT1) on OS cell proliferation, invasion, autophagy, and apoptosis in vitro were examined. Moreover, molecular control of PRMT1 on c‐Myc or transactivation of BCAT1 on c‐Myc was assessed by chromatin immunoprecipitation and quantitative reverse transcription PCR assays. The effects of PRMT1 in vivo were examined with a xenograft tumor model. The results showed that PRMT1 was potently upregulated in OS tissues and cells. Upregulation of PRMT1 markedly increased OS cell proliferation and invasion in vitro and reduced cell apoptosis, whereas PRMT1 silencing showed the opposite effects. Cisplatin, one of the most effective chemotherapeutic drugs, improved cell survival rate by inducing the expression of PRMT1 to downregulate the cisplatin sensitivity. Meanwhile, the cisplatin‐induced upregulation of PRMT1 expression caused dramatically autophagy induction and autophagy‐mediated apoptosis by inactivating the mTOR signaling pathway, which could be reversed by 3‐methyladenine, an autophagy inhibitor, or PRMT1 silencing. PRMT1 could activate c‐Myc transcription and increase c‐Myc‐mediated expression of BCAT1. Furthermore, BCAT1 overexpression counteracted the effects of PRMT1 knockdown on cell proliferation, invasion, and apoptosis. Of note, deficiency of PRMT1 suppressed tumor growth in vivo. PRMT1 facilitated the proliferation and invasion of OS cells, inhibited cell apoptosis, and decreased chemotherapy sensitivity through c‐Myc/BCAT1 axis, which may become potential target in treating OS. [ABSTRACT FROM AUTHOR]

The removal of chlorine from high chlorine wastewater using cuprous oxide was studied. The effects of cuprous oxide dosage, reaction temperature and reaction rime on the chlorine removal rate were investigated. The test conditions were optimized by response surface method. The results show that under the conditions of cuprous oxide dosage of n(Cu)/n(Cl) = 1.3, reaction temperature of 70 C and reaction rime of 2. 0 h,the chlorine removal rate is 95. 37%. After optimization by response surface method, under the conditions of cuprous oxide dosage of n(Cu)/n(Cl) = 1. 35, reaction rime of 2.26 h and reaction temperature of 79.8 °C, the chlorine removal rate Is 97. 61 %, which is 0. 08% lower than the prediction results. This indicates that the prediction results of the second-order model of chlorine removal rate are reliable and effective, and the optimal technological conditions of cuprous oxide treatment of high choline wastewater by response surface method are reasonable and feasible. [ABSTRACT FROM AUTHOR]