Uncovering the Potential Mechanism of Xue Fu Zhu Yu Decoction in the Treatment of Intracerebral Hemorrhage

Background Chinese herbal medicine (CHM) is characterized by “multi- compounds, multi-targets and multi-pathway”, which has advanced benefits for the preventing and treating complex diseases, but still exists unsolved issues, mainly include unclear material basis and underling mechanism of prescription. Integrated pharmacology is a hot cross research area based on system biology, mathematic and poly-pharmacology. It can systematically and comprehensively investigate the therapeutic reaction of compounds or drugs on pathogenic genes network, and is especially suitable for the study of complex CHM systems. Intracerebral Hemorrhage (ICH) is one of the main causes of death among Chinese residents, which is characterized by high mortality and high disability rate. In recent years, the treatment of ICH by CHM has been deeply researched. Xue Fu Zhu Yu Decoction (XFZYD), one of the commonly used prescriptions in treating ICH at clinic level, has not been clear about its mechanism in treating ICH. Methods Here, we established a strategy, which based on compounds-targets, pathogenetic genes, network analysis and node importance calculation. Using this strategy, the core compounds group (CCG) of XFZYD was predicted and validated by in vitro experiments. The molecular mechanism of XFZYD in treating ICH was deduced based on CCG and their targets. Results The results show that the CCG with 43 compounds predicted by this model is highly consistent with the corresponding Compound-Target (C-T) network in terms of gene coverage, enriched pathway coverage and accumulated contribution of key nodes at 89.49%, 88.72% and 90.11%, respectively, which confirmed the reliability and accuracy of the effective compound group optimization and mechanism speculation strategy proposed by us. Conclusions Our strategy of optimizing the effective compound groups and inferring the mechanism provides a strategic reference for explaining the optimization and inferring the molecular mechanism of prescriptions in treating complex diseases of CHM.

Pengaruh Proprioceptive Neuromuscular Facilitation terhadap Kekuatan Fungsi Prehension Cylindrical Grip pada Pasien Stroke Non-Hemoragik

Stroke is a disease that is most commonly found today, stroke has a high mortality and disability rate. Stroke can cause physical disability in productive age and old age. This study aims to determine the effect of Proprioceptive Neuromuscular Facilitation (PNF) on the strength of the prehension Cylindrical grip function in non-hemorrhagic stroke patients. This research is a quantitative study with a quasi-experimental design, one group pretest and posttest, the samples were taken by purposive sampling, namely non-hemorrhagic stroke patients who visited the physiotherapy poly at Grandmed Lubuk Pakam Hospital. The results showed a p-value of 0.001 which means that there is an effect of PNF on the strength of the prehension Cylindrical grip function in non-hemorrhagic stroke patients.

Future Trends in Disability and Its Determinants Among Chinese Community Patients With Anxiety Disorders: Evidence From a 5-Year Follow-Up Study

Background: Anxiety disorders (ADs) are a group of disorders with a high disability rate and bring a huge social burden. In China, information on future trends in the disability among community ADs patients and its determinants are rare. The objectives of this study are to describe the future trends in the disability among ADs patients living in community and to investigate the determinants of the disability.Methods: Participants diagnosed with 12-month ADs in the China Mental Health Survey (CMHS) were followed up by telephone from April to June 2018 to assess the future trends in the disability in a 5-year interval using the World Health Organization's Disability Assessment Schedule 2.0. The disability rate was reported and its determinants were analyzed by complex sample design multivariate logistic regression.Results: Totally 271 patients were interviewed by telephone and 33 informants finished proxy interviews. The disability rates were 45.9% and 14.3% among ADs patients at baseline and during the follow-up. Patients with general anxiety disorder (GAD) or agoraphobia with/without panic disorder (AGP) had the lower decrease and higher disability during the follow-up than patients with other subtypes. Patients aged in middle age (aged 40–49 years old, OR = 11.12, 95% CI: 4.16–29.72), having disability at baseline (OR = 7.18, 95% CI: 1.37–37.73), having comorbidity with three or more physical diseases (OR = 9.27, 95% CI: 2.48–34.71), and having comorbidity with other mental disorders (OR = 3.97, 95% CI: 1.13–13.96) had higher disability during the follow-up.Conclusions: The disability rate tends to decrease among ADs patients living in communities. Treatment priority should be given for ADs patients with disability and those in middle age. Treatments for the comorbidity of other mental disorders or physical diseases should be considered when treating anxiety.

RADT-28. RECURRENT MENINGIOMA WITH 1p/22q SOMATIC MUTATION OF GNAS: A CASE REPORT

OBJECTIVE Refractory meningioma faces the problems of low total resection rate, high recurrence rate and high disability rate. Here we report a patient with recurrent refractory meningioma who was benefited from precision treatment plan based on molecular diagnosis. METHODS Molecular diagnosis by next generation sequencing (NGS) test was used to test the hybridized captured DNA in the tumor tissue of the patient. RESULTS The 53-year-old female diagnosed with meningioma was admitted to our hospital after tumor progression was observed for 3 weeks. She had received 4 operations for the tumor previously. The first three times of postoperative pathology indicated WHO Ⅰ grade meningioma. The fourth postoperative pathology showed excessive meningioma, with active growth of tumor cells in some areas and small focal necrosis, WHO Ⅰ- fair grade. Somatic mutation GNAS p.F309VFS *25 and deletion of the short arm of chromosome 1 / long arm of chromosome 22 were also found (1P / 22Q) by NGS test. The second recurrent foci showed partial amplification of 17q and 19, except for 1p/22q deletions, compared with the first. Meningiomas with 1p/22q deletion are type C meningiomas (more than half are grade WHO Ⅰ). Meningiomas have been shown to be highly vascularized neoplasms, with a 2-fold increase in VEGF expression in atypical meningiomas and a 10-fold increase in malignant meningiomas. According to the molecular diagnosis results, the precise treatment plan was determined: concurrent chemoradiotherapy, followed by anti-VEGF-targeted drugs combined with temozolomide for 2 months. The residual lesions were significantly reduced after treatment. CONCLUSION This case is the first to report a meningioma with pituitary tumor driver gene GNAS mutation, which is more prone to recurrence due to the combination of 1P / 22Q chromosome mutation. Molecular diagnosis can guide precise treatment to benefit patients.

217Using excess heat factor to measure effect of heatwave severity on foodborne disease incidence

Background This study aims to analyse the distribution characteristics of ideal cardiovascular health (ICH) metrics status of the oldest-old and centenarians, and also to explore the relationships with disability and quality of life. Methods 1002 centenarians and 798 oldest-old were included in the analysis. ICH, disability and quality of life were assessed according to standard methods. Results The median number of ICH metrics among centenarians and oldest-old were 4 (4-5) and 3(3-5) respectively. The highest proportion of ICH metrics at ideal levels were glucose (90.2%), BMI (89.8%), and smoking (89.4%), the lowest proportion of ICH metrics at ideal level was blood pressure (8.3%). The disability rates of BADL and IADL decreased with the number of ICH metrics. BADL disability changed from 100.0% to 73.2%, and the IADL disability rate dropped from 100% to 80.0%. BADL disability rate decreased from 45.0% to 25.3% and IADL disability decreased from 100.0% to 57.1% among the oldest-old. The EQ-5D vas, EQ-5D score showed increasing trend along with the number of ICH metrics (p < 0.05). Compared with centenarians who had only 0-2 ICH metrics, the ORs for BADL disability were 0.82, 0.66, 0.52, 0.44, and the ORs for IADL disability were 0.74, 0.65, 0.58, 0.41 for those with 3, 4, 5, ≥6 ICH metrics. Conclusions ICH metrics of centenarians and oldest-old were at a relatively good level, and there was a strong and independent inverse relationship between ICH metrics with both disability and lower quality of life. Key messages This was the first survey about the distribution of ICH metrics and association with both disability and quality of life based on elderly aged over 80 years old. The results highlighted the importance of cardiovascular prevention even at 80 years and over, which made up for the evidence gap based on this age group.

Identification of Potential Biomarkers and Pathways in Neonatal Hypoxic-Ischemic Brain Injury: Based on Bioinformatics Technology

Background Neonatal hypoxic-ischemic brain damage (HIBD) is one of the most common serious diseases in newborns, with a high mortality and disability rate. This study aims to use the bioinformatics analysis to identify potential hematologic/immune systems tissue-specific genes and related signaling pathways neonatal HIBD.Methods Microarray datasets in HIBD were downloaded from the Gene Expression Omnibus database, and DEGs were identified by R software.Enrichment analyses were performed and protein–protein interaction networks were constructed to understand the functions and enriched pathways of DEGs and to identify central genes and key modules. Results In the cerebral cortex tissue with HIBD, 2598 DEGs were identified, including 2362 up-regulated and 236 down-regulated DEGs. In the blood with HIBD, 1442 DEGs were identified, including 540 up-regulated and 902 down-regulated DEGs. The results of biological processes and KEGG enrichment were very similar in DEGs of the two kinds of tissues, and both involved inflammation, immunity and apoptosis. The common DEGs of the two kinds of tissues also showed similar results in biological processes and KEGG enrichment.and four hematologic/immune system tissues specifically expressed potential biomarker genes were confirmed through a variety of methods, which were verified by GEO datasets and published experimental research. Conclusion The DEGs of HIBD including the potential peripheral biomarkers TYROBP, ITGAM, EGR1 and HMOX1, which may play a role in the pathogenesis of HIBD through inflammation and immune-mediated signaling pathways.

Mechanism of Macrophage Action in Osteoarthritis

Osteoarthritis (OA) is the most common chronic joint disease and the main cause of pain and disability in adults (typical clinical OA characteristics), and women are more predisposed to this disease than men. About 400 million people worldwide and more than 100 million in China suffer from arthritis. OA was named the 11th largest contributor of mortality in the world, with a disability rate of as high as 53%, and is among the three major killers threatening the health of the elderly. Colloquially, OA is called the “number one disabling disease of the 21st century.” It is the main reason for the malfunctioned mobility of the elderly. Generally, women and men start to have OA at 40 and 50, respectively. Incidence rates increased dramatically between the ages of 55 and 60. The prevalence rate among older persons over 70 years of age is almost 80–90%. In addition, the disease is a chronic progressive disease, which can not only lead to the decline of life function and the reduction or even loss of quality of life, but also has an important and huge impact on health care and social costs. This disease may also demand higher economic requirements of the affected families. Until now, since the pain mechanism of the disease is not clear, there are no effective treatment methods, and surgical joint replacement is the only choice to treat the end-stage disease. This paper focuses on the role of macrophages in OA development, with particular attention to the occurrence of pain and possible mediators involved.

Research Progress on Refractory Hypertension in Traditional Chinese Medicine

At present, the mortality rate and disability rate caused by cardiovascular and cerebrovascular diseases are very high in China. Individuals with refractory hypertension are at a greater risk of developing chronic kidney disease, heart failure, stroke and myocardial infarction. Therefore, how to effectively control blood pressure and identify the cause of refractory hypertension is a problem that medical workers need to solve, and it is also the key to prevent cardiovascular disease. In recent years, the government actively supports the development of traditional Chinese medicine. Since the curative effect of traditional Chinese medicine is recognized by the public, the prospect of traditional Chinese medicine in the prevention and treatment of refractory hypertension is considerable, and it is expected to become the main key research direction in the future.