Clinical Observation and Research on Prevention and Treatment of Epilepsy Complicated with Cognitive Impairment by Quyu Dingxian Zhengtong Mixture for Dispelling Stasis and Resolving Phlegm / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of Chinese medicinal mixture for dispelling stasis and resolving phlegm combined with western medicine in the treatment of epilepsy combined with cognitive impairment by randomized， double-blind， placebo-controlled， parallel-group trial. MethodA total of 123 inpatients and outpatients with epilepsy complicated with cognitive impairment admitted to the department of neurology at Longhua Hospital from October 2020 to October 2021 were randomly assigned into a control group （62 cases， carbamazepine + placebo） and a treatment group （61 cases， carbamazepine + Quyu Dingxian Zhengtong mixture） by random number table method. In the treatment group， 4 cases were exfoliated and eliminated. In the control group， 3 cases fell off. Finally， 57 cases in the treatment group and 59 cases in the control group were included. The total course of treatment for both groups was 12 weeks. The clinical efficacy， efficacy for traditional Chinese medicine （TCM） syndromes， and incidence of adverse reactions were compared between two groups. The changes of seizure frequency， abnormal rate of electroencephalogram （EEG）， cognitive function score， serum homocysteine （HCY）， folic acid， and vitamin B12 （B12） were measured and compared before and after treatment. ResultAfter 12 weeks of treatment， the treatment group had higher clinical efficacy ［92.98% （53/57） vs 79.66% （47/59）， χ2=4.327， P<0.05］ and efficacy for TCM syndromes ［96.49% （55/57） vs 84.75% （50/59）， χ2=4.660， P<0.05］ than the control group. The treatment group was superior to the control group in reducing the seizure frequency （Z=-3.938， P<0.01） and improving the Montreal cognitive assessment （MoCA） score （t=4.333， P<0.01） and mini-mental state examination （MMSE） score （t=9.531， P<0.01）. The variations in serum HCY， folic acid， and B12 in the treatment group were less than those in the control group （t=-7.233， t=-7.972， t=-6.871， P<0.01）. After treatment， the abnormal rate of EEG in the treatment group was lower than that in the control group （χ2=4.437， P<0.05）. The incidence of adverse reactions in the treatment group （1.75%， 1/57） was lower than that （13.56%， 8/59） in the control group （corrected χ2=4.116， P<0.05）. ConclusionChinese medicinal mixture for dispelling stasis and resolving phlegm in combination with western medicine had better efficacy and safety than western medicine alone in the treatment of epilepsy complicated with cognitive impairment. Specifically， the combination outperformed western medicine alone in terms of clinical efficacy， efficacy for TCM syndromes， reduction in seizure frequency， abnormal rate of EEG， adverse reactions， improvement of cognitive function， and variations in serum folic acid， B12， and HCY values. Chinese medicinal mixture for dispelling stasis and resolving phlegm may improve the clinical efficacy and safety by changing the metabolism of folic acid， B12， and HCY in serum of the patients with epilepsy complicated with cognitive impairment.

Huangqin Decoction Attenuates DSS-Induced Mucosal Damage and Promotes Epithelial Repair via Inhibiting TNF-α-Induced NF-κB Activation / 中国结合医学杂志

OBJECTIVE@#To investigate the protective effect of Chinese herbal formula Huangqin Decoction (HQD) on ulcerative colitis mouse model induced by dextran sulphate sodium (DSS) and human intestinal epithelial cell injury induced by tumour necrosis factor-α (TNF-α).@*METHODS@#In vivo, 30 male C57BL/6 mice were divided into 5 groups using a random number table (n=6 per group), including control, DSS, 5-aminosalicylic acid (5-ASA), HQD low- (HQD-L) and high-dose (HQD-H) groups. The colitis mouse model was established by 3% (w/v) DSS water for 5 days. Meanwhile, mice in the HQD-L, HQD-H and 5-ASA groups were administrated with 100, 200 mg/kg HQD or 100 mg/kg 5-ASA, respectively, once daily by gavage. After 9 days of administration, the body weight, disease activity index (DAI) score and colon length of mice were measured, the pathological changes of colons were analyzed by hematoxylin-eosin staining (HE) staining, and the levels of serum interleukin (IL)-6, IL-1β and TNF-α were measured by enzyme linked immunosorbent assay. In vitro, the human colon epithelial normal cells (FHC cells) were exposed to HQD (0.6 mg/mL) for 12 h and then treated with TNF-α (10 ng/mL) for 24 h. The tight junction (TJ) protein expression levels of Claudin-4 and Occludin, and the protein phosphorylation levels of p65 and inhibitor of nuclear factor kappaB (NF-κB)-α (IκBα) were measured by Western blot.@*RESULTS@#In vivo, compared with the DSS group, HQD-H treatment attenuated the weight loss and reduced DAI score of mice on the 8th day (P<0.05). Moreover, HQD-H treatment ameliorated the colon shortening in the DSS-induced colitis mice (P<0.05). HE staining showed HQD attenuated the pathological changes of colitis mice, and the histological scores of HQD-H and 5-ASA groups were significantly decreased compared with the DSS group (P<0.05). Meanwhile, HQD-H and 5-ASA significantly decreased the serum IL-1β, IL-6 and TNF-α levels of mice (P<0.05). In vitro experiments showed that HQD up-regulated Occludin and Claudin-4 protein expressions and inhibited p-p65 and p-IκBα levels in FHC cells compared with the TNF-α group (P<0.05).@*CONCLUSION@#HQD significantly relieved the symptoms in DSS-induced colitis mice by inhibiting pro-inflammatory cytokines expression and maintained the homeostasis of TJ protein in FHC cells by suppressing TNF-α-induced NF-κB activation.

Changes of skin lesion, anxiety and depression in patients with facial hormone-dependent dermatitis before and after treatment / 中华医学美学美容杂志

Objective:To observe the changes of skin lesion, anxiety and depression in patients with facial hormone-dependent dermatitis before and after treatment.Methods:Ninty-two cases of hormone-dependent dermatitis were collected from October 2014 to December 2020 in the Department of Dermatology, the First People＇s Hospital of Changshu, Jiangsu province, including 24 males and 68 females, aged 18 to 52 (31±10) years. The skin lesions and subjective symptoms changes were compared 2 weeks and 4 weeks after treatment. Depression and anxiety changes were compared before and after treatment with Hamilton depression scale and Hamilton anxiety scale. Telephone follow-up was conducted 4 weeks and 8 weeks after treatment.Results:The skin lesions and subjective symptoms of the 92 cases were improved in different degrees after 2 weeks and 4 weeks treatment, and the effective rates were 52.17% (48 cases) and 88.04% (81 cases) respectively, and the difference was statistically significant ( Z=-9.24, P<0.01). The depression scores (16.89±4.53) before treatment were significantly higher than those after treatment (4.38±2.10), and the difference was statistically significant ( t=35.79, P<0.01). 28 cases (30.43%) had clinically significant depression symptoms before treatment, and none after treatment. The difference was statistically significant ( Z=-5.39, P<0.01). The scores of anxiety (14.39±3.97) before treatment were significantly higher than those after treatment (4.46±1.67). and the difference was statistically significant ( t= 28.87, P<0.01). 50 cases (54.35%) had clinically significant anxiety symptoms before treatment, and none after treatment. The difference was statistically significant ( Z=-7.07, P=<0.01). The total scores of Hamilton depression scale were positively correlated with course of disease before and after treatment ( r=0.27, P<0.05; r=0.22, P<0.05). The total scores of Hamilton anxiety scale were positively correlated with course of disease before and after treatment ( r=0.29, P<0.01; r=0.35, P<0.01). They were followed up by telephone 4 weeks and 8 weeks after the end of treatment, and there was no relapse. Conclusions:Facial hormone-dependent dermatitis can affect appearance, leading to depression and anxiety, and early and full treatment can achieve satisfactory results.

Analysis of norovirus surveillance in adult infectious diarrhea in Putuo District of Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and epidemiological characteristics of norovirus in adult cases with infectious diarrhea in Putuo District of Shanghai， and provide scientific evidence for the prevention and control of infectious diarrhea caused by norovirus. MethodsFecal samples， clinical information and epidemiological data were collected from January 2013 through December 2019 in surveillance hospitals in Putuo District of Shanghai. Norovirus was examined by real-time fluorescent quantitative reverse transcription polymerase chain reaction （rRT-PCR）. ResultsIn 1 389 adult cases with infectious diarrhea， norovirus positive rate was 25.41%， which was significantly higher in male （27.16%） than female （23.89%）. Furthermore， in 353 cases positive for norovirus， GⅡ group was the most common （77.98%）.The positive rate was highest in the cases aged 30-44 years. Spring， autumn and winter were the seasons with higher incidence of norovirus （September to May）. The norovirus-infected cases had more nausea， vomiting， hyperactivity of bowel sounds， and watery stool， compared to the negative cases （P<0.05）. ConclusionThe detection rate of norovirus remains high in adult cases with infectious diarrhea in Putuo District of Shanghai， of which GII is predominant. Seasonality may be spring， autumn and winter. Therefore， it warrants the countermeasures， such as surveillance and health education， for prevention and control of norovirus in susceptible population during epidemic seasons.

Analysis of norovirus surveillance in adult infectious diarrhea in Putuo District of Shanghai / 上海预防医学

ObjectiveTo investigate the prevalence and epidemiological characteristics of norovirus in adult cases with infectious diarrhea in Putuo District of Shanghai， and provide scientific evidence for the prevention and control of infectious diarrhea caused by norovirus. MethodsFecal samples， clinical information and epidemiological data were collected from January 2013 through December 2019 in surveillance hospitals in Putuo District of Shanghai. Norovirus was examined by real-time fluorescent quantitative reverse transcription polymerase chain reaction （rRT-PCR）. ResultsIn 1 389 adult cases with infectious diarrhea， norovirus positive rate was 25.41%， which was significantly higher in male （27.16%） than female （23.89%）. Furthermore， in 353 cases positive for norovirus， GⅡ group was the most common （77.98%）.The positive rate was highest in the cases aged 30-44 years. Spring， autumn and winter were the seasons with higher incidence of norovirus （September to May）. The norovirus-infected cases had more nausea， vomiting， hyperactivity of bowel sounds， and watery stool， compared to the negative cases （P<0.05）. ConclusionThe detection rate of norovirus remains high in adult cases with infectious diarrhea in Putuo District of Shanghai， of which GII is predominant. Seasonality may be spring， autumn and winter. Therefore， it warrants the countermeasures， such as surveillance and health education， for prevention and control of norovirus in susceptible population during epidemic seasons.

Effect of Banxia Xiexin Decoction on intestinal flora of mice with ulcerative colitis induced by dextran sodium sulfate / 中国中药杂志

The aim of this paper was to investigate the effect of Banxia Xiexin Decoction(BXD) on inflammatory factors and intestinal flora in a dextran sulfate sodium induced ulcerative colitis(DSS-UC) mouse model, and to explore the mechanism of BXD in treating ulcerative colitis from the perspective of flora disorder. Forty C57 BL/6 J mice were randomly divided into control group, model group and BXD group. A 2.5% DSS-induced ulcerative colitis model was established. On the 8 th day, normal saline, normal saline, and BXD were given daily for 14 days. After 14 days, HE staining was used to observe histopathological changes of the colon. Serum inflammatory factor content was detected by ELISA, and the change of intestinal flora in mice feces was detected by 16 S rRNA sequencing technology. Compared with control group, the colonic tissue of mice in model group was damaged seriously, and the contents of IL-6 and TNF-α in serum were significantly increased(P<0.05). Compared with model group, mice in BXD group had less colonic damage, and the contents of IL-6, TNF-α in serum were decreased significantly(P<0.05). After creation, the richness of Patescibacteria was increased significantly at the phylum level(P<0.05). At the same time, the richness of Faecalibaculum(P<0.01), norank_f_Muribaculaceae(P<0.01) were decreased significantly at the genus level, while the richness of Turicibacter(P<0.01), Romboutsia(P<0.01), Clostridium_sensu_stricto_1(P<0.01) were increased significantly. After the intervention with BXD, the content of Patescibacteria was significantly reduced at the phylum level(P<0.05), and the contents of Lactobacillus(P<0.01), Clostri-dium_sensu_stricto_1(P<0.01), Enterorhabdus(P<0.01), Candidatus_Saccharimonas(P<0.05), Eubacterium_fissicatena_group(P<0.05) were decreased significantly at the genus level, while the contents of Dubosiella, Bacteroides and Allobaculum were increased significantly. Therefore, BXD could significantly improve the symptoms of DSS-UC mice. It not only could reduce the contents of IL-6 and TNF-α, but also could reduce the richness of Patescibacteria at the phylum level, and those of Clostridium_sensu_stricto_1, Candidatus_Saccharimonas, Eubacterium_fissicatena_group at the genus level. Inaddition, BXD could increase the richness of Bacteroides and Bifidobacterium. It suggested that BXD could play a role in the treatment of ulcerative colitis partially through reducing inflammatory factors and regulating the structure of the gut microbiota.

Discussion on the Inhibitory Mechanism of Lanthanum Chloride on Vascular Smooth Muscle Cell Calcification Induced by High Phosphorus Based on NF-κB Signaling Pathway / 中国药房

OBJECTIVE：To discuss the inhibitory effect of lanthanum chloride on the calcification of vascular smooth muscle cells（VSMCs）induced by high phosphorus and its mechanism. METHODS ：On the basis of screening the action concentration and time of lanthanum chloride by MTT method ，human VSMCs were divided into control group （1 mmol/L phosphorus solution ）， lanthanum chloride high concentration control group （1 mmol/L phosphorus solution+ 60 μmol/L lanthanum chloride），model group （3 mmol/L phosphorus solution ），sodium chloride group （3 mmol/L phosphorus solution+ 180 μmol/L sodium chloride），nuclear factor κB（NF-κB）signaling pathway agonist+lanthanum chloride group （3 mmol/L phosphorus solution+ 1 μg/mL lipopolysaccharide+ 60 μmol/L lanthanum chloride），positive control group （3 mmol/L phosphorus solution+ 100 μmol/L sodium pyrophosphate），and lanthanum chloride low ，medium，and high concentration groups （3 mmol/L phosphorus solution+ 15，30，60 μmol/L lanthanum chloride）. Alizarin red S staining and Von Kossa staining were used to detect cell calcification in each group after treated with phosphorus solution for 6 d and relevant medicine for 2 d. Western blot assay was used to detect the protein expression of TNF-α receptor associated protein 6（TRAF6），nuclear factor κB inhibitor protein α（IκBα），NF-κB p65，bone morphogenetic protein 2 （BMP-2），smooth muscle 22 α（SM22α）and Runt related transcription factor 2（Runx2）. Real-time fluorescence quantitative polymerase chain reaction was used to detect mRNA expression of TRAF 6，IκBα，BMP-2，SM22α and Runx2. RESULTS ： Compared with control group ，no cell calcification was observed in the lanthanum chloride high concentration control group ，while obvious cell calcification and significant increase of OD value were observed in model group and sodium chloride group （P＜ 0.01）；protein and mRNA expression of TRAF 6 and BMP- 2 in cytoplasm as well as mRNA expression of Runx 2，protein expression of NF-κB p65 and Runx 2 in nucleus were significantly increased （P＜0.01）；protein and mRNA expression of IκBα and SM22α as well as protein expression of NF-κB p65 in cytoplasm were significantly decreased （P＜0.01）. Compared with model group，cell calcification was significantly improved in lanthanum chloride groups and positive control group ，while OD values were significantly reduced ；the expression levels of the above-mentioned protein and mRNA were reversed to varying degrees （P＜0.05 or P＜0.01）. Compared with lanthanum chloride high concentration group ，obvious cell calcification was observed in NF-κB signaling pathway agonist + lanthanum chloride group ，and OD value was significantly increased ；the above indexes were significantly reversed in cytoplasm and nucleus （P＜0.05 or P＜0.01）. CONCLUSIONS ：Lanthanum chloride can inhibit the calcification of VSMCs induced by high phosphorus ，and its mechanism may be related to the inhibition of NF-κB signaling pathway activation.

Differences of Gut Microbiota Diversity between Patients with Abdominal Aortic Aneurysm and Atherosclerosis / 中国医学科学院学报

Objective To investigate the differences of gut microbiota between patients with abdominal aortic aneurysm and atherosclerosis.Methods From December 2018 to June 2019,20 fresh stool samples were collected respectively from the patients with abdominal aortic aneurysm and atherosclerosis treated at the Department of Vascular Surgery,Peking Union Medical College Hospital.The 16S rDNA high-throughput sequencing was employed to compare the composition,abundance,and α and β diversities of gut microbiota between the two disease groups,and further determine the significantly differential genera.Results The two groups had great similarities in the composition of gut microbiota.There was no statistical difference in α diversity.Although β diversity did not have statistically significant difference,certain microbial taxa showed differences between the two groups.The LEfSe demonstrated that the abdominal aortic aneurysm group had higher relative abundance of

Clinical application of self-made minimally invasive hood-assisted transforaminal lumbar interbody fusion via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases / 中国骨伤

OBJECTIVE@#To explore the advantages of self made minimally invasive hook assisted transforaminal lumbar interbody fusion (TLIF) via modified bilateral Wiltse approach in the treatment of lumbar degenerative diseases.@*METHODS@#The clinical data of 140 patients underwent lumbar spine fusion surgery from October 2016 to October 2017 were retrospectively analyzed. Among them, 72 cases were treated by self-made minimally invasive hook-assisted TLIF via modified bilateral Wiltse approach (group A), there were 37 males and 35 females, aged (48±16) years old;68 cases were treated by TLIF via traditional posterior median approach (group B ), there were 38 males and 30 females, aged (45±15) years old. The surgical incision size, operation time, intraoperative blood loss volume, postoperative drainage volume, postoperative wound healing, and intervertebral fusion rate at the final follow-up were recorded between two groups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess the clinical efficacy.@*RESULTS@#All the patients were followed up for 3 to 13 (8±5) months. The wound in group A healed well after operation, and 1 case in group B occurred wound necrosis after operation, and healed after debridement and suture. There were no significant differences in operation time and postoperative fusion rate between two surgical methods (@*CONCLUSION@#The self made minimally invasive hook assistedTLIF via modified bilateral Wiltse approach has the characteristics of minimally invasive, less intraoperative blood loss, less postoperative drainage, fewer complications, and more stable fusion in the treatment of lumbar degenerative desease.

Effect of Different Combinations of Arbuscular Mycorrhiza on Paris polyphylla var. yunnanensis and Chemical Components / 中国实验方剂学杂志

Objective:To study the effects of different arbuscular mycorrhizal（AM） fungi combinations on the growth and quality of<italic> Paris polyphylla</italic> var. <italic>yunnanensis</italic> seedlings，in order to provide reference for the cultivation of high quality <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic>. Method:Through the room temperature pot inoculation test method，nine groups of different AM fungi combinations were inoculated into sterilized soil，and the control group was not inoculated. The effects of different AM fungi combinations on root infection rate，photosynthetic parameters，physiological indexes and chemical components of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic> seedlings were observed. Result:The spore density in rhizosphere soil，the infection rate and intensity of AM fungi in roots，and the activities of succinate dehydrogenase and alkaline phosphatase in roots of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic> were significantly increased by inoculating the combination of exogenous AM fungi. Compared with the control group，the contents of chlorophyll，malondialdehyde，soluble sugar，soluble protein content and the activities of antioxidant enzymes in leaves of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic> were increased in different AM fungi treatment groups. The content of total saponin increased from T1 to T2，decreased rapidly from T2 to T4，and increased at T5. Conclusion:Different mixed AM fungus can form a good symbiotic relationship with the roots of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic>，improve the mycorrhizal vitality，enhance the resistance of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic> to adverse environment，promote the growth and development of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic> and improve the quality of rhizome. According to the comprehensive inoculation effect，the combination of S5，S8 and S9 AM fungus has the best effect，which provides reference value for the application of mycorrhizal biotechnology of <italic>P. polyphylla</italic> var. <italic>yunnanensis</italic>.

Risk Factors for Patients Using Intraoperative Vasopressor Infusions During Carotid Body Tumor Excision / 中国医学科学院学报

Objective To investigate the risk factors for patients using intraoperative vasopressor infusions during carotid body tumor(CBT)excision.Patients' mean arterial pressure(MAP)and heart rate(HR)fluctuations as well as their requirements for vasoactive agents during surgery were assessed. Methods The patients receiving CBT excision in Peking Union Medical College Hospital from May 1,2013 to July 31,2017 were included for a retrospective cohort study.The potential factors of intraoperative requirement for vasopressor infusions were investigated using univariate analysis and Logistic multivariate analysis.Furthermore,the relationships of Shamblin types of CBT with intraoperative MAP/HR fluctuations and requirements for vasoactive agents were analyzed. Results A total of 108 patients with 116 CBTs were included.Univariate analysis revealed that maximum tumor diameter >4 cm,intraoperative internal carotid artery injury,internal carotid artery reconstruction,malignant pathology,advanced Shamblin types(type Ⅱ and Ⅲ),estimated blood loss ≥400 ml,and operation duration >4 hours were associated with intraoperative requirements for vasopressor infusions.Logistic analysis showed that Shamblin type Ⅲ(OR=2.286,95% CI=1.324-14.926,P=0.016)and operation duration >4 hours(OR=3.874,95% CI=1.020-14.623,P=0.046)were risk factors for intraoperative requirements for vasopressor infusions during CBT surgery.In addition,Shamblin type Ⅲ was associated with intraoperative abnormal HR elevation and requirements for vasopressors.Conclusions Shamblin type Ⅲ and operation duration>4 hours are risk factors for intraoperative requirements of patients for using vasopressor infusions during CBT surgery.Shamblin type Ⅲ is associated with intraoperative abnormal HR elevation and requirements for vasopressors.

Research-based learning teaching reform in genetics experimental course for medical undergraduates / 中华医学教育探索杂志

This paper elaborates the specific implementation process of the "research-based learning" teaching reform of genetic experiment in medical undergraduate education, including the change of teaching philosophy among teachers, the integration and expansion of experimental contents, the innovation of classroom-teaching model, the compilation of proper textbook, the update of assessment methods and the establishment of evaluation mechanism for teaching and so on. Preliminary research shows that RBL teaching reform can stimulate medical students' interest and potential in learning, and improve their practical and scientific research innovation ability.

Correlation Analysis Between Bulb Quality and Rhizosphere Soil Factors of Fritillaria taibaiensis / 中国实验方剂学杂志

Objective::To explore the correlation between bulb quality and rhizosphere soil factors of Fritillaria taibaiensis of different origins and years, in order to provide theoretical basis for the high quality and safe production of F. taibaiensis. Method::Totally 11 samples of bulb and rhizospheric soil of F. taipaiensis of different origins and years were taken as the research objects. Available N, available P, available K, organic matter, pH and six soil enzyme activities in rhizosphere soils were determined by soil agrochemical analysis method. Peimisine and nine nucleosides in F. taibaiensis bulbs were determined by HPLC, and total alkaloid content was determined by UV. SPSS 22.0 software was used to analyze the correlation of the measured data. Result::There were significant differences in rhizosphere soil factors and bulb quality between F. taibaiensis of different origins and years (P<0.05). In terms of soil factors, the contents of available N, available K, organic matter and six soil enzyme activities in rhizosphere soil of wild varieties were higher than those of cultivated varieties, while the contents of available P and pH were lower than those of cultivated varieties. With the increase of growth years, the soil nutrient index of cultivated varieties showed different change trends, while that of wild varieties did not change significantly. However, most of the soil enzymes in both groups decreased in varying degrees. In terms of bulb quality, the contents of nine nucleosides and alkaloids in F. taibaiensis bulbs decreased with the increase of growth years, with larger change trends of cultivated varieties, while that of wild varieties was not significant. The contents of nucleosides and alkaloids in most cultivated varieties were higher than those in wild varieties. The correlation analysis showed certain correlations between soil factors in rhizosphere as well as soil factors and bulb quality. In general, soil nutrient status and bulb quality decreased with the increase of years. Conclusion::The quality of F. taibaiensis is mainly affected by its rhizosphere soil factors. In the process of field conservation and artificial cultivation, attention shall be paid to increase or decrease of the content of soil nutrients and their proportional relationship according to actual situations, so as to ensure the quality of F. taibaiensis.

Vesselplasty for the treatment of spinal metastases complicated by posterior wall destruction of vertebral body / 中国骨伤

OBJECTIVE@#To evaluate the early clinical efficacy and safety of vesselplasty for the treatment of spinal metastases complicated by posterior wall destruction of vertebral body.@*METHODS@#The clinical data of 19 patients(21 segments) with spinal metastases complicated by posterior wall destruction of vertebral body treated from January 2016 to January 2017 were retrospectively analyzed. There were 15 males and 4 females, aged 40 to 85 years old with a mean of (66.00±10.25) years . All patients had severe low back pain before the operation, which were diagnosed by CT as damage-type metastatic tumor of the vertebral posterior wall. All patients were treated by vesselplasty technique. Nineteen vertebrae received percutaneous unilateral pedicle puncture and two vertebrae received percutaneous bilateral pedicle puncture. VAS, ODI were recorded before operation, 1 d and 3 d after operation respectively. X-ray and CT scan were used to observe bone cement leakage and complications.@*RESULTS@#All the operations were successful and postoperative pain was significantly relieved. Postoperative VAS score and ODI of the two groups were significantly improved (<0.05). A small amount of bone cement leakage occurred in one vertebral body, which was a vertebral venous plexus leakage, but no clinical symptoms after operation.@*CONCLUSION@#Vesselplasty for the treatment of spinal metastases complicated by posterior wall destruction of vertebral body can significantly reduce the symptoms of thoracolumbar back pain, improve the quality of life, reduce the incidence of bone cement leakage, and has high clinical efficacy and safety.

Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours / 中国医学科学院学报

To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(=0.019),the maximum diameter of tumours on axial images(=0.003),the maximum upper and lower diameters(=0.004),Shamblin classification(=0.012),and number of blood supply arteries(<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

Effect of Mixed Inoculation of Arbuscular Mycorrhizal on Growth and Chemical Composition of Aucklandia lappa Seedlings / 中国实验方剂学杂志

Objective:To explore the synergistic effect of arbuscular mycorrhizal（AM） fungi mixed inoculation on the growth，physiological and biochemical characteristics，root biomass and terpenoid component accumulation of Aucklandia lappa seedlings，so as to provide a reference for the combination and application of the dominant complementary effect mycorrhizal fungi. Method:The effect of different AM fungi combined with inoculation on the root mycorrhizal infection rate，plant growth，physiological and biochemical characteristics，root biomass，costunolide and dehydrocostus lactone of A. lappa seedlings were determined by pot inoculation at room temperature. Result:It was found that AM fungi could form good mycorrhizal symbiosis with the roots of A. lappa.The formation of mycorrhizal symbiosis system could increase the chlorophyll content of A. lappa leaves，increase the activities of catalase（CAT），peroxidase （POD），superoxide dismutase （SOD），reduce the content of malondialdehyde（MDA），and promote photosynthesis of A. lappa. Compared with CK group，AM fungus treatment could significantly promote the accumulation of costunolide and dehydrocostus lactone，and the accumulation of its metabolites，costunolide and dehydrocostus lactone，into roots during the symbiotic cultivation of A. lappa seedlings，indirectly improving the quality of medicines and yield of alantolactone. Conclusion:Inoculation of AM fungi can improve the root mycorrhizal viability，increase the absorption of nutrients and promote the growth of woody incense.The mixed inoculation treatment of S2，S4 and S5 had the best mycorrhizal effect in artificial cultivation，and the growth and medicinal quality of A. lappa were the best，which provided technical support for the application and popularization of A. lappa mycorrhizal biotechnology.

Effect of Different Arbuscular Mycorrhizal Fungi Combinations and Inoculation Periods on Rhizosphere Soil Physicochemical Properties and Microbial Quantity of Paris polyphylla var. yunnanensis Seedlings / 中国实验方剂学杂志

Objective:To study the effects of different arbuscular mycorrhizal （AM） fungi combinations on rhizosphere soil physicochemical properties and microbial quantity in the seedlings of Paris polyphylla var. yunnanensis at different inoculation periods，so as to lay a foundation for cultivating high-quality P. polyphylla var. yunnanensis. Method:The spore density，infection rate，nutrient and enzyme activity in the soil around the roots of P. polyphylla var. yunnanensis seedlings under different AM fungi combinations and different inoculation periods were analyzed by the greenhouse pot inoculation trials and soil agrochemical analysis methods. Result:The infection rate of different AM fungi treatment groups was more than 80% in different inoculation periods，and the spore density was higher than control （CK） group in some periods. It reflected that the relationship between AM fungi and roots of Paris polyphylla seedlings was favorable. The content of nitrogen in the soil decreased，but the content of available P，available K and soil pH increased. The soil nutrients in the cultivar one-year seedlings and wild seedlings were higher. The total number of soil microorganisms showed that bacteria>actinomycetes>fungi. The cultivar two-year seedlings with AM fungi combinations of S3，S5 and S8 had better soil structure and higher biomass carbon content. The growth rates of phosphatase and protease activity were higher in the soil，but catalase activity was lowest. In the treatment groups S2，S3，S4，S5 and S6，the soil enzyme activities of the wild seedlings and one-year-old seedlings were best. Conclusion:Different AM fungal treatment groups and different inoculation periods had certain effects on rhizosphere soil physicochemical properties and microbial quantity in the seedlings of P. polyphylla var. yunnanensis， which provided a technical basis for the cultivation of P. polyphylla var. yunnanensis.

Status of anxiety and depression in male patients with gonococcal infection in paraurethral ducts before and after paraurethral duct dilatation / 中华医学美学美容杂志

Objective To verify the change of the anxiety and depression of patients anteriorposterior treatment at paraurethral duct dilitation after gonococcal infection of paraurethral duct.Methods Twenty-eight patients of paraurethral duct dilatation after male gonococcal infection of paraurethral duct were enrolled,and the patients were treated in the Department of Dermatology and Venerology,the First People's Hospital of Changshu City.The anxiety and depression of patients anteriorposterior treatment were assessed and compared with Hamilton depression scale and Hamilton anxiety scale.Results The total scores of Hamilton depression scale and Hamilton anxiety scale before treatment were positively correlated with course of disease (r =0.481,P =0.0095;r =0.549,P =0.0025).The total scores of Hamilton depression and anxiety before treatment were from 1 to 31 (18.9±7.5) and from 4 to 30 (14.9±6.8).The symptoms of depression and anxiety appeared in 11 patients and 15 patients respectively.The total scores of Hamilton depression andanxiety after treatment were from 0 to 8 (4.3±1.7) and from 0 to 8 (3.3±1.7).There was no symptom of depression and anxiety.The difference of the total score of Hamilton depression and anxiety before and after treatment had statistical significance (t =12.270,P＜0.001,t =10.626,P＜0.001).The difference of positive rate of depressive and anxious symptom before and after treatment had statistical significance too (x2 =9.05,P=0.003;x2 =13.06,P=0.000).Conclusions The sequelae of gonococcal paraurethral duct infection in male paraurethral duct dilatation can result in the anxiety and depression of patients,which should be treated.Effective therapy can relieve or cure the anxiety and depression of patients without the assistance of psychotropic drugs.

Sequence analysis of the HBV S protein in patients with chronic hepatitis B / 中华检验医学杂志

Objective To analysis the frequency and mutational patterns of HBV(hepatitis B virus) S protein in the different phases of chronic hepatitis B patients, exploring the clinical implication of these mutations in CHB. Methods The difference of S protein mutation rates and mutation site among each groups were analyzed by cases-comparison. 112 cases of chronic hepatitis B patients in Shanghai Shu-guang hospital were enrolled in this study; they were divided into four groups, immune-tolerance group [IT, 36 cases, male 20 cases,female 16 cases,age 28.00 (25.00,30.75)years], immune-clearance group [IC, 28 cases, male 17 cases,female 11 cases,age 29.00 (25.25,31.75) years], low-replication group [LR, 25 cases, male 17 cases,female 8 cases,age 39.00 (35.00,45.50) years], reactivation group [RE, 23 cases, male 15 cases,female 8 cases, age 43.00 (36.00, 48.00) years]. DNA sequencing was used to detection HBV S protein gene mutation. Difference between categorical variables were analyzed using Chi-square test, Non-parametric test (kruskal-wallis H and Mann-Whitney U) was used for non-normal distribution data. Results Naturally occurring MHR (major hydrophilic region) variants was 16.67％ (6/36 cases) in IT group, preferentially within"a"determinant in the first loop, compared with IC (21.43％,6/28 cases), LR (20.00％,5/25 cases) and RE (34.78％,8/23 cases), there was no statistics Significance (χ2=2.814, P=0.421), while variant frequencies outside the MHR were 11.11％ (4/36 cases) and 14.29％ (4/28 cases) in IT and IC group, viral diversity gradually increased during LR phase with 24.00％(6/25 cases) of mutation frequency, and peak at RE phase (52.17％, 12/23 cases) with a statistics significance (χ2=15.041, P=0.002). Conclusion Amino acid substitutions is not only the consequence of the pressure of host immunity, it may be a probably cause of disease reactivation.

Clinical efficacy of sorafenib in treatment of primary hepatic carcinoma and its effects on serum VEGFR -2 and PLGFlevels / 临床肝胆病杂志

To investigate the clinical efficacy of sorafenib in the treatment of primary hepatic carcinoma (PHC) and its effects on serum vascular endothelial growth factor receptor -2 (VEGFR -2) and placental growth factor (PLGF) levels.Methods A total of 110 patients with a confirmed diagnosis of PHC who received treatment in Jinshan Hospital Affiliated to Fudan University from July 2014 to March 2016 were randomly and equally divided into observation group and control group .The control group was given routine treatment, while the observation group received sorafenib in addition to the routine treatment .Serum levels of VEGFR -2 and PLGF were measured by ELISA.Liver function parameters, aspartate aminotransferase (AST), prothrombin time (PT), total bilirubin (TBil), albumin (Alb), and alanine aminotransferase (ALT), were also recorded.Comparison of continuous data between groups was made by independent samples t -test, and the changes in continuous data after intervention in each group were evaluated by paired samples t -test.Comparison of categorical data between groups was made by chi -square test.Results The observation group showed significant reductions in serum VEGFR -2 and PLGF levels after treatment (VEGFR -2: 7053.2 ±1836.1 ng/L vs 8721.4 ±2427.8 ng/L, t =4.089, P <0.001; PLGF: 468.4 ±136.5 pg/ ml vs 656.8 ±191.4 pg/ml, t =5.975, P <0.001).After treatment, the observation group had significantly lower serum VEGFR -2 and PLGF levels than the control group (VEGFR -2: 7053.2 ±1836.1 ng/L vs 8097.5 ±2325.4 ng/L, t =2.64, P <0.05; PLGF: 468.4 ± 136.5 pg/ml vs 643.3 ±195.8 pg/ml, t =2.48, P <0.05).The observation group showed significant changes in serum AST and ALT lev - els after treatment (t =4.302 and 3.097, both P <0.05).After treatment, the observation group had significantly lower serum AST and ALT levels than the control group (t =2.56 and 2.39, both P <0.05).Compared with the control group, the observation group had better follow -up results, with a significantly increased disease control rate (27.3% vs 47.3% , χ2 =4.705, P =0.030), and had a significantly higher survival rate at 40 months after treatment (43.6% vs 69.1%, χ2 =7.245, P =0.007).Conclusion Sorafenib is effective in the treatment of PHC patients, as it can significantly reduce the serum levels of VEGFR -2 and PLGF, prolong the survival time of patients, and improve the prognosis of patients.