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Objective To investigate the effect of the SMAC gene on paclitaxel sensitivity and cellular activity in lung adenocarcinoma cells based on the caspase-3/Bcl-2/Bax signaling pathway. Methods A paclitaxel-resistant cell line A549/Taxol was established for lung adenocarcinoma, and the cells were divided into four following groups: pcDNA-NC (transfected with pcDNA-NC blank vector), pcDNA-SMAC (transfected with pcDNA-SMAC vector), siRNA-NC (transfected with siRNA-NC empty virus vector), and siRNA-SMAC groups (transfected with siRNA-SMAC lentiviral vector). The SMAC mRNA expression in cells was detected by qRT-PCR; cell sensitivity was detected by MTT; cell proliferation ability was detected by cloning assay; cell invasion ability was detected by Transwell; apoptosis ability was detected by flow cytometry assay; and caspase-3, Bcl-2 and Bax protein expression in cells were detected by Western blot analysis. Results The SMAC mRNA expression was significantly lower in A549 cells compared with BEAS-2B cells (P < 0.05). The SMAC mRNA expression was significantly higher in the pcDNA-SMAC group than that in the pcDNA-NC group cells (P < 0.05). The SMAC mRNA expression was significantly lower in the cells of the siRNA-SMAC group (P < 0.05) than that in the siRNA-NC group. The SMAC mRNA expression was significantly lower in the cells of the siRNA-SMAC group (P < 0.05) than in the siRNA-NC group. Compared with the pcDNA-NC group, the cell IC50, cell clone number, cell invasion ability, and Bcl-2 protein and Bcl-2/Bax ratio were significantly lower in the pcDNA-SMAC group, the cell resistance index reversal was 2.51-fold, and the apoptosis ability and caspase-3, as well as Bax protein expression, were significantly higher (P < 0.05). Compared with the siRNA-NC group, cell IC50, cell clone number, cell invasion ability, and Bcl-2 protein and Bcl-2/Bax ratio were significantly higher in the siRNA-SMAC group, and apoptosis ability and caspase-3 and Bax protein expression were significantly lower (P < 0.05). Conclusion High expression of SMAC increases paclitaxel sensitivity, inhibits cell growth and invasion, promotes apoptosis in lung adenocarcinoma cells, and has a regulatory effect on the caspase-3/Bcl-2/Bax signaling pathway.
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OBJECTIVE To study the protective effect and potential mechanism of Hypericum perforatum on cerebral ischemia- reperfusion in rats. METHODS The male SD rats were randomly divided into sham operation group， model group， positive control group （nimodipine 0.012 g/kg）， H. perforatum high-dose and low-dose groups （5.212， 1.303 g/kg）， with 10 rats in each group. Except for sham operation group， the left middle cerebral artery ischemia-reperfusion model was established with the modified suture method. Administration groups were given relevant medicine intragastrically since the second day after surgery， once a day， for 7 consecutive days. The neurological function scores of rats were measured before drug intervention （the first day after modeling） and after the last administration， and the cerebral infarction after the last administration was observed using TTC staining method；HE staining and TUNEL staining methods were used to observe the pathological changes of the cerebral cortex and hippocampus， and the apoptosis of nerve cells， respectively. Western blot and RT-PCR were used to observe the protein and mRNA expressions of erythropoietin （EPO）， erythropoietin receptor （EPOR）， Janus kinase 2 （JAK2） and signal transduction and activator of transcription 3 （STAT3）， and protein expression of phosphorylated STAT3 （p-STAT3）， respectively. RESULTS Compared with sham operation group， neurological function score and the proportion of cerebral infarction in model group were significantly increased before intervention and after the last administration （P＜0.01）， with significant damage to nerve cells in cerebral cortex and hippocampus， an increase in apoptotic nerve cells， and a significant increase in apoptosis rate （P＜0.01）； protein and mRNA expressions of EPO and EPOR in the brain tissue were significantly reduced （P＜0.01）， while the protein expressions of JAK2， p- STAT3 and STAT3， and mRNA expressions of JAK2 and STAT3 were significantly increased （P＜0.01）. Compared with model group， the damage and apoptosis of nerve cells in cerebral cortex and hippocampus of rats in administration groups were improved， and the quantitative indicators were almost significantly improved （P＜0.05 or P＜0.01）. CONCLUSIONS H. perforatum has a protective effect against cerebral ischemia-reperfusion injury in rats， and the related mechanism may be related to the regulation of EPO-mediated JAK2/STAT3 signaling pathway.
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【Objective】 The involvement of upper motor neuron (UMN) degeneration is crucial to the diagnosis of amyotrophic lateral sclerosis (ALS). This study aimed to determine objective and sensitive UMN degeneration markers for an accurate and early diagnosis. 【Methods】 A total of 108 ALS patients and 90 age- and gender-matched control subjects were recruited from ALS Clinic of The First Affiliated Hospital of Xi’an Jiaotong University. The motor homunculus cortex thickness data in MRI were collected from all the participants. The clinical characteristics and UMN clinical examination of bulbar, cervical, thoracic and lumbosacral regions were collected from the ALS patients. 【Results】 Cortical thickness was significantly thinner in the ALS group than in the control group in bilateral head-face-bulbar and upper-limb areas (P<0.05). The cortical thickness of the global UMN positive group was significantly thinner than that of control groups in bilateral head-face-bulbar and upper-limb areas (P<0.05). The cortical thickness of the UMN positive group in the corresponding region was significantly thinner than that of control groups in bilateral head-face-bulbar and upper-limb areas (P<0.05). 【Conclusion】 The thinning of the motor homunculus cortex can be used as an objective marker of UMN involvement in ALS patients in clinical practice.
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【Objective】 To investigate cortical thickness changes in the face-head region of the primary motor cortex (PMC) and its effect on survival in amyotrophy lateral sclerosis (ALS) patients. 【Methods】 A retrospective analysis was performed on 105 ALS patients who underwent head MRI scan at the same time. The A4hf (face-head) region of PMC was used as the region of interest (ROI). According to clinical symptoms, patients were divided into two groups: bulbar involvement and non-bulbar involvement. The differences of clinical features and cortical thickness in ROI were analyzed. According to the symptoms of bulbar palsy, physical examination of nervous system and EMG of tongue muscle, the patients with bulbar palsy were divided into lower motor neuron (LMN), upper motor neuron (UMN) and LMN+UMN groups. The differences of bulbar subgroup score and ROI of cortical thickness were analyzed. Age at onset, body mass index, delayed time of diagnosis, bulbar subgroup score, and ROI cortical thickness were included in survival analysis. 【Results】 ① The ROI cortical thickness was significantly lower in bulbar involvement group than non-bulbar involvement group (-0.198±0.87 vs. 0.235±0.95, P=0.017). ② There were no significant differences in the bulbar subgroup scores or cortical thickness of ROI between LMN, UMN and LMN+UMN groups (P>0.05). ③ Survival analysis showed age of onset (HR=3.296, 95% CI:1.63-6.664, P=0.001), delayed time of diagnosis (HR=0.361, 95% CI:0.184-0.705, P=0.003), bulbar subgroup score (HR 0.389, 95% CI:0.174-0.868, P=0.021), and ZRE_ROI cortical thickness (HR=2.309, 95% CI:1.046-5.096, P=0.038) were independent influencing factors of ALS survival. 【Conclusion】 Cortical thickness in A4hf (face-head) region can more objectively reflect UMN signs of region bulbar. In addition to age of onset and delayed time of diagnosis, bulbar subgroup score and cortical thickness of face-head region are also independent influencing factors, and cortical thinning in face-head region is a protective factor for survival of ALS patients.
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【Objective】 To explore the factors affecting Babinski sign in amyotrophic lateral sclerosis (ALS). 【Methods】 We enrolled 262 patients diagnosed with ALS with adequate data in Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University from 2015 to 2020. The relationship between the clinical characteristics of patients with positive and negative Babinski sign was analyzed for both sides, respectively. Furthermore, for patients with left or right lower limb weakness complaint, the relationship between Babinski sign and the lower limb involvement characteristics was analyzed. 【Results】 Positive Babinski sign was positively correlated with higher diagnostic category (left correlation coefficient 0.297, P<0.001; right correlation coefficient 0.292, P<0.001). Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) score was lower in patients with positive Babinski sign (left P=0.001, right P=0.001); the proportion of complaints of ipsilateral lower limb weakness was higher (left P=0.008, right P=0.038); the positive rate of ipsilateral upper limb Hoffmann sign was higher (left P=0.004, right P=0.002). In patients with complaints of lower limb weakness, positive Babinski sign was positively correlated with better foot dorsiflexor muscle strength (left correlation coefficient 0.207, P=0.021; right correlation coefficient 0.264, P=0.003), and the proportion of ipsilateral tibialis anterior atrophy was lower in positive Babinski sign group (left P<0.001, right P=0.008); the ratio of ipsilateral common peroneal nerve compound muscle action potential (CMAP)/tibial nerve CMAP was different in positive Babinski sign and negative groups (left P=0.008, right P=0.015), which were positively correlated (left correlation coefficient 0.246, P=0.007; right correlation coefficient 0.223, P=0.015). 【Conclusion】 Patients with positive Babinski sign usually have a higher diagnostic category and more extensive clinical involvement. In ALS patients with complaints of lower limb weakness, Babinski sign is more likely to be elicited when the degree of weakness and atrophy of the anterior calf muscles is relatively low.
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AIM: To analyze the current status, hotspots and trends of studies on the treatments of diabetic retinopathy.METHODS: Relevant literatures on diabetic retinopathy in Chinese National Knowledge Infrastructure(CNKI)and Web of Science core collection database were retrieved from creation to June 15, 2023, and CiteSpace 6.2.R2 and VOSviewer were used to conduct visualized analysis with the country/issuing institution, research author and keywords.RESULTS: A total of 5 919 Chinese literatures and 11 475 English literatures were included. The top three countries with global publications are the United States, China and the United Kingdom, respectively. The top three institutions for issuing articles at abroad are Harvard Medical School, Harvard University and Johns Hopkins University, while the top three institutions for issuing articles in China are the Eye Hospital of China Academy of Chinese Medical Science, Hunan University of Chinese Medicine, and Zhongshan Ophthalmic Center of Sun Yat-sen University. The research results of high-frequency keywords in both Chinese and English show that the laser photocoagulation, vitrectomy, traditional Chinese medicine therapy, vascular endothelial growth factor and ranibizumab are research hotspots.CONCLUSIONS: In recent years, the research hotspots of diabetic retinopathy mainly focus on surgery, vascular protective agents, traditional Chinese medicine therapy, anti-vascular endothelial growth factor, etc., and the research trend mainly focuses on anti-vascular endothelial growth factor drugs.
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Abstract Objective: To investigate the clinical features of patients with definite vestibular migraine (dVM). Methods: A total of 91 patients with vestibular symptoms accompanied by migraines/migrainelike symptoms were enrolled and diagnosed according to the criteria of the Bárány Society and the International Headache Society. Baseline data were collected. Videonystagmography and immune-related laboratory tests were performed. Results: Among the 91 patients, 62 (68.1%) had dVM (11 men, 51 women). Among dVM patients, migraine occurred earlier than vestibular symptoms in 42 (67.7%) patients. Spontaneous vertigo occurred in 41 (66.1%) patients. Induced vertigo occurred in 21 (33.9%) patients. Motion sickness occurred in 33 (53.2%) patients. Central oculomotor dysfunction was observed in 11 (17.7%) patients. Caloric test revealed unilateral horizontal semicircular canal dysfunction in 12 (19.4%) patients. Severe intolerance during the test occurred in 44 (71.0%) patients with dVM. 12 (19.4%) patients showed abnormal immune-related indicators. Conclusion: dVM is more common in women. The onset of migraine precedes that of vestibular symptoms, which are often accompanied by photophobia and phonophobia. Motion sickness and severe caloric test intolerance can contribute to the diagnosis of dVM. Immunological indicators are abnormal in some patients with dVM, dVM may be secondary or an accompanying disorder, but the causal relationship needs further investigation. Level of evidence: IV.
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Objective:To investigate the effect of alprostadil combined with metformin in the treatment of diabetic nephropathy.Methods:50 cases of diabetic nephropathy patients were enrolled and then divided equally into the observation group and the control group. The patients in the control group were treated with conventional therapy and metformin, and the patients in the observation group were treated with alprostadil on the basis of the treatment of the control group. Compare the glycemic index, lipid index, renal function index, inflammatory response index, and oxidative stress response index of the two groups of patients before and after the 4-week treatment. The ratio of the number of effective cases (significant + effective) to the total number of cases, i.e., the total effective rate, was used to characterize the treatment effect.Results:The total effective rate in the observation group was higher than that in the control group (88.00% vs. 60.00%, P<0.05). After the 4-week treatment, no adverse effects occurred in either group. Compared with the control group, patients in the observation group had higher fasting blood glucose (FBG), glycosylated hemoglobin(HbA1c), mean blood glucose(MBG), blood glucose fluctuation rate(BGFR), standard deviation of blood glucose(SDBG), triglyceride(TC), total cholesterol(TG), high-density lipoprotein(HDL), low-density lipoprotein(LDL), serum creatinine(Scr), urinary microalbumin(UmALB), glomerular filtration rate(eGFR), albumin/creatinine ratio(ACR), cyclic adenosine monophosphate(cAMP), renin, protein kinase(PKA), epinephrine (E), angiotensin-converting enzyme inhibitor Ⅱ(ACEI Ⅱ), and norepinephrine(NE) were improved(all P<0.05). Conclusions:The effect of alprostadil combined with metformin in the treatment of diabetic nephropathy is accurate, safe, and reliable.
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Objective:To explore the effect of simulation teaching combined with case-based learning (CBL) on the practice of thoracic surgery nursing students.Methods:Cluster sampling method was adopted to select 30 practice nurses of the thoracic surgery department of 2019 as the control group, and traditional teaching was adopted. Another 30 thoracic surgery practice nurses of 2020 were selected as the research group, and simulation teaching combined with CBL was adopted. After the training, the two groups of practice nurses were assessed on theory and basic skills, and the nurses' recognition of teaching was assessed through questionnaire surveys. SPSS 22.0 was used for t test and chi-square test. Results:After the training of practical nurses, the research group had better performances of theoretical and basic skills tests than the control group, with significant differences ( P<0.001). The practice nurses of the research group did significantly better than those of the control group in such 8 dimensions as improving basic nursing skills, improving autonomous learning ability, improving the clinical thinking ability, enhancing our emergency response ability, improving the ability of theory combined with practice, improving training interest in learning, training team cooperation ability, cultivating the ability of doctor-patient communication and so on ( P<0.05). Conclusion:The combination of simulation teaching and CBL applied in the practice of thoracic surgery nursing students can improve the proficiency of nurses' nursing skills and improve the quality of clinical teaching.
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Objective To evaluate the performance of micro-flow imaging(MFI)in the differential diagnosis of benign and malignant thyroid nodules. Methods Totally 50 patients with thyroid nodules examined by conventional ultrasound,MFI,and contrast-enhanced ultrasound and confirmed by histological or cytological pathology in the First Medical Center of Chinese PLA General Hospital from May to December in 2020 were enrolled in the study.The clinical data and ultrasound images were retrospectively analyzed.A binary logistic regression model was established to evaluate the performance of the model in predicting benign and malignant thyroid nodules. Results Logistic regression showed that composition and "S-W-C" sign were independent risk factors for predicting malignant thyroid nodule.The sensitivity,specificity,and Youden index of the logistic regression model were 73.33%,80.00%,and 0.53,respectively,and the area under receiver operating characteristic curve was 0.799(95%CI=0.662-0.899). Conclusion MFI facilitates the differential diagnosis of benign and malignant thyroid nodules and has the potential to be applied in the future.
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Humans , Diagnosis, Differential , ROC Curve , Retrospective Studies , Thyroid Nodule/diagnostic imaging , Ultrasonography/methodsABSTRACT
Background/Aims@#Angiogenesis is essential for the outgrowth and metastasis of tumors. The structure and characteristics of tumor vasculature differ from those of normal vessels. We compared the characteristics of differentially expressed genes in endothelial cells (ECs) isolated from gastric and normal cells. @*Methods@#Previously, we had isolated pure tumor ECs (TECs) and normal ECs (NECs) from advanced gastric cancer (AGC) lesions and normal mucosal tissues, respectively. Using the oligomer chip platform of the Affymetrix GeneChip technology, genes that were expressed more than three-fold with a significance of p≤0.001 were measured. The intercellular adhesion molecule 1 (ICAM-1) was found to be overexpressed in the TECs compared to the normal gastric ECs. In this study, the upregulation of ICAM-1 was confirmed in cultured TECs by immunofluorescence. @*Results@#The expression of ICAM-1 was upregulated in the ECs, as well as in the stromal and immune cells, in early human gastric preneoplastic and hepatic fibrotic tissues. Upregulation of ICAM-1 was observed in the TECs, immune cells, and cancer epithelial cells in AGC and hepatocellular carcinoma (HCC). These results suggest that increased ICAM-1 expression in the ECs of the tissue microenvironment progressively contributes to the recruitment of immune cells to promote inflammation, leading to fibrosis and tumorigenesis. @*Conclusions@#Therefore, upregulated ICAM-1 in the tissues in premalignant gastric diseases or hepatic fibrosis and their malignant cancers could be a promising target for disease prevention and treatment.
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To address the issue of weight gain and abnormal lipid metabolism caused by clozapine and olanzapine administration in patients with schizophrenia， a qualitative and systematic review was carried out， thus providing references for clinical treatment and future research. This review embraces the aspects of pharmacotherapy， traditional Chinese medicine treatment and so on.
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@#Bonding of brackets to dental fluorosis has always been a difficult problem for clinicians. At present, clinical research has adopted several methods to facilitate bracket bonding, including prolonging etching time, enamel microabrasion, enamel ground, using adhesion promoter and laser etching. Prolonging etching time is suitable for mild-to-moderate dental fluorosis with easy chair-side operation; however, over-etching may cause severe tooth damage. Microabrasion can be applied to mild dental fluorosis while removing pigment deposition simultaneously; however, rubber dam protection is needed. Enamel ground can improve the bond strength to all kinds of dental fluorosis at the price of removing a relatively large amount of superficial enamel. Adhesion promoters might improve the bond strength of moderate to severe dental fluorosis; however, the current results conflict with one another. This needs further verification using larger-sample clinical trials. Laser etching has no effect on improving bond strength; however, it can remove pigment without destroying tooth enamel, which is worth further modification and enhancement.
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Objective:To analyze clinical characteristics of cutaneous delayed-type hypersensitivity caused by injection of equine tetanus antitoxin (TAT) or equine anti-tetanus immunoglobulin F (ab′) 2. Methods:Clinical data were collected from 181 outpatients or inpatients with cutaneous delayed-type hypersensitivity caused by injection of equine TAT or anti-tetanus immunoglobulin from 2008 to 2020, and retrospectively analyzed.Results:Before the injection of equine TAT or anti-tetanus immunoglobulin, skin test was negative in 171 (94.47%) of the 181 patients, and the 10 (5.53%) patients with positive skin test responses received desensitization injection. Among the 181 patients, there were 118 males and 63 females aged from 11 to 68 years, with the disease duration of 1 to 7 days and alatency period of 4 to 14 days. There was no significant difference in the clinical manifestations between the patients receiving injection of TAT (130 cases) and those receiving injection of equine anti-tetanus immunoglobulin (51 cases) . Urticaria-like rashes were the main clinical manifestation, and infiltrative erythema occurred at the injection site in 12 patients, of whom 10 developed generalized urticaria all over the body. Of the 181 patients, 163 (90.06%) presented with generalized skin rashes, and 56 (30.94%) had systemic symptoms such as chest tightness, fever, etc, of whom 15 (26.79%) had a history of allergies and 6 with severe symptoms had no history of allergies. Thirty-four (18.78%) patients had single or multiple laboratory abnormalities, such as increased white blood cell counts, elevated C-reactive protein level and urinary glucose, and presence of occult blood in urine. All cases responded well to the treatment with antihistamines and glucocorticoids. The treatment duration ranged from 3 to 10 days, and the outcome was good.Conclusion:TAT-or anti-tetanus immunoglobulin-induced cutaneous delayed-type hypersensitivity may still occur in patients with a negative skin test or after desensitization treatment, and mainly manifests as urticaria-like rashes.
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BACKGROUND@#Fetal weight is an important parameter to ensure maternal and child safety. The purpose of this study was to use three-dimensional (3D) limb volume ultrasound combined with fetal abdominal circumference (AC) measurement to establish a model to predict fetal weight and evaluate its efficiency.@*METHODS@#A total of 211 participants with single pregnancy (28-42 weeks) were selected between September 2017 and December 2018 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University. The upper arm (AVol)/thigh volume (TVol) of fetuses was measured by the 3D limb volume technique. Fetal AC was measured by two-dimensional ultrasound. Nine cases were excluded due to incomplete information or the interval between examination and delivery >7 days. The enrolled 202 participants were divided into a model group (134 cases, 70%) and a verification group (68 cases, 30%) by mechanical sampling method. The linear relationship between limb volume and fetal weight was evaluated using Pearson Chi-squared test. The prediction model formula was established by multivariate regression with data from the model group. Accuracy of the model formula was evaluated with verification group data and compared with traditional formulas (Hadlock, Lee2009, and INTERGROWTH-21st) by paired t-test and residual analysis. Receiver operating characteristic curves were generated to predict macrosomia.@*RESULTS@#AC, AVol, and TVol were linearly related to fetal weight. Pearson correlation coefficient was 0.866, 0.862, and 0.910, respectively. The prediction model based on AVol/TVol and AC was established as follows: Y = -481.965 + 12.194TVol + 15.358AVol + 67.998AC, R2adj = 0.868. The scatter plot showed that when birth weight fluctuated by 5% (i.e., 95% to 105%), the difference between the predicted fetal weight by the model and the actual weight was small. A paired t-test showed that there was no significant difference between the predicted fetal weight and the actual birth weight (t = -1.015, P = 0.314). Moreover, the residual analysis showed that the model formula's prediction efficiency was better than the traditional formulas with a mean residual of 35,360.170. The combined model of AVol/TVol and AC was superior to the Lee2009 and INTERGROWTH-21st formulas in the diagnosis of macrosomia. Its predictive sensitivity and specificity were 87.5% and 91.7%, respectively.@*CONCLUSION@#Fetal weight prediction model established by semi-automatic 3D limb volume combined with AC is of high accuracy, sensitivity, and specificity. The prediction model formula shows higher predictive efficiency, especially for the diagnosis of macrosomia.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03002246; https://clinicaltrials.gov/ct2/show/NCT03002246?recrs=e&cond=fetal&draw=8&rank=67.
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Child , Female , Humans , Pregnancy , Birth Weight , Fetal Macrosomia , Fetal Weight , Prospective Studies , Thigh/diagnostic imaging , Ultrasonography, PrenatalABSTRACT
OBJECTIVE：To study the effects of couplet medicine of Rheum p almatum-Salvia miltiorrhiza on the contents of enterogenous urotoxin and intestinal barrier function in chronic renal failure （CRF）model rats. METHODS ：Totally 55 male Wistar rats were randomly divided into sham operation group （10 rats）and modeling group （45 rats）. In sham operation group ，the kidneys were isolated but not removed ；CRF model was reproduced by 5/6 nephrectomy in modeling group. After modeling （excluding 5 dead and non-modeling rats ），modeling rats were divided into model group （water），Niaoduqing granules group （2.5 g/kg），couplet medicine of R. palmatum -S. miltiorrhiza groups（6，3 g/kg，by crude drug ），with 10 rats in each group. Sham operation group and model group were given constant volume of water intragastrically. Administration groups were given relevant medicine intragastrically ，once a day ，for consecutive 12 weeks. After last administration ，the contents of creatinine （Scr）and urea nitrogen（BUN）in serum ，the content of urinary creatinine （Ucr） in urine were determined by automatic biochemical analyzer；creatinine clearance rate （Ccr）was calculated. The contents of enterogenous urotoxin [trimethylamine-N-oxide （TMAO），indoxyl sulfate （IS）and p-cresyl sulphate （PCS）] were determined by UPLC-ESI-MS/MS. Real-time RT-PCR and immunofluorescence assay were used to detect the mRNA and protein expression of Occludin and ZO-1 in the ileum tissue. HE staining and Masson staining were used to observe the pathologi cal changes of renal tissue. The ultrastructural changes of rat colon were observed by transmission electron microscope. RESULTS ：Compared with sham operation group ，serum contents of Scr，BUN，TMAO，PCS and IS were increased significantly in model group （P＜0.01），while urine content of Ucr ，Ccr，mRNA and protein expression of Occludin and ZO- 1 in ileum tissue were decreased significantly （P＜0.01）；renal glomerulosclerosis ， renal tubules dilation and inflammatory invasion and fibrosisin the interstitium were all found ；the intestinal epithelial barrier structure of colon tissue was severely damaged. Compared with model group ，serum contents of Scr ，BUN，TMAO，PCS and IS were decreased significantly in administration groups （P＜0.05 or P＜0.01）；the mRNA and protein expression of Occludin and ZO-1 in the ileum tissue were increased significantly （except for mRNA expression of ZO- 1 in R. palmatum -S. miltiorrhiza low-dose group （P＜0.05 or P＜0.01）；the infiltration of inflammatory cells in renal interstitium ，the degree of fibrosis and the damage of intestinal epithelial barrier structure in colon tissue were reduced. CONCLUSIONS ：Couplet medicine of R. palmatum -S. miltiorrhiza can effectively protect the residual renal function of CRF model rats ，the mechanism of which may be associated with reducing the serum contents of enterogenous urotoxin ，up-regulating mRNA and protein expresssion of Occludin and ZO- 1 in the ileum tissue so as to improve intestinal barrier function.
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Objective:To explore the influence of flipped classroom teaching mode on college students' attitudes towards psychological help-seeking.Methods:The small private online course and experiential teaching method were combined to teach the course of mental health. Before and after the course, the Attitudes toward Seeking Professional Psychological Help Scale (Hao Zhihong 2007 Revision) and the Self-Stigma of Seeking Professional Psychological Help Scale (Vogel et al.) were used to measure the professional help-seeking attitudes and self-stigma of 258 randomly selected subjects. SPSS 22.0 and paired sample t-test were used and related data were analyzed. Results:A total of 242 valid scales were collected. The teaching mode of flipped classroom reduced self-stigma ( t=2.067, P=0.040) and increased the willingness of professional psychological help-seeking among students ( t=2.483, P=0.015). Before the course, there was no significant difference between the high-input group and the low-input group in the attitudes of help-seeking ( t=0.515, P=0.607) and self-stigma ( t=0.432, P=0.666). After the course, the scores of help-seeking attitudes in the high-input group were significantly higher than those in the low-input group ( t=2.401, P=0.018), and the self-stigma scores in high-input group were significantly lower than those in low-input group ( t=2.185, P=0.031). Conclusion:The teaching mode of flipped classroom helps to reduce self-stigma evaluation and forms a more positive attitude towards seeking help. Attitudes changed significantly in those students who have higher commitment in knowledge learning, self-expression and self-reflection.
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Objective:To investigate clinical application of preoperative "second eye" ultrosound guided orientation in non-palpable breast lesions surgery.Methods:100 patients were involved in the present study, with 136 impalpable breast lesions. Patients were divided into treatment group and control group by using random number table method. Patients of the control group were operated according to the preoperative ultrasonic location alone, while lesions of patients from the treatment group were located not only by preoperative surface location, but also by the "second eye" ultrasonic examination performed by surgeons. Volume of resected specimen and the operation time and the average length of incision were observed and compared between the two groups.Results:All lesions were completely resected. The average operation time of the treatment and control groups was 20 minutes vs 28 minutes ( P<0.05) , the average volume of resected specimens was 3.0 ml vs 4.1 ml ( P<0.05) , and the average length of incision was 25 mm vs 30 mm ( P=0.21) . Conclusions:It is an accurate, safe and effective method to remove clinical non-palpable breast lesions by the "second eye" ultrasound operated immediately before the surgery. It can obviously shorten the operation time, precisely remove the specimen, and reduce damage to normal tissues. In clinical practice, breast ultrasonic characteristics are recommended to be mastered by surgeons so that it could be helpful to the surgery.
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China and Asean countries all have a history of usingtraditional medicine. With the establishment and development of asean economic zone, traditional medicine has been included in the key areas of economic and social cooperation between China and Asean Countries. We designed and constructed the China-Asean traditional medicine database for understanding and taking advantages of traditional medicine in Asean countries. Based on the principle of software engineering design, referred to the construction ideas, functional modules and construction methods of traditional Chinese medicine database, this paper designed and constructed China-Asean traditional Chinese medicine database, which has provided the basic information system for the exchange, cooperation and development. The database of and asean traditional medicine based on Internet is established, which provides basic data information service for the mutual exchange, cooperation and development of traditional medicine research. The "China-Asean traditional medicine database" has been token as the basic data platform for information centralization and sharing, and it lays a foundation for the construction of higher level knowledge base and intelligent application system to accumulate data in the field of traditional medicine.
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Objective: To investigate the clinical and electrophysiological characteristics of upper limb onset classic amyotrophic lateral sclerosis (ALS) and ALS variant flail-arm syndrome (FAS) so as to provide reference for differential diagnosis and prognosis. Methods: We recruited 120 upper limb onset classic ALS and 18 FAS patients from Neurology Department of The First Affiliated Hospital of Xi'an Jiaotong University between January 2013 and December 2018. The clinical and electrophysiological characteristics and survival were compared between the two groups. Results: Compared with those in upper limb onset classic ALS, FAS patients' diagnostic level was lower (P<0.001), diagnostic delay time was longer (15 mon vs. 11 mon; Z=-2.749, P=0.005), progression rate was slower (0.33 vs. 0.64; Z=-3.055, P=0.002), and time from the first region to the second was longer (33 mon vs. 8 mon; Z=-4.852, P<0.001). FAS patients were as likely to have single lateral upper limb onset as those with upper limb onset classic ALS, but the proportion of patients with bilateral upper limbs onset in FAS group was higher than that in the upper limb onset classic ALS group (33.3% vs. 8.3%; χ2=7.261, P=0.007), the proportion of proximal upper limb being more severely affected was higher in FAS group (55.6% vs. 18.3%; χ2=8.856, P=0.003). The proportion of FAS patients with high upper limb reflex or pathologic sign was lower (11.1% vs. 72.5%; χ2=25.759, P<0.001). Compared with upper limb onset classic ALS, FAS group's ratio of compound muscle action potential (CMAP)abductor pollicis brevis/CMAPabductor digiti minimi was higher, but without statistical significance; needle electrode electromyographic results were similar between the two groups. Survival time of FAS patients was longer than that of patients with upper limb onset classic ALS (53 mon vs. 22 mon; Z=-4.421, P<0.001), and FAS diagnosis itself was an independent prognostic factor of lower death risk compared with the diagnosis of upper limb onset classic ALS (HR=0.174, 95% CI: 0.061-0.496, P=0.001). Conclusion: Although natural histories of FAS and upper limb onset classic ALS are different, their EMG performance is similar. Characteristics including bilateral arms onset, proximal symptoms being severer than distal ones, lower motor neuron findings being more prominent have some implications for diagnosis of FAS.