Intervention effect and mechanism of Hippophae rhamnoides oil on glucocorticoid resistance in superantigen-induced atopic dermatitis mice / 中国药房

OBJECTIVE To study the intervention effect of Hippophae rhamnoides oil on glucocorticoid resistance in superantigen-induced atopic dermatitis （AD） mice，and to explore the mechanism of action. METHODS Fifty mice were randomly divided into 5 groups，i.e. normal control group （group A），model group （group B），dexamethasone intervention group （positive control，group C），H. rhamnoides oil intervention group （group D），dexamethasone+H. rhamnoides oil intervention group （group E），with 10 mice in each group. Except for group A，other groups were given 2，4-dinitrochlorobenzene+staphylococcal enterotoxin B to induce the AD mice model. Starting from the 7th day of the experiment，groups C，D and E were given dexamethasone （1.5 mg/kg） and/or H. rhamnoides oil （10 mL/kg） intragastrically，once a day，for 28 consecutive days. After the last medication，the pathomorphological changes of ear tissue were observed by 节作用。E-mail：57667478@qq.com HE staining； the serum levels of immunoglobulin E （IgE） and interleukin 4 （IL-4） were detected by enzyme-linked immunosorbent assay. Positive cell count of glucocorticoid receptor α （GRα） and GRβ in the ear tissue of mice was detected by tyramide signal amplification. The expressions of GRα protein，GRβ protein，and protein kinase B （AKT）/ribosomal protein S6 kinase 1，S6K1 （S6K1） signaling pathway-related proteins were determined by Western blot assay. RESULTS Compared with group B，the skin inflammation in the left ear of the mice was significantly reduced in groups C，D and E，the serum levels of IgE and IL-4 were decreased significantly in groups D and E （P＜ 0.05），while the number of GRα positive cells and GRα protein expression were increased significantly （P＜0.05）； the protein levels of G protein inhibitory subunit 1 （Gαi1），Gαi3，phosphorylated S6K1 （p-S6K1） and phosphorylated AKT （p-AKT） were decreased significantly （P＜0.05）； the number of GRβ positive cells and protein expression of GRβ was decreased significantly in group E（P＜0.05）. Compared with group C，the skin inflammation in the left ear of the mice was almost clear away in group E，the serum levels of IgE and IL-4 were decreased significantly （P＜0.05）； the number of GRα positive cells and GRα protein expression were increased significantly in groups D and E （P＜0.05）； the protein levels of GRβ，Gαi1，p-S6K1 and p-AKT were all decreased significantly in groups D and E（P＜0.05）； and protein level of Gαi3 was decreased significantly in group E （P＜0.05）. CONCLUSIONS H. rhamnoides oil has an intervention effect on superantigen-induced glucocorticoid resistance of AD mice，which may be exerted by inhibition of the Gαi1/3-induced AKT/S6K1 signaling pathway.

Effects of Wenyang jieyu decoction on PI3K/Akt signaling pathway and neurotransmitters in kidney-yang deficiency depressed rats / 中国药房

OBJECTIVE To investigate the effects of Wenyang jieyu decoction on phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway and neurotransmitters in rats with kidney-yang deficiency depression. METHODS The SD rats were divided into blank group， model group， fluoxetine group （positive control of western medicine， 4.17 mg/kg）， Xiaoyao powder group （positive control of TCM， 1.88 g/kg） and Wenyang jieyu decoction low-dose， medium-dose and high-dose groups （1.25， 2.50， 5.00 g/kg）， with 15 rats in each group. Except for blank group， the other groups were treated with corticosterone 20 mg/kg subcutaneously to induce kidney-yang deficiency depressed model， meanwhile the mice were given relevant medicine intragastrically， once a day， for 28 consecutive days. The general conditions of rats were observed. The sucrose preference rate and the static time of forced swimming were detected， and organ indexes of rats were calculated. The levels/contents of neurotransmitters in serum were detected， the expressions of PI3K/Akt pathway-related proteins in hippocampus were detected， and the number of dendritic spines was determined. RESULTS Compared with blank group， model group suffered from the symptoms such as hair loss， fear of cold， curling up； sucrose preference rate， indexes of adrenal gland， thymus gland and spleen，serum levels of cyclic adenosine phosphate （cAMP）， brain-derived neurotrophic factor and gamma-aminobutyric acid， the ratio of cAMP to cyclic guanosine monophosphate， the contents of norepinephrine， dopamine and 5-hydroxy-tryptamine， the expressions of PI3K， Akt， mammalian target of rapamycin， and the number of dendritic spines in the hippocampus were significantly decreased （P＜0.01）. The time of immobility， level of glutamic acid and protein expression of glycogen synthetase kinase-3β were prolonged and increased （P＜0.01）. Compared with model group， depression symptoms of rats in each administration group were improved， and the above indexes were mostly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS Wenyang jieyu decoction can improve depression-like behavior and the deficiency of kidney-yang， regulate the secretion of neurotransmitters， and activate PI3K/Akt signaling pathway， thus playing a role in protecting hippocampal neurons.

New di-spirocyclic labdane diterpenoids from the aerial parts of Leonurus japonicus / 中国天然药物

Phytochemical investigation on the ethanol extract of a well-known medicinal herb Leonurus japonicus, led to the separation of 18 labdane type diterpenoids (1-18). Through comprehensive spectroscopic analyses and quantum chemical calculations, these compounds were structurally characterized as six new interesting 5,5,5-di-spirocyclic ones (1-6), two new (7 and 8) and six known (13-18) interesting 6,5,5-di-spirocyclic ones, a new rare 14,15-dinor derivative (9), and three new ones incorporating a γ-lactone unit (10-12). An in vitro neuroprotective assay in RSC96 cells revealed that compounds 7 and 12 exhibited neuroprotective activity in a concentration-dependent way, comparable to the reference drug N-acetylcysteine.

Interaction between microplastics and microorganisms in soil environment: a review / 生物工程学报

As a widespread pollutant in the environment, research on microplastics have attracted much attention. This review systematically analyzed the interaction between microplastics and soil microorganisms based on existing literatures. Microplastics can change the structure and diversity of soil microbial communities directly or indirectly. The magnitude of these effects depends on the type, dose and shape of microplastics. Meanwhile, soil microorganisms can adapt to the changes caused by microplastics through forming surface biofilm and selecting population. This review also summarized the biodegradation mechanism of microplastics, and explored the factors affecting this process. Microorganisms will firstly colonize the surface of microplastics, and then secrete a variety of extracellular enzymes to function at specific sites, converting polymers into lower polymers or monomers. Finally, the depolymerized small molecules enter the cell for further catabolism. The factors affecting this degradation process are not only the physical and chemical properties of the microplastics, such as molecular weight, density and crystallinity, but also some biological and abiotic factors that affect the growth and metabolism of related microorganisms and the enzymatic activities. Future studies should focus on the connection with the actual environment, and develop new technologies of microplastics biodegradation to solve the problem of microplastic pollution.

Si Junzitang Regulates NKG2A Expression to Improve Anti-colon Cancer Function of NK Cells / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Si Junzitang in regulating the expression of NKG2A to affect the anti-colon cancer function of natural killer （NK） cells. MethodNK cells isolated from healthy honors were cultured and used to construct the three incubation models of NK cells， human colon cancer HCT116 cells， and NK cells + HCT116 cells （co-incubation）. real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was conducted to determine the mRNA levels of natural killer group 2 member A （NKG2A） and interleukin （IL）-15 in NK cells， as well as the mRNA level of histocompatibility leucocyte antigen E （HLA-E） in HCT116 cells. The secretion of IL-15 was detected by enzyme-linked immunosorbent assay （ELISA）. Methyl thiazolyl tetrazolium （MTT） assay was employed to determine the applicable concentration of IL-15 and test the effects of Si Junzitang and IL-15 on the activities of NK cells and the HCT116 cells in the co-incubation model. The effects of Si Junzitang and IL-15 on the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells were detected by Real-time PCR. Monalizumab （M， anti-NKG2A mab） was used to block the NKG2A-HLA-E pathway in co-incubation model， and then the proliferation of HCT116 cells was detected by MTT assay. ResultThe interaction of NK cells and HCT116 cells up-regulated the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells （P<0.05）， as well as the expression level and secretion of IL-15 （P<0.05）. Compared with the blank group， Si Junzitang and Si Junzitang + IL-15 promoted the proliferation and improved the anti-colon cancer function of NK cells （P<0.01）. Furthermore， they down-regulated the mRNA levels of NKG2A in NK cells and HLA-E in the HCT116 cells co-incubated with NK cells （P<0.01）. M and IL-15 + M inhibited the proliferation of HCT116 cells compared with the groups without M （P<0.01）. ConclusionThe interaction of NK cells and HCT116 cells can induce activation of NKG2A-HLA-E pathway to impair NK cell function. Si Junzitang can inhibit the activation of NKG2A-HLA-E pathway to restore the anti-colon cancer function of NK cells.

Effect of music therapy on depression and anxiety in patients with maintenance hemodialysis: a randomized controlled study / 中华肾脏病杂志

Objective:To investigate the effect of music therapy on depression and anxiety status in maintenance hemodialysis (MHD) patients.Methods:The study was a single-center, open, and randomized controlled trial. The patients with regular hemodialysis of more than 3 months and the Beck depression inventory (BDI) scores ≥10 in China Rehabilitation Research Center from March 1 to April 24, 2021 were selected. Random envelope method was used to divide the enrolled patients into music group and control group. The music therapist selected the treatment music and established the preset repertoire library in the music therapy programs, and the total duration of music was about 2 hours. The music group received listening music therapy of 1.0 to 1.5 hours 3 times a week during routine hemodialysis treatment, while the control group only received routine hemodialysis treatment. All the enrolled patients completed treatment of 8 weeks. The BDI and state-trait anxiety inventory (STAI) were used to assess the psychological status of MHD patients before and after treatment.Results:A total of 64 MHD patients were enrolled, aged (59.19±11.61) years old, among whom 38 patients (59.38%) were males. There were 32 patients in the music group and 32 patients in the control group. BDI scores [2 weeks (9.81±6.25) scores, 8 weeks (8.30±8.49) scores, F=49.75, P<0.001] and STAI scores [2 weeks (49.30±7.27) scores, 8 weeks (47.07±7.39) scores, F=13.09, P<0.001] in the music group decreased significantly after 2 weeks of treatment and remained stable for 8 weeks. After treatment, the BDI scores in the music group were significantly lower than those in the control group [2 weeks (9.81±6.25) scores vs (14.13±7.33) scores, t=-2.53, P=0.014; 8 weeks (8.30±8.49) scores vs (12.56±5.67) scores, t=-2.34, P=0.023], and STAI scores in the music group were significantly lower than those in the control group [2 weeks (49.30±7.27) scores vs (54.00±8.36) scores, t=-2.06, P=0.043; 8 weeks (47.07±7.39) scores vs (51.34±8.87) scores, t=-2.06, P=0.044]. Conclusion:Music therapy can improve depression and anxiety of MHD patients quickly and effectively.

Morphological characteristics of lung tissue in two cases with critical corona virus disease 2019 / 中华传染病杂志

Objective:To observe the morphological characteristics of lungs in patients with critical corona virus disease 2019 (COVID-19), and to analyze the clinical-pathological relationship.Methods:Two critical patients with COVID-19 who died in Beijing You′an Hospital, Capital Medical University on February 13 and 14, 2020, respectively, were examined by bilateral lungs biopsy. The obtained samples were dehydrated, paraffin embedded, sectioned, stained with hematoxylin-eosin as routine methods, and then observed under light microscope.Results:The pulmonary morphology changes of patients with COVID-19 showed diffuse alveolar damage. Case one was an elderly patient with underlying diseases and her lesions were mainly exudation and hyaline membrane formation, which showed an acute exudation stage of diffuse alveolar damage. Case two was a patient without underlying diseases and his pathological changes were diffuse inflammatory cell infiltration, extensive fibrosis of alveolar wall, filling of necrotizing inflammatory cellulosic exudate in alveolar airspace, extensive destruction of alveoli and pulmonary consolidation, which was characterized by organized stage of diffuse alveolar damage complicated with bacterial pneumonia. The injury of paracronchial submucosal gland was not observed in the two patients.Conclusions:Diffused alveolar damage is the main pathological feature of critical COVID-19. Diffused alveolar damage can induce or aggravate the underlying diseases of elderly patients in the early stage. Extensive destruction of alveoli, pulmonary consolidation and secondary infection are the main causes of respiratory failure in the late stage.

The dynamic change of incidence and its influence on the quality of life in patients with minor post-stroke apathy / 中华行为医学与脑科学杂志

Objective:To explore the incidence and dynamic change of apathy after minor stroke and its influence on the quality of life.Methods:One hundred and six patients with minor stroke(NIHSS≤3) were selected as the research group, one hundred and six cases with healthy physical examination were selected as control group.The apathy evaluation scale, clinician version(AES-C) scale was used to evaluate the degree of apathy after minor stroke, then the patients were divided into minor post-stroke apathy group(mPSA group) and non post-stroke apathy group(NPSA group). At 1, 3, 6, 9 and 12 months after onset, the follow-up visits were carried out and AES-C, modified Barthel index(MBI), modified Rankin scale(mRS) and stroke-specific quality of life scale(SS-QOL) were evaluated.The incidence of minor post-stroke apathy and its dynamic changes over time were analyzed, and the differences of related scales scores between the mPSA group and the NPSA group were compared.Results:The incidence of apathy in research group(35.1%) was higher than that of the control group(7.5%) ( P<0.05). The scores of MRS in the mPSA group at 1 month(1.06±0.86), 3 months(1.18±0.97), 6 months (1.09±0.85), 9 months(1.11±0.71), 12 months(1.11±0.72) after stroke were not significantly different from those in the NPSA group at 1 month(1.00±0.89), 3 months(0.95±0.83), 6 months (0.97±0.87), 9 months (1.00±0.80), 12 months(1.03±0.79) (all P>0.05). The scores of MBI in the mPSA group at 1 month (92.42±5.75), 3 months(91.32±5.81), 6 months (91.71±5.14), 9 months(91.67±4.78), 12 months (91.14±5.01) after stroke were not significantly different from those in the NPSA group at 1 month (91.97±5.79), 3 months(92.42±5.64), 6 months(92.29±5.67), 9 months(92.07±5.46), 12 months(92.12±5.35) (all P>0.05). The scores of SS-QOL in the mPSA group at 1 month (135.09±26.88), 3 months (132.71±24.91), 6 months (134.31±26.63), 9 months(135.89±24.86), 12 months (138.77±27.83) after stroke were lower than those in the NPSA group at 1 month (183.79±24.80), 3 months(183.77±24.18), 6 months (181.80±26.62), 9 months(179.86±28.92), 12 months (179.98±29.13) (all P<0.05). There were no significant differences in the incidence of mPSA at each time point of follow-up( P>0.05). Conclusion:The incidence of apathy after minor stroke is significantly higher than that of the control group, and it remains relatively stable in the first year and seriously affect the quality of patients' life.

Correlation study between T lymphocyte-related cytokines and the outcome of chronic immune thrombocytopenia in children / 中华实用儿科临床杂志

Objective:To detect the levels of cytokines in peripheral blood of patients with chronic immune thrombocytopenia (ITP) and analyze their significance in the clinical prognosis of children with chronic ITP.Methods:Thirty patients with chronic ITP who were treated in the Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical Univercity from October 2015 to October 2018 were followed and enrolled in the experimental group and 40 healthy children in the same hospital were enrolled in the healthy control group.The levels of interleukin-2(IL-2), interferon-γ(IFN-γ), tumor necrosis factor(TNF), interleukin-4(IL-4), interleukin-6(IL-6), interleukin-10(IL-10) and interleukin-17A(IL-17A) in the experimental group and the healthy control group were detected by flow cytometry (CBA). The relationship between cytokines and prognosis of children with chronic ITP were analyzed.Results:Thirty patients with ITP were enrolled. The expressions of IL-2 and IL-17A in the experimental group before treatment were (7.86±3.90) ng/L and (10.45±12.35) ng/L, while those of IL-2 and IL-17A in the healthy control group were (3.11±2.41) ng/L and (2.97±7.04) ng/L. The levels of IL-2 and IL-17A in the experimental group were significantly higher than those in the healthy control group, and the differences were statistically significant ( t=-7.123, -5.582, all P<0.01). The expressions of IL-4 and IL-10 in the experimental group before treatment were (0.38±0.25) ng/L and (1.80±1.25) ng/L, while those of IL-4 and IL-10 in the healthy control group were (3.08±0.26) ng/L and (4.55±3.44) ng/L. The levels of IL-4 and IL-10 in the experimental group were significantly lower than those in the healthy control group, and the differences were statistically significant ( t=8.400, 5.653, all P<0.01). The expressions of IL-6, TNF and IFN-γ in the experimental group before treatment were (7.30±9.16) ng/L, (4.85±7.60) ng/L and (7.68±20.41) ng/L, while those of IL-6, TNF and IFN-γ in the healthy control group were (5.44±4.18) ng/L, (1.97±0.37) ng/L, (4.81±17.71) ng/L. There was no significant difference between the two groups ( P>0.05), and no significant difference in the levels of cytokines between the patients with chronic ITP before and 12 months after treatment ( P>0.05). Conclusions:The changes of T lymphocyte related cytokines are closely related to the pathogenesis and development of chronic ITP in children. There may be persistent immune dysfunction in children with chronic ITP. Dynamic monitoring of cytokines IL-2, IL-4, IL-10, IL-17A, especially IL-17A, is helpful to judge the prognosis of ITP in children, and may be of guiding significance in evaluating clinical prognosis.

Induction effect of DNCB on atopic dermatitis BALB/c mice and its mechanism / 吉林大学学报(医学版)

Objective: To induce the atopic dermatitis (AD) by 2, 4-dinitrobenzene (DNCB) in the BALB/c mice, and to explore the possible mechanism of DNCB as hapten to induce AD. Methods: A total of 12 BALB/c mice were randomly divided into control group (n = 6) and AD model group (n = 6). The dorsal skin of the mice in AD model group was sensitized by 1.0% DNCB at days 1, 4, and 7 and the back skin of the left ears were challenged by 0. 5% DNCB at days 14, 17, 19, 22, 24, 27, and 29. The mice in control group were given substrate solution with the same volume at the same time points. The inflammation scores of the skin tissue of the mice in two groups were evaluated, the appearance changes of the ear skin of the mice in two groups were observed, the pathomorphology of the skin tissue in left ear of the mice in two groups were observed by HE staining and toluidine blue staining, the epidermal thickness of the skin tissue at lesion site of the mice in two groups was measured, and the number of mast cells in the skin tissue at lesion site of the mice in two groups was counted; the expression levels of interleukin-4 (IL-4) in the skin tissue at lesion site of the mice in two groups was detected by immunohistochemistry staining, and the levels of serum IgE was detected by ELISA method. Results: The inflammation score of the mice in AD model group was higher that in control group (P < 0. 01). The skin tissue in left ear of the mice in AD model presented as redness swelling and hardening accompaning with abnormal scratching marks; the epidermal thickness, the number of mast cells, the expression level of IL-4 in skin tissue at lesion site and the level of serum IgE of the mice in AD model group were all increased compared with control group (P < 0. 05 or P < 0. 01). Conclusion: The AD mouse can be successfully induced by 1. 0% DNCB for sensitizing and 0. 5% DNCB for chllenging in the BALB/c mice, and its mechanism may be related with the increasing of IL-4 expression level in skin tissue and IgE level in serum.

Surgical selection and metastatic warning of splenic lymph node dissection in advanced gastric cancer radical surgery: a prospective, single-center, randomized controlled trial / 中华胃肠外科杂志

Objective@#To investigate the surgical options for splenic lymph node dissection in patients with advanced gastric cancer undergoing radical total gastrectomy, and to evaluate the sentinel effect of No. 4s lymph node on splenic lymph node metastasis.@*Methods@#A prospective, single-center, randomized and controlled study was carried out (Trial registration, No.NCT02980861). Enrollment criteria: (1) >18 years old and <65 years old; (2) gastric adenocarcinoma locating in the proximal or corpus; (3) preoperative clinical staging as cT2-4aN0-3M0; (4) D2 radical total gastrectomy feasible judged before operation; (5) physical ability score 0 to 1; (6) I to III of ASA classification. Pregnant or lactating women, patients with severe mental illness or previous history of upper abdominal surgery, those suffered from other malignant tumors in the past 5 years, or heart and lung system diseases judged to affect surgery before operation, those receiving preoperative chemotherapy, radiotherapy or targeted therapies, and distant metastases being found during surgery were excluded. According to above criteria, 222 patients at The First Medical Center of Chinese PLA General Hospital from December 2016 to December 2017 were enrolled prospectively and were randomly divided into the laparoscopic splenic hilar lymph node dissection group (laparoscopic group, n=114) and the open splenic hilar lymph node dissection group (open group, n=108). The result of rapid frozen immunohistochemistry of harvested No.4s lymph nodes was used to evaluate the sensitivity and specificity of sentinel effect on splenic hilar lymph node metastasis. The surgical parameters, postoperative recovery parameters, and complication rates were compared between the two groups.@*Results@#There were 80 males and 34 females in the lapascopic group with a mean age of (56.1±10.2) years, and 69 males and 39 females in the open group with a mean age of (58.4±10.9) years. There were no significant differences in baseline data between the two groups (all P>0.05). Total blood loss was less in the laparoscopic group [(96.3±82.4) ml vs. (116.6±101.9) ml, t=1.124, P<0.001], and the amount of bleeding from the splenic hilar lymph nodes dissected was also less than that in the open group [(25.3±17.8) ml vs. (59.5±36.4) ml, t=1.172, P<0.001]. However, the operation time, the time of splenic hilar lymph node, the number of lymph node dissected and number of splenic hilar lymph node dissected were not significantly different between the two groups (all P>0.05). As compared to the open group, the laparoscopic group had shorter time to the first flatus [(1.3±1.2) days vs. (1.6±1.5) days, t=1.665, P=0.021], shorter time to fluid diet [(4.6±1.4) days vs. (4.9 ± 1.6) days, t=1.436, P=0.007], shorter time to remove nasogastric tube [(3.9±2.6) days vs. (4.3±2.4) days, t=0.687, P<0.001] and shorter hospital stay [(10.3±6.6) days vs. (12.1±7.2) days, t=0.697, P<0.001]. Complication rate was 14.0% (16/114) and 12.0% (13/108) in the laparoscopic group and the open group, respectively, without significant difference (χ2=6.723, P=0.331). The sensitivity of the No. 4s lymph node for the prediction of splenic hilar lymph node metastasis reached 89.5%, and the specificity reached 99.6%.@*Conclusions@#Laparoscopic technique is safe and feasible in the treatment of splenic hilar lymph node dissection in advanced gastric cancer. The No.4s lymph node examination has good sentinel effect on predicting the metastasis of splenic hilar lymph nodes.

Comparison of the superiority of different TNM staging systems in Siewert III adenocarcinoma of esophagogastric junction / 中华胃肠外科杂志

OBJECTIVE@#To compare the prognostic value of TNM staging systems in the 7th edition and the 8th edition AJCC in Siewert III adenocarcinoma of esophagogastric junction (AEG).@*METHODS@#Data of 160 patients with Siewert III AEG who underwent radical surgery (R0) from January 2009 to January 2013 in PLA General Hospital were collected retrospectively. Exclusion standards:(1)preoperative neoadjuvant chemoradiotherapy;(2)with distant metastasis before or during operation;(3)palliative operation or R1/R2 resection;(4)pathological type as non-adenocarcinoma;(5)number of retrieved lymph nodes less than 16;(6)diagnosed with other malignant tumors concurrently or within 5 years after operation;(7)incomplete clinical or follow-up data. According to the above criteria, 160 patients were included in this study finally. All the patients underwent radical total or proximal gastrectomy by abdominal approach. D1 or D1+ lymph node dissection was performed in early patients and D2 in advanced patients. All the patients were re-staged by the gastric cancer TNM7 (G7), the gastric cancer TNM8 (G8) and the esophageal cancer TNM7(E7). Univariate analysis and Cox regression analysis were performed. Kappa value and Akaike's information criterion (AIC, the less AIC, the better prognosis) value were compared between different staging systems in agreement and predicting prognosis.@*RESULTS@#There were 128 males and 32 females(sex ratio 4:1), and the average age was (60.2±11.6) years and 17 patients with basic disease. Of all the patients, 133 cases (83.1%) underwent radical total gastrectomy and 27 cases (16.9%) underwent proximal gastrectomy. The median number of dissected lymph nodes were 31 and the median number of positive lymph nodes were 4. Multivariate analysis showed that the G7, G8, E7 staging systems were independent prognostic factors (HR=1.374, 1.407 and 1.305 respectively,all P<0.001). Stage migration between G7 and G8 were only observed in IIIA, IIIB and IIIC, and stage migration rate was 8.1% (13/160), and the agreement was very good (weighted Kappa 0.904, P<0.001). However, the difference between G8 and E7 was quite obvious, stage migration rate was 40.6%(65/160), and the agreement between G8 and E7 was not satisfied (weighted Kappa 0.536, P<0.001). AIC value was 811.4 in G8, 812.8 in G7 and 815.9 in E7, respectively.@*CONCLUSION@#Compared with G7 and E7 staging systems, the G8 staging system is superior in predicting the prognosis of patients with Siewert III AEG.

Exercise combined with fluoxetine medication can relieve post-stroke depression / 中华物理医学与康复杂志

Objective To observe the effect of exercise combined with fluoxetine medication on depression and the expression of BDNF and TrkB protein in the hippocampus and to explore possible mechanisms.Metbods Forty-eight male Wister rats were randomly divided into a sham operation group,a model group,a fluoxetine group and a combined treatment group,each of 10.A model of post-stroke depression was induced in all except the rats in the sham operation group through occlusion of the middle cerebral artery using the intraluminal tread method followed by imposing chronic but unpredictable stress.The model and sham operation groups were not given any training or medication.The fluoxetine group was treated with fluoxetine,while the combined treatment group received exercise training and the fluoxetine treatment at the same time for 28 days.After one,14 and 28 days the four groups were given the sucrose preference test,a forced swimming test and were weighed.Brain tissue was resected to detect the expression of BDNF and TrkB in the left hippocampus using western blotting.Results There were significant differences between the model group and the sham operation group in all measurements.After both 14 days and 28 days of treatment,the average immobility times in the fluoxetine and combined treatment groups was significantly shorter than that in the model group,while their sucrose preference,average body weight and the expression of BDNF and TrkB in the left hippocampus were all significantly higher.The same differences were observed between the combined group and the fluoxetine group.Conclusion Exercise combined with fluoxetine medication can relieve depression,at least in rats.

Effects of hand robot-assisted training on hemiplegic stroke patients' recovery of upper-limb function : A randomized and controlled trial / 中华物理医学与康复杂志

Objective To explore the effect of intensive upper limb therapy assisted by a hand robot on motor function after stroke and performance in the activities of daily living.Methods Thirty-two hemiplegic stroke survivors were randomly divided into a conventional rehabilitation group (group A,n =10),a robot-assisted therapy group (group B,n=10),and a robot-assisted intensive therapy group (group C,n=12).The three groups all received routine drug therapy and daily 40 min sessions of conventional rehabilitation training 5 days a week for 4 weeks.Those in groups B and C were additionally provided with 20 min of robot-assisted therapy or 40 min of more intensive robot-assisted intensive therapy respectively.Before and after the intervention,the 3 groups were assessed using the Fugl-Meyer assessment for the upper extremities (FMA-UE),the action research arm test (ARAT) and the modified Barthel Index (MBI).Results No significant differences were observed among the 3 groups in any of the measurements before the treatment.In each group the average FMA-UE,MBI and ARAT scores had increased significantly after four weeks of treatment.The improvements in the average FMA-UE and ARAT scores were more significant in group B than in group A,while the FMA,MBI and ARAT scores suggested a significantly greater improvement in group C than in group B.Conclusion Robot assistance can help to improve upper extremity motor function after a stroke.It also has an obvious effect on improving performance in the activities of daily living.

Magnetic resonance study on the binding ability between targeted neuropilin-1 probe and ectopic glioma in mice / 中华行为医学与脑科学杂志

Objective To detect the binding ability of the molecular probe of neuropilin-1( NRP-1) to mouse ectopic glioma by magnetic resonance imaging ( MRI) . Methods Glioma model mice were pre-pared by glioma tissue transplantation.Thirty tumor bearing mice were randomly selected for tissue anatomy(n=12) and other 18 mice were randomly divided into 3 groups:the control group ( group A) ,the probe con-trol group (group B) and the probe group (group C),which were given 20 μl saline,20 μl USPIO-PEG, 20μl USPIO-PEG-tLyP-1 through the tail vein of the mice respectively.And at 0h,6h,12h,24h after admin-istration,T2WI and T2MAPPING sequences were detected by MRI. Then the tumor bearing mice were killed immediately and the glioma tissue was used to detect the iron content by Prussian blue staining to detect the binding ability of the glioma tissue with the new molecular probe. The biological toxicity of the new molecular probe was detected by pathological staining. Results The expression of NRP-1 in glioma tissues was signifi-cantly higher than that in the liver,kidney and brain(P<0.05).The 24h relaxation time ((14.19±0.87)ms) of the glioma tissue in the C group was significantly lower than that in the B group ((25.94±0.77)ms) (P<0.05) ,and the blue staining particles in the C group were more than those in the B group(P<0.05) . Conclu-sion In the animal experiment,the molecular probe with NRP-1 as the target has obvious targeting effect and good biocompatibility,which provides a clinical basis of glioma for further clinical diagnosis.

Exploration on impacting factors for restricting two-way referral system from patient's perspective / 重庆医学

Objective To explore and discuss the factors for restricting the two-way referral system from the patient's perspective in order to promote the formation of hierarchical medical system in Changsha City.Methods The stratified random sampling method was adopted to divide the Chansha City into the 3 grades of high,middle and low according to the regional economical development situation,2 districts in one grade,including 6 districts.Then each district was redivided into high,middle and low grades according to the economic situation,2 basic medical institutions were selected from each grade.A total of 360 patients were randomly sampled for conducting the questionnaire investigation.The patients and doctors specially participating in the two-way referral conducted the deep interview.Results The patients choosing to primary hospital for first visit accounted for 60.9％.The awareness degree of patients to two-way referral system was 21.1％,and the two-way referral service satisfaction in the patients with two-way referral was 85.7 ％.The patients' will of transfer treatment from primary hospital to superior hospital in case of disease condition need was 82.9 ％.The patients' will for conducting rehabilitation treatment from superior hospital to primary hospital was 77.6 ％.Conclusion Few patients choose primary hospital for first visit.The signing rate of family contract services is low and awareness degree of two-way referral system is not high.

Knocking down fascin inhibits cervical cancer cell proliferation and tumorigenesis in nude mice / 南方医科大学学报

OBJECTIVE@#To study the effect of knocking down fascin on cervical cancer cell proliferation and tumorigenicity in nude mice.@*METHODS@#Cervical cancer CaSki cells were infected with a lentiviral vector carrying fascin siRNA or with a negative control lentivirus, and fascin mRNA and protein expressions in the cells were detected using qRT-PCR and Western blotting. MTT assay was used to determine the proliferation of CaSki cells with fascin knockdown. CaSki cells transfected with fascin siRNA or the control lentiviral vector and non-transfected CaSki cells were inoculated subcutaneously in nude mice, and the volume and weight of the transplanted tumor were measured; Western blotting was used to detect the expressions of proliferating cell nuclear antigen (PCNA), survivin, cyclin dependent kinase 4 (CDK4) and p21 proteins in the tumor xenograft.@*RESULTS@#Infection with the lentiviral vector carrying fascin siRNA, but not the negative control vector, caused significant reductions in the expression levels of fascin mRNA and protein in CaSki cells ( < 0.05). Fascin knockdown resulted in significantly reduced proliferation of CaSki cells ( < 0.05). The nude mice inoculated with CaSki cells with fascin knockdown showed reduced tumor volume and weight, lowered levels of PCNA, survivin and CDK4, and increased expression of p21 protein in the tumor xenograft compared with the control mice. The negative control lentivirus did not affect the proliferation or tumorigenicity of CaSki cells in nude mice or the expression levels of PCNA, survivin, CDK4 or p21 proteins in the xenografts.@*CONCLUSIONS@#Knocking down fascin can inhibit the growth and tumorigenicity of cervical cancer cells in nude mice.

Implementation status quo of contractual family doctor system based on hierarchical diagnosis and treatment in Changsha City / 重庆医学

Objective To investigate the implementation status quo of the contracted family doctor system in Wangcheng District of Changsha City. Methods Sixty-three health workers and 185 medical residents were selected from 6 township health centers in Wangcheng district which implementing the contracted family doctor system and performed the questionnaire survey on the implementation status quo of the contracted family doctor system and its influencing factors.. Implementation status of contracted family doctor system and its influencing factors were investigated by using questionnaires. Results The total satisfaction of the residents in Wangcheng District to township hospitals was 49.44%;the satisfaction differences to different institutions were analyzed,the results showed that the medical environment, service attitude and medical equipments had statistical difference among 6 township health center(P<0.05);Logistic regression analysis results showed that queuing time for consultation, medical price, service attitude, explain of disease state,technological level and medical effect were the main influence factors affecting the residents' satisfaction (P<0.05) ;the development prospects,distribution of workload and time, equity and work risk were the influence factors for the medical workers' satisfaction (P<0.05). Conclusion Many problems and influencing factors exist in the implementation process of the contracted family doctor system in Wangcheng District, which can be perfected in the aspects of the job responsibility of family doctors,performance assessment of family doctors and distribution of medical insurance reimbursement ratio.

CT and MRI features of sclerosed hemangioma of the liver / 中华放射学杂志

Objective To investigate CT and MRI features of hepatic sclerosed hemangioma (HSH).Methods CT and MRI findings were retrospectively reviewed in 20 cases of HSH,all of which were confirmed pathologically after hepatic surgery.Twenty patients underwent CT scan,4 patients underwent MRI.Meanwhile,the enhancement pattern and signal intensity were analyzed either.Results Twenty patients showed main part of tumor was hypo-attenuating on CT plain scanning,and 16 patients showed the central area of tumor was markedly more hypo-attenuating on CT plain scanning.After administration of intravenous contrast media,multifocal linear or small nodular enhancement in the peripheral area was seen during the arterial phase on 16 patients of HSH.Venous phases showed centripetal enhancement or spread around the nodules enhancement which continued to delayed phases with low density of no enhancement in the lesion area.Four patients showed no obvious enhancement on arterial phases and slight separation sample enhancement at the edge or inside of the lesions with a wide range of non enhancement areas on venous phase and delayed phase.Four patients were performed MRI examination,the lesions demonstrated hypointensity with a lower signal area on T1WI,hyperintensity with a higher signal intensity area on T2WI.The DWI sequence of b value were 0,150,800 s/mm2,all of which were obviously hypointensity.The edge of lesions showed small nodular enhancement on arterial phase,irregular concentric enhancement on venous phase and delayed phase,and there was no enhancement area with lower signal in the center of the lesion.Conclusions The enhancement pattern of HSH different from cavernous hemangioma,with a larger non enhancement area in the center of the lesions and similar to other hepatic masses with central scar,differential diagnosis dependence on CT and MRI dynamic enhanced scan.

Clinicopathologic characteristics and prognosis of gastric hepatoid adenocarcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics, diagnosis, treatment and prognosis of gastric hepatoid adenocarcinoma(HAS).</p><p><b>METHODS</b>Retrospective analysis of clinicopathological data of 24 cases with gastric HAS diagnosed by surgery and pathology in Chinese PLA General Hospital from January 2013 to May 2016 were carried out. All the patients underwent preoperative serum alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), endoscopy and imaging examination (CT or B-mode ultrasonography), and those with elevated AFP were excluded from liver cancer, cirrhosis, endodermal sinus tumor and other diseases. The follow-up ended in June 2016 or the death of the patient. The survival was from the operation to the death of the patient or the end of follow-up.</p><p><b>RESULTS</b>There were a total of 24 cases with gastic HAS, accounting for 1.03%(24/2 326) of the total number of patients with gastric cancer diagnosed at the same time in our center. There were 19 males and 5 females, the ratio of male to female was 3.8:1.0, the mean age of the patients was 55.9 (31 to 72) years, and 2 of them had liver metastasis. The first symptom in 50% (12/24) patients was epigastric pain, in 25%(6/24) was abdominal distension with vomiting, and the rest included dysphagia (12.5%, 3/24), hematemesis (8.3%, 2/24) and melena (4.2%, 1/24). Preoperative serum levels of AFP and CEA were elevated in 10 (41.7%) and 5 patients (20.8%) respectively. All the patients underwent surgical treatment, including 23 cases with D2 radical resection of gastric cancer and R0 resection, and the other of palliative gastrojejunostomy. Lesions of HAS located in gastric antrum in 11 cases (45.8%), in cardia in 7 cases (29.2%), and in gastric body in 6 cases (25%). Tumor maximum diameter of 10 cases was larger than 5 cm, and the average diameter was 5.7(1.0 to 12.0) cm. Postoperative pathological TNM staging: stage I(b was in 1 cases, stage II( in 7 cases, stage III( in 14 cases, stage IIII( in 2 cases; lymph node metastasis in stage N1-3 in 20 cases (83.3%). Poorly-differentiated tumors were found in 21 cases (87.5%), and no well-differentiated tumors were found. There were 11 cases (45.8%) with formation of intravascular tumor thrombi. In immunohistochemistry, AFP positive expression was found in 11 cases(45.8%). Seventeen HAS cases (70.8%, 17/24) received postoperative SOX(oxaliplatin + S-1) or XELOX (oxaliplatin + capecitabine) as adjuvant chemotherapy, 5 cases postoperative immune therapy, and 2 cases postoperative traditional Chinese medicine. All the patients were followed up for 0.7 to 42.0 months (median 8 months). A total of 9 patients died, of whom, 1 case underwent gastrojejunostomy because of liver and peritoneal metastasis before operation, and died 20 days after surgery; 4 cases died of multiple liver metastases after 1.5 to 12.0 months with survival of 3 to 18 months; 3 cases presented local recurrence after 2 to 17 months with survival of 6 to 22 months; 1 cases had peritoneal metastasis after 12 month with survival of 26 months.</p><p><b>CONCLUSIONS</b>HAS is a rare type of gastric cancer with poor prognosis. The diagnosis is mainly based on histopathology, and radical resection is the mainstay treatment.</p>