Clinical characteristics and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement / 中华神经科杂志

Objective:To investigate the clinical manifestations, imaging features and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement (PRES-SCI).Methods:The clinical data of 1 patient with PRES-SCI admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University in November 2021 were analyzed, and the data of 38 patients with PRES-SCI reported in domestic and foreign databases and this patient were collected for pooled analysis.Results:The main clinical manifestations of 39 PRES-SCI patients (including this patient) included headache (79.5%, 31/39), visual disturbance (79.5%, 31/39), vomiting (46.2%, 18/39), disturbance of consciousness (38.5%, 15/39), limb weakness (28.2%, 11/39) and seizure (23.1%, 9/39). There were up to 97.4% (38/39) of patients who had significantly elevated blood pressure. The imaging feature was long-segment spinal cord lesion involving central gray matter. Approximately 89.7% (35/39) of the spinal cord lesions originated from the junction of the medulla oblongata and the cervical spinal cord. The median number of abnormal spinal cord segments corresponding to the vertebral body was 9 (the shortest was 4 and the longest was the entire spinal cord). Thirty-eight patients had brain lesions, and the most frequently involved sites were medulla oblongata (82.1%, 32/39), occipital lobe (46.2%, 18/39), pons (43.6%, 17/39), parietal lobe (41.0%, 16/39), and cerebellum (38.5%, 15/39). Among 38 patients completing the follow-up, 31 patients (81.6%) were clinically recovered.Conclusions:Posterior reversible encephalopathy syndrome could involve the spinal cord. For patients with long-segment spinal cord lesions and significantly increased blood pressure or other risk factors, PRES-SCI should be considered. Timely identification and treatment could make most patients recovery.

LINC00926 promotes pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells by recruiting ELAVL1 / 南方医科大学学报

OBJECTIVE@#To investigate the regulatory role of the long non-coding RNA LINC00926 in pyroptosis of hypoxia-induced human umbilical vein vascular endothelial cells (HUVECs) and explore the molecular mechanism.@*METHODS@#HUVECs were transfected with a LINC00926-overexpressing plasmid (OE-LINC00926), a siRNA targeting ELAVL1, or both, followed by exposure to hypoxia (5% O2) or normoxia. The expression of LINC00926 and ELAVL1 in hypoxia-treated HUVECs was detected using real-time quantitative PCR (RT-qPCR) and Western blotting. Cell proliferation was detected using Cell Counting Kit-8 (CCK-8), and the levels of IL-1β in the cell cultures was determined with ELISA. The protein expression levels of pyroptosis-related proteins (caspase-1, cleaved caspase-1 and NLRP3) in the treated cells were analyzed using Western blotting, and the binding between LINC00926 and ELAVL1 was verified with RNA immunoprecipitation (RIP) assay.@*RESULTS@#Exposure to hypoxia obviously up-regulated the mRNA expression of LINC00926 and the protein expression of ELAVL1 in HUVECs, but did not affect the mRNA expression of ELAVL1. LINC00926 overexpression in the cells significantly inhibited cell proliferation, increased IL-1β level and enhanced the expressions of pyroptosis-related proteins (all P < 0.05). LINC00926 overexpression further up-regulated the protein expression of ELAVL1 in hypoxia-exposed HUVECs. The results of RIP assay confirmed the binding between LINC00926 and ELAVL1. ELAVL1 knockdown significantly decreased IL-1β level and the expressions of pyroptosis-related proteins in hypoxia-exposed HUVECs (P < 0.05), while LINC00926 overexpression partially reversed the effects of ELAVL1 knockdown.@*CONCLUSION@#LINC00926 promotes pyroptosis of hypoxia-induced HUVECs by recruiting ELAVL1.

Effect of Xinnao Shutong capsule and its active ingredients on damage of cerebral microvascular endothelial cell barrier integrity caused by oxygen glucose deprivation/reoxygenation and its mechanism / 中国药理学通报

Aim To investigate the effect of XNST and its monomeric components on the barrier structure and tight junction protein expression of brain microvascular endothelial cells damaged by oxygen glucose deprivation/reoxygenation (OGD/R) and the possible mechanism. Methods The mouse brain microvascular endothelial cell line bEnd. 3 was inoculated in the upper layer of the Transwell chamber to establish an OGD/R damage model, and the effect of the drug on the integrity of the endothelial cell barrier was investigated by the transmembrane resistance value and fluorescein-so-dium transmittance. Claudin-5 immunofluorescence staining was used to observe the changes of tight junction structure between endothelial cells. RT-PCR and Western blot were employed to detect mRNA and protein expression levels of tightly linked proteins Claudin-5 , Occludin, ZO-1. Western blot was applied to detect the expression levels of MAPKs (JNK, p38, ERK) , I kappa B a, I kappa B kinase phosphorylated protein expression, and Western blot and immunofluorescence were utilized to detect NF-K.B/p65 nucleation expression. Results XNST and its three monomers could significantly increase endothelial cell resistance and de- crease fluorescein-sodium transmittance. Claudin-5 fluorescence staining showed that the tight junction between cells in the model group was significantly damaged , while XNST and its monomer components could significantly improve its tight structure. RT-PCR and Western blot results showed that it could significantly upregulate the expression of mRNA and protein of Claudin-5, Occludin and ZO-1, and further study on the mechanism showed that XNST and its monomer components could significantly inhibit the phosphoryla-tion of JNK, p38 and ERK, inhibit the phosphorylation of I kappa B a and I kappa B kinases, and significantly inhibit the nuclear translocation of NF-KB/p65. Conclusion Both XNST and its monomeric components can exert cerebroprotective effects by increasing the tight junction structure between cells to promote barrier integrity, and the mechanism may be related to inhibition of NF-kB and MAPKs signaling pathway activation.

The effect of Pit-Crew cardiopulmonary resuscitation on the quality of chest compression / 中华急诊医学杂志

Objective:To observe the effect of team resuscitation with Pit-Crew cardiopulmonary resuscitation (CPR) mode on improving the quality of chest compression.Methods:A control method was conducted in this study. Sixty-four medical staffs in ICU and Emergency departments were divided into the role division group and non-role division group according to the ratio of doctors to nurses, with 8 teams in each group and 4 staffs in each team. A team leader was appointed in each team of the role division group to organize and coordinate the whole CPR process, and the non-role division group was not appointed. Each team performed chest compression for 8 min according to the recommendations of the 2020 AHA CPR Guideline under the monitoring of the CPR quality tracking system using a resuscitation manikin. CPR time, chest compression fraction (CCF), times of pressing interruption, times of pressing exceeding standard interruption (>10 s), pressing frequency, chest full recoil rate and other parameters were observed and recorded. The computer system recorded the above parameters, Student's t test and Mann-Whitney U test were used to compare the differences of indexes between the two groups. Results:After the training, the role division group achieved higher CCF [(69.13±1.55)% vs. (59.13 ± 6.08)%, P<0.05], and the total time was significantly shorter and times of overshoot interruptions was significantly less in the role division group compared with the non-role division group [(79.88±28.76) s vs. (135.25±32.99) s; 4 (3, 5) times vs. 2 (1, 2) times respectively; P<0.01]. There were no statistical differences in the total time of CPR and interruption numbers ( P>0.05). In addition, there were also no statistically significant differences in the pressing total numbers, correct times, pressing frequency, pressing depth, and the full rebound times of compression, as well as the substandard indicators of compression such as pressing too fast, too slow, too deep and insufficient rebound times of compression (all P>0.05). Conclusions:Pit-Crew CPR mode with designated team leader contributes to the implementation of high quality CPR, and the monitoring of CPR quality parameters and the applying of real-time feedback system can effectively improve the quality of chest compression.

The protective effects of salvianolic acid B, ginsenoside Rgl and notoginsenoside R1 on oxygen-glucose deprivation/reoxygenation and reoxygenation of astrocytes / 中国药理学通报

eration-toxicity test kit was used to detect the cell viability of astrocytes, and flow cytometry to detect mitochondrial membrane potential, KOS release and intracellular calcium concentration.KT-PCK was employed to detect the niHNA expression of BDNF, NGF, KtFIcx in astrocytes.Western blot was used to detect the phosphorylation of PI3K, ART and STA'13 protein in astrocytes.Results OGD/K significantly decreased cell viability.HOS release and intracellular calcium ion concentration of astrocytes, mitochondrial membrane potential and p-STAT3 , p-PI3K, p-AKT ex¬pression decreased in OGD/R group.Sal 15, Rgl and HI significantly increased the viability of damaged cells, and regulated KOS release, calcium ion concen¬tration and mitochondrial membrane potential to varying degrees.Sal B and Rgl increased the expression of p- STA'13 and p-AKT.Hie expression of BDNF and NGF niRNA in OGD/R group significantly decreased, and Sal B, Hgl and HI could significantly increase the ex¬pression of BDNF niHNA in damaged cells.Hgl could increase NGF niRNA expression.Sal B increased the expression of IGFla niRNA.Conclusions Sal B, Kgl, and HI reduce the oxidative stress response of astrocytes after OGD/R injury by regulating the PI3K/ ART and STA'13 signaling pathway, reduce intracellu¬lar calcium overload, and play a protective role in as-trocytes, increase the release of astrocyte neurotrophic factor, which may further play a protective role in neu¬rons.

Psoriasis-related Signaling Pathways Regulated by Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

As an inflammatory skin disease with a gradually increasing prevalence，psoriasis has negatively impacted the quality of life of patients and has attracted widespread attention from the medical community. The pathogenesis of psoriasis can be affected by a variety of genetic，environmental， and immune factors，and cytokine-driven epidermal proliferation，abnormal differentiation，inflammation， and neovascularization contribute to the pathogenesis，involving the interaction between immune and skin cells. However， some pathogenesis is still a blind spot for research，which brings great challenges to clinical treatment. Therefore， the identification of effective targets for psoriasis is critical in the research on psoriasis. Signaling pathways， another hotpot in the research on psoriasis， play an important cellular transduction role in the pathological mechanism of psoriasis and serve as key transduction factors regulating the immune and inflammatory responses to psoriasis. With the in-depth research in the field of network pharmacology and molecular biology， single Chinese medicine and Chinese medicinal compound can exert a therapeutic role by regulating multiple signaling pathways related to psoriasis. In recent years，traditional Chinese medicine （TCM） has achieved good clinical efficacy in the prevention and treatment of psoriasis，such as relieving pruritus，decreasing the area of skin lesions，improving anxiety， and preventing complications， which confirms the credibility of TCM in the understanding and treatment of psoriasis. Despite the rich theoretical and clinical research on the prevention and treatment of psoriasis，studies on the regulation of psoriasis-related signaling pathways and mechanisms of action by TCM are rarely reported. Therefore，the present study reviewed the available research in recent years and introduced the following six major signaling pathways related to psoriasis which are regulated by TCM： Janus kinase（JAK）/signal transducer and activator of transcription（STAT） signaling pathway，mitogen-activated protein kinase（MAPK） signaling pathway，phosphatidylinositol-3-kinases（PI3K）/protein kinase B（Akt） signaling pathway，nuclear transcription factor-κB（NF-κB） signaling pathway，Wnt signaling pathway， and Notch signaling pathway.

Effect of Intervention with Traditional Chinese Medicine on Th17/Treg Balance in Psoriasis： A Review / 中国实验方剂学杂志

Psoriasis is an autoimmune disease presented in the context of inflammation， and it mainly results from proliferation and differentiation defects of keratinocytes and abnormal immune response. However， some cellular and molecular mechanisms remain unclear. Although a variety of drugs and physiotherapies are applicable to this disease， they can only be utilized for a short-term period considering their transient effect， high cost， and serious adverse reactions. It is difficult to achieve satisfactory long-term results in the treatment of psoriasis. With the development of network pharmacology and molecular biology and the modernization of traditional Chinese medicine （TCM）， the multi-component and multi-target characteristics of TCM have become prominent， promoting the in-depth research on TCM by doctors and scholars. Nevertheless， there is no detailed summarization on the mechanisms of TCM in interfering with T helper 17 （Th17）/regulatory T （Treg） cell balance to prevent and treat psoriasis. After reviewing the recent literature data， this paper has found that Chinese herbal monomers， active ingredients， and compounds obviously regulate the Th17/Treg axis in psoriasis. Th17 cells have a pro-inflammatory effect， while Treg cells are responsible for maintaining peripheral tolerance. They function in a mutually exclusive manner， and maintaining the Th17/Treg balance helps to effectively reduce inflammatory reaction and regulate immune homeostasis. As revealed by a series of clinical and experimental studies carried out based on the Th17/Treg axis in psoriasis， reducing the percentage of Th17 cells，increasing the percentage of Treg cells，and regulating the levels of related cytokines and transcription factors are conducive to alleviating inflammation and regaining immune homeostasis，which has provided new ideas for further elucidating the pathological mechanism of psoriasis and alternative plans for developing new treatments against psoriasis.

Effects of prunus tomentosa thunb total flavonoids on levels of inflammatory factors in raw264.7 cells and their mechanisms / 吉林大学学报(医学版)

Objective:To investigate the influence of Prunus tomentosa thunb total flavonoids (PTTTF) in the inflammatory factors in the lipopolysaccharide(LPS)-induced cellular inflammation model, and to clarify its mechanism. Methods:The cellular inflammation models of the RAW264.7 cells and human neutrophils (PMN) induced by LPS were established. The cells were divided into control group, model group, dexamethasone group (DXM), and different doses (0.4,4.0, and 40.0 mg·L-1) of PTTTF groups. The expression levels of inflammatory factors including interleukin-1β(IL-1β), interleukin-6(IL-6), inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α) and high mobility group protein B1(HMGB1)mRNA in the RAW264.7 cells were detected by RT-PCR. The expression levels of NF-κB, and signal pathway key molecules ERK1/2 and p-JNK proteins in the RAW264.7 cells were determined by Western blotting method. Flow cytometry was used to detect the percentages of RAW264.7 cells in different cell cycles and the apoptotic rates of PMN. Results:Compared with control group, the expression levels of IL-1β, IL-6, iNOS, TNF-α, and HMGB1 mRNA in the RAW264.7 cells in model group were significantly increased (P<0.05 or P<0.01),and the expression levels of NF-κB,ERK1/2, and p-JNK proteins were also significantly increased (P<0.01);the percentage of RAW264.7 cells in S phase was increased (P<0.05);the apoptotic rate of PMN was significantly decreased (P<0.05). Compared with model group,the expression levels of IL-1β, iNOS, TNF-α, and HMGB1 mRNA in the RAW264.7 cells in 4.0 and 40.0 mg·L-1 PTTTF groups and DXM group were significantly decreased(P<0.05 or P<0.01), the expression levels of NF-κB,ERK1/2, and p-JNK proteins were significantly decreased(P<0.05), and the percentages of RAW264.7 cells in S phase were significantly decreased (P<0.05 or P<0.01); the apoptotic rates of PMN were increased(P<0.05 or P<0.01). Conclusion:PTTTF can down-regulate the expression levels of inflammatory factors in the RAW264.7 cell inflammation models induced by LPS. This effect may be related to decreasing the percentage of inflammatory cells in S phase, promoting the apoptosis, and down-regulating the expressions of NF-κB, ERK1/2, and p-JNK proteins.

Time course of attention bias in face recognition of patients with depression / 中华行为医学与脑科学杂志

Objective@#To explore the characteristics of cognitive processing over time in recognition of different emotional faces in patients with depression.@*Methods@#Totally 29 patients with depression(patient group) and 30 normal control (control group)were selected.Subjects freely viewed positive, sad, threatening and neutral facial stimuli.Eye movement data were collected during the process of watching, and the differences of attention bias in time when the two groups of subjects recognized the four emotional faces were compared.The temporal variation trend of attention between the two groups was analyzed.@*Results@#There was no significant difference in the fixation duration between the patient group and the control group in 0-2 s((10.39±1.83)ms, (9.63±1.28)ms), 2-4 s((12.61±2.34)ms, (11.21±3.00)ms), 4-6 s ((12.26±3.11)ms, (10.47±4.06)ms)(all P>0.05). Within 6-8 s((12.64±3.42)ms, (8.90±4.02)ms), 8-10 s((12.55±4.19)ms, (9.36±4.02)ms), the fixation duration in the patient group was significantly longer than that in the control group (P<0.01). The fixation time of the positive faces in the patient group in 0-2 s ((12.07±2.65)ms, (14.50±3.54)ms), 2-4 s((10.69±3.26)ms, (14.66±5.25)ms), 4-6 s((10.11±4.24)ms, (15.43±8.02)ms), 6-8 s((9.39±5.12)ms, (16.88±9.60)ms), 8-10 s ((9.45±4.94)ms, (16.63±10.15)ms) was significantly lower than that in the control group (all P<0.01).@*Conclusion@#Patients with depression tend to pay attention to negative stimuli in the later stage of cognitive processing, while the attention to positive stimuli decreases in the early stage of cognitive processing.Cognitive processing of emotional stimuli in patients with depression is manifested as increased attention duration of negative stimuli and decreased attention duration of positive stimuli.

Effect of air mattress bed on the quality of hands-only chest compression / 中华急诊医学杂志

Objective To observe the effect of air mattress bed on the quality of chest compression during cardiopulmonary resuscitation (CPR). Methods This was a self-controlled study and included twenty formally CPR-trained doctors. According to the 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, chest compression was randomly tested on a manikin for two minutes in A, B, C group. Group A was tested in ordinary bed, group B was compress in air mattress and hard backboard, and group C was tested in air mattress bed. There was a ten minutes rest between each compression. All compression data, including compression rate, depth, incomplete recoil and shallow number, were collected via real-time feedback device. Statistical analysis was performed using SPSS 22.0. Multiple groups were compared with One-way ANOVA and within groups were compared with t test. The enumeration data was analyzed by chi-square test. Results There was no statistically significant difference between groups in mean chest compression rates (107.9±5.1 vs. 107.7±4.56 vs. 109.7±4.86, P=0.6). Mean compression depth was significantly better in group A and B than in group C [(53.45±2.04) mm and (52.65±2.13) mm vs. (48.45±1.36) mm, all P<0.05)]. The number of shallow compression in group C was significantly higher than those in group A and B [(97.3±23.4) vs. (23.6±19.3) and (35.3±33.9), all P<0.05)]. The retention rates in group A was better than those in group B and C [(58.43±4.17％) vs. (62.51±4.37)％ and (62.63±4.22)％, all P<0.05]. The compression depth of group C in the second minute was significantly less than that in the first minute (46.45±1.43 mm vs. 50.05±1.64 mm, P<0.05), and the number of shallow compression was more than the first minute (62.1±16.4 vs. 35.3±8.5, P<0.05). Significant difference in accuracy was observed among the three groups (33.64％ vs. 28.66％ vs. 19.24％, P<0.05). Conclusions The use of air mattress bed in CPR has a significant impact on the quality of manual chest compression. Eliminating the elasticity of air mattress bed would effectively improve the quality of chest compressions.

Synthesis of phacolysin / 军事医学

Objectve To optimize the synthesis process of phacolysin 1 for industrial production.Methods Phacolysin as the target product was synthesized with a total yield of 40.7% by condensation reaction of O-phenylenediamine and sulfonation reaction.The yield reported in literature was 24.8%.Results Such factors as the ratio of the raw materials,the catalyst,and the reaction time were inveatigated and optimized to make the reaction conditions mild and easy to control with less side effect.Conclusion The structure is confirmed by 1HNMR and MS,and the optimized process is more suitable for industrial production.

Syntheses of dimorpholine benzothiazole-phenylurea selective PI3Kβ inhibitors / 国际药学研究杂志

Objective To investigate and optimize the syntheses of dimorpholine benzothiazole-phenylurea selective PI3Kβinhibitors. Methods With 2,4,6-three bromine aniline as the raw material,all the target compounds were prepared through thiophos?gene,cyclization,Buchwald-Hartwig cross coupling reaction and Suzuki coupling. The structures of intermediates and target com?pounds were characterized by MS and 1H NMR spectra. Results Six derivatives were synthesized. Compared with the method report?ed in the literature,the total yield of this new synthesis method increased from 16.2%to 26.9%. Conclusion The raw materials of op?timized synthesis method are cheap and easy to obtain,and the reaction operation steps are simplified. The post-processing process avoids steps of column chromatography and improves the experimental efficiency.

Synthesis of istradefylline / 军事医学

Objective To optimize the synthesis process of istradefylline 1 for industrial production.Methods Istrade-fylline was synthesized from dimethyl carbonate and ethylamine through a series reactions including condensation,cycliza-tion,nitrosation,and reduction to produce 1,3-diethyl-5,6-diaminouracil(6),which was subjected to amidation with (E)-3,4-dimethoxycinnamic acid (8),followed by cyclization and methylation reaction.Compound 8 was prepared from veratr-aldehyde and propanedioic acid by Knoevenagel condensation.The structures of intermediate and target compounds were confirmed by MS and 1 H-NMR.Results and Conclusion The quality control points of each key process were optimized so that the total yield was 26.2% and the purity of the product was 99.76%.This improved synthesis method has some advan-tages,such as mild reaction conditions,simple operation,and applicability to industrial production.

Anti-hepatitis B virus drugs:research advances / 国际药学研究杂志

The main compounds to treat HBV are nucleoside analogues and interferon,which generally possess the disadvan?tages of susceptibility to resistance,high cost and serious side effect. In order to overcome the problems above,a large amount of drugs are being developed,including the prodrug of nucleoside analogues(such as besifovir,CMX157 and tenofovir alafenamide),interfer?on(such as P1101)and antiviral drug based on certain new mechanisms(such as GS-9620,ARC520 and REP-9AC). Among them, the most attention is GS-9620 and REP-9AC,which could against HBV by strengthening body′s immune function. Immunotherapy has been a hot area of antiviral drug research nowadays. In this paper,we review the recent research of a series of new anti-HBV drugs which are undergoing clinical phases.

Synthesis of ATP-competitive inhibitor Wye-125132 / 军事医学

Objective To synthesize Wye-125132,an inhibitor of mTOR,and to establish a synthetic route for industrial production.Methods Barbituric acid was used as the raw material to synthesize the intermediate 2, 4, 6-trichrolo-pyrimidine-5-carbaldehyde 2 via Vilsmeier-Haack and chlorination reaction, while intermediate 5 was prepared via 3-step reaction from 1,4-dioxaspiro-[4,5]decan-8-one.The condensation of 2 and 5 was followed by substitution reaction to obtain the key intermediate 7.The side chain 9 was prepared by 3-step reaction from bromine aniline.Then the title product 1 was obtained with the reaction of Suzuki cross-coupling of 7 and 9.The structures of intermediate and target compounds were confirmed by MS and 1 H-NMR.Results and Conclusion Compared with the method reported in the literature,this new synthesis method possesses some advantages, such as ready availablity of raw materials, simple operation, mild reaction conditions and easy disposal of products.The total yield is 13.2%,and the purity of the target compound is 99.77%.

Synthesis of iloperidone / 军事医学

Objective To optimize the synthesis process of iloperidone 1 for industrial production.Methods Piperi-dine-4-carboxylic acid, acetic acid and acetic anhydride were used as starting materials to generate 2 via amidation, Friedel-Crafts acylation, hydration, oximation, intramolecular cyclization and salification.Compound 2 was treated with 4-(3-chloropropoxy)-3-methoxyphenylethanone through condensation to afford iloperidone.The target compound 1 was prepared with an overall yield of 34.9%.Results and Conclusion Such factors as the ratio of the raw materials, the catalyst, reactive time were investigated and optimized to make the reaction conditions mild and easy to control with less side effects.The structure has been confirmed by IR, 1 H-NMR and MS.

Study on the Impact of Regional Economy on Structure of Total Health Expenditure / 中国卫生经济

Objective: To explore the impact of regional economy on structure of total health expenditure. Methods: According to the panel data of China from 2002 to 2011, the partial least-squares regression method was used to build the relationship model of regional economy and total health expenditure construction. Results: Per capital GDP, the proportion of the tertiary industry, financial revenue per capita and urban residents disposable income have negative correlation with resident individual health expenditure, while the Engel coefficient has positive relationship with them. Conclusion: Optimizing industrial structure and raising the income of residents are the key factors of optimizing the structure of total health expenditure.

Study on the Relationship of Economic Social Factors and Human Health Status / 中国卫生经济

Objective:To explore the main economic and social factors influencing human health. Methods:By using the partial least squares(PLS) method and the panel data from areas of China in 2011, regression model related with economic social factors and human life expectancy was built. Results: Per capital GDP, the proportion of the tertiary industry, the number of people beyond college diploma per million people and the number of health technical personnel per 1 000 people has inverse relationshop with life expectancy;the proportion of medical costs accounted for fiscal expenditure, the ratio of fiscal deficit, rate of unemployment and Gini coefficient have reverse relationshop with life expectancy. Conclusion: To improve the level of human health, it needs to take comprehensive measures.

Transcatheter arterial embolization for postoperative intraperitoneal and gastrointestinal hemorrhage in a patient with severe acute pancreatitis

Pancreatitis is associated with pseudoaneurysm in 4-10% of patients. Intraperitoneal and gastrointestinal hemorrhage resulting from rupture of a pseudoaneurysm is an uncommon complication of pancreatitis. We report a male with severe acute pancreatitis presenting with intraperitoneal and gastrointestinal hemorrhage 13 days and 68 days after debridement and drainage of infected necrosis of pancreas, which were successfully managed by a transcatheter arterial embolization with "two points" [both sides of the bleeding point]. This case not only reveals the management of intraperitoneal and gastrointestinal hemorrhage, but also indicates "two points" embolization could be the definitive therapy for hemorrhage secondary to severe acute pancreatitis

Management of postoperative acute intraperitoneal and gastrointestinal hemorrhage in patients with severe acute pancreatitis

Acute intraperitoneal and gastrointestinal hemorrhage [AIGH] is a fatal postoperative complication of severe acute pancreatitis [SAP]. Prompt diagnosis and correct treatment of AIGH remain a challenge. The current study presents the procedures undertaken by a single institution in managing postoperative AIGH in patients with SAP. Thirty-four patients with SAP who exhibited AIGH after debridement and drainage of infected necrosis were analyzed retrospectively. Clinical presentations, vessels and accompaniments involved in bleeding, and the diagnostic methods, as well as the therapeutic approaches and outcomes were reviewed. All patients exhibited AIGH 47 times. Fresh blood flowing out from abdominal drains and bloody stools were the predominant [44.9%] symptoms for AIGH. Ten patients that bled several times underwent early surgeries, and 5 of them repeatedly underwent surgeries. Splenic artery was the vessel most commonly involved in bleeding [46.8%]. Seventeen patients bled in one site 23 times, accompanied by gastrointestinal or choledochal fistula. Seventeen patients bled in multiple sites 24 times. AIGH cases were diagnosed successfully by contrast-enhanced computed tomography [51.7%] and arteriography [46.8%]. Transcatheter arterial embolization [TAE] with "one point" was performed 7 times with 5 [71.4%] recurrent bleedings, whereas TAE with "two points" was performed 12 with only 1 [8.3%] re-bleeding. Early surgical intervention and repeated surgery are two risk factors of AIGH. This condition is related to either one-site bleeding accompanied by a gastrointestinal or choledochal fistula or multi-site bleeding. The diagnostic methods and treatments should be selected based on venous or arterial bleeding. A disciplined three-vessel mesenteric arteriogram should be obtained, and TAE with "two points" embolization is recommended to stop arterial bleeding