Effect and Mechanism of Epigallocatechin-3-gallate on Learning and Memory Abilities of Epileptic Rats / 中国实验方剂学杂志

ObjectiveTo investigate the effects of epigallocatechin-3-gallate （EGCG） on learning and memory abilities of amygdala electrical kindling-induced epilepsy in rats and its mechanism. MethodMale SD rats were randomly divided into the normal group， model group， intervention group （model+25 mg·kg-1 EGCG）， and EGCG group （25 mg·kg-1 EGCG）. Rats in the EGCG group were only given EGCG intraperitoneal injection， those in the normal group were only given electrode implantation， and those in the other experimental groups were given amygdala electrical kindling stimulation to establish a chronic kindling epilepsy model. EGCG was injected intraperitoneally daily before electrical stimulation. Twenty-four hours after the last electrical stimulation， the escape latency and percentage of target quadrant were recorded by the Morris water maze. Twenty-four hours after the behavioral test， rats in each group were sacrificed by decapitation. The number of hippocampal neurons was observed by Nissl staining. The thickness of postsynaptic density in the hippocampus， synaptic cleft， length of active zone and the curvature of synaptic interface were observed by transmission electron microscopy （TEM）. The expressions of synapse-related proteins synaptotagmin （Syt）， postsynaptic density-95 （PSD-95） and Kalirin-7 in the hippocampus were examined by Western blot. ResultCompared with those in the normal group， the escape latency was significantly prolonged （P<0.05， P<0.01） and the target quadrant ratio was significantly decreased in the model group （P<0.05）. The number of hippocampus neurons decreased significantly （P<0.01）. The synaptic cleft of the hippocampus was widened significantly， and the length of active zone and the thickness of postsynaptic density were significantly decreased （P<0.05， P<0.01）. The expressions of synapse-related proteins Syt， PSD-95 and Kalirin-7 in the hippocampus were significantly decreased （P<0.05，P<0.01）. Compared with those in the model group， the escape latency was significantly shortened and the percentage of target quadrant was significantly increased in the intervention group （P<0.05， P<0，01）. The number of hippocampal neurons significantly increased （P<0.01）. The synaptic cleft of the hippocampus was significantly shortened， and the length of active zone and postsynaptic density were significantly increased （P<0.05， P<0.01）. The expressions of synaptic related proteins Syt， PSD-95 and Kalirin-7 were significantly increased （P<0.05， P<0.01）. ConclusionEGCG can effectively improve cognitive dysfunction after epilepsy. Its protective effect may be achieved by protecting the ultrastructure of hippocampal synapses and regulating the expressions of synapse-related proteins Syt， PSD-95 and Kalirin-7.

Effect of early off-bed mobility on diaphragm function in intensive care unit patients undergoing mechanical ventilation / 中华危重病急救医学

Objective:To explore the improvement of diaphragm function after early off-bed mobility intervention in intensive care unit (ICU) patients undergoing mechanical ventilation.Methods:A randomized controlled trial was conducted. A total of 147 adult patients undergoing mechanical ventilation admitted to ICU of Affiliated Hospital of Zunyi Medical University from October 2019 to March 2022 were enrolled. The patients were divided into control group and observation group by convenient sampling. Except for the different intervention programs of early mobility, other treatment and nursing of the patients in the two groups were carried out according to ICU routine. Progressive early activities were performed in the control group, while early off-bed mobility was performed in the observation group. The changes of diaphragm thickness at the end of inspiratory (DTei), diaphragm thickness at the end of expiratory (DTee) and diaphragm thickening fraction (DTF) before and 24, 48, 72 and 96 hours of intervention, and the duration of mechanical ventilation, length of ICU stay and 24-hour re-intubation rate after intervention were compared between the two groups.Results:Among the 147 patients, there were 4 cases of detachment in the control group and 5 cases of detachment in the observation group. Finally, 138 patients were enrolled, 69 cases in the control group and 69 cases in the observation group. There was no significant difference in gender, age, diagnosis of ICU, sedatives, muscle strength, ventilator model, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and DTei, DTee, DTF before intervention between the two groups. The DTei, DTee and DTF in both groups were increased gradually with the extension of intervention time, especially in the observation group [DTei (cm) at 24, 48, 72 and 96 hours of intervention in the observation group were 0.247±0.014, 0.275±0.016, 0.300±0.013 and 0.329±0.013, while in the control group were 0.242±0.015, 0.258±0.013, 0.269±0.014, and 0.290±0.017, effect of time: F = 993.825, P = 0.000, effect of intervention: F = 82.304, P = 0.000, interaction effect between intervention and time: F = 84.457, P = 0.000; DTee (cm) of the observation group were 0.213±0.014, 0.227±0.013, 0.243±0.016, 0.264±0.010, while in the control group were 0.213±0.016, 0.218±0.013, 0.224±0.013, 0.234±0.014, effect of time: F = 385.552, P = 0.000, effect of intervention: F = 28.161, P = 0.000, interaction effect between intervention and time: F = 45.012, P = 0.000; DTF of the observation group were (15.98±4.23)%, (21.35±4.67)%, (24.09±4.44)% and (25.24±3.74)%, while in the control group were (14.17±4.66)%, (18.11±3.92)%, (20.22±4.19)% and (20.98±4.12)%, effect of time: F = 161.552, P = 0.000, effect of intervention: F = 49.224, P = 0.000, interaction effect between intervention and time: F = -4.507, P = 0.000]. The duration of mechanical ventilation and length of ICU stay in the observation group were significantly shorter than those in the control group [duration of mechanical ventilation (hours): 112.68±12.25 vs. 135.32±22.10, length of ICU stay (days): 7.84±1.78 vs. 10.23±2.43, both P < 0.01]. However, there was no significant difference in 24-hour re-intubation rate between the observation group and the control group (0% vs. 2.90%, P > 0.05). Conclusions:Both early off-bed mobility and progressive early activities can prevent diaphragm weakness in ICU patients undergoing mechanical ventilation, and the effect of early off-bed mobility is better. Early off-bed mobility can significantly shorten the duration of mechanical ventilation and length of ICU stay, and it is safe and feasible.

Efficacy of laparoscopic choledochoscopy combined with holmium laser lithotripsy versus traditional laparotomy in treatment of bile duct stones： A Meta－analysis / 临床肝胆病杂志

ObjectiveTo systematically review the efficacy and safety of laparoscopic choledochoscopy combined with holmium laser lithotripsy through a meta－analysis. MethodsThis study was conducted based on PRISMA guidelines， with a PROSPERO registration number of CRD42023406221. Chinese databases including CNKI， Wanfang Data， and VIP and foreign language databases such as PubMed， Embase， the Cochrane Library， and Web of Science were searched for original articles on traditional laparotomy versus laparoscopic choledochoscopy combined with holmium laser lithotripsy in the treatment of bile duct stones. Dichotomous variables were assessed by odds ratio （OR） and 95% confidence interval （CI）， while continuous variables were assessed by weighted mean difference （WMD） and 95%CI， and a sensitivity analysis was performed for outcome measures with relatively high heterogeneity. The Begg test and Egger test were used to evaluate publication bias. Stata 15.0 and Review Manager 5.3 were used to perform the statistical analysis. ResultsA total of 26 retrospective studies from China were included in this study， with 2 238 patients in total. The meta－analysis showed that compared with traditional laparotomy for the treatment of bile duct stones， laparoscopic choledochoscopy combined with holmium laser lithotripsy had significantly shorter time of operation （WMD＝－1.26， 95%CI： －1.36 to －1.16， P<0.001）， length of hospital stay （WMD＝－1.93， 95%CI： －2.64 to －1.12， P <0.001）， and time to bowel function recovery （WMD＝－1.52， 95%CI： －1.68 to －1.35， P<0.001）， significantly less intraoperative blood loss （WMD＝－1.79， 95%CI： －1.93 to －1.66， P<0.001）， a significantly lower rate of intraoperative residual stone （OR＝0.15， 95%CI： 0.11－0.20， P<0.001）， and significantly fewer complications （OR＝0.17， 95%CI： 0.13－0.23， P<0.001）. ConclusionCompared with traditional laparotomy， laparoscopic choledochoscopy combined with holmium laser lithotripsy shows better efficacy in the treatment of bile duct stones.

Aurantii Fructus Immaturus， Atractylodis Macrocephalae Rhizoma， and Their Combination Treat Colonic Motility Disorders in Rats with Slow Transit Constipation via PINK1/Parkin Signaling Pathway-mediated Mitophagy / 中国实验方剂学杂志

ObjectiveTo observe the effects of Aurantii Fructus Immaturus， Atractylodis Macrocephalae Rhizoma， and their combination on slow transit constipation via PTEN-induced putative kinase 1 （PINK1）/Parkin pathway-mediated mitophagy. MethodFifty-six male SD rats were randomly assigned into normal group， model group， natural recovery group， Aurantii Fructus Immaturus group， Atractylodis Macrocephalae Rhizoma group， Aurantii Fructus Immaturus combined with Atractylodis Macrocephalae Rhizoma group， and mosapride group， with 8 rats in each group. Slow transit constipation model was established by gavage with loperamide （3 mg·kg-1·d-1） for 14 days in other groups except the normal group. After successful modeling， except that the model group was continuously induced by loperamide， the normal group and the natural recovery group were administrated with 0.9% normal saline by gavage， and the rats in the Aurantii Fructus Immaturus （1.35 g·kg-1·d-1） group， the Atractylodis Macrocephalae Rhizoma （2.7 g·kg-1·d-1） group， the Aurantii Fructus Immaturus combined with Atractylodis Macrocephalae Rhizoma （4.05 g·kg-1·d-1） group， and the mosapride （1.56 mg·kg-1·d-1） group were administrated with corresponding drugs by gavage for 7 days. The amount of feces， fecal water content， and intestinal propulsion rate of rats were determined. The pathological changes of the colon were evaluated by hematoxylin-eosin （HE） staining and Alcian blue-periodic acid-Schiff （AB-PAS） staining. The activity of respiratory chain complex and the ultrastructure of the colon tissue were determined by ultraviolet spectrophotometry and observed by transmission electron microscopy， respectively. Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） was employed to determine the mRNA levels of PINK1， Parkin， and p62， and Western blot to determine the protein levels of microtubule-associated protein 1 light chain 3 （LC3）， PINK1， and Parkin. ResultCompared with the normal group， the model group and the natural recovery group showed decreases in the amount of feces， fecal water content， intestinal propulsion rate （P<0.05，P<0.01）， and activities of mitochondrial respiratory chain complexes Ⅱ， Ⅲ， and Ⅳ in the colon tissue （P<0.05，P<0.01）. Further， the mRNA levels of PINK1 and Parkin and the protein levels of PINK1， Parkin， and LC3 were up-regulated （P<0.01） and the mRNA level of p62 was down-regulated in the model group （P<0.05） and the natural recovery group. Compared with the model group and the natural recovery group， the Aurantii Fructus Immaturus combined with Atractylodis Macrocephalae Rhizoma group showed increased amount of feces， fecal water content， intestinal propulsion rate， and activities of mitochondrial respiratory chain complexes Ⅱ， Ⅲ， and Ⅳ （P<0.05，P<0.01）. Moreover， the combination meliorated the degree of mitochondrial swelling in the colon tissue， down-regulated the mRNA levels of PINK1 and Parkin and the protein levels of PINK1， Parkin， and LC3 （P<0.05，P<0.01）， and up-regulated the mRNA level of p62 （P<0.05）. ConclusionAurantii Fructus Immaturus and Atractylodis Macrocephalae Rhizoma， and their combination may remedy the colonic motility disorders in rats with slow transit constipation by blocking PINK1/Parkin signaling pathway to inhibit the excessive mitophagy in interstitial cells of Cajal in the colon tissue.

Effect of Rhei Radix et Rhizoma and Persicae Semen on inflammatory cytokines and intestinal mucosal barrier in rats with adhesive intestinal obstruction / 国际中医中药杂志

Objective:To observe the effect of Rhei Radix et Rhizoma and Persicae Semen on inflammatory cytokines and intestinal mucosal barrier in rats with postoperative adhesive intestinal obstruction, and to explore its mechanism. Methods:Sixty SD rats were randomly divided into normal group, sham operation group, model group, low, medium and high dose of Rhei Radix et Rhizoma and Persicae Semen group. Except for the normal group and the sham operation group, and the other animals groups were established the model of postoperative adhesive intestinal obstruction. Rhei Radix et Rhizoma and Persicae Semen low, medium and high dose groups were perfused with Rhei Radix et Rhizoma and Persicae Semen decoction with the concentration of 0.2, 0.6 and 1.8 g/ml, the normal group, sham operation group and model group were gavaged with equal volume of sterile saline from the first day after the operation, once a day. After corresponding treatment, the adhesion score was observed on the 7th day after the operation, the contents of interleukin-1 β (IL-1β), D-lactic acid (D-LA), diamine oxidase (DAO) and vascular endotoxin (ET) in serum were detected by ELISA method, and the expression of SIgA, CD4 +T and CD8 +T cells in intestinal mucosa were assessed by immunohistochemical method. Results:Compared to the model group, the adhesion score in the low, medium and high dose of Rhei Radix et Rhizoma and Persicae Semen group significantly decreased ( P<0.05), the level of serum IL-1β [(8.66 ± 1.07) ng/L, (8.15 ± 1.23) ng/L, (7.99 ± 1.11) ng/L vs. (14.08 ± 2.54) ng/L] significantly decreased ( P<0.01), the expression of SIgA (1.38 ± 0.15, 2.87 ± 1.17, 2.79 ± 0.80 vs. 0.65 ± 0.12) in intestinal mucosa in the low, medium and high dose of Rhei Radix et Rhizoma and Persicae Semen group significantly increased ( P<0.01). The levels of serum D-LA [ (8.57 ± 1.73) mg/L, (7.13 ± 1.75) mg/L vs. (14.58 ± 2.81) mg/L], ET [ (77.39 ± 6.83) mg/ml, (50.49 ± 7.80) mg/ml vs. (138.22 ± 7.79) mg/ml] significantly decreased ( P<0.01), the expression of CD4 +T (2.61 ± 0.83, 2.91 ± 1.62 vs. 1.15 ± 0.98) and CD8 +T (2.88 ± 0.69, 3.01 ± 1.86 vs. 1.26 ± 0.74) cells in intestinal mucosa in the medium and high dose of Rhei Radix et Rhizoma and Persicae Semen group significantly increased ( P<0.01). Conclusion:Rhei Radix et Rhizoma and Persicae Semen decoction can improve intestinal mucosal permeability, protect intestinal mucosal immune barrier and reduce inflammatory reaction in the treatment of adhesive intestinal obstruction.

Exploration of Rapid Screening Mode of Wearable Intelligent ECG Device / 中国医疗器械杂志

This study established a rapid ECG screening system through the application of wearable ECG equipment. The closed-loop and self-service process of ECG inspection, data collection, transmission and printing have been realized. The new rapid ECG screening system docking with HIS system in the hospital, forming a new intelligent mode of rapid ECG screening. This paper introduces the design of the intelligent mode of ECG rapid screening from the aspects of hardware, software, wearable ECG examination equipment, and briefly describes its implementation path and technical scheme. With the rapid ECG screening system, human power can be saved, the timeliness of ECG examination can be enhanced. The level of ECG diagnosis in the basic units can be improved through building a multiple medical centers which is rely on the cloud platform.

Right-sided abdominal evisceration in the treatment of retroperitoneal liposarcoma / 中华普通外科杂志

Objective:To investigate the feasibility and safety of right-sided abdominal evisceration in retroperitoneal liposarcoma.Methods:The clinical data of 16 cases of retroperitoneal liposarcoma performed with right-sided abdominal evisceration at Sarcoma Center of Peking University Cancer Hospital from Sep 2015 to Feb 2019 were analyzed retrospectively.Results:Complete resection were successfully performed in all 16 cases.The median tumor size was 29cm(13-43 cm), the median operative time was 660 min(429-940 min), the median estimated blood loss was 2 000 ml(300-6 000 ml). The major postoperative complications rate (Clavien-Dindo classification Ⅲ-Ⅴ) was 38%. Median overall survival is 41.0 months while the median disease-free survival is 32.6 months.Conclusions:Right-sided abdominal evisceration is a favorable procedure to attain complete resection with acceptable complication rate.

CT imaging and quantitative analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma and hepatic metastasis / 中华肝胆外科杂志

Objective To study the use of abdominal enhanced CT imaging and quantitative index analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma (HEH) and hepatic metastasis.Methods A study group of 12 patients with HEH who underwent abdominal enhanced CT scanning at the First Affiliated Hospital of Zhengzhou University from February 2014 to October 2018 was retrospectively compared with a control group of 52 patients with hepatic metastases diagnosed clinically and by imaging examinations.The general information and imaging data of these patients were collected and analyzed.Results The lesions in the 2 groups mainly presented as multiple and diffuse lesions.The diffuse lesions of HEH often fused into strips.The hepatic metastasis group showed a higher CT attenuation and TNR in the portal vein phase than the HEH group (P ＜ 0.05).The area under the ROC curves of the two indexes were 0.756 and 0.841 respectively.The centers of the lesions showed almost no or slightly homogeneous enhancement in the HEH group,while the liver metastasis group showed slightly and moderately heterogeneous enhancement,with a significant difference between the two groups (P ＜ 0.05).Female,subcapsular distribution,capsular contraction,target ring sign and lollipop sign were independent risk factors for HEH (P ＜0.05),while a high CT attenuation and TNR in the portal vein phase,elevated tumor markers and lymph node metastasis were independent risk factors for liver metastasis on logistic regression analysis (P ＜ 0.05).Conclusions CT attenuation,TNR,central enhancement features in the portal vein phase,special signs and secondary changes of lesions were helpful for the differential diagnosis between HEH and liver metastasis.

Study on differentiation and features of the medical records about constipation in ancient books with doctors Wumen medical school / 国际中医中药杂志

Objective@#The characteristics of prescription medication for constipation in Wumen doctors in Ming and Qing Dynasties were analyzed by data mining method, so as to provide reference for the treatment of contemporary clinical constipation.@*Methods@#The Wumen medical school doctors in Ming and Qing Dynasties treating constipation in clinical case were selected for digital acquisition and process. The association rules and complex networks analysis were used for data mining in order to explore experience of famous doctors in Wumen medical treated constipation.@*Results@#A total of 202 cases records of constipation were collected from acient TCM books by the database of ancient books and literatures of library of Nanjing University of Traditional Chinese Medicine. The results showed that the highest syndromes of 202 prescriptions was Qi stagnation and yin deficiency, followed by damp-heat, blood deficiency and liver-stomach disharmony, and the top ten medicines for internal use were angelica, almond, arborvitae, flaxseed, pinellia, cistanche, dried rehamnnia root, radix paeoniae alba, rhubarb, poria, licorice, etc. The core medicine in pairs included the Platycodon grandiflorum-almonds, safflower-peach kernel, safflower-angelica and other drugs outside, carthami-semen pruni-Peach kernel, carthami-semen pruni-Angelica, carthami-angelica-peach, peony-rhubarb-magnolia.@*Conclusions@#Most of the doctors in the Ming and Qing Dynasties believed that constipation was based on deficiency and reality, took Xinrun Tongluo as its treatment method, and paid attention to the treatment of activating blood circulation, warming yang and regulating qi and resolving phlegm, and emphasized the relationship between constipation and lung, spleen, liver and kidney.

Effect of remote medical information platform on efficiency of chest pain diagnosis and treatment and on a clinical decision analysis in chest pain center / 中华老年医学杂志

Objective To investigate the effect of remote medical information platform on efficiency of chest pain diagnosis and treatment and on clinical decision analyses in chest pain center.Methods A total of 537 chest pain patients who met the inclusion and exclusion criteria were consecutively enrolled and divided into two groups.The group without the chest pain platform(before setting up the platform)was 251 cases,and the group with chest pain platform(after setting up the platform)was 286 cases.The constituent ratio of acute coronary syndrome (ACS),the numbers of cases of both emergency thrombolysis and emergency percutaneous coronary intervention(PCI),the mean transfer treatment time,the first time medical contact to balloon catheter technique(FMC-to-B) and the door-to-balloon(D-to-B) time were compared between the two groups.The important multivariate factors affecting the D-to-B time were analyzed.Results The group with versus without chest pain platform showed the statistically significant improvements in the parameters as follows:(1)getting long range treatment (249 cases or 87.1％ vs.92 cases or 36.7 ％,x2 =146.56,P ＜0.05),(2) receiving thrombolysis(64 cases or 22.4％ vs.15 cases or 6.0％,x2 =28.61,P＜0.05),(3)average transfer treatment time(TTT) (176.3 ± 86.1 min vs.360.7 ± 107.4 min,t =11.53,P ＜0.05),(4)FMC-to-B(203.8±65.9 min vs.583.4±125.1 min,t =8.41,P＜0.05)and (5)D-to-B time(86.5±30.6 min vs.148.2 ± 41.7 min,t =4.49,P ＜ 0.05).Especially,patients after setting up the chest pain platform reached the standard of D-to-B time less than 90 min.According to whether reaching the standard of D-to-B time or not,clinical decision-making model analysis showed that the average Gini coefficient achieving the millennium development goal(MDG) was highest in the hospital referral,followed by the average transfer treatment time and emergency thrombolysis.Conclusions Reducing average transfer treatment time,improving the efficiency of hospital referral,and refining the remote terminal information platform for chest pain diagnosis and treatment are important for chest pain center by analyzing clinical data of chest pain patients.

Relationship between GSK-3β and Drp-1 during diabetes mellitus-caused antagonization of cardio-protection induced by sevoflurane postconditioning in rats / 中华麻醉学杂志

Objective To investigate the relationship between glycoprotein synthase kinase-3 (GSK-3β) and mitochondrial cleavage protein (Drp-1) during diabetes mellitus-caused antagonization of cardioprotection induced by sevoflurane postconditioning in rats.Methods Clean-grade healthy male Sprague-Dawley rats,weighing 250-300 g,were used in this study.Diabetes mellitus was induced by high-fat and high-sucrose diet and intraperitoneal streptozotocin 30 g/kg.Forty rats with diabetes mellitus were divided into 5 groups (n =8 each) using a random number table method:ischemia-reperfusion (I/R) group,sevoflurane postconditioning group (SP group),sevoflurane postconditioning plus Drp1 inhibitor Mivi-1 group (SM group),sevoflurane postconditioning plus GSK-3β inhibitor SB216763 group (SB group) and sevoflurane postconditioning plus Mivi-1 plus SB216763 group (SMB group).Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of the coronary artery followed by 120 min reperfusion.The rats inhaled 2.5％ sevoflurane for 10 min starting from 5 min before reperfusion in SP,SM,SB and SBM groups.Mivi-1 1.2 mg/kg was injected via the caudal vein at 15 min before reperfusion in group SM.SB216763 0.2 mg/kg was injected via the caudal vein at 5 min before reperfusion in group SB.Mivi-1 1.2 mg/kg and SB216763 0.2 mg/kg were injected via the caudal vein at 15 and 5 min before reperfusion,respectively,in group SMB.Blood samples were collected from the abdominal aorta at 120 min of reperfusion for determination of serum cardiac troponin Ⅰ (cTnⅠ) concentrations.The rats were sacrificed and myocardial specimens were obtained from the apex for determination of the cell apoptosis (by TUNEL) and expression of caspase-3 (by Western blot),and apoptotic index (AI) was calculated.Results Compared with group I/R,no significant change was found in caspase-3 expression,AI or serum cTnⅠ concentrations (P＞0.05),and the pathological changes of myocardium were comparable in group SP,and the expression of caspase-3 was significantly down-regulated,and AI and serum cTnⅠ concentration were decreased (P＜0.05),and the pathological changes of myocardium were significantly attenuated in SM,SB and SMB groups.Compared with group SP,the expression of caspase-3 was significantly down-regulated,AI and serum cTnⅠ concentrations were decreased (P＜0.05),and the pathological changes of myocardium were significantly attenuated in SM,SB and SMB groups.Compared with group SMB or group SB,the expression of caspase-3 was significantly down-regulated,AI and serum cTnI concentrations were decreased (P＜0.05),and the pathological changes of myocardium were significantly attenuated in group SMB.Conclusion It is not a single regulatory relationship between GSK-3β and Drp-1 in the pathophysiological process of diabetes mellitus-caused antagonization of cardioprotection induced by sevoflurane postconditioning in rats.

The application value of spectral scanning combined with iterative reconstruction in double-low technique scanning for severe liver cirrhosis / 中华放射医学与防护杂志

Objective To investigate the clinical feasibility of spectral monochromatic imaging combined with adaptive statistical iterative reconstruction-V (ASIR-V) in upper abdominal enhanced scanning with double-low technique for severe liver cirrhosis.Methods Totally 126 cases performed abdominal contrast-enhanced CT scanning were collected prospectively and assigned to 3 groups with 42 cases in each group with random number table method.The filtered back projection algarithm,120 kV and contrast agent dose of 420 mgI/kg were used for the cases of control group.The cases for spectral group and combined group were scanned with spectral imaging mode and contrast agent dose of 300 mgI/kg.The 60 keV monochromatic images combined with pre-0％ and post-40％ ASIR-V were selected and analyzed for spectral group.Combined group with pre-40％ ASIR-V was divided into 2 subgroups with 50 keV,post -50％ ASIR-V and 60 keV,post-40％ ASIR-V separately.One-way ANOVA test was used for analysis of radiation dose and quantitative parameters,and Rank sum test was used for image subject evaluation.Results The CT numbers and CNR had significant differences among spectral group,combined group and control group(F=4.293-13.134,P＜0.05) except for the images of liver parenchyma in PVP and that of 50 keV combined 50％ASIR-V group were higher than that of control group (q=1.825-3.736,P＜0.05).No significant differences existed for image noise and overall image quality scores of organs in four groups.The visualization of hepatic vascular branches in 50 keV combined 50％ASIR-V group was higher than that of other three groups(Z=2.793-6.328,P＜0.05).The radiation dose of combined group was lower than that of spectral and control group (q =-4.879--2.531,P ＜ 0.001).Conclusions Spectral monochromatic imaging combined with pre-and post-ASIR-V can reduce contrast agent dose and radiation dose without degrading image quality for the severe liver cirrhosis in upper abdominal enhanced scanning.

Theimagingfeaturesofintracranialmedulloepithelioma / 实用放射学杂志

Objective Toanalyzetheimagingfeaturesofmedulloepitheliomaforfurtherunderstanding.Methods Theimaging findingsof12casesofmedulloepitheliomaprovedbypathologywereanalyzedretrospectively.Results Thelesionswerelocatedin cerebralhemisphere(6),cerebellum (3),ventricularsystem (3),andalloftheminvolvedbothgrayandwhitematter.Thefeatures includedlargegrosstumorvolume,clearboundaryandperitumoraledema(8/12).Othersincludedcystic-solidlesions(11/12),completelysolidlesion (1/12),andiso-orslightlyhyper-densitywithcalcificationonCTscan.ThetypicalfeatureofMRIwas "mid-lakeisland"sign,and solidcomponentshowediso-orhypo-intensityonT1WI,isoorhyper-intensityonT2WIwithhemorrhageandnecrosis,aswellasthe tumorshowedobviousheterogeneousenhancementaftercontrast.Cystcomponentshowedthin-wallring-enhancement.Conclusion Thetypicalfeatureofthemedulloepitheliomaisthe "mid-lakeisland"sign.Thetumorhasalargevolume,andthe majorityshow cystic-solidlesions.Aboveall,medulloepitheliomashouldbeconsideredifthereisasolid-cysticlesionwithclearboundaryatchildren andadolescents.

Analysis of short 3 term survival rate and morbidity of extremely preterm infants / 中华实用儿科临床杂志

Objective To assess survival rates and major complications of extremely preterm infants( EPI) discharged from the hospital,in order to provide some evidence for the treatment of such cases in the future. Methods A retrospective study Was performed by revieWing the clinical data of 299 infants at gestational age(GA)﹤28 Weeks Who Were admitted at the Neonatal Intensive Care Unit( NICU)of Tianjin Central Hospital of Gynecology Obstetrics from January 1st 2011 to December 31st,2017. The survival rates and major morbidities of EPI according to different GA Were compared by trend Chi－squaΥe and t test. Results A total of 299 cases of EPI Were included in the study,With a mean GA of 26. 5 Weeks(22 +3 －27 +6 Weeks)and mean birth Weight of 958. 5 g(360－1 550 g). From 2011 to 2017, the number of hospitalized EPI increased gradually( from 21 cases in 2011 to 79 cases in 2017),especially in EPI of loWer GA(GA﹤25 Weeks)Which increased from 4 cases in 2011－2014 to 26 cases in 2015－2017. The rates of sur﹣vival infants With GA﹤28 Weeks Were 78. 6%(235／299 cases),including 18. 2%(2／11 cases)at GA≤23 Weeks, 52. 6%(10／19 cases)at 24 Weeks,75. 8%(25／33 cases)at 25 Weeks,78. 5%(62／79 cases)at 26 Weeks and 86. 6%(136／157 cases)at 27 Weeks,respectively,Which shoWed that survival rates increased With the groWth of GA( χ2 ﹦31. 3,P﹦0. 000). Major morbidities among the survival infants Were severe retinopathy of prematurity(ROP,stageⅢor above according to international classification and received treatment)[16. 2%(38／235 cases)],bronchopulmonary dysplasia(BPD,supplemental oxygen use at a postmenstrual age of 36 Weeks)[15. 3%(36／235 cases)],late－onset sepsis(LOS)[24. 7%(58／235 cases)],intraventricular hemorrhage(IVH),grade 3 or 4)or periventricular leukoma﹣lacia(PVL)[9. 4%(22／235 cases)],necrotizing enterocolitis(NEC),stage≥Ⅱof Bell,criteria)[3. 0%(7／235 cases)],and decreased With increased gestational age(χ2 ﹦18. 450,19. 773,15. 024,all P﹦0. 000). Rates of ROP, BPD and LOS in EPI With GA﹤25 Weeks Were 41. 7%(5／12 cases),58. 3%(7／12 cases)and 66. 7%(8／12 cases), respectively,Which Were much higher than those of EPI With GA 25－28 Weeks[14. 8%(33／223 cases),13. 0%(29／223 cases),22. 4%(50／223 cases)](all P﹤0. 05). Conclusions From 2011 to 2017,the number of hospitalized EPI increased gradually and the rate of survival rose With every 1－Week increase in GA,While major morbidities Were reduced accordingly. EPI of GA﹤25 Weeks had a greater risk of mortality and major morbidities.

Study on differentiation and features of the medical records about constipation in ancient books with doctors Wumen medical school / 国际中医中药杂志

Objective The characteristics of prescription medication for constipation in Wumen doctors in Ming and Qing Dynasties were analyzed by data mining method, so as to provide reference for the treatment of contemporary clinical constipation. Methods The Wumen medical school doctors in Ming and Qing Dynasties treating constipation in clinical case were selected for digital acquisition and process. The association rules and complex networks analysis were used for data mining in order to explore experience of famous doctors in Wumen medical treated constipation. Results A total of 202 cases records of constipation were collected from acient TCM books by the database of ancient books and literatures of library of Nanjing University of Traditional Chinese Medicine. The results showed that the highest syndromes of 202 prescriptions was Qi stagnation and yin deficiency, followed by damp-heat, blood deficiency and liver-stomach disharmony, and the top ten medicines for internal use were angelica, almond, arborvitae, flaxseed, pinellia, cistanche, dried rehamnnia root, radix paeoniae alba, rhubarb, poria, licorice, etc. The core medicine in pairs included the Platycodon grandiflorum-almonds, safflower-peach kernel, safflower-angelica and other drugs outside, carthami-semen pruni-Peach kernel, carthami-semen pruni-Angelica, carthami-angelica-peach, peony-rhubarb-magnolia. Conclusions Most of the doctors in the Ming and Qing Dynasties believed that constipation was based on deficiency and reality, took Xinrun Tongluo as its treatment method, and paid attention to the treatment of activating blood circulation, warming yang and regulating qi and resolving phlegm, and emphasized the relationship between constipation and lung, spleen, liver and kidney.

Efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis in 17 cases: a clinical observation / 中华皮肤科杂志

Objective To evaluate the clinical efficacy of single-session plasmapheresis therapy alone for the treatment of toxic epidermal necrolysis (TEN),and to investigate its adverse reactions.Methods Patients with TEN receiving single-session plasmapheresis therapy alone were collected from the Second Affiliated Hospital of Xi'an Jiaotong University between September 2010 and December 2017.Clinical data on the disease severity,clinical efficacy,hospitalization duration and adverse reactions were analyzed.Results A total of 17 patients with TEN were enrolled into this study,including 9 males and 8 female,with an average age of 36.1 ± 25.4 years.Their initial SCORTEN and STENS scores were 2.1 ± 1.24 and 29.9 ± 6.6 respectively.After treatment,the STENS score decreased to 3.5 ± 1.8.Of the 17 patients,15 were cured after single-session plasmapheresis therapy,1 showed response to the treatment,and 1 died.The duration of intensive care unit stay was 6.4 ± 1.8 days,and the total hospitalization duration was 12.1 ± 5.7 days.There was no significant difference in the STENS score among the day 1,4,7,10 and 20 after hospital admission (F =18.569,P ＜ 0.05).No severe adverse reactions were observed,except 2 cases of plasma allergy.Conclusion Single-session plasmapheresis therapy alone is effective for the treatment of TEN without obvious adverse reactions.

Da Vinci robot assisted radical gastrectomy with carbon nanoparticle lymph node dyeing for advanced gastric cancer / 中华普通外科杂志

Objective To investigate the application value of carbon nanoparticle lymphatic tracer in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer.Methods The clinical data of 63 advanced gastric cancer patients in Gansu Provincal Hospital in 2016 were analyzed retrospectively.Patients were divided into three groups:robot with carbon nanoparticle group,laprascopy with carbon nanoparticle group and laprascopy surgury group.Numbers of harvested lymph were compared between the 3 groups,and the perioperative complications were evaluated.Results The number of harvested lymph nodes in carbon nanoparticle group (31.5 ± 3.8) was significantly higher than those of laprascopy joint carbon nanoparticle group (25.3 ± 2.6),F =5.5,P =0.03 and laprascopy group (21.1 ± 2.7),F =6.1,P=0.01.The number of blackdyed harvested lymph node was 481 (76.2％) and the metastasis rate of black-dyed lymph node was 26.8％ in robot joint carbon nanoparticle group.There was no significant difference in the metastasis rate of black-dyed between the robot joint carbon nanoparticle group and laprascopy joint carbon nanoparticle group,x2 =0.17,P =0.22.Condusions The application of diluted carbon nanoparticle lymphatic tracer helps in the dissection of lymph nodes in Da Vinci robot-assisted radical gastrectomy for advanced gastric cancer.

Effect of ulinastatin on postoperative cognitive dysfunction in preoperative sleep deprived aged rats / 中华麻醉学杂志

Objective To evaluate the effect of ulinastatin on postoperative cognitive dysfunction in preoperative sleep deprived aged rats.Methods Sixty clean healthy male Sprague-Dawley rats,aged 18 months,weighing 350-500 g,were divided into 3 groups (n=20 each) using a random number table:control group (group C),sleep deprivation group (group D) and ulinastatin group (group U).Sleep deprivation was induced by using modified multiple platform method in D and U groups,and then splenectomy was performed in three groups.Ulinastatin 100 U/g was intraperitoneally injected before sleep deprivation and immediately after operation in group U.Ten rats were randomly selected at 3 days after operation and sacrificed,and hippocampi were removed for determination of the contents of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) by enzyme-linked immunosorbent assay.Morris water maze test was performed at 3-7 days after operation in the rest ten rats in each group,and the escape latency and time of staying at the original platform were recorded.Results Compared with group C,the escape latency was significantly prolonged at 4-6 days after operation,the time of staying at the original platform was shortened,and the contents of IL-1β,IL-6 and TNF-α were increased at 3 days after operation in D and U groups (P＜0.05).Compared with group D,the escape latency was significantly shortened at 4-6 days after operation,the time spent in the original platform was prolonged,and the contents of IL-1β,IL-6 and TNF-α were decreased at 3 days after operation in group U (P＜0.05).Conclusion Ulinastatin can mitigate postoperative cognitive dysfunction in preoperative sleep deprived aged rats,which is related to inhibiting inflammatory responses.

The new view on the prevention and treatment of patent ductus arteriosus in preterm infants / 中华实用儿科临床杂志

Patent ductus arteriosus (PDA) is one of the common neonatal pathological phenomena,which is more common in preterm infants.The lower the gestational age and birth weight of the newborn cause the higher incidence of PDA.PDA can affect the hemodynamic stability and have adverse effects on various systems in preterm infants,which directly affect the mortality and long-term prognosis of premature infants.There is still a lack of consensus on early and correct prevention and treatment of PDA in premature infants,which is one of the bewilderment faced by doctors at home and abroad.In this article,the new views on the harm,diagnosis,treatment time,treatment object and treatment methods of PDA of preterm infants at home and abroad in recent years are expounded.

Expressions of TREM-1 and COX-2 in rectal carcinomaand their relationship with prognosis / 西安交通大学学报(医学版)

Objective To detect the differences of triggering receptor expressed on myeloid cells-1 (TREM-1) and cyclo-oxygenase-2 (COX-2) expressions in rectal cancer tissues and carcinoma adjacent tissues so as to explore the relationship between the two factors and clinical pathological characteristics and their effects on the patients` survival.Methods The expressions of TREM-1 and COX-2 were analyzed in 68 cases of rectal cancer tissues and 58 cases of carcinoma adjacent tissues with the method of immunohistochemical staining.We made a regular follow-up of the patients, analyzed the relationship between the two factors and prognosis of rectal cancer.Results The positive expression rates of TREM-1 and COX-2 in rectal cancer tissues were higher than those in carcinoma adjacent tissues (P<0.05).The expression of TREM-1 was related to lymph node metastasis, while COX-2 was related to pathological stage and lymph node metastasis (P<0.05).However, the two factors were not related to age, sex, histological differentiation or tumor size.The expressions of the two factors were positively correlated (r=0.550, P<0.001).The overall survival (OS) of TREM-1 and COX-2 positive expression groups was shorter than that of the negative groups (P<0.05).Cox multiple regression analysis showed that the expression of TREM-1, pathological stage, lymph node metastasis and tumor size affected the prognosis.Conclusion The expressions of COX-2 and TREM-1 in rectal cancer increase, suggesting that the two factors may promote the development and lymph node metastasis of rectal cancer, and the expressions of the two factors are related to the patients` poor prognosis.