Astragalus polysaccharide improves diabetic ulcers by promoting M2-polarization of macrophages to reduce excessive inflammation via the ß-catenin/ NF-κB axis at the late phase of wound-healing.

Ethnopharmacological relevance: Astragalus polysaccharide (APS), the most biologically active ingredient of Astragali Radix, is used to treat diabetes mellitus (DM)-related chronic wounds in traditional Chinese medicine for several decades. This herb possesses an anti-inflammatory effect. Our study proved that APS can reduce excessive inflammation at the late phase of wound-healing in diabetic ulcers. Aim of the study: To clarify the molecular mechanism of APS in promoting wound-healing via reducing excessive inflammation in diabetic ulcers during the late stages of wound-healing. Methods and materials: The rat model of the diabetic ulcers was established via intraperitoneal injection of streptozocin (60 mg/kg). We detected the regulation of APS on diabetic ulcers by measuring wound-healing rates. Bioinformatics was used to predict the target genes of APS, and autodocking was used to predict the combination of APS and target genes. Immunohistochemistry, Enzyme-linked immunosorbent assay, Western blot, immunofluorescence staining, flow cytometry, and flow cytometric sorting were investigated. Results: The results demonstrated that APS promoted wound-healing and inhibited excessive inflammation at the late phase of wound-healing in diabetic rats. Mechanistic findings showed that APS promoted the expression of ß-catenin and Rspo3 while inhibiting the expression of NF-KB and GSK-3ß, which leads to the transformation of M1-type macrophages into M2-type macrophages and thus reducing excessive inflammation at the late phase of wound-healing in diabetic ulcers. Conclusion: We found an interesting finding that APS promoted the polarization of macrophages towards M2-type through the ß-catenin/NF-κB axis to reduce excessive inflammation at the late phase of wound-healing. Therefore, APS may be a promising drug for treating diabetic ulcers in clinic.

Application of three-dimensional imaging device to colonoscopy / 中华消化内镜杂志

Objective:To evaluate the application of three-dimensional (3D) imaging device to colonoscopy.Methods:A total of 60 patients who underwent painless colonoscopy in Beijing Friendship Hospital, Capital Medical University from November to December, 2019 were enrolled and divided into 2 groups according to random code. Each patient underwent colonoscopy twice, while 2D colonoscopy was used for cecal intubation. Thirty patients were assigned to the experimental group (primary withdrawal used 3D colonoscopy, and secondary withdrawal used 2D colonoscopy), and 30 others to the control group (primary withdrawal used 2D colonoscopy, and secondary withdrawal used 3D colonoscopy). The detection of polyps, the withdrawal time, operating experience, image quality and complication were evaluated in the two groups.Results:The polyp detection rate at the first colonoscopy in the experimental group was 77.3% (17/22), which was higher than 43.5% (10/23) in the control group ( χ2=5.351, P=0.021). Ten operators in the experimental group had dizziness, while the operators in the control group had no dizziness ( P=0.001). There were no significant differences between the two groups in the polyp diameter [0.50 (0.70) cm VS 0.30 (0.20) cm, U=57.000, P=0.170], withdrawal time (4.6±1.5 min VS 5.2±1.9 min, t=-1.189, P=0.239) or image quality (27 cases with 3 points in the identification of lesion nature, and 28 cases with 3 points in the identification of duct both in the two groups, P=1.000) at the first colonoscopy. No complication occurred in either group. Conclusion:Application of 3D imaging device is feasible for colonoscopic polyp detection, and it can be used in clinical practice.

A study of the practice of "three early education" combined with medical ethics literacy cultivation to improve medical students' post competence / 中华医学教育探索杂志

Clinical post competence and medical ethics literacy are the key qualities that applied medical talents should have. The synergy of medical education is an effective way to deepen the reform of competence-oriented medical education. Under the background of synergy of medical education and considering the orientation of training applied medical talents in our college, we explore a progressive path of "three early education", which means early exposure to specialties, early exposure to practice, and early exposure to clinical practice. Meanwhile, we strengthen the cultivation of medical students' medical ethics literacy throughout the whole process of "three early education", laying a solid foundation for medical students before they enter the stage of clinical practice training. Practice shows that the progressive "three early education" mode and the cultivation of medical ethics literacy throughout the whole process can effectively improve medical students' clinical post competence.

Fine particulate matter exposure aggravates ischemic injury via NLRP3 inflammasome activation and pyroptosis.

AIMS: Accumulating evidence has suggested that airborne fine particulate matter (PM2.5) exposure is associated with an increased risk of ischemic stroke. However, the underlying mechanisms have not been fully elucidated. In this study, we aim to investigate the role and mechanisms of NLRP3 inflammasome and pyroptosis in ischemic stroke after PM2.5 exposure. METHODS: The BV-2 and HMC-3 microglial cell lines were established and subjected to oxygen-glucose deprivation and reoxygenation (OGD/R) with or without PM2.5 exposure. We used the CCK-8 assay to explore the effects of PM2.5 on cell viability of BV-2 and HMC-3 cells. Then, the effects of PM2.5 exposure on NLRP3 inflammasome and pyroptosis following OGD/R were detected by western blotting, ELISA, and the confocal immunofluorescence staining. Afterwards, NLRP3 was knocked down to further validate the effects of PM2.5 on cell viability, NLRP3 inflammasome activation, and pyroptosis after OGD/R in HMC-3 cells. Finally, the intracellular reactive oxygen species (ROS) was measured and the ROS inhibitor N-acetyl-L-cysteine (NAC) was used to investigate whether ROS was required for PM2.5-induced NLRP3 inflammasome activation and pyroptosis under ischemic conditions. RESULTS: We found that PM2.5 exposure decreased the viability of BV-2 and HMC-3 cells in a dose- and time-dependent manner under ischemic conditions. Furthermore, PM2.5 exposure aggravated NLRP3 inflammasome activation and pyroptosis after OGD/R, as indicated by an increased expression of NLRP3, ASC, pro-caspase-1, Caspase-1, GSDMD, and GSDMD-N; increased production of IL-1ß and IL-18; and enhanced Caspase-1 activity and SYTOX green uptake. However, shRNA NLRP3 treatment attenuated the effects of PM2.5 on cell viability, NLRP3 inflammasome activation, and pyroptosis. Moreover, we observed that PM2.5 exposure increased the production of intracellular ROS following OGD/R, while inhibiting ROS production with NAC partially attenuated PM2.5-induced NLRP3 inflammasome activation and pyroptosis under ischemic conditions. CONCLUSION: These results suggested that PM2.5 exposure triggered the activation of NLRP3 inflammasome and pyroptosis under ischemic conditions, which may be mediated by increased ROS production after ischemic stroke. These findings may provide a more enhanced understanding of the interplay between PM2.5 and neuroinflammation and cell death, and reveal a novel mechanism of PM2.5-mediated toxic effects after ischemic stroke.

Effect of cromolyn sodium combined with diclofenac sodium eye drops on allergic conjunctivitis / 中国医师杂志

Objective:To investigate the application of cromolyn sodium combined with diclofenac sodium eye drops in allergic conjunctivitis (AC) and its effect on tear film function, interleukin-10 (IL-10), interleukin-17 (IL-17) and immunoglobulin E(IgE).Methods:From April 2018 to May 2020, 78 patients with AC collected in Liaoning Armed Police Crops Hospital were divided into control group and observation group according to the random number table method (39 cases in each group). The control group was given cromolyn sodium eye drops, and the observation group was given cromolyn sodium combined with diclofenac sodium eye drops. The efficacy, clinical symptoms, changes of signs, tear film function [tear film rupture time (BUT), Schirmer I test (SIt)], tear inflammation indicators [interleukin-4 (IL-4), tumor necrosis factor-α (TNF-α), IL-10, IL-17], tear allergy mediators [eosinophil cationic protein (ECP), hyaluronic acid (HA), IgE] and safety.Results:The total effective rate of observation group was 100.00%, which was higher than that of control group (84.62%), with statistically significant difference ( P<0.05). After treatment, the scores of eye itching, tearing, photophobia, eye secretion, conjunctival hyperemia, conjunctival edema and blepharoconjunctival papillary follicular hyperplasia in the two groups were significantly lower than those before treatment, and the observation group was lower than the control group, with statistically significant difference (all P<0.05). The BUT in the observation group was higher than that in the control group after treatment, with statistically significant difference ( P<0.05). After treatment, the tear levels of IL-4, TNF-α, IL-10 and IL-17 in the observation group were lower than those in the control group, with statistically significant difference (all P<0.05). After treatment, the tear ECP, HA and IgE level in the observation group were lower than those in the control group, with statistically significant difference (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Cromolyn sodium combined with diclofenac sodium eye drops is effective in the treatment of AC, which can effectively improve the clinical symptoms and signs, promote stable tear film function, alleviate local metamorphosis and inflammation, and has good safety.

Clinical analysis of nonsyndromic cleft lip and palate in 109 patients living at high altitude / 中国基层医药

Objective:To analyze the risk factors and characteristics of nonsyndromic clef lip and palate living at high altitude, providing evidence for preventing cleft lip and palate.Methods:The clinical data of 109 Tibetan patients with nonsyndromic cleft lip and palate who received treatment in People's Hospital of Ganzi Tibetan Autonomous Prefecture between August 2016 and August 2020 were retrospectively analyzed.Results:The 109 patients with cleft lip and palate were aged 4 months to 48 years. The ratio of male to female patients was 1.42∶1. The ratio of male to female patients with simple cleft lip was 1.40∶1. The ratio of male to female patients with cleft lip and palate was 1.71∶1. The ratio of male to female patients with simple cleft palate was 1.3∶1. The mothers of all patients did not undergo prenatal examination and did not take folic acid during pregnancy. Eight patients (7.3%) had a family genetic history of cleft lip and palate. Two patients (1.8%) had consanguineous marriage within three generations. Seven patients (6.4%) took drugs in the first three months of pregnancy. One patient (0.9%) had malnutrition during pregnancy. Among 65 patients (59.1%) had simple cleft lip, 48 patients (73.8%) had incomplete cleft lip. Among 25 patients (22.9%) had simple cleft palate, 14 patients (56.0%) had incomplete cleft palate. Nineteen patients (17.2%) had cleft lip and palate. The number of patients with unilateral cleft lip with or without cleft palate was greater than that of patients with bilateral cleft lip with or without cleft palate. The number of patients with left cleft lip with or without cleft palate was greater than that of patients with right cleft lip with or without cleft palate. The ratio of the number of patients with unilateral cleft lip to the number of patients with bilateral cleft lip was 12∶1. The ratio of the number of patients with left cleft lip to the number of patients with right cleft lip was 1.9∶1. The ratio of the number of patients with unilateral cleft lip and palate to the number of patients with bilateral cleft lip and palate was 5.3∶1. The ratio of the number of patients with left cleft lip and palate to the number of patients with right cleft lip and palate was 2.8∶1. Twelve patients (63.2%) had complete cleft palate.Conclusion:Popularizing knowledge of pregnancy health care and strengthening pre-pregnancy and during-pregnancy examination can reduce the incidence of cleft lip and palate.

Study of electrophysiological mechanism of dopamine inhibiting insulin secretion by Kv channels / 中国药理学通报

Aim To study the electrophysiological mechanism of dopamine inhibiting insulin secretion hv voltage-dependent potassium ( Kv) channels.Methods Islets and (3 cells were isolated from male SD rats.D,-like receptor agonist ( SKP38393), D2-like receptor agonist (Quinpirole) and antagonist (Epiclopride) were used according to the experiment.Insulin secretion was detected by insulin radioimmunoassay.Whole-cell j J patch-clamp technique was applied to detect Kv channel currents and action potential duration of p cells.Di- BAC4(3) staining was used to observe membrane potential.Results SKF38393 did not affect insulin secretion and the Kv channel currents.Quinpirole signifi cantly inhibited insulin secretion and increased Kv channel currents.Dopamine significantly inhibited insulin secretion, increased Kv channel currents and shortened action potential duration of p cells, which could be reversed by epiclopride.In addition, dopamine de-creased membrane potential of INS-1 cells.Conclusions Dopamine inhibits insulin secretion by acting on D2-like receptors, resulting in actived Kv channels, shortened action potential duration and decreased cell membrane potential.

Clinicopathological features of missed synchronous multiple early gastric cancer / 中华消化内镜杂志

Objective:To investigate the clinicopathological features of missed synchronous multiple early gastric cancer (SMEGC).Methods:Clinical and pathological data of 10 missed SMEGC patients in Beijing Friendship Hospital collected from January 2015 to December 2019 were reviewed for the clinicopathological and endoscopic features.Results:Ten missed SMEGC patients were all over 60 years old, and 6 of them were males. Six patients had family history of tumor and 6 had comorbidity (hypertension, diabetes, dyslipidemia, cardiovascular or cerebrovascular diseases). In terms of endoscopic and pathological manifestations, missed lesions of 6 cases were not smaller than the initial lesions, and more than half of the missed lesions had the same vertical location in the stomach (6/10), infiltration depth (8/10), histological classification (9/10), atrophic (8/10) and intestinal metaplasia (8/10) as the initial lesions.Conclusion:Physicians should be aware of the possibility of missed lesions during the first endoscopic treatment and the follow-up, especially at the same vertical location of the initial lesions in elderly males with family history of tumor and comorbidity.

PHF19 activates hedgehog signaling and promotes tumorigenesis in hepatocellular carcinoma.

Aberrant activation of Hedgehog-Gli1 signaling and accumulation of Gli1 in hepatocellular carcinoma (HCC) are frequently observed. However, the mechanisms leading to the overactivation of this signaling pathway are not fully understood. In this study, we show that the short isoform of PHD finger protein 19 (PHF19) interacts with ß-TrCP, the E3 ligase of Gli1, and that knocking down PHF19 promotes the ubiquitination of Gli1. In a biological function study, PHF19 was found to promote the growth of HCC cells both in liquid culture and in soft agar. Moreover, knocking out PHF19 in a HCC mouse model (MycF/F) using the hydrodynamic method inhibited tumorigenesis and improved survival. Taken together, these results demonstrate that PHF19 promotes the growth of HCC cells by activating the Hedgehog signaling pathway.

Multi-slice spiral CT angiography in the diagnosis of aortic dissection / 中国基层医药

Objective:To investigate the application value of multi-slice spiral CT angiography in the clinical diagnosis of aortic dissection.Methods:The clinical data of 78 patients with aortic dissection diagnosed by digital subtraction angiography and treated between January 2015 and December 2019 in Putuo District People's Hospital of Zhoushan and Zhoushan Hospital were retrospectively analyzed. All patients underwent multi-slice spiral CT angiography and digital subtraction angiography. The type of aortic dissection, the number of aortic lacunas, the distance between the lacuna and the left subclavian artery, the involved branches, the percentage of artery wall calcification, and arterial dissection thrombosis determined by multi-slice spiral CT angiography and digital subtraction angiography were compared.Results:All 78 patients were diagnosed with aortic dissection by digital subtraction angiography, and 75 (96.2%) were diagnosed with aortic dissection by multi-slice spiral CT angiography. The same type of aortic dissection was detected by multi-slice spiral CT angiography and digital subtraction angiography, but three patients were misdiagnosed with pericarditis by multi-slice spiral CT angiography. There were no significant differences in the number of aortic lacunas and the distance between the lacuna and the left subclavian artery between the two methods ( t = 1.02, 0.57, both P > 0.05). The involved branches [61.3% (46/78),] the percentage of artery wall calcification [26.7% (20/78)], and the percentage of arterial dissection thrombosis [78.7% (59/78)] determined by multi-slice spiral CT angiography were significantly higher than 43.6% (34/75), 12.8% (10/75), and 62.8% (49/75) respectively determined by digital subtraction angiography ( χ2 = 4.83, 4.65, 4.62, all P < 0.05). Conclusion:Multi-slice spiral CT angiography exhibits a similar capacity to identify aortic dissection to digital subtraction angiography. It can accurately determine the number and location of aortic lacunas, display the calcification and thrombosis of vascular wall, and is minimally invasive and simply operated. Therefore, multi-slice spiral CT angiography is of high application value in the clinical diagnosis and preoperative evaluation of aortic dissection.

Chronic granulomatous disease caused by compound heterozygous mutation in NCF2 gene: case report and literature review / 中华实用儿科临床杂志

Objective:To explore the relationship between the type of mutation and clinical features, prognosis, and clinical characteristics of chronic granulomatous disease (CGD) caused by compound heterozygous mutations in the NCF2 gene in children. Methods:The clinical data of 1 case of neonatal CGD caused by compound heterozygous mutations of NCF2 gene at Tianjin Children′s Hospital in August 2019 was analyzed, and domestic and international literatures were searched to summarize the clinical characteristics, gene mutation type and prognosis of CGD caused by NCF2 mutation. Results:The diagnosis of CGD was confirmed by the presence of compound heterozygous mutations c. 196_197insA (p.Arg66Glnfs23X) and c. 1180T>G (p.Tyr394Asp) in the NCF2 gene, accompanied with the clinical manifestations of fever, cough, multiple clumps and nodules in the chest CT at 25 days after birth, and the neutrophil respiratory burst test stimulation index(SI) 23.This new mutation was not reported in the Human Genetic Mutation Database.The child had a residual portion of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity and was followed up until the age of 9 months with an antifungal drug without recurrent infection.A total of 101 cases of CGD patients with NCF2 gene mutation were reported in domestic and international databases.Totally, 33 cases had SI results, with 22 cases below 3, 11 cases above 3, and 8 cases of missense mutations. Conclusions:c. 196_197insA and c. 1180T>G are new mutations in NCF2 gene that can lead to CGD.CGD patients containing missense mutations in the NCF2 gene may have more residual NADPH oxidase activity.

The efficacy and safety of autologous platelet-rich plasma in the treatment of moderate to severe dry eye disease / 中国医师进修杂志

Objective:To evaluate the efficacy and safety of using platelet-rich plasma (PRP) eyedrops for the treatment of moderate to severe dry eye disease (DED).Methods:A total of 395 patients (790 eyes) with moderate to severe DED diagnosed and treated in the Armed Police Liaoning Corps Hospital and the PLA 967 Hospital from March 2018 to October 2019 were collected. Random number table method was used to divide into autologous PRP treatment group (196 cases, 392 eyes) treated with autologous PRP and control group (199 cases, 398 eyes) treated with artificial tears. The changes of subjective symptoms of DED, Schirmer test (ST), corneal fluorescein staining (CFS) and Ocular Surface Disease Index (OSDI) before and after treatment were observed in both groups.Results:After 1 course of treatment, the ST values of both groups increased, which was statistically significant compared with before treatment ( P<0.05). After treatment, the OSDI and CFS scores of the two groups were reduced. The difference in OSDI and CFS scores of the PRP treatment group before and after treatment was statistically significant ( P<0.05), and there was no statistically significant difference in the control group before and after treatment ( P>0.05). After treatment, the OSDI and CFS scores of the PRP treatment group were lower than those of the control group [(16.8 ± 18.7) scores vs. (43.2 ± 14.5) scores, (0.21 ± 0.53) scores vs. (1.62 ± 0.69) scores], the differences were statistically significant ( P<0.05). After one course of treatment, the total effective rate of the autologous PRP treatment group was higher than that of the control group [80.1% (157/196) vs. 51.76% (103/196)], the difference was statistically significant ( P<0.05). Conclusions:Autologous PRP can treat patients with moderate-to-severe autologous PRP treatment group, which can greatly improve patients' eye discomfort and other symptoms.

Clinical, endoscopic and pathological features of early Barrett esophageal adenocarcinoma and its treatment efficacy by endoscopic submucosal dissection / 中华消化内镜杂志

Objective:To investigate the clinical, endoscopic and pathological characteristics of early Barrett esophageal adenocarcinoma (BEA) and to evaluate the treatment efficacy of endoscopic submucosal dissection (ESD).Methods:Data of 13 patients who were diagnosed as early BEA and treated by ESD in Beijing Friendship Hospital from November 2015 to June 2018 were retrospectively analyzed, including clinical data, endoscopic manifestations and pathological information.Results:Out of 13 patients, 10 were male. One had underlying long-segment Barrett esophagus (LSBE), 6 had short-segment Barrett esophagus (SSBE), and 6 had super short-segment Barrett esophagus (less than 1 cm). Two arose from circumferential Barrett esophageal (BE) and 11 from tongue-like BE. Ten lesions were located on the right anterior side wall (12-2 o′clock) of the esophagogastric junction (EGJ), and 12 lesions were superficial type (0-Ⅱ). ESD was successfully conducted in all the patients without any complication. The en bloc and curative resection rate was 100% (13/13) and 92% (12/13), respectively. Pathology examination found 9 well-differentiated adenocarcinoma and 10 intramucosal cancer. No recurrence was detected in 11 patients during follow-up of 3.3-29.3 months.Conclusion:Early BEA tends to occur in elderly male, and mostly originated from non-LSBE and tongue-like BE. Most lesions are superficial type and located on the right anterior side wall of EGJ. In pathology, most lesions are well-differentiated adenocarcinoma and limited to the mucosa. ESD is a safe and efficient treatment for BEA.

Influencing factors of postoperative bleeding in endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer / 中华消化内镜杂志

Objective To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection ( ESD/EMR) for early gastric cancer. Methods Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information ( age, gender and history ) , endoscopic lesion characteristics ( tumor size, location and morphology) and postoperative pathological features ( differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. Results A total of 195 patients with early gastric cancer were included in the study and 9 cases ( 4. 6％) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group ( P=0. 018 and P=0. 034 ) . Multivariate analysis showed a history of clopidogrel ( OR=10. 223, 95％CI:1. 143-91. 468, P= 0. 038 ) , multiple lesions ( OR= 6. 412, 95％CI:1. 123-36. 616, P=0. 037) and lesions sizes of larger than 2 cm ( OR=6. 718, 95％CI:1. 130-39. 935, P=0. 036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel ( P<0. 001) and lesions sizes of more than 2 cm ( P=0. 022) . Conclusion More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions.

Predictors for operation time of endoscopic submucosal dissection for superficial gastric lesions / 中华消化内镜杂志

Objective@#To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions.@*Methods@#Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min.@*Results@#The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P<0.001) and size (r=0.209, P=0.007) were risk factors of the operation time by univariate analysis, while age, body mass index, American Society of Anesthesiologists (ASA) grade, roughness of lesion surface, presence or absence of white moss and ulcer, depth of lesion invasion, operative period, gross shape of lesion, degree of differentiation, and experience of operator were not associated with operation time (all P>0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI: 2.291-13.964, P<0.001), body of stomach (OR=2.667, 95%CI: 1.048-6.785, P=0.040) and >2 cm in size (OR=2.761, 95%CI: 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min.@*Conclusion@#Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD.

Evaluation of endoscopic submucosal dissection and surgery in the diagnosis and treatment of early gastric cancer / 中华消化内镜杂志

Objective@#To compare the efficacy and safety of endoscopic submucosal dissection(ESD) and surgery in the treatment of early gastric cancer.@*Methods@#Clinical data of patients with early gastric cancer who received ESD or surgery in Beijing Friendship Hospital from June 2012 to May 2018 were collected. Complete resection rate, complication incidence, hospital stay and expenses between the two groups were compared.@*Results@#There was no significant difference between two groups in complete resection rate[95.7%(245/256) VS 99.0%(97/98), P=0.191], or the complication incidence [5.9%(15/256) VS 8.2%(8/98), P=0.471]. Hospital stay was shorter in the ESD group than that in the surgery group(11.5±3.7 d VS 19.4±13.0 d, P=0.000). Expenses were less in the ESD group than those in the surgery group (27 383.1±10 143.0 yuan VS 78 004.3±79 027.8 yuan, P=0.000).@*Conclusion@#The efficacy and safety of ESD are comparable with surgery in the treatment of early gastric cancer, but ESD is superior to surgery in hospital stay and expenses.

Pharmacological Mechanism of Xiaoyaosan in Treating Depression Due to Liver Stagnation and Spleen Deficiency / 中国实验方剂学杂志

Depression belongs to the category of "stagnation syndrome" in traditional Chinese medicine. There are many clinical types of depression in which liver stagnation and spleen deficiency syndrome is one of the main types. As a classic prescription for liver-soothing and spleen-strengthening, Xiaoyaosan has a definite curative effect in the treatment of depression due to liver stagnation and spleen deficiency. With fewer adverse reactions, a high safety and good patient compliance, it can be combined with western medicine to reduce the recurrence rate and adverse reactions of western medicine, and has become the focus and hotspot of research in recent years. Although many experts and scholars have conducted a lot of research on the pharmacological mechanism of Xiaoyaosan in the treatment of depression due to liver stagnation and spleen deficiency, its mechanism is still unclear. In addition, there are many types of animal models for depression due to liver stagnation and spleen deficiency but only a few systematic reports on Xiaoyaosan in treating depression of liver stagnation and spleen deficiency. Therefore, based on two classic models of chronic mild unpredictable stress depression model (CUMS) and chronic restraint stress depression model (CIS), a review was conducted on the pharmacological mechanisms of Xiaoyaosan in the treatment of depression due to liver stagnation and spleen deficiency by regulating neurotransmitter concentration, affecting the expression of neurotrophic factor, regulating hytothalamus-pitutary-adrenal(HPA)axis imbalance, improving intestinal micro-ecology and gastrointestinal function, regulating endogenous metabolite levels and immune inflammatory factor levels and improving synaptic structure and plasticity, so as to provide potential guidelines for basis study and clinical application of Xiaoyaosan in the treatment of depression due to liver stagnation and spleen deficiency.

The clinical value of magnetic resonance imaging T2WI texture analysis in the diagnosis of prostate cancer / 中华内分泌外科杂志

Objective To evaluate the clinical value of magnetic resonance imaging T2WI texture analysis in the diagnosis of prostate cancer.Methods A total of 78 patients with pathological-confirmed prostate cancer and prostatic hyperplasia from Jan.2016 to Dec.2018 in our hospital were retrospectively collected.MaZda software was used to analyze 300 texture feature parameters of each lesion on T2WI images,and Weka software was used to select the most discriminative texture feature parameters.The differences of texture features between the two groups and diagnostic efficacy were compared by independent sample t test,Mann-Whitney U test and ROC.Results There were 7 texture feature parameters of the most discriminative significance between the two groups:AngScMom,Contrast,Entropy,Horzl_GLevNonU,45dgr_RLNonUni,WavEnLL_s-1 and WavEnHL_s-3,respectively.There were significant differences in 7 texture feature parameters between prostate cancer group and prostate hyperplasia group (P＜0.05).The AUC of each texture feature was between 0.78 and 0.91,the accuracy was between 79.6％ and 92.1％,the sensitivity was between 70.8％ and 91.9％,and the specificity was between 72.2％ and 92.5％,respectively.Conclusions The texture features parameters of T2WI images are different in the diagnosis of prostate cancer and prostatic hyperplasia.As an objective and quantitative analysis method,texture features analysis can be used in the differential diagnosis of prostate cancer and prostatic hyperplasia.

Exploration into mechanism of antidepressant of Bupleuri radix based on network pharmacology / 药学学报

This study was designed to explore the antidepressant mechanism of Bupleuri radix through establishing the active components-targets network and protein interactions network and analyzing the functions and pathways of targets. The main active ingredients of Bupleuri radix were obtained by TCMSP, literature study and the results of our own work. Based on the DRAR-CPI, GeneCards and OMIM were used to predict and screen the active components of Bupleuri radix. The Cytoscape software was used to construct the active components-targets network of Bupleuri radix. The protein interactions network was constructed using the String database and Cytoscape software. The relation of the main active ingredients and targets were validated by Systems Dock Web Site. The GO and KEGG pathways involved in the targets were analyzed by DAVID. Using DisGeNET database to attribute the type of targets. The results showed that 15 active components and 50 targets of Bupleuri radix were involved. The network results showed that the process of metabolism, regulation and response to stress were mainly involved, by adjusting the PI3K-AKT, MAPK, Rap1, Ras, FoxO, neurotrophin and other signaling pathways to play its antidepressant effect. This study reflects the characteristics of multicomponents-multi-targets and multi-pathways of Bupleuri radix, which provides new ideas and clues for further research on the mechanism of anti-depressive effects of Bupleuri radix.

Simultaneous Determination of Eight Kinds of Neurotransmitters in Rat Blood Serum by Ultra-high Performance Liquid Chromatograph- Tandem Mass Spectrometry / 分析化学

An ultra-high performance liquid chromatography tandem mass spectrometric ( LC-MS/MS ) method for simultaneous determination of 8 kinds of neurotransmitters (5-HT, GABA, Glu, ACH, NE, DA, 5-HIAA, HVA) in rat serum was developed.The blood samples were extracted by 0.1% formic acid in acetonitrile and separated on a Waters ACQUITY UPLC BEH C18(2.1 mm×100 mm, 1.7 μm) using gradient elution, with the mobile phase consisting of acetonitrile and 0.1% formic acid in water.The samples were then ioniZed with positive electrospray ( ESI+) , and detected under multiple reaction monitoring ( MRM ) mode.As a result, 8 kinds of neurotransmitters were determined accurately in 10 min with a limit of quantitation of 1.8 ng/mL and intra-day and inter-day precisions of ≤9.2% ( n=6 ).This method showed a good linearity in detection of neurotransmitters and the linear correlation coefficients were greater than 0.994.Also the stability, recovery and matrix effect were eligible for the analysis.This method showed high accuracy, sensitivity, strong specificity, good stability, small matrix effect and short time for analysis, and was suitable for the quantitative determination of monoamine, amino acids and acetylcholine neurotransmittes in rat serum.