Efficacy of electroacupuncture stimulating Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6) on spatial learning and memory deficits in rats with insomnia induced by para-chlorophenylalanine: a single acupoint combined acupoints.

OBJECTIVE: To investiage the effect of electroacupuncture (EA) at a single acupoint of Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6) and at combined acupoints of Shenmen (HT7) and Baihui (GV20) and Sanyinjiao (SP6) on the PKA/CREB and BDNF/TrkB signaling, as well as neuroapoptosis and neurogenesis in hippocampus and elucidate the underlying mechanism of single and combined acupoints on ameliorating spatial learning and memory deficits in a rat model of primary insomnia. METHODS: Primary insomnia was modeled by intraperitoneal injection of para-chlorophenylalanine (PCPA) once daily for 2 d. EA was applied at Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6), or Shenmen (HT7) + Baihui (GV20) + Sanyinjiao (SP6) (combined) for 30 min daily for 4 d. Spatial learning and memory function was evaluated by the Morris water maze (MWM) test. Protein expressions of hippocampal cAMP-dependent protein kinase (PKA)-Cß, phosphorylated cAMP-responsive element-binding protein (p-CREB), brain-derived neurotrophic factor (BDNF), and tyrosine kinase receptor B (TrkB) were evaluated by Western blotting. Neuronal apoptosis in the hippocampus was detected with the transferase-mediated dUTP-X nick end labeling assay. Endogenous neurogenesis was examined with bromodeoxyuridine staining. The MWM test and hippocampal p-CREB, BDNF, and TrkB protein levels in the combined acupoints group were evaluated after the administration of a PKA-selective inhibitor (H89). RESULTS: Spatial learning and memory were significantly impaired in rats with insomnia. The spatial learning deficits were ameliorated in the Shenmen (HT7), Baihui (GV20), Sanyinjiao (SP6), and combined groups; this improvement was significantly greater in the combined group than the single acupoint groups. The spatial memory impairment was improved in the combined, Baihui (GV20), and Shenmen (HT7) groups, but not the Sanyinjiao (SP6) group. The expressions of PKA-Cß, p-CREB, BDNF, and TrkB were decreased in rats with insomnia. All these proteins were significantly upregulated in the combined group. PKA/p-CREB protein levels were elevated in the Baihui (GV20) and Shenmen (HT7) groups, whereas BDNF/TrkB expression was upregulated in the Sanyinjiao (SP6) group. The staining results showed significant attenuation of hippocampal cell apoptosis and increased numbers of proliferating cells in the combined group, whereas the single acupoint groups only showed decreased numbers of apoptotic cells. In the combined group, the PKA inhibitor reversed the improvement of spatial memory and upregulation of p-CREB expression caused by EA, but did not affect its activation of BDNF/TrkB signaling. CONCLUSIONS: EA at the single acupoints Baihui (GV20), Shenmen (HT7), or Sanyinjiao (SP6) had an ameliorating effect on the spatial learning and memory deficits induced by insomnia. EA at combined acupoints exerted a synergistic effect on the improvements in spatial learning and memory impairment in rats with insomnia by upregulating the hippocampal PKA/CREB and BDNF/TrkB signaling, facilitating neurogenesis, and inhibiting neuronal apoptosis. These findings indicate that EA at combined acupoints [(Baihui (GV20), Shenmen (HT7), and Sanyinjiao (SP6)] achieves a more pronounced regulation of hippocampal neuroplasticity than EA at single acupoints, which may partly explain the underlying mechanisms by which EA at combined acupoints exerts a better ameliorative effect on the cognitive dysfunction caused by insomnia.

Value of transrectal multimodal ultrasound combined with prostate specific antigen in predicting clinically organ-confined prostate cancer / 中华健康管理学杂志

Objective:To explore the predictive value of transrectal multimodal ultrasound and prostate specific antigen (PSA) in clinically organ-confined prostate cancer.Methods:It was a cross-sectional study. The clinical data of patients with suspected prostate nodules treated in the First Hospital of Shanxi Medical University from May 2014 to April 2020 were analyzed retrospectively. Of the patients, 48 cases of clinically organ-confined prostate cancer and 51 cases of benign prostatic hyperplasia confirmed by clinical data and pathology were selected as research objects. The characteristics of transrectal multimodal ultrasound in the two groups were compared. Combined with PSA, logistic regression analysis was applied to screen the statistically significant features, and then the diagnosis model was established, and odds ratio of the variables were compared. The receiver operating characteristic (ROC) curve was constructed to analyze the predicting ability of the diagnosis model.Results:Four features were obtained with logistic regression analysis finally, including enhancement type, enhancement degree, elastography mode and PSA. The odds ratio of enhancement degree was higher than those of the other independent variables. The area under ROC curve of the diagnosis model was 0.868 ( P<0.01), the cut-off value was 0.514. The sensitivity and specificity of the diagnosis model in predicting clinically organ-confined prostate cancer was 79.2% and 80.4%, respectively. Conclusions:This combined diagnosis model of transrectal multimodal ultrasound and PSA has a certain clinical value in predicting clinically organ-confined prostate cancer.

Risk factors of long-term mortality in patients with acute pulmonary embolism and the predictive value of echocardiography / 中华全科医师杂志

Objective:To investigate the risk factors of long-term mortality in patients with acute pulmonary embolism (APE) and to explore the predictive value of echocardiography.Methods:A total of 109 APE patients admitted in First Hospital of Shanxi Medical University between December 2010 and November 2014 were enrolled in this study. APE was diagnosed by computed tomography pulmonary angiography (CTPA) or ventilation-perfusion pulmonary scintigraphy. Transthoracic echocardiography (TTE) parameters and clinical parameters within 48 h of onset were collected. All the patients were treated with standard anticoagulation, thrombolysis, or thrombectomy. Regular follow-up was carried out, with the average follow-up period of (7.20±1.04) years. The patients were divided into survival group and fatal group according to their follow-up results. The echocardiographic parameters and primary biochemical laboratory parameters within 48 h after onset were compared between the survival group and the fatal group by t test or χ 2 test. Cox regression analysis was conducted to analyze the influencing factors of long-term prognosis of patients with APE. Survival analysis was performed in patients with echocardiographic assessment of right ventricular (RV) enlargement and/or dysfunction and without RV enlargement and/or dysfunction by Kaplan-Meier method, and the survival curves were plotted. The comparison between the two groups was performed by log-rank test. Results:The average follow-up period was (7.20±1.04) years. Fourteen patients were lost in the follow-up, and 95 patients were included in the final analysis, among whom 58 survived and 37 died with a fatality rate of 39.0%. Cox regression analysis showed that age ( HR=2.32, 95% CI:1.31-4.13, P=0.004), malignancy ( HR=6.49, 95% CI:2.32-18.14, P<0.001), right atrial (RA)/left atrial (LA) area ratio ( HR=2.01, 95% CI:1.16-3.48, P=0.013), RV enlargement and/or dysfunction ( HR=5.90, 95% CI: 1.45-23.94, P=0.013), Charlson comorbidity index (CCI) score ( HR=1.75, 95% CI: 1.04-2.96, P=0.035), low oxygen saturation ( HR=1.70, 95% CI:1.14-2.53, P=0.009) were independent risk factors associated with long-term mortality in patients with APE. Kaplan Meier survival curve analysis showed that the cumulative survival rates of patients with RV enlargement and/or dysfunction at 1, 3, 5 and 7 years were 92.8%, 66.7%, 59.4% and 52.2% respectively, and those without RV enlargement and/or dysfunction were 96.2%, 92.3%, 84.6% and 84.6%,respectively (log rank test, P=0.006). Conclusions:Patients with APE have high long-term mortality. Early echocardiographic RV enlargement and/or dysfunction, RA/LA area ratio, age, malignant tumor, CCI score and low oxygen saturation are independent risk factors related to long-term mortality in patients with APE. Ultrasound evaluation of patients with RV enlargement and/or dysfunction has a certain value in predicting long-term mortality in patients with pulmonary embolism.

Analysis of research hot-spots and development trends of county-level TCM hospitals in China based on CiteSpace / 国际中医中药杂志

Objective:To analyze the current development status, research hot-spots and development trends of county-level Chinese hospitals in China.Methods:By retrieving the papers of county-level Traditional Chinese Medicine (TCM) hospitals in China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodicals Full-text Database (VIP), Wanfang and China Biomedical Database (SinoMed ) with CiteSpace 5.5.R2 software to draw maps of the author, institution and keyword and make analysis.Results:A total of 598 papers are included in this study, and the trend of publications shows an upward trend and then a downward trend. Researchers conduct research in the form of forming research teams. The research institutions are mainly medical colleges and scientific research institutions. The most frequently showed keyword is "medical reform". The keyword knowledge map shows that the research content mainly involves medical reform, problem analysis and countermeasures, economic operation efficiency, TCM service capability, data envelopment analysis and so on.Conclusions:The county-level TCM hospitals generally show sound development trend in China. The research trend is dominated by county-level TCM hospitals. Scale development has been transformed into the study of hospital operation efficiency. County-level TCM hospitals need to start from their own actual conditions, strengthen cooperation in the form of teams and strengthen academic cooperation among institutions, so as to realize the basic TCM services for ordinary people.

Cohort study of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis in China: evaluation of risk models and new predictor of pulmonary consolidation on computed tomography / 医学前沿

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe diseases. This study aimed to validate the predictive ability of risk models in patients with SJS/TEN and propose possible refinement in China. Patients in the Department of Dermatology of Huashan Hospital from January 2008 to January 2019 were included. Results showed that the severity-of-illness score for TEN (SCORTEN) had a good discrimination (area under the receiver operating characteristic curve (AUC), 0.78), and it was superior to auxiliary score (AS) and ABCD-10, which indicates age, bicarbonate level, cancer, dialysis, and 10% involved body surface area (AUC, 0.69 and 0.68, respectively). The calibration of SCORTEN (Hosmer-Lemeshow goodness-of-fit test, P = 0.69) was also better than that of AS (P = 0.25) and ABCD-10 (P = 0.55). SCORTEN and ABCD-10 were similar (Brier score (BS), 0.04 and 0.04) in terms of accuracy of predictions. In addition, the imaging appearance of pulmonary consolidation on computed tomography was associated with high mortality. Refined models were formed using the variables and this imaging appearance. The refined AS and ABCD-10 models were similar in discrimination compared with the original SCORTEN (0.74 vs. 0.78, P = 0.23; 0.74 vs. 0.78, P = 0.30, respectively). Therefore, SCORTEN showed good discrimination performance, calibration, and accuracy, and refined AS or ABCD-10 model may be an option when SCORTEN variables are not available.

Effect of intensive analgesia on post-traumatic stress disorder in patients with acute trauma / 中华急诊医学杂志

Objective:To explore the influence of intensive analgesia on the incidence of post-traumatic stress disorder (PTSD) in acute trauma patients, and to develop new ideas for the prevention and treatment of PTSD.Methods:From January 2018 to November 2019, a prospective study was conducted on trauma patients who visited the Emergency Center of Affiliated Hospital of Xuzhou Medical University and met the enrollment criteria. The patients were divided into the intensive analgesia group (< 4) and non-intensive analgesia group (≥ 4) according to the mean pain score in 30 days. The epidemiological data, trauma-related parameters, analgesic schemes, VAS score, PCL-5 score, HADS score and incidence of PTSD of enrolled patients were collected. Appropriate statistical methods were used to analyze differences among the indicators between the two groups.Results:Eighty-four acute trauma cases were included in the study, 39 cases in the intensive analgesia group and 45 in the non-intensive analgesia group. There was no significant difference in baseline data between the two groups (all P>0.05). The incidence rate of PTSD and PCL-5 score of patients in the intensive analgesia group were all significantly lower than those in the non-intensive analgesia group in 1 month after the trauma (all P< 0.05). The HADS anxiety and depression scores of patients in the intensive analgesic group were significantly lower than those in the non-intensive analgesic group (all P< 0.05). All the analgesics were converted into the dosage of dezocine for comparison. The total dosage of analgesics (dezocine) used in patients of the intensive analgesia group was significantly higher than that in the non-intensive analgesia group within 30 days after injury ( P< 0.05). Conclusion:In the acute trauma patients, intensive analgesia after trauma can significantly reduce the incidence of PTSD as well as improve anxiety and depression symptoms.

Application of 5G technology in surgery / 中华消化外科杂志

The fifth generation wireless systems (5G technology) has the characteristics of high system capacity, high data transmission rate, massive device connectivity, extremely low latency, and ultra-reliability. With the advent of 5G technology, modern surgery has made new progress in telesurgery, tele-consultation, remote instruction and teaching, remote monitoring and ambulance. "5G+ surgery" is still in its infancy, and with the gradual improvement of 5G technology, its application in the surgical field will continuously deepen and expand.

The effect of traumatic pain on the incidence of early post-traumatic stress disorder / 中华急诊医学杂志

Objective:To investigate the effect of post-traumatic pain on post-traumatic stress disorder (PTSD).Methods:A prospective trial was conducted with the recruitment of patients referred to the Emergency Center of Affiliated Hospital of Xuzhou Medical University for acute trauma from January 2018 to June 2019, with the exclusion criteria: age < 18 years, severe eye injury, severe craniocerebral injury and other critical conditions. The clinical data and written informed consent were collected at admission, the post-traumatic pain was assessed by VAS scores and the trauma severity was assessed by ISS score. APACHEⅡ score were evaluated within 24 h after admission. One month after trauma, patients with history of mental illness, or history of major psychogenic trauma within one year or drug addiction were further excluded. Accordingly, 64 eligible patients were evaluated by VAS, and the PCL-5 scale was used to evaluated their PTSD symptoms. The patients were divided into the PTSD group and non-PTSD group according to PCL-5 score≥ 38, and the difference between the two groups in post-traumatic VAS scores was compared. Logistic regression analysis was used to analyze the risk factors of PTSD. Spearman correlation analysis was adopted to establish the correlation between VAS score at admission and PCL-5 score at one month after trauma. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of traumatic pain intensity for PTSD onset.Results:Sixty-four patients were selected and defined as the PTSD group ( n=19) and non-PTSD group ( n=45). The VAS score at admission was significantly higher in the PTSD group than that in the non-PTSD group ( P=0.006). There was no significant difference in VAS scores and VAS variations at 1 month, and in ISS scores at admission and APACHEⅡ scores within 24 h after admission between the two groups. Traumatic pain was an independent risk factor for PTSD ( P=0.043). VAS score at admission was positively correlated with PCL-5 score at 1 month post-traumatically ( r=0.355, P=0.004). In addition, ROC curve analysis showed that VAS score > 8 at admission had predictive value for PTSD (sensitivity=100%, specificity=33%, P=0.000 2). Conclusions:Post-traumatic severe pain is an independent risk factor for PTSD, which requires prompt medical intervention.

Moderating effect of sleep quality on the relationship between problematic mobile phone use and anxiety of college students / 中国学校卫生

Objective@#To describe the prevalence of problematic mobile phone use and anxiety in college students, and explore the mediating effect of sleep quality on the relationship between problematic mobile phone use and anxiety, and to provide reference for physical and mental health promotion of college students.@*Methods@#One medical college and a comprephensive college were selected in Hefei city of Anhui Province and Shangrao City of Jiangxi Province, respectively, and a cross-sectional survey was conducted. A total of 1 135 valid questionnaires were collected. The self-rating questionnaires regarding basic information of college students, use the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use(SQAPMPU) and the Self-Rating Questionnaire for Depression-Anxiety-Stress for Adolescent Problematic Mobile Phone Use(DASS-21) was used to evaluate problematic mobile phone use and anxiety, respectively. The Pittsburgh Sleep Quality Index(PSQI) was used to evaluate sleep quality.@*Conclusion@#The detection rates of college students with problematic mobile phone use and poor sleep quality were 24.6% and 13.3%, respectively. The detection rates of college students anxiety grouped by severity were 5.1%, 23.9%. Multiple Logistic regression analysis showed a positive linear correlation between problematic mobile phone use and anxiety[OR values(95%CI) were 1.86(1.01-3.44), 4.34(3.14-5.99), P<0.01]. The results of process showed that sleep quality played a moderating role between problematic mobile phone use and anxiety(R2=0.37, F=220.52, P<0.01). Interaction term s β=0.09(P<0.05).@*Conclusion@#The prevalence of problematic mobile phone use is high in college students, and problematic mobile phone use is positively related to anxiety. Good sleep quality can alleviate the relationship between mobile phone dependence and anxiety of college students.

Effect of interferon-γ combined with tumor necrosis factor-related apoptosis-inducing ligand on programmed necrosis of HaCaT cells and its mechanisms / 中华皮肤科杂志

Objective To evaluate the inductive effect of interferon-γ(IFN-γ) combined with tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) on programmed necrosis of the human immortalized keratinocyte cell line HaCaT,and to explore its mechanisms.Methods In vitro cultured HaCaT cells were divided into several groups:negative control group receiving no treatment,IFN-γ group treated with 50 μg/L IFN-γ,TRAIL group treated with 4 μg/L TRAIL,and cytokine combination group treated with 50 μg/L IFN-γ and 4 μg/L TRAIL or zVAD combination group pretreated with 40 μmo/L zVAD for 1 hour followed by the treatment with 50 μg/L IFN-γand 4 μg/L TRAIL.After 48-hour treatment,the morphology of HaCaT cells were observed under a light microscope,methyl-thiazolyl-tetrazolium assay was performed to evaluate the inhibitory effect of the treatment on the proliferation of HaCaT cells,and double staining flow cytometry to detect the necrosis of HaCaT cells.Meanwhile,real-time fluorescence-based quantitative PCR (qPCR) was conducted to determine the mRNA expression of receptor interaction protein kinase 3 (RIP3) and mixed lineage kinase domain-like protein (MLKL),Western blot analysis to determine the expression of RIP1,RIP3,MLKL proteins and their phosphorylated forms (pRIP1,pRIP3,pMLKL),immunofluorescent staining to observe the distribution of pRIP3 and pMLKL in HaCaT cells,and the level of reactive oxygen species (ROS) in HaCaT cells in the above groups was detected by the fluorescence probe DCFH-DA.Statistical analysis was carried out with SPSS 22 software by using one-way analysis of variance (ANOVA) for comparing indices among different groups,and least significant difference (LSD)-t test for multiple comparisons.Results After 48-hour treatment,HaCaT cells in the cytokine combination group and zVAD combination group showed necrosis-like morphologic features.Methyl-thiazolyl-tetrazoliumassay revealed significant differences in the survival rate of HaCaT cells among the IFN-γgroup,TRAIL group,cytokine combination group,zVAD combination group and negative control group (73.16％ ± 5.71％,81.46％ ± 4.68％,72.18％ ± 2.93％,69.67％ ± 3.24％ and 100％,respectively;F =24.34,P ＜ 0.001).The necrosis rate of HaCaT cells was notably higher in the cytokine combination group and zVAD combination group (9.86％ ± 1.31％,10.33％ ± 2.16％,respectively) than in the negative control group (5.26％ ± 0.91％,t =4.61,5.07,respectively,both P ＜ 0.05).qPCR revealed that the mRNA expression of RIP3 and MLKL significantly increased in the cytokine combination group and zVAD combination group compared with the negative control group (tRIP3 =0.99,1.84,tMLKL =1.51,2.17,respectively,all P ＜ 0.05).Western blot analysis suggested that the protein expression of RIP1,RIP3,MLKL,pRIP1,pRIP3 and pMLKL significantly increased in the cytokine combination group compared with the negative control group (all P ＜ 0.05),and the zVAD combination group showed significantly decreased caspase 8 expression and increased expression of the above proteins compared with the cytokine combination group.Fluorescence microscopy showed that enhanced green dot-like or clump-like fluorescent spots (representing pRIP3) could be observed in the cytoplasm,and red fluorescent spots (representing pMLKL) could be seen on the cell membrane in the cytokine combination group.The average fluorescence intensity of ROS was significantly higher in the cytokine combination group than in the negative control group (t =702.00,P ＜ 0.05).Conclusion IFN-γcombined with TRAIL can induce the programmed necrosis of HaCaT cells with increased level of ROS.

Application value of pancreaticojejunostomy with double-layer continuous suture in total laparoscopic pancreaticoduodenectomy / 中华消化外科杂志

Objective To investigate the application value of pancreaticojejunostomy with double-layer continuous suture in total laparoscopic pancreaticoduodenectomy (TLPD).Methods The retrospective crosssectional study was conducted.The clinicopathological data of 21 patients who underwent TLPD with pancreaticojejunostomy using double-layer continuous suture in the Second Hospital of Jilin University between January and December 2017 were collected.The anastomosis used Child method,and pancreaticojejunostomy,choledochojejunostomy and gastroenteric anastomosis in turn were done.Observation indicators:(1) surgical and postoperative recovery;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival and tumor recurrence or metastasis up to February 2018.Measurement data with normal distribution were represented as x±s.Measurement data with skewed distribution were described as M (P25,P75).Results (1) Surgical and postoperative recovery:21 patients underwent successful TLPD with pancreaticojejunostomy with double-layer continuous suture.The operation time,time of pancreaticojejunostomy and volume of intraoperative blood loss were respectively (352±25)minutes,(46±8)minutes and (168±34) mL.There was no intraoperative blood transfusion.The time of postoperative abdominal drainage-tube removal was (10.1±4.4)days.Of 21 patients,12 were complicated with biochemical fistula,and 3 with grading B of pancreatic fistula (pancreatic duct in type Ⅱ),and they were improved by inhibiting pancreatic secretion and drainage patency.There was no occurrence of biliary fistula,chylous fistula,postoperative bleeding,abdominal infection and delayed gastric emptying.The duration of postoperative hospital stay of 21 patients was (11.3± 2.0) days.(2) Postoperative pathological examination:surgical margins of 21 patients were negative.The pathological type:8,6,4,2 and 1 patients were diagnosed as distal bile duct cancer,ampulla cancer,duodenal papilla and duodenal cancer,pancreatic head cancer and neuroendocrine cancer of ampulla,respectively.(3) Follow-up and survival situations:21 patients were followed up for 3-12 months,with a median time of 7 months.During the follow-up,all the patients survived,and there was no tumor recurrence and metastasis.Conclusion Pancreaticojejunostomy with double-layer continuous suture is safe and feasible for TLPD,with advantages of exact anastomosis effect and good application value.

Current situation of traditional Chinese medicine on the health management / 国际中医中药杂志

Awareness of Health-Preservation management of traditional Chinese medicine (TCM) in public was investigated from June to early July in 2017 by the web of question nairein vestigation"Wenjuanxing". The result showed that 324 of 369 questionnaires were received and checked, accounting for 87.8%. In conclusion, the awareness of Health-Preservation management of TCM in public was poor, and it's important to raise the publicity of Health-Preservation management of TCM firstly in the community hospital in order to increase the awareness of people's acception.

Influence of size and depth of thyroid carcinoma on diagnostic accuracy of ultrasound-guided fine-needle aspiration / 中国介入影像与治疗学

Objective To investigate the influence of size and depth of thyroid carcinoma for diagnostic accuracy of ultrasound-guided fine-needle aspiration (US-FNA).Methods A retrospective review of clinical and preoperative US-FNA data of 87 malignant thyroid nodules confirmed by surgical pathology from 87 patients was performed.According to the the Bethesda System for Reporting Thyroid Cytopathology (BSTC),the grade that higher than grade Ⅳ was the cytologic criteria for diagnosis of thyroid carcinoma.According to the cytopathological data of thyroid carcinoma confirmed by surgical pathology,the patients were divided into group A (cytopathological data was same as the surgical pathology result) and group B (cytopathological data was not same as the surgical pathology result).The longest diameter of malignant thyroid nodules and the distance from the shallow of thyroid nodules to superficial capsule of thyroid gland were analyzed.The ROC analysis was performed to find the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland.Results The consistent rate between US-FNA and surgical pathologic results was 79.31 ％ (69/87).The longest diameter of thyroid carcinoma of group A and group B was (1.63±0.58)cm and (1.01±0.42)cm respectively,which was statistically different (P＜0.01).The distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland of group A and group B was (4.15±1.83) mm and (7.86±2.08)mm respectively,which was statistically different (P＜0.01).According to the ROC analysis results,the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland was 1.05 cm and 6.1 mm respectively.Conclusion Diagnosis accuracy of US-FNA could be influenced by size and depth of thyroid carcinoma.

Isomers and their metabolites of endosulfan induced cytotoxicity and oxidative damage in SH-SY5Y cells.

As an organochlorine insecticide, endosulfan has been widely banned or restricted, but it is still largely used in many developing countries. Previous studies have shown multiple adverse health effects of endosulfan. However, the neurotoxicity of endosulfan has not been fully elucidated. In this study, endosulfan isomers (α-/ß-endosulfan) and their major metabolites (endosulfan sulfate, endosulfan diol, and endosulfan lactone) were, respectively, exposed to human neuroblastoma SH-SY5Y cells. Results showed that both α-endosulfan and ß-endosulfan caused decrease of cell viability and morphological damages in a dose-dependent manner. Their median effective concentrations (EC50s) were respectively 79.6 µM (α-endosulfan) and 50.37 µM (ß-endosulfan) for 72 h exposure. EC50s of α/ß-endosulfan mixture were lower than that of the single isomer. However, EC50s of its metabolites were higher than that of technical endosulfan. Endosulfan and its metabolites caused increases of reactive oxygen species and the lipid peroxidation, but decrease of superoxide dismutase in a dose-dependent manner. These results indicate that α-endosulfan exhibits higher neurotoxicity than ß-endosulfan. Mixture of endosulfan isomers shows stronger cytotoxicity than the single isomer. After endosulfan is degraded, cytotoxicity of its metabolites decreases gradually. The neurotoxicity of endosulfan and its metabolites is closely related to oxidative damage and antioxidative deficit.

STAT3 expression and its relationship with DNA methylation in patients with systemic lupus erythematosus / 中华皮肤科杂志

Objective To investigate DNA methylation status as well as signal transducer and activator of transcription 3 (STAT3) gene expression in peripheral blood T-lymphocytes from patients with systemic lupus erythematosus (SLE),and to explore their relationship.Methods Peripheral blood samples were obtained from 34 patients with SLE and 23 healthy controls followed by the isolation of T-lymphocytes.Flow cytometry was performed to evaluate DNA methylation status using antibodies against 5-methylcytosine (5-me),reverse transcription (RT)-PCR to detect the mRNA expression of STAT3 in T-lymphocytes.Results Compared with healthy controls,17 patients with active SLE showed significantly decreased DNA methylation levels (8.50 ± 1.42 vs.11.31 ± 1.34,P ＜ 0.01),but increased STAT3 mRNA expression levels (1.34 ± 0.32 vs.1.02 ± 0.28,P ＜ 0.01).However,there were no significant differences between 17 patients with stable SLE and healthy controls in DNA methylation levels (11.30 ± 1.34 vs.11.31 ±1.34,P ＞ 0.05) or STAT3 mRNA expression levels (1.01 ± 0.27 vs.1.02 ± 0.28,P ＞ 0.05).Patients with active SLE also showed significantly reduced DNA methylation levels,but enhanced STAT3 mRNA expression compared with those with stable SLE (both P ＜ 0.01).As Pearson correlation analysis showed,SLE disease activity index (SLE-DAI) was negatively correlated with DNA methylation levels in patients with SLE (r =-0.78,P ＜ 0.01),but positively correlated with STAT3 mRNA expression (r =0.50,P ＜ 0.01),and no significant correlation was observed between STAT3 mRNA expression and DNA methylation levels (r =-0.13,P ＞ 0.05).Conclusion The aberrant expression of STAT3 in peripheral blood T-lymphocytes may be related to disease activity in SLE,but unrelated to DNA methylation levels.

Effects of Recombinant Human Interferon α1b Combined with Ribavirin on Thyroid Function in Chronic Hepatitis C Patients / 中国药房

OBJECTIVE:To observe the effects of recombinant human interferon (IFN)α1b on thyroid function of patients with chronic hepatitis C(CHC). METHODS:Retrospective collection 90 CHC patients,according to whether to merge with hyper-thyroidism into hypothyroidism group,hypothyroidism group and CHC group,30 cases in each group. 3 groups were given IFN-α1b 40μg,qod,combined with ribavirin 0.1 g,tid,for antiviral therapy. Before and after therapy,RVR,EVR,ETVR and SVR were observed in 3 groups,and the levels of T3,T4,FT3,FT4 and TSH were observed in hypothyroidism group,hypothyroidism group before and after antiviral therapy. RESULTS:After treatment,RVR,EVR,ETVR and SVR levels of 3 groups increased sig-nificantly,with statistical significance,compared with before treatment(P0.05);there was no statistical sig-nificance in the levels of T3,T4,FT3,FT4 and TSH before and after treatment(P>0.05). CONCLUSIONS:IFN-α1b combined with ribavirin can obtain good antiviral effect and not worsen existing thyroid disease in the treatment of CHC complicated with thy-roid disease.

Effects of electroacupuncture on the activities of gliocytes of cervical spinal cord in rats with thyroid incisional pain / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts of electroacupuncture (EA) on microgliacytes and astrocytes of cervical spinal cord in rats with thyroid incisional pain and explore the mechanism of acupuncture anesthesia in thyroid surgery.</p><p><b>METHODS</b>Sixty Wistar male rats were randomized into a normal group, a model group, a Futu (LI 18) group, a Hegu (LI 4)-Neiguan (PC 6) group and a Zusanli (ST 36)-Yanglingquan (GB 34) group, 12 rats in each one. Except the normal group, a longitudinal incision, about 1.5 cm in length was done along the neck midline in the rats of the rest groups to prepare the model of thyroid incisional pain. In the Futu (LI 18) group, the Hegu (LI 4)-Neiguan (PC 6) group and the Zusanli (ST 36)-Yanglingquan (GB 34) group, after modeling for 4 h, 24 h and 48 h, EA was applied to bilateral "Futu" (LI 18), "Hegu" (LI 4) "Neiguan" (PC 6) and"Zusanli" (ST 36) "Yanglingquan" (GB 34) separately, once a day, continuously for 3 days. In the normal group and the model group, no any intervention was applied. The thermal radiant apparatus was used to detect the thermal pain threshold (PT). The fluorescence quantitative RT-PCR and the Western blotting (WB) were used to determine the expressions of protein and gene of microglia activation markers Iba1 and CD11b and the astrocyte specific protein marker, glial fibrillary acid protein (GFAP) in cervical spinal cord (Cto C) after intervention in the rats of each group.</p><p><b>RESULTS</b>After intervention, as compared with the normal group, in the model group, the neck PT was reduced apparently (<0.05), the expressions of Iba1 and CD11b and GFAP mRNA as well as the protein expressions in the spinal cord of Cto Cwere up-regulated apparently (<0.05,<0.01). As compared with the model group, in the Futu (LI 18) and the Hegu (LI 4)-Neiguan (PC 6) group, PT was increased significantly (both<0.05) and that did not change apparently in the Zusanli (ST 36)-Yanglingquan (GB 34) group (>0.05). In the Futu (LI 18) group, the protein and gene expressions of Iba1, CD11b and GFAP were lower than those in the model group (all<0.05). In the Hegu (LI 4)-Neiguan (PC 6) group, the expressions of Iba1 mRNA, CD11b protein, GFAP mRNA and protein were all lower apparently than those in the model group (all<0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1, CD11b and GFAP proteins were not different significantly as compared with the model group (all>0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1 mRNA and CD11b mRNA and protein expressions in the spinal cord of Cto Cwere higher apparently than those in the Futu (LI 18) group (<0.01,<0.05); the expressions of Iba1 mRNA and CD11b protein expressions were higher than those in the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05); GFAP mRNA and protein expressions were higher apparently than those in the Futu (LI 18) group and the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05).</p><p><b>CONCLUSIONS</b>EA at "Futu" (LI 18) or "Hegu" (LI 4), "Neiguan" (PC 6) relieves the acute neck incisional pain in the rats and its effect may be closely relevant with the down-regulation of the activities of microgliacytes and astrocytes in the spinal cords.</p>

Analysis of traditional Chinese medical institutions service quantity in 2008-2013 / 国际中医中药杂志

The service of Traditional Chinese medical institutions consists Outpatient Care and Inpatient Care. The author summarizes the service situation of Traditional Chinese medical institutions in the last six years, by contrasting and analyzing the following quotas: the total number of treatment in the emergency door, the number of discharged patients, hospital admissions per 100 outpatient emergency treatment, rate of utilization of hospital beds, the average days of staying in hospital and doctors work efficiency, and then give some reasonable suggestions.

Effect of Cdc42 gene inhibited on proliferation, migration and invasion in human hepatocellular carcinoma cells / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of Cdc42-shRNA plasmid to proliferation, migration, invasion and other malignant biological behavior in hepatoma SMMC-7721 cells.</p><p><b>METHODS</b>Cdc42-shRNA interfering vector transfected to SMMC-7721 cells with liposome method. The growth curve of transfected cells SMMC-7721, U6-control, Cdc42-shRNA2 was detected by MTT. The cells mobility was detected by wound healing experiment. Transwell chamber experiments to observe the cell migration and invasion. Detected AFP and PCNA expression level by Western blot.Human hepatoma SMMC-7721 transplanted subcutaneously in nude mouse, detected the expression of Cdc42 of the tumor by immunohistochemistry.t test was used to analyze the data between two groups.</p><p><b>RESULTS</b>The doubling time of Cdc42-shRNA2, U6-control and SMMC7721 was 42.7 h, 34.9 h and 35.1 h. The relative migration distance of Cdc42-shRNA2 and U6-control on 36 h was (47.1 ± 4.1)% and (86.6 ± 5.3)% (t=-10.21, P<0.05). Transwell chamber experimental methods showed the numbers of permeating cells were 18.2 ± 2.1(Cdc42-shRNA2) and 41.0 ± 3.5 (U6-control) (t=-9.67, P<0.05) on 24 h. The AFP and PCNA expression of hepatoma cells is significantly inhibited after the Cdc42-shRNA2 was transfected compared with U6-control group.The tumor average weight of group Cdc42-shRNA2 was (335.1 ± 178.2) mg, which was much lighter than that of SMMC-7721 group ((925.3 ± 241.4) mg) and U6-control group ((910.5 ± 225.6) mg) (t=-4.47, -4.39; P<0.05) and the Cdc42 expression was also weak positive.</p><p><b>CONCLUSION</b>Cdc42 interfere with plasmid significant changes in human malignant biological behavior of hepatocellular carcinoma cells, and reduces liver cancer cell growth, invasion and metastasis of capacity.</p>

Clinical efficacy of surgical treatment for chronic pancreatitis with mass in the head of the pancreas / 中华消化外科杂志

Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.