BACKGROUND: There are many reports on treatment of senile memory impairment with huperzine A, aniracetam, ginkgobiloba, etc. But, a strict double-blind and double-dummy design is deficit during experiment.OBJECTIVE: With cognition, symptoms of yin deficiency of liver and kidney and memory taken as observed indexes, double-blind and doubledummy method was used to observe the therapeutic effects of Chinese drug naolibao on senile memory impairmentof yin deficiency of liver and kidney. DESIGN: Prospective clinical experiment with randomized controlled double-blind and double-dummy method was designed. SETTING: Department of Neurology of Affiliated Hospital with Changchun College of Chinese Medicine, Department of Medicament of 2nd Clinical Hospital Affiliated to Jilin University.PARTICIPANTS: Totally 80 cases of memory impairment were from the clinic of Department of Neurology of affiliated Hospital with Changchun College of Chinese Medicine from April to December 2000. They were aged varied from 40 to 75 years, with mild non-constant poor memory, differentiated as yin deficiency of liver and kidney and diagnosed as questionable dementia in Chinese medicine, scored as 0 or 0.5 according to Clinical Dementia Assessment Scale (CDAS) and their integrals were > 17 (illiteracy) or > 20 (elementary-school educated) or > 23 (juniorschool educated) and < 30 according to MMSE (mini mental status examination).METHODS:The patients were randomized into experimental group (n=43) and the control (n=37). In experimental group, naolibao wan was administrated, composed of dihuang (Radix Rehmanniae), tusizi (SemenCuscutae), digupi (Cortex Lycii), yuanzhi (Radix Polygalae), shichangpu (Rhizoma Acori Graminei) and fuling (Poria), 4 pills/times, 3 times/day,and piracetan blank tablet was given, 2 tablets/time, 3 times/d. In the control, piracetan tablet 400 mg/tablet was prescribed, two tablets/time,3 times/day and naolibao blank pill was administrated, 4 pills/time,3 times/day. The course of treatment was 6 weeks. On observed spot,named base-line spot (before treatment) and terminal spot (after treatment), the integrals were examined and recorded on symptoms, physical signs and neuropsychology successively. Follow-up visit was carried on for the cases with remarkable effects. Therapeutic effects of syndromes in Chinese medicine were based on the evaluating criteria of Clinical Plan of Treatment with Naolibao Wan for Senile Memory Disturbance of Yin Deficiency of Liver and Kidney. In comparison of decreased symptomatic integral after treatment with average symptomatic integral before treatment, remarkable effect: ≥ 2/3, effect: 1/3-2/3, no effect: ≤ 1/3. The therapeutic effects on cognition and memory were assessed by the formula [(integral after treatment-integral before treatment)÷integral before treatment] ×100%. Clinical control: ≥ 85%, remarkable effect:≥ 50%, effect: ≥ 20% and no effect: ≥ 20%.MAIN OUTCOME MEASURES: ① Comparison before and after treatment of yin deficiency of liver and kidney in two groups. ② Comparison of integrals before and after treatment for yin deficiency of liver and kidney of two groups. ③ Comparison of evaluation of every index for memory in two groups. ④ Results of follow-up visits for the cases with remarkable effects. ⑤ Harmful accident and side effects.RESULTS: Totally 43 cases in experimental group and 37 cases in the control were all employed in result analysis. ① Comparison before and after treatment of yin deficiency of liver and kidney in two groups: The reduced score in differentiation of symptoms, improvement of severity of yin deficiency of liver and kidney and promoted therapeutic effects on syndrome in experimental group were superior to those in the control, indicating significant difference (P < 0.05-0.01). ② Comparison of integrals before and after treatment for yin deficiency of liver and kidney of two groups: The improvement of dream-disturbed sleep, tinnitus and deafness in experimental group was superior to that in the control, indicating significant difference (P < 0.05-0.01). ③ Comparison of evaluation of every index for memory in two groups: The improvement of immediate recall and retarded recall in experimental group was superior to that in the contol,indicating significant difference (P < 0.05-0.01). ④ Results of follow-up visits for the cases with remarkable effects: Three months later, the disease was not aggravated among the cases with remarkable effects in two groups.⑤ Harmful accident and side effects: After treatment, there was no abnormal alternation and harmful reaction for safe indexes compared with those before treatment, such as blood routine, urine routine, feces routine, liver function, kidney function, etc.CONCLUSION: Naolibao wan improves memory, immediate recall, recog nition, dream-disturbed sleep, tinnitus and deafness for aged people, which is superior to piracetan tablet and it is safe and reliable in treatment.

Objective To evaluate the biological potential of surface topography of biomimetic matrix combined PRP gels with RGD modification. Methods Surface topography of nβ-TCP/Cs/PCL matrix was made by Nd: YAG laser, tissue-engineered bone was constructed in the following ways: ADSCs were loaded to nβ-TCP/Cs/PCL matrix with PRP gels plus RGD modification (group A), ADSCs were cultured to nβ-TCP/Cs/PCL matrix with RGD modification (group B), ADSCs implantation with topography-surfaced treatment of matrix (group C), ADSCs cultivation with smooth-surfaced treatment of matrix (group D). SEM and CLM were used to observe cellular pattern, survival rate, cell activity, ALP and collagen type Ⅰ level were detected at 1, 4, 8, 12, 16, 20, 24,28 days. Runx2 and OPG expressions were assayed at different interval. Results Under observation of SEM and CLM, new tissue showed more remarkable cell proliferation with abundant ECM in group A. Compared with other groups, the survival rate in group A was significantly higher (88.16 ± 1.29, P ＜ 0.05),and the level of cell activity, ALP, collagen type Ⅰ were significantly higher (0.92± 0.13, 87.27 ± 3.08, 93.27 ± 3.91, P＜ 0.05), and remarkable expression of Runx2 and OPG was also seen. Conclusion Topography-surfaced treatment of matrix combined PRP gels with RGD modification enhances the cell proliferation and acts as a feasible osteopromotive method.

Objective To study the value of three-dimensional pseudo-continuous arterial spin labeling(3D pCASL) for estimating collateral flow after middle cerebral artery(MCA) stenosis.Methods 3D pCASL was performed in 28 cases of negative diffusion weighted imaging(DWI) patients with MCA stenosis for estimating collateral vessels formation.The post-labeling delay(PLD) of 3D pCASL was set to 1.5 s and 2.5 s.The cerebral blood flow (CBF) of 3D pCASL with two PLD was calculated by AW workstation respectively.Nineteen normal persons were regarded as the control group.The 95% confidence interval of the ratio of left/right side of CBF of control group was set as reference value.The characteristic of the ratio of stenosed/contralateral side of CBF was analyzed.The characteristics of collateral flow was investigated with digital subtraction angiography(DSA).Results Abnormal perfusion was found in 28 patiens.Two types of abnormal perfusion were found, including typeⅠ: rCBF(PLD=1.5 s) decreased,rCBF(PLD=2.5 s) was normal (n=16);typeⅡ:rCBF(PLD=1.5 s) decreased,rCBF(PLD=2.5s) decreased (n=12).On brain DSA, abundant of collateral flow supply was found in 16 patients with typeⅠabnormal perfusion,whereas deficiency of collateral flow supply was found in 12 patients with typeⅡ.Conclusion 3D pCASL with two PLDs may provide important reference value for estimating collateral flow after middle cerebral artery stenosis.

Objective To explore the value of intravoxel incoherent motion (IVIM) imaging in evaluating diffusion and perfusion variations in subacute brain infarction.Methods MRI data of 35 patients with subacute brain infarction were analyzed retrospectively,including routine DWI,IVIM imaging and three-dimensional arterial spin labeling (3D-ASL) sequence.The ADC maps were obtained by routine DWI sequence.Pure molecular-based diffusion coefficient (D) maps,pseudo diffusion coefficient of perfusion (D*) maps and perfusion fraction (f) maps were obtained by IVIM sequence.Cerebral blood flow (CBF) maps were obtained by 3D-ASL sequence.ADC,D,D*,f,CBF values and the relative values (rADC,rD,rD*,rf,rCBF) of brain infarction lesion and contralateral mirror area were calculated.All the parameters between brain infarction lesion and contralateral mirror area were compared.The correlations were analyzed between rADC value and rD,rD*,rf values respectively,as well as between rCBF value and rD,rD*,rf values respectively.Results Quantitative analysis showed significant decreases of ADC,D,D*,f and CBF values in the brain infarction lesion compared with those in the contralateral mirror area (all P＜0.05).There were positive correlations between rADC value and rD,rf values (r=0.687,0.601,P=0.005,0.018).And the positive correlation was found between rCBF value and rf value (r=0.581,P=0.022).Conclusion IVIM imaging can concurrently provide the perfusion and diffusion informations of subacute brain infarction patients,which is helpful to further elucidate the mechanisms of subacute brain infarction.

Objective To study the efficacy of laparoscopic tumor resection combined with iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis. Methods There were 30 patients diagnosed as rectal carcinoma with synchronous hepatic metastasis detected by CT scan. Hepatic metastases were confirmed by needle biopsy under laparoscopy. Laparoscopic radical resection of rectal carcinoma and metastatic hepatic tumors was performed. Those metastatic tumors that could not be resected were managed by RAF. Iodine-125 was planted in the tumors' site. Results Seven new hepatic metastases were found by the laparoscopic ulstrasound during the operation. 8 hepatic metastatic lesions were removed, 25 tumors located in the right liver were managed by RAF. All patients were followed-up from 12 to 25 months(average 22. 3 months), Local recurrence was found in 6 patients, the 1-year survival rate was 73% (22/30). Conclusions Laparoscopic excision, Iodine-125 and radiofrequency ablation in the treatment of rectal carcinoma with synchronous hepatic metastasis is safe、effective、minimally invasive.

BACKGROUND:Polyvinyl alcohol (PVA) hydrogel with similar porous structure and mechanical properties to the natural cartilage is very suitable for the repair of articular cartilage. However, the pure PVA hydrogel after lyophilization wil be accompanied by the shrinkage of the polymer network and the col apse of the pores, leading to the inhomogeneous performance of the material even in the state of re-swel ing. Addition of the active polymer wil increase the cel adhesion ability of PVA hydrogel. OBJECTIVE:To construct PVA/lota-carrageenan (l-CA) composite materials with different mass fractions of l-CA and evaluate the biocompatibility with vascular endothelial cel s. METHODS:PVA/l-CA composite films with different contents of l-CA were fabricated and then co-cultured with vascular endothelial cel s. Attachment, proliferation and morphological changes of vascular endothelial cel s on the composite were observed by scanning electron microscope and MTT assay to evaluate its biocompatibility. PVA/l-CA three-dimensional scaffold with different contents of l-CA were constructed, and hemolysis experiment was conducted according to the biological evaluation standards of medical devices, and the porosity and pore size were observed using scanning electron microscope. RESULTS AND CONCLUSION:In vitro experimental results showed that the addition of l-CA could significantly increase the biological activity of PVA hydrogel, and promote the cel attachment and proliferation on the scaffold. The hemolysis rate of each experimental group was less than 5%(the accepted safety standard), suggesting that the composite materials were in accordance with the standard of medical devices for hemolysis experiment. These findings indicate that the composite scaffolds with 20%-30%l-CA possess the pore size suitable for cel growth and proliferation and the porosity beneficial for transportation of nutrients and metabolites, which can serve as an excel ent scaffold for tissue engineering.

Objective To study the clinical features and prognostic factors of patients with acute paraquat poisoning.Methods The clinical data of 108 patients with acute paraquat poisoning in Affiliated Hospital of Southwest Medical University from June 2013 to June 2015 were collected and followed up for half a year.The clinical features and prognostic factors were analyzed.Results Of 108 patients,about 90.00％ cases were from the rural areas,the married population accounted for 81.48％.Among them,53 people were living,55 cases were dead,and the death rate was 51.00％.The average amount of poison,average hospitalization time,poison to gastric lavage time interval in the survival group were (22.08 ±5.32) mL,(16.5 ± 3.72) d,(2.00 ±0.49) h,respectively,which in the death group were (88.12 ± 14.96) mL,(5.50 ± 1.20) d,(8.56 ± 1.65) h,respectively.The average amount of poison in the death group was far greater than that of the survival group,about 3.6 times,and the average hospitalization time was significantly reduced,only 1/3 of the survival group.The gastric lavage time interval was also lengthened 1.7 times than that of the survival group,the differences were statistically significant (all P ＜ 0.05).The proportions of fever,increased serum creatinine,liver function damage and pulmonary fibrosis in the death group were significantly higher than those in the survival group,the differences were statistically significant (x2 =12.20,8.35,8.84,50.68,all P ＜ 0.05).Conclusion Mortality rates are still high in patients with acute paraquat poisoning.The amount of poison is still the key factor of death in patients.Early gastric lavage and blood purification,as soon as possible to clear the poison,as far as possible to reduce the absorption of the toxic chemical and aggressive treatment can significantly improve the prognosis of patients.Early fever,liver and kidney function damage and pulmonary fibrosis may predict the poor prognosis of patients.

Objective::To explore the effects of the biomimetic network membrane prepared by chitosan/gelatin/pectin on the proliferation and mineralization of mesenchymal stem cells (MSCs) , and to evaluate its feasibility of constructing tissue engineering bone.Methods:Chitosan, gelatin and pectin were made into a new biomimetic network membrane in a certain ratio by biomimetics.The experiment was divided into control group (MSCs+conventional medium) , material group (MSCs+network membrane+conventional medium) and material+OS group (MSCs+network membrane+OS medium) .The cell morphology was observed by inverted phase contrast microscope;the growth and secretion of extracellular matrix of the MSCs were observed under scanning electron microscope (SEM) .The proliferation of cells was determined by MTT assay (The MSCs were divided into negative control group and material group, and they were cultivated with blank medium and medium including materials) .The expression of calcium in MSCs was detected by Alizarin Red staining.Real-time polymerase chain reaction (RT-PCR) was used to determine the expression levels of osteocalcin (OC) mRNA and osteopontin (OPN) mRNA in the MSCs.Results:The network membrane was semitransparent thin film.The MSCs were short shuttle and clustered under inverted phase contrast microscope.After cultured for 7d, the MSCs were shuttle;after cultured for 14d, the number of MSCs was increased, with pseudo feet on the membrane;after cultured for21d, the MSCs clustered with a lot of neo-formed extracellular matrix.The MTT results showed that there was no significant difference in the proliferation level of MSCs between material group and negative control group (P＞0.05) .The Alizarin Red staining results showed that the MSCs in the network membrane were dyed orange red.The RT-PCR results showed that the expression levels of OC mRNA in the MSCs in material group and material+OS group were lower on the 7th and 14th days, but on the 21th day, the expression levels were significantly increased and reached the peak;the expression level of OC mRNA in the MSCs in material group was significantly increased on the 7th day, and the expression level reached the peak on the 14th day, then fell slightly on the 21th day;compared with control group, the expression levels of OC mRNA and OPN mRNA in the cells in material group and material+OS group at different time points were significantly increased (P＜0.01) , but there were no significant differences between material group and material+OS group (P＞0.05) .Conclusion:Chitosan/gelatin/pectin biomimetic network membrane has good biocompatibility, and MSCs can grow and proliferate well on the membrane.The membrane can induce the MSCs to express mineralization-related genes and proteins without inducers.

Objective: To investigate the effect of cartilage tissue engineering scaffold PVA/ι-CA on the biological behavior of the ATDC-5 cells,and to evaluate its feasibility on constructing tissue engineering cartilage. Methods:The polyvinyl alcohol (PVA)and carrageenan were used to make the composite scaffold material PVA/ι-CA according to a certain proportion by physical blending technology and repeated freezing thawing method,and the porosity and pore size of PVA/ι-CA were detected.The ATDC-5 cells were seeded into the composite scaffold and its growth was observed; the expressions of collagen type Ⅱ in the ATDC-5 cells were tested by immunohistochemical staining and immunofluorescence staining; the morphology of the ATDC-5 cells was confirmed by Toluidine blue staining.The growth and secretion of extracellular matrix of the ATDC-5 cells were observed under scanning electron microscope (SEM);the proliferative rates of ATDC-5 cells in composite scaffold materials in negative control group (added with DMEM culture media)and experimental group (added with DMEM contain scaffold)were determined by MTT assay.The composite scaffolds were implanted subcutaneously in the SD rats.The histocompatibility and vascularization in vivo of the composite scaffolds were evaluated.Results:The average porosity of cartilage tissue engineering scaffold PVA/ι-CA was (86.88±3.88)%,and the average pore size was 20-40 μm.The HE staining results showed that the ATDC-5 cells grew well with the polygon and plumpness morphology. All the samples were stained positive for collagen type Ⅱ by immunohistochemistry and immunofluorescence staining,which verified the normal phenotype of chondrocytes on the scaffolds. All the sample were stained positive for toluidine blue staining,which verified ECM deposition of the ATDC-5 cells on the scaffolds.The number of the positive cells was significantly increased with the prolongation of time.After cultured for 7 d,few of the ATDC-5 cells presented polygonal;after cultured for 14 d,the ATDC-5 cells distributed more densely,and contacted with each other on the scaffold;after cultured for 21 - 28 d,the ATDC-5 cells filled the interconnected pores of the scaffolds,synthesizing a significant amount of neo-formed ECM.The proliferation of ATDC-5 cells in PVA/ι-CA grew fast during 7-14 d,and it became slow during 21-28 d;the difference was not statistically significant compared with control group (P >0.05).The subcutaneous implantation results showed the inflammatory reactions were slight at the early stage and eviated gradually,there was an increasing angiogenesis at the late stage,and the degradation and absorption of the meterial were slight.Conclusion:PVA/ι-CA composite material will be an ideal material for the cartilage tissue engineering.

Objective:To understand residents' health status and disease characteristics by analyzing the disease spectrum and disease patterns of the entire population and elderly hospitalized patients in Tianjin between 2018 and 2020, thus providing scientific evidence for disease prevention and treatment.Methods:Information on the first page of inpatient medical records from 77 secondary or higher-level hospitals was provided by the Tianjin Health and Medical Big Data Platform.The codes of the International Classification of Diseases 10th revision(ICD-10)were used by the system for standardized diagnoses at hospital discharge.The disease spectrum of inpatients was analyzed based on the systems implicated by diseases.Age stratification was performed in examining changes in the orders of diseases across the spectrum.Results:Between 2018 and 2020, a total of 3 568 034 patients were discharged, with 1 204 733 in 2018, 1 372 747 in 2019, and 990 554 in 2020.Male patients accounted for 49.2%(1 756 867/3 568 034), elderly patients(65 years or older)accounted for 33.5%(1 194 189/3 568 034), and patients from tertiary hospitals accounted for 86.5%(3 085 482/3 568 034).According to the ICD-10, there were 19 categories of diseases when diagnoses at discharge were considered.Over the three-years period, the top ten diseases made up 81.1%(2 893 430/3 568 034)of all cases at discharge, with high consistency in their rankings(harmonic index value Wa=0.986, χ2=70.989, P<0.001).The circulatory system and the nervous system always occupied the top two positions, while the respiratory system decreased from third to seventh place in 2020.The rankings of factors affecting health and healthcare access increased.The circulatory system, nervous system, respiratory system, digestive system, and tumors consistently ranked among the top six categories in the disease spectrum of the elderly and the rankings of diseases related to the eye, ear, endocrine system, musculoskeletal system, and connective tissue system were also up compared to those of the entire population. Conclusions:Hospitalized patients are concentrated in tertiary hospitals, with a relatively high proportion of elderly patients.In the disease spectrum, circulatory system diseases, neurological system diseases, digestive system diseases, tumors, and respiratory system diseases have always been at the top of the list for medical treatment, both for the entire population and for elderly patients, with a significant decrease in the ranking of respiratory system diseases in 2020.The rankings of eye, ear, endocrine, musculoskeletal, and connective tissue diseases in elderly patients have increased compared to the entire population, indicating a need to step up the development of geriatric medicine and related specialties and the importance to promote the healthy China initiative and healthy aging.