Objective To analyse correlated risk factors of evolving cerebral infarction(ECI).Methods The follow data was recorded in the acute cerebral infarction (ACI)cases when they were admitted :sex,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),history of disease (diabetes mellitus,hypertension,hyperlipidaemia,cerebral infarction,hyperuricemia or smoking).The following examinations or determinations were done,including:white blood cell count (WBC),platelet count (PLT),blood gluconate(GLU),PT-INR,fibrinogen(FG),TT-INR,APTT-INR,C-reactive protein(CRP),D-dimer(D-D),products of fibrin degradation(FDP),anti-thrombin Ⅲ(ATⅢ),apolipoprotein A(apoA),apolipoprotein B(apoB),blood urea nitrogen(BUN),creatinine(CR),triglyceride (TG),high density lipoprotein (HDL),low density lipoprotein (LDL),very low density lipoprotein (VLDL),GOT,lactate dehydrogenase(LDH),creatine phosphokinase (CPK),MB isoforms of creatine phosphokinase (CPK-MB),? hydroxybutyrate dehydrogenase (?-HBDH),troponin I(TnI),cerebral CT or MRI and carotid ultrasonography.The patients were divided into two groups,ECI and completed cerebral infarction (CCI),according whether neurons function scale deteriorated.When cases of both groups exceeded 50,we took statistic test by SPSS10.0 statistic software.Results 8 of the above 46 markers had significant defference between the two groups,including CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH and DBP.ECI was more common in patients who had lower DBP or higher CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH when they were admitted.Conclusion The increase of CRP,WBC,apoB,GLU,LDH,CPK-MB,?-HBDH or decrease of DBP when patients are admitted can be predictive markers of ECI.

Objective To observe the effect and safety of the aversion therapy with furazolidone on patients with alcohol dependence.Methods 90 patients with alcohol dependence were randomly divided into the aversion therapy group and the control group with 45 cases in each group. The cases of the aversion therapy group were treated by aversion therapy with furazolidone and those of the control group were treated with routine therapy. The changes of the blood pressure, pulse and respiratory rate before and after drinking were observed and the rate of successful abstinence in one year was investigated.Results The effect of the aversion therapy group treated with furazolidone was significantly better than that of the control group ( P<0.05). The aversion therapy was safe.Conclusion The aversion therapy with furazolidone is more effective and safe.

Objective:To analyze the prognostic factors for survival in elderly patients with glioma.Methods:We performed a retrospective analysis of prognostic factors for elderly patients with glioma,who were treated by the same attending doctor during June 2014 and June 2016,to investigate the correlations of the age,dimension of pathology,histological grade,extent of resection,adjuvant therapy,preoperative Karnofsky Performance Scale (KPS) score,postoperative KPS score,molecular markers [isocitrate dehydrogenase-1 (IDHH-1),O6-methylguanine DNA-transferase (MGMT),epidermal growth factor receptor (EGFR),Ki-67] with the prognosis.Results:A total of 45 patients were included in the study.The median overall survival (OS) was 11 months.The median progression-free survival (PFS) was 6 months.Univariate analysis revealed that the age,gender,dimension ofpathology,histological grade and preoperative KPS score had no significant correlation with survival (P＞0.05).The gross total resection,higher postoperative KPS score,adjuvant therapy,lower Ki-67 index were significantly correlated with survival.The expressions of MGMT and EGFR were significant factors for survival.High postoperative KPS score (P=0.019),adjuvant therapy (P=0.024),and the expression of MGMT (P=0.026) were independent predictors for increased median OS in a multivariate regression model.Conclusion:The extent of resection,adjuvant therapy,postoperative KPS score and molecular markers are the influential factors for survival.Larger prospective studies are needed to confirm these findings.

Objective To analyze the literature on the application of infrared technology in acupuncture and moxibustion at home and abroad by using bibliometrics and visualization software,discuss the research status,main forces,frontier hotspots and dynamic trends,and provide reference for promoting the cross fusion application of infrared technology in acupuncture and moxibustion research.Methods In this study,CiteSpace and VOSviewer were used to analyze the number of articles,authors,institutions and keywords of 478 articles screened from CNKI and 188 articles screened from Web of Science Core Collection database in the field of acupuncture and moxibustion,drawing the visual map of authors,institutions and keywords.Cluster,co-occurrence and time superposition analysis of keywords were made at the same time.Results The research on the application of infrared technology in acupuncture and moxibustion started earlier in China,while the international research started later.Xu Jinxin,Shen Xueyong,Pan Xiaohua and Ding Guanghong have done a lot of work in the cross research of infrared technology and acupuncture and moxibustion.Internationally,Litscher gerhard,Shen xueyong and Yoo ho-ryong are the main authors.The Fujian Academy of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine and Beijing University of Traditional Chinese Medicine have the highest number of papers;Internationally,Med Univ Graz,Daejeon Univ and Korea Inst Oriental Med are the main research institutions.The hot spots of visualization discovery are the application of infrared thermal imaging technology to diagnose and evaluate the clinical efficacy of acupuncture related therapies,the assistance of infrared therapeutic effects in acupuncture and moxibustion to enhance the clinical efficacy and product transformation development,the exploration of the meridian along the line development phenomenon,the infrared spectral characteristics of meridians and acupoints to assist in disease diagnosis,the study of infrared radiation spectral characteristics of moxibustion,and the functional near-infrared spectral imaging study of acupuncture and moxibustion therapy.Conclusion The cross fusion of infrared technology and acupuncture covers both diagnosis and clinical aspects,involving theoretical research and applied research.At present,it is mainly carried out around six hot spots.The application research of infrared technology in the field of acupuncture and moxibustion has great development potential,which is worthy of more in-depth cross fusion research and cooperation between multiple institutions and personnel;In the future,infrared meridian and acupoint diagnostic equipment,the introduction of new infrared technology and the molecular mechanism of acupuncture meridian specific infrared phenomenon will have broad prospects.

OBJECTIVETo assess the association of neural development-related genes LIS1and TSNAX with bipolar disorder in a Chinese Han population.

METHODSThree hundred and eight five patients (including 188 males and 197 females) from Guangzhou Brain Hospital with bipolar disorder meeting the Diagnostic and Statistic Manual of Bipolar Disorder (BDI) (Fourth Edition) criteria and 475 healthy controls from the local community were recruited. Ten single nucleotide polymorphisms (SNPs) of the LIS1 and TSNAX genes were genotyped by GoldenGate genotyping assay on an Illumina Beadstation 500 machine. Association analyses of SNPs and haplotypes were performed with Plink 1.07 software.

RESULTSAnalysis of the total sample has failed to find any association of SNP or haplotype of the two genes with BDI (P> 0.05). When patients were divided into subgroups with or without psychotic symptom, no significant association of the two genes was found with psychotic BDI or non-psychotic BDI (P> 0.05). No significant association was found between any SNP and haplotype of two genes and female BDI or male BDI, nor were significant association found between age of onset and LIS1 and TSNAX gene polymorphisms.

CONCLUSIONOur results indicated that LIS1 and TSNAX genes are not associated with susceptibility to bipolar I disorder in Chinese Han population.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; genetics ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; ethnology ; genetics ; Bipolar Disorder ; ethnology ; genetics ; Case-Control Studies ; DNA-Binding Proteins ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Microtubule-Associated Proteins ; genetics ; Middle Aged ; Polymorphism, Single Nucleotide ; Young Adult

Objective:To investigate the clinical efficacy of pancreaticoduodenectomy (PD) for periampullary diseases.Methods:The retrospective cohort study was conducted. The clinico-pathological data of 2 019 patients with periampullary diseases who underwent PD in the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2020 were collected. There were 1 193 males and 826 females, aged 63(15) years. Observation indicators: (1) surgical situations; (2) postoperative conditions; (3) postoperative pathological examinations; (4) prognosis of patients with periampullary carcinoma. Regular follow-up was conducted by telephone interview and outpatient examination once every 3 months within the postoperative first year and once every 6 months thereafter to detect the survival of patients with periampullary carcinoma. The follow-up was up to December 2021. Measurement data with skewed distribution were represented as M(IQR) or M(range), and comparison between groups was analyzed using the rank sum test. Count data were described as absolute numbers and (or) percentages, and comparison between groups was analyzed by the chi-square test or Fisher exact probability. Kaplan-Meier method was used to draw survival curves and calculate survival rates, and Log-Rank test was used to conduct survival analysis. Results:(1) Surgical situations: of 2 019 patients, 1 116 cases were admitted from 2016-2018 and 903 cases were admitted from 2019-2020. There were 1 866 cases undergoing open PD and 153 cases undergoing laparoscopic or robot-assisted PD. There were 1 049 cases under-going standard PD and 970 cases undergoing pylorus-preserved PD. There were 215 cases combined with portal mesenteric vein resection, 3 cases combined with arterial resection. The operation time of 2 019 patients was 255(104)minutes and the volume of intraoperative blood loss was 250(200)mL. The intraoperative blood transfusion rate was 31.401%(623/1 984), with the blood transfusion data of 35 cases missing. The proportions of pylorus-preservation, combination with portal mesenteric vein resection, intraoperative blood transfusion were 585 cases(52.419%), 97cases(8.692%), 384 cases(34.941%) for patients admitted in 2016-2018, versus 385 cases(42.636%), 118 cases(13.068%), 239 cases(27.006%) for patients admitted in 2019-2020, showing significant differences between them ( χ2=19.14,10.05,14.33, P<0.05). (2) Postoperative conditions: the duration of postoperative hospital stay of 2 019 patients was 13 (10) days. One of 2 019 patients lacked the data of postopera-tive complications. The overall postoperative complication rate was 45.292%(914/2 018), of which the incidence rate of grade B or C pancreatic fistula was 23.439%(473/2 018), the rate of grade B or C hemorrhage was 8.127%(164/2 018), the rate of grade B or C delayed gastric emptying was 15.312%(309/2 018), the rate of biliary fistula was 2.428%(49/2 018) and the rate of abdominal infection was 12.884%(260/2 018). The reoperation rate of 2 019 patients was 1.932%(39/2 019), the in-hospital mortality was 0.644%(13/2 019), the postoperative 30-day mortality was 1.238%(25/2 019), and the postoperative 90-day mortality was 2.675%(54/2 019). There were 541 cases(48.477%) with overall postoperative complications, 109 cases(9.767%) with grade B or C hemorr-hage, 208 cases(18.638%) with grade B or C delayed gastric emptying , 172 cases(15.412%) with abdominal infection, 39 cases(3.495%) with postoperative 90-day mortality of 1 116 patients admitted in 2016-2018. The above indicators were 373 cases(41.353%), 55 cases(6.098%), 101 cases(11.197%), 88 cases(9.756%), 15 cases(1.661%) of 902 patients admitted in 2019-2020, respectively. There were significant differences in the above indicators between them( χ2=10.22, 9.00, 21.30, 14.22, 6.45 , P<0.05). The in-hospital mortality occurred to 11 patients(0.986%) of 1 116 patients admitted in 2016-2018 and to 2 cases(0.221%) of 903 patients admitted in 2019-2020, showing a significant difference between them ( P<0.05). (3) Postoperative pathological examinations. Disease area of 2 019 patients reported in postoperative pathological examinations: there were 1 346 cases(66.667%) with lesions in pancreas, including 1 023 cases of carcinoma (76.003%) and 323 cases(23.997%) of benign diseases or low potential malignancy. There were 250 cases(12.382%) with lesions in duodenal papilla, including 225 cases of carcinoma (90.000%) and 25 cases(10.000%) of benign diseases or low potential malignancy. There were 174 cases(8.618%) with lesions in bile duct, including 156 cases of carcinoma (89.655%) and 18 cases(10.345%) of benign diseases or low potential malignancy. There were 140 cases(6.934%) with lesions in ampulla, including 134 cases of carcinoma (95.714%) and 6 cases(4.286%) of benign diseases or low potential malignancy. There were 91 cases(4.507%) with lesions in duodenum, including 52 cases of carcinoma (57.143%) and 39 cases(42.857%) of benign diseases or low potential malignancy. There were 18 cases(0.892%) with carcinoma in other sites. Postoperative pathological examination showed carcinoma in 1 608 cases(79.643%), benign diseases or low potential malignancy in 411 cases(20.357%). The histological types of 1 608 patients with carcinoma included adenocarcinoma in 1 447 cases (89.988%), intra-ductal papillary mucinous carcinoma in 37 cases(2.301%), adenosquamous carcinoma in 35 cases(2.177%), adenocarcinoma with other cancerous components in 29 cases(1.803%), neuroendocrine carcinoma in 18 cases(1.119%), squamous carcinoma in 1 case (0.062%), and other histological malignancies in 41 cases(2.550%). The histological types of 411 patients with benign or low poten-tial malignancy included intraductal papillary mucinous neoplasm in 107 cases (26.034%), chronic or autoimmune inflammatory disease in 62 cases(15.085%), neuroendocrine tumor in 58 cases(14.112%), pancreatic serous cystadenoma in 52 cases(12.652%), pancreatic solid pseudopapillary tumor in 36 cases(8.759%), gastrointestinal stromal tumor in 29 cases(7.056%), villous ductal adenoma in 20 cases(4.866%), pancreatic mucinous cystadenoma in 2 cases(0.487%), pancreatic or duodenal trauma in 2 cases(0.487%) and other histological types in 43 cases(10.462%). (4) Prognosis of patients with periampullary carcinoma. Results of survival analysis of 1 590 patients with main locations of periampullary carcinoma showed that of 1 023 patients with pancreatic cancer, 969 cases were followed up for 3.0-69.6 months, with a median follow-up time of 30.9 months. The median overall survival time, 1-year, 3-year and 5-year survival rates of pancreatic cancer patients were 19.5 months [95% confidence interval ( CI) as 18.0-21.2 months], 74.28%, 29.22% and 17.92%. Of 225 patients with duodenal papillary cancer, 185 cases were followed up for 3.0-68.9 months, with a median follow-up time of 36.7 months. The median overall survival time, 1-year, 3-year and 5-year survival rates were unreached, 94.92%, 78.87% and 66.94%. Of 156 patients with distal bile duct cancer, 110 cases were followed up for 3.0-69.5 months, with a median follow-up time of 25.9 months. The median overall survival time, 1-year, 3-year and 5-year survival rates were 50.6 months (95% CI as 31.4 to not reached), 90.37%, 56.11% and 48.84%. Of 134 patients with ampullary cancer, 100 cases were followed up for 3.0-67.8 months, with a median follow-up time of 28.1 months. The median overall survival time, 1-year, 3-year and 5-year survival rates were 62.4 months (95% CI as 37.8 months to not reached), 90.57%, 64.98% and 62.22%. Of 52 patients with duodenal cancer, 38 cases were followed up for 3.0-69.5 months, with a median follow-up time of 26.2 months. The median overall survival time, 1-year, 3-year and 5-year survival rates were 52.0 months (95% CI as 30.6 months to not reached), 93.75%, 62.24% and 40.01%.There was a significant difference in overall survival after PD between patients with different locations of periampullary malignancies ( χ2=163.76, P<0.05). Conclusions:PD is safe and feasible in a high-volume pancreas center, but the incidence of overall postoperative complications remains high. With the increase of PD volume, the incidence of overall postoperative complications has significantly decreased. There is a significant difference in overall survival time after PD among patients with different locations of periampullary malignancies. The 5-year survival rate after PD for duodenal papillary cancer, ampullary cancer, duodenal cancer and distal bile duct cancer is relatively high, whereas for pancreatic cancer is low.

ObjectiveTo observe the effect of salvianolate on the protein expressions of adenosine monophosphate （AMP）-activated protein kinase （AMPK）， silent information regulator 1 （SIRT1） and peroxisome proliferator-activated receptor-γ coactivator-1α （PGC-1α）， autophagy and apoptosis in kidney tissue of rats with membranous nephropathy （MN）， and to explore its possible molecular mechanism against MN. MethodEighty male SD rats were randomly divided into normal group， model group， benazepril hydrochloride group （10 mg·kg^-1）， and salvianolate low-， medium-， and high-dose groups （16.7， 33.3 and 66.7 mg·kg^-1）. The rats were modeled by injection of cationized bovine serum albumin （C-BSA） into the tail vein. After successful modeling， rats in the administration groups were given corresponding doses of drugs for 4 consecutive weeks， and then 24-hour urine， serum and kidney tissue were collected for the detection of 24-hour urinary protein （UTP）， blood urea nitrogen （BUN）， serum creatinine （SCr）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， C reactive protein （CRP）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， and malondialdehyde （MDA）. The pathological changes of kidneys were observed by light microscope， electron microscope and immunofluorescence. Western blot was used to detect the protein expressions of phospho-AMPK （p-AMPK）， AMPK， phospho-SIRT1 （p-SIRT1）， SIRT1 and PGC-1α in rat kidney tissue. The protein expressions of autophagy-specific gene （Beclin-1）， microtubule-associated protein 1 light chain 3 （LC3） Ⅱ， ubiquitin-binding protein （p62）， B cell lymphoma （Bcl-2）， Bcl-2-associated X （Bax）， and cysteine aspartic protease-7 （Caspase-7） in rat kidney tissue were determined by immunohistochemistry （IHC）. ResultCompared with the conditions in the normal group， the levels of UTP， IL-6， TNF-α， CRP and MDA in the model group were increased （P<0.05） while the levels of SOD and GSH-Px were decreased （P<0.05）， and there was no difference in BUN and SCr. Compared with the model group， the administration groups had lowered UTP， IL-6， TNF-α， CRP and MDA （P<0.05） while elevated SOD and GSH-Px （P<0.05）. It could be seen from hematoxylin and eosin （HE） staining， Masson staining， immunofluorescence and electron microscopy that the pathological damage of rat kidney tissue in the model group was significant， but after treatment with benazepril hydrochloride and salvianolate， the pathological damage of kidney cells was gradually improved. The expressions of p-AMPK/AMPK， p-SIRT1/SIRT1， PGC-1α， Bcl-2， Beclin-1 and LC3Ⅱ in rat kidney in the model group were lower than those in the normal group （P<0.05） while the expressions of Bax， Caspase-7 and p62 were higher （P<0.05）. Compared with the model group， benazepril hydrochloride group and salvianolate groups had an up-regulation in the expressions of p-AMPK/AMPK， p-SIRT1/SIRT1， PGC-1α， Bcl-2， Beclin-1 and LC3Ⅱ in the kidney （P<0.05） while a down-regulation in the expressions of Bax， Caspase-7 and p62 （P<0.05）. ConclusionThe protective effect of salvianolate on the kidneys of MN rats may be related to the activation of AMPK/SIRT1/PGC-1α signaling pathway， the up-regulation of autophagy and the reduction of apoptosis.