Objective To observe the curative effects of Mailuoning oral liquid combined with Mecobalamin tablets in treating aged diabetic peripheral neuropathy (DPN).Methods Forty-nine patients with DPN were randomly divided into treatment group (n=25) and control group (n=24).The patients in two groups were given Mecobalamin tablets,and the treatment group was added treated with Mailuoning oral liquid.The period of treatment was 3 months.Scores of Toronto clinical scoring system (TCSS) and traditional Chinese medicine (TCM) symptoms quantitative scale were compared between the two groups.The curative effects of all the patients were judged by the TCM symptoms quantitative scores.Results The TCSS levels in two groups after treatment were both significantly lower than those before treatment (all P<0.05).The TCSS level after treatment in treatment group was significantly lower than that in control group (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that before treatment (P<0.05).The TCM symptoms quantitative score after treatment in treatment group was significantly lower than that in control group (P<0.05).The total effective rate in treatment group (88%) was significantly higher than that in control group (50%) (χ2=6.631,P=0.01).Conclusion Mailuoning oral liquid combined with Mecobalamin tablets is safe and effective for treating DPN.

Objective To investigate the development and prognosis of peroxisome proliferator-activated recepor-γ(PPAR-γ) and cyclooxygenase-2(COX-2) in endometrial carcinoma. Methods The electron microscopic immunohistochemical technique was used to observe the ultrastructure location of COX-2 protein labeled by colloidal gold in the endometrial carcinoma. Results 1.There were negative immunohistochemical staining signals of PPAR-γ in both the normal endometrium and hyperplasia endometrium, whereas, was positive staining in the endometrial carcinoma;2.The intensities of the COX-2 immunohistochemical staining were significantly statistical difference among the normal endometrium, the hyperplasia endometriu and the endometrial carcinoma(P<0.01);3. The COX-2 labelled by colloidal gold granules was observed in the endoplasmic reticulum, nuclear membrane and nuclei in the endometrial carcinoma. Conclusion Both PPAR-γ and the COX-2 might play an important role in the development of the endometrial carcinoma.

Objective To investigate the effect of different dose of dexmedetomidine for pre-venting the visceral traction reaction during caesarean section under spinal anesthesia.Methods Two hundred ASA physical status Ⅰ-Ⅱ patients,full-term primiparas scheduled for elective cesarean sec-tion were enrolled in this randomized,placebo-controlled study.Patients were randomly allocated to receive dexmedetomidine in four groups:group C (0.9% normal saline),group D1(dexmedetomidine 0.6 μg/kg),group D2(dexmedetomidine 0.8 μg/kg),group D3 (dexmedetomidine 1.0 μg/kg),50 cases in each group.Two minutes after cutting umbilical,groups D1,D2,D3 received an intravenous infusion single-dose of 0.6,0.8,1.0 μg/kg dexmedetomidine respectively for 10 minutes.Group C was injected the same dose of saline.Maternal blood pressure (BP),heart rate (HR),Ramsay scores,visceral traction reaction conditions were recorded at three points:before iv (T0 ),10 min af-ter iv (T1 )and abdominal exploration (T2 ).Results As for the inhibition of visceral traction pain, groups D2 and D3 were obviously better than groups D1 and C,and there was no statistically signifi-cant difference between groups D2 and D3 at T2 (P <0.05 ).The effects of slowing down heart rate and increasing blood pressure were weaker in group D2 than that in group D3 at T2 .Ramsay scores were higher in groups D2 and D3 than in groups D1 and C (P <0.05),and there was no significant difference between groups D2 and D3 at T2 .Conclusion Administration of dexmedetomidine 0.8 μg/kg could alleviate the visceral traction reaction and had little effect on maternal hemodynamics.

Objective To explore the effect of Sunset Abelmoschus on podocyte injury in adriamycin-induced nephropathy rats.Methods Fifty male SD rats were randomly divided into five groups:sham operation group (n=10),model group (n=10),Sunset Abelmoschus low dose group (0.5 g·kg-1· d-1 n=10),middle dose group (1.0 g· kg-1· d-1,n=10) and high dose group (2.0 g· kg-1· d-1,n=10).Unilateral nephrectomy combined repeated adriamycin injection were performed to establish adriamycininduced nephropathy models.The rats were administered with the corresponding dose of Sunset Abelmoschus during the experiment period.Urinary protein,urinary N-acetyl glucose aminotransferase (NAG),serum albumin,serum creatinine and blood lipid were measured before operation and 2,4,6,8 weeks after operation.The rats were sacrificed on week 8 for the renal histological examination,including light microscope and electron microscope.Expression of nephrin was examined by immunofluorescence assays.Results As compared to model group,urinary protein and NAG significantly decreases in Sunset Abelmoschus groups in each time point,especially in high dose group (P＜0.01),meanwhile the serum albumin increased and the disturbance of lipid metabolism was improved in Sunset Abelmoschus groups (P＜0.05).Compared with sham group,Scr increased significantly in model group and Sunset Abelmoschus groups at the 4th week.At the 8th week,Scr in high dose group was lower than that in model group (P＜0.05),and the ratio of glomerular globe sclerosis and segmental sclerosis,tubulointerstitial damage reduced in Sunset Abelmoschus groups,especially in high dose group.The podocyte damage and the extent of foot process fusion were improved in Sunset Abelmoschus groups compared with model group.Expression of nephrin increased in Sunset Abelmoschus groups than that in model group.Conclusion Sunset Abelmoschus can ameliorate proteinuria and renal tissue damage of adriamycin-induced nephropathy rats,whose mechanism may be associated with the improvement of podocyte injury.

Background:Primary biliary cirrhosis( PBC ) is an autoimmune liver disease,the cause of the disease remain incompletely understood. In addition to genetic and environmental factors,autoantibodies,multiple immunocytes and cytokines are considered to be involved in the development of PBC. Recent studies indicated that interleukin-9(IL-9)had pleiotropic functions in inflammatory regulation in allergic and autoimmune diseases. Aims:To investigate the expression and clinical significance of IL-9 in patients with PBC. Methods:A total of 30 specimens of peripheral blood and 20 specimens of liver tissue from PBC patients were collected. Ten specimens of peripheral blood from healthy subjects and 4 specimens of normal liver tissue were served as controls. Level of serum IL-9 was determined by ELISA,and expression of IL-9 in liver tissue was detected by immunohistochemistry. Correlations between IL-9 and serum biochemical indicators, immune indicators and histologic stage of liver tissue were analyzed. Results:Level of serum IL-9 was significantly increased in PBC patients than in normal control group(P<0. 05),and was positively correlated with level of serum IgG (r=0. 681,P<0. 01). Amount of IL-9 positive cells in liver tissue was significantly increased in PBC patients than in normal control group(P <0. 01),and was positively correlated with histologic stage of liver tissue(rs =0. 465,P <0. 05). Conclusions:Expression of IL-9 is significantly increased in peripheral blood and liver tissue in patients with PBC and is positively correlated with level of serum IgG and histologic stage of liver tissue,which suggests an important role of IL-9 in the pathogenesis of PBC.

Objective To explored high-risk HPV genotyping PCR testing whether as a feasible means for the early screening of cervical cancer and precancerous lesions. Methods From January 2013 to June 2014, 15 192 outpatients in China-Japan Friendship Hospital voluntary were tested by high-risk type HPV genotyping PCR. The average age of them were (33±8) years old. High-risk HPV types genotyping PCR tested by fluorescence PCR technology,in which 13 kinds of high-risk HPV subtypes were detected,
including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. A total of 4 315 cases of them were tested by the liquid-based cytology (LCT), among them with positive of high-risk HPV genotyping tested by PCR (n=2 366) were biopsy under colposcope (648 cases) in those LCT results were positive or LCT negative but HPV16 positive or LCT negative but had the clear clinical symptoms or and non-HPV16 positive but with clear clinical symptoms. (1) Analysis high-risk HPV infection status of 15 192 women.(2)As the pathological diagnosis was the gold standard in the diagnosis of cervical lesions, analysis of the relationship among high-risk HPV infection,virus loads and cervical lesions. (3) To evaluated the value of high-risk HPV genotyping PCR tested method in screening of cervical cancer and precancerous lesions. Results ⑴ Of 15 192 cases tested by high-risk HPV genotyping PCR, 2 366 cases were HPV positive (HPV infection), the overall infection rate was 15.57%(2 366/15 192), in which a single subtype of HPV infection in 1 767 cases, infection rate was 11.63%(1 767/15 192), and multiple subtypes of HPV infection (two and more subtypes HPV infection) in 599 cases, infection rate was 3.94%(599/15 192). The HPV16, 52 and 58 infections were the most common HPV subtypes in 13 subtypes, the infection rate was 3.95% (600/15 192), 2.86%(435/15 192) and 2.67% (406/15 192), respectively. (2) The most relevant subtypes with cervical intraepithelial neoplasia (CIN)Ⅱand even higher lesion were HPV16, 52 and 58, accounted for 57.7%(154/267) of all above CINⅡlesions. The most relevant subtype with the cervical glandular intraepithelial neoplasia (CGIN) Ⅱ or above lesions was HPV18, 3 cases with CGIN Ⅱ or above lesions were all single HPV18 infection. The pathologic examination positive percentage of patients which HPV virus loads≤103 copys/104 cells was 18.2%(25/137), while the pathologic examination positive proportion was 33.3%(247/742) which HPV virus loads≥104 copys/104 cells , there was statistically significant difference between them (χ2=27.06, P=0.000).(3)Sensitivity, specificity, positive predictive value and negative predictive value for detection of CINⅡ or above using HPV genotyping PCR were 96.11%, 85.76%, 30.94% and 99.70%, respectively. Conclusions There were a guiding significance for high-risk HPV genotyping PCR tested in screening of cervical cancer and precancerous lesion. HPV16, 52 and 58 were related to the severe cervical squamous epithelial lesions, while HPV18 was related to cervical severe glandular cell pathological changes. HPV genotyping is feasible and economical as the first choice of opportunistic screening in tertiary hospitals.

Objective To investigate the risk factors and establish the Cox's regression model and the personal prognosis index for the recurrence of ischemic stroke in 3-year follow-up.methods 1058 patients were retrospectively reviewed consecutively diagnosed with ischemic stroke admitted to the Neurology Department of the Hebei united University Affiliated Hospital from January 1,2013 to December 31,2013.Cases were followed up since the onset of ischemic stroke.The follow-up was finished in January 1,2016.Kaplan-Meier methods were used for recurrence rate description.Monovariant and multivariate Cox's proportional hazard regression model were used to analyze risk factors associated with recurrence.Thus,a recurrence model was set up.Result sDuring the period of follow-up,184 cases relapsed.The 1-year recurrence rate was 29.9 person-year,2-year recurrence rate was 46.6 person-year,3-year recurrence rate was 52.7 person-year.Monovariant and multivariant Cox's proportional hazard regression model showed that the independent risk factors associated with recurrence were age(X1)(RR=1.303;95%CI:1.019~1.666)history of heart disease(X2)(RR=1.788;95%CI:1.127~2.836),hypertension(X3)(RR=1.897;95%CI:1.097~3.280),diabetes(X4)(RR=1.674;95%CI:1.015~2.760),total cholesterol(X5)(RR=2.136;95%CI:1.396~3.266).The personal prognosis index(PI)of recurrence model was as the following: PI=0.265X1+0.581X2+0.640X3+0.515X4+0.759X5.Conclusion sAge,history of heart disease,hypertension,disease progression,and total cholesterol are the independent risk factors associated with recurrence of ischemic stroke.The recurrence model and the personal prognosis index equation are successful constructed.

OBJECTIVE To compare the outcome measurement scores for hearing impaired people with hearing aids. Two kind of questionnaires of Chinese version--COSI and IOI-HA were developed in order to find out the more specific outcome measurements for hearing aid users in China. METHODS The COSI and IOI-HA were administered for 30 hearing aid users via telephone or by clinical interview. SPSS software was used to analyze the collecting data. RESULTS Five prevalent problems to which most of the people with hearing aids pay attention were summarized. The mean level of the satisfaction of all the participants was high. CONCLUSION The outcome measurement inventory reflects the major problems which patients concern most and it can be used to evaluate the aural intervention and rehabilitation. After further study, this method is worth extending clinical application.

Objective:To accurately identify the relationship between the arterial radiomics score (rad-score) and pathologic superior mesenteric vein (SMV) resection margin in patients with pancreatic head cancer.Methods:The clinical data of 181 patients with pathologically confirmed pancreatic head cancer, who underwent multi-slice computed tomography (MDCT) within one month of resection in the First Affiliated Hospital of Naval Medical University between January 2016 and December 2018 were collected. Based on the pathology of SMV resection margin, the patients were divided into SMV negative margin group ( n=127) and SMV positive margin group ( n=54). The clinical, pathological and radiological features were compared between two groups. 3D slicer software was used to draw the region of interest in each layer of the primary CT arterial images for tumor segmentation. Rython package was applied to extract the radiomics features of pancreatic tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculated the arterial rad-score. Univariate and multivariate logistic regression models were used to analyze the association between the arterial rad-score and SMV resection margin. ROC was drawn and AUC, sensitivity, specificity and accuracy for diagnosing the SMV resection margin were calculated. The clinical usefulness of arterial rad-score for diagnosing SMV resection margin was determined by decision curve analysis (DCA). Results:There were statistical differences on LVSI and the touching angle of tumor and SMV/portal vein (PV) between SMV negative margin group and SMV positive margin group (all P<0.001). A total of 1 029 arterial radiomics CT features were obtained, and 14-selected arterial phase features associated with SMV resection margin were determined after being reduced by the Lasso logistic regression algorithm. Univariate analysis showed that the arterial radiomics score, LVSI, the touching angle of tumor and SMV/PV were all correlated with SMV resection margin (all P<0.001). Multivariate analyses confirmed that patients with high arterial radiomics score had a 3.63-fold risk of positive resection margin compared with that with low arterial radiomics score, and a higher arterial rad-score was associated with a higher risk of SMV positive resection margin ( P<0.0001). At the cut-off value of -0.711, AUC of the arterial rad-score for diagnosing SMV resection margin was 0.838, and the sensitivity, specificity and accuracy was 77.8%, 75.6% and 76.24%. Decision curve analysis demonstrated that the percentage of the arterial radiomics score for predicting the positive SMV resection margin was >0.02, and the application of the arterial radiomics score could benefit the patients. Conclusions:The arterial rad-score was strongly correlated with SMV resection margin of pancreatic cancer, and can accurately predict SMV resection margin and provide a new tool for preoperative noninvasive evaluation of the SMV resection margin.

Objective:To explore the differential diagnosis of pancreatic acinar cell carcinoma (PACC) and pancreatic ductal adenocarcinoma (PDAC) based on multidetector computed tomography (MDCT) features.Methods:The clinical, pathological and MDCT imaging data of 26 patients with pathologically confirmed PACC and 145 patients with pathologically confirmed PDAC who underwent MDCT from November 2013 to April 2021 were retrospectively studied. The differences of MDCT features including tumor location, tumor size, common pancreatic duct and bile duct dilatation, pancreatitis, lymph node metastasis, cyst, pancreatic parenchyma atrophy, duodenal involvement, bile ductal and vascular involvement between the two groups were compared. Univariate analysis and multivariate analysis by logistic regression models were performed to identify the independent predictive factors for PACC.Results:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement were significantly different between PACC group and PDAC group (all P value<0.05). Multivariate analysis revealed that the tumor size ( OR=1.07, 95% CI 1.028-1.15, P=0.001), lymph node metastasis ( OR=0.23, 95% CI 0.065-0.800, P=0.02), pancreatic parenchyma atrophy ( OR=0.15, 95% CI 0.048-0.490, P=0.002) were closely associated with PACC. Conclusions:The tumor size, bile duct dilatation, lymph node metastasis, pancreatic parenchyma atrophy and vascular involvement evaluated by MDCT had a certain value in differentiating PACC from PDAC, and the tumor size, lymph node metastasis and pancreatic parenchyma atrophy were independent predictors for the diagnosis of PACC.