AIM: To investigate the adsorptive and separative properties of 5 kinds of macroporous adsorbing resins to the total saponins and alkaloids, which treated atrophic gastritis with Sanqi Qilian Decoction (Radix et Rhizoma Notoginseng, Radix Astragali, Rhizoma Coptidis.) METHODS: The adsorption capacities, contents and recoveries of the total saponins and alkaloids were selected as the evaluating quotas. The determination of the contents of the total saponins and alkaloids and the investigation into leakage and elution curve were completed with UV-VIS spectrophotometric method. RESULTS: AB-8 resin had the best adsorptive and separative properties to the total saponins and alkaloids in Sanqi Qilian Decoction. The applicable technology was as follows: the concentration of original solution of the extract of Sanqi Qilian Decoction was 40 mg/mL; the largest adsorption capacities on resin to the total saponins and alkaloids were 5.28 mg/mL and 12.38 mg/mL respectively; the eluant was 50% ethanol with 8 times of resin volume, and the elution velocity was 2 mL/min. AB-8 resin could be used for 4 times repeatedly after being reproducted by 95% ethanol and 1 mol/L NaOH. CONCLUSION: Under the process condition which had been selected above, AB-8 resin can be used successfully to adsorb and separate with over 20% of the content of the total saponins Sanqi Qilian Decoction, and 30% of the content of the total alkaloids in the 50% ethanol eluate, and with over 75% of total saponins recovery and 65% of total alkaloids recovery respectively.

Objective To explore the clinical therapeutic effects of St. John's Wort exact (SWE)on depressive disorder and blood glucose in elderly type 2 diabetic patients Methods 118 patients with type 2 diabetes and depressive disorder were randomly assigned to SWE group (26 cases),lorazepam group (22 cases ), psychotherapy group (24 cases), physicotherapy group (24 cases) and control group (routine therapy,22 cases) for 12 weeks' treatment. The clinical effects were evaluated with the percentage reduction in HAMD score after the treatment, HbAlc levels were obtained to monitor glycemic control. Results (1) The percentage reduction in HAMD score in SWE group was the highest (80. 8%), and it was lower in lorazepam group ( 63. 6%), psychotherapy group (62. 5%) and physicotherapy group(58. 3%). The percent decrease in H AMD score was higher in four groups than in control group ( 18. 2%) and the difference was significant (P < 0. 01). The therapeutic effect of SWE was better than the others(P0. 05). (2) The level of HbAlc in SWE group (6.5±0. 6)% was significantly lower than the others [( 7. 5 ± 0. 8) %, (7.4 ± 0. 8) %, (7. 4 ±1.0) % (P < 0. 01 )]. Conclusions St. John' s Wort exact (SWE) can efficiently improve the depressive disorder in elderly type 2 diabetic patients, and it is good for controlling blood glucose of the patients.

Objective To discuss the clinical application of reverse dorsal metatarsal artery perforator flap for reconstruction of forefoot soft tissue defects.Methods Since January,2008 to March,2016,43 patients with forefoot soft tissue defect due to various causes were reconstructed with the flap based on dorsal metatarsal artery perforator.Dorsal pedis was used as a donor site with dorsal metatarsal artery perforator as the donor artery.The flap size varied from 2.0 cm × 4.0 cm to 6.0 cm × 8.0 cm.Among them,27,8,4 and 4 cases were reconstructed with flap based on first,second,third and fourth dorsal metatarsal artery perforator flap respectively.Results All the patients were followed-up which ranged from 3 months to 24 months.Six flaps suffered from post operative venous congestion.Out of 6,4 survived with early emergency management while the remaining 2 suffered epidermal necrosis which survived with regular dressing change.Eventually,all the flaps survived.They had good texture and they were elastic,good-looking and very wear-resisting.Walking function was normal.Conclusion Reverse dorsal metatarsal artery perforator flap is an ideal choice in reconstruction of small to medium sized soft tissue defects of forefoot.

Objective To analyze the outcome of childhood B-cell acute lymphoblastic leukemia treated (ALL) with SCMC-ALL-2005 protocol. Methods Newly diagnosed B-cell ALL from May 1, 2005 to April 30, 2009 in ifve hospitals were treated and followed up according to SCMC-ALL-2005 protocol. Results A total of 601 cases with newly diagnosed B-cell ALL were enrolled. Among them, 539 cases (89.68%) were followed up until September 30, 2011. In 601 patients, there were 284 low-risk cases (LR group), 231 moderate-risk cases (MR group) and 86 high-risk cases (HR group) which were treated with SCMC-ALL-2005 protocol. The total complete remission rate during the period of induction was 98.84%and 7 cases did not achieve complete remission. The median time of the ifrst event occurring was 35 months (2.94 years). Among 539 cases completing follow-up, 403 cases (74.77%) completed treatment including 223 cases (86.43%) in LR group, 150 cases (73.17%) in MR group and 30 cases (39.47%) in HR group. The rate of cases completing treatment was signiifcantly different among three groups (P=0.001). The completion rate was highest in LR group and lowest in HR group. The 3-year overall survival (OS) rate was (83.3±1.8)%, and the 3-year EFS (event-free survival) rate was (79.2±1.9)%using a Kaplan-Meier method. The 5-year OS rate was (79.5±3.3)%, and the 5-year EFS rate was (70.9±3.7)%. There were signiifcant differences in 3-year EFS rate and 5-year EFS rate among three groups (P<0.05). Conclusions Childhood B-ALL treated with SCMC-ALL-2005 protocol achieved a better therapeutic effect and prognosis. The multi-center collaborative research is useful for the standard treatment of ALL.

OBJECTIVE: To investigate the serological and molecular characteristics of a pedigree carrying an allele for ABO*BW.11 blood subgroup. METHODS: The ABO blood type of 9 pedigree members were determined by serological methods. Exons 6 and 7 of the ABO gene were amplified by PCR and directly sequenced. The patient and her father were also subjected to clone sequencing analysis. RESULTS: Serological tests demonstrated that the proband and her younger brother had an ABw subtype, whilst her father and two daughters had Bw subtype. Clone sequencing found that the exon 7 of the ABO gene of the proband had a T>C substitution at position 695, which was identified as a BW.11 allele compared with the reference sequence B.01. This BW.11 allele was also identified in the proband's father, brother and two daughters. Due to allelic competition, the A/BW.11 and BW.11/O alleles demonstrated significantly different phenotypes. CONCLUSION The c.695T>C substitution of the ABO gene may lead to allelic competition in the Bw11 subtype. Combined molecular and serological methods is helpful for precise blood grouping.
ABO Blood-Group System/genetics* ; Alleles ; Female ; Genotype ; Humans ; Male ; Pedigree ; Phenotype

Objective     To explore the clinical value of artificial intelligence (AI) quantitative parameters of pulmonary ground-glass nodules (GGN) in predicting the degree of infiltration. Methods     A retrospective analysis of 168 consecutive patients with 178 GGNs in our hospital from October 2019 to May 2021 was performed, including 43 males and 125 females, aged 21-78 (55.76±10.88) years. Different lesions of the same patient were analyzed as independent samples. Totally, 178 GGNs were divided into two groups, a non-invasive group (24 adenocarcinoma in situ and 77 minimally invasive adenocarcinoma), and an invasive group (77 invasive adenocarcinoma). We compared the difference of AI quantitative parameters between the two groups, and evaluated predictive valve by receiver operating characteristic curve and binary logistic regression model. Results     (1) Except for the gender (P=0.115), the other parameters, such as maximal diameter [15.10 (11.50, 21.60) mm vs. 8.90 (7.65, 11.15) mm], minimum diameter [10.80 (8.85, 15.20) mm vs. 7.40 (6.10, 8.95) mm], proportion of consolidation/tumor ratio [13.58% (1.61%, 63.76%) vs. 0.00% (0.00%, 0.67%)], mean CT value [–347.00 (–492.00, –101.50) Hu vs. –598.00 (–657.50, –510.00) Hu], CT maximum value [40.00 (–40.00, 94.50) Hu vs. –218.00 (–347.00, –66.50) Hu], CT minimum value [–584.00 (–690.50, –350.00) Hu vs. –753.00 (–786.00, –700.00) Hu], danger rating (proportion of high-risk nodules, 92.2% vs. 66.3%), malignant probability [91.66% (85.62%, 94.92%) vs. 81.81% (59.98%, 90.29%)] and age (59.93±8.53 years vs. 52.04±12.10 years) were statistically significant between the invasive group and the non-invasive group (all P<0.001). (2) The highest predictive value of a single quantitative parameter was the maximal diameter (area under the curve=0.843), the lowest one was the risk classification (area under the curve=0.627), the combination of two among the three parameters (maximal diameter, mean CT value, and consolidation/tumor ratio) improved the predictive value entirely. (3) Logistic regression analysis showed that maximal diameter and mean CT value both were the independent risk factor for predicting invasive adenocarcinoma. (4) When the threshold of v was 1.775%, the diagnostic sensitivity of invasive adenocarcinoma was 0.753 and the specificity was 0.851. Conclusion     AI quantitative parameters can effectively predict the degree of infiltration of GGNs and provide a reliable reference basis for clinicians.

Objective: Ischemia-reperfusion (IR) injury is a leading cause of flap compromise and organ dysfunction during free-tissue transfer, and remains a great challenge for plastic surgeons. Thioredoxin-1 (Trx-1) was proved to protect the IR flap by mitigating the oxidative stress, and inhibiting the activation of apoptosis signal-regulating kinase-1 (ASK-1) and mitogen-activated protein kinase (MAPK) pathway. The aim of this study is to investigate the distinction of Trx-1 expression, apoptosis indices in different layers of IR flaps, and the feasibility of tissue-layer-specific administration of Trx-1. Methods: Ten patients′ specimens of IR flaps for DIEP breast reconstruction were collected and assessed for apoptosis and Trx-1 expression. Twenty mice were used to establish the IR flap model. The mice were sacrificed twenty-four hours after reperfusion. The flap tissues were harvested and tested by immunohistochemistry staining and TUNEL assay. The tissue-layer-specific dermoprotective effect of Trx-1 and the molecular mechanisms were assessed by an in vitro epithelial skin cell hypoxia-reoxygenation model. The statistics were conducted by t test and ANOVA using SPSS 20.0. Results: Trx-1 expression and apoptotic cells were observed mainly located in the basal layer of epidermis and the papillary layer of dermis in human IR flaps and mice models. Trx-1 depletion was 24.19 %± 2.23% in the basal layer of epidermis and the papillary layer of dermis of patient IR flaps, decreasing significantly compared with 70.71% ± 6.38% in control group (t = 27.54, P< 0.001). Similar tissue-layer-specific down regulation of Trx-1 also displayed in mice IR flap models (19.83% ± 2.34% vs. 76.59% ± 4.88%; t = 34.71, P<0.001). The apoptotic index in human samples significantly increased from 1.32% ± 1.52% in control group to 43.71 %± 3.17% in IR group (t =38.23, P<0.001); while it was proved to be dramatically raised in mice models from 0.86% ± 1.15% in control group to 41.14 %± 4.21% in IR group (t= 36.96, P < 0.001). Western Blot analysis revealed Trx-1 down regulation and a significant increase in ASK-1, p-p38, and c-PARP abundance in the hypoxia-reoxygenation-treated HaCaT cells (P < 0.01). Supplementation of recombinant human Trx-1 significantly reduced the apoptosis-related protein expression. Conclusions The basal layer of epidermis and the papillary layer of dermis are the main damaged tissue layers in the early stage of skin flap ischemia-reperfusion injury. The IR flap can be protected by precisely replenishing the vulnerable layers with Trx-1.