Objective:To observe the effect of icariin on the osteoporosis of the ovariectomized rats,and to explore the mechanism.Methods:Fifty female rats aged 6 months were randomly divided into sham operation group, model group,positive drug group,low dose of icariin group and high dose of icariin group (n= 10).The rats in positive drug group were given with 1 mg· kg-1 nilestriol every week;the rats in low and high doses of icariin groups were given with 50 and 100 mg · kg-1 icariin every day.The bilateral ovaries of rats were excised by operation to establish the osteoporosis models.2 weeks after operation,the rats were treated with icariin for 12 weeks,and then they were sacrificed by drawing blood from abdominal aorta under anesthesia condion.The bone mineral density (BMD),serum biochemical indicators,bone histomorphology and the expressions of apoptosis-related proteins were detected.Results:Compared with sham operation group,the BMD of the rats in model group was decreased (P <0.01),the serum calcium level was decreased (P <0.05),and the serum phosphorus level was increased (P <0.05),and the serum BGP,ALP,NO and NOS levels were significantly decreased (P <0.05 or P <0.01).Compared with model group,the BMD of the rats in positive drug group and high dose of icariin group were obviously increased (P < 0.01 ), the serum calcium levels were increased, the phosphorus levels were decreased (P <0.05),and the BGP and ALP levels were increased significantly (P < 0.05 ). Compared with control group,the cortical in model group was thinned,the width of bone trabecula was reduced,the Bax and Caspase-3 expression levels in bone tissue were increased,and the Bcl-2 expression level was decreased.Compared with model group,the cortical in icariin group was thicked,the width of bone trabecula was increased,the Bax and Caspase-3 expression levels were decreased,and the Bcl-2 expression level was increased (P <0.05 or P <0.01). Conclusion:Icariin can protect the osteoporosis of ovariectomized rats,the function may be related to the inhibition of apoptosis.

Objective To investigate the correlation of serum levels of retinol binding protein 4 (RBP4) and andomen?tin-1 with ischemic stroke and carotid artery stenosis. Methods Healthy adult (n=50) were selected as the control group while ischemic stroke patients with different degrees of carotid artery stenosis (n=143) were enrolled as the disease group. According to the ultrasonic Doppler performance, these ischemic stroke patients were divided into three groups:mild steno?sis group (carotid artery stenosis was normal or less than 50%, n=67), moderate stenosis group (carotid artery stenosis was 50%to 70%, n=45), severe stenosis group (carotid artery stenosis was 70%to total occlusion, n=31). BMI index, hyperten?sion, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and fasting blood glucose (FPG) were detected by Automatic biochemical analyzer and serum levels of RBP4 and omentin-1 were measured by ELISA. Results Hypertensive population in carotid artery stenosis group was larger than that in control group (P<0.05). Serum TC, TG, LDL, FPG and RBP4 levels were significantly higher while omentin-1 level decreased remarkably in disease group than those in the control group (P<0.05). Logistic regression analysis showed that TC and RBP4 were the risk factors of ischemic stroke with carotid artery stenosis, while omentin-1 was a protective factor. Conclusion RBP4 is a risk factor for ischemic stroke with carotid artery stenosis and omentin-1 is a protective factor.

Objective To explore the effect of support with total parenteral nutrition(TPN)or early enteral and parenteral nutrition(EN+PN)on immune function of critically ill neurosurgical patients.Methods In this prospective control study,patients were divided inte TPN group and EN+PN group based on the timing of admission.The changes of immunological indicators including CD3,CD4,CD8,CD4/CD8,CD3/CD25,IgA,IgG,IgM,and serum protein before and after nutritional support were compared.Results The percentage of T lymphocyte subsets CD3,CD4,and CD8,the ratio of CD3+/CD25+,the plasma leveh of IgA,IgM,and IgG,and the serum protein were significantly increased after nutrifional supports(P<0.05,P<0.01).However,compared with the TPN group,the percentages of T lymphocyte subsets(CD3,CD4,and CD8),the ratio of CD4+/CD8+,the plasma levels of IgA,IgM,and IgG,and the serum protein were significantly higher in EN+PN group(P<0.05,P<0.01).Conclusions Both TPN and EN+PN can promote the recovery of immune function,while EN+PN is superior to TPN.Early nutritional support should be provided to critically ill neurosurgical patients.

Objective To investigate the value of continuous renal replacement therapy (CRRT) coupled with minimally invasive ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGD) for the treatment of severe acute biliary pancreatitis.Methods Hospitalized patients with severe acute biliary pancreatitis were recruited from the intensive care unit (ICU) of the Mfiliated Hospital of Qingdao University from June 2010 to June 2015,and divided into conventional CRRT alone group (n =30) and CRRT + PTGD group (n =30).Comparisons of postoperatively symptoms (time required for abdominal pain relief,time consumed for,gastrointestinal decompression),laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT,ALB,Lac) and acute physiology and chronic health evaluation score (APACHE Ⅱ,Balthazar CT,MODS) were carried out between two groups.The occurrence of complications (ARDS,abdominal infection,bile leakage,abdominal hemorrhage,intestinal injury,catheter translocation,catheter dislocation) was observed.The differences in duration of ventilator support,the length of stay in ICU,and fatality rate were compared between the two groups.Results Compared with the conventional CRRT alone group,the postoperative symptoms were significantly relieved,and time required for abdominal pain relief and time consumed for gastrointestinal decompression were evidently shortened in the CRRT + PTGD group (P ＜ 0.05).There were statistically significant differences in laboratory findings (WBC,PLT,PCT,CRP,AMS,TBIL,ALT) between two groups (P ＜ 0.05).The differences in APACHE Ⅱ,Balthazar CT and MODS score between the two groups also presented statistical significance (P ＜ 0.05).The comparisons of the duration of ventilator support [(6.1 ± 1.3) d vs.(9.5 ± 1.4) d] andthe length of stay [(15.7 ± 1.1) dvs.(21.1 ± 2.5) d] between thetwo groups revealed statistical significance (P ＜ 0.05).Conclusions CRRT coupled with PTGD for the treatment of severe acute biliary pancreatitis can effectively eliminate the inflammatory mediators and toxins from patients.On this basis,the coupled therapy with gallbladder puncture and drainage is capable of decompressing the biliary tract,improving liver function,effectively relieving clinical symptoms,minimizing the changes of laboratory findings an,d APACHE Ⅱ score,and thereby optimizing the prognosis of patients.

BACKGROUNDUsing the most comprehensive available data on lung cancer incidence and mortality in China, the mortality time trends were described and the incidence and mortality profile in 2000 and 2005 were estimated and projected, so as to provide evidence and reference for clinic, basic research and making prevention and control strategy for lung cancer in China.

METHODSThe Joinpoint model was used to analyze the lung cancer mortality trends during 1987-1999, based on data reported to WHO from the Ministry of Health in China. Combined with the data from the second national mortality survey in 1990-1992 and the lung cancer incidence and mortality data from several cancer registries in China which involved in Cancer Incidence in Five Continents, the 8th version, using the log-linear model (based on Poisson distribution), the incidence and mortality profile for lung cancer in 2000 and 2005 in China were estimated and projected.

RESULTSThe age-standardized mortality rates increased during the study period, especially in rural areas (the expected annual percentage changes were 2.7% in men and 3.6% for women, both were statistically significant) and showed among almost all age groups (above age 15). From 2000 to 2005, there would be 0.101 million more lung cancer deaths (from 327643 in 2000 to 428936 in 2005) and 0.116 million more new incident cases (from 381487 in 2000 to 497908 in 2005).

CONCLUSIONSDue to the double effects from both changes in the risk factors for the disease and the population growth and aging, lung cancer is becoming one of the most common and increasing malignant neoplasmin China . The prevention and control for this disease will be theemphasis for future cancer control strategy of China in which tobacco control is critically important .

Objective:To analyze the clinical characteristics of intracranial infection caused by Mycobacterium lentiflavum. Methods:The clinical data of a patient with intracranial infection caused by Mycobacterium lentiflavum admitted to Tianjin Haihe Hospital in May 2023 were collected. Meanwhile relevant literatures in databases were searched. Only 1 English literature (1 patient) was obtained. The clinical characteristics of this patient and the case reported in the literature were analyzed and summarized. Results:Totally 2 patients, including this case, and the patient with meningoencephalitis caused by Mycobacterium lentiflavum reported in the literature, both are females, 42 and 55 years old respectively, both manifested a chronic course, without fever, and presented progressive headache and cognitive impairment. Clinical manifestations also included abnormal mental behavior, limb weakness, and seizure. At the early stage, only intracranial pressure increased, and cerebrospinal fluid tests were negative. As the disease aggravated, there was an elevation of cerebrospinal fluid cells and protein, with normal levels of glucose and chloride. Using brain tissue obtained by biopsy for polymerase chain reaction or next-generation sequencing examination, the pathogenic microorganism was confirmed, which made accurate diagnosis possible. Antibiotic treatment had good efficacy, with a long treatment course and a good prognosis. Conclusions:Central nervous system infection caused by Mycobacterium lentiflavum is very rare, and a chronic disease course makes diagnosis very difficult. The treatment effect is significant, and the prognosis is excellent.

A 10-year follow-up case of aldosterone and cortisol-secreting adrenocortical carcinoma, a rare disease presenting as an adrenal space-occupying lesion accompanied with hypertension and hypokalemia was reported, and the medical record was investigated in detail. Through case presentation and literature review, it was noted that patients with adrenocortical carcinoma presented a difference in clinical manifestations, pathology, and biological behaviors. This paper may help clinicians enhance their understanding of adrenocortical carcinoma. Especially significant adrenal space-occupying lesions highly suspicious of recurrence and producing different types of endocrine hormones should be paid more attention.

Objective To analyze the impact of hepatitis B virus (HBV) replication and its coded X gene (HBx) expression on cell gene expression profile,especially the immune related gene expression level changes.Methods Overexpressed HBx gene was transiently transfected through lenti-virus and pcDNA3,the RNA-Seq and RT-qPCR methods were used to detect the expression levels of immune related genes,which were verified in HBV replication cell line.Results This study found that the HBV replication and HBx expression suppressed the expression of immune checkpoint PD-1 ligand gene (PD-L1/CD274) in a dose-dependent manner,while the expression of H-box mutant in HBx gene lost this inhibition effect.Conclusion HBV/HBx possesses the ability for inhibiting PD-L1/CD274 ligand gene expression,may relieve the checkpoint of antigen-specific T cell activation in viral infection acute stage,activates cytotoxic T cells,which may cause that T cell attack and clear highly replicated cells,helps virus to enter the lower replication status,and reaches the balance status between virus-host and lays a basis of HBV chronic infection.

OBJECTIVETo assess the impact of stomach cancer on the Chinese population by epidemiological analysis of its mortality distribution.

METHODS1990-1992 data on stomach cancer mortality collected by sampling survey involved one tenth of the total Chinese population.

RESULTSThe crude mortality rate of stomach cancer in China was 25.2 per 10(5) (32.8 per 10(5) for males and 17.0 per 10(5) for females), which comprised 23.2% of the total cancer deaths from 1990 to 1992, making stomach cancer the leading cause of cancer death. The stomach cancer mortality rate of males was 1.9 times of that of females. The Chinese mortality rates of stomach cancer adjusted by the world population were 40.8 per 10(5) and 18.6 per 10(5) of males and females, which were 4.2-7.9 (of males) and 3.8-8.0 (of females) times of those in the developed countries. Age-adjusted mortality rates of stomach cancer in China have distinct geographical difference: form the lowest 2.5 per 10(5) to the highest 153.0 per 10(5) in the 263 surveyed localities, 15.3 per 10(5) in urban areas and 24.4 per 10(5) in rural areas giving a difference of 1.9 times.

CONCLUSIONThe prevention and treatment of stomach cancer in China, especially in the countryside and the under-developed areas in the northwest, should be a long-term focus in control of cancers of the digestive system. Urgent measures for prevention and early detection of stomach cancer should be taken.

Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Mortality ; Sex Factors ; Stomach Neoplasms ; epidemiology ; mortality

In the HPLC analysis of bendamustine hydrochloride, two related substances(IMP01 and IMP02)were detected. These two related substances were identified by LC-MS/MS and their structural confirmation was unambiguously carried out by synthesis followed by characterization using Q-TOF/MS and NMR. Based on the spectral data, related substances IMP01 and IMP02 were characterized as 4-(1-methyl-5-morpholino-1H-benzo［d］imidazol-2-yl)butyric acid hydrochloride and 4-{1-methyl-5-［(2-chloroethyl)(2-hydroxyethyl)amino］-1H-benzo［d］imidazol-2-yl)} butyric acid hydrochloride, respectively. Bendamustine hydrochloride and its related substances were separated under the established LC-MS condition. HPLC is a useful method for the determination of the related substances in bendamustine hydrochloride. Results obtained are valuable for its manufacturing process and quality control.