Objective:To investigate the effects of Zhuanggu Zhitong Capsules on JNK signaling molecules and their phosphorylated proteins in postmenopausal osteoporosis model female mice.Methods:The rats were divided into sham-operation group, blank group, model group, positive drug group, and Zhuanggu Zhitong Capsules group according to the random number table method, with 10 rats in each group. The model group, the positive drug group and the Zhuanggu Zhitong Capsules group were prepared by bilateral ovarian detomy to prepare a female mouse model of postmenopausal osteoporosis. The positive drug group was given 0.9 mg/kg of alendronate sodium, the Zhuanggu Zhitong Capsules group was given was Zhuanggu Zhitong Capsules 1.944 g/kg for gavage, and the blank group, sham-operation group, and model group were given the same volume of normal saline for gavage, once a day for a total of 13 weeks. Rat vaginal exfoliated cells were stained with Wright's staining; serum Omentin-1 and 25(OH)D 3 levels were determined by ELISA; renal tissue and femoral structure were observed by HE staining; JNK and p-JNK protein expressions were detected by immunohistochemical staining; JNK mRNA levels were detected by PCR. Results:Compared with the model group, the serum levels of 25(OH)D3 and Omentin-1 in the Zhuanggu Zhitong Capsules group and the positive drug group increased ( P<0.01), the mean gray values of JNK and p-JNK protein in bone and kidney tissues decreased ( P<0.01), and the mRNA levels of JNK in bone and kidney tissues decreased ( P<0.01). Conclusion:Zhuanggu Zhitong Capsules can effectively improve the bone microstructure of postmenopausal osteoporotic rats, and its mechanism may be related to the regulation of JNK signaling pathway.

Breast cancer is the most common malignant disease in women,it seriously threatens women's physical and mental health.Traditional surgical resection is the treatment of first choice.With the innovation of surgical treatment concept and the continuous development of medical technology,the thermal ablation technology,as a kind of local precision treatment,has gradually attracted the attention and application in medical field.Among thermal ablation techniques,micro wave ablation(MW A)is an emerging thermal ablation technology used in the treatment of breast cancer.Compared with traditional surgery,MW A has the advantages of less trauma,quick recovery,less complications,satisfactory cosmetic effect,and maximum protection of patient's organ functions.Moreover,some studies have revealed that MWA can motivate anti-tumor immune response,therefore,it is expected that MW A combined with immunotherapy may become a new therapeutic regimen.This article aims to make a detailed review about the latest research progress in MWA for the treatment of breast cancer.

Objective:To evaluate the efficacy and safety of radiofrequency introduction of L-vitamin C in patients with melasma.Methods:From March to June 2019, 20 patients with melasma were admitted to the Department of Dermatology, the Seventh Medical Center of PLA General Hospital, including 19 females and 1 male, aged 30-60 years, with an average age of 43.5 years. All patients were treated with 22 percent of L-vitamin C once a week, a total of 8 times of treatment and followed up for 12 weeks. Each subject was assessed with standardized clinical photo, skin tests (VISIA skin image analyzer and CK multifunctional skin tester) and patient self-assessment. In addition, the adverse reactions were recorded.Results:Physician evaluation and patient self-evaluation showed that skin symptoms were improved obviously after treatment. 90% of the subjects thought that all of the skin moisture, pores, fine lines, glossiness, and color spots were improved after 12 weeks. The skin texture, ultraviolet stain and the brown spots which were detected with VISIA skin image analyzer were all improved after one week and one month. Difference was statistically significant ( P<0.05). Skin glossiness was significantly improved, skin moisture content increased and melanin decreased, which were detected with CK multifunctional skin tester. The differences were statistically significant ( P<0.05). But there was no significant change in transdermal water loss and red pigment index ( P>0.05). Conclusions:22% L-vitamin C can be used to treat melasma and improve photoaging safely without affecting skin barrier function.

Objective To analyze the results of syphilis serology test results among hospitalized patients ,and to investigate the prevalence of syphilis .Methods T he results of syphilis antibody test of 199498 patients of Haikou People′s Hospital from 2011 to 2016 were retrospectively analyzed . All samples were screened by Treponema pallidum (TP) antibody using enzyme linked immunosorbent assay (ELISA) .Syphilis toluidine red unheated serum reagin test (TRUST ) was used to test nontreponemal antibody .The TP-ELISA positive samples were confirmed by Treponema pallidum particle agglutination test (TPPA) .Chi-square test was used for statistical analysis .Results A total of 7616 cases were positive of anti-TP ,with positive rate of 3 .82％ .From 2011 to 2016 ,the annual cases tested were 23188 ,32010 ,35079 ,35734 ,35406 and 38081 ,respectively .The annual positive rates of anti-TP w ere 4 .11％ (952/23188 ) ,3 .94％ (1261/32010 ) ,4 .55％ (1597/35079 ) ,3 .85％ (1376/35734 ) , 3 .47％ (1229/35406) ,and 3 .15％ (1201/38081) ,respectively ,and the difference was statistical significant (χ2 =108 .167 ,P<0 .05) .Anti-TP positive rate in male patients was 4 .85％ (4899 cases) , and 2 .76％ (2717 cases) in female ,and the difference was statistically significant ( χ2 =593 .443 , P<0 .05) .The positive rate of TP antibody in the elderly over 80 years old was 6 .09％ ,and 5 .03％ in patients older than 60 years old .In all samples ,TRUST was positive in 3413 cases (1 .71％ ) .From 2011 to 2016 , the annual positive cases were 179 , 390 , 585 , 768 , 816 and 675 , respectively , with coresponding rates of 0 .77％ ,1 .22％ ,1 .67％ ,2 .15％ ,2 .3％ and 1 .77％ ,respectively .The difference was statistically significant (χ2 = 763 .779 , P< 0 .05) .TRUST was positive in 2022 (2 .01％ ) male patients and 1391 (1 .41％ ) female patients ,and the positive rates were significantly different (χ2 =102 .887 ,P<0 .05) .From 2011 to 2016 ,the annual TRUST positivities among patients -9 years old and -19 years old were not different (χ2 = 1 .198 and 11 .018 ,both P> 0 .05) ,while those among patients aged -29 ,-39 ,-49 ,-59 ,-69 ,-79 ,and ≥80 years old were statistically different (χ2 =20 .100 ,38 .387 ,89 .360 ,75 .874 ,87 .743 ,71 .035 and 30 .593 ,respectively ,all P<0 .05) .Conclusions From 2011 to 2016 ,the positive rates of syphilis is increased and then decreased .And it is significantly different among different genders and age groups .The positive rate in elderly is significantly higher .

Objective To understand the degree of job burnout in nurses of intensive care unit (ICU) and to explore its influence on compliance with head-of-bed elevation in patients receiving mechanical ventilation.Methods A total of 42 nurses of ICU in Tengzhou Central People's Hospital were investigated on the level of job burnout with the nursing burnout scale (NBS) from September 2016 to February 2017. Besides, the implementation of head-of-bed elevation in patients receiving invasive mechanical ventilation without contraindications was inspected. The compliance with head-of-bed elevation was also calculated. The data was analyzed by SPSS 17.0.Results Among 42 nurses of ICU, there were 52.38% of them with severe emotion exhaustion, 59.52% with severe depersonalization, 40.47% with low personal accomplishment. The mean compliance with head-of-bed elevation was 64.29%. Spearman correlation analysis showed that the emotion exhaustion dimension had a negative correlation with compliance (r=-0.545,P<0.01). The depersonalization was negatively associated with compliance (r=-0.480,P<0.01). The sense of achievement had a positive correlation with compliance (r=0.516,P<0.01).Conclusions The job burnout in nurses of ICU has certain influences on compliance with head-of-bed elevation in patients receiving mechanical ventilation.

Objective To observe expression level of serum vascular endothelial growth factor-C (VEGF-C),VEGF-C receptor-2 and VEGF-C receptor-3 in patients with acute leukemia (AL) and to explore its clinical significance.Methods Enzyme-linked immuno sorbent assay (ELISA) was used to detect the serum expression levels of VEGF-C,VEGFR-2,and VEGFR-3 of 51 patients diagnosed with acute leukemia,43 patients under medical treatment and 16 healthy blood donors.Results (1) Serum VEGF-C,VEGFR-2,and VEGFR-3 expression levels in AL patients were significantly higher than those in normal control group.(2) Serum VEGF-C and VEGFR-2 expression levels in complete remission (CR) group significantly declined after treatment.Serum VEGF-C and VEGFR-2 expression levels in non-complete remission (NR) group slightly declined after treatment but no significant difference was found (P＞0.05).(3) No significant difference was found in serum VEGFR-3 expression levels both in CR group and NR group after treatment (P＞0.05).(4) Serum VEGF-C,VEGFR-2,and VEGFR-3 expression levels in NR group were significantly higher than those in CR group before treatment (P＜0.08).Conclusions Observing serum expression level of VEGF-C,VEGFR-2,and VEGFR-3 of AL patients may be helpful in monitoring curative effects and prognosis of acute leukemia.

Objective To assess the expression pattern of protease-activated receptor 2 (PAR2) in human keratinocytes and to characterize its biological functions in the regulation of skin barrier.Methods Primary human keratinocytes and human N/TERT keratinocytes were used as the subject of this study.The expression and distribution of PAR2 in the keratinocytes were analyzed by using immunoflorescence staining and Western blot.Two different PAR2 agonists,trypsin and a PAR2-activating peptide (AP),as well as a PAR2-antagonistic peptide (H2N-FSLLRY-COOH) and a control peptide were used to induce the activation of PAR2 in the keratinocytes.Then,a fluorescence-based calcium mobilization assay was performed to evaluate the biological function of PAR2.Data were statistically analyzed by one-factor analysis of variance.Results Under normal culture conditions,PAR2 was weakly expressed in keratinocytes,and the expression was unaffected by culture medium composition or culture duration.Calcium mobilization was induced by trypsin of 50-250 nmol/L and the PAR2-activating peptide in a dose-and time-dependent pattern.The maximal activation of PAR2 was observed in keratinocytes treated with the PAR2 agonist HAN-SLIGKV-COOH of 75-250 μmol/L.The PAR2-antagonistic peptide (H2N-FSLLRY-COOH) obviously suppressed the increase in calcium mobilization induced by trypsin,while the control peptide PAR-RAP showed no inductive effect on the PAR2 activation based on the absence of calcium mobilization.The substrate-induced calcium release was complete within 250 seconds,and peaked at 50 seconds after the initial trypsin or PAR-AP stimulation.Moreover,the activation of PAR2 was accompanied by an increase in ERK phosphorylation and elicitation of MAPK signaling pathway in keratinocytes.Conclusions Human keratinocytes positively express PAR2,which can be activated by trypsin and PAR2-activating peptides,and the activation of PAR2 may influence the physiological function of keratinocytes by inducing intracellular calcium release.

Objective To explore the predictive value for coronary heart disease by epicardial adipose tissue(EAT) thickness and carotid intima-media thickness(IMT) measured with high-frequency ultrasound.Methods According to the results of coronary angiography, the cases were divided into the normal control group (29 patients),coronary artery disease group with single-vessel lesion (43 patients),coronary artery disease group with multi-vessels lesion (28 patients), respectively. EAT and IMT were measured by high-frequency ultrasound. Results The EAT in the three groups were (4.8 ± 1.3) mm, (7.6 ± 1.8) mm,(10.1±2.6) mm respectively, and the IMT were (0.8±0.1)mm,(1.0±0.2)mm,(1.1 ± 0.2)mmrespectively. In either coronary artery disease group with single-vessel lesion or multi-vessels lesion, the EAT and IMT were significantly higher than those in the normal control group ( P＜ 0.01 ). And the difference between groups of single-vessel lesion and multi-vessels lesion was also statistically significant (P＜ 0.01). The areas under receive operating characteristic(ROC) curve to predict coronary heart disease by EAT and IMT was 0.947 and 0.917, respectively, there was no significant difference between the two areas. For patient with coronary artery stenosis＞50%, the sensitivity and specificity of EAT＞6 mm were 90.1% and 86.2% ,respectively,the sensitivity and specificity of IMT＞0.85 mm were 87.3% and 82.8%,respectively. Conclusions EAT and IMT measured by high-frequency ultrasound can precisely predictcoronary heart disease. EAT can be a new predictor to diagnose coronary heart disease.

Objective To explore the correlation between epicardial adipose tissue(EAT) thickness and cardiovascular risk factors in patients with coronary artery disease.Methods According to the results of coronary angiography,84 cases of patients undergone coronary angiography were divided into the normal control group(28 patients),coronary artery disease group with single-vessel lesion (28 patients),coronary artery disease group with multi-vessels lesion(28 patients),respectively,then measured the EAT thickness and carotid intima-media thickness(IMT) by high-frequency ultrasound.A correlation analysis was carried out between the EAT and IMT and cardiovascular risk factors.Results In either coronary artery disease group with single-vessel lesion or multi-vessels lesion,the thicknesses of EAT and IMT were significantly higher than those in the normal control group(P ＜0.01),and the difference between group of single-vessel lesion and multi-vessels lesion was also statistically significant (P ＜0.01).A correlation analysis between the EAT and IMT and cardiovascular risk factors showed that there were significantly positive correlations between EAT and the IMT,age,weight,waist circumference,body mass index,low-density lipoprotein,Creactive protein (r = 0.124～0.790,P ＜0.05 or P ＜0.01),and the significantly negative correlation between EAT and high-density lipoprotein (r = - 0.203,P ＜ 0.05).Correlation between EAT and the IMT was 0.678,0.713,0.737 in the normal control group,group with single-vessel lesion,group with multivessels lesion,respectively.Conclusions There were favorable correlation between EAT and carotid IMT in cardiovascular risk factors.The more severity of coronary heart disease,the more high correlations of EAT and IMT.EAT can be a valuable index in evaluating coronary artery disease.

To investigate the prognostic effects of integrated traditional Chinese and Western medicine therapy without antibiotics in treatment of patients with severe acute pancreatitis (SAP).