Objective To observe the clinical efficacy of butylphthalide soft capsules for treatment of acute cerebral infarction and its effect on the neurological function and inflammatory reaction of patients.Methods A total of 100 patients with acute cerebral infarction in the First Hospital of Zhangjiakou City and the Third Hospital Affiliated to Hebei North University from January 2016 to October 2016 were selected and divided into control group (n =50) and treatment group (n =50) according to the treatment protocols.The patients in the control group were given anti-platelet aggregation,statins,and other routine treatment;based on this,the patients in treatment group were orally administrated with butylphthalide soft capsules.The elbow venous blood of patients in the two groups was collected and the C reactive protein(CRP),interleukin-6 (IL-6) levels,the platelet aggregation rate were detected.The change of National Institute of Health stroke scale(NIHSS) score of patients after four weeks treatment was compared between the two groups.The recovery of neurological function of patients in the two groups was evaluated by modified Rankin grading after three months treatment.Results There was no statistic difference in the CRP,IL-6 levels and platelet aggregation rate before treatment between the two groups (P ＞ 0.05).The CRP,IL-6 levels and platelet aggregation rate of patients in the two groups after one week treatment were significantly lower than those before treatment (P ＜ 0.05);and the CRP,IL-6 levels and platelet aggregation rate of patients in the treatment group were significantly lower than those in the control group after one week treatment (P ＜ 0.05).The NIHSS score of patients in the treatment group was significantly lower than that in the control group after four weeks treatment (P ＜ 0.05);the Rankin score of patients in the treatment group was significantly lower than that in the control group after three months treatment (P ＜ 0.05).The total effective rate of patients in the treatment group was significantly higher than that in the control group (x2 =13.22,P ＜ 0.05).Conclusion Butylphthalide soft capsules can significantly reduce the inflammatory reaction in patients with acute cerebral infarction,improve and recover the neurologic impairment;and its curative effect is remarkable.

Aim To investigate the time-dependent effect of insulin on the expression of SREBP-1(sterol regulatory element binding protein-1),FAS(fat acid synthase)and lipid droplet formation in HKC cells(human renal proximal tubular epithelial cells line).MethodsHKC cells were respectively treated with 100 nmol·L~(-1) insulin for 0,2,4,6,12 h and 24 h.The analysis of SREBP-1 and FAS mRNA was performed by RT-PCR and the expression of SREBP-1 protein was detected by Western blot and immunocytochemistry.Furthermore,Oil Red O staining was used to determine cellular lipid droplet formation.ResultsCompared with HKC cells of 0 h group,there was no difference of SREBP-1 and FAS mRNA in HKC cells of 2 h group.However,the expression of SREBP-1 and FAS mRNA was significantly increased in HKC cells of 4,6 h and 12 h group.Further,the most expression of SREBP-1 and FAS mRNA was at 6 h group and was respectively increased by 3.578 and 4.272 times compared with 0 h group.The results of Western blot showed that the precursor and mature segments of SREBP-1 protein in 4,6 h and 12 h group HKC cells were increased and those of 6 h group HKC cells were the highest and about 4.106 and 5.167 times than those of 0 h group HKC cells.Immunocytochemistry presented the result that SREBP-1 protein was located in the plasma and the expression of 4,6 h and 12 h group HKC cells was significantly higher than that of 0,2 h and 24 h group HKC cells.The result of Oil Red O staining showed that lipid droplet markedly deposited in 6 h group HKC cells,contrarily,no lipid droplet was found in HKC cells of other groups.ConclusionAbove results suggested that insulin up-regulated SREBP-1 and FAS in time-dependent manner that led to cellular lipid droplet deposit,which may play an important role in the pathogenesis of renal lipid accumulation in metabolism syndrome.

Purpose To investigate the role of PTEN in podocyte injury in patients with diabetic nephropathy ( DN) . Methods Uri-nary samples from 30 patients with DN and 10 healthy volunteers were collected to detect the level of PCX by ELISA. Renal biopsies were reviewed to observe the morphological changes. All patients with DN were divided into three groups by glomerular lesion. The ex-pression of p-Akt and PTEN in glomeruli was detected by immunohistochemistry. Results The levels of PCX in the urine were signifi-cantly higher in patients with DN compared with those in healthy volunteers, and gradually increased along with glomerular lesion aggra-vating. The expression of p-Akt and PTEN increased in patients with DN compared with healthy volunteers. Although the expression of p-Akt and PTEN decreased with the aggravation of glomerular lesion, they were still higher than that in volunteers. There were obvious-ly positive correlation between the level of PCX and 24-h urinary protein and negative correlation between the level of PCX and the ex-pression level of p-Akt and PTEN. Conclusion PTEN down-regulation may be associated with podocyte injury in DN, which may be associated with the phosphorylation of Akt.

Objective Based on the theoretical connotation of"Dredge Du meridian remodeling god"intervention in PSD,two rounds of expert questionnaire were conducted in combination with Delphi survey method to optimize the diagnosis and treatment scheme of massage intervention in PSD,and to develop an optimal operation mode of Tuina for PSD.Methods Experts with rich experience in Tuina intervention in different provinces and cities in China were selected to participate in two rounds of questionnaires.Items were screened after statistical analysis of experts′ basic information,positive degree,coordination coefficient and authority coefficient of the two rounds of questionnaires.Results In the two rounds of Delphi survey,34 and 37 experts were selected for questionnaire survey,and the positive coefficients of experts were 94.44%and 94.47%,respectively.The average expert authority coefficients of the two rounds were 0.65 and 0.74.The expert coordination degree of the two rounds of questionnaires was medium,and Kendall coefficient W>0.4.Conclusion After two rounds of expert research in Delphi,the specific techniques,techniques and treatment frequency were screened and demarcated,and the optimized PSD diagnosis and treatment plan of"Dredge Du meridian remodeling god"Tuina intervention with high expert authority and good consensus was formed,which can be promoted and applied to PSD patients clinically.

Objective To investigate the risk factors for rebleeding after emergency esophageal variceal ligation (EVL) in patients with liver cirrhosis. Methods A retrospective analysis was performed for the clinical and laboratory data of 290 patients with liver cirrhosis who underwent emergency EVL in The Fifth Medical Center of Chinese PLA General Hospital from January 2016 to December 2019, and according to the presence or absence of rebleeding within 1-year follow-up, they were divided into rebleeding group and non-rebleeding group. The t -test was used for comparison of normally distributed continuous data between two groups, and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A multivariate logistic regression analysis was performed with the statistically significant factors as independent variables to screen out the independent risk factors for rebleeding after emergency EVL, and the receiver operating characteristic (ROC) curve was plotted to obtain the indices for predicting the probability of rebleeding and establish a predictive model. Results The univariate analysis showed that there were significant differences between the two groups in platelet count ( t =-1.888, P =0.047), Child-Pugh score ( χ 2 =5.975, P =0.049), albumin level ( t =-2.229, P =0.029), and splenic vein diameter ( t =3.808, P =0.001). The multivariate logistic regression analysis showed that Child-Pugh score (odds ratio [ OR ]=0.280, 95% confidence interval [ CI ]: 0.108-0.729, P =0.009), splenic vein diameter ( OR =1.549, 95% CI : 1.197-2.005, P =0.001) and albumin level ( OR =0.832, 95% CI : 0.729-0.949, P =0.006) were independent influencing factors for rebleeding after EVL. The predictive model based on these three factors had an area under the ROC curve of 0.796, with a sensitivity of 83.7% and a specificity of 74.5% at the cut-off value of -0.086. Conclusion Child-Pugh score, albumin level, and splenic vein diameter are independent risk factors for rebleeding after emergency EVL, and the combination of the three indices has the highest sensitivity and specificity in predicting rebleeding.