Objective To observe the clinical efficacy of Ziyin Yikang Recipe plus hexadecadrol on anti-HCG antibody positive secondary sterility and the influence on anti-HCG antibody titers. Methods Sixty patients with anti-HCG antibody positive secondary sterility were randomly divided into treatment group (TG) and control group (CG), 30 cases in each. Patients in the TG were treated with Ziyin Yikang Recipe plus hexadecadrol, while patients in the CG were given hexadecadrol only. The Chinese medicine symptom scores and changes of anti-HCG antibody titers were evaluated and compared between the two groups.Results The Chinese medicine symptom scores in the two groups decreased compared with those before treatment (P<0.05), and the TG showed a more significant decrease than the CG (P<0.05). The anti-HCG antibody titers in both groups dropped compared with those before treatment (P<0.05, P<0.01). There was no statistically difference between the two group after treatment (P>0.05). The total effective rate in the TG was higher that that in the CG (P<0.05), with 63.33% (19/30) in the TG and 47.66% (14/30) in the CG.Conclusion The treatment of Ziyin Yikang Recipe plus hexadecadrol on anti-HCG positive secondary sterility can obviously improve the clinical syndrome of yin deficiency and fire hyperactivity, and promote pregnancy success.

Objective To study the clinical features and differential diagnosis of Langerhans cell histiocytosis (LCH).Methods A case of LCH was reported and the literatures were reviewed.Results The of multisystem LCH patient,presented with a diabetes insipidus (DI) and panhypopituitarism,was 44 years old,and developed costal,tibial and femoral multiple lesions.The final diagnosis as LCH was made based on biopsy of tibia and lymph nodes.The biopsy specimen showed that the cells were infiltrated exhibiting the characteristic morphologic features of Langerhans cell (LC) with a convoluted shape,elongated nuclei exhibiting longitudinal grooves,and immunohistochemistry results revealed positive LC for the S-100,CD1a and Langerin immunostaining.Conclusions LCH may range from a solitary lytic bone lesion (for example eosinophilic granuloma) with a favorable course to a fatal disseminated leukaemia-like form.LCH typically involves the bone,lesions almost can be found in all organs.DI and CNS involvement often present as a puzzling syndrome,which renders the diagnosis problematicly,and often delays the diagnosis of LCH.The damage to the pituitary/hypothalamus axis results in life-long hormonal replacement therapy.

Objective To establish the mouse models of focal cerebral ischemic/reperfusion (I/R) injury combined with diabetes mellitus (DM),and investigate the possible mechanism of brain injury.Methods Eighty healthy C57BL/6J mouse were randomly divided into normal group and DM group;normal saline or streptozotocin was given to the mice in the two groups via intraperitoneal injection,and the concentration of glucose in peripheral blood was measured at different time points (2,4,6 and 8 weeks after injection);and then,the mice in the two groups were subdivided into normal sham-operated group,normal I/R group,DM sham-operated group and DM+I/R group (n=20).The focal I/R models were induced by thread occlusion method;the neuroethology assessment was determined by Zea Longa method in the normal I/R group and DM+I/R group;the morphology of the brain tissues in the four groups was observed by HE staining;changes of mRNA expressions of interleukin (IL)-1β,IL-6 and tumor necrosis factor (TNF)-α were analyzed by quantitative real-time PCR.Results (1)The glucose concentration in DM group was stable at a high level within the 8 weeks;as compared with normal group,DM group had significantly higher glucose concentration at each time point (P＜0.05).(2) The assessment scores of DM+I/R group (2.800±0.092) were significantly higher than those of I/R group (1.750±0.123,P＜0.05).(3) Typical pathological changes were presented by HE staining,DM+I/R group presented worse damage to the brain as compared with normal I/R group.(4) Quantitative real-time PCR showed that the IL-1β and TNF-α mRNA expressions in the normal I/R group was significantly higher than those in the normal sham-operated group (P＜0.05);the mRNA expressions of IL-1β,IL-6 and TNF-α in DM+I/R group were significantly increased as compared with those in the DM sham-operated and normal I/R group (P＜0.05).Conclusion The simple and reliable focal cerebral I/R combined with DM models are successfully established;inflammation reaction mediated by inflammatory factors might play an important role in this aggravating damage.

Objective:To investigate the effect of peer support education on family function of breast cancer patients with breast reconstruction.Methods:Totally 146 patients who received surgical treatment in the department of plastic surgery for breast cancer from June 2017 to June 2019 were randomly divided into the experimental group and the control group by the method of random number table, 73 cases each. The control group received routine education. Patients in the observation group received regular education and peer support education. The intervention time was from admission to 6 months after discharge, and the control group received routine nursing care. Quality of life questionnaire was used to evaluate the quality of life of the patients at six months after operation, family care index questionnaire was used to evaluate the family function of the patients, and comprehend social support scale was used to evaluate the level of social support, then various indicators of the two groups of patients were compared.Results:6 months after operation, the scores of quality of life function and symptom dimension of the intervention group were 6.43±1.54. 5.83±1.47, while control group were 6.02±1.59; 6.39±1.63. There were statistically significant differences between the two groups ( t values were 4.30, 5.01, P < 0.05); family care scores of the two groups were compared, the intervention group was 8.78±2.04. The control group was 8.43±2.05. There were statistically significant differences between the two groups ( t value was 2.02, P < 0.05); the comprehension support score of the two groups was compared, and that of the intervention group was 62.24±14.81. The control group was 55.74±13.58. There were statistically significant differences between the two groups ( t value was 4.26, P < 0.05). Conclusion:Peer support education can improve the quality of life and family care of breast cancer patients with breast reconstruction.

Objective:To measure the salary satisfaction level of medical staff in county-level public hospitals and provide reference for the design of policy reforms. Method:Eight county-level public hospitals were investigated. All analyses were performed using SPSS 19. 0 via statistical description and binary logistic regression. Results: The total salary satisfaction of the medical staff was 48 . 8%, and the average score was 54 . 05 ± 18 . 04 . The welfare satis-faction is the lowest (38. 8%), and the average score is 7. 98 ± 3. 51. Logistic regression analysis shows that the ac-ademic degree, department category, working hours per week, acceptance of bribes, and officially budgeted posts are the main factors affecting overall compensation satisfaction. Conclusion:The overall salary satisfaction level of medi-cal staff in county-level public hospitals is very low, and the welfare satisfaction is the lowest. Establishing the rea-sonable level of compensation, the rise of compensation, and the welfare mechanism are feasible choices to improve salary satisfaction.

Objective To explore the expressions of miR-221 and miR-222 in papillary thyroid carcinoma (PTC),and relativi-ties with clinical pathological features.Methods Samples from patients of PCT (43 cases),nodular golter(21 cases),and para-carcinoma thyroid tissues(14 cases),78 cases in total (from 06/2015 to 05/2016,Shaanxi Provincial People’s Hospital) were collected.Real time-PCR tests were carried out,then analyzed in relation to clinical pathology features,and statistical a-nalysis was used to evaluate the results.Results The expressions of miR-221 and miR-222 were significantly higher in PTC (11.54±3.37,10.67±2.45)than in nodular golter (3.21±1.12,2.89±1.23)and normal thyroid tissue (2.02±0.76, 1.98±0.34)(t=3.62,3.25;3.27,3.01,all P<0.05),which were significantly related with Regional lymph node metasta-sis,tumor invasion coated,distant metastasis and clinical stage (P<0.05),while not related with the gender,age,or size of the tumor of the patients (P>0.05),and no differences were found in nodular golter and in normal thyroid tissue (t=0.91, 0.79,P>0.05).Conclusion miR-221 and miR-222 could be considered as a specific molecular marker of PTC,may play an important role in the diagnosis and treatment on PTC.

Objective To investigate whether cerebral ischemia reperfusion (I/R) injury combined with diabetes mellitus (DM) could elevate concentrations of serum high mobility group box 1 (HMGB 1) and its related inflammatory factors,and to explore the underlying mechanism of cerebral I/R injury combined with DM by blocking HMGB 1.Methods One hundred and forty healthy male C57BL/6 mice were randomly divided into four groups:normoglycemia (NG) group (n=25),NG+I/R group (n=25),hyperglycemia (HG) group (n=25),and HG+I/R group (n=65);40 mice in the HG+I/R group were chosen and divided into anti-HMGB1 group and IgG control group (n=20).High-fat feeding and i.p.injection of streptozotocin were used to establish HG mouse models,and then,middle cerebral artery occlusion was performed to establish the HG+I/R mouse models.Mice were treated with tail intravenous injection of 30 μg/g anti-HMGB 1 polyclonal antibody or control IgG 1 h before ischemia as previously described.After accomplishment of animal models,serum HMGB1 concentrations were evaluated by ELISA,the permeability of blood brain barrier (BBB) was observed by Evans-blue fluorescence quantitative method,quantitative real-time PCR was introduced to detect the mRNA expressions of interleukin (IL)-1β,IL-6,and inducible nitric oxide synthase (iNOS).Morphology changes of damaged brains were observed by HE staining.Results The serum HMGB 1 level in the HG+I/R group was significantly higher than that in the NG+I/R group (P＜0.05).HG+I/R group had significantly higher BBB permeability than NG+I/R group (P＜0.05),while anti-HMGB1 group had significantly lower BBB permeability than HG+I/R group (P＜0.05).As compared with the NG group,the HG+I/R group had unclear cellular structures in the brain tissues with necrosis neurocytes and interstitial edema,while the cellular structures were obviously improved in the anti-HMGB1 group.Expressions ofIL-1β,IL-6 and iNOS in the HG+I/R group were significantly elevated as compared with those in the NG+I/R group (P＜0.05),while those in the anti-HMGBl group had significantly decreased levels ofIL-1β and iNOS as compared with those in the HG+I/R group (P＜0.05),and the IL-6 level showed no significant difference between the two groups (P＜0.05).Conclusion The pathogenesis of DM could increase concentration of serum HMGB 1,and anti-HMGB 1 mAb could alleviate brain injury by blocking HMGB 1,and render a new promising therapeutic way for DM patients suffered with ischemic stroke.

Autism spectrum disorder (ASD), a representative disease of children's neurodevelopmental disorders, brings huge pressure and financial burden to families and society. It is of great significance to explore its etiology and pathogenesis. Therefore, we established an ASD Cohort based on the existing China National Birth Cohort (CNBC), which applied parallel design to recruit and follow up families who achieved pregnancy after receiving assisted reproductive technologies (ART) and families with spontaneous conception. The main aims of this study are to compare the incidence of ASD among children born after ART with those born under spontaneous pregnancy, and to evaluate the impact of ART on the neurobehavioral development of offspring. Additionally, with a variety of clinical and behavioral related information collected during pregnancy and at early life of offspring, we are able to investigate the risk factors associated with ASD comprehensively. This article briefly introduces the objectives, contents, preliminary progress, strength and limitations, as well as further prospects of the ASD cohort study, mainly focusing on the overall design and current progress.

Objective: To evaluate the efficacy and safety of Xiaoaiping combined with chemotherapy in the treatment of advanced esophageal cancer. Methods: This is a multi-center, randomized, open label and parallel controlled study. A total of 124 advanced esophageal cancer patients with Karnofsky Performance Status (KPS) score ≥60 and expected survival time≥3 months were enrolled. We adopted design and divided the patients into study and control group. The patients in study group received Xiaoaiping combined with S-1 and cisplatin. The control group received S-1 and cisplatin. Each group included 62 patients and 21 days as a treatment cycle. The efficacy and adverse events in patients of the two groups were observed and compared. Results: 57 patients in the study group and 55 in the control group were included in efficacy assessment. The response rate was 54.4% and 34.5% in the study group and control group, respectively(P<0.05). Disease control rates were 86.0% and 69.1%, respectively(P<0.05). The median progression-free survival (PFS) was 7.97 in the study group and 6.43 months in the control group(P<0.05). The median overall survival(OS) was 12.93 in the study group and 10.93 months in the control group(P<0.05). The most common adverse events in the two groups were nausea and vomiting, thrombocytopenia, anemia, neutropenia, liver damage, pigmentation, oral mucositis, renal impairment and diarrhea. The incidences of nausea, vomiting, thrombocytopenia, leukopenia, neutropenia and diarrhea in the study group were significantly higher than those in the control group(P<0.05). Conclusion Xiaoaiping combined with S-1 and cisplatin significantly increased response rate, and prolongedpatients′ survival in patients with advanced esophageal cancer.

OBJECTIVES: Varicella-zoster virus (VZV) is one of the most common etiologies of viral meningitis/encephalitis. The early clinical manifestations and cerebrospinal fluid (CSF) changes of VZV meningitis/encephalitis lack specificity, and it is easy to be misdiagnosed as other viral encephalitides or tuberculous meningitis. This study aims to investigate whether the clinical characteristics, CSF analysis findings, and CSF cytokine levels could distinguish VZV meningitis/encephalitis from central nervous system (CNS) herpes simplex virus (HSV) and Mycobacterium tuberculosis (MTB) infections. METHODS: The medical records from 157 CNS infections, including 49 HSV (45 HSV-1, 4 HSV-2), 55 VZV, and 53 MTB infections between January 2018 and June 2021 in the Cytology Laboratory, Department of Neurology, Third Xiangya Hospital of Central South University were retrospectively reviewed. The data of 3 groups included demographic characteristics, laboratory results, radiographic findings, and outcomes. The levels of 12 cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17, IFN-γ, IFN-α, and TNF-α) in the CSF of 68 patients (13 HSV, 22 VZV, and 33 MTB infection cases) were quantified. Clinical and laboratory data were compared among the 3 groups. RESULTS: The most common clinical manifestations in the 3 groups were fever, headache, vomiting, and neck stiffness. The clinical manifestations of HSV and VZV CNS disease were similar, although fever and altered consciousness were less common in the VZV group than those in the HSV and MTB groups (63.6% vs 87.8% vs 96.2%, P<0.001, and 14.5% vs 26.5% vs 47.2%, P=0.004, respectively). Seven patients (7/55, 12.7%) presented cutaneous zoster in the VZV group. CSF leukocyte count was significantly higher in the VZV group (230×10⁶ cells/mL) and MTB groups (276×10⁶ cells/mL) than that in the HSV group (87×10⁶ cells/mL, P=0.002). CSF protein level was significantly higher in the VZV than that in the HSV group (1 034 mg/L vs 694 mg/L, P=0.011) but lower than that in the MTB group (1 744 mg/L, P<0.001). IL-6 (VZV vs HSV vs MTB: 2 855.93 pg/mL vs 2 128.26 pg/mL vs 354.77 pg/mL, P=0.029) and IL-8 (VZV vs HSV vs MTB: 4 001.46 pg/mL vs 1 578.11 pg/mL vs 1 023.25 pg/mL, P=0.046) levels were significantly different among the 3 groups and were elevated in the VZV group.Post hoc analysis revealed that IL-6 and IL-8 were significantly higher in the VZV group than those in the MTB group (P=0.002 and P=0.035, respectively), but not in the HSV group (P>0.05). CONCLUSIONS VZV meningitis/encephalitis presents with CSF hypercellularity and proteinemia, challenging the classical view of CSF profiles in viral encephalitis. CSF IL-6 and IL-8 levels are elevated in patients with VZV meningitis/encephalitis, indicating a more intense inflammatory response in these patients.
Humans ; Central Nervous System Infections ; Encephalitis ; Encephalitis, Varicella Zoster/diagnosis* ; Encephalitis, Viral/diagnosis* ; Herpesvirus 3, Human ; Interleukin-6 ; Interleukin-8 ; Meningitis ; Retrospective Studies