Objective:To explore therapeutic effect of Tanshinone IIA‐sulfonic sodium on patients with coronary heart disease (CHD) and its influence on hemorheology ,cytokines and blood lipid levels .Methods :A total of 98 CHD patients treated in our hospital were selected .According to random number table ,they were randomly and e‐qually divided into routine treatment group and Tanshinone IIA group (received intravenous drip of Tanshinone IIA sulfonate sodium based on routine treatment group ) . Therapeutic effect , hemorheologic indexes , cytokines and blood lipid levels before and after treatment ,and adverse drug reaction were compared between two groups .Re‐sults:Compared with routine treatment group , there was significant rise in total effective rate (73.47% vs . 93.88% ) in tanshinone IIA group ,P=0.003. Compared with before treatment ,after treatment ,there were signif‐icant improvement in levels of blood lipid ,blood viscosity ,and cytokines in Tanshinone IIA group , P< 0.01 all . Compared with routine treatment group after treatment ,there was significant rise in HDL‐C level [ (1.32 ± 0.20) mmol/L vs .(1.74 ± 0.26) mmol/L] ,significant reductions in levels of LDL‐C [(3.27 ± 0.50) mmol/L vs .(2.03 ± 0.29) mmol/L] ,TG [ (2.69 ± 0.48) mmol/L vs .(1.43 ± 0.30) mmol/L] and TC [ (6.89 ± 1.02) mmol/L vs . (4.29 ± 0.71) mmol/L];significant reductions in plasma viscosity [ (2.59 ± 0.61) mPa s vs .(1.45 ± 0.32) mPa s] , whole blood viscosity [(4.63 ± 1.37) mPa s vs .(2.97 ± 0.85) mPa s] ,platelet adhesion rate [(36.73 ± 4.51)% vs . (30.74 ± 3.37)% ] ,levels of Fg [(4.12 ± 0.99) g/L vs .(3.04 ± 0.78) g/L] ,ICAM‐1 [(106.79 ± 30.15) pg/ml vs . (78.43 ± 14.52) pg/ml] ,CRP [(19.98 ± 3.89) mg/L vs .(10.82 ± 2.19) mg/L] and TNF‐α[(27.91 ± 4.78) pmol/L vs .(17.84 ± 3.56) pmol/L] in Tanshinone IIA group ,P<0.01 all .No severe adverse reaction was found in two groups .Conclusion:Tanshinone IIA sulfonate sodium possesses significant therapeutic effect on CHD patients .It can significantly improve patient′s hemorheology ,blood lipid and reduce cytokine levels ,and it′s safe and reliable .

Objective To summarize the key points in surgical cooperation of laparoscopic left lateral segment liver resection. Methods The clinical data of 24 patients undergoing laparoscopic left lateral segment liver resection from March to September of 2013 were analyzed retrospectively to summarize the key points in surgical cooperation of preoperative preparation and intraoperative coordination.Result All the operations were successful with the operation mean time of(72.0±26.8)min,no intraoperative transfer or termination of the operations.Conclusion Sufficient preoperative preparation together skilled surgical nursing cooperation in laparoscopic left lateral segment liver resection is critical for the success of operation.

Objective To investigate the combined biological effects of low dose radiation,carbon monoxide,benzene and noise on rats.Methods Sixteen male SD rats were randomly divided into experiment group and control group.The experiment group was exposed to carbon monoxide,benzene,low dose radiation and noise daily,the control group was in common environment.Peripheral blood,organ index,and marrow DNA content were detected.Two-dimensional electrophoresis (2-DE) was performed on serum protein analysis.Differential expressed proteins were identified by a matrix assisted laser desorption/ionization time of flight mass spectrometry (MAIDI-TOF-MS).Results Compared to control group,the liver index,spleen index,thymus index,leukocytes,platelets count,and marrow DNA content of the experiment group were decreased significantly (t =2.732,4.141,3.053,2.211,2.668,11.592,P ＜0.05).12 altered proteins were detected and through identification,3 proteins were definite in terms of serum amyloid A-4 protein (SAA4),trichoplein keratin filament-binding protein (TCHP) and tubulin alpha-4A chain (TUBA4A).Conclusions The hematopoietic system and immune system of rats are damaged significantly with the changes of several serum protein expressions by the combined exposure of low dose radiation,carbon monoxide,benzene and noise.This study may provide new information for the mechanism of the combination effects.

Objective To explore the impact of dexamethasone on inflammatory response of thyrocytes.Methods Primary thyrocytes were extracted from thyroid tissue of patients with Graves' disease.The cells were stimulated with interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α),and cultured in dexamethasone.Thyrocytes were divided into 4 groups:control group,dexamethasone group,TNF-α + IFN-γ group,and dexamethasone+TNF-α+IFN-γ group.Interferon-γ-induced protein 10 (CXCL10) and CCL2 in supernatant of cell cultured in 4 groups were detected by enzyme-linked immunosorbent assay.Cell protein in 4 groups was extracted and GSK-3β,P50,and P100 protein were detected by Western blotting.Results MTT assay demonstrated that 10-5 mmol/L concentration of dexamethasone was optimal for cell culture.The CXCL10 level in TNF-α+IFN-γ group was higher than that in the control group and dexamethasone group (P＜0.01),but no difference was found between dexamethasone+TNF-α+IFN-γgroup and TNF-α+IFN-γgroup(P＞0.05).The CCL2 level in TNF-α+IFN-γ group was higher than that in control group and dexamethasone group(P＜0.01).There was a significant lowering of CCL2 level in dexamethasone + TNF-α + IFN-γgroup compared with TNF-α + IFN-γ group (P ＜ 0.05).The expression of GSK-3β and P100 protein was increased in TNF-α + IFN-γgroup compared with control group.The expression of GSK-3β and P100 protein was lower in dexamethasone+TNF-α + IFN-γ group than that in TNF-α + IFN-γ group.Conclusion TNF-α + IFN-γ could stimulate the secretion of CXCL10 and CCL2 in thyrocytes and thus activate the inflammatory response.Dexamethasone could reduce CCL2 secretion.Dexamethasone had little effect on CXCL10.Dexamethasone could reduce GSK-3β and P100 expressions,and inhibit the activation of NF-κB signaling pathway and thus the inflammatory response.

This article was aimed to study the physiological mechanisms in frozen storage to reduce early bolting of Angelica sinensis. By analyzing the root soluble sugar, soluble protein, MDA content changes before and after -10oC processing of the Angelica sinensis seedlings of different size from different sources , the physiological mechanisms in frozen storage reducing early bolting of A . sinensis had been studied. The results indicated that the greater seedlings , the higher content of soluble sugar , lower protein content and higher MDA . There were no obvious differences on the soluble sugar , soluble protein and MDA content of the same size seedlings from different sources . After -10oC freezing , the content of soluble sugar and protein in the seedlings with the same size were decreased. Meanwhile, the content of MDA was increased. It was concluded that the content of soluble sugar, soluble protein and MDA were obviously related to the size of Angelica sinensis seedlings from the same source before and after low temperature process .

Objective To study the immunologic mechanism of electroacupuncture at Sanyin points on chronic abacterial prostatitis rats. Methods Forty-eight male rats were divided randomly into normal group, model group, drug group and electroacupuncture group, 12 rats in each group. The animal model was made by SC purified prostate protein twice with immunologic adjuvant, and the rats in electroacupuncture group and drug group were treated by electroacupuncture at Sanyin points and feeding Cernilton for 15 days. The changes of prostate weight, index, pathology and contents of IgG, expressions of IL-2 and IL-8 in prostate homogenate were observed. Results Compared with normal group, the prostate weight and index were significantly increased in model group (P<0.05), the content of IgG was significantly increased (P<0.05), cytokine IL-2 and IL-8 were highly expressed (P<0.05, P<0.01), prostate tissue’s morphology and structure were significantly impaired in model group. Compared with model group, the prostate weight and index were significantly decreased in electroacupuncture group after treatment (P<0.05 or P<0.01), pathological changes reduced significantly, the content of IgG decreased significantly (P<0.05), the expressions of cytokine IL-2 and IL-8 were significantly decreased (P<0.05, P<0.01), and the pathological manifestation of chronic inflammation was significantly improved. Conclusion Electroacupuncture at Sanyin points can reduce the secretion of local prostate antibody IgG, regulate the expression of cytokine IL-2 and IL-8, protect the morphology and structure of prostate tissue from damage. Electroacupuncture at Sanyin points can adjust local immunologic function and promote the recovery of prostate.

Objective To evaluate the effect of endoplasmic reticulum stress in trophocytes,in patients with intrahepatic cholestasis of pregnancy (ICP).Methods Sixty-one pregnant women who were hospitalized in Women's Hospital,School of Medicine,Zhejiang University from January to December 2015 were recruited.Thirty-one women who were diagnosed as ICP were defined as the ICP group and 30 healthy pregnant women were defined as the control group.The localization and expression intensity of glucose regulated protein 78 (GRP-78) in placental tissues were detected by immunohistochemistry technique.Electronic microscope was used to observe ultra-microstructure change of the endoplasmic reticulum in trophocytes and cell line Swan71.Reverse transcription (RT)-PCR and western blot were used to investigate the expression of GRP-78 mRNA and protein in Swan 71 cell.Results (1) GRP-78 protein was mainly expressed in the cytoplasm of cytotrophoblasts and syncytiotrophoblasts.The protein expression of GRP-78 in placentas of the ICP group (13.2±2.4) was significantly higher than that in the control group (7.8±1.3,P＜0.01).(2) The volume of endoplasmie reticulum did not increase and the microvilli developed well,with no swelling and no expansion of endoplasmic reticulum in the control group.In the ICP group,microvilli injury,endoplasmic reticulum edema were found;the volume of endoplasmic reticulum increased,with dilation,vacuolation and significant degranulation.After treated with 100 μmol/L cholyglycine for 24 hours,universal dilatation of the endoplasmic reticulum were seen in the Swan71 cells.(3) In Swan71 cells,cholylglycine displayed a concentration-dependent up-regulation on the expression of GRP-78.The expressions of GRP-78 mRNA in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.17,2.17±0.16,5.47±0.36,5.65 ± 0.82,respectively.The expression of GRP-78 protein in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.04,1.17±0.15,1.33±0.13,1.73±0.13,respectively.The expression of GRP-78 mRNA and protein in 100 and 50 μ mol/L cholylglycine experimental group were significantly higher than 0 μmol/L (all P＜0.01).Conclusion The obvious expansion of endoplasmic reticulum and the increased expression of GRP-78 in trophocytes indicated that endoplasmic reticulum stress of trophocytes may be involved in the pathogenesis of ICP.

Mild cognitive impairment (MCI) is a pre-clinical stage of Alzheimer's disease (AD). In recent years, transcranial direct current stimulation (tDCS), as a neuromodulation technique, has being applied in the field of cognitive intervention for MCI, but its effect is controversial because of many factors. In order to promote the application of tDCS in intervention for MCI, this study performed a systematic review of the previous studies that used tDCS to improve cognitive functions of MCI individuals. The results indicate that tDCS could improve episodic memory, working memory, and language of individuals with MCI, while there is a lack of strong evidence that supports a positive effect of tDCS on attention of individuals with MCI. The placement of electrodes, time course of treatment, and current intensity all affected the intervention effect of tDCS. Future studies should take brain networks underlying cognitive processes and personalized factors such as age and education level into consideration to design better stimulation protocols, and they should be conducted in combination with neuroimaging technologies to evaluate the intervention effect of tDCS more accurately and objectively and to discover the neural mechanisms of tDCS intervention.

Objective:In this study, the clinical data of biliary atresia(BA) and infant intrahepatic cholestasis(IHC) was reviewed, and the utility of gamma-glutamyl transpeptidase(GGT) and liver Young′s modulus in the differential diagnosis of BA and IHC in infants was discussed.Methods:Based on the clinical data of 120 infants with cholestasis treated in the Children′s Hospital Affiliated to Xi′an Jiaotong University, from September 2017 to December 2019, the infants were divided into two groups according to the results of intraoperative cholangiography and follow-up: BA group( n=50); IHC group( n=70). The age, clinical manifestations, laboratory examination results, gallbladder contraction rate, hepatobiliary scintigraphy, liver Young′s modulus, and medical treatment effects were compared between the two groups.The utility of GGT and liver Young′s modulus in the differential diagnosis of BA and IHC was analyzed. Results:The age, alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bile acid, fasting blood glucose, blood ammonia and splenomegaly between the two groups were compared and the results showed no statistical significance( P>0.05). In contrast, there were statistically significant differences( P<0.001) in stool color, liver size, total bilirubin(TB), direct bilirubin(DB), GGT, liver Young′s modulus, positive hepatobiliary scintigraphy, gallbladder contraction rate at 1 hour after meal, and medical treatment effect between the two groups.TB, DB, GGT, liver Young′s modulus and GGT combined with liver Young′s modulus were analyzed using ROC curves, and the area under the curve(AUC) were 0.820, 0.809, 0.906, 0.876 and 0.926, respectively.When GGT exceeded the cut-off value of 198.85 U/L, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 82.0%, 84.3%, 78.8%, 86.8% and 83.3%, respectively.When liver Young′s modulus exceeded the cut-off value of 8.6 kPa, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of BA were 88.0%, 80.0%, 75.9%, 90.3% and 83.3%, respectively.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of GGT combined with liver Young′s modulus in diagnosing BA were 98.0%, 68.6%, 69.0%, 98.0% and 80.8%, respectively.Multivariate logistic regression analysis found that DB>115.55 μmol/L, GGT>198.85 U/L, and liver Young′s modulus>8.6 kPa were risk factors for BA( OR=9.510, P=0.001; OR=24.634, P<0.001; OR=21.469, P<0.001). Conclusion:GGT and liver Young′s modulus are useful in the differential diagnosis of BA and IHC.If GGT and liver Young′s modulu sexceed the threshold values of 198.85 U/L and 8.6 kPa respectively, it can effectively indicate that the child is BA.

Objective To objectively study the current progress of China Healthcare Improvement Initiative, and its effectiveness and shortcomings for further improvement. Methods Questionnaires were customized by expert consultation and pre-investigation, and distributed by the National Health Commission in April 2018 to the hospitals.Data of 5 469 hospitals were recovered and analyzed with a statistics software for descriptive analysis.Results Implementation progress of the five working systems varied with regions, and rooms of improvement were found in such aspects as outpatient appointment, clinical pathway management and social work system.In 2017, the proportion of outpatient appointments of 5 469 hospitals averaged 19.1%.Progress of the ten major service models also varied, as defects were found in such service models as continuous medical service, intelligent service, and interconnection service.In 2017, only 6.7% of the 5 469 hospitals had put in place hierarchical integrated clinical pathways within their medical alliances.Conclusions Improvement of the medical services calls for not only the efforts of medical institutions themselves, but also top-level design by the local health authorities. In particular, an online information platform should be established for the whole region, to unify the information standards and processes, and corresponding mechanisms and system support are needed.