Objective] To explore the relationship between excessive internal heat in TCM and intestinal microflora ,provide scientific evidences for pathogenesis of excessive internal heat.[Method]With the research methods of clinical observation and literature review,analyze the characteristics of excessive internal heat,and collect research progress about intestinal microflora to find out the link.[Result] Head and facial tissue is more susceptible to injury,which is determined by the organizational characteristics. People suffering from excessive internal heat widely have problems of energy metabolism and mucosal immune disorders. Intestinal microflora plays an important role in energy production,conversion,storage and use.They can change the way that organizations use energy,and change AMPK phosphorylation to influence the energy metabolism of the body.Thus gut microflora imbalance may lead to disorders of energy metabolism.On the other hand,inflammatory mediators express abnormally in these people. Impaired immune function leads to inflammatory states,which causes imbalance of gut microflora.While intestinal microflora also can regulate intestinal mucosal immune response by adjusting related effective factors. [Conclusion]Excessive internal heat is closely related with intestinal microflora from the aspects of energy metabolism and mucosal immunity,which may provide new ideas to explore the pathogenesis of this disease.The researches based on intestinal microflora and diseases bring brilliant prospects of individual prevention and treatment for TCM and western medicine .

Objective To investigate the expression of Golgi protein?73(GP73) and Ki?67 antigen in gallbladder carcinoma ,and to analyze their correlations with proliferation ,invasion ,and prognosis of gallbladder carcinoma. Methods Streptavid?in?peroxidase (SP) immunohistochemistry was used to detect the expression of GP73 and Ki?67 in surgically resected specimens of 58 gallbladder carcinomas ,15 gallbladder adenomas and 15 gallbladder polyps samples . Results The positive rates of GP73 and Ki?67 protein in gallbladder carcinomas were 72.4% and67.24%,respectively ,which wer significantly higher than those in gallbladder adenomas(GP73:40.0%,Ki?67:26.7%,P<0.05)and in gallbladder polyps(GP73:13.3%,Ki?67:25.0%,P<0.05).The expression of GP73 was positively correlated with tumor differentiation ,Nevin staging and lymph node metastasis(P < 0.05), and the expression of GP73 was positively correlated with tumor differentiation ,Nevin staging(P < 0.05). GP73 expression was positively correlated with Ki?67 expression in gallbladder carcinoma (r = 0.473 ,P = 0.000). Patients with negative expression of GP73 and Ki?67 had longer survival time than those with positive expression of GP73 and Ki?67. Conclusion The expression of GP73 and Ki?67 was associated with proliferation ,invasion of gallbladder carcinoma. The combined detection of GP73 and Ki?67 is conducive to judging the progress and prognosis of the gallbladder carcinoma .

Objective To discover more novel bat viruses and molecularly characterize bat-borne bocavirus diversity in Yunnan.Methods Twenty-six Aselliscus stoliczkanus were sampled in Jinghong , Yunnan, and subjected to viral metagenomic analysis.Specific PCR was used to detect any bocavirus in these samples based on the metagenomic result , while full genome was amplified and compared with other bocaviruses .Results and Conclusion Totally, 3 of the 26 (11.5%) bats were positive for bocavirus, the full genome of which contained 5203 nucleotides and could encode NS1, NP and VP1/VP2 proteins.Phylogenetic analysis showed that this virus shared up to 58.7% and 53.3% amino acid identities with canine bocavirus 1 and canine minute virus .According to ICTV criteria (85%amino acid sequence identity ) on a new species of bocavirus , this virus could be a novel species within genus Bocaparvovirus .This study provides important data to better understand viral diversity in bats and to uncover the relationship between bocavirus and its hosts .

Objective To observe the clinical outcomes of the superior gluteal neurocutaneous flap for sacrococcygeal pressure sores. Methods Twelve cases with sacrococcygeal pressure sores were covered by the superior gluteal neurocutaneous flap from May 2005 to Nov. 2009. The sore size ranged from 15 cm ×30 cm to 5 cm × 8 cm, while the flap size ranged from 17 cm × 32 cm to 10 cm× 12 cm. Results All 12 flaps survived totally with the pressure sores healed. The longest follow-up time was four years, the short follow-up time was half a year, the average time was 2.5 years. The superior gluteal neurocutaneous flap was good blood circulation, pressure sores not recur. Conclusion The superior gluteal neurocutaneous flap is a good treatment for sacrococcygeal pressure sores for its reliable blood supply and simple harvesting.

Objective To investigate the effect of cyclosporine blood level at first year after kidney transplantation on patients with a survival time over 10 years. Methods 380 patients with functional allograft, a survival time over 10 years and long-term administration of cyclosporine A (CsA) were studied, and received CsA-based treatments. According to the blood CsA level at the first year after kidney transplantation, patients were divided into five groups: group 1, blood CsA level was above 0. 208 μmol/L (1 μmol/L = 1201.9 μg/L), group 2, blood CsA level between 0. 166-0. 208μmol/L; group 3, blood CsA blood level between 0. 125-0. 166 μmol/L; group 4, blood CsA blood level between 0. 083-0. 125 μmol/L; group 5, blood CsA level less than 0. 083 μmol/L. Systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine(SCr), uric acid (UA), cholesterol (CH), triglyceride (TG), alanine aminotransferase (ALT), direct bilirubin (DBil) and total bilibubin (TBil), albumin (Alb), hemoglobin (Hb), count of white blood cells and positive rate of proteinuria in 5 groups at the 1st, 5th and 10th year after kidney transplantation were analyzed. Results At the 5th year SBP in groups 1 and 2 was higher than in groups 3, 4 and 5. UA level in group 5 was lower than other groups, and Alb level in group 5 was higher than other 4 groups. Proteinuria positive rate in groups 4 and group was lower than other groups. At the 10th year after kidney transplantation,indexes among 5 groups had no statistically significant difference, except for SBP, DBP, DBil and CH in some groups. There was also no significant difference in SCr level among 5 groups at the 5th or 10th year after transplantation. Conclusion Blood CsA levels at the first year after kidney transplantation has no significant effect on long-term allograft function. But higher level of CsA (＞0. 166μmol/L) at the first year maybe predict high rate of hypertension, high blood UA and proteinuria at the 5th and 10th year after transplantation.

Objective:To investigate the role of three-dimensional dose distribution-based deep learning model in predicting distant metastasis of head and neck cancer.Methods:Radiotherapy and clinical follow-up data of 237 patients with head and neck cancer undergoing intensity-modulated radiotherapy (IMRT) from 4 different institutions were collected. Among them, 131 patients from HGJ and CHUS institutions were used as the training set, 65 patients from CHUM institution as the validation set, and 41 patients from HMR institution as the test set. Three-dimensional dose distribution and GTV contours of 131 patients in the training set were input into the DM-DOSE model for training and then validated with validation set data. Finally, the independent test set data were used for evaluation. The evaluation content included the area under receiver operating characteristic curve (AUC), balanced accuracy, sensitivity, specificity, concordance index and Kaplan-Meier survival curve analysis.Results:In terms of prognostic prediction of distant metastasis of head and neck cancer, the DM-DOSE model based on three-dimensional dose distribution and GTV contours achieved the optimal prognostic prediction performance, with an AUC of 0.924, and could significantly distinguish patients with high and low risk of distant metastasis (log-rank test, P<0.001). Conclusion:Three-dimensional dose distribution has good predictive value for distant metastasis in head and neck cancer patients treated with IMRT, and the constructed prediction model can effectively predict distant metastasis.

Objective To observe the impacts of acupuncture and moxibustion on kelch like epichlorohydrin related protein 1(Keap1)and nuclear factor E2 related factor 2(Nrf2)signal pathway in kidney tissue of cisplatin(DDP)-induced kidney injury model mice,and to explain the protective mechanism of acupuncture and moxibustion on improving kidney injury caused by DDP.Methods Forty SPF male KM rats were randomly divided into 4 groups,with 10 rats in each group.One day before the start of treatment,the three groups of mice outside the blank group were intraperitoneally injected with cisplatin 10 mg·kg-1 according to their body weight,and the blank group was injected with the same dose of 0.9%NaCl solution.The model was established 24 hours later.Both acupuncture group and moxibustion group selected"Dazhui"(GV14),"Ganshu"(BL18),"Shenshu"(BL23)and"Zusanli(Housanli)"(ST36)for acupuncture and moxibustion respectively,once a day for 5 days.The other two groups were fixed every day without treatment.After fasting for 1 day,the contents of BUN,Scr,CysC and NGAL in serum and Keap1 and Nrf2 in renal tissue were detected by ELISA;Western blot and Real-time PCR were used to detect the protein expression and gene transcription of Keap1 and Nrf2 in the kidney tissue of mice in each group.Results Compared with the blank group,the content of Keap1 protein,protein expression and relative expression of mRNA in the model group increased(P<0.05),the content of Nrf2 protein,protein expression decreased(P<0.05),Nrf2 relative expression of mRNA increased(P<0.05);Compared with the model group,the content of Keap1 protein,the expression of Keap1 protein and the relative expression of Keap1 mRNA in the kidney of mice in the acupuncture and moxibustion groups decreased(P<0.05);Nrf2 protein content,protein expression and relative mRNA expression increased(P<0.05).Conclusion Acupuncture and moxibustion can improve the renal function of DDP renal injury model mice and enhance their antioxidant stress ability,so as to improve the renal injury caused by DDP chemotherapy.Its mechanism may be related to Keap1/Nrf2 signal pathway.

ObjectiveTo investigate the effect and possible mechanism of Shenfu Injection （参附注射液） on rat cardiomyocyte injury induced by isoproterenol from the perspective of regulating the high mobility group protein B1 （HMGB1）/ Toll-like receptor 4 （TLR4）/nuclear factor κB （NF-κB） pathway through the deacetylation modification of silent information regulator 1 （SIRT1）. MethodsThe optimal concentration and intervention duration of isoproterenol hydrochloride and the optimal intervention concentration of Shenfu Injection were screened out by CCK-8 method. Logarithmically growing H9c2 rat cardiomyocytes were taken at 5×10⁴ cells/well and divided into normal group， model group， Shenfu Injection group， and SIRT1 inhibitor group， with 3 replicates in each group.Except for the normal group， the cells in the other groups were induced by isoproterenol hydrochloride to establish a chronic heart failure cell model. After modeling， the Shenfu Injection group was given Shenfu Injection at the optimal intervention concentration， and the SIRT1 inhibitor group was given 1 μmol/L of SIRT1 inhibitor EX-527， for optimal intervention duration.CCK-8 assay was used to detect the cell activity and calculate the inhibitory rate. ELISA assay was used to detect the nicotinamide adenine dinucleotide oxidation state/ nicotinamide adenine dinucleotide reduction state （NAD+/NADH） in cardiomyocytes. Immunofluorescence was used to detect the immunofluorescence localization of HMGB1 and SIRT1 in cardiomyocytes. Western blotting was used to detect the protein expression of acetylated HMGB1 in cardiomyocytes， HMGB1 in the nucleus and cytoplasm， and SIRT1， TLR4， myeloid differentiation factor 88 （MYD88） and NF-κB p65 in cardiomyocytes. RT-qPCR was used to detect the mRNA expression of SIRT1， HMGB1， TLR4， MYD88 and NF-κB p65 in cardiomyocytes. ResultsThe optimal intervention concentration of isoproterenol hydrochloride was 300 μmol/L， and the intervention duration was 48 hours； 8% was the optimal intervention concentration of Shenfu Injection. Compared to those in the normal group， the cell activity， NAD+/NADH value， nuclear HMGB1 protein expression， cardiomyocyte SIRT1 protein and mRNA expression in the model group decreased， while the cell inhibition rate， cardiomyocyte acetylated HMGB1 and cytoplasmic HMGB1 protein expression， cardiomyocyte TLR4， MYD88， NF-κB p65 protein and mRNA expression all increased （P＜0.05）； fluorescence localization showed that the content of HMGB1 in cardiomyocytes in the model group increased and was localized in both the nucleus and cytoplasm.Compared to the model group and the SIRT1 inhibitor group， the Shenfu Injection group showed significant improvements in all the above indicators （P＜0.05）； fluorescence localization showed that the SIRT1 content increased in the Shenfu injection group， while the HMGB1 content decreased， and was mainly located in the nucleus. ConclusionShenfu Injection can improve myocardial cell damage by increasing SIRT1 expression to reduce the acetylation level of HMGB1， regulating the HMGB1/TLR4/NF-κB pathway and inhibiting the nuclear translocation of HMGB1.

Objective To evaluate the characteristics of spatial distribution and time accumulation of impact acceleration at different parts of human body during backward falling process. Methods Four healthy men and four healthy women (20-20 years old) were enrolled. The tri-axial acceleration on head, chest, left/right arm/hand/foot, left/right front/back hip, left/right femur head, sacrum and coccyx throughout the backward falling were measured by ADXL335 tri-axial acceleration sensor. Systemic acceleration distribution of backward falling was polynomial fitted by signal magnitude vector (SMV) of its first peak. Besides, parameters of impulse mechanics such as zero-g time, total falling time, peak SMV, relative pressure impulse of the vulnerable sites (head, hip and its related sites) were also calculated. Results Compared with the other parts of the body, the peak SMV and relative impulses of left/right back hip and head were significantly higher (P＜0.05). Acceleration that paralleled to the ground in left/right back hip was also relatively large. The rotational transform angles of left/right back hip, left/right femur head, sacrum and coccyx were significantly larger (P＜0.05). In addition, during the process of falling backward to the ground, a sliding tendency toward the sagittal plane 53.58°±6.75° occurred at all testing sites. Conclusions Head and hips are vulnerable during backward falling, and their zero-g time (0.26±0.05) s can be used as the longest starting time of falling protection devices. The large change angle of left/right hip, left/right femoral head, sacrum and coccyx may be the important cause of the sprain during backward falling.

Objective:To compare the clinical effects of 4 kinds of neurocutaneous perforator flap with vascular anastomosis for repair of hand and foot wounds.Methods:From January, 2005 to September, 2019, 112 patients with hand and foot wounds were treated, there were 78 cases of fingers, 11 cases of first web, 5 cases of palm, 6 cases of hand and 12 cases of foot. The defect area was 2.0 cm×1.5 cm-21.0 cm×12.0 cm. All 112 cases were repaired by neurocutaneous perforator flaps anastomosed with blood vessels. Types of flap were applied: Radial collateral artery perforator flap (with posterior cutaneous nerve of forearm) in 30 cases. The flap area was 5.0 cm×2.0 cm-13.0 cm×6.0 cm. Superficial peroneal artery flap (without superficial peroneal nerve) anastomosed with blood vessels in 15 cases. The flap area was 2.5 cm×2.0 cm-9.0 cm×6.0 cm. Lateral superficial sural artery perforator flap (with superior sural cutaneous nerve) in 26 cases. The flap area was 2.5 cm×1.8 cm-7.0 cm×5.0 cm. Peroneal artery perforator flap (with middle and lower sural nerve) in 41 cases. The flap was harvested with area of 2.5 cm×1.8 cm-23.0 cm ×14.0 cm to repair the wounds of feet, back of hands, first web, palm and fingers. CTA images were observed in 40 clinical patients, and the occurrence rate of radial collateral artery, superficial peroneal artery, superficial lateral sural artery, and peroneal artery were measured. Anastomosis cutaneous nerve in 97 cases, and no cutaneous nerve anastomosis 15 cases (superficial peroneal artery flap).Results:The peroneal artery perforator flap (41 cases) and radial collateral artery perforator flap (30 cases) were harvested. The incidence of perforator vessels was both 100%, and incidence of superficial sural artery was 80.8% (21/26 cases). In the other 19.2% (5/26 cases), the superficial medial sural artery was replaced by too thin vessels. The utilization rate of superficial peroneal artery was 60.0% (9/15 cases), the other 40.0% (6/15 cases) were converted to peroneal artery perforator flap. All flaps survived except 1 case of superficial perforator flap of lateral sural artery, which underwent necrosis at the distal end and healed after dressing change. One hundred and one cases were followed-up, including 90 cases for repairing soft tissue defects in hands and 11 cases in feet. The followed-up time ranged from 12 to 120 months, with an average of 36.6 months. There were 40 cases with excellent function, 45 cases with good function and 5 cases with fair function. There were 78 cases of cutaneous nerve anastomosis of hand flap, and the sensory function was above S 3 level. There were 12 cases without anastomosis of cutaneous nerve of hand flap, and the sensory function reached S 3 level in 3 cases and S 2 level in 9 cases. In 11 cases, the cutaneous nerve was anastomosed to repair the soft tissue defect of the foot, and the sensory function was above S 3 level. The radial collateral artery perforator flaps were relatively bulky and needed to be treated by fat removal. The other 3 kinds of three flaps were not bulky. Conclusion:The perforating vessels of peroneal artery and radial accessory artery have larger diameter and easy to harvest. The superficial peroneal artery and the lateral superficial sural artery are relatively small in caliber, especially the superficial peroneal artery. Among the 4 kinds of cutaneous nerve nutrient vascular flaps, the radial accessory artery perforator flap was the most bloated. Sensory nerve innervation flaps were found in the upper segment of lateral sural cutaneous nerve, posterior forearm cutaneous nerve and middle and lower segment of sural nerve. The superficial peroneal artery perforator flap was accompanied by superficial peroneal nerve that did not send cutaneous branches into the flap. The upper segment of superficial peroneal nerve was only a passing nerve.