0.05).The effect on traditional Chinese medical syndrome in the treatment group was superior to that in the control group(P 0.05).The average insulin dosage and hypoglycemia incidence were reduced,and the time for blood glucose becoming normal was shortened in the treatment group(P

AIM:To investigate the effects of brain-derived neurotrophic factor(BDNF)on extracellular proteolytic enzymes including matrix metalloproteinases(MMPs)and serine proteases,in particular,the urokinase-type plasminogen activator(uPA)-plasmin system in a human umbilical vein endothelial cell(HUVEC)model.METHODS:The HUVEC was activated with different doses of BDNF(25-200 ?g/L)for different time period(6-48 h).Reverse transcriptase-polymerase chain reaction(RT-PCR)was used to assay MMP-2,MMP-9,TIMP-1,and TIMP-2 mRNA in HUVEC.The cultured conditioned medium was analyzed for MMP and uPA activity by gelatin zymography and fibrin zymography,respectively.uPA,PAI-1,TIMP-1,and TIMP-2 were quantified by Western blotting analysis.RESULTS:The stimulation of serum-starved HUVECs with BDNF caused marked increase in MMP-2 and MMP-9 mRNA expression and induced the pro-MMP-2 and pro-MMP-9 activation without significant differences in proliferation.However,BDNF had no effect on TIMP-1 and TIMP-2 production.BDNF increased uPA and PAI-1 production in a dose dependent manner up to 100 ?g/L,while effects of 200 ?g/L were approximately equal to those of 100 ?g/L.BDNF stimulated uPA and PAI-1 production beyond that in control cultures from 12 h until 48 h after BDNF addition.Protease activity for uPA was also increased by BDNF in a dose dependent manner.CONCLUSION:BDNF activates MMP and uPA/PAI-1 proteolytic network in HUVEC.

Objective:To evaluate the capacity and level of melting point determination of chemical drugs in the laboratories par-ticipating in the proficiency testing. Methods:Two test samples were prepared, and the labs volunteered to participate in the proficien-cy testing program ( PTP) . The melting point determination was performed according to the general principle 0612 in part four of Chi-nese Pharmacopoeia (2015 edition), and the results were analyzed by robust statistics and the determination proficiency of the laborato-ries were evaluated by Z-score. Results:The analysis showed that two test samples were homogeneous and stable, which met the re-quirements of the PTP. Totally 31 laboratories had satisfactory results, which accounted for 83. 8%. Conclusion:The majority of the participant laboratories can accurately determine the melting points of test samples, and the information is very helpful to the next profi-ciency testing program.

Objective:To explore the clinical utility of tongue pressure resistance feedback training in the treatment of post-stroke dysphagia.Methods:Twenty stroke survivors with dysphagia were randomly divided into an experimental group and a control group. Both groups were given conventional swallowing rehabilitation training, while the experimental group was additionally provided with tongue pressure resistance feedback training. Before and after the treatment, MBSImp analysis and the Rosenbek penetration aspiration scale were used to quantify the control of the tongue, food delivery, oral residue, laryngeal elevation, hyoid bone movement, epiglottis turnover, larynx closure, vestibular larynx closure, pharyngal peristalsis and contraction, opening of the upper esophageal sphincter UES, contraction of the base of the tongue, pharyngeal residue and aspiration.Results:No significant differences were observed between the two groups before the intervention. Afterward the average pharyngeal period and aspiration score of the experimental group had decreased significantly compared with the control group′s values.Conclusions:Tongue pressure resistance feedback training is effective in improving pharyngeal swallowing and reducing the risk of aspiration after swallowing.

Objective: To investigate clinicopathological characteristics, diagnosis and treatment of multiple primary colorectal carcinoma (MPCC). Methods: From January 2008 to March 2017, 42 patients diagnosed with MPCC underwent surgery at Beijing Shijitan Hospital, Capital Medical University. Their clinicopathological features, diagnosis and treatment were analyzed. Results: These 42 MPCC patients accounted for 7.1% (42/592) colorectal cancer patients in the same period. There were 64 intestinal cancer lesions in 32 patients (76.2%) with synchronous carcinoma (SC), and 20 intestinal cancer lesions in 10 patients (23.8%) with metachronous carcinoma(MC), where the interval between the first and the recurrent was 18-105 months. The proportion of patients in the SC group with highly to moderately differentiated adenocarcinoma was significantly higher compared with that of the MC group (P<0.05), while the incidence of mucinous carcinoma was lower than that of the MC group(P<0.05). No significant differences were found with regard to tumor size, location, complications with adenoma, TNM stages, lymph nodes metastases or DNA mismatch repair between the SC group and the MC group(all P>0.05). Among 42 patients undergoing radical operation, 6 received colonic metallic stent implantation as a bridge to elective resection in 10 patients with colonic obstruction. Conclusion MPCC, mainly two-lesion cancer, is most commonly found in sigmoid colon and rectum. Those with poorly differentiated cancer, mucinous carcinoma and those complicated with adenoma should be closely followed up with colonoscopy. Colonic metallic stent implantation as a bridge to elective resection may improve the detection rate of SC.

Objective:To investigate the effect and of piperine(PIP)on nerve injury in rats with cerebral infarction.Meth-ods:The rat model of cerebral infarction was prepared by modified thread embolism method.The rats were divided into Sham group,Model group,piperine group(PIP group,20 mg/kg piperine),piperine+PKA inhibitor group(PIP+H-89 group,20 mg/kg PIP+5 mg/kg H-89).The rats were scored for neurological impairment,the volume of cerebral infarction,neuronal damage and neuronal apoptosis were observed,and the levels of cAMP,IL-1β and IL-6 in hippocampus and the protein expressions of GFAP,NSE,AC6,PKA,p-CREB,CREB and BDNF were detected.Results:Compared with Sham group,Model group had large cerebral infarction,cerebral in-farction volume,the neurological deficit score,neuronal apoptosis rate,the levels of IL-6 and IL-1β in hippocampus,and number of GFAP positive cells,the positive expression rates of NSE protein increased,the number of Nissl bodies,and the expressions of cAMP,AC6,PKA,p-CREB and BDNF proteins in hippocampus decreased(P<0.05);compared with Model group,cerebral infarc-tion volume,the neurological deficit score,neuronal apoptosis rate,the levels of IL-6 and IL-1β in hippocampus,and number of GFAP positive cells,the positive expression rates of NSE protein in the PIP group decreased,the number of Nissl bodies,and the ex-pressions of cAMP,AC6,PKA,p-CREB and BDNF proteins in hippocampus increased(P<0.05);the effect of piperine in improving nerve injury in rats with cerebral infarction was able to be reversed by H-89.Conclusion:PIP can inhibit the apoptosis of hippocampal neurons,and improve the neural injury induced by cerebral infarction by activating AC/PKA/CREB signal pathway.

Objective:To investigate the incidences of metachronous advanced adenoma (MAA) in patients with simultaneous multiple primary colorectal cancer (CRC) and patients with sporadic CRC.Methods:From January 1, 2008 to September 30, 2022, at Beijing Shijitan Hospital, Capital Medical University, CRC patients who underwent surgery and 3 years follow-up with endoscopy were enrolled. The patients completed colonoscopy at least 2 times during follow-up in 6 to 36 months after surgery, and the interval between the 2 times colonoscopies was over 6 months. Clinical data including age, gender, and tumor location, stage, pathological features, combined underlying diseases, preoperative carcinoembryonic antigen, hemoglobin and other laboratory results, baseline colonoscopy results, and detection of MAA were collected. According to age (±2 years old), gender, location of primary lesion and stage of tumor, patients with simultaneous CRC or sporadic CRC were matched at 1∶1 ratio by propensity score matching. The cumulative risks of MAA in patients with simultaneous multiple primary CRC and patients with sporadic CRC were calculated. Cox proportional hazard regression was used to analyze the influencing factors in the occurrence of MAA.Results:A total of 814 CRC patients were enrolled and matched. After paired matching, there were 36 cases of simultaneous multiple primary CRC (78 lesions) and 78 cases of sporadic CRC (78 lesions). The cumulative incidences of MAA at 1, 2 and 3 years of simultaneous CRC group were 11.1%(4/36), 22.2%(8/36) and 33.3%(12/36), respectively. The cumulative incidences of MAA at 1-, 2- and 3-year of sporadic CRC group were 3.8%(3/78), 12.8%(10/78) and 20.5%(16/78), respectively.Simultaneous CRC was correlated with an increase in the 3-year cumulative incidence of MAA ( HR=4.163, 95% confidence interval(95% CI) 1.032 to 4.721, P=0.047). Especially in left-sided CRC, the risk of MAA in simultaneous CRC increased ( HR=7.186, 95% CI 1.602 to 20.787, P=0.010). The results of multivariate cox-regression analysis indicated that detection of simultaneous advanced adenoma at baseline endoscopy was an independent risk factor of MAA ( HR=3.175, 95% CI 1.411 to 7.142, P=0.005). Conclusion:Colouoscopy follow-up should be strengthened in patients with simultaneous multiple primary CRC and simultaneous advanced adenomas.

Objective To analyze the imaging characteristics of contrast-enhanced ultrasound(CEUS) and dynamic contrast enhanced magnetic resonance imaging ( CEMRI) for diagnosis of hepatic epithelioid hemangioendothelioma ,and to increase the accuracy of diagnostic imaging . Methods The imaging characteristics of CEUS and dynamic CEMRI in 11 patients with hepatic epithelioid hemangioendothelioma confirmed by surgical pathology or fine needle aspiration biopsy were retrospectively analyzed . Results On conventional ultrasound ,14 lesions in 11 patients showed hypoechoic . The peripheral blood flow was detected in most patients by color Doppler flow imaging and the average resistant index was 0 .62 ± 0 .05 . During the arterial phase ,6 lesions showed diffuse enhancement ,6 lesions showed annular enhancement and 2 lesions showed branch enhancement .As to time of peak enhancement ,compared to the normal hepatic parenchyma ,hypoenhancement ,isoenhancement and hyperenhancement were observed in 1 lesion ,7 lesions and 6 lesions respectively . Synchronous enhancement was observed in 8 lesions on contrast-enhanced ultrasound ,rapid enhancement was observed in 5 lesions and slow enhancement was observed in 1 lesion and all lesions decreased quickly in portal phase and delayed phase . On CEMRI ,all lesions showed low signal on TIWI ,high signal on T2WI and DWI . There were 5 lesions showed obvious annular constant enhancement and 1 lesion showed obvious annular progressive enhancement . Progressive peripheral enhancement and fully filling in delayed phase were found in 4 lesions .While progressive peripheral enhancement and incompletely filling in delayed phase were found in 3 lesions . One lesion displayed constant enhancement and incompletely filling in delayed phase . Halo sign" , lollipopsign" , capsular retraction sign" and vessel sign" were appeared in 6 ,7 ,8 and 8 patients respectively . Conclusions Both contrast-enhanced ultrasound and CEMRI have characteristic manifestations for the diagnosis of hepatic epithelioid hemangioendothelioma and cominbing them would be great significance to improve the preoperative diagnostic accuracy .

Objective To explore the support status in nursing work among the second grade hospitals from such perspectives as the allocation of nursing human resources, logistics support system and nursing management model in the central and eastern regions of China. Methods Totally 63 second grade hospitals in 13 provinces were investigated by a self-designed questionnaire including the general information, general hospital circumstances, construction of nurse team, hospital logistic support, nursing function, etc. Results Among 63 second grade hospitals, all of them had adopted responsibility nursing system, and 82. 54%hospitals were going to the stage of “start, prepare, acquire achievement” for nurse position management. For nurse allocation, bed/nurse ratio was 1 ∶ (0. 54 ± 0. 17) in average, and 39. 68% of hospital own less than 50% of nursing graduated from junior college or beyond, 58. 73% of hospital having more then 60% of nurses occupying Charge Nurse occupational title or below, 73. 2% of hospital having more than 25% of nurses less than 3 years work experience, and 69. 84 of hospital having no personal care assistant. Logistics support system:only 30. 2% hospitals had care works and 12. 7% hospitals had full-time staff to configuration intravenous fluid. In the logistic support system, more than 50% hospitals already arrange specially-assigned person for collecting and sending sterilize items, specimen, sending patients for examination, maintaining ward order and clean, but just 12. 7% hospital had specially-assigned person for IV liquid configuration. At the aspect of nursing management, there were over 90% hospital carrying out quality control management, in service, nurses resource adjustment within hospital, 61. 9% hospital involving nursing recruitment and nurse manager appointed and dismissed, 41. 27% hospital distributing money award by job performance. Conclusions The hospitals in the central and eastern regions of China have widely practiced quality care service and gradually implement nurse position management. In the support system for care work, the allocation of human resources have improved. However, the team structure still shows the young age, low job title and educational level, still having gap with national one two five planning. In addition, logistics support system needs to be improved and the vertical management doesn′t carry out well. Second grade hospitals would strengthen the support for care work based on their own features so that it can promote the process of nursing reform.