Upper gastrointestinal hemorrhage (UGH) is a kind of intensive disease commonly encountered clinically. In recent years, the diagnosis and treatment method of UGH had achieved satisfied progress. But with the development of aged tendency of population, its morbidity is still in a high level. Especially in older patients with serious complications, the fatality rate is much higher. It has been proved practically, traditional Chinese medicine (TCM) has remarkable effects in treating UGH. This article summarized the progress of TCM or integrative medicine studies on UGH through etiology and pathogenesis, therapeutic principle and methods.

BACKGROUND:Adipose-derived stem cells are easily col ected and abundantly cultured, which can proliferate rapidly when being cultured in vitro. With multi-directional differentiation potential, adipose-derived stem cells are expected as seed cells for tissue engineering.
OBJECTIVE:To isolate, culture and identify of adipose-derived stem cells from Sprague-Dawley rats in vitro.
METHODS:The subcutaneous adipose tissue was obtained from the iliac region of rats under the aseptic condition, and then was digested with 0.075%type Ⅰ col agenase and cultured in vitro. The morphology and proliferation characteristics of the cells were observed under an inverted phase contrast microscope. The third passage was put into gauge for growth curve by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, and the cells were also identified by CD44, a stem cellmarker, with immunofluorescence staining. Adipose-derived stem cells were induced and differentiated into adipocytes in Dulbecco’s modified Eagle’s medium/Ham’s nutrient mixture F-12 containing 10%fetal bovine serum, dexamethasone and insulin, and then the cells were identified with oil red“O”staining. Adipose-derived stem cells were induced and differentiated into neural cells, and then the cells were identified with immunohistochemical staining.
RESULTS AND CONCLUSION:The growth curve of adipose-derived stem cells was opposite-like“S”shape, and it strongly expressed CD44 that can designate a stem cell. The passage cells were exposed to a defined medium for adipocyte differentiation, and then could be stained with oil red. After being induced and differentiated into nerve cells, the cells expressed neuron-specific enolase. The adipose-derived stem cells of Sprague-Dawley rats are characterized by easy isolation, culture and proliferation in vitro, expressing related phenotypes of mesenchymal stem cells, as wel as induction and differentiation under certain conditions.

Objective To investigate the factors influencing the prevalence of echinococciasis in Gansu Province.Methods With the method of stratified random sampling,all the administrative villages in pastoral areas,half pastoral areas,agriculture and urban areas in the 72 counties in Gansu Province were selected;according to the layers of the population of the county population proportion calculated,the layer investigation numbers were determined,and a total of 16 administrative villages were selected in each county.In the 16 administrative villages,more than 200 people of permanent residents were surveyed in each village (shortage was made up from a nearby village),at least 3 200 people were investigated in a county.By using the combined method of inquiry and field observation,natural factors,such as drinking water,farming and animal husbandry production data were surveyed.All data were analyzed using SPSS 19.0 statistical software.Unauy linear and multiple linear regression analysis of influencing factors and the relationship between the prevalence were analyzed.Results Unary linear regression analysis showed that longitudes,latitudes,altitudes,average annual temperature,annual rainfalls,secondary industries,animal husbandry towns,drinking water sources,the number of epidemic towns,epidemic villages,per capita net incomes in animal husbandry regions,the total number of livestock and the number of sheep were factors influencing the prevalence of echinococciasis (F =4.705,P ＜0.05).Latitude,altitude,animal husbandry towns,the number of epidemic towns,epidemic villages,per capita net incomes in animal husbandry regions,the total number of livestock and the number of sheep and the prevalence of echinococciasis was positively correlated (r =0.282,0.285,0.387,0.508,0.540,0.317,0.475,0.594,all P ＜0.05);longitude,average annual temperature,annual rainfall,secondary industries,drinking water sources and the prevalence of echinococciasis was negatively correlated (r =-0.311,-0.244,-0.244,-0.389,-0.311,all P ＜0.05).Multiple linear regression analysis showed that differences of interactions of annual rainfalls,drinking water sources,epidemic villages,per capita net incomes of herdsmen,secondary industries and the total number of livestock between groups were statistically significant (t =-1.822,-3.920,3.013,1.715,-1.609,3.264,all P ＜0.05).Conclusion The factors influencing the prevalence of echinococciasis in Gansu Province are correlated with annual rainfalls,drinking water sources,epidemic villages,per capita net incomes of herdsmen,secondary industries and the total number of livestock.

Objective To discussion the effect of endoscopic single nostril transsphenoidal pituitary tumor resection on improving clini-cal symptoms and related quality of life of patients. Methods Selected 114 cases of patients with pituitary tumors in our hospital from August 2013 to August 2015, and randomly divided them into the nasal endoscopic group and the microscopic group according to the random number table,with 57 patients in each group. Patients of the 2 groups were treated with nasal endoscopic and microscopic single nostril transsphenoi-dal pituitary tumor resection respectively. The operation situation,hormone decline,incidence of complications after surgery and SNOT-20 and VAS score of the two groups were compared. Results Operative time of nasal endoscopic group was significantly higher than that in the mi-croscopic group,whlie the blood loss,length of hospital stay in endoscopic group was significantly lower than the microscopic group,and the difference was statistically significant (P<0. 05). The total resection rate of pituitary tumor of the two groups were of no statistically signifi-cance (P>0. 05). One week after operation,cerebrospinal fluid cell count,cerebrospinal fluid protein,adrenocorticotropic hormone,serum chloride,sodium, growth hormone,and prolactin levels of the nasal endoscopic group were lower than the microscopic group (P<0. 05). The complication rate was 14. 9% in the nasal endoscopic group,which was obviously lower than 59. 6% in the microscopic group (P<0. 05). One week after operation,the SNOT-20 scores and VAS scores were increased in both of the two groups,but the microscopic group increased more significantly (P<0. 05). Conclusion Endoscopic single nostril transsphenoidal pituitary tumor resection surgery cost longer operation time,but it lead to less trauma and less postoperative complications,which may delay the decline of patients’ quality of life and promote the improvement of prognosis.

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

Objective To investigate the improvement of postpartum pelvic floor by rehabilitation training assessed with three-dimensional transperineal ultrasound . Methods One hundred cases of healthy postpartum women were randomly divided into two groups :control group and training group .The control group received the customary education ,and the training group received pelvic floor rehabilitation training . At 6 and 12 weeks postpartum ,levator hiatus area ,thickness of the levator ani muscle ,bladder neck mobility ,and bladder posterior horn were measured with three-dimensional transperineal ultrasound in all the subjects . Meanwhile ,the muscle strength situations were tested . Results At 12 weeks postpartum ,the anal levator hiatal area ,bladder neck mobility and bladder posterior horn in the training group were lower than those of the control group[ ( 21 .6 ± 3 .2) cm 2 vs ( 25 .6 ± 2 .4 ) cm 2 ,( 27 .9 ± 5 .3) mm vs ( 31 .5 ± 5 .9) mm ,( 126 .3 ± 21 .2)° vs (135 .3 ± 11 .6)°] ( P < 0 .05) . Compared with control group ,the thickness of the levator ani muscle increased in training group [ ( 13 .6 ± 2 .3) mm vs ( 15 .3 ± 2 .5) mm ] ( P < 0 .05) . The incidence of stress urinary incontinence in the training group ( 5% ) was significantly lower than the control group ( 12 .5% ) at 12 weeks postpartum ( χ2 = 5 .487 , P = 0 .025) . The muscle strength had no significant difference at 6 weeks postpartum . At 12 weeks postpartum ,the pass rate of class Ⅰ muscle fiber was 78 .5% ,and that of class Ⅱ muscle fiber was 83 .3% in the training group ;the pass rate of class Ⅰ muscle fiber was 28 .5% ,and class Ⅱ muscle fiber was 37 .3% in the control group , the improvement was significant at 12 weeks postpartum . Conclusions The result of the transperineal real-time ultrasonographic evaluation of post-natal pelvic floor rehabilitation training has high consistency with the measurement of muscle strength . The ultrasound examination is simple and accurate ,and has highly applicable value in evaluating the effect of post-pelvic rehabilitation training .

A 3D finite element model of bilateral distal-extension edentulous dentition, which includes mandible, incisors, canines and premolars, was established in the first place. Based on it, another model with extra-coronal attachments and dentures was also developed. Moreover, contact elements were applied to the regions between the denture and alveolar bone. The von Mises stress distributions of the abutments and their periodontal tissues, edentulous alveolar bone in the two models were compared. The results indicate that the stresses in the abutments and the alveolar sockets obviously increase at the buccal and lingual sides after reparation, and that the stresses on the edentulous alveolar bone also increase.
Dental Abutments ; Dental Stress Analysis ; Denture Design ; Denture Precision Attachment ; Finite Element Analysis ; Humans ; Models, Biological ; Periodontium ; physiology

From alveolar bone and the complete dentition CT images, a three-dimensionalysis of nonlinear finite element model of mandibular unilateral distal-extension with extracoronal precision attachment was established. The contact elements were used between the denture and alveolar bone. The result shows that, the stress in the second premolar and periodontal tissue decreased obviously as the second abutment was added. However, the stress difference was unapparent as the third abutment was added. Considering various facts, the attachment with two abutments was suggested to be used. With the decrease of the periodontal tissue, the stress in the periodontal tissue increased, however the stress in the tooth changed slightly. Thestress in the periodontal tissue decreased effectively when the third abutment was added, as the tooth root was absorbed by 50%. In this situation, the extracoronal precision attachment can also be used.
Dental Stress Analysis ; Denture Precision Attachment ; Denture, Partial, Removable ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Mandible ; diagnostic imaging ; physiology ; Models, Biological ; Tomography, X-Ray Computed

Objective To evaluate the efficacy of in-situ split liver transplantation (ISSLT) in children.Methods From June 2015 to August 2018,10 liver grafts from DBD were split in-situ.All the donors were male,and the median age of the donors was 28.5 year old (18-48 year).One left half graft and 9 left lateral lobe grafts (including 2 reduced size grafts) were transplanted to 10 pediatric recipients.Four grafts were transplanted in our center,and the rest 6 grafts were shared to other two transplant center.The primary diseases of the recipients included biliary atresia (8/10),hepatic sinus obstruction syndrome (1/10) and Alagille syndrome (1/10).The median age of the recipients was 10 month (7 month-11 year),and the mean body weight was 9.8 ± 6.6 kg (5-28 kg).Results All liver grafts were split in-situ.The mean split time of liver grafts was 88.5 ± 18.9 min.The mean weight of split grafts was 336.7-± 85.4 g.All recipients were subjected to piggyback liver transplantation.Operation time was 542.5 ± 112.1 min.Anhepatic time was 52.0 ±-13.5 min.GRWR was (3.98 ±0.96)％.GRWR of two cases was more than 5％,so segment Ⅲ was partially reduced.During the follow-up period,9 cases were alive and 1 case died due to multiple organ failure 1 day after liver transplantation.Conclusions ISSLT can enlarge the graft pool for children and achieve good results.

Objective:To analyze the epidemic status and spatial and temporal cluster distribution of visceral leishmaniasis (VL) in Gansu Province, and to provide evidence for making precise prevention and control measures and epidemic surveillance.Methods:The data of VL cases in Gansu Province reported in the China Disease Prevention and Control Information System Infectious Disease Reporting Information Management System from 2015 to 2021 were collected, descriptive epidemiology analysis was performed (three distribution of the disease). SaTScan v9.6 and ArcMap 10.7 were used for spatio-temporal cluster analysis.Results:A total of 368 VL cases were reported from 2015 to 2021, 89.13% (328/368) were concentrated in Longnan City and Gannan Tibetan Autonomous Prefecture. The number of VL cases increased year by year from 2015 to 2017, reaching a peak in 2017 (79 cases, accounting for 21.47%), and had decreased year by year since 2018. There were cases every month throughout the year, and the peak was in April in spring (38 cases). The ratio of male to female patients was 1.3 ∶ 1.0 (208/160). Scattered children aged less than 5 years old were more common (41.30%, 152/368). The spatio-temporal cluster analysis showed that both the spatial and temporal aggregation zones of VL in Tanchang County and Chengxian County were of statistical significance ( P < 0.05). Conclusion:The incidence of VL in Gansu Province is showing a low epidemic trend, having spatio-temporal aggregation, and precise monitoring and prevention and control should be strengthened in epidemic areas with different prevalence levels.