BACKGROUND: Plasminogen activator inhibitor 1 is the main regulator of the fibrinolytic system in vivo. The increase of plasminogen activator inhibitor 1 is closely related to thrombotic disease and it is also an independent risk factor for development of thrombotic disease.OBJECTIVE: To investigate the effect of huangqi(Astragalus), danggui (Angelica) and ligustrazine as medicines activating blood and eliminating stasis on the expression of plasminogen activator inhibitor 1 in HepG2 hepatocarcinoma cell strain.DESIGN: A randomized controlled study.SETTING: First Cadre Department of General Hospital of Chinese People' s Armed Police Force.MATERIALS: The experiment was completed in Academy of Military Medical Sciences of PLA from August to December 2004. HepG2 hepatocarcinoma cell strain was cultured. According to different drugs in culture medium, they were divided into six groups: control group, huangqi group,danggui group, huangqi + danggui group, compound danshen group and ligustrazine group.METHODS: Huangqi, danggui, huangqi + danggui, compound danshen and ligustrazine were added in HepG2 culture medium respectively. MTS assay was used to detect the effect of medicines activating blood and eliminating stasis on proliferation of HepG2 cells, plasminogen activator inhibitor 1 was assayed by specific enzyme-linked immunosorbent assays(ELISA),plasminogen activator inhibitor 1 activity was measured by amidolytical assay. 0.5 μg/mL of transforming growth factor β1 cells was added in HepG2 culture medium to stimulated production of plasminogen activator inhibitor 1. Control group was treated under the same conditions but without Chinese herbs.RESULTS: The inhibitory rates of cellular proliferation in huangqi and danggui groups werc(6.51 ±2. 66)% and (4.42 ±2. 19)%, but those in huangqi + danggui, compound danshen and ligustrazine groups were (12. 06 ±4. 98)%, (16. 38 ±4.06)% and(32. 83 ±9.8)% respectively,t = 2. 447 - 3. 707, P ＜ 0.05. Compared with the control group, huangqi,danggui, compound danshen and ligustrazine significantly inhibited plasminogen activator inhibitor 1 expression(22.68 ± 2.20, 11.11 ± 1.23,19.66±1.53, 15.45±1.27, 16.90±0.33, 14.01±0.74, t=2.447-3.707, P ＜ 0.05) and activity(2.16±0.014, 2.01 ±0.006, 1.95±0.014, 1.79±0. 104, 1.53±0.045, 1.48±0.012, t =2.447-3. 707,P ＜ 0.05) in HepG2 cells. The evident inhibitory effects were observed in the group of huangqi + danggui, especially in compound danshen and ligustrazine.CONCLUSION: The plasminogen activator inhibitor 1 expression and activity were inhibited effectively by huangqi, danggui, compound danshen and ligustrazine.

Objective To observe the affection of smoking on atherosclerosis. Methods The research objects were divided into two groups,smoking group and control group in 60 cases. intima-media thickness and the numbers of plaques were measured in both sides of common carotid arteries by gray-scale imaging.Results There was significant difference between smoking group and control group(P

Objective To analyze the related factors of carotid atherosclerosis in type 2 diabetes mellitus pa-tients complicated with nonalcoholic fatty liver disease .Methods 288 type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease were divided into carotid atherosclerosis group (group A) and non-carotid athero-sclerosis group ( group B ) , according to whether they had carotid atherosclerosis .The related factors of these two groups,such as BMI,blood pressure,blood glucose,blood lipid,liver function were analyzed.Results The two groups had no significant differences in systolic pressure and diastolic pressure (P>0.05).ALT,BMI,HbA1c,FPG,TG,TC, AST of group A were significantly higher than group B [ALT (55.12 ±9.13)mmol/L vs (36.22 ±8.76)mmol/L, BMI (28.48 ±4.69)kg/m2 vs (23.96 ±3.73)kg/m2,HbA1c (8.57 ±1.69)mmol/L vs (7.62 ±1.28)mmol/L, FPG (9.36 ±2.24)mmol/L vs (8.67 ±1.98)mmol/L,TG (2.12 ±0.38)mmol/L vs (1.23 ±0.17)mmol/L,TC (5.56 ±1.25)mmol/L vs (4.31 ±1.09)mmol/L,AST (25.34 ±5.23)mmol/L vs (21.19 ±4.71)mmol/L](t=17.564,8.726,5.163,2.694,8.788,6.894,all P<0.01).The multiple stepwise regression analysis showed that there was a positive correlation between ALT and BMI (r=0.132,P<0.01),a negative correlation between ALT and AST(r=-0.091,P<0.01).Conclusion The level of ALT could be used as a risk index to judge whether the type 2 diabetes mellitus patients complicated with nonalcoholic fatty liver disease had carotid atherosclerosis .

Objective To investigate prevalence and epidemiologic features of Saffold virus (SAFV) in hospitalized children with acute respiratory infection or digestive tract infection Tianjin area. Methods Nasopharyngeal aspirates from children with acute respiratory infection and fecal samples from children with digestive tract infection in Tianjin Children ’s Hospital were collected from January 2013 to December 2013. Viral nucleic acid was extracted, and SAFV infection was determined by using real-time quantitative PCR. Positive PCR products were sequenced. The sequencing results were aligned with known gene sequences of SAFV sequences in GenBank. The positive viral infection rate of nasopharyngeal aspirates and fecal samples, viral positive constituent ratio and positive detection rate in different age groups, seasonal distribution of SAFV infection were calculated. Other common respiratory tract or digestive tract viruses were also detected. Results Fourty-three (11.9%) nasopharyngeal aspirates from children with acute respiratory infection tested positive for SAFV. There was no significant difference between male and female infected children (aged between 6 d and 12 years old). The 79%(34/43) of the patients with SAFV infection aged under 1 year old. The infection most occurred in summer and winter. The 63 (16.4%) fecal samples from children with digestive tract infection tested positive for SAFV. There was significant difference between male and female infected children (aged between 5 h and 11 years old). SAFV infection was found to be year round. There was no significant difference in different age groups of nasopharyngeal aspirates and fecal samples. The mixed infection rate with SAFV and other respiratory tract or digestive tract viruses were 7.0%(3/43)and 12.7%(8/63), respectively. Conclusion Infection of SAFV had occurred in children with acute respiratory infection or digestive tract infection in Tianjin. SAFV has high detection rate in these children and is more common in children
aged under 1 year old. The data suggest that some of acute respiratory infection or digestive tract infections in pediatric patients are related to SAFV. The Clinical doctors should pay attention to them .

Objective To evaluate the value of endorectal ultrasonography (ERUS) in assessment of mesorectal fascia (MRF) invasion in rectal cancer.Methods Data of 44 patients who accepted preoperative ERUS and total mesorectal excision surgery within a week were retrospective analyzed.There were 18 patients who accepted preoperative neoadjuvant chemotherapy and 26 patients didn't acceped.Taking the pathological diagnosis of circumferential resection margin (CRM) as the gold standard,the diagnostic efficiency of ERUS for the MRF invasion in rectal cancer was evaluated.Results The final pathological T staging was T1 in 2 cases,T2 in 17 cases and T3 in 25 cases.There were 2 cases of CRM positive results,and 42 cases of CRM negative results.With regard to the location of tumor,there were 16 cases located in low,and 28 cases in mid rectum.There were 26 cases located in anterior or antero-lateral wall of rectum,13 cases in posterior or postero-lateral wall,and 5 cases with a circle of rectum.The diagnostic accuracy were 83.33 ％ (15/18) and 92.31％ (24/26) for cases of accepting and not accepting the preoperative neoadjuvant chemotherapy;80.77％ (21/26) for cases located in anterior or antero-lateral wall,and 100％ (13/13) for cases located in posterior or postero-lateral wall;75.00％ (12/16)and 96.43 ％ (27/28) for low position and mid position tumors.The total diagnostic accuracy was 88.64％ (39/44).Conclusion ERUS can be an effective method in preoperative assessment of the MRF invasion in rectal cancer.

Objective To investigate the value of endorectal ultrasonography (ERUS) inpreoperative assessment of rectal cancer post neoadjuvant chemoradiation therapy.Methods From Jan.2016 to Dec.2016,90 rectal cancer patients who underwent preoperative neoadjuvant chemoradiation therapy and total mesorectal excision surgery in the Sixth Affiliated Hospital of Sun Yat-Sen University were retrospectively analyzed,and all patients underwent ERUS examination post neoadjuvant chemoradiation therapy.Of these,64 patients were evaluated by ERUS pre and post neoadjuvant chemoradiation therapy and 26 patients were evaluated only post neoadjuvant chemoradiation therapy.Wilcoxon rank sum test for paired sample was performed to compare the distance from inferior margin of tumor to anal margin,the length and thickness of the tumor pre and post neoadjuvant chemoradiation therapy respectively in rectal cancer.Taken pathologic findings as golden standard,the accuracy of T staging assessed by ERUS post neoadjuvant chemoradiation therapy was evaluated.Results Compared with pre neoadjuvant chemoradiation therapy,the distance from inferior margin of tumor to anal margin significantly increased after neoadjuvant chemoradiation therapy [(58.63±21.71) mm vs (51.68± 19.81) mm],and the length [(26.10± 10.07) mm vs (40.82±9.18) mm] and thickness [(9.73±2.50) mm vs (14.92±5.30) mm] of tumor also evidently decreased post neoadjuvant chemoradiation therapy,respectively (Z were 4.996,6.153 and 6.076,all P ＜ 0.01).The final pathological T stage was pathologic complete response (pCR) or pT0 in 15 patients,pT1 in 3 patients,pT2 in 30 patients and pT3 in 42 patients.The diagnostic accuracy of T staging of rectal cancer post neoadjuvant chemoradiation therapy for ERUS was uT0 82.2％ (74/90),uT1 96.7％ (87/90),uT2 66.7％ (60/90),uT3 67.8％ (61/90) and uT4 96.7％ (87/90),and the overall accuracy was 82.2％ (74/90).Conclusion ERUS could effectively record the morphological changes of rectal cancer pre and post neoadjuvant chemoradiation therapy,which may contribute to the re-evaluation of the distance from inferior tumor margin to anal margin and the range and depth of tumor involvement pre surgical resection.

Objective:To investigate the diagnostic value of ultrasound contrast agent enema (UCAE) for anastomotic leakage (AL) after rectal cancer surgery.Methods:From January 2020 to December 2022, a total of 95 patients with presacral fluid collection after rectal cancer surgery in the Sixth Affiliated Hospital of Sun Yat-sen University who received perineal ultrasound (PNUS) and UCAE were retrospectively selected. Among them, 70 patients (73.3%) were diagnosed with AL.After PNUS scanning, all patients received a diluted ultrasound contrast agent administered through the rectum. Receiver operating characteristic (ROC) curve were used to compare the accuracies of PNUS, UCAE, CT, MRI and water-soluble contrast enema in the diagnosis of AL. Factors that may have impacts on the sensitivity of UCAE were thoroughly analyzed.Results:UCAE improved the consistency (Kappa value: 0.757 vs 0.292, P<0.001) and accuracy (AUC: 0.893 vs 0.693, P<0.001) of PNUS in the diagnosis of AL, and its diagnostic accuracy was comparable to that of CT (AUC 0.807), MRI (AUC 0.811) and water-soluble contrast enema (AUC 0.923) (all P>0.05). For mid-to-high AL (anastomotic stoma distance ≥70 mm) and tiny AL (≤3 mm), the sensitivity of UCAE decreased significantly (anastomotic stoma position: 25.0% vs 85.5%, P=0.001; anastomotic leak diameter: 42.9% vs 87.5%, P=0.002). Conclusions:UCAE can significantly improve the diagnostic accuracy and consistency of PNUS for AL after rectal cancer surgery, and its diagnostic sensitivity is affected by the anastomotic stoma distance and the diameter of the leak.

【Objective】 To investigate the clinical effects of treatment of single-segment lumbar tuberculosis by oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation. 【Methods】 We collected the clinical data of 47 patients with lumbar tuberculosis treated in The First Affiliated Hospital of Xi’an Jiaotong University from March 2017 to January 2020. Among them， 22 patients underwent oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation （minimally invasive group） and 25 patients underwent open surgery combined anterior-debridement and posterior-fixation （control group）. The related data were collected， including gender， sex， body mass index （BMI）， systemic symptoms of tuberculosis， operation duration， intraoperative bleeding， postoperative drainage， hospital stay， complications， visual analogue score （VAS）， erythrocyte sedimentation rate （ESR）， and Oswestry disability index （ODI）. 【Results】 Baseline clinical characteristics did not significantly differ between the two groups （P>0.05）. Compared with control group， the minimally invasive group had shorter operation duration ［（188.64±18.59） min vs. （201.60±22.67） min］， less intraoperative blood loss ［（118.64±22.95） mL vs. （553.60±100.54） mL］， less postoperative drainage ［（134.55±36.48） mL vs. （291.20±61.53） mL］， and shorter hospitalization time ［（12.86±2.17） d vs. （15.80±3.03） d］ （all P<0.05）. However， there was no significant difference in fusion time or complication rate （P>0.05）. Compared with the preoperative ones， ESR， VAS score and ODI score significantly decreased and Cobb angle significantly increased in both groups （all P<0.001）. At postoperative 3 months， the VAS score was lower in the minimally invasive group than in control group ［（3.59±0.96） vs. （4.16±0.85）］ （P<0.05）. With regard to other characteristics， there was no significant difference between the two groups at the same point （P>0.05）. 【Conclusion】 Both minimally invasive technique and open surgery can achieve excellent clinical results， but the minimally invasive technique can reduce the surgical trauma and shorten the hospitalization time.

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.