Objective To study the relevance between blood loss, widespread brain contusion injury and consumptive coagulopathy. Methods One hundred and fifty-three cases with severe brain injury was studied about their coagulation data. Analyzed the relationship between blood loss group according to ≥3000 ml and ＜ 3000 ml and coagulation features, the relationship between widespread brain contusion injury and disorder of coagulation;according to whether with brain contusion injury,kinds of bloods transplant and prognosis were asseseed;according to whether with widespread brain contusion injury in ≥ 3000 ml blood loss group,kinds of bloods transplant and prognosis were assessed. Results Compared with ＜ 3000 ml blood loss patients, ≥ 3000 ml patients' blood coagulation changed obviously, with PT prolonging, Fbg and Plt decreasing, the differences were statistically significant (P ＜ 0.05). Compared with no extensive brain contusion injury patients, in extensive brain contusion injury patients, APTT, PT, TT prolonged, Fbg and Plt decreased,and the difference was statistically significant (P ＜0.05). Extensive brain contusion injury patients with blood loss compared with those without such loss, needed more blood transfusion volume,larger amount of input of fresh frozen plasma Plt volume,the former survival rate was lower [68.29%(28/41)vs. 96.43%(108/112)], the difference between them was statistically significant (P＜ 0.05 ). In 41 patients who had brain widespread contusion ,the cases with extensive blood loss ( ≥ 3000 ml) were compared with those ＜ 3000 ml, and the differences in blood transfusion treatment, fresh frozen plasma, Plt volume,survival rate were statistically significant (P ＜ 0.05). Conclusion When blood loss ≥ 3000 ml after trauma,patients show various degrees of coagulopathy,and when accompanied with extensive brain tissue injury,coagulation disorders are more obvious, and the prognosis is even worse.

Objective To investigate the salty, efficacy and feasiblify on eholedochotomy with endobiliary drainage and prumary closure of the common bile duct. Methods There were 20 partients without introhepatic or re-tained stones and biliary stricture underwent common bile duet exploration. 20 of them with endobiliary tube drainage and primary CBD closure and the other 20 patients with T tube drainage. Results The average of the time to return routine home was (9. 2 ±1. 3)d, (15. 2 ± 3.6) d(P < 0. 01). The hospital expense of postoperation was (3 252± 312)Yuan,(4 116±388)Yuan(P<0.01). Conclusion Choledochotomy with endobiliary catheter and primary closure of CBD is a safe, effective and feasible procedure for the management of choledochohthiasis.

Objective To observe the expression of PAX-2 and PTEN in different types of endometrial lesions, and to study their relationship with endometrial intraepithelial neoplasia (EIN). Methods 60 cases of endometrial hyperplasic lesions and 70 cases of endometrial carcinoma were enrolled. All cases were reclassified by using the diagnostic criteria of EIN, and PAX-2 and PTEN were stained to compare the difference among them. Results The deletion rates of PAX-2 in benign hyperplasia, EIN and endometrial carcinoma were 39.5 % (15/38), 72.7 % (16/22) and 78.6 % (55/70), respectively, and there was a statistical difference (χ2= 21.664, P= 0.000). The deletion rates of PTEN in benign hyperplasia, EIN and endometrial carcinoma were 47.4%(18/38), 54.5%(12/22) and 75.7%(53/70), respectively, and there was no statistical difference (χ2=2.878, P=0.411). Conclusion The staining of PAX-2 could be considered as a reliable adjuvant diagnostic method in the diagnostic criteria of EIN, however, the loss of PTEN just should be regarded as a suggestion of EIN, not a confirmed diagnostic basis.

BACKGROUND:Human amniotic epithelial cells have some properties of stem cells, which can be induced to differentiate into corneal epithelial cells, but cannot be tracedin vitro. OBJECTIVE:To investigate the feasibility and infection efficiency of adenovirus vector carrying enhanced green fluorescent protein (EGFP) into the human amniotic epithelial cells. METHODS:The adenovirus vectors carrying EGFP was transferred into human amniotic epithelial cells culturedin vitro. After cultured and amplified, the morphology difference between transfected and non-transfected human amniotic epithelial cels was observed. The transfected human amniotic epithelial cells were observed under fluorescence microscope, and the cell cycle and the expression rate of EGFP in transfected human amniotic epithelial cells were detected by flow cytometry. RESULTS AND CONCLUSION:No obvious difference in the cell morphology was found between transfected human amniotic epithelial cells and normal human amniotic epithelial cells cultured in vitro. Flow cytometry analysis revealed that the EGFP positive rate was highest and reached up to 99.01% at 48 hours after transient transfection. The cell cycle of human amniotic epithelial cells transfected by the adenovirus vector was slowed a bit. To conclude, the adenovirus vector is a good medium of transfecting EGFP into human amniotic epithelial cells, and makes it more convenient to observe the further transformation of human amniotic epithelial celsin vitro.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

OBJECTIVE: To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA). METHODS: Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American College of Rheumatology 20 (ACR20) was used as efficacy evaluation criteria. RESULTS: In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications. CONCLUSION: The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.

The purpose of this study was to investigate the formation thermodynamics of baicalein(BE)-nicotinamide(NCT)cocrystals in three solvents including ethyl acetate, acetone and trichloromethane. The solubilities of BE, NCT and BE-NCT in the above solvents at 25 °C were measured. Ternary phase diagrams(TPDs)of the BE-NCT-solvent systems were established. The non-linear fitting equation according to 1 ∶1 complexation mechanism of BE-NCT cocrystals demonstrated a good correlation between calculated and experiment data. ΔG0< 0 suggested that BE-NCT cocrystal formation was a spontaneous process. Among the organic solvents studied, the absolute value of ΔG0 in trichloromethane was significantly lower than that in the other two solvents. In addition, the cocrystallization zone in trichloromethane was far away from stoichiometric line. This study provides a theoretical foundation for solvent selection and preparation-condition optimization of BE-NCT cocrystals.

Objective: To study risk factors for non-alcoholic fatty liver disease (NAFLD) and vascular erectile dysfunction (ED) in patients with metabolic syndrome (MS). Methods: A total of 18 096 subjects were selected from people undergoing physical examination from 2008 to 2009 in northern cities of China by random cluster sampling method, and analyzed the risk factors for NAFLD and ED. Results: The 18 096 cases with age 18~76 (46.8±10.1) years old，containing 10 096 (55.79%) males and 8 000 (44.21%) females. Awareness rate of MS was 8.33% and prevalence rate of MS in healthy adults was 21.18%. Most common components of MS were hyperuricemia (27%, 4838/18096), obesity and overweight (21%), hypertension (20%,) and dyslipidemia (17%) in turn. Body mass index (BMI, kg/m2) and waist/hip ratio (WHR) of all MS subgroups from high to low were ED group [(28.9±1.1), (1.26±0.03)], overweight or obesity group [(27.5±2.3), (1.31±0.03)], prediabetes group [(26.8±2.6), (1.03±0.03)] and hypertension group [(26.1±1.3), (0.90±0.04)] in turn. A total of 3 721 MS patients （20.56%）complicated with NAFLD; By means of NAFLD complicated by MS as dependent variable, Logistic regression analysis indicated that increased ALT, waist circumference（WC）, age, DM family history, LDL-C and BMI (β=1.004~0.479, P=0.000~0.016 in turn) were risk factors for NAFLD, and physical exercise and occupational physical work were protective factors for NAFLD. There were 106 ED males and its prevalence rate was 1.04%; Logistic regression analysis indicated that age, WC, LDL-C, DM family history and BMI (β=0.681~0.238, P=0.000~0.018 in turn) were risk factors for ED, and educational degree, physical exercise and occupational physical work were protective factors for ED. Conclusion: Risk factors for NAFLD and ED in MS were closely correlated with MS. It’s a new path to prevent and treat NAFLD and ED through correcting risk factors of MS.

Objective To design a simple screening tool for non-alcoholic fatty liver disease based on Chinese healthy physical examination population. Methods Subjects were selected from the health management center of China Medical University since January 2017 to December 2017. A total of 32,578 subjects were included. 80% subjects were randomly selected as the training set for modeling and internal assessment, and the remaining 20% subjects were used as the verification set for external assessment. Stepwise logistic regression analysis was used to construct the NAFLD screening index. Results Multivariate regression analysis showed that body mass index (BMI), fasting glucose (FPG), serum triglyceride (TG), and aspartate aminotransferase/alanine aminotransferase (AST/ALT) were included in the NAFLD screening model. The constructed NAFLD screening index was 2×BMI+FPG+3×TG-7×(AST/ALT). The AUC of the index was 0.883 [95%CI (0.879, 0.887)] in the training set and was 0.888 [95%CI (0.880, 0.896)] in the verification set. Conclusion The NAFLD screening index, as a simple and effective screening tool, can be used to screen large-scale population at high risk, which has certain epidemiological and health economic significance.

Objective:To investigate the correlation between gender, age, blood collection time, season and changes in cTnT concentration.Methods:In this study, 3548 patients (non-cardiovascular diseases) in Zhongshan Hospital of Fudan University were selected from 1 January to 31 December 2019. The basic data of the patients were collected, including gender, age, time of blood collection, medical history, clinical diagnosis, and results of cTnT testing. 1 840 males and 1 708 females were finally enrolled, with an age distribution of 65 (53, 75) years. The distribution of the data was assessed using the Kolmogorov-Smirnov (K-S) test, where non-normally distributed data were expressed as M( Q1, Q3). The Mann-Whitney U-test was used to compare cTnT concentrations between men and women, and to analyse the influence of gender on cTnT results. The Kruskal-Wallis test was used to compare cTnT levels between gender groups, to analyse the correlation between different times of blood collection, seasons, and other factors and cTnT concentrations. Result:cTnT concentrations increased with age in both males and females over the age of 60 years. cTnT levels were highest in individuals over the age of 90 years (0.028 ng/ml in males and 0.018 ng/ml in females). cTnT levels were higher in males (0.012 ng/ml) than in females (0.009 ng/ml) in all age groups ( H=6.340, P<0.01). The concentrations of cTnT varied at different time points of blood collection. In both males and females, cTnT concentrations reached a maximum at 8:00 and 13:00 (0.013 ng/ml and 0.012 ng/ml, respectively). Analysis of the physiological effect of season on cTnT secretion showed that cTnT levels were generally higher in spring and winter(0.012 ng/ml) than in summer and autumn(0.010 ng/ml). Conclusions:cTnT concentration is influenced by gender, age, time of blood collection and season. When analysing cTnT results in clinical practice, the gender and age of the individual should be taken into account, as well as the time point of blood collection and seasonal factors.