ObjectiveTo investigate the inhibitory effect of Biejiajian Pills （BJJW） on the growth of liver cancer， as well as its potential mechanism in mediating the AMP-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） pathway through mitochondrial energy metabolism. MethodsHuman hepatoma Huh7 cells were used to establish a nude mouse model of subcutaneous xenograft tumor. A total of 18 tumor-bearing nude mice were randomly divided into model group， BJJW group （2.2 g/kg）， and metformin group （250 mg/kg）， and the corresponding drug was given by gavage for 14 consecutive days. Tumor volume and weight were monitored during the experiment； HE staining was used to observe histopathological changes； the levels of reactive oxygen species （ROS） and adenosine triphosphate （ATP） in tumor tissue were measured； immunohistochemistry and Western blotting were used to measure the expression levels of proteins associated with the AMPK/mTOR pathway. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Tukey’s test was used for further comparison between two groups； the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Dunn’s test was used for further comparison between two groups. ResultsCompared with the model group， the BJJW group had a tumor inhibition rate of 45.73%， with significant reductions in both tumor volume and weight （P<0.01）. Pathological examination showed that compared with the model group， the BJJW group had a significant reduction in the number of tumor cells and the presence of extensive necrosis. Mechanistic studies showed that compared with the model group， the BJJW group had a significant increase in ROS level （P<0.001） and a significant reduction in ATP level （P<0.001）， as well as significant increases in p-AMPK/AMPK ratio （0.81±0.20 vs 0.13±0.04， P<0.01） and p-ULK1/ULK1 ratio （0.69±0.17 vs 0.18±0.13， P<0.01） and a significant reduction in p-mTOR/mTOR ratio （1.34±0.16 vs 3.20±0.62， P<0.01）. ConclusionBJJW may inhibit the growth of liver cancer by inducing mitochondrial energy metabolism dysfunction， increasing the level of ROS， reducing the level of ATP， and activating the AMPK/mTOR signaling pathway.

Objective:To investigate the effect of prolonged negative pressure drainage time after parotidectomy and analyze its relationship with the incidence of postoperative salivary fistula.Methods:The clinical data of 94 patients with benign parotid gland tumors who received treatment in the Department of Otolaryngology-Head and Neck Surgery of The First Affiliated Hospital of Xiamen University from July 2021 to June 2022 were retrospectively analyzed. These patients were divided into an observation group and a control group ( n = 47 per group). In the observation group, the negative pressure drainage tube was removed after 1 week of simple negative pressure drainage, while in the control group, conventional local bandaging of the parotid gland was performed for 2 weeks, and negative pressure drainage was given for 2-3 days. Postoperative drainage volume, pain degree, and the incidence of salivary fistula were recorded for each group. Results:The total drainage volume in the observation group was (77.93 ± 23.83) mL, which was significantly greater than (47.06 ± 24.71) mL in the control group ( t = 6.17, P < 0.001). The Visual Analogue Scale score in the observation group was (3.021 ± 1.07) points, which was significantly lower than (7.53 ± 1.27) points in the control group ( t = 18.63, P < 0.001). The incidence of postoperative salivary fistula in the observation group was 2.1% (1/47), which was significantly lower than 17.0% (8/47) in the control group ( χ2 = 4.42, P = 0.035). Conclusion:Simple prolongation of negative pressure drainage time can achieve full drainage, improve the quality of life of patients after parotidectomy and reduce the occurrence of postoperative salivary fistula, which is worthy of clinical promotion.

Nucleoside analogues and nucleotide analogues can not only achieve long-term viral suppression in the treatment of most CHB patients but also have a positive impact on other CHB therapeutic goals and an improved prognosis. A certain difference can be observed in the impact of nucleotide analogues such as TDF and TAF and nucleoside analogues such as ETV on the clinical outcomes of CHB. Studies on the mechanism of action indicate that apart from inhibiting the direct antiviral effects of HBV reverse transcriptase, these two categories of drugs exhibit distinct impacts on immune-related signaling pathways, gene expression, genome stability, and other non-antiviral mechanisms. This article reviews the evidence on the potential non-antiviral mechanism of action of nucleoside analogues and nucleotide analogues and proposes a preliminary explanation for the observation trend of nucleotide analogues having a comparative advantage in clinical outcomes in CHB patients based on the latest research advancement.

Objective　To observe the incidence of white matter hyperintensities （WMHs） and the distribution of right to left shunt （RLS） in migraine patients，and to explore whether WMHs is related to RLS. Methods　106 patients with migraine were selected as the research objects. The basic data and clinical information of migraine were collected. The WMHs were evaluated by cranial MRI. The RLS was diagnosed and graded by transcranial Doppler （TCD） bubbles test. The correlation between WMHs and RLS was analyzed. Results　Among 106 migraine patients，33 （31.1%） were in WMHs+ group and 73 （68.9%） in WMHs- group. The total positive rate of RLS was 48.1% （51/106）. The distribution of different shunt levels was as follows：grade Ⅰ shunt in 27 cases （25.5%），grade Ⅱ shunt in 4 cases （3.8%），grade Ⅲ shunt in 6 cases （5.6%），grade Ⅳ shunt in 14 cases （13.2%）. In "WMHs+" group，there were 5 cases of grade Ⅰ shunt，1 case of grade Ⅱ shunt，3 cases of grade Ⅲ shunt and 10 cases of grade Ⅳ shunt；in "WMHs-" group，there were 22 cases of grade Ⅰ shunt，3 cases of grade Ⅱ shunt，3 cases of grade Ⅲ shunt and 4 cases of grade Ⅳ shunt. Compared with "WMHs+" group and "WMHs-" group，there was no statistical difference in the overall positive rate of bubbles test between the two groups （P>0.05，χ2=1.719），but the large shunt rate of "WMHs+" group was significantly higher than that of "WMHs-" group （P<0.01，χ2=13.188）. Conclusion　There is no significant correlation between WMHs and RLS in migraine patients，but large RLSs will increase the risk of WMHs in migraine patients.

OBJECTIVE: To establish a headspace gas chromatography-mass spectrometry method for the determination of 14 chlorinated hydrocarbons in urine. METHODS: The urine sample 4.00 mL and anhydrous sodium sulfate 3.00 g were added into a 10.00 mL headspace bottle, then the headspace bottle was maintained at 70 ℃ for 40.0 min. After headspace pretreatment, 14 chlorinated hydrocarbons in headspace air were separated in the DB-5 MS capillary column of the gas chromatography and detected by mass spectrometer. RESULTS: There was a good linear relationship of 14 chlorinated hydrocarbons in urine in the range of 0.62-1 630.00 μg/L. The linear correlation coefficient was greater than 0.999 0.The minimum detectable concentration was 0.19-0.43 μg/L and the minimum quantitative concentration was 0.62-1.44 μg/L. The average recovery rate was 89.8%-107.1%. The within-run relative standard deviation(RSD) was 4.0%-8.5% and the between-run RSD was 6.3%-9.1%. Urine samples can be stored at 4 ℃ or-8 ℃ for 3 days and below-20 ℃ for 7 days. CONCLUSION: This method is rapid, simple, sensitive, accurate and has little interference,which can be used as a method for detecting 14 kinds of chlorinated hydrocarbons in urine samples of patients with occupational poisoning.

OBJECTIVE To discuss the therapeutic effect of one stage surgical treatment in the multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma.METHODS The thoracoscopy group: dissecting the esophagus and mediastinal lymph node assisted with thoracoscope, and then opened abdominal cavity to make gastric tube. Head and neck group: doing the cervical lymph node dissection, total laryngectomy, total hypopharyngectomy and total esophagectomy, and then anastomosis of the pharynx with gastric tube. All cases were received conventional radiotherapy and chemotherapy after operation.RESULTS All the cases in this group were successfully underwent the one stage operation. The postoperative complications were pulmonary infection in 3 cases, pleural effusion in 2 cases and tracheal tear in one case. No anastomotic fistula or postoperative deaths occurred. The 3 and 5 year survival rates were 63.6% and 50.0% respectively.CONCLUSION It should take necessary examinations of cervical thoracic esophagus to prevent missing the multiple primary carcinoma of the hypopharyngeal carcinoma. The total laryngectomy, total hypopharyngectomy and total esophagectomy, and anastomosis of the pharynx with gastric tube for multiple primary hypopharyngeal and cervical thoracic esophageal carcinoma is a feasible and active treatment method.

Accidents ; Adolescent ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; genetics ; metabolism ; Carcinoma, Renal Cell ; genetics ; pathology ; surgery ; Chromosomes, Human, X ; Diagnosis, Differential ; Gene Fusion ; Humans ; Kidney ; injuries ; Kidney Neoplasms ; genetics ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Translocation, Genetic

Objective To assess the clustering of cardiovascular risk factors and their effects on target organ damage in elderly patients with hypertension .Methods 421 treated elderly hypertension patients were divided into 5 groups based on the number of risk factors :hypertension without additional risk factor (group A ,25 cases) ,and the other 4 groups were complicated with 1 (group B ,76 cases) ,2(group C ,127 cases) ,3(group D ,128 cases)and ≥ 4 (group E ,65 cases) risk factors .The structure and function of heart and carotid artery were examined by ultrasonography in order to evaluate the damage of target organ and the morbidity .Re-sults The patient groups with three or more risk factors showed significantly higher levels of BMI ,plasma glucose ,triglyceride , LDL-C cholesterol ,serum creatinine and serum uric acid ,and needed greater number of antihypertensive drugs ,compared with other groups(P<0 .05) .The patient groups with two or more risk factors showed significantly higher levels of LVMI ,IMT and MAU/Cr compared with group A(P<0 .05) ,and significantly lower levels of the creatinine clearance (P<0 .05) .In addition ,they showed significantly higher incidences of coronary heart disease and cerebrovascular disease and chronic kidney disease compared with group A (P<0 .05) .Conclusion These results suggest that the hypertensive patients with clustering risk factors required greater number of antihypertensive drugs .The more additional risk factors exit ,the more target organ damages and higher morbidity occur ,and more intensive intervension are required to control not only blood pressure but also other complicated risk factors .