BACKGROUND: It is generally thought that the pathogenesis of the chronic blocking pulmonary disease (COPD) is characteristics in chronic inflammations of air passage, lung essence and the lung blood vessels. As the classic Chinese medicine, Maxing Shigan decoction has the pharmaco logical effects on fever alleviation, anti-inflammation, anti-virus, cough relieving and phlegm resolving, which is suitable for the treatment of phlegm heat cumber lung COPD, and is remarkable in the curative effect.OBJECTIVE: To probe into the mechanism of Maxing Shigan decoction ini the treatment of COPD by studying the changes in interleukin-8 (IL-8),tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-4 (IL-4)and the ratio between IFN-γ and IL-4 in rats with COPD.DESIGN: Randomized control animal experiment.SETTING: Affiliated Hospital of Shandong University of Traditional Chinese Medicine.MATERIALS: Seventy-two healthy male Wistar rats of SPF level with the body mass of (200±20) g were selected. Maxing Shigan decoction, composed of 5 g of ephedra, 9 g of almond, 6 g of liquorices, 18 g of gypsum.The water-decocted enrichment was 0.475 g/mL, and the medical herb pieces were supplied by the TCM Dispensary of Affiliated Hospital of Shandong Medical University of Traditional Chinese Medicine.METHODS: The experiment was conducted in the Central Laboratory,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from April to October 2005. ① 72 healthy male Wistar rats were randomly divided into 3 groups: blank control group (n=24), retention of phlegm-heat modeling group (modeling group, n=24) and retention of phlegm-heat treatment group (treatment group, n=24). Improved smoking and trachea dropping lipopolysaccharide was adopted to copy COPD model, and model of phlegm heat cumber lung was remodeled for copy.② Rats in the treatment group were lavaged with 2 mL of Maxing Shigan decoction per day (the medicine composition: Chinese ephedra 5 g, almond 9 g, licorice 6 g, gypsum 18 g, the water fries the concentration for the density 475 g/L concentrated solution) from the 30th day, while rats in the modeling group were lavaged with 2 mL of normal saline each day.Rats in the blank control group received no interventions, which ate and drank freely under the same environment. ③ The contents of IL-8, IL-4 and TNF-α in the homogenate of lung tissues were tested by radio-immune method. ④ The content of IFN-γ in the homogenate of lung tissues was detected by the enzyme immunoassay method. ⑤ The ratio of IFN-γ and IL-4 was calculated. MAIN OUTCOME MEASURES: The contents of IL-8, TNF-α, IFN-γ,IL-4 as well as the ratio between IFN-γ and IL-4 in the homogenate of lung tissues in rats of each group.RESULTS: ① The level of IL-8 in the modeling group was markedly higher than that in the blank control group [(581.41±74.72), (318.63±40.01 ) ng/L,P ＜ 0.01], which was significantly decreased after the treatment [(533.95±68.67) ng/L,P ＜ 0.01], while there was difference in comparison with the blank control group (P ＜ 0.05). ② The level of TNF-α in the modeling group was significantly higher than that in the blank control group [(160.78±20.90), (100.29±24.2) ng/L, P ＜ 0.01], which was remarkably decreased after the treatment [(147.08±19.43) ng/L,P ＜ 0.05],whereas it was different in comparison with that in the blank control group(P ＜ 0.01). ③ Compared with the blank control group, the level of IFN-γ in the modeling group was markedly decreased [(230.32±72.33), (328.08±50.57) ng/L ,P＜ 0.01], which was obviously increased after the treatment [(267.24±55.14) ng/L ,P ＜ 0.05], and there were differences between the two groups (P ＜ 0.01). ④ The level of IL-4 was significantly increased in the modeling group than that in the blank control group[(135.08±29.17), (82.41±14.66) ng/L,P ＜ 0.01], which was significantly decreased after the treatment [(107.99±23.76) ng/L,P ＜ 0.01], and there was difference between the two groups (P ＜ 0.01 ). ⑤ The ratio between IFN-γ and IL-4 declined markedly in the modeling group than that in the blank control group (1.77±0.73,4.09±0.91 ,P ＜ 0.01), and the ratio increased markedly after the treatment(2.59±0.79, P ＜ 0.01 ). There was difference between the two groups(P ＜ 0.01 ).CONCLUSION: Maxing Shigan decoction can regulate the changes in level of multiple cytokines in rats with COPD, which has the effects of anti-inflammation and enhancing the immunity of organism immunization with clear curative effect on COPD (syndrome of retention of phlegmheat).

BACKGROUND: Many diseases accompany with changes of gene expression which can provide a valuable clue for pathogenesis and therapy of cognitive diseases.OBJECTIVE: To screen expression of different genes in lung tissue of model rats with chronic obstructive pulmonary disease (COPD) by gene expression profiling technique. DESIGN: Open study. SETTING: Affiliated Hospital of Shandong University of Traditional Chinese Medicine; Radiation Medical Institute of Academy of Military Medical Sciences of Chinese PLA; Shangdong University of Traditional Chinese Medicine.MATERIALS: The experiment was carried out in the Central Laboratory of Affiliated Hospital, Shandong University of Traditional Chinese Medicine from April to October 2005. ① Fifteen healthy male Wistar rats of SPF grade and aged 50 days were randomly divided into normal group, model control group and Chinese herb group with 5 in each group. ② Type of gene chip was BiostarR-40S and provided by Shanghai Boxing Gene Chip Company Limited (batch number: G050510010052).METHODS: ① COPD models in model control group and Chinese herb group were established with modified smoking-fumigated method plus adding lipopolysaccharide in windpipe. Pathological changes of airway were observed under optic microscope. Models were established successfully based on the following phenomenon: hyperemia and edema in mucous membrane of airway; degeneration and necrosis of epithelial cells; infiltration of bronchial cavity in lung tissue and surrounding chronic inflammatory cells; proliferation of smooth muscle and fibrocyte surrounding dissepiment; thin and broken interval; amplifying confluence of pulmonary alveolus; thickness of vascular wall of arteriole; decrease of vaso-cavity; infiltration of surrounding inflammatory cells. ② At 30 days after modeling,0.65 g/mL self-made Chinese herb (mahuang, xingren, huangqi, etc.) wasperfused into rats in Chinese herb group with 2 mL each time, once a day,for successive 14 days. Rats in model control group were perfused with 2 mLsaline; however, rats in normal group were untouched. All rats drank freely under the same internal environment. ③ After administration, rats in each group were sacrificed to extract total RNA, label and hybridizated with probe, wash pieces, analyze gray value of clip with clip imaging software,obtain original signal of each gene point (signal values of foreground and background) and determine differently expressed genes. If size of test was more than 2.0, genes were regarded as up-regulation genes; otherwise, if ratio was less than 0.5, they were regarded as down-regulation genes. In this study, based on reliability, if size of test was more than 2.5, they were regarded as up-relation genes; however, if ratio was less than 0.375, they were regarded as down-regulation genes.MAIN OUTCOME MEASURES: ① Comparisons of differently expressed genes in normal and model control groups; ② Comparisons of differently expressed genes in normal and Chinese herb groups; ③Comparisons of differently expressed genes in model control and Chinese herb groups.RESULTS: Fifteen rats were all involved in the final analysis. ① As compared with those in normal group, there were 57 differently expressed genes in model control group, involving in immunity, metabolism, signal transduction, adjusting of gene expression, cell cycle, cell transport, cell migration, fibrosis, etc. ② Gene expression in Chinese herb group reached normal level and there were 11 differently expressed genes as compared with those in normal group, involving in stress, signal transduction, cytoskeleton, etc. ③ As compared with those in model control group, there were 7 differently expressed genes in Chinese herb group, involving in immunity and excretion of neurotransmitter.CONCLUSION: Changes of gene expression may be one of reasons of COPD pathogeneses; moreover, most differently expressed genes can recover the normal level after drug therapy which is beneficial to correct pathological changes of COPD.

OBJECTIVE:To prepare nifedipine (NF) hollow controlled-release microspheres and evaluate the quality. METH-ODS:Solvent diffusion volatilization method was used to prepare microspheres,using comprehensive scores of cumulative release in 2,12,24 h(Q2 h,Q12 h,Q24 h)as indexes,orthogonal test was designed to screen the carrier material ethyl cellulose(EC),poly-vinyl pyrrolidone(PVP)and main drug NF amounts;appearance,particle size distribution,drug loading,floating and cumulative release of the microspheres prepared by optimal formulation were evaluated and compared of in vitro release behavior with imported preparation of Nifedipine controlled-release tablets (Adalat?). RESULTS:The optimal formulation was as follow as NF 3.00 g, PVP 1.60 g,EC 15.65 g. Prepared NF hollow controlled-release microspheres were spherical in shape with particle size distribution of 24-40 mesh and drug loading of 8.66%;24 h floating rate in release medium was 97.93%,Q2 h,Q12 h,Q24 h were 20.49%, 52.90%,91.00%(RSD<10%,n=3). Compared with the imported preparation,similarity factor f2 values of cumulative release were higher than 50,showing in vitro drug-release was consistent with the zero-order kinetic equation (r=0.9993);n of Rit-ger-Peppas equation (r=0.9807) was 0.478. CONCLUSIONS:Prepare NF hollow controlled-release microspheres show similar drug-release behavior with the imported preparation,the drug is released by the combination of diffusion and erosion.

Objective To study the effect of mental intervention on patients with postsurgical gastroparesis syndrome (PGS). Methods 70 patients with gastroptroparesis syndrome after abdominal operation were divided into the control group and the experimental group with 35 patients in each group according to chronological order.The patients in the control group accepted routine care,and the experimental group was given mental intervention based on routine care.Center for Epidemiological Survey Depression Scale (CESD) was used to evaluated the emotional state before and after intervention.Besides,the recovery of gastrointestinal function was appraised. Results The improvement level of anxiety in the experimental group was higher than the control group.The extinction time of symptoms,indwelling time of gastric tube,recovery time of food intake were shorter than the control group.Drainage time when gastric juice ＞ 800ml/d was shorter,recovery time of PGS and hospitalization time were shorter,the treatment cost was reduced,compared with the control group. Conclusions Mental intervention can alleviate the negative emotion and shorten the recovery time of patients with postsurgical gastroparesis syndrome.

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.

The spectrum of biopsy-confirmed kidney disease varies with regions and periods. We describe the distribution of pathological types and epidemiological characteristics of kidney diseases in Northwest China due to regional differences in geographical environment, social economy, and dietary habits. Methods: Kidney biopsy cases from 2005 to 2020 in Xijing Hospital were retrospectively analyzed. Pathological characteristics of patients in different periods were analyzed using the t test or chi-square test. Joinpoint regression was used to analyze trends in pathological types and disease spectrum. Results: A total of 10,528 eligible patients were included. Primary glomerular disease (PGD) accounted for the majority of the cases and exhibited an obvious downward trend, whereas secondary glomerular disease (SGD) showed an obvious upward trend. Among PGD, immunoglobulin A nephropathy (IgAN) remained the most common pathological type, and the detection rate of membranous nephropathy (MN) was significantly increased. Among SGD, Henoch-Schönlein purpura nephritis (HSPN) was the most common pathological type and may present a significant characteristic of Northwest China. Diabetic nephropathy (DN) exhibited the most obvious upward trend in the whole process, whereas the fastest growth since 2012 was in hypertensive nephropathy. Conclusion: The proportion of SGD increased whereas PGD declined. IgAN remained the most common PGD, and HSPN was the most common SGD. MN and DN showed the most obvious upward trend among PGD and SGD, respectively. Changes in the spectrum of kidney disease, especially the constituent ratio of SGD, pose a great challenge to public health.

Objective: To study the clinical application of three-dimensional (3D) visualization technology in liver resection of complicated liver cancer. Methods: A retrospective analysis of 28 patients with complicated liver cancer treated from June 2017 to June 2018 in the Department of Hepatobiliary Surgery, the Affiliated Tumor Hospital of Guangxi Medical University. There were 26 males and 2 females, aged (46±10) years old. A treatment plan on how to perform liver resection for these patients was developed under the guidance of 3D visualization technology. The actual surgical procedures, operation time, intraoperative blood loss, and postoperative complications were documented. The virtual resected liver volume was compared with the actual resected liver volume. The virtual surgical resection margin was also compared with the actual surgical resection margin. Results: All the 28 patients with complicated liver cancer completed the 3D visualization analysis with the location, shape and quantity of tumor being clearly shown. Of the 27 patients who underwent liver resection, 13 underwent anatomical hepatectomy, and 14 underwent non-anatomical hepatectomy. The operation time ranged from 145 to 350 min (median 240 min). The intraoperative blood loss ranged from 100 to 1 500 ml (median 300 ml). The incisional wound healed slowly in 4 patients, pleural effusion developed in 8 patients, and ascites in 2 patients. There were no significant differences in the virtual resected liver volume compared with the actual resected liver volume (P>0.05). There was an excellent positive correlation between the patient's virtual resected liver volume and the actual resected liver volume (r=0.986, P<0.05). There was no significant difference between the virtual surgical resection margin and the actual surgical resection margin (P>0.05). There was an excellent positive correlation between virtual surgical resection margin and the actual surgical resection margin (r=0.983, P<0.05). Conclusion Three-dimensional visualization technology accurately assessed the liver status, optimized surgical procedures, and played an important role in liver resection of complex liver cancer.

Objective To investigate the expression and clinical significance of transcription factor SOX5 in peripheral blood mononuclear cells (PBMCs) and serum in patients with rheumatoid arthritis (RA). Methods The relative expression of representative genes of the SOX gene family in the PBMCs from RA patients were detected by Real-Time Polymerase Chain Reaction (RT-PCR), and serum levels of SOX5 expression were measured by enzyme-linked immunosorbent assay (ELISA) in 30 RA patients, 27 osteoarthritis (OA) patients and 30 healthy controls (HC). The expression levels of SOX5 in PBMCs were detected by RT-PCR after stimulated with IL-6, TNF-α, IL-1β and IL-17 for 24 hours. The relationship between SOX5 and receptor activator of nuclear factor κB ligand (RANKL) was detected by co-Immunoprecipitation (co-IP). The formation of TRAP-positive cells after silence SOX5 in osteoclast precursor cell treated with RANKL was observed by Tartrate-resistant acid phasphate stain (TRAP). The differences were tested using one-way ANOVA followed by Student-Newman-Keuls post hoc analysis Correlations were analyzed using Pearson's analysis. Results SOX5 was predominantly expressed in the PBMCs of RA as compared with other SOX family genes in PBMC. PBMC levels of SOX5 in RA patients (21±19) were higher than the OA patients (10±8) and healthy control group (5±4)(F=8.343, P<0.01). While, Serum levels of SOX5 in RA patients [(19132±12054) pg/ml were higher than the OA patients [(9065±15172) pg/ml] and healthy control group [(3242±1251) pg/ml] (F=15.31, P<0.01). IL-6, TNF-α, IL-1β and IL-17 led to the up-regulation of SOX5 expression in PBMCs. IL-6, TNF-α, IL-1β promoted the interaction of SOX5 and RANKL in PBMCs. Silencing SOX5 reduced the formation of TRAP-positive cells in osteoclast precursor cell treated with RANKL. Conclusion Our results have proven that transcriptional factor SOX5 regulates the expression of RANKL and participates in the process of RA bone erosion. Inhibition of SOX5 expression may be a new therapy target of RA.

Objective:To evaluate artificial intelligence constructed by deep convolutional neural network (DCNN) for the site identification in upper gastrointestinal endoscopy.Methods:A total of 21 310 images of esophagogastroduodenoscopy from the Cancer Hospital of Chinese Academy of Medical Sciences from January 2019 to June 2021 were collected. A total of 19 191 images of them were used to construct site identification model, and the remaining 2 119 images were used for verification. The performance differences of two models constructed by DCCN in the identification of 30 sites of the upper digestive tract were compared. One model was the traditional ResNetV2 model constructed by Inception-ResNetV2 (ResNetV2), the other was a hybrid neural network RESENet model constructed by Inception-ResNetV2 and Squeeze-Excitation Networks (RESENet). The main indices were the accuracy, the sensitivity, the specificity, positive predictive value (PPV) and negative predictive value (NPV).Results:The accuracy, the sensitivity, the specificity, PPV and NPV of ResNetV2 model in the identification of 30 sites of the upper digestive tract were 94.62%-99.10%, 30.61%-100.00%, 96.07%-99.56%, 42.26%-86.44% and 97.13%-99.75%, respectively. The corresponding values of RESENet model were 98.08%-99.95%, 92.86%-100.00%, 98.51%-100.00%, 74.51%-100.00% and 98.85%-100.00%, respectively. The mean accuracy, mean sensitivity, mean specificity, mean PPV and mean NPV of ResNetV2 model were 97.60%, 75.58%, 98.75%, 63.44% and 98.76%, respectively. The corresponding values of RESENet model were 99.34% ( P<0.001), 99.57% ( P<0.001), 99.66% ( P<0.001), 90.20% ( P<0.001) and 99.66% ( P<0.001). Conclusion:Compared with the traditional ResNetV2 model, the artificial intelligence-assisted site identification model constructed by RESENNet, a hybrid neural network, shows significantly improved performance. This model can be used to monitor the integrity of the esophagogastroduodenoscopic procedures and is expected to become an important assistant for standardizing and improving quality of the procedures, as well as an significant tool for quality control of esophagogastroduodenoscopy.

ObjectiveTo establish a rat model of diabetic wound by feeding on a high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin （STZ） and surgical preparation of full-thickness skin defects， observe the effect of cinnamaldehyde on the wound healing of diabetes rats， and explore the therapeutic mechanism of cinnamaldehyde in improving wound healing of diabetes rats based on the PTEN-induced putative kinase （PINK1）/Parkin pathway-mediated mitochondrial autophagy. MethodForty-eight male SD rats were randomly divided into blank group （n=12） and diabetes group （n=36）. The diabetes group was further randomly divided into model group， cinnamaldehyde group， and Beifuxin group， with 12 rats in each group. The blank group and the model group received routine disinfection with physiological saline after creating the wounds， while the cinnamaldehyde group received topical application of polyethylene glycol 400 （PEG 400） gel containing 4 μmol·L^-1 cinnamaldehyde， and the Beifuxin group received topical application of Beifuxin gel. Dressings were changed once daily. The wound healing rate of each group was observed. On the 7th and 14th days after intervention， the wound tissues of the rats were collected. Hematoxylin and eosin （HE） staining was performed to observe the pathological changes in the local tissues. Immunohistochemistry （IHC） was used to detect the expression of interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， vascular endothelial growth factor （VEGF）， and collagen fibers. Immunofluorescence （IF） and Real-time polymerase chain reaction （Real-time PCR） were used to detect the protein， and mRNA expression of PINK1， Parkin， microtubule-associated protein 1 light chain 3 Ⅱ （LC3 Ⅱ）. ResultAfter intraperitoneal injection of STZ， compared with the blank group， the random blood glucose values of rats in the diabetic group increased significantly （P<0.01）， all higher than 16.7 mmol·L^-1， and persistently hyperglycemic for some time after modeling. Compared with the blank group， the model group showed poor growth and healing of granulation tissue in the wounds， and the wound healing rate decreased （P<0.01）. On the 7^th day after intervention， the blank group had squamous epithelial coverage on the wounds. Compared with the blank group， the model group only had a small amount of scab at the wound edges， with a large number of infiltrating inflammatory cells in the wounds. The protein expression levels of IL-6 and TNF-α in the tissues increased （P<0.01）， and the protein and mRNA levels of PINK1， Parkin， and LC3Ⅱ decreased （P<0.01）. On the 14^th day after the intervention， the granulation tissue in the wounds of the blank group was mature and well-healed. Compared with the blank group， the model group still had infiltrating inflammatory cells and red blood cell exudation. The protein expression levels of VEGF and collagen fibers in the tissues decreased （P<0.01）， and the protein and mRNA expression levels of PINK1， Parkin， and LC3Ⅱ increased （P<0.01）. Compared with the model group， the cinnamaldehyde group and the Beifuxin group showed better wound healing， with increased wound healing rates （P<0.01）. On the 7th day after intervention， the protein expression levels of IL-6 and TNF-α in the tissues decreased （P<0.01）， and the protein and mRNA expression levels of PINK1， Parkin， and LC3Ⅱ increased （P<0.01）. On the 14th day after intervention， the protein expression levels of VEGF and collagen fibers in the tissues increased （P<0.01）， and the protein and mRNA expression levels of PINK1， Parkin， and LC3Ⅱ decreased （P<0.01）. ConclusionCinnamaldehyde can promote the wound healing of diabetes rats by increasing the wound healing rate， reducing the levels of inflammatory factors IL-6 and TNF-α， and increasing the levels of VEGF and collagen fibers. Its mechanism may be related to the regulation of the PINK1/Parkin signaling pathway， activation of mitochondrial autophagy， inhibition of inflammatory responses， and promotion of angiogenesis and collagen synthesis， thereby promoting the wound healing of diabetes rats.