Objective To investigate the effect of Qidan Tongmai tablet (QDTMT) on apoptosis and nitric oxide synthase (NOS) of ischemia/reperfusion myocardium in rats. Methods Male Sprague-Dawley (SD) rats were divided randomly into 4 groups:Sham, ischemia/reperfusion (control), QDTMT-Ⅰ (1.08 g/kg) treatment and QDTMT-Ⅱ (3.24 g/kg) treatment. Anesthetized and the open-chest animals were subjected to 40 min of myocardium ischemia followed by 4 h-reperfusion. The cardiomyocyte apoptosis was determined by terminal deoxynucleotidyl transfease-mediated dUTP nick-end labeling (TUNEL) method. The activity of NOS in heart tissue was assessed by chemical assay. Results Pretreatment with QDTMT at different doses reduced cardiomyocyte apoptosis indexes significantly compared with the control (P

Objective: To investigate the factors influencing the therapeutic effect in acupuncture treatment of apoplectic pseudobulbar palsy (PBP). Methods: Sixty patients with apoplectic pseudobulbar palsy in pattern of obstruction of wind and phlegm in the meridians were randomly divided into the treatment group and control group, to observe the therapeutic effect. Results and Conclusion: The therapeutic effect was significantly better in the treatment group than in the control group (P＜0.05). It has been found in the study that with increase in the occurrence of cerebral apoplexy, the incidence rate of severe dysphagia increased and dysphagia took place progressively earlier, indicating the importance of early treatment and prevention of cerebral apoplexy.

Objective To study the changes of oxidative stress and caspase-3 in swine with traumatic hemorrhagic shock in dry-heat environment of desert.Methods A total of 48 Landrace small swine were randomly(random number)divided into 2 groups(n=24 in each group), and then the traumatic hemorrhagic shock was established in room temperature environment and in dry-heat environmentin swine.Dry-heat environment traumatic hemorrhagic shock group (DHS), which was made in an artificial experiment cabin mimic the reality included swine exposed in the dry-heat environment of desert for 3 h (T0, n=6), T1 (50 min after shock modeling, n=6), T2 (100 min after shock modeling, n=6), T3 (150 min after shock modeling, n=6).At each interval, blood sample was collected to detect urea nitrogen (BUN) and creatinine, urine sample was collected to detect neutrophil gelatinase-associated lipoprotein (NGAL), kidney tissue samples were collected to evaluate renal morphological and tubular scores, as well as to detect catalase (CAT), superoxide dismutase (SOD) and malondialdehyde (MDA).Western blot was used to detect the level of caspase-3.Traumatic hemorrhagic shock group of room temperature environment (RTS) was established and variety of assays were carried out as same as those deteced in the dry-heat environment group.Results Compared with the room temperature environment exposed group,kidney damage index, antioxidant and caspase-3 were increased in desert dry-heat environment exposed for 3 h group, but there were no statistically significant difference(P> 0.05).And from T1 then on, the levels of NGAL, CAT and SOD in DHS groups were increased which were significant different from those in RTS group (P<0.05 or P<0.01).There were significant differences in BUN and creatinine at T2 between two groups(P<0.05).At T3, caspase-3 protein content in DHS group was significantly different from that in RTS group (P<0.01).Correlation analysis showed that the NGAL level was correlated with the levels to MDA (rRTS=0.935, rDHS =0.858, P<0.01) in RTS group and DHS group.Compared with RTS group, renal tissue under light microscope showed that Bowman appeared dilated with degeneration and exfoliated epithelial cells, proximal tubule epithelial shedding, and interstitial edema in DHS group.Electron microscope showed that mitochondria became pleomorphic, endoplasmic reticulum with fold broadening.Conclusions When traumatic hemorrhagic shock happened in the desert dry-heat environment, desert dry-heat environment can aggravate kidney damage, possibly by reducing the renal tissue antioxidant enzyme content and increase renal tissue caspase-3 activity to promote renal tissue apoptosis.Antioxidant stress and apoptosis may be an important role in the prevention of the secondary kidney injury induced by traumatic hemorrhagic shock in dry-heat environment.

Objective To investigate the predictive values of serum complement C3, C4 and cholesterol levels in the prognosis of patients with sepsis. Methods The clinical data of all the patients with sepsis admitted to the Department of Critical Care Medicine of the General Hospital of Xinjiang Military Command from January 2015 to January 2017 were retrospectively analyzed. The levels of serum complement C3, C4, cholesterol, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure score (SOFA), etc. were recorded within 24 hours after admission, the patients were divided into survival group and death group according to the 28-day prognosis, and the differences in various indexes between the two groups were compared respectively;the predictive efficacies of C3, C4 and cholesterol levels in the prognosis of sepsis patients were evaluated by plotting receiver operating characteristic curves (ROC). Results Finally, 120 patients with sepsis were enrolled, including 57 patients in the survival group and 63 patients in the death group. Compared with the survival group, the APACHE Ⅱscore and the SOFA score of the death group were increased significantly (APACHE Ⅱ score: 20.29±5.90 vs. 15.32±5.98, SOFA score: 7.62±3.11 vs. 5.16±2.50, both P < 0.01), however, serum C3, C4 and cholesterol levels were obviously decreased [C3 (g/L): 0.67±0.22 vs. 0.82±0.24, C4 (g/L): 0.17±0.05 vs. 0.20±0.06, cholesterol (mmol/L): 2.77±1.23 vs. 3.46±1.02, all P < 0.01]. ROC curve analyses showed: each of the following items, complement C3, C4, and cholesterol, alone predicting the prognosis of sepsis patients, the area under ROC curve (AUC) and 95% confidence interval (95%CI) were as follows: AUC = 0.680 (95%CI = 0.583-0.777, P = 0.001), AUC =0.657 (95%CI = 0.560-0.754, P = 0.003), and AUC = 0.711 (95%CI = 0.619-0.804, P < 0.001) respectively; when complement C3, C4 and cholesterol combination to predict the prognosis of patients with sepsis, the resulting predictive value was better than the predictive value results obtained by each one of the items or each combination of any two of them (the AUC of C3+C4+cholesterol was 0.725, 95%CI = 0.633-0.817, P < 0.001; the AUC of C3+C4 was 0.697,95%CI = 0.603-0.791, P < 0.001; the AUC of C3 + cholesterol was 0.718, 95%CI = 0.626-0.811, P < 0.001; the AUC of C4+cholesterol was 0.722, 95%CI = 0.629-0.815, P < 0.001). Conclusion Using combination of serum complement C3, C4 and cholesterol levels to predict the prognosis of patients with sepsis may obtain important predicting value, that can provide a reference to clinical doctors.

In recent years, the artificial intelligence machine learning and deep learning technology have made leap progress. Using clinical decision support system for auxiliary diagnosis and treatment is the inevitable developing trend of wisdom medical. Clinicians tend to ignore the interpretability of models while pursuing its high accuracy, which leads to the lack of trust of users and hamper the application of clinical decision support system. From the perspective of explainable artificial intelligence, the authors make some preliminary exploration on the construction of clinical decision support system in the field of liver disease. While pursuing high accuracy of the model, the data governance techniques, intrinsic interpretability models, post-hoc visualization of complex models, design of human-computer interactions, providing knowledge map based on clinical guidelines and data sources are used to endow the system with interpretability.