Objective To observe the effect of acupuncture plus rehabilitation on the development quotient in patients with mental retardation (MR) and its therapeutic efficacy by using the Neural and Mental Development Check List for Children Aged 0-6. Method Sixty MR patients were divided into a treatment group and a control group by the random number table, 30 cases in each group. The treatment group was intervened by acupuncture plus rehabilitation training, while the control group was by rehabilitation alone. The improvement of development quotient and therapeutic efficacy were evaluated after 3 treatment courses. Result The improvement of development quotient in the treatment group was more significant than that in the control group; the total effective rate was 83.3% in the treatment group versus 73.3% in the control group, and the difference was statistically significant (P<0.05). Conclusion Acupuncture plus rehabilitation training can produce a more significant efficacy than rehabilitation alone in treating MR.

Purpose To investigate the mutation status of KRAS and PIK3CA gene in colorectal cancer (CRC) primary lesions and corresponding liver metastasis and its clinical significance.Methods The gene mutations of KRAS and PIK3CA were detected in 58 cases of primary lesions of CRC and corresponding liver metastasis tissue by real-time PCR.Results The mutation rates of KRAS were 31.03％ (18/58) and 25.86％ (15/58) in primary lesions of CRC and corresponding liver metastasis tissue,respectively,in which G12D was most commonly detected.The mutation rates of PIK3CA were 8.62％ (5/58) and 10.34％ (6/58) respectively,in which the most common mutation site was E545K.Only one case carried simultaneously both mutations of KRAS (G12D) and PIK3CA (E545K).The mutation of KRAS and PIK3CA had a good consistency between primary lesions and liver metastasis.Univariate analysis showed that the mutation of KRAS was related to the primary lesion of tumor location,the quantity of metastasis and the types of tumor (P ＜ O.05),PIK3 CA mutation was associated with the synchronous/metachronous liver metastasis and the quantity of metastasis (P ＜ 0.05).Multivariate Cox regression analysis showed that synchronous/metachronous liver metastasis and the mutation of KRAS were influencing factors for prognosis of CRC.The overall survival of patients with CRC who had simultaneous liver metastases was longer than those with heterotopic liver metastases;the overall survival of KRAS wild-type mutant patients was longer than those of mutant patients (P ＜ 0.05).Conclusion The G12D site of KRAS gene has the highest mutation frequency in CRC,KRAS/PIK3CA mutation has a good consistency of the primary lesions of CRC and corresponding liver metastasis.Primary lesions can be as the source of molecular detection.To achieve individualized treatment,we need to reassess the genetic status of metastasis based on the choice of targeted therapy for precision medicine.

Objective:To determine the role of lncRNA TUG1 in pancreatic β cells functioning both in vitro and in vivo.Methods:The lncRNA TUG1 expression in mice pancreas,brain,muscle and other different tissues was examined through qRT-PCR.MTT,flow cytometry,GSIS,ELISA and immunochemistry analyses were performed to detect the effect of lncRNA TUG1 on insulin secretion in vitro and in vivo.Results:lncRNA TUG1 was highly expressed in pancreatic tissue compared with other organ tissues.Knockdown of lncRNA TUG1 expression resulted in decreased insulin secretion in β cells both in vitro and in vivo.Immunochemistry analyses showed decreased relative islet area after treatment with lncRNA TUG1 siRNA.Conclusions:Downregulation of lncRNA TUG1 expression can affect insulin secretion in pancreatic β cells in vitro and in vivo,and lncRNA TUG1 may represent a factor that regulates the function of pancreatic β cells.

This paper summarizes the experiences of nursing care of five patients with stoma after small bowel allotransplantation. The nursing care focused on observation of the survival,motility,secretion and other functions of early transplanted bowel,preparation and cooperation for colonoscopy,stoma care during enteral nutritional support,observation of the digestion,absorption and rejection of transplanted bowels. The five patients survived after operations. The stoma of transplanted bowels was ruddy and had a good circulation without complications such as rupture of skin around stoma. The patients gradually restored the normal diet by mouth.

Objective To evaluate the reproducibility of macular ganglion cell layer(GCL)measurements with high?resolution spectral domain?optical coherence tomography(SD?OCT)in both normal people and glaucoma patients. Methods In this study,24 normal subjects and 21 glauco?ma patients were prospectively included. Macular GCL thickness in 9 areas defined by Early Treatment Diabetic Retinopathy Study was measured with Spectralis SD?OCT applying posterior pole asymmetry analysis pattern. Within?subject standard deviation(Sw),coefficient of variation(CV) and intraclass correlation coefficient(ICC)in normal subjects and glaucoma patients were assessed. Results In normal subjects,the GCL thick?ness in macular central area was 12.58±2.69μm,the average GCL thickness in inner ring area was 48.87±3.81μm,the average GCL thickness in outer ring area was 37.28±1.75μm,and the GCL thickness mapping in normal subjects was horseshoe?shaped with opening to temporal. In glauco?ma patients,the GCL thickness in central area was 9.57±2.06μm,the average GCL thickness in inner ring area was 34.70±9.67μm,the average GCL thickness in outer ring area was 28.20±5.51μm,and the GCL thickness in every macular area in glaucoma eyes was thinner than that in normal eyes(P<0.001). For measurements of GCL thickness in normal subjects,Sw was 0.46 to 0.87μm,CV was 0.67%to 3.71%,and ICC was 0.904 to 0.977. For measurements of GCL thickness in glaucoma patients,Sw was 0.53 to 1.65μm,CV was 1.18%to 5.75%,and ICC was 0.833 to 0.993. Conclusion Spectralis SD?OCT had an excellent reproducibility for measurements of GCL thickness in both normal people and glaucoma patients, which is a reliable technique for evaluating longitudinal change and follow?up in glaucoma.

Objective To investigate the diagnostic value of twinkling artifact in urinary calcium stones.Methods Calcium oxalate monohydrate,hydroxyapatite and whitlockite stone phantoms were prepared and embedded in porcine kidneys for ultrasound scanning.The length and width of twinkling artifact were measured.The intensity of twinkling artifact and the contrast-to-noise ratio (C/N ratio) of acoustic shadowing were recorded and all the data was analyzed statistically.Results All the stone phantoms generated twinkling artifact and acoustic shadowing.The difference of the intensity,length and width of twinkling artifact and the C/N ratio of acoustic shadowing had statistically significant each composition (P ＜0.01).There was no overlap between 95％ confidence interval of the intensity of twinkling artifact for any two compositions,and any two compositions of stones could be differentiated by the intensity of twinkling artifact (P ＜0.05).The C/N ratio of acoustic shadowing of calcium oxalate monohydrate and whitlockite stone phantoms were higher than those of hydroxyapatite ones (P ＜0.05).The receiver operating characteristic (ROC) curve displayed that the cutoff value of 1 127 of the intensity of twinkling artifact could be used to diagnose hydroxyapatite stones.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and area under the curve (AUC) were 74 ％,68 ％,69.8％,72.3％ and 0.743 respectively.Conclusions Twinkling artifact could be used to differentiate the calcium stones,which will be helpful for clinical treatment.

Objective To quantitatively analyze the value of color Doppler twinkling artifact and CT in distinguishing urinary stone composition of uric acid from that of cystine,and to assess the ability of color Doppler twinkling artifact and CT to diagnose urinary stone composition of uric acid.Methods Artificial stones made of uric acid and cystihe were inserted in porcine kidneys respectively.Color Doppler ultrasound and CT scanning were performed in vitro and twinkling artifact videos were recorded.The CT attenuation value,the width and length of twinkling artifact (TAW,TAL) were measured.The color pixels representing twinkling artifact intensity (TAI) were calculated.The differences between artificial cystine and artificial uric acid stones in TAW,TAL,TAI and CT attenuation value were compared.The receiver operating characteristic (ROC) curve was used to assess the ability of TAW,TAL,TAI and CT attenuation value to diagnose urinary stone composition of uric acid.Results The TAW [(4.16 ± 1.54)mm vs (4.97 ± 1.93)mm],TAL[(3.75 ± 1.05)mm vs (5.12 ± 2.51)mm] and TAI [(3 005.50 ± 812.33) vs (5 433.86±2 505.81)] of artificial cystine stones were less than those of artificial uric acid stones while the CT attenuation value of artificial cystine stones [(573.75 ± 110.10)HU vs (364.09 ± 67.28)HU] were greater (P ＜0.05).The ROC curve was displayed to diagnose urinary stone composition of uric acid,and the area under curve of CT attenuation value was bigger than that of TAI (0.936 vs 0.817,Z =2.308,P =0.021).Combination of color Doppler twinkling artifact and CT value would dramatically increase the diagnostic accuracy to 98％.Conclusions Both color Doppler ultrasound and CT were reliable examinations for distinguishing urinary stone composition of cystine from that of uric acid.Combination of color Doppler ultrasound and CT would be good references to diagnose urinary stone composition of uric acid.

Objective:To analyze the epidemiological features of geriatric humeral surgical neck fractures from 2010 through 2019 in The Third Hospital of Hebei Medical University.Methods:A retrospective study was conducted of the data of the inpatients aged ≥60 years who had been treated for humeral surgical neck fractures in The Third Hospital of Hebei Medical University from 2010 through 2019. The patients were divided into 2 groups by the year of admission: the former five-year group (group A from January 1, 2010 to December 31, 2014) and latter five-year group (group B from January 1, 2015 to December 31, 2019). The data of the patients were compared between the 2 groups to find the epidemiological characteristics and trends of the humeral surgical neck fractures in the 10-year period.Results:A total of 312 geriatric humeral surgical neck fractures were included, accounting for 1.2%(312/25, 764) of the upper limb fractures and 0.4% (312/88, 886) of all the fractures in the same period. There were 64 males and 248 females, giving a male/female ratio of 0.26∶1. Their ages ranged from 60 to 93 years. The peak age of the fractures was from 60 to 69 years for both males and females. Falls and indoor activity injuries accounted for the largest proportion (71.2%, 222/312). The common fracture types were 11-A2 and 11-A3. The proportion of overweight and obese patients by the body mass index (BMI) was the largest (58.7%, 183/312). There were no statistically significant differences between groups A and B in male/female ratio (0.37:1 versus 0.22:1) or in proportion of peak age patients [42.7% (38/89) versus 55.2% (123/223)] ( P>0.05). There were statistically significant differences between the 2 groups in injury causes, fracture types and BMI distribution ( P<0.05). Conclusions:The geriatric humeral surgical neck fractures accounted for 1.2% of the upper limb fractures and 0.4% of all the fractures in the same period. There were more female patients than male ones. Falls and indoor activity injuries were the most common causes. The proportions of complex fractures and overweight and obese patients increased.

AIM To study the chemical constituents from Nepeta angustifolia C.Y.Wu.METHODS The ethyl acetate fraction of N.angustifolia 70％ ethanol extract was isolated and purified by silica,Sephadex LH-20,ODS and semi-preparative HPLC column,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Ten compounds were isolated and identified as oleanolic acid (1),betulinic acid (2),ursolic acid (3),3-sitosterol (4),angelicin (5),bakuchiol (6),blumenol C glucoside (7),psoralen (8),methyl rosmarinate (9),hesperidin (10).CONCLUSION Compounds 5-8are isolated from genus Nepeta for the first time,compounds 1,4-10 are first isolated from this plant.

Objective To explore the bioeffect of different parameters on 4 cell lines by ultrasoundmediated microbubble destruction.Methods The orthogonal experimental design was used to investigate the effect of three factors on the bioeffects of four cell lines under three levels.Three factors included microbubble concentration,sound intensity,irradiation time.Human breast tumor (MCF-7) cells,ovarian tumor (A2780) cells,liver tumor (Bel7402) cells and thyroid tumor (ARO) cells were exposed to ultrasound in the presence of SonoVue.The cell survival rate was determined by MTT methods and the cell luminosity factor was detected by flow cytometry.Results The optimum parameters for Bel7402 and ARO cell were the same (A2B3C2),and they were different from those from MCF-7 (A3B1C1) and A2780 (A1B3C3) cell.The cell survival rates for 4 cell lines were above 75％,and the cell luminosity factors were different among 4 cell lines.Conclusions The optimum parameters by ultrasound-mediated microbubble destruction for different cell lines are different,and under the optimum parameters the bioeffects of different cell lines are different.