AIM: To investigate effect of naringenin on ADP-induced platelet aggregation and its possible mechanism.METHODS: The levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were measured in the platelets with ADP stimulation using ELISA in the presence or absence of different concentrations of naringenin.The effect of naringenin at different concentrations on the change of phosphodiesterase (PDE) activity was measured by high efficiency liquid chromatography.The effects of naringenin at different concentrations on phosphorylation of vasodilator-stimulated phosphoprotein (VASP) at positions Ser157 and Ser239 in washed platelets with ADP stimulation were analyzed by Western blot.The phosphorylation of VASP at Ser239 was also analyzed in the presence of protein kinase A (PKA), protein kinase G (PKG), or protein kinase C (PKC) inhibitors before incubation with naringenin.The platelet aggregation was measured in the presence of PKA or PKG inhibitors before incubation with naringenin.RESULTS: Naringenin elevated cGMP levels significantly but not cAMP levels in the platelets with ADP stimulation in a dose-dependent manner.Naringenin inhibited PDE activity.Naringenin increased the phosphorylation of VASP at Ser239 in a dose-dependent manner in the platelets with ADP stimulation but only modest changes in the phosphorylation at position Ser157.The phosphorylation level of VASP at Ser239 position was inhibited when the platelets were treated with PKA inhibitor before incubation with naringenin.Incubation of platelets with neither PKG nor PKC inhibitors before treatment with naringenin affect the phosphorylation of VASP at Ser239.Pretreatment with PKA inhibitor but not PKG inhibitor significantly reversed the antiplatelet aggregation by naringenin in ADP-stimulated platelets.CONCLUSION: Naringenin may inhibit platelet activation through the elevation of cGMP-and PKA-mediated VASP phosphorylation.

AIM: To investigate the antiplatelet aggregation of naringenin and its possible mechanism . METHODS:The effects of naringenin at different concentrations on adenosine diphosphate ( ADP)-induced platelet aggre-gation and platelet spreading on immobilized fibrinogen were detected by aggregational detector and observed under fluores -cence microscope, respectively.The expression of phosphoinositide 3-kinase (PI3K) and the phosphorylation of Akt were analyzed by Western blot .RESULTS:Naringenin significantly inhibited ADP-induced platelet aggregation in a dose-de-pendent manner in vitro and in vivo, and inhibited platelet ' s spreading on immobilized fibrinogen in vitro.Further studies indicated that naringenin inhibited platelet activation accompanied by attenuating not only the activation of PI 3K, but also the phosphorylation of Akt .Moreover, naringenin combined with LY294002 additively inhibited the ADP-induced platelet aggregation.CONCLUSION:Naringenin may inhibit platelet activation by regulation of PI 3K/Akt signaling pathway.

Objective To systematically assess the clinical efficacy and security of Wendan Decoction in the treatment of dyslipidemia. Methods Retrieved from CNKI, CBM, VIP database, Wanfang Database, and PubMed, articles of RCTs about Wendan Decoction in the treatment of dyslipidemia were included. The searching range was from the establishment of the database to April, 2016. NoteExpress3.2.0 was used to establish database. Two researchers independently screened the articles and extracted the data. Cochrane Systematic Review Manual 5.1.0 was used for quality evaluation. Meta-analysis was performed with RevMan5.3 software. Results 12 articles involving 848 patients were included. Results of Meta-analysis showed that compared with the western medicine treatment, Wendan Decoction group was more capable of significantly improving clinical effective rate of dyslipidemia [OR=2.46, 95%CI (1.41, 4.30), P=0.001], lowering the level of TG [WMD=-0.31, 95%CI (-0.46, -0.15), P=0.0001] and LDL-C [WMD=-0.25, 95%CI (-0.30, -0.20), P=0.00001], but there was no statistical significance in regulating TC [WMD=-0.14, 95%CI (-0.35, -0.08), P=0.49] and HDL-C [WMD=0.04, 95%CI (-0.01, -0.1), P=0.13] between the two groups; compared with the western medicine group, Wendan Decoction combined with western medicine group was more capable in the clinical effective rate of dyslipidemia (P<0.05), regulating the level of TG [WMD=0.30, 95%CI (-0.37, -0.23), P=0.00001], TC [WMD=0.65, 95%CI (-0.80, -0.69), P=0.00001], LDL-C (P<0.05, P<0.01) between the two groups; Wendan Decoction combined with western medicine group had low rate of adverse reactions. Conclusion Wedan Decoction can effectively regulate dyslipidemia, with good safety. High quality RCTs in large-scale and multi-center are necessary for further evidence due to the poor methodological quality of included trials with few samples and other limitations.

Objective To investigate the effect of miRNA-200b-specific inhibitor on hepatic stellate cells(HSCs) activation,proliferation,and extracellular matrix production.Methods The miRNA-200b-specific inhibitors were designed,synthesized,and transfected into HSCs with lipofectamine 2000.The supernatant and HSCs were collected after incubation for 48 h.The expression of miR-200b was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR).The expression ofα-smooth muscle actin (oα-SMA) protein in HSCs was detected by Western blotting.The cell proliferation was assayed by methyl thiazolyl tetrazolium (MTT) method.Contents of type Ⅲ procollagen and hyaluronic acid in supernatant were determined by radioimmunoassay.Results Compared to the control group,miRNA-200b expression was decreased in the miRNA-200b inhibitor group by 82％ (P ＜ 0.01),α-SMA protein expression was reduced in the miRNA-200b inhibitor group by (19 ± 3) ％ (P ＜ 0.05),and the activity of HSCs proliferation was reduced by(33 ± 5)％ (P ＜0.01),and the contents of type Ⅲ procollagen and hyaluronic acid in supernatant were reduced in miRNA-200b inhibitor group by (35 ± 4)％ and (31 ± 2)％,respectively(P ＜0.01).Conclusions The miRNA-200b-specific inhibitor could significantly reduce the expression of miRNA-200b,and inhibit HSC proliferation,activation,and extracellular matrix production.

Objective To summarize the stomach via laparoscopic and natural orifice transluminal endoscopic surgery (NOTES) Clinical application of abdominal exploration and peritoneal biopsy unexplained ascites. Methods A retrospective analysis of our hospital clinical datum of unexplained ascites patients, 20 cases were undergone single port laparoscopic operation from January 2014 to October 2015 and 11 cases were undergone NOTES from May 2015 to July 2016. Operation time, hospitalization expenses, intraoperative bleeding, postoperative hospital stay, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were compared in tow groups. Results Laparoscopy group 20 cases, 11 cases diagnosed as tuberculous ascites, 8 cases malignant ascites, 1 case was still unknown;NOTES group 11 cases, 9 cases diagnosed as tuberculous ascites, 1 case malignant ascites and 1 case liver cirrhosis. In two groups, 30 cases were accurate diagnosed (96.8%), tuberculous ascites 20 cases (64.5%), malignant ascites nine cases (29.0%). Laparoscopy group compared with NOTES group, operation time was longer and hospitalization expenses was more, there were statistical signiifcant differences (P<0.05);postoperative hospital stays were higher (P < 0.05); intraoperative bleeding, postoperative abdominal pain score, fever and leukocyte on the 3rd postoperation were no statistical difference (P>0.05). Conclusion The two methods were able to quickly and accurately diagnose ascites reason, in order to facilitate treatment and surgical trauma, less serious complications. Comparison of laparoscopy, NOTES may be more advantageous in ascites diagnosis.

OBJECTIVE: To investigate the correlation betwen varying degrees of non-acute tinnitus and anxiety and depression. METHOD: Seventy-seven outpatients with non-acute tinnitus as their in chief complaint were submitted to Tinnitus Handicap Inventory(THI), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale (SDS). RESULT: THI and its three subscales were found to have significant correlations with SAS and SDS. The group (THI ≥ 38) had more anxiety and depression than the mild (THI < 38). Significant correlations were also observed between THI, SAS and SDS in the group with THI ≥ 38, in contrast with the group of THI < 38. CONCLUSION Patients with THI ≥ 38 suffered from severe anxiety and depression than the mild. Doctors should pay more attention to these patients, especially their psychological disorders.
Anxiety ; complications ; Depression ; Depressive Disorder ; Humans ; Personality Inventory ; Stress, Psychological ; Surveys and Questionnaires ; Tinnitus ; complications ; psychology

Objective To explore the clinical value of transgastric natural orifice transluminal endoscopic surgery(NOTES)in diagnosing unexplained ascites.Methods The clinical data in 12 cases of unexplained ascites diagnosed by adopting transgastric approach NOTES and performed abdominal exploration and peritoneal biopsy in our hospital from November 2015 to July 2016 were retrospectively analyzed.The operative risk and clinical application value were evaluated by statistically analyzing the postoperative complications occurrence and the diagnosis rate of disease.Results The definite diagnosis rate reached 100％ verified by pathology after abdominal exploration and peritoneal biopsy,in which 8 cases(66.7％)were tuberculous peritonitis,2 cases(16.7％)were liver cirrhosis,1 case(8.3％)was peritoneal mesothelioma,1 cases(8.3％)was peritoneal metastatic carcinoma;2 cases appeared abdominal pain after operation,including 1 case of neutrophil ratio increase,symptoms and persistent time of abnormal laboratory indexes did not exceed 24 h,the incidence rate was 8.3％;no complications of abdominal cavity infection,incision bleeding and puncture site fistula occurred.Conclusion The transgastric NOTES for conducting abdominal exploration and peritoneal biopsy in the diagnosis of unexplained ascites has the advantages of small trauma,less complications and rapid postoperative recovery,possesses an important clinical application value.

Clinical phenotype and gene characteristics of a patient diagnosed with Imerslund-Gr?sbeck syndrome (IGS) in Department of Neurology, Children′s Hospital of Soochow University in December 2018 were analyzed retrospectively, and literature review was conducted.The 16 years and 5 months old boy was admitted to the hospital with symptoms of weakness of lower limbs for 2 weeks.He had a history of megaloblastic anemia and isolated proteinuria.Genetic metabolism of hematuria showed methylmalonic academia.Genetic analysis revealed a compound heterozygous AMN gene mutation[c.742C>T(p.Q248 *) and c. 761G>A(p.G254E)]. These two mutations were derived from his parents respectively, which had been reported before.Symptoms of the patient improved after intramuscular administration of hydroxycobalamin and oral betaine.Review of the literature indicated that the clinical manifestations of AMN gene-related IGS were mostly megaloblastic anemia and isolated proteinuria, and the older children might suffer from neurological symptoms such as movement disorders, dementia, delirium or psychosis.The clinical phenotype of this disease was variable, which might easily lead to misdiagnosis.The patient presented with a special phenotype of mild reversible peripheral neuropathy, which expanded the clinical phenotype of pathogenic genes of AMN gene.In addition, peripheral neuropathy caused by vitamin B 12 metabolic disorders is reversible, and it is suggested to measure vitamin B 12, test related genes and treatment with vitamin B 12 in peripheral neuropathy of unknown etiology.

Objective:To explore the effect of homemade aromatic masks on nausea, vomiting and pain in non-small cell lung cancer patients with chemotherapy.Methods:From October 2018 to August 2019, convenience sampling was used to select 82 patients with non-small cell lung cancer admitted to the 900th Joint Logistic Support Unit of the People's Liberation Army of China. All patients were randomly divided into control group and experimental group, each with 41 cases. Control group carried out the routine care, and experimental group was treated with the homemade aromatic mask on this basis. The Chinese version of Index of Nausea and Vomiting and Retching (INVR) and the Brief Pain Index (BPI) were used to compare nausea, vomiting and pain indicators of patients between two groups during chemotherapy.Results:On the third day of chemotherapy, the total score of nausea and vomiting, and the average pain score of experimental group were (11.00±5.46) and (1.63±1.14) respectively, lower than those of control group, and the differences were statistically significant ( t=-6.635, -4.781; P<0.01) . Conclusions:The homemade aromatic mask can relieve chemotherapy-induced nausea and vomiting in non-small cell lung cancer patients with chemotherapy, and reduce the pain of patients.

Objective To explore the effects of case management on the stigma and coping style of discharged patients with bipolar disorder.Methods During October 2012 to October 2015, 116 cases of patients with bipolar disorder in our hospital were selected as the research object. Patients were randomly di-vided into the control group and the observation group, with 58 cases in each group. Patients in two groups were given routine nursing care, and patients in the observation group also received case management. The scores of stigma, coping style and quality of life (QOL) of patients between two groups before and after intervention were compared.Results After intervention, the scores of social contact, ability and treatment of stigma scale in the observation group were (12.75±3.05), (9.53±2.28) and (11.13±2.45), and they were all significantly lower than the control group (t=2.396,2.504,2.559;P<0.05). After intervention, the scores of solving problems, self-accusation, seeking help, fantasy, avoidance and rationalization of coping style scale in the observation were (8.02±3.06), (3.11±2.16), (6.13±2.62), (3.05±2.24), (4.09±2.06) and (6.61±3.28), and they were significantly better than those in the control group (t=2.573,2.537,2.186,2.389,1.996,2.557;P<0.05). After intervention, the total QOL health score of patients in the observation (56.87±17.13) was significantly better than (53.83±16.46) in the control group (t=2.279,P<0.05).Conclusions The case management can significantly reduce the stigma of patients with bipolar disorder, and improve the coping style and QOL of patients, so it can be further promoted and used.