OBJECTIVETo investigate the short-term prognostic value of the indocyanine green clearance test when used in combination with the model for end-stage liver disease (MELD) scoring system to assess patients with hepatitis B virus acute-on-chronic liver failure (HBV-ACLF).

METHODSClinical data of 105 patients diagnosed with HBV-ACLF were retrospectively analyzed. The indocyanine green retention rate at 15 minutes (ICGR15), clinical data within 24 h after diagnosis, Child-Turcotte-Pugh (CTP) classification, MELD score, MELD combined with sodium concentration (MELD-Na) score, and King's Hospital (KCH) criteria data were collected for analysis. Measurement data were assessed by t-test and count data by the chi-square test. Short-term predictive accuracy for patients with HBV-ACLF was compared between different models using the area under the receiver operating characteristic (ROC) curve (AUC).

RESULTSThe mortality rate for all patients was 45.71%. Comparison of the survivors versus the non-survivors showed that age, total bilirubin, albumin, cholinesterase, creatinine, international normalized ratio, and incidence positive rate of relative complications (hepatorenal syndrome, hepatic encephalopathy) were significantly different between the two groups (all, P less than 0.05). The ICGR15 was found to be positively correlated with MELD score (r = 0.205, P less than 0.05). The MELD-ICGR15 model constructed by logistic regression analysis was: Logit(P) = 0.193 * MELD + 0.130 * ICGR15 - 11.256. The AUC was 0.880 and the cut-off was -0.706, with 89.6% sensitivity and 75.4% specificity. The AUC of the MELD-ICGR15 model was significantly higher than that of the ICGR15 (0.820), MELD score (0.779), MELD-Na score (0.761), KCH criteria (0.680), and CTP classification (0.631) (all, P less than 0.05).

CONCLUSIONICGR15, MELD score, and MELD-Na score had higher predictive values for HBV-ACLF than did CTP classification or KCH criteria. Furthermore, the MELD-ICGR15 model was better than any single parameter model for predicting the short-term prognosis of patients with HBV-ACLF.

Acute-On-Chronic Liver Failure ; diagnosis ; virology ; Adult ; Aged ; End Stage Liver Disease ; Female ; Hepatitis B ; complications ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Young Adult

To explore the depression in type 2 diabetic patients treated with insulin and compared to those treated with oral anti-diabetic drugs.283 type 2 diabetics were seclected randomly from outpatient and inpatient departments of endocrionology in Jiangsu Province Hospital of Traditional Chinese Medicine,with the self-designed questionnaire and Zung self-rating depression scale to conduct the survey.Comparisons between the two groups were carried out with t-test or x2 test for quantitative and qualitative data,respectively.Logistic regression were used for the analysis of the relationship between the therapeutic regimen and depression.Overall,43.1％ of the type 2 diabetic subjects showed depressive symptoms in different degrees.Compared to the oral drug group,the insulin group showed a significantly higher prevalence of depressive symptoms (insulin group,53.5％,oral drug group,30.5％;P＜0.01)and higher self-rating depression scale scores (insulin group,51.7 ± 12.4,oral drug group,44.8 ± 10.6;P＜0.01).Moreover,after an adjustment for age,sex,body mass index,diabetic duration,complications,HbA1Cand so on,the insulin group showed a significantly higher frequency of depression (OR=4.218,95％ CI 1.764-13.285,P=0.004),compared to the oral drug group.The data showed that insulin treatment is an independent risk factor to the presence of depressive symptoms in type 2 diabetics,and it is necessary to pay more attention to their psychological support.

Objective To explore the effects of cobalt chloride (CoCl2)-induced hypoxia on migration of melanoma cells, and to detect the transcription, expression and secretion of Follistatin-like 1(FSTL1) in this process. Methods B16F10 melanoma cell line was treated with CoCl2 in order to mimic hypoxia. Experimental cells were divided into three groups: 0μmol/L, 50μmol/L and 100μmol/L CoCl2 treatment groups. MTT assay was used to assure cell viability, and to determine the treatment concentration of CoCl2. Transwell assay was used to determine the migration ability of B16F10 melanoma cell line. Real-time PCR was used to measure the mRNA expression of Fstl1. Western blot assay was used to detect the intracel?lular and extracellular protein expression of FSTL1. Results The cell viability of B16F10 melanoma cell line was signifi?cantly reduced by CoCl2 treatment, with a time and concentration-dependent manner. The migration ability of B16F10 cell line was significantly increased in CoCl2 treated group compared with that of control group (P<0.05). The mRNA level of Fstl1 was obviously higher in CoCl2 treated group than that of control group (P<0.05). The intracellular expression of FSTL1 protein was consistent with the expression trend of Fstl1 mRNA. Simultaneously, the extracellular protein level of FSTL1 was significantly decreased compared with that of control group. There was no expression of FSTL1 in 100μmol/L CoCl2 treat?ment group. Conclusion The migration ability of melanoma cell line is enhanced by CoCl2 treatment, which may be associ?ated with expression and secretion of FSTL1, however, the relevant mechanism still needs further investigation.

Objective To explore the effects of different degrees of intermittent hypoxia (IH) on the activation and the secretion of extracellular matrix in MLg lung fibroblast cell line. Methods MLg lung fibroblast cells in logarithmic growth phase were exposed for 5%O2 for 100 seconds and 21%O2 for 120 seconds in 1 h, 4 h and 8 h groups (IH1, IH4 and IH8) and normoxia group (21%O2 for 8 h, N group). The cells in each group were collected at the end of experiment. Real-time PCR was used to measure the mRNA expression levels ofα-SMA and typeⅠcollagen (COL1) A1, and Western blot assay was used to detect the protein expression levels ofα-SMA and COL1. Results The mRNA and protein expression levels ofα-SMA and COL1 were significantly increased in IH1, IH4 and IH8 groups than those in N group (all P < 0.05). Furthermore, expression levels of α-SMA and COL1 showed a time-dependent increase with IH exposure time. Conclusion The intermittent hypoxia can promote the cell activation and the extracellular matrix secretion of mouse lung fibroblast cells, which may be related with the oxidative stress.

Objective To explore risk factors of depression in patients with polycystic ovarian syndrome (PCOS).Methods 142 patients diagnosed as PCOS and meeting criterions were collected from Aug.2013 to Nov.2016 in our hospital.Demographic data,menstrual status,signs,serum hormone levels,treatment were collected and recorded.The degree of depression was evaluated by Hamilton Depression scale (HAMD).They were divided into two groups:depression and non-depression group.Univariate x2 test and multivariate logistic regression analysis were used to explore risk factors for complicating depression in patients with PCOS.Results Depression occurred in 44 patients (30.98％),with 28 cases of mild depression,14 cases of moderate depression,and 2 cases of severe depression.Univariate x2 test revealed that BMI (x2=4.385,P=0.036),infertility (x2=8.367,P=0.004),LH/FSH (x2=4.592,P=0.032) and serum levels of FT (x2=5.777,P=0.016) were factors related to depression.Multivariate logistic regression analysis revealed that BMI＞25 kg/m2 (OR=12.874,95％ CI:1.675～75.824,P=0.013),infertility (OR=17.526,95％ CI:1.436～94.335,P=0.008),LH/FSH＞2 (OR=7.326,95％ CI:1.263～43.128,P=0.021) and abnormal FT (OR=9.724,95％ CI:3.625～56.524,P=0.016) were risk factors of depression.Conclusions Patients with PCOS have mild or moderate depressive tendencies.BMI＞25 kg/m2,infertility,LH/FSH＞2,abnormal FT were the risk factors of depression.

Objective To investigate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) by combination use of lobaplatin and arsenic trioxide in treating primary hepatocellular carcinoma (PHC) in elderly patients.Methods Based on the different medication program,a total of 95 PHC patients,whose liver function belonged to Child-Pugh A or B grade (middle-late stage PHC) or who suffered from early-stage PHC and were unwilling to undergo surgical treatment,were divided into the observation group (n=48) and the control group (n=47).TACE was performed in all patients of both groups.Lobaplatin (40 mg/m2) and arsenic trioxide (10 mg/m2) were adopted for patients of the observation group,while arsenic trioxide (10 mg/m2) was employed for patients of the control group.TACE was carried out once every 6 weeks.The objective response rate (ORR),disease control rate (DCR),the median progression free survival time (mPFS) and the incidence of adverse reactions of both groups were analyzed.Results The ORR of the observation group and the control group was 50.0％ and 48.9％ respectively,and the difference was not statistically significant (P＞0.05).The DCR of the observation group and the control group was 85.4％ and 80.9％ respectively,and the difference was not statistically significant (P＞0.05).The mPFS of the study group and the control group was 9 months and 6 months respectively,and the difference was statistically significant (P＜0.001).The main adverse reactions in the two groups were nausea,vomiting,fever,elevation of aminotransferase,etc.,but the differences between the two groups were not statistically significant (P＞ 0.05).Conclusion For the treatment of PHC in elderly patients,TACE by combination use of lobaplatin and arsenic trioxide can prolong mPFS,and the adverse reactions can be well tolerated by patients.This therapeutic regimen may be a better treatment means for PHC in elderly patients.However,large sample randomized and controlled studies are needed to further confirm its curative effect before it can be reliably used as a routine clinical medication regimen.

BACKGROUND:As a common clinical digestive disorder,irritable bowel syndrome becomes an advantageous disease of acupuncture treatment.However,the therapeutic mechanisms remain unclear.The methodological characteristics of omics coincide with the multi-target and multi-level characteristics of acupuncture,providing the possibility of revealing the principle of acupuncture in the treatment of the disease. OBJECTIVE:To investigate the pathogenesis of irritable bowel syndrome with diarrhea(IBS-D)and the effect of acupuncture at the combined points(selected based on etiologies and symptoms)on IBS-D based on proteomics. METHODS:Twelve 3-month-old male Sprague-Dawley rats were randomly divided into three groups:a control group,an IBS-D model group and an acupuncture group.The IBS-D rat models were prepared using the CAS method.After successful modeling,bilateral Zusanli points,bilateral Neiguan points and Guanyuan points were selected for acupuncture treatment in the acupuncture group,with a frequency of 120 times/minute,1 minute of acupuncture every 4 minutes,and 15 minutes of needle retention,at an interval of 1 day every 6 days,for 28 days in total.Rats in the normal control group and the model group were not given any intervention.The pressure threshold of rat abdominal retraction reflex was measured to evaluate the visceral hypersensitivity of rats.Proteomics analysis was performed using the liquid chromatography-tandem mass spectrometry-based platform.MaxQuant software,Perseus software and DAVID,KOBAS,VENNY,STRING online tools were used for the bioinformatics analysis of proteomic data.Visualization analysis was done using Cytoscape 3.7.1 software. RESULTS AND CONCLUSION:There were 47 differentially expressed proteins between the IBS-D model and control groups.Function analysis of differentially expressed proteins revealed that the pathogenic mechanism of IBS-D was associated with abnormal energy metabolism,the imbalance of colon motor function and increased visceral sensitivity.Important proteins related to IBS-D pathogenesis included Atp5a1,Atp5c1,Idh3b,Atp2a3,Pdhb,Ppp1ca and Mapk3.Sixty-one differentially expressed proteins were identified between the acupuncture group and IBS-D model group.Acupuncture at the combined points reversed the up-regulation of nine differentially expressed proteins and the down-regulation of nine differentially expressed proteins.Bioinformatics analysis revealed that acupuncture at the combined points for IBS-D could function via multi-targets and multi-pathways,reverse the damage of energy metabolism caused by IBS-D,and play a role against oxidative stress and inflammation,thereby relieving pain and regulating the imbalance of intestinal function.Important proteins related to acupuncture effects included Atp5a1,Atp5c1,Pdhb,Sars,Uqcrc2,Prdx2,Prdx4,Ppp1ca,Manf and Tmsb4x3.All these findings preliminarily illustrate the potential molecular mechanisms of IBS-D and the effect of acupuncture at the combined points in the treatment of IBS-D at the protein level,which provide a basis for the clinical application of acupuncture at the combined points.

To determine the contents of oxypeucedanin, oxypeucedanin hydrate, byakangelicol and byak-angelicin both before and after Angelicae Dahuricae Radix was stewed with yellow rice wine by high-performance liquid chromatography, and study the mutual transformation mechanisms of oxypeucedanin into oxypeucedanin hydrate, as well as byakangelicol into byak-angelicin. The research results indicated that the contents of oxypeucedanin and byakangelicol were decreased, but the contents of oxypeucedanin hydrate and byak-angelicin were increased after Angelicae Dahuricae Radix was processed with yellow rice wine. The contents' changes of these chemical compounds were due to the ring opening reaction of epoxy compounds, such as oxypeucedanin and byakangelicol under the weak acidity and heating conditions of yellow rice wine. This research could provide a scientific basis for the processing mechanism of Angelicae Dahuricae Radix with yellow rice wine stewing.

Objective To observe the electromyography characteristics of children's handwriting with attention deficit hyperactivity disorder(ADHD),and explore its electrophysiological mechanism,so as to provide an objective basis for developing non-pharmacological treatment for such children.Methods Between September 2021 and April 2022,29 ADHD children were recruited from an ordinary public primary school and the psychiatric clinic of a class-3 grade-A hospital in Beijing.Among them,25 were boys and 4 were girls,with an average age of 8.21±1.78 years.Meanwhile,23 male and 5 fe-male healthy counterparts were selected with the age gap no more than 6 months.The Delsys wireless surface EMG system was used to collect the electromyographic signals of the abductor pollicis breve,the first dorsal interosseous muscle,the flexor radial carpi motor and the extensor finger muscles dur-ing their writing tasks such as tracing trajectories,writing Arabic numerals 0-9,26 small and capital English letters,Chinese characters one to ten and"Yong".The percentage of the averaged electromyog-raphy(AEMG)of a muscle in the sum value of all measured muscles,and the coefficient of differ-ence were selected to evaluate the muscle contribution rate and the consistency of exertion,respective-ly.Moreover,the independent sample t-test was employed to compare the two different groups with the significance set at α=0.05.Results There was a significant difference in the muscle contribution of abductor pollicis breve and first dorsal interosseous muscles when writing Arabic numerals and that of abductor pollicis breve muscles when writing Chinese characters between ADHD children(27.29%,25.58%and 27.53%)and their healthy counterparts(42.87%,19.96%and 37.13%)(P<0.05).Most muscle differentiation coefficients of ADHD children were higher than 100%,with that of the domi-nant hand radial wrist flexor muscle reaching 270%in the trajectory tracing task.Conclusion Accord-ing to the characteristics of EMG signals,school-age ADHD children show an immature writing pat-tern,including poor stability of writing-related muscles,insufficient control of small finger muscle groups,poor control of hand coordination,and insufficient muscle inhibition of non-dominant hand.It is recommended to conduct the electromyoelectric assessment of handwriting movements in ADHD chil-dren,so as to carry out targeted intervention at an early stage.

Objective: To build a comprehensive information system of radiological health in Shanghai and provide basic data for prevention and control of radiation hazards factors. Methods: A management information platform of radiological health suitable for Shanghai was constructed by sorting out the historical archives and records, combining with content of current work, and using the information platform in China for reference. All Institutions are responsible for the collection and input of the data generated in the work, and the system judges the nature of the data according to the rules, and then completes the interactive analysis of the data with the municipal platform according to the standards, which forms the three-level platform management mode of the city, districts and medical institutions. Results: Data module platform covering health records, environmental monitoring, business warning and statistical reports was built in one year since its preliminary inception in 2014. In the beginning there were only 468 usersof institutions, and by the end of 2018, about 1 241 users were active. Nearly 300 000 pieces of data were collected. Conclusions The construction of comprehensive management information platform of radiological health in Shanghai promotes the standardization and effectiveness of radiological health information management, provides a monitoring model for sustainable long-term development, and provides basic data for further policy management or decision-making.