Background and purpose:Literature report of treatment and prognosis in gastrointestinal stromal tumors(GIST) with hepatic metastasis and recur rent metastasis was rare, This study was to discuss the clinicopathological characteristics and the situation of treatment and prognosis in GIST with hepatic metastasis and recurrent again metastasis. Methods:We reviewed two cases of GIST with hepatic metastasis reported from our hospital, and comprehensively analysed the related literature. Results:Two cases of GIST with hepatic metastasis in our hospital were analysed: one case of primary intestinel tumor,13 years after the treatment of the patient was diagnosed with hepatic metastasis. After operation, the patient accepts imatinib mesylate therapy for 400 mg per day and gave up one and a half month later because of serious side reactions. 1 year 10 months later, the patient was diagnosed with liver, kidney, peritoneum and diaphragm metastasis again, after excised lesions the patient continued to accept Imatinib therapy, and persisted takes about 8 months until now. The primary tumor of recowd case came from greater omentum, 2.5 years later after primary tumor excised hepatic metastasis occured, after operation the patient accepted Imatinib therapy for 400 mg per day, until now 15 months. Two cases followed respectively until now was 2.5 and 1.5 years, without recurrence or metastasis again, all are surviving. Conclusions:The patients of GIST with hepatic metastasis and recurrence again, by suitably lengthened Imatinib therapy cycle after the excision of the lesions, it is still to be possible to obtain the good curative effect .

Objective To investigate the effects of tetanic stimulation of peripheral nerve on intracranial direct electrical stimulation motor-evoked potentials (MEP) in patients undergoing cerebral functional area operation. Methods Eight patients undergoing elective brain tumor resection under propofol-fentanyl anesthesia with partial neuromuscular blockade were enrolled in the study. Both conventional MEP (C-MEP) monitoring and posttetanic MEP (P-MEP) monitoring were performed throughout the operation for each patient, and the two groups of data were recorded. For one group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the abductor pollicis brevis, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA, duration 5 s) to the ipsilateral tibial nerve.For the other group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the tibialis anterior, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA and duration 5 s) to the contralateral tibial nerve. Randomized crossover method was used for C-MEP and P-MEP recording in each group, with an interval of 120 s. The adverse effects were observed. Results Amplitudes of P-MEP from the abductor pollicis brevis and tibialis anterior were significantly higher than those of C-MEP. Three patients had body movement during intraoperative cortex stimulation, while there was no awareness during operation and other electrical stimulation-related nervous system impairment and complications. Conclusion The application of tetanic stimulation of peripheral nerve before direct electrical stimulation can augnent the amplitudes of MEP from the abductor pollicis brevis and tibialis anterior in patients undergoing cerebral functional area operation.

AIM: To study the effect of ligustrazine on the cardiacmyocyte lesion in rats with type 2 diabetes mellitus.METHODS: Male Wistar rats were injected with STZ via tail vein under high-glucose and high-fat feeding for 4 weeks to establish the animal model of type 2 diabetes mellitus.Ligustrazine at different doses was used to treat the diabetic rats.The body weight, blood glucose and the morphology of heart tissues were observed.The myocardial levels of IL-1β, IL-6 and TNF-α were detected by ELISA, and the protein expression of IKKβ and NF-κB in the myocardium was determined by Westeren blotting.RESULTS: Ligustrazine at high dose alleviated the body weight reduction and blood glucose elevation cause by diabetes, and reduced pro-inflammatory factors IL-1β, TNF-α and IL-6.Moreover, the protein expression of IKKβ and NF-κB was significant decreased by ligustrazine.CONCLUSION: Ligustrazine inhibits the myocardial inflammation caused by diabetes through anti-inflammatory pathway.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expression of FasL mRNA and caspase-3 protein in renal tissue after renal ischemia-reperfusion injury (IRI) in order to elucidate the underlying mechanisms.Methods Rats were randomly divided into thrcc groups: sham group(n=8),IRI group(n=8) and IRI+HBO group(n=8).The IRI group and the IRI+HBO group recieved 45 minutes hibateral renal ischima and the IRI +HBO group received additional HBO therapy at the 1st,24th and 48th hour after ischemia.The kidneys were removed at the end of HBO therapy.Malondialdehyde (MDA) level and superoxide dismutase (SOD) activity were measured to determine the extent of oxidative stress.The expression of FasL mRNA and caspase-3 protein was detected by quantitative real-time PCR and immunohistochemical staining in renal tissue respectively.Results Compared with the sham group,MDA level increased markedly and SOD activity decreased markedly after ischemia.After HBO treatment,MDA level decreased and SOD activity increased significantly (P ＜0.05).In IRI group,the expression of FasL mRNA and caspase-3 protein were higher than those in the sham group (P＜0.01),which were reduced significantly by HBO treatment (P＜0.01).Conclusion The expression of FasL mRNA and caspase-3 protein increases along with the lasting of reperfusion and HBO exhibites protection against cell apoptosis through improving the antioxidant-oxidant balance and reducing IRI in acute stage of IRI.

This study designed a studio English classroom which was based on foreign nursing jobs related language.It included high-frequency words,foreign nurse-patient dialogue,and European and American nursing video which was foreign patients’ nursing procedures oriented.The studio classroom was characterized as interactive internet platform.It provided a complete system for input and output in English language,and motivated students to learn nursing English.Therefore,it improved students’ professional verbal competencies.

[Objective]To explore the experiences of professor ZHENG Qizhong to use classical prescription treating the cold-heat complex pediatric diseases.[Method]By following professor ZHENG Qizhong, gathering the cases that are all treated by professor ZHENG Qizhong to treat pneumonia asthma case using Xiao Qinglong Decoction plus Shigao, abdominal pain and diarrhoea cases using Banxia Xiexin Decoction, diarrhoea and pertussis cases using Wumei pill, pneumonia asthma accompanied by diarrhea case using Mahuang Shengma decoction, analysing the mechanism of the upper prescription and the clinical experiences of treating cold -heat complex paediatric diseases. [Results] Cold -heat complex paediatric diseases are very common in paediatric acute or chronic diseases, professor ZHENG Qizhong has an original idea and in -depth study of classical prescription, and using them flexibly to treat various paediatric diseases such as pneumonia asthma, abdominal pain, diarrhea, pertussis, etc, and always acquires good results. [Conclusion]The clinical experiences of ZHENG Qizhong using the classical prescription to treat Cold-heat Complex Paediatric Diseases is effective and has the value to study, popularization and application.

Objective To investigate the association of Mycoplasma pneumoniae(MP) infection with disease activity of ankylosing spondylitis. Methods A total of 158 subjects in our hospital were enrolled in this study, including patients with ankylosing spondylitis(AS, n=66), rheumatoid arthritis (RA, n=31),osteoarthritis(OA, n=25) and normal controls(NC, n=36). MP infection was defined as anti-MP IgM antibody positive. Anti-MP IgM antibodies were determined by a mycoplasma pneumoniae(Mac strain)membrane-based agglutination test. AS patients were divided into two groups: MP infection group and non-MP infection group. T-test was used for statistical analysis of age, blood white cells, ESR, CRP, immunoglobulin, BASDAI index, global assessment on VAS scale, Schober test and chest expansion reflecting spinal mobility.χ2-test was used to compare the positive rate of MP infection in different groups. Gender difference and prevalence of clinical infection in past four weeks between MP infection and MP-free group in AS patients was also compared. Ridit analysis was used to analyze the association of MP infection with degree of sacroiliac damage on CT. Results The prevalence of MP infection in AS (52%, 34/66) was much higher than that in rheumatoid arthritis (RA, 6%, P＜0.01 ), osteoarthritis(OA, 4%, P＜0.01 ) and normal controls (NC, 11%, P＜0.01) . Compared with the non-MP infection group, the MP infection group had more active disease in term of BASDAI(4.0±1.1 vs 3.0±1.9, P=0.017), ESR[(44±32) mm/1h vs (28±23) mm/1h, P=0.029], CRP [(40±38) mg/L vs (22±21) mg/L, P=0.025] serum total IgG level [(18±3) g/L vs (16±5) g/L, P=0.027],but not in serum total IgA and IgM. Regarding to the sacroiliac joint and spinal mobility, MP infection group did not exhibit any association with the sacroiliac grading on CT, Schober test and expansion. In AS patients with MP infection, only 44.1%(15/34) was complicated by clinical manifestations of upper respiratory tract in the past 4 weeks. However, a higher prevalence of MP infection was found in AS patients with clinical manifestation of upper respiratory tract, compared with those with negative clinical manifestation(71% vs 42%,P=0.027). Conclusion Mycoplasma pneumoniae is the most common reported pathogen in ankylosing spondylitis and relates to the disease activity of AS. MP infection is probably a principal triggering factor in the pathogenesis of AS.

Objective: To explore the association between factors affecting language development and Chinese dyslexia, providing scientific evidence for prevention and intervention of dyslexia. Methods: Twelve elementary schools were selected in Baoan, Shenzhen. The parents and head teachers of 12 868 children in grade 3-5 were surveyed by the Questionnaire for Children s Reading Ability, the Dyslexia Checklist for Chinese Children and the Pupil Rating Scale Revised Screening for Learning Disabilities. Results: The prevalence rate of dyslexia was 2.71%, with 349 children suffering from dyslexia. Gender, parental education and occupations, family income, whether parents work away from home before their child was 3 years old, average time mother spends with her child daily and number of languages spoken in family had statistical significance on dyslexia(all P <0.05). After adjusting for parental education and occupations, and family income, the children who spent more than 1 hour with their mothers per day had a significantly reduced risk of dyslexia (1-2: OR =0.46; 3-4: OR =0.45; 5-6: OR =0.40; >7 h: OR =0.36, P <0.05); the children living in families where two languages were used for communication had a significantly reduced risk of dyslexia( OR=0.74, 95%CI=0.57-0.96, P =0.02). Children with a history of language development disorders had a significantly increased risk of dyslexia( OR=17.30, 95%CI=7.86-38.09, P <0.01). Conclusion Increase of time mother spend with their child daily and paying more attention to the children with a history of language development disorders can help to prevent the occurrence of dyslexia.

OBJECTIVE: To investigate the clinical significance of miRNA-146, OX-LDL and ROS in patients with primary ovarian insufficiency (POI). METHODS: 100 patients with POI were prospectively collected and 100 women with normal ovarian function were randomly selected as control group. Serum miRNA-146 expression level was detected by qRT-PCR and serum OX-LDL and ROS expression levels were detected by ELISA. Ovarian granulosa cells of mouse were transfected with miRNA-146 mimics or inhibitors, and then treated with OX-LDL. Cell viability, colony forming ability, apoptosis rate and toll like receptor 4 (TLR4)/nuclear factor-κB (NF-κB) of pathway proteins were evaluated respectively. RESULTS: Compared with control group, the expression level of miRNA-146 in POI group was significantly lower, the expression level of OX-LDL and ROS were significantly higher, and the ovarian volume and peak systolic blood flow velocity of ovarian artery were significantly decreased in POI group. Upregulation of miRNA-146 expression had a protective effect on OX-LDL injured ovarian granulosa cells, as evidenced by increased ovarian granulosa cell viability and colony number, reduced apoptosis, and downregulation of TLR4/NF-κB expression. CONCLUSION miRNA-146 can target downstream TLR4/NF-κB signaling pathway affects oxidative stress and inflammatory response of POI induced by OX-LDL and ROS, and is expected to become a biomarker for early prediction of POI and a new target for treatment.
Humans ; Female ; Mice ; Animals ; Toll-Like Receptor 4/metabolism* ; NF-kappa B/metabolism* ; MicroRNAs/metabolism* ; Reactive Oxygen Species/pharmacology* ; Primary Ovarian Insufficiency/genetics* ; Apoptosis/genetics*

ObjectiveTo evaluate the clinical efficacy of modified Zhibai Dihuangwan on children （female） with idiopathic precocious puberty （ICPP） and to explore the mechanism. MethodA total of 78 children with ICPP who were treated in Henan Children's Hospital from July 2019 to July 2020 were randomized into the observation group and control group by sealed envelope randomization with 39 in either group. The observation group was given modified Zhibai Dihuangwan （1 dose/day， oral， divided into two times） and the control group Zhibai Dihuangtang （1 dose/day， oral， divided into two times orally）. The treatment lasted 3 months for both groups. The changes of mammary nucleus length， maximum follicular diameter， uterus， and ovarian volume before and after treatment in the two groups were observed， and serum luteinizing hormone （LH） level， follicle-stimulating hormone （FSH） level， prolactin （PRL） level， and estrogen （E₂） level were detected in the two groups. At the cellular level， the secretion of gonadotropin releasing hormone （GnRH） and mRNA expression of precocious puberty-related genes Kiss-1 and G protein-coupled receptor 54 （GPR54） were measured. ResultLevels of serum sex hormones of the two groups were significantly decreased after treatment as compared with those before treatment （P<0.01）. After treatment， the length of the mammary nucleus and the maximum follicular diameter in the observation group were smaller than those in the control group （P<0.01）. The total clinical effective rate in the observation group was higher than that in the control group （P<0.01）. At the cellular level， the expression levels of GnRH， Kiss-1 and GPR54 mRNA in GT1-7 cells treated with modified Zhibai Dihuangwan were lower than those treated with traditional Zhibai Dihuangtang. ConclusionModified Zhibai Dihuangwan can effectively inhibit levels of serum sex hormones in children with ICPP and delay the development of mammary nucleus and ovary in children with precocious puberty. It is more effective than traditional Zhibai Dihuangtang， which is worthy of clinical promotion. The mechanism is the likelihood that it inhibits the expression of Kiss-1 and GPR54 mRNA.