Objective To explore the effects of bilirubin on myeloid differentiation factor 88 (MyD88)and interleukin-1 receptor associated kinase-4(IRAK-4).Methods Seven-day-old Sprague Daw-ley rats (clean grade),male or female,weighing 12.0 to 15.0 g,were randomly assigned to 6 groups.There were normal saline group(Ⅰ),lipopolysaccharide(LPS)control group (LPS,Ⅱ),15 mg /kg bilirubin con-trol (free-LPS)group (Ⅲ),15 mg /kg group (Ⅳa),30 mg /kg group (Ⅳb)and 50 mg /kg group (Ⅳc), and then subsequently divided into 2 h,5 h and 24 h subgroups in each groups.Some of the 200 newborn rats died amid the experiment.Finally a total of 144 were involved in the analysis of results,and 8 rats in each subgroups.Newborn Sprague Dawley rats were administered at various doses of bilirubin (15 mg /kg, 30 mg /kg and 50 mg /kg respectively)intravenously;1 h after injection,the rats were administered LPS intrap-eritoneally at a dose of 1 mg /kg;MyD88 and IRAK-4 were detected by immunohistochemistry at 2 h,5 h and 24 h after the injection of bilirubin.Results (1 )LPS could stimulate the expression of MyD88 and IRAK-4 in spleen cells (qMyD88 2 h =49.89,qMyD88 5 h =139.54,qIRAK-4 2 h =7.93,qIRAK-4 5 h =24.30,qIRAK-4 24 h =6.97 ,P <0.01 ).(2)Low concentration of bilirubin could promote the expression of MyD88 and inhibit the ex-pression of IRAK-4 (qMyD88 2 h =0.76,qMyD88 5 h =5.05,qIRAK-4 2 h =6.43,qIRAK-4 5 h =22.37,qIRAK-4 24 h =1.50, P <0.01 ).(3)LPS stimulation MyD88 affected by low concentration of bilirubin was not obvious (q2 h =1.48,q5 h =1.45,q24 h =0.10,P >0.05).Effects of medium and high concentration of bilirubin on LPS stim-ulation MyD88 were inhibitory(qⅣb 2 h =42.87,qⅣc 2 h =51.38,qⅣb 5 h =103.61 ,qⅣc 5 h =1 15.44,qⅣb 24 h =1.18,qⅣc 24 h =1 1.66,P <0.01 ).(4)Effects of low,medium and high concentration of bilirubin on LPS stimulation IRAK-4 were inhibitory(qⅣa 2 h =9.52,qⅣb 2 h =14.39,qⅣc 2 h =25.55,qⅣa 5 h =38.83,qⅣb 5 h =54.62,qⅣc 5 h =60.51 ,qⅣa 24 h =2.41 ,qⅣb 24 h =1.47,qⅣc 24 h =7.61 ,P <0.01 ).(5)The inhibition of biliru-bin to MyD88 and IRAK-4 was observed at 2 h,strengthened at 5 h,disappeared at 24 h in low-mid concen-trations of bilirubin(P <0.01 )while still visible at 24 h in high concentration of bilirubin.(6)There was neg-atively correlation between the expression level of MyD88,IRAK-4 and bilirubin concentration(rsMyD88 2 h =-0.86, rsMyD88 5 h =-0.92,rsMyD88 24 h =-0.53,rsIRAK-4 2 h =-0.82,rsIRAK-4 5 h =-0.86,rsIRAK-4 24 h =-0.57,P <0.01).(7) Under the effect of bilirubin and LPS,there were positively correlation between the expression levels of MyD88 and IRAK-4 of spleen cells(r2 h =0.77,r5 h =0.9,r24 h =0.67,P <0.01).Conclusion Bilirubin could inhibit the expression of MyD88 and IRAK-4.As the concentration of bilirubin increasing,its inhibition is more obvious and prolonged.The mechanism that bilirubin affects immune function of newborn rat may be related to regulation of expression of MyD88 and IRAK-4 at toll-like receptor 4 signal pathway.

AIM: To observe clinical curative efficacy about Fushu Granule(Radix Angelicae Sinensis,Pollen Typhae,etc.) on extravasated-blood diseases such as women's lochia can't go or go but can't end,abdominal pain,menoxenia,dysmenorrhoea and amenorrhoea. METHODS: 400 cases were divided into two groups.250 cases of which were treated with Fushu Cranule and remaining 150 cases were treated with Motherwort Paste.A course of treatment was seven days for both. RESULTS: The effective rate of the treatment group was(92.8%),and the control one was(82.0%).Compared with the two groups,the difference was quite distinct(P

Objective To explore the influence of hyperbaric oxygen therapy (HBOT) on the learning and memory ability using a rat model of vascular dementia (VD).Methods Sixty Sprague-Dawley rats were selected and divided into a normal group,a sham operation group,a VD group and an HBOT group,each of 15 rats using a random number table.The improved four-vessel method was used to establish a VD model in all except the rats in the normal group,but for the sham operation group,the vertebral artery was not subjected to firing and the arteria carotis communis was not clipped.The HBOT group was then given HBOT for 7 days.The Morris water maze test was used to evaluate their learning and memory ability of all 4 groups.Results Compared to the normal group,the mean escape latency of the sham operation group,the VD group and the HBOT group was significantly longer in each case (P＜0.05).Their platform quadrant crossing times were also significantly less,and their quadrant swimming distance as a proportion of their total swimming distance was significantly smaller (P＜0.05).Compared with the sham operation group,the mean escape latency of the VD and HBOT groups was significantly longer (P＜0.05),the times of crossing platform quadrant were less and their quadrant swimming distance was a smaller proportion of their total swimming distance.As compared with the VD group,the mean escape latency of the HBOT group was significantly shorter [(25.73±6.20) s],the average platform quadrant crossing times were significantly more [(9.51±2.25) times] and the platform quadrant swimming distance of the HBOT group was significantly longer [(494.72±208.26)],representing a significantly larger proportion of the total swimming distance [(28.71 ± 5.32) ％] (P＜0.05).Conclusion HBOT can effectively improve learning and memory in vascular dementia,at least in rats.

Objective To explore the effects of bilirubin on myeloid differentiation factor phospho-p38 mitogen-activated protein kinase (p-p38MAPK) and apoptosis in splenocytes of neonatal rats.Methods Seven-day-old Sprague Dawley rats (clean grade),male or female,weighting 12.0-15.0 g,were randomly assigned to 6 groups.There were blank control group (Ⅰ),lipopolysaccharide (LPS) control group (Ⅱ),15 mg/kg bilirubin control (free-LPS) group (Ⅲ),15 mg/kg group (Ⅳa),30 mg/kg group (Ⅳb) and 50 mg/kg group (Ⅳc),and then subsequently divided into 2 h,5 h and 24 h subgroups in each groups.Some of the 200 newborn rats died amid the experiment,tinally,a total of 144 cases were involved in the analysis of results,and 8 rats in each subgroups.Newborn Sprague Dawley rats were administered at various doses of bilirubin (15 mg/kg,30 mg/kg and 50 mg/kg,respectively) intravenously; 1 h after injection,the rats were administered LPS intraperitoneally at a dose of 1 mg/kg;p-p38MAPK were detected by immunohistochemistry;Apoptosis in splenocytes was detected by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling methods at 2 h 5 h and 24 h after the injection of bilirubin.Results 1.Expression of p-p38MAPK in each group:bilirubin in low-mid concentrations of range inhibited LPS-induced p38MAPK activation (qⅣa =20.93,10.37,respectively at 2 h,and 5 h,all P ＜ 0.01 ;qⅣ b =79.97,14.79,all P ＜ 0.01).The inhibition strengthened with increasing concentration of bilirubin.The effect was observed at 2 h,strengthened at 5 h,disappeared at 24 h.Bilirubin in the high concentrations of range stimulated the expression of p-p38MAPK (qⅣc =32.55,19.23,27.72,respectively at 2 h,5 h and 24 h,all P ＜0.01),observed at 5 h,reduced at 24 h.2.Effects of bilirubin on apoptosis in splenocytes:LPS could increased the apoptosis index (AI) of splenocytes(q =54.62,P ＜ 0.01);The AI of splenocytes had no significant change in low concentrations of range of bilirubin (q =43.92,P ＞ 0.05).Low-mid concentration of bilirubin with LPS reduced the AI of splenocytes (q Ⅳ a =4.48,P ＜ 0.01 ;q Ⅳ b =2.07,P ＜ 0.05),while high concentration of bilirubin with LPS increased the AI of splenocytes (q =5.08,P ＜ 0.01).Conclusions Bilirubin in low-mid concentrations of range could inhibit the expression of LPS-induced p38MAPK,while bilirubin in high concentrations of range stimulated the expression.As the concentration of bilirubin elevated,its inhibition was prolonged.Bilirubin in high concentrations of range bilirubin could induce apoptosis in splenocytes.The immune dysfunction in neonatal hyperbilirubinemia may have something to do with the regulation of phosphorylation of p38MAPK and activation of apoptotic pathways.

Objective:To evaluate the efficacy of self-made Wenyang-Huoxue Decoction combined with gestrinone capsule in the treatment of adenomyosis dysmenorrhea. Methods:A total of 88 patients with adenomyosis dysmenorrhea who met the inclusion criteria in Datong Traditional Chinese Medicine Hospital from January 2016 to December 2018 were enrolled and divided into two groups according to random number table method, 44 cases in each group. The control group was treated with conventional western medicine and the study group was treated with self-made Wenyang-Huoxue Decoction on the basis of the control group. Two groups were treated continuously for 6 months. The TCM syndrome score and dysmenorrhea score were performed before and after treatment. The vaginal ultrasound was used to detect and calculate uterine volume, Nottingham Health Poofite (NHP) was used to evaluate the quality of life. The ELISA was used to detect serum carbohydrate antigen 125 (CA125), TNF-α and IL-8 levels. The clinical efficacy was evaluated. Results:The total effective rate of the study group was 93.2% (41/44) and that of the control group was 72.7% (32/44), where the difference between the two groups was statistically significant ( χ2=6.510, P<0.01). After treatment, the TCM syndrome score, dysmenorrhea score and uterine volume of the study group were significantly lower than those in the control group ( t values were 7.956, 4.959 and 4.235, respectively, all Ps<0.01); the scores of pain, energy, emotion, sleep, social activity and physical activity were significantly lower than those in the control group ( t values were 8.592, 9.341, 6.652, 13.597, 4.085, 7.858, respectively, all Ps<0.01). After treatment, serum CA125 (33.02 ± 5.11 IU/ml vs. 46.22 ± 6.51 IU/ml, t=10.580), TNF-α (41.13 ± 5.03 pg/ml vs. 55.50 ± 6.15 pg/ml, t=11.997) and IL-8 (38.02 ± 5.50 pg/ml vs. 49.42 ± 6.51 pg/ml, t=8.873) in the study group were significantly lower than those in the control group ( P<0.01). Conclusions:Self-made Wenyang-Huoxue Decoction combined with gestrinone capsule can reduce the levels of serum CA125, TNF-α and IL-8 in patients with adenomyosis dysmenorrhea, and improve the clinical symptoms, and the quality of life.

[Abstratct] Objective To investigate the preventive effect of atomization inhalation with mixture of baikal skullcap root and light yellow sophora root for proventing invasive fungal infection on lower respiratory tract infection after chemotherapy. Methods A total of 60 cases of patients with lower respiratory tract infections after chemotherapy were selected and randomized into control groups and treatment groups, there were 30 cases in every group, anti-infection was taken in two groups according to drug sensitivity test,atomamdation inhalation with mixture of baikal skullcap root and light yellow sophora root was taken in treatment groups in addition, clinical effect was contrasted, incidence rate and time of fungal infection were contrasted between control group and treatment group,and index of blood gas analysis was contrasted between control group and treatment group after two weeks. Results Clinical efficiency was 86.67% in treatment group and was 70.00% in control group,clinical efficiency was higher in treatment groups than in control group,incidence rate of fungal infection was 6.67% in treatment group and was 23.33% in control group,incidence rate of fungal infection was lower in treatment group than in control goup,time of fungal infection was (11.58±1.31)days in treatment group and was (9.41±1.10)days in control group,time of fungal infect was later in treatment group than that in control group. There were no significant differences of the levels of pH,SaO2,PaCO2 and PaO2 between the two groups before treatment, the levels of pH,SaO2,and PaO2 were higher and PaCO2 was lower in treatment group than that in control goup after treatment. Conclusion Atomization inhalation with mixture of baikal skullcap root and light yellow sophora root could improve clinical curative effect of lower respiratory tract infection after chemotherapy,and im-prove respiratory function,provent invasive fungal infections and has good clinical effect.

Neonatal hyperbilirubinaemia, clinically presenting as jaundice, is a ubiquitous and commonly a benign metabolic condition in newborn infants.It is a leading cause of hospitalization of neonates in the first week of life.Serum bilirubin has been considered as the most potent superoxide with the peroxyl radical scavenger activity.However, uncontrolled hyperbilirubinaemia or rapidly rising bilirubin can reach a neurotoxic concentration, potentially leading to central nervous system sequelae.Thus, the health status of jaundiced newborn infants is dependent on striking an appropriate balance between the protective effects of serum bilirubin and the risk of bilirubin neurotoxicity.In order to standardize the management of neonatal hyperbilirubinemia (jaundice), many countries have developed clinical practice management guidelines.This review sorted out and briefly interpreted the main contents of clinical management guidelines for neonatal hyperbilirubinemia drafted by the American Academy of Pediatrics and other countries, aiming to provide references of clinical diagnosis and treatment practice to domestic pediatrician.

Esophageal cancer (EC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening and early detection are effective in reducing the incidence and mortality of EC. The development of the guideline for EC screening and early detection in line with epidemic characteristics of EC in China will greatly promote the homogeneity and standardization, and improve the effect of EC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of EC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of EC screening and provide scientific evidence for the EC prevention and control in China.

Gastric cancer (GC) is a major digestive tract malignancy in China, which seriously threatens the health of Chinese population. A large number of researches have demons-trated that screening, early detection and early treatment are effective in reducing the incidence and mortality of GC. The development of the guideline for GC screening, early detection and early treatment in line with epidemic characteristics of GC in China will greatly promote the homogeneity and standardization, and improve the effect of GC screening. This guideline was commissioned by the Bureau of Disease Control and Prevention of the National Health Commission. The National Cancer Center of China initiated and convened a working group comprising multidisciplinary experts. Following the World Health Organization Handbook for Guideline Development, this guideline combined the most up-to-date evidence of GC screening, China′s national conditions, and practical experience in cancer screening. This guideline provided evidence-based recommendations with respect to the screening population, technology and procedure management, aiming to improve the effect of GC screening and provide scientific evidence for the GC prevention and control in China.

Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.