Objective To analyse effect of glycyrrhizin on serum levels of platelet derived growth factor ( PDGF ) , interleukin 17 ( IL-17 ) , monocyte chemotactic protein 1 (MCP-1) and serum response factor (SRF) in patients with glioma.Methods 48 patients who were diagnosed with glioma in our hospital were collected.All patients were randomly divided into experimental group and control group,24 cases in each group.All patients were treated with surgery,control group was treated with temozolomid capsule(150 mg/m2 ) orally, one times per day, 28 days for a treatment period of 5 days continuous administration.On the basis of control group, experimental group was treated with compound ammonium glycyrrhetate injection 40 mL, dissolved in 250 mL 5% glucose solution intravenously,one times per day,four weeks was a period of treatment.After two groups were treated two period of treatment,the serum levels of PDGF, IL-17,MCP-1and SRF were detected in all patients.Results After treatment, compared with control group, the serum PDGF level was lower than that of experimental group (P<0.05);the serum IL-17 level was lower than that of experimental group (P<0.05);the serum MCP-1 level was higher than that of experimental group ( P <0.05 );the serum SRF level was lower than that of experimental group ( P <0.05).Conclusion Glycyrrhizin could significantly reduce the serum PDGF, IL-17 and SRF levels,increase MCP-1 levels, have guidance significance for clinic.

Objective To study the effect of Bupi-Qufeng decoction on total serum IgE (TIgE) and EOS counts of atopic dermatitis (AD).Methods A total of 101 cases were randomly recruited into a treatment group and a control group.During the treatment both groups were give Danggui-Bohe ointment for external use,and based on this,oral Bupi-Qufeng decoction was added in the treatment group and loratadine in the control group.TIgE level and EOS count were detected both before the treatment and four weeks after the treatment.Results TIgE in the treatment group decreased significantly after the treatment (t=8.0063,P＜0.001),the decreased value of which was larger than the control group (t=3.6434,P＜0.001).EOS count in the treatment group also obviously decreased after the treatment (t=3.0314,P＜0.01) ; the decreased value of which was also larger than the control group (t=3.3331,P＜0.01).Conclnsion Bupi-Qufeng decoction could decrease TIgE and EOS level of AD patient,while the therapeutic mechanism needed further research.

Objective To investigate the incidence and risk factors of acute kidney injury (AKI)in hepatitis B virus (HBV)related acute-on-chronic liver failure (ACLF)patients,and to explore the impact of AKI on the prognosis of ACLF.Methods The medical records of 227 patients who were diagnosed with HBV-related ACLF at the Department of Infectious Diseases in the First Affiliated Hospital of Nanchang University from January 2015 to August 2016 were retrospectively reviewed.Patients were divided into AKI group and non-AKI group based on the AKI criteria published by International Club of Ascites in 2015 .Demographic and clinical data were compared between groups.The AKI incidence and its impact on patients’prognosis were analyzed.The comparison of continuous variables was done by t test or rank-sum test.The comparison of categorical variables was done byχ2 test or Fisher exact test.AKI risk factors were analyzed by using logistic regression.Results There were 66 (29.1 %)cases were diagnosed with AKI among 227 ACLF patients,among which,45 patients (68.2%)were stage Ⅰ,14 (21 .2%) were stage Ⅱ and 7 (10.6%)were stage Ⅲ.Age,cirrhosis,concentrations of total bilirubin and albumin,international normalized ratio (INR),percentage of neutrophils,MELD scores and spontaneous peritonitis rate (SBP)were all statistically different between AKI group and non-AKI group (all P <0.05).The binary logistic regression analysis revealed that only INR (OR=3.132,P =0.001 )and SBP (OR=4.204,P =0.001 )were the independent risk factors of AKI.The optimal cut-off value for INR was 2.025 with AUROC of 0.609 (P =0.01),sensitivity of 59.1 % and specificity of 62.1 %.The 30-day mortality of AKI group was significantly higher than non-AKI group (χ2= 18.324,P < 0.01). Conclusions AKI is relatively common in patients with ACLF.The risk factors of AKI are INR and SBP. AKI has significant impact on the short-term survival rate of ACLF.Therefore,physicians should pay attention to patients with INR of ACLF at admissions and SBP during the management so as to prevent the occurrence of AKI and to reduce the fatality of ACLF.

Objective To observe hepatocellular apoptosis and inflammatory cytokines expression and their mechanisms for lipopolysaeeharide (LPS)-induced acute liver failure in D-ga|actosamine (D-GalN)-sensitized rats. Methods Fifty-six rats were randomly divided into following groups: 0, 1, 2, 4, 6, 24 and 48 hours. 0 hour group served as control group and the rest did as treatment groups. The rats in the treatment groups received intraperitoneal injections of LPS (50 ng/g) and D-GaIN (300 μg/g) dissolved in 1 mL sterile 0.9% sodium chloride solution, while the rats in control group were treated with 1 mL sterile 0.9% sodium chloride solution only. The rats were sacrificed in the corresponding time points and their sera and liver tissues were collected. Liver tissues were fixed and stained with hematoxylin and eosin for optical microscopy examination. The serum cytokine expressions were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of tumor necrosing factor (TNF)-α, interleukin (IL)-1β, inducible nitric oxide synthase (iNOS) and p53 gene were detected by reverse transcriptase-polymerase chain reaction, and the 24 hours treated rats liver Caspase-3,8,9,12 activity were detected by chromogenie substrate method. Data for the experiments were expressed as x±s, and differences among means were compared using the analysis of variance. Results After drug treatment, liver tissues showed piecemeal necrosis and inflammatory cell infiltration, which significantly increased from 6 hours, 24 hours to 48 hours. The 1 hour treatment group with the highest concentration of TNF-α (727. 8 ± 261. 3) ng/L were significantly higher than the control group and other treatment groups(F= 49.82, P<0.01), 2 hours treatment group (156.4 ± 52.2) ng/L was significantly lower than the 1 hour group, but significantly higher than the control group (F = 30. 23, P< 0.01 ). But serum concentrations of IL-1β gradually increased, reaching the highest level in 24 hours group (360.5±121.6)ng/L (F= 18. 61, P<0. 01). Liver Caspase-3,8,9, 12 activity in 24 hours treatment group was significantly higher than in the control group (F= 84.96, P<0.01). The mRNA expression of iNOS gene, which were not detected in normal controls, reached the peak at 6 hours group after drug treatment and notably dropped in 24 hours and 48 hours groups(F=34.07,P<0.01), p53 gene expression significantly upregulated at 24 hours and 48 hours groups(F=37.43,P<0.01). TNF-α and IL-1β gene expression in the treatment group were higher than in the control group(F=2.94,P<0.05), and both reached the peak at 1 hour treatment group. Conclusions Acute liver failure can be induced by low dose LPS in D-GaiN-sensitized rats. One of the features changes is that Caspase-3,8,9,12 activities are markedly enhanced, and the occurrence of liver injury may be associated with the early high expression of TNF-α, iNOS and p53 gene.

Objective To explore the relationship between Graves disease and hypokalemic periodic paralysis or thymus hyperplasia.Methods Sixty-two patients with Graves disease were enrolled in this study.Thirty-three patients without thymus hyperplasia were selected as group A and other 29 patients were group B.In addition,30 healthy volunteers served as control group.Results There were no significant difference between group A and group B in terms of sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of free triiodothyronine (FT3),free thyroxin (FT4),thyroid stimulating hormone (TSH) (P ＞ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves disease with thymus hyperplasia was 62％ (8/13),higher than that in female patients (6％ (1/16),x2 =10.24,P ＜ 0.05).The incidence rate of hypokalemic periodic paralysis in male Graves patients was 62％ (16/26),higher than in female Graves patients (6％ (2/36),x2 =22.96,P ＜ 0.05).There was no significant relationship between Graves disease patients combined with thymus hyperplasia and sex,age,illness course,thyroid enlargement,exophthalmos,periodic paralysis and the levels of FY3,FT4,TSH.Conclusion The incidence rate of hypokalemic periodic paralysis in male Graves disease patients combind with thymus hyperplasia is higher than in female,and therefore it should pay more attention of male Graves patients in case misdiagnosis.

Objective To investigate the expression level and promoter methylation of SOX17 gene and the clinical correlations in Chinese patients with chronic myeloid leukemia ( CML ) . Methods The levels of SOX17 expression and methylation were detected by RQ-PCR and RQ-MSP. Results SOX17 expression level was significantly lower in CML compared with 30 controls (P=0.001). The area under the receiver operating characteristic (ROC) curve (AUC) was 0.748 to differentiate CML from control (P=0.001). There was a trend of correlation between SOX17 expression and bcr/abl transcript (r = 0.439,P = 0.068) in CML patients. Hypermethylation of SOX17 promoter was detected in 3 (4%) CML patients, however, there was no difference as compared with 32 controls. In our study, SOX17 hypermethylation was not corrected with its expression. Conclusion Decreased SOX17 expression is a common molecular event in CML and may be considered as an available biomarker to diagnose CML. Dysregulated SOX17 is not caused by promoter hypermethylation in CML.

Objective: To evaluate the effectiveness of surgery combined with multiple interventions in treating patients with ear keloid by network meta-analysis. Methods: Databases including " PubMed" , " Cochrane Library" were searched using key words " (((((((((((Ear, External[MeSH Terms]]] OR (Ears, Exernal]] OR (Outer Ear]] OR (Ear, Outer]] OR (Ears, Outer]] OR (External Ear]]] AND (((keloid[Mesh Terms]]] OR (keloids]]] AND ((((((surgery[MeSH Terms]]] OR (operative therapy]] OR (operative procedures]] OR (invasive procedures]] OR (operations]]]] AND (randomized controlled trial[pt]]" , database " Embase" was searched using key words ((′external ear′/exp] OR(′auricle′/exp] OR (′ear lobe′/exp]] AND ((′surgery′/exp] OR (′ear surgery′/exp]] AND (′keloid′/exp] AND (′randomized controlled trial′/exp] and Chineses journals full-text database, China biology medicine disc, VIP database, and Wanfang database were searched using key words in chinese version "耳瘢痕疙瘩,手术" to obtain the randomized controlled trails about surgery combined with multiple interventions in the treatment of ear keloid from the establishment of each database to June 2018. EndNote X7, Revman 5.3, STATA 14.0, GeMTC 14.3 statistical software were used to extract data from studies, study quality assessment, drawing network figure, publication bias analysis, traditional meta-analysis, heterogeneity test, consistency test, similarity test, network meta-analysis. Results: A total of 18 trails involving 8 therapeutic measures were included, and 1 425 patients with ear keloid were included. All of the 18 trails had high risk of bias. The network figure shows that there are 28 different pairwise comparisons among the eight treatments. Of the 18 studies included, 10 were directly compared, and the remaining 18 were not directly evidenced, those comparisons will be made indirectly by the network meta-analysis. The basic symmetry of each point in the funnel plot and the P values of Beggs test and Eggers test were all greater than 0.05, shows that the existence of publication bias is less likely. Traditional meta-analysis showed that the efficiency of surgery + hormone, surgery + pressure, surgery + radiotherapy and surgery + hormone + radiotherapy were better than that of simple surgery, and the difference was statistically significant(P<0.05); the efficiency of surgery + hormone + radiotherapy was better than that of surgery + hormone, the difference was statistically significant(P=0.001); surgery + hormone + fluorouracil and surgery + hormone + radiotherapy had statistical significance(P<0.05). Efficiency is higher than surgery + radiotherapy, the difference is statistically significant. The rest of the direct comparisons are not statistically significant. All P values in the heterogeneity test were greater than 0.1 and I² was less than 50%, so there was no significant heterogeneity in the study. 8 treatments formed 4 closed loops, the inconsistency factor IF ranged from 0.06 to 0.23, and the lower limit of 95% CI was 0, it means than the consistency of those loops were good. The similarity test of the 18 studies was good. Based on Bayesian theory, the random effect model of MCMC method was analyzed by network meta analysis. The results of 7 combined therapies were statistically significant compared with those of simple operation, and were superior to those of simple operation. The results of the seven combined therapies were statistically significant as follows: surgery + hormone + fluorouracil VS surgery + radiotherapy (OR = 0.28, 95% CI 0.08-0.93], surgery + hormone + fluorouracil was better than surgery + hormone; surgery + hormone + radiotherapy + VS surgery + hormone (OR = 0.06, 95% CI 0.01-0.23], surgery + hormone + radiotherapy Surgery + hormone + radiotherapy VS surgery + pressure (OR = 0.07, 95% CI 0.01-0.37], surgery + hormone + radiotherapy is better than surgery + pressure; surgery + hormone + radiotherapy VS surgery + radiotherapy (OR = 0.06, 95% CI 0.01-0.30], surgery + hormone + radiotherapy is better than surgery + radiotherapy. There was no significant difference in the curative effect between the other combined treatments. The SUCRA curves were drawn according to the randomized effect model of MCMC. The SUCRA values of each treatment measure were as follows: surgery, 0.4%; surgery + hormone, 33.0%; surgery + pressure, 52.2%; surgery + radiotherapy, 34.6%; surgery + imiquimod 53.3%; surgery + fluorouracil 51.6%; surgery + hormone + fluorouracil, 76.4%; surgery + hormone + radiotherapy, 34.6%; surgery + hormone + fluorouracil, 53.3%; surgery + hormone Radiotherapy, 98.4%. According to the results of SUCRA chart, the effectiveness of each treatment measure was sorted as follows: operation + hormone + radiotherapy > operation + hormone + fluorouracil > operation + imiquimod > operation + pressure > operation + fluorouracil > operation + radiotherapy > operation + hormone > operation. Conclusions Surgery combined with a variety of treatments for ear keloid were superior to simple surgical treatment, of which surgery + hormone + radiotherapy is the best.

Objective:To clarify the anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava during laparoscopic surgery.Methods:In December 2018, two frozen and two fresh adult cadavers were dissected. The chest of the frozen cadavers was opened along the bilateral midline of the clavicle, the anterior pericardial wall was opened, and the superior vena cava and the inferior vena cava was dissected. The abdominal cavity was opened along the midline of the abdomen, the left and right hepatic lobes were turned over, the inferior vena cava and the second hilum of the posterior segment of the liver were exposed, and the hiatus of the inferior vena cava was opened and entered the pericardium.The anatomical characteristics and adjacent relationship of the superior segment of the inferior vena cava were observed, and the length of the superior segment of the inferior vena cava was measured. The fresh frozen cadaver patients underwent laparoscopic surgery.Five 12 mm trocars were placed at the side of umbilicus, right rectus abdominis about 4 cm from umbilicus, midline of abdomen about 6 cm above umbilicus, right axillary front about 2 cm below inferior edge of liver, left midline of clavicle about 2 cm below inferior edge of liver. Laparoscopic-assisted turning of the left and right hepatic lobes, exposing the posterior inferior vena cava and the second hilum of the liver, opening of the vena cava hiatus into the pericardium.The anatomical characteristics and adjacent relationship of the upper diaphragmatic segment of the inferior vena cava were observed.Results:In two autopsies, the inferior vena cava entered the chest through the cava sulcus of the liver and the phrenic foramen cava, and then through the fibrous pericardium into the right atrium. The length from the diaphragm of inferior vena cava to the right atrium was 1.67 cm, 2.57 cm. In laparoscopic operation, the diaphragm entrance of the posterior segment of the liver inferior vena cava, the second hepatic portal and the inferior vena cava could be well exposed.The diaphragm could be opened along the hole of the vena cava with a relatively non vascular anatomical layer of adipose tissue.There was a large anatomical gap between the pericardium and the right atrium, and the inferior vena cava, the superior vena cava and the right atrium could be well exposed, and the whole diaphragm could be completely and continuously exposed from the bottom to the inferior vena cava at the entrance segment of the right atrium.Conclusions:There was a relatively avascular anatomical layer beside the inferior vena cava. During laparoscopic operation, opening the diaphragm through the abdominal cavity could safely enter the pericardium and expose the inferior vena cava, the superior vena cava and the right atrium, which provides a possibility for the removal of Mayo Ⅳ grade inferior vena cava tumor thrombus through this approach.

Objective To investigate the effect of verapamil on chemosensitivity and apoptosis of esophageal cancer cells.Methods The IC50 values (IC501) of three kinds of chemotherapy drugs:paclitaxel,cisplatin,and 5-fluorouracil were detected by CCK-8 method in 4 kinds of esopha geal cancer cell lines (EC109,EC9706,KYSE-450,TE-1).Each cell was processed by verapamil (4.91 μg/mL) combined with the chemotherapy treatment above,IC50 (IC502) value was detected by CCK8 assay combined with chemotherapy for the verapamil of the 4 esophageal carcinoma cell lines (EC109,EC9706,KYSE-450 and TE-1).A pair of esophageal cancer cells with the most significant reversal of the resistance to chemotherapy by VER detected by the previous experiments were included as research objects,and Annexin V-PI double staining method was used to detect the apoptosis of esophageal cancer cells.Results The IC50 values of paclitaxel in KYSE-450 and EC9706 cell lines were significantly higher than that in EC109 and TE-1.The IC50 values of cisplatin in TE-1 cells were significantly less than those in the other three cells,while the IC50 values of 5-fluorouracil in EC109 were significantly higher than that in other three cell lines.After adding verapamil,the IC50 values of paclitaxel,cisplatin and 5-fluorouracil in four esophageal cancer cell lines (EC109,EC9706,KYSE-450 and TE-1) all decreased to different degrees,and the above three kinds of chemotherapeutic drugs had increased their sensitivity to varying degrees.Among them,the cisplatin group before adding verapamil had different degrees of resistance compared with EC109,EC9706,KYSE-450,TE-1.After joining verapamil,IC50 value change for the EC9706 multiplied for 15.2 times,suggesting that the reversal was sensitive;IC50 value change for EC109 was 1.6 times smaller,suggesting that the reversal was tolerant.Conclusion Verapamil reversal of EC9706 adriamycin has highest efficiency index (15.2 times),there was significant difference compared with the EC109 cells (1.6 times).Tipthe EC9706 (DDP) sensitivity to the reversal of verapamil,and EC109 (DDP) reverse resistance of verapamil.Verapamil may enhance the ability to reverse chemotherapy tolerance by promoting cell apoptosis,thereby enhancing the sensitivity of chemotherapeutic drugs.

Objective To investigate the effect of verapamil on chemosensitivity and apoptosis of esophageal cancer cells.Methods The IC50 values (IC501) of three kinds of chemotherapy drugs:paclitaxel,cisplatin,and 5-fluorouracil were detected by CCK-8 method in 4 kinds of esopha geal cancer cell lines (EC109,EC9706,KYSE-450,TE-1).Each cell was processed by verapamil (4.91 μg/mL) combined with the chemotherapy treatment above,IC50 (IC502) value was detected by CCK8 assay combined with chemotherapy for the verapamil of the 4 esophageal carcinoma cell lines (EC109,EC9706,KYSE-450 and TE-1).A pair of esophageal cancer cells with the most significant reversal of the resistance to chemotherapy by VER detected by the previous experiments were included as research objects,and Annexin V-PI double staining method was used to detect the apoptosis of esophageal cancer cells.Results The IC50 values of paclitaxel in KYSE-450 and EC9706 cell lines were significantly higher than that in EC109 and TE-1.The IC50 values of cisplatin in TE-1 cells were significantly less than those in the other three cells,while the IC50 values of 5-fluorouracil in EC109 were significantly higher than that in other three cell lines.After adding verapamil,the IC50 values of paclitaxel,cisplatin and 5-fluorouracil in four esophageal cancer cell lines (EC109,EC9706,KYSE-450 and TE-1) all decreased to different degrees,and the above three kinds of chemotherapeutic drugs had increased their sensitivity to varying degrees.Among them,the cisplatin group before adding verapamil had different degrees of resistance compared with EC109,EC9706,KYSE-450,TE-1.After joining verapamil,IC50 value change for the EC9706 multiplied for 15.2 times,suggesting that the reversal was sensitive;IC50 value change for EC109 was 1.6 times smaller,suggesting that the reversal was tolerant.Conclusion Verapamil reversal of EC9706 adriamycin has highest efficiency index (15.2 times),there was significant difference compared with the EC109 cells (1.6 times).Tipthe EC9706 (DDP) sensitivity to the reversal of verapamil,and EC109 (DDP) reverse resistance of verapamil.Verapamil may enhance the ability to reverse chemotherapy tolerance by promoting cell apoptosis,thereby enhancing the sensitivity of chemotherapeutic drugs.