Objective: To explore application value of brachial-ankle pulse wave velocity (baPWV) in physical examination in Shenyang district and its risk factors.Methods: A total of 1610 cases, who received regular physical examination in health management center of General Hospital of Shenyang Military Command and met enrollment standards, were selected.Bilateral baPWV and other indexes were measured in all subjects.Logistic regression analysis was used to assess relationship among age, body mass index (BMI), arterial blood pressure, blood biochemical indexes and baPWV.Results: Compared with women, there was significant rise in baPWV[(1361.03±244.72) cm/s vs.(1397.93±239.08) cm/s, P=0.003]in men.baPWV rose along with age increased despite male or female.Compared with normal baPWV group (<1400 cm/s), there were significant rise in age[(45.57±8.95) years vs.(57.07±10.50) years], BMI[(25.25±6.82) kg/m2 vs.(26.14±3.44) kg/m2], fasting blood glucose[FBG, (4.88±1.73) mmol/L vs.(5.43±2.02) mmol/L], low density lipoprotein cholesterol[LDL-C, (2.67±0.82) mmol/L vs.(2.84±0.77) mmol/L], total cholesterol[TC, (4.88±0.99) mmol/L vs.(5.13±0.98) mmol/L], triglyceride[TG, (1.73±1.65) mmol/L vs.(2.15±1.91) mmol/L], systolic blood pressure[SBP, (116.72±12.04) mmHg vs.(136.87±16.21) mmHg], diastolic blood pressure[DBP, (76.99±9.01) mmHg vs.(86.34±10.84) mmHg]and pulse pressure[PP, (39.72±8.32) mmHg vs.(50.53±14.17) mmHg]in elevated baPWV group (≥1400cm/s), P<0.01 all.Multivariable Logistic regression analysis indicated that age, FBG,TG, SBP, DBP and PP levels were independent risk factors for elevated baPWV (OR=1.549~5.943, P<0.05 or <0.01).Conclusion: In Shenyang district, baPWV is closely correlated with cardiovascular risk factors, and it possesses good application value in physical examination and early risk screening of cardiovascular diseases.

Objective To evaluate the biomechanical effect of cortical screw support technique in fixation of the femoral neck fractures. Methods The models of subcapital femoral neck fracture were made in eight matched pairs of embamled cadaver femurs and decided into experiment group and control group (four pairs per group). The side of experiment group was fixed using three cannulated compression screws with cortical screw support and that of control group with conventional screw placement. The speci-mens in two groups were tested in aspects of torsion and axial loading. Results In axial load test at load of 600 N and 800 N, the displacements in cortical screw support group were (0.677±0.135) mm and (0.907±0.132) mm respectively, while those of femoral head in conventional screw placement group were (0.899±0.160) mm and (1.202±0.152) nun respectively (P <0.05). There was signifi-cant difference between the two groups (P < 0.05). The maximal vertical loading for failure of the fixa-tion was (2 782±228) N in cortical screw support group and (1 950±281) N in conventional screw placement group (P < 0.01). In torsibility test at 4° and 6° torsibility, the torque-moments of cortical screw support group were (10.406±1.515) Nm and (15.328 ±1.471) Nm respectively and those of conventional screw placement group (6.628±1.163) Nm and (9.072±1.570) Nm respectively, with statistical difference between two groups (P <0.01). The maximal torque-moment for failure of the fixa-tion was (25.437±5.213) Nm in cortical screw support group and (13.235±3.012) Nm in conven-tional screw placement group (P < 0.01). Conclusion Fixation of femoral neck fractures by using cortical screw support can significantly enhance anti-torsion and anti-compression of internal fixation.

Objective To observe the relation between onset age and the motor complications involved Parkinaon' s disease (PD).Methods The detailed clinical information of 195 patients with idiopathic PD and good response to L-dopa were recorded and followed up.The data were calculated with SPSS statistic software.Results Although the time interval between the onset of the disease and the use of L-dopa was significantly longer in the 57 early-onset patients as compared to the 138 later-onset ones ((3.88±3.33) years vs (2.36±2.21) years, t = 3.142, P = 0.002), the time interval between the use of L-dopa and the occurrence of motor complications was not significantly longer in the early-onset group ((3.81±2.06) years vs (4.24±2.00) years, t = -0.888, P = 0.378).There was no difference in the constituent ratio of non-L-dopa use from onset between early-onset and later-onset PD groups (28.07% (16/57) vs 27.54% (38/138), χ2 = 0.006, P = 0.940).There was also no difference in the dosage of daily L-dopa use when motor complications occurred between early-onset and later-onset PD groups ((601.8± 296.7) mgvs (655.6±192.5) mg, t = -0.912, P=0.365).Seven-tenths of the patients with an onset age younger than 40 years old carried the risk of motor complications after using L-dopa for 5-years and those older than 70 years had the risk at a rate of 1/10.Conclusions Delaying the of use of L-dopa may not necessarily delay the onset of motor complications.The high incidence of motor complications among younger patients may not be related with drug dosage and the type of drug firstly chosen.Younger onset age does inerease the ineidence of motor complicatious.

Objective To study the effect of age on the hemodynamics of common carotid artery. Methods 47 healthy volunteers werestudied. Wall shear stress (WSS) values localized at common carotid artery 2 cm below the bifurcation were calculated with cine phase-contrastMR imaging combined three-dimensional paraboloid (3DP) model. On the spatial distribution, common carotid artery wall was dividedinto 24 equal parts. Calculate the mean WSS in a cardiac cycle on each part, and choose the minimal WSS value. Then the effects of age onthe average WSS and minimal WSS were observed. Results Total 94 common carotid arteries of 47 health volunteers were examined, inwhich 9 carotid arteries in 9 volunteers were excluded because of uninterpretable high-resolution MRI findings or volunteer's intolerance forthe detection. In the remaining 85 common carotid arteries, the average WSS and the minimal WSS during a cardiac cycle on the spatial distributionwere (7.45±2.12) dyne/cm2 and (5.98±1.93) dyne/cm2 respectively. Both average WSS and minimal WSS were negative correlatedwith age (P<0.05). Conclusion With the age increased, mean WSS and minimal WSS on the spatial distribution of common carotid arterydecreased.

A method of high performance liquid chromatography coupled with time-of-flight mass spectrometry was used to detect the endogenous metabolites changes in plasma of normal rats, rats of dampness stagnancy due to spleen deficiency and Astragalus flavone component intervention rats. Metabolism map of rat plasma was obtained and the mechanism of Astragalus flavonoids on dampness stagnancy due to spleen deficiency was studied. Rat model with dampness stagnancy due to spleen deficiency was established by high fat and low protein diet plus load swimming. Liquid chromatography tandem mass spectrometry was used for the analysis of rat plasma sample, and 0.05％ formic acid water with 0.05％ formic acid acetonitrile as the mobile phase was applied in gradient elution with Halo C18 chromatographic column. In this study, partial least squares discriminant analysis and variance analysis were used to screen the potential biomarkers, it was found that the metabolic profile of the Astragalus flavonoids was different from that of the model group, which was close to that of the normal group. A total of 11 potential biomarkers were identified, including glycerol phospholipids, sphingolipids, amino acids, and so on. The metabolic pathways of biomarkers including three tricarboxylic acid cycle, glycerol phospholipid metabolism, fatty acid metabolism, amino acid metabolism and so on, which mainly related to energy metabolism and fat metabolism in the body. Related indexes of rats with syndrome of spleen deficiency of water and dampness were significantly callback after Astragalus flavone intervention, including macro indicators such as body weight, independent activities and micro indicators such as metabolic markers, blood lipids and others. The result showed that Astragalus flavonoids played the role of strengthening the spleen and draining the water mainly through regulating the energy metabolism, fat metabolism and so on.

OBJECTIVETo establish an allele-specific PCR method for detect screening of CYP21A2 gene mutation.

METHODSAllele-specific PCR primers and analogy primers were designed based on the sequence alignment of CYP21A2 and CYP21AP genes. Genomic DNA was extracted from blood specimens of 4 patients with 21-hydroxylase deficiency and 5 healthy controls and respectively amplified with allele-specific PCR primers and analogy primers and sequenced.

RESULTSMutations of CYP21A2 including IVS2-13A/C>G, Arg356Trp and Arg149Pro were found with the established method in all of the 4 patients but not in the healthy controls. When detected with the analogy primers set, IVS2-13A/C>G and Arg356Trp were observed in both patients and healthy controls.

CONCLUSIONThe allele-specific PCR-based method is a simple, effective and reliable method for the detection of CYP21A2 gene mutation.

Adrenal Hyperplasia, Congenital ; enzymology ; genetics ; Alleles ; Base Sequence ; DNA Mutational Analysis ; methods ; DNA Primers ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; Polymerase Chain Reaction ; methods ; Steroid 21-Hydroxylase ; genetics

Non-alcoholic fatty liver disease(NAFLD)is the leading cause of chronic liver disease and has posed significant challenges to global public health and medical care.Due to the unclear pathogenesis of NAFLD,lipid accumulation plays a key role in its development.AMPK,as a crucial molecule in lipid metabolism regulation,can improve lipid accumulation caused by NAFLD.This article describes the specific mechanisms of AMPK-related molecules in improving lipid accumulation and treating NAFLD,and lists the current experimental and therapeutic drugs related to AMPK.The potential of AMPK-related drugs in improving lipid accumulation and treating NAFLD is demonstrated,providing ideas and references for future research on AMPK-related drugs for treating NAFLD.

Background: Metabolic diseases pose considerable burden on the healthcare system worldwide, indi-cating the significance of prevention and treatment. In constitution theory of traditional Chinese med-icine, phlegm-dampness constitution (PDC) is the common basis of metabolic diseases. In clinical practice, Huatan Qushi (HTQS) decoction targeting on PDC can effectively improve metabolic indicators. However, its underlying biochemical mechanism still remains unclear.Methods: Eight PDC participants received HTQS decoction for three months. Their blood was collected at baseline and 1 and 3 months after intervention started. Related biomedical indicators were detected. High-throughput sequencing and RT-qPCR were used for validation. Due to the missing data, repeated measures with missing values in mixed models were used. Results: After 3-month treatment, HDL-C level increased (P<.001) and FBG, FINS, and HbA1c all showed decreasing trend at different time points (all P < .05). After miRNA high-throughput sequencing, compared with the baseline, differential miRNAs at 1 and 3 months were screened, and target gene prediction and KEGG pathway enrichment analysis were performed. The results displayed that metabolic disease-related pathways mainly included pathways in cancer, PI3K-Akt signaling pathway, etc. Further, RT-qPCR showed that hsa-miR-1237-3p differed statistically (P =.008). Then we validated the target genes of hsa-miR-1237-3p in the"Pathways in Cancer"pathway including SDF1, AC, CRK, and HGF, also known as upstream target genes of PI3K/AKT pathway. The results showed that two indicators of CRK and HGF were in statistical significance (P=.045 and P=.036, respectively). Conclusion: PDC serves as a common basis for various metabolic diseases. Through adjusting PDC, HTQS decoction can improve biomedical indicators including blood glucose, HbA1c, insulin, and HDL-C. The target pathway is"Pathways in cancer". Specifically, HTQS decoction acts on targets of CRK and HGF by regulating hsa-miR-1237-3p, and probably exerts effects on their downstream PI3K/AKT pathway.

Objective:To compare and analyze the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic assisted surgery (LAS) in the treatment of advanced gastric cancer.Methods:Articles of the efficacy comparison of HALS and LAS in D2 radical gastrectomy for gastric cancer from 2000 to 2019 published in PubMed, Cochrane library, EM-BASE, China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese full-text database of Chinese Sci-Tech journals, Chinese biomedical literature database were retrieved, and the literatures were screened according to the pre-established inclusion and exclusion criteria. The quality of the two groups was evaluated, and the short-term indexes and complications for meta-analysis of the two groups were analyzed by using Revman 5.3 software.Results:A total of 1277 patients were included in 10 articles, including 629 in the HALS group and 648 in the LAS group. The results of the meta-analysis showed that compared with the LAS group, the operation time was shorter in the HALS group (WMD=24.02, 95% CI: -40.41--7.62, P=0.004), but the auxiliary incision was slightly longer (WMD=0.27, 95% CI: 0.06-0.47, P=0.01), and there were no statistically significant difference in the remaining number of lymph node dissections (WMD=0.58, 95% CI: -1.22-2.39, P=0.53), intraoperative blood loss (WMD=-7.94, 95% CI: -16.21-0.33, P=0.06), gastrointestinal tract recovery time (WMD=0.00, 95% CI: -0.03- 0.04, P=0.85), total length of hospital stay (WMD=-0.14, 95% CI0: -0.36-0.09, P=0.23) and postoperative complications ( OR=0.89, 95% CI: 0.58-1.37, P=0.61). Conclusions:Compared with the LAS for D2 radical surgery of advanced gastric cancer, HALS has significantly shorter operation time and is easier to perform than LAS, but the incision length is slightly increased. Physicians can choose the appropriate operation method according to the specific conditions of the operation and themselves.

Objective To investigate the effect of Changyuning prescription on PTEN,TLR2,Caspase-3,Caspase-9 in phosphatidylinositol-3 kinase/protein kinase B(PI3K/AKT)signaling pathway in colon tissue of 2,4,6-trinitrobenzenesulfonic acid(TNBS)-induced ulcerative colitis(UC)rats.Methods After adaptive feeding for 7 days,70 SPF rats were divided into blank group of 10 and modeling group of 60.The rats in the modeling group were given TNBS/ethanol solution enema to induce UC model.The rats that successfully bulit the model were randomly divided into model group,mesalazine group,Changyuning high-dose,medium-dose and low-dose groups,and Changyuning high-dose,medium-dose and low-dose groups,respectively,and the equivalent amount of crude drug was 4 g·mL-1,2 g·mL-1,1 g·mL-1 of Changyuning prescription solution 10 mL·kg-1,the mesalamine group was given 10 mL·kg-1 of mesalamine suspension equivalent to 0.2 g·kg-1 crude drug,the blank control group and model group were given an equal volume of 10 mL·kg-1 of normal saline was given by gavage.The rats in each group were given intragastric administration once a day for 14 consecutive days.Rats were sacrificed after the last administration.Disease activity index was evaluated;colon changes were observed by HE staining;colon tissue damage index was evaluated;The expression of PI3K,AKT,PTEN,TLR2,Caspase-3,and Caspase-9 proteins was detected by Western Blotting in colon tissue.Results Compared with the blank group,the protein expression levels of PI3K,AKT,Caspase-3,Caspase-9 and TLR2 in the model group were increased(P<0.05),and the protein expression level of PTEN was decreased(P<0.05).Compared with the model group,the expression levels of PI3K,AKT,Caspase-3,Caspase-9 and TLR2 proteins in the Changyuning high-dose group were significantly decreased(P<0.05),and the protein expression levels of PTEN were significantly increased(P<0.05);The levels of PI3K,AKT and Caspase-3 in the salazine group and Changyuning medium dose were decreased(P<0.05),the expression level of PTEN protein was increased(P<0.05),and there was no statistical significance in the expression of Caspase-9;There was no statistical significance in the expression of each protein between the Changyuning low-dose group and the model group.Conclusion Changyuning recipe has a significant effect on the treatment of UC,and its mechanism may be related to the regulation of PI3K/AKT signaling pathway and its related proteins PTEN,TLR2,Caspase-3,and Caspase-9,which can effectively relieve the symptoms of UC rats and reduce colon pathological damage.