Objective To extraction method optimization and the content of the different parts of Xinjiang Bergenia crassifolia (L.), provide the basis for efficient extraction of Bergenia crassifolia pigment. Method Using the orthogonal experiment, the alcohol extraction process of ethanol concentration, dosage of ethanol, extraction time, extraction times, as well as to Bergenia crassifolia pigment content of the different part. Results Of optimization, the best ethanol extract of xinjiang Bergenia crassifolia pigment process conditions is 8 times the amount of 50%ethanol, extracting 3 times, each time 0.5 h. In Bergenia crassifolia pigment content of different parts exists obvious difference. Bergenia crassifolia pigment content of Taproot and fibrous root is higher, at 8.65%to 9.58%, while Bergenia crassifolia pigment content of the leaves is relatively low, at just 0.15%. Bergenia crassifolia pigment content of leaves significantly higher than the old leaves. Conclusion This experimental study on efficient extraction of xinjiang Bergenia crassifolia pigment to provide strong technical support and theoretical basis.

Objective To investigate the diagnostic and prognostic values of 18 F?FDG PET/CT in pa?tients with cervical nodal metastases from carcinoma of unknown primary site (CCUP). Methods A total of 137 consecutive patients(95 males, 42 females, age range 24-84 (55.77±11.71) years) with histological proven CCUP who underwent 18 F?FDG PET/CT imaging to find primary tumors from March 2010 to June 2015 were retrospectively analyzed. The gold standard was the final pathological diagnosis or clinical long?term fol?low?up (≥6 months) results. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT imaging in detecting primary tumors were calculated. Kaplan?Meier anal?ysis was conducted for survival analysis and to identify the presence of any prognostic factors, such as age, gender, presence or absence of distant metastasis, region of involved cervical lymph nodes, left (right)?side/both sides of lymph node involvement, histopathologic tumor type and primary site found or not by PET/CT imaging. Results Primary tumors were confirmed in 96 patients, of which 87 patients were diagnosed correct?ly by 18 F?FDG PET/CT imaging. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 90.6% (87/96), 80.5% (33/41), 87.6% (120/137), 91.6% (87/95) and 78.6% (33/42) respectively. Primary tumors were found most commonly in the head, neck and lung. However, the false positive and negative lesions were also mainly seen in those sites. Distant metastasis and the inferior region of cervical lymph node metastasis were associated with the worst survival (χ2=20. 990 and 12?277, both P<0.01) . The ROC curve revealed that patients with SUVmax>6.5 were of higher mortality risk than those with SUVmax≤6.5 (χ2=7.120, P<0.01) . Conclusions Whole?body 18 F?FDG PET/CT scan is a significant and valuable tool in the identification of the primary tumor site in patients with CCUP . Further? more, according to the distant metastasis and region of cervical lymph nodes metastasis, 18 F?FDG PET/CT scans are of value in prognostic evaluation even if without the need to identify the primary tumors.

With the widely development of psychiatric clinical researches,the ethical issue has been concerned gradually.Although the ethical review has strict rules on informed consent,there are many problems and challenges on informed consent implementation because of the special mental illness population.According to the relevant laws and regulations,combined with the characteristics of clinical psychiatric researches,this paper discussed the protection of subjects' fights and interests during the implementation of informed consent in psychiatric clinical researches,from the following aspects:providing a quiet,comfortable,and relatively independent environment for the participants to ensure informed consent,guaranteeing full informed consent time,choosing qualified researchers for informed consent,ensuring the effective process of informed consent,and guiding the subjects to correctly sign their names and the date.

OBJECTIVETo explore the relationship between use of rush poppers and HIV infection, and associated factors among men who have sex with men in Changsha.

METHODSA cross-sectional study was conducted in Changsha from April to December, 2014. Men who have sex with men who came for HIV counseling and testing services were invited to fill out a survey. A total of 608 MSM were finally recruited. The survey included socio-demographic characteristics, sexual roles, sexual behaviors in last 6 months and rush poppers use, HIV infection among MSM. After finishing the questionnaire, 5 ml blood was also drawn for HIV testing. Chi-square test or Fisher probabilities was used to compare usage of rush poppers and HIV antibody positive rate among MSM who had different characteristics and sexual behaviors. Multi-factor unconditioned logistic regression model was used to explore related factors about rush poppers use and HIV infection of MSM.

RESULTSAmong 608 MSM, 29.8% (181) said they ever used rush poppers, and 13.3% (81 cases) were HIV positive. Among MSM who ever used rush poppers, 18.8% (34/181) were HIV positive; While among those who never used rush poppers, 10.5% (45/427) were HIV positive (χ(2)=7.65,P=0.006). Compared with MSM who had no For One Night sex in the last 6 months,OR (95% CI) value of MSM who had 6-10 times For One Night sexes in last 6 months to use rush poppers was 4.32 (1.77-10.57). Compared with MSM who self-identified as top,OR (95% CI) value of MSM who self-identified as bottom or versatile using rush poppers were 2.99 (1.53-5.86), or 3.60 (2.13-6.09). Compared with MSM who self-identified as top, OR (95% CI) value of MSM who self-identified as bottom or versatile to infect HIV were 3.19 (1.35-7.58), or 2.33 (1.12-4.85). Compared with MSM who used condoms at every anal sex,OR (95% CI) value of MSM who used condoms sometimes or never used to infect HIV were 1.93 (1.12-3.35) or 1.87 (0.64-5.50). Compared with MSM who never used rush poppers,OR (95% CI) value of MSM who ever used rush poppers to infect HIV was 1.88 (1.12-3.16).

CONCLUSIONA large percentage of MSM population in Changsha used rush poppers, and HIV antibody positive rate among MSM was high. MSM who had more frequencies of For One Night sexes, self-identified as bottom or versatile were more likely to use rush poppers and more susceptible to HIV infection. In addition, MSM who had low frequency of condom use in the last 6 months in anal intercourse were more likely to infect HIV.

Condoms ; Cross-Sectional Studies ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Logistic Models ; Male ; Mass Screening ; Multivariate Analysis ; Risk Factors ; Safe Sex ; Sexual Behavior ; Substance-Related Disorders ; epidemiology ; Surveys and Questionnaires

Objective:To systematically review the severe risk in common chronic diseases and coronavirus disease 2019 (COVID-19) cases.Methods:PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Biology Medicine disc, medRxiv, SSRN and ChinaXiv were searched for clinical and epidemiological studies that reported chronic diseases in patients with COVID-19. Only studies of severe COVID-19 in comparison with non-severe controls were included. The prevalence rates of chronic diseases including chronic obstructive pulmonary disease (COPD), diabetes mellitus, hypertension, malignant tumor, cardiovascular diseases, cerebrovascular disease, chronic kidney disease, and chronic liver disease were estimated. Pooled odds ratio ( OR) with 95% confidence interval ( CI) between patients with severe COVID-19 and non-severe groups were calculated. R 3.6.3 software was used for meta-analysis. Results:The search yielded 2 455 articles. A total of 19 eligible comparative studies with 4 792 patients were included in a quantitative analysis. Meta-analysis showed that there was a proportion of 55.0% (95% CI 40.0%-80.0%) male among patients with COVID-19, and the overall pooled prevalence of any chronic diseases in COVID-19 cases was 30.4% (95% CI 24.0%-37.0%). The most prevalent comorbidity was hypertension (16.9%(95% CI 14.0%-20.0%)), followed by diabetes mellitus (8.3%(95% CI 8.0%-9.0%)). The proportion of male patients with severe COVID-19 was higher than that of male patients with non-severe COVID-19 (64.4% vs 52.8%, OR=1.49, 95% CI 1.08-2.05, Z=4.63, P<0.01). The prevalence rates of COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor in severe COVID-19 patients were higher than those of non-severe patients ( OR=5.77, 95% CI 3.80-8.74; OR=4.47, 95% CI 2.71-7.38; OR=3.55, 95% CI 2.86-4.40; OR=3.05, 95% CI=1.76-5.28; OR=2.82, 95% CI=1.96-3.97; OR=2.39, 95% CI=1.77-3.23; OR=2.15, 95% CI 1.27-3.66, respectively, Z=8.37, 6.01, 11.60, 4.20, 5.46, 5.71, 3.12, all P<0.01). There was no significant difference in the prevalence of chronic liver disease between severe and non-severe patients ( OR=1.35, 95% CI 0.84-2.17, P=0.11). Conclusion:COVID-19 patients with chronic diseases have higher risk of developing severe disease, and the ORs from high to low are COPD, cerebrovascular disease, diabetes mellitus, chronic kidney disease, hypertension, cardiovascular diseases and malignant tumor.

The contents, application progress, application effect and optimization strategy of group pregnancy health care model were reviewed, in order to provide reference for the establishment of standardized intervention and health management practice strategies of rural women′s pregnancy care in line with China′s national conditions.

Objective To investigate histopathology and proteinopathy in the spinal cord of patients with common neurodegenerative diseases. Methods Spinal cord tissues from clinically and neuropathologically confirmed neruodegnerative diseases were enrolled in this study , including 3 cases of multiple system strophy , 4 cases of amyotrophic lateral sclerosis , 5 cases of Alzheimer′s disease ( AD, included 2 cases of AD combined with Parkinson′s disease ) , 2 cases of progressive supranuclear palsy , 1 case of dementia with lewy body and 1 case of corticobasal degeneration from 1955 to 2013 at Chinese People′s Liberation Army General Hospital.Four normal control cases were also included.Routine HE and Gallyas-Braak staining , and immunohistochemical stainings for anti-PHF tau ( AT8 ) , anti-α-synuclein , anti-TDP-43 and anti-ubiquitin were performed.Results Examination of the spinal cord in 3 cases with multiple system strophy revealed severe neuron loss in the intermediolateral nucleus of thoracic segment and Onuf′s nucleus of the sacral segment , along with moderate neuron loss in the anterior horn of the cervical segment and mild myelin pallor in the anterior funiculus and anterolateral funiculus in the cervical and thoracic segments.Large amount of argentophilic , ubiquitin and synuclein positive oligodendroglial cytoplasmic inclusions were found widely distributed in the anterior horn and the anterior funiculus and anterolateral funiculus of the full spinal cord.Severe neuron loss and several morphological changes with gliosis in the anterior horn and severe loss of myelin in the anterior funiculus and anterolateral funiculus of the full spinal cord were observed in 4 cases of amyotrophic lateral sclerosis , 2 of which were found with Bunina bodies in neurons of the anterior horn.Three amyotrophic lateral sclerosis cases had ubiquitin-positive neuronal inclusions and TDP-43 positive neuronal and glial inclusions in the anterior horn at cervical and lumbar segments.A few argentophilic , tau positive neurofibrillary tangles ( NFTs) and neuropil threads in the anterior horn at cervical and lumbar segments were found in 4 AD cases.Examination of spinal cord in 2 cases with Parkinson′s disease combined with AD and 1 case with dementia with lewy body revealed severe neuron loss in the intermediolateral nucleus of thoracic segment , and a few synuclein positive lewy bodies and neuritis were also observed.There was mild neuron loss in the anterior horn at cervical and lumbar segments, along with some argentophilic , tau positive globous NFTs and many argentophilic , tau positive neutrophil threads were observed in 2 progressive supranuclear palsy cases and 1 corticobasal degeneration case.Conclusion Each common neurodegenerative diseases of the spinal cord including multiple system strophy,amyotrophic lateral sclerosis and Parkinson′s disease has its own specific histopathology and proteinopathy characteristics .

Objective To explore the expression of serum bone morphogenetic protein 2(BMP2),bone morphogenetic protein 7(BMP7)level and its association with left ventricular hypertrophy(LVH)among patients with chronic kidney disease(CKD).Methods A total of 93 CKD patients admitted to Yan'an People's Hospital from June 2019 to June 2023 were collected as CKD group,divided into LVH group(n=34)and non-LVH group(n=59)according to whether concurrence was combined with LVH.A total of 60 healthy volunteers were selected as control group in the same period.The clinical data were collected and serum BMP2 and BMP7 levels were detected by enzyme-linked immunosorbent assay(ELISA).The association between serum BMP2,BMP7 and CKD stage was analyzed by Spearman's rank correlation analysis.Logistic regression analyze was performed to analyze the influencing factors of CKD patients with concomitant LVH.ROC curves were plotted to assess the diagnostic value of serum BMP2,BMP7 on LVH.Results Serum BMP2(106.09±19.34 pg/ml)in CKD group was higher than that in control group(83.76±15.27 pg/ml),and serum BMP7(15.16±4.92 pg/ml)in CKD group was lower than that in control group(26.53±5.80 pg/ml),the differences were statistically significant(t=7.559,13.002,all P<0.05).Serum BMP2 was sequentially increased in patients with CKD stages Ⅰ,Ⅱ,Ⅲ,Ⅳ and Ⅴ(90.32±6.04,98.56±6.63,110.32±7.49,121.13±7.82,131.81±7.97 pg/ml),and serum BMP7 was sequentially decreased (20.06±2.79,17.01±2.22,13.34±2.18,11.20±2.01,9.35±2.09 pg/ml),and the differences were statistically significant(F=19.863,11.567,all P<0.05).Serum BMP2 was positively correlated with CKD stage(r=0.592,P<0.05),while serum BMP7 was negatively correlated with CKD stage(r=-0.603,P<0.05).BMP2 was an independent risk factor for LVH in CKD patients[OR(95％CI):1.640(1.317～2.043),P<0.05].BMP7 was a protective factor for LVH in CKD patients[OR(95％CI):0.521(0.349～0.779),P<0.05].Both serum BMP2 and BMP7 had diagnostic value for LVH with AUC(95％CI)of 0.782(0.719～0.832)and 0.791(0.726～0.859),respectively.The AUC(95％CI)of the combination of two indicators was 0.873(0.812～0.930),which was greater than that of single indicator(Z=2.357,2.027,all P<0.05).Conclusion BMP2 is abnormally elevated and BMP7 is abnormally decreased in CKD patients,and the abnormal expression of two indicators is associated with CKD disease and LVH.Early combined detection of two indexes can be used as an indicator for diagnosing LVH.

Objective To promote the Institutional Review Board(IRB) construction and development via paying more attention to the detail management and providing better protection of subjects' rights and interests in ethical review of clinical trials and scientific research projects.Methods Assessment criteria were established according to the domestic and international laws and regulations on the management of ethical and scientific research project.Ethical site visit was performed on the 37 clinical trials/scientific research projects approved by IRB during the year 2012-2015.Results Clinical trials/scientific research projects were divided into tree types:the registered clinical trials,the post-marketing clinical trials and the researcher initiated scientific research project.All the types met with the following assessment criteria:satisfy the requirement of equipment,facilities and qualifications of drug preservation required for conducting clinical research;subjects were given compensation according to the protocol;informed consent were obtained.Among them,the registered clinical trials meet more criteria than other research types.Regarding to the standard of informed consent implementation,all types met with the following assessment criteria:all the subjects enrolled signed informed consent forms,informed consent forms are well documented;investigators and subjects/ the guardian signed the forms.However,during the site visit,some other criteria were also neglected more or less.Particularly,only few project recorded the consent process and time spots singed the forms.Conclusions Investigators should pay more attention to the activities and behaviors taken place during the research implementation process.Researchers and management staffs should pay attention to ethical detail management to guarantee better protection of subjects' rights and interests.

OBJECTIVETo investigate histopathology and proteinopathy in the spinal cord of patients with common neurodegenerative diseases.

METHODSSpinal cord tissues from clinically and neuropathologically confirmed neruodegnerative diseases were enrolled in this study, including 3 cases of multiple system strophy, 4 cases of amyotrophic lateral sclerosis, 5 cases of Alzheimer's disease (AD, included 2 cases of AD combined with Parkinson's disease), 2 cases of progressive supranuclear palsy, 1 case of dementia with lewy body and 1 case of corticobasal degeneration from 1955 to 2013 at Chinese People's Liberation Army General Hospital. Four normal control cases were also included. Routine HE and Gallyas-Braak staining, and immunohistochemical stainings for anti-PHF tau (AT8), anti-α-synuclein, anti-TDP-43 and anti-ubiquitin were performed.

RESULTSExamination of the spinal cord in 3 cases with multiple system strophy revealed severe neuron loss in the intermediolateral nucleus of thoracic segment and Onuf's nucleus of the sacral segment, along with moderate neuron loss in the anterior horn of the cervical segment and mild myelin pallor in the anterior funiculus and anterolateral funiculus in the cervical and thoracic segments. Large amount of argentophilic, ubiquitin and synuclein positive oligodendroglial cytoplasmic inclusions were found widely distributed in the anterior horn and the anterior funiculus and anterolateral funiculus of the full spinal cord. Severe neuron loss and several morphological changes with gliosis in the anterior horn and severe loss of myelin in the anterior funiculus and anterolateral funiculus of the full spinal cord were observed in 4 cases of amyotrophic lateral sclerosis, 2 of which were found with Bunina bodies in neurons of the anterior horn. Three amyotrophic lateral sclerosis cases had ubiquitin-positive neuronal inclusions and TDP-43 positive neuronal and glial inclusions in the anterior horn at cervical and lumbar segments. A few argentophilic, tau positive neurofibrillary tangles (NFTs) and neuropil threads in the anterior horn at cervical and lumbar segments were found in 4 AD cases. Examination of spinal cord in 2 cases with Parkinson's disease combined with AD and 1 case with dementia with lewy body revealed severe neuron loss in the intermediolateral nucleus of thoracic segment, and a few synuclein positive lewy bodies and neuritis were also observed. There was mild neuron loss in the anterior horn at cervical and lumbar segments, along with some argentophilic, tau positive globous NFTs and many argentophilic, tau positive neutrophil threads were observed in 2 progressive supranuclear palsy cases and 1 corticobasal degeneration case.

CONCLUSIONEach common neurodegenerative diseases of the spinal cord including multiple system strophy, amyotrophic lateral sclerosis and Parkinson's disease has its own specific histopathology and proteinopathy characteristics.

Alzheimer Disease ; pathology ; Amyotrophic Lateral Sclerosis ; pathology ; DNA-Binding Proteins ; metabolism ; Humans ; Immunohistochemistry ; Inclusion Bodies ; pathology ; Neurodegenerative Diseases ; pathology ; Neurofibrillary Tangles ; pathology ; Neurons ; pathology ; Parkinson Disease ; pathology ; Spinal Cord ; pathology ; Ubiquitin ; metabolism ; alpha-Synuclein ; metabolism