AIM: To investigate the effect of ligustrazine (Lig) on cerebral injury in LPS-induced septic shock rats and to explore the underlying mechanism.METHODS: Wistar rats (n =48) were randomly divided into control group, LPS group and LPS +Lig treatment group.The rats in LPS group were randomly divided into 2 subgroups at time points of 6 h and 12 h.After ligustrazine treatment, the venous blood was collected by removal of eyeballs to detect the con-centration of neuron-specific enolase (NSE) using ELISA.The nitric oxide (NO) concentration in the homogenate of brain tissues was examined.The apoptosis in the hippocampus was analyzed by TUNEL staining.The protein expression of Bax and Bcl-2 was determined by Western blot.RESULTS: Ligustrazine inhibited the elevation of NSE and NO concentrations in LPS-induced septic shock rats.Furthermore, ligustrazine administration also attenuated LPS-induced increase in Bax ex-pression and decrease in Bcl-2 expression.CONCLUSION: Ligustrazine decreases the concentration of NSE and NO, and attenuates cerebral injury in LPS-induced septic shock rats.These effects may be related to the regulation of Bax and Bcl-2 expression.

OBJECTIVE To explore the comprehensive endoscopic management to prevent hospital infection and reduce the incidence of infection in hospitals. METHODS According to the characteristics of the endoscopy,the quatitative evaluation of endoscopic examination management was included in the inspection and implementation system. RESULTS During quantitative evaluation in the past three years,there were no outbreaks of epidemics and the quantitative evaluation improved year by year. CONCLUSIONS Endoscopy management,leadership attention and support are the keys to ensure effective measures of co-management and quantitative evaluation.

Objective:To study clinical features of rheumatoid arthritis (RA) patients with peripheral neuropathy (PN).Methods:The clinical data of 46 RA patients with PN in the First Affiliated Hospital of Zhengzhou University from August 2012 to August 2019 were retrospectively analyzed, including clinical manifestations, laboratory and imaging results, previous treatment, treatment and clinical outcome. The other 92 RA patients without PN at the same period were selected as controls.Results:In RA patients with PN, the male to female ratio was 1∶2.1 with an average age (59.1±11.8) years. The course of RA and PN was 102.0 (19.0-156.0) months and 4.2 (0.7-5.5) months respectively. Numbness (84.8%, 39/46) and muscle weakness (21.7%, 10/46) were the most common symptoms. According to results of electromyography, polyneuropathy (60.0%, 27/46) was the predominant manifestation, followed by mononeuritis multiplex (31.1%, 14/46). Compared to RA patients, rheumatoid factor (RF) ( P<0.001) and the percentage of cutaneous vasculitis ( P=0.042) were higher in RA patients with PN. Logistic regression analysis revealed significant correlation between RF>178.4 IU/ml ( OR＝5.626, 95% CI 2.509-12.618, P<0.001) and development of PN. Paresthesia in 27 patients (58.7%, 27/46) were relieved after treatment of high dose glucocorticoid and immunoglobulins (IVIG). Twelve patients were followed up regularly and the mean duration of follow-up was 17.0(4.8-52.8)months. Paresthesia in 10 (10/12) patients were relieved compared to that at discharge, 1 (1/12) patient achieved complete remission. Conclusion:Numbness and muscle weakness are the common symptoms in RA patients with PN and polyneuropathy is the main type. RF>178.4 IU/ml is correlated with the development of PN in RA patients. Intensive treatment such as high dose glucocorticoid and IVIG are effective.

ObjectiveTo know about the correlation analysis of the physical and mental status of organ transplanted patients' family members during the patients' rehabilitation period and the long term survival of the transplanted organs.MethodsA total of 600 organ transplanted patients' family members were investigated by Zung self-rating anxiety scale (SAS) and simple coping style questionnaire.The results underwent subsequent analysis.ResultsAnxious state of organ transplanted patients' family members was more severe than that of domestic norm (P<0.01).There were some differences in terms of anxious state of family members with different genders,education backgrounds,income and the resource of medical expenditure (P<0.05).Family members most took positive coping styles,whereas fewer adopted negative coping styles (P<0.01).Positive coping styles were negatively correlated with the anxiety of family members (P<0.01) and positively correlated with long term survival of transplanted organ(P<0.05).However,negative coping styles of family members were significantly positively correlated with their anxiety (P<0.05) and were negatively correlated with long term survival of transplanted organ.ConclusionsThe anxiety generally exists in organ transplanted patients' family members.There are differences in terms of anxious state among family members of different genders,different education backgrounds,income or with the resource of medical expenditure.The more they adopt positive coping styles,the lower anxiety level they show and the longer the transplanted organ survive.Conversely,the more they adopt negative coping styles,the higher anxious level they show and the shorter the transplanted organ survive.

Objective The purpose of this study was to assess the analysis capabilities of the dot immunogold filtration method on detecting serum amyloid A ( SAA ) protein in blood.It also aimed to research the clinical value of SAA in diagnosing the infectious diseases of children .Methods ( 1 ) The performance evaluation including the accuracy , within-run precision, inter assay variations , the linear and the distraction-analysis of SAA-SPOT was estimated following the EP file; From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled into this observational study.Data including white blood WBC count , CRP and SAA were obtained.(2) From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled randomly into this observational study.This study used a cross-sectional survey research method , and 386 children with bacterial infection and 219 children with virus infection were as the research object.The general , clinical diagnosis , treatment information as well as the data of blood SAA , C-reactive protein ( CRP ) and white blood cell ( WBC ) of children were collected.Data were analyzed by variance , independent t test, ROC curve analysis and stepwise regression statistics method.Results ( 1 ) The average recovery rate is 103.74 %.Coefficient of variation (CV) for 10 mg/L,100 mg/L within-run assays were 8.77%, 3.61% and between-run assays were 9.01%, 3.74%;the inter-day CV were 9.07%, 4.03%respectively;the linear range was 5 mg/L-200 mg/L, hemoglobin(5 g/L),serum bilirubin(800 μmol/L),triglyceride(TG, 22 mmol/L), and had no interference in SAA detection.When compared to the BNPRO quantitate system of SIEMENS , the coefficient of association of detection of SAA by SAA-SPOT was R2 =0.96.( 2 ) Compared with control group , the serum SAA of infection group ( bacterial infection group , t =13.05, P=0.001;virus infection group t =7.68, P=0.001) and SAA/CRP ratio (bacterial infection group t=2.29, P=0.023;virus infection group t=3.32, P=0.01) were significantly increased.(3) The serum CRP and SAA rose similarly in bacterial infection, while in viral infection, only SAA increased significantly , CRP had no apparent change.In combination with CRP and WBC , SAA had the better diagnostic efficiency apparently.Conclusions As a POCT detection project , analysis capabilities of the SAA assayed by domestic SAA-SPOT can meet the requirements of clinical test.Combined with CRP , WBC and SAA can improve the efficiency in the diagnosing of infectious disease especially in the virus infection.As a new biomarker of infections , SAA is useful for the early auxiliary diagnosis and differential diagnosis of childhood infection.

Objective To study the possible mechanisms,efficacy and safety of acetaminophen and platelet-rich plasma (PRP) on promoting the closure of ductus arteriosus in preterm infants.Method From January 2016 to May 2018,preterm infants (gestational age＜34 weeks) with symptomatic patent ductus arteriosus (sPDA) admitted to our neonatal intensive care unitwere enrolled prospectively.15 mg/kg of acetaminophen was orally given every 6 hours for three days (acetaminophen group).If acetaminophen was contraindicated (PRP group) or acetaminophen therapy failed (PRP rescue group),PRP transfusion was given at a single dose of 20 ml/kg.Echocardiogram,platelet-derived growth factors (PDGF) and urinary prostaglandin E2 (PGE2) were examined before and 72 hours after treatment.The data were analyzed using ANOVA,student's t test,Kruskal-Wallis H method and chi-square test.Result A total of 70 cases were enrolled.61 cases were treated with acetaminophen.The success rate (67.2％,41/61) was similar to PRP group (6/9) (P=1.000),and significantly higher than PRP rescue group (6/17) (P=0.017).The complications in acetaminophen group included 22 cases of hyperbilirubinemia (36.1％),5 cases of upper gastrointestinal hemorrhage (8.2％),4 cases of positive fecal occult blood test (6.6％),3 cases of oliguria (4.9％),1 case of Grade Ⅲ ～ Ⅳ intraventricular hemorrhage (IVH) (1.6％),and 1 case of≥ Ⅱ stage necrotizing enterocolitis (NEC) (1.6％).A total of 3 cases of hyperbilirubinemia were in PRP group.One case of hyperbilirubinemia,one oliguria,one Grade Ⅲ～ Ⅳ IVH and one ≥ Ⅱ stage NEC were in PRP rescue group.The urinary PGE2 level in post-treatment was lower than pre-treatment in acetaminophen group (t=6.878,P＜0.001).The blood platelet count and PDGF level in post-treatment were higher than pre-treatment in PRP group (t=-2.496,-8.906;P=-0.037,＜0.001) and PRP rescue group (t=-3.374,-2.503;P=0.004,0.024).Conclusion Oral acetaminophen and PRP transfusion had similar efficacy in promoting the closure of ductus arteriosus in preterm infants.If oral acetaminophen was contraindicated or failed,PRP transfusion could be one of the candidates for rescue therapy to promote the closure of ductus arteriosus in preterm infants.

Objective To investigate the innovation ability status of undergraduate students in Third Military Medical University,and put forward some effective suggestions.Methods A questionnaire was applied to survey the innovation ability status of undergraduate students in Third Military Medical University.A total of 210 valid questionnaires were collected.The questionnaires covered five aspects including undergraduate students' basic information,innovative consciousness,innovation thinking,innovation skills and basic knowledge.The results were assessed by using SPSS 19.0 statistical software for t-test or ANOVA of students from different grades,majors and academic years.Inspection level was α=0.05.Results The total score of innovation ability in undergraduates was (70.5 ± 8.2) point,and no significant difference was observed in the total score of undergraduates' innovation ability within different grades (P=0.435).However,the innovation thinking ability of undergraduates in Grade Four was significantly higher than that in Grade Two [(77.0 ± 10.7) vs.(72.6 ± 10.9),P=0.030)],and the score of basic knowledge of undergraduates in Grade One was significantly higher than that in Grade Four [(76.2 ± 6.0) vs.(69.3 ± 8.7),P=0.014)].The total score of innovation ability of undergraduates from clinical medicine was significantly higher that of undergraduates from preventive medicine and other majors [(72.5 ± 8.8) vs.(69.9 ± 7.5),P=0.035;(72.5 ± 8.8) vs.(66.7 ± 7.9),P=0.004].There were no significant differences in total score of innovation ability or score of any first level index of undergraduates between eight-and five-year system of preventive medicine (P＞0.05).Conclusion The overall innovation ability of undergraduates in military medical university was relatively high,and undergraduates from different grades,majors and academic years have their own special advantages in innovative consciousness,innovation thinking,innovation skills and basic knowledge,and it is necessary to carry out more researches focusing on educational and training mechanism of innovation ability according to the personality of undergraduates in military medical universities.

Exposure to ionizing radiation intervenes in genomic stability and gene expression,resulting in the disruption of normal metabolic processes in cells and organs by causing complex biolog-ical responses.Altered genomic variations,gene expression and metabolite concentrations in blood or tissue samples reflect systemic radiation damage.With the application of new techniques and exten-sive study on the mechanisms for ionizing radiation damage,related indicators such as chromosomal variation,gene expression,lipid and metabolism are being recognized and promise to be the markers for early diagnosis and prognosis of radiation exposure.Therefore,this article reviews recent progress in and potential applications of biomarkers related to ionizing radiation injury.

Objective:To study the clinical and immunological features of two case of rare antisynthetase syndrome (ASS), so as to improve the level of diagnosis and treatment.Methods:Two cases with rare antisynthetase syndrome admitted to the First Affiliated Hospital of Zhengzhou University from July 2020 to August 2022 were collected.Results:The two rare ASS were anti-Zo antibody and anti-Ha antibody positive patients, both of which had interstitial lung disease (ILD) as the main clinical manifestation and positive anti-Ro52 antibody. Two rare antisynthetase autoantibodies manifested cytoplasmic ANA indirect immunofluorescence (IIF) staining pattern, but it is different from the cytoplasmic dense speckled pattern of several common ASS antibodies. After treatment with glucocorticoids and immunosuppressants, case 1 died of respiratory failure due to a long course of disease and late diagnosis, the lung lesions of case 2 improved significantly.Conclusion:When encountering the cytoplasmic ANA fluorescent pattern in ILD patients, especially with anti-Ro52 antibody, it is necessary to screen more myositis specific antibodies to rule out the possibility of rare ASS.

Objective:To compare the performance and surgical outcomes of disposable digital flexible ureteroscope with a reusable fiberoptic flexible ureteroscope in treatment of upper urinary stones.Methods:A prospective, multicenter, single-blind and randomized controlled study was performed from April 2018 to December 2018. Eligible patients were randomized, in a ratio of 1∶1, to either experimental group or control group. The inclusion criteria for the study were: aged 18-60 years, solitary upper urinary stone or multiple stones with stone size less than 2 cm, absence of urinary tract infection (UTI) or UTI was controlled, normal liver and renal function. Exclusion criteria included: patients with congenital anomalies, calyceal diverticular stone, IP angle less than 30°, renal insufficiency. pregnancy or lactation, cardiopulmonary function abnormality and coagulation abnormalities. Patients in experimental group received ureteroscopy through a disposable digital flexible ureteroscope (PU3022A, PUSEN), while patients in control group received ureteroscopy through a reusable fiberoptic flexible ureteroscope (Flex-X2, STORZ). The primary endpoint was the high-quality rate of images during the operation. The secondary endpoints included success rate of fragmentation and postoperative complication rates.Results:93 patients were recruited, and 90 of them were finally complete the study (i.e., 45 patients in each group). The demographic and preoperative parameters were comparable between the two groups except the stone size in patients with solitary stone. The high-quality rate of images was significantly higher in experiment group than that in control group (100.0% vs. 15.6%, P<0.001). There were no significant differences in terms of success rate of fragmentation(68.9% vs. 71.1%, P=0.818), hemoglobin dropped (3.91 g/L vs. 3.62 g/L, P=0.880), serum creatinine changed, and postoperative complication rates(6.7% vs.6.7%, P=1.000). Conclusions:Disposable digital flexible ureteroscope achieves similar surgical outcomes to the reusable fiberoptic flexible ureteroscope with a better quality of endoscopic images.