To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

OBJECTIVETo evaluate the clinical effects of dynamic neutralization system (K-Rod) in treating multisegmental lumbar degenerative disease.

METHODSFrom October 2011 to October 2013, 20 patients with multisegmental lumbar degenerative disease were treated with dynamic neutralization system (K-Rod). There were 8 males and 12 females with an average age of 45.4 years old (ranged from 31 to 65) and an average course of 3.8 years (ranged from 9 months to 6.25 years). All patients had the history of low back and legs pain. Among them, 10 cases were far lateral lumbar disc herniation, 7 cases were lumbar spinal stenosis, 3 cases were lumbar spondylolisthesis (degree I in 2 cases and degree II in 1 case). Every patient had only one responsible segment which causing the symptom would have to be rigidly fixed during operations, and the adjacent intervertebral disc of the responsible segments at least 1 segment has already obvious degenerated. All patients underwent the operation to relieve compressed nerves and reconstruct spinal stability with K-Rod system (the responsible segments were fixed with interbody fusion, and the adjacent segments were fixed with dynamic stabilization). Visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA) and Oswestry Disability Index (ODI) were used to evaluate the clinical effects. Imaging data were used to analyze the range of motion (ROM), intervertebral disc height and intervertebral disc signal (according to modified Pfirrmann grading system) in degenerative adjacent segment.

RESULTSAll patients were followed up for more than 1 year, and preoperative symptoms obviously relieved. There were significant differences in VAS, JOA, ODI between preoperative and postoperative (postoperative at 1 week and 1 year) (P<0.05). Radiological examination showed that all responsible segments had already fused, and no looseness, displacement and breakage of internal fixations were found. Postoperative at 1 year, the ROM of adjacent segments were decreased (P<0.05). There was no significant difference in intervertebral disc height between preoperative and postoperative at 1 year (P>0.05). According to modified Pfirrmann grading system to classification for the 25 disks of adjacent segment, 8 disks (32%) got improvement, 15 disks (60%) got no change and 2 disks (8%) got aggravation at 1 year after operation.

CONCLUSIONDynamic neutralization system (K-Rod) combined with interbody fusion could obtain short-term clinical effects in the treatment of multisegmental lumbar degenerative disease.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Spondylolisthesis ; surgery

Objective To investigate the clinical features, laboratory findings, chest CT findings and treatment of patients with COVID-19, and to analyze their relationship with prognosis. Methods From January to February 2020, the clinical data on the 42 patients with COVID-19 admitted to the Wenzhou Sixth People′s Hospital were analyzed retrospectively. Results The clinical symptoms of the 42 cases included fever (35 cases), cough (26 cases), fatigue (14 cases), aspiration (9 cases), sore throat (4 cases), muscle ache (5 cases), headache (2 cases), nausea (4 cases), diarrhea (6 cases) and abdominal pain (1 case).The absolute number of blood lymphocyte decreased to different degrees in 22 cases.Fourteen cases had lactate dehydrogenase obviously, with no obvious change in procalcitonin.The imaging manifestations were cloud-like and ground-glass-like high density shadows scattered outside the lungs, small flaky consolidation and bronchus inflating sign were seen locally.A few images showed diffuse high density, most of the lesions showed consolidation or striate change, and local fibrosis was formed in the lower lobes of both lungs. Conclusion Fever and cough are the first symptoms of COVID-19, and a few cases are associated with shortness of breath and diarrhea, accompanied by different degrees of systemic symptoms, but most of the patients improve their conditions after active antivirus, anti-infection, systematic symptoms improvement and supportive treatment.The disease is highly infectious and its condition changes rapidly.Therefore, early detection, early diagnosis and comprehensive treatment of the whole body as soon as possible are the keys to treatment.

OBJECTIVETo evaluate the effects of red clover isoflavones on the proliferation and apoptosis of human benign prostatic hyperplasia (BPH) stromal cells.

METHODSWe treated human prostate stromal cells with red clover isoflavones at the concentration of 12.5, 25, 50 and 100 microg/ml, and established a PBS blank control, a dimethyl sulphoxide (DMSO) negative control and four finasteride positive control groups (at the concentration of 12.5, 25.0, 50.0 and 100.0 microg/ml). We determined the effects of different concentrations of red clover isoflavones on the proliferation of the cells by MTT assay and on their apoptosis by Annexin V/PI double staining flow cytometry.

RESULTSRed clover isoflavones inhibited the proliferation of the BPH stromal cells by 18.86% at 25.0 microg/ml, compared with 5.17% in the blank control group (P < 0.05), and more obviously at a higher concentration. At 50.0 microg/ml, red clover isoflavones exhibited a weaker inhibitory effect than finasteride (28% vs 69.88% , P < 0.05). Annexin V/PI double staining flow cytometry showed that red clover isoflavones at 25.0 microg/ml induced the apoptosis of the prostate stromal cells by (18.54 +/- 2.5)%, with significant differences from the negative control and blank control (P < 0.01).

CONCLUSIONRed clover isoflavones can inhibit the proliferation and promote the apoptosis of human BPH stromal cells.

Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Humans ; Isoflavones ; pharmacology ; therapeutic use ; Male ; Plant Extracts ; pharmacology ; therapeutic use ; Prostate ; cytology ; drug effects ; Prostatic Hyperplasia ; drug therapy ; pathology ; Stromal Cells ; drug effects ; Trifolium ; chemistry

OBJECTIVETo access the prevalence of menopause-like symptoms, and their related factors in old and middle-aged males in the area of Hefei.

METHODSThis study included 1 026 males aged over 45 years that came to the clinic for health examination. We collected their personal data, and evaluated their general health status and the results of the questionnaire investigation using the Aging Males' Symptoms (AMS) scale.

RESULTSThe total incidence of menopause-like symptoms was 64.7% among the old and middle-aged males in Hefei area, of which 58.1% were mild, 30.9% moderate and 11.0% severe. The average AMS score was 31.2 +/- 6.8, in which the scores on psychological, physical and sexual function symptoms were 8.3 +/- 2.1, 12.4 +/- 4.8 and 9.3 +/- 4.5, respectively. Sexual function symptoms were increased significantly with the increase of age (P < 0.05), but psychological and physical symptoms showed no obvious correlation with age (P > 0.05). The main risk factors of menopause-like symptoms included age, smoking, diabetes, cardiovascular diseases, and obesity, but physical exercise was an important protective factor against them.

CONCLUSIONWith the increase of age, the prevalence of male menopause-like symptoms rises and sexual function declines gradually, but psychological and physical scores are not affected significantly. Age, general health status and lifestyle are closely associated with the prevalence of menopause-like symptoms among old and middle-aged males.

Aged ; Aged, 80 and over ; Aging ; Andropause ; China ; epidemiology ; Humans ; Incidence ; Life Style ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo study the status of loss of heterozygosity (LOH) of chromosome 1p/19q and p53 protein expression in oligodendroglioma, as compared to astrocytoma.

METHODSOne hundred and ninety-one cases of glioma of different histologic types and grades, including 116 cases of low-grade of oligodendroglioma (86 paraffin-embedded and 30 fresh tissues), 45 cases of anaplastic oligodendroglioma (all paraffin-embedded tissues) and 30 cases of astrocytoma of various grades (all paraffin-embedded tissues), were enrolled into the study. The LOH of chromosome 1p/19q was investigated by polymerase chain reaction (PCR)-based microsatellite analysis. The p53 protein expression was demonstrated by immunohistochemical staining.

RESULTSThe rates of 1p loss, 19q loss and 1p/19q loss were 69.8%, 64%, and 57.0% respectively in the 86 paraffin-embedded low-grade oligodendroglioma samples, as compared to 71.1%, 60.0% and 55.6% respectively in the 45 paraffin-embedded anaplastic oligodendroglioma samples. There was no difference of LOH of 1p/19q between low-grade oligodendroglioma and anaplastic oligodendroglioma (P>0.05). In the 30 cases of low-grade oligodendroglioma with fresh tissues available, the rates of 1p loss, 19q loss and 1p/19q loss were 70.0%, 63.3% and 60.0% respectively. The LOH of 1p/19q between paraffin-embedded and fresh samples was not statistically significant (P>0.05). In the 30 cases of astrocytoma, the rates of 1p loss, 19q loss and 1p/19q loss were 23.3%, 33.3% and 20.0% respectively, which were significantly less than those in oligodendroglioma (P<0.05). The expression of p53 protein was significantly lower in low-grade oligodendroglioma (8.1%) than in anaplastic oligodendroglioma (31.1%, P=0.007). The expression of p53 protein in oligodendroglioma was also lower than in astrocytoma (P=0.001). Furthermore, p53 protein expression negatively correlated with 1p/19q loss in anaplastic oligodendroglioma (P<0.05).

CONCLUSIONSBoth paraffin-embedded and fresh tissues are suitable for analysis of LOH of chromosome 1p/19q. Oligodendroglioma demonstrates a higher frequency of LOH of chromosome 1p/19q and lower expression of p53 protein than astrocytoma. The LOH of chromosome 1p/19q negatively correlates with the expression of p53 protein. These parameters have both diagnostic and prognostic values.

Adolescent ; Adult ; Aged ; Astrocytoma ; genetics ; metabolism ; Brain Neoplasms ; genetics ; metabolism ; pathology ; Child ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 19 ; Female ; Humans ; Loss of Heterozygosity ; Male ; Middle Aged ; Oligodendroglioma ; genetics ; metabolism ; pathology ; Paraffin Embedding ; Tumor Suppressor Protein p53 ; metabolism ; Young Adult

Objective To investigate the application of cervical diffusion tensor imaging (DTI) in the diagnosis of amyotrophic lateral sclerosis (ALS). Methods Cervical DTI and conventional magnetic resonance imaging (MRI) was performed in 28 ALS patients rated with ALS functional rating scale (ALSFRS) and 20 healthy control subjects to obtain the mean diffusivity (MD) and fractional anisotropy (FA) histograms of the cervical spinal cord. Correlation analysis between DTI of the cervical spinal cord and the ALSFRS scores of the ALS patients was conducted. Results Compared with the control subjects, the ALS patients had significantly lowered mean FA and reduced cross-sectional area of the cervical spinal cord (P<0.05), but the MD value did not differ significantly between the two groups (P>0.05). A close correlation was found between the mean FA of the cervical spinal cord and the ALSFRS score (r=0.730,P=0.000), but not between the MD value and the ALSFRS score in the ALS patients. Conclusion Patients with ALS have significantly lowered mean FA, which may serve as an indicator for the diagnosis orALS. Together with the ALSFRS score, cervical DTI can better characterize the progression of ALS.

Objective A phase Ⅱ study was conducted to test the efficacy and toxicity of the combination of cisplatin,5-Fu and nimotuzumab,as induction treatment of resectable head and neck squamous cell carcinoma (HNSCC).Methods Forty cases of resectable HNSCC were treated with nimotuzumab (400 mg on day 1 ) combined with PF regimens ( cisplatin 75 mg/m2 on days 1 and 5-Fu 750 mg/m2 on days 1 -5 q3wks ). After 2 cycles,an organ-preservation local therapy (surgery or radiotherapy) was recommended.The primary endpoints of this study were overall response rate,pathologic complete response and safety of the induction treatment.Mean age of 40 patients was 54 years old,of them 9 patients with oropharyngeal cancer (22.5％ ),16 hypopharyngeal cancer (40.0％ ),10 laryngeal cancer (25.0％),and 5 oral cancer (12.5％ ).Results With a 2-cycle induction treatment,34 (85.0％)patients achieved complete or partial response. Twenty-four patients (60.0％) got downstage,with T downstage in 21 (52.5％ ) patients and N downstage in 8(20.0％) patients.Totally 27 patients got surgery after the induction treatment,of them 20 patients (74.1％ ) preserved organ functions. Four patients' primary tumors ( 10.0％ in all 40 patients and 14.8％ in operated 27 patients) showed pathologically complete responses.The toxicity was mild and manageable.The most common grade 3/4 toxicities were neutropenia ( 5.0％ ),nausea/vomiting ( 2.5％ ),stomatitis ( 2.5％ ) and thrombocytopenia ( 2.5％ ).One patient got grade 2 renal insufficiency and one patient got grade 1 skin rash. Conclusion For resectable HNSCC,nimotuzumab plus PF regimen as induction treatment is highly effective for preserving the organ function and the toxicities are well tolerable.

Objective To discuss the common complications of single-nostril transsphenoidal surgery for pituitary adenomas, and the prevention ofpostsurgical complications. Methods Clinical and follow-up (1-36 months) data of 241 patients with pituitary adenomas treated with single-nostril transsphenoidal surgery were collected and analyzed retrospectively by EXCEL software with regard to the patients' sex, age, tumor dimension and quality, postsurgical complications, and so on. Results Total removal of tumors was achieved in 171 (71%) cases, subtotal removal in 28 (11.6%), most removal in 26 (10.7%), and partial removal in 16 (6.6%). After the operation, 38 (15.8%) cases were found with transient diabetes insipidus, 12 (4.9%) cases with worse sight, 4 (1.6%) with cerebrospinal fluid rhinorrhea, 2 (0.8%) with unilateral oculomotor paralysis, and 2 (0.8%) with anterior pituitary insufficiency; during the operation, there were 2 (0.8%) cases with severe cavernous sinus hemorrhage, 2(0.8%) with nasoseptal perforation, no internal carotid artery injuries or death. Conclusions Though the damage of single-nostril transsphenoidal surgery for pituitary adenomas was small, there were a few complications. In order to prevent the complications and reduce the mortality, we should be familiar with the regional anatomy and better master the surgical skills, meanwhile, clinical experience is also very important in improving the therapeutic efficacy.

Objective To discuss the common complications of large acoustic neuromas performed surgery via suboccipital retrosigmoid approach under neurophysiological monitoring, and the prevention of postsurgical complications. Methods One hundred and sixteen patients with large acoustic neuromas, admitted to our hospital from May 2006 to April 2010, were performed surgery via suboccipital retrosigmoid approach under neurophysiological monitoring; clinical data and follow-up data (3-12 months) of these patients were collected and analyzed retrospectively; the influence of tumor dimension on short- and long-term postoperative complications after the surgery were compared.Results Total tumor resection was achieved in 107 patients, subtotal resection in 7 patients, and partial resection in 2 patients. After the operation, the facial nerve was preserved anatomically in 101 patients (87.07%); and the functional valuation of facial nerve according to postoperative House-Brackman showed 89 patients (76.72%) in grade Ⅰ-Ⅱ, 13 patients (11.21%) in gradeⅢ-Ⅳ and 14 patients (12.07%) in grade Ⅴ-Ⅵ. Short-term postoperative complications included hoarse voice in 16 patients and herpes catarrhalis of injured side in 20 patients. Long-term postoperative complications included loss of hearing (n=83) and permanent facial paralysis (n=23). Patients with tumor dimension larger than 5 cm had a significantly higher incidence of short-term postoperative complications than those within 3-5 cm (P< 0.05). No patient died. Conclusion The keys to avoiding the complications are to master the clinical anatomy of the approach, accumulate surgical experiences, preoperatively study the individual imaging and clinical data, and use intraoperative nerve monitoring.