Objective To investigate the clinical practice pressure and mental health of medical students with type D personality.Methods Type D Scale-14 (DS14) and Beck-Srivastava Stress Inventory (BSSI) test were applied to 371 medical students to assess the personality types and pressure.The symptom checklist 90 (SCL-90) was used to evaluate the psychological health.Results ①The detection rate of type D personality of medical students was 36.39％.②The average score in BSSI of medical students of type D personality was (99.27± 10.51),which was higher than medical students of non-type D personality (87.60± 11.37),and the difference was statistically significant (t=9.9711,P=0.0000).The medical students' score of type D personality in SCL-90 of 9 factors were all higher than medical students of non-type D personality,but the statistically significant difference were only in the score of depression,anxiety and psychosis-like symptoms (t=2.4409,P=0.0151;t=2.8662,P=0.0044;t=2.7783,P=0.0057).Conclusion In face of the same pressure of medical clinical practice,the medical students of type D personality are more likely to have a heavier psychological burden,and the college should pay special attention to the problem and try to intervene the problem,so as to reduce the pressure caused by a variety of psychological problems.

Lumbar dysfunction closely relates to the weakness or deficiency of lumbar proprioception, and accurate and comprehensive lumbar proprioception test is the important basis of training program formulation, efficacy assessment and prognostic evaluation. Comprehensive lumbar proprioception test includes position sense test, kinesthesia test and vibration sense test. It has been widely used in clinic at abroad, and is rich in test equipments and methods. Domestic research is still at the preliminary stage in this field, and is lack of accurate, objective and unified test methods. According to an overview of relevant literature, this article discussed the lumbar proprioception test methods, the influential factors and reliability of the test, finally, put forward the prospects about the research direction in this field.

Objective To observe the effect of telbivudine combined with adefuvir dipivoxil in the treatment of Hepatitis B patients with decompensated cirrhosis.Methods 56 Hepatitis B patients with decompensated cirrhosis were divided into two groups:treatment group (30 cases) and control group (26 cases).During 24 weeks,the control group received adefuvir dipivoxil( 10mg daily),supportive and symptomatic treatments,while the treatment group received telbivudine therapy(600mg daily) combiled with adefuvir dipivoxil ( 10mg daily) based on the regular treatments.After 24 weeks,the effect was observed and compared between the two groups.Results After treatment,the biochemical markers,Child-Pugh score of the treatment group was (33.2 ± 13.8) μmol/L,(44.5 ± 16.4) U/L,(36.1 ±1.5) g/L,(6.1 ± 1.8) points,respectively,and was better than those of the control group[ (71.8 ±18.6) μ mol/L,(89.9 ±44.9) U/L,(29.7 ± 1.3)g/L,(8.1 ±2.2) points] (t=15.32,15.20,23.37,6.09,all P＜0.05) ;HBV-DNA negative rate,HBeAg seroconversion rates of the treatment group was 93.3％ (28/30),43.3％(13/30),and was higher than that of the control group[76.9％ (20/26),7.6％ (2/26) ] (x2 =4.87,9.08,all P＜0.05).Conclusion Telbivudine combined with adefuvir dipivoxil was effective and safe for the treatment of Hepatitis B patients with decompensated cirrhosis.

Objective To investigate the role of TLR4/NF-κB signaling pathway under the action of TAK-242 in the cardiomyocyte apoptosis after coronary micro-embolism (CME) in rats.Methods Fortyfive rats were randomized (random number) into three groups:sham operation,CME and CME plus TAK242 groups (n =15 per group).CME was induced by injecting polyethylene microspheres (42 μm) into the left ventricle except the sham group.CME plus TAK-242 group was treated with TAK-242 (2 mg/kg) via the tail vein of mice 30 min before CME modeling.Cardiac function was evaluated 6 h after operation.Tissue biopsy was stained with HBFP to measure the size of infarction area.TUNEL assay was used to detect cardiomyocyte apoptosis.Western blot and qPCR were used to evaluate the protein levels and mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3,respectively.Statistical analysis was performed using one-way analysis of variance followed by LSD-t test.Results Compared with the sham group,left ventricular ejection fraction (LVEF) in the CME group was significantly decreased [(68.91 ± 4.12) ％ vs.(84.80 ± 2.51) ％,P ＜ 0.05],and the infarction area (P ＜ 0.05),the apoptosis index [(3.36 ± 0.63) ％ vs.(0.19 ± 0.08) ％,P ＜0.05],the mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3 in CME group were increased significantly (all P ＜ 0.05).Compared with CME group,LVEF in the CME plus TAK-242 group was significantly improved [(75.58 ± 5.01) ％ vs.(68.91 ± 4.12) ％,P＜0.05],and the infarction area [(8.58 ± 2.12) ％ vs.(14.65 ± 4.23) ％,P＜0.05],the apoptosis index [(1.43 ± 0.51) ％ vs.(3.36 ± 0.63) ％,P ＜ 0.05],the mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3 in CME + TAK-242 group were decreased significantly (all P ＜ 0.05).Conclusions TAK-242 effectively improved CME-induced cardiac dysfunction by regulating TLR4/NF-κB signaling pathway and then reducing the cardiomyocyte apoptosis.

AIM: To study the roles of Toll-like receptor 4 ( TLR4 ) and TLR4 activator lipopolysaccharide ( LPS) in colonic inflammation recovery .METHODS:Normal intestinal epithelial cells were cultured with LPS in vitro. The subgroups of the intestinal epithelial cells with differential expression of TLR 4 ( low, normal and high ) were construc-ted by the technique of lentivirus transfection .The cells with normal and high expression of TLR 4 were induced by LPS for 0 h, 2 h and 4 h.Inflammatory cytokines TNF-α, IL-6 and IL-8 in the culture supernatant were detected by ELISA .The mRNA levels of TNF-α, IL-6, IL-8, IL-10 and IL-1βwere detected by qPCR .The cell mobility was also monitored by wound healing assay .RESULTS:The protein expression of TLR 4 was significantly higher after LPS treatment than that in control groups of both cells with TLR4 normal and high expression (P<0.05).The inflammatory cytokines TNF-α, IL-6, IL-8 and IL-1βat mRNA and protein levels were also significantly increased after LPS treatment compared with control group (P<0.05).The protein levels of TNF-α, IL-6 and IL-8 between the 2 groups were also different with statistical sig-nificance ( P<0.05 ) .Higher mobility was observed in the cells with TLR 4 high expression compared to control cells . CONCLUSION:LPS induction might play a role in the activation of TLR 4-mediated inflammatory pathways by up-regula-ting the expression of inflammatory cytokines at both transcriptional and translational levels .

Per2 gene plays one of the most critical roles of clock gene which modulates circadian rhythm both in the physiological, biochemical and behavioral processes of organisms. The distributions of per2 gene include suprachiasmatic nucleus of the hypothalamus, central nucleus of amygdala, bed nucleus of the stria terminalis, hippocampus and other components of limbic system; it affects the emotional and visceral activities through participating in the system of circadian rhythm. The central per2 gene regulates the hypothalamus-pituitaryadrenal axis through integration of light input, steroid hormones and other neurotransmitters integration, acting on the target organs, and presentes a circadian rhythm of movement. This article reviewed the morphology and biology of per2 gene, and its participation in limbic system regulating the circadian rhythm of motional and visceral activities.

Purpose: This study was performed to investigate influencing factors of preoperative muscle mass-to-fat ratio (MMFR) and its impact on overall survival and postoperative complications of colon cancer. Methods: Patients who underwent colectomy for stage I–III colon cancer at the Second Affiliated Hospital of Soochow University between January 2016 and December 2022 were included. The skeletal muscle and fat area at the third lumbar vertebra were measured with preoperative CT measurement. MMFR was defined as the ratio of skeletal muscle area to total fat area, and low MMFR was defined as the 2 lowest tertiles (≤0.585). Univariate and multivariable analyses were conducted to assess the impact of MMFR on overall complications and survival outcomes. Kaplan-Meier survival curves and log-rank test were used to compare the overall survival between high MMFR and low MMFR groups. Results: A total of 885 patients were analyzed. Female sex, older age, high body mass index, sarcopenia, and high cancer stage were more likely to result in low MMFR. Complications, including intestinal fistula, chylous fistula and organ space surgical site infection were significantly higher in the low MMFR group. Low MMFR was an independent factor associated with overall complications (odds ratio, 1.940; 95% confidence interval [CI], 1.252–3.007; P < 0.01) and long-term survival (hazard ratio, 2.222; 95% CI, 1.443–3.425; P < 0.01). Furthermore, patients with high MMFR had a higher survival rate than patients with low MMFR (P < 0.01). Conclusion Low MMFR is an independent factor that predicts worse overall survival and complications in patients with colon cancer.

Thirteen compoumds were isolated from the n-BuOH portion of the 70% ethanolic extract of Comastoma pedunculatum by a combination of various chromatographic techniques including silica gel, macroporous adsorbent resin, Sephadex LH-20, and preparative HPLC, of which nine were triterpenoid saponins and four were flavone C-glycosides. Their structures were elucidated by spectroscopic data as saikogenin F (1), 3-O-beta-D-fucopyranosylsaikogenin F (2), clinoposaponin XV (3), saikosaponin A (4), 6"-acetylsaikosaponin A (5), clinoposaponin I (6), bupleuroside I (7) , clinoposaponin XII (8) , saikoponin b3 (9), isovitexin (10) , swertisin (11) , isoorientin (12), 3',4',5-trihydroxy-7-methoxy-6-C-beta-D-glucopyranosyl-flavone (13). Compounds 1-10, 12-13 were all isolated from Comastoma genus for the first time.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Flavones ; analysis ; isolation & purification ; Gentianaceae ; chemistry ; Saponins ; analysis ; isolation & purification ; Spectrometry, Mass, Electrospray Ionization

Sepsis is a serious complication of infection, and its further development may lead to multi-organ dysfunction syndrome. Sepsis cardiomyopathy is a common complication of sepsis and has been directly linked to high mortality. Although the pathogenesis of septic cardiomyopathy is not fully understood, in-depth study of the pathogenesis of septic cardiomyopathy and the identification of its potential therapeutic targets may reduce mortality in patients with sepsis. Ferroptosis is an iron-dependent mode of cell death that has been shown to be involved in the pathophysiological mechanisms of many diseases. Some related studies have reported that ferroptosis may be a potential mechanism of septic cardiomyopathy. This review provides new insights into the mechanisms of mitochondrial dysfunction, lipid peroxidation, xc-system, glutathione peroxidase 4 (GPX4), iron metabolism and the role of ferroptosiswith septic cardiomyopathy for further research and treatment of septic cardiomyopathy.

Objective: To evaluate the efficacy, toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost intensity-modulated radiotherapy (IMRT-SIB) after breast conservative surgery (BCS) for early breast cancer patients. Methods: A total of 76 patients with stage TisT_1-2N₀M₀ breast cancer treated with BCS were enrolled in the analysis. The patients who underwent breast radiotherapy without regional lymph node irridiation and hypo fractionated IMRT/VMAT were used. All patients received whole breast IMRT/VMAT with tumor bed SIB. The doses delivered to the whole breast was 42.4 Gy in 16 fractions, and the dose delivered to tumor bed for SIB was 49.6 Gy in 16 fractions. Cosmetic evaluation was based on the Harvard system. Acute and late toxicities were scored according to CACAT version 3.0. Survival and recurrence rates were calculated by Kaplan-Meier method. The univariate and multivariate analysis were conducted with logistic regression. Results: The median follow-up was 29 months (range 16-40 months). The follow-up rate was 100%. The 1-, 2-and 3-year overall survival rates were 100%. No recurrence or metastasis was observed in this study. The incidence of grade 1 acute skin toxicity was 68.4%, grade 2 was 7.9%. The late skin toxicity of grade 1 was 13.1%, grade 2 was 2.6%.In all, 82.4% of patients had excellent and good cosmetic outcome. The Mean dose of the tumor bed was predictive factor for grade 2 dermatitis. Conclusion: The efficacy, cosmetic effect, the acute and late treatment-related toxicity of hypofractionated IMRT/VMAT-SIB in patients with early breast cancer following BCS might be acceptable. A longer follow-up is needed to define the efficacy on outcomes. Trial registration Chinese clinical trial registry, ChiCTR1800016287