Objective To investigate the clinical efficacy of acupuncture at affected-limb gallbladder meridian points and its effect on the recovery of lower limb function in treating hemiplegia patients with cerebral infarction. Methods Sixty hemiplegia patients with cerebral infarction were randomly allocated to treatment and control groups, 30 cases each. The treatment group received acupuncture at the gallbladder meridian points of the affected-side lower limb as main therapy and the control group, conventional acupuncture. After two courses of treatment, a pre-/post-treatment change in the Lower Extremity Fugl-Meyer Assessment score was observed in the two groups and post-treatment walking paces, pace lengths and incidences of strephenopodia were compared between the two groups.Results There was a statistically significant pre-/post-treatment difference in the Lower Extremity Fugl-Meyer Assessment score in the two groups (P<0.01). There was a statistically significant post-treatment difference in the Lower Extremity Fugl-Meyer Assessment score between the treatment and control groups (P<0.05). There were statistically significant post-treatment differences in walking pace, pace length and the incidence of strephenopodia between the treatment and control groups (P<0.05).Conclusion Acupuncture at affected-limb gallbladder meridian points can improve lower limb function and reduce the incidence of strephenopodia in hemiplegia patients with cerebral infarction.

Objective: To examine the association between neonatal birth weight and maternal type 2 diabetes (T2DM), so as to provide insights into the formulation of the early T2DM prevention and improvements of maternal and children health. Methods: Single-nucleotide polymorphisms (SNPs) were collected from two genome-wide association studies (GWAS) that examined the association between neonatal birth weight and maternal T2DM. Inverse variance weighted method was employed for forward Mendelian randomization with 26 birth weight-associated SNPs as instrumental variables and maternal T2DM as the study outcome and for reverse Mendelian randomization with 18 maternal T2DM-associated SNPs as instrumental variables and maternal effects of neonatal birth weight as the study outcome. The heterogeneity was examined using Cochran's Q test, and the pleiotropy was evaluated using MR-Egger regression, while the robustness of the results was evaluated using leave-one-out test. Results: Cochran's Q test detected heterogeneity across two studies (P=0.019, 0.038), and random effect models were employed. Mendelian randomization showed that an increase in neonatal birth weight by per standard error (approximately 488 g) resulted a 29.9% reduction in the risk of maternal T2DM (OR=0.701, 95%CI: 0.547-0.899), and maternal T2DM increased the neonatal birth weight by 0.074 standard errors (OR=1.074, 95%CI: 1.043-1.106). No horizontal pleiotropy was seen for instrumental variables (P=0.241, 0.188). With each SNP excluded in turn, the results of Mendelian randomization study were robust. Conclusion There are bidirectional associations between neonatal birth weight and risk of maternal T2DM.

Objective To observe the effect of the yang-warming and fluid retention-resolving mothed on neuroendocrine and inflammatory factors in chronic heart failure (CHF) rats. Methods A total of 50 healthy adult male SD rats were randomly divided into blank group (10), CHF group (40). In CHF group, the rat model of chronic heart failure was replicated by intraperitoneal injection of adriamycin (ADR). After the completion of the model making, doppler echocardiography was used to determine the cardiac function of rats. There rats were randomly divided into the model group, the yang-warming and fluid retention-resolving group, the Xuefu-Zhuyu group and the captopril group. After continuous administration for 28 d and 2 h after the last dose, the HE staining was used to observe the pathological morphological changes of myocardium in each group. The levels of AngⅡ, TNF-α and IL-6 in serum were by ELISA. Results Compared with model group, the content of serum AngⅡ(294.33 ± 25.45 pg/ml, 265.86 ± 27.80 pg/ml, 301.87 ± 41.67 pg/ml vs. 615.44 ± 22.31 pg/ml), TNF-α(117.15 ± 11.33 pg/ml, 114.02 ± 11.57 pg/ml, 133.35 ± 34.80 pg/ml vs. 185.72 ± 36.53 pg/ml), IL-6 (23.97 ± 4.77 pg/ml, 27.61 ± 7.01 pg/ml, 28.38 ± 5.78 pg/ml vs. 58.45 ± 6.36 pg/ml) in the yang-warming and fluid retention-resolving group, Xuefu-Zhuyu group and captopril group significantly decreased (P<0.01 or P<0.05). Compared with Xuefu-Zhuyu group, the content of serumAngⅡ (301.87 ± 41.67 pg/ml vs. 265.86 ± 27.80 pg/ml) in the captopril group significantly increased (P<0.05). Conclusions The yang-warming and fluid retention-resolving mothed can reduce early CHF rats through reducing the serum TNF-α, Ang and ILⅡ -6 content, which could be one of the mechanism of action of the treatment of CHF.

Objective: To investigate the underlying influential factors related to emotional overeating behavior among college students,and to provide a reference for formulating intervention strategies for prevention of unhealthy eating behavior of college students. Methods: A questionnaire designed based on the social ecosystem theory was used to assess the potential influential factors of at personal, social, physical and macro level emotional overeating behavior of 2 045 college students. The Emotional Overeating Questionnaire was used to measure the frequency of emotional overeating behavior among normal weight college students. Binary Logistic regression analysis was performed to analyze the association between dietary norms and the influence emotional overeating behaviors. Results: In the full adjusted model, dietary norms (OR=1.28,95%CI=1.16-1.41)，emotion scale (OR=1.46, 95%CI=1.24-1.73) and close friends attitude(OR=0.75, 95%CI=0.59-0.95)were associated with emotional overeating behaviors. Sex, urban and rural origin, monthly living expenses, parental attitude, distance to frequent fast food restaurants outside the school, and the unmarked proportion of nutritional content and calorie information on food packaging were not associated with emotional overeating behaviors (P>0.05). Conclusion Dietary norms and emotion scale might increase the risk of motional overeating, close friends attitude might reduce the risk of emotional overeating. For reducing the frequency of unhealthy eating behavior, our results implied that 1) it s necessary to improve mental health of the college students; strengthening health education in order to make them distinguish the unhealthy dietary norms is important; peer education might be effective.

Objective: To observe the change and clinical significance of the peripheral blood T-lymphocytes CD45RA⁺ and CD45RO⁺ in children with Henoch-Schonlein purpura (HSP) under different clinical classification. Methods: From October 2015 to July 2017, the clinical data of 80 children with HSP in the Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.According to the clinical classification, they were divided into three groups: skin involvement group (35 cases), abdominal type group (36 cases), and renal type group (9 cases). Another 80 healthy children were selected as the control group.The changes and clinical significance of peripheral blood T-lymphocytes CD45RA⁺ , CD45RO⁺ and CD45RA⁺ /CD45RO⁺ ratio were analyzed. Results: Among the 80 children, 40 cases were male and 40 cases were female, with age of (7.2±2.3)years old.The CD45RA⁺ and CD45RO⁺ rates in the HSP group were (13.19±7.09)%, (12.07±3.46)%, respectively, which were significantly lower than those in the control group [(23.26±6.01)%, (21.74±3.46)%], the differences were statistically significant (t=9.69, 16.42, all P<0.05). The CD45RA⁺ ratio, CD45RA⁺ count and CD45RA⁺ /CD45RO⁺ ratio of the kidney type group were (8.02±3.63)%, (2.19±0.33)/μL, (-0.28±0.19), respectively, which were significantly lower than those of the skin group [(15.74±7.71)%, (2.55±0.33)/μL, (0.27±0.12)], the differences were statistically significant(t=3.085, 2.709, 4.013, all P<0.05). The ratio of CD45RA⁺ /CD45RO⁺ in the abdominal group was significantly lower than that in the skin group[(-0.07±0.27)vs.(0.27±0.12), t=2.989, P<0.05]. Conclusion Peripheral blood T lymphocyte subsets CD45RA⁺ and CD45RO⁺ may play a role in the generation and development of immune function changes in children with HSP, and the decrease of CD45RA⁺ T cells may be related to the risk of HSP nephritis.

Objective: In order to provide guidance for the prevention and control of epidemic situations in schools, this paper explores the risk perception and prevention behaviors of college students after classes resume in the post-epidemic period of novel coronavirus pneumonia. Methods: By using convenient sampling method, 835 college students who resumed classes were randomly selected from a university in Guizhou. Self-efficacy questionnaire, perceived social support questionnaire and self-designed questionnaire were adiministered. Results: Totally 37.0% of college students believed that the risk of infection was high, 57.4% of college students believed the severity of infection was very high once get infected, meanwhile, 84.3% of them think that keeping away from crowded places was a better preventive behavior, 89.7% of college students often wear masks, 91.4% of college students wash their hands frequently. There was a significant positive correlation between general self-efficacy, perceived social support and preventive behavior (r=0.10-0.65, P<0.01). General self-efficacy and perceived social support play both a partial intermediary role and a chain intermediary role between risk perception and preventive behavior. Conclusion Risk perception of Novel Coronavirus was moderate among college students, who can take active measures to effectively prevent it. Risk perception could not only directly affect the prevention behavior of college students, but also indirectly affect the prevention behavior of college students through understanding social support and general self-efficacy.

Objective To investigate the relationship between the incidence of deep vein thrombosis (DVT) during hospitalization and the energy of injury in tibial plateau fractures (TPFs).Methods 140 patients were enrolled in the study between September,2014,and October,2017 in Honghui Hospital,Xi'an Jiaotong University.According to the Schatzker classification,the low-energy group (Schatzker Ⅰ-Ⅲ) X-ray showed a simple or lateral fracture or compression fracture of the lateral plateau (n =63);the high-energy group (Schatzker Ⅳ-Ⅵ) X-ray showed the medial tibia or double of the tibial plateau (n =77).Duplex Ultrasonography was performed in lower extremities before and after surgical intervention for DVT evaluation and record the incidence of DVT,the days during hospitalization,the blood loss during surgery and the level of D-Dimer.All patients received mechanical and chemical thromboprophylaxis.The patient was followed up for one month after surgery,and the lower extremity ultrasound was reviewed and recorded.The measurement data were expressed as ((x) ± s),and the categorical variables were expressed in composition ratio.The measurement data were all in accordance with the normal distribution and the variance was uniform.The t-test was used,and the Chi-square test was used for comparison between groups.Results The incidence of thrombosis of tibial plateau fracture in TPFs was 36.43％ and 46.43％ pre-operation and post-operation respectively.The thrombosis incidence was 31.75 ％ (20/63) in the low-energy group and 40.26％ (31/77) in the high-energy group pre-operation.The thrombosis incidence was 44.44％ (28/63) in the low-energy group and 48.05％ (37/77) in the high-energy group post-operation.Statistical analysis showed no significant difference between the two groups pre-operation (P =0.298) and post-operation(P =0.785).The days during hospitalization [(11.94 ± 4.18) d,(9.56 ± 2.54) d],the blood loss during surgery [(208.96 ±224.43) ml,(129.68 ± 142.14) ml] and the level of D-Dimer [(2.39 ± 3.38) mg/L,(1.21 ± 2.32) mg/L] at pre-operation showed differences in the high energy group and the low energy group,respectively.Conclusions The incidence of DVT in TPFs is high during the hospital,but most of DVT is concentrated in the distal to the knee.Although the incidence of high energy injury and low energy injury DVT is not significantly different in TPFs,we should also be alert to the occurrence of DVT.

Objective:To evaluate the role of silencing information regulator 1 (SIRT1)/nuclear factors E2-related factor2 (Nrf2) signaling pathway in berberine-induced reduction of renal ischemia-reperfusion (I/R) injury in mice.Methods:Thirty SPF healthy male C57BL/6 mice, aged 6-8 weeks, weighing 18-22 g, were divided into 5 groups ( n=6 each) using a random number table method: sham operation group (S group), renal I/R group (RIR group), berberine+ I/R group (B group), berberine+ I/R+ SIRT1 inhibitor EX527 group (BE group) and berberine+ I/R+ Nrf2 inhibitor ATRA group (BA group). After the right kidney was removed, the left renal artery was clamped for 45 min followed by reperfusion to establish the model of renal I/R injury.In B, BE, and BA groups, berberine 100 mg·kg -1·d -1 was given for intragastric administration at 14 days before surgery.In group BE and group BA, EX527 5 mg·kg -1·d -1 and ATRA 10 mg·kg -1·d -1 were injected intraperitoneally at 3 days before surgery, respectively.The equal volume of normal saline was given for 14 consecutive days in group S and group RIR.Blood samples were collected from orbital vein at 24 h of reperfusion for measurement of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations, for determination of the interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) contents (by enzyme-linked immunosorbent assay) and expression of SIRT1, Nrf2, apoptosis-associated speck-like protein containing CARD (ASC), caspase-1, nucleotide-binding oligomerization domain-like receptor containing pyrin domain (NLRP3) (by Western blot) and for examination of the pathological changes of renal tubules (with a light microscope). The damage to the renal tubules was scored. Results:Compared with group S, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly increased in RIR, B, BE and BA groups, the expression of SIRT1, Nrf2, ASC, caspase-1 and NLRP3 was up-regulated in RIR, BE and BA groups, and the expression of SIRT1, Nrf2, caspase-1 and NLRP3 was up-regulated in group B ( P<0.05). Compared with group RIR, the concentrations of serum Cr and BUN, the contents of renal IL-1β and TNF-α and renal tubular injury score were significantly decreased in B, BE and BA groups, the expression of SIRT1 and Nrf2 in group B, Nrf2 and ASC in BE group and SIRT1, ASC and caspase-1 in BA group was up-regulated, and the expression of ASC, caspase-1 and NLRP3 in group B, SIRT1 and NLRP3 in BE group and Nrf2 in BA group was down-regulated ( P<0.05). Compared with group B, the serum concentrations of Cr and BUN, the contents of IL-1β and TNF-α and renal tubular injury score were significantly increased in BE and BA groups, the expression of ASC, caspase-1 and NLRP3 in BE and BA groups was up-regulated, and the expression of SIRT1 in BE and Nrf2 in BA groups was down-regulated ( P<0.05). Conclusion:SIRT1/Nrf2 signaling pathway is involved in the process of berberine-induced reduction of renal I/R, which is related to inhibiting pyroptosis in mice.

Objective To investigate the incidence of and risk factors for deep venous thrombosis (DVT) at the uninjured limb during hospitalization in patients with lower extremity fracture. Methods The clinical data were retrospectively analyzed of the 494 patients who had been hospitalized for lower extremity fracture at Department of Orthopedics, Honghui Hospital from September 1, 2014 to October 1, 2017. They were 228 males and 266 females with an average age of 58.9 ± 18.9 years ( from 16 to 94 years ) . 290 fractures occurred proximally to the knee, 101 fractures around the knee and 103 fractures distally to the knee. They received anticoagulant prophylaxis or treatment during hospitalization. After operation, they were examined with Doppler sonography for bilateral lower limbs to detect occurrence of thrombus. The incidence of DVT at the uninjured limb during hospitalization was recorded and its possible risk factors were analyzed statistically. The possible risk factors ( gender, age, fracture type, body mass index, concomitant internal disease, time from injury to surgery, time from surgery to discharge, American Society of Anesthesiologists rating, operation duration, blood loss, fluid infusion volume and D-dimer level ) were screened by single factor logistic regression analysis and the major independent risk factors were determined by multi-factor logistic re-gression analysis.Results DVT occurred at the injured limb during hospitalization in 237 cases ( 47.97%). Of them, 221 ( 44.74%) had peripheral thrombus, 7 central thrombus ( 1.42%) and 9 mixed thrombus ( 1.82%). DVT occurred at the uninjured limb during hospitalization in 98 cases ( 19.84%). Of them, 90 (18.2%) had peripheral thrombus, one central thrombus (0.2%) and 7 mixed thrombus (1.4%). Of the 98 patients with DVT at the uninjured limb, 74 (75.51%) had DVT at both lower limbs and 24 (24.49%) had DVT only at the uninjured limb. Age and D-dimer level one day after surgery were independent risk factors for DVT at the uninjured limb during hospitalization. Conclusions The incidence of actual DVT at the unin-jured limb in patients with lower extremity fracture cannot be ignored in spite of use of anticoagulants for pro-phylaxis or treatment during hospitalization. We should also be aware that age and D-dimer level one day after surgery are independent risk factors for DVT at the uninjured limb during hospitalization.

Bladder cancer is one of the most common malignant tumors of the urinary system, among which urothelial carcinoma is the main one. The traditional treatment methods are mainly surgical resection and chemotherapy, but the treatment effect of advanced patients is not good, and the prognosis is poor. In recent years, with the development of immune checkpoint inhibitors, there are many treatment options that are more effective than traditional therapies. Programmed cell death protein 1 (PD-1)and programmed cell death ligand 1(PD-L1)inhibitors stop the negative regulation of the immune system by blocking the binding of PD-1 and PD-L1, thereby enhancing the anti-tumor activity of the body's immune system. This article mainly reviews the efficacy and safety of PD-1/PD-L1 inhibitors commonly used in the clinical treatment of locally advanced or metastatic urinary tract carcinoma of the bladder.