Objective To analyze the HLA - DRB1 gene polymorphism and the hereditary association with unexplained recurrent spontaneous abortions(URSA)in a population of Tujia and Han nationality from west part of Hunan province in China. Methods The alleles at the HLA-DRB1 typing were analyzed by polymerase chain reac-tion-sequence specific primers (PCR-SSP) in 76 URSA Tujia population and 68 URSA Han population and 82 healthy Tujia population and 75 healthy Han population. Results ①DRB1*04 frequency of URSA in Tujia and Han population was strikingly higher than that of the healthy Tujia and Han population(RR>1,Pc <0.01),but the DRB1*12 frequency was strikingly lower than that of the healthy Tujia and Han population respectively(RR<1,Pc <0.01). ②DRB1*07 frequency of URSA in Tujia population was strikingly higher than that of the URSA in Han population (18.08% : 5.28%, Pc<0.01). Conclusion HLA-DRB1*04 maybe predisposing genes of URSA in Tujia and Han population,and HLA-DRB1*12 maybe associated with an antagonist effect in the pathogenesis of UR-SA in this population.

Objective: To determine the long-term prognostic value of ~(99m)Tc-sestamibi (MIBI) Gated myocardial perfusion imaging(G-MPI)in patients with coronary artery disease.Methods: A total of 1345 consecutive symptomatic coronary artery disease patients who underwent ~(99m)Tc-MIBI G-MPI were studied.1250 patients were followed-up by telephone interview, the median follow-up time was 26.7±13.6 months.Events were defined as cardiac death, nonfatal myocardial infarction and revascularization by coronary artery bypass graft or percutaneous coronary artery intervention.Results: Cox regression analysis indicated that summed stress score (3.8±6.1,χ~2=67.25), summed different score (1.1±3.0,χ~2=21.09) and left ventricular ejection fraction (LVEF) (0.667±0.097,χ~2=42.26) were independent predictive factors of cardiac events (P<0.01).Kaplan-Meier analysis indicated that cardiac event free survival was significantly lower in the patient with LVEF≤50%.Conclusion: In Patients with symptomatic coronary artery disease, the summed stress score, summed rest score, summed different score and LVEF had prognostic value, and low LVEF indicated worse prognosis.

The effect of inhibition of proliferation of a novel human megakaryoblastic leukemia cell line (HIMeg) by two physiological factors, 1.25-dihydroxyvitamin D3 [1,25(OH)2 D3] and 13-cis-retinoic acid (RA), was investigated. At the range of 10-9 - 10-6 mol/L, 1,25(OH)2 D3 and RA showed significant inhibition of proliferation of the megakaryoblastic leukemia cells,which was demonstrated by count of survival cells,incorporation of [3H]-TdR and [3H]-UR, and cloning efficiency. From above, it can further explain the m.echanism of differentiation-inducers and the effect of 1,25(OH)2D3 on myelofibrosis. It is possible for 1,25(OH)2D3 and RA to be used for a new -treatment.

Objective:To explore the clients' assessment for the ethical behavior of the counselors and psychotherapists.Methods:The main method used in this evaluation was questionnaire,and the self-made questionnaire of the ethical problems in psychotherapy and counseling(for the clients)were used as evaluation tools.Totally 1100 clients,from 12 cities in China,were investigated with 807 questionnaires returned.Results:84.5% of the clients were confident in the treatments,and 89.2% of them gave positive assessment for the ability of their counselors and psychotherapists.15.9% of clients said the counselors and psychotherapists showed impatience or talked to them about their stress sometimes.Besides,59.1% knew about the characters,names and charge of the psychotherapies and counseling,and 53.4% knew the background of the counselors and psychotherapists.91.3% of clients thought the privacy and treatment could be kept secret.7% of clients had intimate relationship with their counselors or psychotherapists,1.5% had sexual relations,and 18.3% made friends in lives.79% of clients could receive timely psychotherapies and counseling.Conclusion:From the assessment of the clients,the vast majorities of the counselors and psychotherapists do well in work ability,confidentiality and time-setting,but not so well in informed-consent and dual relations,which need to be paid attention to and improved.

Objective To isolate and culture rats liver KCS ,and to explore the effect of IRE1-XBP1 pathway on regulation of polarization in activated Kupffer cells (KCs) .Methods (1)Rat KCs were isolated by Ⅳ type collagenase digestion and gradient cen-trifugation methods .(2)KCs were transfected and randomly divided into four groups :XBP1-shRNA group ,Ctrl-shRNA group , AdV-XBP1 group and Ctrl-AdV group .(3)The transfection level of KCs XBP1 ,IL-6 ,IFN-γ ,TNF-α and IL-17 were detected by RT-PCR ;the protein expression level of JAK1 ,JAK2 ,STAT1 and STAT3 were evaluated by Western blot .(4)The changes of KCs expression type in each group were detected by flow cytometry (FCM ) and the laser confocal .(5)T cells derived from rat spleen cells were co-cultured within the 4 groups of KCs mentioned above ;T cells proliferation was measured by Brdu labeling assay .(6)T cells apoptosis was determined by Annexin V /PI FCM analysis .(7)The density of IL-6 ,IFN-γ ,TNF-α ,IL-17 and IL-10 in the su-pernatant of co culture was assessed by ELISA .Results (1)The mRNA and protein level of XBP1 were measured by RT-PCR and western blot ,those in XBP1-shRNA group were significantly reduced compared with those in the other three groups ,while in AdV-XBP1 groups ,results demonstrated entirely the opposite tendency (P< 0 .05) .(2)The expression of marker molecules on the sur-face of KCs such as M HC Ⅱ ,CD86 and CD40 in XBP1-shRNA group were significantly lower (P< 0 .05) ,but CD204 and CD206 expression were much higher compared with the other three (P< 0 .05) .However the expression tendency of these surface markers were shown the opposite results in AdV-XBP1 group (P < 0 .05) .(3)Western blot revealed the XBP1-shRNA could statistically suppress the protein levels and phosphorylation of JAK 1 ,JAK2 ,STAT1 and STAT3 ,which involved in the pro inflammatory cyto-kines regulation and KCs polarization (P< 0 .05) .But in AdV-XBP1 group ,these protein and its phosphorylation were markedly promoted (P< 0 .05) .ELISA results collaborated with Western blot .(4)3 d after co cultured with KCs transfected with XBP1-shR-NA ,the levels of T lymphocyte proliferation and pro inflammatory cytokines secretion were significantly reduced ,but the levels of T lymphocyte apoptosis and anti inflammatory cytokines secretion were remarkably enhanced (P< 0 .05) .Conclusion Blockage of IRE1-XBP1 activation could alter the phenotype of active KCs to M 2 like type and attenuated the capacity of antigen present of KCs ,while up regulated the expression of IRE1-XBP1 pathway could change the phenotype of KCs to M 1 type plus the promotion of antigen present capacity .

[ ABSTRACT] AIM:To investigate the antipyretic effect of patchouli oil on lipopolysaccharide ( LPS)-induced fe-ver in rabbits.METHODS:Male rabbits (n=42) were randomly divided into 7 groups according to their body weight and basal body temperature, including control group, model group, western medical positive group, traditional Chinese medical positive group, and high, middle and low doses (2%, 1%and 0.5%) of patchouli oil groups.Subsequently, except the controls, the rabbits were injected with LPS at a dose of 1 mL/kg (2 mg/L) through marginal ear vein to establish rabbit fever model and the rabbits in control group received the same volume of NS.The rabbits in control group and model group were injected with 0.5%Tween-80 0.5 h late, and the rabbits in the other groups were treated with correspoonding drugs. The effect of patchouli oil on the body temperature was observed, and the levels of interleukin-1β( IL-1β) and tumor nec-rosis factor-α(TNF-α) in the serum, and prostaglandin E2(PGE2) and cyclic adenosine monophosphate (cAMP) in the hypothalamus were measured by radioimmunoassay.RESULTS: The body temperature and the levels of IL-1β, TNF-α, cAMP and PGE2 in model group were significant higher than those in control group.Patchouli oil notably inhibited the body temperature in the febrile rabbits.From 1.5 h to 5.5 h after administration, the body temperatures were increased by (1.06 ±1.55), (1.62 ±1.36), (1.38 ±1.22), (0.98 ±0.98) and (0.48 ±0.95) ℃in high patchouli oil group, re-spectively.From 3.5 to 5.5 h after administration, the body temperatures were elevated by ( 1.47 ±0.73 ) , ( 1.15 ± 0.68) and (0.63 ±0.54) ℃ in middle patchouli oil group, respectively.A tendency of downregulation of the elevated body temperatures was observed at every time point after administration in low patchouli oil group.Patchouli oil significantly decreased the levels of TNF-αin the serum and cAMP content in the hypothalamus, and attenuated the elevated tendency of the IL-1βlevel in the serum and PGE2 level in the hypothalamus.CONCLUSION:Patchouli oil evidently has antipyretic effect on LPS-induced fever in the rabbits.The antipyretic mechanism might be related to the inhibition of TNF-αlevel in serum and cAMP content in the hypothalamus.

Objective To evaluate the clinical efficacy of laparoscopic hepatectomy and open hepatectomy for the treatment of hepatocellular carcinoma.Methods Two hundred and sixteen patients with hepatocellular carcinoma who were admitted to the Chongqing Three Gorges Central Hospital from October 2014 to December 2017 were enrolled in this study,52 patients undergoing laparoscopic hepatectomy (laparoscopic group) and 164 patients undergoing open hepatectomy,52 patients (open group) were matched by propensity score matching method to reduce confounding bias.The operation time,tumor sizes,resection margin,time of hepatic inflow occlusion,volume of blood loss,blood transfusion,postoperative complication rate,drainage tube removal time,postoperative anal exhaust time,duration of postoperative hospital stay and survival rates were compared.T test was used for the measurement data in line with the normal distribution,and the results were represented by (Mean ± SD) tandard deviation;Wilcoxon test was used for the measurement data in the skewed distribution,and M(range) was used for represention,and the chi-square test or Fisher's exact probability test was used for the counting data.Kaplan-meier method was used to describe the survival curve,and log-rank test was used to compare the survival rate.Cox regression model was used to evaluate the risk factors affecting the survival of patients with hepatocellular carcinoma.Results All patients were recovered with no perioperative death.The operation time,tumor sizes,resection margin,time of hepatic inflow occlusion were (226.1 ±67.5) min,(49.2 ± 15.5) mm,(14.3 ± 4.9) mm,(34.1±18.1) min and (227.0 ±55.7) min,(49.4 ±16.6) mm,(14.6 ±4.0) mm,(38.2 ± 16.1) min,with no significant differences between the two groups(P ＞ 0.05).The volume of blood loss,blood transfusion,postoperative complication rate,drainage tube removal time,postoperative anal exhaust time,duration of postoperative hospital stay were 325(50-1 200) ml,11.5％,15.4％,(4.8 ±0.9) d,3(2-5) d,(11.9± 3.5) d and 375(100-2 000) ml,19.2％,23.1％,(5.9 ±0.8) d,4(3-5) d,(14.9 ±6.2) d,with significant differences between the 2 groups(P ＜0.05).1-and 3-year overall survival rates were 93.4％,83.7％ and 1-and 3-year disease-free survival rates were 87.7％,71.2％ in laparoscopic group;1-and 3-year overall survival rates were 94.1％,82.5％ and 1-and 3-year disease-free survival rates were 88.3％,70.8％ in open group,with no significant differences between the 2 groups(P ＞0.05).Cox regression analysis revealed that ICG R15,tumor size and tumor differentiation were independent risk factors of survival (hazard ratio ＞ 1,P ＜ 0.005).Conclusions Application of Laparoscopic hepatectomy for the treatment of selective hepatocellular carcinoma patients has better short-term efficacy than open hepatectomy and long-term efficacy is comparably.The propensity score matching can reduce confounding bias and have value for clinical research.

Objective:To evaluate the effect of propofol anesthesia on autophagy in hippocampal neurons of newborn rats.Methods:Thirty-nine healthy Sprague-Dawley rats, aged 7 days, weighing 10-12 g, were divided into 3 groups ( n=13 each) using a random number table method: control group (group C), fat emulsion group (group F) and propofol group (group P). Normal saline 8 ml/kg was intraperitoneally injected for 5 consecutive days in group C. Medium-/long-chain fatty emulsion injection 8 ml/kg was intraperitoneally injected for 5 consecutive days in group F. Medium-/long-chain propofol injection 80 mg/kg was intraperitoneally injected for 5 consecutive days in group P. Five rats were sacrificed on 1st day after the end of propofol anesthesia, and hippocampal tissues were taken for determination of the expression of microtubule-associated protein 1 light chain 3B (LC3B) and Beclin-1 (by Western blot). The remaining rats in each group underwent the Morris water maze test on 19th day after the end of propofol anesthesia (30 days after birth), and the escape latency, percentage of time of staying at the target quadrant and the number of crossing the original platform were recorded. Results:Compared with group C, no significant change was found in the expression of hippocampal LC3B and Beclin-1, escape latency, percentage of time of staying at the target quadrant, and the number of crossing the original platform in group F ( P>0.05), and the expression of hippocampal LC3B and Beclin-1 was significantly up-regulated, the escape latency was prolonged, percentage of time of staying at the target quadrant was decreased, and the number of crossing the original platform was decreased in group P ( P<0.05 or 0.01). Conclusion:The mechanism by which propofol anesthesia causes long-term cognitive dysfunction may be related to promoting autophagy in hippocampal neurons of newborn rats.

Renal interstitial fibrosis（RIF）is a common pathway for the progression of chronic kidney disease to renal failure，and its pathogenesis is mainly related to renal inflammatory damage，oxidative stress，apoptosis，and excessive extracellular matrix（ECM） deposition. Transforming growth factor-β₁（TGF-β₁） signaling pathway，mammalian target of rapamycin（mTOR） signaling pathway and other signaling pathways mediate the occurrence and development of RIF. Because of the complicated mechanism of RIF，there have been no specific prevention and treatment measures in clinical practice. Autophagy is a non-damaging response produced by eukaryotic cells. It maintains the balance of tissue homeostasis through degradation and reabsorption. At present， Chinese medicine has achieved desirable clinical effects with its unique advantages of multiple components，multiple effects，and multiple targets in the treatment of chronic kidney disease to delay the process of RIF. Scholars have found that autophagy is consistent with the Yin-Yang theory and the theory of abdominal mass in traditional Chinese medicine （TCM） to a certain extent，and it is involved in many aspects of RIF. The progression of RIF is closely related to autophagy. The targeted therapy of RIF by intervention in autophagy has become the frontier of research. However，little is known about the role of autophagy in RIF and the regulation of autophagy by Chinese medicine in the treatment of RIF. Therefore，it is necessary to further elucidate the relationship between autophagy and RIF in order to clarify the mechanism of autophagy in RIF and the mechanism of Chinese medicine regulating autophagy in targeted therapy of RIF. This article focused on the correlation between autophagy and RIF based on TCM theory，and systematically summarized the role of autophagy in RIF and the intervention of Chinese medicine by combining the effects of autophagy on inflammation damage，oxidative stress，apoptosis，and excessive ECM deposition in RIF， and the regulation mechanism of autophagy in TGF-β₁ and mTOR signaling pathways in RIF. This study was expected to provide a certain reference for the clinical treatment of RIF and the development of new drugs.

Objective:To explore the clinical value of "hydration therapy" in the treatment of severe acute paraquat poisoning (APP).Methods:A prospective historical control observation was conducted. Fifty-eight patients with severe APP admitted to Shouguang People's Hospital Affiliated to Weifang Medical College from February 2014 to June 2019 were enrolled. Twenty-six patients admitted before May 10th, 2016 were enrolled in the standard treatment group. After being admitted to intensive care unit (ICU) from the department of emergency, patients in the standard treatment group were immediately given standard treatment such as repeated gastric lavage, catharsis, adsorption of poison by activated carbon or montmorillonite powder, drug treatment and blood purification. From May 10th, 2016, 32 patients were enrolled in the intensive treatment group. On the basis of standard treatment, "hydration therapy" was carried out, that was, 0.9% NaCl and/or 5% glucose injection were used for continuous intravenous infusion throughout the day, so as to ensure that the total amount of fluid infusion per day reached 200 mL/kg within 48-72 hours after ICU admission. At the same time, furosemide was used to strengthen diuresis to ensure the balance of water and electrolyte. If heart failure or acute pulmonary interstitial edema occurred during the treatment, "hydration therapy" should be stopped immediately. Six months after treatment, all patients were followed up. The patients with normal activity, no complaints of discomfort and no damage of heart, lung, liver, kidney and other organs were regarded as cured. The therapeutic effect of "hydration therapy" was evaluated.Results:There was no significant difference in gender, age, dosage or time from taking poison to ICU between the two groups. In the intensive treatment group, 32 patients did not appear heart failure during continuous rehydration treatment. Follow-up after 6 months showed that the overall cure rate in the intensive treatment group was significantly higher than that in the standard treatment group [59.4% (19/32) vs. 19.2% (5/26), P < 0.05]. In the 6-month follow-up, there was no significant difference in age or time from taking poison to ICU between the two groups, but the dosage in the intensive treatment group was significantly higher than that in the standard treatment group (mL: 54.06±26.03 vs. 23.00±4.47, P < 0.05). After 6 months of follow-up, chest CT showed that the lesions of pulmonary fibrosis of cured patients in both group gradually reduced with time, not completely progressive and irreversible. Conclusion:"Hydration therapy" with intensive diuresis can significantly improve the rescue success rate of patients with severe APP.