ObjectiveTo investigate the clinical epidemiology of intrahepatic cholelithiasis in Guangxi area. MethodsAn retrospective analysis was made on 8?585 cases of intrahepatic cholelithiasis proved by exploration in a period of 19 years. Data were collected and analyzed by computer PEMS.ResultsThe intrahepatic cholelithiasis accounted for more than one third of all biliary stone disease treated during the same period. The prevalence of intrahepatic cholelithiasis in peasants victim increased from 23.4% out of all gall stones in a period of 1981～1985 to 55.8% between 1991～1999. The constituent ratio of intrahepatic lithiasis in males was nearly the same to that in females. The peak age range of patients with intrahepatic lithiasis was 31～40, and the mortality was the highest among all biliary stone disease. ConclusionsIntrahepatic cholelithiasis is by no means a vanishing disease,especially in rural area.

Objective To investigate the mecA gene expression lvevl in clinically isolated Staphylococcus aureus (SA) strains and its correlation with drug resistance .Methods Clinically isolated 186 SA strains were collected .The K-P method was adopted to conduct the durg sensitivity test .Then DNA of these strains was extracted and the mecA gene was amplified by using PCR .Results The detection rate of methicillin-resistant SA(MRSA) was 30 .65% (57/186) ,the positive mecA gene was detected in 56 strains of MRSA and 10 strains of methicillin susceptible S .aureus(MSSA) among 129 strains of MSSA ;except susceptible to vancomycin and linezolid ,the resistance rate of MRSA to ther antibacterial durgs were higher than that of MSSA ,the resistance rate to antibac-terial durgs in the strains carrying mecA gene was higher than that in the strains without carrying mecA gene ,ther difference be-tween them had statistical significance (P<0 .05) .Conclusion Clinically isolated SA strains carrying mecA gene are resistant to multiple antibacterial drugs ,which indicating that mecA gene play an important role in SA drug-resistance mechanism .

Objective To assess the therapeutic effect of bone marrow‐derived mesenchymal stem cells (BMSCs) on osteoporotic fracture healing .Methods Bone marrow of the rat bilateral femur and tibia bone tissue were collected ,and BMSCs were isolated by the whole bone marrow adherence method .Sixty female 11‐week‐old SD rats were ovariectomized (OVX) to induce osteoporosis followed by bilateral fracture generation .Twenty rats were left without giving any further treatment (OVX controls) ,20 received injection of saline (OVX+placebo control) and 20 were given injection of BMSCs (OVX+BMSCs) .X‐ray scan was performed at 3‐day ,4‐week and 8‐week post‐fracture ,respectively .Results Flow cytometry analysis revealed that the isolated BMSCs express sur‐face antigens similar to those reported previously .X‐ray results showed that compared with OVX and OVX+placebo groups ,BM‐SCs treatment markedly accelerated fracture healing of in osteoporotic rats .Conclusion Transplantation of BMSCs can effectively improve the healing of primary osteoporotic fracture .

Objective To compare the clinical effects of improved posterolateral minimally invasive approach and traditional posterolateral approach combined with modular femoral head prosthesis in the treatment of femoral neck fractures in the elderly. Methods The study involved 70 patients with femoral neck fractures (26 males and 44 females; at age range of 67-95 years,mean 78.3 years) treated from October 2008 to June 2010.There were 62 patients with fresh femoral neck fractures and eight with old femoral neck fractures (2-4 months post-injury),all of whom were type Ⅲ or Ⅳ fractures according to the Garden' s classification.All surgeries were completed by the same operation group.The improved posterolateral minimally invasive approach group involved 32 patients including 12 males and 20 females and the traditional posterolateral approach group involved 38 patients including 14 males and 24 females.The two groups were compared in aspects of incision size,operative time,perioperative complications,prosthesis stability and hip functional recovery. Results All patients were followed up for an average of 16 weeks (range,12-18 weeks).The differences between the two groups were significant regarding the incision length,perioperative blood loss,and blood product transfusio amount (P ＜0.01 ),but insignificant in operative time ( P ＞ 0.05 ).All patients were able to take weight-bearing walk six weeks postoperatively.The two groups showed significant difference in the hip joint function by Chamley's criteria six weeks postoperatively ( P ＜ 0.05 ),but insignificant difference in the hip joint function by Harris' s criteria at the last follow-up ( P ＜ 0.05). Conclusion The modified posterolateral minimally invasive approach combined with modular femoral head prosthesis is a satisfactory method in treatment of femoral neck fractures in senile patients,for it can result in less intra-operative soft tissue damage and blood loss,as well as shorter rehabilitation time.

PAK1 plays an important role in the development of tumors. It is of great significance to screen and develop new PAK1 inhibitors as targeted drugs for cancer treatment. The traditional PAK1 inhibitor screening method has the problems of high cost and low efficiency. Computer virtual screening can reduce the cost of finding active lead compounds and improve the screening efficiency. In this study, a kind of PAK1 candidate compound was screened by computer assisted virtual screening combined with Z′lyteTM high flux kinase screen. In vitro enzyme activity screening showed that compound 18(K788)had good PAK1 inhibitory activity(inhibition rate was 42. 7%). Furtherly by MTT detection, it was found that K788 had significant PAK1 positive tumor killing activity, which was even better than the positive drug IPA-3. Flow cytometry and Western Blot showed that K788 could activate caspase apoptosis pathway and induce apoptosis of colon cancer cell DLD-1 by inhibiting PAK1 expression and activation. K788 has great potential for clinical development and application, and can be used as a PAK1 target for further research.

Objective To explore the implementation styles on the therapeutic effects on the neurosurgical intensive care unit (NICU) patients. Methods Patients were enrolled during February 3, 2015 to February 3, 2016. The key point time was August 3, 2015 when the treatment in our NICU was fully implemented by NICU professional doctors. Based on this time point, all the enrolled patients were divided into non-NICU professional doctor implementing (NNPDI) group and NICU professional doctor implementing (NPDI) group. Thus non-NICU professional doctors and professional doctors were the leaders of diagnosis and treatment in tow groups. The length of hospital stay, complications, prognosis and other therapeutic outcomes were compared between two groups. Results The length of hospital stay was longer in NPDI group than that in NNPDI group (P<0.05). The incidence of water-electrolyte imbalance was lower in NPDI group than that in NNPDI group (P<0.05). There were no significant differences in the incidence of the ventilator-associated pneumonia (VAP), the hepatic and renal insufficiency, the intracranial infections and stress ulcers between the two groups (P>0.05). The proportion of referral to other wards and fatality rate were both lower in NPDI group than those in NNPDI group (P<0.05). And the discharge rate from NICU was higher in NPDI group than that of NNPDI group (P<0.05). There was no significant difference in the rate of patients left hospital without treatment between the two groups (P>0.05). Conclusion The NICU professional doctor implementing may be contribute to, at least in part, the improving of prognosis of NICU patients without obvious advantages in most complications. The level of professional management remains to be improved.

GC-MS and LC-MS are the main techniques used for the structural identification of new psychoactive substances at present. However, they are hard to give accurate structure information because of the hardly available corresponding reference standards and the quickly changing status of these compounds. This leads tremendous obstacle on the rapid identification of new psychoactive substances. Nuclear magnetic resonance spectroscopy is one of the most effective methods for structures identification. Therefore, NMR is especially suitable for the analysis and identification of new psychoactive substances even with rapid structural changes. This article summarizes the NMR applications for the structural analysis of new psychoactive substances including synthetic cannabinoids, synthetic cathinones, piperazines, phenethylamines, ketamine & phencyclidine-type substances, and fentanyls. It is found that the NMR signals of the main frame structure of each kind of the new psychoactive substances are basically the same. Hence, these frame structure NMR signals can provide scientific evidence for the rapid identification of new psychoactive substances. This article also look ahead the prospect for the application of LC-NMR and DOSY in new psychoactive substances, which provides new ideas for the screening of new psychoactive substances.

[Summary] To explore the therapeutic effect of fecal microbiota transplantation (FMT) for severe psoriasis. A patient, male, 36 years old, diagnosed as severe plaque psoriasis for 10 years and irritable bowel syndrome (IBS) for 15 years, was administrated twice FMT via both upper endoscopy and colonoscopy with a 5‐week interval. The following items were used to evaluate responses: body surface area (BSA), psoriasis area and severity index (PASI), dermatology life quality index (DLQI), histological examination, intestinal symptoms, adverse reactions and serum level of tumor necrosis factor (TNF)‐α. After second FMT treatment for 5 weeks, aforementioned items were improved greatly compared with those before treatment. Moreover, IBS was completely relieved and no adverse reactions were observed during the treatment and follow‐up. In conclusion, FMT could be a novel therapy for psoriasis. Further clinical trials are needed to provide solid evidences.

Objective:To create radiomics models based on abbreviated multimodal magnetic resonance imaging (MRI) for the diagnosis of breast cancer.Methods:All breast MR imaging data between Jun 2014 and Mar 2019 were retrospectively collected. Patients with pathological results of puncture or surgical resection were involved in this study. One thousand three hundred and six patients (416 benign and 890 breast cancer) were divided into training cohort ( n=702), internal validation cohort ( n=302), and external validation cohort ( n=302). All images were reduced to: the joint model group [including T2 weighted imaging (T2WI), DWI (diffusion-weighted imaging) and first contrast-enhanced sequences], non-enhanced group (T2WI and DWI) and single-phase enhanced group (first contrast-enhanced sequences). Analysis of variance (ANOVA) and least absolute shrinkage and selection operator (LASSO) were used to reduce the dimension of texture features. Three supervised machine learning algorithms (Bagging decision tree, Gaussian process, support vector machine) were used to predict benign and malignant breast lesions, and the best classifier was selected to construct breast cancer diagnosis model. Models were validated by internal and external validation cohorts. Results:The Gaussian process algorithm was chosen. The area under the curve (AUC) of the joint model and the non-enhanced model for predicting breast cancer were 0.903 and 0.893 for the training cohort, 0.893 and 0.863 for the internal validation cohort, and 0.878 and 0.864 for the external validation cohort.Conclusions:The radiomics model based on abbreviated multimodal MRI can accurately diagnose breast cancer. And the non-enhanced model can accurately diagnose breast cancer without contrast enhancement, which provides feasibility for simplifying the diagnosis process.

Osteoporosis is a common disease of old age that affects millions of people worldwide. Besides, it has been a chronic disease difficult to treat in the elderly, so it is of great significance to develop new drugs for the treatment of senile osteoporosis. The endocannabinoid system contains cannabinoid ligands, endocannabinoid receptors, and enzymes required for the synthesis and degradation of endocannabinoids, which play an important role in bone metabolism. Preclinical studies using endocannabinoid system-based therapies in animal models and in vitro have shown that endocannabinoid systems can prevent senile osteoporosis and highlight their therapeutic potential for senile osteoporosis. In this paper, PubMed, ScienceDirect, CNKY, and Wanfang databases were searched for articles related to the endocannabinoid system and osteoporosis. This paper analyzed the pathogenesis of senile osteoporosis (such as calcium, active vitamin D3 deficiency or insufficiency, sex hormone deficiency, cell function decline and secondary to chronic diseases, etc.), and reviewed the various components of the endocannabinoid system and their application in osteoporosis by regulating bone homeostasis in recent years, providing a new direction for the clinical treatment of senile osteoporosis.