Objective To investigate the clinical efficacy of aconite cake moxibustion with different quantity of moxa in treating primary osteoporosis. Method Ninety patients were randomly allocated to three groups, 30 cases each. The three groups were given low, moderate and high-intensity aconite cake moxibustions, respectively. The therapeutic effects were compared after two courses of treatment. Result The bone density T-score was better in the moderate and strong stimulation groups than in the weak stimulation group (P<0.05) and better in the strong stimulation group than in the moderate stimulation group (P<0.05). Conclusion Moderate and high-intensity aconite cake moxibustion has a better relieving effect on osteoporosis. The high-intensity moxibustion produces a more marked effect.

Objective To observe the change of intestinal microflora on the process of nonalcoholic steatohepatitis(NASH),and to explore the synbiotics therapeutic effect on NASH.Methods Rats were administrated with high fat diet to establish NASH model.In the process of NASH rats modeling,the level of triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low density lipoprotein (LDL), fasting blood sugar (FBS) and fasting insulin (FINS) was dynamically tested by automatic biochemical analyzer.The change of main intestinal flora was detected by 16 S rRNA fluorescence quantitative polymerase chain reaction.NAFLD activity score was calculated.HE staining was used to observe the hepaticpathological changes and the TLR4 expression was detected by using enzyme-linked immunosorbent assay and immunohistochemical method.Until the 4th,8th,10th weekin the process of NASH modeling, 10 rats were feeded with synbiotics for 2 weeks, and all of above indicators were tested and observed.Results 1)With the extension of a high-fat diet feeding time, the degree of hepatocyte steatosis obviously increased.NAFLD score was significantly heightened(P<0.01).2)Number of independent activities of rats significantly increased, the serological level of TG, TC, LDL, FBS and FINS were lower significantly after intervention with synbiotics for 2 weeks(P<0.05).3)Synbiotics intervention for two weeks significantly increased the amount of bifidobacterium and lactobacillus and decrease the amount of enterococcus significantly(P<0.05).4)The expression of TLR4 was gradually increased in the process of NASH rats modeling(P<0.05),but decreased after 2 weeks of the synbiotics-intervention (P<0.05).Conclusions Intestinal microecology change is closely related to the development of NASH,therefor, synbiotics could improve the quality of life and biochemical indicators of NASH rats through adjusting intestinal microecology and the expression level of TLR4 protein might been involved.

Objective To analyze the effect of siRNA targeting MIF( MIFsiRNA) on the growth of colorectal cancer xenografts and the life quality of tumor-bearing mice.Methods BALB/C mouse model carring colorectal cancer was established.Thirty mice were divided into three groups randomly and managed respectively with intratumor injection of DEPC water, MIFsiRNA(0.15 nmol/g) and non-specific siRNA (0.15 nmol/g), respectively twice a week for consecutively 4 weeks.Drinking water, fodder consumed and body weight was recorded daily, and tumor volume was measured once a week.Mice were sacrificed after four weeks.ELISA and immunohistochemistry were used to detect the expression of MIF in serum and in tumor tissues.Spectrophotometric detection was used to detect caspase-3 protein.TUNEL was used to detect apoptotic cells.Results MIF expression in serum in MIFsiRNA group was lower than the other two groups [(22 ± 6) ng/ml vs (32 ± 8) ng/ml and (33 ± 8) ng/ml, P ＜ 0.01]; MIF expression in tissues was less than the other two groups [(85 ± 20) /500 vs.(423 ± 23) /500 and (442 ± 31) /500, P ＜ 0.01]; Tumor was smaller than the other two groups at third and fourth week (P ＜ 0.01) ; Tumor weight was significantly less than the other two groups [(1.93 ±0.21) g vs (4.40 ±0.30) g and (5.25 ±0.44) g, P＜0.01]; Mice in MIFsiRNA group were healthier than the other two groups as judged by water and fodder consumption (P ＜ 0.01 ) , while weight change was not significantly different among the three groups ( P ＞ 0.05 ).Caspase-3 protein in tissues was higher than the other two groups [(0.74 ±0.06) μg vs (0.57 ±0.08) μg and (0.56 ±0.02) μg, P ＜0.01]; Apoptosis cells in tissues were higher than the other two groups [(12 ± 2)/ 100 个vs 0 and 0, P ＜ 0.01].Conclusions Knockdowning MIF gene expression inhibits the growth of colorectal cancer xenografts and improves life quality of tumor-bearing mice, possibly by a mechanism in which MIFsiRNA activates caspase-3 promoting cell apoptosis.

Objective Observe the effect of Total paeony glycoside(TPG)has on the T-cell immune action and apoptosis process of Oral lichen planus patients and analyze the mechanism.Methods 20 OLP patients are recruited into this experiment, each is treated with TPG,and their clinical effect is taken notes of.Observe the apoptosis of OLP lesions from each of the patients before and after the treatment,compare the apoptosis condition and the expression of CD4 + ,CD8 + ,and the CD4 +/CD8 + ratio,to analyze the role TPG plays on the immune expression of T-cell and the effect on apoptosis process.Results TPG improve the clini-cal manifestation of OLP patients significantly,resulting in the decrease of reticulum and erosive areas,and the pain index is de-creased obviously.The expression of CD4 + and CD8 + are decreased in OLP lesions after the treatment of TPG.Conclusion TPG may induce the apoptosis of the T-cell in lamina propria of the OLP lesions to regulate the T-cell immune action of OLP patients, and slow the development of inflammatory process of OLP,and in that way,TPG shows its potential in treating OLP,and this ex-periment can provide the primary evidence.

Objective:To investigate the efficacy of Suchan-Yishen Decoction combined with western routine medicine on proteinuria due to chronic glomerulonephritis. Methods:A total of 86 patients with urinary protein, who met the inclusion criteria in Zhongshan people's hospital from January of 2017 to December of 2018, were selected and divided into two groups according to the random number table method with 43 patients in each group. The control group took valsartan capsule orally on the basis of conventional western medicine, and the observation group took Suchan-Yishen Decoctionon the basis of the control group. Both groups were treated continuously for two months. The CD3 +, CD4 +, CD8 + were determined by flow cytometry; the serum levels of interleukin (IL)-6, IL-17 and tumor necrosis factor (TNF)-α were determined by ELISA method. Results:The total effective rate was 88.4% (38/43) in the observation group and 67.4% (29/43) in the control group. The difference between the two groups was statistically significant ( χ2=4.324, P=0.038). After the treatment, levels of urinary protein (0.82 ± 0.13 g vs. 1.04 ± 0.17 g, t=6.009), BUN (6.12 ± 0.71 mmol/L vs. 6.60 ± 0.75 mmol/L, t=6.411) and SCr (82.87 ± 10.43 μmol/L vs. 94.11 ± 11.17 μmol/L, t=17.433) in the observation group at 24 h were all significantly lower than those of the control group ( P<0.01). After the treatment, levels of CD3 + and CD4 + in the observation group were significantly higher than those of the control group ( t values were 7.981, 8.904, respectively, all Ps<0.01), and level of CD8 + was significantly lower than that of the control group ( t=8.933, P<0.01). Serum levels of IL-6, IL-17, TNF-α in the observation group were significantly lower than those of the control group ( t values were 10.983, 49.005, 13.994, respectively, all Ps<0.01). Conclusions:The Suchan-Yishen Decoction combined with conventional western medicine can relieve the clinical symptoms of chronic glomerulonephritis patients, increase the therapeutic effect of proteinuria, correct the imbalance of T cell subgroup, and down-regulate serum levels of IL-6, IL-17, TNF-α.

Moxibustion is one of the main first aid measures in ancient. Emergency moxibustion has a long history， which can be traced back to the “Foot and Arm Eleven Pulse Moxibustion Sutra （《足臂十一脉灸经》）” and “Yin and Yang Eleven Pulse Moxibustion Sutra （《阴阳十一脉灸经》）” unearthed from the Mawangdui Han Tomb. “Emergency Standby Remedies （《肘后备急方》）” in Jin dynasty used emergency moxibustion to treat as many as 28 kinds of emergencies； In the Tang and Song dynasties， moxibustion continued to develop， and the first emergency moxibustion monograph “Moxibustion for Emergency （《备急灸法》）” appeared； During the Ming and Qing dynasties， moxibustion was widely used in surgical emergencies. The long period of clinical practice confirmed that moxibustion has a definite effect on syncope， asthma， pain and diarrhoea， carbuncle sores and ulcers， leakage and dystocia， epilepsy and convulsions， epistaxis and laryngeal paralysis， and other emergencies， involving the departments of internal medicine， surgery， gynecology， pediatrics and ear-nose-throat. Moxibustion has the function of warming the meridians， reinforcing healthy qi and dispelling the evil， restoring yang to save from collapse. Besides， modern research has also proved that moxibustion played the role of anti-inflammatory， analgesic， and enhancing the immune system. Tracing the theory of moxibustion for emergencies is conducive to provide new ideas for the application of moxibustion in modern clinical emergencies， better inherit and develope the emergency treatment technology of traditional Chinese medicine， and promote the diversified development of modern emergency medicine.

Objective To evaluate the regulatory role of azithromycin-induced persistent Chlamydia trachomatis (Ct) infection in the apoptosis of Hela229 cells.Methods Hela229 cells were firstly co-cultured with Ct for 22 hours,and then cultured with Dulbecco's modified Eagle's medium (DMEM) containing 0.08 mg/L azithromycin for 26 hours to establish a cell model of persistent Ct infection (persistent infection group).These infected Hela229 cells cultured with azithromycin-free DMEM served as a cell model of acute Ct infection (acute infection group).After 48-hour infection with Ct,azithromycin was removed,and infected Hela229 cells in the above 2 groups were successively cultured with DMEM for the resurgence of Ct.Immunofluorescence assay and electron microscopy were performed to verify the persistent Ct infection model.The Hela229 cells in the persistent infection group and acute infection group as well as uninfected Hela229 cells (control group) were treated with staurosporine (STS) for 4 hours to induce the apoptosis,and then cell apoptosis was detected by Hoechst 33258 staining,annexin V/propidium iodide staining and flow cytometry.Results After the treatment with azithromycin,atypical inclusions with aberrant reticulate bodies appeared in the Ct-infected cells.After removing azithromycin,cells were cultured until 96 hours after infection,and infectious elementary bodies reappeared in the Ct inclusions.After the treatment with STS,Hoechst staining showed that there was loose chromatin in the persistently infected cells,while chromatin condensation was observed in the uninfected cells.After 24-hour infection with Ct and 4-hour induction with STS,the apoptosis rate was significantly higher in the persistent infection group (45.567％ ± 2.631％) than in the acute infection group (38.567％ ± 1.701％,t =2.686,P =0.028),but significantly lower in the persistent infection group than in the uninfected group (69.800％ ± 2.835％,t =8.187,P ＜ 0.001).After 48-hour infection with Ct and 4-hour induction with STS,there was a significant difference in the apoptosis rate between the persistent infection group (46.700％ ± 5.257％) and acute infection group (61.767％ ± 1.815％,t =5.781,P ＜ 0.001),as well as between the persistent infection group and the uninfected group (68.667％ ± 3.156％,t =7.421,P ＜ 0.001).Conclusion This study showed that azithromycin-induced persistent Ct infection regulated the apoptosis of host cells,and this effect lasted 48 hours.

Purpose: Loss-of-function mutations in the adenomatous polyposis coli (APC) gene are common in metastatic colorectal cancer (mCRC). However, the characteristic of APC specific mutations in mCRC is poorly understood. Here, we explored the clinical and molecular characteristics of N-terminal and C-terminal side APC mutations in Chinese patients with mCRC. Materials and Methods: Hybrid capture-based next-generation sequencing was performed on tumor tissues from 275 mCRC pati-ents to detect mutations in 639 tumor-associated genes. The prognostic value and gene-pathway difference between APC specific mutations in mCRC patients were analyzed. Results: APC mutations were highly clustered, accounting for 73% of all mCRC patients, and most of them were truncating mutations. The tumor mutation burden of the N-terminal side APC mutations group (n=76) was significantly lower than that of the C-terminal side group (n=123) (p < 0.001), further confirmed by the public database. Survival analysis showed that mCRC patients with N-terminus side APC mutations had longer overall survival than C-terminus side. Tumor gene pathway analysis showed that gene mutations in the RTK/RAS, Wnt and transforming growth factor β signaling pathways of the C-terminal group were significantly higher than those of the N-terminal group (p < 0.05). Additionally, KRAS, AMER1, TGFBR2, and ARID1A driver mutations were more common in patients with C-terminal side APC mutations. Conclusion APC specific mutations have potential function as mCRC prognostic biomarkers. There are obvious differences in the gene mutation patterns between the C-terminus and N-terminus APC mutations group, which may have certain guiding significance for the subsequent precise treatment of mCRC.

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

Objective To establish a method for determining the content of Gd³⁺ in gadoteric acid meglumine salt injection. Methods ICP-MS was used. The separation column was a metal chelate column (1-ml Chelating Sepharose column), column temperature was normal temperature. Flow rate was 1 ml/min. Injection volume was 500 μl. Atoms were measured by ICP-MS with a molecular weight of 157 (The molecular weight of Gd was 157). The carrier gas was argon. Results The linear range of Gd³⁺ mass concentration was 0-500 ng/ml (r=1.000); The precision, stability and repeatability of the sample recovery test were all in accordance with the requirements. Conclusion The method was simple in operation, accurate in results and good in repeatability, which could be used to determine the content of Gd³⁺ in gadoteric acid meglumine salt injection.