Objective To explore the clinical efficacy of Shuxuening combined with epalrestat in the treatment of diabetic nephropathy. Methods Eighty patients from March 2014 to June 2015 in Metabolic Disease Department of the Second Hospital of Tianjin were randomly divided into observation group and control group with 40 patients in each group.The control group received epalrestat, and the observation group received Shuxuening injection on the baisis of control group. The related indicators were compared between two groups.Results After treatment, the 24 h-urine microalbumin, plasma low density lipoprotein and serum creatinine in observation group [(239.31 ±106.54)mg/L,(2.45 ±0.55)mmol/L,(95.54 ± 22.13)mol/L]were lower than those in control group [(349.90 ±148.40),(3.41 ±0.52),(108.76 ±34.30)](P<0.05).The β2-microglobulin (β2-MG) and plasma high-sensitive C-reactive protein (hs-CRP) in observation group [(0.39 ±0.06),(6.31 ±1.58)mg/L]were lower than those in control group [(0.49 ±0.12),(7.89 ±1.35)](P<0.05).The total efficacy in observation group was higher than that in control group (70.0%vs.45.0%,P<0.05).Conclusion Shuxuening injection joint epalrestat has the exact efficacy in treatment of patients with diabetic nephropathy.

Mai is the important concept in TCM and this term has been found in the early classic work of TCM. With the development and perfection of TCM theory, the original meaning of mai is "blood vessels entirely distrusted in the body". In five dynasties, the meaning of it was supplemented as "distribution of qi and blood in five zang and six fu organs to the four extremities", in which, not only blood but also qi has been included. With the constant understanding on mai, qi and blood, the unique concept of meridian and collateral is gradually generated. In terms of the modern study on the original meaning of mai and the academic evolution of meridian and collateral, it is discovered that qi is predominated and distributed in meridian and collateral as compared with blood. It is very significant to study the original meaning and academic evolution of mai, as well as the origin of the concept of meridian and collateral and to provide the reference support for the terminology standardization and basic study.
Acupuncture ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Meridians ; Qi ; history ; Terminology as Topic

Objective By 1 H magnetic resonance spectroscopy( 1 H MRS) ,small for gestational age (SGA)and appropriate for gestational age(AGA) as the detection of brain metabolites and MRI plus soft-ware measurement in different brain areas of volume,investigate its cerebral metabolites and the changes of brain in different parts of the volume and significance. Methods Select 88 patients eligible infants, SGA group of 27 cases and AGA group of 21 cases of premature infants;SGA group of 22 cases and AGA group of 18 cases of term infants. Preterm infants with a gestational age of 32 to 36 weeks,term infants with a gesta-tional age of 37 to 41 weeks. Check time between 4 to 7 days old. Calculation of cerebrum volume,cerebellar volume and cerebrospinal fluid volume and intracranial volume,N-acetylaspartic acid(NAA),as 1H MRS area of metabolites measured right frontal choline compounds( Cho) and creatine compounds( Cr) wave,calcu-lation of Cho/Cr and NAA/Cho ratio of NAA/Cr. Results NAA/Cr,the cerebrum volume and intracranial volume of SGA in premature infants group,term infants group and mixed group were 0. 627 ± 0. 183,(2. 831 ±0. 199) ×105 mm3,(3. 178 ±0. 209) ×105 mm3;0. 706 ±0. 139,(3. 056 ±0. 217) ×105 mm3,(3. 411 ± 0. 212 ×105 mm3;0. 708 ± 0. 171,(2. 932 ± 0. 234) × 105 mm3,(3. 282 ± 0. 239) × 105 mm3,respective-ly. NAA/Cr,the cerebrum volume and intracranial volume of AGA in premature infants group,term infants group and mixed group were 0. 734 ± 0. 101,(2. 987 ± 0. 111) × 105 mm3,(3. 347 ± 0. 137) × 105 mm3;0. 805 ± 0. 106, ( 3. 228 ± 0. 284 ) × 105 mm3 , ( 3. 588 ± 0. 306 ) × 105 mm3; 0. 721 ± 0. 119, ( 3. 098 ± 0.240) ×105 mm3,(3.458 ±0.258) ×105 mm3,respectively. The data of SGA group were all lower than those in AGA group,which had significant difference(P<0. 05,respectively). In SGA group,NAA/Cr,the cerebrum volume and intracranial volume of premature infants group were all lower than those in term infants group,which had significant difference(P<0. 001,respectively). In SGA group,Cho/Cr,cerebellar volume and cerebrospinal fluid volume of premature infants group,term infants group and mixed group were[1. 653 ± 0. 343,(1. 816 ± 0. 119) × 104 mm3 ,(1. 651 ± 0. 235) × 104 mm3;1. 588 ± 0. 223,(1. 936 ± 0. 957) × 104 mm3,(1. 623 ± 0. 210) × 104 mm3; 1. 612 ± 0. 262,(1. 870 ± 0. 124) × 104 mm3,(1. 649 ± 0. 206) × 104 mm3 ,respectively. In AGA group, Cho/Cr, cerebellar volume and cerebrospinal fluid volume of premature infants group,term infants group and mixed group were 1. 531 ± 0. 226,(1. 872 ± 0. 159) × 104 mm3 ,(1. 731 ±0.280) ×104 mm3;1.528 ±0.107,(2.017 ±0.302) ×104 mm3,(1.648 ±0.169) ×104 mm3;1.583 ± 0.222,(1.939±0.244)×104mm3,(1.681±0.252)×104mm3,respectively.ThedataofSGAgrouphad no significant difference with corresponding AGA group(P >0. 05,respectively). In the premature infants groups,the NAA/Cho of SGA group(0. 401 ± 0. 737) was lower than in the AGA group(0. 506 ± 0. 116), which had significant difference(P=0. 000). In the term infants groups,the NAA/Cho of SGA group(0. 483 ±0. 605) was lower than in the AGA group(0. 472 ± 0. 987),which had no significant difference(P =0. 653). In the AGA groups,NAA/Cr,NAA/Cho,cerebellar volume and cerebrospinal fluid volume of pre-mature infants group and term infants group had no significant difference ( P>0. 05 ) . Both of the cerebellar volume and cerebrospinal fluid volume between the premature infants AGA group and premature infants AGA group had no significant difference(P>0. 05). Conclusion Neurons in the brain,the cerebrum volume,the cranial cavity volume and NAA/Cr of SGA was significantly lower than those of AGA,but Cho/Cr,cerebel-lar volume and cerebrospinal fluid volume of SGA and AGA had no significant difference. NAA/Cr in the brain and the cerebrum volume of SGA may be associated with low volume of small nerve mental retarda-tion,worthy of further study.

Objective To study the clinical presentations,radiologic features,prognosis,and possible causes of liver injury associated umbilical venous catheter (UVC ).Methods We reviewed database of our NICU from December 2012 to November 2015 and identified preterm infants with liver injury while UVC in place.The gestational age,birth weight,gender,days of UVC in place prior to liver injury, the depth of UVC (cm),UVC tip position,ultrasound findings of liver injury,laboratory tests,treatment and outcomes were collected.Results During study period,322 infants received UVC insertion.Ten cases (3.1 %)of liver injury associated with UVC were diagnosed.Of the ten infants,nine were diagnosed as extravasation of fluid to liver parenchyma,and one was diagnosed as liver hematoma.The mean birth weight was (1184 ±207)g,mean gestational age was (28.5 ±1.7)weeks.The UVC tip was at thoracic (T) vertebrae T 9 to T 11 level,nine UVC tips were below the right diaphragm level.All UVCs were used for total parenteral nutrition before liver injury was diagnosed.Six infants had clinical manifestations,and four infants were free of clinical manifestations.The most prominent clinical signs were abdominal distension (n =5),weak bowel sounds (n =5)and hepatomegaly (n =4).One infant who was diagnosed with liver hematoma also had progressive hemoglobin decline (minimum 34 g/L)and shock.Abdominal ultrasound showed well-limited,irregular,hyperechoic rimmed lesions with heterogeneously hypoechoic centers or anechoic liquid dark space.Extravasation of fluid to liver parenchyma will restorate within one week after the UVC was remove.One baby who was diagnosed as liver hematoma passed away at 9 days of life.Liver ultrasound of eight returned to normal in 52 days to 3.5 months,and one had calcified lesions at 9 months of age.Conclusions Liver injury is an unusual complication of UVC insertion and usage.Proper positioning of the UVC tip may help to avoid this complication.Early recognition,prompt diagnosis with liver ultrasound examination and timely treatment can lead to better outcome in newborns with extravasation of fluid to liver parenchyma.

Objective To investigate the regional cerebral stimulation after central analgesics nasal spray and its mechanism with pharmacological functional magnetic resonance imaging (phfMRI). Methods Eighteen healthy right-handed volunteers participated. Butorphanol tartrate nasal spray was used as the experiment agent. Ethological experiment was carried out to record the participants' subjective feeling and the onset time of the analgesics, followed by the functional MRI (fMRI) scan two weeks later. Block design was adopted. Two phases of fMRI scan were performed at 7 min and 25 min after the nasal spray, respectively. Participants were also given pain stimulation in the dorsum of hand during the fMRI scanning. The data were post-processed with Matlab 6.5 and SPM 2. Results ①Onset time of butorphanol tartrate was 15-35 min after nasal spray administration, which was consistent with its concentration-time curve. ②After nasal spray, activations were observed in the cerebral cortex, including frontal lobe (orbitofrontal gyrus, medial frontal gyrus, superior frontal gyrus), temporal lobe (insula, middle temporal gyrus, inferior temporal gyrus), parietal lobe (precuneal gyrus), limbic system (anterior cingulate gyrus, middle cingulate gyrus, hippocampus, parahippocampal gyrus);subcortical region (globus pallidus) and cerebellum (6-9 of cerebellar cortex, cerebellar peduncle, vermis). ③The number and activation intensity of the second phase were more obvious than those of the first phase (P<0.01). Conclusion The feasibility of phfMRI study on cerebral stimulation and the mechanism of nasal spray is demonstrated. The study of butorphanol tartrate further validates the main distribution of opioid receptors in the central nervous system and the possible mechanism of central analgesia.

Objective To compare imaging quality and radiation dose on full-field digital mammography (FFDM) system and dual-sided reading CR mammography (DSCRM) system.Methods The TRM of ALVIM statistics phantom was exposed by FFDM system and (DSCRM) with the same radiation dose.The exposure parameters and the entrance surface dose (ESD) were recorded.Then,the phantom was exposed by DSCRM system with different mAs and same kV,and the ESD was recorded.The images obtained above were read by three radiologists on the monitor of diagnosis work station with the same window width and window level.The evaluation of the images were given using a five-level confidence scale.ROC curves were drawn and probability Pdet were calculated.Results The ROC analysis of microcalcifications and masses showed A(z) values of 0.730-0.925 and 0.670-0.945 for FFDM,and 0.632-0.815 and 0.575-0.785 for DSCRM when the radiation dose is 1.36 mGy.The radiation dose with DR system could be reduced compared with dual-sided reading CR system at the same probabilities Pdet,the ESD reduced from 1.63 mGy to 1.36 mGy by 19.8％,the AGD reduced from 0.65 mGy to 0.56 mGy by 16.0％.Conclusions The observable details with FFDM system were proved to be superior to DSCRM system at the same radiation dose.With the similar image quality,the radiation dose of FFDM system was less than the DSCRM system.

Hemorrhage after prostate biopsy is common, but hemorrhagic shock is rare. We reported a case of sudden severe hematuria on the third day after prostate biopsy, which was considered to be bleeding at the puncture site. Conservative treatment was ineffective, and interventional embolization was performed. Bilateral bulbar urethral arteries were embolized, and the bleeding was stopped successfully. On the 4th day after embolization, the patient developed hypovolemic shock. Angiography showed bilateral prostatic artery bleeding, and the bleeding site and its superior branch arteries were embolized immediately. At 4 months after embolization, no bleeding related events occurred.

Objective:To investigate the clinical value of radiomics based on computed tomography (CT) examination in preoperative differential diagnosis of pancreatic serous cystadenoma (SCA) and mucinous cystadenoma (MCA).Methods:The retrospective case-control study was conducted. The clinicopathological and imaging data of 154 patients with pancreatic cystic neoplasms who were admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from January 2012 to December 2019 were collected. There were 24 males and 130 females, aged (50±13)years. Of the 154 patients, 99 cases were diagnosed as SCA and 55 cases were diagnosed as MCA. All the 154 patients underwent plain and enhanced CT scan of pancreas before operation. The clinical characteristics, radiology features and radiomics features of all patients were collected to construct the clinical characteristics model, radiology model, radiomics model and fused model. The receiver operating characteristic (ROC) curve of each model was drawn, and those constructed models were evaluated by area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value. Based on the optimal model, the nomogram was constructed. Observation indicators: (1) establishment and validation of clinical characteristics model; (2) establishment and validation of radiology model; (3) establishment and validation of radiomics model; (4) establishment and validation of fused model; (5) nomogram of fused model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Establishment and validation of clinical characteristics model: 3 clinical characteristics, including age, symptoms and preoperative serum CA19-9, were selected using multinomial logistic linear regression analysis to construct the clinical characteristics model. Result of the multinomial logistic linear regression analysis was expressed by formula ①: clinical characteristics model score=0.635-0.007×age+0.054×clinical symptoms+0.108×preoperative serum CA19-9. The ROC curve for the test dataset of clinical characteristics model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of clinical characteristics model were 0.611(95% confidence interval as 0.488?0.734, P<0.05), 56.6%, 66.7%, 56.3%, 41.5%, 78.4% for the training dataset and 0.771(95% confidence interval as 0.624?0.919, P<0.05), 77.8%, 63.1%, 88.5%, 80.1%, 76.7% for the test dataset, respectively. (2) Establishment and validation of radiology model: 5 radiology characteristics, including tumor location, the number of tumors, tumor diameter of cross section, lobulated tumor and polycystic tumor (more than 6), were selected using multinomial logistic linear regression analysis to construct the radiology model. Result of the multinomial logistic linear regression analysis was expressed by formula ②: radiology model score=?0.034+0.300×tumor location+0.202×the number of tumors+0.014×tumor diameter of cross section?0.251×lobulated tumor?0.170×polycystic tumor (more than 6). The ROC curve for the test dataset of radiology model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of radiology model were 0.862(95% confidence interval as 0.791?0.932, P<0.05), 78.8%, 81.8%, 77.5%, 62.8%, 90.2% for the training dataset and 0.853(95% confidence interval as 0.713?0.994), P<0.05), 88.9%, 89.4%, 88.5%, 85.0%, 92.0% for the test dataset, respectively. (3) Establishment and validation of radiomics model: 4 categories of a total 1 067 radiomics features were extracted from 154 patients with pancreatic cystic neoplasms, including 7 first-order histogram features, 53 texture features, 848 wavelet features and 159 local binary pattern features. A total of 896 stable radiomics features were retained to construct the model, based on the condition of intraclass correlation coefficient >0.9. After selected by variance threshold and correlation coefficient threshold, 350 radiomics features were retained. Fifty synthetic radiomics features were constructed based on the original features in order to obtain potential radiomics features, and the total number of radiomics features was 400. After analyzed by the five-fold recursive feature elimination, 22 radiomics features were screened out, including 13 wavelet features, 7 synthetic radiomics features and 2 local binary pattern features. The support vector machine algorithm was used to construct the radiomics model. The penalty coefficient 'C' and parameter 'γ' of the radiomics model were 35.938 and 0.077, respectively. The kernel function of the radiomics model was 'radial basis function kernel'. The ROC curve of radiomics model using 5-fold cross validation was drawn. The average AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the radiomics model were 0.870 ( P<0.05), 83.1%, 81.8%, 83.8%, 73.8% and 89.2%, respectively. (4) Establishment and validation of fused model: the fused model was constructed after selecting the tumor location and lobulated tumor of radiology characteristics and radiomics score. Result of the multinomial logistic linear regression analysis was expressed by formula ③: fused model socre=?0.154+0.218×tumor location?0.223×lobulated tumor+0.621×radiomics score. The ROC curve for the test dataset of fused model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of fused model were 0.893(95% confidence interval as 0.828?0.958, P<0.05), 83.7%, 81.8%, 84.5%, 71.1%, 90.9% for the training dataset and 0.966(95% confidence interval as 0.921?0.999, P<0.05), 91.1%, 84.2%, 96.2%, 94.1%, 89.3% for the test dataset, respectively. (5) Nomogram of fused model: the nomogram of fused model was illustrated with the Youden index of 0.416. Conclusion:The prediction model based on the radiomics signature and radiological features extracted from preoperative CT examination can make the differential diagnosis of pancreatic SCA from MCA.

Objective:To investigate the role of heparin-binding protein (HBP) as a predictor of early bacterial infections in patients with traumatic intracerebral hemorrhage.Methods:Patients with traumatic intracerebral hemorrhage admitted to the Emergency Department of the First Hospital of Shanxi Medical University from September 2021 to June 2022 were collected prospectively. Patients with bacterial infection diagnosed by pathogenic examination were classified as the infected group, and those with negative pathogenic examination were classified as the non-infected group. Peripheral blood HBP counts were measured within 48 h of admission, and general information and relevant laboratory tests were collected. The differences of the indicators between the two groups were compared, the receiver operating characteristic (ROC) curve was drawn, the predictive value of the indicators for patients with co-infection was assessed, and the valuable predictors were screened out using multivariate logistic regression analysis.Results:Eighty-five patients [44 males and 41 females, aged (55.09±1.18) years] , were included in the study. Among the patients included in the study, 39 patients had bacterial infection and 46 were non-infected. Patients in the infected group were older , and had more surgeries, higher respiratory rate and injury severity score, and higher levels of HBP [(33.00±3.49) ng/mL vs. (16.27±1.61) ng/mL, P<0.001], leukocytes, and neutrophils [(15.32±3.19) ×10 9/L vs. (6.69±0.57) ×10 9/L, P=0.005] than in the non-infected group, while the Glasgow Coma Scale [(8.72±0.63) vs. (11.37±0.48), P=0.001] was lower than that in the non-infected group, with statistically significant differences (all P<0.05). There was no significant differences in lymphocytes, red blood cells, platelets, calcium, procalcitonin and coagulation indexes between the two groups (all P>0.05). Logistic regression analysis showed that neutrophils ( OR=1.252, 95% CI: 1.075-1.457, P=0.004) and HBP ( OR=1.081, 95% CI: 1.025-1.141, P=0.004) were independent risk factors for infection in patients with traumatic cerebral hemorrhage. The area under ROC curve for HBP of diagnosing early co-infection in patients with traumatic intracerebral hemorrhage was 0.82 (95% CI: 0.71-0.88), the sensitivity was 92.31%, and the specificity was 52.17%. Conclusions:HBP is a valuable predictor of early traumatic intracerebral hemorrhage complicated with bacterial infection in the emergency department, and has a good supplementary value to the existing test indicators.

Objective: To explore the role of mitochondrial biogenesis and the neuroprotective mechanism of resveratrol in fluoride neurotoxicity. Methods: SH-SY5Y cells in exponential phase were treated with different concentrations (20, 40, 60 mg/L) of sodium fluoride (NaF) for 24 h. Co-treatment with 60 mg/L NaF, 20 μmol/L resveratrol (RSV) was administrated in the resveratrol intervene trial. Western blotting was used to determine the expression levels of mitochondrial biogenesis key regulating factor of peroxisome proliferator-activated receptor gamma coactivator 1α (PGC-1α) , nuclear respiratory factor 1 (NRF1) and mitochondrial transcription factor A (TFAM) in SH-SY5Y cells. The mRNA levels of PGC-1α, NRF1 and TFAM were determined by Quantitative Real-time PCR in SH-SY5Y cells, as well as the relative mitochondrial DNA (mtDNA) contents and mRNA expression of mitochondrial respiratory chain complexes subunit CO1 and ATP8. Flow cytometry was used to determine mitochondrial membrane potential in SH-SY5Y cells. Results: Both the protein and mRNA levels of PGC-1α, NRF1 and TFAM were decresed after 60 mg/L NaF treatment in SH-SY5Y cells (P<0.05) . The relative mtDNA contents and mRNA expression of complexes subunit CO1 and ATP8 were also significantly decreased compared with control (P<0.05) . Mitochondrial membrane potential were also significantly decreased after 60 mg/L NaF treatment in SH-SY5Y cells (P<0.05) . Compared with 60 mg/L NaF group, the protein and mRNA levels of PGC-1α, NRF1 and TFAM in 20 μmol/L RSV+60 mg/L NaF group were significantly increased (P<0.05) . The relative mtDNA contents, mitochondrial membrane potential and mRNA levels of complexes subunit CO1 and ATP8 in 20 μmol/L RSV+60 mg/L NaF group were also significantly higher than that in 60 mg/L NaF group (P<0.05) . Conclusion Resveratrol may alleviate the fluoride-induced mitochondrial biogenesis dysfunction in SH-SY5Y cells.