Objective:To investigate esomeprazole combined with early enteral nutrition on the immune function and intestinal flo-ra in the elderly by patients with severe acute pancreatitis. Methods:Totally 78 elderly by patients with severe acute pancreatitis were selected and randomly divided into the observation group (39 cases) and the control group (39 cases). The control group was treated with early enteral nutrition therapy, and the observation group was treated with esomeprazole additionally. The treatment course was 14 days. Results:The total effective rate of the observation group was higher that of the control group (P<0. 05). The abdominal pain relief time, recovery time of bowel sounds, abdominal distension relief time, and the time of serum amylase returning to normal and u-rine amylase returning to normal in the observation group were all better than those in the control group (P<0. 05). The incidence of intestinal flora disorders in the observation group was lower than that in the control group (P<0. 05). After the treatment, CD3+, CD4+ and CD4+/CD8+ increased in both groups (P<0. 05), and those in the observation group were higher than those in the con-trol group (P<0. 05). Serum amylase and urine amylase decreased in both groups after the treatment (P<0. 05), and the decrease in the observation group was more significant than that in the control group (P<0. 05). No serious adverse drug reactions appeared in both groups. Conclusion:Esomeprazole combined with early enteral nutrition in the elderly by patients with severe acute pancreatitis shows significant effect, and the effect may be related with improving the immune function and intestinal flora.

Objective To analyze the CT and MRI performances of chromophobe cell renal carcinoma,to improve the understanding of the disease.Methods The CT and MRI performances of 16 patients with chromophobe cell renal carcinoma confirmed by post-operation pathology were analyzed retrospectively.Results Among 13 cases examined by CT,8 cases had homogeneous lesion including the homogeneous lesions density of 5 cases higher than that of normal renal parenchyma,and the other 5 cases had inhomogeneous density.After enhanced scan,the uneven essence ingredients were markedly enhanced in homogeneous density and inhomogeneous density cases,and the enhancement degree in arterial phase was lower than that of the renal cortex and higher than that of the renal medulla.Among 8 cases checked by MRI,2 cases had signal homogeneity with long T1 weighted imaging and long T2 weighted imaging signal,of which 5 cases appeared high signal in T1 weighted imaging flat lesions.The enhancement mode were similar with CT.In 5 patients examined by CT and MRI at the same time,their density,signal and the pattern strengthening were similar.Conclusions Chromophobe cell renal carcinoma is a rare malignant renal cell carcinoma,and CT and MRI can reflect the composition and hemodynamic changes.When homogeneity and high density or T1WI appeared high signal,disease was large and necrosis was less,and strengthening belt was appeared in lesions,it is value on diagnosis of chromophobe cell renal carcinoma.

Objective To investigate the value of ECG-gated dual-source computed tomography angiography (DSCTA) in the diagnosis of single atrium (SA).Methods DSCTA was performed in 29 patients with SA.The classification diagnosis was made,and the complicated deformities were observed.Results Among 29 patients,atrial situs solitus was found in 14 (14/29,48.28％),atrial situs inversus was found in 6 (6/29,20.69％) and atrial situs ambiguous was found in 9 (9/29,31.03％,including right atrial isomerism in 8 and left atrial isomerism in 1 patient).The patients complicated with 39 kinds,totally 228 deformities.The bronchi and lung structures were found in the same position as atrium in 23 patients (23/29,79.31％),including atrial situs solitus in 13,right atrial isomerism in 7 and atrial situs inversus in 3 patients.Conclusion DSCTA can accurately diagnose SA and associated abnormalities.The features of bronchus and lung structures are helpful to identifying left and right atrial appendage.

Objective To investigate the expression of IL-10 in serum of patients with type 2 diabetic mellitus (T2DM) and its relationship with carotid atherosclerosis.Methods Totally 168 cases of T2DM patients treated in our hospital from May 2013 to December 2016 were retrospectively analyzed.According to the IMT value,the patients were divided into the normal group,the thickening of the group and carotid atherosclerosis plaque formation group.In addition,65 cases of healthy volunteers in our hospital physical examination center at the same period were treated as control group.The levels of serum inflammation index,blood glucose,blood lipid and other indicators of all subjects were compared,at the same time,the correlation between IL-10 and other detection index was analyzed.Additionally,the risk factors of T2DM patients with carotid atherosclerosis were analyzed.Results Compared with the control group,the levels of IL-6,blood glucose,blood lipid and other indicators in T2DM patients increased significantly(P＜0.05),while the level of IL-10 decreased significantly(P＜0.05);with the increase of IMT,the levels of IL-6,blood glucose,blood lipid and other indicators in T2DM patients increased significantly,but the level of IL-10 decreased significantly,meanwhile the differences between the groups were statistically significant (P＜0.05).Compared with normal group,the levels of IL-6,blood glucose,blood lipid and other indicators of patients in thickening group and plaque group significantly elevated,but the level of IL-10 decreased significantly;the levels of IL-6,blood glucose,blood lipid and other indicators of patients in plaque group were obviously higher than those of thickening group,and IL-10 level was significantly lower than thickening group,and the differences were statistically significant (P＜0.05);the levels of IL-10 in the serum were negatively correlated with blood glucose,blood lipid and other indicators (P＜0.05);multifactor non-conditional Logistic analysis showed that IL-6,Hcy and UA were the risk factors for atherosclerosis in T2DM patients,and IL-10 was the protective factor.Conclusion The level of IL-10 of patients with T2DM is closely related to the occurrence and development of carotid artery atherosclerosis,which provides a new target for clinical treatment.

Laparoscopic cholecystectomy (LC) is a standard procedure for symptomatic cholelithiasis.Single incision laparoscopic cholecystectomy (SILC) as one kind of LC has been paid more attention nowadays.This article aims to review the therapeutic effect,complications and limitations of SILC.

Objective:To explore the effects and mechanism of Salvianolic acid B(SalB)on Parkinson's disease(PD).Methods:Forty-eight C57BL/6 male mice were randomly separated into control group(control)withoutdrugs,model group(MPTP)with intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrah-ydropyridine(MPTP),SalB control group with intraperitoneal injection of SalB,and SalB treatment group(MPTP+SalB).Construction of PD mouse model by intraperitoneal injection of MPTP,and treatment with intraperitoneal injection of SalB.Pole climbing test was applied to assess behavior differences.The time of first black stool excretion and water content of feces were measured to evaluate intestinal dysfunctions.The number of tyrosine hydroxylase(TH)positive cells in substantia nigra and the level of Toll like receptor 4(TLR4)in colon were analyzed by immunohistochemistry.The pathological changes of colonic mucosa were observed by HE staining.The levels of calprotectin(CP)and tumor necrosis factor-α(TNF-α)in colon were determined by ELISA.Western blot was used to determine the level of TH in midbrain,the protein level of TH,tight junction protein(ZO-1),and protein level of TLR4/MyD88/NF-κB signaling pathways which express in colon.Results:Com-pared with the Control group,the climbing time,T-turn time and the first black stool excretion time in MPTP group increased while the fecal water content and the number of TH positive cells in substantia nigra were decreased.Accompanied by TLR4 positive cells in colon,pathological injury score of colonic mucosa,levels of CP and TNF-α in colon increased,expression of TH in midbrain and expression of ZO-1 in colon decreased.Expressions of TLR4,MyD88,Nuclear NF-κB p65 and p-NF-κB p65 in colon increased.Com-pared with MPTP group,SalB treatment shortened the climbing time,T-turn time and the first black stool excretion time in SalB treat-ment group,increased the fecal water content and the number of TH positive cells in substantia nigra,lowered TLR4 positive cells in colon,enhanced expression of TH in midbrain and colon,reduced the pathological injury score of colonic mucosa,significantly decreased levels of CP and TNF-α in colon,enhanced expression of ZO-1 in colon,inhibited expressions of TLR4,MyD88,Nuclear NF-κB p65 and p-NF-κB p65 in colon.Conclusion:SalB can protect the nerves and intestines and alleviate the intestinal inflamma-tion of PD mice,which may be related to the inhibition of TLR4/MyD88/NF-κB signal pathway.

OBJECTIVETo investigate the regulatory mechanism of bone marrow mesenchymal stem cells(BMSC) on the biological profiles of KATO-III( cell lines of gastric cancer.

METHODSTranswell cubicle was applied to build the co-cultured model in non-contact style. The differences of cell proliferation and the resistance of anti-tumour drug (5-fluoropyrimidinedione, 5-FU and Cisplatin, CDDP) between co-cultured group and single cultured group were evaluated by Cell Counting Kit 8-assay(CCK-8). The invasion ability was detected by Transwell assay. The expressions of stem cell makers, apoptosis-related factors and epithelium-mesenchymal transition (EMT)-related factors were detected by RT-PCR.

RESULTSThe proliferation ability of KATO-III( cells in co-cultured group was significantly stronger than that in single cultured group. The growth rate of KATO-III( cells in co-cultured group was significantly higher than that in single cultured group after treatment of 5-FU and CDDP(P<0.05). The mRNA expression level of Bcl-2 was significantly higher in co-cultured group KATO-III( cells(P<0.05), while the mRNA expression level of Bax was significantly lower in co-cultured group KATO-III( cells(P<0.05) in comparison with those in single cultured group. As compared to KATO-III( cells in single cultured group, the number of infiltrating-membrane cells was significantly higher (37.33±5.22 vs 14.56±2.54, P<0.01) in co-cultured group, and the mRNA expression levels of Snail and N-cadherin were significantly higher in co-cultured group KATO-III( cells (P<0.05), while the mRNA expression level of E-cadherin was significantly lower in co-cultured group KATO-III( cells (P<0.05). The expressions of CD133, Nanog and Sox-2 mRNA in co-cultured group KATO-III( cells were significantly higher than those in single cultured group(P<0.05).

CONCLUSIONSIn co-cultured model sharing non-contact style, BMSC can enhance such properties of KATO-III( gastric cancer cells as the proliferation, the invasion and the chemoresistance. Furthermore, the regulatory mechanisms may be related to the increase of the expressions of some stem cell markers in gastric cancer cells.

Antineoplastic Agents ; Apoptosis ; Bone Marrow Cells ; Cadherins ; Cell Line, Tumor ; Cell Proliferation ; Cisplatin ; Coculture Techniques ; Epithelial-Mesenchymal Transition ; Fluorouracil ; Humans ; RNA, Messenger ; Stem Cells ; Stomach Neoplasms

Autism spectrum disorder (ASD) is a multifactorial disease, with social difficulties and repetitive behaviors as its core symptoms. With the improvement of diagnostic methods, the detection rate of ASD is increasing year by year.Cognitive flexibility impairment is very obvious in most autistic patients.More and more studies have shown that cognitive flexibility impairment is related to the occurrence and development of core symptoms. However, the mechanism of cognitive flexibility impairment in autism remains unclear. The frontal lobe plays an important role in advanced cognition, and its complete development is related to cognitive function. Recent studies have shown that frontal lobe dysfunction is closely related to cognitive flexibility deficits in autistic patients, and the abnormal changes in the frontal lobe, the associated default mode network dysfunction and frontal striatal circuit defects may be the important mechanisms of cognitive flexibility impairment. Based on the recent clinical and basic studies on cognitive flexibility in autism, this article reviews the mechanisms of frontal lobe and related circuits involved in the impairment of cognitive flexibility in autism.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.