Objective To assess the effect of Chinese Rhubarb in assisting the treatment of severe acute pancreatitis (SAP) by nasojejunal tube (NJ) and nasogastric tube (NG).Methods Cochrane Library, PubMed, Embase, Science Citation Index Expanded-SCIE, EBSCO-CINAHL Complete, SinoMed, VIP network and Wan Fang net were retrieved systematically and randomized controlled trails (RCT) that involved in Chinese rhubarb assisting the treatment of SAP by NJ and NG were searched.According to eligibility and extraction standards, 2 researchers independently selected relevant literature and extracted the relevant data.The quality of literature was evaluated using criteria published by Australian Evidence-Based Health Care Center (2008).RevMan5.3 software was employed for Meta analysis.Results Eleven RCTs were enrolled and the quality of all the 11 papers was B grade.Compared with NG, NJ had lower score of APACHE-Ⅱ, shorter time of decreased CRP, amylase activity, IL-6 and IL-1, and shorter recovery time of bowel function and abdominal pain, and the differences were statistically significant (P<0.01).However, there were no significant differences between two groups on complication rate, mortality, the rate of bowel function failure, the rate of surgical operation and recovery rate.Conclusions Chinese Rhubarb by NJ irrigation in assisting the treatment of SAP can rapidly alleviate abdominal pain, promote bowel function recovery and reduce inflammatory reaction, which had better efficacy than NG.

Objective　To investigate the efficacy and safety of endovascular treatment technology in patients with anterior circulation acute ischemic stroke (AIS) with different pathogenesis.Methods　Seventy-seven patients with AIS in our hospital from February 2019 to October 2020 were enrolled,and divided into three groups according to the different pathogenesis,IAD group (intracranial atherosclerotic disease,n=32) and CE group (cardioembolism,n=45).Endovascular therapy was given to patients.Then the clinical efficacy and safety were compared between different treatments.Results　Gender,NIHSS score and primary history showed no significant difference between groups at baseline (P>0.05).The rate of multimodal combined therapy,Utilization rate of angioplasty,the use of antiplatelet drugs during operation,and the time of emergency operation in IAD group were significantly longer than those in CE group (P<0.05).No significant difference was found in final recanalization rate,24-hour NIHSS,good prognosis rate,intracranial hemorrhage,embolism complication rate and 3-month mortality (P>0.05).Conclusion　Application of endovascular treatment technology in patients with anterior circulation AIS with different pathogenesis is an effective and safe treatment method.

OBJECTIVETo summarize retrospectively the 5-year survival rates and long-term complication of stage Ib-IIIa cervical carcinoma treated by combination of subradical external radiation and brachytherapy plus radical operation.

METHODS106 patients with cervical carcinoma were all treated by radical hysterectomy and pelvic lymphadenectomy, of whom 78 had had preoperative radiotherapy (external radiation and brachytherapy), 16 combination of brachytherapy and radical operation, 12 adjuvant postoperative radiotherapy (external radiation and brachytherapy). (60)Co was used for external radiation, in which the point B dose was 25 - 30 Gy in preoperative radiation and 40 - 50 Gy in postoperative radiation. (192)Ir high-dose-rate afterloading unit was used in brachytherapy, with a dose of 6 - 18 Gy at point A.

RESULTSThe follow up rate was 95.3%. The overall 5-year survival rates were 78.2% (61/78) in the preoperative radiotherapy group, 68.8% (11/16) in brachytherapy plus radical operation, 33.3% (4/12) in the postoperative radiotherapy group, showing a higher 5-year survival rate in the preoperative radiotherapy group than the postoperative radiotherapy group (P < 0.05). In stage II patients, the preoperative radiotherapy group -77.6% (45/58) also gave a higher survival than the postoperative radiotherapy group -25.0% (1/4) (P < 0.05). But all the other groups gave differences of insignificance. The chief long-term complications were radio-proctitis and cystitis, with incidences of 34.6% (27/78), 31.3% (5/16), 33.3% (4/12) in the preoperative radiotherapy group, brachytherapy plus radical operation group and the postoperative radiotherapy group (P > 0.05).

CONCLUSIONThe overall 5-year survival rate of combined subradical external radiation and brachytherapy plus radical operation was obviously higher than that of postoperative radiotherapy for stage Ib-IIIa and II patients, with statistically significant differences. However, the incidence of long-term complications give no statistical significance in the preoperative radiotherapy group or brachytherapy plus the operation group as compared with the postoperative radiotherapy group.

Adult ; Aged ; Aged, 80 and over ; Brachytherapy ; Combined Modality Therapy ; Female ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms ; mortality ; radiotherapy ; surgery

OBJECTIVE: To explore the genotype-phenotype correlation of a case with GM1-gangliosidosis caused by compound heterogenic variants in GLB1. METHODS: Genomic DNA was extracted from peripheral blood samples from the patient and her parents. Trio-based whole-exome sequencing (WES) was performed for the family and suspected mutation was verified by Sanger sequencing. RESULTS: The proband, a 2-year-3-month old Chinese girl, presented with psychomotor deterioration, absent speech, intellectual disabilities and behavior problem. Trio-based WES has identified compound heterozygosity for 2 variants in the GLB1 gene: NM_000404.2:c.1343A>T, p.Asp448Val and c.1064A>C, p.Gln355Pro (GRCh37/hg19),which was inherited from the mother and father, respectively. Homozygous or compound heterozygous pathogenic variants in GLB1, encoding β-galactosidase, are responsible for GM1-gangliosidosis,an autosomal recessive lysosomal storage disorder characterized by variable degrees of neurodegeneration and skeletal abnormalities. The p.Asp448Val variant has been classified as pathogenic for GM1 gangliosidosis in medical literatures for the reason that functional studies demonstrated that expression of the p.Asp448Val variant in COS-1 cells resulted in no detectable β-galactosidase activity compared to wild type GLB1. The p.Gln355Pro variant has not been reported in literatures or database. The variant is highly conserved residue (PM1), and was not found in either the Genome Aggregation Database or the 1000 Genomes Project (PM2) and was predicted to have a deleterious effect on the gene product by multiple in silico prediction tools (PP3). Next, the β-galactosidase activity of the patient's peripheral blood leukocytes was determined by fluorescent method. The result was 0.0 nmol/mg. It showed that the p.Gln355Pro variant also resulted in loss of β-galactosidase activity, thus the variant was classified into clinical pathogenic variant. CONCLUSION Our study expands the mutational spectrum of the GLB1 gene and provides genetic counseling for the family.
Asians/genetics* ; China ; Female ; G(M1) Ganglioside ; Gangliosidosis, GM1/genetics* ; Humans ; Mutation ; beta-Galactosidase/genetics*

OBJECTIVETo investigate promoter methylation status of LITAF gene in B-cell lymphoma and to explore transcription regulation of 5-Aza-2'-deoxycytidine (5-Aza-CdR) on LITAF gene.

METHODSOne hundred and five paraffin specimens including 54 cases of diffuse large B cell lymphoma (DLBCL), 15 small lymphocytic lymphoma (SLL), 8 mucosa-associated lymphoid tissue lymphoma (MALT) and 6 follicular lymphoma (FL) were included. Five reactive lymphoid hyperplasia samples were collected as control. Methylation status of CpG island in LITAF gene in the specimens and in Raji, Pfeiffer and Daudi cell lines were detected by methylation-specific PCR (MSP). LITAF expression in Raji, Pfeiffer and Daudi cell lines with or without 5-Aza-CdR treatment was detected by Western blot and immunohistochemistry. The inhibitory ratio in the three cell lines was measured by MTT assay.

RESULTSThe frequency of LITAF gene methylation in B-cell lymphoma was 89.5% (94/105) . Among them, 3.8% (4/105) showed complete hypermethylation. In control group, however, there was no methylation in CpG island of LITAF gene promoter. The expression of LITAF was recovered or increased along with the cell growth inhibition when the cells exposed to demethylating reagent.

CONCLUSIONSLITAF gene silencing with aberrant CpG methylation is probably one of the critical events to the oncogenesis of B-cell lymphoma, which may have important implications as a candidate marker for diagnosis and target gene therapy.

Adult ; Azacitidine ; analogs & derivatives ; metabolism ; Cell Line, Tumor ; CpG Islands ; DNA Methylation ; Gene Silencing ; Humans ; Lymphoma, B-Cell ; genetics ; metabolism ; Lymphoma, B-Cell, Marginal Zone ; genetics ; Lymphoma, Large B-Cell, Diffuse ; genetics ; Nuclear Proteins ; genetics ; metabolism ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Transcription Factors ; genetics ; metabolism

To determine there characteristic components content of Tibetan Medicine Triphala through establishing a HPLC method and its total tannin content through spectrophotometry. The chromatographic column of Agilent ZORBAX SB-Aq (250 × 4.6 mm, 5 μm) with methanol-0.1％ formic acid/water as the mobile phase, the flow rate 1 mL/min, and the detection wavelength 270 nm was applied to determine the Gallic acid, colijing and ellagic acid content in medicinal materials and the tannin parts of Tibetan Medicine Triphala. With the gallic acid as control group, total tannin content of Triphala and its tannin parts was determined through spectrophotometry. It revealed in the HPLC test that the linear range of gallic acid, coracine and ellagic acid was 0.91-4.55 μg, 0.274-1.368 μg and 0.329-2.634 μg respectively. It also showed that the average recovery rates of the three components in the medicinal materials were 101.06％, 101.72％and 100.27％ respectively. And the average recovery rates of the three components in the tannins were 100.4％, 100.85％and 101.70％ respectively. The result of spectrophotometry showed that gallic acid was linear in1.008-10.08 μg·mL-1, and that the recovery rate of medicinal materials and tannin parts were 100.25％ and 100.52％ respectively. The method is rapid, accurate and repeatable, and it can provide basis for the quality control of Tribescens and its tannins.

Objective To analyze the influence of patients with multiple cerebral infarction complicated with vascular Parkinsonism (VaP) on cognitive function, and to provide a theoretical basis for the diagnosis and treatment of patients with multiple cerebral infarction complicated with VaP. Methods A toatl of 206 patients with multiple cerebral infarction admitted to Ningde municipal hospital of ningde normal university from January 2020 to January 2022 were selected and divided into VaP group (n=58) and control group (n=148) according to whether they were complicated with VaP. Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of patients. The scale included 8 cognitive domains including attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation and orientation. Pearson was used to analyze the correlation between VaP and MoCA score in patients with multiple cerebral infarction. Age, sex, years of education, white matter disease, diabetes mellitus, coronary heart disease and other vascular risk factors were compared between the two groups. The independent risk factors for VaP in multiple cerebral infarction were analyzed by multiple linear regression. Results MoCA score in VaP group was significantly lower than that in control group (P<0.05). In terms of each item, scores of attention and concentration, memory, language and computation in VaP group were significantly lower than those in control group (P<0.05). Pearson correlation analysis showed that attention and concentration, memory, language and computational scores were correlated with VaP in patients with multiple cerebral infarction (r=-0.475, -0.314 , -0.302 , -0.389, P<0.05). There were statistically significant differences between the two groups in white matter lesions, lesion sites in left hemisphere and frontal lobe, diabetes mellitus and carotid artery plaque (P<0.05).White matter lesions (OR=2.571), diabetes mellitus (OR=2.369) and lesion location in the left hemisphere (OR=2.958) were independent risk factors for VaP in patients with multiple cerebral infarction (P<0.05). Conclusion The risk of VaP in multiple cerebral infarction is high, which is related to the cognitive function of patients. Early intervention such as brain function training should be given to patients with white matter lesions, diabetes and lesions in the left hemisphere. , can significantly improve patients' cognitive function and reduce the occurrence of VaP.

Objective : To study the effect of changes in estradiol (E2 ) levels on the reproductive outcomes of patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian stimulation (COS) with gonadotropinreleasing hormone antagonist (GnRH⁃ant) protocol. Methods : A retrospective study was conducted involving 338 patients with polycystic ovary syndrome (PCOS) infertility who underwent GnRH⁃ant protocol for controlled ovarian hyperstimulation followed by in vitro fertilization ( IVF) or intracytoplasmic sperm injection ( ICSI) , and subsequently underwent their first frozen⁃thawed embryo transfer ( FET) . The clinical data of these patients were analyzed. Patients were grouped based on the changes in serum E2 levels on the first and fourth day of GnRH⁃ant administration (blood samples collected before GnRH⁃ant injection) : the E2 elevation group (Group A , E2 v~alue increased more than 30% , 165 cases) , the E2 stable group (Group B , E2 rate of change was within - 30% 30% , 162 cases) , and the E2 decline group (E2 value declined more than 30% , 11 cases , not included in statistical analysis due to small sample size) . The differences in demographic characteristics , ovulation induction outcomes , embryo outcomes and clinical pregnancy⁃related indicators were analyzed between Groups A and B. Results : There were no statistically significant differences in basic information such as age , duration of infertility , body mass index (BMI) , basal endocrine levels , and anti⁃Müllerian hormone (AMH) levels between groups A and B. Regarding embryo characteristics , there were no statistically significant differences in fertilization method and number of transferred embryos between groups A and B. However, group A had a higher total number of retrieved oocytes , normal fertilization rate , number of high⁃quality embryos , and rate of high⁃quality embryos compared to group B , with statistically significant differences ( P < 0. 05) . In terms of clinical pregnancy outcomes , there were no statistically significant differences in the incidence of severe ovarian hyperstimulation syndrome (OHSS) between groups A and B. However, group A had higher rates of clinical pregnancy , implantation , and live birth compared to group B , with statistically significant differences. Group A also had a lower rate of early miscarriage compared to group B , with statistically significant differences. Conclusion Choosing the GnRH⁃ant protocol for IVF/ICSI⁃FET in PCOS patients , if the blood E2 level increases by more than 30% after 4 days of adding the antagonist (blood sample collected before administering GnRH⁃ant) , the clinical pregnancy outcome will be better.