Objective To study the therapeutical effect of γ-aminobutyric acid on monocrotaline(MCT )induced pulmonary hy-pertension rats ,and to elucidate the expression of VEGF and MMP-9 .Methods Thirty SD rats were randomly divided into 3 groups :a normal control group(control group) ,a MCT-induced pulmonary hypertension group(model control group) ,and anγ-ami-nobutyric acid treatment group(treatment group) .The mean right ventricular pressure(mRVP)were detected ,the right ventricular hypertrophy index(RVHI)were measured ,WT% and WA% were evaluated ,and the expression of VEGF mRNA in the lung tissue and MMP-9 were detected wtih FQ-PCR and immunohistochemical staining method respectively .Results mRVP ,RVHl ,WT% , WA% and the expression of MMP-9 and VEGF mRNA of treatment group were lower than those in the model control group(P<0 .05) ,but higher than the control group(P<0 .05) .Conclusion GABA has a therapeutic effect on pulmonary hypertension rats through regulating the expression of VEGF mRNA and MMP-9 protein .

Objective? To explore the influence of the information-motivation-behavior skills model based intervention on patients＇ fear of disease progression and incidence of postoperative complications in patients after endoscopic resection of intestinal polyps. Methods? By convenience sampling, 129 patients who planned to undergo endoscopic resection of intestinal polyps in the Department of Gastroenterology, Wuxi No.2 People＇s Hospital from January 2017 to June 2018 were selected as the participants in this study. According to the random number table, they were divided into the control group (n=64) and the observation group(n=65). The control group received routine nursing care, while the observation group received the information-motivation-behavior skills model based intervention on the basis of the routine care. The two groups were compared in the scores of fear of disease progression,recover condition and incidence of postoperative complications. Results? After intervention, the score of fear of disease progression in the observation group (29.18±7.84) was lower than the control group (35.62±9.43) with statistical difference (P＜ 0.05). After surgery, in the observation group 63 patients recovered, 2 patients developed complications among whom one patient experienced bleeding, and the other one patient developed ulcers. In the control group, 54 patients recovered, 10 patients developed complications among whom 6 patients experienced bleeding, 2 patients got perforation and 3 patients developed ulcers. The incidence of postoperative complications in the observation group was lower than the control group with statistical difference(P＜ 0.05). Conclusions? Information-motivation-behavior skills model based intervention can reduce the patients＇ fear of disease progression as well as the incidence of postoperative complications in the patients after endoscopic resection of intestinal polyps.

Objective: To evaluate the value and safety of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients. Methods: The clinical data of 377 elderly patients with therapeutic ERCP from January 2010 to September 2017 in Changzhou First People′s Hospital of Jiangsu Province were retrospectively analyzed. Among them, there were 34 patients (observation group) aged ≥ 90 years and 343 patients (control group) aged 75 to 89 years old. The results of ERCP examination, treatment of bile duct stones and related complications were compared between 2 groups. Results: There was no statistical difference in the success rate of ERCP between 2 groups (P>0.05). There were no statistical difference in detection rates of bile duct stones, cholangiocarcinoma and benign biliary stricture between 2 groups (P<0.05); however, the detection rates of duodenal papillary carcinoma and nipple diverticulum in observation group were significantly higher than those in control group: 11.8% (4/34) vs. 2.0% (7/343) and 38.2% (13/34) vs. 18.7% (64/343), and there were statistical differences (χ² = 10.326 and 7.294, P<0.01). There were 21 patients with bile duct stones in observation group, including 14 patients with multiple stones; there were 241 patients with bile duct stones in control group, including 188 patients with multiple stones. The maximum stone diameter, rate of in-line stent drainage and rate of extracorporeal lithotripsy in multiple stones patients of observation group were significantly higher than those in multiple stones patients of control group: (1.5 ± 0.3) cm vs. (1.2 ± 0.4) cm、9.5% (2/21) vs. 1.7% (4/241), 4.8% (1/21) vs. 0.4% (1/241), and there were statistical differences (P<0.05). There was no statistical difference in incidence of ERCP complications between observation group and control group: 14.7% (5/34) vs. 6.7% (23/343), P>0.05; but the incidence of cardiac accidents in observation group was significantly higher than that in control group: 5.9% (2/34) vs. 1.2% (4/343), and there was statistical difference (χ² = 4.393, P<0.05). There was no statistical difference in the length of hospital stay between observation group and control group: (11.5 ± 5.0) d vs. (13.2 ± 5.8), P>0.05. Conclusions Therapeutic ERCP is an important treatment for elderly patients with biliary and pancreatic diseases. For patients over 90 years old, ERCP is safe and reliable, but it is necessary to actively pay attention to comorbidities, especially cardiac function.

Objective To assess scoliosis in adolescence and adults by three-dimensional ( 3-D ) ultrasound imaging . Methods A commercial available ultrasound instrument with a magnetic sensor system was used for long distance 3-D ultrasound imaging .Specific phantoms were imaged to evaluate the precision of this imaging system . Twenty healthy adults and 20 patients with scoliosis were imaged by 3-D ultrasonography and radiography . The deformity angle of the patients with scoliosis was measured on the reconstructed coronal plane ( C plane) of 3-D ultrasound imaging . The relevance between the curvature measured by ultrasound and the Cobb angles originated by radiography were evaluated . Results There was no significant difference between the angles of the phantom measured by the 3-D ultrasound imaging system and that measured by an angle gauge ( P = 0 .479) . The transverse process ,vertebral arch and acoustic shadow of the central spinous process of spines in healthy adults can be displayed on the reconstructed C plane by 3-D ultrasound imaging . The morphology of scoliosis in all the twenty patients can be observed on the reconstructed C planes ( multi-layers) by 3-D ultrasound imaging ,which accorded well with that observed on radiograph . In 9 patients ,part of the spinal segment could not be totally displayed on one single coronal plane and no additional measurement was carried out . In 11 patients ,all the segments of the spine could be clearly displayed on a single coronal plane and the curvature of scoliosis was then measured . There were no significant differences between the angle measured on 3-D ultrasound imaging and the Cobb angle measured on radiograph( P =0 .974) and the two measurement methods have high correlation( r =0 .991 , P <0 .0001) . Conclusions The commercial available 3-D ultrasound imaging system applied in this study offers a viable method to assess scoliosis in adolescence and adults in a reliable and radiation-free manner .

Inguinal hernia (IH) is a common complication in prostate cancer patients undergoing radical prostatectomy (RP), which seriously affects their quality of life.The repair of IH is often challenging due to the adhesion in the inguinal area caused by previous surgery.This article focuses on the risk factors for IH after RP, including surgical approach, postoperative anatomical changes, low body mass index (BMI), muscle loss, advanced age, international prostate symptom score (IPSS), and patent sheath process, and prevention strategies for IH after RP, including robot assisted laparoscopic radical prostatectomy (RARP) with IH repair, preservation of the posterior pubic space in RARP, treatment of the spermatic cord, extraperitoneal RARP, and intraoperative management of the sheath like process, aiming to provide reference for urologists and to improve patients' quality of life.

【Objective】 To explore the expression of USP9X in platelets and its effect on platelet function. 【Methods】 The expression of USP9X in human and mouse was evaluated by PCR and Western blot. Platelets from young and old mice were separated and prepared, and the expression of USP9X was detected. USP9X inhibitos were used to assess the regulation of USP9X in platelet function, including aggregation, ATP release and spreading. Platelet lysates were collected in different time points to evaluate the change of phosphorylation of Akt in USP9X inhibitors treated platelets. 【Results】 Both human and mouse platelets expressed USP9X. Compared to the young mice, the old mice showed significantly enhanced expression of USP9X(P<0.05). To assess the effect of USP9X on platelet function, USP9X inhibitor was used to pre-incubate platelets for 30 min and platelet function were examined later. Results showed that USP9X inhibitor significantly decreased platelet activation including aggregation, ATP release and spreading(P<0.05). Compared to the control group, the inhibitor treated group showed a significant decrease in the spreading area after 45 minutes. The Western blot results showed a significant decrease in Akt phosphorylation levels of platelets in the USP9X inhibitor treated group. 【Conclusion】 Both human and mouse platelet express USP9X, and inhibition of USP9X decreased platelet function including aggregation, ATP release and spreading. USP9X can also influence the phosphorylation of Akt. The inhibitor of USP9X may become a potential therapeutic target for thrombosis intervention.

Objective and MethodChemical components in four varieties of Moringa Folium （MF）； traditional Indian YD， modified species of Indian species PKM1， modified species of PKM1 species PKM2， and red river No.1 variety HH） were qualitatively analyzed by ultra-high performance liquid chromatography quadrupole time of flight mass spectrometry（UPLC-Q-TOF-MS） and gas chromatography mass spectrometry（GC-MS）， and potential mechanism and material basis of MF in the treatment of constipation were revealed based on network pharmacology. ResultData of accurate relative molecular mass and fragment ions in primary and secondary mass spectra in both positive and negative ion modes were acquired by UPLC-Q-TOF-MS， and then 20 nonvolatile components were identified from the four varieties by comparison with references and consulting literature reports. Nineteen volatile components were identified by comparing mass spectrometry information and that in NIST （version 1.7） based on GC-MS， and 674 chemical component targets were predicted using SwissTargetPrediction and SEA after integration and duplicate elimination. A total of 1 086 constipation-related targets were predicted using GeneCards. With Venny， 88 intersection targets were obtained by mapping chemical component targets and disease targets and venny diagram was drawn. STRING and Cytoscape were used to plot protein-protein interaction（PPI） network diagram. Gene ontology（GO） function analysis and Kyoto encyclopedia of genes and genomes（KEGG） pathway analysis were completed through Metascape， which indicated that MF treated constipation mainly via thyroid hormone signaling pathway， advanced glycation end products/receptor for advanced glycation end products（AGE/RAGE） signaling pathway， and cancer signaling pathway. Additionally， the "component-target-pathway" map was plotted by Cytoscape， which predicted that the key components of MF in the treatment of constipation were adenosine， astragalin， geranylacetone， 2-methyloctan-3-one， palmitic acid and oleamide. Also， we inferred that the core targets might be prostaglandin-endoperoxide synthase 2（PTGS2）， tumor necrosis factor（TNF）， mitogen-activated protein kinase 1（MAPK1）， alpha 2A adrenergic receptor（ADRA2A）， and interleukin （IL）-6， which distributed in multiple tissues such as colon， small intestine， and rectum. ConclusionThis study clarified the volatile and non-volatile divisions in four varieties of MF comprehensively， and explained that MF treated constipation by reducing inflammatory state and promoting intestinal movement and secretion of intestinal fluid， which provided reference for further quality evaluation and clinical research of MF.

ObjectiveTo investigate the mechanism of Yiqi Huoxue Tongluo prescription （YHTP） in the treatment of diabetic neuropathic pain （DNP）. MethodNinety SPF-grade SD male rats were randomized into blank， model， low- （2.25 g·kg^-1）， medium- （4.5 g·kg^-1）， and high-dose （9 g·kg^-1） YHTP， and mecobalamin （0.175 mg·kg^-1） groups. Except those in the blank group， the rats in the remaining 5 groups were fed with a high-fat and high-glucose diet and subjected to intraperitoneal injection of low-dose （35 mg·kg^-1） streptozotocin （STZ） to establish the model of DNP. The sciatic nerve conduction velocity in DNP rats was measured by the neurophysiological method， and the levels of interleukin-6 （IL-6）， IL-1β， and tumor necrosis factor-α （TNF-α） were measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was employed to measure the mRNA levels of glial fibrillary acidic protein （GFAP） and extracellular signal-regulated kinase （ERK） in the spinal cord. Western blot was employed to measure the protein levels of GFAP and phosphorylated ERK （p-ERK）， and immunofluorescence staining to measure the fluorescence intensity of GFAP and p-ERK in the spinal cord. In the cell experiments， 100 mmol·L^-1 high glucose was used to induce the activation of astrocytes （CTX-TNA2） for the modeling of nerve cell injury. The cells were randomized into the normal， model， drug-containing serum （10% YQHT）， inhibitor ［10 mol·L^-1 corynoxeine （COR）］， drug-containing serum + inhibitor （10% YHTP + 10 mol·L^-1 COR） groups. The levels of pro-inflammatory factors （TNF-α and IL-1β） and the anti-inflammatory factor IL-10 in CTX-TNA2 cells were determined by ELISA， and the protein levels of GFAP and p-ERK in CTX-TNA2 cells by Western blot. ResultThe animal experiments showed that compared with the blank group， the model group presented reduced mechanical withdrawal threshold （MWT）， thermal work limit （TWL）， and nerve conduction velocity， elevated levels of fasting blood glucose， IL-1β， TNF-α， and IL-6， and up-regulated protein levels of GFAP and p-ERK， and mRNA levels of ERK1， ERK2， GFAP （P<0.01）. Compared with model group， YHTP increased the MWT， TWL， and sciatic nerve conduction velocity （P<0.01）， lowered the levels of IL-1β， TNF-α， and IL-6 （P<0.01）， and down-regulated the protein levels of GFAP and p-ERK， and mRNA levels of ERK1， ERK2， GFAP in the spinal cord （P<0.05， P<0.01）. The cell experiments showed that compared with the blank group， the model group had decreased survival rate， elevated levels of pro-inflammatory factors， and up-regulated protein levels of ERK and GFAP （P<0.01）. Compared with the model group， the YHTP-containing serum lowered the levels of IL-1β and TNF-α （P<0.05， P<0.01）， elevated the level of IL-10 （P<0.01）， and down-regulated the protein levels of ERK and GFAP （P<0.01）. ConclusionYHTP may inhibit the activation of astrocytes by inhibiting the ERK signaling pathway to reduce inflammation and thus relieve DNP.