Arsenic is a carcinogenic metal-like poison that is widely present in the natural environment. Acute or long-term exposure to arsenic can cause a series of liver injury, such as hepatomegaly, liver fibrosis, cirrhosis, and even liver cancer. In recent years, new progress has been made in the study of the mechanism of arsenic exposure on liver injury. This article will systematically review the main pathogenesis of arsenic-induced liver injury, mainly covering DNA methylation, oxidative stress, inflammatory response, hepatocyte apoptosis, liver fibrosis and autophagy. It aims to provide a theoretical reference for the prevention and treatment of arsenic poisoning.

Aim To investigate the effect of deguelin on the proliferation of non-small cell lung cancer cell line A549 and nude mice. Methods CCK-8 assay was used to detect the inhibition of deguelin on proliferation of SH-SY5Y cells; Hoechst stains and Annex-inV-FITC/PI double stained method were employed to observe the apoptotic morphology and apoptotic rate; flow cytometry was applied to determine the effect of deguelin on cell cycle of A549; tumor xenograft experiment and HE staining were conducted to investigate the effect of deguelin on growth of transplanted tumor in nude mice. Results Deguelin inhibited cell proliferation of A549 dose- A nd time-dependently; Hoechst stains and AnnexinV-FITC/PI double stained further confirmed that deguelin could induce the apoptosis of A549 cells, while deguelin blocked A549 cell cycle in G2/M phase in concentration-dependent manner. The nude mice xenograft model and HE staining experiments showed that deguelin significantly inhibited the growth of xenografts in A549 nude npce (P < 0. 01). Conclusions Deguelin has a significant inhibitory effect on non-small cell lung cancer cell line A549, pointing to a basis for the study of the antitumor activity of deguelin.

Aim To observe the protective effects of probiotics on alcoholic liver injury in rats .Methods Male Wistar rats were randomly divided into the follow-ing three groups: control group , normal diet with nor-mal (5 ×108 CFU· kg -1· d -1) treatment group.Ex-cluding the rats in the normal control group , the other animals were initially received intragastric administra-tion with 56%( V/V) ethanol 5.5~11.0 mL· kg -1 · day -1 for 8 weeks.Then the rats’ faeces were collect-ed, and the liver and the small intestine were obtained for pathologic and ultrastructural observation .Serum ALT, AST and ALP was measured by method of bio-chemistry .Serum DAO and D-LA was measured by en-zyme linked immunosorbent assay .The expression of FOXO4 in small intestine was detected by immunohis-tochemistry .The intestinal flora genome DNA was ex-tracted from faeces and the sequence of 16 S rDNA was analyzed by high-throughput sequencing technologies . Results Hepatic steatosis was obviously improved in probiotics treatment groups compared with ethanol-trea-ted group , and the ultrastructural such as mitochondri-al and rough endoplasmic reticulum pathological chan-ges was significantly alleviated . The ultrastructural changes in intestinal were better in probiotics treatment group than in the ethanol-treated group .And ethanol-induced rats ’ serum ALT, AST, ALP, D-LA and DAO levels showed a significant reduction in the probi-otics treatment groups compared with the ethanol-trea-ted group ( P<0.05 ) .The FOXO4 expression was in-creased obviously in the probiotics treatment groups compared with the ethanol-treated group ( P <0.05 ) . And the intestinal flora diversity was impacted after feeding alcohol , and probiotics had a certain regulative action in helping the intestinal flora back to normal state; At phylum level , the Firmicutes quantity was lower and the Bacteroidetes quantity was higher in eth-anol-treated group than those in the control group ( P<0.05 ) , and the conditions were improved after supple-menting probiotics .At genus level , the percent of ge-nus abundance was similar to normal control group in the probiotics treatment groups compared with the etha-nol-treated group .Conclusion Probiotics can relieve liver injury induced by alcohol in rats , and the mecha-nism may be related to the modulation of probiotics on the intestinal flora distribution and intestinal barrier .

OBJECTIVETo investigate the sleep quality and related factors among medical students in China, understand the association between dormitory environment and sleep quality, and provide evidence and recommendations for sleep hygiene intervention.

METHODSA total of 555 undergraduate students were selected from a medical school of an university in Beijing through stratified-cluster random-sampling to conduct a questionnaire survey by using Chinese version of Pittsburgh Sleep Quality Index (PSQI) and self-designed questionnaire. Analyses were performed by using multiple logistic regression model as well as multilevel linear regression model.

RESULTSThe prevalence of sleep disorder was 29.1%(149/512), and 39.1%(200/512) of the students reported that the sleep quality was influenced by dormitory environment. PSQI score was negatively correlated with self-reported rating of dormitory environment (γs=-0.310, P<0.001). Logistic regression analysis showed the related factors of sleep disorder included grade, sleep regularity, self-rated health status, pressures of school work and employment, as well as dormitory environment. RESULTS of multilevel regression analysis also indicated that perception on dormitory environment (individual level) was associated with sleep quality with the dormitory level random effects under control (b=-0.619, P<0.001).

CONCLUSIONSThe prevalence of sleep disorder was high in medical students, which was associated with multiple factors. Dormitory environment should be taken into consideration when the interventions are taken to improve the sleep quality of students.

Beijing ; epidemiology ; Housing ; Humans ; Logistic Models ; Prevalence ; Risk Factors ; Schools, Medical ; Self Report ; Sleep Wake Disorders ; epidemiology ; Social Environment ; Students, Medical ; psychology ; statistics & numerical data

OBJECTIVE To investigate the effect of Shuzheng granules on diabetic foot pain,ulcer healing and lower limb blood supply of the patients with diabetic foot after taking interventional treatment.METHODS Patients with diabetic foot who had taken interventional therapy successfully were randomly divided into Shuzheng granules treatment group(n=22)and basic treatment group(n=21).The two groups were given the same regular basic treatment while Shuzheng granules was add-ed to the first group.Then the results including pain symptoms integral,ulcer healing extent,ankle-brachial index(ABI),ar-terial flow velocity and the artery diameter before and after the treatment of the two groups were compared.RESULTS The improvement in pain symptoms integral depth of ulcer,ulcer area,ankle-brachial index,arterial blood flow velocity,arterial diameter and hemarheology were better in the treatment group(P<0.05).CONCLUSION ShuZheng granules combined with basic therapy has advantages in ulcer healing,pain relieving and lower limb blood flow increasing for patients with diabetic foot after intervention.

Objective:To explore the effect of "321" health education model in elderly patients with osteoporotic thoracolumbar fractures (OTF) .Methods:From January 2019 to June 2021, convenience sampling was used to select 112 elderly patients after OTF surgery in Hefei First People's Hospital as the research object. The patients were divided into the experimental group and the control group by random number table method, 56 cases in each group. The control group was given routine nursing and health education for patients after OTF surgery, while the experimental group was given "321" health education. The scores of Health Behavior Questionnaire, incidence of complications, and quality of life scores were compared between the two groups before intervention and after 6 months follow-up.Results:There were 54 and 51 patients in the experimental group and the control group, respectively, who completed the study. After 6 months of follow-up, the total score and the dimension scores of the Health Behavior Questionnaire in the two groups were higher than those before the intervention, except for the other behavior dimension, the total score of the Health Behavior Questionnaire and the scores of other dimensions in the experimental group were higher than those in the control group, all differences were statistically significant ( P<0.05) . The incidence of complications in the experimental group (3.70%, 2/54) was lower than that in the control group (15.69%, 8/51) , and the difference was statistically significant (χ 2=4.669, P=0.031) . The total score and the dimension scores of quality of life in the two groups were lower than those before education, and the total score and the dimension scores of quality of life in the experimental group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The "321" health education model in elderly patients after OTF surgery is beneficial to promote the osteoporosis prevention and health behavior of elderly patients after OTF surgery, reduce the occurrence of complications after OTF surgery, and improve the quality of life of patients.

Extracorporeal membrane oxygenation (ECMO) has been used for cardiac and respiratory failure for over 30 years. Recently, however, ECMO has emerged as a useful means of short-term support in the management of hypoxic patients for nontraditional indications. Here, we report the use of veno-venous ECMO as a bridge to support a patient with severe airway obstruction because of tumor compression. Case 1: A patient with extrinsic airway compression secondary to a large metastatic cancer on neck was successfully managed using ECMO. Case 2: The successful use of ECMO to support a patient with extrinsic airway compression secondary to a recurred thyroid cancer. Case 3: A pregnant woman with airway obstruction secondary to metastatic lymphadenopathy of lung cancer who underwent successful tracheal stent insertion. The 3 patients were successfully weaned off ECMO without any complication. Although these conditions are uncommon indications, ECMO is a potential option for such life-threatening conditions.
Airway Obstruction ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Lung Neoplasms ; Lymphatic Diseases ; Neck ; Pregnant Women ; Respiratory Insufficiency ; Stents ; Thyroid Neoplasms

Objective: To investigate the incidence and clinical characteristics of left atrial appendage (LAA) thrombus in patients with hypertrophic cardiomyopathy (HCM) and non-valvular atrial fibrillation (AF) . Methods: Data from 10 440 patients with AF who had undergone transesophageal echocardiography (TEE) before cardioversion or catheter ablation at Beijing Anzhen Hospital from April 2006 to December 2018 were retrospectively screened. Two hundred and five HCM patients were included, 820 AF patients with the same CHA₂DS₂-VASc score over the same period were selected as the control group. HCM patients were divided into two subgroups based on presence or absence of LAA thrombus/sludge. The baseline of clinical information, transthoracic echocardiographic and TEE measures were compared among all the groups. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of left atrial diameter (LAD) for LAA thrombus/sludge. Multivariate logistic regression analysis was applied to analyze the correlative factors of LAA thrombus/sludge in HCM patients. Results: The incidences of LAA thrombus or sludge were higher in HCM group than in control group (10.7% (22/205) vs. 0.7% (6/820); 8.8% (18/205) vs.7.0% (57/820), P<0.001) . In HCM patients, LAD was significantly larger in LAA thrombus/sludge subjects than in those without thrombus/sludge ((48.9±5.1)mm vs. (45.2±6.1) mm, P<0.001). CHA₂DS₂-VASc score was similar between the two subgroups ((2.0±1.4) vs. (1.8±1.4), P>0.05). There was no difference in the rate of patients with a CHA₂DS₂-VASc scores ≥2 between the subgroups(62.5% (25/40) vs. 57.0% (94/165), P=0.525). The incidences of LAA thrombus in HCM and AF patients with CHA₂DS₂-VASc scores of 0, 1 and 2 were 8.8% (3/34) , 9.6% (5/52) , 11.8% (11/119) , respectively; and the rate of LAA sludge were 8.8% (3/52) , 7.7% (4/52) , 9.2% (11/119) , respectively. The cut off value of LAD for the diagnosis of LAA thrombus/sludge was 44.5 mm. Multivariate logistic regression analysis showed that LAD≥44.5 mm (OR=5.134, 95%CI 1.862-14.156, P=0.002) , non-paroxysmal AF (OR=2.782, 95%CI 1.238-6.252, P=0.013) , previous thromboembolism or stroke (OR=1.820, 95%CI 0.774-4.227, P=0.017) were independent determinants of LAA thrombus/sludge. Conclusions The incidence of LAA thrombus/sludge is higher in patients with HCM and AF than in AF patients without HCM. The CHA₂DS₂-VASc score is similar between HCM and AF patients with LAA thrombus/sludge and those without thrombus/sludge. Patients with CHA₂DS₂-VASc score 0-1 are also likely to suffer LAA thrombus/sludge. Left atrial enlargement is associated with LAA thrombus/sludge.

Objective: To investigate the effect of non-vitamin K antagonist oral anticoagulants (NOAC) on left atrial or atrial appendage (LA/LAA) thrombi in patients with nonvalvular atrial fibrillation (NVAF). Method: Data from 3 042 patients with atrial fibrillation(AF), who underwent transesophageal echocardiography (TEE) examination before cardioversion or catheter ablation for the detection of LA/LAA thrombus in our department from March 2016 to January 2018 were prospectively analyzed. Among these patients, LA/LAA thrombus was detected by TEE in 57 patients. A total of 19 patients who received dabigatran or rivaroxaban for ≥3 weeks and underwent repeated TEE were included, 38 patients were excluded (7 patients with rheumatic heart disease, 1 patient treated with pericardial decortication, 1 patient treated with surgical repair of endocardial cushion defect, 1 patient with LA thrombus associated with the atrial septal occluder device, 14 patients received warfarin therapy, 14 patients did not receive repeated TEE). Results: First repeated TEE results showed that LA/LAA thrombus was not completely resolved in 4 out of 4 patients treated with dabigatran (110 mg bid) for a median time of 119 (47, 258) days, whereas LA/LAA thrombus was completely resolved in 5 out of 11 patients treated with dabigatran (150 mg bid) for a median time of 80 (58, 147) days. Thrombus was completely resolved in 2 out of 2 patients treated with rivaroxaban (15 mg qd) for 110 days and 95 days respectively, and in 1 out of 2 patients treated with rivaroxaban (20 mg qd) for 91 days. Second repeated TEE was performed in 8 patients. Thrombus was resolved completely in 2 out of 3 patients with undissolved thrombus treated by dabigatran (110 mg bid) after increasing the dabigatran dosage (150 mg bid). Thrombus was resolved in 3 (1 patient prolonged treatment with dabigatran 150 mg bid and 2 patients switched to rivaroxaban 20 mg qd) out of 4 patients with undissolved thrombus under the dabigatran 150 mg bid regimen, whereas the thrombus remained unresolved in 1 patient switched to rivaroxaban (15 mg qd). After receiving rivaroxaban 15 mg bid treatment, the thrombus was finally resolved in 1 patient with undissolved thrombus treated by rivaroxaban 20 mg qd. There was no clinical thromboembolism or major bleeding events during the median follow up time of 462 (305, 558) days. Conclusions Our data show that NOAC is an effective therapeutic option for the treatment of LA/LAA thrombi. When eligible, a higher NOAC dosage may be preferred due to the higher efficacy on thrombus resolvement.

Objective:To detect the mRNA expression and methylation status of leucine rich repeat containing 55(LRRC55) gene in pancreatic carcinoma tissues, and discuss the clinical value.Methods:Resected pancreatic ductal adenocarcinoma and normal adjacent specimens from 37 patients admitted in General Surgery of First Affiliated Hospital of Naval Medical University were collected from May 2019 to May 2021. Another two normal pancreas specimens and two blood samples from healthy adults were also collected. All patients′ age, gender, tumor location, tumor size, tumor differentiation, TNM staging, lymphatic metastasis, CEA and CA19-9 level were recorded. Bisulfite treatment of genomic DNA and sequencing analysis was used to study methylation patterns in CpG islands of the promoter for LRRC55 gene in fresh tissues from 2 pancreatic adenocarcinoma and adjacent tissues, 2 normal pancreatic tissues, 2 pancreatic cancer cell lines (PaTu8988 and ASPC1). LRRC55 mRNA in 35 pancreatic adenocarcinoma and adjacent tissues was detected by real-time quantitative PCR and the correlations with clinical parameters were analyzed.Results:CpG islands of LRRC55 in pancreatic adenocarcinoma tissues and pancreatic cancer cell lines was highly methylated and the mean methylation rate was 53% and 71%, respectively; while LRRC55 gene in pancreatic adjacent tissues and normal pancreatic tissues was lowly methylated, and the mean methylation rate was 8% and 11%. The relative expression in the pancreatic adenocarcinoma tissues and the paired adjacent normal tissues was 0.21 (0.02, 1.00 ) and 0.98 (0.33, 3.66 ), respectively; the former was significantly lower than the later and the difference was statistically significant ( P=0.003). Correlation analysis showed that LRRC55 mRNA expression level was related to tumor differentiation and CEA, but not correlated with patients′ age, gender, tumor location and size, CA19-9 level, lymphatic metastasis and TNM staging. Conclusions:Pancreatic cancer tissue and cell lines had abnormal methylation of LRRC55 gene; LRRC55 gene hypermethylation was related with its lower mRNA expression level in pancreatic cancer, which was correlated with the tumor differentiation and CEA level. LRRC55 may be a potential suppressor gene for pancreatic cancer.