Objective To investigate the major risk factors of aseptic necrosis of bone in patients with systemic lupus erythemattrsus (SLE),and thus provide evidence for decision-making on prevention.Methods Meta-analysis Was used to systemically evaluate the 14 case-control studies about the risk factors of aseptic necrosis of bone in patients with SLE.Review Manager 4.2 Was utilized to carry out homogeneity checking and calculate the pooled odds ratio (OR) with 95% confidence interval.Results The OR values of risk factor of AVN in patients with SLE and 95% CI were as follows:Raynaud's phenomenon 2.43(1.12～5.29):dental ulcer 2.33(1.11～4.88);renal involvement 1.76(1.27～2.44);vasculitis 4.65(1.62～13.33):hyperlipidemia 3.28(1.76～6.12);anti-phospholipid antibody(APL)2.06(0.84～5.06):hypocomplementemia 0.63(0.35～1.14).Conclusion Glucocorticosteroid is an important risk factor in inducing aseptic necrosis of bone in patients with SLE,but it is not the only factor.Raynaud's phenomenon,dental ulcer,renal involve-ment,vasculitis and hyperlipidemia are major risk factors of aseptic necrosis of bone in patients with SLE.

Objective: To search for the best condition of microwave assisted extraction(MAE) for the flavonoids in Radix glycyrrliza and to compare with traditional boiling water extraction(WE). Methods: MAE and BWE were adopted, and its proper experimental conditions were examined and optimized by means of uniform design. The flavonoids in Radix glucyrrliza were determined by spectrophotometry. Results: Appropriate MAE conditions included extraction time of 1min, ethanol concentration of 38%, liquid/solid ratios of 8∶1(ml/g) and the power of microwave oven of 288W, the recovery of flavonoids from Radix glycyrrliza with MAE(24.6mg/g) was higher than BWE (11.4mg/g). Conclusion: Compared with traditional boiling water extraction(BWE), the experiment results demonstrated higher extracting rate and shorter extracting time. It indicated that MAE was more suitable to extraction of the flavonoids.

Objective To investigate the tracing value of drug-loaded nano-active carbon for lymphatic visualization and its potential application in the lymphadenectomy of gastric cancer. Methods Sixty-three patients with advanced gastric carcinoma were randomized into 2 groups:control group and tracing group. For the tracing group, 5-Fu-loaded nano-active carbon (NP-5-FU) suspension was intratumorally administered by preoperative gastroscope-guided or intra-operative injection. No tracing reagents was given in the control group. The numbers of removed lymph nodes and metastasis-involved lymph nodes as well as the lymph node staining were recorded and compared between the two groups. The adverse effects was monitored. Results The resected lymph nodes in the tracing group were much more than that of control group (43.73 ± 9. 25 vs. 25. 36 ± 4. 73, t = 3.82,P ＜ 0. 05). For the N1, N2 and N3 lymph nodes, 27. 17 ± 5. 82,13.73 ± 4. 61 and 2. 83 ± 0. 15 per case of the tracing group were desected, while they were 14. 45 ± 2. 75,8. 27 ± 1.89, and 2. 64 ± 0. 11 per case in the control group,respectively (P ＜ 0. 05 ). 26. 2% (211/842) of the lymph nodes in the tracing group showed black intensity,higher than that of unstain lymph nodes (4. 5% ,21/470,χ2 =95. 108,P ＜0. 05) and that in control group (16.9%, 142/837)( χ2 =7.485 ,P ＜ 0.05, ). No local and systemic adverse reactions were observed for the local injection of nano-active carbon. No extension of operating time and increased complications occurred. Conclusion Local injection of nano-active carbon which was loaded with 5-FU around the tumor is a very useful measure to trace the lymph nodes and facilitate the lymphedetectomy and chemotherapy.

Objective To select the best condition for microwave assisted extraction (MAE) of flavones from leaves of Ginkgo biloba L . and compare this method with the most conventional extraction way. Methods Both microwave assisted extraction and theat maceration were adopted for flavones from leaves of Ginkgo biloba L. , and the total content was determined by spectrophotometry. Results Under appropriate MAE conditions, both the recovery and purity of total flavones obtained from the experiments by uniform design and the orthogonal design were very similar. The optimal recovery and purity by orthogonal experimental design were 212 4 mg/g and 61 9%, respectively. The optimal results by orthogonal experimental design were 216 2 mg/g and 57 1%, respectively. However, the results by maceration were only 114 6 mg/g and 40 1%, respectively. Conclusion MAE is a more suitable method for the extraction of flavones from leaves of Ginkgo biloba L . because of its higher extraction rate and purity.

AIM: To explore the biopharmaceutical character of the combination of Fructus Schisandrae and Radix Salvia Miltiorrhizae. METHODS: Mice were divided into four group according to schizandrol A, Schizandrin B, Fructus Schisandrae and combination with Radix salvia Miltiorrhizae and then perfused. Mouse's bood plasma was collected in sequence, and the test solusion was prepared by adding amine sulfate and the mixture of acetonitrile methanol (4∶1). Its contents were measure by HPLC in the aid of SIP and 3p97 program. RESULTS: Metabolic rate in mouse of schizandrol A and schizandrin B from combination is apparently lower than that of non combination. CONCLUSION: Chinese Traditional medicinal combination has its biopharmaceutical value.

Objective:To explore the characteristics of type 3 secretion system and biofilm of Pseudomonas aeruginosa in diabetic foot wound, and to analyze the relationship between these factors, as well as to the antibiotic sensitivity.Methods:Thirty-three strains of Pseudomonas aeruginosa were collected from the foot wounds of diabetic foot inpatients in Tianjin Medical University Chu Hsien-I Memorial Hospital from February 1, 2018 to December 31, 2018. Thirteen strains of Pseudomonas aeruginosa were collected from non-diabetic wounds. All strains were tested for antibiotic sensitivity. The virulence genes exoS or exoU of Pseudomonas aeruginosa and the ability of biofilm formation were tested. The characteristics of exoS or exoU and biofilm of Pseudomonas aeruginosa were analyzed. Patients′ clinical outcomes were also analyzed.Results:Pseudomonas aeruginosa with exoS gene was the major pathogen, 90.9% found in diabetic foot group and 84.6% in control group, with no significant difference( χ2=0.54, P=0.46). The drug-resistant strains of Pseudomonas aeruginosa with exoS accounted for 16.7% in diabetic foot group and 18.2% in control group, also with no significant difference( χ2=0.18, P=0.83). There were 5 strains of Pseudomonas aeruginosa carrying exoU, 3 strains in diabetic foot group, of which 1 was resistant, 2 in control group, no resistant strain. Pseudomonas aeruginosa increased the ability of biofilm formation in diabetic foot group, accounting for 57.6%, and for resistant strains, 83.3% of them increased the biofilm formation ability. Two kinds of Pseudomonas aeruginosa produced different biofilms, but they were effectiveless for carbapenem antibiotics. The times of debridement ( P<0.01), time of antibiotic use ( P<0.01) were more in biofilm wound, but the healing rate reached 75%-90%. Conclusion:Pseudomonas aeruginosa secreting ExoS is the main one in the diabetic foot wound. The ability of Pseudomonas aeruginosa to produce biofilm in DF wound is increased. Biofilm is one reason for its antibiotic resistance. Multiple debridement combined with sensitive antibiotics is an effective method to remove biofilm.

Objective To study the epidemiological tendency and influencing factors for major chronic diseases in the elderly in Changsha,and to provide the scientific basis for the prevention and control strategies for the aged people.Methods Multi-stage randomized cluster sampling method was used in selecting 3135 persons aged 65 and over in Changsha.Using unified questionnaire and face to face asking method to investigate the prevalence of chronic diseases and its influencing factors.Results 95.7％ of questionnaires were valid (3000/3135).The total prevalence rate of chronic disease was 86.33％ in patients aged from 65-96 (74.83±6.63) years,with 85.49％ (1332) in males,and 87.23％ (1258) infemales(x2=1.93,P=0.164).Most of them had 1-3 kinds of chronic diseases,in 1 patient with 13 kinds of chronic diseases at the most.The most common chronic diseases among the elderly were hypertension,heart diseases,osteoarthritis,diabetes mellitus,benign prostatic hyperplasia,and fatty liver.Multivariate logistic regression suggested that age,marital status,smoking,quality of sleep were common influencing factors for hypertension,heart diseases and diabetes mellitus.Conclusions The prevalence of chronic diseases is high and the influencing factors are ubiquitous among the elderly in Changsha community.Community health education should be carried out to improve the effect of prevention and control of chronic diseases.

Objective To study the clinical, laboratory, X-ray and the pathological features of Parkinson disease patients with rheumatoid-like deformities. Methods One patient was described and the relevant English literature in recent 50 years were reviewed. Results Rheumatoid-like deformities in Parkinson disease was mostly observed in women. The ratio between male and female was about 1:5.6. Joint deformities occurred after 7.6 years of Parkinson's disease in average. The manifestations of joints included the flexion of the metacarpophalangeal (MCP) joints, hyperextension of the proximal interphalangeal (PIP) joints, flexion of the distal interphalangeal (DIP) joints, and ulnar deviation of wrists and bilateral feet hallux valgus. Whole-blood analysis, biochemistry profile, erythrocyte sedimentation rate, C -reactive protein were all in normal range. Rheumatoid factor and ANA, anti-ENA profile, AKA, anti-cyclic citrullinated peptide (anti-CCP) antibody and antiperinuclear factor (APF) were all negative. Periarticular erosion was not observed in plaint X -ray films. Synovial pathology showed non -specific infla -mmation without classical syno vial membrane proliferation and pannus formation. NSAIDs and DMARDs were uneffective, but on the contrary, anti -parkinson' s disease therapy could relieve joints symptoms. Conclusion Parkinson disease can be accompanied with rheumatoid-like deformities which may be misdiagnosed as RA and should be differentiated from RA by laboratory, radiographs and synovium pathology examination.

Objective:To analyze the characteristics of clinical manifestation, auxiliary examination and gene mutation of 3-hydroxy-isobutyryl-coenzyme A hydrolase (HIBCH) deficiency to better understand this disease.Methods:The clinical manifestations and genetic results of a patient with HIBCH deficiency were analyzed. The clinical features and genetic characteristics of HIBCH deficiency were summarized based on the literature review.Results:The proband, female, one year and four months old, was admitted to Children′s Hospital Affiliated to Zhengzhou University for “vomiting and diarrhea for 15 days, dyspnea and intermittent convulsions for 13 days after digestive tract infection”. The intelligence was normal, however, the motor development was slightly delayed before onset. Physical examination showed light coma, poor response and insensitivity to light. She also had shortness of breath, weak positive three concave signs and coarse breath sound in both lungs with sputum purrs. In addition, the muscle tension of extremities was increased. Bilateral Brudzinski′s sign, Babinski′s sign and Kernig′s sign were negative. Serum hydroxybutyryl carnitine (C4OH) was increased. Cranial magnetic resonance imaging (MRI) showed atrophy in bilateral cerebral hemispheres and abnormal symmetry signals in bilateral globus pallidus and cerebral peduncle. Novel compound heterozygous variants of HIBCH, c.489T>A (p. C163*) and c.740A>G (p. Y247C), were found in the patient, which respectively inherited from her healthy parents. Her symptoms were relieved after“cocktail”therapy and symptomatic treatment. Literature related to HIBCH deficiency published all around the world was reviewed. As a result, 17 articles, including 24 cases, had been reported. The majority of patients presented with poor feeding, dystonia and progressive motor developmental delay in early infancy. Cranial MRI showed lesions in bilateral basal ganglia. Serum C4OH concentration was elevated. And compound heterozygous or homozygous variants of HIBCH gene were found in patients with HIBCH deficiency.Conclusions:The detection of serum amino acids and acylcarnitine profiles on HIBCH deficiency was relatively specific and it was helpful to make a clear diagnosis by combining with cranial MRI and genetic tests. In this study, a case of HIBCH deficiency was confirmed, which expanded the mutation spectrum of HIBCH gene. Meanwhile, summarizing the clinical and genetic characteristics of cases reported improved understanding of HIBCH deficiency.

Objective To determine the improved effect of methylene blue(MB)on cognitive func-tion in brain-inflammatory-aging rats and investigate the underlying mechanism.Methods A total of 38 healthy 12-month-old SD rats were randomly divided into healthy control group,lipopo-lysaccharide(LPS)group,MB vehicle group and MB group,with 8 rats in the control and 10 rats in the other three groups.LPS was injected into the fourth ventricle with aid of a subcutaneous sustained release pump to establish a rat model of brain chronic inflammatory aging.MB of 0.5 mg/(kg·d)was added into the pump in the rats from the MB group.T-maze test and new object recognition test were employed to evaluate the learning and memory abilities of the rats.The acti-vation of microglia and astrocytes in the hippocampal CA1 region of the rats was detected by im-munofluorescence assay.The release of inflammatory factors IL-1β and IL-6 was measured by ELISA,and neuronal death in the CA1 region was assessed by neuronal nuclei(NeuN)fluores-cence staining.Results There was no significant difference in the exploration time for new and old objects between the LPS group and the MB solvent group(P＞0.05).The MB group spent significantly longer time in exploring the new objects than the old object(22.50±4.32 s vs 11.60± 3.01 s,P=0.000).The alternating selection rate of new arm and expression level of NeuN antigen were significantly decreased,and the expression levels of ionized calcium binding adaptor mole-cule-1(Iba-1)and glial fibrillary acidic protein(GFAP)and the contents of IL-1β and IL-6 were obviously increased(P＜0.05)in the LPS group and the MB vehicle group than the healthy con-trol group.Compared with the MB vehicle group,the MB group had notably increased alternating selection rate of new arms and higher NeuN expression level,and decreased Iba-1 and GFAP ex-pression and IL-1β and IL-6 contents(P＜0.05).Conclusion Subcutaneous administration of MB could significantly inhibit the damages of spatial learning and memory abilities in the LPS-induced brain chronic inflammatory aging rats.The mechanism may be closely associated with MB inhibi-ting inflammatory glial cells and protecting hippocampal pyramidal neurons.