Objective To investigate the immunomodulatory effect of black rice anthocyanin(BA) on biochemical indicators in blood and macrophages in rats.Method Twenty four female SD rats were randomly divided into 4 groups:control group,BA low,middle and high-dose groups(BAL 25;BAM 50;BAH 100 mg/kg bw).The control group was treated with normal saline,while BA groups were i.g.administered with defferent doses for 30 d.The blood biochemical indicators were detected by automatic biochemistry analyzer.The activities of lactate dehydrogenase(LDH),acid phosphatase(ACP),superoxide dismutase(SOD),and maleic dialdehyde(MDA) contents in peritoneal macrophage(PM) and alveolar macrophage(AM) were determined by biochemical methods.The ability of macrophages to phagocytose neutral red was measured by colorimetric method.Results The levels of urea nitrogen(UN),uric acid(UA),triglyceride(TG),total cholesterol(TC) and low density lipoprotein(LDL) in blood were reduced.The activities of ACP,LDH in PM were increased.and the activities of SOD in PM and AM were increased whereas MDA was reduced.The ability of PM and AM to phagocytose neutral red was strengthened significantly.Conclusion BA shows significant immunomodulatory effection blood biochemical indicators and macrophages in rats.

AIM: To study the effects of Rhodiola(Rho), nitric oxid e (NO), hem oglobin (HB) on the multiple organ dysfunction syndrome(MODS) in early stage aft er burn in rabbits. METHODS:The rabbits were divided into the sh am burn group (SB), burn group (B), orally taken Rho group (R), burn and Rho therapy group (BR ). The changes of hemodynamics were monitored. The index of pulmonary permeabili ty was calculated. These data reflected separately the functions of heart, live r, lung, kidney and blood coagulation system were also determined. NO contents i n ser um and bronchoalveolar lavage fluid (BALF) were measured by Griess method. The l e vels of serum HB were measured. RESULTS:① The dysfunctions of hear t, liver and kidney achieved the criterion of MODS in group B at 48 h postburns (B 48 h ). The N O content of group B significantly increased in serum and BALF at B 48 h . ② The cardiac index (CI) and creatine phosphokinase (CK), urea nitrogen (BUN) markedly raised or decreased in group BR at 48 h postburns (BR 48 h ) than B 48 h . The NO cont ents in serum and BALF markedly raised. ③ HB contents in serum markedly raised in group B and BR at 0 h postburns (B 0 h , BR 0 h ) than group SB, B 48 h , R, BR 48 h , but NO was reverse. CONCLUTIONS: ① HB contents in serum markedly raise d at 0 h post burns, but NO was reverse. ② Rho promoted the increases of NO synthesis and the blood perfusion of organs, which might be one of mechanisms to prevent the devel opment of MODS.

Objective To analyze the MR manifestations of the focal nodular hyperplasia (FNH)in liver and observe the MRI changes after 30-36 months.Methods 12 (14 lesions)of the 13 patients (1 5 lesions)were firstly diagnosed as FNH by MRI with plain scan and dynamic Gd-DTPA enhancement,and then were confirmed by the follow-up survey with similar MRI after 30 - 36 months.The last one patient was also scanned with Gd-EOB-DTPA enhancement but with similar plain scans.The size,signal,en-hancement patterns of the lesions were analyzed and compared with those in the follow-up survey.Results Typical MR manifesta-tions were found in 93.33%(14/1 5)of the lesions with hypo-or iso-intensity on T1 WI,hyper-or iso-intensity on T2 WI,marked en-hancement in arterial phase and attenuation but still equal to or higher than normal liver parenchyma in portal and delayed phases af-ter Gd-DTPA administration.In addition,the central scar showed hypointensity on T1 WI,hyperintensity on T2 WI,and enhance-ment in delayed phase.The enhanced small vessels inside lesions and the pesudocapsule enhancement could be seen in delayed phase. The only one lesion with Gd-EOB-DTPA enhancement showed marked enhancement in arterial and portal phases,and slight hyperin-tensity in hepatocellular phase with hypo-intense central scar in any phases.As for the only one lesion with atypical manifestation,it showed isointensity on T1 WI,slightly hyperintensity on T2 WI,nonenhancement in arterial phase,slightly enhancement in portal phase,and small vascular enhancement inside the lesion in delayed phase.After the follow-up survey of 30-36 months 92.86%(13/14)lesions did not change,however one lesion (10mm)disappeared.Conclusion Typical FNH shows similar MRI characteristics, iso-intense or slightly hypo-intense signal on T1 WI,iso-intense or slightly hyper-intense signal on T2 WI,marked enhancement in ar-terial phase,the central scar enhancement and the inside small vascular enhancement of lesions in delayed phase.It is valuable in dif-ferential diagnosis.

Objective To observe the effects of different levels of stroke volume variation (SVV)directed fluid therapy on prognosis in elderly patients.Methods One hundred and ten patients (male 67 cases,female 43 cases,aged 65-80 years,ASA grade Ⅰ or Ⅱ)undergoing abdominal sur-geries were randomized into three groups on the basis of SVV level:1 1%≤SVV≤14% (group H,n=37),7%≤SVV≤10% (group M,n = 37),3% ≤ SVV≤ 6% (group L,n = 36).Each group ac-cepted different fluid therapy strategy.Perioperative intake and outtake volume were recorded.Progno-sis indicators included gastrointestinal function recovery,post and total length of hospital stay and so on were collected.Postoperative complications were also recorded.Results Along with the level of SVV dropped,The volume of colloid and crystalloid among groups were significantly increased (P <0.05).There were no remarkable difference in the time interval of activity off bed,liquid diet,gastrointestinal decompres-sion and catheterization.Group L had a delayed exhaust time compared with group H (P <0.05).Patients in the group M had a shorter time to have semi-liquid diet.The transition of diet was also shortest in the group M.But these differences were not statistically significant.The group M also had a shorter time in first-degree or above nursing time and post and total length of hospital stay compared with group L (P <0.05).The incidence of postoperative infection in group L was higher than other two groups.Incidence of anastomosis leakage in group H was higher than that in other two groups (P <0.05).Conditions of compli-cations in group L were more severe and complicated compared with other two groups.Conclusion 3%≤SVV≤6% may increase the risk of postoperative infection and prolong the time of hospitalization.Patients in the level of 7%≤SVV≤10% may have a better postoperative recovery.This level could be a better goal of perioperative fluid therapy in elderly patients.

In recent 10 years, social neuroscience has developed rapidly, which integrates social psychology, cognitive neuropsychology, and neuroscience, and puts forward the concept of social cognition. Clinical studies have shown that social cognitive impairment is easy to occur after stroke, which seriously affects the neurological rehabilitation and quality of life of patients. This article reviews the concept, mechanism, clinical manifestations, neuropsychological evaluation and intervention measures of social cognitive impairment in stroke patients, hoping to improve neurologists' awareness of the social cognitive impairment in stroke patients, actively prevent the occurrence of social cognitive impairment after stroke, and give corresponding intervention, so as to help patients better adapt to social life.

Objective:To investigate the status of We-Media platforms opened and opera-ted by surgeons in tertiary first-class hospitals nationwide and analyze its influence on patients and surgeons.Methods:The retrospective cross-sectional investigation study was conducted. The investigation was conducted on the surgeons who had opened We-Media platforms in their units or associations through the contact of all members of the second Elite Committee of Chinese Digestive Surgery of the Chinese Journal of Digestive Surgery from November 5 to 30, 2021. Questionnaires were distributed through wechat, and the software platform was Questionnaire Star. Observation indicators: (1) results of questionnaire survey; (2) basic information of surgeons running We-Media platforms; (3) daily workload and research background of surgeons running We-Media platforms; (4) information related to We-Media platforms; (5) influence of running We-Media platforms on patients; (6) influence of running We-Media platforms on surgeons; (7) feelings and suggestion of surgeons after running We-Media platforms. Measurement data with normal distribution were expressed as Mean± SD, and count data were expressed as absolute numbers and percentages. Results:(1) Results of questionnaire survey: a total of 229 complete and valid questionnaires were collected in this survey. (2) Basic information of surgeons running We-Media platforms: of 229 surgeons, there were 195 males and 34 females, aged (40±8)years. There were 120 surgeons aged from 36-45 years, 80 surgeons aged <35 years and 29 surgeons aged >45 years. There were 86.46% (198/229) of surgeons from teaching hospitals and 74.67%(171/229) of surgeons from provincial cities. Of 229 surgeons, junior, intermediate, deputy senior and senior titles accounted for 17.90%(41/229), 27.51%(63/229), 37.12%(85/229) and 17.47%(40/229), respectively. Surgeons with working years ≤5 years, 6-10 years, 11-15 years and ≥16 years accounted for 19.21%(44/229), 22.27%(51/229), 26.64%(61/229) and 31.88%(73/229), respectively. Hepatobiliary and pancreatic surgeons, esophageal and gastrointestinal surgeons were the main specialties, accounting for 48.03%(110/229) and 14.41%(33/229), respectively. The original intentions of opening We-Media platforms (multiple choice) included increasing patient population and improving the income, accumulating cases to facilitate clinical research projects, increasing the popularity of the industry and gain peer recognition, increasing social awareness and improving spiritual satisfaction, passive assignments form units or hospitals, which accounted for 52.84% (121/229), 54.15%(124/229), 64.19%(147/229), 58.08%(133/229), 17.90%(41/229), respectively. (3) Daily workload and research background of surgeons running We-Media platforms: 60.26%(138/229) of surgeons participated in offline social welfare activities 1-3 times per year and 26.64%(61/229) of surgeons participated >3 times per year. There were 47.60% (109/229) of surgeons performing 5-10 operations per week and 33.19%(76/229) of surgeons performing >10 operations per week. In terms of scientific researches, 38.43%(88/229) of surgeons had not published high-quality English articles as the first author or co-first author, 24.89%(57/229) of surgeons had published 1-3 articles and 36.68%(84/229) of surgeons had published >3 articles. There were 51.09%(117/229) of surgeons without any longitu-dinal projects, 13.54%(31/229) of surgeons with national projects, 35.37%(81/229) of surgeons with provincial and ministerial projects. (4) Information related to We-Media platforms: there were 65.50%(150/229) of surgeons running wechat public account, 55.02%(126/229) of surgeons running consultation platform, 31.44%(72/229) of surgeons running TikTok, 21.40%(49/229) of surgeons running wechat video account (some surgeons operated multiple We-Media platforms). The time of operating the platform was <1 year in 35.81%(82/229) of surgeons, 1-3 years in 42.79%(98/229) of surgeons, >3 years in 21.40%(49/229) of surgeons, respectively. The contents of We-Media platforms were updated >2 weeks in 45.85%(105/229) of surgeons. There were 63.32%(145/229) of surgeons with We-Media platforms win-ning emotional support from their department or hospital, 12.66%(29/229) of surgeons with We-Media platforms winning financial support. There were 82.53%(189/229) of surgeons operating We-Media platforms by theirselves. The We-Media plat-form operation was smooth in 47.16%(108/229) of surgeons, unsustainable in 50.22%(115/229) of surgeons and suspended in 2.62%(6/229) of surgeons. On average, it took less than 30 minutes for 60.70%(139/229) of surgeons and 30-60 minutes for 27.07%(62/229) of surgeons to operate the We-Media platforms of surgeons every times, respec-tively. The background message or consulta-tion was allowed in 89.08%(204/229) of surgeons. The number of leaving messages was <5 times in 52.84%(121/229) of surgeons and >50 times in 6.99%(16/229) of surgeons. On average, each content in 59.39%(136/229) of surgeons were "liked" or "viewed" <100 times, and each content in 29.26%(67/229) of surgeons were "liked" or "viewed" 100-300 times. There were 60.26%(138/229) of surgeons having content with the highest "liked" or "viewed" clicks <1 000 times and 6.99%(16/229) of surgeons having content with the highest "liked" or "viewed" clicks >10 million times. On average, each content in 74.67%(171/229) of surgeons were "forwarded" <100 times, and each content in 6.55%(15/229) of surgeons were "forwarded" >300 times, respectively. The number of followers was <1 million in 87.34%(200/229) of surgeons. The We-Media audiences (multiple choices) included related professional peers, related health care professionals, patients of surgeons, general public, accounting for 42.36%(97/229), 31.00%(71/229), 52.40%(120/229), 53.71%(123/229), respectively. (5) Influence of running We-Media platforms on patients: 34.93%(80/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients of themselves, 29.69%(68/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients in their departments, respectively. In the view of 75.98%(174/229) of surgeons, the percent of outpatient and inpatient patients by We-Media platforms was <10%. After 6 months of We-Media operation, 39.74%(91/229) and 25.33%(58/229) of surgeons believed that inpatient and outpatient compliance was significantly improved, respectively, and 46.29% (106/229) of surgeons believed that preopera-tive and pre-chemotherapy or pre-radiotherapy conversations saved more time. (6) Influence of running We-Media platforms on surgeons: 20.09%(46/229) and 6.55%(15/229) of surgeons attributed the success to "long-term, sustainable, absorbed operation" and "important contents of We-Media platforms and wide audiences". There were 72.49%(166/229) of surgeons yet to be successful. There were 26.64% (61/229) and 22.27%(51/229) of surgeons believing that opening We-Media platforms was conducive to the association's employment and multicenter clinical research. Operating We-Media platforms was conducive to professional knowledge improvement, clinical research ability enhancement and teaching level of students, which was believed by 54.59%(125/229), 40.17%(92/229) and 48.91%(112/229) of surgeons, respectively. Although the total income in 88.65%(203/229) of surgeons increased less than 20% after 6 months of operation, 47.60%(109/229) of surgeons believed that "the sense of achievement or pleasure in work has been significantly improved", and 48.91%(112/229) of surgeons did not have the idea of quitting. There were 7.42%(17/229) of surgeons with the idea of quitting the operation of We-Media platforms. (7) Feelings and suggestions of surgeons after running We-Media platforms: the proportion of surgeons who hoped to get help from departments, hospitals, associations and the society were 61.57%(141/229), 72.05%(165/229), 47.16%(108/229) and 53.28%(122/229), respectively. Only 9.61%(22/229) of surgeons did not require help. Commercial advertisement was allowed by 40.17%(92/229) of surgeons and forbidden by 59.83%(137/229) of surgeons. In terms of alternative suggestion, 70.74%(162/229) of surgeons believed that it was necessary for the We-Media platforms to involve more doctors of different specialties, but 40.61%(93/229) of surgeons believed that relevant departments or associations should strengthen supervision under the current situation. In addition, 32.75%(75/229) of surgeons believed that the operation of We-Media platform requires more investment. The were 27.95%(64/229) of surgeons giving specific suggestions on running We-Media platforms, 7.81%(5/64) of which did not suggest a blind try.Conclusions:Most surgeons who open and operate We-Media platforms in China are faced with problems such as busy work, limited time and energy, low-income increase, and lack of professional promotion and maintenance teams and external support. Even so, there are still many surgeons who have achieved success through long-term persistence and high-quality content output, thus increasing the number of patient visits, improving their own ability and industry influence, and bringing a greater sense of professional achievement.

Purpose: Patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer can benefit from trastuzumab deruxtecan. Given the unclear prognostic characteristics of HER2-low breast cancer, we investigated the prognostic characteristics of HER2-low expression from primary tumor to residual disease after neoadjuvant chemotherapy (NACT). Materials and Methods: The data of HER2-negative patients receiving NACT at our center were collected. Pathological complete response (pCR) rate were compared between HER2-0 and HER2-low patients. The evolution of HER2 expression from primary tumor to residual disease and its impact on disease-free survival (DFS) were examined. Results: Of the 690 patients, 494 patients had HER2-low status, of which 72.3% were hormone receptor (HR)–positive (p < 0.001). The pCR rates of HER2-low and HER2-0 patients (14.2% vs. 23.0%) showed no difference in multivariate analysis regardless of HR status. No association was observed between DFS and HER2 status. Of the 564 non-pCR patients, 57 (10.1%) changed to HER2-positive, and 64 of the 150 patients (42.7%) with HER2-0 tumors changed to HER2-low. HER2-low (p=0.004) and HR-positive (p=0.010) tumors before NACT were prone to HER2 gain. HER2 gain patients had a better DFS compared with HER2-negative maintained patients (87.9% vs. 79.5%, p=0.048), and the DFS of targeted therapy group was better than that of no targeted therapy group (92.4% vs. 66.7%, p=0.016). Conclusion Although HER2-low did not affect the pCR rate and DFS, significant evolution of HER2-low expression after NACT creates opportunities for targeted therapy including trastuzumab.

Objective:To observe the clinical efficacy of mouse nerve growth factor (mNGF) combined with rehabilitation on children with global developmental delay(GDD).Methods:It was a prospective multicenter clinical randomized controlled trial (RCT) involving 120 children with GDD admitted to 5 hospitals in China from May 2020 to January 2022.They were randomly divided into mNGF group and conventional rehabilitation group using block randomization method.All children were managed by standardized rehabilitation after recruitment, and those in the mNGF group were additionally given mNGF injections.All subjects were surveyed using the Gesell Development Diagnosis Schedules(GDDS) at baseline, 90 days and 120 days after treatment, and their developmental quotient (DQ) was recorded.Clinical efficacy was analyzed by the paired t-test, rank sum test and Chi- squared test. Results:After 90 days of treatment and the continuous follow-up to 120 days, the increases in the DQ of gross motor (7.520±13.900 vs.0.450±11.459), fine motor (7.800±15.346 vs.1.250±11.581), adaptive behavior (7.730±13.428 vs.2.100±12.022) and personal-social behavior (6.780±11.651 vs.1.780±10.120) than baseline were significantly higher in mNGF group than those of conventional rehabilitation group (all P<0.05). Serious adverse events and important drug-related medical events were not reported. Conclusions:mNGF combined with rehabilitation effectively enhances the development levels of gross motor, fine motor, adaptive behavior and personal-social behavior, and continuously improves the condition of GDD in children with a high safety.