Objective To observe the effects of telmisartan on cogtive function and the expression of Ghrelin receptors,growth hormone secretagogues receptor(GHSR) in diabetic rats. Methods Forty rats were randomly divided into 3 groups: control group,diabetic model group,and telmisartan treatment group. Streptozotocin-induced diabetic rat model(65 mg/kg,ip) was established. In the telmisartan treatment group,the rats were treated with telmisartan (13.3 mg?kg-1?d-1) for 12 weeks. Learning and memory abilities of the rats were tested by the Morris water maze. The mRNA and protein levels of GHSR in frontal cortex were detected by RT-PCR and immunohistochemistry. Results Compared with the diabetic model group,the telmisartan treatment group showed a significant decrease in the mean time of escape latencies(P

Artemisinin is the antidote to malaria, and has made hundreds of millions patients get rid of the disease since application in clinic. At present, the main accesses to artemisinin are directly extracted from Artemisia annua,chemical synthesis and biosynthesis. By comparing the differences of artemisinin production process between China and abroad, this research analyzes the reasons of the problem, and put forward their views and suggestions, so as to provide references for Artemisia annua further research.

Objective:To study the relationship between hepatitis B surface antigen(HBsAg)and the primary liver cancer (PLC).Methods:A 20-year prospective follow-up study was performed continuously in Qidong on a cohort of 515 HBsAg positive male patients aged 20-60 years old.The markers of hepatitis B virus,HBsAg,HBsAb,HBeAg,HBeAb and HBcAb (HBVM 1,2,3,4,5)were detected at the first time of the follow-up.Results:The PLC incidence of the whole cohort was 1340.90/100 000 person years(PY).The middle age of the PLC diagnosis was 43 with an average survival of 15 months.The PLC incidence was significantly higher in 41-50 age group than that of other age groups(P＜0.05).The three major HBVM patterns were 15,135 and 145 in the cohort with percentages of 38.83%(200/515),15.92%(82/515)and 44.08%(227/515)respective1y.The PLC incidences of these three patterns were 1 433.69/100 000 PY,2 284.71/100 000 PY,984.10/100 000 PY respectively,showing a significant difference between 135 and 145(P＜0.01).The percentages of 15,135 and 145 were 39.64%(44/111),23.42%(26/111)and 35.14%(39/111)in PLC patients respectively,showing a significant difference between 15 and 135(P＜0.01).The liver cirrhosis mortality of those three patterns were 195.50/100 000 PY,966.61/100 000 PY and 277.57/100 000 PY respectively,showing the significant differences between 135 and other two patterns(P＜0.01).Conclusion:HBsAg carriers were high risk population of PLC.The regular following-up is helpful on early diagnosis and treatment of PLC in those people,and can prolong the survival time.It was found that 135 had higher PLC risk than other HBVM patterns,suggesting a relationship between HBV duplication and PLC.The anti-virus treatment may delay or remove the occurring of PLC.

ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS) in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs). Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group). The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P＜0.000 01) and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P＜0.000 01); meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P＜0.000 01), as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P＜0.000 01). As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P＜0.000 01) and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001). ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.

BACKGROUND:Along with the widespread application of biodegradable materials in the field of medicine and the in-depth research of biomechanics,the drawbacks of traditional medical metal materials are increasingly appearing.In recent years,researchers at home and abroad focus on biodegradable materials that are represented by high molecular polymer to seek new breakthroughs in the field of spinal instability.OBJECTIVE:To investigate biomechanical changes of polylactic acid-polyglycolic acid (PLGA) lumbar interbody fusion cage in the body and discusses its feasibility for treating segmental instability of the spine.METHODS:Forty-two healthy pigs (9 months old) were randomly divided into two groups (n=21),and L4/5 intervertebral disc nucleus pulposus was removed in all animals.In experimental group,PLGA lumbar interbody fusion cage filled with broken bone was implanted;and in control group,autologous bone was implanted.X-ray was performed to observe the fusion of operation segments at 4,12 and 72 weeks postoperatively.Feasibility of fibrous fusion was measured by biomechanical test.Histologically,bone graft fusion at the surgical site and material degradation were detected.RESULTS AND CONCLUSION:(1) Imaging examination:Bone graft fusion in two groups was not visible at 4 weeks after operation.Evidence of increasing fusion was found in the experimental group at 12 weeks after operation;a visible part of the bone bridge was found in the control group,in which there was one case of fusion.Degradation of the fusion cage with one case of fusion in experimental group was found after 72 weeks after operation,and two cases of fusion in the control group.(2) Biomechanical test:There was no difference in the spinal range of motion between the two groups in different states at 4 weeks after operation (P ＞ 0.05).The spinal range values of motion at most of the states at 72 weeks after operation were significantly lower than those at 4 weeks after operation.(3) Cell histology observation:With the passage of time,the materials in the experimental group degraded gradually;new bone grew slowly and then fast,with bone fusion step by step.Fusion results were similar in the two groups.Our experimental findings indicate that the PLGA lumbar fusion cage has good biocompatibility.In addition to the individual state (left flexion),the mechanical properties of the fusion cage are similar to that of autogenous bone,and the fusion cage enables the segmental reconstruction of the pig spine to the maximum extent.

OBJECTIVETo evaluate whether first-degree family history of liver cancer plays a role in liver cancer incidence by prospective evaluation of a patient cohort in Qidong, China over a 20-year period.

METHODSIn May 1992, 708 hepatitis B surface antigen (HBsAg) carriers and 730 HBsAg-negadve controls from Qidong city were enrolled for participation in a prospective cohort study ending in November 2012.Follow-up was carried out every 6 to 12 months, and evaluations included serum assays to measure concentrations of alpha fetoprotein (AFP), HBsAg and alanine aminotransferase (ALT), as well as abdominal ultrasound to assess liver disease.The relationship between baseline (study entry) information of patients with first-degree family history of liver cancer and liver cancer incidence during the two decades of study was statistically assessed.

RESULTSThere were 172 newly diagnosed liver cancer cases in the cohort during 25 753 person-years (py) of follow-up, representing an incidence of 667.88/100 000 py.The incidence rates of liver cancer among participants with or without liver cancer family history were 1 244.36/100 000 py and 509.70/100 000 py respectively, and the between-group difference reached the threshold for statistical significance (P less than 0.01, Relative Risk (RR):2.44, 95% Confidence Interval (CI):1.80-3.31).The incidence rates of liver cancer among participants who had a sibling with liver cancer and participants who had a parent with liver cancer were not significantly different (P > 0.05), but the liver cancer incidence among participants who had a mother with liver cancer was significantly higher than that of participants who had a father with liver cancer (P < 0.05, RR:1.86, 95% CI:1.03-3.36). Among the participants with liver cancer family history, 56.52% (39/69) were diagnosed before 50 years old, and this rate was significantly higher than that of participants without a family history of liver cancer (40.78%, 42/103, P less than 0.05).The incidence rate of liver cancer among the participants who were family history-positive and HBsAg-positive was significantly higher than that of participants who were family history-negative but HBsAg-positive (P < 0.01, RR:1.75, 95% CI:1.29-2.38), and was 59.59 times higher than for participants who were family history-negative and HBsAgnegative.Subgroup analysis of liver cancer incidence among participants who were family history-positive but HBsAg-negative and participants who were family history-negative and HBsAg-negative produced anRR of 2.60, but there was no statistically significant difference between the two subgroups (P > 0.05).At the study's end, the incidence rates of liver cancer for the different subgroups were 32.21% for the family history-positive and HBsAgpositive participants, 19.80% for the family history-negative and HBsAg-positive participants, 1.71% for the family history-positive and HBsAg-negative participants, and 0.65% for the family history-negative and HBsAg-negative participants.

CONCLUSIONFirst-degree family history of liver cancer is a risk factor of liver cancer in Chinese patients from Qidong, and exhibits synergism with HBsAg-positivity for incidence of liver cancer.

Alanine Transaminase ; Carrier State ; China ; Cohort Studies ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; Middle Aged ; Prospective Studies ; Risk Factors ; alpha-Fetoproteins

Objective:To establish a GC method for the imultaneous determination of cinnamaldehyde, bornyl acetate, costunol-ide,dehydrocostus lactone,magnolol and honokiol in Dutong pills. Methods: The determination was performed on an HP-5 column (30 m ×0.32 mm,0.25 μm) with programmed temperature. The carrier gas was nitrogen with the flow rate of 2.0 ml·min-1. The injection volumn was 1 μl and the sample split ratio was 5:1. The inlet temperature was 280 ℃. The detector was a flame ionization detector with temperature at 300 ℃. Results:The linear ranges were 32.28-516.40 μg·ml-1for cinnamaldehyde(r=0.999 3), 27.06-433.00 μg·ml-1for bornyl acetate(r=0.999 2),25.65-410.40 μg·ml-1for costunolide(r=0.999 3),26.10-417.60 μg ·ml-1for dehydrocostus lactone(r=0.999 3),24.01-384.20 μg·ml-1for magnolol(r=0.999 0) and 18.32-293.10 μg·ml-1 for honokiol(r=0.999 4). The average recovery was 99.71%(RSD=0.67%),99.34%(RSD=1.18%),100.16%(RSD=0. 34%),100.40%(RSD=0.39%),99.32%(RSD=1.22%) and 99.58%(RSD=0.58%)(n=6),respectively. Conclusion:The method is simple,sensitive and accurate,can be used to supplement the insufficient quality control of Dutong pills.

Objective:To learn about the infection and gene polymorphisms of hepatitis E virus (HEV) in murine-shaped animals of plague foci in Yunnan Province.Methods:From July to August 2019, around 16 natural villages (4 in Mile City, 6 in Mangshi and 6 in Lianghe County), which were the foci of domestic plague in Yunnan Province, the murine-shaped animals were captured by the night-time method. The liver RNA was extracted, and the target gene of rat HEV was detected by one-step real-time fluorescence quantitative PCR, and the positive rate of rat HEV was calculated. The rat HEV positive samples were amplified by PCR for further clone sequencing, and the resulting sequences were compared with the HEV sequences registered in the GenBank and a phylogenetic tree was constructed by using MegAlign and MEGA 7.0.Results:A total of 491 murine-shaped animals were captured from 3 orders, 5 families, 8 genera, 15 species, and the positive rate of rat HEV was 4.89% (24/491). Among them, the positive rate of Rattus tanezumi and Niviventer fulvescens was 9.39% (23/245) and 1/3, respectively; and other species were negative. There was a statistically significant difference in the positive rate of rat HEV between different habitats ( P = 0.014), and the positive rate of rat HEV in the habitats near the dwellings was higher than that in other habitats ( P < 0.05). The sequence comparison analysis showed that the gene sequence of P018 from Lianghe County was 100.0% homologous to the MG813927.1 sequence of the first patient with rat HEV in Hongkong, and it was clustered into the same branch with the sequences of MG813927.1 and LC549185.1 from rat, was the type HEV C. G024 from Mangshi shared a low homology (20.7% - 31.5%) with other virus strains, and it was clustered into the same branch with a HEV sequence from an avian (AY535004.1). Conclusions:Rat HEV is prevalent in murine-shaped animals of plague foci of Yunnan Province, and there may be gene polymorphisms of rat HEV. In addition, the difference infection rate may be related to the habitats.

Objective: To evaluate the patients′ survival and effectiveness of the live cancer screening for population at high risk for liver cancer in Qidong. Methods: According to the Expert Scheme proposed the Expert Committee of Early Detection and Early Treatment, China Cancer Foundation, diagnostical screening by using combined methods of alpha-fetoprotein and B ultrasound monitoring were carried out biannually in individuals with positive HBsAg who were screened from Qidong area. The evaluation indices of the effectiveness are task completion rate of screening, detection rate of liver cancer, early diagnosis rate, and treatment rate. The deadline of the follow-up for the surviving outcome was March 31, 2016. The life-table method was used to calculate the observed survival, and to make comparison and significant tests between survival rates in Group A (those found via repeated periodic screening) and Group B (those diagnosed without periodic screening). Results: Since 2007, 38 016 target population have been screened, and 3 703(9.74%) individuals with positive HBsAg were found. Except for 29 patients with liver cancer at the initial screening, 3 674 persons in the cohort were followed up; 268 patients with liver cancer were detected from the 33 199 person-times screening, with an annual detection rate of 1.61%. Of them, 186 patients were found in Group A(1.12%), in which 149 patients were the early cases, with an early detection rate of 80.11%; 167 out of 186(89.78%) patients received treatment after diagnosis. The incidence of liver cancer in this HBsAg (+ ) cohort of 25 452 person-years was 1 052.96 per 100 000 annually, 187 cases in males(1 488.45/100 000)and 81 cases in females(628.46/100 000). The 1-, 3-, 5-, and 8-year survival of all patients with liver cancer were 64.55%, 40.50%, 32.54%, and 19.65%, respectively. The 1-, 3-, 5-, and 8-year survival rates were 77.16%, 49.04%, 38.53%, and 24.25% in Group A, and were 36.25%, 21.21%, 21.21%, and 0% in Group B, respectively, with significant differences between two groups (P<0.05). Conclusion The findings show that screening of individuals at high-risk of development of liver cancer, with semiannual AFP and B ultrasound, according to the Expert Scheme, is effective not only in increasing detection rate but also in detecting liver cancer at early stage, and in improving patients′ survival as well.

OBJECTIVE： To evaluate therapeutic efficacy of reteplase versus alteplase in the treatment of acute myocardial infarction in China， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Cochrane library， PubMed， Embase， Medline， CJFD， CSJD， Wanfang database by computor， etc.， also by manual search， RCTs about therapeutic efficacy （recanalization rate of thrombolysis） of reteplase （trial group） versus alteplase （control group） in the treatment of acute myocardial infarction in China were collected from Jan. 1995 to Sept. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed for recanalization rate of thrombolysis by using Rev Man 5.3 software. RESULTS： A total of 23 RCTs were included， involving 1 742 patients. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group was significantly higher than control group， with statistical significance [OR＝0.61，95％CI（0.50，0.73），P＜0.001]. Sub-group Meta-analysis was performed according to the successful time of thrombolysis. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group 1 h [OR＝0.38，95％CI（0.25，0.58），P＜0.001]， 1.5 h [OR＝0.44，95％CI（0.25，0.79），P＝0.006] and 2 h [OR＝0.62，95％CI（0.42，0.92），P＝0.02] after thrombolysis were significantly higher than control group， with statistical significance. CONCLUSIONS： The recanalization rate of thrombolysis by reteplase in Chinese patients with acute myocardial infarction in better than by alteplase.