Objective To evaluate the impact of chronic hepatitis B virus (HBV) infection on the outcome following resection for intrahepatic cholangiocarcinoma (ICC) patients.Methods The clinicpathological data of 60 consecutive operated ICC patients were collected.These patients were divided into group A with HBV infection,represented by serum positive hepatitis B surface antigen (HBsAg),group B with hepatitis B surface antibody (HBsAb) positive,and group C with all serum marker of HBV negative.The overall survival rate was evaluated.Results The 1-and 3-year overall survival rate and median survival of three groups were 50％ vs 53％ vs 29％ ; 22％ vs 18％ vs O; and 12.0 m vs 12.0 m vs 6 m,respectively.The difference was statistically significant(P =0.037).Multivariate analyses revealed that the preoperative serum level of TIBL,tumor location,HBV infection or injection of hepatitis B vaccine,hepatolithiasis and adjuvant chemotherapy were related to the prognosis.Conclusions HBV infection or injection of hepatitis B vaccine is favorable independent factor for prognosis of patients with intrahepatic cholangiocarcinoma after resection.

Objective To explore the relationship between metabolic syndrome(MS) and glomerular filtration rate(GFR).Methods A total of 10 140 adults aged 40 years and older inhabitants in Zhaiji community of Guiyang urban areas were investigated from May 2010 to August 2010 by adopting stratified cluster sampling method.The venous blood sample was drawn for the measurements of serum creatinine(Cr), fasting plasma glucose(FPG), OGTT 2hPG, fasting insulin, triglyceride(TG), total cholesterol(TC), high-density lipoprotein-cholesterol(HDL-C), low-density lipoprotein-cholesterol(LDL-C), and fasting plasma insulin.The definition of MS in our study was modeled after the Adult Treatment Panel Ⅲ(ATP-Ⅲ).Decreased GFR was defined as an estimated GFR<60 ml·min-1·(1.73 m2)-1.Results The prevalence of GFR less than 60 ml·min-1·(1.73 m2)-1 were 3.0% and 1.2% in participants with and without MS, respectively.The multivariate-adjusted odds ratios[95% confidence interval(CI)] of MS, which were independently associated with decreased GFR, were with elevated blood pressure, higher TG, lower HDL-C, and elevated FPG, their statistically odds ratios were 1.78, 2.96, 1.06, and 1.22, respectively.The prevalence of GFR decreased with the increase of MS components by 0.56%, 1.10%, 1.50%, 2.87%, 3.23%, and the odds ratios were 1.00, 1.57, 1.93, 3.07, and 2.89, respectively.Conclusion With the increase of MS components the risk of GFR decline increased.The occurrence of chronic renal dysfunction(CKD) might integrate multiple different risk factors of MS.

Objective To investigate the relationships and types between pulmonary subsolid nodules and bronchi and vessels,and their diagnostic values in differentiating subsolid nodules.Methods MSCT images of 40 subsolid nodules were retrospectively reviewed.The relationships between subsolid nodules and bronchi were divided into five types.Type Ⅰ:the bronchi were “cutoff”in the solid part of nodules.Type Ⅱ:the bronchi were distortion and extension in the solid parts of nodules.Type Ⅲ:the bronchi were distortion and extension in the GGO parts of nodules.Type Ⅳ:the bronchi were normal course in the GGO parts of nodules.Type Ⅴ:the bronchi were circumvent nodule lesions.The relationships between subsolid nodules and vessels were categorized into four types.Type Ⅰ:vessels passing by SSNs;Type Ⅱ:intact vessels passing through SSNs;Type Ⅲ:distorted,dilated or tortuous vessels seen within SSNs;Type Ⅳ:more complicated vessels other than described above.The relationship types were correlated to pathologic and/or clinical findings of subsolid nodules.Results Of 40 subsolid nodules,4 were preinvasive nodules,6 micro infiltrating adeocarcinomas and 30 invasive ones that were pathologically proven.Types Ⅰ,Ⅱ,Ⅲ and Ⅳ vascular relationships were observed in 0,8,21 and 11 subsolid nodules,respectively.Type Ⅲ relationship was the dominating one.All 11 subsolid nodules were invasive adenocarcinomas,when the relationship between subsolid nodules and vessle was type Ⅳ.There were 17 invasive adenocarcinomas,2 preinvasive ones,and 2 infiltrating ones when the relationship between subsolid nodules and vessel was type Ⅲ.Correlation analysis showed strong correlation between invasive adenocarcinoma and type Ⅲ and Ⅳ relationships.There was significantly statistical significance among 3 groups of relationships between subsolid nodule and vessels(χ2 =1 5.1 90,P =0.004).Types Ⅰ,Ⅱ,Ⅲ,Ⅳ and V brochi relationships were observed in 20,5,6,9 and 0 subsolid nodules,respectively.Type I relationship was the dominating relationship.There were 1 7 invasive adenocarcinomas, 1 preinvasive one,2 micro invasive ones when the relationship between subsolid nodules and bronchi were typeⅠ.There was significantly statistical significance among 3 groups of relationships between subsolid nodule and bronchi (χ2 =23.81 1,P =0.001 ).Conclusion Different subsolid nodules have different relationships with bronchi and vessels.Understanding and recognizing the characteristic subsolid nodule-bronchi and subsolid nodule-vessel relationships may help to identify which nodules are more likely to be malignant.

Objective To investigate the relationship between changes of ankle brachial index (ABI) and adverse cardiovascular events. Methods Baseline survey was conducted in 4 160 forty-year-old or older citizens living in Yunyan District of Guiyang City from May to August of 2011, which was in the way of cluster sampling to obtain their ABI and to collect information related to physical and blood biochemical examination and disease history. These citizens were conducted a follow-up survey for (39.29±1.47) months from July to December of 2014. Based on the change of ABI (ΔABI) from initial survey to follow-up survey, participants were subsequently divided into three groups: ΔABI>0.15 group,-0.15≤ΔABI≤0.15 group and ΔABI<-0.15 group. The adverse cardiovascular events during follow-up survey were compared between three groups. The risk factors affecting the adverse cardiovascular events were analyzed. Results Follow-up surveys were completed in 3 220 citizens in 3 years. The follow-up rate was 77.4%. Eighty-two new cases (2.5%) of adverse cardiovascular events were found in 3 220 cases in follow-up. The incidence rates of adverse cardiovascular events were higher inΔABI<-0.15 group compared with those of-0.15≤ΔABI≤0.15 group (8.3%vs. 2.4%, P<0.016 7). Logistic regression analysis indicated that age, hypertension history, and ΔABI<-0.15 were risk factors for adverse cardiovascular events. Exercise was the protective factor for adverse cardiovascular events. Conclusion Subjects withΔABI<-0.15 are at high risk for adverse cardiovascular events. The ΔABI can be used as a means of monitoring of adverse cardiovascular event, which provides certain forecast value for determining the possibility of adverse cardiovascular event.

Objective To investigate the relationship between brachial ankle pulse wave velocity and the incidence of cardio-cerebral events in people aged over 40. Methods Cluster sampling method was used to prospectively study 4 380 residents aged over 40 in Guiyang City District from May to August in 2011. Data of ba-PWV were collected. The follow-up examination was conducted from July to November of 2014. According to ba-PWV values, participants were divided into three groups:<14 m/s (control, n=1 039) group, 14-17.9 m/s group (n=1 393) and≥18 m/s group (n=809). Multi-factor Logistic regression model was used to analyze the relationship between ba-PWV values and risk factors of cardio-cerebral events. Results After three-year follow-up, a total of 3 241 participants were included in the final analysis. The cardio-cerebral events were identified in 63 (2.0%) cases, which were 0.6%, 2.2%and 3.2%in control group, 14-17.9 m/s group and≥18 m/s group. The value of ba-PWV increased significantly in those two groups compared with that of normal group. Logistic regression analysis showed that the incidence rates of cardiovascular and cerebralvascular events in 14-17.9 m/s group and≥18 m/s group were 2.777 (1.123-6.864) and 2.786 (1.032-7.526) times of control group after adjusting age, gender, systolic blood pressure, risk factors of diabetes, hypertension and blood lipids. Conclusion There is higher incidence rate of cardio-cerebral events in people aged over 40 in higher ba-PWV group. The value of Ba-PWV can be used to predict the occurrence of cardio-cerebral events.

Objective To explore the relationship between risk of stroke and calcaneal quantitative ultrasound(QUS)T score under-2. 5. Methods 5 847 subjects over the age of 40 from Yunyan District, Guiyang City were investigated with questionnaire, physical examination, blood lipids, other metabolic indexes and calcaneus bone density determination from May to October, 2011 by cluster sampling method and were followed up for 3 years. Subjects were divided into stroke group(99 subjects) and non-stroke group(5 748 subjects) according to the occurrence of stroke in the follow-up period. The relationship between risk of stroke and QUS T score under-2. 5 was analyzed. Results Compared to the non-stroke group, the number of subjects with T score under-2. 5 in calcaneal QUS was larger in the stroke group, the difference of which was statistically significant(P<0. 05). T score of bone density under-2. 5 in calcaneal QUS was found to be an independent risk factor for predicting stroke after adjusting for age, sex, and body mass index(HR=1. 467, 95%CI 0. 753-2. 855). The relationship between risk of stroke and T score under-2. 5 in calcaneal QUS remained unchanged after further adjust ment of smoking, diabetes, education, and hypertension(HR=1. 265, 95%CI 0. 647-2. 475). Conclusion The risk of stroke and T score of bone density under-2. 5 in calcaneal QUS was independently associated, and the latter is an independent risk factor for predicting stroke.

Objective To explore the epidemiological characteristics of the prevalence and incidence of metabolic syndrome(MS) in subjects with different TSH levels, which can provide a certain clinical basis for the prevention and treatment of MS. Methods According to the reference range of the TSH test system in our hospital, the subjects were divided into TSH normal group and TSH elevation group. From May to August of 2011, the whole group sampling method was used to conduct a baseline survey of 10140 permanent residents aged 40 and above in Yunyan district of Guiyang City. A total of 9618 cases were included. The prevalence of MS and its components were calculated with different TSH levels at baseline. After eliminating 3926 MS in 2011, 5692 patients with no MS were followed up for 3 years. Incidence of MS and its components were compared among different TSH levels. The median follow-up was (38. 6 ± 1. 6) months and the completion rate was 75. 40％. Results The total crude and standard prevalence of MS were 40. 82％ and 34. 46％ respectively. The crude and standard prevalence of MS in TSH normal group were 39. 96％ and 33. 90％, respectively, and in TSH elevation group were 44. 3％ and 37. 56％respectively . The comparison of crude prevalence of MS between the two groups was statistically significant (P>0. 05) and the standard prevalence of MS in TSH elevation group was also higher than that in TSH normal group. After 3 years of follow-up, the total crude and standard incidences of MS were 22. 51％ and 20. 64％, respectively. The total crude and standard incidence of MS in TSH normal group were 22. 01％ and 20. 22％, respectively and in TSH elevatlon group were 24. 69％ and 23. 20％, respectively. There was no statistically significant difference between crude incidences of MS in two groups, but the standard incidence of MS in TSH elevation group was higher than that in TSH normal group. Binary Logistic regression analysis showed that there was a positive correlation between TSH and incidence of MS in TSH elevation group. Conclusion Higher than normal levels of TSH may increase the prevalence and incidence of MS and its some components.

Objective To induce the psychological stress-asthmatic rat model by ovalbumin (OVA)mix-ture sensitization with restraint,which simulated the pathogenic factors of bronchial asthma with liver -qi stagnation pattern,as well as to evaluate the model using indicators of the macro characterization,behav-iors,pulmonary function,peripheral blood inflammatory cells,bronchial tissue pathomorphology.Meth-ods A total 32 male rats were randomly divided into four groups—control group,stress group,asthmatic group,and stress-asthmatic group.Rats of stress group and stress-asthmatic group were immobilized in restrained box once daily at different time,ten minutes more than the day before with the first duration of 2 hours.Rats of stress-asthmatic group and asthmatic group were sensitized by intraperitoneal injection 1 mL mixture of OVA with aluminium hydroxide on the first day,and after 13 days,they were stimulated by inhalation of 1 % OVA for 20 min for consecutive 14 days.The rats of control group were sensitized and stimulated by saline,without immobilizing .28 days later,the macro characterization,behaviors, peripheral blood eosinophils,pulmonary function,bronchial tissue pathomorphology were observed.Re-sults Stress asthmatic rats showed low mood,loss of interest,dull hair,loose stools,reducing food in-take,slowly weight gain,and scratched noses and abdominal skin,coughed,sneezed and wheezed in the throat when stimulated.Compared with control group,the points of vertical movement decreased signifi-cantly(P <0.05 or P <0.01).Preference for sucrose,the times of active moves in tail suspension test (TST)of stress-asthmatic rats obviously decreased(P <0.01),and the duration of immobility increased significantly(P <0.01 ).Pulmonary function indicators,including peak expiratory flow(PEF),forced expiratory flow (FEF 25% -75% ),forced expiratory volume in 0.3 s [FEV(0.3]/forced expiration volume capacity (FVC)significantly declined(P <0.05,P <0.01,P <0.01 ),while mean inspiratory airway resistance (Ri)and mean expiratory airway resistance (Re)increased remarkably (P <0.05,P<0.01).Peripheral blood eosinophil cells increased(P <0.01),and infiltration of inflammatory cell in lung tissue was obvious.Compared with the stress group or asthmatic group,the signs and indicators of stress-asthmatic group were all much worse.Conlusion The psychological stress-asthmatic rat model, induced by VOA mixture with restraint,was proved to be successful.It is in accordance with clinical characteristics of bronchial asthma with liver-qi stagnation pattern,which can be used to study asthma caused by emotion .

Objective: To explore and validate the potential targets of Paeoniae Radix Alba (P. Radix, Bai Shao) in protecting against chemical liver injury through network pharmacology, molecular docking technology, and in vitro cell experiments. Methods: Network pharmacology was used to identify the common potential targets of P. Radix and chemical liver injury. Molecular docking was used to fit the components, which were subsequently verified in vitro. A cell model of hepatic fibrosis was established by activating hepatic stellate cell (HSC)-LX2 cells with 10 ng/mL transforming growth factor-β1. The cells were exposed to different concentrations of total glucosides of paeony (TGP), the active substance of P. Radix, and then evaluated using the cell counting kit-8 assay, enzyme-linked immunosorbent assay, and western blot. Results: Analysis through network pharmacology revealed 13 key compounds of P. Radix, and the potential targets for preventing chemical liver injury were IL-6, AKT serine/threonine kinase 1, jun proto-oncogene, heat shock protein 90 alpha family class A member 1 (HSP90AA1), peroxisome proliferator activated receptor gamma (PPARG), PTGS2, and CASP3. Gene Ontology (GO) enrichment analysis indicated the involvement of response to drugs, membrane rafts, and peptide binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that the main pathways involved lipid and atherosclerosis and chemical carcinogenesis-receptor activation. Paeoniflorin and albiflorin exhibited strong affinity for HSP90AA1, PTGS2, PPARG, and CASP3. Different concentrations of TGP can inhibit the expression of COL-Ⅰ, COL-Ⅲ, IL-6, TNF-α, IL-1β, HSP-90α, and PTGS2 while increasing the expression of PPAR-γ and CASP3 in activated HSC-LX2 cells. Conclusion P. Radix primarily can regulate targets such as HSP90AA1, PTGS2, PPARG, CASP3. TGP, the main active compound of P. Radix, protects against chemical liver injury by reducing the inflammatory response, activating apoptotic proteins, and promoting the apoptosis of activated HSCs.

At present, diabetes mellitus has become an increasingly serious disease which affects public health in the word. Clinical treatment of diabetes is mainly based on oral hypoglycemic drugs, insulin injections and lifestyle interventions (diet and exercise) . The new intervention method targeting intestinal microflora opens up new ideas for diabetes treatment. This article reviews the application of new intestinal microbial therapy (probiotic treatment, oral prebiotics/synbiotics, fecal microbiota transplantation) and treatment by regulating intestinal microflora (bariatric surgery, antibiotic therapy and traditional Chinese medicine) in diabetes. This article also summarized the nursing intervention based on intestinal microbial therapy so as to improve the understanding of the relationship between intestinal microflora and diabetes, and provide a reference for treatment and nursing care for type 2 diabetes.