e factors of elder age, abdominal surgeries and malignant tumor.

Acute pancreatitis is considered an autodigestive disorder in which inappropriate activation of trypsinogen to trypsin within pancre-atic acinar cells leads to the development of pancreatitis.Autophagy is an evolutionarily preserved degradation process of cytoplasmic cellular constituents,and it is one of the early pathological processes in acute pancreatitis.Autophagic flux is impaired in acute pancreatitis,which mediates the key pathologic responses of this disease.Impaired autophagy,dysfunction of lysosomes,and dysregulation of autophagy suggest a disorder of the endolysosomal pathway in acute pancreatitis.The role of autophagy in acute pancreatitis is discussed from the aspects of au-tophagic process,autophagy and activation of trypsinogen,impaired autophagy and acute pancreatitis,and defective autophagy promoting in-flammation.

Objective To investigate the value of cysteine-rich secretory protein LCCL domain-containing 2 (CRISPLD2) in diagnosis and prognosis in patients with sepsis.Methods Clinical data of patients admitted to intensive care unit (ICU) of the First Hospital of Hebei Medical University from December 2014 to December 2016 were retrospectively analyzed. According to the severity of sepsis, the patients were divided into three groups: sepsis patients, severe sepsis patients and septic shock patients, and 100 healthy persons were enrolled as control group. Levels of serum CRISPLD2, procalcitonin (PCT) and C-reactive protein (CRP), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, and 28-day prognosis were recorded. Analysis of the correlation between CRISPLD2 and PCT, CRP, APACHEⅡscore, SOFA score was done. The receiver operating characteristic (ROC) curve was plotted for the CRISPLD2 value for the diagnosis and prognosis in patients with sepsis.Results A total of 115 patients with sepsis were enrolled in this study, including 52 sepsis, 48 severe sepsis, and 15 septic shock; 29 patients died after 28 days, 28-days mortality rate was 25.2%. There was no significant difference in CRISPLD2 between sepsis and healthy control group (mg/L: 204.1±74.5 vs. 211.3±12.0, P > 0.05); the level of CRISPLD2 in septic shock group was significantly lower than that in sepsis group and severe sepsis group (mg/L: 139.0±55.0 vs. 240.2±89.6, 233.0±8.9, bothP < 0.05). The level of PCT, CRP and APACHE Ⅱ score, SOFA score in sepsis patients were significantly higher than those in healthy control group, and increased with the severity of sepsis. There was no statistically significant difference in CRISPLD2 level between the dead and the survival of sepsis, and the levels of PCT and CRP in death group were significantly higher. The levels of CRISPLD2 were significantly negative correlated with the levels of PCT, CRP, APACHE Ⅱ score and SOFA score (r values were -0.089,-0.431, -0.115, -0.201, respectively, allP < 0.05). It was shown by ROC curve analysis that the area under ROC curve (AUC) and 95% confidence interval (95%CI) of CRISPLD2, PCT, CRP for diagnosis of sepsis were 0.907 (0.871-0.944), 0.922 (0.886-0.958), 0.916 (0.878-0.954) respectively, allP = 0.000; when the cut-off value of CRISPLD2 > 216.0 mg/L, the sensitivity was 96.7%, and the specificity was 92.6%, which power lied between PCT and CRP. The AUC of CRISPLD2 for prognosis was significantly lower than that of PCT [0.617 (0.507-0.727) vs. 0.786 (0.668-0.903),P <0.01]; when the cut-off value of CRISPLD2 was 103.5 mg/L, the sensitivity was 100%, and the specificity was 25.6%. Conclusion CRISPLD2 is a potential biomarker in sepsis, but cannot predict the prognosis of patients with sepsis.

Objective To observe the efficacy and safety of Bushen Huoxue Prescription in the treatment of kidney deficiency and blood stasis type primary osteoporosis. Methods Totally 50 patients with kidney deficiency and blood stasis type primary osteoporosis were collected. They were given Bushen Huoxue Prescription granules twice a day, taking with water, for 12 weeks. Before and after treatment, the femoral neck, Ward's area, L1–4 bone mineral density (BMD) were measured. VAS and TCM syndrome integrals were evaluated before and 4, 8 and 12 week of treatment. The level of serum osteocalcin (OC), β-C-terminal telopeptides of type I collagen (β-CTX) and osteoprotegerin (OPG) were detected before and after treatment. Hematuria routine, liver and kidney function were under safety testing before and after treatment. Results Bushen Huoxue Prescription could significantly increase BMD of left femoral neck and Ward's triangle (P=0.001, P=0.044). L1–4 BMD increased, without statistical significance (P=0.172). The total effective rate was 60.870% (28/46) for L1–4 and left femoral neck and 58.696% (27/46) for Ward's triangle. The VAS and TCM syndrome integral decreased significantly 4 weeks treatment compared with that before the treatment (P<0.01), and the scores decreased significantly with the prolongation of treatment time (F=159.690, P<0.001; F=163.970, P<0.001). After 12 weeks, treatment, the total effective rate for TCM syndromes was 78.26% (36/46). Serum levels of OC and β-CTX showed a tendency to increase, while serum levels of OPG showed a tendency to decrease, without statistical significance (P=0.087, P=0.091, P=0.419). There was no serious adverse reaction in hematuria routine and liver and kidney function. Conclusion Bushen Huoxue Prescription has obvious clinical efficacy for kidney deficiency and blood stasis type primary osteoporosis, which can improve the patients' BMD, improve bone metabolism, relive bone pain, with high level of safety.

Objective To investigate diagnostic approaches of cervical glandular intraepithelial neoplasia (CGIN) for improving the diagnostic levels of CGIN.Methods Clinical data of 106 cases with CGIN admitted in hospital from Jan.2008 to Dec.2010 were analyzed retrospectively.All data from preoperative thin-prep cytologic test (TCT),cervical biopsies and postoperative pathological examination of the excised cervical tissues were reviewed.Results Among 106 patients,62 cases (58.5％,62/106) were low grade CGIN (L-CGIN),44 cases (41.5％,44/106) were high grade CGIN (H-CGIN) ; 25 cases (23.6％,25/106) were pure CGIN and 81 cases (76.4％,81/106) were CGIN mixed with cervical intraepithelial neoplasia (CIN).Fifteen cases (14.2％,15/106) were found atypical glandular cell (AGC)by TCT..In the 15 cases,there were 4 cases (6.5％,4/62) L-CGIN,and 11 cases (25.0％,11/44)H-CGIN,there was significant difference between the two groups (P ＜ 0.05) ; among 15 cases with AGC,11 cases of them (44.0％,11/25) were pure CGIN,4 cases (4.9％,4/81) mixed with CIN,in which there were significant difference (P ＜0.01).Seven cases (25.0％,7/28) were detected glandular lesions in 28 cases by endocervical curettage (ECC).Totally 23 cases (22.8％,23/101) were detected CGIN by colposcopy-directed biopsy,11 cases (19.0％,11/58) were with L-CGIN,12 cases (27.9％,12/43)H-CGIN,there was no significant difference between them (P ＞ 0.05).Among the 23 cases,13 eases(52.0％,13/25) were pure CGIN,10 cases (12.3％,10/81) CGIN mixed with CIN,which showed significant difference (P ＜ 0.01).All 106 patients were treated,101 cases treated with cervical conization and 5 cases performed hysterectomy; 23 cases were diagnosed CGIN preoperation,the ratio of preoperative diagnosis was 21.7％ (23/106),83 cases (80.3％,83/106) diagnosed postoperatively.Conclusions Routine diagnostic methods of CGIN were not satisfaction,most CGIN were diagnosed after cervical resection.Cervical conization may play a very important role in diagnosis of CGIN.The positivity of TCT in H-CGIN was higher than L-CGIN.There was no different in diagnosing different CGIN grades by colposcopy-directed biopsy.The ratio of preoperative diagnosis of pure CGIN was higher than those with CGIN mixed with CIN.

OBJECTIVE:To assess the feasibility of production and effects of Tobramycin eye drops prepared in this hospital for treating ocular infections .METHODS: 77 patients with external ocular infections were randomly divided into two groups with imported Tobrex as control drug to compare the effects.Assessment was made according to Gwon project results.RESULTS: Overall improvement rates were 92.7% in Tobramycin eye drops group and 94.4% in control group without significant difference between two groups(P＞ 0.05) .CONCLUSION: The technology of Tobramycin eye drops production is simple, therapeutic effect is satisfactory, and the production in hospital is feasible.

Objective:To understand the level of iodine nutrition in the areas with iodine deficiency and high iodine in Anyang City of Henan Province, and to provide a basis for taking targeted prevention and treatment measures and scientific adjustment of intervention strategies.Methods:In 2019, three areas with iodine deficiency (median iodine in water < 10 μg/L) and three areas with high water iodine (median iodine in water > 100 μg/L) were selected from counties (cities and districts) in Anyang City by stratified random sampling. Children aged 8-10 and pregnant women were selected in areas with high iodine and areas with iodine deficiency, respectively. Urine samples and salt samples were collected and tested, and children's thyroids were examined by B-mode ultrasound.Results:A total of 654 salt samples were collected in iodine deficiency areas, among which non-iodized salt accounted for 1.83% (12/654). A total of 628 salt samples were collected from areas with high iodine, among which non-iodized salt accounted for 6.05% (38/628). The difference in non-iodized salt rate between the two areas was statistically significant (χ 2=15.19, P < 0.05). A total of 654 urine samples were collected from children in iodine deficiency areas, with a median of 211.15 μg/L of urinary iodine, and 628 urine samples were collected from high iodine areas, with a median of 390.50 μg/L of urinary iodine. The difference was statistically significant ( U=- 18.34, P < 0.05). A total of 300 urine samples were collected from pregnant women in iodine deficiency areas, with a median of 223.95 μg/L, and 127 urine samples were collected from pregnant women in high iodine areas, with a median of 258.00 μg/L. The difference was statistically significant ( U=- 4.07, P < 0.05). The thyroid volume of 560 children in the iodine deficient areas was detected, and the swelling rate was 1.43% (8/560). The thyroid volume of 628 children in high iodine areas was detected, and the swelling rate was 2.07% (13/628). Conclusion:The iodine nutrition level of the population in the iodine deficiency areas of Anyang City is appropriate, while the iodine nutrition level of the population in the water source high iodine areas is excessive.

Objective To investigate the effects of berberine on tumor-associated macrophages (TAM)and the expression of cyclooxygenase-2 (COX-2)of intestinal polyps in Apc(Min/+) mice.Methods A total of 20 Apc(Min/+) mice,four weeks old,were equally divided into the control group and the berberine group,10 in each group.The mice of the control group drank plain water,while the mice of berberine group drank water with 0.1 % berberine.After 12 weeks,all the mice were sacrificed.The intestine and colon were isolated,and the numbers of polyps were counted.The expression of F4/80,inducible nitric oxide synthase-2 (iNOS),macrophage mannose receptor (MR)and COX-2 was detected by immunohisto-chemistry method.The relative expression of COX-2 at protein level was measured by Western blotting. The t test was performed for comparison between two independent groups.Results The total number of intestinal polyps,the number of small intestinal polyps and the number of colon polyps of the berberine group (11 .50±2.05 ,10.50±1 .77 and 1 .00±0.46,respectively)were all less than those of the control group (30.63±1 .69,28.00±2.00 and 2.63±0.74,respectively),and the differences were statistically significant (t=16.727,16.952 and 3.162,P =0.001 ,0.001 and 0.010,respectively).The percentage of F4/80 positive cells in the stroma of polyps of the berberine group ((17.40 ±4.23 )%)was less than that of the control group ((31 .24±6.34)%),and the difference was statistically significant (t =5 .327, P =0.043).The percentage of iNOS positive cells in the stroma of polyps of the berberine group ((7.43± 1 .78 )%) was higher than that of the control group ((2.72±0.68)%), and the difference was statistically significant (t=7.335 ,P =0.004).The percentage of MR positive cells in stroma of polyps of the berberine group ((19.52±1 .54)%)was less than that of the control group ((12.63±0.68)%),and the difference was statistically significant (t=5 .634,P =0.016).The percentage of COX-2 positive cells in stroma of polyps of berberine group ((3.38 ± 0.51 )%)was less than that of the control group ((7.60±0.57 )%),and the difference was statistically significant (t = 7.234,P = 0.001 ).The relative expression of COX-2 at protein level of polyps of the berberine group was lower than that of the control group. Conclusion Berberine may take the role in inhibiting the growth of intestinal polyps in Apc(Min/+) mice through interfering the differentiation of TAM in polyps and suppression the expression of COX-2.

Objective:To investigate the influence of P27RF-Rho mRNA gene silencing in the drug sensitivity of 5-fluorouracil(5-Fu)to the liver cancer SMMC cell line,and to provide theoretical basis for the treatment of advanced liver cancer.Methods:The P27RF-Rho RNAi vector was constructed and the P27RF-Rho gene silencing lentivirus were used to infect the SMMC7721 cells.Western blotting method was used to detect the gene silencing effect.The SMMC7721 cells were divided into Scramble-siRNA group, 5-Fu group, P27RF-Rho siRNA group and P27RF-Rho siRNA + 5-Fu group.Western blotting was used to detect the transfection efficiency of RNAi.MTT method was used to detect the cell growth in various groups.Scratching test was used to detect the migration ability of cells in various groups.Transwell experiment were used to detect the invasion ability of cells in various groups.The expressions of P27 and RhoC protein were detected by Western blotting method.Results:P27RF-Rho RNAi lentiviral vector was successfully constructed.The Western blotting results showed that the expression of P27RF-Rho protein in P27RF-Rho siRNA group was decreased compared with 5-Fu group and Scramble-siRNA group(P<0.05).Compared with other three groups, the growth speed of the cells in P27RF-Rho siRNA + 5-Fu group was significantly decreased(P<0.05).The migration ability of the cells in P27RF-Rho siRNA + 5-Fu group was significantly lower than those in other three groups (P<0.01);the average number of cells passing through the Transwell microporous membrane was significantly less than those in other three groups (P<0.01).The Western blotting analysis results showed that the expression level of P27 protein in the cells in P27RF-Rho siRNA + 5-Fu group was significantly higher than those in other three groups(P<0.05);the expression level of RhoC protein was significantly lower than those in other three groups(P<0.05).Conclusion:P27RF-Rho gene silencing can significantly enhance the drug sensitivity of 5-Fu to SMMC7721 cells.

BACKGROUND: It has been reported that human adipose-derived mesenchymal stem cells can be induced to differentiate into hepatocyte-like cells with the function of albumin synthesis and urea secretion in vitro.OBJECTIVE: To investigate the potential of adipose-derived mesenchymal stem cells differentiating into hepatocyte-like cells in vitro.METHODS: Adipose-derived mesenchymal stem cells were isolated from the subcutaneous fat of hepatitis B virus infection patients by collagenase digestion and adherent method. Adipose-derived mesenchymal stem cells were induced by three-phase induction method and observed morphologically. The expression levels of alpha-fetoprotein, albumin and cytokeratin 18 were detected by immunohistochemical staining and glycogen synthesis function was detected by glycogen staining method.RESULTS AND CONCLUSION: Most of adipose-derived mesenchymal stem cells induced by three-phase induction method were differentiated into hepatocyte-like cells with polygonal morphology. Immunohistochemistry staining results showed that hepatocyte-like cells expressed alpha-fetoprotein, albumin and cytokeratin 18, and the expression levels of albumin and cytokeratin 18 increased with the culture time. The induced cells had the function of glycogen synthesis and were positive for periodic acid Schiff staining. These results showed that the subcutaneous adipose-derived mesenchymal stem cells could be induced into functional hepatocyte-like cells in hepatitis B virus infection patients.