This study was aimed to investigate the theoretical basis of Jian-Shen Li-Shui (JSLS) formula. Knowledge
of acute phase of cerebral hemorrhage in ancient Chinese medicine literature, modern pathophysiology theories, experimental researches and clinical results were studied, in order to discuss theoretical basis of JSLS formula. The results showed that JSLS formula embodied basic theories of traditional Chinese medicine (TCM) and experiences of physicians from different generations. It also reflected modern pharmacology research results. It was supported by animal experiments and clinical research results. It was concluded that JSLS formula was in accordance with essence of TCM syndrome differentiation. There were enough evidences for the formation of the formula. It was worthy of further study.

Objective To assess the potential of whole blood IFN-γassay for diagnosing mycobacterium in rhesus macaques.Methods Firstly, basic serum IFN-γconcentrations of TST-negative and -positive rhesus macaques were detected.Then, heparinized whole blood from TST-negative and-positive rhesus macaques was incubated with PBS and 200 IU bovine-PPD ( tuberculin purified protein derivative ) for about 24 h, respectively.The supernatant plasma were harvested and used to determine the concentrations of IFN-γ.The results of plasma IFN-γconcentrations and stimulation index ( SI) were used to analyze the diagnostic potential of the whole blood IFN-γassay.Results The basic serum concentrations of IFN-γfor the TST-positive monkeys were significantly higher than that of the TST-negative macaques, showing a high coefficient of variation.There was no significant effect on the production of IFN-γin the TST-negative macaques.While significantly elevation of IFN-γconcentrations was found in stimulated plasma of TST-positive macaques (P<0.01).The SI of TST-positive macaques was significantly higher than the TST-negative ones.ROC curve analysis revealed that IFN-γconcentrations and SI could be used as evaluation index of whole blood IFN-γassay.Conclusions Based on a small sample experiment we have demonstrated that whole blood IFN-γassay may be one possible auxiliary diagnostic method for tuberculin skin test.

Objective To explore the neuroprotection of Shuxuetongmai capsule pretreatment, and the effect on the expression of p38 mitogen-activated protein kinase (p38MAPK) in rats with middle cerebral artery occlusion. Methods Ninety-six male SD rats were divided randomly into sham-operated group,ischemia/reperfusion group (I/R),ischemia preconditioning group (IP),and Shuxuetongmai group(n=24). Each group was further randomly divided into 4 subgroups by 3 h, 6 h, 24 h and 72 h after reperfusion, 6 rats in each subgroup. Sham-operated group was only performed artery separation . The middle cerebral artery occlusion (MCAO) model was set up in I/R rats by Longa method. The IP rats were performed for three minutes on the bilateral carotid artery ligation, and formed MCAO model 24 hours later. The rats in the Shuxuetongmai group were pretreated with Shuxuetongmai capsules for 14 days on gavage before the establishment of MCAO model. The neurological deficits were graded in rats by Zea Longa method. Western Blot was used to determine the protein expression of p38MAPK and P-p38MAPK. Tunel method was applied to detect the apoptosis of neurons and the relationship between expression of p38MAPK, P-p38MAPK and apoptosis of neuron. Results No neurological dysfunction appeared in the sham-operated group at each time points, but not for the other groups, which reached the peak at 24 h. Compared with the I/R group, IP group and Shuxuetongmai group presented the mild neurologic function deficiency at different time points in rats (P<0. 05), and no significant differences occurred between ischemia preconditioning group and Shuxuetongmai group (P>0.05). The obvious variation of the value of P-p38MAPK/p38MAPK wasn't detected in sham-operated group at different time points, while obviously presented in I/R group, and the ratios of P-p38MAPK/p38MAPK were increased gradually followed with reperfusion, approaching to the highest level at 24 h. Compared with the I/R group, the P-p38MAPK/p38MAPK declined from 3 h and to the lowest level at 24 h of reperfusion, in both IP and Shuxuetongmai groups(P<0. 05), and with similar phosphorylation. At different time points,very few neurons apoptosis were detected in sham-operated groups, but which increased gradually after reperfusion in other groups, and reached to the peak at 24 h. The neurons apoptosis in both IP group and Shuxuetongmai group were less than that in IR group ( P<0. 05 ) at different time points, and it showed no significant differences on neurons apoptosis between ischemia/preconditioning group and Shuxuetongmai group in rats (P>0. 05). Conclusion Shuxuetongmai capsule pretreatment can induce brain ischemic tolerance, attenuate the apoptosis of neurons in cerebral ischemia reperfusion, and improve neurologic function. The mechanism may be related to the inhibition of p38MAPK phosphorylation.

Objective To explore the mechanism of Jianshen Lishui Decoction on nerve cell apoptosis in rats with cerebral hemorrhage.Methods The expression of miR-153 in cerebral hemorrhage was analyzed by miRNA microarray and RT-PCR,and the relationship between miR-153 and neuronal apoptosis in cerebral hemorrhage was observed,and predicted the target gene of miR-153;the binding of miR-153 to target genes was studied by dual-luciferase reporter gene Experiments,and to observe the effects of overexpression and inhibition of miR-153 on target genes.Subsequently,the relationship between target genes and neuronal apoptosis in cerebral hemorrhage was determined.Finally,the effect of Jianshen Lishui Decoction on miR-153 and the target gene,and finally explored the related mechanism of Jianshen Lishui Decoction on nerve cell apoptosis in rats with cerebral hemorrhage.Results Microarray chip and RT-PCR detection showed that miR-153 was lowly expressed in cerebral hemorrhage(P<0.05),and miR-153 was negatively correlated with neuronal apoptosis(R:-0.875,P=0.0002).The online databases TargetScan and miRDB showed that miR-153 has a binding region with TREM1,and the dual-luciferase reporter gene demonstrated a binding relationship between the two.When miR-153 was overexpressed,the expression of TREM1 was down-regulated,conversely,up-regulated when miR-153 was repressed,and TREM1 was positively correlated with nerve cell apoptosis(R:0.857,P<0.001).The expression of TREM1,the number of nerve cell apoptosis and the score of Neurological Deficit Scores in the Jianshen Lishui Decoction group were lower than those in the model group(P<0.05),and the expression of miR-153 was higher than that in the model group(P<0.05).The expression of TREM1,the number of nerve cell apoptosis and the score of Neurological Deficit Scores in the Jianshen Lishui Decoction +miR-153 inhibition group were higher than those in the Jianshen Lishui Decoction group(P<0.05).Conclusion Jianshen Lishui Decoction inhibits the apoptosis of nerve cells and protects the neurologicalfunctions in rats with cerebral hemorrhage by promoting miR-153 expression and inhibitingTREM1 expression.

Objective:To explore the survival status of rectal cancer patients with liver metastasis after receiving different treatments and its influencing factors.Methods:The clinicopathological characteristics, treatment methods and survival of 211 rectal cancer patients with liver metastasis who received different treatments in Shanxi Provincial Cancer Hospital from January 2012 to December 2016 were retrospectively analyzed. Cox proportional hazards regression model was used to analyze the related factors affecting the prognosis of patients.Results:The median overall survival (OS) time of 211 rectal cancer patients with liver metastasis was 19 months (1-115 months), and the 1-, 3- and 5-year OS rates were 66%, 22% and 10%. The OS of rectal cancer patients with metachronous liver metastasis was better than that of rectal cancer patients with simultaneous liver metastasis ( χ2 = 17.225, P < 0.01). The OS of patients with primary tumor resection was better than that of patients without primary tumor resection ( χ2 = 69.54, P < 0.01). Among patients with primary tumor resection, the OS of patients with untreated liver metastasis was worse than that of patients with interventional treatment of liver metastasis ( χ2 = 7.311, P = 0.007). Among the patients without primary tumor resection, the OS of patients with chemotherapy alone was better than that of untreated patients ( χ2 = 4.123, P = 0.042). The OS of patients with primary tumor resection and untreated liver metastasis and patients with primary tumor resection and liver metastasis intervention therapy was better than that of patients with chemotherapy alone (both P < 0.01). The results of Cox regression analysis showed that the differentiation degree of primary tumor, liver metastasis and carbohydrate antigen 199 level at diagnosis were independent factors influencing the survival of rectal cancer patients with liver metastasis (all P < 0.01). Conclusion:For patients with diagnosed rectal cancer, even if there is liver metastasis before surgery, active surgical resection of the primary tumor and local treatment of liver metastasis can still improve the survival.

Objective To investigate the changes of coagulatory function in septic rats induced by cecal ligation and puncture(CLP). Methods Cecal ligation and puncture(CLP)were performed to induce sepsis in SD rats. Coagulation indexes were detected at 8,16 and 48 h after operation, and histopathological changes of the lung, kidney, liver and spleen were examined using HE staining. Results The 12-day survival rate of the CLP-induced septic rats was 30%,with an acute onset and high mortality. In the acute phase of disease development of the CLP rats, the activated partial thromboplastin time(APTT)was prolonged(P<0.05)at 8 h,the prothrombin time(PT)was prolonged at 16 h (P<0.05), the factor XII activity in the endogenous coagulation pathway and the factor VII activity in the extrinsic coagulation pathway showed a transient inhibition, the thrombin time(TT)was prolonged at 48 h(P<0.01), and the content of fibrinogen(FIB)was increased gradually from 16 h(P<0.001). Among the other important coagulation and anticoagulation indexes,the number of platelets(PLT)was decreased gradually from 8 h(P<0.01),while the number of vWF:Ag increased gradually from 8 h(P<0.001). The D-dimer amount gradually increased from 16 h(P<0.05),and the amount of PS:Ag significantly decreased until 48 h(P<0.001). However, there was no significant change in the antithrombin-III(AT-Ⅲ)content. The histopathological examination showed that there are different degrees of damages in the lung,kidney,liver and spleen tissues,but no obvious venous thrombosis and bleeding were found. Conclusions In the acute phase,there is coagulatory dysfunction in the septic rats,however,no histopathological changes such as venous thrombosis and bleeding were observed in the lung,kidney,liver and spleen tissues due to coagulatory dysfunction.

【Objective】 To investigate the effects of one-stage additional posterior pedicle screws （PPS） internal fixation on early Cage subsidence after oblique lateral interbody fusion （OLIF）. 【Methods】 We made a retrospective analysis of 118 patients with lumbar degenerative diseases treated with OLIF at the Department of Orthopedics， Sir Run Run Shaw Hospital， School of Medicine， Zhejiang University， from January 2016 to December 2019. We divided the patients into OLIF stand-alone group （58 ones） and OLIF with PPS fixation group （60 ones） according to the surgical procedure. All the patients had preoperative frontal and lateral radiographs of the lumbar spine， and CT and MR scans were performed. The clinical outcomes and reoperation rates of the two groups were compared at immediate postoperative follow-up and at 1， 3， 6 and 12 months. X-ray and CT examinations were performed to assess Cage subsidence in both groups at each postoperative follow-up. 【Results】 There was no statistical difference between the two groups in baseline data and surgical segmentation. Of the 118 patients with 141 discs who underwent OLIF surgery， 58 patients with 68 discs received OLIF stand-alone surgery and 60 ones with 73 discs received OLIF with PPS fixation. There were no significant differences in intraoperative bleeding， complications， or postoperative clinical outcomes between the two groups （P>0.05）， and the Cage subsidence rate was 22.4% in OLIF stand-alone group and 5% in OLIF with PPS fixation group， with significant difference between the two groups （P<0.01）. 【Conclusion】 Both OLIF stand-alone and OLIF additional PPS fixation can achieve good early clinical outcomes， and first-stage additional PPS fixation can significantly reduce the occurrence of Cage subsidence in the early postoperative period after OLIF.