Event related potential generated and developed in 1990's,which provides an objective and feasible approach to describe mental activities and evaluate cognitive function.It has become a study focus of mentalics,neurology,gerontology and psychology.Event related potential plays an important role in clinically evaluating and identifying various cognitive disorders.This paper summarized clinical application of event related potential P300.

Objective To observe the biological characteristics of db/db mice, and to provide the basis for application of db/db mice in experimental research.Methods Spontaneous type 2 diabetes BKS.Cg-Dock7m +/+ Leprdb/JNju mice and wild type mice of the same age were used in this study.Their fasting blood glucose was determined at 8,12,16, 20 and 24 weeks of age, the body weight was recorded at 10, 12,16, 20 and 24 weeks of age, the levels of serum insulin, total cholesterol and triglyceride were measured, the organ weight and liver coefficient were determined, and the liver and pancreas were taken for pathological examination at 24 weeks of age.Results The db/db mice maintained a high level of fasting blood glucose and body weight.Levels of serum insulin, total cholesterol, and triglyceride were significantly higher than the wild type mice.Compared with wild type mice, liver weight and kidney weight were also significantly increased.Obvious pathological changes of liver and pancreas were observed in 24-week old db/db mice.Conclusions db/db mouse has obvious characteristics of type 2 diabetes, such as hyperglycemia, hyperlipidemia, and hyperinsulinemia, can maintain stable levels of high blood glucose,and is an ideal animal model for experimental study of type 2 diabetes mellitus.

'Three-acupoint and Five-needle Method' is a summary of Prof. Shao Jing-ming's clinical experience in the treatment of asthma for years. It is used to alleviate asthma during seizure and to improve the pulmonary functions, strengthen the body constitution and prevent recurrence in the remission stage. This article introduces the theoretic source and basic principle, and concrete operating method, i.e. puncturing bilateral Feishu (BL 13), Dazhui (GV 14) and bilateral Fengmen (BL 12), and adding acupoints based upon pattern identification, in combination of moxibustion and cupping therapy for promoting the clinical application of this method.

Objective To observe the efficacy of Zheng’s “gold hook fishing acupuncture” in the treatment of scapulohumeral periarthritis. Methods Sixty patients were randomly divided into gold hook fishing group and reinforcing-reducing group, with 30 cases in each group. Gold hook fishing group chose the main points from the Tianzong (SI11), Bingfeng (SI12), Jiajixue (double EX-B2), Binao (LI14), Jianyu (LI15), Jianliao (SJ14), Jianzhen (SI9), Ashi, Naoshu (SI10), Quchi (LI11), Waiguan (SJ5), Hegu (LI4), Houxi (SI3), Tiaokou (ST38) and Chengshan (BL57). Needles were pierced at tendon junction points and Ashi points, and golden hook fishing acupuncture was operated. Other points were given reinforcing-reducing method. The reinforcing-reducing group was treated with reinforcing-reducing method at points the same as gold hook fishing group. Patients were treated once a day for 2 courses, 5 days as a treatment course. The pain visual analogue scale (VAS), shoulder range of motion (ROM), and ability of daily life (ADL) were observed before and after treatment to evaluate the clinical efficacy. Results The total effective rate of gold hook fishing group was 90.0% (27/30), better than the reinforcing-reducing group 83.3% (25/30, P<0.05); VAS pain score, ROM score and ADL score before and after treatment in the two groups were improved to some extent (P<0.05), and scores in the golden hook fishing group were improved more significantly compared with reinforcing-reducing group (P<0.05). Conclusion Zheng’s gold hook fishing acupuncture can effectively improve the clinical symptoms and signs of patients with scapulohumeral periarthritis and their life quality.

Microplastics(MPs)have attracted growing attention worldwide as an increasingly prevalent environmental pollutant.In addition,chicken meat is currently the most widely consumed kind of poultry in the global market.Consumer demand for chicken is on the rise both at home and abroad.As a result,the safety of chicken raising has also received significant attention.The lungs play an essential role in the physiological activities of chickens,and they are also the most vulnerable organs.Lung injury is difficult to repair after the accumulation of contaminants,and the mortality rate is high,which brings huge economic losses to farmers.The research on the toxicity of MPs has mainly focused on the marine ecosystem,while the mechanisms of toxicity and lung damage in chickens have been poorly studied.Thus,this study explored the effects of exposure to polystyrene microplastics(PS-MPs)at various concentrations for 42 d on chicken lungs.PS-MPs could cause lung pathologies and ultrastructural abnormalities,such as endoplasmic reticulum(ER)swelling,inflammatory cell infiltration,chromatin agglutination,and plasma membrane rupture.Simultaneously,PS-MPs increased the expression of genes related to the heat shock protein family(Hsp60,Hsp70,and Hsp90),ER stress signaling(activating transcription factor 6(ATF6),ATF4,protein kinase RNA-like ER kinase(PERK),and eukaryotic translation initiation factor 2 subunit α(eIF2α)),pyroptosis-related genes(NOD-,LRR-and pyrin domain-containing protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),interleukin-1β(IL-1β),cysteinyl aspartate-specific proteinase 1(Caspase1),and gasdermin-D(GSDMD)),and the inflammatory signaling pathway(nuclear factor-κB(NF-κB),inducible nitric oxide synthase(iNOS),and cyclooxygenase-2(COX-2)).The above results showed that PS-MP exposure could result in lung stress,ER stress,pyroptosis,and inflammation in broilers.Our findings provide new scientific clues for further research on the mechanisms of physical health and toxicology regarding MPs.

Objective To explore the effect of ankle pump on wound healing of diabetic foot ulcer (DFU). Methods Using convenience sampling method, patients hospitalized in Podiatry Department of Tianjin Medical University Metabolic Diseases Hospital from July to December 2015 and eligible for inclusion-exclusion criteria were recruited to control group, and patients who were hospitalized from May to October 2016 were recruited to observation group according inclusion-exclusion criteria. A total of 162 patients with DFU were recruited and 156 patients completed the whole study, with 72 cases in observation group and 84 cases in control group. Routine treatment and nursing care of DFU were given to both groups, and on the basis of that ankle pump motion therapy training was given to the observation group. After treatment for 9 weeks, the foot ulcer area, healing condition, transcutaneous arterial oxygen tension (TcPO2), foot skin temperature and ankle brachial index (ABI) were compared. In addition, the adverse events throughout the process of the two groups were recorded. Results After 9-week treatment, the healing rate of observation group was higher than the control group, and the difference wasn't statistically significant (χ2=3.714, P=0.054). The area of foot ulcer of both groups decreased, and the difference wasn't statistically significant before and after treatment (P<0.01). Ulcer surface area in the intervention group decreased more significantly after treatment than the control group(P<0.01). Wagner grading Ⅲ, Ⅳ patients' TcPO2, skin temperature of both groups,and wagner grading Ⅲ patients' ABI of oberservation group all increased than before treatment, with statistical difference (P> 0.05). There was no statistical difference of TcPO2, ABI and skin temperature between the two groups before treatment (P> 0.05). In observation group, Wagner grading Ⅱ patients' skin temperature and ABI, Wagner grading Ⅲ patients' TcPO2 and skin temperature, Wagner grading Ⅳ patients' TcPO2were all higher than those of the control group, with statistical difference (P<0.01). There were 4 cases of asymptomatic hypoglycemia in each group, and there was no statistical difference of adverse event in both groups. Conclusions The ankle pump motion has a positive effect on the wound healing of DFU, which has the advantage of high safety.

Objective:To explore the long-term effect of endoscopic radiofrequency ablation for the treatment of unresectable ampullary carcinoma.Methods:Clinical data of patients with ampullary carcinoma who received endoscopic radiofrequency ablation in the Third Affiliated Hospital of Naval Medical University from January 2012 to May 2019 were retrospectively collected, including basic information, frequency of radiofrequency ablation, the type of biliary stent, postoperative complications, and follow-up. Kaplan-Meier method was used to analyze the survival of patients after endoscopic radiofrequency ablation. Relationship between frequency of radiofrequency ablation, type of biliary stent and overall survival time was analyzed.Results:A total of 50 patients were enrolled, including 31 males and 19 females, aged 73.0±9.7 years. Twenty-five patients (50.0%) underwent 1 radiofrequency ablation treatment, while 25 patients (50.0%) underwent radiofrequency ablation treatments more than twice. Postoperative complications occurred in 6 patients (12.0%), all of which were mild symptoms. The average follow-up was 22.3 months, with a total of 39 (78.0%) deaths, 5 (10.0%) lost to follow-up, and 6 (12.0%) surviving. The median overall survival time was 16.9 (95% CI: 9.1-24.8) months, with cumulative survival rates of 62.0%, 38.5%, 27.0%, and 12.6% at 1, 2, 3, and 5 years, respectively. The median overall survival time of those treated with radiofrequency ablation ≥2 times showed a trend of prolongation compared to patients treated once, but the difference was not statistically significant [26.7 (95% CI: 9.7-43.7) months VS 12.6 (95% CI: 4.9-20.3) months, χ2=3.049, P=0.081]. Plastic stents were used in 32 patients (64.0%) and metal stents in 18 patients (36.0%). There was no significant difference in median overall survival time between patients using metal and plastic stents [17.1 (95% CI: 6.1-28.0) months VS 15.9 (95% CI: 6.9-24.9) months， χ2=0.029， P=0.865]. Conclusion:Endoscopic radiofrequency ablation is a safe treatment for unresectable ampullary carcinoma, and multiple consecutive treatments may increase the survival benefit.

Objective:To evaluate endoscopic ultrasonography (EUS) in the diagnosis and preoperative assessment of hilar cholangiocarcinoma.Methods:Data of consecutive patients with hilar biliary strictures who underwent EUS and were confirmed by postoperative pathology from April 2016 to December 2019 were collected in the retrospective study. The clinical information, EUS image characteristics and lymph nodes of patients were recorded and analyzed.Results:A total of 58 patients were finally included in our study. Hilar cholangiocarcinoma of EUS image was characterized by heterogeneous hypoechoic, non-rich blood supply masses and (or) asymmetric thickening of bile duct wall. Among the 58 cases, 45 cases (77.6%) were manifested as masses and 32 cases (55.2%) were presented as thickening of bile duct wall. Nineteen cases (32.8%) had both manifestations above. There were 10 cases of vascular invasion detected by EUS scanning, including 3 cases of portal vein invasion, 4 cases of hepatic artery invasion, 3 cases of invasion of both loci. Postoperative pathology confirmed 14 cases of vascular invasion, with the diagnostic coincidence rate of 71.4% (10/14). A total of 101 lymph nodes were found in 53 patients by EUS scanning. The malignant lymph nodes presented hypoechoic, round or oval shape, and homogeneous echo. Compared with benign lymph nodes, malignant lymph nodes had higher morphological score (11.41±0.6 VS 9.01 ± 0.15, P<0.001), but there was no significant difference in size (13.29±0.90 mm VS 11.87±0.56 mm, P=0.28). According to the malignancy criteria of EUS lymph nodes (morphological score≥12), the accuracy, the sensitivity, the specificity, the positive predictive value and the negative predictive value of EUS for malignant lymph nodes were 92.1%(93/101), 76.5% (13/17), 95.2% (80/84), 76.5% (13/17) and 95.2% (80/84) , respectively. Conclusion:EUS can show the whole extrahepatic bile duct and part of intrahepatic bile duct, which is helpful to determine the location of tumor in the diagnosis of hilar cholangiocarcinoma. Moreover, EUS is helpful to diagnose hilar cholangiocarcinoma, which is of guiding significance in operative decisions.

Objective:To evaluate the feasibility, efficacy, and safety of ultra-fine metal stents for malignant hilar biliary strictures (MHBS).Methods:Ultra-fine metal stents were simultaneously placed into the intrahepatic duct of 30 patients with unresectable malignant hilar biliary strictures of Bismuth type Ⅱ or higher (based on imaging or histological and/or cytological findings) by using the stent-by-stent mode from January 2014 to June 2021 at the Department of Gastroenterology, Eastern Hepatobiliary Surgical Hospital. The technical success rate, clinical efficacy and incidence of complications were observed.Results:The technical success rate was 100.0% (30/30), and the clinical success was achieved in 28 patients (93.3%) . The mean procedure time was 55.7±20.7 min and the placement time was 28.3±18.2 min. Early adverse events included mild acute pancreatitis ( n=2) and cholangitis ( n=5). The median stent patency and the median overall survival were 243 days (95% CI: 186.6-299.4 days) and 237 days (95% CI: 149.0- 325.0 days), respectively. The incidence of late cholangitis was 36.7% (11/30). Stent malfunction occurred in 14 of the 30 patients, and 5 of them received endoscopic reintervention. The technical success rate for the reintervention was 4/5 with the mean procedure time of 49.8±6.9 min. Conclusion:Malignant hilar biliary obstruction endoscopic palliation with ultra-fine metal stents using the stent-by-stent mode is safe, feasible and effective.

Objective:To explore the efficacy of the combination of radiofrequency ablation(RFA) and endoscopic metal stent in the treatment of patients with unresectable cholangiocarcinoma.Methods:From January 3, 2012 to June 30, 2019, at the Department of Endoscopic of the Third Affiliated Hospital of Naval Medical University, the clinical data of 44 patients with unresectable cholangiocarcinoma who were treated by the combination of RFA and endoscopic metal stent were retrospectively collected, which included age, gender, location of cholangiocarcinoma(hilar cholangiocarcinoma and distal cholangiocarcinoma), etc. Postoperative evaluation was conducted based on the follow-up, including clinical success rate, postoperative complication rate, time of stent patency and overall survival time (OS). The Kaplan-Meier method and log-rank test were used to analyze the difference of OS between patients with hilar cholangiocarcinoma and distal cholangiocarcinoma. Mann-Whitney U test was used for statistical analysis. Results:The age of the 44 patients with cholangiocarcinoma was (70.3±11.6) years old, with 20 males (45.5%). There were 22 patients (50.0%) with hilar cholangiocarcinoma and 22 patients (50.0%) with distal cholangiocarcinoma. The clinical success rate of 44 patients was 93.2%(41/44). A total of 5 patients(11.4%) had postoperative complications, which were all improved by appropriate treatment. The median time of follow-up of the 44 patient was 9.2 months(ranged from 3.1 to 57.6 months), the median time of stent patency was 7.0 months (ranged from 5.8 to 8.2 months). Thirty-two patients (72.7%) died during the follow-up, and the median OS was 10.9 months(ranged from 9.0 to 12.8 months). The median OS of patients with hilar cholangiocarcinoma was 7.8 months(ranged from 4.6 to 11.0 months) and that of patients with distal cholangiocarcinoma was 12.5 months(ranged from 5.7 to 19.4 months), and there was no statistically significant difference( P>0.05). Conclusion:RFA combined with endoscopic metal stent is safe and effective in the treatment of patients with unresectable cholangiocarcinoma.