Angiocentric Glioma has been newly identified as an epilepsy associated tumory. Up to now, reported cases are still scarce. The tumor causes drug-resistant epilepsy. On histological findings, monomorphous bipolar tumor cells are arranged around vessels. Imaging studies show that the tumor is diffused or rimlike hyperintensity on T1-weighted SE sequences and a stalklike extension to the ventricle on T2-weighted sequences. The World Health Organization listed this new entity in its fourth edition of the WHO classification of tumors of the central nervous system published in 2007.

Angiocentric Glioma has been newly identified as an epilepsy associated tumory. Up to now,reported cases are still scarce. The tumor causes drug-resistant epilepsy. On histological findings,monomorphous bipolar tumor cells are arranged around vessels. Imaging studies show that the tumor is diffused or rimlike hyperintensity on T1-weighted SE sequences and a stalklike extension to the ventricle on T2-weighted sequences. The World Health Organization listed this new entity in its fourth edition of the WHO classification of tumors of the central nervous system published in 2007.

Objective To study genotypes,antibiotic resistance and epidemiology of extendedspectrum β-lactamases (ESBL)-producing Shigella isolated in Tianjin,and to discuss the relationship between ESBL-producing Shigella and drug-resistance plasmid.Methods A total of 136 Shigella spp.were isolated from stool specimens of patients with diarrhea who presented mainly with bloody purulent stool from Tianjin Children's Hospital,Tianjin Medical University No.2 Hospital and Tianjin No.1 Central Hospital between May 2009 and September 2010.Suspicious ESBL-producing isolates were screened by K-B disc diffusion method. The conjugation experiment was performed in the confirmed ESBL-producing strains and antibiotic resistance was compared between clinical strains and transconjugants to confirm the plasmid-mediated resistance. The genotypes of these isolates were detected by polymerase chain reaction (PCR) using universal primers for TEM,SHV,CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,respectively.Intergenic consensus PCR (ERIC-PCR) was employed to understand the molecular homology of the ESBL-producing isolates. The data were analyzed by x2 test.ResultsESBL were identified in 14.7％ (20/136) of Shigella isolates,but no AmpC enzyme were detected.Among all the Shigella isolates,16 strains were genotype CTX-M-14,4 were genotype CTX-M-15.The strains with CTX-M ESBL were resistant to multiple antibiotics,while 100％ sensitive to imipenem.The transconjugant test of 18 ESBL-producing isolates were positive,and these conjugations were only resistant to β-lactamases. Conclusions CTX-M type is the common genotype of ESBL-producing Shigella isolates in Tianjin. ESBL-producing is the main cause of multiple resistance to β-lactams.The transmission of CTX-M producing strains is mainly mediated by plasmids.

Objective To evaluate the reliability of a rat model of acute cerebral ischemia and reperfusion by using cerebral perfusion functional CT.Methods A stable and reversible focal ischemia model with unilateral middle cerebral artery occlusion was established and evaluated by CT perfusion imaging and TTC staining.Results Artificial Occlusion of the MCA resulted in ipsilateral cerebral infarcts in all study animals.Hypoperfusion was definitely recorded in all CT perfusion images obtained after MCA occlusion and was significantly correlated with the final lesion size.Blood flow was restored after pulling the thread out of the artery.Conclusions The method of establishing an acute focal cerebral ischemia and reperfusion model by thread insertion in our study is simple and stable.If we can screen the stroke model with CT perfusion examination,the error caused by variance of model can be reduced.Thereby it provides a platform for researchers to investigate acute cerebral ischemia and recirculation.

Objective: To investigate the status quo and associated factors of drinking water knowledge, attitude and behavior among primary school students in rural areas, so as to provide evidence for health behavioral intervention of drinking water in primary school. Methods: Twentythree primary schools in rural area from Hebei, Henan, Shandong and Shanxi provinces were selected by using purposive sampling method from March 1 to April 27 in 2023. Selfdesigned questionnaires regarding knowledge, attitude and behavior of drinking water were distributed to all students in grade 3-6, and 2 173 valid questionnaires were obtained. Multivariate Logistic regression was used to analyze the influencing factors of drinking water knowledge, attitude and behavior of primary school students. Results: The attainment rates of drinking water knowledge, attitude and behavior level were 20.02%, 26.65%, and 31.20%, respectively, among primary school students. The median of daily water intake was 1 000 mL, and the average daily water intake was (1 172.99±771.89)mL. In addition, 66.31% of students water intake reached the minimum standard of 800 mL recommended. The results of multiple Logistic regression indicated that drinking water accessibility in school, health education of drinking water, and individual selfcontrol ability were positively correlated with the knowledge (OR=1.31, 1.57, 1.58), attitude (OR=2.07, 1.65, 1.73), behavior (OR=1.40, 1.49, 1.91) of drinking water and daily water intake (OR=1.41, 1.38, 1.20) (P<0.05). Conclusions Primary school students in rural areas are generally lack of appropriate health awareness on drinking water including knowledge, attitude and behavior. Schools should take targeted measures to focus on the cultivation of students selfcontrol ability, so as to improve students knowledge and attitudes of drinking water, and furthermore help students shape their healthy behaviors of drinking water.

There are abundant and stable circular RNAs in tumor-derived exosomes, which play an important role in the occurrences and developments of tumors. Exosome-circRNAs can be used as the marker of tumors diagnosis and prognosis, and have different roles in regulating tumors immune responses, regulating tumors progressions and mediating tumors drug resistances in different tumors. Exploring and applying the potential value of exosome-circRNAs will provide a new choice for the diagnosis and treatment of tumors.

Objective:To investigate the effectiveness, safety, and advantages of modified radical neck dissection by gasless unilateral axillary approach (GUA-MRND) in the surgical management of selected patients with papillary thyroid cancer.Methods:We retrospectively analyzed patients with papillary thyroid cancer who underwent GUA-MRND (endoscopic group, n=16) versus unilateral open modified radical neck dissection (MRND) (open group, n=32) during the period from Jan. 2019 to Jun. 2021, including the differences in surgical efficiency, complication rate, and incisional satisfaction.Results:Compared MRND with GUA-MRND, the patients were younger ( P<0.05) , operative time and postoperative drainage anterior ( P<0.01) were slightly inferior in the latter, but it had obvious advantages in cervical swallowing discomfort and incision satisfaction evaluation ( P<0.05) . There was no significant difference in the incidence of temporary recurrent laryngeal nerve injury, intraoperative and postoperative bleeding, hematoma, infection, lymphatic or chylous leakage and supraclavicular numbness after surgery ( P>0.05) . The number of dissected lymph nodes in area II in the GUA-MRND was lower ( P<0.05) , but it was significantly higher ( P<0.01) in area III. And the average regional cleaning efficiency in the GUA-MRND was level Ⅲ (35.5%) , level Ⅵ (28.59%) , level Ⅳ (23.21%) , level Ⅱ (7.18%) and level Ⅴ (7.12%) , suggested that GUA-MRND had higher efficacy for level III, level Ⅵ and Level IV. Conclusion:GUA-MRND is safe, effective, and has high cosmetic satisfaction in the treatment of selected patients with lateral cervical lymph node metastases from papillary thyroid cancer.

Objective:To summarize the prognosis of medullary thyroid carcinoma (MTC) patients with biochemical recurrence (the increase of postoperative calcitonin and no abnormal imaging) and to investigate the optimal cut-off value of calcitonin for postoperative structural recurrence (with imaging abnormality).Methods:Literature retrieval was conducted for PubMed, CNKI, EMbase, Web of Science, Cochrane and other databases, and literatures related to the increase of calcitonin after MTC surgery were included. Review Manager 5.4 software was used for Meta-analysis of the recurrence and death. SPSS 23.0 software was used and receiving operating characteristic (ROC) curve was used to analyze the rising folds of postoperative calcitonin level in comparison with the maximum value of experiment detection, and to predict the outcome of biochemical recurrence transforming to structural recurrence, and then the optimal cut-off value could be worked out.Results:A total of 7 studies including 1 005 MTC patients (276 cases of biochemical recurrence and 542 cases of biochemical cure). Meta-analysis showed that structural recurrence rate in postoperative biochemical recurrence group [40.6% (112/276) vs. 2.2% (12/542); OR = 27.99, 95% CI 14.57-53.78, P < 0.001] and mortality [10.0% (19/190) vs. 0.96% (3/312); OR = 7.26, 95% CI 2.42-21.84, P < 0.001] were higher than those in the biochemical cure group (normal postoperative calcitonin level and no disease state). The data of 89 MTC patients with biochemical recurrence were collected in another 4 studies. ROC curve analysis showed that area under the curve of the rising folds of postoperative calcitonin level in predicting structural recurrence was 0.825; according to the cut-off value at all sections, the optimal cut-off value of the increased postoperative calcitonin was 50 times, the sensitivity was 66. 7%, the specificity was 88.6%. Conclusions:MTC patients with postoperative biochemical recurrence have higher structural recurrence rate and mortality compared with patients with normal postoperative calcitonin. The postoperative elevation of calcitonin more than 50 times the maximum value of the laboratory detection can be taken as the critical diagnostic value, when more than 50 times is prone to structural recurrence.

OBJECTIVE： To provide a theoretical basis for the development of the following products of Coptis chinensis- Zingiber ojjicinale couplet medicine （“Coptis chinensis-Zingiber ojjicinale” for short） prescription. METHODS： The prescriptions containing Coptis chinensis-Zingiber ojjicinale were collected from the Dictionary of TCM Prescription and input into TCM inheritance support platform software （V2.5） to establish the database. The frequency of major diseases and compatibility medicinal materials were analyzed statistically. The core combination of medicinal materials in the prescriptions containing Coptis chinensis-Zingiber ojjicinale were analyzed statistically with association rule Apriori algorithm （support degrees were 15％， 20％， 25％， confidence was 0.90）. Top 2 main diseases in the list of frequency， compatibility medicinal materials for dispelling internal cold and medicine for clearing heat with highest compatibility frequency were selected and analyzed in respect of prescription rules. RESULTS： A total of 492 prescriptions containing Coptis chinensis-Zingiber ojjicinale were screened， 9 kinds of major diseases （frequency≥15）， such as dysentery， diarrhea， accumulation， fullness. There were 21 commonly used compatibility medicinal materials （frequency≥55）， including Angelica sinensis-Panax ginseng， Magnolia officinalis， Aconitum carmichaelii， Scutellaria baicalensis， etc. There were 19 commonly used medicinal materials combinations， including Coptis chinensis-Zingiber ojjicinale-Panax ginseng， Coptis chinensis-Zingiber ojjicinale- Magnolia officinalis， Coptis chinensis-Zingiber ojjicinale-Angelica sinensis. There are 5 kinds of core medicinal materials commonly used in treating dysentery with Coptis chinensis-Zingiber ojjicinale，and 9 kinds of core medicinal materials for treating dysentery. There are 8 kinds of core medicinal materials in Coptis chinensis-Zingiber ojjicinale compatible with medicine for dispelling internal cold Aconitum carmichaelii prescription.and 7 core medicinal materials in compatible with medicine for clearing heat Scutellaria baicalensis prescription. CONCLUSIONS： The major diseases treated with prescriptions containing Coptis chinensis-Zingiber ojjicinale are mainly digestive tract diseases. It can treat different diseases being compatible with different medicinal materials， this study aslo can provide theoretical basis for the development of subsequent products.

Metformin has been used for the treatment of type II diabetes mellitus for decades due to its safety, low cost, and outstanding hypoglycemic effect clinically. The mechanisms underlying these benefits are complex and still not fully understood. Inhibition of mitochondrial respiratory-chain complex I is the most described downstream mechanism of metformin, leading to reduced ATP production and activation of AMP-activated protein kinase (AMPK). Meanwhile, many novel targets of metformin have been gradually discovered. In recent years, multiple pre-clinical and clinical studies are committed to extend the indications of metformin in addition to diabetes. Herein, we summarized the benefits of metformin in four types of diseases, including metabolic associated diseases, cancer, aging and age-related diseases, neurological disorders. We comprehensively discussed the pharmacokinetic properties and the mechanisms of action, treatment strategies, the clinical application, the potential risk of metformin in various diseases. This review provides a brief summary of the benefits and concerns of metformin, aiming to interest scientists to consider and explore the common and specific mechanisms and guiding for the further research. Although there have been countless studies of metformin, longitudinal research in each field is still much warranted.
Humans ; Metformin/pharmacokinetics* ; Diabetes Mellitus, Type 2/metabolism* ; Hypoglycemic Agents/pharmacology* ; AMP-Activated Protein Kinases/metabolism* ; Aging