Objective To evaluate the causes and prognosis of severe trauma in the elderly.Methods The 168 patients in elderly group (aged 60 to 91 years), 517 in middle-aged group (aged 36to 59 years) and 405 in young group (aged 18 to 35 years) were evaluated using an abbreviated injury scale (AIS2005) and injury severity score (ISS). All patients with ISS ≥ 16 were selected during a seven-year period. The injury severity, injury site number, cause of injury, injury site, emergency operation, diseases before injury, secondary infection after injury, development of multiple organ dysfunction, number of patients with Intensive Care Unit (ICU) stay, length of stay in ICU and prognosis were compared among three groups. Results The main cause of injury was accident (64patients, 38.1%), followed by traffic accident (63 patients, 37.5%) in elderly group. The traffic accident was major cause of injury in middle-aged and young group (246 patients, 47.6%; 153patients, 37.8%, respectively), followed by fall from high places (128 patients, 24.8%; 102 patients, 25.2%, respectively). The main injury sites were head and chest in elderly, middle-aged and young group (155 patients, 92.3%; 411 patients, 79.5%; 321 patients, 79.3%, respectively).There were significant differences among three groups in injury site number, emergency operation,pre-injury diseases, secondary infection after injury, number of patients with ICU stay and length of stay in ICU (F=8. 299, P＜0.01; x2= 14.88, P=0.001; x2=254.6, P＜0.01; x2=10. 54, P=0. 005; x2 = 15.62, P＜0.01; F= 5.760, P= 0.005, respectively ). In spite of injury severity (F=2.950, P= 0.053), there were significant differences between elderly group and middle-aged or young group (t=2.325, P=0.021; t=2.128, P=0.034, respectively). The incidence of multiple organ dysfunction had no significant difference among the three groups (x2 = 1.142, P= 0.565). The cure rate and unhealed automatically discharged patients had significant differences (x2 = 13.77, P= 0. 001;x2 =6.025, P= 0.049, respectively). The mortalities were similar (x2 = 1.397, P= 0.497). The leading cause of death among three groups was a serious head injury. Conclusions For elderly patients, it is important to reduce accidental injuries and traffic accidents, to improve the cure rate,and to reduce the unhealed and mortality rate.

Objective: To develop an HPLC method for determining feruloyltyramine in Pothi chinensis herba. Methods: The HPLC determination was performed on a Thermo ODS-2 Hypersil column(250 mm × 4. 6 mm, 5 μm) with isocratic elution of metha-nol-0. 4% phosphoric (35:65) as the mobile phase. The flow rate was 1. 0 ml·min-1 . The column temperature was at 25℃, and the detection wavelength was set at 318 nm. Results: Feruloyltyramine showed good linearity,and the recovery was 99. 40% with RSD of 1. 44% (n =9). Conclusion: The method is quick, simple and reproducible, which can be used to control the quality of Pothi chinensis herba.

Objective To investigate genes and involved biological processes closely associated with stem cell markers of colorectal cancer-epithelial cell adhesion molecule (EpCAM) + and CD44+.Methods By the bioinformatics method,with microarray data of colorectal cancer from gene expression omnibus (GEO) database and R2 platform,the genes significantly related with CD44 and EpCAM expression were screened out.The differences in expression of related genes were analyzed on the basis of gender,family history of cancer,alcohol and Dukes stage.The expression of related genes in colorectal cancer was compared with that of other tumors and healthy subjects.At same time,the pathways of the genes and Kyoto encyclopedia of genes and genomes (KEGG) of CD44 and EpCAM significantly related genes were analyzed with gene ontology (GO) and KEGG method.Single factor analysis of variance and Chi-square test of four-fold table with correction for continuity were used for statistical analysis by R2 platform embedded statistical tools.Results The expressions of CD44 and EpCAM were detected in all 315 colorectal cancer samples.A total of 888 and 6 316 genes were screened out which were significantly associated with CD44 and EpCAM expression.CD44 was positively correlated with EpCAM.There was no obvious correlation between the expression of five genes which expressed in all 315 tissues and gender family history of cancer,alcohol and Dukes stage (all P＞0.05).By further compared with the expression in other tumors and tissues,the expressions of two genes solute carrier family 12,member 2 (SLC12A2) and proteome of centriole 1 centriolar protein B (POC1B) in colorectal tumor were significantly higher than that in other tumors (F=289.422、128.456,all P＜0.01),and its expression in colorectal cancer was obviously higher than that in tissues of health subjects (F=349.519、128.456,all P＜0.01).GO analysis indicated there were 15 GO semantics related with both CD44 and EpCAM.The genes related with CD44 and EpCAM were analyzed by KEGG access pathway method,while seven and 10 pathways were found to be statistically significant (all P＜0.01).Conclusions CD44 and FpCAM commonly expressed in colorectal cancer.The genes related with CD44 and EpCAM expression are involved in multiple tumor biological processes.

Background:Bioinformatics is an effective technology for microarray data mining and gene function prediction. Aims:To analyze the gene CRELD2 that associated with pathogenesis,disease activity and efficacy of biological agents in ulcerative colitis( UC)by bioinformatics to provide a theoretical basis for subsequent studies on its biological function and molecular mechanism in the development and progress of UC. Methods:The microarray data associated with pathogenesis, disease activity and efficacy of biological agents in UC were downloaded from the Gene Expression Omnibus( GEO database);the data mining and analyses were conducted by using bioinformatics tools such as BRB-ArrayTools, ProtParam,ELM,SignalP 4. 1,PBIL-IBCP Lyon Gerland,GO and STRING. Results:Cross-over analyses revealed that expressions of four genes(CDC25B,CRELD2,IL1RN,PITPNC1)were up-regulated in the order from colonic mucosa of healthy subjects,un-inflamed mucosa of active UC patients to inflamed mucosa of active UC patients,meanwhile these four genes were significantly down-regulated in infliximab responders after treatment when compared with that before treatment and infliximab non-responders. The function of CRELD2 gene was unknown. Bioinformatics analyses showed that CRELD2 gene was located on the long arm of chromosome 22(22q13. 33),and encoded a secreted protein composed of 402 amino acids. This protein contained several epidermal growth factor( EGF)-like domains,mainly distributed in Golgi apparatus, endoplasmic reticulum and extracellular site and had calcium- and protein-binding effect. Interactions existed between CRELD2 and CHRNA4,CHRNB2 and RHBDD3 proteins. Conclusions:Gene CRELD2 may have EGF-like biological function and via participating directly or indirectly the regulation of immunocytes to affect the pathogenesis and disease activity of UC. It might be used as a biomarker for diagnosis and assessment of disease activity and therapeutic efficacy of UC. Furthermore,it might be a potential target for treatment of UC.

This article aims to retrieve the articles which are related to the application and mechanism of Siguan points in treating the mental disease, such as depression, insomnia, apsychia, madness, dementia and stroke. We hope to find out a new model of its utility and wider range of applicability for maximum medical effect.

Objective:To explore the effect of personalized nutritional support based on nutritional risk screening on nutritional status and prognosis of patients with inflammatory bowel disease.Methods:A total of 100 patients with inflammatory bowel disease admitted to the Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University from January 2021 to September 2022 were selected as the study objects, and were divided into control group and observation group according to the random number method. NRS 2002 nutritional risk screening was performed on all patients. The control group was given routine nursing and nutritional support. On this basis, the observation group received patient-centered personalized nutrition support program shared by doctors and patients. The nutritional status, inflammatory indicators and prognosis of the two groups were compared and observed at admission, discharge, 1 month after discharge, and 3 months after discharge.Results:From admission to 3 months after discharge, albumin, prealbumin, nitrogen balance, triceps skinfold thickness in the two groups were significantly increased ( F = 8.43, 14.32, 10.27, 23.41, 7.66, 8.91, 6.84, 8.90, P < 0.05), while the malnutrition inflammation score was significantly decreased ( F = 4.84, 7.42, P < 0.05). Albumin, prealbumin, nitrogen balance, triceps skinfold thickness in the observation group were significantly higher than those in the control group at 3 months after discharge ( t = 7.95, 17.43, 6.55, 6.72, P < 0.001), and the malnutrition inflammation score was significantly lower than that of the control group ( t = 6.95, P < 0.001). As treatment progressed, the levels of C-reactive protein and fecal calprotectin gradually decreased and the erythrocyte sedimentation rate slowed down in both groups compared with the admission, with statistical significance ( F = 9.03, 11.28, 18.37, 19.20, 32.42, 28.88, P < 0.001). The levels of C-reactive protein and fecal calprotectin and erythrocyte sedimentation rate in the observation group were significantly lower than those in the control group 3 months after discharge ( t = 8.29, 7.99, 10.34, P < 0.001). Patients in the observation group had good compliance with the formulated diet plan, and no related rejection events occurred. The readmission rate of patients in the observation group was significantly lower than that of the control group ( χ2 = 10.18, P < 0.05). Conclusion:Individualized nutrition support programs based on nutritional risk screening can help improve the nutritional status and disease status of patients with inflammatory bowel disease.

OBJECTIVETo investigate the changes in the circulating levels of Treg cells in patients with rheumatoid arthritis (RA) and their associations with the disease activity.

METHODSThe fraction of circulating CD4+CD25+FOXP3+ Treg cells in 40 active RA patients and 40 healthy controls were determined by flow cytometry. The serum levels of interleukin-10 (IL-10) and transforming growth factor-β1 (TGF-β1) were measured using enzyme-linked immunosorbent assay, and the expression of Foxp3 mRNA was detected with real-time PCR. The correlation of the changes in the fraction of Treg cells and the disease activity of RA was analyzed.

RESULTSRA patients showed a significantly lower level of circulating Treg cells than the control subjects [(5.36∓1.55)% vs (7.49∓1.46)%, P<0.01]. The expression of Foxp3 mRNA (P<0.01) and serum IL-10 level (P=0.000) were significantly lower, whereas TGF-β1 significantly higher (P=0.000) in RA patients than in the controls. Spearman analysis showed that serum level of IL-10 but not TGF-β1 was correlated to the fraction of Treg cells and Foxp3 mRNA expression, but the fraction of Treg cells was not correlated to such indices of disease activity as tender joint counts, swollen joint counts, visual analog scale, HAQ, disease activity score in 28 joints, ESR, or CRP, nor to RA self-antibodies (including RF and anti-CCP antibodies).

CONCLUSIONA lower fraction and dysfunction of circulating Treg cells might be involved in the pathologies of RA, and a higher disease activity is associated with a greater reduction of Treg cells.

Adult ; Aged ; Arthritis, Rheumatoid ; blood ; pathology ; physiopathology ; Blood Sedimentation ; CD4 Lymphocyte Count ; Case-Control Studies ; Female ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Humans ; Interleukin-10 ; blood ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; cytology ; Transforming Growth Factor beta1 ; blood

Objective To investigate the association of serum fibroblast growth factor 21(FGF-21)with coronary heart disease(CHD)and biochemical indexes. Methods Serum FGF-21 expression was detected by ELISA.310 healthy control subjects and 310 CHD patients were recruited.Basic information was obtained by clini-cal questionnaires. Venous blood was tested for serum lipid,fasting glucose,and C-reactive protein(CRP). All the data were analyzed with the SPSS 19.0. Results There were no significant differences in gender and age be-tween CHD and controls(P > 0.05). FGF-21 level was significantly higher in CHD patients than in the controls (P<0.05).Univariate analysis showed serum FGF-21 was a risk factor of CHD.The group of higher score for FGF-21 had a 5.20-fold risk of CHD than the group of lower score without adjustment for confounding factors(95% CI:4.23~8.42).After control of the confounding factors,the group of higher score had a 7.21-fold risk of CHD(95% CI:3.78~13.67)than the group of lower score,it remains the significant difference(P<0.05).Conclusion Ele-vation of serum FGF-21 was closely associated with initiation and development of CHD.

Objective To investigate the value of contrast‐enhanced ultrasound ( CEUS ) in the differential diagnosis of pancreatic neoplasia ( SPN ) before operation . Methods Forty‐six cases of SPN confirmed by operation and histopathological results from January 2012 to June 2018 were enrolled in the study . According to the European Ultrasound Association ( EFSUMB) guidelines for CEUS in 2018 ,the enhancement pattern of pancreatic lesion with normal surrounding pancreatic parenchyma was used for reference . T he enhancement pattern of SPN were observed during the arterial phase ,venous phase and delayed phase . CEUS pattern of 16 cases with pancreatic ductal adenocarcinoma ( PDAC ) with cystic changes proved by histopathology were observed and compared with SPN . Results T he mean size of 46 cases of SPN was ( 32 .72 ± 25 .51) mm . Fifteen SPN lesions located in the head of pancreas ,31 cases located in the body and tail of the pancreas . Most of SPN were solidcystic lesions with thin separation on conventional B mode ultrasoud ,without communication with the main pancreatic duct . Color flow signals could be detected in 78 .3% ( 36/46) SPN lesions . After the injection of 2 .4 ml ultrasound contrast agent , the substantial part of all SPN showed hyperenhancement ( n＝ 44 ,99 .7% ) or isoenhancement ( n ＝ 2 , 4 .3% ) during the arterial phase ,venous phase and late phase . However ,93 .8% ( 15/16 ) of the PDAC lesion with cystic changes showed consistent hypo enhancement throughout the arterial ,venous and late phase ( P ＜0 .05) . T he accuracy of preoperative diagnosis of CEUS was 95 .6% . Conclusions Depending on its unique advantages such as real‐time observation ,high‐resolution imaging ,and no radiation ,CEUS is helpful for early detection ,accurate localization and preoperative diagnosis of SPN . CEUS has potential role for clinical decision‐making before treatment .

The protective efficacy of DNA plasmids encoding avian infectious bronchitis virus (IBV) S1, N, or M protein was investigated in chickens. Chickens were inoculated monovalently (with plasmid pVAX1-16S1, pVAX1-16M, or pVAX1-16N alone) or multivalently (combination of the three different plasmids, pVAX1-16S1/M/N). A prime-boost immunization protocol against IBV was developed. Chickens were immunized with the multivalent DNA vaccine twice and then boosted with an inactivated vaccine once. Antibody titers of the chickens immunized with pVAX1-16S1/M/N were much higher than those of the monovalent groups (p < 0.01). A protective rate up to 90% was observed in the pVAX1-16S1/M/N group. The serum antibody titers in the prime-boost birds were significantly higher than those of the multivalent DNA vaccine group (p < 0.01) but not significantly different compared to the inactivated vaccine group at 49 days of age. Additionally, the prime-boost group also showed the highest level of IBV-specific cellular proliferation compared to the monovalent groups (p < 0.01) but no significant difference was found compared to the multivalent DNA vaccine group, and the prime-boost group completely protected from followed viral challenge.
Aging ; Animals ; Antibodies, Viral/blood ; Cell Proliferation ; Chickens ; Coronavirus Infections/prevention & control/*veterinary/virology ; Immunization, Secondary/veterinary ; Infectious bronchitis virus/*immunology ; Poultry Diseases/*prevention & control/virology ; T-Lymphocyte Subsets/cytology/physiology ; Vaccines, DNA/immunology ; Vaccines, Inactivated/immunology ; Viral Vaccines/*immunology