Objective The study was to explore the safety, firmness and convenience of the fascia around the ischial spine as a new fixation site for the vaginal fornix. Methods Between June 2007 and January 2008, detailed dissections and related measurements of the regions around the ischial spine were performed on 10 Chinese female cadavers (3 unembalmed and 7 embalmed cadavers). At the same time, the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were exposed and the pull-out strength sequentially tested using a digital push-pull force gauge. Results The fascia on the ischial spine was firm and strong, with a thickness of 3 about mm. No major vessels or nerves were observed on the ischial spine. The greatest pullout strengths of the sacrospinous ligament,the fascia on the ischial spine, the iliococcygeus fascia as well as the vaginal fornix were (102±26),(64±15),(33±8)and(32±6)N, respectively. Conclusion The fascia at 1 cm from anterior lateral ischial spine, free of major vessels and nerves, is safe and strong and could be used as a new site for suspension in vaginal prolapse.

Objective To investigate the feasibility of low-c oncentration iso_osmolar contrast agent together with low tube voltage and iterative reconstruction algorithm in rabbit liver computed tonography (CT) perfusion imaging.Methods A total of 15 bealthy New Zealand rabbits were scanned twice of liver CT perfusion scans each with 24 hours interval.The first scan (routine group) was acquired at 100 kV and 100 mAs with ultravist (370 mg/ml),while the second (double low group) was acquired at 80 kV and 100 mAs with iodixanol (270 mg/ml) at 24 hours after the first scan.The obtained images were reconstructed with filtered back projection (FBP) and adaptive iterative dose reduction (AIDR-3D)algorithms in the controlled and experimental groups,respectively.The perfusion parameters including hepatic artery perfusion(HAP),portal vein perfasion(PVP),hepatic perfusion index(HPI),and total liver perfusion(TLP) and image quality as image quality score,average CT value of abdomen aorta,signalto-noise ratio(SNR),carrier-to-noise ratio(CNR),and figure of merit(FOM) were compared used pair ttest or Mann-Whitney U-test between the two groups wherever appropriate.The effective radiation dose and iodine intake were also recorded and compared.Results The image quality and perfusion parameters had no significantly different between the two groups except for FOM.The effective radiation dose and iodine intake were 38.79％ and 27.03％ lower in the double low group.Conclusions Low concentration iso _osmolar contrast agent (iodixanol,270 mg/ml) together with low tube voltage (80 kV) helps to reduce radiation dose and iodine intake without compromising perfusion parameters and image quality in liver CT perfusion imaging.

Objective To compare the efficiency of National Early Warning Score (NEWS),Chronic Respiratory Early Warning Score(CREWS) and BAP-65(elevated Blood urea nitrogen,Altered mental status,Pulse＞109bpm,age＞65 years)among patients with AECOPD (acute exacerbations of chronic obstructive pulmonary disease).Methods Totally 181 patients with AECOPD were investigated by these three scales,and the efficiency of NEWS,CREWS and BAP-65 was compared.Results The scores of NEWS,CREWS and BAP-65 in the death group were higher than those in the survival group and the general ward group(P＜0.01).Regarding the predicted results of hospital death,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.878,0.836 and 0.774,respectively,and the differences were not statistically significant(P＞0.05);for predicted results of ICU admission,the area under the ROC curve of NEWS,CREWS and BAP-65 was 0.826,0.813 and 0.716,respectively,and the differences were not statistically significant (P＞0.05).Conclusion NEWS,CREWS and BAP-65 have satisfied predictive efficiency for prognosis,and NEWS and CREWS are much easier and faster to use.

Objective:To investigate the effect of salvianolic acid on depressive behavior in depression model rats induced by chronic mild stress (CMS) and its mechanism.Methods:Fifty healthy male clean grade Sprague-Dawley(SD) rats were divided into five groups according to a random number table with 10 in each group: control group (nCMS+ Nal group), CMS+ normal saline group (CMS+ Nal group), CMS+ fluoxetine group (CMS+ Flu group), CMS+ salvia acid group (CMS+ Sal group), CMS+ fluoxetine+ Salvia acid group (CMS+ Flu+ Sal group). Except the control group, the rats in the other four groups were all received CMS modeling for 21 days. Twenty-one days after CMS modeling, rats were intraperitoneally injected with 0.9% normal saline (10 mg·kg -1·d -1), fluoxetine (20 mg·kg -1·d -1), salvia acid(40 mg·kg -1·d -1), fluoxetine(20 mg·kg -1·d -1)+ salvia acid(40 mg·kg -1·d -1)for 21 days. During the administration period, rats in the other four groups continued to receive CMS intervention for 21 days. Forced swimming test and sucrose preference test were conducted at baseline (day 0), after modeling (day 21) and after intervention (day 42) so as to evaluate depression like behavior. Then the rats were sacrificed and the hippocampus and prefrontal cortex were taken. The mRNA levels of Toll like receptor 4 (TLR4) and myeloid differentiation primary response 88 (MyD88) were detected by RT-qPCR. The cytokines including interleukin-1β(IL-1β), interleukin-2(IL-2), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) were detected by Luminex technique.SPSS 21.0 was used for statistical analysis.Repeated measurement ANOVA was used for behavioral data analysis, one-way ANOVA was used for molecular index data analysis, and Spearman was used for correlation analysis. Results:The results of repeated measurement ANOVA showed that the interaction effects between group and time of body mass, sucrose preference, forced swimming immobility time were significant at baseline, after modeling and after intervention ( F=18.238, 6.921, 7.591, all P<0.05). After modeling, compared with nCMS+ Nal group, the rats in CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and CMS+ Nal group had lower body weight, lower sucrose preference rate and longer forced swimming immobility time (all P<0.05). After intervention, compared with CMS+ Nal group(body weight (350.15±41.65)g, sucrose preference(52.95±11.13)%, static time(91.40±15.22)s), the body weight((378.21±30.78)g, (385.12±43.19)g, (391.41±31.21)g, (402.33±18.67)g, all P<0.05) and sucrose preference((69.30±15.56)%, (68.12±10.99)%, (71.18±9.51)%, (75.47±11.55)%, all P<0.05) of CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and nCMS+ Nal group were all increased, while the forced swimming immobility time ((68.81±21.74)s, (66.10±25.51)s, (63.53±22.32)s, (71.21±21.41)s, all P<0.05) were shorter (all P<0.05). After intervention, among the body weight, sucrose preference and the immobility time of CMS+ Flu group、CMS+ Sal group and CMS+ Flu+ Sal group, there were no differences between each two groups(all P>0.05). After intervention, the levels of TLR4 mRNA and MyD88 mRNA in prefrontal cortex and hippocampus of CMS+ Flu group, CMS+ Sal group, CMS+ Flu+ Sal group and nCMS+ Nal group were all lower than those in CMS+ Nal group (all P<0.05). In prefrontal cortex, the levels of TLR4 mRNA (0.715±0.358) and MyD88 mRNA (0.739±0.233) in CMS+ Flu+ Sal group were lower than those in CMS+ Sal group (1.943±0.606, 1.815±0.897) (both P<0.05). The level of TLR4 mRNA in prefrontal cortex and hippocampus of rats were positively correlated with the level of MyD88 mRNA and TNF-α level and forced swimming immobility time and negatively correlated with sucrose preference rate (prefrontal cortex r=0.915, 0.041, 0.027, -0.178, all P<0.05; hippocampus r=0.810, 0.070, 0.011, -0.153, all P<0.05). Conclusion:The antidepressant effect of salvianolic acid is presumedly achieved by inhibiting the immunoinflammatory response mediated by the TLR4/Myd88 signaling pathway in CMS rats.

Objective To explore the regulatory effect of Mertk expression level on NF-κb pathway in rat Schwann cells and its possible mechanism.Methods Rat Schwann cells were cultured in vitro,and the expression of Mertk in Schwann cells exposed to high glucose was detected by Western blot.Co-immunoprecipitation was used to detect the interaction between endogenous Mertk and Ikbkb.Western blot was used to detect the expression levels of Ikbkb,P65 and tumor necrosis factor-α in Schwann cells after Mertk silencing.The protein expressions of Mertk,Ikbkb and P65 after silencing Mertk were detected by immunofluorescence.Results Mertk was expressed in Schwann cells,and the expression level increased with the increase of glucose concentration.Co-immunoprecipitation assay showed that Mertk interacted with Ikbkb in rat Schwann cells.Compared with the control group,the expression level of Mertk was significantly decreased(P<0.05),while Ikbkb,P65 and TNF-α were significantly increased(P<0.05)after knock down expression of Mertk in Schwann cells.Immunofluorescence experiments showed that the fluorescence of Mertk was decreased,and the fluorescence of Ikbkb and P65 was increased in the silenced Schwann cells.Conclusion After the expression of Mertk is decreased,it can mediate the regulation of NF-κb pathway in Schwann cells through interaction with Ikbkb,and up-regulate the expression of P65 and inflammatory factor TNF-α.

Four cases of Pentalogy of Cantrell were diagnosed by prenatal ultrasonography and confirmed by autopsy after labor induction.There were 1 case of complete Pentalogy of Cantrell and 3 cases of incomplete Pentalogy.In 3 cases of incomplete Pentalogy of Cantrell,1 case presented with high umbilical cord prolapse,extraspectoral heart,partial defect of the lower part of the sternum,partial defect of the pericardium,single umbilical artery and cervical lymphatic cyst;1 case presented with high umbilical cord prolapse,extraspectoral heart,thoracic fissure and ventricular septal defect;and 1 case presented with umbilical cord,extraspectoral heart,partial inferior sternal segment defect,ventricular septal defect and bilateral clubfoot varus.In l case of complete Pentalogy of Cantrell,there were high umbilical cord bulge,extraspectoral heart,chest fissure and inferior segment defect,anterior diaphragm and pericardium defect,total forebrain deformity,right 12th ribs loss and ventricular septal defect.Ectopic heart and omphalocele are typical echographic features of Pentalogy of Cantrel and prenatal ultrasonography is of important value in early diagnosis of this congenital malformation.

Objective To investigate the effect of miR-218-1-3p on the proliferation,cycle,and apoptosis of A549 cells in non-small-cell lung cancer.Methods miR-218-1-3p was transfected into non-small cell lung cancer A549 cells by LipofectamineTM 2000 Reagent,and the expression of miR-218-3p was detected by real-time PC R.Invasion and migration were assayed using the Transwell method.The effect of miR-218-1-3p on the proliferation of A549 cells was assayed by the MTS method.Changes in the cell cycle and apoptosis of A549 cells transfected with miR-218-1-3p was detected by flow cytometry.Changes in indicators related to cell proliferation,cycle,and apoptosis were detected by fluorescence quantitative PCR.Results Compared to the control group,the cell proliferation of A549 cells was significantly inhibited (P ＜ 0.05) and the proportion of cells in the S and G2-M phases was significantly decreased when miR-218-1-3p was up-regulated.In addition,compared with the control group,the early apoptotic rate was significantly increased by up-regulating miR-218-1-3p.We further detected indicators related to cell proliferation,cycle,and apoptosis and found that CYCLIN-D1 and BCL-2 were significantly downregulated.Conclusion miR-218-1-3p may inhibit proliferation,induce cell cycle arrest,and promote cell apoptosis of non-small cell lung cancer A549 cells by regulating CYCLIN-D 1 and BCL-2.

Objective To preliminarily analyze the prediction efficiency of multimodal MRI?based radiomics model for preoperative glioma IDH1 gene expression type. Methods The MRI data of 108 surgery?proven glioma patients from May 2015 to January 2019 were retrospectively analyzed, and the MRI data included axial T1WI,T2WI,fluid attenuated inversion recovery (FLAIR),DWI imaging and enhanced T1WI sequence.Forty-seven cases were IDH1 mutant type, and 61 cases were IDH1 wild type. All patients were divided into training and validation groups according to the 7∶3 ratio of the random forest model. Seventy-three cases were in training group, and 35 cases were in validation group. Independent predictors of IDH1 mutation were screened by univariate analysis combined with multivariate logistic regression analysis (P<0.05) in order to construct a random forest diagnosis model of general clinical information and conventional MRI morphological features.General clinical information and conventional MRI morphological features included gender, age, umbers of cases of left and right hemispheres, location of tumors, maximum diameter of tumors, peritumoral edema, intratumoral cystic degeneration, enhancement and ADC value of tumors. The ROI was manually outlined by MaZda software in the most obvious level of 5 sequences of tumor mass and the radiomics features were extracted, including the gray?level co?occurrence matrix(GLCM), the run?length matrix(RUN), the absolute gradient(GRA),the auto?regressive model(ARM) and wavelets transform (WAV). The least absolute shrinkage and selection operator (LASSO)regression were used to select image radiomics features with a method of 10 fold cross?validation and to reduce the dimensions. The screened image radiomics labels were combined with the conventional morphological feature independent predictors to construct a multimodal MRI?based random forest model, and the validation data set was used to evaluate the accuracy and diagnostic efficiency of each model. The sensitivity and specificity of conventional MRI morphological feature model and multimodal MRI?based radiomics prediction model were evaluated dynamically by drawing ROC curves, and the prediction efficiency of the two models was quantified by using AUC statistical indicators. The model classification error rate under different outcomes and the classification error rate of out of bag(OOB)were used to evaluate the stability of the multimodal MRI?based random forest model. The contribution rate of each variable to the model was reflected by the characteristic variables importance assessment map. Results Univariate regression analysis of the conventional MRI morphological characteristics showed that peritumoral edema, cystic degeneration and enhancement were the three independent predictors of IDH1 gene expression (P<0.01). LASSO algorithm and 10?fold cross?validation identified six robust radiomic features including high frequency coefficients of wavelet transform (WavEnHH_s?4) of T2WI, S(4, 4) inverse difference of gray uniformity measurement (InvDfMom), S(5, 0) Entropy (entropy), WavEnHH_s?4 of T1WI enhancement, S(1, 1) InvDfMom, S(1, -1) Entropy Difference (DifEntrp)of Flair.The error rate of classification for different outcomes and classification error rate of random forest OOB data of multimodal MRI radiomics diagnosis model finally stabilized at 10%. The results of Characteristic Variable Importance Assessment Map: Mean Decrease Accuracy and Mean Decrease Gini index were consistent, which showed that besides three conventional MRI morphological predictors peritumoral edema, enhancement and cystic degeneration, the radiomics labels also played a key role in the model. The results of ROC curve showed that the accuracy, specificity,sensitivity and AUC of conventional MRI morphological feature model were 82.7%, 68.4%, 90.9% and 0.835, respectively, and those of multimodal MRI?based radiomics model were 88.5%, 89.5%, 87.8% and 0.956 respectively. Conclusion Multimodal MRI?based radiomics random forest model can improve the predictive efficiency of preoperative glioma IDH1 gene expression type more quantitatively.

Objective To investigate the effect of prenatal stress (PS) at different pregnant time on emotion and cognition of adult offspring rats.Methods Twelve healthy female Sprague Dawley (SD) rats were randomly divided into control group(CON,n=4),the early pregnancy group(PS1,the 1～ 7 days of pregnancy,n=4) and the late pregnancy group(PS3,the 15 ～ 21 days of pregnancy,n=4).The pregnant rats were exposed to single-prolonged stress(SPS) on gestational day 7 or 15 respectively,except control group.The offspring were measured every weekend from 1-7 week after birth.At the eighth weekend,the sucrose intake (anhedonia) and Morris water maze (MWM) were performed to assess depression-like behavior and spatial learning and memory.Results The body weight of the first to seventh weeks after birth showed that there was a statistically significant difference among the three groups (F=28.207,P＜0.01),and there was a significant difference in time effect (F=1 041.546,P＜0.01).The body weight of two PS groups was significantly lower than those of control group(P＜0.05).The body weight of PS3 was lower than that of PS1 significantly(P＜0.05).Sucrose preference:PS3((27.70± 19.31) ％) were reductive on sucrose consumption than CON significantly((66.93±19.67) ％)(P＜0.05)while PS1 ((89.80±6.79) ％) increased in sucrose consumption compared with the CON significantly(P＜0.05).MWM:in training stage the difference of average avoid latency was existed in the three groups of the first 5 days(F=11.121,P＜0.01).Similarly,there was a significant difference in measure time(F=91.327,P＜0.01),the escape latency of the PS3 was decreased,while PS1 was significantly increased compared with CON;in testing stage,PS3 ((54.50±4.64) s,(53.21±4.45)) showed a significant increase in the duration in target site and numbers of times across the target site compared with CON((32.24±.4.17) s,(31.68±4.00)) (P＜0.05).Conclusion The acceptance of stress in the late pregnancy may lead to depression like behavior in the adult offspring and also enhance the learning and memory ability.And acceptance of stress in early pregnancy can cause impairment of learning and memory ability in adult offspring rats.

ObjectiveTo develop traditional Chinese medicine （TCM） formulae for the treatment of nonsevere coronavirus disease 2019 （COVID-19） and to explore its anti-inflammatory mechanism. MethodsThe dysregulated signaling pathways were determined in macrophages from bronchoalveolar lavage fluid of COVID-19 patients and in lung epithelial cells infected with SARS-CoV-2 in vitro based on transcriptome analysis. A total of 102 TCM formulae for the clinical treatment of nonsevere COVID-19 were collected through literature. The pathway-reversing rates of these formulae in macrophages and lung epithelial cells were evaluated based on signature signaling pathways， and the basic formula was determined in conjunction with TCM theory. The commonly used Chinese materia medica for nonsevere COVID-19 were summarized from the 102 TCM formulae as abovementioned. And together with the screening results from the Pharmacopoeia of the People's Republic of China， a “Chinese materia medica pool” was esta-blished for the development of TCM formulae for COVID-19. The regulatory effects of each herb on signaling pathways were obtained based on targeted transcriptome analysis. Oriented at reversing dysregulated signaling pathways of COVID-19， the calculation was carried out， and the artificial intelligent methods for compositing formulae， that are exhaustive method and parallel computing， were used to obtain candidate compound formulas. Finally， with reference to professional experience， an innovative formula for the treatment of nonsevere COVID-19 was developed. The ethanol extract of the formula was evaluated for its anti-inflammatory effects by detecting the mRNA expression of interleukin 1b （Il1b）， C-X-C motif chemokine ligand 2 （Cxcl2）， C-X-C motif chemokine ligand 10 （Cxcl10）， C-C motif chemokine ligand 2 （Ccl2）， nitric oxide synthase 2 （Nos2）， and prostaglandin-endoperoxide synthase 2 （Ptgs2） using reverse transcription-quantitative polymerase chain reaction （RT-qPCR） in RAW264.7 cells treated with lipopolysaccharide （LPS）. ResultsIn macrophages and lung epithelial cells， 34 dysregulated signaling pathways associated with COVID-19 were identified respectively. The effects of the 102 formulae for clinical treatment of nonsevere COVID-19 were evaluated based on the dysregulated signaling pathways and targeted transcriptome， and the result showed that Yinqiao Powder and Pingwei Powder （银翘散合平胃散， YQPWP） ranked first， reversing 91.18% of the dysregulated signaling pathways in macrophages and 100% of the dysregulated signaling pathways in lung epithelial cells. Additionally， YQPWP had the function of scattering wind and clearing heat， resolving toxins and removing dampness in accordance with the pathogenesis of wind-heat with dampness in COVID-19. It was selected as the basic formula， and was further modified and optimized to develop an innovative fomula Qiaobang Zhupi Yin （翘蒡术皮饮， QBZPY） based on expert experience and artificial intelligence in composing formulae. QBZPY can reverse all the dysregulated signaling pathways associated with COVID-19 in macrophages and lung epithelial cells， with the reversing rates of 100%. The chief medicinal of QBZPY， including Lianqiao （Fructus Forsythiae）， Xixiancao （Herba Siegesbeckiae） and Niubangzi （Fructus Arctii）， can down-regulate multiple signaling pathways related with virus infection， immune response， and epithelial damage. RT-qPCR results indicated that compared with the model group， the QBZPY group down-regulated the mRNA expression of Il1b， tumor necrosis factor （Tnf）， Cxcl2， Cxcl10， Ccl2， Nos2 and Ptgs2 induced by LPS in RAW264.7 cells （P＜0.05 or P＜0.01）. ConclusionBased on targeted transcriptome analysis， expert experience in TCM and artificial intelligence， QBZPY has been developed for the treatment of nonsevere COVID-19. The ethanol extract of QBZPY has been found to inhibit mRNA expression of several pro-inflammatory genes in a cellular inflammation model.