AIM: To discuss the mechanism of action of Zhiyu Granules on treating diabetic peripheral neuritis. METHODS: The model of diabetic peripheral neuritis in mice was induced by streptozotocin.The effect of Zhiyu Granules on the contents of sciatic nerve inositol in model mice through ELSD(evaporative light scattering detector) was examined,and the activity of Na~+-K~+ pump in sciatic nerve was measured,and the activity of SOD and the contents of MDA in erythrocytes were detected,and the ultrastructures of sciatic nerve,pancreas and kidney in model mice were observed by electric microscope. RESULTS: Zhiyu Granules could increase the contents of sciatic nerve inositol in model rats,and enhance the activity of Na~+-K~+ pump,and improve the ultrastructures of sciatic nerve and pancreas cell.Zhiyu Granules couldn't improve the ultrastructure of renal corpuscles,or affect the activity of SOD and the contents of MDA in erythrocytes of model mice yet. CONCLUSION: Zhiyu Granules is effective in clinical treatment of diabetic peripheral neuritis.

BACKGROUND:It is reported that gelatin sponge particles and chitosan/α, β-glycerophosphate gel microspheres have high application prospects in the treatment of hemoptysis of pulmonary tuberculosis.METHODS: Forty SPF Kunming mice were selected to make animal models of pulmonary tuberculosis hemoptysis using aerosolized inhalation device and randomly divided into two groups undergoing embolization for hemostasis using gelatin sponge particles and chitosan/α, β-glycerophosphate gel microspheres, respectively. Body mass changes, hemostasis time, effective rate of hemostasis, related indexes of myocardium and pathological changes of pulmonary tuberculosis were observed at 15 and 30 days after treatment.RESULTS AND CONCLUSION:(1) Mice in the chitosan/α, β-glycerophosphate gel microspheres group had higher body mass than those in the gelatin sponge group at 15 days after treatment (P < 0.05). (2) Compared with the gelatin sponge group, the hemostatic efficiency was higher and the time of hemostasis was shorter in the chitosan/α, β-glycerophosphate gel microspheres group (P< 0.05). (3) There were no significant differences in the levels of BNP precursor, creatine kinase isoenzyme and creatine kinase between the two groups (P > 0.05). (4) The lymphocyte infiltration and necrotic lesions were found around the microspheres, necrotic lesions were found, and there were a lot of active cells on the microspheres. There were a few lymphocytes in the gelatin sponge group. These results show that that the chitosan/α, β-glycerophosphate gel microspheres have better hemostatic effects in comparison with gelatin sponge particles in a mouse model of pulmonary tuberculosis.

Objective To study the expression levels of microRNA (miR)-16 and miR-146a in rat lungs of decompres-sion sickness (DCS) caused by fast buoyancy ascent escape or diving .Methods At 0.5 h after fast buoyancy ascent es-cape or diving, the pathological changes in rat lungs and expression levels of miR-16,and miR-146a were detected by re-verse transcription-quantitive polymerase chain reaction and compared with normal control group .Results The pathological characteristics of lungs in two DCS groups were tissue damage .At 0.5 h after DCS caused by fast buoyancy ascent escape , the lung tissue expression levels of miR-16 and miR-146a did not significantly change compared with normal control and diving DCS groups ,but the rat lung tissue expression level of miR-146 a in diving DCS group was obviously increased , com-pared with normal control group .Conclusion miR-146a may play a role in post-transcriptional regulation in the process of diving DCS .

Objective: To investigate the impact of thyroid hormone on atrial ifbrillation (AF) prevalence in patients with chronic heart failure (CHF).
Methods: A total of 322 non-valvular heart disease CHF patients treated in our hospital from 2011-0-01 to 2012-10-01 were retrospectively studied. Based on previous history and the ECG at admission, the patients were divided into 2 groups: AF group,n=187 and Sinus rhythm group,n=135. The proifle of serum levels of free thyroxine (FT4), free triiodothyronine (FT3), hyroid stimulating hormone (TSH) and LDL-C were examined within 24 hours of admission; 12 lead ECG and echocardiography were conducted to analyze the related factor for AF occurrence.
Results: Compared with Sinus rhythm group, AF group had increased FT4 level as 14.52 (12.74, 15.85) pmol/L vs 13.11 (11.68, 14.85) pmol/L,P<0.001, while FT3 level was similar between 2 groups as 4.06 (3.76, 4.44) pmol/L vs 4.1(3.80, 4.52) pmol/L,P=0.250. Spearman related analysis indicated that FT4 level was positively related to left atrial dimension (LAD) (r=0.134,P=0.016), FT3 level was positively related to LDL-C (r=0.235,P<0.001) and negatively related to age (r=-0.268, P<0.001). Taking FT4 as the continuous variable, Logistic regression analysis indicated that FT4 level [OR=1.227, 95% CI (1.112-1.354),P<0.001], LAD [OR=1.154, 95% CI (1.105-1.205),P<0.001], age [OR=1.038, 95% CI (1.012-1.064),P=0.003], CHF duration [OR=1.111, 95% CI (1.021-1.209),P=0.015], LDL-C level [OR=0.689, 95% CI (0.493-0.963),P=0.029] were related to AF prevalence in CHF patients.
Conclusion: High serum level of FT4 may increase the risk AF occurrence in CHF patients.

Anemia, Aplastic ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans

Objective: To investigate and analyze the impact on PLT recovery of recombinant human thrombopoietin (rhTPO) in severe aplastic anemia (SAA) patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods: A retrospective analysis of Hematology Division of General Hospital of Jinan Military Command was conducted in the 85 SAA cases who treated with allo-HSCT from January 2010 to March 2017. According to the administration of medicines for platelets, 85 patients were divided into rhTPO group (n=29), rhIL-11 group (n=27) and blank group (n=29), respectively. The median time of PLT ≥20×10⁹/L, PLT ≥50×10⁹/L, and PLT ≥100×10⁹/L, the numbers of megakaryocytes in marrow smear (25±5) days after transplantation and the quantities of platelet transfusion were analyzed retrospectively. The adverse events of rhTPO and rhIL-11 groups were observed. Results: There were no significant differences in the recovery of granulocytes and PLT ≥20×10⁹/L among the three groups (P>0.05). The time of PLT ≥50×10⁹/L in rhTPO group was shorter than that in blank group [16.5 (11-39) d vs 22 (14-66) d, P<0.05], as well as the time of PLT ≥100×10⁹/L [rhTPO: 23 (12-51) d; rhIL-11: 28 (12-80) d; blank group: 35 (18-86) d, P<0.05]. Platelet transfusions were also less in rhTPO group than in rhIL-11 and blank groups [20 (10-30) U, 30 (10-50) U, 35 (10-70) U, P<0.05]. The counts of megakaryocyte in rhTPO group, rhIL-11 group and blank group were 31.5 (0-200), 12 (0-142) and 11(0-187) (P<0.05), respectively. The difference between rhTPO group and rhIL-11 group was statistically significant (P<0.05), but no difference between rhIL-11 group and blank group (P>0.05). Multivariate analysis showed that rhTPO was an independent factor for platelet recovery [HR=4.01 (95%CI 1.81-9.97), P=0.010]. The rhTPO group had no obvious adverse events. Conclusion rhTPO can promote platelet recovery of SAA patients after allo-HSCT, reduce platelet transfusion with safety.

Objective To discuss the effect of functional electric stimulation (FES) on motor evoked potential(MEP),glial fibrillary acidic protein (GFAP) expression and muscle wet weight in rats after spinal cord injury (SCI).Methods Seventy-two adult male SD rats were chosen and randomly divided into 3 groups:sham-operated group,FES group and model group (n=24).T9 spinal cord complete injury animal models in the FES group and model group were induced by NYU blow.Rats in the FES group were performed FES at posterior thigh and rats in the model group only placed electrode without electricity.7,14,28 and 56 d after FES,potentiometer test was performed to detect the MEP latency; immunohistochemical staining was employed to detect the GFAP expression; and hind leg extensor muscle wet weight was measured.Results The MEP latency in the FES group was detected 14,28 and 56 d after FES,which was significantly longer than that in the sham-operated group (P＜0.05); the MEP latency in the FES group 28 and 56 d after FES was significantly shortened than that in the model group (P＜0.05).Muscle wet weight in the FES group 28 and 56 d after FES was significantly increased than that in the model group (P＜0.05).GFAP-positive cells in the FES group 28 and 56 d after FES were significantly decreased than those in the model group (P＜0.05).Conclusion FES in the treatment of spinal cord injury can not only inhibit the expression of GFAP and shorten MEP latency,but also inhibit paralyzed limb muscle atrophy and promote motor function recovery.

Objective? To explore the frailty condition in elderly inpatients and analyze its influencing factors. Methods? Using convenience sampling method, 360 elderly patients with chronic diseases hospitalized in Beijing Friendship Hospital from May 2017 to September 2018 were selected as the subjects of this study. The incidence of frailty was investigated by Fried Weakness Phenotype Assessment. In addition, the general data and clinical related indicators of the subjects were collected, and the influencing factors of elderly patients' frailty were analyzed by univariate and multivariate analysis. Results? In this study, 89 patients with frailty were enrolled, accounting for 24.72%(89/360). Univariate analysis showed that there were statistically significant differences in gender, age, living conditions, sleep status, albumin level, hemoglobin level, fall risk, ability of daily living(ADL), cognitive function, mental health and nutritional risk condition between the frailty group and non-frailty group (P＜ 0.05). Multivariate logistic regression analysis showed that age, sleep status, fall risk, mental health and nutritional risk were the influencing factors of elderly hospitalized patients' frailty (P＜ 0.05). Conclusions? There is a high incidence of frailty in the elderly inpatients. Old age, poor sleep quality, high risk of falling, depression and malnutrition are the influencing factors of frailty. Therefore, it is suggested that comprehensive assessment should be carried out as soon as possible to improve the quality of life of elderly patients.

Objective:To explore the effect of multidisciplinary collaborative discharge preparation service in elderly patients with chronic pancreatitis.Methods:From January 2020 to March 2021, a total of 152 elderly patients with chronic pancreatitis who were hospitalized in Department of Geriatrics of Beijing Friendship Hospital Capital Medical University were selected by convenience sampling method and divided into the observation group and the control group (76 cases in each group) using random number table method. The control group conducted conventional nursing, and the observation group carried out multidisciplinary collaboration discharge preparation services based on conventional nursing. Laboratory indicators, quality of life (SF-36) , readmission rates, and clinical stage progression were investigated.Results:After discharge, hemoglobin, prealbumin, albumin and SF-36 scores of the observation group were higher than those of the control group, while the fasting blood glucose of the observation group was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Hemoglobin, prealbumin, albumin and SF-36 scores of the observation group after discharge were higher than those before discharge, and the differences were statistically significant ( P<0.05) . The readmission rates of the observation group and the control group were 14.47% and 21.58% respectively, and the clinical stage progression rates were 10.53% and 25.00% respectively. The differences in the readmission rate (χ 2=6.273, P<0.05) and clinical stage progression rate (χ 2=5.449, P<0.05) between the two groups were statistically significant. Conclusions:Multidisciplinary collaborative discharge preparation services applied to elderly patients with chronic pancreatitis can effectively improve patients' nutritional status and quality of life, reduce readmission rates and delay disease progression.

Objective:To analyze the clinicopathological characteristics of differentiated early cardia cancer and to evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD).Methods:A total of 329 patients (331 lesions) who underwent ESD at Nanjing Drum Tower Hospital from October 2014 to December 2019 and were pathologically confirmed as differentiated early cardia cancer were included in the study and followed up. The endoscopic and pathological data of patients were reviewed to analyze the clinicopathological characteristics of differentiated early cardia cancer. The short-term (including en bloc resection rate, curative resection rate and incidence of short-term complications) and long-term efficacy (including incidence of metachronous cancer, recurrence and distant metastasis, and overall survival rate) of ESD was evaluated.Results:The ratio of male to female in 329 patients with differentiated early cardia cancer was 4∶1, and their age was 65.69±8.02 years. Tumor diameter of ≤2.0 cm accounted for 65.9% (218/331). Most lesions were located on the posterior wall (50.5%, 167/331), followed by the minor curve (36.3%, 120/331). The endoscopic morphology of 0-Ⅱc type accounted for 49.5% (164/331). There were 69.8% (231/331) lesions confined to the mucosal layer. The en bloc resection rate was 100.0% (329/329), and the curative resection rate was 83.3% (274/329). Short-term complications occurred in 28 patients (8.5%). With a median follow-up time of 39 months, 11 patients (3.3%) developed metachronous cancer, 2 (0.6%) developed distant metastasis, and no recurrence occurred. Seven patients died, and the overall survival rate during the follow-up period was 97.9% (322/329). The survival rate of patients with curative resection and additional surgery was 100.0% (3/3), while that without additional surgery was 99.3% (269/271). The survival rate of patients with non-curative resection and additional surgery was 96.0% (24/25), and that without additional surgery was 86.7% (26/30).Conclusion:Most differentiated early cardia cancers are well-differentiated adenocarcinomas, with less than 2 cm in diameter at the time of diagnosis with a low rate of ulcer and vascular invasion. ESD is safe and effective for the treatment of differentiated early cardia cancer with a high rate of curative resection, fewer intraoperative and postoperative complications, low incidences of metachronous cancer, distant metastasis and recurrence, and a high overall survival rate. However, additional surgical treatment is recommended for patients with non-curative resection.