OBJECTIVE:To study the effects of Suanzaoren decoction on learning and memory ability and brain neurotransmit-ters content of senile insomnia model rats. METHODS:Rats were randomly divided into normal group,model group,positive group [Estazolam tablet,2 × 10-3 g/(kg·d)] and Suanzaoren decoction low-dose,middle-dose and high-dose groups [5,10,15 g/(kg·d)],with 10 rats in each group. Except for normal group,those groups were given D-galactose ih on the back+sleep depriva-tion to induce senile insomnia model. 6 weeks after modeling,treatment groups were given relevant medicine intragastrically for one week,and normal group and model group were given normal saline intragastrically. The escape latency,the percentage of swimming time and the time of original platform crossing were observed,and the contents of Glu and GABA in cerebral tissue were determined as well as the contents of IL-1β and 5-HT in hypothalamus. RESULTS:Compared with normal group,escape la-tency of rats prolonged and the contents of IL-1β and 5-HT in hypothalamus decreased,while the percentage of swimming time of original platform quadirant,the time of original platform crossing and the contents of Glu and GABA in cerebral tissue increased (P<0.05). Compared with model group,above index of treatment groups improved significantly,with statistical significance(P<0.05). Compared with positive group,the changes of above index were more significant in Suanzaoren decoction middle-dose and high-dose groups,with statistical significance (P<0.05). CONCLUSIONS:Suanzaoren decoction could markedly enhance the learning and memory ability of senile insomnia model rats,and reduce neurotransmitters content and relieve the delayed neuronal damage which led by Glu and GABA.

Objective To explore the value of procalcitonin (PCT)and interleukin -6 (IL -6)in the early diagnosis and prognostic evaluation of the patients with lumbar intervertebral disc herniation,and their correlation with the course and lumbar function.Methods 100 patients with lumbar disc herniation (study group)and 35 patients with lumbar non -borne diseases (control group)were collected,their preoperative clinical symptoms were scored on the basis of the lumbar scoring system of Japanese Orthopaedic Association (JOA),the enzyme -linked immunosor-bent assay was applied to determining the content changes of PCT and IL -6 of the two groups,and the linear correla-tion analysis was used to explore the relevance of PCT and IL -6 to the course.Results The contents of the PCT and IL -6 in the study group's serum were respectively (25.13 ±0.86)ng/L and (10.26 ±0.36)ng/L,while those in the control group's serum were respectively (223.85 ±0.61)ng/L and (50.11 ±1.23)ng/L,both with statistical sig-nificance (t =2.542,2.206,P <0.01).The IL -6 was positively correlated with the disease duration of the patients with lumbar disc herniation (r =0.32,P =0.000),and negatively correlated with their JOA score (r =-0.45,P =0.003),and the PCT was positively correlated with the patients'disease duration (r =0.35,P =0.001),and nega-tively correlated with their JOA score (r =-0.53,P =0.005).Conclusion The PCT and IL -6 have a certain role in the early diagnosis of lumbar disc herniation,and have some relevance to the course of disease and the lumbar func-tion changes.

To study the distribution of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries, 32 samples of endarterectomy and 10 autopsies of normal carotid specimens were fixed and embeded in paraffin, sections were stained with hematoxylin-eosin, toluidine blue,monoclonal antibodies against the two major proteases of mast cells(tryptase and chymase) and monoclonal antibodies against CD-3 of T lymphocytes and CD-68 of macrophages. The quantity,distribution and degranule of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries were investigated,and the ratio of mast cells to T lymphocytes and macrophages in atherosclerotic lesions was calculated. The density(cells/mm 2 ) of mast cells in shoulder region of plaque(6 3?4 0) was much higher than that in normal intima,cap and core region(1 3?2 3,2 3?2 6,2 2?3 7) .The proportion of chymase-containing mast cells to tryptase-containing mast cells was 0 36,0 51,0 47 and 0 39 respectively in normal intima,cap,core and shoulder region of plaque.The propotion of degranulated mast cells was the highest in shoulder region of plaque(65%).The ratios of mast cells to T lymphocytes and to macrophages were 0 25 and 0 14 respectively in shoulder region of plaques.Light microscopic studies of mast cells revealed that mast cells were more commonly observed in thrombus and around calcification and blood vessels of plaque.Mast cells play a role in the formation of plaque,and participate in the destabilization of plaque.

Objective To introduce a modified replantation for thumb rotating avulsion amputation,and to evaluate its short term clinical outcome.Methods From January 2007 to July 2009,7 patients with thumb rotating avulsion amputation underwent replantation,including 6 males and 1 female,aged from 21 to 47 years (average,28.3 years).The amputation level of each thumb was metacarpophalangeal joint.During operation,fusion of metacarpophalangeal joint was performed according to injury degree of soft tissue; interphalangeal joint of the thumb was fixed in 15 degrees of flexion by sewing flexor pollicis longus muscle tendon and extensor pollicis longus muscle tendon to tendon sheath or soft tissue; the superficial vein harvested from ipsilateral forearm was used to bridge the dorsal carpal branch of radial artery and the ulnar palmacollateral artery of the thumb; direct anastomoses of dorsal veins were performed in 6 cases and venous transplantation in 1 case; and bilateral nerves were transferred to the back of the first metacarpal and anastomosed to the superficial branch of the radial nerve.Results All 7 replanted thumbs survived completely.Arterial crisis occurred in 1 case after operation,which was cured after operative and medication treatment.The follow-up period ranged from 3 to 24 months.The appearance and opposition function of replanted thumbs were satisfactory and the sensation of fingertip recovered to S4 in 4 cases and to S3 in 3 cases.The two point discrimination ranged from 8 to 12 mm.Conclusion Because bridging the dorsal carpal branch of radial artery and the ulnar palmar collateral artery of the thumb with a superficial vein harvested from ipsilateral forearm to reconstruct blood supply of the thumb is available and easy to be performed,this modified replantation is an ideal way to repair thumb rotating avulsion amputation.

ObjectiveTo evaluate the diagnostic value of high-frequency ultrasonography for dorsal wrist cyst.MethodsThe ultrasonographic characteristics of 136 dorsal wrist cysts were retrospectively studied and compared with the pathological results, the locations and the imaging characteristics of the cysts were analysed, hence to conclude the diagnostic value of high-frequency ultrasonography.ResultsBased on the anatomical location diagnosed by high frequency ultrasound, the 136 dorsal cysts were divided into three types: extensor retinaculum cysts, synovial tendon sheath cysts and dorsal interosseous ligament cysts, each accounted for 1.5% (2/136), 24.3% (33/136) and 74.2% (101/136) of the study group. The most frequently detected locations for dorsal cysts were dorsal scapholunate ligament,tendinous sheath of extensor digitorum and extensor indicis, as well as tendinous sheath of extensor carpi radialis longus and brevis,each accounted for 60.3% (82/136), 8.1% (11/136) and 6.6% (9/136) of all dorsal wrist cysts respectively. Dorsal wrist cysts had typical ultrasonographic features on 2-D gray-scale ultrasonography, the extensor retinaculum cyst demonstrated as a well-marginated, small-sized and oval anechoic area, which was commonly located in the oedematous extensor retinaculum, but it had no adjunction with the extensor tendon, and it was accompanied with dorsal scapholunate ligment cyst frequently. Synovial tendon sheath cyst demonstrated as a oval or eggplant-shaped anechoic area which was usually winding around the extensor tendon, but it had no adjunction with the dorsal interosseous ligament and the extensor retinaculum. Meanwhile, the dorsal interosseous ligament appeared to be normal strip-like echo texture with a smooth and clear margin. Dorsal interosseous ligament cyst demonstrated as a out-of-shape anechoic area and located superior to the injured ligament. Meanwhile, the impaired ligament was thickened with uneven margin and decreased echo texture. No blood lfow signals was detected in all dorsal wrist cysts by color doppler lfow imaging.ConclusionHigh-frequency ultrasonography can be used to diagnosis dorsal wrist cysts, and can be served as the preferred imaging modelity to guide the clinical treatment.

Gynecology and obstetrics is a theoretical and practical subject. It is an important goal for the medical students to develop the clinical thinking ability and operating skills and apply them in the diagnosis and treatment of disease. To overcome the limited teaching resources, the rare clinical skills opportunities caused by doctor-patient relationship tension, virtual patient (VP) combined with clinical teaching was applied in clinical teaching, which can reproduce the real, and bring the students to the role of the clinician , enrich the content of the obstetrics and Gynecology clinical teaching. Along with the reform the teaching faculty with high quality was established, their clinical teaching experiences and innovative thinking were improved significantly. The results were evaluated by means of clinical comprehensive ability test. The present study aimed to establish virtual patients of OBGYN (virtual patient, VP) learning to promote learning of basic knowledge, clinic skills, and thinking ability.

Objective To study whether there is a correlation between the content of neutrophil gelatinase-asociated lipocalin (NGAL) and extravascular lung water index (EVLWI) in patients with acute lung injury (ALI) induced by septic shock.Methods We prospectively collected 110 patients with septic shock from December 2013 to June 2015,who had already completed the initial fluid resuscitation within 6 hours according to the guide.In accordance with whether combined with ALI,patients were divided into two groups:non ALI group was A group (n =61),and ALI group was B group (n =49).Baseline information,EVLWI and other indexes of hemodynamic monitored by PICCO of each group was collected prior to admission in intensive care unit.EVWI and the content of NGAL in alveolar lavage fluid,which detected by ELISA,were gathered after the initial fluid resuscitation.Results There were no significant differences at the baseline level between the two groups (P ＞ 0.05).The risk factors of EVLWI in patients with septic shock were analyzed by multivariate linear regression analysis.The risk factors contained fluid balance,NGAL,cardiac index (CI),Global end diastolic volume index (GEDI),human albumin (ALB),globulin (GLO).The results showed that EVLWI had linear regression with NGAL and GEDI.The equation of linear regression were Y(NGAL) =2.017 + 0.035X,and Y(GEDt) =-0.671 + 0.004X,respectively.Correlation analysis indicated that there was significantly positive correlation between EVLWI and GEDI (r=0.835,P=0.000)and between NGAL and GEDI (r=0.489,P=0.000).In contrast,after immobilization of GEDI,we did not find any significant correlation between EVLWI and NGAL (r =0.381,P =0.060).Conclusions In case of fluid infusion volume is relatively too much,there is a strong correlation between NGAL in alveolar lavage fluid and EVLWI levels for early fluid resuscitation in patients with sepetic shock.

Objective Leucine-rich repeat transmembrane neuronal protein 2 (LRRTM2) localizes to excitatory glutamatergic synapses,and triggers the formation of excitatory synapses.This study aims to investigate the expression of LRRTM2 protein in the temporal lobe tissue of SD rats induced by lithiumpilocarpine,and explore its roles in epilepsy.Methods Fifty-six Sprague-Dawley (SD) rats were induced by lithium-pilocarpine and randomly divided into 6h,24h,72h,7d,14d,30d and 60d subgroups.Eight SD rats were treated with normal saline instead of pilocarpine as controls. Expression of LRRTM2 protein was accessed by immunohistochemistry,immunofluorcscence and Western blot analysis. Results LRRTM2 protein mainly expressed in neurons of temporal lobe,gradually decreased in acute phase,and then up-regulated in latent and chronic periods.The immunohistochemistry A values in model rats from 6 h,24h,72h,7d,14d,30d and 60d subgroups were 0.286 ±0.012,0.227 ± 0.008,0.425 ± 0.015,0.509 ±0.019,0.579 ± 0.018,0.488 ± 0.018 and 0.566 ± 0.014,respectively,compared to 0.330 ±0.016 in control group ( t =3.965,11.987,9.131,14.121,20.452,12.929 and 22.786,all P＜0.05). Gray value ratios of LRRTM2/β-actin in different groups of model rats were 0.0354 ± 0.0043,0.0174 ± 0.0026,0.0685 ± 0.0064,0.0957 ± 0.0125,0.1044 ± 0.0103,0.0910 ± 0.0108,and 0.1012 ±0.0063,respectively,which were significant differences from control group (0.0471 ± 0.0033,t=4.354,14.191,5.989,7.541,10.565,7.730and15.316,allP＜0.05).Conclusions LRRTM2 protein gradually increases in the neurons of temporal lobe of SD rats treated by lithium-pilocarpine in silence and chronic phases,which indicates that it may play an important role in cpileptogenesis.

Objective:To investigate the efficacy of Qingruxiao granules combined with tamoxifen in the treatment of breast hyperplasia and its effect on serum hypoxia-inducible factor-alpha (HIF-α), angiopoietin-2 (Ang-2) and prolactin (PRL) levels. Methods:Ninety-eight patients with breast hyperplasia admitted to Xi'an No.3 Hospital from June 2020 to January 2022 were retrospectively included in this study. They were divided into control and observation groups ( n = 49/group) according to different treatments. The control group was treated with tamoxifen alone. The observation group was treated with Qingruxiao granules combined with tamoxifen. Clinical efficacy, symptom score, ultrasound parameters (glandular layer thickness, longest diameter of mass, maximum diameter of hypoechoic area, inner diameter of lactating tube), endocrine hormone levels (estradiol, progesterone, and prolactin), HIF-α, and Ang-2 pre- and post-treatment, as well as the incidence of adverse reactions were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [93.88% (4/49) vs. 77.55%, χ2 = 5.33, P < 0.05). After treatment, breast mass score, breast pain, systemic accompanying symptom, and nipple discharge in the observation group were (1.34 ± 0.29) points, (1.02 ± 0.36) points, (0.68 ± 0.17) points, (0.97 ± 0.15) points, respectively, which were significantly lower than (1.57 ± 0.23) points, (1.45 ± 0.41) points, (0.95 ± 0.26) points, and (1.28 ± 0.26) points, respectively, in the control group ( t = 4.35, 5.52, 6.08, 7.23, all P < 0.001). The glandular layer thickness, the longest diameter of mass, the maximum diameter of hypoechoic area, and the inner diameter of lactating duct in the observation group were (9.45 ± 1.67) mm, (11.46 ± 3.68) mm, (14.37 ± 4.22) mm, and (1.23 ± 0.39) mm, respectively, which were significantly lower than (11.26 ± 2.51) mm, (16.33 ± 4.01) mm, (19.87 ± 5.01) mm, (1.54 ± 0.48) mm in the control group ( t = 4.20, 2.26, 5.88, 3.51, all P < 0.001). Serum estradiol and prolactin levels in the observation group were (122.35 ± 29.76) ng/L and (205.64 ± 36.42) IU/L, respectively, which were significantly lower than (139.76 ± 30.48) ng/L and (251.49 ± 41.87) IU/L in the control group ( t = 2.86, 5.78, both P < 0.05). Serum progesterone level in the observation group was (9.22 ± 1.57) μg/L, which was significantly higher than (7.18 ± 1.21) μg/L in the control group ( t = -7.20, P < 0.05). Serum HIF-α and Ang-2 levels in the observation group were (0.15 ± 0.05) ng/L and (0.98 ± 0.11) ng/L, respectively, which were significantly lower than (0.24 ± 0.07) ng/L and (1.49 ± 0.22) ng/L in the control group ( t = 7.32, 14.51, both P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Qingruxiao granules combined with tamoxifen can effectively improve clinical symptoms, reduce tumor size, regulate endocrine hormone levels, decrease the expression of angiogenic factors in patients with breast hyperplasia, and is highly safe.

AIM:To investigate the expression of CUE domain-containing 2 (CUEDC2) in hepatocellular car-cinoma ( HCC) and to analyze its clinical prognostic significance .METHODS:Total 186 formalin-fixed paraffin-embed-ded tissues obtained from surgical HCC with detailed clinicopathological and follow -up data were used .The expression of CUEDC2 was detected by immunohistochemistry .The relationships between the expression of CUEDC 2 and clinicopatholog-ical characteristics and prognosis were analyzed .RESULTS: The positive rate of CUEDC 2 in HCC was 85.5% ( 159/186), among which, the low expression was 52.2%(97/186) and the high expression was 47.8%(89/186).CUEDC2 expression was correlated with serum alpha-fetal protein (AFP) level, tumor size, tumor number, tumor differentiation and TNM stage (P<0.05).Kaplan-Meier survival curves showed that the patients with high expression of CUEDC 2 were asso-ciated with significantly shorter overall survival and recurrence-free survival than those with low CUEDC 2 expression ( P<0.05).Multivariate Cox regression analysis revealed 3 independent prognostic factors including CUEDC 2 expression, ser-um AFP and tumor number .CONCLUSION:CUEDC2 was expressed in most HCC tissues , which was relevant to tumor growth, tumor differentiation and prognosis .CUEDC2 could be a novel valuable molecular marker to predict the HCC prog-nosis.