Objective The study aimed to investigate the best extraction process and the analgesia and anti-inflammatory properties of total flavonoids from Euphorbia prolifera. Methods Through single factor experiment and orthogonal test,factors that affect the extraction yield of total flavonoids were studied,including the extraction time,solid to liquid ratio, ethanol concentration and extraction times. The mice models of ear edema induced by xylene and twisting induced by acetic acid were used to evaluate the analgesia and anti-inflammatory effects of different extractions from Euphorbia prolifera. Results Total flavonoids were extracted by the refluxing method,and the optimum conditions were extracting for 3 hours,solid to liquid ratio of 1:30,ethanol content of 60% in the solvent,and processed for 2 times. The highest extraction yield of total flavonoids from Euphorbia prolifera was 5. 63%. The ethanol,ethyl acetate and n-butanol extracts decreased twisting and ear swelling in mice. Conclusion The extraction for total flavonoids from Euphorbia prolifera is simple,efficient and reproducible. The ethanol,ethyl acetate and n-butanol extracts of total flavonoids have obvious analgesia and anti-inflammatory effects.

Objective:To study the effect of PRR13 expression and the sensitivity of colorectal cancer cells to oxaliplatin, as well as the effect of PRR13 expression on the apoptosis rate of colorectal cancer cells under the action of oxaliplatin. Methods:Two colorectal cancer cell lines(SW620, SW480) were screened from the colorectal cancer cell lines commonly used by ATCC. Lentiviral vectors were used for cell transfection to construct a PRR13-silent colorectal cancer cell model. MTT oxaliplatin drug sensitivity experiments were conducted and compared. In this study, a colorectal cell model stably transfected with shRNA lentivirus containing the silenced PRR13 sequence was defined as the silent group, and a colorectal cell model stably transfected with empty vector of lentivirus was defined as the control group. After silencing the PRR13, the colorectal cancer cells changed the IC 50 of oxaliplatin, and then used a double staining flow cytometry apoptosis experiment to compare the expression of PRR13 and the rate of apoptosis of colorectal cancer cells under the action of oxaliplatin relationship. The measurement data were expressed as mean±standard deviation ( Mean± SD), and the comparison between groups used independent sample t test. The count data were expressed as percentage (%), and the comparison between groups used chi-square test. Results:The IC 50 of the same cell model decreased significantly with time. At the same time point, the IC 50 of the silent group was significantly lower than that of the control group. In the same cell model with the same concentration, the apoptosis rate of the silent group was significantly higher than that of the control group (SW620 silent group 22.5% vs SW620 control group 11.35%, SW480 silent group 13.63% vs SW480 control group 4.59%), the ratio of viable cells was significantly lower than that of the control cell model (SW620 silent group 76.0% vs SW620 control group 87.2%, SW480 silent group 74.5% vs SW480 control group 89.3%). Conclusion:Silencing the PRR13 can reduce the sensitivity of cells to oxaliplatin and reduce the drug resistance of oxaliplatin and the effect of treatment is more significant.

Objective: To explore the association between screen time and autistic behavior in infants and young children, and to provide clues to the mechanism for further research. Methods: The primary caregivers of 22 586 children in the district of Longhua in Shenzhen were surveyed. Demographic data and screen time were collected using a selfdisigned questionnaire, and children’s autistic behavior was assessed using the child Autism Behavior Checklist(ABC).The chisquare test was used to analyze the correlation between demographic data and screen time, demographic data and autistic behavior, and screen time and autistic behavior. Unconditioned Logistic regression model was used to study the effect of electronic screen exposure on autistic behavior. Results: The amount of screen time spent in infancy increased with age. For children ages 0-,1- and 2-3 years, 60.1%, 35.0% and 20.2% respectively did not watch TV, and 74.0%, 52.6% and 26.8% respectively did not watch the new generation of electronic products. The positive rate of ABC scale screening was 5.3%, including 6.0% male and 4.4% female, OR(95%CI)=1.37 (1.23-1.54).There was correlations between screen time and autistic behavior in infants at all ages (P<0.05).Screen time increased the risk of autistic behavior in younger age groups than in older age groups. For 1 year olds with moderate screen exposure, increased screen exposure at 2 to 3 years of age was associated with an increased risk of autistic behaviors, while reduced screen exposure at 2 to 3 years of age was associated with a lower risk of autistic behaviors(OR=2.14, 2.77, P<0.05). The higher daily screen time at 0-3 years old was, the greater risk of autistic behaviors. Compared with the noncontact electronic screen group, the OR values of the daily TV screens in the ≥1 h/d group and the ＜1 h/d group were 2.01 and 2.45, respectively (P＜0.05).Compared with the non-contact electronic screen group, the OR values of the screens exposed to the new generation of electronic products in the ≥1 h/d group and the ＜1 h/d group were 2.01 and 2.33, respectively(P<0.05).The higher the time of single exposure to electronic screen between 0 and 3 years old, the greater the risk of autistic behaviors. The OR values were 2.50, 1.79 and 1.47 when ≥1 h/time, 0.5-1 h/time and 15-30 min/time compared with <15 min/time（P<0.05）. Conclusion Early exposure to electronic screens in infants, excessive total daily exposure to electronic screens, and excessive screen time each time are all likely to increase autistic behavior. Therefore, it is suggested that children under 2 years old should not be exposed to electronic screens every day. Children aged 2-3 years old who are exposed to electronic screens＜0.5 h/d and whose screen time <15 min might not significantly increase autistic behaviors.

Objective:To explore the application effect of the intelligent interactive health education model in the health management of the smokers with high-risk of chronic obstructive pulmonary disease (COPD).Methods:From September 2019 to January 2020, 72 smokers with high-risk of COPD were recruited from Health Management Center, the First Affiliated Hospital of Nanjing Medical Universit y. The subjects were randomly divided into traditional group (35 cases) and intelligent group (37 cases) according to the intervention model. The traditional group used the method of mailing health education materials, while the intelligent group sent health education materials with the help of mobile intelligent platform for interactive feedback and intervention. After 12 weeks of intervention, the subjects′ nicotine dependence, international physical activity, population satisfaction, time consumption for follow-up and other indicators were compared. Results:After the intervention, the score of nicotine dependence in the intelligent group was lower than that in the traditional group [(1.86±1.48) vs (3.77±1.66), P<0.05], the number of smoking cessation cases was more than that in the traditional group (11 vs 1, P<0.05), the number of cases with significant improvement in the score of international physical strength scale was significantly improved than that in the traditional group (15 vs 0, P<0.01), and the satisfaction was higher than that in the traditional group (97.30% vs 42.85%, P<0.01), and the time consumption was less than that in the traditional group [(18.03±2.96) vs (25.14±2.64) min, P<0.01]. Conclusion:The intelligent interactive health education model can improve the health education effect of the smokers with high risk of developing COPD, and improve the health behavior of the population.

Objective To analyze the concordance of KRAS, NRAS, BRAF and PIK3CA gene mutations detected in plasma and matched tumor tissues in colorectal cancer patients, in order to provide good evidences to support plasma could be a potential surrogate of tumor tissue for gene mutation test. Methods One hundred and seventy?five cases of colorectal cancer were collected at the First Hospital of Jilin University, from October 2016 to October 2017.There were 101 males and 74 females, their ages ranged from 28 to 85 years,with median age of 59 years. The KRAS, NRAS, BRAF and PIK3CA gene mutations in the plasma and paired tumor specimens of all patients were detected by next generation sequencing. Results The results of tissue samples test were gold standard. Comparison of the four genes showed that concordance rates between plasma and tissue samples were 81.1%(Kappa=0.543), 99.4%(Kappa=0.886), 99.4% (Kappa=0.886) and 97.7%(Kappa=0.714) respectively for KRAS, NRAS, BRAF and PIK3CA. The plasma detection rates of these genes were related to tumor stage(P=0.001), but not to gender(P=0.468) and age(P=1.000) of patients. Conclusions The study shows a high concordance of KRAS, NRAS, BRAF and PIK3CA gene mutations in plasma against mutation status in tumor tissue. In colorectal cancer, tumor tissue remains the best specimen for gene detection. However, patients from tumor tissue specimens cannot be obtained, especially those with advanced metastases, plasma can be used instead of tissue to detect the mutation status of KRAS, NRAS, BRAF and PIK3CA to guide targeted therapy.

Objective To observe the clinical efficacy of Wenyang Huayin Prescription(cooked Aconiti Lateralis Radix Praeparata,Cinnamomi Ramulus,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Poria,Descurainiae Semen Lepidii Semen,etc.)combined with conventional western medicine in the treatment of elderly patients with chronic heart failure(CHF).Methods A total of 120 elderly CHF patients with fluid retention due to yang deficiency syndrome who were treated in People's Hospital of Chenghai District from December 2021 to December 2022 were selected as the research objects.They were randomly divided into control group and observation group,with 60 cases in each group.The control group was given conventional western medicine treatment,and the observation group was treated with Wenyang Huayin Prescription on the basis of the treatment of the control group.The course of treatment was four weeks.The indexes of the two groups were observed before and after treatment:(1)TCM syndrome scores;(2)serum levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6);(3)left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD);(4)6-minute walking distance.The clinical efficacy and safety of the two groups were compared.Results After treatment,(1)the scores of TCM syndromes in the two groups were significantly lower than those before treatment(P＜0.05),and the scores in the observation group were significantly lower than those in the control group(P＜0.05).(2)The levels of serum hs-CRP,TNF-α,IL-6 and NT-proBNP in the two groups were significantly lower than those before treatment(P＜0.05),and the levels in the observation group were significantly lower than those in the control group(P＜0.05).(3)The levels of LVEF in the two groups were significantly higher than those before treatment(P＜0.05),and the levels of LVEDD were significantly lower than those before treatment(P＜0.05).The level of LVEF in the observation group was significantly higher than that in the control group(P＜0.05),and the level of LVEDD was significantly lower than that in the control group(P＜0.05).(4)The 6-minute walking distance in the two groups was significantly increased when compared with that before treatment(P＜0.05),and the increase in the observation group was significantly greater than that in the control group(P＜0.05).(5)The total effective rate of the observation group(96.67%)was significantly higher than that of the control group(86.67%)(P＜0.05);the total incidence of adverse reactions in the observation group(1.67%)was significantly lower than that in the control group(11.67%)(P＜0.05).Conclusion Wenyang Huayin Prescription combined with conventional western medicine treatment can effectively reduce the TCM syndrome score of elderly CHF patients with fluid retention due to yang deficiency syndrome,improve clinical symptoms and cardiac function,and reduce the body's inflammatory response.The clinical efficacy is superior to that of western medicine alone,and the safety is relatively high.

Objective To determine the utility of computed tomographic (CT) enteroclysis for characterization of the status of the anastomotic site in patients with Crohn's disease (CD) who have previously undergone ileocolic resection. Methods Totally 31 CD patients who had previously undergone ileocolic resection were enrolled in the study. After having been orally administered with isosmotic mannitol, the patients received CT scanning including plain scan, arterial phase scan, and portal venous phase scan. The abnormal CT findings were analyzed based on portal venous phase images. CT enteroclysis findings in 31 patients were evaluated by two radiologists in consensus. Endoscopic findings, histopathologic findings, and/or the Crohn's disease activity index (CDAI) were used as the reference criteria. Associations between CT enteroclysis findings and anastomotic site status were assessed. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of CT enteroclysis for the diagnosis of normal anastomosis versus anastomotic recurrence were estimated. Results Twenty-six cases and 5 cases were diagnosed as disease recurrence and normal anastomosis, respectively. In the disease recurrence group, 11 patients (42%) had lymphadenopathy (diameter＞ 1 cm) and 8 patients (31%) had peri-anastomotic fistulas, which were absent in normal anastomosis group, but the difference was not significant Anastomotic wall thickening more than 6 mm, marked mucosal enhancement, stratification, and peri-anastomotic stranding were found in 16 (62%), 19 (73%), 14 (54%), and 20 (77%) cases, respectively, in disease recurrence group, which were absent in normal anastomosis group ( all P ＜ 0.05 ). When the diagnosis of anastomotic recurrence was based on more than two of the following six variables, including lymphadenopathy, peri-anastomotic fistulas, anastomotic wall thickening more than 6 mm, marked mucosal enhancement, stratification, and peri-anastomotic stranding, its sensitivity, specificity, postive predictive value, negative predictive value, and accuracy yielded 88%, 100%, 100%, 63%, and 90%, respectively. The diagnostic accuracy of anostomotic stenosis with CT was only 53%. Conclusion CT enteroclysis yields objective and relatively specific morphologic criteria that help differentiate between recurrent disease and normal at the anastomotic site after ileocolic resection for CD.

Objective To evaluate the optimal indications for the ambulatory laparoscopic cholecystectomy (ALC).Methods From Jan.2016 to Sep.2018,2277 case who underwent laparoscopic cholecystectomies were performed in Beijing Friendship Hospital,Capital Medical University,including 1072 cases of ALC (ALC group) and 835 cases of overnight laparoscopic cholecystectomy (OLC group).Indications including age,diagnosis,comorbidity and ASA score,and outcomes including operative time,analgesic,unplanned readmission and hospital cost were compared between ALC group and OLC group.Statistical analysis was conducted by the software of SPSS 20.0.Results There were no differences in the operative time [(42.6 ± 12.4) min vs.(48.7 ±20.3) min,P =0.326] and unplanned readmission (6/1072 vs.3/835,P =0.526).The examination cost [(1 667.10 ± 461.69) vs (3 156.44 ± 884.90)] and hospital cost (8 881.69 ± 1 954.34 vs.12 149.79 ± 3 476.59) was significant lower in ALC group,and the differences were statistically significant (P ＜ 0.01).Conclusions The comorbidities were not absolute exclusion criterion for ALC.More patients could be treated by ALC if the preoperative assessment streamlining in outpatient clinic was more improved.

Objective To construct the growth percentile curves of weight-,length/height-,head circumference and BMI for 1 to 4 year-olds who had been breastfed in urban areas.Methods Data was from the longitudinal study on 1 025 breastfed children aged 1 to 4 years,in 8 urban areas during 2008-2012.MLwiN2.25 was selected to construct the multi-level models of weight-for-age,length for-age,head circumference-for-age and BMI-for-age.The models included many growth relevant factors including gender,age,family and social demographic characteristics,perinatal factors,parent biological characteristics,dietary patterns and diseases of childen.Based on these models,predicted values (P3,P15,P50,Ps5,P97) were estimated to fit the percentiles reference curves.Results The percentiles reference curves of weight-,length/height,head circumferenceand BMI-for-age for the 1-4 year-olds who had been breastfed in the urban areas were developed.Differences of all the indicators between boys and girls were statistically significant (P＜0.001).Weight,length/height,head circumference and BMI were higher in boys than those in girls,with an average differences as 0.56-0.76 kg,0.89-1.12 cm,0.64-0.91 cm and 0.31-0.52 kg/m2.Conclusion The percentiles reference curves on growth,constructed by the longitudinal observational data and scientific method,were important in reflecting the development ofbreastfed children in urban areas.

Objective: To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People′s Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood. Method: Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales. Result: In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6. Conclusion The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.