Objective: To study optimum inclusion process conditions for Bencaosuansu. Methods: The study was carried out with orthogonal design. The process conditions were studied by determining the utilization ratio of Bencaosuansu, the oil-bearing rate and extract ratio of inclusion compound. Results: The optimum preparation conditions for inclusion were established as: Bencaosuansu: ?-CD was 1∶12, pH6, the inclusion time was for 5h. The utilization ratio of Bencaosuansu is 94.61 percent. Conclusion: The method can be used for production of ?-CD inclusion compound.

Objective:To explore the abnormalities of efficiency in resting state functional brain network in patients with paranoid schizophrenia and the correlations between efficiencies and clinical symptoms.Methods:A total of 73 patients with schizophrenia (SZ group) met with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) criteria for schizophrenia and 70 healthy controls (HC group) were included .All subjects were checked by using functional magnetic resonance imaging (fMRI), and positive and negative syndrome scale(PANSS) were used to assess the symptoms.Abnormalities of global and local efficiency of brain regions in brain functional network were analyzed by graph theory.Pearson correlation was used to analyze the correlation between the abnormal global efficiency and local efficiency of brain regions of SZ group and PANSS.SPSS 20.0 software was used for dependent-sample t-test, ANOVA test and Pearson correlation analysis. Results:Compared with the HC group, SZ group showed increased global efficiency in bilateral thalamus(left: 0.26±0.06, 0.28±0.04, t=2.03, P=0.044.right: 0.26±0.06, 0.28±0.05, t=2.08, P=0.040), right orbital part of middle frontal gyrus(0.21±0.04, 0.23±0.05, t=2.25, P=0.026), cerebellar lobule Ⅸ(0.19±0.06, 0.21±0.05, t=2.56, P=0.011) and vermis Ⅲ(0.15±0.08, 0.19±0.07, t=3.27, P=0.001), while decreased global efficiency in bilateral parahippocampal gyrus(left: 0.25±0.05, 0.22±0.05, t=-3.34, P=0.001.right: 0.27±0.04, 0.23±0.05, t=-4.96, P=0.000), superior occipital gyrus(left: 0.27±0.03, 0.26±0.03, t=-2.70, P=0.008.right: 0.27±0.02, 0.26±0.03, t=-2.73, P=0.007), superior parietal gyrus(left: 0.27±0.03, 0.26±0.05, t=-2.63, P=0.010.right: 0.27±0.03, 0.25±0.05, t=-2.76, P=0.007), paracentral lobule(left: 0.28±0.03, 0.26±0.07, t=-2.47, P=0.015.right: 0.28±0.04, 0.25±0.07, t=-3.06, P=0.003), left precental gyrus(0.28±0.04, 0.27±0.04, t=-1.98, P=0.049), left cuneus(0.26±0.04, 0.25±0.04, t=-2.08, P=0.039), left lingual gyrus(0.29±0.03, 0.28±0.03, t=-2.28, P=0.024), left middle occipital gyrus(0.29±0.03, 0.28±0.03; t=-2.74, P=0.007), left middle temporal gyrus(0.28±0.03, 0.26±0.03, t=-2.73, P=0.007), temporal pole in left middle temporal gyrus(0.20±0.06, 0.18±0.06, t=-2.59, P=0.011) and right hippocampus(0.27±0.04, 0.26±0.06, t=-2.05, P=0.042).Compared with the HC group, SZ group showed increased local efficiency in bilateral caudate nucleus(left: 0.33±0.06, 0.35±0.05, t=2.54, P=0.012.right: 0.33±0.07, 0.35±0.04, t=2.77, P=0.007) and left superior occipital gyrus(0.39±0.03, 0.40±0.02, t=2.17, P=0.031), while decreased local efficiency in bilateral parahippocampal gyrus(left: 0.35±0.04, 0.32±0.07, t=-3.16, P=0.002.right: 0.34±0.04, 0.32±0.07, t=-2.91, P=0.004), left supplementary motor area(0.36±0.02, 0.35±0.05, t=-2.01, P=0.047), left inferior parietal but supramarginal and angular gyrus(0.35±0.03, 0.34±0.05, t=-2.65, P=0.009), left cerebellar crus Ⅱ(0.37±0.03, 0.36±0.04, t=-2.01, P=0.046), lobule ⅦB(0.37±0.03, 0.35±0.07, t=-1.98, P=0.049), right posterior cingulate gyrus(0.36±0.04, 0.34±0.07, t=-2.07, P=0.041), right superior parietal gyrus(0.37±0.03, 0.36±0.05, t=-2.19, P=0.031), right precuneus(0.36±0.02, 0.35±0.04, t=-2.36, P=0.020), right paracentral lobule(0.37±0.02, 0.36±0.06, t=-2.07, P=0.041) and right temporal pole in middle temporal gyrus(0.33±0.08, 0.30±0.09, t=-2.09, P=0.038).The global efficiency of bilateral paracentral lobule and left temporal pole in middle temporal gyrus in SZ group were negatively correlated with the negative scale scores( r=-0.25, -0.25, -0.26, all P<0.05).The global efficiency of right hippocampus in SZ group was positively correlated with total scores of PANSS( r=0.23, P=0.049).The global efficiency of left middle temporal gyrus in SZ group was negatively correlated with total scores of PANSS( r=-0.23, P=0.049).The local efficiency of right paracentral lobule in SZ group was negatively correlated with the positive scale scores( r=-0.24, P=0.038). Conclusion:The brain networks of patients with first-episode paranoid schizophrenia may have regional dysfunction in the transmission efficiency and fault-tolerant ability of resting state brain functional network, and the abnormalities of efficiency may be associated with the severity of psychiatric symptoms in several brain regions.

The functional cure of hepatitis B means that patients have good clinical outcomes, which is the ideal endpoint of hepatitis B antiviral treatment. Whether chronic hepatitis B patients can achieve functional cure is related to the nature of the virus itself, such as virus species, virus replication and expression of related proteins, on the other hand, it is also related to the host body's immunity, including innate immunity and specific immunity. Immune factors play a vital role in the functional cure of hepatitis B. Antiviral drugs, including interferon, often play an antiviral role by regulating immunity. This paper reviews the relationship between hepatitis B and functional cure from the perspective of immunity, in order to provide the basis for the clinical pursuit of functional cure, hoping to provide guidance for clinical practice.

Objective:To study the predictors of postpartum hepatitis in pregnant women with chronic HBV infection.Methods:In this retrospective study, liver function and hepatitis B virology tests of pregnant women with chronic HBV infection at delivery and within 48 weeks were collected from the clinical medical system after the enrollment of eligible patients. Statistical analysis was performed on the obtained data.Results:A total of 533 pregnant women meeting the criteria were enrolled, and the average age of all patients was 29.5±3.7. A total of 408 pregnant women took antiviral drugs during pregnancy for prevention of mother-to-child transmission; 231 patients developed hepatitis within 1 year after delivery. There were significant differences in alanine transaminase (ALT), aspartate transaminase (AST), HBV DNA during delivery, hepatitis B e antigen (HBeAg) during delivery and baseline HBeAg between patients with and without hepatitis. Multivariate binary logistic regression analysis showed that HBeAg ( OR=0.19, 0.074-0.473; P<0.001), ALT ( OR=1.05, 1.021-1.071; P<0.001), albumin ( OR=0.91, 0.833-0.995; P=0.038), platelet ( OR=0.995, 0.992-0.999; P=0.01), neutrophils ( OR=0.98, 0.973-0.995; P=0.004) had significant difference. Conclusions:Baseline HBeAg and ALT are powerful predictors of postpartum hepatitis in pregnant women with chronic HBV infection.

Objective:To evaluate the relationship between the preoperative neutrophil/lymphocyte ratio(NLR) and postoperative delirium (POD)in elderly patients.Methods:Nine hundred and thirty-seven patients, undergoing elective knee or hip arthroplasty under combined spinal and epidural anesthesia, in whom Mini-Mental State Examination was completed at 1 day before operation, with Mini-Mental State Examination score≥24, were selected. Elbow venous blood samples were collected before surgery, neutrophils and lymphocytes were counted, and the ratio of neutrophils to lymphocytes was calculated.Cerebrospinal fluid (CSF) 2 ml was extracted after successful spinal-epidural puncture for measurement of preoperative amyloid beta40 (Aβ40), amyloid beta42 (Aβ42), total Tau (T-tau), and phosphorylated Tau (P-tau) by enzyme-linked immunosorbent assay. POD was assessed by Confusion Assessment Method, and the severity of POD was assessed by the Memorial Delirium Assessment Scale.The logistic regression equation was used to identify the risk factors for POD, and the mediating effect of CSF biomarkers was analyzed. Sensitivity analysis was used to test the stability of the results. The receiver operating characteristic curve was introduced, and the area under the curve was calculated to evaluate the accuracy of preoperative NLR in predicting POD.Results:A total of 853 patients were finally enrolled in this study, and 17.4% patients developed POD. Logistic regression analysis showed that the increased levels of NLR ( OR 1.141, 95% confidence interval [ CI] 1.033-1.260, P=0.010), P-tau in CSF ( OR 1.093, 95% CI 1.076-1.110, P<0.001) and T-tau in CSF( OR 1.003, 95% CI 1.001-1.005, P<0.001) were risk factors for POD, while the increased level of Aβ42 in CSF( OR 0.998, 95% CI 0.997-1.000, P=0.028) was a protective factor for POD after adjusting for multiple confounding factors. Analysis of mediating effect: T-tau and P-tau in CSF were the mediating factors in the relationship between NLR and POD with the mediating effects of 0.011 9 and 0.020 0 respectively, and the proportion of mediating effect was 46.1% and 53.1% respectively.The receiver operating characteristic curve showed that the area under the curve of NLR and combination of NLR and CSF biomarkers in predicting POD was 0.711 and 0.939 respectively. Conclusions:Increased preoperative NLR level is a risk factor for POD, and combination of NLR and CSF biomarkers shows a higher accuracy in predicting POD. T-tau and P-tau in CSF serve as the key mediators in the relationship between NLR and POD.

Objective Regional homogeneity (ReHo) and functional connectivity (FC) were used to study obsessive-compulsive disorder(OCD),and to explore the mechanism of OCD in resting state.Method Resting-state functional magnetic resonance imaging (RS-fMRI) was performed in 55 patients with OCD (OCD group) and 50 normal controls (control group) matched by sex,age,nationality and education.The data and screening abnormal brain areas were analyzed and compared by DPARSFA2.3 and Rest software in OCD group.Whole brain FC analysis was performed with abnormal brain areas as seed points.Result Compared with the control group,ReHo in right thalamus (MNI:x=9,y=-24,z=6,t=4.3217) and left superior marginal gyrus (MNI:x =-45,y =-30,z =27,t =3.6320) increased and ReHo in right caudate nucleus (MNI:x=3,y=15,z=9,t=-3.1687) decreased in obsessive-compulsive disorder group,and the difference was statistically significant(P＜0.05).Using left superior marginal gyrus,fight thalamus and right caudate nucleus as seed voxels,the whole brain FC analysis showed that there were abnormal functional connections between bilateral cerebellar foot 1/2 area and left supramarginal gyrus,right thalamus and right caudate nucleus (P＜0.05) and the left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit existed in 0CD group.Conclusion The left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1,2-right caudate nucleus-right thalamic circuit may play an important role in the mechanism of OCD.

Objective:To evaluate the relationship between preoperative levels of serum uric acid (SUA) and postoperative delirium (POD).Methods:Seven hundred and fifty patients of either sex, aged 50-90 yr, with American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective knee replacement under spinal-epidural anesthesia, were selected.Venous blood samples were collected before anesthesia and levels of SUA were determined by enzyme-coupled assay.L 3-4 was selected as the puncture space, and the cerebrospinal fluid (CSF) specimens were obtained from the subarachnoid space for determination of concentrations of β-amyloid 42, total tau (t-tau) and phosphorylated tau (p-tau) by enzyme-linked immunosorbent assay.The patients were divided into hyperuric acid group (group HS) and non-hyperuric acid group (group NS) according to clinical diagnostic criteria of hyperuricemia, and into POD group (group POD) and non-POD group (group NPOD) according to the occurrence of POD.Logistic regression was used to identify the risk factors for POD.The mediating effect of CSF biomarkers was analyzed.The efficacy of SUA and CSF biomarker concentrations in predicting POD was evaluated using the receiver operating characteristic curve. Results:A total of 699 patients were finally enrolled in the study, and the incidence of POD was 21.5%.The results of logistic regression analysis after adjusting for multiple confounding factors, such as age, sex, years of education, Mini-Mental State Examination score, smoking history, drinking history, hypertension and diabetes history, showed that increased concentrations of SUA and p-tau and t-tau in CSF were risk factors for POD ( P<0.05). The results of mediation analysis showed that the concentrations of p-tau and t-tau in CSF were the mediating factors of the relationship between SUA and POD, with mediating effects of 0.000 301 (95% confidence interval 0-0.000 152) and 0.000 236 (95% confidence interval 0-0.000 092), respectively, and the intermediary proportion were 14.9% and 11.7%, respectively.The area under the receiver operating characteristic curve of SUA in predicting POD was 0.774 ( P<0.05). Conclusions:Increased preoperative SUA is a risk factor for POD, and the accuracy of predicting POD is high, and concentrations of p-tau and t-tau in CSF are mediators of SUA affecting POD.

Objective:To investigate the distribution characteristics and related factors of HBsAb in infants born to women with chronic hepatitis B virus (HBV) infection.Methods:A total of 605 infants born to women with chronic HBV infection who met the requirements for inclusion were selected as the subjects. Information about the mother′s previous HBV infection, biochemical indicators during pregnancy, pregnancy complications, information about delivery, and hepatitis B test result after birth were collected. HBsAg and HBsAb at the age of 1 year were determined, and HBsAg and HBsAb at the age of 7 months were retrospectively collected. The factors influencing HBsAb in infants were analyzed by ordered logistic regression.Results:In 605 infants, the infection rate was about 1%. Among them, 6 infants were positive for HBsAg and HBV DNA at 7 months and 1 year of age. Uninfected infants were divided into groups according to HBsAb titers. The result showed that there were significant differences in prothrombin activity (PTA) ( χ2=11.17, P=0.01), positive rate of HBeAg ( χ2=7.87, P=0.049) and HBsAg positive rate at birth ( χ2=10.52, P=0.02) among different groups. Multivariate ordered Logistic regression analysis showed that HBsAg negative at birth was an independent protective factor for HBsAb at 7 months of age ( OR=1.564, 95% CI 1.092-2.239, P=0.015). Logistic regression analysis of HBsAb at 1 year of age showed maternal gestational diabetes mellitus ( OR=1.578, 95% CI 1.126-2.210, P=0.008), infant enhanced immunization ( OR=81.207, 95% CI 31.202-211.352, P < 0.001) and antibody level at 7 months of age ( OR=42.123, 95% CI 22.824-77.739, P < 0.001) were independently associated with HBsAb at 1 year of age. Conclusions:HBsAg negative in venous blood at birth was an independent protective factor for HBsAb at 7 months of age, and enhanced immunization was an independent protective factor for HBsAb at 1 year of age.

Objective:To analyze the clinical features of postpartum hepatitis flares in pregnant women with hepatitis B virus (HBV) infection.Methods:A retrospective study was conducted. Patients who met the enrollment criteria were included. Liver function and HBV virology tests were collected from pregnant women with chronic HBV infection at delivery, 6, 24, 36, and 48 weeks after delivery through the hospital information and test system. Additionally, antiviral therapy types and drug withdrawal times were collected. Statistical analysis was performed on all the resulting data.Results:A total of 533 pregnant women who met the inclusion criteria were included, with all patients aged (29.5±3.7) years old. A total of 408 cases received antiviral drugs during pregnancy to interrupt mother-to-child transmission. There was no significant difference in the levels of alanine aminotransferase (ALT, z ?=?-1.981, P ?=?0.048), aspartate aminotransferase (AST, z ?=?-3.956, P ?

Objective To investigate the onset of liver inflammation and related predictive factors in patients with HBeAg-positive chronic hepatitis B virus (HBV) infection who have normal alanine aminotransferase (ALT) and a high viral load. Methods A retrospective analysis was performed for the clinical data of 183 patients with HBeAg-positive chronic HBV infection who had normal ALT and a high viral load and were treated from October 2008 to May 2015, and according to the results of liver biopsy, they were divided into hepatitis group and non- hepatitis group. The t -test or Mann-Whitney U testwas used for comparison of normally distributed continuous data between groups, the chi-square test was used for comparison of categorical data. The predictive factors were analyzed by univariate binary logistic regression, the multivariate binary logistic regression was carried out by stepback method, and the cut-off values were analyzed by receiver operating characteristic curve (ROC) and Jordan index. Results There were 37 patients (20.2%) in the hepatitis group and 146 patients (79.8%) in the non-hepatitis group. Compared with the non-hepatitis group, the hepatitis group had a significantly lower proportion of male patients (45.9% vs 68.5%, χ 2 =6.508, P =0.011), a significantly higher level of aspartate aminotransferase [24 (21.25~35.55) U/L vs 21.2 (18.08~ 24.65) U/L, Z =-3.344, P =0.001], and a significantly lower log(HBsAg) value [4.4(4.28~4.49) vs 4.46(4.4~4.74), Z =-2.184, P =0.029]. Log(HBsAg) value was a predictive factor for hepatitis (odds ratio=0.077, P =0.017), and the cutoff value of HBsAg was 33884.4I U/mL. Conclusion Among the patients with HBeAg-positive chronic HBV infection who have normal ALT and a high viral load, 20.2% have liver inflammation, and HBsAg may be a predictive factor for liver inflammation.