Objective: To study the mechanism of Heshi-Gejiugao on the nerve endocrine immune network in the treatment of perimenopausal syndrome. Methods: A total of 100 patients with perimenopausal syndrome were randomly divided into treatment group and control group, 50 cases in each group. The control group was only given general treatment, while the treatment group was treated with Heshi-Gejiugao on the basis of general treatment for 30 days. The clinical efficacy, Kupperman score, nerve, endocrine and immune related indexes of the two groups before and after treatment were observed. Results: The total effective rate was 96.0% (48/50) in the treatment group and 50.0% (25/50) in the control group. There was significant difference between the two groups (χ²=37.639, P<0.01). The Kupperman score (17.52 ± 2.73 vs. 24.22 ± 6.87, t=6.409) in the treatment group was significantly lower than that in the control group (P<0.01). After treatment, NE (1 878.08 ± 931.57 ng/m vs. 1 278.43 ± 866.32 ng/ml, t=3.331), DA (1 568.56 ± 597.15 ng/ml vs. 1 183.62 ± 798.72 ng/ml, t=2.729) in the treatment group were significantly higher than those in the control group (P<0.05); E₂ (42.12 ± 9.77 pg/ml vs. 35.91 ± 12.55 pg/ml, t=2.761), FSH (62.70 ± 15.96 mIU/ml vs. 72.67 ± 30.18 mIU/ml, t=2.065), LH (33.88 ± 12.18 mIU/ml vs. 42.93 ± 9.83 mIU/ml, t=4.089) were significantly lower than those of the control group (P<0.05). CD3⁺ (1 087.34/μl ± 432.19/μl vs. 918.27/μl ± 199.72/μl, t=2.511), CD4⁺ (738.16/μl ± 326.75/μl vs. 588.43/μl ± 212.55/μl, t=2.716) and CD4/CD8 (1.87 ± 0.56 vs. 1.16 ± 0.55), t=6.483) were significantly higher than those of the control group (P<0.05); CD8⁺ (788.32/μl ± 214.56/μl vs. 976.37/μl ± 318.62/μl, t=3.462) was significantly lower than that of the control group (P<0.05). Conclusions Heshi-Gejiugao can reduce the symptoms and improve the quality of life by regulating the multi target and multi direction of the neuroendocrine immune network of perimenopausal patients.

Objective To study the effects of single nucleotide polymorphisms (SNP) in Plasminogen activator inhibitor 1 (PAI-1) on breast cancer susceptibility and patients' prognosis among a Chinese Han women population.Methods Six tag SNP (tSNP) of PAI-1 were selected according to HapMap CHB population,and TaqMan realtime PCR method was used to genotype the 6 tSNP in 1 160 breast cancer cases and 1 318 age-matched controls among Chinese Han women.Haplotypes and diplotypes were inferred according to genotyping data and linkage disequilibrium.Finally,the associations of tSNP,haplotypes and diphypes with breast cancer susceptibility and patients' prognosis were analyzed.Results Regarding to breast cancer susceptibility,for rs6090 (G ＞ A),AA genotype carriers had 3.79 times higher risk of develoPing breast cancer (OR =4.79,95％ CI =1.01-22.64,P =0.048 0) than GG or GA genotype carriers.For rs2227672 (G ＞ T),TT genotype carriers had 1.52 times higher breast cancer risk than GG or GT genotype carriers (OR =2.52,95％ CI =1.26-5.01,P =0.008 6).Regarding to breast cancer prognosis,women who carried rs2227692 (C ＞ T) CT genotype had 46％ lower risk of developing recurrence,metastasis or death than CC genotype carriers (HR =0.54,95％ CI =0.30-0.97,P =0.040 4).Using stratified association analysis,among BMI ＜ 23 patients,those women who carried AA genotype of rs2227631 (G ＞ A) had 3.99 times higher risk of developing the events (recurrence,metastasis or death) than GG or GA genotype carriers (HR =4.99,95％ CI =1.66-15.02,P =0.004 2).Among HER2 positive patients,those women who carried AA genotype of rs2227667 (G ＞ A) had 2.98 times higher risk of developing the events (recurrence,metastasis or death) than GG or GA genotype carriers (HR =3.98,95％ CI =1.47-10.80,P =0.006 7).Among patients with tumors ＞ 2 cm,those women who carried rs2227692 (C ＞ T) CT or TT genotype had 51％ lower risk of developing the events (recurrence,metastasis or death) than CC genotype carriers (HR =0.49,95％ CI =0.27-0.88,P =0.017 0).Conclusions The study indicates that single nucleotide polymorphisms in PAI-1 may affect breast cancer susceptibility and survival in Chinese Han women.The study may contribute to individualized evaluation of breast cancer risk and patients' prognosis if these data are validated in some other Chinese Han populations.

Objective? To explore the effect of rehabilitation nursing based on 5E concept in patients after SuperPath minimally invasive total hip replacemen(t THR). Methods? From February 2016 to February 2018, 194 patients who underwent THR through SuperPath approach in Huzhou Central Hospital of Zhejiang Province were selected as the study subjects. The patients were randomly divided into observation group (n=97) and control group by coin flipping method. The control group was given routine nursing care while the observation group was given the rehabilitation nursing based on 5E concept on the basis of that in the control group. The degree of pain, hip function score, incidence of complications and compliance of functional exercise were compared between the two groups. Results? The Harris score of the patients in the observation group was (65.25±5.29) at 1 month, (87.69±6.47) at 3 months and (93.85±8.66) at 6 months after operation, while that of the control group was (55.84±4.14), (77.48±5.89), (82.45±7.69). There were significant differences between the two groups (t=13.767, 11.511, 9.465;P＜ 0.05). The incidence of postoperative complications was 4.12% (4/97) in the observation group and 27.84% (27/97) in the control group (χ2=20.310, P＜ 0.05). The total compliance rate of functional exercise was 95.88% (93/97) in the observation group and 87.63% (85/97) in the control group, the difference was statistically significant (χ2=4.359,P＜ 0.05). The nursing satisfaction of patients in the observation group was 96.91% (94/97) and 81.44% (79/97) in the control group. The difference was statistically significant (χ2=12.015,P＜0.05). Conclusions? The application of comprehensive rehabilitation nursing based on 5E concept in SuperPath minimally invasive THR can effectively promote the recovery of hip function, reduce the occurrence of complications after operation, enhance the compliance of patients with functional exercise, and significantly improve the satisfaction of patients with nursing.

Objective To evaluate the etiology,epidemiological characteristics,clinical diagnosis,and outcomes of hospitalized patients with AKI in Xinjiang,analyzing the risk factors of their clinical prognosis.Methods A multicenter retrospective survey was conducted,investigating adult patients admitted to four hospitals in Xinjiang in January and July 2013.Patients with AKI were screened out based on KDIGO's inclusion and exclusion criteria.Clinical variables of patients with AKI including demographics,clinical data,laboratory tests,treatment measures and prognosis were collected.Results Among 32,157 adult hospitalized patients,there were 722 AKI patients.Excluding those with incomplete data,719 patients were enrolled in this study.The detection rate of AKI was 2.25％ (722 of 32,157) by KDIGO criteria.The main cause for AKI was pre-renal injury,led mainly by cardiac output,low blood volume,and the use of nephrotoxic drugs.The non-recognition rate of AKI was 72.4％ (407/557).Multivariate binary logistic regression analysis showed that AKI stage,peripheral vasodilation and renal parenchyma were protective factors of the omission diagnosis.In the short-term prognostic analysis,the overall mortality rate was 12.8％(92/719).Among the 323 patients with AKI who survived discharge,43.7％(141) had renal function recovery;40.2％(130) did not fully recover their renal function but ceased maintenance dialysis;16.4％ (53) were still on dialysis at discharge.Multivariate Cox regression model suggested that DIC,shock and department of obstetrics were independent risk factors for death during hospitalization of AKI.In addition,the risk of death for AKI from department of obstetrics and gynecology patients was higher than that of other departments.Conclusions The most common reason for AKI in hospitalized patients in Xinjiang was pre-renal injury.The main risk factors were low cardiac output and low blood volume.The omission diagnosis of AKI was serious;AKI stage,peripheral vasodilation and renal parenchymal injury however were its protective factors.Poor-DIC,shock,hospitalization in obstetrics were independent risk factors for death in patients with AKI.

Deep brain stimulation(DBS),including optical stimulation and electrical stimulation,has been demonstrated considerable value in exploring pathological brain activity and developing treatments for neural disorders.Advances in DBS microsystems based on implantable microelectrode array(MEA)probes have opened up new opportunities for closed-loop DBS(CL-DBS)in situ.This technology can be used to detect damaged brain circuits and test the therapeutic potential for modulating the output of these circuits in a variety of diseases simultaneously.Despite the success and rapid utilization of MEA probe-based CL-DBS microsystems,key challenges,including excessive wired communication,need to be urgently resolved.In this review,we considered recent advances in MEA probe-based wireless CL-DBS microsystems and outlined the major issues and promising prospects in this field.This technology has the potential to offer novel therapeutic options for psychiatric disorders in the future.