Aim: To investigate the chemical components in Zhizidahuang decoction( ZZDHD) to reveal the possible material therapeutic basis. Methods: High performance liquid chromatography coupled with photodiode array detector and tandem mass spectrometry ( HPLC-PDA-MS/MS) was applied to simultaneously characterize the chemical components and their structures in ZZDHD. The analysis was preformed on a Lichrospher C_(18) column using a binary eluent of 0. 1% acetic acid( A) and methanol( B) mixed under the gradient mode; UV spectra were scaned from 210 nm to 480 nm; negative ESI experiments in data-dependent scan mode were performed. Results: HPLC-PDA-MS/MS chromatogram of ZZDHD was achieved. Based on UV spectral data, information of molecular weight and mass fragmentation behaviors connected with extracted ion current( EIC) chromatogram, twenty kinds of components were detected and identified, including flavonoids, anthraquinones, iridoids and other constituents. Conclusion: The method presented in this study, which combined HPLC with UV and MS, allowes the characterization of compounds in the complex herbal system even without the reference standards.

Objective To explore hypoxemia on transportation in elderly patients who underwent laparoscopic cholecystectomy(LC) under general anesthesia. Methods SPO 2 was monitered continuously during peridecannulation period, especially within the first 5 minutes in case of incidence of hypoxemia. Results 15 out of 100 cases were found to undergo hypoxemia with SPO 2≤92%. The incidence rate of hypoxemia was 15%(15/100). Conclusions It is important to monitor SPO 2 and administer oxygen inhalation continuously on transfer from operation room back to ward to prevent hypoxemia in elderly patients.

Objective To observe the effect and safety of low dose milrinone used in patients suffering from refractory heart failure and renal dysfunction. Methods Forty-two patients with refractory heart failure and renal dysfunction were divided into treatment group(21 cases ) and control group(21 cases )by random digits table. All the patients accepted a therapy of cardiac booster, diuretics and vasodilators, and treatment group also accepted the therapy of milrinone [0.375 μ g/( kg· min), 10 mg/d, for 7 days]. And then the symptom, signs, blood pressure, heart rate, heart function and renal function before and after the treatment were observed. Results The total effective rate in treatment group was 85.7%( 18/21 ) ,significantly higher than that in control group [57.1% (12/21)] (P ＜0.05＝. After treatment,the heart rate,systolic blood pressure,diastolic blood pressure,stroke volume,cardiac output and left ventricular ejection fraction in treatment group and control group improved significantly than those before treatment, and these index improved better in treatment group [(79.3 ± 12.4) beats/min vs. (85.4 ± 10.2) beats/min, ( 107.6 ± 15.4)mm Hg ( 1 mm Hg = 0.133 kPa) vs.( 119.1 ± 13.5 ) mm Hg, (60.8 ± 9.4) mm Hg vs. (65.8 ± 8.5 ) mm Hg,(66.3 ± 10.2 ) ml vs. (61.2 ± 9.3 ) ml, (5.3 ± 0.6 ) L/min vs. (4.8 ± 0.9) L/min, (56.6 ± 8.4 )% vs. (48.9 ±7.3)% ,P ＜ 0.05＝. In two groups,there were no statistical difference in renal function. Conclusions Low dose of milrinone can improve the heart function of the patients with refractory heart failure and renal dysfunction and has good renal safety.

Objective To investigate the functional changes of anastomosed vascular or neurovascular mini-muscle transfer and to provide experimental data to clinical application. Methods 32 New Zealand rabbits were operated on by anastomosed neurovascular mini-muscle transfer. In group A, 16 rabbits accepted the anastomosed vascular mini-muscle transfer. In group B, 16 rabbits accepted the anastomosed neurovascular mini-muscle transfer. The electromyography was measured 2 months and 3 months after operation. Results The amplitude of electrical muscle graph (EMG) data in the group A was (2.02±0.41)mV 2 months after operation, and (1.73±0.18) mV 3 months after operation. The EMG data in the group B was (3.90±0.52) mV 2 months after operation and (3.35±0.86) mV 3months after opera-tion. The difference between the two groups was significant (P<0.01). The EMG of anastomosed neu-rovasular mini-muscle transfer was significantly greater than that of anastomosed vasular transfer only.There was no significant difference in latent period of EMG between the two groups (P>0.05). Conclu-sions The muscle functional recovery of anastomosed neurovascular mini-muscle transfer is significant with less demage and no secondary deformity. The results suggest that this technique is worthy to apply for treating facial paralysis.

Objective To explore humor experience and its relationship with theory of mind in patients with schizophrenia. Methods sixty?one schizophrenic patients without treatment and sixty?three healthy subjects were assessed with the Humor Picture Test ( HPT) ,Humor Video Test ( HVT) and the Theory?of?Mind Picture?Se?quencing Task ( ToM?PST) . Results Compared with healthy subject in HPT,schizophrenic patients showed sig?nificantly higher non?humor picture rating score (24.41 ± 8.82 vs 28.41 ± 11.56, P<0.05),and less humor picture rating score (45.65 ± 11.49 vs 34.41 ± 13.06, P<0.05). Compared with healthy subject in HVT,schizophrenic patients also showed significantly less humor video rating score (3.56 ± 0.57 vs 2.46 ± 0.79, P<0.01) and the number of standard humorous moments (3.68 ± 1.19 vs 2.42 ± 1.40, P<0.01) and the sensitivity of standard hu?morous moments?d’(humor) score (1.11 ± 0.46 vs 0.47 ± 0.42, P<0.01). Schizophrenic patients had significant?ly less total score (39.89 ± 12.33 vs 58.76 ± 0.64, P<0.01) of ToM?PST compared to normal control. Correlation analysis showed a negative correlation between d’ ( humor) score and the Positive and Negative Syndrome Scale ( PANSS) total score ( r=-0.380, P<0.01) for the patients. There was significantly negative correlation between non?humor picture rating score and ToM?PST total score ( r=-0.316, P<0.05) ,and positive correlation between d’ (humor) score and ToM?PST total score ( r=0.400, P<0.01) in schizophrenic patient. After controlling for the PANSS total score,the correlation between d’(humor) score and ToM?PST total score remained significant. Conclusion Schizophrenic patients have poor humor experience,which is related to the impairments of theory of mind.Humor experience deficit may share a common neuropsychological base with the impairment of theory of mind.

Objective To reproduce a stable animal model of brain death in pigs, observe the change regularity of cerebral oxygen metabolism during the process of brain death, and to evaluate the significance and value of cerebral oxygen metabolism parameters for the diagnosis of brain death. Methods Twelve landrace pigs were used to create the brain death models using modified method of increasing epidural intracranial pressure (ICP). The mean arterial pressure (MAP) and ICP were monitored continuously during the process. The pigs were divided into four groups according to cerebral perfusion pressure (CPP) decreasing degree during brain death, namely CPP normal group and CPP decreasing 0%-30%, 30%-70%, and 70%-100% groups. Blood gas analysis of the external carotid artery and internal jugular vein were monitored discontinuously. The changes in cerebral oxygen metabolism parameters, including external carotid artery-internal jugular vein bulb oxygen content difference (AJDO2), internal jugular bulb-external carotid artery carbon dioxide partial pressure difference (DPCO2) and DPCO2/AJDO2 ratio, were observed. Results Brain death model were successfully reproduced in 12 experimental pigs. With MAP and ICP monitoring, the models at different stages of CPP could be repeatedly induced. The levels of AJDO2 and DPCO2 were increased gradually and then decreased, while the ratio of DPCO2/AJDO2 was constantly increased with the decrease of CPP. The level of AJDO2 in CPP decreasing 0%-30%group was significantly higher than that in CPP normal group [(5.86±1.21)% vs. (3.92±0.64)%], the levels of DPCO2 in CPP decreasing 0%-30% and CPP decreasing 30%-70% groups were significantly higher than those in CPP normal group [mmHg (1 mmHg = 0.133 kPa): 10.33±1.83, 11.48±2.32 vs. 6.11±1.43], and the ratios of DPCO2/AJDO2 in CPP decreasing 30%-70% and CPP decreasing 70%-100% groups were significantly higher than those in CPP normal group and CPP decreasing 0%-30% group (2.81±0.53, 4.12±1.07 vs. 1.57±0.64, 1.62±0.81). All the differences above were statistically significant (all P < 0.05). Conclusions With the decrease of CPP, cerebral oxygen metabolism showed a regular change during brain death. DPCO2 combined with DPCO2/AJDO2 is a reliable blood gas analysis index indicating intracranial hypoperfusion, which has certain reference value for the determination of brain death.

ObjectiveTo explore the relationship among the aggressive behavior,hostile attribution bias and childhood trauma in schizophrenic patients.Methods 135 schizophrenic patients were tested with Modified Overt Aggression Scale (MOAS),the Chinese-version of the Ambiguous Intentions Hostility Questionnaire (AIHQ-C) and Childhood Trauma Questionnaire (CTQ).According to the score of the MOAS,the patients were divided into the aggressive group ( n =58 ) and the non-aggressive group ( n =77 ).The hostile attribution bias and the childhood trauma were compared between the two groups,and correlation and hierarchical regression analysis were used to investigate the relationships of the variables.ResultsCompared with the non-aggressive patients,the aggressive patients had significantly higher AIHQ-C total hostility bias score (6.27 ± 1.20 vs 5.90 ± 0.97,P ＜0.05 ),total blame bias score (8.04 ± 1.97 vs 6.91 ± 2.10,P ＜ 0.01 ) and total aggression bias score ( 6.17 ±1.02 vs 5.59 ± 1.04,P ＜ 0.01 ).Correlation analysis showed that the MOAS score,AIHQ scores and the total score of CTQ were significantly positively correlated with each other ( r =0.171 ～ 0.350,P ＜ 0.05 ～0.01 ).Regression analysis indicated the hostile attribution bias directly predicted the aggressive behavior( β =0.342,P ＜0.05) and completely mediated the relationship between the childhood trauma and the aggressive behavior.ConclusionThe aggressive behavior in schizophrenic patients is associated with the experience of childhood trauma and the attribution style.The childhood trauma indirectly influences the aggressive behavior by the mediating of the hostile attribution bias.

OBJECTIVETo investigate the suppressive effect of resveratrol on growth of U251 human glioma cells and its correlated mechanism.

METHODU251 human glioma cells were treated with resveratrol at various concentrations, MTT assay was used to determine the inhibitory rate of cell proliferation, FCM to detect the cell apoptosis, the expressions of Bcl-2, Bcl-XL, STAT3 and CyclinD1 were analysed by immunohistochemistry and Western blot to examine the expression of Bcl-2, Bcl-XL, STAT3, CyclinD1, Caspase-3 and Bax.

RESULTAfter treatment with resveratrol, MTT assay showed the growth of U251 cells was inhibited in dose-dependent and time-dependent manners, apoptosis of cells advanced stage was built up, immunohistochemical staining displayed decreased the expression of Bcl-2, Bcl-XL, STAT3 and CyclinD1 and Western blot showed that resveratrol decreased the expression of Bcl-2, Bcl-XL, STAT3 and CyclinD1, and built up Bax and Caspase-3.

CONCLUSIONIt is possible that downregulated the expression of Bcl-2, Bcl-XL, but upregulated Bax and Caspase-3, and the indication was obviously in dose-dependent and time-dependent manners.

Apoptosis ; drug effects ; Blotting, Western ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cyclin D1 ; metabolism ; Gene Expression Regulation, Neoplastic ; drug effects ; Glioma ; drug therapy ; metabolism ; Humans ; Immunohistochemistry ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; STAT3 Transcription Factor ; metabolism ; Stilbenes ; therapeutic use ; bcl-2-Associated X Protein ; metabolism ; bcl-X Protein ; metabolism

Objective:To retrospectively analyze the relationship between patterns of local recurrence and radiotherapy target dose after adjuvant radiotherapy for the pancreatic ductal adenocarcinoma(PDAC), aiming to provide reference for exploring reasonable target and dosage.Methods:Clinical data of 138 patients with T 1-4N 0-2M 0 PDAC who underwent adjuvant radiotherapy after radical resection from April 2012 to December 2020 were analyzed retrospectively. The influencing factors of local recurrence and the correlation between local recurrence site and radiotherapy target dose were analyzed. Results:The median follow-up time was 37.2 months. The median overall survival (mOS) was 29.9 months. The 5-year OS rate was 27.4%. And the median progression-free survival (mPFS) was 13.9 months. There were 24 cases of local recurrence (17.4%), and 10 cases of local recurrence complicated with distant metastasis (7.2%). The correlation between local recurrence site and radiotherapy target dose could be evaluated in 19 patients with complete clinical data. The first local recurrence occurred near the para-aortic (Ao), the celiac axis (CA) and the superior mesenteric artery (SMA) were 8, 5 and 4 cases, respectively. The radiotherapy doses of 8 patients with local recurrence only in the PTV field were above 45 Gy. There were 8 cases of local recurrence both in and out of the PTV field, including 3 cases with dose line between 40 and 52 Gy, 2 cases with dose line between 20 and 47.5 Gy, and 3 cases with dose line between 0.5 and 52.5 Gy. There were 3 cases of local recurrence out of the PTV field, and the dose line ranged from 0 to 20 Gy.Conclusions:The local recurrence rate of PDAC after radical surgery combined with postoperative radiotherapy is low, but a small number of patients have recurrence in the high-dose range of radiation field and regional recurrence out of the field. For these patients, it may be necessary to explore a more appropriate target dose and range for adjuvant radiotherapy.

Objective:To investigate the effect of S-phase kinase-associated protein 2 (SKP2) expression level on radiosensitivity of human hepatocellular carcinoma (HCC) cells and the correlation of SKP2 expression with clinical prognosis of patients with HCC.Methods:The expression levels of SKP2 gene in liver cancer tissues and normal tissues were validated and its correlation with clinical prognosis of HCC patients was analyzed based on the TCGA database. Western blot was used to determine the SKP2 protein levels in HCC cell lines before and after radiation. CRISPR/Cas9 technology was employed to delete the promoter and first exon of SKP2 gene in PLC/PRF/5 (PLC) and Hep3B HCC cells for generating the SKP2 knockout cell lines. The difference of radiosensitivity and cell survival rate between normal (SKP2 +/ +) and SKP2 knockout (SKP2 -/ -) HCC cells was determined by using cell clonogenic assay and CCK8 kit. Results:Compared with normal tissues, the expression levels of SKP2 gene in HCC were increased based on the results of TCGA database analysis. K-M analysis showed that the HCC patients with high SKP2 expression had relatively poor prognosis. The 5-year overall survival (OS) was 34.6% in high SKP2 expression HCC patients and 50.6% in low SKP2 expression HCC patients, respectively ( HR=2.18, 95% CI=1.46-3.27, P<0.001). In vitro experiment showed that the expression levels of SKP2 were significantly increased after radiation in HCC cells. Simultaneously, deletion of SKP2 significantly increased the radiosensitivity of HCC cells. Conclusion:The expression level of SKP2 gene is increased in HCC patients, and patients with high SKP2 expression have worse prognosis than those with low expression. Radiation can upregulate the SKP2 expression levels in HCC cells, while the radiosensitivity of the cells is significantly increased after SKP2 deletion.