Objective To study the effect of antipsychotic drugs combined with psychological intervention on the elderly patients with acute mental disorders after surgery operation.Methods 100 cases of elderly male patients undergoing surgery in our hospital from January 2015 to December 2016 as the object of study in the course of the study,were randomly divided into control group and experimental group,with 50 cases in each group.The control group received routine care,antipsychotic drug combined with psychological nursing intervention for patients in the experimental group,focusing on the psychological status of patients,strengthen exchanges and communication with patients,patients with heart to eliminate negative emotions,help patients recover as soon as possible.The anxiety and depression of the experimental group and the control group were compared and analyzed.Results After the corresponding nursing,the experimental group of patients with anxiety self rating scale and self rating Depression Scale score was significantly better than before nursing, the difference was statistically significant(P<0.05).The self rating depression scale of the experimental group was(44.23±3.78),and the self rating Anxiety Scale score was(42.35±5.98).In the control group,the depression score was(48.73±2.53),and the anxiety score was(45.94±4.92).The anxiety score and depression score of the experimental group were significantly better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Antipsychotic drugs combined with psychological intervention can help the elderly male surgical acute mental disorders recovered to a certain extent,ease the patients with depression and anxiety,with further clinical promotion and application significance.

Objective To investigate the effects of Rho GTPase expression,actin cytoskeleton re- organization and cell migration in hepatic stellate cells after transform growth factor(TGF)?_1 stimulated. Methods Primary rat hepatic stellate cells were isolated and cultured.A Transwell Chamber system was used to observe the changes of serum starved HSCs haptotactic migration (direct stimulation) and chem- otactie migration(indirect stimulation) after different concentration of TGF?_1 treatment.Changes in ac- tin cytoskeletal organization were visualized by fluorescence staining using FITC labeled phalloidin and fluorescence images were recorded using confocal microscopy.The activation of GTP-loaded GTPases were evaluated by GST pull-down assays with GST-fusion proteins of GTPase hinging domains of differ- ent effectors for Rho GTPases.Results TGF?_1 treatment of hepatic stellate cells resulted in the en- hancement of migration in response to haptotactic and chemotactic stimuli,especially after 5ng/ml TGF?_1 stimulation(haptotactic migration cells :130.90?7.64 vs 102.93?1.01,P＜0.05;chemotactie migration cells:205.17?10.78 vs 102.93?1.01,P＜0.05).Serum-starved,untreated cells had a rounded-up morphology.Stimulation of hepatic stellate cells with 5 ng/ml TGF?_1 induced a rapid mor- phological change concomitant with a robust reorganization of actin cytoskeleton.Five minutes after TGF?_1 stimulation,the cells flattened out and the formation of lamellipodia occurred.Five minutes after TGF?_1 was added,stress fibers became visible,and after 15-30 minutes,the cells became well spread with fully developed stress fibers.TGF?_1 stimulation did not alter the amount of GTP-bound Racl.In contrast,Cdc42 and RhoA GTPase activity was significantly augmented after more than 5ng/ml TGF?_1 stimulation(GTP-Cdc42:0.273?0.024 vs 0.176?0.001,P＜0.05;GTP-RhoA:0.176?0.005 vs 0.096?0.004,P＜0.05).Conclusion The stimulation of TGF?_1 can induce the actin cytoskeleton re- organization,which appears to be mediated through the activity of the Rho GTPases signaling pathway. The ability of TGF?_1 to trigger activation of Cdc42 and RhoA GTPase along with actin cytoskeleton reor- ganization might well play a crucial role in hepatic stellate cells migration.

Objective To study the influence of serum containing Fuzheng Toudu Qudu Recipe, a Chinese formula with the actions of supporting healthy qi to expel and remove toxicity, on serum levels of interleukin 2 (IL-2) and soluble interleukin 2 receptor (sIL-2R) at different stages of CD34+derived dendritic cells (DC) of patients with minimal residual disease of myelogenous leukemia ( MRD-L) , and to explore the biological mechanism of Fuzheng Toudu Qudu Recipe in promoting CD34+ to transform into DC in MRD-L patients. Methods Bone marrow mononuclear cells ( BMMC) were separated from the bone marrow of acute myeloid leukemia patients at complete remission stage by using Ficoll centrifugation. CD34+ cells were isolated by using immuno-magnetic mircobeads method, and then were cultured with various concentrations of Chinese medicine medicated serum and cytokines in vitro for the induction of DC. The morphologic characteristics of DC were observed with the inverted phase contrast microscope, and the expression levels of DC surface molecules such as CD83, CD80, CD86, CD1a and HLA-DR were detected by using flow cytometry. On culturing day 0, 6 and 9, serum levels of IL-2 and sIL-2R of each group were measured by enzyme-linked immunosorbent assay ( ELISA). Results ( 1) Chinese medicine medicated serum combined with cytokines was effective on promoting CD34+ to differentiate into DC with typical morphology, and inducing DC to have high expression of CD80, CD83, CD86 and HLA-DR, which differed from those in fetal calf serum (FCS) group and blank rabbit serum group (P<0.01). Middle- and low-dose combination groups increased expression of CD1a, which differed from high-dose combination group and cytokines group ( P<0.01). ( 2) Content of IL-2 in combination groups was higher than that in blank rabbit serum group on culturing day 0. In the combination groups, IL-2 was higher on culturing day 6 and 9 than that on culturing day 0. Middle and high-dose combination groups had higher IL-2 content on culturing day 9 than on culturing day 6 ( P<0.05 or P<0.01). At the same time point, combination groups had higher IL-2 content than the blank rabbit serum group (P<0.05 or P<0.01). (3) Content of sIL-2R in the combination groups was lower than that in blank rabbit serum group on culturing day 0. In the combination groups, sIL-2R was lower on culturing day 9 than that on culturing day 0 and 6 ( P<0.01) . High-dose combination group had lower sIL-2R content on culturing day 6 than that on culturing day 0 (P<0.05), and the difference of sIL-2R in other groups was insignicant between on culturing day 6 and on culturing day 0 ( P>0.05) . At the same time point, combination groups had lower IL-2 content than the blank rabbit serum group (P<0.05 or P<0.01). Conclusion Fuzheng Toudu Qudu Recipe is effective on increasing serum content of IL-2 and reducing sIL-2R content, and the changes of cytokine contents are more obvious along with the maturity of DC, which indicates that the recipe plays positive effect in the process of promoting CD34+cells to differentiate into DC.

Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Objective To investigate the expression of glucagon-like peptide-1 receptor (GLP-1R) of skeletal muscle cells and the changes of skeletal muscle microstructure of diabetic rats, and to explore the relationship between the expressions of GLP-1R and insulin resistance in skeletal muscle. Methods Male Wistar rats were divided into two groups, normal glucose tolerance ( NT, n =25 ) , diabetes group ( DM group, n=30), the methods of creating diabetes model were used high-sugar high-fat diet and low-dose in-traperitoneal injection of streptozotocin. Immunohistochemical methods was used to detect the expression of GLP-1R in the muscle cells. The number of GLP-1R positive cells in the muscle of two groups was observed and compared. The relationship was analyzed between the homeostasis model assessment insulin resistance (HOMA-IR) and the number of GLP-1R positive cells. Results ⑴Compared to the NT group, the num-ber of GLP-1R positive cells in muscle of DM group was decreased (P<0. 05); ⑵ Compared to the NT group, HOMA-IR was increased in DM group (P<0. 05);⑶ Pearson correlation analysis showed that the percentage of GLP-1R positive cells expressed in rat skeletal muscle was negatively correlated with HOMA-IR (r= -0. 538, P<0. 01). Conclusions The expression of GLP-1R positive cells was decreased in the skeletal muscle of diabetic rats, insulin resistance increased. Therefore, the expression of GLP-1R on skele-tal muscle cells may promote the development of insulin resistance and diabetes mellitus.

Objective: To establish the Wistar rat model of acute diquat poisoning and observe the pathological damage of main target organs. Methods: Thirty-six Wistar rats were randomly divided into six groups (n=6) , including one normal saline control group and five treatment groups which were separately given single-dose of intragastric administration at the doses of 46.2 mg/kg, 77.0 mg/kg, 115.5 mg/kg, 231.0 mg/kg and 346.5 mg/kg. The pathological changes of lung, liver and kidney were observed by hematoxylin and eosin (HE) and Masson staining. The optimal dose was determined according to the general situation and pathological changes. Thirty-six Wistar rats were randomly divided into five treatment groups and one normal saline control group. Treatment groups were given single-dose of intragastric administration according to the optimal dose. The rats were sacrificed at 1st, 3rd, 7th, 11th and 14th day after exposed, respectively. The activity of serum glutamic-pyruvic transaminase (ALT) and glutamic-oxalacetic transaminase (AST) were measured by chemical colorimetry. The pathological changes of lung, liver and kidney were observed by HE and Masson staining. Results: According to 14 d survival rate, the toxic symptoms and pathological changes, 115.50 mg/kg was determined the best dose. Given single-dose of intragastric administration at the doses of 115.50 mg/kg, it was found that the serum AST and ALT activity of rats on the first and third day of exposure was significant higher than those in control group. The results of pathological examination exhibited that in 115.50 mg/kg group, the pathological changes of lung, liver and kidney began to appear on the first day of exposure, the pathological changes were the most serious on the third day, and then gradually alleviated. On the 14th day, the alveolar septum was slightly widened, with inflammatory cell infiltration, local alveolar cavity became narrow, atrophy, peripheral alveolar compensation, bronchi and alveolar septum collagen fiber proliferation; The local renal tubular epithelial cells were enlarged and necrotic; the central vein surrounding hepatic cells showed vacuolar degeneration with punctate necrosis. Conclusion The rat model of acute diquat poisoning can be successfully induced by single-dose of intragastric administration. The condition of wistar rats and the pathological damage of the main target organs could be observed during the whole course of 115.50 mg/kg administration.

Objective:To systematically evaluate the efficacy and safety between neoadjuvant chemoradiotherapy followed by surgery and immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer.Methods:Literature review was performed from PubMed, Embase, Cochrane Library, Web of Science, CBM, Wanfang, CNKI and VIP from the inception date to February, 2020 using the key words including "pancreatic neoplasm, pancreatic cancer, surgery, preoperative chemoradiotherapy, neoadjuvant chemoradiotherapy" in both English and Chinese. The randomized controlled clinical trials (RCTs) of neoadjuvant chemoradiotherapy followed by surgery versus immediate surgery in the treatment of resectable and borderline resectable pancreatic cancer were searches. Literature screening, data extraction and estimation of the risk of bias were independently conducted by two researchers. The HR and 95% CI were used for estimating the overall survival time. The R 0 resection rate, overall incidence of postoperative complications, and mortality rate throughout treatment were assessed by the RR and 95% CI. The heterogeneity of the studies was analyzed using the I2 test. Results:A total of 4 RCTs were included. Among 400 patients, 197 cases were assigned into the neoadjuvant chemoradiotherapy combined with surgery group and 203 in the immediate surgery group. The results of Meta-analysis showed that patients in the neoadjuvant chemoradiotherapy followed by surgery group obtained longer overall survival ( HR=0.76, 95% CI: 0.60-0.97, P=0.03) and higher R 0 resection rate ( RR=1.72, 95% CI: 1.40-2.13, P<0.01). Besides, the overall incidence of postoperative complications ( RR=1.02, 95% CI: 0.73-1.43, P=0.90) and mortality rate throughout treatment ( RR=1.19, 95% CI: 0.48-2.93, P=0.71) did not significantly differ between two groups. Conclusions:During the treatment of resectable or borderline resectable pancreatic cancer, neoadjuvant chemoradiotherapy followed by surgery may bring more survival benefits than immediate surgery and does not increase the incidence of postoperative complications and mortality rate throughout treatment. Therefore, neoadjuvant chemoradiotherapy followed by surgery can be used as a recommended treatment for patients with resectable or borderline resectable pancreatic cancer.

Objective:To investigate the current situation of emergency medical service (EMS) system and its effect on treatment of the acute stage and short- and long-term prognosis in patients with acute myocardial infarction in Hebei province.Methods:Totally 2 961 patients with acute myocardial infarction who were admitted to major tertiary and some representative secondary hospitals in Hebei province from January 2016 to December 2016 were collected. According to the pattern of arriving hospital, all the patients were divided into the EMS group and self-transport group. The general conditions, time from onset to treatment, treatment methods, in-hospital mortality rate and 3-year mortality rate were compared between the two groups.Results:Of the included 2 961 patients, 33.13% of them were transported through EMS and 66.87% of them by private transport. Patients with a history of hypertension and ST-segment elevation myocardial infarction were more likely to choose EMS, and the difference was statistically significant ( P<0.05). Moreover, patients in the EMS group were more likely to go to tertiary hospitals for treatment (88.58% vs 85.76%, P=0.033). The time from onset to treatment of the EMS group was significantly shorter than that of the self-transport group (160 min vs 185 min, P<0.01), and the proportion of patients in the EMS group from onset-to-door time in <3 h and 3-6 h was higher than that of the self-transport group (55.76% vs 49.14%, 21.41% vs 19.09%, P<0.01). Compared with the self-transport group, the EMS group has a higher rate of reperfusion therapy (67.48% vs 61.67%, P=0.002). Patients in the EMS group had a higher in-hospital mortality rate in the acute stage (7.03% vs 4.44%, P=0.003), but its 3-year mortality rate was lower than that of the self-transport group (17.31% vs 20.77%, P<0.05). Conclusions:EMS can shorten symptom-onset-to-arrival time, increase the rate of reperfusion therapy and improve long-term prognosis of patients with acute myocardial infarction.

Objective:To assess the efficacy of immunosuppressor on treatment of Henoch-Sch?nlein purpura nephritis(HSPN).Methods:Literatures were searched in PubMed, Cochrane library, Web of Science, Wanfang database, CNKI and CBM database from inception to January 2021.The studies that investigated the effect of immunosuppressor on HSPN outcomes were included.Article screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by STATA 14.Results:Ten studies were included with 443 cases, of which, 245 cases were in the experimental group while 198 cases were in the control group.The Meta-analysis showed that the experimental group had higher complete remission rate( OR=1.95, 95% CI 1.19-3.22, P=0.009), total remission rate ( OR=2.92, 95% CI 1.74-4.88, P<0.001), proteinuria decreasing level ( SMD=0.35, 95% CI 0.09-0.61, P=0.008), the increasing level of serum albumin ( SMD=1.27, 95% CI 0.43-2.11, P=0.003) and the increasing level of estimated glomerular filtration rate ( SMD=0.48, 95% CI 0.21-0.76, P=0.001), lower relapse rate ( OR=0.19, 95% CI 0.05-0.72, P=0.015) as well as death rate ( OR=0.19, 95% CI 0.04-0.78, P=0.021)than those of the control group. Conclusion:The immunosuppressor could enhance complete remission rate, total remission rate, proteinuria decreasing level, the increasing level of serum albumin and the increasing level of estimated glomerular filtration rate, reduce relapse rate and death rate of HSPN patients.