Rat models of diabetes were established by injecting streptozocin intraperitoneally.According to random number table,three groups were divided:normal group,diabetic group,and fisetin-treated group.After 24 weeks,all rats were sacrificed.Biochemical parameters of blood and urine samples were tested.The pathological changes were observed by paraffin sections staining with HE.The expression of extracellular matrix proteins was analyzed via PAS and Masson staining.Location of p300 protein expression was analyzed by immunohistochemistry.The protein expressions of p300 and MMP-2 were determined by Western blotting.The mRNA expressions of MMP-2 were analyzed via real-time PCR.The biochemical parameters and kidney pathological images in fisetin-treated group were better than those in diabetic group.The expression of extraeellular matrix proteins was lower than that in diabetic group.Immunohistochemistry analysis showed that among three groups the expression of p300 was mainly in glomeruli,and was also expressed in cell nucleus and cytoplasm and the coloration of fisetin-treated group was weakened as compared with diabetic group.Western blotting analysis showed that the expression of p300 protein in fisetin-treated group was lower than that in diabetic group(P＜O.05).The expressions of MMP-2 mRNA and MMP-2 protein were higher than those in diabetic group (P ＜ 0.05).It is suggested that fisetin may attenuate diabetes associated abnormalities in the kidney of rats,owing probably to inhibiting the expressions of p300 and enhancing the expressions of MMP-2.

Objective:To evaluate the efficacy and safety of acupuncture-moxibustion in the treatment of cerebral palsy-related speech impairment.Methods:A systematic literature search of 7 electronic databases was conducted between January 7,2000 and January 12,2021 to find randomized controlled trials(RCTs)examining the benefits of acupuncture-moxibustion combined with rehabilitation training to cerebral palsy-induced speech impairment.The included trials'quality was assessed using the Cochrane Reviewers'Handbook as a guide,and statistical analysis was carried out using the RevMan 5.3 software.Results:A total of 17 RCTs with 1238 subjects were finally recruited and analyzed.When acupuncture-moxibustion was combined with rehabilitation training,the results showed a considerable improvement in speech impairment compared with the rehabilitation training alone.The most commonly used points for the treatment of speech disorders are Baihui(GV20),Speech Area,Zhisanzhen[Shenting(GV24)and bilateral Benshen(GB13)],Niesanzhen[2 Cun above the ear tip as the first point,with 1.0 Cun anterior and posterior to the current point as the second and third points],and Sishenzhen[1.5 Cun anterior,posterior,and bilateral to Baihui(GV20)].Conclusion:Acupuncture-moxibustion has a stronger effect on children's development of receptive and expressive language,as well as the developmental quotient.Acupuncture-moxibustion in combination with rehabilitation training is not only more successful than the control treatment,but also safer and more dependable.Baihui(GV20),Speech Area,Zhisanzhen,Niesanzhen,and Sishenzhen are the most widely used points for speech impediment.

OBJECTIVETo verify the clinical efficacy on postmenopausal osteoporosis treated with acupoint injection of salmon calcitonin.

METHODSNinety patients of postmenopausal osteoporosis were randomized into three groups, 30 cases in each one. In the acupoint injection group, Shenshu (BL 23) and Zusanli (ST 36) were selected bilaterally. The injection 4 mL was prepared with salmon calcitonin 100 U (1 mL) and 0.9% sodium chloride injection. Each acupoint was stimulated with the injection, 1 mL. In the blank group, 0.9% sodium chloride injection was applied to bilateral Shenshu (BL 23) and Zusanli (ST 36), 1 mL at each acupoint. In the intramuscular injection group, salmon calcitonin 100 U was injected at gluteus maximus. The treatment was given once every two days in the patients of the three groups and lasted for 2 months. The levels of bone mineral density (BMD), bone alkaline phosphatase (NBAP), C-terminal telopeptides of typeⅠcollagen (CTX), urine calcium/creatinine (Ca/Cr) and the symptom score of osteoporosis were detected in the patients of the three groups before and after treatment.

RESULTSIn the patients of the three groups, NBAP and BMD in lumbar vertebra after treatment were higher than those before treatment (all<0.05); CTX, Ca/Cr and symptom score were lower than those before treatment (all<0.05). After treatment, NBAP was (32.7±2.5) μg/L in the acupoint injection group, higher than those in the blank group and the intramuscular injection group (both<0.05). In the acupoint injection group, CTX was reduced to (239.7±63.6) μmmol/L and Ca/Cr was reduced to 0.525±0.274, apparently lower than those in the blank group and intramuscular injection group (both<0.05). After treatment, in the acupoint injection group, BMD of lumbar vertebra was (0.731±0.062) g/m, higher than the level of the rest two groups (both<0.05). After treatment, the symptom score was 5.2±0.6 in the acupoint injection group, lower than those in the blank group and intramuscular injection group (both<0.05).

CONCLUSIONSSalmon calcitonin injec-tion at Zusanli (ST 36) and Shenshu (BL 23) achieves significant efficacy on postmenopausal osteoporosis, stimulating osteoblast activity and inhibiting bone absorption of osteoclast.

Objective To analyze the prognosis of patients with pulmonary artery sling (PAS) combined with tracheal stenosis(TS) without tracheal intervention,and to discuss the method for improving the effect of treatment.Methods The clinical data of 17 children with PAS/TS (moderate or severe) who received treatment at Beijing Bayi Children's Hospital Affiliated to General Hospital of Bejing Military Command from October 2011 to July 2015 were retrospectively analyzed,and the relationship between the effect and prognosis of re-implantation of the left pulmonary artery (LPA) without tracheal intervention was analyzed.Results Seventeen patients received re-implantation of the left pulmonary artery without tracheal intervention.Extubation was successfully performed in 12 of the 17 patients and they healed.The remaining 5 patients received tracheal intervention after the first operation but they all died.Of those 5 patients,3 received tracheal stent implantation (1 died from necrotizing enterocolitis,2 died from infection and multiple organ failure),and 2 received traheoplasty (both of them died from infection and tracheal fistula).Respiratory symptoms were reduced or resolved in all survivors.Diameter/length (％) in survivors without tracheal intervention was significantly higher than those who received tracheal intervention [(10.14 ± 1.58) ％ vs.(5.72 ± 1.17) ％,t =3.600,P ＜ 0.001].Patients with PAS undergoing LPA re-implantation achieved a good outcome if the diameter/length(％) of the trachea was up to (10.14 ± 1.58) ％.Patients with PAS undergoing LPA re-implantation achieved a bad outcome if the diameter/length(％) of the trachea was below to (5.72 ± 1.17) ％.Conclusions Most of patients with PAS/TS undergoing LPA re-implantation without tracheal intervention have a good outcome.It is feasible for them to avoid tracheal intervention.Diameter/length (％) may be a reliable indicator for determining tracheal intervention in surgical management of PAS.

Background:Zinc finger protein of cerebellum 2(ZIC2)is a transcriptional activator or repressor that is important for the organogenesis of the central nervous system.Previous studies have reported that ZIC2 is widely upregulated in a variety of tumors. Methods:Oncomine database was used to evaluate the expression levels of ZIC2 in hepatocellular car-cinoma(HCC)and normal liver tissues.Quantitative real-time polymerase chain reaction and immu-nohistochemistry were conducted to validate the results from the database.Cox regression analysis and survival curves were performed to assess the survival effect of ZIC2 in HCC. Results:Increased expression of ZIC2 was detected in HCC tissues compared with normal liver tissues.In addition,patients with high ZIC2 levels had a poor prognosis.Multivariate analysis showed that clinical stage(T or M classification)and ZIC2 levels were independent prognostic factors for overall survival.Moreover,a subgroup analysis revealed that patients with moderate or poor grade tumors,T1-2 tumors,N0 tumors,early American Joint Committee on Cancer(AJCC)stage,and old age were more likely to present with overexpression of ZIC2.To conclude,ZIC2 is upregulated in HCC and associated with the histology and survival of HCC patients. Conclusions:The expression status of ZIC2 may serve as an independent prognostic marker of HCC.

Objective To evaluate the effectiveness of urgent surgical correction for infra-cardiac total anomalous pulmonary venous connection(TAPVC)in neonates.Methods From October 2009 to Janu-ary 2015,13 patients with infra-cardiac TAPVC received surgical correction.The age of patients ranged from 6 to 28 days[(15.08 ±7.42)days],the body weight ranged from 2.5 to 4.8 kg [(3.34 ±0.67)kg].A median sternotomy was performed.Continuous cardiopulmonary bypass using bicaval cannulation with aortic cross-clamping and mild systemic hypothermia were used in all patients.Bi-atrial incision technique making anastomosis between the posterior left atrial wall and the vertical vein were employed in 3 cases.In the other 10 cases,the heart was elevated upward and to the right to expose the anomalous descending vertical vein to facilitate the anastomosis between the posterolateral left atrial wall and vertical vein.Results Emergent or subemergent operations were performed in all patients without surgical death.In the early stage after opera-tion,delayed sternal closure was employed in 1 1 patients,pulmonary hypertension crisis occurred in 3 pa-tients,small atrial septal defect was kept open for hemodynamic stabilization in 6 patients,temporary cardiac pacemaker for proper heart rate in 3 patients.All patients were uneventfully discharged except 2 patients died of severe low cardiac output syndrome.During the period of follow up,2 patients presented with recurrent pulmonary infection and signs of pulmonary venous obstruction including the increased flow speed at the site of anastomosis.One of 2 patients was lost of follow up and the other patient was uneventfully discharged after the second operation.The rest 9 patients received postoperative follow up for 1 month to 5 years,echocardio-graphy,X ray chest radiography,and electrocardiogram were performed during this period.As a result,all children had good cardiac function and with sinus rhythm on electrocardiogram and apparently reduced pul-monary congestion on radiography.No obstructive pulmonary venous return was observed on echocardio-graphy.Conclusion Corrective operation for infra-cardiac TAPVC in neonate on urgent basis may provide favorite outcomes.

Objective:To retrospectively analyze the clinical and serological characteristics in rehabilitated patients with common novel coronavirus pneumonia(COVID-19).Methods:A total of 165 patients with common COVID-19 were enrolled in this retrospective study, in which clinical data was collected from February 23 to March 15, 2020 in Leishenshan Hospital(Wuhan, China). The patients with COVID-19 were divided into elderly group and non-elderly group according to their age, and the differences in the clinical and serological metabolic characteristics between these two groups were analyzed.Results:49.7% patients were over 60 years old. The most common clinical symptoms were fever, cough, and fatigue, followed by muscle soreness. Expectoration and digestive tract symptoms were rare. Dyspnea occurred more frequently in the elderly group than in non-elderly group(47.56% vs 25.30%, P<0.01). Hypertension was the most common concomitant disease(accounting for 29.1%)followed by diabetes. Hypertension was more common in the elderly group than in non-elderly group(41.46% vs 16.86%, P<0.01), but without significant difference in diabetes between the two groups. The counts of leukocytes and lymphocytes in all patients were in the normal range, and no difference was observed between the groups. The comparison of serological indicators showed that serum creatinine in the elderly group was higher than that in the non-elderly group( P<0.01)while serum albumin, glomerular filtration rate, and serum calcium were lower in the elderly group. After serum albumin correction, the levels of albumin corrected calcium in all patients were in the normal range, without significant difference between these two groups. There was no significant difference between the two groups when the length of hospital stay was taken as the index of outcome [(34.01±10.24) vs(30.97±10.51)d, P>0.05]. Conclusion:Fever, cough, and fatigue are the most common clinical symptoms in patients with ordinary COVID-19. The elderly are more likely to develop dyspnea. The blood routine and metabolic characteristics in patients with common COVID-19 are normal, but serum albumin level is more likely to decrease in elderly patients with COVID-19.

Objective To analyze the cancer mortality and epidemiological characteristics of digestive system cancer in Xianyou County, Fujian Province, and to provide a scientific evidence for formulating preventive measures for digestive system cancer. Methods Excel and SPSS software were used to collect the monitoring data of digestive system cancer death in Xianyou County from 2014 to 2018, and then analyzed the mortality, the standardized rate (according to the Chinese 2000 population census) and the cause of death. Results From 2014 to 2018, the deaths of malignant tumors in Xianyou County accounted for 35.00% of all deaths. Among them, the four common digestive system malignant tumors (gastric cancer, esophageal cancer, liver cancer and colorectal cancer) accounted for 62.44% of malignant tumors. Gastric cancer ranked first and accounted for 27.36%. Average annual rate of crude mortality and standardized mortality of malignant tumor in the digestive system were 108.93/10⁵ and 89.34/10⁵, respectively, and the ratio of male to female was 2.27 to 1. Significant differences were found between town and village, as the terrain gets lower, the death rate goes down gradually. Compared with the data of 2011-2012, the standardized death rate of gastric cancer, esophageal cancer and liver cancer were reduced by 29.71%, 23.92% and 12.06%, respectively, while the rate of colorectal cancer was increased by 28.80% and the average annual growth rate was 7.83%. Conclusion Although the death rates of gastric cancer, esophageal cancer and liver cancer have decreased significantly, the malignant tumor of the digestive system is still the main disease that causes the death of residents in Xianyou County, Putian City. Therefore, it is necessary to strengthen the education of health in order to achieve the early discovery, diagnosis and treatment.

Background::In East Asia, Helicobacter pylori ( H. pylori) infection and related diseases are common, primarily during childhood and adolescence. The rates of primary antibiotic resistance in H. pylori among East Asian children and adolescents have not been extensively explored; few relevant systematic reviews or meta-analyses have been conducted. We evaluated the rates of antibiotic resistance in H. pylori among East Asian children and adolescents, with the goal of facilitating individualized treatment recommendations. Methods::We searched PubMed, Embase, and the Cochrane Library for studies in any language published up to February 2023 that explored antibiotic resistance in H. pylori among East Asian children and adolescents. We used MeSH and non-MeSH terms related to the topic, including terms related to children, adolescents, antibiotic resistance, H. pylori, and nations or regions. Additionally, we reviewed the reference lists of relevant articles. Studies that matched our strict predefined eligibility criteria were included in the screening process. Using established assessment methods, we evaluated the quality of the included studies. Results::We identified 15 observational studies involving 4831 H. pylori isolates, all published between 2001 and 2022. There was substantial primary antibiotic resistance in H. pylori isolates from East Asian children and adolescents. The rates of primary resistance were 51% (95% confidence interval [CI]: 40–62%) for metronidazole; 37% (95% CI: 20–53%) for clarithromycin; 19% (95% CI: 11–28%) for levofloxacin; and less than 3% each for amoxicillin, tetracycline, and furazolidone. Subgroup analysis revealed a prominent increase in metronidazole resistance over time. Clarithromycin and levofloxacin resistance rates fluctuated between 2005 and 2015, then remained stable; other antibiotic resistance rates were generally stable. Metronidazole, clarithromycin, and levofloxacin resistance rates were significantly higher in the Chinese mainland than in other East Asian regions. The rates of dual and multiple antibiotic resistance were 28% (95% CI: 21–36%) and 10% (95% CI: 7–14%), highlighting the potential for diverse resistance patterns. Conclusions::H. pylori isolates from East Asian children and adolescents exhibit high levels of metronidazole and clarithromycin resistance, particularly in the Chinese mainland. The non-negligible rates of dual and multiple resistance highlight the complexity of this problem. Registration::PROSPERO, No. CRD42023402510.

Objective: To compare the clinical efficacy of icotinib and gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with epidermal growth factor receptor(EGFR) sensitive gene mutation. Methods: Fifty-four advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation were selected.According to the random number table method, the patients were divided into two groups, with 27 cases in each group.The icotinib group received icotinib hydrochloride targeted therapy, and the gefitinib group was orally given gefitinib.The clinical efficacy, quality of life score, adverse reactions, progression free survival(PFS) were compared between the two groups. Results: There were no statistically significant differences in clinical curative effect between the two groups[complete remission(0 cases vs.0 cases), partial remission(9 cases vs.8 cases), stable(12 cases vs.14 cases), progress disease(6 cases vs.5 cases), objective response rate(33.3% vs.29.6%), disease control rate(77.8% vs.81.5%), Z=1.060, χ²=0.143, 0.100, all P>0.05]. After treatment, the differences of body function, social function, psychological function, common symptoms and side effects, specific modules in the gefitinib group were not statistically significant compared with those before treatment(t=1.402, 1.199, 1.840, 1.860, 1.275, all P>0.05). The icitinib group had better body function, psychological function, common symptoms, side effects and specific modules than before treatment(t=2.525, 3.335, 4.477, 3.778, all P<0.05). The psychological function, common symptoms and side effects, specific module life quality scores in the icotinib group were (39.72±4.23)points, (38.84±4.67)points, (38.94±4.56)points, respectively, which were higher than (37.08±5.14)points, (35.48±5.02)points, (35.85±4.97)points in the gefitinib group(t=2.061, 2.546, 2.380, all P<0.05). The incidence rate of Ⅰ-Ⅱ grade adverse reactions between the two groups had no statistically significant difference (χ²=4.667, P>0.05). The incidence rate of Ⅲ-Ⅳ grade adverse reactions of the icotinib group was 7.4%, which was lower than 25.9% of the gefitinib group(χ²=9.000, P<0.05). The total incidence rate of adverse reactions of the icotinib group was 40.7%, which was significantly lower than 70.4% of the gefitinib group(χ²=25.694, P<0.05). There was no statistically significant difference in mean PFS between the two groups in the 19delete mutation of EGFR gene(t=0.795, P>0.05). The average PFS of the icotinib group under EGFR gene 21L858R mutation was (14.62±3.85)months, which was longer than (10.73±5.61)months of the gefitinib group(t=2.971, P<0.05). Conclusion Icotinib, gefitinib in the treatment of advanced(stage Ⅳ) lung adenocarcinoma patients with EGFR sensitive gene mutation has similar clinical effect, but icotinib has higher safety, better tolerability, and can significantly improve the quality of life of patients, prolong the EGFR mutation of the 21L858R gene under the survival of patients.