Objective To compare the efficacy of endovascular interventional treatment and surgical clipping in posterior communicating artery aneurysm (PCoAA) patients with fetal-type posterior cerebral artery (fPCA).Methods The PCoAA patients with fPCA were enrolled.Their baseline clinical data were collected.The modified Rankin Scale (mRS) was used to assess the clinical outcomes at six months after procedure.The mRS score 0-2 was defined as good outcome.Results A total of 35 PCoAA patients with fPCA were enrolled into the study,23 were treated with interventional embolization therapy and 12 were treated with craniotomy clipping.There were no significant differences in age,gender,preoperative Fisher grade,Hunt-Hess grade,baseline GCS scores,and aneurysm typing between the 2 groups.The good outcome rate of the interventional embolization group at 6 months was higher than that of the surgical clipping group,but there was no significant difference (65.22％ vs.41.67％;P =0.282).Results The efficacy of PCoAA using interventional embolization therapy combined fPCA is almost the same as craniotomy clipping.

Objective:Explore the hydrogen-nuclear magnetic resonance ( 1H-NMR) application potential of metabolomics in early screening of vitamin A deficiency(VAD). Methods:From January to June 2019, 40 cases of left-behind children with confirmed VAD <1 year old were enrolled in Zunyi area as VAD group, and 40 healthy children were selected as healthy control group.Urine from the 2 groups of children was collected and 1H-NMR spectrum was measured.By combining metabonomics technology and multivariate statistical analysis, the 2 groups of metabolites were compared, and the differential metabolites of children with VAD were screened out. Results:Compared with VAD group [(0.56±0.10)μmol/L], the difference in the serum retinol concentration of healthy control group [(1.35±0.18)μmol/L] was statistically significant ( t=23.93, P<0.001). Compared with healthy group, VAD group showed higher level of methylmalonate, 2-ketoisovalerat, N-acetyl glycoprotein signal, dimethylglycine and betaine, with statistically significant differences (| r|>0.602, all P<0.05). The level of Isovalerylglycine, 2-hydroxyisobutyrate, creatine, phosphate choline/glycerophosphocholine, 4-PY and Hippurate were significantly decreased, with statistically significant differences (| r|>0.602, all P<0.05). Conclusions:Compared with healthy children, children with VAD have differences in urine Metabolites.Differential metabolites are closely correlated with intestinal microecological ba-lance, digestive system diseases, respiratory system diseases, immune-related diseases, energy metabolism, growth and development.Urine 1H-NMR metabolomics analysis has potential application value in the early screening of VAD.

Objective To evaluate the clinical efficacy of laparoscopic hepatectomy and open hepatectomy for the treatment of hepatocellular carcinoma.Methods Two hundred and sixteen patients with hepatocellular carcinoma who were admitted to the Chongqing Three Gorges Central Hospital from October 2014 to December 2017 were enrolled in this study,52 patients undergoing laparoscopic hepatectomy (laparoscopic group) and 164 patients undergoing open hepatectomy,52 patients (open group) were matched by propensity score matching method to reduce confounding bias.The operation time,tumor sizes,resection margin,time of hepatic inflow occlusion,volume of blood loss,blood transfusion,postoperative complication rate,drainage tube removal time,postoperative anal exhaust time,duration of postoperative hospital stay and survival rates were compared.T test was used for the measurement data in line with the normal distribution,and the results were represented by (Mean ± SD) tandard deviation;Wilcoxon test was used for the measurement data in the skewed distribution,and M(range) was used for represention,and the chi-square test or Fisher's exact probability test was used for the counting data.Kaplan-meier method was used to describe the survival curve,and log-rank test was used to compare the survival rate.Cox regression model was used to evaluate the risk factors affecting the survival of patients with hepatocellular carcinoma.Results All patients were recovered with no perioperative death.The operation time,tumor sizes,resection margin,time of hepatic inflow occlusion were (226.1 ±67.5) min,(49.2 ± 15.5) mm,(14.3 ± 4.9) mm,(34.1±18.1) min and (227.0 ±55.7) min,(49.4 ±16.6) mm,(14.6 ±4.0) mm,(38.2 ± 16.1) min,with no significant differences between the two groups(P ＞ 0.05).The volume of blood loss,blood transfusion,postoperative complication rate,drainage tube removal time,postoperative anal exhaust time,duration of postoperative hospital stay were 325(50-1 200) ml,11.5％,15.4％,(4.8 ±0.9) d,3(2-5) d,(11.9± 3.5) d and 375(100-2 000) ml,19.2％,23.1％,(5.9 ±0.8) d,4(3-5) d,(14.9 ±6.2) d,with significant differences between the 2 groups(P ＜0.05).1-and 3-year overall survival rates were 93.4％,83.7％ and 1-and 3-year disease-free survival rates were 87.7％,71.2％ in laparoscopic group;1-and 3-year overall survival rates were 94.1％,82.5％ and 1-and 3-year disease-free survival rates were 88.3％,70.8％ in open group,with no significant differences between the 2 groups(P ＞0.05).Cox regression analysis revealed that ICG R15,tumor size and tumor differentiation were independent risk factors of survival (hazard ratio ＞ 1,P ＜ 0.005).Conclusions Application of Laparoscopic hepatectomy for the treatment of selective hepatocellular carcinoma patients has better short-term efficacy than open hepatectomy and long-term efficacy is comparably.The propensity score matching can reduce confounding bias and have value for clinical research.

Objective To evaluate the clinical outcomes of split fractures of humeral greater tuberosity treated by our self-designed new type of anatomical locking plate.Methods From September 2012 to February 2017,23 patients were treated for acute split fracture of the humeral greater tuberosity using our self-designed new type of anatomical locking plate.They were 13 males and 10 females with a mean age of 52.8 years (range,from 25 to 81 years).Of them,6 were beyond 60 years old, 12 had comminuted fracture,10 were complicated with glenohumeral dislocation,and 12 with rotator cuff tear.The patients were evaluated clinically with Constant-Murley score,visual analog scale (VAS),range of motion and complications at the last follow-ups.Results This series were followed up for 12 to 30 months (mean,23.2 months).All the fractures healed after an average time of 10.6 weeks (range,from 8 to 12 weeks).Their mean Constant-Murley Score was 92.1 points (range,from 70 to 100 points),giving an excellent and good rate of 95.7％ (22/23);their VAS scores averaged 0.8 points (range,from 0 to 4 points).Their forward flexion averaged 160.6°,abduction 157.8°,external rotation 46.4°,and internal rotation up to the T11 level,respectively.Their complications rate was 17.4％ (4/23).One case of axillary nerve injury,one case of relapse of glenohumeral dislocation at sports,and 2 cases of stiff shoulder were observed.Conclusion Split fractures of the humeral greater tuberosity can be successfully treated with our new type of anatomical locking plate which serves as a new alternative treatment.

Objective:To document any effect of environmental enrichment on nerve regeneration in a mouse model of sciatic nerve compression and explore its mechanism.Methods:A crushed sciatic nerve model was successfully established in 22 C57BL/6 mice, and they were then randomly divided into an intervention group and a control group. The mice of the intervention group were raised in a cage with an enriched environment, while those of the control group were kept in a standard cage. Two weeks later, both groups′ gait was analyzed and the compound muscle action potential (CMAP) of the sciatic nerve was measured. The proportion of myelinated sciatic nerve fibers was examined using toluidine blue staining, and the expression of myelin basic protein (MBP), growth associated protein-43 (GAP43) and p75 neurotrophin receptor (p75 NTR) was measured using immunofluorescence intensity. Results:①The latency of the CMAP [(1.05±0.04)ms] was significantly shortened in the intervention group compared with the control group and the amplitude was significantly higher. ②Gait analysis showed a significant increase in the average contact intensity, stride length and stride rate of the intervention group compared with the control group. However, the step axis angle of the intervention group was significantly smaller than in the control group on average. ③The stained nerve fibers in the intervention group were orderly and dense, and the average number of myelinated fibers was significantly greater than in the control group. ④Quantitative analysis of the immunofluorescence showed that the levels of MBP, GAP43 and p75 NTR in the sciatic nerves of the intervention group were, on average, significantly higher than in the control group. Conclusion:An enriched environmental can promote the regeneration and functional recovery of crushed sciatic nerves by promoting the proliferation and myelination of Schwann cells.

Objective:To analyze the urine of normal healthy left-behind children under 1 year old and left-behind children with zinc deficiency under 1 year old in Zunyi area using hydrogen nuclear magnetic resonance ( 1HNMR), thus providing a new biomarker for the early diagnosis of zinc deficiency. Methods:From January to August 2018, a total of 40 normal healthy left-behind children under 1 year old in Zunyi area(healthy control group)[22 males and 18 females, average age of (7.78±3.62) months, average height of (65.01±2.67) cm and average body mass of (7.15±1.59) kg] and 40 age-matched left-behind children with zinc deficiency in the same region(zinc deficiency group)[19 males and 21 females, average age of (7.89±3.57) months, average height of (64.25±2.95) cm and average body mass of (7.02±1.68) kg] were included for a cross-sectional study by stratified sampling.The urine 1HNMR spectra of children in the 2 groups were measured, and the age, height, body mass and serum zinc content of children in the 2 groups were compared.The metabolites of the 2 groups were compared by metabono-mics technology combined with multivariate statistical analysis, and the differential metabolites of children with zinc deficiency were screened out. Results:There were no significant differences in age, height and body mass between the 2 groups (all P>0.05). The serum zinc level of healthy control group was significantly higher than that of zinc deficiency group [(54.3±3.06) mmol/L vs.(39.2±3.77) mmol/L, t=22.65, P<0.05]. Urine 1HNMR spectrogram results showed that compared with healthy controls, 4-hydroxyphenylpyruvic acid, phenyl acetyl glycine, and hippuric acid salt water were significantly lower in zinc deficiency group ( r=-0.620, -0.689, and -0.721, respectively, all | r|>0.602, all P<0.05). Conclusions:Zinc deficiency in left-behind children under 1 year old in Zunyi area is mainly manifested by decreased metabolites of 4-hydroxyphenylpyruvic acid, phenylacetyl glycine and horse-urate, suggesting metabolic disorder of intestinal flora.Differentially expressed metabolites have a potential application value in the early diagnosis of zinc deficiency.

Objective To evaluate the effect of camptothecin on the autophagy of human primary keratinocytes (HPKs).Methods HPKs were isolated from foreskin tissues of healthy males by a two-step digestion method,and the third-passage cells were used for following experiments.These HPKs were randomly divided into several groups:experimental groups treated with camptothecin at concentrations of 200 nmol/L,2 and 6 μ mol/L separately,and a control group treated with 0.1％ dimethyl sulfoxide (DMSO).After 24-and 48-hour treatment,cell counting kit-8 (CCK-8)assay was conducted to estimate the proliferative activity of HPKs.Flow cytometry was performed to detect cell apoptosis after 24-hour treatment,and Western blot analysis to measure the expression of autophagy-associated proteins such as microtubule-associated protein 1 light chain-3 (LC3) and p62.Some other HPKs were treated with 2 μmol/L camptothecin for 24 hours.Indirect immunofluorescence assay was performed to observe changes in LC3 expression,and transmission electron microscopy to observe the ultrastructure of autophagosomes,so as to further validate the inductive effect of camptothecin on autophagy.Results The inhibitory effect of camptothecin on the proliferation of HPKs gradually increased along with the increase of camptothecin concentration,and there was a significant difference in the proliferation inhibition rates among the experimental groups and control group at 24 hours (F =152.9,P ＜ 0.01).Additionally,the proliferation inhibition rates were significantly higher in the 2-,6-μmol/L camptothecin groups than in the control group (t =12.09,18.76,both P ＜ 0.01),but there was no significantly difference between the 200-μmol/L camptothecin group and control group (t =2.24,P ＞ 0.05).At 48 hours,there was still a significant difference in the proliferation inhibition rates among the experimental groups and control group (F =123.8,P ＜ 0.01),and all the experimental groups showed increased proliferation inhibition rates compared with the control group (all P ＜ 0.01).At 24 hours,the cell apoptosis rates also significantly differed among the control group,200-nmoYL,2-μmol/L and 6-μmol/L camptothecin groups (2.30％ ± 1.68％,15.90％ ±2.14％,29.33％ ± 3.51％,35.28％ ± 3.05％,respectively;F =89.57,P ＜ 0.01),and all the three experimental groups showed higher cell apoptosis rates compared with the control group (all P ＜ 0.01).After 24-hour treatment with 2 or 6 μmol/L camptothecin,the protein expression of LC3]Ⅱ were significantly up-regulated,but the protein expression of p62 was significantly down-regulated.Indirect immunofluorescence assay showed that the percentage of autophagosome-positive cells was significantly higher in the 2-μmol/L camptothecin group than in the control group (60.16％ ± 8.78％ vs.38.96％ ±13.12％,t =3.003,P ＜ 0.05).After 24-hour treatment with 2 μmol/L camptothecin,autophagosomes and autolysosomes were observed in HPKs with a transmission electron microscope.Conclusion Camptothecin at concentrations of 2 and 6 μmol/L can increase the autophagy level in HPKs,meanwhile,inhibit cell proliferation and induce cell apoptosis.

ObjectiveTo investigate the potential active ingredients and targets of Baihu Jia Renshentang（BHJRST） for the treatment of obesity combined with type 2 diabetes mellitus（T2DM） by network pharmacology and in vivo experiments. MethodUltra performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS） was used to analyze and identify the material basis of BHJRST. Subsequently， potential targets for the action of the active ingredients were queried in databases such as ChEMBL， Therapeutic Target Database（TTD）， YaTCM， DisGeNET and Traditional Chinese Medicine on Immuno-Oncology（TCMIO）， and the shared targets were identified by taking the intersection of these targets with disease targets. The shared targets were imported into the STRING database to construct a protein-protein interaction（PPI） network， the hub genes were identified by cytoHubba plug-in， and molecular docking was used to validate the binding energy of the hub genes to the bioactive ingredients in BHJRST. Meanwhile， the shared targets were imported into the DAVID platform for gene ontology（GO） functional annotation and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis. The predicted results were subsequently verified by animal experiments. Eighteen 8-week-old male skeletal muscle insulin-like growth factor-1 receptor dysfunction（MKR） mice were induced by a high-fat diet for 12 weeks in order to prepare a mouse model of obesity combined with T2DM. The mice were randomly divided into the model group， metformin group（0.2 g·kg^-1） and BHJRST group（27 g·kg^-1 in raw material）， and another 6 male FVB mice of the same age as the normal group. The mice in each group were were given the corresponding drugs by gavage， and the normal and model groups were given the same amount of distilled water by gavage， 1 time/d for 6 consecutive weeks. At the end of administration， the body mass， Lee's index， fasting blood glucose（FBG）， oral glucose tolerance test（OGTT） of mice in each group were examined， and the pathological morphology of the white adipose tissue of the epididymis was observed， and the expression of the mRNA of the hub genes in the white adipose tissue of the epididymis was detected by real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）. ResultA total of 200 bioactive components of BHJRST were identified， of which 64 bioactive components were reverse-matched to 384 targets， and a total of 308 targets were associated with obesity combined with T2DM. Hub genes included mitogen-activated protein kinase 1（MAPK1）， signal transducer and activator of transcription 3（STAT3）， MAPK3， interleukin（IL）-2， Janus kinase 1（JAK1）， nuclear transcription factor-κB p65（RELA）， estrogen receptor 1（ESR1）， transcription factor AP-1（JUN）， MAPK14 and lymphocyte-specific protein tyrosine kinase（LCK）. GO functional annotation showed that it was mainly enriched in cytoplasm， cell membrane and nucleus， and was closely related to important biological processes such as peptide serine phosphorylation， protein phosphorylation and inflammation. In KEGG enrichment analysis， metabolic pathway， lipid and atherosclerosis， phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt） and MAPK signal pathways were significantly enriched. The molecular docking results showed that the hub genes had a stable binding relationship with 10 bioactive components， including quercetin， isoliquiritigenin， and morin， in BHJRST. The results of animal experiments showed that BHJRST could significantly reduce body mass， Lee's index and FBG levels（P<0.01） in mice with obesity combined with T2DM， improve the pathological changes of white adipose tissue， and down-regulate the the mRNA expression of the hub genes in white adipose tissue of the epididymis（P<0.01）. ConclusionIn this study， 10 potentially active components such as quercetin， isoliquiritigenin， and morin in BHJRST are identified through network pharmacology and animal experiments， and it is possible to treat obesity combined with T2DM by regulating lipid and atherosclerosis， phosphatidylinositol PI3K/Akt and MAPK signal pathways， which provides important clues and theoretical basis for the study of its mechanism and clinical application.

Objective To investigate the overweight status of military officers and soldiers and to analyze the risks of the induction of chronic diseases. Methods Questionnaires and biochemical analysis were used to randomly survey the living and training status of 485 officers and soldiers in a military unit. Blood and urine samples were collected and analyzed using blood biochemical analysis methods and conventional dry chemical methods. Statistical analysis was performed through EXCEL 2007 and SPASS 12.0 software. Results The survey results showed that the proportion of BMI abnormal people in the officers and soldiers was high. Compared to the normal population, the officers and soldiers with abnormal BMI had more bad daily life habits such as smoking and drinking, while their diet balance was relatively poor, and their frequency of daily exercise was significantly less. Biochemical tests showed that the proportion of the officers and soldiers with hyperuricemia and hyperbilirubinemia was high, but there was no significant difference in the officers and soldiers with different BMI. Urine analysis showed that the number of urinary protein and occult blood in the officers and soldiers increased significantly after military training, and the BMI abnormal population was more significant than the normal population. Conclusion There was a relatively low correlation between different BMI and chronic metabolic diseases in military officers and soldiers, but those with abnormal BMI were at high risk for exercise-induced kidney injury. Military officers and soldiers should strengthen health management and actively control the acquired factors that cause BMI abnormalities, to effectively prevent and reduce the BMI abnormality and lower the risk of induced early chronic kidney injury disease, promoting the overall health level.

OBJECTIVE： To establish the method for simultaneous determination of ephedrine hydrochloride， pseudoephedrine hydrochloride， methamphetamine hydrochloride and paeoniflorin in Xiaoqinglong granule. METHODS： Micellar capillary electrophoresis （MCE） method was adopted. The optimum conditions for the separation were as follows as a fused silica capillary column as the separation channel， the buffer solution composed of 10 mmol/L borax-10 mmol/L SDS （95 ∶ 5， pH 10.5）， detection wavelength of 195 nm， separation voltage of 20 kV， capillary column temperature of 15 ℃，the sampling at a pressure for 0.5 psi×5 s. Two batches of Xiaoqinglong granules were collected from 2 manufacturers to determine the contents of ephedrine hydrochloride， pseudoephedrine hydrochloride， methamphetamine hydrochloride and paeoniflorin. The results of content determination were compared with the results determined by HPLC method stated in Chinese Pharmacopeia of 2015 edition. RESULTS： The linear range of ephedrine hydrochloride， pseudoephedrine hydrochloride， methamphetamine hydrochloride and paeoniflorin were 10-160， 10-160， 1-100， 10-500 μg/mL （r＝0.997 9-0.999 8）， respectively. RSDs of precision， reproducibility and stability tests were all ≤2.74％ （n＝5-6）. The average recoveries were 101.55％， 101.62％， 100.15％， 101.85％ （RSD≤3.94％， n＝6）， respectively. The contents of 4 components determined by micellar capillary electrophoresis were in accordance with the results of HPLC method. CONCLUSIONS： The established MCE method is simple， quick and sensitive， and can be used for simultaneous determination of 4 components mentioned above in Xiaoqinglong granule.