【Objective】To observe the effect of Zhenzhumu Pill(mainly composed of Concha Margaritifera Usta,Dens Draconis,Lignum Aquilariae Resinatum,Poria cum Radix Pini,Radix Angelicae Sinensis,Radix Rehmanniae Preparata,Radix Codonopsis,Semen Ziziphi Spinosae,Semen Platycladi,etc.) on insomnia induced by negative life events.【Methods】One hundred and twenty-one insomnia patients were randomized into two groups.Groups A(n=63) and B(n=58) received paroxetine hydrochloride Tablets,and group A received decoction of Zhenzhumu Pill additionally.The treatment lasted 90 days.After treatment,sleeping dysfunction rating scale(SDRS) and the Hamilton anxiety scale(HAMA) were used to evaluate the therapeutic effect and adverse reactions.【Results】In group A,22 patients were markedly effective,35 effective,and 6 ineffective.In group B,13 patients were markedly effective,28 effective,and 17 ineffective(P0.05).Meanwhile,the incidence of adverse reactions such as nausea and vertigo was less in group A than that in group B(P

Objective To investigate the value of digital image analysis (DIA) of endoscopic ultrasonography (EUS) in the differential diagnosis of benign and malignant pancreatic neuroendocrine neoplasm (PNEN).Methods The relation between various parameters of EUS-imaging and benign and malignant lesions in 47 patients clinically diagnosed PNEN were retrospectively analyzed.Photoshop CS5 software was performed for digital image processing,and lesions related parameters were collected,including area,perimeter,length,circularity,gray,gray ratio,and gray standard deviation.The statistical method of t test was performed for comparison between two groups.Receiver operating characteristic (ROC) curve was analyzed in length,circularity,average gray scale ratio and gray standard deviation.Results Among the 47 patients,35 cases and 12 cases were in benign group and malignant group,respectively.The mean gray scale ratio and the circularity of benign group were significantly higher than those of malignant group (0.80±0,05 vs 0.74±0.07,0.63±0.17 vs 0.40±0.09),and the differences were statistically significant (t=2.659 and 5.787,both P＜0.05).The gray standard deviation of benign group were lower than that of malignant group (9.90 ± 1.24 vs 12.55± 3.27),and the difference was statistically significant (t=-2.733,P=0.018).The area under the curve (AUC) of circularity was 0.724 (95％ confidence interval(CI):0.546 to 0.901),the cut-off value was 0.767,the sensitivity and specificity were 71.43 ％ and 66.67％,respectively.The AUC of average gray ratio was 0.888 (95％CI:0.785 to 0.991),the cut-off value was 0.412,the sensitivity and specificity were 94.29％ and 75.00％,respectively.The AUC of gray standard deviation was 0.811 (95％CI:0.647 to 0.974),the cut-off value was 11.02,the sensitivity and specificity were 66.67％ and 85.71％,respectively.When combined with the three parameters of circularity,average gray scale ratio and gray standard deviation,the sensitivity and specificity were 97.14％ and 83.33％,and the accuracy was 93.61％.Conclusions EUS with DIA technology can improve the detection of EUS images to PNEN,and which may be complementary to EUS guided fine needle aspiration.It also privided a noninvasive,objective,convenient,and effective option for the differential diagnosis of benign and malignant PNEN.

Objective To investigate the effects of interferon-α (IFN-α) and gefitinib on the proliferation and apoptosis of human colon cancer cell line HCT116. Methods Colon cancer cell line HCT116 was selected as research objective. The biological effects of IFN-α and gefitinib alone or combined on the cells were observed at different time point (after worked for 24, 48 and 72 hours). The proliferation inhibition of the medicine on the HCT116 cells was measured by methyl thiazolyl tetrazolium (MTT) assay. Morphologic changes were observed under optical microscope. Apoptosis was measured by flow cytometry (FCM). The results were analyzed with SPSS 13.0 software, two groups compare was tested by t test, and single factor variance analysis was for multiple group data compare. Results IFN-α and gefitinib alone or combined could significantly inhibit the proliferation of HCT116 cells (P<0.05), and there was a time and dose-dependent manner between the degree of inhibition and the working time and concentration of the medicine. With the work of the medicine, apoptosis morphologic changes were observed in the cells. And FCM result indicated that the apoptosis rate significantly increased. After treated with IFN-α and gefitinib alone or combined for 72h, the cell apoptosis rate were 15.6%±0.6%, 13.6%±0.4% and 31.2%±0.3% respectively, which was obviously higher than control group (6.8%±0.3%, P<0.05). Conclusion Both IFN-α and gefitinib were able to inhibit the proliferation and induce apoptosis of HCT116 cells moreover, and a synergistic effect was observed while combine used there two medicines.

Objective To investigate the effect of protein inhibitor of activated signal transducer and activator of transcription 1 ( PIAS1 ) gene silencing on the inflammatory response of rat pancreatic acinar cell lines AR42J with cerulein stimulation, to study its role in the pathogenesis of acute pancreatitis.Methods The siRNA targeting PIASI was designed, synthesized, transfected into AR42J cells by lipofectmine 2000.24 h later, cerulean was added and cultured for another 24 h.Subsequent AR42J cells with cerulein stimulation were divided into 4 groups: cerulein, liposome, negative-siRNA and PIAS1-siRNA groups.In addition, a group with PBS was as control group.The activity of p38 mitogen- activated protein kinase (p38MAPK) was detected by western blotting.TNF-α, IL-1β, IL-6, matrix metalloproteinase (MMP) 9 expression were analyzed by RT-PCR and western blotting, respectively.Results The expression of p38MAPK in PIAS1-siRNA, negative-siRNA, liposome, cerulein,and control group was 1.93 ±0.11, 1.22 ±0.10, 1.30 ±0.17,1.32 ± 0.21, 0.12 ± 0.02;while the expression of phosphorylated p38MAPK was 2.10 ± 0.25, 1.36 ± 0.20,1.26 ±0.15, 1.23 ±0.25, 0.58 ±0.48, the expression in PIAS1-siRNA group was significantly increased when compared with other groups (P＜0.05).The levels of TNF-α, IL-1β, IL-6, MMP-9 mRNA were 1.66 ±0.15,1.66 ± 0.15,1.90 ±0.01, 1.56 ±0.20 in PIAS1-siRNA group, while the expression of protein was 2.06 ±0.37,2.20 ±0.34, 1.80 ±0.10, 1.17 ±0.05, which was markedly higher than those in other group (P ＜0.05).Conclusions PIAS1 gene silencing could enhance p38MAPK activity, and improve inflammatory mediator expression in pancreatic acinar cells with cerulein stimulation.

ObjectiveTo investigate the expression of protein inhibitor of activated STAT-1 ( PIAS1 )in rat with acute pancreatitis (AP) and study its prediction value for severity and prognosis.MethodsSD rats were randomly divided into control,acute edematous pancreatitis (AEP),and acute necrotizing pancreatitis (ANP) groups with 15 rats in each group.The rats were sacrificed at 0.5,6,16,24,48,72 h postoperatively.Serum CRP and amylase levels were determined.Water content of pancreas was measured.The pancreatic tissue was routinely harvested and underwent pathologic examination and was scored.The PIAS1protein expression was measured by Western blot and immunohistochemistry method.The survival rates at 72h were recorded and the risk analysis of multiple factors was investigated by Cóx regression method.ResultsThe pathologic score,water content of pancreas,serum CRP and amylase levels at 16h in ANP group were (7.70 ±2.55),(2.91 ±0.57)％,(0.36 ±0.05)mg/L,(3141 ±625)U/L,which were significandy higher than those in AEP group [(2.60 ±1.04),(2.04 ±0.47)％,(0.24 ±0.05)mg/L,(1984 ± 637)U/L)],and also significantly higher than those in control group [ (0.80 ±0.42),( 1.21 ±0.27)％,(0.14 ±0.03)mg/L,(978 ± 353) U/L,(P ＜ 0.05or 0.01 ) ].The survival time of ANP rats was [ (26.36 ± 3.41 ) h,95％ CI:19.67～33.06 h],which were significantly shorter than that in AEP group [ (57.26 ±4.16)h,95％ CI:49.11 ～ 65.42) ],and also significantly shorter than that in control group [ (71.33 ±0.54) h,95％ CI:70.26 ～71.40,P ＜0.01 ].The expression of PIAS1 at 16h in ANP group was significantly lower than those in AEP group and control group ( 0.10 ± 0.01 vs.0.80 ± 0.07,0.87 ± 0.05,P ＜ 0.01 ).The Cox analysis suggested that PIAS1 was an independent prognosis factor for the survival time of AP rats.ConclusionsPIAS1 is lowly to moderately expressed in ANP,and is negatively correlated with AP severity,and may be an independent risk factor for the prediction of severity and prognosis of AP.

Objective To investigate the changes of regulatory T cells (Treg) distribution in trinitrobenzene sulfonic acid (TNBS) induced mice colitis and the therapeutic effects of dexamethasone (DEX).Methods A total of 40 mice were evenly divided into healthy control group,ethanol control group,model group and DEX treatment group.The model group was given 2.5 mg TNBS through enema,while healthy control group and ethanol control group were administered with 0.9％ NaCl solution and ethanol solution respectively.DEX treatment group was intraperitoneal injected with DEX (0.6 mg/kg) since the first day after modeling.Mice were executed at 3rd,5th and 7th day after modeling,mice body weight of each group were observed and the rate of both CD25+ forkhead box P3(Foxp3) positive and CD4 positive cells in spleen and mesenteric lymph nodes were measured by flowcytometry.At the 7th day,disease activity index (DAI) and colonic histopathological score were evaluated,the expression of Foxp3 in colon tissue were measured by immunohistochemistry.t-test was applied for each group comparison.Results Compared with healthy control group and ethanol control group,the mice body weight of model group significantly decreased (t=3.604 and 2.422,both P＜0.05); DAI score and colonic histopathologic score increased (t=2.630 and 2.438,both P＜0.05;t=7.910 and 6.600; both P＜0.01).Compared with the model group,DAI score decreased (t=2.076,P＞0.05) and histopathologic severity in DEX treatment group improved significantly (t =2.320,P＜0.05).At the 7th day after modeling,the rate of both CD25+ Foxp3 positive and CD4 positive cells in spleen and mesenteric lymph nodes of model group was 3.320％ ± 0.533％ and 2.888％±0.379％,lower than that of healthy control group (5.379％ ±0.518％ and 4.688％±0.553％; t=2.769 and 2.686; both P＜0.05).After DEX treatment,the rate increased.The expression of Foxp3 in colon tissue of healthy control group,model group and DEX treatment group was 3.000±0.577,7.200±0.800 and 6.000±0.931 per high power field respectively,and the expression of model group and DEX group significantly increased (t=4.257 and 2.739,both P＜ 0.05).Conclusions The distribution of Treg in spleen and colon were abnormal in TNBS-induced mice colitis model.DEX may improve the disease state of the mice model through upregulating Treg.

BACKGROUND: The biomechanical features of the plate internal fixation for the fractures are commonly analyzed utilizing direct contact and low accuracy sensor. However, it has some limitations such as direct contact and low accuracy. The digital speckle method used in the biomechanics of fractures is more accurate to analyze the characteristics of the screw breakage.OBJECTIVE: To measure the displacement of screws under different tensile force conditions after the internal fixation surgery of compression plate for adult thighbone using digital speckle method. METHODS: A total of six femur samples from adults were used to prepare model of midshaft humerus fractures. Each of two ends of fractured samples was fixed with five screws, and the pull test was conducted under the load of 200 and 300 N by electronic versatile machine to measure the displacement of the screws under 10 conditions. RESULTS AND CONCLUSION: The displacement distance of the screw was significantly longer under 300 N loading force compared with 200 N (P < 0.01). Except screws 1 and 10, 2 and 9, 3 and 8, 4 and 7, and 5 and 6, there were significant differences in the displacement between any two screws (P < 0.05). Results showed that the displacement of the screws increased with increasing pulling force, and the displacement near the fracture line significantly changed with pulling force.

Objective: To explore the effects of effort-reward imbalance (ERI) at work on the occupational burnout, job satisfaction and turnover intention of doctors in public hospitals. Methods: By using self-designed questionnaires to in-vestigate job attitude, this paper adopts a stratified random sampling method to select 1910 doctors from public hospitals in Jinan, Weifang and Dezhou cities based on the level of economic development in Shandong province. The data are ana-lyzed using descriptive analysis, correlation analysis, hierarchical regression analysis, etc. Results: The effort-reward imbal-ance at work exists in the surveyed public hospitals. The job effort of doctors is 1. 39 ± 0. 37 times higher than job reward. The effort-reward imbalance at work has positive predictive effects on occupational burnout, negative predictive effects on job satis-faction, and positive predictive effects on turnover intention. Conclusions:Public hospital administrators should improve the ef-fort-reward ratio of doctors in order to stabilize doctors' professional attitude at work and enhance their morale.

Objective To evaluate the diagnostic value of endoscopic ultrasonography (EUS ) combined with detection of immunoglobulin (Ig ) and T‐cell receptor (TCR ) gene rearrangements in primary gastrointestinal lymphoma (PGIL) .Methods From 12nd January ,2012 to 23rd May ,2014 ,the clinical data of 24 patients with suspicious PGIL under endoscopy (regular biopsy negative and without treatment) and underwent further EUS examination was retrospectively analyzed .All patients received EUS‐guided biopsy or EUS‐guided fine needle aspiration (FNA) and the tissue specimens were detected for Ig and TCR gene rearrangements .Considering biopsy result ,surgical pathological diagnosis and follow‐up result as gold standard ,the clinical significance of sensitivity ,specificity ,positive predictive value (PPV) , negative predictive value (NPV ) and accuracy of EUS combined with Ig /TCR gene rearrangements in PGIL were explored .Results Among 24 patients ,19 patients were finally diagnosed as PGIL ,which were all non‐Hodgkin′s lymphoma (NHL ) ;monoclonal gene rearrangement was found in 13 cases of the 19 cases .The left five cases were not lymphoma lesions (three cases of gastritis ,one case of leather stomach and one case of malignant melanoma) with no monoclonal gene rearrangement .In cases diagnosed as PGIL , 14 were B cell NHL ,which included eight cases of muscosa‐associated lymphoid tissue (MALT) lymphoma and six cases of diffuse large B cell lymphoma .Of which ,immunoglobulin heavy chain (IgH)/immunoglobulin kappa (IgK) gene rearrangement was found in 11 cases .A total of five cases were T cell NHL including one case of anaplastic large cell lymphoma , one case of NK /T cell lymphoma and three cases of enteropathy‐associated T‐cell lymphomas . TCR gene rearrangement was found in two cases .Because theoretically ,there was no gene rearrangement in natural killer (NK )/T cell lymphoma ,so NK /T cell lymphoma was excluded from statistical analysis .The sensitivity ,specificity ,PPV ,NPV and accuracy of EUS combined with Ig /TCR gene rearrangements detection in PGIL were 72 .2% ,100 .0% ,100 .0% , 50 .0% and 78 .3% ,respectively .Conclusion The detection of monoclonal gene rearrangement in tissues from EUS‐guided biopsy or EUS‐guided FNA had better diagnostic value in PGIL ,which improved the objectivity and accuracy of lymphoma diagnosis .

Objective To elaborate the role of hepatic inherent macrophages and monocyte-derived macrophages in acute liver injury.Methods A model of acute liver injury in mice was induced via intraperitoneally injection of CCl 4 .Af-ter CCl4 injection, analysis of the expression of CD45, F4/80, Ly6C and CD11b on the hepatic macrophage surface was performed by flow cytometry at 24, 48 and 72 h before the hepatic inherent macrophages (CD45+F4/80hi) and monocyte-de-rived macrophages ( CD45+F4/80 lo ) were sorted at the same time .The relative expression of cytokines in the two popula-tions of macrophages was detected by qRT-PCR.Results Compared with control , the number of total F4/80 +cells in the liver was markedly increased after CCl 4 injection, especially at 72 h.The number of CD45+F4/80lo cells increased signifi-cantly after CCl4 injection 24 h.The mRNA levels of MCP-1, TNF-α, TGF-β1, matrix metalloproteinase(MMP)-12 and MMP-13 were elevated significantly both in F 4/80 hi and F4/80 lo macrophages .IL-12βand IL-6 mRNA levels increased significantly only in F4/80hi macrophages, while the level of MMP-9 mRNA increased markedly only in F4/80lo macropha-ges.When compared with F4/80lo macrophages, MCP-1 and MMP-12 mRNA levels were elevated significantly , while the level of TNF-αmRNA decreased significantly in F4/80hi macrophages.Conclusion In acute liver injury, hepatic inherent macrophages and monocyte-derived macrophages both express inflammatory cytokines , promoting inflammation response and leading to liver damage .The ability to recruit inflammatory monocytes into the liver is much stronger ,the expression of in-flammatory cytokines ( IL-12βand IL-6 ) and MMP-12 is higher , but the expression of inflammatory cytokines ( TNF-α) MMP-9 is lower in hepatic inherent macrophages than in monocyte-derived macrophages .