OBJECTIVETo explore the protective effect and mechanism of ligustrazine (LGT) and propofol (PRO) on peri-operational liver ischemia-reperfusion injury (HIRI).

METHODSThirty-six patients scheduled for hepatic surgery were randomly divided into the control group, the LGT group, the PRO group and the LGT + PRO group, 9 patients in each group. Changes of superoxide dismutase (SOD), lipid peroxide (LPO), ratio of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1alpha (6-keto-PGF1alpha), alanine aminotransferase (ALT) activity, and the ultrastructure of liver tissue were dynamically observed.

RESULTSCompared with the control group, SOD activity was significantly higher, LPO concentration, TXB2/6-keto-PGF1alpha ratio and ALT value were significantly lower (P < 0.05 and P < 0.01) in the LGT group, the PRO group and the LGT + PRO group during HIRI, with the abnormal changes of hepatic ultrastructure 25 min after reperfusion significantly alleviated in the three treated group.

CONCLUSIONCombination of ligustrazine and propofol shows protective effect on liver by decreasing oxygen free radical level, reducing lipid peroxidation and adjusting TXA2/PGI2 imbalance after hepatic ischemia-reperfusion in patients undergoing hepatic cancer surgery.

6-Ketoprostaglandin F1 alpha ; blood ; Adult ; Drug Therapy, Combination ; Female ; Humans ; Lipid Peroxides ; blood ; Liver ; blood supply ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Propofol ; therapeutic use ; Pyrazines ; therapeutic use ; Reperfusion Injury ; prevention & control ; Superoxide Dismutase ; blood

Objective:To evaluate the auxiliary role of the Python-based handover database in online teaching activities for medical clerks and to complete the teaching tasks during the COVID-19 epidemic.Method:Sixteen teachers were randomized into two groups, experimental group and control group, with 8 ones in each group. The experimental group used the self-built handover database, while the control group used the hospital's HIS system. To make multimedia courseware for medical students, suitable cases were screened. The time to acquire cases and picture data, and the index like numbers were statistically analyzed, and the quality of multimedia courseware was scored. All the data were analyzed by SPSS 25.0 statistical software.Results:The time for the two groups of teachers to acquire target cases during making multimedia coursewares were (8.88±3.48) min and (43.50±5.26) min respectively; the time to obtain the pictures were (5.62±1.92) min and (30.25±5.39) min; the numbers of obtained pictures were (11.12±2.17) and (6.12±2.80); and the scores of coursewares were (92.62 ± 4.93) points and (84.75 ± 6.20) points respectively, all with significant differences.Conclusion:The application of the self-made handover database can significantly improve the speed of teachers' access to related teaching data, and also can improve the quality of multimedia courseware.

Objective:To establish a nomogram for preoperative differentiating intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC) based on clinical, ultrasound, and contrast-enhanced ultrasound (CEUS) data.Methods:A retrospective analysis was conducted on ultrasound and CEUS data of 462 patients who underwent hepatectomy in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2016 to December 2023, including 262 cases of HCC (56.7%) and 200 cases of ICC (43.3%). The data were randomly divided into training set ( n=324) and validation set ( n=138) in a 7∶3 ratio. Univariate analysis was used to initially screen for variables with statistically significant differences between HCC and ICC groups in the training set, and LASSO regression was performed to select the variables with higher coefficients. Logistic regression analyses were then used to predict independent risk factors for ICC. A nomogram was drawn using R software. The performance of the nomogram was then validated using ROC curve, calibration curve, and decision curve analysis (DCA). Results:Univariate analysis showed that there were significant differences in age, gender, liver cirrhosis, HBsAg (+ ), ALP >185 U/L, CA19-9 >27 kU/L, CA242>10 kU/L, irregular shape, border, cholangiectasis, portal vein tumor thrombus, enhanced pattern in arterial phase, clearance time <60 s, intra-tumoral vein between ICC and HCC groups (all P<0.05). The top 10 features were selected for LASSO regression analysis. Logistic regression analysis revealed that gender, cirrhosis, CA19-9>27 kU/L, CA242>10 kU/L, cholangiectasis, clearance time <60 s, intra-tumoral vein and enhanced pattern in arterial phase were risk factors for ICC (all P<0.05). The area under the ROC curve in the training and validation groups were 0.963 and 0.914, respectively. In the training group, the specificity and sensitivity of the nomogram were 0.926 and 0.917, respectively, and in the validation group, they were 0.875 and 0.871, respectively. The calibration curve showed that the prediction effect of the model was in good agreement with the actual situation. DCA showed that the nomogram could increase the net benefit to the different diagnosis of ICC in patients. Conclusions:The nomogram based on clinical, ultrasound and CEUS features has a good predictive value for preoperative identification of ICC and provides reliable evidence for clinical practice.

Objective:To establish and evaluate a clinical and ultrasound parameters-based nomogram for the preoperative differentiating diagnosis of intrahepatic cholangiocarcinoma (ICC).Methods:A total of 723 patients undergoing hepatectomy in Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University from January 2016 to August 2022 were retrospectively screened. A total of 399 patients with hepatocellular carcinoma (HCC, 198 cases) or ICC (201 cases) were enrolled in this study, including 284 males and 115 females, aged (60.5±10.5) years. Through random sampling using computer-generated random numbers, patients were divided into training ( n=279) and validation groups ( n=120) in a ratio of 7∶3. Univariate and multivariate logistic regression were performed to identify factors differentiating ICC, and a nomogram was established using R software based on independent risk factors for ICC. The accuracy of the nomogram was evaluated by receiver operating characteristic curve and calibration curves. Decision curve analysis was performed to assess the net benefit of the model. Results:Multivariate logistic regression analysis showed that irregular shape, cholangiectasis, female, cirrhosis, carbohydrate antigen 242 >10 U/ml, carbohydrate antigen 125 >30 U/ml and alpha-fetoprotein >10 μg/L were independent differentiating factors for ICC (all P<0.05). A nomogram was constructed based on those factors. The nomogram showed a better discrimination between ICC and HCC. The area under the curve of the training group and the validation group were 0.966 and 0.956, respectively. The calibration curve showed that the prediction effect of the model is in good agreement with the actual situation. Decision curve analysis showed that the nomogram was more effective than diagnosing all patients as either HCC or ICC, which yielded a net benefit at the most reasonable threshold probabilities. Conclusion:The nomogram for the preoperative diagnosis of ICC based on clinical and ultrasound features showed a good diagnostic performance.

Objective To investigate the level of metronidazole and prohibited drug residues in poultry meat and eggs in Hubei Province. Methods A total of 168 chicken and egg samples were collected from 13 prefecture level cities and autonomous prefectures of Hubei Province, Qianjiang City and Xiantao City. The residues of metronidazole, ribavirin, amantadine and rimantadine were determined by ultra performance liquid chromatography-mass spectrometry. Results Amantadine, ribavirin and rimantadine were not detected. The detection rate of metronidazole was 4.17% (7/168). There was significant difference in the detection rate of metronidazole in different years, but there was no trend of increase or decrease with the year; the difference of detection rate of banned drugs in different years was statistically significant, and had a trend of decreasing with the year. Conclusion The illegal use of metronidazole still exists in some areas of Hubei Province, which needs to be paid attention to by relevant departments.

Objective To investigate the distribution characteristics of antibiotics in source water and their health risks to human body in Yichang City, and to provide a scientific basis for the prevention and control of new types of pollution such as antibiotics in drinking water. Methods Solid phase extraction (SPE) was used for enrichment, and ultra-high performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was used to detect and analyze the content of five types of antibiotics including sulfonamides, tetracyclines, chloramphenicol, quinolones and β-lactams in the main drinking water sources of Yichang City. The human health risk assessment of these antibiotics was conducted. Results All five types of antibiotics were detected in the source water of Yichang City, and the detection rate was 6.25% to 81.25%. The total detection rate of β-lactam antibiotics was the highest, and the highest detection concentration of norfloxacin was 213.9 ng/L. The health risk assessment of 11 antibiotics detected in the source water showed that these antibiotics would not cause obvious health harm to human body, but the risk entropy (RQ_H) tended to increase with the younger age. Conclusion The distribution level of antibiotics in source water of Yichang City will not cause obvious health harm to human body.

ObjectiveTo observe the effects of electroacupuncture at Zhongwan （CV12） on gastric nociceptive response induced by gastric acid stimulation and explore the underlying mechanisms associated with nuclei of the medullary viscerosensory and visceral motor neurons. MethodsTwenty SD rats were given intragastric administration of 0.5 mol/L diluted hydrochloric acid （0.5 ml/100 g） to induce gastric nociceptive response induction. Eight rats were randomly selected to record the gastric slow wave （GSW） area under the curve， and extracellular discharge frequency of neurons in the nucleus of the solitary tract （NTS） and dorsal motor nucleus of the vagus nerve （DMV） before intragastric administration and at 1， 5， 10， 15， 20， 25， 30， 35， 40， 45， 50， 55， and 60 minutes after intragastric administration. The remaining 12 rats received electroacupuncture intervention at Zhongwan within 5 to 25 minutes after intragastric administration of diluted hydrochloric acid， with a duration of one minute. The GSW area under the curve and extracellular discharge frequency of NTS and DMV neurons were compared between the 1-minute intervals before and after electroacupuncture intervention. ResultsCompared to the baseline before intragastric administration， the area under the curve of GSW significantly increased at 1， 5， 10， 15， 20， and 25 minutes after intragastric administration， and the extracellular discharge frequency of excitatory neurons in the NTS （accounting for 90%， 57/63） significantly increased at 1， 5， 10， 15， 20， 25， 30， 35， and 40 minutes， both reaching peak values at 1 minute after intragastric administration （P＜0.01 or P＜0.05）. The extracellular discharge frequency of inhibitory neurons in the DMV （accounting for 91%， 20/22） showed a non-significant increase at 1 minute after intragastric administration （P＞0.05）， but significantly decreased at other timepoints （P＜0.05）. Compared to the baseline before electroacupuncture intervention， the GSW area under the curve and the extracellular discharge frequency of excitatory neurons in the NTS significantly decreased （P＜0.05）， while the extracellular discharge frequency of inhibitory neurons in the DMV showed no significant difference （P＞0.05）. ConclusionElectroacupuncture at Zhongwan can improve gastric nociceptive response induced by gastric acid stimulation， possibly by reducing the transmission of visceral sensation and decreasing the excitability of NTS neurons in the medulla.