Objective To discuss the clinical value of magnetic resonance diffusion-weighted imaging (MR-DWI) in distinguishing tumor remnants from tumor necrosis of pancreatic carcinoma after cryoablation treatment.Methods Conventional MRI T1WI,T2WI scan,DWI sequence and dynamic enhanced MRI scan were performed in 26 patients with pancreatic carcinoma who were received cryoablation treatment.The changes in MRI signals after cryoablation treatment were recorded.The apparent diffusion coefficient (ADC) values of the normal pancreas,preoperative tumor tissue,postoperative remnants and necrosis tissue were calculated,and the results were compared.The correlation between the ADC values and the size of the tumor was evaluated,and the differences in ADC values among the tumors that had different diameter,location and staging were statistically analyzed.Results Of the 26 patients,complete necrosis of tumor was obtained in 16.The necrotic tumor tissue displayed low-signal on T1WI,high-signal on T2WI and low-signal on DWI,with no enhancement on dynamic enhanced imaging.Active residual tumor tissue was detected in 9 patients,among them the residual tumor diameter ＞5 cm was seen in 7 patients;the residual rate was 34.6％.ADC values of the following tissue,from low to high in order,were preoperative pancreatic tumor tissue (1.022± 0.126)x10-3 mm2/s,postoperative residual tumor tissue (1.130±0.155)x10-3 mm2/s,normal pancreatic tissue (1.924±-0.124)×10-3 mm2/s and postoperative necrosis tissue (2.312-±0.214)×10-3 mm2/s.No statistically significant difference in ADC values existed between preoperative pancreatic tumor tissue and postoperative residual tumor tissue (P=0.452),while statistically significant difference in ADC values existed between normal pancreatic tissue and postoperative necrosis tissue (P＜0.001).The ADC values of pancreatic tumor tissue bore a negative correlation with the tumor size (R=-0.43,P=0.027 2),while the ADC values lacked the relationship to the tumor location as well as to the tumor staging (P=0.738 8 and P=0.089 5 respectively).Conclusion MR-DWI can effectively distinguish the residual tumor tissue from the necrotic tumor tissue of pancreatic carcinoma after cryoablation treatment,which provides reliable basis for further clinical diagnosis and treatment.

Objective To observe the protective effect of the traditional Chinese medicine prescription, Jiu Nao Yi Zhi water extract, on human neuroblastoma SH-SY5Y cell line, its effect on expression of insulin signal transduction pathway, and to explore the related mechanisms.Methods SH-SY5Y cells cultured in vitro, were divided into control group, Jiu Nao Yi Zhi No.1 prescription group and No.3 prescription group.The doses were 0.0625 mg/mL, 0.125 mg/mL, 0.25 mg/mL, 0.5 mg/mL and 1 mg/mL.The thiazolyl blue ( MTT) metabolic rate of each group was determined.The dose of 0.125 mg/mL was chosen for cell immunofluorescence analysis, and to observe the expression of insulin receptor substrates-1 ( IRS-1 ) , cAMP response element binding protein ( CREB ) , and the factors of insulin signal transduction pathway.Results Compared with the control group, MTT metabolic rates of the Jiu Nao Yi Zhi groups were significantly increased (P<0.05), and the cell morphology was much better in those groups, cell body more plump, well-adherent and neurite extensions were observed.The expressions of IRS-1 and CREB were higher than that in the control group.Conclusions The traditional Chinese medicine prescription Jiu Nao Yi Zhi water extract can protect neurons by promoting nerve cell growth, and improving the expression of IRS-1 and CREB, the factors of insulin signal transduction pathway.

Objective:To prove the pharmacological action of Qingfei Capsules.Methods: Some tests such as suppressing cough, dispelling phlegm, calming panting, anti-inflammation, anti-virus, its effects on the nonspecific immunity and cellular immunity of mice were carried out. Results: Qingfei Capsules could prolong the incubation period of cough, wheezing and panting, possess the actions of dispelling phlegm and inhibiting inflammation, raise the nonspecific immunity of body, promote humoral immunity, and raise the cellular immune function.Conclusions: These results provide a basis for clinical application of Qingfei Capsules.

BACKGROUND:The effects of advanced glycation end products (AGEs) on osteoclast-induced bone resorption is controversial and the underlying mechanisms remain unclear. Most of the studies indicate that AGEs can enhance bone resorption, while some othersshowthe opposite effects.
OBJECTIVE:To investigate the effects of AGEs on osteoclast-induced inorganicmatrixdissolution and organic componentdegradation and the underlying mechanisms.
METHODS:RAW 264.7 cels were induced to generate osteoclasts,and AGEs (50-400 μg/mL) or control-bovine serum albumin (100 μg/mL) was added since the beginning of the induction. The effect of AGEs on bone resorption was evaluated by analyzing the area of resorption pits on the Osteo Assay Surface plates and the expression of cathepsin K. Furthermore, the number of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cels, nuclei per osteoclasts and the expression of integrinανβ3were detected.
RESULTS AND CONCLUSION:The area of resorption pits and expression of cathepsin K in AGEs groups were significantly decreased compared withthecontrol group, and this inhibiting effect became more obvious with the increase of AGEs concentration. TRAP staining also showed that number of TRAP-positivemultinucleated celsand nuclei per osteoclast were significantly reduced in an AGE dose-dependent manner. Quantitative PCR revealed that the expression of integrin ανβ3decreased significantly with the extension of AGEs incubation time. These data indicate that AGEs can exert inhibitory effects on organic and inorganicmatrixdegradation induced by osteoclasts. The underlying mechanism may be involved in the inhibitory effects of AGEs on directed differentiation and cel fusion of osteoclast precursor cels, and migration and adhension of osteoclasts.

OBJECTIVETo evaluate the feasibility of combined high dose leucovorin plus 5-fluorouracil infusion for head-neck and digestive tract cancers.

METHODSFifty-six patients with head-neck and digestive tract cancer were treated by combined high dose leucovorin (HD-CF) plus 5-fluorouracil (5-Fu) 48 hour continuous infusion with each patient receiving an average of 3.8 cycles (2-6 cycles). Twenty-five of these 56 patients were untreated and 31 recurrent. Their clinical stages were II 4, III 13 and IV 39.

RESULTSThe over all response rate (CR + PR) was 35.7% and the clinical beneficial response rate was 80.4%. The main side effects were peripheral phlebitis, suppression of bone marrow, oral ulcer, nausea and vomiting of grade I to II.

CONCLUSIONHigh dose leucovorin plus 5-fluorouracil 48 hour continuous infusion is useful with favorable cost/utility ratio for head-neck and digestive tract cancer patients. Further studies are warranted.

Adult ; Aged ; Aged, 80 and over ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Digestive System Neoplasms ; drug therapy ; Drug Therapy, Combination ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; therapeutic use ; Head and Neck Neoplasms ; drug therapy ; Humans ; Leucovorin ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome

Objective To systematically review the efficacy of acupuncture in the treatment of post-operative gastroparesis syndrome.Methods Computer searches were conducted on PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang,VIP,and Chinese biomedical literature database.The ran-domized controlled trial(RCT)on postoperative gastroparesis syndrome after acupuncture treatment was in-cluded.The retrieval time was from the establishment of the database to May 2023.Meta-analysis was per-formed using RevMan 5.3 software.Results Fifteen RCTs involving 1 072 patients were included,545 pa-tients in the acupuncture group and 527 patients in the control group.Compared with the control group,the effective rate of treatment in the acupuncture group was significantly increased(RR=1.08,95％CI 1.09 to 1.27,P＜0.01),the levels of gastrin(SMD=1.86,95％CI 1.40 to 2.32,P＜0.01)and motilin(SMD=1.53,95％CI 0.99 to 2.06,P＜0.01)after operation were significantly increased,the recovery time of postoperative gastrointestinal function was significantly shortened(MD=-4.53 d,95％CI-6.51 to-2.55 d,P＜0.01).Conclusion Acupuncture can improve the effective rate of PGS treatment,in-crease the levels of Gastrin and motilin after operation,and promote the recovery of gastric motility after op-eration.

Objective:To detect pathogenic gene expression in patients with high risk hereditary cardiovascular diseases and explore its predictive value for high risk ventricular arrhythmia .Methods :The expression of pathogenic genes in 30 patients with clinically diagnosed high risk hereditary cardiovascular diseases were detected by using second‐generation high‐throughput sequencing on the basis of gene chip probes associated with high risk hereditary cardiovascular diseases .The patients were divided into two groups by whether the malignant ventricular arrhythmia had happened . And gene expression features of pathogenic genes in the two groups were comparatively analyzed .Results: Among the 30 patients , there were 8 patients (positive rate 26 .67% ) with pathogenic genes .In ten cases with history of high risk ventricular arrhythmia ,the pathogenic gene positive rate was 20% (2/10) .And the pathogenic gene positive rate in control group was 30% (6/20) .The difference between the two groups was not statistically significant .Conclusions :There is a certain positive rate of pathogenic genes in patients with high risk hereditary cardiovascular diseases .However ,further researches are needed to confirm the predictive value of the pathogenic gene expression for high risk ventricular arrhythmia happened in these patients .

Objective: To explore the correlation between screen time, exposure time to different screens and psychology behaviors of preschool children. Methods: A total of 2 582 children from kindergartens in urban Xuzhou areas were recruited to perform the physical examination, a cluster sampling method being explored. Parent questionnaires were performed to understand the time of screens and children’s psychology behaviors. Multi-linear regression and Logistic regression models were also used to analyze the correlation between them in preschool children. Results: The prevalence of abnormal internalization behavior of preschool children in Xuzhou City was 3.8%, the detection rate of abnormal externalization behavior was 22.4%, and the detection rate of prosocial behavior abnormality was 20.9%. The time spent by the preschool boys on TV time, learning day screen time and one-week video time is significantly higher than the girls (P<0.05). After adjusting for age and gender, the results of multiple linear regression analysis showed that the longer the average screen time, the more serious the problem of internalizing and externalizing problems; and the longer the average screen time of the weekend and the week, the worse the prosocial behavior of children (P<0.05). After correcting multiple covariates, it was found that the average screen time was positively correlated with children’s internal and external behavioral problems (P<0.05). Logistic regression analysis showed that after adjusting for age and gender, the average screen time of study day, weekend and week was a risk factor for preschool children’s internal and external behavior problems, and the average weekly screen time was a protective factor for prosocial behavior (P<0.05). After adjusting for multiple covariates, the learning day and the average weekly screen time were risk factors for children’s internal and external behavior (P<0.05). In addition, the results of association analysis between different types of video time exposure and psychological behavior showed that after adjusting for age and gender, all types of video exposures affected the internal and external behaviors of patients (P<0.05); after correcting multiple covariates The association was still statistically significant (P<0.05). Logistic regression analysis showed that after adjusting for age and gender, the exposure time of each type of video screen was a risk factor for children’s internal and external behavior problems (P<0.05). After correcting multiple covariates, all types of video exposure were internalized behavior problems. The risk factors, and the video time of other electronic products were risk factors for externalization behavior problems (P<0.05). Conclusion Average screen time has a significant positive correlation with psychological behavior, and the exposure time of screens such as TV and mobile phone could increase the incidence of psychological behaviors in preschool children.

Objective To systematically evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)in the treatment of postoperative nausea and vomiting(PONV)after laparoscopic non-gastrointestinal surgery.Methods Databases such as PubMed,Cochrane library,Web of Science,Embase,CNKI,Wanfang,and Chinese biomedical database(CBM)were searched to find and screen ran-domized controlled trials(RCTs)of TEAS in the prevention and treatment of PONV after laparoscopic non-gastrointestinal surgery.The retrieval time was from the establishment of the database to July 2023.Meta-a-nalysis was performed using RevMan 5.3 software.Results Twenty-two RCTs involving 3 538 patients were included,including 1 799 in the TEAS group and 1 739 in the control group.The results of meta-analysis showed that the total incidence of PONV in the TEAS group was significantly lower than that in the control group 0-24 hours after operation(RR=0.54,95％CI 0.44-0.68,P＜0.001),and the incidence of postoperative remedial antiemetic was significantly reduced(RR=0.54,95％CI 0.38-0.77,P＜0.001).There was no significant difference in the incidence of postoperative acupoint stimulation-related adverse reactions between the two groups(RR=0.62,95％CI 0.15-2.51,P=0.500).Conclusion TEAS has good clinical efficacy and safety in the treatment of PONV after laparoscopic non-gastrointestinal surgery.

To further improve the diagnosis and treatment level of integrated traditional Chinese and Western medicine for the prevention and treatment of postoperative gastrointestinal disorder, and to promote the standardization of clinical practice guidelines for postoperative gastrointestinal disorder. It was initiated by the Chinese Society of Integrative Anesthesiology, and the " Clinical practice guidelines for prevention and treatment of postoperative gastrointestinal disorder by integrated traditional Chinese and Western medicine: a protocol" was jointly formulated by the institutions such as Gansu Province Clinical Research Center of Integrative Anaesthesiology, Center of Anesthesiology and Pain Medicine of Gansu Provincial Hospital of Traditional Chinese Medicine, World Health Organization Collaborating Center for Guidelines Implementation and Knowledge Translation, GRADE China Center, Industry Technology Centre for Medical Guidelines of Gansu Province, and Evidence-based Medicine Center of Lanzhou University. The Guidelines Formulation Committee followed the principles, methods and procedures of evidence-based guidelines formulation, assembled a multidisciplinary team of experts, and provided an evidence-based clinical practice guidelines using the GRADE method. This protocol mainly expounds the purpose and method of guidelines formulation and the publication, promotion, implementation and update of guidelines.