ObjectiveTo investigate the correlation between ineffective esophageal motility (IEM)and gastroesophageal reflux disease (GERD).MethodsA total of 90 GERD patients were enrolled in our study,including 62 patients with reflux esophagitis (RE) and 28 with non-erosive reflux disease (NERD).All the patients underwent gastroscopy,24-hour esophageal pH monitoring and esophageal manometry.ResultsIn the RE group 30 (48.4％) patients were diagnosed as having IEM,which was significantly higher than the NERD group (6 patients,21.4％ ) (P＜0.05).Positive esophageal acid exposure was more often seen in patients with IEM than in those with normal esophageal motility (91.7％ v.s.57.2％,P ＜0.01 ).The values of total percentage of time with pH ＜4,percentage of reflux time in supine position,long-duration episodes ( ＞5 min) and the longest reflux time and DeMeester score were significantly higher in the IEM cases than those in the normal esophageal motility cases ( P ＜ 0.01 ),so was the values of number of reflux episodes (P ＜ 0.05).ConclusionIEM is the most common esophageal dysmotility in patients with GERD and closely related to distal esophageal acid exposure and RE.

OBJECTIVE:To investigate the occurrence of ADR induced by over-the-counter(OTC)drug in order to guide the rational use of drugs. METHODS:45 cases of ADR induced by OTC drug were analyzed retrospectively in terms of patient's gen-eral information,allergic history,allergenic drugs,reason for drug use,route of administration,incubation period,days of hospi-talization,clinical manifestation,treatment,outcome,etc. RESULTS:Among 45 patients,there were 14 male and 31 female. The patients were mainly 20-30 year-old(31.1%). Three patients had previous history of allergy(6.7%). Most ADR were induced by oral drugs(82.2%). Reasons for drug use were mainly disease of respiratory system(23 cases,51.1%). The results of causality as-sessment were positive in 3 patients(6.7%),probable in 35(n=77.8%),and possible in 7 patients(15.6%). ADR were mainly induced by non-steroidal anti-inflammatory drugs (NSAIDs,57.8%),Chinese patent medicine (20.0%),drugs for external use (17.8%). The clinical manifestations mainly included exanthematous drug eruption (33.3%),erythama multiforme drug eruption (24.4%),urticarial drug eruption(13.3%). CONCLUSIONS:NSAIDs are the main allergenic drugs,and ADR induced by OTC traditional Chinese medicine can not be ignored. To improve medical knowledge and skills of the public and the scientific use of OTC drug are beneficial to improve the clinical treatment level.

Objective:To study feasibility of preparing artificial antigen by membrane coated with hapten-carrier.To compare the Emodin-BSA membrane antigen immunogenicity and specificity against the liquid antigen.Methods:Emodin-BSA-PVDF membrane was prepared by the method that BSA was coated on PVDF membrane and the BSA was coupled with Emodin-couplint agent derivative.Rats were immunized by subcutaneous implantation.The immunogenicity and antibody specificity were characterized using Emodin-CA or Chrysophanol-CA or Physcion-CA membrane immunoassay. Results: The immunogenicity of Emodin-BSA coated membrane antigen was higher than Emodin-BSA liquid antigen;the specificity for three anthraquinones was almost the same(P>0.05). Conclusion:Emodin antiserum generated using Emodin-BSA coated membrane antigen has a high immunogenicity and specificity to Emodin.The results show it is feasible that membrane coated with hapten-carrier is used as artificial antigen.

[Objective]To investigate the chemical compositions,antioxidant and anti-inflammatory activities of Jiangshan Polygonatum sibiricum alcoholic extract(PSAE)in vitro.[Methods]The chemical compositions of PSAE were identified by ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q/TOF-MSE),its antioxidant activity was studied,and in vitro experiments were conducted to determine its effect on lipopolysaccharide(LPS)-induced THP-1 cells.Molecular docking was further used to validate the results.[Results]PSAE contained 17 chemical compositions,including 5 flavonoids,5 saponins,3 lignans,1 phenolic acid,1 steroid and 2 other compositions.In vitro experiments showed that PSAE possessed great antioxidant activity.Besides,PSAE could increase the viability of LPS-induced THP-1 cells,significantly decrease the levels of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)in cell supernatants and the expression of NOD-like receptor thermal protein domain associated protein 3(NLRP3),apoptosis-associated speck-like protein containing CARD(ASC)and cysteinyl aspartate specific proteinase-1(Caspase-1).Molecular docking results showed that 16 of the 17 chemical compositions detected in PSAE had good docking activities with the core targets of NLRP3,ASC and Caspase-1.[Conclusion]PSAE has great antioxidant and anti-inflammatory activities,and the main active compositions may be flavonoids and saponins.

Animals ; Biocatalysis ; Cattle ; Enteropeptidase ; chemistry ; metabolism ; Humans ; Models, Molecular ; Oryzias ; metabolism ; Structure-Activity Relationship ; Substrate Specificity

Objective:To invastigate the targets and signaling pathways of Gubiao Fanggan Modified Formula in regulating the defense against influenza A virus in immunosuppressed mice by network pharmacology,and the key targets were verified by immuno-suppressive mice model.Methods:TCMSP database was used to search the active ingredients of Gubiao Fanggan Modified Formula,and GeneCard,OMIM,PharmGkb databases were used to obtain the potential targets of the active ingredients to prevent influenza,and take their intersection targets were taken;STRING11.5 database was used to make protein-protein interaction network analyzed and finded the core targets;Cytoscape3.8.1 was used to build a traditional Chinese medicine-ingredient-disease target network,and GO enrichment analysis and KEGG enrichment analysis were performed.Intraperitoneal injection of cyclophosphamide was used to construct a mouse model of immune function suppression,normal group,model control group,Gubiao Fanggan Modified Formula group and oseltamivir group were set up,followed by prophylactic administration,and influenza virus intervention was performed on the fourth day.After 7 days of intragastric administration,the key targets were verified by mouse spleen index,HE staining,RT-qPCR and immunohistochemistry.Results:There were 82 active ingredients in five traditional Chinese medicines in Gubiao Fanggan Modi-fied Formula,and 72 common targets of drugs and diseases such as IL-6,TNF-α,IL-2,etc,mainly involving IL-17,TNF and AGE-RAGE signaling pathway.Gubiao Fanggan Modified Formula could increase spleen index and significantly reduce mRNA and protein expressions of IL-6 and TNF-α in spleen tissue of mice(P<0.05 or P<0.01).Conclusion:Gubiao Fanggan Modified Formula may regulate body's immune function through targets such as IL-6 and TNF-α,thereby preventing influenza virus infection.

OBJECTIVE: To determine the prevalence and influencing factors of work-related musculoskeletal disorders(WMSDs) among workers in a shipyard. METHODS: A total of 496 workers in a large shipyard in Guangdong Province were selected as research subjects using the convenient sampling method. The Questionnaire of Musculoskeletal Disorders was used to investigate the prevalence of WMSDs in various regions of the body in the past year.Multivariate logistic regression was used to analyze the potential influencing factors of WMSDs in the frequently affected body parts. RESULTS: The prevalence of WMSDs was 70.2%(348/496). The prevalence rates of WMSDs in different body regions were: lower back/waist(43.1%), neck(29.4%), shoulder(29.0%), hand/wrist(25.4%), knee(22.4%), hip/leg(14.3%), ankle/foot(12.1%), upper back(11.3%) and elbow(9.3%). Multivariate logistic regression analysis results showed that increased risk of lower back/waist WMSDs occurred in workers who carry heavy objects>5.0 kg, who work in uncomfortable positions, who repeatedly perform the same work every day, and who repeatedly perform the same action using the lower limbs and ankles(P<0.05). Employees working ≤8 hours or more than 8 hours per day had higher risk of developing lower back/waist WMSDs compared with workers working 8-10 hours per day(P<0.05). CONCLUSION: The prevalence of WMSDs among workers in the shipyard is high.The lower back/waist WMSD is the most common one. The influencing factors include work organization and adverse ergonomic factors.

Objective:To explore the feasibility of deep learning-based restoration of obscured thyroid ultrasound images.Methods:A total of 358 images of thyroid nodules were retropectively collected from January 2020 to October 2021 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and the images were randomly masked and restored using DeepFillv2. The difference in grey values between the images before and after restoration was compared, and 6 sonographers (2 chief physicians, 2 attending physicians, 2 residents) were invited to compare the rate of correctness of judgement and detection of image discrepancies. The ultrasound features of thyroid nodules (solid composition, microcalcifications, markedly hypoechoic, ill-defined or irregular margins, or extrathyroidal extensions, vertical orientation and comet-tail artifact) were extracted according to the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). The consistency of ultrasound features of thyroid nodules before and after restoration were compared.Results:The mean squared error of the images before and after restoration ranged from 0.274 to 0.522, and there were significant differences in the rate of correctness of judgement and detection of image discrepancies between physicians of different groups(all P<0.001). The overall accuracy rate was 51.95%, the overall detection rate was 1.79%, there were significant differences also within the chief physicians and resident groups (all P<0.001). The agreement rate of all ultrasound features of the nodules before and after image restoration was higher than 70%, over 90% agreement rate for features such as solid composition and comet-tail artifact. Conclusions:The algorithm can effectively repair obscured thyroid ultrasound images while preserving image features, which is expected to expand the deep learning image database, and promote the development of deep learning in the field of ultrasound images.

Objective To explore the automated identification and diameter measurement methods for inferior vena cava (IVC) based on clinical ultrasound images of IVC. Methods An automated identification and localization method based on topology and automatic tracking algorithm was proposed. Tracking algorithm was used for identifying and continuously locating to improve the efficiency and accuracy of measurement. Tests were conducted on 18 sets of ultrasound data collected from 18 patients in intensive care unit (ICU),with clinicians' measurements as the gold standard. Results The recognition accuracy of the automated method was 94.44％ (17/18),and the measurement error of IVC diameter was within the range of±1.96s (s was the standard deviation). The automated method could replace the manual method. Conclusion The proposed IVC automated identification and localization algorithm based on topology and automatic tracking algorithm has high recognition success rate and IVC diameter measurement accuracy. It can assist clinicians in identifying and locating IVC,so as to improve the accuracy of IVC measurement.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.