Objective To investigate the therapeutic efficacy of combining Kangfuxin solution with compound Bingpengsan on patients with diabetes mellitus complicated with pressure sores. Methods Fifty-two diabetes mellitus patients complicated with pressure sores admitted in Department of Emergency in the PLA 155th Central Hospital were divided into observation group and control group by lot method,26 cases in each group. Observation group was treated by combining Kangfuxin solution with compound Bingpengsan,the control group was given Mepliex application therapy,they all had change of dressing once a day. After treatment for 20 days,the therapeutic efficacy of pressure sore,healing time and frequency of changing dressing were observed. Results The total effective rate in observation group was significantly higher than that of control group〔96.1%(25/26)vs. 80.6%(21/26),P<0.05〕, in the observation group,the pressure sore healing time was significantly shorter than that of the control group(day:Ⅱstage:9.5±1.7 vs. 13.0±2.1,Ⅲstage:13.1±3.1 vs. 18.1±5.1,Ⅳstage:15.3±3.7 vs. 19.6±5.9,all P<0.05)and the number of times of changing dressing was significantly reduced compared with that of control group (times:Ⅱ stage:16.39±1.89 vs. 19.32±2.26,Ⅲ stage:19.56±2.52 vs. 22.36±2.69,Ⅳ stage:23.54±2.86 vs. 26.47±3.96,all P<0.05). Conclusion The Kangfuxin solution combined with compound Bingpengsan for treatment of deep pressure ulcers in patients with diabetes mellitus has significant effect,its cure rate is relatively high,the pressure sore healing time is reduced and the patients' suffering is alleviated.

Objective To investigate the expressions of Na+/H+ exchanger regulatory factor 1 (NHERF1) and β-catenin in extramammary Paget's disease tissue as well as their significance.Methods Immunohistochemistry was performed to detect the protein expressions of NHERF1 and β-catenin in paraffin-embeded tissue samples from 18 patients with in situ and 22 patients with invasive extramammary Paget's disease.Results There was a high expression of NHERF1 protein in 18 (81.82％) invasive and 7 (38.89％) in situ extramammary Paget's disease samples (x2 =7.78,P ＜ 0.01).Statistical differences were observed in the membrane expression rate and cytoplasmic or nuclear expression rate of β-catenin between invasive and in situ extramammary Paget's disease tissue samples (0 (0/22) vs.33.33％ (6/18),x2 =8.63,P ＜ 0.01; 81.82％ (18/22) vs.44.44％ (8/18),x2 =6.08,P ＜ 0.05).In extramammary Paget's disease in situ tissue samples,the expression of NHERF1 was negatively correlated with the cytomembrane expression of β-catenin (ρ =-0.488,P ＜ 0.01),but positively correlated with the cytoplasmic or nuclear expression of β-catenin (ρ =0.623,P ＜ 0.01),and there was a negative correlation between the cytomembrane and cytoplasmic or nuclear expression of β-catenin (ρ =-0.572,P ＜ 0.01).Conclusions There is an abnormal expression of NHERF1 and β-catenin in extramammary Paget's disease tissue,which may be associated with the initiation,progression,and invasion of primary extramammary Paget's disease.

Objective To evaluate the clinical value of mini-probe endoscopic ultrasonography (EUS) in determin-ing the therapeutic strategy for early gastric cancer (EGC) before surgery. Methods 151 EGC lesions were enrolled in the study. The accuracy of EUS-determined depths were compared with histopathologic results, and the effects of EUS-based therapeutic decision-making plan was evaluated. Results The overall accuracy of EUS-determined T staging was 74.8%. Multivariate analysis revealed that tumor size larger than 2 cm, endoscopic ulceration and tumor located at upper two thirds of the stomach were associated with EUS misdiagnosis ( < 0.05). 75.3 %(107/142) of the EGC patients received proper treatment according to EUS-based therapeutic selection. Conclusions Mini-probe EUS is a useful utility in T-staging and therapeutic strategy selection for EGC. Special attention should be paid when tumor diameter exceeds 2 cm, co-existence of ulcer or tumor located in the upper two-thirds portion of the stomach.

Objective To investigate the anti-fatigue activity of fermented grain-containing blueberry anthocyanins ( LANHE,LH) in mice.Methods Experiments were conducted in two phases .In the first phase , forty mice were randomly divided into four groups:control group(distilled water,dw) and three LH administration groups (8.75,17.5 and 35.08 ml/kg body mass).In the second phase, mice were randomly divided into two groups:high-dose LH group (35.08 ml/kg body mass) and control group (dw 35.08 ml/kg body mass).After four weeks, a forced swimming test was performed and the biochemical parameters related to fatigue were examined .Results and Conclusion The administration groups showed a significant increase of swimming time to exhaustion compared with the control group , especially the high-dose group ( P<0.001).There was no significant change in the blood lactate between the two groups , but at 20 min after swimming, the lactic acid(LA) contents of the high-dose group were lower than in the control group (P>0.05).LH could significantly increase the liver glycogen contents and decrease the serum contents (P<0.05).These data indicate that LH has anti-fatigue activity and can elevate the exercise tolerance in mice .

Objective To investigate the safety and efficacy of endoscopic submucosal dissection (ESD) in elderly patients (age ≥ 65 years) with early gastric cancer.Methods The retrospective cohort study was adopted.The clinical data of 145 patients with early gastric cancer who underwent ESD at the Peking University Cancer Hospital between January 2011 and June 2014 were collected.Of 145 patients,57 (age≥65 years) were allocated into the elderly group and 88 (age ＜ 65 years) were allocated into the non-elderly group.ESD was performed to all the patients after the multidisciplinary discussion and evaluation.Observation indicators included operation time,volume of intraoperative blood loss,duration of hospital stay,complications,integrity of resected specimens,negative resection margin,tumor cure and follow-up (survival,tumor recurrence and metastasis).The follow-up using outpatient examination and telephone interview was performed to detect survival of patients and tumor recurrence and metastasis till June 2015.Measurement data with normal distribution were presented as x ± s and comparison between groups was analyzed using t test.Measurement data with skewed distribution were presented as M (range) and comparison between groups was analyzed using nonparametric U test.Count data were analyzed using the chi-square test.Results Operation time,volume of intraoperative blood loss,duration of hospital stay,numbers of patients with postoperative perforation,bleeding,en bloc resection of tumor,piecemeal resection of tumor,negative resection margins,positive resection margins,curative resection,extended curative resection and non-curative resection were 100 minutes (range,20-470 minutes),25 mL (range,5-200 mL),5 days (range,2-10 days),1,2,52,5,50,7,30,17,10 in the elderly group and 110 minutes (range,25-480 minutes),25 mL (range,5-600 mL),4 days (range,2-29 days),3,3,85,3,83,5,47,24,17 in the non-elderly group,respectively,with no significant differences between the 2 groups (U =2 451.000,2 183.500,2 116.500,x2=1.544,1.018,1.210,0.142,P ＞ 0.05).Patients with complications were improved after symptomatic treatment.Of 145 patients,135 were followed up for a median time of 26 months (range,12-53 months).Tumor recurrence rates in the elderly and non-elderly groups were 1.8％ (1/57) and 2.3％ (2/88),showing no significant difference between the 2 groups (x2=0.000,P ＞ 0.05).No tumor recurrence and metastasis and death were occurred in other patients.Conclusion ESD is safe and feasible in the treatment of elderly patients with early gastric cancer,and it is equivalent to short-and long-term efficacies of ESD in non-elderly patients.

The pathogenesis of Parkinson's disease is related to the imbalance of viscera,qi,blood,and yin and yang. Some Parkinson's symptoms show opposite characteristics and abnormal constraints because of the influence of its complex pathogenesis. At the qi transformation level,static tremor and muscular rigidity exhibit two opposite states of yang qi:dispersion and contraction. At the spirit level,the sleep disorder of rapid eye movement is caused by the abnormal constraint of the soul on the corporeal soul. The liver is in charge of ascending,whereas the lung is in charge of descending. The liver prefers to disperse,whereas the lung prefers to converge;the lung restrains the liver,and metal (representing the lungs) overcomes wood (representing the liver). Therefore,the liver and lung also possess opposing and mutually restraining characteristics. This study explored the correlation between the liver and lung of patients with Parkinson's disease at the three levels of spirit,qi transformation,and viscera based on the theory of "restraining excessiveness to acquire harmony". It established the connection between motor and non-motor symptoms of Parkinson's disease through the interaction of these three factors. The study elaborated on the generation of symptoms and treatment options for both motor and non-motor symptoms. Under physiological conditions,the liver and lung maintain a dynamic equilibrium of " restraining excessiveness from acquiring harmony" through restraint without suppression,promoting coexistence and harmony. However,under pathological conditions,the functions of the spirit,qi transformation,and viscera of the liver and lung may exhibit abnormalities,and they could mutually influence each other. This study investigated the "restraining excessiveness to achieve harmony" relationship between the liver and lung,focusing on spirit,qi transformation,and viscera levels. The aim of this study was to deepen the understanding of the pathogenesis of Parkinson's disease and to offer novel insights into its clinical diagnosis and treatment.

Objective To develop a method for measuring serum total glycerol by isotope dilution (ID)liquid chromatography tandem mass spectrometry(LC/MS/MS).Methods Serum samples were mixed with [13C3]-glycerol(internal standard)and treated with alcoholic potassium hydroxide to hydrolyze serum glycerides to glycerol.The natural glycerol and the internal standard were benzoylated with the Schotten-Baumann reaction and the benzoates were analyzed by LC/MS/MS.Results The correlation coefficients between the peak area ratios and glycerol concentrations were 0.999 9 and higher.The withinrun coefficients of variation(CV)for serum total glycerol analysis averaged 0.94%(ranged 0.21%～2.62%)and the total CV 1.15%(0.62%～2.00%).Results on certified reference materials(SRM 909b Level Ⅰ and LevelⅡ;GBW 09146 and GBW 09147)showed an averaged bias of 0.20%(-0.20%～1.06%).Conclusions An ID-LC/MS/MS method for serum total glycerol has been developed.The method iS highly specific and precise and may be used as a candidate reference method for serum total glycerol measurements.

Objective: To explore the relationship between behavioral problems and accidental injuries among preschoolers, and to provide evidence for the targeted prevention of children s accidental injuries. Methods: During September to October 2019, parent of 2 062 children aged 3 to 6 selected from 8 kindergartens in Hefei through stratified clustering method were investigated. The prevalence of accidental injuries and behavioral problems among preschoolers was collected by questionnaire survey. Results: The prevalence of accidental injury during the past year was 14.55%(300), and behavioral problems 14.21%(293). Total rate of behavioral problems and rate of each dimensions in children with accidental injury were 32.67%, 2.33%, 19.67%, 15.00%, 2.00%, 1.00 % and 5.00%, compared to 11.07%, 0.45%, 6.41%, 4.88%, 0.40%, 0.17% and 0.79% in children without accidental injury ( χ 2=98.11, 12.54, 58.90, 44.12, 10.51, 6.08, 32.68, P <0.01). Multivariate Logistic regression analysis showed that psychosomatic problems( OR =3.13, 95% CI =2.11-4.66), learning problems( OR =2.73, 95% CI =1.86-3.99), abnormal hyperactivity index ( OR =3.16, 95% CI =1.40-7.14) and left behind children ( OR =1.53, 95% CI =1.13-2.07) were associated with higher risk of accidental injuries( P <0.05). Conclusion Behavioral problems are significantly associated with unintentional injuries among preschool children, which deserved further attention and intervention when formulating prevention and control measures for childhood accidental injury.

Objective To explore the computed tomography (CT) features of gastric cancer invasion to the pancreas and significance in the assessment of resectability of primary lesions.Methods The retrospective cohort study was conducted.The clinical data of 31 gastric cancer patients who were admitted to the Peking University Cancer Hospital between February 2011 and August 2016 were collected.Of 31 patients receiving CT examinations,11 who were diagnosed with suspected pancreas invasion by preoperative CT examinations but operation confirmed no invasion were allocated into the pancreas negative (PN) group,11 who were confirmed as pancreas invasion and under vent radical gastrectomy of gastric cancer combined with pancreas resection were allocated into the pancreas invasion (PI) group,and 9 who were confirmed as pancreas invasion and had unresectable primary lesions were allocated into the pancreas invasion non-resected (PI-NR) group.Observation indicators:(1) morphologic type of contact surface between gastric cancer and pancreas;(2) comparison of CT findings among the 3 groups:primary lesion location,tunor thickness,Borrmann type,serosa pattern of gastric cancer,judging obvious region invaded by gastric cancer,contact or invasion site with pancreas,contact length between gastric cancer and pancreas,pattern,clarity and CT values of contact surface or peripancreas invaded and normal peripancreas;(3) treatment or follow-up situations.All the patients underwent radical resection and palliative resection for gastric cancer or non-operation according to results of exploration.Telephone interview was performed to detect the survival of patients up to February 2017.Measurement data with skewed distribution were described as M (Qn),and comparisons among groups were done by the Kruskal-Wallis test.Comparison of count data were done by the Fisher exact probability.Results (1) Morphologic type of contact surface between gastric cancer and pancreas:there were 4 types according to results of CT examination.Type Ⅰ.pancreas contacted with gastric cancer and there was no change in the morphology and radian of contact surface.Type Ⅱ:pancreas contacted with gastric cancer and radian of contact surface became flattened or shallow depression.Type Ⅲ:contact surface showed a inserted sign or obvious depression.Type Ⅳ:pancreas didn't contact with gastric cancer and there was increased density in fat space between pancreas and gastric cancer,with a smudge sign or strip-and sheet-like opacity.Of 31 patients,type Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 5,10,4 and 12 patients,respectively.(2) Comparison of CT findings among the 3 groups:nodular protrusion,spiculation and strip shape,clounding patch opacity of serosa panern of gastric cancer were detected in 1,6,4 patients in the PN group and 5,4,2 patients in the PⅠ group and 0,2,7 patients in the PI-NR group,respectively,with a statistically significant difference (X2=10.054,P＜0.05).Two,8 and 8 patients in the PN,PI and PI-NR groups had obvious tumor invasion located at a adjacent region between stomach and pancreas,with a statistically significant difference (X2 =11.259,P＜0.05).Contact or invasion site with pancreas located at head,body and tail of pancreas was detected in 6,5,0 patients in the PN group and 1,7,3 patients in the PI group and 5,4,0 patients in the PI-NR group,respectively,with a statistically significant difference (X2=8.390,P＜0.05).Type Ⅰ,Ⅱ,Ⅲ and Ⅳ of contact surface between gastric cancer and pancreas were detected in 5,6,0,0 patients in the PN group and 0,4,4,3 patients in the PI group and 0,0,0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2=29.291,P＜0.05).Number of patients with clear and ambiguous contact surface was 10,1 patients in the PN group and 0,11 patients in the PI group and 0,9 patients in the PI-NR group,respectively,with a statistically significant difference (X2 =26.227,P＜ 0.05).CT values of contact surface or peripancreas invaded were-46 HU (-57 HU,-20 HU) in the PN group and-34 HU (-41 HU,-25 HU) in the PI group and-10 HU (-15 HU,-10 HU) in the PI-NR group,respectively,with a statistically significant difference (Z=15.306,P＜0.05).CT values of normal peripancreas were-87 HU (-96 HU,-76 HU) in the PN group and-88HU (-70 HU,-1 HU) in the PI group and-83 HU (-98 HU,-74 HU) in the PI-NR group,respectively,with statistically significant differences in CT values between contact surface or peripancreas invaded and normal peripancreas among the 3 groups (Z=12.581,13.780,7.793,P＜0.05).(3) Treatment or followup situations:of 31 patients,22 underwent radical gastrectomy and 9 underwent simplex exploration or short surgery.All the 31 patients were followed up for 6.0-71.0 months,with a median time of 13.5 months.Postoperative 1-and 2-year survival rates were 82.6％ and 77.1％.Conclusions There are significant differences in pancreatic invasion and resectability between CT features of contact surface of gastric cancer and pancreas and tumor classification.CT features include that pancreas contacts with gastric cancer in the PN group,radian of contact surface becomes flattened and with a inserted sign in the PI group,and there are increased density in fat space between pancreas and gastric cancer and a smudge sign or strip-and sheet-like opacity in the PI-NR group.

Abstract The prevalence of overweight and obesity among children in China has entered a new phase of pandemic, with substantial regional differences. There are diverse and complex determinants for overweight and obesity in school age children, it is necessary to take targeted measures towards children of different ages and regions, comprehensively consider the effects of physiological, social, household and behavioral factors and simultaneously strengthen connections between schools, medical institutions and families, so as to actively respond to the severe situation of childhood obesity epidemic.