Background: Gurgem-13, a traditional Mongolian medicinal formula, is described in the Four Medical Tantras as having therapeutic effects against liver disorders, toxins, renal “wind” conditions, urinary retention, hot-natured conditions, and parasitic infections. It has been widely used in Mongolian traditional medical practice for the treatment of various liver diseases. Aim: To evaluate the effects of Gurgem-13 fractions on the viability of LX-2 cells (human hepatic stellate cell line). Materials and Methods: Gurgem-13 powder was extracted by multiple solvents, including acetonitrile, methanol, distilled water, petroleum ether, n-hexane, ethyl acetate, and anhydrous ethanol, to obtain distinct fractions. LX-2 cells were cultured under standard conditions and treated with varying concentrations of each fraction. Cell proliferation was assessed using the MTT assay. Results: All Gurgem-13 fractions exhibited dose-dependent inhibitory effects on LX-2 cell proliferation. At concentrations of 50 and 100 µL/mL, a statistically significant reduction in cell proliferation was observed (p<0.05). Among the tested fractions, the ethyl acetate fraction demonstrated the highest inhibitory activity. Conclusion Gurgem-13 fractions, particularly the ethyl acetate fraction, significantly suppresses the proliferation of hepatic stellate cells in vitro, suggesting potential antifibrotic activity. These findings support the traditional use of Gurgem-13 in liver disease and suggest its potential therapeutic value against liver fibrosis.

Objective To explore the effect of visual balance training combined with digital treadmill intervention on walking func-tion in patients with ischemic stroke.Methods From July,2023 to December,2024,90 patients with ischemic stroke in Gansu Provincial Hospital were ran-domly divided into control group(n=30),treadmill group(n=30)and combined group(n=30).All groups re-ceived routine rehabilitation treatment,while the treadmill group added digital treadmill training,and the com-bined group added visual feedback balance training and digital treadmill training,for four weeks.All groups were assessed with Berg Balance Scale(BBS),Pro-Kin visual feedback balance training system,Tinetti Performance-Oriented Mobility Assessment(POMA),digital treadmill system,Timed Up and Go Test(TUGT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE),Functional Ambulation Category(FAC)and modified Barthel Index(MBI)before and after intervention.Results The effects of intra-group(F>147.291,P<0.001),inter-group(F>4.919,P<0.05)and interaction(F>18.386,P<0.001)were all significant for the indicators including BBS score,length trajectory and elliptical area of eyes open or closed,POMA score,step length,hip and knee range of motion on the healthy and affected side,TUGT time,FMA-LE score,and MBI score.Post-hoc tests showed that after treatment,all the above indicators improved in each group(P<0.01),and they were the best in the combined group,followed by the treadmill group(P<0.05).After treatment,the FAC grades improved in all the groups(|Z|>1.971,P<0.05),and it was better in the combined group than in the control group(P<0.01).Conclusion Visual feedback balance training combined with digital treadmill intervention can improve balance function,walking ability and activities of daily living in patients with ischemic stroke,which is more effective than tread-mill training alone.

Objective To explore the effect of visual balance training combined with digital treadmill intervention on walking func-tion in patients with ischemic stroke.Methods From July,2023 to December,2024,90 patients with ischemic stroke in Gansu Provincial Hospital were ran-domly divided into control group(n=30),treadmill group(n=30)and combined group(n=30).All groups re-ceived routine rehabilitation treatment,while the treadmill group added digital treadmill training,and the com-bined group added visual feedback balance training and digital treadmill training,for four weeks.All groups were assessed with Berg Balance Scale(BBS),Pro-Kin visual feedback balance training system,Tinetti Performance-Oriented Mobility Assessment(POMA),digital treadmill system,Timed Up and Go Test(TUGT),Fugl-Meyer Assessment-Lower Extremities(FMA-LE),Functional Ambulation Category(FAC)and modified Barthel Index(MBI)before and after intervention.Results The effects of intra-group(F>147.291,P<0.001),inter-group(F>4.919,P<0.05)and interaction(F>18.386,P<0.001)were all significant for the indicators including BBS score,length trajectory and elliptical area of eyes open or closed,POMA score,step length,hip and knee range of motion on the healthy and affected side,TUGT time,FMA-LE score,and MBI score.Post-hoc tests showed that after treatment,all the above indicators improved in each group(P<0.01),and they were the best in the combined group,followed by the treadmill group(P<0.05).After treatment,the FAC grades improved in all the groups(|Z|>1.971,P<0.05),and it was better in the combined group than in the control group(P<0.01).Conclusion Visual feedback balance training combined with digital treadmill intervention can improve balance function,walking ability and activities of daily living in patients with ischemic stroke,which is more effective than tread-mill training alone.

Objective:Distribution and antibiotic resistance of pathogen isolated from children with intra-abdominal infection (IAI) associated sepsis in the intensive care unit (ICU) were analyzed to provide a reference for the empirical anti-infective treatment of IAI in children.Methods:We retrospectively analyzed the data of 116 children with culture-positive IAI-associated sepsis admitted to Children's Hospital of Zhejiang University School of Medicine from January 2019 to December 2021. Clinical isolation and drug resistance analysis were conducted based on different years of onset, locations of onset, and primary diseases.Results:A total of 186 strains of pathogens causing children with IAI-associated sepsis in ICU were collected. The distribution and antibiotic resistance of pathogen were as follows: the percentages of gram-positive bacteria, gram-negative bacteria, and fungi were 53.2%, 40.9%, and 5.9%, respectively; the top four strains were Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis, accounting for 57.0% of all isolates; Enterococcus faecium(19.9%) and Enterococcus faecalis (10.2%) were the dominating gram-positive bacteria; Escherichia coli (13.4%) and Klebsiella pneumoniae (13.4%) were more common gram-negative bacteria; Fungi were dominated by Candida albicans (3.8%).Fifty-seven strains of gram-positive bacteria were detected in 61 children with infectious diseases, mainly Enterococcus faecium (28 strains). There were 53 gram-negative strains, mainly Klebsiella pneumoniae (21 strains). Thirty-two strains of gram-positive bacteria were detected in 40 children with digestive tract malformation, and Enterococcus faecalis (six strains) were the most common. There were 14 gram-negative strains, mainly Escherichia coli (six strains). In 13 children with malignant tumors of digestive system, nine strains of gram-positive bacteria were cultured, and Enterococcus faecium (four strains) was the most common. There were eight gram-negative strains, mainly Escherichia coli (four strains).In the 46 community-acquired IAI patients,30 gram-positive isolates were cultured,mainly including Enterococcus faecium (12 strains), Staphylococcus epidermidis (seven strains), and Viridans streptococci (six strains); Forty gram-negative isolates mainly contained Escherichia coli (16 strains), Klebsiella pneumoniae (14 strains), and Enterobacter cloacae (five strains). In the 70 hospital-associated IAI patients, 69 gram-positive isolates such as Enterococcus faecium (25 strains), Enterococcus faecalis (17 strains), Enterococcus gallinarum (eight strains), and Staphylococcus aureus (seven strains) were cultured;Tirty-six gram-negative isolates were dominated by Klebsiella pneumoniae (11 strains), Escherichia coli (nine strains), Pseudomonas aeruginosa (four strains), and Acinetobacter baumannii (four strains). The mixed infection rate of clinical pathogens was up to 46.6%, and the overall resistance rate was 43.4%, in which gram-negative bacteria had high sensitivity to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, and tigecycline.The detection rates of Klebsiella pneumoniae and Escherichia coli producing extended-spectrum β-lactamases were 36.0% and 24.6%, respectively, with 100% sensitivity to tigecycline. Gram-positive bacteria showed 100% sensitivity to vancomycin, linezolid, and tigecycline. Conclusion:Pathogen isolated from children with IAI-associated sepsis in ICU were dominated by Enterococcus faecium, Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis,respectively. Before confirmation of pathogenic bacteria, antibacterial agents can be selected according to the infection type. It is important to note that a single broad-spectrum antibacterial agent or combination medication can be considered the initial empirical choice due to the large variety of pathogens, high rates of mixed infections, and high overall resistance.

Objective To assess the effects of repeated mild traumatic brain injury(rmTBI)in the parietal cortex on neuronal morphology and synaptic plasticity in the medulla oblongata of mice.Methods Thirty-two male ICR mice were randomly divided into sham operation group(n=8)and rmTBI group(n=24).The mice in the latter group were subjected to repeated mild impact injury of the parietal cortex by a free-falling object.The mice surviving the injuries were evaluated for neurological deficits using neurological severity scores(NSS),righting reflex test and forced swimming test,and pathological changes of the neuronal cells in the medulla oblongata were observed with HE and Nissl staining.Western blotting and immunofluorescence staining were used to detect the expressions of neuroligin 1(NLG-1)and postsynaptic density protein 95(PSD-95)in the medulla oblongata of the mice that either survived rmTBI or not.Results None of the mice in the sham-operated group died,while the mortality rate was 41.67%in rmTBI group.The mice surviving rmTBI showed significantly reduced NSS,delayed recovery of righting reflex,increased immobility time in forced swimming test(P<0.05),and loss of Nissl bodies;swelling and necrosis were observed in a large number of neurons in the medulla oblongata,where the expression levels of NLG-1 and PSD-95 were significantly downregulated(P<0.05).The mice that did not survive rmTBI showed distorted and swelling nerve fibers and decreased density of neurons in the medulla oblongina with lowered expression levels of NLG-1 and PSD-95 compared with the mice surviving the injuries(P<0.01).Conclusion The structural and functional anomalies of the synapses in the medulla oblongata may contribute to death and neurological impairment following rmTBI in mice.

Objective To assess the effects of repeated mild traumatic brain injury(rmTBI)in the parietal cortex on neuronal morphology and synaptic plasticity in the medulla oblongata of mice.Methods Thirty-two male ICR mice were randomly divided into sham operation group(n=8)and rmTBI group(n=24).The mice in the latter group were subjected to repeated mild impact injury of the parietal cortex by a free-falling object.The mice surviving the injuries were evaluated for neurological deficits using neurological severity scores(NSS),righting reflex test and forced swimming test,and pathological changes of the neuronal cells in the medulla oblongata were observed with HE and Nissl staining.Western blotting and immunofluorescence staining were used to detect the expressions of neuroligin 1(NLG-1)and postsynaptic density protein 95(PSD-95)in the medulla oblongata of the mice that either survived rmTBI or not.Results None of the mice in the sham-operated group died,while the mortality rate was 41.67%in rmTBI group.The mice surviving rmTBI showed significantly reduced NSS,delayed recovery of righting reflex,increased immobility time in forced swimming test(P<0.05),and loss of Nissl bodies;swelling and necrosis were observed in a large number of neurons in the medulla oblongata,where the expression levels of NLG-1 and PSD-95 were significantly downregulated(P<0.05).The mice that did not survive rmTBI showed distorted and swelling nerve fibers and decreased density of neurons in the medulla oblongina with lowered expression levels of NLG-1 and PSD-95 compared with the mice surviving the injuries(P<0.01).Conclusion The structural and functional anomalies of the synapses in the medulla oblongata may contribute to death and neurological impairment following rmTBI in mice.

Objective:To analyze the correlation between indocyanine green retention rate at 15 minutes (ICG-R15) and modified Scheuer score in liver tissues of patients with hepatitis B e antigen-positive/negative chronic hepatitis B (CHB), and further explore the indocyanine green clearance test (ICGCT) applied value in judging the progress of CHB-related liver disease.Methods:407 HBeAg (+) / HBeAg (-) CHB inpatients with normal or slightly elevated serum alanine aminotransferase (ALT) [< 2 times the upper limit of normal (ULN)] and modified Scheuer score were collected, and divided into mild liver disease group (M group, 131 cases, modified Scheuer score < G2S2) and progressive liver disease group (A group, 276 cases, modified Scheuer score≥G2 and / or S2). Furthermore, the groups were sub-divided into HBeAg (+) - M group, HBeAg (-) - M group, HBeAg (+) - A group and HBeAg (-) - A group. The correlation between ICG-R15 and modified Scheuer score was analyzed retrospectively. The data were analyzed by SPSS 24.0 software.Results:Basic clinical characteristics: Among the 407 CHB cases with normal or mildly elevated serum ALT, 171 were HBeAg(+) CHB and 236 were HBeAg(-) CHB. The baseline mean serum HBV DNA was higher in HBeAg(+) CHB patients [(6.06 ± 1.95) log10IU/ml] than HBeAg(-) CHB patients [(3.60±1.37)log10IU/ml ( P = 0.000)]. Included patients ICG-R15 detection characteristics: (1) The baseline mean value of ICG-R15 was not statistically significant between the two groups of HBeAg(+) CHB and HBeAg(-) CHB, and was basically within the normal range (< 10%); (2) Comparison of ICG-R15 baseline mean value among the subgroups showed that the patients in the HBeAg(+)-A group/HBeAg(-)-A group were higher than the HBeAg(+)-M group/HBeAg(-)-M group patients, and the difference was statistically significant ( P = 0.013/ P = 0.000). Included patients’ correlation analysis between ICG-R15 and modified Scheuer score: (1) ICG-R15 and modified Scheuer score had shown weak positive correlation with inflammatory activity grade (g) in HBeAg (+) / HBeAg (-) CHB ( r = 0.237, P = 0.002); r = 0.244, P = 0.000); (2) There was a weak positive correlation between ICG-R15 and fibrosis stage (s) in HBeAg (+) / HBeAg (-) CHB ( r = 0. 254, P = 0; r = 0.225, P = 0.001). Included patients ICG-R15 predictive value for the severity of liver histological progression: when the cut-off value of ICG-R15 was 5.1%, the area under the receiver operating characteristic curve from M group to A group was 0.601 ( P = 0.001) for predicting HBeAg (+) / HBeAg (-) CHB patients. Conclusion:ICG-R15 is positively correlated with the modified Scheuer score of liver tissue in HBeAg (+)/HBeAg (-) CHB patients with normal or slightly elevated ALT. In addition, when the cut-off value of ICG-R15 was 10%, it could not accurately reflect the effective hepatocyte reserve function of HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT. Importantly, when the cut-off value of ICG-R15 is 4.0% ~ 5.0%, it may have predictive value for liver disease progression to modified Scheuer score ≥ G2 and / or ≥S2 in HBeAg (+) / HBeAg (-) CHB patients with normal or slightly elevated ALT.

Objective To evaluate the image quality,diagnosis accuracy and dose reduction of split-bolus CT urography (CTU) with low voltage scan and sinogram affirmed iterative reconstruction (SAFIRE).Methods A total of 80 cases of consecutive patients with confirmed or suspected urinary system disease needed CTU examination were divided into two groups (control group and test group) by using random number table.In control group,convention scan (120 kV) with one time injection was used.But low voltage scan (80 kV) with SAFIRE algorithm and split-bolus injection (SBI) was used in experiment group.The radiation dose,image quality and diagnosis accuracy were compared.Results A total of 77 cases completed CTU examination successfully in the two groups,including 39 cases in control group and 38 cases in test group.The effective dose reduced from (26.68 ± 4.07) in control group to (3.93 ± 0.85) mSv in test group (t =-33.78,P ＜ 0.05).Subjective image quality score was (4.49 ± 0.79) in control group and (4.39 ± 1.53) in test group,with no significantly statistical difference (Z =2.71,P ＞ 0.05).Signal-to-noise ratio (SNR) of objective image quality in test group was higher than that in control group (127.3±15.9 vs.109.6 ± 13.2,t =4.49,P＜0.05).But there was no significantly statistical difference in contrast-to-noise ratio (CNR) between control group(100.8 ± 12.9)and test group (109.0 ± 14.4,P ＞ 0.05).For diagnosis accuracy,no statistical difference were found between two groups(84.62％ and 81.58％,P ＞ 0.05).Conclusions The combination of low voltage scan with SAFIRE algorithm and split-bolus injection CTU could reduce the radiation dose significantly,but the objective image quality,CNR (except SNR) of subjective image quality and diagnosis accuracy were all unaffected obviously.

Objective To investigate the effect of laparoscopic cholecystectomy (LTCBDE) in treatment of patients with secondary extrahepatic bile duct stones. Methods Eighty-seven cases of our hospital patients with secondary to extrahepatic bile duct stones were randomly divided into the laparoscopic bile duct exploration and T tube drainage surgery (LCBDE) treatment group and the laparoscopic transcystic duct exploration of common bile duct lithotomy (ltcbde) treatment group. The observation focused on the operation time, bleeding volume , postoperative transfusion , postoperative drainage time , postoperative hospitalization time , cost of hospitalization, postoperative recovery time and complications compared clinical efficacies. Results LTCBDE group of patients in operation time (2.1 ± 0.5) was longer than that of the control group (1.6 ± 0.4), (P <0.001), while the bleeding volume, postoperative fluid volume, postoperative drainage time, postoperative hospitalization time, hospitalization expenses and postoperative recovery time were (17.4 ± 5.4), (6 550.4 ± 1 076.9), (3.5. 1.6), (4.1 ± 1.7), (12 243.5 ± 2 379.6), (11.3 ± 3.5) were lower than that of the group LCBDE (22.1 ± 7.5), (8 304.2 ± 1 394.8), (32.9 ± 10.4), (6.4 ± 2.4), (14 098.1 ± 2 897.3), (16.1 ± 5.7) P, respectively (P values were defined as 0.001, 0, 0, 0.015, 0.001, 0 individually); LTCBDE group of patients with bile leakage, acute peritonitis rates were 1/46,1/46,in which those were lower than the corresponding LCBDE in 6/41, 7/41 (P values were 0.033, 0.016, separately). Conclusion According to indications, LTCBD surgery has the advantages of less injury, less cost, less complications and so on. It has important significance to improve the condition of patients with secondary extrahepatic bile duct stones.

ObjectiveTo investigate the effect of acupuncture on motor function and serum expressions of TNF-aand IL-6 contents in cerebral hemorrhage rats.MethodSeventy-two male Wistar rats were randomized into sham operation, model and acupuncture groups. A rat model of cerebral hemorrhage was made by intracerebral injection of autoblood. Baihui-to-Qubin acupuncture was performed after successful model making. The TNF-aand IL-6 contents of rat serum were measured by enzyme linked immunosorbent assay at three time points: one, three and seven days.ResultBaihui-to-Qubin acupuncture markedly increased the neurological function score and reduced neurologic deficits in cerebral hemorrhage rats. At the same time point, serum TNF-aand IL-6 contents were significantly lower in the acupuncture group of rats thanin the model and acupuncture group; there were statistically significant differences (P<0.01).ConclusionBaihui-to-Qubin acupuncture can reduce neurologic deficits in cerebral hemorrhage rats. It may be related to decreases in serum TNF-aand IL-6 contents after acupuncture.