Sarcopenia is a common complication in patients with liver cirrhosis, with an incidence rate of up to 40%-70%, which increases the incidence rate of complications in patients with liver cirrhosis and seriously affects patients' quality of life and survival time. Sarcopenia in liver cirrhosis has a complex pathogenesis, and its clinical manifestations are easily ignored. No consensus has been reached on diagnostic criteria, and there are few targeted therapeutic drugs. Therefore, it should be taken seriously by clinician and the research on pathogenesis and therapeutic drugs should be strengthened.

Objective: To analyze the epidemiological and etiological characteristics of aggregation epidemics of infectious diarrhea induced by norovirus, and to provide the scientific basis for the prevention and control. Methods: A descriptive epidemiological analysis of aggregation epidemics events occurred during 2016-2018 in Longhua District of Shenzhen was carried out, with subtypes identified by real-time fluorescence quantitative PCR, Region B and Region C fragment sequence determination. Results: There were 34 aggregation epidemic events,including 448 cases, the mean attack rate was 18.26%(448/2 454). The median duration of aggregation epidemic was 3 days. The peak season appeared in autumn and winter, and the peak of epidemic emerged from December 2016 to April 2017. About 91.18% (31/34) of the epidemics occurred in schools and child care centers, and among children aged 3-6 years (78.79%, 353/448). The clinical symptoms were mainly nausea and vomiting (95.77%, 408/426) in children and adolescents but diarrhea in adult group (95.45%, 21/22). The differences between vomiting and diarrhea were both statistically significant in the two age groups (χ2=98.89，99.61，P<0.01). 29 cases were transmitted through interpersonal network, of which 21 cases were found to have unregulated treatment of vomit on campus. The detection rate of biological samples was 49.15% (203/413), all of which were G Ⅱ norovirus. The genotype was mainly GⅡ.P16-G Ⅱ.2(n=49)from November 2016 to April 2017. Conclusion Norovirus can cause large-scale outbreaks in child care centers and schools easily. Early standardized patient isolation and proper management of vomit and diarrhea are the key steps in prevention and control measures.

Objective To evaluate the effects of neural stem cells (NSCs) overexpressing brainderived neurotrophic factor (BDNF) on the levels of neurotrophic factors and microglia activation in hippocampus after brain irradiation.Methods Hippocampal NSCs were isolated from fetal rat brain and infected with GFP-lentivirus and GFP-BDNF-lentivirus.SD rats were randomized into four groups:control group,irradiated group (R group),GFP-modified NSCs transplantation group with irradiation (R+NSCs group),and GFP-BDNF modified NSCs transplantation group with irradiation (R+BDNF-NSCs group).NSCs were transplanted into the bilateral hippocampus of rats one month after whole brain irradiation at a single dose of 20 Gy.The expressions of BDNF,glial-derived neurotrophic factor (GDNF) and nerve growth factor (NGF) in hippocampus were detected at 2 and 8 weeks after transplantation.The activation of microglia was observed by immunofluorescence.Results At 2 and 8 weeks after transplantation,the expressions of BDNF and NGF proteins in hippocampus of R+BDNF-NSCs group were significantly higher than those of R group (P＜0.05).The activated microglia in the R+NSCs group and the R+BDNF-NSCs group had no decrease compared with R group (P＞ 0.05).Conclusions The transplantation of NSCs overexpressing BDNF promotes the production of BDNF and NGF,which improves the level of neurotrophic factors in hippocampus after radiation.

Objective: To establish a CT image radiomics-based prediction model for the differential diagnosis of silicosis and tuberculosis nodules. Methods: A total of 53 patients with silicosis and 89 patients with tuberculosis who underwent routine CT scans in Suzhou Fifth People's Hospital from January to August, 2018 were enrolled in this study. AK/ITK software was used to segment the images to obtain 139 silicosis lesions and 119 tuberculosis lesions. For each lesion image, 396 features were extracted, and feature dimension reduction was applied to select the most characteristic feature subset. Support vector machine (SVM) , feedforward back propagation neural network (FNN-BP) , and random forest (RF) were implemented using R software (Rstudio V1.1.463) , and the algorithm that achieved the largest area under of the receiver operating characteristic (ROC) curve (AUC) was selected as the final prediction model. Results: RF was the best prediction model for the differential diagnosis of silicosis and tuberculosis nodules, with an accuracy of 83.1%, a sensitivity of 0.76, a specificity of 0.9, and an AUC of 0.917 (95% confidence interval: 0.8431-0.9758) . RF had a significantly larger AUC than SVM and FNN-BP (P<0.05) . Conclusion CT image-based RF prediction model can be used to differentially diagnose silicosis and tuberculosis nodules.

Objective: To investigate the role of p75 neurotrophin receptor (p75NTR) in the irradiation-induced hippocampal neurogenesis impairment. Methods: Thirty Sprague-Dawley rats were subject to whole brain irradiation with a single dose of 10 Gy 4 MeV electron beam. At 1 month after irradiation, the hippocampal tissues of the rats were collected. Western blot was used to detect the changes in the expression level of p75NTR protein. Immunofluorescence confocal laser microscopy was performed to observe the variations in the hippocampal neurogenesis. The stereotatic method was adopted for intra-hippocampal injection of AAV-shp75NTR to specifically knock out p75NTR.The relationship between p75NTR and hippocampal neurogenesis was analyzed. Results: Western blot demonstrated that the expression of p75NTR protein was significantly up-regulated by 43.8% after irradiation (P<0.05). Immunofluorescent staining showed that the quantity of BrdU⁺ NeuN⁺ cells in rats was significantly decreased by 81.5% at 1 month after irradiation compared with that in the control group (P<0.01). After the specific knockout of p75NTR, hippocampal neurogenesis was obviously protected. Conclusion p75NTR plays a pivotal role in the irradiation-induced hippocampal neurogenesis impairment.

Objective To analyze the causes of delayed hemorrhage after colonoscopic treatment in colorectal diseases and the value of second colonoscopic treatment.Methods A retrospective study was conducted on 45 patients with colorectal protrusion lesions (polyps,adenoma,early carcinoma and lipoma) in the Daping hospital of the Third Military medical University from January 2010 to December 2016.The patients suffered from delayed hemorrhage after argon knife coagulation,submucosal resection,submucosal dissection or nylon snares colonoscopic treatment.The mode and clinical outcome of second colonoscopic treatment were summarized by aiming at the reasonsof delayed hemorrhage.Results The predilection sites of delayed hemorrhage were in turn rectum (28.89 ％),sigmoid colon (24.44 ％) and ascending colon (22.22 ％).Adenoma and intraepithelial neoplasia lesions were easier to occurr (88.89 ％).The types of delayed hemorrhage were mainly blood oozing at the lesion resection wound surface as well as blood gushing or ejection.The second colonoscopic treatment modes in these cases were mainly titanium clipping and ring clipping and suturing.Five cases were treated by submucosal injection of adrenaline (1 ∶ 10 000) combined with argon knife coagulation.Thirtyfive cases conducted argon knife coagulationcombined with titanium clipping,3 cases conducted titanium clipping and 2 cases adopted ring clipping hemostasis.Forty-two cases stopped bleeding by once colonoscopic treatment,while 3 cases suffered from re-bleeding,the colonoscopic treatment was performed again,1 case stopped bleeding after using titanium clipping and ring clipping hemostasis again,while other 2 cases were transfered to the surgery department for conducting colectomy.All 43 cases of delayed hemorrhage in this group were cured and discharged after successful hemostasis by colonoscopy.The firm wound treatment after colonoscopic treatment was very important for preventing delayed hemorrhage,and the underlying diseases and postoperative diet management were also the important factors of delayed hemorrhage.Conclusion Timely second colonoscopic examination and treatment can obtain satisfactory clinical effects in the patients sufferring from delayed hemorrhage after colonoscopic treatment.

Objective This study is to investigate the changes in the NFATc 4/3 signaling pathway in rat hippocampus after whole brain radiation. Methods A total of 120 one?month?old male Sprague?Dawley rats were randomly divided into four groups to receive whole brain radiation using 4?MeV electron beams with doses of 0( control) ,2,10,and 20 Gy,respectively,in a single fraction. At 6 hours,12 hours,1 day,3 days,1 week,and 2 weeks after radiation,Western blot and real?time PCR were used to evaluate the changes in expression levels of CaN, NFATc 4/3, p?NFATc 4/3, and GSK?3β. Results There were no significant changes in the expression of NFATc 4/3 or p?NFATc 4/3 at 6 and 12 hours after whole brain radiation. At 1 day after radiation,compared with the control group,the expression of p?NFATc 4/3 in the radiation groups was significantly increased in a dose?dependent manner ( 2 Gy:P= 0. 014;10 Gy:P=0. 011;20 Gy:P=0. 000 );however, there was no significant difference in the expression of NFATc 4/3 between the radiation group and the control group. The expression of NFATc 4/3 was significantly decreased in the radiation groups than in the control group at day 3 ( 2 Gy:P=0. 040;10 Gy:P=0. 000;20 Gy:P=0. 000),1 week (2 Gy:P=0. 692;10 Gy:P=0. 032;20 Gy:P=0. 021),and 2 weeks (2 Gy:P=0. 001;10 Gy:P=0. 000;20 Gy:P=0. 000) after radiation,while there was no significant difference in the expression of p?NFATc 4/3 between any two groups. There were no time?or dose?dependent changes in expression of CaN or GSK?3β. Conclusions Ionization radiation has an inhibitory effect on the NFATc 4/3 signaling pathway in rat hippocampus. Combined with our previous results,this study suggests that radiation?induced cognitive dysfunction is associated with the NFATc 4/3 signaling pathway.

Background:Non-variceal vascular originated gastrointestinal bleeding has been attracted more and more attention in clinical practice. Because of the poor efficacy of conventional drug therapy and the high rebleeding rate,endoscopic therapy or interventional therapy have become the first choice. Aims:To investigate the therapeutic value of endoscopic therapy and interventional therapy in non-variceal vascular originated gastrointestinal bleeding. Methods:Retrospective analysis was performed in 77 patients with non-variceal vascular originated gastrointestinal bleeding who underwent endoscopic therapy or interventional therapy from January 2010 to May 2016 at Daping Hospital of the Third Military Medical University. The therapeutic efficacy of the two therapies was compared. Results:In 77 patients,48 patients received endoscopic therapy and 29 patients received interventional therapy. Compared with interventional therapy group, hemoglobin was significantly higher (P = 0. 007)and Blatchford score was significantly lower in endoscopic therapy group (P = 0. 021). Stomach lesion was found in 22 patients,25 in duodenum,18 in small intestine,9 in colon and 3 in rectum. Angiodysplasia lesion was found in 35 patients,ulcer combined with angiodysplasia in 26 patients,arterial rupture in 13 patients,and angiotelectasis in 3 patients. Rebleeding occurred in 7 patients underwent endoscopic therapy within 72 hours. No rebleeding was found in patients underwent interventional therapy,however,1 patients died from pulmonary embolism. Conclusions:Most patients with upper gastrointestinal angiodysplasia can benefit from endoscopic therapy. Surgery may be a better choice for those with more severe mucosal damage and rebleeding within 72 hours after treatment. Interventional treatment may be a first choice for those who have bleeding from small intestinal angiodysplasia,lower hemoglobin and a higher Blatchford score.

Background:With the deepening of researches on etiology of gastrointestinal bleeding,bleeding caused by pancreatic diseases has been understood better by the clinicians. Upper gastrointestinal bleeding (UGIB)is an uncommon but highly lethal complication of pancreatic diseases. Aims:To analyze the clinical characteristics of UGIB caused by pancreatic diseases for improving the diagnosis and management of this condition. Methods:A total of 22 inpatients who were diagnosed as UGIB caused by pancreatic diseases from Sep. 2010 to Sep. 2016 at Daping Hospital,the Third Military Medical University were recruited and analyzed retrospectively. Results:There were 15 males and 7 females;the disease was more prevalent in young patients than in middle-aged and elderly patients (45. 5% vs. 31. 8% and 22. 7%). The top five causes of bleeding were as follows:stress ulcer related to acute pancreatitis (36. 4%),pancreatic pseudocysts related to chronic pancreatitis (18. 2%),severe acute pancreatitis (13. 6%),post-operative bleeding related to pancreatic surgery (9. 1%)and left-sided portal hypertension (9. 1%). The diagnosis was commonly made by gastroscopy, abdominal contrast-enhanced CT and angiography. Ten patients received medical therapy only,6 were treated by surgical operation,5 by endoscopic hemostasis,and 1 by angioembolization. Hemostasis was achieved in 18 patients (81. 8%), and rebleeding occurred in 4 patients,of which two received medical therapy initially. Two elderly patients died of uncontrollable bleeding and multiple organ failure,respectively. Conclusions:UGIB caused by pancreatic diseases are prone to occur in young and middle-aged males. Pancreatitis and its complications are the major cause of this condition. Medical therapy is ineffective for most of the patients and a multidisciplinary approach of endoscopy,transarterial intervention and surgery is recommended.

Objective To explore the clinical characters,treatment and prognosis of gastrointestinal Dieulafoy lesion in China.Methods Dieulafoy was used as search term,the literatures about Chinese patients with Dieulafoy lesions from January 1998 to October 2016 were retrieved in the Chinese literature library including China National Knowledge Infrastructure,VIP network,Wanfang database and China Biology Medicine disc,and a total of 515 literatures,5 145 patients were enrolled and analyzed.The gender,age,geographical distribution,location of the lesion,treatment and prognosis of the disease were summarized.Results Among the 5 145 patients (male 3 959,female 1 186) with Dieulafoy disease,the ratio of male to female was 3.34∶1.00.The age was from 3 to 95 years,and mean age was 51 years.The lesion location was mainly in stomach (88.82％,4 570/5 145) and second was small intestine (8.28％,426/5 145).In stomach,the lesions were mainly located in gastric corpus,fundus and cardia.The small intestinal Dieulafoy lesions were mainly located in duodenum.The main manifests were sudden hematemesis,melena,and hematochezia.The treatments mainly was endoscopic treatment (72.56％,3 733/5 145),and second was surgery (25.27％,1 300/5 145).Among the5 145 patients withDieulafoy disease,5 099 patients (99.11％) were cured and 46 patients (0.89％) died.The proportions of endoscopic treatment,interventional therapy and first endoscopic treatment within 24 hours in tertiary hospitals were all higher than those of nontertiary (all P＜0.01).The cure rate of tertiary hospitals (99.22％,3 674/3 793) was significantly higher than that of nontertiary hosptials (98.54％,1 421/1 442) (x2 =0.89,P＜0.05) and the mortality was significantly lower than that of nontertiary hospitals (P＜ 0.05).Conclusions The male is more susceptible to Dieulafoy lesion which occurred at any age than the female in China.The predilection sites of Dieulafoy lesion were stomach and duodenum.The primary treatments were endoscopic treatment and surgery,and the disease usually had a good prognosis.