Objective:To investigate the risk factor analysis and model prediction of bleeding after endoscopic retrograde cholangiopancreatography in patients with malignant obstructive jaundice (MOJ).Methods:A retrospective analysis was performed on 302 patients with MOJ treated with ERCP who were treated in the No. 363 Hospital Affiliated to Southwest Medical University from January 2015 to June 2021. The general clinical data of the patients were collected, and the biochemical indicators of the pancreatic and bile ducts were detected. The patients were followed up after discharge, and the patients were divided into a bleeding group ( n=47) and a control group ( n=255) according to whether the follow-up patients were bleeding after ERCP. Compared the general and clinical data of the two groups of patients, including age, gender, platelet count, presence of bile duct stones, acute cholangitis, acute pancreatitis, number of stones, intraoperative bleeding, pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and pre-surgical incision. The measurement data that obey the normal distribution were represented by the mean±standard deviation ( ± s), and the two independent sample t test was used for the comparison between groups; the data that do not conform to the normal distribution were represented by M ( Q1, Q3), and the comparison between groups was used Mann-Whitney U test. The comparison of enumeration data between groups adopted chi-square test. Logistic multivariate regression was used to analyze the independent risk factors of postoperative bleeding after ERCP, and a nomogram prediction model was established and verified according to the independent risk factors of postoperative bleeding. Results:The two groups of patients were compared in age, gender, platelet count, bile duct stones, acute cholangitis, acute pancreatitis, the number of stones, intraoperative bleeding and other aspects, the difference was not statistically significant ( P>0.05). The percentages of pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and surgical pre-incision in the bleeding group were 12.77%, 17.02%, 19.15%, 51.06%, 59.57%, and 14.89%, respectively. , the percentages of the control group were 3.92%, 5.10%, 9.02%, 19.22%, 17.65%, and 5.88%, and the difference was statistically significant between the two groups ( P<0.05). Taking postoperative bleeding as the dependent variable, and using the indicators with statistical differences in univariate analysis as independent variables, multivariate Logistic regression analysis showed that the patient had pancreatic cancer ( OR=1.838, 95% CI: 1.524-4.613, P=0.041), cholangiocarcinoma ( OR=2.548, 95% CI: 1.870-5.116, P=0.015), stone incarceration ( OR=3.078, 95% CI: 2.374-6.012, P<0.001), duodenum Intestinal papillary diverticula ( OR=1.140, 95% CI: 1.045-1.628, P<0.001), surgical pre-incision ( OR=1.640, 95% CI: 1.321-1.928, P<0.001) were associated with postoperative bleeding in MOJ patients after ERCP independent risk factors. The predictive ability of duodenal papillary diverticulum was the highest; the predictive ability of stone incarceration and cholangiocarcinoma was the second, and there was no significant difference between them; the predictive ability of pancreatic cancer, stone diameter, and pre-incision on bleeding after ERCP in MOJ patients smaller. Pancreatic cancer, cholangiocarcinoma, large stone diameter, stone incarceration, duodenal papillary diverticulum, and pre-incision scores were 42, 63, 28, 65, 76, and 34 points respectively, and the total score was 308 points corresponding to the nomogram model. The predictive power of the nomogram was 61.6%, and overall, the nomogram had good predictive performance. Harrell concordance index analysis and ROC curve were used to evaluate the model discrimination, the C-index calculation result was 0.826 (95% CI: 0.771-0.847), the ROC curve AUC was 0.843 (95% CI: 0.801-0.884), and the ROC prediction The value and the calculation result of C-index are relatively close. The model discrimination is applied in this study and has a certain prediction effect. The nomogram model in the Calibration curve predicted the probability of postoperative bleeding after ERCP in MOJ patients with high consistency with the actual probability. Conclusion:ERCP is safe and feasible for most patients with MOJ, but for patients with pancreatic cancer, bile duct cancer, large stone diameter, stone incarceration, and duodenal papillary diverticulum, it should be performed with caution, and preoperative incision should be avoided, to reduce the risk of postoperative bleeding. In addition, the nomogram model has a strong predictive ability in predicting bleeding after ERCP in patients with MOJ, which is worthy of reference in clinical research.

Gene therapy represents a promising treatment for the Alzheimer׳s disease (AD). However, gene delivery specific to brain lesions through systemic administration remains big challenge. In our previous work, we have developed an siRNA nanocomplex able to be specifically delivered to the amyloid plaques through surface modification with both CGN peptide for the blood-brain barrier (BBB) penetration and QSH peptide for -amyloid binding. But, whether the as-designed nanocomplex could indeed improve the gene accumulation in the impaired neuron cells and ameliorate AD-associated symptoms remains further study. Herein, we prepared the nanocomplexes with an siRNA against -site amyloid precursor protein-cleaving enzyme 1 (BACE1), the rate-limiting enzyme of A production, as the therapeutic siRNA of AD. The nanocomplexes exhibited high distribution in the A deposits-enriched hippocampus, especially in the neurons near the amyloid plaques after intravenous administration. In APP/PS1 transgenic mice, the nanocomplexes down-regulated BACE1 in both mRNA and protein levels, as well as A and amyloid plaques to the level of wild-type mice. Moreover, the nanocomplexes significantly increased the level of synaptophysin and rescued memory loss of the AD transgenic mice without hematological or histological toxicity. Taken together, this work presented direct evidences that the design of precise gene delivery to the AD lesions markedly improves the therapeutic outcome.

Objective:To study relationship among serum homocysteine (Hcy) level ,paraoxonase 1 (PON1) activity and carotid atherosclerosis .Methods:A total of 179 residents from a community of Shanghai ,who participated in cardiovascular risk factor screening from 2012 to 2014 ,were selected .They received carotid ultrasonic examination and measurements of serum Hcy ,PON1 and other biomarkers .According to serum Hcy level ,subjects were divided into elevated Hcy group (n=85) and normal Hcy group (n=94) .Results:Spearman correlation analysis indicated that serum Hcy level was significant inversely correlated with PON1 activity (r= -0.738 ,P=0.001) .Compared with normal Hcy group ,there were signifi‐cant rise in age [(60.66 ± 7.18) years vs .(64.57 ± 7.29) years] ,male proportion (27.66% vs .63.53% ) ,serum creati‐nine [(69.62 ± 12.76)μmol/L vs .(88.47 ± 20.86)μmol/L] ,uric acid [(267.85 ± 63.02)μmol/L vs .(307.51 ± 76.07)μmol/L] ,triglyceride [(1.33 ± 0.79) mmol/L vs .(1.76 ± 1.70) mmol/L]and systolic blood pressure [(134.93 ± 15.82) mmHg vs .(142.72 ± 17.86) mmHg] ,and significant reductions in levels of high density lipoprotein cholesterol [HDL‐C , (1.17 ± 0.26) mmol/L vs .(1.06 ± 0.27) mmol/L]and PON1 [(288.58 ± 73.80) kU/L vs .(187.81 ± 16.31) kU/L]in el‐evated Hcy group , P<0. 05 or <0. 01. Incidence rate of carotid atherosclerosis in elevated Hcy group was significantly higher than that of normal Hcy group (64. 7% vs .44. 7% ) , P=0. 001 .Multi‐variate gradual Logistic regression analysis indicated that serum creatinine and Hcy levels were independent risk factors for serum PON 1 activity(OR=1.055 ,1.139 , P<0.01 ,<0.05);Hcy isn′t an independent risk factor (OR=1.020 ,P=0.497) for carotid atherosclerosis .Conclusion:Serum Hcy level is significant inversely correlated with serum PON 1 activity ,and both of them are related to occurrence of carotid atherosclerosis .

Objective To observe the effect of total flavonoids of ampelopsis grossedentata on blood lipid and hemorheology in atherosclerosis rats .Methods The atherosclerosis model in rats was made by freeing high grease food and intraperitoneal injection of vitamin D3 ,total flavonoids of ampelopsis grossedentata was gave by gavage ,and the level of serum lipid and blood rheology were tested 24 weeks later .Results Total flavonoids of ampelopsis grossedentata could obviously decreased the level of TG ,TC ,LDL , and increased HDL(P<0 .05) .It could significantly decrease whole blood viscosity ,plasma viscosity and hematocrit (P<0 .05) . Conclusion Total flavonoids of ampelopsis grossedentata can adjust fatty substance metabolism ,improve hemorheology of athero-sclerosis rats ,and has therapeutic effect for atherosclerosis .

Gilbert Disease ; Hemochromatosis ; Humans

OBJECTIVETo compare the dissolution properties of Ginseng micropowder and common powder in vitro and investigate the effect of micronization on dissolution of Ginseng.

METHODSFive ginsenosides including Rg1, Re, Rf, Rb1, and Rb2 were determined by high performance liquid chromatography, and the dissolution curves of Ginseng micropowder and common powder were drawn.

RESULTSThe dissolution rates of ginsenosides from micropowder exceeded 90% within 5 min, significantly greater than that from common powder. But when the powders were packed in tea bags, the dissolution rates of ginsenosides were higher from common powder than from micropowder.

CONCLUSIONMicronization treatments can promote dissolution of ginsenosides from Ginseng.

Chromatography, High Pressure Liquid ; Ginsenosides ; analysis ; chemistry ; Panax ; chemistry ; Particle Size ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Powders ; chemistry ; Solubility

Objective To compare the dissolution properties of Ginseng micropowder and common powder in vitro and investigate the effect of micronization on dissolution of Ginseng. Methods Five ginsenosides including Rg1, Re, Rf, Rb1, and Rb2 were determined by high performance liquid chromatography, and the dissolution curves of Ginseng micropowder and common powder were drawn. Results The dissolution rates of ginsenosides from micropowder exceeded 90%within 5 min, significantly greater than that from common powder. But when the powders were packed in tea bags, the dissolution rates of ginsenosides were higher from common powder than from micropowder. Conclusion Micronization treatments can promote dissolution of ginsenosides from Ginseng.

Objective To compare the dissolution properties of Ginseng micropowder and common powder in vitro and investigate the effect of micronization on dissolution of Ginseng. Methods Five ginsenosides including Rg1, Re, Rf, Rb1, and Rb2 were determined by high performance liquid chromatography, and the dissolution curves of Ginseng micropowder and common powder were drawn. Results The dissolution rates of ginsenosides from micropowder exceeded 90%within 5 min, significantly greater than that from common powder. But when the powders were packed in tea bags, the dissolution rates of ginsenosides were higher from common powder than from micropowder. Conclusion Micronization treatments can promote dissolution of ginsenosides from Ginseng.

Objective To investigate the expressions of platelet activation-dependent granule membrane protein and platelet-derived growth factor receptor-αB, and the ultra-microstructure changes of platelets in patients with acute ST-segment elevation myocardial infarction(STEMI). Method The expressions of platelet activationdependent granule of glycoprotein (CD62P)and platelet derived growth factor receptor αβ subtype (PDGFR-αβ)of platelets in peripheral blood in 36 patients with acute ST-segment elevation myocardial infarction(STEMI) hospitalized and another 34 healthy subjects over the same period (control group) were investigated by flow cytometry and data were analyzed. The changes of ultra microstructure and activity of blood platelets in those patients and control group were observed under the scanning electron microscope. Results The expressions of CD62P and PDGFR-αβin patients with STEMI group before treatment were (3.65 ± 1.87) % and (0.43 ± 0.39) %, respectively, and those after treatment were (0.96 ± 0.79) % and (0.28 ± 0. 24) %, respectively, whereas those in control group were (0.67 ± 0.35) % and (0.27 ± 0.22) %, respectively, which were much lower in control than those in patients with STEMI before treatment (P ＜ 0.01 or P ＜ 0.05) respectively. There were statistically significant differences in the expressions of CD62P and PDGFR-αβ in patients group between pre-treatment and posttreatment (P ＜0.01 or P ＜0.05), respectively. Obvious ultra-microstructure changes of platelet surface in patients with STEMI group were observed. Conclusions Due to platelet activation in AMI, the expressions of CD62P can be used as effective indicators for monitoring coronary heart disease, and the PDGFR-αβ can be used as a reference indicator. The platelet surface ultra-microstructure changes during platelet activation in patients with AMI can be found by scanning electron microscopy.

BACKGROUNDTo establish an ADM resistant Lewis lung cancer cell line and to investigate its biological characteristics.

METHODSThe multidrug-resistant cell line was gradually induced by ADM from Lewis lung cancer cell line (L3-8), its growth characteristics and cancinogenicity were observed. The fluorescent density of ADM and Rh-B in the cells were analyzed by IPP image analysis system. The ADM concentration in cells was assayed with fluorescent meter. The IC50 was evaluated by MTT assay and the drug resistant index was counted.

RESULTSThe drug resistant Lewis lung cancer cell line, L3-8/ADM, which can grow in the medium containing 0.4mg/l ADM was acquired after 14 months selective culture. Its tumor generatic rate was 10/10. When the L3-8/ADM was cultured in 0.15mg/l ADM and general 1640 medium, the doubling time was 22.0h and 21.8h separately. After culturing in 4mg/l ADM and Rh-B medium, the fluorescent density ratio of L3-8/ADM and L3-8 were 2.82:1 and 2.65:1 separately. The ADM concentration of L3-8/ADM was only 64.7% of its parental, but there was no significant difference in their ADM release rate. Except for ADM, L3-8/ADM was resistant to DNR, VCR, MIT and CDDP in different degrees.

CONCLUSIONSL3-8/ADM cell is a typical MDR cell line. The cell membrane obstruction of drug infiltration might be the cause of drug resistance. This study will provide a basis for the establishment of lung cancer MDR animal model.