ObjectiveTo explore the role of neuroimaging features monitored by functional near-infrared spectroscopy （fNIRS） in postoperative delirium （POD） in elderly patients undergoing joint replacement during perioperative period， and to provide a basis for early clinical prediction. MethodsA total of 105 elderly patients who underwent joint replacement under general anesthesia were included. The Mini-Mental State Examination （MMSE） scale was used to evaluate the patient's cognition one day before the operation. Before the start of the surgery， fNIRS was used to monitor the changes of cerebral blood oxygen saturation when the patient performed the task state. The 3-minute delirium diagnostic scale （3D-CAM scale） was used to evaluate the occurrence of POD at 24， 48 and 72 h after operation. Brain network analysis was performed and Logistic regression analysis was used to explore the relationship between fNIRS monitoring data and POD in elderly patients undergoing joint replacement surgery during preoperative task state. The receiver operating characteristic curve （ROC curve） was constructed to evaluate the diagnostic efficacy， and the Hosmer-Lemeshow goodness-of-fit test was used to test the goodness of fit of the model. ResultsAmong 105 patients， 100 cases were effectively analyzed， of which 20 cases （20%） had POD. Brain network analysis showed that the r value of functional connectivity correlation coefficient in POD group （0.069±0.118） was lower than that in non-POD group （0.073±0.084）. The low channel connectivity of right primary somatosensory cortex-right primary motor cortex （RS1-RM1） and left anterior pole-right Broca's triangle （LFP-RBA44） was an important factor affecting the occurrence of POD （P < 0.05）. Based on this result， the area under the ROC curve was 0.797 and 0.784， respectively. The results of Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well （all P>0.5）. ConclusionThe neuroimaging features extracted from the cerebral oxygen saturation data monitored by fNIRS are significantly correlated with the risk of POD in elderly patients undergoing joint replacement during perioperative period. Among them， the low connectivity of preoperative RS1-RM1 and LFP-RBA44 brain network channels is an important influencing factor of POD occurrence. Predicting the occurrence of POD based on fNIRS is conducive to the early intervention and risk reduction of perioperative complications， improving medical quality and promoting precision medical practice.

Objective To investigate the effect of Yiqi Jiedu Recipe(YQ)on the proliferation,migration,and invasion of nasopharyngeal carcinoma cells,and to explore its mechanisms of action on proliferation,migration,and invasion through the TGF-β1/SMAD3 signaling pathway.Methods(1)The 5-8F cells were divided into four groups:solvent control group,YQ 0.5 mg·mL-1 group,YQ 1.0 mg·mL-1 group,and 5-fluorouracil 2 μg·mL-1 group.Cell proliferation was monitored using real-time cell analysis(RTCA).Wound healing experiment was conducted to assess cell migration.After 24 hours of drug intervention,transwell assay was employed to measure cell invasion.The protein expression levels of β-catenin,E-cadherin,N-cadherin,TGF-β1,and SMAD3 in the cells were evaluated using the Western Blot method.(2)The 5-8F cells were divided into five groups:solvent control group,TGF-β1 10 ng·mL-1 group,TGF-β1 10 ng·mL-1+YQ 1.0 mg·mL-1 group,YQ 1.0 mg·mL-1 group,and LY3200882 10 μmol·L-1 group.Cell proliferation was monitored using RTCA.Wound healing experiment was conducted to assess cell migration.After 24 hours of drug intervention,transwell assay was employed to measure cell invasion.The protein expression levels of β-catenin,E-cadherin,N-cadherin,TGF-β1,and SMAD3 in the cells were evaluated using Western Blot.(3)The nude mice were randomly assigned into the model group,YQ group,and 5-fluorouracil group.Subcutaneous injection of 5-8F cell suspension was performed to establish the xenograft nude mouse model of nasopharyngeal carcinoma.After the tumors reached a certain size,the 5-fluorouracil group received intraperitoneal injection of 5-Fu once every 2 days,while the other groups were orally administered corresponding drugs once a day for three consecutive weeks.Tumor volume was measured every 3 days.Western Blot was conducted to assess the protein expression levels of β-catenin,E-cadherin,and N-cadherin in the tissues of each group.Results Compared with the solvent control group,the proliferation curves of 5-8F cells in the YQ(0.5 mg·mL-1,1.0 mg·mL-1)groups showed a decrease.The migration and invasion abilities of the cells were both reduced(P＜0.05,P＜0.01).Additionally,the expression of E-cadherin protein significantly increased(P＜0.01),while the protein expression of β-catenin,N-cadherin,TGF-β1,and SMAD3 all decreased(P＜0.05,P＜0.01).Compared with the model group,the transplanted tumor volume of nasopharyngeal carcinoma in the YQ group significantly decreased(P＜0.05).Furthermore,the protein expression of β-catenin and N-cadherin in the transplanted tissues of the YQ group was significantly downregulated(P＜0.05,P＜0.01),while the expression of E-cadherin protein was significantly upregulated(P＜0.01).After the addition of the activator and inhibitor of TGF-β1 signaling pathway,compared with the YQ 1.0 mg·mL-1 group,the TGF-β1 10 ng·mL-1+YQ 1.0 mg·mL-1 group showed a significant increase in the expression of TGF-β1,SMAD3,β-catenin,and N-cadherin proteins(P＜0.05,P＜0.01)and obvious enhancement of the abilities of cell proliferation,migration,and invasion(P＜0.01).Conclusion Yiqi Jiedu Recipe can inhibit the proliferation,migration,and invasion by regulating the TGF-β1/SMAD3 signaling pathway.

Polyphyllin Ⅰ(PPⅠ)and polyphyllin Ⅱ(PⅡ)are the main active substances in the Paris polyphylla.However,liver toxicity of these compounds has impeded their clinical application and the potential hepatotoxicity mechanisms remain to be elucidated.In this work,we found that PPⅠ and PⅡ exposure could induce significant hepatotoxicity in human liver cell line L-02 and zebrafish in a dose-dependent manner.The results of the proteomic analysis in L-02 cells and transcriptome in zebrafish indicated that the hepa-totoxicity of PPⅡ and PⅡwas associated with the cholesterol biosynthetic pathway disorders,which were alleviated by the cholesterol biosynthesis inhibitor lovastatin.Additionally,3-hydroxy-3-methy-lglutaryl CoA reductase(HMGCR)and squalene epoxidase(SQLE),the two rate-limiting enzymes in the choles-terol synthesis,selected as the potential targets,were confirmed by the molecular docking,the over-expression,and knockdown of HMGCR or SQLE with siRNA.Finally,the pull-down and surface plasmon resonance technology revealed that PPⅠ could directly bind with SQLE but not with HMGCR.Collectively,these data demonstrated that PPⅠ-induced hepatotoxicity resulted from the direct binding with SQLE protein and impaired the sterol-regulatory element binding protein 2/HMGCR/SQLE/lanosterol synthase pathways,thus disturbing the cholesterol biosynthesis pathway.The findings of this research can contribute to a better understanding of the key role of SQLE as a potential target in drug-induced hepatotoxicity and provide a therapeutic strategy for the prevention of drug toxic effects with similar structures in the future.

Objective To investigate the exposure to stroke risk factors, the proportion of high?risk individuals, and the relationship between risk factor exposure and impaired cerebrovascular hemodynamics in patients at Pu'er People's Hospital. Methods Between April 2014 and June 2017, this study enrolled inpatients and outpatients of the neurology department of Pu'er People's Hospital who underwent cerebrovascular hemodynamic examinations to evaluate stroke risk. A total of 30 103 (12 793 males and 17 310 females) participants aged 22 to 99 (53.3±14.5) years were included. The distribution of exposure rates for stroke risk factors and proportion of high?risk individuals were determined according to age and sex. The relationships between integral scores of cerebrovascular hemodynamics and exposure to risk factors were also analyzed. Results Exposure rates for risk factors of hypertension, dyslipidemia, diabetes, heart disease, stroke family history, cigarette smoking, alcohol drinking, and overweight or obesity in males were 36.6%, 11.4%, 8.8%, 5.9%, 7.0%, 41.6%, 37.8%, and 51.4%, respectively. The exposure rates in females were 31.2%, 11.3%, 7.6%, 5.5%, 6.8%, 0.7%, 1.6%, and 48.8%, respectively. Differences between age groups for all risk factors were significant (P<0.01). Exposure rates for hypertension, diabetes, cigarette smoking, alcohol drinking, and overweight or obesity in males were significantly higher than in females (P<0.01). High?risk males and females accounted for 41.8% and 35.6% (χ2=119.82, P<0.01) and the rates in both groups increased significantly with age (χ2=1 838.2, 2 881.5, P<0.01). Risk factors including age, hypertension, dyslipidemia, diabetes, heart disease, stroke family history, alcohol drinking, and body mass index were independent predictors of increased individual risk of stroke. Conclusions Exposure levels for stroke risk factors and the proportion of individuals at high risk of stroke were relatively high in the hospital population. Cerebrovascular dysfunction is closely related to exposure to common risk factors for stroke.

Objective To investigate the difference between Han nationality residents and the Hani nationality residents in southern Yunnan about the effects of stroke risk factors on cerebral vascular hemodynamic indicators.Methods In the cohort crowds,Hani nationality outpatient patients were selected as the Hani nationality group,the Han nationality outpatient patients with the same gender and similar age were randomly selected as the Han nationality group with the ratio of nearly 1 ∶ 3.The risk factors of stroke and the differences of the hemodynamic indicators were compared between the two groups.Results The dyslipidemia proportion of the Hani nationality group was lower than that of the Han nationality group [48 cases (11.5 ％) vs.257 cases (17.5 ％),x2 =8.867,P =0.003],and the drinking proportion of the Hani nationality group was higher than that of the Han nationality group [79 cases (18.9％) vs.214 cases(14.6％),x2 =4.498,P =0.034],the other risk factors exposure rates had no statistically significant differences between the two groups (all P ＞ 0.05).The ratio of numbers of cerebral vascular hemodynamic indicators below 75 points(optimum truncation points) in the Hani nationality group and the Han nationality group were 30.3％ and 31.9％,respectively,the proportion of the two groups of integral value distribution had statistically significant difference (x2 =12.614,P ＜ 0.01);Vmean (left:t =0.632,P =0.527;right:t =0.642,P =0.532),Vmin (left:t =-0.349,P =0.727;right:t =-0.540,P =0.589),Wv(left:t =0.297,P =0.767;right:t =1.119,P =0.263),Zcv(left:t =0.297,P =0.767;right:t =1.247,P =0.213),Rv(left:t =0.837,P =0.403;right:t =1.222,P =0.222),DR(left:t =0.720,P =0.482;right:t =0.396,P =0.692),Cp(left:t =0.614,P =0.539;right:t =1.486,P =0.138) and other indicators of the two groups had no statistically significant differences.Conclusion The Hani nationality residents'stroke risk factors and CVHI integral distribution in different age groups are different from Han people in southern Yunnan.

Objective To measure the expression of La-related protein 1 (LARP1) in gastric carcinoma and investigate its relationship with the biologic behavior of gastric carcinoma.Methods Expression of LARP1 protein in 30 gastric carcinoma tissues and para-carcinoma tissues and 30 normal gastric specimens was detected by immunohistochemistry.Results The mean density of LARP1 expression in gastric carcinoma (0.19-± 0.13) was significantly higher than that in adjacent tissues (0.07 ± 0.12) and normal tissue (0.01 ± 0.03) (P ＜ 0.01).Along with the increasing of TNM stage,LARP1 in gastric carcinoma tissue expression was significantly increased (stage Ⅰ vs.Ⅱ vs.Ⅲ + Ⅳ =0.06 ± 0.07 vs.0.20 ± 0.12 vs.0.30 ± 0.08,P =0.001) and lymph node metastasis in patients with LARP1 expression levels than those without lymph node metastasis (0.22 ± 0.12 vs.0.11 ± 0.14,P =0.038).The amount of expression in poorly differentiated carcinoma LARP1 is significantly higher than that in high grade carcinoma (0.24 ± 0.12 vs.0.12 ± 0.12,P =0.022),but has no correlation with age or gender of patient.It has no correlation with the size and location of tumor.Conclusions LARP1 is overexpres sed in gastric carcinoma and para-carcinoma tissues.It is significantly related to the malignant biological behavior of gastric cancer and may play an important role in the carcinogenesis and development of gastric carcinoma.

Objective To evaluate the olfactory functions in patients with Parkinson's disease (PD) with a smell identification test developed for the Chinese population and to examine possible factors contributing to PD patients' olfactory performance.Methods Fifty-five patients with idiopathic and nondementia PD and 55 demographically matched healthy controls (HC) were recruited and their olfactory identification tested using the Chinese Smell Identification Test developed by the Institute of Psychology at Chinese Academy of Sciences.Results Olfactory identification score was significantly lower (t =-6.827,P＜0.01) in the PD group (19.3 ±5.4) as compared with the HC group (26.5 ±5.7).Of all PD patients,63.6％ scored over 1 SD below the age norm.In particular,of those with Hoehn-Yahr ratings between 2 to 3,77.8％ scored over 1 SD below the age norm.Receiver operating characteristic (ROC) curve analysis indicated that a cut-off score of 22.5 on the Chinese Smell Identification Test distinguished between PD patients and HC with a sensitivity of 74.6％ and specificity of 70.9％.Within the PD group,age,education,Hoehn-Yahr rating and Mini-Mental State Examination score were not found to correlate with olfactory performance (all P ＞ 0.05).Conclusion PD patients in China show significant impairment of olfactory identification,which is effectively captured by the Chinese Smell Identification Test.

Objective To investigate the prevalence of dyspepsia and the relationship between dyspepsia,psychological and social factors among the college students in Naning city,and to improve the prevention and treatment of dyspepsia in this region.Methods Rome Ⅲ diagnostic questionnaire for adult dyspepsia,Chinese college student mental health scale (CCSMHS),Chinese college student psychological stress scale (CCSPSS),Chinese college student adaptation scale (CCSAS) and Chinese college student personality scale (CCSPS) were performed through interview survey in 2 580 Nanning college students.Chi square test and rank sum test were used to compared differences between groups.Correlation analysis was performed by Pearson correlation and Logisitic regression analysis.Results A total of 2 520 qualified Rome m questionnaires were recovered.The prevalence of dyspepsia in Nanning college students was 5.36％(135/2 520).The most common appearance of dyspepsia in college students were dislike of drinking tea (86.96％(100/115) vs 79.10％(1 605/2 029)),dislike of pickled food (85.22％(98/115) vs 76.29％(1 548/2 029)) and missing meals (40.87％(47/115) vs 30.31％(615/2 029)),the differences were statistically significant (x2 =4.122,4.860,5.685;all P＜0.05),while the dyspepsia was not related with drinking,smoking and taking raw,cold or spicy food (all P＞0.05).The results of multifactor regression analysis showed that the prevalence of dyspepsia was not correlated with diet.Among the twelve dimensions of psychological health,the somatization,anxiety,depression,low self-esteem,social withdrawal,sexual psychology,paranoia,force,dependency,psychotic tendencies of dyspepsia group were significantly higher than those with non-dyspepsia group (x2 =16.981,21.805,12.520,13.539,6.998,6.154,15.013,9.457,10.715,4.260,all P＜0.05).Among the seven dimensions of psychological stress,study pressure and development pressure were negative life events,and their of dyspepsia group were significantly higher than those with non-dyspepsia group (x2 =6.216,Fisher exact probability test,both P＜0.05).There was no statistically significant difference between two groups in the seven personality,such as active,outgoing,tenacity,rigorous,altruism,affectionate and easy-going (all P＞0.05).Among the seven dimensions of adaptation,the adaptation to campus life,emotion and career choice of dyspepsia group were significantly lower than those with non-dyspepsia group (x2 =8.223,8.148,5.713,all P＜0.05).While there was no statistically significant difference between two groups in the other four dimensions of adaption,such as relationships,learning,ego and satisfaction (all P＞0.05).The results of Logistic regression analysis in psychological health,stress and adaption of dyspepsia group and non-dyspepsia group indicated that dyspepsia was associated with somatization (odds ration (OR) =1.610,95％ confidence interval (CI) 1.012-2.559),anxiety (OR=1.955,95％CI 1.216-3.142) and the study pressure (OR=2.159,95％CI 1.106-4.213).The results of Pearson correlation analysis in study pressure,somatization and anxiety of dyspepsia group showed that both somatization and anxiety were correlated with study stress in dyspepsia group (r=0.314,0.323;both P＜0.05).Conclusions Dyspepsia is a common symptom in Nanning college students.Students with dyspepsia have different degrees of psychological problems which are mostly anxiety and somatization.And study stress as a negative event is the major stress factor.

AIM:To clarify the relationship between serum copper/zinc ratio(CZR) and histopathological classification as well as prognosis of Hodgkin's disease (HD). METHODS:The serum copper level(SCL),serum zinc level(SZL)and CZR were determined by atomic absorption spectrophotometry(AAS)in 135 patients with HD and 100 healthy individuals.RESULTS:The results showed that SCL and CZR were higher and SZL was lower in patients with HD than in healthy individuals (P＜0.01). SCL and CZR were significantly higher in the patients with lymphocyte depleted type(LD)than mixed cellulal type(MC), SCL and CZR were higher in MC type than nodular sclerosis type(NS)and lymphocyte predominance type (LP)(P＜0.01). It was also found that with the development of the disease, the SCL and CZR elevated but SZL dropped. And with the alleviation of the disease, the SCL and CZR rose while SZL dropped. While the illness is relieved and the SCL and CZR markedly dropped and SCZ rose. SCL and CZR were strongly correlated with histopathologic type and clinical stage of tumor.CONCLUSION:SCL, SZL and CZR are parameters useful for clarifying histopathological classification, clinical stage and prognosis of HD.

AIM: To clarify the relationship between serum copper/zinc ratio(CZR) and histopathological classification as well as prognosis of Hodgkin's disease (HD). METHODS: The serum copper level(SCL),serum zinc level(SZL)and CZR were determined by atomic absorption spectrophotometry(AAS)in 135 patients with HD and 100 healthy individuals.RESULTS: The results showed that SCL and CZR were higher and SZL was lower in patients with HD than in healthy individuals ( P