Objective To evaluate the efficacy of modified Liumo decoction combined with polyethylene glycol 4000 powder in the treatment of functional constipation (FC) with Qi stagnation type.Methods A total of 92 FC patients who met the inclusion criteria were divided into two groups by random number table method,46 in each group.The control group was treated with polyethylene glycol 4000 powder orally on the basis of routine treatment.The treatment group was treated with modified Liumo decoction on the basis of the control group.Both groups were treated for 4 weeks and followed up for 6 months.TCM syndrome was scored before and after treatment.The Serum levels of NOS,NO,SOD,MDA and glutathione (GSH) were detected by ELISA.The adverse reaction during treatment was observed and the recurrence rate was calculated.Results After treatment,the score of defecation discomfort,abdominal distention,bowel ringing,sagittal frequency and chest and rib fullness in the treatment group was significantly lower than those in the control group (t=-4.749,-5.140,-5.835,-6.883,-6.919,all Ps＜0.01).The level of serum NOS (26.95 ± 5.11 U/ml vs.31.36± 7.61 U/ml,t=-3.263),NO (61.91 ± 12.62 U/ml vs.72.35 ± 12.03 U/ml,t=-4.061) in the treatment group was significantly lower than those in the control group (P＜0.01),the level of serum SOD (24.66 ± 3.82 U/ml vs.21.39 ± 3.41 U/ml,t=4.331),GSH (12.15 ± 1.52 U/ml vs.8.13 ± 1.42 U/ml,t=-1 3.278) in the treatment group was significantly higher than those of the control group (P＜0.01),while the MAD level (2.73 ± 0.83 U/ml vs.4.92 ± 0.75 U/ml,t=13.108) in the treatment group was significantly lower than that in the control group (P＜0.01).After 6 months of follow-up,the recurrence rate of the control group was 27.3％ (9/33),which was significantly higher than 4.8％ (2/42) of the treatment group,and the difference was statistically significant (x2=7.482,P=0.006).Conclusions The modified Liumo decoction combined with polyethylene glycol 4000 powder can improve the levels of intestinal neurotransmitters,SOD,MDA and GSH in patients with FC,alleviate the symptoms of traditional Chinese medicine and reduce the recurrence rate.

ObjectiveTo investigate the interventional effect of mangiferin on carbon tetrachloride (CCl4)-induced hepatic fibrosis in mice and the potential mechanism. MethodsA total of 45 male C57BL/6 mice were randomly divided into three groups: normal control group (NC group), liver fibrosis model group (CCl4 group), and mangiferin pretreatment group (CCl4+M group), with 15 mice in each group. An automatic biochemical analyzer was used to measure the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST); HE staining and Masson staining were performed to observe liver pathological changes; ELISA was used to measure the serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNFα); Western Blot was used to measure the protein expression of α-smooth muscle actin (α-SMA), nuclear factor-kappa B (NF-κB), IL-1β, p62, and microtubule-associated protein 1 light chain 3 (LC3) in the liver; quantitative real-time PCR was used to measure the mRNA expression of type I collagen (Col-I) and α-SMA in the liver. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. ResultsHE staining and Masson staining showed a low proportion of mice with hepatocyte degeneration and necrosis and a significant reduction in collagen fibers in the CCl4+M group. Compared with the CCl4 group, the CCl4+M group had significant reductions in the serum levels of ALT and AST (both P＜001). ELISA showed that compared with the CCl4 group, the CCl4+M group had significant reductions in the serum levels of IL-1β, IL-6, and TNF-α (all P＜0.01). Western Blot showed that compared with the CCl4 group, the CCl4+M group had significant reductions in the protein expression of α-SMA, NF-κB, IL-1β, and LC3-II/I in the liver (P＜0.01, P＜0.05, P＜0.01, and P＜0.05) and a significant increase in the protein expression of p62 (P＜0.05). Quantitative real-time PCR showed that compared with the CCl4 group, the CCl4+M group had significant reductions in the mRNA expression of Col-I and α-SMA (P＜0.05 and P＜0.01). ConclusionMangiferin can alleviate CCl4-induced hepatic fibrosis in mice, possibly by reducing inflammation to protect liver function and inhibiting autophagy to reduce the activation of hepatic stellate cells.

Objective: To investigate the expression of Tim-3 on the surface of T cells in patients with esophageal cancer, and to explore its clinical significance. Methods: Fresh tumor tissues, paracancerous tissues, and peripheral blood were collected from 25 patients with esophageal cancer at the first affiliated Hospital of Zhengzhou University from September 2016 to April 2018. Peripheral blood from 10 healthy subjects was also collected during the same time period. The expressions of Tim-3, early apoptotic molecules and intrinsic factors in tumor tissues and peripheral blood PBMCs of 25 esophageal cancer patients were determined by flow cytometry. Also, the correlation between Tim-3+ T cell proportion and pathological parameters was investigated. The expression of Tim-3 in tumor tissues and paracancerous tissues was detected by fluorescence quantitative real-time polymerase chain reaction (qPCR). TCGA database was used to further verify the expression of Tim-3 in tumor tissues and paracancerous tissues, as well as its relationship with prognosis. Results: Tim-3 expression on T cells was higher in tumor tissues from esophageal cancer patients (P<0.01). Tim-3+ T cell function was in an exhausted status(P<0.05 or P<0.01), and the expression of Tim-3 on the surface of T cells in esophageal cancer microenvironment was closely related to lymph node metastasis and clinical staging (all P<0.01). Conclusion: Taken together, Tim3 expression on the surface of T cells could induce T cell dysfunction in patients with esophageal cancer, suggesting that Tim-3 may serve as a potential therapeutic target for esophageal cancer.

Objective To establish a method for the determination of residual solvents in tulobuterol by GC and optimize the purified process of crude tulobuterol product by this method. Methods The analysis was performed on Agilent DB-624 capillary column (30 m×0.32 mm,1.8 μm).The carrier gas was nitrogen at 1 mL·min-1.The injector temperature was 250 ℃.Detector was FID with hydrogen at 45 mL·min-1and air at 450 mL·min-1.The detector temperature was 250 ℃.The column temperature program was used.And the flow ratio was 10:1.Dimethyl sulfoxide (DMSO) was used as solvent of reference and test solution. Results Ethanol,tert-butylamine,dichloromethane,tert-butyl-methyl ether,n-hexane and 1,4-dioxane were completely separated.The calibration curve of each solvent showed good linear correlation. The RSD of precision was less than 5.0% and the average recovery ranged from 97.0% to 104.0% (RSD<5%).By optimizing the purification process of toloterol,the residue of organic solvent in the preparation of tolobuterol was in accordance with the Chinese Pharmacopoeia ( 2015) limit. Conclusion Validated by methodology,this simple,rapid and precise method can be used for the test of residual solvents in tulobuterol.

Objective The present research aimed to explore the relationship of serum CA19-9,CEA,CA125 and sICAM-1 concentration with the diagnosis valuation and tumor metastasis of pancreatic cancer.Methods Ninety pancreatic cancer patients in First Affiliated Hospital of Hebei North University from January 2014 to December 2016 were enrolled in this study.The concentrations of serum CA19-9,CEA,CA125 and sICAM-1 were assayed in different stage of pancreatic cancer patients.The concentrations of these parameters were also detected in metastasis patients and non-metastasis patients.In the same period,90 cases of health examination as contrd group.Measurement data were represented as ~ ± s.Comparison between groups was analyed using t test.single-factor analysis of variance (ANOVA) was used for comparison among groups,and the resuhs were compared by F test.The correlation analysis was performed by spearman method.Results The results showed that CA19-9/ β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.25 ± 0.03,0.27 ± 0.04,0.31 ± 0.06,0.38 ± 0.09,0.68 ± 0.10,respectively),CEA/β-actin (control group and Ⅰ / Ⅱ / Ⅲ/Ⅳ stage pancreatic cancer were 0.29 ±0.07,0.34 ±0.08,0.47 ±0.09,0.58 ±0.12,0.68 ±0.14,respectively),CA125/β-actin(control group and Ⅰ/Ⅱ/Ⅲ/Ⅳ stage pancreatic cancer were 0.31 ±0.05,0.36 ±0.07,0.55 ±0.13,0.58 ±0.14,0.63 ± 0.14,respectively),sICAM-1/β-actin (control group and Ⅰ/Ⅱ/ Ⅲ /Ⅳ stage pancreatic cancer were 0.34 ± 0.05,0.36 ± 0.08,0.41 ± 0.08,0.49 ± 0.10,0.58 ± 0.12,respectively) were higher in pancreatic cancer than control(P ＜0.05).The tumor metastasis group was higher than tumor un-metastasis group CA19-9/β-actin(un-metastasis group and metastasis group was 0.36 ± 0.09,0.58 ± 0.12),CEA/β-actin (un-metastasis group and metastasis group was 0.42 ± 0.09,0.61 ± 0.14),CA125/β-actin (un-metastasis group and metastasis group was 0.48 ± 0.09,0.60 ± 0.14),sICAM-1/β-actin (un-metastasis group and metastasis group was 0.42 ±0.09,0.52 ± 0.10) (P ＜ 0.05).The results showed that CA19-9,CEA,CA125 and sICAM-1 concentrations are positively (r value were 0.832,0.698,0.748 and 0.845) with the metastasis of pancreatic cancer patients while negatively with the prognosis (r value were-0.867,-0.832,-0.916 and-0.908) and clinical stage (r value were-0.815,-0.896,-0.798,and0.912) of pancreatic cancer patients.Conclusion CA19-9,CEA,CA125 and sICAM-1 concentrations are positively related with the metastasis of pancreatic cancer patients while negatively with the clinical stage and prognosis of pancreatic cancer patients.

OBJECTIVETo identify and assess the potential public health risks of emergency events of infectious disease in the surrounding areas of Hangzhou during the 11th G20 summit, and to assess their impacts on the G20 summit.

METHODSThe surrounding cities of Hangzhou included Ningbo, Wenzhou, Jiaxing, Huzhou, Shaoxing, Jinhua, Quzhou, Zhoushan, Taizhou and Lishui. Background information on infectious diseases in Zhejiang province was collected, and the brainstorming and expert consultation methods were used to identify the risks. The local risks and the impact of local risks on the G20 summit were assessed.

RESULTSThe criteria for public health risk was first established. Through the assessments,a total of 27 kinds of infectious diseases in 4 types of public health risks were identified. The impact of these risks on Hangzhou G20 summit was divided into 1 item of high-risk, 12 items of medium risk and 14 items of low risk.According to the results of risk assessment, the recommendations for risk management of respiratory infectious diseases, intestinal infectious diseases, imported infectious diseases like Middle East respiratory syndrome and other infectious diseases were made. With risk management, Middle East respiratory syndrome was not occurred during the G20 summit, and the epidemic situation of other infectious diseases with middle or low risks was almost the same with that of past years.

CONCLUSIONSsThe public health risks of Hangzhou G20 summit from sudden infectious diseases in outlying areas are mainly medium and low risks. The recommendations on risk management provide a basis for reducing the adverse consequences of public health risks in the event of an outbreak of infectious diseases, avoiding the impact of various risk factors in the outlying areas on G20 summit.

Objective To investigate the risk assessment ,prevention and management for perioperative stroke in elderly patients with hip fractures. Methods A total of 179 patients aged 65 years and older were admitted to our department due to hip fracture. In managements of perioperative stroke ,the preoperative risk assessment and the management of stroke ,identifying the risk population for stroke prevention ,controlling risk factors of the preoperative stroke ,intraoperative monitoring , postoperative treatment ,etc.were studied retrospectively.The incidence of perioperative stroke was recorded and analyzed. Results Of 179 patients with hip fracture ,overviews of diagnosis and treatment were as follows.Twenty-four (24/179 ,13.41% ) cases did not receive operative treatments.Head and neck CT angiography(CTA)-showed severe stenosis or occlusion of intracranial artery and internal carotid artery were in 9(5.03% ,9/179)patients ,of whom the 5(2.79% ,5/179) cases underwent cerebrovascular digital subtraction angiography (DSA ) ,balloon dilation and stent implantation ,then received the operation for hip fracture 10 days later ,finally were discharged uneventfully.1 (0.56% ,1/179 ) patient underwent orthopaedic surgery due to the results of DSA showing no indication of interventional therapy ,and was discharged unevenfully.3 (1.68% ,3/179 ) patients refused to receive the further DSA examination or interventional therapy ,strongly demanded for orthopaedic surgery and would take the surgical risk ,and were discharged uneventfully.2(1.12% , 2/179)patients were found to have cerebral aneurysm diagnosed by CTA and DSA ,and underwent surgery for hipfracture without special treatment.2(1.12% ,2/179)patients were diagnosed as new occurrence of cerebral infarction before the operation ,and received head and carotid stenting at the department of cerebrovascular surgery ,followed by combined antithrombotic therapy of aspirin , clopidogrel and low molecular weight heparin for 4 weeks ,then underwent orthopaedic surgery for hip fracture.2 (1.12% ,2/179 ) patients were diagnosed as new cerebral infarction after orthopaedic surgery ,then were transferred to the department of neurology for treatment. Conclusions The thorough preoperative risk assessment and management of stroke ,reasonable perioperative antiplatelet and anticoagulation therapy ,intense intraoperative monitoring and active postoperative complications management make it possible for high-risk and new ischemic stroke patients with hip fractures to receive early orthopaedic treatment.

Objective To evaluate the protective effect of apneic oxygen insufflation on the operated lung of patients undergoing one-lung ventilation (OLV).Methods Fifty-four American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 50-75 yr,scheduled for elective pulmonary tumorectomy,were divided into 2 groups using a random number table method:conventional group (group C,n=27) and apneic oxygen insufflation group (group A,n=27).The patients were intubated with a double-lumen tube after induction of anesthesia.Apneic oxygen insufflation was performed on the operated lung immediately after OLV by continuously administrating oxygen at 5 L/min with inspiratory oxygen fraction of 100％.Blood samples were taken from the radial artery at 1 min before OLV (T1) and 3 and 33 min after OLV (T2,3) for blood gas analysis,pulmonary oxygenation index and intrapulmonary shunt rate were calculated,and the occurrence of oxygen index less than 200 and 300 mmHg was recorded.Blood samples of the internal jugular vein were collected to detect the concentrations of surfactant protein B (SPB) and surfactant protein C (SP-C) in serum.The lung on the operated side was lavaged at T3,and the broncho-alveolar lavage fluid was collected for determination of the concentrations of SP-B and SP-C by enzyme-linked immunosorbent assay.Results Compared with group C,the oxygenation index was significantly increased at T2,3,the intrapulmonary shunt rate was decreased,the concentrations of SP-B and SPC in serum were decreased,and the concentrations of SP-B and SP-C in broncho-alveolar lavage fluid were increased in group A (P＜0.05).Conclusion Giving apneic oxygen insufflation 5 L/min to the operated lung during OLV can reduce the damage to the operated lung.

OBJECTIVE:To prepare borneol-modified colchicine ethosome,and to evaluate its in vitro transdermal permeation. METHODS:Borneol-modified colchicine ethosome was prepared with ultrasonic injection-probe ultrasonic method,and its ethosome was characterized. The content and moditication rate of borneol in borneol-modified colchicine ethosome was determined by GC;content and encapsulation rate of colchicine was determined by HPLC.Accumulative permeability and permeation rate were investigated for colchicine ethanol solution,colchicine-borneol-ethanol solution,colchicine ethosome without borneol-modification, borneol- modified colchicine ethosome after diffused for 1,3,6,8,12,16,24,48 h. RESULTS:The average particle size of borneol- medified colchicine ethosome was about(110.4 ± 5.1)nm,polydispersity index was 0.110 ± 0.030,Zeta potential was (2.33±0.20)mV,prepared ethosome is approximately spherical in shape and multilaminar vesicles in structure. Encapsulation rate of colchicine was 56.12%,and modification rate was 9.85%. The in vitro diffusion tests showed that after diffused for 48 h, accumulative permeability per unit area of borneol-modified colchicine ethosome was 103.52 μ g/cm2;permeation rate was 1.26 times as colchicine ethosome without borneol-modification,1.77 times as colchicine-borneol-ethanol solution and 5.14 times as colchicine ethanol solution. CONCLUSIONS:Prepared borneol-modified colchicine ethosome has small particle size,narrow particle size distribution,high modification rate and good transdermal permeation.

Objective:To review the clinicopathological characteristics and analyze the prognostic factors of hepatoid adenocarcinoma of stomach(HAS).Methods:From August 2012 to June 2017,30 patients with HAS were diagnosed in Daycare of Peking University Cancer Hospital.Clinicopathological data and follow-up information of these patients were retrospectively collected and analyzed.Re-sults:The median age of these 30 patients was 58 years at diagnosis,with a male-to-female ratio of 2.75:1.Twenty-nine patients were confirmed to have lymph node metastases and 7 patients had distant metastases.Ten patients died because of the cancer within the follow-up period.The 1-and 3-year survival rates were 60% and 52%,respectively.Cox multivariate regression revealed that elevated serum CA199 levels,higher lymph node staging,not having undergone radical surgery,and stronger immunohistochemical(IHC)stain-ing intensity of alpha fetoprotein(AFP)were independent poor prognostic factors.Conclusions:Elevated serum CA199 levels,lymph node staging,and IHC staining intensity of AFP are verified in this study as independent risk factors of poor outcome in HAS patients. Early detection and diagnosis of the disease may improve the clinical prognosis.Multidisciplinary team discussions are important in making therapy decisions and radical surgery should be performed whenever possible.