Objective:To evaluate the effect of patent foramen ovale on the development of post-operative stroke in the patients undergoing non-cardiac surgery using a meta-analysis approach.Methods:A comprehensive search was conducted across multiple databases including PubMed, Embase, Web of Science, CINAHL, Cochrane Library, China Biomedical Literature Database, Wanfang Data Knowledge Service Platform, and China Journal Full Text Database.The inclusion criteria encompassed studies assessing the correlation between patent foramen ovale and post-operative stroke.The primary outcome measure focused on the incidence of post-operative stroke, and secondary outcome measures comprised mortality, myocardial infarction rate, and readmission rate within 30 days after surgery. The quality of literature meeting the inclusion criteria was evaluated and data were extracted, and then meta-analysis was conducted using RevMan 5.4 software.Results:Eight retrospective cohort studies involving 21 142 237 patients were included.The results of meta-analysis showed that patent foramen ovale was associated with post-operative stroke and readmission within 30 days after surgery.There were no significant differences in all-cause mortality and myocardial infarction rates between patent foramen ovale group and mon-patent foramen ovale group ( P>0.05). Conclusions:Patent foramen ovale can increase the risk of post-operative stroke in the patients undergoing non-cardiac surgery.

Objective:To explore the relationship between the expression of angiopoietin 1 (ANGPT1) and Smadhomolog 9 (Smad9) genes in cancer tissues and tumor metastasis, invasion behavior and prognosis in patients with lung adenocarcinoma.Methods:Sixty patients with lung adenocarcinoma in Chengwu Hospital Affiliated to Shandong First Medical University from October 2018 to December 2019 were selected as the research objects. The expressions of ANGPT1 and Smad9 mRNA in cancer tissues and adjacent tissues were compared, as well as the expressions of ANGPT1 and Smad9 mRNA in cancer tissues of patients with different tumor metastasis and invasion behaviors. The relationship between ANGPT1 and Smad9 mRNA expression and tumor metastasis and invasion behavior of lung adenocarcinoma were analyzed, and the 1-year survival rate of patients with lung adenocarcinoma was calculated. The 1-year survival rate of patients with different ANGPT1 and SMAD9 mRNA expression levels were compared.Results:The relative expression of ANGPT1 mRNA and Smad9 mRNA in cancer tissues were lower than those in adjacent tissues: 2.45 ± 0.26 vs. 11.18 ± 0.93, 4.23 ± 0.31 vs. 7.58 ± 0.65, the differences were statistically significant ( P<0.05). There were significant differences in the relative gene expression of ANGPT1 and Smad9 mRNA in different clinical stages, tumor diameter, degree of differentiation, lymph node metastasis and pleural invasion ( P<0.05). Spearman correlation analysis showed that the expression of ANGPT1 and Smad9 mRNA were negatively correlated with clinical stage, tumor diameter, lymph node metastasis and pleural invasion ( r = - 0.517, - 0.539, - 0.606, - 0.679, P<0.05), and positively correlated with the degree of differentiation ( r = 0.628, P<0.05). The 1-year survival rate of 58 patients was 72.41%. Kaplan-Meier curve analysis showed that the 1-year survival rate of patients with low expression of ANGPT1 and Smad9 mRNA in cancer tissues were were lower than those in patients with high expression ( P<0.05). Conclusions:Down-regulation of ANGPT1 and Smad9 genes in cancer tissues will accelerate the metastasis and invasion behavior of lung adenocarcinoma. Up-regulating the expression of both genes can be a potential way to improve survival.

ObjectiveTo investigate the effect of Bufeitang on intestinal flora of rats with lung Qi-deficiency syndrome of chronic obstructive pulmonary disease（COPD）， and to explore the mechanism of traditional Chinese medicine in regulating intestinal flora and thus restoring the balance of lung-gut axis. MethodA total of 84 rats were randomly divided into 7 groups， including blank group， model group， fecal bacterial transplantation（FMT） group， dexamethasone group and low， medium and high dose groups of Bufeitang， 12 rats in each group. Except for the blank group， cigarette and sawdust fumigation combined with intratracheal instillation of lipopolysaccharide（LPS） were used to establish the COPD rat model with lung Qi-deficiency syndrome in all other groups. The low， medium and high dose groups of Bufeitang were intragastric administrated with Bufeitang（3.645， 7.29， 14.58 g·kg^-1）， the FMT group was given fecal bacteria liquid enema（10 mL·kg^-1）， dexamethasone group was given dexamethasone acetate tablet suspension by gavage（0.135 mg·kg^-1）， the blank group and model group were given equal amount of distilled water. Fresh feces were collected after 28 d of continuous intervention for 16S rRNA gene sequencing. Lung and colon tissues were stained with hematoxylin-eosin（HE） for pathomorphological observation， and enzyme-linked immunosorbent assay （ELISA） was performed to detect the contents of tumor necrosis factor-α（TNF-α） and interleukin-8（IL-8） in lung tissues. ResultCompared with the blank group， the model group showed severe abnormal lung tissue structure with alveolar atrophy and collapse accompanied by severe inflammatory cell infiltration. Compared with the model group， the extent of injury was significantly improved， and inflammatory cell infiltration was reduced with basically normal alveolar structure in the high dose group of Bufeitang. Compared with the blank group， the model group had severely abnormal colonic tissue structure， the epithelial cells in the mucosal layer were eroded and shed， the number of inflammatory cells increased， the submucosal layer was edematous and the gap was enlarged. Compared with the model group， the extent of damage was significantly improved in the medium and high dose groups of Bufeitang， the epithelial cells in the mucosal layer were neatly and closely arranged， with only a small amount of inflammatory cell infiltration and no significant degeneration. Compared with the blank group， the TNF-α and IL-8 levels of lung tissue in the model group were significantly increased（P<0.01）. Compared with the model group， the TNF-α and IL-8 levels of lung tissues in the low， medium and high dose groups of Bufeitang were significantly decreased（P<0.01）. Bufeitang significantly modulated the number of bacteria species as well as alpha and beta diversity of model rats， corrected the return of intestinal flora to normal abundance and diversity， and positively regulated 4 differential phyla（such as Firmicutes， Proteobacteria） and 13 differential genera（such as Turicibacter， Lactobacillus， Anaerobiospirillum， Intestinimonas） in COPD model rats with lung Qi-deficiency syndrome， and down-regulated 2 carbohydrate metabolic pathway functions， including the pentose phosphate pathway（non-oxidative branch） Ⅰ and the Calvin-Benson-Bassham cycle. ConclusionBufeitang can modulate the abundance and diversity of intestinal flora species， affect the function of metabolic pathways， repair the structure of lung and colon tissues， regulate the level of inflammatory factors， and thus improve COPD with lung Qi-deficiency syndrome. The mechanism may be related to its regulation of inflammation-related intestinal flora to restore the balance of lung-gut axis in COPD with lung Qi-deficiency syndrome.

Objective To analyze the effect of Noggin silencing on the BMP and Wnt signaling pathways in hair follicle development.Methods The expression of BMP-2, BMP-4, BMPR-IA, BMP-6, BMP-7, LEF-1 andβ-catenin in Noggin silencing MC3T3-E1 stable cell line was detected by RT-PCR and western blot.Results RT-PCR results showed that the expressions of five genes in BMP signaling pathway were all significantly influenced by Noggin silencing, the ex-pressions of BMP-2 (P<0.001), BMP-4 (P<0.01), BMP-6 (P<0.001) and BMP-7 (P<0.001) were all increased and the expression of BMPR-IA (P<0.01) was decreased.While the expressions of the two genes LEF-1 (P<0.001) and β-catenin ( P<0.001) in Wnt signaling pathway were significantly decreased.Western blot results showed that the ex-pressions of these proteins in the two signaling pathways were also affected.The expressions of BMP-2 (P<0.05), BMP-4 (P<0.05), BMP-6 (P<0.05) and BMP-7 (P<0.05) were all increased, while the expressions of BMPR-IA (P<0.05), LEF-1 (P<0.01) andβ-catenin (P<0.001) were decreased.Conclusions There may be a negative feedback regulation of Noggin on the BMP signaling pathway in vitro, but a positive feedback regulation on the Wnt signaling pathway in vitro.It provides certain evidence for studies on the effect of Noggin gene on BMP and Wnt signaling pathways in vivo. There may be an interaction between hair follicle development-related signaling pathways, which still needs further experi-ments to prove.

Objective To investigate the diagnostic value of multiplex polymerase chain reaction (m-PCR) for diagnosing second infection of severe acute pancreatitis ( SAP), and to provide evidence for anti-infection treatment of SAP .Methods From January 2011 to December 2014 , thirty five patients of SAP were enrolled .Seven to fourteen days after SAP onset , patients′blood samples were taken and the presence of infection was determined by mP-CR.In the meantime, peripheral blood or the paracentesis fluid was cultured , and the result of culture was regard as golden standard to diagnose infection .Rseults The m-PCR could simultaneously detect 9 kinds of intestinal resident pathogenic bacteria , and the lower limit of detection was 10~1 000 copies.The detection rates were as follows (cultivation vs. m-PCR):staphylococcus aureus 6 vs 5 cases, staphylococcus epidermidis 11 vs 9 cases, enterococcus faecalis 2 vs 3 cases, enterococcus faecium 6 vs 7 cases, escherichia coli 19 vs 17 cases, klebsiella pneumoniae 2 vs 3 cases, pseudomonas aeruginosa 6 vs 4 cases, acinetobacter baumannii 2 vs 2 cases, malt narrow food aeromonas 4 vs2 cases.The 7th~14th days after SAP onset, the blood or paracentesis fluid culture was positive in 27 patients,and negative in 8 cases. And the m-PCR results were positive in 30 patients, and negative in 8 cases.The m-PCR results were positive in 30 patients, negative in 5 patients.The m-PCR results were positive in 3 patients who had negative culture results.In the remaining 32 cases, the results were consistent between the two detection methods .When the culture result was regarded as golden standard , the sensitivity, specificity and accuracy of m-PCR were 100%, 62.5%and 91.43%, respectively.The positive predictive value and the negative predictive value were 90%and 100%, respectively.It took (26 ±15) hours on average to obtain the result of culture method , and it took (102 ±32) hours on average to obtain the confirmative results .It took (12 ±8) hours on average to obtain the result of the m-PCR method.The time course of m-PCRwas significantly shorter than that of the traditional culture method, and the difference was statistically significant (P<0.05).Conclusions The m-PCR method can be used to monitor the bacterial infection in patients with SAP .The m-PCR method is a highly sensitive and rapid detection approach , which is worth of clinical application .

Parkinson's disease (PD) is a complicated disease, commonly diagnosed among the elderly, which leads to degeneration of the central nervous system. It presently lacks an effective therapy for its complex pathogenesis. Adverse effects from Western drug-based medical intervention prevent long-term adherence to these therapies in many patients. Traditional Chinese medicine (TCM) has long been used to improve the treatment of PD by alleviating the toxic and adverse effects of Western drug-based intervention. Therefore, the aim of this study is to evaluate the efficacy and safety of Xifeng Dingchan Pill (XFDCP), a compound traditional Chinese herbal medicine, taken in conjunction with Western medicine in the treatment of PD patients at different stages in the progression of the disease.

OBJECTIVETo investigate the relationship between the molecular characteristics and phylogenetic evolution of rabies N gene.

METHODSSaliva samples were collected from rabies cases, and RT-PCR was used to amplify the N gene of rabies virus with the specific primers. The amplifying product of RT-PCR was cloned to pUCm-T vector and transformed into E.coli XL1-Blue and then the blue-white selection, PCR screening and gene sequencing were carried out to identify the positive clones. Finally, ExPASy and other bioinformatics software were used to analyze and predict the structure and biological characteristics of the N genome.

RESULTSThe amplification product of RT-PCR was 1 353 bp, the recombinant plasmid pUCm-T/N was constructed, the whole length of the N gene open reading frame was composed of 1 353 nucleotide residues to code 450 amino acids (20 kinds), the accession number submitted to the Genbank was HM756692, its sequence homology of nucleotides and amino acids compared with the vaccine strain CTN-1-V was 90% and 99% respectively. The evolutionary analysis showed that the isolated strain belonged to genotype I with certain geographic regionality.

CONCLUSIONThe characteristics investigation and bioinformatics analysis of Hunan0806 N gene will provide fundamental data to reveal the significance of the N gene characteristics for rabies epidemiology and its prevention & control.

Amino Acid Sequence ; Gene Expression Regulation, Viral ; physiology ; Humans ; Models, Molecular ; Molecular Sequence Data ; Nucleocapsid Proteins ; genetics ; metabolism ; Phylogeny ; Protein Conformation ; Rabies ; virology ; Rabies virus ; genetics ; metabolism ; Saliva ; virology

Objective To evaluate the effect of enteral nutrition (EN) versus total parenteral nutrition(TPN) on gut barrier function in patients with severe acute pancreatitis (SAP). Methods Sixtythree patients with SAP enrolled from 4 hospitals were randomly assigned into EN group(29 cases) and TPN group(34 cases). EN group patients were fed via a spiral nasojejunal feeding tube placed routinely by endoscopy or fluoroscopy, and TPN group patients were nourished intravenously with TPN during the same period. The changes of serum endotoxin, diamine oxidase, and urinary excretion of lactulose and mannitol ratio (L/M) were observed. Results Plasma concentration of endotoxin were markedly decreased in EN group as compared with that in TPN group at the 7th,14th ,21th day of entry trial [(39. 30 ± 15. 82) EU/L vs (73.05 ±21.16) EU/L,(22.64 ±14.31) EU/L vs (49.34 ±24.54) EU/L,(14.81 ± 10.93)EU/L vs ( 30. 08 ± 14. 10 ) EU/L, P ＜ 0. 05]. Plasma concentration of diamine oxidase were markedly decreased in EN group as compared with that in TPN group at the 7th, 14th day of entry trial [(9. 97 ± 3. 84)U/Lvs (19.89±9.89)U/L,(5.42±1. 84) U/Lvs (8.79 ±4.08) U/L, both P ＜ 0. 05]. The urinary L/M decreased significantly in EN group than those in TPN group at the 7th, 14th,21th day of entry trial (0.28 ±0.25 vs 0. 65 ±0.45,0.21 ±0. 18 vs 0.54 ±0.41,0.08 ±0.04 vs 0.29 ±0.06, all P＜0.05).Conclusion EN has better effect on improving intestinal barrier function than TPN in treatment of patients with SAP.

Objective To assess the effects of Danhong injection on the perfusion function of the pancreas in patients with acute pancreatitis (AP). Methods A total of 102 patients with AP were collected, and there were 25 patients with severe acute pancreatitis ( SAP) and 77 patients with mild acute pancreatitis (MAP). They were randomly divided into routine treatment group ( RTG,n =54) and Danhong treatment group (DTG,n =48) , respectively. Another 33 normal individuals were used as controls. Patients in RTG received gastric decompression, acid inhibition, anti-infection and nutritional support. Patients in DTG received Danhong injection 30 ml i. v. b. i. d besides routine treatment. The hemodynamic parameters ( BF, BV, MTT, and PS) of perfusion of the pancreas were measured by 16-slice spiral CT scanner. Results The values of BF of control, MAP, SAP group were time was ( 12.6 ± 2.7) d in DTG, which were significantly shorter than those in routine treatment group [(14.5 ±3.2)d, (18.5 ±5.5)d, P <0.05]. Conclusions The parameters of CT perfusion imaging of the pancreas can be a quantitative criterion to assess the severity of microcirculation dysfunction in patients with AP, and Danhong injection is effective to improve the blood perfusion of the pancreas during the treatment of AP.

Objective To explore the effects of batroxobin on the microcirculation of patients with severe acute pancreatitis (SAP). Methods A total of 38 patients with SAP were randomly divided into group A (21 cases) and group B (17 cases). Patients in group A were treated with routine method andpatients in greup B were treated with routine method plus batroxobin injection. Another 18 normal individuals were used as control. The levels of plasma endothelin (ET), thromboxane B_2 (TXB_2) and 6-keto-PGF_(1α)were measured by radioimmunoassay. At the same time, the ratio of TXB_2/6-keto-PGF_(1α) was observed. The Balthazar CT and APACHE Ⅱ scores were monitored and compared between group A and group B. Results The levels of plasma 6-keto-PGF_(1α) were significantly higher while the levels of plasma ET, TXB_2 and the ratio of TXB_2/6-keto-PGF_(1α) were significantly lower in group B at 6 days after admission [(129.3 ± 12.9) ng/L, (93.8 ± 9.9) ng/L, (254.4 ± 24.9) ng/L and 1.83 ± 0.31]as compared with those in group B on admission [(98.9 ± 10.7) ng/L, (140.3 ± 13.1) ng/L, (311.4 ± 31.5) ng/L and 3.16 ± 0.54]and group A at 6 days after admission [(108.2 ± 11.6) ng/L, (120.3 ± 11.4) ng/L, (308.5 ± 31.1) ng/L and 2.84 ± 0.43](P < 0.05). The Balthazar CT and APACHE Ⅱ scores in group B at 6 days after admission were significantly lower than those in group B on admission and group A at 6 days after admission (P< 0.05 or < 0.01). Conclusion Batroxobin is an effective way to improve the microcirculation in SAP.