Objective To investigate the expression of serum circPTP4A2 and circFOXP1 and their relationship with prognosis in patients with acute ischemic stroke(AIS).Methods The clinical data of 132 AIS patients(AIS group)and 140 healthy subjects(normal control group)were collected.The expression levels of serum circPTP4A2 and circFOXP1 in the two groups were detected by quantitative reverse transcription PCR(qRT-PCR).According to the NIHSS score at 24 h after admission,the patients were divided into mild group(＜4 points),moderate group(4-15 points),and severe group(＞15 points).According to the mRS score at 90 d of follow-up,the patients were divided into good prognosis group(≤2 points)and poor prognosis group(＞2 points).The Pearson method was applied to analyze the correlation between the expression levels of serum circPTP4A2 and circFOXP1 with the degree of AIS.Multivariate Logistic regression was applied to analyze the factors influencing the prognosis of AIS patients.ROC curve was applied to analyze the predictive value of serum circPTP4A2 and circFOXP1 expression for the prognosis of AIS patients,and the comparison of areas under curve(AUC)was performed through Z-test.Results Compared with those in normal control group,the level of serum circFOXP1 in the AIS group was significantly decreased,and the level of circPTP4A2 was significantly increased(all P＜0.001).There were significant differences in the levels of serum circPTP4A2 and circFOXP1 among the mild group,the moderate group and the severe group(F=151.235,P＜0.001;F=178.161,P＜0.001).Compared with those in mild group,the levels of serum circPTP4A2 in the moderate group and severe groups were significantly increased,and the levels of circFOXP1 were significantly decreased(all P＜0.05).Compared with those in moderate group,the level of serum circPTP4A2 in the severe group was significantly increased,and the level of circFOXP1 was significantly decreased(all P＜0.05).The level of serum circPTP4A2 was positively correlated with the severity of AIS(r=0.447,P＜0.001),and the level of serum circFOXP1 was negatively correlated with the severity of AIS(r=-0.412,P＜0.001).Compared with those in good prognosis group,the infarct volume,NIHSS score and serum circPTP4A2 level in the poor prognosis group were significantly increased,and the serum circFOXP1 level was significantly decreased(all P＜0.001).Multivariate Logistic regression analysis showed that circPTP4A2 was a risk factor for poor prognosis in AIS patients(OR=2.217,95％CI:1.429-3.439,P＜0.001),and circFOXP1 was a protective factor(OR=0.466,95％CI:0.295-0.737,P=0.001).The combined prediction of serum circPTP4A2 and circFOXP1 for poor prognosis was better than that of individual prediction(Z=2.532,P=0.011;Z=3.668,P=0.000).Conclusion The level of serum circPTP4A2 in AIS patients is increased,and the level of serum circFOXP1 is decreased,both of them have certain predictive value for the prognosis of AIS patients.

Objective To investigate the expression of serum circPTP4A2 and circFOXP1 and their relationship with prognosis in patients with acute ischemic stroke(AIS).Methods The clinical data of 132 AIS patients(AIS group)and 140 healthy subjects(normal control group)were collected.The expression levels of serum circPTP4A2 and circFOXP1 in the two groups were detected by quantitative reverse transcription PCR(qRT-PCR).According to the NIHSS score at 24 h after admission,the patients were divided into mild group(＜4 points),moderate group(4-15 points),and severe group(＞15 points).According to the mRS score at 90 d of follow-up,the patients were divided into good prognosis group(≤2 points)and poor prognosis group(＞2 points).The Pearson method was applied to analyze the correlation between the expression levels of serum circPTP4A2 and circFOXP1 with the degree of AIS.Multivariate Logistic regression was applied to analyze the factors influencing the prognosis of AIS patients.ROC curve was applied to analyze the predictive value of serum circPTP4A2 and circFOXP1 expression for the prognosis of AIS patients,and the comparison of areas under curve(AUC)was performed through Z-test.Results Compared with those in normal control group,the level of serum circFOXP1 in the AIS group was significantly decreased,and the level of circPTP4A2 was significantly increased(all P＜0.001).There were significant differences in the levels of serum circPTP4A2 and circFOXP1 among the mild group,the moderate group and the severe group(F=151.235,P＜0.001;F=178.161,P＜0.001).Compared with those in mild group,the levels of serum circPTP4A2 in the moderate group and severe groups were significantly increased,and the levels of circFOXP1 were significantly decreased(all P＜0.05).Compared with those in moderate group,the level of serum circPTP4A2 in the severe group was significantly increased,and the level of circFOXP1 was significantly decreased(all P＜0.05).The level of serum circPTP4A2 was positively correlated with the severity of AIS(r=0.447,P＜0.001),and the level of serum circFOXP1 was negatively correlated with the severity of AIS(r=-0.412,P＜0.001).Compared with those in good prognosis group,the infarct volume,NIHSS score and serum circPTP4A2 level in the poor prognosis group were significantly increased,and the serum circFOXP1 level was significantly decreased(all P＜0.001).Multivariate Logistic regression analysis showed that circPTP4A2 was a risk factor for poor prognosis in AIS patients(OR=2.217,95％CI:1.429-3.439,P＜0.001),and circFOXP1 was a protective factor(OR=0.466,95％CI:0.295-0.737,P=0.001).The combined prediction of serum circPTP4A2 and circFOXP1 for poor prognosis was better than that of individual prediction(Z=2.532,P=0.011;Z=3.668,P=0.000).Conclusion The level of serum circPTP4A2 in AIS patients is increased,and the level of serum circFOXP1 is decreased,both of them have certain predictive value for the prognosis of AIS patients.

Objective Based on the network pharmacology and animal experiments,to investigate the protective effect and possible molecular mechanism of ethanol extract from Atractylodes lancea on liver function in mice with liver fibrosis induced by bile duct ligation.Methods The main active ingredients atractylodin,atractylenolide Ⅰ,Ⅱ and Ⅱ from Atractylodes lancea were selected,which had been verified by literature and experiments,and the targets of these active ingredients were obtained through the SwissTargetPrediction database.The liver fibrosis disease targets were obtained through On-line Mendelian Inheritance in Man (OMIM),DisGeNET and GeneCards databases.The targets were added to the Wei Sheng Xin platform to find the intersection target for Atractylodes lancea in treating liver fibrosis.Cytoscape 3.10.1 was used to construct the "drug-component-target-disease" network diagram and protein-protein interaction core target network diagram.GO functional enrichment analysis and KEGG pathway analysis were performed,and molecular docking was performed between active components and core targets.Liver fibrosis was induced in mice by bile duct ligation,and liver function markers were measured.Results A total of 91 corresponding targets of atractylodin,atractylenolide Ⅰ,Ⅱ and Ⅲ and 9296 liver fibrosis disease targets were obtained,including 74 intersecting targets and 31 core targets.KEGG enrichment analysis showed that the main signaling pathways involved included inflammatory pathways such as epidermal growth factor receptor (EGFR) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt).Molecular docking results showed that the active ingredients had strong binding activity with the core target protein.The results of animal experiments showed that,compared with the sham surgery group,the model group displayed notable,the liver index,spleen index,activity of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST),degree of liver fibrosis,mRNA and protein expression of α-smooth muscle actin (α-SMA) and recombinant collagen type Ⅰ alpha 1 (COL1A1),and mRNA of recombinant collagen type Ⅳ alpha 2 (COL4A2) were significantly increased,and the thymus index was sigficantly decreased (P<0.05);compared with the model group,the liver injury of mice in the Atractylodes lancea administration group reduced liver injury,its liver index,spleen index,activity of serum ALT and AST,degree of liver fibrosis,mRNA and protein expression of α-SMA and COL1A1,and mRNA of COL4A2 were significantly decreased,and the thymus index was sigficantly increased (P<0.05).Conclusion Atractylodes lancea can improve liver function and alleviate tissue pathological damage in mice with liver fibrosis,which may be related to activating pathways such as PI3K/Akt,inhibiting oxidative stress and inflammatory reactions,and intervening in liver fibrosis.

Most foreign bodies are often discharged without obvious symptoms after swallowing, but some may be misdiagnosed and stay in the body, resulting in serious complications. Different diagnostic methods should be integrated to diagnose such patients. Once diagnosed, they should be treated as soon as possible if necessary. The authors reported a case of retention in the body for 6 years after swallowing a wooden chopstick, resulting in the insertion into the psoas muscle after duodenal perforation, complicated by abdominal abscess. During the operation, endoscopic assisted laparoscopic foreign body removal was performed, and the patient showed good prognsis, which provided references for the diagnosis and treatment of the disease.

ObjectiveTo investigate the efficacy and mechanism of berberine hydrochloride （BBH） against lung cancer cells through the mevalonate （MVA） pathway. MethodHuman lung cancer A549 cells and mouse Lewis lung carcinoma （LLC） cells were used as research subjects. Cell proliferation and cell counting kit-8 （CCK-8） assay were performed to detect the inhibitory effect of BBH （10， 20， 30， 40， 50 μmol·L^-1） on the proliferation of the two kinds of cells （48 h）. Then cell scratch assay was used to explore the influence of BBH （40 μmol·L^-1） on the migration of A549 and LLC cells （24， 48 h）， and colony formation assay was conducted to compare the colony formation ability of the cells under different concentrations of BBH （10， 20， 40 μmol·L^-1）. Moreover， the effects of BBH （40 μmol·L^-1） on the content of acetyl-coenzyme A （A-CoA） and total cholesterol （TC） in A549 and LLC cells were determined by kit assay. AutoDock Vina was used for the dock of BBH and MVA pathway regulatory protein， sterol regulatory element-binding protein 2 （SREBP2）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to observe the effects of BBH （40 μmol·L^-1） on the mRNA expression of nine genes related to the MVA pathway in A549 and LLC cells： hydroxymethylglutaryl-CoA synthase 1 （HMGCS1）， hydroxymethylglutaryl-CoA Reductase （HMGCR）， mevalonate kinase （MVK）， phosphomevalonate kinase （PMVK）， mevalonate 5-pyrophosphate decarboxylase （MVD）， farnesyl diphosphate synthase （FDPS）， squalene epoxidase （SQLE）， farnesyl-diphosphate farnesyltransferase 1 （FDFT1）， and geranylgeranyl diphosphate synthase 1 （GGPS1）. Western blot was performed to clarify the effects of BBH （40 μmol·L^-1） on the expression of three key proteins of the MVA pathway： HMGCS1， HMGCR， and FDFT1. The Cancer Genome Atlas （TCGA） database was searched to analyze the relationship between HMGCS1， HMGCR， FDFT1 and transcription gene SREBF2 in non-small cell lung cancer （NSCLC）. ResultCompared with the conditions in the control group， the proliferation， migration， and colony formation of A549 and LLC cells in the BBH group were decreased （P<0.01）， while the cell apoptosis rate was increased （P<0.01）. Molecular docking showed that BBH had good binding activity with SREBP2. In addition， the content of A-CoA and TC of the MVA pathway was reduced （P<0.01）. BBH down-regulated the mRNA expression of HMGCS1， HMGCR， MVK， PMVK， MVD， FDPS， SQLE， FDFT1， and GGPS1 in A549 and LLC cells （P<0.01）， and lowered the levels of HMGCS1， HMGCR， and FDFT1 proteins （P<0.05， P<0.01）. In NSCLC patients， HMGCS1， HMGCR， and FDFT1 were highly correlated with SREBF2 （R=0.54， R=0.57， and R=0.48）. ConclusionBBH can inhibit the proliferation， migration， and colony formation of A549 and LLC cells and promote cell apoptosis， which may be related to the regulation of MVA pathway by BBH binding to SREBP2.

Objective:To explore the characteristics of color Doppler ultrasound images of breast lymphoma, and to improve the coincidence rate of ultrasound diagnosis.Methods:The color Doppler ultrasound images characteristics of 24 lesions in 21 patients with breast lymphoma in Fujian Cancer Hospital from June 2011 to January 2020 were retrospectively analyzed, and the diagnostic coincidence rate was counted.Results:All the patients were female, 18 cases were unilateral, 3 cases were bilateral. ALL cases were confirmed as primary or secondary breast lymphoma by coarse needle biopsy or surgical pathology. Pathological types included 18 cases (85.7%) of diffuse large B-cell lymphoma, 1 case of anaplastic large cell lymphoma kinase (ALK)-negative anaplastic large cell lymphoma, 1 case of Burkitt lymphoma, 1 case of Burkitt lymphoma or unclassifiable lymphoma with features intermediated between diffuse large B-cell lymphoma and Burkitt lymphoma. The maximum diameter of the lesions was (5.7±2.1) cm (range 1.4-16.0 cm), and all lesions were solid in ultrasound images; 19 lesions (79.2%) were mass-type and 5 lesions (20.8%) were diffuse. According to the characteristics of internal echo, the lesions were divided into hypoechogenicity (2 lesions, 8.3%), hyperechogenicity packed with hypoechogenicity (12 lesions, 50.0%), and hyperechogenicity interweaved with hypoechogenicity (10 lesions, 41.7%). According to Adler semi-quantitative method, the blood flow of the lesions was 3 lesions (12.5%) in grade Ⅰ, 6 lesions (25.0%) in grade Ⅱ, and 15 lesions (62.5%) in grade Ⅲ. The detection rate of lesions by color Doppler ultrasound was 100.0% (24/24), but the diagnostic coincidence rate was only 41.7% (10/24).Conclusions:Most of the breast lymphoma is diffuse large B-cell lymphoma, and the lesions can be effectively screened by color Doppler ultrasound, but the diagnostic coincidence rate is low. Most of the breast lymphoma grows in the form of mass with abundant internal blood flow signals. When the ultrasound image of the breast lesion is hyperechoic packed or interweaved with hypoechoic, the possibility of breast lymphoma should be considered.

Objective:To evaluate the value of conventional ultrasound(US) combined with contrast-enhanced ultrasound(CEUS) in the diagnosis of Breast Imaging Reporting and Data System( BI-RADS) category 4 small(≤ 2 cm) breast nodules.Methods:A total of 175 breast nodules in 175 patients from Fujian Cancer Hospital between September 2015 and August 2018 classified as BI-RADS category 4 breast nodules with maximum diameter ≤2 cm were evaluated by US and CEUS examinations. All nodules were examined by core-needle biopsy or surgical pathology.The collected ultrasound images and videos were analyzed by blind method. Stepwise Logistic regression was used to analyze the odds ratio of malignant nodules in ultrasound images, and the risk prediction score model was constructed according to OR value. The BI-RADS category was readjusted, and the diagnostic efficiencies before and after adjustment were compared with the ROC curve. Results:Multivariate Logistic regression analysis showed that the odds ratios of breast malignant nodules were non-circumscribed margin ( OR=3.32, P=0.052), calcification in the mass ( OR=7.42, P=0.002), architectural distortion ( OR=38.58, P<0.001), ductal dilatation ( OR=0.01, P=0.010), suspicious or abnormal axillary lymph nodes ( OR=10.92, P=0.003), enlarged lesion scope ( OR=3.38, P=0.040), penetrating vessels ( OR=10.79, P=0.006), and non-circumscribed margin after enhancement( OR=6.24, P=0.003). When the cut-off value was 3.5, the area under ROC curve, sensitivity, specificity and accuracy were 0.951, 87.80%, 89.20% and 88.57%, respectively. After adjusting BI-RADS classification and taking the adjusted BI-RADS category 4a as the biopsy threshold, the biopsy rate decreased from 100% to 58.86%, the cancer detection rate increased from 46.86% to 75.73%, and the risk of missed diagnosis was 2.29%. The area under ROC curve before and after BI-RADS classification adjustment was 0.838 and 0.937, respectively. Conclusions:US combined with CEUS can improve the diagnostic efficiency of BI-RADS category 4 small breast nodules and reduce unnecessary biopsy.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective To analyze the performance of contrast-enhanced uhrasound(CEUS) in the evaluation of response to neoadjuvant chemotherapy (NAC) for breast cancer in different periods.Methods A prospective study consisting of 46 patients with invasive ductal carcinoma who received NAC and surgery subsequently was conducted.One patient underwent CEUS before NAC,after the second cycle of NAC and before surgery.CEUS outcomes were compared with histopathologic response by Kappa test using the Miller-Payne Grading(MPG) system.The changes of CEUS quantitative parameters in different periods of NAC were compared.Results 31 patients showed a good response by histopathology while 29 patients by CEUS,which showed good consistence.Kappa value was 0.713.The peak intensity (PI) of the lesions decreased significantly after the second cycle of NAC compared with that before NAC (P＜0.05).The peak intensity (PI),wash-in slope (WIS),and area under curve(AUC) of the lesions decreased significantly before surgery compared with those before NAC (P＜0.05).Conclusion CEUS shows good consistence with histopathologic outcomes.The peak intensity (PI) is a sensitive indicator of early changes after NAC.

Objective To comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP).Methods Literatures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3. Results Twenty-one studies were included with 2222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77％ (362/827) vs. 55.26％ (604/1093), odds ratio (OR) =0.68, 95％ confidential interval (95％CI) = 0.56-0.82,P = 0.0001], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95％CI = 2.60-6.66,P < 0.00001], incidence of MODS [25.93％ (70/270) vs. 55.36％ (155/280),OR = 0.26, 95％CI = 0.14-0.49,P< 0.0001], and incidence of ARDS [30.37％ (82/270) vs. 51.07％(143/280),OR = 0.42, 95％CI = 0.30-0.61,P < 0.00001], and inefficiency rate [8.72％ (13/149) vs. 34.64％ (53/153),OR=0.17, 95％CI = 0.09-0.34, P < 0.00001] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies.Conclusion HP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.