Objective:To examine the effects of Zishenwan Prescription on bile acid metabolism in mice with diabetic encephalopathy; To explore its mechanism of improvement of diabetic encephalopathy.Methods:Male C57BL/6J mice were used to replicate the mouse model of type 2 diabetes mellitus by using high-fat chow and a single intraperitoneal injection of streptozotocin (120 mg/kg). The mice were screened for diabetic encephalopathy by using the Morris water maze test after 8 weeks of continuous stimulation with hyperglycemia, and were divided into model group and Zishenwan Prescription group according to random number table method, with 12 mice in each group. The mice in the Zishenwan Prescription group were treated with the crude extract of Zishenwan Prescription (9.36 g/kg) by gavage, and the normal group and the model group were treated with the same volume of distilled water once a day for 8 weeks. At the end of the treatment, Morris water maze test was used to investigate the cognitive function of diabetic encephalopathy mice; cresyl violet staining was used to detect the number of granule neurons in the hippocampus; serum and feces were collected to detect the content of bile acids by liquid-liquid coupling; hepatic bile acid synthase CYP7a1 and CYP27a1, farnesol X receptor (FXR), fibroblast growth factor 15 (FGF15), fibroblast growth factor receptor 4 (FGFR4), and ileocecal apical sodium-dependent bile acid transporter protein (ABST) mRNA levels were detected by using fluorescence quantitative PCR assay.Results:Compared with the model group, mice in the Zishenwan Prescription group had shorter evasion latency time ( P<0.05 or P<0.01), decreased time to first reach the platform ( P<0.01), increased number of times to traverse the platform ( P<0.01), and reduced neuronal cell damage in hippocampal area; mice in the Zishenwan Prescription group showed decreased serum and fecal total bile acid content ( P<0.05 or P<0.01); the liver CYP7a1 and CYP27a1 mRNA expressions increased ( P<0.01), and FXR and FGF15 mRNA expressions decreased ( P<0.01); ileal ABST mRNA expression decreased ( P<0.01). Conclusion:Zishenwan Prescription may regulate bile acid metabolism, inhibit FRX-FGF15/FGFR4 signaling and ABST expression to promote new bile acid synthesis and conjugated bile acid reabsorption, and thus improve cognitive function in diabetic encephalopathy mice.

Objective:To explore the impact of the early warning model based on UpToDate on the adverse reactions and disease uncertainty of patients receiving AC-T chemotherapy after breast cancer surgery.Methods:Two hundred patients with breast cancer who received AC-T chemotherapy after surgery in Gansu Cancer Hospital from October 2020 to October 2022 were included and randomly divided into control group and observation group(100 cases each).Both groups of patients underwent surgical treatment and received AC-T chemotherapy after surgery.During the treatment period,the control group received routine specialized nursing care,while the observation group received a warning mode based on UpToDate,with continuous intervention for 3 months.The psychological status,Hamilton anxiety scale(HAMA),Hamilton depression rating scale(HAMD),medical uncertainty inventory scale(MUIS),and European Organization for Research and Treatment of Cancer quality of life questionnaire core-30(EORTC-QLQ-C30)scores and adverse reactions between two groups were compared.Results:After 3 months of intervention,the HAMA,HAMD and MUIS scores of the observation group were 14.39±2.70,10.91±2.22 and 66.36±7.55,respectively,which were significantly lower than those of the control group(17.76±4.15,15.62±3.34 and 76.23±10.31,respectively),and the differences were statistically significant(all P＜0.05).The total quality of life score of the observation group was 81.23±13.26,which was higher than that of the control group(73.69±8.45)(P＜0.05).In the symptom scale,the fatigue,malignancy,vomiting,and pain scores of the observation group were 18.75±3.34,24.72±5.18 and 22.26±3.04,respectively,which were lower than those of the control group(29.03±6.07,35.07±8.15 and 28.31±5.16,respectively)(all P＜0.05).In the individual test,the insomnia score of the observation group was 18.65±3.37,which was lower than that of the control group(22.60±5.24)(P＜0.05).The incidence rates of nausea and vomiting,decreased appetite,abdominal pain and diarrhea,and decreased blood cells in the observation group were lower than those in the control group(all P＜0.05).Conclusion:The early warning mode based on UpToDate can improve the psychological status of breast cancer patients receiving chemotherapy after surgery,reduce adverse reactions and the uncertainty of disease,and improve the quality of life.

Objective:To explore the impact of the early warning model based on UpToDate on the adverse reactions and disease uncertainty of patients receiving AC-T chemotherapy after breast cancer surgery.Methods:Two hundred patients with breast cancer who received AC-T chemotherapy after surgery in Gansu Cancer Hospital from October 2020 to October 2022 were included and randomly divided into control group and observation group(100 cases each).Both groups of patients underwent surgical treatment and received AC-T chemotherapy after surgery.During the treatment period,the control group received routine specialized nursing care,while the observation group received a warning mode based on UpToDate,with continuous intervention for 3 months.The psychological status,Hamilton anxiety scale(HAMA),Hamilton depression rating scale(HAMD),medical uncertainty inventory scale(MUIS),and European Organization for Research and Treatment of Cancer quality of life questionnaire core-30(EORTC-QLQ-C30)scores and adverse reactions between two groups were compared.Results:After 3 months of intervention,the HAMA,HAMD and MUIS scores of the observation group were 14.39±2.70,10.91±2.22 and 66.36±7.55,respectively,which were significantly lower than those of the control group(17.76±4.15,15.62±3.34 and 76.23±10.31,respectively),and the differences were statistically significant(all P＜0.05).The total quality of life score of the observation group was 81.23±13.26,which was higher than that of the control group(73.69±8.45)(P＜0.05).In the symptom scale,the fatigue,malignancy,vomiting,and pain scores of the observation group were 18.75±3.34,24.72±5.18 and 22.26±3.04,respectively,which were lower than those of the control group(29.03±6.07,35.07±8.15 and 28.31±5.16,respectively)(all P＜0.05).In the individual test,the insomnia score of the observation group was 18.65±3.37,which was lower than that of the control group(22.60±5.24)(P＜0.05).The incidence rates of nausea and vomiting,decreased appetite,abdominal pain and diarrhea,and decreased blood cells in the observation group were lower than those in the control group(all P＜0.05).Conclusion:The early warning mode based on UpToDate can improve the psychological status of breast cancer patients receiving chemotherapy after surgery,reduce adverse reactions and the uncertainty of disease,and improve the quality of life.

Objective: To explore the effect of Qishen-Xiaodian Decoction combined with laser acupoint irradiation on oxidative stress and renal function on children with recurrent henoch schonlein purpura (HSP). Methods: A total of 120 children with recurrent HSP in the dermatology department clinic of Hospital of Xinle City from January 2015 to November 2017 were divided into two groups according to the random number table method, with 60 cases in each group. The control group took loratadine, Troxerutin and vitamin C orally, while the treatment group took Chinese medicine combined with laser acupoint irradiation based onthe control group. Drugs were taken orally for 4 weeks, laser acupoint irradiation treatment for 2 weeks. The level of glutathione peroxidase (GSH-Px) in plasma was detected by ELISA, the levels of MDA and SOD in plasma were detected by thiobarbituric acid colorimetry and hydroxylamine method, the level of IgG, micro albumin (Alb), β2-microglobulin (β2-MG) in urine were detected by radioimmunoassay, and the clinical effect was evaluated. The recurrence was recorded. Results: After treatment, the plasma GSH-Px (90.45 ± 15.36 μmol/L vs. 81.62 ± 13.68 μmol/L, t=3.318), SOD (99.64 ± 18.66 IU/ml vs. 84.21 ± 16.73 IU/ml, t=4.769) in the treatment group were significantly higher than the control group (P<0.01); the MDA (5.58 ± 1.31 μmol/L vs. 4.37 ± 1.36 μmol/L, t=4.964) was significantly lower than the control group (P<0.01); the ratio of urine IgG (3.48 ± 0.95 mg/L vs. 6.56 ± 1.47 mg/L, t=13.630), Alb (7.80 ± 2.94 mg/L vs. 12.73 ± 4.26 mg/L, t=7.378), β2-MG (4.02 ± 1.61 mg/L vs. 6.95 ± 2.10 mg/L, t=8.577) were significantly lower than those of the control group (P<0.01). The total effective rate was 95.0% (57/60) in the treatment group and 80.0% (48/60) in the control group. There was statistically significant difference between two groups (χ²=6.171, P=0.013). Follow-up of 6 and 12 months, the recurrence rate of the treatment group were significantly lower than that of the control group (χ² value were 4.931, 4.574, P<0.05). Conclusions Qishen-Xiaodian Decoction combined with laser acupoint irradiation can improve the oxidative stress of children with recurrent HSP, protect the renal function, improve the clinical efficacy and reduce the recurrence rate.

OBJECTIVE:To provide basis for the further development of health education about rational drug use. METH-ODS:1 000 permanent residents in 4 urban and rural communities of Chongqing were investigated and collected by random sam-ple,self-designed assessment questionnaires about knowledge-behavior-attitude level of rational antibiotics use were used before and after intervention of health education for essessing of the effects. RESULTS:Totally 2 000 questionnaires were sent out,and 2 000 were effectively received with effective rate of 100%. After intervention,the awareness rate of surveyed residents about“antibi-otics are not anti-inflammatory drugs”“in order to avoiding the infection in daily life,antibiotics can not be used frequently and preventively”and other related knowledge was significantly improved(P<0.05);correct rate of surveyed residents about“the use of antibiotics has its special rules,so it should be cautious to follow the guidance of physicians and can not be used freely”and oth-er related attitude was significantly improved(P<0.05);incidence of surveyed residents about“if discomfort,will you self-seek an-tibiotics(such as purchasing/finding donated/finding previous drugs left in family)”and other related misbehaviors was significantly reduced(P<0.05). The average scores of knowledge,attitude and behavior scores and total scores were significantly higher than be-fore(P<0.05). CONCLUSIONS:It is quite necessary to develop health education intervention of rational antibiotics use in commu-nity residents. Targeted health education intervention has significant effect on improving the knowledge-behavior-attitude level of ra-tional antibiotics use in community residents,and it is worthy of further promotion.

ObjectivePresent treatment in plastic surgery on giant congenital melanocytic nevus has always been a tough practice because it is difficult to achieve balance between effects and costs of treatment.This paper aimed to explore the concrete procedure of tangential excision and dermabrasion in treatment of adult giant congenital melanocytic nevus. Methods Taking into consideration pathological examination results before surgery,diseased regions,psychological expectancy and other factors,we used a humby knife or globe grinding head to remove giant congenital relanocytic nevus by wiping off the surface of it in 10 cases.After operation,the operated area of the skin underwent a process of healing in a moisturized state.In each case,surgical procedure was carried out by 1 2 sta ges,with the interval period ranges from 3 months to 6 months.ResultsOne to 3 years follow-ups showed that among those cases,5 cases obtained good results in which skin color of surgical area turned to normal and pathological examination showed that nevus cells disappeared,4 cases achieved improvement,and 1 case was relapsed.ConclusionsThe two alternative methods for treatment of giant congenital melanocytic nevus,either tangential excision or dermabrasion,with combination of pathological examination results,diseased regions,and psychological expectancy should be taken into consideration,which can remain a maximum balance between effects and costs of treatments.Tangential excision and dermabrasion are effective in some cases of giant congenital nevus where traditional methods do not work,or in order to reduce the cost of body appearance in treatment.Therefore,these two methods deserve to be adopted extensively in clinical therapy.But it still needs further accumulation of experience in practice and longer period of follow-up after operation.

Objective To explore the mechanism of LMWH therapy for SAP.Methods 48 wistar rats were random divided into 3 groups,sham group(S group),severe acute pancreatitis group(SAP group)and LMWH therapy group(H group).Serum amylase,IL-6,acinar cell apoptosis and the activity of NF-κB were detected and compared.Results The expression of amylase and IL-6 in SAP group was significantly higher than that in H group(P＜0.01).The apoptosis index of acinar cell in SAP group wag significantly lower than that in H group(P＜0.01),while the activity of NF-κB in SAP groupwas stronger than that in H group.Conclusions LMWH therapy may ameliorate SAP by inducing acinar cell apoptosis through suppressing the activity of NF-κB.

Objective To explore the safety, therapeutic-effect-evaluating standards and clinical value of the interventional treatment used as preoperative chemotherapeutic embolism of pelvic tumors and palliative treatment of the patient unsuitable for surgery. Methods Twenty-nine cases of pelvic tumors with complete materials were selected from the cases treated by Seldinger’s interventional techniques from March 1997 to March 2002 and comprehensively analyzed. Results After the chemotherapeutic embolism, most of the arterial supply to the tumors were blocked off; the tumor stains were decreased by more than 75 %; the intra-operating bleeding ranged from 820 to 1530 ml and averaged 1220 ml; the surgical removals were successful. The pathological examinations of the postoperative specimens showed that the necrostic rate of tumor ranged 91%～98%; the remission rate of painful symptoms reached 100%. No severe complications were found in this series.Conclusion The interventional treatment of pelvic tumors is safe, reliable and simple in operation, and can reduce the intra-operative bleeding and improve the successful rate of the surgery. It is regarded not only as the effective auxiliary therapy before surgical removal, but also as the first-selected method for the palliative treatment of the patient unsuitable for the surgery.

Objective To explore the value of imaging diagnosis of nerve-root-type cervical spondylosis(NRTCS)and to study the relative factors to the nerve root disturbance.Methods 188 cases of NRTCS clinically proved and with complete imaging data were retrospectively analyzed.The imaging characteristics of CR,CT and MRI of NRTCS were compared and the relative factors to the nerve root disturbance were analyzed in combination with the clinical characteristics.Results ①CR films in six-position could show the whole expression of the cervical spine.The anterior-posterior and functional position CR showed the physiological curvature change in 122(64.9%),narrowing of intervertebral space in 96(51.2%)and vertebral-body unstability or slide in 49(26.1%).The oblique CR showed the intervertebral-foramen lessening or narrowing in(26.1%)and Luschka-or intervertebral-joint osteophyte in 82(43.2%);②CT scans showed Luschka-or intervertebral-joint osteophyte in 76(40.4%),disc herniation and calcification of cartilage nodus in 80(42.6%)and hypertrophy or calcification of ligamenlum flavum in 66(39.8%);③MRI showed intervertebral-disk degeneration and protrusion in 105(55.8%),hypertrophy or calcification of ligamentum flavum in 51(27.1%),the nerve root and spinal cord compressed in 69(36.7%)and edema or degeneration of spinal cord in 23(12.2%).Conclusion The nerve root disturbance is closely correlated with the imaging appearances in NRTCS.It is of importance in early diagnosis and treatment for NRTCS to analyse synthetically the imaging data and clinical characteristics.

Objective To study the diagnostic value of imageology(CR,CT and MRI) for sacraoiliac pathological changes(SIPC) in ankylosing spondylitis(AS).Methods A retrospective analysis was made on the manifestations of CR,CT and MRI of the sacraoiliac joints in 98 cases of clinically-proved AS,including the grading,site and number,calcification,joint-space and sub-articular-surface-bone changes.Results The characteristics of AS in sacraoiliac joint on CR were: joint-space narrowing(67),articular-surface sclerosis(22),cystic change(15) and joint stiffness(17) and calcification(38).CT features were:the lesions involving iliac-side synovium of the sacraoiliac joint mainly,chondral calcification(55),joint-space narrowing(42),cystic change(43) and sclerosis(65) of the articular surface and sub-surface bone structure,and calcification of sacraoiliac-ligament(52).MRI showed: articular-cartilage damage(40),edema around the lesion(57) and intrabony fat sedimentation(15).Conclusion For sacraoiliac joint in AS,CR examination is the basic imaging method,CT in grading lesions is more accurate,while SIPC in AS can be early diagnosed by MRI.