ObjectiveTo investigate the therapeutic effect of sequential administration of Dihuang Baoyuan granules （DHBY， the prescription for consolidating body resistance） and Fuling Yunhua granules （FLYH， the prescription for treating symptoms） on spontaneous type 2 diabetes mellitus （T2DM） in mice. MethodsAccording to the fasting blood glucose （FBG） level， 12-week-old db/db mice were randomized into six groups： model， DHBY （18.02 g·kg^-1）， FLYH （14.80 g·kg^-1）， sequential administration 1 （SEQ-1， DHBY 18.02 g·kg^-1+FLYH 14.80 g·kg^-1）， sequential administration 2 （SEQ-2， FLYH 14.80 g·kg^-1+DHBY 18.02 g·kg^-1）， and dapagliflozin （Dapa， 1.3 mg·kg^-1）. The m/m mice in the same litter were selected as the normal group. The mice were administrated with corresponding drugs by gavage for 8 consecutive weeks. During the 8 weeks of drug administration and 2 weeks after withdrawal， the retinal thickness， FBG， hemoglobin A1c （HbA1c）， and insulin were determined， and histopathological changes of the pancreas， liver， kidney， and retina were observed by hematoxylin-eosin （HE） staining. ResultsCompared with the model group， SEQ-1 for 4 weeks lowered the FBG level （P<0.05）， raised the insulin level， decreased the triglyceride （TG） level （P<0.05）， increased the number of optic ganglion cells and diminished vacuolar degeneration of pancreatic islet and liver. SEQ-2 lowered FBG and HbA1c levels （P<0.05）， rose the insulin level， increased the retinal thickness and the number of optic ganglion cells （P<0.05）， and alleviated vacuolar degeneration of pancreatic islet and liver. Two weeks after drug withdrawal， Dapa tended to increase FBG and HbA1c compared with those at the time of drug withdrawal. However， the levels of FBG and HbA1c in the SEQ-2 group remained decreasing （P<0.05）. ConclusionSEQ-1 and SEQ-2 can lower the blood glucose level and ameliorate diabetic retinopathy， and SEQ-2 outperformed DHBY and FLYH in lowering the blood glucose level. Moreover， SEQ-2 can maintain the blood glucose-lowering effect after drug withdrawal.

ObjectiveTo investigate the therapeutic effect of sequential administration of Dihuang Baoyuan granules （DHBY， the prescription for consolidating body resistance） and Fuling Yunhua granules （FLYH， the prescription for treating symptoms） on spontaneous type 2 diabetes mellitus （T2DM） in mice. MethodsAccording to the fasting blood glucose （FBG） level， 12-week-old db/db mice were randomized into six groups： model， DHBY （18.02 g·kg^-1）， FLYH （14.80 g·kg^-1）， sequential administration 1 （SEQ-1， DHBY 18.02 g·kg^-1+FLYH 14.80 g·kg^-1）， sequential administration 2 （SEQ-2， FLYH 14.80 g·kg^-1+DHBY 18.02 g·kg^-1）， and dapagliflozin （Dapa， 1.3 mg·kg^-1）. The m/m mice in the same litter were selected as the normal group. The mice were administrated with corresponding drugs by gavage for 8 consecutive weeks. During the 8 weeks of drug administration and 2 weeks after withdrawal， the retinal thickness， FBG， hemoglobin A1c （HbA1c）， and insulin were determined， and histopathological changes of the pancreas， liver， kidney， and retina were observed by hematoxylin-eosin （HE） staining. ResultsCompared with the model group， SEQ-1 for 4 weeks lowered the FBG level （P<0.05）， raised the insulin level， decreased the triglyceride （TG） level （P<0.05）， increased the number of optic ganglion cells and diminished vacuolar degeneration of pancreatic islet and liver. SEQ-2 lowered FBG and HbA1c levels （P<0.05）， rose the insulin level， increased the retinal thickness and the number of optic ganglion cells （P<0.05）， and alleviated vacuolar degeneration of pancreatic islet and liver. Two weeks after drug withdrawal， Dapa tended to increase FBG and HbA1c compared with those at the time of drug withdrawal. However， the levels of FBG and HbA1c in the SEQ-2 group remained decreasing （P<0.05）. ConclusionSEQ-1 and SEQ-2 can lower the blood glucose level and ameliorate diabetic retinopathy， and SEQ-2 outperformed DHBY and FLYH in lowering the blood glucose level. Moreover， SEQ-2 can maintain the blood glucose-lowering effect after drug withdrawal.

Acute variceal bleeding(AVB)is one of the most common complications in the patients with liver cirrhosis,seriously threatening the life safety of the patients.The application of transjugular intrahepatic portosystemic shunt(TIPS)in the treatment of AVB patients has become an important therapeutic approach.However,the selection of TIPS treatment timing has always been a challenging issue for clinical physicians.Priority TIPS treatment can improve the survival rate of high-risk patients and reduce the rebleeding rate,but its effectiveness for other patients remains unclear.Currently,elective TIPS treatment is still a second-line treatment regimen for preventing variceal rebleeding.This paper discussed from the angle of the priority TIPS,alternative TIPS and salvage TIPS in order to provide reference for the clinicians'decision-making and help to better grasp the timing selection and matters needing attention of TIPS treatment,thus enhancing the treatment efficacy and patients'survival rate.

Objective To summarize the preliminary clinical outcomes of combination therapy with molecular targeted agents/immunological agents and to explore the potential value of multidisciplinary therapy in the treatment of postoperative refractory recurrent hepatobiliary tumor.Methods 52 cases of postoperative refractory recurrent hepatobiliary tumor during June 2016 to January 2019 from outpatient and inpatient departments at the First Medical Center of PLA General Hospital were prospectively collected,including 37 males and 15 females,with a mean age of (56.2 ± 8.5) years.Referring to the results of next-generation sequencing (NGS) and other-omics,we designed individualized therapy options for each patient.Follow-ups were done regularly and tumor responses were assessed by modified response evaluation criteria in solid tumors (mRECIST).Results Of 52 patients,median follow-up was 10 months (range 3-31 months).14 (26.9％) patients achieved a complete response (CR).8 (15.3％) patients achieved a partial response (PR).14 (26.9％) patients had stable disease (SD).16 (30.8％,including 4 deaths) had progressive disease (PD).Objective response rate and disease control rate were 42.3％ (22/52) and 69.2％ (36/52),respectively.The median progression-free survival (PFS) was 7 months.6-and 12-month overall survival rates were 100％ (48/48),87.5％ (21/24),respectively.Conclusions Precision medicine has good guidance on the treatment of refractory recurrence of hepatobiliary tumors.The combination therapy of multi-target tyrosine kinase inhibitors and immune checkpoint inhibitors may achieve better disease control and deserve further promotion in clinical application.

Objective To explore the value of radiomics in stratifying the Gleason score (GS) of prostate cancer based on vast image features from biparametric MRI. Methods Three hundred and sixteen patients were enrolled in this study from October, 2015 to December, 2018 and their results of surgical pathology were obtained. The lesions were manually depicted by 3D?Slicer. Then, 106?dimensional features extracted by radiomics were used to conduct Spearman non?parametric correlation test with the high and low risk stratification of GS. The constructed Neural Network was trained with the features after dimension reduction by principal component analysis as the input. Then, the testing set was fed in to get the predictive capability of the model. In the end, 10?fold cross?validation and shuffle of 100 times were used to test the accuracy of the prediction and the generalization ability of the model. Results Seventy seven?dimensional features with significant correlation were found at the level of P valued=0.05 (two?tailed). After dimensional features were reduced, 21 dimensional new feature spaces with 99% original feature information were obtained. The results on the testing data after the 10?fold validation and shuffle were AUC=0.712 with T2WI, AUC=0.689 with DWI(b=1 000 s/mm2), AUC=0.689 with DWI (b=2 000 s/mm2) and AUC=0.691 with DWI (b=3 000 s/mm2). Conclusion The neural network after extracting features from biparametric MRI images can accurately and automatically distinguish the high risk and low risk groups of Gleason grade of prostatic cancer.

Objective: To explore the value of radiomics in stratifying the Gleason score (GS) of prostate cancer based on vast image features from biparametric MRI. Methods: Three hundred and sixteen patients were enrolled in this study from October, 2015 to December, 2018 and their results of surgical pathology were obtained. The lesions were manually depicted by 3D-Slicer. Then, 106-dimensional features extracted by radiomics were used to conduct Spearman non-parametric correlation test with the high and low risk stratification of GS. The constructed Neural Network was trained with the features after dimension reduction by principal component analysis as the input. Then, the testing set was fed in to get the predictive capability of the model. In the end, 10-fold cross-validation and shuffle of 100 times were used to test the accuracy of the prediction and the generalization ability of the model. Results: Seventy seven-dimensional features with significant correlation were found at the level of P valued=0.05 (two-tailed). After dimensional features were reduced, 21 dimensional new feature spaces with 99% original feature information were obtained. The results on the testing data after the 10-fold validation and shuffle were AUC=0.712 with T₂WI, AUC=0.689 with DWI (b=1 000 s/mm²), AUC=0.689 with DWI (b=2 000 s/mm²) and AUC=0.691 with DWI (b=3 000 s/mm²). Conclusion The neural network after extracting features from biparametric MRI images can accurately and automatically distinguish the high risk and low risk groups of Gleason grade of prostatic cancer.

Objective To investigate the effect of Ba Duan Jin sequential therapy on quality of life in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods Eighty-two patients with STEMI were randomly divided into experimental group and control group. The control group received standard treatment, while the experimental group was given Ba Duan Jin sequential therapy on the basis of standard treatment. The clinical efficacy was evaluated at 1 d, 3 months, 6 months after intervention by Integrated Chinese and Western Medicine Scale for coronary disease. Results After six months of intervention, the item score of Chinese and Western Medicine Scale of the coronary heart disease in the experimental group was significantly higher, and rehabilitative efficacy was better than that in the control group (P ＜0. 05). Conclusion Ba Duan Jin sequential therapy can effectively improve the postoperative quality of life of patients with STEMI after re-perfusion.

Objective To investigate the effect of Ba Duan Jin sequential therapy on quality of life in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). Methods Eighty-two patients with STEMI were randomly divided into experimental group and control group. The control group received standard treatment, while the experimental group was given Ba Duan Jin sequential therapy on the basis of standard treatment. The clinical efficacy was evaluated at 1 d, 3 months, 6 months after intervention by Integrated Chinese and Western Medicine Scale for coronary disease. Results After six months of intervention, the item score of Chinese and Western Medicine Scale of the coronary heart disease in the experimental group was significantly higher, and rehabilitative efficacy was better than that in the control group (P ＜0. 05). Conclusion Ba Duan Jin sequential therapy can effectively improve the postoperative quality of life of patients with STEMI after re-perfusion.

ObjectiveTo compare the effects of different feeding methods on plasma Ghrelin(a peptide hormone)level, growth and development of premature infants.Methods A total of 147 cases of very low birth weight newborn were randomly divided into nasogastric tube feeding group(group A, 38 cases), nasogastric tube feeding combined with non-nutritional sucking group(group B, 39 cases), nasogastric tube feeding combined with infantile touching group(group C,34 cases), nasogastric tube feeding combined with non-nutritional sucking and infantile touching group(group D,36 cases). Anthropometric indicators and plasma Ghrelin levels of premature infants before and after the feeding were compared among four groups.Results At 2 weeks post admission, the body weight of premature infants in four groups were(1503±206)g(group A),(1487±211)g(group B), (1494±228)g(group C), and(1615±242)g(group D). The differences between group D and other groups were statistically significant(t=2.004, 2.262, 2.061;P<0.05). At 4 weeks post admission, the plasma Ghrelin levels of premature infants in four groups were(38.3±7.4)μg/L(group A),(39.3±6.9)μg/L(group B),(35.7±6.6)μg/L(group C), and(34.5±9.1)μg/L(group D). The increases of plasma Ghrelin levels between group A and group C or D were statistically significant(t=2.65,5.20;P<0.05). Similar results were also observed between group B and group C or D(t=3.01, 5.79;P<0.05).Conclusions Nasogastric tube feeding combined with non-nutritional sucking and infantile touching is efficient in improving quality of life of very low birth weight newborns and saving medical cost.

Objective To investigate the expression of helper T cells (Th)17/regulatory T cells (Treg) balance associated factors in rheumatoid arthritis (RA) patients and their correlation with serum midkine (MK).Methods A total of 60 RA patients were divided into active RA patients (n=32) and inactive RA patients group (n=28).MK level in sera was detected by enzyme linked immunosorbent assay (ELISA) in 60 patients with RA and 30 healthy controls (HCs).The fraction of CD4+CD25+FOXP3+ Treg cells and IL-17+CD4+ Th17 cells in RA patients and healthy controls were determined by flow cytometry (FCM), and the expreasion of Foxp3, RORγt, Signal transducer and activator of transcription (STAT) 3 and STAT5 mRNA were detected with real-time polymerase chain reaction (PCR).Results were evaluated using ANOVA followed by q tests for comparisons of Th17 population between active RA patients, inactive RA patients and HCs, t test was used for comparing of Foxp3, RORγt, STAT3, STAT5 mRNA between RA group and HCs.The correlations between serum MK concentration and peripheral Treg cells, Th17 cells, Foxp3, RORγt, STAT3, STAT5 mRNA were analyzed by Pearson's correlation analysis.Results The percentages of Treg cells from active RA patients, inactive RA patients and HCs were significantly different (F=129.6, P＜0.01), the percentages of Treg cells of active RA patients [(1.41±1.05)％] were lower than that of the inactive RA patients [(3.6±1.6)％;q =7.92, P＜0.05] and healthy group [(7.7±1.7)％;q=22.45, P＜0.05], and there was significant difference between healthy group and inactive RA group (q=14.53, P＜0.05).The percentages of Th17 cells of the three groups were also significantly different (F=36.3, P＜0.01),the percentage of Th17 cells of active RA patients [(1.84±1.01)％] was significantly higher than that of inactive RA patients [(0.71±0.28)％;q=9.59, P＜0.05] and healthy group (0.53±0.16)％ [(P＜0.05;q=1 1.10, P＜0.05], there was no significant difference between the inactive RA group and healthy group (q=1.51, P＞0.05).The expression of RORγt and STAT3 mRNA in RA patients was higher than that of healthy controls (t=5.84, P＜0.01;t=4.52, P＜0.01).The expression of Foxp3 and STAT5 mRNA in RA patients were lower than healthy controls (t=6.01, P＜0.01;t=2.18, P＜0.05).Serum MK values were correlated with STAT5 (r=-0.55, P＜0.01), but not with Foxp3, RORγt, STAT3 mRNA or the percentage of Treg/Th17 cells.Conclusion Serum MK expression and the percentage of Th17 cells increase, while the percentage of Treg cells decrease in RA patients.Serum MK values are negatively correlated with STAT5 mRNA which is associated with Th17/Treg balance.This may be important in the pathogenesis of RA.