AIM:To observe the effect of icariin-astragaloside Ⅳ-puerarin mixture(Yin-Huang-Ge mixture,YHG)on cognitive function and ferroptosis amino acid metabolism pathway in hepcidin(HAMP)knockout APPswe/PS1dE9(APP/PS1 HAMP-/-)mice.METHODS:The mice were divided into 7 groups:negative control(C57BL/6 mice)group,APP/PS1 group,APP/PS1 HAMP-/-group,APP/PS1+YHG group,APP/PS1 HAMP-/-+YHG group,APP/PS1+de-ferasirox(DFX)group,and APP/PS1 HAMP-/-+DFX group,with 6 mice in each group.The YHG and DFX were adminis-tered intragastrically,while the mice in C57 group,APP/PS1 group and APP/PS1 HAMP-/-group were given intragastric administration of distilled water,once a day for 2 months.The iron content in mouse brain tissues was detected by tissue iron kit.The morphological changes of the mitochondria in hippocampal neurons were observed by transmission electron microscopy.Morris water maze was used to detect the learning and memory ability of the mice.The content of neuronal nu-clear antigen(NeuN)in mouse brain tissues was detected by immunofluorescence staining.The expression of glutathione(GSH)in mouse brain tissues was detected by biochemical kit.The expression levels of glutamate-cysteine ligase catalytic subunit(GCLC)and glutamatase 2(GLS2)in mouse brain tissues were detected by Western blot.RESULTS:Compared with C57BL/6 mice,the brain iron content of APP/PS1 mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seri-ously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.01).Compared with APP/PS1 mice,the brain iron content of APP/PS1 HAMP-/-mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seriously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.05).After treatment with YHG and DFX,the brain iron content was significantly decreased(P＜0.01),the mitochondrial damage was alleviated,the learning and memory ability was significantly increased(P＜0.05),the brain neuron damage was alleviated(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly increased(P＜0.05).CONCLUSION:The YHG can improve the cognitive function of APP/PS1 HAMP-/-mice,and its mechanism may be related to the regulation of ferroptosis amino acid metabolism and the enhancement of antioxidant capacity.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective:To determine the therapeutic effect of in vitro cultivation of bezoar on a mouse model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. Method:BALB/c mice were randomly divided into six groups according to their weight grade： normal group， HCoV-229E infection group， cold and damp group， a mouse model combining disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome， and high and low dose group of in vitro cultivation of bezoar. The combination model of human coronavirus pneumonia with Yidu Xifei syndrome mice was established by the method of cold dampness condition stimulation+coronavirus HCoV-229E infection. In vitro cultivation of bezoar （0.128，0.064 g·kg^-1） was administrated by gavage for 3 days from the day of infection. The observation indexes included： general state observation of mice， inhibition rate of lung index and lung index of mice. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the viral load in the lung tissues of mice. Serum levels of motilin（MTL）， gastrin （GAS）， and cytokines interleukin（IL）-10，IL-6， tumor necrosis factor-α（TNF-α）and interferon-γ（IFN-γ） in lung tissue of mice were determined by enzyme-linked immunosorbent assay（ELISA）. The percentages of CD4⁺ T lymphocytes，CD8⁺ T lymphocytes and B lymphocytes in the blood of mice were determined by flow cytometry. Result:The high and low dose group of in vitro cultivation of bezoar can significantly improve the general condition of model mice. Compared with blank group， model group mice lung index increased significantly （P<0.01）， nucleic acids significantly increased expression of lung tissue in mice （P<0.01）， significantly higher serum MTL content in mice， GAS content significantly decreased （P<0.05，P<0.01）， lung tissue cells in the immune factor TNF-α， IL-10 and IL-6 were significantly increased （P<0.01）， peripheral blood lymphocyte CD4⁺ T cells in mice， The percentages of CD8⁺ T cells and B cells were significantly decreased （P<0.01）. Compared with model group， in vitro cultivation bezoar mice lung index of high and low dose group were significantly lower （P<0.01）， the lung tissue of mice express nucleic acid decreased significantly （P<0.01）， MTL content decreased significantly （P<0.01）， the lung tissue of mice in the IL-6， IL-10， the TNF-α， IFN-γ levels were significantly lower （P<0.01）， in vitro cultivation bezoar high dose group can significantly increase the CD4⁺ T cell percentage （P<0.05）， in vitro cultivation bezoar can to a certain extent reduce model mice lung inflammatory exudation， pulmonary interstitial edema， as well as blood stasis symptoms. Conclusion:In vitro cultivation of bezoar has a significant therapeutic effect on a mice model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. It can be treated by reducing the lung index of the model mice， improving the pathological damage of the lung tissue， adjusting the immune effective and inhibiting the clearing of inflammatory factors， and to provide a laboratory basis for clinical medication.

Objective:To correlate creatine kinase (CK) and creatine kinase- isoenzyme MB (CK-MB) with different states of bipolar disorder in patients.Methods:A total of 206 patients with bipolar disorder who received treatment in The 7 th People's Hospital of Wenzhou, China between January 2018 and June 2019 were included in the patient group. A total of 369 healthy controls who concurrently received physical examination were included in the control group. CK and CK-MB levels were detected in all participants. The Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD)-7 scale, the Bech-Rafaelsen Melancholy Scale (BRMS), and modified version of the Overt Aggression Scale (MOAS) were used to evaluate the mental symptoms, depression, mania and aggression of patients. The CK and CK-MB levels were compared between patients with different states of bipolar disorder. Results:In the control group, CK and CK-MB levels in males were 112.5 (94.5, 156.5) U/L and 17.0 (15.0, 20.0) U/L, respectively, which were significantly higher than those in females [73.0 (61.0, 86.3) U/L, 15.0 (13.0, 18.0) U/L, Z = -9.732, -3.535, both P < 0.001). In the patient group, CK and CK-MB levels in males were 129.0 (80.0, 233.5) U/L, 12.0 (10.0, 17.0) U/L, respectively, which were significantly higher than those in females [73.0 (55.0, 94.0) U/L, 13.5 (11.0, 17.0) U/L, Z = -9.510, -4.746, both P < 0.001]. There was no significant difference in CK level in males between the control and patient groups ( Z = -1.003, P = 0.316), but significant difference in CK-MB level in males was observed between the two groups ( Z = -6.570, P < 0.001). There were significant differences in CK and CK-MB levels in females between the control and patient groups ( Z = -2.535, -9.707, P = 0.011, P < 0.001). In the patient group, CK level in the manic, depressive, and symptom-alleviated states was 132.0 (78.0, 297.0) U/L, 85.0 (56.0, 145.0) U/L, 128.0 (110.0, 165.0) U/L respectively in males, and it was 73.0 (49.0, 122.3) U/L, 51.0 (45.0, 67.0) U/L and 84.5 (61.0, 193.0) U/L, respectively in females. There was significant difference in CK level in males and females between different states of bipolar disorder ( χ2 = 9.019, 16.720, P = 0.011, P < 0.001). In males, CK level was correlated with the BPRS total score, BRMS total score, and MOAS total score in the manic state, as well as the BPRS total score in the symptom-alleviated state ( r = 0.282, 0.286, 0.236, 0.574). In females, CK level was correlated with the MOAS total score in the manic state ( r = 0.260). In males, CK-MB level was correlated with the BRMS total score in the manic and depressive states ( r = 0.186 and 0.496). In females, CK-MB level was correlated with the MOAS total score and the BRMS total score in the manic state ( r = 0.155, 0.572). Conclusion:CK and CK-MB levels are correlated with bipolar disorder in different states and they are of certain clinical significance and provide innovative insights into the diagnosis of bipolar disorder.

[Summary] Extracellular calcium is essential for the regulation of a variety of biological processes. Calcium-sensing receptor (CaSR) plays a central role in maintaining Ca2+ homeostasis, while G-protein α-11 (Gα11 ) subunit and adaptor-related protein complex 2 sigma (AP2σ) are also involved in CaSR signaling transduction. Loss- or gain-of-function mutations of these encoding genes cause different types of familial hypocalciuric hypercalcaemia (FHH) and autosomal dominant hypocalcaemia (ADH). Calcimimetic and calcilytic drugs are useful in treating these FHH and ADH disorders. The current paper is a Chinese translation of a review entitled as “Disorder of the calcium-sensing receptor and partner proteins: insights into the molecular basis of calcium homeostasis” published in 《 Journal of Molecular Endocrinology》(2016,57:R127-R142) with the permission from the author and the journal.

Objective To obtain reasonable treatment by urodynamic detection and analysis in patients with diabetic cystopathy (DCP) complicated with benign prostatic hyperplasia (BPH).Methods Sixty patients with DCP complicated with BPH were selected,among the total 32 patients (duration of diabetes ＞ 12 years,blood glucose control was not ideal) were recognized as experimental group,and 28 patients (duration of diabetes ≤ 8 years,blood glucose control was stable) were recognized as control group.Using the Laborie UDS-120XLT urodynamic detection instrument,the urodynamic was detected and the international prostate symptom score (IPSS) was evaluate,and the results were compared between the 2 groups.Results There was no statistical difference in residual urine volume between experimental group and control group [(146 ±71) ml vs.(160 ±64) ml,P ＞0.05].The maximum urinary flow-rate in experimental group was significantly lower than that in control group [(5.4 ± 2.0) ml/s vs.(8.0 ± 3.2) ml/s],the symptom total score of IPSS was significantly higher than that in control group [(25.8 ± 4.1) scores vs.(22.6 ±5.0) scores],there were statistical differences (P ＜0.01).The maximum bladder capacity,compliance,incipient micturition desire volume in experimental group were significantly lower than those in control group,there were statistical differences (P ＜ 0.01).Conclusions The influence of DCP on the function of the bladder in BPH patients is significant.Urodynamic detection can provide objective basis for the selection of therapeutic methods,suitable to be operated and forecast the postoperative effect.It has an important reference value in DCP complicated with BPH patients.

Objective To investigate mechanism of cyclooxygenase-2 ( COX-2) in bone loss in a postmenopausal osteoporosis (PMOP) rat mode with ovarietomy (OVX).Methods Forty female Sprague Dawley adult rats at age of 3 months were randomly divided into 4 groups,10 in each group,including shamoperated (sham) group,OVX group,OVX treated with nilesteriol (OVX + E) group and OVX treated with aspirin ( OVX + P) group.All rats in OVX,OVX + E and OVX + P groups underwent ovarietomy under abdominal anesthesia with 10％ chloral hydrate.Rats in sham group were only taken with fat tissue with same weight under bilateral ovary.After surgery,penicillin was administered to prevent infection.At day 7 after surgery,agents were given by intragastric administration for 12 weeks.Nilestriol at 1.0 mg/kg was used in OVX + E group once a week,aspirin at 45 mg · kg - 1 · d- 1 was used in OVX + P group once a day.Saline with same volume was used in rats in sham and OVX groups.All agents were administered one time per day.Dose of agents were adjusted by weight per week.At end of study,bone mineral density (BMD) of right femurs and lumbar vertebrae 3 -5 (L3-5) were measured.Morphology of bone was detected by hematoxylineosin,and expression of COX-2 was determined by immunohistochemistry staining.Results ( 1 ) BMD:BMD of right femur and L3-5 was (0.209 ±0.010) g/cm2 and (0.230 ±0.012) g/cm2 in sham group and (0.181 ±0.008) g/cm2 and (0.201 ± 0.016) g/cm2 in OVX group,which reached statistical difference (P＜0.01).BMD of right femur and L3-5 was (0.203 ±0.009) g/cm2 and (0.224 ±0.028) g/cm2 in OVX + E group and (0.200 ± 0.011 ) g/cm2 and (0.204 ± 0.003 ) g/cm2 in OVX + P group,which were all higher than those in OVX group (P ＜0.01,P ＜0.05).However,there was no statistical difference in BMD between OVX + E and OVX + P group ( P ＞ 0.05).(2) Morphology of bone:bone trabeculae became fewer and degenerated in OVX group.However,bone trabeculae were regular and dense in OVX + P group and OVX + E group,which were similar to those in sham group.(3) Expression of COX-2:cells with COX-2 positive and expression of COX-2 around bone trabeculae in OVX group were more than those in sham,OVX + E and OVX + P group.Conclusion COX-2 plays an important role in PMOP.Aspirin could prevent bone loss by decreasing COX-2 expression in OVX rats.

Objective To analyse the application status of antihyportensive drug among community elderly patients with hypertension in Gaomi city. Methods Based on the investigation data of antihypertensive application in communities, various manifestations and the causes of antihypertensive application in community elderly patients are summarized, and the improvement proposals are put forward. Results A total of 1487 elderly patients with hypertension were investigated, 332 of them were untreated, among 1155 patients who received drug therapy the irrational drug use ratio was 77.4%. The main factors that caused the rational use of antihypertensive drug include: patients paid little attention to hypertension , they usually had little knowledge of this disease, and they lacked of professional guidance, as well as other factors such as economic factors, adverse drug reactions, et al. Conclusions There are many problems consist in community hypertension drug therapy, and it is necessary to strengthen the work of community hypertension control.

Objective To evaluate the MR imaging and CT appearances of focal nodular hyperplasia (FNH) of the liver and improve the accuracy of diagnosis in FNH. Methods 6 patients with solitary FNH underwent MR exiamnation. Dynamic Gd-DTPA enhancement were performed in all the lesions. Of the 6 patients, three underwent CT plain and dynamic contrast scan; one underwent CT plain scan. More attention was payed to the atypical appearances. Results Atypical lesion appearances ineludod:apparent hypointensity on T1 WI and hyperintensity on T2WI,diffusly heterogeneous enhancement in arterial phase, pseudocapsule enhancement in delayed phase;the dynamic contrast MR and CT appearance in each phase were not all similar. Conclusion MR and CT especially dynamic contrast enhancemenl is of great value to the diagnosis of FNH. The atypical appearances of FNH shoud keep in mind to avoid misdiagnosis.

ObjectiveTo study the MRI features of children with cerebral palsy(CP) resulting from anoxia.Methods The clinical and MRI findings in 83 premature or mature children affected by cerebral palsy resulting from PVL were reviewed retrospectively to search for the MRI features and the data were analyzed by statistic. Results1. MRI features of CP children resulting from anoxia were clearly demonstrated:1) MRI features of PVL: reduction of white matter ;T2W signal hyperintensity in white matter; ventricle enlarged or irregular appearance; lateral fissure;deepened or widened Sulci;and abnormal corpus callossum; 2) other abnormal MRI features: basal ganglion damaged; cerebral cortex atrophy or malacia. 2.Differences in MRI features between premature and mature CP children: there are significant differences between premature and mature children at malacia and cyst of deep white matter; enlargement and irregularity of the lateral ventricles. ConclusionsMRI examination can clearly display the level and scope of focus of PVL,and the differences in MRI features between premature and mature children.The level and degree of premature children are deeper and more extensive than those of mature children.Cyst and malacia in deep white matter,enlargement and irregularity of the lateral ventricles occur more frequantly in premature children.