OBJECTIVE To observe the effects of Panax quinquefolium-Acorus calamus on learning and memory abilities in diabetes mellitus(DM) mice and investigate the mechanism of Panax quinquefolium-Acorus calamus in treating diabetic cognitive impairment(DCI) through network pharmacology and animal experiments. METHODS Diabetic mouse model was established by intraperitoneal injection of streptozotocin(80 mg·kg−1), followed by 8 weeks of oral administration and assessment of drug efficacy using the Morris water maze. The active ingredients and targets of Panax quinquefolium-Acorus calamus were collected using TCMSP, Swiss Target Prediction, and Gene Cards. The protein-protein interaction network of "Traditional Chinese Medicine-Ingredient-Disease targets" was constructed using the String platform and Cytoscape, visualized, and subjected to enrichment analysis using the Metascape database. The anti-DCI mechanism of Panax quinquefolium-Acorus calamus was examined through ELISA and Western blotting, while changes in hippocampal neurons of diabetic mice were observed using HE staining. RESULTS Panax quinquefolium-Acorus calamus reduced the escape latency of diabetic mice(P<0.05), without significant impact on swimming speed. Network pharmacology results indicated that the main components of Panax quinquefolium-Acorus calamus in treating DCI were ginsenoside Re, ginsenoside Rh2, and shanjin phenol, which regulated the Nrf2-Keap1 signaling pathway to treat DCI. Animal experiments demonstrated that Panax quinquefolium-Acorus calamus increased SOD activity(P<0.05), decreased MDA levels(P<0.01), enhanced the expression of HO-1, Keap1, Nrf2 in mouse brain(P<0.01), and alleviated the loosening of granule cell arrangement and nuclear condensation in the hippocampal CA1, CA3, and DG regions. CONCLUSION Using animal experiments combined with network pharmacology, this study preliminarily elucidates the potential targets and mechanisms of Panax quinquefolium-Acorus calamus in intervening DCI, and predictes the molecular basis for its intervention in DCI through molecular docking, providing insights for further in-depth research on Panax quinquefolium-Acorus calamus.

Objective:In order to cope with the rising risk pressure on the economic operation of public hospitals,it aims to re-search and construct a comprehensive economic operation evaluation index,and improve the comprehensiveness,scientific and dynamic nature of monitoring and analysis of the economic operation of public hospitals.Methods:Literature research,expert consultation and hierarchical analysis were adopted.Results:A comprehensive evaluation model of public hospitals'economic operation covering 5 dimensions and 25 indexes,including structural optimization,controllable risk,efficiency enhancement,smooth operation and sustain-able development,has been constructed;empirical analyses of the overall index,sub-indexes and monthly indexes have been carried out on the data of some of the tertiary hospitals in Shanghai,which have verified the validity of the above index model in enhancing the monitoring,analysis and evaluation of the hospitals'economic operation,and revealed the role of the above index model in the changes of the economic conditions of the hospitals and the factors.Conclusion:Constructing a comprehensive evaluation index can effectively complement management such as comprehensive assessment and evaluation of public hospitals and traditional financial descriptive analysis.

OBJECTIVE：To evaluate guidelines f or health technology assessment （HTA）at home and abroad ，and to provide reference for scientific formulation of HTA guidelines in China. METHODS ：Databases including PubMed ，Embase，Guidenlines International Network and 83 official websites from 26 countries governments and academic organizations were searched to collect HTA guidelines from inception to April 2020. Two reviewers independently screened literature and extracted data ，including basic characteristics， content of guideline and assessment content. Then a descriptive analysis was conducted. RESULTS & CONCLUSIONS：A total of 19 guidelines published during 2001 to 2018 were included ，7 guidelines（36.8％）were published in 2015-2020；in addition to 1 guideline from WHO ，14 guidelines （73.7％）were published in Europeand ，2 guidelines（10.5％） in North America and 1 guideline each from South America and Asia （5.3％）. There were 11 guidelines（57.9％）developed by academic organizations and 8 guidelines（42.1％）by health administration ；11 guidelines（57.9％）were evidence-based ，while the others weren ’t evidence- based （42.1％）. The purpose ，content and object of assessment are demonstrated in 19 guidelines；18 guidelines specified the assessment method （94.7％），and 16 guidelines（84.2％）defined the subject of assessment ；14 guidelines （73.7％）specified the HTA assessment process ；12 guidelines（63.3％）mentioned the conflict of interest in HTA assessment process；7 guidelines（36.8％）mentioned the application of assessment results. There are some differences in the formulation methods and contents of HTA guidelines in foreign countries ，but the core contents ar e basically the same. At present ，there is a lack of HTA guidelines in China. We can refer to foreign guidelines，and establish applicable HTA guidelines which aresuitable for national conditions ，so as to provide scientific guidance for HTA research.

BACKGROUND: Skin reproducing membrane is a biomaterial used directly in contact with skin defects, so its toxicity to the body must be taken into consideration. OBJECTIVE: To systematical y evaluate the biocompatibility of skin reproducing membrane of medical fibroin. METHODS: Skin irritation test: the skin defect of New Zealand white rabbit was covered with the skin reproducing membrane of medical fibroin, formaldehyde or normal saline, respectively, and erythema and edema were observed at 24 and 72 hours after treatment. Acute systematic toxicity test: the mice were given extracts of skin reproducing membrane of medical fibroin, phenol and normal saline via tail vein injection; then status of mice, toxicity grade and death were recorded at 24, 48 and 72 hours after injection. Cytotoxicity test: L-929 cel s were co-cultured with 100%, 50%, 25%, 10% skin reproducing membrane of medical fibroin extracts, and absorbance values were detected by ultraviolet spectrophotometry at 2, 4 and 7 days after culture, as wel as by MTT assay after 48 hours of culture, respectively. Besides, L-929 cel s were co-cultured with 100% skin reproducing membrane of medical fibroin extracts, and mRNA expression of fibronectin was determined by qPCR technology after 48-hour culture. RESULTS AND CONCLUSION: Skin reproducing membrane of medical fibroin has no adverse reaction, acute cytotoxicity, skin irritation and systemic toxicity, and additional y, it does not affect mRNA expression of fibronectin. In general, skin reproducing membrane of medical fibroin has good biocompatibility.

Objective To investigate the clinical efifcacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of liver metastasis of colon cancer. Methods A total of 68 patients with liver metastasis of colon cancer in the Sixth Affiliated Hospital of Sun Yat-sen University from June 2007 to May 2011 were enrolled in this prospective study. The informed consents of all patients were obtained and local ethical committee approval had been received. There were 43 males and 25 females with a mean age of (59±4) years old. The patients were divided into RFA group and Control group with 34 cases in each group according to random number table method. Patients in both groups underwent TACE ifrstly and patients in RFA group underwent RFA 3 weeks after TACE treatment. Cluster of differentiation (CD) 3+, CD4+, CD8+positive cell percentage and CD4+/CD8+ratio were deifned by flow cytometry before and after treatments in two groups. The tumor diameter after treatments and general efifcacy were observed. The patients were followed up and the tumor recurrence and survival of the patients were observed. The comparisons of tumor diameter and immune function between two groups were conducted using t test. The comparison of efifcacy between two groups was conducted using rank sum test. The survival analysis was conducted using Log-rank test and Z test. Results The CD4+, CD8+percentage and CD4+/CD8+ratio were (42±4)%, (13±3)%, 2.9±0.9 in RFA group after treatment and were (33±4)%, (17±3)%, 2.3±0.9 in Control group, where signiifcant differences were observed (t=5.483,-6.488, 9.321;P<0.05). The tumor diameter in RFA group after treatment [(0.9±0.1) cm] was significantly smaller than that in Control group [(1.9±0.2) cm] (t=-4.573, P<0.05). The total effective rate in RFA group was 62%(21/34) and was 35%(12/34) in Control group. The treatment efifcacy of RFA group was better than that of Control group (Z=4.769, P<0.05). The 2-, 3-year survival rates in RFA group (38.2%, 23.5%) were significantly higher than those in Control group (14.7%, 5.9%) (Z=4.836, 4.221; P<0.05). Conclusions TACE combined with RFA is a safe and effective regimen in treating liver metastasis of colon cancer. The efifcacy may be associated with the improvement of the body’s immune function.

ObjectiveTo investigate the diagnosis and treatment of purple urine bag syndrome following transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Clinical data of 13 patients who developed purple urine bag syndrome out of 117 patients undergoing TACE for HCC in the Sixth Afifliated Hospital of Sun Yat-sen University between January 2012 and May 2014 were retrospectively studied. Among the 13 patients, 4 were males and 9 were females with the age ranging from 35 to 68 years old and the median of 53 years old. The tumor diameter was≤5 cm in 8 cases and was > 5 cm in 5 cases. The operative duration of TACE was≤30 min in 6 cases and was >30 min in 7 cases. The informed consents of all patients were obtained and the local ethical committee approval had been received. The diagnostic criteria was pink to purple urine in the urine bag after TACE and no blood urine detected by urine routine test.ResultsThe incidence of purple urine bag syndrome following TACE was 11.1% (13/117). After purple urine bag syndrome was confirmed, the patients were given the comprehensive therapy of urine acidification, rehydration, regular change of urinary catheter and urine bag, and gastrointestinal function improvement. No anti-infective therapy was given. The average indwelling time of urinary catheter was (12±3) d.ConclusionsIt is not a rare case for purple urine bag syndrome following TACE for HCC, thus it should be taken seriously. The treatment mainly includes urine acidiifcation, rehydration and gastrointestinal function improvement.

BACKGROUNDDue to racial differences in the morphology of the knee joint and due to most prostheses available in the market being designed using measurements from Caucasians, the objective of this study was to provide the morphometric data of the patella for the southern Chinese population for total knee arthroplasty (TKA), patellar resurfacing, and prostheses design.

METHODSThe CT slices of the knee joint were obtained from both knees of 40 Chinese volunteers (20 females, 20 males, and age from 20-25 years) by performing a computer tomographic scan. A 3D model was reconstructed by Mimics software based on the computed tomography images. Six metrical characteristics were measured by digital ruler. Statistical analysis was performed with the SPSS statistical program.

RESULTSThe mean, standard deviation and P values of measurements and ratios were calculated using SPSS. All dimensions showed a significant gender difference with P < 0.05, but the six variables of the left and right knees had no statistical significance with P > 0.05. In addition, we studied the relationship between six couples (H-W, H-T, H-HAF, W-T, W-HAF, T-HAF) of the four variables (H: height, W: width, T: thickness and HAF: height of articulating facet) that were measured, which showed a significant correlation.

CONCLUSIONSExamination of the southern Chinese population revealed that males have larger patellae than women. In both genders, comparing data between left and right knees shows no statistically significant difference. Compared with Westerners in previous studies, the patella in our study was thin and small. There was a good linear regression correlation between measurements of the patella. The indirect measurement method on 3D models makes it easy to obtain anatomical data, and the results can provide a region and gender specific database for morphometric measurements of the patella, and can be helpful for designing implants suited for southern Chinese patients.

Adult ; Arthroplasty, Replacement, Knee ; China ; Female ; Humans ; Male ; Patella ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

Objective To observe the inhibitory effect on lymph node metastasis of pancreatic cancer and lymphangiogenesis in mice by injection of KAll gene within xenograft tumor.Methods Pancreatic cancer cell line MiaPaCa-2 wag used to construct the nude mice models bearing tumors,then the mice were divided into normal saline group,Ad group and Ad-KAI1 group.Since the successful model construction,normal saline,Ad,Ad-KAI1 was injected every week for 3 times,respectively in the three groups,then the tumor size was documented.50 d after model construction,the tumor and enlarged lymph nodes were collected and subjected to pathological exam,and the expression of LYVE-1 and the MLVD in xenograft tumor was detected by immunohistochemistry.Results Two weeks after MiaPaCa-2 implantation,the model was 100％ successfully constructed.The growth curve of subcutaneous tumor among 3 groups was not statistically significant (P＞0.05) ; the weights of subcutaneous tumor in the 3 groups were (2514.4 ±351.3),(2466.1 ± 295.5),(2294.4±255.4) mg after 50 d,and the difference among the 3 groups was not statistically significant (P ＞0.05).Enlarged lymph nodes metastasis was observed in 8 mice (80％) in normal saline group,and 20 lymph nodes were collected,with 2.0 lymph nodes per mice; and enlarged lymph nodes metastasis was observed in 7 mice (70％) in Ad group,and 15 lymph nodes were collected,with 1.5 lymph nodes per mice; while enlarged lymph nodes metastasis was observed in 4 mice (40％) in Ad-KAI1 group,and 6 lymph nodes were collected,with 0.6 lymph nodes per mice.All the lymph nodes were confirmed to be metastasis of the primary tumor after pathologic exam.The difference of lymph nodes metastasis,number of lymph nodes metastasis per mice among the 3 groups was statistically significant (F =3.14,3.35,P ＜ 0.05).The MLVD of subcutaneous tumor among the 3 groups was (18.70 ± 5.60),(19.40 ± 4.58),(9.80 ±4.10)/400 times magnification,the MLVD of Ad-KAI1 group was significantly lower than those in normal saline group and Ad group (F10.76,11.36,P ＜ 0.05),but the difference between normal saline group and Ad group was not statistically significant.Conclusions KAI1 can inhibit the lymph node metastasis of pancreatic cancer,and the mechanism may be related with decreased lymphangiogenesis and reduced lymphatic vessel density.

Objective To explore the effectiveness of dietary treatment in reducing macrosomia risks for pregnancies with borderline gestational glucose intolerance (BGGI).Methods From July 2009 to June 2011,a total of 1046 pregnant women with BGGI were randomized into group A (intervention,n =525) and group B (non-intervention,n =521).Another 521 pregnancies with normal glucose screening were assigned into group C (normal control).Randomization was applied following stratification according to age,body mass index (BMI),prior Cesarean section (C-section) and multiparity,etc.Women in group A underwent the examinations of fasting plasma glucose (FPG),2 h-post prandial glucose and HbA1c once every 2 weeks.Their newborn outcomes were collected for analysis.Results Women of three groups were similar in age,parity,initial BMI and initial FPG.Dietary treatment for group A improved glucose-related indices and women's pregnancy weight gain (P ＜0.0l).Also,in comparison with group B,the intervention of group A reduced risk of macrosomia (9.14％ vs.13.82％,P =0.02),prior C-section rate (43.87％ vs.56.07％,P ＜ 0.01) and postpartum hemorrhage (3.81％ vs.7.10％,P =0.02).However these indices were no better than group C.Dietary treatment did not increase the risk of fetal growth restriction,neonatal hypoglycemia and hyperbilirubinemia.Conclusion As a simple noninvasive therapeutic measure for improved glucose tolerance,BGGI may reduce the risk of risk of macrosomia and prior C-section rate.

Objective To study the mechanism of hypoxia inducing factor-1α(HIF-1α)pathway in establishment of hypoxia inducing low endometrial receptivity.Methods RL95-2 cell lines.the ideal model of study ER,were cultured in hypoxia condition induced by CoCl2,and the expression of mRNA and protein of HIF-1α and tumor necrosis factor like weak inducer of apoptosis(TWEAK)were measured by reverse transcription-PCR and western blot. The apoptosis rate was analyzed by flow eytometry.Then the mechanism confirmed by comparing the two factors in endometrium and the ultra-appearance of inflammatory reaction and apoptosis between recurrent spontaneous abortion women and control women.Results (1)On difierent time point(0,12,24,48 hour),mRNA expression of HIF-1α were 0.272±0.010,0.354±0.020,0.591±0.020.0.890±0.020,while the expression of TWEAK were 0.104±0.010,0.510±0.020,1.021±0. 020, 1. 237 +0. 040, respectively, the expression level between 12, 24, 48 and 0 hour all showed significant differences (P＜0. 05 ). (2) Protein expression of HIF-1α were 0. 853 +0. 010, 0. 931 ±0. 030,1. 124±0.010, 1.317±0.0 20 respectively, while was 0.042±0.010, 0.091 ±0.010, 0. 131±0.020,0. 205 ±0. 030 in TWEAK expression, the different level were statistically significant ( P＜0. 05 ). ( 3 )With longer culture under hypoxia, the cell apoptosis rate increased obviously. The apoptosis rate of each time point were ( 3.2±1.4 ) %, ( 16. 2 ±3.2 ) %, ( 26. 3±3.5 ) %, ( 31.8±3.5 )%, the differences between 12, 24, 48 and 0 hour had significance (P ＜0. 05). (4) The positive rate of HIF-1α stained in epithelium cells and stroma cells of test group were 32. 3%, 8.4% and 16. 7%, 7. 3% in control group. The positive rate of TWEAK were 28. 3%, 3.9% in recurrent spontaneous abortion group and 11.6%, 2. 7% in control group ( P ＜0. 05 ). The ultra-appearance of inflammatory cell infiltrated and apoptosis were obvious in test group. Conclusions Cell inflammation reaction and apoptosis induced by HIF-1α pathway may participate the mechanism of hypoxia inducing low endometrial receptivity. HIF-1α might become a novel target for improving poor endometrial receptivity.