Objective:To investigate the effects of external application of Sanying Plaster on the size of thyroid nodules and the states of depression and anxiety in patients with benign thyroid nodules.Methods:A randomized controlled trial was conducted. A total of 120 patients with benign thyroid nodules from the outpatient clinic of the Department of Thyroid Diseases at Shanghai Traditional Chinese Medicine Hospital from June to December 2022 were selected as the subjects of the study. They were divided into two groups using the random number table method, with 60 patients in each group. The control group received lifestyle intervention treatment, while the treatment group received Sanying Ointment in addition to the treatment of the control group. Both groups were treated for 3 months. TCM syndrome scores were measured before and after treatment; the maximum diameter of thyroid nodules was measured using a color Doppler ultrasound transverse section; the quality of life was assessed using the short form 36 (SF-36); the degree of anxiety and depression was evaluated using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS); adverse reactions during the treatment period were recorded, and the clinical efficacy was evaluated.Results:During the treatment period, 4 cases in the treatment group and 3 cases in the control group did not complete the treatment. Finally, 56 cases in the treatment group and 57 cases in the control group entered the efficacy evaluation. The total effective rate of the treatment group was 71.4% (40/56), and that of the control group was 14.0% (8/57), with a statistically significant difference between the two groups ( χ2=26.82, P<0.001). After treatment, the TCM syndrome score of the treatment group (10.02±3.65 vs. 16.65±3.44, t=-10.24) was lower than that of the control group ( P<0.001); the maximum diameter of thyroid nodules [11.00 (4.65, 19.93) mm vs. 15.00 (7.15, 28.50) mm, Z=-2.43] was lower than that of the control group ( P<0.05); the SF-36 score [121.83 (117.00, 130.00) vs. 114.42 (104.25, 127.50), Z=-2.62] was higher than that of the control group ( P<0.01); the SDS (46.72±4.59 vs. 57.02±5.99, t=14.80) and SAS (42.25±5.72 vs. 50.60±7.12, t=10.04) scores were lower than those in the control group ( P<0.001). The incidence of adverse reactions during the treatment period in the treatment group was 3.5% (2/57), and no adverse reactions occurred in the control group. Conclusion:The external application of Sanying Ointment helps to reduce the size of thyroid nodules in patients with benign thyroid nodules, improve the quality of life and anxiety and depression, and increase clinical efficacy with good safety.

Enzyme-catalysis self-assembled oligopeptide hydrogel holds great interest in drug delivery, which has merits of biocompatibility, biodegradability and mild gelation conditions. However, its application for protein delivery is greatly limited by inevitable degradation of enzyme on the encapsulated proteins leading to loss of protein activity. Moreover, for the intracellularly acted proteins, cell membrane as a primary barrier hinders the transmembrane delivery of proteins. The internalized proteins also suffer from acidic and enzymatic degradation in endosomes and lysosomes. We herein develop a protease-manipulated hybrid nanogel/nanofiber hydrogel for localized delivery of intracellularly acted proteins. The embedded polymeric nanogels (CytoC/aNGs) preserve activity of cytochrome

Objective:To investigate the prognostic value of serum levels of miR-134 and miR-146b in elderly patients with acute ischemic stroke(AIS).Methods:A total of 162 elderly patients with AIS admitted to the Third People's Hospital of Haikou from January 2017 to October 2019 were enrolled.According to modified Rankin Scale(mRS)scores, they were divided into the good prognosis group(n=98, mRS score≤2)and the poor prognosis group(n=64, mRS score>2). Based on the National Institutes of Health Stroke Scale(NIHSS), patients were divide into the mild group(n=46, NIHSS score<5), moderate group(n=75, 5≤NIHSS score≤20), and severe group(n=41, NIHSS score>20). Real-time fluorescence quantitative PCR was used to detect serum levels of miR-134 and miR-146b in each group.Multivariate logistic regression was used to analyze risk factors for poor prognosis in elderly patients with AIS.The receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-134 and miR-146b levels in predicting poor prognosis of elderly patients with AIS.Pearson correlation was used to analyze the correlations of serum levels of miR-134 and miR-146b with NIHSS and mRS scores in elderly patients with AIS.Results:Serum levels of miR-134(3.26±1.13 vs.0.85±0.38)and miR-146b(2.27±0.93 vs.0.56±0.21)were higher in the AIS group than in the control group( t=14.360 and 12.527, P<0.01). Serum levels of miR-134(4.35±1.46 vs.2.28±0.85)and miR-146b(3.07±1.04 vs.1.51±0.66)were higher in the poor prognosis group than in the good prognosis group( t=13.520 and 11.242, P<0.01). Serum levels of miR-134 and miR-146b in the severe group were higher than in the moderate and mild groups( t=10.815 and 9.462, P<0.01), and they were also higher in the moderate group than in the mild group( t=13.627, 11.611, P<0.01). Multivariate Logistic regression analysis showed that serum miR-134( OR=2.470, 95% CI: 1.603-4.927)and miR-146b( OR=1.914, 95% CI: 1.350-3.406)were risk factors for poor prognosis in elderly AIS patients( P<0.05). The ROC curve analysis showed that the optimal cut-off values of serum miR-134 and miR-146b to predict poor prognosis in elderly AIS patients were 3.84 and 2.68, respectively.The area under the ROC curve(AUC)of combined serum miR-134 and miR-146b(0.926, 95% CI: 0.865-0.987)for the prediction of poor prognosis was higher than that of either marker alone, with a sensitivity and specificity of 92.4% and 86.2%, respectively.The correlation analysis showed that serum levels of miR-134 and miR-146b were positively correlated with NIHSS and mRS scores in elderly AIS patients( r=0.806, 0.871, 0.785 and 0.842, all P<0.01). Conclusions:Increased serum miR-134 and miR-146b levels are correlated with the severity of neurological impairment and prognosis in elderly patients with AIS.Serum miR-134 and miR-146b levels together have a high value in predicting poor prognosis in elderly AIS patients.

Objective:To investigate the clinical characteristics and possible mechanisms of remote intracranial hematoma (RIH) in patients with intracranial aneurysm after interventional embolization.Methods:Six patients with RIH from a series of 58 consecutive patients with intracranial aneurysm, admitted to and performed interventional embolization in our hospital from January 2016 and December 2018, were chosen in our study. Their clinical data were analyzed retrospectively and compared with those without RIH at the same period.Results:In these 6 patients, 4 had history of hypertension, 5 had aneurysm located in the internal carotid artery, 5 were treated with stents combined with postoperative routine anticoagulation treatment. The remote intracranial hematoma occurred within 7 d of interventional embolization, and the hematoma was located in the cerebral hemisphere on the same side of the aneurysm; 4 patients underwent intracranial hematoma puncture catheter drainage; 1 patient was treated conservatively, and one was treated by craniotomy. After treatment, 1 patient recovered (modified Rankin scale [mRS] score of 1), 1 patient had poor prognosis (mRS scores of 5) and discharged automatically, and the rest 4 patients (mRS scores of 3-5) left some degrees of neurological dysfunction. As compared with 52 patients without RIH, 6 patients with RIH had significantly higher percentages of patients used stents and postoperatively used anticoagulation, and higher percentages of patients with poor clinical outcomes at discharge ( P<0.05). Conclusion:Stent-assisted coil embolization in patients with internal carotid artery aneurysm combined with hypertension should be highly vigilant about the possibility of RIH.

OBJECTIVE: To assess the association of Eph-receptor tyrosinekinase-type A2 (EphA2) gene polymorphisms with susceptibility to age-related cataract (ARC) among ethnic Han Chinese from Hubei Province. METHODS: 280 patients with cortical ARC and 200 healthy controls were recruited. Polymorphisms at four loci (rs3768293, rs3754334, rs477558 and rs7548209) of the EphA2 gene were detected by PCR-restriction fragment length polymorphism (PCR-RELP) assay. Allelic and genotypic frequencies of the two groups were compared. RESULTS: Compared with the control group, the AA genotype of rs3768293 locus was more common, while the AC genotype was much rarer (P< 0.05). No significant difference was found in allelic and genotypic frequencies of rs3754334 locus between the two groups (P> 0.05). The AA genotype of the rs477558 locus was more common in the patient group, while the AG genotype was much rarer (P< 0.05). The genotype GG of the rs7548209 locus was more common in the patient group, while the CG genotype was rarer (P< 0.05), though no significant difference in allelic or haplotypic frequencies between the two groups (P> 0.05). CONCLUSION Polymorphisms of rs477558, rs7548209 and rs3768293 loci of the EphA2 gene are associated with susceptibility to ARC among ethnic Han Chinese from Hubei province.
Asian Continental Ancestry Group ; Cataract ; genetics ; China ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Polymorphism, Genetic

Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.

Objective To discuss the pathological classification and lesion's inner imaging features of lung adenocarcinoma presented as pure ground-glass opacity.Methods CT imaging features of 156 pGGO lesions which confirmed by surgery and pathology were analyzed in retrospectively.There were 58 lesions of pre-invasive (including atypical adenomatous hyperplasia and adenocarcinoma in situ),32 lesions of minimally invasive adenocarcinoma and 66 lesions of invasive adenocarcinoma.CT features were analyzed including lesion density,vacuole sign,air bronchogram and abnormal vascular changes (vascular dilatation,distortion or rigid).Results There were statistical difference in lesions density and abnormal vascular changes in 3 different pathological types (P ＜ 0.05),with increase of lesions invasive,the incidence of uneven density and abnormal vascular changes increase,its mean the more invasive of the lesion,the lesion tent to be more uneven and higher incidence of the dilation,twist or rigid of the vascular happened;while the incidence of the air bronchogram will be higher when the lesions invasive degree increased,but there was statistical difference only between the pre-invasive and invasive groups (including minimally invasive adenocarcinoma and invasive adenocarcinoma) (x2 =4.868,P =0.027).Conclusions The uneven density and abnormal vascular changes had certain value in differential diagnosis of lung adenocarcinoma presented as pGGO.

Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

Objective To research the change rule of peripheral serum Th1/Th2/Th17 balance and relevant cytokines in atopic dermatitis(AD) and to further study its immunologic mechanism .Methods The levels of peripheral serum IFN‐γ,IL‐4 ,IL‐17 ,IL‐21 and IL‐23 in the patients with AD were detected by the flow immunofluorescence technology and the detection results were performed the statistical analysis ,thus the change rule of Th1/Th2/Th17 balance in AD was analyzed .Results The IL‐4 level in peripheral serum of the patients with AD was increased compared with the healthy control group (P<0 .05);the IFN‐γ/IL‐4 and IFN‐γ/IL‐17 in the AD group were significantly decreased compared with the control group (P<0 .01);IL‐17 was positively corre‐lation with SCORAD scores of AD severity (P<0 .05) .Conclusion Th1/Th2 and Th1/Th17 are decreased in the AD course .Th1/Th2/Th17 balance drift may be the important mechanism of AD pathogenesis .

Objective To investigate whether there is correlation exists in the effection of chronic unpredictable stress on active avoidance behavior and electroencephalogram ( EEG) of rat. Methods Twenty male SD rats (weight～200 g) were randomly divided into control group( n= 10) and model group( n- 10). Rats in model group were subjected to chronic unpredictable stress . Active avoidance response were observed with GeminiTM avoid system and EEG power spectrum was evaluated with Powerlab system. Results The failure rate in active avoidance test was correlation with delta wave power in EEG. Compared with control group, rats in model group had reduced failure rate in active avoidance task(42 ±36)% vs (82 ±30)% , P＜0.05). The EEG power spectrum of model group rats increased in delta band((47.09 ±22.86)μV2 vs (22. 55 ± 11. 57) μV2, P＜0. 05), which had the significant difference between the two group rats. The failure rate of active avoidance task in model group rats was positive correlation with EEG power spectrum of delta wave (r = 0. 717, P ＜ 0. 05) . Conclusion Chronic unpredictable stress facilitated active avoid behavior and changed spontaneous EEG, which suggested chronic unpredictable stress actived the neurotransmitter network system involved with active avoidance task in central nervous system. Brain cognitive function correlated positively with brain electrophysiology activity measured in chronic unpredictable stress induced rat model.