Hepatic ascites is one of the common and difficult complications in the decompensated stage of liver cirrhosis， and its incidence is increasing. In clinical practice， the prognosis of patients with hepatic ascites after surgery is worse， and the disease is recurrent. Traditional Chinese medicine （TCM） has certain advantages in treating hepatic ascites. However， there is no uniform standard for the preparation of animal models of hepatic ascites in accordance with TCM evidence. Therefore， this paper summarized the literature on animal models of hepatic ascites and analyzed the existing animal models of hepatic ascites based on the clinical diagnostic criteria of hepatic ascites in TCM and western medicine. The results show that the commonly used modeling methods for hepatic ascites mainly include the single-factor method， composite factor induction method， surgical method， and immunization method. Most of them are guided by western medicine theories， and their pathogenic mechanisms are mostly consistent with those of western medicine and are different from TCM evidence. Therefore， it is suggested that TCM intervening factors should be imposed in the process of model preparation， so as to prepare an animal model of hepatic ascites that meets the clinical evidence characteristics of TCM and western medicine.

Objective:To explore the effects of estrogen receptor α (ERα) encoded by protein encoding gene ESR1 on the radiation resistance of breast cancer cells and their molecular mechanisms.Methods:The ESR1 overexpression plasmid was transfected into estrogen receptor (ER)-negative breast cancer cells. Then, the shRNA-ESR1 vector was introduced into ER-positive cell to establish models with different phenotype. The ATG5 mRNA level and protein expression levels of LC3B-I, LC3B-II, P62, FIP200, ATG5, ATG7, ATG12, Beclin1, ULK1 were detected using qPCR and Western blot techniques. Cell death was measured using flow cytometry. The radiation sensitivity was determined through the colony formation assay. The mortality of breast cancer cells under the autophagy gene knockdown and overexpression or treated with estrogen receptor inhibitor (TAM) combined with ionizing radiation were detected by trypan blue staining.Results:Under the condition of 8 Gy X-ray irradiation, the knockdown of ESR1 in ER-positive ZR75 breast cancer cells promoted cell death ( t = 3.49, 3.13, P < 0.05), while the overexpression of ESR1 in ER-negative MDA-MB-231 breast cancer cells inhibited cell death ( t = 4.16, 7.48, P < 0.05). Compared to the control group, the treatment with chloroquine increased the number of formed colonies of ESR1 knockdown ZR75 cells ( t = 8.49, P < 0.05), and inhibiting autophagy could reduce the death of ZR75 cells caused by ESR1 silencing. Under the treatment with ionizing radiation, the overexpression of ESR1 in MDA-MB-231 cells promoted protective autophagy, which, however, was reduced after ESR1 knockdown in ZR75 cells. Furthermore, it was observed that the knockdown of ATG5 in ZR75 cells was associated with reduced autophagy and an increase in cell death ( t = 4.19, 6.39, P < 0.05). In contrast, the overexpression of ATG5 in ZR75 cells reversed the increase in cell death caused by ESR1 knockdown ( t = 1.70, 4.65, P < 0.05). After the treatment of ER-positive ZR75 breast cancer cells with TAM, the expressions of ATG5 and ATG12 decreased, suggesting inhibited autophagy and an increase in cell death ( t = 18.70, P < 0.05). Furthermore, these processes were promoted by ionizing radiation ( t = 16.82, P < 0.05). Conclusions:The estrogen receptor encoded by ESR1 promotes protective autophagy of ER-positive breast cancer cells by increasing ATG5, further leading to radiation resistance in ER-positive breast cancer cells. Treatment with tamoxifen combined with ionizing radiation can increase the radiation sensitivity of ER-positive breast cancer cells.

ObjectiveTo collect and analyze the properties and application characteristics of external use of roots and rhizomes of Chinese herbal medicines in the Chinese Materia Medica（《中华本草》） to provide data references for the research on clinical external use of Chinese medicine， in order to provide data reference for clinical external use of traditional Chinese medicine（TCM）. MethodThe Chinese herbal medicines included in the Chinese Materia Medica were systematically screened. The inclusion criterion was the explicit mention of terms like "root", "rhizome", "root bark", "tuber", "tuberous root", etc. under the "Source" in the Chinese Materia Medica. Information on properties, flavors, meridian tropism, medicinal parts, fresh use, toxicity, efficacies and indications, and dosage of roots and rhizomes of Chinese herbal medicines was collected. The information was then entered into an Excel spreadsheet for statistical analysis. ResultThe Chinese Materia Medica records 2 662 roots and rhizomes of Chinese herbal medicines, of which 1 653 are suitable for external use. The predominant properties and flavors are cool, cold, bitter, pungent, and sweet. These Chinese herbal medicines mainly act on the liver, lung, and spleen meridians. The primary medicinal parts used include root, rhizome, and root bark. More than half of the roots and rhizomes of Chinese herbal medicines can be used in their fresh form. The main efficacies include clearing heat, removing toxins, resolving stasis, dispersing accumulation, resolving blood stasis and stopping bleeding, reducing swelling and alleviating pain, dispelling dampness and relieving pain. The main indications are skin sores, traumatic injuries, and rheumatic diseases. Common external application methods include poultice, decoction for washing, and applying powdered form. Most of these Chinese herbal medicines lack specific dosage guidelines for external use, with an emphasis on using an appropriate amount. ConclusionThe Chinese Materia Medica contains a wide range of roots and rhizomes of Chinese herbal medicines suitable for external use, with definite therapeutic effects, providing a broad perspective for the application of Chinese medicine externally. However, there are still problems such as unclear dosages and limited research. Further studies are necessary to better utilize the advantages of the external use of Chinese medicine.

ObjectiveTo understand the pathogenic spectrum and epidemiological characteristics of severe acute respiratory infection （SARI） in adult inpatients in Yangpu District， Shanghai， China， in order to explore strategies for the prevention and treatment of respiratory infectious diseases. MethodsIndividual cases were from adult inpatients with SARI in Yangpu District， Shanghai， China from January 2019 to July 2021. Their respiratory samples were collected for etiological pathogen testing. ResultsA total of 681 SARI cases were enrolled for sampling and lab testing. Among them， 79.00% were aged 60 years and older， and 75.48% had confirmed chronic disease history. A total of 163 infection inpatients （23.94%） were positive for at least one pathogen. The pathogens identified most frequently were influenza A virus （6.75%）， followed by rhinovirus/enterovirus （3.23%）， parainfluenza virus （PIV） （2.79%）， Mycoplasma pneumoniae （2.35%）， coronavirus （CoV） （2.06%）. The positive rates of adenovirus （AdV）， human metapneumovirus （hMPV）， respiratory syncytial virus and bocavirus were all less than 2%. Bacterial strains were identified in eleven SARI cases， including Staphylococcus aureus and Pseudomonas aeruginosa （4 strains）， Klebsiella pneumoniae （3 strains）. Legionella pneumophila was detected in 9 cases （1.32%） and Bordetella pertussis in 5 cases （0.73%）. Two pathogens were co-detected from 11 cases， accounting for 1.62% of 163 positive cases. The most common co-detected pathogens were influenza A virus and other pathogens， accounting for 54.55% of the mixed infection. The positive rates of pathogens were not significantly different between less than 60 years old and over 60 years old groups except for Bordetella pertussis， adenovirus and Mycoplasma pneumonia（P<0.05）. Influenza virus had epidemic peak in winter and spring， but not in summer from 2019 to 2021. ConclusionVarious respiratory pathogens are detected from adult SARI cases. It is mainly influenza virus， with co-detected pathogens and rare pathogens. This study provides helpful information for targeted prevention and control measures including vaccination.

ObjectiveTo count and analyze the toxic traditional Chinese medicines and their characteristics in Chinese Materia Medica， so as to provide reference for the development and application of toxic drugs. MethodThe traditional Chinese medicines included in Chinese Materia Medica were screened one by one， and the inclusion criteria were "drug properties"， "usage and dosage" and "major poison， highly poisonous， poisonous， slightly poisonous， slightly poisonous" appearing in ancient books. Standard toxic traditional Chinese medicines were entered into an excel sheet for statistical analysis. ResultA total of 1 408 toxic Chinese medicines were included. The properties and flavors were mainly cold， bitter， pungent and sweet； the main meridians were liver， lung， spleen and stomach； the root， whole grass and leaves were the most used medicinal parts， and there were many toxic drugs. The pre-treatment methods are mainly sun-dried， fresh， fried， calcined， and sunburned； the efficacy categories are mainly heat-clearing drugs， rheumatism drugs， blood-activating and stasis-removing drugs； oral administration methods are mainly decoctions， pills， and powders ， mainly for external application， dipping， and coating； the dosage for oral administration is mostly 9-15 g， 3-9 g， 3-6 g， and an appropriate amount is mainly for external use. ConclusionThere are many toxic Chinese medicines clearly recorded in Chinese Materia Medica， but only 83 kinds of clearly toxic Chinese medicines are included in Chinese Pharmacopoeia， which need to be further strengthened by experimental observation and clinical data verification. The clinical application of toxic traditional Chinese medicine is mainly based on heat toxin blood syndrome and rheumatic arthralgia， which is closely related to its nature， taste and meridian return. Able to move， has the effect of activating Qi and activating blood， "sweet" can replenish energy and slow down， and has the effect of tonic， alleviation and pain relief， and mostly used for the treatment of heat syndrome， blood syndrome and arthralgia syndrome. However， there are certain limitations in the classification and processing conditions of toxic traditional Chinese medicines， which need to be further improved and scientifically verified.

ObjectiveTo analyze the characteristics and trends of notifiable infectious diseases in Yangpu District of Shanghai， from 1950 to 2020， and to provide scientific basis for the formulation of control measures. MethodsDescriptive epidemiological method was used to collect and analyze the epidemiological data of notifiable infectious diseases. ResultsA total of 1 186 675 cases from 38 types of infectious diseases were reported. The annual morbidity of Class A and Class B infectious diseases fluctuated between 138.22/10⁵ and 7 861.45/10⁵， showing a decreasing trend. Among the 3 785 cases of death， the top five were measles， viral hepatitis， dysentery， tuberculosis and epidemic cerebrospinal meningitis. The high incidence diseases were intestinal infectious diseases， and the respiratory infectious diseases fluctuated in a wide range. Furthermore， blood-borne infectious diseases and sexual -transmitted diseases had continued to increase in recent years. As the result of normative vaccination， the incidence of associated infectious disease showed a downward trend. ConclusionThe incidence of infectious diseases in Yangpu District was on the drop from 1950 to 2020. Prevention and control work should focus on respiratory infectious diseases， blood-borne infectious diseases and sexual -transmitted diseases in the future. Furthermore， it is important to guarantee normative vaccination， especially， for prevention and control of infectious diseases.

Objective: To study the clinicopathologic features of intraductal papillary neoplasm of the bile duct(IPNB) and to analyze the diagnostic and therapeutic patterns. Methods: The data of 46 patients with IPNB undergoing surgery in Department of Hepatobiliary and Pancreatic Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to November 2017 were retrospectively analyzed.There were 23 males and 23 females with age of (64±8)years.Patients were followed up by clinics and telephone inquiry.Categorical data were compared with χ² test or Fisher′s exact test. Results: Abdominal pain(in 31 patients), fever (in 15 patients) and jaundice (in 11 patients) were the most common symptoms.Twenty-five patients were accompanied with cholangiolithiasis and 25 were accompanied with liver atrophy.Preoperative laboratory examination was mainly manifested as the abnormal liver function caused by biliary obstruction.Typical imaging findings included bile duct dilation (in 45 patients) and mass within bile duct (in 22 patients). All the patients were diagnosed as IPNB histopathologically.Among them, high-grade intraepithelial neoplasia and related adenocarcinoma were more common in mucus-hypersecretion IPNB ((13/15 vs. 51.6%(16/31))(χ²=5.331, P=0.021). Hepatectomy was performed in 25 patients, hepatectomy combined with biliary resection and reconstruction in 12 cases, biliary resection and reconstruction in 3 cases, pancreatoduodenectomy in 3 cases, hepatopancreaticoduodenectomy in 1 case, liver transplantation in 1 case and radiofrequency ablation in 1 case.Forty-one patients were followed up with a median of 30 (12, 41) months.Seven patients suffered recurrence and 6 died. Conclusion IPNB is a rare disease with limited knowledge currently.Images are the main diagnositc means and surgery is the first choice.

Objective To investigate the status of fatigue and depression and their influencing factors in patients with acute coronary syndrome, and analyse the correlation of fatigue, depression and self-management behavior. Methods 113 patients were investigated by using Fatigue Symptom Inventory (FSI), Patient Health Questionnaire-9 (PHQ-9), Coronary artery disease Self-management Scale (CSMS). Results The score of fatigue was (4.59±1.93)points, while depression scored (5.05±1.48)points and self-management behavior scored (57.29 ±8.29)points; the score of fatigue, depression of female patients were higher than that of male patients, which had statistical difference(t=2.535-5.894, P<0.05);Regression analysis showed that gender, time of illness, number of other chronic diseases were major factors affecting fatigue while gender and treatment method were major factors affecting depression; there were negative ralationships between self-management and fatigue, self-management and depression (r=-0.855-0.682). Conclusions Fatigue, depression are common in patients with acute coronary syndrome, and can affect their self-management behavior, and the female patients are more susceptible to fatigue and depression.

Objective To investigate the effect of the whole course health education on heart rehabilitation of old patients with percutaneous coronary intervention(PCI).Methods One hundred and twentyone old patients with coronary heart disease who all underwent complete PCI in Tangshan Gongren Hospital from January 2008 to December 2009 were selected as our subjects.All subjects were randomly divided into the intervention group (60 cases) and the control group (61 cases).All patients were treated by PCI ± standard drug therapy.Patients in control group were given the conventional health education,while in intervention group were given the extending health education plus the conventional health education.Questionnaire was used to collect the coronary heart disease knowledge,recovery and secondary prevention behavior.The levels of blood pressure,density lipoprotein cholesterol,fasting blood glucose (FB) were measured at 6,12,24 months at discharge hospital.Meanwhile the reaching standard rate of coronary heart disease risk factors control was also used to evaluate the effect of education.Results The scores of knowledge of coronary heart disease rehabilitation of intervention group at 6,12 and 24 months after discharge were (79.69 ± 4.66),(83.26± 8.38),(81.81 ± 9.21) respectively,higher than that of control group ((72.36 ± 8.16),(69.96 ± 10.69),(70.00 ± 11.32) respectively),and there were significant differences between groups(t =3.26,5.39 and 4.41respectively,P ＜ 0.05).The scores of the second level prevention act of intervention group were (79.00±5.65),(79.88 ± 6.34) and (79.13 ± 11.21) respectively,higher than that of control group((70.72± 7.59),(68.84 ± 5.36) and (66.52 ± 9.15) respectively),and there was significant difference between groups (t =3.75,5.99 and 3.63 respectively; P ＜ 0.05).The reach standard rate of low density lipoprotein cholesterol(LDL-C),exercise of intervention group at 6 months were 60.0％ (36/60),65.0％ (39/60),higher than that of the control group(37.7％ (23/61),32.8％ (20.61)),and there was significant difference between groups(x2 =6.045,10.871,P ＜0.05),while there was no significant difference in terms of the reach standard rate of blood pressure,FB and quit smoking(P ＞ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were 75.0％ (45/60),76.6％ (46/60),96.6％(58/60),81.7 ％ (49/60),75.0％ (45/60),higher than that of control group (49.2 ％ (30/61),32.8 ％(20/61),80.3％ (49/61),57.4％ (35/61),31.1％ (19/61),and there was significant difference between groups(x2 =8.021,28.438,8.431,10.435 and 23.128 respectively,P ＜ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were (75.0％ (45/60),81.7％ (49/60),95.0％ (57/60),86.7％ (52/60),81.7％ (49/60)),higher than that of control group (44.3％ (27/61),31.1％ (19/61),75.4％ (46/61),47.5％ (29/61),34.4％ (21/61)),and there was significant difference between groups (x2 =11.710,35.810,8.112,25.450 and 25.650 respectively,P＜0.05).Conclusion Whole course health education is proved to reach the purpose of long-term heart rehabilitation,and decrease the risk of the risk factors for PCI.Meanwhile it is a safe,effective,compliant heart rehabilitation model after PCI in old patients.

A modified "cross-modal delayed response" paradigm was used to investigate whether the visual mismatch negativity can be elicited by cartoon facial expressions, and to define the mechanism underlying automatic processing of facial expressions. Subjects taking part in the tests were instructed to discriminate the type of the tones they heard as quickly and accurately as possible, and to act merely when they heard the response imperative signal. Neutral, happy and angry faces were presented during intervals between a tone and a response imperative signal. Visual mismatch negativity (VMMN) was obtained by subtracting the event - related potential (ERP) elicited by neutral faces from that elicited by happy faces or angry faces. The angry-related VMMN was more negative than happy-related VMMN, and both were more negative in the left than in the right cerebral hemisphere. The results indicated that VMMN can be elicited by the cartoon facial expressions, and the facial expressions can be processed automatically.
Adult ; Brain ; physiology ; Cartoons as Topic ; Evoked Potentials, Visual ; physiology ; Facial Expression ; Female ; Humans ; Male ; Pattern Recognition, Visual ; physiology ; Photic Stimulation ; Visual Perception ; physiology ; Young Adult