Objective To analyze the composition of the aqueous extract of Polygonatum Cyrtonema Hua(PCHE)and evaluate its antitumor activity in vitro and in vivo.Our aim is to provide a theoretical basis for the further development and utilization of Polygonatum Cyrtonema Hua.Methods(1)PCHE was prepared by aqueous extraction,and the chemical composition of PCHE was analyzed by UPLC-Q-TOF/MS and phenol-sulfuric acid method.The inhibitory activity on tumor cells proliferation of PCHE was detected by CCK-8 assay.Cell cycle and apoptosis were detected by flow cytometry,and the expression of apoptosis-related proteins Bcl-2 and Bax was detected by Western Blot.The inhibitory activity of PCHE-containing serum on cell proliferation was detected.(2)A B16 tumor-bearing mice model was constructed and model mice were randomly divided into the model group(saline),the positive drug group(CTX:50 mg·kg-1),and PCHE low-,medium-,and high-dose groups(55.9,111.8,223.6 mg·kg-1),and treated by gavage for 7 days.Changes in body weight and tumor volume of mice were observed during the treatment period.The mice were executed after the treatment,and the histopathological changes of heart,liver,spleen,lung,kidney and tumor were observed by hematoxylin-eosin(HE)staining.The protein expression of Bcl-2 and Bax in tumor tissues was detected by immunohistochemistry(IHC).Results The polysaccharide content of PCHE reached(10.07±1.3)%,and the flavonoid content was(0.044±0.004)%,and thirty-nine components were detected by UPLC-Q-TOF/MS,which contained antitumor components such as flavonoids(baicalein,quercetin,luteolin and rutin),organic acids(ferulic acid)and polyphenols(gallic acid),etc.PCHE exhibited the inhibitory effects on Hela,A549,4T1,B16,MFC and HepG2 cells,among which the inhibitory effect on B16 cells was the most significant(P＜0.001),and PCHE induced cell cycle arrest at G0/G1 phase in B16 cells(P＜0.001).The results of double-staining flow cytometry and Western Blot showed that PCHE significantly promoted apoptosis of B16 cells,decreased the expression of Bcl-2,and promoted the expression of Bax(P＜0.01,P＜0.001).and PCHE constituents absorbed into blood also had an inhibitory effect on B16 cells(P＜0.001).In addition,the results of in vivo activity assay showed that different doses of PCHE could inhibit tumor growth,induce tumor cell necrosis,reduce Bcl-2 expression,and increase Bax expression compared with the model group.Conclusion The ingredients in PCHE are abundant.It contains a variety of antitumor active ingredients,which can inhibit tumor growth,induce tumor cell apoptosis,show strong anti-tumor effects and be worthy of in-depth study.

Exercise therapy is an important part of the comprehensive treatment of peripheral vascular diseases, including walking, high-intensity intermittent exercise, resistance exercise and other forms. This article reviews the intensity (exercise load, severity of claudication during exercise, increase of exercise volume) and duration (duration of each exercise, exercise rest ratio, weekly exercise frequency, duration of treatment course) of exercise, and points out that medical and nursing staff should formulate personalized "exercise prescriptions" according to patients' tolerance, and provide personalized nursing guidance to patients, so that patients with peripheral vascular diseases can obtain great benefits in exercise therapy.

Objective Based on the liquid chromatography-tandem mass spectormetry (LC-MS/MS), to study the effects of Pogostemon cablin on serum metabolism of Guizhou miniature pigs， and to explore its pharmacological mechanism.MethodsNine healthy Guizhou miniature pigs were divided into two groups, namely Pogostemon cablin drug group (n=5) and control group (n=4). The pigs in Pogostemon cablin drug group were orally fed with traditional Chinese medicine formula granules, each 0.5 g per day, for consecutive 8 days, while those in control group were given normal feeding without additional treatment. After the feeding experiment, serum samples were collected and analyzed using the LC-MS/MS technology. The metabolomics data was annotated and compared with KEGG, HMDB and Lipidmaps databases. Bioinformatics analysis methods including partial least squares discriminant analysis (PLS-DA), intergroup clustering, differential metabolite analysis and functional enrichment were used to screen differential metabolic biomarkers and their possible metabolic pathways.Results Forty-four differential metabolites (P<0.05) were screened out from the 443 metabolites, eight differential metabolites were significantly up-regulated (P<0.01), namely cinnamoylglycine, N-benzyl-N-isopropyl-N'-[4-(trifluoromethoxy) phenyl]urea, hypotaurine, D-glucose 6-phosphate, cis-2-decenoic acid, 11(Z),14(Z)-eicosadienoic acid, prostaglandin A2 and 10-hydroxydecanoic acid, and three differential metabolites were significantly down-regulated (P<0.01), namely lysophosphatidyl choline 22:5, lysophosphatidic acid 22:6 and lysophosphatidic acid 22:5. The differential metabolites were mainly enriched in the metabolic pathways of alanine, aspartate and glutamate metabolism (MapID: map00250) and taurine and hypotaurine metabolism (MapID: map00430).Conclusion Pogostemon cablin can significantly affect the metabolism of lysophosphatidic acids in porcine, and relieve the disorder of amino acids metabolism and regulate the occurrence of inflammation by affecting the metabolic pathways of alanine, aspartate and glutamate metabolism and taurine and hypotaurine metabolism.

Objective To evaluate the value of high-frequency color ultrasound for different types of thyroid nodules during healthy examinations. Methods A total of 150 subjects with ultrasound diagnosis of thyroid nodule abnormality were enrolled. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ultrasound diagnosis for differentiating benign and malignant thyroid nodules were evaluated with histopathological examinations of surgical thyroid specimens as a gold standard. Results A single thyroid nodule was found in all patients, and histopathological examinations identified 102 benign thyroid nodules and 48 malignant nodules. Microcalcification showed the highest accuracy for prediction of benign and malignant thyroid nodules (98.1%; χ² = 45.67, P = 0.001), followed by taller than wider shape of thyroid nodule (92.1%; χ² = 34.06, P = 0.001), central vascularity (82.0%; χ² = 13.29, P = 0.001), halo (76.0%; χ² = 6.15, P = 0.008) and hypoechogenicity (70.3%; χ² = 10.63, P = 0.001). In addition, ultrasound diagnosis showed a 100.0% sensitivity, a 94.1% specificity, a 88.9% positive predictive value, a 100.0% negative predictive value and a 96.0% accuracy for differentiation between benign and malignant thyroid nodules (χ² = 41.830, P < 0.001). Conclusion High-frequency color ultrasound has a high diagnostic accuracy for differentiating benign and malignant thyroid nodules, and microcalcification and taller than wider shape of thyroid nodule exhibit high values for predicting the malignancy of thyroid nodules.

Objective:To evaluate the value of ultrasound-guided transperineal systematic prostate biopsy(SPB)and cognitive fusion multi-parameter magnetic resonance imaging(mpMRI) suspicious transperineal targeted biopsy(CFTB) in the prostate cancer with different serum prostate specific antigen(PSA) levels.Methods:A retrospective analyses were performed in 527 patients with suspected prostate cancer who underwent ultrasound-guided SPB from January 2018 to December 2019 in Shanghai Jiaotong University Affiliated 6th People′s Hospital. According to the PSA levels, they were divided into group A(PSA 4-10 μg/L) and group B(PSA>10 μg/L). All the patients underwent ultrasound-guided SPB, 376 patients with suspicious mpMRI had two additional targeted biopsies. The detection rates of ultrasound-guided SPB and CFTB in prostate cancer were tested by χ 2 test. Compared with pathological results, the sensitivity, specificity, accuracy of two methods were calculated and tested by χ 2 test, and a P<0.05 was defined as statistically significant difference. Results:Prostate cancer was detected in 319 of 527 patients(60.5%). One hundred and three cases of 198 patients in group A were diagnosed as prostate cancer, with an overall detection rate was 52.0%. Among them, ultrasound-guided SPB detected 72 cases of prostate cancer, the detection rate was 36.4%, sensitivity was 67.9%, specificity was 17.7%, accuracy was 26.5%, the detection rate, sensitivity, specificity and accuracy of CFTB were 39.9%, 75.6%, 91.6% and 88.8%, respectively. In this group, there were no statistically significant differences in the detection rate and sensitivity of the two methods in the diagnosis of prostate cancer (χ 2=0.525, 0.005, both P>0.05), and the differences in specificity and accuracy were statistically significant (χ 2=108.340, 79.829, respectively, both P<0.05). Two hundred and sixteen cases of 329 patients in group B were diagnosed as prostate cancer, with an overall detection rate was 65.7%. Among them, 160 cases of perineal prostate cancer were detected by ultrasound-guided SPB, with the detection rate was 48.6%, sensitivity was 78.2%, specificity was 37.6% and accuracy was 49.5%. A total of 189 cases of prostate cancer detected by CFTB, the detection rate was 57.4%, the sensitivity was 89.3%, the specificity was 90.6%, and the accuracy was 90.2%. All the differences were statistically significant in group B(χ 2=5.131, 4.391, 61.339, 38.982, all P<0.05). Conclusions:When PSA is greater than 10 μg/L, CFTB has a higher diagnostic efficiency than SPB.When PSA is 4-10 μg/L, there are no significant differences between the two methods in the detection rate and sensitivity of prostate cancer.

Objective:To evaluate the identification rate of separating gel or HB&L pretreatment methods of MALDI-TOF-MS, thereby to provide a new idea for the rapid and accurate identification of pathogens of bloodstream infections in daily clinic practice.Methods:A total of 149 alarmed positive blood culture samples of single bacterial infection by routine laboratory methods were collected between January to December 2020 from the Sixth Medical Center, Chinese PLA General Hospital. Samples were pretreated with the separation gel accelerating tube method or the HB&L microbial culture system, followed by direct MALDI-TOF MS bacterial identification, the identification rates of the two pretreatment methods were compared and results from the traditional method were used as the standard control.Results:Among the 149 positive blood culture samples, 47.0% (70/149) were gram-negative (G -) bacteria and 53.0% (79/149) were gram-positive (G +) bacteria. Identification rate of G -strain level was 78.6% (55/70) by serum separation gel coagulation tube method and 91.4% (64/70) by HB&L microbial culture system, the difference was statistically significant ( P=0.033). Identification rate of G +strain levels was 73.4% (58/79) by serum separation gel coagulation tube method and 87.3% (69/79) by HB&L microbial culture system, the difference was statistically significant ( P=0.028). For G -bacteria in the range of 3.000-2.300, the identification rate was 22.9% (16/70) by serum separation gel accelerating tube method and 38.6% (27/70) by the HB&L microbial culture system, the difference was statistically significant ( P=0.044). For G +bacteria in the range of 3.000-2.300, the identification rate was 19.0% (15/79) by serum separation gel accelerating tube method and 34.2% (27/79) by the HB&L microbial culture system, the difference was statistically significant ( P=0.031). Conclusion:The identification rate of HB&L microbial culture system is higher than that of serum separation gel coagulation tube method. Direct MALDI-TOF MS identification of pathogenic bacteria in positive blood culture samples after pretreatment is feasible in daily clinical practice.

Objective: To analyze the physical characteristics of fine particulate matters (PM_2.5) and submicron particulate matters (PM₁), and investigate the factors influencing the emission peak of printer particles. Methods: A 12-hour particle concentration monitoring for PM_2.5 and PM₁ was conducted in a printing shop on January 5^th, 2018. PM_2.5 in the air was analyzed after the monitoring process to figure out morphological characteristics and element composition of printer particles. Besides, experiments were carried out in an enclosed space to detect the number concentration peaks of PM₁ during every printing process. Influencing factors investigated in this study were printer types, toner coverages and interval time between different printing processes. Results: The 12-hour particles concentration monitoring showed that the number concentration of PM₁ and the mass concentration of PM_2.5 were 7.510×10⁴ pt/cm³ and 96.85 μg/m³. The diameter of most PM_2.5 was less than 100 nm, with a fractal dimension of 2.591. Most PM_2.5 appeared as regular spheres with typical agglomeration phenomenon, while some were in rhabditiform or irregular shapes. Element analysis showed that PM_2.5 was mainly composed of C, O, Si, Ca, with less metallic element. The PM₁ emission peak values of three printers were 3.60×10⁴, 3.43×10⁴, 0.31×10⁴ pt/cm³, respectively and the difference was not statistically significant (χ²=5.42, P>0.05). When the page coverage rate was 0%, 2.5%, 5%, 10%, 20% and 50%, the PM₁ emission peak value of printer A was 6.74×10⁴, 4.62×10⁴, 3.82×10⁴, 2.82×10⁴, 1.00×10⁴ and 1.08×10⁴ pt/cm³, and the difference was also not statistically significant (χ²=7.01, P>0.05). The natural logarithm of PM₁ emission peak value in printing work was associated with the resting time before printing and the change value of heating roller temperature (r value was 0.83 and 0.89, respectively, all P values<0.05). Conclusion PM_2.5 and PM₁ in the printing shop stayed at a high level. Particles appeared as various shapes and element compositions were complex. The temperature change of heating roller was one of most important factors that lead to the increased number concentration peak of PM₁.

Objective To probe the reasonable range of central lymph node dissections(CLNs)for papillary thyroid carcinoma (PTC) in cN0 T1/T2 by analyzing the metastasis regulations of PTC in cN0 T1/T2.Methods Data of 891 PTC patients in cN0T1/T2 cases according to the research criterion from Oct.2013 to Sep.2017 were analyzed.All the patients were under the treatment of the same group of surgeons in Department of Thyroid Surgery of the First Affiliated Hospital of the Kunming Medical University and had undergone operation of bilateral total resection of thyroid gland and central lymph node.The clinical and pathological data were collected.Univariate and multivariate analysis were used to investigate the risk factors of central neck lymph node metastasis and high volume central neck lymph node metastasis.Results ①Univariate analysis showed that gender (P=0.002),age(P=0.002),multiform(P=0.000),nodular goiter(P=0.000)and with Hashimoto's(P=0.031)had significant influence in prevalence of CLN node metastasis.Gender(P=0.010)and tumor size(P=0.000)showed significant influence in prevalence of high volume CNL node metastasis.In multivariate analysis,age (OR=0.962,OR=2.856)and nodular goiter(OR=0.969,OR=3.012)showed the independent risk factor of CNL node metastasis and high volume CNL node metastasis.②The numbers of lesion in unilateral lesion were not correlated with IpsiCLNs and Cont-CLNs metastasis (P=0.347,P=0.653).The tumor diameter was correlated with Ipsi-CLNs and ContCLNs metastasis (P=0.010,P=0.000).The tumor diameter of bilateral multifocal carcinoma was correlated with LN-prRLN-CLNs metastasis (P=0.019).The tumor diameter of left and right unilateral single focal lesion was not correlated with LN-prRLN-CLNs metastasis(P=0.684,P=0.072).Conclusions According to the study,it is recommended that the PTC in cN0 T1/T2 should routinely undergo preventive central lymph nodes dissection in the case of technical support:①Preventive overall CLND is recommended for unilateral non-microscopic carcinoma and bilateral multiform carcinoma,especially in those older than 55.②For patients with unilateral single or multifocal microscopic carcinoma,only ipsilateral central lymph nodes dissection can be considered.③ Generally,routine dissection is not necessary for the lymph nodes of the right recurrent laryngeal nerve in the central region of the neck.However,for bilateral non-small cancers and right non-small cancers,LN-prRLN-CLNs dissection is recommended.

Objective To investigate the value of CT in detecting incidental extracardiac findings (IEFs) when used for attenuation correction during SPECT/CT myocardial perfusion imaging (MPI).Methods A total of 520 patients (288 males,232 females,average age 65.8 years) who underwent SPECT/CT MPI between July 2014 and February 2016 were retrospectively analyzed.Low dose CT attenuation correction was used during MPI.IEFs of lung,mediastinum and chest wall,large blood vessels,spine,and part of upper abdomen were recorded independently.All findings were divided into three categories:IEFs requiting further examination and treatment measures taken immediately (group A),IEFs requiring follow-up or further examination (group B),IEFs need no further treatment (group C).Results IEFs (n =356) were observed in 52.31％ (272/520) of the patients,with 24 cases in group A (4.62％,24/520),105 cases in group B (20.19％,105/520) and 143 cases in group C (27.50％,143/520).There were 158 clinically significant IEFs in 129 patients (24.81％,129/520),including 5(0.96％,5/520) with newly diagnosed malignancy.Conclusion IEFs detected by CT used for attenuation correction during SPECT/CT MPI are not uncommon,including a few cases with clinically significant findings.