Background The widespread use of herbicides has led to environmental contamination and has implications for human health. The liver is an important organ for the detoxification of environmental pollutants; however, studies on the association between herbicide exposure and liver function are limited. Objectives To investigate the association between baseline serum herbicide levels and changes in liver enzyme levels and liver enzyme abnormalities over a 5-year period in middle-aged and older adults. Methods This study was based on a nested case-control population of type 2 diabetes established in the Dongfeng-Tongji cohort, with a total of 1388 subjects included in this study and followed up for 5 years. Epidemiological data were collected through questionnaires, and baseline serum concentrations of three herbicides (metolachlor, propham, and acetochlor) were measured by gas chromatography-triple quadrupole mass spectrometry. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were detected at baseline and follow-up visits. The associations between baseline serum herbicide levels and changes in AST and ALT over 5 years were assessed using linear regression models with herbicide levels categorized into quartiles, adjusting for age, sex, education level, smoking status, drinking status, physical activity, body mass index, and new-onset type 2 diabetes occurred during follow-up. The relationship between baseline serum herbicide levels and the risk of liver enzyme abnormalities during follow-up was further analyzed using logistic regression models. Results The positive rates of metolachlor, propham, and acetochlor were all higher than 80%, and their spiked rates of recovery ranged from 73.46% to 106.77%. The mean ± standard deviation of the age of subjects at baseline was (62.7±7.6) years, with 34.1% being male. The median serum levels of metolachlor, propham, and acetochlor at baseline were 0.05, 0.16, and 0.03 ng·mL⁻¹, respectively. There was no significant difference in baseline serum herbicide levels between the normal and abnormal liver enzyme groups at follow-up (P >0.05). The baseline liver enzyme levels and the changes in AST and ALT over 5 years in those who developed abnormal liver enzymes were significantly higher than those in the normal liver enzyme group (P <0.05). The linear regression analysis showed that the changes in AST increased progressively over 5 years in the second, third, and fourth quartiles of propham compared to the lowest quartile group (the second quartile: b=1.49, 95%CI: 0.10, 2.87; the third quartile: b=1.52, 95%CI: 0.14, 2.90; the fourth quartile: b=1.69, 95%CI: 0.31, 3.08; P <0.05). The associations of serum metolachlor and acetochlor with changes in AST were not significant. Additionally, no significant relationships were found between the three serum herbicides and the changes in ALT over 5 years or the risk of liver enzyme abnormalities. Conclusion Serum propham levels in middle-aged and older adults are positively associated with changes in liver enzyme AST, which may have an effect on liver function. More studies are needed to provide scientific evidence for the association between herbicide exposure and liver function.

Objective To investigate the effect of acupuncture on the morphology of the dry eye rabbit's cornea and the nuclear factor κB(NF-κB)signaling pathway of the corneal tissue to analyze the mechanism of acupuncture on dry eyes.Methods Twenty-four healthy New Zealand rabbits,without restriction on sex,were randomly divided into four groups,including a blank group,a model group,an acupuncture group,and a sham acupuncture group,with 6 in each group.Rabbits in the blank group were not treated;rabbits in the other three groups were treated with scopolamine hydro-bromide 2.0 mg·kg-1 by subcutaneous injection at 8:00,11:00,14:00 and 18:00 each day for 35 consecutive days un-til the end of the experiment.Rabbits in the sham acupuncture group were treated with sham acupuncture on the 22nd day after successful modeling by quickly pricking acupoints(Jingming BL1,Cuanzhu BL2,Sizhukong SJ23,Taiyang EX-HN5 and Tongziliao GB1)with a blunt acupuncture needle,once a day,for a total of 14 days.Rabbits in the acupuncture group were treated with acupuncture at the same acupoints as the sham acupuncture group after successful modeling.The corneal fluorescence staining was conducted on Days 0,21,28 and 35 after modeling.On Day 35,corneal confocal microscope ex-aminations were conducted.Then,the rabbits were sacrificed,the corneal morphological changes were observed by light microscope and transmission electron microscope,and the expression of corneal NF-κB protein was detected by Western blot.Results Compared with the model group,the score of rabbit corneal fluorescein staining in the acupuncture group and blank group decreased on the 28th and 35th days after modeling,and the differences were statistically significant(all P＜0.05).The results of the confocal microscope examination on Day 35 after modeling showed that,compared with other groups,there were a large number of globular immune cells and activated stromal cells with unclear boundaries and irregu-lar sizes in the stromal layer and inflammation in the area with irregular intercellular space in the model group and the sham acupuncture group.In the acupuncture group,the morphology of stromal layer cells improved,the cells were slightly acti-vated,and there were no obvious abnormalities in the corneal nerve morphology.On the 35th day after modeling,the re-sults of the light microscope showed that,the surface of the corneal tissue in the model group and the sham acupuncture group showed hyperkeratinized flat epithelial cells,lymphocyte infiltration,increased number of focal epithelial cell layers,and epithelial cell detachment.In the acupuncture group,there were 4-6 layers of epithelial cells in the corneal epitheli-um,and epithelial shedding decreased.In addition,the lymphocyte infiltration decreased compared with the model group.On the 35th day after modeling,the results of the transmission electron microscope showed that abnormal microvilli oc-curred and epithelial cells were absent in the corneal epithelial cells of rabbits in the model group and the sham acupuncture group,the cell space was widened,the rough endoplasmic reticulum was severely expanded,and desmosomes were dis-banded with mitochondrial swelling.In the acupuncture group,the microvilli structure of epithelial cells was sparse and short,local deletion was still observed,the rough endoplasmic reticulum was slightly expanded,and no obvious swelling of mitochondria was observed.On the 35th day after modeling,the Western blot examination results showed that,compared with the blank group,the expression of p-NF-κB p65 was up-regulated in both the model group and sham acupuncture group(both P＜0.05);compared with the model group and sham acupuncture group,the expression of p-NF-κB p65 in the acupuncture group was down-regulated(both P＜0.05).Conclusion Acupuncture can inhibit the NF-κB signaling path-way to play an anti-inflammatory role and relieve corneal inflammation and injury of dry eye rabbit models.

Objective:To explore the associations of platelet parameters platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) with the risk for stroke in people with different blood pressure levels.Methods:All the participants were from Dongfeng-Tongji cohort, including 38 295 retired employees from Dongfeng Motor Corporation at the first follow-up survey. After excluding participants with coronary heart disease, stroke, cancer, history of platelet influential drug use and those with missed data of platelet parameters or blood pressure or lost to follow-up, finally a total of 21 294 participants were included in this study. All the participants completed baseline questionnaires, physical examinations, clinical biochemical tests, and blood sample collection. Cox proportional hazard models were used to estimate the hazard ratios ( HRs) and the corresponding 95% confident intervals ( CIs) for the associations between platelet parameters and risk for stroke in people with different blood pressure levels. Results:After a mean follow-up of 8.0 years, 1 578 participants developed incident stroke [1 266 ischemic stroke (IS) cases and 312 hemorrhagic stroke (HS) cases]. Compared with the participants with PLT<188×10 9/L, those with PLT≥188×10 9/L among hypertension cases were significantly associated with higher risks for stroke and IS (stroke: HR=1.27, 95% CI: 1.12-1.44; IS: HR=1.39, 95% CI: 1.21-1.60). Among hypertension group, compared with participants with PCT<0.165%, PCT≥0.165% were significantly associated with higher risk for stroke ( HR=1.15, 95% CI: 1.01-1.30) and lower risk for HS ( HR=0.70, 95% CI: 0.53-0.93); Among non-hypertension and hypertension group, PCT ≥0.165% were significantly associated with higher risks of IS ( HR=1.27, 95% CI: 1.05-1.54; HR=1.31, 95% CI: 1.14-1.50). MPV and PDW were not significantly associated with risk for stroke. Risk for stroke increased significantly in hypertension cases with different platelet parameters levels compared with non-hypertension cases with lower levels of each platelet parameters. Conclusion:Higher levels of PLT and PCT could increase the risks for stroke and IS in middle-aged and elderly hypertension patients, and lower levels of PCT could decrease the risk for HS in hypertension patients.

Objective To discuss the injury mechanisms of posterior keen dislocation with anterior tibial plateau fracture and to provide theoretic support for clinic diagnosis and treatment.Methods Total of 25 cases with posterior knee dislocation and anterior tibial plateau fracture were enrolled from June,2009 to June,2012.Injury mechanisms were analyzed from the point of view of mechanics by combining with detailed histories,X-ray,CT scan and MRI results,and surgical findings.Results All of 25 cases were high-energy injury,with 13 falling from heights (about 2-5 meters),10 injured in traffic accident,1 falling down by carrying heavy backpacks and 1 rolling down hill.Posterior knee dislocation with the anterior tibial plateau fracture were found in all the 25 cases,among which 5 cases were with common peroneal nerve injury and popliteal artery rupture,and 1 case was with capitulum fibulae fracture and the rest were with no obvious artery nerve injury One years after operation,the average HSS score of the knee joint was 88.5 and the excellent and good rate was 93.7％.Conclusion The main reason of the backward dislocation of knee joint with the anterior border fracture of tibial plateau was high energy trauma and it was a new type of fracture-dislocation of knee joint.After backward dislocation of knee joint,we should carefully check whether there is the anterior-edge fracture of tibial plateau before operation to avoid misdiagnosis;reduction of the anterior-edge fracture of tibial plateau must be done Anatomically in operation,which can reduce the occurrence of instability of knee joint after operation and improve the operation effect.

Objective To investigate the effect of Shuyusan on the behavior, content of tumor necrosisfactor-α(TNF-α) in cortex of cerebral and neuropeptide expression in hippocampus of rats with chronic mild unpredictable stress (CMUS) depression. Methods Fifty mice were randomly divided into 5 groups:normal group, model group, fluoxetine group, and high-, low-dose group of Shuyusan. Except normal group, the other groups were given CMUS. Tail suspend test (TST) and sucrose preference test (SPT) were used to estimate animals’ behavior. The contents of TNF-αwas determined by enzyme linked immunosorbent assay (ELISA). The immunocytochemical technique was used to evaluate hippocampus neuropeptide immunoreactive expression. Results The fluoxetine group and high dose of Shuyusan group showed significant increase in the sucrose consumption and decrease in the immobility time in TST, there was significant difference compared with CMUS model group (P<0.05). The TNF-αlevel was significantly lower in fluoxetine group and high dose of Shuyusan group, there difference was significant compared with model group (P<0.05). The neuropeptide immunoreactive neurons in hippocampus area was decreased by a marked number in fluoxetine group and high dose of Shuyusan group, the average optical density decreased significantly, compared with the model group, there were significant differences (P<0.05). Conclusion Shuyusan has anti-depression likely effect, with dose-effect relationship.

Objective To investigate the effect of Shenlongtang decoction on learning and memory ability and expression of Bcl-2 and Bax on rats hippocampus with cerebral ischemia model. Methods The cerebral ischemia animal model was established by two-vessel occlusion. Fifty rats were randomly divided into control group, model group, pisacetam group, Shenlongtang groups (low and high dosage). After modeling, rats were administrated with corresponding drugs for 28 days, the learning and memory ability was tested with Morris water maze, the number of positive cells and the integral optical density of the immunostaining on Bcl-2 and Bax protein expression in the hippocampus was detected. Results With Morris water maze test, the latency time increased significantly and times of searching submerged platform decreased significantly in the model group, the difference was significant compared with control group (P<0.01). Compared with model group, the latency time of Shenlongtang high dosage group decreased significantly and times of searching submerged platform increased significantly (P<0.05). Compared with model group, the expression of positive cells number of Bax protein expression in the hippocampus area was significantly increased (P<0.05), the Bcl-2 protein expression in the hippocampus region was significantly decreased (P<0.01). Conclusion Shenlongtang could significantly improve the learning and memory ability of cerebral ischemia rats, the mechanism may be related to regulating the expression of Bcl-2 and Bax.

Objective To investigate the effect of Shenlongtang decoction (SLT) on the learning and memory ability and serum level of neuropeptide Y (NPY) and expression of NPY in hippocampus of rats with cerebral ischemia/reperfusion. Methods 50 rats were randomly divided into 5 groups: control group with sham operation; model group with cerebral ischemia/reperfusion; pisacetam group as positive control;and SLT groups (low and high dosages). The rats' model was established with two-vessel occlusion. After modeling, the rats were administrating with SLT or pisacetam for 28 d. Learning and memory ability was tested with Morris water maze, the level of NPY was detected with radioimmunoassay, and the number of positive cells of NPY in hippocampus was detected. Results Compared with the control group, the latency time increased significantly and frequence of searching submerged platform decreased significantly in the model group (P<0.01); and compared with the model group, the latency time decreased significantly and frequence of searching submerged platform increased significantly in SLT high dosage group (P<0.05). Compared with the control group, the serum levels of NPY increased significantly in the model group, and the number of positive cell of NPY in hippocampus area significantly increased (P<0.01); and compared with the model group, the serum levels of NPY decreased significantly, and the number of positive cell of NPY in hippocampus area significantly decreased in the SLT high dosage group and pisacetam group (P<0.05). Conclusion SLT could improve the learning and memory function.The mechanism may be related to regulate the serum level and expression of NPY in hippocampus area of rats with cerebral ischemia/reperfusion.

Objective To investigate the effect of Shuyuningxin decoction on the expression of Bcl-2 and Bax in hippocampus of chronicstress depression rats. Methods 60 SD rats were randomly divided into control group, model group, fluoxetine group, high dose ofShuyuningxin decoction group, middle dose of Shuyuningxin decoction group and low dose of Shuyuningxin decoction group. All thegroups were given the chronic unpredicted mild stress for 21 d to induce depression models except the control group. Then they were administratedtheir drugs for 21 d. The level of Bcl-2 and Bax in hippocampus were investigated with immunohistochemistry technique. ResultsCompared with the control group, the level of Bax increased and Bcl-2 decreased in the model group (P<0.05). Compared with modelgroup, the level of Bax decreased and Bcl-2 increased in the middle dose of Shuyuningxin decoction group, high dose of Shuyuningxin decoctiongroup and the fluoxetine group (P<0.05). Conclusion The anti-depression effect of Shuyuningxin decoction may be associated withthe expression of Bax and Bcl-2.

ObjectiveTo explore the effects of Shenlongjiannao capsule on the learning and memory of the cerebral ischaemia model rat as well as reactive nitrogen intermediates in the cerebral cortex.MethodsThe cerebral ischaemia animal model was established by two-vessel occlusion. 50 rats were randomly divided into 5 groups: control group with sham operation, model group, positive control group with pisacetam, Shenlongjiannao capsule groups (low and high dosage). After four weeks, the learning and memory function was tested with Morris water maze, and the contents of nitric oxide(NO) and inducible nitric-oxide synthsae(iNOS) in cerebral cortex were measured.ResultsAfter treatment, the learning and memory ability improved significently and the contents of NO and iNOS in cerebral cortex decreased in Shenlongjiannao capsule groups.ConclusionShenlonjiannao capsule can improve the learning and memory of rats with cerebral ischaemia by lowering the activity of NO and iNOS in the cerebral cortex.

Objective To investigate the epidemiological features of 937 patients wounded in China Wenchuan earthquake. Methods An analysis was done on 937 patients treated in the city of Deyang in aspects fo their gender,age,injury causes,wound sites,complications and misdiagnosis.Results There were more wounded females than males,with ratio of male to female of 1:1.12.The main injury causes were crush injury and falling injury.The most frequent injury sites include head,chest,ankle and foot,tibia and fibula,spine and hip.The rate of misdiagnosis was as high as 15.5%,mainly brain injuries and chest iniuries. Conclusion The main causes are crush iniury and falling in-jury.Lower limb fractures account for the most.While close brain and thoracic injuries are likely to be misdiagnosed.