OBJECTIVE To investigate the protective effect of Tibetan medicine Sanguo decoction on hyperlipidemic rats based on the Nrf2/HO-1 signaling pathway and its related mechanisms. METHODS Forty-eight male SD rats were randomly divided into six groups: the normal control group, the model control group, the simvastatin group(3.5 mg·kg−1), and the Tibetan medicine Sanguo decoction low, medium, and high dose groups(0.43 , 0.86 , 1.72 g·kg−1), with eight rats in each group. The normal control group was fed a basal diet, and the remaining groups were fed the H10060 high-fat diet to prepare a hyperlipidemic rat model. At the same time, each treatment group was given corresponding drugs by gavage once a day. The normal control group and model control group were given an equal volume of physiological saline(once a day) by gavage for 6 consecutive weeks. After 6 weeks, serum levels of lipids[totalcholesterol(TC), triglyceride(TG), low density lipoprotein(LDL) and high density lipoprotein(HDL)] and oxidative parameters[malondialdehyde(MDA), superoxide dismutase(SOD), and glutathione(GSH)] were measured by reagent kit. Nuclear factor erythroid 2-related factor 2(Nrf2), heme oxygenase 1(HO-1), Keap1, and quinone oxidoreductase(NQO1) protein expression in liver tissues were analyzed by Western blotting. The correlation of lipid and oxidative indices was investigated by person correlation. RESULTS Compared with the normal control group, the model control group showed a significant increase in body weight, significantly higher serum levels of TC, TG, LDL, and MDA, significantly lower serum levels of HDL, and significantly lower SOD and GSH activity. Compared with the model control group, each administration group showed a decrease in body weight and serum TC, TG, LDL, and MDA levels. In comparison with the model control group, the body weight was reduced, the serum levels of TC, TG, LDL, and MDA were significantly lower, the serum levels of HDL were significantly higher, and the SOD and GSH activities were significantly higher. Keap1 protein level expression was significantly up-regulated compared with the normal control group, and Nrf2, HO-1, and NQO1 protein level expression were significantly down-regulated in the model control group. Keap1 protein level expression was significantly down-regulated compared to the model control group, and Nrf2, HO-1, and NQO1 protein level expression were significantly up-regulated in the liver tissues of low and high doses of Sanguo decoction. The expressions of Nrf2, HO-1, and NQO1 were significantly up-regulated. Correlation analysis showed that TG was negatively correlated with SOD, HO-1, and NQO1, and positively correlated with Keap1, while TC was negatively correlated with SOD, HO-1, GSH, and Nrf2, and positively correlated with Keap1 and MDA. CONCLUSION The Tibetan medicine Sanguo decoction can improve body weight and blood lipid levels in hyperlipidemic rats, and the mechanism may be related to the regulation of the Nrf2/HO-1 signaling pathway and the improvement of oxidative stress.

Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.

Objective:To explore the value of diffusion tensor imaging (DTI) in evaluating the effects of hyperbaric oxygen therapy (HOT) in treating spinal cord injury.Methods:The modified Allen′s method was used to induce a traumatic spinal cord injury in 30 rats who were then divided randomly into an injured group and a treatment group, each of 15. The treatment group was given HOT twice a day for 3 days, then once a day for a total of 4 weeks. The injured group did not receive HOT. DTI was performed (along with Basso-Beattie-Bresnahan (BBB) evaluation) at 0h, 6h, 24h, as well as 3, 7, 14, 21 and 28 days after the operation. Two-factor repeated measures ANOVA was conducted to analyze any differences in the DTI results: the fractional anisotropy, mean apparent diffusivity, radial diffusivity and axial diffusivity, as well as the BBB scores. LSD t-tests were performed to analyze the significance of the differences at different time points.Results:At each time point after 24h the average FA value of the treatment group was significantly higher than the injured group′s average, while its average MD and RD values were significantly lower. Beyond 14 days the average AD value of the treatment group was significantly higher than that of the injured group. The treatment group′s average BBB score was also significantly higher at all the time points beyond 3 days.Conclusions:DTI results can evaluate spinal cord function and provide valuable information for the dynamic assessment of hyperbaric oxygen therapy after a traumatic spinal cord injury, and the therapy promotes the recovery of motor function, at least in rats.

Objective:To explore human papillomavirus (HPV) infection status in 2 110 patients with cervical cancer in Henan province and analyze the main infection subtypes.Methods:A total of 2 110 patients with cervical cancer were detected for HPV subtypes by flow-through hybridization after PCR. The results were analyzed.Results:Among 2 110 patients with cervical cancer, 1 856 were detected to be HPV positive and the infection rate was 87.96%(95% CI: 86.57%-89.35%). The top six genotypes were HPV16, 58, 18, 52, 35 and 33. Single infection was the main type of infection in HPV positive cervical cancer patients (77.48%), and double infection was the second type infection(16.76%). The infection rate of HPV16 was 60.19%, occupying a predominant position in single or multiple infections. Among HPV positive cervical cancer patients, 1 599 cases were detected to be infected with high-risk subtypes and covered by nine-valence HPV vaccine, and the coverage rate reached 86.15% (1 599/1 856). Cervical cancer patients were mainly distributed in age group 40- years. The main HPV subtypes of cervical cancer patients were different among different age groups, but HPV16 subtype was in a predominant position in any age group. Conclusions:The main subtypes of HPV infection were HPV16, 58, 18, 52, 35 and 33 in cervical cancer patients in this study. The main infection type was single infection. There were more cervical cancer patients in age group 40- years.

Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). Conclusion Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.

Objectives: To investigate the expression of phosphoserine aminotransferase 1 (PSAT1) in pancreatic cancer tissues, and its potential role in pancreatic cancer. Methods: The expression of PSAT1 in 98 human pancreatic cancer tissues, which were collected from the People＇s Hospital of Guizhou, between July 2013 to July 2017, and the corresponding adjacent normal tissues was analyzed by immunohistochemical staining. Additionally, the relationship between the expression of PSAT1 and the clinicopathological parame-ters, overall survival (OS), and disease-free survival (DFS) of patients with pancreatic cancer was evaluated. The human pancreatic can-cer cell lines, BxPC-3 and SW1990, were transfected with PSAT1-siRNA, to investigate the effect of PSAT1 knockdown on cell prolifera-tion, migration, and invasion. Additionally, we performed Western blot to assess the expression of PI3K/Akt/mTOR-related proteins in PSAT1-knockdown cells. Results: The percentages of PSAT1-positive cells in pancreatic cancer and adjacent non-tumor tissues were 69.4% (68/98) and 5.0% (5/98), respectively, indicating a significantly higher expression of PSAT1 in pancreatic cancer tissues com-pared to adjacent non-tumor tissues (P<0.05). The increased expression of PSAT1 in pancreatic cancer tissues correlated with lymph node metastasis and TNM stage. Kaplan-Meier analysis suggested that a high expression of PSAT1 correlated with a poor OS and DFS compared to a low expression of PSAT1 (P<0.05). Cox regression analysis showed that the expression of PSAT1 is an independent prog-nostic marker for OS and DFS in pancreatic cancer patients (P<0.05, all). Transient transfection of BxPC-3 and SW1990 cells with PSAT1-siRNA markedly reduced the cell proliferation, migration, and invasion abilities of these cells compared to transfection with NC-siRNA (P<0.05). Knockdown of PSAT1 in pancreatic cancer cells also inhibited the expression of p-Akt and p-mTOR (P<0.05). Conclusions: The expression of PSAT1 increases in human pancreatic cancer tissues and cell lines. Additionally, PSAT1 regulates cell proliferation and in-vasion through the PI3K/Akt/mTOR pathway.

Objective: To explore human papillomavirus (HPV) infection and genotype distribution in male patients with condyloma acuminatum (CA). Methods: Totally 332 male patients with CA were enrolled from March 2015 to September 2017 at Henan Provincial People′s Hospital. By means of flow-through hybridization after polymerase chain reaction (PCR), the wart tissue HPV DNA genotypes were detected by gene chip. χ²test was used to perform statistical analysis. Results: Among 332 male CA patients, 239 was positive for HPV with the positive rate of 71.99% (95%CI: 67.16%-76.82%). A total of 37 kinds of genotypes, except for genotypes 26, 45, 69, 70, the others were all detected. The positive rate of genotype 6 was the highest in all detected genotypes (39.46%, 95%CI: 34.20%-44.72%) and the second one was genotype 11 (22.59%, 95%CI: 18.09%-27.09%), and the difference was significant (χ²=22.070, P<0.05). Among 239 HPV-positive CA patients, 158 were single infection and 139 were low-risk genotype (low-risk vs hight risk genotype: χ²=182.3, P<0.05), and 81 were multiple infection and 55 were mixed genotype (mixed vs low-risk genotype: χ²=32.241, P<0.05; mixed vs high-risk genotype: χ²=60.201, P<0.05). The CA patients mainly distributed in those aged 20 to 29 years, followed by those aged 30 to 39 years. Conclusions The genotypes of HPV infection in male patients with CA are mainly low-risk genotypes 6 and 11. Single infection is common, and the age of patients mainly distributes among 20 to 29 years old.

Objective To evaluate the treatment outcome, prognostic factors, radiation dose, and toxicities in patients with early-stage primary diffuse large B-cell lymphoma of Waldeyer's ring (WR-DLBCL) treated with intensity-modulated radiotherapy (IMRT).Methods This study included 80 patients with a confirmed diagnosis of stage Ⅰ-Ⅱ primary WR-DLBCL who were admitted to our hospital from 2008 to 2015.Only 3 patients received radiotherapy alone, and the other patients received radiotherapy and chemotherapy.After chemotherapy, 24 patients achieved complete remission (CR), and 53 patients achieved partial remission (PR).IMRT was given to the primary lesion and cervical lymphatic drainage region.Survival analysis was performed using the Kaplan-Meier method and log-rank test.The Cox model was used for analysis of prognostic factors.The toxicities were scored using the RTOG criteria.Results The median follow-up was 64 months.The 5-year locoregional control (LRC), overall survival (OS), and progression-free survival (PFS) rates were 94%, 88%, and 84%, respectively.The dose-volume histogram showed that the maximum, mean, and minimum doses to primary gross tumor volume were 54.47 Gy, 52.27 Gy, and 38.83 Gy, respectively.Prognostic analysis showed that age>60 years and increased lactate dehydrogenase (LDH) were influencing factors for OS (P=0.009 and 0.002), and that aged>60 years, IPI ≥2, and increased LDH were influencing factors for PFS (P=0.001, 0.035, and 0.007).Among all patients, 12, 53, and 8 experienced grade 1-3 radiation-induced acute oral mucositis, respectively, and 16 and 13 experienced grade 1 and 2 xerostomia as the late toxicity, respectively.Conclusions For patients with early-stage primary WR-DLBCL, IMRT results in satisfactory OS, PFS, and LRC and has tolerable early or late radiation-induced toxicities.

In this work, a fast and efficient microwave-assisted extraction (MAE) method was developed to extract main bioactive alkaloids from lotus plumue. To optimize MAE conditions, three main factors were selected using univariate approach experiments, and then central composite design (CCD). The optimal extraction conditions were as follows: methanol concentration of 65%, microwave power of 200 W, and extraction time of 260 s. A high performance liquid chromatography–diode array detector (HPLC–DAD) method was established to quantitatively analyze these phytochemicals in different lotus plumule samples and in different part of lotus. Chromatographic separation was carried out on an Agilent Zorbax Extend-C18 column (4.6 mm×150 mm, 3.5 μm). Gradient elution was applied with the mobile phase constituted with 0.1%triethylamine in water (A) and acetonitrile (B): 40%?70% B at 0?8 min, 70%?100% B at 8–9 min, 100% B for 2 min, and then equilibrated with 40%B for 2 min.

Objective To study calcium chelator BAPTA-AM antagonize the cellular oxidative stress induced by hydrogen peroxide ( H2 O2 ) and to explore the effect of calcium ion on the cell degeneration mediated by NLRP3.Methods The SHSY5Y cell model of oxidative stress was made by hydrogen perox-ide,then the cell model was treated with calcium ion carrier A23187 or BAPTA-AM,a higher efficiency cal-cium chelating agent.The cells were divided into 4 groups:H2O2 treatment group,H2O2+A23187 group, H2 O2+A23187 +BAPTA-AM group and control group.NLRP3 protein was detected by Western blot,and Caspase-1 and IL-1βwere detected by ELISA.Results NLRP3 expression was significantly increased in cells treated by hydrogen peroxide(P<0.05) .The NLRP3 protein continued to increase, and the expression of Caspase-1((57.1±19.2)pmol/L) and IL-1β((484.2±49.5)pg/ml) protein was also increased signifi-cantly in cells treated by A23187,and the difference had statistically significant for caspase-1 or IL-1βin H2O2+A23187 group compared with those in control group(Caspase-1:(26.8±12.9)pmol/L,IL-1β:(326.9 ±52.1) pg/ml) (P<0.05, P<0.01) .NLRP3,Caspase-1 and IL-1βwere all significantly reduced after adding a high-er efficiency calcium chelating agent BAPTA-AM.Conclusion Calcium overload is likely to enhance the oxidative stress induced by hydrogen peroxide and engender neurodegeneration mediated by NLRP3 inflammasome.