The pre-metabolic disease state is the body state of substance metabolism disorder that has not yet reached the physical and chemical indicators of the disease, and abnormal glucose metabolism is often the key link of metabolic disorder. In TCM, the healthy function of the spleen is the cornerstone of the production and distribution of fine substances. This article discussed the pre-metabolic disease state based on the theory of "overflow of Five Qi" in the Nei Jing, taking the loss of spleen preparedness as the starting point, in order to provide new ideas and directions for the prevention and treatment of clinical metabolic diseases.

Objective:To observe the anastomotic status of the vortex veins in patients with central serous chorioretinopathy (CSC).Methods:A cross-sectional study of clinical practice. From July 2021 to July 2022, 50 cases (50 eyes) of monocular CSC patients diagnosed through ophthalmic examination at the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, there were 37 males (74.0%, 37/50) and 13 females (26.0%, 13/50), with the mean age of (44.30±9.59) years old. The course of disease from the onset of symptoms to the time of treatment was less than 3 months. The affected eye and contralateral eye of CSC patients were divided into the affected eye group and contralateral eye group, respectively. Fifty healthy volunteers of the same age and gender were selected as the normal control group with 50 eyes. The macular area scanning source optical coherence tomography (OCT) vascular imaging examination was performed with Visual Microimaging (Henan) Technology Co., Ltd. VG200D. Horizontal watershed vortex veins anastomosis rate and asymmetric vortex-venous dilation rate were observed by en face OCT. The device comes with software to calculate the central foveal choroidal thickness (SFCT), mean choroidal thickness (MCT), and choroidal vascular index (CVI). One-way analysis of variance and χ2 test were used to compare the three groups. When variances were unequal between groups, nonparametric tests were performed. Results:The SFCT values of the affected eye group, contralateral eye group, and normal control group were (567.12±129.02), (513.26±133.17), (327.64±97.40) μm, respectively; MCT were (407.38±97.54), (388.24±94.13), (275.46±60.55) μm, respectively; CVI were 0.34±0.05, 0.32±0.04, and 0.27±0.04, respectively; anastomosis rates of vortex veins were 98% (49/50), 78% (39/50), and 40% (20/50), respectively; asymmetric dilation rates of vortex veins were 96% (48/50), 88% (44/50), and 48% (24/50), respectively. The differences of SFCT ( F=53.974), MCT ( Z=51.415), CVI ( F=28.082), vortex vein anastomosis rate ( χ2=43.056), asymmetric dilation rate of vortex veins ( χ2=37.728) among three groups were statistically significant ( P<0.001). Compared with the contralateral eye group, the SFCT, MCT, CVI, vortex vein anastomosis rate, and vortex vein asymmetric dilation rate in the affected eye group were significantly higher than those in the contralateral eye group. Among them, the differences of SFCT ( t=2.054), CVI ( t=2.211), and vortex vein anastomosis rate ( χ2=9.470) were statistically significant ( P<0.05); the differences of MCT ( Z=7.490), asymmetric dilation rate of vortex veins ( χ2=2.714) were not statistically significant ( P=1.000, 0.140). Conclusions:SFCT, MCT, and CVI in the affected and contralateral eyes of monocular CSC patients significantly increase. The anastomotic rate and asymmetric dilation rate of the vortex vein in the opposite eye were lower than those in the affected eye.

Objective To evaluate the clinical effect of alveolar bone augmentation by applying autogenous tooth bone graft material to patients with alveolar bone deficiency in orthodontic treatment. Methods Four patients with a stable periodontal condition managed with fixed orthodontic treatment were included, and the number of graft sites was 17. Cone beam computed tomography (CBCT) showed labial alveolar bone deficiency. The treatment plan included extraction, and the extracted teeth were used to prepare autogenous tooth bone material. The alveolar bone width was measured at the same site at multiple heights prior to operation and at 3 and 6 months post-operation.Results The alveolar bone width was higher at both 3 and 6 months post-operatively (P ＜ 0.05) than that pre-operatively. The alveolar bone width at 6 months post-operation was lower than that at 3 months post-operation (P ＜ 0.05). Conclusion Applying autogenous tooth bone graft material to patients with alveolar bone deficiency in orthodontic treatment can expand the range of tooth movement and result in good clinical outcomes.

PURPOSE: The characteristic expression of DNA damage response proteins in familial breast cancers with BRCA1, BRCA2, or non-BRCA1/2 mutations has not been analyzed in Chinese patients. Our study aimed to assess the differential expression of microcephalin 1 (BRIT1), ATM serine/threonine kinase (ATM), checkpoint kinase 2 (CHEK2), BRCA1, RAD51 recombinase (RAD51), and poly (ADP-ribose) polymerase 1 (PARP-1) and establish the profile of Chinese familial breast cancers with different mutation status. METHODS: We constructed five tissue microarrays from 183 familial breast cancer patients (31 with BRCA1 mutations; 14 with BRCA2 mutations, and 138 with non-BRCA1/2 mutations). The DNA response and repair markers used for immunohistochemistry analysis included BRIT1, ATM, CHEK2, BRCA1, RAD51, and PARP-1. The expressions of these proteins were analyzed in BRCA1/2 mutated tumors. The association between pathologic characteristics with BRCA1/2 mutation status was also analyzed. RESULTS: In familial breast cancer patients, BRCA1 mutated tumors were more frequent with high nuclear grade, estrogen receptor/progesterone receptor/human epidermal growth factor receptor 2 negative, low Ki-67, and positive CK5/6. BRCA1 mutated tumors had lower CHEK2 and higher cytoplasmic BRIT1 expression than BRCA2 and non-BRCA1/2 mutation tumors. BRCA2-associated tumors showed higher CHEK2 and cytoplasmic RAD51 expression than those in other groups. Nuclear PARP-1 expression in BRCA1/2-associated tumors was significantly higher than in non-BRCA1/2 mutation tumors. Moreover, we found quite a few of negative PARP-1 expression cases in BRCA1/2 mutated groups. CONCLUSION: The clinicopathologic findings of BRCA1-associated Chinese familial breast cancers were similar to the results of other studies. Chinese familial breast cancer patients with BRCA1/2 mutations might have distinctive expression of different DNA damage response proteins. The reduced expression of PARP-1 in Chinese BRCA1/2 mutated breast cancer patients could influence the therapeutic outcome of PARP-1 inhibitors.
Asian Continental Ancestry Group* ; Breast Neoplasms* ; Breast* ; Checkpoint Kinase 2 ; Cytoplasm ; DNA Damage* ; DNA Repair ; DNA* ; Estrogens ; Genes, BRCA1 ; Genes, BRCA2 ; Humans ; Immunohistochemistry ; Phosphotransferases ; Rad51 Recombinase ; Receptor, Epidermal Growth Factor

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.

Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.

Objective To optimize the matrix formula of propranolol hydrochloride gels. Methods On the basis of single factor experiment, central composite design-response surface method was used to optimize the formula. Addition levels of glycerol (A), PEG-400 (B) and HPMC (C) were evaluated as the independent variables.Eight-hour accumulative penetration amount per unit area measured by HPLC was used as the index. Quadratic polynomial was used to estimate the relationship between the index and the independent variables, and to delineate response surface and overlay contour plots in order to select the optimal formulations.Finally, predicted responses were verified. Results The optimized formula consisted of 18.53% glycerol, 8.54% PEG-400 and 2.35% HPMC.The quadratic polynomial regression model of 8-h accumulative penetration amount per unit area:R1=-7 415. 69+306. 10A+167. 47B+4 820. 59C-8. 26A2-9. 81B2-1 025. 75C2 , and the cumulative transmittance was 49.6%. Conclusion A credible model is established by using central composite design-response surface method and the formula of propranolol hydrochloride gels is optimized and the gel is stable and controllable.

Objective To evaluate the effects of interventional thermotherapy(60℃)via hepatic artery on the vascular permeability of hepatic tumor tissue and normal liver tissue in VX2 tumor-bearing rabbits.Methods Thirty white rabbits were used in this experiment,Thirty VX2 tumor-bearing rabbits models were established by direct injection of VX2 tissue particle into the liver parenchyma and were randomly and equally divided into three groups:(1)non-perfusion group(n=10),used as control group; (2)normal thermal perfusion group(n=10),a perfusion of 30ml saline at 37 4±0.5℃ via hepatic artery in 15 minutes was used;(3)hyper-thermai perfusion group(n=10),a perfusion of 30ml saline at 60±0.5℃via hepatic artery in 15 minutes was used.The vascular permeability of the tumor tissue and the normal liver tissue was estimated with Evan's blue method.Results In all three groups the vascular permeability was significantly incleased in tumor tissue than that in normal liver tissue(P＜0.05).Normal thermal perfusion resulted in a significant increase in the permeability of vasculature(JP＞0.05).Hyper-thermal peffusion resulted in a significant increase in vascular permeability of tumor tissue (P＜0.05),and vascular permeability was increased in tumor tissue mole markedly than that in normal tissue(P＜0.05).Conclusion Hyperthermia hepatic arterial perfusion can increase vascular permeability for both tumor tissue and normal tissue in VX2 tumor-bearing rabbits.

Thirty-six cases of delayed tramatic intracranial hematomas are reported in this paper. Among them 9, 5, 10 and 12 cases were epidural, subdural, intracerebral and multiple hematomas, respectively. The initial CT scans showed normal or brain contusions accompanied by a Me hemorrhage in 23 patients, and delayed intracranial hematomas developed after the earlier neurosurgical operations for evacuations of another traumatic mass lessions for urgent decompressions in 13 patients. Delayed hematomas occurred mostly in the acute stage of head injuries and most patients were impacted occipitally. Deterioration of consciousness was the most important manifestation for diagnosis. The responsible mechanisms of delayed intracranial hematomas are investigated and the indications of repeat CT scans or surgery for its early diagnosis are Droposed.

Four different methods are suggested for the practical supplementation of selenium to the residents in Keshan Disease areas. They are: distribution of selenite tablets, enrichment of table salt with sodium selenite, use of foliar sprays on grain crops and selection of relatively selenium-rich foods in affected areas.Selenium contents of corn and rice could be raised to a level of about 0.07 and 0.05 pprn respectively by application of foliar sprays. A vailability of the increased selenium is similar to that occurred naturally in corn, as demonstrated by animal experiment. Furthermore, by this method the bio-availability of selenium is better than the other methods of administration.Observation on residents who were treated with selenite table salt for three years and three months revealed that the salt enriched with 10 ppm of sodium selenite is enough to maintain the residents' hair selenium concentration to a level above 0.2 ppm, if an average of 15 g of the salt could be taken from meals daily by an adult. Either by calculation based upon 10 ppm of sodium selenite concentration suggested or by dietary survey, a daily selenium intake of around 60 ?g is required to maintain such a hair selenium level.Since about a half-year's administration is required in order to raise the hair selenium level above 0.2 ppm, an extraoral selenite tablet supplementation seems needed during the early stage of Se table salt treatment.Availability of selenium in selenite iodized table salt is not altered either after one-year storage or after manufacture for fermented soybean curd or salted vegetables. No harmful substance was detected during manufacture of dishes as evidenced by animal experiment.Fresh water products such as shrimps, eels, small fishes and loaches, as well as various species of mushrooms were found to be selenium-rich foods in Keshan Disease area. Their selenium contents ranged from 0.3 to 1.0 ppm.The authors are of the opinion that one may select any method introduced above and at the same time urge the people to take more selenium-rich foods in their diets, thus residents in Keshan Disease areas would obtain enough selenium to prevent them from being seleniumdeficient.