Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

ObjectiveTo explore the differences of cognitive function in patients with treatment-resistant depression and drug-naive first-episode major depressive disorder， and to examine the relationship between severity of clinical symptoms and cognitive function， so as to provide references for prognosis improvement. MethodsFrom November 2016 to December 2019， 119 patients with drug-naive first-episode major depressive disorder and 82 patients with treatment-resistant depression in a hospital in Guangzhou were enrolled， meantime， another 71 healthy individuals recruited from the community were set as healthy control group. Clinical symptoms were assessed using Hamilton Depression Scale-17 item （HAMD-17） and Hamilton Anxiety Scale （HAMA）. Cognitive domains， including speed of processing， working memory， verbal learning and memory， and visual learning and memory were measured with the MATRICS Consensus Cognitive Battery （MCCB）. Multiple covariance analysis was used to compare the differences in cognitive function among three groups. Thereafter， partial correlation analysis was performed within patient groups to explore the relationship of HAMD-17/HAMA score with the four dimensions of MCCB. ResultsThe speed of processing， visual learning and memory scores of treatment-resistant depression group and drug-naive first-episode depression group were lower than those of healthy control group， and the working memory score of the treatment-resistant depression group was lower than that of the healthy control group， with statistical significance （P<0.05 or 0.01）. The speed of processing， visual learning and memory scores of treatment-resistant depression group were significantly lower than those of drug-naive first-episode depression group （P<0.05 or 0.01）. Partial correlation analysis within patient groups found that HAMD-17/HAMA total score had no correlation with the four dimensions of MCCB （P>0.05）. ConclusionCompared with drug-naive first-episode major depressive disorder patients and healthy controls， the impairments of speed of processing， visual learning and memory are more severe in patients with treatment-resistant depression. Moreover， the cognitive function impairment in patients with drug-naive first-episode major depressive disorder and treatment-resistant depression has no correlation with the severity of depressive and anxious symptoms.

Background: Fucosyltransferase 2 (FUT2) and FUT3 specifically catalyze the biosynthesis of human histo-blood group antigens, and has been demonstrated to be closely related to inflammatory bowel disease (IBD). However, there are few clinical studies focusing on FUT2, FUT3 and IBD. Aims: To investigate the expressions of FUT2 and FUT3 in intestinal mucosa of IBD patients with various clinical characteristics and their clinical relevance. Methods: Patients initially diagnosed as active IBD in the Affiliated Hospital of Hangzhou Normal University from January 2019 to December 2020 were recruited consecutively. Endoscopic biopsy specimens prior to the initiation of treatment were collected to assess the expressions of FUT2 and FUT3 immunohistochemically. Correlations of FUT2, FUT3 with the clinical characteristics and inflammatory indicators were analyzed. Results: Seventy cases of ulcerative colitis (UC), 37 Crohn's disease (CD), and 66 healthy subjects were enrolled. The positivity rate and relative expression level of FUT2 were decreased, while those of FUT3 were increased in CD group than in control group (all P<0.05). In UC group, the relative expression levels of both FUT2 and FUT3 were increased as compared with control group (all P<0.05). No correlations were observed between expressions of FUT2, FUT3 and the disease severity, disease extent/location, clinical manifestations (including abdominal pain, diarrhea, fever and anemia), and alcohol drinking and cigarette smoking in IBD patients (all P>0.05). But moderate positive correlations were found between FUT3 expression and the serum C-reactive protein and fecal calprotectin (r=0.259, P=0.007; r=0.388, P=0.001). Conclusions: FUT2 and FUT3 might be used as indicators for the assistant diagnosis of IBD and assessment of drug therapy response.

Objective:To investigate the clinical significance of preserving supraclavicular nerve in the reduction and fixation of clavicular fracture.Methods:A retrospective study was conducted of the 68 pa-tients with clavicular fracture who had been treated surgically from October 2016 to April 2018 at Department of Orthopedics and Traumatology, Heyuan Hospital of Traditional Chinese Medicine.They were 35 males and 33 females, aged from 25 to 45 years (average, 34.8 years).The supraclavicular nerve was preserved in the re-duction and fixation of clavicular fracture in 32 patients (reservation group) but not in the other 36 ones (control group).The 2 groups were compared in terms of operation time, intraoperative blood loss, fracture healing time; postoperative pain tolerance, feeling (by the British Medical Research Council assessment), shoulder function (by the Constant-Murley scoring) and impact of numbness on life.Results:The 2 groups were compatible due to insignificant differences in the general clinical data between them ( P>0.05).All the 68 patients were followed up for 12 to 26 months (average, 15 months).There was no significant difference between the 2 groups either in intraoperative blood loss or fracture healing time ( P>0.05).The preservation group had significant longer operation time (72.6 min±7.2 min) than the control group (47.3 min±7.4 min), but a significantly lower rate of analgesic usage on the postoperative day [6.3%(2/32)] than the control group [91.7%(33/36)] (both P<0.05).By the British Medical Research Council assessment, the postoperative feeling was rated as S3 or S4 in 93.8%(30/32) of the patients in the preservation group, significantly higher than the 72.2% (26/36) of the control group ( P<0.05).The preservation group was also significantly better than the control group in Constant-Murley scores of the injured shoulder [100.0 (93.5, 100.0) versus 87.0 (81.0, 89.0)] and impact of numbness on life [0 versus 50.0%(18/36)] (both P<0.05). Conclusion:In surgical treatment of clavicular fracture, preservation of the supraclavicular nerve can have a positive effect on reducing postoperative pain in the operative area and impact of numbness on life.

Objective To compare the difference between transthoracic device closure of ventricular sep-tal defect and conventional thoracotomy and examine the effect and safety of transesophageal echocardiography (TEE) guided minimally invasive transthoracic device closure of ventricular septal defect. Methods Three hun-dred and sixty-eight patients underwent isolated ventricular septal defect surgery in our hospital from May 2014 to May 2016. There were 40 patients in group A underwent TEE guided minimally invasive transthoracic device clo-sure of ventricular septal defect and 328 patients in group B underwent conventional thoracotomy surgery.By using the method of propensity score matching,we selected 40 conventional thoracotomy patients as a control group in our study. Results All patients were survived after surgery without death and other serious complications. Compared with conventional thoracotomy surgery,patient with transthoracic device closure of ventricular septal defect had sta-tistical improvement in surgery time(1.97 ± 0.48 vs. 3.55 ± 1.95)h, ICU stayed time(21.15 ± 30.52 vs. 38.37 ± 10.91)h,volume of thoracic drainag(28.39 ± 32.67 vs.174.84 ± 85.36)mL,surgery incision length(2.98 ± 0.72 vs. 11.76 ± 2.89)cm.There were no significant differences in postoperative valvular regurgitation,arrhythmia and resid-ual shunt between the two groups.Conclusion TEE guided minimally invasive transthoracic device closure of ven-tricular septal defect is safe,effective,feasible,less trauma,less bleeding,faster recovery and etc.

Objective: To explore the clinical efficacy of acupuncture combined with three oxygen in the treatment of postherpetic neuralgia. Methods: According to the digital table, 70 patients with neck thoracolumbar sacral postherpetic neuralgia were randomly divided into control group (conventional acupuncture plus oral gabapentin+ Bailemian capsule oral group) and observation group (abdominal acupuncture + floating needle + three oxygen paravertebral injection group), 35 cases in each group.The clinical efficacy, sleep state (SRSS), anxiety state (HAMA) and visual analogue scale (VAS) of the two groups were observed and recorded after treatment. Results: The curative effect of the observation group was significantly better than that of the control group (91.43% vs.65.71%, χ²=6.873, P<0.05), and the SRSS, HAMA and VAS scores after treatment in the observation group were better than those in the control group[SRSS: (17.23±3.36)points vs.(10.79±2.48)points, t=8.472, P<0.05; HAMA: (12.14±2.62)points vs.(8.49±2.77)points, t=7.251, P<0.05; VAS: (3.19±0.98)points vs.(1.87±0.68)points, t=6.919, P<0.05)]. Conclusion Acupuncture combined with three oxygen in the treatment of postherpetic neuralgia has significant curative effect, without toxic and side effects, it has higher clinical practical value.

Objective:To observe the effects of low intensity pulsed ultrasound(LIPUS) on the osteogenic differentiation of rat bone marrow mesenchymal stem cells(BMSCs) on titanium surface.Methods:BMSCs from Wistar rat bone marrow were respectively cultured on the flat titanium surface and the large grain blast acid etched(SLA) titanium surface,and induced by mineralization medium.Then,the cells were interfered by LIPUS and a control condition.Alkaline phosphatase(ALP) were quantitative determinated after 3 and 7 d mineralization induction respectively,ALP staining were observed after 14 d induction.Alizarin red staining were observed after 21 d mineralization induction.Osteogenic related protein and gene expressions were detected after mineralization induction.Results:ALP in culture medium of LIPUS group was higher than that of the control group after 3 d and 7 d mineralization induction(P＜0.05).LIPUS group showed stronger ALP staining and alizarin staining,and more mineralized nodules than control group.The expression of osteogenic related proteins,including Runx2,BMP2,OPN in LIPUS group increased.Osteogenic related genes expression,including ALP,Runx2,BMP2,OPN,OCN and Col-1 of the LIPUS group increased.Conclusion:The osteogenic differentiation of BMSCs on the fiat titanium surface or SLA titanium surface can be promoted by LIPUS.

Background:Secondary lymphoid tissue chemokine( SLC)is involved in lymphoid homing and anti-tumor immune response,and has a chemotactic effect on intestinal lymphocytes. Several animal studies have shown that SLC is involved in the occurrence and development of ulcerative colitis( UC). Aims:To investigate the expression and significance of SLC in UC. Methods:Forty active UC patients from Dec. 2010 to Dec. 2012 at Affiliated Hospital of Nantong University were enrolled,and 20 healthy volunteers were served as controls. Expression of SLC in the colon mucosa was detected by immunohistochemistry,and its relationship with severity of UC was analyzed. Results:SLC was positively expressed in all UC patients,while was negatively or weakly positively expressed in controls. Expression of SLC in UC patients was significantly higher than that in controls(4. 16 ± 0. 78 vs. 0. 52 ± 0. 11,P<0. 05). Expression of SLC was correlated with the severity of involvement of UC. Conclusions:Expression of SLC participates in development and progress of UC. SLC may play an important role in the induction of local damage and pathological changes of UC.

Objective To avoid misdiagnosis of adult abdominal epilepsy. Methods Analyzed the clinical data of a misdiagnosed adult patient with 16 years of abdominal epilepsy, also reviewed the related literatures. Results Both adult abdominal epilepsy and the misdiagnosis of it for 16 years were very rare. Differential diagnosis of it should be used to distinguish with a variety of diseases. Conclusion It is crucial to avoid misdiagnosis of the disease that exam-ining patient with electroencephalogram (EEG) at the onset of abdominal pain and thinking carefully with detailed and comprehensive analysis. Once the diagnosis is definite, antiepileptic therapy should be applied.

Objective To investigate the roles of the chemokine receptor CXCR3 and its ligand I-TAC in the pathogenesis of immune thrombocytopenic purpura (ITP).Methods A total of 48 ITP patients were enrolled in this study:30 with newly diagnosed or relapse ITP and 18 in remission after treatment,and 24 healthy volunteers were as controls.IFNγ and I-TAC in plasma were detected by ELISA.The mRNA expression of CXCR3 in the peripheral blood mononuclear cells (PBMNCs) was determined by quantitative RT-PCR.Results The IFNγ level in the plasma of ITP patients before the treatment was obviously increased than those in the remission group and controls[ (71.45 ± 17.62)ng/L vs (36.94 ±14.86 )ng/L and (25.28 ± 12.85 )ng/L,all P ＜ 0.05 ]and those in the remission group was higher than in the controls ( P ＜ 0.05 ).In contrast,there were no statistic differences of the levels of I-TAC among the three groups[ (455.56 ± 144.70 ) ng/L,( 488.24 ± 164.70 ) ng/L and ( 382.97 ± 167.43 ) ng/L,P ＞0.05 ].Both ITP patients before the treatment and remission groups expressed more CXCR3 mRNA [ 6.76(3.03,37.00),1.76 (0.45,14.18 ) vs 0.12 ( 0.04,0.28 ),P ＜ 0.05 ].After effective therapy,CXCR3mRNA expression decreased,while it was still higher than that in the controls.Conclusions Our data demonstrate that Th1 cytokine (IFNγ) dominance is reflected in ITP.Simultaneously,the CXCR3 + cell may play a role in cell-mediated immunity through chemotaxis in ITP.