Objective To explore the effect of exercise combined with dieting on chronic inflamma-tion based on fatty acids and peripheral blood mononuclear cell(PBMC)immunophenotypes.Methods Thirty-one obese volunteers(age:30.1±5.5 years,height:170.1±8.1 cm,weight:101.13±21.40 kg,BMI:34.66±5.01 kg/m2)were recruited and given a 5-week program of exercise combined with diet-ing.The exercise regimen consisted of daily 3-hour training at 60%-75%HRmax intensity,while the di-eting regimen was a moderate to high energy restriction model,with a daily reduction of 250 kcal in the 1st week and 600 kcal from the 2nd to 5th weeks.Before and after the intervention,all volunteers were measured morphological indicators(body weight,BMI,fat-free mass,body fat percentage,waist-to-hip ratio and visceral fat index),blood lipids(total cholesterol,triglycerides,high-density lipopro-tein cholesterol and low-density lipoprotein cholesterol),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),visfatin(VF),and the content of fatty acids in the blood.Moreover,the expression of cell surface receptors CD36,TLR4,and nuclear factor-κB(NF-κB)on PBMC sub-sets was tested before and after intervention.Results After intervention,a significant decrease was ob-served in the body composition indices,as well as in the four major blood lipid parameters.Levels of chronic inflammatory markers,including hs-CRP,VF and TNF-α,decreased significantly(P<0.01).Except for C6:0,C11:0,C12:0,C23:0,and C24:0,the levels of other fatty acids also decreased sig-nificantly(P<0.05,P<0.01).Among the measured fatty acids,13,31,and 15 were found to be signif-icantly and positively correlated with hs-CRP,VF,and TNF-α,respectively(P<0.05,P<0.01).More-over,the expression of monocyte cluster of differentiation 36(CD36),Toll-like receptor 4(TLR4),and nuclear factor-κB(NF-κB)in PBMC subsets decreased significantly after the intervention(P<0.05).In lymphocytes,CD36 and TLR4 expression lowered significantly after intervention(P<0.05 and P<0.01),while in granulocytes,CD36 and NF-κB expression decreased significantly(P<0.01 and P<0.05).Conclusion Exercise combined with dietary intervention can better body composition and physi-cal function in obese individuals,alleviating their chronic inflammation.The reduction in chronic in-flammation is closely related to the decrease in circulating fatty acid levels,which results in the re-duced expression of CD36 and TLR4 receptors on the surface of PBMC and the inhibition of the NF-κB signaling pathway.

Pheochromocytoma/paraganglioma is an adrenal tumor that secrets catecholamines and is extremely rare in pregnant women. Its clinical presentation is lack of specificity, and the combination of low prevalence and nonspecific clinical presentation makes diagnosis and treatment difficult. In this study, the clinical data and prognosis of 5 pregnant patients with pheochromocytoma/paraganglioma were analyzed. It was found that hypertension first occurred in 4 patients during pregnancy, and the clinical manifestations of each case were different. Surgical treatment is the first choice in the treatment, patients who cannot operate can choose radionuclide therapy, chemotherapy and targeted therapy. Through follow-up, they all showed recurrence and metastasis at different times. Among them, the patients who continued to be pregnant to the middle and late stages of surgical treatment progressed rapidly, and there were multiple bone metastases throughout the body in a short period of time, and two cases died in a short period of time. Therefore, effective diagnosis, individualized treatment and lifelong follow-up are particularly important.

ObjectiveTo investigate the association between thromboelastography (TEG) parameters and bleeding in patients with liver cirrhosis and whether TEG can be used to predict the risk of spontaneous bleeding in patients with liver cirrhosis, and to provide a basis for its preventive treatment. MethodsA retrospective analysis was performed for the clinical data of 174 patients with liver cirrhosis who attended Huadu People’s Hospital from May 2018 to April 2020 and did not receive invasive procedure, and according to the condition of bleeding, they were divided into non-bleeding group(n=64), gastrointestinal bleeding group(n=61), and mucocutaneous/oronasal bleeding group(n=49). The medical record system and laboratory information system were used to collect related information and laboratory test results for statistical analysis. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. MedCalc software was used for receiver operating characteristic (ROC) curve analysis, and the area under the ROC curve (AUC) was calculated for commonly used coagulation markers and TEG parameters in predicting the risk of bleeding in patients with liver cirrhosis. Cut-off value, sensitivity, specificity, positive predictive value, and negative predictive value were determined, and the Z test was used for comparison of indices in predicting mucocutaneous/oronasal bleeding. ResultsOf all 174 patients, 110 (63.2%) experienced spontaneous bleeding, among whom 61 (55.5%) had gastrointestinal bleeding and 49 (44.5%) had mucocutaneous/oronasal bleeding. There were significant differences in maximum amplitude (MA) and K between the bleeding group and the non-bleeding group (t=2.241 and -2.605, both P＜0.05). There were significant differences between the mucocutaneous/oronasal bleeding group and the non-bleeding/gastrointestinal bleeding groups in platelet count (PLT) and the TEG parameters of clot formation time, a-angle, MA, and coagulation index (CI) (F=3.947, H=12.867, F=4.007, F=8.498, F=5.420, all P＜0.05). Among the TEG parameters, reaction time and Lys30 were generally within the normal range, while there was a prolonged kinetics (K) time and reductions in a-angle, MA, and CI. PLT ≤40×109/L, MA ≤357 mm, K time ＞4.2 minutes, a-angle ≤51.6, and CI ≤-5.9 could be used to predict spontaneous mucocutaneous/oronasal bleeding in patients with liver cirrhosis (all AUC ＞0.7), with positive predictive values of 82.4, 88.9, 81.0, 72.7, and 73.7, respectively, and negative predictive values of 68.3, 72.5, 73.0, 69.4, and 66.7, respectively. ConclusionPLT and the TEG parameters of K time, a-angle, MA, and CI can predict spontaneous bleeding caused by abnormal coagulation in liver cirrhosis, while conventional coagulation parameters prothrombin time and activated partial thromboplastin time cannot predict such bleeding, which provides a basis for the treatment of coagulation disorder and transfusion of blood components for patients with liver cirrhosis.

Objective:To observe and compare the efficacy and safety of glucosamine sulfate (GS) and chondroitin sulfate (CS) in the treatment of adult Kashin-Beck disease (KBD), so as to provide effective medical evidence for the standardized treatment of adult KBD.Methods:A clinical randomized controlled trial was conducted in Fuyu County and Shangzhi City, KBD historical seriously ill areas in Heilongjiang Province. A total of 247 patients were selected according to the standard of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010). According to gender, age and KBD condition, they were randomly divided into GS and CS groups, 124 and 123 respectively. Follow up once a month to investigate the medication and clinical symptoms of patients, and distribute drugs for the next stage. Fasting blood and urine samples were collected before, during and at the end of treatment (0, 90 and 180 d). Serum interleukin (IL)-1β content and urine pyridine (PYD) level were measured by enzyme-linked immunosorbent assay (ELISA). The visual analogue scale (VAS) score, affected joints, self-evaluation of curative effect and side effects were evaluated through the questionnaire, joint dysfunction and drug efficacy were evaluated according to the criteria of "Evaluation of Therapeutic Effect of Kashin-Beck Disease" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: at 180 d of treatment, serum IL-1β contents and urinary PYD levels in GS and CS groups were lower than those at 0 d of treatment ( Z = - 2.461, - 2.160, - 5.075, - 5.471, P < 0.05). VAS score: at 90 and 180 d of treatment, the scores of knee pain, stiffness and function in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05); and at 180 d of treatment, the scores of knee stiffness and function in GS group were lower than those in CS group ( P < 0.05). Evaluation of affected joints: at 90 and 180 d of treatment, the scores of joint pain, swelling and stiffness in GS and CS groups were lower than those at 0 d of treatment ( P < 0.05). Self-evaluation of curative effect: at 180 d of treatment, the self-evaluation of curative of CS group were better than that at 90 d of treatment (χ 2 = 9.376, P < 0.05). Evaluation of side effects: at 90 and 180 d of treatment, the side effects in GS and CS groups were mainly gastrointestinal symptoms. Joint dysfunction score: at 90 d of treatment, the sum of effective rate and markedly effective rate in GS group was higher than that in CS group (χ 2 = 4.042, P < 0.05), but there was no significant difference between the two groups at 180 d of treatment (χ 2 = 0.869, P > 0.05). Conclusion:GS and CS have certain therapeutic effects on adult KBD, which can improve symptoms and reduce serum IL-1β content and urinary PYD level, but GS takes effects quickly, and its effect on improving joint stiffness and function are better than CS.

Objective:To observe and compare the therapeutic effects of glucosamine sulfate (GS) and diacerein (DCN) on adult Kashin-Beck disease (KBD).Methods:A clinical randomized controlled trial was conducted in the historical severe KBD areas Fanrong Township, Fulu Town, Long'anqiao Town, Lianghe Town, Shaowen Township of Heilongjiang Province, and 240 patients were selected according to the criteria of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), then divided into GS and DCN groups (gender, age, and KBD condition balanced) via the random number table method, with 120 patients in each group. Followed up once a month to investigate the patient's medication and clinical symptoms, and distributed drugs for the next stage. Fasting blood samples and urine samples were collected before, during, and at the end of treatment (0, 90, and 180 days). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum interleukin (IL)-1β level and urine pyridinol (PYD) level. Visual analog scale (VAS) scores, evaluation of affected joints, self-evaluated efficacy, and evaluation of adverse reactions were carried out through questionnaires. Joint dysfunction scores and medications efficacy determination were performed according to the "Judgment of Kaschin-Beck Disease Treatment Effect" (WS/T 79-2011).Results:Expression of cytokines related to cartilage metabolism: after 180 days of treatment, serum IL-1β levels, urine PYD levels in GS group and urine PYD levels in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.332, - 5.420, - 5.204, P < 0.05). VAS scores: after 90 days of treatment, the pain, stiffness scores of patients in GS group and the pain, stiffness, and function scores in DCN group were lower than those in the same group at 0 day of treatment ( Z = - 2.612, - 2.359, - 3.637, - 2.881, - 2.238, P < 0.05); after 180 days of treatment, the pain, stiffness and function scores of patients in GS and DCN groups were significantly lower than those of the same group at 0 day of treatment ( Z = - 6.738, - 9.530, - 7.781, - 5.428, - 3.761, - 3.587, P < 0.01). Evaluation of affected joints: after 90 and 180 days of treatment, except for pain of weather changes in DCN group, the scores of symptomatic joints in the two groups were lower than those at 0 day of treatment ( P < 0.05). Efficacy self-evaluation: after 180 days of treatment, the self-evaluated efficacy ratio of DCN group was higher than that of GS group and the same group after 90 days of treatment (χ 2 = 4.165, 4.022, P < 0.05). Evaluation of adverse reactions: after 90 and 180 days of treatment, the main adverse reactions of patients in GS and DCN groups were gastrointestinal symptoms. Joint dysfunction scores: after 90 days of treatment, the sum of the effective rate and the markedly effective rate of GS group was higher than that of DCN group (χ 2 = 4.993 , P < 0.05); while after the 180 days of treatment, there was no significant difference between the two groups (χ 2 = 0.417 , P > 0.05). Conclusions:Both GS and DCN have a certain therapeutic effect on adult KBD and can improve clinical symptoms. The GS takes effect quickly, and long-term use can protect cartilage from inflammatory factors to a certain extent.

Objective:To investigate the effects of glucosamine sulfate, chondroitin sulfate and diacetarine on urinary renal function indexes UREA, creatinine (CREA), urinary microprotein(mALB) and N-acetyl-β-D-glucosidase (NAG) in adult patients with Kashin-Beck disease.Methods:According to the criteria of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), adult patients with degrees Ⅰ and Ⅱ Kashin-Beck disease in Heilongjiang Province were selected in 2019. They were randomly divided into three treatment groups according to age, gender, disease classification and other condition by clinical randomized controlled trial, group A (glucosamine sulfate group), group B (chondroitin sulfate group) and group C (diacetarine group). Fasting mid-morning urine was collected at 0, 90 and 180 days of treatment. The levels of UREA, CREA, mALB and NAG were measured using an automatic biochemical analyzer. And the abnormal rates of the above indexes were analyzed.Results:At 0 day of treatment, there were 118, 99 and 116 people in the 3 groups, respectively; after 90 days of treatment, 115, 93 and 106 people remained in the 3 groups; after 180 days of treatment, 95, 80 and 93 people remained in the 3 groups. The results showed that there was no significant difference in the levels of UREA, CREA, NAG and mALB among the 3 groups at 0 and 180 days of treatment ( H = 0.055, 0.923, 0.276, 1.125, 1.635, 3.873, 1.045, 4.135, P > 0.05). After 90 days of treatment, there was no significant difference in CREA level among the 3 groups ( H = 1.719, P > 0.05), the levels of UREA and NAG in group C were higher than those in group B ( P < 0.05), and the level of mALB in group B was higher than that in group C ( P < 0.05). The comparison results of all indexes before and after treatment showed that after 90 days of treatment, the levels of mALB in the 3 groups were lower than those of 0 day ( Z = - 2.858, - 3.217, - 2.124, P < 0.05), the levels of NAG were higher than those of 0 day ( Z = - 3.700, - 2.222, - 4.672, P < 0.05); and the level of UREA in group C was higher than that of 0 day ( Z = - 2.393, P < 0.05). After 180 days of treatment, the levels of CREA in the 3 groups were higher than those of 0 day ( Z = - 5.853, - 6.984, - 6.255, P < 0.05), and the levels of mALB in the 3 groups were lower than those of 0 day ( Z = - 3.785, - 2.624, - 3.427, P < 0.05). The abnormal rates of CREA in the 3 groups after 180 days of treatment were higher than those of 0 and 90 days (χ 2 = 39.499, 37.707, 71.534, 57.959, 58.160, 55.129, P < 0.05). There was no significant difference in the abnormal rate of CREA between 0 day and 90 days of treatment (χ 2 = 0.004, 2.068, 0.053, P > 0.05). The abnormal rates of NAG in groups A and C after 90 days of treatment were higher than those of 0 day (χ 2 = 8.999, 11.227, P < 0.05). The abnormal rates of NAG in group C after 180 days of treatment was higher than that of 0 day (χ 2 = 5.006, P < 0.05). There was no significant difference in the abnormal rate of NAG between group A and group C after 90 days and 180 days of treatment (χ 2 = 1.976, 1.413, P > 0.05). The abnormal rates of mALB in groups A and B after 90 days and 180 days of treatment were lower than those of 0 day (χ 2 = 6.461, 8.881, 7.563, 4.999, P < 0.05), and there was no significant difference between 90 days of treatment and 180 days of treatment (χ 2 = 0.638, 0.013, P > 0.05). Conclusions:The effects of glucosamine sulfate, compound chondroitin sulfate and diacetarine on renal function of the patients are not significantly different after 180 days of medication, but the three drugs all have certain effects on CREA and NAG. Follow-up work should be done during drug treatment to closely monitor the changes of the two indicators.

Objective:To investigate the efficacy and safety of neuroendoscopy in the treatment of non-acute traumatic intracranial hematoma.Methods:Thirty-six patients with non-acute traumatic intracranial hematoma, admitted to our hospital from June 2018 to December 2019, were chosen in our study. These patients accepted small-bone window craniotomy and straight incision, or removal of intracranial hematoma by neuroendoscopy. The clinical data of these patients were retrospectively analyzed. Pain numerical rating scale (NRS) was used to assess degrees of pain in 22 patients with headache one d before surgery and three d after surgery. The neurological functions after treatment were evaluated by activity of daily living (ADL) evaluation criteria one d before surgery and 7 d after surgery.Results:All 36 patients were cured and discharged from hospital, and no death was noted; length of hospital stays was (6.7±1.1) d. No secondary hemorrhage re-craniotomy was needed, no postoperative complications such as cerebrospinal fluid leakage were noted, and no re-injection of urokinase was needed to melt the hematoma. As compared with the preoperative NSR scores (7.82±1.097), the postoperative NSR scores of 22 headache patients were significantly decreased (1.05±0.653, P<0.05). In these 36 patients, preoperative ADL level I was noted in 8 patients, level II in 14 patients, level III in 12 patients, and level IV in 2 patients. Postoperative nerve function in 30 patients were fully recovered, with ADL level I; and 6 patients had mild symptom of dizziness, with ADL level II. Conclusion:Non-acute traumatic intracranial hematoma treated by neuroendoscopy enjoys good curative effect, less surgical trauma, short hospital stays and high safety.

OBJECTIVE： To establish QAMS method for content determination of paeoniflorin， rutin， oroxin B， baicalin and cinnamates in Yanyan tablets. METHODS： HPLC method was adopted. The determination was performed on Hypersil GOLD-C18 column （250 mm×4.6 mm，5 μm） with mobile phase consisted of methanol-0.35％ phosphoric acid solution （gradient elution） at flow rate of 1 mL/min. The detection wavelengths were set at 280 nm （rutin， oroxin B， baicalin， cinnamates） and 230 nm （paeoniflorin）. The column temperature was 30 ℃， and sample size was 10 μL. Using paeoniflorin as internal reference， relative correction factors （RCF） of rutin， oroxin B， baicalin and cinnamates were established. Effects of different chromatogram system， chromatogram column， mobile phase proportion， flow rate and column temperature on relative correction factors were investigated； the chromatographic peaks of the components were located according to the relative retention time. The content of paeoniflorin as internal reference was determined by external standard method， and the other four components were determined by QAMS， and then compared with the results of external standard method. RESULTS： The separation degree of each component to be measured was greater than 1.5. The linear range was 3.97-119.22 μg/mL for paeoniflorin，1.96-58.68 μg/mL for rutin，2.39-71.64 μg/mL for oroxin B， 1.92-57.51 μg/mL for baicalin， 0.54-16.24 μg/mL for cinnamates（r≥0.999 7）， respectively. RSDs of precision， reproducibility and stability tests were all lower than 2％. Average recoveries were 97.20％-98.07％（RSD＜3％，n＝6）. RCFs of rutin， oroxin B， baicalin and cinnamates were 0.554 6，1.815 6，2.489 3 and 5.423 2， using paeoniflorin as internal reference. RSDs of RCF and relative retention time were all lower than 5％ under different chromatogram conditions. Absolut relative error of four components （except for internal reference） in 10 batches of Yanyan tablets sampled by QAMS and external standard method were all less than 1％. The results of the two methods were identical. CONCLUSIONS： The established method is accurate， rapid， efficient and inexpensive， and it can be used for simultaneous determination of 5 indicator components in Yanyan tablet.

Objective To analyze the characteristics of breast medullary carcinoma in CEUS and to compare with pathologic features.Methods Morphologic characteristics of 13 breast medullary carcinomas in CEUS were analyzed.The diameter of mass before and after CEUS were compared.Parameters from time-intensity curves of masses were analyzed in contrast with peripheral breast parenchyma.All the results from CEUS analysis were compared with pathological manifestations.Results Breast medullary carcinoma was characterized as irregular shape (n=10),clear margins (n=11) and uniform enhancement (n=11) in CEUS.These characteristics were in accordance with their morphologic characters in pathology.The diameter of mass before and after CEUS had no significant defference (P=0.61),which was in accordance with expansive growth in pathology.In contrast with peripheral breast parenchyma,the arrival time and time to peak of breast medullary carcinoma were significantly shorter (P=0.034,0.021),and peak enhancement intensity was significantly stronger (P=0.005),which were in accordance with the increased vascular density and their uniform distribution,big arteries at the margin of masses in pathology.Conclusion Breast medullary carcinoma has distinguished characteristics in CEUS,which are in accordance with characters in pathology,and can be used as the basis in clinical diagnosis and differential diagnosis of breast medullary carcinoma.

Objective To investigate celecoxib self-microemulsifying drug delivery system (CXB-SMEDDS) that was developed to increase the dissolution rate and oral bioavailability of celecoxib.Methods The formulation of CXB-SMEDDS was optimized by pseudo-ternary phase diagrams analysis.The appearance, morphology, particle size distribution and in vitro drug release behavior of CXB-SMEDDS were investigated after diluted by water.The bioavailability of CXB-SMEDDS was determined by oral administration to rats compared with CXB suspension.Results An optimized formulation was selected: Medium chain triglycerides as oil phase, Tween 20 as surfactant, Transcutol HP as cosurfactant.The ratio of oil phase, surfactant and cosurfactant was 2∶9∶9.Upon mixing with water, CXB-SMEDDS formed a clear and transparent microemulsion solution with homogeneous small spherical under transmission electron microscopy.For particle size of CXB-SMEDDS was found to be (57.6±14.2) nm.The in vitro dissolution test indicated a significant improvement in release characteristics of CXB.The AUC of CXB-SMEDDS and CXB suspension were (5.54±0.94) and (3.32±0.59) mg·L-1·h, respectively.The relative bioavailability was 166.9%.Conclusion The SMEDDS can significantly increase celecoxib dissolution in vitro and bioavailability in vivo.