Objective:To study the potential mechanism of Ganwei Baihe Decoction in the treatment of gastric ulcer (GU) based on bioinformatics and validate it through animal experiments.Methods:TCMSP, DisGeNET, and GeneCards databases were used to retrieved active components and action targets of Ganwei Baihe Decoction. After obtaining the intersection, protein interaction data of the intersection genes were obtained through the STRING database. A PPI network was constructed by Cytoscape 3.10.0 software and the key genes and key components were obtained. DAVID online analysis database was used for GO functional enrichment and KEGG pathway enrichment analysis of key targets. Animal experiments were used for verification. Totally 36 SD rats were divided into blank group, model group, Omeprazole group and Ganwei Baihe Decoction group according to the random number table method, with 9 rats in each group. After 7 days of gavage of the corresponding drugs to each group of rats, they fasted and but with water for 24 hours, and then re-gavaged once. After 1 hour of administration, a gastric ulcer rat model was prepared by gavage of 80 mg/kg of indomethacin. After 3 hours of administration, anesthesia was used to extract the sample. The expression level of Caspase-3 protein in the gastric tissue of rats was to be determined by Western blot method.Results:There were 234 effective active components with 290 targets in Ganwei Baihe Decoction, and 6 496 therapeutic targets for GU. 213 potential targets for GU were screened out. There were 437 GO function and 153 KEGG pathway enriched entries. Compared with the model group, the protein expression of Caspase-3 in the Ganwei Baihe Decoction group and Omeprazole group decreased ( P<0.05). Conclusion:The mechanism of Ganwei Baihe Decoction in treating GU may be through key components such as quercetin and β-sitosterol acting on key targets such as AKT1 and CASP3, regulating the Apoptosis pathway, PI3K-Akt signaling pathway, MAPK signaling pathway, etc. to exert inhibitory effects on apoptosis.

Objective To investigate the application of intra pelvic pressure(IPP)in ultramicro-channel percutaneous nephrolithotripsy.Methods From January 2022 to January 2023,60 patients with urinary calculi who needed Super mini-PCNL(SMP)in The First Hospital of Jiaxing selected as the study objects.According to random number method,the patients were divided into control group and experimental group,with 30 cases.Both groups were treated with ultra-micro channel percutaneous nephrolithotripsia,while the experimental group was monitored and regulated IPP in real time during the operation,and observed and compared clinical indicators,IPP,fever,urinary protein,renal function,hemoglobin(Hb)and adverse reactions between the two groups.Results Compared with the control group,the hospitalization time of experimental group was shortened and the stone clearance rate was increased(P<0.05).The IPP levels of experimental groups at 6min,12min,24min and 36min were lower than those of control group(P<0.05).The fever of experimental group was lower than that of control group at 2d,3d,4d and 5d after operation(P<0.05).The urinary protein level of experimental group was lower than that of control group at 1d,2d,3d and 4d after operation(P<0.05).Compared with control group,blood urea nitrogen(BUN)and serum creatinine(SCr)levels of experimental group were decreased,and Hb levels were increased(P<0.05).The incidence of adverse reactions in experimental group was lower than that in control group(P<0.05).Conclusion Monitoring and adjusting intrapelvic pressure during super-mini percutaneous nephrolithotomy is beneficial in reducing postoperative fever in patients with urolithiasis,reducing urinary protein expression and kidney function damage,and controlling the occurrence of adverse reactions.It is worth recommending.

Objective:To explore the appropriate use of a self-developed scoliosis rehabilitation robot in treating adolescent idiopathic scoliosis (AIS), and also its safety and effectiveness.Methods:The scoliosis rehabilitation robot consists of a closed-loop pneumatic control system and multi-segment torso, pelvis and upper extremity fixation devices. It provides three-dimensional synchronous correction. Eighteen AIS subjects first received 30min of robot-assisted treatment using the maximum tolerable orthotic force. The angles of their spinal processes were evaluated using ultrasound before the treatment and after 30 seconds, 5 minutes and 30 minutes of treatment, then 5min later. In a second 30sec course of treatment the transverse orthotic force was 10%, 15%, 20%, 25%, and 30% of the patient′s body weight. Any adverse effects were observed and recorded.Results:The robot ran smoothly and could apply intelligent and precise correction. No severe adverse effects were reported. The mean correction of the spinal process angles showed a significant cumulative effect with treatment time, reaching 104% at 30min. The mean process angle correction increased with the applied force. Force at 25% of the patient′s weight produced an average correction of 104% in patients with mild AIS and 65% in those whose AIS was moderate.Conclusion:The scoliosis rehabilitation robot is safe and immediately effective. Setting the transverse force at 25% of a patient′s weight gives the best corrective effect with mild AIS. Moderate AIS requires more force.

Objective To analyze the factors affecting the prognosis of patients with pulmonary sarcomatoid carcinoma (PSC) and construct a nomogram prediction model for the prognosis of PSC patients. Methods Based on the SEER database, 1671 patients diagnosed as PSC from 1988 to 2015 were collected and divided into modeling group and validation group according to the ratio of 7:3. Univariate and multivariate Cox regression analysis were performed in the modeling group to explore independent risk factors affecting the prognosis and construct a nomogram survival prediction model. The consistency index and calibration curve were used for verification in the modeling group and the test module respectively. Results Age, gender, histological type, TNM stage, tumor diameter > 50mm, surgery, radiotherapy and chemotherapy were independent factors that affected the prognosis of PSC patients. The nomogram prediction model was constructed and verified based on independent factors. The C indexes of the modeling group and the test model were 0.790 (95%CI: 0.776-0.804) and 0.781 (95%CI: 0.759-0.803), respectively. The calibration curves of the modeling group and the test model indicated that the predicted survival rate was basically the same as the actual survival rate. Conclusion The nomogram prediction model constructed based on the results of multivariate analysis can predict the prognosis of PSC patients, and has high accuracy and consistency.

OBJECTIVE： To study the effects of ligustrazine on miR-20b/VEGF and BMP2/Smad1 pathways in subchondral bone of knee osteoarthritis （KOA） model rats， and to investigate the mechanism of ligustrazine for KOA prevention and treatment. METHODS： Totally 18 healthy male SD rats were randomly divided into normal control group， model group and ligustrazine group， with 6 rats in each group. The rats in the latter two groups were used to establish KOA model by intra-articular injection of 4％ papain solution. From the 2nd day after the last injection， ligustrazine group was given intragastrical administration of Ligustrazine suspension （100 mg/kg） 2 mL； normal control group and model group were given intragastrical administration of isometrical normal saline， once a day， for consecutive 6 weeks. After the last after medication， the situation of bilateral knee articular cartilage of rats were observed after exposure. The knee joints of rats were sectioned and stained with HE. The pathological change of articular cartilage were observed by microscope and scored by modified Mankin’s score. mRNA expression of VEGF， BMP2 and Smad1， and the expression of miR-20b were detected by RT-PCR； the protein expression of VEGF， BMP2 and Smad1 were detected by Western blot assay. RESULTS： Model group and ligustrazine group suffered from cartilage injury of knee joint at varying degrees. Compared with normal control group， Mankin’s scores of knee joint and cartilage tissue were increased significantly in model group （P＜0.01）； mRNA and protein expression of BMP and Smad1， the expression of miR-20b in subchondral bone of model group were decreased significantly， while mRNA and protein expression of VEGF were increased significantly （P＜0.01）. Compared with model group， Mankin’s score of cartilage tissue were decreased significantly in ligustrazine group （P＜0.01）； mRNA and protein expression of BMP and Smad1， the expression of miR-20b in subchondral bone were increased significantly， while mRNA and protein expression of VEGF were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS： Ligustrazine can repair damaged articular cartilage in KOA model rats， the mechanism of which may be associated with inhibiting the protein expression of VEGF and activating BMP-2/Smad1 signaling pathway via up-regulating the expression of miR-20b， and promoting the degradation of VEGF mRNA in subchondral bone.

Objective: To observe the effect of action observation combined with occupational therapy on the upper limb function and ability in the activities of daily living after a stroke. Methods: Forty-two stroke survivors were randomly divided into a treatment group and a control group, each of 21. Both groups were given conventional rehabilitation training and conventional occupational therapy. The treatment group additionally performed action observation. The Fugl-Meyer assessment (FMA-UE), a Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) and the Modified Barthel index (MBI) were used for assessment before and after 8 weeks of treatment. Results: Before the treatment there were no significant differences between the two groups. Afterward, significant improvement was observed in all of the measurements in both groups. Compared with the control group, the treatment group showed more significant improvement in its average FMA-UE, FTHUE-HK and MBI scores. Conclusion Action observation can improve the effects of rehabilitation and occupational therapy after stroke.

Objective To explore the effect of pattern-specific physical therapy based on functional impair-ment on chronic neck pain ( CNP ) . Methods Ninety-three CNP patients treated in the outpatient department of our hospital between March 2016 and November 2017 were randomly divided into a study group ( n=46) and a control group ( n=47) . The control group received routine physical treatment, while the study group was treated with pattern-specific physical therapy involving local pain management, traction, soft tissue relaxation, mobilization, strength training, posture control training and active exercise as well as health education. Each was based on a physical exami-nation and pattern classification by doctors and therapists. The subjects in both groups were required to complete 3 to 6 ninety-minute sessions of outpatient treatment and 6 thirty-minute sessions of self-training at home over 2 weeks. Pain intensity and cervical dysfunction were rated using a visual analogue scale ( VAS) and a neck disability index ( NDI) before and after the two-week intervention and one month later. Before the intervention and during the follow-up, postural analyses for the head and neck in a standing position were performed. The cranial vertebral angle ( CVA) , protracted shoulder angle ( PSA) and sagittal head elevation were measured. Results Eighty-seven par-ticipants completed the treatments and follow-up. After the 2-week intervention, the average VAS rating at the end of cervical anteflection in the study group was significantly lower than that in the control group ( P≤0.05) . Significantly greater improvement in the NDI scores was observed in the study group than the control group ( P≤0.05) . During the follow-up, it was found that the average CVA score had improved more significantly in the study group than with the control group ( P≤0.01) , but there were no significant differences in the other measurements between the two groups.Conclusion This pattern-specific physical therapy process is more effective for relieving the end pain during cervical anteflection quickly. It can improve functioning and ability in daily activities to some degree, as well as correct head and neck posture in the long term. It may be helpful in regulating physical therapy for neck pain and for developing a standardized treatment protocol for CNP .

Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment (VCI).Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group,each of 20.Regular and computer-aided cognition training were applied in both groups,while training using the Valpar system was additionally used in the treatment group.Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI) before,and after 4 and 8 weeks of treatment.Results Before the treatment,there were no significant differences between the 2 groups in LOTCA and MBI scores (P＞0.05).After 4 and 8 weeks of treatment,the average total LOTCA score in the observation group was significantly better than before the treatment,as were the average scores on the various dimensions,and the average MBI score (P＜0.05).After 4 weeks of treatment the control group showed significant improvement in the patients' orientation (3.50±0.89),visual perception (13.50± 1.43),spatial perception (2.40±0.50),visuomotor construction (24.00± 1.17) and attention (2.30±0.87).However,after both 4 and 8 weeks of treatment,all the measurements of the observation group were significantly better than those of the control group at the same time point (P＜0.05).Conclusion The Valpar system can significantly improve the recovery of cognitive function and ability in the activities of daily living of patients in the early stage of VCI.It is worth applying in clinical practice.

Objective To compare the static standing balance of stroke patients after different biofeedback protocols.Methods Thirty-two stroke patients were randomly divided into a knowledge of performance (KP) group,a knowledge of results (KR) group and a control group.All 3 groups received 4 weeks of conventional rehabilitation training plus another 30min of static standing balance training per day.The KP group received audio-visual feedback in real time during the training.The KR group received section result feedback.The control group received no feedback during the extra balance training.Before and after the training,the performance of the 3 groups was evaluated using Berg's Balance Scale (BBS) and a portable biofeedback device.Results Average BBS performance improved significantly more in the KP group (3.08± 1.08) than in KR group (1.30±0.67) and control group (1.20± 0.79) (P＜0.05).No significant difference was detected between the KR and control groups (P＞0.05).The average improvements of the KP group in terms of Standing with Eyes Closed and Tandem Standing (0.92±0.79 and 0.83± 0.39) were significantly highcr than those in the KR (0.30± 0.48 and 0.20± 0.42) and control groups (0.01 ± 0.01 and 0.40±0.52) (P＜0.05).Average trunk angular displacements in all four directions [Anterior (2.83±0.93;6.15± 1.85),Posterior (2.56±0.88;5.97±1.74);Left (2.86±1.16;6.49±2.42),Right (2.68±1.43;5.98±2.05)] in the KP group was significantly higher than in the others (P＜0.05).No significant differences were detected between the KR and control groups in BBS results or in posture.Conclusions Static standing training should incorporate real time biofeedback.It is then more effective than conventional standing training or training with section results feedback.It is worth spreading in clinical applications.

OBJECTIVETo investigate clinical phenotype and genetic characteristics of a 30-year-old infertile female carrying a mosaic ring 21 chromosome.

METHODSA combination of techniques including G-banding, C-banding, fluorescence in situ hybridization (FISH) and SNP array were performed to investigate the breaking point of the r(21).

RESULTSThe karyotype of the patient was mos 46,XX,r(21)[166]/46, XX,der(21)[60]/45, XX, -21[20]/46, XX,dic r(21)[4].ish del(21)(q22.2?)(21qter-, AML1+, D21S259/D21S341/D21S342+). arr 21q22.3(43 457 934-48 093 361) × 1, 21q22.2q22.3(40 218 429-43 457 934)× 1-2. The karyotypes of her parents were both normal.

CONCLUSIONClinical phenotypes of patients carrying a ring 21 mainly depends on the percentage of abnormal cells and the deleted chromosomal fragment. The small uterus and oligomenorrhea in our patient may be attributed to the mosaic ring 21 chromosome.

Adult ; Chromosome Banding ; Chromosome Deletion ; Chromosomes, Human, Pair 21 ; genetics ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Infertility, Female ; diagnosis ; genetics ; Karyotyping ; Ring Chromosomes