ObjectiveTo evaluate the clinical efficacy and adverse effects of Shugan Hewei prescription combined with vonoprazan in the treatment of refractory gastroesophageal reflux disease （RGERD） due to qi depression and phlegm obstruction. MethodEighty RGERD patients who met the inclusion criteria underwent 24-hour pH impedance and high-resolution esophageal manometry and electronic gastroscopy. The 80 patients were randomly assigned to an observation group （Shugan Hewei prescription， one bag each time， twice a day + vonoprazan， 20 mg each time， once a day） and a control group （vonoprazan， 20 mg each time， once a day） by the random number table method. The treatment in both groups lasted for 4 weeks. The clinical efficacy was examined. The scores of TCM symptoms （pharyngeal discomforts such as phlegm obstruction， retrosternal discomfort， and belching）， somatic symptoms， quality of life， and improvement of esophageal mucosa under gastroscopy were observed in both groups before treatment and after treatment for 2 and 4 weeks. ResultSeventy-five patients completed the trial were included in this study， including 38 patients in the observation group and 37 patients in the control group. The total response rate in the observation group was 89.47%（34/38）， which was higher than that （62.16%，23/37） in the control group （χ²=13.014， P<0.01）. After treatment， the scores of esophageal mucous membrane， reflux disease symptoms， TCM symptoms， gastroesophageal reflux disease health-related quality of life scale （GERD-HRQL）， and somatic self-rating scale （SSS） decreased in both groups（P<0.05）. Moreover， the observation group outperformed the control group in alleviating heartburn， acid reflux， throat discomforts， midnight coughing， nausea and dry vomiting， mucousy mouth， and insomnia in the patients with GERD （P<0.05，P<0.01）. However， the two groups showed no statistically significant differences in the improvement of esophageal mucosa after treatment. ConclusionThe combination of Shugan Hewei prescription with vonoprazan was superior to vonoprazan alone in treating RGERD regarding clinical symptoms， physical signs， quality of life， and somatic symptoms， without causing obvious adverse effects.

Myocardial fibrosis is a key link in the occurrence and development of diabetic cardiomyopathy. Its etiology is complex, and the effect of drugs is not good.Cardiomyocyte apoptosis is an important cause of myocardial fibrosis. The purpose of this study was to investigate the effect of gaseous signal molecule sulfur dioxide (SO2 ) on diabetic myocardial fibrosis and its internal regulatory mechanism. Masson and TUNEL staining, Western-blot, transmission electron microscopy, RT-qPCR, immunofluorescence staining, and flow cytometry were used in the study, and the interstitial collagen deposition, autophagy, apoptosis, and changes in phosphatidylinositol 3-kinase (PI3K)/AKT pathways were evaluated from in vivo and in vitro experiments. The results showed that diabetic myocardial fibrosis was accompanied by cardiomyocyte apoptosis and down-regulation of endogenous SO2 -producing enzyme aspartate aminotransferase (AAT)1/2 . However, exogenous SO2 donors could up-regulate AAT1/2 , reduce apoptosis of cardiomyocytes induced by diabetic rats or high glucose, inhibit phosphorylation of PI3K/AKT protein, up-regulate autophagy, and reduce interstitial collagen deposition. In conclusion, the results of this study suggest that the gaseous signal molecule SO2 can inhibit the PI3K/AKT pathway to promote cytoprotective autophagy and inhibit cardiomyocyte apoptosis to improve myocardial fibrosis in diabetic rats. The results of this study are expected to provide new targets and intervention strategies for the prevention and treatment of diabetic cardiomyopathy.

Objective:To observe the effect of methylphenidate hydrochloride (MPH) combined with mentalization-based family therapy (MBFT) on clinical efficacy and social function in children with attention deficit hyperactivity disorder (ADHD).Methods:Sixty-four children with ADHD diagnosed in Wuxi Children's Hospital and Affiliated Hospital of Jiangnan University from June 2019 to May 2021 were selected and divided into observation group ( n=32) and control group ( n=32) according to the random number table.Children in both groups received methylphenidate hydrochloride extended-release tablets, while those in the observation group were given additional MBFT.The duration of treatment was 12 weeks in both groups.The parent symptom questionnaire (PSQ), swanson nolan and pelham-version Ⅳ (SNAP-Ⅳ) parent Al scale, and Weiss impairment functional scale (WFIRS-P) were used to evaluate the effectiveness of treatment.Statistical analysis was performed by SPSS 25.0 statistical software.In particular, the χ2 test was used for counting data and the paired sample t test was used for comparison of measurement data between the two groups before and after treatment. Results:(1) All the PSQ dimension scores of patients in the observation group and the control group after treatment were significantly lower than those before treatment (all P<0.01). Compared with the control group after treatment, the PSQ dimension scores of personality and behavior problems ((1.25±0.15), (0.94±0.18), t=7.484, P<0.001), learning problems ((1.57±0.16), (1.32±0.20), t=5.522, P<0.001), psychosomatic disorders ((0.56±0.11), (0.44±0.13), t=3.986, P<0.001), impulse hyperactivity ((1.76±0.23), (1.54±0.25), t=3.663, P<0.001), anxiety ((0.94±0.12), (0.76±0.11), t=6.255, P<0.001) and hyperactivity index ((1.74±0.19), (1.51±0.16), t=5.238, P<0.001) decreased significantly in the observation group after treatment.(2) Compared with the pre-treatment period, the SNAP-Ⅳ scale scores of attention deficit, impulsivity-hyperactivity and oppositional defiance were significantly lower in both groups after treatment (all P<0.01); and compared with the control group, the SNAP-Ⅳ scale scores of the above three dimensions were significantly lower in the observation group (all P<0.01). (3) All six dimensions (family, learning and school, life skills, self-management, social activities, and risk-taking activities)of the WFIRS-P scale were significantly lower in the children in the observation group after treatment compared with those before treatment (all P<0.01), and all the six dimensions of the WFIRS-P scale were significantly lower in the observation group compared with those in the control group (all P<0.01). Conclusion:Methylphenidate hydrochloride extended-release tablets combined with MBFT can significantly improve the clinical symptoms and social function of children with ADHD.

OBJECTIVE:To investigate the effects of levetiracetam on sex hormone and thyroid hormone of epileptic children and to evaluate its safety. METHODS:A total of 22 newly diagnosed epileptic children were selected from the Affiliated Hospital of Nantong University(hereinafter refferred as our hospital)during Jul. 2013-Feb. 2015 as observation group. During same peri-od,17 children underwent physical examination in our hospital were selected as control group. Observation group was given Le-vetiracetam tablets with initial dose of 10 mg/kg,increasing by 10 mg/(kg·d) every week or every two weeks [target dose of 30-40 mg/(kg·d)] for 12 months. The levels of sex hormone(follicle stimulating hormone,luteinizing hormone,prolactin,proges-terone,testosterone and estradiol)and thyroid hormone(TT3,TT4,FT3,FT4,TSH)were observed before medication in control group and before and 3,6,12 months after medication in observation group. The occurrence of ADR was recorded in observation group. RESULTS:Before medication,there was no statistical significance in the levels of sex hormone or thyroid hormone be-tween 2 groups(P>0.05). Three,six,twelve months after medication,there was no statistical significance in the levels of sex hormone in observation group compared to before medication(P>0.05). Three,six months after medication,there was no statis-tical significance in the levels of thyroid hormone in observation group compared to before medication (P>0.05). Twelve months after medication,there was no statistical significance in the levels of TT3,TT4,FT4 or TSH compared to before medi-cation(P>0.05);the level of FT3 was increased significantly,with statistical significance(P<0.05). Two cases of observation group suffered from ADR (9.1％). Without special treatment,the symptoms all disappeared 1-2 weeks later. CONCLUSIONS:Levetiracetam can be used for pediatric epilepsy and has no significant effects on the level of sex hormone,but increases the lev-el of FT3.

Objective to provide the evidence for inducing the SAP model in rats with proper concentration of sodium taurocholate.Methods 60 SD rats were divided into sham operated group, group of 1.5% in concentration, group of 3.5% in concentration and group of 5% in concentration randomly, while the SAP model was induced by the sodium taurocholate concentration of 1.5%,3.5% and 5% with the method of retrograde injection into the biliopancreatic duct.To calculate the mortality of different groups, measure the serum amylase, tumor necrosis factor -α(TNF -α) and interleukin -6 (IL -6),and to observe the pancreatic pathological scores of HE staining in rats.Results The mortality in group of 5% in concentration has a significant ascending compared with group of 1.5% in concentration, while the serum amylase, tumor necrosis factor -α(TNF -α) , interleukin -6( IL -6), pathological score of hemorrhage and acinar necrosis in group of 5% in concentration have a significant ascending compared with group of 1.5% in concentration and group of 3.5% in concentration.Conclusions A better SAP model may be induced by sodium taurocholate with the concentration of 5% by the method of retrograde injection into the biliopancreatic duct, which may accord with the physiological and pathological manifestation of SAP.

Objective To investigate the changes in the abilities of invasion and metastasis in surviving human lung adenocarcinoma (A549) cells after X-ray irradiation and the related mechanism.Methods The change in radiosensitivity after X-ray irradiation was determined by colony formation assay.The abilities of invasion and metastasis were evaluated by MTF adhesion assay and Transwell invasion and migration assay in vitro.The mRNA and protein expression of E-cadherin,vimentin,tumor growth factor (TGF)-β1,matrix metalloproteinase (MMP)-2,and MMP-9 was measured by real-time RT-PCR using SYBR Green fluorescence and Western blot.Results The colony formation assay showed that the surviving A549 cells after X-ray irradiation were more resistant to irradiation (ratio of D0 values =0.94).Their abilities of adhesion,invasion,and migration were significantly increased by 1.46 times,1.40 times,and 1.45 times,respectively.In addition,the surviving cells showed enlarged intercellular spaces and had many long pseudopodi.Compared with those in the control group,the mRNA expression levels of vimentin,TGF-β1,MMP-2,and MMP-9 of surviving cells were increased by 1.37 times,2.37 times,1.80 times,and 1.50 times,respectively,the protein expression levels of the above substances were increased by 1.60 times,1.80 times,1.10 times,and 1.20 times,respectively,and the mRNA and protein expression levels of E-cadherin were decreased by 59.4％ and 74.6％.Conclusions The surviving A549 cells after X-ray irradiation have significantly increased abilities of invasion and metastasis.This may be due to radiationinduced TGF-β1 expression increase that in turn promotes epithelial-mesenchymal transition and also due to radiation-induced MMP-2 and MMP-9 expression increase.

Objective To investigate the effect and mechanism of decitabine (DAC) on the proliferation of human cholangiocarcinoma CCLP1 cells in vitro and in vivo.Methods After treated with various concentrations of DAC,cell growth inhibition rates were determined by CCK-8 assay.Cell cycle and cell apoptosis were analyzed by flow cytometry.Cell autophagy was observed under fluorescence microscope.The effect of DAC on the growth of cholangiocarcinoma in vivo was determined in a CCLP1 mice xenograft model.Results The proliferation rate of CCLP1 cells in the DAC-treated group decreased in a time-concentrated dependent manner.After treatment with DAC,the cell cycle of CCLP1 cells was arrested at the G2/M phase.The apoptosis rate was significantly higher in the treatment group over the control group.Cell autophagy was observed after treatment with DAC in CCLP1 cells.The tumor growth of implanted CCLP1 cells significantly slowed down after the mice were treated with 0.8 mg/kg DAC,6 times weekly for 2 weeks.Conclusion DAC can inhibit the proliferation of cholangiocarcinoma in vitro and in vivo.

Objective To control IDS virus (HIV)transmission through blood, provide low -risk blood donors to donate regularly, and ensure blood safety and reduce the risk of blood transfusion. Methods By analyzing HIV antibody(anti-HIV) test results, HIV infection and prevalence of blood donors from 2000 to 2009, susceptible people were identified,prevented,educated,in order to prevent the spread of HIV. Results A total of 10 years in Huainan region 361 cases of anti-HIV positive were screened out. Anti-HIV-positive of voltmtary blood donors were recognized anti-HIV positive in 4 cases ,accounting for 0.209/10 000 of the total voluntary blood donation. Epidemiological analysis in 4 cases of anti-HIV confirmed positive results: the education level of all was less than high school,75% were the local household registration ;25% were mobile population, and all were young adults, aged from 23 to 38 years;75% were workers,and 25% were temporary workers and the service sector. Conclusion By strictly blood screening to blood donation, strengthening the management, intensify propaganda against AIDS in efforts, raising people 's awareness of prevention,the spread of AIDS could be prevented and controlled.

Objective To observe the effect of contortrostafin on human glioma xengoraft model and explore its mechanism.Method Animal models were established on BALB/c nude mice with subcutaneously transplanted neoplasma of U87 glioma.The nude mice bearing withU87 slioma were devided randomly into two groups,which were treated without drugs or with doses of 40 μg/d.The dimension of xenografts was measured and the living state of nude mice with U87 glioma was observed.The protein expression of microvesel density(MVD),bFGF in each paraff in imbedded xenograft of nude mice bearing with U87 glioma were detected by immunohistochemistry staining.Result Contortrostafin inhibited the growth of xenografts in nude mice with U87 glioma(P＜0.05),and the tumor volume was reduced by 50%.Meanwhile the control group highly expressed bFGF at the level of protein,coupling with increase of MVD.Compared with the dissolvent control group,contortrostatin treated group showed lower expression of bFGF,(P＜0.01)and more decrease in MVD(P＜0.01).Conclusion Contortrostatin diffusa has significant inhibitive effect on human glioma xenograft.

Objective To investigate the efficacy, technical tip, safety and complication prevention of combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms. Methods Among 10 cases who were diagnosed with giant intracranial aneurysms,Neuroform stents were released for supporting the neck of aneurysms, then micro-catheters were inserted into aneurysms through lumina of stents and coils were implanted. Results All the operations were completed successfully. There was no complication in these cases. The aneurysms were packed totally in 9 cases and partly in 1 case.Eight postoperative cases were followed up by 6 to 17 months. Neither bleeding nor thrombus was found, and all the patients recovered well. Conclusion Combining Neuroform stents and Guglielmi detachable coils for treating acute ruptured giant intracranial aneurysms is a safe and effective method.