ObjectiveTo explore new targets and herbal medicines of total ginsenosides in ameliorating alcoholic hepatitis （AH） by data mining and experimental validation and to provide new directions for the clinical treatment of AH. MethodGSE28619 was selected as the test set from the GEO database and GSE83148 and GSE103580 were selected as the validation sets. The limma package and weighted gene co-expression network analysis （WGCNA） were employed to identify the AH-related differentially expressed genes and modular genes， and Venny was used to extract the common genes. The protein-protein interaction （PPI） network was constructed and the enrichment analysis was carried out. The hub genes were further screened and evaluated for their diagnostic value. After validation with the datasets， new potential targets of AH and traditional Chinese medicine were predicted. Molecular docking between the targets and active ingredients of traditional Chinese medicine was performed， and the results were validated by experiments. Eight out of 48 SD rats were randomly selected into a blank group and received an equal amount of normal saline. The rest rats were subjected to modeling with ethanol by gavage and then randomized into low- （10 mg·kg^-1）， medium- （20 mg·kg^-1）， and high-dose （40 mg·kg^-1） total ginsenosides， model， and positive control （metadoxine， 117 mg·kg^-1） groups. After 3 weeks of gavage， serum samples were collected for the measurement of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） levels， and liver samples were collected for hematoxylin-eosin （HE） staining. Western blot and Real-time PCR were employed to determine the protein and mRNA levels， respectively， of potential targets in the liver tissue. ResultData mining predicted the potential genes： Proto-oncogene FOS and collagen type Ⅰ alpha 2 （COL1A2）. Experimental validation showed that the liver injury was alleviated after drug administration compared with that after modeling. The serum AST and ALT levels were reduced after drug administration. The protein and mRNA levels of FOS were significantly up-regulated， while those of COL1A2 were down-regulated after drug administration. ConclusionTotal ginsenosides ameliorate HA via FOS and COL1A2.

Objective:To provide a reference for the hierarchical management of clinical nurses in top three hospitals, the hierarchical management evaluation system was conducted and evaluated in the present study.Methods:On the context of three-dimensional structure theory of medical quality, the Delphi method was applied to conduct two rounds of correspondence consultation among 23 nursing experts, and then related indexes were established based on the evaluation results and recommendations.Results:An evaluation system for hierarchical management of clinical nurse in top three hospitals was finally constructed, which included 3 first-grade and 19 second-grade indexes. The effective recovery rate of the two rounds of expert questionnaires and authority Cr of two rounds of expert consultation were 100% and 0.915, respectively. The Kendall coefficients of concordance for significance and operability of the first-grade and second-grade indexes were 0.353/0.515 and 0.344/0.469, respectively ( P<0.01). Conclusions:The hierarchical management of clinical nurses in top three hospitals constructed based on three-dimensional structure theory has reliability and feasibility.

Objective:To explore the relationship between input and output of occupational health funds, and to provide basis for relevant departments to make decisions.Methods:In September 2018, a state-owned iron ore in Hebei Province (mining history of more than 10 years, which can represent the general type of iron ore) was selected as the research object. Through the investigation and collection of enterprise general situation, occupational health input, loss and output related indicators, the iron mine occupational health expenditure input-output table and model were established, and the digital relationship between the investment and output was solved by MATLAB software.Results:The labor consumption in the departments of underground mining, open pit mining, crushing and rock discharging, transportation, tailings and mineral processing (taking labor wages as reference) were 756.46, 1.281.78, 987.61, 1 570.71, 50.956 and 18.9116 million yuan/year respectively. The output value of each sector is 11 207.19, 18 989.95, 15 176.40, 25 294.00, 7.704.94 and 280.1797 million yuan/year respectively. The ratio of health input to total output was 0.004 5, and the ratio of occupational health input to output was 1/0.046.Conclusion:The input-output table model of occupational health in iron mine can reflect the relationship between input and output of occupational health funds. The input situation of the coal mine is poor, and the input does not bring obvious occupational health benefits.

Objective:To explore the relationship between input and output of occupational health funds, and to provide basis for relevant departments to make decisions.Methods:In September 2018, a state-owned iron ore in Hebei Province (mining history of more than 10 years, which can represent the general type of iron ore) was selected as the research object. Through the investigation and collection of enterprise general situation, occupational health input, loss and output related indicators, the iron mine occupational health expenditure input-output table and model were established, and the digital relationship between the investment and output was solved by MATLAB software.Results:The labor consumption in the departments of underground mining, open pit mining, crushing and rock discharging, transportation, tailings and mineral processing (taking labor wages as reference) were 756.46, 1.281.78, 987.61, 1 570.71, 50.956 and 18.9116 million yuan/year respectively. The output value of each sector is 11 207.19, 18 989.95, 15 176.40, 25 294.00, 7.704.94 and 280.1797 million yuan/year respectively. The ratio of health input to total output was 0.004 5, and the ratio of occupational health input to output was 1/0.046.Conclusion:The input-output table model of occupational health in iron mine can reflect the relationship between input and output of occupational health funds. The input situation of the coal mine is poor, and the input does not bring obvious occupational health benefits.

OBJECTIVE: To compare the efficacy and safety of different antiviral and antifibrotic regimens in patients with chronic hepatitis B (CHB) and hepatic fibrosis and the incidence of hepatocellular carcinoma (HCC) associated with these therapies. METHODS: A total of 840 patients with CHB and concurrent hepatic fibrosis, who received antiviral therapy in Nanfang Hospital between June, 2010 and June, 2018, were enrolled in this follow-up cohort study. The patients were assigned to 3 cohorts matched for gender, age (difference≤5 years), HBeAg status and liver stiffness measurement (LSM) for treatment with one of the 3 antiviral drugs, namely entecavir, tenofovir dipivoxil and adefovir dipivoxil; each cohort was divided into 2 groups, with one of the groups having a combined treatment with Fufang Biejiaruangan tablet. The cumulative negative conversion rate of HBV DNA, normalization rate of ALT, hepatic fibrosis regression and the incidence of HCC were compared among the 3 cohorts and across the 6 groups at 144 weeks. RESULTS: A total of 749 patients were available to follow-up at 144 weeks. Compared with the baseline data, the cumulative negative conversion rate of HBV DNA increased gradually and the abnormal rate of ALT decreased significantly over time during the treatment in all the 6 groups (all < 0.001). Compared with the any of the antiviral drugs used alone, the combined treatments all resulted in significantly better antifibrotic effects (χ=11.345, χ=10.160, χ=6.358; all < 0.05). At 144 weeks, the incidence of HCC were 2.2%, 1.7%, 1.7% and 3.3% in enecavir group, enecavir with Biejiaruangan tablet group, adefovir group, and adefovir with Biejiaruangan tablet group, respectively, showing no significant difference between the two cohorts (4 groups; χ=6.813, =0.138). None of the patients in the 2 groups with tenofovir treatment had HCC by the end of the observation. CONCLUSIONS Antiviral therapy combined with antifibrotic therapy can effectively reverse hepatic fibrosis and reduce the incidence of HCC in patients with CHB; among the 3 antiviral drugs, tenofovir dipivoxil can be a better option for reducing the incidence of HCC in these patients.
Antiviral Agents ; Carcinoma, Hepatocellular ; etiology ; DNA, Viral ; Follow-Up Studies ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; complications ; Liver Neoplasms ; etiology ; Prospective Studies

Objective The aim of this study was to retrospectively review the efficacy and safety of treatment for unresectable locally advanced non-small cell lung cancer (LA-NSCLC).Methods A total of 98 patients treated in our hospital between January 2010 and December 2015 were enrolled in this study.Patients were divided into three groups:the thoracic radiotherapy (TRT) alone,concurrent chemoradiotherapy,and sequential chemoradiotherapy groups.The progression-free survival (PFS) and overall survival (OS) were analyzed via the Kaplan-Meier method,and compared with the log-rank/Breslow test.The prognostic factors were analyzed using the Kaplan-Meier and Cox multivariate proportional hazards models.Results The median PFS in the concurrent therapy group was longer than that in the TRT alone group (P ＜ 0.05).The median OS was improved in patients treated with concurrent or sequential therapy than in the TRT alone group (P ＜ 0.05).N stage,chemotherapy regimens,and radiotherapy modalities were independent prognostic factors of PFS in all patients (P ＜0.05).Similarly,N stage was an independent prognostic factor of OS in all patients (P ＜ 0.05).Overall,the treatment was deemed safe.The occurrence of hematotoxicity related to Karnofsky performance score (KPS) and chemotherapy regimens (P ＜ 0.05).Conclusion Patients with a lower N stage who received cisplatin-based double chemoradiotherapy demonstrated improved survival rates.Survival was significantly improved in LA-NSCLC patients treated with concurrent or sequential therapies compared with TRT alone.Overall,the treatment is safe.KPS and chemotherapy combination regimens may increase the occurrence of hematotoxicity.

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.

Objective To explore the effect of aerobic exercises on synaptic plasticity and expression of PDE-4 in hippocampus during the aging process of rats.Methods Forty-five adult male SpragueDawley rats were randomly divided into a control group(group C),an D-galactose induced aging group (group A) and an D-galactose induced aging & aerobic exercise intervention group(group AE).All rats were induced aging for 6 weeks and group AE was given swimming exercise intervention of a moderate load simultaneously.Then Nissl's staining was conducted to observe the neurons in the dentate gyrus(DG).The immunofluorescence was employed to detect the number and density of synaptophysin (Syp) and metabotropi glutamate receptor 1(mGluR1).And the expression level of Phos-phodiesterase 4(PDE-4) mRNA and protein was observed using the,real-time PCR and Western blotting.Results Compared with group C,senile signs such as mental retardation,lethargy and tardy movement,significantly less neurons in the hippocampus,bigger cell spacing and shallower Nissl body in the cytoplasm were observed in group A.The integrated optical density(IOD) values of Syp and mGluR1 in group A decreased significantly compared to group C(P＜0.01),while those of group AE were significantly higher than group A(P＜0.01).The expression of PDE-4 mRNA and protein in Group A increased significantly compared with group C (P＜0.01),but that of group AE was significantly lower than group A (P＜ 0.01).The expression of PDE-4 mRNA was negatively correlated to the IOD value of Syp and mGluR1 (P＜0.01,P＜0.05).Conclusions The aerobic exercises can improve the morphology of hippocampal neurons and keep the number and density of Syp and mGluR1 at a certain level to maintain the synaptic plasticity,so as to improve brain function and delay the aging process.Moreover,exercise may affect brain function through down-regulating the expression of the PDE-4 gene.

Objective To investigate the serum homocysteine (HCY)levels of patients with various liver diseases,and discuss the clinical value of combined detection of HCY and other liver function indicators in liver disease diagnosis.Methods Se-lected 123 cases of inpatients with different liver diseases (79 cases of male,44 cases of female),including 39 cases of chronic active hepatitis,52 cases of cirrhosis and 32 cases of primary hepatic cancer from Department of Gastroenterology,and 90 ca-ses of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospi-tal.Detected serum HCY and some indicators of liver function (TBIL,ALT,GGT and TBA)in different liver disease groups and normal control group with Roche MODUALR automatic biochemical analyzer,and did statistic analysis.Results The serum HCY levels of chronic active hepatitis,liver cirrhosis and primary hepatic cancer were 16.25± 3.98μmol/L,20.89± 4.26μmol/L and 22.92 ± 6.08μmol/L respectively,and significantly higher than those in normal control group (8.16 ± 4.03μmol/L,t=5.352~9.021,P<0.01).The serum HCY levels of liver cirrhosis and primary hepatic cancer group were higher than that of chronic active hepatitis group (P<0.05).Serum levels of HCY were obviously lower after treatment than that before treatment (P<0.05)for three groups of liver diseases.The positive rate of HCY was higher than those of other liver function indicators (P<0.05).Conclusion Serum homocysteine may be as one of the most important indexes of liver damage,and the combined detection of other liver function indicators may have important clinical value for liver disease diagnosis,differential diagnosis,treatment and prognosis.

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.