OBJECTIVE: To identify phytochemical constituents present in the extract of flowers of Xanthoceras sorbifolia and evaluate their anti-oxidant and anti-hyperglycemic capacities. METHODS: The AlCl₃ colorimetric method and Prussian Blue assay were used to determine the contents of total flavonoids and total phenolic acids in extraction layers, and the bioactive layers was screened through anti - oxidative activity in vitro. The Waters ACQUITY UPLC system and a Waters ACQUITY UPLC BEH C₁₈ column (2.0 mm × 150 mm, 5 μm) were used to identify the ingredients. And anti-oxidative ingredients were screened by off-line UPLC-QTOF-MS/MS-free radical scavenging. The ameliorative role of it was further evaluated in a high-fat, streptozotocin-induced type 2 diabetic rat model and the study was carried out on NADPH oxidase (PDB ID: 2CDU) by molecular docking. RESULTS: Combined with the results of activity screening in vitro, the anti - oxidative part was identified as the ethyl acetate layer. A total of 24 chemical constituents were identified by liquid chromatography-mass spectrometry in the ethyl acetate layer and 13 main anti-oxidative active constituents were preliminarily screened out through off-line UPLC-QTOF-MS/MS-free radical scavenging. In vivo experiments showed that flowers of X. sorbifolia could significantly reduce the blood glucose level of diabetic mice and alleviate liver cell damage. Based on the results of docking analysis related to the identified phytocompounds and oxidase which involved in type 2 diabetes, quercetin 3-O-rutinoside, kaempferol-3-O-rhamnoside, isorhamnetin-3-O-glucoside, and isoquercitrin showed a better inhibitory profile. CONCLUSION The ethyl acetate layer was rich in flavonoids and phenolic acids and had significant anti-oxidant activity, which could prevent hyperglycemia. This observed activity profile suggested X. sorbifolia flowers as a promising new source of tea to develop alternative natural anti-diabetic products with a high safety margin.

Objective:To compare the short-term efficacy and the safety of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (BTNs).Methods:This prospective randomized controlled trial, performed from December 2019 to September 2021, included 36 patients with solid or predominantly solid BTNs who met the eligibility criteria and provided written informed consent at the Nanjing sub-center (Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine). Patients were assigned to either the MWA group or the RFA group (18 patients in each group) at a ratio of 1∶1 using a block randomization design and allocation concealment using sealed envelope randomization. The independent-sample t-test and χ2 test were used to compare the volume reduction rates (VRRs), effective rates (VRRs≥50%), cosmetic scores, and complication rates at 1, 3, and 6 months after treatment between the two groups. Results:The clinical characteristics of the two groups of patients were comparable. After ablation, the nodule volume was significantly reduced in both groups. At 1, 3, and 6 months, there was no significant difference in the volume between the two groups (all P>0.05). At 3 months, the RFA group had a larger VRRs than that in the MWA group (62.08%±12.46% vs. 46.90%±23.16%, t=-2.45, P=0.021). However, at 1 and 6 months, no statistical significance was observed (both P>0.05). No significant difference was observed in the effective rates at the last follow-up (14/18 vs. 18/18, P=0.104). However, the RFA group had a lower cosmetic score than that in the MWA group (1.78±0.43 vs. 2.17±0.51, t=-2.47, P=0.019). There was no statistically significant difference in the complication rates between the two groups (all P>0.05). Conclusions:Both MWA and RFA were effective and safe treatments for BTNs, with no significant differences in short-term efficacy and safety. In addition, the RFA group showed slightly more favorable outcomes than the MWA group in terms of cosmetic improvement.

To investigate the effectiveness and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021. The patients were followed up once every 3 months for 3-12 months. Levels of serum parathyroid hormone (PTH), calcium and phosphorus were detected before and 20 min, 4h and 1day after ablation, and during follow-up period. The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up. The technical and clinical success of MWA were assessed as well. At the end of follow-up, median serum PTH [66.60 (42.21,80.03) ng/L vs.169.90 (89.01,396.50) ng/L] and calcium [2.39 (2.32,2.49) mmol/L vs. 2.75 (2.57,2.96) mmol/L] levels in 12 patients decreased significantly (all P<0.05). A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients, while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range, and 2 of the patients remained abnormal PTH and calcium levels. The clinical cure rate was 50%. The volumes of all lesion after ablation were significantly decreased ( P<0.05), with the technical success rate reaching 92.3%. No serious complications were observed. Ultrasound-guided MWA, thus, is safe and effective in the treatment of PHPT.

Objective:To investigate clinical significance and related factors of magnetic resonance hyperintense vessel sign (HVS).Methods:The clinical data and related imaging parameters of 109 patients with acute anterior circulation occlusion cerebral infarction, who admitted to Northern Theater Command General Hospital of People′s Liberation Army from April 2017 to August 2019, were analyzed retrospectively. Brain magnetic resonance imaging (MRI) examinations including fluid attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI) and three dimensional time of flight magnetic resonance angiography (3D TOF MRA) sequences within 24 hours of onset were performed. According to the distribution range of HVS in FLAIR sequence, the patients were divided into four grades (0, 1, 2 and 3), grades 0 and 1 belonging to HVS low grade group, and grades 2 and 3 HVS high grade group. Univariate and multivariate analyses were made to explore related factors of HVS. Fifty-two patients who completed baseline CT within six hours of onset before MRI examination were performed CT-Alberta Stroke Program Early CT Score (CT-ASPECTS) and DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS).The difference between CT-ASPECTS and DWI-ASPECTS was calculated. When the difference of ASPECTS ≤1, they were categorized as ASPECTS unchanged group (AN group); when the difference of ASPECTS>1, they were categorized as ASPECTS changed group (AY group). These two groups were compared to explore whether there was any difference in HVS grade, and Spearman correlation analysis was performed to investigate the relationship between HVS grade and the difference of ASPECTS.Results:The difference of hyperlipidemia, TOAST classification (large artery atherosclerosis (LAA), other etiology (SOE) or undetermined etiology (SUE)) and Willis circle classification (types Ⅰ, Ⅱ, Ⅲ and Ⅳ) between HVS groups were remarkable (58.6% (34/58) vs 37.3% (19/51), χ2=4.959, P=0.026; 23/5/23 vs 43/1/14, P=0.004; 3/14/12/22 vs 7/29/14/8, χ2=13.124, P=0.004). Other clinical factors and the locations of vessel occlusion did not show significant difference ( P>0.05). Multivariate Logistic regression analysis indicated that LAA in TOAST classification (LAA vs SOE or SUE, OR=3.054, 95% CI1.257-7.422, P=0.014), Willis circle type Ⅰ (type Ⅰ vs type Ⅳ, OR=5.494, 95% CI1.074-28.091, P=0.041), and type Ⅱ (type Ⅱ vs type Ⅳ, OR=5.571, 95% CI1.895-16.372, P=0.002) were independent related factors to stimulate wide distribution of HVS. The grades of HVS were significantly different between the AN group and the AY group (1/15 vs18/18, χ2=9.114, P=0.002). Spearman correlation analysis showed that HVS grade was negatively correlated with the difference of ASPECTS ( r=-0.573, P<0.001). Conclusions:Both TOAST and Willis circle classifications are crucial factors affecting HVS distribution. HVS distribution range reflects the status of collateral compensatory. Recognizing HVS may help to evaluate the progress of early cerebral infarction volume.

Active surveillance ( AS ) is now regarded as an alternative strategy of treatment for papillary thyroid microcarcinoma ( PTMC) . Most cases of newly diagnosed thyroid cancer are small indolent microcarcinoma and could be good candidates for AS instead of immediate surgery. Many considerations must be taken into account for establishing selection criteria suitable for AS of PTMC, including the characteristics of the tumor, the patient, and the medical team. If possible, AS of PTMC should be a part of a prospective clinical trial to ensure long-term safety and to identify clinical and ( or) molecular markers of the progression of PTMC. In this review, we discuss lessons regarding surgical interventions for PTMC, and then describe the concept, application, caveats, unanswered questions, and future perspectives of AS for PTMC. For appropriately selected patients with PTMC, AS can be a good alternative to immediate surgery.

Objective To investigate the relationship between histogram analysis of DCE-MRI quantitative parameters and clinical stage of nasopharyngeal carcinoma (NPC).Methods 70 patients with NPC confirmed by pathology underwent MRI examination and staging.NPC tumors were measured by full-volume ROI setting method,and the obtained DCE-MRI quantitative parameters were analyzed by histogram.Spearman correlation coefficients were obtained to evaluate the potential correlation between the DCE-MRI histogram quantitative parameters and NPC clinical stages.Results The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (mean,10 th,kurtosis),and Ve (mean,90 th,skewness)had correlation with T stage (P＜0.05,respectively).The histogram-based Ktrans (mean)and Ve (mean,90 th) showed correlation with N stage (P＜0.05,respectively).The histogram-based Kep (kurtosis)and Ve (mean)had correlation with M stage (P＜0.05,respectively).The histogram-based Kep had no correlation with N stage,and Ktrans had no correlation with M stage. The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (10 th,75 th,kurtosis)and Ve (mean,75 th,90 th)had correlation with overall stage (P＜0.05,respectively).Conclusion The histogram analysis of DCE-MRI quantitative parameters showed that the multiple parameters associated with NPC overall stages.DCE-MRI quantitative parameters non-invasively reflect the aggressiveness and progression of NPC.The histogram analysis of DCE-MRI quantitative parameters may play a role in clinical stage of NPC.

Objective To explore the dynamic trend and main influencing factors of the prevalence of subthreshold depression after stroke,so as to provide reference for the primary prevention and nursing intervention of post-stroke depression. Methods A total of 123 stroke patients admitted to the department of neurology of Daqing People's Hospital from September 2017 to June 2018 were selected by convenience sampling method. Major Depressive Disorder Scale (CES-D), Hamilton Depression Scale (HAMD-17), Behavioral Inhibition System and Behavioral Activation System Scale (BIS/BAS) and National Institutes of Health Stroke Scale (NIHSS) were applied in the investigation. Results The prevalence of subthreshold depression after stroke at baseline, 3 months and 6 months was 25.6%,18.6% and 20.4% respectively, and there was no statistical significant in the difference in prevalence at each time point (P＞ 0.05). The results of regression analysis showed that, at the time point of 2 weeks after stroke, gender, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 3 months, age and behavioral activation level were the main factors of subthreshold depression after stroke; after 6 months, the number of complications and the level of behavioral activation were the main factors of subthreshold depression after stroke. Conclusions The prevalence rate of post-stroke subthreshold depression decreased first and then increased with time. The main factors of post-stroke subthreshold depression were different at each time point, and medical staff should treat differently according to different time points, so as to achieve the primary prevention of post-stroke depression.

Objective To evaluate the role of the diffusion kurtosis imaging(DKI)in the differential diagnosis of breast lesions. Methods Seventy five breast lesions(32 benign and 43 malignant)in 72 patients confirmed by histopathology were studied. All patients underwent 3.0 T MR examinations, including T1WI, T2WI, T2WI-spectral adiabatic inversion recovery, 4b diffusion-weighted imaging, and dynamic contrast-enhanced MR imaging(DCE-MRI). Data were post-processed by mono-exponential and diffusion kurtosis models for quantitation of ADC, apparent diffusion for non-Gaussian distribution(D), and apparent kurtosis coefficient(K). All breast lesions were described with the classification by breast imaging report and data system(BI-RADS). Lesions with BI-RADS class 4B or above were rated as malignancy. Independent sample t test was used to compare the ADC, D, and K value differences between benign and malignant lesions . ROC analysis was performed to assess the role of ADC, D, K value, and BI-RADS in the differential diagnosis of breast lesions. The morphological characteristics, time-signal curve(TIC)type, and other differences between benign and malignant lesions were analyzed with Chi-square test. Results ADC and D values were significantly lower in malignant than in benign lesions(P<0.01). Conversely, K value was significantly higher in malignant lesions than in benign ones(P<0.01). The shape of the benign and malignant breast lesions, edge, enhancement mode, TIC, and BI-RADS classification difference had statistical significance(P<0.05, respectively). The areas under the ROC curve of ADC, D, K, DCE-MRI, and DCE-MRI combined with K value were 0.857, 0.884, 0.949, 0.806, and 0.958, respectively. DCE-MRI combined with K value had the highest diagnosis efficiency. At a cutoff value of K= 0.856, the sensitivity and specificity were 83.7% and 93.8%, respectively. Conclusions DKI model showed higher diagnostic efficiency than that of traditional DWI model. DCE-MRI combined with K value can increase the diagnostic efficiency in breast lesions.

Objective:To establish the control charts for early warning of diarrhea based on the syn-dromic surveillance data from enteric clinic in Beijing .Methods:The outpatient data from enteric clinic of a Grade Three General hospital in Haidian district , Beijing from April 1 to Oct.31, 2009 and from May 1 to Nov.10, 2010 were collected, according to the moving average method , the baseline calcula-ted, the value of probability αand μα, the early warning value based on the formula “w=Xj +μαSj”calculated and the early warning control charts drew at last .Results:According to the harmfulness , the severity and controllability of diarrheal diseases , the value of probability αwas determined as 0.01, thenμα( unilateral) as 2, based on the early warning value , the control charts of diarrheal diseases , bacillary dysentery and other infectious diarrhea were established .Conclusion:The enteric clinic requires to fur-ther collect baseline data to evaluate and continuously adjust the established control charts for the best early warning model in accordance with the enteric clinic .