Objective To investigate the effect of Yinchenhao decoction on renal oxidative stress injury in rats with obstructive jaundice and its association with the regulation of the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear translocation. Methods A total of 32 male Sprague-Dawley rats were randomly divided into sham-operation group (S group), model group (O group), low-dose Yinchenhao decoction group (LY group), and high-dose Yinchenhao decoction group (HY group), with 8 rats in each group. For the rats in the S group, the upper common bile duct was isolated without ligation, and for those in the other groups, double ligation of the middle and upper 1/3 of the common bile duct was performed to establish a model of obstructive jaundice. After 7 days, the rats in the LY group and the HY group were given Yinchenhao decoction by gavage at a dose of 6.3 and 18.9 mL/kg, respectively, while those in the S and O groups were given an equal volume of distilled water by gavage every day for 7 consecutive days, and the rats were treated on day 14. ELISA was used to measure the serum levels of total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT), blood urea nitrogen (BUN), and creatinine (Cr); spectrophotometry was used to measure the activity of the oxidative stress factors superoxide dismutase (SOD) and malondialdehyde (MDA) in renal tissue; quantitative real- time PCR and Western blotting were used to measure the mRNA and protein expression levels of Nrf2, Kelch-like ECH-associated protein 1 (Keap1), and NAD(P)H quinone dehydrogenase 1 (NQO1) in renal tissue; immunohistochemistry was used to measure observe the nuclear translocation of Nrf2 protein in renal tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further pairwise comparison within groups. Results Compared with the S group, the O group had significant increases in the levels of TBil, DBil, ALT、GGT, BUN, and Cr, a significant reduction in the activity of SOD, and a significant increase in the level of MDA (all P < 0.05). Compared with the O group, the LY group and the HY group had significant reductions in liver and renal function parameters, a significant increase in the activity of SOD, and a significant reduction in the level of MDA (all P < 0.05). Compared with the S group, the O group had significant reductions in the mRNA and protein expression levels of Nrf2 and NQO1 in renal tissue (all P < 0.05), and compared with the O group, the LY group and the HY group had significant increases in the mRNA and protein expression levels of Nrf2 and NQO1 (all P < 0.05), while there was no significant difference in the protein expression level of Keap1 between groups ( P > 0.05). Compared with the S group, the O group had a significant reduction in the positive rate of Nrf2 in cell nucleus in renal tissue ( P < 0.05), and compared with the O group, the LY group and the HY group had a significant increase in the positive rate of Nrf2 in cell nucleus ( P < 0.05). Conclusion Yinchenhao decoction can effectively alleviate renal injury caused by obstructive jaundice, possibly by upregulating the protein expression of Nrf2 in renal tissue and regulating the nuclear translocation of Nrf2 protein, so as to mediate the protein expression of downstream NQO1, regulate oxidative stress response caused by obstructive jaundice, and thereby alleviate renal injury in rats.

Objective:To investigate the clinical effects of intermittent oro-esophageal tube feeding (IOE) combined with Xuanqiaoliyan decotion in stroke patients with dysphagia.Methods:A prospective study was conducted. Stroke patients with dysphagia admitted to Yidu Central Hospital Affiliated Hospital of Weifang Medical University from January 2018 to December 2019 were enrolled. According to the simple random sampling method, the patients were divided into control group and observation group, with 50 cases in each group. The control group was given routine swallowing function training, including low-frequency pulse electrical stimulation, swallowing function training and acupuncture treatment. The observation group was given IOE and Xuanqiaoliyan decoction (prescription composition: Rhizoma acori tatarinowii 15 g, Radix polygalae 10 g, Rhizoma gastrodiae 15 g, Arisaema cum bile 6 g, Rhizoma typhonii 6 g, Scorpio 6 g, Bombyx batryticatus 6 g, Perilla frutescens 10 g, Rhizoma pinelliae 10 g, Pericarpium citri reticulatae 10 g, Rhizoma zingiberis recens 3 tablets, decoction 200 mL, twice in the morning and evening by oral or nasal feeding) on the basis of the control group. Both groups were treated for 14 days. The standard swallowing function assessment (SSA) and water swallow test were used to evaluate the swallowing function before and after treatment. The time required for the improvement of swallowing function, total hospitalization time and the therapeutic effects were observed and the safety assessment was conducted. Results:There were no significant differences in the gender, age, course of disease, and location and frequency of stroke between the two groups. After treatment, both the SSA scores in the two groups were decreased, and the grading of water swallow test was improved. The SSA scores in the observation group were significantly lower than that in the control group (19.8±1.8 vs. 23.2±3.2, P < 0.05), the recovery degree of water swallow test was higher than that in the control group [complete recovery (cases): 18 vs. 13, basic recovery (cases): 23 vs. 18, effective (cases): 9 vs. 19, χ 2 = -2.107, P = 0.008]. The total effective rate of swallowing function in the observation group was higher than that in the control group (94.0% vs. 80.0%, Z = 4.684, P = 0.012), the time for improvement (days: 12.8±2.6 vs. 16.9±4.3, t = 11.628, P = 0.008) and total hospitalization time (days: 20.8±4.2 vs. 33.5±5.6, t = 10.924, P = 0.015) were shorter than those in the control group. In the observation group, there was 1 case of throat discomfort during the operation of IOE, and the symptoms disappeared after the operation; there was 1 case of mild elevation of alanine aminotransferase (ALT) and blood urea nitrogen (BUN) respectively, which returned to normal after the treatment. No adverse symptoms and damage to the liver and kidney were observed in the control group. Conclusion:IOE combined with Xuanqiaoliyan decotion could significantly improve the swallowing function of stroke patients with dysphagia, shorten the hospitalization time, and improve the curative effects and lifequality.

Objective:To explore the changes in serum metabolic profile in patients with oral squamous cell carcinoma (OSCC) and to identify the diagnostic biomarkers in order to provide new ideas for the early diagnosis of OSCC.Methods:In total, 76 OSCC patients who were diagnosed at the Department of Oral and Maxillofacial Surgery and 70 healthy individuals who at the Department of Medical Center of The First Affiliated Hospital of Zhengzhou University from August 2019 to January 2020 were recruited in The study. According to the random number table method, all subjects were divided into a test group ( n=96) and a verification group ( n=50). Subjects in the test group consisted of 51 OSCC patients and 45 healthy subjects and subjects in the verification group included 25 OSCC patients and 25 healthy individuals. Serum samples and clinical data of each of the subjects were collected. The serum samples were analyzed by ultra-high-performance liquid chromatography quadrupole-Orbitrap high resolution accurate mass spectrometry. Principal component analysis, orthogonal partial least square discrimination analysis and t-test were used to profile the differential metabolites in the test group. Pathway analysis of differential metabolites was performed. In addition, binary logistic regression analysis and receiver operating characteristic analysis were used in order to establish the potential diagnostic panel. Results:Twenty-one endogenous differential metabolites were identified showing significant association with OSCC. Results of pathway analysis suggested that OSCC associated with lipid metabolism and amino acid metabolism ( P<0.05). A novel diagnostic panel consisting of lysophosphatidylcholine (LysoPC) (16∶0/0∶0), LysoPC[18∶1(9z)/0∶0], taurine and D-glutamic acid was defined. The panel performed a high area under the receiver operating characteristic curve (0.998, 95% CI: 0.994-0.999, P<0.05). Conclusions:There were obvious lipid and amino acid metabolism disorders in OSCC patients. It was an effective method to establish a diagnostic model by metabolomics.

Objective:To construct a prediction model of pancreatic fistula after pancreaticoduodenectomy and explore its application value.Methods:The retrospective case-control study was conducted. The clinicopathological data of 285 patients with periampullary diseases who underwent pancreaticoduodenectomy in the the First Affiliated Hospital of Harbin Medical University from January 2015 to September 2018 were collected. There were 183 males and 102 females, aged (56±14)years, with a range from 12 to 84 years. According to the random numbers showed in the computer, patients were randomly divided into training dataset consisting of 214 patients and validation dataset consisting of 71 patients, with a ratio of 3∶1. The training dataset was used to construct prediction model, and the validation dataset was used to evaluate performance of prediction model. Observation indicators: (1) incidence of postoperative pancreatic fistula; (2) construction of prediction model of pancreatic fistula after pancreaticoduodenectomy; (3) validation of prediction model of pancreatic fistula after pancreaticoduodenectomy. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. The accuracy of prediction model was analyzed by drawing receiver operating characteristic curve and calculating area under curve (AUC). Results:(1) Incidence of postoperative pancreatic fistula: of 214 patients in the training dataset, 45 patients had postoperative pancreatic fistula, including 39 of grade B and 6 of grade C, respectively. (2) Construction of prediction model of pancreatic fistula after pancreaticoduodenectomy. Results of univariate analysis showed that body mass index(BMI), diameter of the main pancreatic duct on computed tomography (CT) scan, diameter of the main pancreatic duct by intraoperative exploration, pancreas texture, and level of amylase in ascites at the postoperative first day were related factors for pancreatic fistula after pancreaticoduodenectomy ( χ2=32.450, 15.789, 19.577, 4.559, Z=-7.962, P<0.05). Results of multivariate analysis showed that BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651U/L were independent risk factors for pancreatic fistula after pancreaticoduodenectomy ( odds ratio=0.148, 4.286, 0.086, 95% confidence interval: 0.058-0.376, 1.736-10.580, 0.032-0.231, P<0.05). Based on results of multivariate analysis, a prediction model of pancreatic fistula after pancreaticoduodenectomy was built: the predicted value of pancreatic fistula=Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]/1+ Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]. The model had the AUC of 0.888 (95% confidence interval : 0.832-0.943, P<0.05). (3) Validation of prediction model of pancreatic fistula after pancreaticoduodenectomy: in the validation dataset, the prediction model of pancreatic fistula after pancreaticoduodenectomy had the AUC of 0.868 (95% confidence interval: 0.780-0.957, P<0.05). There was no significant difference in the AUC between the training dataset and validation dataset ( Z=0.514, P>0.05). Conclusions:BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651 U/L are independent risk factors for pancreatic fistula after pancreaticoduodenectomy. Construction of a prediction model of pancreatic fistula after pancreaticoduo-denectomy can effectively predict the risks of postoperative pancreatic fistula.

Objective To investigate the prevalence of common thyroid diseases and urinary iodine levels in the population migrated from inland to coastal areas and to evaluate the epidemiological trend of thyroid disease in Heibei Cangzhou. Methods A retrospective analysis method was adopted. All the persons who were employees of enterprises and institutions,were divided into three groups:the migrated group,who migrated from Cangzhou City and the west counties of Cangzhou City to the Port of Huanghua where they had settled permanently because of the job; the inland group, who lived in Cangzhou City all the time and the seaport group, who lived in the Port of Huanghua for a long-term. Migrated groups were divided into stable occupants and intermittent occupants. During 2010 - 2016, a follow-up survey was conducted in the three groups at Examination Center of Cangzhou Central Hospital Physical. We compared the cumulative incidences of thyroid diseases including: chronic lymphocytic thyroiditis (CLT), nodular thyroid disease and Graves's disease (GD). In migrated group, 28 persons who occasionally lived in the Port of Huanghua were detected urinary iodine levels intermittently.We compared the two parts of urinary iodine level changes for three times by collecting a urine sample,including one part from people who lived in the Port of Huanghua continuously for more than a month,and another part of people who lived in Cangzhou or Hejian County for more than half a month then returned to Port of Huanghua. Results In 2010 - 2016, a total of 7 180 residents were surveyed, of which 2 012 were in the migrated group, 2 858 were in the inland group and 2 310 in the seaport group. The incidences of CLT and nodular thyroid disease were 2.29% (46/2 012)and 8.60% (173/2 012)in the migrated group,which were much higher than that of the inland group and the seaport group [1.05% (30/2 858), 5.42% (155/2 858); 1.47% (34/2 310), 6.88% (159/2 310), P < 0.01 or < 0.05]. At the same time,the incidences of GD was 0.45%(9/2 012) in the migrated group, which was higher than that of the inland group [0.10% (3/2 858), P < 0.05]. In migrated group, there were 1 503 residencies, including 482 stable occupants and 1 021 intermittent residents. The incidences of CLT and nodular thyroid disease in intermittent residents were 3.23% (33/1 021) and 9.89% (101/1 021), which were much higher than that of stable occupants [1.45% (7/482), 6.64% (32/482), P < 0.05]. The urinary iodine levels in the persons who lived in the Port of Huanghua occasionally (464.6 μg/L) were much higher than that of the persons who lived in Cangzhou for a long time(301.4 μg/L, U = 4.648, P < 0.01).There was a marked fluctuation of the median of urinary iodine determined 6 times which were 485.7,285.2,431.7,310.6,470.3 and 304.4 μg/L,respectively.Conclusions The incidence of many thyroid diseases of people migrated from inland to coastal areas has increased, which is not only higher than that of inland people,but also higher than that of coastal people.Large fluctuations in iodine intake due to migration flow and residential instability may be part of the reason for the high incidence of thyroid diseases. In the future, we should pay more attention to thyroid diseases of migratory population.

OBJECTIVE:To observe the effectiveness and safety of different doses of rosuvastatin in the treatment of acute ce-rebral infarction. METHODS:Totally 120 patients with acute cerebral infarction were selected from Weifang Yidu Central Hospital during Jan. 2014-Dec. 2015,and then divided into observation group and control group according to admission order,with 60 cas-es in each group. Both groups received routine treatment as Shuxuening injection 10 mL,iv,1-2 times a day(or 20 mL added into 5% Glucose injection 250-500 mL,ivgtt,qd)+Aspirin enteric-coated tablets 0.1 g,po,qd. Control group and observation group were additionally given Rosuvastatin calcium tablets 10 mg and 20 mg,po,qd(after supper). Both groups were treated for 30 d. The levels of serum inflammatory factors(hs-CRP,TNF-α,IL-6),blood lipid indexes(TC,TG,LDL-C),neurological function and activity of daily life score were observed in 2 groups before and after treatment. The clinical efficacy and occurrence of ADR were recorded. RESULTS:Before treatment,there was no statistical significance in the levels of hs-CRP,TNF-α,IL-6,TC,TG and LDL-C,NIHSS scores and Barthel index (BI) scores between 2 groups (P>0.05). After treatment,the levels of hs-CRP, TNF-α,IL-6,TC,TG and LDL-C,NIHSS scores in 2 groups were decreased significantly,while BI scores were decreased signifi-cantly,observation group were significantly better than those of control group,with statistical significance (P<0.05). Total re-sponse rate of observation group (93.33%) was significantly higher than that of control group (86.67%),with statistical signifi-cance (P<0.05). The incidence of ADR in observation group (23.33%) was significantly higher than control group (6.67%), with statistical significance(P<0.05). CONCLUSIONS:Rosuvastatin can significantly reduce the inflammatory reaction and blood lipid level of patients with acute cerebral infarction,inhibit the formation of atherosclerotic plaque and improve prognosis. The large dose of rosuvastatin have better efficacy for acute cerebral infarction and can significantly improve the symptom of neurologi-cal deficits and daily living ability of patients.

Objective To investigate the effect of up-regulation of miR-132 on expressions of angiopoietin-1 (Ang-1)/endothelium-specific tyrosine kinase receptor 2 (Tie2) in focal cerebral ischemia reperfusion injury of rats.Methods Forty adult healthy SD rats were randomly divided into sham-operated group,cerebral ischemia group,miR-132 mimic group and negative control group (n=10).The models of middle cerebral artery occlusion in the later three groups were established by using modified Longa suture method.Rats in the miR-132 mimic group and negative control group were injected miR-132 mimic 15 μg and negative control 15 μg via paracele.Rats in each group were sacrificed 24 h after ischemia,and the brain tissues were collected;the total infarct volumes were calculated by TTC staining.The mRNA expressions ofmiR-132,Ang-1 and Tie2 in ischemic cerebral cortex tissues were detected by real-time fluorescence quantitative PCR.The protein expressions of Ang-1,Tie2,CD31 and vessel endothelial growth factor (VEGF) in ischemic cerebral cortex tissues were detected by Western blotting.Results The total infarct volume in the miR-132 mimic group was (27.92±3.05) mm3,which was significantly smaller than that in the cerebral ischemia group and negative control group ([51.34±2.86] mm3 and [50.46±2.57] mm3,P＜0.05).The relative mRNA expression levels of miR-132,A ng-1,Tie2,and the protein expression levels of Ang-1,Tie2,CD31,VEGF in the ischemic cerebral cortex tissues of the miR-132 mimic group were significantly higher than those in the negative control group,cerebral ischemia group and sham-operated group (P＜0.05);and those in the negative control group and cerebral ischemia group were significantly higher than those in the sham-operated group (P＜0.05).Conclusion Up-regulation ofmiR-132 expression could improve the ischemic states of ischemic stroke in rats,which might be related to Ang-1/Tie2 increased expressions to promote angiogenesis in ischemic brain tissues.

Objective To evaluate the treatment and clinical outcome of pancreatic pseudocysts.Methods Clinical data of 53 pancreatic pseudocyst patients treated from Jan 2008 to Oct 2014 was retrospectively analyzed.Results 9 cases underwent CT-guided percutaneous catheter drainage,among them 3 cases underwent reoperation.8 cases underwent endoscopic ultrasonography-guided transmural drainage,including transgastric approach in 7,transduodenal approach in 1,Procedures in all these 8 cases were successful and pseudocyst disappeared completely without complication.Surgical procedures were performed in 36 cases,3 by external drainage,1 of the 3 underwent reoperation;11 cases underwent cystgastrostomy,with 2 suffering from postopertative gastrointestinal bleeding;3 cases underwent cystduodenostomy;19 cases underwent Roux-en-Y cystojejunostomy,with 1 suffering from postopertative gastrointestinal bleeding.Follow-up ranged from 4 months to 6 years,there was no cyst recurrence.Conclusion The treatment of pancreatic pseudocysts is diversified and should be individualized.Internal drainage is the mainstay of treatment,preferably through endoscopic ultrasonography-guided transmural drainage,leaving difficult cases to open cystojejunostomy.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.

Objective To verify the detection ability of experimental animal quality detection laboratories in China for Staphylococcus aureus.Methods The testing samples for Staphylococcus aureus detection were prepared by bacterial culture, homogeneity test and stability test, according to the study plan approved by CNAS.Then the samples and operation instruction were sent to the participant laboratories.The detection reports from these laboratories should be submitted before the deadline expires, and the collected data were summarized and analyzed.Results There were 28 laboratories which joined to this test plan.Among them 22 laboratories ( 78.57%) achieved satisfactory test results, and six laboratories (21.43%) had unsatisfactory test results.27 Laboratories used the national standard detection assay, while only one labo-ratory used PCR assay.Conclusions Most of experimental animal quality testing laboratories in China have sufficient pro-ficiency in detection of Staphylococcus aureus.The obtained information are very helpful for the laboratory ability verification testing in future.