ObjectiveTo investigate the protective effect of tanshinone I (T-I) on hepatic ischemia-reperfusion injury (HIRI) in mice. MethodsA total of 36 C57BL/6J mice were randomly divided into sham-operation group, ischemia-reperfusion (IR) group, IR+T-I (5 mg/kg) group, IR+T-I (10 mg/kg) group, IR+T-I (20 mg/kg) group, and IR+T-I (40 mg/kg) group, with 6 mice in each group. Each group was given intraperitoneal injection. The mice in the sham-operation group and the IR group were injected with an equal volume of the solvent olive oil; the mice in the IR+T-I groups were administered once a day for 7 consecutive days, a model of 70% HIRI was established at 2 hours after the last administration, and serum and liver samples were collected after 6 hours of reperfusion. Related kits were used to measure the serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the content of superoxide dismutase (SOD), malondialdehyde (MDA), caspase-3, and reduced glutathione (GSH) in liver tissue; HE staining was used to observe liver histopathology; the TUNEL method was used to measure the level of hepatocyte apoptosis; immunohistochemistry was used to measure the protein expression of caspase-3 and heme oxygenase-1 (HO-1). 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 comparison between two groups. ResultsCompared with the IR group, the IR+T-I (20mg/kg) group had significant reductions in the serum levels of ALT (192.48±23.67 U/L vs 336.90±41.52 U/L, P＜0.01) and AST (123.19±9.16 U/L vs 206.90±18.81 U/L, P＜0.01), and thus 20 mg/kg was determined as the optimal concentration. Compared with the IR group, the IR+T-I (20 mg/kg) group had significant reductions in MDA (1.34±0.21 μmol/mg vs 3.48±0.95 μmol/mg, P＜0.05) and caspase-3 (0.69±0.97 μmol/mg vs 1.04±0.35 μmol/mg, P＜0.05) and significant increases in SOD (274.47±30.53 U/mg vs 160.29±27.37 U/mg, P＜0.05) and GSH (2.12±0.27 μmol/mg vs 1.03±0.42 μmol/mg, P＜0.05). HE staining showed that the IR group had disordered structure of hepatic lobules and focal or extensive degeneration and necrosis of hepatocytes; compared with the IR group, the IR+T-I (20 mg/kg) group had a reduction in the area of hepatocyte necrosis and a basically complete structure of the liver. Immunohistochemistry showed that compared with the IR group, the IR+T-I (20 mg/kg) group had significant reductions in the number of apoptotic hepatocytes and the protein expression of caspase-3 and a significant increase in the protein expression of HO-1. ConclusionT-I exerts a protective effect against HIRI in mice by inhibiting liver oxidative stress response and hepatocyte apoptosis.

Objective:To analyze and compare clinical characteristics and risk factors of patients with uremic encephalopathy (UE).Methods:A retrospective analysis was performed from January 2014 to January 2019 in our hospital. Seventy patients diagnosed with chronic kidney disease (CKD) at the end stage (according to diagnosis standard of CKD) complicated with UE were classified into the UE group. In principle matching with sex, age and duration of disease, seventy patients with chronic kidney disease at the end stage but without UE were classified into the non-UE group (NUE group). The demographic data, laboratory examination, CT or MRI examination were recorded and analyzed by using t or χ 2 test. In addition, independent risk factors of patients with UE were analyzed by using Logistic model. Results:A total of 70 patients in the UE group and 70 patients in the NUE group were collected. The proportion of patients with a history of alcohol comsumption, chronic obstructive pulmonary disease and polycystic kidney disease were higher in the UE group than in the NUE group ( P<0.05). There were no significant differences in hypertension, diabetes, and coronary artery disease history between the two groups ( P>0.05). The proportion of cerebral focus and lesions for brain white matter revealed by head CT or MRI in the UE group were significantly higher than that in the NUE group ( P<0.05). The serum NLR and UA levels in the UE group were higher than those in the NUE group ( P<0.05), but the serum ALB and FT3 levels in the UE group were lower than those in the NUE group ( P<0.05). Logistic regression analysis showed that serum NLR, ALB and FT3 levels were independent risk factors for UE patients. Conclusions:Cerebral focus and lesions for brain white matter revealed by CT or MRI are typical abnormal in UE patients. The serum NLR, FT3 and ALB levels are independent risk factor for UE patients.

The adjacent anatomy of the pelvis is complicated, with digestive, urinary, reproductive and other organs as well as important blood vessels and nerves. Therefore, accurate resection of pelvic tumors and precise reconstruction of defects after resection are extremely difficult. The development of medical 3D printing technology provides new ideas for precise resection and personalized reconstruction of pelvic tumors. The “triune” application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis in pelvic tumor limb salvage reconstruction treatment has achieved good clinical results. However, the current lack of normative guidance standards such as preparation and application of 3D printing personalized lesion model, osteotomy guide plate and reconstruction prosthesis restricts its promotion and application. The formulation of this consensus provides normative guidance for 3D printing personalized pelvic tumor limb salvage reconstruction treatment.

Objective To observe the effects of endoscopic drug therap on hemostasis, re-bleeding and the risk of occurrence of complication in patients with acute esophageal and gastric variceal bleeding (EGVB). Methods A retrospective method was conducted, and 100 patients with EGVB who were admitted to the Affiliated Hospital of Yan'an University from June 2015 to June 2017 were enrolled. According to the difference in treatment methods, they were divided into an endoscopy Sclerotherapy and Ligation group and transjugular intrahepatic portosystemic shunt (TIPS) group, 50 cases in each group. The TIPS group was treated with TIPS; the endoscopy Sclerotherapy and Ligation group underwent endoscopic variceal sclerotherapy, endoscopic esophageal variceal ligation and postoperative non-selective β blockers oral administration. After 2 years of follow-up, the patients' hemostasis, re-bleeding at acute stage, survival situation and the incidences of complications were recorded. Before treatment and 2 weeks after treatment, the levels of serum albumin (Alb), total bilirubin (TBil) and platelet count (PLT) were measured by Hitachi automatic biochemical analyzer in the two groups. Results The success rate of hemostasis in the endoscopy Sclerotherapy and Ligation group was significantly higher than that in the TIPS group [98.0% (49/50) vs. 82.0% (41/50) ], and the recurrence rate of varices, during 1- and 2-year follow-up, the recurrence rate of bleeding and the incidences of complications were significantly lower than those in TIPS group [the recurrence rate of varicose veins: 6.0% (3/50) vs. 24.0 (12/50), 1-year re-bleeding rate: 12.0% (6/50) vs. 30.0% (15/50), 2-year re-bleeding rate: 42.0% (21/50) vs. 66.0% (33/50), esophageal ulcer: 2.0% (1/50) vs. 14.0% (7/50), upper abdominal discomfort: 2.0% (1/50) vs. 14.0% (7/50), hepatic encephalopathy:4.0% (2/50) vs. 16.0% (8/50), chest pain: 6.0% (3/50) vs. 20.0% (10/50), all P < 0.05]. After treatment, the levels of Alb and PLT in the endoscopy Sclerotherapy and Ligation group were higher than those in the TIPS group [Alb (g/L):43.84±4.34 vs. 40.83±3.21, PLT (×109/L): 26.33±3.37 vs. 21.12±3.89, both P < 0.05], and the TBil was lower than that in the TIPS group (μmol/L: 13.82±4.32 vs. 19.33±4.59). Conclusion Endoscopic Sclerotherapy and Ligation can significantly improve the effect of hemostasis of patients with acute EGVB, the rate of re-bleeding does not increase compared with that of western medicine group using TIPS, and the incidences of complications are significantly lower than those of applying TIPS.

Objective To investigate the toxicokinetic properties of ginkgolide B(GB) injection after single or repeat-ed administration by intravenous drip in Beagle dogs and to provide evidence for its rational use. Methods Beagle dogs were randomly divided into three groups,and received GB injection at big,medium and small doses of 80,20 and 5 mg·kg-1, re-spectively,by iv drip for 30 min per day and for 6 consecutive days per week for up to 91 days.The blood samples of Beagle dogs were drawn at different time points on the first and last day of administration,and concentrations in plasma were detected by GC-MS method.Toxicokinetic parameters were calculated by DAS pharmacokinetic software and statistically analyzed by SPSS 11.5 software. Results The elimination half-life (t1/2β) of GB at single dose of 5,20,80 mg·kg-1were(110.2±32.6),(115.4± 12.8),(98.6±26.8) min, respectively.The AUC0-twere (61.1±7.4), (348.6±90.5), (2 046.2±356.4) mg·L-1·min,re-spectively.The t1/2βof GB at mutiple doses of 5,20,80 mg·kg-1on the 91rd day were (117.9±28.0),(118.2±17.0),(120.5± 49.4) min,respectively.The AUC0-twere (67.9±14.9), (218.3±31.8), (1 986.4±426.6) mg·L-1·min, respectively.There was no significant difference in main toxicokinetic parameters including t1/2βamong the single or repeated dosage groups, but AUC0-tand Cmaxincreased proportionally with doses. Conclusion The curves of single and repeated intravenous drip of GB in-jection in beagle dogs were in line with the two atrioventricular model,with linear dynamic characteristics and there was no accu-mulation of repeated drug delivery in the body.

Objective To evaluate effects of extremely high hepatic venous pressure gradient (HVPG) on the prognosis of endoscopic therapy in secondary prophylaxis for patients with gastroesophageal varices.Methods This was a single center prospective cohort study.From April 1st,2013 to May 31st,2015,patients with gastroesophageal varices and treated for secondary prophylaxis were enrolled and divided into extremely high HVPG group (HVPG≥20 mmHg,1 mmHg=0.133 kPa) and non-extremely high HVPG group (HVPG＜ 20 mmHg).After combination of endoscopic ligation and tissue glue treatment,one-year,two-year and threeyear rebleeding rates and survival statuses were compared.Cox regression was performed for further analysis of prognosis factors related with rebleeding and survive.Results Eventually,126 patients were enrolled and divided into extremely high HVPG group (32 cases) and non-extremely high HVPG group (94 cases).The one-year rebleeding rates of extremely high HVPG group and non-extremely high HVPG group were 37.9 ℃ (11/29) and 27.6 ％ (24/87),respectively,and the difference was not statistically significant (x2 =1.105,P =0.293).The two-year rebleeding rate of extremely high HVPG group was significantly higher than non-extremely high HVPG group 51.7％ (15/29) vs 29.9％ (26/87),and the difference was statistically significant (x2 =4.539,P=0.033).And so was the three-year rebleeding rate,51.7％ (15/29) vs 29.9％ (24/87),and the difference was statistically significant (x2 =4.539,P=0.033).The one-year,two-year and three-year survival rates of extremely high HVPG group and non-extremely high HVPG group were 92.6％ (25/27) vs 94.0％ (78/83),85.2％ (23/ 27) vs 94.0 ％ (78/83),and 85.2％ (23/27) vs 94.0％ (78/83),and the differences between two groups were not statistically significant (all P＞0.05).Single factor analysis showed that portal vein thrombosis was associated with rebleeding (hazard ratio (HR)=1.883,95％ confidence interval (CI) 1.015 to 3.492,P=0.045).No prognosis factors associated with survival were found.Conclusions Medium and long term rebleeding rate of the extremely high HVPG group is higher than that of the non-extremely high HVPG group.Extremely high HVPG does not affect the one-year prognosis of endoscopic therapy in secondary prophylaxis for patients with gastroesophageal varices.

Colorectal cancer (CRC) is one of the most common gastrointestinal malignancies with poor prognosis and high mortality.SEPT9 gene is a tumor suppressor gene and plays an important role in the end of cell division.Studies have shown that methylation of SEPT9 gene could be used in the early diagnosis of CRC.This article reviewed the advances in study on SEPT9 gene methylation in the screening and diagnosis of CRC.

RNF180 is a novel membrane-bound E3 ubiquitin ligase that participates in cell development,proliferation and apoptosis.It is a tumor suppressor gene that inhibits cell proliferation and induces apoptosis and may inhibit gastric cancer cell lymph node metastasis.The study found that RNF180 gene methylation and gastric cancer is closely related to the occurrence and development.Therefore,RNF180 gene methylation is expected as a tumor marker of gastric cancer for early diagnosis and prognosis of gastric cancer.In this paper,RNF180 on the diagnosis of gastric cancer research progress made a review.

Objective To examine characteristics of patients with blood urea nitrogen (BUN) levels higher and lower than the normal limit.Methods During January 2012 to January 2015,116 patients with upper gastrointestinal diseases were selected to study,according to the patient's blood urea nitrogen level,all the patients were divided into high BUN group and low BUN group,and there were 76 patients in the high BUN group,and 40 patients in low BUN group,compared the biochemical indices,gastrointestinal bleeding forrest grading and disease severity of the two groups,and univariate logistic regression analysis.Results The serum white blood cell count,blood urea nitrogen,creatinine and glycated hemoglobin levels in patients of high BUN group [(9 593±5 012)× 102/μl,368.1±162.3 mg/L,11.2±3.7 mg/L and 6.38±1.08％] were significantly higher than that of low BUN patients [(6 804 ± 2 087) × 102/μl,121.0 ± 39.3 mg/L,8.1 ± 3.2 mg/L and 5.51 ± 0.42 ％] (t =3.645～12.659,all P＜0.05),and the hemoglobin levels (87.3±35.1 g/L) of the patients in high BUN group was significantly lower than that of the low BUN patients (108.0 ± 31.2 g/L) (t=3.252,P=0.032).Logistic regression analysis showed the presence of hemoglobin and glycosylated hemoglobin levelst of wo groups of patients was significantly different (P＜0.05),and showed that showed the highest correlation with BUN.Gastrointestinal bleeding forrest hierarchical data of the two groups of patients showed no significant difference (P＞0.05).The proportion of patients with gastric ulcers of high BUN patients was significantly higher than that of the low BUN patients (x2 =39.655,P=0.000).Conclusion Patients with high expression of serum urea nitrogen had more severe upper gastrointestinal bleeding,and it is worthy of attention in the process of clinical diagnostic.

Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.