Objective: To examine the effects of Berberine(BBR)on inflammatory pathways related to endoplasmic reticulum stress(ERS)in the penumbra area following focal cerebral ischemia-reperfusion injury in type 2 diabetic rats. Methods: A total of 72 healthy male Sprague-Dawley rats were fed a high-fat, high-sugar diet and injected with streptozotocin to establish a type 2 diabetes mellitus model.The diabetic rats were randomly divided by digital lottery method into a Sham operation group(Sham group), a diabetic rat + BBR treatment group(BBR group), a diabetic middle cerebral artery occlusion(MCAO)model group(MCAO group), and a diabetic rats MCAO + BBR treatment group(MCAO + BBR group). Six rats were included in each group.The two treatment groups received prespecified doses of BBR through gastric perfusion at 48 h, 24 h before surgery, and 6h after surgery.The MCAO model was prepared by a suture occlusion method.The neurological deficit scores were performed, and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)was detected by enzyme-linked immunosorbent assay(ELISA). The mRNA expression of ERS marker protein GRP78 was detected by quantitative real time polymerase chain reaction(RT-qPCR), and the expression of ERS-related inflammatory pathway proteins[78 Glucoseregulated protein(GRP78)、Pancreatic endoplasmic reticulum Rinase(PERK)、nuclear factor-κB(NF-κB)]was detected by Western blot. Results: the cerebral ischemic penumbra area, after 2 h of ischemia and 24 h of reperfusion, the neurological deficit score in the MCAO group was higher than that in the MACO+ BBR group [(2.83±0.41)vs.(1.67±0.52), P<0.05], and the expression levels of pro-inflammatory cytokines(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)were also significantly increased(all P<0.05). However, BBR treatment was able to alleviate the neurological dysfunction caused by cerebral ischemia-reperfusion in type 2 diabetic rats(P<0.05). Similarly, BBR treatment also reduced the expression levels of pro-inflammatory factors(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)in the cerebral ischemic penumbra area(all P<0.05). Conclusions Through inhibiting ERS-related inflammatory pathways, BBR plays a neuroprotective role to alleviate cerebral ischemia-reperfusion injury in type 2 diabetic rats.

Objective To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3％) in the diagnosis and treatment of hepatocellular carcinoma.Methods From October 2016 to March 2018,at Affiliated Hospital of Qingdao University,160 patients diagnosed with hepatocellular carcinoma,32 patients with intrahepatic cholangiocarcinoma (ICC),52 patients with post-hepatitis B liver cirrhosis,53 patients with chronic hepatitis B and 50 healthy controls were enrolled.The serum levels of hs-AFP-L3％ and α-fetoprotein were measured.Mann-Whitney U test,Spearman correlation analysis,Wilcoxon signed rank test and chi-square test were performed for statistical analysis.Results The serum levels of hs-AFP-L3％ and α-fetoprotein in hepatocellular carcinoma group were 24.90％ (4.68％ to 61.85％) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L),respectively,which were higher than those in ICC group (0.50％,0.50％ to 0.50％;and 2.79 μg/L,1.72 μg/L to 4.04 μg/L),cirrhosis group (0.50％,0.50％ to 5.25％;and 18.35 μg/L,3.95 μg/L to 31.93 μg/L),chronic hepatitis group (0.50％,0.50％ to 4.25％;and 2.70 μg/L,1.80 μg/L to 17.00 μg/L),and healthy control group (0.50％,0.50％ to 0.50％;and 1.94 μg/L,1.46 μg/L to 2.63 μg/L),and the differences were statistically significant (U =461.00,1 485.50,1 141.00,625.00;401.50,2 207.00,1 254.00,266.00;all P ＜0.01).The sensitivity of hs-AFP-L3％ and α-fetoprotein in the diagnosis of hepatocellular carcinoma was 66.3％ and 70.0％,respectively;and the difference was not statistically significant (x2 =0.54,P ＞ 0.05).The sensitivity of the combined detection was 82.5％,which was higher than that of the separate detection,and the differences were statistically significant (x2 =24.04 and 18.05,both P ＜0.01).The specificity of hs-AFP-L3％ was 95.2％,which was higher than that of α-fetoprotein (68.6％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).The specificity of the combined detection of these two markers was 68.6％,which was lower than that of hs-AFP-L3％ alone (95.2％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).There was no statistically significant difference in the specificity between the combined detection and α-fetoprotein detection alone (68.6％,P ＞ 0.05).The sensitivity of hs-AFP-L3％ in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein ＜ 20 μg/L) hepatocellular carcinoma was 41.7％.The serum levels of hs-AFP-L3％ and α-fetoprotein were both positively correlated with tumor size and clinical stage (hs-AFP-L3％ r =0.272 and 0.436;α-fetoprotein r =0.375 and 0.458;all P ＜ 0.01).The reduction of serum hs-AFP-L3％ in 38 patients with hepatocellular carcinoma after operation was 82.2％,which was higher than that of oα-fetoprotein (69.2％),and the difference was statistically significant (U =532.50,P =0.049).There was no correlation between serum level of hs-AFP-L3％ and α-fetoprotein level (r =0.077,P ＞ 0.05).Conclusions The sensitivity of hs-AFP-L3％ is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma,while the specificity of hs-AFP-L3％ is higher than that of α-fetoprotein.The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma.The hs-AFP-L3％ has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma.

Objective To investigate the epidemiological characteristics and the influencing factors of the unintentional injuries among Wenzhou elementary school children. Methods A total of 3 050 students were selected from the 1st to 6th grades in 6 primary schools in Wenzhou urban area by multi - stage sampling and were investigated during 2013 to 2015. Results 2 859 students completed the investigation. The morbidity of annual average unintentional injuries was 30. 81%(95% CI:29. 12% - 32. 50% )and the occurrence density was 2. 79. Unintentional injuries occurred mainly at home (37. 69% )and school(32. 39% ),and the most common site of injuries were leg(35. 02% )and hand(33. 79% ). For overall incidence,the slip falling injury(35. 64% )was highest,followed by cut or pierced(33. 40% )and crush injury (25. 08% ). Schoolgirl was a protective factor of the injury of crushed,electrical,traffic accident,bashed,burn , exploded,drown,poisoning and bit(OR ﹤ 1),but was a risk factor of multiple injuries(OR = 1. 323). Age was a risk factor of injury of fallen,crushed,bashed,burn,cut or pierced,exploded and bit(OR ﹥ 1. 1),but was a protective factor of poisoning(OR = 0. 671). compared with the students who walked to school alone,the children who were accompanied by their family member and rode alone to school were protective factors of the traffic accident. Conclusion The incidences of the unintentional injuries of elementary school children were increased with the age,and the boy was easier to be hurt. It was suggested for parents,schools and the government to strengthen healthy education for children at the early age.

Objective To observe the clnical effects of influence of tanshinone type ⅡA sulfonate on preventing hepatic artery thrombosis after transplantation.Methods A total of 60 patients after liver transplantation were randomly individed into the treatment group and control group, each 30 patients. The treatment group received tanshinone ⅡA sodium sulfonate treatment (60 mg qd, ivgtt continuous 10d) , while the control group used conventional heparinization. The blood coagulation index and the thrombelastograph variables were detected after 7 days and the hepatic artery resistance index (RI) was detected by using Doppler ultrasonography. The postoperative complications and mortality rates were analyzed.Results Although it had little improvement on the coagulation function after liver transplantation, tanshinone ⅡA sodium sulfonate had significant improvement on the time of thrombelastograph parameters reaction (6.35 ± 1.59 minvs. 5.21 ± 1.37 min,t=2.453) and maximum amplitude (58.07 ± 5.42 mmvs. 61.67 ± 5.63 mm,t=-2.532). It showed that RI have significantly statistical difference between the two groups after treatment (0.73 ± 0.11vs. 0.62 ± 0.10;t=-2.948,P<0.01). During the trial, the control group had 2 cases of postoperative complications, HAT and bleeding.Conclusions The Tanshinone ⅡA sodium after liver transplantation can improve the clotting mechanism, preventing HAT.

Background:The TNM staging system is far from perfect in predicting the survival of individual cancer patients because only the gross anatomy is considered. The survival rates of the patients who have the same TNM stage disease vary across a wide spectrum. This study aimed to develop a nomogram that incorporates other clinicopatho-logic factors for predicting the overall survival (OS) of non-metastatic nasopharyngeal carcinoma (NPC) patients after curative treatments. Methods:We retrospectively collected the clinical data of 1520 NPC patients who were diagnosed histologically between November 2000 and September 2003. The clinical data of a separate cohort of 464 patients who received intensity-modulated radiation therapy (IMRT) between 2001 and 2010 were also retrieved to examine the extensibil-ity of the model. Cox regression analysis was used to identify the prognostic factors for building the nomogram. The predictive accuracy and discriminative ability were measured using the concordance index (c-index). Results:We identiifed and incorporated 12 independent clinical factors into the nomogram. The calibration curves showed that the prediction of OS was in good agreement with the actual observation in the internal validation set and IMRT cohort. The c-index of the nomogram was statistically higher than that of the 7th edition TNM staging sys-tem for predicting the survival in both the primary cohort (0.69 vs. 0.62) and the IMRT cohort (0.67 vs. 0.63). Conclusion:We developed and validated a novel nomogram that outperformed the TNM staging system in predict-ing the OS of non-metastatic NPC patients who underwent curative therapy.

OBJECTIVETo know about the status of self-rated health and life style among 5 kinds of occupational populations in 6 provinces in China and to explore the influencing factors related with health of the occupational population.

METHODSFrom May to August 2009, a total of 13 492 persons aged 18 - 60 years including civil servants, scientific and technical personnel, administrative staff, teachers and physical workers were selected by multi-stage stratified sampling from Beijing city, Ningxia Hui autonomous region, Liaoning, Zhejiang, Hubei and Qinghai provinces to undergo surveys on the Lifestyle of Occupational Population in Urban in China and Self-rated Health Measurement Scale Version 1.0 (SRHMS V1.0). The effects of lifestyles on health scores were analyzed by logistic linear regression.

RESULTSOverall, 13 073 valid questionnaires of the Lifestyle of Occupational Population in Urban in China and 13 177 valid questionnaires of SRHMS V1.0 were collected. The valid rate was 96.9% and 97.7% respectively. Among the respondents, 46.9% (6136/13073) ate timely in a day, 50.9% (6658/13 073) ate breakfast every day, 27.8% (3635/13 073) worked over 8 hours per day, 31.0% (4057/13 073) didn't do any exercises, 14.6% (1906/13073) sat for over 4 hours in spare time, 39.3% (5137/13 073) were drinking and 24.8% (3230/13 073) were current smokers. The average score of SRHMS of all respondents was 73.34 +/- 11.86, of which the civil servant had the highest score (74.83 +/- 11.89) while the teacher had the lowest score (71.65 +/- 11.44, P < 0.05). The results of multiple linear regression showed that females (b = -0.945, b' = -0.041), the elderly (b = -0.098, b' = -0.087), teachers (b = - 2.151, b' = -0.074), the divorced (b = -1.607, b' = -0.021), the widowed (b = -2.926, b' = -0.019), and smokers (b = -1.198, b' = -0.045) were with worse condition. Respondents with higher education (b = 0.588, b' = 0.037), eating timely (b = 2.301, b' = 0.141), eating breakfast every day (b = 1.503, b' = 0.096), paying more attention on diet (b = 0.499, b' = 0.021) and doing more exercises (b = 1.820, b' = 0.058) had better condition.

CONCLUSIONEating irregularly, working long hours, lack of exercise, sitting for long hours, smoking and drinking were common among occupational population. The self-rated physical health status was associated with gender, age, education level, occupation, diet and exercise.

Adolescent ; Adult ; China ; Female ; Health Status ; Humans ; Life Style ; Male ; Middle Aged ; Occupations ; Self Report ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo learn the status quo of lifestyle among women of five occupations in six provinces of China.

METHODSA questionnaire was administered among 7416 women from five occupations (civil servants, teachers of elementary and high schools, technical staff, enterprise managers and physical laborers) in Beijing, Hebei, Jilin, Hubei, Ningxia and Gansu of China. The sample was selected by multi-stage stratified cluster random sampling method from December 2009 to June 2010. The questionnaire information included demographic characteristics, diet, sleep habit, smoking, physical exercise. The χ(2) test was used to analyze the different in life style of different occupations.

RESULTSThere were 7416 valid questionnaires received, and the valid rate of the questionnaires was 97.58% (7416/7682). About 38.00% (2818/7416) respondents preferred to bland diet and 28.44% (2109/7416) preferred to salty and oily food and 33.56% (2489/7416) had no preference. The proportion of sleep time between seven and eight hours per day was highest (accounting for 56.23%, 4154/7416), 25.27% (1867/7416) with sleep time less than seven hours. Among the population who had the sleep time less seven hours, teacher that had the highest rate accounted for 33.19% (531/1607) and technical staff had the lowest rate accounted for 21.05% (301/1401) (P < 0.01). Most of respondents were non-smokers, accounting for 93.10% (6869/7416). 22.73% (1671/7416) respondents passively smoked. The proportion of always passive smoking was highest among civil servants and lowest among teachers, accounting for 26.60% (404/1531) and 18.71% (298/1607), respectively. The proportion of having no physical exercises was highest, accounting for 62.87% (4637/7416). The proportion of having three times physical exercises per week was 12.68% (935/7416). The proportion of having no physical exercises among physical laborers (66.42%, 912/1386), enterprise managers (66.64%, 987/1491) and teachers (62.40%, 999/1607) were higher than others and the proportion of having physical exercises per week among technical staff was 40.83% (569/1401), higher than others (P < 0.01). The proportion of person who worked in sitting quietly beyond six hours per day was 42.62% (3146/7416). The technical staff had the higher rate than other occupational populations (P < 0.01), accounting for 57.83% (809/1401).

CONCLUSIONThe female occupational population had some unhealthy lifestyles, such as taking in high salt food, lacking of sleep, smoking and passive smoking, lacking of physical exercises and working in sitting quietly. Different occupational populations had different unhealthy lifestyles.

Adolescent ; Adult ; China ; epidemiology ; Female ; Humans ; Life Style ; Middle Aged ; Occupations ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo establish a comprehensive evaluation indicator system for healthy literacy based on national survey data.

METHODA multi-stage stratified sampling method was carried out to select the sample population in six provinces of China, which were adults aged 18 - 69 years old. The national health literacy questionnaire was used to investigate the sample populations. The answers were scored according to the error answer of 0, uncertain answer of 1 and the correct answer of 2. The degrees of difficulty and difference were calculated and be used to screen the indicators from the questionnaire as to establishing the comprehensive evaluation indicator system of the health literacy. The Cronbach alpha coefficient, correlation analysis, regression analysis and cluster analysis methods were used to assess the reliability and validity of the indicator system.

RESULTSThe samples were 11 759 people, the valid questionnaires were 11 693 and the effective recovery rate was 99.4%, the Myer' index of sample was 4.92. There were 40 indexes selected to establish the comprehensive evaluation indicator system of health literacy. The correlation coefficient between indicator system and the questionnaire scores was 0.948 (P < 0.01), there were the significant differences between groups of being clustered by Q cluster analysis method (P < 0.01). The VIF of these four dimensions was less than 5.

CONCLUSIONIn this study, the comprehensive evaluation indicator system had a good reliability and validity, and there existed no collinearity among four dimensions of indicator system, it should be the foundation for developing comprehensive evaluation index of health literacy.

Adolescent ; Adult ; Aged ; China ; Health Knowledge, Attitudes, Practice ; Health Status ; Humans ; Middle Aged ; Outcome Assessment (Health Care) ; Quality of Life ; Surveys and Questionnaires ; Young Adult