Objective To observe the protective effect of modified Baishile Decoction on hippocampal neuronal cells cultured in vitro;To explore its mechanism of treating post-stroke depression.Methods Hippocampal neuronal cells from mammary rats were isolated and cultured in vitro,cell injury was induced by oxygen glucose deprivation combined with lipopolysaccharide.The cells were divided into normal group,model group,blank serum group(10%)and modified Baishile Decoction containing serum group(10%).Invertedmicroscope was used to observe cell morphological changes,CCK-8 method was used to detect cell survival rate,Hoechst33342 staining was used to observe apoptosis,ELISA was used to detect Glu,5-HT,TNF-α,IL-1β,and IL-6 contents in cell supernatant,the expressions of purinergic P2X7 receptor(P2X7R)and NOD-like receptor protein 3(NLRP3)were detected by immunofluorescence staining.Results Compared with the normal group,the hippocampal neurons in the model group showed significant changes in cell morphology,the cell survival rate significantly decreased(P<0.01),the cell apoptosis increased(P<0.01);Glu,TNF-α,IL-1β,IL-6 contents in cell supernatant significantly increased(P<0.05,P<0.01),5-HT content significantly decreased(P<0.01),P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly increased(P<0.01).Compared with the model group,the morphology of hippocampal neurons in modified Baishile Decoction containing serum group was significantly improved,the cell survival rate significantly increased(P<0.01),the cell apoptosis reduced(P<0.01);Glu,TNF-α and IL-1β content in cell supernatant significantly reduced(P<0.05,P<0.01),5-HT content significantly increased(P<0.01),and P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly decreased(P<0.01).Conclusion Modified Baishile Decoction may exert a protective effect on oxidative glucose deprivation combined with lipopolysaccharide induced hippocampal neuronal inflammation damage by inhibiting the P2X7R/NLRP3 signaling pathway,regulating neurotransmitter secretion,and inhibiting inflammatory factor release,thus treating post-stroke depression.

Objective:To evaluate the association of cognitive function,clinical symptoms,and plasma C-reac-tive protein(CRP)level in patients with treatment-resistant obsessive-compulsive disorder(trOCD).Methods:Fif-ty-five patients with trOCD,45 patients with non-trOCD,and 65 normal controls were enrolled.The Yale-Brown Obsessive-Compulsive Scale(YBOCS),Hamilton depression scale,Hamilton anxiety scale,MATRICS Consensus Cognitive Battery(MCCB)were used to evaluate the OCD,depressive or anxious clinical symptoms,as well as cognitive function,in above-mentioned subjects.The plasma CRP level were examined by using the latex-enhanced immunoturbidimetry methods in three groups.Results:Compared with the other two groups,the MCCB cognition scores,especially information processing speed,working memory,inferential knowledge and problem-solving skills were higher in the trOCD group,respectively(Ps＜0.05).The plasma CRP level and percentage of cases with high CRP level(≥3 mg/L)in the trCOD group were higher than those in other two groups(P＜0.05).However,difference of MCCB and its factorial scores revealed no statistical significances in non-trOCD group(Ps＞0.05).Logistic regression analysis showed that potential risk factors of treatment-resistant OCD including,more obsessive-compulsive symptoms(OR=2.01),higher severity of OCD(OR=2.29),lower MCCB total scores(OR=4.01),higher plasma CRP level(OR=4.24),and longer disease course of OCD(OR=3.23)(P＜0.05).Conclusion:Impaired cognitive function,high plasma C-reactive protein level,may be associated with more obsessive-compul-sive symptoms,higher severity of OCD,as well as long disease course of OCD.

Objective To systematically evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) in perioperative management of pancreatectomy.Methods Literatures were researched using CNKI,Wanfang database,VIP database,PubMed,Cochrane Library,Embase from January 1990 to March 2018 with the key words including "快速康复外科,加速康复外科,胰腺切除术,胰十二指肠切除术,惠普而术,ERAS,enhanced recovery,fast track,pancreatic surgery,pancreatectomy,Whipple,pancreatoduodenectomy,pancreatoduodenal resection".The cohort study about ERAS in elective pancreatic surgery or pancreaticoduodenectomy were received and enrolled.The patients using ERAS in perioperative management and using traditional perioperative management were respectively allocated into the ERAS group and control group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as odds ratio (OR) and 95％ confidence interval (CI).Weighted Mean Difference (WMD) was used as a consolidated statistics for measurement data that were measured using the same tool,and standardized mean difference (SMD) was used as a consolidated statistics for measurement data that were measured using the different tools.The heterogeneity of the studied was analyzed using the I2 test.Results Nineteen retrospective cohort studies were enrolled in the Meta analysis,and total sample size was 3 699 patients,including 1 823 in the ERAS group and 1 876 in the control group.The results of Meta analysis showed that there were statistically significant differences in the time of postoperative nasogastric tube removal,time for postoperative solid diet intake,time of postoperative defecation recovery,incidence of postoperative overall complications,incidence of postoperative delayed gastric emptying,incidence of postoperative intra-abdominal infection,duration of postoperative hospital stay and hospital expenses between ERAS group and control group (WMD=-1.70,-3.61,-0.86,OR =0.65,0.60,0.70,WMD=-4.64,SMD=-0.48,95％CI:-2.97--0.42,-4.70--2.53,-1.01--0.71,0.52-0.81,0.45-0.80,0.54-0.91,-5.91--3.38,-0.77--0.18,P ＜ 0.05).There was no statistically significant difference in the operation time,volume of intraoperative blood loss,incidence of postoperative pancreatic fistula,incidence of postoperative wound infection,readmission rate,reoperation rate and mortality between ERAS group and control group (WMD=-9.73,-14.39,OR=0.85,0.72,1.05,0.81,0.74,95％CI:-34.24-14.78,-116.96-88.17,0.72-1.01,0.46-1.14,0.83-1.32,0.58-1.13,0.53-1.02,P＞0.05).The results of subgroup analysis showed that heterogeneity of data was from eastern and western countries.Conclusion ERAS in the perioperative management of pancreatectomy is safe and feasible,it can also promote postoperative recovery of patients and reduce incidence of complications and financial burden.

Objective To investigate the feasibility and safety of "G"-shaped surgical approach in laparoscopic pancreaticoduodenectomy.Methods The clinical data of 33 patients who received " G"-shaped laparoscopic pancreaticoduodenectomy in the First Hospital of Shanxi Medical University from April 2015 to March 2018 were retrospectively analyzed.Results All patients underwent surgery successfully.The time required for surgery ranged from 340 to 498 min,the blood loss ranged from 150 to 800 ml,and the specimen resection time ranged from 135 to 270 min.There were 10 cases of biochemical leakage,3 cases of B grade pancreatic fistula and 1 case of bile leak.Postoperative pathology confirmed lower bile duct adenocarcinoma in 17 cases,duodenal papillary adenocarcinoma in 11 cases and poorly differentiated adenocarcinoma of the pancreatic head in 5 cases.Conclusions " G"-shaped approach as a simple,effective and safe way for LPD,is particularly helpful for inexperienced hands.

OBJECTIVE:To systematically review the efficacy and safety of insulin glargine versus insulin detemir in the treat-ment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,randomized controlled trials (RCT) about the clinical efficacy and safety of insulin glargine versus insulin detemir in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation by Cochrane 5.1.0. RESULTS:A total of 18 RCTs,in-volving 3 638 patients were included. Results of Meta-analysis showed there was no significant difference in reducing glycosylated hemoglobin[MD=0.08,95%CI (-0.01,0.17),P=0.09];fasting blood glucose level in insulin glargine group was significantly lower thaninsulin detemir,the difference was statistically significant [MD=0.15,95%CI(0.03,0.27),P=0.02]. And there was no significant difference in the incidence of hypoglycemia [OR=0.97,95%CI(0.91,1.03),P=0.25];the degree of body mass gain ininsulin detemir was significantly lower than insulin glargine group [MD=-0.95,95%CI(-1.06,-0.85),P=0.003],but the in-cidence of injection site reactions was significantly higher than insulin glargine group [OR=2.28,95%CI(1.16,4.50),P=0.02],the differences were statistically significant. CONCLUSIONS:The insulin glargine has better efficacy,than insulin detemir with lower incidence of injection site reactions but higher degree of body mass gain than insulin detemir in the treatment of type 2 diabetes.

Objective To investigate the effects of different processing methods on contents of main chemical components isoferulic acid in Cimicifuga heracleifolia. Methods Cimicifuga heracleifolia from the same batch were prepared by processing method. HPLC were used to determine the contents of isoferulic acid in crudes samples, wine-prepared samples, vinegar-prepared samples, and carbonized samples. Results The contents of isoferulic acid of crudes samples and the three different processed products were in the order as follows:carbonized samples (0.404 7%)>vinegar-prepared samples (0.302 3%)>wine-prepared samples (0.262 4%)>crudes samples (0.231 3%). Conclusion Different processing methods had certain effects on the content of isoferulic acid in Cimicifuga heracleifolia.

Objective To investigate the effects of different methods of preparation on the contents of nuzhenide and oleanolic acid in Ligustri Lucidi Fructus. Methods The same batch of Ligustri Lucidi Fructus was under preparation and process. RP-HPLC was used to determine the contents of nuzhenide and oleanolic acid in crude samples, wine-prepared samples, vinegar-prepared samples, and salt-prepared samples. Results The contents of nuzhenide were in the order as follow:salt-prepared samples (1.997 5%)>crude samples (1.600 7%)>wine-prepared samples (1.144 6%)>vinegar-prepared samples (0.894 6%). The contents of oleanolic acid were in the order as follow:wine-prepared samples (1.120 2%)>salt-prepared samples (0.924 6%)>vinegar-prepared samples (0.913 2%)>crude samples (0.899 8%). Conclusion Different methods of preparation have certain effects on the contents of nuzhenide and oleanolic acid in Ligustri Lucidi Fructus.

Objective To analyze the features of clinical diagnosis and treatment of duodenal gastrointestinal stromal tumors(GIST).Methods Retrospective analysis was performed on clinical data of 5 cases of duodenal GIST treated in our hospital between April 2002 and May 2009.Results The duodenal GIST was mainly located in the 2nd(3/5)and 3rd portion of duodenum(2/5).Clinical diagnosis of the disease mainly depended on barium meal examination, gastrointestinal endoscopy, and CT scanning.Two patients were treated with pancreaticoduodenectomy, 1 with segmental duodenectomy and 2 with local resection.After operation, 2 patients had recurrence and 1 of them underwent adjuvant therapy with Gleevec.Conclusion Surgical resection is the only effective therapeutic method for duodenal GIST.Various surgical procedures are mainly determined by the location and size of the tumors.For patients with a high degree of pathologic grade, adjuvant therapy with Gleevec is necessary.

OBJECTIVE To improve the professional ability of nosocomial infection managers.METHODS By analyzing the status quo and questions among nosocomial infection managers,we explored the essentiality of professionalism construction of the team of nosocomial infection managers and brought forward a way for it.RESULTS It is necessary to set up a professional education and culture system,improve the related guarantee system and keep the team of nosocomial infection managers in stabilization for strengthening the professionalism construction of the team.CONCLUSIONS It is the objective requirement to promote the construction and development of nosocomial infection discipline that impels professionalism construction of the team of nosocomial infection managers.

OBJECTIVE To investigate the function of department of nosocomial infection management in practice.METHODS It was analyzed the situation that the functional management of department of nosocomial infection in China could not be fully used at present.As far as the main content of nosocomial infection control was concerned,it brought forward the idea of performing the functional management of department of nosocomial infection in practice.RESULTS According to establishing the function of department of nosocomial infection management,strengthening the professional ability,and improving the service,both the effect and quality of nosocomial infection management could be enhanced.CONCLUSIONS The same as medical treatment,scientific research,nursing and logistic management,nosocomial infection management should stick to the legal management,and then its function can be effectively used.