Objective: To observe the effects of apocynum venetum leaves extract(AVLE) on anxiety-like behavior caused by chronic restraint stress(CRS). Methods: Male C57BL/6 mice were randomly divided into 4 groups, 5 per group: control group(equivalent physiological saline 0.2 ml/10 g), CRS model group(equivalent physiological saline 0.2 ml/10 g), AVLE treatment group(AVLE 120 mg/kg) and positive control group(paroxetine hydrochloride 3 mg/kg). The anxiety mouse model of chronic restraint stress was established, and the anxiety level of mice treated with apocynum venetum leaf extract was evaluated by open field test and elevated cross maze test. Immunofluorescence staining was used to detect the changes of serotonin receptor in hypothalamic paraventricular nucleus. Chemogenetics combined with adeno-associated virus was used to detect the effect of hypothalamic oxytocin neurons on the anxiety regulation of AVLE. Results: Compared with the model group, apocynum venetum leaves extract could increase the total distance of open field exercise, the activity time, the time of mice entering the central area(P<0.05), and the activity distance and time of mouse elevated maze(P<0.05). The expression of serotonin 1A receptor in the paraventricular nucleus of hypothalamus was enhanced after treatment with AVLE, and inhibition of serotonin 1A receptor and oxytocin neurons in hypothalamic paraventricular nucleus could decrease activity level in mice(P<0.05). Conclusion AVLE can improve the anxiety state and activity ability of CRS mice, and its effect is related to serotonin receptor and oxytocin neurons in hypothalamic paraventricular nucleus.

Objective To investigate the regulatory effect of Jiedu Huayu Tongfu prescription on intestinal homeostasis in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome, as well as its effect on endotoxin, inflammatory factors, and cellular immune function. Methods A total of 72 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from June 2019 to January 2021 and met the diagnostic and inclusion criteria were enrolled as subjects and then randomly divided into observation group and control group, with 36 patients in each group. In the treatment group, 2 patients were lost to follow-up, 2 patients were excluded, and 32 patients completed the study; in the control group, 2 patients were lost to follow-up, 1 patient was excluded, and 33 patients completed the study. In addition to the basic treatment including antiviral therapy and liver-protecting treatment, the patients in the observation group were given Jiedu Huayu Tongfu granules, and those in the control group were given oral administration of Bifidobacterium tetravaccine tablets; the course of treatment was 4 weeks for both groups. The 16S rDNA sequencing technique was used for sequencing of fecal flora, and the two groups were measured in terms of the changes in liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), and albumin (Alb)], endotoxin (ET), levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and T lymphocyte subsets (CD3 + T, CD4 + T, CD8 + T, and CD4 + /CD8 + ) after treatment. For normally distributed continuous data with homogeneity of variance, the paired t -test was used for comparison within each group, and the independent samples t -test was used for comparison between two groups; the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data. The chi-square test was used for comparison of categorical data. Results The observation group had a significantly higher overall response rate than the control group (87.5% vs 60.6%, χ 2 =-2.299, P =0.022). After treatment, both groups had significant reductions in ALT, AST, and TBil and a significant increase in Alb (all P < 0.05), and compared with the control group, the observation group had a significantly greater reduction in TBil ( Z =-2.165, P =0.030). After treatment, both groups had significant improvements in the levels of CD3 + T, CD4 + T, and CD4 + /CD8 + , and the observation group had significantly greater improvements than the control group ( Z =-2.146, -2.940, and 3.157, P =0.032, 0.003, and 0.002). After treatment, both groups had significant reductions in the levels of TNF-α, IL-6, and ET, and the observation group had significantly greater reductions than the control group ( Z =-2.139, -1.982, and -2.062, P =0.032, 0.048, and 0.043). Both groups had an increase in the number of operational taxonomic units after treatment. As for the abundance of intestinal flora at the phylum level, the observation group had a significant increase in the abundance of Firmicutes and a significant reduction in the abundance of Bacteroidetes after treatment ( Z =-3.181 and -2.215, P =0.001 and 0.027); compared with the control group, the observation group had significantly greater increases in the abundance of Firmicutes and Cyanobacteria and significantly greater reductions in the abundance of Bacteroidetes, Cercozoa, and ε-Proteobacteria (all P < 0.05). At the genus level, the observation group had a significant increase in the abundance of Bifidobacterium after treatment ( Z =-2.045, P =0.041). The alpha-diversity analysis showed that the observation group had significant increases in Chao1 and Ace indices after treatment ( t =-4.263 and -3.328, P =0.001 and 0.005) and a significantly greater increase in Ace index than the control group ( t =2.292, P =0.030). The beta-diversity analysis showed that the two groups had a similar composition of flora without significant difference (all P > 0.05). Conclusion Jiedu Huayu Tongfu prescription, in combination with etiological and basic treatments, can alleviate clinical symptoms, reduce liver injury, and improve cellular immune function in patients with hepatitis B cirrhosis with liver-gallbladder damp-heat syndrome. Jiedu Huayu Tongfu prescription can improve the imbalance of intestinal flora by increasing the abundance of the probiotic bacteria such as Firmicutes, Lactobacillus, and Bifidobacterium and the pathogenic bacteria such as Bacteroidetes and Cercozoa, and its effect in further improving liver and immune function may be associated with the regulation of intestinal microecology.

Primary hyperparathyroidism (PHPT) is a disorder of calcium metabolism, which is characterized by elevated blood calcium and PTH urine calcium, which is easy to involve multiple systems. The disease is mainly caused by a benign adenoma of parathyroid tissue, a few of which are parathyroid hyperplasia or parathyroid adenocarcinoma. As awareness of physical examination increased, the proportion of asymptomatic PHPT patients gradually increased. The disease can be cured by surgical resection of the parathyroid gland, most of which is a real good prognosis, but a few of them are complex and difficult to diagnose and treat. At present, there continue to be many controversies about the diagnosis and treatment of PHPT.This article is a review of the progress in the diagnosis and treatment of PHPT.

Objective To investigate whether Wnt/β-catenin signaling pathway mediating the neuroprotection of isoflurane post-conditioning in hippocampal neurons damage induced by ischemia/reperfusion injury in rats.Methods According to the randomized principle, 60 male Sprague-Dawley rats were randomly divided into five groups (12 rats in each group):sham group (group S), model group (group M), ISO+model group (group MI), ISO+model+DKK-1 group (group MDI) and model+DKK-1 group (group MD).A rat model of middle cerebral artery occlusion (MCAO) was established with 90 min ischemia followed by 24 hreperfusion.Group S was only exposed to one side of the internal carotid artery without fishing line.Isoflurane post-conditioning groups (group MI, MDI) were immediately treated with 1.5％isoflurane for 60 min at the onset of reperfusion.DKK-1 (5μg/kg) was injected intracerebroventricularly 30 min before the model established in group MDI and group MD.After reperfusion for 24 h, Longa score method was used for neurological deficit score.HE staining and Tunel fluorescence was employed to observe the morphological changes of neurons.Immunohistochemistry and Western Blot were applied to detect the expression of target protein in CA1 region.Results Compared with group S, the neurobehavioral score, the number of apoptosis and the expression of Bax and GSK-3βprotein in group M all increased (P<0.05), while the expression ofβ-catenin and Bcl-2/Bax ratio decreased (P<0.05) ;Compared with group M, the neurobehavioral score, the number of apoptosis and the expression of Bax protein were significantly decreased (P<0.05), while the expression of Bcl-2, β-catenin protein and the Bcl-2/Bax ratio were significantly increased (P<0.05) in group MI.Compared with group MI, the neurobehavioral score, the number of apoptosis, Bax and GSK-3βprotein in group MDI were significantly increased (P<0.05), while the Bcl-2, β-catenin protein expression, and Bcl-2/Bax ratio were significantly decreased (P<0.05).Conclusion Isoflurane post-conditioning may protect the hippocampus neurons against cerebral ischemic reperfusion-induced damage via the way that the Wnt/β-catenin signaling pathway regulates the expression levels of Bcl-2 and Bax proteins in rats.

Objective To evaluate the effects of isoflurane postconditioning on angiogenesis during cerebral ischemia-reperfusion ( I∕R) in rats and the role of Shh signaling pathway. Methods Thirty-two clean-grade healthy male Sprague-Dawley rats, aged 6-8 weeks, weighing 220-280 g, were divided into 4 groups ( n=8 each) by a random number table method:sham operation group ( Sham group) , I∕R group, isoflurane postconditioning group ( ISO group) , and isoflurane postconditioning plus Shh signaling pathway specific inhibitor cyclopamine group ( ISO+CYC group) . Cerebral ischemia was produced by inserting a 3-0 nylon thread with a rounded tip into the internal jugular vein. The nylon thread was threaded cranially until resistance was met. Occlusion was maintained for 1. 5 h followed by 24 h reperfusion. Neurological deficit was scored at 24 h of reperfusion. Rats were then sacrificed, and brains were removed for determination of cerebral infarct volume ( by TTC) and expression of glioma-associated oncogene homolog 1 ( Gli1) , vascu-lar endothelial growth factor ( VEGF) and transmembrane phosphoglycoprotein protein ( CD34) in cerebral cortex (by Western blot) and for examination of the pathological changes (by Nissl staining). Results Compared with Sham group, the neurological deficit score and cerebral infarct volume were significantly in-creased, and the expression of Gli1, VEGF and CD34 in the cerebral cortex was up-regulated in I∕R and ISO groups ( P <0. 05) . Compared with I∕R group, the neurological deficit score and cerebral infarct vol-ume were significantly decreased, and the expression of Gli1, VEGF and CD34 in the cerebral cortex was up-regulated ( P<0. 05) , and the pathological changes of brain tissues were significantly attenuated in ISO group, and no significant change was found in the parameters mentioned above in ISO + CYC group ( P>0. 05) . Compared with ISO group, the neurological deficit score and cerebral infarct volume were signifi-cantly increased, and the expression of Gli1, VEGF and CD34 in the cerebral cortex was down-regulated in ISO+CYC group ( P<0. 05) . Conclusion The mechanism by which isoflurane post-conditioning attenuates cerebral I∕R injury is related to activating Shh signaling pathway and promoting angiogenesis in rats.

Objective To explore the expression of nutrition information based on consumer cognitive psychology,and improve the applicability of pre-packaged food nutrition labels.Method Taking the "nutrition label" of a biscuit as an example:First,the energy (kilojoules) of the biscuit is converted into "food exchange serving";Then,the energy supply ratio of three major calorigenic nutrients of various foods in the biscuit is calculated according to the "China Food Composition Table",and the energy supply ratio of three major calorigenic nutrient in different food combinations is also calculated.Finally,we determined whether energy supply ratio of the three major calorigenic nutrients of the biscuit is similar to a mix of certain energy ratios of certain types of food.Thus,the new nutritional information expression of'nutrition labels' was determined.The applicability and operability of balanced food practice was compared between the existing and improved nutrition information expression by the'desktop deduction'method.Results The biscuit contains 1 823 k] of energy per 100 g,which is about 5 "food exchange servings".The average energy supply ratio of protein,fat,and carbohydrate of all kinds of food are as follows:The cereals were 15％,5％ and 80％ respectively;the meats were 55％,39％ and 10％ respectively;the vegetables were 27％,9％ and 58％ respectively;and the fruits were 5％,3％ and 91％,respectively.If different types of food are mixed according to their energy ratio,then the energy supply ratio of the three energy producing nutrients is different.The energy ratio of the three energy producing nutrients of the prepackaged food will always be similar to that of the mixture of some kinds of food.The biscuit is similar to 1:4 energy mixed with oil foods and cereals,which translates to about 10 g of oils and 100 g of grains,based on the'food exchange serving'.Hence,if you eat 100 g of these cookies,subtract about 10 g of fat and 100 g of cereal from your three meals per day.Conclusion The nutritional ingredient list of'prepackaged food nutrition label'should increase the expression of 'food exchange'and food category and energy proportion,so as to facilitate the practice of balanced diet by consumers.

OBJECTIVE To explore the clinical features of patients carrying deletions of the rod domain of the dystrophin gene. METHODS Clinical data of 12 Chinese patients with Becker muscular dystrophy (BMD) and such deletions was reviewed. RESULTS Most patients complained of muscle weakness of lower limbs. Two patients had muscle cramps, one had increased creatine kinase (CK) level, and one had dilated cardiomyopathy. CONCLUSION Compared with DMD, the clinical features of BMD are much more variable, particularly for those carrying deletions of the rod domain of the dystrophin gene. Muscular weakness may not be the sole complaint of BMD. The diagnosis of BMD cannot be excluded by moderately elevated CK. For male patients with dilated cardiomyopathy, the possibility of BMD should be considered.

Objective To observe the effect and adverse reactions of ultrasound guided continuous femoral nerve block in postoperative analgesia after total knee arthroplasty(TKA) and to conduct the comparative study with traditional patient-controlled intravenous analgesia. Methods Forty patients undergoing elective unilateral knee replacement in this hospital from August 2015 to March 2016 were selected and divided into the group A and B, 20 cases in each group. The group A adopted ultrasound guided continuous femoral nerve block analgesia, while the group B adopted patient-controlled intravenous analgesia(PCA). The VAS score on postoperative 4,8,12,24,48 h were compared between the two groups, the VAS score of continuous passive motion on postoperative 24,48,72 h were compared between the two groups, the muscle strength grade and knee joint maximum passive flexion and extension on postoperative 2-6 d were compared between the two groups. Postoperative adverse reactions were observed. The levels of C-reactive protein(CRP) and interleukin- 6 (IL-6) were tested. The ultrasound monitoring of lower extremity deep vein thrombosis occurrence was performed and the changes of serum D -dimer was observed. Results The rest state VAS score at each time point in the group A was significantly lower that in the group B (P<0.05). The VAS score of continuous passive function exercise at postoperative 24,48,72 h in the group A was significantly lower than that in the group B (P<0.05). The passive flexion and extension mobility on postoperative 2,3,4 d in the group A was significantly higher than that in the group B(P<0.05). There was no signifi cant difference in muscle strength at each time point between the two groups (P>0.05). The number of PCA pressing times in the group A was less than that in the group B (P<0.05). The CRP level at postoperative 6 h in the group the A was lower than that in the group B (P<0.05). The IL-6 level after operation in the two group was higher than that before operation, but the intergroup had no significant difference (P>0.05). The lower extremity deep venous thrombosis formation detected by ultrasound had no significant difference between the two groups. The D-dimer level during perioperative period in the group A was lower than that in the group B (P<0.05). Conclusion Ultrasound guided continuous femoral nerve block used in postoperative analgesia in the patients undergoing knee arthroplasty has definite analgesic effect, can alleviate postoperative stress damage and incidence of postoperative complications, and is conducive to consolidate the operative curative effect.

Objective To explore the dose-effect,time-effect and safety of alteplase in the treatment of acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were selected,among whom 50 patients whose time window ≤3.0 h were divided into group A and group B by random digits table method with 25 cases each,and 60 patients whose time window 3.1-4.5 h were divided into group C and group D by random digits table method with 30 cases each.The patients in group A and group C received alteplase 0.6 mg/kg (maximum dose 60 mg) intravenous thrombolysis;the patients in group B and group D received alteplase 0.9 mg/kg (maximum dose 90 mg) intravenous thrombolysis.The national institutes of health stroke scale (NIHSS) scores before treatment and 1 h,24 h,7 d,30 d and 90 d after treatment were observed in the 4 groups.The therapeutic effect,complication incidence and fatality rate were compared.The prognosis was estimated by modified Rankin scale (mRS) score 90 d after treatment.Results The NIHSS scores 1 h,24 h,7 d,30 d and 90 d after treatment were significantly lower than those before treatment in the 4 groups,and there were statistical differences (P ＜ 0.05).The NIHSS score decreased significantly with time.There were no statistical differences in NIHSS score between group A and group B,group C and group D.There were no statistical differences in complication incidence and fatality rate 90 d aftcr treatment in group A and group D compared with group B and group C (P＞ 0.05).The rate of eusemia in group A was 76.00％ (19/25),in group B was 64.00％ (16/25),in group C was 43.33％ (13/30),and in group D was 53.33％ (16/30).And there were no statistical differences between group A and group B (x2 =0.620,P ＞0.05),and between group C and group D (x2 =0.069,P＞ 0.05).Conclusions The low dose alteplase is also effective and safe to acute cerebral infarction patients at time window ≤ 3 h.It is also effective and safe to acute cerebral infarction patients at time window 3.0-4.5 h at standard dose.

ObjectiveTo investigate the association between PPARγ gene rs3856806 polymorphism and nonalcoholic fatty liver disease (NAFLD). MethodsThe blood samples of 189 patients who were diagnosed with NAFLD by B-ultrasound and 184 healthy normal subjects were collected to determine the genotypes of PPARγ gene rs3856806 by improved multiple ligase detection reaction. Comparison of categorical data between the two groups was made by Pearson chi-square test, and comparison of continuous data was made by t test. And the logistic regression analysis was used for calculating odds ratio (OR) and 95% confidence interval (95%CI). ResultsThe NAFLD group had significantly higher body weight, waist circumference, hip circumference, and levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, glucose, triglyceride, total cholesterol, and low-density lipoprotein than the control group (P＜0.05). However, the NAFLD group had a significantly lower level of high-density lipoprotein than the control group (P＜0.01). There were no significant differences in the allele and genotype frequencies of rs3856806 between the two groups (P＞0.05). The patients with rs3856806 T allele showed higher risk of developing NAFLD than those with C allele (OR=1.068, 95%CI: 0.748-1.525, P＞005). The unconditional logistic regression analysis showed that the patients with TT/TC genotypes had higher risk of developing NAFLD than those with CC genotype (OR=1.077, 95%CI: 0.706-1.643, P＞0.05). ConclusionPPARγ gene rs3856806 polymorphism is not significantly associated with NAFLD.