Xihuang pills are a classic Chinese patent medicine following the theoretical principle of combining eliminating pathogen with reinforcing healthy qi in both local areas and the whole body， with the effects of clearing heat， detoxifying， alleviating edema， and dissipating mass. This medicine is traditionally used for treating carbuncle， furuncle， multiple abscess， carcinoma of breast， phlegm nodule， scrofula， lung abscess， and intestine abscess caused by fire depression， phlegm stasis， and heat toxin stagnation. It is used for treating malignant tumors， breast hyperplasia， herpes zoster， lymphadenitis， pelvic inflammatory disease， mastitis， vocal cord leukoplakia， and acne in modern medicine. Xihuang pills are now included in the 2020 edition of the Chinese Pharmacopoeia. The use of high-quality medicinal materials and modern technology enables full retaining of the active components in the medicinal materials. The chemical components in this medicine mainly include amino acids， terpenoids， fatty acids， fatty acid esters， phenols， bile acids， bile pigments， and volatile oils. Modern pharmacological studies have shown that a variety of active components such as bilirubin， bile acid， boswellic acid， and volatile oil in Xihuang pills interact with each other to exert anti-tumor， anti-breast hyperplasia， immunomodulatory， anti-inflammatory， and neuroendocrine-regulating effect. This paper reviews the research progress in the active components and pharmacological effects of Xihuang pills and predicts the quality markers （Q-markers） of this medicine according to the transmission， traceability， specificity， efficacy， measurability， and compound compatibility in the concept of Q-marker. It is suggested that bilirubin， bile acid， taurine， muskone， 11-carbonyl-β-boswellic acid， β-boswellic acid， 3-acetyl-11-keto-β-boswellic acid， octyl acetate， β-elemene， and myrrhone can be used as Q-markers of Xihuang pills， which can provide a basis for research on the material basis and the quality control of Xihuang pills.

Objective:To observe the clinical efficacy of neck Gongfa exercise in intervening people at high risk for cervical spondylosis. Methods:A total of 212 participants from 8 companies at high risk for cervical spondylosis were divided into two groups using the random number table method,with 105 participants in the control group receiving health education and 107 participants in the trial group receiving an additional neck Gongfa exercise.After successive 3-month interventions,the two groups were compared in terms of cervical soft tissue tension and neck disability index(NDI)score.The incidence of cervical spondylosis was observed 3 months later. Results:During the process,10 cases dropped out in the trial group,and the control group had 9 dropout cases.After the intervention,the cervical soft tissue tension value and NDI score improved in both groups(P<0.05)and showed significant differences between the two groups(P<0.05).At the 3-month follow-up,the trial group had a lower incidence rate of cervical spondylosis than the control group(P<0.05). Conclusion:For people at high risk for cervical spondylosis,neck Gongfa exercise can effectively improve cervical soft tissue tension and motor dysfunction and lower the incidence of cervical spondylosis in the short run.

Esophageal squamous cell carcinoma (ESCC) is a kind of malignant tumor with high incidence and mortality in the digestive system. The aim of this study is to explore the function of lnc-ABCA12-3 in the development of ESCC and its unique mechanisms. RT-PCR was applied to detect gene transcription levels in tissues or cell lines like TE-1, EC9706, and HEEC cells. Western blot was conducted to identify protein expression levels of mitochondrial apoptosis and toll-like receptor 4 (TLR4)uclear factor kappa-B (NF-κB) signaling pathway. CCK-8 and EdU assays were carried out to measure cell proliferation, and cell apoptosis was examined by flow cytometry. ELISA was used for checking the changes in glycolysis-related indicators.Lnc-ABCA12-3 was highly expressed in ESCC tissues and cells, which preferred it to be a candidate target. The TE-1 and EC9706 cells proliferation and glycolysis were obviously inhibited with the downregulation of lnc-ABCA12-3, while apoptosis was promoted. TLR4 activator could largely reverse the apoptosis acceleration and relieved the proliferation and glycolysis suppression caused by lnc-ABCA12-3 downregulation. Moreover, the effect of lnc-ABCA12-3 on ESCC cells was actualized by activating the TLR4/NF-κB signaling pathway under the mediation of exosome. Taken together, the lnc-ABCA12-3 could promote the proliferation and glycolysis of ESCC, while repressing its apoptosis probably by regulating the TLR4/NF-κB signaling pathway under the mediation of exosome.

OBJECTIVES: To compare the short-, mid-, and long-term outcomes in patients with esophageal cancer between minimally invasive esophagectomy via Sweet approach in combination with cervical mediastinoscopy (MIE-SM) and minimally invasive esophagectomy via McKeown approach (MIE-MC), and to evaluate the value of MIE-SM in the surgical treatment of esophageal cancer. METHODS: A prospective, nonrandomized study was adopted. A total of 65 esophageal cancer patients after MIE-SM and MIE-MC from June 2014 to May 2016 were included. Among them, 33 patients underwent MIE-SM and 32 patients underwent MIE-MC. Short-term outcomes (including the duration of surgery, intraoperative blood loss volume, ICU stay time, postoperative complications, postoperative hospital stay, reoperation, open surgery, number of dissected lymph nodes, and 30-day mortality), mid-term outcomes, [including Quality of Life Core Questionnaire (QLQ-C30) and the esophageal site-specific module (QLQ-OES18)], long-term outcomes [including overall survival and disease-free survival] were compared between the 2 groups. RESULTS: Radical resection (R0) were achieved in all patients. There were no significant differences in the duration of surgery, intraoperative blood loss volume, ICU stay time, postoperative complications, and postoperative hospital stay between the 2 groups (all CONCLUSIONS MIE-SM appears to be a safe surgical approach, which may get better quality of life, suffer less pain, and can achieve the same therapeutic effect as MIE-MC. Therefore, MIE-SM should be considered as a valuable approach for the treatment of middle and lower esophageal cancer.
Esophageal Neoplasms/surgery* ; Esophagectomy ; Humans ; Laparoscopy ; Mediastinoscopy ; Minimally Invasive Surgical Procedures ; Postoperative Complications/epidemiology* ; Prospective Studies ; Quality of Life ; Retrospective Studies ; Treatment Outcome

Since epileptic seizure is unpredictable and paroxysmal, an automatic system for seizure detecting could be of great significance and assistance to patients and medical staff. In this paper, a novel method is proposed for multichannel patient-specific seizure detection applying the earth mover's distance (EMD) in scalp EEG. Firstly, the wavelet decomposition is executed to the original EEGs with five scales, the scale 3, 4 and 5 are selected and transformed into histograms and afterwards the distances between histograms in pairs are computed applying the earth mover's distance as effective features. Then, the EMD features are sent to the classifier based on the Bayesian linear discriminant analysis (BLDA) for classification, and an efficient postprocessing procedure is applied to improve the detection system precision, finally. To evaluate the performance of the proposed method, the CHB-MIT scalp EEG database with 958 h EEG recordings from 23 epileptic patients is used and a relatively satisfactory detection rate is achieved with the average sensitivity of 95.65% and false detection rate of 0.68/h. The good performance of this algorithm indicates the potential application for seizure monitoring in clinical practice.
Classification ; Discriminant Analysis* ; Electroencephalography* ; Epilepsy* ; Humans ; Medical Staff ; Methods ; Scalp* ; Seizures ; Weights and Measures

Objective To investigate the clinical efficacy of jejunal interposed single-tract and doubletract reconstruction after proximal gastrectomy for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods The prospective study was conducted.The clinicopathological data of 108 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to the Affiliated Tumor Hospital of Shanxi Medical University between August 2013 and November 2016 were collected.All the patients underwent proximal gastrectomy and were allocated into the 2 groups by random number table,including patients using single-tract jejunal interposition reconstruction in the single-tract group and patients using double-tract jejunal interposition reconstruction in the double-tract group.Digestive tract reconstruction:after end-to-side anastomosis between distal jejunum and esophagus and side-to-side anastomosis between posterior wall of the gastric remnant and jejunum,single-tract jejunal reconstruction was done through ligating jejunum at 3 cm below the anastomotic stoma,and then side-to-side anastomosis between proximal jejunum and jejunum was performed in the single-tract group.Patients in the double-tract group used the same digestive tract reconstruction,but jejunum was not ligated.The postoperative pathological examinations showed that patients with positive lymph nodes or tumor invading all layers of gastric wall underwent chemotherapy.Observation indicators:(1) intra-and post-operative situations;(2) follow-up situations.Follow-up using telephone interview was performed to detect postoperative complication,gastrointestinal function and body mass index (BMI) up to November 2017.Measurement data with normal distribution were represented as-x± s and comparison between groups was analyzed using t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was analyzed using the nonparametric test.Repeated measurement data were analyzed by the repeated measures ANOVA.Comparisons of count data were done using chi-square test.Ordinal data were analyzed by the Kruskal Wallis H test.Results One hundred and eight patients were screened for eligibility,including 55 in the single-tract group and 53 in the double-tract group.(1) Intra-and post-operative situations:total operation time,digestive tract reconstruction time,volume of intraoperative blood loss,time to initial anal exsufflation,postoperative complications,cases with gastroesophageal reflux,intestinal obstruction and Visick grading ＞ Ⅱ and duration of postoperative hospital stay were respectively (145±26) minutes,(30±6) minutes,(181±37) mL,(53± 16) hours,1,1,1,(10.0±2.4) days in the singletract group and (139±29)minutes,(26±3)minutes,(176±31)mL,(50±17) hours,3,0,3,(9.4±l.4)days in the double-tract group,with no statistically significant difference between groups (t =0.725,0.219,0.162,-0.576,x2 =2.960,5.830,t =-0.993,P＞0.05).Four patients with gastroesophageal reflux received motilium and omeprazole therapy for 2 weeks,and were improved by symptomatic treatment such as increasing the solid food intake.One patient in the single-tract group had internal hernia-induced intestinal obstruction and was cured by reoperation.There was no anastomotic leakage,bleeding,infection,dumping syndrome and gallstone between groups.Of 108 patients,71 underwent 6-cycle SOX chemotherapy,including 67 with perigastric lymph node metastasis and 4 with tumor invading all layers of gastric wall.(2) Follow-up situations:108 patients were followed up for 12.0-48.0 months,with a median time of 28.6 months.During the follow-up,bowel sound in the double-tract group and single-tract group was 8 times / minute (range,5-12 times / minute) and 3 times /minute (range,2-5 times/ minute),with a statistically significant difference between groups (Z=-0.692,P＜0.05).The single food intake,serum gastrin level,ratio of serum pepsinogen Ⅰ and Ⅱ levels and BMI from preoperation to postoperative 12 months were from (1 117± 129)mL to (817± 127)mL,from (12±5)pmol/L to (41±13) pmol/L,from 11.3±2.8 to 5.1±2.2,(65±7)kg to (63±5) kg in the single-tract group and from (1 095±118)mL to (783±80)mL,from (10±4)pmol/L to (40±10)pmol/L,from 12.4±2.9 to 4.2±1.3,from (63±6) kg to (58±6)kg in the double-tract group,respectively,with no statistically significant difference in single food intake,serum gastrin level and ratio of serum pepsinogen Ⅰ and Ⅱ levels between groups (F =0.468,0.108,0.161,P＞0.05).There was a statistically significant difference in changing trend of BMI between groups (F=24.930,P＜0.05).Conclusion Jejunal interposed single-tract and double-tract reconstruction after proximal gastrectomy for Siewert type Ⅱ and Ⅲ AEG have the same surgical safety and don't affect secretion function of gastric remnant,but there are frequent bowel sounds and obvious weight loss.

Objective To explore the operation of C-type osteotomy for reduction of prominent zygomatic complex. Methods Based on the severity and characteristics of prominent zygomaitc complex, Ctype osteotomy was designed for the malar complex reduction by using oral and minor pre-auricular approaches under general anaesthesia. Two paralleled osteotomic lines of C-type were marked from zygomatic alveola to the conjunction of lateral orbital margin and zygomatic arch through the inferio-lateral edge of orbit. The extension of zygomatic arch reduction was determined the width of two osteotomic lines. The bone which marked lines was removed by reciprocating saw and osteotome. The zygomatic arch root was osteotomiced by pre-auricular approaches. Then, the zygomatic complex could move freely towards superior-medial position. Finally, the zygoma was fixed with titanium mini-plates. Results 12 patients with prominent zygomatic complex had been successfully operated by C-type osteotomy from July 2006 to April 2009. Of them, six cases were symmetrical and six cases were unsymmetrical. Postoperative follow-up for 4-24 months, infection was not occurred, and the scar of pre-auricular incision was not obvious. All the patients obtained positive results. Conclusion C-type osteotomy for correction of prominent zygomtic complex through intra-oral and minor pre-auricular approach is an effective surgical method and gives superior results. It preserves the intactness of maxillary sinus, prevents facial slack, and is especially effective for patients with prominent zygomatic arch.

Objective To investigate the neural circuit of inhibitory control in late-onset depressed patients(LOD) by functional magnetic resonance imaging(fMRI). Methods Fourteen late-onset depressed patients (LOD group) and thirteen elderly healthy subjects( control group) were recruited. The two groups were age, gender, and education matched. All the subjects performed a visual Go/Nogo task during the fMRI scan. Erect or inverted isosceles triangular figures were used for stimuli. The two groups were instructed to press a button as quickly and correctly as possible when the erect triangular figures(Go) were presented, but not to response when the inverted triangular figures(Nogo) were presented. The differences of brain activation between the two groups were compared. Results ( 1 ) During Go trials, there were no significant differences in reaction time and hit rate between the two groups (P ＞ 0.05 ). During Nogo trials, however, the late-onset depressed patients showed much higher false alarm rate(0.09 ±0.06) compared with control group(0.04 ±0.02) (P＜0.05＝. (2) During Go trials , LOD group showed significantly greater activity in left postcentral gyrus, left inferior parietal lobule, right precentral gyrus, left paracentral lobule, right inferior parietal lobule, right anterior cingulate cortex, left middle frontal gyrus, right middle frontal gyrus, right superior frontal gyrus compared with the control group. Whereas during Nogo trials, LOD group exhibited greater activity in left inferior parietal lobule and left middle frontal gyrus compared with the control group. Conclusion This study suggests that inhibitory control dysfunction in late-onset depressed patients may be closely related to frontostriatal circuit impairment. Over activation in left middle frontal gyrus, right middle frontal gyrus and right anterior cingulate cortex may contribute to the pathogenesis of late-onset depression.

BACKGROUND: Donor antigen presenting cells immigrated into the recipient can induce the immunological tolerance of recipient T cells to donor, leading to a final acceptance to grafts, lnterleukin-10 (IL-10) modification maintains dendritic cells at a desirable differentiating state, which is an effective method to promote the protection to kidney in the simultaneous liver-kidney transplantation.OBJECTIVE: To observe the immigration of IL-10-modified dendritic cells in rats subjected to simultaneous liver-kidney transplantation and to investigate the mechanism of action.DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed in the Medical College of Sun Yat-sen University between June 2004 and February 2006.MATERIALS: Male DA donor rats (n=60) and Lewis recipient rats (n=60), both were adult and of clean grade, were included.Sixty Lewis rats were randomly and evenly divided into 3 groups: IL-10-modified cell group, simple cell group, and model control group.METHODS: Donor rat liver and kidney were harvested by simultaneous liver-kidney transplantation. Recipient rats in each group were subjected to orthotopic liver and left kidney transplantation to establish models of immunological rejection. Under sterile condition, donor rat femur and tibia were harvested. Dnlbecco's modified eagle's medium (DMEM) was used to wash out the bone marrow. After removal of red cells, dendritic cells were isolated and cultured by adherent method. After modified with 20 μg/L IL-10 for 72 hours, dendritic cells were intravenously transfused into rat bodies in the IL-10-modified group, 2×10(7) cells/rat, In the simple cell group, rats were treated with donor dendritic cells without modification with IL-10. Rats in the model control group received no any interventions.MAIN OUTCOME MEASURES: [1]Dynamic changes of vital sign, urine volume, liver and renal function in recipient tissues;[2] Pathohistological detection results;[3]Distribution of donor dendritic cells in the recipient rats by in situ hybridization.RESULTS: In the simple cell and model control groups, urinary volume was reduced to 0 mL 5-6 days after transplantation. In addition, both groups presented with severe acute rejection. In the IL-10-modified cell group, urinary volume maintained at 6-12mL within 2 weeks after transplantation. The acute rejection of liver and kidney transplantation was obviously inhibited, surviving for(20.0±2.6) days on average, which was significantly longer than that in the simple cell group and model control group. A probability value of less than 0.05 in the Log Rank test was considered statistically significant. There were many Y chromosome-labeled dendritic cells immigrated into the mesenteric lymph node in the recipient rats.CONCLUSION: IL-10-modified dendritic cells play an immunoprotective effect on the liver and kidney transplanted simultaneously. Donor immature dendritic cells immigrated into recipient tissue could reduce acute rejections and prolong the survival time of liver and kidney grafts and recipients.

BACKGROUNDTo explore a rapid and accurate method for examining cancer cell from the sputum in patients with lung cancer.

METHODSOne hundred and twenty patients with lung cancer diagnosed by operation and pathologically confirmed were enrolled in this study. Sputum sediment section and sputum smear examinations were performed and compared for diagnosis of lung cancer.

RESULTS(1) The positive rate of lung cancer cell was 71.67% (86/120) by sputum sediment section examination, however, only 31.67% (38/120) by sputum smear examination ( P < 0.001). The diagnostic rate of combination of two methods for lung cancer was 90.83% (109/120), which was significantly higher than that of single sputum sediment section examination ( P < 0.001). (2) With routine HE staining, 55 patients (55/86,63.95%) could be histologically identified by sputum sediment section examination, but only 6 patients (6/38,15.79%) by sputum smear examination ( P < 0.001). (3) In 31 patients unidentified with routine HE staining, 29 were further histologically confirmed by sputum sediment section examination with immunohistochemistry.

CONCLUSIONSCompared to sputum smear examination, sputum sediment section examination can make use of more sputum materials, show a higher sensitivity for cancer cell, and accurately identify the histological classification of tumor. It is supposed to be a good examination for lung cancer and deserved to be extended in clinical application.