Objective To systematically review the efficacy of different artificial liver support systems in the treatment of acute-on-chronic liver failure (ACLF) using a network Meta-analysis. Methods PubMed, Embase, the Cochrane library, Clinical Trial, CNKI, SinoMed, and Wanfang Data were searched for randomized controlled trials (RCTs) on different artificial liver support systems in the treatment of ACLF. Literature screening, data extraction, and method ological quality assessment were performed according to inclusion and exclusion criteria, and Stata15.1 software and R4.1.0 software were used to perform a network Meta-analysis. Results A total of 14 RCTs were included, with 1141 patients in total. The network meta-analysis showed different intervention methods had no significant difference in reducing mortality rate based on cross comparison (all P > 0.05). The probability ranking diagram showed that plasma exchange (PE) showed the best effect in reducing 30-day mortality rate, followed by extracorporeal liver assist device (ELAD), fractionated plasma separation and adsorption with Prometheus system, molecular adsorbent recirculating system (MARS), Biologic-DT liver dialysis device, and PE+MARS. PE showed the best effect in reducing 90-day mortality rate, followed by Prometheus, ELAD, and MARS. Biologic-DT showed the best effect in improving hepatic encephalopathy, followed by MARS, PE+MARS, and ELAD. Patients undergoing ELAD had the lowest risk of bleeding, and compared with standard medical treatment, Biologic-DT might increase the risk of bleeding [risk ratio=1.9×10 8 , 95% confidence interval: (4.6-6.2)×10 27 ]. Conclusion PE might be the best option for reducing 30- and 90-day mortality rates in ACLF patients. Biologic-DT has a better effect in improving hepatic encephalopathy, but it may increase the risk of bleeding.

Objective:To investigate the efficacy of salbutamol combined with budesonide aerosol inhalation in the treatment of patients with acute attack of bronchial asthma and its influence on serum inflammatory factors.Methods:From January 2017 to December 2018, 78 patients with acute attack of bronchial asthma in Zhejiang Xin'an International Hospital were selected, and they were divided into combined group and control group according to the random number table method, with 39 cases in each group.The control group was treated with routine western medicine, and the combined group was treated with salbutamol and budesonide aerosol inhalation on the basis of the control group.The two groups were treated for 2 weeks.The changes of vital capacity(VC), forced expiratory volume in one second(FEV 1) and peak expiratory flow(PEF) were compared before and after treatment.The changes of serum high mobility group protein 1(HMGB1), C-reactive protein(CRP) and tumor necrosis factor-alpha(TNF-α) were measured before and after treatment. Results:The total effective rate of the combined group was 87.18%(34/39), which was higher than 68.57%(24/39) of the control group, the difference was statistically significant(χ 2=5.791, P<0.05). The values of VC, FEV 1 and PEF between the two groups before treatment had no statistically significant differences( t=0.588, 0.892, 0.371, all P>0.05), which in the two groups after treatment were all increased(the combined group: t=16.045, 7.193, 6.667; the control group: t=7.834, 8.354, 4.262, all P<0.05). The values of VC, FEV 1 and PEF in the combined group after treatment were higher than those in the control group ( t=6.591, 9.615, 11.383, all P<0.05). The levels of HMGB1, CRP and TNF-α in the two groups before treatment had no statistically significant differences( t=0.306, 0.669, 0.371, all P>0.05), which in the two groups after treatment were all decreased (the combined group: t=10.235, 16.992, 12.371; the control group: t=4.763, 15.663, 13.115, all P<0.05). The levels of HMGB1, CRP and TNF-α in the combined group were lower than those in the control group after treatment( t=6.591, 3.559, 8.307, all P<0.05). Conclusion:Salbutamol combined with budesonide aerosol inhalation in the treatment of acute attack of bronchial asthma has better effect, which can effectively improve the lung function of patients, inhibit the release of inflammatory factors, and with high safety.

Objective To compare the efficacy of direct anterior approach ( DAA ) and posterolateral approach (PA) in hip arthroplasty for elderly patients with femoral neck fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 67 elderly patients with femoral neck fractures admitted to Second People's Hospital of Changzhou City, Affiliated Hospital of Nanjing Medical University from July 2015 to December 2017. There were 25 males and 42 females, aged 60-90 years [(76. 1 ± 7. 6)years]. There were 31 patients with right femoral neck fracture and 36 with left femoral neck fracture, all of whom underwent operations within 72 hours after injury. There were 18 patients with type III and 49 with type IV according to Garden typing. All patients were treated with total hip arthroplasty. Direct anterior approach ( DAA) was performed in 36 patients ( DAA group) and posterior approach ( PA) was performed in 31 patients ( PA group) . The operation time, intraoperative blood loss, postoperative drainage, recessive blood loss, total blood loss, the time when the patients got out of bed, and hospitalization time were compared between the two groups. Visual analogue scale ( VAS) and Harris score were used to evaluate hip joint function one month after operation. The complications of the two groups were recorded. Results All patients were followed up for 3-6 weeks, with an average of one month. The operation time of DAA group was longer than that of PA group [(75. 0 ± 10. 5)minutes vs. (54.0±11.4)minutes] (P<0.01). The DAA group had less intraoperative blood loss [(174.3 ± 60.1)ml vs. (254.8±79.9)ml] (P<0.05), total blood loss [(745.7 ±238.8)ml vs. (977.9 ± 301. 9)ml] (P<0. 05), recessive blood loss [(315. 4 ± 196. 7)ml vs. (457. 7 ± 286. 2)ml] (P<0. 05) than the PA group. There was no significant difference in the postoperative drainage between DAA groupandPAgroup[(246.1 ±110.1)ml vs. (265.3±164.2)ml] (P >0.05). DAA group had shorter durations in terms of the time when patients got out of bed [(23. 7 ± 18. 1)hours vs. (35. 1 ± 22. 5)hours] (P<0. 01) and hospitalization time [(9. 2 ± 1. 5)days vs. (12. 3 ± 2. 0)days] than the PA group (P <0. 05). The VAS scores of the DAA group and PA group at 1 month after surgery [(3. 0 ± 1. 9)points vs. (3. 3 ± 1. 9) points] and the Harris score [(87. 9 ± 6. 5) points vs. (87. 0 ± 6. 1)points ] were not significantly different (P>0. 05). Intraoperative and postoperative complications included femoral periprosthetic fracture in three patients, lateral femoral nerve injury in two patients and severe anemia requiring blood transfusion in two patients in DAA group. In the PA group, there was one patient with deep venous thrombosis of the lower extremity at one month after operation, two patients with posterior dislocation of the hip, four patients with periprosthetic fracture and four patients with severe anemia requiring blood transfusion (P>0. 05). Conclusion For femoral neck fracture in the elderly, compared with PA hip arthroplasty, DAA hip arthroplasty has less bleeding, earlier time to get out of bed and shorter hospital stay, with satisfactory short-term results.

Objective: To investigate the effect of adding glutathion(GSH) to tumescent solution on autologous fat graft survival. Methods: 14 male and female New Zealand rabbits were divided into experimental group and control group randomly, 7 in each group. Experimental group: The donor areas of the rabbits were injected with 3 ml of tumescent solution with GSH. Control group: The donor areas of the rabbits were injected with 3 ml regular tumescent solution. DCFH-DA probe was used for fluorescent staining of harvested fat cells. Then stained fat cells were measured for the intracellular reactive oxygen species(ROS)content by fluorescence microplate. The grafts were harvested at 3 months after transplantation and assessed by general observation, volume measurement, wet weight measurement, HE staining for the number of fat cells, and CD34 immunohistochemical staining for the measurement of micro-vascular density. T test was performed by using SPSS 24.0. Results: The intracellular ROS content of harvested fat cells in experimental group was lower than that in control group, and the difference was statistically significant (P<0.05). At 3 months after transplantation, the wet weight of fat grafts in experimental group was (1133.21±87.97) mg and that in control group was (718.79±79.27) mg. The volume of fat grafts in experimental group was (1.00±0.04) ml and that in control group was (0.59±0.03) ml. The number of fat cells in experimental group was (746.6±15.7)/10 high magnification vision and that in control group was (350.1±32.4)/10 high magnification vision. The density in group experimental was (8.1±2.0)/high magnification vision and that in control group was (6.7±2.4)/high magnification vision. The grafts′ volume, wet weight, and the number of fat cells in experimental group were higher than those in control group, and the differences were statistically significant (P<0.05). The difference of micro-vascular density between experimental group and control group had no statistical significance (P>0.05). Conclusions The addition of GSH to tumescent solution optimizes the process of autologous fat harvest, thereby improving the survival of fat graft.

Objective: To observe the dynamic changes of plasma level thymosinβ4 (Tβ4) in acute myocardial infarction (AMI) patients with intervening therapy within 15 days of onset and to explore the relationship between Tβ4 and clinical prognosis in AMI patients.
Methods: Our research included 2 groups:AMI group, n=69 and Control group, the patients with suspected chest pain while CAG excluded coronary artery stenosis, n=32. Plasma levels of Tβ4 were examined in all AMI patients on admission day and every day until 15 days of onset;AMI patients were followed-up for 18 months and the endpoint was defined as major adverse cardiovascular event (MACE) occurrence.
Results: ①Compared with Control group, AMI group had increased plasma level of Tβ4 on admission day and on day-15 of onset, P<0.01. ② With intervening therapy, AMI group had elevated Tβ4 level upon immediate onset, it was decreased on day-1, reached low level on day-3 and elevated to peak on day-6, then reduced followed by slightly raising on day-11.③During follow-up period, the AMI patients without MACE had the higher mean in-hospital maximum Tβ4 value than those with MACE occurrence, P<0.01. Logistic regression analysis indicated that the mean in-hospital maximum Tβ4 value was related to MACE occurrence during follow-up period (OR=0.999, 95%CI 0.999-1.000).
Conclusion: AMI may induce up-regulated expression of plasma Tβ4;with intervening therapy, Tβ4 showed a trend of“elevation-reduction-elevation-reduction”at the early stage of AMI. High expression of Tβ4 was helpful for improving clinical prognosis in AMI patients which may provide a theoretical basis for exogenous use of Tβ4 in AMI treatment.

This study aimed at investigating the inhibitory effects and the anti-tumor mechanisms of co-adminis-tration of fusion proteins mGM-CSF/βhCG ( GC ) and hVEGF121/βhCG ( VC ) on RM-1 prostatic cancer and B16 F10 melanoma in the C57 BL/6 J mouse model. Two recombinant stains containing pET-28 a-mGM-CSF-X10-βhCGCTP37 and pET-28 a-VEGF-M2-X10-βhCG-CTP37 were induced by lactose to express fusion proteins. The fusion proteins were separated and purified to prepare the anti-tumor protein vaccines ( VC protein vaccine and GC protein vaccine) , which were then mixed to prepare a combined protein vaccine named VGC protein vac-cine. The prostatic cancer and melanoma tumor-bearing mice C57 BL/6 J were immunized with described vac-cines, then the growth of each tumor was measured;splenocyte proliferation of immunized mice was detected;and the cytotoxic effects of the vaccine on tumor cells were tested. After that, the in vivo concentrations of IFN-γ and anti-hVEGF antibodies were investigated by ELISA. The difference between each experimental group and normal saline group ( NS) was statistically significant in both tumor-bearing mouse models ( P <0. 05) respectively. Besides, VGC group exhibited significantly better anti-tumor effect compared with the GC and VC groups with the anti-tumor rate ( 41. 7 ± 0. 83)% and ( 46. 4 ± 1. 27)% for prostatic cancer and melanoma tumor, respectively. The co-administration of the two proteins, VC and GC, could inhibit the growth of RM-1 prostatic tumor and B16F10 melanoma effectively via anti-tumor immunity and anti-tumor angiogenesis.

Objective: To establish Candida albicans vaginitis in mice and explore the best modeling conditions to provide an economical and practical animal model of Candida albicans vaginitis.Methods: After given estradiol valerate respectively at low, medium and high dose (0.001 5, 0.015, 0.15 mg/10 g) by gavage for continual 7 days, Kunming female mice were inoculated Candida albicans to establish the vaginitis model.The amount of Candida albicans in vaginal lavage fluid was analyzed and the vaginal pathological changes were observed.Results: The colony count in vaginal lavage with estradiol valerate at low, medium and high dose was 124.67±19.01, 217.67±22.50 and 282.00±27.87, respectively, and compared with that in the high dose group, there were significant differences in the medium dose group and low dose group (P＜0.05 or P＜0.01).HE staining and PAS staining showed that the high dose group had more polymorphonuclear neutrophils (PMNs) infiltration and purple red line hypha.Conclusion: Estradiol valerate at high dose is the best modeling condition for Candida albicans vaginitis in mice.

OBJECTIVE:To systematically review the effectiveness and safety of Yinzhihuang oral liquid in the adjuvant treat-ment of neonatal jaundice,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Da-tabase,Wanfang Database,Medline and EMBase,randomized controlled trials(RCT)about the effectiveness of Yinzhihuang oral liquid(test group)based on the canventional treatment(control group)in the adjuvant treatment of neonatal jaundice were collect-ed,and Meta-analysis was performed by using Rev Man 5.2 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 12 RCTs were enrolled,involving 1585 patients. Results of Meta-analysis showed total effective rate [OR=0.19,95%CI(0.12,0.30),P<0.001],serum total bilirubin levels [MD=-40.78,95%CI(-42.68,-38.89),P<0.001] and time of bilirubin decreased to normal [MD=-2.56,95%CI(-2.72,-2.40),P<0.001] in test group were significantly better than control group,the differences were statistically significant between 2 groups;3 reports of adverse reactions showed scme children had vomiting and mild diarrhea,they were improved after symptomatic treatment,and it did not affect the treatment. CONCLU-SIONS:The effectiveness of Yinzhihuang oral liquid is good in the adjuvant treatment of neonatal jaundice,with mild adverse reac-tions.

OBJECTIVE:Tosystematically evaluate the efficacy of Yixinshu capsule in the adjuvant treatmentof angina pecto-ris,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from CJFD,VIP Database,Wanfang Data-base,Medline and EMBase,randomized controlled trials(RCT)about the efficacyof Yixinshu capsule(test group)versus other drugs (control group) in the adjuvant treatment of angina pectoris were collected. Meta-analysis was performed bu using Rev Man 5.2 software after data extraction and quality evaluation by modified Jadad. RESULTS:Totally 11 RCTs were enrolled,involving 1 827 pa-tients. Results of Meta-analysis showed the total effective rate of angina pectoris improvement [OR=0.30,95%CI(0.23,0.40),P<0.001] and electrocardiogram improvement [OR=0.52,95%CI(0.41,0.66),P<0.001] in test group were significantly higher than control group,there was significant difference between 2 groups. CONCLUSIONS:Yixinshu is effective for the adjuvant treatment of angina pectoris.

OBJECTIVE:To systematically review the efficacy of Qijiao shengbai capsule in the adjuvant treatment of leukope-nia,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from CJFD,VIP,Wanfang Database and Medline and EMBase,randomized controlled trials(RCT) about the efficacy of Qijiao shengbai capsule (test group) versus blank control(control group) in the adjuvant treatment of leucopenia were collected. Meta-analysis was performed by using Rev Man 5.2 software after the quality assessment and data extraction. RESULTS:A total of 15 RCTs were included,involving 1 383 patients. Results of Meta-analysis showed the total effective rate [OR=0.31,95%CI(0.23,0.43),P<0.001],obvious effective rate [OR=0.31,95%CI(0.24,0.41),P<0.001],leukocyte count [MD=-1.04,95%CI(-1.10,-0.98),P<0.001] and myelosuppres-sion reduction [OR=0.27,95%CI(0.14,0.52),P<0.001] in test group were significantly higher than control group,there were sig-nificant differences. Only 9 patients had adverse reactions of mild diarrhea,nausea and other symptoms,and it relieved after symp-tomatic treatment. CONCLUSIONS:Qijiao shengbai capsule has achieve good efficacy in the adjuvant treatment of leukopenia. Due to the limits of quality and sample size,more strict designed,long-term follow-up of large scale RCTs are needed for the fur-ther verification of the conclusion.