Objective To screen the pharmacodynamic material basic components of Artemisiae Annuae Herba and study its antioxidant activity in vitro by investigating the spectrum-effect relationship between the HPLC fingerprints of 11 batches of Artemisiae Annuae Herba(dried aerial part of Artemisia annua L.).Methods The determination was performed on Aglient C18 column(250 mm×4.6 mm,5 μm)with mobile phase consisted of 0.2%phosphoric acid solution-Methanol(gradient elution)at the flow rate of 1.0 ml/min.The column temperature was indoor temperature,and detection wavelength was 220 nm,with sample size of 10 μl.Using isochlorogenic acid A as reference,HPLC fingerprints of 11 batches of samples were determined.The common peaks of 11 batches of samples were identified and recorded through TCM chromatographic fingerprint similarity evaluation system(2012 edition).Using scavenging rate of DPPH and ABTS free radical as pharmacodynamic indicators of antioxidant effects,SIMCA 14.1 analysis software was used for PLSR to establish the spectra-effect relationship.Results There were 48 common peaks on 11 batches of sample,11 components were identified as scopoletin,scoparone,isochlorogenic acid B,A,C,luteolin,apigenin,chrysosplenetin,artemisinin,artemisetin and artemisinic acid.The scavenging activity of 11 batches of samples to DPPH and ABTS free radicals was detected.The spectrum-effect relationship showed that isochlorogenic acid A,B,C and scoparone were positively associated with its antioxidant capacity,and variable projection value was greater than 1.It was suggested that these components were the material basis of antioxidant effect in Artemisiae Annuae Herba.Conclusion This study investigates the antioxidant capacity of different substances in Artemisiae Annuae Herba in vitro,and proves that isochlorogenic acid A,B,C and scoparone play a major role for the antioxidant capacity.

Laparoscopic pancreaticoduodenectomy is an important surgical undertaking, mostly used for benign and malignant tumors in the pancreatic head and periampullary region. The postoperative pancreatic fistula is the main factor to cause death after pancreaticoduodenectomy, and pancreaticojejunostomy is an independent risk factor for pancreatic fistula. In order to reduce the incidence of pancreatic fistula, surgeons have proposed dozens of pancreaticojejunostomy, but so far there are no randomized trials proved which method of pancreaticojejunostomy is better than the others. This article reviews the methods and characteristics of different pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.

Objective:To preliminarily investigate dermoscopic characteristics of trichoblastoma, and to provide ideas for clinical diagnosis of trichoblastoma.Methods:Clinical data were collected from 5 patients with trichoblastoma who underwent both dermoscopic and histopathological examinations in Wuhan No.1 Hospital from November 2018 to July 2021, and dermoscopic features were analyzed retrospectively.Results:According to the presence or absence of pigments, trichoblastoma was divided into 2 subtypes: pigmented trichoblastoma (3 cases) and non-pigmented trichoblastoma (2 cases) . Dermoscopic examination of the 3 cases of pigmented trichoblastoma showed blue-gray ovoid nests (3 cases) , arborizing vessels (2 cases) , blue-gray globules (2 cases) , bright white structureless areas (2 cases) , concentric structures (1 case) and ulcers (1 case) ; no yellow-whitish homogenous structure was found. As for non-pigmented trichoblastoma, dermoscopic features included arborizing vessels (2 cases) , yellow-whitish homogenous structures (2 cases) , bright white structureless areas (2 cases) and blue-gray globules (1 case) ; no ulcers or blue-gray ovoid nests were observed in either case.Conclusion:Dermoscopic patterns differ between pigmented and non-pigmented trichoblastoma, so dermoscopy can provide preliminary diagnostic clues for trichoblastoma.

Objective:To explores the clinical efficacy and safety of carotid endarterectomy in patients with high bifurcation carotid artery stenosis.Methods:A total of 169 patients with carotid artery stenosis (147 patients with non-high bifurcation carotid artery stenosis and 22 patients with high bifurcation carotid artery stenosis), underwent carotid endarterectomy under surgical microscope in our hospital from January 2017 to January 2020, were included in the study. Patients with high bifurcation carotid artery stenosis were operated by cutting off the posterior abdomen of the digastric muscle to assist in exposing the distal end of the internal carotid artery plaque. Cervical CTA/DSA examination was performed within one week of surgery to confirm whether carotid artery stenosis was relieved; ultrasound examination of cervical vessels was performed 6 months and 1 year after surgery to determine whether restenosis was appeared in the carotid artery. The surgical efficacy, perioperative complications and re-examination results were compared between the two groups.Results:Postoperative carotid artery stenosis was relieved in both groups. The proportions of new cerebral infarction and temporary neurological impairment between the two groups (4.5% vs. 2.0%; 9.1% vs. 3.4%) showed no significant differences ( P>0.05). Carotid artery restenosis was not found in both groups. There was no obvious functional abnormality in the digastric muscles of patients with high bifurcation carotid stenosis. Conclusion:Cutting off the posterior abdomen of the digastric muscle during carotid endarterectomy can better expose the distal end of the internal carotid plaque in patients with high bifurcation carotid stenosis, and provide convenience for effective relief of carotid artery stenosis with high safety.

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

Objective:To explore the efficacy of bridging therapy (BT) and direct endovascular therapy (DEVT) in patients with acute ischemic stroke induced by large vessel occlusion (LVO-AIS) within 4.5 h of onset.Methods:The clinical data of 154 patients with LVO-AIS within 4.5 h of onset, admitted to our hospital from January 2017 to July 2019, were retrospectively collected. Among them, 88 patients were hospitalized within 3 h of onset (54 accepted BT and 34 accepted DEVT); 66 patients were hospitalized within 3-4.5 h of onset (39 accepted BT and 27 accepted DEVT). The differences in clinical data and treatment efficacy between patients from the BT group and DEVT group that were hospitalized within 3 h of onset and within 3-4.5 h of onset, respectively, were compared. Multivariate Logistic regression was used to analyze the independent protective factors for favorable outcome 90 d after treatment in patients within 3.0-4.5 h of onset and within 3 h of onset, respectively.Results:(1) In patients within 3 h of onset: as compared with the DEVT group, the BT group had significantly higher improvement rate of neurological function at 24 h after treatment (41.2% vs. 70.4%) and higher percentage of patients enjoying favorable outcome 90 d after treatment (44.1% vs. 66.7%, P<0.05); multivariate Logistic regression analysis showed that BT was an independent protective factor for favorable outcome 90 d after treatment in patients within 3 h of onset ( OR=4.644, 95%CI: 1.238-12.805, P=0.041). (2) In patients within 3-4.5 h of onset: as compared with the BT group, the DEVT group had significantly higher proportion of patients having time from onset to groin puncture≤4 h, and significantly higher proportion of patients with favorable outcome 90 d after treatment ( P<0.05); multivariate Logistic regression analysis showed that the time from onset to groin puncture≤4 h was an independent protective factor for favorable outcome 90 d after treatment in patients within 3-4.5 h of onset ( OR=5.724, 95%CI: 1.192-11.676, P=0.024). Conclusion:For LVO-AIS patients, BT is the first choice in patients hospitalized in the early time window; and BT should be performed within 4 h of onset to the greatest extent for patients hospitalized in the late time window; if time from onset to groin puncture is not within 4 h, DEVT should be the first choice.

Objective To study epidemic of schistosomiasis in the Qiandao Lake reservoir area,and to provide a reference for prevention and control of schistosomiasis in the construction of large water conservancy projects in the epidemic area of schistosomiasis.Methods The data over the years of snail condition and monitoring of schistosomiasis before and after building the dam,and water conservancy project reconstruction related information were collected.Based on the survey results of the river channel,the lake beach and the dissipation zone in the reservoir area,the influence of Xin'an River water conservancy project on epidemic of schistosomiasis in the Qiandao Lake reservoir area was analyzed,and the epidemic factors of the schistosomiasis in the Three Gorges reservoir were compared and analyzed.Results Before the dam was built,an area of 38 144 000 m2 was examined but Oncomelania was undetected.The Qiandao Lake reservoir area belonged to a non epidemic area of schistosomiasis.After the dam was built,557 cases of schistosomiasis were found in 6 232 immigrants during 1962-1965,resulting in an imported epidemic.In 1970-1980,an area of 379 654 m2 in which Oncomelania was found was examined and snails were mainly distributed in some rice fields and ditches in the end of the reservoir.949 cases of local schistosomiasis were found in the snails.The condition and condition of the snail are gradually controlled through several decades of comprehensive prevention and control.Compared with the epidemic factors of schistosomiasis in Qiandao Lake and the Three Gorges reservoir,the environment of elevation beach and ecologically fragile fluctuation zone coexist in the two reservoir areas.Conclusion From the long-term longitudinal monitoring data of the Qiandao Lake reservoir area and the epidemic regularity of schistosomiasis and the comparison with the ecology of the Three Gorges reservoir,it is concluded that the two reservoir areas will not cause a large range of schistosomiasis epidemic in general,but it does not exclude the possibility of the breeding of the inputting Oncomelania.

Objective To research the expressions of Sirtuin 1 (SIRT1) in colorectal cancer and normal tissue and the relationship with clinicopathologic features.Methods The expression levels of SIRT1 mRNA and protein were detected respectively by quantitative real-time reverse transcriptase PCR (RT-QPCR) and immunohistochemistry (IHC) in 45 cases of colorectal carcinoma and 30 cases of normal mucous membrane tissue,and the relationships between the expression status and clinicopathologic features were analyzed.Results In colorectal carcinoma,the expression of SIRT1 mRNA were higher than that in control group [M(QR):2.488(3.447) vs.1.563(2.867),Z =-2.304,P ＜0.05],so was the protein level (71.1％ vs.43.3％,x2 =5.787,P =0.029).The expression of SIRTI was associated with lymph node metastasis (RT-QPCR:Z =-2.160,P =0.031;IHC:P =0.043),neoplasm stages (RT-QPCR:Z =-2.411,P =0.016;IHC:P =0.008),and might associated with the tissue differentiation (RT-QPCR:x2 =10.864,P =0.004;IHC:P =0.322).On the other hand,no significant differences were observed regarding age,sex,tumor size,gross type,depth of invasion,tumor site and distant metastasis.Conclusion The expression of SIRT1 in colorectal cancer is higher than that in control group,the high level of SIRT1 is related to the tumorigenesis and progression of colorectal cancer as well as correlated with prognosis in colorectal cancer.

Objective To explore the function of stereotactic radiation therapy (SRT) and wholebrain radiation therapy (WBRT) in treatment of multiple brain metastasis tumor.Methods Fifty-two patients with multiple brain metastasis tumor were retrospectively analyzed.The patients were divided into simple stereotactic radiation therapy group (22 cases) and whole-brain radiation therapy + stereotactic radiation therapy group (30 cases) according to the radiation therapy method.The median overall survival time and distant brain tumor recurrence rate in 1 year etc.were compared between 2 groups.Results There were no statistical differences in the median overall survival time and fatality rate between simple stereotactic radiation therapy group and whole-brain radiation therapy + stereotactic radiation therapy group:13.0 months (95％ CI 8.05-27.84) vs.13.4 months (95％ CI 8.57-19.48),86.36％ (19/22) vs.86.67％ (26/30),P＞ 0.05.The distant brain tumor recurrence rate in 1 year in simple stereotactic radiation therapy group was significantly higher than that in whole-brain radiation therapy + stereotactic radiation therapy group:45.45％ (10/22) vs.20.00％ (6/30),and there was statistical difference (x2 =3,861,P =0.049).Conclusion Stereotactic radiation therapy and whole-brain radiotherapy can achieved similar median overall survival time.

Objective To compare the effect of occupy effects of tumor in situ before surgery(OETS) and after neurosurgery (ANS) on neuroendocrine dysfunction and grading of neuroendocrine function in children with craniopharyngioma. Methods The grading evaluation criteria of neuroendocrine dysfunction in children with craniopharyngioma were drew up according to references and the endocrine feedback principle. Based on these grading evaluation criteria, the clinical date of 227 cases of children with craniopharyngioma who underwent neurosurgical treatment were retrospectively studied. These children were divided into pre-pubertal group (167 cases) and pubertal group (60 cases). The neuroendocrine impairment status before and after the surgery were evaluated separately. Results Among 227 children with craniopharyngioma, after the surgery, the incidence of the hypothalamus-pituitary-thyroid dysfunction increased from 16.74%(38/227) to 67.40%(153/227), the incidence of the hypothalamus-pituitary-adrenal gland dysfunction increased from 14.54%(33/227) to 44.49%(101/227), and the the incidence of pituitary function impairment increased from 17.62%(40/227) to 21.15%(48/227). Meanwhile, the incidence of body temperature dysregulation, sleeping disorder, personality abnormality and cognitive abnormality all increased after the surgery. The scoring and grading on neuroendocrine dysfunction in pre-pubertal group were increased after the surgery (Z=-5.20, P<0.01; Z=-4.94, P<0.01,). The scoring and grading on neuroendocrine dysfunction in pubertal group were increased after the surgery( Z=-4.10, P<0.01;Z=-4.25, P<0.01). Conclusions Both the mass effect of tumor in situ of craniopharyngioma and the neurosurgical treatment can be harmful to the neuroendocrine function. Even though the surgery can remove the mass effect of tumor in situ in the saddle area, it can increase the level of grading of neuroendocrine dysfunction. The status of neuroendocrine dysfunction can be evaluated by the grading evaluation criteria of neuroendocrine dysfunction in children with craniopharyngioma, which then provides an effective evaluation tool for the reconstruction and rehabilitation of neuroendocrine function.