Objective:To investigate the predictive value of neutrophil/lymphocyte ratio (NLR) on the discharge outcome in elderly patients with acute ischemic stroke (AIS) receiving intravenous thrombolysis (IVT).Methods:Elderly patients with AIS received IVT in the Department of Neurology, the Second Affiliated Hospital of Soochow University from August 2018 to August 2020 were retrospectively included. The modified Rankin Scale was used to evaluate discharge outcome, and the score >2 was defined as poor outcome. Symptomatic intracranial hemorrhage (sICH) was defined as any intracranial hemorrhage found on imaging examination accompanied by neurological deterioration, where the National Institutes of Health Stroke Scale (NIHSS) score increased by ≥4 from baseline or bleeding led to death. Multivariate logistic regression analysis was used to determine independent risk factors for sICH and poor discharge outcome. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of NLR for sICH and poor discharge outcome. Results:A total of 228 elderly patients with AIS receiving IVT were enrolled, including 118 males (51.8%), aged 73.64±8.16 years, with a baseline NIHSS score of 6.23±6.54. Ninety patients (39.5%) had poor outcome at discharge, and 16 (7.0%) developed sICH. Univariate analysis showed that the NLR in the poor outcome group was significantly higher than that in the good outcome group ( P<0.01). Multivariate logistic regression analysis showed that a higher NLR was an independent risk factor for poor discharge outcome (odds ratio [ OR] 1.245, 95% confidence interval [ CI] 1.044-1.484; P< 0.05) and sICH ( OR 1.124, 95% CI 1.010-1.251; P<0.05). ROC curve analysis showed that the area under the curve of NLR for predicting poor discharge outcome was 0.693 (95% CI 0.620-0.765; P<0.01). The optimal cutoff value was 4.345. Its corresponding sensitivity and specificity were 47.8% and 87.7%, respectively. The area under the curve of NLR for predicting sICH was 0.651 (95% CI 0.498-0.804; P<0.05). The optimal cutoff value was 3.515. Its corresponding sensitivity and specificity were 68.8% and 61.8%, respectively. Conclusions:A higher NLR is independently associated with sICH and poor discharge outcome in elderly patients with AIS receiving IVT, and have certain predictive value for sICH and poor discharge outcome.

A novel sort of nano-component was extricated and isolated from Descurainiae Semen Carbonisatum (DSC), and its hemostatic component was considered through pharmacological experiments. A muffle furnace was used to prepare DSC at 250 ℃, 300 ℃ and 350 ℃, and the DSC dialysate at each temperature was obtained by the extraction and separation method. Low-resolution transmission electron microscopy (TEM) and high-resolution transmission electron microscopy (HR-TEM) were utilized to characterize the nano-components. Ultraviolet spectroscopy (UV-Vis), fluorescence spectroscopy (FL) and infrared spectroscopy (FTIR) were utilized to measure its optical characteristics and functional group information. The anti-hemorrhagic effects were evaluated by liver bleeding tests and the related hemostatic mechanisms of the obtained nano-components were further assessed by detecting blood coagulation and PLT quantity to discuss the hemostasis mechanism. The experiments complied with the Animal Ethics Committee of Beijing University of Chinese Medicine. TEM results showed that there was a novel type of nano-component in the DSC dialysate bag, which was named DSC nano-components (DSC-NCs). The experimental results of liver bleeding in mice showed that DSC-NCs prepared at 250 ℃, 300 ℃, and 350 ℃ could reduce the bleeding time of mice liver. Among them, DSC-NCs prepared at 350 °C had the best effect. In addition, DSC-NCs prepared at various temperatures can also reduce the prothrombin time (PT) value, increase the fibrinogen (FIB) value and the platelet (PLT) value to varying degrees. DSC-NCs have a certain hemostatic effect, which may be related to the activation of the exogenous coagulation system, the increase of FIB value and the increase of platelet content. This provides a new research direction for exploring the treatment of bleeding diseases, and provides a new perspective for the potential application of DSC-NCs in the medical field.

OBJECTIVE: Traditional epidemiological studies have shown that C-reactive protein (CRP) is associated with the risk of cardiovascular diseases (CVDs). However, whether this association is causal remains unclear. Therefore, Mendelian randomization (MR) was used to explore the causal relationship of CRP with cardiovascular outcomes including ischemic stroke, atrial fibrillation, arrhythmia and congestive heart failure. METHODS: We performed two-sample MR by using summary-level data obtained from Japanese Encyclopedia of Genetic association by Riken (JENGER), and we selected four single-nucleotide polymorphisms associated with CRP level as instrumental variables. MR estimates were calculated with the inverse-variance weighted (IVW), penalized weighted median and weighted median. MR-Egger regression was used to explore pleiotropy. RESULTS: No significant causal association of genetically determined CRP level with ischemic stroke, atrial fibrillation or arrhythmia was found with all four MR methods (all Ps > 0.05). The IVW method indicated suggestive evidence of a causal association between CRP and congestive heart failure ( OR: 1.337, 95% CI: 1.005-1.780, P = 0.046), whereas the other three methods did not. No clear pleiotropy or heterogeneity were observed. CONCLUSIONS Suggestive evidence was found only in analysis of congestive heart failure; therefore, further studies are necessary. Furthermore, no causal association was found between CRP and the other three cardiovascular outcomes.
C-Reactive Protein/metabolism* ; Cardiovascular Diseases/metabolism* ; Genetic Predisposition to Disease ; Genotype ; Humans ; Japan ; Mendelian Randomization Analysis ; Polymorphism, Single Nucleotide ; Risk Factors

【Objective】 To explore the effect of antiviral treatment and treatment adherence on the disease spectrum of patients with chronic hepatitis B virus(HBV) infection. 【Methods】 Data of patients with chronic HBV infection treated in the Department of Infectious Diseases of the Third Affiliated Hospital of Sun Yat-sen University in 2018 were retrospectively collected. According to the antiviral treatment history, the patients were divided into antiviral group(n = 460) and non-antiviral group(n = 1 240); according to the treatment adherence, the patients were divided into standard antiviral group(n = 277) and non-standard antiviral group(n = 183). The distribution of disease spectrum was compared between these two groups. Meanwhile, the differences of the proportion of disease spectrum were compared with previous data in 2011. 【Results】 The proportion of patients diagnosed as chronic hepatitis B(CHB) (moderate), CHB(severe), acute-on-chronic liver failure(ACLF) and cirrhosis(compensated stage) in antiviral group was significantly lower than that in nonantiviral group(P < 0.01), while the proportion of patients diagnosed as cirrhosis(decompensated stage) was higher than that in non-antiviral group(70% vs. 37.1%, P < 0.001). The proportion of CHB(moderate), CHB(severe) and ACLF in the standard antiviral group was significantly lower than that in the non-standard antiviral group(P < 0.01), and the proportion of patients diagnosed as cirrhosis(decompensated stage) in the standard antiviral group was significantly higher than that in the non-standard antiviral group(P < 0.001). There was a significant difference between the data of 2011 and those of 2018(P < 0.001). Compared with that in 2011, the proportion of patients diagnosed with CHB(moderate) and CHB(severe) decreased in 2018(P < 0.05), while the proportion of ACLF increased significantly(11.8% vs. 16.9%, P < 0.001). The proportion of hospitalized patients with hepatocellular carcinoma was significantly higher in 2018 than in 2011(19.5% vs. 10.5%, P < 0.001). In 2018, the proportion of inpatients who have received antiviral therapy was higher than that in 2011(27.1% vs. 17.2%, P < 0.001), and the proportion of patients who had poor adherence was significantly higher than that in 2011(P = 0.003) . 【Conclusions】 Antiviral treatment can reduce the proportion of CHB patients hospitalized due to hepatitis activities, but the non-standard antiviral treatment increases the proportion of patients with CHB (severe) and ACLF. The number of patients with combined diagnosis of HCC is increasing.

Objective:To investigate the effects of of anti tumor necrosis factor-α (TNF-α) in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis.Methods:From February 2011 to August 2016 in Huadu District People′s Hospital Affiliated with Southern Medical University, 122 patients with strangulated intestinal obstruction combined with ischemic intestinal necrosis were selected and were equally divided into the experimental group and control group with 61 cases in each group according to the random draw envelope principle. Conventional surgical resection and anastomosis was used in control group, the postoperative anti TNF-α therapy was given for 2 weeks based on the treatment in control group.Results:All patients completed surgery and there were no serious complications during operation.The postoperative anal exhaust time and symptom remission time in experimental group were significantly lower than those in control group: (2.14 ± 0.41) d vs. (6.24 ± 1.28) d and (3.54 ± 0.77) d vs. (6.99 ± 0.91) d ( P<0.05). The incidence of postoperative 14 d complications such as anastomotic leakage, wound infection, anastomotic stenosis and pulmonary infection in the experimental group was 4.9%(3/61), and that of the control group was 18%(11/61), and the incidence of postoperative complications in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 1d and 7 d serum TNF-α content in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 14 d anal function in the experimental group was significantly better than that in the control group ( P<0.05). MRASP and MSP of postoperative 14 d in experimental group were all significantly higher than those in the control group: (80.24 ± 11.39) mmHg (1 mmHg=0.133 kPa) vs. (76.24 ± 12.11) mmHg, (231.98 ± 45.29) mmHg vs. (226.39 ± 41.87) mmHg ( P<0.05). Conclusions:The anti TNF-α in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis can promote the recovery of clinical symptoms and inhibit the release of TNF-α. It also can reduce the incidence of postoperative complications and improve gastrointestinal motility of patients.

Houpo Wenzhongtang was contained in Neiwaishang bianhuolun.It was composed of seven medicinal materials of Magnoliae Officinalis Cortex(processed with ginger),Citri Reticulatae Pericarpium(remove white sac),Glycyrrhizea Radix et Rhizoma(processed with honey),Alpiniae Katsumadai Semen,Poria,Aucklandiae Radix and Zingiberis Rhizoma.It was a classic prescription for treatment of deficient cold of spleen and stomach,distention of chest and abdomen,autumn and winter guest cold crime stomach and feel pain at times by LI Dongyuan,who was a famous doctors in Jin-Yuan dynasties.It has been included in the Catalogue of Ancient Classical Prescription(The First Batch) issued by the State Administration of Traditional Chinese Medicine in 2018.This paper systematically reviewed the relevant research progress of Houpo Wenzhongtang from the aspects of famous doctors' theory,usage and dosage,chemical composition,quality analysis,pharmacology and toxicology,clinical application in database,and to provide a reference for further exerting the clinical application of this classical prescription.

OBJECTIVE: To observe the correlation between referred pain distribution and acupoint sensitization in patients with intestinal diseases. METHODS: In clinical research, 443 patients from 8 hospitals were recruited, including the outpatients and inpatients of Crohn's disease (=143), ulcerative colitis (=108), chronic appendicitis (=87) and other intestinal diseases (=105). The site with tenderness on the body surface and the morphological changes of local skin were observed and recorded in the patients. Using a sensory tenderness instrument, the pain threshold at the sensitization point was measured in 60 patients with ulcerative colitis. In animal experiment, SD rats were used and divided into a enteritis group (=8), in which the enteritis model were established, and a control group (=3), in which no any intervention was given. After the injection of Evans blue (EB) at caudal vein, the blue exudation points on the body surface were observed and the distribution rule was analyzed statistically. RESULTS: The referred pain on the body surface in the patients with intestinal diseases was mainly located in the lower abdomen (93.9%, 416/443), the lumbar region (70.9%, 314/443) and the lower legs (33.0%, 146/443). The diameter of tenderness region was 1.5 to 2.5 cm. Compared with the region without sensitization, the pain threshold of the sensitization point in the patients with ulcerative colitis was reduced significantly (<0.001). The referred pain on the body surface in the patients with appendicitis was located in the right lower abdomen (97.7%, 85/87), the waist and back (54.0%, 47/87) and the right lower limbs on the medial side (71.3%, 62/87). The tenderness region was 1 to 2 cm in diameter and was irregular in form. After modeling of enteritis in the rats, the EB exudation points were visible from T to L. CONCLUSION Intestinal diseases induce referred pain on the body surface where is the same as or adjacent to the location of the spinal segment corresponding to the affected intestinal section. These sensitization regions are related to the locations of acupoints.
Acupuncture Points ; Animals ; Colitis, Ulcerative ; Humans ; Intestinal Diseases ; Pain Threshold ; Pain, Referred ; diagnosis ; therapy ; Rats ; Rats, Sprague-Dawley ; Sensation

Gastrointestinal stromal tumor (GIST) is one of the most common tumors originating from gastrointestinal mesenchymal tissues, accounting for about 0.2% of all gastrointestinal tumors. It can occur anywhere in the gastrointestinal tract. Because gastrointestinal stromal tumors have the biological characteristics of non-directional differentiation and potential malignancy, it is very important to resect them completely in time.Traditional surgical excision has a good prognosis in the past, but it has some shortcomings, such as large trauma, slow postoperative recovery and more complications. In recent years, with the continuous development of digestive endoscopy technology, many new endoscopic techniques have emerged for the treatment of gastric stromal tumors, such as endoscopic mucosal dissection (ESD), endoscopic full-thickness resection (EFTR), endoscopy and laparoscopic combined surgery, but the safety and effectiveness of endoscopic surgery for gastric stromal tumors are still controversial in the industry.

Objective To set up and apply the evaluation standards for photography of schistosomiasis control theme,so as to offer the scientific advice for enriching the health information carrier of schistosomiasis control.Methods Through the litera-ture review and expert consultation,the evaluation standard for photography of schistosomiasis control theme was formulated. The themes were divided into 4 projects,such as new construction,natural scenery,working scene,and control achievements. Results The evaluation criteria of the theme photography were divided into the theme(60%),photographic composition (15%),focus exposure(15%),and color saturation(10%).A total of 495 pictures(sets)from 59 units with 77 authors were collected from schistosomiasis epidemic areas national wide.After the first-step screening and second-step evaluation,the prizes of 3 themes of control achievements and new construction,working scene,and natural scenery were selected,such as 6 pictures of first prize,12 pictures of second prize,18 pictures of third prize,and 20 pictures of honorable prize.Conclusions The eval-uation standards of theme photography should be taken into the consideration of the technical elements of photography and the work specification of schistosomiasis prevention and control.In order to improve the ability of records for propaganda purpose of schistosomiasis control and better play a role of guiding correct propaganda,the training and guidance of photography of profes-sionals should be carried out.

OBJECTIVETo clarify the impact of increased heme oxygenase-1 (HO-1) expression on cardiac function of diabetic rats with myocardial infarction and its mechanism.

METHODSSixty adult male Wistar rats were randomly divided into five groups (n = 12): sham operation group (sham), diabetes + sham operation group (DM + sham), diabetes + MI group (DM + MI) , diabetes + myocardial infarction + cobalt original porphyrin (CoPP) group (DM + MI + CoPP), diabetes + myocardial infarction + CoPP+ tin porphyrin (SnMP) group (DM + MI + CoPP + SnMP). CoPP 4.5 mg/kg or SnMP 15 mg/kg were administered at the day next to MI operation, for six weeks, once a week. At the 28th week post operation, the echocardiography, left heart via the carotid artery indoor intubation were used to observe the long-term influence of HO-1 inducer (cobalt protoporphyrin, CoPP) and activity of HO inhibitor (tin porphyrin, SnMP) on the indices of left ventricular remodeling and cardiac function after the intervention. Blood glucose (GLU), total cholesterol (TC), C-reactive protein (CRP), serum creatinine (Cr), aminotransferase (ALT) and other indicators were measured. ELISA was used to test interleukin-6 (IL-6), tumor necrosis factor (TNF), nitric oxide (NO), prostacyclin (PGI2), adiponectin, and ultra sensitive CRP (HsCRP) level.

RESULTSHO-1 inducer, CoPP, could ameliorate ± dp/dtmax, left ventricular ejection fraction and left ventricular shortening fraction in diabetic myocardial infarction rats. It could also decrease left ventricular end-diastolic diameter. The serum bilirubin, NO and PGI2 levels, myocardial phosphorylated endothelial nitric oxide synthasee(peNOS), phosphorylated activated protein kinase (pAkt), phosphorylated adenosine monophosphate-activated protein kinase (pAMPK) expression were also significantly elevated, and the serum hs-CRP and TNF levels were significantly inhibited. Compared to inducer group, cardiac function were worse in the inhibitor group.

CONCLUSIONUpregulated HO-1 level can improve the endothelial function, inhibite of the inflammatory response and enhance the antioxidant substances in serum bilirubin via peNOS-pAMPK pathway, which effectively inhibit ventricular remodeling and improve the long-term cardiac function after infarction in diabetic rats.

Animals ; Antioxidants ; metabolism ; Bilirubin ; blood ; Diabetes Mellitus, Experimental ; physiopathology ; Heme Oxygenase (Decyclizing) ; metabolism ; Male ; Myocardial Infarction ; enzymology ; Myocardium ; enzymology ; Rats ; Rats, Wistar ; Signal Transduction ; Up-Regulation ; Ventricular Function, Left ; Ventricular Remodeling ; drug effects