Objective To explore the value of serum insulin-like growth factor-1 (IGF-1) levels in diagnosis and treatment of primary hyperthyroidism. Methods 150 patients with primary hyperthyroidism (hyperthyroidism group) and 85 patients with hypothyroidism (hypothyroidism group) were selected as study subjects. During the same period, 60 healthy individuals were selected as control group. The levels of serum IGF-1, thyroid peroxidase antibody (TPOAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3) and total thyroxine (T4) were measured in the three groups. The serum visfatin levels in the three groups were detected using an enzyme-linked immunosorbent assay. Multifactor Logistic regression analysis was used to screen for risk factors of primary hyperthyroidism. Results The levels of IGF-1, FT3, FT4, T3 and T4 in the hyperthyroidism group were significantly higher than those in the hypothyroidism and control groups, while TSH levels were significantly lower (P < 0.05). TPOAb and visfatin levels in the hyperthyroidism group were significantly higher than those in the control group, but significantly lower than those in the hypothyroidism group (P < 0.05). The serum IGF-1 levels in patients with primary hyperthyroidism before and after 3 months of treatment were (60.11±7.23) and (30.23± 3.22) μg/L, respectively, showing a statistically significant difference (t=8.436, P < 0.001). Serum FT3, FT4, T3, T4, TPOAb, IGF-1 and visfatin levels increased and serum TSH levels decreased as risk factors for primary hyperthyroidism (P < 0.05). Conclusion The level of serum IGF-1 is closely related to thyroid function and may serve as an important reference indicator for the diagnosis and monitoring of the efficacy of primary hyperthyroidism treatment.

Oxidative stress(OS)is one of the factors leading to vascular cognitive impairment(VCI). Reactive oxygen species(ROS)produced by Nicotinamide adenine dinucleotide phosphate oxidase(NOX)is an important pathogenic molecule of VCI.Risk factors for VCI such as hyperglycemia and decomposition/re-implantation always increases an upstream NOX activation.Other risk factors such as advanced age, hypertension and stroke are the downstream damage caused by NOX-dependent ROS.The causes of VCI include both risk factors related to NOX and the cell damage caused by NOX-dependent ROS.Studies have shown that the inhibiting of NOX activity can reduce cognitive impairment and the risk factors in animal models of VCI.In this article, we review the research progress of the role and mechanism of NOX in VCI.

Objective:To cultivate human-derived prostate cancer (PCa) cells via conditional reprogramming cell (CRC) technology, and establish individualized cell bank for PCa research in vitro.Methods:We obtained three fresh PCa tissue samples from different patients between January 2019 and April 2019. Then each sample was divided into two parts. One was used for cancer nature confirmation by intraoperative biopsy. Another part was sent to the laboratory and digested into single primary cancer cells with 0.25% EDTA enzyme for CRC technology. The details were described as followed: 1. The primary PCa cells were co-cultured with 3T3-J2 cells irradiated by 30 Gy (feeder cells) in conditioned medium, and observed for the growth of cell clones, 2. The feeder cells were removed by 0.25% EDTA trypsin for 1 minute before primary PCa cells digested for passage. All primary PCa cells were validated by multiple experiments such as immunofluorescence, immunohistochemistry, immunoblotting and fluorescence in situ hybridization (FISH).Results:Total three cases of human-derived PCa cell lines were successfully established during 15days through CRC technology. All those primary PCa cells could be steadily and continuously passaged, which also expressed AR, CK5, CK18, P504s and PSA. FISH demonstrated that each cell line harbored≥1.6% TMPRSS2/ERG fusion and conformed to the features of PCa.Conclusion:CRC technology can be used for stable and continuous PCa cell culture in vitro.

Objective:To investigate the characteristics of Parkinson's disease (PD)combined with orthostatic hypotension (OH)and the impact of the condition on cognitive function.Methods:A total of 210 PD patients admitted to Beijing Tiantan Hospital were consecutively enrolled.Demographic data and clinical characteristics were recorded.Patients were divided into the PD with OH (PD-OH)group and the PD without OH (PD-NOH)group based on blood pressure values measured in both the supine and upright positions.Cognitive function of PD patients was evaluated using the Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment (MoCA)scales.Results:Of 210 PD patients, 68 (32.4%)had OH.Patients in the PD-OH group had a higher mean age (69.7±8.9 years vs.62.1±11.3 years), longer disease duration [5.0 (3.0-8.0)years vs.4.0 (2.0-6.0)years], a higher incidence of diabetes (30.9% vs.17.4%), higher levels of fasting blood glucose (5.3±1.1 mmol/L vs.5.0±1.0 mmol/L)and glycated hemoglobin A1c (6.1±0.9% vs.5.7±0.7%), and more advanced Hoehn-Yahr staging [stage 2.5 (2.0-3.0) vs.stage 2.0 (1.5-2.5)]than the PD-NOH group ( P<0.05). The total scores of the MMSE and MoCA scales were lower in the PD-OH group than in the PD-NOH group (25.1±4.9 scores vs.26.8±4.0 scores, 19.4±5.4 scores vs.21.4±5.3 scores, P<0.05). A comparison of each cognitive domain of the MMSE scale between the two groups revealed that the scores of attention and calculation (3.7±1.7 scores vs.4.2±1.3 scores), delayed recall (2.1±1.0 scores vs.2.5±0.8 scores)and visuospatial ability (0.6±0.5 scores vs.0.7±0.5 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). A comparison of each cognitive domain of the MoCA scale between the two groups displayed that the scores of visuospatial and executive function (2.4±1.6 scores vs.2.9±1.7 scores)and delayed recall (1.3±1.4 scores vs.2.3±1.6 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). Logistic regression analysis showed that age ( OR=1.061, 95% CI: 1.022-1.102, P=0.002)and score of delayed recall of the MoCA scale ( OR=0.690, 95% CI: 0.498-0.955, P=0.025)were independent related factors for PD-OH. Conclusions:Compared with patients without OH, PD-OH patients are older and have a longer duration, increased disease severity, and a higher incidence of and more serious diabetes mellitus.Age is an independent related factor for PD-OH.Cognitive function is significantly impaired in PD-OH patients, and delayed recall is an independent related factor for PD-OH.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury.Methods Fifty-four male specefic pathogen free (SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group.Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes.The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days.OCT and electroretinogram (ERG) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer (NGI)and electrophysiological changes of retina,respectively.Retrograde labelling of retinal ganglion cells (RGCs) was used to evaluate the survival number of RGCs.Western blot analysis was used to detect NLRP3,apoptosis-associated speck-like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c-caspase 1),IL-18,and IL-1β expression.The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology (ARVO) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The thickness of retinal NGI in model control group was (58.2 ± 1.7) μm,which was significantly lower than (84.8 ± 1.9) μm in normal control group and (71.1 ±2.4) μm in paeoniflorin group (both at P＜0.05).The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group (both at P＜0.05).The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group (both at P＜0.05).The relative expressions of NLRP3,ASC,c-caspase 1,IL-18 and IL-1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P＜0.05).Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.

Objective To retrieve and analyze the guidelines on diabetic foot offloading, and summarize the evidence of high quality guidelines, so as to provide reference for standardizing the offloading treatment of diabetic foot in China. MethodsThe clinical practice guidelines of diabetic foot in the major guideline networks, databases and professional association websites were retrieved by computer. Three researches evaluated the quality of the guidelines, and two researches extracted evidence from documents that met the quality criteria. ResultsA total of 7 guidelines were included, and 5 aspects, 30 recommendations were extracted, including comprehensive treatment, the principle of offloading, offloading of the plantar ulcer, offloading of the non-plantar ulcer, and the gap between the evidence and practice. ConclusionsThis study summarize the best evidence of the diabetic foot offloading therapy, and provides a reference for medical institution to develop appropriate procedures and standardize the practice of diabetic foot offloading therapy. Most of the interventions recommended in the guidelines come from relatively developed countries, but their application may be limited in less developed countries or regions. Therefore, it is urgent to explore offloading methods which have positive offloading effect as well as conform to our national conditions, and apply them to clinical practice gradually in order to improve the therapeutic effect of diabetic foot and improve prognosis.

Objective: To explore the relationship between monocyte-to-lymphocyte ratio (MLR) in peripheral blood of patients with pulmonary sarcomatoid carcinoma (PSC) and their clinicopathological features and prognosis, and to investigate its clinical significance. Methods: A retrospective analysis was carried out to analyze the complete case data of 80 patients with PSC from October 2010 to April 2017 in Tianjin Cancer Hospital (monocyte and lymphocyte counts of peripheral blood, clinicopathological features, and survival follow-up). The receiver operating curve (ROC) was used to determine the best cut-off value of MLR for the prediction of overall survival time (OS). The patients were divided into high MLR group and low MLR group. Kaplan-Meier method was used to calculate OS and draw survival curves. The Log-Rank test was used to compare the difference in OS between the two groups. The variables with statistical significance in univariate analysis were included into the COX risk regression model to verify and calculate thehazard ratio (HR)and 95% confidence interval (95%CI). Results: The absolute median values of monocytes and lymphocytes were 0.63×109/L and 1.84×109/L, respectively. The best cut-off value of MLR is 0.44. Univariate analysis shows that MLR≥0.44 (P<0.01), no radical surgery (P<0.01), clinical stage Ⅲ+Ⅳ (P<0.01), tumor maximal diameter > 3 cm (P<0.01), and LDH>247 U /L (P<0.01) are the poor prognostic factors affecting overall survival. Multivariate analysis shows that MLR≥0.44（HR=3.554; 95%CI=1.671-6.125; P<0.01), and clinical stage Ⅲ+Ⅳ（HR=3.275; 95%CI=2.047-9.399; P<0.01) are the independent risk factors for the overall survival of PSC, and radical surgery is an independent protective factor affecting the overall survival of PSC（HR=0.360; 95%CI=0.195-0.848; P<0.01). Conclusion: High MLR is an independent risk factor for poor prognosis in patients with PSC.

[Abstract] Objective: To explore the relationship between the preoperative blood indicators (platelets, monocytes, neutrophils-to-lymphocyte ratio) and clinicopathological characters and the prognosis of the early stage malignant melanoma（MM）patients. Methods: Clinicopathological data of 120 cases of stage I-III MM patients, who received initial treatment and radical operation in the Cancer Hospital of Tianjin Medical University from January 2007 to May 2012, were obtained for this study. The correlations between parameters of PLR (platelet-to-lymphocyte ratio), LMR (lymphocyte-to-monocyte ratio), NLR (neutrophil-to-lymphocyte ratio), hemoglobin, neutrophils, lymphocytes, monocytes, eosinophils, basophils, platelets, lactate dehydrogenase, age, stage as well as ulcer and the prognosis of the patients were evaluated. Results: Patients whose tumor with ulceration have higher NLR and basophilic granulocyte (all P< 0.05）. Univariate analysis showed that NLR, PLR, LMR, neutrophil, lymphocyte, monocyte, lactic dehydrogenase, age, stage and ulceration were the risk factors of poor 5-year overall survival (P<0.05). The multivariate analysis identified PLR（HR=4.206， 95%CI:1.65410.696， P<0.01），stage（HR=7.670， 95%CI:3.977-14.795， P<0.01）and ulceration（HR=1.931， 95%CI:1.029-3.623， P<0.05）as independent risk factors for the prognosis of the MM patients. Conclusion: Higher preoperative PLR can be used as a predictive factor for poor prognosis of the early stage MM patients.

Objective To investigate the mechanisms of paeoniflorin in protection of retinal ischemia injury. Methods Fifty.four male specefic pathogen free ( SPF) degree Wistar rats were randomly divided into normal control group,model control group and paeoniflorin group. Retinal ischemia injury was induced by raising the intraocular pressure of right eyes of rats to 110 mmHg for 30 minutes. The rats of paeoniflorin group were administrated through intraperitoneal injection of 5 mg/kg paeoniflorin each day for 14 days. OCT and electroretinogram ( ERG ) were performed to detect the thickness of retinal nerve fiber layer+retinal ganglion cell layer+inner plexiform layer ( NGI) and electrophysiological changes of retina, respectively. Retrograde labelling of retinal ganglion cells ( RGCs ) was used to evaluate the survival number of RGCs. Western blot analysis was used to detect NLRP3,apoptosis.associated speck.like protein containing a caspase activation and recruitment domain (ASC),cleaved caspase 1 (c.caspase 1), IL.18,and IL.1β expression. The use and care of animals complied with the statement of the Association for Research in Vision and Ophthalmology ( ARVO ) and Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results The thickness of retinal NGI in model control group was ( 58. 2 ± 1. 7)μm, which was significantly lower than ( 84. 8 ± 1. 9)μm in normal control group and(71. 1±2. 4)μm in paeoniflorin group (both at P<0. 05). The amplitudes of A and B waves in paeoniflorin group and normal control group were significantly higher than those in model control group ( both at P<0. 05 ) . The number of RGC in model control group was significantly lower than that in paeoniflorin group and normal control group ( both at P<0. 05). The relative expressions of NLRP3,ASC,c.caspase 1,IL.18 and IL.1β in model control group were significantly higher than those in normal control group and paeoniflorin group (all at P<0. 05). Conclusions The paeoniflorin can prevent retinal ischemia induced injury of the retina through NLRP3 inflammasomes pathway,which provides a new treatment strategy for clinical therapy.

OBJECTIVE:To establish a method for the residual simultaneous determination of methanol,alcohol,dichlorometh-ane,n-hexane,tetrahydrofuran and benzene in tosufloxacin tosylat. METHODS:Headspace GC was performed on the capillary col-umn with 6%cyanopropylphenyl-94%dimethylpolysiloxane(DB-624)as fixative lipid,temperature programmed,the inlet temper-ature was 180 ℃,detector was flame ionization detector with temperature of 300 ℃,carrier gas was high purity N2 at a flow rate of 1.5 mL/min,split ratio was 10:1,headspace equilibrium temperature was 100℃,equilibrium time was 40 min,headspace sam-ple volume was 10 mL,and the headspace sample volume was 1 mL. RESULTS:The linear range was 178.3-1782.7 μg/mL for methanol (r=0.9991),301.2-3012.1 μg/mL for alcohol(r=0.9997),33.81-338.10 μg/mL for dichloromethane(r=0.9993), 18.02-180.22 μg/mL for n-hexane(r=0.9991),43.26-432.58 μg/mL for tetrahydrofuran(r=0.9991)and 0.1268-1.2681 μg/mL for benzene(r=0.9991);limits of quantification were 0.31,3.00,0.67,0.02,0.005,0.10 μg/mL,limits of detection were 0.15, 1.51,0.22,0.01,0.001,0.05 μg/mL;RSD of precision test was no higher than 3.1%;RSDs of methanol and n-hexane in stabili-ty and reproducibility tests were no higher than 5%;recoveries were 93.72%-102.20%(RSD=3.1%,n=9),90.10%-101.79%(RSD=4.0%,n=9),97.07%-103.11%(RSD=2.0%,n=9),92.38%-103.83%(RSD=3.9%,n=9),95.44%-103.62%(RSD=2.8%,n=9),and 94.00%-104.73%(RSD=4.1%,n=9). CONCLUSIONS:The method is rapid,sensitive,accurate,and suitable for the residual determination of methanol,alcohol,dichloromethane,n-hexane,tetrahydrofuran and benzene in tosufloxacin tosylat.