Objective:To examine the mid - and long-term outcomes of surgical treatment of brachiocephalic Takayasu arteritis.Methods:This is a retrospective case series study. The clinical data of 39 patients,which had been diagnosed as brachiocephalic Takayasu arteritis (244 cases),who underwent surgical treatment,were analyzed between July 2012 to November 2022 at Department of Endoluminal Vascular Surgery, the First Affiliated Hospital of Zhengzhou University. There were 5 males and 34 females, aged (37.9±14.0)years (range:13 to 71 years). Despite medical treatment, the patients suffered severe ischemic symptoms continually and then underwent surgical interventions. Among them, 20 patients underwent endovascular procedures, 11 underwent open surgical procedures, and 8 underwent hybrid procedures. Patients were followed up through outpatient visits at 1, 3, 6 months after surgery and once every year later. Follow-up was conducted until November 2022. Operation status, postoperative complications and re-intervention of patients were recorded and the Kaplan-Meier survival curves were used to analyze postoperative vascular patency rates.Results:All 39 surgeries were successful, with no intraoperative death or serious complications. The follow-up period was (48.8±38.2) months(range:1 to 123 months). Thirty-three patients experienced symptom relief after surgery, and 6 patients required secondary surgical interventions. The patency rates for the endovascular treatment group at 1-, 3-, 5-, and 10-year were 95.0%, 75.2%, 60.2%, and 60.2%, respectively, while the patency rates for open surgery were all 90.9%. In the hybrid surgery group, the patency rates at 1-, 3-, 5-, and 8-year were all 87.5%.Conclusion:For patients with brachiocephalic Takayasu arteritis, choice of an appropriate blood flow revascularization intervention should be based on the patient′s condition,and the mid-and long-term outcomes are satisfactory.

Berberine is an antipyretic and detoxicating drug commonly used in clinical practice,and it is currently used for the routine treatment of gastrointestinal diseases such as bacterial gastroenteritis and diarrhea.However,several recent studies have shown that berberine can exert a therapeutic effect on the diseases such as autoimmune hepatitis,viral hepatitis,nonalcoholic fatty liver disease,and liver cancer by regulating the AMPK and TGF-β pathways and altering the composition of intestinal flora.This provides new drugs for the treatment of these diseases,expands the potential indications of berberine,and provides clues for the follow-up research and development of similar drugs.This article summarizes the therapeutic effect and mechanism of berberine on various liver diseases,in order to provide a reference for effective clinical application.

Objective:To examine the mid - and long-term outcomes of surgical treatment of brachiocephalic Takayasu arteritis.Methods:This is a retrospective case series study. The clinical data of 39 patients,which had been diagnosed as brachiocephalic Takayasu arteritis (244 cases),who underwent surgical treatment,were analyzed between July 2012 to November 2022 at Department of Endoluminal Vascular Surgery, the First Affiliated Hospital of Zhengzhou University. There were 5 males and 34 females, aged (37.9±14.0)years (range:13 to 71 years). Despite medical treatment, the patients suffered severe ischemic symptoms continually and then underwent surgical interventions. Among them, 20 patients underwent endovascular procedures, 11 underwent open surgical procedures, and 8 underwent hybrid procedures. Patients were followed up through outpatient visits at 1, 3, 6 months after surgery and once every year later. Follow-up was conducted until November 2022. Operation status, postoperative complications and re-intervention of patients were recorded and the Kaplan-Meier survival curves were used to analyze postoperative vascular patency rates.Results:All 39 surgeries were successful, with no intraoperative death or serious complications. The follow-up period was (48.8±38.2) months(range:1 to 123 months). Thirty-three patients experienced symptom relief after surgery, and 6 patients required secondary surgical interventions. The patency rates for the endovascular treatment group at 1-, 3-, 5-, and 10-year were 95.0%, 75.2%, 60.2%, and 60.2%, respectively, while the patency rates for open surgery were all 90.9%. In the hybrid surgery group, the patency rates at 1-, 3-, 5-, and 8-year were all 87.5%.Conclusion:For patients with brachiocephalic Takayasu arteritis, choice of an appropriate blood flow revascularization intervention should be based on the patient′s condition,and the mid-and long-term outcomes are satisfactory.

Objective:To analyze the clinical characteristics of patients with spontaneous splenorenal shunt (SSRS) in liver cirrhosis, and to compare the effects and prognosis of different treatments.Methods:The data of cirrhotic patients with SSRS at the First Affiliated Hospital of Zhengzhou University between 2016-2022 were retrospectively analyzed.Patients were divided into Group A receiving conservative treatment, Group B by simple embolization, Group C undergoing TIPS combined with embolization, and Group D given liver transplantation. Life status, liver function changes, incidences of adverse events, and survival between groups were compared.Results:SSRS diameter was positively correlated with blood ammonia ( R=0.478) and negatively correlated with portal vein diameter ( R=-0.301). SSRS diameter is a protective factor for gastrointestinal hemorrhage and ascites and a risk factor for hepatic encephalopathy; Blood ammonia decreased and prothrombin time prolonged after treatment in group A ( P<0.05), blood ammonia decreased and albumin increased in group B ( P<0.05). Hemoglobin and bilirubin increased in group C ( P<0.05), blood ammonia and bilirubin decreased and platelets and albumin increased in group D ( P<0.05); Survival analysis showed that the prognosis of groups A and C was related to liver function, and the survival rate of group D was the highest of all ( P<0.05). Conclusions:SSRS embolization is safe and effective, and liver transplantation improves patient survival. Individualized treatment should be selected based on patient symptoms, liver function, and shunt diameter.

Gallstone disease is a common and frequently seen disease of digestive system, and is a common cause of inflammation of gallbladder and bile duct, biliary tract tumor and obstructive jaundice, however, its pathogenesis is not yet fully understood. Recent studies have revealed that intestinal flora and immunity play important roles in the formation of gallstones. This paper reviewed the relationship between the abundance and composition of intestinal flora, immuno - globulins, mucins and immune cells, as well as the interactions between intestinal flora and biliary immunity and gallstone formation for providing new ideas and methods for gallstone prevention and treatment.

Objective To analyze the expression of ROCK2 in osteosarcoma tissues and explore its effect on the invasion and migration of osteosarcoma cells and related mechanism. Methods Real-time fluorescent quantitative PCR, Western blot and immunohistochemical staining were used to detect the expression of ROCK2 in osteosarcoma tissues. The migration and invasion of osteosarcoma cells were analyzed by wound-healing and Transwell assays after the knockdown of ROCK2 expression. The effect of reducing ROCK2 expression on metastasis in vivo was tested by tail vein metastasis experiment. We detected the expression of EMT-related proteins in osteosarcoma cells, and added the EMT inducer TGF-β to osteosarcoma cells with down-regulated ROCK2 expression to detect the changes of cell invasion and migration. Results The expression of ROCK2 in osteosarcoma tissues was significantly higher than that in corresponding adjacent tissues (P < 0.05). After down-regulating the expression of ROCK2 in osteosarcoma cells, the invasion and migration abilities in vivo and in vitro were significantly inhibited (P < 0.05). The expression of EMT-related protein E-cadherin decreased, while N-cadherin and Vimentin proteins increased significantly. Inducing EMT could attenuate the inhibitory effect of down-regulating ROCK2 on the invasion and migration of osteosarcoma cells. Conclusion The expression of ROCK2 is increased in osteosarcoma tissues, which promotes the invasion and migration of osteosarcoma cells by inducing EMT. ROCK2 may be a potential biomarker for targeted therapy of osteosarcoma.

Objective:To explore the clinical value of heparin binding protein (HBP) in bronchoalveolar lavage fluid (BALF) for diagnosis and differential diagnosis of bacterial pneumonia.Methods:Eighty eight patients with pulmonary infection from the respiratory department of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to January 2021 were enrolled in the study, including 48 cases of bacterial pneumonia and 40 cases of non-bacterial pneumonia; meanwhile, 40 non-pulmonary infection patients were also enrolled as the control group. The BALF levels of HBP, procalcitonin (PCT), interleukin-6 (IL-6) were measured, and the clinical values of the above indexes in differential diagnosis of bacterial and non-bacterial pneumonia were analyzed.Results:The BALF levels of HBP and IL-6 in bacterial pneumonia group were significantly higher than those of the non-bacterial pneumonia group and the control group ( P<0.05). ROC curve showed that the areas under the curve (AUC) of HBP and IL-6 were 0.930 and 0.893 for the early diagnosis of bacterial pneumonia; and the sensitivity was 88.5% and 82.7%, the specificity was 92.5% and 92.5%, respectively. Combined detection of HBP and IL-6, the AUC was 0.942 and the sensitivity was 94.2% and the specificity was 95.0%. When they were used to distinguish bacterial pneumonia, the AUC of HBP and IL-6 were 0.890 and 0.777, and the sensitivities were 80.8% and 71.2%, and the specificity were 91.7% and 75.0%, respectively. Combined detection of HBP and IL-6, the AUC was 0.902, and the sensitivity was 96.2% and the specificity was 79.2%. Conclusions:BALF HBP and IL-6 have good clinical value in the early diagnosis and distinguishing bacterial pulmonary infection and the joint value of the two is better.

【Objective】 To explore the effects of gestational diabetes mellitus (GDM) and mid-pregnancy blood glucose levels on gestational weeks in Northwestern China. 【Methods】 For this prospective cohort study, we recruited the first-trimester pregnant women who underwent obstetrical examinations at Northwest Women’s and Children’s Hospital from July 2018 to July 2019 as the cohort. We investigated their socio-demographic characteristics and risk factors of adverse pregnancy outcomes. Additionally, we collected the OGTT test results of pregnant women in mid-pregnancy and followed up their pregnancy outcomes. The relationship of GDM and blood glucose levels with gestational weeks was analyzed by using the generalized linear model. 【Results】 A total of 2 434 subjects were included in this study. There were 668 pregnant women with GDM, with a ratio of 27.44%. GDM in pregnant women shortened the gestational weeks (β=-0.17, 95% CI: -0.28—-0.05). Fasting blood glucose, OGTT-1 h blood glucose, and OGTT-2 h blood glucose increased by 1 mmol/L; gestational weeks were shortened by 0.17 (95% CI: -0.28—-0.05), 0.05 (95% CI: -0.09—-0.02) and 0.07 (95% CI: -0.12—-0.03). Fasting blood glucose and OGTT-1 h blood glucose abnormalities shortened gestational weeks by 0.18 (95% CI: -0.31—-0.05) and 0.28 (95% CI: -0.47—-0.10) respectively. An increase by 1 mmol/L or abnormality of fasting blood glucose would increase preterm delivery risk by 1.44 (95% CI: 1.01-2.06) and 1.73 times (95% CI: 1.10-2.69), respectively. 【Conclusion】 GDM in pregnant women may shorten their gestational weeks; the abnormal and elevated fasting blood glucose, in particular, would increase the risk of preterm delivery. Therefore, we should carry out active health education to control the blood glucose and other risk factors of GDM patients and promote healthy pregnancy.

【Objective】 To explore the association of gestational diabetes mellitus (GDM) and blood glucose level with birth weight of the newborns in Northwest China. 【Methods】 Pregnant women in their first trimester who joined the birth cohort of Northwest Women and Children’s Hospital from July 2018 to July 2019 were consecutively enrolled. We collected their basic demographic characteristics, lifestyle behavior and other data. We followed up the results of the OGTT test and pregnancy outcomes. The generalized linear model was used to analyze the effects of GDM and blood glucose levels on the birth weight of newborns. 【Results】 A total of 2 422 subjects were included in this study, and 656 (27.09%) pregnant women had GDM during pregnancy. Pregnant women with GDM increased the birth weight (β=50.00, 95% CI: 17.48-82.51), Z-value (β=0.11, 95% CI: 0.03-0.19) and Z Centile value (β=3.22, 95% CI: 0.88-5.55), and increased the risk of macrosomia (OR=1.54, 95% CI: 1.04-2.28). Abnormal FPG value during the second trimester would increase the risk of macrosomia and LGA. With the increase of OGTT blood glucose value in the second trimester, the birth weight value and the incidence of macrosomia and LGA showed an upward trend. 【Conclusion】 Pregnancy in women with GDM might increase the birth weight of newborns and the risk of macrosomia, especially FPG. We should vigorously control the blood glucose level of GDM patients to promote the health of mothers and infants.

Objective To design the control system of a magnetic resonance image (MRI) navigated pneumatic surgical robot. Method The driven system of the robot was constructed by combining with pneumatically driven and ultrasonic motor. The cylinder position control loop was established based on proportion integration differentiation (PID) control. The mathematical model of the pneumatic servo system was established by system identification. The PID parameter tuning and the simulation of the system characteristics were conducted. The stability analysis was conducted using the Nyquist criterion, and the acupuncture accuracy and the magnetic compatibility of the robot were verified. Results The simulation results showed that the maximum steady-state error was about 0.4 mm and the maximum tracking error was less than 2 mm, indicating that the PID control system had high control precision and trajectory tracking ability. The error of the acupuncture accuracy test was 0.72 mm. The results of water-modeling experiments showed that the magnetic resonance images were clear indicating that the influence of the robot on the MRI images was small. Conclusions The results of imulation, acupuncture and water-modeling tests showed that the pneumatic robot system can meet the requirements of brachytherapy surgery.