Objective To explore the effect of Shuanglu Tongnao Formula on neuronal ferroptosis in ischemic stroke rats and its regulatory mechanism on the silent information regulator 2 homolog 1(SIRT1)/nuclear factor erythroid 2-related fac-tor 2(Nrf2)/glutathione peroxidase 4(GPx4)signaling pathways.Methods Twenty rats were selected as sham operation group by the random number table method,and the remaining seventy rats were made ischemic stroke rat models by the middle cerebral artery occlusion method.The rats that had been successfully modeled were randomly divided into the model control group,Shuanglu Tongnao formula group,Shuanglu Tongnao formula+SIRT1 inhibitor group(Shuanglu Tongnao formula+EX527 group),with 20 rats in each group.After 14 days,the rats were scored for neurological injury;TTC staining was applied to detect the area of cerebral infarction in rats;HE staining was applied to detect pathological changes in rat brain tissue;Nissl staining was applied to detect the number of neurons in rat brain tissue;the kit was applied to detect the levels of ferri ion(Fe2+),superoxide dismutase(SOD),glutathione(GSH),and malonaldehyde(MDA)in rat brain tissue;immunohistochemistry was applied to de-tect the positive expression of acyl-CoA synthetase long-chain family member 4(ACSL4),transferrin receptor(TFR),and ferritin heavy polypeptide 1(FTH1)proteins in rat brain tissue;Western blotting method was applied to detect the expression of SIRT1,Nrf2,GPx4,and cystine/glutamate antiporter solute carrier family 7 member 11(SLC7A11)proteins in rat brain tissue.Results Compared with the sham operation group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expressions of ACSL4 and TFR in model control group were increased(P<0.05);the number of neurons,the con-tents of SOD and GSH,the protein expression of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 were all reduced(P<0.05).Compared with the model control group,the neurological deficit score,cerebral infarction area,the contents of Fe2+and MDA,and the protein expression of ACSL4 and TFR in the Shuanglu Tongnao formula group were reduced(P<0.05),and the number of neurons,the contents of SOD and GSH,the protein expressions of FTH1,SIRT1,Nrf2,GPx4,and SLC7A11 are all increased(P<0.05).The results of the SIRT1 inhibitor supplementation experiment showed that the SIRT1 inhibitor reversed the inhibitory effect of Shuan-glu Tongnao formula on neuronal ferroptosis,while also inhibited the expression of Nrf2 and GPx4(P<0.05).Conclusion The Shuanglu Tongnao formula may inhibit neuronal ferroptosis in ischemic stroke rats by activating the SIRT1/Nrf2/GPx4 signa-ling pathway.

Objective:Evaluate the influence of different pressure transmission media of urodynamic water filled catheter(WFC) and air charged catheter(ACC) on the pressure measurement results to determine whether they can be used interchangeably.Methods:The results of 2 147 patients who underwent urodynamic examination in our hospital from January 2014 to December 2020 were retrospectively analyzed. A total of 2 538 times of bladder manometry data were obtained, including 1 299 times in WFC group, 856 times in male and 443 times in female, aged 37(24, 50)years, course of disease 1.2(0.4, 5.0) years, 1 130 times in neurogenic bladder(NB)and 169 times in non-neurogenic bladder(N-NB); In ACC group, there were 1 239 times, 773 times for male and 466 times for female, with age of 37(24, 55)years, course of disease of 1.5(0.5, 6.0)years, 1 040 times for Nb and 199 times for N-NB. There was no significant difference in baseline data of general clinical data between the two groups. The intravesical pressure(Pves), intra-abdominal pressure(Pabd)and detrusor pressure(Pdet) of WFC and ACC patients during filling and urination were analyzed. For traumatic spinal cord injury(SCI) and idiopathic patients, the two sets of pressure measurement data were analyzed separately. Nonparametric test and Chi-square test were used to compare the Pves, Pabd, and Pdet recorded by the two manometry catheters before, at the end and after urination, the maximum detrusor pressure at DO(Pdet.max-DO), and the maximum detrusor pressure during spontaneous urination (Pdet. max) and the detrusor pressure (Pdet.Qmax) corresponding to the maximum urine flow rate, the maximum urethral pressure (MUP) and the maximum urethral closure pressure (MUCP) during resting urethral pressure profile, and the initial cough Pdet signal pattern (typeⅠ, typeⅡand typeⅢ).Results:Regardless of the cause, the Pabd values measured by ACC were significantly higher than WFC before filling, end filling and after voiding[18(10, 26)cmH 2O vs.15(11, 21)cmH 2O; 23(16, 31)cmH 2O vs. 20(14, 26)cmH 2O; 23(15, 31)cmH 2O vs.18(12, 24)cmH 2O], and Pdet were significantly lower than WFC[0(0, 0) cmH 2O vs. 0(0, 1)cmH 2O; 5(1, 13)cmH 2O vs. 9(4, 17)cmH 2O; 6(1, 12)cmH 2O vs. 7(3, 14)cmH 2O]. In the initial cough state, Pves and Pabd increase value were also significantly lower than that of WFC [22(12, 36)cmH 2O vs. 23(14, 38)cmH 2O; 20(10, 33)cmH 2O vs. 21(12, 36)cmH 2O]. The Pves measured by ACC was also significantly higher than WFC before filling and after voiding[18(10, 27)cmH 2O vs. 16(11, 21)cmH 2O; 30(22, 39)cmH 2O vs. 26(20, 36)cmH 2O]. Maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) measured by ACC were significantly higher than WFC [91(69, 118)cmH 2O vs.81(64, 106)cmH 2O; 77(55, 103)cmH 2O vs. 68(48, 91)cmH 2O], and there were no significant differences in Pdet.max-DO、Pdet.max和Pdet.Qmax. For patients with traumatic SCI, the Pves measured by ACC was significantly higher than WFC before filling[15(10, 24)cmH 2O vs. 14(10, 20)cmH 2O], and only MUP was significantly higher than WFC in the measurement of urethral pressure[95(71, 119)cmH 2O vs. 85(65, 112)cmH 2O], and there were no significant differences in Pdet.max-DO, Pdet.max, Pdet.Qmax and MUCP. For idiopathic patients, Pves measured by ACC before filling and after urination were significantly higher than WFC[25(20, 29)cmH 2O vs. 18(11, 23)cmH 2O; 35(29, 44)cmH 2O vs. 28(20, 38)cmH 2O], while Pdet.max-DO, Pdet.max, Pdet.Q max, MUP and MUCP were not significantly different in different pressure measurement systems. For the comparison of the initial cough Pdet signal pattern, ACC is easier to detect type Ⅰ, and WFC is easier to detect type Ⅱ and type Ⅲ. Conclusions:Compared with WFC, ACC measured higher Pves and Pabd and lower Pdet in resting state, and lower Pves and Pabd in initial cough state. The pressure values and signal pattern measured by WFC and ACC are not completely consistent, so they cannot be used interchangeably.

Objective:To investigate the accuracy of pure titanium and cobalt-chromium alloy frameworks fabricated using the additive manufacturing (AM) of selective laser melting technology (SLM) for the mandibular implant-supported fixed prostheses and the maxillary removable partial denture (RPD), and to provide a reference for clinical application of SLM pure titanium frameworks.Methods:One edentulous mandibular model with implants and screw fixed abutments at bilateral canines and the first molars was selected and used as the mandibular full arch implant-supported model. At the same time, a Kennedy class Ⅰ maxillary dentition defect model was selected. The digital models were obtained by scanning the dental models, and the metal frameworks of the mandibular full arch implant-supported denture and the maxillary RPD (design model) were designed using the 3 Shape software. Meanwhile, 12 mandibular frameworks in the cobalt-chromium alloy and the pure titanium (6 in each group were treated with heat treatment, while the other 6 were not treated), and 7 maxillary frameworks in the cobalt-chromium alloy and the pure titanium were respectively made by SLM with the improved dual-laser metal printer. The axial direction of the printing powder accumulation was taken as the Z-axis. During the design process, the software (3Shape Dental System 2018) automatically generated the X-axis and Y-axis, X axis was the sagittal axis of the dental model and Y axis was the coronal axis of the dental model. The deviation of the interface center of the abutment of the digital model of the mandibular frameworks from the design model in the X, Y and Z axes was analyzed. As for the trueness of the mandibular framework, the larger the deviation data was, the worse the trueness was. The deviation of the whole maxillary framework and 7 measuring points (palatal plate center point and bilateral occlusal rests, I bars, proximal plates) were analyzed. The fitness of the whole maxillary framework to the design model was expressed by root mean square (RMS) of the deviation data, and the fitness of measuring points was expressed by the mean±standard deviation of the data. The trueness differences of each group before and after heat treatment of the mandibular framework and the fitness of the maxillary framework were compared.Results:The cobalt-chromium alloy frameworks showed lower trueness on the X, Y, Z-axes [(96.3±12.1), (86.3±11.4), (61.2±13.2) μm] than did the pure Ti frameworks [(82.3±11.2), (72.2±10.2), (51.2±11.6) μm] by SLM, and the heat treatment could reduce the discrepancy between the SLM frameworks and STL models, for pure titanium frameworks [(62.4±11.3), (55.2±13.2), (41.3±10.8) μm] and for cobalt-chromium alloy [(84.5±10.5), (72.3±11.2), (54.2±11.6) μm]. For the thin RPD major frameworks, pure titanium had better fitness [(121.3±17.0) μm] than cobalt-chromium alloy [(174.0±18.3) μm] by SLM, and the difference was statistically significant ( P<0.05). Conclusions:Pure titanium frameworks fabricated by SLM additive manufacturing technology exhibited better fitness and trueness than did the Co-Cr frameworks after heat treatment respectively, and this satisfied the requirements of implant-supported fixed prostheses and RPD major metal frameworks.

Objective To investigate the safety and efficacy of endoscopic subserosal dissection (ESSD)for patients with upper gastrointestinal submucosal tumors. Methods A retrospective study was performed on the data of 6 patients with submucosal tumor undergoing ESSD in Nanjing Drum Tower Hospital from October 2016 to February 2017. The surgery time, surgical success rate, postoperative pathology and complications were analyzed. Results All patients successfully completed surgery. One patient had serosal perforation. The mean diameter of tumor was 27.5±10.0 mm. The mean surgery time was 49±18 min. The postoperative pathology of lesions was very low risk stromal tumor. No serious complications occurred. Conclusion ESSD is safe and reliable for patients with tumor originated from muscularis propria.

Objective: To research the best processing method for ginger pinellia by orthogonal tests.Methods: The orthogonal tests included the soaking time, boiling water and cooking time as the influencing factors, an HPLC method was used for the determination of 4 nucleosides (uridine, guanosine, adenosine, inosine), and the alum limit and extract content were also studied.The results were evaluated by multi index comprehensive weighted score to optimize the processing technology of ginger pinellia.Results: The best processing technology of ginger pinellia was as follows: soaked for 60 hours, the proportion of boiling water and pinellia tuber was 15:1, and boiled for about 5 h.Conclusion: The optimum processing technology of ginger pinellia is reasonable, reliable and reproducible, which can be used as the reference for the processing standardization of Chinese crude drugs.

Objective To investigate the protective effects of Lycopene (LP) on hepatic oxidative stress injury in type 2 diabetic rats.Methods The diabetic rat models were setup by intraperitoneal injecting STZ (60 mg/kg). 60 models were selected and randomly divided into three groups: diabetes model control group, LP 10 and 20 mg/kg treated groups, with 20 experimental animals in each group. While, selected another 20 normal same-aged rats as normal control group. The drug was given by intragastric administration for 4 weeks, once a day. Before the drug was given and after 2, 4 weeks, the level of blood sugar was determined. Four weeks later, the body weight and hepatic index were detected; the activity of ALT, AST, ALP and the level of T-AOC in serum were determined; the activity of SOD, GSH-Px, CAT and the content of MDA in hepatic tissue were determined; and the hepatic tissue histopathological changes was observed by HE staining.Results Compared with the diabetes model group, the activity of ALT in serum of LP 10, 20 mg/kg treated groups was significantly decreased (714.8±291.5 U/L, 862.7±348.1 U/Lvs. 1 007.6±375.7 U/L); AST was significantly decreased (75.2±18.6 U/L, 87.6±20.3 U/L vs. 99.3±21.5 U/L); and the content of MDA in hepatic tissue was significantly decreased (5.56±1.02 U/L, 5.83±0.98 U/L vs. 6.37±1.18 U/L); the blood sugar level of LP  20 mg/kg treated group was significantly decreased(16.6±1.1 mmol/L vs. 17.9±1.2 mmol/L), the body weight was significantly increased(281.5±24.8 g vs. 252.3±23.5g) and the hepatic index was significantly decreased (26.2±5.3 ‰vs. 30.4±5.8‰), the activity of ALP in serum was significantly decreased (135.2±30.8 U/L vs. 167.4±32.5 U/L) and the level of T-AOC was significantly increased (10.8±2.8 U/L vs. 8.7±2.4 U/L), the activity of SOD in hepatic tissue was significantly increased(10.8±2.3 U/mgvs. 9.1±2.3 U/mg), GSH-Px was significantly increased (16.1±3.4 U/mgvs. 14.3±3.5 U/mg), CAT was significantly increased (3.16± 1.08 U/mgvs. 2.63±0.90 U/mg).ConclusionLP had dose-dependent protective effect for hepatic oxidative stress injury in type 2 diabetic rats.

Objective To study medical fear and its influencing factors in hospitalized school-age children in Lanzhou area.Methods Children's Medical Fear Scale was used to investigate 110 cases of hospitalized school-age children,and the investigation result underwent analysis.Results The total score of children's medical fears was (50.43±7.34),the three items with the highest score among 30 items were surgery,death,being deprived of education,homework delay,surgery and death tied for first.Conclusions Medical fear of school-age children was related with age and gender,female was significantly higher than that of male.No relationship with the family education environment,duration of illness,area of residence.

BACKGROUND: Differences of thick and thin tissues in imaging areas is great because of postero-anterior images in cervical spine-thoracic spine.Although there are many image processing functions in direct digital radiography(DR)image with big range dynamic exposing,but routine direct DR hardly reveals anatomic structure of cervical spine-thoracic spine to detect diseases.Image quality of cervical spine-thoracic spine requires improvement.OBJECTIVE: To evaluate the difference between direct DR image with tissue equalization(TE)technique and standard DR in cervical spine-thoracic spine,so as to explore the best image quality in cervical spine-thoracic spine.METHODS: A total of 200 cases were randomly selected from DR cervical thoracic image from Department of Radiology,General Hospital of Chinese PLA between April 2005 and August 2009 to evaluate the difference between these images of DR processed by tissue equalization and that of standard DR.RESULTS AND CONCLUSION: The detail images of DR with tissue equalization in different thickness area of body could be revealed clearly in the same image,while the detail images of standard DR in cervical thoracic could be revealed clearly by adjusting window width and location repeatedly.Results show that the image quality of TE technique of direct digital X-ray radiography in cervical spine-thoracic spine could be clearly improved,it could be easily read and avoid the influence of body thickness area.Moreover,it could reveal clearly other part of body in detail.DR image with TE technique in cervical spine-thoracic spine can be applied widely due to simple operation,high diagnosis rate and low cost.

BACKGROUND:The cervical pedicle screws mistakenly inverted the cervical pedicle could lead to the many complications such as spinal cord,vertebral arteries and nerve root damage.If the parameter of inserting pedicle screws were measured accuracy,the rate of inserting pedicle screws successfully could be improved.OBJECTIVE:To get 3D anatomic parameter of inserting pedicle screws in the cervical vertebrae with the CT three-dimensional recontruction.METHODS:The Dicom data that the cervical vertebrae had been scanned by SIEMENS EMOTION 16 CT were converted into the soft Mimics 8.1,GE workstation and three-dimensional cervical vertebrae were reconstructed.The parameters of inserting cervical pedicle screws were measured with the consideration of the diameter of pedicle screw.RESULTS AND CONCLUSION:The cervical three-dimension images were reconstructed clearly with the CT three-dimensional reconstruction techniques.The cervical pedicular width,the axial length,α and β angles were measured by the soft measure function.The average inserting angular safe range of α angle was gained with the consideration of the diameter of pedicle screw.This method can mimic the operation and it is significant way in measuring the three-dimension anatomic parameter of the cervical vertebrae.The method is a good way that how to insert the cervical pedicle screw safely.

Objective To investigate errors and mechanism of acalculia in patients with brain injury.Methods Forty patients with brain injury and forty-eight normal adults who were matched in age and years of education were tested with EC301 standardized battery. Patients were divided into the left-brain damaged (LBD) group (n=20), right-brain damaged (RBD) group (n=9) and bilateral brain damaged (BBD) group (n=11). The data of all subjects were statistical analyzed.Results Both total scores and scores of 27 out of 31 items were remarkable lower in patients than those in the normal control group ( P<0.05). The total scores and items' scores for number sequences, numerical transcodings were significantly lower in LBD group than those in RBD group ( P<0.05). Total scores and each items' score did not significantly differ between BBD group and LBD group, or between BBD group and RBD group ( P>0.05).Conclusion The abilities of number processing and calculation are impaired in patients with brain injury. There is either association or dissociation in terms of performance of acalculia and aphasia in LBD patients. Visuospatial impairment is related to performance of acalculia in RBD patients.