Objective To investigate the distribution and clinical characteristics of TCM syndromes in infertility patients with autoimmune thyroiditis(AIT).Methods By referring to the relevant literature on the distribution of TCM syndromes of AIT and infertility in women of childbearing age,the TCM Syndromes Survey of Infertility Patients with Autoimmune Thyroiditis was formulated.256 cases of infertility patients with AIT who underwent in vitro fertilization-embryo transfer(IVF-ET)at the Reproductive Center of The First Affiliated Hospital of University of Science and Technology of China from June 2019 to December 2020 were retrospectively analyzed.The data of basic information,TCM syndromes,basic thyroid-stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)were collected.By means of frequency analysis and systematic cluster analysis,the distribution regularity of TCM syndromes in infertility patients with AIT were concluded.Results After analysis,the following 5 common syndrome elements were obtained,namely,qi deficiency,liver depression,spleen deficiency,kidney deficiency and blood stasis.In addition,it was concluded that this disease was more common in complex syndromes.Through systematic clustering analysis,main TCM syndromes of this disease were obtained,which were qi deficiency and liver depression syndrome(69 cases,26.9%),spleen and kidney deficiency syndrome(45 cases,17.6%),spleen qi deficiency syndrome(38 cases,14.8%),qi deficiency and blood stasis syndrome(36 cases,14.1%),kidney deficiency and liver depression syndrome(32 cases,12.5%)and other syndrome types(36 cases,14.1%).The basic TSH level was higher in patients with qi deficiency and liver depression syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome than other syndrome types,with statistical significance(P<0.05).There was no significant difference in TPO-Ab and TG-Ab titers among different syndromes(P>0.05).Conclusion TCM syndromes of infertility patients with AIT can be clustered into qi deficiency and liver depression syndrome,spleen and kidney deficiency syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome,kidney deficiency and liver depression syndrome and other syndrome.The main element of syndrome is qi deficiency,and the pathological sites involved spleen,kidney and liver.Stasis blood is a main pathological product.It is required to pay close attention to the thyroid function in AIT patients with qi deficiency.

Objective To prepare paclitaxel-natural borneol complex,and to explore the prescription and preparation process of paclitaxel-natural borneol complex drug-loaded submicroemulsion,and its in vitro anti-tumor effect.Methods The Paclitaxel-natural borneol complex was prepared by grinding method and identified by Fourier Transform infrared spectroscopy(FT-IR)and differential scanning calorimetry(DSC).The compound drug-loaded submicroemulsion was prepared using a two-step high-pressure emulsification method.The single-factor investigation and the orthogonal experimental design were applied to optimize the formulation and preparation process.MTT assay,cell cloning assay,and cell scratch assay were used to evaluate the effect of this preparation on HCT-116 cells.Results The infrared spectral absorption peaks of taxol-natural borneol complex at 3 312.76 cm-1 and 3 513.92 cm-1 disappeared,and DSC analysis showed that a new absorption peak of taxol-natural borneol complex appeared at 154.56 ℃,indicating that taxol be coupled with natural borneol to form a new complex.The optimal prescription was 0.44％active pharmaceutical ingredient[paclitaxel-natural borneol(1∶3)],10％medium chain triglyceride,3％emulsifier[egg yolk lecithin-Poloxam 188(1∶2)],2％glycerol,0.3％oleate.The optimal process was emulsification at 80 ℃,60 MPa high pressure homogenization 10 times.The half inhibitory concentration(IC50)was 0.75 μg·mL-1 by MTT asssy in cell.In the cell cloning assay,the scratch healing area of blank control group,paclitaxel raw material and paclitaxel/natural borneol submicroemulsion were(36.44±3.35)％,(13.59±9.28)％,(8.30±4.09)％,respectively.The results were statistically significant(P＜0.05).In the plate cloning experiment,the cell cloning rates of blank control group,paclitaxel bulk drug group and submicroemulsion group were(37.92±0.729)％,(9.16±1.335)％and(3.36±1.065)％,respectively,the differents were statistically significant(P＜0.05).Conclusion This submicroemulsion has reasonable prescription,feasible process and good stability.Cell experiments showed that the submicronemulision effectively inhibits the proliferation and migration of HCT-116 cells,suggesting its potential as a promising antitumor agent.

30 patients with chronic periodontitis and Type 2 diabetes mellituse were included.By a split-mouth design,the teeth in the left side were served as the experiment group and given Nd∶YAG and Er∶YAG laser therapy adjunctive to conventional periodontal treatment;the teeth in the right side were served as the control group and given conventional periodontal treatment alone.Before and after treatment perio-dontal and CBCT image indexes were examinde and compare between the 2 groups.Before treatment all the indexes were not statistically dif-ferent between the 2 groups(P＞0.05).3 months after treatment,the bleeding index(BI)and probing depth(PD)of the experimental group were significantly lower than those of the control group(P＜0.05).6 months after treatment,BI,PD and attachment loss(AL)in the experi-mental group were significantly lower than those in the control group,and the surface area and volume of the root in the alveolar bone were significantly higher than those in the control group(P＜0.05).Nd∶YAG and Er∶YAG laser therapy adjunctive to conventional periodontal treatment is more effective than conventional periodontal treatment alone in the treatment of chronic periodontitis with type 2 diabetes melli-tus.

Objective:To evaluate the differential diagnosis of papillary thyroid carcinoma (PTC) based on CT signs.Methods:Retrospective analysis was performed on 156 patients with PTC confirmed by surgery and pathology in the Imaging Department of Jinhua Hospital Affiliated to Zhejiang University College of Medicine from Jan. 2017 to Jan. 2022 as PTC group, and 132 patients with nodular goiter (NG) as NG group. There were 112 females and 45 males in the PTC group. The age was (49.32±3.25) years. There were 104 females and 52 males in NG group. The age was (50.12±3.27) years. Preoperative plain and contrast-enhanced CT scans were performed to analyze the features of the images, and univariate analysis was performed on the morphologic features, high tension, plain "bite cake sign" , enhanced "bite cake sign" , microcalcification, blurred/reduced scope after enhancement, nodule density, and asymmetric diffuse enlargement of thyroid gland. Statistically significant factors were included in the multivariate Logistic regression analysis, and the differential model of PTC was established according to the selected risk factors. The value of the model in the differential diagnosis of PTC was evaluated by ROC curve.Results:The percentages of irregular shape, no high tension, plain scan "bite cake sign" , enhanced "bite cake sign" , microcalcification, enhanced blur/reduced scope, uniform nodule density, completely slightly low tissue density, no cystic degeneration, and asymmetric thyroid diffuse enlargement in PTC group were higher than those in NG group ( χ2=161.014, 3.387, 95.885, 151.331, 60) . 200, 18.104, 105.260, 16.855, 89.064, 16.913, P<0.05) , suggesting that the above CT signs had important diagnostic value in differentiating PTC and NG. Among the single CT signs, plain scan "bite cake sign" had the highest sensitivity, specificity and accuracy. The sensitivity of PTC diagnosis combined with other signs gradually decreased, while the specificity gradually increased. At the same time, plain scan "bite cake sign" and microcalcification signs had high specificity in PTC identification, and the specificity of PTC identification reached 100.00% when any 4 or more signs were present. Multivariate Logistic regression analysis. The results showed that irregular morphology ( OR=15.831, 95% CI: 7.444-33.670) , high tension ( OR=0.162, 95% CI: 0.108-0.242) , plain scan "bite cake sign" ( OR=5.601, 95% CI: 2.691-11.659) , microcalcification ( OR=4.031, 95% CI: 2.062-7.880) , edge blur/range reduction after enhancement ( OR=4.761, 95% CI: 3.126-7.260) , uniform density of nodules ( OR=4.778, 95% CI: 3.299-6.290) and increased asymmetric diffusion ( OR=3.758, 95% CI: 1.911-7.391) were important signs for distinguishing NG from PTC ( P<0.05) . The above factors were incorporated into the Logistic regression equation to construct the model, and then the ROC curve was drawn. The results showed that the area under the curve of the model established based on CT signs was 0.94 (0.925-0.983) , and the sensitivity and specificity were 90.37% and 91.45%, respectively. Conclusions:In CT signs, irregular shape, high tension, "biting cake sign" on plain scan, microcalcification, blurred edge/scope reduction signs after enhancement, and uniform nodule density are important signs for differentiating papillary thyroid carcinoma from nodular goiter. The constructed model has good predictive value for identifying papillary thyroid carcinoma.

Purpose: We aimed to investigate whether obtaining a higher level of education was causally associated with lower breast cancer risk and to identify the causal mechanism linking them. Methods: The main data analysis used publicly available summary-level data from 2 large genome-wide association study consortia. Mendelian randomization (MR) analysis used 65 genetic variants derived from the Social Science Genetic Association Consortium as instrumental variables for years of schooling. The outcomes from the Breast Cancer Association Consortium (BCAC) were the overall breast cancer risk (122,977 cases/105,974 controls in women) and the two subtypes: estrogen receptor (ER)-positive breast cancer and ER-negative breast cancer. Fixed and random effects inverse variance weighted methods were used to estimate the causal effects, along with other additional MR methods for sensitivity analyses. Results: Results showed that each additional standard deviation of 4.2 years of education was causally associated with a 27% lower risk of ER-negative breast cancer (odds ratio, 0.73; 95% confidence interval, 0.64–0.84; p-value < 0.001). This finding was consistent with the results of the sensitivity analyses. Physical activities can help improve the protective effect of education against breast cancer, with relatively large mediation proportions. Education increases the risk of ER-positive breast cancer due to alterations in high-density lipoprotein level, triglyceride level, height, waist-to-hip ratio, body mass index, and smoking status, with relative medium mediation proportions. Other mediators including low-density lipoprotein, hip circumference, number of cigarettes smoked per day, time spent performing light physical activity, and performing vigorous physical activity for > 10 minutes explain a small part of the causal effect of education on the risk of developing breast cancer, and their mediation proportion is approximately 1%. Conclusion A low level of education is a causal risk factor in the development of breast cancer as it is associated with poor lipid profile, obesity, smoking, and types of physical activity.

Objective:To investigate the predictive value of maternal peripheral blood fetal DNA, creatine kinase (CK), and alpha-fetoprotein (AFP) in pregnant women with placenta previa complicated with adhesion or implantation.Methods:From April 2018 to April 2019, 72 patients with placenta previa confirmed by cesarean section in Chengde Central Hospital were retrospectively collected. Among them, 23 patients complicated with placental adhesion were enrolled in the placenta adhesion group, 19 patients complicated with placenta implantation were in the placenta implantation group, and 30 patients with simple placenta previa were in the simple placenta previa group. The amount of fetal DNA, CK and AFP in maternal peripheral blood were measured at 20 to 27 weeks of gestation. The general data of the three groups, the amount of fetal DNA in maternal peripheral blood, CK and AFP were compared. The value of the amount of fetal DNA, CK, and AFP in maternal peripheral blood for predivting placenta previa were analyzed. At the same time, the incidence of adverse pregnancy outcomes was counted, and patients were divided into adverse pregnancy outcomes group and good pregnancy outcomes group according to pregnancy outcomes. The fetal DNA amount, CK and AFP levels in the maternal peripheral blood of the two were compared, and the factors affecting the adverse pregnancy outcome of placenta previa were analyzed.Results:The levels of fetal DNA, CK and AFP in the maternal peripheral blood of the placenta implantation group were significantly higher than those of the placenta adhesion group and the simple placenta previa group: (1 018.96 ± 442.15) copies/ml vs. (659.27 ± 320.26) copies/ml and (390.64 ± 102.53) copies/ml , (103.54 ± 26.39) U/L vs. (88.30 ± 20.65) U/L and (62.78 ± 15.84) U/L, (319.65 ± 62.14) μg/L vs. (284.62 ± 55.96) and (232.64 ± 48.62) μg/L, and the difference was statistically significant ( P<0.01). The amount of fetal DNA in maternal peripheral blood was positively correlated with CK and AFP ( r = 0.899 and 0.769, P<0.01), and CK was positively correlated with AFP ( r = 0.782, P<0.01). The AUC of maternal peripheral blood fetal DNA in predicting placenta previa complicated with placenta adhesion was 0.842, and the sensitivity and specificity were 78.26% and 83.33% respectively. The levels of fetal DNA, CK and AFP in maternal peripheral blood of patients with adverse pregnancy outcomes were higher than those of patients with good pregnancy outcomes: (928.64 ± 257.73) copies/ml vs. (460.02 ± 188.95) copies/ml, (105.83 ± 26.88) U/L vs. (66.33 ± 20.39) U/L and (292.52 ± 58.39) μg/L vs. (259.29 ± 42.65) μg/L, and the difference was statistically significant ( P<0.05). Placenta adhesion, placenta implantation, postpartum hemorrhage, maternal peripheral blood fetal DNA, CK and AFP levels were influential factors for the adverse pregnancy outcome of placenta previa ( OR = 3.544, 4.183, 3.413, 3.222, 3.109 and 3.313, 95% CI 1.905 to 6.593, 2.401 to 7.286, 1.832 to 6.359, 1.729 to 6.005, 1.659 to 5.827 and 1.831 to 5.994, P<0.01). Conclusions:The amount of fetal DNA, CK and AFP in maternal peripheral blood have a certain predictive value in placenta previa complicated with placental adhesion or implantation, and are closely related to the pregnancy outcome of patients with placenta previa. Early detection of the above indicators will help clinically to formulate reasonable intervention measures and promote the improvement of pregnancy outcomes.

Objective To estimate the diagnostic value of cytology, DNA-ICM(DNA-image cytometry),cytology combined with DNA-ICM for pancreatic malignancy,and to explore the cut-off value for DNA-ICM. Methods Patients with suspicious pancreatic malignancy were retrospectively identified. In total,145 EUS-FNA specimens acquired from 140 separate patients were examined by cytology and DNA-ICM. Diagnostic values among cytology, DNA-ICM and the combination of the techniques in detecting pancreatic malignancy were compared. Results Compared with cytology, DNA-ICM had a lower sensitivity (63.0% VS 82.4%)and accuracy(69.7% VS 85.5%). After combining the techniques, the diagnostic value for pancreatic malignancy significantly improved compared with that by cytology(0.941 VS 0.912, P=0.007 0)or DNA-ICM only(0.941 VS 0.815, P<0.000 1). By using the Youden index, the cut-off value for DNA-ICM to detect pancreatic malignancy was one cell with DI(DNA index)≥2.5. Notably,with this standard, the sensitivity and accuracy of DNA-ICM significantly increased to 72.3% and 77.2%, and those of the combined techniques increased to 91.6% and 93.1%, respectively. Conclusion Automated DNA-ICM is an objective and effective method for pancreatic malignancy. Although DNA-ICM has a lower diagnostic value than that of conventional cytology, an improved value was obtained after combining the techniques.

Objective To observe the effects of mitochondrial protectant on hippocampal mito-chondrial function and synaptic plasticity in isoflurane-anesthesia aged mice.Methods Forty-eight fif-teen-month-old male C57BL/6 mice were equally divided into 4 groups (n=12):oxygen+normal sa-line (group CN),oxygen+SS-31 (group CS),isoflurane+normal saline (group IN),and isoflurane+SS-31 (group IS).SS-31(5 mg/kg)or normal saline was intraperitoneally administered with a vol-ume of 0.4 ml/kg 30 min before gas inhalation.After two hours gas inhalation,the hippocampus was removed to determine complex Ⅰ-Ⅳ activities,adenosine triphosphate (ATP)and mitochondrial membrane potential (MMP)levels from isolated mitochondria,and measure the content of synapsin-1,PSD-95,NMDAR2A,NMDAR2B,CaMKⅡα and CaMKⅡβ.Results Compared with the group IN,complex Ⅰ activity,ATP and MMP levels were increased,synapsin-1 and PSD-95 were up-regu-lated,whereas NMDAR2B,CaMK Ⅱα and CaMK Ⅱβ were down-regulated in the group IS (P <0.05).No significant difference was observed in the complex Ⅱ-Ⅳ activities and NMDAR2A expres-sion.Conclusion Mitochondrial protectant SS-31 attenuates isoflurane-induced mitochondrial dysfunc-tion and neuron synaptic plasticity impairments in aged mice.

Objective:To analyze the effect and security of lidocaine combined with tramadol for preemptive analgesia .Meth-ods:A totle of 90 patients undergoing laparoscopic cholangiotectomy under total infusion venus anesthesia (TIVA) were divided into Group T1 ,Group T2 and Group C ,with 30 patients in each group .Before and after the operation ,the patients in Group T1 received intravenous tramadol 100 mg ;the patients in Group T2 received intravenous lidocaine 50 mg and tramadol 50 mg ;the patients in Group C received saline injection .The awakening time ,alertness/sedation (OAA/S) scale ,visual analoue scale (VAS) ,and the untoward effects of patients after operation among the 3 groups were compared .Results:The postoperative a-wakening time of patients in 3 groups had no statistical difference ,and the OAA/S score at postoperative15 min in Group T1was higher than those in Group T2 and Group C (P<0 .05) .The VAS scores at 0 .5、1、2 、4、6、12 h after the operation in Group T1 and Group T2 were lower than those in Group C (P<0 .05) ,but those in Group T1 and Group T2 had no statistical diffe-rences .The blood pressure and heart rate of patients in Group T 2 were more stable than those in Group T1 and Group C .Con-clusions:Lidocaine combined with tramadol intravenously injected shows definite preemptive analgesia effects and stable anes-thesia recovery ,and it is better than tramadol alone .

OBJECTIVETo conduct an experimental study on in vitro transdermal absorption of prepared Shangshi Zhitong cataplasm.

METHODFranz diffusing cells and mice were adopted for the percutaneous penetration study. The accumulative percutaneous permeation of total alkaloids, strychnine and atropine in certain time was determined by acid dye colorimetry and HPLC.

RESULTThe accumulative permeation of alkaloids (Q) increased with time (t), with a linear relation between them.

CONCLUSIONThe in vitro percutaneous penetration of Shangshi Zhitong cataplasm complies with the zero-order kinetics.

Administration, Cutaneous ; Alkaloids ; pharmacokinetics ; Animals ; Atropine ; pharmacokinetics ; Drugs, Chinese Herbal ; pharmacokinetics ; Male ; Mice ; Rats ; Rats, Wistar ; Skin Absorption ; Strychnine ; pharmacokinetics