Objective To analyze the short-term survival and prognostic quality of life of patients with liver cirrhosis complicated by bacterial infection. Methods This study collected and analyzed 300 patients with liver cirrhosis complicated with infection who were hospitalized in the First Affiliated Hospital of Hebei North University, and followed up to discuss their survival and quality of life. Results In this study, the top two causes of infection were spontaneous bacterial peritonitis (60.67% of patients) and pneumonia (50.67% of patients). The second causes were urinary tract infections (15.33%), gastrointestinal infections (12.33%), and other causes. There was no statistically significant difference between male and female patients (P>0.05). In addition, the proportion of hospital infections was 71.00%, and there was no statistically significant difference between male and female patients (P>0.05). A total of 353 strains of pathogenic bacteria were isolated in this study (73.37% of patients with hospital infections). The distribution analysis of pathogenic bacteria showed that the highest proportion of ECO was 35.98%, followed by Klebsiella pneumoniae (18.98%). The distribution trend of 259 strains of pathogenic bacteria among hospital patients was consistent with that of all strains, and the difference was not statistically significant (P>0.05). Gram negative bacteria accounted for 79.60% (281/353) of all detected strains, of which Escherichia coli was mostly detected in patients with spontaneous bacterial peritonitis, Klebsiella Pneumoniae (KPN) and Pseudomonas aeruginosa (PAE) were mostly detected in patients with pneumonia, and Enterococcus (ENF) was mostly detected in patients with urinary tract infection; Among gram-negative bacteria, Staphylococcus epidermidis (SEP) and Staphylococcus aureus (SAU) are mostly found in patients with other infectious causes (blood flow infection, etc.) , and Streptococcus (STR) accounts for a high proportion in patients with Spontaneous bacterial peritonitis. In this study, 9 cases of death prognosis were detected during follow-up, and there was no statistically significant difference in the detection of death prognosis between different bacterial strains in both genders, as well as the difference in detection of death prognosis between hospital infections and out of hospital infections in both genders (P>0.05). There was no statistically significant difference in the detection of death prognosis between males and females due to different causes of infection, P>0.05. The quality of life scores of 291 surviving patients were compared between baseline and follow-up, indicating an increase in follow-up scores, especially in the dimensions of physiological function and physical pain. There was no statistically significant difference between different bacterial strains, infection causes, and hospital/non hospital infections (P>0.05) . Conclusion Spontaneous bacterial peritonitis and pneumonia are the main causes of infection that deserve special attention, and the main pathogens of infection are Gram negative bacteria. Targeted treatment and rehabilitation should be provided for patients with liver cirrhosis complicated by infection. At the same time, the proportion of hospital infections is relatively high, and attention should be paid to, prevention and control measures should be implemented as well.

Objective:To investigate the factors associated with the occurrence of coccoid forms in clinical isolates of Helicobacter pylori ( H. pylori) and its relationship with the pathological changes of gastric mucosa. Methods:A total of 66 H. pylori-infected patients admitted to People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to June 2021 were included.The clinical data of the patients were collected. Immunohistochemical staining was performed on gastric mucosal biopsy specimen to observe the occurrence of coccoid forms of H. pylori and pathological changes of gastric mucosa. Chi-square test was used for statistical analysis. Results:After immunohistochemical staining of 66 gastric mucosa biopsy specimens from H. pylori-infected patients, the co-existence of helical and coccoid forms of H. pylori was found in 26(39.39%) specimens, and no simple coccoid H. pylori change was found. Among them, the patients with a history of eradication therapy had a coccoid forms rate of 52.63%(20/38), and those without a history of eradication therapy had a coccoid forms rate of 21.43%(6/28), and the difference was statistically significant ( χ2=6.57, P=0.012). There were no significant differences in the coccoid forms rates between patients with different gender, ethnicity, age and gastric mucosal pathological changes (including atrophy, gastric intestinal metaplasia, inflammation, activity)(all P>0.050). Seventeen (73.9%) of the 23 patients whose endoscopy was more than one to three months from the last eradication therapy developed coccoid forms, while three of 15 patients whose endoscopy was more than three months from the last eradication therapy had coccoid forms, and the difference was statistically significant ( χ2=10.59, P=0.002). Conclusions:The transformation of H. pylori coccoid forms is related to the previous eradication therapy. The coccoid forms of H. pylori is equally pathogenic relative to the helical forms of H. pylori.

Objective:To examine the burden of caregivers for elderly Parkinson's patients(PD)and to analyze the mediating effects of social support on primary PD caregivers' burden and their quality of life.Methods:In this cross-sectional study, 281 primary caregivers for elderly Parkinson's patients who visited the Department of Neurology's outpatient clinics of Qilu Hospital of Shandong University from January to May 2021 were surveyed via a convenience sampling method, with 242 valid questionnaires(86.1%). The Chinese versions of the Caregiver Burden Questionnaire, Social Support Rating Scale and 36-Item Short Form Health Survey were used for the investigation.Pearson correlation analysis was used to establish a structural equation model for the influence of social support in the burden and quality of life of caregivers for PD patients.The mediating effects were tested using Process v2.16.3 and re-tested using AMOS.The mediating effects were validated with Bootstrap.Results:Primary caregivers' scores on burden, social support and quality of life were(26.9±23.1), (40.5±8.7)and(593.7±163.3), respectively.Caregiver burden was negatively correlated with social support(r=-0.482, P<0.01), and social support was positively correlated with quality of life(r=0.513, P<0.01). Caregiver burden was negatively correlated with quality of life( r=-0.654, P<0.01), The validated mediating effects showed caregiver burden's direct effects on quality of life(95% CI: -0.38-0.61)and mediating effects of social support(95% CI: -0.08-0.21), not including 0, indicating that the care burden of primary caregivers for elderly PD patients was not only able to predict their quality of life, but also predict their quality of life through the mediating effects of social support(direct effect: -0.50 and mediating effect: -0.14, accounting for 78.0% and 22.0%, respectively, of the total effect of -0.64). Conclusions:Care burden and social support are important factors affecting the quality of life of primary caregivers for elderly PD patients.Reducing care burden can not only directly affect the quality of life, but also indirectly affect the quality of life by increasing social support.

Objective: To assess the casual effect of childhood obesity on adulthood coronary artery disease (CAD) using Mendelian randomization (MR) method. Methods: Data on BMI of children aged 2-10 years in 2015 were downloaded from Early Growth Genetics Consortium and Genetic Investigation of Anthropometric Traits Consortium. Twenty-seven genetic variants related to children’s BMI were selected as instrumental variables (IVs), and the associations between IVs and CAD were extracted from a Meta-analysis of the genome-wide association study of CAD cases published in UK Biobank 2015. We used MR-Egger regression to test whether there was the pleiotropy of the selected SNPs. In the present MR methods, we conducted MR analyses by using mode-based estimate method as primary method for summary-level of associations to estimate the causal association between childhood obesity and CAD. Results: The intercept term estimated for CAD from MR-Egger method suggested that the selected SNPs don’t exert pleiotropy with a 95%CI including the null (-0.008-0.018). In addition, we found evidence that support the effect of childhood obesity on CAD risk: a 1 s increase in children BMI (kg/m²), and the risk of suffering from CAD in adulthood increased by an average of 37% (OR=1.37, 95%CI: 1.09-1.72). Conclusion This study provides a causal association between childhood obesity and CAD risk.

Objective To analyze the clinical characteristics , therapeutic outcomes , and prognostic factors of primary salivary gland type nasopharyngeal carcinoma ( SNPC) . Methods The medical records of 54 patients with SNPC at single institution between 1963 and 2006 were reviewed, 2 patients received surgery alone, 30 patients received radiotherapy alone and 22 patients received combined modality therapy consisting of surgery (S) and radiotherapy ( RT) ( S + RT in 15 and RT + S in 7). Of them, 8 patients received chemotherapy , including post-operative adjuvant chemotherapy in 1 patient, palliative chemotherapy in 6 patients and concurrent chemotherapy in 1 patient. 36 patients had adenoid cystic carcinoma ( ACC) ,11 mucoepidermoid carcinoma ( MEC) , and 7 primary traditional adenocarcinoma ( AC) . The Kaplan-Meier method was used to calculate the overall sunival ( OS) , locoregional failure-free survival ( LRFFS) , and distant failure-free survival ( DFFS) rates. Univariate analyses were performed using the Log-rank method.Comparisons of variables between cases were performed using Pearson chi-square test. Results The follow-up was 89％ . The 2-, and 5-year overall survival rates, loco-regional failure free survival rates and distant failure free survival rates were 85％ and 61％ , 74％ and 55％ , 92％ and 70％, respectively. Among the 35 patients with treatment failure, 26 patients had locoregional failure (1 in primary site and cervical lymph node ,23 in primary site and 2 in cervical lymph node) ,and 13 had distant metastasis. The lung was the most common site of metastasis ( n =10) , followed by liver (n = 3), bone ( n = 2) , brain ( n = 1) , and subcutaneous tissue ( n = 1) . Univariate analyses indicated that histological subtypes correlated with overall survival ( X2 = 15. 29, P = 0. 000) and cervial lymph node metastases correlated with distant failure-free survival ( X2 =9. 08 ,P = 0. 003) . Conclusions Primary salivary gland type nasopharyngeal carcinoma is a locally aggressive disease with a long course. The optimal treatment policy for patients with SNPC may be surgery plus radiotherapy.

Objective To study the expression of PIWIL1, PIWIL3 and PIWIL4 in human colon cancer and its clinical significance. Methods We collected cancerous tissues and its adjacent tissues of 106 patients with colon cancer, two tissue microarrays were constructed, with 62 and 150 points respectively. We studied the expression of PIWIL1, PIWIL3 and PIWIL4 through immunohistochemistry. Results The expression of PIWIL1, PIWIL3 and PIWIL4 were significantly higher in cancerous tissues than those in adjacent tissues (P＜0. 01). In cancerous tissues and its adjacent tissues, postive correlation were seen among PIWIL1, PIWIL3 and PIWIL4 expression (P＜0. 01). PIWIL1 expression was significant higher in low differentiation group than that in high differentiation group (t =- 2. 840, P＜0.01 ). PIWIL3 expression was higher in high clinical stage than that in low clinical stage (F= 3. 112, P＜0.05). The expression of PIWIL3 and PIWIL4 were significantly higher in patients with colon cancer with distant metastasis than those without distant metastasis (t= -3. 349, P＜0.01 ; t = - 2. 168, P＜0. 05). PIWIL3 and PIWIL4 expression were correlated with occurring of colon cancer (P＜0. 01). Conclusions The expressions of PIWIL1,PIWIL3 and PIWIL4 in colon cancer were correlated with the differentiation, clinical stage and distant metastasis of colon cancer. PIWIL3 and PIWIL4 expression were two independent related factors of occurring of colon cancer, which would be furtherly investigated to be served as novel markers for early diagnosis and promising molecular targets for colon cancer therapy.

OBJECTIVETo establish the HPCE chromatogram of prepared products of Rhizoma Coptidis (RC) for analyzing the difference of Alkaloids in RC prepared by different methods, in order to offering reference for studies on the preparing mechanism.

METHODThe chromatograms were obtained by HPCE, in which the background electrolyte was 0.05 mol x L(-1) Na2B4O7-H3PO4 (pH 7.0) containing 35% MeOH. The voltage was 15 kV, the detection wavelength was 225 nm, and the samples were developed at room temperature. The correlation relativity of retention time and peak area of each chromatographic peak in different prepared samples were explored, respectively, and benzyl tri-ethyl ammonium chloride was chosen as the reference to calculate the relative retention time and the ratio of peak area for each chromatographic peak.

RESULTEight co-possessing peaks were selected as the characteristic of different prepared products of RC. The relative area of the same peak in different prepared products were distinct, but the area ratio of the 8 peaks in each product prepared with the same method was a relative constancy basically.

CONCLUSIONIt is proved that the new method is stable and reliable. It can be used as the characteristic chromatogram of the prepared RC, and it can be useful in the quality control of this material.

Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coptis ; chemistry ; Plant Extracts ; analysis ; Rhizome ; chemistry

Objective To evaluate the impact of rosiglitazone (Ros) on liver expression of peroxisome proliferator-activated receptor γ (PPARγ),nuclear factor (NF-κB) and cyclooxygenase-2(COX-2) in treatment of nonalcoholic steatohepatitis (NASH) rats.Methods Thirty Sprague-Dawley rats were divided into normal group,model group and Ros treated group with 10 each.Except the normal group,the other two groups were given high fat diet for 12 weeks for NASH model.The rats in Ros treated group were gavaged 4 mg/kg of Ros daily at the 12th week for 8 weeks.All rats were sacrificed at the 20th week for blood sample and liver tissue.Biochemical parameters of liver function,lipid metabolism,glycometabolism and antioxidant enzyme activities were measured.The histological change of the liver were assessed with HE and Masson staining.The level of tumor necrosis factor (TNF)-α and prostaglandin E2 (PGE2) was measured using ELISA.The expression of PPARγ,NF-κB and COX-2 was detected with immunohistochemistry.The mRNA and protein expressions of COX-2 were tested by real-time PCR and Western blotting,respectively.Results In comparison with model group,Ros treated group showed significant improvement in hepatic steatosis,inflammation and fibrosis(all P value<0.05).In model group,the serum levels of fasting blood glucose,insulin and HOMA-insulin resistance index (HOMA-IRI),total cholesterol (TC),total triglyeride (TG),lowdensity lipoprotein cholesterol (LDL-C) and free fatty acids were increased,but HDL-C level was decreased.All above parameters markedly improved after Ros treatment.The levels of ALT and AST,total anti-oxidation competence,superoxide dismutase,catalase,glutathione peroxidase and malondialdehyde in Ros treated group were significantly ameliorated when compared with those in model group.Immunohistochemistry showed that the expression of NF-κB and COX-2 was significantly elevated,but PPARγ was decreased in model group.Real-time PCR and Western blot revealed that the mRNA and protein expressions of COX-2 were higher in the model group than those in normal group (0.57±0.08 vs 0.38±0.03;2.83±0.24 vs 1.00±0.03,P=0.000 and P=0.004,respectively),but significantly lower in Ros treated group (0.55±0.06 and 1.84±0.13,P<0.01).Conclusions Ros can reduce oxidative stress and insulin resistance in NASH rats by activing PPARγ expression and inhibiting expression of NF-κB and cyclooxygenases.

Objective To analyze the dose distributions of changing target volumes during intensity modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC). Methods Twenty-one NPC patients received definitive IMRT. A total of 126 computed tomography (CT) planning images were acquired, including the first CT scan for the primary plan and a series of scans taken weekly from the start of treatment to the fifth week. The images were registered to the planning images. Target volumes (GTV_(nx), CTV_1 ,CTV_2 ,PTV, and PTV_2) and normal structures (the parotid, brain stem and spinal cord) were re-contoured on the fusion CT images. Results The D_(mean) D_(95), D_(90), D_(10), D_5 and V_(100) of GTV_(nx) were 15.44 -15.60 Gy (F=0.07,P=0.996),14.66 -14.92 Gy (F=0. 11,P=0.990),14.81 -15.06 Gy (F= 0. 12,P=0.988),15.88 -16.29 Gy (F =0.28,P=0.924),16.00 -16.38 Gy (F=0.25,P =0. 940) and 98. 1% -99. 5 % (F = 0. 08, P = 0. 995), CTV_1 with 14. 75 -14. 98 Gy (F = 0. 07,P = 0. 997), 13.39 -13.73 Gy (F=0.20,P=0.964),13.74 -13.96 Gy (F=0.08,P=0.995), 15.65 -15.90 Gy (F= 0.09,P=0.994),15.91 -16.05 Gy (F=0. 10,P=0.992), 98.2% -99.5% (F=0.02,P= 1.000), and CTV_2 with 13.34 -13.64 Gy (F=0. 18,P=0.970),12.71 -13. 18 Gy (F=0.32,P=0.898), 12.89 -13.28Gy(F=0.23,P=0. 949) ,13.79 -14.03Gy(F=0. 12,P=0. 987) ,13.92 -14. 16 Gy (F=0. 12,P=0.987), 94.4% -99.6% (F=0.25,P=0.937), respectively. Conclusions No significantly different dose distributions exists with the changes of the target volumes, even on the largest variations of external contours. The primary plan could ensure adequate doses to the changing target volumes. The replanning is unnecessary in terms of the change of target volumes during radiotherapy.

Objective To evaluate the treatment results of the patients with nasopharyngeal mucoe-pidermoid carcinoma (MEC), and explore an appropriate treatment method. Methods Eleven patients with pathologically confirmed nasopharyngeal MEC were included in this study. The number of patients with pathologically well-, medium-and poorly-differentiated tumor were 1, 2 and 7, respectively. Radiotherapy (RT) alone and surgery (S) alone were given to 1 patient each. Combined modality treatment was RT + S in 6 patients and S + RT in 3 patients. Results After a median follow-up of 41.5 months (range, 8 to 153 months), one patient died of heart disease and one was lost follow-up. The remaining 9 patients were alive, including 6 with disease-free and 3 with residual tumors. None of them had cervical lymphatic spread or dis-tant metastasis. Conclusions Nasopharyngeal MEC progresses slowly and has good prognosis, which should be followed up for a long time. Primary surgery followed by radiotherapy is recommended.