ObjectiveTo investigate the therapeutic effect of Qingjie Huagong decoction （QJHGD） on a mouse model of severe acute pancreatitis （SAP） and the mechanism of action of QJHGD against inflammatory response. MethodsA total of 36 male C57BL/6J mice were randomly divided into blank group， model group， Western medicine group （ulinastatin）， and low-， middle-， and high-dose QJHGD groups， with 6 mice in each group. All mice except those in the blank group were given 5% sodium taurocholate by retrograde pancreaticobiliary injection to establish a model of SAP. After modeling， the mice in the low-， middle-， and high-dose groups were given QJHGD （1， 2， and 4 g/kg， respectively） by gavage， and those in the Western medicine group were given intraperitoneal injection of ulinastatin （5×10⁴ U/kg）， for 7 days in total. HE staining was used to observe the histopathological changes of the pancreas； ELISA was used to measure the levels of α-amylase， lipase， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， interleukin-18 （IL-18）， and tumor necrosis factor-α （TNF-α） in mice； RT-qPCR was used to measure the mRNA expression levels of NOD-like receptor protein3 （NLRP3）， Toll-like receptor 4 （TLR4）， and nuclear factor-kappa B （NF-κB） in pancreatic tissue； immunohistochemistry was used to measure the positive expression rates of NLRP3， TLR4， and NF-κB in pancreatic tissue； Western blot was used to measure the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6. An analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the blank group， the model group had diffuse destruction of pancreatic tissue structure， focal dilatation of pancreatic lobular septum， pancreatic acinar atrophy， and massive inflammatory cell infiltration， as well as significant increases in the content of α-amylase， lipase， IL-1β， IL-6， IL-8， IL-18， and TNF-α （all P<0.05）， the mRNA expression levels and positive expression rates of NLRP3， TLR4， and NF-κB （all P<0.05）， and the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6 （all P<0.05）. Compared with the model group， the low-， middle-， and high-dose QJHGD groups and the Western medicine group had slightly tighter and more intact structure of pancreatic tissue， ordered arrangement of pancreatic acinar cells， a small amount of inflammatory cell infiltration， and hemorrhagic foci of pancreatic lobules， as well as significant reductions in the content of α-amylase， lipase， IL-1β， IL-6， IL-8， IL-18， and TNF-α （all P<0.05）， the mRNA expression levels and positive expression rates of NLRP3， TLR4， and NF-κB （all P<0.05）， and the protein expression levels of NLRP3， TLR4， NF-κB， IL-1β， and IL-6 （all P<0.05）. ConclusionQJHGD may exert a protective effect on the pancreatic tissue of SAP mice by inhibiting the activation of NLRP3/TLR4/NF-κB signaling pathway-related proteins， reducing the release of inflammatory mediators， and preventing the enhancement of inflammatory cascade response.

Objective:To investigate the expression of calcium binding-protein A9 (S100A9) in cervical cancer and its relationship with the efficacy of TC (paclitaxel+carboplatin) regimen chemotherapy in patients.Methods:A total of 119 patients with cervical cancer who were scheduled to undergo TC regimen chemotherapy in the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from July 2017 to May 2021 were selected to conduct a prospective study. The tissue samples of all patients were obtained by biopsy before treatment, and the expressions of S100A9, matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) in cervical cancer tissues and paracancerous normal tissues were detected by immunohistochemistry. The correlation of S100A9 expression with MMP-9 and VEGF expressions in cervical cancer tissues were analyzed by using Spearman method. The patients were divided into the effective group (complete remission+partial remission) and the ineffective group (stable disease+progressive disease) according to the effectiveness of chemotherapy, and the expressions of S100A9, MMP-9 and VEGF in cervical cancer tissues of the two groups were compared. The influencing factors for TC regimen chemotherapy efficacy were analyzed by using multivariate logistic regression method.Results:Compared with paracancerous tissues, the positive expression rates of S100A9 [90.76% (108/119) vs. 45.38% (54/119)], MMP-9 [55.46% (66/119) vs. 17.65% (21/119)] and VEGF [78.99% (94/119) vs. 24.37% (29/119)] were all elevated in cervical cancer tissues ( χ2 values were 47.03, 36.69 and 71.09, all P < 0.001). The S100A9 expression in cervical cancer tissues was positively correlated with MMP-9 and VEGF expressions ( r values were 0.619 and 0.784, both P < 0.001). The effective rate of TC regimen chemotherapy was 47.06% (56/119). The positive expression rate of S100A9 in cervical cancer tissues of the effective group was higher than that of the ineffective group [98.21% (55/56) vs. 84.13% (53/63), P < 0.05], while the positive expression rates of MMP-9 [35.71% (20/56) vs. 73.02% (46/63)] and VEGF [67.86% (38/56) vs. 88.89% (56/63)] were lower than those of the ineffective group (both P < 0.001). Multivariate logistic regression analysis showed that clinical stage Ⅳ ( OR = 2.707, 95% CI 1.865-4.119, P < 0.05), lymph node metastasis ( OR = 4.468, 95% CI 3.221-5.823, P < 0.001), deep myometrial invasion ( OR = 5.686, 95% CI 4.308-7.247, P < 0.001), vascular tumor thrombus or parauterine invasion ( OR = 3.758, 95% CI 2.584-5.163, P < 0.001), MMP-9 positive expression in cancer tissues ( OR = 3.904, 95% CI 2.876-5.228, P < 0.001) and VEGF positive expression in cancer tissues ( OR = 2.609, 95% CI 1.793-4.052, P < 0.05) were the risk factors affecting the TC regimen chemotherapy efficacy, while the S100A9 positive expression in cancer tissues was the protective factor for TC regimen chemotherapy efficacy ( OR = 0.660, 95% CI 0.417-0.854, P < 0.05). Conclusions:The expression of S100A9 in cervical cancer tissues increases and correlates with MMP-9 and VEGF expressions. The high expression of S100A9 could increase the effectiveness of TC regimen chemotherapy in cervical cancer patients, while clinical stage Ⅳ, lymph node metastasis, deep muscle invasion, vascular tumor thrombus or parauterine invasion, MMP-9 positive expression and VEGF positive expression may increase the risk of ineffective chemotherapy with TC regimen in patients.

Objective:To evaluate the clinical efficacy and safety of fecal microbiota transplantation(FMT)for the treatment of chronic functional constipation in the elderly.Methods:A total of 33 elderly patients with chronic functional constipation were included and given three sessions of FMT.Changes in fecal characteristics, constipation, mood and quality of life in these patients were evaluated using the Bristol stool form scale(BSFS), the constipation assessment scale(CAS), patient assessment of constipation symptoms(PAC-SYM), the Zung self-rating anxiety scale(SAS), the Zung self-rating depression scale(SDS), and the patient assessment of constipation quality of life(PAC-QOL)before and 12 weeks after treatment.The clinical efficacy was based on comparison between pre-and post-treatment results for each patient.Results:Clear improvement was achieved in 33 patients 12 weeks after treatment, compared with before transplantation.Post-treatment scores of the constipation assessment scale and symptom self-assessment questionnaire for patients with constipation were(8.9±1.2)scores and(26.5±2.4)scores, respectively, significantly lower than pre-transplantation scores of(12.2±1.1)scores and(32.4±2.4)scores( t=15.034, 13.904, both P<0.001). Similarly, post-treatment scores were also lower than pre-transplantation levels for the self-rating anxiety scale[(50.4±8.4)scores vs.(57.5±9.0)scores, t=10.333, P<0.001], the self-rating depression scale[(50.6±8.4)% vs.(55.0±10.5)%, t=5.301, P<0.001], and self-assessment questionnaire for quality of life[(88.2±7.3)scores vs.(103.7±7.3)scores, t=23.300, P<0.001]. Conclusions:FMT can improve fecal characteristics and constipation symptoms, relieve anxiety and depression, improve the quality of life, and provide a new option for the treatment for elderly patients with chronic functional constipation.

Dyslipidemia is an important risk factor of atherosclerotic cardiovascular disease (ASCVD). Statins delay the occurrence and development of ASCVD, and reduce the risk of cardiovascular events and death. Due to safety concerns, there exist insufficient use of lipid-lowering agents and a high withdrawal rate of the agents in the elderly. To promote the prevention and treatment of ASCVD, this expert consensus is issued and focuses on the management of dyslipidemia of Chinese elderly basing on the clinical evidence of the use of lipid-lowering drugs by the elderly, and the lipid management guidelines and expert consensus recommendations at home and abroad.

Objective To investigate the expression of Cofilin in alveolar and peripheral blood mononuclear cells in COPD patients and the correlation with the function of phagocytic aspergillus. Methods 20 COPD pa-tients were selected from July 2015 to May 2016 in the outpatient department of respiratory medicine of Zhujiang Hospital of Southern Medical University ,then divided into the experimental group 1(group Aand B in 2011 version of GOLD),group 2(test group C and group D in 2011 version of GOLD),and the healthy control group in 10 people. The AM and MDM in the peripheral bloodwere extracted respectively in the 3 groups by bronchoalveolar lavage and,and the ability of AM and MDM in each group were detected. The expression of Cofilin protein was measured by real-time fluorescence quantitative(qRT-PCR) and Western blotting ,and the differenceswere compared among the three groups. Results The colony numbers of MDM/AM in the 3 groups were 17 ± 3,16 ± 2, 42 ± 3(F = 73.446 ,P < 0.001),and the colony numbers of MDM/AM in the two test groupshad significantly different from the healthy group ,while no significant difference was found in the two test groups. The results of fluorescence quantitative reverse transcription polymerase chain reaction and Western blot analysis showed that the expression of Cofilin in the two test groups was significantly higher than that in the healthy group. Conclusion The decreased function of phagocytic aspergillus in the alveolar and peripheral blood mononuclear cells in COPD patients may relates to the increase of cofilin.

Objective T o study the correlation of daily living activities with location and severity of trau-m atic brain injury (TBI) and to provide a theoretical basis for im proving the accuracy of expert opinion. Methods Five hundred and one cases of patients with TBI were selected. D etailed records included fol-lowing: pre-injury situation, location and severity of injury, treatm ent and education. D aily living activi-ties scale (B arthel index) was applied to test the subjects’daily living activities. T he relevance am ong location and severity of TBI and B arthel index was statistically analyzed. Results In m ild TBI group, there wasnosignificantdifferenceinBarthelindex among each location (P>0.05).Inmoderate TBIgroup, there were significant differences in B arthel index between subarachnoid hem orrhage and cerebral lobe injury, also between parietal, occipital lobes injury and frontal lobe injury, parietal, occipital lobes injury and temporallobe(P<0.05),respectively,whereasnosignificantdifference in Barthelindexbetween frontal lobe injury and tem poral lobe injury (P>0.05).In severe TBI,there were significant differences in Barthel index between every two different locations (P<0.05). Conclusion T here is som e correlation between the location of TBI and B arthel index, which provides an im portant reference value for analyzing and deter-m ining daily living activities after TBI.

Objective To observe the expression of ghrelin and growth hormone secretagogue receptor (GHSR) in pancreas of rats with acute necrotizing pancreatitis (ANP),and investigate the role of ghrelin in the pathogenesis of ANP.Methods Seventy SD rats were randomly divided into ANP group (n =35) and control group (n =35).ANP model was induced by retrograde injection of 4％ sodium taurocholate into the biliary and pancreatic duct.Rats in the control group underwent laparotomy with gentle pancreas manipulation only.At 3,6,12,24,48 h after ANP induction,the rats were sacrificed,and the serum level of amylase was determined,pathological changes in pancreatic tissue were routinely observed and scored.The expressions of ghrelin mRNA,protein and GHSR mRNA,protein in pancreas were evaluated by RT-PCR and Western blot.Results Serum amylase level began to increase at 3h after sodium taurocholate injection and reached the peak value at 6 h [(8244 ± 2950) U/L],which was significantly higher than that in control group (P ＜ 0.05).Pancreatic injuries was aggravated with time,the pathologic score at 24 h was (11.91 ± 1.31) score,which was significantly higher than (3.12 ± 1.60) score in the control group.The expressions of ghrelin mRNA and GHSR mRNA in pancreas of ANP group were increased gradually with time,and were significantly higher than those of control group at all time points,at 48 h,1.29 ±0.64 vs 0.58 ±0.05 and 0.94 ±0.16vs 0.19 ±0.03,P ＜ 0.05.The expressions of ghrelin protein and GHSR protein in pancreas of ANP group were significantly higher than that in control group at 12,24,48 h.at 48 h,3.05 ± 0.48 vs 2.18 ± 0.23 and 2.34 ± 0.32 vs 1.55 ± 0.10 (P ＜ 0.05).Conclusions The expressions of ghrelin mRNA,protein and GHSR mRNA,protein of pancreas are significantly increased in rats of ANP,and are associated with the severity of ANP.

Objective To determine the cerebral protective effect of different concentrations of desflurane anesthesia during craniotomy.Methods Twenty two patients, scheduled for selective craniotomy for resections of supratentorial mass lesions, were anesthetized by inhalation of desflurane. When the concentrations of desflurane were maintained at 0.7,1.0 and 1.3 mean alveolar concentration (MAC) for 30 min during removing the tumor, venous blood samples which were drawn through internal jugular bulb were analyzed. Mean arterial pressure (MAP), heart rate (HR), and jugular bulb pressure (JBP) were recorded during the craniotomy.Results Jugular bulb oxygen saturation (SjO2) was significantly declined at 1.0 and 1.3 MAC compared with that at 0.7 MAC (P<0.05 and P<0.01 respectively). There was no significant changes in SjO2 between 1.0 and 1.3 MAC (P>0.05). MAP declined dose dependently, and decreased more significantly at 1.3 MAC (P<0.01).HR and JBP increased slightly with the raising concentration of desflurane but there were no significant changes at any MAC of desflurane (P>0.05).Conclusion Desflurane anesthesia at 1.0 MAC shows cerebral protection effect during craniotomy with stable hemodynamics and improved cerebral oxygen supply and demand.

OBJECTIVETo investigate the effect of night work near the day of ovulation on outcome of pregnancy.

METHODSDaily early morning urine samples were collected from eligible shift women workers, and human chorionic gonadotropin(hCG), follicle-stimulating hormone(FSH), the urinary steroid metabolites of estrogen and progesterone(PDG, E1C) were measured to confirm the day of ovulation and early fetal loss(EFL). Questionnaires were used to know workshift, other occupation exposures, and related information.

RESULTS12 clinical spontaneous abortion(SAB), 18(EFL) and 44 clinical living birth were analyzed in relation to SAB, EFL and night shift near the day of ovulation by using single factor and multi-factor logistic regression. The result showed that night shift on the day of ovulation and the day before or after ovulation was related with SAB both in single- and muti-factorial analysis(single factor: OR = 2.48, 95% CI 1.10-5.60; multi-factor; OR = 3.90, 95% CI 1.28-11.90).

CONCLUSIONNight shift near the day of ovulation may be related to SAB.

Abortion, Spontaneous ; etiology ; Chorionic Gonadotropin ; blood ; Female ; Fetal Death ; etiology ; Follicle Stimulating Hormone ; blood ; Humans ; Logistic Models ; Ovulation ; Pregnancy ; Work Schedule Tolerance

Objective To explore the mechanism of Eomecon chionantha alkaloids (ECA) against Oncomelania hupensis by means of observing the effect of ECA on the genital system of O.hupensis. Methods O.hupensis was dissected after immersed in ECA for 48 hours; the testes and ovary were took out and made for electron microscopy samples by the conventional method. The change of structure was observed by Hitach H-600 Transmission Electron Microscope. Results After immersed in ECA, oocyte of O.hupensis was obviously atrophied and spermatogonium pyknosis occured. Conclusion ECA could damage the genital system of O.hupensis seriously.