Objective To explore the prognostic value of albumin/globulin(AGR)in patients with stage Ⅲ-Ⅳ non-small cell lung cancer(NSCLC)treated with first-line chemotherapy.Methods From January 2016 to December 2020,288 patients with ad-vanced NSCLC initially diagnosed in the Affiliated Hospital of Xuzhou Medical University were selected.AGR critical value was deter-mined by receiver operating characteristic(ROC)curve,patients were divided into high AGR group(n=104)and low AGR group(n=184).Survival curve was plotted using Kaplan-Meier method,overall survival(OS)and progression-free survival(PFS)were com-pared between the two groups.COX proportional risk regression model was used to analyze the factors affecting prognosis of NSCLC pa-tients.Results The critical value of AGR was 1.5,the area under the curve of AGR was 0.693,the sensitivity was 76.8％,and the specificity was 58.3％.AGR was correlated with age,pathological type and curative effect(P＜0.05).The high AGR group had longer PFS and OS than the low AGR group(9 months vs 5months,25months vs 19months).Multivariate COX regression analysis showed that low level of AGR was an independent risk factor for NSCLC patients(P＜0.05).Conclusion AGR can be used as an effective prognos-tic indicator for patients with stage Ⅲ-Ⅳ NSCLC treated with first-line chemotherapy,and low levels of AGR suggest poor prognosis.

Objective To investigate the impact of matrine(Mat)on renal injury in rats with chronic glomerulonephritis by regulating the monocyte chemotactic protein-1(MCP-1)/chemokine C-C-motif receptor 2(CCR2)signaling pathway.Methods The rat model of chronic glomerulonephritis was established by subcutaneous injection of bovine serum albumin,the rats were randomly grouped into control group,model group,low and high dose matrine groups(Mat-L group,Mat-H group),and matrine+CCR2 group(Mat+CCR2 group),with 10 rats in each group.After continuous gavage for 4 weeks,24-hour urine protein excretion was measured;spleen and thymus were removed and organ index was calculated;The levels of blood urea nitrogen(BUN)and serum creatinine(Scr)in the serum of each group were detected,the pathological changes of renal tissue were observed by HE staining;the levels of tumor necrosis factor α(TNF-α)and interleukin(IL)-6 in renal tissue were detected by ELISA;Flow cytometry was applied to detect the proportion of T lymphocyte subsets in peripheral blood of rats in each group;Western blotting was applied to determine the expression of MCP-1 and CCR2 proteins.Results The spleen index and thymus index of rats in the model group rats were obviously reduced,and there were a large number of inflammatory cell infiltration in the renal tissue,the 24-hour urine protein,BUN,Scr,TNF-α,IL-6,and the expression of MCP-1 and CCR2 obviously increased,the peripheral blood T cell subpopulations CD3+,CD4+,and CD4+/CD8+ratio obviously reduced,the proportion of CD8+obviously increased(P＜0.05);The spleen index and thymus index of rats in the Mat-L and Mat-H groups of rats increased,and the phenomenon of renal tissue inflammation and infiltration improved,the 24-hour urine protein,BUN,Scr,TNF-α,IL-6,and the expression of MCP-1 and CCR2 obviously decreased,the peripheral blood T cell subpopulations CD3+,CD4+,and CD4+/CD8+ratio obviously increased,the proportion of CD8+obviously decreased(P＜0.05);CCR2 attenuated the effect of Mat-H on immune function in rats with chronic glomerulonephritis.Conclusion Matrine can alleviate the inflammatory damage and improve the peripheral immune function of rats with chronic glomerulonephritis,and its mechanism may be related to the inhibition of MCP-1/CCR2 signaling pathway.

Autism spectrum disorder (ASD) is a group of neurodevelopmental behavioral disorders, with the annually increased incidence in recent years.As one of the core symptoms of ASD, sensory abnormality not only affects the skill acquisition of affected children, but also brings great pain to caregivers and families.It is shown that early intervention of sensory abnormality can significantly improve the prognosis of ASD.However, early intervention depends on the early identification and diagnosis of sensory abnormality by clinicians.This study aims to review the clinical features, assessment tools, and intervention methods of sensory abnormalities in ASD children in recent years, thus contribu-ting to the accurate and effective diagnosis, and timely intervention of ASD.

Objective: To compare the application effect of the colonoscopy, fecal immunochemical test (FIT) and novel risk-adapted screening approach in colorectal cancer screening in Xuzhou population. Methods: From May 2018 to April 2019, 4 280 subjects aged 50-74 were recruited from Gulou district, Yunlong district and Quanshan district of Xuzhou. They were randomly assigned to the colonoscopy group (n=863), FIT group (n=1 723) and novel risk-adapted screening approach group (n=1 694) according to the ratio of 1∶2∶2. For the novel risk-adapted screening approach group, after the risk assessment, high-risk subjects were invited to undergo colonoscopy and low-risk subjects were invited to undergo FIT examination. All FIT positive subjects were invited to undergo colonoscopy. Colonoscopy participation rate [(the number of colonoscopies completed/the number of colonoscopies invited to participate)×100%], detection rate of colorectal lesions [(the number of diagnosed patients/the number of colonoscopies completed)×100%], colonoscopy resource load (the number of colonoscopies completed/the number of diagnosed advanced tumors) and FIT resource load in each group were calculated and compared. Results: The age of all subjects was (61±6) years old, including 1 816 males (42.43%). There was no statistically significant difference in the socio-demographic characteristics of the subjects in different screening groups. The colonoscopy participation rate was 22.60% (195/863) in the colonoscopy group, 57.04% (77/135) in the FIT group, and 33.94% (149/439) in the novel risk-adapted screening approach group, respectively. The colonoscopy participation rate was higher in the FIT group than in the colonoscopy group and the novel risk-adapted screening approach group (P<0.001). The colonoscopy participation rate of novel risk-adapted screening group was significantly higher than the colonoscopy group (P<0.001). The detection rates of advanced tumors were 6.67% (13/195), 9.09% (7/77) and 8.72% (13/149), respectively, and the difference was not statistically significant (P>0.05). The colonoscopy resource load (95%CI) was 15 (13-17) in the colonoscopy group, 11 (9-14) in the FIT group and 11 (10-13) in the novel risk-adapted screening approach group, respectively. Among them, the colonoscopy resource load of high-risk individuals in the novel risk-adapted screening approach group was 12 (9-15). FIT resource loads (95%CI) were 207 (196-218) and 88 (83-94) in the FIT group and the novel risk-adapted screening approach group. Conclusion: The combined application of risk-adapted screening approach and FIT may have a good application effect in colorectal cancer screening.
Aged ; Colonoscopy ; Colorectal Neoplasms/pathology* ; Early Detection of Cancer ; Feces ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Occult Blood

Animals ; Aspartate Aminotransferases ; Drugs, Chinese Herbal/pharmacology* ; Male ; Myocardial Ischemia/drug therapy* ; Myocardium ; Rats ; Rats, Sprague-Dawley ; Triglycerides

OBJECTIVE: To investigate the phenolic composition, antioxidant properties, and hepatoprotective mechanisms of polyphenols from green tea extract (GTP) in carbon tetrachloride (CCl)-induced acute liver injury mouse model. METHODS: High-performance liquid chromatography was used to analyze the chemical composition of the extract. Antioxidant activity of GTP was assessed by O, OH, DPPH, and ferric-reducing antioxidant power (FRAP) assay in vitro. Sixty Kunming mice were divided into 6 groups including control, model, low-, medium-, and high-doses GTP (200, 400, 800 mg/kg) and vitamin E (250 mg/kg) groups, 10 in each group. GTP and vitamin E were administered at a level of abovementioned doses twice per day for 7 days prior to exposure to a single injection of CCl. Hepatoprotective effects of GTP were evaluated in a CCl-induced mouse model of acute liver injury, using commercial enzyme linked immunosorbent assay kits, histopathological observation, terminal deoxynucleotidyl transferase-mediated dUTPNick-end labeling (TUNEL) assay and Western blot. RESULTS: GTP contained 98.56 µg gallic acid equivalents per milligram extract total polyphenols, including epicatechingallate, epigallocatechin gallate, epicatechin, and epigallocatechin. Compared with the model group, low-, medium-, or high doses GTP significantly decreased serum levels of alanine aminotransferase and aspartate transaminase (P<0.01). Histopathological observation confirmed that pretreatment of GTP prevented swelling and necrosis in CCl-exposed hepatocytes. Hepatoprotective effects of low-, medium-, and high-dose GTP were associated with eliminating free radicals and improving superoxide dismutase, catalase, and glutathione peroxidase activity in the liver. Additionally, low-, medium-, and high-dose GTP decreased cell apoptosis in the CCl-exposed liver (P<0.01). Phosphorylated nuclear factor kappa-B (NF-κB), p53, Bcl-2 associated x protein/B-cell lymphoma/leukemia-2 gene, cytochrome C, and cleaved caspase-3 levels were downregulated compared with the model group (P<0.01). CONCLUSION GTP achieves hepatoprotective effects by improving hepatic antioxidant status and preventing cell apoptosis through caspase-3-dependent signaling pathways.

Objective To analyze and estimate the possibility of early control in Shanghai if COVID-19 had begun in Shanghai. Methods Comparison was made in the processes of early control between H7N9 avian influenza in Shanghai in 2013 and COVID-19 in Wuhan in 2019.The early incidence data of Korean COVID-19 was simulated and analyzed to predict whether the medical resources needed in Shanghai were available. Results If it had occurred in Shanghai, it would have taken 22 days from the first case to the government′s emergency response.It was estimated that there would have been 602-763 patients with cumulative onset and onset after incubation period.At least 500 beds of infectious diseases could have been allocated in Shanghai in case of emergency.Through adding beds and resources reallocation in the whole city, patients could have been fully admitted and treated. Conclusion If COVID-19 epidemic had occurred in Shanghai, it′s early control would have been possible though there might have difficulties.

Objective: Based on the Chinese Medicine Heritage Auxiliary Platform (V2.5) software, to analyze the differences in prescriptions for the treatment of Alzheimer's disease and Vascular dementia in the literature of the past five years, and to find the rules of prescription. Methods: Screening CNKI, VIP, and Wan fang data for nearly 5 years to find the prescriptions for the treatment of Alzheimer's disease and Vascular dementia, and constructing a prescription database through the Chinese Medicine Heritage Auxiliary Platform (V2.5) software, and utilizing the Data mining algorithms such as association rules and entropy clustering of the software. Compare the frequency of medication, the drug.s natural, flavor and channel tropism, the common drug pairs, the potential drug pairs, and the differences in the new prescriptions used in the treatment of senile dementia and vascular dementia. Results: 13 of the top 20 high frequency herbs used in AD and VD are the same, the other is different. Its common pathogenesis reflect the interaction of deficiency, stasis and phlegm, while the difference shows that AD focuses on spleen and kidney deficiency, insufficiency of essence and blood, but VD focuses on the interaction of phlegm blood stasis and toxic turbidity obstruction in collaterals. They both use warm herbs in nature and flavor, but AD mainly use sweet and warm herbs, followed by calm and cold herbs, while VD mainly use bitter and warm herbs, followed by cold and calm herbs; The channel tropisms both are mainly liver channel, followed by heart channel, spleen channel and kidney channel. In addition, 16 potential medicine pairs, 7 new prescriptions, 26 new prescriptions and 13 new prescriptions were found. Conclusion:Prescriptions for AD and VD have similarities and differences, with emphasis on each other, suggesting that the former focuses on warming Yang and invigorating spleen, while the latter focuses on resolving phlegm and removing blood stasis, detoxifying and awakening the brain.

AIM:To investigate the roles of Notch signaling in lipopolysaccharide(LPS)-induced proliferation and secretion of interleukin-6(IL-6)and chemokine CXCL1 in bone marrow mesenchymal stem cells(BMSCs). METHODS:BMSCs were isolated by whole bone marrow culture.The expression levels of Notch signaling pathway recep-tors and ligands in the BMSCs treated with LPS were measured by qPCR and Western blot.The proliferation of BMSCs was analyzed by MTT assay and viable cell counting.The secretion levels of IL-6 and CXCL1 induced by LPS were measured by ELISA.RESULTS:Treatment with LPS at 1 mg/L effectively induced the proliferation of BMSCs and the secretion of IL-6.Obvious expression of Notch receptors and ligands in the BMSCs was observed,and LPS had little effect on the mRNA and protein levels of Notch receptors and ligands,but LPS increased the protein levels of Hes1 and Hey1,the target genes of Notch signaling.LPS at 1 mg/L increased the proliferation of BMSCs,whereas DAPT(Notch signal inhibitor)reduced the basal and LPS-induced proliferation of BMSCs(P<0.01).LPS treatment robustly increased the secretion of IL-6 and CXCL1 as assessed by ELISA.However,inhibition of Notch signaling almost completely abolished LPS-induced secretion of IL-6 and CXCL1(P <0.05).CONCLUSION: Inhibition of Notch signaling reduced not only the proliferation of BMSCs but also IL-6 and CXCL1 secretion induced by LPS.

Objective To explore a more minimally invasive and economical treatment for atrial septal defect (ASD) through comparing the efficacy and safety in percutaneous transcatheter closure of atrial septal defect procedure,guided by transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods From March 2014 to September 2017,197 patients with ASD who were feasible to treated with percutaneous transcatheter closure procedure evaluated by preoperative ~ were recruited.TTE showed ASD belonged to secundum(central type) with a maximal diameter range from 2 mm to 35mm,including 82 cases of the ASD without aortic rim.There were 106 patients(47males and 59 females including 37 ASD without aortic rim) with a mean age of 14.2 years(6 months-59 years) old and a mean body weight of 29.5(8.5-64.0)kg were performed percutaneous transcatheter closure of ASD guided by TEE under general anesthesia and endotracheal intubation,and 91 patients(41males and 50 females with 45 ASD without aortic rim inside) with a mean age of 13.8 years(9 months-65 years) old and a mean body weight of 30.4 (9.5-61.0)kg were treated with the percutaneous transcatheter procedure guided by TTE when patients in waking state of local anesthesia(general anesthesia were adopted in patients under 12 years old without intubation).The size of the occluder was selected on the basis of the maximal diameter plus 2-6mm.All 197 cases intraoperation and postoperation data were collected,including complications 、operation time 、operation room stay time and total cost.Results 1 patients in 106 cases of the the TEE group were transferred to small incision on the chest performing transthoracic transcatheter closure of ASD because the difficult stuck of the occluder.3 patients in TEE group transferred to repair under cardiopulmonary bypass(CPB) via small incision on the chest because the difficult stuck of the occluder even in using transthoracic transcatheter closure way.86 patiens in TTE group successfully treated with percutaneous transcatheter closure,and there were 5 failed cases including 2 patients who transferred to TEE guided because of the poor imaging of TTE,another 2 cases treated with transthoracic transcatheter closure of ASD because the difficult stuck of the occluder,and 1 patient performed ASD repair procedure under CPB via small incision on the chest because of the huge ASD without aortic rim and difficult stuck of the occluder.All the 197 patients were cured and discharge from hospital,and there were no complications.There was no significant difference in age,weight,and maximum diameter of ASD between TEE group and TTE group (P ＞ 0.05).Follow-ups were conducted by TTE at month 3 post-operation,and all 197 cases performed no residual shunt of ASD,there were no difference between 2 group.The stay time in the operation room was(68.2 ± 17.3) min in group TEE and (34.7 ± 16.8) min in group TTE,there was obviously shortened the stay time in operation room(P ＜0.01).The total cost of the TTE group was(24.2 ± 2.1) thousand yuan,and the group TEE was(29.3 ± 1.4) thousand yuan,and the cost was significantly reduced in TTE group (P ＜ 0.01).Conclusion The treatment of percutaneous transcatheter closure of ASD guided by TTE is effective and safe,and the feature of more non-invasive and socioeconomic benefits show a broad application prospect.