ObjectiveTo explore new targets and herbal medicines of total ginsenosides in ameliorating alcoholic hepatitis （AH） by data mining and experimental validation and to provide new directions for the clinical treatment of AH. MethodGSE28619 was selected as the test set from the GEO database and GSE83148 and GSE103580 were selected as the validation sets. The limma package and weighted gene co-expression network analysis （WGCNA） were employed to identify the AH-related differentially expressed genes and modular genes， and Venny was used to extract the common genes. The protein-protein interaction （PPI） network was constructed and the enrichment analysis was carried out. The hub genes were further screened and evaluated for their diagnostic value. After validation with the datasets， new potential targets of AH and traditional Chinese medicine were predicted. Molecular docking between the targets and active ingredients of traditional Chinese medicine was performed， and the results were validated by experiments. Eight out of 48 SD rats were randomly selected into a blank group and received an equal amount of normal saline. The rest rats were subjected to modeling with ethanol by gavage and then randomized into low- （10 mg·kg^-1）， medium- （20 mg·kg^-1）， and high-dose （40 mg·kg^-1） total ginsenosides， model， and positive control （metadoxine， 117 mg·kg^-1） groups. After 3 weeks of gavage， serum samples were collected for the measurement of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） levels， and liver samples were collected for hematoxylin-eosin （HE） staining. Western blot and Real-time PCR were employed to determine the protein and mRNA levels， respectively， of potential targets in the liver tissue. ResultData mining predicted the potential genes： Proto-oncogene FOS and collagen type Ⅰ alpha 2 （COL1A2）. Experimental validation showed that the liver injury was alleviated after drug administration compared with that after modeling. The serum AST and ALT levels were reduced after drug administration. The protein and mRNA levels of FOS were significantly up-regulated， while those of COL1A2 were down-regulated after drug administration. ConclusionTotal ginsenosides ameliorate HA via FOS and COL1A2.

Objective:To investigate the intention to obtain disease related information and its influencing factors among the elderly at their end-of-life stage.Methods:A cross-sectional survey was conducted among 414 elderly people aged ≥60 in 7 long-term residential care facilities and 15 communities in the central urban area of Fuzhou using the late-life care preference questionnaire from October 2016 to June 2017. Univariate analysis, multiple linear regression analysis and ordered multi-classification logistic regression analysis were used to identify information preference of the disease-related information and influencing factors among the elderly.Results:The level of disease-related information needs of the elderly was scored (17.1±4.9); 48.8% (202/414) preferred detailed or maximum information; 30.7% (127/414) wanted selective and partial information; 20.5% (85/414) did not want to know any information. Multiple linear regression analysis showed that age, education, and whether or not they had received or seen other life-sustaining treatments were the main factors affecting the level of disease-related information needs (standardized regression coefficients were -0.141, 0.116, 0.115, all P<0.05); ordered multi-classification logistic regression analysis showed that age (compared with 60-69 years old, 70-79 years old: OR=0.544, 95% CI: 0.310-0.957; 80-89 years old: OR=0.526, 95% CI: 0.289-0.956), education level (compared with primary school and below, college or above: OR=2.166, 95% CI: 1.093-4.290), main sources of living expenses (compared with other allowance, family support: OR=7.303, 95% CI: 1.157-46.108, pension: OR=9.288, 95% CI: 1.502-57.415; provident fund scheme/saving: OR=15.676, 95% CI: 2.122-115.793), whether or not they had received or seen other life-sustaining treatments (compared with yes, OR=1.985, 95% CI: 1.150-3.425) were the main factors affecting the level of disease-related information needs. Conclusions:Most of the elderly prefer to know disease-related information. Age, educational level, main sources of living expenses and whether or not they had received or seen other life-sustaining treatments are the main influencing factors.

OBJECTIVES: Glioma is the most common intracranial primary tumor in central nervous system. Glioma grading possesses important guiding significance for the selection of clinical treatment and follow-up plan, and the assessment of prognosis. This study aims to explore the feasibility of logistic regression model based on radiomics to predict glioma grading. METHODS: Retrospective analysis was performed on 146 glioma patients with confirmed pathological diagnosis from January, 2012 to December, 2018. A total of 41 radiomics features were extracted from contrast-enhanced T RESULTS: A total of 5 imaging features selected by LASSO were used to establish a logistic regression model for predicting glioma grading. The model showed good discrimination with AUC value of 0.919. Hosmer-Lemeshow test showed no significant difference between the calibration curve and the ideal curve ( CONCLUSIONS The logistic regression model using radiomics exhibits a relatively high accuracy for predicting glioma grading, which may serve as a complementary tool for preoperative prediction of giloma grading.
Brain Neoplasms/diagnostic imaging* ; Glioma/diagnostic imaging* ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; ROC Curve ; Retrospective Studies

A new electrochemical sensor for organophosphate pesticide(methyl-paraoxon)detection based on bifunctional cerium oxide(CeO2)nanozyme is here reported for the first time.Methyl-paraoxon was degraded into p-nitrophenol by using CeO2 with phosphatase mimicking activity.The CeO2 nanozyme-modified electrode was then synthesized to detect p-nitrophenol.Cyclic voltammetry was applied to investigate the electrochemical behavior of the modified electrode,which indicates that the signal enhancement effect may attribute to the coating of CeO2 nanozyme.The current research also studied and discussed the main parameters affecting the analytical signal,including accumulation potential,accumulation time,and pH.Under the optimum conditions,the present method provided a wider linear range from 0.1 to 100 μmol/L for methyl-paraoxon with a detection limit of 0.06 μmol/L.To validate the proof of concept,the electrochemical sensor was then successfully applied for the determination of methyl-paraoxon in three herb samples,i.e.,Coix lacryma-jobi,Adenophora stricta and Semen nelum-binis.Our findings may provide new insights into the application of bifunctional nanozyme in electro-chemical detection of organophosphorus pesticide.

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To investigate the clinical effect of fingertip reconstruction using the toenail osteocutaneous flap without vascular anastomosis.Methods:From January 2015 to October 2020, the clinical data of patients with fingertip injuries were analyzed retrospectively, which were treated with the toenail osteocutaneous flap without vascular anastomosis in Chang’an Xin’an Hospital. The donor site was closed primarily or covered by a local flap. The appearance and function of the patients’ fingers were followed up. All cases were evaluated by the standard of thumb finger reconstruction function evaluation of the Chinese Medical Association of Hand Surgery. Appearance and function of nail bed after reconstruction was evaluated from four aspects.Results:A total of 11 cases (12 fingers) were enrolled, including eight males and three females. The average age was 35.6 years (range, 17-50 years). The etiologies included crush-related injury, cutting injury, mangled injury, and chemical corrosion injury. The injuries were found in thumb, index finger, middle finger, ring finger, or combined with multiple fingers. All fingertip defects were located distal to the nail root, including the defects distal to lunula in four cases, the defects distal to middle of the nail in five fingers , and the defects distal to 1/3 of the nail in three cases. Elective surgery was performed in 7 cases and emergency surgery in 4 cases. The defects ranged from 0.2 cm/0.5 cm/0.5 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/finger pulp). The size of the toenail osteocutaneous flap ranged from 0.2 cm/0.5 cm/0.7 cm to 0.6 cm/0.8 cm/1.0 cm (phalanx/nail/flap). The defects length of the finger pulp were less than 1.0 cm. All reconstructed fingers survived, and the follow-up was 6-30 months (average, 12.5 months). The appearances of the reconstructed fingers were pulmp and ruddy, and the nails were flat. There was no dysfunction in the donor site. The average healing time of bone was 2.1 months (range, 1.5-3.0 months). According to the evaluation of index function, seven cases were excellent, four cases were good. The appearance and function of the nail bed were excellent in six fingers, good in five fingers, and poor in one finger.Conclusion:It is a simple and effective way to reconstruct the fingertip using the toenail osteocutaneous flap without vascular anastomosis.

Objective:To introduce some rare clinical features of the variant Guillain-barre syndrome (GBS) and to explore its possible pathogenesis for the early diagnosis.Methods:The clinical data, laboratory data and treatment outcomes of four patients, who admitted to Shenzhen People′s Hospital from October 2017 to June 2018 and diagnosed with variant GBS were analyzed and summarized.Results:All the four patients presented limb weakness as a first manifestation. However, they all had clinical features that were inconsistent with typical GBS, and the clinical features were shown differently in each patient. One patient showed asymmetrical limb paralysis. The first manifestation of one patient was severe and persistent back pain accompanied by paraplegia. One patient was accompanied by obvious headache and positive meningeal irritation. One patients had the plane of sensory obstacles, paraplegia, and positive pathological sign. Cerebrospinal fluid examination showed protein cell dissociation in four patients. Electromyogram was consistent with peripheral neurogenic damage. Magnetic resonance imaging (MRI) of the brain and the spinal cord showed no obvious abnormalities. The four patients with obvious improvement in symptoms were treated with gamma globulin and glucocorticoid.Conclusions:Variant GBS is rare and clinical symptoms are various. Patients with atypical clinical symptoms should still be diagnosed by relevant auxiliary examinations to avoid delayed illness.

Objective:To explore the diagnostic efficacy of nomogram based on multi-parameter MRI for assessment of bowel fibrosis in patients with Crohn disease（CD).Methods:The clinical and imaging data of CD patients diagnosed by surgical histopathology in the First Affiliated Hospital of Sun Yat-sen University from June 2015 to March 2018 were prospectively collected. All the patients underwent conventional MRI and diffusion kurtosis imaging（DKI) within 2 weeks before surgery. Patients who underwent surgery between June 2015 and September 2017 were included in the model building group, and those who underwent surgery between October 2017 and March 2018 were included in the model validation group. We measured the apparent diffusion coefficient（ADC) from monoexponential model of diffusion-weighted imaging（DWI), apparent diffusional kurtosis（K app), and apparent diffusion for non-Gaussian distribution（D app) from non-Gaussian DKI model, and observed T 2WI signal intensity and enhancement pattern of the same segment. One to three intestinal specimens per patient were stained with Masson′s trichrome for the histological grading of fibrosis. Correlations between qualitative/quantitative MRI indexes and histological grades were evaluated using the Spearman rank test. Multivariate logistic regression analysis was performed to identify independent factors to be included into the nomogram for predicting the degree of bowel fibrosis and its diagnostic performance was assessed by internal and external validation. Results:A total of 40 CD patients were included, including 31 in the model construction group and 9 in the model verification group. A total of 81 intestinal specimens from 31 patients were graded as none-to-mild bowel fibrosis（ n=32) and moderate-to-severe bowel fibrosis（ n=49) according to a scoring system of fibrosis. In the training cohort, the K app value of moderate-to-severely fibrotic bowel walls was significantly higher than that of none-to-mildly fibrotic bowel walls, and the D appand ADC values of moderate-to-severely fibrotic bowel walls were significantly lower than those of none-to-mildly fibrotic bowel walls（ Z=-5.999, -4.521 and -3.893; P<0.001). There was no significant difference in T 2WI signal intensity or enhancement pattern between these two groups（χ2=1.571 and 0.103; P>0.05). Moderate and mild correlations of histological fibrosis grades with K appand D app( r=0.721 and -0.483; P<0.001), and a mild correlation with ADC（ r=-0.445, P<0.001) were found. Independent factors derived from multivariate logistic regression analysis to predict the degree of bowel fibrosis were K app and D app. Internal and external validation revealed good performance of the nomogram with concordance index of 0.901（95% confidence interval, 0.824-0.978) and 1.000, respectively, for differentiating none-to-mild from moderate-to-severe fibrosis. Conclusion:The DKI-based nomogram can be used to evaluate the bowel fibrosis in CD patients and provides a visual and simple prediction method for clinic.

Objective: To assess the risk factors associated with nosocomial infection in patients with non-surgical basal ganglia intracranial hemorrhage (ICH) in the acute phase to provide evidence for prevention and intervention of nosocomial infections. Methods: Clinical data of 224 patients with non-surgical basal ganglia ICH from January 2014 to December 2018 in the Shenzhen People′s Hospital were analyzed. Patients were divided into 2 groups based on the presence or absence of infection. Clinical data between the two groups were compared including gender, age, past medical history, bleeding volume, hematoma growth rate, systolic blood pressure, diastolic blood pressure, GCS, NIHSS, WBC, RBC, FBI, PLT, CR, BUN, GLU, CRP, UA, CHOL, TG, LDL, HCY. Multivariate Logistic regression analysis and the area under the ROC curve were performed on meaningful variables (P<0.05) to determine the early independent predictors of risk factors for nosocomial infections. ResuIts: Nosocomial infection occurred in 47 of 224 patients, with an infection rate of 20.98%. Compared with infected group, non-infected group had a higher value of age [(63.91 ± 12.37) years vs. (58.66 ± 12.37) years, P=0.010], bleeding volume [(10.33 ± 7.94) ml vs. (7.61 ± 6.58) ml, P=0.034], hematoma growth rate [(7.34 ± 9.17) ml/h vs. (4.33 ± 6.77) ml/h, P=0.040], systolic blood pressure [(177.94 ± 25.28) mmHg (1 mmHg=0.133 kPa) vs. (164.85 ± 22.34) mmHg, P=0.001], NIHSS score [(7.89 ± 4.92) scores vs. (4.84 ± 4.59) scores, P<0.01], WBC [(9.50 ± 3.23) × 10⁹/L vs. (8.25 ± 2.28) × 10⁹/L, P=0.015], FBI [(3.44 ± 0.95) g/L vs. (3.03 ± 0.63) g/L, P=0.007], BUN [(7.01 ± 5.84) mmol/L vs. (4.95 ± 1.93) mmol/L, P=0.021], GLU [(7.27 ± 2.84) mmol/L vs. (5.96 ± 1.75), P=0.004] and CRP [(11.94 ± 21.4) mg/L vs. (4.39 ± 6.41) mg/L, P=0.021]. Multivariate Logistic regression analysis showed that systolic blood pressure (OR=1.021, 95% CI 1.005 -1.037, P=0.012), NIHSS score (OR=1.143, 95% CI 1.056 - 1.237, P=0.001), BUN (OR=1.174, 95% CI 1.025 - 1.344, P=0.020), CRP (OR=1.063, 95% CI 1.016 - 1.112, P=0.008) and age (OR=1.053, 95%CI 1.019 -1.089, P=0.002) was an independent risk factor for nosocomial infection in non-surgical basal ganglia ICH patients in the acute phase. The Area Under Curve (AUC) of the above independent risk factors was calculated, and the results showed that systolic blood pressure (AUC=0.653, 95% CI 0.564 -0.741, P=0.001), NIHSS score (AUC=0.679, 95% CI 0.592 - 0.767, P=0.000), BUN (AUC=0.617, 95% CI 0.526 - 0.708, P=0.014), CRP (AUC=0.691, 95% CI 0.614 - 0.768, P=0.000) and age (AUC=0.643, 95% CI 0.557 - 0.728, P=0.003) had an early predictive value for the occurrence of nosocomial infection in non-operative basal ganglia ICH patients in the acute stage. Conclusions The occurrence of nosocomial infections has identifiable and early predictive risk factors in patients with non-surgical basal ganglia ICH during acute phase. Therefore, controllable risk factors need to be controlled to reduce the incidence of nosocomial infections.

Objective: To report the clinical effect of skin grafting in small wounds with exposed vascular anastomosis. Methods: From January, 2011 to May, 2018, 16 small wounds with anastomotic vascular exposure were treated by full-thickness skin grafting. Of which, 4 performed after replantation, 9 after reconstruction and 3 after flap transplantation. Thirteen wounds were on hand and 3 in foot. After anastomosing the vessels, 3 arterial anastomoses, 9 venous anastomoses and 4 arterial-and-venous anastomoses were left exposure in wounds. Sizes of artery exposed in wound were 0.8 to 2.3 mm with an average of 1.0 mm. Sizes of vein exposed in wound were 0.8 to 2.5 mm with an average of 1.2 mm. The areas of soft tissue defect were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm, and the areas of grafted skins were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm. Grafted skin were covered without package nor pressurization. Donor areas were directly sutured. Postoperative follow-up was conducted to observe the postoperative effect. Results: Fourteen grafted skin completely survived, one partially survived and healed after immobilization of the limb and change of dressing, and one developed necrosis. All patients were followed-up for 6-24 months (mean 14.4 months). CDU, HHD or CTA were used at the final follow-up. Vascular anastomoses were patency in 15 patients, and 1 patient had embolism developed. No pigmentation was found on the grafted skin. All grafted skin was soft and wearable with two point discrimination at 7-10 mm. The pulse of anastomotic artery could be felt on the grafted skins. Only linear scars were left in the donor sites. Conclusion The operation of full-thickness skin grafting in small wounds with exposed vascular anastomosis was easy to perform and with high survival rate. The effect of operation is satisfactory. The exposure of anastomosed vessels does not affect the patency of anastomotic vessels, and has considerable clinical values.