Objective Based on gender differences,this paper discusses the characteristics of facial color diagnosis in male and female patients with metaplastic chronic atrophic gastritis(CAG),and explores the pathological mechanism of different gender patients from the perspective of TCM pathogenesis,so as to provide personalized reference for TCM prevention and treatment of metaplastic CAG.Methods In this study,the complexion information of patients with chronic non atrophic gastritis(CNG)and CAG was collected by MT-BX-01 four-diagnostic instrument.The color colorimetric characteristics of male and female metaplastic CAG patients and CNG patients were analyzed by case-control study.Results In female patients,the L value and a value of liver region in CAG with mild intestinal metaplasia(IM)group,moderate and severe IM were significantly lower than those in CNG group(P<0.05).In male patients,the L value of spleen region in CAG with moderate and severe IM group was significantly higher than that in CNG group(P<0.05).Conclusion There is a certain gender difference in the facial color characteristics of patients with metaplastic CAG.The facial chromaticity value of female patients with metaplastic CAG changes most significantly in the liver area,while that of male patients mainly in the spleen area.It is suggested that the incidence of female metaplastic CAG is mostly related to liver,while that of male is mostly related to spleen,which provides a personalized method for clinical diagnosis and treatment of metaplastic CAG based on gender differences.

Objective:To investigate the early clinical characteristics of elderly patients with severe burns and the risk factors on prognosis.Methods:This study was a retrospective case series study. Clinical data of 124 elderly patients with severe burns who met the inclusion criteria and were admitted to the 12 hospitals from January 2015 to December 2020 were collected, including 4 patients from the Fourth People's Hospital of Dalian, 5 patients from Fujian Medical University Union Hospital, 22 patients from Guangzhou Red Cross Hospital of Jinan University, 5 patients from Heilongjiang Provincial Hospital, 27 patients from the First Affiliated Hospital of Naval Medical University, 9 patients from the First Affiliated Hospital of Nanchang University, 10 patients from Affiliated Hospital of Nantong University, 9 patients from Tongren Hospital of Wuhan University & Wuhan Third Hospital, 12 patients from the 924 th Hospital of PLA, 6 patients from Zhangjiagang First People's Hospital, 4 patients from Taizhou Hospital of Zhejiang Province, and 11 patients from Zhengzhou First People's Hospital. The patients' overall clinical characteristics, such as gender, age, body mass index, total burn area, full-thickness burn area, inhalation injury, causative factors, whether combined with underlying medical diseases, and admission time after injury were recorded. According to the survival outcome within 28 days after injury, the patients were divided into survival group (89 cases) and death group (35 cases). The following data of patients were compared between the two groups, including the basic data and injuries (the same as the overall clinical characteristics ahead); the coagulation indexes within the first 24 hours of injury such as prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time, D-dimer, fibrinogen degradation product (FDP), international normalized ratio (INR), and fibrinogen; the blood routine indexes within the first 24 hours of injury such as white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, monocyte count, red blood cell count, hemoglobin, and hematocrit; the organ function indexes within the first 24 hours of injury such as direct bilirubin, total bilirubin, urea, serum creatinine, aspartate aminotransferase, alanine aminotransferase, total protein, albumin, globulin, blood glucose, triglyceride, total cholesterol, alkaline phosphatase, creatine kinase, electrolyte indexes (potassium, sodium, chlorine, calcium, magnesium, and phosphorus in blood), uric acid, myoglobin, and brain natriuretic peptide; the infection and blood gas indexes within the first 24 hours of injury such as procalcitonin, C-reactive protein, pH value, oxygenation index, base excess, and lactate; treatment such as whether conducted with mechanical ventilation, whether conducted with continuous renal replacement therapy, whether conducted with anticoagulation therapy, whether applied with vasoactive drugs, and fluid resuscitation. The analysis was conducted to screen the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns. Results:Among 124 patients, there were 82 males and 42 females, aged 60-97 years, with body mass index of 23.44 (21.09, 25.95) kg/m 2, total burn area of 54.00% (42.00%, 75.00%) total body surface area (TBSA), and full-thickness burn area of 25.00% (10.00%, 40.00%) TBSA. The patients were mainly combined with moderate to severe inhalation injury and caused by flame burns. There were 43 cases with underlying medical diseases. The majority of patients were admitted to the hospital within 8 hours after injury. There were statistically significant differences between patients in the 2 groups in terms of age, total burn area, full-thickness burn area, and inhalation injury, and PT, APTT, D-dimer, FDP, INR, white blood cell count, platelet count, urea, serum creatinine, blood glucose, blood sodium, uric acid, myoglobin, and urine volume within the first 24 hours of injury (with Z values of 2.37, 5.49, 5.26, 5.97, 2.18, 1.95, 2.68, 2.68, 2.51, 2.82, 2.14, 3.40, 5.31, 3.41, 2.35, 3.81, 2.16, and -3.82, respectively, P<0.05); there were statistically significant differences between two groups of patients in whether conducted with mechanical ventilation and whether applied with vasoactive drugs (with χ2 values of 9.44 and 28.50, respectively, P<0.05). Age, total burn area, full-thickness burn area, serum creatinine within the first 24 hours of injury, and APTT within the first 24 hours of injury were the independent risk factors for the mortality within 28 days after injury in elderly patients with severe burns (with odds ratios of 1.17, 1.10, 1.10, 1.09, and 1.27, 95% confidence intervals of 1.03-1.40, 1.04-1.21, 1.05-1.19, 1.05-1.17, and 1.07-1.69, respectively, P<0.05). Conclusions:The elderly patients with severe burns had the injuries mainly from flame burns, often accompanied by moderate to severe inhalation injury and enhanced inflammatory response, elevated blood glucose levels, activated fibrinolysis, and impaired organ function in the early stage, which are associated with their prognosis. Age, total burn area, full-thickness burn area, and serum creatinine and APTT within the first 24 hours of injury are the independent risk factors for death within 28 days after injury in this population.

A high-performance liquid chromatographic(HPLC)method for the assay of pregabalin gastric retention sustained-release tablets was established,successfully solving the problem of low recovery of pregabalin through a special sample pretreatment method.By comparing salting-out and excipient dispersion,the pretreatment methods to overcome the viscosity of the test solution were established.Both methods can be used for the determination of the product content,but the salting-out method is easier to operate.The HPLC conditions were Inertsil ODS-3(4.6 mm×0.25 m,5 μm)column with mobile phase of 3.4 g/L potassium dihydrogen phosphate(pH adjusted to 6.3 by ammonia)and methanol(85︰15);the column temperature was 30℃;the flow rate was 1.0 mL/min;the sample size was 50 μL;and the detection wavelength was 210 nm.Through the validation of the salting-out method,the average recovery of the drug was 99.74%and the RSD was 0.43%;the precision test RSD was 0.77%;the test solution was stable within 12 h;the chromatographic system had good durability;and the excipient did not interfere with the content detection.The method is stable,reliable and suitable for the assay of pregabalin gastric retention sustained release tablets.

Objective:To compare the diagnostic efficacy of 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT and mpMRI in the diagnosis of pelvic lymph node metastasis of prostate cancer (PCa). Methods:The clinical data of 30 patients who underwent 18F-PSMA-1007 PET/CT and mpMRI examinations in Sichuan Cancer Hospital from November 2018 to April 2021 were analyzed. The average age was (68.4±6.4) years old. The preoperative total PSA was 45.70(16.07, 100.00)ng/ml. Among 30 patients, 14 cases were found lymph node positive by PET/CT and 7 cases were found lymph node positive by mpMRI.Combined with the two preoperative imaging methods and the patient's PSA level, there was 1 patient in stage T 1, 20 patients in stage T 2, 6 patients in stage T 3, and 3 patients in stage T 4. Twenty-nine cases were classified as high risk group and one case was in moderate risk group.All 30 patients underwent laparoscopic radical prostatectomy and enlarged pelvic lymph node dissection (ePLND). According to the postoperative pathological results, the sensitivity, specificity, positive predictive value and negative predictive value of the two imaging techniques for the diagnosis of PCa pelvic lymph node metastasis were calculated, and the consistency of the two imaging techniques for the postoperative pathological results was observed by Kappa test. Results:All the 30 patients were confirmed to be PCa by postoperative pathology, among which 10 patients were positive for pelvic lymph node biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT for pelvic lymph node metastasis were 100.0% (10/10), 80.0% (16/20), 71.4%(10/14) and 100.0%(16/16) respectively, and Kappa value was 0.727. The sensitivity and specificity of mpMRI were 70.0% (7/10) and 100.0% (20/20), the positive and negative predictive values were 100.0% (7/7) and 87.0%(20/23)respectively, and the Kappa value was 0.757. The P values of sensitivity, specificity, positive predictive value and negative predictive value between the two imaging methods were 0.18, 0.07, 0.30, <0.01, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing the number of pelvic lymph node metastasis were 100%(28/28), 98.2% (373/380), 80.0% (28/35) and 100.0%(373/373), respectively. The sensitivity, specificity, positive predictive value and negative predictive value of mpMRI in diagnosing the number of pelvic lymph node metastasis were 78.6% (22/28), 100.0% (380/380), 100.0% (22/22) and 98.4%(380/386), respectively. The P values of the sensitivity, specificity, positive predictive value and negative predictive value of lymph node detection by the two imaging methods were all <0.01, and the differences were statistically significant. Conclusions:The sensitivity and negative predictive value of 18F-PSMA-1007 PET/CT for the detection of positive lymph node were higher than mpMRI. The specificity and positive predictive value of mpMRI in detecting positive lymph node metastasis were higher than 18F-PSMA-1007 PET/CT examination.

Objective:To examine the effect of robotic assisted laparoscopic radical prostatectomy with different approaches on early postoperative effects.Methods:Totally 44 patients (average age of 65.9 years, range: 46 to 81 years) underwent robotic assisted laparoscopic radical prostatectomy by a single operator at Department of Urology, Peking Union Medical Collage Hospital from March 2018 to March 2020 were retrospectively analyzed. The mean age was 65.9 years (range: 46 to 81 years), including 24 cases in the anterior bladder approach group (anterior approach group) and 20 cases in the posterior bladder approach group (posterior approach group). The preoperative clinical data, perioperative related data and postoperative urinary control recovery were compared between the two groups by t test, χ 2 test or Fisher exact test. Results:In terms of clinical data, there was no difference in age, prostate volume, preoperative prostate specific antigen and Gleason score(all P>0.05). There was no significant difference in operation time ((184±43) minutes vs. (193±42) minutes, t=-0.599, P=0.55), bleeding volume ((218±88) ml vs. (225±115) ml, t=-0.244, P=0.81), postoperative stage (T2/T3: 15/9 vs. 12/8, χ2=0.029, P=0.87) and positive rate of cutting edge (29.2% (7/24) vs. 30.0% (6/20), χ2=0.004, P=0.95). In terms of postoperative urinary control, patient rates who achieved urinary control immediately after extubation was significantly higher for the posterior approach group than the anterior approach group (30.0% (6/20) vs. 4.2% (1/24), P=0.04). There was no significant difference between two groups for those who achieved urinary control 3 months after operation (6 cases vs. 11 cases, P=0.06), 6 months after operation (20 cases vs. 19 cases, P=0.36) and those who achieved urinary control 12 months after operation (23 cases vs. 19 cases, P=1). Conclusion:For robotic assisted laparoscopic radical prostatectomy, the posterior approach does not prolong the operation time, does not increase the amount of bleeding, and improves the short-term postoperative urinary control.

Objective:To examine the effect of robotic assisted laparoscopic radical prostatectomy with different approaches on early postoperative effects.Methods:Totally 44 patients (average age of 65.9 years, range: 46 to 81 years) underwent robotic assisted laparoscopic radical prostatectomy by a single operator at Department of Urology, Peking Union Medical Collage Hospital from March 2018 to March 2020 were retrospectively analyzed. The mean age was 65.9 years (range: 46 to 81 years), including 24 cases in the anterior bladder approach group (anterior approach group) and 20 cases in the posterior bladder approach group (posterior approach group). The preoperative clinical data, perioperative related data and postoperative urinary control recovery were compared between the two groups by t test, χ 2 test or Fisher exact test. Results:In terms of clinical data, there was no difference in age, prostate volume, preoperative prostate specific antigen and Gleason score(all P>0.05). There was no significant difference in operation time ((184±43) minutes vs. (193±42) minutes, t=-0.599, P=0.55), bleeding volume ((218±88) ml vs. (225±115) ml, t=-0.244, P=0.81), postoperative stage (T2/T3: 15/9 vs. 12/8, χ2=0.029, P=0.87) and positive rate of cutting edge (29.2% (7/24) vs. 30.0% (6/20), χ2=0.004, P=0.95). In terms of postoperative urinary control, patient rates who achieved urinary control immediately after extubation was significantly higher for the posterior approach group than the anterior approach group (30.0% (6/20) vs. 4.2% (1/24), P=0.04). There was no significant difference between two groups for those who achieved urinary control 3 months after operation (6 cases vs. 11 cases, P=0.06), 6 months after operation (20 cases vs. 19 cases, P=0.36) and those who achieved urinary control 12 months after operation (23 cases vs. 19 cases, P=1). Conclusion:For robotic assisted laparoscopic radical prostatectomy, the posterior approach does not prolong the operation time, does not increase the amount of bleeding, and improves the short-term postoperative urinary control.

Objective: To summarize the diagnosis and prognosis of adrenocortical carcinoma in children. Methods: Medical records of 10 pediatric patients with adrenocortical cancer treated in Children's Hospital of Nanjing Medical University from September 2010 to March 2018 were retrospectively reviewed, and their clinical manifestation, laboratory, auxiliary, and pathological examination results, and prognosis were analyzed. Results: The average age of all patients (5 male and 5 female pediatric patients) was (53.3+48.4) months. Clinical mani-festations included abdominal mass, hypertension, cortisol level, and peripheral precocious puberty. Laboratory tests showed that lactate dehydrogenase, neuroenolase, and cortisol levels were high in some patients, and sex hormones were abnormal. Auxiliary examination using the abdominal computed tomography enhancement showed irregular an adrenal gland, uneven density, necrosis, mass calcification, and some infiltration into the surrounding tissue. Pathological examination suggests tumor cell pleomorphism, more frequent pathological division, high mitotic index, abundant interstitial sinusoid, necrosis, tumor infiltration, vascular invasion, and Weiss score of≥3 points. Lactate acid dehydrogenase and cortisol levels; Weiss score; and tumor size, staging, and resection rate were not statistically different among prognostic factors. Conclusions: For pediatric patients with adrenal masses, the survival rate should be improved by combining the clinical manifestation, laboratory examination, and auxiliary examination for the early diagnosis of adrenocortical carcinoma and to select the appropriate treatment. Combined with pathological results, adrenocortical carcinoma can be well differentiated from other adrenal masses.

Objective To study the relationship between the abnormal blood fat components and the serum hypersensitivity C reaction protein concentration and the progression of diabetic retinopathy.Methods Fundus examination was carried out to inpatients in the Department of Endocrinology in the hospital from From July 2015to July 2017.These patients were divided into three groups according to results of fluorescein sodium contrast:The non retinopathy group (group A) , the non proliferative retinopathy group (group B) , the retinopathy proliferative phase group (group C) .The content of blood fat component and serum hypersensitivity C reaction protein in the experimental cases were measured, and the ratio of TC/HDL-C was calculated.The statistic software of SAS9.4was used for statistical processing.Results The concentration of the serum hypersensitive C reaction protein in patients with diabetic retinopathy was significantly increased and the ratio of TC/HDL-C increased significantly (P<0.05) .The hs-CRP concentration and TC/HDL-C ratio of the three study groups were compared with those of the healthy control group:the difference was statistically significant (P<0.05) .Among them, the hs-CRP concentration and TC/HDL-C ratio of group A were compared with group B and group C respectively and the difference were statistically significant (P<0.05) .There was no significant difference in hs-CRP concentration and TC/HDL-C ratio between group B and group C (P>0.05) .Linear correlation analysis was used to analyze the concentration of serum hypersensitive C reaction protein and the ratio of TC/HDL-C.It was found that there was a positive correlation between them, and there was a positive synergistic effect.Conclusion The measurement of serum hypersensitive C reactive protein has important clinical value for the discovery, evaluation and prognosis of diabetic retinopathy.The abnormalities of the blood fat component reflected by the TC/HDL ratio are also an important factor in assessing the progression of diabetic retinopathy.

Objective To analyze the prognostic factors of adrenal tumor in children under 12 years of age. Methods A total of 90 children with 97 adrenal tumors admitted from June 2006 to August 2017 were selected in Children's Hospital of Nanjing Medical University.The age distribution,tumor type,biochemistry and tumor indicators, treatment,stage classification and prognosis were analyzed.Results There were 46 males and 44 females in 90 cases. Ages ranged from 4 days to 11 years and 1 month,with an average of (38.1 ± 31.3)months.The main clinical mani-festations were abdominal mass,fever and abdominal pain.Eighty cases (82.5%)underwent surgery,while 17 cases (17. 5%)did not.Open resection was performed in 48 cases,open partial resection in 11 cases,laparoscopic surgery in 10 cases,and just biopsy in 11 cases.The pathological examination showed 43 cases with neuroblastoma,13 cases with ganglioneuroblastoma,8 cases with ganglioneuroma,5 cases with adrenocortical carcinoma,3 cases with teratoma,1 case with pheochromocytoma,1 case with malignant rhabdoid tumor.Statistical analysis revealed that neuron－specific eno-lase(NSE)value of neuroblastoma and lactate dehydrogenase(LDH)value of cortical cancer increased significantly. The age was correlated with tumor stage,and patients had older age on stage Ⅳ.Complete resection in surgery was correlated with the stage of the tumor,as tumor in lower tumor stage seemed easier to be completely removed.Fifty－three cases (58.9%)were followed up for 2 months up to 11 years and 4 months.Forty－four cases survived and 9 ca-ses died.Higher tumor stage predicated worse prognosis.Conclusions Adrenal gland tumors need early diagnosis and active treatment.Earlier onset of age,complete surgical resection with patients have better prognosis.Complete resection of the disease was a key factor in the prognosis.

Exploiting cells as vehicles combined with nanoparticles combined with therapy has attracted increasing attention in the world recently. Red blood cells, leukocytes and stem cells have been used for tumor immunotherapy, tissue regeneration and inflammatory disorders, and it is known that neutrophils can accumulate in brain lesions in many brain diseases including depression. -Acetyl Pro-Gly-Pro (PGP) peptide shows high specific binding affinity to neutrophils through the CXCR2 receptor. In this study, PGP was used to modify baicalein-loaded solid lipid nanoparticles (PGP-SLNs) to facilitate binding to neutrophils . Brain-targeted delivery to the basolateral amygdala (BLA) was demonstrated by enhanced concentration of baicalein in the BLA. An enhanced anti-depressant effect was observed and The mechanism involved inhibition of apoptosis and a decrease in lactate dehydrogenase release. Behavioral evaluation carried out with rats demonstrated that anti-depression outcomes were achieved. The results indicate that PGP-SLNs decrease immobility time, increase swimming time and climbing time and attenuate locomotion in olfactory-bulbectomized (OB) rats. In conclusion, PGP modification is a strategy for targeting the brain with a cell-nanoparticle delivery system for depression therapy.