Objective To predict the potential suitable distribution areas of Polygala tenuifolia in Shanxi Province;To provide basis for the excavation and utilization of existing resources and the selection of cultivation areas of Polygala tenuifolia.Methods The distribution information of 1 102 Polygona tenuifolia samples was collected(Among them,there were 1 060 samples of Polygala tenuifolia Willd.,42 samples of Polygala sibirica L.).Combined with the 55 ecological factor data,the MaxEnt model and ArcGIS were applied to analyze the main ecological factors affecting the distribution of Polygala tenuifolia.Results The dominant ecological factors for the suitability distribution of Polygala tenuifolia were vegetation type,precipitation,temperature,etc.The potential suitable distribution areas of Polygala tenuifolia in Shanxi Province were mainly concentrated in Linfen,Lvliang,Taiyuan,Changzhi,Jinzhong,southeastern of Yuncheng,northwestern of Xinzhou,southwestern of Shuozhou,etc.Conclusion The ecological suitability zoning map of Polygala tenuifolia Willd.and Polygala sibirica L.was obtained,which can provide reference for the reasonable selection of planting areas and standardized production of Polygala tenuifolia in Shanxi Province.

Objective To establish the distribution zoning of Ziziphus jujuba var.spinosa in Shanxi Province;To help the development of Z.jujuba var.spinosa industry in Shanxi Province.Methods Combined with the information of longitude and latitude of sample points from the forth national survey resources and environment factors data in Grid Database of Spatial Information of TCM Resources,the MaxEnt model and ArcGIS were applied to analyze the main environmental factors affecting the suitability distribution of Z.jujuba var.spinosa.Results Dominant ecological factors for the suitability distribution of Z.Jujuba var.spinosa were vegetation type,lowest temperature of coldest month,monthly precipitation in November,monthly precipitation in October,altitude,and slope.The reclassified suitability grid data of ArcGIS software showed that Z.jujuba var.spinosa suitability distribution area including 0.73×104 km2 of high suitability area,1.41×104 km2 of medium suitability area and 4.33×104 km2 of low suitability area.The potential suitable distribution areas of Z.jujuba var.spinosa were mainly concentrated in the central and southern Shanxi Province.Conclusion This study shows that the most suitable growth area of Z.jujuba var.spinosa is mainly located in central and southern Shanxi Province,which can provide reference for the development,utilization and standardized planting of wild resources of Z.jujuba var.spinosa.

Objective: To explore growth and intelligence development of low birth weight infants (LBWI) at 24 and 36 months of age, so as to provide reference for early monitoring and intervention of the development of LBWI. Methods: A total of 100 LBWI born and managed in Hefei Maternal and Child Health Care Institution were selected from 2012 October 1 to 2015 December 30, and 99 normal birth weight infants (NBWI) under child health management in the same sitinstitution were selected as controls. According a prospective cohort study method, and based on the establishment of a cohort and monitoring of childhood growth and development, a unified method was used to longitudinally follow up and observe the physical fitness of two groups of infants at the determined time points. The development of LBWI and NBWI at 24 and 36 months of age was surveyed using the Gesell Development Scale. Results: Weight, length and head circumference of LBWI children at the age of 15-36 months were significantly lower than those of NBWI children ( P <0.05). In addition, 117 children (43.98%) completed the full assessment of intelligent development scale, including 62 LBWI and 55 NBWI. The scores of Gesell in NBWI group was higher than that in LBWI group at 24 and 36 months of age, including adaptability, gross motor, fine metor skills, language and personal social functions ( t =-4.17, -3.82, -3.21 , -3.03, -2.61; -4.23, -3.16, -3.07, -3.13, -3.99, P <0.05). Multivariate linear regression analysis found that birth weight was positively correlated with adaptability, gross motor, fine motor skills, language functions at 24 and 36 months of age and personal social function at 36 months of age ( β =0.004, 0.010; 0.003, 0.008; 0.003, 0.007; 0.004, 0.009; 0.011, P ＜0.05). Conclusion The growth and development of LBWI children are significantly delayed compared to NBWI children. The scores of LBWI children are lower than those of NBWI children in all functional areas. Weight is the main factor affecting children s intellectual development. Early monitoring and intervention of low birth weight infants should be carried out to avoid or mitigate adverse consequences.

Objective Chinese herbal injections called Shenkang injections(SKI)have become widely used for treating chronic kidney disease in the clinic.An investigation into the underlying mechanisms of SKI inhibition of renal tubular epithelial cell trans differentiation treated with TGF-β1 was carried out in this study.Methods To create an in vitro model of RF,HK-2 cells were treated with TGF-1(10 ng·mL-1)at 37℃for 48 h.After the cells were treated with SKI for 48 h,the morphology of the cells was observed by electron microscope.And Western blot,RT-PCR and immunofluorescence techniques were used to detect α-Smooth muscle actin(α-SMA),type III collagen(COI-Ⅲ),TGF-β1,Smad3,Smad7 and TβR-I expression changes of proteins and genes.Results SKI can significantly reduce expressed proteins and genes related to renal fibrosis,such as α-Smooth muscle actin(α-SMA)and type Ⅲ collagen(COI-Ⅲ).SKI control the production of proteins associated with the TGF-β/Smad signaling pathway.By downregulating TGF-β1,Smad3,and TβR-I protein expression,as well as upregulating Smad7 protein expression,it is able to prevent cell trans differentiation.Conclusions SKI can inhibit renal tubular epithelial cell mesenchymal trans differentiation.In addition,this drug may prevent chronic kidney disease by downregulating the expression of TβR-I and regulating the TGF-β/Smad pathway-related molecules.

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA ＜20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.

Objective To investigate the clinical features of hepatitis B core antibody (anti-HBc)positive patients with liver injury.Methods A total of 212 anti-HBc positive and HBsAg negative patients who were primarily diagnosed with liver injury from August 2013 to August 2014 at Ruijin Hospital were collected for this study.The patients were divided into cirrhosis group (n=60) and non-cirrhosis group (n =152) according to the status of cirrhosis.The 60 cases with cirrhosis were further compared with 60 cases with post-hepatitis B cirrhosis.The general information,biochemistry and immunology data were assessed.ANOVA was used to compare multiple groups of means,and Wilcoxon rank-sum test was used for non-parametric comparisons of the two groups.Results Only one case was positive for HBV DNA with the positivity rate of 0.5％.The causes for liver injury were as follows,60 cases with cryptogenic cirrhosis,which accounted for 28.3 ％;45 cases with drug-induced hepatitis,which accounted for 21.2 ％;33 cases with unexplained liver injury,which accounted for 15.6％;28 cases with acute hepatitis E,which accounted for 13.2％ and 15 cases with autoimmune hepatitis,which accounted for 7.1％.There were significant differences of T cell subpopulation,hepatitis B surface antibody (HBsAg) and hepatitis B e antibody (anti-HBe) quantitative level,red blood cells (RBC),platelet counts (PLT),prealbumin,albumin,alamine aminotransferase (ALT),aspartate transaminase (AST),international normalized ratio (INR),hyaluronic acid (HA),collagen Ⅲ (COL-Ⅲ) and collagen Ⅳ (COL-Ⅳ) between the cirrhosis group and non-cirrhosis group (all P＜0.05).The CD3+ CD4+ and CD3+ CD8+ counts,white blood cells (WBC),ALT,AST,total bilirubin (TBil) and albumin in anti-HBc-positive cirrhosis group were statistically different from those in post-hepatitis B cirrhosis group (all P＜0.05).Conclusions Some patients with positive anti-HBc still have HBV replication and infectivity.HBV anti-HBc positivity and HBsAg negativity may be associated with some cryptogenic cirrhosis and primary liver cancer.Patients with positive anti-HBc are prone to be complicated with drug-induced hepatitis,autoimmune hepatitis,and other liver damage related to immune mechanisms.Patients with cirrhosis have a higher risk to induce immune tolerance and progress to chronic disease than non-cirrhotic patients.Quantitative anti-HBc might be used as an indicator to predict disease progression after HBV infection.Disease condition in cirrhotic group with positive anti-HBc and negative HBsAg is less severe than that in post-hepatitis B cirrhosis group.

Objective To understand the status and influencing factors of benefit finding in patients with cancer.Methods 350 patients with cancer were collected with convenience sampling method from two Jiangsu hospitals.All patients received a questionnaire survey.Multiple linear regression analysis was used to analyze the influencing factors of benefit finding in patients with cancer.Results (1) The score of benefit finding in patients with cancer was statistically significant in different frequency of physical exercise (F=8.37,P=0.00),different character (F=3.04,P=0.04) and different educational level (F=2.91,P=0.03).(2) There was a positive correlation between benefit finding(78.53± 10.50) and communication with physicians(7.27±2.19),medical coping(43.48±4.50),optimism(17.33±2.24) and social support(44.81±3.91)(r=0.31,0.35,0.29,0.23,all P＜0.05) in patients with cancer.The benefit finding in patients with cancer was negatively correlated with depression(8.59± 1.83) (r=-0.37,P＜0.05).(3) Multiple linear regression analysis results showed that medical coping modes-confrontation,objectively social support and utilization,physical exercise,depression,communication with physicians and character were the factors influencing benefit finding in patients with cancer(△R2 =28％,P＜ 0.05;△R2 =5.5％,P＜ 0.05;△R2 =3.1％,P＜ 0.05;△R2 =1.9％,P＜0.05;△R2 =1.7％,P＜0.05;△R2 =1.0％,P＜0.05;△R2 =1.1％ P＜0.05),which explained 42.0％ of the total variance.Conclusion Medical coping modes-confrontation,objectively social support and utilization,physical exercise,depression,communication with physicians and character are the factors influencing benefit finding in patients with cancer.

Objective: To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in prophylaxis neutropenia after chemotherapy in patients with lymphoma. Methods: This was a multicenter, single arm, open, phase Ⅳ clinical trial. Included 410 patients with lymphoma received multiple cycles of chemotherapy and PEG-rhG-CSF was administrated as prophylactic. The primary endpoint was the incidence of Ⅲ/Ⅳ grade neutropenia and febrile neutropenia (FN) after each chemotherapy cycle. Meanwhile the rate of antibiotics application during the whole period of chemotherapy was observed. Results: ①Among the 410 patients, 8 cases (1.95%) were contrary to the selected criteria, 35 cases (8.54%) lost, 19 cases (4.63%) experienced adverse events, 12 cases (2.93%) were eligible for the termination criteria, 15 cases (3.66%) develpoed disease progression or recurrence, thus the rest 321 cases (78.29%) were into the Per Protocol Set. ②During the first to fourth treatment cycles, the incidences of grade Ⅳ neutropenia after prophylactic use of PEG-rhG-CSF were 19.14% (49/256) , 12.5% (32/256) , 12.18% (24/197) , 13.61% (20/147) , respectively. The incidences of FN were 3.52% (9/256) , 0.39% (1/256) , 2.54% (5/197) , 2.04% (3/147) , respectively. After secondary prophylactic use of PEG-rhG-CSF, the incidences of Ⅳ grade neutropenia decreased from 61.54% (40/65) in the screening cycle to 16.92% (11/65) , 18.46% (12/65) and 20.75% (11/53) in 1-3 cycles, respectively. The incidences of FN decreased from 16.92% (11/65) in the screening cycle to 1.54% (1/65) , 4.62% (3/65) , 3.77% (2/53) in 1-3 cycles, respectively. ③The proportion of patients who received antibiotic therapy during the whole period of chemotherapy was 34.39% (141/410) . ④The incidence of adverse events associated with PEG-rhG-CSF was 4.63% (19/410) . The most common adverse events were bone pain[3.90% (16/410) ], fatigue (0.49%) and fever (0.24%) . Conclusion During the chemotherapy in patients with lymphoma, the prophylactic use of PEG-rhG-CSF could effectively reduce the incidences of grade Ⅲ/Ⅳ neutropenia and FN, which ensures that patients with lymphoma receive standard-dose chemotherapy to improve its cure rate.

Objective To observe the dynamic histological changes of condylar cartilage ,and detect expression of estrogen re‐ceptors and collagen typeⅡin the ovariectomized rat ,exploring the relationship between OA and abnormity of shorting estrogen . Methods Histological changes of condylar cartilage of the ovariectomized rat at different ages were observed by HE staining meth‐od .The expression of estrogen receptors and collagen typeⅡwere determined by immunohistochemical method ,and the average per‐centage of positive staining area was measured by image analyzer .Results The lack of estrogen led to the degeneration of condylar cartilage .The expression of ER and ColⅡ were suppressed at low concentration of estrogen ,and these effects were enhanced when the treating time was prolonged .Conclusion The lack of estrogen might lead to the rat′s condylar cartilage lesion ,and the low con‐centration of estrogen could suppress the expression of ER .These results highlight the results that expression of condylar cartilage collagen is associated with estrogen .