Background Lipid metabolism in liver shows circadian-dependent profiles. The hepatotoxicity of environmental chemicals is dependent on circadian time. Objective To observe the effects of bisphenol A (BPA) exposure at different zeitgeber time (ZT) on hepatic and blood lipid metabolism and decipher the underlying mechanisms related to circadian rhythm in mice. Methods Thirty-five female C57BL/6J mice were sacrificed every 4 h in a light-dark cycle (12 h/12 h). The liver tissues were collected to describe the circadian profiles of hepatic Rev-erba, Bmal1, Clock, Srebp1c, and Chrebp mRNA expression levels within 24 h. Thirty female mice were divided into 6 groups by the timing (ZT3 represents the 3 h after light on, ZT15 represents the 3 h after light off) and dose (50 or 500 μg·kg⁻¹·d⁻¹) of BPA exposure to observe hepatotoxicity. Mice were gavaged with designed doses of BPA once per day for 4 weeks. Mice were maintained with ad libitum access to food and water and measured body weight weekly. After the experiment, mice were euthanatized and liver tissues were separated to determine the biochemical indicators of lipid metabolism and lipid metabolism- and circadian-related gene mRNA expressions. Results Hepatic Rev-erba, Bmal1, Clock, Srebp1c, and Chrebp mRNA expression levels were rhythmic during a 24 h period in mice. At ZT3 and ZT15, BPA did not alter body weight, plasma glucose, plasma total cholesterol, plasma low density lipoprotein cholesterol, and plasma triglycerides (P>0.05). The plasma high density lipoprotein cholesterol decreased in the 50 μg·kg⁻¹·d⁻¹ BPA group at ZT3 by 14.56% compared with the control group (P<0.05). The liver triglycerides increased in the 50 μg·kg⁻¹·d⁻¹ BPA group at ZT15 by 115.20% compared with the control group (P<0.05). BPA decreased Srebp1c mRNA expression level when dosing at ZT3 and increased Chrebp, Srebp1c, and Acc1 mRNA expression levels when dosing at ZT15 compared with the control group (P<0.05). BPA increased Bmal1 mRNA expression level and decreased Rev-erbα mRNA expression level at ZT3 exposure and decreased Bmal1 and increased Rev-erbα mRNA expression level at ZT15 exposure (P<0.05). Conclusion BPA exposure at light or dark period has different effects on hepatic lipid metabolism in mice. Hepatic lipid deposit appears when BPA is dosed at dark period. Rev-erbα-Bmal1 regulation circuits and the subsequent upregulation of Srebp1c and Chrebp and the target gene Acc1 may be involved.

An intravascular ultrasound-enhanced thrombolysis excitation system with adjustable frequency, amplitude and duty cycle was designed based on FPGA (ZYNQ-7Z020). Firstly, the FPGA generated waveform amplitude binary data based on direct digital frequency synthesis (DDS) technology, and then the data was converted into burst signal through an external daughter card, which included D/A conversion circuit, active low-pass filter, power amplifier circuit and impedance matching circuit. The test results demonstrated that the output waveform reached the target with advantages of simple implementation and flexible control, the peak negative pressure generated from ultrasound transducer was doubled by means of an electrical impedance matching network. In vitro thrombus models were applied to verify the excitation system, it turned out that ultrasound cavitation effect generated could accelerate the penetration of urokinase and increase the thrombolysis rate by about 20%.
Amplifiers, Electronic ; Electric Impedance ; Thrombolytic Therapy ; Ultrasonography ; Ultrasonography, Interventional

Objective:To explore the value of laparoscopic and endoscopic cooperative surgery with the patient lying on supine position under general anesthesia in the operation of type I Mirizzi syndrome with choledocholithiasis.Methods:From Jan 2018 to Jan 2020, 53 cases of Mirizzi syndrome with choledocholithiasis undergoing laparoscopic and endoscopic cooperative surgery (preLC+ ERCP+ EST) at the Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed.Results:53 patients successfully underwent LC without conversion to open surgery, and 2 patients failed in ERCP + EST attempt, with a success rate of 96.2%. One patient developed pancreas pseudocyst as a result of post-operative hemorrhagic necrotizing pancreatitis. Two patients suffered from chronic pancreatitis. Three patients complaining postoperative upper abdominal discomfort were finally diagnosed as stump cystic duct inflammation by MRCP, and no abnormalities were found in the follow-up of the remaining cases.Conclusion:Laparoscopic and endoscopic cooperative surgery in the treatment of patients with type I Mirizzi syndrome combined with choledocholithiasis is minimally invasive and effective.

Objective: To evaluate and compare the clinical value of early enteral nutrition (EEN) and total parenteral nutrition (TPN) af-ter esophageal cancer surgery. Methods: We retrospectively analyzed 237 patients who underwent esophageal cancer surgery at Bei-jing Shijitan Hospital from March 2011 to March 2019. They were assigned into two groups based on the postoperative nutritional sup-port used: EEN (136 cases) and TPN (101 cases). Nutritional status, liver function, recovery of gastrointestinal function, days of hospital-ization, and postoperative complications were compared between the two groups after propensity score matching. Results: Using 1 :1 nearest neighbor matching, we successfully matched 91 pairs of patients. The prealbumin (PA) level was significantly higher in the EEN group than in the TPN group 7 days after surgery (P<0.05); however, there was no significant difference in albumin (ALB) level before surgery, 3 or 7 days after surgery. Additionally, the levels of ALT and AST in the EEN group were significantly lower than those in the TPN group 3 and 7 days after surgery (P<0.05). The incidence of acid reflux, vomiting, and diarrhea in the EEN group was higher than that in the TPN group, while the incidence of pulmonary edema and pulmonary infection was lower in the EEN group than in the TPN group (P<0.05). Conclusions: Compared with TPN, EEN is associated with a high incidence of acid reflux, vomiting, and diarrhea after esophageal cancer surgery, but it has a lower impact on liver function. EEN can promote the recovery of intestinal function, improve nutritional indicators, and shorten hospitalization time.

Objective To evaluate the value of T2WI scores for diagnosis and differential diagnosis of transition zone prostate cancer(PCa).Methods T2WI of 43 cases of transition zone PCa and 91 cases of benign prostatic hyperplasia(BPH) were analyzed retrospectively.Transition zone T2WI signs were divided into the main signs and the secondary signs, which were given different scores and were evaluated separately by receiver operating characteristic (ROC) curve for their diagnostic value.Results In a total of 11 scores sections (-1-10), as the increase of scores, the sensitivity of transition zone PCa was decreased while the specificity and positive predictive value were both increased.According to the ROC curve, when the critical value of scores≥4.5, the sensitivity, specificity, negative predictive value, and the accuracy were 81%,73.3%,90.9%,70.4% respectively.When the scores ≥8.5,the specificity and positive predictive value were both 100%.When the scores ≥0.5 and ≥1.5,the negative predictive value were 100%.Conclusion T2WI scores can quantitatively analyze the transition zone PCa,which has an important value to improve the clinical diagnosis and guide treatment.

Objective To evaluate the diagnostic capabilities of T2 WI features in peripheral zone prostate cancer.Methods The characteristics of T2 WI in 56 cases of peripheral zone prostate cancer,75 cases of benign prostatic hyperplasia and 7 cases of prostatitis confirmed by pathology were analyzed retrospectively.Eight indexes were initially screened byχ2 test,then indexes with significant difference were entered into multivariate Logistic regression analysis.Results The indexes showing statistical differences between prostate cancer and benign prostatic disorders were as following:lesion shape,signal intensity,signal uniformity,boundary of peripheral zone and transition zone,the volume of peripheral zone and prostatic capsule on T2 WI (P<0.05).Margin of lesion and capsule between two groups were not statistical differences (P>0.05).By multivariate Logistic analysis,the statistically significant difference were found in lesion shape, the volume of peripheral zone,prostatic capsule and boundary of peripheral zone and transition zone.Conclusion The lesion shape, volume of peripheral zone and prostatic capsule on T2 WI are independent risk factors for peripheral zone prostate cancer.

Objective To explore the effect and mechanism of fragile site WWOX gene on regulating proliferation of gallbladder cancer cells in vitro. Methods The pcDNA3.0 - WWOX recombinant plasmid which was previous successfully built was transfected to GBC-SD cells and empty carrier by liposome medium. Liposome and GBC-SD were served as the negative control and the blank control,respectively. After 48 hours transfection, inverted microscope was used to observe the changes of gallbladder cancer cells' morphology,MTT and BrdU were used to detect the proliferation level of gallbladder cancer cells,and flow cytometry instrument was used to detect the change of the cell proliferation cycle. Results The results of inverted microscope shown: the number of GBC-SD cells in pcDNA3.0-WWOX group decreased significantly,the suspension cells and cell debris increased,while cells in the vector control,NC and Mock groups were in normal proliferation state. MTT test showed the proliferation levels of GBC-SD cells in pcDNA3.0-WWOX group was lower than those in the control group in 24 h,48 h,72 h,96 h and 120 h,and the differences were statistically significant(P < 0.05). The cell proliferation activity in the pcDNA3.0-WWOX group was obviously inhibited over time. BrdU detection results showed the cell proliferation rate of pcDNA3.0 - WWOX group was(0.44±0.03),while that in the three control groups was(0.78±0.02), (0.81±0.01)and(0.85±0.01),respectively. It showed that cell proliferation activity in pcDNA3.0-WWOX group was lower than the control groups,and the difference was statistically significant(P < 0.05). Cell cycle detection showed the cells increased in G0/G1 phase and decreased in G2/M and S phases of pcDNA3.0-WWOX group. The cell apoptosis rate was significantly higher and the proliferation index was significantly lower than those of the control groups(P < 0.05). However,there were no significant differences among the three control groups(P > 0.05). Conclusion The overexpression of WWOX gene in vitro could effectively inhibit the proliferation activity of gallbladder cancer cells. WWOX might participate in the development of the malignant biological behavior of gallbladder cancer cells. It is expected to become a new potential target for the gene therapy to gallbladder cancer.

Objective To evaluate MRI in judging the therapeutic effect of argon-helium cryoablation therapy for prostate cancer. Methods The clinical data and imaging materials of 16 patients with prostate cancer , who had received ultrasound-guided argon-helium knife cryogenic treatment at authors ’ hospital during the period from March 2012 to Oct. 2014, were retrospectively and comprehensively analyzed. The preoperative and postoperative laboratory test results were compared with MRI findings, and the ablation effect was assessed, focusing on the surgical residue, metastasis, etc. Results One months after the surgery, MRI demonstrated that satisfactory ablation extent was obtained in all patients, the ablated tumor tissue was characterized by long-T2 signal and no obvious recurrence could be found on DWI and DCE-MRI. A slight decrease of PSA level was observed. Six months after the surgery, MRI revealed that the prostate size was significantly reduced, PSA level was markedly decreased and no obvious evidence of recurrence was observed. No severe postoperative complications, such as urethral necrosis, urethral stricture or urethro-rectal fistula, occurred. During the 6-month following-up time, one patient died from other causes. Conclusion MRI has excellent clinical application value in estimating the ablation extent and in judging postoperative recurrence or metastasis of prostate cancer after argon-helium cryoablation treatment.

Ultrafine powder and cell wall-broken powder of herbal medicine lack of the morphological characters and microscopic identification features. This makes it hard to identify herb's authenticity with traditional methods. We tested ITS2 sequence as DNA barcode in identification of herbal medicine in ultrafine powder and cell wall-broken powder in this study. We extracted genomic DNAs of 93 samples of 31 representative herbal medicines (28 species), which include whole plant, roots and bulbs, stems, leaves, flowers, fruits and seeds. The ITS2 sequences were amplified and sequenced bidirectionally. The ITS2 sequences were identified using Basic Local Alignment Search Tool (BLAST) method in the GenBank database and DNA barcoding system to identify the herbal medicine. The genetic distance was analyzed using the Kimura 2-parameter (K2P) model and the Neighbor-joining (NJ) phylogenetic tree was constructed using MEGA 6.0. The results showed that DNA can be extracted successfully from 93 samples and high quality ITS2 sequences can be amplified. All 31 herbal medicines can get correct identification via BLAST method. The ITS2 sequences of raw material medicines, ultrafine powder and cell wall-broken powder have same sequence in 26 herbal medicines, while the ITS2 sequences in other 5 herbal medicines exhibited variation. The maximum intraspecific genetic-distances of each species were all less than the minimum interspecific genetic distances. ITS2 sequences of each species are all converged to their standard DNA barcodes using NJ method. Therefore, using ITS2 barcode can accurately and effectively distinguish ultrafine powder and cell wall-broken powder of herbal medicine. It provides a new molecular method to identify ultrafine powder and cell wall-broken powder of herbal medicine in the quality control and market supervision.

Objective To explore the influence of whole-course individualized nursing intervention on treatment compliance among intractable epilepsy children with ketogenic diet therapy.Methods 80 intractable epilepsy patients with ketogenic diet therapy were divided into the control group and the experimental group with 40 cases in each group.The routine nursing was given to the control group.On basis of routine nursing,whole-course individualized nursing intervention was given to the experimental group.The investigation was carried out before and after intervention in two groups by using self-designed questionnaire.The treatment compliance and therapeutic effect were compared between two groups.Results The treatment compliance and therapeutic effect were significantly alleviated in the experimental group compared with the control group in the third,sixth and twelfth months.Conclusions The whole-course individualized nursing intervention can improve the parental awareness of the disease,enhance their confidence and determination to adhere to the treatment,improve their treatment compliance,thereby improve the effect of treatment.