ObjectiveTo validate the efficacy of Yunpi Huatan Tongqiao prescription （YHTP） in down-regulating glycolysis to modulate microglia phenotype and improve inflammation and cognitive memory deficits in obstructive sleep apnea （OSA） mice. MethodForty-eight male Balb/C mice were randomly divided into a normal group， a model group， a montelukast sodium group （30 mg·kg^-1）， and low， medium， and high dose groups of YHTP （8.28， 16.56， and 33.12 g·kg^-1）， with 8 mice in each group. All groups， except the normal group， received intraperitoneal injections of lipopolysaccharide （LPS） and underwent chronic intermittent hypoxia （CIH） modeling for 4 weeks. Subsequently， the mice were treated with medications for 4 weeks and then sampled. Animal behavioral tests assessed memory impairment due to hypoxia. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to measure mRNA expression levels of M1-associated inflammatory factors interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， and markers such as T lymphocyte activation antigen （CD86） and inducible nitric oxide synthase （iNOS）， as well as M2-associated inflammatory factors interleukin-10 （IL-10）， transforming growth factor-β （TGF-β）， and the marker mannose receptor （CD206） in hippocampal tissue. Western blot was employed to detect differences in the expression of M1 and M2 microglia phenotypic markers （CD86， CD206） and glycolysis-related proteins glucose transporter type 1 （GLUT1）， hexokinase 2 （HK2）， phosphofructokinase （PFKM）， pyruvate kinase 2 （PKM2）， and monocarboxylic acid transporter 1 （MCT1）. ResultBehavioral tests showed that compared to the results in the normal group， the Y-maze autonomous alternation rate was significantly reduced in the model group （P<0.01）. The latency time for the target hole in the Barnes' maze during the training period （days 2， 3， 4） and testing period （days 5， 12） was significantly increased （P<0.05， P<0.01）. M1 glial cell markers CD86 and iNOS， as well as inflammatory factors IL-1β and TNF-α mRNA， were significantly elevated （P<0.01）. In contrast， the mRNA expression of M2 glial cell markers IL-10， CD206， and TGF-β was significantly reduced （P<0.01）. The protein expression of glycolytic proteins HK2， PFKM， PKM2， MCT1， and the M1 marker CD86 was significantly increased （P<0.05， P<0.01）， while M2 marker CD206 protein expression was significantly decreased （P<0.01）. Compared to the results in the model group， the Y-maze autonomous alternation rate was significantly increased in the medium and high dose groups of YHTP （P<0.05， P<0.01）. The latency time for the target hole during the training （day 4） and testing periods （days 5， 12） was significantly reduced （P<0.01）. Real-time PCR results indicated that mRNA expression levels of M1-related pro-inflammatory factors in the hippocampal tissue were significantly reduced in the low， medium， and high dose groups of YHTP （P<0.01）， while M2-related inflammatory factors' mRNA expression was significantly increased （P<0.01）. Western blot results showed that in the medium and high dose groups of YHTP， the expression of the M1 marker CD86 in the hippocampus was reduced， whereas the expression of the M2 marker CD206 was significantly increased （P<0.01）， with a significant decrease in the expression of glycolysis-related proteins （P<0.01）. ConclusionYHTP can improve inflammation and cognitive impairment induced by hypoxia in OSA model mice. This is achieved by downregulating glycolysis in brain microglia， inhibiting M1 activation， reducing pro-inflammatory factor release， and promoting M2 activation， thereby exerting a therapeutic effect on inflammation and cognitive impairment caused by OSA.

Objective To analyze the characteristics of breast architectural distortion(AD)in mammography,MRI,and ultrasound,and to explore the value of each imaging examination in the diagnosis of AD lesions.Methods The mammography,ultrasound,and MRI data of 46 patients(48 lesions)with AD detected by mammography were analyzed retrospectively.Based on the pathological results,the imaging characteristics of benign and malignant AD were compared.Results The morphological and central density differences between benign and malignant lesions were statistically significant.There was no significant difference in microcalcification between benign and malignant AD.On 48 breast MRI,26 lesions showed mass enhancement,17 lesions showed non-mass enhancement,3 lesions showed punctate enhancement and 2 lesions showed no enhancement.There was no statistical significance in the distribution of enhancement types.The difference in time-signal intensity curve(TIC)types between benign and malignant AD was statistically significant.There was no statistical significance in ultrasound manifestation between benign and malignant AD.Using imaging findings greater than those in the breast imaging reporting and data system(BI-RADS)4 categories as a suspected malignant diagnosis,based on pathological examination results.The area under the curve(AUC)by mammography,ultrasound,and MRI was 0.582,0.426,and 0.764,respectively,showed significant differences in diagnostic efficiency.Conclusion MRI has higher sensitivity and specificity in detecting breast AD,which significantly improves the diagnosis coincidence rate of lesions,and can provide an important basis for clinicians to make decisions on surgical treatment.

Objective:To identify the distal and proximal influencing factors of father involvement, and explore the mediating role of father's role perception and the moderating role of depression in the effect of his family-of-origin paternal parenting on father involvement.Methods:Totally 572 fathers with children aged under 12 years old completed the father involvement questionnaire, role of the father questionnaire (ROFQ), parental bonding instrument (PBI) and the center for epidemiologic studies depression scale (CES-D). The Pearson correlation analysis and non-parametric percentile Bootstrap method were conducted via SPSS 21.0.Results:(1)Father involvement (2.86±0.58) was found to be negatively correlated with his own family-of-origin paternal indifference (7.30±3.86) ( r=-0.175, P<0.01), positively correlated with his family-of-origin paternal care (10.46±3.98) ( r=0.291, P<0.01), negatively correlated with his depression (7.07±5.09) ( r=-0.266, P<0.01) and positively correlated with his role perception (61.52±5.92) ( r=0.522, P<0.01). (2)Father's role perception partially mediated the relationship between his family-of-origin paternal care and his own paternal involvement (the mediating effect was 0.015, which was 35.71% of the total effects) and fully mediated the relationship between his family-of-origin paternal indifference and his own paternal involvement (the mediating effect was -0.016). (3)Father's depression played a moderating role between his family-of-origin paternal care and his own role perception ( β=-0.069, P<0.05). And it also played a moderating role between his family-of-origin paternal indifference and his own role perception ( β=0.121, P<0.001). The results of J-N methods showed that the values and significance of simple slopes varied according to father's depression levels in both two models. Conclusion:The paternal parenting that fathers had experienced in his family of origin is an important factor affects his own paternal involvement.In the relationship between father's family-of-origin paternal parenting and his own paternal involvement, father's role perception plays a mediating role and his depression level plays a moderating role.

Objective: To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution. Methods: In the Affiliated Hospital of Yangzhou University, 25 cases of cervical scraping and 22 cases of cervical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation, the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis, the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution. Results: The new rapid pathological diagnosis technology required less space and no pollution, and the diagnosis took about 2-3 min, which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique, and the quality of cervical scraping produced with conventional pathological technique was consistent, which could satisfy the needs of pathological cytological diagnosis; twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy. Conclusion Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping, improve the positive detection rate of the first biopsy of cervical biopsy, and the cost is low, suitable for promotion in primary medical institution.

Objective? To explore the clinical effects of intermittent oral gastrogavage in aged patients with dysphagia. Methods? Totally 66 aged patients with dysphagia hospitalized in the Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital between May 2016 and February 2018 were selected using convenient sampling and divided into the treatment group and the control group according to the random number table. Patients in the control group received nasogastric tube feeding, while patients in the treatment group received intermittent oral gastrogavage. The degree of aspiration, the effects on deglutition function and nutrition were compared between the two groups. Finally, totally 60 patients in the treatment group (n=30) and the control group (n=30) completed the study. Results? After 3 months, patients in the treatment group showed Class Ⅰ-Ⅱ aspiration, while 3 patients in the control group were found with Class Ⅲ or Ⅳaspiration (Z=-3.227,P＜ 0.05). The rehabilitation efficiency of deglutition function of the treatment group was higher than that of the control group (Z=-3.158,P＜0.05). The serum albumin and the pro-protein of the treatment group was (47.17±3.28) g/L and (0.32±0.08) g/L respectively, both higher than those of the control group (t=-10.500, 3.677; P＜ 0.05). Conclusions? Intermittent oral gastrogavage can enhance the patients' deglutition function, reduce their aspiration levels and improve their nutritional status, which is worth promoting in clinical practice.

Objective To explore the diagnostic value of magnetic resonance diffusion weighted imaging(DWI),3D time of flight magnetic resonance angiography(3D-TOF MRA),and 3D arterial spin labeled MR perfusion imaging(3D-ASL)in the senile ischemic cerebrovascular diseases.Methods Ninety patients with acute cerebral infarction and 69 with transient ischemic attack were retrospectively analyzed based on data of DWI,3DTOF MRA and 3D-ASL MRI.Additionally,60 healthy individuals were recruited as a control group.SPSS 21.0 statistical software was used.Results In 90 acute cerebral infarction(ACI)group,the 3D-ASL MRI showed hypoperfusion in 85 patients,hyperperfusion in 2 patients,and no apparently perfusion abnormality in 3 patients.In 85 hypoperfusion patients,the average hypoperfusion area showed by 3D-ASL MRI was(2 543±1 133)mm2,which was higher than the area of high signal in DWI(817±413) mm2 (P＜0.01),with ASL＞DWI in 83 cases and ASL≈DWI in 2 cases.In 69 transient ischemic attack patients,25 patients had artery stenosis and abnormal ASL,11 patients had artery stenosis and normal ASL,17 patients had normal vascular and abnormal ASL,15 had normal vascular and normal ASL.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were higher in 3D-TOF MRA combined with 3D-ASL than in their individual inspection(x2=10.35,P＜0.01,P＜0.05),and the rates of missed diagnosis and misdiagnosis were lower in 3D-TOF MRA combined with 3D-ASL than in their individual inspection (x2 =4.93,P ＜ 0.05).Conclusions ASL,MRA,and DWI can =reflect the different characteristics of the senile ischemic cerebrovascular diseases,and should be used as the standard sequence in geriatric neurology to provide more comprehensive information for the diagnosis and treatment of senile ischemic cerebrovascular disease.

Objective To study the effects of hypothermia on learning and memory ability and mRNA expression of fusion gene and fission gene of mitochondria in hippocampus of rats.Methods 32 Wistar rats were randomly divided into 4 groups according to low-temperature exposure time in the test:high-exposure group(low-temperature exposure for 24 h/d),middle-exposure group(low-temperature exposure for 12 h/d),low-exposure group(low-temperature exposure for 6 h/d) and control group.The temperature of low-temperature exposure was 0-5 ℃.The total test time was 45 d.Morris water maze test was performed on each group from the fifth day before the end of the low-temperature test to the first day after the low-temperature test.After the water maze test,the mRNA expressions of mitochondrial fusion genes (Mfn1,Mfn2) and fission genes(Fis1,Drp1) in hippocampus were detected by RT-qPCR.Results Compared with the control group,the escaping latency of the high-exposure group and the middle-exposure group at the first day and the fifth day of water maze test were significantly longer than those in the control group,and the difference was statistically significant(P＜0.05,P＜0.01).The escaping latency of the sixth day and the number of platform crossings at the beginning of the water maze test were significantly different from those in the control group(P ＜0.05,P＜0.01).Compared with the control group,the escaping latency of the high-exposure group and the middle-exposure group was significantly prolonged on the sixth day,and the number of the platform crossings decreased significantly.The difference was statistically significant (P＜ 0.05,P＜ 0.01).The high,middle and low-exposure group of mitochondrial fusion and fission genes mRNA expressions were as follows respectively:Mfn1:4.05 ±0.21,1.51±0.23,1.17 ±0.83;Mfn2:5.38 ±0.74,0.84 ±0.53,0.47 ±0.33;Fis1:1.65 ±0.58,0.49 ± 0.42,0.40±0.32;Drp1:4.11 ±0.37,0.99 ±0.82,0.55 ±0.29.Compared with the control group,the mRNA expression of the fusion and the fission genes in the high-exposure group increased significantly(P＜0.01).Conclusion The abnormalities of mitochondrial fusion and fission gen mRNA expression in the hippocampus may be one of the mechanisms of the decline of learning and memory functions caused by low temperature exposure.

Objective To investigate the CT findings of primary abdominal dedifferentiated liposarcoma(DDL),and to improve the diagnostic accuracy.Methods CT images of 23 cases with primary abdominal DDL confirmed by pathologically were analyzed retrospectively,and the CT findings were compared with pathological results.Results The masses in 20 cases out of 23 cases were located in retroperitoneal region,2 in abdominal cavity and 1 in the pelvic extraperitoneal space.The mean diameter of the masses was 26.5 cm.CT showed the fatty and non-fatty regions in the masses.In 2 1 cases,the non-fatty region was manifested as a single mass and was located at the edge or on the surface of fatty region.In 2 cases,the non-fatty region was manifested as multiple well-defined masses and was located within the fatty region.In 2 1 cases,the fatty region showed misty density with strip and reticular septa.In 2 other cases,the fatty region showed slightly low density,mingled with some fat tissue density,which showed no enhancement with mild enhanced internal septa.In 20 cases,the non-fatty region showed soft tissue density,with mild to moderate heterogeneous enhancement.In 3 other cases,the density of non-fatty region varied between liquid and soft tissue with patchy enhancement on delayed phase.In addition,stippled calcification was found in 4 cases.Conclusion The primary abdominal DDL has relatively specific CT findings,which different dedifferentiated components pro-duce different CT characterizes.Finding well-differentiated fat components around non-fatty mass may help to improve the accuracy of diagnosis and reduce the misdiagnosis.

Objective The study was designed to comparatively analyze ultrasonic appearance,laboratory and pathological findings in autoimmune hepatitis(AIH),and their correlation.The clinical value of ultrasound in diagnosing autoimmune hepatitis was studied.Methods By retrospectively reviewing the ultrasonic images,pathological and laboratory results of 68 patients with autoimmune hepatitis admitted to the PLA 302 Hospital from 2014 to 2015,we tried to reveal the correlation between ultrasonic features and pathological and laboratory findings.Results The ultrasonic diagnosis of liver fibrosis was not statistically correlated with the features of pathological ″interface hepatitis″ and serological liver function test.But it was positively correlated with the features of pathological ″spotty necrosis″(r=0.5099,P ＜ 0.001).The ultrasonic features of ″cord-like structure″ and ″nodular change″ had statistically improved the classification of the degree of AIH fibrosis on ultrasonic diagnosis(t=3.9547,P ＜ 0.01).The ultrasonic feature of the change of ″liver size″ and ″morphology″ also have statistically improved the diagnosis of AIH fibrosis with ultrasonography(t=2.070,2.137,4.584,3.773,all P＜0.05).Conclusion Ultrasonic images could provide objective evidence in diagnosis of AIH and evaluation of fibrosis degree.

Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in ICU . Methods The bacteria identification and drug sensitive test were carried out on all pathogenic bacteria in ICU of our hospital from January 2013 to December 2013 .Results A total of 187 strains of pathogenic bacteria were separated ,among them 37 strains (19 .79% ) were Gram‐positive bacteria ,which was dominated by staphylococcus aureus ,with drug resistance rate to vancomycin , teicoplanin and linezolid of 0 .00% ;135 strains were Gram‐negative bacteria (72 .19% ) ,which was dominated by pseudomonas aeruginosa ,acinetobacter baumannii ,klebsiella pneumoniae and escherichia coli ,the drug resistant rate of acinetobacter baumannii to cefoperazone/sulbactam and minocycline was lower (43 .59% ,46 .15% ,which of pseudomonas aeruginosa to amikacin ,cefotaxime , cefoperazone/sulbactam were 27 .91% ,32 .56% and 30 .23% ,respectively ;15 strains(8 .02% ) of fungi were isolated ,which were mainly candida albicans and candida tropicalis .Conclusion Regular detection of distribution types and drug resistance change can provide the basis for climical rational use of antibacterial drugs .