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ObjectiveTo explore the potential mechanism of Zuogui Jiangtang Jieyu Formula （左归降糖解郁方， ZJJF） for diabetic rats with depression. MethodsSixty rats were randomly divided into normal group， model group， wingless MMTV integration site family member 5a （Wnt5a） agonist group， ZJJF group， and ZJJF plus Wnt5a inhibitor group， with 12 rats in each group. Except for the normal group， the rats were fed with high-fat chow， streptozotocin injection， and chronic mild unpredictable stress combination， to establish model of diabetes mellitus complicated with depression. After successful modelling， rats in the Wnt5a agonist group were given bilateral hippocampal stereotactic injections of Wnt5a agonist Foxy-5 with 5 μl each for 7 consecutive days； rats in ZJJF group were given 20.52 g/（kg·d） of ZJJF by gavage； rats in ZJJF plus Wnt5a inhibitor group were given the drug by gavage， and bilateral hippocampal stereotactic injections of Wnt5a inhibitors Box5， with the same dosage and injection method as above. The normal group and model group were given 10 ml/（kg·d） of normal saline by gavage. All groups were gavaged for 4 consecutive weeks. At the end of the intervention， the depression-like behaviour of rats was evaluated using the forced swimming experiment （immobility time） and the absent field experiment （number of activities）； the blood glucose and insulin levels of rats were measured and the insulin resistance index was calculated； the dendritic morphology of dentate gyrus neurons in the hippocampus was observed using Golgi staining； the level of dentate gyrus neuron proliferation was measured using 5-bromodeoxyuracil nucleoside （Brdu） injection and immunofluorescence； RT-qPCR and Western blot were used to detect the mRNA and protein expression of Wnt5a， Ras homologue genomic member A （RhoA） and Rho homologue-associated coiled-coil protein kinase 1 （ROCK1） in the dentate gyrus. ResultsCompared with the normal group， rats in the model group had significantly higher blood glucose， insulin and insulin resistance indices， longer immobility time， fewer activities， lower Brdu integral optical density values and Wnt5a， RhoA， ROCK1 protein and mRNA expression in the dentate gyrus of the hippocampus （P＜0.05 or P＜ 0.01）； the dendritic branches of rat hippocampal dentate gyrus neurons could be seen to be significantly reduced or broken， and their length shortened. Compared with the model group， the blood glucose， insulin and insulin resistance indices of rats in ZJJF group and the ZJJF plus Wnt5a inhibitor group significantly reduced （P＜0.05 or P＜0.01）； the immobility time of rats in the Wnt5a agonist group and ZJJF group was significantly shortened， the number of activities increased， the Brdu integral optical density values elevated， and the Wnt5a， RhoA， ROCK1 protein and mRNA expression elevated （P＜0.05 or P＜0.01）， and the number of dendritic branches of hippocampal dentate gyrus neurons significantly increased， the length lengthened， and the complexity of dendrites increased. Compared with the Wnt5a agonist group， rats in the ZJJF group showed significant decrease in blood glucose， insulin and insulin resistance indices， prolongation of immobilisation time， reduction in the number of activities， and reduction in the Brdu integral optical density value； except for the Wnt5a mRNA in ZJJF group， Wnt5a， RhoA， ROCK1 protein and mRNA expression reduced in both ZJJF group and ZJJF plus Wnt5a inhibitor group （P＜0.05 or P＜0.01）. Compared with ZJJF group， Wnt5a， RhoA， ROCK1 protein and mRNA expression were reduced in ZJJF plus Wnt5a inhibitor group （P＜0.05 or P＜0.01）. ConclusionZJJF can improve hyperglycemia and depressive-like behaviours in rat models of diabetes with depression， and its antidepressant effects may be related to the activation of hippocampal Wnt5a/RhoA signaling and promotion of dentate gyrus neuron dendritic growth.

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The theory of "linkage between spleen and small intestine" has been put forward by doctors as early as the Ming dynasty. In traditional Chinese medicine， the spleen and small intestine cooperate and work together physiologically， and they are also closely related and interact with each other pathologically. The spleen governs transportation and transformation， which involves the function of the small intestine in transforming water and grain. The small intestine， governing the receiving and transformation of substances， depends on the normal transportation of the spleen. At the same time， it provides guarantee for the spleen to transform Qi and generate blood as well as ascend lucidity and descend turbidity. The dysfunction of spleen in transportation is closely related to the dysfunction of small intestine. The stability of intestinal microecology necessitates the normal functioning of the spleen. When the original balance of intestinal flora is disturbed， the spleen functioning will be affected. This study explored the pathogenesis and treatment of diabetes based on the physiological functions of the spleen and small intestine and the Western medicine targets of "nutrients-intestinal flora". According to modern medicine， nutrients are essential to maintain the normal physiological activities of the human body. Proper intake of nutrients can affect the absorption and metabolism of the human body for nutrients by regulating the composition and function of intestinal flora， so as to prevent the occurrence of diabetes. The imbalance of intestinal flora which harbors rich microorganisms may lead to the disturbance of energy metabolism and the dysfunction of the immune system， eventually leading to diabetes. As a metabolic disease， diabetes is closely related to the imbalance of intestinal flora and nutrient intake. Based on the theory of "linkage between spleen and small intestine"， this paper discusses the relationship between spleen and small intestine. Furthermore， this paper discusses the correlation between "spleen-small intestine" and "nutrients-intestinal flora" by reviewing the latest progress in modern medicine and clinical research， aiming to provide a theoretical basis and new ideas for the clinical prevention and treatment of type 2 diabetes mellitus.

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OBJECTIVE@#To investigate the effect of Zuogui Jiangtang Jieyu Decoction (ZJJ) on Shh signaling and self-renewal of neural stem cells in the hippocampal dentate gyrus of diabetic rats with depression.@*METHODS@#Diabetic rat models with depression were randomly divided into model group, positive drug (metformin + fluoxetine) group, and low-, medium-, and high-dose ZJJ groups (n=16), with normal SD rats as the control group. The positive drugs and ZJJ were administered by gavage, and the rats in the control and model groups were given distilled water. After the treatment, blood glucose level was detected using test strips, and behavioral changes of the rats were assessed by forced swimming test and water maze test. ELISA was used to examine the serum level of leptin; The expressions of nestin and Brdu proteins in the dentate gyrus of the rats were detected using immunofluorescence assay, and the expressions of self-renewal marker proteins and Shh signaling proteins were detected using Western blotting.@*RESULTS@#The diabetic rats with depression showed significantly increased levels of blood glucose and leptin (P < 0.01) and prolonged immobility time in forced swimming test (P < 0.01) and increased stage climbing time with reduced stage seeking time and stage crossings in water maze test (P < 0.01). The expressions of nestin and Brdu in the dentate gyrus, the expressions of cyclin D1, SOX2, Shh, Ptch1, Smo in the hippocampus and the nuclear expression of Gli-1 were decreased (P < 0.01) while hippocampal Gli-3 expression was increased significantly (P < 0.01) in the rat models. Treatment of rat models with high-dose ZJJ significantly reduced the blood glucose (P < 0.01) and leptin level (P < 0.05) and improved their performance in behavioral tests (P < 0.01). The treatment also obviously increased the expressions of nestin, Brdu, cyclin D1, SOX2, Shh, Ptch1, and Smo and the nuclear expression of Gli-1 in the dentate gyrus (P < 0.01) and reduced hippocampal expression of Gli-3 (P < 0.05) in the rat models.@*CONCLUSION@#ZJJ can significantly improve the self-renewal ability of neural stem cells and activate Shh signaling in dentate gyrus of diabetic rats with depression.

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Objective:To explore the effect of long-chain fat emulsion in parenteral nutrition therapy on the perioperative nutritional status of patients with low rectal cancer.Methods:A total of 204 patients who underwent rectal cancer surgery in the Third Hospital of Shanxi Medical University from January 2017 to June 2020 were retrospectively analyzed. The patients were divided into two groups according to the specific nutritional treatment methods, 100 cases in the study group used long-chain fat emulsion for parenteral nutrition support, and 104 cases in the control group used medium- and long-chain fat emulsion injection. After admission, the nutritional status of patients were evaluated according to the results of Scored Patient-Generated Subjective Global Assessment (PG-SGA) and related laboratory tests. At 7th day before the operation, the patients were treated with nutrition and electrolyte support. Parenteral nutrition and enteral nutrition combined treatment and early enteral nutrition were given after the operation. The albumin, prealbumin, retinol-binding protein, total cholesterol and body mass index (BMI) at 7th day before the operation, 1st day after the operation and 7th day after the operation and the patient's first exhaust time after surgery, occurrence of postoperative complications, postoperative fever and total hospital stay were recorded and compared between the two groups.Results:Postoperative first exhaust time [(42±11) h vs. (54±10) h], fever time [(48±8) h vs. (57±7) h], total hospital stay [(16.0±0.7) d vs. (18.0±0.9) d)], resting energy expenditure at the 7th day after surgery [(5 326±589) kJ/d vs. (5 840±599) kJ/d] and total cholesterol at the 7th day after surgery [(4.8±0.3) mmol/L vs. (5.0± 0.4) mmol/L] in the study group were lower than those in the control group, and albumin [(33±3) g/L vs. (28± 3) g/L], prealbumin [(0.189±0.041) g/L vs. (0.164±0.037) g/L] and retinol-binding protein [(0.039±0.016) g/L vs. (0.032±0.013) g/L] at the 7th day after surgery in the study group were higher than those in the control group, and the differences between the two groups were statistically significant (all P < 0.05). There was no statistical difference in other detection indexes between the two groups (all P > 0.05). Conclusion:The use of long-chain fat emulsion in low rectal cancer patients with malnutrition during the perioperative period may be more conducive to the recovery of the body.

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OBJECTIVE@#To analyze the clinical characteristics and pregnancy outcomes of pregnant women complicated with coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of 3 pregnant women with COVID-19 admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from January 19 to February 10, 2020 were retrospectively analyzed.@*RESULTS@#There was one case in the first-trimester pregnancy (case 1), one in the second-trimester pregnancy (case 2) and one in third-trimester pregnancy (case 3). Cough, fever, fatigue, lung imaging changes were the main manifestations. The white cell count, lymphocyte percentage had no significantly changes in case 1 and case 3, while the levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IL-6 and IL-10 elevated. The lymphocyte count and lymphocyte percentage decreased and the inflammatory indicators significantly increased in case 2. All patients were treated with antiviral, antitussive, oxygen inhalation; case 3 received glucocorticoids, case 2 with severe illness received glucocorticoids and additionally gamma globulin. All three cases were cured and discharged. Case 1 with early pregnancy chose to terminate pregnancy after discharge; case 2 chose to continue pregnancy without obstetric complications; and case 3 had cesarean section delivery due to abnormal fetal heart monitoring.@*CONCLUSIONS@#The report shows that COVID-19 in pregnancy women could be cured with active treatment, and the maternal and fetal outcomes can be satisfactory.

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Objective To explore the effect of lncRNA of growth arrest-specific 5 (lncRNA GAS5) on the radiosensitivity of colon cancer cells by targeting miR-223.Methods The expressions of lncRNA GAS5 in a few of colon cancer cell lines were detected by real-time quantitative PCR (qPCR).The cell lines with low expression level of lncRNA GAS5 were selected for subsequent study.The effect of overexpression of lncRNA GAS5 on the radiosensitivity of colon cancer SW480 cells was detected by cell cloning experiments.The target gene miR-223 of lncRNA GAS5 was predicted and validated by the bioinformatics database starBase and dual luciferase reporter assays.qPCR was used to detect the expression of miR-223 in various colon cancer cell lines and the influence of lncRNA GAS5 overexpression on the expression of miR-223 in SW480 cells.Results Compared with normal human colonic epithelial cells (NCM460),the expressions of lncRNA GAS5 in the colon cancer SW480,LOVO,HT-29 and SW620 cell lines were significantly lower(t =15.25,8.69,14.42,11.62,P ＜ 0.05),with the lowest level in SW480 cells.Both overexpression of lncRNA GAS5 and down-regulation of miR-223 significantly increased the radiosensitivity of colon cancer cells by decreasing cell survival fraction (at 8 Gy,lncRNA GAS5,t =13.51,P ＜ 0.05;anti-miR-223,t =14.93,P ＜ 0.05)and promoting apoptosis (lncRNA GAS5,t =8.30,P ＜ 0.05;anti-miR-223,t =7.32,P ＜ 0.05).Bioinformatics analysis showed that the 3'sequence of lncRNA GAS5 contained the binding sites with miR-223.After overexpression or downregulation of lncRNA GAS5,the expression of miR-223 was enhanced or reduced.Conclusions The lncRNA GAS5 promotes the apoptosis of colon cancer cells and inhibits its survival by targeting miR-223 expression,thereby increases the radiosensitivity of colon cancer cells.

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Objective To analyze the changes of age, sex, and urban-rural characteristics of inpatients with malignant tumors in Shanxi Cancer Hospital from 2005 to 2014. Methods The data of malignant tumor patients from January 2005 to December 2014 in Shanxi Cancer Hospital were analyzed, which were stratified by age, sex and residence. SAS 9.2 statistical software was used to analyze the changes of age, sex and residence of patients with malignant tumors. Results The average age of malignant cancers was 59.16-60.99 years old for men and 50.7-52.06 years old for women from 2005 to 2014. The incidence between male and female was decreased from 0.81 in 2005 to 0.71 in 2014. The incidence ratio of urban-rural was decreased from 3.5 in 2005 and 2.13 in 2014. The disparities in urban-rural areas still existed in recent 10 years.The incidence number of women in rural areas and the average age of malignant tumors in our hospital was increased significantly respectively. Lung cancer, breast cancer, cervical cancer, esophagus cancer and stomach cancer were the major cancers. The incidence of lung cancer ranked in the first place in male tumors, and the breast cancer ranked in the first place for female tumors. Conclusions It still exists gender and urban-rural differences in patients with malignant tumors in Shanxi Cancer Hospital from 2005 to 2014, and aging tends to be more obvious. The prevention and control of lung cancer, digestive system cancer, female breast cancer are the emphasis in Shanxi Province, while the promotion of health education intervention should be undertaken. Besides, other kinds of comprehensive prevention and control measures are necessary including the screening for major cancers in key areas and the early diagnosis.

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Objective To evaluate the effect of immune enhanced enteral nutrition on immune function in postoperative patients with gastric cancer by using meta-analysis. Methods The databases of PubMed, the Cochrane Library, CNKI, CBM, VIP and Wanfang Data were used to search randomized controlled trials (RCT) about the effect of immune enhanced enteral nutrition and conventional enteral nutrition on immune function in postoperative patients with gastric cancer. The retrieval time span was from inception to Sept 1, 2016. The studies were screened according to the inclusion and exclusion criteria, the data were extracted and the quality was evaluated by 2 reviewers independently. Besides, the meta-analysis was conducted by using RevMan 5.3 software. Results Meta-analysis included 5 RCT, 216 cases in total. The results showed that the immune parameters of immune enhanced enteral nutrition such as IgA (MD=0.18, 95 % CI 0.09-0.27, P0.05). Regarding to cellular factor, the IL-6 level of immune enhanced enteral nutrition was lower than conventional enteral nutrition after 9 days of gastric surgery (MD=-77.40, 95 %CI-112.25 - -42.55, P 0.05). Conclusion Immune enhanced enteral nutrition for postoperative patients with gastric cancer can improve and enhance the immune function under stress, and reduce the excessive inflammatory reaction, which is more conducive to the safety of patients with gastric cancer.

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Objective To analyze the changes of age, sex, and urban-rural characteristics of inpatients with malignant tumors in Shanxi Cancer Hospital from 2005 to 2014. Methods The data of malignant tumor patients from January 2005 to December 2014 in Shanxi Cancer Hospital were analyzed, which were stratified by age, sex and residence. SAS 9.2 statistical software was used to analyze the changes of age, sex and residence of patients with malignant tumors. Results The average age of malignant cancers was 59.16-60.99 years old for men and 50.7-52.06 years old for women from 2005 to 2014. The incidence between male and female was decreased from 0.81 in 2005 to 0.71 in 2014. The incidence ratio of urban-rural was decreased from 3.5 in 2005 and 2.13 in 2014. The disparities in urban-rural areas still existed in recent 10 years.The incidence number of women in rural areas and the average age of malignant tumors in our hospital was increased significantly respectively. Lung cancer, breast cancer, cervical cancer, esophagus cancer and stomach cancer were the major cancers. The incidence of lung cancer ranked in the first place in male tumors, and the breast cancer ranked in the first place for female tumors. Conclusions It still exists gender and urban-rural differences in patients with malignant tumors in Shanxi Cancer Hospital from 2005 to 2014, and aging tends to be more obvious. The prevention and control of lung cancer, digestive system cancer, female breast cancer are the emphasis in Shanxi Province, while the promotion of health education intervention should be undertaken. Besides, other kinds of comprehensive prevention and control measures are necessary including the screening for major cancers in key areas and the early diagnosis.

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Objective:To implement rapid acquisition gradient echo(RAGE)pulse sequence in clinical MRI scaner.Methods:Pascal language is engaged to edit source code.Number of slice excited,order of phase encoded,phase recycle of RF pulse,NEX,on/off of the gradients,and so on are all controlled by sequence parameters.SI×N_(phase)×N_(slice) data of 32 bctys were allocated to restore the k space.Source code of sequence was compiled with executable file and is loaded to RINMR software.Image of human brain are acquired.The experiment has been conducted on 0.36T permanent MRI system.Resuits:In the case of 256×256 matrix acquisition,time of single slice is 4 seconds.The resolution and SNR of the image are all adquately satisfy the clinical application.

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Objective To realize K space image reconstruction by using VC++ and Matlab in the development of MRI software.Methods VC++ called FFT(Fast Fourier Transform Algorithm) function of matlab math dlls to realize transforming the data from k space to real space.Results Image reconstruction was realized successfully for the clinical demand.The development circle and programming workload were greatly reduced.Conclusion The mixed programming by VC++ and Matlab can reduce the developing process and improve the reliability of the software.