Modified gasless trans-subclavian approach endoscopic lateral neck dissection for treatment of papillary thyroid carcinoma: a series of 31 cases / 中华外科杂志

Objective: To examine the feasibility of the modified gasless trans-subclavian approach endoscopic thyroidectomy for lateral neck dissection (LND) in papillary thyroid carcinoma (PTC). Methods: The clinical data of 31 patients with PTC who underwent modified gasless trans-subclavian approach endoscopic LND in the Department of Head and Neck Surgery, Run Run Shaw Hospital, from January to October 2022 were retrospectively analyzed. There were 2 males and 29 females, aged (32.6±8.3) years (range: 17 to 55 years). The maximum diameter of the primary thyroid lesion (M(IQR)) was 1.06 (1.16) cm (range: 0.53 to 2.44 cm), and the maximum diameter of the metastatic lymph node was (1.04±0.37) cm (range: 0.44 to 1.88 cm). Operation time, postoperative hospital stay, number of lymph nodes dissected, and postoperative complications were recorded. Outpatient follow-up was conducted until November 30, 2022. Results: All operations were successfully completed with the endoscopy approach without conversion to open surgery. The operation time was 160 (20) minutes (range: 100 to 215 minutes), and the postoperative hospital stay was 4 (2) days (range: 2 to 14 days). The number of lymph nodes obtained by dissection in the central and lateral compartment of the neck was 11 (12) (range: 0 to 37) and 34.7±14.8 (range: 15 to 69), respectively. Temporary hypoparathyroidism occurred in 4 cases and all recovered within 1 month after the operation. One case suffered from recurrent laryngeal nerve injury (continuing followed up to assess whether it is a temporary injury). The complication of LND included 1 case of chylous leakage that was recovered with conservative treatment, 1 case of Horner syndrome returned to normal 3 months after surgery. During follow-up, there was no residual tumor or recurrence. Conclusion: The modified gasless trans-subclavian approach endoscopic LND for PTC is feasible, with a thorough dissection and concealed incision.

Analysis of OTC gene variants in four children with delayed onset Ornithine transcarbamylase deficiency / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical manifestation and genetic basis for four children with delayed onset Ornithine transcarbamylase deficiency (OTCD).@*METHODS@#Clinical data of four children with OTCD admitted to the Children's Hospital of the First Affiliated Hospital of Zhengzhou University from January 2020 to April 2021 were reviewed. Peripheral blood samples of the children and their parents were collected and subjected to whole exome sequencing (WES). Bioinformatic analysis and Sanger sequencing verification were carried out to verify the candidate variants. Impact of the candidate variants on the protein structure was also predicted.@*RESULTS@#The clinical manifestations of the four children included vomiting, convulsion and disturbance of consciousness. WES revealed that the child 1 was heterozygous for a c.421C>T (p.R141X) variant in exon 5, children 2 and 3 were hemizygous for a c.119G>A (p.R40H) variant in exon 2, and child 4 was hemizygous for a c.607T>A (p.S203T) variant in exon 5 of the OTC gene. Among these, the c.607T>A variant was unreported previously and predicted to be pathogenic (PM1+PM2_Supporting+PP3+PP4). Bioinformatic analysis has predicted that the variant may result in breakage of hydrogen bonds and alter the protein structure and function. Sanger sequencing confirmed that the variants in children 2 to 4 have derived from their mothers.@*CONCLUSION@#The pathogenic variants of the OTC gene probably underlay the delayed OTCD in 4 children. The discovery of the c.607T>A variant has enriched the mutational spectrum of the OTC gene.

Clinical analysis of gasless transoral endoscopic thyroidectomy via oral vestibular approach for papillary thyroid carcinoma / 中华普通外科杂志

Objective:To study the safety and feasibility of gasless transoral endoscopic thyroidectomy though vestibular approach using self-retaining retractor for papillary thyroid carcinoma.Methods:The clinical data of 39 papillary thyroid carcinoma patients undergoing gasless transoral endoscopic thyroidectomy were collected at Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from Nov 2020 to Jun 2021.Results:All cases successfully underwent laparoscopic surgery without conversion to open surgery. The mean duration of operation was (142±35) min, and the postoperative mean hospital stay was (4.1±0.8) days. The mean maximum diameter of the tumor was (8.5±4.5) mm, and the mean number of lymph node harvest of by central compartment dissection was 7.7±5.9. Postoperative complications were transient hypoparathyroidism in 2 cases but recovered in 1 month. Scalp hydrop in 1 patient,fading subsequently. Transient sensory change around the lower lip in 3 cases, which recovered in 6 months. No patient suffered from recurrent laryngeal nerve palsy or hematoma, no permanent hypoparathyroidism occurred, nor of the postoperative bleeding .Conclusion:The gasless transoral endoscopic thyroidectomy viaoral vestibular approach is a feasible approach in selected papillary thyroid carcinoma patients.

Current status of hospital infection management in psychiatric hospitals in the Ningxia Hui Autonomous Region / 四川精神卫生

ObjectiveTo investigate current status of hospital infection management in psychiatric hospitals in the Ningxia Hui Autonomous Region， so as to provide references for improving the level of hospital infection management of psychiatric hospitals. MethodsIn December 2020， on-site supervision was conducted on hospital infection management in all 9 psychiatric hospitals in the Ningxia Hui Autonomous Region， meantime， the self-compiled questionnaire on hospital infection management status was used for investigation. ResultsAmong the selected hospitals， nine （100.00%） psychiatric hospitals had the main hospital leaders in charge of hospital infection management， five （55.56%） hospitals had established a hospital infection management committee， six （66.67%） hospitals had established an independent hospital infection management department， and one （11.11%） hospital had developed all 13 systems mentioned in the questionnaire related to hospital infection management and job responsibilities. In terms of hospital infection management staff， there were 23 staff members in the nine psychiatric hospitals， including 3 in the specialty （13.04%） and 20 in the part-time setting （86.96%）. The score of the implementation of the basic system of hospital infection management in nine hospitals was （3.28±2.22）. ConclusionThe system specification related to hospital infection management in the Ningxia Hui Autonomous Region psychiatric hospitals needs to be improved and further strengthened， the professionalism of hospital infection management personnel needs to be improved.

Effect of Hirsutine on Proliferation， Apoptosis， Metastasis， and Invasion of Human Cervical Cancer Ca Ski Cells / 中国实验方剂学杂志

ObjectiveTo investigate the effects of hirsutine on proliferation， apoptosis， metastasis， and invasion of human cervical cancer Ca Ski cells and its action mechanism. MethodThe cell proliferation was determined by cell counting kit-8 （CCK-8） assay and the cell apoptosis by Hoechst 33258 staining and flow cytometry. The mRNA expression levels of B cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， and p53 were detected by real-time fluorescence quantitative polymerase chain reaction. The scratch test was conducted to detect the cell mobility， followed by the detection of cell invasion ability using a Transwell chamber. The contents of fibronectin （FN）， matrix metalloproteinase-2 （MMP-2）， and matrix metalloproteinase-9 （MMP-9） were measured by enzyme linked immunosorbent assay （ELISA）， and their protein expression levels were assayed by Western blot. ResultCompared with the control group， hirsutine inhibited the proliferation of Ca Ski cells in a dose- and time-dependent manner. The apoptosis rates and Bax and p53 mRNA expression levels in the 8.0， 16.0， 32.0 μmol·L-1 hirsutine groups rose （P<0.05， P<0.01）， while the Bcl-2 mRNA expression and phosphorylated Src （p-Src） and phosphorylated signal transducer and activator of transcription factor 3 （STAT3） protein expression declined （P<0.05， P<0.01）. Compared with the control group， the 1.0， 2.0， 4.0 μmol·L-1 hirsutine groups exhibited lowered cell mobility， number of transmembrane cells， FN， MMP-2 and MMP-9 contents， and hypoxia inducible factor-1α （HIF-1α）， Vimentin， and N-cadherin protein expression （P<0.05， P<0.01）， but elevated E-cadherin protein expression （P<0.01）. ConclusionHirsutine inhibits the proliferation， metastasis， and invasion of human cervical cancer Ca Ski cells and induces their apoptosis， which may be related to its regulation of Src/STAT3 and HIF-1α/epithelial mesenchymal transformation （EMT） signaling pathways.

Application of metabonomics in study of traditional Chinese medicine syndrome:a review / 中国中药杂志

Syndrome is a nonlinear "internal-excess external-deficiency", "dynamic spatial-temporal" and "multi-dimensional" complex system and thus only by using a versatile method can the connotation be expounded. Metabonomics, which is dynamic, holistic, and systematic, is consistent with the overall mode of traditional Chinese medicine(TCM)(holistic view and syndrome differentiation and treatment). Therefore, metabonomics is very important for the research on the differentiation, material basis, and metabolic pathways of syndromes, and efficacy on syndromes. This study reviewed the application of metabonomics in the study of TCM syndromes in recent years, which is expected to objectify the research on TCM syndromes.

Evaluation of efficacy of intravenous nalbuphine before epidural labor analgesia in inhibiting uterine contraction pain in primiparae / 中华麻醉学杂志

Objective:To assess the value of nalbuphine intravenously injected before epidural labor analgesia in inhibiting uterine contraction pain in primiparae.Methods:A total of 140 expectant primiparae who were suitable and willing to receive epidural labor analgesia with a singleton fetus in vertex presentation, aged 20-40 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅱ, with their cervical dilation of 2-3 cm, were divided into nalbuphine group (N group) and routine control group (C group), with 70 cases in each group.Group N received intravenous injection of nalbuphine 0.1 mg/kg (in normal saline 5 ml) at 10 min before epidural puncture, while group C received intravenous injection of the equal volume of normal saline at 10 min before epidural puncture.The epidural puncture-related items including the intensity of pain (Numeric Rating Scale [NRS] scores) and degree of sedation-agitation (Riker sedation agitation scores) during uterine contraction, duration of epidural procedure, parturients′ satisfaction with epidural puncture, successful epidural catheterization at first attempt and complications (nerve paraesthesia and inadvertent intravascular punctures) were recorded.Results:Compared with group C, the NRS scores and Riker scores for uterine contraction pain were significantly decreased during epidural procedure ( P<0.05), with NRS score <6 and Riker sedation agitation scores of 4, the duration of epidural puncture was shortened, the success rate of epidural puncture at first attempt was increased(51%/70%), and the incidence of nerve paraesthesia and inadvertent intravascular puncture was decreased(17%/6%, 14%/4%), and the parturients′ satisfaction with epidural puncture was increased in group N ( P<0.05). Conclusions:Nalbuphine 0.1 mg/kg intravenously injected before epidural labor analgesia can safely and effectively reduce uterine contraction pain without limb agitation, which is helpful in implementating epidural puncture in primiparae.

High frequency ultrasound combined with ultrasound-guided core needle biopsy for the diagnosis of primary thyroid lymphoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.

Risk factors for severe acute pancreatitis complicated with infection and the effects on immune level / 中华胰腺病杂志

Objective:To analyze the risk factors for severe acute pancreatitis (SAP) complicated with infection and the effects on immune level.Methods:A total of 150 SAP patients admitted to Deyang People′s Hospital from February 2018 to April 2019 were divided into the infected group ( n=90) and the uninfected group ( n=60) according to whether SAP was complicated with infection or not; the changes of pathogenic bacteria in the infection focus, infection risk factors, blood inflammatory cytokines levels and T-lymphocyte subgroups were analyzed. Results:A total of 105 pathogenic bacteria were detected in 90 SAP patients with infection, among which 74(70.5%) were gram-negative bacteria, mainly escherichia coli, klebsiella pneumoniae and pseudomonas aeruginosa. There were 27 strains (25.7%) of gram-positive bacteria, mainly staphylococcus aureus, and 4 strains (3.81%) of fungi. Biliary causes, total parenteral nutrition time≥1 week, APACHEⅡ score≥11, surgical intervention, and respiratory mechanical ventilation were all independent factors for SAP infection (all P<0.05). At 24 hours after onset, blood IL-4(59.1±6.2)ng/L, IL-6(134.1±12.2) ng/L, IL-10(146.4±13.2)ng/L, TNF-ɑ(76.3±5.2)ng/L in infected group were all significantly higher than those in the uninfected group (all P values <0.05); at 30 days after the onset, blood IL-4(33.6±5.8)ng/L, IL-6(49.2±6.8)ng/L of the infected group, IL-10(80.7±8.8)ng/L, TNF-ɑ(28.7±5.5)ng/L in infected group were significantly lower than those in the uninfected group (all P values <0.05). At 24 hours after onset, the proportion of CD 4+ T lymphocytes in the infected group was significantly higher than that in the uninfected group [(45.3±5.5)% vs (32.3±5.2)%], and the proportion of CD 8+ T lymphocytes was significantly lower than that in the uninfected group [(20.6±4.2)% vs (29.7±4.8)%]; at 30 days after onset, the proportion of CD 4+ T lymphocytes in the infected group was significantly lower than that in the uninfected group [(21.6±3.7)% vs (40.2±2.5)%], and the proportion of CD 8+ T lymphocytes was significantly higher in the uninfected group [(48.4±4.1)% vs (32.8±4.0)%]; and all the differences were statistically significant (all P <0.05). Conclusions:The strains of concurrent infection with SAP were mainly gram-negative bacteria. Biliary causes, total parenteral nutrition time, surgical intervention and respiratory mechanical ventilation were all risk factors for concurrent infection with SAP. SAP infection may cause excessive inflammatory response and lead to immune cell damage, which should be paid attention to in clinical treatment.

Influencing factors of postencephalitic epilepsy in children with viral encephalitis at acute symptomatic seizure / 中华实用儿科临床杂志

Objective:To discuss the incidence rate and influencing factors of postencephalitic epilepsy (PE) in children with viral encephalitis at acute symptomatic seizure(ASS).Methods:The data of 132 children with ASS in the First Affiliated Hospital of Zhengzhou University from September 2013 to July 2018 were retrospectively analyzed, and the patients were divided into PE group (62 cases) and non-PE group (70 cases) according to whether they had PE at final follow-up.The risk factors of PE in children with ASS were analyzed using the multivariate Logistic regre-ssion methods. Results:The incidence of PE in children with ASS was 46.97% (62/132 cases). There were statistically significant differences in terms of psychological and behavioral abnormalities[19.4%(12/62 cases) vs.2.9%(2/70 cases)], repetitive seizures (more than 5 seizures) [67.7%(42/62 cases) vs.17.1%(12/70 cases)], status epilepticus (SE) [30.6%(19/62 cases) vs.11.4%(8/70 cases)], generalized seizures [72.6%(45/62 cases) vs.88.6%(62/70 cases)], endotracheal intubation [21.0%(13/62 cases) vs.2.9%(2/70 cases)], the duration of fever [5.5(3.0, 11.0) d vs.3.0(2.0, 6.0) d], the duration in the intensive care unit (ICU) [13(5, 21) d vs.6(3, 8) d], electroencephalography epileptiform discharges [49.1%(27/55 cases) vs.6.8%(4/59 cases)], presence of subcortical involvement on neuroimaging [37.3%(22/55 cases) vs.20.3%(14/59 cases)] in children with ASS between the PE group and the non-PE group(all P<0.05). The multivariate Logistic regression analysis showed that repetitive seizures (more than 5 seizures) ( OR=5.256, 95% CI: 1.538-17.961, P=0.008), SE( OR=6.003, 95% CI: 1.411-25.539, P=0.015), electroencephalography epileptiform discharges ( OR=36.693, 95% CI: 7.031-191.485, P<0.01) and the duration in ICU ( OR=1.170, 95% CI: 1.058-1.298, P=0.002) were the risk factors for PE in children with ASS. Conclusions:The incidence rate of PE in children with ASS is high.Children with ASS are more likely to develop into PE if they have repetitive seizures (more than 5 seizures), SE, electroencephalography epileptiform discharges, and the longer duration in ICU.

Guided bone regeneration combined with kidney-tonifying therapy for repairing femoral bone defect in rats / 中国组织工程研究

BACKGROUND: Guided bone regeneration technology, as a most widely used method for repairing bone defects, has been extensively used in the field of stomatology. However, there are few reports on the guided bone regeneration technology in long bone defects. OBJECTIVE: To explore the effects of guided bone regeneration combined with kidney-tonifying therapy on the repair of femoral bone defects in rats, and investigate its osteogenic efficacy and underlying mechanism. METHODS: Thirty-six Sprague-Dawley rats were randomly divided into six groups: blank group, guided bone regeneration group, high-, moderate-, and low-dose kidney-tonifying groups, and ossotide tablets group. The femur bone defect model of rats was established, and was treated by guided bone regeneration except for blank group. Bio-Gide collagen membrane combined with autologous bone was implanted by guided bone regeneration. The kidney-tonifying groups were given 0.216, 0.108 and 0.054 g/(kg•d) Qianggu capsule via gavage for 8 weeks. The ossotide tablets group was given 0.58 mg/(kg•d) ossotide tablets via gavage for 8 weeks. At 12 weeks after surgery, the osteogenesis was evaluated by X-ray examination, hematoxylin-eosin staining and Masson staining of bone tissue. The mRNA expression levels of alkaline phosphatase, Runx-2, vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissues were detected by quantitative real-time RT-PCR. RESULTS AND CONCLUSION: Results of X-ray examination and hematoxylin-eosin staining and Masson staining of bone tissue showed that the scores of Lane Sandhu and Huddleston in each group were significantly higher than those in the blank group (P < 0.001). The scores in the high-and moderate-dose kidney-tonifying groups were significantly higher than those in the guided bone regeneration group (P < 0.01). RT-PCR results showed that the mRNA expression levels of alkaline phosphatase, Runx-2, vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissue in the high-and moderate-dose kidney-tonifying groups were significantly higher than those in the blank group (P < 0.01), and were superior to the guided bone regeneration group (P < 0.05). In summary, guided bone regeneration combined with kidney-tonifying can significantly promote the repair of femoral bone defects, reduce bone absorption and improve osteogenic efficacy in rats. The mechanism of promoting bone regeneration and angiogenesis may be by up-regulating the expression of related osteogenic factors and angiogenic factors in the environment where the membrane barrier creates a dominant growth of bone tissue.

Effect of electroacupuncture on rehabilitation of knee joint movement after anterior cruciate ligament reconstruction / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the rehabilitation of knee joint function after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#A total of 140 patients with ACL reconstruction were randomly divided into an observation group (58 cases recruited, 12 cases dropped out) and a control group (65 cases recruited, 5 cases dropped out). The patients in the control group were treated with routine rehabilitation treatment. The patients in the observation group, on the basis of the treatment in the control group, were treated with EA at Fengshi (GB 31), Futu (ST 32), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40), Xuanzhong (GB 39), Diji (SP 8) and Sanyinjiao (SP 6) on the affected side (2 Hz/100 Hz of dilatational wave, 2-5 mA). Each EA treatment lasted 20-30 min, twice a day for 7 days. The swelling degree (d), pain visual analogue scale (VAS), knee joint range of motion (ROM), scores of International Knee Documentation Committee (IKDC) subjective short form and scores of Lysholm were observed in the two groups 1 day, 1 month, 3 months, 6 months and 1 year after operation.@*RESULTS@#One month and 3 months after operation, the swelling degree (d) and VAS scores in the observation group were lower than those in the control group (0.05). One month, 3 months, 6 months and 1 year after operation, the ROM of the knee joint in the observation group was higher than that in the control group (<0.05), the IKDC score and Lysholm score were higher than those in the control group (<0.05). Within one year, there were no relaxations, fractures and other related complications in the two groups. The pivot shift test, anterior drawer test and the Lachman test were all negative.@*CONCLUSION@#EA combined with routine rehabilitation training could obviously reduce the pain of knee joint, improve the swelling degree, increase the ROM of knee joint, promote the functional recovery in patients with ACL reconstruction, which are superior to rehabilitation training alone.

Investigation of medication compliance in patients with pneumoconiosis complicated with chronic obstructive pulmonary disease at stable stage / 中华劳动卫生职业病杂志

Objective@#To investigate the compliance of inhalation during stable phase of pneumoconiosis complicated with COPD and to explore the factors influencing compliance.@*Methods@#The patients with pneumoconiosis complicated with COPD who were hospitalized in the four Department of occupational disease prevention and treatment in Hunan province from December 2016 to August 2017 were selected as the research subjects. The examination of Chest radiograph, HRCT and lung function was perfected, and CAT score and MRC score were carried out. The age, culture, smoking history, acute aggravation of 1 years, medical insurance and so on were collected, and follow-up was conducted after 6 months.@*Results@#Of the 115 patients who had successfully followed up, 14 cases (12.17%) were persisted in medication, and 101 cases (87.83%) did not adhere to the medication. The smoking index median of the non adherence group was 30 (15, 40) , while that of the adherence group was 16 (6, 31) . The smoking index of the adherence group was lower than that of the non adherence group. The FEV1% in the unadhered group was 44.69+15.48, and the drug group was 37.12+16.98, the FEV1/FVC in the unadhered group was 52.43+9.19, and the drug group was 44.43+11.88, and the lung function of the drug group was worse than that of the unadhered group. The adherence rate of group COPD (group D) was higher than that of group A, B and C, and the difference between D group and B group was statistically significant. The adherence rate of pneumoconiosis stage Ⅲ was higher than that of pneumoconiosis stageⅡand pneumoconiosisⅠ.@*Conclusion@#The compliance of long acting bronchodilator inhalation is low in stable phase of pneumoconiosis complicated with COPD. The poorer the lung function, the higher the compliance of inhalation. The compliance of pneumoconiosis patients with Medical insurance for industrial injury is higher than that of pneumoconiosis patients with New rural cooperative medical service.

Complications and influencing factors of pneumoconiosis patients undergoing CT guided percutaneous lung biopsy / 中华劳动卫生职业病杂志

Objective@#To investigate the safety and influencing factors of ct-guided percutaneous lung biopsy in pneumoconiosis patients.@*Methods@#The data of 63 patients with pneumoconiosis who underwent ct-guided percutaneous lung biopsy in our hospital were studied to analyze the incidence of complications and influencing factors of percutaneous lung biopsy.@*Results@#63 cases of pneumoconiosis patients received CT guided percutaneous lung biopsy. There were 29 cases of complications (46.03%) , including 20 pneumothorax (37.75%) , 12 bleeding (19.05%) , and 3 cases of liquid pneumothorax (4.76%) . The single factor chi square analysis showed that there were significant differences in age, depth of focus, puncture position and puncture times (P<0.05) , and there was significant difference between the occurrence of hemorrhage and age, type of focus, size of focus, and the location of puncture site (P<0.05) . The unconditional LogisticL multiple factor regression analysis showed that the depth of the lesion was an independent risk factor for concurrency pneumothorax, and the size of the lesion was an independent risk factor for bleeding.@*Conclusion@#Complications of CT-guided percutaneous pulmonary biopsy are mainly pneumothorax and hemorrhage. Age, focus type, focus size, focus depth, puncture site, and puncture times are all the factors of complications.

Expression of socs1 and shp1 in JAK2V617F mutation positive myeloproliferative neoplasms and regulation effect of ruxolitinib / 第二军医大学学报

Objective To analyze the relationship between the JAK2V617F mutation and the expressions of phosphorylated Janus kinase 2 (p-JAK2), suppressor of cytokine signaling 1 (SOCS1), and SH2-containing protein tyrosine phosphatase 1 (SHP1) in JAK2V617F mutation positive myeloproliferative neoplasm (MPN) tissues, and to investigate the effects of JAK2 inhibitor ruxolitinib on regulating the proliferation of JAK2V617F mutation positive human erythroleukemia cell lines HEL and the expressions of SOCS1 and SHP1 in HEL cells. Methods A total of 48 patients with JAK2V617F mutation positive MPN (MPN group) and 24 patients with anemia (control group) in Hebei General Hospital and The First People’s Hospital of Baoding from Jul. 2012 to Aug. 2016 were enrolled in this study. The protein expressions of p-JAK2, SOCS1 and SHP1 in bone marrow biopsies (BMBs) were detected by immunohistochemistry. The correlations between JAK2V617F mutation level and the protein expressions of SOCS1 and SHP1 were analyzed by Spearman rank correlation analysis. HEL cells were treated with ruxolitinib at different concentrations (50, 100, 250, 500 and 1 000 nmol/L), and the viability of cells was determined by CCK-8 assay. The JAK2V617F mutation levels in MPN tissues and HEL cells and the mRNA expressions of JAK2, SOCS1 and SHP1 in HEL cells were detected by qPCR. The protein expressions of JAK2, SOCS1 and SHP1 in HEL cells were detected by Western blotting analysis. Results The ratio of JAK2V617F/JAK2 was (57.33±20.82)% in the MPN group and was zero in the control group. The protein expressions of p-JAK2, SOCS1 and SHP1 in BMBs of MPN patients were significantly different from those in the control group (all P0.01). The protein expressions of SOCS1 and SHP1 were negatively correlated with the mutation level of JAK2V617F (r＝－0.648, －0.692; P0.05). The expressions of SOCS1 and SHP1 in MPN patients with JAK2V617F/JAK250% were significantly higher than those in MPN patients with JAK2V617F/JAK2≥50% (P0.01), while the expression of p-JAK2 was significantly lower than that in MPN patients with JAK2V617F/JAK2≥50% (P0.01). After treatment with 250 nmol/L ruxolitinib for 24 h, 48 h, and 72 h, the viabilities of HEL cells were (60.06±3.87)%, (52.05±2.88)%, and (36.43±2.01)%, respectively. With the increase of ruxolitinib concentrations, the mRNA and protein expressions of JAK2 and the protein expression of p-JAK2 were gradually decreased (P0.01, P0.05), while the mRNA and protein expressions of SOCS1 and SHP1 were gradually increased (all P0.01). Conclusion Ruxolitinib can inhibit the expressions of JAK and the phosphorylation of JAK in HEL cells, enhance the expressions of SOCS1 and SHP1, and reduce the viability of HEL cells.

Establishment of the culture system of γδ T cells in vitro and the anti-tumor effect / 中华肿瘤杂志

Objective@#To establish the culture technique for culturing γδ T cells in vitro and evaluate the basic characteristics, security and anti-tumor effect of the cultured γδ T cells.@*Methods@#Phytohemagglutinin, zoledronic acid, interleukin-2 and interleukin -7 were used to induce the abundant expansion of peripheral blood mononuclear cells in vitro. Flow cytometry assay, in vitro killing assay and mouse model of human lung cancer were also adopted to assess the characteristics and the anti-tumor effect of cultured γδ T cells. Additionally, the contamination of exogenous agents and the acute toxicity of γδ T cells were determined.@*Results@#After culturing 14-16 days in vitro, the total number of γδ T cells was more than 1.0×1010. Among these γδ T cells, CD3+ γδ TCR+ cells accounted for more than 90%. None of contaminations of bacteria, fungi, mycoplasma and virus were observed. At effect target ratio (E/T ratio) of 50/1, killing efficiency of γδ T cells cultured in vitro to SK-MES-1, Ho8910, A549 and K562 reached more than 65%. In vivo experiments showed that the tumor volume of γδ T-treated mice was (828.99±61.05) mm3, significantly lower than (1 723.51±84.30) mm3 of the control mice (P<0.05). Meanwhile, no acute toxicity effect was observed in γδ T cells treated mice.@*Conclusion@#The number, purity and activity of γδT cells cultured in our institute can reach the requirement of clinical application, and the γδT cells also display strong cytotoxic activity against tumor cells such as lung cancer, ovarian cancer and leukemia.

Effect of S1PR2 inhibition on epithelial ovarian cancer SKOV3 cell proliferation in vitro and in vivo / 中华妇产科杂志

Objective To study the effect and mechanism of S1PR2 inhibition on epithelial ovarian cancer SKOV3 cell proliferation in vitro and in vivo. Methods(1)A pair of S1PR2 gene small interference RNA(siRNA),namely si-S1PR2,and a pair of negative control siRNA were designed.Western blot methods were used to detect the silence efficiency of the S1PR2 in the si-S1PR2 group,blank control group and negative control group.(2)Study in vitro: the experiment included three groups, namely si-S1PR2 group, blank control group and negative control group. Cell counting kit-8(CCK-8)assay was used to detect the proliferation inhibition rates of the transfected cells. The cell cycles of the transfected cells were measured by flow cytometry. Western blot was used to detect the levels of phosph-extracellular regulated protein kinase 1/2(p-ERK1/2)of the transfected cells.(3)Study in vivo:to establish intraperitoneal transplantation models, 8 mice in each group were intraperitoneally injected with 5×106SKOV3 cells. Phosphate buffered saline(PBS)or JTE-013 were administered into mice twice per week starting on day 7 after the injection of the cancer cells. Twenty-eight days after nude mice intraperitoneal injection with JTE-013 or PBS,the mice were sacrificed and the number and the weight of visible tumors were calculated. Results(1)The results of western blot showed that the relative S1PR2 protein expression levels were 0.24±0.04 in the si-S1PR2 group,which was lower than that in the blank control group(1.10±0.14,P<0.01) and negative control group(1.07 ± 0.13, P<0.01).(2)The results of CCK-8 assay indicated that after transfected for 24, 48 and 72 hours, the proliferation inhibition rate of si-S1PR2 group were respectively (26.6±3.3)%,(35.0±3.4)%,and(34.0±2.8)%,significantly lower than those in the blank control group (all 0;all P<0.01)and negative control group[(1.7±0.9)%,(2.5±0.5)%,and(2.4±1.1)% respectively;all P<0.01].The results of flow cytometry showed that the G0/G1ratio in the si-S1PR2 group[(70.9±2.8)%]was significantly higher than those in the blank control group[(61.7±2.4)%,P<0.01]and negative control group [(62.1 ± 3.3)%, P<0.01]. Western blot showed that the relative expression level of p-ERK1/2 in si-S1PR2 group(0.11±0.03)was significantly lower than those in the blank control group[(0.62±0.09),P<0.01]and negative control group[(0.68±0.09),P<0.01].(3)Twenty-eight days after nude mice intraperitoneal injection with JTE-013 or PBS,the tumor number of the control group and JTE-013 group were respectively 15.4±4.3 and 8.2±3.7,the tumor weight were(0.45±0.12)and(0.21±0.07)g,respectively.The tumor number and weight in the JTE-013 group were significantly less than those in the control group(all P<0.01). Conclusions The growth of ovarian cancer cells could be decreased by S1PR2 inhibition in vitro and in vivo. One of the mechanisms of the growth inhibitory effect is probably that S1PR2 inhibition lower the phosphorylation level of extracellular regulated protein kinase 1/2(ERK1/2)pathway, which prevent the transformation of ovarian cancer cells from phase G1to S.

Medical consumables management mode under new informatization environment / 医疗卫生装备

Object To explore a new management mode to increase the efficiency of medical consumables management while decrease the hospital cost. Methods The management mode involved in management theories and technologies as well as modern information system so that a set of medical consumables management flow was established.Results Whole-course traceability was implemented for the medical consumables from admittance to utilization, and medical consumables active management mode was constructed in the secondary warehouse.Conclusion The new management mode of medical consumables helps to improve the management level and competitiveness of the hospital.

Association of articular cartilage YKL-40 levels with osteoarthritis / 实用医学杂志

Objective To determine the association of articular cartilage (AC) levels of YKL-40 with osteoarthritis (OA) at different stages of symptomatic severity in patients with knee OA.Methods 42 patients with knee OA were recruited into this study.The radiographic disease severity of OA was assessed by the Kellgren-Lawrence (K-L) grading system.11 patients with non knee OA were selected as normal control group.AC levels of YKL -40 were explored by immunohistochemical method.Symptomatic severity was determined using Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores from OA patients.Results YKL-40 levels in AC were positively related to WOMAC pain,function scores and total scores.WOMAC stiffness scores did not correlated with YKL-40 concentrations in AC.The correlation between AC YKL-40 levels and WOMAC scores was further analyzed by multinomial logistic regression.Multiple regression analysis showed that the correlation between AC YKL-40 levels and WOMAC scores was still significant after adjusting for other confounding factors.AC YKL-40 levels were significantly correlated with K-L grading in patients with knee OA.Conclusions YKL-40 in AC can be used as a potential biomarker for assessing the symptomatic severity of OA.

Preparation of Protein Hybrid Fluorescence Nanoclusters for Rapid Detection of Mercury Ion / 分析化学

One-step green synthetic approach,with bovine serum albumin(BSA) as stabilizer and reductant, was developed for preparation of BSA hybrid fluorescence gold nanoclusters (AuNCs@BSA). The prepared AuNCs@BSA exhibited strong red fluorescence under UV light illumination. Upon excited at 360 nm, the fluorescence spectrum of AuNCs@ BSA exhibited maximum emission peak at 635 nm. AuNCs@ BSA was presented as uniform spherical morphology with diameter at (2.0 ±0.05) nm. The fluorescence of AuNCs@BSA could be quenched by Hg2+because of its metallophilic reaction. Based on the fluorescent spectrometry, a rapid detection system was developed for Hg2+detection in tap water. The AuNCs@BSA amount, pH and buffer system were optimized in this study. According to optimization results, ultrapure water (pH 5.0) was selected to dilute the AuNCs@BSA by 100 times, and 50 μL/well of AuNCs@BSA dilution was applied to detect mercury ion in tap water. Under the optimized conditions, the detection could be completed within 3 min,the fluorescence intensity of the system was linearly proportional to the concentration of mercury ion in the range of 0.5–900 μg/L with linear equations y=-26.76lgx+803.1(0.5-75 μg/L,R2=0.9951) and y=-0.27x+762.02 (75-900 μg/L,R2=0.9959). The limit of detection was 0.14 μg/L(3σ). The average recoveries in spiked tape water samples ranged from 86.8%-113.4% with relative standard deviation of less than 15%. The result implied that the developed method was able to apply to detect mercury ion rapidly, sensitively and conveniently.