ObjectiveTo investigate theefficacy of transcutaneous acupoint electrical nerve stimulation plus acupoint pressing in treatingheadachesafter ethmoidectomyforchronic nasosinusitis.MethodOne hundred patients withchronic nasosinusitiswho hadundergoneethmoidectomyunder general anesthesia were randomly allocated to treatment and control groups, 50 cases each.The control group received routine treatment (auricular plastertherapy,anti-inflammatoryandhemostatic therapy, andoxygen uptake) and the treatment group, transcutaneous acupoint electrical nerve stimulation plus acupoint pressing in addition.Postoperative headache severities were comparedbetweenthe two groups at 6, 12 and 24 hrs after thebeginningof treatment.ResultHeadaches were relieved more significantly in the treatment group than in thecontrol groupat 6, 12 and 24 hrs, especially at 24 hrs. ConclusionsTranscutaneous acupoint electrical nerve stimulation plus acupointpressing has a marked therapeutic effect on headachesafter paranasal sinus surgeryand cansignificantlyimprove postoperative quality of life in the patients.This treatment is non-invasive and more easily accepted by the patients and canimprovethe operatingefficiency and feasibility.

Objective: To investigate the influence and significance of DHA on expression of angiogenesis-related genes in SGC7901 cells. Methods:SGC7901 were treated with DHA (5, 10, 20, 40, and 80μmol/l) for different times (24, 48, and 72 h), and the growth inhibition was detected by MTT. The expression of vascular endothelial growth factor (VEGF-C), cyclooxygenase-2 (COX-2) vascular cell adhesion molecule-1 (VCAM-1), and PTEN mRNA were detected by fluorescence-based quantitative poly-merase chain reaction (qRT-PCR). Their corresponding protein levels were tested by Western blot. Results:DHA significantly inhibited the growth of SGC7901 cells in a dose-and time-dependent manner (P<0.05). The expression of the angiogenesis-related genes signifi-cantly changed, as shown by RT-PCR and Western blot analyses. Compared with the control group, the expressions of VEGF-C, COX-2, and VCAM-1 were down-regulated, whereas the expressions of PTEN were up-regulated, after DHA treatment (P<0.05). Con-clusion:DHA inhibits cell growth in gastric cancer SGC7901 cells. The effect may be due to its reduction of VEGF-C, COX-2, and VCAM-1 gene expression, as well as its promotion of PTEN expression in gastric cancer cells.

Objective To investigate the effects of dihydroartemisinin (DHA) on the proliferation of gastric cancer cell line SGC7901 and its mechanism.Methods SGC7901 cells were divided into the DHA group and the control group.SGC7901 cells in the DHA group were treated with DHA of different concentrations (6.25,12.50,25.00,50.00,100.00 μmol/L),SGC7901 cells in the control group were cultured in the 0.1％ DMSO medium.The proliferation of SGC7901 cells was detected by the MTF method at different time points (24,48,72 hours).Cell cycles of SGC7901 in the DHA group were observed by flow cytometry at 24 hours after treatment.The expressions of Cyclin A,Cyclin D1,Cyclin E,Cyclin-dependent kinase 4 (CDK4) and P16 were detected by Western blot after treating SGC7901 with DHA at concentration of 100μmol/L for 24 hours.The interaction between CDK4 with Cyclin D1 or P16 was examined using the co-immunoprecipitation assay.All data were analyzed using the one-way analysis of variance or the t test.Results The proliferation of SGC7901 cells was significantly inhibited after the treatment with DHA at different concentrations (6.25,12.50,25.00,50.00,100.00 μmol/L) for 24,48 and 72 hours (F =78.66,235.37,93.75,P ＜ 0.05).Compared with control group,the number of SCG7901 cells in the G0/G1 phase in the DHA group was significantly increased (F =18.42,P ＜0.05).After treating SGC7901 cells with DHA for 24 hours,the protein expressions of Cyclin D1 and CDK4 were 0.67 ± 0.15 and 0.64 ± 0.18 in the control group,which were significantly higher than 0.17 ± 0.05and 0.24 ± 0.06 in the DHA group (t =7.746,5.164,P ＜ 0.05).The protein expressions of Cyclin E were 0.42 ± 0.06 in the control group and 0.35 ± 0.06 in the DHA group,with no significant difference (t =2.021,P ＞ 0.05).The protein expressions of Cyclin A were 0.35 ± 0.09 in the control group and 0.38 ± 0.08 in the DHA group,with no significant difference between the 2 groups (t =1.266,P ＞ 0.05).The protein expressions of P16 were 0.29 ± 0.07 in the control group and 0.54 ± 0.12 in the DHA group,with significant difference between the 2 groups (t =4.408,P ＜ 0.05).The results of co-immunoprecipitation assay showed that DHA decreased the interaction between CDK4 and Cyclin D1,and increased the interaction between CDK4 and P16.Conclusion DHA induces SGC7901 cells arrested in G0/G1 phase,and the effect may be related with its downregulation of Cyclin D1 and CDK4,up-regulation of P16,decreasing the interaction between CDK4 and Cyclin D1,and increasing the interaction between CDK4 and P16.

Objective:This study aimed to establish an eXtreme Gradient Boosting(XGBoost) model that can predict the recurrence of hepatocellular carcinoma(HCC)patients after laparoscopic hepatectomy (LH) surgery.Methods:A total of 440 patients with primary HCC who received LH treatment for the first time from January 2013 to September 2016 in Affiliated Hospital of Chengde Medical University were selected as the research objects. The diagnosis method was pathological diagnosis. Research objects were divided into training group ( n=88) and verification group ( n=352) at a ratio of 2∶8 by random number table method. The Kaplan-Meier method was used to draw the recurrence-free survival curve, and the Log-rank test was used to compare the survival of the two groups; the training group was used to establish the COX regression model and the XGBoost model to screen independent predictors of recurrence after LH; receiver operating characteristic(ROC) curve was used to analyze the predictive abilities of the two models, and conducted internal verification in the verification group; Hosmer and Lemeshow Test was used to evaluate the calibration of the two models, and P>0.05 was used as a good fit between the model and the actual situation. Results:Both the COX regression model and the XGBoost model screened out tumor thrombus, low degree of differentiation, tumor microvascular infiltration (MVI), number of tumors, large tumors, and positive hepatitis B surface antigen were independent predictors of tumor recurrence( HR=2.477, 0.769, 1.786, 1.905, 1.544, 1.805; 95% CI: 1.465-4.251, 0.619-0.819, 1.263-2.546, 1.354-2.704, 1.272-1.816, 1.055-2.555). The XGboost model scores were 32 points, 29 points, 24 points, 18 points, 16 points, 11 points, respectively. In the training group, the area under the curve (AUC) of the COX regression model and XGBoost model for predicting recurrence were 0.746 (0.730-0.762) and 0.802 (0.785-0.818), respectively. The XGBoost model had strong predictive ability and was confirmed in the validation cohort. Conclusions:This study had established and verified the XGBoost model that can predict the recurrence of HCC patients after receiving LH for the first time. It can be used in clinics to assist doctors in formulating personalized postoperative monitoring programs for patients. Early detection, early diagnosis and early treatment of tumors and strengthening of postoperative follow-up are important measures to improve the prognosis of patients.

Objective To investigate the expression of TAZ in peripheral blood and tumor tissue of the patients with colorectal cancer and to analyze their relationship and clinical significance.Methods Eighty-five cases of pathologically verified colorectal cancer treated by radical operation were selected as the operation group,and 35 cases with postoperative relapse served as the recurrent group.Meanwhile 50 age and sex-matched healthy persons were selected as the control group.The immunohistochemical(SP)technique was adopted to detect the expression of TAZ in tumor tissues and expression of TAZ in peripheral blood was tested with enzyme linked immunosorbent assay(ELISA).Results The level of preoperative TAZ in peripheral blood of the operation group was significantly higher than that of the control group(P＜0.05).The level of peripheral blood TAZ after operation in the operation group had no significant change compared with the control group (P＞0.05).The level of peripheral blood TAZ in the recurrent group was significantly higher than preoperative level of operation group(P＜0.05).The expression of tumor tissue TAZ was significantly higher than that of normal mucosal tissue(P＜0.05);the expression of tumor tissue TAZ in the recurrent group was higher than that in the operation group(P＜0.05).The tumor tissue TAZ level in the operation group and recurrent group had obvious correlation with peripheral blood TAZ level(P＜0.05).Conclusion Monitoring the TAZ level has obvious reference value for predicting colorectal cancer staging and timely understanding tumor recurrence.

Objective:To compare the efficacy of laparotomy and laparoscopic Glisson pedicle transecting segmental hepatectomy in the treatment of hepatocellular carcinoma.Methods:The clinical data of 138 patients with hepatocellular carcinoma who underwent Glisson pedicle transection hepatectomy in the Affiliated Hospital of Chengde Medical College from March 2012 to November 2015 were collected retrospectively. 45 patients underwent laparoscopic surgery (laparoscopic group) and 93 patients underwent laparotomy. 45 patients were selected as open group according to the most clinical ratio of propensity score. The baseline data, operation, stress index, liver function index and postoperative survival rate were compared between the two groups. COX proportional hazard regression model was used to analyze the influencing factors of 5-year prognosis. Normally distributed measurement data were expressed as mean±standard deviation ( Mean± SD), and independent sample t test was used for comparison between groups. The chi-square test was used to compare the enumeration data between groups. Results:The operation time, intraoperative blood loss, blood transfusion cases, complications, postoperative eating time, drainage tube removal time, and hospital stay in the laparoscopic group were (219.48±53.61) min, (208.53±39.74) mL, 2, 3, (3.62±0.51) d, (4.73±0.85) d, (10.59±1.37) d, the open group were (185.37±46.92) min, (267.49±35.83) mL, 8, 10, (4.56±0.73) d, (5.29±0.94) d, (13.87±1.68) d, the differences between the two groups were statistically significant ( P<0.05). Cortisol, norepinephrine, C-reactive protein, aspartate aminotransferase, alanine aminotransferase, total bilirubin in the postoperative laparoscopic group) And albumin levels were (258.39±30.76) ng/mL, (66.78±7.31) ng/mL, (28.39±3.45) μg/mL, (66.51±7.14) U/L, (73.39±7.85) U/L, (20.67±2.74) μmol/L, (37.52±6.48) g/L, the open group were (316.92±37.51) ng/mL, (75.63±8.39) ng/mL, (38.47±4.56) μg/mL, (82.39±9.06) U/L, (94.05±9.74) U/L, (22.93±3.18) μmol/L, (34.65±5.87) g/L, the differences between the two groups were statistically significant ( P<0.05). There were no statistically significant difference in overall survival rate and tumor-free survival rate between the laparotomy group and the laparoscopic group at 1, 3, and 5 years after surgery ( P>0.05). The COX proportional hazards regression model showed that HBsAg positive, Child-Pugh grade, alpha-fetoprotein, and tumor diameter were risk factors affecting the 5-year prognosis of patients ( HR=6.627, 7.518, 5.143, 4.881, 95% CI: 1.516-9.738, 2.382-12.495, 3.078-6.249, 1.925-7.723, P<0.05). Conclusion:The long-term effects of laparotomy and laparoscopic Glisson pedicle transection hepatectomy are the same in selective hepatocellular carcinoma cases, but laparoscopic surgery can reduce intraoperative blood loss, blood transfusion cases and complications, facilitate early removal of drainage tube and food intake, shorten hospital stay, reduce stress reaction, and promote the recovery of liver function, so the short-term effect is better.

Objective:To investigate pathological features and differential diagnosis in the gonads with disorder of sex development.Methods:Thirty-six cases of clinically diagnosed hermaphroditism with gonadal biopsy in the Department of Pathology, the Seventh Medical Center of People′s Liberation Army General Hospital from April 2007 to July 2021, were collected. All biopsy pathological sections were reviewed, and the gonadal cases with abnormal pathological morphology were screened out. The clinical and imaging data and karyotype of these cases were reviewed. Additional immunohistochemical staining was performed and relevant literature was reviewed.Results:Seven cases of ovotesticular disorder of sex development (OTDSD) were identified, which were characterized by the presence of testicular and ovarian differentiation in the same individual. All patients were under 15 years old and presented with abnormal appearance of external genitalia, and the ratio of male to female was 2∶5. Ultrasonography showed testicular structure in all female patients and cryptorchidism in all male patients. The most common karyotype was 46, XX. One case with undifferentiated gonadal tissue (UGT) and one case with streak gonads were screened out. UGT germ cells were neither in seminiferous tubules nor in follicles, but randomly distributed in an ovarial-type interstitial background, sometimes accompanied by immature sex cords. Streak gonads resembled UGT without germ cells. FOXL2 was positive in granulosa cells, but negative in Sertoli cells. SOX9 expression was opposite. OCT4 was weakly positively/negatively expressed in oocytes and positively expressed in the germ nuclei of UGT.Conclusions:Four differentiation patterns need to be identified in the gonadal biopsy: ovarian differentiation, testicular differentiation, undifferentiated gonadal tissue and streak gonad. The positive expression of SOX9 indicates testicular differentiation, while the positive expression of FOXL2 confirms ovarian differentiation, and the expression of both markers in the same tissue indicates ovotestis differentiation. It is very important to identify UGT, because that has a high probability of developing into gonadoblastoma in the future.

Objective To study the frequency range of "Ling Six Sounds"(LST) in Standard Chinese (SC)and compare with American English (AE) version,and to obtain reference for conducting the "Ling Six Sounds" test in the mainland of China.Methods A total of 60 adults (30 females,30 males) with normal hearing speaking Standard Chinese in their ordinary conversation were recruited to record [m],[u],[a],[i],[(s)],[s] and syllables of [mo],[(s)(l)],[s(l)] (/mo/,/shi/,/si/).This study extracted first formant (F1) and second formant (F2) of vowels and center of gravity of consonants to analyze.Results The frequency range of "Ling Six Sounds" in Standard Chinese was approximately from 200 to 11 000 Hz which was broader than American English.The six sounds of SC showed greatly diverse frequency distributions,especially the sibilants [(s)],[s].There were significant differences between genders (P＜0.05) and the frequency of isolated consonants was slightly higher than consonants in syllables which also had significant differences (P＜0.05) except [m].Conclusion The six sounds in AE and SC version show greatly diverse frequency distributions.It's necessary to pay attention to the manner of articulation when administer the test in consonants and acquire an adaption version of LST,eg adding tone tests and investigating the frequency range of LST in dialectal areas in China.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.