Objective To explore the diagnosis and clinical application of fibrin monomer(FM)and D-dimer(D-D)in gerontal pa-tients with malignancy tumor.Methods FM and D-D were detected in 29 gerontal patients with malignant tumor,20 gerontal pa-tients with non-malignant tumor,24 gerontal healthy controls and 30 non-gerontal healthy controls by immunoturbidimetry(ITM). Results The testing results of FM and D-D in the tumor patients were significantly higher than those in the healthy controls(P <0.05).There was no statistical difference in FM and D-D between the gerontal patients with malignant tumor and the gerontal pa-tients with non malignant tumor(P >0.05).There was no statistical difference in FM between the gerontal healthy examination and non-gerontal healthy examination(P >0.05).There was statistical difference in D-D between the gerontal healthy examination and non-gerontal healthy examination (P < 0.05 ).Conclusion FM and D-D could be used as the indicators for diagnosing tumor thrombus in gerontal patients with tumor.However,D-D has meaningless in diagnosing tumor thrombus.In the diagnosis of tumor thrombus in gerontal patients with malignant tumor,the combination of FM and D-D should be needed.

AIM: To observe the therapeutic effect of hepatocyte growth promoting factor (PHGF) combined with transmetil in treatment of chronic severe hepatitis (CSF). METHODS: 120 patients were divided randomly into two groups: the combined treatment group and the routine group. All the patients received ordinary therapy, and 62 patients, based on the therapy, received PHGF combined with transmetil in the combined treatment group. RESULTS: Compared with the routine treatment group, the levels of total serum bilirubin and prothrombin time were decreased significantly (P

Objective To explore the diagnostic value of C‐reactive protein(CRP) for diagnosing chronic obstructive pulmonary disease(COPD) to dig a new marker for COPD diagnosis .Methods A total of 199 cases of COPD ,159 cases of pulmonary malig‐nant tumor and 115 individuals undergoing the physical examination were collected .The whole blood CRP level was detected in 3 groups and the detection results were compared among 3 groups .The receiver operating characteristic(ROC) curve was drawn . Then the sensitivity ,specificity and Youden′s index(YI) were calculated to find the cut‐off value of diagnosis .Results Compared with the individuals undergoing healthy physical examination ,the CRP level in the COPD patients and the patients with pulmonary malignant tumor was significantly increased ,the difference was statistically significant(P<0 .05);the area under ROC curve(AUC) was 0 .768 ,the maximal YI was 0 .418 ,the sensitivity and specificity were 64 .7% and 77 .1% respectively ,the corresponding cut‐off value was 49 .75 mg/L .Conclusion CRP has a certain diagnostic value and can serve as a new index of COPD diagnosis .

Objective:To investigate the influence and mechanism of Portulaca extracts on Tumor Necrosis Factor -α(TNF-α), Interleukin-4(IL-4) in skins of rats with atopic eczema (AE).Methods:40 SD rats were randomly divided into normal control group , model group,Cortex Phellodendri group and Porulaca group.2,4-dinitrochlorobenzene was used on the right back of rat for making atopic eczema.21 days later , all animals were sacrificed , compared the weight of the same size of the eczema and healthy skin.The levels of TNF-αand IL-4 in rats skins were detected by immunohistochemical method.Results:The right back of rats in model group appeared obvious erythema ,erosion and leakage ,which meant the modeling succeeded.Compared with model group ,the swelling degree of Cortex Phellodendri group and Purslane group were significantly decreased ( P<0.01 ) ,compared with Cortex Phellodendri group ,the swelling degree of Purslane group were less than them ( P<0.05 ).The levels of TNF-α, in rats skins of normal control group , model group,Cortex Phellodendri group and Portulaca group were (6 652.66±1 190.94 ),(19 927.10±5 494.21 ), (7 515.13±877.66 ), (6 809.93±1 385.54).The levels of IL-4 were (5 378.44±1 685.01),(26 334.89±3 993.48),(7 814.84±1 751.38),(8 246.57± 975.08 ).Compared with model group ,the levels of TNF-α,IL-4 in rats skins of Cortex Phellodendri group and Purslane group were sig-nificantly decreased(P<0.01).Compared with positive drug group,the levels of TNF-α,IL-4 in rats skins of Purslane group were a little decreased(P<0.05).Conclusion:Purslane extracts has effect to treat atopic eczema ,its possible mechanism is by erducing the proinflammatory factor ,and moderating the anti-inflammatory factor and the ratio between them.

To determine immune responses and immunopathology in ICOSL knockout (ICOSL KO) mice infected with Schistosoma japonicum,ICOSL- KO mice and wild-type C57BL/6J mice were used as experimental models for Schistosoma japonicum infection.The splenic lymphocytes were isolated from the mice the day before infection (0 week) as well as 4,7,12,16 and 20 weeks post infection,and stimulated with SEA for 72 hours in culture.The concentrations of Th1 cytokines (IFN-γand IL- 12) and Th2 cytokines (IL- 4,IL-10 and IL-13) in the culture supernatants were measured by sandwich ELISA.The levels of SEA-specific IgG antibody and its subtypes (IgG1 and IgG2a) were measured in mouse sera by ELISA.Pathological changes of hepatic granuloma in mice were determined by hematoxylin and eosin (H&E) staining.After the infection,the levels of Th1 cytokines,IFN- γ and IL 12,in ICOSL- KO mice were higher than those in wild-type C57BL/6J mice.However,the levels of Th2 cytokines (IL- 4,IL- 10 and IL- 13) were significantly decreased in ICOSL-KO mice compared to those in wild-type C57BL/6J mice.The levels of SEA-specific IgG antibody and its subtypes (IgG1 and IgG2a) in the sera of ICOSL- KO mice were also significantly lower than those of wild -type C57BL/6J mice.Moreover,the Th2 differentiation index was lower in ICOSL- KO mice than in wild-type C57BL/6J mice at 4,7,12,16 and 20 weeks post-infection.Similarly,the ratio of IgG1/IgG2a in ICOSL-KO mice was significantly lower than that in wild- type C57BL/6J mice at 7,12 and 16 weeks post- infection.Furthermore,throughout the course of disease progression,the volume of hepatic egg granuloma in ICOSL- KO mice was significantly smaller than that in wild-type C57BL/6J mice.In conclusions,there is a substantially down-regulated Th2 immune response in ICOSL- KO mice infected with Schistosoma japonicum,thus results in an attenuated hepatic lesion caused by egg granulomas.The findings indicate that the ICOS ICOSL co-stimulatory pathway plays an important role in the hepatic egg granuloma formation of schistosomiasis.

To explore the action target of praziquantel (PZQ) and its underlying mechanism of action, adult male worms of Schistosoma japonicum were collected from the hepatic vein of Kunming mice infected at least 6 or more weeks previously with single-sex cercariae of S.japonicum by perfusion method. These worms were subjected to the action of calcium channel blockers (CCBs) or actin depolymerizing/stabilizing agents interfering with function of the calcium channel. The adult male worms in DMEM culture medium were co-cultivated with near-lethal dose of PZQ(14 μmol/L) overnight(16 hours).Then, the parasites were washed 3 times with sterile physiologic saline next morning after cultivation, re-suspended in new and drug-free medium and then observed under stereo-microscopy during the following 5 days. The experimental results showed that majority of adult male worms of S.japonicum were killed by the action of PZQ in a dose of 14 μmol/L in vitro under normal condition; while the worms pre-incubated with the actin depolymerizing agent cyto chalasin D (CyD) were able to survive in the condition containing 14 μmol/L of PZQ with a survival rate of 100%, and the worms pre-incubted with CCBs, such as nitrendipine and nifedipineu showed a survival rate of about 50% under the same condition. The results of this study suggest that the calcium channel of Schistosomes may be involved in the action target of PZQ and its underlying mechanism.

Objective To explore the role of dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN) in the tubulointerstitial lesions of immune-mediated nephrotoxic nephritis (NTN) and the intervention regulation by anti-P-selectin lectin-EGF domain monoclonal antibody (PsL-EGFmAb). Methods WKY rats were randomly divided into control,NTN and PsL-EGFmAb-treated groups. The mrs in NTN group were injected with 1 ml nephrotoxic rabbit serum per kilogram of rat body weight; the ones in PsL-EGFmAb-treated group were injected with 2 mg PsL-EGFmAb per kilogram of rat body weight simultaneously and 2 h later after nephrotoxic rabbit serum injection; and those in control group were injected with equal volume of 0.9% saline. Renal function and pathology were observed at day 4, 7 and 14 after the induction of NTN. Distribution of DC-SIGN + dendritic cells (DCs) in renal tissues was measured by immunofluorescence. Real-time PCR was performed to examine the expression of P-selectin,RANTES, TNF-α, IL-10, IFN-γ and IL-4. Expression of MHC Ⅱ , CD80 and DC-SIGN on dendritic cells was analyzed by flow cytometry. Transendothelial migration was used to detect the ability of DCs migration. DCs ability to activate T cells was determined by mixed lymphocyte reaction (MLR). ELISA was used to detect the concentration of IFN-γ and IL-4 in the supernatant of MLR. Results At day 4, immature DC-SIGN+ DCs infiltrated the rat renal tubulointerstium of NTN group, matured at day 14, and enhanced the ability to migrate and activate T cells. The distribution of DC-SIGN + DCs was significantly related to the form of crescent, tubulointerstial lesions and renal function. In addition, expression of chemokine RANTES and proinflammatory cytokine TNF-α continuously augmented since day 4, while anti-inflammatory eytokine IL-10 decreased after markedly increased at day 4. At day 14, IFN-γ/IL-4 mRNA increased, which was obviously related to DCs maturation. The intervention of PsL-EGFmAb supressed the expression of DC-SIGN and CD80 on DCs, depressed DCs maturation, migration and ability to activate T cells,down-regulated proinflammatory cytokines and up-regulated anti-inflammatory cytokines in kidney,and thus regulated Th1/Th2 bias. At the same time, kidneys showed the decrease of crescents,improvement of tnbulointerstium damage and renal function. Conclusions DC-SIGN may mediate DCs tubulointerstitial infiltration. It may be also a potent regulator of local immune reaction imbalance and pathology of tubulointerstium. PsL-EGFmAb may depress DCs migration and downregulate DCs maturation and function through DC-SIGN, and thus having a role in prevention and treatment.

Objective: To investigate the difference in the clinical efficacy by thoracoscopy or thoracotomy for treating esophageal atresia. Methods: Thirty-one cases of type-Ⅲ esophageal atresia undergoing surgical treatment from February 2015 to May 2018 at the Department of Pediatric Surgery of Fujian Provincial Maternity and Children′s Hospital were included, and according to the different surgical methods they were divided into thoracoscopic group (15 cases) and thoracotomy group (16 cases). The operation duration, blood loss, postoperative chest drainage time, posto-perative hospital stay and postoperative complications were analyzed between 2 groups. Results: The mean time of operation was (181.33±13.86) min in the thoracoscopic surgery group and (139.06±10.98) min in the thoracotomy group, the thoracoscopic group had longer operation duration than thoracotomy group, and there was a significant difference in operation duration between two groups (t=9.44, P=0.000); mean blood loss was (3.07±0.96) mL in the thoracoscopic surgery group and (5.06±1.12) mL in the thoracotomy group, the thoracoscopic group had less amount of blood loss than thoracotomy group, and there was a significant difference in blood loss between two groups(t=-5.29, P=0.000); mean postoperative chest drainage time was(11.67±1.34) d in the thoracoscopic group and (12.25±1.06) d in the thoracotomy group, and there was no significant difference in postoperative chest drainage time between two groups(t=-1.34, P=0.19); mean time of postoperative hospitalization time was(15.20±0.94) d in the thoracoscopic group and (16.00±0.96) d in the thoracotomy group, and there was a significant difference in the postoperative hospitalization time between two groups (t=-2.33, P=0.027); the anastomotic leak rates were 33.33% (5 cases) versus 25.00% (4 cases) with closed or open approaches, respectively; anastomotic stricture rates were 40.00%(6 cases) versus 31.25% (5 cases) with closed or open approaches, respectively.There was no significant difference in postoperative incidence of anastomotic fistula and anastomotic stenosis between two groups. Conclusions Compared with thoracotomy in the treatment of esophageal atresia, thoracoscopic approach has smaller incision and less bleeding, less chest deformity, short hospital stay postoperatively, so it is safe and effective.However, the surgeon must have experience in doing thoracoscopic operation.

Objective:To compare the clinical efficacy of minimally invasive anterior column screw placement assisted by orthopedic robot with anterior subcutaneous internal fixation (INFIX) in the treatment of unstable pelvic fracture.Methods:A retrospective cohort study was conducted to analyze 42 patients (25 males and 17 females; aged 16-68 years [(41.8±3.2)years] with unstable pelvic fracture admitted to Guizhou Provincial People′s Hospital from June 2018 to December 2021. Anterior column screw group ( n=22) received orthopedic robot-assisted anterior column screw fixation of anterior pelvic ring fracture, and INFIX group ( n=20) received subcutaneous INFIX of anterior pelvic ring fracture. Posterior pelvic ring injuries were treated with closed reduction and percutaneous sacroiliac screw internal fixation. The operation time of anterior pelvic ring fixation, intraoperative blood loss, intraoperative fluoroscopy times, off-bed activity time when the visual analogue scale (VAS) was<3 points during weight-bearing and fracture healing time were compared between the two groups. The quality of pelvic fracture reduction was assessed according to the Matta scoring criteria at 2 days after surgery. The Majeed functional score was used to assess the functional status at the last follow-up. Intraoperative and postoperative complications were observed in both groups. Results:All patients were followed up for 6-24 months [(11.3±0.5)months].The operation time of anterior pelvic ring fixation was (33.4±2.6)minutes in anterior column screw group and (30.2±2.9)minutes in INFIX group ( P>0.05). The intraoperative blood loss was (15.9±3.1)ml in anterior column screw group and (41.4±6.2)ml in INFIX group ( P<0.01). The intraoperative fluoroscopy times were 12.2±2.4 in anterior column screw group and 14.7±2.5 in INFIX group ( P>0.05). The off-bed activity time was (3.2±0.4) weeks in anterior column screw group and (6.6±1.2)weeks in INFIX group ( P<0.01). The fracture healing time was (12.7±1.4)weeks in anterior column screw group and (16.2±1.9) weeks in INFIX group ( P<0.01). According to Matta scoring criteria, the excellent and good rate of posterior pelvic ring reduction quality was 100% in both groups, while the excellent and good rate of the quality of anterior pelvic ring reduction was 100% (excellent in 16 patients and good in 6) in anterior column screw group compared with 90.0% (excellent in 11 patients, good in 7, and fair in 2) in INFIX group ( P<0.05). During the final follow-up, the excellent and good rate of Majeed functional score was 90.9% (excellent in 16 patients, good in 4 and fair in 2) in anterior column screw group, significantly different from 80.0% (excellent in 10 patients, good in 6 and fair in 4) in INFIX group ( P<0.05). During the operation, no important tissue injuries such as blood vessels, nerves or spermatic cord occurred in either group. In anterior column screw group, no postoperative complications such as infection, spermatic cord injury or implant breakage occurred; in INFIX group, there were 2 patients with incision fat liquefaction, 4 with lateral femoral cutaneous nerve symptoms and 1 with heterotopic ossification, without the occurrence of implant breakage. Conclusion:Compared with anterior subcutaneous INFIX, orthopedic robot-assisted anterior column screw internal fixation for the treatment of unstable pelvic fracture has advantages of less bleeding, earlier tambulation, faster fracture healing, better fracture reduction quality, more satisfied postoperative functional recovery, and fewer complications.

Objective To investigate the diagnostic value of B7-H3 and carcinoembryonic antigen (CEA) on diagnosis of malignant pleural effusion (MPE).Methods We collected and analysed the expression of B7-H3 and CEA in 40 MPE cases and 22 cases of benign pleural effusion (BPE) using enzyme-linked immunosorbent assay (ELISA).Receiver operator characteristic curves (ROC) were drawn according to the expression of B7-H3 and CEA, calculated diagnosis sensitivity, specificity and the area under curve (AUC).Results The diagnosis sensitivity of B7-H3 was 62.5％, specificity 81.0％, with the AUC of 0.777;similarly, The diagnosis sensitivity of CEA was 72.5％, specificity 81.0％, with the AUC of 0.850.Higher AUC of 0.910 was gained in combination ROC, with sensitivity and specificity of 72.5％, 81.0％, respectively.Conclusion B7-H3 and CEA could be available diagnosing markers for MPE.Combined applications of B7-H3 and CEA have higher AUC.They may be widely applied in future clinical practice.