Objective To improve the therapeutic effects and to prevent the recurrence of the blepharoptosis. Methods The frontalis muscle was cut to form the ladder shaped frontalis muscle flaps, which was than were transferred under the orbicularis to touch the tarsus with its broad lower part perfectly. The flap was sutured with the tarsus directly. Results All blepharoptosis of twenty four eyes in sixteen patients were treated with excellent results in function and cosmetic appearance. The upper eyelids could be closed effectively. There were no any recurrence and complications in this group. Conclusions The transfer of the ladder shaped frontalis muscle flaps applied in this group benefits the moving of upper eyelid because of its effectiveness in contraction and stable suture with the tarsus. It is more suitable for the treatment of severe blepharoptosis.

Objective:This study investigated the professional identity of administrators in 3rd class hospitals in Shanghai, analyzing the professional identity of administrators and associated factors in public hospitals.Methods:In May 2019, Huashan Hospital conducted a questionnaire survey. Through the analysis of the survey data, this study discussed the correlation between the professional identity degree and the external factors. Three main dimensions of occupational identity were extracted by principal component analysis, namely the professional self-identity, organizational identity and social identity. External influencing factors were analyzed by factor analysis, and five main factors were extracted. Results:It was found that the professional self-identity was much higher than the organizational and social identity. The degree of organizational identity was significantly related to external factors ( r=0.212,0.426,0.146,0.580,0.610, P <0.01). Respect factors ( r=0.553,0.580,0.570) and self-realization factors ( r=0.563,0.610,0.433) had the highest correlation with professional identity. Conclusion:Initiating with improving organizational identity, the authorities and hospitals should establish a scientific and reasonable promotion and incentive mechanism to enhance the degree of professional identity.

Objective:This study investigated the professional identity of administrators in 3rd class hospitals in Shanghai, analyzing the professional identity of administrators and associated factors in public hospitals.Methods:In May 2019, Huashan Hospital conducted a questionnaire survey. Through the analysis of the survey data, this study discussed the correlation between the professional identity degree and the external factors. Three main dimensions of occupational identity were extracted by principal component analysis, namely the professional self-identity, organizational identity and social identity. External influencing factors were analyzed by factor analysis, and five main factors were extracted. Results:It was found that the professional self-identity was much higher than the organizational and social identity. The degree of organizational identity was significantly related to external factors ( r=0.212,0.426,0.146,0.580,0.610, P <0.01). Respect factors ( r=0.553,0.580,0.570) and self-realization factors ( r=0.563,0.610,0.433) had the highest correlation with professional identity. Conclusion:Initiating with improving organizational identity, the authorities and hospitals should establish a scientific and reasonable promotion and incentive mechanism to enhance the degree of professional identity.

Objective:To explore the clinical effects of flaps with cervical cutaneous branch of transverse cervical artery in repairing neck radiation ulcer.Methods:The retrospective observational research was conducted. From January 2016 to December 2019, 8 cases with neck radiation ulcer were admitted to Guangzhou Red Cross Hospital of Jinan University and repaired with flaps based on cervical cutaneous branch of transverse cervical artery. There were 6 males and 2 females, aged 52-75 years. The ulcers occurred 14.5 years after radiotherapy on average, with ulcer areas of 5.0 cm×3.0 cm-7.0 cm×6.0 cm on admission. The wound areas were ranged from 6.0 cm×5.0 cm to 13.0 cm×6.5 cm after ulcers and fibrotic tissue around were resected. Seven cases underwent resection of flaps and wound repair operation on the first stage, and the other 1 case underwent pre-expansion of flap donor area on the first stage and resection of flap and wound repair operation on the second stage, with flap sizes of 8.0 cm×7.0 cm-15.0 cm×8.5 cm. The wounds in the donor areas of flaps in 7 patients were sutured directly, and the wound in the donor area of flap in the other 1 patient was repaired with thin split-thickness skin graft from thigh after being sutured partially. The preoperative ulcer tissue was collected for pathological examination, and the postoperative survival of the flaps and healing of the flap donor areas were observed. The flaps, the recurrence of the neck ulcers and neck function, and the scar hyperplasia in the donor areas of flaps were observed during follow-up.Results:Preoperative pathological examination of ulcer tissue showed that full-thickness necrosis occurred in ulcer skin, obvious fibrotic tissue hyperplasia, collagenization, and small-scale calcification in the base and surrounding tissue of the ulcers, and a large amount of chronic inflammatory cells and a small amount of acute inflammatory cells infiltration were observed in intercellular substance, which excluded the recurrence of tumor. All the flaps in 8 cases survived, the wounds were repaired effectively, and the postoperative donor areas of flaps healed well. During postoperative follow-up of 6-24 months, the flaps had good appearances without recurrence of ulcer, the movement function of neck was significantly improved, and no obvious scar hyperplasia was observed in the donor areas of flaps.Conclusions:Radiation ulcer in the neck is a serious long-term complication of neck after radiotherapy, which is difficult to heal with conservative treatment. The flap with cervical cutaneous branch of transverse cervical artery is close to the neck, with rich blood supply, constant anatomy, and is easy to cut. Neck radiation ulcers treated with the flaps showed good wound healing and improved functions, with no obvious scar hyperplasia.

Objective: To investigate the effect of long-chain non-coding RNA AL117378.1 on the proliferation and invasion of bladder cancer cells. Methods: From August 2016 to December 2017, the tumor tissues and adjacent tissues of 14 patients with bladder cancer treated by Huangshi Central Hospital of Edong Healthcare Group were selected. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of AL117378.1 in 14 pairs of bladder cancer tissues and corresponding adjacent tissues, bladder cancer cell lines (5637, J82, T24, BIU-87) and corresponding human bladder normal epithelial cells (SV-HUC-1). The negative control plasmid (control group) and the plasmid carrying the AL117378.1 (experimental group) were transfected into the bladder cancer cell line with the lowest expression level. qRT-PCR was used to detect the expression levels of AL117378.1 and non-receptor protein tyrosine phosphatase 9 (PTPN9) mRNA in the transfected cells. The expression levels of PTPN9, E-cadherin, α-SMA, CDK4 and Cyclin A2 protein were detected by Western blotting. MTT assay and Transwell invasion assay were used to detect the cell proliferative capacity and invasive ability of the two groups. Measurement data were expressed as mean± standard deviation(Mean±SD), and comparison between groups used independent sample t test. Results: The expression of AL117378.1 in bladder cancer tissues was lower than that in adjacent tissues (P<0.01). The expression of AL117378.1 in bladder cancer cell lines was lower than that in human bladder normal epithelial cells (P<0.01), and the expression level of AL117378.1 was the lowest in J82 cells (P<0.01). The expression levels of AL117378.1 in the control and experimental groups were 1.02 ± 0.11 and 7.96 ± 1.06, respectively, and the difference was statistically significant (t=6.51, P<0.01). The expression of PTPN9 mRNA was 1.01 ± 0.08 and 4.99 ± 0.50, respectively. the difference was statistically significant (t=7.84, P<0.01). Western blotting results showed that the expression of PTPN9 and E-cadherin increased, and the expression of α-SMA, CDK4 and Cyclin A2 decreased. MTT experiments showed that the proliferation of cells transfected with AL117378.1 was significantly decreased (P<0.05). Transwell invasion experiments showed that the number of invasive cells in the control group and the experimental group were 97.96±13.71 and 38.02±7.51, respectively, and the difference was statistically significant (t=3.84, P<0.01). Conclusions The expression of AL117378.1 was significantly decreased in bladder cancer tissues and cell lines (5637, J82, T24, BIU-87). AL117378.1 can significantly inhibit the proliferation and invasion of bladder cancer cells by positively regulating the expression of PTPN9 gene.

Objective:To explore the method and clinical effect of repairing neck radiation ulcer with superficial cervical artery flap.Methods:January 2016 to June 2019, 11 cases of neck radiation ulcer were repaired with superficial cervical artery flap. The ulcer occurred 13.4 years after radiotherapy on average, with an area between 1 cm×2 cm and 3 cm×7 cm, extensive fibrosis.After pathological examination, surgical removal of ulcer and surrounding fibrotic tissue, and avoid injuring the neck’s main blood vessels. Wound size after debridement: 6 cm×9 cm-8 cm×13 cm. The flap rotation point is 4-5 cm beside the spine on the acromion level.The flaps were designed along the skin branch of the superficial cervical artery which located by the Doppler blood flow detector.The distance from the rotation point to the flap’s proximal edge is about 2 cm longer than that of the wound’s proximal edge.The size of the flap is about 2 cm larger than the wound.Then the flaps were excised from far to near after exposing the pedicle. The flap was then transferred to the neck to repair the defect formed by the radiation ulcer’s excision. If the tension is low, the donor sites were dissociated about 2-3 cm, then sutureddirectly after reducing tension.If the tension is high, part of the donor site was sutured to reduce the area and then grafted with medium-thickness skin.The postoperative changes of the patient were carefully observed.Among them, 7 cases underwent one-stage operation, 4 cases underwent two-stage operation after the donor area’s pre-expansion.Results:All patients with radiation ulcers were healed completely.The appearance and function of the operation area were good.Followed up for 6-24 months, no recurrences of radiation ulcer were observed. Among them, the flaps of 10 cases survived completely, and the wound healed in one stage.The distal area of the flap necrosed in one case, and repaired by dressing change and skin grafting.Conclusions:Radiation ulcer of the neck is a serious long-term complication after radiotherapy. Once it occurs, it is difficult to heal by conservative treatment. Skin grafting is difficult to survive as well. The superficial cervical artery flap has a constant and abundant blood supply and a hidden donor area, which is a feasible method for the treatment of radiation ulcer of the neck and reconstruction of the function.

Objective:To explore the method and clinical effect of repairing neck radiation ulcer with superficial cervical artery flap.Methods:January 2016 to June 2019, 11 cases of neck radiation ulcer were repaired with superficial cervical artery flap. The ulcer occurred 13.4 years after radiotherapy on average, with an area between 1 cm×2 cm and 3 cm×7 cm, extensive fibrosis.After pathological examination, surgical removal of ulcer and surrounding fibrotic tissue, and avoid injuring the neck’s main blood vessels. Wound size after debridement: 6 cm×9 cm-8 cm×13 cm. The flap rotation point is 4-5 cm beside the spine on the acromion level.The flaps were designed along the skin branch of the superficial cervical artery which located by the Doppler blood flow detector.The distance from the rotation point to the flap’s proximal edge is about 2 cm longer than that of the wound’s proximal edge.The size of the flap is about 2 cm larger than the wound.Then the flaps were excised from far to near after exposing the pedicle. The flap was then transferred to the neck to repair the defect formed by the radiation ulcer’s excision. If the tension is low, the donor sites were dissociated about 2-3 cm, then sutureddirectly after reducing tension.If the tension is high, part of the donor site was sutured to reduce the area and then grafted with medium-thickness skin.The postoperative changes of the patient were carefully observed.Among them, 7 cases underwent one-stage operation, 4 cases underwent two-stage operation after the donor area’s pre-expansion.Results:All patients with radiation ulcers were healed completely.The appearance and function of the operation area were good.Followed up for 6-24 months, no recurrences of radiation ulcer were observed. Among them, the flaps of 10 cases survived completely, and the wound healed in one stage.The distal area of the flap necrosed in one case, and repaired by dressing change and skin grafting.Conclusions:Radiation ulcer of the neck is a serious long-term complication after radiotherapy. Once it occurs, it is difficult to heal by conservative treatment. Skin grafting is difficult to survive as well. The superficial cervical artery flap has a constant and abundant blood supply and a hidden donor area, which is a feasible method for the treatment of radiation ulcer of the neck and reconstruction of the function.

Objective:To observe the expression of long non-coding RNA (lncRNA) PEBP1P2 in renal cell carcinoma (RCC) tissues and its effect on the proliferation and migration of RCC cells.Methods:The expression of PEBP1P2 in 51 RCC tissues and RCC cell lines was detected by real-time quantitative polymerase chain reaction (qPCR). The A498 cells with the lowest expression of PEBP1P2 were transfected, and the cells transfected with PEBP1P2 plasmid were used as the PEBP1P2 group, and the cells transfected with the negative control plasmid were used as the NC group. qPCR was used to detect the expression of PEBP1P2 in the two groups of cells. MTT assay and Transwell migration assay were used to detect the proliferation and migration ability of RCC cells. qPCR and Western blotting were used to detect the expression of caspase recruitment domain family member 10 ( CARD10) gene and NF-κB pathway protein, respectively. Measurement data were expressed as mean±standard deviation ( Mean± SD), and LSD- t test was used for comparison between groups. Results:The expression of PEBP1P2 in RCC tissues was lower than that in adjacent tissues ( t=4.89, P<0.01). The expression of PEBP1P2 in RCC cells was lower than that in normal renal tubular epithelial cells ( P<0.01). The expression of PEBP1P2 in A498 cells of the PEBP1P2 group and NC group was (11.01±1.26) and (1.06±0.19), respectively, and the PEBP1P2 group was significantly higher than that in the NC group ( t=7.81, P<0.01). Overexpression of PEBP1P2 significantly inhibited the proliferation of RCC cells ( P<0.05) and migration ability ( t=3.65, P<0.05). Overexpression of PEBP1P2 significantly suppressed the expression of CARD10 gene in RCC A498 cells ( t=6.83, P<0.01) and inhibited the transduction of NF-κB signaling pathway proteins. Conclusions:PEBP1P2 expression was significantly decreased in RCC tissues. Overexpression of PEBP1P2 significantly inhibited the proliferation and migration of RCC A498 cells. Its molecular mechanism is that PEBP1P2 down-regulates CARD10 gene expression and inhibits NF-κB signaling pathway.

Objective:To investigate the expression of long non-coding RNA (lncRNA) COX10-AS1 in renal cell carcinoma tissues and cell lines and its effect on proliferation and migration of renal cancer cells.Methods:Fluorescence real-time quantitative PCR (qRT-PCR) was used to detect the expression of COX10-AS1 in surgical specimens that have been diagnosed as renal cancer tissues and adjacent tissues by pathology, renal cancer cell lines (786-O, CaKi-1, A498, ACHN) and normal renal tubular epithelium cell line (HK-2). The ACHN cells with the lowest expression were divided into a control group (transfected with a negative control plasmid carrying nonsense sequences) and an experimental group (transfected with a plasmid carrying COX10-AS1 sequences). The expression level of COX10-AS1 was detected by qRT-PCR in two groups of cells. The proliferation and migration ability of ACHN cells were detected by MTS assay and cell scratch assay. The expression of MFN2 mRNA was detected by qRT-PCR. The expressions of MFN2 and Ras-NF-κB signaling pathway proteins were detected by Western blotting. The measurement data were expressed as mean±standard deviation ( Mean± SD), the comparison between the two groups used the t-test, and the comparison among multiple groups adopts the one-way analysis of variance. Results:The expression of COX10-AS1 in renal cell carcinoma was significantly lower than that in adjacent tissues ( P<0.01), The expression of COX10-AS1 in renal cell carcinoma cells was significantly lower than that in renal tubular epithelial cells ( P<0.05), the expression of COX10-AS1 was the lowest in ACHN cells( P<0.01), the above differences were statistically significant compared with the control group, the expression of COX10-AS1 in ACHN cells of experimental group was significantly increased ( P<0.01), the above differences were statistically significant compared with the control cells, the proliferation of ACHN cells in the experimental group was significantly decreased ( P<0.05), and the cell migration ability was significantly decreased ( P<0.01). Compared with the control cells, the expression of MFN2 mRNA in ACHN cells of experimental group was significantly increased ( P<0.01). The expression levels of MFN2 were significantly up-regulated ( P<0.01), and Ras-NF-κB signaling pathway proteins were significantly down-regulated ( P<0.05), the above differences were statistically significant. Conclusions:The expression of COX10-AS1 is decreased in renal cell carcinoma tissues and cell lines. COX10-AS1 may inhibit the proliferation and migration of ACHN cells by promoting the expression of MFN2 gene.

Objective:To investigate and analyze the current situation, screening, clinical characteristics, prevention and treatment of bleeding esophageal varices in cirrhotic patients with portal hypertension in Tibet region.Methods:Clinical data of cirrhotic patients with portal hypertension through March 2017 to February 2020 from Tibet region were collected and analyzed retrospectively.Results:511 cases with liver cirrhosis were included in the study, of which 185 cases (36.20%) had compensated cirrhosis and 326 cases (63.80%) had decompensated cirrhosis. Further analysis of the etiological data of liver cirrhosis showed that 306 cases (59.88%) were of chronic hepatitis B, 113 cases (22.11%) of alcoholic liver disease, and 68 cases (13.31%) of chronic hepatitis B combined with alcoholic liver disease. Among patients with compensated liver cirrhosis, 48 cases (25.95%) underwent endoscopic examination of which 33 diagnosed as high-risk variceal bleeding. However, none of these 33 cases had received non-selective β-blocker therapy, and only four patients had received endoscopic variceal banding therapy. Among patients with decompensated liver cirrhosis, 83 cases (25.46%) had a history of upper gastrointestinal bleeding, 297 cases (91.10%) had ascites, 23 cases (7.05%) had hepatic encephalopathy, and 3 cases (0.92%) had hepatorenal syndrome. Among the patients with a history of upper gastrointestinal bleeding, 42 cases (50.60%) had received secondary preventive treatment for bleeding esophageal varices, including 39 cases of endoscopic treatment, 1 case of endoscopic combined drug treatment, 3 cases of interventional treatment, and 2 cases of surgical treatment.Conclusion:Chronic hepatitis B and alcoholic liver diseases are the main causes of liver cirrhosis in Tibet region. Moreover, this region lacks screening, prevention and treatment for bleeding esophageal varices in cirrhotic patients with portal hypertension. Therefore, it is necessary to increase the screening of high-risk groups to prevent and improve the first-time bleeding, and promote multidisciplinary team to prevent and treat re-bleeding.