Using Isopropyl amine (0.003 mol/L), p-methyl-phenol (0.03 mol/L) and methanol (1 mol/L) for simulating amino groups, phenol groups and hydroxyl groups in silk fibroin respectively, the reaction rate of different nucleophilic groups in silk with monochlorotriazine reactive dye was studied at various temperature and pH by high performance liquid chromatography. It was found that the overall reaction rate of dyes′ phenolysis was by far higher than that of ammonolysis and alcoholysis on the conditions of 70-95 ℃ and pH=8-10. The phenolysis overall reaction rates of C.I. reactive red 24 and C.I. reactive orange 2 were 8.5 and 12.5 times of their ammonolysis′, and 23 and 50 times of their alcoholysis′ in the term of pH 9 and 95 ℃. The phenolysis efficiencies of those two dyes were 47.4 and 96.3, the ammonolysis efficiencies were 4.6 and 6.9, and the isopropyl amine, p-methyl-phenol and methanol to simulate the silk fibroin, the reaction selectivity between the monochlorotriazine reactive dyes and nucleophilic groups in silk fibroin was investigated. It was deduced that monochlorotriazine reactive dyes are suitable for dyeing silk on the conditions of about 85 ℃ and pH=8-9, and under this condition, phenol groups are the major groups in silk dyeing with monochlorotriazine reactive dyes, amino groups are the minor groups, and the contributions of hydroxyl groups can be neglected.

Objective To observe the short term effects of Rho-kinase inhibitor and Qiliqiangxin capsule on serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in patients with chronic heart failure,and explore the mechanism.Methods 120 chronic heart failure patients received conventional treatment for 4 weeks were divided into blank control group(Group A,n=30),Rho-kinase inhibitor treated group(Group B,n=30), Qiliqiangxin capsules-treated group (Group C,n =30 ),and the other 30 cases were treated with Rho-kinase inhibitor combined with Qiliqiangxin capsules(GroupD,n=30).TNF-α,IL-6 and BNP were measured and cardiac function was evaluated before and after treatment.The difference between 4 groups was analyzed. Results After treatment,the levels of TNF-α,IL-6,BNP in the observation group were lower than that in the control group.The difference was statistically significant(P<0.05 ).The levels of TNF-α,IL-6,BNP in the D group were lower than that in the B and C group.The difference was statistically significant(P<0.05 ).Conclusion Rho-kinase inhibitor combined with Qiliqiangxin capsule can improve cardiac function and reduce levels of serum cytokines associated with chronic heart failure,which is conducive to the treatment of chronic heart failure.

Objective To investigate the prognostic factors and the clinical outcome of locally recurrent rectal cancer after radical resection. Methods From April 2000 to April 2004, 105 patients with locally recurrent rectal cancer after radical resection were re-treated in Tianjin cancer hospital. Thirty-four patients were re-treated with surgery combined with adjuvant chemoradiotherapy (group 1), 35 with surgery alone (group 2), and 36 with chemoradiotherapy (group 3). The impact of 17 clinicopathological factors and treatment modalities on the survival was analyzed. Results The follow-up rate was 95. 2%. The median survival time was 23 months. The 1-, 3-and 5-year survival rates of patients with locally recurrent rectal cancer were 63% ,34% and 19%, respectively. The 1-, 3-and 5-year survival rates were 79%, 55% and 32% in group 1 ; 68%, 40% and 14% in group 2; and 64%, 36% and 11% in group 3; respectively (χ~2 =7. 96,P =0. 019). The univariate analysis showed that the degree of differentiation, depth of tumor invasion, number of metastatic lymph nodes, initial TNM stage, recurrent location, time to recurrence, and surgery combined with adjuvant therapy were significant prognostic factors, with the last 4 being the independent prognostic factors. Conclusions Surgery combined with chemoradiotherapy may improve the survival of patients with locally recurrent rectal cancer.

Objective To evaluate the clinical presentations,pathologic characteristics,and the diagnosis and treatment of eosinophilic cystitis.Methods Two cases of eosinophilic cystitis were analyzed,and the relevant literature was reviewed.Case 1,a 63-year-old man,complained of voiding urgency and frequency,dysuria,intermittent hematuria,and lower abdominal pain.Cystoscopic examination showed that an about 5cm?3cm abnormal focus was 0.2-0.4 cm above bladder mucosa at the fundus of the bladder.Case 2,a 42-year-old woman,complained of voiding urgency and frequency,dysuria,and suprapubic pain with intermittent hematuria.Cystoscopic examination showed that about 4 cm?3 cm?2 cm abnormal foci of cauliflower-like were 0.3-0.4 cm above bladder mucosa at the fundus and neck of the bladder.Imaging examinations(Bultrasound,CT and IVU) showed diffuse thickening of bladder wall and tumor-like lesions.They both underwent transurethral resection of the lesions and were treated with oral steroids and antibiotics.Results Postoperative pathology confirmed eosinophilic cystitis in both cases.The follow-up was 6 months.The voiding symptoms disappeared,and imaging examinations showed no space-occupying lesions of the bladder in them.Up to now,there has no evidence of relapse.Conclusions Eosinophilic cystitis is a very rare tumor-like inflammatory disease.It is easily misdiagnosed as bladder neoplasm.Cystoscopy and biopsy are gold standard for the diagnosis.Current treatment modalities include transurethral resection of the bladder lesion along with nonspecific medical therapy.

Objective To prepare mouse model with heat stress and determine its pathological changes of the lung and brain during heat stress. Methods BALB/c mouse were randomly (random number) divided into two groups, control group and heat stress group. The animals in the control group were sham- heated at a temperature of ( 25 ± 0.5) ℃ and humidity of (35 ± 5 ) %. The animals of heat stress group were placed in a prewarmed incubator maintained at (35.5 ± 0.5) ℃ and relative humidity of (60 ± 5) %. Rectal temperature (Tc) was monitored, and when Tc respectively reached 39 ℃, 40 ℃ , 41 ℃ and 42 ℃, those study animals were killed. The other animals were removed from the incubator and allowed to cool at an ambient temperature of (25 ±0. 5)℃ and humidity of (35 ±5)% , respectirvely for 12 and 24 hrs when Tc reached 41 ℃ , and for 6 hrs when Tc reached 42 ℃. The lung and brain of all the animals were isolated. Hematoxylin and eosin stain and light microscope were used to detect their pathological changes. Results All the animals displayed uniform response to the heat stress. Low degree of heat stress could induced obviously pathological changes of the lung, progressively greater damage to lung with further congestion of lung matrix, asystematic hemorrhage of alveolar space, abscission of alveolar epithelial cell and disappear of pulmonary alveolus tissue structure were detected with the rise of Tc to 42 ℃. However, absorption of congestion and hemorrhage and recovery of pulmonary alveolus tissue structure could also be seen with cooling at ambient temperature. With low degree of heat stress, the brain only showed moderate edema. Neuronal denaturation and necrosis were detected when Tc reached to 42 ℃. Interestingly, the lesions of brain further aggravated even through cooling treatment after Tc reached to 42 ℃ , but recovery could been observed after cooling treatment followed with Tc of 41 ℃. Conclusions The pathological changes of the lung and brain showed distinctive lesions to heat stress and cooling treatment, and these changes were correlated with the timing and time of cooling treatment, which provide the experimental basis to further study the mechanisms between the heatstroke and multiple organ dysfunction syndrome (MODS).

BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.

Objective:The present study was aimed to determine the value of cone beam CT (CBCT) in predicting the risk of lingual bone plate injury during extraction of impacted mandible third molar (IMTM).Methods:The original CBCT data of 150 teeth (50 in vertical, 50 in angular and 50 in horizontal ) in January 2018 to December 2019 in Panzhihua Central Hospital of Sichuan Province were collected and analyzed. The thickness of lingual bone plate in enamel cementum boundary (ECB), root middle (RM) and root tip (RT) of each IMTM was measured by the software of CBCT system, and datas were analyzed by one-way ANOVA.Results:The average thickness of lingual bone plate in ECB of IMTM was (1.36±0.43)mm, (1.21±0.44)mm and (1.28±0.40)mm in vertical, horizontal and angular groups, respectively, with no significant difference ( F=1.07, P=0.35). The average thickness of lingual bone plate in RM of IMTM was (1.48±0.33)mm, (1.06±0.57)mm and (1.11±0.45)mm, respectively, with statistically significant difference ( F=8.78, P<0.01). The average thickness of lingual bone plate in RT of IMTM was (1.44±0.49)mm, (0.84±0.58)mm and (0.86±0.64)mm, respectively, with statistically significant difference ( F=12.35, P<0.01). Compared with the mandibular second molar, there were statistically significant differences in the average thickness of the lingual bone plate in ECB ( F=5.03, P<0.01), the RM ( F=15.13, P<0.01) and the RT ( F=33.12, P<0.01) of the IMTM among the three groups. In addition, the horizontal and angular IMTM, the thinness of lingual bone plate in RT region was more likely to occur than in vertical, and the absence of lingual bone plate was most likely to occur in patients with partial buccal crown. Conclusions:The doctor-patient communication and risk prediction should be sufficient before IMTM extraction when CBCT shows that the lingual bone plate of RT region is thin or absent. At the same time, we should avoid violent operation and thoroughly protect the lingual bone plate in the process of tooth extraction, and guard against serious complications such as perforation or fracture of lingual bone plate of mandible, and root displacement.

Objective:To explore an effective treatment method for mycobacterial infection of multiple abscesses in the face and breast after autologous fat injection.Methods:Six patients with non-tuberculous mycobacterial infection after autologous fat injection in the face and chest were treated from June to September in 2018. All patients underwent preoperative ultrasound localization. The small incision was opened for debridement and the necrotic granular tissues were completely scraped. Vacuum aspiration therapy in the sinus was used to promote wound growth, in line with the standard anti-tuberculosis drug treatment.Results:All six patients in this group were being followed up for 10-14 months. The average follow-up time was 12 months. All the infected patients were recovered, and the appearance of the infected site was satisfied by the patients.Conclusions:Small incision debridement with vacuum aspiration therapy combined with a variety of anti-tuberculosis drugs can effectively treat non-tuberculous mycobacterial infection after autologous fat injection, and achieve good results.

Objective To validate the value of Cleveland Clinical Score in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 230 adult patients were included.Based on Cleveland Clinical Score,the patients were divided into 3 risk stages:0 to 2 point,3 to 5 point,and 6 to 8 point.The incidence of RRT-AKI were compared between different stages.And the predictive value of the Cleveland Clinical Score model was assessed by area under the receiver operating characteristic curve(AUC-ROC) and the model calibration was assessed using the Hosmer-Lemeshow test.The patients were also divided into two groups:Non-RRT group and RRT-AKI group.The mortality were compared between these two groups.Results The incidence of RRT-AKI was 1.67％ vs the predicted ratio of RRT-AKI 1.70％ (x2 =0.018,P =0.892).Among the stage 1,2,and 3,the actual incidence of RRT-AKI,was 1.23％,2.66％,and 16.7％ vs the predicted incidence 0.40％,1.80％,and 9.50％,respectively.The AUC-ROC for Cleveland Clinical Score predicting RRT-AKI was 0.64 [95 ％ CI(0.57,0.71),P ＜0.01].Compared with Non-RRT group,the RRT-AKI group got a higher mortality(87.00％ vs 1.50％,x2 =1 330,P ＜0.01).Conclusion The Cleveland Clinical score had no real predictive value for RRT-AKI in Chinese adult patients after cardiac valve surgery.The incidence of RRT-AKI of the whole population and the stage 3 patients could be predicted by the model.And the patients with a high Cleveland score got a higher mortality than that of patients with a low Cleveland score.

Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.