Objective To detect the expression of stem-cell related factors Nanog and CD44 in spheroid body-form?ing cells of gastric cancer cell line MKN-45. Methods The gastric cancer cell line MKN-45 was used to culture spheroid bodies in non-adherent condition in a serum-free medium supplemented with epidermal growth factor (EGF) and basic fibro?blast growth factor (bFGF). Using Western blot analysis, immunofluorescence staining and quantitative real time polymerase chain reaction(qRT-PCR), the expression levels of stem cell-related genes Nanog and CD44 were studied. Results In this study, we observed that MKN45 cells formed spheroid bodies in non-adherent condition in a serum-free medium, and the levels of Nanog and CD44 mRNA expression in spheroid body-forming cells were 2.34 ± 0.22 and 1.18 ± 0.04,respectively, which were higher than those in parental cells (1.00±0.00 and 1.00±0.05). The levels of Nanog and CD44 protein expression in spheroid body-forming cells were 0.18±0.02 and 0.24±0.04, respectively, which were significantly higher than those in pa?rental cells (0.07±0.02 and 0.18±0.01, P<0.05). Nanog protein was positively stained within the perinuclear and cytoplasm of the spheroid body-forming cells, and CD44 was positively stained mainly in the membrane. Dual staining of Nanog/CD44 indicated that the embryonal protein Nanog was co-localized with CD44 in the spheroid body-forming cells. Conclusion Spheroid body-forming cells developed from human gastric cancer cell line MKN-45 in serum-free medium supplemented with EGF and bFGF show characteristics of cancer stem cell (CSC). The cells co-expressed of CD44 and Nanog maybe a phe?notype of gastric CSCs.

ObjectiveTo analyze the clinical efficacy of open reduction and internal locking system (PHILOS) in management of three- and four-part proximal humeral fractures in the elderly patients.MethodsA retrospective study was performed on 18 elderly patients (age≥80 years) with proximal humeral fractures who were treated surgically from June 2008 to June 2010 and received complete follow-up.The fractures were Neer three- and four-part fractures and managed with PHILOS.Rehabilitation exercise was performed postoperatively and followed up regularly.ResultsThe patients were followed up for average 15.3 months,which showed sound healing of all fractures.Shoulder joint function was assessed by Constant-Murley score that was 55 to 83 points (mean 72.5 points) at 12 months,with an overall excellence rate of 67％.ConclusionOpen reduction and fixation with PHILOS can attain satisfactory clinical outcome for the elderly patients with three- and four-part proximal humeral fractures.

Objective To explore MSCT appearances of lung lacerating injury.Methods The MSCT findings of lung lacerating injury in 31 patients were analyzed retrospective.Results The lung lacerating injury of the 31 cases with 67 lesions in total was found,18 of whom were located on the back side of lung near the pleura,11 of whom had solitary lesion and 20 of whom had multiple ones. The MSCT findings included lung cavity in 9 eases,liquid airbag cavity in 1 7 and lung hematoma in 5 .The pulmonary contusion with different degrees was found in all 3 1 cases.Dynamic observation showed the cavities and hematoma could be transformed into each other.Conclusion MSCT is the best method for diagnosis and observation of lung lacerating injury and helpful for the guide of clinical treatment.

Objective Toinvestigatetheincidenceofchronicrenalobstructiveexternalappendageinvolvementandtheresultsof MSCTdetection.Methods MSCTdataof120patientswithchronicurinarytractobstructionwereretrospectivelyanalyzed.Results Among120patients,75caseswerefoundwiththeextrarenalappendageinjury(62.5%).Theinjuryoftheextrarenalappendageincluded thickeningofrenalcapsule(8.00%),effusionofrenalsubcapsular(14.67%),thickeningofbridgingseptaoftheperinephricspace (100.00%),lamellarshadowoffatlayerintheperirenalspace(36.00%),thickeningofrenalfascia(96.00%),pararenalspaceeffusion (88.00%),thickeningperitoneal(76.00%),pseudocyst(1.33%),lamellarshadowoffatlayerinextraperitoneal(22.67%)andnapes(6.67%), increasedintraperitonealfatdensity(32.00%)andperitonealeffusion(4.00%).Conclusion MSCTcanclearlydemonstrateextentand rangeoftheperinephricspaceandpararenalspaceinvolvementinchronicurinarytractobstruction.CTscanplayanimportantrolein chronicurinarytractobstruction.

This study aimed at analyzing the medication regularity based on differentiation in traditional Chinese medicine (TCM) for losing weight using text mining technique.All the references over losing weight were retrieved in CNKI,Wangfang Database,VIP Database and Pubmed.The drugs from the references were classified in accordance with drug property,drug flavor,channel tropism and drug efficacy.Frequency and constituent ratio of a single drug in TCM prescriptions for losing weight were put into analysis using chi square test and factor analysis to find out the medication regularity.It was found that the properties of TCM drugs in the prescriptions contained both cold and warm,while the flavors of the drugs involved pungent,sweet and light.The channel tropism of the drugs mainly belonged to spleen meridian,liver meridian,stomach meridian and lung meridian.They were mostly tonic,relieving,blood-activating,qi regulating,inhibiting-damp and antipyretic drugs.Through factor analysis we found that the common formula compatibilities were concluded as:cassia seed,lotus leaf,hawthorn,salvia miltiorrhiza,polygonum cuspidatum and radix polygonum multiflorum;capillary artemisia,epimedium herb,stephania tetrandra and ligusticum wallichii;dried tangerine peel,pinellia ternata and poria cocos;plantain seed,pericarpium arecae and selfheal;paeonia lactiflora,angelica sinensis,scutellaria baicalensis and ligusticum wallichii;poria cocos,cassia twig,atractylodes and glycyrrhiza;immature bitter orange and bark of magnolia;radix bupleuri,lycium chinensis and jujube;Chinese yam and coix seed;and astragalus,pueraria lobata and polygonatum.In conclusion,formula compatibility mainly combined syndrome differentiation with disease differentiation for the treatment of obesity in clinic,using the drugs belonging to liver meridian,spleen meridian,stomach meridian and lung meridian with the flavors of sweet,bitterness or pungent and the nature of both warm and cold.

Objective To explore MSCT findings of pulmonary tuberculoma.Methods MSCT data of 62 patients with pulmonary tuberculoma confirmed by clinical and pathological results were analyzed retrospectively.Results Of the 62 patients,64 lesions were detected with single in 60 cases and multiple in 2 cases.The MSCT signs showed as follows:circumscribed round,oval,egg-like or irregular nodules or masses,size ranging from 2-3 cm,cavity in 31 lesions,calcification in 25 lesions,pleural indentation sign in 45 lesions and pleural tail sign in 1 2 lesions.Conclusion The MSCT features of pulmonary tuberculoma are relatively specific such as the multiple patch calcifications within mass,calcification of the whole mass and semilunar cavity on the lateral side of the hilum.The MSCT is a valuable examination for the accurate diagnosis of pulmonary tuberculoma.

Objective:To evaluate the effect of Bushen-Tianjing-Huayu Decoction combined with conventional western medicine in the treatment of type 2 diabetes mellitus with osteoporosis. Methods:A total of 83 patients with type 2 diabetes mellitus and osteoporosis who met the inclusion criteria in the Community Health Service Center of Malu Town from January 2018 to December 2018 were recruited and divided into control group (41 cases) and study group (42 cases), according to the random number table method. The control group was treated with conventional western medicine, and the study group was treated with Bushen- Tianjing-Huayu Decoction based on the control group. Both groups were treated for 3 months. The fasting blood glucose and 2 hPG were detected by Accu-Chek Performa roche glucometer, HbAlc was detected by ion exchange chromatography, IL-6 and NO were detected by ELISA, the bone density of femoral neck, L 2-4 and Wards triangle were measured by dual energy X-ray bone mineral density detector. Results:The total effective rate was 90.5% (38/42) in the study group and 70.7% (29/41) in the control group, and the difference between the two groups was statistically significant ( χ2=5.198, P=0.023). After the treatment, the fasting blood glucose, 2 hPG and HbAlc levels in the study group were significantly lower than those of the control group ( t values were 6.822, 6.133 and 5.768, respectively, all Ps<0.001). After the treatment, the bone density levels of femoral neck (0.92 ± 0.10 g/cm 2vs. 0.78 ± 0.09 g/cm 2, t=6.700), L 2-4 (0.98 ± 0.12 g/cm 2vs. 0.87±0.10 g/cm 2, t=4.531) and Wards triangle (0.69 ± 0.08 g/cm 2vs. 0.61 ± 0.06 g/cm 2, t=5.144) in the study group were significantly higher than those of the control group ( P<0.01). The levels of serum IL-6 and NO were significantly lower than those of the control group ( t values were 23.244 and 13.541, all Ps<0.001). Conclusions:The Bushen-Tianjing-Huayu Decoction combined with conventional western medicine can control the blood glucose level, improve bone density, reduce serum IL-6 and NO levels, and improve clinical efficacy for the patients with type 2 diabetes mellitus and osteoporosis.

Objective:To evaluate the anesthetic efficacy of remiazolam combined with alfentanil in the patients undergoing painless gastroscopy.Methods:A total of 400 patients of both sexes, aged 20-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective painless gastroscopy, were divided into 2 groups ( n=200 each) using the computer-generated random numbers: remimazolam combined with alfentanil group (group RA) and propofol combined with alfentanil group (group PA).All subjects inhaled oxygen and were denitrogenated by deep inhalation.Alfentanil 7 μg/kg and remimazolam 0.2 mg/kg were intravenously injected in group RA, and alfentanil 7 μg/kg and propofol 1.5 mg/kg were intravenously injected in group PA.When body movement occurred during operation, remimazolam 2.5 mg was intravenously injected in group RA, propofol 0.5 mg/kg was intravenously injected in group PA, and anesthesia was defined as failure when there was still body movement after 3 times of additional injection within 15 min.The success of anesthesia, effective time of sedatives, time of gastroscopy, emergence time, perioperative adverse reactions, and satisfaction score of endoscopic surgeons-anesthesiologists-patients were assessed using visual analog scale score. Results:Compared with group PA, the incidence of hypotension (6.2%/14.0%), bradycardia (6.2%/19.0%), respiratory depression (3.1%/8.0%), injection pain (2.1%/30.0%), postoperative nausea (6.3%/25.0%), fatigue (7.8%/14.0%) was significantly decreased, and the incidence of hiccup (8.3%/1.0%) and patient′ s satisfaction score were increased in group RA ( P<0.05).There was no significant difference between the two groups in the success rate of sedation, effective time of sedatives, time of gastroscopic examination, emergence time, satisfaction scores of anesthesiologists-endoscopic surgeons, and incidence of postoperative vomiting, dizziness, and lethargy ( P>0.05). Conclusions:Compared with conventional anesthesia for painless gastroscopy, remiazolam (0.2 mg/kg) combined with alfentanil (7 μg/kg) has a certain optimization effect in anesthesia for gastroscopy.

Objective To analyze the relationship between ferritin, carbohydrate antigen (CA)125, CA153, lactic dehydrogenase (LDH), albumin and progression and prognosis of Sj?gren's syndrome with inter-stitial pneumonitis (pSS-IP). Methods Five hundred and twenty-seven primary pSS patients from 2011 to 2017 were analyzed retro-spectively. According to the lung imaging and clinical features, they were divided into groups. The differences of ferritin, CA125, CA153, LDH and albumin (ALB) levels in each group were analyzed by Mann-Whitney U test. Logistic regression was used to analyze the risk factors of pSS complicated with interstitial pneumonitis. Results ① Among the 527 pSS patients, 206 (39.1％) were diagnosed with IP. Compared with 321 patients without interstitial pneumonitis (pSS-N-IP), ferritin, CA125, CA153 and LDH in pSS-IP were relatively higher [189(116, 380) ng/ml vs 138(75, 258) ng/ml, Z=-3.777, P<0.05;19(12, 36) U/ml vs 12(9, 19) U/ml, Z=-5.974, P<0.05;22(12, 34) U/ml vs 9(6, 14) U/ml, Z=-4.582, P<0.05;206(165, 258) U/L vs 161(139, 195) U/L, Z=-8.770, P<0.05], while albumin was lower [34(31, 37) g/L vs 36(34, 39) g/L, Z=5.210, P<0.05]. ② pSS-IP were divided into pSS-IP progression group (46 cases) and pSS-IP stable group (60 cases) according to their lung imaging characteristics. Compared with pSS-IP stabilization group, pSS-IP progression group had higher ferritin [254(129, 693) ng/ml vs 161(104, 259) ng/ml, Z=-2.437, P<0.05]. ③ Logistic regres-sion analysis showed that there was correlation between ferritin and the progress of pSS-IP (OR=1.002). Conclusion Ferritin, CA125, CA153, LDH, albumin are related to pSS-IP. Ferritin isrelated to the progress of pSS-IP, and is a risk factor for the progress of pSS-IP.

Objective:Based on the degradation of skeletal muscle protein MuRF mediated by pFoxO1 when insulin resistance occurs, this paper explores the content change of skeletal muscle protein and the effect of Jianpi Qinghua formula when insulin resistance occurs.Methods:C57 mice were fed with high-fat food and made as the model of obesity accompanied by insulin resistance. Then they were divided into model group, Jianpi Qinghua formula group and metformin group according to random number table method with 10 mice in each group. Jianpi Qinghua formula group was orally administered with water decoction 20.961 g/kg, and the metformin group was orally administered with metformin suspension 18.498 g/kg, once a day for 12 consecutive weeks. Intraperitoneal Glucose Tolerance Tests (IPGTT) was used after the model was established and intervened respectively. The relative protein content of pFoxO1, FoxO1, MuRF, MyoD and myosin were detected by Western blot method, and the localization of MyoD and myosin was detected by immuno-histochemistry.Results:Compared with the model group, the blood glucose of IPGTT at 0 min, 60 min and 120 min of both Jianpi Qinghua formula group and Metformin group decreased ( P<0.05). Compared with model group, the ratio of pFoxO1/FoxO1 protein expression level (0.27±0.07, 0.24±0.14 vs. 0.05±0.03) of both Jianpi Qinghua formula group and Metformin group increased ( P<0.05), and the relative expression of MuRF protein (1.22±0.42, 1.15±0.32 vs. 3.21±0.35) of both Jianpi Qinghua formula group and Metformin group decreased ( P<0.05). The relative protein expression of MyoD (1.42±0.45 vs. 0.40±0.11) and myosin (0.80±0.11 vs. 0.51±0.08) relative protein expression of Jianpi Qinghua formula group was significantly higher than that of model group ( P<0.05). Immunohistochemical staining showed that MyoD (5.06±1.72 vs.2.28±0.83) and myosin (60.28±7.47 vs. 39.77±3.34) of Jianpi Qinghua formula group significantly increased compared with model group ( P<0.05). Conclusion:Jianpi Qinghua formula could effectively increase the content of skeletal muscle protein, enhancing the phosphorylation of FoxO1 in skeletal muscle and the inhibition of MuRF degradation pathway.