Objective To analyze the reasons of CT misdiagnosis of solid-pseudopapillary tumor of pancreas (SPTP), including wrong orientation, mislocation. Methods The literatures on SPTP were discussed. Results Lesions of SPTP could appear at any position of the pancreas. Conclusion The result is very significant for guiding treatment and judging prognosis.

Objective To summarize the nursing experience of 1 case of very low birth weight infant decannulation difficult in PICC. Methods The nursing key points included: full assessment analysis decannulation difficult reason, consult the PICC catheter outpatient health nurses, give magnesium sulfate hydropathic compress, mucopolysaccharide polysulfate cream local besmear outside, sanyrene outside, at the same time give low-molecular-weight heparin calcium injection subcutaneous injection such as anticoagulant active treatment and nursing. Results After 7 days ,the infant left axillary mass dispel, PICC pull out smoothly. Conclusions Decannulation difficult of very low birth weight infant requires full evaluation, multidisciplinary cooperation and specialist consultation, can give targeted personalized nursing safety smooth tube drawing, is worthy of reference for clinic.

Objective To investigate the effect of Goserelin in protection of the ovarian function of pre-menopausal breast cancer patients. Methods Eighty premenopausal patients with breast cancer randomly divided equally into study group and control group. The two groups were compared in terms of the menstrual status and the levels of E2,FSH,LH before and after chemotherapy. Results The menstrual recovery rates of the study group and the control group were 90% and 57.5%,respectively ,with statistically significant difference between them (P = 0.018). In the study group,the serum E2 decreased gradually to the postmenopausal level,and the serum levels of FSH and LH were also significantly decreased during the treatment. While in the control group ,the E2 levels gradually decreased ,but the levels of FSH and LH significantly increased during the chemotherapy. Conclusions Goserelin can effectively prevent the injury of ovarian function caused by chemotherapy.

Objective:To investigate the clinical effect of thoracoscopy combined with puncture-positioned internal fixation of multiple rib fractures accompanied with hemopneumothorax.Methods:A retrospective case-control study was used to analyze the clinical data of 68 patients with multiple rib fractures accompanied with hemopneumothorax admitted to Fujian Provincial Hospital from September 2016 to December 2018, including 49 males and 19 females, aged 25-86 years [(47.3±7.4)years]. There were 55 patients with unilateral lung contusion and laceration, and rest 13 patients with bilateral lung contusion and laceration. A total of 36 patients were treated by thoracoscopy combined with puncture-positioned internal fixation (thoracoscopy group) and 32 patients by open reduction group (open reduction group). The incision length, operation time, intraoperative blood loss, chest tube drainage time, ICU hospitalization time, total hospitalization time, and complications were recorded. Numeric rating scale (NRS) score was assessed at postoperative 1, 2, 3, 7 days. The MOS 36-item short-form health survey (SF-36) was conducted at the latest follow-up.Results:All patients were followed up for 8-34 months [(18.9±4.3)months]. Thoracoscopy group showed incision length of (4.3±1.3)cm, operation time of (66.3±12.1)minutes, intraoperative blood loss of (86.5±23.4)ml, chest tube drainage time of (5.3±1.1) days, ICU hospital stay of (2.3±0.8)days, total hospital stay of (6.8±1.7)days, and total complication rate of 8%, showing significant differences compared to open reduction group [(11.6±2.2)cm, (105.9±19.4)minutes, (191.4±35.6)ml, (8.1±1.6)days, (4.7± 1.4)days, (10.6±2.1)days, 29%] ( P<0.05 or 0.01). In thoracoscopy group, the NRS scores at day 1, 2, 3, and 7 were respective (6.6±1.2)points, (5.9±1.0)points, (4.4±0.9)points and (2.7±0.7)points, significantly lower than those in open reduction group [(7.3±1.2)points, (7.0±1.1)points, (5.7±1.0)points and (3.9±0.8)points] ( P<0.05 or 0.01). The SF-36 score in thoracoscopy group was (86.4±12.1)points, significantly higher than that in open reduction group [(75.6±11.5)points] ( P<0.01). Conclusions:Compared with open reduction and internal fixation, thoracoscopy combined with puncture-positioned internal fixation for multiple rib fractures has the advantages of smaller surgical incision, shorter operation time, less intraoperative bleeding, shorter chest tube drainage time, shorter ICU hospital stay, shorter total hospital stay, and less postoperative complications. The technique can also reduce the postoperative pain and improve the patients' quality of life.

BACKGROUND: The silk fibroin/type II collagen composite scaffold has been prepared by low-temperature bio-3D printing technology in the previous study and the scaffold has good mechanical properties. Studies have shown that mechanical stimulation is beneficial to bone remodeling, and gradient loading strain is beneficial to the activation of osteoblasts and osteoclasts. OBJECTIVE: To co-culture silk fibroin/type II collagen composite scaffolds with chondrocytes under compression loading, to observe the proliferation of cells, and to observe the preliminary repair effect of silk fibroin/type II collagen composite scaffold on cartilage defects. METHODS: The silk fibroin/type II collagen composite scaffold was prepared by low-temperature 3D printing to detect the porosity of the scaffold. The passage 3 mouse chondrocytes ADTC-5 were inoculated on the silk fibroin/type II collagen composite scaffold and cultured under static culture and mechanical load respectively. (1) Static culture: blank scaffold was set as control, and cell proliferation was detected by MTT assay at 1, 3, 5, 7, 10, 14 days of inoculation. (2) Culture under mechanical load: blank scaffold was set as control. At 1 day after inoculation, 0％, 1％, 5％, 10％, 15％, 20％ compressive strains were applied to the cell-scaffold complex, and continued to load for 3 days. Cell proliferation was detected by MTT assay, and the distribution, adhesion and morphology of the cells on the scaffold were observed by scanning electron microscopy and hematoxylin-eosin staining. A cartilage defect of 3.5 mm in diameter was made in the bilateral knee joint of New Zealand rabbits. The silk fibroin/type II collagen composite scaffold was implanted onto the left side, and no material was implanted onto the right side. The repair site was observed at 8 weeks after surgery. RESULTS AND CONCLUSION: (1) The porosity of the scaffold was (89.3±3.26)％, which was conducive to cell attachment. (2) After 5 days of static culture, the chondrocytes proliferated well on the surface of the composite scaffold. Under 0％, 1％, 5％, 10％, 15％, 20％ compressive strains, the cell proliferation on the scaffold first increased and then decreased, wherein the cell proliferation was highest under 10％ compressive strain, and lowest under 20％ compressive strain. (4) Under the scanning electron microscopy, the chondrocytes in the 0％ load group were distributed in the surface of the scaffold with irregularities, the cell morphology was obvious, and the cell protrusions were fully extended. There were few or no chondrocytes on the contact surface of the 10％ load group, and more cells distributed on the lateral and internal surfaces of the first layer, but the cell morphology was flat with obvious protrusions. (5) Hematoxylin-eosin staining showed that the chondrocytes in the 0％ load group were concentrated on the surface of the scaffold, and there were almost no cells in the pores, while the chondrocytes in the 10％ load group were distributed in the scaffold pores. (6) There was still a circular defect model with no scaffold implantation, and no obvious repair appeared; similar hyaline cartilage appeared in the defect after scaffold implantation, but there was no adhesion to the surrounding defected cartilage, and the new hyaline cartilage was independent. Overall, the adsorption, proliferation and growth of chondrocytes on the silk fibroin-type II collagen scaffolds is better when the compressive strain is 10％, and the composite scaffold can be used as a repair material for cartilage defects.

Objective To investigate the expression of IL-17-producing regulatory T cells ( Treg) in patients with systemic lupus erythematosus ( SLE) and to analyze their clinical significance. Methods This study recruited 32 patients with SLE ( including 14 with active SLE and 18 with inactive SLE) and 13 healthy subjects matched for age and sex. Flow cytometry was performed to detect the expression of Foxp3 and IL-17 in CD4 T lymphocytes and the phenotypic characteristics of IL-17-producing Treg. Correlations between these cells and clinical indicators of SLE were analyzed. Peripheral CD4+CD25+ T cells were isola-ted from five healthy subjects and then stimulated with IL-6 and IL-1βalone or in combination. An in vitro T cell polarization assay was performed to investigate the role of cytokines in the polarization and regulation of IL-17-producing Treg. Results Compared with the healthy subjects and patients with inactive SLE, the pa-tients with active SLE had a higher percentage of IL-17-producing Treg in peripheral blood. Moreover, the expression of Foxp3 and CD45RA by IL-17-producing Treg in the active SLE group was down-regulated, while that of IL-2, granzyme B (GramB), programmed cell death protein 1 (PD-1) and glucocorticoid-in-duced tumor necrosis factor receptor ( GITR) was up-regulated. Inflammatory cytokines such as IL-6 and IL-1 could induce Treg to produce IL-17. Conclusions This study suggested that increased inflammatory cytokines might correlate with higher percentages of IL-17-producing Treg in patients with active SLE. These cells were a subset of pathogenic Treg failing to prevent autoimmune.

OBJECTIVE: To explore the mechanism underlying the inhibitory effect of quercetin against testicular oxidative damage induced by a mixture of 3 commonly used phthalates (MPEs) in rats. METHODS: Forty male Sprague-Dawley rats were randomly divided into control group, MPEs exposure group, and MPEs with low-, median- and high-dose quercetin treatment groups. For MPEs exposure, the rats were subjected to intragastric administration of MPEs at the daily dose of 900 mg/kg for 30 consecutive days; Quercetin treatments were administered in the same manner at the daily dose of 10, 30, and 90 mg/kg. After the treatments, serum levels of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testicular malondialdeyhde (MDA), catalase (CAT) and superoxide dismutase (SOD) were detected, and testicular pathologies of the rats were observed with HE staining. The expressions of nuclear factor-E2-related factor 2 (Nrf2), Kelch-like ECH2 associated protein 1 (Keap1) and heme oxygenase 1 (HO-1) in the testis were detected using immunofluorescence assay and Western blotting. RESULTS: Compared with the control group, the rats with MPEs exposure showed significant reductions of the anogenital distance, weight of the testis and epididymis, and the coefficients of the testis and epididymis with lowered serum testosterone, LH and FSH levels (P < 0.05). Testicular histological examination revealed atrophy of the seminiferous tubules, spermatogenic arrest, and hyperplasia of the Leydig cells in MPEs-exposed rats. MPEs exposure also caused significant increments of testicular Nrf2, MDA, SOD, CAT and HO-1 expressions and lowered testicular Keap1 expression (P < 0.05). Treatment with quercetin at the median and high doses significantly ameliorated the pathological changes induced by MPEs exposure (P < 0.05). CONCLUSION Quercetin treatment inhibits MPEs-induced oxidative testicular damage in rats possibly by direct scavenging of free radicals to lower testicular oxidative stress and restore the regulation of the Nrf2 signaling pathway.
Rats ; Male ; Animals ; Testis ; Quercetin/pharmacology* ; Rats, Sprague-Dawley ; NF-E2-Related Factor 2/metabolism* ; Kelch-Like ECH-Associated Protein 1/metabolism* ; Oxidative Stress ; Testosterone/pharmacology* ; Superoxide Dismutase/metabolism* ; Follicle Stimulating Hormone ; Luteinizing Hormone