Objective To study curative efficacy of aluminum phosphate gel combined with omeprazole in treatment of peptic ulcer and its effects on Gas, TGF-αlevels.Methods 80 patients of peptic ulcer who received therapy from April 2015 to April 2016 in our hospital were selected as research objects.According to random number table, those patients were divided into the observation group and the control group, 49 patients in each group.the control group was treated with omeprazole, while the observation group was treated with aluminum phosphate gel combined on the basis of control group.Then Transforming growth factor, adverse reaction and curative effect were compared.Results After treatment, the serum levels of Gas and TGF-αin both groups were improved (P<0.05); Two weeks after treatment,the level of GAS in the observation group were lower than those in the control group(P<0.05), TGF-αlevel was higher than that in control group(P<0.05); The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05); The total effective rate in the observation group was higher than that in the control group(P<0.05). Conclusion Combined use of aluminum phosphate gel and omeprazole in the treatment of peptic ulcer can effectively improve the patient-related serum markers, improve the quality of ulcer healing, significant efficacy, high safety and low incidence of adverse reactions.

Objective To investigate the correlation of plasma brain natriuretic peptide (BNP) level with serum albumin, serum total bilirubin and thrombin time in patients with liver cirrhosis.Methods RandomLy selected from January 2014 to June 2016 to our hospital diagnosis and hospitalization of 200 cases of cirrhosis patients, according to the standard of Child-Pugh classification provided by Chinese Medical Hepatology Division in 2006, 48 cases were Child A group, 96 cases were Child B group and 56 cases were Child C group.The plasma BNP, serum albumin, serum total bilirubin, prothrombin time and QTc interval of electrocardiogram were analyzed in the clinical data of each group of patients and the correlation between plasma BNP and their correlation.Results The levels of plasma BNP in Child A, B and C groups were higher than those in B group and B group.The correlation between plasma BNP and Child's grade showed a positive correlation, and the results of each group were statistically different (P<0.05).The plasma BNP level was negatively correlated with ALB ( P<0.05 ) .The level of plasma BNP was positively correlated with ALB ( P <0.05 ) .The correlation between plasma BNP and PTIL was correlated with TBIL.The correlation between plasma BNP and TBIL was significantly correlated with TBIL ( P <0.05), The higher the plasma BNP, the regression analysis showed that plasma BNP and TBIL were positively correlated, the difference was statistically significant (P<0.05).The correlation between plasma BNP level and QTc was analyzed.The QTc interval of plasma BNP level was higher than that of the control group ( P<0.01 ) , and the difference was statistically significant ( P <0.01 ) .Conclusion The plasma BNP level in patients with liver function is closely related to ALB, TBIL, PT, QTc interval, and has the value of evaluating and predicting liver function.

Objective To investigate the relationship between killer cell immunoglobulin-like receptors(KIR)and HLA by distribution of KIR gene in leukemia patients and their siblings who have same HLA-A/B/DR typing.Methods KIR genotypes were detected by PCR-SSP on 78 patients and their siblings who have same HLA-A/B/DR typing.Results There were 48.72%in 78 patients who had same KIR genotypes with their siblings while the 44.87%patients had different KIR genotypes with their siblings.There was no difference in frequency between patients and their siblings(P＞0.05).There were no differences in frequency among chronic myelocytic leukemia(CML),non acute lymphoblagtic leukemia(NALL)and acute lymphoblagtie leukemia(ALL)but the frequency of KIR2DS4 in CML was higher than others.Condusion The KIR gene and HLAⅠ antigen are heredity independently and relatively stable.The factor of disease has little effect on KIR gene.

Objective To investigate the clinical effect of atorvastatin calcium on carotid artery plaque in patients with cerebral infarction.Methods From January 2016 to September 2017,100 patients with cerebral infarction in the Second People's Hospital of Yuyao were selected.According to random number table method,the patients were randomly divided into observation group and control group,with 50 cases in each group.The control group was treated by intravenous injection of ginkgo leaf extract and dipyridamole injection.The observation group was treated by intravenous injection of ginkgo leaf extract and dipyridamole injection combined wth atorvastatin calcium therapy.The clinical effects and changes of blood indicators were compared between the two groups.Results Before treatment,the IMT thickness,plaque thickness,blood flow velocity,TG,TC,LDL-C,HDL-C,plasma viscosity,erythrocyte aggregation index,erythrocyte volume,fibrinogen and erythrocyte sedimentation rate (ESR) between the two groups had no statistically significant differences (all P ＞ 0.05).After treatment,the IMT thickness,plaque thickness,blood flow velocity,TG,TC,LDL-C,HDL-C,plasma viscosity,erythrocyte aggregation index and hematocrit,fibrinogen,ESR and total effective rate in the observation group were significantly better than those in the control group,and the differences between the two groups were statistically significant(t =5.012,6.225,8.147,6.225,5.110,6.021,5.002,5.012,6.002,5.102,5.042,6.053,x2 =8.125,all P ＜ 0.05).Conclusion Atorvastatin calcium tablets combined with intravenous injection of ginkgo leaf extract and dipyridamole in the treatment of atherosclerotic cerebral infarction can effectively improve blood rheological parameters and blood lipid parameters,and the treatment effect is better than ginkgo leaf extract and dipyridamole.

Aim To observe the effect of total flavonoid from Mori folium(TFMF) on renal interstitial fibrosis in type 1 diabetic mice and its possible mechanism.Methods Diabetic mice were induced by intraperitoneal injection of streptozotocin(STZ) dissolved in 0.01 mol·L-1 citrate buffer(pH 4.5) at 150 mg·kg-1 body weight after 12 h of food deprivation.Forty model mice were divided randomly into four groups: model group, and low-(0.25 g·kg-1), moderate-(0.5 g·kg-1), high-dose groups(1 g·kg-1) fed with TFMF once daily.In addition, eight normal mice were used as normal group.After 12 weeks, the fasting blood glucose(FBG), serum creatinine(Cr), blood urea nitrogen(BUN) and microalbuminuria(mAlb) were measured.Masson staining, Sirius red staining and collagen type Ⅳ immunohistochemical staining were used to detect the expression of collagen protein in the cortex, while laminin staining to assess the degree of glomerular and renal tubular basement membrane thickening.The protein expressions related to epithelial-mesenchymal transition and PI3K/Akt/mTOR in the renal cortex of mice were detected by Western blot.Results The moderate and high dose of TFMF could significantly decrease the levels of FBG, Cr, BUN and mAlb in diabetic mice, meanwhile decreasing the expression of α-SMA protein by inhibiting the activation of PI3K/Akt/mTOR signaling pathway, which led to the amelioration of the pathological alterations of renal tissue.Conclusions The moderate and high dose of TFMF can reduce the level of renal interstitial fibrosis in type 1 diabetic mice, and its mechanism may be related to the inhibition of activation of PI3K/Akt/mTOR signaling pathway.

Objective To investigate the relation between TMB and the efficiency of PD-1/PD-L1 inhibitors treatment for non-small-cell lung cancer. Methods Studies were searched from PubMed, Embase, Cochrane Library database, Chinese Biomedical Literature Database and Wanfang Database up to March 25, 2020. RevMan 5.3 software and STATA15.0 were used for analysis. Results Twelve literatures were involved, including 1209 patients. TMB significantly improved PFS (HR=0.54, 95%CI: 0.42-0.70, P < 0.001) but reduced the ORR (OR=4.41, 95%CI: 2.54-7.63, P < 0.001) of NSCLC patients treated with PD-1/PD-L1 inhibitors. The subgroup analyses showed that the predictive value of TMB was significant in non-small cell lung cancer treated by PD-1/PD-L1 inhibitors combined with anti-CTLA-4 therapy or chemotherapy. No significant publication bias was observed by the Begg's test and Egger's test. Conclusion High tumor mutation burden may predict the improved PFS of non-small cell lung cancer by PD-1/PD-L1 inhibitors treatment, but its predictive value for OS, ORR and long-term survival need more exploration.

Objective:To explore the clinical effects of partially de-epithelized local flaps in repairing tubercular chest wall defects.Methods:A retrospective observational study was conducted. From April 2010 to February 2021, twelve patients who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the Eighth Medical Center of PLA General Hospital, including 9 males and 3 females with age of (42±18) years. The sizes of tubercular chest wall defects of patients were ranged from 4 cm×3 cm×2 cm to 16 cm×8 cm×5 cm, which were all repaired with partial de-epithelized local flaps. The widths of flaps were equal to the widths of the defects, and the lengths of flaps were 2 cm longer than those of the defects. In one patient, the local flap was too large to close the donor site directly by suturing, so an autologous back free medium thickness skin graft was used for repair. In other patients, the collection areas of local flaps were small, and the donor areas of flaps were directly closed. The duration of operation, intraoperative bleeding, and postoperative drainage volume and indwelling time of drainage tube were observed and recorded. In two weeks after operation, the survival, color, and texture of flaps, the presence of subcutaneous hydrops and skin ulcer, and donor site healing including wound disruption, local infection, hematoma were observed. Chest X-ray, CT scan, or nuclear magnetic resonance imaging was performed in one month after operation to check whether new local hydrops and bone destruction occurred in the chest wall defects and the concomitant tuberculose focus of patients. All patients were followed up for more than 6 months to record whether the surgical incisions of the chest wall defects of the patients were complicated by hypertrophic scar, redness, swelling, and sinus.Results:In surgery, the patient had (104±18) min of operation duration, (119±53) mL of intraoperative bleeding, (134±49) mL of cumulative drainage of drainage tube, and (5.3±1.7) days of drainage tube indwelling time. In two weeks after operation, all the grafted local flaps survived, and the color and texture of flaps were similar to the surrounding normal skin. One patient had fluid leakage from the incision of chest wall defect area with the incision partially dehisced, which healed well after a phase Ⅱ operation; no wound infection, subcutaneous hydrops, or wound rupture occurred in other patients. The incisions of donor sites in all the patients healed well and no wound disruption, local infection, or hematoma occurred. One month after operation, no new bone destruction was observed in the operative region by chest imaging examination. Patients were followed up for 6 to 96 months, with one patient having wound swelling, ulceration, and sinus in the operative area of the chest wall defect in 12 months after surgery, which healed after phase Ⅱ operation; the incisions of chest wall defect wounds in other patients healed well and had no scar, redness and swelling, or sinus.Conclusions:Partially de-epithelized local flap could be used in repairing tubercular chest wall defect wounds, with the advantages of flexible flap design, minimal donor site injury, and good postoperative wound healing.

Objective To investigate ecological isolation between Oncomelania hupensis snail populations in hilly regions and marshland and lake regions in Yuanjiang valley, Changde City, Hunan Province, and to unravel its underlying mechanisms. Methods Taoyuan County, Shimen County, Linli County and Lixian County in Changde City were selected as snail sampling sites in hilly regions, and Lixian County, Jinshi City, West Lake Administration District, Hanshou County and Dingcheng District were selected as snail sampling sites in marshland and lake areas. Cytochrome C oxidase 1 (cox 1) gene was amplified in snail samples and sequenced. The genetic sequences of O. hupensis snails were aligned using the software MEGA 11, and the haplotypes of O. hupensis snails were determined using the software DNASP 5.10.01. The phylogenetic tree was generated using Bayesian inference with the software MrBayes 3.2, and analysis of molecular variance (AMOVA) was performed to analyze the source of genetic divergence and estimate the genetic divergence index (F_ST) among snail populations with the software Arlequin 3.5.2.2. The genetic barrier among 11 O. hupensis snail populations was estimated using the Monmonier algorithm of adegenet toolkit in R package. The settings with “land in winter and water in summer” in the Yuanjian River section were divided into two categories according to the upstream and downstream, and the areas with “land in winter and water in summer” in the upstream and downstream were transformed into raster data, and then loaded into the software Fragstats 4 for analysis of landscape indicators. The trends in changes of digital elevation were extracted from the Yuanjiang River section based on the digital elevation model, and made three-dimensional visualization using the R package. Results The mitochondrial cox 1 gene were amplified in 165 O. hupensis snais from 11 sampling sites and sequenced, and a total of 152 valid gene sequences were obtained, with 46 haplotypes or 9 populations determined. No haplotype was shared in snails between Taoyuan County and Dingcheng District and Hanshou County along the downstream of the Yuanjiang River. The total area of settings with “land in winter and water in summer” was 617.66 hm² in the upsteram of the Yuanjiang River, which consisted of 473 patches, with each patch measuring 1.31 hm², the largest area index of 0.735 2, the landscape division index of 0.999 9, and the landscape shape index of 45.293 7. The total area of settings with “land in winter and water in summer” was 9 956.92 hm² in the downstream of the Yuanjiang River, which consisted of 771 patches, with each patch measuring 12.91 hm², the largest area index of 97.839 9, the landscape division index of 0.042 7, and the landscape shape index of 7.249 6. The area of settings with “land in winter and water in summer” was much larger in the downstream than that in the upstream of the Yuanjiang River, and the stronger landscape connectivity and non-remarkable alteration of riverbed elevation provided suitable habitats for snail breeding. Conclusion The hydrological and environmental characteristics of the upstream of the Yuanjiang River restrain the breeding and spread of O. hupensis, resulting in ecological isolation between Oncomelania hupensis in Taoyuan County and those in the downstream of Yuanjiang River.