OBJECTIVE To investigate the effect of asiaticoside (AS) on endothelial-to-mesenchymal transition (EndoMT) in hypoxia pulmonary hypertension (HPH). METHODS Male Sprague-Dawley (SD) rats were divided into normoxia control group, hypoxia model group, and AS 25 and 50 mg · kg-1 group. Hypoxia model group and AS group were subjected to intermittent hypoxia exposure. Control group and model group received 1-1.5 mL saline daily, and AS groups were ig administrated with AS 25 and 50 mg·kg-1 for 4 weeks. Human pulmonary artery endothelial cells (HPAECs) were divided into normoxia control group and hypoxia AS groups. Hypoxia groups were cultured with AS 0, 25, 50, 100 and 200 mg·L-1 for 72 h under hypoxic (5%O2, 5%CO2) conditions. Anti-proliferation effect of AS was investigated by CCK-8 assay. Then, HPAECs were divided into normoxia control group, normoxia AS 100 mg · L-1 group, hypoxia model group, and hypoxia AS 100 mg · L-1 group. After five days of culture, migration ability of cells was detected by Transwell test. Expression of CD31 andα-SMA was detected by immunofluorescence and Western blotting in both in vivo and in vitro experiments. RESULTS In both in vivo and in vitro experiments, compared with normoxia control group, expression of CD31 was reduced (P<0.01) andα-smooth muscle actin (α-SMA) was increased (P<0.01) in hypoxia model group in both immunofluorescent analysis and Western blotting. Compared with hypoxia model group, expression of CD31 was increased andα-SMA was decreased (P<0.05, P<0.01) in AS treatment groups. Compared with normoxia control group, proliferation and migration ability of HPAEC were elevated in hypoxia model group (P<0.05). Compared with hypoxia group, AS 100 mg · L-1 depressed proliferation and migration of HPAEC under hypoxia exposure up to 72 h (P<0.05). CONCLUSION EndoMT might be involved in HPH and could be partly inhibited by AS.

Objective To investigate pathological characteristics and differential diagnosis of desmoplastic melanocytic nevus.Methods Four cases of desmoplastic melanocytic nevus were analyzed based on the clinical manifestations and histological,immunohistochemical and fluorescence in situ hybridization (FISH) features.Results Of the 4 cases,2 were male and 2 were female.Their age ranged from 19 to 30 years with the average age being 26.5 years.The skin lesions were located on the extremities in 3 cases,on the vulva in 1 case.Histologically,the lesions were bilaterally symmetrical intradermal nevus.Nevus cells appeared epithelioid and/or fusiform,some were clustered or scattered in the proliferative fibrous tissue.None of lymphocyte aggregation,necrosis or ulceration was observed.Immunohistochemical examination showed positive staining for S100 and Melan A in 3 cases,positive staining for P16 in 2 cases,Ki-67-1abeling index less than 5％ in all the 4 cases,and negative staining for factor XⅢ (FXⅢ) and CD34 in 2 cases.FISH assay showed no copy-number variations in gene loci 6p25 (RREB1),6q23 (MYB),6p11.1-q11.1 (Cep6) and 11q13 (CCND1) in desmoplastic nelanocytic nevus.Conclusion Desmoplastic melanocytic nevus is a kind of histologically unique,benign melanocytic nevus,and immunohistochemical staining for Ki-67,S-100,Melan A and FXmand FISH assay on melanoma can be helpful for the differential diagnosis between cutaneous fibrous histiocytoma and melanoma.

Objective To study the association between leptomeningeal anastomosis (LMA) collateral circulation and cerebral infarction in patients with middle cerebral artery (MCA) M1-segment stenosis by observing the compensatory characteristics of LMA collateral circulation.Methods One hundred and fourteen MCA M1-segment stenosis patients were divided into cerebral infarction group (n=68) and cerebral infarction-free group (n=46).The hemilateral phenomenon of homolateral anterior cerebral artery (ACA) stenosis and posterior cerebral artery stenosis was assessed and its effect on the incidence of cerebral infarction was studied according to its magnetic resonance angiography.Results The ACA score and MCA stenosis severity were significantly different between cerebral infarction group and cerebral infarction-free group (P＜0.05).Multivariate logistic regression analysis showed that low ACA score and MCA M1-segment stenosis were two independent risk factors for cerebral infarction (OR =0.390,95％ CI:0.154-0.987;OR =2.421,95％CI:1.324-4.428,P＜0.01).Conclusion The incidence of cerebral infarction is low in MCA M1-segment stenosis patients with good ACA collateral circulation.

Objective:To investigate the clinical efficacy of Omalizumab in the treatment of moderate-to-severe allergic asthma with allergic comorbidities in children.Methods:The clinical data of 50 children with moderate-to-severe allergic asthma and allergic comorbidities, who were treated with Omalizumab and completed 12-month follow-up in the Department of Pediatrics of Peking University First Hospital from July 2018 to March 2022, were retrospectively analyzed.A comparison was performed on the scale scores of childhood allergic asthma and allergic comorbidities including allergic rhinitis (AR) and chronic spontaneous urticaria (CSU), pulmonary function test indices and fractional exhaled nitric oxide (FeNO) concentration before and after treating with Omalizumab.The data were compared by ANOVA, paired t-test, chi- square test and rank sum test. Results:(1)Improvement of clinical symptoms: after 12 months of Omalizumab treatment, the childhood asthma control test score of 42 children aged ≤11 years increased from (20.98±5.03) points to (26.95±0.22) points ( F=18.189, P<0.001). The asthma control questionnaire 7 score of 50 children decreased from (0.89±0.11) points to (0.10±0.02) points ( F=5.662, P=0.006). The score of visual analogue scale of 47 children with AR decreased from (11.00±1.65) points to (0.2±0.14) points ( F=14.901, P<0.001), and the urticaria control test score of 13 children with CSU decreased from (4.82±0.88) points to (1.87±0.61) points ( F=4.329, P=0.018). (2)Improvement of quality of life: compared with those before treatment, the pediatric asthma quality of life questionnaire score in 50 children increased from (124.50±32.13) points to (159.40±6.21) points ( F=12.052, P<0.001), and global evaluation of asthma treatment effectiveness decreased from (2.23±0.70) points to (1.07±0.26) points ( F=68.865, P<0.001) after Omalizumab treatment for 12 months.(3)Improvement of pulmonary function results: after 12 months of Omalizumab treatment, the number of children with forced expiratory volume in one second/forced vital capacity< 80% decreased from 13 cases (26%) to 1 case (2%), and the values increased from (91.39±12.88)% to (96.96±8.54)%( χ2=11.960; t=2.486, all P<0.05). The peak expiratory flow of predicted value increased from (86.73±16.05)% to (94.01±13.11)% ( t=2.445, P<0.05). The number of children with two indicators among the forced expiratory flow at 50% of forced vital capacity exhaled, forced expiratory flow at 75% of forced vital capacity exhaled and maximal mid-expiratory flow lower than 65% decreased from 31 cases (62%) to 7 cases (14%) ( χ2=24.450, P<0.001). There was no significant difference in FeNO concentration before and after treatment ( P>0.05). Safety of Omalizumab: no obvious adverse reactions were found during treatment and follow-up. Conclusions:Omalizumab can significantly improve the clinical symptoms, small airway function and quality of life of children with allergic asthma and concomitant AR or CSU.It is a potential targeted drug for treating a variety of allergic diseases in children.

Objective:To explore the application value of 3D-slicer software in measuring renal volume parameters of renal transplant donors in evaluating renal function.Methods:The data of 31 renal donors admitted to Beijing Friendship Hospital, Capital Medical University from October 2019 to September 2022 were retrospectively analyzed. Glomerular filtration rate (GFR) were measured by SPECT radioactive dynamic imaging, and renal cortex volume (RCV), renal parenchymal volume (RPV) were measured after 3D reconstruction of urinary enhanced CT based on 3D slicer software. The estimated GFR(eGFR) predicted by creatinine-based GFR estimation equations (C-G equation, modified and simplified MDRD equation) and volume-based GFR estimation equations (Herts equation, Choi equation). Different eGFR were calculated, and the correlation between kidney volume parameters, eGFR equations and measured GFR was analyzed. The deviation, accuracy and consistency between different equations eGFR and measured GFR were analyzed and compared. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. Measurement data with non-normal distribution were represented by M( Q1, Q3), and non-parametric test was used for comparison between groups. Results:The correlation between different eGFR and measured GFR is poor, and the deviation is small, and with good accuracy and consistency. Except for the weak correlation between the Choi equation eGFR and measured GFR ( r=0.382, P=0.034), there was no significant correlation between eGFR by other equations and measured GFR ( P>0.05). Among them, the deviation between the Herts equation-eGFR and measured GFR was the smallest (0.30 mL·min -1·1.73 m -2), with a 10% coincidence rate (61.29%) and a 30% coincidence rate (96.77%), and the best consistency with measured GFR, with a consistency limit of -28.75 to 29.34 mL·min -1·1.73 m -2. Conclusion:Compared with the laboratory index formula method, the Herts equation has better prediction efficiency in estimating GFR, The measurement of renal volume parameters by 3D slicer software has a certain clinical value in evaluating the renal function of renal donors, which is worthy of further application.

This study reports the diagnosis and treatment of 2 children with isolated testicular recurrence (ITR) of acute B lymphoblastic leukemia (B-ALL) treated with CD 19 targeted chimeric antigen receptor T (CD 19 CAR-T) cells in May and December 2019 in the Department of Hematology and Oncology, Children′s Hospital of Soochow University, and explores the efficacy of CD 19 CAR-T cells therapy versus conventional radiotherapy and chemotherapy through literature review.Both cases were diagnosed as B-ALL by the morphologic, immunologic, cytogenetic and molecular biology methods.ITR was diagnosed by testicular biopsy at 60 months and 38 months after initial diagnosis in 2 cases, respectively.After infusion of CD 19 CAR-T cells at 7.0×10 6/kg and 1.5×10 7/kg, respectively for 7-10 days, testicular leukemia cell infiltration disappeared and complete remission was obtained.Among them, case 2 developed cytokine release syndrome and immune effector cell-related neurotoxicity syndrome after treatment, which was improved after drug intervention.It is suggested that CD 19 CAR-T cells are effective in the treatment of ITR in children, which may be an alternative to orchiectomy or local radiotherapy for ITR in children with B-ALL.

Objective:To investigate the application value of three-dimensional image reconstruction technology based on 3D-slicer software in urology.Methods:The data of 36 patients with urinary tract diseases admitted to Beijing Friendship Hospital, Capital Medical University from May 2019 to December 2021 were retrospectively analyzed, including 20 males and 16 females; the median age was 53.50(41.75, 66.25) years. There were 10 relative kidney transplant donors, 12 cases with renal tumors, 6 cases with hydronephrosis and 8 patients with urinary calculi. The CT urography data of 36 cases were reconstructed into three-dimensional image models based on 3D-slicer software, and the morphology of the target tissue was measured.Results:In the urinary system model of 10 relative kidney transplant donors constructed in this study, the type of donor renal artery was single artery in 7 cases and accessory renal artery in 3 cases; In the three-dimensional model of 12 tumor kidneys, 4 tumors were located at the upper part of the kidney (2 near ventral and 2 near dorsal), 5 tumors were located at the middle part of the kidney (2 near ventral and 3 near dorsal), and 3 tumors were located at the lower part of the kidney near ventral. The average maximum diameter of the tumors was (27.3 ± 9.63) mm, and the tumor volume was (15.89 ± 5.93) cm 2. The study also successfully constructed a three-dimensional image model of the urinary system in 6 patients with hydronephrosis and 8 patients with urinary calculi (without hydronephrosis). Three-dimensional model image reconstructed by 3D-slicer software clearly showed the spatial structure of renal parenchyma, blood vessels, renal pelvis, calyces and ureter. The diameter, position and direction of ureters and blood vessels can be observed clearly based on the three-dimensional reconstruction model, and clinicians could also evaluate the location, shape, size and adjacent relationship with surrounding tissues of renal cysts, tumors, stones or other masses. Conclusion:3D-slicer software platform can assist clinicians to reconstruct the three-dimensional model of urinary system, which is worthy of further clinical application.

Objective To observe and compare the concentrations of tryptophan-kynurenine pathway metabolites in serum and urine of adolescents with depression individuals using liquid chromatography-tandem mass spectrometry(LC-MS/MS).Methods The major metabolites in this pathway,such as tryptophan(TRP),kynurenine(KYN),kynurenic acid(KYNA),and 3-hydroxykynurenine(3-HK)were quantitatively analyzed using isotope-labeled internal standards.The separation was achieved using a Shimadzu C18 col-umn with gradient elution of 0.2％aqueous acid and acetonitrile.The detection was performed within 7 minutes using positive ion mode and multiple reaction monitoring(MRM).The parameters,such as linear range and precision were evaluated to assess reliability of the method.Subsequently,this method was applied to detect and compare the results in the samples of serum and urine from 143 adoles-cents with depression and 110 healthy controls.Results Taking TRP as the example,the linear ranges for serum and urine were 0.54 to 107.84 μmol/L and 0.74 to 147.06 μmol/L,respectively.The intra-batch coefficient of variation(CV)was ≤6.3％,the inter-batch CV was ≤3.22％,and the total laboratory CV was ≤6.5％.The results showed the KYNA,KYN and TRP levels were lower in the de-pression group compared to the control group,while 3-HK levels were higher in the depression group with statistical significance(P＜0.01).Apart from TRP,the levels of other metabolites were significantly higher in urine than those in serum,with statistical signifi-cance(P＜0.01).Conclusion Compared to the results of serum,the concentrations of TRP metabolites,including KYN,KYNA and 3-HK were higher than those in urine.The concentrations of TRP-KP metabolites in urine,i.e.,KYN,KYNA and 3-HK were higher than those in serum,and the detection of TRP-KP metabolites in urine may offer a greater advantage because the urine collection process is non-invasive.

Objective:To explore the application value of perioperative nursing information management system based on mobile applications (APP) in Orthopedic Operating Room.Methods:A total of 55 patients who underwent orthopedic surgery from February 2018 to January 2019 were set as the control group adopting routine perioperative nursing information management. A total of 57 patients who underwent orthopedic surgery from February 2019 to January 2020 were set as the observation group carrying out the perioperative nursing information management system based on mobile APP. We compared the waiting time for consecutive operations, operation time, operation safety check implementation rate, Operating Room nursing quality score, incidence of medical disputes and patient satisfaction of two groups of patients.Results:The waiting time for consecutive operations and operation time of patients in the observation group were shorter than those in the control group with statistically significant differences ( P<0.05) . The operation safety check implementation rate before anesthesia, before operation and before leaving the room in the observation group was higher than those in the control group, and the differences were statistically significant ( P<0.05) . There was no statistically significant difference in the incidence of medical disputes and patient satisfaction between the observation group and the control group ( P>0.05) . Conclusions:The application of perioperative nursing information management system based on mobile APP in Orthopedic Operating Room can effectively improve nurses' work efficiency and nursing quality, and ensure patient safety to a certain extent.

Objective:To discuss the application effect of lean management based on time-action method in Operating Room of General Surgery Department.Methods:A total of 106 patients who underwent surgery in General Surgery Department of Jizhong Energy Xingtai Mining Group General Hospital from April 2018 to March 2020 were selected. According to the admission time, 51 patients admitted from April 2019 to March 2020 were set as the observation group, and 55 patients admitted from April 2018 to March 2019 were set as the control group. The control group adopted routine nursing management, while the observation group accepted lean management based on time-action method on this basis. The quality of Operating Room management, operation efficiency, nursing risk events and occurrence of postoperative infection were observed and compared between the two groups.Results:In the observation group, the scores and total scores of item preparation, sterility, cooperation of nursing staff and equipment management after intervention were respectively (17.94±1.58) , (18.15±1.67) , (25.50±1.86) , (26.74±1.93) and (88.45±5.34) , higher than (16.01±1.33) , (15.92±1.28) , (23.11±1.75) , (24.63±1.81) and (79.71±4.86) in the control group, and the differences were statistically significant ( t=6.821, 7.749, 6.816, 5.809, 8.822; P<0.01) . The preoperative preparation time, time of transporting patients and the overtime of nursing staff in the observation group were respectively (26.35±8.12) , (20.26±5.48) , (134.40±19.84) min, which were lower than (38.56±10.27) , (31.05±9.13) and (209.38±25.96) min of the control group, and the differences were statistically significant ( t=6.755, 7.306, 6.816, 16.611; P<0.01) . The incidence of nursing risk in the observation group was 1.96%, which was lower than12.73% in the control group (χ 2=4.396, P=0.036) . The total incidence of postoperative infection in the observation group was 5.88%, which was lower than 20.00% in the control group (χ 2=4.601, P=0.032) . Conclusions:The use of lean management based on the time-action method for Operating Room of General Surgery Department can improve quality of nursing and operation efficiency, reduce postoperative infections and reduce the incidence of nursing risk events.