Objective To investigate the clinical efficacy and safety of 90Sr-90Y applicator combined with topical timolol maleate for infantile superficial hemangiomas.Methods A total of 59 infants with hemangiomas were randomly divided into a study group (n=33; ≤3 months,15 cases;＞3 months,18 cases) and a control group (n=26; ≤3 months,10 cases; ＞3 months,16 cases).The study group was treated with 90Sr-90Y applicator combined with timolol maleate solution (0.5％) and the control group was treated with the same dose of 90Sr-90Y applicator combined with saline.Treatment effectiveness was compared between the two groups,and x2 test was used for statistical analysis.Adverse reaction was observed and recorded.Results The effective rate was 18/18,and the cure rates were 14/15 (≤ 3 months) and 16/18 (＞3 months) in the study group.The effective rates were 8/10 (≤3 months) and 11/16 (＞3 months),and the cure rates were 6/10 (≤3 months) and 9/16 (＞3 months) in the control group.Both the effective rate and cure rate of the study group were significantly higher than those of control group (x2 =22.22 and 30.29,≤3 months; x2 =36.69 and 27.31,＞3 months; all P＜0.01).Significant adverse reaction was not found in both groups.Conclusion 90Sr-90Y applicator combined with 0.5％ solution of topical timolol maleate has a very high effective and cure rate for infantile superficial hemangiomas,without significant adverse reaction observed.

Objective To investigate the clinical value of homocysteine(Hcy) ,coagulation function ,platelet parameters and he-morheology detection in patients with cerebral infarction .Methods 114 patients with cerebral infarction were served as cerebral in-farction group ,while 112 healthy people as control group .Their platelet parameters ,coagulation function ,Hcy and hemorheology were detected .Results Hcy ,Fibrinogen(Fib) and D-dimer(D-D) of patients in cerebral infarction group were higher than those in control group(P<0 .05) ,while the differences of prothrombin time(PT) ,activated partial thromboplastin time(APTT) and throm-bin time(TT) between the two groups showed no statistically significant (P> 0 .05) .In cerebral infarction group ,platelet count (PLT) of patients was lower ,and platelet distribution width(PDW) and mean platelet volume(MPV) were higher than those in the control group(P<0 .05) while plateletcrit(PCT) showed no statistically significant difference between the two groups (P<0 .05) . Whole blood viscosity ,plasma viscosity and hematocrit of patients in the cerebral infarction group were higher than those in the con-trol group(P< 0 .05) .Conclusion Hcy ,coagulation function ,platelet parameters and hemorheology detection have important significance for prediction and early diagnosis and treatment of cerebral infarction .

BACKGROUND:Common therapies for damage to the central tendon of finger extensor tendon include Matev, Carrol, Fowler methods as wel as residual central tendon flipping repair, but the therapeutic effects are no satisfied with bloated appearance, tendon adhesions, limited joint function. OBJECTIVE:To investigate the clinical effects of dorsal longitudinal driling and segmental tendon graft to repair old central tendon injury. METHODS:Eighty patients with old central tendon injury were randomized into treatment group and control group, with 40 cases in each group. In the treatment group, dorsal longitudinal driling and segmental tendon transplantation were given; while in the control group, Carrol, Matev, Fowler methods were chosen according to the individual conditions. Then, the therapeutic outcomes were compared between two groups. RESULTS AND CONCLUSION:The excelent and good rate was 85% in the treatment group and 65% in the control group, and there was a significant difference between the two groups (P < 0.05). Results from Valpar Component Work Samples showed that the number of cases adapting to the original work was 30 cases (75%) in the treatment group and 16 (40%) in the control group, and there was also a significant difference between the two groups (P < 0.05). The degree of proximal interphalangeal joint flexion was increased gradualy in the two groups at admission, at 15 days after hospitalization, at 1 day before discharge and at 4 months after discharge, and meanwhile, the degree of proximal interphalangeal joint dorsiflexion was reduced gradualy (P < 0.05). There were significant differences in the degree of proximal interphalangeal joint flexion and degree of proximal interphalangeal joint dorsiflexion between the two groups at 15 days after hospitalization, 1 day before discharge, and 4 months after discharge (P < 0.05). These findings indicate that the dorsal longitudinal driling and segmental tendon graft for repair of old central tendon injury can play an effective role in the recovery of articular flexion and extension function.

Objective To study the inhibition effects of oncostatin M (OSM) gene on human breast cancer cell line(michigan cancer foundation-7,MCF-7).Methods MCF-7 cells were infected with the optimized dose of retrovirus expressing OSM.Expression of the target gene was determined by reverse transcriptionpolymerase chain reaction(RT-PCR) and enzyme-linked immunosorbent assay(ELISA).Methyl thiazolyl tetrazolium (MTT) assay was employed to examine growth inhibition effect of OSM gene on MCF-7 cells.Cell apoptosis was determined by flow cytometry.The morphologic changes of nucleus was detected by Hochest staining,in addition,the expression of apoptosis related genes in tumor cells were further detected by RT-PCR.Results OSM gene was well expressed in human breast cancer MCF-7 cell by retrovial vetor and it could significantly inhibit the growth of MCF-7 cell(MTT,P =0.0162,P ＜ 0.05) and induce its apoptosis (Annexin V/PI,P =0.02,P ＜ 0.05).Conclusion OSM gene has significant inhibitory effects on MCF-7 cells,which mechanism might be related to the upregulation of Bax and Caspase3 and the downregulation of Bcl-2.

AIM To investigate the effect of tamoxifen on the proliferation of the anterior pituitary cell of rats and its mechanism. METHODS Primary culture of the anterior pituitary cell of rats and 3H TdR incorporation method were applied. The changes of cell morphology were observed directly by electric microscope. RESULTS Tamoxifen could inhibit the proliferation of the anterior pituitary cell of rats. The inhibitory effect of tamoxifen (0 1 ?mol?L -1 ) could be reversed by estrogen.The classical apoptotic changes appeared in the cells after tamoxifen incubation for 48 h. CONCLUSION Tamoxifen can inhibit the proliferation of the anterior pituitary cell of rats and resultin the cell apoptosis.

AIM:To investigate the expression of C/EBP homologous protein (CHOP) and its correlation with proliferative/apoptotic ratio (PAR) in colorectal adenoma-carcinoma sequence under the same genetic background .ME-THODS:Four kinds of tissue samples under the same genetic background from 23 patients, including normal colorectal tissue, adenoma with low-grade intraepithelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma samples , were collected .TUNEL method and Ki-67 immunohistochemistry were applied to determine the PAR.The expression of CHOP was detected by immunohistochemistry SABC method .RESULTS: ( 1 ) Under the same genetic background , the level of CHOP expression is significantly higher in colorectal adenocarcinoma than that in the ade -noma with high-grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal muco-sa.The level of CHOP expression was significantly higher in the adenoma with high -grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .The level of CHOP expression was signifi-cantly higher in the adenoma with low-grade intraepithelial neoplasia than that in normal mucosa .(2) Under the same ge-netic background , PAR was significantly higher in the colorectal adenocarcinoma than that in the adenoma with high -grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significant-ly higher in the adenoma with high-grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significantly higher in the adenoma with low-grade intraepithelial neoplasia than that in the normal mucosa.(3) CHOP levels were positively correlated with PAR in the adenoma with low-grade intraepi-thelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma .CONCLUSION:CHOP expression and PAR continuously increased and positively correlated along the adenoma -carcinoma sequence , indica-ting that endoplasmic reticulum stress mediates the carcinogenesis of colorectal adenomas .

Objective To investigate the potential effect of glucagon-like peptide-1 (GLP-1) analogue exendin-4 (Ex-4) on immune function of T lymphocytes via neuroendocrine modulation mechanism in mice following severe burns.Methods Male BALB/C mice were randomly (ramdam number) divided into thermal injury group (n =50) and sham-thermal group (n =30).The thermal injury model was made by exposing the back skin of 15％ total body surface area (TBSA) to 95 ℃ water for 7 seconds,while in sham-thermal model the mice were immersed in 37 ℃ water instead.The expression of GLP-1 receptor (GLP-1 R) was determined in sorted CM + T cells from normal mice by immunofluorescence method.In ex vivo experiment,the mice were sacrificed at 24 h post-bum,then the mononuclear cells (MNC) from spleen were separated from both groups and cultured in RMPI 1640 with 10％ FCS (fetal calf serum) in presence of ConA (concanavalin A,5 μg/mL).Cells were pretreated with catecholamine receptor antagonist propranolol (prop) for 1 hour,followed by consecutive dose of Ex-4 for another 48 h.In in vivo experiment,prop (30 mg/kg) was i.p.injected 30 minutes before thermal injury,then Ex-4 (2.4 nmol/kg) was injected i.p.immediately after scalding.Mice were sacrificed at 6 h and 24 h after thermal injury,then the serum and the spleens were collected.Results GLP-1R was expressed on splenic CD4 + T cells from normal micc.Ex-4 exerted no marked effect on the functions of T cells in terms of proliferation and IL-2 secretion at all doses examined ex vivo,which was not affected by pretreatment with prop.In vivo,T cell functions were suppressed by Ex-4 in thermal mice (P ＜ 0.05),but was restored by pretreatment with prop.Regardless of ex vivo or in vivo,Ex-4 could induce T cells switched to Th2 response (P ＜ 0.05).Moreover,the Th2 switch by Ex-4 was greatly potentiated by prop intervention in thermal mice in vivo other than ex vivo.Norepinephrine level was increased and epinephrine was decreased by Ex-4 in thermal mice.Both norepinephrine and epinephrine levels were obviously enhanced by pretreatment with prop.Conclusions Ex-4 can inhibit the proliferation and IL-2 secretion of splenic T lymphocytes through the sympathetic nervous system,however,it might induce Th2 switch from Th cells by acting directly on GLP-1R.

Objective:To check the effect of immunosuppressants as adjuvants for DNA vaccine to prevent autoimmune disease.Methotis:Three immunosuppressants,Cyclosporin A(CsA),Tacrolimus(FK506)and Mycophenolate Mofetil(MMF)Were combined with DNA vaccine of Multiple Sclerosis(MS)and injected intramuscuarly.The splenocytes of immunized mice were checked for regulatory T cells(Treg),T cell proliferation and maturation of dendritic cells(Dcs)as well as release of intereleukin 10(IL-10).The immunized mice were induced as EAE animal model to check the preventive effect of FK506 as adjuvant.Results:More Treg cells Were induced in the mice immunized with FK506 and DNA vaccine and also T cell proliferation Was suppressed.DCs maturation Was blocked and high level of IL-10 in DCs Was induced in mice treated with FK506 and DNA vaccine.The clinic scores of EAE were significantly decreased in mice treated with FK506 and DNA vaccine compared with other control groups.Conclusion:FK506 as adjuvant of DNA vaccine can stimulate Treg cells and immune tolerance,then prevent from the autoimmune disease.

Objective:To investigate the status of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) in emergency department.Methods:Participants of a national emergency conference from August 1st to August 4th in 2019 from hospitals of different levels in different regions were interviewed by online questionnaire to collect data about the current status and limitations of the application of RCA in emergency CRRT by convenient sampling.Results:Totally 407 questionnaires were collected through internet, and the completeness of the answers was as high as 100%. Twenty-three responses with logic errors were excluded, and 384 questionnaires were finally retrieved, with an effective rate of 94.35%. Representatives from 29 provinces, autonomous regions and municipalities directly under the Central Government participated in the questionnaire survey, and the hospitals in which they worked were mainly class Ⅲ grade A [70.31% (270/384)]. The survey showed that 61.46% (236/384) of the emergency departments could carry out CRRT independently. There were less than 10 CRRT cases per month in most emergency departments [52.87% (166/314)]. In the emergency departments where CRRT were carried out, heparin was a widely used and well-applied anticoagulant [82.17% (258/314)], and 199 emergency departments (63.38%) were proficient in RCA. In clinical practice, heparin [49.68% (156/314)] was preferred to RCA [25.80% (81/314)] and low molecular weight heparin [23.56% (74/384)]. In the emergency departments where RCA could be used skillfully, 4% sodium citrate was the main regional anticoagulant [68.34% (136/199)]. Anticoagulation protocol came from different sources, most of which were from nephrology or dialysis center (29.65%). Most departments could adjust the ionized calcium before the filter to the target safety level [0.9-1.2 mmol/L, 88.94% (177/199)], and adjust the ionized calcium after the filter to the target ideal anticoagulation level [0.2-0.4 mmol/L, 93.47% (186/199)] within 4 hours. The common complications that emergency physicians concerned were accumulation of citrate [58.29% (116/199)], metabolic alkalosis [54.77% (109/199)] and metabolic acidosis [37.19% (74/199)]. In 281 emergency departments that could not use RCA, there were kinds of factors that limited the use of citrate, such as higher cost than heparin (31.67%), unskilled personnel (21.00%), limited source of citrate (17.08%), concerns of complications (11.74%). At present, the substitution fluids used in clinical practice were mainly the commercial products (45.54%). In most cases, emergency CRRT filters had a life span of 12-23 hours (39.49%).Conclusions:The use of RCA in domestic emergency CRRT is low. Compared with the international peers, we are still lacking of adequate understanding of RCA. Therefore, it is necessary to develop an anticoagulation protocol of RCA for emergency departments in China, and promote training of CRRT.

Objective:To analyze the influencing factors of the medical insurance balance of hospitalization expenses for gastric cancer surgery patients under DRG payment, for reference for promoting the reform of DRG payment in public hospitals and controlling hospitalization expenses reasonably.Methods:The gastric cancer patients enrolled in the gastroenterology department of a tertiary comprehensive hospital from January to July 2022 were selected as the research subjects. The indicators such as patient age, medical insurance balance, hospitalization expenses and their composition were extracted from the hospital information management system and the medical insurance settlement system a certain city. Descriptive analysis was conducted for all data, and stepwise multiple linear regression was used to analyze the influencing factors of patients′ medical insurance balance. Monte Carlo simulation method was used to simulate different combination scenarios of various influencing factors to analyze the probability of medical insurance balance.Results:A total of 205 patients were contained, including 117 in the medical insurance balance group and 88 in the loss group. The difference in hospitalization expenses and medical insurance balance between the two groups of patients were statistically significant ( P<0.05). The intervention of medical insurance specialists, correct DRG enrollment, parenteral nutrition preparation costs, anti infective drug costs, examination costs, and consumables costs were the influencing factors of patient medical insurance balance ( P<0.05). Through Monte Carlo simulation verification, patients with different cost parenteral nutrition preparations, or different anti infective drug schemes had the higher probability of medical insurance balance in the scenario where the medical insurance commissioner intervenes and the DRG enrollment was correct. Conclusions:The hospital adopted interventions from medical insurance specialists to ensure the correct DRG enrollment of patients, accurate use of parenteral nutrition and anti infective drugs, and reasonable control the cost of examinations and consumables, which could increase the probability of medical insurance balance for gastric cancer surgery patients. In the future, hospitals should further promote the procurement of drug consumables in bulk, reduce unnecessary examinations, develop standardized perioperative nutritional interventions and anti infection treatment pathways, ensure the accuracy of DRG enrollment, optimize clinical diagnosis and treatment pathways to improve the efficiency of medical insurance fund utilization and provide high-quality medical services for patients.