Objective To investigate the feasibility of endoscopy in diagnosis and treatment of compressed peripheral nerves. Methods An 1.5 cm transverse incision posterior to the margin of pectoralis major along the second rib was made in 2 old and 9 fresh cadaver specimens. The distance from the incision to the insertions of anterior and middle scalene muscle on the first rib was measured at various angles. The structures surrounding the approach was observed and measured to find a safer approach for endoscopic treatment of brachial plexus compression syndrome. Results With the upper limb hyperabducted at 120 degrees, anteriorly tilting at 30 degrees, through an 1.5 cm transverse incision made posteriorly to the margin of pectoralis major and along the second rib, the apparatus was inserted toward the point 6.5 cm laterally apart from the sternoclavicular articulation and 7.8 cm in depth, reaching the insertions of the anterior and middle scalene muscle on the first rib without injury to the nerves and vessels. Conclusion The approach is safe for endoscopic apparatus reaching the insertions of the anterior and middle scalene muscles on the first rib. It also provides a basis for further investigation of cutting anterior and middle scalene muscles through endoscope.

The use of the accessory nerve as a donor is one of the best possibilities for treatment of the brachial plexus in case of paralysis due to root avulsion. In this paper, a brief history of the use of accessory nerve tran sfer for treatment of brachial plexus injury and recent development in the anato my of accessory nerve are introduced. The nerve transfer methods and the effects of the accessory nerve are discussed in particular. The progress in and the dev elopment trend of the accessory nerve transfer methods are also analyzed. It is advisable that the accessory nerve is transferred to restore the suprascapular n erve so as to obtain shoulder abduction. And it is a clinical trend that the dis tal terminal branch of the accessory nerve is used and the function of the upper part of the trapezius muscle is preserved in the transfer. At last, the factors affecting functional outcome in accessory nerve transfer are discussed.

In the long course of traditional Chinese medicine (TCM) development history,generations of physicians in their long-term medical practice,have paid attention to assimilate and apply new technology and new theory,constantly enrich and perfect the medical technologies,methods and theory systems.It is particularly important to promote the innovation of TCM theory and guide the clinical application of TCM through the learning and absorption of advantages from modern technologies and biomedicine to transform as part of TCM,and then,to expatiate with TCM language.It is especially important in the promotion of TCM theory innovation and clinical guidance of TCM practice.This paper overviewed the common points between TCM and modern medicine from the aspects of balance and steady state of organism,zangfu-organ relationship,etiology and pathogenesis,syndrome differentiation methods,compatibility of Chinese herbal medicine and formula,medicinal properties and pharmacology,etc.The feasibility of applying modern medicine in the interpretation of TCM and its development prospects was expatiated.It provided new ideas and new methods in TCM development.

Objective To separate the CD133 + subpopulation in human hepatocellular carcinoma (HCC) and investigate the tumorigenicity.Methods The human liver cancer tissues were subcutaneously transplanted into nude mice to generate xenograft tumors which were then isolated to prepare single cell suspension.The expression of CD133 + subpopulation was further detected using flow cytometry.The CD133 + subpopulations were separated and depurated with magnetic-activated cell sorting system.Immunofluorescence was performed to identify the histological phenotype of CD133 + subpopulation.The in vitro and in vivo clone formation assay and in vivo xenograft formation assay were performed, respectively.Results Flow cytometry analysis revealed that a percentage of (4.1 ± 0.6) ％ CD133 + cells were detected in xenografts.Immunofluorescence studies showed that (86.8 ± 7.5) ％ of the isolated cells were CD133 +.Compared with CD133-population, CD133 + cells showed a higher capability to generate clone sphere in vitro and a higher tumorigenicity in nude mice (P ＜ 0.05).Conclusion The CD133 + subpopulation in human hepatocellular carcinoma had a potent tumorigenicity and was enriched in cancer stem cells.

Objective To analyze the expression of peripheral blood CD13+CD4+CD25hi regulatory T cells (Treg cells) in patients with diffuse large B-cell lymphoma (DLBCL) and its clinical significance. Methods The expression of peripheral blood CD13+CD4+CD25hi Treg cells in 58 newly diagnosed patients with DLBCL and 30 healthy adults was detected by flow cytometry, and the relationship between its expression and the clinical indicators were analyzed statistically. Results The levels of peripheral blood CD13+CD4+CD25hi Treg cells in newly diagnosed DLBCL and healthy adults were different, with statistically significant difference [(36.37 ±11.89) % vs. (9.03 ±2.10) %, t = 7.168, P < 0.001]. The level of peripheral blood CD13+CD4+CD25hi Treg cells was significantly higher in patients with IPI score 3ˉ5 than that in patients with IPI score 0ˉ2[(44.28±10.10)%vs. (21.51±6.23)%, t=ˉ9.347, P=0.03]. The expression of peripheral blood CD13+ CD4+ CD25hi Treg cells in stages Ⅱ, Ⅲ and Ⅳ patients were (19.48 ±1.34) %, (33.98 ±8.03) % and (47.89±8.25) %respectively, and there were significant differences among three groups (F= 38.363, P<0.001). The levels of peripheral blood CD13+CD4+CD25hi Treg cells had no relationship with age, sex or LDH level (all P>0.05). Conclusion The levels of peripheral blood CD13+CD4+CD25hi Treg cells are higher in DLBCL patients, which has a close relationship between the expression of CD13+CD4+CD25hi Treg cells and clinical stage and prognosis.

Objective To investigatethe role of NF-κB played in the process of the cord blood monocytes differentiating into dendritic cells(DCs)induced by astragalus polysaccharide(APS)and to explore the signal transduction pathway involved in this process.Methods Umbilica]cord blood was collected in aseptic conditions.The cord blood monocytes were obtained by density gradient centrifugation and were divided into three groups afterwards.In the control group.cells were cultivated in the RPMI 1640 complete medium.In the APS group.cells were cultivated in the RPMI 1640 complete medium containing 100 mg/L APS.In the PDTC group:cells were treated with 10 μmol/L disulfide carbamate(PDTC).NF-κB inhibitor in 30 min followed by cultivalion in the RPMI 1640 complete medium containing 100 mg/L APS.,The morphological changes were observed during the process of cultivation by the optical microscope and transmission electron microscopy.Cells were collected 12 d later and the cellular immunophenotyping was assayed by FCM.,The activation and migration of NF-κB fluorescence in the cells was examined by the immunoflouresce microscopy.Results (1)Cells in the control group grown up without cluster forformation and were found fusiform and macrophage-like in 12 d.Cells in the APS group grown up in clnstem,and morphological changes were found from the circular shape to a typical dendritic cells-like shape.Cells in the inhibitor group grown up slowly and without cluster formation,and cell morphdogy had no significant change.(2)The expression of DCs-specific antigen CD80,CD83 and CD86 in the APS group was higher than that in the control group and inhibitom group(P<0.01).The expression of those antigen in the control group and PDTC group was similar and had no statistically significance(P>0.05).(3)NF-κB fluorescence in the nuclei was examined by the immunoflourescence microscopy and was much higher in the APS group than that in khe other groups,especially in 72 h with the activation rate of NF-κB (75.20±7.37)%,while(13.20±3.46)% of PDTC group and(8.20 ±1.92)%,respectively(P<0.01).Conclusion Astragalus polysaccharide can induce the differentiation of umbilical cord blood cells into DCs,and NF-κB is the key component of the signal transduction pathway involved in this process.

Objective To investigate the status of the establishment and service of the rehabilitation departments in comprehensive hospitals in China mainland.Methods A questionnaire survey was conducted in 240 comprehensive hospitals with different grades distributed in the capital city of 31 provinces, autonomous regions, and municipality cities in China mainland in a stratified sampling way. The contents investigated are the settings of rehabilitation departments, the performances of the rehabilitation services, the staffing of the rehabilitation workers and the problems faced in rehabilitation. Then, statistical analysis were done between the developed eastern regions and economically less developed middle-western regions, as well as different grades of comprehensive hospitals. Results In total, 216 valid questionnaires were collected (72 tertiary hospitals, 72 secondary hospitals and 72 primary hospitals), and there are no statistically difference between eastern regions and middle-western regions(P=0.61). About 69% of the hospitals surveyed have built up the rehabilitation departments, and there are no statistically difference between different regions (P=0.30). As far as the performance of the rehabilitation services are concerned, 97.2% of them have carried out rehabilitation service, 60% of them can satisfy the demands of the patients, and there are no difference between the different grades and between the eastern and middle-western regions(P>0.05). In addition, 76.4% of them have rehabilitation doctors, 68.4% have physiotherapists(PT), 52.3% have traditional Chinese medicine doctors, 50.5% have occupational therapists(OT), 36.9% have speech therapists(ST), 17.8% have psychologists, and only 2.3% have social workers. The staff status on PT, OT and ST of the hospitals in eastern regions are significantly better than that in middle-western regions(P<0.01), and the staff status on rehabilitation doctors, PT, OT, ST and psychologists in the tertiary hospitals are significantly better than that in the secondary hospitals and primary hospitals(P<0.01). Finally, the first five problems the rehabilitation department faced are following: short of professional workers(63.9%), lack of training areas(51%), lack of modern rehabilitation service management system (50.5%), out-of-date equipments(49.5%) and low fees of rehabilitation treatment(49.1%). Conclusion Many problems exists in the rehabilitation departments of comprehensive hospitals, such as the development of rehabilitation departments, the professional workers, the quality and width of the service, the efficient use of rehabilitation resources, rehabilitation management and profession permission, the relative policies and regulations, personnel training and so on. Therefore, the government should enhance to put the supported policies into practice, and reinforce investment to the comprehensive hospitals, in particular, enhance the support of the comprehensive hospitals in middle-western regions, as well as the primary hospitals and the secondary hospitals, all of which will play a much more efficient role in rehabilitation for the disabled in the comprehensive hospitals.

Objective To investigate the effect of early intervention with mirror therapy on hemiparetie survivors of ischemic stroke.Methods Thirty-six hemiplegic patients within one month after a stroke were randomly divided into a mirror therapy group (MT group,n=18) and a routine rehabilitation control group (RRC group,n=18).The participants in the MT group received MT for 45 min/d,5 d/wk for 3 weeks in addition to conventional stroke rehabilitation.Those in the RRC group received exercise therapy at the same frequency without the mirror protocol.The Fugl-Meyer assessment (FMA),Wolf motor function test (WMFT),functional ambulation category scale (FAC),Brunnstrom stages of motor recovery,and the modified Ashworth scale (MAS) were used to assess changes in the upper limb,gross hand dexterity and lower limb recovery before and right after the interventions,as well as one and two months after the treatment.Results Significant improvement was observed in the limb function of both groups after the treatment.Compared with the RRC group,there was significantly greater improvement observed in the MT group.This was true of the FMA ratings at all time points,the average WMFT scores one and two months after the intervention,the FAC ratings two months after the intervention,and the Brunnstrom stages at both one and two months after the intervention.However,no significant difference between the two groups in terms of the average MAS scores was observed at any time point.Conclusion Early intervention with MT can significantly accelerate the recovery of a paretic upper limb aud improve walking ability after stroke.Such intervention is worthy of promotion and application in clinical practice.

Objective To observe the effect of external recombinant human basic fibroblast growth factor (rh-bFGF) on the skin and muscles.Methods 40 BALB/c mice of 6 weeks were randomly divided into skin and muscle groups.The skin group was randomly divided into group A and group B.The skin group was injected with 100U rh-bFGF and the same dose of saline in the chin.The muscle groups were randomly divided into C,D,E,and F,and the muscle group was injected into the left calf muscle in order of 200,400,800U rh-bFGF and the same dose of normal saline.The materal was taken at week 8.HE staining was used to observe the submental tissue and muscle fiber morphology.Two groups of muscle fibers,collagen and fibrous tissue were detected by trichrome stain.Immunohistochemistry was used to determine the blood vessel density of the chin and gastrocnemius.Results In week 8,10 mice in group A had a mass in the lower jaw,and the gastrocnemius of the groups C and D showed hypertrophy.Group A showed the thickness of epidermis,dermal papillary layer and mucosa,hair follicle and blood vessel quantity,glandular cavity,collagen and fiber content were sigificantly greater than that of group B (P＜0.05).In the groups C,D and E,the gastrocnemius muscle was significantly thicker than that of group F,and the thickening of group D was the most obvious (P＜0.05),and the contents of collagen and fiber in the groups C,D and E were significantly higher than that in group F.Conclusions Subcutaneous injection of rh-bFGF leads to submental skin thickening,vascular hyperplasia,increased diameter of hair follicle and higher collagen and fiber contents;intramuscular injection of it may induce the muscular hypertrophy and vascular proliferation.

Objective:To investigate the expression of B7-H3 in diffuse large B-cell lymphoma (DLBCL) and its prognostic significance.Methods:The paraffin-embedded tumor tissues of 103 patients with newly diagnosed DLBCL in Linyi Central Hospital from May 2013 to May 2019 were detected by using immunohistochemistry. The association of the expression of B7-H3 protein with the clinicopathological features, progression-free survival (PFS) and overall survival (OS) of DLBCL patients was analyzed. Cox proportional hazards model was used to analyze the factors affecting PFS and OS.Results:The positive rate of B7-H3 protein in patients with DLBCL was 68.0% (70/103). There were no statistically significant differences in the positive rate of B7-H3 protein among patients with different gender, age, clinical staging, international prognostic index (IPI) score, treatment effect, B symptoms, pathological type and other clinicopathological characteristics (all P > 0.05). The 5-year PFS and 5-year OS rates were 24% and 32% in all patients, the 5-year PFS rates were 47% and 14% in B7-H3 negative and B7-H3 positive patients, respectively ( P < 0.01); and 5-year OS rates were 50% and 24% in B7-H3 negative and B7-H3 positive patients, respectively ( P < 0.001). Multi-factor Cox regression analysis showed that B7-H3 positive was an adverse affecting factor of PFS ( HR = 2.685, 95% CI 1.503 - 4.789, P = 0.001) and OS ( HR = 2.262, 95% CI 1.248 - 4.098, P = 0.007). Conclusions:The moderate and high expression of B7-H3 may be related to the poor prognosis of DLBCL patients.