Objective To compare the efficacy between the treatment courses of 4 weeks and 8 weeks of lansoprazole in the treatment of endoscopic mucosal stripping ( ESD ) induced iatrogenic gastric ulcer.Methods 84 gastric adenoma or early gastric cancer patients were randomly divided into two groups after lansoprazole(30 mg/day) treatment for 4 weeks and 8 weeks.After 8 weeks of ESD, the efficacy between two groups were compared.Results 69 patients from the total 84 patients were included into the final analysis, 34 patents in 4 week-treatment group and 35 patients in 8 week-treatment group.There was no significant difference between the two groups of the ulcer stage(68% in the scar stage of 4 week-treatment group and 69% in the scar stage of 8 week-treatment group, P=0.93 ).There was no significant difference between the two groups of ulcer reduction radio (0.0081 ±0.015 in 4 week-treatment group and 0.0037 ±0.008 in 8 week-treatment group, P=0.15) 8 weeks after ESD.There was no difference in scar stage and ulcer reduction radio between 4 week-treatment group and 8 week-treatment group of patients with large ulcers ( >30 mm ) . Conclusion For ESD-induced gastric ulcer, there was no significant difference in efficacy of lansoprazole between 4 week-treatment and 8 week-treatment.It may be sufficient for proton pump inhibitors only 4 weeks’ treatment in ESD-induced gastric ulcers.

Objective To explore the clinical efficacy of locking plate in the treatment of postoperative nonunion of limb long bone fracture.Methods We treated 53 patients whose limb long bone fracture failed to unite after operation with locking plate between April 2011 and November 2014.They were 38 men and 15 women,aged from 20 to 69 (average,39.7).There were 18 humeral fractures,5 radioulnar ones,9 femoral ones,and 21 tibial ones.On average,each patient had undergone 1.2 previous operations (from 1 to 2 times),including plating in 29 cases,intramedullary nailing in 15,and external fixation in 9.In the 15 patients whose intramedullary nails were reserved because of slightly loosening only under axial stress,lateral force and rotation,the nonunion was treated with bone autograft + unicortical or full-thickness locking plate.In the other 38 patients whose original implants were removed,the nonunion was treated by re-reaming of the medullary cavity + bone autograft + locking plate internal fixation.Regular radiological follow-ups were conducted for the patients.The functional recovery of upper limbs was evaluated by the Neer system while that of the lower limbs by the Johner-Wruhs system.Results One patient was lost to the follow-up.The rest 52 were followed up for 4 to 15 months (average,12.7 months).Nonunion was found in 2 patients whose internal fixation was broken and loosened.Bone healing was achieved in 50 cases after 4 to 6 months(average,5 months).Removal of implants was conducted in 36 patients at 12 to 24 months after operation (average,13.3 months).At the final follow-ups,the Neer score of upper limb was excellent in 15 cases,good in 5,fair in one and poor in one,giving an excellent to good rate of 90.9％;the Johner-Wruhs score of lower limb was excellent in 24 cases,good in 3,fair in 2 and poor in one,giving an excellent to good rate of 90.0％.Conclusion Locking plate can have good curative efficacy in the treatment of postoperative nonunion of long bone fracture.

Objective To explore the expression of miR-146a and its effect on the biological characteristics in gastric carcinoma. Methods The expressions of miR-146a in gastric cancer tissue and carcinoma adjacent tissue were detected by RT-qPCR , and human gastric cancer cell line MKN-28, SGC-7901, MKN-45 and immortalized gastric epithelial cell GES-1 were cultured,GES-1 as a reference, the expressions of miR-146a in each cell line was detected by RT-qPCR; miR-146a mimics and miR-146a control were transfected into gastric cancer cell line MKN-45, and the expression of miR-146a was detected by RT-qPCR;CCK8 was used to detect the effect of miR-146a on the proliferation of cells;flow cytometry was used to detect the effect of miR-146a on cell apoptosis. Western blot was used to detect the expressions of the apoptosis-related proteins. Results The expression of miR-146a in gastric cancer tissue was significantly lower than carcinoma adjacent tissue(P<0.01); expression of miR-146a in gastric cancer cell MKN-45 was the lowest campared to GES-1, so the gastric cancer cell MKN-45 was selected as a follow-up study. The expression of miR-146a in miR-146a mimics group was significantly higher than control group(P<0.01); CCK8results showed that the proliferation rateof miR-146a mimics group was significantly lower thanmiR-146a control on 24 hour (P<0.05),and was significantly lower than miR-146a control on 48 hour and 72 hour (P<0.01).The results of flow cytometry showed that the apoptosis rate in miR-146a mimics group was significantly higher than miR-146a control;Western blot showed that the expressions of Cleaved-caspase-3 and Bax protein in miR-146a mimics group was significantly lower than those in miR-146a control, and Bcl-2 protein expression was significantly higher than miR-146a control (P< 0.05). Conclusion The expression of miR-146a in gastric carcinoma was lower than carcinoma adjacent tissue, and the miR-146a could inhibit cell proliferation and promote cell apoptosis after transfected.

Objective To explore the mechanism of β-catenin/Akt signaling pathway in the apoptosis of gastric cancer cells induced by selenite sodium.Methods Gastric cancer cell line SGC-7901 was cultured, and 0 mol/L, 5 mol/L, 10 mol/L and 20 mol/L selenite sodium treated cells; flow cytometry was used to detect the cell apoptosis rate after 24 h;10 mol/L sodium selenite treated cells, flow cytometry was used to detect the cell cycle changes after 24 h;10 mol/L sodium selenite treated cells,protein expression ofβ-catenin,cyclin D1 and protein kinase B ( Akt) activity were detected by Western blot after 0,6,12,24 h.Results Cells apoptosis rate was significantly higher than 0 mol/L after cells was treated by 5 mol/L, 10 mol/L and 20 mol/L sodium selenite, due to cells apoptosis rate was higher by 10 mol/L sodium selenite treated than 5 mol/L and 20 mol/L, 10 mol/L sodium selenite treated cells for follow-up study;gastric cancer cells was treated by 10 mol/L sodium selenite for 24 h, compared with the control group, G0/G1 phase cells decreased, cells in S phase and G2/M phase significantly increased(P<0.05);gastric cancer cells was treated by 10 mol/L sodium selenite for 0 h, 6 h, 12 h and 24 h,protein expression of β-catenin and cyclin D1 and Survivin in 6 h, 12 h and 24 h was significantly lower than that in 0 hour (P<0.01),and with the extension of time, protein expression gradually decreased;gastric cancer cells was treated by 10 mol/L sodium selenite could significantly decrease the phosphorylation of p-Akt in 6,12,24 h, while there was no significant difference of Akt among difference time points( P <0.01).Conclusion Sodium selenite could induce apoptosis of gastric cancer cells, and the cells were arrested in S phase.The mechanism may be associated with beta-catenin/Akt signaling pathway.

OBJECTIVE To explore the changes in gene expression in patients with allergic rhinitis(AR). METHODS 14500 gene DNA microarray(Affymetrix) was used to examine the gene expression in 6 AR nasal mucosal samples and 6 normal nasal mucosal samples.The differentially expressed genes were identified and subjected to real time RT-PCR analysis. RESULTS Compared with normal sinus tissues,161 genes were found to be differentially expressed in AR samples.Forty-seven genes were upregulated,114 genes were downregulated.The differentially expressed genes mostly involved in immune transcription regulatory molecules,signal transduction.Real-time RT-PCR results of CCL20,GPK4 were consistent with that of gene chip analysis.CONCLUSION Microarray expression profile of AR samples is differential.GPK4 and CCL20 may play an important role in cell signal transduction in mechanisms of AR.

Objective To explore the clinical efficacy of rectangle advancement flaps used in the reconstruction of skin defects around the Achilles tendon in children.Methods From May 2014 to June 2015,7 children with skin defects around the Achilles tendon were admitted to our trauma center.The areas of skin defect ranged from 3.4 cm × 2.7 cm to 5.5 cm × 4.0 cm.The integrity of Achilles tendon was preserved in 6 cases but the tendon insertion was partly disrupted in one case.The skin defects were reconstructed with self-designed rectangle advancement flaps after debridement.In the one case with the Achilles tendon partly disrupted,the contaminated tendon ends were excised before wound closure.The injured ankles were immobilized in plantar flexion with one 1.5 mm K-wire and plaster splint to decrease the postoperative tension of the flap.Results All the flaps survived completely by primary intention but local infection occurred in 2 wounds which was cured by second intention of dressing change.The follow-up periods ranged from 8 to 12 months (average,11.5 months).The scar around the flap was remarkable in 2 cases,but the flaps in the other cases appeared normal in terms of color and texture.The ankle function was satisfactorily normal in all the cases.Conclusion Our self-designed rectangle advancement flaps provide a simple,safe and reliable way to repair skin defects around the Achilles tendon in children.

Objective To investigate the clinical efficacy of semi-open cancellous bone grafting for infected bone defect combined with soft tissue defect of lower limb.Methods A retrospective case control study was conducted to analyze the clinical data of 26 patients with infected bone defect combined with soft tissue defect of lower limb admitted to the Third Hospital of Hebei Medical University from March 2010 to August 2017.There were 16 males and 10 females,aged 16-65 years [(39.6 ± 12.8)years].The bone defect area before bone grafting was 1.4-6.0 cm [(3.3 ± 1.2) cm].The surface soft tissue defect of bone graft granules was 2.3 cm × 1.1 cm-8.5 cm × 5.0 cm after bone grafting.If the defect was segmental defect of more than 6 cm,the defect was firstly reduced by bone transport.When the defect was near the docking point,the bone defect was repaired by open bone grafting.If the defect was located at the metaphyseal end of the calcaneus or tibia,stage Ⅰ or stage Ⅱ open bone grafting was performed after debridement.After bone grafting,antibiotic-containing cement sheets were used to cover the wound in 14 patients (semi-open group),and vacuum sealing drainage (VSD) devices were used to cover the wound in 12 patients (VSD group).The time of granulation tissue covering bone graft granules,wound healing time,bone defect healing time,material cost and complications (wound infection and necrosis of bone graft granules) were compared between the two groups.The limb function was evaluated according to Paley score.Results All patients were followed up for 12-40 months [(19.3 ±7.2) months].In the semi-open group and VSD group,the time of granulation tissue coverage was 22.2 days (15.0-44.0) days and 20.2 days (15.0-44.0) days (P ＞ 0.05);wound healing time was 3.1 months (1.5-5.5) months and 3.1 months (1.5-6.5) months (P ＞ 0.05);bone defect healing time was (5.5 ± 2.2) months and (5.9 ± 2.4) months (P ＞ 0.05);the cost of covering wound materials was (2 056.1 ± 23.4) yuan and (5 555.3 ± 1 105.5) yuan respectively (P ＜ 0.05).No wound infection occurred in either group.Two patients in the semi-open group and one patient in the VSD group had bone graft granules surface necrosis (P ＞0.05).According to Paley's functional score,the results were excellent in 12 patients and good in two in the semiopen group,compared with excellent in 11 and good in one in the VSD group (P ＞ 0.05).Conclusion For infected bone defect combined with soft tissue defect of lower limb,semi-open bone grafting can simplify the nursing of wound,prevent wound infection,promote wound healing and fracture healing.It has similar therapeutic effect with VSD,but its treatment cost is significantly reduced.

Objective To study the release characteristics of colon-targeted pellets of volatile oil of Radix Angelica Sinensis (Danggui)in rats.Methods Rats were administrated intragastrically with the colon-targeted pellets of the volatile oil of Radix Angelica Sinensis.At different time points,the rats were sacri-ficed and their gastrointestinal tracts were resected,in which the contents were collected.Ligustilide,as the index of volatile oli of Danggui to evaluate the release characteristics of the colon-pellets in digestive tracts,was determined using HPLC.Results The linear range of ligustilide in the digestive tract of rats was 1.268 ~507.2 mg/L.Four hours after administration,ligustilide was detected in cecum and colon. And 20 h later,ligustilide could still be detected.That meant the colon-targeted pellets could maintain the drug release for a long time in colorectal sites of rats.Conclusion The prepared Danggui volatile pellets can be used as the carrier for targeting on colon,which can be used in the study of the chemo-pre-vention of inflammation related to colorectal cancer at the late stage.

Objective To investigate the clinical efficacy of bone filling mesh bag combined with pedicle anchoring for the treatment of Stage Ⅲ reducible Kummell disease.Method The 35 paients with Stage Ⅲ reducible Kummell disease were treated with bone filling mesh bag combined with pedicle anchoring from January 2018 to December 2022.The operation Time,intraoperative blood lose,bone cement injection volume and surgical complications were recorded.The VAS score,ODI value,kyphosis Cobb angle and midline height of the injured vertebral were compared at preoperative,postoperative 1 day and last follow-up.Results All patients were followed up for 12-24 months[(15±3.5)months].Operation time was 35-63 min[(45±5.8)min],intraoperative blood loss was 10-35 ml[(20±5)ml],bone cement injection volume was 4.5-7.8 ml[(5.5±1.8)ml].There were 4 cases of bone cement leakage,there were 1 case of intervertebral leakage,2 cases of lateral leakage,1 case of anterior leakage and no patient with intracanal leakage.All bone cement leakage did not lead to clinical symptoms,bone cement poisoning and pulmonary embolism.No cement mass slip.All patients were followed up for 12 to 24 months[(15±3.5)months].VAS scores and Oswestry Disability Index(ODI)values were significantly lower on the first day after surgery than before surgery,with statistical significance(P＜0.05).The 3-month follow-up was slightly higher than that on the first day after surgery,and the difference was not statistically significant(P＞0.05).The midline height and Cobb Angle of the injured vertebra were measured by imaging.The height of the injured vertebra recovered significantly on the first day after operation,and the Cobb Angle decreased significantly,the difference was statistically significant(P＜0.05).The midline height of the injured vertebrae decreased and the Cobb Angle increased slightly at 3 months after the operation,but the difference was not statistically significant(P＞0.05).Conclusion In the the treatment of Stage Ⅲ reducible Kummell disease,Bone filling mesh bag combined with Pedicle anchoring have good clinical efficacy,which can significantly reduce the pain of patients,relieve clinical symptoms,improve spinal function,improve quality of life,and reduce the incidence of bone cement leakage and slippage.

Objective To optimize the procedure of extracting components from Sophora alopecurcurodies ( Kudouzi) . Methods After external use of the extracts of Kudouzi by four different extraction proce-dures on the footpad inflammation rat model induced by carrageenan, the swelling rate was observed as the therapeutic index. The contents of oxysop hocarpine and oxymatrine of extracts from Kudouzi, as the two chemical indexes, were measured by using HPLC. The extraction procedure was screened by thera-peutic index combined with chemical indexes. Then the parameters of the procedure screened were opti-mized by orthogonal test. Results All the extracts inhibited footpad swelling in rats, and the effect of the ethanol extract was the strongest, and in which the contents of oxysop hocarpine and oxymatrine were the highest. The footpad swelling rate was negatively correlated with the contents of the two chemical in-dexes. The optimized extraction procedure was obtained with 10 times of 80%( V/V) alcohol, 4 hours at 50℃. Conclusion The extraction procedure of Kudouzi was stable and feasible, and the contents of ac-tive components were positively correlated with their effects.