Objective To compare the effects of closed reduction and interlocking intramedullary nail and percutaneous minimally invasive locking compression plate in treatment of tibial fractures.Methods 70 patients with tibial fractures were selected as research subjects,and they were randomly divided into the control group and the observation group according to the digital table,each group in 35cases.The control group was treated with closed reduction and interlocking intramedullary nail,while the observation group was treated with percutaneous minimally invasive locking compression plate.Then,the operation index,postoperative complications,treatment effect after treatment between two groups were compared.Results The operation time,fracture healing time,length of stay in the observation group were less than those in the control group[(70.37±11.06)min vs.(82.13±12.15)min,(3.02±0.61)month vs.(4.21±0.70)month,(13.39±3.02)d vs.(16.26±3.21)d](t=4.234,3.852,7.582,all P<0.05).The incidence rate of complication in the observation group was lower than that in the control group[14.28%(5/35) vs.51.42%(18/35)](χ2=10.943,P<0.05).The excellent rate in the observation group was statistically higher than that in the control group[94.28%(33/35) vs.74.28%(26/35)](χ2=5.285,P<0.05).Conclusion Closed reduction and interlocking intramedullary nail and minimally invasive percutaneous locking compression plate are successful in the treatment of tibial fracture,but interlocking intramedullary nail easily leads to delayed healing,complications and higher rate of surgery two times,while minimally invasive percutaneous locking compression plate can promote healing,curative effect is better.

Objective To investigate the incidence of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in the colorectal laterally spreading tumors (LST) and the risk factors. Methods Data of 51 patients with coloretral LST,treated with ESD from January 2010 to May 2014 at Shengjing hospital affiliated to China Medical University,were reviewed.The incidence of electrocoagulation syndrome was analyzed and logistic regression was used to evaluate risk.Results The incidence of electro-coagulation syndrome was 9.8%(5 /51).The incidence of tumors in the rectal area(7.1%,2 /28)was lower than that of the left half colon (12.5%,1 /8),and the right colon (13.3%,2 /15).Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were LST located in non-rectum area (OR =1.655,P <1.655),lesion size larger than 25 mm (OR =1.028, P <0.05),the operation time longer than 129 min (OR =1.016,P <0.05),age older than 62 year old (OR =0.987,P <0.05).Conclusion For the patients aged over 62 year old,lesion size larger than 25 mm,the operation time longer than 129 min and LST located outside the rectum,the mucous membrane should be separated from the muscularis propria in the ESD procedure to reduce electrocoagulation time as much as possible. In the postoperative period,patients need fasting,fluid replacement support,and prevention of post endoscopic submucosal dissection electrocoagulation syndrome (PEECS).

BACKGROUNDTo culture and proliferate dendritic cells from the peripheral blood of patients with lung cancer, to observe the morphologic and phenotypic characteristics of these cells and to lay a foundation for applying dendritic cells in the biotherapy of lung cancer.

METHODSThe mononuclear cells isolated from peripheral blood of patients with lung cancer were cultured with the supplement of DCGF to generate dendritic cells. Tumor associated antigens were added into dendritic cell culture on the eighth day. The morphologic characteristics of those cells were observed with inverted or electron microscopes and the phenotypic figures were analyzed with FCM.

RESULTSA large number of mature dendritic cells were obtained from the peripheral blood of patients with lung cancer and showed specific morphologic and phenotypic characteristics. The specific antigen expressed as follows: CD80: 81.8%, HLA DR: 98.3%, CD86: 69.8%, CD1a: 19.7%, CD14: 83.1%.

CONCLUSIONSThe mature dendritic cells can be obtained by culturing the peripheral blood of lung cancer patients, which lays the further foundation for clinical biotherapy of tumor.

Objective:To optimize the paper-roasted technology of Aucklandiae Radix. Methods:With methanol-water (65: 35) as the mobile phase, the contents of costunolide and dehydrocostuslactone were determined by HPLC. Senna was used to make diarrhea model in mice, and the sample decoction was administered for the mice by i. g at the dose of 10 g·kg-1 and the diarrhea index was de-termined. The paper-roasted technology of Aucklandiae Radix was optimized by L9 (34 ) orthogonal design taking the contents of cost-unolide and dehydrocostuslactone, and the diarrhea index in mice as the indices with the paper-roasted time, the paper-roasted temper-ature and the layer number as the influencing factors. Results:The variance analysis results show that the layer number and the paper-roasted temperature has the significant impact on the contents of costunolide and dehydrocostuslactone and the diarrhea index in mice. The best paper-roasted technology of Aucklandiae Radix was as follows:a layer of paper was covered by 4mm Aucklandiae Radix and repeated the same operation 5 times, and put them in drying baker at 120℃ for about 2 hours. After the essential oil of Aucklandi-ae Radix permeated on the paper with burnt flavor and dark brown in color, Aucklandiae Radix could be taken out. Conclusion:The optimum paper-roasted technology of Aucklandiae Radix is reasonable and feasible, which can provide reference for the establishment of the quality standard for paper-roasted Aucklandiae Radix pieces and the expanding of the clinical application.

BACKGROUNDTo study the inhibitive effect of LAK cells induced by dendritic cells (DCs) on implanted lung adenocarcinoma in nude mice.

METHODSThe lung adenocarcinoma model was constructed in nude mice using the resected samples of lung cancer patient. The lung cancer cell lysate was obtained by free-zing and thrawing cycles. Peripheral blood mononuclear cells (PBMNC) were obtained from venous blood of the same patient, in which the adherent PBMNC fraction was cultured with DCGF, and the non-adherent PBMNC fraction was cultured with rhIL-2. DCs were pulsed with lung cancer cell lysates. And then mature DCs were incubated with LAK cells and the mixed cells were named DC-LAK cells. DC-LAK cells were injected into lung cancer-bearing nude mice to observe the inhibitive effect.

RESULTSThe lung adenocarcinoma mo-del was successfully constructed. The average tumor weights of DC-LAK, LAK, DC and saline control groups were 0.47, 1.05, 1.30 and 1.58 g respectively, and the inhibitive rates of DC-LAK, LAK and DC were 70.3%, 33.5% and 17.9% respectively. The antitumor activity of DC-LAK cells was significantly stronger than that of LAK cells (P < 0.05).

CONCLUSIONSThe results of in vivo experiment show that the antitumor activity of DC-LAK cells is stronger than that of LAK cells, so DC-LAK cells treatment may be a more efficient approach of lung cancer biological therapy. This experiment may provide a foundation for clinical application of DC vaccine.

Objective To investigate the expression of Focal adhesion kinase (FAK) and p53 in rheumatoid arthritis (RA) Fibroblast Like Synoviocytes and to explore the pathogenesis of RA.This study also studied the effect of FAK and p53 on the proliferation of Fibroblast Like Synoviocytes in RA on order to identify new target for the treatment of RA.Methods Synovial tissue from RA patients were cultured in vitro;FLS were cultured in TNF-α (10 ng/ml) and different density of protease inhibitor (MG-132) (1,5,10,20 μmol/L)for 48 h.Then the level of mRNA of both FAK and p53 in each group was tested by real time polymerase chain reaction (RT-PCR).FLS were cultured with different density of protease inhibitor (MG-132) (1,5,10,20μmol/L) for 24 h,48 h,72 h,96 h then the cell proliferation of each group were tested.ANOVA was used to compare the means between groups.Results ① After TNF-α stimulating,the level of FAK mRNA was higher than the control group [(1.48±0.09 vs(1.03±0.33),F=7.807,P＜0.05).Compared with the control group,the level of p53 mRNA decreased [(0.97:±0.03) vs (1.30±0.39),F=19.933,P＞0.05).② After stimulated with different density of MG-132,the level of p53 mRNA was higher than the control group [(3.12±0.72) vs (1.30±0.39),F=19.933,P＜0.05),and the 5μ mol/L group was the highest of them.Compared with the control group,the level of FAK mRNA decreased [(0.93±0.20) vs (1.03±0.33),F=7.807,P＞0.05).③ After stimulated with different density of MG-132,the proliferation of FLS was slower than the control group (24 h F=16.654,P＜0.05;48 hF=13.652,P＜0.05;72 h F=72.999,P＜0.05;96 h F=51.533,P＜0.05).Conclusion In vitro,after stimulated with TNF-α,the level of mRNA of Focal adhesion kinase is increased,while the level of that decreases after MG-132 stimulation.Focal adhesion kinase is involved in the pathogenesis of rheumatoid arthritis.In vitro,after MG-132 stimulating,the level of mRNA of p53 is increased.p53 inhibits the excessive proliferation of RA synovial fibroblast cells and plays an important role in the pathogenesis of rheumatoid arthritis.

Objective:To investigate the mediating effect of rumination in primiparae on the expectation gap of social support and postpartum depression, so as to provide a reference basis for early detection and intervention in the regulation of meternal postpartum depression.Methods:In this cross-sectional study, questionnaires were administered from November 2021 to March 2022 using the general information questionnaire, the Ruminant Thinking Response Scale, the Postpartum Social Support Scale, and the Edinburgh Postpartum Depression Scale to 266 primiparae at three tertiary level A hospitals, the First Affiliated Hospital of Xi′an Jiaotong University, the Second Affiliated Hospital of Xi′an Jiaotong University, and the Northwest Women′s and Children′s Hospital, for postpartum review, and the relationship between ruminant thinking, social support expectation gap, and postpartum depression was analyzed using correlation analysis, structural equation modeling, and application of Bootsrap method.Results:The social support expectation gap, ruminative thinking, and postpartum depression average scores were (16.74 ± 12.77), (39.43 ± 4.14), (6.77 ± 2.77) points, respectively.There were positive correlations between social support expectation gap and ruminative thinking, postpartum depression, and ruminative thinking and postpartum depression ( r=0.62, 0.75, 0.70, all P<0.01). Primiparae ruminative thinking partially mediated the relationship between social support expectation gap and postpartum depression, with the mediating effect accounting for 22% of the total effect. Conclusions:Social support expectation gap can directly affect the occurrence of postpartum depression, but also indirectly through ruminative thinking, and postpartum depression can be prevented and intervened from the perspective of reducing ruminative thinking in clinical practice.

Objective:To investigate the prevalence and related factors of chronic kidney disease (CKD).Methods:A total of 42 223 subjects who received annual physical examination from January to December 2019 were selected as the research objects, a cross-sectional study was conducted. They were divided into CKD patients and healthy control groups. The basic information of the subjects was collected by questionnaire, including age, sex, marital status, education level, smoking history, drinking history, physical exercise and previous disease history, etc. The height, weight, waist circumference and blood pressure of the subjects were measured through physical examination, and laboratory indicators including fasting blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, blood uric acid, creatinine and urine routine were collected. The influencing factors of CKD were analyzed by logistic regression.Results:A total of 42 223 subjects were included in the study. The prevalence of CKD was 5.62%, with 7.77% in males and 3.39% in females. The prevalence of CKD increased with age. The prevalence of CKD was the highest in ≥80 years old (25.84%), followed by 70-79 years old (13.08%), the prevalence of CKD in males was higher than that in females in all age groups. Most of the detected CKD patients were in the early stage (stage 1-2), and the total prevalence of early CKD was 5.13%, and the total prevalence of stage 3-5 was 0.49%. Multivariate logistic regression analysis showed that age 70-79 years old ( OR: 1.63, 95% CI: 1.17-2.27),≥80 years old ( OR: 0.82, 95% CI: 2.61-5.91), male ( OR: 1.55, 95% CI: 2.61-5.91), high diastolic blood pressure ( OR: 1.014, 95% CI: 1.007-1.021), high fasting blood glucose level ( OR: 1.22, 95% CI: 1.17-1.27), SUA ( OR: 1.001, 95% CI: 1.000-1.002), hypertension ( OR: 1.44, 95% CI: 1.23-1.68), coronary heart disease ( OR: 1.36, 95% CI: 1.10-1.69) and stroke ( OR: 1.63, 95% CI: 1.09-2.43) were independent risk factors for CKD (all P<0.05); Physical activity 15-30 min/day ( OR: 0.81, 95% CI: 0.71-0.93),>60 min/day ( OR: 0.82, 95% CI: 0.70-0.96) was a protective factor for the prevalence of CKD (all P<0.05) Conclusion:The prevalence of CKD in the health check-up population is low, and most of them are in the early stage of the disease. The prevalence of CKD is related to male, old age, physical exercise, elevated diastolic blood pressure, elevated blood glucose, elevated blood uric acid, hypertension, coronary heart disease, and stroke.

Objective To investigate the effects of 11-ethoxyviburtinal of Valeriana jatamansi Jones on the expression of enterochromaffin cells ( EC) and mast cells ( MC) in rats with irritable bowel syndrome ( IBS) . Methods The IBS rat model was induced by chronic unpredictable stress with isolation. Male SD rats were randomly divided into six groups:control group,model group, pinaverium group at the dose of 25 mg/kg,and high-, mid-and low-dose of 11-ethoxyviburtinal group at dose of 1. 2, 0. 6, and 0. 3 mg/kg respectively. The number of 5-HT positive immunoreactive colonic EC was detected by the method of immunohistochemistry and that of colonic MC was measured with toluidine blue staining. Results Compared with control group, the number of 5-HT positive immunoreactive colonic EC and MC increased significantly in model group ( P <0 . 05 ) . The high dose of 11-ethoxyviburtinal could significantly de-crease the number of colonic EC and MC ( P<0 . 05 ) . Conclusion The 11-ethoxyviburtinal of Valeri-ana jatamansi Jones could significantly reduce the number of 5-HT positive immunoreactive 5-HT positive immunoreactive EC and MC in colon tissue of rats with IBS.

Objective:To systematically evaluate the qualitative research on human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients′experience of participating in advance care planning (ACP), so as to provide reference for the application of ACP in HIV/AIDS patients.Methods:Computer searched qualitative studies on HIV/AIDS patients′participation in ACP experience in Web of Science, PubMed, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, Wanfang, VIP, China Biomedical Literature Database. The search time limit was from inception to December 1, 2023, and the research results were integrated using Meta integration method after quality evaluation.Results:A total of 10 articles were included, and 58 research results were extracted, forming 12 new categories, and 4 integrated results were obtained: HIV/AIDS patients′understanding of ACP; attitudes of HIV/AIDS patients towards ACP; the influencing factors of HIV/AIDS patients′participation in ACP; suggestions for implementing ACP for HIV/AIDS patients.Conclusions:Medical staff should promptly identify the needs of HIV/AIDS patients for ACP, help them increase their awareness and acceptance of ACP. At the same time, based on China′s unique cultural background and healthcare system, relevant laws and regulations should be continuously improved to promote the development and improvement of ACP in China.