Liver sinusoid endothelial cells are the first defense mechanism that protects the liver against various injuries,and they also play a significant role in the development of liver fibrosis and liver cirrhosis caused by chronic liver injury.They are involved in liver fibrosis by mediating liver inflammation,participating in sinusoid capillarization and revascularization,activating hepatic stellate cells,secreting many proinflammatory cytokines,participating in extracellular matrix formation,and mediating liver microcirculation disturbance.Clarification of these mechanisms helps to identify new targets and develop new regimens for the treatment of liver fibrosis.

Objective To explore the different doses of dexmedetomidine for prevention of shivering in cesarean section effect in patients with spinal and epidural anesthesia, summarize the clinical experience.MethodsIn 40 cases of spinal epidural anesthesia in cesarean section with large doses of dexmedetomidine for intervention, and classified into control group, according to the in the other 40 patients using small doses of dexmedetomidine for intervention, and classified as the observation group, then observe two groups of patients with chills were compared, the patients were in our hospital from February 2016 to January 2017 were found.ResultsWith comparison of two groups of patients with chills, two group in the overall number of cases no significant difference.The observation group, a total of 9 cases of patients with chills, the control group had 10 cases of chills, while no significant difference between the two groups of shivering grade;the patients in the observation group of 2 cases (5%) had adverse reaction, the control group had 9 (22.5%) cases of adverse reactions,P<0.05 between the two groups showed significant differences.ConclusionDifferent doses of dexmedetomidine on preventing shivering effect analysis of cesarean section in patients with spinal and epidural anesthesia after the discovery, which can play the effect of the intervention in patients with chills, and can reduce the incidence of adverse reactions in patients after surgery, it is worthy of reference.

Abstract: Objective　To collect extensively drug-resistant tuberculosis (XDR-TB) Mycobacterium tuberculosis strains isolated from Xi'an City between 2019 and 2020, and analyze the drug resistance patterns of XDR-TB strains to second-line anti-tuberculosis drugs and the occurrence of new defined extensively drug-resistant tuberculosis in Xi'an, in order to provide evidence for guiding clinical drug use of multidrug-resistant tuberculosis (MDR-TB) patients. Methods A total of 3 088 strains of Mycobacterium tuberculosis that underwent phenotypic drug susceptibility testing at Xi'an Chest Hospital from January 2019 to December 2020 were retrospectively selected to analyze the resistance of anti-tuberculosis drug. Among the stored MDR-TB strains, 114 strains of preserved multidrug-resistant Mycobacterium tuberculosis were randomly selected for bedaquiline and linezolid susceptibility testing. Combined with the results of previous second-line drug susceptibility testing, the incidence of newly defined extensive drug resistance was analyzed. Results Among the 3 088 Mycobacterium tuberculosis strains analyzed, 411 strains (14.3%) showed resistance to isoniazid, 347 strains (11.2%) showed resistance to rifampicin, 142 strains (4.6%) showed resistance to ethambutol, 550 strains (17.8%) showed resistance to streptomycin, and 237 strains (7.6%) exhibited multidrug resistance. Of 237 MDR-TB strains, the resistance rates of ethambutol, moxifloxacin, rifampicin, sodium para-aminosalicylate, prothioconazole, capreomycin, amikacin, and clofazimine were 44.3%, 26.6%, 33.3%, 24.1%, 5.1%, 4.2%, 3.0%, and 2.5%, respectively. Among the randomly selected 114 MDR-TB strains, none showed resistance to bedaquiline, three showed resistance to linezolid, and one strain met the new definition for extensively drug-resistant tuberculosis. Conclusion In Xi'an City, high rates of resistance among MDR-TB strains are observed for ethambutol, quinolone and sodium para-aminosalicylate, and the drug susceptibility tests should be obtained as much as possible when using these drugs. The incidence of new definition extensively drug-resistant tuberculosis is low, and bedaquiline and linezolid remain effective drugs for the treatment of multidrug-resistant tuberculosis even without drug susceptibility testing results.

Objective To summarize the nursing cooperation during anterior cruciate ligament(ACL)reconstruction with autogenous quadurpled hamstring tendons under arthroscopic guide.Method Data of 25 cases of ACL reconstruction with autogenous quadrupled hamstring tendons under arthroscopic guide during January 2008 and December 2012 were analyzed and summarized the key points retrospectively.Result All the cases of ACL reconstruction were completed smoothly without any complication.Conclusion Excellent nursing cooperation including well-done preoperative preparation of instruments and accurate surgical cooperation are a guarantee of successful operation.

Aims The purpose of this study is to investigate thediagnostic value of SWEfor fibrosis in patients with CHBand the factorsinfluencing the accuracy. Methods From July 2013 to October 2015, 261 patients with CHB were recruited from the First Affiliated Hospital of Sun Yat-sen University.All patients received SWE, anthropometry measurement, blood cell count, liver function test and virological indicators measurement. Liver fibrosis was staged from F0 to F4 by METAVIR scorebased onliver biopsy results of 133 CHB patients , while 128 patients were diagnosed as decompensated cirrhosis. Diagnostic accuracyof SWE were evaluated by Receiver Operating Characteristic Curve (ROC) using liver hepatic pathology and decompensated cirrhosis as gold standards. Logistic model was used to find out confounding factors that influence the accuracy of SWE. Results The Area Under ROC (AUC) for liver stiffness measurement with SWE were 0.891, 0.932 and 0.910 for the diagnosis of significant fibrosis (≥ F2), advanced fibrosis (≥F3) and cirrhosis (F4), respectively. A multifactor logistic regression combined modelwas built and showed that hepatic steatosis will decrease the accuracy of SWE. Conclusion SWE could be a valuable method for the noninvasive liver fibrosis assessment. The accuracy of SWE may be influenced by hepatic steatosis.

BACKGROUND:Leukemia cells can obtain drug resistance phenotype mediated by adhesion to bone marrow stromal cells. But, for chronic myelogenous leukemia with adhesion functional defects, the role and mechanism of bone marrow stromal cells in imatinib-resistant formation remain unclear. OBJECTIVE:To construct the co-cultured model of bone marrow stromal cells-K562 cells and to investigate the influences of the co-culture with bone marrow stromal cells from the patients with chronic myelogenous leukemia on imatinib sensitivity of K562 cells and cellcycle. METHODS:The co-culture model was constructed by co-culturing K562 cells with bone marrow stromal cells isolated and cultured from the patients with chronic myelogenous leukemia. The IC50 values of K562 cells exposed to imatinib were quantified by MTT assay. The apoptotic rates of K562 cells exposed to 0.5μmol/L imatinib for 72 hours were detected by flow cytometry through Annexin V-FIT/PI labeling. The cellcycles, cellcycle protein (cyclin A, cyclin D1 and cyclin E) expression of K562 cells co-cultured with bone marrow stromal cells for 72 hours were analyzed by flow cytometry.RESULTS AND CONCLUSION:The IC50 values of co-culture group and suspension culture group were respectively (0.52±0.02)μmol/L and (1.27±0.05)μmol/L, and their comparison showed significant differences (P<0.01). After 72 hours of treatment with 0.5μmol/L imatinib, the apoptotic rates in the co-culture group and suspension culture group were respectively (15.48±4.17)%and (32.01±6.83)%, and their comparison showed significant differences (P<0.01). The percentages of G0-G1 phase of K562 cells co-cultured with bone marrow stromal cells for 72 hours were (48.81±8.27)%, which were significantly higher than the suspension culture group (25.78±3.26%) (P<0.01). The co-culture with bone marrow stromal cells from the patients with chronic myelogenous leukemia could mediate K562 cells resistance to imatinib. The mechanism was possibly related with G0/G1 arrest of K562 cells induced by co-culture with bone marrow stromal cells.

Objective To determine the expression of interleukin-21 (IL-21) in patients infected with hepatitis B virus (HBV) and its association with HBV-DNA and ALT. Methods Clinical dates and blood specimen were collected from 25 unrelated healthy controls (HC) and 101 independent chronic HBV infected patients, including 25 patients in immune tolerant phase (IT), 25 in immune clearance phase (IC), 26 patients in inactive HBV carrier state (IA) and 25 patients in immune reactive phase (IR). Serum IL-21 levels were measured by Cytometric Bead Array (CBA). IL-21 mRNA and IL-21 receptor mRNA were measured by real-time PCR. Results Chronic HBV-infected patients had higher levels of serum IL-21 and IL-21 mRNA , with P <0.001 for both. In subgroup analysis, both serum IL-21 and IL-21 mRNA levels in IC, IR were higher than those in IT, IA and HC (all P < 0.001). Serum IL-21 level in IA was higher than that in HC and IT (P <0.001, P = 0.036). IL-21R mRNA levels were different between groups. Serum IL-21 level was associated with HBV-DNA (r = -0.472, P < 0.001), but not with ALT. Conclusion IL-21, up-regulated in chronic HBV infection, is associated with immune activity and may play a key role in HBV control.

Objective To investigate the first human brucellosis outbreak in Fujian Province,aiming to identify the source,risk factors of infection,and recommend control measures.Methods Epidemiological investigation was conducted by combining with agricultural sector on human and animal in the incident area of Zhangzhou City of Fujian Province.Respondents included 17 professionals from the outbreak sheep farm,as well as 9 ones from four nearest farms (including 2 pig farms,1 sheep farm and 1 cow farm) in directions of eastern,southern,western and northern.Then information of cognitive level and daily protection on brucellosis among pasture breeding staffs through case studies were got,serum of pasture breeding staffs and animals was collected (including 262 from the outbreak sheep farm and 50 from another sheep farm which nearly 5 kilometres away) to detect brucellosis antibody,and sheep sources were investigated simultaneously.Results A total of 26 people were detected,the infection rate was 26.9％ (17 people,in the epidemic area),the other four farming units without brucellosis infection.In epidemic focus,seven human infections (5 confirmed cases,2 asymptomatic infected) were identified,with an infection rate 41.2％ (7/17) and the brucellosis antibody positive rate among sheep was 46.2％ (121/262),while no positive sheep in the nearest sheep farm (0/50).Both unprotected lamb handling and stillbirth treatment got a 100.0％ infection rate.Among the investigated professional staffs,92.3％ (24/26) had no awareness of clinical symptoms and signs of brucellosis,while 11.5％ (3/26) took protective measures when working.Conclusions Unquarantined sheep is the infection source of this brucellosis outbreak,unprotected lamb handling and stillbirth treatment are the main route of transmission.High sheep infection rate,lack of brucellosis awareness,precaution missing among pasture breeding staffs and animal quarantine are all contributing to this outbreak.

Objective:To study effects of neuroligin (NLG) on the proliferation and apoptosis in human neuroblastoma SH-SY5Y cells.Methods:The SH-SY5Y cells were cultured in vitro for 24 hours,and then transfected with NLG siRNA at dose of 50,100,200 μmol/L,respectively.MTT procedure was used to detect the cell proliferation,and expression levels of apoptosis gene including Bax or Bcl-2 and Bcl-xl were measured by RT-PCR.Results:Compared to control groups proliferation of SH-SY5Y cells were distinctly inhibited after NLG siRNA transfection accompany with a dose-dependent,which was caused by activation of apoptosis.Conclusions:NLG protect neuron by inhibiting apoptosis.

Objective To analyze epidemic status and influencing factors for the poor vision of the students in Henan in 2014 and to provide the scientific basis of more targeted myopia prevention strategies.Methods The data of 34 886 students aged 9 to 18 who were involved in the students'physical fitness survey in Henan province in 2014 was used to analyze epidemic status and influencing factors for the poor vision.Results The prevalence rate of myopia among Henan students was 62.5％.In addition,high school was higher than middle school which was higher than primary school.Girl was higher than boy,and urban was higher than rural.Through the unconditional logistic regression,having breakfast three to five times a week,eating eggs three to five times a week,drinking milk unusually,doing exercise over two hours a day,and watching TV over two hours a day were the protective factors for poor vision,of which the OR were 0.850,0.883,0.864,0.830,0.738 respectively.Correspondingly,the 95％ CI were 0.776-0.931,0.813-0.960,0.812-0.920,0.722-0.955,0.681-0.799.While sleeping less than seven hours,PE class one time a week or less,refusing to run longdistance,doing homework over two hours,and playing the e-productions over two hours were the risk factors of which OR were 1.100,1.091,1.100,1.375,1.155 respectively.Correspondingly,the 95％ CI were 1.009-1.199,1.017-1.172,1.024-1.183,1.287-1.469,1.072-1.244.Conclusions The rate of the myopia among the students in Henan is still severe.There are multifarious factors related to poor vision.Therefore,much more targeted measures should be taken to prevent poor vision from developing.