Objective To investigate the clinical efficacy and safety of endoscopic variceal ligation (EVL) combined with endoscopic variceal sclerosis (EVS) for treating patients with esophageal variceal bleeding (EVB).Methods Ninety patients with EVB were divided into observation group and control group by treatment methods with 45 patients each.The observation group was given EVL combined with EVS and the control group was given EVL.The elimination of varicosity after the first treatment,time and times required to eliminate,rehaemorrhagia,varicosity recurrence,complication and prognosis of the 2 groups were observed.Results The elimination rate of varicosity of observation group was 97.8％(44/45),the control group was 93.3％(42/45),there was no significant difference (P＞ 0.05).The elimination rote of varicosity after the first treatment of observation group was significantly higher than that of control group,the time and times required to eliminate were significantly lower than those of control group [71.1％(32/45) vs.48.9％(22/45),(17.24±5.65) d vs.(36.01 ± 11.81) d,(1.42 ±0.47) times vs.(1.87 ±0.61) times,P ＜ 0.05 or ＜0.01].The rates of early-onset rehaemorrhagia,delayed rehaemorrhagia and varicosity recurrence of observation group were significantly lower than those of control group [4.4％(2/45) vs.17.8％(8/45),6.7％(3/45) vs.22.2％ (10/45),2.2％ (1/45) vs.22.2％ (10/45),P ＜0.05].The rate of complication of observation group was significantly lower than that of control group [11.1％ (5/45) vs.42.2％ (19/45),P ＜0.01].Conclusion The EVL combined with EVS is an effective method for emergency hemostasis and preventing rehaemorrhagia in the patients with EVB.

Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.

Objective To investigate the expression and activation of extracellular signal-regulated kinase 1/2 (ERK 1/2), its upstream molecule, epidermal growth factor receptor (EGFR), and downstream transcription factor, Ets-like protein 1 (ELK-1), in lesions of psoriasis vulgaris, and to evaluate the relationship between ERK pathway and psoriasis vulgaris. Methods Tissue samples were obtained from the lesions of 40 patients with psoriasis vulgaris and normal skin of 20 normal human controls. Immunohistochemistry and Western blot were performed to detect the expressions of phosphorylated ERK1/2, EGFR and ELK-1 in the tissue samples.Results As immunohistochemistry showed, the integrated optical density (IOD) of p-ERK1/2, p-EGFR and p-ELK-1 was 269.85 ± 57.96, 136.88 ± 30.33 and 237.61 ± 56.29 respectively in the psoriatic lesions, significantly higher than that in the normal controls ( 140.24 ± 24.42, 110.66 ± 28.99 and 119.04 ± 21.99, respectively, all P ＜ 0.05). A positive correlation was observed between the expression of p-EGFR and p-ERK1/2(r = 0.57, P ＜ 0.05) and between that of p-ERK1/2 and p-ELK-1 (r=0.72,P＜0.05) in psoriatic lesions.Conclusion The enhanced signal transduction through phosphorylated EGFR→ERK1/2→ELK-1 pathway may play a certain role in the pathophysiological process of psoriasis vulgaris.

Objective To quantitative the changing information of estrogen receptor βgene which was in tissue and organ of sex gland during oestrus and dioestrus of Beagles, and to show the different expression situation of hypothalamus-pituitary-gonad axis during oestrus and dioestrus, and providing the basic of theory to research deeply the mechanism of heat of Beagles. Methods As the key gene in regulation reproduction, ERβgene is located in hypothalamus-pituitary-gonad axis, so using Beagles which was in oestrus and dioestrus, and extract the RNA from hypothalamus、pituitary、ovary and uterus respectively,after reverse transcription we detected the expression of ERβgene by real-time quantitative PCR.Results The expression of ERβgene mRNA from ovary、uterus、pituitary、hypothalamus of Beagles which was in dioestrus was 0.35 times, 0.17 times, 0.44 times and 0.43 times than the expression of ERβgene mRNA from ovary, uterus, pituitary, hypothalamus of Beagles which was in oestrus.Conclusion The expression of ERβgene was up-regulation in hypothalamus-pituitary-ovary axis of Beagles which was in oestrus.

Objective:To identify the value of ultrasound radiomic features extracted from the bladder wall at tumor base in predicting myometrial invasion of bladder cancer.Methods:A total of 175 cases with bladder cancer confirmed by pathology from January 2017 to February 2022 in the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. They were divided into training set and testing set in a ratio of 7∶3. The MaZda texture analysis software was used to draw the region of interest (ROI) of the bladder wall and the tumor region for extracting texture features. The minimum absolute reduction and variable selection operator (LASSO) regression and 10-fold cross-validation were used to screen the features of training set for establishing the models. And the ROC curve was used to evaluate the efficiency of the models.Results:A total of 279 texture features were extracted from the ROI of the bladder wall and the tumor region, and 5 texture features were screened out for constructing omics scoring models by LASSO regression and 10-fold cross-test. The area under ROC curve (AUC)s used in training set and testing set of the bladder wall were 0.921 and 0.856, while the AUCs applied in training set and testing set of the tumor region were 0.849 and 0.704. Both in the training set and test set, the AUCs of the model of the bladder wall were higher than those of the model of the tumor region (all P<0.05). Conclusions:The omics scoring model based on the texture features of the bladder wall at tumor base can effectively identify muscle-invasive bladder cancer(MIBC) and non-muscle-invasive bladder cancer(NMIBC), and has better performance than the model based on the texture feature of the tumor region.

Objective:To investigate the clinical and molecular features of patients with CD7 +relapsed or refractory acute myeloid leukemia(r/rAML)and the prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods:172 r/rAML patients who underwent allo-HSCT in department of hematology, Aerospace Center Hospital between January 1st 2017 and December 31st 2020 were retrospectively analyzed The patients were were divided into CD7 + group( n=75) and CD7 - group( n=97) according to the expression CD7 in the initial immunophenotype. Mann-Whitney U and Chi-square test were used to compare the clinical data, molecular and cytogenetic characteristics of the two groups of patients. Kaplan-Meier method was used to analyze the median progression-free survival (PFS) and median overall survival (OS) of the two groups of patients, and Cox regression screenthe prognostic factors of the patients. Results:The median follow-up time was 19 months. The recurrence rates were 23.71% and 50.67%, respectively in CD7 - and CD7 + group (χ 2=13.428 P<0.001). In relapsed patients, 86.96 percentage of CD7 - group did not express CD7 while 86.84 percentage of CD7 + group expressed CD7. The median PFS was 25 and 5 months in CD7 - and CD7 + group (χ 2=8.695, P=0.003), and the medianOS was 34 and 15 months in CD7 - and CD7 + group (χ 2=2.579, P=0.108). Univariate analysis showed that the CD7 +group, had the lower rates of morphological remission (χ 2=10.014, P=0.002), molecular remission (χ 2=22.809, P<0.001), and more male patients (χ 2=5.281, P=0.022). The incidence of CEBPA double-site mutation was higher (23.4% vs 8.2%, χ 2=8.180, P=0.004) and the rearrangement of RUNX1::RUNX1T1 was lower(4.0% vs18.6%, χ 2=8.362, P=0.004)in CD7 +group than in CD7 -group. Multivariate analysis showed that pre-transplant tumor load was the only prognostic factor for PFS (HR, 1.600; 95% CI, 1.203 to 2.127; P=0.001) and OS (HR, 1.737; 95% CI, 1.273 to 2.369; P<0.001) in r/r AML patients. Conclusion:CD7 expression is a risk factor for poor prognosis in r/r AML patients, and CD7 expression is stable after relapse. Positive CD7 can be used as a target for immune targeted therapy.

Objective: To investigate the association of within-day drinking occasions with average amount consumed per drinking occasion during spring among college students in Hebei Province and to provide the basic data for the revision of quantity of consumption among Chinese residents. Methods: A total of 156 college students in Hebei Province were selected by using simple random sampling method. Information on daily amount and types of water consumption was recorded using the 7-day 24-hour recording method. The daily amount and type of drinking water by sex and BMI were analyzed and compared. Results: The daily median drinking water intake was 1 135 mL; the daily median number of drinking occasion was 6, with 34.6% of participants less than 6 drinking occasions; the median amount consumed per drinking occasion was 177 mL. The daily number of water and plain water drinking occasion of females were higher than males(χ2/Z=8.34, -2.03, P<0.05); the amount consumed per drinking occasion, the amount of plain water and beverages consumed per drinking occasion of males were higher than females(χ2/Z=23.86, -5.48, 3.70, P<0.01); The differences of the amount of plain water consumed per day among students and their BMI were of statistical significance(χ2=9.17, P=0.03), the amount of drinking water each time was positively correlated with body surface area(r=0.18, P=0.03), and frequency of drinking water was positively correlated with the amount of drinking water, negatively correlated with the amount of drinking water each time. The amount of drinking water was positively correlated with the amount of drinking water each time(r=0.30, -0.47, 0.61, P<0.01). Conclusion There is a certain proportion of unhealthy drinking behavior among college students; drinking behavior is different by sex and BMI. With the increase of drinking occasions, the amount consumed in each drinking occasion decreases, but total amount of drinking water increases.

Objective:To explore the application effect of defect scenario simulation combined with joint review action in the training of blood-borne occupational exposure of nursing assistants.Methods:From February 1, 2020 to February 1, 2021, a total of 97 nursing assistants from Central District of Provincial Hospital Affiliated to Shandong First Medical University, were selected as the experimental group and 89 nursing assistants from the Eastern District were selected as the control group. The control group received routine training, while the observation group received defect scenario simulation combined with action training. After 1 year of training, the incidence of blood-borne occupational exposure and blood-borne occupational exposure knowledge scores of nursing assistants in the two groups were compared.Results:During the intervention period, 1 nursing assistant in the experimental group resigned, 2 nursing assistants asked for leave twice or more, and 94 nursing assistants were finally enrolled. In the control group, 2 nursing assistants resigned and 3 nursing assistants asked for leave twice or more, and 84 nursing assistants were eventually enrolled. The incidence of blood-borne occupational exposure of nursing assistants in the experimental group was lower than that in the control group and the score of blood-borne occupational exposure knowledge was higher than that in the control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Defect scenario simulation combined with joint review action has a good effect in blood-borne occupational exposure training of nursing assistants, which can reduce the incidence of blood-borne occupational exposure and improve their blood-borne occupational exposure knowledge scores. It is worthy of clinical promotion.