Objective:To study the inhibitory effect of salidroside on the proliferation of fibroblast-like synoviocytes with rheumatoid arthritis in human(HFLS-RA) induced by tomor necrossi factor-α(TNF-α),and to clarify the molecular mechanism of its control effect on rheumatoid arthritis(RA).Methods:The HFLS-RA were cultured in vitro,then treated with TNF-α and different concentrations of salidroside.The cells were divided into normal control group(0 μg·L-1TNF-α),model control group(10.0 μg·L-1TNF-α)and 12.5,25.0,50.0,and 100.0 μmol·L-1 salidroside groups(10.0 μg·L-1TNF-α+salidroside).The proliferation activity was detected by MTT mehthod;the expression levels of β-catenin,matrix metalloproteinase-7(MMP-7),and Cyclin-D1 in supernatant of the cells were detected by ELISA method;the expression level of β-catenin protein in cells was detected by Western blotting method.Results:Compared with normal control group,the proliferation activity of the HFLS-RA in model control group was significantly increased (P<0.05);compared with model control group,the proliferation activities of the HFLS-RA in 12.5 and 25.0 μmol·L-1 salidroside groups were decreased but there were no significant differences(P>0.05),and the proliferation activities of the HFLS-RA in 50.0 and 100.0 μmol·L-1 salidroside groups were significantly decreased (P<0.05).Compared with normal control group,the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in model control group were increased(P<0.05).Compared with model control group,the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in 12.5 and 25.0 μmol·L-1 salidroside groups were decreased,but there were no significant differences(P>0.05);the expression levels of β-catenin,MMP-7,and Cyclin-D1 in the supernatant of the cells in 50.0 and 100.0 μmol·L-1 salidroside groups were decreased(P<0.05).The Western blotting results showed that the expression level of β-catenin protein in the cell in model control group was higher than that in normal control group(P<0.01);the expression levels of β-catenin protein in the cells in 12.5 and 25.0 μmol·L-1 salidroside groups were lower than that in model control group,but there were no significant differences(P>0.05);the expression levels of β-catenin protein in the cells in 50.0 and 100.0 μmol·L-1 salidroside groups were lower than that in model control group(P<0.05).Conclusion:Salidroside could inhibit the proliferation of HFLS-RA,and its control effect might be related to the regulation of Wnt/β-catenin single pathway.

Objective To investigate the imaging features of the calvarial cavernous hemangioma and the surgical efficacy to improve diagnosis and treatment of the calvarial cavernous hemangioma.Methods The clinical information,imaging materials and surgical efficacy from ten cases of calvarial cavernous hemangioma confirmed by pathology and the related literature was reviewed.Results The lesion was located in frontal bone in eight cases,in parietal bone in one case and in occipital bone in one case.The lesions were round-shape hypodensity with clear margin in X-ray.The lesions were hyperdensity or slightly hyperdensity on CT scan,and were osteolytic lesions with a characteristic honeycomb or starburst pattern on bone window.The MRI features were complicated and variable.The lesions were heterogenous and unevenly enhanced signal intensity.Nine patients underwent radical resections and reconstructed immediately by titanium mesh.The patient with tumor in occipital bone underwent radical resection only.Macroscopically,the pathologic bone was a huge purple-red blush mass protruding from the skull surface.Histological examination revealed the diploe with large,thin-walled,dilated blood-filled spaces lined by flattened endothelial cells without evidence of malignancy.No recurrence was noted in any case during a follow-up period from 3 to 24 months.All the patients survived well without recurrence.Conclusions The imaging features of calvarial cavernous hemangioma have a high value in the diagnosis and may provide guidance for the treatment.The radical resection and immediate reconstruction treatment for calvarial cavernous hemangioma is satisfied.

Objective:To analyze the changes of mean arterial pressure (MAP) and end expiratory carbon dioxide (ETCO 2) in patients after emergency endotracheal intubation (ETI). To explore the values of MAP and ETCO 2 monitoring in early prediction of severe cardiovascular collapse (CVC) after emergency ETI. Methods:The clinical data of adult patients who underwent ETI from March 2015 to May 2020 were collected consecutively in the emergency departments of Peking Union Medical College Hospital. The values of MAP and ETCO 2 were observed and recorded at 5, 10, 30, 60 and 120 min after intubation. According to whether severe CVC occurred after ETI, the patients were divided into the severe CVC group and non-severe CVC group. The values of MAP and ETCO 2 were compared at the same time points between the two groups and the adjacent time points within the groups. The correlation between MAP and ETCO 2 after ETI was also analyzed. ROC curve was used to analyze the ability of MAP and ETCO 2 at 5 min and 10 min after ETI to predict severe CVC. Results:Totally 116 patients were enrolled in this study, among them 75 (64.7%) cases had severe CVC after ETI. The majority were male and elderly patients in the severe CVC group. The values of MAP and ETCO 2 in 5, 10, 30, 60 and 120 min after ETI in severe CVC group were significantly lower than those in the non-severe CVC group. The values of MAP and ETCO 2 in the two groups showed simultaneous decrease from 5 min to 30 min after ETI, reached the lowest value at 30 min after ETI, and appeared the synchronous recover from then to 120 min after ETI. After ETI, the changes of MAP was correlated with that of ETCO 2 ( rs = 0.653, P<0.01). At 5 min after ETI, MAP could predict severe CVC (AUC=0.86, P<0.01), MAP≤72 mmHg was the best cutoff value (sensitivity 78.7%, specificity 87.8%); ETCO 2 could also predict severe CVC (AUC=0.85, P<0.01), and ETCO 2≤35 mmHg was the best cutoff value (sensitivity 77.3%, specificity 85.4%). At 10 min after ETI, MAP could predict severe CVC (AUC = 0.90, P<0.01), MAP≤67 mmHg was the best cutoff value (sensitivity 89.3%, specificity 85.4%), ETCO 2 could also predict severe CVC (AUC=0.87, P<0.01), and ETCO 2≤33 mmHg was the best cutoff value (sensitivity 81.3%, specificity 78.0%). There was no significant difference in the ability of prediction between any two indexes of the MAP and ETCO 2 at 5 min and 10 min after ETI ( P>0.05). Conclusions:Patients with severe CVC after ETI have early signs of decreased MAP and ETCO 2, but the delayed recognition and insufficient intervention may be related to the occurrence and development of severe CVC. MAP and ETCO 2 at the early stage after ETI have high accuracy in predicting severe CVC. MAP≤72 mmHg, ETCO 2≤35 mmHg at 5 min after intubation, MAP≤67 mmHg and ETCO 2≤33 mmHg at 10 minutes after intubation all suggest the possibility of severe CVC.

Objective:To investigate the clinical significance of the primary tumor size in patients with endometrial carcinoma (EC).Methods:A total of 385 patients with EC admitted to Peking University People's Hospital from January 2006 to December 2016 with complete follow up data were selected, whose tumor size data before biopsy were retrospectively studied.Results:(1) The mean diameter of the primary tumor was (3.6±1.8) cm (range: 1-15 cm). And 48 cases were 0-<2 cm, 78 cases were 2-<3 cm, 92 cases were 3-<4 cm, 73 cases were 4-<5 cm, 94 cases were ≥5 cm. The diameter of the tumor was associated with age <60 years old, premenopause, CA 125≥35 kU/L, non-parturition, poor differentiation, stage Ⅲ-Ⅳ, depth of myometrial infiltration ≥1/2, cervical interstitial involvement, adnexal metastasis and lymph node metastasis (all P<0.05), but not associated with body mass index, hypertension, diabetes mellitus, pathology, lymph-vascular space invasion (all P>0.05). (2) Among the 334 patients underwent lymphadenectomy, 45 (13.5%, 45/334) cases with lymph node metastasis were observed. Stratified analysis showed that lymph node metastasis and recurrence rate of patients with EC gradually increased with the increase of tumor size ( P<0.05). Adopting 2, 3, 4 and 5 cm as cut-off values of tumor size, there were significant differences in the rate of lymph node metastasis and recurrence among them observed ( P<0.05), except for lymph node metastasis rate and recurrence rate when the cut-off value was 2 cm ( P>0.05). (3) An receiver operating characteristic (ROC) curve analysis showed that a tumor diameter of 4.25 cm was the cut-off prognostic value to predict lymph node metastasis and recurrence of EC. Conclusions:Tumor diameter is significantly correlated with lymph node metastasis and recurrence in patients with EC. Tumor size should be considered in determining the scope of surgery and adjuvant therapy.

Objective To study the effect of functional electrical stimulation(FES) with innovative static state combined assistance pattern on lower extremity muscle status,motor function and walking function in children with spastic diplegic cerebral palsy.Methods A total of 40 children with spastic diplegic cerebral palsy were randomly divided into a observation group (20 cases) and a control group (20 cases),which were selected from the Third Affiliated Hospital of Jiamusi University from March 2016 to July 2016.The observation group included 11 males and 9 females,aged 3 to 6 years old,on the average of (4.80 ± 1.06) years;the control group including 7 males and 13 females,aged 3 to 6 years old,with mean age (4.75 ± 0.96) years.The control group was only treated with conventional rehabilitation therapy such as kinesitherapy and occupational therapy.On the basis of routine rehabilitation therapy,the observation group was treated with functional electrical stimulation with innovative static state combined with intelligent assistance patterns.All the therapies including conventional and FES treatment were conducted once per day,5 times per week,total for 8 weeks totally.The outcomes before treatment,4 weeks after treatment and 8 weeks after treatment for all the subserved objects were evaluated by modified Ashworth scale(MAS),including joint range of motion(ROM),manual muscle assessment (MMT),gross motor function scale (GMFM-88 D and E regions),gait analysis and musculoskeletal ultrasound (measured muscle thickness).All the data were collected and analyzed by SPSS 17.0 statistical software.Results After 4 weeks to 8 weeks of treatment,2 groups of children with joint range of motion of lower limbs,muscle strength,muscle tension,GMFM-88 score of D and E regions,muscle thickness and gait in 2 groups of children were improved than those before treatment (P ＜ 0.05),after 4 to 8 weeks of treatment,2 groups of children with lower limb joint activity,muscle strength,muscle tension,GMFM-88 score,D and E regions of the muscle thickness and gait in 2 groups of children were improved than those before treatment,and the differences were significant (P ＜ 0.05).The evaluation index of the observation group,Ashworth [left (1.80 ± 0.52) scores,right (3.40 ± 0.88) scores],ROM [left (19.5 ± 2.8) °,right (19.4 ± 1.5) °],muscle strength [left (1.80 ± 0.52) grade,right (2.O0 ± 0.56) grade] and muscle thickness[left gastrocnemius (32.35 ± 1.79) mm,right gastrocnemius (32.95 ± 2.63) mm,left anterior tibial muscle (30.60 ± 1.00) mm,right anterior tibial muscle (30.05 ± 1.8) mm],were all significantly better than those of the control group (all P ＜ 0.05).Step length (23.75-3.19) cm and step speed (0.45 ± 0.01) m/s compared with the control group improved significantly compared with the control group (P ＜ 0.05),the GMFM scores [D regions (31.30 ± 1.46) scores,E regions (48.95 ± 1.40) scores] was significantly higher than those of the control group (P ＜ 0.05).Conclusions The FES with innovative static state combined with intelligent assistance pattern can effectively improve the lower limb muscle state and motor function in children with spastic diplegic cerebral palsy.

Objective: To evaluate the surgical prediction accuracy of Proplan CMF software for zygomatic reduction surgery using L-shaped osteotomy. Methods: Pre-and-postoperative 1-year CBCT data of 26 patients with zygomatic arch hypertrophy were imported in Proplan CMF software during 2014 Jan. to 2016 Jun., the 3D models were reconstructed for simulation of L-shaped osteotomy, characteristic landmarks were selected and 3D point measurement system was established. The measurement result were analyzed by one-way ANOVA. Meanwhile, the overlap color grading charts of preoperative and simulated images were also observed. Results: The facial width, bilateral zygomatic process angle and facial width index were [(128.56±2.72) mm, (106.87±2.53)°, (108.56±3.02)°and 1.41±0.03] in postoperative result, [(129.49±2.26) mm, (108.68±2.40)°, (108.85±3.02)°and 1.42±0.03]in simulated result and [(135.45±2.45) mm, (102.50±2.60)°, (103.41±2.56)°and 1.48±0.05] in preoperative result, with significant difference between preoperative and postoperative result, or between preoperative and simulated result (P<0.05), while no significance between postoperative and simulated result (P>0.05). The soft tissue zygomatic process distance was(153.25±2.58) mm in preoperative result, (150.23±2.76)mm in postoperative result , (149.36±3.27)mm in simulated result, with no significance between any of two groups result (P>0.05). The zygomatic process distance and bilateral zygomatic process tragal distance were (126.35±2.56) mm, (68.75±2.15) mm and(68.86±3.21) mm in postoperative result, showing significant differences compared with preoperative result [(120.16±3.18) mm, (74.58±3.19) mm and(76.14±3.15) mm] and simulated result [(118.86±3.45) mm, (73.85±3.57) mm and(76.87±2.58) mm] respectively(P<0.05), while zygomatic arch distance was not statistically different among the three groups(P>0.05). It indicated that predictive accuracy of facial width, facial width index, zygomatic process angle, soft tissue zygomatic arch distance was high but the soft tissue zygomatic process distance and zygomatic process tragal distance was relatively low. Meanwhile, the color overlay image showed that predictive accuracy was not good in the zygomatic region while the zygomatic arch area was high. Conclusions The predictive accuracy of Proplan CMF software for zygomatic arch hypertrophy is relatively high except for the zygomatic region. Further improvement of the CMF software is needed.

Objective To study the expression of BDNF and TrkB in hippocampal microglia cells of poststroke depression (PSD) rats.Methods Forty healthy adult SD rats were randomly divided into normal group,depression group,stroke group and PSD group (10 in each group).Expression of BDNF and TrkB in OX42-marked hippocampal microglia cells of PSD rats was detected with immunofluorescence staining on day 29 and 57 after a MCAO model rats was established and a chronic stress depression model of rats was established by chronic unpredictable mild stress (CUMS) combined with separate breeding.Results The absorbance value of BDNF and TrkB was 83.35t5.74 and 82.35±5.74 respectively in PSD group on day 29 after the CUMS of rats was established,which was significantly lower than other 3 groups (P＜0.05),and was significantly higher in depression group than in stroke group (141.23±9.16 vs 133.31±7.89;141.23± 8.07 vs 128.62±6.92,P＜0.05).The absorbance value of BDNF and TrkB was 81.63±7.19 and 74.43±7.42 respectively in PSD group on day 57 after the CUMS of rats was established,which was lower than in other 3 groups,and was significantly lower in stroke group than normal group and depression group (93.36±7.56 vs 124.11±11.39、116.65±10.55,87.14±6.56 vs 112.58± 10.99、108.05±10.57,P＜0.05).Conclusion Hippocampal microglia cells play an important role in the pathogenesis of PSD by down-regulating the expression of BDNF and TrkB in PSD rats.

Objective To explore the effect of mobile phone-based health education on independent living ability of postoperative patients with hypertensive intracerebral hemorrhage. Methods Sixty patients with postoperative hypertensive intracerebral hemorrhage who underwent craniotomy in our hospital during March 2016 and December 2017 were divided into experimental and control groups, 30 cases in each group, according to the random number table method. Functional training conducted during hospitalization in both groups. After discharge, the control group used a telephone for follow-ups every 2 weeks and took part in a face-to-face training in the first month to implement continuous nursing intervention for a total of 3 months. After discharge, in the experimental group, various information forms of rehabilitation training for hypertensive intracerebral hemorrhage were comprehensively integrated, and mobile phone education was used for a total of 3 months in addition to the training as in the control group. The two groups were compared in terms of independent living ability between the two groups. Result The scores of independent living ability and self-care ability, action ability, metastatic ability, social cognitive ability and communication ability of the experimental group were significantly higher than those of the control group (P＜0.05). Conclusion The mobile phone-based education can promote the effect of rehabilitation exercise in patients with hypertensive intracerebral hemorrhage, so as to promote the independent living ability of patients.

Objective:To promote emergency airway management from the perspective of training and to explore the training mode of emergency airway management based on clinical procedures.Methods:Airway management training courses were designed according to the clinical treatment principle centered on patient safety in combination with actual clinical procedures. The course took the CHANNEL process of airway management as the main line and focused on artificial ventilation, oxygen therapy and rapid induction of intubation techniques. During the teaching, we took the clinical handling process as the main line, and adopted methods of equipment display, video presentation and on-site explanation. Courses were freely registered or oriental enrollment. Online questionnaires were used to collect feedback from the students after class and were then analyzed.Results:A total of 15 training sessions were held in 13 cities across the country, with 566 participants, and 185 questionnaire responses were received. About the content of single course, participants thought that the first three parts were difficult to understand, including oxygen therapy (48, 25.9%), CHANNEL process explanation and practice (48, 25.9%) and rapid induction of intubation process (47, 25.4%). After class, 41 participants (22.2%) changed work procedures of emergency airway management, 140 (75.7%) partially changed work procedures of emergency airway management, and 4 (2.2%) still used the original work procedure.Conclusion:The course of emergency airway management based on clinical procedures meets the current clinical needs and can better improve the training of clinical competency.

0bjective: To establish a three-dimensional finite element model of mandible and study the transverse displacement of proximal segment after Bilateral Sagittal Split Ramus Osteotomy (BSSRO) with different retrogression amounts during mastication. Methods: DICOM data of a skull model were processed with MIMICS and ANSYS software, reconstructing the 3D model including the teeth and temporomandibular joint in order to simulate BSSRO and evaluate the transverse displacement of proximal segment with different retrogression amounts during mastication. Results: The mean of proximal segment width change were 2.955 mm and 3.490 mm, when retrogression amounts of distal segmentwere 3 mm and 8 mm, respectively.No significant difference between the two groups were found (P=0.131). Meanwhile the displacement color scale of the 3D finite element models showed that the apparent transverse displacement distribution of the proximal segment was measured around the gonial area, decreased from the exterior to the interior. Conclusions The mandibular angle width was significantly expanded right after BSSRO. The masticatory muscle system and single cortical fixation system played an important role in expanding the width of proximal segment. However there was no correlation between the widening effect and retrogression amounts of distal segment of mandible.