Objective To compare the efficacy and safety of endoscopy and laprotomy for gastric stromal tumor,and to evaluate the clinical value of endoscopy.Methods A retrospective analysis was made based on the clinical data of 142 patients with gastric stromal tumor(diameter＜3 cm with clear boundary),with 83 patients who underwent endoscopic resection assigned to the endoscopy group,and 59 patients who underwent laprotomic resection to the operation group.The clinical and pathological data in both groups were analysed and the safety,perioperative situation and prognosis of two groups were compared.Results Compared with the laprotomy group,the endoscopy group required the same time,[(88.25±12.18) min VS (90.15±10.25) min,P=0.367],yielded to less intraoperative blood loss[(42.15±22.13) ml VS (140.55±35.66) ml,P＜0.01],early postoperative feeding[(2.30± 1.20) d VS (5.40± 1.28) d,P＜0.01],and shorter postoperative hospital stay [(5.43± 1.78) d VS (9.42± 1.65) d,P＜0.01].Follow-up was performed in two groups for 5-55 months (median,30 months),with no recurrence or metastasis.Conclusion Compared with surgery,endoscopic therapy is safe and effective for the gastric stromal tumor,whose diameter is less than 3 cm with clear boundary.

Objective To compare two sources of mesenchymal stem cells ( MSCs) from human placenta and umbilical cord, and to optimize a technical solution for bench or clinical studies of MSCs.Methods MSCs were isolated from human placenta and umbilical cord and expanded for analysis.The cell morphology was observed under invert microscope, the immunophenotypic feature of MSCs was analyzed with flow cytometer, the cell proliferation ability was determined by cell cycle assay and cell doubling time, the cell differentiation potential was evaluated by osteogenic and adipogenic induction in vitro as well.Results Both sources of MSCs were adherent cells and exhibited fusiform and fibrous morphology. Furthermore, both MSCs high expressed CD90 and CD105, and were negative for the markers of CD34, CD45 and HLA-DR.The population doubling time of MSCs form human placenta and umbilical cord was 39.5 h and 40.8 h separately, and the results of cell cycle analysis showed that the percent of the two sources of MSCs in G0/G1 phase was 52.12%and 57.50% respectively. The above results demonstrated that both sources of MSCs possessed the similar biological characteristics in morphology, phenotype and as well as proliferation ability.In addition, both of them could be induced into osteoblasts and adipocytes in vitro.Conclusion MSCs from human placenta have the similar biological characteristics to these from human umbilical cord, and both of them are better candidates for bench and clinical research.

Objective:To investigate the effect of HLA-DRB1*07,13 allelic genes on the immune response to hepatitis B vaccination.Methods:896 healthy college students of Han nationality from Guangxi province,who had received standard courses of vaccination with recombinant hepatitis B virus vaccine,were tested the level of anti-HBs with ELISA method at the sixth month after their last vaccination.The non- or hypo-responders were selected to receive another 20 μg doses of recombinant vaccine and were examined anti-HBs once more four weeks later.99 non- or hypo-responders and 136 medium or hyper-responders were selected for the study subjects.HLA-DRB1*07,13 allelic genes of the subjects were detected by polymerase chain reaction using sequence specific primer (PCR-SSP) method.Results:The frequencies of HLA-DRB1*07 gene in the non- or hypo-responders group were significantly higher than that in the medium or hyper-responder group (16.16% vs 4.41%,P＜0.05). No significant difference of HLA-DRB1*13 gene between the two groups (1.01% vs 3.68%,P=0.389).Conclusion:There is a close relationship between the expression of HLA-DRB1*07 gene and the non- or hypo-response to HB vaccine;No relationship between HLA-DRB1*13 gene expression and the response to HB vaccine is found.

ObjectiveTo elucidate the association of immune response to hepatitis B vaccination with HLA-DRB1 * 12 allele as well as the level of IL-4 and IFN-γ.MethodsSeventy-four healthy college students from Guangxi province who had non- or hypor -response to recombinant hepatitis B vaccination and 64 medium- or hyper-responders with the conditions of similar were selected randomly and involved in this study.HLA-DRB1 * 12 was detected by PCR-SSP,the level of IFN-γ and IL-4 cytokines were examined by ELISA.Results(1)The allelic frequencies of HLA-DRB1 * 12 was lower in the non- or hypor-responders than that in the medium- or hyper-responders ( 10.8％ vs 32.8％,P=0.002) ; (2)The expression level of IFN-γ in the non- or hypor-responders ( 7.21±7.92 ) ng/ml was much less than that of the medium- or hyper- responders ( 16.36± 11.00) ng/ml ( P=0.000).(3) The expression level of IL-4 in the non- or hyporresponders (3.18±4.45) ng/ml was much less than that of the medium- or hyper- responders (7.76±5.71 ) ng/ml(P=0.000).(4)No significant differences was seen between the expression level of IFN-γ in the HLA-DRB1 * 12 positive ( 13.18± 11.24) ng/ml and the negative ( 11.00± 10.29 ) ng/ml ( P =0.349 ).(5)No significant differences was seen between the expression level of IL-4 in the HLA-DRB1 * 12 positive (5.947±4.530) ng/ml and the negative (5.132±5.800) ng/ml (P=0.423).ConclusionHLA-DRB1 * 12 might be the allele enhanced immune response to hepatitis B vaccination.The expression levels of IFN-γand IL-4 correlating to Thl/Th2 cells might affect on the immune response to hepatitis B vaccination.

BACKGROUND:Human umbilical cord mesenchymal stem cells with capabilities for self-renewal and multi-differentiation have attracted widespread attention. OBJECTIVE:To develop an efficient method for isolation and culture of human umbilical cord mesenchymal stem cells, and to analyze the cellbiological features. METHODS:Mesenchymal stem cells were isolated and cultured from human umbilical cord by improved tissue cultivation. Immunophenotype and cellcycle were analyzed by flow cytometry. Growth curve was determined by MTT assay, and differentiation ability was evaluated by in vitro osteogenic and adipogenic induction as wel . RESULTS AND CONCLUSION:Some fusiform cells crawled out from human umbilical cord tissues after cultivation for 5 days and formed colonies about 10 days later. When the removed tissues were further cultured, more cells appeared again within 2 days and formed colonies after 5 days. The isolated cells exhibited similar morphology of fibroblast-like shape after passage. Furthermore, the cells expressed CD90, CD105, but were negative for the markers of CD34, CD45, HLA-DR. Population doubling time of the cells calculated from the result of MTT was about 50 hours and cellcycle analysis showed that 41.24%cells were in the G 2/S phrase. Therefore, the isolated cells had a high prolification ability. In addition, the isolated cells could be induced into osteoblasts and adipocytes in vitro. In a word, the results of this study demonstrated that the cells from the second tissues culture possessed the biological characteristics of mesenchymal stem cells and more primary umbilical cord mesenchymal stem cells were acquired through the improved method.

BACKGROUND:Placenta is a valuable source of mesenchymal stem cels for stem cel therapy and future application in the field of regenerative medicine. However, conventional methods cannot acquire a large amount of purified human placenta-derived mesenchymal stem cels. Here, we present a new method for isolating human placenta-derived mesenchymal stem cels suitable for banking strategies and for future clinical applications. OBJECTIVE:To analyze the biological characteristics of human placenta-derived mesenchymal stem cels cultured by tissue dissociating and colagenase digestion. METHODS: Human placenta-derived mesenchymal stem cels were obtained from human placenta by tissue dissociating and colagenase digestion method. Immunophenotype was analyzed by flow cytometry. Growth curve was determined by MTT assay, and differentiation ability was evaluated byin vitro adipogenic, osteogenic and chondrogenic induction as wel. RESULTS AND CONCLUSION:Human placenta-derived mesenchymal stem cels could be passaged stablyin vitro. Furthermore, the cels expressed CD73, CD90, CD105, but were negative for the markers of CD11b, CD19, CD34, CD45, and HLA-DR. Human placenta-derived mesenchymal stem cels proliferated actively and began to grow logarithmicaly at days 3-5 folowed by a plateau period at day 6. In addition, the isolated cels could be induced into adipocytes, osteocytes, chondrocytesin vitro. In a word, the results of this study demonstrated that the tissue dissociating and colagenase digestion method is an efficient method for obtaining a large amount of human placenta-derived mesenchymal stem cels that can be stably cultured in vitro and have strong proliferative ability.

Objective:To understand the current situation and influencing factors of successful aging in widowed elderly.Methods:From May to October 2019, 225 widowed elderly people were investigated by questionnaire in 7 communities and 5 villages in Shandong Province. The Successful Aging Scale of the Flood was used to assess their successful aging status. The general data sheet, Physical Activity Scale for the Elderly (PASE), Multidimensional Scale of Perceived Social Support(MSPSS), Connor-Davidson Resilience Scale (CD-RISC) and Mini Mental State Examination(MMSE) were used to measure its influencing factors.Results:The successful aging score of the widowed elderly was 46.22 ± 9.49. The results of multiple linear regression analysis showed that the influencing factors of the successful aging of the widowed elderly were: social activity participation, household registration, consciously successful aging status, psychological resilience, MMSE—attention and computing power, perceived social support—other people, leisure physical activity, which can explain a total of 70.7% of the regression equation.Conclusions:The successful aging status of widowed old people is at a low level, and its influencing factors have both common factors and specific characteristics compared with those with spouses. In particular, more attention should be paid to "participation in social activities", and the widowed old people should be actively encouraged to participate and improve their successful aging.

Objective:To explore the intervention effect of Shumu Peitu herb-partitioned moxibustion on clinical signs and symptoms and negative emotions of diarrhea-predominant irritable bowel syndrome (IBS-D) patients with liver-stagnation and spleen-deficiency pattern.Methods:A total of 72 patients with IBS-D of liver-stagnation and spleen-deficiency pattern treated in the Department of Gastroenterology of Nanjing Vniversity of Chinese Medicine from September 2021 to June 2022 were selected for randomized controlled trial. The patients were randomly divided into the observation group (2 cases dropped off, 34 cases in total) and control group (1 case dropped off, 35 cases in total) by random number table method. The patients in control group were treated with Tongxieyaofang (TXYF). The patients in observation group were treated with oral administration of TXYF and Shumu Peitu herb-partitioned moxibustion, and both groups were treated for 4 weeks. The clinical efficacy, Traditional Chinese Medicine (TCM) syndrome integral, IBS Quality of Life Questionnaire (IBS-QOL), IBS Symptom Severity Scale (IBS-SSS), Bristol Stool Form Scale and Hospital Anxiety and Depression Scale (HADS) were compared before and after treatment.Results:After treatment, the total effective rate of the observation group was 94.12%(32/34), which was higher than the 71.43%(25/35) in the control group, the difference was significant ( χ2 = 6.18, P<0.05). After treatment, the TCM syndrome integral in the observation group was (7.62 ± 4.08), which was lower than the (9.89 ± 4.71) in the control group, the difference was significant ( t = 2.14, P<0.05). After treatment of 3 days, the scores of quality of life in the five dimensions of dysthymia, behavior disorder, health worry, avoidance of eating and social function in the observation group were (82.44 ± 11.46), (80.25 ± 11.67), (76.23 ± 12.67), (59.80 ± 15.14) and (79.23 ± 11.59) points, which were different with the (73.57 ± 12.39), (72.35 ± 15.48), (69.76 ± 13.11), (50.00 ± 16.17) and (73.04 ± 13.11) points in the control group, the difference were significant ( t values were -3.09 - -2.08, all P<0.05). Three days after treatment, the score of IBS-SSS and Bristol fecal character in the observation group were (118.24 ± 40.64) and (5.09 ± 0.62) points, which were lower than the (146.86 ± 60.09) and (5.51 ± 0.66) points in the control group, the difference were significant ( t = 2.31 and 2.76, both P<0.05). After treatment, the score of HADS-A and HADS-D in the observation group were (6.26 ± 1.75) and (5.29 ± 1.47), which were different with the (7.26 ± 2.19) and (6.17 ± 2.11) in the control group, the difference were significant ( t = 2.08 and 2.00, both P<0.05). Conclusions:Shumu Peitu herb-partitioned moxibustion can effectively improve IBS-D patients with liver-stagnation and spleen-deficiency pattern, relieve clinical symptoms, reduce negative emotions, and improve quality of life.

Venous adventitial cystic disease(VACD)is a rare vascular disease which often manifests as unilateral limb swelling,and so misdiagnosed as other diseases such as deep vein thrombosis.Color Doppler ultrasound,CT angiography and magnetic resonance imaging play a crucial role in the diagnosis of VACD.Surgical treatment is the main method for VACD,including cyst incision,cyst wall resection,cyst puncture,aspiration and cyst and vessel resection.The recurrence rate of VACD is relatively high,ranging from 20%to 83%.Enhancing the understanding of VACD,making accurate diagnoses and appropriate surgical operation are of great significance for improving treat-ment outcomes and reducing the recurrence rate.

Objective:To understand the status of health-promoting lifestyle of middle-aged and elderly patients with knee osteoarthritis, and to comprehensively analyze the influencing factors based on the biological-psychological-social medicine model, to explore controllable factors.Methods:Using convenient sampling method, 177 middle-aged and elderly patients with knee osteoarthritis who were hospitalized in First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital) from July 2020 to November 2020 were selected for questionnaire survey. The Health Promotion Lifestyle Profile Ⅱ (HPLP-Ⅱ) was used to evaluate their health promotion lifestyle status, the influencing factors were measured by general data sheet, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), disease recognition questionnaire for knee osteoarthritis patients, Social Support Rating Scale (SSRS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Self-efficacy for Managing Chronic Disease (CDSES), respectively.Results:The total score of HPLP-Ⅱ, the total score of WOMAC, the score of disease recognition questionnaire, the total score of SSRS, the score of HAMA, HAMD, CDSES were (117.52 ± 15.58), (105.63 ± 31.64), (14.21 ± 3.23), (38.60 ± 5.18), (7.76 ± 4.41), (6.01 ± 4.54), (33.77 ± 6.04) points for middle-aged and elderly patients with knee osteoarthritis. The results of multiple linear regression analysis showed that the influencing factors were disease cognition, per capita monthly income, imaging grade, self-efficacy, support utilization, objective support, a total of 71.9% variation of regression equation could be explained.Conclusions:Middle-aged and elderly knee osteoarthritis patients health promotion lifestyle score at a low level, to improve, affected by disease cognition, imaging grading, self-efficacy, social support, medical staff should combine the degree of disease and individualized factors for disease health education, improve patients′ self-efficacy and social support level, prompting patients to adopt a healthy lifestyle.