Objective To investigate the changes of clinical symptoms and liver or lung functions after inferior vena cava stent implantation in Budd Chiari syndrome patients. Methods 35 cases of Budd Chiari syndrome patients were enrolled and retrospective analysized, such as ascites, edema of lower limbs, abdomen wall of varicose veins and serum total bilirubin, serum albumin, prothrombin time, FVC, MVV, PEF, FEV1.0, FEV1.0/FVC and other pulmonary functional changes were analyzed before and 1 months after inferior vena cava stent implantation. Results Ascites, edema of lower limbs, abdominal varicose veins and other clinical symptoms were significantly reduced or disappeared, the total serum bilirubin significantly decreased, serum albumin significantly increased, and prothrombin time significantly reduced 1 month after surgery in patients with Budd Chiari syndrome, (t = 1.95, 2.31, 2.07, P < 0.01). FVC, MVV, PEF, FEV1, the indexes of FEV1/FVC improved obviously after surgery (t = 1.83, 2.69, 1.47, 1.69, 1, 97, P = 0.041, 0.029,0.046, 0.043, 0.043, 0.038). Conclusion Inferior vena cava stent implantation could effectively improve the clinical symptoms of patients with Budd Chiari syndrome.

Objective To study the clinical significance of intercostobrachial nerve ( ICBN) reservation in radical resection of breast cancer .Methods 42 cases with breast cancer at stageⅠ,ⅡorⅢa were randomly divided into experimental group(n=28) and control group(n=14).In the experimental group,the ICBN were preserved in the axillary lymph node dissection operation ,while in the control group ,the ICBN were resected in the operation .After the operation,both two groups were treated as breast cancer and the patients were followed up .The operation time,the number of ALND , local tumor recurrence and distant metastasis rates after operation , survival rate were compared between the two groups.Results Postoperative 14 days,3 months and 6 months,the incidence rates of the sensory disorder in the internal upper arms in the control group were 85.7%,64.3% and 50.0% respectively,those in the experimental group were 10.7%,3.5% and 0.0%.The differences were statistically significant between the two groups(P<0.05).The average operation time,average number of lymph node dissection between control group and experimental group had no significant difference [(80.0 ±12.9) min vs (88.0 ±15.6) min,(16.4 ±5.4) vs (14.8 ±6.1)](P >0.05).In the control group,the local recurrence rate,distant metastasis rate and survival rate were 0.0%,7.0%and 0.0%,those in the experimental group were 0.0%,0.0% and 0.0%.There were no statistically significant differences between the two groups .Conclusion It is feasible to preserve the ICBN in radical resection of breast cancer ,which reserves the skin sensory function of the internal upper arm and axilla ,and enhance the patients'quality of life.

Objective To explore the effect of endovenous laser treatment ( EVLT) for varicose great saphe-nous veins complicated with ulcers .Methods 40 cases ( 46 limbs ) of varicose great saphenous veins complicated with ulcers underwent EVLT .The abnormal vein branches of the base of ulcers and adjacent ulcers were burned and closed.Results Except a case suffered the secondary transplantation for skin flap necrosis ,no infection,skin necro-sis,deep vein thrombosis complications occurred in other 39 cases.All the ulcers healed ,and postoperative lower limb varicose veins were disappeared .The operation time was (65 ±11.6) min.All the ulcers healed and the hospitalization time was (21 ±4.6)d.All the patients were followed up for 6-36 months,and no recurrence was found.Conclusion EVLT for varicos e great saphenous veins complicated with ulcers has the advantages of good effect ,minimal incision , and quick recovery .

Objectives To investigate the changes of erythropoietin(EPO)expression in rats after focal cerebral ischemia/reperfusion injury.Methods Male Sprague-Dawley rats were randomly divided into normal,sham,cerebral ischemic/reperfusion(CIR)groups.Middle cerebral artery occlusion(MACO)model was established by Longa's method,and reperfusion was followed 2 hours after occlusion in CIR group.The rats' brain neurological deficit scores were evaluated at 24 h,48 h,72 h and 96 h after reperfusion.The protein expression of EPO was determined by immunohistochemistry staining and Western blotting in each time points.Results The rats' brain neurological deficit scores at 48 h,72 h and 96 h were significantly increased(3.40±0.32,3.60±0.17,3.70±0.21,all P<0.05)compared with those at 24 h(3.00±0.22)after reperfusion in CIR group.The results of immunohistochemistry staining and Western blotting showed that the positive expression of EPO proteins in rats started at 24 h(0.36±0.05,140.20±0.30)after cerebral ischemic/reperfusion injury,increased significantly at 48 h(1.09±0.10,145.40±0.16),reached the peak at 72 h(1.29±0.09,156.23±0.12),began to decline at 96 h(0.98±0.04,141.56±0.36).Conclusions Cerebral ischemia and reperfusion injury can induce increased expression of EPO protein,which suggests that EPO may have protective effect on nerve cells under the condition of ischemia and reperfusion.

OBJECTIVE:To put forward relevant suggestions for formulating and implementing medical insurance budget impact analysis(BIA)research guideline in China. METHODS:The medical insurance BIA guidelines or relevant documents were retrieved from ISPOR,Canada and the United States. Their similarities and differences were compared. The experiences of them were summarized in respects of research framework,data source and report format of medical insurance BIA. RESULTS &CONCLUSIONS:ISPOR,Canada,USA and other guidelines or relevant documents have some similarities in normalization requirements of research perspectives,target population calculation based on natural reason and epidemiological data,3-5 years as the research time limit and some other respects. But the calculation of additional costs as drug price addition,distribution fee should be specifically adjusted according to the unique characteristics of the health systems of countries or regions. Based on the actual conditions of our own health care system,our country can draw up the guidelines for medical insurance BIA impact analysis,which contain model design,research perspective,target population,current use of intervention measures,prediction on the effects of new intervention measure introduction on the market,cost,time range,discount and uncertainty analysis of current and new interventions,situational analysis and verification,so as to better play its role in the formulation and adjustment of medical insurance catalogues and in drug price negotiations.

OBJECTIVE The N-methyl-D-aspartate(NMDA)receptor has been shown to be strongly associ-ated with rapid antidepressant effects.GW043 is a com-pound with a novel structure that we designed and syn-thesized to act on the NMDA receptor(NMDAR).METH-ODS In this study,we first confirmed the target of GW043 using a receptor binding assay.We observed the effect of GW043 on NMDAR currents in vivo and in vitro assays using a membrane clamp technique with a view to characterizing the function of GW043.We investi-gated the antidepressant effect of GW043 in rodent behavioral models such as FST,TST and CUMS.Fur-thermore,we explored the mechanism of GW043 onset using Western blotting,BrdU staining,Golgi staining and electrophysiological techniques.RESULTS GW043 interacts with high affinity only at the NMDAR.Electro-physiological studies have indicated that GW043 is a par-tial agonist of NMDAR.Meanwhile,behavioral experi-ments were conducted to confirm the antidepressant effect of GW043 in rodents.The mechanism study found that GW043 regulate synaptic plasticity through LTP and BDNF/mTOR pathways and increase the number of new-born neurons to cause antidepressant effects.GW043,a partial agonist of NMDAR,reversed depression-like behav-ior in rats by modulating synaptic plasticity,suggesting an antidepressant effect.CONCLUSION The results suggest that GW043 is a partial agonist of NMDA recep-tors and has significant antidepressant effects.

Objective To analyze the efficacy,safety,and survival of laparoscopic cholecystectomy(LC)combined with lymph node dissection in the treatment of elderly primary gallbladder cancer.Methods 59 elderly patients with primary gallbladder cancer who underwent open cholecystectomy combined with lymph node dissection from January 2018 to July 2021 were selected as the control group,and 59 elderly patients with primary gallbladder cancer who underwent LC combined with lymph node dissection were selected as the study group.The clinical efficacy,perioperative indicators,and T cell subsets were compared between the two groups CD4+、CD4+/CD8+]、Quality of life(SF-36).Results The difference in recent treatment effectiveness between the research group and the control group is relatively small,(94.0％VS 72.5％,x2=0.209,P=0.648).The time required for lymph node dissection was(39.27±5.63)min and surgery time was(235.16±31.37)min in the study group,which was longer than that in the control group[(35.61±4.75)min and(194.59±30.82)min(P＜0.05).In the study group,the intraoperative bleeding volume was(32.63±5.42)ml and first exhaust time was(3.18±0.72)d,gastrointestinal function recovery time was(3.98±1.04)d,and hospitalization time was(6.24±1.25)d,which were shorter than those in the control group[(61.27±7.85)ml,(4.02±0.83)d,(4.65±1.18)d,(10.41±2.18)d,respectively,(P＜0.05)].After surgery,the levels of CD3+(16.52％±5.24％),CD4+(15.79％±3.83％),and CD4+/CD8+(0.47％±0.11％)in the study group were higher than those in the control group(13.74％±4.30％,10.83％±3.14％and 0.29％±0.05％)(P＜0.05).One month after surgery,the total quality of life score(SF-36)of the observation group(90.86±3.75)was higher than that of the control group(86.85±3.14)(P＜0.05).The incidence of complications in the study group was lower than that in the control group(7.01％VS 23.73％,x2=4.627,P＜0.05).The median survival time of the study group was(13.8±1.50)months,which was significantly higher than that of the control group[(12.5±1.25)months,P＞0.05].Conclusion LC combined with lymph node dissection is a safe and effective treatment for elderly primary gallbladder cancer,without affecting long-term prognosis and survival.

Objective:To preliminarily investigate the effect of blue light on the biological activity of human skin keratinocytes, fibroblasts and melanocytes.Methods:Discarded foreskin tissues were collected from 10 healthy children aged from 3 to 12 years after circumcision surgery in the First Affiliated Hospital of Kunming Medical University from June 2021 to December 2021. After epidermis-dermis separation, selective culture was performed to isolate keratinocytes, fibroblasts, and melanocytes. According to the pre-experiment results, the above three types of cells were irradiated with 440 - 450 nm blue light at doses of 0, 5, 10, 20, 30, and 40 J/cm 2, and then continued to be cultured for 0, 6, 24, and 48 hours. Cell counting kit 8 (CCK8) assay was performed to evaluate cellular proliferative activity at each time point, enzyme-linked immunosorbent assay (ELISA) to detect levels of interleukin (IL) -18, IL-33, nerve growth factor (NGF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) secreted by keratinocytes, as well as levels of IL-33 and keratinocyte growth factor (KGF) secreted by fibroblasts, NaOH lysis method to determine melanin synthesis rates in melanocytes, and Western blot analysis to determine the relative expression of tyrosinase (TYR), tyrosine-related protease 1 (TRP-1) and dopachrome isomerase (DCT) in melanocytes. Two-way analysis of variance was used to analyze group effects, time effects and interaction effects. Results:After irradiation with blue light, the cellular proliferative activity significantly differed among different doses of blue light irradiation groups and different time points in keratinocytes ( Ftime = 516.20, Fdose = 421.20, Finteraction = 25.05, all P < 0.003), fibroblasts ( Ftime = 129.30, Fdose = 477.80, Finteraction = 10.91, all P < 0.003), and melanocytes ( Ftime = 77.61, Fdose = 138.70, Finteraction = 3.50, all P < 0.003) ; immediately after irradiation, the proliferative activity of keratinocytes and fibroblasts was significantly lower in the 20 - 40 J/cm 2 blue light group than in the 0 J/cm 2 blue light group (all P < 0.003), and the proliferative activity of melanocytes was significantly higher in the 5 J/cm 2 blue light group than in the 0 J/cm 2 blue light group ( P < 0.003) ; the proliferative activity of the 3 types of cells showed decreasing trends with the increase of blue light irradiation doses and culture time. ELISA showed that the concentrations of IL-18, IL-33, NGF, and GM-CSF secreted by keratinocytes, as well as the concentrations of IL-33 and KGF secreted by fibroblasts, tended to increase with the increase of blue light irradiation doses and culture time. The melanin synthesis rates in melanocytes significantly differed among different doses of blue light irradiation groups and different time points ( Ftime = 833.50, Fdose = 249.40, Finteraction = 81.38, all P < 0.003) ; during 0 - 24 hours after blue light irradiation, the melanin synthesis rates tended to increase with the increase of blue light irradiation doses and time; during 24 - 48 hours, the melanin synthesis rates showed decreasing trends with the increase of blue light irradiation doses and culture time compared with that at 24 hours after irradiation; 24 hours after irradiation, the melanin synthesis rates were significantly higher in the 5, 10, 20, 30 and 40 J/cm 2 blue light groups (159.50% ± 10.88%, 218.76% ± 8.49%, 333.72% ± 7.72%, 393.29% ± 6.00%, 427.21% ± 8.39%, respectively) than in the 0 J/cm 2 blue light group (102.29% ± 6.57%, all P < 0.003). The relative expression of TYR ( Ftime = 67.94, Fdose = 28.99, Finteraction = 3.71, all P < 0.003), TRP-1 ( Ftime = 21.73, Fdose = 8.38, both P < 0.003) and DCT ( Ftime = 34.51, Fdose = 11.79, both P < 0.003) in melanocytes significantly differed among different doses of blue light irradiation groups and different time points, and tended to increase with the increase of blue light irradiation doses and culture time. Conclusion:Blue light irradiation at doses of 5 - 40 J/cm 2 could inhibit the proliferative activity of human skin keratinocytes, fibroblasts, and melanocytes, and the inhibitory effect tended to increase with the increase of blue light irradiation doses, except an enhancing effect on the proliferative activity of melanocytes observed immediately after irradiation with blue light at 5 J/cm 2; additionally, blue light irradiation at 5 - 40 J/cm 2 could enhance the expression of melanin synthesis-related enzymes in melanocytes, and increase the melanin synthesis rate in melanocytes over a short period of time.

Objective To investigate the clinicopathological characteristics , diagnostic criteria and differential diagnosis of placental chorioangioma.Methods Twenty-five cases of placental chorioangioma were analyzed for their clinical data , histomorphology and immumohistochemical staining .Relevant literature was reviewed.Results The average age of the 25 patients was 29 years.Fourteen patients had full-term pregnancy , 10 had preterm labor , and 1 had intrauterine fetal death .Nineteen patients had pregnancy complications.The tumors presented as red or dusty pink nodules with clear borders.The tumor size ranged from 1 to 16 cm.Microscopically , the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells.These cells were positive for CD 34 and Ki-67 index <10%.Conclusions Placental chorioangioma is a rare benign tumor of the placenta , and is associated with various pregnancy complications .Misdiagnosis of cell-rich type tumor should be avoided .

OBJECTIVETo investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.

METHODSTwenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.

RESULTSThe average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.

CONCLUSIONSPlacental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.

Adult ; Diagnosis, Differential ; Endothelial Cells ; pathology ; Female ; Fetal Death ; Hemangioma ; pathology ; Humans ; Infant, Newborn ; Placenta ; pathology ; Placenta Diseases ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; Stillbirth