Objective To investigate the effects of penehyclidine hydrochloride injection combined with safflower injection on TLRs/NF-κB signaling pathway and T cell subsets in mononuclear cells of patients with organophosphorus pesticide poisoning. Methods 80 cases of organophosphate poisoning patients from June 2014 to June 2016 in onglu first people's hospital were selected,randomly divided into control group and observation group, the control group was treated with penehyclidine hydrochloride,observation group were treated with Honghua injection based on the treatment of control group. The effects were compared between two groups of TLRs/NF-κB in peripheral blood mononuclear cells pathway and T cell subsets in peripheral blood, and compared two groups of patients with cholinesterase activity. Results On the third,fifth and 7th day of treatment,cholinesterase activity in both groups was higher than that before treatment,the activity of cholinesterase in the observation group was significantly higher than that in the control group (P<0.05).After treatment,compared with before treatment,the levels of TLR2,TLR4 and NF-κB in the two groups were significantly decreased,and TLR2,TLR4,NF-κB levels in the observation group were lower than those in the control group, the difference was statistically significant (P<0.05),Th17,Th17/Treg levels in the observation group were significantly lower,and lower than the control group,Treg content was significantly higher,and higher than the control group,the difference was statistically significant (P<0.05). Conclusion Penehyclidine hydrochloride injection combined with safflower injection can help to reduce Th17,Th17/Treg levels,increased Treg cell content,regulate the inflammatory response, and promote recovery of cholinesterase activity.

Objective To explore humidifying effects for artificial airway of mechanically ventilated patients by heat/moisture exchanger(HME) combined closed endotracheal suctioning(CS).Methods A total of 114 patients who had mechanical ventilation for at least 48h were randomly divided into two groups with 59 cases in experimental grooup and 55 cases in control group.HME combined CS were used in the experimental group,heated humidifier combined open endotracheal suctioning were used in the control group.The effect of humidification, the reserved time of artificial airway,the time on mechanical ventilation, the time of stay in ICU, the incidence of ventilator-associated pneumonia(VAP) and the mortality rate between the two groups were compared.Results Significant differences were found in the effect of humidification between the experimental group and the control group,more cases found insufficiency of humidification or excessive humidification and airway spasm in the control group, however,less time on mechanical ventilation and stay in ICU in the experimental group.The incidence of VAP in the control group was significantly higher than that in the experimental group.There were no significant differences existed in the reserved time of artificial airway and the mortality rate between the two groups.There were no accident of humidification occurred in the experimental group,while 8 cases complicated with choking with water in the control group.Condusion HME combined CS,used in mechanically ventilated patients ,could help to improve the effects of airway humidification and reduce the incidence of VAP,also shorten the duration of mechanical ventilation.

A 41-year-old female patient developed round,bright yellow patches on the left calvarial region without obvious precipitating factors 40 years prior to the presentation,which gradually grew to form plaques with age.Two years prior to the presentation,nipple-like lesions appeared in the calvarial and temporal region with an erythematous and wet surface; concurrently,black masses developed in the left temporal region and gradually enlarged with central ulceration but no subjective symptoms.At about 1 year of age,pitchy macules developed on the light tan patches located on the left jaw,posterior and anterior neck,trunk and upper limbs,and gradually increased in quantity and size with the involvement of the homolateral dorsal hand and gradual appearance of papules.Skin examination revealed two well-marginated,indurated,bright red neoplasms sized 3 cm × 2 cm and 2 cm × 1 cm respectively,with erosive and cauliflower-like surface; black or pink papules were scattered between these neoplasms.There was a ring-shaped black mass sized 1.5 cm × 1.5 cm in the left temporal region with central ulceration.Pitchy tough macules and papules were observed on the light tan patches located in the left cheek,lower mandible,posterior and anterior neck,protothorax,shoulder and back,upper limbs and dorsal hand.Based on the histopathology of multiple lesions,the cauliflower-like lesions on the head were diagnosed as syringocystadenoma papilliferum,the yellow plaques as syringocystadenoma papilliferum complicated by sebaceous adenoma,the black proliferative lesions in the temporal region as trichoblastoma accompanied by basal cell epithelioma,the black papuloid lesions and brown maculopapuloid lesions on the lower mandible as nevus spilus.The patient was diagnosed with skin adnexal tumor with multipotential differentiation (syringocystadenoma papilliferum,sebaceous adenoma,trichoblastoma and basal cell epithelioma)accompanied by nevus spilus.

Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.

Objective:To analyze the status of ethical management of biobanks in Shanghai public hospitals. Methods :A questionnaire survey on ethical management of biobanks was conducted in 9 representative ethics com-mittees, which were established in public hospitals with biobanks in Shanghai. Results: The ethics committees in Shanghai public hospitals had paid relatively high attention to ethical review of protocols were related to biobanks. Nonetheless, the ethical supervision and training on biobanks in Shanghai public hospitals should be enhanced. Con-clusion:The unified ethical guideline on biobanks should be developed in Shanghai for strengthening the standard-ized ethical management and ethics training to promote the development and use of biological samples library re-sources.

Apoptosis has been considered as the only form of regulated cell death for a long time. However, a novel form of programmed cell death called necroptosis was recently reported. The process of necroptosis is regulated and plays a critical role in the occurrence and development of multiple human diseases. Thus, the study on the molecular mechanism of necroptosis and its effective inhibitors has been an attractive field for researchers. Herein, we introduce the molecular mechanism of necroptosis and focus on the literature about necroptosis drug screening in recent years. In addition, the identification of the critical drug targets of the necroptosis is also discussed.

Objective To research the effect to the semen quality of the three operation methods of superiority of highly selective varicocele high ligation,transinguinal canal and laparoseopic of renovated polomo management of varicocele.Methods 561 patients in our hospital who charged by infertility had the operation were analyzed retrospectively and were recruited with primary varicocele above grade II for this study.These patients were divided into three group according to three kinds of operation methods of varicocele :group A was treated with highly selective varicocele high ligation and had 300 patients;group B was treated with transinguinal canal operation and had 181 patients; and group C was treated by laparescopic of renovated polomo operation with 80 patients.Through the comparing of the fertility ability of the three operation methods,to evaluate the therapeutic effect of the three methods.Results The increasing rates of the quality of semen in group B was higher than other groups if patients' ages were lower than 30.The increasing rates of the quality of semen in every group was also higher if patients' ages were lower than 30.No difference was found between three groups in natural conception rate (P＞0.05).Conclusion The methods of highly selective varieecele high ligation would be a better choice in the management of patients with primary varicecele because of higher quality of semen.

Objective:To investigate the effect of bone mesenchymal stem cells derived exosomes (BMSC-Exo) on improving hippocampal microangiogenesis, energy metabolism, and behaviors in depression mouse models.Methods:(1) Mouse bone marrow mesenchymal stem cells were isolated and cultured to extract BMSC-Exo; BMSC-Exo morphology was observed by transmission electron microscopy, BMSC-Exo particle diameter ranges were determined by Zetaview analyzer, and expressions of CD9 and CD63 in BMSC-Exo were detected by Western blotting. (2) Depression models were established in 2 mice by chronic unforeseeable mild stress (CUMS); 24 h after stereotaxic injection of phosphate buffer solution (PBS) or DiR labeled BMSC-Exo, BMSC-Exo uptake was detected by in vivo imaging system. (3) Thirty-six mice were randomly divided into control group, model group and BMSC-Exo group ( n=12); CUMS was used to establish depression models in the latter 2 groups; brain stereotaxic injection of 1 μL BMSC-Exo was given to mice in the BMSC-Exo group after modeling, and same amount of PBS was given to the control group; behaviors were observed by forced swimming test (FST), tail suspension test (TST) and open field test (OFT); hippocampal microvascular length and number were detected by alkaline phosphatase staining; energy metabolism in the hippocampus was detected by micro positron emission tomography/computed tomography (mPET/CT); glucose transporter 1 (GLUT1) expression in the hippocampus was detected by Western blotting. Results:(1) BMSC-Exo had a typical disk-like vesicle-like structure with particle size of (100.5±1.4) nm; Western blotting confirmed that CD9 and CD63 expressed in BMSC-Exo. (2) In vivo imaging showed no fluorescence in the brain and liver after PBS injection, but obvious local fluorescence after BMSC-Exo injection. (3) Compared with the control group, the model group and BMSC-Exo group had significantly longer rest time in FST and TST and shorter movement distance and time in the central region of OFT ( P<0.05); compared with the model group, BMSC-Exo group had significantly shorter rest time in FST and TST and longer movement distance and time in the central region of OFT ( P<0.05). Compared with the control group, the model group and BMSC-Exo group had significantly decreased standard uptake value (SUV) of regions of interest, microvascular length and number, and GLUT1 expression in the hippocampus ( P<0.05); compared with the model group, the BMSC-Exo group had significantly higher SUV, microvascular length and number, and GLUT1 expression in the hippocampus ( P<0.05). Positive correlations were noted between hippocampal microvascular length and SUV and between microvascular number and SUV in the 3 groups ( r=0.540, P<0.001; r=0.600, P<0.001). Conclusion:BMSC-Exo could promote microangiogenesis energy metabolism in the hippocampus to improve depression-like behaviors in depression mouse models.

Pancreaticoduodenectomy is one of the most difficult abdominal operations, and the difficulty in resection and complicated digestive tract reconstruction have brought great challenges for surgeons. At present, laparoscopic pancreaticoduodenectomy has been widely used in clinical practice, and compared with traditional 2D laparoscopy, 3D laparoscopy has the features of high magnification, high definition, and three-dimensional vision, which enables surgeons to see more clearly and operate more accurately, and thus it has great potential to be widely used in pancreaticoduodenectomy.

Identification of the risk factors for conversion to cesarean section during labor can significantly improve the mother and infant outcomes. Though advocated by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), intrapartum ultrasound is not widely practiced in managing labor progress. The Obstetrics and Gynecology Center of Zhujiang Hospital of Southern Medical University has carried out intrapartum ultrasound in recent years. We summarize the clinical key point and the significance of measuring the major sonographic parameters during labor and illustrate the role of occiput-spine angle, a new sonographic index, in predicting fetal head descent during the first stage of labor.