Objective: To investigate the expression of tumor suppressor gene PTEN in the radiation-induced mouse thymoma cells, and to observe the inhibitory effect of exogenous PTEN transfection on the in vitro proliferation and in vivo tumor forming ability of radiation-induced thymoma. Methods: Immunohistochemistry SP and Western blotting assay were used to examine the expression of PTEN, γ-H2AX, and Rad51 protein in radiation-induced mice thymoma and normal thymus tissues. RT-PCR assay was conducted to examine the PTEN gene loss. Exogenous PTEN gene was transferred into mouse thymoma cells and its inhibitory effects on cell proliferation and tumor-forming ability were observed. Results: The positive rate of PTEN protein expression was 22.73% (5/22) in radiation-induced thymoma tissue, significantly lower than that in the normal thymus tissue (P < 0.01). Western blotting assay showed that the expression of PTEN protein in thymoma was markedly lower than that in the normal thymus tissue (P<0.01). RT-PCR found that in tumor tissue there was high-frequency of PTEN gene loss. Exogenous PTEN expression in thymoma significantly inhibited the cell proliferation and the tumor-forming ability (P<0.01). The expression of γ-H2AX protein in the thymoma tissue was significantly higher than that in the normal thymus tissue; the expression of Rad51 protein was significantly lower than that in the normal tissue. Conclusion: Loss of PTEN gene may contribute to radiation-induced thymoma via influencing the Rad51-mediated DNA repair pathway. Exogenous PTEN gene transfer can inhibit the in vitro proliferation of thymoma cells, which may contribute to the treatment and prevention of radiation-induced tumor.

Objective: To investigate the effects of estradiol on 60Co γ-ray induced apoptosis of bone marrow hematopoietic cells of mice, and to discuss the related anti-irradiation mechanism. Methods: KM mice were randomly divided into 3 groups (15 mice/each group): control group (without radiation), pure radiation group and estradiol + radiation group (ER group). The pure radiation group was irradiated by 4.0 Gy γ-ray at a dose rate of 1.15Gy/min; the ER group was administered with 0.1 mg estradiol (IM) at 10 days before 4.0 Gy γ-ray radiation; and the control group received no special treatment. The apoptotic DNA segments of bone marrow hematopoietic cells were analyzed by DNA agarose gel electrophoresis; flow cytometry was used to examine the apoptosis rate of cells and expression of Fas and Bcl-2 at 4 h, 8 h, and 12 h after irradiation. Results: Eight hours after radiation, the apoptotic DNA segments were obviously increased and apoptotic DNA ladder appeared, which was not seen in the other 2 groups. The apoptosis rate of bone marrow hematopoietic cells in ER group was significantly lower than that in the pure radiation group at 4, 8, and 12 h after irradiation(P<0.01). Fas expression was only slightly elevated in the ER group than in the control group, but was markedly lower than that in pure radiation group(P<0.01), and showed no typical crest-time; Bcl-2 expression was significantly higher in the ER group than in the pure radiation group(P<0.01). Conclusion: Estradiol can decrease the apoptosis of mice bone marrow hematopoietic cells induced by γ-ray, probably through down-regulation of Fas and up-regulation of Bcl-2 expression.

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.

Objective To compare the X-ray features between Hirschsprung alied disease (HAD)and Hirschsprung disease ( HD), and analyze the differentiations. Methods From December 2004 to December 2009, nineteen cases of HAD, aged from 30 days to 10 years (median, 14 months), received barium enema examinations in our institution. Other 19 cases with HD, also received barium enema examinations, were chosen randomly. They were aged from 42 days to 8 years ( median, 8 months). The imaging features of HAD and HD were analyzed retrospectively. The incidence rate of colon stenosis,"truncation sign" and spasm notch and R/C ratio (the longest diameter of rectum/colon) were calculated and compared between these two groups. In all these cases, diagnosis was confirmed by postoperative histopathology. The position of barium retained was also evaluated. These parameters of both groups were compared by x2 and Fisher test. Results There was statistical significance in the incidence rate of colon stenosis between HAD (9/19) and HD (18/19) (x2 = 10.364, P ＜0.01). However, there was no statistical significance in "truncation sign" and spasm notch between HAD (4/19 and 3/19, respectively)and HD ( 1/19 and 1/19, respectively) (P ＞0. 05 for both). R/C ratio was 0. 42 ±0. 15 in HAD group and 0.29±0. 12 in HD group, and there was statistical significance between them (t =2.892,P＜0.01). In HAD group, barium retained in distal sigmoid colon in 1 case (1/19), in distal descending colon in 7 cases (7/19), in distal transverse colon in 1 case (1/19), in total colon in 6 cases (6/19); However, in HD group, barium retained in distal rectum in 3 cases (3/19), in distal sigmoid colon in 13 cases ( 13/19), in distal descending colon in 3 cases (3/19). Conclusions There were some differences in the imaging features between HAD and HD though they presented similar clinic experience. HAD cases presented a lower incidence rate of colon stenosis and a higher R/C ratio than HD cases. In HAD cases, the most common site of barium retained is distal descending colon, while in HD cases, it is distal sigmoid colon.

OR group,moreover the differences were significant(P0.05),however,both genes in the 2 groups′ expression level significantly were lower than that in control group(Pa

AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Objective To investigate the value of high-frequency ultrasound in diagnosis of thyroid carcinoma by comparative analysis of high-frequency ultrasound and spiral CT imaging results. Methods The imaging results of patients with thyroid carcinoma proved by postoperative pathology or biopsy results were reviewed.High-frequency ultrasound and spiral CT were used to examine the 35 patients in The Tumor Hospital of Harbin Medical University between 2007 and 2009. Results Diagnosis of thyroid carcinoma by application of Highfrequency ultrasound were 27 cases, diagnosis rate was 77.1%(27/35);by spiral CT were 25 cases, diagnosis rate was 71.4% (25/35);comparison of the two methods showed no significant difference (x2= 0.3, P ＞ 0.05). Combined application of high-frequency ultrasound and spiral CT diagnosed 33 patients with thyroid carcinoma, diagnosis rate was 94.3%(33/35), which was significantly higher than that of high-frequency ultrasound alone or that of spiral CT alone(compared with high-frequency ultrasound, x2 = 4.2, P ＜ 0.05;and spiral CT, x2 = 6.4, P ＜ 0.05). Conclusion Combined application of high-frequency ultrasound and spiral CT can improve the diagnosis rate of thyroid carcinoma.

Objective To investigate the predictive value of fluid overload for mortality in children with severe sepsis.Methods In this retrospective study,the children with severe sepsis who were admitted to the Pediatric Intensive Care Unit (PICU),Children's Hospital of Soochow University between January 2011 and March 2015.Fluid accumulation was calculated in the first 72 hours after admission.Pediatric index of mortality Ⅱ (PIM2) score was calculated during the first 1 hour after admission.Multivariate Logistic regression analysis assessed the relationship between fluid overload and mortality after adjustment for confounding factors.The predictive value of fluid overload for mortality was assessed by the receiver operating characteristic curve and au area under the receiver-operating-characteristic curve (AUC).Results Of the 199 children admitted,62 cases (31.2％) died during PICU stay.Among the children,133 cases (66.8％) had fluid overload of＜5％,55 cases (27.6％)had fluid overload of≥5％-10％,and 11 cases (5.6％) had fluid overload of≥ 10％.Multivariate regression analysis showed that a high fluid overload percent (OR =1.263,95 ％ CI:1.113-1.434,P ＜ 0.001),a high PIM2 score (OR =1.028,95 ％ CI:1.012-1.043,P ＜ 0.001) and multiple organ dysfunction syndrome(OR =4.160,95％ CI:1.728-10.012,P =0.001) were independent risk factors for mortality in children with severe sepsis.The fluid overload was significantly associated with mortality (OR =1.309,95％ CI:1.158-1.480,P ＜0.001),even after adjustment for age and illness severity assessed by PIM2 scores.Fluid overload achieved AUC of 0.741 (95％ CI:0.661-0.820,P ＜ 0.001) for predicting mortality in children with severe sepsis.Conclusion Fluid overload developed during the first 72 hours after admission is independently associated with and predictive of PICU mortality in children with severe sepsis.

OBJECTIVE: To evaluate decision regret among patients receiving penile girth enhancement with acellular dermal matrix (PGE with ADM) and to investigate the potential indicators for decisional regret so as to facilitate the decision-making process for this special group. METHODS: In the study, 78 patients receiving PGE with ADM from Jun. 2016 to Jan. 2019 at Peking University People's Hospital and cooperative hospitals were eligible. Penile girth was taken by only one surgeon 1 week before surgery. Hospital anxiety and depression scale (HAD), international index of erectile function (IIEF) and a 10 cm long visual analogue scale named visualized penile image (VPI) were applied to measure psychological burden, erectile function and satisfaction with penile image respectively at the same time. All the patients were followed up for 3 months. Decision regret scale (DRS) was adopted for measuring decisional regret. Multivariate analysis of variance was applied to investigate the potential indicators for regret. Data analysis process was conducted with SPSS (version 24.0; SPSS, Chicago, IL, USA). RESULTS: Mean penile girth recorded before intervention was (8.29±0.30) cm and increased to (9.46±0.29) cm post surgery (t=76.28, P < 0.01). As for both subscales of HAD measuring psychological burden, a signi-ficant reduction in the mean score was seen, that is, 2.8±1.3 (t=19.28, P < 0.05) for anxiety and 3.0±1.2 (t=20.67, P < 0.05) for depression, respectively. The average score of VPI increased by 3.7±1.1 (t=30.63, P < 0.05). There was no significant change in the average score of IIEF measuring erectile satisfaction (t=1.60, P=0.11). Twenty-nine (38.2%) patients expressed regret to some degree, and the mean DRS score was 23.4±14.8. The scores of DRS correlated negatively with scores of visualized penis image (r=-0.348, P < 0.01), and positively with scores of anxiety (r=0.760, P < 0.01) and depression subscale (r=0.471, P < 0.01). The scores of DRS was irrelevant to those of IIEF (r=0.02, P=0.867). The patients with high annual income (> 120 000 yuan) and education level above undergraduate were more prone to experience decision regret after intervention (P < 0.01). CONCLUSION PGE with ADM did augment penile girth and lower psychological burden, the regret rate of which was acceptably low among the patients. High income and good education might indicate more post-operative regret. Additional decision-making aids should be offered to patients with high income and education level above high school.
Acellular Dermis ; Emotions ; Humans ; Male ; Patient Satisfaction ; Penile Erection ; Penis ; Reconstructive Surgical Procedures

Objective: To understand characteristics of men who have sex with men (MSM) who applied for HIV antibody self-testing reagents through "AIDS self-testing" column of a WeChat official account named "Dark Blue Public Health Center" in Tianjin City, so as to provide insights into exploring online modes of HIV antibody self-testing for MSM. Methods: Data of MSM who were 18 years old or above, currently lived in Tianjin City, had sex with men in the past six months and applied for HIV antibody self-testing reagents through "AIDS self-testing" column from May 2018 to December 2022 were collected. Demographic characteristics, results return and positive findings were descriptively analyzed. Results: Data of 2 064 MSM were collected, including 1 052 MSM aged 20 to 29 years (50.97%), 1 522 unmarried MSM (73.74%), 545 workers (26.41%), 1 385 MSM with college education or above (67.10%), and 315 MSM without testing for HIV antibody in the past (15.26%). A total of 6 470 self-testing reagents were applied, and 5 942 testing results were returned, with a return rate of 91.84%. There were 33.28% (687/2 064) of the applicants applying for 66.32% (4 291/6 470) reagents multiple times. There were 73 MSM with positive results, accounting for 1.23%. Conclusions The MSM applying for HIV antibody self-testing reagents through "AIDS self-testing" are mainly young and highly educated, including some who have never tested for HIV. However, attention should be paid to duplicate applications and the return rate should be increased.