Objective Stem cell transplantation is a new approach to the treatment of lower limb ischemia ( LLI) .This study was to investigate the therapeutic effect of the transplantation of autologous bone marrow mesenchymal stem cells ( BM-MSCs) in the treatment of LLI. Methods We established the left LLI model in 12 New Zealand rabbits and divided them into a control and a trial group of equal number.The control animals were injected with DMEM, while the rabbits in the trial group with autologous BM-MSCs, into the ischemic skeletal muscle.Four weeks after injection, we performed CT angiography and perfusion imaging of both lower limbs of the rabbits and conducted HE staining of the paraffin sections of the skeletal muscle of the ischemic limbs. Results Dynamic ob-servation revealed different degrees of ecderon necrosis in 2 of the LLI models in the control group, even with toenail coloboma, but no necrosis in the trial group except for some slight muscular atrophy. Both collateral arteries and blood perfusion were obviously increased in the ischemic lower limbs in the trial than in the control group.HE stai-ning showed a significantly higher density and percentage of capillaries in the skeletal muscle fibers in the former than in the latter ([6.500 ± 1.049]/HP vs [3.670 ±0.816]/HP, [9.68 ±0.56]%vs [5.87 ± 0.86]%, P<0.01), with no necrosis in either group, nor hematoma, bony tissue, or fibroid tumor in the trial group. Conclusion Autologous transplantation of BM-MSCs can improve neovascularization in ischemic lower limbs in rabbits and can be used as a safe and effective treatment of limb ischemia.

Objective To study the imaging features of meningiomas of ethmoid sinuses. Methods Six cases of meningiomas of ethmoid sinuses verified pathologically were analyzed retrospectively. Results CT scans of 6 cases exhibited huge cystic masses ( n =3), huge cystic solid masses ( n =2), huge solid mass ( n =1). The cystic walls were remarkable osteosclerosis. The density of solid masses were homogeneous, or heterogeneous with calcifications and cystic changes, and prominent contrast enhancement. MR images of 1 case (1/6) showed a cystic solid mass, the cystic portion was highsignalintensity on T 2WI and lowsignalintensity on T 1WI, while the solid mass was isosignalintensity on T 1WI and T 2WI. The solid portion was enhanced. X ray plain films of 3 cases (3/6) displayed ethmoid sinuses enlargement and high density. Conclusion For the meningiomas of ethmoid sinuses, CT finding was specific, MRI was helpful in differential diagnosis, and X ray plain film was of no qualitative value.

0.05).Singnificant difference of p21 positive rates was showed between tumor lack of blood supplies and arterial blood (?

Objective To study the relationship among SCT features of tumor margin and tumor size, immunohistochemical findings, grade of cell differentiation, and to explore the potency of tumor marginal features on multiphase spiral CT for evaluating biological behavior of small hepatocellular carcinoma (SHCC).Methods Multiphase spiral CT scans were performed in 30 patients with 33 lesions of SHCC (≤3.0 cm in diameter) confirmed histopathologically. Of these patients,26 were male and 4 were female. Immunohistochemical and HE staining were performed in surgical samples of all patients with SHCC. All samples' size was measured and the number of masses in each patient was counted.Results Of all masses, 6 were complete capsule, 15 incomplete capsule and 12 non-capsule. In multiple linear regression analysis, the pseudocapsula presentation and completion of SHCC on SCT were positively related with tumor size and VEGF expression, negatively with CD34 and p21, and were not in association with p53 and histological grade. Tumor size was the strongest contributor to pseudocapsula completion(R=0.5115), and then VEGF(R=0.2917), CD34(R=-0.2981) and p21(R=-0.2726), which had the similar standardized regression coefficients.Conclusion Tumor size is the strongest relative factor that influenced pseudocapsula presentation and completion of SHCC. VEGF always expressed positively in SHCC with complete pseudocapsula, and negatively in the group of SHCC with incomplete pseudocapsula or without pseudocapsula. In the group of SHCC with incomplete pseudocapsula or without pseudocapsula, p21 always express positively. Neither p53 expression nor histological grade is in association with the pseudocapsula presentation and completion of SHCC on SCT.

ObjectiveTo investigate the changes of high resolution computerized tomography (HRCT) of chest and quality of life and the main correlated factors of HRCT for interstitial lung disease(ILD) in patients with rheumatoid arthritis(RA).MethodsTwenty-six initial treatment patients with RA-ILD were enrolled.The following parameters were noted at baseline,12 and24 weeks for each patient:clinical features,HRCT,quality of life.ANOVA was used for repeated measurement data and stepwise multiple regression analysis were used to analyze the relativity between HRCT and other parameters.ResultsTwentysix patients were included.Twelve male(46％) patients were followed up for 24 weeks and pulmonary infection occurred in 11 patients,so the frequency rate was 42％.After being treated with prednisone and cyclophosphamide for 24 weeks,the HRCT scores were lower than before [(8+6) vs(12±5),respectively] and 16 patients' condition were improved,6 were in stable and 4 had deteriorated disease.For quality of life,the impact scores,symptom scores,activity scores,and total scores of St.George's respiratory questionnaire (SGRQ) were significantly decreased(F=3.783,6.362,4.217,4.426,P＜0.05) and all domains of the short form-36 health survey questionnaire(SF-36) had significant improvement after treatment.Stepwise multiple regression analysis showed that the impact scores(P=0.000) and symptom scores(P=0.001) of SGRQ,vitality (P=0.012) of questionnaire,globulin (P=0.027) in prior treatment and symptom scores (P--0.001 ) of SGRQ,course of disease (P=0.002),MRC score (P=0.011),vitality (P=0.036) of SF-36 questionnaire in post-treatment were the main correlated factors with HRCT features.ConclusionMale RA patients are prone to develop ILD and RA-ILD is susceptible to pulmonary infection.After early treatment,HRCT and quality of life in most patients can be improved.Respiratory symptoms,severity of dyspnea,globulin level,course of disease and vitality of patients are significantly correlated with HRCT.

Objective To research the efficacy and safety of sequential rivaroxaban use in reducing blood loss after applying tranexamic acid(TXA)in total hip arthroplasty(THA).Methods According to the design by the random control principle,150 pa tients undergoing unilateral primary THA from September 2012 to June 2015 were selected and randomly divided into the group A,B,C,D and E (n=30).The group A did not use TXA,the group B received intravenous drip of 10 mg/kg TXA at 10 min before skin incision,the group Creceived intravenous drip of 15 mg/kg TXA at 10 min before skin incision,the group D respectively received intravenous drip of 15mL/kg TXA at 10 min before skin incision and after 3 h,the group E received intravenous drip of 15 mL/kg TXA at 10 min before skin incision and articular cavity use of 1 g TXA before closing the incision.Oral 10 mg rivaroxaban was given at postoperative 6-12 h when the drainage volume was less than 30 mL/h and then the conventional dose was used until postoperative 35 d.The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,postoperative anticoagulation time,time of removing drainage tube,postoperative prothrombin time on postoperative 1 d,activated partial thromboplastin time,descend value of hemoglobin,and occurrence rates of postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE) were observed in the group A,B,C,D and E.Results The intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate and descend value of hemoglobin on postoperative 1 d had statistical differences among 5 groups(P＜0.05).The are significant differences between the group D and A in the intraoperative blood loss,postoperative drainage volume,hidden blood loss,blood transfusion rate,descend value of hemoglobin on postoperative 1 d,postoperative anticoagulation time and removal drainage tube time(P＜0.05).All cases had no symptomatic DVT and PE during the perioperative period and postoperative 3-month outpatient or telephone follow-up.Conclusion Sequential rivaroxaban use after applying TXA during THA perioperative period is safe and effective.Moreover intravenous drip of 15 mL/kg TXA at 10 min before skin incision and after 3 h has most significant effect in reducing bleeding volume during THA perioperative period.

Objective To investigate the effects of hemolysis on glycated albumin (GA) determined by ketoamine oxidase method and its correction.Methods GA concentration and hemolytic parameter(optical density,A) in non-hemolytic serum and different degree hemolytic serum samples were measured.The impact of hemolysis on GA and the relationship between hemolysis and GA were analysed.A formula was developed to correct the interference of hemolysis on GA measurement using regressive Multiple analysis.Results Compared with non-hemolytic serum,hemolysis resulted in the significantly decreased concentrations of GA detected by ketoamine oxidase method(P ＜ 0.01),which were significantly associated with the degree of hemolysis (R2 =0.943 4).Y and Z represented GA concentration of non-hemolytic serum and different degree hemolytic serum,while X represented optical density of hemolytic parameter.Formulas for GA measurement were presented:Y =2.468X + Z-0.015 73,GA concentrations of hemolytic samples can be reverted to the values without statistical difference from the GA concentration in corresponding non-hemolytic samples.The bias of corrected GA was less than 10％.Conclusion Our results indicate that the level of GA measured through ketoamine oxidase method is negatively affected by hemolysis.The formula of mathematical correction of GA results in hemolytic samples should be suitable for the requirements of clinical laboratory.

Human challenge trial (HCT) is a test in which human volunteers are intentionally infected with pathogens in order to evaluate the efficacy of candidate preventive or therapeutic drugs. During the COVID-19 pandemic, the HCT of vaccines has aroused people's attention due to its significant advantages over clinical trial. This paper introduces the concept, development and application of HCT, the advantages and limitations of HCT for vaccine evaluation, and the consideration of future HCT of COVID-19 vaccine in China.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Objective:To investigate the incidence and determinants of vaccine hesitancy towards national immunization program in China and understand the current status of parents' hesitancy to different vaccines used in national immunization program.Methods:A cross-sectional survey was conducted in Beijing, Sichuan and Gansu. The methods of proportional probability sampling and convenience sampling were used to select the eligible study subjects for questionnaire surveys.Results:A total of 3 592 parents were enrolled in the study, in whom 38.22% fully accepted all the vaccines, 59.35% agreed to let their children to receive all the vaccines but showed slight concern, and 2.42% had hesitancy to the vaccines. The vaccine with the most hesitancy was polio vaccine (0.89%), followed by diphtheria pertussis tetanus vaccine (0.70%) and hepatitis A vaccine (0.64%). The dominant reason for vaccine hesitancy was the risk-benefit perception of vaccination (31.03%), followed by the low awareness of the parents (21.84%) and the inconvenience caused by distance and time (21.84%).Conclusions:The incidence of vaccine hesitancy towards national immunization program was low in parents in China, but over 50% of the parents showed concern to the vaccines. It is essential to improve the service quality of national immunization program and strengthen the health education about the vaccination to reduce the incidence of vaccine hesitancy in parents.