Objective To explore a new microsurgical method for reconstruction of finger pulp defect.Methods From May 2008 to May 2009,10 male patients with finger pulp defect were treated in our hospital,aged from 18 to 38 years (average,26 years).The index finger was involved in 6 patients,the middle finger in 3 patients and the ring finger in 1 patient.All finger pulp defects were caused by machine injury.The defect sizes ranged from 1.5 cm×2.0 cm to 2.0 cm×3.0 cm.Six patients suffered from single skin defect,and 4 patinets suffered from skin defect combined with nail bed laceration and distal phalangeal fractures.All patients were performed emergency operations.The defects were reconstructed by using arterialized venous flap with microsurgical suture of the dorsal branch of the proper digital nerve.The fractures were fixed by Kirschner wires.The donor area was covered with skin grafts.Results All flaps survived completely.The fractures healed 8 to 10 weeks postoperatively.All patients were followed up for 4 to 6 months,all flaps presented satisfactory appearance,normal texture,with no pigmentation at the last followup.The static 2-point discrimination of the flaps ranged from 8 to 12mm.All injured fingers obtained good recovery of flexion and extension of the distal interphalangeal joints.The nails of the fingers with laceration of nail bed grew smoothly.The nail bed with laceration grew smoothly,and some new nails could be seen.The skin grafts applied to the donor area survived completely.Conclusion The arterialized venous flap with suture of the dorsal branch of the proper digital nerve is a good method for reconstruction of finger pulp defect,which had the following advantages:slight donor injury,low anesthesia risk,simple operative technique,and satisfactory postoperative function and appearance.

AIM: To investigate the RNAi effect of the inhibitory member of the ASPP family (iASPP) on the apoptosis of human breast cancer cell MCF-7 which expressed the wild type p53 gene. METHODS: The recombinant plasmid pAd-iASPP-RNAi was transfected into MCF-7 cells. The expression of iASPP mRNA and protein was analyzed by RT-PCR and Western blotting, respectively. The cell apoptosis was detected by FCM, and then the MCF-7 cells were transplanted into nude mice to set up transplantation model. The expression of iASPP RNA and protein in transplanted neoplasm were determined by RT-PCR and Western blotting, the apoptosis index was detected by FCM at the same time. RESULTS: The results showed that the expression of iASPP descended in MCF-7 cells (mRNA 95.4% and protein 96.8%, respectively, P<0.01) and the apoptosis rate and necrosis rate of MCF-7 cells increased (P<0.01) after transfection. As treated with pAd-iASPP-RNAi, the expression of iASPP in transplantation tumor cells descended 87.4% (mRNA) and 89.2% (protein), respectively (P<0.01), and the apoptosis rate and necrosis rate increased accordingly (P<0.01, P<0.05). CONCLUSION: The inhibition of iASPP may resume the ability of p53 to induce apoptosis in breast cancer cells which is able to express wild type p53.

Objective To observe the therapeutic effect of adjunctive treatment with Qiangzhu Recipe for ankylosing spondylitis(AS). Methods Forty-eight AS patients were evenly randomized into observation group and control group according to the admission order. The observation group was given Qiangzhu Recipe together with sulfasalazine and celecoxib orally, and the control group received oral use of sulfasalazine and celecoxib. Four weeks constituted one treatment course, and the treatment covered 3 courses. The main clinical outcomes of the patients included Bath AS functional index ( BASFI) , Bath AS disease activity index ( BASDAI) , pain visual analog scale ( VAS) scores, global VAS scores, spinal mobility indexes ( finger-to-floor distance, occiput -wall distance, thoracic mobility, Schober test, scoliolosis test) , and laboratory inflammatory indicators of erythrocyte sedimentation rate (ESR) and C-reactive protein. Moreover, the incidence of adverse reaction was also recorded. Results (1) After treatment for 4, 8, and 12 weeks, the percentage of the patients arriving at the degree of ASAS20 was 16.67%, 33.34%, and 70.83% respectively in the observation group, and was 8.33%, 29.17%, and 58.33% in the control group; the percentage of the patients arriving at the degree of ASAS40 was 4.17%, 20.83%, and 37.50% respectively in the observation group, and was 0.00%, 12.50%and 25.00% in the control group. The differences of the percentage of the patients arriving at the degree of ASAS20 and ASAS40 were insignificant between the two groups (P>0.05). (2) After treatment, symptoms were much relieved, spinal mobility was improved, and inflammatory indicators of ESR and CRP were alleviated in the two groups ( P<0.05 or P<0.01 compared with those before treatment) . The observation group had better effect on BASDAI than the control group ( P<0.01) , but only showed a trend on improving the other clinical outcomes ( P>0.05 compared with the control group). Conclusion Adjunctive treatment with Qiangzhu Recipe exerts certain synergistic action on sulfasalazine and celecoxib in treating ankylosing spondylitis.

Objective To detect the expression pattern of microRNA in A549 cells treated by lipopolysaccharide, study the expression of miRNA-1247-3P in A549 cells under LPS treatment and explore the possible mechanism of miRNA-1247-3P in A549 cells under LPS treatment. Methods A549 cells were divided into experimental and control groups. Immunocytochemical method and RT-PCR were used to detect the changes of SP-A and SP-C. The expression of miRNAs were detected using miRNAs array in different groups. The key miR-1247-3P was collected to detect the changes of miR-1247-3P in all groups using quantitative real-time polymerase chain reaction. Results Compared with control group, the expressions of SP-A and SP-C were significantly decreased in the experimental groups (P < 0.05). MiRNA array showed that 31 miRNAs were up-regulated and 3 miRNAs were down-regulated. Compared with control group, the expression of miR-1247-3P was significantly increased in the experimental groups (P < 0.05). Conclusion The increased expression of miR-1247-3P may play an important role in the pathogenesis of ARDS.

Objective To investigate the efficacy and safety of dexmedetomidine on prevention of emergence agitation in adult patients during recovery period after abdomen surgery.Methods 1 20 ASA I -II patients scheduled for elective abdominal surgery under general anesthesia were randomly divided into three groups:dexmedetomidine group (group A),midazolam group (group B)and the saline control group (group C),40 cases in each group.40min before the end of surgery,dexmedetomidine 0.6μg/kg was continued intravenous infusion 1 0min in group A,midazo-lam 30μg/kg and 1 mL physiological saline were respectively intravenously injected in group B and group C.The post-operative recovery room (PACU)of restlessness,sedation,blood pressure,SpO2 and extubation time were observed. Results In of midazolam group,the time of anesthesia recovery[(1 8.2 ±1 .9)min],extubation[(32.1 ±3.9)min] and PACU staying[(48.7 ±3.1 )min]were significantly longer compared with the dexmedetomidine group[(1 3.1 ± 2.4)min,(26.5 ±2.2)min and (39.8 ±3.4)min,P =0.023,0.040 and 0.003]and the saline group[(1 2.6 ± 2.3)min,(24.8 ±2.9)min and (38.6 ±4.3)min,P =0.01 7,P =0.023 and P =0.001〗.The postoperative seda-tion scores of dexmedetomidine [(2.3 ±0.2 )points,P =0.025 ]and midazolam group [(2.4 ±0.1 )points,P =0.020]were significantly higher than the saline control group[(1 .1 ±0.5)points].The postoperative agitation score of dexmedetomidine (1 .3 ±0.5)points was lower than midazolam group [(2.5 ±0.5)points,P =0.01 1 ]and the saline control group[(2.4 ±0.6)points,P =0.020].HR and MAP of three groups at 2 min before extubation were observed,in the immediate extubation and at 5 min after extubation,the HR of dexmedetomidine group[(62.7 ± 4.1 )times/min,(67.3 ±3.4)times/min and (63.2 ±4.3)times/min]was significantly delayer than midazolam group [(72.3 ±3.4)times/min,(84.9 ±5.3)times/min and (82.1 ±3.1 )times/min],(P =0.002,P =0.001 and P =0.001 )and the saline control group [(73.6 ±2.9 )times/min,(85.3 ±4.7 )times/min and (83.3 ± 4.5)times/min],(P =0.001 ,P =0.023 and P =0.038)at the three time.In the immediate extubation,the MAP of patients in dexmedetomidine group[(87.3 ±4.2)mmHg)]was lower than midazolam group[(93.1 ±4.3)mmHg, P =0.001 ]and the saline control group[(95.6 ±5.8)mmHg,P =0.001 ].At 5 min after extubation,the MAP of patients in both of dexmedetomidine[(84.5 ±3.1 )mmHg)]and midazolam[(85.1 ±2.9)mmHg]group were lower than that in the saline control group[(92.3 ±4.6)mmHg,P =0.023 and P =0.038〗.Conclusion Dexmedetomi-dine could be one of the ideal drug to relieve emergence agitation in adult patients during recovery period after abdo-men surgery and the curative effect is better than midazolam.

Objective To investigate the effects of alcohol extract of Kunmu decoction on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLS). Methods Synovial tissues were obtained from patients with active RA received joint replacement or arthroscopy. The surface antigen and the amount of apoptotic cells were determined by flow cytometry. The inhibitive effect was detected by MTT assay. Results The CD90+surface antigen of synoviocytes was (94.78 ± 0.98)%. The inhibitive effect on the proliferation in all treatment groups were in a time-and dose-dependent manner. The apoptosis rate was increased in a dose-dependent manner among all dosage alcohol extract groups. Conclusion Kunmu decoction might inhibit proliferation and induce apoptosis of RA-FLS.

Objective To evaluate the effect of hydrogen-rich saline on the regulatory T cells (Tregs ) in the peripheral blood during global cerebral ischemia-reperfusion (I/R ) in rats .Methods Seventy-seven male Sprague-Dawley rats ,aged 2-3 months ,weighing 260-300 g ,were randomly divided into 3 groups using a random number table:sham operation group (group S , n=11) ,group I/R (n=33) ,and hydrogen-rich saline group (group H , n=33 ) .Global cerebral I/R was produced by 4-vessel occlusion method .The bilateral carotid arteries were blocked for 15 min followed by reperfusion in I/R and H groups .In group H ,0.6 mmol/L hydrogen-rich saline 5 ml/kg was injected intraperitoneally at 0 and 6 h of reperfusion ,while the equal volume of normal saline was injected instead in the other two groups .Before ischemia (T0 ) in group S and at 6 ,24 and 72 h of reperfusion (T1-3 ) in I/R and H groups ,7 rats were chosen ,the blood samples from the peripheral vein were collected for determination of the number of Tregs . Then the animals were sacrificed and the spleen was removed for measurement of transforming growth factor-β1 (TGF-β1) content .The left 4 rats of each group were sacrificed at T0 and T1-3 and the brains were obtained for examination of the pyramidal cell morphology in the hippocampal CA 1 region and for determination of the number of pyramidal cells in brain tissues .Results Compared with group S , the number of pyramidal cells in the hippocampal CA1 region ,the number of Tregs in the peripheral blood and content of TGF-β1 in the spleen were significantly decreased at T1-3 in group I/R ( P<0.05) .Compared with group I/R ,the number of pyramidal cells in the hippocampal CA 1 region and the number of Tregs in the peripheral blood at T2-3 ,and the content of TGF-β1 in the spleen at T1-3 were significantly increased ( P<0.05) ,and the pathological changes of pyramidal cells were attenuated in group H .Conclusion The mechanism by which hydrogen-rich saline attenuates global cerebral I/R injury may be related to the increased number of Tregs in peripheral blood and promoted secretion of TGF-β1 in rats .

Objective:To verify and discuss the consistency and applicability of the semi empirical formula and Monte Carlo simulation method in the radiation shielding calculation for high energy synchrotron radiation source.Methods:The semi empirical formula and Monte Carlo simulation were used to calculate the ambient dose equivalent outside of the shielding.Results:The ratio of Jenkins semi empirical formula result to Monte Carlo simulation result was 111%-153%. The ratio of Sakano semi empirical formula result to Monte Carlo simulation result was 201%.Conclusions:For a single shielding material, the semi empirical formula can be simple and conservative to complete the shielding calculation for high-energy electron accelerator. For a variety of shielding materials, Monte Carlo simulation method should be used.

Objective:To investigate the efficacy of two-way needle suture technique (TNST) in the minimally invasive repair of acute closed Achilles tendon rupture.Methods:From June 2019 to June 2021, 26 patients with acute closed Achilles tendon rupture were treated at Zhengzhou Orthopedic Hospital. They were 20 males and 6 females, with a mean age of 28 (23, 31) years. The rupture end was (4.2±1.3) cm away from the calcaneal insertion, and the interval from injury to operation 4.3 (2.0, 5.0) d. Preoperative MRI examinations revealed in all the patients closed Achilles tendon rupture which was to be repaired by TNST. The operation time, incision length, incidence of complications, ankle dorsiflexion and plantar flexion were recorded. The Arner-Lindholm scoring was used to evaluate the clinical efficacy.Results:The operation time was (20.0±5.0) min and the incision length (2.5±0.4) cm. Postoperatively, all incisions healed by the first stage, with no complications like incision infection, skin edge necrosis, deep vein thrombosis at lower limbs, injury to the sural nerve, or re-rupture of the Achilles tendon. All patients were followed up for (12.0±6.0) months. At the last follow-up, the patients walked normally, their incisions healed well, the continuity of the Achilles tendon was good by palpation, their heel lift was strong, and all their activities were restored to the levels before rupture of the Achilles tendon. The ankle dorsiflexion was 22.6°±3.7° and the plantar flexion 25.3°±3.7°, According to the Arner-Lindholm evaluation, the clinical efficacy was rated as excellent in 25 cases and as good in 1 case, giving an excellent and good rate of 100% (26/26).Conclusion:In the minimally invasive repair of acute closed Achilles tendon rupture, TNST shows the advantages of limited surgical invasion, a low incidence of postoperative complications, and reliable curative effects.

Objective:To investigate the expression of programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) pathway in patients with acute myeloid leukemia (AML) and its relationship with clinical features and prognosis, and to examine its effect on PD-1-positive natural killer (NK) cells against AML cells in vitro.Methods:The bone marrow samples of 65 AML patients and the peripheral blood of 32 AML patients diagnosed in Affiliated Cancer Hospital of Zhengzhou University from July 2019 to December 2020 were prospectively collected, and the peripheral blood of 24 healthy people was taken as healthy control. The expression level of PD-L1 in bone marrow tumor cells and expression level of PD-1 in peripheral blood NK cells were detected by flow cytometry. The correlations of PD-1 expression in bone marrow tumor cells and PD-1 expression in NK cells with the clinicopathological features, curative effect and prognosis of patients were analyzed. Flow cytometry was used to detect the expression level of PD-L1 in AML cell line THP-1 (target cells) and the expression level of PD-L1 in NK cell line NKL (effector cells). THP-1 cells treated with and without 25 μmol/L of PD-L1 inhibitor fraxinellone were used as experimental group and control group, and co-cultured with NKL cells at different effector-to-target ratios. The apoptosis of THP-1 cells and the expression of NKG2D in NKL cells were detected by flow cytometry, the cell proliferation status was detected by CCK-8 and the cell proliferation inhibition rate was calculated; the levels of interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) in the supernatant of co-culture system were detected by enzyme-linked immunosorbent assay (ELISA).Results:The proportion of AML patients with PD-L1-positive expression in bone marrow tumor cells was higher than that in the healthy control group [38.5% (25/65) vs. 8.3% (2/24), P = 0.029]. The proportion of AML patients with PD-1-positive expression in peripheral blood NK cells was higher than that in the healthy control group [40.6% (13/32) vs. 12.5% (3/24), P = 0.035]. There were no statistical differences in sex, age, hemogram, proportion of primordial cells, risk stratification, chromosomal karyotype, gene mutation (except NPM1 gene), fusion gene and French-American-British cooperative group (FAB) typing between patients with PD-L1 positive and negative in bone marrow tumor cells and between patients with PD-1 positive and negative in peripheral blood NK cells (all P > 0.05). In relapsed/refractory patients, the proportion of patients with PD-L1-positive expression in bone marrow tumor cells was higher than that in newly treated patients [58.8% (10/17) vs. 31.2% (15/48), P = 0.045]. There was no significant difference in the proportion of patients with PD-1-positive expression in peripheral blood NK cells between relapsed/refractory patients and newly treated patients [(38.5% (5/13) vs. 42.1% (8/19), P = 0.837]. There was no statistical difference in complete remission (CR) rate between PD-L1 positive and negative patients [69.6% (16/23) vs. 74.3% (26/35), P > 0.05]. There was no statistical difference in CR rate between PD-1 positive and negative patients [66.7% (8/12) vs. 70.6% (12/17), P > 0.05]. There was no statistical difference in recurrence rate after CR between PD-L1 positive and negative patients [12.5% (2/16) vs. 19.2% (5/26), P > 0.05]. There was no statistical difference in recurrence rate after CR between PD-1 positive and negative patients [25.0% (2/8) vs. 16.7% (2/12), P > 0.05]. Flow cytometry showed that the positive rate of PD-1 in NKL cells was (67±6)% and the positive rate of PD-L1 in THP-1 cells was (85±5)%. After co-culture with NKL cells, the apoptotic rate and proliferation inhibition rate of THP-1 cells were higher in the experimental group compared with the control group, the expression of NKG2D on the surface of NKL cells was elevated, and the levels of IFN-γ and TNF-α in the co-culture supernatant were increased. Conclusions:In AML patients, the expression of PD-L1 in bone marrow tumor cells is high, and the expression of PD-1 in peripheral blood NK cells is also high. The expression of PD-L1 in bone marrow tumor cells of relapsed/refractory AML patients is higher than that of newly treated patients. Inhibition of PD-L1 expression in THP-1 cells can enhance the tumor killing activity of NKL cells in vitro. The mechanism may be that inhibition of PD-L1 expression in THP-1 cells up-regulates the expression of NKL cell activated receptor NKG2D and promotes the secretion of IFN- γ and TNF- α.