OBJECTIVE:To improve the formula of urea cream and establish its quality control methods.METHODS:The matrix component of formula was adjusted to prepare O/W matrix.Prednisone was added into matrix to prepare urea cream;UV spectrophotometry was applied to determine the content of urea and evaluate the quality of preparation and the stability of 3 batches of samples setting for 40 days under different conditions.RESULTS:The preparation was white cream and its inspection results were in line with the standards stated in Chinese Pharmacopoeia(2005 edition).The linear range of urea was 30.5～180.2 ?g?mL-1(r=0.999 0) with an average recovery of 99.68%(RSD=0.49%).The quality of 3 batches of samples kept stable during observation.CONCLUSION:Improved formula is reasonable,simple in preparation technology and quality control.

BACKGROUND: Muscle-derived stem cells (MDSCs) have been accepted as seeding cells in tissue engineered artificial nerves. Tacrolimus exhibits anti-immunologic rejection and promotes nerve regeneration and recovery. Whether can combine these factors with acellular nerve to form a new bridge that can inhibit immunologic rejection and promote nerve regeneration is uncertain. OBJECTIVE: Using the freeze-thawing combined optimized acellular nerve hypotonic-chemical detergent to prepare acellular nerveallograft scaffold. To explore the effect of co-application of MDSCs and FK-506 on nerve regeneration and function recovery following acellular nerve ailograft implantation.METHODS: The sciatic nerve derived from SD rats was prepared nerve bridge after acallular disposal. Gel containing FK-506 and MDSCs was injected into acellular nerveallograft scaffold with 100 μL microsyringe to repair defects. A total of 32 SD rats were randomly divided into 4 groups, with 8 animals in each group. Agap of 10 mm of left sciatic nerve was removed. And then the defects were repaired by extracted nerve graft containing FK-506+MDSCs, MDSCs and FK-506, respectively. In the control group, only hyaluronic acid gel was injected. Sciatic nerve function index (SFI) and electrophysiological exam were performed at weeks 8 and 12 after operation. Gross observation, neurohistological and ultrastructure were observed at week 12 after operation.RESULTS AND CONCLUSION: Compared with the same time point, the SFI, recovery rate of the motor nerve conduction velocities (MNCV), and myelinated nerve fibers in grafting part and in its distal part in the FK-506+MDSCs group were superior to other groups (P < 0.05). The nerve grafts were in normal size with considerabie blood vessels and slightly connected to peripheral Ussues. Compared to other groups, the regenerated nerve fiber in the FK-506+MDSCs group was more density with well-arranged order. A great quantity of Schwann cells proliferated in grafting. The density end diameter of myelinated fiber in the middle and distal part of the grafting were all greater than that of MDSCs and FK-506 groups, and there were few connective tissues between microfascicles, which was close to normal level. The co-application of MDSCs and FK-506 enhances peripheral nerve regeneration and functional recovery in acelluler nerve allograft graft. Therefore, MDSCs and FK-506 are synergistic factors in peripheral nerve injury repair.

Objective To observe the safety and efficacy of the posterior spinal instrumentation (PSI) with preserving of the intraspinal rib head in neurologically intact patients with scoliosis secondary to Neurofibromatosis type 1 (NF1).Methods The clinical and radiographic data of nine NF1 scoliosis patients with rib head protrusion into the spinal canal,who had undergone PSI from August 1998 to March 2012,were retrospectively investigated.The average age of these patients (4 males,5 females) was 15.4±7.6 years,and their neurological status all were Frankel grade E preoperatively.The intraspinal rib head was not resected in all patients intraoperatively.The following parameters,including the magnitude of rib head penetration into the spinal canal (MRPC),the angle between the bilateral rib (ABR),the angle between the dislocated rib and the posterior vertebral wall (ARV),the coronal Cobb angle and the sagittal Cobb angle,were measured before and after surgery.Results The follow-up period was 0.5 to 4.8 years.The average MRPC decreased from preoperative 32.8％±9.9％ to postoperative 16.8％±15.2％ (P=0.026); the average ARV increased from preoperative 34.7°±16.4° to postoperative 47.8°±17.5° (P=0.001); the average ABR decreased from preoperative 83.0°±19.5° to postoperative 67.9°±13.3° (P=0.009); the average coronal Cobb angle decreased from preoperative 70.7° ±17.7° to 35.4°±17.0° immediately after operation (P=0.000) and the sagittal Cobb angle decreased from preoperative 59.7°±17.6° to 24.7°±10.8° immediately after operation (P=0.001).The coronal Cobb angle and sagittal Cobb angle had no significant change during follow-up period.The neurological status was Frankel grade E in all patients immediately after operation and at final follow-up.Conclusion For NF1 scoliosis patients with rib head penetration into the spinal canal without impingement of the spinal cord and neurological deficits,the deformity can be corrected safely and effectively without resecting the intraspinal rib head.

Objective To investigate the utility of combined test of neutrophil CD64 and C-reactive protein(CRP)for early diag-nosis of burn sepsis.Methods A prospective study was conducted in 76 hospitalized burn patients,including three groups:burn sepsis(n=27),local infection(n=31)and controls without bacterial infection (n=18)based on their diagnosis.Blood samples were collected within 24-48 h after hospital admission for analysis of neutrophil CD64,CRP,white blood cell count (WBC), neutrophils percentage (N)by flow cytometry,and bacterial culture.These parameters were re-evaluated for the patients in sepsis group 7 and 14 days after antibiotic therapy.Results Neutrophil CD64,CRP,WBC and N were significantly higher in sepsis patients than the corresponding values in the patients with local infection or control patients (P < 0.01 ).Neutrophil CD64 and CRP in the patients with local infection were significantly higher than those in the control patients without bacterial infection (P < 0.01).Neutrophil CD64 was positively correlated to CRP.Neutrophil CD64 and CRP decreased 7 days after an-tibiotic therapy,but the difference was not statistically significant compared to the pretreatment levels.Neutrophil CD64 and CRP decreased significantly 14 days after antibiotic therapy compared to the pretreatment levels (P < 0.01),but still higher than the levels in the control group.The receiver operating characteristic (ROC)curve of CD64 + CRP combined test,CD64, CRP,WBC,N for detecting bacterial infection showed an area under curve (AUC)of 0.952,0.923,0.904,0.756 and 0.728,respectively.Conclusions Neutrophil CD64 is useful in early diagnosis of burn sepsis.The expression of neutrophil CD64 does not have significant difference between gram-positive and gram-negative bacterial infections.Combined test of neutrophil CD64 and CRP can improve the efficiency for diagnosis of burn sepsis.

Objective To analyze the phenomenon of sleep benefit in Parkinson's disease (PD)and its correlation factors.Methods One hundred PD patients in Department of Neurology,Qilu Hospital of Shandong University from February 2017 to November 2017 were included.They were recorded in detail the clinical information and clinical classification.Sleep conditions were assessed by Pittsburgh Sleep Quality Index,Parkinson Disease Sleep Scale,Epworth Sleepiness Disorder Scale and Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire.The general information,disease duration,medication,movement function,sleep condition and anxiety status were compared between sleep benefit group and without sleep benefit group.The correlation factors of sleep benefit was evaluated using unconditional Logistic regression analysis.Results Fifty-one cases (51％) of sleep benefit were determined in our cohort of 100 PD patients.Sleep benefit group adminstered lower levodopa equivalent daily dose (LEDD,(354.77 ± 279.64) mg/d) compared with patients without sleep benefit ((510.76 ± 266.26) mg/d,t =-2.734,P =0.006),including levodopa ((289.04 ± 228.73) mg/d vs (392.65 ± 211.20) mg/d,t =-2.366,P =0.021) and dopamine agonist dose ((41.13 ± 51.48) mg/d vs (68.01 ± 57.10) mg/d,t =-1.950,P =0.054).Sleep benefit group had higher percentage of using dopamine agonist (23(45.1％) vs 35 (71.4％),x2 =7.112,P=0.008) and longer duration of nocturnal sleep episode ((6.51 ± 1.31) h vs (5.89 ± 1.29) h,t =2.412,P =0.018).In addition,sleep benefit had a higher prevalence in tremor-dominant subtype of PD (19/27 (70.4％) vs 20/46 (43.5％),x2 =4.855,P =0.025).Logistic regression indicated that sleep benefit had a positive correlation with duration of nocturnal sleep episode and tremor-dominant subtype,as well as a negative correlation with LEDD and dose of levodopa.LEDD and duration of nocturnal sleep episode were the independent factors of sleep benefit (OR =0.998,95％CI 0.997-1.000,P＜0.05;OR=1.407,95％CI1.004-1.972,P＜0.05).Conclusion PD patients with sleep benefit administered low dose of dopamine and took long nocturnal sleep,which may relate to the relativelv preserved dopamine storage function of dopaminergic neurons.

Objective To examine the association between uric acid (UA)levels of patients with acute ischemic stroke at ad-mission and discharged outcome.Methods The acute ischemic stroke patients of Xinganmeng People’s Hospital in Inner Mongolia,from June 1,2009 to May 31,2012 were continuity included in the present study,the included analysis sample size were 3 440 cases.Poor discharged outcome was defined as the occurrence of disability or death.With reference to the Modi-fied Rankin's Scale (MRs)Stroke Scale,Scores were recorded in the questionnaires,score of 3 or more (MRs≥3)was de-fined as disability.The patients were all grouped by P20,P60,P90 of UA,binary logistic regression were used in studying of risk factors,calculated the odds ratios (Odds ratio,OR)and 95% confidence interval (95% Confident interval,95%CI).All tests were two-sided test and a significance level of 0.05.Results A total of 359 people occurred poor outcomes in the stud-y,accounting for 10.44%.Univariate logistic regression analysis of poor outcome occurred showed that relative to the lowest group(P20,UA≤222.6 mmol/L),the second and third group (UA:222.7 ~ 310.9 mmol/L and 311.0~419.7 mmol/L) OR (95% CI)were:0.70(0.53~0.91)(P <0.05)and 0.66(0.49~0.88)(P <0.05).After adjusted age,body tempera-ture,high blood pressure,hyperglycemia,history of stroke,high triglycerides,high LDL-C and smoking,relative to the low-est level group,the second and third group occurred poor outcoming OR (95% CI)were:0.70(0.53~0.93)(P <0.05)and 0.66(0.48~0.90)(P <0.05).Conclusion Higher levels of uric acid levels in patients with acute ischemic stroke may inde-pendently related with occurred poor discharged outcome.

Objective:To investigate the effect of Zhitong-Rusheng Decoction on wound healing and serum fibronectin (FN) and epidermal growth factor (EGF) levels after anal fistula operation. Methods:A total of 102 patients after anal fistula operation in our hospital from March 2018 to March 2020 were randomly divided into control group (51 cases) and observation group (51 cases) according to the random number table method. The control group was treated with conventional western treatment, while the observation group was treated with Zhitong-Rusheng Decoction on the basis of control group. The two groups were treated for 3 weeks. The clinical symptoms were scored before and after treatment, and the levels of serum FN and EGF were detected by ELISA. The wound healing time, hematochezia disappearance time, wound longitudinal diameter and wound area before and after treatment were observed. The clinical efficacy was evaluated after treatment. Results:The total effective rate was 98.0% (50/51) in the observation group and 72.6% (37/51) in the control group, with significant difference between the two groups ( χ2=13.209, P<0.01). After treatment, the pain degree score, wound exudation score and granulation morphology score of the observation group were significantly lower than those in the control group ( t=15.448, 21.424, 28.641, P<0.001). After treatment, the wound healing time [(6. 04 ± 1.20) d vs. (9.42 ± 1.58) d, t=12.166] and the disappearance time of hematochezia [(15.72 ± 2.86) d vs. (19.95 ± 4.33) d, t=6.862] of the observation group were significantly shorter than thosse of the control group( P<0.01). After treatment, the wound longitudinal diameter [(1.89 ± 0.31) cm vs. (2.82 ± 0.54) cm, t=10.666] and wound area [(3.26 ± 0.54) cm 2vs. (4.98 ± 1.10) cm 2, t=10. 024] of the observation group were significantly less than those in the control group ( P<0.01). The serum FN [(2.92 ± 0.50) mg/L vs. (2.45 ± 0.39) mg/L, t=5.293], EGF [(7.03 ± 1.44) μg/L vs. (5.47 ± 1.03) μg/L, t=6.293] of the observation group were significantly higher than those in the control group ( P<0.01). Conclusion:Zhitong-Rusheng Decoction on the basis of conventional treatment on patients after anal fistula operation has a good efficacy, which is conducive to wound healing, reducing clinical symptoms, and improving serum levels of FN and EGF.

Objective:To compare the clinical efficacy and complications of intra-arterial chemotherapy (IAC) and intravenous chemotherapy (IVC) for unilateral advanced retinoblastoma (RB).Methods:A retrospective clinical study. From January 2020 to January 2021, 40 patients (40 eyes) unilateral group cT2 RB patients diagnosed at Baoding Children’s Hospital and Beijing Children’s Hospital were recruited in this study. There were 22 males (22 eyes) and 18 females (18 eyes). All were monocular. All the patients were assigned to two groups according to different treatment modalities they received: IVC group and IAC group. There were 26 eyes and 14 eyes, respectively. When the tumor invades the optic nerve, choroid, sclera, anterior chamber and iris, enucleation was performed. The globe salvage rate, tumor extraocular metastasis rate, solid tumor control rate, treatment-related complications and pathological high-risk factors after enucleation were observed. The globe salvage rate and solid tumor control rate were compared between the groups by chi square test.Results:The globe salvage rate of IAC group and IVC group were 88.5% (23/26) and 50.0% (7/14), respectively. Solid tumor control of IAC group and IVC group were 84.6% (22/26) and 42.9% (6/14), respectively. There were statistically significant differences in globe salvage rate and solid tumor control between the two groups ( χ 2=7.18, 7.56; P<0.05). Compared with IVC group, IAC group had less systemic complications, mild ocular and periocular side effects. Among 26 cases in IAC group and 14 cases in IVC group, 3 and 7 cases underwent enucleation respectively. The results of pathological examination showed that there were 2 cases and 3 cases with pathological high-risk factors in the two groups, respectively. During the follow-up period, 2 cases in IAC group had extraocular metastasis, there was no extraocular metastasis in IVC group. Conclusion:Compared with IVC, IAC has the advantages of high tumor control rate, high globe salvage rate, less and mild complications, however, there is still tumor recurrence.

AIM:To investigate the expression of centromere protein-H(CENP-H)in adrenocortical carcino-ma(ACC)and its relationship with disease progression and prognosis,and to explore the impact of CENP-H gene knock-down on the viability and migration of ACC cells.METHODS:The mRNA expression level of CENP-H in 76 ACC pa-tients and 128 healthy controls,and its correlations with tumor stages and prognosis were analyzed by GEPIA2 database.The mRNA expression of CENP-H in different stages of ACC and its correlation with disease prognosis were further ana-lyzed by ULCAN database.The protein expression of CENP-H was examined by immunohistochemical staining of paraffin-embedded ACC and normal adrenal gland specimens.Knockdown of CENP-H by siRNA(siCENP-H)was performed in human ACC cell line H295R.The viabilty of H295R cells transfected with siCENP-H or siNC was measured by CCK-8 as-say,the cell migration was detected by wound-healing assay,and the protein levels of CENP-H,p-ERK1/2,t-ERK1/2,p-P38,t-P38,p-JNK1/2 and t-JNK1/2 were detected by Western blot.RESULTS:The mRNA level of CENP-H was signifi-cantly higher in ACC than that in normal controls,and was correlated with tumor stages and prognosis.The protein level of CENP-H was significantly higher in ACC specimens than that in normal adrenal gland.Knockdown of CENP-H in H295R cells resulted in decreased cell viability and migration.The protein levels of p-P38 and p-JNK1/2 were decreased in si-CENP-H group.CONCLUSION:CENP-H is highly expressed in ACC,and is correlated with tumor stages and poor prognosis.Knockdown of CENP-H can inhibit the viability and migration of ACC cells,and its mechanism may related to inactivation of P38 and JNK signaling pathways.

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly， and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment？ Who can apply for the assessment？ What is the assess tool？ How to pay the assessment fee？" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China， the Netherlands， Germany， Japan and the United States from four aspects： assessment subject， assessment object， assessment cost source， and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries， domestic appraisers’ discipline and professional background are simpler. In foreign countries， the evaluation objects of elderly care needs are more extensive； the legal and financial support system of needs evaluation is more mature； and the evaluation dimensions are more objective and comprehensive. Based on this study， we suggest China to establish a national unified elderly care needs assessment system， cultivate professional assessment teams， expand the coverage of care needs assessment objects， improve the standards of assessment objects and assessment dimensions， and improve the law and financial support regulations related to needs assessment.