ObjectiveTo summarize the effect of staged operations strategy for delayed spontaneous rupture of esophagus with empyema.MethodsThree patients in the department of thoracic surgery of the second affiliated hospital of Guangzhou medical university underwent staged operative treatment for delayed spontaneous rupture of esophagus with empyema.The primary operative procedure consisted of removal of empyema sac,T-tube drainage and jejunostomies.The second operative procedure included alimentary reconstruction with thoracic esophageal resection and exclusion,or with esophageal resection and exclusion later.ResultsAll cases were cured with mean hospitalization of 78.7 days.None of them had any dysphagia at followup of 5-14 months.ConclusionDelayed spontaneous rupture of esophagus with empyema can be managed safely and effectively through staged operations strategy.

Objective To evaluate regional and global left ventricular systolic function after coronary artery bypass grafting (CABG) by speckle tracking imaging (STI).Methods Transthoracic echocardiography (TTE) was performed in 32 patients with coronary heart disease (CHD) preoperative and 3 months after CABG.The two-dimensional data were obtained in apical 4-chamble,2-chamble and long axis view.Peak systolic longitudinal strain (SLs),global longitudinal systolic strain (GLS) and average global strain(GLS-Avg) were measured using STI.30 healthy volunteers were involved as controls.Results SLs in the control group increased from the basal to the apical ventricular.SLs in the control group and CHD group apical segment were significantly higher than the basal and middle segments.Compared to the control group,SLs,GLS in part of myocardial ischemic segments were lower in CHD group before CABG (P ＜0.05).SLs and GSL in the corresponding segments showed significantly improving 3 months after CABG in CHD group (P ＜ 0.05).There was good relationship between GSL-Avg and left ventricular ejection fraction.Conclusions STI technology can be used to objectively and quantitatively evaluate the change of regional and global left ventricular systolic function.Therefore,it provide a non-invasive means for evaluation of curative effect and prognosis judgement of CHD after CABG.

Objective To study the probability safety assessment to analyze and evaluate radiation error risk in the external beam radiotherapy,so as to establish and strengthen the control and management of the radiotherapy process,continuous improvement of quality control and quality management.Methods To build the whole of radiotherapy flow chart and process tree,using the decision tree model to determine critical control points in the whole process,making risk assessment chart and analyzing 4 patients with potential safety hazards error.Results The whole process is divided into 22 missions in 3 functional areas,the entire cover 15 branches and 59 key and 11 key control point.The enumeration of error as risks and critical control points has certain correlation.Conclusions Probabilistic safety assessment method have strengthened manage,analyze and control to risk,and all these provide the basis for developing and improving radiotherapy process control management.Radiotherapy quality management for future multidisciplinary and high-level management personnel who take up provides a prospective study.

BACKGROUND:The meningeal defect patients can be treated with artificial dural materials combined neurosurgical techniques which can protect the integrity of brain tissue. OBJECTIVE:To analyze the biocompatibility and application feasibility of various artificial dura mater materials. METHODS:The artificial dura materials were classified according to the different sources, and the biocompatible and application feasibility of various artificial dura mater materials were analyzed, as wel as the advantages and disadvantages of various materials. The anticoagulant and hemolytic properties of the materials were analyzed through recalcification test and hemolysis test. 100 patients receiving col agen membrane repair selected from Department of Neurosurgery, Dongfang Hospital of Beijing University of Chinese Medicine were observed. RESULTS AND CONCLUSION:The dural repair materials mainly include autologous material, al ograft materials, dissimilar materials, synthetic materials and natural materials. Each kind of material has its advantages and disadvantages. Meningeal defect complications include cerebrospinal fluid leakage, pseudo meninges, infection and arachnoiditis. There are many problems of artificial dural materials to be solved, and the novel biological dural materials and absorbable materials are the direction of dural material research.

Objective To investigate the changes of serum TNF-α,IL-1β,IL-10,IL-13,lung ultrastructure and respiratory function in the early stage of pulmonary contusion. Method 16 white rabbits were randomly assigned to lung contusion group and control group. Pulmonary contusion was established. Serum TNF-α,IL-1β, IL-10 and IL-13 level at 1 ,2 ,3 and 4 h after contusion were tested. Respiratory function data was obtained and ultrastructure was observed. Results In the early phase after pulmonary contusion ,the expression of IL-1β and TNF-αincreased while IL-10 and IL-13 decreased continuously. Lung ultrastructure changes included alveolar dam-age and massive erythrocyte sedimentation and inflammatory cell exudation in alveolar cavity. Alveolar ventilation and PO2 decreased significantly,P-AO2 increased continuously and lung compliance reduced. Conclusions In the early phase after pulmonary contusion ,the expression of IL-1β and TNF-α increases while IL-10 and IL-13 de-creases,lung ultrastructure is progressively destructed and lung function is severely damaged.

AIM To study the inhibitory effect of the cytotoxin (CTX) from guangxi cobra venom on human nasopharyngeal cancer cell (CNE) and other tumons cells. METHODS The cytotoxin was isolated and purified from Guangxi cobra venom by successive chromatography on Sephadex G-50 and CM Sepharose CL-6B columns. Its cytotoxic effects and does-effect relationship on human tumors cell lines were examined by MTT assay. RESULTS The inhibitory effects of CTX CM-5 on CNE, human ovarian carcinoma cell (Ho8990), uterus cervical carcinoma cell (HELA) and lymphoma (YAC) cell lines showed a definite does-effect relationship. The IC 50 (48 h in cubation) was 1.84, 2.59, 1.84 and 0.75 mg?L -1 respctively. The inhibitory effects of CTX CM-5 on CNE increased with time. The IC 50 (3 h and 24 h cubation) was 4.78 and 1.04 mg?L -1 respctively. CONCLUSION CTX from Guangxi cobra venom exhibites strong suppressive effect on cultured tumor cells line in vitro.

Aim To investigate the ameliorative effects pseudoberberine(Y53), a berberine(BBR) analogue, on diabetic nephropathy( DN) in streptozotocin( STZ)-induced diabetic mice. Methods Diabetes mellitus ( DM) of the C57BL/6J mice was induced by intraper-itoneal injection of STZ at 120 mg·kg-1 . The diabetic animals were divided into 4 groups, which were orally treated with saline, 50 mg · kg-1 of BBR, 50 mg · kg-1 of Y53 or 5 mg · kg-1 of rosiglitazone ( ROSI ) , respectively. During and after the experiment, the u-rine, blood, serum and kidney of the animals were harvested for determination of relevant parameters by kits. Kidney tissues of the mice were subjected to pathological examination by hematoxylin & eosin( HE) staining;mRNA and protein expression levels of target genes in the kidney were determined by quantitative re-al-time reverse transcriptase-polymerase chain reaction ( qRT-PCR) and Western blot, respectively. Results Y53 greatly reduced the fasting blood glucose ( FBG ) and glycosylated hemoglobin( GHb) , improved diabet-ic symptoms such as polyphagia and polyuria in the di-abetic mice( P<0. 01 vs DM control group) . Y53 po-tently reduced the blood urea nitrogen ( BUN ) , serum creatinine( Scr) , 24 h urinary protein, kidney index, serum and kidney advanced glycation end-products ( AGEs) and nitric oxide( NO) , as well as kidney cho-lesterol( CHO ) and triglyceride ( TG ) contents ( P <0. 05 or P<0. 01 vs DM control group) . In the patho-logical examination, Y53 greatly restored kidney mor-phology and suppressed glomerular sclerosis( P<0. 001 vs DM control group). In addition, Y53 significantly reduced the renal expression of fibrosis-related genes, such as the transforming growth factor-β1 ( TGF-β1 ) and smad2(P<0. 01 vs DM control group). The reno-protective efficacies of Y53 were superior to those of BBR and ROSI in our study ( P<0. 05 or P<0. 01 ) . Conclusions The BBR analogue Y53 has potent ac-tivities in ameliorating renal injury and restoring renal function in STZ-induced diabetic mice. Y53 may be developed as a novel kind of agent for the treatment of DN in the future.

Objective: To construct a prediction model for preterm birth risk among pregnant women, so as to provide the reference for screening high-risk population and preventing preterm birth. Methods: Pregnant women who received antenatal examination and delivered at the Women's Hospital, School of Medicine, Zhejiang University from January 1 to December 31, 2019 were selected as the study subjects, among them, 80% were included in the modeling group, and 20% were included in the validation group. Demographic and clinical information were collected. A multivariable logistic regression model was used to analyze the predictive factors of preterm birth risk in the modeling group, and a preterm birth risk prediction model was established based on the OR values of predictive factors. The model was validated with the data from the validation group. The Youden index was used to determine the critical score for predicting preterm birth risk. The prediction performance of the model was evaluated using the receiver operating characteristic (ROC) curve. Results: A total of 15 197 pregnant women were surveyed, including 12 131 pregnant women in the observation group and 3 066 pregnant women in the validation group. There was no statistically significant difference in age, education level and gravidity between the two groups of pregnant women (all P<0.05). Multivariable logistic regression analysis identified the number of pregnancies, education level, place of residence, hypertension, diabetes, history of preterm birth, twin-pregnancy, placenta praevia, and gestational hypertension as risk prediction factors for preterm birth risk among pregnant women. The risk score system for preterm birth was established as follows: >2 pregnancies (2 points), high school education or below (4 points), college degree or above (-4 points), rural residence (5 points), hypertension (7 points), diabetes (11 points), history of preterm birth (11 points), twin-pregnancy (28 points), placenta previa (19 points), and gestational hypertension (12 points). The total score of the preterm birth risk scoring system ranged from -4 to 99 points. When the critical score was 8 points, the Youden index was the highest at 0.480, with an area under the ROC curve of 0.749 (95%CI: 0.732-0.767), a sensitivity of 0.610, and a specificity of 0.886, indicating good prediction performance of the model. Conclusion The preterm birth risk prediction model established in this study based on demographic and clinical characteristics of pregnant women can effectively predict the risk of preterm birth among pregnant women.

A series of novel N-(2-arylethyl) isoquinoline derivatives were designed, synthesized and evaluated for their anti-cancer activities. Among these analogs, compound 9a exhibited the potential anti-cancer activities on HepG2 and HCT116 cells with IC50 values of 2.52 and 1.99 microg x mL(-1), respectively. Cell cycle was blocked at S phase of HepG2 cells treated with 9a by flow cytometry detection. Our results provided a basis for the development of a new series of anti-cancer candidates.

Scavenger receptor CD36 could bind and endocytose oxLDL into macrophages which were then differentiated into foam cells that constitute the atherosclerotic lesion core, and was considered to be a potential target to treat atherosclerosis. In the establishment of the compound library of berberine (BBR, 1) analogues, we discovered that 13-hexylberberine (2) showed an antagonistic activity against CD36. Taking 2 as the lead compound, 21 derivatives were synthesized and their antagonistic activities were evaluated via an ELISA-like high-throughput screening (HTS) model. The primary structure-activity relationships were studied. It was indicated that the introduction of suitable groups at the 2- and 3-position of the aromatic ring A or at the 9-position of the aromatic ring D could enhance the activity. Among the 21 studied compounds, 7g bearing a benzyloxyl group at the 9-position provided a highest CD36 antagonistic activity with the IC50 value of 7.7 micromol L(-1). Besides, its antagonistic activity was further verified with Sf9 insect cell HTS model. So berberine analogues are a new family of CD36 receptor antagonists and worthy to be studied further.