Objective: To study the role of Hippo signaling pathway using mouse liver metastasis and semi-spleen model of colorectal cancer in vivo. Methods: Twenty BALB/c mice were randomly divided into sham operated group and experimental group. In the sham operation group, the abdomen of mouse was opened and closed. In the experimental group, the mouse colonic adenocarcinoma CT26 cells were injected into the lower pole of spleen, and excised to establish a liver metastasis model. After 7 days, the mice were sacrificed and dissected. The expression levels of epinephrine (EPI), glucagon (GC), lysobisphosphatidic acids (LPA) and sphingosine-1 phosphate (S1P) in plasma collected from the eyeballs of mice were detected by ELISA. The successful semi-spleen liver metastasis modeling of colorectal cancer was determined by HE staining. The yes-associated protein 1 (YAP1) and phospho-YAP1 (p-YAP1) were localizated by immunohistochemistry. The expression levels of YAP1 and p-YAP1 proteins in the liver tissues of mice were detected by Western blotting. Results: The liver metastasis rate was 100% after 7 days of spleen hemisection model establishment. The levels of plasma EPI and GC in the sham operated group were significantly higher than those in the experimental group (both P< 0.01). The levels of plasma LPA and S1P in the experimental group were significantly higher than those in the sham operated group (both P< 0.01). The HE staining result of experimental group showed typical features of poorly differentiated adenocarcinoma with mitotic division. In the normal liver tissues of sham operated group, YAP1 protein expressed in the cytoplasm [nuclear YAP (-) and cytoplasmic YAP (+)], p-YAP1 protein expressed in the cytoplasm and nuclei [nuclear p-YAP1 (+) and cytoplasmic p-YAP1 (+)]; In the tumor liver tissues of experimental group, YAP1 protein expressed in the cytoplasm and nuclei [nuclear YAP1 (+) and cytoplasmic YAP1 (+)], p-YAP1 protein was not expressed in the cytoplasm or nuclei [nuclear p-YAP1 (-) and cytoplasmic p-YAP1 (-)]. The expression level of YAP1 protein in the liver of experimental group was significantly higher than that in the sham operated group (P< 0.01), while the expression level of p-YAP1 in the liver of experimental group was significantly lower than that in the sham operated group (P < 0.01). Conclusion: The liver metastasis model of colorectal cancer is successfully established. The expressions of EPI and GC are negatively correlated with YAP1, and positively correlated with p-YAP1. The expressions of LPA and S1P are positively correlated with YAP1, and negatively correlated with p-YAP1. It is expected to develop a targeted therapeutic study for Hippo signaling pathway-related blood factor modulators.

The dialysis method was employed to prepare blank and doxorubicin (DOX) loaded micelles formed by temperature- and pH- sensitive polyhistidine-co-polyDL-lactide-co-glycolide-co-polyethyleneglycol-co-polyDL-lactide-co-glycolide-co-polyhistidine (PHis-b-PLGA-b-PEG-b-PLGA-b-PHis). The critical micelle concentrations (CMC) of the copolymers were measured with Pyrene Fluorescent Probe Technique. The temperature- and pH- sensitive properties of the blank micelles solution were investigated by optical transmittance measurement. The morphology and diameter of DOX micelles were characterized by transmission electron microscopy (TEM) and dynamic light scattering (DLS). The entrapment rate and drug-loading rate were determined with dialysis method. The in vitro release study was further performed to examine the temperature- and pH-responsive drug release behavior from DOX-loaded micelles. The results indicated that the CMC, entrapment efficiency and drug-loaded amount of the micelles were 7.5 x 10(-3) g x L(-1), 85.2 +/- 3.1% and 10.4 +/- 4.5%, respectively. The DOX micelle was globular-shaped with a mean diameter of 91.1 +/- 15.8 nm. The transmittance of micelle solution consistently increased with the increasing temperature or decreasing pH. In comparison to the drug release profile at physiological conditions (37 degrees C, pH 7.4), the DOX-loaded micelles showed faster drug release rate at higher temperature (41 degrees C), lower pH (pH 7.0, pH 6.5, pH 5.0) or higher temperature and lower pH (41 degrees C, pH 5.0). This indicated that the micelles showed a temperature and pH-triggered drug release pattern. Base on the above results, it can be concluded that PHis-b-PLGA-b-PEG-b-PLGA-b-PHis block copolymer micelles which respond to temperature and pH stimuli are promising smart carriers for anti-tumor drugs with the advantages of temperature- and pH- triggered drug release.

Objective To evaluate renal hemodynamic changes in hydronephrosis children with no image on intravenous urography by color doppler flow image(CDFI). Methods The resistance indexes(RIs)in main renal arteries(MRAs),interlobar renal arteries(IRAs)and arcuate renal arteries(ARAs)were measured in 48 children with hydronephrosis with no image on intravenous urography.The thickness and area were also measured in hydronephrotic kidneys.Resistive index ration(RIR=hydronephrotic kidneys RI/contralateral RI)was calculated. And pathological changes of kidneys were graded in these cases.Spearman's correlation test was used to compare RIR and pathological grades in these kidneys. Results In healthy and hydronephrotic kidneys,the relevant parameters were as fol1.13±0.14,1.14±0.09,respectively in MRAs,IRAs,ARAs in hydronephrotic kidneys(P＞ness,area of hydronephrotic kidneys(P＜0.05),also between RIR and thickness,araa(P＜0.05),MRAs,IRAs,ARAs and pathologic grades(P＜0.05),especially in IRP(s(r=0.795,P＜0.01).Conclusions RIR of IRA could be an ideal parameter of renal hemodynamics to evaluate renal damage in children with congenital hydronephrosis with no image on intravenous urography.

ObjectiveTo investigate the value of prospective ECG-gated dual-source CT (DSCT)in the diagnosis of coarctation of aorta ( CoA ).MethodsSixteen patients clinically suspected of CoA underwent prospective ECG-gated DSCT angiography and color Doppler flow imaging (CDFI). The diagnostic accuracy of DSCT and CDFI were compared according to the results of operation or DSA.The nonparametric chi-square test was used for the statistics.ResultsSixteen patients were diagnosed as CoA by DSCT,4 were complicated with artial septal defect (ASD),9 with ventricular septal defect (VSD),1 with transposition of the great arteries,3 with dysplasia of aortic arch,7 with patent ductus arteriosus (PDA),1 with abnormal origin of the coronary artery, 1 with bronchus artery dilation. Fifteen patients were diagnosed as CoA by CDFI,1 was diagnosed as interruption of aortic arch. Four were complicated with ASD,9 with VSD,2 with bicuspid aortic valve (BAV),1 with transposition of the great arteries,2 with dysplasia of aortic arch,7 with PDA,1 with bronchus artery dilation.Abnormal origin of the coronary artery was not found.The diagnostic accuracy of DSCT and CDFI were 97.2％ ( 140/144)and 97.9％ (141/144)respectively,there was no significant difference (x2 =0.00,P ＞ 0.05 ).The sensitivity of DSCT and CDFI were both 93.2％ ( 41/44 ),the specificity were 99.0％ (99/100) and 100.0％ (100/100).The mean effective radiation dose was 0.42 mSv. Conclusion Prospective ECG-gated DSCT is a good imaging technique for the diagnosis of aortic coarctation in children.

Hippo signaling pathway plays a significant role in the development of colorectal cancer,and acts as an important regulatory pathway which regulates cell proliferation and cell differentiation.Multiple proteins and genes in Hippo signaling pathway,especially the downstream YAP protein,play important roles in the occurrence,metastasis,drug resistance and recurrence of colorectal cancer.YAP and other related genes can be used as targeted markers for predicting drug resistance to colorectal cancer.Hippo signaling pathway gene network can be used as targeted therapy or combination therapy,thus providing new ideas for the treatment of colorectal cancer.

Objective Through the investigation of the research funding status of returnees before and after their long-term (more than 3 months) study at abroad in a three class hospital,this paper analyzed the influence of the hospital level initial funding to help young talent to obtain scientific research funding,discussed appropriate measurement to enhance the scientific research capacity of hospital young talents to provide reference for management.Methods Long-term sponsored study abroad returnees from 2005 to 2015 of this hospital were recruited as subjects,divided into two groups according to whether they got the hospital-level initial funding after returning,comparative analysis was conducted to understand the influence of such funding to help obtaining subsequent research projects of these young talents.Results The number of subjects per capita returned to the obtained group was higher than that of the non obtained group,and the proportion of high-level subjects at provincial and ministerial levels was higher than that of the non-obtained group (P＜0.05),and the average time interval between the groups after returning home was less than that of the non-obtained group (P＜0.05).Conclusions The hospital-level initial funding for overseas returnee can obviously improve the quality and speed of the subsequent projects of the young talents in the hospital,and have a significant positive effect on mobilizing the enthusiasm for scientific research,improving their scientific re search ability,and improving the overall scientific research level and competitiveness of the hospital.

The paper presented the " Professors Evaluation System" initiated by the hospital since July 2009, which was designed for quantitative assessment of senior medical professionals of non-management category in terms of their performance in medical, teaching, research and management work. Seven periods of appraisal have witnessed a significant elevation of the rate of excellence among such professionals, proving that such a system can motivate and guide these professionals to continuously improve their competence in medical, teaching, research and management work.

Objective To explore the surgical technique of applying the pedicle composite tissue flap based on superficial palmar branch of the radial artery to repair the soft tissue defect of thumb and evaluate the clinical ef-fect. Methods From February,2013 to March, 2016, 5 cases of the soft tissue and tendon defect of thumb were treated with the pedicle composite tissue flap based on superficial palmar branch of the radial artery. The flap was de-signed at wrist not exceeding the wrist rasceta and the donor site was sutured directly. The size of the harvested flaps was between 3.0 cm ×2.2 cm to 4.2 cm ×3.2 cm, and the sensation of thumb or the flap was reconstructed via median nerve cutaneous branch. The Extensor pollicislongus muscle tendon defect was repaired via palm tendon carried by composite tissue flap. Postoperative follow-up was done termly. Results All transfering flaps survived and all cases were followed-up for 4 to 11 months. The donor site got primary healing with a linear scar. The appearance and tex-ture of the flap was satisfactory. The two-point discrimination ranged from 8 to 11 mm. The appearance of thumb re-covered well and the digit joint had a good motion. Conclusion The pedicle composite tissue flap based on superfi-cial palmar branch of the radial artery is easy to harvest and its vascular anatomy is constant, which is masked and a small incision for the donor site. When necessary, palm tendon or median nerve cutaneous branch can be contained in the flap to form a composite transplant. It is an ideal method for repair of thumb soft tissue defect.

To evaluate the surgical technique and clinical effect of applying Flow-through flap pedicled with superficial palmar branch of radial artery for bridging finger replantation complex defect of soft tissue and vessel. Methods From February, 2013 to March, 2018, 9 cases of severed fingers composited defect of soft tissue and vessel were treated with Flow-through flap pedicled with superficial palmar branch of radial artery.The flap was designed from the proximal end of rasceta and the donor sites were sutured directly. The size of flaps was 3.0 cm ×1.5 cm-4.0 cm×2.2 cm. The superficial branch of the radial artery in the flap was used to bridge the finger artery. And the vein of proximal and distal ends in the finger was bridged by the subcutaneous vein. The proper palmar digi-tal nerve defect was bridged by palm skin graft of median nerve. The appearance, feeling and joint function of fingers was followed-up regularly after operation. Results All transfering flaps survived and all cases were followed-up for 7 to 33 months. The donor sites got primary healing with straight scars. The appearance and texture of the flaps were satisfactory. Two-point discrimination ranged from 8 to 11 mm. The pain sensation, warmth sensation and touch sen-sation of the flaps got better. And the appearance and functions of severed fingers recovered well. Conclusion The Flow-through flap pedicled with superficial palmar branch of radial artery is easy to harvest and anastomose, which is masked and a small incision for the donor site. It is an ideal method for bridging severed fingers and repairing of fin-ger wound.

Objective:To evaluate the clinical application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali in the treatment of intra-articular calcaneal fractures.Methods:From January 2016 to January 2019, 68 patients were treated at Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for intra-articular calcaneal fractures of Sanders types Ⅱ-Ⅳ. According to different designs of screw placement into the sustentaculum tali, they were assigned into a control group (38 cases and 42 feet) and an observation group (30 cases and 33 feet). There were 24 males and 14 females with an age of 39.3 years±8.8 years in the control group. There were 17 males and 13 females with an age of 42.0 years ± 7.6 years in the observation group. The control group was given a routine placement design based on the X-ray and MSCT scanning images of the injured feet. In the observation group, a Mimics model was first constructed using the X-ray and MSCT scanning images of the normal or less injured feet for further virtual screw placement into the sustentaculum tali on a 3D printed model. The disparity was investigated between the parameters designed and the actual values in both groups. The 2 groups were compared in terms of average placements, screw distribution, placement accuracy, placement time and Maryland scores of foot function one year after operation.Results:There were no significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The design parameters and actual values in the control group were respectively as follows: 17.7°±3.2° versus 15.1°±5.9° in upward oblique angle, 20.3°±2.1° versus 16.2°±6.8° in backward oblique angle, and 47.9 mm ± 3.8 mm versus 45.4 mm ± 4.2 mm in length of screw path, showing significant differences ( P< 0.05). The design parameters and actual values in the observation group were as follows: 16.5°±3.5° versus 17.1°±3.9° in upward oblique angle, 20.9°±4.3° and 19.6°±3.8° in backward oblique angle, and 48.1 mm ± 3.1 mm versus 47.3 mm ± 3.8 mm in length of screw path, showing insignificant differences ( P>0.05). The average screw placements into the sustenta culum tali in the observation group (1.6±0.5) were significantly more than those in the control group (1.2±0.4). Compared with the control group, the observation group had a higher rate of placement of 2 screws[60.6 % (20/23) versus 16.7% (7/42)], higher accuracy of placement [94.3% (50/53) versus 77.6% (38/49)], less placement time for each screw (9.6 mm±3.9 min versus 13.2 mm±4.7 mm), less placement time for each foot (15.6 mm±4.8 min versus 20.5 mm±3.8 mm), and higher Maryland scores at one year after operation (94.2±6.5 versus 89.7±6.9). All the above comparisons were statistically significant ( P<0.05). Conclusions:Application of virtual and simulation techniques to aid pre-operative design for precise screw placement into the sustentaculum tali can improve the outcomes of intra-articular calcaneal fractures, because it increases the number of screws placed, enhances quality of screw placement, shortens operation time, and thus facilitates functional recovery of the injured foot.