Objective To observe the effects of Chinese herbal medicine of Yiqi Huoxue (YQHX) on proliferation and expression of E-CD and invasion of human lung cancer cell lines - small cell lung cancer (NC-H446) in vitro. Methods By cell measured method, immunohistochemistry method, technique of image and Boyden Chamber method, the effects of YQHX or all trans-tretinoin acid (ARTA) on proliferation and expression of E-CD and invasion of NC-H446 cell lines with different time cultured by YQHX or ARTA in vitro were studied. Results The proliferation of NC-H446 were inhibited significantly by 5% YQHX or 10-5 mmol/L ARTA (P0.05). The shape and structure of cell NC-H446 was occurred variant. YQHX enhanced remarkably expression of E-CD of NC-H446 with 36 hour cultured (P 0.05). The quantity of NC-H446 cells crossed Matrigel and polyvinylpyrrolidone-free polycarbonate filter were more than the control group (P 0.05). Conclusion YQHX can inhibit the proliferation, enhance expression of E-CD on NC-H446, and decrease invasion and metastasis of NC-H446.

Objective To investigate the distribution of T follicular helper(Tfh)cell subsets in hepa-titis B patients at different immune stages and to clarify the relationships between the level of CXCL13 and the distribution of Tfh cell subsets. Methods Flow cytometry analysis was performed to detect the distribution of Tfh cells. Enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of CXCL13 in ser-um samples collected from hepatitis B patients. RT-PCR and Western blot assay were used to analyze the expres-sion of CXCL13 in HepG2 and HepG2. 2. 1. 5 cells. Results The percentages of Tfh1 cells were significantly up-regulated at the immune activation(IA)stage,while those of Tfh2 cells were significantly raised at the im-mune tolerance(IT)stage. The percentages of Tfh17 cells in patients at the stage of IT were similar to those in patients at the stage of IA,but were higher than those in responders with HBsAg seroconversion(RP)or healthy controls(HC). The expression of CXCL13 was positively correlated with the percentage of Tfh2 cells. More over,hepatitis B virus(HBV)enhanced the expression of CXCL13 at both transcriptional and translational lev-els. Conclusion HBV might up-regulate the percentage of Tfh2 cells through promoting the expression of CXCL13,which resulted in the induction of immune tolerance. Elucidating the functions of Tfh1,Tfh2 and Tfh17 cells and understanding the type conversion mechanism among the three subsets are important for further researches on HBV-induced immunosuppression.

Objective To evaluate the therapeutic effect of Xiao'er Zhixie Paste (XZP) by using the young rat model of chronic diarrhea,and to explore its mechanism.Methods Chronic diarrhea model in young rats was induced by ig senna.Rats were ig with Montmorillonite powder of 1.62 g/kg,XZP of low,medium,and high dose (2.03,4.05,and 8.10 g/kg) for treatment.Loose stools rate,loose stool grade and diarrhea index were determined 1 and 3 d after treatment respectively.The water content of small intestine was measured and blood was collected for testing serum succinate dehydrogenase (SDH),amylase,D-xylose by colorimetric determination,testing serum D-lactic acid,IL-1 β,and TNF-α by Elisa after administration.Results The rate of loose stools in XZP 4.05 and 8.10 g/kg dose group,and diarrhea index in 8.10 g/kg dose group significantly reduced after the first treatment.The loose stools rate of XZP 2.03,4.05,and 8.10 g/kg dose group,diarrhea index,serum D-lactic acid level in 4.05,8.10 g/kg group significantly reduced,and serum D-xylose level in 8.10 g/kg dose group significantly increased 3 d after treatment.However,XZP had no significant effect on SDH,amylase activity and IL-1β,TNF-α levels.Conclusion XZP has obvious therapeutic effect on chronic diarrhea in young rats,the mechanism is to increase improve the absorptive function and permeability of intestinal tract.

Objective To improve the informatization of field clinic for quicker and more effective cure of the wounded and the sick.Methods Making the use of the experiences from many years' application of No.1 Military Medical Project,the digital field clinic was set up based on HIS under the circumstances of wireless network.Results The digital field clinic provided convenience for doctors and nurses,optimized the curing procedure,standardized the material management,improved the curing efficiency,and enlarged the curing scope.Conclusion The digital field clinic facilitates the data transmission of medical nursing and assistant diagnosing photos.During the implementing process,the digital field clinic also provides new ways and ideas for the informatization of medical support of other types.

Objective:To evaluate our novel path based on anatomical division of the anterior lateral wall of calcaneus and the sustentaculum tali for precise sustentacular screw placement in the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ.Methods:The anterior lateral wall of the calcaneus was divided into the anterior-superior zone S 1, the anterior-inferior zone S 2, the posterior-superior zone S 3 and the posterior-inferior zone S 4 for demarcation of the screw insertion points by our method of Four Zones, and into the front, middle and rear sections by our method of Three Sections for demarcation of the screw target points. The specimens were scanned by CT and modeled by Mimics. On the 3D virtual model of the calcaneus, one screw was placed from each zone of the anterior lateral wall of the calcaneus to the sustentaculum tali body. The screw placement target for S 1 and S 2 was the medial intersection point P 1 of the front and middle sections of the sustentaculum tali, and that for S 3 and S 4 was the medial intersection point P 2 of the middle and rear sections of the sustentaculum tali. It was observed whether the screws were placed in the bone channel. A total of 72 patients were included who had been admitted to Department of Orthopaedics, Suqian Hospital Affiliated to Xuzhou Medical University for calcaneal fractures of Sanders types Ⅱ and Ⅲ from January 2017 to January 2021. They were divided into an anatomical division group and a 3D printing group according to their screw placement method for the sustentaculum tali. In the anatomical division group of 32 patients subjected to screw placement based on our anatomical division, there were 25 males and 7 females, aged from 24 to 60 years; in the 3D printing group of 40 patients subjected to screw placement assisted by 3D printing, there were 31 males and 9 females, aged from 25 to 58 years. The disparities between the parameters of sustentacular screw placement and the actual values were compared in the anatomical division group, and the total number of screws, screws on average, distribution of screws, and accuracy of screw placement were compared between the 2 groups. Results:All the screws which were virtually placed in the specimens of the calcaneus from S 1 and S 2 to P 1 and from S 3 and S 4 to P 2 passed through the bony channel, with no perforation into the tarsal sinus. There was no significant difference in the general date between the anatomical division group and the 3D printing group, showing they were comparable ( P > 0.05). In the anatomical division group, a total of 52 screws were placed to the sustentaculum tali with an average of (1.63 ± 0.48) screws per patient, and 2 screws were placed in 20 patients, yielding an accuracy rate of screw placement of 92.3% (48/52). There were no statistically significant differences between the parameters and the actual values of screw placement in the anatomical division group ( P > 0.05). In the 3D printing group, a total of 63 screws were placed to the sustentaculum tali with an average of (1.58 ± 0.49) screws per patient, and 2 screws were placed in 23 patients, yielding an accuracy rate of screw placement of 93.7% (59/63). There were no significant differences in the above comparisons between the anatomical division group and the 3D printing group ( P > 0.05). Conclusion:In the surgical treatment of calcaneal fractures of Sanders types Ⅱ and Ⅲ, the sustentacular screw placement based on our anatomical division of the anterior lateral wall of the calcaneus and the sustentaculum tali can lead to similar clinical accuracy as 3D printing-assisted screw placement does.

OBJECTIVE： To establish antibiotics use rationality evaluation model in type Ⅰ incision surgery patients， and to provide reference for prescription review of clinical pharmacists. METHODS： Totally 432 inpatients underwent type Ⅰ surgical incision in a hospital from Jan. 1st- Dec. 31st， 2017 were selected as the research objects. The information of diagnosis and treatment including age， nosocomial infection， the number of kinds of antibiotics used were extracted. Based on the results of clinical pharmacists’ comments on the antibiotics use rationality in patients’ prevention and treatment， non-conditional Logistic regression and support vector machine （SVM） in machine learning method were used to convert clinical pharmacists’ comments into objective index that can be recognized by the machine learning model， using categories of antibiotics （preventive or therapeutic use） as dependent variables and the patient’s diagnosis and treatment information as independent variables. Classification and identification model was established for antibiotics use rationality in type Ⅰ incision surgery patients. Using sensitivity， specificity and Youden index as indexes， established mode was validated on the other 61 samples of type Ⅰ incision surgery patients. The rationality of antibiotics prescriptions in type Ⅰ incision surgery patients before （by manual review， Jan.-Dec. 2017） and after （Jan.-Oct. 2018） using the model were collected， and the effects of the model were evaluated. RESULTS： The sensitivity， specificity and Youden index of non-conditional Logistic regression model were 65.63％， 75.00％ and 40.63％， respectively. Main parameters of the model established by SVM included gamma 0.01， cost 10， sensitivity 92.19％， specificity 87.50％， Youden index 79.69％. The model established by SVM was better than non-conditional Logistic regression. SVM was used to validate established mode， and sensitivity， specificity and Youden index were 100％， 88.57％ and 88.57％， respectively. Compared with before using the model， the evaluation ratio increased from 69.44％ to 100％， the rate of prophylactic use of antibiotics decreased from 23.84％ to 16.43％， the rate of rational drug type selection increased from 37.86％ to 54.39％， and treatment course shortened from 5.01 days to 3.26 days after using the model. CONCLUSIONS： Established antibiotics use rationality evaluation model in typeⅠincision surgery patients by SVM in machine learning method fully covers all the patients， promotes rational use of antibiotics in typeⅠincision surgery patients， and provides a new idea for pharmacist prescription comment.

Objective : To investigate the molecular mechanisms underlying the feedback regulation of single immunoglobin interleukin-1 related receptor ( SIGIRR) expression by the nuclear factor kappa-κB ( NF-κB) in human renal tubular epithelial cells ( HKC) ． Methods : The pLNCX2-G418-SIGIRR overexpression vector was constructed by molecular cloning，and the SIGIRR overexpression cells and control cells were constructed by infecting HKC cells after packaging with PT67 cells．Using IL-1 β induction，Western blot verified that overexpression of SIGIRR inhibited NF-κB activation．After using NF-κB blocker and interfering with NF-κB activity ，immunofluorescence assay verified that activated NF-κB regulated SIGIRR expression． Online tools predicted the presence of NF-κB binding sites in the SIGIRR promoter region．The SIGIRR promoter sequence containing the binding site was obtained from within human genomic DNA by molecular cloning，ligated to the luciferase vector pGL3-Luc，constructed pGL3-Luc-SIGIRR , and mutated the binding site．The luciferase reporter gene assay and chromatin immunopre- cipitation technique ( ChIP) were used to jointly verify that activated NF-κB could bind to the SIGIRR promoter region to regulate SIGIRR gene expression. Results : The results showed that the constructed pLNCX2-G418-SIGIRR retroviral vector was verified by enzymatic digestion and sequencing to be identical to the coding sequence of the SIGIRR gene for comparison，the recombinant and control vectors were transferred into HKC cells after viral packaging，and the HKC / SIGIRR experimental and HKC / Co control cell lines were successfully constructed at the mRNA and protein levels of SIGIRR expression differences were statistically significant (P＜0．05，P＜0. 001) ．Overexpression of SIGIRR cell groups reduced IL-1 β-induced NF-κB activation compared to control cells (P＜0. 001) . SIGIRR expression was downregulated after inhibition of NF-κB activation and interference with NF-κB expression. After extracting human genomic DNA ，the SIGIRR target promoter sequence was obtained by molecular cloning method and linked to the vector，and the pGL3-Luc-SIGIRR luciferase vector was successfully constructed and targeted to mutate the vector，which was verified to be identical to the target sequence by digestion and sequencing. The luciferase reporter gene assay and CHIP assay confirmed that NF-κB could bind to SIGIRR promoter region and regulate SIGIRR expression． Conclusion It has been verified that SIGIRR can influence the activation of NF-κB in HKC cells，and activated NF-κB can bind to the promoter region of SIGIRR and regulate the gene expression changes of SIGIRR , forming a feedback system to control the over-activation of NF-κB.

Objective To understand the prevalence,treatment and influence factors of hypertension in maintenance hemodialysis (MHD) patients in Anhui Province.Methods A total of 2724 adult patients on MHD from January 1st 2014 to March 31st 2014 in 26 hospitals of southern,northern and central Anhui Province were investigated.Their demographic characteristics,primary disease,complications,medications,dialysis and laboratory examination were explored.The prevalence treatment rate and control rate of hypertension were analyzed.Associated factors for controlling hypertension [systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg] were assessed by logistic regression analysis.Results (1) The prevalence of hypertension in the hemodialysis patients was 87.0％.Their treatment rate and control rate were 93.2％ and 23.9％ respectively.The average of SBP was (145.90±21.18) mmHg,and the DBP on average was (83.60± 12.21) mmHg.The most commonly used anti-hypertensive drug is calcium channel blocker (88.2％).Over one third (45.7％) of patients were treated with two kinds of anti-hypertensive drug,26.2％ with 1 kind,21.7％ with 3 kinds,and 6.4％ with 4 kinds or more.(2) Compared with non-hypertension patients,patients with hypertension have older age,higher body mass index (BMI),phosphorus,SBP and DBP,as well as lower hemoglobin and Kt/V (all P ＜ 0.05).(3) The multivariate logistic regression analysis showed that Ca ＞ 2.50 mmol/L (OR=2.084,95％CI 1.008-4.307,P=0.047) positively correlated with controlling hypertension,while smoke (OR=0.594,95％CI 0.356-0.911,P=0.046) and BMI 18.5 ～ 23.9 kg/m2 (OR=0.516,95％CI 0.293-0.907,P=0.022) negatively correlated with it.Conclusions High prevalence yet low control rate of hypertension in MHD patients in Anhui Province were observed.Hypocalcemia may be a protective factor for hypertension control,while smoke and BMI may be risk factors for it.