Livin is the inhibitor of apoptosis proteins (IAPs), a new member, in most malignant tissues of high expression, and its main function is to inhibit cell apoptosis. Apoptosis and tumor cells is closely related to the occurrence and development, more on which the survival of tumor angiogenesis. Vascular endothelial growth factor (VEGF) is one of the strongest of vascular growth factor, and almost all human tumors and tumor cell lines have over-expression of it. Livin and VEGF protein expression in tumor was summarized.

Polyethersulfone hollow fiber membranes were prepared from polyethersulfone/N, N-Dimethylacctamide/poly (N-vinyl-2-pyrrolidinone) systems by dry/wet phase inversion process using water as coagulation bath. The effects of coagulation bath temperature and air gap distance on the surface structure, cross section structure and water flux of membranes were discussed. As increasing the temperature of coagulation bath and the air gap distance, the size of the pores at the surface effectively increased, while the finger-like structure under the outer surface changed to a sponge-like structure.

Objective To compare the effect of conservative and operative treatment for cervical spinal cord injury without fracture and dislocation (CSCIWFD)and to detect mechanism of injury as well as its relationship to outcome.Methods A retrospective review was conducted on 688 patients with CSCIWFD treated from August 1994 to March 2013.There were 155 patients managed conservatively (conservation group) and 533 surgically (operation group).Neurological function improvement was compared between two groups to detect the correlation of patents' age and treatment methods with outcome.Results The patients were followed up for mean 17.9 months (range,3-36 months).Neurological function was estimated using Japanese Orthopedic Association (JOA) score:(1) the recovery rate of patients aged over 40 years in operation group was better than that in conservation group (P ＜0.05) ; (2) the recovery rate in patients aged under 39 years was unsatisfactory in both groups,with insignificant difference between the two groups (P ＞ 0.05).Conclusions Different age of patients with CSCIWFD has different injury mechanism,injury severity and outcome.Surgery provides better results than conservative treatment for patients aged over 40 years,but both results are poor for patients aged under 39 vears.

Objective To retrospectively analyze medical data of patients with colorectal cancer (CRC) so as to provide evidence for clinical use of opportunistic screening.Methods A total of 2450 CRC patients (male 1377,female 1073) who were treated at five hospitals in North China during October 2001 and September 2011 and had complete medical records and pathological results were recruited.The correlations of incidenceofCRCwithage,gender,tumorlocationandhistologicaltypeswere analyzed.Results Of all the CRC patients,those less than 50 years old accounted for 18.14％ ; and the incidence of CRC was substantially increased in those over 50 years old.Seventy-three percent of tumor occurred at the rectum and sigmoid colon,6％ at descending colon,7％ at transverse colon and 14％ at ascending colon.Moderately,well or poorly differentiated adenocarcinoma accounted for 50.33％,40.35％and 9.32％,respectively.Histological differentiation was not correlated with age and gender ( P ＞ 0.05 ).Conclusions Age and gender should not be considered a determination of opportunistic screening for CRC.Colonoscopy is recommended as an alternative CRC screening procedure.

Objective:To explore whether tryptophan metabolism is related to bone growth by comparing the differences in tryptophan metabolism after rotator cuff tear (RCT) repair between rats with normal bone remodeling capability and those with defective bone remodeling capability.Methods:Of the 50 adult female Sprague Dawley (SD) rats used for this study, 18 were randomly selected to undergo bilateral ovariectomy (OVX) (OVX group), and the remaining 32 underwent bilateral OVX sham surgery (sham surgery group). All rats were maintained in standard conditions. Three months after surgery, 4 rats were randomly selected from OVX group and the sham surgery group, respectively, for Micro CT identification of bone loss at the rat humeral head. The remaining rats in OVX group underwent RCT modeling and surgical repair of acute supraspinatus muscle transection (OVX+RCT group) ( n=14); the remaining rats in the sham surgery group were subjected to either surgical repair of acute supraspinatus muscle transection (RCT group, n=14) or RCT sham surgery (SO group, n=14). The grip power of the rats was tested 2 weeks after surgery. The supraspinatus tendon-bone complex was harvested for evaluation of new bone formation and growth through real-time fluorescence quantitative polymerase chain reaction (qPCR), hematoxylin eosin (HE) staining, and immunohistochemistry (IHC) staining. The tryptophan metabolism was analyzed using ultra high performance liquid chromatography (UPLC). Results:The grip power test showed that SO group had the greatest grip power, followed by RCT group and OVX+RCT group, with statistically significant differences between the 3 groups ( P<0.05). The qPCR showed that the relative expression of osteosclerosis in the tendon-bone complex in SO group was significantly higher than that in OVX+RCT group and RCT group; IHC staining showed that the relative expression of osteocalcin in RCT group was significantly higher than that in SO group and OVX+RCT group ( P<0.05). The UPLC showed that the content of tryptophan in the rotator cuff tendon-bone complex was similar among SO, RCT, and OVX+RCT groups, showing no significant difference ( P>0.05). The qPCR showed that the expression of indoleamine 2, 3-dioxygenase 2 in the Kynurenic acid metabolism pathway showed an increasing trend from SO group to RCT group to OVX+RCT group, with OVX+RCT group significantly higher than SO group ( P<0.05). The expression of 3-hydroxybenzoate 3, 4-dioxygenase in OVX+RCT group was significantly higher than that in RCT group and in SO group ( P<0.001). The subtypes A and B of monoamine oxidase in the 5-hydroxytryptamine metabolism pathway increased from SO group to RCT group to OVX+RCT group. The subtypes A and B of monoamine oxidase in the 5-hydroxytryptamine metabolism pathway increased among SO, RCT, and OVX+RCT groups( P<0.001). The expression of dopamine decarboxylase in the indole metabolism pathway in OVX+RCT group was significantly higher than that in SO group ( P<0.01). The expression of cytochrome P450 oxidoreductase increased from SO group to RCT group to OVX+RCT group ( P<0.001). Conclusions:The tryptophan metabolism in the supraspinatus tendon-bone complex after RCT in rats is mainly dominated by kynurenic acid metabolism, followed by 5-hydroxytryptamine metabolism. In RCT bone remodeling, the 5-hydroxytryptamine metabolic pathway changes the most, followed by the indole pathway. The contents of niacin and xanthurenic acid in the kynurenic acid metabolism pathway are related to bone growth; the 5-hydroxytryptamine, hydroxyindoleacetic acid, and melatonin in the 5-hydroxytryptophan metabolic pathway are related to bone growth; the tryptophan and indole lactate in the indole metabolism pathway are related to bone growth. Therefore, tryptophan metabolism is related to bone growth, providing potential therapeutic targets for RCT repair.

Slow transit constipation (STC) is generally considered as a complex idiopathic disease affected by multiple factors synergistically. Primarily caused by the condition of gut dysmotility, the transit of intestinal contents turned so slow that the moisture absorption increases, defecation frequency decreases, bowel movement is weakened or even disappeared with or without abdominal distension, dry and hard stool. Its etiology and pathogenesis remains unclear.Recently some researches reported the pathogenesis may be associated with the changes of the enteric nervous system (ENS), such as the change or degeneration of intestinal nerve cells, gut glial cell damage and neurotransmitter changes. Besides, intestinal myopathy, ICC reduction, immune factors, endocrine factors, laxative, mental psychological factors, diet and exercise habits may also be associated with the occurrence and aggravation of STC. The current understanding of STC mechanism can not meet the needs of clinical diagnosis and treatment. Conservative treatment is the main treatment of STC nowadays. For those receiving normative medical treatment but with little effect, surgery is necessary. "Jingling procedure" and "antiperistaltic anastomosis" can both get good efficacy. Treatment aiming at causes of disease will be uncovered as the development of the researches on the pathogenesis and treatment of slow transit constipation.

Objective To investigate the clinical value of re-using ultrafiltrated and concentrated ascites fluid for refractory ascites in patients with hepatitis B cirrhosis. Methods A retrospective study was conducted, one hundred and thirteen patients with intractable ascites (all patients received intraperitoneal reinfusion of ultrafiltrated and concentrated ascites fluid therapy) admitted to the Department of Gastroenterology of No.254 Hospital of the Chinese People's Liberation Army from December 2013 to November 2016 were enrolled and assigned as the study group, fifty-two patients with intractable ascites admitted in the same period as above group in this hospital without undergoing above ascites fluid reinsfusion were served as the control group. Both groups were given conventional therapies, including measures for hepatoprotection, increase of plasma osmotic pressure, correction of hypoproteinemia (intravenous injection albumin 10 g, 3 times a week), reduction of portal venous pressure (octreotide 0.2 mg, q8 h), improvement of microcirculation, correction of water and electrolyte balance disorders, diuresis (furosemide 100 mg/d), etc. On the basis of the above conventional treatment, the system with ascites ultrafiltration, concentration and reinfusion into abdominal cavity was applied to carry out the concentrated ascites fluid reinfusion therapy in the study group. The relieve of abdominal bloating, conscious, blood pressure, 24-hour urine output, endogenous creatinine clearance rate (CCr), serum potassium ion (K+), serum sodium ion (Na+), ascites albumin quantity, serum albumin levels before treatment and after treatment for 1 week, abdominal infection situation after treatment for 1 week were observed in the study group. The difference in incidence of abdominal infection between the study group and control group (at the end of 12 weeks after treatment) was compared. Results In the study group, after treatment, the patients with abdominal bloating had different degrees of relief, 24-hour urine output was increased compared with that before treatment (mL: 1291.3±123.4 vs. 1265.0±61.5, P = 0.051), no cases with conscious changes, blood pressure instable. There were no statistical significant difference in blood K+ and Na+ (P > 0.05). And ascites albumin concentration was increased compared with before treatment (g/L: 19.1±2.9 vs. 17.2±4.1, P = 0.000); 1 week after treatment, CCr was significantly higher than that before treatment (μmol/L: 71.2±8.7 vs. 56.1±5.4, P = 0.000); serum albumin was increased after 3 times of treatment in 1 week (g/L: 25.7±4.4 vs. 24.6±3.0), but the difference was not statistically significant (P = 0.054). No abdominal infection occurred within 1 week after treatment were observed in patients of study group. There was no statistical significant difference in the incidence of abdominal infection between the study group and control group in 12 weeks after treatment [9.7% (11/113) vs. 13.6% (7/52), P = 0.476]. Conclusions The re-using of ultrafiltrated and concentrated ascites fluid can effectively relieve the abdominal bloating symptom, improve CCr, be beneficial to the re-use of ascites albumin, and does not increase the incidence of abdominal infection within 12 weeks after the therapy, therefore the treatment has relatively high therapeutic value for intractable ascites in patients with hepatitis B cirrhosis.

Objective:To investigate the differences in incidence of deep vein thrombosis (DVT) after closed fracture of lower extremity between patients with different blood types ABO.Methods:A retrospective study was conducted in the 1, 951 patients who had been admitted to Department of Orthopaedics Trauma, Honghui Hospital Affiliated to Xi'an Jiaotong University for lower extremity fractures from August 2014 to June 2018. They were 924 males and 1,027 females with a mean age of 63 (46, 78) years (range, from 16 to 102 years). Of them, 572 were type O, 564 type A, 609 type B and 206 type AB. Venous ultrasonography was performed on both lower extremities within 12 hours after admission. The incidences of DVT after fracture were compared between different blood types in all the patients, patients with proximal fracture of the knee, peri-knee fracture and distal fracture of the knee, and patients<60 years old and ≥60 years old.Results:The incidences of DVT were, respectively, 26.75% (153/572), 28.72% (162/564), 34.32% (209/609) and 29.61% (61/206) for patients with blood type O, type A, type B and type AB. The DVT incidence for type B was significantly higher than that for type O ( P< 0.008). The incidences of DVT were, respectively, 28.74% (98/341), 28.99% (100/345), 39.45% (144/365) and 30.97% (35/113) for blood type O, type A, type B and type AB in the patients with proximal fracture of the knee. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). There were no significant differences in the DVT incidence between different blood types ABO in the patients with peri-knee fracture, distal fracture of the knee,<60 years old or ≥60 years old( P>0.05). The incidences of DVT were, respectively, 30.99% (97/313), 33.33% (108/324), 45.22% (156/345), 34.74% (33/95) for blood type O, type A, type B and type AB in the patients ≥60 years old. The DVT incidence for blood type B was significantly higher than those for blood type O and blood type A ( P< 0.008). Conclusions:The incidence of DVT varied with different blood types ABO after lower extremity fracture. The highest DVT incidence was found in patients with blood type B. The impact of blood type on the DVT incidence after lower extremity fracture was mainly observed in the patients with proximal fracture of the knee or an age of ≥ 60 years old.

Objective To investigate the occurrence of deep venous thrombosis (DVT) in the perioperative period of patients with fracture distal to the knee,so that clinicians have a better understanding of the occurrence of DVT in the perioperative period of the fracture distal to the knee.Methods A retrospective analysis of the clinical data of 365 patients with distal knee fractures who underwent surgery in the Department of Orthopaedics Trauma,Xi'an Jiaotong University Medical College Red Cross Hospital from June 2014 to March 2018 was conducted.There were 213 males and 152 females,aged (45.05 ± 15.24) years,with an age range of 17-83 years.Classification of fracture sites:177 cases of tibiofibular shaft fracture,130 cases of ankle fracture,and 58 cases of foot fracture.According to whether thrombosis occurred or not,the patients were divided into thrombotic group and non-thrombotic group before and after operation.There were 66 patients with thrombosis before operation,299 patients without thrombosis before operation,88 patients with thrombosis after operation,and 277 patients without thrombosis after operation.The incidence of thrombosis and the location of the thrombus were recorded.The sex,age,fracture site,ASA score,operation time,the time from injury to admission,the time from injury to surgery,intraoperative tourniquet time,intraoperative blood transfusion volume,intraoperative blood loss,intraoperative transfusion volume,hemoglobin volume at admission and 1 day after operation,D-dimer level at admission and 1 day after operation,multiple injuries,chronic hepatitis and medical diseases were analyzed.The measuremernt data of normal distribution and homogeneity of variance were expressed as mean ± standard deviation (Mean ± SD),the t test was used for comparison between two groups.The comparison of count data was performed by x2 test or Fisher exact probability method,and multivariate logistic regression analysis was performed on the risk factors affecting the occurrence of DVT in both lower extremities.Results The preoperative DVT rate was 18.1％ (66/365).In patients with thrombosis,distal thrombosis accounted for 93.94％ (62/66),and mixed thrombosis accounted for 6.06％ (4/66).The incidence of postoperative DVT was 24.1％ (88/365).In patients with thrombosis,distal thrombosis accounted for 94.32％ (83/88),proximal thrombosis accounted for 1.14％ (1/88),and mixed thrombus accounted for 4.55％ (4/88).Fracture site,ASA score,operation time,intraoperative tourniquet time,intraoperative blood transfusion volume,intraoperative blood loss,intraoperative transfusion volume were not statistically significant(P ＞0.05).Age ≥ 40 years (OR =2.691,95％ CI:1.422-5.093,P =0.002),the time from injury to admission ＞ 3 days (OR =1.927,95 ％ CI:1.072-3.463,P =0.028)were independent risk factors for DVT formation in fracture distal to the knee before operation.Age ≥ 40 years (OR =3.925,95 ％ CI:2.161-7.129,P =0.000),the time from injury to surgery ＞ 5 days (OR =1.835,95 ％ CI:1.080-3.119,P =0.025),D-dimer level at 1 day after operation (OR =1.191,95％ CI:1.096-1.293,P =0.000),combined with multiple injuries (OR =1.981,95％ CI:1.006-3.902,P =0.048),combined with coronary atherosclerotic heart disease (OR =2.692,95％ CI:1.112-6.517,P =0.028) were independent risk factor for DVT formation after operation for fracture distal to the knee.Conclusions The occurrence of DVT before and after the fracture of the knee is mainly caused by distal thrombosis,and proximal thrombosis also occurs.Those patients aged≥40 years,combined with multiple injuries and coronary heart disease,should focus on preventing the occurrence of DVT.After the injury,the patient is immediately admitted to the hospital for DVT screening,and when the general condition allowed,shortening the preoperative waiting time can reduce the occurrence of DVT.

Objective:To investigate the risk factors of hypoalbuminemia (HA) in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) after endovascular mechanical thromboectomy (EMT) and impact on outcomes.Methods:Patients first diagnosed with anterior circulation LVO-AIS and underwent emergency EMT at the Department of Acute Stroke, the Affiliated Hospital of Jining Medical University from June 1, 2020 to April 31, 2023 were retrospectively included. According to the first follow-up serum albumin examination after procedure (6-8 d), the patients were divided into HA group (<35 g/L) and non-HA group (≥35 g/L). According to the modified Rankin Scale score at 90 d after EMT, the patients were divided into a good outcome group (0-2) and a poor outcome group (3-6). Univariate and multivariate logistic analysis was used to determine independent risk factors for HA after EMT and their impact on outcomes. Results:A total of 144 patients were enrolled, including 107 males (74.30%) with a median age of 64 years (interquartile range, 56-71 years). There were 50 patients (34.72%) in the HA group and 94 (65.28%) in the non-HA group; 60 (41.67%) in the good outcome group, and 84 (58.33%) in the poor outcome group. Multivariate logistic regression analysis showed that age (odds ratio [ OR] 1.061, 95% confidence interval [ CI] 1.014-1.111; P=0.011) and pulmonary infection ( OR 5.136, 95% CI 1.917-13.760; P=0.001) were independent risk factors for HA; HA ( OR 4.345, 95% CI 1.367-13.814; P=0.013), pneumonia ( OR 5.113, 95% CI 1.217-12.528; P=0.026), and onset to reperfusion time ( OR 5.473, 95% CI 1.090-16.05; P=0.038) were independent risk factors for poor outcomes. Conclusions:Age and pulmonary infection are independent risk factors for HA in LVO-ASI patients after EMT, and HA is the independent risk factor for poor outcomes of the patients.