Objective To observe protective and repairing effect of Aorui Gel on esophageal mucosa injury in reflux esophagitis rats. Methods Rat models of reflux esophagitis were established by partial pylori ligation plus cardiomyotomy. Model control group,low-,middle-and high-dose Aorui Gel groups,positive control group,excipient control group and sham operation group were set up. Rats were treated with the corresponding drugs 7 days after operation. After treatment for 14 days,the rats'general state,and macroscopic features and pathological features of esophageal mucosa were compared. Results Macroscopic features and pathological features of esophageal mucosa in Aorui Gel groups differed from those in the model control group,inflammation of esophageal mucosa in Aorui Gel groups was alleviated,and pathological features were relieved and arrived to the normal state. Conclusion Aorui Gel can alleviate esophageal mucosa injury in reflux esophagitis rats,indicating that Aorui Gel has protective and repairing effect on esophageal mucosa injury.

Objective To investigate the influence of arsenic trioxide (AS2 O3 )in the vasculogenic mimicry (VM ) of HepG2 cells, and to preliminary clarify the possible mechanism of inhibition of AS2 O3 on the VM. Methods Themean inhibitory concentration (IC50 )of AS2 O3 72 h after treatment of HepG2 cells was calculated by CCK-8 assay.The HepG2 cells were cultured on 3-D Matrigel and randomly divided into control group, 1/2 IC50 AS2 O3 group and IC50 AS2 O3 group.IPP software was used to calculate the number,length and area of VM,and the expression levels of VM-related proteins VE-cadherin and MMP-2, apoptotic-related protein caspase-3 and proliferation-related protein PCNA were detected by Western blotting method.Results The IC50 of AS2 O3 was 10μmol·L-1 72 h after treatment of HepG2 cells.The number,length and area of VM in 1/2 IC50 and IC50 AS2 O3 groups were significantly lower than those in control group (P<0.01);the number,length and area of VM in IC50 AS2 O3 group were also lower than those in 1/2 IC50 AS2 O3 group (P<0.05).Compared with control group,the expression levels of VE-cadherin and MMP-2 in 1/2 IC50 and IC50 AS2 O3 groups were decreased (P<0.05),and the expression levels of caspase-3 and PCNA had no significant change (P>0.05).Conclusion AS2 O3 can inhibit the forming of VM of HepG2 cells,which indicated that its mechanism may be related to inhibiting the expressions of VE-cadherin and MMP-2 .

Objective To describe and analyze the distribution of medical expenditure of Liaoning province in 2014 in terms of population beneficiary based on the System of Health Accounts 2011(SHA 2011).Methods By means of multistage and stratified sampling, a total of 252 medical institutions were selected from four cities in Liaoning province according to their economic status and geographical distribution.Macro data including the outpatient income and hospitalization income were taken into account, to calculate the beneficiary population of the province in 2014 according to SHA2011.Results GBD classification found that the highest medical expenditure category was non-communicable diseases, accounting for 63.02% in total medical expenditure.ICD classification found that respiratory disease as consuming the highest medical expenses (43.76%).The average medical expenditure of the elderly population was the highest per person, up to 3 041.70 yuan per person.Conclusions Medical expenses of non-communicable diseases, respiratory disease and elderly population were still high.Thus we need to emphasize disease prevention, and take efficient measures against such key diseases to curb the medical expenses.The elderly population calls for specific and effective measures to reduce their medical expenses.

We report the management and maternal and neonatal outcomes of four cases of delayed interval delivery after cervical cerclage in twin pregnancies, who hospitalized in Shanghai First Maternity and Infant Hospital from year 2017 to 2018. Four patients with dichorionic diamniotic twin pregnancies all presented with gradually weakened uterine contractions after spontaneous vaginal delivery of twin 1. After informed consent, the patients received cervical cerclage at 2 to 3 days after delivery when the maternal and fetal conditions were stable, to delay delivery of twin 2. The gestational weeks at delivery of twin 1 were 25 +4, 23 +1, 27 +1, and 23 weeks, which were noted for 30 +1, 32 +6, 31 +4, and 24 weeks for twin 2, respectively. Delayed delivery intervals were 32, 69, 31 and 7 d. Three of the four twin 2 survived, with Apgar score ≥ 8 at 1 minute and birth weight of 1 390, 2 290 and 1 620 g. During a 2-year follow-up, no developmental abnormalities were observed in the children, and no serious maternal complications were found, including severe infection, bleeding or cervical laceration.

BACKGROUND:There are several reports about the application of fresh bone marrow aspirate being injected directly to repair partial ligament injury, but the application about fresh bone marrow aspirate directly being planted on scaffolds to build tissue-engineered ligament is rarely mentioned.
OBJECTIVE:To evaluate the feasibility of applying fresh bone marrow aspirate planted directly on scaffolds to construct tissue-engineered ligament
METHODS:We constructed fibroin fiber/smal intestinal submucosa composite scaffold, then planting fresh bone marrow directly to built bone marrow seeding group and planting seed cel s (bone marrow mesenchymal stem cel s) on the scaffold to built cel seeding group. The control group had no treatment. After that, we detected the density of cel adhesion, cel proliferation ability and extracel ular matrix secretion. Then, the composite in the bone marrow seeding group was implanted into the broken anterior cruciate ligament in rabbits, and material biocompatibility in vivo was evaluated after 12 weeks.
RESULTS AND CONCLUSION:After 4 hours of incubation, bone marrow seeding group was significantly higher than the cel seeding group in cel adhesion density and proliferation rate (P<0.05). Bone marrow seeding group and cel seeding group showed higher type I, III col agen secretion compared with the control group (P<0.05), but the col agen secretion of bone marrow seeding group and cel seeding group showed no significant difference. Composite cel scaffold implantation in vivo did not cause fatal immune rejection and severe inflammatory reaction, and no significant ligament regeneration and vascularization occurred. These findings indicate that fresh bone marrow aspirate can be seeded directly on scaffolds to construct tissue-engineered ligament, and the short-term biocompatibility in vivo is good.

Objective To investigate the predictive value of left ventricular diastolic function on mechanical ventilation weaning in patients with left ventricular ejection fraction (LVEF) > 0.50.Methods A retrospective case control study was conducted. Sixty-five patients with LVEF > 0.50 undergoing mechanical ventilation for more than 48 hours admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from June 2014 to December 2016 were enrolled. The clinical data and parameters of echocardiography before spontaneous breathing trial (SBT) were collected. The possible relationship between left ventricular diastolic function and the results of weaning was analyzed according to analysis of blood flow filling parameters of mitral valve orifice. According to the grading standard of left ventricular diastolic function, the patients were divided into normal, mild (level 1) and moderate to severe (level 2-3) groups, and the outcomes of weaning were compared among the groups. Then patients were also divided into two groups of weaning successfully and weaning failure, and the clinical data and left ventricular diastolic function parameters of patients were compared between the two groups. The predictive value of left ventricular diastolic function on results of weaning was evaluated with receiver operating characteristic curve (ROC).Results Sixty-five patients were enrolled and 28 patients (43.1%) failed weaning, 22 patients failed the first SBT and 6 required reintubation within 48 hours, 31 of the patients presented normal left ventricular diastolic function, 9 of patients presented mild diastolic dysfunction, and 25 of them presented moderate to severe diastolic dysfunction. So with the gradual increase of the severity of diastolic dysfunction, the rate of weaning failure was gradually increased, which was 16.1%, 44.6% and 76.0% respectively (χ2 = 20.240,P = 0.001). Patients who failed weaning presented evidence of increased left ventricular filling pressures at pre-SBT, by demonstrating decreased deceleration time of E (DTE, s: 180.4±5.1vs. 196.8±4.0,t = 2.567,P = 0.013), increased left ventricular mitral valve diastolic early and late filling velocity ratio (E/A: 1.47±0.08 vs. 1.14±0.05, t = 3.827,P = 0.000), increased lateral, septal and averaged left ventricular mitral valve diastolic early velocity and maximal velocity of mitral annulus in early diastolic velocity ratio (E/Em: 10.26±0.52 vs. 7.28±0.41,t = 4.535, P = 0.000; 10.08±0.58 vs. 8.16±0.40,t = 2.797,P = 0.007; 10.17±0.48比7.72±0.35,t = 4.231,P = 0.000), and the rapid shallow breathing index (RSBI) was also increased significantly (61.7±3.6 vs. 50.6±2.7,t = 2.507, P = 0.015). It was shown by ROC curve analysis that the basic left ventricular diastolic function at pre-SBT had the diagnostic performance in predicting the outcome of weaning from mechanical ventilation, especially E/A and lateral E/Em. Pre-SBT values of E/A greater than 1.2 and lateral E/Em greater than 7.9 predicted weaning failure with an area under the ROC curve (AUC), sensitivity, and specificity of 0.81±0.06 and 0.85±0.06, 82.6% and 91.3%, 81.4% and 80.7%, respectively, and the AUC was higher than RSBI (0.70±0.07). The AUC of combination of E/A > 1.2 and lateral E/Em > 7.9predicting weaning failure was 0.86±0.05 with a sensitivity of 78.3% and a specificity of 93.6%.Conclusions The results suggest that left ventricular diastolic dysfunction is significantly associated with weaning outcome in critical patients with LVEF > 0.50. The combination of E/A ratio greater than 1.2 and E/Em ratio greater than 7.9 may identify patients at high risk of weaning failure.

Objective:To investigate the association of muscle mass loss with atherosclerosis in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 322 patients with T2DM aged≥60 years old were divided into muscle mass loss group( n=152) and non-muscle mass loss group( n=170) according to their appendicular skeletal muscle mass index(ASMI). All participants underwent physical examination, dual-energy X-ray absorptiometry check, carotid and lower extremity ultrasound, as well as laboratory tests. Results:Among 322 patients, 49(15.22%) patients were suffered from sarcopenia and 152(47.2%) patients with reduced muscle mass. The carotid and lower extremity atherosclerosis grades in the muscle mass loss group were significantly higher than those in the non-muscle mass loss group( P<0.05), with lower body mass index(BMI), T-score, ASMI, uric acid, and homeostasis model assessment of insulin resistance index( P<0.05). Multivariate logistic regression analysis showed that carotid atherosclerosis and lower extremity atherosclerosis were risk factors for muscle mass loss while BMI and 25-(OH)D 3 were protective factors for muscle mass loss. There existed a consistency in carotid atherosclerosis grade and lower extremity atherosclerosis grade of elderly patients with T2DM( P<0.01). Conclusion:Atherosclerosis has a predictive value for early sarcopenia in elderly patients with T2DM.

Background and purpose:T-cell non-Hodgkin’s lymphoma(T-NHL) has relatively high incidence in Asian countries, and the incidence rate showed an upward tendency. It has a dual characteristic of both ethnic and regional. We conducted this study in order to analyze the clinical characteristics, pathological type and survival of T-NHL in our hospital. Methods:Records of 50 cases with T-NHL treated from Jan. 2002 to Dec. 2012, were analyzed in terms of clinical characteristics, distribution of pathological type and survival. Results:Patients with T-NHL account for 24%of NHL cases in our study. Of the 50 cases, 37 were Han, 13 were Uygur;The most frequent type was NK/T cell lymphoma(NK/TCL)(16/50, 32%). We performed pathological type for each age group:4 cases with children’s group were all T-lymphoblastic leukemia/lymphoma(T-LBL)(4/4,100%), the most frequent type of youth and middle age group was NK/TCL(8/20, 40%;7/13, 53.8%), as the senile group was angioimmunoblastic T-cell lymphoma(AITL)(6/13, 46.2%). There was also a signiifcant difference in pathological type between the stage, with stageⅠ-Ⅱwere all NK/TCL(12/12, 100%), stageⅢ-Ⅳwere observed with peripheral T-cell lymphomas-unspeciifed(PTCL-U)(9/38, 23.7%) and AITL(9/38, 23.7%). The frequent type of Han was NK/TCL(14/37, 37.8%), as the Uygur was T-LBL(5/13, 38.5%). The median overall survival(OS) time was 12 (ranged 0-112) months. The 5 year OS rate was 39%. Both pathological type and age group were important factors influencing survival. The difference in outcome for the pathological type(P<0.05): NK/TCL and anaplastic large cell lymphoma(ALCL) had the better 3 year OS rates(71%, 61%), but PTCL-U and T-LBL had poor prognosis(19%, 7%). Age did a signiifcant effect on OS(P<0.05):children’s group had the worse 5-year OS rate (0%), middle age group had a better prognosis (67%), the OS of the youth group was 35%, for the senile group was 21%. Conclusion:T-NHL in Xinjiang region have their unique clinical characteristics:The overall incidence rate was similar with the domestic report, however, higher than the reports abroad. The incidence of Han was higher than Uygur. Pathological type showed in this study was different from that in European and American countries. There was a significant difference in distribution of pathological type in different age group, stage and nation. The long-term survival and prognosis of patients in Xinjiang region was poor. Both pathological type and age group were important factors inlfuencing survival.

Objectives To investigate the expression of B lymphocyte stimulator (BLyS) and its receptor BAFF-R(a receptor of B-cell activator factor, belonging to the TNF family) in peripheral blood mononuclear cells (PBMCs) from patients with systemic lupus erythematosus (SLE), and to explore their clinical significance. Methods The patients were separated into active group (n = 28) and inactive group (n = 24) according to the SLE disease activity index (SLEDAI). The mRNA and protein expression of BLyS and its receptor BAFF-R were measured by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western-blot in PBMCs from the patients and 21 healthy volunteers. The relationship between the expression of BLyS and BAFF-R and SLEDAI was analyzed. Results In the case of the expression of mRNA and protein of BLyS and BAFF-R, the patients had a higher level than the healthy controls (P 0.05). Conclusions These findings indicate that BLyS and its receptor BAFF-R might be involved in the pathogenesis of SLE. Also, BLyS expression level might be a new parameter for the evaluation of SLE disease activity and therapeutic effect.

Objective To observe the effect of continuous incision infusion different concentra-tion of ropivacaine for postoperative analgesia after radical mastectomy.Methods One hundred pa-tients under radical mastectomy,aged 40-70 years,ASA Ⅰ or Ⅱ,were randomly divided into four groups (n =25 each):0.2% (group R1),0.3% (group R2),0.4% (group R3)ropivacaine incision continued infiltration group and patient-controlled intravenous analgesia (group PCIA)as control group.VAS pain scores,sedation Ramsay score and side effects were recorded at each time point in rest and turning over 90°,2 h (T1 ),4 h (T2 ),8 h (T3 ),12 h (T4 ),24 h (T5 ),48 h (T6 )after the operation.Results VAS scores in group R1 at T1-T6 in rest and turn over 90°were significantly high-er than that of group PCIA (P <0.05).There were no significant differences among the group PCIA, group R2 and group R3.Sedation score in PCIA group was significantly higher than that in the other three groups (P <0.05),and the adverse reactions,such as nausea and vomiting,in group PCIA (2 cases)were more serious than that in the other groups (0 cases ).There were no significant differences among the other groups.Conclusion Ropivacaine plays an effective role in infiltration an-algesia when its concentration reaches 0.3% subcutaneous after radical mastectomy.