OBJECTIVE:To discuss the relationship between the changes in pla sma endotoxin levels and use of antibiotics in patients with serious traumatic injury before and after operation.METHODS:The plasma bacterial endotoxin levels were dynamically detected by kinetic turbidimetric assay in20patients with severe traumatic injury used with different antibiotics before and after operation,at the same time the normal control group was established.RESULTS:Plasma endotoxin levels in patients with severe traumatic injury increased remarkably before and after operation,as compared with the normal control group(P0.05).CONCLUSION:Intestine-borne endotoxin induced in a stress condition can strengthen the pathological reaction of the body ,therefore dy?namic detection of plasma endotoxin can provide guidance for clinical therapy.

Objective: To investigate the expression of interleukin (IL)-1α, IL-1β and IL-1 receptor antagonist (IL-1RN) in cervical cancer and its correlation with clinical feature and prognosis of cervical cancer. Methods: The data of 4 databases were collected and analyzed on April 28, 2019. The Cancer Genome Atlas (TCGA) database was used to analyze the relationship between IL-1α, IL-1β and IL-1RN mRNA expression and prognosis in cervical cancer tissues (292 cases). The GEPIA (Gene Expression Profiling Interactive Analysis) database (http://gepia.cancer-pku.cn) was used to analyze the correlation between IL-1α, IL-1β and IL-1RN mRNA expression and prognosis in cervical cancer tissues (292 cases), the LinkedOmics database (http://www.linkedomics.org) was used to analyze IL-1α, IL-1β and IL-1RN mRNA expression in different pathological types of cervical cancer tissues (226 cervical squamous cell carcinoma tissues and 47 cervical adenocarcinoma tissues), and the STRING database (https://string-db.org) was used to analyze protein interaction networks of IL-1α and IL-1β. Results: The expressions of IL-1α, IL-1β and IL-1RN mRNA in cervical cancer tissues were significantly higher than those in normal cervical tissues (1.54 vs. 0.04, 4.82 vs. 0.46 and 73.53 vs. 0.67), and there were statistical differences (P<0.01); Kaplan-Meier survival curve analysis showed that high expression of IL-1α and IL-1β mRNA suggested poor prognosis (HR=1.7 and 1.7, P=0.021 and 0.028), and IL-1RN mRNA expression was not associated with prognosis (P>0.05). The expressions of IL-1α, IL-1β and IL-1RN mRNA were correlated between any two indexes (P<0.01), and the correlation between IL-1α and IL-1β was stronger (r=0.87, P<0.01); Kaplan-Meier survival curve analysis showed that the assessment prognosis value of IL-1α combined with IL-1β was the highest (HR=2.0). The expressions of IL-1α, IL-1β and IL-1RN mRNA in cervical squamous cell carcinoma tissues were significantly higher than those in cervical adenocarcinoma tissues (6.535 vs. 2.936, 7.382 vs. 5.588 and 11.170 vs. 8.639), and there were statistical differences (P<0.01). The associated proteins with IL-1α and IL-1β included IL-1 receptor type 1 (IL-1R1), IL-1 receptor type 2 (IL-1R2), IL-10, IL-4, IL-18, IL-1 receptor accessory protein (IL1RAP), tumor necrosis factor (TNF), caspase 1 (CASP1) and IL-8; IL1R1 mRNA expression in cervical cancer tissues was significantly lower than that in normal cervical tissues (9.56 vs. 40.961), the expressions of TNF, CASP1, IL1RAP, IL-18 and IL-8 mRNA were significantly higher than those in normal cervical tissues (1.51 vs. 0.06, 33.70 vs. 12.61, 11.12 vs. 3.02, 24.59 vs. 3.54 and 20.01 vs. 0.48), and there were statistical differences (P<0.01 or <0.05); high expression of IL-8 mRNA suggested poor prognosis (HR=2.9, P<0.01). Conclusions Overexpression of IL-1α, IL-1β and IL-1RN plays an important role in the proliferation of cervical cancer. IL-1α and IL-1β can prompt the inflammatory response and prognosis of cervical cancer, and provide a theoretical basis for the early diagnosis and prognosis of cervical cancer.

Objective To investigate the relationship between the expression patterns of fibronectin (Fn) and its receptors-α5β1 and αVβ3 integrins and angiogenesis after cerebral ischemia in aged mice. Methods Both young (2 months) and aged (18 months) C57BL6 male mice were subject to middle cerebral artery occlusion. The brain endothelial cells (BECs) proliferation was assessed by using dual-immunofluorescent staning (IF) for Ki67 and CD31 and the vessel density was quantified by counting the number of CD31-positive vessels per field of view. The expression patterns of Fn,α5β1 and αVβ3 on blood vessels was assessed by using dual-IF for CD31/ɑ5,CD31/β3 and CD31/Fn. Results The number of CD31/Ki67 dual-positive cells in the penumbra at day 7 after cerebral ischemia of was significantly lower in the aged mice than in the young mice (4.7±0.8/field, P<0.05). The number of CD31-positive vessels in the penumbra at day 7 and 14 of was both significantly lower in aged mice than in the young mice (38.3±3.9/field, 45±4.4/field, both P<0.01). Furthermore, the expression of Fn, α5 and β3 on blood vessels in the penumbra at day 7 after cerebral ischemia was significantly lower in age mice than in the young mice (P<0.05). Conclusions The cerebral angiogenesis after ce?rebral ischemia is impaired in the aged stroked mice, which is associated with the low expression of fibronectin and its receptors-α5β1 andαVβ3 integrins on blood vessels.

BACKGROUND:Traditional core decompression and al ograft fibula supporting can reduce the stress load within femoral head and improve mechanical properties of femoral head. However, it cannot provide supports for maintaining the stability of five pathological areas fol owing femoral head necrosis. OBJECTIVE:To observe the clinical effect of fan-shaped decompression and al ograft fibula supporting internal fixation in treatment of early femoral head necrosis in adults, taking al ograft fibula grants as the control. METHODS:Forty patients with early femoral head necrosis were randomly divided into treatment group and control group, receiving fan-shaped decompression plus al ograft fibula supporting internal fixation and traditional decompression plus al ograft fibula grafting, respectively. The therapeutic effects in two groups were observed and compared. After treatment, patients were detected by bilateral hip anteroposterior films, Harris scoring and X-ray ARCO staging to evaluate the col apse severity and restoration of necrosis. RESULTS AND CONCLUSION:At the last fol ow-up, Harris scores in the treatment group were significantly higher and the repairing effect was better than control group (P<0.05). In treatment group, 18 hips restored wel (72%) and 7 hips delayed or failed to restore (28%);in control group, 9 hips restored wel (60%) and 6 hips delayed or failed to restore (40%). Our findings indicate that, fan-shaped decompression plus al ograft fibula supporting internal fixation yields a more complete decompression, a higher stability of femoral head and a more reliable supporting, compared with traditional decompression plus al ograft fibula grafting.

Objective Proper selection of reconstruction method is the key point to get a successful result in nasal reconstruction.The purpose of the article is to evaluate the results of repairing the partial nasal defect with different surgical strategies.Methods Different surgical methods were used according to the area and type of nasal defects of nasal defects,the different sub-unit of nasal de fects and the different tissue damage levels.Local skin flaps,auricular composite tissue flaps,nasolabial skin flaps and superficial temporal artery pedicle flaps were used in these patients.Results 23 cases suffering from partial nasal defects were repaired with flaps or tissue graft,including 4 auricular composite tissue flap,5 nasolabial skin flap,3 forehead island flap with a pedicle of superficial temporal vessels,7 local flap,and 1 skin graft.After 5-16 months of follow-up,the color and texture around the nose were basically consistent,the appearance of nose was satisfactory,and the postoperative effect turned out fine.Conclusions The method of surgical reconstruction of partial nasal defects should be considered carefully according to the area of nasal defects,sub-unit of nasal defects and the different tissue damage levels.

Objective To study the expressions of S100A4 and urokinase plasminogen activator(uPA) in pancreatic cancer cells and their correlation with patients prognosis.Methods The expressions of S100A4 and uPA were examined in 63 surgical specimens of primary pancreatic carcinoma by suing immunohistochemistry PV methods,and correlation of their expressions and prognosis of pancreatic cancer was analyzed.Results ( 1 ) Positive immunostaining for S100A4 and uPA was observed in 74.6％ (47 cases) and 65.1％ (44 cases) of 63 pancreatic cancer samples respectively.(2) The positive expressions of S100A4 and uPA were significantly correlated in pancreatic cancer( P =0.000,r =0.567 ).( 3 ) The expression of S100A4 significantly correlated with TNM stages( P =0.002 ),lymph node metastasis ( P =0.002 ) and distant metastasis ( P =0.007 ).The expression of uPA had a significant correlation with TNM stages ( P =0.002),lymph node metastasis ( P =0.001 )and differentiation(P =0.003).(4) Kaplan-Meier survival analysis showed that the median survival (21 months) of patients with S100A4 ( - ) was significantly longer than the median survival ( 9 months) of the patients with S100A4( + )(P=0.000) ;the median survival(9 months) of patients with uPA( + ) was significantly shorter than the median survival ( 18 months) of the patients with uPA ( - ) ( P =0.000) ; the median survival(23 months)of 13 patients with S100A4( - )/uPA( - )was significantly longer than the median survival of other cases ( Log-rank test,x2 =54.444,P =0.000).( 5 ) Cox regression model ( x2 =53.974,P =0.000 )analysis suggested:the differentiation(P =0.004),lymph node metastasis(P =0.017) 、S100A4( + ) expression ( P =0.000) and uPA ( + ) expression ( P =0.001 ) were independent prognostic factors for pancreatic cancer.Conclusion S100A4 and uPA are highly expressed in pancreatic cancer cells,and S100A4 expression has positive correlation with uPA expression,which indicates that the overexpression of S100A4 and uPA maybe poor prognosis factors for pancreatic cancer patients.S100A4 maybe promote extracellular matrix and basement membrane degradation by up-regulation of uPA protein expression,and ultimately promote tumor invasion and metastasis,which is not favorable to prognosis.They may be potential indicators of metastasis and predictors for prognosis of pancreatic cancer.

Objective To study the experiences of severe acute pancreatitis (SAP) treated by combmation of traditional Chinese and western medicine.Methods Two hundred and forty patients with SAP were divided into A and B groups randomly,140 patients of group B were treated by combination of traditional Chinese and western medicine;100 patients of group A were treated by western medicine.Results After treatment in group B, the serum and urine amylase, and c-reactive protein,signiflcantly decreased.The complication rate of group A and group B was 55.00 % and 12.86 %(P

Objective To explore the value of combined detection with MMP-9 and uPA in the progno-sis of pancreatic carcinoma. Methods By immunohistochemistry PV methods,the expression of MMP-9 and uPA was respectively studied in 63 surgical specimens of primary pancreatic carcinoma and the survival time of patients with pancreatic carcinoma was analysed. Results The expressions of MMP-9 and uPA were positively related(r=0. 573,P=0. 000). The expression of MMP-9 and uPA significantly correlated with differentiation (r= -0. 271,P=0. 032;r= -0. 333,P=0. 008),TNM stages(r= -0. 449,P=0. 000;r= -0. 430,P=0. 000)and lymph node metastasis(r=0. 329,P=0. 009;r=0. 400,P=0. 001),separately. The expression of MMP-9 had also a significant correlation with tumer size(r= -0. 297,P=0. 018)and distant metastasis(r=0. 320,P=0. 011). Univariate analysis identified that tumor size(χ2 =8. 766,P=0. 012),differentiation(χ2 =29. 050,P=0. 000),clinical stage(χ2 =24. 940,P=0. 000),distant metastasis(χ2 =12. 846,P=0. 000), lymph node metastasis(χ2 =15. 457,P=0. 000),MMP-9(χ2 =32. 700,P=0. 000)and uPA(χ2 =41. 495,P=0. 000)were significantly associated with prognosis. Kaplan-Meier survival analysis showed that 1-year survival rate of patients with MMP-9 ( -),uPA ( -)were significantly longer than that of the patients with MMP-9( ﹢),uPA( ﹢),respectively(χ2 =32. 700,P=0. 000;χ2 =41. 495,P=0. 000);1-year survival rate of patients with MMP-9( -)/uPA( -)was significantly longer than the others( Log-rank test,χ2 = 54. 892, P=0. 000). COX regression revealed that differentiation(RR=2. 315,P=0. 004),clinical stage(RR=1. 694, P=0. 002),MMP-9(RR=0. 165,P=0. 000)and uPA(RR=0. 244,P=0. 007)was independent prognostic factors in pancreatic carcinoma. Conclusion They may have a synergistic function in the the process of growth and invasion in pancreatic cancer between MMP-9 and uPA,and the posssible mechanism is that uPA activate degradation of MMP-9,which is not favorable to prognosis. Combined analysis of MMP-9 and uPA may lead to a more reliable prognostic estimation,as the beneficial supplement of the differentiation,and clinical stage to judge the prognosis of pancreatic cancer.

Objective To compare the pre-and post-operative tumor target volume and to examine the consistency in physical dosimetric parameters of organs at risk (OAR) following 3D-printed coplanar template (3D-PCT)-assisted and CT-guided radioactive seed implantation.Methods The 3D-printed coplanar template was designed using a computer software, and the coordinate system was established where the center was used as the basis for setting the x axis and y axis.Crosses defining the center of treatment were drawn on the patient''s body and matched with the corresponding central point, x axis, and y axis of the coplanar template.3D-PCT-assisted and CT-guided radioactive seed implantation was performed based on the pre-operative plan, and the pre-operative, operative, and post-operative plans were designed to evaluate the target tumor volume and the normal dose received by the tissues.In addition, dosimetric parameters, including D90(minimum dose received by 90% of the gross target volume), V100, V150, V200(percentage of GTV that received 100%, 150%, and 200% of the prescribed dose, respectively), minimum peripheral dose (MPD), conformal index (CI), external index (EI), and homogeneity index (HI) in the pre-operative and post-operative plans were also assessed and compared using the Wilcoxon test. Results Fourteen patients treated in our institution from August to October, 2016 were included in this study. The median age of the patients was 61.5 years, and the median Karnofsky Performance Scale score was 80. A total of 14 lesions from the 14 patients were treated by seed implantation in the neck (n=4), chest (n=3), abdomen (n=5), and pelvis (n=2). Of the 14 patients that underwent implantation, 8 had previously received radiation therapy, and 6 had not received radiation therapy. Dosage optimization was performed for all patients during the operation. The median activity of the implanted seeds was 0.625 mCi (0.55-0.75 mCi,1 Ci=3.7×1010 Bq), and the preoperatively planned median number of needling and implanted seeds were 9(4-34) and 45.5(10-162), respectively. However, the actual median number of needling and implanted seeds were 9.5(4-34) and 45.5(10-162), respectively. Dosimetric analysis showed that there were no significant changes in tumor volume (P=0.135), D90(P=0.208), MPD (P=0.104), V100(P=0.542), V150(P=0.754), V200(P=0.583), CI (P=0.426), EI (P=0.326), and HI (P=0.952) after implantation. Conclusions 3D-PCT guidance and dosage optimization can result in good consistency between pre-and post-operative plans for radioactive seed implantation. 3D-PCT is a convenient and cheap technique suitable for large-scale clinical application.

BACKGROUND:Whether controling of post-injury inflammatory response combined with neural stem cel (NSC) transplantation can improve the curative efficacy for spinal cord injury stil remains unclear. OBJECTIVE:To investigate the repair of spinal cord tissue, myelin regeneration, axon regeneration, motor function recovery and the possible mechanism after early application of tumor necrosis factor α antagonist (Etanercept) combined with tyrosine kinase C (TrkC) gene-modified NSC transplantation. METHODS:TrkC-overexpressed NSCs (TrkC-NSCs) were constructed by lentiviral transfection technique. The rat models of spinal cord transection injury were prepared, and then subjected to Etanercept combined with TrkC-NSCs transplantation. The number of neurons and neuroregeneration after injury were measured by Nissl's staining, immunofluorescence and western blot. The rat motor function was detected by Basso Beattie Bresnahan score and evoked potential. The myelin regeneration was detected by electron microscopy and toluidine blue staining. RESULTS AND CONCLUSION:Compared with the other groups, the Etanercept combined with TrkC-NSCs transplantation group had more survived anterior horn motor neurons at 28 days after injury, more myelin-encapsulated axons, higher Basso Beattie Bresnahan score, greater amplitude of the evoked potentials, and relatively shorter latency (alP < 0.05). These findings indicate that early application of tumor necrosis factor-α antagonist combined with TrkC-NSCs transplantation after spinal cord injury in rats can effectively promote myelin regeneration, axon regeneration, and further promote motor function recovery.