2～3 cm). MVC of preoperative bioptic specimens will help to choose the length of distal clearance.

BACKGROUND:Stem cel is a kind of pluripotent cels with self-replication ability, which can differentiate into various cels under certain conditions. Furthermore, stem cels are rich in a variety of growth factors, which can induce the generation of vessels and nerves, and improve the blood supply of lower limbs, thereby achieving the treatment and preventions of lower limb ischemia OBJECTIVE:To summarize and compare the recent achievements in the theory and therapeutic efficacy of stem cels from different sources in the treatment of diabetic foot. METHODS:The first and second authors retrieved PubMed, Sciencedirect and Medline databases for relevant articles published from January 2000 to January 2015. The key words were “diabetic foot, pathogenesis, stem cel therapy” in English. Initialy, 186 articles were retrieved, and finaly 44 articles were included in result analysis. RESULTS AND CONCLUSION:Stem cels can be a new choice for the treatment of diabetic foot. After stem cel therapy, corresponding symptoms have been aleviated, including the generation of new blood vessels and the reshaping of the colateral vessels, the improvement of motor nerve conduction velocity and nerve reflex, the improvement of the sense of skin pain and temperature, and pain relief. It is stil unclear whether alogeneic stem cels are safe or not, but autologous stem cels, especialy bone marrow mesenchymal stem cels, can be better able to repair damaged vessels and nerves and restore the microcirculation of blood supply. Currently, we need to do more basic and clinical researches to solve the folowing problems: to confirm the effectiveness and safety of stem cel therapy for diabetic foot; to identify whether there is a difference in the differentiation and secretory activity between stem cels in diabetic patients and ordinary people; to give ful play to the treatment of diabetic foot.

Objective To analyze the clinical, endoscopic and histopathological features of eosinophilic gastroenteritis ( EG) in children. Methods A retrospective study of 76 children with EG was performed to analyze clinical symptoms, laboratory and imaging results, endoscopic and pathological features, status of Helicobacter pylori ( H. pylori) infection, treatment and outcomes. Results The main clinical symptoms were abdominal pain in 55. 3%(42/76) cases, vomiting in 39. 5% (30/76) cases and hematochezia in 38. 2% cases( 29/76) . The hemoglobin level decreased significantly in 34 cases ( 44. 7%, 34/76). Peripheral blood eosinophil (EOS) count increased significantly in 9 cases (11. 8%,9/76) and EOS percentage increased significantly in 13 cases(17. 1%,13/76). Total serum IgE elevated in 32 cases ( 54. 2%, 32/59 ) . There were also 18 cases ( 36. 7%, 18/49 ) positive in serum allergen?specific immunoglobulin E ( sIgE) test and 25 cases ( 32. 9%,25/76) positive in fecal occult blood test. Among 51 cases of abdominal ultrasound examination, there were 7 cases of ascites, 4 cases of pelvis fluid and 3 cases of intestinal wall change. Endoscopic examination in 76 cases showed 63 cases ( 82. 9%) of mucosal hyperemia/edema,20 cases ( 26. 3%) of ulceration, 17 cases ( 22. 4%) of erosion, 11 cases ( 14. 5%) of nodularity or hyperplasia and 9 cases ( 11. 8%) of normal mucosa. The pathological examination showed mucosal inflammation with a large number of EOS infiltration(≥20 per HPF).There were 12 cases(15. 8%, 12/76) of H. pylori infection. Among the 76 cases, clinical symptoms improved significantly in 74 patients after treatment with dietary allergen avoidance, anti?allergy medications, antacids, montelukast and corticosteroid, and the total efficacy was 97. 4%. The efficacy of dietary allergen avoidance, anti?allergy medications, antacids and montelukast was 93. 8%( 61/65 ) . The efficacy of corticosteroid was 86. 7%(13/15). Conclusion The clinical manifestations and endoscopic characteristics of EG in children lack specificity. In terms of diagnosis, the elevated total serum IgE and the positive sIgE test may be taken as reference for the diagnosis of EG. The definite diagnosis is based on pathological examination ( EOS infiltration≥20 per HPF).While in terms of treatment, dietary allergen exclusion, anti?allergy medications, antacids and montelukast are highly effective, which can be taken as the first option. There is no need of corticosteroid as routine therapy.

Objective: To summarize the experience of respiratory tract management in a case of spinal muscular atrophy with neuromuscular scoliosis. Methods: Respiratory tract nursing included prevention of pulmonary infection, inspiratory muscle training, rebuilding respiratory form before surgery, and assessment of sputum expectoration capacity, pain management, airway management after surgery. Results: The patient was discharged without pulmonary complications. Conclusions For patient with breathing problem, respiratory tract management can prevent pulmonary complications during perioperative period.

Objective:To observe the effect of Tiaozhi granule combined with rosuvastatin calcium tablets in the treatment of phlegm and blood stasis syndrome of hyperlipidemia. Methods:A total of 108 patients with hyperlipidemia who met the inclusion criteria in our hospital from March 2016 to December 2017 were recruited and randomly divided into 2 groups with 54 patients in each group. The control group took rosuvastatin calcium tablets orally, and the observation group tookTiaozhi granule on the basis of the control group. Both groups received continuous treatment for 3 months. TCM symptoms were scored, and serum TG, TC, LDL-C and HDL-C levels were detected by automatic biochemical analyzer. The Homocysteine (Hcy) levels were detected by chemiluminescence, the Intercellular adhesion molecule-1 (ICAM-1) levels were detected by ELISA, the endothelin (ET) levels were determined by radio-immunoassay, and the NO levels were determined by nitrate reductase. The Intima-media thickness (IMT) of carotid artery was determined by color doppler ultrasound imaging, and the clinical efficacy was evaluated.Results:The total effective rate was 92.6% (50/54) in the observation group and 77.8% (42/54) in the control group, and the difference between the two groups was statistically significant ( χ2=4.696, P=0.030). After the treatment, the scores of vertigo, chest tightness, sputum and limb anesthesia in the observation group were significantly lower than those in the control group ( t value were 3.630, 4.035, 3.184, 5.372, respectively, all Ps<0.01). Serum levels of TG, TC and LDL-C in the observation group were significantly lower than those of the control group ( t value were 6.073, 3.159, 5.020, respectively, all Ps<0.01), and HDL-C levels were significantly higher than those of the control group ( t=7.120, P<0.05). After the treatment, IMT (1.64 ± 0.17 mm vs. 2.35 ± 0.08 mm, t=-15.928) in the observation group was significantly lower than that of the control group ( P<0.01). After the treatment, the serum levels of Hcy, ICAM-1 and ET in the observation group were significantly lower than that of the control group ( t value were 5.346, 14.281, 19.028, respectively, all Ps<0.01). The NO level was significantly higher than that of the control group ( t=13.035, P<0.01). Conclusions:Tiaozhi granule combined with rosuvastatin calcium tablets can improve the disorder of lipid metabolism in patients with hyperlipidemia, reduce IMT and improve clinical efficacy.

Background and objective It has been proven that video assited thoracoscopic surgery (VATS) achieved the same survival rates compared with traditional open chest operation in the treatment of early stage of lung cancer. but it is unclear if there is any difference of body inlfammatory reaction between the two operation. hTe aim of this study is to investigate the changes of inlfammatory state of thoracoscopic radical lobectomy in early peripheral lung cancer patients. Meth-ods Senventy-one early peripheral lung cancer patients who have underwent radical lobectomy were divided into two groups based on the different operation method. hTe VATS group was treated by thoracoscopic lobectomy. hTe thoracotomy group was treated by traditional thoracotomy. hTen the level of serum C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), in-terleukin-6 (IL-6) and IL-10 at 1-day before operation and 3-day, 7-day postoperation were measured and compared between the two groups. Results No signiifcant difference was found in the level of serum CRP, TNF-α, IL-6 and IL-10 before opera-tion. Compared to the thoracotomy group, the level of serum CRP, TNF-α, IL-6 and IL-10 in the VATS group were signiifcant-ly lower atfer operation. Conclusion Compared with thoracotomy lobectomy, thoracoscopic lobectomy for early peripheral lung cancer patients is associated with lower inlfammatory responses .

Objective:To investigate influences of ginsenoside Rg1 regulating miR-144-3p on neuroinflammation and blood-brain barrier damage in rats with experimental cerebral hemorrhage,and its regulation on formyl peptide receptor 2(FPR2)/p38 path-way.Methods:Ninety SD rats were randomly divided into control group,cerebral hemorrhage group,ginsenoside Rg1 low-dose group(10 mg/kg),ginsenoside Rg1 high-dose group(40 mg/kg),ginsenoside Rg1 high-dose+ago-miR-144-3p group(40 mg/kg ginseno-side Rg1+ago-miR-144-3p),with 18 mice in each group.Except for control group,experimental intracerebral hemorrhage rat model was constructed by injecting collagenase Ⅱ into right caudate nucleus,and then each group was given intraperitoneal administration and intracerebral injection as required.Neurological damage in rats was scored;rat brain water content was determined by dry-wet spe-cific gravity method;levels of TNF-α,IL-6 and IL-1β in rat brain tissues homogenate were determined by ELISA;ultrastructure around cerebral edema was observed by electron microscope;permeability of blood-brain barrier in rats was determined by Evans blue(EB)method;expressions of miR-144-3p/FPR2/p38 pathway were determined by qRT-PCR and Western blot.Results:Compared with control group,blood-brain barrier damage was aggravated in cerebral hemorrhage group,neurological function damage score,brain water content,miR-144-3p,TNF-α,IL-6,IL-1β,p38 mRNA,p-p38/p38 expressions in brain homogenate were increased(P<0.05),FPR2 mRNA and protein expressions were decreased(P<0.05);compared with cerebral hemorrhage group,blood-brain barrier damage was reduced in ginsenoside Rg1 low-dose group and ginsenoside Rg1 high-dose group,neurological function damage score,brain water content,miR-144-3p,TNF-α,IL-6,IL-1β,p38 mRNA,p-p38/p38 expressions in brain homogenate were decreased(P<0.05),FPR2 mRNA and protein expressions were increased(P<0.05);ago-miR-144-3p was able to reverse protective effects of gin-senoside Rg1 on blood-brain barrier and neuroinflammation in rats(P<0.05).Conclusion:Ginsenoside Rg1 may inhibit blood-brain barrier damage and neuroinflammation in rats by regulating miR-144-3p/FPR2/p38 axis.

ObjectiveBased on tumor necrosis factor alpha （TNF-α）/tumor necrosis factor receptor 1 （TNFR1）/receptor-interacting protein kinases （RIPKs） signaling pathway， this paper aims to study the effect of modified Erchentang on inflammation in rats with chronic obstructive pulmonary disease （COPD） and explore its mechanism of action. MethodA total of 60 SD rats were randomly divided into normal group， model group， high， medium， and low-dose groups （20， 10， 5 g·kg^-1·d^-1） of modified Erchentang， and Xiaokechuan group （3.5 mL·kg^-1·d^-1）， with 10 rats in each group. The COPD rat model was established by cigarette smoke combined with lipopolysaccharide （LPS）. The normal group and model group were given the same amount of normal saline for 21 days by gavage administration. The contents of TNF-α and TNFR1 in bronchoalveolar lavage fluid （BALF） of rats were detected by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expressions of RIPK1， RIPK3， and mixed lineage kinase domain-like （MLKL） in the lung tissue. The protein expressions of RIPK1， RIPK3， and MLKL in the lung tissue were detected by Western blot. The pathological changes in lung tissue were observed by hematoxylin-eosin （HE） staining. ResultCompared with the normal group， the contents of TNF-α and TNFR1 in BALF of the model group were significantly increased （P<0.01）， and the mRNA and protein expression levels of RIPK1， RIPK3， and MLKL in the lung tissue were significantly increased （P<0.01）. Compared with the model group， the contents of TNF-α and TNFR1 in BALF of high， medium， and low-dose groups of modified Erchentang and Xiaokechuan group were decreased （P<0.01）. The mRNA and protein expression levels of RIPK1， RIPK3， and MLKL in the lung tissue were decreased to different degrees （P<0.05， P<0.01）. ConclusionModified Erchentang can effectively improve the inflammatory response of lung tissue in COPD rats， and the mechanism may be by inhibiting the activation of the TNF-α/TNFR1/RIPKs signaling pathway.

Purpose: 5-Fluorouracil (5-Fu) is used as a conventional chemotherapy drug in chemotherapy forpatients with advanced colorectal cancer, but many patients still suffer from treatment failuredue to 5-Fu resistance. Emerging observations revealed the important role of chemokine(C-X-C motif) ligand 13 (CXCL-13) in tumor microenvironment and its relationship with prognosisin patients with colorectal cancer. This study is designed to reveal the important roleof CXCL-13 in causing colorectal cancer resistance to 5-Fu. Materials and Methods: CXCL-13 levels of patient's serum or cell culture supernatants were measured separatelyby enzyme-linked immunosorbent assay. In cell assays, cell viability is detected by Cell CountingKit-8. Therefore, the recombinant human CXCL-13 was used to simulate its high expressionin cells while its antibody and siRNA were used to reduce CXCL-13 expression in cells. Results: In this study, we demonstrated that CXCL-13 is associated with 5-Fu resistance by culturemedium exchange experiments and cytokine arrays of colorectal cancer resistant and nonresistantcells. Clinical studies showed that CXCL-13 is highly expressed in the serum of5-Fu–resistant patients. High levels of serum CXCL-13 also predict a worse clinical outcome.The addition of recombinant CXCL-13 cytokine resulted in 5-Fu resistance, while its antibodyovercame 5-Fu resistance, and knockdown of CXCL-13 expression by siRNA also reduced5-Fu resistance, which can be saved by added recombination CXCL-13. Conclusion These results not only identify a CXCL-13 mediated 5-Fu resistance mechanism but alsoprovide a novel target for 5-Fu–resistant colorectal cancer in prevention and treatmentstrategies.

Objective:To explore the occurrence and influencing factors of paralytic ileus (PI) in patients with adolescent idiopathic scoliosis (AIS), so as to provide references and basis for the formulation of clinical nursing intervention measures.Methods:Using the convenient sampling method, a total of 93 AIS patients who were hospitalized in Spine Center of Peking Union Medical College Hospital from January 2019 to June 2020 were selected as the research objects. The general information, disease and operation related information of patients were collected, and the incidence of PI was recorded. Binomial Logistic regression was used to analyze the influencing factors of PI occurrence in AIS patients after surgery.Results:PI occurred in 41.9% (39/93) patients, and the incidence of anorexia, abdominal distention, nausea, vomiting and abdominal pain were 66.7% (26/39), 61.5% (24/39), 59.0% (23/39), 30.8% (12/39) and 20.5% (8/39), respectively. Binomial Logistic regression analysis showed that straight leg elevation exercise ( OR=3.582, P=0.023), postoperative first feeding time ( OR=1.209, P=0.027), proton pump inhibitors ( OR=6.820, P=0.002) and osteotomy ( OR=5.516, P=0.007) were the influencing factors of PI occurrence after AIS. Conclusions:The incidence of PI is higher in AIS patients after surgery and the accompanying symptoms are mainly anorexia, abdominal distension and nausea. Straight leg elevation exercise, time of first postoperative feeding, proton pump inhibitors and osteotomy are the influencing factors of postoperative PI in AIS patients.