Objective Todiscusstheangiographicfeaturesofhepaticneuroendocrineneoplasm(NEN),and to analyze the survival time of patients.Methods The clinical data of 60 patients with hepatic NEN were retrospectively reviewed.Transcatheter arterial chemoembolization (TACE),used as main therapy,was employed in 17 patients,22 patients received palliative treatment with no use of TACE,and 21 didn't receive any related treatment.The angiographic features of hepatic NEN were analyzed.Kaplan-Meier method was used to calculate the survival rate,and the survival prognostic factors were evaluated by Cox multivariate analysis method.Results Angiography showed that most neuroendocrine tumors (NETs) were characterized by hypovascular lesion,while neuroendocrine carcinomas (NECs) were manifested as hypervascular mass.The median overall survival time of 60 patients was 13.8 months.The 6-month,one-,2-and 3-year cumulative survival rates were 85.0％,52.0％,40.0％ and 33.8％,respectively.Cox regression analysis indicated that pathological grade of tumor (P=0.001) and treatment mode (P＜0.001) were the independent prognostic factors.Conclusion The rich or poor vascularity of hepatic NEN is helpful for the judgment of tumor grading.Patients whose hepatic NENs belong to high pathological grade (grade Ⅲ) usually have a poor prognosis.TACE is an effective therapy for hepatic NEN.

Aim To explore the effect of pharmacolog-ical activation of serotonin 5-HT2C receptor (5-HT2C R) on naloxone-precipitated withdrawal in morphine-de-pendent mice. Method EthoVision Noldus video tracking system was used to record the effect of 5-HT2C R agonist WAY on locomotor activities and behavioral performances in mice.Results Selective 5-HT2C R ag-onist WAY (0.5,0.75 or 1 .0 mg·kg -1 ,i.p.)a-lone did not alter the locomotor activities as determined by distance traveled and velocity (all P values >0.05).Chronic morphine treatment induced depend-ence in mice as demonstrated by increases in distance traveled,velocity and jumping behavior.WAY (0.5, 0.75 or 1 .0 mg·kg -1 ,i.p.)and clonidine (0.2 mg ·kg -1 ,i.p.)significantly ameliorated naloxone-pre-cipitated withdrawal symptoms,including burrowing, jumping,body grooming,rearing,“wet dog”shakes, head shakes,face grooming,penile grooming,scratch (all P values <0.05).Conclusion Pharmacological activation of 5-HT2C R ameliorates naloxone-precipitated withdrawal symptoms in morphine-dependent mice.5-HT2C R may be a novel target to develop therapeutic ap-proach against morphine physical dependence,craving and relapsing.

Objective To establish a simple and sensitive method for the determination of plasma drug concentration in rats after intragastrical and intravenous administration of paclitaxel loaded nanoparticles and to evaluate its pharmacokinetic characteristics .Methods AgilentTC-C18 column (250 mm × 4 .6 mm ,5 μm) was used for HPLC at the flow rate 1 ml/min with ketoconazole as internal standard and methanol acetonitrile water (45:20:35) as the mobile phase .The statistical mo-ment method was applied to calculate the pharmacokinetic parameters and to evaluate pharmacokinetic characteristics .Results There was a good liner relationship (r=0 .9997) when rat blood concentration of Paclitaxel ranged from 0 .5 to 20μg /ml .The accuracy and precision were in line with the requirements of biological sample analysis .The t1/2 were 3.86 ,3.76 ,3.35 and 2 .62 h after intravenous injection of three lab-made paclitaxel nanoparticles and paclitaxel solution via rat tail vein .The t1/2 were 5 .28 and 3 .72 h respectively after intragastrical administration of lab-made paclitaxel nanoparticles and paclitaxel suspen-sion .Conclusion This method can be used for the pharmacokinetic study of paclitaxel nanoparticles in rats .The paclitaxel loaded nanoparticles exhibited significantly longer in vivo retention time than paclitaxel injection and paclitaxel suspension .

As China has not yet established a sound regional trauma treatment system and standardized trauma centers at all levels, the trauma treatment capability in China is poorer than that in the developed countries. At present, Shaanxi Province has not established a regional trauma treatment system and standardized trauma centers at all levels. Based on the analysis of the characteristics of geography, population and social environment in Shaanxi Province, the authors explore the concept of the trauma treatment system and the construction of trauma centers at all levels in Shaanxi Province on the platform of the trauma center of Shaanxi People's Hospital ( Grade I trauma center) . The authors clarify the respective hardware facilities, team structure, treatment process and quality control goals, training and management system of professional trauma teams in trauma centers at all levels, so as to provide reference for improving the overall level of trauma treatment in Shaanxi Province.

BACKGROUND: Bone defect difficult to manage clinically and it is a big challenge to repair it. Secondary metabolites source from herb has shown potential for the treatment of bone defect. METHODS: Mesenchymal stem cells (MSCs) were isolated from mice and incubated with urolithin A (UA) (10, 25, and 50 lg/mL). 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay was performed to estimate apoptosis and mineralisation was evaluated by alkaline phosphatase assay and alizarin red S staining. A middle femoral defect was induced in mice and bone tissue was prepared for endochondral ossification by treating with UA. The effect of UA was estimated by determining markers of osteoblast proliferation in serum and micro-computed tomography to analyse bone defects. RESULTS: UA enhanced mineralisation of MSCs and osteogenic gene markers in MSCs in vitro. Also, the bone defect score and bone mineral density were improved by UA. Moreover, UA ameliorated the altered Wnt3a protein and histopathological changes in bone defect mice. CONCLUSION Presented report conclude that UA enhances osteoblast proliferation in bone-defect mice by activating the Wnt pathway.

Objective:To investigate the clinical features and risk factors of multiple organ dysfunction syndrome (MODS) caused by wasp sting.Methods:A retrospective cohort study was conducted to collect the general data of wasp sting patients who had a clear history of wasp sting disease and clinical manifestations from June 2016 to December 2020 and were first diagnosed as wasp sting in hospital. Patients with hematological diseases, malignant tumors, severe liver and kidney dysfunction, cardiac insufficiency, and patients who had received hormone therapy before admission were excluded. Patients who were unable to obtain effective laboratory results due to hemolysis or other reasons within 48 h of admission were also excluded. The white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), hemoglobin count (HB), myoglobin (Mb/MYO), activated partial thromboplastin time (APTT), albumin (ALB), K, Na, and Cl of the blood samples collected within 48 h after admission were recorded. Patients were divided into the MODS group and non-MODS group according to whether MODS occurred during hospitalization. Uni- and multivariate analysis were used to analyze the factors affecting the occurrence of MODS in wasp sting patients during hospitalization, and the receiver operating characteristic (ROC) curve was plotted to evaluate the predictive effect of myoglobin level on the occurrence of MODS in wasp sting patients during hospitalization.Results:Mb, WBC, NEU, APTT and serum potassium in the MODS group [3890.00 (1416.90-4057.00) ng/mL, (21.99 ± 8.18) × 10 9/L, (19.61 ± 7.33)× 10 9/L, (93.75 ± 45.77) s, and (4.99 ± 0.95) mmol/L] were significantly higher than those in the non-MODS group [73.50 (34.30-264.20) ng/mL, (13.40 ± 4.14)× 10 9/L, (11.18±4.73)× 10 9/L, (37.00 ± 17.16) s, and (4.05 ± 0.56) mmol/L] (all P < 0.05); blood chlorine and ALB [(101.50 (98.25-105.00) mmol/L and (35.36 ± 6.44) g/L)] were significantly lower than those in the non-MODS group [(105.00 (103.00-107.00) mmol/L and (40.71 ± 5.48) g/L)] (all P < 0.05). Multivariate logistic regression analysis showed that NEU ( OR = 0.729, 95% CI: 0.542~0.981), Mb ( OR = 0.999, 95% CI: 0.998~1.000), and APTT ( OR = 0.951, 95% CI: 0.921~0.982) were independent risk factors for MODS in wasp sting patients. ROC curve analysis showed that NEU, Mb and APTT could be used to evaluate the occurrence of MODS in wasp sting patients. Among them, Mb had the highest predictive value (AUC = 0.950, 95 % CI: 0.891~0.982). The optimal cutoff value of Mb for predicting the occurrence of MODS in wasp sting patients was 515.30 ng/mL, and the corresponding sensitivity and specificity were 90.62% and 87.23%, respectively. Conclusion:Mb is an independent risk factor for MODS in wasp sting patients, which can be used as a good predictor of MODS in wasp sting patients.

Objective To explore the consistency of different intensity setting methods of aerobic exercise in order to provide the safe and effective strength setting method for patients with coronary heart disease (CHD).Methods From July, 2016 to July, 2017, CHD patients in our hospital were recruited. The basic data were collected. The patients received cardiopulmonary exercise test firstly to obtain anaerobic threshold, peak oxygen intake and other indicators. They underwent Six-minute Walk Test after a day off. The target heart rate was calculated using anaerobic threshold method (AT), peak oxygen uptake index method (PI), heart rate reserve method (HRR), age estimates method (AE) and quiet heart rate plus 20 method (HR20), respectively. The correlation and consistency of different methods were analyzed.Results There was no correlation (r=-0.131, P>0.05) and there was a very significant difference (P<0.001) between AE and AT on determining target heart rate. There was no correlation (r=0.372, P>0.05) between HR20 and AT. There was correlation (r=0.872, P<0.01) and there was no significant difference (P>0.05) between PI and AT on determining the target heart rate, and the Bland-Altman test showed a consistency between them. There was correlation (r=0.836, P<0.001) and there was no significant difference (P>0.05) between HRR and AT on determining the target heart rate, and Bland-Altman test demonstrated a consistency between them.Conclusion There was no correlation and consistency of AE and HR20 to AT on the target intensity of aerobic exercise. There was significant correlation and consistency between AT and HRR/PI.

Objective:To evaluate the trauma center model in general hospitals for patients with severe trauma.Methods:The data of 1,248 patients with severe trauma (ISS≥16) were retrospectively analyzed who had been admitted to the trauma centers in 6 Chinese general hospitals from January 2019 through June 2020. They were 987 males and 261 females with an age of 50.4 years ± 15.4 years. Their injuries were caused by a traffic accident in 622 cases, falling from a height in 357 cases, a knife in 62 cases, and others (like a heavy object and fall) in 207 cases. Upon admission, their injury severity scores (ISS) were 24.9±8.5 and their Glasgow coma scores (GCS) 12.6±3.6. They were all treated in a scientific and standard manner by a multidisciplinary team at the trauma center of their specific general hospital. Recorded were deaths within 30 days after admission, 30-day mortality and causes of death.Results:All the patients were treated effectively. 101 deaths occurred within 30 days after admission, yielding a 30-day mortality of 8.1%. The main causes of death were severe craniocerebral injury in 56 cases, hemorrhagic shock in 26 cases, multi-organ failure in 11 cases and others in 8 cases.Conclusions:Establishment of trauma centers in China can make up for the disadvantage of over-division of clinical specialties in large general hospitals which has led to insufficient care for patients with severe trauma and multiple injuries. The trauma centers in general hospitals may be a feasible model to be popularized in treatment of patients with severe trauma and multiple injuries.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.