Objective To investigate the relationship between the plasma inflammatory cytokines and carotid atherosclerosis in patients with ischemic cerebrovascular disease(ICVD).Methods The levels of plasma interleukin (IL)-6,matrix metalloproteinase (MMP)-8 and soluble CD40 ligand (sCD40L) in 64 patients with ICVD were detected by enzyme-linked immunosorbent assay (ELISA),the severity of bilateral carotid atherosclerosis was measured by colour ultrasound.The results were compared with those of non ICVD controls. The association of the levels of plasma IL-6,MMP-8,sCD40L and the severity of carotid atherosclerosis were analysized. Results The levels of plasma IL-6,MMP-8,and sCD40L in patients with ICVD were significantly higher than those in control group(all P

The construction and implementation of a coder assessment system are crucial for strengthening DRG payment reform and promoting high-quality development of hospitals.Against the backdrop of DRG payment reform,this paper analyzes the construction and internal logic structure of the coder assessment system from three perspectives:target system,index system,and mechanism of results application and feedback.It also discusses the implementation methods after establishing the assessment system from three angles:modular decomposition of assessment objectives,introduction of performance management tools,and baseline data measurement.

OBJECTIVETo explore the interaction between herbal medicines and western drugs based on CYP3A4 enzyme metabolism by using testotesrone as a probe in liver microsome metabolism system in vitro.

METHODThe mixed liver microsome enzymatic system consisting of rat liver microsomes by ultra-high-speed centrifuge was established. The substrate testosterone was added into the system and enzyme CYP3A4 metabolic activity was expressed by the output of 6beta-hydroxy-testosterone which was measured by HPLC method. The proper conditions for testotesrone metabolism in liver microsome system included substrate concentration, incubation time, pH and incubation temperature. When the conditions in vitro were determined, three kinds of Chinese herbal medicinal ingredients (Tetrahydropalmatine, neferine, panax notoginseng saponins) were diluted into different concentrations and incubated with testotesrone in the liver microsomes incubation system, respectively. The results were measured through metabolite production with or without the presence of Chinese medicines. We assessed the Chinese herbal medicinal ingredients effect on the metabolism of CYP3A4 enzyme through 6beta-hydroxy metabolite of testosterone production.

RESULTLiver microsomes were incubated in the system, the testosterone metabolited into 6beta-hydroxy testosterone. The metabolism conditions were proper at the concentration of testosterone 200 micromol x L(-1) which was incubated for 3.5 hours at 37 degrees C in pH 7.0, PBS 0.1 mol x L(-1). The inhibition of tetrahydropalmatine and panax notoginseng saponins on testotesrone were weak with IC50 > 100 micromol x L(-1). The neferine had a little inhibition on testotesrone metabolism, IC50 < 100 micromol L(-1).

CONCLUSIONTetrahydropalmatine and panax notoginseng saponins had no obvious effect on testotesrone metabolism. Neferine had a little effect on testotesrone metabolism. It prompted that drug-interaction could not be apparent between two kinds of Chinese medicines and the CYP3A4 enzyme substrate, Neferine could bring about drug-interaction.

Animals ; Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; metabolism ; Drug Interactions ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Male ; Microsomes, Liver ; chemistry ; drug effects ; enzymology ; Rats ; Rats, Wistar ; Testosterone ; analysis ; pharmacokinetics

Since the discovery of adipose-derived mesenchymal stem cell (ADSC) in more than ten years, a great progress has been made from its basic research to clinical application. Compared with bone marrow mesenchymal stem cells, ADSCs are more abundant in reserve, easier to obtain with fewer injuries and less complications. These cells have multiple differentiation potential and can differentiate into adipocytes, chondrocytes and osteoblasts with the influence of different inducing factors. Early studies of ADSCs mainly focused on the ability of multi-directional differentiation, espe-cially on the regeneration of bone defects and cartilage tissue. At present, the researches mainly focus on immunoregulation and paracrine function of ADSCs. Although ADSCs have made a great progress in clinical application, the cell preparation, use pattern, and mechanisms in clinical treatment are not clear. This paper elaborates on these issues.

Objective To study the serotype distribution characteristics and genotypes of Salmo-nella strains isolated in Yunnan Province from 2015 to 2017. Methods Automatic microbiological identifi-cation system and mass spectrometer were used to identify Salmonella strains. Their serotypes were detected using the White-Kauffmann-Le Minor (WKL) scheme based on serological detection. Genotyping was car-ried out by referring to the molecular typing method of Salmonella serotype pulse field gel electrophoresis (PFGE) in PulsenetChina. Cluster analysis was performed with Bionumerics (7.6). Results A total of 408 strains of Salmonella were detected in food and patients in Yunnan Province form 2015 to 2017,belong-ing to 70 serotypes. Thirty-four Salmonella derby strains were detected in food,accounting for 19.10% of all Salmonella strains detected in food. Among the Salmonella strains detected in patients,71 were Salmonella enteritis and 67 were Salmonella typhimurium,accounting for 30.34% and 27.63%, respectively. Results of PFGE revealed that Salmonella derby and Salmonella typhimurium were polymorphic,and Salmonella en-teritis had obvious advantages PFGE band patterns. No obvious time or geographical aggregation was found in the PFGE bands of the three Salmonella species. Conclusion Seventy Salmonella serotypes had been iden-tified in Yunnan Province by 2017. Salmonella derby was the predominant serotype detected in food, while Salmonella enteritidis and Salmonella typhimurium were the predominant serotypes in patients. These three Salmonella species caused sporadic infections in Yunnan Province.

Objective To analyze the effects of rapid rehabilitation surgical procedures on recovery and stress response in patients undergoing hepatectomy.Methods Retrospective analysis of 60 patients with liver resection in Zhujiang Hospital of Southern Medical University from January 2012 to December 2015,40 males and 20 females.According to the rehabilitation method,it was divided into intervention group (n=30) and control group (n=30).The operation time,intraoperative blood loss,postoperative complications,and interleukin-6 (IL-6),C-reactive protein (CRP),and white blood cell count (WBC) on days 1st,3rd,and 5 th before and after surgery were compared between the two groups.Results Both groups completed the operation successfully.There was no significant difference in intraoperative blood loss and operation time between the two groups (P＞0.05).The duration of postoperative ventilation and postoperative hospitalization in the intervention group was less than that in the control group,and the incidence of postoperative complications (23.3％ vs.50.0％) and the first and second day after surgery were lower than those in the control group,with statistically significant differences (P＜0.05).On the first,third and fifth days after surgery,IL-6 and CRP in the intervention group were lower than those in the control group,respectively (64.96± 24.10) μg/L vs.(286.74±67.98) μg/L,(60.52±18.31)μg/L vs.(162.33±52.62) μg/L,(31.61± 9.42) μg/L vs.(77.44±24.54)μg/L and (24.64±17.45) mg/L vs.(41.46±20.79) mg/L,(81.11± 36.58) mg/L vs.(117.23±44.80) mg/L,(44.90±22.31) mg/L vs.(65.27±38.05) mg/L,the differences were statistically significant (P＜0.05).Conclusion The concept of rapid rehabilitation surgery applied to patients with hepatectomy can reduce postoperative stress response,reduce postoperative complications,and accelerate the recovery process.

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 clinical efficacy of lenalidomide combined with second-line immunochemotherapy as a salvage regimen in the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL).Methods:The clinical data of 37 relapsed/refractory DLBCL patients receiving lenalidomide combined with second-line immunochemotherapy as a salvage regimen who had recurrence after autologous hematopoietic stem cell transplantation or who were not eligible for transplantation or had no intention to transplant between January 2016 and December 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. Among 37 patients, 6 cases with primary central nervous system (CNS) lymphoma and 3 cases with secondary CNS lymphoma. The short-term efficacy after treatment was evaluated. Kaplan-Meier method was used to analyze the overall survival (OS) and progression-free survival (PFS), and log-rank test was used for subgroup comparison.Results:The median follow-up time of 37 patients was 20.4 months (2.7-37.0 months). At the end of treatment, the overall response rate (ORR) of all patients was 64.9% (24/37), the complete response (CR) rate was 45.9% (17/37), and the median duration of response (DOR) of 24 patients who responded to treatment was 17.7 months (3.6-33.6 months). The median PFS time of all patients was 11.2 months, and the 1-year PFS rate was 48.6% (95% CI 32.5%-64.7%). The median OS time of all patients was not reached, and the 1-year OS was 67.6% (95% CI 52.5%-82.7%). Among 24 responding patients, 17 cases who received lenalidomide maintenance therapy after remission tended to have a better response compared with 7 cases who did not receive lenalidomide maintenance therapy after remission, although there was no significant difference in OS and PFS between both groups (both P > 0.05). Additionally, neutropenia was the most common adverse reaction with an incidence of 81.1% (30/37). Conclusions:Lenalidomide combined with the second-line immunochemotherapy may be an effective salvage therapy for patients with relapsed/refractory DLBCL, especially for patients with CNS involvement. The patients achieving remission after salvage therapy continue to receive lenalidomide maintenance therapy and could have a better prognosis.

From January 2010 to December 2017, 4 patients of thumb with necrosis caused by electric burns (all male, aged from 31 to 58 years) were admitted to our hospital, with 1 patient of second degree injury of right thumb, 2 patients of third degree injury of right thumb, and 1 patient of third degree injury of left thumb. Routine debridement under general anesthesia was performed within 7 days after injury. The compound tissue flap of contralateral second toe was transplanted to reconstruct the thumb with third degree defect, and compound tissue flap of ipsilateral distal hallex was transplanted to reconstruct the thumb with second degree defect. Dorsalis pedics artery was anastomosed with radial artery, saphenous vein or dorsalis pedics vein was anastomosed with cephalic vein. The donor site was transplanted with split-thickness skin graft from autologous thigh. All the tissue flaps and skin grafts survived in 2 weeks after surgery. Within 1 year of follow-up, the reconstructed thumbs can achieve radial abduction and palmar abduction with good function. Reconstruction of thumb with free transplantation of compound tissue flap of toe is a good method to repair thumb with necrosis caused by electric burn.

Objective:To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS).Methods:This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration.Results:(1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant ( P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups ( P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion:The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.