Objective:To investigate the role of transforming growth factor β1 (TGFβ1) in the development of Helicobacter pylori ( H. pylori)-associated non-metaplastic atrophic gastritis. Methods:The expressions of TGFβ1, CD68 and smooth muscle actin(SMA) were detected immunohistochemically in 10 patients with mild non-atrophic gastritis, 30 patients with mild non-metaplastic atrophic gastritis, and 32 patients with severe non-metaplastic atrophic gastritis having H. pylori infecion. Meanwhile, three cases of mild non-atrophic gastritis and 4 cases of severe non-metaplastic atrophic gastritis were observed with electron microscope. Results: The count of TGFβ1 positive cells per high-power field (HPF) in severenon-metaplastic atrophic gastritis group (53±22 ) was significantly higher than that in mild non-atrophic gastritis group(22±/HPF) and mild non-atrophic gastritis group(0-3/HPF, P＜0.01). The count of CD68 positive cells in severe non-metaplastic atrophic gastritis group (23±7/HPF) was significantly higher than that in mild non-atrophic gastritis group (13±/HPF) and mild non-atrophic gastritis group (0-3/HPF, P＜0. 01). Correlation analysis showed that the expressions of TGFβ1 and CD68 had a moderate correlation in each group ( r = 0. 634, P＜ 0. 01; r = 0. 699, P＜ 0. 01). Compared with mild non-atrophic gastritis, SMA-positive myofibroblasts and smooth muscle cells in the lamina propria increased in mild and severe non-metaplastic atrophic gastritis. Ultrastructurally, the proliferation of fibroblasts in gastric lamina propria was observed in mild non-atrophic gastritis, while the proliferation of fibroblasts and presence of myofibroblasts could be observed in mild non-metaplastic atrophic gastritis, and there was a parallel phenomenon between myofibroblasts and fibroblasts, as well as smooth muscle cells.Conclusion: Our findings indicate that TGFβ1 expression increases with severity of H. pylori-associated non-metaplastic atrophic gastritis, suggesting that TGFβ1 might play an important role in the development of non-metaplastic atrophic gastritis.

Objective To evaluate the application value of the micro movement sensitive mattress sleep monitoring system(MSMSMS) in the diagnosis of children with obstructive sleep apnea syndrome (OSAS).Methods One hundred and twenty-nine children aged from 3 to 14 years who visited the sleep center of Beijing Children's Hospital Affiliated to Capital Medical University from June 2013 to June 2015 due to sleep snoring were enrolled.Children with acute respiratory infection,cranial facial abnormalities,chronic lung diseases and neuromuscular diseases were excluded.According to the criteria,36 children were diagnosed as OSAS with average age of (7.3 ± 2.5) years,including 28 males and 8 females.Ninety-three non-OSAS children were recruited with average age of (6.3 ± 2.3) years,including 61 males and 32 females.Subjects were monitored with polysomnography(PSG) and MSMSMS simultaneously.Apnea/hypopnea index (AHI) ＞ 5 or obstructive apnea index (OAI) ＞ 1 were used to define whether OSAS existed.The consistency between MSMSMS and PSG in the diagnosis of OSAS and the determination of sleep efficiency were compared.Results The Kappa consistency coefficient of MSMSMS and PSG in the diagnosis of OSAS was 0.70(95％ CI:0.57-0.84),Z =7.99,P ＜ 0.000 1,which indicated the consistency between PSG and MSMSMS was good.The consistency of sleep efficiency of MSMSMS and PSG were compared.Bland-Altman results showed that there were 3％ (5/129 cases)points out of 95％ consistency bound and the interclass correlation coefficient (ICC) was 0.69 which indicated the consistency of 2 methods was good in determination of sleep efficiency.MSMSMS was able to detect respiratory event that was associated with sub-cortical arousals with no electroencephalogram arousal or blood oxygen reduction.Conclusions There is an adequate consistency between MSMSMS and PSG in the diagnosis of children with OSAS and determination of sleep efficiency.The MSMSMS has an advantage in detection of sub-cortical arousals and respiratory event.

Objective To summarize the clinical features and technical key points on brain death during decision-made process in children with suspected brain death.Methods Twenty-four coma children with Glasgow coma scale score 3 and no spontaneous respiration were collected from May 2015 to February 2017 in Beijing Children's Hospital,Capital Medical University to make the brain death determination.All children received at least one confirmatory test.According to the Chinese standards for determining brain death (pediatric),all patients were divided into brain death group and non-compliance group.The clinical features were analyzed.The sensitivity,specificity,false positive rate and false negative rate of electroencephalogram (EEG),short latency somatosensory evoked potential (SLSEP) and transcranial Doppler sonography (TCD) were calculated.Results Among these 24 cases,there were 16 males and 8 females,aged 5.6 (2.0,8.8) years old.Ten cases met the criteria of brain death.Twelve (50％,12/24 cases) cases received autonomic breathing test.A total of 25 tests were conducted,of which 21 were successful.The completion rates of EEG,TCD and SLSEP were 100.0％ (24/24 cases),83.3 ％ (20/24 cases) and 54.2％ (13/24 cases),respectively.EEG had the highest sensitivity (100％) and specificity (79％).SLSEP had good sensitivity (100％),but the specificity was only 40％.The combination of EEG with SLSEP had the highest specificity and sensitivity,both of which were 100％,and the false positive rate and false negative rate were 0.Conclusions The key to determine brain death successfully is to make adequate preparations,to receive formal training and to apply standard operation.In the determination of brain death in children,EEG has a good sensitivity and specificity in single confirmation test,which is the priority item.The combination of EEG with SLSEP is the most advantageous.

Objective To evaluate the efficacy and safety of Chushizhiyang ointment for the treatment of mild atopic dermatitis in infants.Methods A multicenter,randomized,open,active-controlled clinical trial was conducted.A total of 204 infants with atopic dermatitis were enrolled and randomly divided into 2 groups to be topically treated with Chushizhiyang ointment (test group,n =103) and hydrocortisone butyrate cream (control group,n =101),respectively,for 2 weeks.The improvement of eczema area and severity index (EASI) scores and quality of life was evaluated at 7 days and 14 days after the treatment,so was the incidence of adverse events and adverse reactions.Results Ninety-eight infants in the test group and 101 in the control group were included in the full analysis set,which revealed that the disease severity significantly decreased after the treatment in both groups.The EASI scores at the baseline and on days 7 and 14 were 2.47 ± 4.04,0.92 ± 1.25 and 0.39 ± 1.04 respectively in the test group,as well as 2.13 ± 2.01,0.85 ± 1.58 and 0.45 ± 1.65 respectively in the control group.Furthermore,the test group and control group both showed that EASI scores on days 7 and 14 significantly decreased compared with those at the baseline (the test group:T =-1 666,-1 793,respectively,both P ＜ 0.001;the control group:T =-1 951,-1 941,respectively,both P ＜ 0.001).No significant differences in EASI scores at the baseline or on days 7 and 14 were observed between the test group and control group (all P ＞ 0.05).The response rates in the test group and control group were 47.96％ (47/98) and 55.44％ (56/101) respectively on day 7,as well as 79.59％ (78/98) and 84.16％ (85/101) respectively on day 14,and there were also no significant differences between the two groups (both P ＞ 0.05).The adverse reactions mainly manifested as erythema,itching and scaling in the test group,as well as hypopigmentation,telangiectasia,scaling and hyperpigmentation in the control group.No significant difference in the incidence of adverse events was found between the test group (2.9％,3/103) and control group (6.9％,7/101).Conclusion Chushizhiyang ointment shows definite efficacy for mild atopic dermatitis in infants with good safety and tolerability,and can be a teatment option for mild atopic dermatitis in infants.

Objective To explore the relationship between the fibroblast growth factor 2 (FGFR2) gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) and the breast cancer risk in Tibetan population ,Qinghai province .Methods This is a case con‐trol study .Peripheral blood samples from 210 breast cancer patients and 230 healthy women in Qinghai area were collected .DNA samples were extracted from peripheral blood cells .FGFR2 gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) were typed by Taqman‐MGB probe based on PCR and DNA sequencing ,then analyzed its correlation with breast cancer in Tibetan population , Qinghai province .Results The genotype frequencies of rs 2981582 CC ,CT and TT were 40 .48% ,39 .05% and 20 .47% among the breast cancer patients while 36 .09% ,48 .69% and 15 .22% among the controls .The genotype frequencies of rs 1219648 GG ,AG and AA were 24 .76% ,26 .19 % and 49 .05% among the patients while 23 .91% ,47 .39% and 28 .70% among the controls .The genotype frequencies of rs 2420946 CC ,CT and TT were 29 .05% ,45 .24% and 25 .71% among the patients while 30 .87% , 51 .74% and 17 .39% among the controls .The genotype frequencies of all genetic loci had no significant difference between rs 2981582 and rs 2420946 (P>0 .05) .But the genotype frequencies of rs 1219648 AA have statistical sense (P< 0 .05) ,compared with GG ,the incidence of breast cancer was remarkably increased with AA [OR=1 .65 ,95% CI= (1 .01 ,2 .69)] .Conclusion This study shows that FGFR2 rs1219648 AA is related to breast cancer risk among Tibetan population .

Objective To explore methods of culturing peritonealdialysate pathogen in patients with peritoneal dialysisrelated peritonitis, providing reliable basis for more effective clinical treatment. Methods 235 patients with peritoneal dialysis related peritonitis were selected from the Department of Nephrology of Xijing Hospital Affiliated to the Air Force Medical University from January 2015 to December 2018, and they were randomly divided into four groups. Group A (traditional group,n=58): 10 ml peritoneal dialysate were directly extracted and then injected into blood bottle culture. Group B (suspension group,n=58):10 ml extracted peritoneal dialysate were placed for 1 hour then injected into blood bottle culture. Group C (centrifugation group,n=59): 50 ml extracted peritoneal dialysate were centrifuged for 15 min, and whose supernatant sediment was suspended by 5 ml sodium chloride solution of 9% and then injected into the blood culture bottle. Group D (suspension+ centrifugation group,n=60): After the dialysate were given to patients and placed for 1 hour, 50 ml peritoneal dialysate was extracted and centrifuged for 15 min, and whose supernatant sediment was suspended by 5 ml sodium chloride solution of 9% and then injected into the blood culture bottle. The positive culture rates were observed and compared in these four groups. Results There was a statistically significance in the differences of the positive culture rates of the 4 groups, which were 55.2 %, 70.7 %, 76.3 %, and 86.7 %, respectively(χ2=15.233,P＜ 0.01). Further pairwise comparison indicated that the positive culture rates of centrifuge culture group and suspension + centrifuge culture group was significantly higher than that of traditional culture group(χ2=5.787, 14.262;P＜ 0.01). Conclusions The positive culture rate of peritoneal dialysate pathogen would be increased through the culturing method of suspension + centrifugation, providing basis for the subsequent treatment and estimation of peritonitis.

Objective:To identify the risk factors for early neurological complications after revascularization in adult patients with moyamoya disease.Methods:The medical records of patients of both sexes with moyamoya disease, aged 18-65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, who underwent revascularization in our hospital from January 2017 to June 2019, were retrospectively collected.According to the occurrence of early postoperative neurological complications, patients were divided into early postoperative neurological complication group and non-early postoperative neurological complication group.The factors such as patient′s age, gender, preoperative clinical symptoms, previous history of hypertension, history of diabetes, history of coronary heart disease, American Society of Anesthesiologists physical status, methods of anesthesia, type of operation, anesthesia time, time for start of operation, operation time, intraoperative urine volume, times of intraoperative vasoactive drugs used, and time of the post-anaesthesia observation room (PACU) stay were collected.Logistic regression analysis was used to identify the risk factors for postoperative early neurological complications.Results:A total of 510 adult patients with moyamoya disease underwent revascularization were enrolled in this study, and the incidence of early postoperative neurological complications was 9.0%.The results of logistic regression analysis showed that preoperative ischemia, intraoperative use of vasoactive drugs more than 3 times and PACU stay time>90 min were risk factors for postoperative neurological complications ( P<0.05). Conclusion:Preoperative ischemia, intraoperative use of vasoactive drugs >3 times and PACU stay time>90 min are risk factors for early neurological complications after revascularization in the patients with moyamoya disease.

Objective:To evaluate the efficacy of scalp nerve block combined with general anesthesia in optimizing anesthesia in the patients with moyamoya disease undergoing revascularization.Methods:A total of 154 patients with moyamoya disease, aged 18-64 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective revascularization, were divided into 2 groups ( n=77 each) using a random nunber table method: scalp nerve block combined with general anesthesia group (GN group) and general anaesthesia group (G group). Anesthesia was induced with intravenous midazolam 0.05 mg/kg, sufentanil 0.5-1.0 μg/kg, rocuronium 0.6 mg/kg and etomidate 0.2-0.3 mg/kg.After the patients were tracheally intubated after anesthesia induction, ipsilateral scalp nerve block (2 ml for supraorbital nerve block, 2 ml for supratrochlear nerve block; 3 ml for auriculotemporal nerve block, 3 ml for greater occipital nerve block, 3 ml for less occipital nerve block) was performed with 0.5% ropivacaine in GN group.The equal volume of normal saline was locally injected in G group.Anesthesia was maintained by inhalation of sevoflurane and intravenous infusion of remifentanil 0.05-0.10 μg·kg -1·min -1 and cisatracurium 0.1 mg·kg -1·h -1.The consumption of intraoperative remifentanil, requirement for postoperative rescue analgesia, nausea and vomiting, length of postoperative hospital stay, and early neurological complications were recorded.The modified Rankin Scale scores were evaluated before operation, at discharge and at 6 months after operation. Results:Compared with G group, the consumption of intraoperative remifentanil and requirement for postoperative rescue analgesia were significantly decreased ( P<0.05), and no significant change was found in the incidence of postoperative nausea and vomiting, incidence of neurological complications, length of postoperative hospital stay, and modified Rankin Scale scores at each time point in GN group ( P>0.05). Conclusions:Scalp nerve block combined with general anesthesia can increase the perioperative analgesic efficacy and is helpful in achieving a low-opioid anesthesia mode when used in the patients with moyamoya disease undergoing revascularization.

Objective To propose on and improve direct settlements by medical insurance offices and hospital systems in their processing of medical treatment in allopatry (MTA), by analyzing such data as the homepages of medical records of such inpatients at a tertiary cancer hospital with their medical expenses settled directly. Methods Data of 6 379 MTA inpatients with direct settlements of in-hospital fees from April 2017 to March 2018 were included in this study. Such data were used to identify the change trend of their case counts and their regional distribution, and analyzed with hierarchical clustering to calculate the settlement counts of various provinces. Results Analyses found that the total cases of such patients remained stable at the hospital, yet the cases of direct settlement rose from five to 1 263, and the proportion of direct settlement among all MTA inpatients rose month by month from 0.14% to 29.26%. Most of MTA inpatients come from Hebei, Shandong, Inner Mongolia and Shanxi provinces in turn, yet the direct settlement counts and hospitalization case trends appear different. Clustering results indicate Hebei as the type-1 province with the highest proportion of direct settlement inpatients, accounting for 30. 41% ;Shandong, Inner Mongolia and Shanxi as the type-2 provinces, accounting for 15. 05% , 13. 45% and 11.00% respectively; Liaoning, Henan and Heilongjiang as the type-3 provinces, accounting for 6.79% , 4.81% and 4.42% respectively; while the rest provinces as the type-4, accounting for less than 3%. Conclusions Regional distribution varies distinctively among such inpatients, and the number of these inpatients keeps rising stably. In such circumstances, hospitals are recommended to enhance their management in strengthening medical insurance audit systems, speeding up settlement, and building regional medical alliances.

BACKGROUND:Sodium alginate,a natural polysaccharide,has become one of the ideal materials for preparing injectable hydrogels because it is an abundant and cheap resource,and has good biocompatibility and biodegradability.It has been widely used in the production of injectable hydrogels. OBJECTIVE:To review the properties of sodium alginate,the preparation of injectable sodium alginate hydrogel,and its application progress in tissue engineering. METHODS:Web of Science,PubMed,and CNKI were searched by computer.Chinese search terms were"sodium alginate;hydrogel;injectable",and English search terms were"alginate;hydrogel;inject".The time range of searching literature was mainly from June 2017 to June 2022. RESULTS AND CONCLUSION:Alginic acid comes from a wide range of sources,and there are many modifiable groups in its molecular structure,so many injectable hydrogels with excellent properties can be produced by various chemical crosslinking or physical crosslinking methods.Introducing other bioactive molecules or drugs into sodium alginate gel can adjust its properties and broaden its application fields.In addition,injectable sodium alginate hydrogels have great application prospects in biomedicine because of their good biocompatibility,biodegradability and other physical and chemical properties.Sodium alginate hydrogels are evenly mixed with various drugs,cells,factors or other biological molecules in vitro,and can form gels in the human body,which plays a pivotal role in gene carrier,cell scaffold and wound repair.