Background: Esophageal variceal bleeding is a clinical emergency and the major cause of death in patients with liver cirrhosis.Aims: To assess the value of platelet count (PC)/spleen diameter (SD) ratio in predicting the presence of esophageal varices (EV) in patients with HBV-related cirrhosis in China.Methods: A total of 91 consecutive HBV-related cirrhosis patients with EV from Aug.2013 to Dec.2015 at Renji Hospital (South Campus),School of Medicine,Shanghai Jiao Tong University were enrolled.Thirty-two HBV-related cirrhosis patients without EV were enrolled as controls.Upper gastrointestinal endoscopy,routine laboratory examinations and abdominal ultrasonography were performed and the related parameters were collected.Binary Logistic regression analysis was carried out to identify independent risk factors associated with EV.ROC curve was used to evaluate the predictive performance of PC/SD ratio for the presence of EV.Results: The PC/SD ratio was significantly lower in EV group than in non-EV group (538.2±327.0 vs.1 105.9±426.6,P=0.001).Binary Logistic regression analysis showed that the PC/SD ratio was independently associated with the presence of EV (OR=57.29,95％ CI: 15～214,P=0.000).In ROC curve analysis,the area under the curve (AUC) of PC/SD ratio in predicting the presence of EV was 0.853;the optimal cutoff value was 842,and the sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,75.0％,90.7％,and 64.9％,respectively.Conclusions: PC/SD ratio can be used as a non-invasive tool for prediction of the presence of EV in patients with HBV-related cirrhosis.It may reduce the number of unnecessary endoscopy.

Background:More and more evidences suggest that microRNA plays an important role in the development of gastric cancer (GC).Expression of miR-129 in GC tissues is found abnormal, however, the mechanism of miR-129 in cell proliferation and invasion is still undefined.Aims:To investigate the expression of miR-129 in GC tissue and GC cell lines and the mechanism of miR-129 in proliferation and invasion of SGC-7901 cells.Methods:Eighty-two GC tissues and corresponding paracancerous tissues were collected, human gastric epithelial cell line and different GC cell lines were cultured, qPCR was conducted to assess miR-129 expression.SGC-7901 cells were transfected with miR-129 mimic or miR-NC, and then were transfected with overexpressed HMGA2 plasmid.Colony formation assay was used to detect cell proliferation ability, and Transwell chamber was used to assess cell invasion ability.Pearson correlation analysis was used to analyze the correlation between miR-129 and HMGA2 mRNA expression.Luciferase assay was performed to determine the activity of luciferase.mRNA and protein expressions of miR-129, HMGA2 were determined by qPCR and Western blotting, respectively.Results:Compared with paracancerous tissues, expression of miR-129 was significantly decreased in GC tissues (P<0.05);when compared with human gastric epithelial cells, expression of miR-129 was significantly decreased in GC cell lines (P<0.05).Compared with miR-NC group, proliferation and invasion abilities of SGC-7901 cells were inhibited in miR-129 mimic group (P<0.05).HMGA2 mRNA expression in GC tissues was significantly upregulated (P<0.05), and was negatively correlated with miR-129 expression (r=-0.543 9, P<0.01).Luciferase activity in wild-type miR-129 mimic group was significantly lower than that in miR-NC group (P<0.05);mRNA and protein expressions of HMGA2 were decreased after transfection with miR-129 mimic (P<0.05).Compared with miR-129+vector group, proliferation and invasion of SGC-7901 cells were significantly increased in miR-129 mimic+HMGA2 group (P<0.05).Conclusions:The expression of miR-129 is decreased in GC tissue and cells;miR-129 inhibits SGC-7901 cells proliferation and invasion by negatively regulating HMGA2.

OBJECTIVETo compare the therapeutic effects between close reduction and plaster slab fixation combined with plaster external traction and operation for the treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications.

METHODSFrom June 2009 to June 2012, 151 children with closed Gartland III supracondylar humerus fractures were retrospectively studied and divided into two groups, including 87 boys and 64 girls, ranging in age from 1 to 12 years old with an average of 5.3 years old. Among them, 76 children (conservative group) were treated with close reduction and plaster slab fixation combined with plaster external traction; 75 children (operation group) underwent surgical operation. The time of elbow joint function exercise, the healing time of fracture, the function recovery of elbow joint and carrying angle was recorded and analyzed. The therapeutic effects were evaluated by the Flynn criteria system.

RESULTSAll patients were followed up from 6 to 36 months (18.3 months on average). The average time of fracture healing and elbow joint functional exercise of the conservative group was shorter than those of operation group (P < 0.001). Motion range of the elbows and carrying angle of two groups were no statistical difference (P > 0.05). According to Flynn criteria system, in conservative group, the result was excellent in 31 cases, good in 35, fair in 7, and poor in 3; in operation group, 27 in excellent, 30 in good, 17 in fair and 1 in poor; there was no significant difference between two groups in therapeutic effects (P > 0.05).

CONCLUSIONClose reduction and plaster slab fixation combined with plaster external traction in treatment of pediatric closed Gartland type III supracondylar humerus fractures without neurovascular injury complications,which has similar effect to surgical treatment, and the time of fracture healing and elbow joint function exercise are significantly shorter.

Case-Control Studies ; Casts, Surgical ; Child ; Child, Preschool ; External Fixators ; Female ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Infant ; Male ; Traction ; methods

Adult ; Aneurysm, Dissecting ; complications ; diagnosis ; Aortic Aneurysm ; complications ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Myocardial Infarction ; complications ; diagnosis

Purpose:To study the expression of CD44v6 protein in breast carcinoma and its prognostic significance. Methods:100 cases of formalin-fixed paraffin-embeded female breast invasive ductal carcinoma tissues were retrospectively analyzed using EnVision~(TM) immunohistochemical method with the monoclonal antibody CD44v6.Statistical analysis was based on the Log-rank test and Cox analysis.Results:Sixty-six of 100 cancer tissues expressed CD44v6.Positive staining was mainly on the cell membranes.There was significant correlation between CD44v6 immunoreactivity and lymph node me- tastasis and TNM stage.The 5-and 10-year survival rates were 82.76% and 78.37% of patients with CD44v6 low-expres- sion tumors,and 64.1% and 49.88% of those with CD44v6 high-expression tumors,respectively;the difference between the two groups of patients was significant(P

AIM: To evaluate the efficacy of vitrectomy and pan-retinal photocoagulation followed with Ahmed implantation in management of neovascular glaucoma ( NVG) retrospectively.
METHODS: Vitrectomy combined with pan retinal photocoagulation and Ahmed implantation was performed on 15 cases ( 15 eyes ) with NVG. All patients were followed up for 12 ~ 36mo. The change of intraocular pressure (IOP), visual acuity, neovascularization of iris, complications were observed.
RESULTS: The visual acuity of 10 eyes was improved postoperative. IOP of postoperative 1, 6 and 12mo were decreased significantly compared with preoperative ( P<0.01 ) . Neovascularization of iris was reduced dramatically. No serious complications occurred.
CONCLUSION: Vitrectomy combined with pan retinal photocoagulation followed Ahmed implantation can manage NVG effectively.

OBJECTIVETo observe the effect of β₃adrenoceptors (β₃-AR) activation on rat thoracic aorta smooth muscle contractility and the possible related mechanism.

METHODSThe endothelium removed thoracic aorta was pre-contracted with 30 mmol/L KCl physiological saline solution (PSS). Then the tension of the thoracic aorta was recorded in presence of BRL37344 (BRL) to determine the action of β₃-AR. The tension of the thoracic aorta was also recorded in the presence of Propranolol (PRA), SR59230A (SR), L-NNA, H-89 and Iberiotoxin (IBTX) respectively to reveal the underling mechanism of β₃-AR activation on rat vascular smooth muscle. Immunohistochemistry was adopted to confirm the existence and the distribution of β₃-AR in rat thoracic aorta.

RESULTSThe results showed that: (1) The thoracic aorta was relaxed by β₃-AR activation, with a relaxation percentage of (10.59 ± 0.79). (2) β₃-AR was expressed in both endothelial and smooth muscle layer in thoracic aorta sections of rats. (3) PRA did not block the effect of BRL on the thoracic aorta. The relaxation actions of BRL could be antagonized by pre-incubating the thoracic aorta with SR. (4) L-NNA (a NOS inhibitor) and H-89 (a PKA inhibitor) reversed the relaxation effect of BRL on vascular smooth muscle. (5) The effect of BRL was decreased after application of Ibriotoxin (IBTX), a large conductance calcium dependent potassium channel blocker.

CONCLUSIONThe results confirmed that activation of β₃-AR led to relaxation of thoracic aorta smooth muscle. The relaxation action of β₃-AR on smooth muscle of rat thoracic aorta was related to activation of NOS and PKA signaling pathway. Large conductance Ca²⁺-K⁺ channels were involved in the relaxation action of β₃-AR activation on rat thoracic aorta smooth muscle.

Animals ; Aorta, Thoracic ; physiology ; In Vitro Techniques ; Isoquinolines ; Large-Conductance Calcium-Activated Potassium Channels ; physiology ; Muscle Contraction ; Muscle Relaxation ; Muscle, Smooth, Vascular ; physiology ; Nitroarginine ; Peptides ; Propanolamines ; Propranolol ; Rats ; Receptors, Adrenergic, beta-3 ; physiology ; Signal Transduction ; Sulfonamides

Adult ; Breast Neoplasms ; metabolism ; pathology ; secondary ; Carcinoid Tumor ; metabolism ; pathology ; surgery ; Carcinoma, Adenoid Cystic ; pathology ; Carcinoma, Lobular ; metabolism ; pathology ; secondary ; Cervical Intraepithelial Neoplasia ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; Keratins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; Sex Cord-Gonadal Stromal Tumors ; metabolism ; pathology ; Synaptophysin ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; pathology ; surgery

We have designed and carried out problem based learning (PBL) pedagogy since 2004. According to clinical eases, students learnt the pathophysiology of heart failure knowledge by themselves. Each group recommen-ded one student to make an oral presentation and wrote a review about heart failure. Preparing clinical cases and group discussions are very important. At the same time we should pay attention to the change in role of the teacher in PBL and cooperation with other disciplines.

The clinical data of a child with chemical pneumonia caused by kerosene in Hainan Maternal and Children′s Medical Center in June 2019 were retrospectively analyzed.The patient was a 2 years and 1 month old boy with a history of kerosene inhalation and fever.The clinical features included low breath sounds in the left lung and dry and wet rales in both lungs.The white blood cells (WBC) level, C-reactive protein (CRP) level, and erythrocyte se-dimentation rate (ESR) were significantly increased.Chest CT showed inhalation pneumonia.Chest ultrasound suggested medium pleural effusion on the left side.The patient was given antibiotics, nebulization and other treatment.On the 12 th day of the course of the disease, his temperature returned to normal, and breath sounds on the left side were stronger than before.The WBC level, CRP level and ESR were improved according to the re-check results, but pulmonary ventilation was still obstructed mildly to moderately.Fourteen days after hospital discharge, the patient coughed less.Reexamination of chest CT prompted the lesions were further absorbed, but the mild to moderate obstructive lesions were still observed.With the reduction of kerosene use in daily life, kerosene-induced chemical pneumonia is rare, but due to its diverse and complex clinical manifestations and slow absorption of pulmonary inflammation, attention should be paid to its progression into chronic cough.