The aim of the present study was to assess whether Fourier transform infrared spectrometry (FTIR) micro-spectroscopy could produce distinct spectral information on protein of old myocardial infarction (OMI) and to set them as molecular markers to diagnose atypical OMI. Paraffin-embedded heart samples were derived from victims dying of OMI. In combination with histological stain, FTIR and infrared micro-spectroscopy, the characteristics of OMI were analyzed morphologically and molecularly. The most relevant bands identified were the amide A, B, I and, II showing crucial spectral differences between apparent normal region and OMI region, including the peak position blue shift and the increased intensity of OMI, moreover relative increase in alpha-helix and decrease in beta-sheet of protein secondary structures in OMI. Comparing to single spectral band, the I1650/I1550 ratio was increased and rationally used as a molecular marker for diagnosing OMI. These novel preliminary findings supported further exploration of FTIR molecular profiling in clinical or forensic study, and were in accordance with histopathology.

Objective To explore the indications of anterior and posterior approach operations for unstable thoraco-lumbar fractures coupled with neurologic deficits and prevention of intraoperative and postoperative complications. Methods We investigated 107 consecutive eases of thoraco-lumbar fractures coupled with spinal cord injury who had been operated on from January 2000 to December 2006.Their average age was 37.8(range.17 to 78) years old. They were 71 males and 36 females. Anterior approach was selected for 46 cases and posterior approach for 61 cases according to their McCormack grades. By the Frankle system for neurologie deficits, 7 cases were graded as A,16 as B,39 as C and 45 as D. Fracture height vecoveries before and after surgery were analyzed statistically. Kyphotic deformity was assessed on lateraJ radiographs using the Cobb method. Results The mean follow-up of 97 cases was 2.8(range,0.5 to 6) years. In both groups. All the cases gained at least 1 grade improvement except those with Frankle grade A. The mean kyphotic angles before operation, after operation and at the latest follow-up were 23.7°,10.6°and13.1°respectively, with significant differences(P＜0.01),in the anterior approach group, while 16.3°,8.4°and 11.7°respectively, with significant differences(P＜0.01),in the posterior approach group. Some complications, such as deficit of cutaneous nerve of thigh, appeared in the 2 groups. Conclusions In treatment of unstable thoraco-lumbar fractures coupled with neurologic deficits, the anterior approach may be better than the posterior approach. The posterior approach can be applied for the cases with less than 7 points in McCormack index. Correct selection of operative approach, careful operation and good rehabilitation after operation are necessary for the prevention of complications.

Objective To investigate the effect of methylprednisolone on T helper 17 cell (Th17 cells) related cytokines (interleukin (IL)-23,17A,21,22,6,and tansforming growth factor (TGF)-β) in serum and cerebrospinal fluid from patients with relapsing remitting multiple sclerosis and their effects on the pathogenesis.Methods We recruited relapsing remitting multiple sclerosis group (38 patients)and noninflammatory neurological disease group (20 controls),and detected the levels of IL-23,IL-17A,IL-21,IL-22,TGF-β and IL-6 in serum and cerebrospinal fluid (CSF) with ELISA kit in both controls and patients before and after treatment by methylprednisolone.Results After treatment in relapsing remitting multiple sclerosis patients,IL-17A,IL-23,IL-21,and IL-22 levels in cerebrospinal fluid and serum were significantly decreased,however,they were still higher than that in the non-inflammatory neurological disease patients.TGF-β levels was significantly increased (serum:(17.2 ± 5.9) pg/ml vs (34.1 ± 6.5) pg/ml,t =14.351,P =0.000 ; CSF:(26.4 ± 4.7) pg/ml vs (73.2 ± 19.7) pg/ml,t =16.352,P =0.000).The levels of TGF-β in serum and CSF in patients before treatment were lower than those of in non-inflammatory neurological disease patients (serum:(30.2 ± 8.9) pg/ml,t =6.769,P =0.012 ; CSF:(3 1.4 ± 7.5) pg/ml,t =9.368,P =0.017).However,the levels of TGF-β in CSF in patients after treatment were significantly higher than those in non-inflammatory neurological disease patients (t =9.138,P =0.000).Correlation analysis showed that IL-23 and IL-17A were positive correlation in the serum of relapsing remitting multiple sclerosis patients before treatment.Moreover,positive correlations among IL-23,IL-17A and IL-21 were detected in the CSF of relapsing remitting multiple sclerosis patients before treatment.Conclusions Decreased levels of IL-23,IL-17A,IL-21 and IL-22,and elevated levels of TGF-β were detected in serum and CSF of patients with relapsing remitting multiple sclerosis after methylprednisolone treatment.IL-23,IL-17A,IL-21,IL-22 and TGF-β might involve in the pathogenesis of relapsing remitting multiple sclerosis.

[Objective]To summarize the experience of modern doctors in treating ulcerative colitis(UC)with"carbuncle",in order to provide more thinking for the treatment of UC by traditional Chinese medicine(TCM).[Methods]From the perspective of treating UC with"carbuncle",the etiology,pathogenesis,syndrome differentiation and treatment strategy of modern doctors treating UC with"carbuncle"were summarized by collating relevant experience articles of modern doctors.[Results]Modern doctors treat UC as"carbuncle",and believe that the cause of UC is related to exogenous evil,improper diet,mood failure,body deficiency and fatigue,the pathogenesis of which is the deficiency in origin and excess in superficiality,deficiency and excess are mixed with spleen deficiency,dampness,heat,blood stasis and poison.In the active stage of the disease,the main cause is evil and excess;in the remission stage,the main cause is spleen and kidney deficiency.Local syndrome differentiation and Yin-Yang syndrome differentiation are emphasized.In the treatment,the three methods of dispersing,promoting and tonifying are applied flexibly,dysentery and carbuncle are treated together,both inside and outside should be treated.[Conclusion]Treating UC as"carbuncle"is an effective TCM diagnosis and treatment idea,and provides a reference for exploring TCM treatment strategies.

The aim of the present study was to assess whether Fourier transform infrared spectrometry (FTIR)micro-spectroscopy could produce distinct spectral information on protein of old myocardial infarction(OMI)and to set them as molecular markers to diagnose atypical OMI.Paraffin-embedded heart samples were derived from victims dying of OMI.In combination with histological stain,FTIR and infrared micro-spectroscopy,the characteristics of OMI were analyzed morphologicallyand molecularly.The most relevant bands identified were the amide A,B,Ⅰ and Ⅱ,showing crucial spectral differences between apparent normal region and OMI region,including the peak position blue shift and the increased intensity of OMI,moreover relative increase in a-helix and decrease in β-sheet of protein secondary structures in OMI.Comparing to single spectral band,the I1650/I1550 ratio was increased and rationally used as a molecular marker for diagnosing OMI.These novel preliminary findings supported further exploration of FTIR molecular profiling in clinical or forensic study,and were in accordance with histopathology.

Objective To explore the role of interleukin-23 (IL-23) and IL-17 in the pathogenesis of relapsing-remitting multiple sclerosis (RRMS),and determine the effect of methylprednisolone on IL-23 and IL-17 levels.Methods Twenty-nine patients with RRMS (RRMS group) and patients with non-inflammatory neurological diseases (controls),admitted to our hospitals from June 2010 to December 2012 group,were chosen in our study; ELISA was employed to detect the serum and cerebrospinal fluid levels of IL-23 and IL-17 in the two groups before and after methylprednisolone treatment.Results Before treatment,IL-23 and IL-17 levels in serum and cerebrospinal fluid of RRMS group (IL-23:[689.66±111.61] pg/mL and [768.82±70.63] pg/mL; IL-17:[88.15±13.16] pg/mL and [91.51±12.45] pg/mL) were significantly higher than those in the control group (IL-17:[90.94±10.70] pg/mL and [85.71±7.21] pg/mL; IL-23:[17.14±1.55] pg/mL and [17.87±1.61] pg/mL],P＜0.05),and the IL-23 level in cerebrospinal fluid was significantly higher than that in serum (P＜0.05); IL-23 and IL-17 levels in RRMS group after treatment (IL-23:[399.91±61.73] pg/mL and [319.34±91.29] pg/mL; IL-17:[48.01±9.62] pg/mL and [49.08±13.72] pg/mL]) significantly decreased as compared with those before treatment (P＜0.05),but they were still statistically higher than those in the control group (P＜0.05).IL-17 and IL-23 levels had positive correlation in the serum and cerebrospinal fluid of RRMS group (r=0.369,P=0.049; r=0.497,P=0.006).Conclusion IL-23 and IL-17 levels are associated with the pathogenesis of multiple sclerosis; methylprednisolone treatment can decrease the levels of IL-23 and IL-17 in multiple sclerosis.

Objective:To explore the application effect of sustainable skin-stretching device in scalp and soft tissue defect.Methods:From June 2017 to January 2020, 5 patients (3 males and 2 females, aged 31-57 (38.0±2.1) years) with large area of scalp and soft tissue defect and skull exposure were admitted to Department of Reparative and Reconstructive Surgery of the Second Hospital of Dalian Medical University. The wound area ranged from 16.0 cm×8.0 cm to 18.0 cm×12.0 cm. The sustainable skin-stretching device was installed after debridement operation for scalp wound. The wound was stretched from the 3rd day after installation of the device, at a basic speed of 1 mm/d and finished for 3 times on average. During stretching, close attention was paid to the changes in blood flow of the wound margin and the subjective feeling of the patients. When the result was negative in the squeezing and pinching test for wound margin after stretching, the further stretching was stopped, the final stretching state was maintained for 3 days, and the wounds were sutured directly. The wound healing during stretching of sustainable skin-stretching device and the occurrence of complications were observed. The rest wound areas after stretching for 5, 10, 15, and 20 days were measured. The wound healing and hair growth were observed during follow-up.Results:All the wounds of 5 patients was sutured directly after stretching for 19-23 d. There was no tension blister on the margin of wounds during stretching, and the margin of wounds healed well after being sutured without skin necrosis. After stretching treatment for 5-20 d, the wound areas were gradually decreased. During follow-up of 2-11 (4.5±1.5) months, the elasticity, color, feeling, and regenerated hair growth of the stretched scalp tissue were close to those of the surrounding normal skin tissue. The linear scar formed on the margin of wounds, but no scar formed on the wounds.Conclusions:The application of sustainable skin-stretching device can reduce the difficulty in repairing scalp and soft tissue defect, with the regenerated hair growing well after treatment, which is worthy of clinical promotion.

Objective To investigate the prevalence and risk factors of diabetes and prediabetes in Jingyuan County in Ningxia. Methods A cross-sectional survey including 10 639 participants (18-88 years of age) with a multistage sampling was conducted in Jingyuan County between January, 2014 and April, 2015. Questionnaires, physical examinations, and laboratory tests were included in the survey. Results Among all the subjects, 10 491 participants (men: 4 826, women: 5 665) with complete data were included in the analysis. The standardized prevalence of diabetes and prediabetes was 4.2% (men: 3.9%, women: 4.5%) and 8.8% (men: 7.6%, women 10.3%), respectively, in which the standardized prevalence of diabetes was higher in Hui (4.5%) than that in Han (3.5%) (P<0.05). Logistic regression analyses showed that age, family history of diabetes, overweight/obesity, hypertriglyceridemia and hypertension were positively associated with prediabetes and diabetes with the odds ratios being 1.60 and 2.14 (age, P<0.001), 1.40 and 3.32 (family history, P< 0.05), 1.47 and 1.57 (overweight/obesity, P< 0.001), 1.88 and 2.55 (hypertriglyceridemia, P<0.001), 1.44 and 1.89 (hypertension, P<0.001), respectively. Conclusions The prevalence of diabetes was relatively low in the rural area in Ningxia. However, it is still essential to take active interventions in people at high risk of diabetes in order to prevent the incident diabetes.

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.

Objective: To investigate the significance of circulating tumor cells (CTC) in squamous cell carcinoma of the head and neck (HNSCC). Methods: Twenty-four patients with HNSCC treated between October 2016 and July 2017 in our department were selected (experimental group), including 23 males and 1 females, aged 47-81 years. There were 14 cases of squamous cell carcinoma of larynx and 10 cases of hypopharynx, including I-Ⅱ stage (5 cases) and Ⅲ- Ⅳ stage (19 cases). All patients were primary and/or relapsed after treatment. Nine healthy volunteers were selected as control group. A novel in vivo capture technique (CellCellector system) was used to detect CTC. SPSS23.0 was used for statistical analysis. Results: The total capture rate of CTC in patients with HNSCC before treatment was 70.8% (17/24), with 40% (2/5) for patients at I-Ⅱ stage, and 78.9% (15/19) for patients at Ⅲ- Ⅳ stage, and was 0 in patients of control group. The total capture rate of CTC in patients with HNSCC after treatment was 50% (8/16). There was no significant correlation between CTC and age, sex, location of tumor or lymph node metastasis (P>0.05). CTC was related to tumor staging and tumor differentiation (P<0.05). The positive rate of EGFRVⅢ in CTC was 26.3% (5/19). Conclusions The CellCollector system is a very efficient way of detecting CTC, and CTC plays an important role in the occurrence, progression and metastasis of HNSCC.