Objective To analyze the clinical value of X ray examination, CT examination and MRI examination in the diagnosis of giant cell tumor of bone.Methods 50 patients with giant cell tumor of bone confirmed by postoperative pathology were selected.The patients' X ray, CT scan and MRI imaging examination data were retrospectively analyzed, and the imaging features of giant cell tumor of bone were discussed and summarized.Results The rate of CT examination and MRI examination in the diagnosis of bone destruction was higher than X ray examination, but the difference was not statistically significant (x2=4.181,P>0.05).CT examination and MRI examination in the soap bubble sign, bone crest, liquid plane and soft tissue mass in the diagnostic rate compared with X ray examination was significantly higher, the difference was statistically significant (x2=5.333,22.941,30.000,38.400,64.000,14.166,6.102,all P<0.05).Conclusion The diagnostic accuracy of CT and MRI in giant cell tumor of bone is higher than X ray, but the value of MRI examination in the diagnosis of edema near the tumor is better.

Objective To investigate the clinical value of digital subtraction angiography (DSA) interventional thrombolysis in the treatment of acute cerebral infarction.Methods 35 patients with acute cerebral infarction were divided into 6h group and 7-12h group in accordance with DSA from the onset time.Before and after thrombolytic therapy,the nerve function defect angiographic recanalization rate and postoperative score of therapeutic effect evaluation were compared between the two groups.Results In the 6h group,the recanalization rate ＞ 70％ (33.33 ％) and the recanalization rate ＞50％ (83.33％) were significantly higher than those in the 7-12h group (18.18％,55.55％),and the differences were statistically significant(x2 =6.56,5.02,all P ＜ 0.05).Before treatment,the ESS score between the two groups was not statistically significantly different(t =0.83,P ＞ 0.05).After treatment for 1d,7d,14d,ESS scores of the two groups [(62.44 ± 9.82) points,(68.95 ± 11.23) points,(73.89 ± 11.24) points,(54.67 ± 9.11) points,(58.02 ± 10.47) points,(61.43 ± 10.23) points] were significantly higher than those before treatment [(42.12 ± 8.79) points,(41.92 ± 9.02) points,t =6.87,7.03,7.92,6.03,6.56,6.77,all P ＜ 0.05].After treatment for 1 d,7d,14d,the ESS scores of the 6h group [(62.44 ± 9.82) points,(68.95 ± 11.23) points,(73.89 ± 11.24) points] were significantly higher than those of the 7-12h group [(54.67 ± 9.11) points,(58.02 ±10.47) points,(61.43 ± 10.23) points],and the differences were statistically significant(t =5.45,5.10,4.23,all P ＜ 0.05).Conclusion DSA interventional thrombolytic therapy can significantly improve the neurological status of the patients,and the onset time is shorter.The clinical treatment is better.In the clinical treatment,we should grasp the opportunity.

Objective To investigate the safety , feasibility , and clinical application value of digital sub-traction angiography ( DSA) -guided insertion of totally implantable venous access port ( TIVAP) in patients with digestive system cancer .Methods We retrospectively analyzed the data of 15 digestive system cancer patients who were inserted with TIVAP under DSA guidance between April 2013 and January 2016, recorded the TIVAP-related complications and indwelling time, and investigated the patients’satisfaction about TIVAP.Paired rank sum test was used for the differences in patients’quality of life before and after the insertion of TIVAP.Results Of the 15 digestive system cancer patients , operation success rate of TIVAP insertion was 100%, with the success rate of venipuncture on first attempt being 100%.The incidence of complication was 6.67% ( 1/15 ) , which was manifested as pull feeling at the neck occurring in the eighth month after insertion .The indwelling time of TIVAP was from 2 to 28 months, with a median value of 9 months.Patients’satisfaction rate of TIVAP was 86.67%(13/15).The proportion of patients with a good quality of life was 100%(15/15), statically signifi-cantly higher than that before the insertion [46.67%(7/15), Z=-3.416, P=0.000).Conclusions TIVAP insertion under DSA guidance in digestive system cancer patients is safe and feasible , with few complications and fair patient satisfaction .It may improve the patient ’s quality of life , worthy of clinical application .

ObjectiveTo investigate the effects of acupuncture combined with Du-Moxibustion (ADM) on peripheral blood cell count and levels of immune factors in patients with occupational chronic benzene poisoning. Methods A total of 70 patients with occupational chronic benzene poisoning (leukopenia and neutropenia) were selected as the research subjects by judgement sampling method. They were randomly divided into a control group and an ADM group using a random number table method, with 35 cases in each group. Patients in the control group were treated with conventional Western medicine such as leukocyte boosting and symptomatic treatment. While patients in the ADM group were treated with ADM treatment in addition to treatments of the control group, once per week for five consecutive weeks. Peripheral blood samples of patients were collected before and after treatment from both groups, to detect cell counts and serum levels of immune factors. Results The white blood cell count, red blood cell count, absolute lymphocyte count, absolute neutrophil count, platelet count, and levels of hemoglobin, immunoglobulins (Ig) A, IgM, IgG, complement C3 and complement C4 of patients in both groups improved after treatment compared with those before treatment (all P<0.05). The white blood cell count, levels of IgA, IgM, IgG, complement C3 and complement C4 of patients in the ADM group were higher than those in the control group after treatment (all P<0.05). Conclusion ADM treatment can increase peripheral blood white blood cells and serum levels of immune factor in patients with occupational chronic benzene poisoning (leukopenia, neutropenia), which helps improve patient recovery and can be promoted clinically.

AIM:To investigate the impact of excessive endoplasmic reticulum stress on apoptotic cell death in a rat model of chronic cyclosporine A ( CsA ) nephrotoxicity .METHODS: Male Sprague-Dawley rats on a low-salt diet were subcutaneously injected with vehicle (olive oil, 1 mL· kg-1· d-1) or CsA (15 mg/kg) daily for 1 or 4 weeks.Tu-bulointerstitial fibrosis and apoptotic cell death were estimated by trichrome staining and TUNEL staining .In addition , im-munohistochemistry and immunoblotting were used to evaluate the expression of immunoglobulin -binding protein ( BiP) , eu-karyotic initiation factor 2α(eIF2α), growth arrest and DNA damage-inducible protein 153 (GADD153), caspase-12 and caspase-3.RESULTS:The rats treated with CsA for 1 week did not develop tubulointerstitial fibrosis and TUNEL-positive cells, whereas 4-week treatment with CsA induced typical tubulointerstitial fibrosis and increased TUNEL-positive cells. CsA induced a significant increase in BiP and caspase-12 expression peaked at 1 week, and then returned to normal levels at 4 weeks.In contrast, the expression of eIF2α, GADD153 and caspase-3 in CsA-treated rat kidneys were significantly in-creased in a time-dependent manner .CONCLUSION:Excessive endoplasmic reticulum stress causes apoptotic cell death by depleting molecular chaperones and stimulating the proapoptotic pathway in chronic CsA nephrotoxicity .

Objective:To investigate the expression of circ0008234 and miR-1205 in breast cancer and the oncology characteristics of CT.Methods:40 patients with breast cancer were collected as observational objects from Jan.2018 to Dec.2018 and 40 patients without breast cancer were selected as the control group. The expression levels of circ0008234 and miR-1205 of all patients were estimated by quantitative real-time polymerase chain reaction. Bioinformatics was used for the predictions of circ0008234 target miRNA. A dual-luciferase reporter assay was used to confirm the interaction between circ0008234 and miR-1205. All patients of the observation group were examined by multi-slice CT. CT images were analyzed through observing tumor size, shape, calcification area, lymph node metastasis and margin. The correlation between CT signs and the expression of circ0008234 and miR-1205 was further analyzed.Results:The levels of circ0008234 of observation group were significantly higher than those of the control group (2.23±0.86, 1.07±0.37, P=0.00) , but the expression levels of miR-1205 were lower than the control group (0.76±0.29, 1.04±0.29, P=0.00) . In the observation group, there were no significant differences in the expression of circ0008234 and miR-1205 among patients with different tumor marginal morphology and micro calcifications. However the expression of circ0008234 in patients with regular lump form were significantly higher than those in patients with inregular form (2.52±0.88, 1.91±0.74, P=0.025) , and the expression of miR-1205 were lower than those in patients with inregular form (0.66±0.30, 0.86±0.25, P=0.025) . In the observation group, the expression of circ0008234 in patients with mass diameter≥2 cm were significantly higher than those in patients with mass diameter<2 cm (2.59±0.95, 1.69±0.17, P=0.001) , but the expression of miR-1205 were lower than those in patients with mass diameter<2 cm (0.65±0.21, 0.92±0.33, P=0.003) . In the observation group, the expression of circ0008234 in patients with lymph node metastasis were higher than those without lymph node metastasis (2.55±1.09, 1.94±0.44, P=0.022) , but the expression of miR-1205 in patients with lymph node metastasis were lower than those without lymph node metastasis (0.65±0.26, 0.85±0.30, P=0.027) . miR-1205 was verified as a direct target of circ0008234 by luciferase assay. circ0008234 could negatively regulate the expression of miR-1205. Conclusion:There is a correlation between CT imaging signs and the expression of circ0008234 and miR-1205 in patients with breast cancer, which can provide more reference for the judgment of malignant degree and prognosis of patients with breast cancer.

Objective To investigate the changes in the percentages of CD4+T lymphocyte subsets and the homeostasis of T lymphocytes among MSM ( men who have sex with men) population with different stages of HIV-1 infection. Methods A total of 166 untreated MSM with HIV infection were enrolled and di-vided into three groups including early HIV infection (EHI, n=38) , HIV (n=94) and AIDS (n=34) groups. Sixty-two MSM negative for anti-HIV antibody were selected as healthy controls. Blood samples were collected into EDTA tubes and detected to analyze the changes in the distribution of CD4+ T cells and CD8+T lymphocyte subsets ( CD4+ CD45RA+, CD8+ CD28+, CD4+ CD25+ CD127-) and the percentages of activated (CD38, HLA-DR) and apoptotic cells (CD95) with disease progression by flow cytometry. Re-sults The expression of CD4+CD45RA+ T lymphocytes gradually decreased with the progression of AIDS. The percentage of CD4+CD45RA+ T lymphocytes in HIV group was lower than that of the control group, but higher than that of the AIDS group (P=0. 015, P=0. 000). No significant difference was found between the EHI and the control groups (P>0. 05). CD8+CD28+T cells were significantly reduced in the EHI group and remained at a low level with disease progression. No significant difference in the proportion of CD4+CD25+CD127- T cells was observed among all groups (P>0. 05). The percentage of CD4+CD38+HLA-DR+T cells increased gradually and the highest level was detected in the AIDS group, followed by those in the HIV, EHI and control groups (P<0. 01). The percentages of CD8+CD38+, CD8+HLA-DR+, CD8+ CD38+HLA-DR+and CD8+CD95+T cells in the EHI, HIV and AIDS groups were significantly higher than those in the control group (P<0. 01), but there was no significant difference among the former three groups (P>0. 05). Con-clusion HIV infection caused the changes in the numbers and functions of T lymphocyte subsets and accel-erated the activation and apoptosis of T lymphocytes, which aggravated the T lymphocyte immune dysfunction even further. A comprehensive analysis of the alterations in different T cell subsets would be conducive to re-flect the immune deficiency and the severity of disease. CD4+ and CD8+ T cells were activated in the early stage of HIV infection, which indicated that studying the immune response during that stage might help to understand their roles in disease progression.

Objective:To investigate the effects of highly active anti-retroviral therapy (HAART) on the activation of T lymphocytes and expression of CD4 + CD45RA + T cell subsets in HIV/AIDS patients. Methods:This study prospectively analyzed 105 HIV/AIDS patients undergoing HAART and 35 HIV-1-negative cases (healthy controls). Flow cytometry was used to detect the activation of T lymphocytes and the percentages of CD4 + CD45RA + T cell subsets in whole blood samples taken from healthy controls and HIV/AIDS patients before and after therapy. Results:The activation of T lymphocytes was significantly enhanced in the 105 HIV/AIDS patients than in the healthy controls before treatment ( P<0.01). The activated T lymphocytes gradually decreased after HAART. Firstly, CD4 + CD38 + HLA-DR + , CD8 + CD38 + and CD8 + HLA-DR + T lymphocytes decreased one month after therapy ( P<0.05). Then, four indicators of T lymphocyte activation including the expression of CD8 + CD38 + HLA-DR + T lymphocytes decreased significantly six months after therapy ( P<0.01). The percentage of CD8 + CD38 + HLA-DR + T lymphocytes detected 12 months after therapy was significantly lower than that analyzed six months after therapy ( P<0.01). No significant difference was found in the expression of the other three indicators for activation ( P>0.05). Twelve months after therapy, the four indicators for T lymphocyte activation in HIV/AIDS patients were still significantly higher than those of the control group ( P<0.01). The percentages of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients were significantly lower than those in healthy controls before and 12 months after treatment ( P>0.05). Conclusions:HAART could reduce immune activation after six months of treatment, but could not reverse the activation nor restore the expression of CD4 + CD45RA + T lymphocytes in HIV/AIDS patients.

Objective:To study the clinical features and prognosis of infantile hepatic hemangioendothelioma-arteriovenous fistula (IHHE-AVF) complicated with heart failure in neonates.Method:From May 2016 to June 2020, neonates with IHHE-AVF complicated with heart failure admitted were retrospectively studied. The clinical presentation, treatment and outcomes were analyzed.Result:A total of 11 cases of IHHE-AVF complicated with heart failure were enrolled (male 5, female 6). The onset age of heart failure was 12.0 (0.0, 17.0) d. 6 cases showed IHHE on fetal ultrasound. All patients had significantly enlarged heart on chest X-ray. All patients had decreased left ventricular systolic function and pulmonary hypertension on echocardiography. All patients required respiratory support and 6 of them were intubated. 3 cases received conservative treatment (all dead). 1 case received surgery (dead). 7 cases received interventional therapy at the age of (25.6±18.5) d. 1 case was dead, and the other 6 cases were improved and discharged. All the 6 cases were followed up to 3~18 months. None of them had heart failure again. The IHHE were shrunk or completely disappeared. Coagulation function and platelet count were normal.Conclusion:The fatality rate of neonatal-onset IHHE-AVF complicated with heart failure is extremely high. Interventional therapy may be more effective than conservative therapy and surgery.

Objective:To summarize the clinical features and prognosis of neonates with congenital fissure of larynx due to choking, and improve the diagnosis and treatment of congenital fissure of larynx by neonatal medical professionals.Methods:This study was a single-center retrospective case series report.With "choking" as the key word, combined with the information from the first page of the medical record, we searched in the electronic medical record system, and summarized the clinical characteristics and prognosis of neonates diagnosed as congenital fissure of larynx.The study period was from January 2017 to February 2021.Results:A total of seven cases were diagnosed as congenital fissure of larynx, accounting for 2.2% of the total number of hospitalized children due to choking during the same period.Among them, six cases were male, gestational age was 38 (36, 39) weeks, birth weight was 2 820 (2 255, 3 420) g, admission age was 18(5, 20) days and hospitalization duration was 26 (6, 45) days.The common clinical symptoms were choking (7/7) and cyanosis (5/7). Six of the seven children with fissure of larynx were clearly classified as type Ⅰ(two cases), type Ⅲ(three cases), and type Ⅳ(one case). All the seven cases were accompanied by other site/tracheal malformations or congenital abnormalities, among which four (4/7) cases had VACTERL syndrome.A total of three children (two cases of type Ⅲ and one case of type Ⅳ) underwent laryngeal cleft repair operation, and all died shortly after surgery.Four cases didn′t receive laryngeal cleft repair operation (two cases of type Ⅰ, one case of type Ⅲ, one case of parting was unknown), one case with type Ⅰ fissure of larynx accepted the tracheoesophageal fistula repair operation only, who was followed up until the age of two years and six months, and he could have normal diet, one case of typeⅠfissure of larynx with gastric tube discharge, who was followed up to one year and eight months old, could be normal diet too, the two cases of children with no difference between the growth with their peers; one case with type Ⅲ fissure of larynx was lost to follow-up; One case, whose classification was unknown, was followed up until he was 40 days old, and still could be fed orally.The physical development of the child was significantly behind that of the same age.Conclusion:Congenital fissure of larynx is rare, with choking as its main symptom and other malformations.Diagnosis and classification require fiberlaryngoscope and bolting laryngoscope under general anesthesia combined with bronchoscopy, which is difficult to treat.Type Ⅰ has a good prognosis, while type Ⅲ and Ⅳ have poor prognosis.