Objective To investigate the effect of exosomes derived from Echinococcus multilocularis on macrophage polarization after treatment for different durations and concentrations. Methods A total of 60 BALB/c mice were used for modeling, among which 4 mice were selected to observe the growth of abdominal lesions on 7.0T MRI. The mice for modeling were dissected, and the protoscoleces was taken from the abdominal lesion and cultured in vitro ; ultracentrifugation was used to extract the exosomes from the supernatant, and transmission electron microscopy and Western blotting were used for the characterization of exosomes. The macrophages without exosome treatment were established as control group, and the macrophages co-cultured with different concentrations of exosomes derived from Echinococcus multilocularis were established as experimental group (10 μg/mL group and 50 μg/mL group) and were cultured for 48 and 72 hours. The morphological changes of macrophages were observed under a microscope, and flow cytometry and ELISA were used to observe polarization state. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results The results of 7.0T MRI showed the formation of diffuse lesions with different sizes in the abdominal cavity of mice, and the exosomes derived from Echinococcus multilocularis were approximately 100 nm in diameter and were cup-shaped or saucer-shaped, with the positive expression of the surface markers CD9, TSG101, and CD63. After co-culture, most of the cells in the experimental group were elongated with an irregular and polygonal shape. Flow cytometry showed that after 48 hours of co-culture, the positive rates of CD16/32, CD206, and CD369 in the control group were 99.53%±0.06%, 90.27%±0.21%, and 2.40%±0.20%, respectively; compared with the control group, except that the 10 μg/mL exosome group had a significant reduction in the positive rate of CD369 (0.80%±0.00%) ( P < 0.05), all the other groups had a significant increase in the positive rates of CD16/32, CD206, and CD369 (all P < 0.000 1); after 72 hours of co-culture, the positive rates of CD16/32, CD206, and CD369 in the control group were 99.67%±0.06%, 85.47%±0.55%, and 6.60%±0.20%, respectively, and compared with the control group, the experimental group had significant increases in the positive rates of CD16/32, CD206, and CD369 (all P < 0.05). ELISA showed that after 48 hours of co-culture, the levels of IL-6 and TNFα in the control group were 58.53±15.52 pg/mL and 320.70±5.30 pg/mL, respectively, and when the exosome concentration was 50 μg/mL, the level of IL-6 in the experimental group was 98.81±15.55 pg/mL, which was higher than that in the control group ( P < 0.05); after 72 hours of co-culture, the levels of IL-6 and TNFα in the control group were 76.22±9.68 pg/mL and 323.90±87.37 pg/mL, respectively, and when the exosome concentration was 10 μg/mL, the level of TNFα was 164.20±14.17 pg/mL, which was significantly lower than that in the control group ( P < 0.05); when the exosome concentration was 50 μg/mL, the level of IL-6 was 99.52±8.35 pg/mL, which was significantly higher than that in the control group ( P < 0.05). Conclusion Exosomes derived from Echinococcus multilocularis can regulate macrophage polarization and induce M2-like polarization of macrophages after co-culture at a concentration of 10 μg /mL for 72 hours, and further studies are needed to clarify the specific method.

Objective: To explore the relationship between physical fitness and energy balance related behaviors (EBRBs), and their influencing factors among primary school students, so as to provide a scientific basis for the improvement of physical fitness in primary school students. Methods: By using a random sampling method, a total of 1 451 pupils aged 10-12 were selected from 8 regions of Shannxi Province (Fengxiang, Weibin, Danfeng, Shangzhou, Huazhou, Linwei, Gaoling, Weiyang). According to the total score of physical fitness test, pupils were divided into the excellent good physical fitness group and the pass failed group. The students EBRBs and their influencing factors were investigated cross sectionally, and the Mann-Whitney U test and stepwise linear regression analysis were used to explore the relationship between physical fitness and EBRBs. Results: Breakfasts behavior( r = 0.061 ) and physical activity behavior( r =0.105) among primary school students were positively correlated with total physical scores, with the excellent good physical fitness group (757.56, 768.57)were higher than that of the pass failed group(710.93, 705.67) ( Z= -2.41, -2.69, P <0.05). The screen behavior ( r =-0.065) was negatively correlated with the total physical fitness scores, with the excellent good physical fitness group (681.96) was significantly lower than the pass failed group(747.04) ( Z=2.78, P < 0.05 ). There was no statistically significant correlation between the frequency of beverage behavior and the total score of physical fitness ( P >0.05). The excellent good physical fitness group scored(762.22, 761.19, 758.82, 756.00, 761.20, 755.57, 761.52, 759.48, 781.78) higher than the pass failed group(708.70, 709.19, 710.32, 711.67, 709.19, 711.88, 709.04, 710.01, 699.36) including health beliefs, parental norms and parental role models for breakfast behaviors, and preferences, self efficacy, and self regulation for physical activities, as well as self efficacy, parental role models, family rules for screen behavior ( Z=-2.40, -2.78, -2.35, -2.48, -2.52, -2.27, -2.35, -2.22, -3.65, P <0.05). Conclusion The physical fitness of primary school students is affected by EBRBs. Parents should model positive behaviors in the family, promote the health behavior of primary school students, improve the physical health of primary school students health.

【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.

Objective:To develop and apply the optimal evidence-based practice plan for enteral nutrition management in severe acute pancreatitis (SAP) patients.Methods:We combined the best evidence and scenario analysis to form the optimal evidence-based practice plan for enteral nutrition management in patients with severe acute pancreatitis, and integrated the plan into clinical practice. According to the procedure of evidence-based practice of the JBI Evidence-based Center, 18 nurses in the intensive care unit (ICU) were trained, and 30 SAP patients were subjected to a baseline review of the implementation of nutritional support care, with obstacles addressed and analyzed. The nutritional support quality were re-examined in another 30 SAP patients after the current plan was practiced.Results:Compared with the results of the baseline review, after the implementation of this plan, the implementation rate of the reviewed indicators was significantly improved; the ICU nurses showed a significant increase in the knowledge of SAP enteral nutrition (88.9% vs 33.3%, P<0.05. Except for the correct rate of catheter selection (100.0% vs 100.0%), the correct rate of implementation of the other 8 indicators (enteral nutrition timing selection, pre-catheterization evaluation, preparation, patients′ position, nutrition preparation selection, perfusion rate regalation, energy calculation, infusion method) was significantly improved (all P value <0.05). Furthermore, both the tolerance and satisfaction of SAP patients for enteral nutrition were significantly improved (all P value <0.05). Conclusions:The application of the optimal evidence-based practice plan for enteral nutrition management of SAP patients was beneficial to standardize the practice of ICU nurses, improve the quality of clinical care and improve the tolerance and satisfaction of enteral nutrition care of SAP patients.

Objective To investigate the pshcyological status and influencing factors of patients with acute pancreatitis. Methods Acute pancreatitis patients admitted in Changhai Affiliated Hospital of Navy Medical University from December 2018 to February 2019 were enrolled, and 120 patients were selected using random number table method. Self-made general questionnaire, self-rating depressing scale, self-rating anxiety scale and coping style questionnaire were used for investigation and patients′ psychological status was evaluated. Results In this survey, 109 questionnaires were collected and eligible for final analysis. The incidence of depression in patients with acute pancreatitis was 44. 0％, and the incidence of anxiety was 20. 2％. Male patients had significantly lower anxiety and depression than women. The levels of anxiety and depression in the 31-50 age group were significantly lower than those in other age groups. The level of anxiety in patients with pancreatitis with children was significantly lower than in patients without children. The coping style of "solving problem" was significantly negatively correlated with depression and anxiety level. The"self-blame" coping style was significantly positively correlated with depression and anxiety level. The"rationalized"coping style was positively correlated with the level of depression. Conclusions The mental health status of patients with acute pancreatitis was not optimistic. Different coping styles were important factors affecting the level of anxiety and depression.

Objective To analyze tumor-free survival rate and recurrence rate of radiofrequency ablation (RFA) versus surgical resection(SR) for small hepatocellular carcinoma. Methods Clinical data of 64 patients (hospitalized from October 2008 to October 2010) with small hepatocellular carcinoma(≤ 5 cm) in our hospital were retrospectively analyzed. 29 cases among them underwent RFA, and the 35 cases underwent SR, then they were further divided into two groups according to the tumor diameter (≤ 3 cm vs. ≤ 3 ~ 5 cm). The rate of complete elimination of tumor , complications , recurrence and metastasis , and survival rate out of tumor-free at year 1, 3, and 5 were compared. Accumulated survival rate of the two groups at year 1, 3, and 5 were compared. Results The rate of complete elimination of tumor, and complications in the RFA group were 89.66% and 6.9% respectively, and no statistically significant difference was found compared with the SR group (100% and 14.29%, respectively) . The rate of recurrence and metastasis and 1, 3, 5- year tumor-free rate in RFA and SR group with tumor diameter < 3 cm were 60.00%, 80.00%, 40.00%, 30.00% and 38.46%, 84.62%, 61.54%, 38.46% (P > 0.05) respectively, and for the cases with tumor diameter in 3 ~ 5 cm, these data showed no significant difference between groups (P > 0.05). No significant difference were found in tumor-free survival rate within groups, while rate of recurrence and metastasis was significantly lower in the < 3 cm group (P < 0.05). The accumulated survival rate in RFA at year 1, 3 and 5 were 100%, 62.07%, 37.93% and 100%, 62.86%, 48.57% in SR group (P > 0.05). Conclusions RFA and SR had similar medium and long term clinical effect for small hepatocellular carcinoma with tumor diameter≤ 5 cm. The larger in size of the tumor, the higher rate of recurrence and metastasis. RFA is less invasive and can avoid complications and should be considered an eligible treatment for small hepatocellular carcinoma with tumor diameter ≤ 5 cm.

BACKGROUND:It is notable to treat cervical spondylosis using the anterior cervical discectomy and fusion, but there are such complications as cervical instability and low fusion rate. Titanium plate with cage can solve those defects, while anterior unfamiliar matter and dysphagia appear. A new anterior cervical interbody fusionZero-Pwith support and fixation function has been widely used in clinic.
OBJECTIVE:To analyze early stability in repairing cervical spondylosis using a newZero-Pinterbody fixation and fusion system, and compare with a titanium plate with cage interbody fixation andfusion system.
METHODS:We retrospectively analyzed the clinical date of 31 patients with cervical spondylosis who underwent the anterior cervical discectomy and fusion in the Department of Orthopedics, Affiliated Hospital of Jiangsu University between August 2010 and August 2014. Fifteen patients were treated with aZero-P implant (Zero-Pgroup) and sixteen patients with a titanium plate with cage (cage group). We recorded operation time, intraoperative blood loss, preoperative and postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores, postoperative incidence of dysphagia and degeneration rate of adjacent joint.
RESULTS AND CONCLUSION:(1) Postoperative symptoms were apparently improved, without severe complications in both groups. (2) Operation time and intraoperative blood loss were better in theZero-P group than in the cage group (P< 0.05). (3) Postoperative Visual Analogue Scale scores and Japanese Orthopedic Association scores were significantly improved in both groups (P< 0.05). The recovery rate of Japanese Orthopedic Association scores was similar between the two groups (81%, 81%;P> 0.05). (4) Mild dysphagia was experienced by one case (7%) in theZero-Pgroup, but nine cases (44%) in the cage group. Significant difference in the incidence of dysphagia was detected between the two groups after treatment (P=0.037). However, no significant difference in degeneration rate was detectable between the two groups (P=0.48). (5) These findings verify that in the anteriorcervical discectomy and fusion, the new Zero-Pand titanium plate with cage interbody fixation and fusion system are effective choices for cervical spondylosis. However, theZero-Pinterbody fixation and fusion system showed a low incidence of postoperative dysphagia and better stability.

Objective To investigate the protective effect of crocin on oxidative stress cell model of PC 12 cell and the effect of crocin on PI3K/Akt signal pathway,as well as further explore the mechanism of protective effect on model cells.Methods Cells were divided into control group,model group,crocin group and VE group.The cell survival rate was detected by MTT method,and the expression of mRNA and protein of PI3K/Akt were detected by RT-PCR and Western blot.Results With the crocin concentration in 0.625 μM and 5 μM,the cell survival rate increased in a dose-dependent manner.The average optical density rate of PI3K and Akt mRNA were 0.435±0.044 and 0.375 ± 0.034,and the PI3K and Akt protein were 0.378± 0.038 and 0.386± 0.043 of crocin group.Compared with the model group,the expression levels of PI3K/Akt increased in crocin group (P＜0.05).Conclusion These results indicate that the antioxidant and antiapoptosis effects of crocin are induced via increasing expression of PI3K and pAkt.

Objective:To explore the infuence of calf spleen extractive injection combined with chemotherapy on immune function of the patients after colorectal carcinoma. Methods:Totally 128 cases of postoperative colorectal carcinoma patients were randomly di-vided into two groups with 64 ones in each. The control group only received FOLFOX 4 regimen, while the study group received calf spleen extractive injection additionally from the first day to the tenth day, 10ml, ivd, and 14-day was one cycle. After 4 weeks, im-mune function, peripheral blood leukocytes ( WBC) , hemoglobin ( Hb) and platelet ( Plt) in the two groups were compared, and the adverse reactions were evaluated as well. Results: After the treatment, CD3 +, CD4 +, CD8 + and CD4/CD8 were increased in the study groups, and those in the study group were much higher than those in the control group (P<0. 05). After the treatment, there were no significant changes in WBC, Plt and Hb in the two groups (P>0. 05), while WBC and Plt in the study group were higher than those in the control group (P<0. 05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0. 05). Conclusion:Calf spleen extractive injection combined with chemotherapy not only can increase the immune func-tion, but also alleviate myelosuppression and gastrointestinal toxicity in the treatment of postoperative colorectal carcinoma patients.

objective To construct the recombinant adenovirus containing p53 up-regulated modulator of apoptosis(Ad-PUMA)and investigate its growth inhibition effect on pancreatic callCer cells in vitro and in vivo.Methodls Ad-Easy system was used to construct Ad-PUMA by recombination in E.coli.The virus was Dackaged in 293 cells and subsequently identified valid.The AsPC-1 cells were infected with AdPUMA.Before and after Ad-PUMA infection,the expression of PUMA protein wag investigated by western blot,the inhibition rate of AsPC-1 cells was examined by MTY assay.The in vivo tumor suppressive effect was detected in nude mice with human AsPC-1 xenograft.PUMA protein and the apoptosis of AsPC-1 xenograft were detected by western blot and TUNEL(terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling)method.Results In vitro,the expression of PUMA protein was increased with titer of Ad-PUMA,the proliferation of AsPC.1 cells were suppressed,significantly,and the effect was in a viral dose-dependent nlanner.In vivo,the growth in nude mice of AsPC-1 infected with Ad-PUMA was significantly inhibited with an inhibition rate of 44.2%.The expression of PUMA was significantly up-regulated,and the apoptosis index wa8 significantiv increased in tumor after Ad-PUMA infection as determined by western blot and TUNEL.Conclusion The expression of PUMA call inhibit the proliferation of pancreatic cancer in vitro and in vivo,and may be used 88 a potential tool for cancer therapy