Objective To study the expression of tumor necrosis factor -α (TNF-a) and correlation with TNF-a in breast cancer. Methods We used SABC method to detect the expression of TNF-a in 112 cases of primary breast cancer, and analysis the relationship between TNF-α with histologic grades and ER. Results The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast (X2 =8.573, P =0.014). There was no significant correlation between histologic grades and TNF-α (X2 =1.304, P =0.521). TNF-a had a positive correlation with ER in breast cancer (X2=11.949, P =0.001). Conclusion The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast.TNF-α had a positive correlation with ER in breast cancer, but the exact mechanism is unclear.

Objective To determine the expression of Human Epidermal Growth Factor Receptor 2 (HER-2) in breast cancer and its correlation with Tumor Necrosis Factor-α (TNF-α). Methods We used SABC method to detect the expression of HER-2 and TNF-α in 112 cases of primary breast cancer, and analyzed the association of HER-2 expression with clinicopathological features and TNF-α expression. Results The positive expression rate of HER-2 in breast cancer was 35.71% (40/112), of which, the expression rate was 35.05% (34/97) in 97 invasive tubic breast cancer, and 33.33% (2/6) in invasive lobular breast cancer,25.00% (1/4) in mucinous carcinoma, and 50. 00% (2/4) in intraductal carcinoma. There was no significant correlation between HER-2 and any clinicopathological features of primary breast cancer ( P ＞ 0. 05 ). The expression of HER-2 in breast cancer had no signiciant association with TNM stage, age, age of menarche,menopause, gravidity, parity and family history of cancer ( Ps ＞ 0. 05 ), The positive rate of TNF-α was 23.61% (17/72) when HER-2 was negative, whereas the positive rate of TNF-α was 52. 50% (21/40) when HER-2 was positive. The expression of HER-2 was signiciantly positively correlated with the expression of TNF-α (r = 0. 881, P ＜ 0. 05 ). Conclusion HER-2 expression had a positive correlation with TNF-α in breast cancer,but the specific mechanism is still unclear.

Objective To evaluate the effect of duodenal shunt procedures for the treatment of cholangitis caused by peripapi llary duodenal diverticulum. Methods Three types of shunt procedure were adopted i.e. Roux-en-Y gastrojejunost omy (14 cases), Billroth-Ⅱ operation (24 cases), duodenojejunostomy (4 cases). Results There was no severe co mplication nor recurrent cholangitis postoperatively in 42 patients at a follow up of 1～10 years. Four patients suffering from moderate delayed empting wer e relieved by conservative measures.Conclusion Duodenal shunt procedures are effective for the treatment of ch olangitis caused by peripapillary duodenal diverticulam.

Objective:To establish a predictive model of acute physiological and chronic health status score (APACHEⅡ) and the British Thoracic Society modified pneumonia score (CURB-65) score on the prognosis of patients with emergency severe pneumonia complicated with acute respiratory distress syndrome (ARDS) and to evaluate the predictive effect.Methods:The relevant clinical data of patients with severe pneumonia combined with ARDS admitted to the Emergency Intensive Care Unit (EICU) of General Hospital of Ningxia Medical University from January 2017 to December 2021 were retrospectively collected, and different logistic regression models were established. On this basis, three prediction models (model 1: APACHE Ⅱ score, model 2: CURB-65 score, Model 3: APACHE Ⅱ score combined with CURB-65 score) were established and the accuracy of the prediction model was evaluated by repeating 50 times of 10-fold cross-validations. The efficacy of the prediction model was evaluated by C statistics, Kendall's tau-a rank correlation coefficient, R2, Brier score, calibration curve, net reclassification index (NRI), composite discriminant improvement index (IDI) and decision curve (DCA).Results:The study eventually included 108 patients, including 81 males and 27 females, with mean age (57.92 ± 16.56) years. Forty-eight patients survived and 60 patients died. The age of the death group was older, and APACHEⅡ score and CURB-65 score of the death group were all greater than those in the survival group, and the differences were statistically significant ( P<0.05). Different logistic regression models showed that the OR value of model 1 was 1.12 (95% CI: 1.06 -1.20), that of model 2 was 2.21 (95% CI: 1.43 - 3.40), and that of model 3 was 1.10 (95% CI: 1.03 - 1.18) and 1.95 (95% CI: 1.24 - 3.07). The average accuracy of model 1, model 2, and model 3 were 0.68±0.14, 0.66±0.11, and 0.72±0.13, respectively. The C statistic, Kendall's Tau-a rank correlation coefficient, R2 and Bril score of model 3 were better than those of model 1 and model 2, and the different models fit well ( P<0.05). The calibration curve results of 500 resampling showed that the calibration degree of model 2 was better than that of model 1 and model 3, and the predictive ability of model 3 was improved compared with model 1, and the IDI was increased by 0.08 ( P<0.01). Compared with model 2, the reclassification ability of cases and the comprehensive discrimination ability of model 3 were improved ( P<0.01). The decision curves of different models showed that the net benefit of model 3 was higher than that of single model 1 and model 2 when the prediction probability was about 25% to 55%, while the benefits of model 1, model 2 and model 3 in other probability prediction intervals were basically equal. Conclusions:Both APACHE Ⅱ score and CURB-65 score have certain predictive power for prognosis of patients with emergency severe pneumonia and ARDS, and their combination has the best prediction effect. CURB-65 score has fewer parameters, and its prognostic benefit in emergency patients with severe pneumonia complicated with ARDS is basically equivalent to APACHE Ⅱ score, which may be more suitable for the prognosis evaluation of emergency patients with severe pneumonia complicated with ARDS.

Objective To explore the application value of IL-8 monoclonal antibody microbubble combined with ultrsound targeted microbubble destruction ( UTMD) on alleviating myocardial ischemia reperfusion/injury ( MIRI) in rabbits .Methods Forty-two rabbits were randomly divided into closed chest group ( n =7) ,open chest control group ( n = 7) and ischemia-reperfusion ( I/R) group ( n = 28) .I/R group were randomly divided into 30 min reperfusion group( n =7) ,60 min reperfusion group( n =7) ,120 min reperfusion group ( n = 7 ) and 180 min reperfusion group ( n = 7 ) .All rabbits were examined by electrocardiogram , echocardiography and HE staining after MIRI . Targeted myocardial contrast echocardiography ( MCE) was performed and ELISA was used to detect IL-8 content in rabbit myocardium before and after UTMD . Results Electrocardiogram and wall motion returned to normal at 60 min after reperfusion .Targeted MCE showed that with the prolongation of reperfusion after I/R ,the video intensity of myocardium in reperfusion area increased gradually , reaching its peak at 120 min and 180 min after reperfusion .After UTMD ,the video intensity decreased ,and the change rate of video intensity in 30 min reperfusion group was higher than those in other reperfusion groups(all P<0 .05) .The content of IL-8 and its neutralization rate in the ELISA results were consistent with the video intensity and rate of change of targeted MCE .HE staining and scanning electron microscopy showed that myocardial injury was found in I/R group .With the prolongation of reperfusion time ,the degree of myocardial injury was gradually aggravated ,and the injury was alleviated after irradiation .Conclusions IL-8 monoclonal antibody combined with UTMD has the advantages of non-invasive and highly effective in alleviating MIRI .It provides a new way to treat MIRI .

Objective To explore the value of real-time shear wave elastography in evaluating gastrocnemius muscle elasticity in patients with lumbar disc herniation.Methods One hundred patients with clinically diagnosed unilateral lumbar disc herniation were selected.Selective nerve root block combined with ozone ablation and pulsed radiofrequency therapy via the lateral crypt was performed.The real-time shear wave elastography was applied to detect the mean elastic modulus (Mean) and the maximum elastic modulus (Max) of bilateral tense gastrocnemius muslcs (kPa) before and after treatment.Statistical analysis was done.Results The EMean and EMax values of ipsilateral tension in gastrocnemius muscle before treatment were (11.28±2.60)kPa and (15.26±2.63)kPa,lower than those of contralateral (EMean:[16.284-5.25]kPa,EMax:[21.13±6.62]kPa;t=78.241,64.634,both P＜0.001).The EMean and EMax values of ipsilateral tension in gastrocnemius muscle after treatment were (13.18±2.38)kPa and (17.63± 2.73)kPa,higher than those before treatment (t=6.407,14.815,both P＜0.001).In different strength condition,EMean and EMax of gastrocnemius muscle before and after treatment were statistically significant (all P＜0.001).With the myodynamia increasing,EMean and EMax also increased before and after treatment.The differences between patients with any two different myodynamia were statistically different (all P＜0.05).Conclusion The muscle tissue recovery can be evaluated quantitatively by detecting EMean and EMax of tense gastrocnemius in patients with lumbar disc herniation using real-time shear wave elastography before and after treatment.

Objective:To explore the evaluation value of sequential organ failure assessment (SOFA) score at different time points in the prognosis of patients with severe pneumonia combined with acute respiratory distress syndrome (ARDS).Methods:A retrospective cohort study method was conducted, including patients with severe pneumonia and ARDS admitted to the emergency intensive care unit (ICU) of General Hospital of Ningxia Medical University from January 2015 to December 2019. General clinical data such as gender, age, and the SOFA scores at 1, 2, 3, and 7 days after admission were recorded. According to the diagnostic test, the prognostic evaluation value of SOFA score in patients with severe pneumonia combined with ARDS at different time points and different ages was analyzed.Results:A total of 88 cases were included in this study, eventually, 42 cases were survived and 46 cases died, the mortality was 52.27%. The age of the death group was significantly older than the survival group (years old: 60.67±14.66 vs. 51.91±15.97), the SOFA score at each time point were significantly higher than those in the survival group (9.83±3.50 vs. 7.54±2.67, 9.98±3.75 vs. 7.48±2.92, 10.84±4.14 vs. 7.23±2.94, 11.71±4.03 vs. 6.51±3.22, respectively at 1, 2, 3, 7 days after admission, all P < 0.01). The receiver operator characteristic curve (ROC curve) showed that the SOFA score at 1, 2, 3, and 7 days after admission had a certain predictive value for the prognosis of patients with severe pneumonia combined with ARDS (all P < 0.01), and with the prolong of ICU stay, the area under ROC curve (AUC) of SOFA score had gradually increased. On the 7th day after admission, the SOFA score had the highest sensitivity in predicting severe pneumonia combined with ARDS patients, which was 92.86%, and the specificity was the highest on the 3rd day after admission, which was 88.10%. The AUC in day 7 was significantly higher than day 2 (0.85 vs. 0.72) , there was no statistically significant difference of AUC at other time points. After stratifying by age, the diagnostic of sensitivity, specificity, accuracy, and AUC of SOFA score for the prognosis had gradually increased, and the predictive value was better. However, only on day 3 after admission, the AUC of SOFA score was significantly higher than day 1 (0.80 vs. 0.77, P < 0.05), and there was no significant difference in AUC at other time points. In patients older than 60 years old, the AUC of the SOFA score predicting the prognosis of patients was relatively small on day 1 and day 2 (0.67, 0.68, respectively), the ability was poor. There was no statistically significant difference in the AUC of SOFA scores at each time point in evaluating the prognosis of patients. The trends over time of patients at different ages and time points showed that regardless of age, the SOFA scores of the patients in the death group showed an upward trend, while showed a downward trend in the survival group, the difference reached the largest on the 7th day after admission, and the death group was significantly higher than the survival group (age < 60 years old: 12.50 vs. 6.69; age≥60 years old: 11.58 vs. 6.21). Conclusion:The initial SOFA score has a certain value in the evaluation of prognosis of severe pneumonia patients combined with ARDS, but the effect is poor for elderly patients.

Background:There is no comparison of the current status of Helicobacter pylori(Hp)infection in different ethnic groups in terms of families and their individuals.Aims:To investigated for the first time the status of Hp infection in Tibetan and Han Chinese families at the household level.Methods:A questionnaire was used to investigate factors associated with Hp in 50 Tibetan families in Ya'an,Sichuan Province,and 50 Han Chinese families in Chongqing Municipality.13C-urea breath test was used to detect Hp infection.Results:The individual and household Hp positivity rates of the Tibetan population in southwest China were 47.10%and 80%,which were significantly higher than those of the Han Chinese,which were 27.81%and 58%(P<0.05).However,the difference between Han and Tibetan in individual and household infection rates was not statistically significant.There are differences between Han Chinese and Tibetans in terms of infection status,geography,economic conditions,living habits and levels of hygiene.Infection was concentrated in certain family groups rather than being evenly distributed in the population.Conclusions:The current detection rate of Hp infection in individuals and families of Tibetan residents is significantly higher than that of Han Chinese,while the proportion of infected individuals is not statistically different.Transmission of Hp is characterized by family aggregation.There are differences in infection status,geographical environment,economic conditions,living habits and hygiene levels between Chinese and Tibetan families.

By analyzing the main problems existing in the current management of medical devices for clinical trials, this study proposes a feasible management model and specific requirements for acceptance, distribution, storage and recovery combining with the characteristics of medical consumable equipment and diagnostic reagent, which provides a favorable guarantee for the authenticity and reliability of clinical trials.
Clinical Trials as Topic ; Equipment and Supplies/standards* ; Indicators and Reagents/standards* ; Reproducibility of Results ; Research Design/standards*