Objective The gastrointestinal tract of neonate becomes colonized with microorganisms from environment and mother immediately after birth. Strong evidences suggested that early composition of the microflora in neonates play an important role for postnatal development of the immune system. This study was designed to investigate the effect of mode of delivery on the development of gut microflora and characteristics of the stool in breast-fed infants by molecular biology methods. Methods Sixty healthy breast-fed term infants were enrolled in the study(including vaginal delivery group and cesarean section delivery group,each group included 30 infants). Anthropometric measurements and stool study were done at 6-week,8-week,10-week,and 12-week. Fecal samples were subjected to quantitative fluorescence real-time polymerse chain reaction assays for the enumeration of lactobacili,bifidobacteria,and subtype of bifidobacteria(bifidobacterium longum and bifidobacterium breve). Results The numbers of lactobacilli and bifidobacterium longum species were less in cesarean delivery group than those in vaginal delivery group(P ＜ 0.05). Stool mean pH was lower in vaginal delivery group than that in cesarean section delivery group(P ＜ 0.05). There were no differences in stool characteristics and growth between two groups. Conclusions Cesarean section is associated with the decrease of bifidobacteria and lactobacilli in breast-fed term infants.

Objective To evaluate the feasibility,safety,and efficacy of endovascular repair combined with second-stage surgical debridement for ruptured femoral pseudoaneurysms (RFP).Methods All patients who underwent emergency repair of an RFP in our institution between 2009 and 2013 were identified.Case notes were retrieved for clinical data.Results Seven patients were identified.All the patients were treated with emergent percutaneous stent-graft implantation and secondary surgical debridement.The procedure time was (55 ± 6.32) min,blood loss was (93.33 ± 25.03) ml,hospital stay was (9.5 ± 0.84) d,and no postoperative complications occurred.Conclusions stent graft implantation for the treatment of RFPs is safe and effective in short-or middle-term outcome.It is an alternative for RFPs and may be the better option,which makes the secondary surgical debridement feasible and viable.

Objective To investigate the changes and the role of plasma thrombomodulin(TM),von willebrand factor (vWF) ,and coagulation status indicators in children with Henoch-Schonlein purpura(HSP).Methods The plasma concentrations of TM,vWF were measured by ELISA method and the levels of D-dimer,PT,APTT,palatelet count were measured in 56 acute SHP patients,50 recovery patients and 40 healthy controls. Results The plasma levels of TM、vWF、D-dimer、palatelet count in acute group were significantly higher than those in healthy controls group and those of recovery group ( P = 0. 000). The plasma levels of PT、APTT showed no significant difference among three groups( P ＞ 0. 05 ). The plasma levels of TM、vWF in recovery group were significantly higher than those in healthy controls group ( P ＜ 0. 05, P ＜ 0. 01 ), while the levels of D-dimer、palatelet count reduced to nomal levels(P ＞0. 05). As compared to non-renal damage group, The plasma levels of TM、vWF、 D-dimer were higher in renal damage group ( P ＜ 0. 05, P ＜ 0. 01 ), the levels of PT 、APTT、palatelet count showed no significant difference ( P ＞ 0. 05 ). Conclusion The damage of vascular endothelium and hypercoagulability play an important role in the pathogenesis of HSP. Changes of plasma TM、 vWF、palatelet count can be used as an indicator of the early lesion of renal function.

Objective:To explore a medical big data algorithm to screen the core indicators in clinical database that can be used to evaluate the prognosis of elderly patients with pneumonia.Methods:Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis.Results:A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators ( n = 7), blood gas indicators ( n = 3), tumor markers indicators ( n = 3),coagulation related indicators ( n = 4), and nutrition and organ function indicators ( n = 6). ① The key indicators of blood gas in patients died of pneumonia: Cl - was 97-111 mmol/L in 51.6% (33 cases) of patients, lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H + was 0-46 mmol/L in 87.5% (56 cases) of patients. ② The key indicators of blood routine of patients died of pneumonia: hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×10 12/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×10 9/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. ③ The key indicators of tumor markers in patients died of pneumonia: 76.6% (49 cases) of patients had negative free prostate specific antigen/total prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 μg/L, and 75.0% (48 cases) had carbohydrate antigen 125 (CA125) between 0-104 kU/L.④ The key coagulation indexes of patients died of pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had adenosine diphosphate (ADP) inhibition rate of 0%-53%. ⑤ Nutrition and organ function key indicatorsin patients died of pneumonia: 92.2% (59 cases) of brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with uric acid (UA) for 21-41 μmol/L, 75.0% (48 cases) of the patients with albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had albumin/globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with lactate dehydrogenase (LDH) from 0-6.68 μmol/L·s -1·L -1. ⑥ Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with pneumonia. Conclusion:By using big data technology, 23 core indicators for evaluating the prognosis of elderly patients with pneumonia can be screened from the clinical database of emergency ward, which provides a new perspective and method for clinical evaluation of the prognosis of elderly patients with pneumonia.

Objective To investigate the regeneration and differentiation of HOCs in the 2-AAF/PHx rat models. To explore the expression of Cyr61and its mechanism in differentiation of HOCs in vitro. Methods In 2-AAF/PHx rats model,induction and expansion of HOCs were detected by immunochemistry and HE staining. West-ern blot was used for observing the expression of Cyr61. Furthermore,the expression of Cyr61 andβ-catenin were detected by Western blot in differentiation of WB-F344 cells in vitro. Results Cyr61 protein level increased as a re-sult of HOCs in rats livers after 2-AAF/PHx. In addition,the expression of Cyr61 and β-catenin significantly in-creased during WB-F344 cells differentiation in vitro. Conclusions Cyr61 might play an important role as a signal-ing mediator in HOCs response and closely correlate with Cyr61 andβ-catenin in proliferation and differentiation of HOCs.

Objective To evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Objective To investigate the chondrogenic feasibility of the human umbilical cord derived mesenchymal stem cells (hUCMSCs)as cartilage tissue engineering seed cells ,type Ⅱ collagen composite glycosaminoglycan scaffold as the cellular carrier and cell‐scaffold complex .Methods The type Ⅱ collagen composite glycosaminoglycan scaffolds was prepared .The pore diameter , porosity and hydrophilia of scaffold materials were observed and measured by electronic microscope .The corresponding histological analysis on the scaffold materials was performed .hUCMSCs of P3 generation were cultured and identified .The hUCMSCs suspen‐sion was inoculated in the type Ⅱ collagen composite glycosaminoglycan scaffold for conducting culture without adding inducer .The samples were taken out after 3 weeks and performed the toluidine blue and safranin O staining ,type Ⅱ collagen immunohistochemi‐cal staining and SEM scanning .Results hUCMSCs of P3 generation highly expressed the mesenchymal cell marker CD29 and CD105 ,while hardly expressed endothelial cells of CD34 and hematopoietic cell markers .The type Ⅱ collagen composite glycosami‐noglycan scaffold presented white porous foam like ,the porosity was (91 .8 ± 2 .17)% ,the average pore diameter was 110‐230 μm , which was homogeneously distributed and had interpenetration .The scaffold showed good hydrophilicity with the water absorption expansion rate of (213 .71 ± 1 .31)% .The scaffold staining of toluidine blue ,safranin O and type Ⅱ collagen was positive .The car‐tilage‐like tissues were observed ,and gradually increased in the surface of cell‐scaffold complex along with culture ,which were posi‐tive in Toluidine blue ,safranin O and type Ⅱ collagen staining ,the electronic microscopic observation displayed that the cells were actively proliferated in the scaffold ,closely adhered with the materials ,the cartilage‐like cells and a large number of peripheral colla‐gen fibers with zigzag connection could be seen .Conclusion Compositing hUCMSCs and type Ⅱ collagen composite glycosamin‐oglycan scaffold could construct tissue‐engineering cartilage in vitro without induction ,which lays a certain experimental foundation for the repair of cartilage damage .

Objective:To evaluate the clinical value of the frozen section assessment of surgical margin in preserving urinary continence and erectile function during robotic radical prostatectomy (RARP).Methods:From Feb. 2022 to Jul 2023, 11 patients underwent RARP using intrafascial dissection technique and frozen section assessment in Beijing United Family Hospital. The median age was 64(61, 69)years, the median PSA was 8.0(6.0, 11.2)ng/ml, and the median IIEF-5 was 17.5(10.3, 22.0). All the patients were diagnosed with prostate cancer and PSMA-PET/CT showed negative for metastasis. The da Vinci Si platform, 4-arm, transabdominal anterior approach was applied in all cases. The prostate specimen was removed from the umbilical incision and submitted to the pathology department for frozen section assessment. If the frozen section assessment showed cancer in the surgical margin, a secondary resection of the ipsilateral periprostatic fascia and neurovascular bundle (NVB) was performed. Totally, 3 cases underwent secondary resection, who underwent unilateral NVB-sparing, and the other 8 cases underwent bilateral NVB-sparing surgery. In follow-up, the PSA, urinary continence and erectile function was assessed and recorded.Results:All the surgeries of 11 cases were successful, without convertion to open surgery. The median operation time was 260(225, 285)minutes, the median blood loss was 200(100, 300)ml, the median hospital stay was 4(3, 5)days. There was no over Clavien Dindo Ⅱ perioperative complications.The median catheter indwelling time was 12(10, 14) days, with 10 cases achieving full continence upon catheter removal. The median follow-up time was 10 months. The median PSA level at 3 months, 6 months and 9 months postoperatively was 0.017(0.006, 0.170)ng/ml, 0.015(0.006, 0.390)ng/ml, and 0.007(0.006, 0.650)ng/ml respectively. The median IIEF-5 at 3 months, 6 months and 9 months postoperatively was 0.017(0.006, 0.170)ng/ml, 0.015(0.006, 0.390)ng/ml, 0.007(0.006, 0.650)ng/ml respectively.The median IIEF-5 at 3 months, 6 months and 9 months post-operation was 5.0(4.5, 11.0), 7.5(4.3, 17.5), and 9.5(6.0, 17.5)respectively.Conclusions:The RARP combined with frozen section assessment of surgical margin has excellent safety profile and can achieve favorable clinical value in tumor control, NVB preserving, urinary continence and erectile function.

This study was aimed to investigate the effects of Si-Wu mixture on the secretion of E2 and the expression of CYP19al gene in granulosa cells after cell injury.Ovarian granulosa cells of SD rats were treated with cisplatin (CDDP).And the expression levels of E2 and CYP19a1 were determined by different testing methods.The results showed that the level of E2 induced by radioimmunoassay of the Si-Wu group was significantly higher than that of the CDDP group.Meanwhile,the group which added TGF-β3 protein pathway blocker was lower than others.The results of immunohistochemistry and western blotting showed that the expression level of CYP 19a1 of the Si-Wu group was higher than that of the CDDP group.In the western blotting,the group which added blocker was significantly lower than the non-blocking group.It was concluded that the pharmacological serum of Si-Wu mixture can enhance the level of E2 in CDDP cells through TGF-β3 protein pathway.And the effect is accomplished by the intervention of CYP 19a1.

Objective To investigate the efficacy of radiotherapy,as well as the prognostic factors of survival in patients with extracranial oligometastases. Methods A total of 164 patients who underwent intensity-modulated radiotherapy ( IMRT ) of the extracranial oligometastases, from January 2013 to December 2016, were enrolled in the study. The short-term efficacy, local control rate, overall survival, progression free survival and adverse effects of treatment were observed. Results Short-term efficacy was assessed within the first 1-3 months after the end of radiotherapy. The objective response rate (CR+PR) was 78. 7% and the short-term efficacy is mainly related to the T stage of primary tumor ( P＝0. 004).Until the last follow-up,all patients with 1-,2-and 3-year LC were 89. 8%,82. 5% and 74. 9% respectively.Univariate analysis showed that the influencing factors of LC include tumor size and gross tumor volume dose ( all P＜0. 05),multivariate analysis found no significant influence factors. The 1-,2- and 3-year OS were 83. 4%, 69. 6% and 54. 6% respectively. Univariate and multivariate analysis showed that the primary tumor sources, metastasis organs,whether synchronous or adjuvant chemotherapy and short-term efficacy were independent prognostic factors in patients of OS ( P＜0. 05 ).Main toxicity-associated events were grade 1-2 acute reactions,with only 6 patients experiencing grade 3 toxicity;no grade≥4 toxic reactions or treatment-related deaths occurred. Conclusions Radiation therapy for the treatment of extracranial oligometastases can achieve good curative effect,is well-tolerated and has low toxicity.