Objective To study the role of CXC chemokine receptor 5 (CXCR5) in the pathogenesis of bullous pemphigoid (BP) by detecting the expression of CXCR5 on follicular helper T (Tfh) cells in skin lesions of BP.Methods An immunohistochemical procedure was used to detect CXCR5 expression in biopsy specimens from skin lesions of 16 patients with BP and normal skin of 10 healthy individuals.Results CXCR5 was mainly expressed in the cytoplasm and membrane of Tfh cells in the basal cell layer of normal skin as well as in both basal cell layer and prickle cell layer of BP lesions.The number of CXCR5-positive ceils per high power field (× 400) was 11.16 ± 4.47 in normal skin specimens,significantly lower than that in lesional skin specimens (35.70 ± 12.20,t =6.07,P ＜ 0.01).Conclusion CXCR5 may be involved in the pathogenesis of BP.

AIM:To investigate the effects of rhTGF-?1 and TGF-?1 gene transfection on the proliferation of cultured rabbit corneal endothelial cells in vitro.METHODS:Cell growth induced by various concentrations of rhTGF-?1 was determined by MTT proliferation assay.Under the induction of liposomes,recombinant pSecTag2-TGF-?1MP vectors were transferred into the corneal endothelial cells.Morphological changes of transfected cells were observed by HE staining.The expression levels of TGF-?1 were assessed by ELISA.Cell cycle analysis was assessed by flow cytometry.DNA fragment analysis was used to confirm the presence of apoptosis.RESULTS:rhTGF-?1 in concentrations of 5-20 ?g/L showed a significant suppressive effect on the proliferation of corneal endothelial cells,0.5-1 ?g/L had no effect,0.05-0.1 ?g/L facilitated cell growth,as compared with negative controls.The morphous of transfected corneal cells had no significant abnormality compared with normal cells.According to the result of ELISA,the concentration of TGF-?1 in the supernatant was calculated to be(98?3)ng/L.Flow cytometry assay showed that S and G2/M phase of transfected cells decreased significantly compared with that of control group,but the cell cycle recovered normally after adding 10 ?g/L EGF into the culture medium.Agarose electrophoresis didn't show marked ladders in transfected group.CONCLUSION:Effects of rhTGF-?1 on the proliferation of corneal endothelial cells are different with various concentrations.TGF-?1 gene transfection shows suppressive effect on the proliferation of cultured corneal endothelial cells,but does not induce cell apoptosis.EGF is the antagonist of this suppressive effect.

Objective To investigate the levels of serum AFP and CEA in healthy physical examination people and their sexual difference.Methods (1 )Healthy physical examination people were divided into the group A(510 males)and group B(477 fe-males);(2)these two groups were subdivided into the group A1 (<40 years old),A2 (40 - <50 years old),A3 (50 - <60 years old),A4(60-<70 years old)and A5 (70 -87 years old),and group B1 (<40 years old),B2(40 -<50 years old),B3 (50 -<60 years old),B4(60-<70 years old)and B5(70-87 years old).The serum AFP and CEA in 987 healthy physical examination peo-ple were measured by the electrochemiluminesence immunoassay,and then the detection results were compared among various groups.Results (1)The detection results of serum AFP and CEA had statistically significant differences between the group A and B (P <0.01);(2)there was no statistical differences among the group A and among the group B.Conclusion The serum AFP and CEA levels in healthy physical examination people in the local area have difference between males and females,which in males are significantly higher than those in females,indicating that the reference range of AFP and CEA should be repectively established ac-cording to different sexes;while the serum AFP and CEA levels have no differences among various age groups in males and fe-males.

Objective To explore the application effect of 3D printing technology applied in nursing teaching of neurosurgery.Methods A total of 76 nursing students who had internship in the neurosurgery of our hospital from July 2015 to March 2016 were randomly divided into the control group and the intervention group by computer random sequence,with 38 cases in each group. Traditional PPT instruction method was applied in the control group,while 3D printing technology was applied in the teaching of intervention group,and it was used to print the 3D models of patients′ skull,intracranial tumor,encephalic blood vessel,etc. Teaching effect of two groups was observed and compared by theoretical examination,self-evaluation and mutual evaluation between nursing students and teachers,and teaching effectiveness.Results The score of theoretical knowledge in the intervention group(90.05±0.74),was higher than that in the control group(82.08±1.04)(t=6.22,P<0.01). The total score of nursing examination in the intervention group was(92.95±0.41),which was higher than that in the control group(80.05±0.87)(t=13.29,P<0.01). Mutual evaluation satisfaction of nursing students and teachers in the intervention group were 92.1% and 97.4%,and they were higher than those in the control group which were 84.2% and 81.6%(P>0.05).Conclusions The application of 3D printing technology in nursing teaching of neurosurgery can effectively improve interns′ comprehensive ability in neurosurgery theoretical knowledge,enhance students′ learning enthusiasm and initiative,and raise the general level of interns.

Objective:To investigate the health status, health-related behaviors and health needs of elderlies in eastern, central and western China and to understand their health experience, for exploring an efficient medical service model, and optimizing allocation of medical resources.Methods:This study used the 2008-2018 database from Chinese longitudinal healthy longevity survey organized by Peking University. It described the concentration trend of medical distance by median, compared the health status, health-related behaviors and health needs of the elderly in eastern, central and western China by χ2 tests, and analyzed time-distribution trends of the poor health status, negative health behaviors and health needs by linear relation test. Results:Among 49 611 subjects included in the study, 7 881 of them self-evaluated their health status as poor, 19 445 evaluated their recent health status as deteriorated, while 14 954 lack routine physical examination, 35 141 lack physical exercise, 8 178 smoked, 7 859 drunk, 35 814 had no access to health education services in their communities, 35 676 expressed their health education needs, and 2 637 lack adequate medical services. The difference of distribution of health status, health-related behaviors and health needs of the elderly in eastern, central and western China was statistically significant ( P<0.05). The health status, negative health behaviors and health needs of the elderly in 2008-2018 presented a linear time distribution trend( P<0.05), while the overall medical distance in eastern, central and western China was 1.02 km, 1.00 km and 1.56 km respectively, and the medical distance in the rural area further than that in the urban areas. Conclusions:The health status of the elderly in China needed to be further improved, the proportion of negative health behaviors was high, and the health needs of the elderly in central and western China were large. Promoting an active medical service mode in central and western China, strengthening the interactions between medical institutions and residential communities will contribute to health needs fulfillment and medical resource utilization.

Objective:To explore the application of digital acoustic analysis in assessing the risk of aspiration among persons with dysphagia using the Praat speech analysis software.Methods:The swallowing of 46 stroke survivors with dysphagia was studied using video fluoroscopy. Each patient was required to pronounce " yi/i/" 3 times before and after taking each mouthful of food, and their voice samples were collected. The subjects were divided into a non-aspiration group of 16 and an aspiration group of 30 based on their penetration-aspiration scale scores. Fundamental frequency, relative average perturbation (RAP), jitter, shimmer, amplitude perturbation quotient and harmonic-to-noise ratio were compared between the two groups before and after taking food.Results:For the non-aspiration group, there was no significant difference in the acoustic data before and after eating. For the aspiration group there were significant differences in fundamental frequency, relative average perturbation and jitter before and after taking food. The average RAP and jitter of the non-aspiration group were significantly better than the aspiration group′s averages before eating. After eating, however, significant differences were observed only in average jitter.Conclusions:Analyzing perturbation and jitter can help to identify persons at risk of aspiration.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.