In order to study the status of cell apoptosis in psoriatic epidermis, we have investigated the changes of the lesions in various stages in patients with psoriasis vulgaris by using terminal deoxynueleotidyl transferase-mediation dUTP-biotin nick end labelling (TUNEL). The results showed that the highest frequency of apoptotic keratinocytes was observed in the early scaling papular lesions, and the frequency was reduced in the progressive maculo-papular lesions and the coalescent plaques successively. The frequency of hyperproliferation of epidermis was in the reverse order in comparison with the above results. These results suggest that increased apoptosis of keratinocytes is the initial change of psoriatic epidermis, then hyperproliferation of keratinoeytes follows.

Objective To analyze the prevalence of hypertension in coal mine male workers and its influencing factors. Methods A total of 1 772 coal mine male workers from a coal mining group were selected as research subjects using multi stage complex sampling method. The prevalence of hypertension and its influencing factors were analyzed. Results The prevalence of hypertension was 33.0%（585/1 772）. Logistic regression analysis of complex sampling showed that body mass index， family history of hypertension， alcohol-drinking， tea-drinking， and snoring were independent risk factors for hypertension（all P<0.05），after adjusting for the effects of other inclusion factors on the basis of age. The risk of hypertension in coal mine male workers was higher in those with overweight and obesity than in normal weight（all P<0.01），higher in those with family history of hypertension than in no history of hypertension（P<0.01），and higher in tea drinkers than in no tea drinkers （P<0.05）. The more the alcohol consumption and the higher the frequency of snoring，the higher the risk of hypertension（all P<0.01）. These factors have a dose-response relationship. Conclusion The body mass index，family history of hypertension，alcohol-drinking，tea-drinking and snoring can affect the prevalence of hypertension in coal mine male workers.

Objective To evaluate the diagnostic value of 18F-FDG PET-CT in looking for tumor primary lesion with multiple bone metastasis.Methods 84 patients with suspected bone metastases were detected by routine imaging (X -ray,CT,MRI)in our hospital from May 2012 to September 2014 were selected,18F -FDG PET/CT were used to find the primary lesion.The final diagnosis were confirmed by tissue pathology or by clinical imaging follow -up.The diagnostic sensitivity,specificity and accuracy on tumor bone metastasis of 18F -FDG PET/CT were recorded.Results In 84 patients,primary tumor was found in 49 cases,of which 46 cases (54.8%)confirmed pri-mary tumor by operation or pathology,the other 3 cases were false positive;35 patients were diagnosed as non meta-static bone tumor by PET/CT,in which 34 cases were finally confirmed as non metastatic bone tumor by pathology and follow -up;accuracy,sensitivity,specificity of 18F -FDG PET/CT were 54.8%(46 /84),93.9% (46 /49)and 95.2%(80 /84);18 cases of lung cancer,9 cases of prostate cancer,7 cases of breast cancer,5 cases of lymphoma, 4 cases of renal cell carcinoma,2 cases of liver cancer,1 cases of Uterine sarcoma were included in 46 primary tumors.Conclusion 18F -FDG PET/CT has a higher specificity,accuracy as well as higher detection rate in search of multiple bone metastases,thus it is beneficial to the clinical therapy.

Objective:To explore the distribution characteristics of respiratory pathogens in patients with community-acquired pneumonia in Lianyungang.Methods:A total of 612 patients admitted to the second people′s Hospital of Lianyungang City because of community-acquired pneumonia (CAP) in 2019 were selected as subjects. Sputum or pharyngeal swabs were collected to extract nucleic acids, and 13-fold nucleic acids of respiratory pathogens were detected by PCR capillary electrophoresis fragment analysis. SPSS statistical software and GraphPad5.0 statistical mapping software were used for statistical analysis.Results:The physical examination rate of respiratory pathogens in the adult group was 82.0% in winter, 48.4% in spring, 28.0% in autumn, 20.0% in summer, χ 2=38.473, P=0.000. The positive rate of nucleic acid detection was significantly different in different seasons, among which the physical examination rate of respiratory pathogens in winter was the highest. The physical examination rate of respiratory pathogens in the juvenile group was 86.0% in spring, 76.2% in winter, 71.3% in summer and 66.7% in autumn, χ 2=7.946, P=0.047 . The positive rate of nucleic acid detection was calculated according to gender grouping. The comparison of nucleic acid positive rate between adult group and juvenile group in different seasons: 86.0% vs 48.4% in spring, χ 2=19.436, P=0.000; 71.3% vs 20.0% in summer, χ 2=22.180, P=0.000; 66.7% vs 28.0% in autumn, χ 2=13.485, P=0.000; 76.2% vs 82.0% in winter, χ 2=0.758, P=0.384. Except in winter, the detection rate of nucleic acid of pathogens in the juvenile group was significantly higher than that in the adult group. Conclusions:The nucleic acid detection rate and etiological distribution characteristics of respiratory pathogens are different in patients with community-acquired pneumonia in different seasons and different age groups. 13 kinds of multiple detection methods of respiratory pathogens can provide favorable laboratory data support for the diagnosis and treatment of clinical CAP patients.

Objective To explore the effect of three surgical positions on needle-assisted thoracoscopic sympathicotomy. Methods Sixty patients undergoing needle-assisted thoracoscopic sympathicotomy were divided into lateral position group，Fowler position group，and modified Fowler position group. The position of the endotracheal tube，noninvasive blood pressure (NIBP) and heart rate were monitored before and after the body position was changed. Moreover，the exposure of surgical field,operation time and comfort degree of patients were recorded. Results The operations were completed successfully under the three positions. Modified Fowler position provided better surgical field and higher comfort degree of patients. Moreover,it was convenient for operative procedure and shortened the operation duration. Conclusion During the operation of needle-assisted thoracoscopic sympathicotomy,modified Fowler position can provide better surgical exposure,enhance comfort of patients,stabilize hemodynamics and shorten operation duration.

Objective To evaluate the efficacy of intravertebral augmentation which including transpedicular bone graft, transpediclebody augmenter and vertebroplasty in preventing the correction loss and implant failure of short-segment pedicle instrumentation for thoracolumbarfractures through meta-analysis. Methods Experimental studies (randomized controlled trails, non-randomized controlled trails)and observational studies (cohort studies, case control studies) related with application of posterior short-segment pedicle instrumentationwith intravertebral augmentation for thoracolumbar fractures were searched from Pubmed, EMBASE and CNKI according to the inclusionand exclusion criteria, and hand-searched in Chinese and English journals. RevMan 5.0.18 provided by Cochrane was used to analyse the data.Results 1 randomized controlled trail and 7 observational studies were included. There were 442 patients, in which 216 patients werewith and 226 patients without intravertebral augmentation. There was no significant difference in correction loss and risk of implant failurebetween these two groups. Conclusion Intravertebral augmentation does little about the risk of correction loss and implant failure associatedwith posterior short-segment pedicle instrumention for patients with thoraculumbar fractures.

Objective To explore the curative effect of fibular flap with limbs composite soft-tissue.Methods From February,2013 to February,2016,13 cases with body severe trauma patients were treated,which including 5 cases of upper limbs and 8 cases of lower limbs,and all existed bone defect,soft tissue defect and trunk vessel defect.Three cases with limbs distal non blood supply were emergency treated with debridment and flow-through fibular flap transplantation renovation,peroneal artery repairing defective blood vesscls to rcstorc limbs distal blood supply,fibular flap repairing bone defect,skin flap repairing soft tissue defect.The limb blood supply for other 10 cases were in good condition,but one case with main artery defect did the second phase of fibular flap transplantation and repaired defective blood vessels,bone and skin soft tissue synchronously according to wound condition.According to the postoperative observation for flap survival and appearance,X-ray films to observe fracture healing after 6 weeks,three months and 6 months of operation as well as evaluating limb function recovery,then analyzed the results.Results Flaps survived successfully for 11 cases,and flaps for the other 2 cases were partial necrosis.One Case was edge flap necrosis,heal scabby after dressing,and the other case was necrosis for 1/3 of the area,but the deep fascia survival,and the skin graft healing after dressing.One case with forearm rolling was in vascular crisis after operation,but tbe crisis was relieved after detection,and fingers blood supply was recovered.All the patients were followed up for 6 to 36 months(mean,14 months).All flaps were survived,fractures healed well and limbs distal blood supply was good.Bone healing time was 8 to 24 weeks,and patients with lower limbs injury could bear load after 3 to 8 months.Lower limbs restored walking function.Upper limbs and hands restored rotation function.Transplant flapshad good elasticity and satisfactory appearance.Conclusion Using fibular flap to repair defective blood vessels,bone and soft tissue synchronously,not only can rescue the limbs on the verge of amputation,but also can repair defective composite tissue and get a good prognosis.It is an effective method for open injuries severely treatment in clinic.

Objective To explore the effects of rehabilitation for adult cervical spinal cord injury without radiological abnormality. Methods 80 patients were studied retrospectively. Results The increase of motor score of anterior, posterior and conservative group were around 5, 2 and 2, whereas that of FIM were 11, 17 and 15, respectively. The changes of sensory score were uncertain.Conclusion The effect of surgical or conservative treatment is limited on neurological recovery, while rehabilitation can bring more functional independence to patients with cervical spinal cord injury without radiological abnormality.

Objective:To investigate the effects of triptolide (TPL) and BET protein inhibitor JQ1 on proliferation inhibition and apoptosis induction of MLL-rearranged acute myeloid leukemia (AML) cell line MV4-11, and to explore their synergistic mechanisms.Methods:MV4-11 cells in logarithmic growth phase were treated with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1, 4 nmol/L TPL or different concentrations of JQ1 combined with 4 nmol/L TPL for 48 h. Cell proliferation was detected by CCK-8 method, apoptosis was detected by flow cytometry (FCM), mitochondrial membrane potential was detected by JC-1 method, and expressions of mitochondrial apoptosis pathway-related proteins were detected by Western blot.Results:The 50% inhibitory concentration ( IC50) value of MV4-11 cells treated with JQ1 for 48 h was (283.9±10.7) nmol/L. However, 4 nmol/L TPL significantly enhanced the inhibitory effect of JQ1 on proliferation of MV4-11 cells, the IC50 value of MV4-11 cells treated with JQ1 combined with TPL was (148.1±2.6) nmol/L, and the difference was statistically significant ( t = 25.31, P = 0.029). The result of FCM assay showed that compared with the JQ1 alone group [(9.6±2.3)%, (12.6±1.4)%, (19.5±3.3)%, and (22.7±2.1)%], 4 nmol/L TPL combined with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1 acted on MV4-11 cells for 48 h, the proportions of apoptotic cells were (16.4±1.9)%, (27.5±2.1)%, (32.9±3.6)%, and (35.5±3.0)%, respectively, the difference was statistically significant ( F = 9.25, P < 0.01). After treated with 4 nmol/L TPL and JQ1 for 12 h, the level of cell membrane potential in MV4-11 cells was significantly lower than that of JQ1 single agent group, and the difference was statistically significant ( P < 0.05). After treated by 4 nmol/L TPL combined with JQ1 for 24 h, the levels of anti-apoptotic proteins bcl-2 and Mcl-1 decreased, and the level of pro-apoptotic protein bax increased. Conclusion:TPL can significantly enhance the proliferation inhibition and apoptosis induction effects of BET protein inhibitor JQ1 on MLL-rearranged AML cells, and the mechanism may be related to enhancing the mitochondrial apoptosis pathway.

Objective To investigate the protective mechanism of hypoxia-inducible factor-1α (HIF-1α) in vascular endothelial cells under hypoxia.Methods 1.After a hemorrhagic shock model was established in mice,the vascular endothelial cells were sorted in a shock group (n =3) and a sham operation group (n =3) for RNA-sequencing to analyze the main differential molecules.2.The expression of HIF-1α and glucose transporter-1 (GLUT1) was measured in human umbilical vein endothelial cells (HUVECs) and the mitochondrial membrane potentials were detected in a control group (normal culture,n =3) and a hypoxia group (hypoxia culture for 6 h,n =3).3.The HUVECs cells were transfected with HIF-1α siRNA for 48 h to interfere with HIF-1 α expression,and the control group(n =3) was transfected with control siRNA.The expression of HIF-1α was detected to determine the interference effect.The mRNA and protein expression of GLUT1 was detected in the interference and the control groups after 6 h of hypoxia culture.The mitochondrial membrane potential was detected by fluorescent probe method.Results 1.The transcriptome sequencing in the vascular endothelial cells in the shock and sham operation groups indicated 25 genes with significant differences.The HIF-1 α expression was significantly increased in the shock group (111.70 ± 15.97) than in the sham operation group (53.49 ± 3.26) (P =0.023).2.The expression of HIF-1 α and GLUT1 in the HUVECs cells was significantly increased in the hypoxia group compared with the control group (P ＜ 0.05).The mitochondrial membrane potential was significantly lower in the hypoxia group (0.781 ± 0.023) than in the control group (1.177 ± 0.062) (P ＜ 0.05),indicating aggravated injury.3.There was no significant difference in the mitochondrial membrane potential between the interference group (1.011 ± 0.076) and the control group (1.151 ± 0.031) (P ＞ 0.05).However,after hypoxia culture for 6 h,there was a significant difference in the mitochondrial membrane potential between the interference group (0.514 ± 0.018) and the control group (0.769 ± 0.044) (P ＜ 0.05),also indicating aggravated damage.Conclusions The expression of HIF-1 α may be significantly increased in hemorrhagic shock.In HUVECs under hypoxia,HIF-1 α may up-regulate the expression of GLUT1,promote glucose transport,improve mitochondrial damage and protect vascular endothelial cells.Thus,targeting HIF-1 α may contribute to the treatment of hemorrhagic shock.