Objective:To investigate whether celastrol can increase the cytotoxic activity of γδ T cells against osteosarcoma (OS) cells line HOS through TRAIL way. Methods:The death receptors 4/5 (DR4/5) protein levels in the OS cell lines HOS was in-vestigated by Western blot analysis. Zoledronate ( ZOL) was used to induceγδT cells from PBMCs of healthy volunteers.γδT cell cy-totoxicity against HOS cells was investigated by a standard lactate dehydrogenase release assay ( LDH ) . Results:Celastrol increased DR4/5 protein expression in HOS ( P<0. 05 ) .γδ T cells from PBMCs of healthy volunteers showed cytotoxicity against HOS ( P<0. 05). Following co-culture with HOS pre-treated with celastrol (1 μmol/L) for 24 h,γδ T cells showed significantly higher cytotoxicity against HOS (P<0. 05). The induction of DR4/5 molecules increased lysis of HOS by γδ T cells which was abolished by addition of a blocking TRAIL antibody. Conclusion:Celastrol can enhance γδ T cells'cytotoxic activity against OS cells line HOS through TRAIL way.

To analyze the risk factors for peri-operative mortality in patients with total anomalous pulmonary venous connection (TAPVC). Methods: A total of 563 TAPVD patients including atrial septal defect, ventricular septal defect and patent ductus arteriosus treated in our hospital from 1996-10 to 2012-12 were retrospectively investigated. There were 219 (38.9%) male, the mean age of patients was (4.6±9.0) years and the mean body weight was (13.2±14.6) kg. The patients were divided into 2 groups: Death group, n=34 and Survival group, n=529. Risk factors for peri-operative mortality were studied by single and multi Logistic regression analysis. Results: The overall peri-operative mortality was 6.0% (34/563). Compared with Survival group, Death group had more patients≤1 year of age (P=0.008), the higher ratio of elective surgery (P=0.002), the longer cardiopulmonary bypass time (P=0.000) and longer aorta clamping time (P=0.001). Multi Logistic regression analysis presented that the age≤1 year was the independent risk factor for TAPVC peri-operative death (OR=3.802, P=0.013) and elective surgery was the protective factor for TAPVC peri-operative death (OR=0.234, P=0.027). Conclusion: The patient's age≤1 year was the independent risk factor for TAPVC peri-operative death, while elective surgery was the protective factor for TAPVC peri-operative death.

BACKGROUND:Titanium artificial cervical disc has good biocompatibility, but titanium al oy is shown to have poor biological activity, low bonding strength, easy release of metal ions under physiological conditions.
OBJECTIVE:To observe the effects of different coating for the titanium plate of domestic cervical artificial disc on adhesion and differentiation ability of rat bone marrow mesenchymal stem cel s.
METHODS:Passage 3 bone marrow mesenchymal stem cel s from Wistar rats were seeded into 24-wel titanium plates with hydroxyapatite coating, titanium powder+hydroxyapatite coating and bare titanium plate. Cel culture was terminated after 24 and 48 hours, and the cel growth was observed under scanning electron microscope. After 24 hours of inoculation, osteogenic inducer was added;then, cel supernatant was col ected at 3, 5, 7 days after cel lysis and centrifugation to detect the activity of alkaline phosphatase.
RESULTS AND CONCLUSION:After composite culture with titanium plates with hydroxyapatite coating or
titanium powder+hydroxyapatite coating, cultured cel s were in polygonal shape, and pseudopodia were extended into the micropores that were adhered closely to the material surface. Cel s cultured with bare titanium plates had poor differentiation and adhesion rate. With time, the expression of alkaline phosphatase was increased in each group, especial y in the groups of titanium plates with hydroxyapatite coating and titanium powder+hydroxyapatite coating (P<0.05). These findings indicate that titanium plates with hydroxyapatite coating or titanium powder+hydroxyapatite coating can promote adhesion and differentiation of rat bone marrow mesenchymal stem cel s.

Objective To investigate the long-term anticoagulation starus and relation of INR and complica-tion,best anticoagulation range and clinical significance in patients after mechanical heart valve replacement. Meth-ods The data of blood clotting test series(containing PT,PT% ,PTR,INR,Fbg,APTT) for patients after 6 months of mechanical heart valve replacement were collected, then the cases were divided into 4 groups according to their INR levels( group Ⅰ : INR < 1.5; group Ⅱ : INR 1.5 ～ 2.0 ; group Ⅲ : INR 2.1 ～ 2.5 ; group Ⅳ : INR > 2.5 ). Results Group Ⅰ contained 28 person-times, with their dosage of warfarin for (3.61 ± 1.44 ) mg, INR 1.38 ± 0. 12, core-bral embolism occurred for 4 person-times,with a inception rate of 14%. Group Ⅱ contained 92 person-times,with their dosage of warfarin for (3.5±1.37)mg,INR 1.65±0. 14,hemorrhinia occurred for 2 person-times,with a in-ception rate of 2%. Group Ⅲ contained 80 person-times, with their dosage of warfarin for (3.18±1.63 )mg, INR 2.23±0.19 ,bematuria occurred for 2 person-times, bemorrhinia occurred for 2 person-times, with a total inception rate of 5% ; Group Ⅳ contained 16 person-times, with their dosage of warfarin for ( 2.32 ± 1. 23 ) mg, INR 2.80± 0.19, hemorrhinia occurred for 2 person-times and hemoptysis occurred for 1 person-times, with a total inception rate of 18.7%. The person-times in group Ⅱ and Ⅲ accounted for 79.6% and the complication rate was the lowest when INR was between 1.5-2.5. Conclusions INR levels between 1.5-2.5 is the most secure, which is the best antico-agu]ation range in our region. Since the anticoagulation strength dynamically changes, the long-term anticoagulation status in patients after mechanical heart valve replacement should be deeply concerned.

Objective To investigate the effects of esophagogastric intramural anastomosis on preventing reflux esophagitis by restoring the cardiac function after esophagectomy.Methods The clinical data of 66 esophagem or cardiac cancer patients(test group)who received esophagogastrie intramural anastomosis at Second Affiliated Hospital of Xi'an Jiaotong University from January 2002 to October 2008 were retrospectively analyzed.Sixty-five patients who received stapled anastomosis during the same period were in control group.Postoperative conditions of patients in the 2 groups were compared by chi-square test and t test.Results (1)Reflux condition:there were 3 patients with degree I and 63 without reflux in test group,and 23 with degree Ⅰ,19 with degree Ⅱ,7 with degree Ⅲ and 16 without reflux in control group.There was a significant difference between the 2 groups(X~2=137.3,P<0.05);(2)results of barium meal fluoroscopy:12 patients in test group and 41 patients in control group had barium reflux,with significant difference between the 2 groups(X~2=27.4,P<0.05);(3)results of gastroscopy:9 patients in test group and 46 patients in control group had morphological changes of mucosa,with significant difference between the 2 groups(X~2=43.5,P<0.05);(4)esophageal sphincter pressure:the pressure of lower esophageal sphincter was(3.4±0.8)kPa in test group and(2.5±0.6)kPa in control group,and the pressure of upper esophageal sphincter wag(7.4±1.7)kPa in test group and(4.2±0.8)kPa in control group.There was a significant difference in esophageal sphincter pressure between the 2 groups(t=4.98,11.59,P<0.05).Conclusion Esophagogastric intramural anastomosis can partly restore the cardiac function and prevent reflux esophagitis effectively.

Objective To investigate the feasibility of surgical intervention on treatment of patients with non-small cell lung cancer (NSCLC)in icotinib hydrochloride targeted treatment. Methods Clinical materials of 6 patients given surgical intervention after icotinib hydrochloride tar-geted therapy were retrospectively analyzed.Results Among 6 patients,1 patient had left total pneumonectomy,3 patients had pulmonary lobectomy,2 patients had local excision.After opera-tion,number of patients with chemotherapy,targeted therapy and observation only was 2,3 and 1 case respectively.Conclusion Well-designed and active surgical intervention may be feasible for patient during icotinib hydrochloride targeted therapy.

Objective To investigate the feasibility of surgical intervention on treatment of patients with non-small cell lung cancer (NSCLC)in icotinib hydrochloride targeted treatment. Methods Clinical materials of 6 patients given surgical intervention after icotinib hydrochloride tar-geted therapy were retrospectively analyzed.Results Among 6 patients,1 patient had left total pneumonectomy,3 patients had pulmonary lobectomy,2 patients had local excision.After opera-tion,number of patients with chemotherapy,targeted therapy and observation only was 2,3 and 1 case respectively.Conclusion Well-designed and active surgical intervention may be feasible for patient during icotinib hydrochloride targeted therapy.

Objective:To investigate the diagnostic performance of continuous-time random-walk (CTRW) diffusion model combined with vesical imaging-reporting and data system (VI-RADS) in the diagnosis of muscle invasion of bladder cancer.Methods:In this case-control study, 64 patients with pathologically confirmed bladder urothelial carcinoma in Peking University First Hospital were retrospectively enrolled from August 2022 to March 2023. The patients were divided into the muscle invasive bladder cancer (MIBC) group and the nonmuscle invasive bladder cancer (NMIBC) group (29 cases and 35 cases, respectively) according to the pathological results. All patients underwent bladder MRI within 4 weeks before surgery, including T 2WI, conventional diffusion weighted imaging (DWI), and multi-b-value DWI. The CTRW model was used to obtain three quantitative diffusion parameters, including D m (an anomalous diffusion coefficient), α (related to temporal diffusion heterogeneity), and β (related to spatial diffusion heterogeneity). The apparent diffusion coefficient (ADC) was calculated using a mono-exponential model. The VI-RADS scores were evaluated based on T 2WI and conventional DWI. The Mann-Whitney U test was used to compare the diffusion parameters between the MIBC group and the NMIBC group. The combination of the parameters was investigated with logistic regression analysis. The diagnostic performance for muscle invasion of bladder cancer was evaluated by receiver operating characteristic analysis and the area under the curve (AUC). The difference between AUC was compared using the DeLong test. Results:There were statistically significant differences in ADC, D m, and α between the MIBC group and the NMIBC group ( Z=-2.31, -2.91, -3.97, P=0.021, 0.004,<0.001). No significant difference was found in β between the two groups ( Z=1.69, P=0.091). The AUC (95% CI) of D m and α for diagnosing MIBC were 0.712 (0.587-0.838) and 0.790 (0.676-0.904) respectively, both of which were higher than that of ADC (AUC 0.669, 95% CI 0.537-0.801) with statistically significant differences ( Z=2.86, 2.27, P=0.004, 0.023). The AUC (95% CI) of CTRW (D m+α) was 0.782 (0.661-0.876), which was significantly higher than that of ADC ( Z=2.35, P=0.019). The AUC (95% CI) of VI-RADS score and VI-RADS combined with CTRW parameter (VI-RADS+D m+α) were 0.823 (0.716-0.930) and 0.900 (0.799-0.961) respectively, with a statistically significant difference between them ( Z=2.16, P=0.031). Conclusion:The D m and α parameters in the CTRW diffusion model show better performance than the ADC in the mono-exponential model for muscle-invasive evaluation of bladder cancer, and the CTRW diffusion model can enhance the diagnostic performance of VI-RADS.

Kupffer cells(KC),an important subset of immune cells in the liver,are essential for maintaining tissue homeostasis and responding quickly to liver damage.The complement receptor of the immuno-globulin superfamily(CRIg)is a receptor protein on the KC membrane.CRIg can not only capture pathogens in the blood flowing through the liver by complement binding but also mediate immune responses by regulating im-mune cells in the liver.Recent studies have confirmed the role of CRIg in regulating liver immunity.This article reviews the main modes of action of CRIg and the research progress of CRIg in regulating liver immunity.

Posterior reversible encephalopathy syndrome is a clinical and radiological entity,caused by a variety of reasons.We report a case of rhabdomyolysis complicated by posterior reversible encephalopathy and suggest that giving fluids early,use of diuretics and alkalization of urine may be reasonable for patients with rhabdomyolysis.Monitoring blood pressure is noteworthy to prevent target organ damage,and if patient condition steadily deteriorates,hemodialysis should be initiated.