0.05). In the group of pirenzepine, the RBF, velocity and volume significantly increased at 0.5 h and 1 h after injection compared with that before injection (P0.05). Conclusion These results suggest that pirenzepine could increase RBF and oxygen in blood with the peak time at 0.5 h and 1 h after intravitreous injection.

Objective To investigate the expression and significance of P-glycoprotein in triple negative breast cancer (TNBC).Methods One hundred and seventy-one cases of breast invasive ductal carcinoma in our hospital were retrospectively analyzed.According to the expression of ER,PR,Her2,we categorized those paitents into triple negative breast cancer group (58 cases) and non triple negative breast cancer group (113 cases).The different expression of P-glycoprotein was detected by immunohistochemieal technology in two groups.We analyzed the relationship between the expression of P-glycoprotein and clinical and pathological features in TNBC,and investigated the effect of P-gp on the rate of recurrence and metastasis in 3 years.Results (1) The expression of P-gp in TN BC was significantly higher than that of NTNBC (53.45％ vs 37.17％) (P ＜ 0.05).(2) The expression of P-gp in TNBC was associated with TNM stage,histological grade,lymph node status and vascular invasion (P ＜ 0.05),but not with age and size of the tumor (P ＞ 0.05).(3) The rate of recurrence and metastasis in positive expression of P-gp in TNBC was 58.06％,which was significantly higher than negative expression of P-gp in TNBC (44.44％),but no statistically significant was found(P ＞ 0.05).Survival analysis showed that P-glycoprotein expression had no relationshiop to 3-year cumulative survival rate (P =0.161 ＞ 0.05).Conclusions The positive expression of P-gp in TNBC is associated with drug resistance and metastasis,but has no obvious significance to recurrence and metastasis,so as to 3-year cumulative survival rate.

Aim To probe the mechanism of the therapeutic effect of APS against DM rats by measuring the level of TNF-?,as well as observing the change of caspase-3 protein in pancreatic beta cells.Methods Thirty DM rats induced by STZ were randomly divided into three groups:DM group,APS low dosage group,APS high dosage group,and another 10 normal rats were taken as the control group.The drug was given for 6 weeks.The research included measuring the level of TNF-? in serum and the expression of caspase-3 protein in pancreatic beta cells.Results ① The level of TNF-? was higher in model group than that of the normal group(P

Objective To evaluate the feasibility of intra-operative ultrasound guide in breast conservative-surgery and its effect on positive margin rate and breast tissue volume.Methods Fifty-five cases of invasive breast cancer staged T1-2N0-1 were randomly assigned to palpation-guided group(control group) 26 cases and ultrasound-guided group(experiment group) 29 cases.Before and during operation,high-frequency ultrasound was used to guide the resection of breast cancer with 1 cm margin in experiment group.The resection margin positive rate deteced by tissue section frozen biopsy and resected breast tissue volume were compared between experiment and control group.Results The clinicopathologic features were accordant between two groups.The margin positive rate and near-margin positive rate in experiment group were 0 and 3.45％ respectively,slightly lower than that of control group 3.85％ and 15.38％,but with no statistical significance (P ＞ 0.05).The same situation occurred at the re-exision rate.The resected breast tissue volume in experiment group (32.40 ± 10.93) cm3 was lower than that of control group (55.11 ± 12.88) cm3,and with statistical significance (P ＜ 0.01).Conclusions Intra-operative ultrasound guide could reduce the margin positive rate and unnecessary resected brcast tissue volume in breast conservative-surgery,and improve cosmetic effect.

Objective To summarize the preliminary experience of endovascular recanalization in treating chronic symptomatic internal carotid artery occlusion.Methods Four patients with chronic symptomatic internal carotid artery occlusion,admitted to and underwent endovascular recanalization in our hospital from August 2013 to August 2014,were chosen in our study; their clinical data were retrospectively analyzed.Results Four patients were successfully opened the internal carotid arteries;cerebral CT angiography showed that all arteries were unobstructed.One appeared intra-operative iatrogenic internal carotid artery cavernous sinus fistula,and successful occlusion of the fistula with internal carotid artery patency was achieved after one week.Three months after the operation,two showed unobstructed internal carotid artery by DSA and the other stated no abnormalities during the telephone follow up.Conclusion Endovascular recanalization is a safe and effective treatment method for chronic symptomatic internal carotid artery occlusion.

Objective To explore the values of three-dimensional digital subtraction angiography(3D-DSA)and CT angiography(CTA)in keyhole surgery of intracranial aneurysms.Methods A retrospective analysis of 175 patients with 192 intracranial aneurysms,treated by keyhole approaches in our hospital from April 2007 to June 2009,was performed.The imaging features of the aneurysms via 3D-DSA and CTA were analyzed; the designed individualized approaches were performed on these patients:supraorbital keyhole approach in 38 patients(40 aneurysms),pterion keyhole approach in 132 patients(146 aneurysms),inferior-temporal keyhole approach in 2(2 aneurysms)and trans-frontal keyhole longitudinal fissure approach in 3(4 aneurysms).The application and significance of 3D-DSA and CTA in keyhole surgery of intracranial aneurysms were summarized.Results All 175 patients successfully finished the one-time surgery:188 aneurysms were clipped and the other 4 were wrapped.All the aneurysms enjoyed satisfactory clipping under DSA or CTA.According to the modified GOS scores,good result was achieved in 165 patients,mild disability in 6,severe disability in 2,and death in 2.Conclusion 3D-DSA and CTA can clearly show the characteristics of three-dimensional shape about intracranial aneurysms and precisely provide a basis for the design of individual keyhole approach which is prerequisite for a successful surgery.

Aim To explore the effeetive components and molecular targets of Guizhi decoetion in treating COVID-19 combined with allergic rhinitis.Methods The potential targets assoeiated with Guizhi deeoetion, allergie rhinitis and COVID-19 were sereened from TC- MSP and Gene Cards databases.Draw Venn Diagram website, String database, and Cytoscape software were used to obtain the common targets of drugs and diseases, followed by generation of PPI network and " herbal-active component-target" network as well as screening of core targets and key components based on the degree value.Metascape and KEGG databases were used for GO and KEGG enrichment analysis.Molecular docking was utilized to validate the affinity between the core targets and the key components.Results A total of 127 effective components of Guizhi decoction were screened, of which 108 components could combine with 52 common targets to exert the therapeutic effects.Common targets were mainly enriched in 1523 (X) terms and 145 KEGG signaling pathways.Molecular docking confirmed that the core targets could spontaneously combine with key components.Conclusions Guizhi decoction is mainly involved in the regulation of viral, immune and inflammation-related signaling pathways and biological cellular processes through the binding of active components such as flavonoids, phy- tosterols and phenols to common targets ( IL-6, TNF, MAPK3, etc.) , ultimately achieving the goal of treating COVID-19 and allergic rhinitis.

OBJECTIVETo study the clinicopathologic features and biologic behavior of pediatric immature teratoma.

METHODSThe clinical data, pathologic features, immunohistochemical findings (for cyclin D1, P27 and Ki-67) and follow-up information of 39 cases of pediatric immature teratoma were analyzed.

RESULTSAmongst the 39 cases studied, 12 arose in the sacrococcygeal region, 12 in testis, 5 in retroperitoneum, 4 in ovary, 4 in abdomen and 2 in mediastinum. Histologically, 16 cases were of grade 1, 8 cases of grade 2 and 15 cases of grade 3. Seven of the cases contained foci of yolk sac tumor. Immature neuroepithelial features used in histologic grading included the presence of primitive neural tubules, immature rosettes, undifferentiated neuroblastoma cells and primitive neuroectodermal structures. Immunohistochemical study showed that cyclin D1 was positive in 3 cases of grade 1 tumors, 4 cases of grade 2 tumors and 9 cases of grade 3 tumors. The positivity rates for p27 were 8, 3 and 6 cases respectively, while those for Ki-67 were 3, 4 and 13 cases respectively. Follow-up data were available in 30 cases. Three of them, including 2 cases with histologic grade 3 (with or without yolk sac tumor component), recurred after operation.

CONCLUSIONSThe expression of cyclin D1 and Ki-67 is a useful adjunct in histologic grading. On the other hand, p27 overexpression shows little correlation with tumor grade. The prognosis of immature teratoma in children is different from that in adults. Sacrococcygeal immature teratoma occurring in patients younger than 1 year old and with low histologic grade do not require postoperative chemotherapy if the tumor is completely excised. Similarly, for testicular immature teratoma occurring in patients below 1 year of age, regardless of tumor grading, need no adjunctive therapy. On the other hand, ovarian immature teratoma with high histologic grade requires postoperative chemotherapy, regardless of age of the patients. The presence of microscopic foci of yolk sac tumor is a useful predictor of recurrence in pediatric immature teratoma.

Adolescent ; Cyclin D1 ; metabolism ; Endodermal Sinus Tumor ; drug therapy ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Ki-67 Antigen ; metabolism ; Male ; Mediastinal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Ovarian Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Proliferating Cell Nuclear Antigen ; metabolism ; Retroperitoneal Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Sacrococcygeal Region ; Survival Rate ; Teratoma ; drug therapy ; metabolism ; pathology ; surgery ; Testicular Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism

Objective: To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. Methods: The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (n=56) and traditional tube feeding group (n=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ² test, Fisher exact test and t test, respectively. Results: Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ²=2.393, P=0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (t=7.720, P=0.000); the general enteral complications were significantly lower (26/52 vs. 5/56, χ²=22.225, P=0.000), the nutritional support complete rate was significantly higher (23/52 vs. 55/56, χ²=39.167, P=0.000). Conclusions Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.

Objective:To understand the infection rate of Coronavirus Disease 2019 (COVID-19) in close contacts in Shandong province and explore the risk factors of infection.Methods:All data from close contacts of 2019 novel coronavirus (2019-nCoV) infected persons in Shandong province were collected for descriptive epidemiological analysis, and risk factors were analyzed by logistic regression.Results:Up to March 6, 2020, a total of 15 702 close contacts had been reported in Shandong province, of whom 321 cases were infected with 2019-nCoV, with an infection rate of 2.04%. Among all the factors, the top five with the highest infection rate were close relatives (13.39%), frequent contact (9.58%), working/living/studying in the same room (7.54%), two or more contact cases (4.58%), and over 60 years old (3.10%). Single-factor analysis showed that exposure to two or more cases, over 60 years old, close relatives with cases, frequent contact and working/living/studying in the same room were the risk factors for infection in close contacts. Multivariate analysis showed that exposure to two or more cases ( OR=2.510, 95% CI: 1.843-3.417), 30~60 year old group ( OR=1.513, 95% CI: 1.141-2.007), frequent exposure group ( OR=20.025, 95% CI: 14.625-27.419), working/living/learning in the same room ( OR=2.406, 95% CI: 1.385-4.182) and medical institution exposure ( OR=2.366, 95% CI: 1.149-4.871) were risk factors of infection in close contacts. Conclusions:Tracking and managing close contacts was an important measure to control the COVID-19 epidemic situation, and reducing crowd concentration, keeping a proper social distance and taking effective protection were effective measures to control 2019-nCoV infection.