A Review Nitric oxide(NO) is a biologically active molecule in vivo ,it has been found to play an important role not only as a cytotoxic effector but also an immune regulatory mediator and a signal molecule of message transmission.The inducible NO synthase (iNOS) produces NO after cells were activated and play a rather complicated pathophysiological action in a variety of human diseases or disorders. The molecular biological character of iNOS,its expression in human diseases and probable significance were reviewed.

Objective To investigate and establish thyroid function reference range during 3 pregnant stages in Chaoshan area:thyrotropin (TSH),free thyroxin (FT4).Methods 863 healthy pregnant women visited antenatal clinic in the Second Affiliated Hospital were included in this study.By detecting serum levels of TSH,FT4,thyroglobulin antibody (TgAb),and thyroid peroxi-dase antibody (TPOAb)in these women,the euthyroid reference ranges of serum TSH and FT4 in different pregnant stages were established based on the standards of the United States National Institute of Clinical Biochemical (NACB)guidelines.Results The ranges of serum TSH in the first,second and third trimester of pregnancy were 0.13-3.93 mIU/L,0.14-4.55mlU/L,and 0.42-3.85 mIU/L,respectively.The ranges of serum FT4 levels in these 3 stages were 12.00-23.34 pmol/L,6.27-12.65pmol/ L, and 9.80-18.20 pmol/L,respectively.The range of serum TSH levels in our study were similar with the reference range recom-mended by the guidelines in China,but were different compared with the American Thyroid Association (ATA)guidelines.Conclu-sion TSH,FT4 levels show dynamic changes during different stages of pregnancy.The thyroid function ranges of healthy pregnant women in Chaoshan area are quite different compared with non-pregnant population and pregnant women in distinct area.Due to the differences of diet,iodine intake,economy and culture in Chaoshan area,regional thyroid function reference ranges specific for differ-ent stages of pregnant women should be established.

Objective To explore methods to develop a hospital quality of care index system of county level hospitals based on the homepage of inpatient medical records and examine the validity of this system. Methods By means of literature review, homepage data and panel discussion, along with theories and statistical methods, indexes were identified. The dimensions and indices of the index system were pinpointed. Confirmatory factor analysis and normalization methods were combined to calculate the weights and scores of such indices. Scores were adjusted by Charlson comorbidity index ( CCI) with multi-regression method. The hospitals were ranked by adjusted scores in each dimension. The validity was evaluated by comparing the application results to universally acknowledged standards, such as hospital level and economic level of the geographic areas. Results An index system with 6 dimensions and 25 indices was developed, and the application results proved valid to some extent. The adjustment of CCI also proved effective. The 6 dimensions were correlated yet their directions were not consistent. Conclusions The methods and data used to develop the system have demonstrated strong operability and availability. The application results can reflect medical care quality in different aspects making it applicable among homogeneous hospitals. It is meaningful to assess dimensions respectively.

Objective: To investigate clinical outcomes of modified reattachment of superior peroneal retinaculum (SPR) for patients with recurrent peroneal tendon dislocation. Methods: A total of 24 cases with recurrent peroneal tendon dislocation from December 2012 to June 2017 were treated with modified reattachment of SPR. There were 20 males and 4 females. The average age was 24.9±9.3 years (14-48 years). The average BMI was 23.18±3.50 kg/m² (15.8-32.2 kg/m²). A 4-5 cm incision was made along the lateral margin of the fibula and curved distally around the fibular tip in line with the peroneal excursion. The superior peroneal retinaculum, peroneus longus and peroneus brevis were exposed. The periosteum and SPR were stripped from the fibula. The false pouch was formed. Two suture anchors were inserted into the postero-lateral ridge of the lateral malleolus without damaging the cartilaginous ridge, after which the SPR was reattached to the lateral malleolus with the anchored suture. The inner layer of the false pouch was incised, while the outer layer (periosteum) was sutured with the SPR in a pants-over-vest style. The following items, including American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), rate of return to previous sports level, time to return to sports activity, complication, and patients satisfaction were evaluated preoperatively and at the final follow-up. Results: The average operation duration was 36.1±8.8 min (20-51 min). The blood loss was 1-10 ml, average 4.1±2.7 ml. The follow-up was carried out in 22 cases for mean 33.9±15.7 months (13-61 months). AOFAS score was improved from 77.8±7.8 points to 95.5±4.3 points significantly (t=-11.89, P<0.001). VAS score was reduced from 4.2±2.4 to 0.3±0.8 significantly (t=7.69, P<0.001). Mean duration return to sports activity was 5.0±1.9 months (3-10 months). A total of 20 patients (91%) returned to their previous sports level. Only one patient (5%) was found with limitation of range of motion, while two patients (9%) reported pain at the scar site without recurrence. The satisfaction rate was 91%. Conclusion Clinical outcomes of modified reattachment of SPR for patients with recurrent peroneal tendon dislocation was safe and effective.

As an important part of tumor microenvironment, neutrophils are poorly understood due to their spatiotemporal heterogeneity in tumorigenesis. Here we defined, at single-cell resolution, CD44-CXCR2- neutrophils as tumor-specific neutrophils (tsNeus) in both mouse and human gastric cancer (GC). We uncovered a Hippo regulon in neutrophils with unique YAP signature genes (e.g., ICAM1, CD14, EGR1) distinct from those identified in epithelial and/or cancer cells. Importantly, knockout of YAP/TAZ in neutrophils impaired their differentiation into CD54+ tsNeus and reduced their antitumor activity, leading to accelerated GC progression. Moreover, the relative amounts of CD54+ tsNeus were found to be negatively associated with GC progression and positively associated with patient survival. Interestingly, GC patients receiving neoadjuvant chemotherapy had increased numbers of CD54+ tsNeus. Furthermore, pharmacologically enhancing YAP activity selectively activated neutrophils to suppress refractory GC, with no significant inflammation-related side effects. Thus, our work characterized tumor-specific neutrophils in GC and revealed an essential role of YAP/TAZ-CD54 axis in tsNeus, opening a new possibility to develop neutrophil-based antitumor therapeutics.
Humans ; Animals ; Mice ; Adaptor Proteins, Signal Transducing/metabolism* ; Transcription Factors/metabolism* ; Stomach Neoplasms/pathology* ; Neutrophils/pathology* ; Signal Transduction/genetics* ; YAP-Signaling Proteins ; Tumor Microenvironment ; Hyaluronan Receptors/genetics*