Objective To analyze the epidemiological and etiological characteristics of an outbreak of hand, foot, and mouth disease(HFMD) in Liaoning Province, in order to provide a reference for the formulation of preventive strategies for HFMD.Methods An outbreak of HFMD occurred in a kindergarten in Dalian, Liaoning Province in 2022. The stool and throat swab specimens of 13 patients were collected for nucleic acid detection and enterovirus isolation. After three generations of blind transmission of positive samples, Liaoning isolates were obtained, and the virus nucleic acid was extracted for genome sequencing. The sequencing results were analyzed by BLAST on the website of National Center for Biotechnology Information(NCBI). The VP1 sequences of Coxsackievirus A16(CVA16) epidemic strains and its main serotype prototype strains were downloaded from GenBank as reference strains, and enterovirus A71(EVA71) prototype strainwas taken as an outgroup taxon, which were analyzed for the homology by MEGA 5.2 software. The genetic phylogenetic tree was constructed by neighbor joining, and the phylogenetic analysis of CVA16 VP1 of Liaoning isolates and epidemic strains from different countries or regions in different years was performed. Results A total of 19 patients were reported in this HFMD outbreak, with an attack rate of 7. 45%, and no severe cases or deaths were reported; there were 15 males(accounting for 78. 95%) and 4females(accounting for 21. 05%); there were 4, 9 and 6 cases at the age of 4, 5 and 6 respectively. The outbreak time was from June 14 to 21, 2022, and the peak incidence occurred on June 19, with 10 cases, accounting for 52. 63% of the total cases. A total of 13 Liaoning isolates were obtained, with nucleotide homology of more than 99. 9%, and had the highest sequence homology with CVA16, belonging to sub-genotype B1c. The amino acid sequences of VP1 were almost identical,and mutations occurred at 19 amino acid sites compared with the prototype strain. Conclusion This HFMD epidemic was caused by the same CVA16 pathogen. In the future, the long-term monitoring of CVA16 should be strengthened to provide scientific basis for early warning of HFMD epidemic and reduce the incidence.

AIM: To determine the aqueous, vitreous, serum levels of pigment epithelium-derived factor (PEDF)and vascular endothelial growth factor(VEGF)in patients with proliferative diabetic retinopathy(PDR), and to speculate on the source of the change in concentration and to discuss its clinical significance.METHODS:Forty-one eyes withproliferative diabetic retinopathy were included in the study, 16 of which were complicated by neovascularization of iris (NVI).Twenty-one eyes with idiopathic macular hole (MH)were as controls. The aqueous, vitreous, serum levels of PEDF and VEGF of all the groups were determined with ELISA. PEDF, VEGF and the levels in the three groups were compared with analysis of variance (ANOVA). The PEDF, VEGF concentrations in aqueous,vitreous and serum were analyzed with Pearson correlation test,and the correlation of PEDF and VEGF levels was also analyzed with Pearson correlation test.RESULTS:The aqueous levels of PEDF decreased significantly in sequence in groups of control, PDR without NVI, PDR with NVI. VEGF levels increased coordinately. The similar findings existed in vitreous samples. The PEDF,VEGF levels in aqueous were not correlated significantly with those in serum,but correlated positively with those in vitreous. The intraocular levels of PEDF had a negative correlation to those of VEGF.CONCLUSION:The reduction of intraocular PEDF level and elevation of intraocular VEGF level may play an important role in the occurrence and progression of PDR. In the development of PDR, the PEDF,VEGF levels in aqueous may be mainly effected by local pathological changes, as anti-angiogenic and pro-angiogenic factors, their unbalanced intraocular distribution may promote the angiogenesis of the iris and retina.

50 cases of the brancnes and anastomoses of the cavernous segment of theinternal corotid artery were dissected on 3 adult and 22 infant cadavers under aspectacle type magnifying glass and a binocular dissection microscope.The principalresults are summarized as follows:1.From the proximal to the distal portion of the cavernous segment of theinternal carotid artery there were two curves,the first one curves forward and thesecond curve curves upward.Both curves divided the cavernous segment into threeportions,i.e.the posterior ascending,horizontal and anterior ascending portions.2.Normally within the cavernous segment of the internal carotid artery therewere two major branches which were the meningo-hypophyseal trunk and the arteryof the inferior cavernous sinus.In some cases there was also a capsular arterypresent.The meningo-hypophyseal trunk usually gave rise to three branches,viz,the tentorial artery,the dorsal meningeal artery and the inferior hypophyseal artery.According to the number of the primary branches within the cavernous segment ofthe internal carotid artery,we classify four types of ramification namely:of onebranch,of two branches,of three branches and of four branches.3.With regard to various branches,their origins,average external diameters,proper names,courses and distributions were presented in detail.4.The anastomoses of the cavernous segment of the internal carotid arterywithin various branches were described.The clinical significance of what has beenmentioned above was discussed.5.Parkinson's cavernous triangle,which is of practical significance to themicrosurgical operation,has been likewise measured.

Objective One hypothesis is that patients with uraemia showing hyporesponsiveness to rHuEPO may have enhanced levels of immune activation causing increased rdease of inflammatory cytokines. To study the effects of chronic inflammation on the hyporesponsiveness to rHuEPO and its possible mechanisms, T cell phenotypes using flow cytometry and the relationship between these changes were detected. Methods 40 patients with MHD and 20 age-matched healthy volunteers were enrolled in the study. The MHD patients were divided into two groups according to the responsiveness to rHuEPO:22 cases with good responders and 18 cases with poor responders. The percentages of T cell subsets including CD+4 ,CD+8,CD+4/CD+28,CD+8/CD+28 T cell using flow cytometry were detected. Results The percentages of CD+4 and CD+8 T cell were lower in MHD patients than that in control group. The percentages of CD4+/CD+28 and CD+8/CD+28 T cell were lower in group of poor responders than in good responders.Conclusion Chronic inflammation state is common in MIlD patients. The percentages of CD+4/CD+28 and CD+8/CD+28 T cell in poor responders were much lower than good responders. The changes of T cell phenotypes may play a role in pathogenesis of hyporespousiveness to rHuEPO.

Objective To investigate the effect of TCF21 on human non-small cell lung cancer A549 cells , and to reveal the role of TCF21 in the development of NSCLC. Methods Overexpression of TCF21 in NSCLC A549 cells was mediated by lentivirus vector. TCF21 protein expression was identified by Western blotting assay. The experimental group, negative control group and the blank control group were set up. A549 cells were subcuta-neously seeded in BALB/c nude mice on the left armpit. Results TCF21 was successful overexpressed in the ex-perimental group. Compared with the negative control group and the blank control group , the tumor growth was slow, and the final tumor volume was significantly reduced in the experimental group. Conclusion Overexpression of TCF21 can inhibit the tumor growth of NSCLC in nude mice , indicating that TCF21 may play an important role in NSCLC development.

Objective To investigate the pathological changes of brain tissues from contused and contralateral non-contused sides and their significance.Methods A total of 100 healthy adult Wistar rats were assigned to brain contusion group and sham operation group according to the random number table.Ten rats in each group were sacrificed at 1,3,6,12,and 24 hours respectively.Brain samples were collected to perform pathophysiological analysis of brain tissues and test blood brain barrier (BBB)permeability by semiquantitative immunohistochemical staining of IgG.Results There was no damage to the bilateral brain tissues in sham operation group and IgG stain was negative.In brain contusion group,angioedema characterized by the breakdown of BBB was seen in the contused side at 1 hour followed by cellular edema at 3 hours,with aggravation of both over time.Moreover,tissue necrosis,inflammatory cell infiltration,and microglia proliferation emerged at 12 hours.Besides,IgG-positive staining was seen at 1 hour,was strongest at 6 hours,and remained a high level at 24 hours.With respect to the non-injured side in brain contusion group,no pathological abnormalities and negatively stained IgG were observed at 1 hour; cellular edema and weakly positive-stained IgG were found at 3 hours; aggravated cellular edema,emergence of angioedema,and IgG strongly positive staining were noted at 6 hours;cellular edema continued aggravation,but angioedema tended to be attenuated,IgG staining weakened,and microglia proliferation were observed at 12-24 hours.Conclusion Pathological changes of brain tissues from the contused and contralateral non-contused sides are differed,which provides a basis in determining treatment choices.

Objective To discuss which is more efficient between Needle-knife precut and Plough-knife precut in difficult biliary cannulation. Methods The difference in the average time of cannula, percentage of cannula achieve-ment and the complication rate between the two kinds of operation were compared. Results The percentage of can-nula achievement about the Needle-knife precut is higher than Plough-knife precut, while there is no notable differ-ence in average time of cannula and the complication rate between the two precuts. Conclusion Needle-knife precut is more efficient than Plough-knife precut in difficult biliary cannulation, if guide wire can not get into pancreatic duct.

Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Objective This study was designed to investigate the correlation between the apparent diffusion coefficient(ADC)value and pathological change of the non-injured side brain tissue of traumatic brain injury(TBI)of rat.Methods Sixty healthy adult Wist-ar rats were randomly divided into two groups:the control or TBI groups.The TBI group was divided into five sub-groups according to the different time intervals:1,3,6,12,24 h(n = 10).The animal brain of each group was scanned with MR-DWI,and the ADC value of damaged areas and contralateral non-damaged areas were measured.After that the brains were taken out at different time points after TBI.The cerebral edema and blood-brain barrier(BBB)changes in structure were examined with an optical micros-copy and transmission electron microscopy,and the IgG content in the same tissues were determined by means of immunohistochem-istry.The data was analyzed with SPSS 13.0 statistical software.Results There was no signal abnormality on MR-DWI and tissue structure in control group,and the IgG stain was negative.In the contralateral non-damaged areas of TBI group,pathological obser-vation revealed no variation at 1 h after TBI,and the IgG stain was also negative.Cellular edema was shown at 3 h and the IgG stain was slight positive.The cellular edema aggravated with time and angioedema appeared at 6 h.IgG stain was shown significantly posi-tive.At 12~24 h,cellular edema kept increasing more severe,however angioedema had a trend to mitigated along with time,IgG stain became slight and the proliferation of glial cells could observed.Compared with control group,the ADC values of the contralat-eral non-damaged areas in each group showed no significant difference (P >0.05).However,in the damaged areas of each group, angioedema appeared at 1 h and gradually aggravated,cellular edema occurred at 3 h,Both of them were aggravated with time. ADC values increased at 1 h,and then decreased until 6 h,then followed a climbing up to 24 h,showed as a “V”-shaped.Con-clusion When contused on one side brain,the contralateral non-inj ured side tissue also has pathological changes that occurs later than those on the inj ured side.Cellular edema of the tissues ap-peares first and is followed by angioedema,which lessens over time..There is no significant difference of ADC values between con-tralateral side of TBI groups and control group(P >0.05),which reveals a “pseudo-normal”phenomenon.

Objective To investigate the transcription factor 21 (transcription factor 21 ,TCF21) gene on human lung cancer A549 cells sensitivity to chemotherapy .Methods Using lentivirus technology in A549 lung cancer cells highly expressed genes TCF21 ,fluorescence quantitative PCR ,Western Blot analysis were used to analyse the expression of the target gene ,MTT assay was used to detect the effect of TCF21 lung adenocarcinoma A549 cells on cisplatin (cis‐Dichlorodiamineplatinum ,DDP) chemosen‐sitivity ,and colony assay was used to detect the effect of overexpression of TCF21 lung adenocarcinoma A549 cells on radiosensitiv‐ity .Results After 72 h ,with the increasing concentration of DDP (0 ,0 .625 ,1 .250 ,2 .500 ,5 .000 ,10 .000 mg/L) ,corresponding in‐hibition rates in each group increased ,and the inhibition rate of the high expression group was significantly higher in empty vector group and untransfected group (P<0 .05) ,no significant difference between the two then;overexpression TCF21 group with drug concentration and time and increase the rate of high expression inhibition corresponding increase (P<0 .05) ;after receiving X radi‐ation ,non‐transfected group ,untransfected plus radiotherapy group ,vector group ,vector plus radiotherapy group ,high expression and high expression + radiotherapy colony formation rates were:95 .17% ± 2 .85% ,88 .20% ± 2 .03% ,93 .80% ± 4 .17% , 85 .60% ± 2 .42% ,71 .67% ± 3 .21% ,56 .00% ± 2 .65% .Conclusion TCF21 gene expression can significantly enhance the sensitiv‐ity to radiotherapy and chemotherapy DDP A549 lung cancer cells .