Objective To investigate the expression of AIF, CYT C, PAF-1, caspase-3, and XIAP in Sprague-Dawley rats with spontaneous mammary neoplasms.Methods One-hundred and thirty 3-4-week old SPF Spargue-Dawley rats (♀∶♂=1∶1) were fed in a specific pathogen free (SPF) breeding barrier for 60 weeks.The occurrence of spontane-ous breast tumors was recorded and histopathology was performed to identify the types of tumors.The rats were divided into 3 groups:rats with normal breast tissue ( group I) , with benign tumors ( group II) and with malignant tumors ( group III) . The expression of AIF, CYT C, APAF-1, caspase-3 and XIAP proteins and mRNAs were detected by immunhistochemistry ( IHC) and RT-PCR assay.Results Among these 130 SD rats, 14 rats were observed having spontaneous mammary neo-plasms with the incidence rate of 10.77%(14/130).In these neoplasm cases, 7 cases were mammary fibroadenomas, 7 cases of breast carcinoma, both with an incidence rate of 5.38%.Immunohistochemistry showed that, compared with the group I, the positive expressions of AIF, APAF-1, caspase-3 were decreased significantly (P<0.01), and the CYT C and XIAP expressions were significantly increased in the group II.The positive expression of all genes except XIAP was de-creased in the group III(P<0.01).Compared with the group II, APAF-1 and XIAP were significantly higher in the group III (P<0.01), and the positive expression of AIF, Cyt C, and caspases-3 were significantly decreased (P<0.01).In the results of RT-PCR assay, except APAF-1 which showed significant correlation with the results of immunohistochemistry ( P<0.05 ) , all the others showed an extremely significant correlation with immunohistochemical results ( P <0.01 ) . Conclusions Mammary tumors are most common spontaneous neoplasms in SD rats.Abnormal expression of mitochondrial apoptotic pathway-related factors AIF, CytC, APAF-1, caspase-3, and XIAP are correlated with the carcinogenesis and de-velopment of breast tumors.

Objective To explore the application value of triggered angiography non-contrast enhanced (TRANCE) technology in diagnosing lower limb arterial occlusive disease.Methods Totally 22 lower limb arterial occlusive disease patients were randomly selected,and then underwent TRANCE and DSA examinations.The arteries from the abdomen to the lower limb were divided into abdominal aorta,common iliac artery,external iliac artery,internal iliac artery,superficial femoral artery,deep femoral artery,popliteal artery,anterior tibial artery,posterior tibial artery and peroneal artery.Totally 337 sections displayed clearly were chosen to go through examinations by TRANCE and DSA.Results Of the 337 sections there were 312 ones with the same stenoses found by TRANCE and DSA,TRANCE found 16 sections with worse stenoses and 9 milder ones than by DSA.There were 153 sections with the same moderate stenoses (≥50％) displayed by TRANCE and DSA;Of the 153 sections,there were 15 ones with worse stenoses and 6 ones with milder stenoses found by TRANCE than by DSA.Kappa value of the two methods was 0.905.Conclusion TRANCE technology is a non-invasive,safe and nonradiative diagnosing method for the lower limb arterial occlusive disease.

Objective:To investigate the effect of etocoxib combined with colchicine on acute gouty arthritis and its influence on serum uric acid, renal function and inflammatory factors.Methods:From January 2018 to June 2019, 60 patients with acute gouty arthritis in the Third People's Hospital of Hangzhou were divided into treatment group (30 cases) and control group (30 cases) according to the random number table method.The patients in the control group were treated with colchicine, while the patients in the treatment group were treated with etocoxib on the basis of the control group.The course of treatment in both two groups was 7 days.The changes of joint swelling, joint tenderness score, blood uric acid, renal function and inflammatory factors were compared before and after treatment.Results:The total effective rate of the treatment group (90.00%) was higher than that of the control group (63.33%) (χ 2=5.963, P<0.05). The scores of joint swelling[(0.49±0.10)points] and joint tenderness[(0.38±0.09)points] in the treatment group were lower than those in the control group[(0.87±0.15)points and (0.91±0.18)points] ( t=11.545, 14.425, all P<0.05). There was no statistically significant difference in serum uric acid level between the two groups ( t=0.777, P>0.05). There were no statistically significant differences in SCR and BUN between the two groups ( t=0.248, 0.150, all P>0.05). The ESR [(15.21±3.04)mm/h], CRP [(7.06±1.04)mg/L] and IL-1β [(4.17±0.76)pg/mL] in the treatment group were lower than those in the control group [(21.98±3.64)mm/h, (10.94±1.26)mg/L and (6.28±1.08)pg/mL] ( t=7.819, 13.008 and 8.751, all P<0.05). Conclusion:The therapeutic effect of etocoxib combined with colchicine on acute gouty arthritis is obvious, but it has no significant effect on the blood uric acid and renal function, and it can reduce the inflammatory reaction.

Objective To learn the endocardial strain patterns of the left ventricles on the short-axis views in normal youth volunteers using feature tracking techniques on cine cardiac MR imaging,and to build up the reference ranges of strain peak and time to peak (TTP) for endocardial strain analysis.Methods Twenty-nine normal youth volunteers aged from 24-34 years old were enrolled in the study in march 2015.The Cine MR imaging were acquired using balance FFE sequence with 24 phases for each cardiac cycle.The standard short-axis imaging planes were basal,mid-cavity and apical levels and divided into 16 segments.The peaks and TTPs of myocardial displacement and its velocity,radial and circumferential strain and strain rate and its velocity in each segment were calculated using feature tracking techniques.The data with normal distribution were analyzed by ANOVA and Student-Newman-Keuls (SNK) method,and Kruskal-Wallis and Wilcoxon rank sum test were used for the data without normal distribution.Results The peaks and TTPs of radial strain and strain rate differed in 16-segmental levels and basal,middle and apical plane levels and had no concordant reference ranges.The circumferential strain and strain rate were homogeneous at basal and middle plane levels [(-27.09 ±9.51)％,(1.94 ±0.98)/s,respectively].Their TTPs were homogenous [0.38 (0.08)RR,0.54 (0.08)RR,respectively],and there were no significant differences in planar-segments or inter-segment level.Except for middle level,the peaks of radial displacement and velocity differed in basal and apical levels and had no concordant reference ranges.But radial velocity TTPs were homogeneous in all 16 segments [0.21 (0.04)RR].Except for the radial strain rate,TTPs showed no significant difference between basal level and middle level.The measurements at apical level revealed high variance.No regular pattern could be found on individual peak and TTP curves of velocity and strain rate.Conclusion The peaks and TTPs of radial strain are different in segmental and planar levels without a concordant reference range.The peaks and TFPs of circumferential strain and the radial velocity rTTPs are homogeneous in middle and apical plane level and have homogeneous reference range.

Objective:To investigate the therapeutic effect of nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on systemic lupus erythematosus (SLE) patients and its immune function.Methods:Sixty-two patients with systemic lupus erythematosus admitted to Third People′s Hospital of Hangzhou from March 2017 to March 2019 were randomly divided into observation group (31 cases) and control group (31 cases) by random number table. The patients in the control group were treated with prednisone and methotrexate, while the patients in the observation group were treated with nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate on the basis of the control group. Both groups were treated for 3 months. The therapeutic effects of the two groups were compared, and the changes of complement C3 and C4, immune function before and after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group [96.77%(30/31) vs.74.19%(23/31)], and there was significant difference ( χ2=6.369, P<0.05). The levels of complement C3 and C4 in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of complement C3 and C4 in two groups were significantly increased ( P<0.05), and the levels of complement C3 and C4 in observation group were significantly higher than those in control group [(1.08 ± 0.15) g/L vs. (0.81 ± 0.13) g/L, (0.24 ± 0.05)g/L vs. (0.18 ± 0.03) g/L], and there were significant differences ( t=7.574, 5.729, P<0.05). The levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in two groups were significantly increased ( P<0.05), and the levels of CD 3+, CD 4+ and CD 4+/CD 8+ in observation group were significantly higher than those in control group [(65.72 ± 5.62)% vs. (58.93 ± 4.25)%, (41.03 ± 1.75)% vs.(38.21 ± 1.43)%, 1.65 ± 0.09 vs.1.41 ± 0.12], and there were significant differences ( t=5.365, 6.948, 8.908, P<0.05). The levels of IgA, IgG and IgM in two groups before treatment had no significant differences ( P>0.05); after treatment, the levels of IgA, IgG in two groups were increased, the level of IgM in two groups was decreased, and there were significant differences ( P<0.05). The levels of IgA, IgG in observation group were significantly higher than those in control group [(1.85 ± 0.38) g/L vs. (2.54 ± 0.42) g/L, (12.19 ± 1.63) g/L vs. (14.53 ± 1.37) g/L], and there were significant differences ( t=6.783, 6.119, P<0.05). Conclusions:Nourishing Yin, clearing heat and detoxifying method combined with hormone and methotrexate in treating SLE is effective, which can effectively improve the levels of complement C3 and C4 and immune function.

Objective : To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19. Methods : All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. Results : By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts. Conclusions The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Objective To investigate the feasibility and clinical significance of sentinel lymph node biopsy(SLNB) after neoadjuvant chemotherapy (NAC) for axillary lymph node-positive breast cancer.Methods Enrolled for a prospective cohort study were 167 patients from Jan 2016 to Jan 2018 with axillary lymph node-positive breast cancer admitted to the Cancer Hospital of Chinese Academy of Medical Sciences.SLNB was performed after NAC by lymphatic dual mapping,followed by axillary lymph node dissection.The primary end point was sentinel lymph node identification rate (IR) and false negative rate (FNR).Results 62 patients (37.1％) had complete pathological response of axillary lymph nodes.There was a significant difference of NAC response in patients with different subtypes (P ＜0.001).The IR of SLNB after NAC was 94.6％,the FNR was 6.7％,the sensitivity was 93.3％,the specificity was 100％,and the accuracy was 95.8％.Univariate analysis showed that there was no significant difference between tumor stage,hormone receptor status,HER2 expression,and pathological remission in SLN detection group and the SLN undetected group (P ＞ 0.05).The proportion of patients who received breast conserving surgery in the undetected group was significantly higher than that in the test group (P =0.006).Conclusions Sentinel lymph node biopsy after breast neoadjuvant chemotherapy by lymphatic dual mapping is highly accurate with a high identification rate and a low false negative rate.

Objective:To explore the optimum opportunity for lumbodorsal muscles exercises of patients undergoing posterior lumbar decompression and instrumentation, and investigate its effect on the rehabilitation outcomes and kinesiophobia.Methods:A randomized controlled trial was used. By convenient sampling method, a total of 120 lumbar disc herniation patients were prospectively selected from Affiliated Nantong Hospital of Shanghai(Nantong Sixth People′s Hospital) from February 2020 to December 2021. The paitients were assigned to early group, middle group and late group, with 40 cases in each group. All patients were given routine postoperative care and lumbodorsal muscles exercises. The early group started to exercise 10th day after operation, the middle group started to exercise 3 weeks after operation, and the late group started to exercise 6 weeks after operation. The intervention effect was respectively evaluated by Japanese Orthopaedics Association (JOA) and Tampa Scale for Kinesiophobia (TSK).Results:There were 3, 1 and 1 missing cases in the early, middle and late group respectively, the age in the 3 groups were (56.05 ± 11.77), (57.33 ± 14.64) and (54.23 ± 15.73) years old in turn. Three months after exercising, the total score of JOA in the early, middle and late group were (25.32 ± 2.45), (24.44 ± 2.19) and (22.13 ± 1.58) in turn, the difference was significant ( F=23.64, P<0.05); the score of TSK in the early, middle and late group were (37.95 ± 6.81), (34.18 ± 6.39) and (33.33 ± 7.36) in turn, the difference was significant ( F=4.82, P<0.05). Conclusions:Lumbodorsal muscles exercises start at 3 weeks after operation can significantly improve the rehabilitation outcome of lumbar disc herniation patients undergoing posterior lumbar decompression and instrumentation, and will not increase the level of kinesiophobia, its can be consider as optimum opportunity for lumbodorsal muscles exercises.

Objectives:To compare the efficacy of cyclosporin A (CsA) alone and CsA combined with recombined human thrombopoietin (rhTPO) in patients with non-severe aplastic anemia (NSAA) .Methods:Data from 83 patients with NSAA between August 2014 and February 2019 were collected retrospectively. The study population included 35 men and 48 women, with a median age of 45 years (14-85 years) . Among them, 57 had been treated with CsA + rhTPO, TPO was administered at 15 000 U QD for 7 days, once a month for 3 months, and the other 26 patients with compatible baseline characters were treated with CsA alone. All the enrolled patients had been treated with CsA for at least 6 months and were followed up for at least 1 year. The efficacy and outcome were compared between the two groups.Results:Total 23 men and 34 women, with a median age of 46 years (14-85 years) were treated with CsA + rhTPO. The median duration of CsA treatment was 17 (8-28) months, and the patients were followed up for a median of 27 (12-45) months. Total 12 men and 14 women, with a median age of 40 years (20-64) were treated with CsA alone. The median duration of CsA treatment was 19 months (9-30 months) , and the median follow-up duration was 29 months (16-66 months) . There was no significant difference in the baseline characteristics of the two groups ( P>0.05) . There was no significant difference in the CR and OR rates of the two groups at 1, 3, 6, 12, and 24 months of treatment ( P>0.05) . The change in the platelet level for the CsA + rhTPO treated group after 1 month[8 (-12-86) ×10 9/L vs. 3 (16-57) ×10 9/L, P=0.029) , 3 months[24 (-6-102) ×10 9/L vs. 7 (-9-76) ×10 9/L, P=0.006], and 6 months[33.5 (-4-123) ×10 9/L vs. 12.5 (-14-109) ×10 9/L, P=0.048] of treatment was higher than that in the CsA alone group, while no significant difference was found between the two groups at other time points. There was no significant difference in the change in the megakaryocyte level between the two groups[3 (0-4) vs. 2 (0-5) , z=-0.868, P=0.385] after 6 months of treatment. Apart from 10.5% (6/57) of the patients in the CsA + rhTPO treated group who reported soreness at the injection site, there was no other significant difference between the two groups in terms of adverse effects. During the follow-up period, there were two cases of increasing paroxysmal nocturnal hemoglobinuria clone to over 10%, one in the CsA + rhTPO treated group, the other in the CsA alone group; and there was one case of progression to SAA in the CsA + rhTPO treated group; while no case of death or thromboembolic event (TEE) , fibrosis or reticulin proliferation, progression to myelodysplastic syndrome (MDS) , or acute myeloid leukemia was observed in either group. There was one case of progression to SAA in the CsA + rhTPO treated group but none in the CsA alone group. Conclusion:Compared to CsA alone, CsA + rhTPO treatment can accelerate the recovery of the platelet level with acceptable adverse effects.

Objective:To gain a deeper understanding of the fear of recurrence in patients with atrial fibrillation during the "blanking period" after catheter ablation.Methods:The interview outline was developed based on common-sense model of self-regulated. From July to September 2023, purposive sampling was used to select 15 patients with atrial fibrillation in the "blanking period" after catheter ablation at the Cardiovascular Outpatient of the Affiliated Hospital of Qingdao University as research subjects, and semi-structured interviews were conducted. The targeted content analysis method was used to analyze data.Results:Four themes were extracted, namely triggering factors of fear of recurrence, perception of atrial fibrillation recurrence, negative emotional distress, and insufficient ability to cope with atrial fibrillation recurrence.Conclusions:For patients with atrial fibrillation during the "blanking period" after catheter ablation, medical and nursing staff should closely monitor the patient's cognitive level and psychological state, and carry out targeted health education to meet the patient's needs for postoperative disease management, life adaptation, and other aspects, so as to reduce the fear of recurrence in atrial fibrillation patients during the "blanking period" after surgery.