AIM: To study the effects of recombinant soluble MHC class Ⅰ chain-related protein A (sMICA) on the cytotoxicity, secretion of IFN-γ, proliferation and apoptosis of peripheral NK cells. METHODS: After NK cells were cocultured with recombinant soluble MICA proteins overnight, the cytotoxicity of NK cell on target cells was detected by flow cytometry. The supemant was collected to determine the concentration of IFN-γ by ELISA. The proliferation of NK cells to sMICA was detected by MTS/PMS. NK cells were labeled with annexin V and PI to analyze their apoptosis. RESULTS: Soluble MICA inhibited the cytotoxicity of NK cells and down-regulated the secretion of IFN-γ, but it showed no effects on the proliferation and apoptosis of freshly isolated peripheral NK cells. CONCLUSION: The soluble MICA shedding from tumor cells could be a pathway of cancer immune evasion by down-regulating the biologic activities of NK cells.

The motor function of the trunk in 10 hemiplegic patlents was evaluated with Biodex Sys- tem Ⅱisokinetic testing aparatus. The result shows that the strength of flexors and extensors of the trunk,especially the flexors,becomes weaker(The ratio of flexors to extensors is less than 1).The patients weretreated with a series of the trunk retraining methods. The motor function of the trunk was improved aftertreatment(P<0.01 ).The total motor function(Fugl-Meyer Assessing Scale)also makes significant progress(P<0.01).The study proposes that the retraining and regaining of the trunk motor function in hemiplegiais quite important not only to the trunk but also to total motor function.

Objective To study the effect of mitogen-activated protein kinas/extracellular signalregulated kinase (MAPK/ERK) signaling pathway on cell proliferation modulated by Sonic Hedgehog (Shh) signaling in fibroblast-like synoviocytes (FLS) isolated from patients with active rheumatoid arthritis (RA).Methods The synovial tissue were collected by the synovial arthroscopic debridement or arthroscopic synovectomy of RA patients with active disease activity [disease activity score(DAS)28 ≥3.2].The RA-FLS were primarily cultured by the explanted culture,and then were treated with Shh agonist purmorphamine,inhibitor cyclopamine or MAPK/ERK signaling pathway inhibitor U0126,respectively.Western blotting was used to examine the phosphorylation level of ERK 1/2 (p-ERK1/2),which was the critical protein of MAPK/ERK signaling.The cell proliferation activity was detected using cell proliferation and cytotoxicity kit-8 (CCK8),and the cell proliferation rate was detected using a flow cytometry.Analysis of variance and Kruskal-Wallis H(K) test were used for statistical analysis.Results Compared with the control group,purmorphamine transiently increased p-ERK1/2 protein at the concentration of 1 μmol/L,and the peak activations of p-ERK1/2 took place at 15 min (P＜0.01).Cyclopamine and U0126 decreased the expression ofp-ERK1/2 protein (P＜0.01).After the RA-FLS treated with purmorphmine(1 μmol/L)for 48 hours,the cell proliferation activity was (114±4)％ and the percentage of S phase cells was (8.39±0.60)％,which was significantly higher than those of the control group (100±0)％ (P＜0.01) and (3.29±0.69)％ (P＜0.01).After treated with cyclopamine (10 μmol/L) for 48 hours,the cell proliferation activity of RA-FLS was (89±1)％ (P＜0.05) and the percentage of S phase cells was (1.53±0.22)％ (P＜0.05).When co-treated with purmorphamine (1 μmol/L) and U0126 (10 μmol/L),the cell proliferative activity was (89±2)％ (P＜0.05) and the percentage of S phase cells was(1.07±0.25)％(P＜ 0.05).Conclusion Shh may promote proliferation of RA-FLS via modulating MAPK/ERK signaling,which in turn contributes to hyperplasia of synovium and ultimately leading to RA.

Objective: To study the anti-gout effect of active ingredients in Poecilobdella manillensis. Methods: Hypoxanthine was used to replicate mouse model of hyperuricemia, and xylene was used to induce mouse auricle swelling model. The hot plate method and writhing method were used to screen the active site of Poecilobdella manillensis, and then the active ingredients were screened. The material basis of anti-gout effect of Poecilobdella manillensis was observed. Results: The water-soluble fraction of Poecilobdella manillensis was the active site against gout, which could reduce the level of serum uric acid in hypoxanthine-induced hyperuricemic mice and inhibit xylene-induced auricular swelling in mice, deduce acetic acid-induced writhing reaction in mice and increase the hot plate pain threshold in mice; Hirudin was the main active ingredient in water-soluble parts. Poecilobdella manillensis active ingredient 0.8 g/kg and 0.4 g/kg and Poecilobdella manillensis residue 2.0 g/kg could significantly reduce serum uric acid levels. The serum uric acid levels decreased from232.73 ± 50.93 umol/L in model group to 140.70 ± 25.97 umol/L, 149.07 ± 39.28 umol/L, 176.45 ± 44.33 umol/L, respectively (P ＜ 0.01) . Poecilobdella manillensis active ingredients 0.8 g/kg, 0.4 g/kg and 0.2 g/kg and Poecilobdella manillensis residue 2.0 g/kg could significantly inhibit xylene-induced ear auricle swelling in mice. The swelling degree was inhibited from 22.80 ± 2.86 mg to 20.10 ± 2.18 mg, 19.80 ± 2.57 mg, 20.10 ± 1.66 mg and 20.85 ± 1.60 mg respectively (P ＜ 0.05) . Poecilobdella manillensis 0.8 g/kg active ingredient could significantly reduce the number of writhing mice caused by acetic acid. The number of times was reduced from 22.80 ± 2.86 times to 20.10 ± 2.18 times (P ＜0.05) . Conclusion: Poecilobdella manillensis anti-gout activity is in water-soluble parts, and Hirudin is the main active ingredient.

Objective:To investigate the effect of repeated freezing and thawing on the clinical outcome of embryo transfer.Methods:A total of 48 cycles of twice frozen-thawed embryo (blastocyst) transfer in the reproductive medicine department, Shenzhen Luohu People′s Hospital from 2015 to 2020 were collected as the observation group, and 98 cycles of one frozen-thawed blastocyst transfer in the same period were randomly selected as the control group. The patient′s age, endometrial thickness, average number of transferred embryos, average number of high-quality embryos transferred, embryo recovery rate, implantation rate, clinical pregnancy rate, abortion rate, ectopic pregnancy rate, and live birth rate were compared.Results:There was no significant difference in age, endometrial thickness, number of embryos transferred and high-quality embryos transferred between the two groups (all P>0.05). There was no significant difference in embryo recovery rate, ectopic pregnancy rate, abortion rate and live birth rate between the two groups (all P>0.05). The embryo implantation rate and clinical pregnancy rate in the observation group were significantly lower than those in the control group (32.47% vs 55.70%, 39.58% vs 66.33%, all P<0.05). Conclusions:The clinical pregnancy rate was significantly lower than that of the control group after repeated vitrification of frozen-thawed embryo transfer, which may affect the subsequent developmental potential of embryos.

Objective:To understand the quality of life of high risk population of stroke in community and analyze the influencing factors.Methods:Four community health service centers in Huangpu District were randomly selected, and the subjects were included by using convenient sampling method among the high risk groups of stroke found in the community stroke screening and prevention and control project in Shanghai.The World Health Organization quality of life scale-brief form questionnaire(WHOQOL-BREF), self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used as the survey tools to study 1200 high-risk stroke subjects.Single sample t-test was used to compare the differences between the scores and the data of 24 centers in the world, and multiple linear stepwise regression were used to analyze the influencing factors. Results:The scores of physical field, psychological field and social relationship field ((13.60±1.86), (14.58±1.97), (13.72±2.10)respectively) of high-risk population of stroke were lower than the scores of general population of 24 centers in the world ( P<0.01), and the scores of environmental field (14.08±1.95) were higher than it ( P<0.01), of which the differences were all statistically significant.The results of multiple linear stepwise regression analysis showed that old age, anxiety and depression were the risk factors influencing the scores of physical field( β=-0.027, -0.056, -0.051), psychological field( β=-0.019, -0.055, -0.050) and environmental field( β=-0.017, -0.040, -0.054); old age and depression were the risk factors influencing the scores of social relationship field( β=-0.026, -0.067); anxiety and depression were the risk factors influencing the self-assessment of quality of life and health ( β=-0.012, -0.014 for quality of life; -0.012, -0.014 for health, all P<0.01). Conclusion:The quality of life of high-risk population of stroke may be related to age, depression, anxiety and other psychological factors.The prevention and treatment of stroke should take both physical and mental measures, take timely intervention for poor psychological status, and gradually improve the quality of life.

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.

Chronic pain is a subjective experience that is difficult to accurately and objectively assess.Electroencephalography(EEG)can record physiological electrical signals generated during brain activity,and time signals reflect brain activity during task processing.The frequency signals reflect quiet brain activity.This paper reviews changes of event-related potential in EEG time signal,changes of different frequency bands in frequency signal and changes of event-related synchronization or desynchronization between the two signals in patients with chronic pain.

Objective:To explore the clinical outcome of bilobed free peroneal artery perforator flap to repair the postoperative defect of maxillofacial malignant tumors.Methods:A total of 47 patients with maxillofacial malignant tumor with postoperative defects in the Affiliated Hospital of Nantong University from January 2018 to December 2021 were included. They were treated with bilobed free peroneal artery perforator skin flap. After the tumor was removed, the left leg was used as donor site. Based on the defect area of maxillofacial region, a bilobed perforator flap was designed and harvested. After surgery, the survival of the flap, recovery of voice, swallowing function, and flap appearance were evaluated. Speech and swallowing function were scored on a scale of 10.Results:A total of 47 patients were included, 27 males and 20 females, aged 43-79 years.There were 19 cases of buccal malignant tumors, 19 cases of tongue malignant tumors, 9 cases of gingival malignant tumors, 40 cases of squamous-cell carcinoma, 5 cases of adenoid cystic carcinoma and 2 cases of mucoepidermoid carcinoma. The area of maxillofacial defects ranges from (54-84) cm 2, the area of the flap ranges from (50-81) cm 2. During the operation, 17 cases were repaired and the mandibular was reconstructed with vascularized fibula flap. All 47 patients were followed up for an average of 12 months. All patients’ postoperative defects were effectively covered, the flaps survived, the appearance was satisfactory, the flap donor area is well restored, and the speech and swallowing functions were good. The scores of speech function and swallowing function were (8.15±1.35) and (7.43±1.19) respectively. Conclusions:The bilobed free peroneal artery perforator skin flap can be applied to repair the defects of maxillofacial malignant tumors. The flap appearance is acceptable, the recovery time is short. The defective skeletal tissue can be repaired at the same time. with concealed the donor site.

Objective To explore the effect of quality control circle ( QCC ) on postoperative ambulation among patients with lumbar spinal stenosis. Methods The QCC group had been established. 5M selection method was used for the topic “To improve the correct rate to get out of bed for postoperative patients with lumbar spinal stenosis”, and then we made plan time table, set up the goal-89. 44% correct rate o get out of bed for postoperative patients with lumbar spinal stenosis after analyzing the incorrect reasons, confirmed 5 reasons after argument, formulated countermeasure and checked out the effects. Results After QCC activities, the rate of correct ambulation ( get out the bed ) amounted 92%, while 76% before the activities, with a significant difference (χ2 =9. 52,P<0. 01). Level of specialty, working passion, team spirit, ability of QCC activity, problem solving skills and communication skills had been improved. Conclusions QCC activities can significantly improve the correct rate of getting out bed, effectively shorten the average length of hospitalization, and improve patients′satisfaction and professional level in clinical nursing.