Objective A new type adsorbent for removal of bacterial ET was prepared by immobilizing L-serine covalently onto polyvinylidene difluoride membrane (PVDF-Ser) to study the effect of hemoperfusion on sepsis induced lung injuries in a pig model. Method Endotoxemia were induced in thirteen pigs by injecting endotoxin (1 μg/(kg·h) ) intravenously for 2 h. One hour later, the pigs were treated with absorber of PVDF-Ser volumn (group hemoperfusion) or empty adsorber (group control) for 2 h. Extravascular lung water indexed to body weight and alveolar capillary permeability, levels of serum endotoxin, tumor necrosis factor-α, interleukin-6, malondialdehyde, glutathione, myeloperoxidase activity, and lung histological changes and myeloperoxidase immunohistochemical analysis were measured. Results Hemoperfusion treatment with PVDF-Ser volumn significantly improved extravascular lung water, pulmonary alveolar capillary permeability and lung injuries ( P ＜ 0. 05). In addition, hemoperfusion attenuated both serum and pulmonary cytokines, and decreased lung malondialdehyde and myeloperoxidase levels ( P ＜ 0. 05). Conclusions Hemoperfusion with the adsorber of PVDF-Ser volumn effectively reduced inflammatory responses and improved lung injuries and oxidative stress in endotoxemia. It has a high potential of clinical application for treatment of patients with severe sepsis.

Objective To investigate the survival profile of the intradermally injected mouse autologous skin fibroblasts and the changes of the collagen fibers by using green fluorescent protein labeling and two-photon fluorescence microscopy. Methods The cultured cells were transfected by EGFP lentivirus, and then the cells were injected into the corresponding mouse skin. Biopsy was taken from the animals after 1 and 2 months. The specimens made serial frozen sections, the survival profile of the injected cells and the changes of the collagen fibers were observed by two-photon fluorescence microscopy. The collagenic area and dermal thickness were measured with image analysis software, and statistical analysis was also carried out. Results Two-photon fluorescence microscopy showed clear images of the injected cells and collagen fibers. Both the area of collagen fibers and the dermal thickness were significantly increased in injected cells after 2 months (P<0.05), however, there were no difference between injected cells and control after 1 mouth (P>0.05). Conclusions Autologous cultured fibroblasts could survive in a long time after transplantating into the skin, and collagen could be newly produced, the depth of dermis increases, which provides a possibility to treat mini-defects of the tissue.

Objective:To investigate and analyze the current status of multimodality therapy for resectable gastric cancer, aiming to provide reference for optimizing the multimodality treatment strategy for gastric cancer.Methods:Clinical data of patients diagnosed with gastric adenocarcinoma undergoing radical gastrectomy in the Second Affiliated Hospital of Soochow University were retrospectively analyzed. Clinical characteristics, preoperative medical comorbidities, pathological features, surgical and perioperative status and clinical efficacy were recorded. The gap between the diagnosis and treatment procedures and the standard guidelines was analyzed. The changes in the multimodality treatment patterns for gastric cancer were understood.Results:A total of 265 patients were included in this study. All patients were divided into two cohorts: early[2008] and late[2013] cohorts. In the early cohort, 127 patients were assigned, and 138 cases in the late cohort. In the early cohort, 67 patients (52.8%) underwent D 2 lymph node dissection, significantly less than 83 patients (60.1%) in the late cohort ( P<0.01). In the early and late cohorts, the proportion of patients with the number of lymph node dissection of ≥15 was 5.5% and 52.8%( P<0.01). The median number of lymph node dissection was increased from 6 to 16. The proportion of patients receiving neoadjuvant chemotherapy in the early and late cohorts was 2.4% and 3.6%( P=0.55). In the early cohort, the proportion of patients treated with postoperative chemotherapy and postoperative adjuvant chemoradiotherapy was 62.6% and 2.4%, significantly higher compared with 58.0% and 8.0% in the late cohort ( P=0.04). In addition, the proportion of patients receiving postoperative chemotherapy in the early cohort was 62.2%( n=79) and 58.0%( n=80) in the late cohort ( P=0.48). Conclusions:Although the level of radical gastrectomy has been continuously improved and standardized in China, which still lags behind the standard D 2 radical gastrectomy in Japan and South Korea. Adjuvant therapies including postoperative adjuvant radiotherapy can bring clinical benefits. However, the proportion of patients receiving adjuvant therapy is still low, and the multimodality therapy of gastric cancer should be widely applied.

Objective To establish LC‐MS/MS method for the determination of fluoxetine in human plasma .Methods After protein precipitation of acetonitrile the plasma sample was separated on an Agilent XDB‐C18 column using acetonitrile‐1 mmol/L ammonium formate(containing 0 .1% formic acid) as mobile phase by gradient elution .Detection was carried out by multiple reac‐tion monitoring(MRM) on 3200QTRAP LC‐MS/MS system .Results The assay was linear over the range 0 .30 -50 .0 ng/mL with a lower limit of quantitation of 0 .30 ng/mL .Intra‐and inter‐day precision were less than 15% ,respectively .The relative devia‐tion was in the range -2 .80% -2 .09% .The recovery of fluoxetine was more than 98% with less matrix effects .The stabilities were good .Conclusion It could be a rapid ,sensitive ,selective and reliable method for the determination of fluoxetine in human plas‐ma for therapeutic drug monitoring and pharmacokinetics .

Objective To investigate the variation of multivoxel 1 H magnetic resonance spectroscopy(1 H-MRS)before and after continuous positive airway pressure(CPAP)treatment in obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Brain multivoxel 1 H-MRS examinations were performed in 25 cases of moderate or severe OSAHS patients before and after CPAP treat-ment,and 25 cases of healthy.The ratios of brain metabolites of the frontal lobe were recorded and analyzed respectively.To observe whether the lactate(Lac)peak appeared or not.Results In the frontal lobe,the NAA/Cr,NAA/Cho of the patients before treatment (2.021 2±0.231 2 and 1.608 8±0.257 1,respectively)was decreased compared with the healthy (2.726 8±0.607 1 and 2.445 6± 0.437 5).The NAA/Cr,NAA/Cho of the patients after treatment (2.314 0±0.312 8 and 2.01 6 4±0.424 0,respectively)was in-creased compared with the patients before treatment (2.021 2±0.231 2 and 1.608 8±0.257 1).The NAA/Cr,NAA/Cho of the pa-tients after treatment (2.314 0±0.312 8 and 2.01 6 4±0.424 0,respectively)was decreased compared with the healthy (2.726 8± 0.607 1 and 2.445 6±0.437 5),and the difierences were statistically significant (P <0.01).The Cho/Cr of the patients before treatment (1.293 2±0.261 5)was increased compared with the healthy (1.129 2±0.157 7),the difference was statistically significant(P <0.05).Lac peak was not detected in all.Conclusion Multivoxel 1 H-MRS can demonstrate sensitively the changes of brain metabolism in pa-tients with OSAHS before and after CPAP treatment,and may provide imaging evidence for clinical therapeutic effect and prognostic evaluation.

Objective To evaluate the efficacy and safety in the treatment of acetabular fractures via anterior approaches,including ilioinguinal,stoppa,pararectus approach.Methods Systematic literature retrieval was carried out to obtain two-arm and one-arm researches on the treatment of acetabular fractures via any one of the three approaches before May 2017,from pubmed,embase,cochrane library Databases.Data extraction and quality evaluation of studies were performed by 3 investigators independently.A meta-analysis was performed by RevMan 5.3 and Meta-Analyst beta 3.13.Results Totally 22 low to moderate quality studies,including 7 two-arm and 15 one-arm were included.There were 980 patients,including 581 in ilioinguinal approach group,264 in stoppa approach group and 135 in pararectus approach group.Meta-analysis showed the rate of anatomic reduction in stoppa approach was higher than that in ilioinguinal approach (OR=0.58,95％CI:0.36-0.94,P=0.03),which in pararectus approach was higher than that in ilioinguinal approach (0R=2.95,95％CI:1.22-7.10,P=0.02).Compared to the ilioinguinal approach,the operation time in the Stoppa approach was shorter (MD=48.01,95％CI:17.08-78.95,P=0.002),there was no statistically significant difference between pararectus approach and ilioinguinal approach.In addition,there were no statistically significant differences among three approaches in intra-operative blood loss,postoperative functional outcomes and complications.Conclusion The available limited evidence suggests that the rate of anatomical reduction in stoppa and pararectus approach may be higher than ilioinguinal approach.Compared to the ilioinguinal approach,the operation time in the stoppa approach may be shorter.In this field,further rigorous design,baseline parallel,direct comparison controlled studies on this topic are still needed.

Objective To evaluate the relationship between interleukin-18(IL-18) and insulin resistance, measured by euglycemic hyperinsulinemic clamp, in women with polycystic ovary syndrome (PCOS). Methods Forty-two young women with PCOS and 38 age-and body mass index (BMI)- matched control women were recruited in this study. A complete hormonal assay was performed and serum IL-18 level was determined in each subject. And euglycemic hyperinsulinemic clamp test was completed in 41 of the above subjects. Results Serum IL-18 levels were increased in the PCOS women, as compared with the control (P=0.033). When all subjects were divided into lean and obese groups, the IL-18 levels were slightly increased in the obese subjects (P=0.902). IL-18 levels were negatively correlated with all the clamp parameters [mean glucose infusion rate (M), M-to-insulin ratio (M/I) and glucose metabolic clearance rate (MCRg), r =-0.419,-0.396,and-0.405,P=0.006,0.010 and 0.009 respectively], but were positively associated with HOMA-β index(r=0.334, P=O.035). Conclusion Serum IL-18 level was significantly increased in PCOS women and was strongly associated with the parameters obtained from the euglycemic hyperinsulinemic clamp, indicating that IL-18 may be an important mediator between inflammation and insulin resistance.

Objective To explore the possible correlation between serum highly sensitive C reactive protein (hs CRP) and blood glucose, insulin, lipids ,insulin sensitivity index (SI),acute insulin response(AIR), and adiponectin in subjects with impaired glucose tolerance (IGT) or newly diagnosed type 2 diabetes mellitus(DM). Methods SI and AIR were assessed by the reduced sample number of Bergman′s minimal model method by intravenous glucose tolerance test in subjects. Meanwhile body mass index (BMI), waist hip ratio (WHR), the serum lipid profile, hs CRP, adiponectin levels were measured. Results Compared with normal control (NC) group[SI(6.6?2.4) 10 -4 (min?mU/L) -1 ,adiponectin7.77(6.35 10.70 mg/L),hs CRP0.40(0.21 1.67mg/L)], the SI and serum adiponectin in IGT group [(1.5?1.1) 10 -4 (min?mU/L) -1 , 4.29(3.59 6.22 mg/L) respectively] and type 2 DM group [(1.5?1.0)?10 -4 (min?mU/L) -1 , 3.46(2.37 4.72 mg/L) respectively] were significantly decreased (all P

Humans ; Female ; Breast Neoplasms/genetics* ; Prognosis ; Gene Expression Profiling ; Biomarkers, Tumor/genetics* ; Gene Expression Regulation, Neoplastic/genetics* ; Receptor, ErbB-2/metabolism* ; Gene Regulatory Networks/genetics*

Objective:To observe and analyze the effect of peripore cavity size on visual function of macular area before and after surgery for idiopathic macular hole (IMH).Methods:A retrospective clinical study. From July 2020 to February 2021, a total of 25 patients with 25 eyes with monocular IMH (operation group) diagnosed by ophthalmology examination in Department of ophthalmology, Fourth Hospital of Hebei Medical University were included in the study. The control group was contralateral healthy eyes. All subjects were examined by best corrected visual acuity (BCVA), microfield of vision, frequency domain optical coherence tomography (SD-OCT), and OCT angiography (OCTA). The diameter of macular hole was measured by SD-OCT. The cystic morphology of deep capillary plexus (DCP) was detected by en face OCT, and the cystic area was measured by Image J software. MP-3 microperimeter was used to measure central macular retinal light sensitivity (MS) and mean macular retinal light sensitivity (MMS). Central macular retinal light sensitivity (CMS), MMS and cystic cavity MS were measured in the operation group. MMS was measured in the control group. The microperimetry images were superimposed on the DCP layer of OCTA to identify and calculate the average MS within the lumen and compare it with the control group. Standard three incisions were performed in all affected eyes by vitrectomy of the flat part of the ciliary body + stripping of the inner boundary membrane + intraocular sterile air filling. Three months after the operation, the same equipment and methods were used to perform relevant examinations. Paired sample t test was used to compare MS between operation group and control group. Pearson correlation analysis was used to analyze the correlation between capsular area, macular hole diameter before and after operation and MS before and after operation. The correlation between BCVA and capsular area before and after surgery was analyzed by Spearman correlation analysis. Results:In the surgical group, the retinal MS was (4.24±3.07) dB. The MMS of control group was (19.08±6.11) dB. The MS in the surgical group was significantly lower than that in the control group, and the difference was statistically significant ( t=10.832, P<0.01). Before operation, the area of cyst was (1.04±0.55) mm 2, and the diameter of macular hole was (564.80±166.59) μm. CMS and MMS were (2.27±2.29) dB and (9.08±3.65) dB, respectively. The diameter of macular hole ( r=0.50, P=0.010) and BCVA before operation ( r=0.57, P<0.001) were positively correlated with peripore cavity area. Before operation, CMS and MMS were negatively correlated with peripore cavity area ( r=-0.53, -0.47; P=0.010, 0.020). At 3 months after surgery, the capsular area was negatively correlated with CMS and MMS ( r=-0.65,-0.76; P=0.020, 0.030). There was no correlation with BCVA ( r=0.23, P=0.470). Conclusions:Retinal MS is decreased in the peri-capsular area of IMH pore. There is a positive correlation between capsule area, BCVA and macular hole diameter before operation. The capsular area is negatively correlated with CMS and MMS before operation.