Radioactive seed implantation in pancreatic cancer is a very effective treatment. Its indications, contraindications and complications have been improved gradually. Radioactive seeds can be implanted precisely under CT or ultrasound-guided. Treatment of seeds can be combined with chemotherapy, radiofrequency ablation and other means to improve the clinical efficacy.

Objective To investigate the relationship between multidrug resistance of X-ray irradiated human nasopharyngeal squanous carcinoma cell line CNE1 and platelet endothelial cell adhesion molecule-1 (PECMA-1)/phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT)/Bcl-2 signaling pathway.Methods ①The CNE1 cells were cultured in incubator.Exponentially growing CNE1 cells were exposed to 50 Gy ionizing radiation administered in 25 fractions,2 Gy per fraction,once every two days,and the CNE1/R cells were collected.②CNE1/R cells were cultured for 24 h,and divided into three groups:the control group,experimental group one (CNE1/R cells were processed through 1 ∶ 600 PECAM-1 antibody for 24 h) and experimental group two (CNE1/R cells were processed through 10 μmol/L PI3K inhibitor LY294002 for 24 h).③The half maximal inhibitory concentration (IC50) values of the control group and two experimental groups of CNE1/R cells were detected by methyl thiazolyl tetrazolium (MTT).④The mRNA expressions of PI3K and Bcl-2 in the control group and experimental group one were measured by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).⑤The mRNA expressions of AKT and Bcl-2 in the control group and experimental group two were measured by semi-quantitative RT-PCR.Results ①The IC50 of the control group,experimental group one and two were (2.99 ± 0.02) μg/ml,(1.50 ± 0.03) μg/ml and (1.60 ±0.05)μg/ml,and the difference among the three groups was statiatically signficant (F =4 381.263,P =0.000).The IC50 of the two experimental groups were obviously lower than that of the control group (t =116.885,P =0.000;t =73.006,P =0.000).②The semi-quantitative values of PI3K in the control group and experimental group one were 1.66 ±0.01 and 0.90 ±0.05 (t =50.394,P =0.000),and the semi-quantitative values of Bcl-2 were 1.66 ±0.02 and 0.71 0.05 (t =183.165,P =0.000),and the differences were statistically significant.③The semi-quantitative values of AKT of control group and experimental group two were 1.53 ± 0.01 and 0.72 ± 0.01 (t =135.281,P =0.000),and the semi-quantitative values of Bel-2 were 1.66 ± 0.02 and 0.63 ± 0.02 (t =128.814,P =0.000),and the differences were statistically significant.Conclusion PECAM-1 induced multidmg resistance of human nasopharyngeal squamous cell carcinoma CNE1 cells may be related to the activity of Bcl-2 through the signal pathway of PI3K/AKT.

Objective To determine the relationship of cytochrome P-450 epoxygenase metabolites of arachidonic acids with impaired endothelium-dependent vasorelaxation in the healthy elderly. Methods A case-control study was employed.The study enrolled 60 healthy young adults (group A) and 60 healthy senior citizens (group B) of Han population in Shanghai. Serum contents of 14,15-dihydroxyeicosatrienoic acid (14,15-DHET) (a stable metabolite of 14,15-EET), 6-Kote-PGF1a (a stable metabolite of prostaglandin) and TXB2 (a stable metabolite of thromboxane A2) were measured using ELISA kits. The endothelium-dependent vasorelaxation (EDV) and endothelium-independent vasorelaxation (NEDV) in brachial arteries were determined by color Doppler ultrasound. Results Compared with group A, group B had significant higher levels of hemoglobin A1c, triglyceride and cholesterol levels (P＜0.01), and significant lower levels of 14,15-DHET and 6-Kote-PGF1a (P＜0.001), leading to increased values of TXB2/6-Kote-PGF1a and TXB2/14,15-DHET. There was bigger basal interior diameter of brachial arterials with reduced EDV and NEDV response (P＜0.01 and P＜0.05, vs. group A respectively) in group B. Moreover, the age was negatively correlated with 14,15-DHET and TXB2/14,15-DHET. Conclusions Our results indicate that the impaired EDV and NEDV in aging are associated with reduced production of arachidonic acid metabolites through cytochrome P-450 epoxygenase pathway and cyooxygenase pathway of endothelium in the healthy elderly.

Objective: : Extracranial supra-aortic dissections (ESADs) with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke. Endovascular stenting to reconstruct non acute phase ESADs (NAP-ESADs) is an alternative to anticoagulant or antiplatelet therapy. However, its feasibility, safety and efficacy of stenting in NAP-ESADs is unclear. This study aims to investigate the long-term outcomes of the feasibility, safety and efficacy of stenting in NAP-ESADs. Methods: : Seventy-four patients with 91 NAP-ESAD vessels with severe stenosis, occlusion and/or pseudoaneurysm presents potential risk of stroke who underwent stent remodeling were enrolled into this respective study from December 2008 to March 2020. Technical success rate, complications, clinical and angiographic results were harvested and analyzed. Results: : Success rate of stent deployment was 99% (90/91) with no procedural mortality or morbidity. Transient ischemic attack occurred in three patients during operation (4.1%, 3/74). Asymptomatic embolisms of distal intracranial vessels were found in two patients (2.7%, 2/74). One hundred and forty-two stents deployed at 85 carotid (135 stents) and six vertebral (seven stents) vessels. Six stent types (Wingspan, 28/135, 20.7%; Solitaire, 10/135, 7.4%; Neuroform, 8/135, 5.9%; LVIS, 2/135, 1.5%; Precise, 75/135, 55.6%; Acculink, 12/135, 8.9%) were deployed at carotid arterial dissection while two types (Wingspan, 5/7, 71.4%; Solitaire 2/7, 28.6%) at vertebral arterial dissection. Digital subtracted angiography (56%, 51/91), computational tomography angiography (41.8%, 38/91) and high resolution magnetic resonance imaging (2.2%, 2/91) were adopted for follow up, with a mean time of 17.2±15.4 months (5–77). All patient modified Rankin Scale scores showed no increase at discharge or follow-up. Angiographically, dissections in 86 vessels in 69 patients (94.5%, 86/91) were completely reconstructed with only minor remnant dissections in four vessels in four patients (4.4%, 4/91). Severe re-stenosis in the stented segment required re-stenting in one patient (1.1%, 1/91). Conclusion : Stent remodeling technique provides feasible, safe and efficacious treatment of ESADs patients with severe stenosis, occlusion and/or pseudoaneurysm.

Objective: To explore the relationship of maternal adverse childhood experiences(ACEs) with mother child relationship, so as to provide reference for parent child relationship and child health promotion. Methods: In June 2021, children aged 3-6 years old of 36 kindergartens in three areas in Anhui Province were selected by stratified cluster sampling method, follow up data were collected in December 2021, and a total of 6 111 children were included in the study. Maternal ACEs and mother child relationship were respectively assessed using the Adverse Childhood Experiences International Questionnaire(ACEs-IQ)and the Child Parent Relationship Scale (CPRS). A multiple linear regression model was established to analyze the association of maternal ACEs and mother child relationship in preschool children. Results: History of maternal childhood sexual abuse, physical neglect and peer bullying were negatively associated with mother child intimacy ( r =-0.03, -0.03, -0.03, P <0.05). Maternal emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, peer bullying, community violence, and total family dysfunction were positively associated with mother child dependence and mother child conflict ( r =0.09, 0.08, 0.05, 0.14, 0.06, 0.11, 0.08, 0.04; 0.18, 0.17, 0.07, 0.20, 0.11, 0.16, 0.12, 0.10, P <0.01). There was no statistically significant between all types of maternal ACEs and mother child intimacy in boys( P >0.05). Mothers with a history of physical abuse, sexual abuse and peer bullying had a statistically significant relationship between mother child intimacy in girls( β =-0.17, -0.62, -0.19, P <0.05). All types of maternal ACEs were positive predictors of mother child conflict between boys and girls( β =0.37-1.96, P <0.05). There was statistical significance between maternal childhood sexual abuse and mother child dependence of boys( β =0.53, P <0.05), but no statistical significance between maternal childhood sexual abuse and mother child dependence of girls( P >0.05). All other types of maternal ACEs were positive predictors of mother child dependence( β =0.09-0.41, P <0.05). Conclusion Maternal ACEs are associated with poor mother child relationship among preschool children, and maternal ACEs should be actively followed, which is of great significance for improving the parent child relationship and promoting child healthy development.

Objective: To explore the relationship and gender difference between family rearing styles with emotional and behavior problems in preschool children aged 3-6 years, so as to provide reference for early prevention and intervention of children s emotional and behavior problems. Methods: Using the method of stratified cluster sampling, 9 647 children aged 3-6 years old from 36 kindergartens in Wuhu, Lu an and Fuyang of Anhui Province were selected in June 2021. Primary caregivers were investigated with self designed questionnaire, Strengths and Difficulties Questionnaire (parents version) and Parental Rearing Style Scale. Results: The detection rate of elevated SDQ total difficulty score was 6.5%, with boys (7.1%) higher than that of girls (5.8%). The detection rate of abnormal emotional behavior were significantly higher in children with high scores on doting, laissez faire, autocracy and inconsistency of family rearing style, compared with those in the low score group ( χ 2=210.32, 203.87, 102.70, 212.69, P <0.01 ), and the detection rate increased with the increase of score. However, the detection rate of abnormal emotional behavior in the high score group of democracy was significantly lower than that in the low score group ( χ 2=156.24, P <0.01), and the detection rate decreased with the increase of score. Logistic regression analysis showed that high level doting ( OR =4.31), laissez faire ( OR = 4.16), autocracy ( OR =3.36) and inconsistency ( OR =4.76) of family rearing style were associated with high risk of children s emotional behavior problems, while high level of democracy ( OR =0.34) in family rearing style was associated with low risk of emotional behavior problems. The comparison between boys and girls showed that the risk of emotional and behavioral problems in the indulgent rearing style of boys was significantly higher than that of girls ( OR =1.90, 2.13) ( P <0.05). Conclusion Family rearing styles are associated with emotional and behavioral problems among preschool children. Boys are sensitive to the negative impact of doting rearing style. Good rearing styles is beneficial to the prevention and control of children s emotional and behavioral problems.

Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.

BACKGROUND:The basic principle of the design of the robot system used for total knee arthroplasty is to combine three-dimensional surgical planning,early warning of danger areas during surgery,real-time data feedback,robot arm assisted osteotomy and other technologies to achieve precision and personalization of total knee arthroplasty,which is exactly its biggest advantage.Therefore,it has become a hot topic in the field of joint surgery in recent years and attracted much attention. OBJECTIVE:To summarize the development status of robotic-assisted total knee arthroplasty in the field of joint surgery and the comparison of advantages and disadvantages with conventional total knee arthroplasty and to prospect the future development of robotic-assisted total knee arthroplasty. METHODS:Relevant articles were searched from PubMed,CNKI,Wanfang and VIP databases by computer.English key words were"robot OR robotic OR robotics OR robotically OR computer,total knee arthroplasty OR total knee replacement,TKA OR TKR".Chinese key words were"robotic-assisted,computer navigation,total knee arthroplasty".Finally,64 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)The robot system used to assist total knee arthroplasty is divided into active,semi-active and passive according to its degree of freedom.The semi-active system,currently widely used in robotic systems,effectively enhances the accuracy and personalization of total knee arthroplasty.However,its high implementation cost and relatively steep learning curve remain key factors to be balanced when promoting its adoption in joint surgery field.(2)Robotic-assisted total knee arthroplasty can achieve precise osteotomy and correct placement of prosthesis in local three-dimensional space of the knee joint.It has been widely proven that it can provide better accuracy of prosthesis implantation,reduce imaging abnormalities,obtain good soft tissue balance during the operation,and ultimately improve the motion and functional status of the knee joint after the operation.(3)However,the current robotic-assisted system still has objective shortcomings,including the problem of learning curve between different robot devices and operators,additional installation and maintenance costs,and potential complications related to robot surgery.Therefore,whether it can truly benefit the medical system and patients still needs to be proven by long-term research,and the robotic-assisted system also needs to be further improved substantially.(4)Robotic-assisted total knee arthroplasty technique is still in the preliminary research stage in clinical practice and has not been widely applied.To better define the usage of robotic-assisted total knee arthroplasty and enhance its clinical procedural standards and safety,refining these aspects will become a focal point of future research on robotic-assisted total knee arthroplasty.

Objective: To analyze the associations among body mass index (BMI), learning screen/gaming screen exposure and executive function in preschool children in Anhui Province, so as to provide a basis for promoting the development of executive function in preschool children. Methods: In June 2022, a stratified cluster sampling and convenience sampling methods were used to survey 3 534 mothers of preschool children in Wuhu City, Luan City, and Fuyang City, Anhui Province. The Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) was used to assess the preschool childrens executive function abnormalities. Binary Logistic regression was conducted to examine the relationships among BMI, learning screen/gaming screen exposure, and their combined effects on executive function abnormalities. Results: The detection rate of abnormal executive function in preschool children was 9.65%. Logistic regression analysis showed that after adjusting for the confounding factors such as pregnancyinduced hypertension, primary caregivers, family per capita monthly income and family structure, the risk of abnormal executive function of children in overweight/obesity group and high learning screen/gaming screen exposure group increased significantly (overweight/obesity:OR=1.78, 95%CI=1.31-2.42, learning screen exposure:OR=1.48, 95%CI=1.18-1.86, gaming screen exposure:OR=1.50, 95%CI=1.18-1.91,P<0.05). Compared with children with normal BMI and low learning screen/gaming screen screen exposure, those with both overweight/obesity and high learning screen/gaming screen exposure had a significantly greater risk of executive function abnormalities (OR=2.07, 95%CI=1.29-3.31; OR=2.42, 95%CI=1.59-3.68,P<0.05). Conclusions Overweight/obesity and high learning screen/gaming screen exposure are important risk factors for executive function abnormalities in preschool children. Therefore, actively guiding preschool children to develop healthy life habits to promote the normal development of their executive functions is essential.

Objective: To explore the relationship and gender difference between maternal adverse childhood experiences (ACEs) with emotional and behavioral problems (EBPs) in preschool children, and to provide a reference to promote emotional and behavioral problems among preschool children. Methods: Using the method of stratified cluster sampling, 9 647 children from kindergartens in three cities of Anhui Province were selected in June 2021. Maternal adverse childhood experiences were investigated with the WHO Adverse Childhood Experiences International Questionnaire(ACEs-IQ), preschool children s emotional and behavioral problems were investigated with Strengths and Difficulties Questionnaire. Results: The detection rate of abnormal emotional behavior was 17.4%, emotional symptoms 16.3%, conduct problems 18.3%, hyperactivity 22.7%, peer problems 34.2%, prosocial behaviors 18.5%. Multivariate Logistic regression analysis showed that maternal adverse childhood experiences were positively associated with the risk of emotional and behavioral problems ( OR =1.51-2.97, P <0.01). Maternal cumulative adverse childhood experiences were also positively associated with the risk of emotional and behavioral problems( OR =3.13-9.61, P <0.01). The association of maternal emotional abuse, physical abuse and community violence with peer problems were stronger in boys than that of girls ( ROR =1.25, 1.26, 1.41, P <0.05). Conclusion The findings suggest maternal adverse childhood experiences were associated with emotional behavior problems among preschool children. Focusing on the maternal adverse childhood experiences is crucial for the prevention and control of childhood emotional and behavioral problems.