Objective Evaluation of the benefit and safety of combined thrombolysis and precutaneous coronary intervention in acute myocardial infarction by retrospective analysis. Methods Precutaneous coronary intervention were performed in 45 patients with acute myocardial infarction immediately after thrombolysis. The clinical and angiographic data were compared with that of 31 patients with thrombolysis alone and 74 patients with primary precutaneous coronary intervention in the same period. Results Angiographic data showed that patients with PCI plus thrombolysis had more frequency of TIMI 3 flow than patients with thrombolysis alone (88.9% vs. 74.2%, P=0.087). Patients with PCI plus thrombolysis and with primary PCI had similar frequency of TIMI 3 flow (88.9% vs. 91.9% P=0.404). Clinical data showed that patients with PCI plus thrombolysis had less major adverse cardiovascular events in hospital than patients with thrombolysis alone (4.4% vs. 12.9%, P=0.181). Patients with PCI plus thrombolysis and with primary PCI had similar major adverse cardiovascular events (4.4% vs. 1.4%, P=0.319). Patients with three strategies of treatment had similar mortality (4.4% vs. 6.5% vs. 4.1%). Patients with three strategies of treatment had similar major bleeding events (4.4% vs. 3.2% vs. 1.4%) in hospital. Conclusion Combined thrombolysis and precutaneous coronary intervention maybe surpass thrombolysis alone, at least similar to primary PCI. This strategy of treatment is safe.

Objective To explore the changes of frequency, BAFF expression and sensitivity to apoptosis of CD19 + CD5 + B cells in endometriosis patients and investigate the relationship between CD19 +CD5 + B cells and endometriosis. Methods Flow cytometry and quantitative PCR were used to assess the frequency, BAFF expression and sensitivity to apoptosis of CD19+ CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies of 39 patients with endometriosis and 31 patients with myoma of uterus ( control subjects). Results: All 39 endometriosis patients had higher frequencies ( all P ＜ 0. 01 ) of CD19 + CD5 + B cells in the peripheral blood, peritoneal fluids and endometrium biopsies than that in 31 control subjects. CD19 + CD5 + B cells from endometriosis patients expressed higher BAFF, and were more resistant to CD95L-induced apoptosis than the cells from control subjects ( P ＜ 0. 01 ). Conclusion CD19 + CD5 + B cells might play an important role in the pathogenesis of endometriosis through higher BAFF expression and more resistance to CD95L-induced apoptosis.

Thyroid carcinoma is the most common malignancy in the endocrine system.Most patients cannot be cured with operation alone.The concept and implementation of multidisciplinary team (MDT) in clinical oncology attributes to improved diagnosis and treatment of cancer.MDT plays an important role in diagnosis,treatment,and post operational management of thyroid carcinoma,as well as in the application of novel techniques and translational medicine.MDT can maximize the expertise of various disciplines,strengthen inter disciplinary cooperation,and provide standardized and individualized comprehensive treatment for patients with thyroid cancer.The most important benefit of MDT is that individual patient gets the most appropriate treatment decision made by a team of experts,including endocrinologists,nuclear medicine specialists,pathologists,radiologists,radiation therapists,and surgeons.This will be of great significance to improve quality of life and prognosis,at the same time,avoid over-treatment of thyroid cancer.

BACKGROUND:In vitro culture of sufficient vaginal epithelial cels and smooth muscle cels is the key for vaginal tissue engineering. However, the culture, purification and passage of vaginal epithelial celsin vitro are difficult. Primary culture and passage of vaginal epithelial cels from large animals such as canines has not been reported. OBJECTIVE:To establish a stable method of culturing canine vaginal epithelial cels and smooth muscle cels. METHODS: Vaginal epithelial cels were isolated from the vaginal specimens by enzymatic digestion with Dispase and trypsin separately, and cultured in keratinocyte serum-free medium. Vaginal smooth muscle tissue were minced and digested with colagenase type II; the colected smooth muscle cels were cultured in DMEM culture medium containing 10% fetal bovine serum. The cultured cels were passaged regularly. Cel morphology and proliferation characteristics were observed and cel phenotypes were confirmed by morphology and immunohistochemistry staining. RESULTS AND CONCLUSION: Primary vaginal epithelial cels began to adhere after 24-36 hours, grew logarithmicaly after 4-5 days, and reached 70% confluence after 7-8 days; the epithelial cels showed a typical cobblestone, with no fibroblasts. Cultured epithelial cels passaged every 4-5 days and subcultured to 6-7 generations continuously. Immunohistochemical staining confirmed a positive staining for anti-pancytokeratin (AEl/AE3). Primary cultured smooth muscle cels adhered and grew after 24 hours. The smooth muscle cels were spindle-shaped and proliferated logarithmicaly. After 4 days, primary cultured smooth muscle cels were confluent and showed a typical shape of “peaks and valeys”, and then the cels could be passaged every 3-4 days and passaged 7-8 generations. Immunohistochemistry staining showed α-actin staining was positive. These findings indicate that canine vaginal epithelial cels and smooth muscle cels could have a long-term stable culture and proliferation, to provide adequate seed cels for vaginal tissue engineering.

Objective To evaluate the feasibility of bladder extracellular matrix (BACM) seeding with autologous cultured vaginal smooth muscle cells (VSMC) repaired rabbit vaginal defect.Methods This study included 24 female rabbits.BACM and vaginal acellular matrix (VACM) were obtained from 8 rabbits by decellularization process.The other 16 rabbits were randomly divided into experimental and control groups.Vaginal tissue biopsies ( ～ 1 cm2) were harvested from female New Zealand rabbits.VSMC were cultured and stained with a-smooth muscle actin antibodies. Cultured VSMC cells were seeded on BACM ( experimental group) or VACM ( control group) at a cell density of 1 × 107 cells/cm2.The cell-seeded matrixes were cultured for 5days.In experimental group of 8 rabbits,a 2 cm segment of vagina was resected and replaced with BACM seeding with VSMC.Then the regenerative segment was studied with histological technique by hematoxylin-eosin staining after 3,6 and 12 weeks postoperative aud vaginography was performed at 12 weeks postoperative.The 8 rabbits in control group underwent the exact same procedure as above but the vaginal defect was repaired with VACM seeding with VSMC,Results The prepared BACM and VACM were transparent,HE staining and scanning electron microscopy showed the two acellular matrix was both consisted of abundant network of fibers with the regular arrangement,without cellular debris.Primary culture of VSMC was successfully established and passaged,and was uniformly spindle-shaped in the confluent state and showed a characteristic hill and valley'formation.Immunohistochemical staining showed VSMC in culture stained positively with a-smooth muscle actin antibodies.VSMC began to adhere to the BACM 5 hour after implanting and the number of the adhered cells increased with time.Cells gradually expanded and showed the typical morphology of smooth muscle cells.Three weeks after implantation in vivo,the luminal surface of matrix was completely covered by vaginal epithelial tissue,a layer of smooth muscle cells was formed in the outer surface of the matrix.Multilayered vaginal epithelial and improved development of organized muscle bundles was observed after 6 weeks.The regenerative tissue was equivalent to the normal vaginal tissue at 12 weeks postoperatively.Vaginography demonstrated the maintenance of full patency and a wide vaginal caliber without fibrosis and graft rejection.There was no significant difference in all evaluated items between experimental and control groups.Conclusions BACM has the same regenerative process as VACM in the replacement of vaginal defect.Moreover,BACM has wider source and appears to be an suitable material for vaginal replacement.

ObjectiveTo explore the changes of the frequency and cytokine production of CD19 + CD5 + B cells in Endometriosis before and after treatment.MethodsFlow cytometry and quantitative PCR were used to assess the frequency,cytokine expression of CD19 + CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies of 35 patients with Endometriosis and 29 patients with myoma of uterus (control subjects).Changes in the CD19+ CD5+ B cell compartment in the peripheral blood were compared before and after treatment.ResultsAll 35 endometriosis patients had higher frequencies(all P ＜0.01 ) of CD19+ CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies [ (13.1 ± 1.9)％,(12.1 ±2.0)％,(11.7 ± 1.7)％] than 29 control subjects[ (2.9 ±0.8)％,(2.6 ±0.9)％,(2.8 ±1.1 )％ ].CD19 + CD5+ B cells from endometriosis patients expressed higher IFN-γ[ (7.2 ± 1.0) × 103,(7.9±1.3) ×103,(7.4±1.1) ×103 copies] than control subjects [ (1.9±0.7)×103,(2.2±0.8)×103,(2.0 ±0.5) × 103 copies).The endometriosis patients also had higher IL-10 production of CD19 + CD5 + B cells [ (6.4 ±0.9) × 103,(6.8 ± 1.2) × 103,(6.1 ±0.8) × 103 copies] than control subjects [ ( 1.7 ±0.5) × 103,(2.1 ±0.9) × 103,( 1.6 ±0.4) × 103 copies].Compared with control subjects,the endometriosis patients had a clinical response to treatment demomtrated a significant decrease in CD19 + CD5 + B cells in the peripheral blood[ ( 13.1 ± 1.9)％ vs (7.3 ± 1.2)％ ],expressed lower IFN-γ [ (7.2 ± 1.0)×103 copies vs (3.3 ±0.6) × 103 copies],produced less IL-10 [(6.4 ±0.9) × 103 copies vs (3.2 ±0.7) × 103 copies].ConclusionsCD19+ CD5 + B cells might play an important role in the pathogenesis of endometriosis through higher IFN-γand IL-10 expression.

Clinical data of 899 patients,who received colposcopic examination,were retrospectively analyzed.Both Reid's colposcopic index(RCI)score and biopsy were performed.The study showed that the value of RCI score was positively related to the severity of cervical lesions(F=2.043,P=0.03).The specificity of RCI for cervicitis,cervical intraepithelial neoplasia(CIN)Ⅰ were 98.8%,95.7% respectively;while sensitivity and negative predictive value for CIN Ⅱ,CIN Ⅲ were 77.7%,70.0%and 96.8%.97.4%,respectively.So RCI scoring can increase the diagnostic value of colposcope.

Riedel's thyroiditis (RT) is a rare form of thyroid disease,and the rate of misdiagnosis is high due to the low incidence of RT and the lack of understanding of the disease by clinicians.There is currently no standard and guidance for the diagnosis and treatment of RT.Improving the understanding of RT is of great significance for standardizing diagnosis and treatment and improving the life quality of patients.

Objective:To evaluate the clinical curative effect of self-made Lishi Qufeng Juanbi Decoction combined with Febuxostat tablet on uric acid nephropathy (UAN).Methods:Randomized controlled trial. A total of 150 patients with UAN in Yixing Hospital of Traditional Chinese Medicine were enrolled as the observation objects between October 2019 to October 2021. According to random number table method, they were divided into two groups, 75 in each group. The control group was treated with Febuxostat tablets on basis of routine diet intervention, while the observation group was treated with self-made Lishi Qufeng Juanbi Decoction on basis of control group. All were continuously treated for 6 months. TCM syndromes were scored before and after treatment. The levels of serum uric acid (SUA) and creatinine (SCr) were detected by full-automatic biochemical analyzer, and levels of serum CRP, IL-6 and IL-8 were detected by ELISA. The 24h urine was collected to detect 24 h urine protein quantitation. The adverse events were recorded, and clinical curative effect was evaluated.Results:There were significant differences in total response rate between observation group and control group [93.33% (70/75) vs. 80.00% (60/75); χ2=5.77, P=0.016]. After treatment, scores of waist soreness-fatigue and frequent nocturia in observation group were significantly lower than those in the control group ( t=9.17, 2.67, P<0.01), and frequency of joint swelling pain was significantly lower than that of the control group ( t=9.49, P<0.01). The levels of serum SUA and SCr, and 24 h urine protein quantitation in observation group were significantly lower than those in the control group ( t=3.38, 2.49, 12.55, P<0.01 or P<0.05), and levels of CRP, IL-6 and IL-8 were significantly lower than those in the control group ( t=5.44, 4.15, 9.61, P<0.01). There was no significant difference in incidence of adverse reactions between observation group and control group [4.00% (3/75) vs. 10.67% (8/75); χ2=2.45, P=0.117]. Conclusion:The self-made Lishi Qufeng Juanbi Decoction combined with Febuxostat tablets can promote uric acid metabolism, improve high uric acid environment, protect renal function, inhibit the release of inflammatory factors, improve curative effect and reduce adverse reactions in UAN patients.

Objective: To explore the associations between sleep duration and negative emotions among junior college students,and to provide reference for mental health promotion among college students. Methods: Cluster sampling method were used to select 2 524 freshmen from a college in Huainan, Anhui Province. Questionnaires were used to investigate general demographic characteristics, sleep timing, negative emotions and other information. The restricted cubic spline and multivariate Logistic regression were used to analyze the relationship between sleep duration and negative emotion among junior college students. Results: The prevalence of depressive symptoms, anxiety symptoms, stress associated symptoms were 19.41%(490), 28.2%(713), 9.9%(250) respectively．The prevalence of negative emotions was higher among boys(24.3%,34.0%,19.1%) than girls(18.7%,27.4%,8.5%). The differences between groups were statistically significant( P <0.01). After adjusting for confounding factors, sleep duration and negative emotions showed a non linear dose response relationship. Compared with the reference group(8-<9 h), sleep duration <7 h was significantly associated with an increased risk of depressive symptoms and stress symptoms, and <8 h was associated with an increased risk of anxiety symptoms. The additional sleep time on weekends ≥5 h was associated with negative emotions compared with the reference group(<1 h)( P <0.01). Conclusion Short sleep duration and extra weekend sleep are associated with negative emotions. Reasonable sleep schedule among junior college students might be helpful for the prevention and control of negative emotions.