Objective To observe the effect of treating generalized anxiety disorder with clearing heart and relieving rstlessness acupuncture combined with western medicine. Methods 87 patients with generalized anxiety disorder were randomly recruited into a control group and a treatment group. Both groups received conventional western medical treatment. On this basis, the control group was given conventional acupuncture therapy, while the treatment was given clearing heart and relieving restlessness acupuncture. The efficacies were evaluated with Hamailton anxiety (HAMA)scale and clinical global impression scale (CGI). The adverse reaction was evaluated with treatment emergent symptoms scale (TESS). Results One week after treatment, the efficacies and adverse reaction in the treatment group markedly decreased comparing with those before the treatment(P<0.05). Two weeks after treatment, the efficacies and adverse reaction of both groups decreased comparing with those before the treatment(P<0.01). Besides, the decrease continues with time passing by. One week after treatment, the HAMA score in the control group markedly decreased comparing with that of the control group (P<0.05), and the CGI score in the treatment group had no significant difference comparing with that of the control group(P<0.05). Conclusion The treatment of clearing heart and relieving restlessness acupuncture on generalized anxiety disorder has rapid effect and good compliance.

Objective To investigate the effect of palato-pharyngo-plastry on patients with coronary heart disease (CHD) plus obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The 113 OSAHS patients with CHD after palato-pharyngo-plastry from January 2001 to December 2006 were enrolled and followed up. The other 125 cases treated with continuous positive airway pressure (CPAP) were as control group. Results The fundmental factors of CHD including cholesterol, triglyeride, fasting blood glucose and body mass index (BM1) showed no statistical differences between two groups (x2 or t= 4.788, 0.479, 0.541, all P>0.05) . Only the oxyhemoglobin saturation during sleep was higher in study group than in control group [(91.2± 2.5)% vs. (87.6±4.2)%, P=0.046]. The angiography showed that 87 cases (77.0%) retained stable, 24 cases (21.2%) became severe in study group. As compared with control group, there were no statistical differences (both P>0.05). 37 cases (32.7%) in study group and 58 cases (46.4%) in control group who suffered from angina became severe with statistical differences between two groups (x2=4.615, P=0.032). The incidences of myocardial infarction and sudden death were lower in study group (3.5% and 0.8%) and in control group (5.6% and 2.4%), showed no statistical, difterences be tween twogroups. x2=0.571 and 0.495, P>0. 05). Conclusions Compared with CPAP, the palato-pharyngo-plastry can improve oxyhemoglobin saturation and reduce angina symptom, but has no better effect on progress of coronary atherosclerosis and acute coronary disease than CPAP.

BACKGROUND:Bone marrow mesenchymal stem cel s can repair intestinal ischemia-reperfusion injuny by interfering inflammatory reactions after intestinal ischemia-reperfusion to protect intestinal barrier functions. In recent years, umbilical cord blood mesenchymal stem cel s are gradual y used as a substitute source of bone marrow mesenchymal stem cel s. OBJECTIVE:To investigate the effects of umbilical cord blood mesenchymal stem cel s on acute intestinal ischemia-reperfusion injury. METHODS:Umbilical cord blood mesenchymal stem cel s were induced, isolated in vitro and tracked by CM-DiI fluorescent labeling. Sixty-three Sprague-Dawley rats were equivalently randomized into three groups:control group received normal saline enema, intestinal ischemia-reperfusion injury group with ethanol diluted trinitro-benzene-sulfonic acid and transplantation group administrated with 1×1010/L umbilical cord blood mesenchymal stem cel suspension via the tail vein at 1 hour after trinitro-benzene-sulfonic acid modeling. At 3 days after transplantation, colon tissues were removed in each group to observe pathological changes of the intestinal tract by hematoxylin-eosin staining. Besides, expression of leptin mRNA in the colon tissues and cyclooxygenase-2 in the mucosa were detected by RT-PCR and immunohistochemistry method, respectively. RESULTS AND CONCLUSION:Transplanted umbilical cord blood mesenchymal stem cel s distributed in the intestinal lymphoid tissue and among glandular epithelial cel s, suggesting that these stem cel s might be involved in the process of intestinal ischemia-reperfusion injury repair. Compared with the control group, intestinal injury in the injury group was significantly aggravated, and most intestinal epithelial cel s shed;and the transplantation group appeared to have significantly reduced intestinal damage and significantly less cel shedding. Expression of leptin mRNA was significantly higher in the injury group than the transplantation group fol owed by the control group, and there were significant differences among the three groups (P<0.05). Additional y, expression of cyclooxygenase-2 in the injury group was significantly higher than that in the control group (P<0.05);compared with the injury group, expression of cyclooxygenase-2 was significantly lower in the transplantation group (P<0.05). To conclude, leptin and cyclooxygenase-2 may be involved in acute intestinal ischemia-reperfusion injury, and umbilical cord blood mesenchymal stem cel transplantation significantly lessens intestinal ischemia-reperfusion injury, which provides an experimental basis for human treating acute intestinal ischemic injury.

Objective To investigate the effect of glutamine in combination with umbilical cord blood mesenchymal stem cells ( MSCs) transplantation on intestinal ischemia-reperfusion injury in rats.Methods Umbilical cord blood mesenchymal stem cells were isolated, and were labeled with CM-DiI fluorescent dye.Eighty Sprague-Dawley rats were randomly divided into normal control group, ischemia reperfusion injury group, glutamine group, MSCs transplantation group and combined group with 15 rats in each group.The control group received saline enema.The injury group was treated with TNBS ( ethanol dilution) enema.The glutamine group at 1 h after TNBS received intravenous injection of 0.45 g/kg glutamine.The rats of MSCs transplantation group had tail vein injection of 1 ×1010/L umbilical cord blood mesenchymal stem cell suspension, and the combined group received intravenous injection of glutamine 0.45 g/kg and 1 ×1010/L umbilical cord blood mesenchymal stem cell suspension.ELISA was used to detect the midgut fatty acid binding protein (iFABP), interleukin 6 (IL-6), and superoxide dismutase (SOD) content in the rat serum.The water content of intestinal tissue was detected at 1 h and 3 h after reperfusion in each group.The expressions of NF-kB, Bcl-2 and caspase-3 mRNA and proteins in the rat intestinal epithelial cells after treated with glutamine in combination with MSCs were detected by RT-PCR and Western blot assays.Results The fluorescent tracer method revealed that the transplanted MSCs cells were distributed in the intestinal mucosal lymphoid tissues and glandular epithelial cells, indicating that MSCs might be involved in the repair process of intestinal ischemia-reperfusion injury.The content of serum IFABP and IL-6 in the injured group was significantly higher than that in the control group, while significantly reduced in the glutamine group, MSCs transplantation group and combined group, with the most obvious in the combined group.The content of SOD in the injury group was significantly lower than that in the control group, and significantly increased than that in the glutamine group, MSCs transplantation group, with the most striking in the combined group ( P<0.05 for all) .The water content of intestinal tissue in the injury group at 1 and 3 hours after reperfusion was significantly higher than that in the control group, significantly lower in the glutamine group, MSCs transplantation group and the combined group, with the most decreased in the combination group, and there was no significant difference between the glutamine group and MSCs transplantation group (P>0.05).Compared with the control group, the caspase-3 and NF-kB mRNA and protein expressions in the intestinal mucosal epithelial cells of the injury group were significantly increased, and the expressions of Bcl-2 mRNA and protein were significantly reduced ( P <0.05 ) , the expressions of caspase-3 and NF-kB mRNA and protein were significantly reduced in the glutamine group, MSCs transplantation group and combined group.The expressions of Bcl-2 mRNA and protein were significantly increased ( P<0.05) , while no significant difference was shown between the glutamine group and MSCs transplantation group (P>0.05), but there was a significant difference between these two groups and the combined group (P<0.05).Conclusions After treated with glutamine and MSCs transplantation, the degree of intestinal ischemia reperfusion injury is obviously reduced in rats.It may be mediated through inhibiting the expression of caspase-3 and NF-kB and promoting the expression of Bcl-2.

Objective:To assess the diagnostic efficient of mean counting ratio method, and to simplify and improve the semi-quantitative method of defining excessive uptake of thyroid nuclides.Methods:One hundred and nine imaging results of thyroid scan in Dalian Municipal Central Hospital from April 2017 to January 2018 were delineated the FOI by two experienced deputy chief physicians and the ratio of average counts per unit area was determined. Clinical diagnosis of hyperthyroidism was used as gold standard, and receptor operation characteristic (ROC) curve was drawn and the optimal diagnostic threshold was calculated. The sensitivity, specificity, accuracy, positive and negative predictive values were calculated and the consistency of the two physicians′ diagnosis was analyzed.Results:The best diagnostic threshold was 6.94 by drawing ROC curve from the measurements of two physicians. The value greater than this was used as a criterion to define the excessive uptake of technetium in thyroid gland. For doctor 1, the sensitivity, specificity and accuracy of differential diagnosis of hyperthyroidism based on diagnostic threshold were 86.0%(37/43), 100.0%(66/66) and 95.5%(103/109), respectively. For doctors 2, they were 88.4%(38/43), 100.0%(66/66) and 95.4%(104/109), respectively. The concordance rate was 96.6%(86/89), interclass correlation coefficient (ICC) was 0.98.Conclusions:Average counting ratio method provides reliable semi-quantitative cut off value for differential diagnosis of high Tc uptake. It has good application value. Different physicians independently complete the semi-quantitative analysis of Tc uptake by average counting ratio method, which has good consistency. In practice, it is simpler and easier than the thyroid/background ratio method.

Objective To explore the expressions of miR-221 and miR-222 in papillary thyroid carcinoma (PTC),and relativi-ties with clinical pathological features.Methods Samples from patients of PCT (43 cases),nodular golter(21 cases),and para-carcinoma thyroid tissues(14 cases),78 cases in total (from 06/2015 to 05/2016,Shaanxi Provincial People’s Hospital) were collected.Real time-PCR tests were carried out,then analyzed in relation to clinical pathology features,and statistical a-nalysis was used to evaluate the results.Results The expressions of miR-221 and miR-222 were significantly higher in PTC (11.54±3.37,10.67±2.45)than in nodular golter (3.21±1.12,2.89±1.23)and normal thyroid tissue (2.02±0.76, 1.98±0.34)(t=3.62,3.25;3.27,3.01,all P<0.05),which were significantly related with Regional lymph node metasta-sis,tumor invasion coated,distant metastasis and clinical stage (P<0.05),while not related with the gender,age,or size of the tumor of the patients (P>0.05),and no differences were found in nodular golter and in normal thyroid tissue (t=0.91, 0.79,P>0.05).Conclusion miR-221 and miR-222 could be considered as a specific molecular marker of PTC,may play an important role in the diagnosis and treatment on PTC.

BACKGROUND: Splint fixation was a common treatment for limb fracture, but there were some limitations, such as lack of individual difference, easy to lose and being unable to self-adjusting.OBJECTIVE: To explore the design method of digital splint and related finite element analysis.METHODS: Forearms were scanned with CT; periphery parameters were extracted, followed by reverse modeling and modifying. The digital splint models were constructed. Material attribute and mechanical loading were conducted. Thelimb length, maximum stress and displacement of the bone, soft tissue and splint were calculated by finite elementanalysis. RESULTS AND CONCLUSION: The digital splint has favorable tight attaching and balanced stress to skin, and whichkeeps well stability for the micro-motion fracture ends. Our study indicated that better tight attaching splint could bedesigned by digital modeling technology. Favorable fracture fixation and mechanical property could be also achieved.

Objective:To investigate the diagnosis and treatment of intravenous leiomyomatosis involving the heart.Methods:From March 2009 to December 2018, 5 patients with intravenous leiomyomatosis with cardiac involvement were collected from The First Hospital of Lanzhou University.All patients were admitted to the hospital as space occupying lesions of right atrium.The relevant data such as echocardiography, CT and MRI were recorded.The preoperative diagnosis, surgical methods and therapeutic effect of the patients were analyzed and summarized.Results:All the 5 patients were female with an average age of (45.8±2.2) years old.Their clinical manifestations were chest tightness and shortness of breath.Three patients had a history of giant hysteromyoma.Echocardiography was performed in all patients, and 3 of them obviously extended to the inferior chamber.Cardiopulmonary bypass was established and thoracoabdominal incision was performed, and the tumors were completely resected in 5 patients, and the origin of tumors was consistent with the result of MRI in 3 cases.The tumor originated from the right uterine vein in 3 cases, and 2 cases originated from the right ovarian vein and was intubated in the femoral vein.The operation was smooth and the postoperative recovery was good.All patients were discharged smoothly.No tumor recurrence was found in pelvic cavity, inferior vena cava and heart after 1 year follow-up.Conclusion:Venous leiomyomatosis involving the heart is rare and easy to be misdiagnosed.Most of them are diagnosed as right atrial space occupying lesions.The diagnosis can be improved by echocardiography, CT and MRI before operation.The operation mode should be adjusted according to the intraoperative findings and different origins, and the tumor should be completely removed as far as possible, and combined with gynecology consultation if necessary.The short-term follow-up showed good prognosis.

Objective To construct YOLOv5x deep learning network model based on SPECT whole body bone scanning,and to observe its value for diagnosing benign and malignant bone lesions.Methods Totally 699 patient who underwent SPECT bone scanning were enrolled,with a total of 5 182 bone lesions,including 3 105 malignant and 2 077 benign lesions.Then 1 121 bone images were divided into training set(n=897),validation set(n=112)or test set(n=112)at the ratio of 8∶1∶1.After augmentation on training set and validation set,the data were inputted to YOLOv5x deep learning network for training to obtain a recognition model.The sensitivity,specificity and accuracy of this model for diagnosing benign and malignant bone lesions were analyzed,and the consistency between its diagnosis results and gold standards was evaluated based on test set.Results The sensitivity,specificity and accuracy of bone scanning YOLOv5x deep learning network model for identifying malignant bone lesions was 95.75％,87.87％and 91.60％,respectively,and for identifying benign bone lesions was 91.62％,94.38％and 93.14％,respectively.The area under the curve(AUC)of this model for identifying bone lesions on bone scanning images was 0.98,for malignant and benign bone lesions was 0.97 and 0.98,respectively.The consistency between the diagnosis results of this model for malignant and benign bone lesions and the gold standards were both good(Kappa=0.83,0.86,both P＜0.05).Conclusion YOLOv5x deep learning network model based on SPECT whole body bone scanning was helpful for diagnosing benign and malignant bone lesions.

Objective:To investigate the clinicopathological characteristics and prognostic factors of Siewert Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospetcive cohort study was conducted. The clinicopathological data of 399 patients with AEG who were admitted to Peking University People′s Hospital from January 1998 to December 2015 were collected. There were 318 males and 81 females, aged 66(range, 19-87)years. Observation indicators: (1) clinicopathological characteristics of Siewert Ⅱ and Ⅲ AEG; (2) follow-up and survival; (3) prognostic factors analysis. Patients were followed up by telephone interview and outpatient examination to detect postoperative survival up to December 2018. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Kaplan-Meier method was used to draw survival curves and calculate survival rates. Log-rank test was used for survival analysis. Univariate and multivariate analyses were done using the COX proportional hazard model. Results:(1) Clinicopathological characteristics of Siewert Ⅱ and Ⅲ AEG. Of 399 patients, 198 cases were Siewert Ⅱ AEG and 201 cases were Siewert Ⅲ AEG. There were 130 cases undergoing transthoracic radical AEG surgery, 172 cases undergoing trans-abdominal proximal gastrectomy and 97 cases undergoing transabdominal total gastrectomy. The age, tumor diameter, cases with surgical method as transthoracic radical AEG surgery, transabdo-minal proximal gastrectomy and transabdominal total gastrectomy, the number of positive lymph nodes, cases in tumor TNM stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were (65±10)years, (5.1±2.4)cm, 102, 68, 28, 17(range, 12?22), 20, 57, 117, 4 for patients with Siewert Ⅱ AEG, versus (62±12)years, (6.3±3.2)cm, 28, 104, 69,18(range, 14?27), 16, 41, 134, 10 for patients with Siewert Ⅲ AEG, showing significant differ-ences betweeen them ( t=2.83, ?3.82, χ2=66.97, U=17 407.05, 17 532.00, P<0.05). (2) Follow-up and survival. All 399 patients were followed up for 34(range, 2?160)months. The 5-year overall survival rate was 29.3% for patients with Siewert Ⅱ AEG, versus 37.0% for patients with Siewert Ⅲ AEG, showing no significant difference betweeen them ( χ2=1.46, P>0.05). The median survival time and 5-year overall survival rate were 29.0 months [95% confidence interval ( CI) as 23.4?34.6 months] and 22.9% for patients undergoing transthoracic radical AEG surgery, 43.0 months(95% CI as 33.9?52.1 months) and 34.7% for patients undergoing transabdominal proximal gastrectomy, 54.0 months (95% CI as 37.6?70.4 months)and 44.3% for patients undergoing transabdominal total gastrectomy, showing a significant difference in the survival among the 3 groups ( χ2=13.81, P<0.05). Of the 198 Siewert Ⅱ AEG patients, the 5-year overall survival rate was 24.6% for the 96 patients undergoing transabdominal surgery, versus 35.4% for the 102 patients undergoing transthoracic surgery, showing no significant difference in the survival between them ( χ2=3.10, P>0.05). Of the 201 Siewert Ⅲ AEG patients, the 5-year overall survival rate was 40.0% for the 173 patients undergoing transabdominal surgery, versus 16.1% for the 28 patients undergoing transthoracic surgery, showing a significant difference between them ( χ2=11.32, P<0.05). (3) Prognostic factors analysis. Results of univariate analysis showed that surgical method, pathological N staging, patholgical M staging were related factors for prognosis of Siewert Ⅱ and Ⅲ AEG ( hazard ratio=0.68, 1.25, 2.18, 95% CI as 0.54?0.86, 1.15?1.36, 1.28?3.73, P<0.05). Results of multivariate analysis showed that transthoracic approach, pathological stage N2?N3 and pathological stage M1 were independent risk factors for prognosis of Siewert Ⅱ and Ⅲ AEG ( hazard ratio=0.64, 1.25, 2.18, 95% CI as 0.51?0.80, 1.16?1.35, 1.28?3.70, P<0.05). Conclusions:Compared with Siewert Ⅲ AEG, Siewert Ⅱ AEG has a smaller tumor diameter, less positive lymph nodes, poorer prognosis. Transthoracic approach is preffered for the Siewert Ⅱ AEG. Transthoracic approach, pathological stage N2?N3 and pathological stage M1 are independent risk factors for prognosis of Siewert Ⅱ and Ⅲ AEG.