Objective To observe the morphological changes of corneal nerve in experimental herpes simplex keratitis (HSK) in rabbit eyes. Methods Inoculation of the scarified cornea with herpes simplex virus-Ⅰ(HSV-Ⅰ)leads to herpetic infection of cornea. The HSK was detected by slit lamp and polymerase chain reaction(PCR), and the changes of corneal nerves in various periods with methylene blue vital staining and ultrastructure of corneal nerve were studied. Results Under light microscope, fewer corneal nerve bundles were observed, scattered with lower density of nerve fiber at center of cornea on the 4th day after the infection. At days 7 and 14, the seriously damaged nerve fiber was intermittent. The neuraxon became shorter with little polarity and the density of nerve fiber was extremely low. At day 30, the density was still low while the nerve fiber was approximately normal. Under electromicroscope, at day 4, the lamellar sheath of nerve fiber in the epitheliums appeared intermittent, and the neuroplasm of endings was partly lysed. During day 7 to day 14,neuroplasm was damaged and became vacuolar. The mitochondria swelled with vacuolar crest, and then were destroyed and lysed. The nerves in stroma were also injured. On day 30, neurilemma sheath was still intermittent with the decrease of microfilament and racuole. Conclusion HSK leads to the damage of nerve and the decrease of nerval density, and the damage of corneal nerve repairs very slowly.

Objective To study the epidemiological status of reproductive health related behaviors of out of school adolescents in Kunming and Shenzhen City,and to explore the social-psychological influencing factors of the behaviors.Methods A cross-sectional study was conducted in 410 out of school adolescents aged 15-24 years who were recruited with accidental sampling.All the subjects were required to complete a self-administrated questionnaire.Single factor Chi-square analysis and multi-factor Logistic method were used for data analysis.Results The correct respondent rate of the questions on reproductive health knowledge among the adolescents was low.The sexual intercourse rate was 42.9％ (176/410).Nearly 44.9％ (79/176) of the adolescents who had sexual experience did not use condom in the latest sexual intercourse,and those who had no less than one sexual partner accounted for 48.9％ (86/176).The prevalence of genital discomfort and sexual transmitted disease was 48.8％ (200/410) and 2.9％ (12/ 410),respectively.Chi-square test showed that marriage,living statue,behaviors of holding hands,kiss,caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort(x2 values were 4.667,10.862,10.032,15.619,17.423,28.239,17.817 and 21.369,respectively ; all P ＜ 0.05).In binary Logistic analysis,living in a dormitory or with other people,behaviors of caress the body,sexual intercourse and having no less than one sexual partner influenced the prevalence of genital discomfort (odds ratio (OR) was 0.449 (95％ CI:0.216-0.933),0.377 (95％ CI:0.147-0.967),4.364 (95％ CI:1.594-11.949),0.312 (95％ CI:0.111-0.877) and2.646 (95％ CI:1.417-4.941),respectively ; all P ＜ 0.05).Conclusions The status of reproductive health was poor among out of school girls in kunming and Shenzhen,and living status,behaviors of caress the body,sexual intercourse and having no less than one sexual partner could influence the prevalence of genital discomfort.Comprehensive measures should be taken to strengthen the reproductive health management in this population.

Objective:To express fusion protein of mouse thymic stromal lymphopoietin (TSLP) and HIV-1 gp120BAL V1/V2 subdomain in 293F cell.Methods:Full length of the V1V2 sequence from BAL isolate was fused with the C-terminus of mouse thymic stromal lymphopoietin (TSLP) and sub-cloned into pCEP-Pu vector to construct the eukaryotic expression plasmid-pCTV1V2BAL.The recombinant plasmid was confirmed by enzyme digestion and sequencing , then transfected into 293 F cells using PEI as a transfection reagent .The fusion protein was purified by metal chelate affinity chromatography and characterized by SDS -PAGE and Western blot . The epitopes of V1/V2 in fusion protein were identified by ELISA .Results:The SDS-PAGE and Western blot results showed that there were highly heterogeneous glycoprotein bands at the site between 35 kD and 55 kD, which reacted with anti-mTSLP rabbit polyclonal antibody and anti-His tag mouse monoclonal antibody .The ELISA analysis showed that antibodies to V 1/V2BAL existed in the sera of HIV-1 positive patients.Conclusion:The mTSLP-V1/V2 fusion protein was successfully expressed in 293F cells, which may be useful for HIV-1 vaccine research .

The solute carrier protein 25 family (SLC25)is one of superfamily in solute carrier protein family. The members of SLC25 family function by transporting various solutes across the mitochondrial mem-brane. Their substrates vary in property,molecular size and mode of transport,and they closely involve in nu-merous physiological functions. More and more researches indicate that some members of SLC25 family are ab-normally expressed in tumors,and some of them play important roles in the occurrence and development of tumors. For example,some members participate in tumorigenesis by regulating cell metabolism,death and pro-liferation.

In order to assess the transvalvular gradient of a Chinese-made Jiuling solid pyrolytic carbon bileaflet heart valve prosthesis, we determined its hydrodynamics in the laboratory and then measured the hemodynamic performance in the animals and patiens. The Jiuling prosthesis was tested in a pulsatile flow simulator in the aortic position. Six sheep subjected to mitral replacement with 21 mm Jiuling prosthesis were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress were performed in two sheep 60 months after implantation. Clinically, 14 cases of aortic valve and 10 cases of mitral valve in the patients who underwent valve replacement with Jiuling heart valve prosthesis were measured by open cardiac catheterization and Doppler echocardiopgraphy. The results showed that Juiling heart valve prosthesis had lower mean transvalvular gradient (below 10 mmHg) at any given tissue annulus diameter. In animal experiments, the transvalvular gradients of 6 sheep were 5.2 +/- 1.7 mmHg intraoperatively, and of 2 sheep 60 months after implantation were 6.1 +/- 0.3 mmHg by catheterization. In patients, the mean transvalvular gradients in the aortic position measured by means of catheterization and echocardiography were 6.26-4.10 mmHg and 9.42-7.48 mmHg; the gradients in the mitral position were 2.10-1.9 mmHg and 5.281-4.10 mmHg respectively. The above results demonstrate that Jiuling valve prosthesis has excellent hemodynamic performance.
Adult ; Animals ; Aortic Valve ; surgery ; Biocompatible Materials ; Carbon ; chemistry ; Echocardiography ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation ; Hemodynamics ; physiology ; Humans ; Male ; Mitral Valve ; surgery ; Prosthesis Design ; Sheep ; Ventricular Function, Left

[摘 要] 目的：基于临床病历信息系统，采用数据挖掘方法从真实世界角度分析中医药非介入治疗肺恶性肿瘤的辨治规律。方法：收集2015年1月1日至2021年12月31日北京中医药大学东直门医院病历系统中诊断为肺恶性肿瘤的患者病史、刻下症和用药信息，在剔除使用介入治疗手段的病例后建立数据库。采用Microsoft Office Excel 2019对高频药物的频数、四气五味、归经及功效进行描述性统计，并对病史和刻下症反映的症状进行数据化统计；对统计得到的高频药物和症状信息借助SPSS Modeler 18.0软件中Apriori算法对核心数据进行关联规则分析，并用Web节点构建关联网状图；借助SPSS Stastistics 23.0进行聚类分析。结果：共纳入119例未进行介入治疗的肺恶性肿瘤患者，中医常见症状为咳嗽、白痰、喘憋、纳差、眠差、痰黏、便秘、乏力、胸闷、气短；药物四气以温药最多；五味以甘味最多；归经以肺经频率最高。关联规则结果显示，二项支持度最高的组合为半夏→柴胡、半夏→瓜蒌、杏仁→麻黄；三项关联支持度最高的组合为半夏→茯苓、柴胡，杏仁→麻黄、半夏，半夏→杏仁、柴胡，半夏→瓜蒌、贝母。聚类结果聚为3类，依次为肺阴虚证、痰热壅肺证和肺气虚证。结论：中医药非介入治疗肺恶性肿瘤的中医药辨治规律为：聚类证型依次为肺阴虚证、痰热壅肺证和肺气虚证。治疗多用和解少阳、行气止咳平喘和清虚热化痰饮为主，药物以半夏、甘草、黄芩、茯苓、柴胡多见。

Objective To explore the feasibility and clinical application value of total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma. Methods Clinical data of 2 patients receiving total laparoscopic radical resection of Ⅳ-type hilar choangiocarcinoma in Hunan Provincial People's Hospital from April 2015 to December 2015 were analyzed retrospectively. The informed consents of both patients were obtained and the local ethical committee approval was received. Case 1, male, 73 years old, hospitalized for icteric skin and sclera for more than 1 month. Case 2, female, 62 years old, hospitalized for icteric skin and sclera for more than 2 months. The admitting diagnosis were both Ⅳ-type hilar choangiocarcinoma. The bilateral hepatic ducts and left portal vein were invaded by tumor in the 2 cases. Before the operation, the patients received symptomatic and supportive treatments for liver protection, jaundice alleviation etc., and then received total laparoscopic radical resection of hilar choangiocarcinoma. The lymph nodes were resected from far to near, the common bile duct was dissected and cut off, the left and caudate lobe was resected, hilar bile duct plasty and Roux-en-Y bilioenterostomy were performed. Results Operations were performed successfully in both patients and the digestive tract was reconstructed. The operative duration were 430, 410 min respectively, the intraoperative blood loss was 800, 600 ml respectively. No perioperative complication was observed.Two patients received abdominal enhanced CT examination 1 year after operation, no tumor recurrence or metastasis was observed. Conclusion Total laparoscopic radical resection of hilar choangiocarcinoma is safe and feasible, in which hemihepatectomy or extended hemihepatectomy including caudate lobe, lymphadenectomy, bile duct plasty and biliary-enteric reconstruction can be performed.

Objective To investigate the application value of two-step separation approach in laparoscopic hemihepatectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 81 patients who underwent laparoscopic hemihepatectomy in the People's Hospital of Hunan Provincial between January 2015 and December 2017 were collected.Patients underwent laparoscopic hemihepatectomy using two-step separation approach after preoperative assessment.Hepatic pedicle,hepatic vein and branches were processed in the liver parenchyma,without intrathecal anatomy.Observation indicators:(1) preoperative assessment,intraand post-operative recovery;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed up to February 2018.Patients with hepatolithiasis received abdominal CT reexaminations at 5-7 days postoperatively for observing postoperative residual stones,and patients with malignant tumor were regularly followed up for 1-3 years.Measurement data with normal distribution were represented as (x)±s.Count data were described as frequency and percentage.Results (1) Preoperative assessment,intra-and post-operative recovery:81 patients underwent preoperative blood biochemistry,tumor biomarker and imaging examinations,and remaining functional liver volume and a liver model in 9 patients were respectively calculated and built using the 3D reconstruction software and 3D printing technology.Of 81 patients,68 underwent left hemihepatectomy and 13 underwent fight hemihepatectomy;77 underwent successful laparoscopic hemihepatectomy using two-step separation approach,4 were converted to open operation,with a rate of 4.9％ (4/81).Of 4 patients with conversion to open operation,1 had difficult tumor separation due to tumor invading port vein induced to close adhesion,1 had stone removal difficulties under laparoscopy due to hepatolithiasis,and 2 were converted to open operation due to severe liver cirrhosis induced to massive intraoperative bleeding.Of 81 patients,70 gained dividing line of hemiliver by intraoperatively hemihepatic blood flow occlusion,and then got effectively control of bleeding combined with Pringle blood flow occlusion,and 11 received Pringle blood flow occlusion in whole liver.Laparoscopic fluorescence imaging technology was intraoperatively used for 2 patients.Operation time,volume of intraoperative blood loss,rate of intraoperative blood transfusion and duration of hospital stay in 81 patients were respectively (206±42)minutes,(195±134)mL,11.1％(9/81) and (11.5+2.7)days.Eighty-one patients were complicated with bile leakage and were cured by conservative treatment,with a bile leakage incidence of 2.5％ (2/81),and without severe complications,such as postoperative bleeding,hepatic dysfunction and subphrenic abscess.There was no perioperative death and reoperation within 30 days postoperatively.(2) Follow-up and survival situations:55 patients with hepatolithiasis were followed up and underwent CT examinations of upper abdomen at 5-7 days postoperatively,including 52 with depletion of stones;3 with residual stones received removal of stones by choledochoscope at 3 months postoperatively,without residual stones.Seventeen patients with malignant tumor were followed up for 12-36 months,with a median time of 15 months,16 had tumor-free survival,and 1 was complicated with intrahepatic metastasis at 1 year after resection of hepatocellular carcinoma,and then underwent transcatheter arterial chemoembolization (TACE) and survived with tumor.Nine patients with benign liver diseases had good recovery during follow-up.Conclusion Two-step separation approach that is rationally used in laparoscopic hemihepatectomy is safe,effective and convenient.

To investigate the effects of down-regulation of prostate androgen regulated (PAR) expression on proliferation of PC3 cells by using RNA interference (RNAi), suppression of PAR expression was achieved by transfection of PC3 cells with short hairpin RNA (shRNA) expression vectors against PAR, designated as psiRNA-PAR1, psiRNA-PAR2 and psiRNA-PAR3. The inhibitory effects were confirmed by RT-PCR. The growth features of PC3 transfectants were analyzed by cell counts, colon formation in soft agar and flow cytometry. The expression of PAR was suppressed by the three shRNA expression vectors. psiRNA-PAR1 was shown to inhibit the PAR expression most efficiently, with the inhibitory rate reaching a peak at (81.18±1.68)% 48 h after the transfection. PC3 transfectants exhibited a decreased proliferation in cell culture and a low efficiency of colon formation in soft agar. Flow cytometry revealed a G2/M arrest and induced apoptosis. Down-regulated PAR expression inhibited the growth of PC3 cells by inducing G2/M arrest and activating apoptotic pathway. As a potential proto-oncogene that triggers and/or has persistent malignant proliferation, PAR may serves as a very target for the gene therapy.

Background::Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods::This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI).Results::In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion::Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.