Objective To observe the effects of mesenchymal stem cells (MSCs)injection from tail-vein on the expression of glial cell line derived neurotrophic factor (GDNF) after the spinal cord injury (SCI) of rats.MethodMSCs were cultured from the thighbone of adult wistar rats.The T10 level spinal cord injury was execute by the modify-Allen's device. The MSCs labeled by bromodeoxyuridine were transplanted into the vein of tail by injection immediately after spinal cord injury. Adult Wistar rats were randomly divided into three groups: SCI cured with MSCs transplantation (group A), SCI received normal saline(group B),and control group (group C). Then MSCs were detected and the expressions of GDNF of the lesion and neighbor areas were examined by Reversetranscription polymerase chain reaction (RT-PCR) and immunohistochemistry.ResultImmunohistochemistry: MSCs labeled by bromodeoxyuridine could be detected in the injuried spinal cord after transplantation. It was located at the nucleolus of MSCs. The cells survived and migrated rostrallyand caudally from the injection sites. With the time passed, the number of MSCs labeled with bromodeoxyuridine was decreased. RT-PCR: The expression of Group A was increased on the followed day, and the expression of Group B was increased on the 1st day but decrease from the 5th day then on.compared with group B, transplantation of MSCs significantly enhanced the expression of GDNF mRNA than group A on the 1st, 3rd, 5th day after cell transplantation(P

Objective To compare the dose distribution between three-dimensional conformal radiotherapy(3D-CRT) and intensity-modulated radiotherapy (IMRT) in treating locally advanced pancreatic cancer,and report the efficacy of IMRT combined with regional chemotherapy using gemcitabine (GEM).Methods Ten patients with locally advanced pancreatic cancer were enrolled in this study.3D-CRT and IMRT plans were designed for each patient.The dose distributions of target volume and normal tissues were analyzed using the dose volume histogram (DVH).Twenty-five locally advanced pancreatic cancers patients who were treated by IMRT combined with regional chemotherapy using gemcitabine (combined group) were retrospective analyzed,as well as 25 hospitalized patients of the same period who were treated by regional chemotherapy using gemcitabine alone (chemotherapy alone group).The therapeutic efficacy and adverse events were compared between two groups.Results IMRT plans decrease the mean dose and volume of duodenum,liver,stomach,both kidney and small bowel that received highdose irradiation.The 1-,2-year survival rate of the combined group and chemotherapy alone group was 60％,28％ and 36％,12％.The median survival time of two groups was 15 and 10 months,respectively (x2 =4.16,P ＜0.05).The total response rate of the combined group and the chemotherapy alone group was 64％ and 32％,respectively (x2 =5.13,P ＜ 0.05).The upper gastrointestinal side-effect rate of the combined group was higher than that of the chemotherapy alone group(Z =-2.354,P ＜ 0.05).There was no statistic significance in hematologic toxicity,liver and renal functional damage between the two groups.Conclusions Compared with 3D-CRT plan,IMRT plan could reduce the dose of organ at risks.IMRT combined with regional chemotherapy using gemcitabine could significantly improve the survival rate of patients with locally advanced pancreatic cancer with mild adverse events.

OBJECTIVE:To study the effect of Zuogui pill on the expression of gap junction protein 43(Cx43)in ovarian tis-sue of mice with premature ovarian failure(POF)induced by intraperitoneal injection of cyclophosphamide(CTX),and explore its mechanism in the treatment of chemotherapy-induced POF. METHODS:72 mice were randomly divided into blank group,model group,Estradiol valerate tablet group (positive control,0.00013 g/kg),Zuogui pill low-dose,medium-dose,high-dose groups (13.65,40.95,122.85 g/kg)by body mass,10 in each group. Except for blank group,other groups were reduce POF model by ip CTX,once a day,for 20 d. Meanwhile,the mice were intragastrically administrated related medicines,once a day,for 30 d. After 2 h of last administration,reverse transcription-polymerase chain reaction method and Western blot method were used to detect the Cx43 mRNA and protein expressions in ovarian tissue respectively,and immunohistochemistry method was adopted to detect the distribution of Cx43 protein in ovarian tissue. RESULTS:Compared with blank group,Cx43 mRNA and protein expressions in ovarian tissue of mice in model group were obviously weakened,and the distribution of Cx43 protein in follicle and granulocytes were obviously reduced(P<0.01). Compared with model group,Cx43 mRNA and protein expressions in ovarian tissue of mice in Estradiol valerate tablet group and Zuogui pill medium-dose,high-dose groups were obviously strengthened,and the distribution of Cx43 protein in follicle and granulocytes were obviously increased(P<0.01). CONCLUSIONS:Zuogui pill can increase the Cx43 mRNA and protein expressions in ovarian tissue of CTX-induced POF mice,increase the distribution of Cx43 in follicle and granu-locytes and gap junction function,which may be one of the treatment mechanism of POF.

Objective:To investigate the application value of spectral computed tomo-graphy (CT) multi-parameter imaging in predicting gastric cancer lymph node metastasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 86 patients with gastric cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to June 2017 were collected. There were 53 males and 33 females, aged from 22 to 87 years, with a median age of 53 years. All patients received abdominal plain scan and arterial and venous phase contrast spectral scan. Images of plain scan, 70 keV monochromatic and iodine-based images in arterial and venous phase were analyzed on post-processing working station. Observation indicators: (1) gastric cancer lymph node metastasis; (2) analysis of influencing factors for lymph node metastasis in gastric cancer; (3) introduction of special cases. Count data were described as absolute numbers. Univariate analysis was performed using the chi-square test or rank sum test. Multivariate analysis was conducted using the Logistic regression model.Results:(1) Gastric cancer lymph node metastasis: of the 86 patients, 64 cases had lymph nodes metastasis and 22 had no lymph nodes metastasis. (2) Analysis of influencing factors for lymph node metastasis in gastric cancer: results of univariate analysis showed that tumor growth pattern, tumor diameter, infiltration of peritumor fat, CT value in arterial phase, CT value in venous phase, iodine value in venous phase were related factors affecting lymph nodes metastasis in gastric cancer ( χ2=6.753, Z=-3.180, χ2=7.649, Z=-2.051, -2.971, -2.547, P<0.05). Results of multivariate analysis showed that infiltration of peritumor fat and the iodine value in venous phase were greater than 12(100 μg/cm 3) and not greater than 16(100 μg/cm 3), or greater than 16(100 μg/cm 3) were independent risk factors affecting lymph nodes metastasis in gastric cancer ( odds ratio=13.154, 3.761, 7.583, 95% confidence interval as 2.597-66.620, 1.893-8.572, 4.769-16.692, P<0.05). (3) Introduction of special cases: case 1 was male, aged 46 years. Results of preoperative spectral CT enhanced scan showed gastric antrum space occupying lesion combined with enlarged lymph nodes. During enhancement arterial phase, spectral CT 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed gastric wall thickening with mild to moderate enhancement, clear fat space in serosa and enlarged lymph nodes in lesser curvature. The spectral CT 70 keV monochromatic images and corresponding iodine-based images below pylorus level in the transverse view showed subpyloric enlarged lymph nodes. During enhancement venous phase, the 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed layered enhancement of gastric antrum lesions and mucosal enhancement, with a high iodine value. The patient was diagnosed as gastric antrum cancer with lymph node metastasis, no serosal or peritumoral fat invasion. Results of postoperative pathological examination showed moderately differentiated adenocarcinoma of gastric antrum with serosal invasion and lymph node metastasis. Case 2 was male, aged 53 years. Results of preoperative spectral CT enhanced scan showed gastric cancer of lesser curvature combined with enlarged lymph nodes. During enhancement arterial phase, 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed gastric wall heterogeneous thickening of lesser curvature, with moderate enhancement, obscure peritumor fat space, unclear serosa, and multiple enlarged lymph nodes in lesser curvature. During enhancement venous phase, 70 keV monochromatic images in the transverse view showed unclear boundary between lesions and enlarged lymph nodes in lesser curvature, obscure peritumor fat. During enhancement arterial phase, 70 keV monochromatic images of celiac trunk layer in the transverse view showed parasplenic artery lymph nodes, with circular enhancement and no enhancement in central necrotic elements. The patient was diagnosed as gastric cancer of lesser curvature with lymph node metastasis, serosal and peritumor fat invasion. Results of postoperative pathological examination showed poorly differentiated adenocarcinoma of gastric antrum with serosal invasion and lymph node metastasis. Conclusion:The infiltration of peritumor fat and iodine value in venous phase are independent factors affecting gastric cancer lymph node metastasis.

Objective:To translate the Canadian Nurse Informatics Competency Assessment Scale into Chinese, revise it and test its reliability and validity.Methods:Translation and back translation were conducted strictly following the Brislin translation model, and 7 experts were organized to adjust the scale. From August to December 2019, convenience sampling was used to select 923 nurses in a ClassⅢ Grade A hospital in Qingdao for investigation with the Chinese version of the adjusted Nurse Informatics Competency Assessment Scale so as to test its reliability and validity.Results:The content validity index of the final Nurse Informatics Competency Assessment Scale was 0.960. Exploratory factor analysis extracted four common factors, and the cumulative variance contribution rate was 70.455%. The confirmatory factor analysis result showed that χ 2/ df was 2.862, and root mean square error approximation was 0.047, and goodness of fit index was 0.893, and comparative fit index was 0.947, and incremental fit index was 0.948, and normative fit index was 0.922, and relative fit index was 0.906, and Tucker-Lewis index was 0.937. The total Cronbach's α coefficient of the scale was 0.950, and the half-fold reliability was 0.863, and the test-retest reliability was 0.827. Conclusions:The Nurse Informatics Competency Assessment Scale has good reliability and validity, and can be used as an evaluation tool for clinical nurses' nursing information competency.

OBJECTIVETo investigate the application value of spectral CT in the differentiation of stage T3 and T4a gastric carcinoma.

METHODSData of 62 gastric cancer patients of stage T3 and T4a undergoing abdominal spectral CT examination in the First Affiliated Hospital of Zhengzhou University from December 2013 to December 2014 were collected retrospectively. There were 38 male and 24 female patients, with age of 33 to 77(58.6±10.4) years old. Abdominal double-phase enhanced scanning in gemstone spectral imaging mode was used to measure Iodine concentration (IC, 100 μg/ml) and water concentration(WC, 100 μg/ml) of perigastric fat tissue adjacent to the lesion during arterial phase(AP) and venous phase(VP), and normalized iodine concentration (nIC) was calculated respectively(nIC=IC/IC of aorta on the same slice). IC, WC, nIC of arterial phase and venous phase between stage T3 and T4a lesions were compared with double independent sample t test and compared with pathology. The diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTSDuring arterial phase in stage T4a cases, IC (100 μg/ml) was -5.19±0.81 and nIC was -0.05±0.01, which was significantly higher than -3.44±1.54 (P=0.000) and -0.03±0.01 (P=0.000) in stage T3 cases. During venous phase in T4a cases, IC (100 μg/ml) was -3.78±0.94 and nIC was -0.04±0.01, which was significantly higher than -1.62±1.43 (P=0.000) and -0.02±0.02 (P=0.000) in stage T3 cases. As compared to arterial phase, IC and nIC of stage T4a and T3 of venous phase were more significantly different (all P<0.05). WC of stage T4a during arterial and venous phase was 955.72±15.68 and 949.86±17.36 respectively, while WC of stage T3 during arterial and venous phase was 947.77±18.43 and 942.46±18.53 respectively. There were no significant differences in WC between two stage cases during arterial and venous phase (P=0.106, P=0.143). ROC analysis showed that area under the ROC of IC and nIC during arterial phase was 0.829 and 0.867 respectively, and cut-off value of nIC was -0.039 for differentiation of stage T3 and T4a with corresponding 83.3% of sensitivity and 75.0% of specificity; area under the ROC of IC and nIC during venous phase was 0.873 and 0.905 respectively, and cut-off value of nIC was -0.031 for differentiation of stage T3 and T4a with corresponding 81.0% of sensitivity and 85.0% of specificity.

CONCLUSIONSAbdominal spectral CT scan is useful in the differentiation of stage T3 and T4a gastric carcinoma. The IC of perigastric fat tissue is significantly higher in stage T4a gastric carcinoma compared to stage T3 gastric carcinoma. Higher diagnostic efficacy can be obtained when taking -0.031 as the cut-off value of nIC during venous phase.

Adipose Tissue ; Adult ; Aged ; Female ; Humans ; Iodine ; Male ; Middle Aged ; Neoplasm Staging ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms ; diagnosis ; Tomography, X-Ray Computed

Objective:To investigate the diagnostic value of ultrasonic measurement of optic nerve sheath diameter (ONSD) and optical disk elevation (ODE) for intracranial hypertension in patients with cerebral venous sinus thrombosis(CVST).Methods:A total of 50 patients with CVST who underwent lumbar puncture and ONSD examination in the Department of Neurology and Emergency Department of Xuanwu Hospital, Capital Medical University from January 2021 to December 2021 were retrospectively enrolled. After lumbar puncture, the patient′s initial intracranial pressure was recorded. Normal ICP was defined as ICP between 80 and 200 mmH 2O, and increased ICP was defined as ICP>200 mmH 2O. Fifty patients with CVST were divided into normal ICP group (14 cases) and increased ICP group (36 cases). The differences of baseline data, ONSD and ODE between the two groups were compared, and the receiver operating characteristic (ROC) curve was generated. The area under the curve (AUC) and the diagnostic cut-off value of ONSD were analyzed. Spearman correlation analysis was used to analyze the correlation between ONSD, ODE, CVST involvement range scores and intracranial pressure. Results:①There were no significant differences in gender, age and body mass index between the normal ICP group and the increased ICP group (all P>0.05). ②The ONSD and ODE in the increased ICP group were higher than those in the normal ICP group, and the differences were statistically significant [(4.83±0.33)mm vs (4.21±0.21)mm, (0.67±0.44)mm vs (0.24±0.29)mm, all P<0.001]. Spearman correlation analysis showed that ONSD and ODE were positively correlated with intracranial pressure ( rs=0.74, 0.51, all P<0.001). ③The extent of CVST involvement in the intracranial hypertension group was higher than that in the normal intracranial pressure group, and the difference was statistically significant [5.0(3.0, 7.5) vs 2.5(2.0, 5.0), P=0.015]. Spearman correlation analysis showed that CVST involvement score was positively correlated with intracranial pressure ( rs=0.43, P<0.001). ④In the diagnosis of intracranial hypertension in patients with cerebral venous sinus thrombosis, the AUC of ONSD was 0.935, the best diagnostic threshold of ONSD was 4.5 mm, the sensitivity was 0.81, and the specificity was 0.93. Conclusions:ONSD and ODE measured by ultrasound are reliable imaging methods to identify intracranial hypertension in patients with CVST.

Objective To discuss the clinical manifestations and the characteristics of spondyloarthritis (SPA) complicated with Turners syndrome,in order to promote the understanding of this disease.Methods A case of ankylosingspondylitis complicated with Turner syndrome in our department was re-ported,7 similar reports of SpA complicated with Turner syndrome in recent chinese and foreign literatures were reviewed.Their symptoms,signs,laboratory examinations etc were analyzed.Results All 8 cases were female,the median age when patients first their visited doctors was 25 (10 to 34 years old),7 of them showed peripheral arthritis,4 of them showed remarkable low back pain and limited motion of the spine,1 showed pain in hip area,3 showed varus or valgus joint deformity,5 combined with osteoporosis.There were 3 chromosome karyotypes:① 45,XO;② 45,XO/46,XX;③ 45X/46,X,psu,idic (X).Per treatment,6 patients received treatment with sulfasalazine tablets and non steroidal anti-inflammatory drugs,1 combined with methotrexate tablets,5 received calcium and vitamin D,1 received treatment with bisphosphonates.For the treatment of Turner syndrome,2 received estrogen replacement therapy,1 received growth hormone therapy.Conclusion The characteristics of SpA complicated with Turner syndrome are remarkable peripheral arthritis,prone to osteoporosis.For treatment we should give consideration to both of the 2 diseases,especially pay attention to the treatment of calcium and vitamin D.

Objective:To investigate the effect of chimney stent for reconstruction of left subclavical artery (LSA) in thoracic endovascular aotic repair (TEVAR) for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.Methods:TEVAR with chimney stent for LSA in 39 cases of acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen was done from Feb 2013 to Jan 2021.Results:Covered chimney stents was used in 11 cases and bare chimney stents in 28 cases. There was no postoperative stroke, left upper limb ischemia, paraplegia, hemiplegia and death. No stent migration, reverse tear and dissection rupture were observed. One bare stent was obstructed after 18 months, and all the remaining stents were patent during follow-up. The rate of immediate type Ⅰa endoleak in covered chimney stent group and bare chimney stent group were 0(0/11) and 32.1%(9/28) respectively ( P=0.04). The distance from proximal tear to LSA in covered chimney stent group, endoleak subgroup and non-endoleak subgroup in bare chimney stent were (5.1±2.3)mm, (14.4±5.2)mm and (7.8±7.0)mm respectively ( P<0.05). False lumen thrombosis was formed in endoleak subgroup 2-8 weeks after operation, and endoleak disappeared. Conclusions:There is a correlation between immediate type Ⅰa endoleak in bare chimney stent for LSA and the distance from proximal tear to LSA, covered chimney stent can reduce the incidence of immediate type Ⅰa endoleak in TEVAR for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.

Objective To explore the effect and possible pharmacological mechanism of Bufei Tongbi Decoction in the treatment of systemic lupus erythematosus interstitial lung disease (SLE-ILD).Methods The effective components and related targets of Bufei Tongbi Decoction were obtained using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Uniprot database. Key genes for SLE-ILD were screened based on DrugBank,DisGeNET,GeneCards,PharmGKB,OMIM,and GEO databases. Using Cytoscape software,a drug active ingredient-target-disease relationship network diagram was constructed to obtain the effective active ingredients and possible mechanisms of action of Bufei Tongbi Decoction in the treatment of SLE-ILD. Gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to reveal related target genes and pathway functions. Taking C57BL/6 mice as normal group,MRL/lpr mice were injected with bleomycin 5mg/kg in the nasal cavity. According to the random number table method,the mice were divided into model group,Bufei Tongbi Decoction low-dose group (10.4 g/(kg·d)),Bufei Tongbi Decoction medium-dose group (20.8 g/(kg·d)),Bufei Tongbi Decoction high-dose group (41.6 g/(kg·d)) and prednisone group (3 mg/(kg·d)). The intervention lasted for 28 days. Hematein eosin and Masson staining were used to observe the pathological changes of mouse lung tissue,the expressions of transforming growth factor-β1 (TGF-β1) and collagen type Ⅲ (Col-Ⅲ) in lung tissue were detected by immunohistochemistry,and the expressions of interleukin-1β(IL-1β),interleukin-10 (IL-10) and interleukin-17 (IL-17) in serum were detected by ELISA. The mRNA expressions of matrix metallopeptidase 1(MMP-1),hypoxia inducible factor-1α(HIF-1α),retinoid-related orphan receptor γt (RORγt ) and forkhead box P3 (FOXP3) in lung tissue were analyzed by RT-PCR,the protein expressions of HIF-1α and MMP-1 in lung tissue were detected by Western blotting,and the expressions of T helper 17 cells (Th17) and regulatory T cells (Treg cells) in blood were detected by cytometry.Results A total of 163 effective ingredients,259 targets,1729 SLE-ILD disease targets,958 SLE-ILD differential genes and 40 drug-disease interaction targets were obtained by screening. GO functional enrichment and KEGG pathway enrichment showed that IL-17 signaling pathway activated by IL-1β and MMP-1,and Th17 cell differentiation activated by IL-1β and HIF-1α were the main pathways. Animal experiments showed that Bufei Tongbi Decoction could effectively improve the degree of lung interstitial lesion and reduce the expressions of TGF-β1 and Col-Ⅲ in SLE-ILD mice (P<0.01). The expressions of IL-1β,HIF-1α and IL-17 were decreased (P<0.01). Medium and high doses of Bufei Tongbi Decoction decreased the expressions of MMP-1 and RORγt mRNA (P<0.01),and increased the expressions of IL-10 and FOXP3 mRNA (P<0.01). Bufei Tongbi Decoction could reduce the proportion of Th17 cells,increase the proportion of Treg cells,downregulate the balance of Th17/Treg (P<0.05),and improve the immune disorder. Conclusion Bufei Tongbi Decoction has the characteristics of multi-target and multi-pathway in treating SLE-ILD,and its mechanism may be related to the regulation of Th17/Treg cell balance.