Objective To observe relationship between the phlegm and adhesion molecule and further explore the functions of the phlegm in the metastatic potential of the tumors. Methods Examin the expression difference of ICAM-1,E-cad,MMP-9 of gastric cancer by enzyme linked immunosorbent assay between the phlegm-stamp type and non-phlegm-stamp type,then reducing phlegm by chinese medicine treatment and comparing theirs expression variation.Results The expressions of ICAM-1,E-cad, MMP-9 were obviouslv different between the phlegm group and non-phlegm group[(403.6±99.7)μg/L,(9.08±1.69)mg/L,(465.0±96.64)μg/L &(319.9±81.4)μg/L,(7.56±1.15)mg/L,(228.1±43.79)μg/L].After using xiao-tan-san-jie recipes,the expressions of ICAM-1 and E-cad of the phlegm group were obviously lower than before(P<0.05);the expression of MMP-9 was also falling down,but the difference was not significative.Conclusion There is a correlation between the phlegm and adhesion molecule, which could take action in tumor metastams by affecting adhesion molecule expression.

OBJECTIVETo explore the new mechanism of propranolol for treatment of hemangioma and the effects of propranolol on proliferation of hemangioma-derived mesenchymal stem cells ( Hem- MSCs).

METHODSWe isolated Hem-MSCs from hemangioma in the proliferating phase by their selective adhesion to plastic culture dishes. Immunofluorescence staining was used to examine the expression of marker antigens in Hem-MSCs. Human umbilical vein endothelial cells(HUVECs) were used as control. Indiuction of multi-lineage differentiation including osteogenesis and adipogeneis was performed with appropriate medium to identify the multi-lineage differentiation potential. MTT cell counting was used to observe the effects of different concentrations of propranolol on proliferation of Hem-MSCs.

RESULTSHem- MSCs were fibroblast-like morphology. All of them expressed vimentin, most expressed α-SMA,CD133, some expressed Glutl, and none of them expressed VEGF. Osteogenic, adipogenic differentiations of Hem- MSCs were induced successfully. Effects of low concentration of propranolol on proliferation of Hem-MSCs were not obvious, while high concentration of propranolol can inhibit the proliferation of Hem-MSCs.

CONCLUSIONSThe cells we isolated from hemangioma are Hem-MSCs. High concentration of propranolol can inhibit the proliferation of Hem-MSCs.

Adipogenesis ; Antigens ; metabolism ; Cell Differentiation ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelium, Vascular ; cytology ; Fibroblasts ; cytology ; Hemangioma ; pathology ; Humans ; Mesenchymal Stromal Cells ; cytology ; drug effects ; metabolism ; Osteogenesis ; Propranolol ; pharmacology ; Umbilical Veins ; Vimentin ; metabolism

Objective To investigate the therapeutic effect of high intensity focused ultrasound (HIFU) ablation combined with homemade liquid fluorocarbon nanoparticles on cervical cancer in nude mice.Methods The cell experiment was divided into three groups:a,control group;b,HIFU group;c, HIFU + PFB nanoparticle group,and the viability of cells was detected using CCK-8 reagent.The mice were also divided into three groups:A,0.9% NaCI group;B,HIFU + 0.9% NaCI group;C,HIFU + PFB nanoparticle group. The tumors were removed and underwent triphenyl tetrazolium chloride(TTC) staining,and the necrosis area was measured.Histopathological changes of the tumors were examined by light microscopy.Results After HIFU irradiation,the viability rate of group c was (40.5 ±9.7)%,it was lower than that of group b (77.7 ±8.5)% (P <0.05) and that of group a(100 ±4.8)% (P <0.05). TTC staining of tumor showed a large scale of necrotic tissue in group C.The necrosis ratio of the three groups was 0%,(34.14±12.2)% and (65.97 ±25.1)%,respectively (P <0.05).HE staining showed karyorrhexis or an absence of nuclei in group B and group C,which demonstrated the coagulation necrosis. Conclusions HIFU ablation combined with liquid fluorocarbon nanoparticles can effectively treat the xenograft model of the human cervical carcinoma in nude mice.

OBJECTIVETo summarize the management of infant vascular tumors with Kasabach-Merritt phenomenon (KMP) and to evaluate the effect of drug combined with sclerotherapy.

METHODSFrom Feb. 2007 to Nov. 2014, 25 cases with KMP, who underwent drug therapy combined with sclerotherapy, were retrospectively studied. Oral corticosteroids (2 mg/kg per day) was used as the first-line therapy on all of the patients and intravenous vincristine (1.5 mg/m2 every week) was added when the platelet counts didn't recover obviously after 2-3 weeks. After the recovery of the platelet counts, the patients were admitted for sclerotherapy (average, 4.56 sessions per case) with 100% alcohol (1-3 ml per session), Lauromacrogol (1.25-5 ml per session) and betamethasone (0.25-1 ml per session). All the patients were followed up for 42 months ( range, 9 months to 6.5 years). Therapeutic outcomes were assessed by evaluating platelet counts, size of lesion, function of trunk and limb.

RESULTSAll the 25 cases got obvious recovery in the platelet counts [average, (94.3 ± 18.5) x 10(9)/L] after drug therapy, of which 16 were treated by single oral corticosteroids for 4-7 weeks and 9 were treated by corticosteroids plus intravenous vincristine for 2-5 weeks. Meantime, 11 cases received platelet transfusions, of which 3 were coupled with gamma globulin intramuscularly. During the first admission, each of the 25 cases received 1-4 sessions of sclerotherapy (average, 2.6 sessions each case). One week after the sclerotherapy, the platelet counts returned to (167-312) x 10(9)/L (average, (258.5 ± 34.4) x 10(9)/L). The hemoglobin and blood coagulation function returned to normal within 1-5 weeks. Meanwhile the mental condition, appetite, body weight, sleeping were greatly improved. The size of the lesions decreased gradually after the combined therapy including 13 cases within 3-12 months and 13 cases within 13-36 months. Long term follow-up indicated that only 1 case need treatment for recurrent decrease of platelet counts, and all of the 25 cases kept the normal weight, height, immunity as well as the growing development.

CONCLUSIONSOral corticosteroids plus intravenous vincristine combined with sclerotherapy is a reliable management with high cure rate, short course and minor side-effect.

Administration, Oral ; Betamethasone ; administration & dosage ; Combined Modality Therapy ; methods ; Ethanol ; administration & dosage ; Glucocorticoids ; administration & dosage ; Humans ; Infant ; Injections, Intravenous ; Kasabach-Merritt Syndrome ; blood ; therapy ; Platelet Count ; Polyethylene Glycols ; administration & dosage ; Retrospective Studies ; Sclerotherapy ; methods ; Vincristine ; administration & dosage

Objective:To investigate the clinical treatment of large segmental humeral defects with unilateral external fixation and bone transport.Methods:A retrospective study was conducted of the 9 patients who had been treated at Department of Orthopedics, Shenzhen People's Hospital for large segmental humeral defects from September 2017 to June 2019. They were 5 males and 4 females with an average age of 29 years (from 21 to 41 years). Their defects were caused by trauma in 2 cases, by chronic osteomyelitis in 6 cases and by bone tumor in one case. The length of bone defect ranged from 4.2 to 9.0 cm, with an average of 5.9 cm. A unilateral external fixator was placed in operation, and adjusted regularly 7 to 10 days after operation for bone transport and bone lengthening to restore the length of humerus gradually. The external fixation bracket was removed after 3 to 4 layers of cortex were observed on X-ray films. Recorded were length and rate of humeral lengthening, fracture healing time, time for carrying external fixator and complications; the Disabilities of the Arm, Shoulder and Hand (DASH) scores were compared between preoperation and 15 months postoperation.Results:All the patients were followed up for 15 to 36 months (mean, 19 months). The length of lengthening averaged 5.9 cm (from 4.2 to 9.0 cm) with an average lengthening rate of 26%, the healing index 31 d/cm, the bone healing time 8.3 months, and the time for carrying external fixator 10.8 months(from 8.0 to 13.5 months). Their average DASH scores improved significantly from 25.0 ± 2.4 preoperation to 12.0 ± 1.8 at 15 months postoperation ( P<0.05). Good correction of large humeral defects was achieved in all but one case who reported temporary radial nerve paralysis. There were no such complications as neurovascular injury. The shoulder and elbow functions were basically normal after operation. Conclusions:In the treatment of large segmental humeral defects, unilateral external fixation plus bone transport can quickly repair the defects and recover the upper limb function of the patients.

Objective:To investigate the clinical characteristics of dermatomyositis (DM) patients with positive anti-melanoma differentiation-associated protein 5 (MDA5) antibody-complicated with pneumomediastinum.Methods:Clinical data of patients with anti-MDA5 antibody-positive DM with or without pneumomediastinum from March 2017 to December 2019 in Ningbo First Hospital were collected and analyzed. The international literature were reviewed and compared. T-test or Mann-Whitney U test was used for measurement data, chi-square test or Fisher exact probability was used for count data. Logistic regression analysis was used to analyze the risk factors for anti-MDA5 antibody-positive DM with pneumomediastinum. Results:Twelve DM patients with -positive anti-MDA5 antibody without pneumomediastinum, and 1 DM patient with positive anti-MDA5 antibody-complicated with pneumomediastinum. Pooling with literature review, 16 DM patients with positive anti-MDA5 antibody-complicated with pneumomediastinum were compared. It was found that the serum ferritin (SF) level [991.6(548.5, 2875.1) ng/ml vs 355 (143.5, 395) ng/ml, Z=-2.506, P=0.012] and the rate of rapid progressive pulmonary interstitial disease (RPILD) in the pneumo-mediastinum group [76.5% vs 16.7%, χ2=10.076, P=0.002] were significantly higher than those in the non-pneumome-diastinum group. Further Logi-stic regression analysis did not show male gender [ OR=0.192, 95% CI(0.009, 4.125), P=0.291]; SF [ OR=1.002, 95% CI(0.998, 1.006), P=0.279]; RPILD[ OR=0.084, 95% CI(0.003, 2.178), P=0.136]; CADM[ OR=0.258, 95% CI(0.009, 7.419), P=0.429] was risk factor for pneumomediastinum. Conclusion:DM patients with positive anti-MDA5 antibody and high seral SF level and rapid progression of pulmonary interstitial disease are more likely to complicate with pneumomediastinum.

Objective:To observe the effects of esketamine combined with butorphanol in endotracheal intubation guided by fiberoptic bronchoscopy with spontaneous breathing.Methods:Forty patients suspected of having difficult airways during elective general anesthesia operations in Hunan Provincial People′s Hospital were prospectively selected and divided into control group and observation group by random number table. Propofol plus sufentanil, esketamine plus butorphanol were used for intravenous general anesthesia respectively. At the same time, they were assisted with cricothyroid puncture and surface anesthesia of nasopharynx and larynx, and then trachea intubation with spontaneous breathing was performed through the nose under the guidance of fiberoptic bronchoscope. The changes of heart rate (HR), mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO 2), and the levels of serum cortisol, norepinephrine and adrenaline before and after endotracheal intubation were compared between the two groups. The number of body motions and coughing at the completion of endotracheal intubation was compared between the two groups. Results:In the control group, the HR and MAP at the completion of intubation were higher than those before intubation, and the PaO 2 was lower than those before intubation (all P<0.05); In the observation group, there was no significant difference in HR, MAP and PaO 2 at the completion of intubation and before intubation (all P>0.05). The HR and MAP at the end of intubation in the observation group were lower than those in the control group, and the PaO 2 was higher than that in the control group (all P<0.05). The number of body motion and coughing in the observation group was significantly less than that in the control group at the completion of endotracheal intubation (all P<0.01). At the end of endotracheal intubation, the serum cortisol, norepinephrine and epinephrine level in the observation group were significantly lower than those in the control group (all P<0.01). Conclusions:Esketamine combined with butorphanol has advantages over propofol combined with sufentanil in the application of fiberoptic bronchoscopy guided tracheal intubation in difficult airways that retain spontaneous breathing, and can better control the stress response caused by tracheal intubation.

Type 2 diabetes (T2D) is characterized by the malfunction of pancreatic β cells. Susceptibility and pathogenesis of T2D can be affected by multiple factors, including sex differences. However, the mechanisms underlying sex differences in T2D susceptibility and pathogenesis remain unclear. Using single-cell RNA sequencing (scRNA-seq), we demonstrate the presence of sexually dimorphic transcriptomes in mouse β cells. Using a high-fat diet-induced T2D mouse model, we identified sex-dependent T2D altered genes, suggesting sex-based differences in the pathological mechanisms of T2D. Furthermore, based on islet transplantation experiments, we found that compared to mice with sex-matched islet transplants, sex-mismatched islet transplants in healthy mice showed down-regulation of genes involved in the longevity regulating pathway of β cells. Moreover, the diabetic mice with sex-mismatched islet transplants showed impaired glucose tolerance. These data suggest sexual dimorphism in T2D pathogenicity, indicating that sex should be considered when treating T2D. We hope that our findings could provide new insights for the development of precision medicine in T2D.