Objective To investigate the technique and effectiveness of CT-guided collagenase injection into prominence of herniated lumbar disc and the surface of prominence in the treatment of lumbar disc herniation. Methods One hundred and fifty-five patients with lumbar disc herniation diagnosed by clinic and CT received CT-guided collagenase injection, with the approaches via intervertebral foramen in L3-4 and L4-5, and the approaches via margo medialis of joint processus articularis in L5-S1. Results Injection was done successfully in all patients (100%), the clinical rate of excellent and good results were 94.2%. The herniation disappeared or significantly reduced as demonstrated by CT scan in 32 of 34 patients (94.1%), the rate of excellent and good results were 100%. No changes existed in 2 cases. There were 2 cases of disc inflammation in our group. Conclusions CT-guided collagenase injection into the prominence of herniated lumbar disc and its surface is a safe and efficient method in the treatment of herniated lumbar disc.

To advocate cadaver donation is to advocate the spirit of devotion and scientific research.It has been proved in the development of modern medicine that many problems of medical education and stubborn diseases were solved by necrospy.However,currently the cadavers donated cannot satisfy practical need,mainly because that few people would voluntarily register to donate their bodies,and those among the registered who actually donated are even fewer.This paper analyzes three factors that contribute to the bottleneck in the cadaver donation.And on the basis of present situation,countermeasures are presented to solve the problems.

Objective CT-guided collagenase injection through posterolateral path into the interior and superficial prominence of the herniated lumbar disc in the treatment of L4-5 lumbar disk herniation.Methods The approach of posterolateral path to the prominence through intervertebral foramen and epidural space of L4-5 was established according to the analysis of anatomical features and vertebral medical images. The accuracy and safety of the approach were evaluated by CT scanning after epidural injection with air. CT-guided injection was operated in 66 cases of prolapse of L4-5 intervertebral disc confirmed by CT. Results Technical success was 100%. Followed up for 3 months to 3 years, 62 cases (93%) were markedly suecessfud with the effective rate of 93%. Twenty-three had CT re-examination three months later showed the prominences becoming smaller or disappeared in 22 patients having a resolved rate of 95%.Conclusions CT-guided injection of collagenase is one of the effective methods for the treatment of prolapse of L4-5 intervertebral disc.

To investigate the expression of polyadenosine diphospho-ribose polymerase 1 (PARP-1) and p16/ retinoblastoma (Rb) protein in hydroquinone (HQ)-induced TK6 cells and their regulatory mechanisms. Methods According to the 2×2 factorial design model, TK6 cells were divided into PBS-TK6 group and HQ-TK6 group based on HQ exposure, and then sub-divided into non-DOX intervention subgroup and DOX intervention subgroup based on DOX intervention, a total of four groups. The PBS-TK6 group was treated with phosphate buffer saline, and the HQ-TK6 group was treated with HQ at a final concentration of 20.0 μmol/L. The non-DOX intervention subgroup was added with 0.05% dimethyl sulfoxide; and the DOX intervention subgroup was added with PARP-1 agonist DOX at a final concentration of 0.5 μmol/L. The distribution of cell cycle was detected by flow cytometry. The protein expression of p16/Rb, cyclin D1 (cyclinD1), multifunctional protein E2 transcription factor 1 (E2F1), Rb, and p-Rb were detected by Western blot, and the level of p16 ribosylation was detected by immunofluorescence and immunoprecipitation. Results Compared with the PBS-TK6 group, the cell cycle distribution percentage in G0/G1 phase and the relative expression levels of p16 proteins were decreased in the cells of the HQ-TK6 group (all P<0.05). The cell cycle distribution percentage in S phase and the relative expression levels of cyclinD1 and p-Rb proteins were up-regulated (all P<0.05). Compared with the non-DOX intervention group, the cell cycle distribution percentage in G0/G1 and G2/M phases and the relative expression level of p16 protein increased in the DOX intervention group (all P<0.05). The percentage of cells in S phase and the relative expression levels of cyclinD1 and p-Rb proteins were down-regulated (all P< 0.05). The results of interaction effect analysis showed that compared with the non-DOX PBS-TK6 cells, the relative expression levels of Rb and E2F1 protein in the DOX PBS-TK6 cells intervention group were down-regulated (all P<0.05). The relative expression level of Rb protein in non-DOX HQ-TK6 cell group was down-regulated (P<0.05), and the relative expression of E2F1 protein was up-regulated (P<0.05). Compared with DOX PBS-TK6 cell group, the relative expression level of Rb protein in DOX HQ-TK6 cell group was down-regulated and that of E2F1 protein was up-regulated (all P<0.05). Compared with the non-DOX HQ-TK6 cell group, the relative expression level of Rb protein in the DOX HQ-TK6 cell group was up-regulated and that of E2F1 protein was down-regulated (all P<0.05). Conclusion PARP-1 participates in cell cycle regulation by regulating the p16/Rb signaling pathway in TK6 cells.

Objective To observe the effects of Bushen Huoxue Formula on free radical metabolism and p16 protein expression in heart of aged rats; To discuss its protective mechanism to the heart of aged rats.Methods One hundred were divided into young control group, the natural aging group,Bushen HuoxueFormula high-, medium- and low-dose groups, with 20 rats in each group. Each medication group was given relevant medicine for gavage, once a day for 16 weeks. 1 hour after the last administration, after the rats were sacrificed, serum and heart were taken. The contents of NO and MDA and activities of CAT and SOD in serum and myocardial,β-galactosidase enzyme and p16 protein expression in myocardial tissue were detected.ResultsCompared with the natural aging group, NO content and SOD activity in the serum of rats inBushen Huoxue Formula high-dose group increased significantly (P<0.05) and MDA content in allBushen Huoxue Formula groups decreased (P<0.01); NO content, CAT and SOD activity in the myocardial tissue of rats inBushen HuoxueFormula high-dose group increased significantly, and MDA content decreased significantly (P<0.05). CAT activity in allBushen HuoxueFormula groups increased (P<0.05,P<0.01).β-galactosidase enzyme and p16 protein expression in myocardial tissue in allBushen Huoxue Formula groups decreased.Conclusion Bushen Huoxue Formula can in hibit the aging of myocardial-aged rats, and the mechanism might be related to its anti-oxidative damage and inhibition of tumor suppressor gene p16 expression.

OBJECTIVE:To improve the quality standard of Shuangshen capsule. METHODS:TLC was conducted for the qual-itative identification of Curcumnae radix and Rehmannia glutinosa in the preparation. HPLC was used for the content determination of salvianolic acid B in the preparation:the column was Diamonsil C18(2)with mobile phase of acetonitrile-0.1% H3PO4(22:78, V/V) at a flow rate of 0.5 ml/min,detection wavelength was 286 nm,column temperature was 30 ℃,and the injection volume was 2 μl. RESULTS:The TLC spots of C. radix and R. glutinosa were clear and well separated;the linear range of salvianolic ac-id B was 0.0792-0.792 μg(r=0.9999);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 100.71%-101.82%(RSD=0.50%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Shuang-shen capsule.

OBJECTIVE:To optimize the processing technology of rehmanniae radix praeparata. METHODS:Using transfer rates of catalpol,rehmaionoside D,acteoside,isoacteoside,polysaccharide as indexes for comprehensive score,heating tempera-ture(pressure),heating time and heating times as investigating factors,L9(34)orthogonal test was used to optimize the processing technology of rehmanniae radix praeparata,and verification test was conducted. RESULTS:The optimal processing technology of rehmanniae radix praeparata was as follow as heating temperature of 125 ℃,pressure of 150 kPa for twice,2 h every time. The comprehensive scores of 3 batches of samples were 0.6985,0.6755,0.7016 in the verification test,respectively,RSDs were less than 5%(n=3). CONCLUSIONS:Optimized processing technology is simple,stable,feasible,and can provide reference for in-dustrial production of rehmanniae radix praeparata.

Objective:To evaluate the efficacy of platelet-monocyte aggregates (PMA) in the clinical diagnosis of sepsis.Methods:From January 2022 to December 2022, patients in the First Affiliated Hospital of Soochow University were recruited in this study, among which 41 were with sepsis (sepsis group), 41 patients had infection but were not diagnosed as sepsis (infection group), and 25 healthy individuals (healthy control group) were simultaneously chosen. Patients with sepsis were divided into the shock group (14 cases) and the non-shock group (27 cases). PMA of all subjects were measured by Beckman Coulter Navios Flow Cytometry and detection of procalcitonin(PCT), C-reactive protein (CRP) and platelet (PLT).The differences of the two indexes between the different groups were compared by nonparametric test. Spearman′s correlation test was used to analyze the correlation among PMA, PCT, CRP and PLT. The diagnostic value of PMA in sepsis was evaluated by drawing the receiver operating characteristic (ROC) curve. Kaplan-Meier survival curve was used to compare the survival time of patient with different PMA. Results:The PMA in the sepsis group, infection group and healthy control group were 52.66% (27.10%, 81.09%), 37.22% (26.52%, 54.56%) and 15.94% (15.10%, 17.02%), respectively. For the three groups, PCT levels were 3.10 (0.23, 15.35)μg/L, 0.15 (0.08, 0.79)μg/L and 0.02 (0.02, 0.02)μg/L, CRP levels were 106.6 (35.87, 175.60)mg/L, 76.45 (27.20, 110.10)mg/L and 1.26 (0.94, 2.42) mg/L, and the PLT counts were 116.00 (90.25, 204.30)×10 9/L, 192.00 (147.30, 333.00)×10 9/L and 199.50 (178.00, 252.80)×10 9/L. The values for PMA, PCT and CRP levels were significantly higher in the septic group compared to the healthy controls (the U values were 0.00, 5.00 and 1.00, P<0.001). But the PLT for the septic group was lower than that from the healthy control ( U=47.00, P<0.05). The differences in PCT and PLT were statistically (the U values were 84.50 and 176.50, P<0.05), but there was no significant difference between the PMA and CRP(the U values were 255.00 and 210.00, P>0.05) for the two groups. PMA was positively correlated with PCT( rs=0.562, P<0.001) and CRP( rs=0.447, P<0.001) in patients. The levels of PMA in shock and non-shock groups were 83.54% (76.51%, 86.82%) and 43.75% (21.59%, 62.83%) respectively ( U=12.00, P<0.05). The AUC of PMA in diagnostic of sepsis was 0.750(95% CI 0.657-0.843), the best cut-off value was 37.99%. Survival curve analysis showed that the survival time was significantly lower in the PMA≥37.99% group ( χ 2=4.805, P<0.05). Conclusion:PMA holds significant clinical reference for sepsis diagnosis and has the potential to serve as a biomarker in sepsis diagnostic procedures.

Objective: To investigate the expression of Apelin and Snail proteins in breast cancer and their relationship with the clinicopathological features and prognosis. Methods: The expression of Apelin and Snail proteins was detected by immunohistochemistry in 89 cases of breast cancer and 50 cases of mammary adenosis collected from January to June in 2008 at Fujian Cancer Hospital; the expression was correlated with the clinicopathological features and outcome of the patients. Results: Apelin and Snail were expressed in 42 cases(47.2%)and 36 cases(40.4%)of breast cancers, respectively, and the expression was higher than that of control group (P<0.01). The expression of Apelin was positively correlated with Snail (r=0.230, P<0.05). Apelin expression was associated with lymph node metastasis and TNM staging(P<0.05). Snail expression was associated with lymph node metastasis(P<0.05). Kaplan-Meier survival curve showed that the prognosis of Apelin positive group was worse than that of Apelin negative group (P<0.01). There was no significant difference in prognosis between Snail negative and positive groups (P>0.05). The prognosis of Apelin and Snail in both positive groups was worse than that of Apelin and Snail both negative groups (P<0.01). Multivariate COX regression analysis showed that Apelin and TNM staging could be used as independent prognostic factors for breast cancer (P<0.05). Conclusions Apelin and Snail are highly expressed in breast cancer, and associated with lymph node metastasis and TNM stage. There is a positive correlation between Apelin and Snail expression, which may suggest a role in breast carcinogenesis. The prognosis of breast cancer with expression of Apelin and co-expression of Apelin and Snail is poor. Therefore, Apelin may be used as an effective indicator to evaluate the prognosis of breast cancer patients.

Objective:To investigate the clinicopathological features and prognosis of medullary thyroid carcinoma (MTC) co-existent with Hashimoto's thyroiditis (HT).Methods:Seven cases of MTC co-existent with HT were collected from Fujian Cancer Hospital between Jan 2007 and May 2021. Its clinicopathological features were analyzed.Results:All patients were adult female with a median age of 49 years, and 6 of them were unilateral MTC. The tumor diameter ranged from 0.4 to 7.0 cm. The thyroid tissue surrounding the tumor showed HT. The follow-up time was 16 to 152 months, with a median time of 61 months, 5 patients (tumor diameter <1 cm) were biochemically cured, 1 patient (tumor diameter >1 cm) was anatomically cured. The another patient died due to tumor progression 30 months after surgery, the tumor cells in which were highly atypia and more mitoses (5~8/10HPF) necrosis and vascular invasion were also observed.Conclusion:MTC with HT are mostly sporadic cases, and most of them have a fair prognosis.