Objective To investigate the expression of tumor suppressor gene p16~(INK4A) in mouse endometrium during the estrus cycle and early pregnancy and its possible role in blastocyst implantation. Methods Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expression of p16~(INK4A) mRNA,immunohistochemistry and Western blotting were applied to detect p16~(INK4A) protein in mouse endometrium tissues during the estrus cycle and early pregnancy. Results The intensity of p16~(INK4A) mRNA expression in mouse early pregnancy was higher than that in the estrus cycle.Compared with the other 3 stages, the level of p16~(INK4A) mRNA expression at estrus was obviously higher. During the early pregnancy, the level of p16~(INK4A) mRNA expression increased steadily from day 2 to day 5,reaching the maximal level on day 5,then decreasing. Both immunohistochemical and Western blotting analysis showed the same results in expression patterns of p16~(INK4A) protein for mouse endometrium tissues as those results of RT-PCR.Conclusion p16~(INK4A) is involved in the embryos penetrating into the endometrial barrier.

Objective To summarize the experience of perioperative management of coronary artery bypass graft(CABG) in high-risk patients with coronary heart disease.Methods The clinical data of 164 patients underwent CABG from March 2004 to November 2005 were analyzed.Of 164 patients,151(92.05%) cases had severe coronary heart disease.Results Totally 144 artery-vessels and 353 venous-vessels were transplanted to patients.Combined operative procedures included 11 cases of ventricular aneurysm resect,5 cases of valve replacement,5 cases of valve repair,and 1 case of surgical repair of perforation of ventricular septum.Post-operative complications included 2 cases of low cardiac output,1 case of respiratory failure,1 case of renal failure,and 1 case of cerbral infarction.Two patients died and the operative mortality was 1.22%.Conclusion CABG procedure is safe in the treatment of high-risk patients with coronary heart disease.Proper preoperative and perioperative treatment can improve the curative effects significantly.

OBJECTIVE To study the effect of different doses of aspirin on clinical efficacy in acute stage of Kawasaki’s disease, and to explore the optimal dose of aspirin. METHODS A total of 150 patients suffered from Kawasaki’s disease were randomly selected by hospital information system from March to May 2022 for retrospective analysis. According to different doses of aspirin, they were divided into three groups: high dose group(>50 mg·kg−1·d−1), medium dose group(30−50 mg·kg−1·d−1) and low dose group(<30 mg·kg−1·d−1). The antipyretic time, the incidence of non-response to intravenous human immunoglobulin, the improvement of laboratory indexes and prevalence of adverse drug reaction were compared among the three groups. RESULTS There was no significant difference in body temperature recovery among the three groups under different doses of aspirin. There was no significant difference in patients with non-response to intravenous human immunoglobulin among the three groups. Before treatment, there were no significant differences in white blood cell(WBC) count, blood platelet(PLT) count and C-reactive protein(CRP) concentration among the three groups. After treatment, the count of WBC, PLT and CRP in the three groups was significantly improved compared with that before treatment, and the difference was statistically significant(P<0.05). However, there was no significant difference in the above indexes among the three groups after treatment. There was a higher incidence of adverse reactions in children treated with medium or high dose aspirin. CONCLUSION Different doses of aspirin combined with intravenous human immunoglobulin have good therapeutic effect on Kawasaki’s disease, but considering the safety and economy of aspirin, low dose administration is recommended.

OBJECTIVE: To develop a cell-based system for the diagnosis of vitamin K-dependent coagulation factor deficiency 1 (VKCFD1). METHODS: In HEK293 cells stably expressing the reporter gene FIX-Gla-PC, the gamma-glutamyl carboxylase (GGCX) gene was knocked out by using CRISPR/Cas9 technology. Enzyme-linked immunosorbent assay (ELISA), DNA sequencing and Western blotting were used to identify the GGCX gene knockout cells. A quickchange point variant method was used to construct the GGCX variant. ELISA was used to assess the influence of GGCX variant on the activity of reporter gene. RESULTS: Two monoclonal cell lines with no reporter activity by ELISA was identified. Edition and knockout of the GGCX gene was confirmed by DNA sequencing and Western blotting. The activity of the reporter gene was recovered by transfection of the wild-type GGCX gene. Thereby two monoclonal cells with GGCX knockout were obtained. By comparing the wild-type and pathogenic GGCX variants, the reporter activity was decreased in the pathogenic variants significantly. CONCLUSION A cell-based system for the detection of GGCX activity was successfully developed, which can be used for the diagnosis of VKCFD1 caused by GGCX variants.

Objective:To investigate the effect of mandibular angle osteotomy on the morphological changes of mandible by using cone beam computed tomography (CBCT) scanning data and three-dimensional cephalometry.Methods:According to included and excluded criteria, the complete CBCT data of 20 female patients (aged 20-35 years with an average age of 25.5 years) from January 2016 to June 2018 who underwent curved mandibular angle osteotomy combined with splitting cortiectomy were selected. Seven items reflecting mandibular morphology before and after surgery were measured respectively. All the data were analyzed by the means of SPSS 12.0; linear correlation analysis and paired t test were used to evaluate the change of andibular morphology.Results:The measurement results of the mandible pre- and post-operative 10 days showed as follows: Go-Go decreased, both sides of Cd-Go, Go-Ri and MR-MA decreased, both sides of Go-Me became longer, both sides of Ar-Go-Me and MP-FH increased. The paired t-test results showed that there was significant difference before and after operation ( P<0.05), but there was no significant difference between the left and right measurement items ( P>0.05). Compared with that in 10 days after operation, the measurement items also changed 6 months after operation. There was no statistical difference between the above measurement items 6 months after surgery and 10 days after surgery ( P>0.05), and no statistical difference between the left and right sides ( P>0.05). Conclusions:The mandibular three-dimensional model which is reconstructed based on CBCT data, not only displays the three-dimensional anatomical structure that cannot be presented on X-ray film visually and comprehensively by means zoom, rotation and other operations, but also precisely and accurately shows the change of the shape of the mandible from the sagittal, coronal and horizontal plane with arbitrary cutting and rotation. The measurement of mandible is more accurate and reliable, and the surgical plan of mandibular angle osteotomy can be accurately planned preoperatively, and the operative effect can be quantitatively evaluated postoperatively.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.

Objective:To explore the surgical experience of high speed rotary excision combined with multi-technology in the treatment of adult nape-fat-pad.Methods:A total of 83 patients with nape-fat-pad in our department from March 2016 to September 2019 were selected for the study. In this marked area, 0. 2 percent lidocaine with 1∶10 000 epinephrine was used for local tumescent anesthesia, then a skin incision of about 0.5 cm was made directly under the fat pad and/or about 2 cm from it. First, use a fork knife to separate the fat pad at multiple planes and angles, then cut off with a rotary excision and sucked out thoroughly. Second, use a thin liposuction tube to pump the transition area between the nape-fat-pad and normal fat until the transition is natural and smooth. Finally, fix the skin in the separation area with oil nail, apply pressure with "8-form" bandage and sleep on the rice pillow for 1 week after surgery. The appearance of the neck, postoperative complications and patient satisfaction were followed up 3-6 months after the operation.Resuts:83 patients had varying degrees of pain and swelling for 1-2 months after operation, 76 cases(91.57%) of the patients had complete disappearance of swelling in about 1 month, 12 cases(14.46%)had cyanosis and ecchymosis, which improved in about 3 weeks, 5 cases(6.02%) had a sense of subcutaneous cord or induration, and recovered completely in 2-3 months. Subcutaneous effusion was found in 2 patients(2.41%) in the early stage of operation and absorbed about 1 week.4 cases (4.82%) had a slight "sense of step" in the operative and normal fat transition area about 1 month after operation. 3 cases (3.61%)had poor wound healing, and the other 80 cases (96.39%)were grade A healing. There was no abnormal skin sensation in the operation area in all the 83 cases.No serious complications such as skin necrosis infection and important vascular injury occurred in all the patients 3 to 6 months after the operation. In the patient satisfaction survey, 70 patients were satisfied, 9 were satisfied, 4 were average, the satisfaction rate of the patients was 95.18%.Conclusions:The high speed rotary excision combined with multi-technology in the treatment of nape-fat-pad has short operation time, good curative effect, few complications and high patient satisfaction.

Objective To investigated the current situation and to explore the risk factors of venous thromboembolism ( VTE) among inpatients according to the retrospective analysis. Methods 539 VTE patients who had treated in a grade III class A hospital in Shanghai during September 2011 to September 2014 were chosen as the case group. The control group included patients who had no VTE but treated in the same hospital during that time. The clinical data of the participants were collected and retrospectively analyzed.Results Univariate analysis demonstrated significant differences in age ( t=5.421, P<0.05) , BMI>25 kg/m2 , major surgery, malignancy, VTE history, pneumonia, central venous catheter, stay in bed>72 h, stroke, immobilization, pelvis/lower extremity fractures, and joint arthroplasty between the two groups (χ2=9.868, 29.711, 16.230, 48.050,5. 613, 16.443, 5.735, 20.403, 4.340, 20.646, 10.343; P<0.05). Furthermore, the logistic regression analysis indicated that the risk factors of VTE were related to stroke[OR=6.414 (2.421,16.995)], joint arthroplasty [OR=5.718(1.268,25.777)], pelvic/lowers extremity fractures[OR=4.918 (2.074,11.659)], central venous catheters[OR=3.446 (1.671,7.107)], surgery history[OR=2.245 (1.338,3.767)], major surgery [ OR=2.189 ( 1. 553, 3. 085 ) ] , BMI>25 kg/m2 [ OR=1. 913 ( 1. 450, 2. 523 ) ] , malignancy [ OR=1. 713 (1. 184,2.477)], and age[OR=1.559 (1.343,1.810)].Conclusions More specific preventive strategies should be focused on and implemented to VTE patients as they suffered from various risk factors at the same time.

Objective    To verify the feasibility of a self-designed magnetic anchoring and traction device (MATD) for assisting two-port video-assisted thoracoscopic esophagectomy. Methods    Three Beagle dogs were selected as animal models with age ranging from 1-6 years and weight ranging from 8-12 kg, and they underwent two-port video-assisted thoracoscopic esophagectomy after general anesthesia. We used the MATD to retract the esophagus to different directions, which assisted mobilizing esophagus, detecting the nerves along esophagus and dissecting paraesophagus lymph nodes. The operation time, blood loss and feasibility of the MATD were recorded. Results    With the aid of the MATD, we successfully retracted and mobilized the esophagus, detected the nerves and dissected the lymph nodes in three Beagle dog models. During the operation, the MATD provided sufficient and steady traction of esophagus to achieve a good exposure of the operative field, effectively decreasing the interference between working instruments. The MATD worked well. The mean operation time was 30 min, and the mean intraoperative blood loss was about 10 mL. Conclusion    It is effective to use the MATD to assist retracting esophagus during video-assisted thoracoscopic esophagectomy. The magnetic anchoring and traction technique can assist to expose the surgical field, decrease the interference between the working instruments and have the potential clinical application.

OBJECTIVE： To provide reference for improving the economics evaluation studies for pediatric therapeutic regime in China. METHODS： By searching the literature published in domestic journals from Jan. 1st， 2009 to Dec. 31th， 2018， the current situation of the measurement of cost （including time range， cost calculation） and health output （including outcome indicators and measurement scales） were explored. Combined with relevant literature at home and abroad， the deficiencies of economics evaluation for pediatric therapeutic regime in terms of cost measurement and health outcome measurement were summarized in China， and the corresponding research prospects were put forward. RESULTS & CONCLUSIONS： Totally 140 related literatures were finally included. In terms of cost measurement， short-term （≤1 year） research accounted for the highest proportion （109 literatures， 77.86％）. Cost calculation mostly had no clear research perspective （125 literatures， 89.29％）. It did not involve the cost of child productivity. The main shortcomings were unclear time range， incomplete cost calculation （lack of productivity， hidden cost） and so on. In terms of health output measurement， 103 （73.57％） used cost-effectiveness analysis， 23 （16.43％） used cost-benefit analysis， and only 4 （2.86％） related to the use of measurement scales. Main shortcomings included that the difficulty in obtaining outcome indicators， lack of child health output measurement scale and so on. Based on this， it is suggested that related demands should be complied before conducting economics evaluation research， we should clarify the research angle， formulate unified and standardized cost measurement methods， rationally select technical analysis methods and health outflow indicators according to research purposes and disease characteristics， and develop appropriate measurement scales according to the physiological and psychological characteristics of children in different age groups. At the same time， future studies can report on the status of family members when reporting on children's related conditions， and conduct an economic evaluation of therapeutic regimen in the family unit.