Objective To discuss Buyang-huanwu decoction preventing the formation of lower limb deep vein thrombosis (DVT) after major orthopedic surgery.Methods 60 patients were randomly divided into a treatment group and a control group.The treatment group was treated with oral liquid of Buyang-huanwu,twice a day; while the control group was treated with 5000IU of low molecular heparin through subcutaneous injection,once daily.Prothrombin time (PT),activated partial thromboplatin time (APTT),fibrinogen (FIB),D-dimer,lower limb deep vein color B ultrasonic and the wound flow changes after 48 hours were observed at 1st,7th,and 14th day after medication.Results ①)Comparison on the incidence of DVT:The incidence of DVT in the treatment group was higher than the control group at 7th day after medication,this incidence turn to equal in the two groups at the 14th day after medication,while at the end of therapy,the incidence of DVT in the treatment group was lower than the control group with significant difference (P＜0.05).②Comparison on D-dimer changes:D-dimer at the 1st and 14th day were (0.782 ± 0.472) mg/1 and (0.320 ± 0.102) mg/1 in the treatment group and (0.720±0.421)mg/1 and (0.417 ± 0.217) mg/l in the control group.Comparing with the same group before treatment [the treatment group was(0.548±0.245)mg/1; the control group was (0.560±0.195) mg/l],D-dimer was increased at the 1 st day with obvious difference (P＜ 0.05),but reduced at the 14th day,without statistical difference (P＞0.05).Conclusion Buyang-huanwu decoction did not show good effects as low molecular heparin at the beginning of the treatment,but the its whole therapeutic effects and safety was better in treating lower limb deep vein thrombosis after major orthopedic surgery.

Objective To discuss the clinical application of multi-slice spiral CT angiography (MSCTA) in acute spontaneous intracranial hemorrhage .Methods 41 cases of acute spontaneous intracranial hemorrhage diagnosed with CT (including subarachniod cavity hemorrhage 29, intra-cerebral hematomas 12)were examined with MSCTA,the techniques of volume rendring (VR) and maximum intensity projection(MIP)were used. 7 cases of intracranial aneurysm closed by titanic clamp , 2 cases of cerebral arteriovenous malformation(AVM) and one case of AVM treated by intra-zest aneurysm excision,the post-operative MSCTA examination were received.Results 11 cases of intra-cerebral aneurysm, 4 cases of cerebral AVM and 1 case of AVM with intra-zest aneurysm were found among the 41 cases of acute spontaneous intracranial hemorrhage. MSCTA clearly demonstrated the size,neck and artery of aneurysms as well as the location, size ,zest shape, artery and vein of AVM. Pre-operative MSCTA findings of 7 cases of intracranial aneurysm clapped by titanic clap ,2 cases of cerebral AVM and 1 case of AVM treated by intra-zest aneurysm excision were confirmed with the operative findings.Post-operative MSCTA showed that the clamp location was normal; arteries were passable; zests of AVM were excised. Conclusion MSCTA is a non-injured, rapid and effective way to find the cause of acute spontaneous intracranial hemorrhage.It also has clinical application of post-operatiove assessment for intracranial aneurysm and cerebral AVM.

Objective To study the therapeutic of anastomotic leakage in post-esophagogastrectomy. Meth-ods There were 18 cases of anastomotic leakage in 127 cases with cancer of the thoracic esophagus who underwent esophagectomy were retrospectively studied. There were ten cases had anastomotic leakage of 67 cases of esophagogas-trectomy from 1995 to 2001 (first phase),the intestines nutrition sustain treatment taked rice water,fish soup and broth, there were eight cases had anastomotic leakage of 60 cases of esophagogastrectomy from 2002 to 2007 (second phase) ,the intestines nutrition sustain treatment taked supportan,fresubin. Results There were six cases death of 10 cases of anastomotic leakage at first phase, and there was any not death in the second phase. Conclusion When anastomotic leakage of esophagogastreetomy,it can elevate the cure rate with early diagncsis and treatment and intes-tines nutrition sustain treatment choose by supportan or fresubin.

Objective:To detect the existence of IFNGR in the stellate ganglion in female goats .Methods:The stellate ganglia were taken from female goats .The expression of IFNGR was detected by PCR method and immunohistochemical SP staining .Results:The results showed that:IFNGR immunoreactive substances were distributed in neurons , supporting cells and passing fiber , and mainly in the cytomembrane and nuclei of neurons .The relative expression of IFNGR was very significantly higher than that of non-neuronal cells (P<0.01).The sequence of IFNGR1 gene amplified by PCR method contained 376 bp, and IFNGR1 gene of goats exhibited the highest homology with sheep(98%),followed by cattle(97%).Conclusion:The results suggested that the IFNGR in the Stellate Gan-glion of female goats mainly expressed and located in sympathetic postganglionic neurons which were provided with the conditions for the role of IFN-γ, which implied that the Stellate Ganglion may act as the critical point to concert the immune regulation of IFN -γand neu-roregulation of autonomic nerve on cardiovascular system .

Objective To investigate the effects of epidermal growth factor (EGF) on the proliferation , migration and apoptosis of adipose-derived stem cells (ADSCs) in vitro. Methods Starved cell model and FasL-induced apoptosis model were established in serum-free media. The effects of 10 nmol/L and 100 nmol/L of EGF on the proliferation, migration and apoptosis of ADSCs in vitro were observed. The exrpessions of signal pathway proteins like phospholipaseC-γ(PLC-γ) , extracellular regulated kinase (ERK) and AKT were also detected. Results The proliferation, migration and anti-ap-optosis of ADSCs were promoted by 10 nmol/L or 100 nmol/L of EGF, and the expressions of PLC-'y, ERK and AKT were up-regulated. Conclusion EGF can promote the proliferation, migration and an-ti-apoptosis of adipose-derived ADSCs in vitro.

Objective To investigate the current dyslipidemia profiles and correlation with etiological factors in early stage post-transplantation, and the impact of lipid metabolic disorder on renal function. Methods The clinical data of 1032 renal allografts from eight hospitals in Beijing between 2004 and 2008 were collected and evaluated retrospectively. Before and at the 1st, 3rd, 6th and 12th month post-transplantation, the changes in blood total cholesterol (TC), triglycerides (TG),low density lipoprotein (LDL)-cholesterol and high density lipoprotein (HDL)-cholesterol were analyzed. The difference in the blood lipid disorder at different stages stratified by time and different age group, the effects of immunosuppressive agents on blood lipid, and the impact of blood lipid disorder on the blood creatinine were studied. Results Except HDL-cholesterol, TC, LDL-cholesterol and TG levels were increased gradually at the first year, especially LDL-cholesterol and TG. The TC and LDL-choleaterol abnormalities were obviously related with age (P<0. 01 ). The effect of Tacrolimus (Tac)-based immunosuppressive regimen on the lipid metabolic disorder was less than cyclosporine (CsA). At the first year, there was no significant difference in blood creatinine between lipid-lowering treatment and non-lipid-lowering treatment (P>0. 05). For the recipients not subject to lipid-lowering treatment and their TG level higher than the normal at the first month after operation, the creatinine level at the first year was significantly higher than in those with normal TG level (P< 0. 05). Conclusion The lipid metabolic disorder following renal transplantation is a common complication after the first transplant year, and was related with age and immunosuppressive agent regimen. Tac-based immunosuppressive regimen has little effects on the blood lipid metabolism.

Objective In order to explore whether neurons in the cervicothoracic ganglion of female goat were equipped with the condition for the role of progesterone .Methods Immunohistochemical SP method was used to detect the expression of progesteron receptor ( PR) in cervicothoracic ganglion of female goats .Results The result indicated that PR-immunoreactive-products were mainly present in the cell bodies of neurons , and satellite cells , Schwann cells , neurapophysis and nerve fiber also had weaker staining .The cell membrane and cytoplasm of neurons represented brown as strong positive ,but the nucleus of neurons showed the presence of heterogeneity , 85.10% neurons ’ nucleus was strong positive,of which 31.91%nucleolus being clear vacuoles were negative;14.90%nucleus displaying vacuolization had no shaining, of which 7.45%nucleolus was strong positive .There were weak positive and flaxen PR-immunoreactive-products in satellite cells, Schwann cells, neurapophysis and nerve fiber .Image analysis shows that PR of neurons was extremely significant compared with other non-nerve cells ( P <0.01 ) . Conclusion The result proved that the sympathetic postganglionic neurons in cervicothoracic ganglion of female goat were the one of main target cells of progesterone ,suggesting that progesterone may be involving in the neuroregulation of cardiac functional activities through affectinng the activities of neurons in the cervicothoracic ganglion of female goat ,and PR in the cervicothoracic ganglion may act as a network node to coordinate endocrine regulation of progesterone and neuroregulation of autonomic nerve on the cardiac functional activities .

Objective Toexploretheapplicationvalueofmulti-parametermagneticresonanceimaging(MP-MRI)inthediagnosis ofprostatecancer(PCa).Methods Theclinicaldataof50patientssuspectedasPCaandadmittedbetweenJanuary2017andJanuary 2018wereretrospectivelyanalyzed.Thepathologicalexaminationwasusedasthegoldstandard,andallpatientsunderwentMP-MRI. Theapplicationvalues(sensitivity,specificity,accuracy,positivepredictivevalue,andnegativepredictivevalue)ofMP-MRIwereevaluatedin thediagnosisofPCa.Results Amongsingleexaminationofeachsequence,thesensitivity,accuracyandnegativepredictivevalueof DWIwerehigher,whilethespecificityandpositivepredictivevalueofT2WIwerehigher.ThesensitivityofMP-MRIcombinationwas assameasthatofDWI,butthespecificity,accuracy,positivepredictivevalueandnegativepredictivevaluewerehigherthanthoseof anysingleexamination.PI-RADSscoresofthePCawerehigherthanthoseofthebenignprostatichyperplasiainT2WI,DWI,DCE-MRI and MP-MRIcombination(P＜0.05).TheADCvalueofthePCawaslowerthanthatofthebenignprostatichyperplasia(P＜0.05). Conclusion MP-MRIcombinationcanobtain moreeffectiveinformationforprostatediseases,andhashigherspecificity,accuracy, positivepredictivevalueandnegativepredictivevalueindiagnosingPCa.

结直肠癌（colorectal cancer，CRC）是常见的消化系统恶性肿瘤之一，其发病率和病死率处于各类肿瘤的第3位。环状 RNA（circular RNA，circRNA）是一种新型长链非编码RNA（long non-coding RNA，lncRNA），早期被当作剪切过程中的副产物且 无生物学意义和功能。近年来研究发现，环状RNA不具有5’末端和3’末端的闭合环状，其结构较其他非编码RNA稳定，能作为 RNA的海绵体以及调控剪切和转录，也能影响蛋白质以及核糖体，参与肿瘤的发生、发展和预后，在肿瘤的早期诊断、分型和分期 中也具有一定的潜能。随着研究的深入，环状RNA在肿瘤组织的差异表达与CRC的发生、发展以及预后存在密切的关系， 为 CRC的诊断、治疗及预后提供了可观的发展前景。本文对环状RNA作为CRC生物标志物近年来的研究进展作一综述。

Objective:To investigate the clinical value of radiomics based on computed tomography (CT) examination in preoperative differential diagnosis of pancreatic serous cystadenoma (SCA) and mucinous cystadenoma (MCA).Methods:The retrospective case-control study was conducted. The clinicopathological and imaging data of 154 patients with pancreatic cystic neoplasms who were admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from January 2012 to December 2019 were collected. There were 24 males and 130 females, aged (50±13)years. Of the 154 patients, 99 cases were diagnosed as SCA and 55 cases were diagnosed as MCA. All the 154 patients underwent plain and enhanced CT scan of pancreas before operation. The clinical characteristics, radiology features and radiomics features of all patients were collected to construct the clinical characteristics model, radiology model, radiomics model and fused model. The receiver operating characteristic (ROC) curve of each model was drawn, and those constructed models were evaluated by area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value. Based on the optimal model, the nomogram was constructed. Observation indicators: (1) establishment and validation of clinical characteristics model; (2) establishment and validation of radiology model; (3) establishment and validation of radiomics model; (4) establishment and validation of fused model; (5) nomogram of fused model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Establishment and validation of clinical characteristics model: 3 clinical characteristics, including age, symptoms and preoperative serum CA19-9, were selected using multinomial logistic linear regression analysis to construct the clinical characteristics model. Result of the multinomial logistic linear regression analysis was expressed by formula ①: clinical characteristics model score=0.635-0.007×age+0.054×clinical symptoms+0.108×preoperative serum CA19-9. The ROC curve for the test dataset of clinical characteristics model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of clinical characteristics model were 0.611(95% confidence interval as 0.488?0.734, P<0.05), 56.6%, 66.7%, 56.3%, 41.5%, 78.4% for the training dataset and 0.771(95% confidence interval as 0.624?0.919, P<0.05), 77.8%, 63.1%, 88.5%, 80.1%, 76.7% for the test dataset, respectively. (2) Establishment and validation of radiology model: 5 radiology characteristics, including tumor location, the number of tumors, tumor diameter of cross section, lobulated tumor and polycystic tumor (more than 6), were selected using multinomial logistic linear regression analysis to construct the radiology model. Result of the multinomial logistic linear regression analysis was expressed by formula ②: radiology model score=?0.034+0.300×tumor location+0.202×the number of tumors+0.014×tumor diameter of cross section?0.251×lobulated tumor?0.170×polycystic tumor (more than 6). The ROC curve for the test dataset of radiology model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of radiology model were 0.862(95% confidence interval as 0.791?0.932, P<0.05), 78.8%, 81.8%, 77.5%, 62.8%, 90.2% for the training dataset and 0.853(95% confidence interval as 0.713?0.994), P<0.05), 88.9%, 89.4%, 88.5%, 85.0%, 92.0% for the test dataset, respectively. (3) Establishment and validation of radiomics model: 4 categories of a total 1 067 radiomics features were extracted from 154 patients with pancreatic cystic neoplasms, including 7 first-order histogram features, 53 texture features, 848 wavelet features and 159 local binary pattern features. A total of 896 stable radiomics features were retained to construct the model, based on the condition of intraclass correlation coefficient >0.9. After selected by variance threshold and correlation coefficient threshold, 350 radiomics features were retained. Fifty synthetic radiomics features were constructed based on the original features in order to obtain potential radiomics features, and the total number of radiomics features was 400. After analyzed by the five-fold recursive feature elimination, 22 radiomics features were screened out, including 13 wavelet features, 7 synthetic radiomics features and 2 local binary pattern features. The support vector machine algorithm was used to construct the radiomics model. The penalty coefficient 'C' and parameter 'γ' of the radiomics model were 35.938 and 0.077, respectively. The kernel function of the radiomics model was 'radial basis function kernel'. The ROC curve of radiomics model using 5-fold cross validation was drawn. The average AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the radiomics model were 0.870 ( P<0.05), 83.1%, 81.8%, 83.8%, 73.8% and 89.2%, respectively. (4) Establishment and validation of fused model: the fused model was constructed after selecting the tumor location and lobulated tumor of radiology characteristics and radiomics score. Result of the multinomial logistic linear regression analysis was expressed by formula ③: fused model socre=?0.154+0.218×tumor location?0.223×lobulated tumor+0.621×radiomics score. The ROC curve for the test dataset of fused model was drawn. The AUC, accuracy, sensitivity, specificity, positive predictive value and negative predictive value of fused model were 0.893(95% confidence interval as 0.828?0.958, P<0.05), 83.7%, 81.8%, 84.5%, 71.1%, 90.9% for the training dataset and 0.966(95% confidence interval as 0.921?0.999, P<0.05), 91.1%, 84.2%, 96.2%, 94.1%, 89.3% for the test dataset, respectively. (5) Nomogram of fused model: the nomogram of fused model was illustrated with the Youden index of 0.416. Conclusion:The prediction model based on the radiomics signature and radiological features extracted from preoperative CT examination can make the differential diagnosis of pancreatic SCA from MCA.