Objective: To explore effects of large dose gamma globulin on cardiac function and immune regulation in patients with dilated cardiomyopathy (DCM) and heart failure (HF).Methods: According to random number table, a total of 90 DCM + HF patients were divided into routine treatment group (n=45) and gamma globulin group (n=45, received gamma globulin based on routine treatment, 400 mg kg-1 d-1 intravenous drip for 5d).After three months, therapeutic effect, cardiac function, levels of cardiac troponin T (cTnT), cTnI, N terminal pro brain natriuretic peptide (NT-proBNP) and anti-cardiac myosin heavy chain auto-antibodies (AMHCA) IgG titer before and after treatment, incidence of adverse reactions were observed and compared between two groups.Results: After three-month treatment, total effective rate of gamma globulin group was significantly higher than that of routine treatment group (80.00% vs.57.50%, P=0.02);compared with routine treatment group after treatment, there were significant reductions in levels of cTnT [(0.54±0.18) μg/L vs.(0.31±0.12) μg/L], cTnI [(1.35±0.18) μg/L vs.(0.72±0.13) μg/L], NT-proBNP [(758.34±64.28) pg/ml vs.(708.34±60.22) pg/ml], and significant rise in left ventricular ejection fraction [LVEF, (39.35±6.23)% vs.(47.32±6.10)%] in gamma globulin group, P<0.05 all;compared with before treatment and routine treatment group after treatment, there was significant reduction in AMHCA IgG titer [(0.099±0.047), (0.092±0.045) vs.(0.069±0.032), P<0.05 both] in gamma globulin group;incidence rate of adverse reaction in gamma globulin group was significantly higher than that of routine treatment group (22.22% vs.6.67%, P=0.04), but the symptoms were mild, and they recovered after symptomatic treatment.Conclusion: Large dose gamma globulin can significantly improve cardiac function and possesses good immune regulation effect in patients with dilated cardiomyopathy and heart failure.

Objective: To detect the relationship between variant of rsl255372 in transcription factor 7-Like 2(TCF7L2) gene and the type 2 diabetes mellitus (T2DM) in Tianjin Han populations. Methods: Three hundred and fifty-two T2DM patients and 176 healthy controls were randomly selected to extract the genome DNA. Denaturing high performance liquid chromatography was used to detect the PCR amplified fragment. The different peaks were chosen for sequencing. The differences of different genotype frequency between the groups were analysed. The Logistic regression was used to evaluate the risk factors of T2DM. Results: The G/T genotype frequencies of rsl2255372 were 18.5% and 2.8% in T2DM group and healthy control group respectively (P < 0.05). The G/T genotype, glycosylated hemoglobin, urea nitrogen and the systolic blood pressure were the independent risk factors of T2DM, and the high density lipoprotein was the protective factor. There was no significant difference of the G/T genotype frequency in T2DM patients with different complications. Conclusion: This study indicates that G/T genotype in the TCF7L2 gene significantly contributes to T2DM susceptibility in Tianjin Han populations. The G/T genotype is one of the risk factors of the T2DM.

BACKGROUND:Articular process of joint is an important bony structure to maintain the spinal stability and normal physiological activities. Clinical study found that bilateral articular process asymmetry is also one of the causes of vertebral degeneration, but the existing research mainly focuses on the adult, and give priority to with cervical vertebra and lumbar vertebra. OBJECTIVE:To explore the morphological and developmental characteristics of thoracic facet joints and bony structures of 10 to 12-year-old children and compare with data of adults. METHODS:A total of 30 normal cases aging from 10 to 12 years were admitted into this study. No cases experienced bone destruction, deformity, fractures, or tumors, and spine surgery was not involved in. DICOM 3.0 data of multi-slice spiral CT (0.625-1.25 mm), ranging from T1 to T12, were used for three-dimensional reconstruction, measurement and statistical analysis. RESULTS AND CONCLUSION:(1) Joint width overal trends in“V”. Joint surface height from T1 to T12 increased gradual y with the increase of the operation sequence. (2) The joint thickness from T1 to T12 showed a gradual y increasing trend with the increase of the job sequence;articular process under the joint thickness was gentle. In the left and right sides of the upper and lower joints, joint surface width, height, and thickness did not show significant difference in addition to the significant difference between the individual vertebral body. Joints spacing on the side and there was no significant difference between upper and lower, articular process spacing between sides showed an increasing trend with the increase of operation sequence;upper and lower joints spacing increased with the job sequence, and showed wide“U”shape. (3) These results confirmed that the application of three-dimensional reconstruction techniques can display shape and characteristics of each vertebral body clearly and intuitively and improve measurement accuracy. Width and height of facet joints in 10-12-year-old school children were overal smal er than those of adults. The distance between upper and lower facet joints changed a little. Distance between left and right facet joints increased from T1 to T12, which complies with the growth and development of children.

Objective To explore the morphological characteristics and change rule of thoracic joint angles in children aged from 10 to 12 years through thinner CT scanning and 3D reconstruction,and to provide theoretical basis for early diagnosis,treatment and prevention.Methods Totally 30 normal cases aged from 10 to 12 years were admitted into this study.There was no bone destruction,deformity,fractures,tumors and spine surgery involved.DICOM 3.0 data of multi-slice spiral CT (0.625 ～ 1.25 mm),ranging from T1 to T12,were used for 3D reconstruction,measurement and statistical analysis.Results The difference between left and right sagittal section angle of zygopophysis was less than 10°.There was no significant differences between T1,T11,and T12for sagittal section angle of upper zygopophysis (P ＞ 0.05).So was it between T3,T4,T9,T10 and T11 for sagittal section angle of lower zygopophysis (P ＞ 0.05).While there were significant differences between others(P ＜ 0.05).The was no significant difference between left and right coronal plane angle of zygopophysis (P ＞ 0.05).Coronal plane angle of lower and upper zygopophysis tended to be ‘ spike-like’,and the maximum points were at T7 to T9.For horizontal plane angle,left and right upper zygopophysis made significant differences between T2,T4,T8,T10 and T12 only,so did T7 lower zygopophysis (P ＜ 0.05).Horizontal angle of upper zygopophysis tended to be stable in the upper thoracic both in the left and right side,while a decreasing trend was shown in lower thoracic.Horizontal angle of lower zygopophysis showed a decreasing trend generally except individual vertebrae.Both upper and lower zygopophysis showed negative angle at T11 and T12 levels.Conclusion Thoracic joint angles(coronal,sagittal and horizontal angle) in children aged from 10 to 12 years can directly reflect the developmental regularity with growth,and it verified the tendency that horizontal facet joints of the cervical spine gradually changes to coronal facet joints thoracic spine and then changes to sagittal facet joints of lumbar spine.And the left and right side facet joints are basically symmetrical with the angle difference less than 10°.

Objective ::To investigate the role of trehalose in hepatic ischemia-reperfusion injury and its underlying mechanisms.Methods:C57BL/6J mice were randomly divided into no-ischemia group, ischemia-reperfusion group, trehalose-treated group and normal saline control group. After ischemia for 90 minutes, reperfusion immediately or 6h, blood and liver tissues were collected, and serum was separated. The liver function parameters of ALT, AST, the inflammatory factors of TNF-α, IL-1β and IL-2, and the pathological changes of liver were detected to study the role of trehalose during hepatic ischemia-reperfusion injury. Hypoxia-reoxygenation cell model was established by AML12 mouse hepatocyte line, and divided into experimental group and control group. The experimental group was divided into low dose group and high dose group according to the concentration of trehalose administrated. And the control group had no use of trehalose. The level of apoptosis was measured to study the effect of trehalose on apoptosis induced by hepatic ischemia-reperfusion injury with flow cytometry. Western blot was utilized for detecting the levels of Caspase-3, Cleaved Caspase-3 and Bcl-2 protein to understand the molecular mechanisms of trehalose in apoptosis during hepatic ischemia-reperfusion injury.Results:In vivo animal experiments showed that liver function and such inflammatory factors as ALT, AST, TNF-α, IL-1β and IL-2 increased in ischemia-reperfusion group after hepatic ischemia-reperfusion ( P<0.05), and liver tissue became necrotic. After a treatment of trehalose, the levels of ALT, AST, TNF-α, IL-1β and IL-2 were lower than those of normalsaline control group and the area of liver tissue necrosis also decreased ( P<0.05). In vitro cell experiments showed that the apoptosis level of hepatocytes in the experimental group decreased compared with the control group.And the level of activated pro-apoptotic protein Cleaved Caspase-3 decreased, the level of anti-apoptotic protein Bcl-2 increased. Conclusions:Trehalose has protective effects on hepatic ischemia-reperfusion injury in vivo and in vitro. The mechanism may be involved in inhibiting inflammation induced by hepatic ischemia-reperfusion injury, suppressing the activation of Caspase-3 and promoting the expression of Bcl-2, thus played a protective role by extenuation of hepatocyteapoptosis.

Objective To analyze the administrative penalties for radiation diagnosis and treatment in Xuzhou, China, 2018—2021, investigate the key illegal behaviors in radiation diagnosis and treatment, and provide a basis for effective supervision with targeted measures. Methods A total of 142 cases of administrative penalties were analyzed for the year of the case, the undertaker, the basic information of the subjects, the amount of penalty, and the specific illegal facts. Results From 2018 to 2021, the case number of administrative penalties for radiation diagnosis and treatment in Xuzhou was relatively stable. The cases were mainly undertaken by the municipal health supervision institution, while the number of cases handled by basic-level health supervision institutions was increasing. The administrative penalties were mainly imposed on persons and primary or non-classified medical institutions. Common illegal behaviors included occupational health management of radiation workers and personal protection during medical exposure. Conclusion We should focus on strengthening the publicity and supervision of personal protection in occupational health management and medical exposure, continue to improve the law enforcement ability of basic-level radiation health supervisors, develop a standardized management system for radiation diagnosis and treatment, innovate the supervision mode and radiation hazard notification mode, promote the “Internet + ” informatization supervision, and recommend to improve and revise radiation-related laws and regulations.

Chronic diseases of the digestive system are becoming more prevalent in the elderly population.To reduce the occurrence of malignant lesions in the upper gastrointestinal tract, it is important to focus on diagnosing and monitoring esophageal and gastric mucosal lesions in the elderly.The advancement of gastrointestinal endoscopy technology has led to the development of various endoscopic equipments and techniques.One such technology is confocal laser microendoscopy, which allows real-time biopsy and cytology of the mucosal surface.This technology holds significant value in the real-time diagnosis of conditions like gastroesophageal reflux disease(GERD), Barrett's esophagus, esophageal high-level intraepithelial neoplasia, early esophageal squamous carcinoma, atrophic gastritis, and pre-cancerous gastric mucosa in the elderly.Understanding the application of confocal laser microendoscopy in diagnosing esophageal and gastric mucosal lesions in the elderly is crucial for clinicians in making diagnostic and therapeutic decisions.

Objective To improve overall value of healthcare industry through setting up critical inpatient medical services strategic plan.Methods Identify major objectives which the local government expects to achieve through strategic map; Standardize inpatient output and assign weight to each group through diagonosis related groups; Translate the objectives of strategic map and result of diagnosis related group to Balanced Score-card; Finally build up strategic map and according action plans.ResultsPreliminarily established 16 objectives、23 measures and 13 tasks in four perspectives including customer,internal work flow,learning and growing and finance.ConclusionThe strategy map and the balanced score-card can help implement full strategic plan of regional inpatient medical services; DRGs is a core management tool of patient-centred service output management; Balanced Score-card is able to realize continuous improvement of Beijing inpatient medical services from macro to micro persoetive.

Objective: The aim of this study was to investigate the effect of co-culture with AEC (amniotic epithelial cell) on the biological characteristics of AMSC (amniotic mesenchymal stem cell), and to investigate the roles of SDF-1/CXCR4 axis in the homing and migration of AMSC. Methods: AMSC andAEC were isolated from human amnion, and then cultured, amplified and identified, respectively. TheAMSC were divided into three groups:AEC co-cultured group, serum-free cultured group and serum cultured group.After culture for 24 h, 48 h, and 72 h, the proliferation viability ofAMSC was measured by CCK-8 assay and trypan blue staining; the expression of CXCR4 mRNAwas analyzed by flow cytometry and Real-time RT-PCR, and the migration ability ofAMSC in vitro was observed by migration assay. Results: Cell viability (48 h and 72 h) and survival rate in the co-culture and serum groups were higher than those in the serum-free group (all P<0.05). The mRNA and protein expressions of CXCR4 in AMSC of the co-culture and serum-free groups were significantly higher than those of the serum group (P<0.05). The migration ability of AMSC in the co-culture and serumfree groups, which increase with the SDF-1 (stromal cell derived factor-1) concentration gradient, were higher than that in the serum group (P<0.05). Conclusion: AMSC co-cultured with AEC still have the basic biological characteristics of MSC, and showed good growth activity. Co-culture withAEC can up-regulate CXCR4 onAMSC surfaces and enhance the migration ability ofAMSC in vitro.