Carcinoma, Squamous Cell ; pathology ; Humans ; Microtomy ; instrumentation ; methods ; Staining and Labeling ; instrumentation ; methods ; Tongue Neoplasms ; pathology

Using the multiple streams theory to better understand the termination of drug supported medical policy and to draw a conclusion that the drug supported medical policy finally came true with the active promotion of policy entrepreneurs,such as government,experts and scholars under the organic combination of problems,policy plans and political situation.The termination of drug supported medical policy would inevitably lead to the obstruction of relevant interest groups.To eliminate the resistance of the termination of drug supported medical policy,it needed to completely abolish drug supported medical policy.After the completion of the top-level design,the reform of financial system and the optimization of doctor's performance incentive mechanism must be done well.

ObjectiveTo optimize human Hexastatin gene,to express,purify protein and conduct activity experimental research,and to provide a theoretical basis for further study of Hexastatin.MethodsHuman Hexastatin gene was optimized and synthesized.It was connected to the pET28a expression vector,induced to express by isopropyl β-D-1-thiogalactopyranoside(IPTG),and optimized induction conditions.After the ultrasonication of bacterial cells and inclusion bodies,the recombinant fusion protein was purified with Ni-NTA chromatographic column,analyzed and identified by SDS-PAGE and Western Blot,and conduct activity experimental research in vitro by MTT.ResultsConstructed production was pET28a-Hexastatin expression plasmid.The human Hexastatin protein was expressed in E.coli BL21 the high level and accounted for 45.1％ of the total bacterial protein.The purification of recombinant protein purified with Ni-NTA chromatographic column reached 90％,and the concentration was 80 μg/ml.Human Hexastatin protein can restrain the growth of C6,MCF-7 and human vascular endothelial cell (HMEC) cells,and inhibition ratio reach to 72.9％±3.6％,48.8％±2.9％,52.7％±2.5％,respectively through MTT test.ConclusionThe optimized human Hexastatin protein was expressed successfully,which confirmed the inhibition to tumour cells.It is a new way for anti-angiogenesis therapy of tumour.

Adult ; Biopsy ; Female ; Graft Rejection ; pathology ; Humans ; Intestinal Mucosa ; pathology ; Intestine, Small ; injuries ; pathology ; transplantation ; Male ; Organ Transplantation ; adverse effects ; Reperfusion Injury ; etiology ; pathology ; Young Adult

BACKGROUNDIncretin-based therapies provide additional options for treating type 2 diabetes. We aimed to evaluate the efficacy and tolerability of exenatide monotherapy in obese patients with type 2 diabetes.

METHODSA 26-week, metformin controlled, parallel-group study was conducted among antidiabetic drug-naive obese patients aged > 18 years, and with type 2 diabetes. Participating patients were randomly assigned to receive exenatide or metformin treatments.

RESULTSFifty-nine patients (age (50.5 ± 8.6) years, body mass index (BMI) (30.2 ± 1.6) kg/m(2), and hemoglobin A1C (HbA(1C) (8.2 ± 1.2)%) were enrolled in the study. Glucose control and weight reduction improved in both groups receiving treatment. HbA(1C) and oral glucose tolerance test (OGTT) 2 hour glycemia reduction with exenatide was superior to that obtained with metformin ((-2.10 ± 1.79)% vs. (-1.66 ± 1.38)%, (-5.11 ± 2.68) mmol/L vs. (-2.80 ± 2.70) mmol/L, P < 0.05). Fast plasma glucose (FPG) reduction was not significantly different between the two groups ((-1.8 ± 2.0) mmol/L vs. (-1.6 ± 1.7) mmol/L, P > 0.05). Patients treated with exenatide achieved HbA(1C) of < 7% (97% of patients) and < 6.5% (79%) at end-point, vs. 93% and 73% with metformin (P > 0.05). Greater weight reduction was also achieved with exenatide ((-5.80 ± 3.66) kg) than with metformin ((-3.81 ± 1.38) kg, P < 0.01). Homeostasis model assessment of beta-cell function (HOMA-B) was not significantly increased, but the insulinogenic index and HOMA for insulin sensitivity (HOMA-S) were greatly improved in the exenatide group (P < 0.05). Nausea was the most common adverse effect in exenatide treatment (30% vs. 8%; P < 0.05), but most cases were of mild to moderate intensity. One case in the exenatide group was withdrawn early because of severe nausea. Hypoglycemia events were often observed during the first 4 weeks, with 12% of patients in the exenatide and 3.2% in metformin groups, respectively (P < 0.05). No incidents of severe hypoglycemia were reported.

CONCLUSIONSExenatide demonstrated more beneficial effects on HbA(1C), weight reduction and insulin resistance during 26 weeks of treatment, but there were more hypoglycemic events and mild-to-moderate nausea compared with metformin. These results suggested that exenatide monotherapy may provide a viable treatment option in newly developed type 2 diabetes.

Adult ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Female ; Glycated Hemoglobin A ; metabolism ; Humans ; Hypoglycemia ; chemically induced ; Hypoglycemic Agents ; adverse effects ; therapeutic use ; Insulin Resistance ; Male ; Metformin ; adverse effects ; therapeutic use ; Middle Aged ; Nausea ; chemically induced ; Obesity ; blood ; drug therapy ; Peptides ; adverse effects ; therapeutic use ; Venoms ; adverse effects ; therapeutic use ; Weight Loss ; drug effects

OBJECTIVETo investigate the clinicopathological features, histogenesis and prognosis of mucinous tubular and spindle cell carcinoma (MTSCC).

METHODSFive MTSCCs were studied with histochemical, immunohistochemical staining, electron microscopy, and review of the related literatures.

RESULTSFour cases of MTSCC were females and one was male. Three patients presented with flank discomfort and two were incidentally found with health examination. In gross examination, the tumors were circumscribed. The cut surface was solid, gray-white, yellow or red. Necrosis was present in one case of high-grade MTSCC. Microscopically, low-grade MTSCC was mainly consisted of tubular, spindle cell and mucinous stroma with relatively bland morphology, and mitoses were rare. While in the high-grade area of one case, the cells were spindle or polymorphic with severe atypia and high mitotic activity, without mucinous stroma and tubular structure. Mucin was positive for Alcian blue. The neoplastic cells were positive for vimentin (5/5), CKpan (5/5), CK7 (5/5), CK19 (5/5), 34betaE12 (1/5), EMA (5/5), E-cadherin (3/5), CD10 (1/5), P504S (5/5), and CAM5.2 (5/5). The Ki-67 index was low (< or = 5%) in the low-grade component, while it was high (15%) in the high-grade component. Ultrastructural study showed short microvilli along glandular lumens. The nuclear membrane was focally invaginated. Four cases were followed up for 3 to 52 months, and recurrence and metastasis were not found.

CONCLUSIONSMTSCC occurs predominantly in females and it is a rare kidney neoplasm. Most of MTSCCs are low-grade and the prognosis is relatively good. However, the patients of high-grade MTSCC should be closely followed up.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Adult ; Carcinoma ; metabolism ; pathology ; surgery ; Carcinoma, Medullary ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; Leiomyosarcoma ; metabolism ; pathology ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Nephrectomy ; Racemases and Epimerases ; metabolism ; Vimentin ; metabolism

OBJECTIVETo propose a method for predicting the postoperative anterior chamber depth value (ACD) based on the evaluation standard of contrast sensitivity function (CSF).

METHODSIn a personalized eye model, the natural lens was replaced with an artificial lens, and the tracing method based on ZEMAX software was utilized to simulate the pseudophakic optical system. The best MTF curve was obtained through optical optimization to calculate the CSF and determine the best contrast sensitivity (CS) curve. The best ACD value was acquired according to the CSF curve. The data form 10 cataract cases without retinal diseases were obtained and the postoperative ACD value was predicted using Holladay, Hoffer Q, SRK/T and the proposed method.

RESULTSConsistency analysis of the results showed that all the ACD values predicated by the 4 methods fell in 95% consistency within the boundaries, and the differences in the largest absolute value between the 3 methods (Holladay, Hoffer Q, and SRK/T) and the proposed method were 0.73 mm, 0.65 mm, and 0.68 mm, and the calculation results of the mean value were 5.846 mm, 5.804 mm, and 5.825 mm. Clinically, the two methods were deemed to have good consistency.

CONCLUSIONThe proposed method establishes a connection between the contrast sensitivity curve and ACD to allow better refraction adjustment for the patients.

Anterior Chamber ; anatomy & histology ; Anthropometry ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Postoperative Period ; Refractive Errors ; complications ; diagnosis ; rehabilitation

OBJECTIVETo measure the degree of satisfaction on various environmental and health components and to discuss the impact of Olympic Games among the residents so as to make relative policy suggestions.

METHODSIn 2006, permanent residents over 15 years old lived in the Asian Games Village Community (where the 29th Olympic Games to be held) were selected to conduct a household's survey, while 1610 valid questionnaires were collected. The questionnaire included demographic information, degrees of satisfaction on various health-related environmental components, living condition and on Olympic events.

RESULTSThe top 4 aspects with the highest satisfaction rates were "overall rates of satisfaction on current life" "green space", "housing conditions" and "water quality", which were 50.43%, 48.59%, 38.95%, 37.08%, respectively. Residents' satisfaction on "impact of hosting the Olympic Games on China's international image", "China's economic development level", "living conditions" and "personal life" were 65.53%, 56.09%, 47.27%, 46.40%, respectively. Data from partial correlation analysis showed that the total scores of satisfaction on environment and life had positive correlation with the total scores of Olympic satisfaction (P < 0.05). The satisfaction degree on Olympic event through factor analysis showed that 10 entries of the Olympic impact could be reflected by two factors--the influence of image to the nation and impact on personal income. Logistic regression showed that the impact of Olympic Games on personal income, the impact of Olympic Games on the image of the nation and standard of living, gender, education level were independent influencing factors of the total scores of environment and life satisfaction (P < 0.05).

CONCLUSIONOther than "green space", most of health-related environment components of Beijing had low degree of satisfaction among inhabitants from the 'typical' communities in Beijing. However, residents had a higher degree of satisfaction on the impact of the Olympic Games to the country's image, the country's economic development level, the environment and personal standard of living.

Adult ; China ; Female ; Humans ; Life Style ; Male ; Middle Aged ; Personal Satisfaction ; Quality of Life ; psychology ; Social Environment ; Sports ; Surveys and Questionnaires

BACKGROUND: Intra-articular injection of cells targeting to change the microenvironment in lesions can act on early osteoarthritis of inflammatory chondrocytes. Implanted cells affect the progress of the disease by the cell characteristics. OBJECTIVE: To explore the synergistic effect of mesenchymal stem cells from human knee adipose (ADMSCs) and synovial tissues (SDMSCs) to inhibit the degeneration of inflammatory chondrocytes. METHODS: ADMSCs, SDMSCs and inflammatory chondrocytes were primary cultured. Under in vitro two-dimensional culture conditions, cell proliferation assay (MTS) was performed to detect the proliferation of three kinds of cells. Differences in chondrogenic markers at mRNA and protein levels between three kinds of adherent cells were detected by quantitative PCR and immunofluorescence. Under in vitro three-dimensional mixed culture conditions, three groups were set up: (1) ADMSCs+inflammatory chondrocytes (A+C group), (2) SDMSCs+inflammatory chondrocytes (S+C group), and (3) ADMSCs-SDMSCs+inflammatory chondrocytes (A+S+C group). Alcian blue staining, safranin O staining and type Ⅱ collagen immunohistochemistry staining were performed on the mixed-cultured cell mass paraffin sections followed by quantitative analysis. Chondrogenic differentiation in each group was detected by quantitative PCR. Culture supernatants were collected to detect the secretion of pro-inflammatory and anti-inflammatory factors by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION: Under the two-dimensional culture, the proliferative rate of ADMSCs was significantly higher than that of inflammatory chondrocytes and SDMSCs (P < 0.05). The expression of type Ⅱ collagen mRNA and protein and proteoglycan protein in inflammatory chondrocytes was significantly higher than that in the other two kinds of cells (P < 0.01). Under the three-dimensional culture, the percentage of chondrogenic area per total area was significantly higher in the A+S+C group than the S+C and A+C groups (P < 0.05). The expression of type Ⅱ collagen and proteoglycan was significantly higher in the A+S+C group than the S+C and A+C groups (P < 0.05). Compared with the other two groups, the S+C group showed higher levels of interleukin 1, interleukin 6, and tumor necrosis factor α, but lower level of interleukin 10 (P < 0.05). To conclude, the combined use of ADMSCs and SDMSCs synergistically inhibits the degeneration of inflammatory chondrocytes.

Objective:To investigate the effects of preoperative nutritional status on postoperative functional prognosis in elderly patients with proximal humerus fracture.Methods:From January 2020 to December 2020, 103 elderly patients (≥65 years old) were treated for proximal humerus fractures by open reduction and internal fixation at Department of Traumatology, Honghui Hospital Affiliated to Xi'an Jiaotong University. Upon admission, according to the Geriatric Nutrition Risk Index (GNRI), they were assigned into a normal nutrition group (55 cases, with GNRI≥92) and a malnutrition group (48 cases, with GNRI<92). The baseline data, preoperative hemoglobin level, time from injury to operation, intraoperative blood transfusion, postoperative complications, 1-year mortality, and Neer shoulder functional scores at 3 months, 6 months and the last follow-up were compared between the 2 groups.Results:The 2 groups were comparable because there were no significant differences in gender, injury side, Neer fracture classification, injury cause, or American Society of Anesthesiologists (ASA) grading ( P>0.05). The age of the malnutrition group was significant older than that of the normal nutrition group ( P<0.05). All patients were followed up for 9 to 16 months (mean, 13.6 months) after surgery. In the normal nutrition group and the malnutrition group, respectively, the preoperative hemoglobin level was (10.24±0.68) g/dL and (8.94±0.89) g/dL, the time from injury to operation (3.9±1.3) d and (5.8±1.2) d, the rate of intraoperative blood transfusion 14.5%(8/55) and 60.4%(29/48), the rate of postoperative complications 20.0%(11/55) and 39.6%(19/48), the 1-year mortality 1.8%(1/55)、4.2%(2/48), and the Neer shoulder function score (46.7±8.8) points and (43.2±5.6) points at 3 months after operation, (67.6±6.2) points and (76.3±5.5) points at 6 months after operation, and (80.4±5.0) points and (76.3±5.5) points at the last follow-up. Comparisons of all the above items showed significant differences between the 2 groups (all P<0.05). Conclusions:Preoperative malnutrition in elderly patients with proximal humerus fracture has adverse effects on preoperative waiting time, intraoperative blood transfusion, complications and postoperative shoulder function. Therefore, perioperatively, attention should be paid to the nutritional status of elderly patients to reduce their stress responses to fracture, surgery and anesthesia, and to improve their postoperative function and quality of life.