AIM:To study the protective effects and mechanism of Fushen Jiangzhuo formula (FSJZ) on the rat renal interstitial fibroblasts with renal tubulointerstitial lesion .METHODS:The serum containing FSJZ and blank con-trol serum were prepared .The rat model of mesangial proliferative glomerulonephritis ( MsPGN) was established and ex-tended the time of modeling to 20th weeks for developing tubulointerstitial lesion naturally .The rat renal interstitial fibro-blasts at the end of 12, 16, 20 week of modeling were isolated and cultured .The effects of FSJZ on the expression of hepa-tocyte growth factor (HGF) and bone morphogenetic protein-7 (BMP-7) at mRNA and protein levels in the pathological re-nal interstitial fibroblasts were determined .RESULTS:The anti-fibrosis factors HGF and BMP-7 were changed in patho-logical renal interstitial fibroblasts .Renal tubulointerstitial lesion significantly down-regulated the expression of HGF and BMP-7, while the drug containing serum of FSJZ significantly up-regulated the expression of HGF and BMP-7.CONCLU-SION:Drug containing serum of FSJZ has protective effect on pathological renal interstitial fibroblasts by regulating the mRNA and protein expression of HGF and BMP-7.

BACKGROUND:Traditional open reduction and internal fixation for type C pilon fractures is characterized extensive periosteal stripping, severe soft tissue injury, many postoperative complications, and unsatisfactory recovery of joint function. Minimal y invasive technology or external fixation combined with limited internal fixation for type C pilon fractures are usual y difficult to achieve anatomical reduction.
OBJECTIVE:To explore the curative efficacy of anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis in treatment of type C pilon fractures and postoperative complication occurrence in order to find out the efficient fixation method for type C pilon fractures.
METHODS:Twenty-six patients with type C pilon fractures (15 males and 11 females, aged from 19 to 68 years, mean age of 39.2 years) were selected and subjected to anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis. CT three-dimensional reconstruction was performed before and plate implantation. X-ray examination was carried out before and after fixation. Al patients were fol owed up for observation of clinical efficacy and complications. The therapeutic effects were evaluated using the Johner-Wruhs scoring system.
RESULTS AND CONCLUSION:The 26 patients were fol owed up for 16 months (from 9 to 24 months). Delayed healing occurred in one case (after 12 months), and the average healing time was 15 weeks (from 11 to 52 weeks). There was no deformity healing. Two patients developed superficial incision infections of Staphylococcus aureus, healed by open wound and dressing change every day for 2 weeks. No deep infection or osteomyelitis was found. One patient was found to have traumatic arthritis of ankle joint, improved by the injection of sodium hyaluronate. There was no flap necrosis and tendon irritation, broken nail or screw withdrawal, and nerve injury. Johner-Wruhs scores were excellent in 11 cases, good in 12 cases, fair in 3 cases, with the total excellent to good rate of 88.5%. These findings indicate that anterolateral“L”type locking plate implantation combined with interior minimal y invasive plate osteosynthesis for delayed treatment of type C pilon fractures can achieve satisfactory fracture reduction, rigid fixation, early functional exercise, less complications, and good recovery of joint function.

Objective:This study aimed to investigate the expression levels of centrosome-associated kinase Aurora-A, mutant type P53 (mt-P53), and c-myc in colorectal cancer. This study was also conducted to investigate the mutual relationship and functions of these factors in tumorigenesis and tumor progression. Methods:We examined the pathological specimens obtained from colorectal cancer, pericancerous tissues, and normal colorectal tissues by tissue microarray technique and immunohistochemistry (SP method) to determine the expression levels of Aurora-A, mt-P53, and c-myc proteins. The clinicopathological parameters were then analyzed. Re-sults: The positive rates of Aurora-A expression in normal colorectal tissues, pericancerous tissues, and colorectal cancer were 0%, 35%, and 69%respectively;by comparison, the positive rates of mt-P53 were 0%, 20%, and 57%, respectively. For c-myc, the positive rates were 0, 37%, and 76%, respectively. The expression levels of Aurora-A, mt-P53, and c-myc were significantly higher in tumor tis-sues than in normal colorectal tissues and pericancerous tissues (P<0.01). Aurora-A overexpression was related to the depth of invasion (P<0.05). Mt-P53 and c-myc overexpression was related to the depth of invasion, lymph node metastasis, and Dukes' classification (P<0.05). A strong positive correlation was observed between the expressions of Aurora-A, mt-P53, and c-myc in colorectal cancer (r=0.362, P<0.01; r=0.487, P<0.01). A strong positive correlation was also observed between the expressions of mt-P53 and c-myc in colorectal cancer (r=0.242, P<0.01). Conclusion:The overexpression of Aurora-A and c-myc and the mutation of P53 were important in tumorigenesis, tumor invasion, and metastasis of colorectal cancer. Thus, the co-detection of Aurora-A, mt-P53, and c-myc may be useful for the early diagnosis and prognosis of colorectal cancer.

Neuromyelitis optica (NMO) is an inflammatory-demyelinating disease of central nervous system that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM).Conventional MRI is the most sensitive method in detection of NMO lesions in brain,spinal cord and optic nerve,which can objectively show the site,number,size and distribution of lesions.The MRI features of NMO lesion in brain,spinal cord and optic nerve lesions were reviewed in this article.

Aim To introduce an improved method of Langendorff perfusion of the isolated rat heart that is easy to determine the termination of digestion.Methods Hearts were excised quickly from anesthetized SD rats.After the perfusate was free of blood,the solution was changed to perfusion buffer(0.6% Collagenase B,0.6% BSA,30 ?mol?L-1 Ca2+ in Tyrode solution)at 37℃.Hearts were isolated by traditional and improved Langendorff perfusion.Individual myocardial cell was measured by video-based motion edge-detection system(IonOptix,USA).Results One group of heart was digested by traditional Langendorff perfusion for 13~16 min.The termination of digestion could not be judged properly by this method.The nature and quality of the cardiocytes were various.The cardiocytes could not keep their survival and viability when exposed to Tyrode Solution with 1.8 mmol?L-1 Ca2+.Another group was digested by improved Langendorff perfusion.More than 80% survival cardiac ventricle myocytes could be obtained by improved Langendorff perfusion.Moreover,about 50% cardiac myocytes exposed to Tyrode solution with 1.8 mmol?L-1 Ca2+ could retain rod-shaped and be used to contraction research.The contraction of cardiocyte was stabile within 1 000 s.Conclusion Cardiac myocytes disassociated from improved Langendorff perfusion can be used in these studies of detecting contraction and relaxation.This method is economical and easy to control.The beginners are able to acquire the technological method over a short-term practice.

Colon cancer is a common malignant tumor in the world, however, its pathogenesis still needs further research. FEZF1- AS1 is highly expressed in colon cancer and other malignant tumors, and is associated with clinicopathological features and prognosis of colon cancer patients. In addition, FEZF1- AS1 promotes the proliferation, invasion and migration of colon cancer cells, regulates the cell cycle and inhibits apoptosis through various mechanisms, suggesting that FEZF1- AS1 may be a new important molecular biomarker and a potential therapeutic target for colon cancer. This article reviews the advances in the study of function and mechanism of FEZF1- AS1 in colon cancer.

Background: Aberrant Bcl-2 transcription is closely related with nodal diffuse large B-cell lymphoma (DLBCL), however, the relationship between Bcl-2 and primary gastrointestinal DLBCL (PGI-DLBCL) was not fully studied.Aims: To investigate the relationship between Bcl-2 gene amplification and protein expression and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL.Methods: Clinical data was collected from 136 PGI-DLBCL patients receiving surgical treatment, and a telephone interview was conducted for survival information.Bcl-2 gene amplification and protein expression in tumor tissue were determined by fluorescence in situ hybridization and immuno-histochemistry, respectively, and relationships between Bcl-2 and clinicopathological characteristics, immunophenotype and prognosis of PGI-DLBCL were analyzed.Results: Among 136 PGI-DLBCL patients, 33 (24.3%) showing gene amplification and 90 (66.2%) showing protein expression of Bcl-2;gene amplification was correlated with primary tumor location, Ann Arbor stage, serum lactate dehydrogenase level, B symptom and International Prognostic Index (IPI) score (P<0.05), while protein expression was correlated with primary tumor location and immunophenotype (P<0.05).5-year overall survival (OS) in patients positive for Bcl-2 gene amplification and patients with non-GCB immunophenotype and positive for Bcl-2 protein expression were inferior to those negative ones (41.5%vs.71.5%, P<0.05;54.6% vs.84.6%, P<0.05).In Bcl-2 gene amplification or protein expression positive patients, 5-year OS of CHOP chemotherapy was inferior to that of rituximab combined with CHOP chemotherapy (48.6%vs.80.3%, P<0.05;66.4%vs.83.4%, P<0.05).Conclusions: Detection of Bcl-2 gene amplification is useful for prediction of prognosis in PGI-DLBCL.Both patients with Bcl-2 gene amplification and non-GCB patients with Bcl-2 protein expression have a poorer prognosis.Rituximab may improve the prognosis in patients with Bcl-2 gene amplification or protein expression.

Objective To investigate the roles of ultrasound,laboratory methods,and genetic diagnostic techniques in screening and diagnosing fetuses with an unbalanced recombination of chromosome 18[rec(18)] due to parental pericentric inversion,and the relationship between rec(18) fetal phenotypes and their recombinant chromosomes.Methods We analyzed two pedigrees with pericentric inversion of chromosome 18 (including the fetuses and their parents) which received prenatal diagnosis and genetic counseling on March 2017 and March 2018 respectively at Xiamen Maternity and Children Health Care Hospital through karyotype analysis,chromosome microarray analysis(CMA) and fluorescence in situ hybridization (FISH).Literatures were retrieved from Scientific Citation Index,PubMed,China National Knowledge Infrastructure(CNKI) and Wanfang Data from 1970 to June 2018.The genetic counseling records,ultrasound and laboratory findings,pregnancy outcomes of families with pericentric inversion of chromosome 18 in this study and the included literatures were reported and analyzed.Results Non-invasive prenatal testing (NIPT) of one case indicated high risk of fetal trisomy 18 at 22 weeks of gestation.And the imaging examination indicated that fetus had interventricular septal defect and micrognathia at 24+2 weeks.Prenatal diagnosis confirmed that the fetal karyotype was 46,XY,rec(1 8)dup(18q) inv(18)(p1 1.32q12.1) pat,which was originated from his father whose karyotype was 46,XY,inv(1 8)(p1 1.32q12.1).In the other case,serum screening testing indicated high risk of fetal trisomy 18 at 12+3 weeks.Imaging examination indicated that fetus had thickened nuchal translucency at 13+3 weeks and bilateral choroid plexus cysts at 15+6 weeks.Prenatal diagnosis confirmed that the fetal karyotype was 46,XY,rec(18)dup(18q)inv(18) (p11.32q12.1) mat,which was originated from his mother whose karyotype was 46,XX,inv(18)(p11.32q12.1).Among the nine fetuses,including seven from five pedigrees reported in the literature retrieved and two from the two pedigrees we reported,seven showed abnormal soft markers or structures in ultrasound and three of the seven pedigrees had high risk of fetal trisomy 18.Conclusions Ultrasound screening is highly sensitive in detecting rec(18) fetuses,yet the association between ultrasound features and fetal karyotypes is not clear.The combination of multiple genetic analysis methods,including karyotype analysis,CMA and FISH,may be conducive to clarifying the types and sources of complex derived chromosomes.

Safe airway management is the primary task of anesthesiologists.Anesthesiologists must have good airway management skills including dealing with all kinds of difficult airway in time and effectively to ensure the ventilation and oxygenation of patients and to avoid regurgitation and aspiration.The second World Airway Management Meeting held in Netherlands in November 2019 discussed fourteen topics related to airway management.This article will focus on six hot issues in this session, namely, 1.Human factors and safe airway management; 2.Management of patients with full stomach; 3.Difficult Airway Society (DAS) Awake Tracheal Intubation (ATI) guidelines; 4.Whether awake tracheal intubation can solve all the difficult airway, and whether succinylcholine is out of date; 5.The Universal Management of Airways Guidelines; 6.Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE). The purpose of interpreting and analyzing the above hot issues is to timely update the knowledge of airway management for anesthesiologists, and to improve the understanding and mastery of airway management, especially difficult airway management.

Objective: To explore the preliminary application effect of real-time fluorescence recombinase polymerase amplification (RPA) in the detection of Candida albicans. Methods: (1) Candida albicans standard strain and negative control bacteria of Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii, Escherichia coli, Candida glabrata standard strains of respectively 1 mL were collected and their DNA were extracted by yeast/bacterial genomic kit. The specificity of polymerase chain reaction (PCR), real-time fluorescent quantitative PCR, and real-time fluorescence RPA in detecting Candida albicans were analyzed. (2) One Candida albicans standard strain and one negative control bacteria of Candida glabrata standard strain were collected, resuscitated, and counted. Candida albicans was diluted 10 times to 1×10⁷ to 1×10¹ colony-forming unit (CFU)/mL. The DNA of the two bacteria were extracted as experiment (1). The sensitivity of PCR, real-time fluorescent quantitative PCR, and real-time fluorescence RPA in detecting Candida albicans were analyzed. The number of cycles for amplification curve to reach the threshold in real-time fluorescent quantitative PCR, and time of appearance of specific amplification curve in real-time fluorescence RPA were recorded and compared with the results in PCR. The detection limit and rate of the above-mentioned 3 methods in detecting Candida albicans were analyzed, and the correlation between concentration of Candida albicans in real-time fluorescence RPA and detection time was analyzed. (3) One standard strain of Candida albicans was collected, and the DNA was extracted as experiment (1) and detected by PCR, real-time fluorescent quantitative PCR, and real-time fluorescence RPA. The total detection time of the above-mentioned 3 methods was recorded, respectively. (4) The DNA of 31 clinical samples of suspected Candida albicans infection and 1 clinical sample of Candida albicans collected from cotton swab were extracted, PCR and real-time fluorescence RPA were carried out, and the positive detection rates of the above-mentioned methods were calculated. The DNA of the clinical samples with positive results in both PCR and real-time fluorescence RPA were extracted by yeast/bacterial genomic kit, chelex-100 boiling method, and repeatedly freeze-thawing with liquid nitrogen method, and real-time fluorescence RPA and PCR were carried out. The negative control bacteria was Candida glabrata in real-time fluorescence RPA, while negative control bacteria in PCR were the same as experiment (1). The positive results in PCR and real-time fluorescence RPA were observed and time for amplification curve to reach the fluorescence threshold in real-time fluorescence RPA was recorded, respectively. Data were processed with linear correlation analysis and t test. Results: (1) Three methods showed positive results in detecting standard strain of Candida albicans, and none of the 5 negative control bacteria showed positive results. (2) As the concentration of bacterial solution of Candida albicans decreased, the number of cycles for the amplification curve to reach the threshold increased in real-time fluorescent quantitative PCR, the time for appearance of specific amplification curve prolonged in real-time fluorescence RPA, and brightness of the gel strip weakened in PCR. None of the negative control bacteria in the above-mentioned 3 detection methods showed corresponding positive results. The detection limit of Candida albicans in real-time fluorescence RPA, PCR, and real-time fluorescent quantitative PCR was 1×10¹ CFU/mL. There was a significant negative correlation between the concentration of Candida albicans and the detection time in real-time fluorescence RPA (r=-0.95, P<0.01). The positive detection rates of PCR and real-time fluorescent quantitative PCR for Candida albicans of 1×10¹ to 1×10⁷ CFU/mL were 100%. The positive detection rate of real-time fluorescence RPA for Candida albicans of 1×10¹ CFU/mL was 78%, and the positive detection rate of real-time fluorescence RPA for Candida albicans of 1×10² to 1×10⁷ CFU/mL was 100%. (3) The total time of PCR, real-time fluorescent quantitative PCR, and real-time fluorescence RPA detection for Candida albicans was 133, 93, and 35 min, respectively. (4) The positive detection rate of real-time fluorescence RPA for 31 clinical samples of suspected Candida albicans infection was 32.26% (10/31), which was slightly lower than 35.48% (11/31) of PCR. Eleven clinical samples showed positive results both in real-time fluorescence RPA and PCR detection. No positive result was observed in the negative control bacteria detected both by real-time fluorescence RPA and PCR. The DNA was extracted by yeast/bacterial genomic extraction kit and chelex-100 boiling method for real-time fluorescence RPA detection. The time for the amplification curve to reach the threshold was (438±13) and (462±12) s, respectively, which was close (t=1.32, P>0.05). The DNA was extracted by repeatedly freeze-thawing with liquid nitrogen method for real-time fluorescence RPA, and the time for the amplification curve to reach the threshold in real-time fluorescence RPA was (584±15) s, which was significantly longer than that in the other 2 methods (t=7.55, 6.39, P<0.01). Conclusions Real-time fluorescence RPA has advantages of rapid detection, simple operation, high sensitivity, and good specificity in detecting Candida albicans, which is worthy of clinical application.