Objective: To investigate the effects of vitamin B 1, C and orange juice on human lung cancer cell proliferation in vitro. Methods: Vitamin C degradation in culture medium was evaluated. The methods included: methy thiazolyl tetrazolium (MTT) assay, colony forming assay and 3H TdR incorporation test. The final concentrations of factors in medium were: orange juice (vitamin C 30,60,120 ?g/ml), vitamin C(30,60,120 ?g/ml), vitamin B 1 (0.01,0.1,1 ?g/ml). Results: (1) In MTT test, orange juice at each level had significant inhibitory effect on the growth of lung cancer cells (P

Aim To study the regulatory effects of PMA,a PKC activator,on Kir 2.3 channel function expressed in Xenopus oocytes and COS-7 cells,and PIP2 involvement in these regulations.Methods Kir 2.3 channel was expressed in Xenopus oocytes and COS-7 cell by RNA microinjection and DNA transfection using calcium phosphate precipitate,respectively.Two-electrode-voltage-clamp and whole-cell patch clamp were used to record the Kir 2.3 current in Xenopus oocytes and COS-7 cell.The PIP2 hydrolysis was detected by confocal microscopy.Results PMA significantly inhibited Kir 2.3 current in Xenopus oocytes.But PMA had no effect on the Kir 2.3 current expressed in COS-7 cell,in which activation of M1 receptor,however,induced a significant inhibition of Kir 2.3 current.It was reported recently that PMA could trigger the PIP2 hydrolysis in membrane of oocytes.Thus PKC inhibition of Kir 2.3 current seen in oocytes could be the result of PIP2 hydrolysis.Following the same line,the inability of PKC inhibition of Kir 2.3 current seen in COS-7 cells would suggest PKC could not induce PIP2 hydrolysis in these cells. This hypothesis was tested by monitoring the PIP2 level in COS-7 cell membrane by confocal microscopy.Dynamic changes in membrane PIP2 level were imaged using GFP fluorescence signal that had been tagged to the PLC?1PH domain known to be able to bind PIP2 specifically. There was no significant change of PIP2 level on COS-7 cell membrane after longtime treatment of PMA,whereas again,the activation of M1 receptor by ACh induced a significant change in the PIP2 level.These results were in perfect agreement with the electrophysiological results.Conclusions PMA,through activation of PKC,inhibited Kir 2.3 current expressed in Xenopus oocytes but not in COS-7 cells.Similarly PMA induced significant reduction in membrane PIP2 level in Xenopus oocytes but not in COS-7 cells. PIP2 hydrolysis plays an important role in PKC-induced inhibition of the Kir channel currents.

BACKGROUND:For pediatric patients with aplastic anemia in China, it is difficult to find human leucocyte antigen-matched sibling donors that are mostly replaced by parental donors.
OBJECTIVE:To retrospectively analyze the clinical efficacy and safety of parental haploidentical peripheral blood hematopoietic stem cel transplantation in children with relapsed and refractory severe aplastic anemia.
METHODS:Seventeen children with relapsed and refractory severe aplastic anemia who had no matched sibling or unrelated donor and failed to respond to immunosuppressive therapy were subjected to parental haploidentical peripheral blood hematopoietic stem cel transplantation. A conditioning regimen of fludarabine+cyclophosphamide+rabbit anti-human thymocyte immunoglobulin antibody and the triple therapy of methotrexate, cyclosporine A and mycophenolate mofetil were applied to prevent graft-versus-host disease.
RESULTS AND CONCLUSION: (1) Of the 17 children, 16 cases (94%) reached hematopoietic reconstitution, and the median time of neutrophils≥ 0.5×109/L and platelets≥ 20×109/L was 13 (11-15) days and 17 (12-28) days, respectively. (2) Incidence of acute graft-versus-host disease was 47% (8 of 17 cases), including 29% (5/17) of grades I-II and 18% (3/17) of grades III-IV. Incidence of chronic graft-versus-host disease was 41% (7/17). (3) With a median folow-up duration of 268 (43-753) days, the overal survival rate was 70.6% (12/17). Five dead cases (29%) belonged to transplantation-related death, including one case of fungal skin infections, one case of graft-versus-host disease, three cases of severe lung infection. No relapse case was reported. These findings indicate that if there are no matched sibling or unrelated donors and the immunosuppression effect is poor, parental haploidentical peripheral blood hematopoietic stem cel transplantation is a safe and effective salvage treatment for children with relapsed and refractory severe aplastic anemia.

Objective To observe the effects of electromyographic biofeedback electric stimulation therapy on lower extremities motordysfunction in children with spastic hemiplegic cerebral palsy (CP). Methods According to the consent of the custodians to the new therapy,60 children with spastic hemiplegic CP were divided into treatment group and control group with 30 cases in each group. All children weretreated with motor training, physical therapy and wore the ankle-foot orthosis (AFO). The treatment group was received electromyographicbiofeedback electric stimulation therapy on their lower extremity additionally. Composite Spasticity Scale (CSS) of the hemiplegic lower extremities,the ankle angle of passive dorsiflexion motion, D and E domains of Gross Motor Function Measure (GMFM-88) were performedto comparatively evaluate the effects before and 12 weeks after treatment. Results The outcomes were improved compared with the ones ofpre-treatment (P<0.05), and improved more in the treatment group (P<0.05). Conclusion The electromyographic biofeedback stimulationtherapy in combination with rehabilitation functional training in the treatment for children with spastic hemiplegic CP is more effective onspasticity of the lower extremity, increasing the range of ankle motion, improving gross motor function of lower extremities.

Objective To introduce the method of using hollow pull screw insertion for the suprapubic fracture with 3D printing navigation template and to evaluate its clinical effect.Methods From March 2016 to August 2017,eighteen cases of suprapubic ramus fractures treated with hollow lag screw fixation in the Department of Orthopedics of Yanan University Affiliated Hospital were retrospectively collected was collected.Before operation,the thin slice CT scan of pelvis was used to get raw data,and the mimics17.0 software was used to reconstruction the model,to design and make the personalized navigation template assisting the suprapubic fractures surgery.The navigation template was printed out pre-operatively,and the nail was inserted via the assisted by the template intra-operatively.After the operation,the fracture reduction was evaluated by Matta imaging scores and the pelvis function was evaluated by Majeed scores.Results All the operations were successfully completed.The Matta scores were excellent in 11 cases,good in 6 cases,and fair in 1 case.The Majeed scores were excellent in 13 cases,good in 3 cases,and fair in 2 cases.Conclusion 3D Printing navigation template assisted the placement of the hollow screw on the suprapubic fracture could provide personalized treatment,reduce the difficulty of operation and satisfy the clinical effect.

Objective:To investigate the clinicopathologic features, diagnosis and differential diagnosis of large nested variant of urothelial carcinoma (LNUC) of urinary bladder.Methods:The clinical and pathologic data of five cases of LNUC of urinary bladder diagnosed between January 2014 and December 2018 at the Department of Pathology, Zhejiang Provincial People′s Hospital were analyzed by immunohistochemistry (IHC) and Sanger sequencing. The relevant literature was reviewed.Results:All five patients were male with a mean age of 63 years (range, 48 to 81 years). The mean tumor size was 3.4 cm (range, 1.7 to 4.7 cm). Histologically, the invasive LNUC tumor cells formed medium to large sized nests of varying shapes, from regular round, bulbous, oval to irregularly fused, branched, dumbbell shaped glands, with mild stromal reaction. In all five cases, focal central necrosis and microcystic changes in the tumor nests were identified. Cytologically, the tumor cells were low grade in four cases; the remaining case was overall low grade with focal high grade areas. Mitoses were scarce. All cases possessed surface urothelial tumors, including three low-grade papillary carcinomas, one high-grade papillary carcinoma and one carcinoma in situ. Three of the LNUC were accompanied by small nested variant of urothelial carcinoma and two by conventional high grade invasive urothelial carcinoma. Perineural involvement and angiolymphatic invasion were each noted in four tumors. Radical cystectomy was performed in four cases with TNM stages as followings: pT3aN0M0 in two cases, pT4aN0M0 and pT4aN1M0 in one case each. The remaining case had transurethral bladder resection and was of pT2 stage. By IHC, all five cases were positive for CK7 and p40; four were positive for GATA3; two were positive for CK20; and the mean Ki-67 proliferation index was 18%. TERT promoter mutation status were successfully performed in three cases, with one showing mutation (C228T) and two were wild type. All patients received postoperative chemotherapy. At a follow-up of 2 to 11 months, one patient died of unrelated causes, two patients developed metastases, and two were alive with no evidence of disease.Conclusions:LNUC is a histologic subtype of urothelial carcinoma with deceptively benign features but aggressive behavior, and appreciation of its unique infiltration patterns can aid in diagnosis and differential diagnosis. LNUC tends to coexist with small nested variant of urothelial carcinoma, suggesting these may represent different manifestations of the same urothelial carcinoma subtype.

Objective To explore the feasibility and safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in patients with severe bilateral carotid stenosis.Methods From Jul 2003 to Sep 2017,unilateral CEA or CAS were performed in 1 046 patients,213 of which were with severe bilateral carotid stenosis.These 213 patients were divided into CEA group and CAS group according to procedures taken.The perioperative outcomes of 213 patients were analyzed retrospectively.Results The incidence of typical cerebral ischemia symptoms of CEA group was higher than that in CAS group (25.3％ vs.13.3％,P =0.029).The incidence of perioperative death or stroke in CEA group was 5.63％ (4/71),which had no significant difference with that in CAS group (2.82％,4/142) (P =0.524).Conclusion Based on adequate preoperative assessment and reasonable surgical selection,CEA and CAS are both safe and feasible for the unilateral lesion during one-stage operation for patients with severe bilateral carotid stenosis

Objective:To investigate the early clinical characteristics and radiographic changes in confirmed novel coronavirus pneumonia (COVID-19) and COVID-19 excluded patients.Methods:Twenty-four patients with suspected COVID-19 admitted to Shanghai Jiaotong University Affiliated Sixth People’s Hospital and Jinshan Branch Hospital between January and February, 2020 were enrolled in this research. Early clinical features and radiographic changes were analyzed in 10 confirmed COVID-19 patients and 14 COVID-19 excluded patients.Results:In the early stage, all 24 suspected patients had minor symptoms, and had normal blood gas analysis results. Of 10 confirmed COVID-19 patients, 5 patients were male. All the 10 patients had fever and fatigue, with body temperature between 37.5 and 38.5 °C. Only 1 patient had hacking cough. Two patients had no clear epidemiological exposure history, the other 8 had clear epidemiological exposure history, with a possible incubation period of 1-10 days. From CT imaging, lesions were characterized as ground glass shadow ( n=9), which could be unilateral ( n=1) or bilateral ( n=9), and were mainly close to the pleura ( n=9), with nodule shadow ( n=1) and without focal necrosis, and could combined with pleural effusion ( n=1). Among the COVID-19 excluded patients, all 14 patients had clear history of epidemic exposure, with an onset time of 1 to 13 days. Twelve patients had fever, including 4 patients with body temperature > 38.5 °C, 8 patients with body temperature bwteen 37.3-38.5 °C, and 2 patients without fever. All patients had fatigue, 7 patients had hacking cough and 2 patients had chest pain. From CT imaging, ground glass shadow appeared in 4 patients, lesions were unilateral in 10 patients and bilateral in 4 patients, and the lesions were relatively sporadic, without necrosis or pleural effusion. Conclusions:Not all patients with COVID-19 have a direct epidemiology exposure history, some patients may be infected unknowingly. According to CT imaging, COVID-19 seems to have no special manifestations being different from other viral pneumonia. COVID-19 is more common among middle-aged people.

This article analyzed the specific path of iron overload affecting EMT "blood countercurrent cell survival/adhesion/invasion/angiogenesis ectopic lesions" from the three aspects of mediating NF-κB and inflammatory reaction, stimulation of abnormal activation of macrophages, and induction of oxidative stress injury; introduced the theoretical connotation of the pathogenesis of "cold coagulation and blood stasis", and briefly described the progress of the pathogenesis of EMT from the perspective of "blood out of menstruation - injury caused by cold pathogenic factors - cold coagulation and blood stasis - long-term accumulation syndrome"; based on the mutual confirmation of "menstruation countercurrent - iron overload microenvironment - cell survival/adhesion/invasion/angiogenesis - ectopic focus" and "blood out of menstruation - cold pathogen injury - cold coagulation and blood stasis - chronic accumulation syndrome", it was believed that starting from iron overload could tap the scientific connotation and microscopic materials of the pathogenesis of "cold coagulation and blood stasis" in EMT, so as to provide new directions and theoretical references for the research of the pathogenesis of EMT and the mechanism of drugs.

To understand the current situation, progress, main contents, and the relevant assessment tools of family care in palliative for pediatric oncology patients, this paper reviewed the relevant literature on family care in palliative for pediatric oncology patients and its assessment tools at home and abroad. Taking family care in palliative care as the starting point, this paper discussed the effect of effective family care on improving the treatment outcome, quality of life, prognosis of pediatric oncology patients and the psychological problems of their families, and to provide a basis for continuing to improve the hospital-family-community care model for pediatric oncology patients, bringing into play the active role of family in palliative care, and promoting the continued development of family care for pediatric oncology patients.