Objective To observe the clinical effect of a silicone tractor in the treatment of nipple inversion. Methods 15 patients were treated with this new type of tractor. Of all the patients, 11 were with mild to moderate nipple inversion, and 4 were serious affected patients. In the seriously affected group, the tractor was used after operation. Patients in the mild to moderate nipple inversion group was treated with the silicone tractor only. Results The result in all the patients was satisfactory after follow-ing-up for 6 to 12 months. The appearance of the nipples was well. Conclusion Continuously pulling with silicone tractor is an ideal method in nipple inversion treatment. It is simple, safe and effective.

Objective To evaluate the diagnostic value of thyroid microcarcinoma using contrastenhanced ultrasound(CEUS).Methods The CEUS characteristics of 31 lesions in patients with thyroid microcarcinoma which were confirmed by surgery and pathology were retrospectively analyzed.[Results]The enhancement features of 31 lesions were hypoenhancement,morphological irregularity,and lack of a complete envelope.The time intensity curve showed late washed in and late washed out.The start-time of the lesions was later than that of normal thyroid tissue.The enhancement intensities of the lesions were lower than that of normal thyroid tissue.Conclusions The contrast enhancement patternshypoenhancement,suggested that the CEUS might provide a useful,quantitative analysis method for the diagnosis of thyroid microcarcinoma,which can improve diagnostic confidence in thyroid microcarcinoma.

Objective To evaluate the diagnostic value of conventional ultrasound and contrastenhanced ultrasound(CEUS) in calcified thyroid nodules.Methods 122 cases of calcified thyroid nodules confirmed by pathology were underwent conventional ultrasound and CEUS.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound and CEUS were evaluated.Receiver operating characteristic (ROC) curve was constructed to assess the differential diagnosis value of conventional ultrasound and CEUS in calcified thyroid nodules.Results There were 73 benign and 49 malignant nodules among 122 calcified thyroid nodules.The sensitivity,specificity,positive predictive,negative predictive and diagnostic coincidence rate of conventional ultrasound were 49.98％,76.71％,58.54％,69.14％ and 65.57％,while for CEUS were 89.80％,91.78％,88.00％,93.06％ and 90.98％,respectively.There was statistical difference for each index between the two methods (all P ＜0.05).The area under ROC curve of CEUS was 0.908,which was bigger than conventional ultrasound.Conclusions Compared with conventional ultrasound,CEUS has higher value in differential diagnosis of benign and malignant calcified thyroid nodules.

Objective:To establish the quality standard for Shule capsules. Methods: The microscopic characteristic identifica-tion of Figwort and Radix bupleuri was performed under a microscope. The qualitative identification of fritillary, andrographispaniculata and polygonumbistorta was studied by TLC. The content of salvianolic acid B in Salvia miltiorrhiza was determined by HPLC. The chro-matographic separation was carried out by using a phenomenex synergi 4 hydro-RP 80A (250 mm × 4. 6 mm) column. The mobile phase consisted of acetonitrile-methanol-formic acid-water(10 :30 :59 :1)with gradient elution at a flow rate of 1. 0 ml·min-1, and the injection volume was 10 μl . The detection wavelength and the column temperature was 286 nm and 20 ℃, respectively. Results:The microscopic characteristics were obvious. The spots in TLC were clear without any interference. The linear range was 10. 001-100. 007 μg·ml-1(r=1. 0000). The average recovery was 99. 3% with RSD of 1. 8% (n=6). Conclusion:The method is simple with high specificity and good repeatability, which can be used as the quality control method for Shule capsules.

Objective:To investigate the changes of related indicators of right heart hypofunction in patients with primary myelofibrosis (PMF).Methods:The clinical data of 55 PMF patients in the Second People's Hospital of Lianyungang in Jiangsu Province and Jiangsu Province Hospital from January 2015 to August 2019 were retrospectively analyzed. The differences in right heart function-related echocardiographic indexes and biochemical indexes between pre-fibrosis/early stage fibrosis patients and obvious stage fibrosis patients were compared. Single factor linear regression method was used to analyze the correlations of pulmonary artery pressure with biochemical indexes.Results:The hemoglobin level [119 g/L (47-224 g/L) vs. 78 g/L (33-182 g/L)] and platelet count [233×10 12/L (5×10 12/L-984×10 12/L) vs. 117×10 12/L (7×10 12/L-731×10 12/L)] of patients in the pre-fibrosis/early stage fibrosis group were higher than those in the obvious stage fibrosis group, and the differences were statistically significant (both P<0.05). Among 22 patients with complete results of cardiac ultrasound, 90.9% (20/22) patients had increased pulmonary artery pressure, 72.7% (16/22) patients had increased left atrial diameter, and 90.9% (20/22) patients had increased right ventricular diastolic diameter. There were no patients with abnormal ejection fraction. The pulmonary artery pressure [48 mmHg (46-90 mmHg) vs. 33 mmHg (20-50 mmHg) (1 mmHg = 0.133 kPa)], left ventricular diastolic diameter [46 mm (36-50 mm) vs. 47 mm (43-53 mm)] and fractional shortening rate [38.1% (36.0%-38.9%) vs. 35.4% (32.7%-37.8%)] of patients in the pre-fibrosis/early stage fibrosis group were higher than those in the obvious stage fibrosis group, and the differences were statistically significant (all P < 0.05). The pulmonary artery pressure of patients had positive correlations with age ( r = 0.590), serum ferritin (SF) ( r = 0.608), lactate dehydrogenase (LDH) ( r = 0.711) and soluble growth-stimulating expression gene 2 (ST-2) ( r = 0.580)(all P<0.05), and had negative correlation with platelet count ( r = -0.596, P = 0.003). Conclusion:PMF patients are prone to right heart hypofunction, the pulmonary artery pressure is higher in older patients and patients with high SF, LDH and ST-2 levels and low platelet count.

Objective:To investigate the surgical management of perifolliculitis capitis abscedenset (PCAS).Methods:From June 2015 to October 2018, 8 patients with PCAS were treated, aged 13-26 years, with an average age of 23 years. Hypepigmented plaques in size were from 0.5-4.0 cm. The operative technique was based on the complete excision of the entire diseased skin and subcutaneous fatty tissue, the fistula was explored using a probe, the seton was inserted through the remaining tract in a double-strand fashion, this double-strand elastic seton was then tied over itself without excessive tension. The wound was covered with absorptive dressing.Results:All the wounds in 8 patients healed primarily. All patients were followed up for 6 months and showed no recurrence after surgery.Conclusions:Perifolliculitis capitis abscedens et suffodiens scalp is a rare chronic suppurative skin disease, its etiology and pathogenesis are unclear, but related with follicular atresia, bacterial infection, immune factors, sex hormones, smoking and obesity. The treatment is difficult, including antibiotics, vitamin A acid, biological agents, photodynamic, laser and surgery. The disease is stubborn and refractory. The technique of wide surgical excision and loose setons drainage is an effective method for PCAS.

Objectives To explore the expression, biological function, and mechanism of MKI67 in pancreatic cancer and its clinical significance. Methods The expression level, diagnosis, and prognostic value of MKI67 in pancreatic cancer were analyzed using public databases. We also investigated the association between the MKI67 with immune cell infiltration and immune checkpoint molecules. We analyzed the functional pathway enrichment to uncover the possible molecular mechanisms. qRT-PCR and Western blot assay were used to verify the expression of MKI67 mRNA and protein. Immunohistochemistry staining was used to detect the expression of MKI67 in tissue protein. Results The high expression of MKI67 was significantly associated with high histological grades and poor outcomes in pancreatic cancer. High MKI67 expression was correlated with poor prognosis of pancreatic cancer patients (P=0.009). MKI67 was an independent risk factor for the patient outcome (95%CI: 1.084-1.743, P<0.05). The MKI67 expression was positively correlated with the helper T cell 2 levels but negatively correlated with plasmacytoid DC, NK cells, mast cells, the T follicular helper, immune DC, and CD8 T cells. Conclusion MKI67 may serve as a biomarker for the diagnosis and prognosis of pancreatic cancer and the mechanism might be associated with immune escape or immunosuppression.

Objective To establish immortalized human hepatocyte lines for studies of bioartificial liver,hepatocyte transplantation,and drug metabolism in vitro.Methods Primary human hepatocytes were isolated by 4-step perfusion technique with collagenase and transfected with recombinant retrovirus containing Simian virus 40 large T antigen(SV40 LT).Subsequently,immortalized human hepatocytes were evaluated by analysis of gene expression and functional characteristics in vitro.Results Two immortalized human hepatocyte lines,HepLi2 and HepLi3,were obtained after primary human hepatocytes being infected by SV40 LT containing recombinant retrovirus for 3-4 weeks.The immortalized human hepatocytes showed classical appearance of hepatocyte observed by phase contrast microscope.The protein expression of SV40 LT in HepLi2 and HepLi3 cells were detected by Western blotting.The mRNA expressions of albumin(Alb),glutathione S-transferase(GST-p),human blood coagulation factor X(HBCF-X)and β-actin in HepLi2 and HepLi3 cells were detected by reverse transcription polymerase chain reaction(RT-PCR),and the mRNA expressions of cytochrome(CY)450 subtypes(CYP3A5,CYP2E1,CYP2C8-19 and CYP3A4)in HepLi2 and HepLi3 cells were also observed by RT-PCR.Levels of alanine transaminase (ALT),lactate dehydrogenase(LDH)and Alb were detected in the supernatant of immortalized human hepatoeyte culture.Conclusions The immortalized human hepatocyte lines have the biological characteristics of primary human hepatocytes and have the CYP450 functions of hepatocytes,which may be heIDful for the studies of bioartificial liver,heoatocvte transplantation and drug metabolism in vitro.

Objective To investigate the characteristics of gut microbiota in SD rat model of diabetes mellitus induced by streptozotocin (STZ). Methods Twenty-five male SD rats were randomly divided into control (C) (n＝10) and diabetes (M) (n＝15) groups. Rats in the group M received intravenous injection of streptozotocin (30 mg/kg) once per day for 5 consecutive days. Fecal samples were collected and examined for the V3 region of the 16S rDNA gene by Illumina Miseq high-throughput sequencing. The abundance and composition of gut microbiota were analyzed by cluster analysis. Results DNA sequence analysis was successfully performed. The Chao 1 index was lower in the group M than group C (P＜ 0. 05). The Shannon index was lower and the Simpson index was higher in the group M than group C (P＜0. 05). At phylum level, the relative abundance of Proteobacteria, Cyanobacteria, Tenericutes, TM7, and Actinobacteria was lower in the group M than group C (P＜ 0. 05). At genus level, 4 weeks after injection,the abundance of Lactobacillus was lower and that of Bacteroidetes was higher in the group M than group C ( P＜ 0. 05). 12 weeks after injection, the relative abundance of Lactobacillus,Bacteroides and Ruminococcus was higher and that of Bifidobacterium was lower in the group M than group C ( P＜ 0. 05). Conclusions This STZ-induced diabetic SD rat model has a low abundance and diversity of gut microbiota. Quantitative analysis of gut microbiota composition in this animal model provides a basic data for the study of relationship between diabetes mellitus and gut microbiota.

Objective To evaluate the effectiveness of family-centered educational intervention on fall prevention knowledge and attitude,compliance and fall incidence of elderly inpatients. Methods A total of 300 elderly inpatients were selected in a first-class grade A hospital in Beijing and divided into the experiment group and the control group equally.The intervention group was given family-centered educational intervention for 6 months,while the control group was given conventional treatment and care in ward.The knowledge and attitude,compliance and the incidence of falls of elderly inpatients were evaluated at discharge and 3 months,6 months after discharge. Results The knowledge and attitude, compliance of elderly inpatients in the intervention group were significantly better than that in the control group (P<0.05).The incidence of falls in the intervention group was significantly lower than that in the control group at discharge and 3 months,6 months after discharge (P<0.05). Conclusions The family-centered educational intervention can enhance the fall prevention knowledge, attitude and compliance of elderly inpatients effectively and reduce the incidence rate of falls.The long-term effect is relatively obvious.