Background and purpose: It was reported that Sonic Hedgehog (SHH) signaling pathway was involved in carcinogenesis and progression of various tumor types. This study was designed to observe the expression of Shh and Gli2 in SHH signaling pathway in hepatocellular carcinoma (HCC) and to study the relationship between the expression of Shh and Gli2 and different clinicopathlogical characteristics, and further to explore the clinical significance. Methods: We studied 30 HCC tissues and 10 normal liver tissue slices using immunochemistry for the expression of Shh and Gli2, 10 fresh HCC tissues, adjacent-tumor tissues and 2 HCC cell lines HepG2, Huh7 by using RT-PCR for the mRNA expression of Shh and Gli2. Results: Immunochemistry showed in 30 HCC tissue slices,the positive ratios of the components of SHH signaling pathway Shh, Gli2 were 63.3% (19/30) and 66.7% (20/30), respectively. Expression of Gli2 was significantly correlated with the pathological grade and the tumor invasion in hepatic portal vein (P=0.017 and P=0.024). Shh and Gli2 did not express in normal liver tissue. RT-PCR showed Shh and Gli2 were detected as positive in both HCC tissues and lines. The expressions of Shh mRNA and Gli2 mRNA were higher in HCC than in adjacent-tumor tissues (P<0.05). The expressions of Shh mRNA and Gli2 mRNA were higher in Huh7 than in HepG2 cell lines, but no significant difference was found between them (P>0.05). Conclusion: The expressions of Shh and Gli2 were elevated in HCC, which indicated that SHH signaling pathway may be involved in human HCC carcinogenesis. The study may be useful for treatment of HCC.

Objective To evaluate the effectiveness of noninvasive positive pressure ventilation(NPPV) as a weaning strategy in patients with acute respiratory failure after failure to wean from invasive positive pressure ventilation(IPPV). Method A prospective randomized and controlled clinical trial of weaning of IPPV was carried out in patients mechanically ventilated in mode of IPPV for more than 48 hours with failure in a spontaneous breathing trial(SBT: PSV 6 cmH_2O). Patients with contraindications to NPPV were excluded. After failure the SBT, patients were randomly divided(random number) in two groups. Patients in NPPV group were extubated after being ventilated with high pressure support for 30 minutes and then placed on NPPV. Patients in IPPV group were weaned following conventional procedure. Arterial blood gases, maximal inspiratory pressure, respiratory rate,tidal volume, rapid shallow breathing index, heart rate, arterial blood pressure, and peripheral oxygen saturation were measured before and after failing the SBT. The rate of complications, including pneumonia and tracheotomy duration mechanical ventilation, days of hospital stay and outcome were observed. Findings of the two groups were vompared using the Student t test and the chi-square test. Results The percentage of complications in the NPPV group was lower(22.9% versus 72.2%, P <0.01) ,with lower incidences of pneumonia(6.1%,36.1%; P <0.01) and tracheotomy. Compared between the two groups, days of ICU stay( 14.16(3.45) d vs. 22.57( 7.71 ) d; P <0.01) and total days of mechanical ventilation(14.88±3.76 days vs. 20.68± 2.79 days, P <0.01) of NPPV group are shorter than IPPV group. Conclusions NPPV is a good alternative to the mechanically venti-lated patients who fail in initial weaning attempts. The key to successful NPPV weaning is the proper selection of weaning candidates and using NPPV as soon as possible after extubation.

OBJECTIVE: To investigate the audiologic characteristics of the children with cleft lip and/or palate. METHOD: Sixty-two children with cleft lip/palate were enrolled in the study. Tympanometry, DPOAE, ABR were tested in all the chidren. RESULT: Regarding the ABR threshold as the diagnostic criteria, 51 (41.13%) ears had hearing loss, mainly moderate. Sixty-three (59.43%) ears had abnormal tympanometry, which meant the disorder function of the middle ear. Twenty-six (56.52%) ears didn't pass the DPOAE. CONCLUSION The proportion of the hearingloss in the children with cleft lip/palate was large. There was a good coherence among the three objective examinations when assess the children with cleft lip/palate.
Audiometry ; Child ; Child, Preschool ; Cleft Lip ; physiopathology ; surgery ; Cleft Palate ; physiopathology ; surgery ; Female ; Humans ; Infant ; Male ; Postoperative Period

Objective:To investigate the quality of Herba Leonuri Preparations sold in market. Methods: The alkaloid content in preparations was determined according to the determination method in China Pharmacopoeia (1995). Results: There were significant differences among Herba Leonuri Preparations from different pharmaceutical factories, place of origin and batches. Conclusions: It is suggested that the determination item of stachydrine hydrochloride be added.

Objective To study the application of modified two-hole laparoscopic cholecystectomy ( LC) for exploring new minimal invasive LC approach. Methods 176 patients with calculous cholecystitis and polypus of cholecyst underwent LC through two abdominal holes. Results 174 gallbladders were removed successfully by modified two-hole LC. The average time of operation was 27.8±7.1minute. The average hospitalized stays of post operation were 2.7±0.8 day. There were two patients whose operation had to be converted to tradition three-hole LC. There were no complication and conversion of open cholecystectomy in all patients. During an average follow-up time of 6 monthw, ranged from 3 to 10month, there were no abdominal pain and jaundice happened to patients. Conclusions The application of modified two-hole LC is a safe and effective LC approach on the basis of skillful perform of traditional three-hole LC. It can reduce the injury to patients and advance the technique of ninimal invasive surgery further.

ObjectiveTo investigate the prevalence and distribution characteristics of dental fluorosis of children aged 8 - 12 in Wushan and Fengjie counties of Chongqing and to provide a scientific basis for prevention and control of the disease.MethodsTwenty townships(towns) in Fengjie county and 18 in Wushan county were selected as survey points by random cluster sampling in 2010.Dental fluorosis of all the children aged 8 - 12 was examined with Dean index.The detection rate of children's dental fluorosis,defect rate and dental fluorosis index were compared between the two counties.Results Totally 38 209 children aged 8 - 12 were investigated.The total detection rate of dental fluorosis was 43.09％( 16 466/38 209) in the two counties.The detection rates of dental fluorosis in Wushan and Fengjie were 48.98％ (9397/19 186)and 37.16％(7069/19 023),respectively,and the difference was statistically significant(x2 =544.03,P ＜ 0.01 ).Total detection rates of dental fluorosis of the five age groups(8,9,10,11,and 12-year-old age groups) were 32.52％(2157/6632),40.07％(2672/6668),43.67％(3420/7831 ),46.01％ (3861/8391) and 50.14％ (4356/8687),respectively,and the difference was statistically significant (x2 =510.50,P ＜ 0.01),Dental fluorosis indexes in Wushan and Fengjie were 0.713 and 0.485,respectively.Defect rates of dental fluorosis in Wushan and Fengjie were 4.05％ (777/19 186) and 1.57％(298/19 023),respectively.Conclusions The total detection rate of dental fluorosis of the two counties is still high,which gradually increases with age.Wushan is still an endemic area of dental fluorosis,and Fengjie is at the edge of the

Objective To compare the effect of anesthesia management between enhanced recovery after surgery (ERAS) protocol and traditional protocol on stress level of thyroid surgery.Methods Sixty-two patients receiving thyroid surgery from May 2016 to August 2016, 13 males and 49 females, aged 18-65 years, of ASA physical status Ⅰ or Ⅱ, were randomly divided into group ERAS (n=29) and traditional group (group C, n=33).Each group had its own anesthesia management protocol.Operation method, operation duration, the level of pain during emergence and on the first postoperative day, the occurrence rate of complications and the satisfaction evaluation of pain and nausea and vomiting after the operation day were recorded.C-reactive protein (CRP), serum cortisol, interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor (TNF-α) before and after the operation day were evaluated.Results The visual analogue scale (VAS) pain score in group ERAS was lower than that in group C during emergence [(0.42±0.83) points vs (0.95±1.16) points]and on the first postoperative day [(1.90±1.21) points vs (2.73±1.40) points] (P<0.05).Group ERAS was more satisfied with pain relief at first day after the surgery than that of group C (P<0.05).The level of CRP in group ERAS was lower than that in group C on the operative day and the first postoperative day (P<0.05).In group C, the level of CRP on the operative day and the first postoperative day were much higher than those before the surgery (P<0.05).The occurrence rate of complications between the two groups had no statistical difference.Conclusion The perioperative ERAS anesthesia management of thyroid surgery is safe and effective in pain management, patient satisfaction and accelerated recovery.

Objective To analyze the research status and hotspot of occupational methanol poisoning at home and abroad. Methods ， The China National Knowledge Resource Database Wanfang Data Knowledge Service Platform and Web of Science were used as the data sources. The relevant literatures on occupational methanol poisoning published in domestic and foreign ， Results journals up to June 30 2021 were searched. The bibliometrics was used to analyzed the literatures. A total of 255 literatures were included in analysis. There were 187 Chinese articles and 68 English articles. Most of Chinese articles were ， ， published from 2001 to 2005 with an average of 26.7 literatures per five years until June 2021. Among them 72 literatures （ ）， ， were published in core journals 38.5% and 176 authors from 27 provinces autonomous regions and municipality directly ， under the central government published relevant literatures. The research contents mainly focused on the classification ， ， poisoning mode clinical manifestations visual impairment and poisoning prevention and treatment of occupational methanol - ， poisoning. Most of the English literatures were published in 2016 2020 with an average of 4.9 articles per five years until June ， （ ）， 2021. Among them 36 were published in SCI journals 52.9% and 57 authors from 11 countries published relevant ， ， ， literatures. The research contents mainly focused on the clinical diagnosis drug treatment intoxication mechanism visual Conclusion sequelae and brain injury of occupational methanol poisoning. The research on occupational methanol poisoning ， ， ， mainly focuses on clinical diagnosis clinical manifestations treatment and prognosis and pathogenesis. The focus of relevant research at home and abroad is different.

Objective To analyze the clinical characteristics of macrophage activation syndrome (MAS). Methods Clinical data was analyzed in 9 children who had been diagnosed as MAS in our hospital from Jan, 2003 to Aug, 2006. Results Seven children were boys, 2 children were girls, aged 5 months to 12 years. Clinical manifestations included long-term fever, hemophagocytic cell in bone marrow, anemia, arthritis, enlargement of lymph nodes, enlargement of liver and spleen, liver dysfunction, abnormal fat metabolism. Two cases had acute respiratory, distress syndrome(ARDS), 2 cases were complicated with multi- pie organ failure(MOF), two patients died. Glucocorticoid combined with immunosuppressive therapy were effective, HP(Plasma Exchange)was applied in one severe case and was shown to he effective. Conclusion MAS is a serious complication of JIA, especially in systemic-onset juvenile idiopathic arthritis. It is very im- portant to recognize and treat MAS earlier.

Objective To investigate the female human papillomavirus(HPV)infection situation in Baoan district,the HPV pos-itive rates in different age groups and the subtypes distribution.Methods PCR followed with reverse dot blot was performed to ex-amine 23 kinds of HPV genotypes in 2 627 female patients in our hospital from the January 2011 to December 2012.Results In 2 627 samples,the positive rate of HPV was 23.94% (629 cases),in which the infection rate of single low-risk type was 15.1%(95 cases),the main HPV genotype was HPV43 (7.79%);the infection rate of high-risk type was 55.17% (347 cases),the 3 most prevalent HPV genotypes were HPV52 (12.56%),HPV16 (9.86%)and HPV58 (7.79%).The multiple HPV infection ac-counted for 29.73% (187 cases).The HPV infection rates in different age groups were 50.0% in age 15-20 years,24.7% in age 21-30 years,20.8% in age 31-40 years,25.8% in age 41 -50 years,42.1% in age >50 years respectively,the differences had statistical significance.Conclusion The HPV infection rate is 23.94% in Bao′an district.The most prevalent HPV genotypes are HPV 52,16,58,43.Women in age 15-20 years old have a higher infection rate.