Objective To evaluate the chnical value of intervention therapy combined with the foot plastic surgery in the treatment of diabetic foot.Methods 67 patients who accepted the intervention therapy combined with the plastic surgery for occlusive lesion of lower limbs arteries were selected.The clinical symptom,ankle brachial pressure index and hemodynamics were observed before and after treatment.All clinical indicators were compared between the therapeutic group and the control group.Results Among 67 patients,63 cases were successful in clinical treatment (the success rate:94.0％).One month,three months,six months after operation,the skin temperature,anklebrachial index,limp distance,clinical symptom,ankle brachial pressure index and hemodynamics were increased.Compared with preoperation,all above-mentioned indicators were improved obviously (P ＜ 0.05,P ＜ 0.01).Conclusion Intervention therapy for diabetic foot has the merits of less trauma,higher effectiveness of treating diabetic foot ulcers,defect repair,maximally reserved limbs and better shapes of limbs,which made both doctors and patients satisfied.It is a new direction for minimally invasive therapy.

Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P<0.05).The daily oral administration amount of morphine at stable pain in the two groups respectively was (226.67±69.74) mg and (258.67±101.34) mg;the morphine related adverse reactions were mainly constipation, and there was no significant difference in the incidence (P>0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.

Objective To compare the botanical characters, yield, and active components in flowers of seven various cultivars from Chrysanthemum morifolium in planting base in Sheyang County, Northern Jiangsu Province and provide the theoretical and practical basis for plangting and expanding reproduction of improved cultivars of C. morifolium. Methods Based on the field experiment, comparison, and analysis of the botanical characters, yield, and active components (total flavonoid and chlorogenic acid) in flowers of the seven cultivars from C. morifolium, such as “Hongxinbaiju”, “Changbanbaiju”, and “Hubaiju” etc. Results The botanical characters of flowers are vary different among the seven cultivars from medicinal C. morifolium in the planting base; the amount of single capitulum is the main factor influencing on the yield of C. morifolium, the yield of “Hongxinbaiju” is the highest; the contents of total flavonoid and chlorogenic acid of “Changbanbaiju” are the highest in the seven cultivars. Conclusion From all the aspects, in the planting base of Northern Jiangsu Province, “Hongxinbaiju” and “Changbanbaiju” can be extended as major cultivars with good characters of superior quality and high yield, “Hubaiju” and “Huangjuhua” also can be cultivated at present.

OBJECTIVETo detect the expression of cell cycle positive regulators cyclin D(1), cyclin E, CDK(2), CDK(4) and negative regulators p21(cip1), p27(kip1), p16(ink4a) and p15(ink4b) during wound healing in rats.

METHODSOpen wounds of full-thickness skin, diameter 1.8 cm, on rat backs were used as the wound model. Wound tissues were harvested on postwounding days 3, 5, 7, 9, 11, 14, 21 and 30. Ki67 expression in granulation tissue was detected by immunohistochemical assay. The patterns of the expression of cyclin D(1), cyclin E, CDK(2), CDK(4) and p21(cip1), p27(kip1), p16(ink4a), p15(ink4b) were detected by Western blot.

RESULTSCell proliferation in granulation tissue took place predominantly within the first week after injury, with the proliferation peak occurring at postwounding day 5. There were no dramatic variations in the expression of cyclin D(1), CDK(2) and CDK(4) during wound healing. Up-regulated cyclin E was maintained from day 3 to 11 after injury, and then was down-regulated. No expression of p16(ink4a) and p15(ink4b) was found. p21(cip1) was expressed only from day 7 to 14, with peak expression observed on day 9. Constitutive p27(kip1) was expressed throughout wound healing with low levels in the proliferating period of day 3 to 5 and with increased levels in the post-mitotic and remodeling stage. The expression of p21(cip1) and p27(kip1) showed an inverse gradient to that of Ki67.

CONCLUSIONp21(cip1) and p27(kip1) play a supervising role in preventing the hyperproliferative tendency in tissue repair.

Animals ; Cell Cycle ; physiology ; Cell Cycle Proteins ; biosynthesis ; physiology ; Cell Division ; physiology ; Cyclin-Dependent Kinase Inhibitor p16 ; biosynthesis ; Cyclin-Dependent Kinase Inhibitor p27 ; Cyclin-Dependent Kinases ; antagonists & inhibitors ; biosynthesis ; Cyclins ; biosynthesis ; Male ; Rats ; Rats, Wistar ; Skin ; cytology ; metabolism ; Tumor Suppressor Proteins ; biosynthesis ; physiology ; Wound Healing

Objective:To compare the efficacy of morphine with intravenous injection and subcutaneous injection in the treatment of advanced cancer,and explore the indications of different drug delivery methods for high-dose morphine. Methods: A prospective study was performed,and 46 cases of patients with advanced cancer pain were collected and divided into intravenous group and subcutaneous group according to the administration route. Pain was assessed during the administration,and the analgesic efficiency and the incidence of adverse reactions were observed to compare the efficacy and safety of two different ways to give high-dose morphine. Results:No statisti-cally significant differences were found in the number of outbreaks needed to be rescued,the frequency of morphine-induced drug deliver-y,the efficiency of analgesia after opioid transfer,and the incidence of opioid-related side effects between the groups (P>0.05). The dose of morphine in the subcutaneous group was higher than that of the intravenous group(P<0.05). Conclusion:The continuous ad-ministration of morphine with intravenous injection and subcutaneous injection can quickly,safely and effectively relieve pain. With the same analgesic efficacy,patients can choose appropriate administration route according to the dose of morphine, the influence degree of primary diseases and the individual will.

Objective To study the effect of autologous bone marrow mesenchymal stem cells in the treatment of osteonecrosis .Methods 56 cases of osteonecrosis of femeral head ( ONFH) were treated with autologous bone marrow mesenchymal stem cells .DSA observed neovascularization after transplantation ,morphological changes of femoral head were observed by imaging method .Results Of the 30 patients who underwent autologous bone marrow stem cell transplantation,86.6％had resuscitation of hip pain,23.3％ had improved hip function,and 85.7％ had walking distance .Examination showed that the arterial artery was significantly increased before transplantation , thickening,faster blood flow.The femoral head area of the bone was significantly improved (100.0％) after 12 -24 months.Conclusion The method of transplantation of bone marrow mesenchymal stem cells is simple ,safe and effective.It is effective for stage I and II of the avascular necrosis of the femoral head .

Objective To explore the curative effect and complication of transcutaneous transcatheter uterine arterial embolization in the treatment of postpartum hemorrhage .Methods 76 cases with postpartum hemorrhage of conservative treatment invalid in the General Hospital of Huainan Oriental Hospital Group from January 2011 to January 2017 , received digital subtraction angiography ( DSA ) to make clear the site of hemorrhage , then bilateral uterine artery embolization was given .Results Seventy -six patients have stopped bleeding immediately after embolization,3 cases were significantly reduced .Bleeding stopped completely after nearly one week of treatment .Mild fever after embolization appearred unable to pain in the lower abdomen ,1 case had hip pain .Conclusion Transcuta-neous transcatheter uterine artery embolization in the treatment of postpartum hemorrhage has advantages of quick hemostasis,less trauma,less complications and preserving the uterus fertility ,which has high clinical value .

Objective To investigate the effect of bilateral internal iliac artery balloon occlusion in cesarean section for dangerous placenta previa and placenta implantation.Methods From January 2011 to December 2016,The clinical data of 15 cases of dangerous placenta previa and placenta implantation were retrospectively analyzed in the General Hospital of Huainan Oriental Hospital Group.All patients underwent internal iliac arterial intubation prior to cesarean section and into the balloon,placed the balloon in the bilateral internal iliac artery,and filled the balloon to temporarily block internal iliac arterial blood flow.The number of hysterectomy cases of cesarean sections were recorded.Results The amount of intraoperative hemorrhage was about 200-4 000mL,average 1 500mL.Intraoperative,postoperative red blood cell was 0-3 000mL,average 1 000mL,there were no maternal and fetal death and serious complications,2 cases in hysterectomy,the resection rate was 10.8％.Conclusion Bilateral internal iliac arterial balloon occlusion can effectively control the bleeding of the dangerous placenta previa during cesarean section and reduce the hysterectomy.The radiation dose is safe for the fetus.

Previously, we found that high doses of genistein show an inhibitory effect on uterine leiomyoma (UtLM) cell proliferation. In this study, using microarray analysis and Ingenuity Pathways Analysis(TM), we identified genes (up- or down-regulated, > or = 1.5 fold, P < or = 0.001), functions and signaling pathways that were altered following treatment with an inhibitory concentration of genistein (50 microg/ml) in UtLM cells. Downregulation of TGF-beta signaling pathway genes, activin A, activin B, Smad3, TGF-beta2 and genes related to cell cycle regulation, with the exception of the upregulation of the CDK inhibitor P15, were identified and validated by real-time RT-PCR studies. Western blot analysis further demonstrated decreased protein expression of activin A and Smad3 in genistein-treated UtLM cells. Moreover, we found that activin A stimulated the growth of UtLM cells, and the inhibitory effect of genistein was partially abrogated in the presence of activin A. Overexpression of activin A and Smad3 were found in tissue samples of leiomyoma compared to matched myometrium, supporting the contribution of activin A and Smad3 in promoting the growth of UtLM cells. Taken together, these results suggest that down-regulation of activin A and Smad3, both members of the TGF-beta pathway, may offer a mechanistic explanation for the inhibitory effect of a high-dose of genistein on UtLM cells, and might be potential therapeutic targets for treatment of clinical cases of uterine leiomyomas.
Activins/*genetics/metabolism/pharmacology ; Anticarcinogenic Agents/*pharmacology ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Cyclin-Dependent Kinase Inhibitor p15/genetics/metabolism ; Down-Regulation ; Female ; Genistein/*pharmacology ; Humans ; Leiomyoma/*metabolism ; Oligonucleotide Array Sequence Analysis ; Signal Transduction/drug effects ; Smad3 Protein/*genetics/metabolism ; Transforming Growth Factor beta/*genetics/metabolism ; Up-Regulation ; Uterine Neoplasms/*metabolism

ObjectiveTo investigate the immunological characteristics of the patients with aplastic anemia （AA） and elevated hemogram parameters treated with Yiqi Yangxue prescription combined with Western medicine and the predictive effects of immunological indexes on elevated hemogram parameters， thus providing a reference for the prediction of the treatment efficacy and the adjustment of the treatment regimen. MethodA retrospective study was conducted， involving 77 AA patients treated with Yiqi Yangxue prescription combined with Western medicine for 6 months in 19 medical institutions including Xiyuan Hospital， China Academy of Chinese Medical Sciences from September 2018 to March 2021. The patients were assigned into two groups according to the elevations in hemogram parameters ［including hemoglobin （HGB）， white blood cell count （WBC）， platelet （PLT）， and absolute neutrophil count （ANC）］ after 6 months of treatment. One group had the elevation <50%， and the other group had the elevation ≥50% compared with the baseline. The clinical and immunological characteristics were compared between the two groups. Result① Compared with the group with HGB elevation<50%， the group with HGB elevation≥50% showed elevated level of CD3⁺ human leukocyte antigen-DR （HLA-DR）⁺ and increased proportion of patients with T-helper cell type 2 （Th2）<5%， CD8⁺≥50%， and CD3⁺HLA-DR⁺≥9% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD8⁺≥50% before treatment was the independent influencing factor for HGB elevation ≥50% ［odds ratio （OR）=12.000， 95% confidence interval （CI） 2.218， 64.928， P<0.01］. ② Compared with the group with WBC elevation<50%， the group with WBC elevation≥50% showed increased proportion of patients with CD3⁺HLA-DR⁺<6% and T-box transcription factor （T-bet）≥200% before treatment （P<0.05）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<6% （OR=2.998， 95%CI 1.036， 8.680， P<0.05） and T-bet≥200% （OR=3.634， 95%CI 1.076， 12.273， P<0.05） before treatment were independent influencing factors for WBC elevation≥50%. ③ Compared with the group with PLT elevation<50%， the group with PLT elevation≥50% presented lowered Th1 and CD3⁺HLA-DR⁺ levels and increased proportion of patients with Th1<12%， CD4⁺≥6%， and CD3⁺HLA-DR⁺<5% before treatment （P<0.05， P<0.01）. The multivariate Logistic regression analysis showed that CD3⁺HLA-DR⁺<5% before treatment was the independent influencing factor for PLT elevation≥50% （OR=16.190， 95%CI of 3.430 to 76.434， P<0.01）. ④ Compared with the group with ANC elevation<50%， the group with ANC elevation≥50% showed no significant changes in the hemogram parameters before treatment. ConclusionAs for the AA patients with rapid elevation in HGB， Yiqi Yangxue prescription combined with Western medicine demonstrate significant effects in the patients with Th2<5% and CD3⁺HLA-DR⁺≥9%， especially those with CD8⁺≥50%. As for the AA patients with rapid elevation in WBC， the therapy was particularly effective in the patients with CD3⁺HLA-DR⁺<6% and T-bet≥200%. As for the AA patients with rapid growth in PLT， the therapy was particularly effective in the patients with Th1<12% and CD4⁺≥6%， especially those with CD3⁺HLA-DR⁺<5%.