Objective To explore whether the polymorphisms within the tumor necrosis factor alpha (TNF-?) and TNF-? gene are associated with the clinical types of patients with chronic hepatitis B virus (HBV) infection. Methods By using a restriction fragment length polymorphism (RFLP) assay of polymerase chain reaction (PCR) products, the single nucleotide polymorphisms (SNPs) within TNF-? and TNF-? gene among 56 patients with chronic severe hepatitis B and 71 patients with chronic mild hepatitis B or asymptomatic carriers as well as 90 healthy controls were analyzed. The TNF-? concentration of serum in 56 patients with chronic severe hepatitis B and 30 healthy controls were determined by radio immunity assay (RIA). Results The frequencies of the TNF1/2 genotype and the TNF2 allele were significantly increased in patients with chronic severe hepatitis compared with healthy controls (25% vs 11.1%,P=0.028;12.5% vs 5.6%,P=0.036) and patients with chronic mild hepatitis B and asymptomatic carriers (25% vs 8.5%,P=0.011;12.5% vs 4.2%,P=0.015). Furthermore, heterozygotes carrying TNF2 allele had significantly higher levels of serum TNF-? than homozygotes for the wild type allele among all patients with chronic severe hepatitis B (P

Objective To study MRI features of fibroma of tendon sheath(FTS)and giant cell tumor of tendon sheath(GCTTS), so as to improve the diagnosis and differential diagnosis of two lesions. Methods Seventeen patients with FTS and 27 patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. All patients were examined with MRI. The location, size, shape and the relationship with the surrounding tissue, the signal feature and enhancing pattern of the two groups were compared. Imaging features in the two groups were assessed and analyzed by using independent samples t test and Chi-square test. Results FTS were nodular or mass-like lesions(n=11). Few lesions appeared adjacent bone absorption(n=2). On T2WI, the lesions showed peripheral low signal ring(n=6)or internal mixed low-signal intensity of was striped or filamentous configurations(n=10). The volume of low-signal intensity accounted for more than 2/3 of the total lesion's volume(n=6). Enhanced T1WI, tumors revealed ring enhancement(n=6). GCTTS appeared mostly lobulated(n=16), common with adjacent bone compressive absorption(n=9). On T2WI, most of lesion had a peripheral low signal ring(n=22). Tumors revealed mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass(n=17), the area of low signal accounts for less than 1/3 of total neoplastic volume(n=18). On contrast T1WI, GCTTS appeared heterogenous enhancement. Statistical analysis showed that the shape of the lesion, the presence or absence of compressive bone absorption, the presence of a low signal ring around the lesion, the shape of the Low-signal in T2WI and the proportion, and the presence of circumferential enhancement(P<0.01), there were statistically significant differences between the two. And there was no statistically significant difference in the age, gender and location of disease(P>0.05). Conclusion FTS and GCTTS has a different characteristic of MRI features. FTS were nodular or mass-like, T2WI signal was mixed low, the shape of the low-signal was striped or filamentous, accounting for more than 1/3 of total lesion's volume, enhanced T1WI, tumor shows ring enhancement;GCTTS appears mostly lobulated.Most of lesion has low signal ring, common with adjacent bone compress compressive absorption. T2WI, tumor reveals mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass. The area of low signal accounts for less than 1/3 of total neoplastic volume.

Objective To explore the design of forehead flap pedicled with supratrochlear artery and shift way for aesthetic reconstruction of the nose without secondary operations for debulking.Methods Origin of blood supplies and the distributed situation of the vessel in the frontal region were studied through the internal carotid artery and the external carotid artery X-ray angiography.The frontal region existed polyphyletic blood supplies,the supratrochlear artery and the supraorbital artery set out many branches,respectively,in the level of frontal bone eyebrow plane.One constant,thicker horizontal branch from the superficial temporal artery obviously extended to the forehead median.The branches from three blood vessels mentioned above constituted the network of artery adequate in the muscle and the subcutaneous tissue level,assumed the three-dimensional distribution in the forchead region.The nasal reconstruction had been done for 9 patients with the oblique orientation designed forehead flap by using one side of supratrochlear artery as the pedicle and cutting skin paddle with the same or the opposite side of forehead flap.Results All flap survived completely with the restoration of nasal shape and functional satisfaction.Conclusion The forehead oblique orientation flap pedicled with one side supratrochlear artery is nourished by the rich blood supply.The flap can be split into two flaps:a myofascial flap and a skin flap in far part.Myofascial flap may be the good package of cartilage framework,and simultaneously split skin flap is favorable of the shape models.The flap may satisfy the demand of the nasal restoration.

Objective To investigate the efficiency of rapid prototyping technology in repair of complex orbital injury.Methods The study involved 16 cases of complex orbital injury.Based on three-dimensional orbital reconstruction,the rapid prototyping technology was used to produce a l∶ 1 scale three-dimensional physical model.Treatment plans were developed with the aid of surgical simulation on the model and were practiced clinically.Results The model was created successfully in the study.Surgical incisions were all healed initially.Satisfactory facial shape,symmetrical orbit,normal ocular motility,and disappeared diplopia were achieved over 3 months to 3 years of follow-up.Conclusion A rapid prototyping model gives solid and accurate display of orbital three-dimensional anatomical structures and their interrelation and hence offers a vital basis for accurate understanding of malformation condition and rational design of surgical plans.

Background: Long non-coding RNAs (lncRNAs) have been illustrated to contribute to the development of gestational diabetes mellitus (GDM). In the present study, we aimed to elucidate how lncRNA taurine upregulated gene 1 (TUG1) influences insulin resistance (IR) in a high-fat diet (HFD)-induced mouse model of GDM. Methods: We initially developed a mouse model of HFD-induced GDM, from which islet tissues were collected for RNA and protein extraction. Interactions among lncRNA TUG1/microRNA (miR)-328-3p/sterol regulatory element binding protein 2 (SREBP-2) were assessed by dual-luciferase reporter assay. Fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), HOMA pancreatic β-cell function (HOMA-β), insulin sensitivity index for oral glucose tolerance tests (ISOGTT) and insulinogenic index (IGI) levels in mouse serum were measured through conducting gain- and loss-of-function experiments. Results: Abundant expression of miR-328 and deficient expression of lncRNA TUG1 and SREBP-2 were characterized in the islet tissues of mice with HFD-induced GDM. LncRNA TUG1 competitively bound to miR-328-3p, which specifically targeted SREBP-2. Either depletion of miR-328-3p or restoration of lncRNA TUG1 and SREBP-2 reduced the FBG, FINS, HOMA-β, and HOMA-IR levels while increasing ISOGTT and IGI levels, promoting the expression of the extracellular signal-regulated kinase (ERK) signaling pathway-related genes, and inhibiting apoptosis of islet cells in GDM mice. Upregulation miR-328-3p reversed the alleviative effects of SREBP-2 and lncRNA TUG1 on IR. Conclusion Our study provides evidence that the lncRNA TUG1 may prevent IR following GDM through competitively binding to miR-328-3p and promoting the SREBP-2-mediated ERK signaling pathway inactivation.

Objective:To determine the predictive value of high-frequency ultrasonography for necrotizing enterocolitis (NEC) requiring surgical treatment in neonates.Methods:From January 2018 to December 2021, neonates diagnosed with NEC (Bell stage Ⅱ and above) in our hospital were retrospectively analyzed. The neonates were assigned into surgical group and non-surgical group according to the treatment. The following ultrasonography results were compared between the two groups: intestinal motility, gastrointestinal (GI) wall perfusion, pneumatosis intestinalis (PI), portal vein gas, peritoneal effusion translucency, depth of ascites fluid and GI wall thickness. Logistic regression was used to determine risk factors of surgical treatment for NEC. ROC curve was drawn to calculate the predictive value of combined and individual factors for NEC requiring surgical treatment.Results:A total of 40 neonates were enrolled, including 18 in the surgical group and 22 in the non-surgical group. No significant differences existed between the two groups in PI and depth of ascites fluid ( P>0.05). The surgical group had higher incidences of decreased intestinal motility, portal vein gas, reduced GI wall perfusion, poor peritoneal effusion translucency and thinner GI wall than the non-surgical group (all P<0.05). Logistic regression analysis showed that poor translucency of peritoneal effusion, thinning of GI wall, reduced GI wall perfusion and decreased intestinal motility were risk factors for surgical treatment of NEC. ROC curve showed that the cut-off value predicting surgical treatment based on GI wall thickness was 1.2 mm, with an area under the curve (AUC) of 0.746, sensitivity of 87.5% and specificity of 65.6%. The AUC of the combined factors predicting surgical treatment was 0.867, with sensitivity of 96.9% and specificity of 75.8%. Conclusions:Decreased intestinal motility and GI wall perfusion, thinning of GI wall and poor peritoneal effusion translucency on high-frequency ultrasonography have high predictive efficacy for the need of surgical treatment in the acute phase of NEC.

ObjectiveTo assess the implementation of insurance-based compensation for adverse reactions following immunization in Wuxi City，Jiangsu Province. MethodsData on basic insurance and supplementary insurance for adverse reactions following immunization from 2020 to 2022 in Wuxi City was collected， and a descriptive epidemiological method was used to analyze the data. ResultsA total of 2 272 cases were compensated for adverse reactions following immunization，with a total compensation amount of 5.255 9 million yuan， and an average of 2.3 thousand yuan per case. Basic insurance accounted for 0.62% of the total cases and 10.72% of the total compensation amount， while supplementary insurance accounted for 99.43% of the total cases and 89.28% of the total compensation amount. Compensation amounts for disability and third-degree damage in basic insurance accounted for 63.18% and 88.71%， respectively， while fourth-degree and lower damage in supplementary insurance accounted for 96.52%. The compensation rate for supplementary insurance was higher than that for basic insurance. The highest number of compensated cases was in the 0‒ year age group， and vaccines included in the Expanded Program on Immunization （EPI） accounted for the majority of the cases and compensation amounts， with a percentage of 70.11% and 73.84%， respectively. For basic insurance， the largest number of compensated cases involved the Bacillus Calmette-Guérin （BCG） vaccine. For supplementary insurance， the top three compensated cases for EPI vaccines were the measles-mumps-rubella （MMR） vaccine， the hepatitis B （HepB） vaccine， and the acellular diphtheria-tetanus-pertussis （DTaP） vaccine. For non-EPI vaccines， the top three compensated cases were the 13 valent pneumococcal polysaccharide conjugate （PPCV13） vaccine， the acellular DPT-inactivated poliovirus-haemophilus influenzae type b combined vaccine （DPT-IPV/Hib）， and enterovirus 71 （EV71） inactivated vaccine. In basic insurance， thrombocytopenic purpura and BCG local abscess both accounted for 21.43% of the cases， while in supplementary insurance， respiratory system diseases accounted for 77.47% of the cases. The time intervals from reporting to submission of compensation materials （<31 d） and from submission to payment of compensation （≤14 d） were 71.43% and 57.14% for basic insurance， and 90.22% and 86.23% for supplementary insurance， respectively. ConclusionThe commercial supplementary insurance for adverse reactions following immunization in Wuxi City has largely compensated for the limitations of basic insurance in terms of coverage and efficiency. It is recommended to further promote commercial compensation insurance for young children and strengthen the monitoring and regulation of commercial supplementary insurance compensation.