BACKGROUND: Microspheric injectable scaffold has a perspective in cartilage tissue engineering; however, it is still limited by in vivo hard forming and microsphere transmigration.OBJECTIVE: To investigate the feasibility of self-assembly scaffolds by attaching negatively charged calcium alginate microspheres and positively charged chitosan microspheres by electrostatic force. METHODS: The calcium alginate and chitosan microspheres were prepared by emulsion-internal gelation and spray drying technique, respectively. The characterizations of the microspheres were determined by means of scanning electron microscopy, optical microscopy and zeta potential analysis methods. Self-assembly scaffolds were fabricated by mixing the aqueous suspensions of the microspheres with oppositely charged surfaces. The phenomenon of electrostatic attachment was characterized by optical microscopy and scanning electron microscopy, and the elastic compress modulus of the scaffolds was also investigated.RESULTS AND CONCLUSION: The average diameter of the calcium alginate microspheres was 52.5 μm, and the chitosan one was 4.1 μm, respectively. The zeta-potential of the calcium alginate microspheres was 23.5 mv, and the chitosan one was +9.8 mv, respectively. The microspheres were spherical and smooth. The small size chitosan microspheres could attach to the surface of the calcium alginate microspheres and anchor the calcium alginate microspheres together. The elastic compress modulus increased with the increase of solid content of the microspheres, but decreased with the increase of the ionic strength. The elastic compress modulus increased firstly and then decreased with the increase of the mass ratio of m (CHI):m (ALG), and it showed the highest elastic compress modulus when m (CHI):m (ALG) was 2:1. The positively charged chitosan microspheres could attach to the negatively calcium alginate microspheres to form a self-assembly scaffold.

Objective To study the expression of clock genes in Parkinson's disease(PD) and also the molecular clock machinery of PD.Methods Seventeen PD patients(nine men,eight women)and sixteen agematched controls(nine men,seven women) were investigated in this study.Bload samples were collected over a 12h span at 21:00,00:00,06:00 and 09:00.Using a real-time PCR assay,the peripheral molecular clock was examined by measuring Bmall and Bmal2 expression in total leukocytes during the dark span(from 21:00 to 09:00)in PD patients and age-matched healthy controls.Results At PD,the relative abundance of Bmall was significantly lower at 21:00,00:00 and 06:00(21:00:(22.17±4.09)vs(51.14±8.31),P=0.003,00:00:(30.30±5.45)vs(100.00±24.71),P=0.008,06:00:(19.02±3.33)vs(65.61±14.11),P=0.002).The relative Bmal2 levels in PD patients were significantly less abundant than controls at 21:00 and 00:00(21:00:(48.09±7.40)vs(84.96±9.34),P=0.005;00:00:((65.85±7.88)vs(100.00±11.78),P=0.025).Conclusion These results suggest that a peripheral molecular clock is altered in PD patients.In addition,the relative abundance of Bmall and Bmal2 was significantly lower in PD patients versus control subjects,which can provide a molecular basis to help monitor disease progression and response to investigational drugs.

β-Amyrin synthase (β-AS) genes of Glycyrrhiza uralensis from 6 different regions were analyzed by PCR-SSCP and sequenced, then the correlationship between β-AS SNP and regions of Glycyrrhiza uralensis were determined. According to the 1 coding single nucleotide polymorphism on the first exon of β-AS gene at 94 bp site, Glycyrrhiza uralensis could be divided into 3 genotypes. In these genotypes, the percentage of 94A type in genuine regions was much higher, and it had significant differences with the percentage in non-genuine regions (P < 0.001). The results of the experiment proved that different β-AS genotypes at 94 bp site from different regions may be one of the important reasons to result in the genuineness of Glycyrrhiza uralensis.

Objective To analyze epidemiological characteristics and changing trends of common respiratory infectious diseases among 6-19 year-old population in Shenzhen from 2013 to 2021, and to provide a reference for prevention and control. Methods Data of influenza, mumps and varicella reported cases among the population aged 6-19 years in Shenzhen from 2013 to 2021 were collected, and descriptive methods and Joinpoint regression model were used to analyze epidemiological characteristics and trends of incidences. Results Between 2013 and 2022 in Shenzhen, the average annual incidence rates of influenza, mumps, and varicella among the population aged 6-19 years were 961.44/100 000, 157.70/100 000, and 664.34/100 000 respectively. The incidence of influenza showed an upward trend in 10 years, with an annual percent change (APC) of 52.88% (P<0.05). The incidence of mumps and varicella both showed an 'up-down' trend, with an inflection point in 2019. The incidence APC of mumps were 11.51% and -43.49%, respectively (P>0.05), while the incidence APC of varicella were 28.88% and -50.03%, respectively (P<0.05), respectively. From the point of seasonal distribution, the incidence of three infectious diseases all showed bimodal distribution, with peaks in winter (December to January of the following year) and at the turn from spring to summer (April to June). The proportion of reported cases of three infectious diseases among people aged 6-<10 years old exceeded 60%. The proportion of varicella cases among people aged 10-<15 and 15-19 was on the rise. The incidence rate of influenza and varicella in people aged 15-19 years increased fastest, with APCs of 77.89% and 33.00%, respectively (both P<0.05). Conclusions The trend analysis based on Joinpoint regression model displayed that the reported incidence of influenza among people aged 6-19 years in Shenzhen during 2013-2022 showed an upward trend, and the incidence of varicella had an 'up-down' trend. Children aged 6-<10 years old are the main incidence group, and the prevention and control of infectious diseases in primary schools should be further promoted. Meanwhile, the rapid rise in the incidence of respiratory infectious diseases among people aged 15-19 years old and the increase in the proportion of varicella cases among people aged 10-19 years old suggest that intervention should be carried out to address the influential factors such as immunization gaps and concentrated accommodation in the older age group of minors.

Purpose To explore the application value of contrast agent in non-vascular channel. Material and Methods Totally 68 patients with drainage tube/stoma were collected in the pattern of real-time contrast enhanced ultrasound. Position, scope and moving of contrast agent in non-vascular channel were observed. Results It was accurately revealed enhanced areas in 68 cases of drainage tube and stoma, including 9 abnormal cases. CEUS implied 3 cases of failed drainage ifrstly, 5 cases of bleeding and 1 case gallbladder stone. It judged the degree and location in 25 PTBD cases and 22 PCN cases. The distance with renal hilum of one parapelvic cyst was measured accurately. Conclusion It is very important in diagnosis and treatment of interventional ultrasound to CEUS, therefore is worthy of wide application.

Objective:To observed and analyze the clinical features of patients with nonarteritic anterior ischemic optic neuropathy (NAION) causes of misdiagnosis.Methods:A retrospective case study. From November 2014 to July 2022, 49 NAION patients with 49 eyes diagnosed in Department of Ophthalmology, The First People’s Hospital of Lanzhou were included in the study. All patients were misdiagnosed with other eye diseases at first diagnosis. All eyes were examined by best corrected visual acuity (BCVA), relative afferent pupil defect (RAPD), orbital magnetic resonance imaging (MRI), visual field, optical coherence tomography (OCT), and graphic visual evoked potential (P-VEP). Fluorescein fundus angiography (FFA) was performed in 32 eyes. Clinical and MRI, visual field, P-VEP、FFA features of the patients were retrospectively analyzed.Results:There were 31 males and 18 females among the 49 patients. All cases were monocular. Age was (59.3±7.8) years. All of them complained of painless visual acuity loss or occlusion sensation in one eye. There were 12 (24.5%, 12/49) and 37 (75.6%, 37/49) cases with disease duration >2 months and ≤2 months, respectively. In 49 eyes, misdiagnosed as optic neuritis, normal tension glaucoma (NTG) or suspected glaucoma, optic disc vasculitis, cataract, diabetic retinopathy, traumatic optic neuropathy and toxic optic neuropathy were 28 (57.1%, 28/49), 11 (22.4%, 11/49), 5 (10.2%, 5/49), 2 (4.1%, 2/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49), 1 (2.0%, 1/49) eyes. 24 (49.0%, 24/49), 16 (32.7%, 16/49) and 9 (18.4%, 9/49) eyes had BCVA<0.1, 0.1-0.5 and> 0.5, respectively. RAPD was positive in 45 eyes (91.8%, 45/49). There were 37 (75.6%, 37/49) and 12 (24.5%, 12/49) eyes with and without optic disc edema, respectively. Bleeding was observed on and around the optic disc in 15 eyes (30.6%, 15/49). MRI examination showed no obvious abnormality in the optic nerve segments of all affected eyes. OCT showed an increase in retinal nerve fiber layer thickness (307.1±62.1) μm in 37 patients with optic disc edema. The visual field examination showed that 24 eyes (49.0%, 24/49) had typical lower visual field defect connected with the physiological blind spot and circumvented the central fixation point, 6 eyes (12.2%, 6/49) had limited visual field defect connected with the physiological blind spot, and 19 eyes (38.8%, 19/49) had diffuse visual field defect. By P-VEP examination, the amplitude of P100 wave decreased moderately to severely in all affected eyes. There were 24 eyes (49.0%, 24/49) with mild peak delay and 11 eyes (22.4%, 11/49) with moderate peak delay. In 32 eyes examined by FFA, the arteries had early peridisk limitation or diffuse delayed filling, and mid-course fluorescein leakage in the corresponding area.Conclusions:The main symptoms of NAION patients are painless visual acuity loss in one eye or occlusion of vision. The main clinical features of NAION patients are visual field defect, retinal nerve fiber layer thickening and visual electrophysiological abnormalities. NAION patients with acute or subacute visual loss accompanied by optic disc edema and/or bleeding are often misdiagnosed as optic neuritis, optic neurovasculitis and other types of optic neuropathy. NAION patients with a disease course of >2 months are easily misdiagnosed as NTG.

We reported a case of trisomy 18 with Abernethy malformation diagnosed by prenatal ultrasound, which was confirmed by chromosome karyotyping after cordocentesis and fetal autopsy. At 24 gestational weeks, fetal sonography revealed a fetus with multiple malformations (cleft lip/cleft palate of left side, left radial dysplasia, hooked hands, bilateral pes valgus, ventricular septal defect, and congenital extrahepatic portocaval shunt), which was diagnosed as trisomy 18 syndrome with Abernethy malformation. The fetus's karyotype was 47, XX+18.

Objective:To evaluate the curative effect of percutaneous transhepatic choledoscopy (PTCS) in the treatment of complex intrahepatic and extrahepatic bile duct stones.Methods:Clinical data of 120 patients with complex intrahepatic and extrahepatic bile duct stones admitted to Baiyin Second People's Hospital from January 2021 to December 2021 were retrospectively analyzed, including 74 males and 46 females, aged (53.3±2.4) years old. Patients were divided the control group ( n=60) who underwent routine laparotomy and the observation group ( n=60) who underwent PTCS. Perioperative outcomes, including the intraoperative blood loss, operation time, postoperative exhaust time, stress status, liver function index [serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] and postoperative complications of the two groups were compared. Results:Compared with the control group, the observation group had a shorter operation time [(1.62±0.24) h vs. (2.35±0.28) h] and postoperative exhaust time [(1.80±0.25) d vs. (2.53±0.28) d], and a decreased intraoperative blood loss [(51.21±8.23) ml vs. (119.21±8.29) ml] (all P<0.05). The serum levels of adrenaline [(119.7±12.0) ng/ml vs. (130.5±14.2) ng/ml], ALT [(70.02±2.42) U/L vs. (87.30±2.56) U/L] and AST [(188.6±24.7) U/L vs. (201.7±28.5) U/L] were lower in observation group one day after surgery (all P<0.05). The total effective rate in observation group was higher than that in control group [96.7%(58/60) vs. 83.3%(50/60), P=0.005]. The rate of complications was also lower in observation group [6.7%(4/60) vs. 36.7%(22/60), P=0.005]. Conclusion:Compared to routine laparotomy, PTCS could be more feasible for complex intra- and extrahepatic bile duct stones, considering its minimal invasiveness, less stress reaction, enhanced postoperative recovery, less disturbance of liver function, and decreased complications.

OBJECTIVEThe aim of this study is to discuss the curative effect of introperitoneal hyperthermic perfusion chemotherapy(IHPC) combined with systemic neoadjuvant chemotherapy on the gastric cancer patients with peritoneal carcinomatosis.

METHODSSixty-four patients with gastric cancer and peritoneal carcinomatosis who were hospitalized in the Department of Gastrointestinal Surgery of First Hospital of Jilin University from December 2006 to December 2013. After peritoneal carcinomatosis was confirmed during laparoscopic exploration, FOLFOX6 (oxaliplatin and calcium folinate and 5-Fu) was performed for systemic chemotherapy. One course was 14 days and a complete treatment includes four courses. At the same time, patients underwent peritoneal catheter insertion and received IHPC(5-Fu 1 500 mg/m(2) and Cisplatin 35 mg/m(2) were added into 0.9% NaCl solution 2 000 ml, the infusion velocity was 35-45 ml/min, infusion time was 45-60 minutes, the temperature was controlled to 41°C). A comprehensive evaluation was taken after the fourth course of treatment before operation. Further surgical therapy was performed according to the assessment result.

RESULTSSixty-four patients received IHPC combined with systemic chemotherapy. Thirty-two patients(50.0%) had partial response, 18(28.1%) stable disease, and 14(21.9%) progressive disease after chemotherapy. No severe complications or death occurred during the neoadjuvant chemotherapy. Thirty-two patients(50.0%) received radical resection, 10(15.6%) palliative operation, and another 22 patients(37.4%) didn't comply with inclusion criteria of operation. Patients receiving operation had a median survival time of 678 days, which was significantly longer than patients without operation, with a median survival time of 251(χ(2)=23.34, P=0.02).

CONCLUSIONSIHPC combined with systemic chemotherapy is an effective therapeutic method for gastric cancer patients with peritoneal carcinomatosis in terms of reducing preoperative tumor load and achieving radical resection.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; drug therapy ; Chemotherapy, Cancer, Regional Perfusion ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Digestive System Surgical Procedures ; Fluorouracil ; therapeutic use ; Humans ; Hyperthermia, Induced ; Laparoscopy ; Leucovorin ; therapeutic use ; Neoadjuvant Therapy ; Organoplatinum Compounds ; therapeutic use ; Peritoneal Neoplasms ; drug therapy ; Peritoneum ; Stomach Neoplasms ; drug therapy ; Treatment Outcome

Objective? To explore the application of intelligent operation arrangement software in shift scheduling in Gynecological Laparoscopic Operating Room. Methods? From January 2013 to December 2017, 13 905 patients' profiles of gynecological laparoscopic surgery in the Gynecological Laparoscopic Operating Room of Zhejiang Provincial People's Hospital were collected. The daily operation volume, specific time of single operation, preparation time of different types of gynecological laparoscopic surgery, and special instruments transmission for gynecological laparoscopic surgery and time of patients' awakening from anesthesia and transfer were analyzed and counted. A database of specialist operations was established. Weights were determined according to key information and data, and relevant calculation formulas were formulated for data calculation. Artificial intelligence scheduling was carried out on the basis of original operation arrangement by simulation and comparison. Results? The average annual, monthly, weekly and daily operation volume from 2013 to 2017 were 1 005.7, 85.6, 24.2 and 6.8, respectively. There were statistically significant differences in the average operation time of single gynecological laparoscopic surgery between different medical groups (P＜ 0.05). The data of different types of gynecological laparoscopic surgery such as interval preparation time, material flow transmission of gynecological laparoscopic surgical instruments and transfer time of anesthesia recovery were input into computer to establish and improve the database of gynecological laparoscopic surgery. The measurement model of different types of operation interval distribution was designed and completed, which improved the accuracy of time estimation and reliability of simulated intellectualized surgical planning . After adopting the intelligent simulation operation arrangement scheme to improve the efficiency of operation room and give priority to the humanization of operation team and patients, the service time for daily use of operating room was saved about 90 minutes and 45 minutes respectively compared with the traditional editor's shift scheduling. Conclusions? Intelligent operation arrangement software can improve the efficiency of operating room for gynecological laparoscopic surgeries and gradually meet the humanistic needs of both doctors and patients in the process of operation. Through the development of internal and external interfaces, the hospital's intelligent and information management can be further improved.