This paper introduces the platform and mode of military medical equipment E-procurement. Composed of the service system in the procurement center, the network system and the client-side, the platform can be applied to on-line bidding, tendering, evaluating, opening bid and so on. The organizational configuration, technical measures and supporting mechanism of the platform are studied. The platform is characterized by low expense, high efficiency, high security, and easy to monitor and expand.

Objective Previous studies regarding the effects of tamoxifen ( TAM) on the thin endometrium are rare .The aim of this study was to explore the effects of TAM on patients with thin endometrium undergoing frozen thawed embryo transfer ( FET ) . Methods One hundred and thirty three patients with thin endometri-um undergoing FET treatment were recruited from January 2014 to June 2016, who canceled embryo transfer ( ET) or after FET due to thin endometrium in natural cycle or hormone replacement therapy cycle .Patients were randomly divided into letrozole ( LE,n=72) group or tamoxifen (TAM,n=61) group.All of the patients started to have oral pills of Estradiol Valerate 4 mg/d on the third day of menstruating cycles , then 6mg/d on the eighth day ,after 10~12 days then having ultrasonic monitoring of endometrial thickness and blood estradiol (E2), progesterone levels, It′s called endometrial preparation for hormone replacement cycle .To letrozole, tamoxifen group,the way of endometrial preparation were as follows:patients started to have oral pills of LE 2.5mg/d,TAM 40 mg/d on the third day of menstruating cycles for 5 days, then having ultrasonic monitoring and used drug of human chorionic gonadotropic hormone ,It′s called HCG day .After the dominant follicle ovulation then took progesterone intramuscular injection 40 mg/d, oral progesterone 20 mg/d to change endometrium ,then to transplant cleavage embryos or blastocysts after taking 3 or 5 days of progesterone , It′s called embryo transplanting day .The way of TAM endometrium preparation was called TAM cycle .The general data , hormone levels and clinical out-come between two groups were analyzed . Results The serum estradiol level of LE group both on HCG and transfer day [(1193.80± 629.64)ng/L vs (2776.30±157.34)ng/L;(1195.90±820.30)ng/L vs (2129.40±1208.71) ng/L,P=0.000] were statistically lower, serum luteinizing hormone level were statistically higher than TAM group [(20.48±15.50)IU/L vs (10.59±8.34)IU/L,P<0.05];im-plantation rate of LE group were statistically lower than TAM (39.32%vs 45.83%,P=0.001).The endometrial thickness and serum E 2 and P levels in TAM cycles were significantly higher compared with those in hormone replacement therapy cycle [(8.49±1.36)mm vs (6.43±0.96)mm,P=0.018]. Conclusion Tam compared LE with patients of thin endometrium undergoing FET can increased en -dometrial thickness and improve implantation rate ,thus Providing a new solution to thin endometrium .

Objective: To study the changes of inflammatory response and apoptosis in parotid gland tissues of rats after X-ray irradiation, and to explore the protective effect and possible mechanism of Sarcandra glabra on radiation-induced parotid injury in rats. Methods: A total of 120 male rats were randomly divided into 5 groups(24 for each): control group, single irradiation group, radiation combined with a high(26.8 g·kg^-1·d^-1), moderate(13.4 g·kg^-1·d^-1) and low(6.7 g·kg^-1·d^-1) dosage of Sarcandra glabra group. The parotid gland of rats in the irradiation group received 15 Gy X-ray. Rats in each group were anesthetized with 2% pentobarbital sodium (0.16 ml/100 g) at 10, 40 and 70 d after irradiation and blood was collected from abdominal aorta. ROS levels in blood serum of each group were detected on the 10th, 40th and 70th days after irradiation. After parotid gland tissue was taken, the pathological changes and ultrastructural changes were observed by hematoxylin-eosin (HE) staining and transmission electron microscopy, respectively. The expression level of TNF-α in parotid gland tissue was detected by immunohistochemistry, and apoptosis of parotid cells was detected by TUNEL assay. Results: The content of ROS and the expression of TNF-α protein in the single irradiation group were simultaneously increased compared with the control group (t=-24.723, -35.013, -19.515, P<0.05; t=-13.563, 43.519, -15.249, P<0.05), while they were reduced by Sarcandra glabra in a dosage dependent manner, especially in the high dosage group of Sarcandra glabra (t=5.295, 8.138, 6.545, P<0.05; t=10.093, -7.868, 10.539, P<0.05). In the control group, the parotid gland tissue structure was intact, without congestion, exudation, edema, etc. For the single irradiation group, the parotid gland tissue became hyperemia, edema and inflammatory cell infiltration at 10 d after irradiation followed by fibrosis at 40 d after irradiation. These pathological alterations in the parotid gland tissue were significantly recovered when the rats were treated with Sarcandra glabra before irradiation, and the tissue damage was negatively correlated with drug dosage. TUNEL assay showed that the apoptosis rate of parotid gland cells in the single irradiation groups was higher than that in the control group (t=-4.639, -3.979, P<0.05). Conclusions Sarcandra glabra protects parotid gland from radiation damage by scavenging radiation-induced ROS and declining inflammatory response, and thus it may be applied as a potential protective agent for radiation injury.

Tissue engineering achieves tissue repair and regeneration through the utilization of three essential components: stem cells, scaffold materials, and growth factors. Inducing the adipogenic differentiation of mesenchymal stem cells (MSCs) and constructing engineered adipose tissue represent innovative strategies for addressing soft tissue defects within the field of plastic surgery. Natural biomaterials exhibit physicochemical properties resembling those of the extracellular matrix, thereby fostering the proliferation and differentiation of stem cells. These natural biomaterials serve as suitable scaffold materials for tissue engineering applications. This review provided a comprehensive summary of the characteristics of various natural biomaterials, including decellularized matrix, extracellular matrix derivatives, filamentous proteins, alginate, chitosan, and bacterial cellulose. It further offered a review of research studies pertaining to their capacity to induce adipogenic differentiation in MSCs, thereby offering insights for the selection of materials in subsequent investigations.

Tissue engineering achieves tissue repair and regeneration through the utilization of three essential components: stem cells, scaffold materials, and growth factors. Inducing the adipogenic differentiation of mesenchymal stem cells (MSCs) and constructing engineered adipose tissue represent innovative strategies for addressing soft tissue defects within the field of plastic surgery. Natural biomaterials exhibit physicochemical properties resembling those of the extracellular matrix, thereby fostering the proliferation and differentiation of stem cells. These natural biomaterials serve as suitable scaffold materials for tissue engineering applications. This review provided a comprehensive summary of the characteristics of various natural biomaterials, including decellularized matrix, extracellular matrix derivatives, filamentous proteins, alginate, chitosan, and bacterial cellulose. It further offered a review of research studies pertaining to their capacity to induce adipogenic differentiation in MSCs, thereby offering insights for the selection of materials in subsequent investigations.

Background::A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI.Methods::In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints.Results::From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a –15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: –3.4%; 95% confidence interval [CI]: –11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: –0.5%; 95% CI: –5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. Conclusion::rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI.Trial registration::www.ClinicalTrials.gov (No. NCT02835534).

The incidence of rib fracture in patients with chest trauma is about 70%. Simple rib fractures do not need special treatment. Multiple rib fractures and flail chest are critical cases of blunt trauma, which often cause serious clinical consequences and need to be treated cautiously. Nowadays, there is a controversy about the diagnosis and treatment of multiple rib fractures and flail chest. In the past, most of the patients were treated by non-operative treatment, and only less than 1% of the patients with flail chest underwent surgery. In recent years, studies have confirmed that surgical reduction and internal fixation can shorten the hospital stay, and reduce pain and cost for patients with flail chest, but there is still a lack of relevant clinical consensus and guidelines for diagnosis and treatment, which leads to great differences in clinical diagnosis and treatment plans. This article reviewed the treatment, surgical indications and surgical timing of multiple rib fractures and flail chest.

Paridis Rhizoma possesses the functions of clearing heat and detoxifying， alleviating swelling and relieving pain， cooling the liver and calming the convulsion. Saponins are the main active components of Paridis Rhizoma. Studies have shown that total saponins in Paridis Rhizoma have obvious inhibitory effect on solid tumors such as breast cancer， lung cancer， gastric cancer， and liver cancer and non-solid tumors such as leukemia. The saponins may exert the anti-tumor effects by inhibiting the proliferation， migration， and invasion of tumor cells， regulating cell cycle， inducing apoptotic and non-apoptotic death pathways， and regulating metabolism and tumor microenvironment. Furthermore， total saponins in Paridis Rhizoma showed anti-inflammatory， antioxidant， antimicrobial， hemostatic， and uterus-contracting activities. At the same time， they may induce apoptosis of normal cells， inflammation and oxidative stress， and metabolic disorders. In recent years， the reports of liver injury， reproductive injury， gastrointestinal injury， hemolysis， and other adverse reactions caused by total saponins in Paridis Rhizoma have been increasing. Pharmacokinetic studies have shown that there are significant differences in the metabolism of total saponins in Paridis Rhizoma administrated in different ways. Injection has a fast clearance rate， while oral administration may have hepatoenteric circulation. Meanwhile， due to the low solubility and activation of P-glycoprotein （P-gp） molecular pump， the prototype absorption， intestinal permeability， and recovery rate of total saponins in Paridis Rhizoma are poor， which affects the bioavailability. The bioavailability can be improved to some extent by preparing new dosage forms or new drug delivery systems with advanced technology. This paper reviews the pharmacological effect， pharmacokinetics， and adverse reactions of Rhizoma Paridis total saponins by searching the China National Knowledge Infrastructure （CNKI）， VIP， and Web of Science with ''Rhizoma Paridis total saponins'' as the keywords， hoping to provide references for the research， development， and clinical application of such components.

OBJECTIVEThe aim of this study was to assess the feasibility and safety of laparoscopic nerve plane-sparing radical hysterectomy (NPSRH) and compare with that of open NPSRH.

METHODSOne hundred and thirty-four patients with FIGO stage Ib1-IIa2 cervical cancer were enrolled in the study. Thirty-three patients underwent laparoscopic NPSRH. During the operation, the pelvic autonomic nerve plane which is directly underneath the ureter was integrally preserved by dissecting the pelvic spaces laparoscopically. The vessels around the nerve plane were controlled by Hem-o-lok polymer clips. One hundred and one patients underwent open NPSRH without special instruments. The clinical, pathological and surgery-related parameters were compared between the two groups. Moreover, postoperative short-term bladder function of these patients was also analyzed.

RESULTSThere was no significant difference between the laparoscopic group and open group in terms of age, body mass index, previous surgery, FIGO stage, pathologic type, etc. (P > 0.05). The mean duration of surgery in the laparoscopic group was significantly longer [(303.8 ± 67.5) min vs. (272.4 ± 57.5) min] (P < 0.01). But, the laparoscopic group had less blood loss [177.0 ml vs. 474.5 ml, P < 0.01] and blood transfusion rate [ 6.1% (2/33 cases) vs. 49.5% (50/101 cases), P < 0.001]. There was no significant difference regarding the proportion of patients who firstly passed the post-void residual urine volume (PVR) test (P > 0.05). The median time of catheterization between the two groups were also comparable (P > 0.05). However, the postoperative hospital stay was significantly shorter in the laparoscopic group [median postoperative hospital stay 9.2 days vs. 11.0 days, P < 0.001].

CONCLUSIONSLaparoscopic NPSRH is feasible. It seems to be comparable with open NPSRH in terms of preserving pelvic nerve function, but is more favorable in terms of blood loss and postoperative recovery.

Female ; Humans ; Hysterectomy ; methods ; Laparoscopy ; methods ; Length of Stay ; Postoperative Complications ; Uterine Cervical Neoplasms ; surgery

ObjectiveTo investigate the induction of ferroptosis by polyphyllin Ⅱ （PPⅡ） in hepatocellular carcinoma HepG2 cells and its underlying mechanism. MethodThe effect of PPⅡ （0， 1.5， 3.0， 4.5， 6.0， 9.0， 18.0 mg·L^-1） on the in vitro proliferation of HepG2 cells was assessed using the methyl thiazolyl tetrazolium （MTT） assay. Colony formation ability of HepG2 cells was evaluated through a colony formation assay. Cell migration ability was assessed via a scratch assay. Lactate dehydrogenase （LDH） content in HepG2 cells was measured using a kit. Reactive oxygen species （ROS） levels in HepG2 cells were observed using a fluorescence inverted microscope. Malondialdehyde （MDA）， glutathione （GSH）， and free Fe²⁺ content in HepG2 cells were detected using respective kits. The mitochondrial ultrastructure in HepG2 cells was observed by transmission electron microscopy. The expression of ferroptosis-related proteins p53， solute carrier family 7 member 11 （SLC7A11）， glutathione peroxidase 4 （GPX4）， long-chain acyl-CoA synthetase 4 （ACSL4）， and transferrin receptor 1 （TFR1） in HepG2 cells was detected using Western blot. ResultCompared with the control group， the PPⅡ treatment groups showed significantly decreased survival rate of HepG2 cells in a dose-dependent manner （P<0.01）， significantly reduced number of cell colonies （P<0.01）， significantly shortened scratch healing distance， inverse correlation of the migration distance with drug concentration （P<0.01）， significantly increased LDH leakage in cells （P<0.01）， significantly enhanced relative fluorescence intensity of intracellular ROS， and significantly increased accumulation of lipid peroxide MDA （P<0.01）， decreased intracellular GSH content with increasing drug concentration （P<0.01）， and significantly enhanced fluorescence intensity of FeRhoNox-1 in cells （P<0.01）. Moreover， cells exhibited vacuolation， and mitochondria showed significant shrinkage with reduced or even disappeared cristae. Compared with the results in the control group， the expression of p53， ACSL4， and TFR1 proteins significantly increased， while the expression of SLC7A11 and GPX4 proteins significantly decreased in the PPⅡ treatment groups （P<0.05）. ConclusionIn summary， PPⅡ induces ferroptosis in HepG2 cells by regulating the p53/SLC7A11/GPX4 signaling axis， promoting ACSL4 expression and Fe³⁺ uptake， leading to an imbalance in the antioxidant system.