BACKGROUND:An ideal scaffold material needs appropriate degradation rate and certain mechanical properties, but the traditional colagen sponge scaffold has rapid degradation velocity and low mechanical strength, which is easy to colapse and difficult to maintain its natural form. Traditional cross-linking methods also have the problems of cytotoxicity or colagen denaturation, severely limiting the application of colagen. OBJECTIVE:To design a new cross-linking method for colagen and to optimize the self-assembly process so as to develop a colagen sponge scaffold with good mechanical properties and resistance to degradation. METHODS:Colagens were modified by self-assembly technology to prepare colagen fibrils which were then freeze-dried into fibrilar colagen sponges. Meanwhile, we optimized the conditions of self-assembly by using orthogonal experiment based on univariate analysis of the effect of initial colagen mass concentration, final phosphate concentration and pH value on the conversion yield of colagen self-assembly. RESULTS AND CONCLUSION:We optimized the conditions of self-assembly revealed that the optimum conditions to prepare colagen fibrils were determined as pH=8.0, initial colagen concentration=2 mg/mL, and final concentration of phosphate=15 mmol/L. The results of scanning electron microscope showed that fibrilar colagen sponges were characterized by refined porous structure which was connected by colagen fibrils. In addition, the fibrilar colagen sponges showed better equilibrium-sweling ratio, water retaining property and mechanical strength compared with unmodified colagen spondages (P < 0.05), to solve the problems in rapid degradation.

AIM:To investigate the mechanisms by which bilirubin inhibits acute lung injury(ALI).METHODS: 30 female Wistar rats were divided into normal group,ALI group and bilirubin treatment group.ALI was induced by intravenous injection of LPS.The contents of OH-,H2O2 and O——?-2 in the lung as well as the expression of caspase-3 in the lungs were investigated.RESULTS:(1) The contents of OH-,H2O2 and O——?-2 in the lung homogenate and the expression of caspase-3 in the lungs in ALI group increased compared with those in normal group(P

Objective:To explore the related factors of postoperative adjuvant therapy for cervical cancer stagedⅠB1-ⅡA2 [according to 2018 International Federation of Gynecology and Obstetrics (FIGO) staging standard], and to establish a nomogram model to predict the risk of postoperative adjuvant therapy for locally advanced cervical cancer.Methods:A total of 714 patients with cervical squamous cell cancer staged FIGO ⅠB1-ⅡA2 treated by surgery in Anhui Provincial Hospital were selected as the research objects from January 2009 to December 2019, and their clinicopathological data were analyzed. Multiple logistic regression analysis was used to determine the influencing factors, and a nomogram model was established to predict the risk of postoperative adjuvant treatment of cervical cancer. The predictive performance of the model was evaluated with the consistency index (C-index), and the compliance of the model was evaluated with the calibration curve.Results:Univariate analysis suggested that postoperative adjuvant therapy for cervical cancer was associated with gravidity ( χ2=11.506, P=0.001), underlying disease (hypertension or diabetes) ( χ2=7.668, P=0.006), squamous cell cancer antigen (SCC-AG) level ( χ2=19.392, P<0.001), imaging risk factors ( χ2=16.392, P<0.001), FIGO stage ( χ2=25.686, P<0.001), tumor size ( χ2=9.392, P=0.025) and surgical path ( χ2=16.590, P<0.001). Multivariate logistic regression analysis suggested that the number of pregnancy >2 times ( OR=1.951, 95% CI: 1.355-2.808, P<0.001), SCC-Ag ≥1.5 μg/L ( OR=2.021, 95% CI: 1.444-2.829, P<0.001), FIGO stage ⅠB3-ⅡA2 [ⅠB3 ( OR=1.933, 95% CI: 1.139-3.282, P=0.015); ⅡA1 ( OR=2.723, 95% CI: 1.556-4.765, P<0.001); ⅡA2 ( OR=3.159, 95% CI: 1.502-6.646, P=0.002)], with underlying disease (hypertension or diabetes) ( OR=1.867, 95% CI: 1.051-3.318, P=0.033), imaging risk factors ( OR=1.997, 95% CI: 1.127-3.537, P=0.018), without neoadjuvant therapy [preoperative neoadjuvant therapy for 1 cycle ( OR=0.402, 95% CI: 0.207-0.783, P=0.007)] and laparoscopic surgery ( OR=2.177, 95% CI: 1.524-3.112, P<0.001) were independent influencing factors for postoperative adjuvant treatment of cervical cancer. Based on the screened variables, the nomogram model to predict the risk of postoperative adjuvant treatment for cervical cancer has good predictive performance (C-index was 0.702) and compliance. Conclusion:The number of pregnancy >2 times, SCC-Ag ≥1.5 μg/L, FIGO stage ⅠB3-ⅡA2, with underlying disease (hypertension or diabetes), imaging risk factors, without neoadjuvant therapy, and laparoscopic surgery are independent influencing factors for postoperative adjuvant treatment of cervical cancer. A nomogram model has been constructed to predict the risk of postoperative adjuvant therapy for locally advanced cerrical cancer, and it can provide evidence for clinical treatment selection.

Objective To compare radiation dose and image quality of prospectively ECG-triggered sequence acquisition mode and Flash(high-pitch spiral acquisition)mode in DSCT angiography of children with congenital heart disease.Methods Sixty children with clinically suspected congenital heart disease and undertook DSCT prospectively ECG-triggered scan were enrolled in the study and randomly divided into two groups.The Flash mode and prospective sequence scanning mode were applied in group A and B,respectively.The CT dose index(CTDIvol),dose length product(DLP),effective dose(E),and image quality were compared between two groups.Refered to surgery or cardiac angiography(DSA),the diagnostic coincidence rates were compared between two groups.Results The CTDIvol in group A and B was(0.32 ± 0.10)and(1.40 ± 0.43)mGy(t=13.32,P＜0.05),respectively.The DLP was(6.46 ±1.92)and(17.91 ±4.80)mGy·cm(t=7.97,P＜0.05).E was(0.19±0.05)and(0.45±0.12)mSv (t=16.64,P＜0.05).The image quality score in group A(4.03 ± 1.15)was higher than that in group B (3.13 ± 1.38)(t=3.55,P＜0.05).The total diagnostic coincidence rates were 100％(A)and 93％ (B).But the deformity diagnostic coincidence rates in group A(91％)was higher than that in group B (75％)(x2=7.72,P＜0.05).Conclusions In DSCT diagnosis of congenital heart disease in children,using flash scan mode can reveal more cardiac deformities than using prospective sequence scanning mode,and could reduce the radiation dose.

Objective To investigate the prevalence of low T3 syndrome in patients with acute myocardial infarction(AMI) and explore the effect of low T3 syndrome on outcome of AMI.MethodsThree hundred and thirty-eight patients with AMI admitted to cardiac care unit(CCU) underwent examinations of thyroid function and cardial ultrasound,and were further categorized according to thyroid hormone profile.The records of noninvasive bi-level positive airway pressure(BiPAP)ventilation utilization,length of hospital stay,mortality during hospitalization were evaluated,and the related factors were analysed.ResultsOne hundred and thirty-nine of the 338 patients(41.12%) with AMI complicated with low T3 syndrome.Free triiodothyronine(FT3) was the independent influential factor for length of hospital stay.Low FT3 was significantly correlated with noninvasive BiPAP ventilation utilization and mortality during hospitalization.The average time of follow-up was(21.4?8.1) months.It was revealed by multivariate Cox regression analysis that FT3 was the chief predictor for cumulative death(risk ratio,4.25;95% confidential interval,2.30-7.87),followed by age and left ventricular ejection fraction.ConclusionThe recognition of AMI complicated with low T3 syndrome plays an important role in predicting the disease severity and outcome.

Objective To determine the prognostic significance of non-thyroidal illness syndrome(NTIS) and FT3 on long-term all-cause and cardiovascular mortality in patients with coronary artery disease(CAD).Methods A total of 1 354 patients underwent coronary angiograhy and participated in the study.After screening,984 patients with CAD were enrolled finally and divided into NTIS group and euthyroid group.The admitted patients were also classified into Tertile 1-3 groups based on FT3 value.The relationship of long-term all-cause and cardiovascular mortality with FT3 was investigated by multivariate Cox regression analysis.Results 129 out of 984 patients had NTIS.As FT3 value decreased,both long-term all-cause mortality (Tertile 1 group 9.6％,Tertile 2 group 11.5％,Tertile 3 group 20.9％,P＜0.01) and cardiovascular mortality (Tertile 1 group 4.5 ％,Tertile 2 group 7.2％,Tertile 3 group 11.0％,P＜0.01) gradually increased.After adjusting for all factors,FT3 (HR =0.614,95％ CI 0.439-0.859)was independently associated with long-term all-cause mortality.FT3 (HR =0.605,95％ CI 0.370-0.986)was also a risk factor for cardiovascular mortality.Conclusion NTIS exists in patients with CAD without myocardial infarction.FT3 reduction is an independent risk factor for long-term all-cause and cardiovascular mortality in patients with CAD.

Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.

In order to meet the needs of national clinical medical education strategy, to train medical students’ability of analyzing and solving problems, it is imminent to carry out the reform on comprehensive experiment in basic medi-cal teaching.During the practice, the basic medical college of Hebei North University tried to integrate functional ex-periment and morphological experiment, and had some experience to share with medical education colleagues.

Objective To develop a practical testing system on internet,to offer a modern pattern of practicing testing for diagnostic imaging and to evaluate the effects.Methods Practical testing system for diagnostic imaging based on PACS was set up and its effect was evaluated by students.Results The developed practical testing system combines question bank,image reading tool and answering interface together and has functions of controlling and managing both the questions and students participating in the examination.In the satisfaction survey of students,practicing testing system of diagnostic imaging got a score of 96.75 (full mark 100) and was highly prized.Conclusions This pattern of online testing offers more imaging information and makes practicing examination of diagnostic imaging more vivid and scientific.

Objective The prognosis of patients with acute myocardial infarction (AMI) is related to age,comorbidities,and other factors,in which non-thyroid sick syndrome (NTIS) may also be an important factor.In this study,determination of blood free triiodothyronine (FT3) was used to explore the short-term and long-term mortality relationship of NTIS with acute myocardial infarction.Methods A total of 1 019 cases of newly diagnosed patients with acute myocardial infarction were enrolled.According to FT3 levels,the enlisted subjects were divided into Quartile 1-4 groups; survival group and non-survival group; normal thyroid function and NTIS group.The enrolled subjects were followed-up for 6-90 months,with the median follow-up time of 44.5 months.Using logistic regression and Cox hazards model,the relationships of short-term and long-term mortality in AMI with NTIS or FT3 were compared.Results The incidence of NTIS in patients with AMI was 27.78％.With the progressively decreasing FT3 and FT3/FT4 ratio,the mortality rates were progressively increased (Quartile 1 group 9.4％,Quartile 2 group 13.8％,Quartile 3 group 14.3％,Quartile 4 group 34.0％,P＜0.01).After being adjusted,FT3 was the strongest influencing factor of mortality within 30 days (RR =0.212,95％ CI 0.125-0.359).Multivariate Cox regression analysis showed that FT3 was independently associated with long-term mortality (RR =0.674,95％ CI 0.514-0.885).Kaplan-Meier showed significant difference in mortality between quartile 1-3 groups and the Quartile 4 group.Even FT3 level was within the low normal range,it was related with the mortality in AMI.Conclusions NTIS is common in patients with AMI.After being adjusted,FT3 was the strongest predictor of mortality within 30 days,and low FT3level in AMI patients was an independent risk factor for long-term all-cause mortality.Even FT3 level was within the normal range,it was still related with mortality in myocardial infarction.