Objective To systematically analyze the effectiveness and security of Chinese medicinal ointment treating eczema for the purpose of making an objective and creditable evaluation and guiding clinical usage. Methods Data in the VIP database (1989-2008) and CHKD (1994-2008) were researched and literatures on the treatment of eczema were included. Randomized control trails (RCTs) of therapeutic effects were compared between Chinese medicinal ointment and western medical treatment. Jadad Scale was adopted and RevMan4.2.7 was used to conduct Мeta analysis. Results 11 RCTs were adopted, including 1415 cases.① Heterogeneity Test: It was found through analysis with fixed effect model that Q= 16.57, and P=0.08>0.05,which indicated that the effective between studies are homogenous. ② Total effect size' ORunited was 0.17,with the 95% confidence interval [0.29,0.58]. ③ x2=5.04 (P<0.01), P<0.05, the total ORunited had statistic significance, which indicated that the treatment of eczema with the Chinese Medicinal Ointment was obviously better than that of western medicinal Ointment. Conclusion It is a effective method to treat eczema with Chinese Medicinal Ointment, and there is no serious ADR. However, because of publication bias and RCTs of universal lower quality, the credibility of the conclusion was reduced.

AIM:To study the effect of bcr - abl gene antisense phosphorothioate oligonucleotides(Aspo) on K562 cell line and explore its significance in chronic myelogencous leukemia (CML) gene therapy. METHODS: Cells were exposed to oligomers, observed by inverted microscope. Cells inhibitory rate were determined by 0.4% trypan blue exclusion. CFU - K562 were cultured in 0.8% methylcellulose. P210 was measured by flow cytometry. RESULTS:K562 cells were treated with Aspo, they still grew in clone state and show antisense sequence specific and dose dependent. When the concentration of Aspo was more than 5?mol/L, the growth of cells was inhibited and P210 was down regulated or completely suppressed, and the greatest growth inhibition was at 120h. There was significant inhibition of cell proliferation in a rang of cells number from 1 ? 10-4/mL to 5 ? 10-4/mL after treatment with 10?mol/L Aspo. b2a2 Aspo was also effect on K562 cells which expressing b3a2 mRNA. CONCLUSION: bcr - abl Aspo has a specific growth inhibition effect on K562 cells, and worths further study in CML gene therapy.

Objective To explore the value of the apparent diffusion coefficient (ADC)of MRI diffusion-weighted (DW)in diag-nosing pathologic stage and histologic grade of bladder cancer.Methods 42 patients with confirmed bladder cancer underwent pelvic MRI examination including T2 WI and diffusion-weighted imaging (b values of 0 and 1 000 s/mm2 )Based on pathologic results,42 cases of bladder cancer were divided into three groups of Ta-T1 stage (non-muscle invasive),T2 stage (muscle invasive)and T3-T4 stage (around the bladder and other organizations invasive).Of 42 bladder cancers,36 urothelial carcinomas were divided into papillary urothelial neoplasm with low malignant potential (PUNLMP),low grade urothelial carcinoma and high grade urothelial carcinoma group.Tumor diameter and ADC were measured on DW imaging,and compared among different groups.Results The mean size of high grade tumors (4.52 ± 1.61)cm was significantly larger than that of PUNLMP (2.28 ± 0.51)cm and low grade tumors (1.69 ± 0.53)cm.The mean ADC of high grade tumors (0.83 ± 0.27)×10-3 mm2/s was significantly lower than that of PUNLMP (1.46 ± 0.30)×10-3 mm2/s and low grade tumors (1.17±0.11)×10-3 mm2/s (P<0.01).T3-T4 stage tumors showed significantly lower ADC (0.82±0.21)×10-3 mm2/s than T2 (1.01 ± 0.09)×10 -3 mm2/s and Ta-T1 stage tumors (1.24 ± 0.13)×10 -3 mm2/s (P <0.01).Conclusion DW ima-ging combined with conventional MR sequences is useful for displaying morphology of bladder cancer.DW imaging and ADC are use-ful in evaluation of pathologic stage and histologic grade of bladder cancer.

Objective：Our aim was to investigate the proportion of autosomal recessive (AR) inheritance among families with patients with Duchenne muscular dystrophy (DMD) and clinical feature in patients with AR form of DMD. Methods:A total of 193 families was studied， 8 of them with at least one girl with “DMD - like” phenotype and 185 with only boys with this kind of phenotype. Based on the number of families with at least one affected girl and the number of patients per sibship among these pedigrees, the proportion of families with DMD inherited as an AR trait was estimated. The clinical examination, family history and serum creatine-kinase were studied in 11 patients diagnosed as AR form of DMD. Results: The proportion of families with AR form of DMD was estimated as 9.4%. The average age of being able to walk is (1.47±1.00) year, serum creatine-kinase levels were (2785.10±1500.29) U/L. The clinical symptom occurred at the average age of (8.11±4.32) year in patients with AR form of DMD. Conclusion： The AR form of muscular dystrophy and DMD not be distingushed clinically. Some families with only affected boys diagnosed as typical DMD, in fact, have the AR form of the disease. This study is very useful for genetic consulting.

AIM:To investigate the expression of C/EBP homologous protein (CHOP) and its correlation with proliferative/apoptotic ratio (PAR) in colorectal adenoma-carcinoma sequence under the same genetic background .ME-THODS:Four kinds of tissue samples under the same genetic background from 23 patients, including normal colorectal tissue, adenoma with low-grade intraepithelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma samples , were collected .TUNEL method and Ki-67 immunohistochemistry were applied to determine the PAR.The expression of CHOP was detected by immunohistochemistry SABC method .RESULTS: ( 1 ) Under the same genetic background , the level of CHOP expression is significantly higher in colorectal adenocarcinoma than that in the ade -noma with high-grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal muco-sa.The level of CHOP expression was significantly higher in the adenoma with high -grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .The level of CHOP expression was signifi-cantly higher in the adenoma with low-grade intraepithelial neoplasia than that in normal mucosa .(2) Under the same ge-netic background , PAR was significantly higher in the colorectal adenocarcinoma than that in the adenoma with high -grade intraepithelial neoplasia , the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significant-ly higher in the adenoma with high-grade intraepithelial neoplasia than that in the adenoma with low-grade intraepithelial neoplasia and the normal mucosa .PAR was significantly higher in the adenoma with low-grade intraepithelial neoplasia than that in the normal mucosa.(3) CHOP levels were positively correlated with PAR in the adenoma with low-grade intraepi-thelial neoplasia , adenoma with high-grade intraepithelial neoplasia and colorectal adenocarcinoma .CONCLUSION:CHOP expression and PAR continuously increased and positively correlated along the adenoma -carcinoma sequence , indica-ting that endoplasmic reticulum stress mediates the carcinogenesis of colorectal adenomas .

Exosome, a major component of extracellular vesicles, is an important media for intercellular communications under physiological conditions. In a variety of hematological malignancies researches, it has been demonstrated that exosome acts as the key carrier for interactions among the components of the bone marrow microenvironment. Due to its widespread existence and containing specific nucleic acid and protein molecules, the importance of exosome as a potential biomarker and therapeutic target/carrier in the diagnosis and treatment of hematological malignancies has been attracting more attention in the past few years.

Objective To explore the pathway of continuous rehabilitation intervention in community stroke patients and to evaluate its effect. Methods Stroke patients (64 cases) were selected from Yuetan community as the rehabilitation group by objective sampling based on inclusive and exclusive standard and 64 stroke patients wre selected from other community in Xicheng district as the control group. At the same time, 16 doctors and nurses from 10 clinics of Yuetan community health service center were trained and they gave reha-bilitative intervention to the rehabilitation group. After intervention for 6 months, the effect of rehabilitative in-tervention was evaluated compared with the control group who did not receive rehabilitative intervention. Re-suits The Fugl-Meyer score of the rehabilitation group was (76.14±12.48), the score of the control group was (19.36±14.32),which had significant difference compared with the rehabilitation group, P < 0.05. The Batthel index of the rehabilitation group was (72.25±10.22), the index of the control group was (22.62±9.71),which was significantly different from that of the rehabilitation group, P < 0.05.Besidcs, the rate of knowing health knowledge and healthy exercise in the rehabilitation group was higher than that of the control group, P < 0.05. Condusions The rehabilitation information net and systemic community rehabilitation intervention can im-prove the motor ability and the ability of daily activity for patients with stroke.

Objective To compare and analyze the surgical efficacy of different ways of left and right transthoracic ap-proaches on patients with middle thoracic esophageal cancer. Methods The 120 patients with middle esophageal carci-noma were divided into observation group (60 cases) and the control group (60 cases) randomly. The patients in obser-vation group were treated with right chest-belly-neck three-incision. The control group accepted left breast single in-cision. The operation duration, postoperative hospitalization time and indwelling chest tube time, the number of lymph node dissection, the rate of proximal spread of tumor, incidence of postoperative complications and 2-year survival rate were recorded and analyzed. Results Compared with control group, the operation duration, postoperative hospitalization time, the number of lymph node dissection and 2-year survival rate in observation group were higher. The rate of proximal spread of tumor in observation group were lower than in control group (P<0.05). The incidence of pulmonary infection and anastomotic leak were higher (P<0.05). Conclusion Compared with left breast single incision, right chest-belly-neck three-incision can provide a wider extent of lymphadenectomy, especially for mediastinal and abdominal, which may improve the survival in two years of patients with middle esophageal carcinoma. But the operation time may be longer and the incidence of pulmonary infection and anastomotic leak may be higher. Surgery should be selected according to the specific circumstances of patients.

Objective:To evaluate the efficacy and safety of endoscopic papillectomy (EP) combined with endobiliary radio frequency ablation (RFA) for duodenal papilla tumor with intraductal biliary infiltration.Methods:Data of 12 patients with histologically confirmed duodenal papilla tumor combined with intraductal biliary infiltration treated by EP with RFA from February 2013 to February 2019 were retrospectively analyzed. Clinical characteristics,endoscopic features, treatment efficacy and postoperative complications of patients were reviewed and recurrence was followed up.Results:The median diameter of lesions measured by endoscopic ultrasound was 18.5 mm×15.5 mm, and the length of intrabiliary invasion was 14.1±5.8 mm. EP combined with RFA was successfully performed in all patients with a technical success rate of 100%. Postoperative pathology showed adenocarcinoma in 5 patients, adenoma with high-grade intraepithelial neoplasia in 6 patients, and adenoma with low-grade intraepithelial neoplasia in 1 patient. Patients received mean 4.1±1.6 times of ERCP with intraductal biopsy during a mean follow-up period of 28.5±10.4 months. Recurrence occurred in 2 patients at 14 and 20 months respectively, both were adenocarcinoma.Conclusion:EP combined with RFA is effective and safe for duodenal papilla tumor with intraductal biliary infiltration. However, given the risk of recurrence, close surveillance is recommended.

Objective To investigate whether prolonged the interval of tumor necrosis factor (TNF)-α inhibitors (TNF-i) injection could continuously improve inflammatory biomarkers and imaging changes of sacroiliac joint and spine in spondyloarthritis (SpA).Methods A total of 154 SpA patients were included and 95 of them received TNF-α inhibitor therapy.TNF-i used in this study included etanercept,infliximab and adalimumab.The dose of etanercept was gradually reduced from 50 mg per week to every two weeks,every three weeks and then per month.The infusion of Infliximab was reduced from 4 mg/kg at 0,2,6 week to every 8 weeks,every 12 weeks and then every 16 weeks.The interval of Adalimumub injection was changed from 40 mg every two weeks to 3 weeks to 4 weeks and then to two months.The levels of inflammatory parameters,bath ankylosing spondylitis disease activity index (BASDAI),bath ankylosing spondylitis functional index (BASFI),ankylosing spondylitis disease activity score (ASDAS),spondyloarthritis research consortium of canada (SPARCC) scores of sacroiliac joint and fat metaplasia,bone erosion,sclerosis and ankylosis changes on magnetic resonance imaging (MRI) were investigated every 3 to 6 months.Radiograhs of spine were assessed by modified stoke ankylosing spondylitis spinal score (mSASSS) scores at baseline and 2 years.Analyses were performed by Paired t-test,Wilcoxon test,Mann-Whitney U test,Kruskal-Wallis and Chi-square test.Results After 3 months of treatment,erythrocyte sedimentation rate (ESR),c reactive protein (CRP),immunoglobulin A (IgA),BASDAI,BASFI,ASDAS and SPARCC scores were significantly lower than those of the baseline [13.00(6.00,31.00) mm/1 h vs 3.00 (2.00,6.00) mm/1 h,Z=-5.61;7.39(2.52,17.90) mg/L vs 1.88(1.21,3.75) mg/L,Z=-5.57;2.89(2.52,17.90) g/L vs 2.27(1.60,2.85) g/L,Z=-4.69;(2.57±1.43) vs (1.17±0.92),t=9.81;17.50(5.00,27.00) vs 4.00(0,11.00),Z=-6.69;2.62(2.02,3.52) vs 1.22(0.92,1.59),Z=-6.96;25.00(10.00,37.00) vs 12.00 (6.00,20.25),Z=-6.68;all P＜0.05].Compared to 3-6 months,SPARCC scores were significantly reduced during 2-3 years in the TNF-i group [12.00 (6.00,20.25) vs 7.00 (3.25,14.75),P=0.02].There were no significant progresses in fat metaplaisa,bone erosions,sclerosis or ankylosis during the follow-up period (61％,57％,x2=0.07,P=1.00;53％,43％,x2=0.40,P=0.75;31％,57％,x2=3.02,P=0.11;14％,7％,x2=0.43,P=0.66).The mSASSS scores were not different between TNF-i group and TNF-i group after 2 years of treatment [2.50 (0,8.00) vs 3.00 (0,8.00),Z=-0.30,P=0.76].Conclusion Prolonged the interval of TNF-i treatment could continuously improve bone marrow edema in SPA,whereas structural damages of sacroiliac joints and spine are not deteriorated.