Objective To investigate and analyze the reference ranges of the common parameters of venous blood cell analysis a ‐mong healthy adults in Kunshan City .Methods The analytical results of venous blood cells from 2 456 healthy adults were selected and the ten indicators of red blood cell ,hemoglobin ,mean corpuscular volume ,mean corpuscular hemoglobin concentration ,mean corpuscular hemoglobin ,hematocrit ,white blood cell ,lymphocytes percentage ,neatrophilic granulocyte percentage ,blood platelet were statistically analyzed by adopting the SPSS 19 .0 software .Results The commonly used 10 parameters of blood cells showed a skewed distribution ,the Mann‐Whitney U tests showed that the gender difference in 10 parameters was statistically significant (P<0 .05) ;the WBC count was slightly higher than that reported by other literature ,the other 9 parameters were close to those reported by the majority of related literature .Conclusion The commonly used parameters of blood cell analysis are influenced by the region , gender ,environment ,living condition and detection instrument ,and it is necessary to establish the reference ranges for each labora‐tory .

Objective To analyze long-term efficacy after surgical treatment of primary liver cancer with fluorouracil plus oxaliplatin plus gemcitabine joint implementation to prevent the overall intervention effect of hepatic arterial infusion chemotherapy and radical resection of hepatocellular carcinoma following ascension.Methods60 cases of primary hepatocellular carcinoma were randomly divided into study group and control group according to the random number method in our hospital from February 2011 to November2013, 30 cases in each group.All patients underwent radical resection of liver cancer and liver (partial) resection.In the control group, the patients were treated with anti viral or immune enhancement after surgery, and the follow-up treatment was not carried out.In study group were given anti-virus or immune intensive treatment and at the end of surgery 3 and 7 weeks after the implementation of a prophylactic transcatheter arterial infusion chemotherapy and selecting drug 5-FU, oxaliplatin and gemcitabine.During 3 years of follow-up, the incidence of adverse reactions in the 3 groups was statistically analyzed, and the recurrence free survival rate, disease-free survival rate and overall survival rate of the two groups were statistically analyzed.ResultsAll patients completed the follow-up, there was no loss of follow-up cases.In adverse reactions, the study group patients were successfully tolerated hepatic artery infusion chemotherapy, no obvious adverse reactions or drug toxicity, more no interruption of chemotherapy cases.The recurrence free survival rate, disease-free survival rate and overall survival rate of the study group were 83.33%, 70.00%, 86.67%, respectively, which were significantly higher than those in the control group (60.00%, 43.33%, 63.33%) (P<0.05).ConclusionPrimary hepatocellular carcinoma should be treated with prophylactic hepatic arterial infusion chemotherapy in time after radical operation, which can greatly improve the survival rate of patients and ensure long-term curative effect.

Objective:To study the effects of Shengui Jiajian Pills on myocardial fibrosis and the transforming growth factor-β1 (TGF-β1)/Smads signaling pathway in elderly rats with hypothyroidism; To preliminarily explore the mechanism of Shengui Jiajian Pills in treating hypothyroid heart disease through the TGF-β1/Smads pathway.Methods:Totally 60 SD rats were randomly divided into normal group, model group, sodium levothyroxine group, and Shengui Jiajian Pills low-, medium-, and high-dosage groups, with 10 rats in each group. A model of elderly hypothyroid heart injury in rats was prepared by freely drinking 0.1% propylthiouracil (PTU) for 10 weeks. Each group of rats was gavaged with the corresponding drug once a day for 6 weeks. After the last gastric lavage, an electrocardiogram was performed, hematoxylin-eosin staining (HE) was used to observe pathological changes in the heart tissue; bitter acid-toluidine blue staining was used to detect fibrosis of the heart tissue; TUNEL staining was used to observe myocardial cell apoptosis; Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) in the serum, as well as brain natriuretic peptide (BNP), creatine kinase isoenzymes MB (CK-MB), and lactate dehydrogenase (LDH); Western blot was used to detect the relative expressions of TGF-β1, p-Smad2, p-Smad3, α-smooth muscle actin (α-SMA), matrix metalloproteinase-1 (MMP-1), TIMP1, Bax, and Caspase-3 in the heart tissue; and immunofluorescence was used to detect the positive expressions of TGF-β1, Smad3, α-SMA, and MMP-1 in the heart tissue.Results:Compared with the model group, the inflammatory cell infiltration and cell damage in the heart of rats in each dosage group of Shengui Jiajian Pills were improved, the myocardial fibrosis area ratio was significantly reduced ( P<0.05), and the myocardial cell apoptosis rate significantly decreased ( P<0.05), the levels of TSH, BNP, CLD, and HK-MB in serum significantly decreased ( P<0.05). The levels of FT3 and FT4 increased in the Shengui Jiajian Pills medium- and high-dosage groups ( P<0.05), while the positive expressions of TGF-β1, Smad3, α-SMA, and MMP-1 decreased ( P<0.05). The protein expression of TGF-β1, p-Smad3, MMP-1, Bax, and Caspase-3 decreased ( P<0.05), and the expression of TIMP-1 increased ( P<0.05). The expression of Smad7 increased in the Shengui Jiajian Pills medium-dosage group ( P<0.05). Conclusion:Shengui Jiajian Pills may reduce myocardial collagen fiber deposition by modulating the TGF-β1/Smad3 signaling pathway, thereby partially reversing the pathological features of hypothyroidism-induced myocardial injury, with more pronounced effects observed in the medium and high dosage groups.

Objective:To explore the short-term efficacy on 3D printing assisted reconstruction of traumatic digit joint defects using rib and costo-osteochondral autograft.Methods:From August 2022 to July 2023, 7 patients with open digit joint defects had undergone emergency primary debridement and fracture fixation in the Department of Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. Patients with more phalangeal defects that could not be aligned were treated with antibiotic bone cement filling in the emergency surgery. In the second stage surgery, bone cement was removed and transfer of rib cartilage graft was performed to reconstruct the digit joint defect. According to a 1∶1 3D printed hand templates, rib cartilage grafts were crafted to the shape of digit joints, and then spliced together the digit joints and bone defects for fixation. Follow-up X-ray examinations were taken and assessment of the healing status of rib and fractures of phalangeal and metacarpophalangeal bones were carried out according to the Paley fracture healing score. At the outpatient follow-up, assessment of transferred joint movement and evaluation of upper limb function were conducted according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association. Visual Analogue Scale (VAS) pain scores were evaluated from the affected digits and donor sites.Results:After reconstructive surgery, all 7 patients had primary healing of the wounds of hand. One patient had fat liquefaction at the donor site, and the rest had primary donor site healing. One patient received further surgery for extensor tendon repair after rib cartilage grafting due to the digital extensor tendon injury. All 7 patients were included in postoperative follow-up for 6-11 months, with an average of 9 months. All patients had excellent fracture healing according to the Paley fracture healing score. At the final follow-up, the extension and flexion of the digit joints were found at 40°-80° (average 56.2°) for proximal interphalangeal joints (4 patients), and 10° in extension and 85° in flexion for metacarpophalangeal joint (1 patient). The range of motion of the thumb interphalangeal joint (2 patients) was 20°-35° (average 27.5°). Hand function was assessed according to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and it was found that 3 patients were in excellent, 3 in good and 1 in fair.Conclusion:This study focused on the treatment of traumatic digit joint defects by transfer of individually crafted rib cartilages in reconstruction of the defected digit joint. It significantly improves the appearance and function of the defected digit joints, especially suitable for the irregular defects of phalangeal bones.

At present the parkinsonian rigidity assessment depends on subjective judgment of neurologists according to their experience. This study presents a parkinsonian rigidity quantification system based on the electromechanical driving device and mechanical impedance measurement method. The quantification system applies the electromechanical driving device to perform the rigidity clinical assessment tasks (flexion-extension movements) in Parkinson's disease (PD) patients, which captures their motion and biomechanical information synchronously. Qualified rigidity features were obtained through statistical analysis method such as least-squares parameter estimation. By comparing the judgments from both the parkinsonian rigidity quantification system and neurologists, correlation analysis was performed to find the optimal quantitative feature. Clinical experiments showed that the mechanical impedance has the best correlation (Pearson correlation coefficient = 0.872, < 0.001) with the clinical unified Parkinson's disease rating scale (UPDRS) rigidity score. Results confirmed that this measurement system is capable of quantifying parkinsonian rigidity with advantages of simple operation and effective assessment. In addition, the mechanical impedance can be adopted to help doctors to diagnose and monitor parkinsonian rigidity objectively and accurately.

Objective    To establish the gene-based esophageal cancer (ESCA) risk score prediction models via whole transcriptome analysis to provide ideas and basis for improving ESCA treatment strategies and patient prognosis. Methods    RNA sequencing data of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC) and adjacent tissues were obtained from The Cancer Genome Atlas database. The edgeR method was used to screen out the differential genes between ESCA tissue and normal tissue, and the key genes affecting the survival status of ESCC and EAC patients were initially identified through univariate Cox regression analysis. The least absolute shrinkage and selection operator regression analysis and multivariate Cox regression analysis were used to further screen genes and establish ESCC and EAC risk score prediction models. Results    The risk score prediction models were the independent prognostic factors for ESCA, and the risk score was significantly related to the survival status of patients. In ESCC, the risk score was related to T stage. In EAC, the risk score was related to lymph node metastasis, distant metastasis and clinical stage. The constructed nomogram based on risk score showed good predictive ability. In ESCC, the risk score was related to tumor immune cell infiltration and the expression of immune checkpoint genes. However, this feature was not obvious in EAC. Conclusion 聽 聽The ESCC and EAC risk score prediction models have shown good predictive capabilities, which provide certain inspiration and basis for optimizing the management of ESCA and improving the prognosis of patients.