Objective To investigate the expression and im plication of cell-cycle related factors(Cyclin D1,CDK4,P16 MTS1 and PRb)in condyloma acuminatum(CA).Methods The expression and distribution of cyclin D1,CDK4,P16 MTS1 and PRb were detected by immunohisto chemical technique streptavidin peroxidase(SP)in 27cases of HPV6/11positive CA that were confirmed by PCR and 10cases of norm al skins(foreskins).Results①Cyclin D1was not expressed in both normal skin and lesions of CA.②The intensity of expression of CDK4was 2.19in the basal cells in the lesions of CA,which was significantly weaker than that in normal skin(4.8,P

Objective To investigate the pathogen-related genes of atmospheric polluting disease so as to clarify the biology mechanism and provide the scientific basis.Methods By using the technique of dot blot hybridization,we analyzed genes’differential expression with cloning by exposure to ≥75 μg/m3 PM2.5 in heating season and < 75 μg/m3 PM2.5 in un-heating season in WI-38 human embryo lung cells.The levels of cytokines TNF-α,IL-2, IL-6 and IL-8 were determined by radio immunity assay. Results After 24h of treatment, compared with control group,more than 100μg/mL PM2.5 significantly increased TNF-α,IL-6 and IL-8 levels,and decreased IL-2 in WI-38 human embryo lung cells (P < 0.05 ).The clear stripe was found in 350 bp in 48 gene samples with segment with differential expression of genes exposed to different concentrations of PM2.5 in WI-38 human embryo lung cells.Through the dot blot hybridization,black brown spots were found in 41 samples in Tester cDNA hybridization,and no similar spots were found in all of the same samples in Driver cDNA hybridization. Conclusion PM2.5 exposure may induce the inflammatory damage of WI-38 human embryo lung cells.Obvious genetic damage was observed in those cells exposed to ≥75 μg/m3 PM2.5 in heating season.

Objective To investigate the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T(hs-cTnT) on monitoring cardiac toxicity associated with anthracycline chemotherapy drug in patients with diffuse large B-cell lymphoma(DLBCL).Methods PW-Tei index,TDI-Tei index of left/right ventricles and radionuclide cardiac measurement were acquired from 56 patients with DLBCL before,after the completion of 2-4 cycle(100-200 mg/m2) and 6-8 cycle(300-400 mg/m2) of the regimen,part of them received serum hs-cTnT detection at the same time.Cardiac toxicity event was defined as a relative reduction of radionuclide left ventricular ejection fraction(LVEF) of ≥10％ during the regime or an absolute radionuclide LVEF≤50％ after the complete chemotherapy.Results Compared with baseline,left ventricular PW-Tei index significantly increased after whole cures [(0.36-± 0.12) vs (0.44 ±0.13) vs (0.40 ± 0.13),P =0.002].After complete regimen,serum hs-cTnT level elevated significantly [(0.006 ± 0.006)tg/L vs (0.012 ± 0.007) μg/L vs (0.020±0.013)tμg/L,P =0.001].The sensitivity,specificity and area under ROC curve of early diagnosis of anthracycline-induced cardiotoxicity with elevated serum hs-cTnT in 2-4 cycle and increased left ventricular PW-Tei index in 6-8cycle detected together were 75％,85％,0.736 and 92％,50％,0.675,respectively(all P ＜0.05).Conclusions Echocardiographic PW-Tei index combined with serum hs-cTnT is a simple method and can be easily obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy.

BACKGROUND:The three-dimensional structure of acupoint anatomy was integrated into the teaching of acupuncture manipulation. Combined with the implementation and application of the acupuncture and moxibustion in digital virtual human, it can greatly improve the teaching effect and learning interest. OBJECTIVE:To investigate the acupuncture virtual human with integration of virtual reality force feedback technology and tissue deformation. METHODS:Using virtual reality technology, with computer as the core, we generated a specific range of virtual environment with realistic visual, auditory and tactile integration, col ected clinical expert acupuncture technique, matched the sensing equipment that can reflect the intensity, displacement and speed sensing of acupuncture. Based on image segmentation of virtual human, we constructed human tissue mechanics model, built virtual acupuncture-force-feedback system, and faithful y transmitted to the operator by a force feedback device. On one hand, based on VOXEL-MAN virtual human development platform, we finished the three-dimensional browser redevelopment of the science of acupuncture and moxibustion of Shu acupoint, which provided visual perception for people. On the other hand, based on modern biomechanics theory, we established models by graphics and image processing technology and force feedback technology. The stress process of the structure of each layer in the acupuncture point area was given to people in a sense of touch by the manner of virtual reality and force feedback. RESULTS AND CONCLUSION:With the man-machine interactive operation platform of virtual acupuncture force feedback system, operator could see the dynamic process of acupuncture needle into human body, and could feel the real counterforce in the control terminal of force feedback instrument. By operating acupuncture needle in virtual environment of force feedback instrument, acupuncture was performed in virtual human. The system meets the two requirements:the feedback changes produced by tissue interaction were similar to real acupuncture feedback force data measured by instrument. The acupuncture needle entered into different tissues, a sense of power changed significantly;there was progressive feeling with different layers, reaching a realistic experience. During the whole training, the image was smooth;virtual needle was responsive, which better meets the requirements of virtual reality.

Acute pancreatitis (AP) is an inflammatory disease of the pancreas. Its pathogenesis is not only related to abnormal activation of trypsinogen, but also related to calcium overload, mitochondrial dysfunction, impaired autophagy and endoplasmic reticulum stress. However, the mechanism has not been fully elucidated and needs to be further studied. Currently, there is no effective treatment for AP. It is difficult to prevent the loss of pancreatic function. An in-depth understanding of the pathophysiological mechanisms of AP may help to identify the potential therapeutic targets. Therefore, the purpose of this study is to review recent advances in the mechanism of AP in order to provide more research direction for treatment.

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 perioperative safety and oncological results of laparoscopic assisted transanal total mesorectal excision (TaTME) and robot assisted total mesorectal excision (TME) in radical resection of low rectal cancer.Methods:A single center retrospective study was conducted. Analyzed the clinical data of 54 patients with low rectal cancer who received robot assisted TME or laparoscopic assisted TaTME in the first hospital of Jilin University from January 2020 to July 2022, including 39 males and 15 females, with a median age of 61 years old. They were divided into robot assisted TME group ( n=29) and laparoscope assisted TaTME group ( n=25) according to the surgical methods. Follow-up was carried out through outpatient, telephone and wechat. The follow-up time was 30 days after operation. The quality of mesorectal excision was divided into high quality and low quality according to the evaluation of the integrity of the mesentery of the specimen after total mesorectal excision and the circumferential cutting edge. The primary outcome was the quality of mesorectal excision, and the secondary end points were surgery related information, postoperative pathological information, and postoperative complications. SPSS25.0 software was used for statistical analysis. The measurement data of skew distribution were expressed by M( Q1, Q3), and the Mann Whitney U test was used for comparison between groups. The counting data were expressed by n(%), and the comparison between groups was conducted by χ2 test or Fisher exact probability method. Results:The high-quality mesorectal excision rate in TaTME group was 88% (22 cases), and the high-quality mesorectal excision rate in robot group was 100%, with no statistical difference( χ2=3.69, P=0.093). The operation time of TaTME group and robot assisted TME group was [180 (165, 220)] min and [140 (117, 168)] min, respectively, with statistical significance ( U=125.00, P<0.001). The preventive ileostomy rate was 100% in the TaTME group and 37.9% in the robot group( χ2=23.27, P<0.001). Compared with TaTME group, robot assisted TME had a longer distance from the lower tumor to the distal cutting edge [10 (5, 25) mm vs 35 (21, 41) mm, U=117.00, P<0.001], a longer distance from the deepest tumor to the circumferential cutting edge [15 (10, 25) mm vs 25 (20, 34) mm, U=165.50, P=0.003], and a larger tumor maximum meridian [20 (4, 52) mm vs 42 (30, 48) mm, U=202.50, P=0.005]. The total incidence of complications within 30 days after operation was 16.7%, of which the incidence of Clavien-Dindo Ⅰ to Ⅱ complications was 11.1%, and the incidence of Clavien-Dindo ⅢA complications was 5.6%. The overall complication rate of TaTME group was higher, but there was no significant difference (20.0% vs 13.8%, χ2=0.37, P=0.718). Conclusion:Both TaTME and robot assisted TME can ensure good quality of TME operation and can be used as an effective and safe treatment for low rectal cancer. When performing TaTME surgery for low rectal cancer, it is more necessary to ensure sufficient distal margin distance.

Objective:Based on the accounting results of total health expenditure in different regions since the 18th National Congress of the Communist Party of China,to analyze the regional disparity and evolution trend of health financing level and financing structure in 2012-2022,so as to provide references for subsequent adjustment and improvement.Methods:Range,standard deviation and coefficient of variation were used to analyze the degree of absolute and relative differences of total regional health expenditure in China and the changing characteristics of regional total health expenditure differences since the New Era(2012-2022).Results:Since 2012,the total health expenditure in various regions has been increasing continuously,and the average annual growth rate of total health expenditure is higher than that of the economy in this region.The relative difference of the proportion of total health expenditure to GDP in 31 provinces has converged in the fluctuation,but the absolute difference is still very large;the relative gap and absolute gap of per capita total health expenditure are expanding;the absolute difference in the proportion of out-of-pocket payments to total health expenditure has narrowed,while the relative difference has gradually narrowed.Conclusion:There are obvious differences in the growth rate of total health expenditure in different regions,so it is suggested that"appropriate growth"and"accurate control of health expenditure"should be carried out in parallel;the regional disparity of health investment in China has not improved,especially the regional disparity of per capita investment level continues to increase,so narrowing the regional disparity is a long-term task.The gap of regional financing structure has converged,but the gap is still large.

After peripheral nerve injury (PNI),myelinated Schwann cells undergo demyelination,dedifferentiation and proliferation,then migrate along basal lamina tubes and align to form the longitudinal cell strands known as bands of Btüngner,which creates suitable conditions for axonal regeneration and remyelination.By reviewing literature,we found that the expression of a transcriptional factor c-Jun increased during demyelination process after PNI,and increasing evidences suggested that demyelination and c-Jun signaling pathways were closely related.This review summarized the research situation and progress of c-Jim signaling pathways regulating demyelination process after peripheral nerve injury.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune encephalitis mediated by anti-NMDAR antibody. Current studies have found that most patients with anti-NMDAR encephalitis have a good prognosis after immunotherapy and tumor therapy, but there are still 4.5%-36.4% patients with relapse. It is important to identify the risk factors for the prevention of relapse. This article aims to review the relapse risk factors of NMDAR encephalitis in order to provide help for the prevention of relapse.