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Objective:To explore the clinical effect of lentinan injection combined with recombinant human endostatin in treatment of gastric cancer patients with abdominal cavity metastasis.Methods:A total of 80 gastric cancer patients with abdominal cavity metastasis were treated in the People's Hospital of Haian City in Jiangsu Province from January 2017 to December 2019 were selected. They were randomly divided into the control group and the observation group according to the number table method, 40 cases in each group. The control group was given FOLFOX (oxalipatin + calcium leucovorin + fluorouracil) chemotherapy combined with recombinant human endostatin, and the observation group was in combination of lentinan injection on the basis of the control group. The short-term efficacy, tumor markers before and after treatment, immune function, angiogenesis related factors levels and adverse reactions of the two groups were analyzed.Results:After treatment, the short-term effective rate in the observation group was higher than that in the control group [67.5% (27/40) vs. 47.5% (19/40), χ2 = 4.256, P < 0.05]. The level of tumor markers like tumor supplied group of factors (TSGF), carcino-embryonic antigen (CEA), and carbohydrate antigen 72-4 (CA72-4) of both groups after treatment was decreased compared with that before treatment; after treatment, the level of TSGF, CEA and CA72-4 in the observation group was lower than that in the control group [TSGF: (48.99±3.14) U/ml vs. (55.17±3.68) U/ml, t = -8.080, P < 0.01; CEA: (0.40±0.09) ng/ml vs. (0.47±0.10) ng/ml, t = -3.291, P = 0.002; CA72-4: (3.51±1.14) U/ml vs. (8.42±2.57) U/ml, t = -11.045, P < 0.01]. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + of both groups after treatment was decreased compared with that before treatment. The proportion of CD3 +, CD4 +, and the ratio of CD4 +/CD8 + in the observation group was higher than that in the control group after treatment [CD3 +: (38.53±5.12)% vs. (31.82±4.75)%, t = 6.076, P < 0.01; CD4 +: (25.36±4.39)% vs. (19.12±3.91)%, t = 6.713, P < 0.01; CD4 +/CD8 +: 1.05±0.24 vs. 0.83±0.19, t = 4.546, P < 0.01]. The level of angiogenesis-related factors like p53, vascular endothelial growth factor (VEGF), and transforming growth factor β 1 (TGF-β 1) of the two groups after treatment was decreased compared with that before treatment. The level of p53, VEGF, and TGF-β 1 in the observation group was lower than that in the control group after treatment [p53: (132.86±31.24) ng/L vs. (163.24±33.27) ng/L, t = -4.210, P < 0.01; VEGF: (425.23±36.79) ng/L vs. (673.57±63.28) ng/L, t = -21.458, P < 0.01; TGF-β 1: (35.87±4.03) ng/ml vs. (38.26±4.32) ng/ml, t = -2.559, P = 0.012]. The incidence of grade Ⅲ-Ⅳadverse reactions in the observation group was lower than that in the control group [47.5% (19/40) vs. 62.5% (25/40), χ2 = 6.142, P < 0.05]. Conclusion:Lentinan injection combined with recombinant human endostatin is safe and effective in treatment of gastric cancer patients with abdominal cavity metastasis, and it is worthy of clinical promotion.

Objective To investigate clinical value of transurethral bipolar plasma cutting and transurethral resection for benign prostatic hyperplasia,to provide a reference for clinical treatment.Methods 100 cases with benign prostatic hyperplasia were selected,according to surgical treatment,they were divided into control group and observation group.50 patients in the control group received TURP surgical treatment,50 patients in the observation group were given TUPKP surgical treatment.The patients were followed up for 3 months,the indwelling catheter time, weight and other clinical indicators of glandular tissue were compared,serum sodium and hemoglobin levels were observed,the quality of life index,international Prostate Symptom Score,complications and other indicators were compared. Results In the observation group,operative time was (60.54 ±8.37)min,blood loss was (108.43 ±21.27)mL, hospital stay was (7.09 ±2.25)d,which were shorter than those of the control group (70.24 ±12.22)min,(188.76 ± 21.36)mL,(8.63 ±2.76)d,the differences were statistically significant (t =5.441,P =0.012;t =8.326,P =0.001;t =6.216,P =0.006).In the observation group after three months,maximum flow rate was (18.95 ±4.11)mL/s, residual urine volume was (28.74 ±4.55)mL,IPSS was (5.12 ±1.27)points,QOL was (1.43 ±0.24)scores, which were better than those of the control group (14.24 ±3.77)mL/s,(20.85 ±5.11)mL,IPSS(6.95 ±1.44)points, QOL(2.03 ±0.32)points,the differences were statistically significant (t =8.763,P =0.000;t =7.616,P =0.003;t =5.472,P =0.011;t =8.044,P =0.002).The incidence rate of complication in the observation group was 10.00%, which was significantly lower than 22.00% in the control group,the difference was statistically significant (χ2 =5.437,P =0.012).Conclusion TUPKP treatment for benign prostatic hyperplasia has significant clinical effect, which can effectively improve the clinical symptoms and quality of life with good safety,it is worthy of clinical application.

Coronary heart disease (CHD) is a common gerontal disease, and percutaneouse coronary interangioplasty (PCI) has already become a main treatment in CHD. However, restenosis to some extend has limited clinical application of PCI. The advent of drug eluting stents brings optimistic prospect in preventing restenosis.

BACKGROUND:Elderly patients with hip surgery in the department of orthopedics are often associated with a variety of diseases, and easily suffer from complications after implantation.
OBJECTIVE:To analyze the characteristics and the factors of complications and mortality of the elderly patients with hip disease by different orthopedic implants.
METHODS:249 patients accepted total hip arthroplasty, femoral head replacement, proximal femoral nail, Gamma nail, and holow screw fixation. We analyzed patients’ age, sex, hip disease type, anesthesia risk assessment, psychological and psychiatric factors, admission hemoglobin, preoperative albumin, Charlson comorbidity index, ways of anesthesia, orthopedic implants, operation time, intraoperative bleeding, length of stay, postoperative complications, mortality and survival.
RESULTS AND CONCLUSION:Hip disease in the elderly was repaired with five kinds of implants. (1) There were significant differences in age, anesthesia risk assessment, hemoglobin on admission and preoperative albumin, length of stay, duration and intraoperative bleeding. No significant difference in complications and death was found. (2) The most significant indicators affecting complications were length of stay and albumin on admission and preoperative Charlson comorbidity index. The most significant
indicators affecting death were age and hemoglobin on admission and preoperative Charlson comorbidity index. (3) Significance of comprehensive assessment of patients before placement: during hip operation, implants were not the factors that affected the complications and mortality after placement, patients with artificial joint replacement could get out of bed early, and complications and mortality could be reduced. Elderly patients with anemia, hypoalbuminemia and Charlson comorbidity index≥3 should be given a high degree of attention. We should assess Charlson comorbidity index as early as possible, positively treat complications, correct anemia and hypoproteinemia, prevent the occurrence of complications, shorten the length of hospital stay, and reduce the mortality after placement.

BACKGROUND:Chronic tendinopathy is a tendon disorder extremely common in athletes and in the general population with repetitive strain injuries of tendons. The pathogenesis of tendinopathy remains unclear and hence treatment of tendinopathy is usual y pal iative.
OBJECTIVE:To investigate the of adipogenic and tenogenic ability of patel ar tendon-derived stem cel s isolated
from chronic tendinopathy and healthy rats in vitro.
METHODS:Tendon-derived stem cel s were isolated from patel ar tendons of chronic tendinopathy and healthy rats respectively. The tendon-derived stem cel s were cultured to the 3rd passage in complete culture medium, and cel morphology was observed. The cel s were divided into adipogenic induction group and control group. Cel s in the adipogenic induction group were cultured in adipogenic induction medium, while those in the control group cultured in complete culture medium. The ability of adipogenic differentiation between tendon-derived stem cel s isolated from the tendon of chronic tendinopathy and healthy rats in vitro was examined by oil red O staining and quantification assay. The mRNA expressions of C/EBPαand PPARγ2 were detected by real-time quantitative PCR. When 70%-80%cel s were confluent, the mRNA expressions of Col1a1, Scx, Tnmd and Dcn were also detected by real-time quantitative PCR.
RESULTS AND CONCLUSION:At the third passage, slender spindle-shaped cel s were seen in both two groups, but there was a little change in the cel morphology in the chronic tendinopathy group. Lipid droplets were formed after the cel s were cultured in adipogenic induction medium for 21 days. This was not observed in the control group. We observed more oil red O-positive oil droplets in tendon-derived stem cel s from the tendons of chronic tendinopathy rats than healthy rats. The difference between them was statistical y significant (P=0.004). The results of real-time quantitative PCR showed that the mRNA expressions of C/EBPαand PPARγ2 in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly higher than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.004);the mRNA expressions of Col1a1, Scx, Tnmd and Dcn in the tendon-derived stem cel s from the tendons of chronic tendinopathy rats were significantly lower than those in tendon-derived stem cel s from the tendons of healthy rats (P=0.009). In conclusion, tendon-derived stem cel s from chronic tendinopathy rats showed a higher ability of adipogenic differentiation, but a lower capacity of tenogenic differentiation compared to tendon-derived stem cel s from healthy rats, which might contribute to better understand the pathogenesis of tendinopathy.

BACKGROUND:Mesenchymal stem cells are commonly used in tissue engineering, while whether
synovium-derived mesenchymal stem cells from human knee joints can make a role in repair and regeneration of bone tissue as the appropriate seed cells need to be further verified.
OBJECTIVE:To study the osteogenic differentiation potential of synovium-derived mesenchymal stem cells which were harvested from human knee joint with end-stage osteoarthritis in vitro. Meanwhile, to identify the osteogenic characteristics of these induced synovium-derived mesenchymal stem cells.
METHODS:cellpopulations were enzymatical y released from the synovial membrane obtained from total knee arthroplasty. Nucleated cells were plated at an appropriate density (200 cells/cm2) for expansion at the maximum rate without colony-to-colony contact. Monoclone was obtained by selecting as primary synovium-derived mesenchymal stem cells. After primary cultured in control medium and expanded to three passages, synovium-derived mesenchymal stem cells were subjected to in vitro assays to investigate their osteogenesis potential in osteogenic medium containing dexamethasone,β-glycerophosphate and ascorbic acid.
RESULTS AND CONCLUSION:Nucleated cells from the synovial membrane formed single cel-derived colonies, which were of polygon shape and star shape, uniform in size. After three passages, homogeneous populations of fibroblast-like cells were observed. Under appropriate culture conditions, synovium-derived mesenchymal stem cells were induced to differentiate to the osteocyte lineages which had typical“slabstone”appearance of osteoblasts. Osteogenesis was stained positively for alkaline phosphatase staining at day 7 and formed mineralized nodular structures at day 21, which was confirmed by Alizarin red staining. Alkaline phosphatase activity assay showed a rise after the osteogenesis induction and reached the peak at day 7. Expressions of osteocyte specific genes, such as col agen type Ⅰ, Runx2, bone-binding protein and osteopontin, were al detected. These genes were expressed positively in osteogenic medium, and the mRNA expressions of col agen type Ⅰ, Runx2, bone-binding protein and osteopontin were enhanced significantly after 21 days. Our study demonstrates that synovium-derived mesenchymal stem cells isolated from knee joint of end-stage osteoarthritis patients could be induced into osteoblasts in vitro, and these induced cells have typical osteogenesis characteristics. Synovium-derived mesenchymal stem cells may play a role in the regenerative response during the process of bone injury, which are promising candidates for bone tissue engineering.

The higher medical education in China starts late and needs further exploration and improvement.While in Germany,it is elite education with a long history.Compared with China,in curriculum setting,Sociology,Medical health security,Humanities and Social Sciences and Organ system classification courses are more emphasized,and in terms of degree,it only has Doctor degree but with higher quality in Germany.Higher medical education in China will also take the path of the elite education.We can learn from the German medical education development experience and pay attention to solving the lack of the curriculum by supplementing social medicine and medical health security,increase the autonomy of the instructors in the training process,strengthen the medical students' social responsibility,and improve the quality of higher medical education in China.

Arrhythmias, Cardiac ; Brugada Syndrome ; Cardiac Conduction System Disease ; Heart ; Heart Conduction System ; abnormalities ; Humans ; Magnetic Resonance Spectroscopy

Objective To compare the difference of ELISA and LABScreen in detecting HLA antibodies and evaluate their effects on allograft rejection.Methods Consecutive patients undergoing kidney transplantion from November,2008 to December,2009 in the First Affiliated Hospital and the following up patients during the same period,with abnormal Scr who had completed kidney biopsies,were included in this study.Patients' HLA antibodies were detected by ELISA (Lambda antigen tray,LATTM) and LABScreen Mix Beads (LABScreen MIX,One Lambda,Canoga Park,CA,USA) or LABScreen Single antigen beads (LABScreenTM single antigen beads,One Lambda,Canoga Park,CA,USA).Patients' Scr were also detected at different time potints.Results There were 277 patietns included.Among them 145 (52.3％) cases were HLA antibody positive detected by LABScreen,which including 118 cases ELISA negative but LABScreen positive,and 27 cases both ELISA and LABScreen positive.No case was ELISA positive but LABScreen negative.Among 118 cases which were LABScreen positive but ELISA negative,41 (34.7％) cases happened acute or chronic rejection.However,only 24 cases happened rejection in 132 double negative cases (18.2％,P =0.003).There were 31％ patients in rejection group while only 12.8％ patients (P=0.01) in non-rejection group whose HLA antibody fluorescence intensity detected by LABScreen single antigen beads still increased two weeks after transplantation.Conclusion LABScreen is more sensitive than ELISA in detecting HLA antibodies,and its result highly correlates with the incidence of allograft rejection.