0.05). No loosening, distortion and breaking of fusion apparatus were found. Conclusion STT arthrodesis simulated in new fusion apparatus does not show displaced even though forced the utmost movement in range of motion of extension 35?/flexion 50?, radial deviation 10?/ulnar deviation 30?. STT arthrodesis can get excellent stability using new fusion apparatus.

Objective To explore the effect of Latexin (Lxn) gene transfection on proliferation of CD13;MIAPaca-2 pancreatic cancer stem-like cells.Methods CD133+ MIAPaca-2 cells were isolated and sorted by magnetic activated cell sorting from pancreatic cancer MIAPaca-2 celt line.CD133+ MIAPaca-2 cells were cultured in serum-free medium and the capacity for proliferation,and tumorigenicity of CD133+ MIAPaca-2 cells was determined by the floating spheres test and tumor xenograft assays.The CD133+ MIAPaca-2 cells were transfected with Lxn plasmid (1,3,5 μg).After transfection,the protein and mRNA expression of Lxn in CD133+ and CD133+-MIAPaca-2 cells were detected by Western blotting and RT-PCR,respectively.Cell proliferation was assayed by CCK-8.Results CD133+ MIAPaca-2 cells were successfully isolated,and it grew into a ball-suspended way,the tumorigenicity rate in nude mice with subcutaneous injection 1 × 105 cancer cells was 100％.After Lxn plasmid transfection,the expression of Lxn in CD133+ MIAPaca-2 cells was increased in a dose dependent manner,the Lxn protein and mRNA expression of tumor cells transfected with 5 μg plasmid was 20.80 ±0.98,16.80± 2.73,which was significantly higher than that in non-transfected cells (1.02 ± 0.01,1.01 ± 0.01),and the difference between the two groups was statistically significant (P ＜ 0.05).After transfection,cellular proliferation activity also showed a transfection dose and culture time-dependent decrease,the inhibition rate of tumor cells transfected with 0.4 μg plasmid was 36.2％,which was significantly different from that in non-transfected cells (P ＜ 0.05).Conclusions CD133+ MIAPaca-2 pancreatic cancer cells have some characteristics of cancer stem cells.Lxn gene transfection can inhibit the proliferation of CD133+ MIAPaca-2 cells.

Objective To investigate the application value of Photoshop in grading invasive risk of gastric stromal tumors (GSTs). Methods EUS image of 97 cases of GSTs confirmed by pathological and immunohistochemical examination were collected. GSTs were divided into four groups (very low risk, low risk, intermediate risk, high risk) by tumor size, mitotic count and rupture of tumor. Mean gray value (intensity of echo) and gray value standard deviation (uniformity of echo) of EUS images of the lesions were determined by Photoshop and then the differences of each group were found by statistical analysis. Results It is difficult to differentiate EUS images of GSTs from each group by visual observation. The mean gray value of EUS image of very low risk group,low risk group, intermediate risk group and high risk group of GSTs respectively were (56.54 ± 6.10), (59.20 ± 7.51), (77.77 ± 10.90) and (83.43 ± 12.47). There was no significant difference between very low risk group and low risk group (P > 0.05). There was no significant difference between intermediate risk group and high risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). The mean gray value standard deviation of EUS image of very low risk group, low risk group, intermediate risk group and high risk group of GSTs respectively were (8.46 ± 2.59), (12.57 ± 5.89), (12.84 ± 4.15) and (16.69 ± 4.69). There was no significant difference between low risk group and intermediate risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). Conclusions The higher risk of GSTs, the higher of echo intensity and the worse of echo uniformity under EUS. Photoshop combined with EUS is helpful for differentiating different risk of GSTs by analyzing mean gray value and gray value standard deviation of the lesions.

Objective:To study the effects of Ophiocordyceps xuefengensis on proliferation of DC -CIK cells and the activity of killing HepG-2 cells by DC-CIK cells.Methods:Peripheral blood mononuclear cells were routinely isolated and induced into DC and CIK.DC and CIK co-cultured by 1∶5 for 7 days,then Ophiocordyceps xuefengensis were added into medicine group ,observed the mor-phology of the cells on the tenth day and counted the DC-CIK number of each group.DC-CIK cells acted as effector cells and the HepG-2 cells as target cells , cck-8 method for the detection of DC-CIK in the killing rate of HepG-2.Results: The Ophiocordyceps xuefengensis was able to proliferate the DC-CIK dramatically ,the optimal concentration was 0.1 mg/ml.Cultivation of Ophiocordyceps xuefengensis induced DC-CIK cells on HepG-2 cells killing effect was better than that of the routine method of DC-CIK cells; the effection of Ophiocordyceps xuefengensis killing HepG-2 cells was not obviously.Conclusion: Ophiocordyceps xuefengensis can enhance the anti-tumor activity of DC-CIK mainly by promoting the proliferation of it.

BACKGROUND: It has been confirmed that acidic peptide has good therapeutic effect on rat models of Alzheimer disease, but the mechanism still needs further exploration.OBJECTIVE: To observe whether acidic peptide can inhibit the production of N-methyl-D-aspartate receptor (NMDAR) and beta-amyloid (β-amyloid) in brain, and accelerate the production and excretion of nerve growth factor (NGF) in rats with Alzheimer disease.DESIGN: A randomized controlled animal experiment.SETTING: Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Zhengzhou University.MATERIALS: The experiments were finished in the first laboratory of Institute of Bioactive Peptide, Zhengzhou University and the Cellular Culture Center, School of Basic Medical Sciences of Zhengzhou University from March 2005 to May 2006. Seventy 10-week-old healthy male SD rats without dementia symptoms were randomly divided into 7 groups with 10 rats in each group: normal control group, model group, saline group, glutamic acid 0.3 g/kg group, acidic peptide 15, 30 and 60 mg/kg groups.METHODS: Except the normal control group, the rats in the other 6 groups were induced into models of Alzheimer disease by damaging bilateral nucleus basalis of Meynert with ibotenic acid, and then intragastric administration of glutamic acid (0.3 g/kg) was given in the glutamic acid 0.3 g/kg group, acidic peptide of corresponding dosages in the acidic peptide 15, 30 and 60 mg/kg groups, and isovolume saline in the saline group respectively, 2 mL for each time, once a day for 20 days continuously.MAIN OUTCOME MEASURES: ① The learning ability of the rats was detected with Y-maze test immediately after the end of intragastric administration, and the times of correct responses were recorded. ② After the end of learning and memory test, the head was cut rapidly to remove brain,treated with immunohistochemical staining, and gray value was scanned with Biosens Digital Imaging System to determine the contents of NMDAR,NGF and β-amyloid in the brain of rats.RESULTS: All the 70 rats were involved in the analysis of results. ①Times of correct responses in the Y-maze test were lower in the other 6groups than in the normal control group (P ＜ 0.01), but higher in the acidic peptide 30 and 60 mg/kg groups than in the model group, saline group, glutamic acid 0,3 g/kg group and acidic peptide 15 mg/kg group (P ＜ 0.01). ②The gray values of NGF in basal forebrain in the model group, saline group,glutamic acid 0.3 g/kg group and acidic peptide 15 mg/kg group were lower than that in the normal control group (69.60±2.41, 69.62±1.46, 69.62±1.46,69.73±1.87, 80.77±2.72, P ＜ 0.01); There were no significant differences between the acidic peptide 30 and 60 mg/kg groups (79.39±2.23, 80.20±1.7, P ＞ 0.05), which were higher than the other groups. ③ The gray values of NMDAR and β-amyloid in cerebral cortex in the model group,saline group, glutamic acid 0.3 g/kg group and acidic peptide 15 mg/kg group were lower than those in the normal control group (NMDAR: 81.01±1.38, 81.31±2.06, 81.37±1.39, 79.38±1.23, 69.50±1.04; β-amyloid:74.26±1.39, 74.89±8.66, 74.88±1.46, 74.16±2.48, 67.40±3.06, P ＜ 0.01),and There were no significant differences between the acidic peptide 30and 60 mg/kg groups (P ＞ 0.05), which were lower than the other groups.CONCLUSION: Acidic peptide of 30 and 60 mg/kg can obviously ameliorate the learning and memory abilities in rat models of Alzheimer disease, which may be realized mainly through up-regulating the NGF content in basal forebrain and down-regulating the NMDAR and β-amyloid contents in cerebral cortex.

BACKGROUND: Functional dressings have been widely used in clinical practice, but so far none of existing dressings can meet the clinical needs in terms of gas permeability, biocompatibility, comfort, and degradability. OBJECTIVE: To systemically evaluate the biosafety properties of water-soluble chitosan lactate/hyaluronan sponge after modification. METHODS: In the study, there were 10 male BALB/C mice of SPF grade (6-8 weeks old), 20 Sprague-Dawley rats of SPF grade (7 weeks old, both genders), and 3 male New Zealand white rabbits (8 weeks old), all provided by Dongguan Songshanhu Pearl Animal Technology Co., Ltd. The chitosan lactate/hyaluronan sponge was prepared for cytotoxicity test. A blank control group was set. According to the GB/T16886 biological evaluation system, the rabbits were subjected to composite sponge stimulation and sensitization and intradermal reaction tests from the perspective of biosafety, and then divided into non-polar extract group, polar extract group and negative control group. The inoculation site was observed within 72 hours. The mice were subjected to acute toxicity test, and divided into experimental group (extraction solution) and control group (pure saline), and their manifestations were observed for 72 hours. The rats were subjected to subchronic toxicity test, and then divided into experimental group (subcutaneous implantation of composite sponge) and control group (making a skin incision on the back followed by suturing). The changes in body weight of the rats were observed, blood samples from the rats were taken intravenously for blood routine analysis at 13 weeks after testing, and the rats were anesthetized and executed in the next day for gross observations of the heart, liver, spleen, kidney, brain, pancreas, thymus, stomach, and bladder. RESULTS AND CONCLUSION: (1) The chemical structure of the modified composite sponge formed as expected. The cytotoxicity of the composite sponge was grade 1, which was not significantly different from the negative control group. (2) The skin irritation test showed no skin erythema and edema in the New Zealand white rabbits after being stimulated by the composite sponge, and the existing stimulation reactions were extremely mild. Almost no obvious sensitization reaction occurred. (3) No erythema and edema were captured in the intradermal reaction test, and intradermal reaction stimulation of the composite sponge was very weak. (4) In the acute toxicity test, no obvious toxicity symptoms such as hypocinesis, dyspnea and abdominal stimulation were observed in the mice. Furthermore, at the observational time point of 72 hours, no acute systemic toxicity occurred in the two groups. (5) In the subchronic toxicity test, no obvious difference was detected in the rat body mass between the experimental and control groups. The same conclusion was made in the hematology and organ coefficient tests. To conclude, the chitosan lactate/hyaluronate sponge has excellent biological properties and good biosafety, which can be applied for further clinical use.

Background and Objectives: Despite advances in wound treatments, chronic diabetic wounds remain a significant medi-cal challenge. Exosomes from mesenchymal stem cells (MSCs) and small molecule activators of nuclear factor erythroid 2–related factor 2 (Nrf2) have emerged as potential therapies for nonhealing diabetic wounds. This study aimed to evaluate the effects of exosomes from bone marrow-derived MSCs (BMSCs) alone, or in combination with a small molecule activator of Nrf2 on diabetic wound healing. Methods: and Results: BMSCs and endothelial progenitor cells (EPCs) were isolated from the femur and tibia bone marrow of Sprague-Dawley (SD) rats and culture-expanded. Exosomes were harvested from the BMSC culture supernatants through ultracentrifugation. The effects of the exosomes and Nrf2 knockdown, alone or in combination, on EPC tube formation were evaluated. Streptozotocin-induced diabetic rats bearing a fresh full-thickness round wound were treated with the exosomes alone, or in combination with a lentiviral shRNA targeting Nrf2 (Lenti-sh-Nrf2) or tert-butylhydroquinone (tBHQ), a small molecule activator of Nrf2. Two weeks later, wound closure, re-epithelization, collagen deposition, neovascularization, and local inflammation were evaluated. BMSC exosomes promoted while Nrf2 knockdown inhibited EPC tube formation. BMSC exosomes accelerated wound closure, re-epithelization, collagen deposition, and neovascularization, and reduced wound inflammation in diabetic rats. These regenerative and anti-inflammatory effects of the exosomes were inhibited by Lenti-sh-Nrf2 but enhanced by tBHQ administration. Conclusions BMSC exosomes in combination with a small molecule Nrf2 activator hold promise as a new therapeutic option for chronic diabetic wounds.

Objective:To explore the differences on clinical characteristics, concomitant diseases and treatment status between psoriasis and psoriatic arthritis (PsA), and provide clues for the early diagnosis and treatment of PsA.Methods:Data were collected by in-person interview of 225 patients with psoriasis and 299 patients with PSA who visited the department of rheumatology and Immunology and Department of Dermatology in People′s Hospital of Peking University from November 2020 to May 2021. After informed consent, the questionnaire was completed on site. The differences of clinical characteristics, concomitant diseases, mental health evaluation and treatment status between patients with arthritis (PsA) and patients with psoriasiswere analyzed and compared. Enumeration data were described by frequency. Chi square test was used to compare categorical variables. Multivariate Logistic regression analysis was used to determine the independent risk factors. P value of less than 0.05 was considered statistically significant. Results:Dactylitis [ OR(95% CI)=8.439(4.677,15.226), P<0.001], hip pain [ OR(95% CI)=3.442(1.829,6.480), P<0.001], heel pain [ OR(95% CI)=2.621(1.652,4.157), P<0.001] and low back pain [ OR(95% CI)=1.924(1.156,3.203), P=0.012] may be closely related to the progression of PsA ( P<0.05). The three most common concomitant diseases of patients with PsA and psoriasis both were overweight [43.1%(129/299)、29.3%(66/225)], fatty liver [(28.4%(85/299)、23.1%(52/225)]and hypertension[24.1%(72/299、13.3%(30/225)]. The proportion of osteoporosis in PsA group at the age of 30-39 and 40-49 years old was significantly higher than those in psoriasis group (30-39 years old:12.5%(10/80) vs 1.5%(1/65), χ2=6.14, P=0.013; 40~49 years old: 19.2%(15/78) vs 2.0%(1/51), χ2=8.46, P=0.004]. The proportion of hypertension in PsA group was also higher than that in psoriasis group at the age of 40~49 years old[7.0% (21/78) vs 2.7%(6/51), χ2=4.99, P=0.026)]. And the proportion of fatty liver in PsA group was also higher than that in psoriasis group at the age ≥60 years old [(46.0%(23/50) vs 29.1(7/24), χ2=4.99, P=0.025)]. Among 299 PsA patients, 47.1%(141/299) had anxiety tendency, 45.2%(135/299) had sleep disorder and 41.8%(125/299) had depression tendency. Among 225 psoriasis patients, 44.4%(100/225) had anxiety tendency, 40%(90/225) had sleep disorder and 36.9%(83/225) had depression tendency, there was no significant difference in above-mentioned situations between the PsA and psoriasis patients ( P>0.05). Conclusion:More attention should be paid to the management of concomitant diseases and psychological intervention in patients with PsA. When psoriasis patients occur with heel pain, dactylitis, low back pain and hip pain, the risk of development into PsA should be considered.

Background and Objectives: Venous thromboembolism (VTE), consisting of deep vein thrombosis (DVT) and pulmonary embolism (PE), is highly prevalent in in-hospital HF patients and contributes to worse prognoses. However, the risk of VTE in out-patients with HF in long-term period is controversial. This study aimed to evaluate the associations between HF and the risk of VTE in a long-term follow-up duration. Methods: We searched for studies investigating the risk of VTE, PE, and DVT in patients with HF before April 15, 2020, in PubMed, MEDLINE, and Embase databases. Cohort studies and post hoc analysis of RCTs were eligible for inclusion if they reported relative risk of VTE, DVT or PE in patients with HF in more than 3-month follow-up period. Results: We identified 31 studies that enrolled over 530,641 HF patients. Overall, patients with HF were associated with an increased risk of VTE (risk ratio [RR]=1.57, 95% confidence interval [CI]=1.34–1.84) and PE (RR=2.00, 95% CI=1.38–2.89). However, the risk of DVT was not significantly increased in HF patients (RR=1.33, 95% CI=0.67–2.63). Subgroup analysis showed that patients with chronic HF (RR=1.54, 95% CI=1.32–1.80) had a higher risk of VTE than those with acute HF (RR=0.95, 95% CI=0.68–1.32). Conclusions In conclusion, HF was an independent risk for VTE and PE but not DVT in a longterm follow-up period. Patients with chronic HF were prone to suffer from VTE than acute HF.

Objective:To study the use of trans gastric sinus stent placement and drainage in management of persistent external pancreatic fistula.Methods:The clinical data of 12 patients who developed persistent external pancreatic fistulae after severe acute pancreatitis, pancreatic trauma or pancreatic surgery who were treated at the First Medical Center of Chinese PLA General Hospital from August 2018 to December 2020 were retrospectively analyzed. There were 10 males and 2 females, aged 30 to 65 years, median 43.5 years. These patients underwent trans gastric sinus stent placement and drainage, and were followed-up to study persistence of pancreatic fistula, new pancreatic fluid accumulation, complications and death.Results:In this study, there were 9 patients who developed persistent external pancreatic fistulae after severe acute pancreatitis, 2 patients after pancreatic trauma, and 1 patient after pancreatic surgery. The median operation time was 47 min (range 38-54 min). The technical success rate was 100.0% (12/12). The median follow-up was 22.5 months (range 2-29 months). Seven days after stenting, the percutaneous drainage tubes (urinary catheters) of all the patients were removed. One patient (8.3%) developed recurrence of pancreatic fistula 17 days after treatment. The same procedure of placing another stent was done and the patient recovered. Six months after treatment, 2 patients (16.7%) lost their stents, and 1 patient developed a pseudocyst (recurrence of pancreatic fistula). The maximum diameter of this pseudocyst increased gradually to 7cm after 9 months. A double pigtail drainage tube was placed under endoscopy in this patient, and the patients recovered. All the other patients did not develop recurrence of pancreatic fistula or pseudocyst. During the follow-up period, no patient developed any new complications including pancreatic fluid accumulation, fever, bleeding, infection and organ dysfunction, and no patients died.Conclusion:It was safe and efficacious to use trans gastric sinus stent placement for treatment of persistent external pancreatic fistula. However, the long-term outcomes require further studies.