OBJECTIVE:To observe the effect of Banxia Xiexin decoction on nuclear transcription factor κB p65 (NF-κB p65),NF-κB inhibitory protein α(IκB-α)and Toll-like receptor 4(TLR4)in colon tissue of rats with ulcerative colitis(UC),and explore the possible mechanism for UC treatment. METHODS:Rats were randomly divided into normal group (normal saline), model group (normal saline),Sulfasalazine enteric coated tablet (SASP,positive group,0.3 g/kg),Banxia Xiexin decoction low-dose,medium-dose,high-dose groups (3.9,7.8,11.7 g/kg),8 in each group. Except for normal group,other groups were used trinitrobenzene sulfonic acid-ethanol method to reduce UC model. After modeling,they were administrated,ig,once a day, for 3 weeks. After administration,NF-κB p65,IκB-α,TLR4 mRNA and protein expressions in colon tissue of rats in each group were detected. RESULTS:Compared with normal group,NF-κB p65,IκB-α,TLR4 mRNA and protein expressions in colon tissue of rats in other groups were significantly increased(P<0.05). Compared with model group,NF-κB p65,IκB-α,TLR4 mRNA and protein expressions in colon tissue of rats in each administration group were significantly decreased (P<0.05);showing certain dose-dependent,and the decreasing degree of above indexes in colon tissue of rats in Banxia Xiexin decoction high-dose group were higher than SASP group (P<0.05). CONCLUSIONS:Banxia Xiexin decoction can down-regulate the NF-κB p65,IκB-α, TLR4 mRNA and protein expressions in colon tissue of UC rats,which may be one of the mechanisms for UC treatment.

Objective:To observe whether there is abnormal expression of tetrodotoxin-resistant (TTX-R)hNa v1.8 channel protein in demyelinated fibers of the affected nerves in patients with trigeminal neuralgia(TN), and to explore the relationship between ectopic discharges and TN.Methods: Six affected inferior alveolar nerves obtained from patients with idiopathic TN were studied. One great auricular nerve and one normal inferior alveolar nerve were used,which were obtained from patients undergoing combined radical neck dissection with glossectomy (negative control) and mandibulectomy (normal controls) . One rat spinal nerve was used as positive control. Immunohistochemical method and electron microscope were used to observe the expression of TTX-R hNa v1.8 channel protein in all groups. Results: Strong expression of hNa v1.8 channel protein was found in the demyelinated fibers of the affected nerves in patients with TN, weak expression in the neuraxon of rat spinal nerve,and none in the normal inferior alveolar nerve and the great auricular nerve. Conclusion: Abnormal expression of hNa v1.8 channel protein in the demyelinated fibers in patients with TN may play an important role in the pathogenesis of TN.

The results of analyzing the managerial characteristics and complexity of product cooperative development suggest that task planning is an important aspect for process management of product cooperative development and the method for planning tasks should be able to model the dependency between tasks and iterations during the development process. In this paper, a DSM-based method and its corresponding optimization algorithms are developed. At first the coupled task sets and uncoupled task setsare identified, and the tasks are then optimized by the corresponding algorithms. The optimal tasks plan will reduce the development time and cost. Considering the practical requirements in real world, a Multilayer DSM is proposed, and its information communication techniques between DSM and traversing principle are described in details.

Objective To discuss the spatial-temporal distribution and epidemic trends of autumn-winter type scrub typhus in Shandong province,and provide scientific evidence for further study for the prevention and control of the disease.Methods The scrub typhus surveillance data during 2006-2014 were collected from Shandong Disease Reporting Information System.The data was analyzed by using software ArcGIS 9.3 (ESRI Inc.,Redlands,CA,USA),GeoDa 0.9.5-i and SatScan 9.1.1.The Moran' s I,log-likelihood ratio (LLR),relative risk (RR) were calculated and the incidence choropleth maps,local indicators of spatial autocorrelation cluster maps and space scaning cluster maps were drawn.Results A total of 4 453 scrub typhus cases were reported during 2006-2014,and the annual incidence increased with year.Among the 17 prefectures (municipality) in Shandong,13 were affected by scrub typhus.The global Moran' s I index was 0.501 5 (P＜0.01).The differences in local Moran' s I index among 16 prefectures were significant (P＜0.01).The "high-high" clustering areas were mainly Wulian county,Lanshan district and Juxian county of Rizhao,Xintai county of Tai' an,Gangcheng and Laicheng districts of Laiwu,Yiyuan county of Zibo and Mengyin county of Linyi.Spatial scan analysis showed that an eastward moving trend of high-risk clusters and two new high-risk clusters were found in Zaozhuang in 2014.The centers of the most likely clusters were in the south central mountainous areas during 2006-2010 and in 2012,eastem hilly areas in 2011,2013 and 2014,and the size of the clusters expanded in 2008,2011,2013 and 2014.One spatial-temporal cluster was detected from October 1,2014 to November 30,2014,the center of the cluster was in Rizhao and the radius was 222.34 kilometers.Conclusion A positive spatial correlation and spatial agglomerations were found in the distribution of autumn-winter type scrub typhus in Shandong.Since 2006,the epidemic area of the disease has expanded and the number of high-risk areas has increased.Moreover,the eastward moving and periodically expanding trends of high-risk clusters were detected.

Objectives:The aim of this study was to assess the influence of graft anastomosis strategies of radial artery on the flow characteristics and early patency in coronary artery bypass grafting(CABG). Methods:Present study enrolled 99 patients(92 males,7 females,aged[57.2±8.7]years),who underwent isolated CABG using a radial artery(RA)graft from January 2019 to December 2021 in our department.The RA was proximally anastomosed to the aorta in 79 patients(group 1)and to another graft as a composite graft in 20 patients(group 2).The intraoperative flow characteristics were evaluated with the transit time flow measurement(TTFM),and the graft patency was assessed by computed tomography coronary angiograms perioperatively and at 1year after operation respectively. Results:Baseline characteristics were similar between the two groups(all P＞0.05).There was no perioperative death.Incidence of minimally invasive cardiac surgery for CABG(MICS CABG)and mean flow(MF)of RA grafts were both higher in group 2 than in group 1(all P＜0.05).Perioperative RA graft failure rate was 24.2%(n=24),which tended to be lower in group 2 than in group 1(10.0%vs.27.8%,P=0.096).CT angiography showed that RA graft failure reduced to 16.1%at one year after operation.Compared to patency group,patients with failure RA grafts perioperatively had higher pulse index(PI)and lower intraoperative MF(all P＜0.05).Patients with failure RA grafts at one year after operation had higher PI and more bypassed to the right coronary artery(RCA)target territories of RA grafts(all P＜0.05). Conclusions:RA proximal anastomosis to the aorta or to another graft dose not affect the perioperative patency in CABG.Some RA graft that failed perioperatively might recanalize at one year after operation.High intraoperative PI and bypassed to RCA of RA grafts may be predictors of graft failure at one year after operation.

Objective To investigate the clinical value of Physiologic Ability and Surgical Stress ( E?PASS) and modified Estimation of Physiologic Ability and Surgical Stress ( mE?PASS) scoring systems in predicting the mortality and surgical risk of gastric cancer patients, and to analyze the relationship between the parameters of E?PASS and early postoperative complications. Methods Clinical data of 778 gastric cancer patients who underwent elective surgical resection in Tianjin Medical University General Hospital from Jan. 2010 to Jan. 2014 were analyzed retrospectively. E?PASS and mE?PASS scoring systems were used to predict the mortality of gastric cancer patients, respectively. Univariate and unconditioned logistic regression analyses were performed to assess the relationships between nine parameters of E?PASS system and early postoperative complications. Results E?PASS and mE?PASS systems were used to predict the mortality in the death group and non?death group. The Z value was -5. 067 and -4. 492, respectively, showing a significant difference between the two groups (P<0.05). AUCs of mortality predicted by E?PASS and mE?PASS were 0.926 and 0.878 (P>0.05), and the prediction calibration of postoperative mortality showed statistically non?significant difference (P>0.05) between the E?PASS and mE?PASS prediction and actual mortality. Univariate analysis showed that age, operation time, severe heart disease, severe lung disease, diabetes mellitus, physical state index and ASA classification score are related to postoperative complications
( P<0. 05 for all ) . Unconditioned logistic regression analysis showed that severe lung disease, diabetes mellitus, ASA classification score and operation time are risk factors for early postoperative complications ( P<0.05 for all) . Conclusions Both mE?PASS and E?PASS scoring system have good consistency in the predicting postoperative mortality and actual mortality, and both are suitable for clinical application. Moreover, the mE?PASS scoring system is clinically more simple and convenient than E?PASS scoring system. Preoperative severe lung disease, diabetes mellitus, ASA classification score and operation time are independent factors affecting the early postoperative complications.

Objective To investigate the clinical value of Physiologic Ability and Surgical Stress ( E?PASS) and modified Estimation of Physiologic Ability and Surgical Stress ( mE?PASS) scoring systems in predicting the mortality and surgical risk of gastric cancer patients, and to analyze the relationship between the parameters of E?PASS and early postoperative complications. Methods Clinical data of 778 gastric cancer patients who underwent elective surgical resection in Tianjin Medical University General Hospital from Jan. 2010 to Jan. 2014 were analyzed retrospectively. E?PASS and mE?PASS scoring systems were used to predict the mortality of gastric cancer patients, respectively. Univariate and unconditioned logistic regression analyses were performed to assess the relationships between nine parameters of E?PASS system and early postoperative complications. Results E?PASS and mE?PASS systems were used to predict the mortality in the death group and non?death group. The Z value was -5. 067 and -4. 492, respectively, showing a significant difference between the two groups (P<0.05). AUCs of mortality predicted by E?PASS and mE?PASS were 0.926 and 0.878 (P>0.05), and the prediction calibration of postoperative mortality showed statistically non?significant difference (P>0.05) between the E?PASS and mE?PASS prediction and actual mortality. Univariate analysis showed that age, operation time, severe heart disease, severe lung disease, diabetes mellitus, physical state index and ASA classification score are related to postoperative complications
( P<0. 05 for all ) . Unconditioned logistic regression analysis showed that severe lung disease, diabetes mellitus, ASA classification score and operation time are risk factors for early postoperative complications ( P<0.05 for all) . Conclusions Both mE?PASS and E?PASS scoring system have good consistency in the predicting postoperative mortality and actual mortality, and both are suitable for clinical application. Moreover, the mE?PASS scoring system is clinically more simple and convenient than E?PASS scoring system. Preoperative severe lung disease, diabetes mellitus, ASA classification score and operation time are independent factors affecting the early postoperative complications.

Objective To analyze the clinical efficacy of subtotal colectomy,90 degree rotation of the cecum and cecorectal side-to-end anastomosis for slow transit constipation (STC).Methods Clinical data of 31 STC patients treated by subtotal colectomy,90-degree rotation round its long axis and cecorectal anastomosis were retrospective analysed.Results Open surgery was performed in 14 cases,and laparoscopic-assisted surgery in 17 cases.There was no perioperative mortality.Anastomotic fistula occurred in 1 case.4 cases suffered from intestinal obstruction including early postoperative inflammatory bowel obstruction in 2 cases,and incomplete intestinal adhesions in 2 cases.All were cured by conservative treatment.In postoperative one month stool frequency averaged at 8 times/d,after half a year the stool frequency was averaged at 6 times/d,after 2 years it was 4 times/d.There was no stool seepage during night time.Conclusions Colon subtotal resection and 90 ° rotation cecal rectal anastomosis in the treatment of STC is effective and without severe complications.

Objective:To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected. There were 6 males and 4 females, aged from 41 to 63 years, with a median age of 54 years. Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe. Observation indicators: (1) preoperative general situations of patients; (2) surgical situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021. Measurement data with normal distribution were expressed as Mean± SD. Count data were expressed was absolute numbers. Results:(1) Preoperative general situations of patients: hepatocellular carcinoma was found in 7 cases, inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case. Three cases had tumors located in S4a segment, 2 cases had tumors located in ventral subsegment of S8 segment, 2 cases had tumors located in dorsal subsegment of S8 segment, and 3 cases had tumors across the ventral segment of S4a+S8. The diameter of tumors was (3.4±1.0)cm. (2) Surgical situation: all the 10 patients underwent R 0 resection successfully, with no intraoperative blood transfusion or conversion to open surgery. The operation time of 10 patients was (149±59)minutes, the volume of intraoperative blood loss was (294±163)mL, the minimum surgical margin of specimen was (1.1±0.2)cm. The alanine aminotransferase was (324±151)U/L on the postoperative first day, the aspartic aminotransferase was (401±113)U/L on the postoperative first day, and the duration of postoperative hospital stay was (9±4)days. No bile leakage, hemorr-hage, reoperation or other complications occurred in all patients. (3) Follow-up: 10 patients were followed up for 7?13 months, with a median follow-up time of 11 months. All patients had no margin recurrence or distant metastasis. Conclusion:It is safe and feasible to construct triangular modal for planning approach of local laparoscopic resection of liver tumors located in superior part of central liver lobe.

Objective:To report the use of right internal mammary artery (RIMA) in coronary artery bypass grafting (CABG) in our center, summarize the purpose and configuration of RIMA graft in CABG.Methods:All clinical data of coronary artery bypass grafting patients in our center performed in the past 6 years were collected and analyzed retrospectively. Those patients were divided into RIMA group and non-RIMA group according to the use of RIMA. Propensity score matching had been performed before these data was compared. Surgical technique of use of RIMA was summarized.Results:1 537 CABG had been performed from January 1st, 2016 to October 31st, 2021 in our center. Of which, 128 cases were allocated to RIMA group. After propensity score matching having been performed, there was no difference in baseline data between the RIMA group and the non-RIMA group (128 cases), and the RIMA group had more grafts and arterial grafts than the non-RIMA group. The postoperative drainage volume in the RIMA group was more than that of the non-RIMA group. However, there was no statistical significance in difference of transfusion between two groups. Also, there was no difference in postoperative mechanical ventilation time, ICU time and length of stay postoperatively. The postoperative complications were similar between two groups. Postoperative patency rate of the RIMA graft was as high as 95.2%. The target vessels of RIMA included left anterior descending branch (45 cases), diagonal branch (19 cases), intermediate branch (12 cases). obtuse marginal or circumflex branch (16 cases), posterior descending branch (5 cases) and right coronary trunk (18 cases). 41 RIMA used as free grafts, 87 used as in situ grafts, of which 19 RIMA need lengthened by other graft vessels.Conclusion:The patency rate of RIMA graft is high and the application of RIMA do not increase the surgical risk significantly. However, there are versatile contour of RIMA grafts. It can be used as artery graft in selected patients.