Objective To investigate the different operative style for the intraspinal extramedullary neoplasms in the cervical vertebrae as well as evaluate the clinical effect of titanium net for spinal canal reconstruction and bone autograft after laminectomy. Methods Since March 2002 to September 2008, 26patents (14 men, 12 women) with the intraspinal extramedullary neoplasm in the cervical vertebrae. The average age was 38 years (range, 6-76 yr). According to Frankel classification, there were 26 cases for grade B before operation, 8 cases for grade C, 11 for grade D, and 4 for grade E. All patients underwent hemilaminectomy (as group HL) or total laminectomy combined with spinal canal reconstruction with titanium net (as group TL). Recovery of nerve function and bone fusion were recorded. Preoperative and postoperative cervical curvature index and ranges of neck motion were recorded and compared. Results Among the 3cases with incomplete paraplegia, neurological status ameliorated from Frankel grade B to C; 8 cases of Frankel grade C recovered to grade D; 11 cases of Frankel grade D improved to grade E in 10 cases and 1to grade D. Bone fusion was formed on the titanium net and spinal stability was well after operation. Loss of cervical curvature indices was 2.2±2.3 in group HL and 4.3±2.5 in group of TL, and the difference was of statistically significant (t=2.05,P＜0.05). At the same time, loss of ranges of neck motion was 1.3°±1.2°ingroup of HL and 9.2°±4.1°in group TL, significant difference was also seen (t=1.71 ,P＜ 0.05). Conclusion Hemi-laminectomy approach to intradural lesions lends itself well to eccentric tumors with smaller size. For the cases of total laminectomy, it is necessary and reliable to reconstitute integrity of spinal canal with titanium net and bone autograft.

Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.

Objective To study the effect ofTiaomai-Yin with the therapy method of clearing heat and cooling blood to treat the tachyarrhythmia with the TCM patterns of deficiency of Qi and Yin, and heat of blood stasis.MethodsA total of 60 patients with tachyarrhythmia were randomly recruited into a control group and a treatment group, 30 patients in each. The treatment group was treated withTiaomai-Yin, while the control group was treated with Metoprolol. After both groups were treated for one month, the changes of TCM symptoms, ECG and 24 h DCG were observed.Results The total effective rate of the treatment groups was significantly better than the control group(86.67%vs. 56.67%;χ2=7.957,P<0.05).Tiaomai-Yin significantly improve the symptoms of shortness of breath (1.40 ± 2.11vs. 2.10 ± 1.87;t=-3.341,P<0.01), tiredness (1.30 ± 2.33vs. 2.10 ± 1.84;t=-3.262,P<0.01), dry mouth (0.09 ± 1.34vs. 2.50 ± 2.41;t=-3.194,P<0.01), and tongue (1.90 ± 1.65vs. 3.90 ± 1.81;t=-3.217,P<0.01) and pulse (2.60 ± 1.71vs. 5.10 ± 2.55;t=-3.283,P<0.01).ConclusionTiaomai-Yin had effects in treating tachyarrhythmia with the TCM patterns of deficiency of Qi and Yin, and heat of blood stasis with improvement of symptoms and fewer side effects.

OBJECTIVE To investigate the blocking activities of a series of potential α1-adrenoceptor (α1-AR) antagonists (Compounds B1 -B9) on α1-AR.METHODS ① A series of potential α1-adrenoceptor (α1-AR) antagonists,indolylpiperidine derivative (IPD) and Compounds B1 -B9,with indolylpiperidine moiety and different substitutes were synthesized through the coupling of indolylpiperidine and piperazine derivatives.② Inotropic responses experiment was used to examine blocking effects of IPD and Compounds B1 - B9 in isolated rat atria by phenylephrine (PE) stimulation.③ Blocking effect of IPD and Compounds B1 - B9 on phosphorylation level of extracellular signal-regulated kinase (ERK) in PE treated HEK293 cells was tested by Western blotting.RESULTS ① Potential α1-adrenoceptor (α1-AR) antagonists with indolylpiperidine moiety and different substitutes were synthesized successfully.② PE caused a dose-dependent inotropic response which was inhibited by pre-incubation of phentolamine (Phen),a non-selective α1-AR antagonist,IPD and Compounds B1,B3,B4,B7,B8 and B9,respectively; IPD and Compounds B4 and B8 caused an obvious rightward shift of inotropic response-curve,the pA2 values for IPD and Compounds B4 and B8 were 6.72 ± 0.21,6.86 ± 0.29 and 6.67 ± 0.19,respectively.③ Phosphorylation level of ERK1/2 was inhibited by pre-incubation with Compounds B1,B2,B3,B5,B6,B7,B8 and B9 or IPD in PE treated α1A-AR stably expressed HEK293 cells; PE-stimulated phosphorylation level of ERK1/2 was inhibited by pre-incubation with Compounds B2,B4,B7 or B8 in α1B-AR stably expressed HEK293 cells.CONCLUSION Compound B4 has a selective blocking activity on α1B-AR,and Compounds B1,B3,B5,B6 and B9 or IPD have a selective blocking activity on the phosphorylation level of ERK1/2.

Objective:To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) therapy in the primary prevention of concurrent chemoradiotherapy-induced neutropenia.Methods:In this single-center, open-label, single-arm clinical observation, the efficacy of PEG-rhG-CSF in the primary prevention of neutropenia after concurrent chemoradiotherapy in 58 patients admitted to Tianjin Medical University Cancer Institute and Hospital from June 2018 to June 2019 was evaluated.Results:During the whole concurrent chemoradiotherapy, chemotherapy delay occurred in 6 patients (10%). Three patients (5%) had delayed concurrent chemotherapy due to leukopenia or neutropenia. The completion rate of chemotherapy cycle was 94.6%(106/112). Radiotherapy delay occurred in 10 patients (17%) including 2 patients (3%) of delayed radiotherapy due to leukopenia or neutropenia. No patient developed febrile neutropenia (FN). Subgroup analysis found that after completing 1 cycle of concurrent chemoradiotherapy, the incidence rates of grade 4 leukopenia and neutropenia were both 0. After completing 2 cycles of concurrent chemoradiotherapy, the incidence rates of grade 4 leukopenia and neutropenia were 0 and 2%.Conclusion:During the chemoradiotherapy, application of PEG-rhG-CSF in the primary preventation can significantly reduce the incidence of FN, grade 4 leukopenia and neutropenia, which is beneficial to ensure the smooth progress of concurrent chemoradiotherapy.

Objective To compare two separation medium of isolation of adult rat cardiomyocytes , and to observe the characteristics of excitation-contraction coupling of cardiomyocytes .Methods The isolated adult rat heart was hanged on to the Langendorff apparatus for aortic counter-current perfusion and collagenase digestion using two different separation medium.The single cardiomyocytes were cultured and infected with adenovirus . The morphological features of cardiomyocytes were observed with microscope and fluorescent microscope . The shortening-re-lengthening features of sarcomere and the intake-discharge features of calcium were simultaneously recorded by IonOptix equipment .Results 70%rod-shaped with clear-striation adult rat cardiomyocytes could be obtained with the stated two separation medium and cultured in serum-free medium for more than 7 days.GFP could express more than 7 days when the cardiomyocytes were infected with adenovirus .Cardiomyocytes obtained by the first separation medium could not contract with the electrical stimulation, while cardiomyoctyes obtained by the second separation medium could be used for the detection of excitation -contraction coupling .The shortening fraction of sarcomere was 11.61%±2.15% and the relaxing time was ( 0.177 ± 0.031) s.The amplitude of calcium transient was 30.79% ±9.74 % and the decaying time of calcium transient was (0.300 ±0.074) s.Conclusion With the stated two separation medium , adult rat cardiomyocytes can be well isolated , cultured and infected with adenovirus .The second separation medium can be used for the detection of excitation-contraction coupling characteristics .

The "Clinical Practice Guidelines for Hypertension in China", released in 2022, has lowered the diagnostic criteria for hypertension. However, no adjustments were made to the diagnostic criteria for hypertension during pregnancy. The impact of adult hypertension diagnostic criteria on the diagnosis of gestational hypertension and pregnancy outcomes remains unclear. Borderline hypertension includes elevated blood pressure and stage 1 hypertension. Compared to pregnant women with normal blood pressure, women with borderline hypertension have an increased risk of adverse pregnancy outcomes. Still, there are no associated guidelines for pregnancy management for now. This article explores the influence of borderline hypertension on pregnancy outcomes and the optimal level for blood pressure control during pregnancy, aiming to improve maternal and fetal outcomes and optimize the management of borderline hypertension during pregnancy.

Objective To purify native F1 antigen from E pestis EV76 strain and determine its ef-ficacy against Y. pestis. Methods A new purification method was developed by the substitution of physical disruption ( glass beads) for organic solvent ( acetone and toluene) one, followed by a combination of ammo-nium sulfate fractionation and SephacrylS-200HR column filtration chromatography. Groups of mice were im-munized with F1 antigen adsorbed to 25% aluminum hydroxide in PBS by intramuscular route. The immu-nized animals were challenged subeutaneously(s, c. ) with 104 CFU of Y. pestis strain 141 at 18 weeks after the primary immunization. Results There was no IgG titre difference between two groups of mice with one-dose immunization, whereas in the two-dose immunization groups, the group F1-40 μg induced a statistically higher antibody titre than the group F1-20 μg. Complete protection was observed for animals immunized with purified F1 antigen by s.c. route. In contrast, the control mice immunized with aluminum hydroxide suc-cumbed to a same dose of Y. pestis 141 challenge. Conclusion This purification strategy is a simple and ef-fective, and can be operated in a large scale. Native F1 antigen extracted from Y. pestis EV76 is highly im-munagenic, and can be used as a key antigen component to develop sub-unit vaccine of plague.

Objective To evaluate the clinical results of the Ilizarov technique for the treatment of the complex rigid talipes equinovarus deformities.Methods From July 2005 to July 2011,28 patients (41 feet) with rigid talipes equinovarus deformities which had been corrected with the Ilizarov technique were retrospectively analyzed,including 18 males (26 feet) and 10 females (15 feet) with an average age of 15.3 years.According to the classification system proposed by Diméglio,31 feet were categorized as grade Ⅲ,and 10 as grade Ⅳ.We performed corrections with a soft tissue release in 23 feet,and with a limited osteotomy in 18,and then a Ilizarov external fixator was applied.Anteroposterior and lateral X-rays were taken to compare the pre and postoperative data in terms of the angle of plantarflexion and dorsiflexion,the range of motion of the ankle joint,radiological measurements of the talocalcaneal angle.Results All the 28 patients achieved an outpatient follow-up,with an average of 25 months.All patients achieved a plantigrade foot with an almost normal appearance as the fixator was removed after applied for an average of 5.1 months (range,2-14).At the preoperative and final follow-up respectively,the angle of dorsiflexion of the foot was -45.0°±12.0° and 9.5°±5.5°,the angle of plantarflexion was 67.0°±14.0° and 45.5°±7.8°,talocalcaneal angle was 6.5°±4.5° and 22.5°±5.5° in anteroposterior radiograph and 5.5°±11.0° and 40.6°±8.5° in lateral radiograph.Spastic ischemia occurred in one foot and relieved by a slower distraction rate.Wire-hole infections occurred in 5 feet and treated by dressing changs,wire tract altering and antibiotic therapy,finally the infections were controlled.Deformity relapsed in one foot three months after the device was removed,then corrected with an additional fixator application and has not recurred till the final follow-up.Toe contracture and residual deformity occurred in 5 feet and 3 feet,respectively.Conclusion The Ilizarov technique is an effective method for correction of complex rigid talipes equinovarus deformities,with which the appearance and function of the foot could be kept as much as possible,and without impact on food development.

Objective To investigate the risk factors of polytrauma combined with multiple organ dysfunction syndrome (MODS).Methods A retrospective case control study was performed on the clinical data of 299 polytrauma patients admitted to the Affiliated Hospital of Jiangsu University from December 2011 to June 2017.The collected information included gender,age,length of hospital stay,number of injured parts,injury severity scores (ISS),neutrophil count,leukocyte level,hemoglobin level,platelet count,activated partial thromboplastin time (APTI),and D-dimer level within 24 hours since admission.In addition,shock within 24 hours since admission,infection after 3 days since admission,damage control surgery,underlying diseases and prognostic outcomes were also recorded.All the patients were divided into MODS group (94 patients) and non-MODS group (205 patients).Univariate and multivariate logistic regression analyses were used to determine the risk factors of polytrauma combined with MODS.Receiver operating characteristic (ROC) curve was applied to further analyze those risk factors identified by the former analyses.Results In the univariate analysis,there were statistically significant differences between the two groups in the number of injured parts,ISS,hemoglobin level,platelet count,APTT,D-dimer level within 24 hours since admission,shock within 24 hours since admission,infection after 3 days since admission,damage control surgery and prognostic outcomes (P ＜ 0.05).No significant differences were found in gender,age,underlying disease,length of hospital stay,neutrophil level,the leukocyte level within 24 hours since admission between the two groups (P ＞ 0.05).The multivariate logistic regression analysis showed that ISS (OR =1.048),shock within 24 hours since admission (OR =3.913),infection after 3 days since admission (OR =27.715),and D-dimer level within 24 hours since admission (OR =1.015) were significantly associated with polytrauma combined with MODS (P ＜ 0.05).In addition,the area under ROC curve of ISS was 0.726 (95 ％ CI 0.667-0.784),and the area under ROC curve of D-dimer was 0.638 (95％ CI 0.571-0.706).Conclusions The risk factors of polytrauma patients combined with MODS include ISS,infection after 3 days since admission,D-dimer level and shock within 24 hours since admission.In the treatment of polytrauma patients,attention should be paid to assessment of injury severity and coagulation function,active resuscitation to correct shock,prevent and control infection,which can reduce and prevent the risks for polytrauma patients combined with MODS.