Objective:To compare the efficacy of internal brace-augmeted reconstruction combined with tape tail-folding anterolateral ligament reconstruction (ALL) and isolated internal brace-augmented reconstruction for high-grade pivot-shift anterior cruciate ligament (ACL) injuries.Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with high-grade pivot-shift ACL injuries who were admitted to 910th Hospital of Joint Logistics Support Force of PLA between March 2021 and March 2023, including 48 males and 12 females, aged 18-40 years [(28.4±5.6)years]. All ACL injuries were at grade III. The pivot-shift test results were classified as grade 2 in 42 patients and grade 3 in 18. According to the surgical technique, 30 patients underwent artificial internal brace-augmented ACL reconstruction combined with tape tail-folding ALL reconstruction (joint ACL reconstruction group), while the other 30 received isolated internal brace-augmented ACL reconstruction (simple ACL reconstruction group). The two groups were compared in terms of operative duration, intraoperative blood loss, improvement rate of pivot-shift at 3 months postoperatively, rate of sports function recovery at the last follow-up, Tegner and Lysholm scores preoperatively, at 3 months postoperatively, and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 6-24 months [(14.8±5.8)months]. The operative duration and intraoperative blood loss were (44.6±8.2)minutes and (45.3±4.6)ml in the simple ACL reconstruction group, significantly shorter or less than (58.0±7.4)minutes and (61.8±9.1)ml in the joint ACL reconstruction group ( P<0.01). At 3 months after surgery, the improvement of pivot-shift test was 93%(28/30) in the joint ACL reconstruction group, higher than 73%(22/30) in the simple ACL reconstruction group ( P<0.05). At the last follow-up, the recovery rate of motor function was 100%(30/30) in the joint ACL reconstruction group, significantly higher than 80%(24/30) in the simple ACL reconstruction group ( P<0.05). There were no statistically significant differences in Tegner or Lysholm scores between the two groups before surgery ( P>0.05). At 3 months after surgery and at the last follow-up, the Tegner scores were (3.8±0.5)points and (5.7±1.1)points in the joint ACL reconstruction group, significantly higher than (2.5±0.6)points and (3.9±0.9)points in the simple ACL reconstruction group ( P<0.01). At 3 months after surgery and at the last follow-up, the Lysholm scores were (67.2±5.7)points and (89.4±6.4)points in the joint ACL reconstruction group, significantly higher than (56.4±5.0)points and (72.6±5.7)points in the simple ACL reconstruction group ( P<0.01). Both groups demonstrated gradual improvement in Tegner and Lysholm scores at all postoperative time points, compared to preoperative values ( P<0.05). After operation, one patient in the joint ACL reconstruction group had superficial tibial infection, with a complication rate of 3% (1/30), whereas there was one patient with superficial tibial infection, and one with ligament injury in the simple ACL reconstruction group, with a total complication rate of 7% (2/30)( P<0.05). Conclusion:For high-grade pivot-shift ACL injuries, internal brace-augmented reconstruction combined with tape tail-folding ALL reconstruction can significantly improve knee rotational stability, promote motor function recovery, and enhance knee joint outcomes, compared to isolated internal brace-augmented reconstruction.

Objective:To compare the efficacy of internal brace-augmeted reconstruction combined with tape tail-folding anterolateral ligament reconstruction (ALL) and isolated internal brace-augmented reconstruction for high-grade pivot-shift anterior cruciate ligament (ACL) injuries.Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with high-grade pivot-shift ACL injuries who were admitted to 910th Hospital of Joint Logistics Support Force of PLA between March 2021 and March 2023, including 48 males and 12 females, aged 18-40 years [(28.4±5.6)years]. All ACL injuries were at grade III. The pivot-shift test results were classified as grade 2 in 42 patients and grade 3 in 18. According to the surgical technique, 30 patients underwent artificial internal brace-augmented ACL reconstruction combined with tape tail-folding ALL reconstruction (joint ACL reconstruction group), while the other 30 received isolated internal brace-augmented ACL reconstruction (simple ACL reconstruction group). The two groups were compared in terms of operative duration, intraoperative blood loss, improvement rate of pivot-shift at 3 months postoperatively, rate of sports function recovery at the last follow-up, Tegner and Lysholm scores preoperatively, at 3 months postoperatively, and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 6-24 months [(14.8±5.8)months]. The operative duration and intraoperative blood loss were (44.6±8.2)minutes and (45.3±4.6)ml in the simple ACL reconstruction group, significantly shorter or less than (58.0±7.4)minutes and (61.8±9.1)ml in the joint ACL reconstruction group ( P<0.01). At 3 months after surgery, the improvement of pivot-shift test was 93%(28/30) in the joint ACL reconstruction group, higher than 73%(22/30) in the simple ACL reconstruction group ( P<0.05). At the last follow-up, the recovery rate of motor function was 100%(30/30) in the joint ACL reconstruction group, significantly higher than 80%(24/30) in the simple ACL reconstruction group ( P<0.05). There were no statistically significant differences in Tegner or Lysholm scores between the two groups before surgery ( P>0.05). At 3 months after surgery and at the last follow-up, the Tegner scores were (3.8±0.5)points and (5.7±1.1)points in the joint ACL reconstruction group, significantly higher than (2.5±0.6)points and (3.9±0.9)points in the simple ACL reconstruction group ( P<0.01). At 3 months after surgery and at the last follow-up, the Lysholm scores were (67.2±5.7)points and (89.4±6.4)points in the joint ACL reconstruction group, significantly higher than (56.4±5.0)points and (72.6±5.7)points in the simple ACL reconstruction group ( P<0.01). Both groups demonstrated gradual improvement in Tegner and Lysholm scores at all postoperative time points, compared to preoperative values ( P<0.05). After operation, one patient in the joint ACL reconstruction group had superficial tibial infection, with a complication rate of 3% (1/30), whereas there was one patient with superficial tibial infection, and one with ligament injury in the simple ACL reconstruction group, with a total complication rate of 7% (2/30)( P<0.05). Conclusion:For high-grade pivot-shift ACL injuries, internal brace-augmented reconstruction combined with tape tail-folding ALL reconstruction can significantly improve knee rotational stability, promote motor function recovery, and enhance knee joint outcomes, compared to isolated internal brace-augmented reconstruction.

Objective To predict the core targets and action pathways of Hedysari Radix based on UPLC-MS/MS and network pharmacology methods,and to verify the results of network pharmacology by molecular docking and molecular dynamics techniques.This article aims to investigate immune regulation mechanism of effective components absorbed into blood from Hedysari Radix.Methods Qualitative quantification of effective components absorbed into blood from Hedysari Radix were operated by using UPLC-MS/MS technique.The corresponding targets of effective components absorbed into blood from Hedysari Radix were screened by TCMSP and HERB databases.Targets of immune-related disease were obtained through DisGeNET,OMIM,TTD,and MalaCards databases.The network of"components absorbed into blood from Hedysari Radix-immune-related diseases"was then constructed.GO and KEGG enrichment analysis and mapped the PPI network were performed.Molecular docking and molecular dynamics techniques were applied for validation.Results A total of 8 prototype components absorbed into blood,synergistically acting on 101 targets,were identified by UPLC-MS/MS.They mediated 538 biological processes including immune response,positive regulation of gene expression,receptor binding,and cytokine activity.Meanuhile,116 signaling pathways,such as HIF-1,Toll-like receptor,JAK-STAT,T cell receptor,PI3K-Akt,and FoxO etc.were involved.The core targets were MAPK14,PTGS2,MMP9,PPARG,CCND1,etc..The results of molecular docking showed that formononetin and calycosin had strong docking binding activity with MAPK14.And molecular dynamics simulations further demonstrated that the binding between MAPK14 and formononetin or calycosin had good structural stability and binding affinity.Conclusion The results of serum pharmacochemistry,network pharmacology and molecular dynamics were verified to reveal the material basis and mechanism of Hedysari Radix in regulating immunity.The aim of this study is to provide scientific basis for its immunomodulatory mechanism.

Objective:To investigate the influence of circ_BACH2 on the malignant biological behavior of papillary thyroid cancer and its molecular mechanism.Methods:Cancer tissues and paracancer tissues of 51 patients with papillary thyroid carcinoma from the Fourth Central Hospital of Tianjin between 2017 and 2019 were collected. Reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expressions of circ_BACH2, miR-370-3p and G protein coupled receptor kinase interacting factor 1 (GIT1) mRNA in tissues and cells; flow cytometry to detect cell apoptosis and cell cycle; plate clone formation experiment to detect the number of cell clones; cell counting kit 8 (CCK-8) to detect cell proliferation; Transwell array to detect cell migration and invasion; western blot to detect protein expressions; dual luciferase report experiment to detect the targeting relationship between circ_BACH2, miR-370-3p and GIT1; the nude mouse tumor formation experiment to detect the effect of circ_BACH2 on tumors in mice.Results:Compared with adjacent tissues, the expressions of circ_BACH2 and GIT1 in papillary thyroid cancer tissues was increased, while the expression of miR-370-3p was decreased. Compared with Nthy-ori3-1 cells, the expressions of circ_BACH2 in papillary thyroid cancer cells TPC-1 and SW579 were increased, the mRNA and protein levels of GIT1 were increased, miR-370-3p expression was decreased. The expression level of GIT1 mRNA was negatively correlated with that of miR-370-3p ( r=-0.634), and the expression level of circ_BACH2 was positively correlated with that of GIT1 ( r=0.635). The expression level of circ_BACH2 was negatively correlated with that of miR-370-3p ( r=-0.394, P＜0.05). Circ_BACH2 and miR-370-3p has a binding site at the 3' UTR of GIT1. After knocking down circ_BACH2, the proportion of G 0/G 1 cells in papillary thyroid cancer cells TPC-1 and SW579 was increased, the proportion of S-phase cells was decreased and the proportion of G 2/M-phase cells did not change significantly. The cell absorbance value was lower than that in si-NC group. The number of cell clone formation was decreased (43±5 vs 100±6, 54±8 vs 100±9); the cell apoptosis rate was increased [(19.60±2.40)% vs (4.30±0.20)%, (18.10±2.10)% vs (5.10±0.23)%]; cell migration number was decreased (61±7 vs 134±15, 58±6 vs 112±11), the invasion number was also decreased (45±6 vs 113±11, 47±4 vs 92±9); the expressions of Snail and Twist1 were decreased, and the expression of E-cadherin was increased ( P＜0.000). Inhibition of miR-370-3p expression reversed the effect of circ_BACH2 knockdown on proliferation, migration, invasion and apoptosis of thyroid papillary cancer cells. Overexpression of GIT1 reversed the effects of overexpression of miR-370-3p on proliferation, migration, invasion and apoptosis of thyroid papillary cancer cells. Mice injected with TPC-1 cells stably transfected with sh-circ_BACH2 showed a reduction in tumor volume [(535±91) mm 3 vs (857±114) mm 3] after 35 days of culture; tumor weight was decreased [(0.62±0.13) mg vs (1.06±0.15) mg, P＜0.05]; the expressions of circ_BACH2 and GIT1 were decreased, and the expression of miR-370-3p was increased in nude mouse tumor tissue. Conclusion:Silencing circ_BACH2 may inhibit the proliferation, migration and invasion of papillary thyroid cancer cells in vitro, promote cell apoptosis, and inhibit tumor growth in vivo through targeted regulation of miR-370-3p/GIT1.

Objective:To investigate the influence of circ_BACH2 on the malignant biological behavior of papillary thyroid cancer and its molecular mechanism.Methods:Cancer tissues and paracancer tissues of 51 patients with papillary thyroid carcinoma from the Fourth Central Hospital of Tianjin between 2017 and 2019 were collected. Reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the expressions of circ_BACH2, miR-370-3p and G protein coupled receptor kinase interacting factor 1 (GIT1) mRNA in tissues and cells; flow cytometry to detect cell apoptosis and cell cycle; plate clone formation experiment to detect the number of cell clones; cell counting kit 8 (CCK-8) to detect cell proliferation; Transwell array to detect cell migration and invasion; western blot to detect protein expressions; dual luciferase report experiment to detect the targeting relationship between circ_BACH2, miR-370-3p and GIT1; the nude mouse tumor formation experiment to detect the effect of circ_BACH2 on tumors in mice.Results:Compared with adjacent tissues, the expressions of circ_BACH2 and GIT1 in papillary thyroid cancer tissues was increased, while the expression of miR-370-3p was decreased. Compared with Nthy-ori3-1 cells, the expressions of circ_BACH2 in papillary thyroid cancer cells TPC-1 and SW579 were increased, the mRNA and protein levels of GIT1 were increased, miR-370-3p expression was decreased. The expression level of GIT1 mRNA was negatively correlated with that of miR-370-3p ( r=-0.634), and the expression level of circ_BACH2 was positively correlated with that of GIT1 ( r=0.635). The expression level of circ_BACH2 was negatively correlated with that of miR-370-3p ( r=-0.394, P＜0.05). Circ_BACH2 and miR-370-3p has a binding site at the 3' UTR of GIT1. After knocking down circ_BACH2, the proportion of G 0/G 1 cells in papillary thyroid cancer cells TPC-1 and SW579 was increased, the proportion of S-phase cells was decreased and the proportion of G 2/M-phase cells did not change significantly. The cell absorbance value was lower than that in si-NC group. The number of cell clone formation was decreased (43±5 vs 100±6, 54±8 vs 100±9); the cell apoptosis rate was increased [(19.60±2.40)% vs (4.30±0.20)%, (18.10±2.10)% vs (5.10±0.23)%]; cell migration number was decreased (61±7 vs 134±15, 58±6 vs 112±11), the invasion number was also decreased (45±6 vs 113±11, 47±4 vs 92±9); the expressions of Snail and Twist1 were decreased, and the expression of E-cadherin was increased ( P＜0.000). Inhibition of miR-370-3p expression reversed the effect of circ_BACH2 knockdown on proliferation, migration, invasion and apoptosis of thyroid papillary cancer cells. Overexpression of GIT1 reversed the effects of overexpression of miR-370-3p on proliferation, migration, invasion and apoptosis of thyroid papillary cancer cells. Mice injected with TPC-1 cells stably transfected with sh-circ_BACH2 showed a reduction in tumor volume [(535±91) mm 3 vs (857±114) mm 3] after 35 days of culture; tumor weight was decreased [(0.62±0.13) mg vs (1.06±0.15) mg, P＜0.05]; the expressions of circ_BACH2 and GIT1 were decreased, and the expression of miR-370-3p was increased in nude mouse tumor tissue. Conclusion:Silencing circ_BACH2 may inhibit the proliferation, migration and invasion of papillary thyroid cancer cells in vitro, promote cell apoptosis, and inhibit tumor growth in vivo through targeted regulation of miR-370-3p/GIT1.

In the procurement management of public hospitals, the proposal of procurement demands and the formulation of procurement budgets are completed by different departments, which can easily lead to the generation of ineffective demands. Strengthening procurement demand management has become an important management direction to promote cost reduction and efficiency increase in hospitals. The authors established a procurement demand management mechanism for public hospitals based on the KANO model. The procurement demands of public hospitals were identified according to basic, expected, charismatic, indifference, and reverse types. Then, a demand satisfaction principle that conforms to the hospital resource allocation principle was formulated, and the demand satisfaction process was supervised by establishing a risk sharing mechanism, selecting qualified decision agents, and establishing a process constraint mechanism. A certain hospital has been implementing procurement demand management practices based on this management mechanism since 2022, effectively strengthening the awareness of procurement demand management, improving the efficiency of resource allocation decision-making and the role of demand traction. This can provide reference for the procurement demand management of public hospitals.

This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.

Malignant tumors are one of the main causes of human death worldwide and pose a serious threat to human health. The current treatment methods are mainly the combination of chemotherapeutics， surgery， radiotherapy， or hormone therapy. The treatment process has limitations such as multidrug resistance， non-selective targeting of cancer cells， and drug toxicity. With the development and application of traditional Chinese medicine （TCM）， Chinese medicine has the characteristics of multi-angle and multi-mechanism coordination and slight toxic and side effects. It can effectively inhibit tumor proliferation， differentiation， and metastasis， and avoid drug resistance， serving as the focus of current tumor treatment research. Hedysari Radix， one of the genuine medicinal materials in Gansu province， is a tonic Chinese medicine with a wide range of pharmacological effects such as anti-inflammation， immune regulation， anti-oxidation， prevention and treatment of diabetic complications. In the majority of the ancient works on herbs of the past dynasties， Hedysari Radix was included under the item of Astragali Radix and used as Astragali Radix. Hedysari Radix is superior to Astragali Radix in enhancing immunity， scavenging free radicals， and resisting liver fibrosis. Studies have found that the effective components of Hedysari Radix have a prominent anti-tumor effect and a significant inhibitory effect on various malignant tumors such as liver cancer， bladder cancer， gastric cancer， breast cancer， and colorectal cancer. They can also combine with clinical anti-cancer drugs to reduce the toxic and side effects of chemotherapy drugs and improve the tolerance of patients during chemotherapy. On the basis of current research， this study summarized the mechanism of Hedysari Radix active components in inducing cell apoptosis， blocking cell cycle， inhibiting tumor cell proliferation， migration， and invasion， regulating micro mRNA （miRNA）， inducing cell autophagy， enhancing immune regulation， as well as reducing toxicity and enhancing efficiency and sensitization with clinical chemotherapeutics， and systematically explained the anti-tumor mechanism of Hedysari Radix active components， aiming to provide a basic reference for the further exploration of the anti-tumor mechanism of Hedysari Radix and the further development and utilization of its effective components.

Gallbladder-duodenal fistula is a rare disease in clinical practice, and difficult to diagnosis. One patient with high suspicion of gallbladder-duodenal fistula in preoperative examination was performed with percutaneous transhepatic gallbladder drainage due to could not tolerate surgical operation, and gallbladder-duodenal fistula was diagnosed with the gastric and intestinal fluids extracted from the drainage tube. In the later of fistula repair and the patient′s nutritional support management, the jejunal nutrition tube is inserted through the bile duct, and then the nutrition support was performed through this jejunal nutrition tube. This patients was recovered well.

OBJECTIVE: To explore the value of interferon-inducible protein 10 (IP-10) in the auxiliary diagnosis of tuberculosis and the judgment of the severity of disease. METHODS: From February, 2013 to February, 2017, a total of 193 patients with TB admitted in our hospital and 84 healthy control subjects were recruited consecutively. The peripheral blood plasma levels of interferon-γ (IFN-γ) and IP-10 were detected using liquid phase chip (Luminex) technique. According to the number of lung fields affected by TB, the patients were divided into group A (with lesions in 1-2 lung fields), group B (3-4 lung fields) and group C (5-6 lung fields), The expressions of IFN-γ and IP-10 in 3 groups were compared. RESULTS: The plasma levels of IP-10 were significantly higher in TB patients than in the control subjects ( < 0.05), but IFN-γ levels were comparable between the two groups ( > 0.05). Among the TB patients, plasma IP-10 levels was the highest in group C ( < 0.05), and IFN-γ levels did not differ significantly among the 3 groups ( > 0.05). CONCLUSIONS Plasma IP-10 has a certain reference value in the auxiliary diagnosis of active tuberculosis and the judgment of the severity of the disease.
Antigens, Bacterial ; Biomarkers ; blood ; Chemokine CXCL10 ; blood ; Humans ; Tuberculosis, Pulmonary ; blood ; diagnosis