PI3K/Akt, Wnt/β-catenin, TGF-β, Nrf2 and Notch signaling pathways are mainly involved in the TCM treatment of chronic refractory wounds (CRW). Chinese materia medica monomers and compound preparations can inhibit protein kinases related to signaling pathways in wound tissue and promote wound healing; reduce the expression of inflammatory factors and inhibit the occurrence of inflammatory response; promote the proliferation and differentiation of growth factors and epidermal stem cells, accelerate the regeneration of granulation tissue, and play a role in repairing wound regeneration.

Objective:To investigate the correlation between pulmonary ultrasound on pulmonary consolidation and T lymphocytes,cytokines in predicting the progression of neonatal pneumonia.Methods:A total of 80 pediatric patients with pulmonary consolidation,who admitted to neonatal ward of Beijing Chao-yang Hospital and were confirmed by the first ultrasound examination on lung from February 2021 to February 2023,were divided into study group,and 50 children,who underwent physical examination during the same period,were divided into control group.The cell subsets and cytokines between two groups were compared.The study group was further divided into mitigation group and progression group according to the disease conditions of pediatric patients of study group after they received 3 d treatment.Multifactor logistic regression was adopted to analyze the correlation among the T lymphocytes,cytokines and the progression of disease.Results:The CD3+,CD8+,CD4+/CD8+cell subsets of T lymphocytes and cytokines such as IL-17-A,TNF-α and ICAM-1 of study group were significantly higher than those of control group(t=16.483,4.933,4.113,22.933,22.433,19.525,P<0.05),respectively,and the CD4+level was significantly lower than that of control group(t=7.773,P<0.05).The CD3+cell subsets and cytokine levels such as IL-17A,TNF-α and ICAM-1 of progression group were significantly higher than those of mitigation group(t=6.815,4.631,4.307,P<0.05),however the CD4+level was significantly lower than that of mitigation group(t=3.044,P<0.05).The results of the multivariate Logistic regression analysis showed that the decrease of CD3+expression,the increase of IL-17A expression and the increase of the area of pulmonary consolidation were the risk factors of the progress of neonatal pneumonia(β=-0.176,0.777,0.931,P<0.05),respectively.The results of the Pearson-correlation analysis showed that CD3+was negative correlation with the progression of neonatal pneumonia(r=-0.295,P<0.001),however,the IL-17A and the area of pulmonary consolidation showed a positive correlation with the progression of neonatal pneumonia(r=0.677,0.517,P<0.001).Conclusion:The CD3+expression,IL-17A of peripheral blood and the area of pulmonary consolidation are significantly predictive factors of pneumonia progression,and are closely related to the progression of pneumonia.

In the development of chemo-immunotherapy, many efforts have been focusing on designing suitable carriers to realize the co-delivery of chemotherapeutic and immunotherapeutic with different physicochemical properties and mechanisms of action. Besides, rapid drug release at the tumor site with minimal drug degradation is also essential to facilitate the antitumor effect in a short time. Here, we reported a cancer cell membrane-coated pH-responsive nanogel (NG@M) to co-deliver chemotherapeutic paclitaxel (PTX) and immunotherapeutic agent interleukin-2 (IL-2) under mild conditions for combinational treatment of triple-negative breast cancer. In the designed nanogels, the synthetic copolymer PDEA-co-HP-β-cyclodextrin-co-Pluronic F127 and charge reversible polymer dimethylmaleic anhydride-modified polyethyleneimine endowed nanogels with excellent drug-loading capacity and rapid responsive drug-releasing behavior under acidic tumor microenvironment. Benefited from tumor homologous targeting capacity, NG@M exhibited 4.59-fold higher accumulation at the homologous tumor site than heterologous cancer cell membrane-coated NG. Rapidly released PTX and IL-2 enhanced the maturation of dendritic cells and quickly activated the antitumor immune response in situ, followed by prompted infiltration of immune effector cells. By the combined chemo-immunotherapy, enhanced antitumor effect and efficient pulmonary metastasis inhibition were achieved with a prolonged median survival rate (39 days).

Oral squamous cell carcinoma (OSCC) is the most common oral cancer. Previous studies have found significantly high miR-155 expression in OSCC. However, the mechanism by which miR-155 plays a role in OSCC oncogenesis is not yet clear. This article reviews the function of the relationship between miR-155 and tumors and the potential role of miR-155 in the development of OSCC. A literature review showed that mir-155, as a small carcinogenic RNA, can inhibit CDC73, BCL6, P27Kip1 and other target genes that play a role in cancer inhibition; promote the proliferation, migration and invasion of OSCC cells; and inhibit apoptosis. miR-155 can also be combined with biological factors (Epstein-Barr virus, human papillomavirus) to promote the development of OSCC.

Objective To evaluate the clinical efficacy of silybin combined with nucleotides in the treatment of viral hepatitis associated with nonalcoholic fatty liver disease (NAFLD).Methods 88 viral hepatitis patients with NAFLD were randomly selected into the clinical research,and they were divided into groups according to the order of treatment.Among them 44 cases of single number were the control group treated with nucleoside(acid) drugs,44 cases of double number were the observation group treated with silibinincombined silybin combined with nucleoside(acid).The therapeutic effect after the end of the course of treatment were was evaluated.Results The effective rate in the observation group was 90.91％,which that in the control group was 70.45％,the difference was statistically significant (x2 =8.87,P ＜ 0.05).The ALT,AST,r-GGT after treatment of the observation group were (37.14 ± 3.56) U/L,(30.45 ±3.35) U/L,(51.65 ± 3.46) U/L,which were significantly reduced than before treatment(t =8.01,8.72,7.80,all P ＜ 0.05),and the differences were significant compared with the control group (t =7.57,8.34,7.29,all P ＜ 0.05).The TG,TC of blood lipid indexes indices after treatment of the observation group were (1.48 ±0.26) mmol/L,(5.18 ± 0.86)mmol/L,which were significantly lower than those before treatment (t =7.62,8.14,all P ＜ 0.05),and the differences were significant compared with the control group (t =7.10,7.55,all P ＜ 0.05).Conclusion The combination of silybin and nucleotides in the treatment of viral hepatitis with NAFLD has significant effect,can significantly improve the clinical symptoms and liver function indicators,and gradually restore the level of blood lipids,it is worthy of promoting the application.

Objective To investigate the clinical and pathological features and prognostic factors for thymoma with myasthenia gravis (MG).Methods The clinical and pathological data of 126 patients with thymoma and MG confirmed by postoperative pathological examination from 2008 to 2014 were analyzed retrospectively.The Kaplan-Meier method was used to calculate survival rates;the log-rank test was applied for univariate prognostic analysis;the Cox regression model was applied for multivariate prognostic analysis.Results The numbers of patients who received the follow-up visits at 3 and 5 years were 88 and 45,respectively (the patients who were admitted before the end of October 2011 and the end of October 2009).The 3-and 5-year survival rates were 97.9％ and 91.8％,respectively.The 3-and 5-year survival rates for patients with WHO types A+AB+B1 +B2 and B3 were 98.6％/95.2％ and 90.6％/92.9％,respectively (P=0.764),and those for patients with Masaoka stages Ⅰ-Ⅱ and Ⅲ-Ⅳ were 98.6％/95.2％ and 97.4％/72.7％,respectively (P=0.791).The 3-and 5-year survival rates for patients with complete and partial resection were 97.8％/91.7％ and 100.0％/50.0％,respectively (P=0.964),and those for patients with complete resection alone and complete resection+postoperative radiotherapy were 96.8％/93.1％ and 100.0％/94.7％,respectively (P=1.000).Conclusions The major treatment modality for thymoma with MG is complete resection followed by radiotherapy according to the specific circumstances after surgery.Complete resection,postoperative radiotherapy,WHO type,and Masaoka stage may be associated with prognosis.

Abstract BACKGROUND: As an emerging technology, tissue-engineered skin has great application prospects. Keratinocyte growth factor (KGF) is proved to promote the proliferation of epidermal cels. OBJECTIVE: To evaluate the effect and characteristics of tissue-engineered skin carrying KGF nanocapsules in repairing skin defects of nude mice. METHODS:(1) The acelular dermal matrix loading KGF (KGF-ADM) was constructed. The human epidermal stem cel population and fibroblasts were captured and cultivated, and then identified. Epidermal stem cels were cultivated on the KGF-ADM and their growth was observed. The tissue-engineered skin loading KGF nanocapsules was transplanted onto the ful-skin defects on the back of nude mice compared with a blank group without keratinocyte growth factor nanocapsules and a control group with skin autograft. In 2, 4 and 6 weeks after transplantation, the contraction and histological healing of the skin were observed respectively. Then anti-human keratin 10-FITC and β1-integrin-Cy3 immunofluorescence were applied to detect the origin, growth and differentiation of stem cels in the epidermis and dermis. RESULTS AND CONCLUSION: The epidermal stem cel population grew wel on the surface of KGF-ADM and attached tightly. There were smal round epidermal stem cels and polygonal terminaly-differentiated cels, which presented with partly cloning growth and a tendency of merging into pieces. The results of tissue-engineered skin with KGF nanocapsules in repairing the skin defects were better than those of the blank group and the control group in 2, 4 and 6 weeks after transplantation. The transplanted skin could fuse with adjacent skin completely, but stil showed some contraction. Under the microscope, they showed good epidermis with layers and normal keratose stratum, and meanwhile, there were stil some β1-integrin+ cels at 8 and 10 weeks, which were epidermal stem cels or transient amplifying cels identified by immunofluorescence. These findings indicate that the tissue-engineered skin carrying KGF nanocapsules has good outcomes in repairing skin defects of nude mice, which is better than common tissue-engineered skin without KGF nanocapsules and autogeneous skin transplantation.

Objective To evaluate the safety and feasibility of endoscopic transumbilical thoracic sympathectomy.Methods The technique was performed in 4 swine models.Under general anesthesia,a newly developed long abdominal trocar (60 cm in lengths) was placed through the umbilicus,which was also used to establish pneumoperitoneum.After insertion of gastroscope through this trocar,two small incisions of diagrams were created by needle-knife,through which the gastroscope was sent into the thoracic cavity to ablate the T3 ganglia by Hot biopsy forceps under One-lung ventilation.The animals were killed at the completion of the procedure.Results This procedure was completed in four pigs.The sympathetic chain was successfully ablated in all swine,as confirmed by gross surgical pathology and histology,the mean operative time was (81.7 ±15.4) minutes.There was no major bleeding.All bilateral T3 sympathetic chains were successfully ablated in the 4 swines as confirmed by gross surgical pathology and histology.There was no severe bleeding and damage to peripheral organs during the operation in any of the cases,and no prominent pneumothorax was revealed by postoperative chest X-ray radiography.Conclusion Endoscopic transumbilical thoracic sympathectomy is safe,feasible and effective with good cosmetic result.

Objective To investigate the blood-saving effect of tranexamic acid in off-pump coronary artery bypass (OPCAB). Methods Two hundred and sixty ASA Ⅰ- Ⅲ and NYHA Ⅰ- Ⅲ patients of both sexes,aged 18-64 yr, with body mass index 16-22 kg/m2 , undergoing OPCAB, were randomly divided into 2 groups (n = 130 each): control group (group C) and tranexamic acid group (group T) . Anesthesia was induced with iv injection of midazolam 0.1 mg/kg, fentanyl 5-10μg/kg and pipecuronium 0.1 mg/kg. The patients were tracheal intubated and mechanically ventilated. PEr CO2 was maintained at 35-45 mm Hg. A bolus of tranexamic acid 1 g was infused intravenously within 30 min after indution followed by continuous infusion at 400 mg/h until the end of operation in group T. While equal volume of normal saline was given in control group. Anesthesia was maintained with inhalation of isoflurane and intermittent iv injection of fentanyl and pipecuronium. Venous blood samples were taken before induction, at the end of operation and at 24 h after operation for determination of Hb, platelet count (P1t), prothrombin time (PT) and international normalized ratio (INR). The volume of chest tube drainage was collected and recorded at 6 and 24 h after operation. The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was also recorded. Results There was no significant difference in Hb, Plt, PTand INR at each time point between the two groups ( P ＞ 0.05). The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was significantly reduced in group T as compared with group C ( P ＜ 0.05 or 0.01 ). No deaths and complications occurred during hospital stay in the two groups. Conclusion Tranexamic acid exerts the blood-saving effect in OPCAB.

Objective To explore the bone marrow pathology ,diagnosis and differential diagnosis of Waldenstrom macroglobulinemia(WM). Methods 19 WM patients was examined by bone marrow aspiration (BMA) and bone marrow biopsy (BMB) for morphology. Flow cytometry (FCM) and immunohistochemistry (IHC) for immunophenotyping. Results Plasmacytoid lymphocytes were identified in 11 BMA. All of 19 BMB were involved by lymphoma cells. 17 cases showed a predominance of small lymphocytes and 2 of plasmacytoid lymphocytes. Typically plasmacytoid lymphocytes were not seen in 4 cases. Patterns of bone marrow involvement were as follow: diffuse (12 cases), nodular (4 cases), interstitial (3 cases). Immunophenotypically, FCM showed all cases were CD_(19)~+, CD_(20)~+, CD_(22)~+, CD_5~- and CD_(10)~-. IHC revealed small lymphocytes and plasmacytoid lymphocytes were Pax5~+ CD_(20)~+ and plasma cells were CD_(38) CD_(138)~+ CD_(20)~- Pax5~-. Conclusion Small lymphocytes proliferation with plasmacytic differentiation is the typical bone marrow pathologic features of WM. IHC is benefit for identifying lymphocytes and plasma cells components. The Combination of morphology, FCM and IHC is contributive to the diagnosis and differentiation of WM.