A new type of anti-slip drainage tube that was supported by pancreatic duct was designed,which consisted of an inner tube and an outer tube,and the nested design was adopted for inner tube and outer tube. The outer wall of the outer tube was designed with an anti-slip piece. The expansion part of the inner tube head and the device of limiting location at the end of the outer tube can prevent complete separation of inner tube and outer tube when relative displacement occurred between inner tube and outer tube,and can ensure the sealing property of them. In the excision surgery of pancreas and duodenum,the new placed support tube of pancreatic duct can effectively prevent pancreatic fistula and stenosis of anastomotic site between pancreas and intestines,and significantly reduce the incidence of postoperative pancreatic fistula and other serious complications of surgery for pancreas and duodenum,which can help patients to recover quickly.

A new type of anti-slip drainage tube that was supported by pancreatic duct was designed,which consisted of an inner tube and an outer tube,and the nested design was adopted for inner tube and outer tube. The outer wall of the outer tube was designed with an anti-slip piece. The expansion part of the inner tube head and the device of limiting location at the end of the outer tube can prevent complete separation of inner tube and outer tube when relative displacement occurred between inner tube and outer tube,and can ensure the sealing property of them. In the excision surgery of pancreas and duodenum,the new placed support tube of pancreatic duct can effectively prevent pancreatic fistula and stenosis of anastomotic site between pancreas and intestines,and significantly reduce the incidence of postoperative pancreatic fistula and other serious complications of surgery for pancreas and duodenum,which can help patients to recover quickly.

Objective:To evaluate the value of ultrasonography in evaluating the influential factors of early insufficient flow after central venous catheter placement in dialysis patients.Methods:Three hundred and twenty seven hemodialysis patients who underwent central venous catheterization at the Affiliated Hospital of Chengde Medical College from May 2016 to June 2019 were selected. According to the catheter flow, the patients were divided into the low catheter flow group(43 cases) and the normal catheter flow group(284 cases). The distribution variance of clinical features(age, gender, blood pressure) were compared and whether some ultrasonic parameters(position of catheter tip, left ventricular ejection fraction, left atrial end-systolic diameter, left ventricular end-diastolic diameter, distance from the catheter tip to superior vena cava beyond right atrial opening) had influence on the insufficient catheter flow in the early stage between the two groups were analyzed.Results:The differences of left ventricular ejection fraction, left atrial end-systolic diameter and position of catheter tip between the two groups were statistically different( P<0.05). However, univariate and multivariate analyses showed that there were significant differences in catheter tip approaches and touches the wall of right atrium( OR=5.393, 95% CI=2.039-14.263, P=0.001), increased left atrial end-systolic diameter( OR=0.321, 95% CI=0.124-0.827, P=0.019), left ventricular ejection fraction in critical range( OR=2.953, 95% CI=1.113-7.835, P=0.030) and decreased left ventricular ejection fraction( OR=5.828, 95% CI=1.869-18.174, P=0.002) were the independent risk factors of early insufficient catheter flow. Conclusions:Insufficient catheter flow after central venous catheterization is related to catheter position, left atrial end-systolic diameter and left ventricular ejection fraction. Ultrasonography evaluation is a primary method to observe the position of the catheter tip in dialysis patients and diagnose the early insufficient catheter flow after central venous catheterization.

Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3％.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P ＞ 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.

OBJECTIVE: To construct a eukaryotic expression vector of bromodomain-containing protein 7 (BRD7) with deletion of bromodomain (BRD7△brd) using the homologous recombination and reverse PCR amplification techniques. METHODS: The linear DNA fragments of bromodomain-deleted mutation of BRD7 (pIRES2-EGFP- 3Flag/BRD7△brd) were amplified by one pair of reverse PCR primers using high-fidelity enzyme, and then these fragments were transformed into E.coli to obtain the eukaryotic expression vector expressing BRD7△brd protein based on homologous recombination and plasmid cyclization. RESULTS: Bromodomain-deleted clones were identified by digestion with restrictive enzymes, and then the sequence and protein expression were further confirmed by sequencing and Western blot assays. The results suggest that pIRES2-EGFP-3Flag/BRD7△brd was successfully constructed. CONCLUSION We establish a simple and quick method to construct plasmids with pIRES2-EGFP- 3Flag/BRD7△brd using reverse PCR amplification and homologous recombination techniques. We also found that the concentration of template in PCR reaction system is one of the critical factors that affect the rate of homologous recombination. Of all, this improved technique could be widely used in the construction of gene mutations.
Chromosomal Proteins, Non-Histone ; genetics ; Escherichia coli ; genetics ; Homologous Recombination ; Humans ; Mutation ; Plasmids ; Polymerase Chain Reaction ; methods ; Sequence Deletion ; Transfection ; methods

OBJECTIVETo investigate the mechanisms underlying the ability ofheparin-treated dendritic cells (DCs) to promote Th0 to Th1 differentiation in chronic hepatitis B (CHB).

METHODSPeripheral blood mononuclear cells (PBMCs) were isolated from CHB patients and cultured in RPMI-1640 with recombinant GM-CSF and IL-4 with or without heparin to obtain DCs for study. The levels of Toll-like receptors (TLRs) on the DCs were measured using FACS and qPCR techniques.DC subsets with high expression of TLRs were selected for analysis of functional changes by treatment with the corresponding TLR-siRNA. The CD4+ T cell subpopulation was purified from peripheral blood by Dynal immunomagnetic beads, and then the production of IL-12 by DCs in the presence of poly(I:C) or R848 and ofIFN and IL-4 by Th cells co-cultured with DCs was evaluated by ELISA. The t-test was used for statistical analysis.

RESULTSTLR3 expression, and not expression of TLR 7 or TLR8,was significantly increased in heparin-treated DCs as compared to levels detected in the DCs without heparin treatment (t =2.849,P less than 0.05;t =3.027,P less than 0.05). The level of IL-12 produced by heparin-treated DCs stimulated with poly(I:C) was obviously higher than that produced by DCs without heparin treatment and stimulated with poly(I: C) (t =8.68,P less than 0.01) or with R848 (t =19.01,P less than 0.01). However, the IL-12 production by TLR3-siRNA transfected-DCs was significantly reduced (t =31.49, P less than 0.01).When Th cells from allogenic patients with CHB were co-cultured with the TLR3-siRNA transfectedDCs, the frequency ofCD4+ IFN+ cells was significantly reduced (1.64+/-0.57% vs.6.31+/-0.88%,P less than 0.01),as was the capability of Thl to generate IFNg (t =20.83,Pless than 0.01).

CONCLUSIONHeparin may have up-regulated the TLR3 expression level of DCs, and sequentially promoted Th0 to Th1 differentiation.

CD4-Positive T-Lymphocytes ; cytology ; Cell Differentiation ; Coculture Techniques ; Dendritic Cells ; cytology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Heparin ; pharmacology ; Hepatitis B, Chronic ; immunology ; Humans ; Interferon-gamma ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-4 ; pharmacology ; Monocytes ; cytology ; Recombinant Proteins ; pharmacology ; Toll-Like Receptor 3 ; metabolism

Objective To explore the causes of secondary breast deformity after breast conservative therapy and its preventive methods.Methods 30 cases were selected from the patients with secondary breast deformity of more than 1 year after breast conservative therapy,and more than half a year after radiotherapy and chemotherapy,and no local recurrence and distant metastasis occurred.After cicatrectomy and contracture loose solution,different methods were used according to varying degrees of the secondary breast deformity to reconstruct and repair the deformity.Results Three reconstructive methods were conducted.Local mammary flaps were used in 7 patients,latissimus dorsi myocutaneous flap in 21 patients,and transverse rectus abdominal musculocutaneous flaps in 2 patients.The shape and feeling were satisfactory in 30 patients with reconstructive breasts,in which 23were excellent (76.7 ％),and 7 were good (23.3 ％).All the patients were followed-up for average 2.5 years,and they were survived without tumor recurrence.Conclusions The secondary breast deformity after breast conservative therapy could be effectively prevented,and successfully reconstructed and repaired with different procedure according to varying degrees of the secondary breast deformity.As a result,the shape and feeling of reconstructive breasts are satisfactory.